HomeMy WebLinkAboutOrd.4212.04-18-2011 BILL NO. 11-37 ORDINANCE NO.
AN ORDINANCE AUTHORIZING THE CITY MANAGER TO
EXECUTE AN AGREEMENT WITH THE MISSOURI
HIGHWAYS AND TRANSPORTATION COMMISSION FOR
THE SAFE ROUTES TO SCHOOL PROGRAM, IN THE
CITY OF CAPE GIRARDEAU, MISSOURI
BE IT ORDAINED BY THE COUNCIL OF THE CITY OF CAPE
GIRARDEAU, MISSOURI, AS FOLLOWS:
ARTICLE 1 . The City Manager, for and on behalf of the City
of Cape Girardeau, Missouri, is hereby authorized to execute an
Agreement with the Missouri Highways and Transportation
Commission for the Safe Routes to School Program. A copy of
said Agreement is attached to this Ordinance and made a part
hereof.
ARTICLE 2 . This Ordinance shall be in full force and effect
ten days after its passage and approval .
f�S✓�i
PASSED AND APPROVED THIS /y DAY OF ,
20�.
- - �� axry E. ed ger, Mayor
ATTEST: g,z'
�Lo
.,
G yle Conrad, Ci ` lezyk - ;`,
I
�`- CCO Form: HS4 City of Cape Girardeau
Approved: 10/06 (BDG) SRTS-INF-H280(106)
Revised: 12/10 (MWH)
Modified:
CFDA Number. #20.205
CFDA Title: Highway Planning and Construction
Award name/number: SRTS-INF-H280(106)
Award Year: 2010
Federal Agency: Federal Highway Administration, Department of Transportation
MISSOURI HIGHWAYS AND TRANSPORTATION COMMISSION
SAFE ROUTES TO SCHOOL PROGRAM AGREEMENT
THIS AGREEMENT is entered into by the Missouri Highways and Transportation
Commission .(hereinafter, "Commission") and City of Cape Girardeau (hereinafter,
"Grantee").
WITNESSETH:
NOW, THEREFORE, in consideration of the mutual covenants, promises and
representations in this Agreement, the parties agree as follows:
(1) PURPOSE: The United States Congress has authorized funds to be used
for Safe Routes to School program activities. The Grantee has applied to the
f Commission for using these funds for qualified purposes. The purpose of this
Agreement is to grant the use of such Safe Routes to School funds to the Grantee.
(2) LOCATION AND NATURE OF PROJECT: The Safe Routes to School
funds which.are the subject of this Agreement are for the project at the following
location: Sidewalk construction on west side of Clark Ave. from Broadway to New
Madrid near St. Vincent de Paul Elementary, east side of Clark Ave. from Broadway to
Themis near Central Middle School and Central Junior High School, east side of
Cordelia'Ave. from Independence to Whitener near Central Middle School and Central
Junior High School, east side of Sheridan Dr. from William St. to Independence near
Central Middle School and Central Junior High School, west side of Minnesota Ave.
from William St. to Independence near Central Middle School and Central Junior High
j School, east side of Keller Ave. from Independence to Themis near Benjamin Franklin
Elementary School, west side of Keller Ave. from Themis to Luce near Benjamin
Franklin Elementary School, west side of Louisiana Ave. from Whitener to Alley near
Benjamin Franklin Elementary School. The general location of the project is shown on
an attachment marked "Exhibit A" and incorporated herein by reference.
I
I.
(3) INDEMNIFICATION:
(A) To the extent allowed or imposed by law, the Grantee shall defend,
indemnify and hold harmless the Commission, including its members and the Missouri
Department of Transportation (MoDOT or Department) employees, from any claim or
liability whether based on a claim for damages to real or personal property or to a
person for any matter relating to or arising out of the Grantee's wrongful or negligent
performance of its obligations under this Agreement.
