WFLHD, Utility Notification Package Forms

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Utility Agreement Package Forms

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Mr. James Brophy
US Guest, Inc.
9th Floor
2002 Main St.
Boise, ID 83702

Dear Mr. Brophy:

IDAHO PFH 116-1(1)
BURKE ROAD

Enclosed are 2 originals of Project Utility Agreement No. XX-X-XX-XXXX. Also enclosed is one copy of Exhibit A (Estimate of Costs) and Exhibit B (Relocation Plans) for your records.

This agreement provides for reimbursing US Guest, Inc. of Boise, Idaho, for their expenditures in relocating the power poles/lines as described in Exhibit B.

Please review the agreement and return one signed copy to Federal Highway Administration, 610 East Fifth Street, Vancouver, Washington, 98661-3893, attention James Brophy.

The enactment of the Debt Collection Improvement Act of 1996 requires all federal payments to be made electronically. Payments will be made via direct deposit by electronic funds transfer for this agreement and all subsequent agreements. Please complete the enclosed APayment Information Form@ and return it to Federal Highway Administration, Western Federal Lands Highway Division (WFLHD) so payment can be processed accordingly. If you have any questions regarding billing information, please call Anne Henderson at (360) 696-7757.

Sincerely yours,

John Durazo
Right-of-Way & Utilities

Enclosures:

cc: Kathy McCormmach, Program Planning, WFLHD
Victoria Peters, A/E/ Team Leader, WFLHD
Ted Woods, Project Manager, WFLHD
James W. Brophy, Right-of-Way & Utilities Coordinator, WFLHD
Anne Henderson, Financial Technician, WFLHD
Project Design Book
Engineer Hold File
ROW Correspondence File

**************************************************************
NOTE: As of April, 1998 a form must be included to incorporate the electronic transfer method of payment.
kjw-9/14/98
June 10, 2002
(DELETE ALL NOT USED + HI-LIGHTED INSTRUCTIONS, AND LINES)
0122F (need new file code!!!!!)
Utility Project Agreement
Do Not Delete This Form--Bring on and give a new # but don't change this form.
**************************************************************

PROJECT UTILITY AGREEMENT
Project Name
Project No.
Agreement No.
Account No.

Adjustment and/or Relocation of Facilities

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
THIS AGREEMENT, by and between the U.S. Department of Transportation, Federal Highway Administration, hereinafter called the Government, and (COMPANY NAME & LOCATION TO BE INSERTED) ____________________ of ____________________ , hereinafter called the "Company," is authorized by Title 23 CFR 645.

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
The Government has planned the construction or improvement of a portion of (HIGHWAY NAME, ROUTE, & PROJECT TO BE INSERTED ____________________ located ____________________.

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
Due to the construction or improvement of this project, it is necessary to adjust and/or relocate certain (INSERT DESCRIPTION) ____________________ facilities belonging to the Company and shown by appropriate symbols on the attached plans marked Exhibit B, and by reference made a part of this agreement.

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
It is deemed to be in the best public interest that the required adjustment and/or relocation of said utility facilities shall be accomplished by the Company as owner of these facilities; and shall be performed under the terms of this agreement and in accordance with and governed by the provisions of the Government's Code of Federal Regulations 23 CFR 645.

Performance of Work

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
Therefore, in consideration of the foregoing, it is mutually agreed that:

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
The Company shall perform or cause to be performed the work herein described, furnishing all materials and supplies necessary and incidental to the adjustment and/or relocation of its facilities in accordance with the plans, specifications, and estimates attached hereto.

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
Preliminary Engineering activities are to be performed by: [(SELECT ONE OF THESE 3)
1. Company Forces
2. Government Forces
3. An Engineering Consultant mutually acceptable to the Company and the Government, the contract to be administered by the (INSERT COMPANY OR GOVERNMENT) ____________________ .

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
Construction work is to be performed by: (SELECT ONE)
1. Company Forces.
2. Contract awarded by the (INSERT COMPANY OR GOVERNMENT)____________________ to the lowest qualified bidder based on appropriate solicitation.
3. Inclusion as part of the Government's Highway Construction Contract.
4. Contract under the provisions of an existing written continuing contract with (INSERT NAME OF CONTRACTOR) ____________________ .
5. Contract awarded by (INSERT COMPANY OR GOVERNMENT) ____________________ .
6. (COMBINATION OF ABOVE) ____________________ .

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
Material incorporated into the work is to be furnished by (INSERT COMPANY OR CONTRACTOR) ____________________ .

