Loading...
HomeMy WebLinkAboutIowa Department of Transportation-7/11/2011IOWA DEPARTMENT OF TRANSPORTATION AGREEMENT FOR PAVEMENT MAINTENANCE PROGRAM PROJECT NUMBER: 911 1 OALO 110 CONTRACT NUMBER: 13115 This is an agreement between the City of Waterloo (hereinafter referred to as SPONSOR) and the Iowa Department of Transportation (hereinafter referred to as the Iowa DOT) for the purpose of funding Pavement Maintenance at the Waterloo Regional Airport. Pursuant to the terms of this agreement, applicable statutes, administrative rules, and program guidelines, the Iowa DOT agrees to provide authorized funding to the SPONSOR for the following project: Routine pavement maintenance In consideration of the foregoing and the mutual promises contained in this agreement, the parties agree as follows: 1. The SPONSOR shall be the lead local agency for carrying out the provisions of this agreement, will follow all applicable statutes and administrative rules, and is responsible to complete the project as specified. 2. The Iowa DOT agrees to reimburse the Sponsor 70% of eligible project costs, not to exceed the maximum amount of $10,000 incurred according to the terms of this agreement. Reimbursements will be made in whole dollar amounts only, rounded down. 3. The Iowa DOT shall determine what costs are eligible for reimbursement. Only costs incurred after authorization from the Iowa DOT are eligible. All other costs, including costs above the maximum amount in this agreement, are the responsibility of the Sponsor. 4. The SPONSOR shall complete and submit the Claim for Reimbursement form to the Iowa DOT, along with copies of the invoices and proof of payment, within six months after this agreement has been signed by the SPONSOR and the Iowa DOT. 5. All notices required under this agreement shall be made in writing to the Iowa DOT and the SPONSOR's contact person. The Iowa DOT's contact shall be the Office of Aviation (515/239-1468). The SPONSOR's contact person shall be Bradley Hagen. 6. This agreement is not assignable without the prior written consent of the Iowa DOT. 7. It is the intent of both parties that no third party beneficiaries be created by this agreement. 8. This agreement shall be executed and delivered in two or more copies, each of which so executed and delivered shall be deemed to be an original and shall constitute but one and the same instrument. 9. The SPONSOR shall comply with all provisions of the equal employment opportunity requirements prohibiting discrimination and requiring affirmative action to assure equal employment opportunity as required by the Iowa Code Chapter 216. No person shall, on the Page 1 of 2 Pavement Maintenance Program Contract Number: 13115 Project Number: 91110ALO1 10 grounds of age, race, creed, sex, color, national origin, religion, or disability, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the SPONSOR receives state funds from the Iowa DOT. 10. The Iowa DOT's obligation hereunder shall cease immediately, without penalty of further payment being required, in any year for which the General Assembly of the State of Iowa fails to make an appropriation or reappropriation to pay such obligations, and the Iowa DOT's obligations hereunder shall cease immediately without penalty of further payment being required at any time where there are not sufficient authorized funds lawfully available to the Iowa DOT to meet such obligations. The Iowa DOT shall give the SPONSOR notice of any termination of funding as soon as practicable after the Iowa DOT becomes aware of the failure of funding for this program. In the event the Iowa DOT provides such notice, the SPONSOR may terminate this agreement or any part thereof. 11 This agreement constitutes the entire agreement between the Iowa DOT and the SPONSOR concerning this project. Representations made before the signing of this agreement are not binding, and neither party has relied upon conflicting representations in entering into this agreement. Any change or alteration to the terms of this agreement must be made in the form of an addendum to this agreement. Said addendum shall become effective only upon written approval of the Iowa DOT and the SPONSOR. IN WITNESS WHEREOF, each of the parties hereto has executed this Agreement as of the date shown opposite its signature below. SPONSOR: ATTEST: (for SPONSOR) Signed By, -`c,--0 Title Title C £ILr1L_ Date .3A1 ,901i Date vA(1 I 9'6 t IOWA DEPARTMENT OF TRANSPORTATION By ///l /7 (. 7 `� Michelle F. McEnan Director, Office of Aviation Page 2 of 2 Date C( /77/ Oiowa Department of Transportation Form 291108wd (07-07) CLAIM FOR REIMBURSEMENT OF AIRPORT PROJECT COSTS 1. Request No.: 2. Contract No.: 0 Progress 0 Final Request 3. Date: 4. Project No.: 5. Airport Name: 6. Airport Sponsor: 7. Type of Project: (City - County - Authority) 8. Total Iowa DOT agreement amount 9. Payments to contractors / vendors submitted with this request: 10. Payments to engineers / consultants submitted with this request 11. Total eligible cost submitted on this request (add lines 9 and 10): 12. DOT agreement percent participation of eligible cost 13. Eligible for reimbursement (multiply Line 11 by Line 12): 14. Prior amount reimbursed for this project: 15. Amount of project agreement remaining (Line 8 — Line 14): 16. Amount Due this Request: (Smaller of Line 13 or Line 15) $ $ $ $0 x $0 $ $0 $ I hereby certify that all eligible project activities for which reimbursement is requested have been completed in substantial compliance with the project plans, specifications, the project agreement, the laws of the State of Iowa, and city/county ordinances. Signature: (Project Engineer or Project Manager) (Date) I certify that the items claimed for payment are proper and true and that no part of this claim has been paid by DOT. Signature: (Airport Sponsor) Return form with copies of vouchers and proof of payment to: Iowa Department of Transportation Office of Aviation 800 Lincoln Way Ames, 1A 50010 (Title) (Date) Attn.: Program Manager E-mail: kay.thede@dot.iowa.gov FAX: 515-233-7983 515-239-1048 Instructions for Use of Form 291108 "Claim for Reimbursement of Project Costs" Line 1. The first claim is invoice No. 1, the next No. 2, and so on. Line 2. Contract Number shown on the agreement signed with the Iowa DOT. Line 3. Date the claim is prepared. Line 4. The number printed on the agreement with the DOT, such as 91 -XX -)000( -XXX Line 5. Airport Name Line 6. Airport Sponsor — City of , or County, or Airport Authority Line 7. List the type of project. Examples: Engineering services, planning, runway rehabilitation, hangar rehabilitation, etc. Line 8. Total maximum amount found in the Iowa DOT Agreement Line 9. Amount paid to contractors or vendors submitted with this request. Attach a ledger or spreadsheet that lists all the bid items and the number of units each completed. Exclude any cost that is not eligible under agreement. Line 10. Amount paid to engineers or consultants that are submitted with this request. Line 11. Add line 9 and 10 to equal the total amount of costs submitted for this request. Line 12 The percentage shown in the agreement that the DOT will reimburse for eligible item costs. Enter a decimal amount only, i.e., enter 75% as .75. Line 13. Multiply amount shown on line 11 by the percentage from line 12. Line 14. Prior amount reimbursed for this project. Add all prior reimbursement amounts received by the sponsor prior to this claim. Line 15. Subtract the reimbursed amount (line 14) from the total agreement amount (Line 8). Line 16. Enter the smaller of Line 13 or Line 15. Note: The certification of the claim must be signed by the Project Engineer or Project Manager. Note: The person who signs on this line must be authorized to do so by the city, county or other agency, either in the agreement or by policy.