(B) The Grantee will require any contractor procured by the Grantee to
work under this Agreement:
(1) To obtain a no cost permit from the Commission's district
engineer prior to working on the Commission's right-of-way, which shall be signed by an
authorized contractor representative (a permit from the Commission's district engineer
will not be required for work outside of the Commission's right-of-way); and
(2) To carry commercial general liability insurance and
commercial automobile liability insurance from a company authorized to issue insurance
in Missouri, and to name the Commission, and MoDOT and its employees, as additional
named insureds in amounts sufficient to cover the sovereign immunity limits for Missouri
public entities as calculated by the Missouri Department of Insurance, Financial
Institutions and Professional Registration, ' and published annually in the Missouri
Register pursuant to Section 537.610, RSMo. The Grantee shall cause insurer to
increase the insurance amounts in accordance with those published annually in the
Missouri Register pursuant to Section 537.610, RSMo.
(C) In no event shall the language of this Agreement constitute or be
construed as a waiver or limitation for either party's rights or defenses with regard to
each party's applicable sovereign, governmental, or official immunities and protections
as provided by federal and state constitution or law.
(4) AMENDMENTS: Any change in this Agreement, whether by modification
or supplementation, must be accomplished by a formal contract amendment signed and
approved by the duly authorized representatives of the Grantee and the Commission.
(5) COMMISSION REPRESENTATIVE: The Commission's District Engineer
is designated as the Commission's representative for the purpose of administering the
provisions of this Agreement. The Commission's representative may designate by
written notice other persons having the authority to act on behalf of the Commission in
furtherance of the performance of this Agreement.
(6) NONDISCRIMINATION ASSURANCE: With regard to work under this
Agreement, the Grantee agrees as follows:
(A) Civil Rights Statutes: The Grantee shall comply with all state and
2
federal statutes relating to nondiscrimination, including but not limited to Title VI and
Title VII of the Civil Rights Act of 1964, as amended (42 U.S.C. §2000d and §2000e, et
seq.), as well as any applicable titles of the "Americans with Disabilities Act" (42 U.S.C.
§12101, et seq.). In addition, if the Grantee is providing services or operating programs
on behalf of the Department or the Commission, it shall comply with all applicable
provisions of Title 11 of the "Americans with Disabilities Act".
(B) Administrative Rules: The Grantee shall comply with the
administrative rules of the United States Department of Transportation relative to
nondiscrimination in federally-assisted programs of the United States Department of
Transportation (49 C.F.R. Part 21) which are herein incorporated by reference and
made part of this Agreement.
(C) Nondiscrimination: The Grantee shall not discriminate on grounds
of the race, color, religion, creed, sex, disability, national origin, age or ancestry of any
individual in the selection and retention of subcontractors, including procurement of
materials and leases of.equipment. The Grantee shall not participate either directly or
indirectly in the discrimination prohibited by 49 C.F.R. §21.5, including employment
practices.
(D) Solicitations for Subcontracts, Including Procurements of Material
and Equipment: These assurances concerning nondiscrimination also apply to
subcontractors and suppliers of the Grantee. .These apply to all solicitations either by
competitive bidding or negotiation made by the Grantee for work to be performed under
a subcontract including procurement of materials or equipment. Each potential
subcontractor or supplier shall be notified by the Grantee of the requirements of this
Agreement relative to nondiscrimination on grounds of the race, color, religion, creed,
sex, disability or national origin, age or ancestry of any individual.
(E) Information and Reports: The Grantee shall provide all information
and reports required by this Agreement, or orders and instructions issued pursuant
thereto, and will permit access to its books, records, accounts, other sources of
information, and its facilities as may be determined by the Commission or the United
States Department of Transportation to be necessary to ascertain compliance with other
contracts, orders and instructions. Where any information required of the Grantee is in
the exclusive possession of another who fails or refuses to furnish this information, the
Grantee shall so certify to the Commission or the United States Department of
Transportation as appropriate and shall set forth what efforts it has made to obtain the
information.