(USE THIS PARAGRAPH IN ALL AGREEMENTS WITH UNDERGROUND TRENCHING)
Trenching and Backfill of underground electric power and communication lines shall be constructed in accordance with the (INSERT STATE DEPARTMENT OF TRANSPORTATION i.e. IDOT, WSDOT, ODOT, ADOT, MDOT) ____________________ Guidelines and Specifications.

Development of Costs

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
The method of developing relocation costs by the Company shall be as outlined in Title 23 CFR 645.117, (USE 1, 2, OR 3)
1. in accordance with established and regularly used Company accounting procedures.
2. for lump sum agreement which payment shall constitute the total payment for all costs of whatever nature and shall be the sole and only obligation of the Government under this agreement.
3. (OTHER APPROVED METHOD FOR DEVELOPING & RECORDING COSTS) .

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
The estimate of costs in support of this agreement as prepared by the Company is attached hereto, marked Exhibit A, and is by reference made a part of this agreement. (USE 1. OR 2. AS APPROPRIATE, NOT FOR LUMP SUM AGREEMENTS)
1. The Company shall maintain separate records of the cost incurred in connection with the adjustment and/or relocation of the facilities indicated on the attached plans to be at Government expense and those to be at Company expense.
2. Reimbursement for the Government's share of the cost of the required work to adjust and/or relocate the Company's facilities as set forth herein will be based on the ratio that the existing (number of poles/length of line) considered to be compensable bears to the total existing (number of poles/length of line) actually adjusted and/or relocated.

(USE THIS PARAGRAPH IN ALL AGREEMENTS EXCEPT LUMP SUM)
The Government's cost share shall be 99.9% of all eligible costs incurred. The total cost to the Government is estimated to be $ 50,000,000 , and shall not exceed this without modification of this agreement by written amendment mutually approved by both parties.

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
The Company, in preparing the estimate in support of this agreement, has considered potential inflationary costs of materials and labor for a minimum duration of one year from the date this agreement was signed. If after a one year time period the agreement has not been fulfilled and the Company is not responsible for delays, the Company may petition the Government for modification to the agreement based on increased costs due to inflation. Cost increase shall be based on the standard inflation index

Credits for Increase in Value

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
The Company, in preparing the estimate in support of this agreement, has considered any increase in value of its facilities which may be attributed to the substitution of a new facility for the existing facility. It has been determined that (SELECT ONE)
1. there is no increase in the value of the facility for which a credit should be applied.
2. the credit as included in the estimate represents the increase in value of the facility due to betterments and/or expired service life.

Scheduling and Coordination

(USE THIS PARAGRAPH IN ALL AGREEMENTS WHERE UTILITIES WILL BE RELOCATED DURING CONSTRUCTION)
The Company has estimated approximately ____________________ days will be required to complete the utility relocation work. The Company shall complete the work herein described by cooperating with the Government's contractor on this project, and will schedule the performance of this work to avoid unnecessary delay or hindrance to the progress of other work in the vicinity. The Company shall provide the Government Contractor the number of days AAdvance Notice@ needed to begin work activities and a schedule of areas the Company will be working in with the duration of utility relocation activities in that area.

Authorization to Proceed

(USE THIS PARAGRAPH IN ALL AGREEMENTS WHERE UTILITIES WILL BE RELOCATED DURING CONSTRUCTION)
In accordance with the schedule negotiated with the Government Contractor the Company is authorized to commence work. Execution of this reimbursable agreement will be limited to those costs incurred subsequent to the date of such authorization, except that reimbursement for preliminary engineering costs incurred since ____________________, will be allowed.

The Company will afford the Government the opportunity of inspecting the work by furnishing notice of the date the work will start to the Project Engineer.

(USE THIS PARAGRAPH IN ALL AGREEMENTS)
The Company will complete the work herein described as soon as practicable after written notice to proceed by the Government, cooperating with the Government's contractor on this project, and will schedule the performance of this work to avoid unnecessary delay or hindrance to the progress of other work in the vicinity.

(FOR OPTIONAL USE, ADD HERE ANY SPECIFIC TIMING REQUIREMENTS)
It is estimated that approximately __________ days will be required to complete the work after written notice is received from the Government.

Authorization to Proceed

(USE THIS PARAGRAPH IN ALL AGREEMENTS WHERE UTILITIES WILL BE RELOCATED PRIOR TO CONSTRUCTION, SELECT ONE)
1. The Company will not commence work until receipt of notice in writing from the Government to begin work,
2. The Company is authorized to commence work upon execution of this agreement,

(IN ALL AGREEMENTS)
and reimbursement will be limited to those costs incurred subsequent to the date of such authorization, except that reimbursement for preliminary engineering costs incurred since (FILL IN DATE) __________ will be allowed.

