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JOINT PARTICIPATION AGREEMENT FOR CONSTRUCTION OF NEW TERMINAL BUILDING WPI NO. 7826659 .. . ~ 1 ,~ ~, I STArn OF FLOJ!.IDA DEPARTMENT OF TRANSPORTATION I . PUBLIC TRANSPORT A TION JOINT PARTICIPATION AGREEMENT FORM 725-OO(}{)(j PUBUC TRANSr ADMIN OOC - 00/96 P\oge 1 of 11 WPI No: 7826659 Fund: 010 SAMAS Approp: 088719 Function: 637 SAMAS Obj.: 790007 Job No: 15007-3877 Federal No: Org. Code: 55072020728 Contract No: AE-ffi8 Vendor No.: F596000289oo2 THIS AGREEMENT, made and entered into this /~ ~ day of m 7 ' 19 97 by and between the STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION, an agency of the State of Florida, hereinafter referred to as the Department, and City of Clearwater, P.O. Box 4748. Clearwater, FL 34618-4748 hereinafter referred to as the Agency. WIT N E SSE T H: WHEREAS, the Agency has the authority to enter into said Agreement and to undertake the project hereinafter described, and the Department has been granted the authority to function adequately in all areas of appropriate jurisdiction including the implementation of an integrated and balanced transportation system and is authorized under 332.006 (6) ,Florida Statutes, to enter into this Agreement; NOW, TdEREFORE, in consideration of the mutual covenants, promises and representations herein, the parties agree as follows: 1.00 Purpose of Agreement: The purpose of this Agreement is to provide funding for the construction of a new terminal building. and as further described in Exhibit(s) ArB.C. and F attached hereto and by this reference made a part hereof, hereinafter referred to as the project, and to provide Departmental financial assistance to the Agency and state the terms and conditions upon which such assistance will be provided and the understandings as to the manner in which the project will be undertaken and completed. ct ~/ /f~f1 / (2) . !-....-! I I FORM 725-<l:J(}{)6 PUBUC TRANSP ADMIN OOC - 09/96 r-.ge 2 or II 2.00 Accomplishment of the Project: 2.10 General Requirements: The Agency shall commence, and complete the project as described in Exhibit "A" attached hereto and by this reference made a part hereof, with all practical dispatch, in a sound, economical, and efficient manner, and in accordance with the provisions herein, and all applicable laws. 2.20 Pursuant to Federal, State, and Loca1 Law: In the event that any election, referendum, approval, permit, notice, or other proceeding or authorization is requisite under applicable law to enable the Agency to enter into this Agreement or to undertake the project hereunder, or to observe, assume or carry out any of the provisions of the Agreement, the Agency will initiate and consummate, as provided by law, all actions necessary with respect to any such matters so requisite. 2.30 Funds of the Agency: 1be Agency shall initiate and prosecute to completion all proceedings necessary including federal aid requirements to enable the Agency to provide the necessary funds for completion of the project. 2.40 Submission of Proceedings, Contracts and Other Documents: The Agency shall submit to the Department such data, reports, records, contracts and other documents relating to the project as the Department may require as listed in Exhibit "e" attached hereto and by this reference made a part hereof. 3.00 Project Cost: The total estimated cost of the project is $ 200,000 This amount is based upon the estimate summarized in Exhibit "B" attached hereto and by this reference made a part hereof. The Agency agrees to bear all expenses in excess of the total estimated cost of the project and any deficits involved. 4.00 Department Participation: The Department agrees to maximum participation, including contingencies, in the project in the amount of $ 100 000 as detailed in Exhibit "B" , or in an amount equal to the percentage(s) of total project cost shown in Exhibit "B" , whichever is less. 4.10 Project Cost Eligibility: Project costs eligible for State participation will be allowed only from the effective date of this Agreement. It is understood that State participation in eligible project costs is subject to: (a) Legislative approval of the Department's appropriation request in the work program year that the project is scheduled to be committed; (b ) Availability of funds as stated in paragraph 17.00 of this Agreement; (c) Approval of all plans, specifications, contracts or other obligating documents and all other terms of this Agreement; (d) Department approval of the project scope and budget (Exhibits A & B) at the time appropriation authority becomes available. 4.20 Front End Funding: Front end funding (XX) (is not) applicable. If applicable, the Department may initially pay 100% of the total allowable incurred project costs up to an amount equaI to its total share of participation as shown in paragraph 4.00. 