(F) Sanctions for Noncompliance: In the event the Grantee fails to
comply with the nondiscrimination provisions of this Agreement, the Commission shall
impose such contract sanctions as it or the United States Department of Transportation
may determine to be appropriate, including but not limited to:
1. Withholding of payments under this Agreement until the
3
Grantee complies; and/or
2. Cancellation, termination or suspension of this Agreement, in
whole or in part, or both.
(G) Incorporation of Provisions: The Grantee shall include the
provisions of paragraph (6) of this Agreement in every subcontract, including
procurements of materials and leases of equipment, unless exempted by the statutes,
executive order, administrative rules or instructions issued by the Commission or the
United States Department of Transportation. The Grantee will take such action with
respect to any subcontract or procurement as the Commission or the United States
Department of Transportation may direct as a means of enforcing such provisions,
including sanctions for noncompliance; provided that in the event the Grantee becomes .
involved or is threatened with litigation with a subcontractor or supplier as a result of
such direction, the Grantee may request the United States to enter into such litigation to
protect the interests of the United States.
(7) ASSIGNMENT: The Grantee shall not assign, transfer or delegate any
interest in this Agreement without the prior written consent of the Commission.
(8) LAW OF MISSOURI TO GOVERN: This Agreement shall be construed
according to the laws of the State of Missouri. The Grantee shall comply with all local,
state and federal laws and regulations relating to the performance of this Agreement.
(9) CANCELLATION: The Commission may cancel this Agreement at any
time for a material breach of contractual obligations by providing the Grantee with
written notice of cancellation. Should the Commission exercise its right to cancel this
Agreement for such reasons, cancellation will become effective upon the date specified
in the notice of cancellation sent to the Grantee.
(10) ACCESS TO RECORDS: The Grantee and its contractors must maintain
all records relating to.this Agreement, including but not limited to invoices, payrolls, etc.
These records must be available at no charge to the FHWA and the Commission and/or
their designees or representatives during the period of this Agreement and any
extension, and for a period of three (3) years after the date on which the Grantee
receives reimbursement of their final.invoice from the Commission.
(11) FEDERAL-AID PROVISIONS: Because responsibility for the
performance of functions or work contemplated as part of this project is assumed by the
Grantee, and the Grantee may elect to construct part of the improvement contemplated
l by this Agreement with its own forces, a copy of Section II and Section Ill, as contained
in the United States Department of Transportation Form Federal Highway
Administration (FHWA) 1273 "Required Contract Provisions, Federal-Aid Construction
Contracts," is attached and made a part of this Agreement as Exhibit B. Wherever the
term `the contractor" or words of similar importappear in these sections, the term "the
Grantee" is to be substituted. The Grantee agrees to abide by and cant' out the
4
condition and obligations of "the contractor" as stated in Section II, Equal Opportunity,
and Section III, Nonsegregated Facilities, as set out in Form FHWA 1273.
(12) ACQUISITION OF RIGHT OF WAY: With respect to the acquisition of
right of way necessary for the completion of the project, Grantee shall acquire any
additional necessary right of way required for this project and in doing so agrees that it
will comply with all applicable federal laws, rules and regulations, including 42 U.S.C.
4601-4655, the Uniform Relocation Assistance and Real Property Acquisition Act,.as
amended, 49 CFR Part 24 and any other regulations promulgated in connection with the
Act. In addition Grantee shall comply with applicable state laws, rules and regulations
including those contained in Chapter 523 RSMo.