The Company will afford the Government the opportunity of inspecting the work by furnishing notice of the date the work will start to the (SELECT ONE)

1. Mr. Ronald Carmichael, Division Engineer, Western Federal Lands Highway Division, Federal Highway Administration, 610 East Fifth Street, Vancouver, Washington 98661-3893, Attention: James W. Brophy, Right of Way and Utilities Coordinator.

2. Project Engineer (INCLUDE ADDRESS & PHONE NUMBER)

Extra Work

(FOR OTHER THAN LUMP SUM AGREEMENTS)
If conditions require a change in the scope of the work, the performance of extra work, or major changes in the planned work as herein described, this agreement shall be modified by a written amendment covering the increases in cost and required changes which, when executed by both parties hereto, shall become a part of this agreement. Reimbursement for increases in the cost of the work and/or substantial changes in the statement of the work shall be limited to the costs covered by an amendment to this agreement. Under emergency conditions, verbal agreement may be reached and work approval given subject to writing and processing of the amendment.

Final Billing

(USE IN ALL AGREEMENTS)
The Company will submit to the Government support data and one final and complete billing marked AFinal Invoice@ of all eligible costs incurred not later than 180 days after satisfactory completion of the work pursuant to the provisions of Title 23 CFR 645.117. Support data shall include a certified statement of costs incurred, itemized as: (1) Salaries and Wages, (2) Transportation Cost, (3) Equipment Charges, (4) Materials, and (5) Other Items-including overhead. Support data shall include the location, labor, equipment mileage and dates covered. The Government will reimburse the Company for all eligible costs incurred under the terms of this agreement. Billing shall be submitted by delivery to:

Western Federal Lands Highway Division
Federal Highway Administration
610 East Fifth Street, Vancouver, Washington 98661-3801
Attention: James W. Brophy, Right of Way & Utilities Coordinator

(WHERE PROGRESS PAYMENTS ARE TO BE PERMITTED--NOT FOR LUMP SUM AGREEMENTS)
Partial payments may be made upon request of the utility. Such partial payments are to cover the costs incurred, and are not to be more frequent than one per month. It is agreed in connection with any request for partial payment that 10 percent of the amount claimed may be withheld until the final payment voucher has been audited and approved for payment; and that the total amounts paid on partial claim, including the amount withheld, will not constitute agreement as to the appropriateness of any item and that any sums paid in excess of the total payment due will be refunded to the Government by the Company. All partial payments shall include support data described above.

Retention of Records and Audit
(IN ALL AGREEMENTS)
During the progress of construction and for a period of 3 years from the date final payment is received by the Company, the records and accounts pertaining to the facility adjustment and/or relocation will be maintained and made available for inspections and audit by representatives of the Government.

Permits

The Company shall make application to appropriate authorities to obtain all necessary permits required to perform work herein described.

IN WITNESS WHEREOF, the parties hereto have executed this Utility Project Agreement
No. ________ as of the date of signature of the Company.

Company: ________________________________________

BY: _____________________________________________

TITLE: __________________________________________

DATE: ___________________________________________

FED TAX I.D.: ___________________________________

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION

BY:___________________________________________
William Parsons

TITLE: __________Contracting Officer__________

DATE: _______________________________________

Payment Information Form
for Electronic Funds Transfers

Please complete this form as soon as possible and mail it to the address listed below. Failure to do so may slow the processing of your first invoice. If your financial institution changes, another form must be completed and mailed as soon as possible to avoid lost or rejected payments.

Name of Company: ____________________

Address of Company: ____________________

Contact Person: ____________________

Phone Number: ( )____-_____

Tax ID Number (TIN): ______________________________

Name and Address of financial institution: ______________________________

Financial Institution's 9-Digit ABA Routing Number: ______________________________

Financial Institution's Account Number to be deposited with funds: ______________________________

Signature & Title of Person Completing this Form: ______________________________

Date: ____________________

Agreement No: 00-A-77-0105
Project No: PRA GLBO 102(9)
Project Name: Main Lark Road, Route 101, Glacier Bay N.P.

Mail Completed Form to:

FEDERAL HIGHWAY ADMINISTRATION
WESTERN FEDERAL LANDS HIGHWAY DIVISION
610 EAST FIFTH STREET
VANCOUVER, WA 98661-3893