5.00 Retainage: Retainage (XX) (is not) applicable. If applicable, N/A percent of the Department's total share of participation as shown in paragraph 4.00 is to be held in retainage to be disbursed, at the Department's discretion, on or before the completion of the final project audit. '-",r J I FORM 72S-OOO-06 PUBUC TRANSP ADMIN OOC - 09/96 Page 3 of 11 6.00 Project Budget and Payment Provisions: 6.10 The Project Budget: A project budget shall be prepared by the Agency and approved by the Department. The Agency shall maintain said budget, carry out the project and shall incur obligations against and make disbursements of project funds only in conformity with the latest approved budget for the project. No budget increase or decrease shall be effective unless it complies with fund participation requirements established in paragraph 4.00 of this Agreement and is approved by the Department Comptroller. 6.20 Payment Provisions: Unless otherwise allowed under paragraph 4.20, payment will begin in the year the project or project phase is scheduled in the work program as of the date of the agreement. Payment will be made for actual costs incurred as of the date the invoice is submitted with the final payment due upon receipt of a final invoice. 7.00 Accounting Records: 7.10 Establishment and Maintenance of Accounting Records: The Agency shall establisA for the project, in conformity with requirements established by Department's program guidelines/procedures and "Principles for State and Local Governments", separate accounts to be maintained within its existing accounting system or establish independent accounts. Such accounts are referred to herein collectively as the "project account". Documentation of the project account shall be made available to the Department upon request any time during the period of the Agreement and for five years after final payment is made. 7.20 Funds Received Or Made Available for The Project: The Agency shall appropriately record in the project account, and deposit in a bank or trust company which is a member of the Federal Deposit Insurance CQrporation, all payments received by it from the Department pursuant to this Agreement and all other funds provided for, accruing to, or otherwise received on account of the project, wltjch Department paymepts and other funds are herein collectively referred to as "project funds". The Agency shall require depositories of project fundstO' secure cOntinuously and fully all project funds in excess of the amounts insured under federal plans, or under State plans which have been approved for the deposit of project funds by the Department, by the deposit or setting aside of collateral of the types and in the manner as prescribed by State Law for the security of public funds, or as approved by the Department. 7.30 Costs Incurred for the Project: The Agency shall charge to the project account all eligible costs of the project. Costs in excess of the latest approved budget or attributable to actions which have not received the required approval of the Department shall not be considered eligible costs. 7.40 Documentation of Project Costs: All costs charged to the project, including any approved services contributed by the Agency or others, shall be supported by properly executed payrolls, time records, invoices, contracts, or vouchers evidencing in proper detail the nature and propriety of the charges. 7.50 Checks, Orders, and Vouchers: Any check or order drawn by the Agency with respect to any item which is or will be chargeable against the project account will be drawn only in accordance with a properly signed voucher then on file in the office of the Agency stating in proper detail the purpose for which such check or order is drawn. All checks, payrolls, invoices, contracts, vouchers, orders, or other accounting documents pertaining in whole or in part to the project shall be clearly identified, readily accessible, and, to the extent feasible, kept separate and apart from all other such documents. .~ , I I FORM n5-OOO-06 PUBUC TRANSP ADMIN OOC - 00/% Page 4 of 11 7.60 Audit Reports: The Agency shall provide to the Department audit reports reflecting the use of the funds of the Department, the Agency, and those from any other source with respect to the project as required by Procedure 450-021-001. Audits shall be performed in accordance with generally accepted government auditing standards contained in the "Standards for Audit of Govenunental Organizations, Programs, Activities and Functions" , issued by the U. S. General Accounting Office and OMB Circulars A-I28 or A-133 where applicable. The Agency shall require its auditors to include in their report a schedule of project assistance as described in Exhibit" A", Special Considerations. 