(13) MAINTENANCE OF DEVELOPMENT: If the project identified in
Paragraph 2, above, involves the construction or dedication of public improvements, the
Grantee shall maintain the herein contemplated improvements without any cost or
expense to the Commission. All maintenance by the Grantee shall be done for the
safety of the general public and the esthetics of the area. In addition, if any sidewalks
or bike trails are constructed on the Commission's right-of-way pursuant to this
Agreement, the Grantee shall inspect and maintain the sidewalks or bike trails
constructed by this project in a condition reasonably safe to the public and, to the extent
allowed by law, shall indemnify and hold the Commission harmless from any claims
arising from the construction and maintenance of said sidewalks or bike trails. If the
Grantee fails to maintain the herein contemplated improvements, the Commission or its
representatives, at the Commission's sole discretion shall notify the Grantee in writing of
the Grantee's failure to maintain the improvement. If the Grantee continues to fail in
maintaining the improvement, the Commission may remove the herein contemplated
improvement whether or not the improvement is located on the Commission's right of
way. Any removal by the Commission shall be at the sole cost and expense of the
Grantee. Maintenance includes but is not limited to mowing and trimming between
shrubs and other plantings that are part of the improvement.
(14) PLANS: The Grantee shall prepare preliminary and final plans and
specifications for the herein improvements. The plans and specifications shall be
r submitted to the Commission for the Commission's review and approval. The
Commission has the discretion to require changes to any plans and specification prior to
any approval by the Commission.
(15) REIMBURSEMENT: The cost of the contemplated improvements will be
bome by the United States Government and by the Grantee as follows:
(A) Any federal funds for project activities shall only be
available for reimbursement of eligible costs which have been incurred by Grantee. Any
costs incurred by Grantee prior to authorization from FHWA and notification to proceed
from the Commission are not reimbursable costs. The federal share for this project will
be 100 percent not to exceed $176,449.40. The calculated federal share for seeking
federal reimbursement of participating costs for the herein improvements will be
5
determined by dividing the total federal funds applied to the project by the total
4 participating costs. Any costs for the .herein improvements which exceed any federal
reimbursement or are -not eligible for federal reimbursement shall be the sole
responsibility of Grantee. The Commission shall not be responsible for any costs
associated with the herein improvement unless specifically identified in this Agreement
or subsequent written amendments. The reimbursable eligible costs for this project are
shown on an attachment marked "Exhibit C" and incorporated herein by reference.
(B) The authority to advertise for bids shall be granted by the
Commission when all right-of-way clearances, environmental clearances, and the
approval of the Plans, Specification and Estimate (PS&E) have been completed. Any
costs incurred by the Grantee prior to authorization from FHWA and notification
to proceed from the Commission are not reimbursable costs.
(C) In the event the Grantee does not submit the PS&E for this project,
and the Grantee does not have construction authorization (authority to advertise for
bids), the Grantee agrees to reimburse the Commission for any monies previously
reimbursed to the Grantee under this Agreement. All monies previously programmed or
spent for this project shall be surrendered by the Grantee at this time. Any costs
incurred by the Grantee prior to authorization from FHWA and notification to
proceed from the Commission are not reimbursable costs.
(D) In the event the Grantee does not complete the project within the
timelines set forth in the Safe Routes to School Administrative Guidelines Issued
03/0112010, all monies previously programmed or spent for this project shall be
surrendered by the Grantee at this time to the Commission. Any costs incurred by
the Grantee prior to authorization from FHWA and notification to proceed from
the Commission are not reimbursable costs.
(E) The Grantee shall complete the "SURVEY ABOUT WALKING AND
BIKING TO SCHOOL FOR PARENTS" (Survey) .for each child in the grades
Kindergarten (K) through 8 of each school involved in the application. An example of
the Survey form is attached hereto as Exhibit D and incorporated herein by reference.
The Grantee shall complete the Survey prior to the project beginning. The Grantee
shall complete the Survey again within 6 months following the completion of the project.
The Grantee shall complete the °SAFE ROUTES TO SCHOOL STUDENT ARRIVAL
AND DEPARTURE TALLY SHEET" (Tally Sheet) for each child in the grades of K-8 of
each school listed in the application prior to the project beginning and again within 6
months following the completion of the project. An example of the Tally Sheet form is
attached hereto as Exhibit E and incorporated herein by reference. The Surveys and
Tally Sheets are a requirement of the applicant per the Safe Routes to School
Administrative Guidelines Issued 03/01/2010. All costs incurred by the Grantee
for the Surveys or Tally Sheets are non-reimbursable. In the event that the
Grantee does not meet these requirements, all monies previously programmed or
spent for this project shall be surrendered by the Grantee at this time to the
Commission.