7.70 Insurance: Execution of this Joint Participation Agreement constitutes a certification that the Agency has and will maintain the ability to repair or replace any project equipment or facilities in the event of loss or damage due to any accident or casualty for the useful life of such equipment or facilities. In the event of the loss of such equipment or facilities, the Agency shall either replace the equipment or facilities or reimburse the Department to the extent of its interest in the lost equipment or facility. In the event this Agreement is for purchase of land or for the construction of infrastructure such as airport runways the Department may waive or modify this section with an Exhibit "C". 8.00 Requisitions and Payments: 8.10 Action by the Agency: In order to obtain any Department funds, the Agency shall file with the Department of Transportation, District Seven Public Transportation Office 11201 N McKinley Drive, Tampa. Florida, 3.3ill its requisition on a form or forms prescribed by the Department, and other data pertaining to the project account (as defined in paragraph 7.10 hereot) to justify and support the payment requisitions. 8.11 Invoices for fees or other compensation for services or expenses shall be submitted in detail sufficient for a proper preaudit and postaudit thereof. 8.12 Invoices for any travel expenses shall be submitted in accordance with Chapter 112.061, F.S. The Department may establish rates lower than the maximum provided in Chapter 112.061, Florida Statutes. 8.13 For real property acquired, submit; (1) the date the Agency acquired the real property, (2) a statement by the Agency certifying that the Agency has acquired said real property, and actual consideration paid for real property. (3) a statement by the Agency certifying that the appraisal and acquisition of the real property together with any atterxlant relocation of occupants was accomplished in compliance with all federal laws, rules and procedures required by any federal oversight agency and with all state laws, rules and procedures that may apply to the Agency acquiring the real property. 8.20 The Department's Obligations: Subject to other provisions hereof, the Department will honor such requisitions in amounts and at times deemed by the Department to be proper to ensure the carrying out of the project and payment of the eligible costs. However, notwithstanding any other provision of this Agreement, the Department may elect by notice in writing not to make a payment on the project if: 8.21 Misrepresentation: The Agency shall have made misrepresentation of a material nature in its application, or any supplement thereto or amendment thereof, or in or with respect to any document or data furnished therewith or pursuant hereto; 8.22 Litigation: There is then pending litigation with respect to the performance by the Agency of any of its duties or obligations which may jeopardize or adversely affect the project, the Agreement, or payments to the project; 8.23 Approval by Department: The Agency shall have taken any action pertaining to the project which, under this agreement, requires the approval of the Department or has made related expenditures or incurred related obligations "',. I I FORM 725-030-06 PUBUC TRANSP ADMIN OOC - 09/96 Page 5 of 11 without having been advised by the Department that same are approved; 8.24 Conflict of Interests: There has been any violation of the conflict of interest provisions contained herein; or 8.25 Default: The Agency has been determined by the Department to be in default under any of the provisions of the Agreement. 8.26 Federal Participation (If Applicable): Any federal agency providing federal financial assistance to the project suspends or terminates federal financial assistance to the project. In the event of suspension or termination of federal financial assistance, the Agency will reimburse the Department for all disallowed costs. 8.30 Disallowed Costs: In determining the amount of the payment, the Department will exclude all projects costs incurred by the Agency prior to the effective date of this Agreement, costs which are not provided for in the latest approved budget for the project, and costs attributable to goods or services received under a contract or other arrangements which have not been approved in writing by the Department. 8.40 Payment Offset: If, after project completion, any claim is made by the Department resulting from an audit or for work or services performed pursuant to this agreement, the Department may offset such amount from payments due for work or services done under any public transportation joint participation agreement which it has with the Agency owing such amount if, upon demand, payment of the amount is not made within sixty (60) days to the Department. Offsetting amounts shall not be considered a breach of contract by the Department. 9.00 Termination or Suspension of Project: 9.10 Termination or Suspension Generally: If the Agency abandons or, before completion,' finally discontinues the project; or if, by reason of any of the events or conditions set forth in paragraphs 8.21 to 8.26 inclusive, or for any other reason, the commencement, prosecution, or timely completionoftbe project by the Agency is rendered improbable, infeasible, impossible, or illegal, the Department will, by written notice to the Agency, suspend any or all of its obligations under this . Agreement until such time as the event or condition resulting in such suspension has ceased or been corrected, or the Department may terminate any or all of its obligations under this Agreement. 9.11 Action Subsequent to Notice of Termination or Suspension. Upon receipt of any final termination or suspension notice under this paragraph, the Agency shall proceed promptly to carry out the actions required therein which may include any or all of the following: (1) necessary action to terminate or suspend, as the case may be, project activities and contracts and such other action as may be required or desirable to keep to the minimum the costs upon the basis of which the financing is to be computed; (2) furnish a statement of the project activities and contracts, and other undertakings the cost of which are otherwise includable as project costs; and (3) remit to the Department such portion of the financing and any advance payment previously received as is determined by the Department to be due under the provisions of the Agreement. The termination or suspension shall be carried out in conformity with the latest schedule, plan, and budget as approved by the Department or upon the basis of terms and conditions imposed by the Department upon the failure of the Agency to furnish the schedule, plan, and budget within a reasonable time. The approval of a remittance by the Agency or the closing out of federal financial participation in the project shall not constitute a waiver of any claim which the Department may otherwise have arising out of this Agreement. 9.12 The Department reserves the right to unilaterally cancel this Agreement for refusal by the contractor or Agency to allow public access to all documents, papers, letters, or other material subject to the provisions of Chapter 119, Florida Statutes and made or received in conjunction with this Agreement. 10.00 Remission of Project Account Upon Completion of Project: Upon completion of the project, and after payment, provision for payment, or reimbursement of all project costs payable from the project account is made, the Agency shall remit to the Department its share of any unexpended balance in the project account. ,'. I I FORM 72S-OJ(HJ(j PUBUC TRANSP ADMIN OOC - 00/% "'.ge 8 0( 11 14.30 When Rights and Remedies Not Waived: In no event shall the making by the Department of any payment to the Agency constitute or be construed as a waiver by the Department of any breach of covenant or any default which may then exist, on the part of the Agency, and the making of such payment by the Department while any such breach or default shaIl exist shall in no way impair or prejudice any right or remedy available to the Department with respect to such breach or default. 14.40 How Agreement Is Affected by Provisions Being Held Invalid: If any provision of this Agreement is held invalid, the remainder of this Agreement shall not be affected. In such an instance the remainder would then continue to conform to the terms and requirements of applicable law. 14.50 Bonus or Commission: By execution of the Agreement the Agency represents that it has not paid and, also, agrees not to pay, any bonus or commission for the purpose of obtaining an approval of its application for the financing hereunder. 14.60 State or Territorial Law: Nothing in the Agreement shall require the Agency to observe or enforce compliance with any provision thereof, perform any other act or do any other thing in contravention of any applicable State law: Provided, that if any of the provisions of the Agreement violate any applicable State law, the Agency will at once notify the Department in writing in order that appropriate changes and modifications may be made by the Department and the Agency to the end that the Agency may proceed as soon as possible with the project. 