6
r
' f
I _
(16) USE OF FUNDS: Any employee of Grantee whose salary or wages are
paid in whole or in part with federal funds is prohibited from participating in certain
partisan political activities, including, but not limited to, being a candidate for elective
office pursuant to Title 5 United States Code (hereinafter, "U.S.C."), Sections 1501-
1508. If an employee of Grantee participates in activities prohibited by the Hatch Act,
Grantee shall no longer pay that employee's salary or wages with federal funds unless
the requirements of 5 U.S.C. Sections 1501-1508 are not applicable to that employee
pursuant to 5 U.S.C. Section 1502(c).
(17) PROGRESS PAYMENTS: The Grantee may request progress payments
be made for the herein improvements as work progresses but not more than once every
two weeks. Progress payments must be submitted monthly for amounts equal to or
greater than $10,000.00. The Grantee shall repay any progress payments which
involve ineligible costs.
(18) PERMITS: The Grantee shall secure any necessary approvals or permits
from any federal or state agency as required for the completion of the herein
improvements. The permits which may be required include, but are not limited to,
environmental, architectural, historical or cultural requirements of federal or state law or
regulation. If this improvement is on the right of way of the Commission, the Grantee
must secure a permit from the Commission prior to the start of any work on the right of
way. The Grantee shall comply with any additional conditions placed on the issuance of
the permit by the Commission, including, but not limited to any bonding requirements of
the Commission.
(19) INSPECTION OF IMPROVEMENTS AND RECORDS: The Grantee shall
assure that representatives of the Commission and FHWA shall have the privilege of
inspecting and reviewing the work being done by the Grantee's contractor and
subcontractor on the herein project. The Grantee shall also assure that its contractor,
and all subcontractors, if any, maintain all books, documents, papers and other
evidence pertaining to costs incurred in connection with the Safe Routes to School
Program Agreement, and make such materials available at such contractor's office at all
reasonable times at no charge during this Agreement period, and for three (3) years
from the date of final payment under this Agreement, for inspection by the Commission,
FHWA or any authorized representatives of the Federal Government and the State of
Missouri, and copies shall be furnished, upon request, to authorized representatives of
the Commission, State, FHWA, or other Federal agencies.
(20) CREDIT FOR DONATIONS OF FUNDS, MATERIALS, OR SERVICES: A
person may offer to donate funds, materials or services in connection with this project.
Any donated funds, or the fair market value of any donated materials or services that
are accepted and incorporated into this project shall be credited according to 23 U.S.C.
§323.
(21) DISADVANTAGED BUSINESS ENTERPRISES (DBE): The Commission
7
will advise the Grantee of any required goals for participation by DBEs to be included in
the Grantee proposal for the work to be performed. The Grantee shall submit for
Commission approval a disadvantaged business enterprise goal or plan. The Grantee
shall comply with the - plan or goal that is approved by the Commission and all
requirements of 49 C.F.R. Part 26, as amended.
(22) VENUE: It is agreed by the parties that any action at law, suit in equity, or
other judicial proceeding to enforce or construe this Agreement, or regarding its alleged
breach, shall be instituted only in the Circuit Court of Cole County, Missouri.
(2 3) NOTICE TO BIDDERS: The Grantee shall notify the prospective bidders
that disadvantaged business enterprises shall be afforded full and affirmative
opportunity to submit bids in response to the invitation and will not be discriminated
against on grounds of race, color, sex, or national origin in consideration for an award.
. (24) FINAL AUDIT: The Commission may, in its sole discretion, perform a final
audit of project costs. The United States Government shall reimburse the Grantee,
through the Commission, any monies due. The Grantee shall refund any overpayments
as determined by the final audit.
(26) OMB AUDIT: If the Grantee expend(s) five hundred thousand dollars
($500,000) or more in a year in federal financial assistance it is required to have an
independent annual audit conducted in accordance with OMB Circular A-133. A copy of
the audit report shall be submitted to MoDOT within the earlier.of thirty (30) days after
receipt of the auditor's report(s), or nine (9) months after the end of the audit period.
Subject to the requirements of OMB Circular A-133, if the Grantee expend(s) less than
five hundred thousand dollars ($500,000) a year, the Grantee may be exempt from
auditing requirements for that year but records must be available for review or audit by
applicable state and federal authorities.
(26) FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT
OF 2006: The Grantee shall comply with all reporting requirements of the Federal
Funding Accountability and Transparency Act (FFATA) of 2006, as amended. This
Agreement is subject to the award terms within 2 C.F.R. Part 170.
[Remainder of Page Intentionally Left Blank]
8
i
i ..
I
( IN WITNESS WHEREOF, the parties have entered into this Agreement on the
date last written below.
Executed by the Grantee this day of 120 -
Executed
20_Executed by the Commission this day of , 20
MISSOURI HIGHWAYS AND
TRANSPORTATION COMMISSION CITY OF CAPE GIRARDEAU
By
Title Title
ATTEST: ATTEST:
By
Secretary to the Commission
Title
Approved as to Form: Approved as to Form:
Commission Counsel
Title
Ordinance No
9
Rece p
�Y 17 211
�
CCO Form: HS4 p1M City of Cape Girardeau
Approved: 10/06 (BDG) FLAiNNiNG -SRTS-INF-H280(106)
Revised: 12/10 (MWH)
Modified:
CFDA Number: #20.205
CFDA Title: Highway Planning and Construction
Award name/number: SRTS-INF-H280(106)
Award Year: 2010
Federal Agency: Federal Highway Administration, Department of Transportation
MISSOURI HIGHWAYS AND TRANSPORTATION COMMISSION
SAFE ROUTES TO SCHOOL PROGRAM AGREEMENT
THIS AGREEMENT is entered into by the Missouri Highways and Transportation
Commission (hereinafter, "Commission") and City of Cape Girardeau (hereinafter,
"Grantee").
WITNESSETH:
NOW, THEREFORE, in consideration of the mutual covenants, promises and
representations in this Agreement, the parties agree as follows:
(1) PURPOSE: The United States Congress has authorized funds to be used
for Safe Routes to School program activities. The Grantee has applied to the
Commission for using these funds for qualified purposes. The purpose of this
Agreement is to grant the use of such Safe Routes to School funds to the Grantee.
(2) LOCATION AND NATURE OF PROJECT: The Safe Routes to School
funds which are the subject of this Agreement are for the project at the following
location: Sidewalk construction on west side of Clark Ave. from Broadway to New
Madrid near St. Vincent de Paul Elementary, east side of Clark Ave. from Broadway to
Themis near Central Middle School and Central Junior High School, east side of
Cordelia Ave. from Independence to Whitener near Central Middle School and Central
Junior High School, east side of Sheridan Dr. from William St. to Independence near
Central Middle School and Central Junior High School, west side of Minnesota Ave.
from William St. to Independence near Central Middle School and Central Junior High
School, east side of Keller Ave. from Independence to Themis near Benjamin Franklin
Elementary School, west side of Keller Ave. from Themis to Luce near Benjamin
Franklin Elementary School, west side of Louisiana Ave. from Whitener to Alley near
Benjamin Franklin Elementary School. The general location of the project is shown on
an attachment marked "Exhibit A" and incorporated herein by reference.
(3) INDEMNIFICATION:
(A) To the extent allowed or imposed by law, the Grantee shall defend,
indemnify and hold harmless the Commission, including its members and the Missouri
Department of Transportation (MoDOT or Department) employees, from any claim or
liability whether based on a claim for damages to real or personal property or to a
person for any matter relating to or arising out of the Grantee's wrongful or negligent
performance of its.obligations under this Agreement.