14.70 Use and Maintenance of Project Facilities and Equipment: The Agency agrees that the project facilities and equipment will be used by the Agency to provide or support public transportation for the period of the useful life of such facilities and equipment as detennined in accordance with general accounting principles and approved by the Department. The Ageocy further agrees to maintain the project facilities and equipment in good working order for the useful life of said facilities or equipment. 14.71 Property Records: The Agency agrees to maintain property records, conduct physical inventories and develop control systems as required by 49 CFR Part 18, when applicable. 14.80 Disposal of Project Facilities or Equipment: If the Agency disposes of any project facility or equipment during its useful life for any purpose except its replacement with like facility or equipment for public transportation use, the Agency will comply with the terms of 49 CFR Part 18 relating to property management standards. The Agency agrees to remit to the Department a proportional amount of the proceeds from the disposal of the facility or equipment. Said proportional amount shall be detenninedon the basis of the ratio of the Department financing of the facility or equipment as provided in this Agreement. 14.90 Cootractuallndemnity: To the extent provided by law, the Agency shall indemnify, defend, and hold harmless the Department and all of its officers, agents, and employees from any claim, loss, damage, cost, charge, or expense arising out of any act, error, omission, or negligent act by the Agency, its agents, or employees. during the performance of the Agreement, except that neither the Agency, its agents, or its employees will be liable under this paragraph for any claim, loss, damage, cost, charge, or expense arising out of any act, error, omission, or negligent act by the Department or any of its officers, agents, or employees during the performance of the Agreement. When the Department receives a notice of claim for damages that may have been caused by the Agency in the performance of services required under this Agreement, the Department will immediately forward the claim to the Agency. The Agency and the Department will evaluate the claim and report their findings to each other within fourteen (14) working days and will jointly discuss options in defending the claim. After reviewing the claim, the Department will determine whether to require the participation of the Agency in the defense of the claim or to require that the Agency defend the Department in such claim as described in this section. The Department's failure to promptly notify the Agency of a claim shall not act as a waiver of any right herein to require the participation in or defense of the claim by the Agency. The Department and the Agency will each pay its own expenses for the evaluation, settlement negotiations, and trial, if any. However, if only one party participates in the defense of the claim at trial, that party is responsible for all expenses at trial. .. '", I , WPI NO. 7826659 JOB NO. 15007-3877 CONTRACT NO. AE-078 EXHIBIT" A" PROJECT DESCRIYfION AND RESPONSIBILITIES This exhibit forms an integral part of that certain Joint Participation Agreement between the State of Florida, Department of Transportation and City of Clearwater, P.O. Box 4748, Clearwater, FL 34618-4748. dated ma.y/~ /997 PROJECT LOCATION: Clearwater Executive Airpark Clearwater, Florida PROJECT DESCRIPTION: Construction of a new terminal building. SPECIAL CONSIDERATIONS BY AGENCY: The audit report(s) required in paragraph 7.60 of the Agreement shall include a schedule of project assistance that will reflect the Department's contract number, WPI number and Job number and the Federal Identification number, where applicable, and the amount of state funding action (receipt and disbursement of funds) and any federal or local funding action and the funding action from any other source with respect to the project. SPECIAL CONSIDERATIONS BY DEPARTMENT: Sql4cmber 1996 _111111 '''',. I I WPI NO. JOB NO. CONTRACT NO. 7826658 15007-3876 AE- 263 EXHmIT liB" PROJECT BUDGET This exhibit fonns an integral part of that certain Joint Participation Agreement between the State of Florida, Department of Transportation and City of Clearwater, P.O. Box 4748, Clearwater, FL 34618-4748 dated /?'1A.j' / If. / 9 9 ? .I I. PROJECT COST: $ 200,000 TOTAL PROJECT COST: $ 200,000 II. PARTICIPATION: Maximum Federal Participation FTA, FAA ( 0 %) or $ 0 Agency Participation In-Kind ( %) $ Cash ( 50 %) $ 100,000 Other ( %) $ Maximum Department Participation, Primary (DS) (DDR)(DIM) (pORT) ( 50 %) or $ 100,000 Federal Reimbursable (DU)(FRA)(DFT A)( %) or $ Local Reimbursable (DL) ( ) %) or $ TOTAL PROJECT COST $ 200,000 Sqlkmber 1996 .. . I I WPI NO. 7826659 JOB NO. 15007-3877 CONTRACT NO. AE-078 (Exhibit updated 9/95) EXHIBIT "e" - A VIA TION (GENERAL) This exhibit forms