(B) The Grantee will require any contractor procured by the Grantee to
work under this Agreement:
(1) To obtain a no cost permit from the Commission's district
engineer prior to working on.the Commission's right-of-way, which shall be signed by an
authorized contractor representative (a permit from the Commission's district engineer
will not be required for work outside of the Commission's right-of-way); and
(2) To carry commercial general liability insurance and
commercial automobile liability insurance from a company authorized to issue insurance
in Missouri, and to name the Commission, and MoDOT and its employees, as additional
named insureds in amounts sufficient to cover the sovereign immunity limits for Missouri
public entities as calculated by the Missouri Department of Insurance, Financial
Institutions and Professional Registration, and published annually in the Missouri
Register pursuant to Section 537.610, RSMo. The Grantee shall cause insurer to
increase the insurance amounts in accordance with those published annually in the
Missouri Register pursuant to Section 537.610, RSMo.
(C) In no event shall the language of this Agreement constitute or be
construed as a waiver or limitation for either party's rights or defenses with regard to
each party's applicable sovereign, governmental, or official immunities and protections
as provided by federal and state constitution or law.
(4) AMENDMENTS: Any change in this Agreement, whether by modification
or supplementation, must be accomplished by a formal contract amendment signed and
approved by the duly authorized representatives of the Grantee and the Commission.
(5) COMMISSION REPRESENTATIVE: The Commission's District Engineer
is designated as the Commission's representative for the purpose of administering the
provisions of this Agreement. The Commission's representative may designate by
written notice other persons having the authority to act on behalf of the m
P 9 Y Commission in
furtherance of the performance of this Agreement.
(6) NONDISCRIMINATION ASSURANCE: With. regard to work under this
Agreement, the Grantee agrees as follows:
(A) Civil Rights Statutes: The Grantee shall comply with all state and
2
u
federal statutes relating to nondiscrimination, including but not limited to Title VI and
Title VII of the Civil Rights Act of 1964, as amended (42 U.S.C. §2000d and §2000e, et
seq.), as well as any applicable titles of the "Americans with Disabilities Act" (42 U.S.C.
§12101, et seq.). In addition, if the Grantee is providing services or operating programs
on behalf of the Department or the Commission, it shall comply with all applicable
provisions of Title II of the "Americans with Disabilities Act".
(i3) Administrative Rules: The Grantee shall comply with the
administrative rules of the United .States Department of.Transportation relative to
nondiscrimination in federally-assisted programs of the United States Department of
Transportation (49 C.F.R. Part 21) which are herein incorporated by reference and
made part of this Agreement.
(C) Nondiscrimination: The Grantee shall not discriminate on grounds
of the race, color, religion, creed, sex, disability, national origin, age or ancestry of any
individual in the selection and retention of subcontractors, including procurement of
materials and leases of equipment. The Grantee shall not participate either directly or
indirectly in the discrimination prohibited by 49 C.F.R. §21.5, including employment
practices.
(D) Solicitations for Subcontracts Including Procurements of Material
and Equipment: . These assurances concerning nondiscrimination also apply to
subcontractors and suppliers of the Grantee. These apply to all solicitations either by
competitive bidding or negotiation made by the Grantee for work to be performed under
a subcontract including procurement of. materials or equipment. Each potential
subcontractor or supplier shall be notified by the Grantee of the requirements of this
Agreement relative to nondiscrimination on grounds of the race, color, religion, creed,
sex, disability or national origin, age or ancestry of any individual.
(E) Information and Reports: The Grantee shall provide all information
and reports required by this Agreement, or orders and instructions issued pursuant
thereto, and will permit access to its books, records, accounts, other sources of
information, and its facilities as may be determined by the Commission or the United
States Department of Transportation to be necessary to ascertain compliance with other
contracts, orders and instructions. Where any information required of the Grantee is in
the exclusive possession of another who fails or refuses to furnish this information, the
Grantee shall so certify to the Commission or the United States Department of
Transportation as appropriate and shall set forth what efforts it has made to obtain the
information.