an integral part ofthat Joint Participation Agreement between the State of Florida, Department of Transportation and the City of Clearwater P.O. Box 4748. Clearwater Fl 34618-4748 dated /YJa-y /(;) 1'1~ 7 Only items indicated with an "X" are applicable. SUBMITT AL/CERTIFICA nON BASIS OF ACCEPTANCE _x_ Consultant Selection Compliance Public Agency Attorney's Certification ___Feasibility Study (if necessary) Public Agency _X_PE/EIS (if necessary) Public Agency _x _Design Submittal 90% 100% Department review letter and written approval Department review letter and written approval X Construction/Procurement -- Public Agency Certification _X_MBE Compliance Public Agency Certification _X_Safety Compliance Public Agency Certification EAlMaster Plan Submittals (Each Section) Preliminary Final Department Review and Written Acceptance X Audit Reports Annually by Agency's Auditor _X_Certification of Completion Agency Letter 1 ". I J Appraisals Applicable State Laws Acquisition of Real Property Agency Attorney Certification and Compliance to Florida Statute Chapter 332 Requests for Reimbursement (Invoice Submittals) in accordance with Section 215.422 Florida Statutes and the requirement of Paragraph 22.00 of this Agreement. 1. REQUIRED SUBMITTAL TIME The Agency must submit an invoice to the Department within ninety (90) days from the ending date of the eligible billing period covered by the invoice. Should the Agency not submit a correctly prepared and documented invoice within the proper time frame, the Department may deny payment of the Department's share of the invoice. 2. REQUIRED SUBMITTAL FORM The Agency shall submit invoices on forms provided by the Department and prepared in accordance with instructions given by the Department. Back-up documentation will include the appropriate items necessary to verify costs incurred and the eligibility of said costs. Invoice Documentation: (Also see Paragraphs 7.40, 21.00 and 22.00). Invoices to the Department must he arranged in the following manner: 1) Department's Invoice Summary Sheet. 2) Spread sheet listing JP A budget items along the top margin, and individual purchases along the left margin, with the amounts in the proper columns. 3) For each purchase, a copy of the purchase order, vendor invoice, and proof of payment. These items must be fastened together in "packages" and arranged in the same order as the purchases listed on the spread sheet. 4) Summary sheet showing current approved budget, amounts previously invoiced, amounts being invoiced, and remaining balances. Line items cannot be exceeded without first obtaining a budget revision from the Department. 5) Invoices must be submitted within 60 days of quarter end during which the expenses were incurred. Exceptions must be documented formally with justifications from the Agency Head to the Department Project Manager. 3. APPROVAL OF SUBMITTAL Goods or services received under this agreement shall be approved/disapproved by the Department no later than five (5) working days after receipt, by the District Public Transportation Office, of a properly prepared and submitted invoice. Should the invoice be incomplete or incorrect, the Department shall inform the Agency within five (5) working days of receipt and return the invoice for corrections. 2 ", .f, I I WPI NO. JOB NO. CONTRACT NO. 7826659 15007-3877 AE-078 EXHmIT "F" SPECIAL AIRPORT ASSURANCES This exhibit forms an integral part of that certain Joint Participation Agreement between the State of Florida, Department of Transportation and City of Clearwater, P.O. Box 4748, Clearwater, FL 34618-4748 dated /J1 ar /~. / '911 7 1. GENERAL a. These assurances shall be complied with in the performance of master planning, land acquisition, economic development or capital improvement projects which contain NO federal funds. b. Upon acceptance of this Joint Participation Agreement by the sponsor, these assurances are incorporated in and become a part thereof. II. DURATION The terms, conditions and assurances of the grant agreement shall remain in full force and effect throughout the usefullife of the facilities developed or equipment acquired for any airport development project, but in any event not to exceed twenty (20) years from the date of acceptance of a grant agreement utilizing state funds for the project. However, there shall be no limit on the duration of the assurances with respect to real property acquired with project funds. III. SPONSOR CERTIFICA nON The sponsor hereby assures and certifies, with respect to this grant: a. It has sufficient funds available for that portion of the project costs not paid for by the State. It has sufficient funds available to assure operation and maintenance of items it will own or control funded under the grant agreement. SqICaDb<< 1996 '. ~ .~ I I b. It holds good title, satisfactory to the Department, to the landing area of the airport or site thereof, or will give assurance satisfactory to the Department, that good title will be acquired. c. If an arrangement is made for management and operation of the airport by any agency or person other than the sponsor or an employee of the sponsor, the sponsor will reserve sufficient rights and authority to ensure that the airport will be operated and maintained in accordance with the Federal Airport and Airway Improvement Act of 1982, or successive legislation; the regulations and the terms, conditions and assurances in the grant agreement; and shall ensure that such arrangement also requires compliance therewith. d. It will adequately clear and protect the aerial approaches to the airport by removing, lowering, relocating, marking, or lighting, or otherwise mitigating existing airport hazards and by preventing the establishment or creation of future airport hazards. . e. It will make its airport available as an airport for public use on fair and reasonable terms. f. It will permit no exclusive rights for the use of the airport by any persons providing, or intending to provide aeronautical services to the public. g. All revenues generated by the airport will be expended by it for the capitai or operating costs of the airport, the local airport system, or other local facilities owned or operated by the owner or operator of the airport and directly related to the actual aerial transportation of passengers or property. h. Once accomplished, it will keep up-to-date a minimum of an Airport Layout Plan of the airport showing (1) boundaries of the airport and all proposed additions thereto, together with the boundaries of all offsite areas owned or controlled by the sponsor for airport purposes and proposed additions thereto; (2) the location and nature of all existing and proposed airport facilities and structures (such as runways, taxiways, aprons, terminal buildings, hangars and roads), including all proposed extensions and reductions of existing airport facilities; and (3) the location of all existing improvements thereon. SepI.cmber 1996 '. ,. Ci cr ------------------------------------------------------------------ -----~------------------------~----------------------------------- ENCUMBRANCE INPUT FORM -------------------------------------------------------------~---- ------------------------------------------------------------------ RUSH X (Needed by _9-30-96__ (date)) Reason for RUSH : PRODUCTION Advertise (Letting Date) ___ Award ___ Renewal ____Letter of Authorization _X_ New Court Order Overrun ____Supplemental ___ Correction ___ Addition ___ Termination Agmt. Contract # ___AE078_ Contract Type Vendor Name city of Clearwater____ Has Written/Verbal Approval from a been received Yes _X_ No Fed Agmt Amt state Funds Local Funds Beginning date of this Agmt: 10/05/96(Must be after fund approval) Ending date of this Agmt: 10/05/99(Estimate if necessary) Execution date of this Agmt: 10/05/96(On1y on original agreements) Has work been authorized to begin? ___ Yes _x_ No Have standard financial provisions been altered by contract terms? ___Yes _x_ No If so, show Revision date: Does this agreement and/or change order include provisions for reimbursement to D.O.T. from other entities? Yes _x_ No **************************************************************** Brief description of work:Construction of a new terminal building. AG__Method of Procurement _G__ Vendor ID F596000289002 Participating Federal Agency ***************************************************************** ORG-CODE *EO * OBJECT * AMOUNT * COjSECjJOB#/PH *FCT (PROGRAM#) (WPI # ) (FUNb) numeric ( FY's ) To be completed if funded in 2 or more fiscal years. ----------------------------------------------------------------- --------------------------------------------------~-------------- 55 072020728 *11 * 790007 * $ 100,000___ *15007-3877/50 * 637 (2091 ) (7826659 ) (010-DS) ( 96/97) 55 * * * * * ( ) ( ) ( ) ( ) ------------------------------------------------------------------ 55 * * * * * ( ( ) ( ) ( TOTAL AMOUNT * $ 100,000_ * originator:_LAURA HOLSTROM Date: 9-26-96____Phone_SC571-6415_ E-mail user ID__PL733LH FOR JOHN ROELLER ****************************************************************** TO BE COMPLETED BY OFFICE OF COMPTROLLER ****************************************************************** BUDGET ENTITY 5590 CATEGORY 088719-97 WORK ORDER BALANCE __AUTH. ON 9/26=100,000.00 ALLOTMENT _AB=3,880,140.00___ YEAR _97_ DATE CHECKED _9/26/96___ FUNDS APPROVED BY _PHILLIP PRYOR FOR THOMAS F. BOYD, CPA, COMPTROLLER DATE: ___9/26/96 ******************************************************************