(F) Sanctions for Noncompliance: In the event the Grantee fails to
comply with the nondiscrimination provisions of this Agreement, the Commission shall
impose such contract sanctions as it or the United States Department of Transportation
may determine to be appropriate, including but not limited to:
1. Withholding of payments under this Agreement until the
3
Grantee complies; and/or
2. Cancellation, termination or suspension of this Agreement, in
whole or in part, or both.
(G) Incorporation of Provisions: The Grantee shall include the
provisions of paragraph (6) of this Agreement in every subcontract, including
procurements of materials and leases of equipment, unless exemptedby the statutes,
executive order, administrative rules or instructions issued by the Commission or the
United States Department of Transportation. The Grantee will take such action with
respect to any subcontract or procurement as the Commission or the United States
Department of Transportation may direct as a means of enforcing such provisions,
including sanctions for noncompliance; provided that in the event the Grantee becomes .
involved or is threatened with litigation with a subcontractor or supplier as a result of
such direction, the Grantee may request the United States to enter into such litigation to
protect the interests of the United States.
(7) ASSIGNMENT: The Grantee shall not assign, transfer or delegate any
interest in this Agreement without the prior written consent of the Commission.
(8) LAW OF MISSOURI TO GOVERN: This Agreement shall be construed
according to the laws of the State of Missouri. The Grantee shall comply with all local,
state and federal laws and regulations relating to the performance of this Agreement.
(9) CANCELLATION: The Commission may cancel this Agreement at any
time for a material breach of contractual obligations by providing the Grantee with
written notice of cancellation. Should the Commission exercise its right to cancel this
Agreement for such reasons, cancellation will become effective upon the date specified
in the notice of cancellation sent to the Grantee.
(10) ACCESS TO RECORDS: The Grantee and its contractors must maintain
all records relating to this Agreement, including but not limited to invoices, payrolls, etc.
These records must be available at no charge to the FHWA and the Commission and/or
their designees or representatives during the period of this Agreement and any
extension, and for a period of three (3) years after the date on which the Grantee
receives reimbursement of their final invoice from the Commission.
(11) FEDERAL-AID PROVISIONS: Because responsibility for the
performance of functions or work contemplated as part of this project is assumed by the
Grantee, and the Grantee may elect to construct part of the improvement contemplated
by this Agreement with its own forces, a copy of Section II and Section III, as contained
in the United States Department of Transportation Form Federal Highway
Administration (FHWA) 1273 "Required Contract Provisions, Federal-Aid Construction
Contracts," is attached and made a part of this Agreement as Exhibit B. Wherever the
term `the contractor" or words of similar import appear in these sections, the term "the
Grantee" is to be substituted. The Grantee agrees to abide by and carry out the
4
condition and obligations of "the contractor' as stated in Section II, Equal Opportunity,
and Section III, Nonsegregated Facilities, as set out in Form FHWA 1273.
(12) ACQUISITION OF RIGHT OF WAY: With respect to the acquisition of
right of way necessary for the completion of the project, Grantee shall acquire any
additional necessary right of way required for this project and in doing so agrees that it
will comply with all applicable federal laws, rules and regulations, including 42 U.S.C.
4601-4655, the Uniform Relocation Assistance and Real Property Acquisition Act, as
amended, 49 CFR Part 24 and any other regulations promulgated in connection with the
Act. In addition Grantee shall comply with applicable state laws, rules and regulations
including those contained in Chapter 523 RSMo.
(13) MAINTENANCE OF DEVELOPMENT: If the project identified in
Paragraph 2, above, involves the construction or dedication of public improvements, the
Grantee shall maintain the herein contemplated improvements without any cost or
expense to the Commission. All maintenance by the Grantee shall be done for the
safety of the general public and the esthetics of the area. In addition, if any sidewalks
or bike trails are constructed on the Commission's' right-of-way pursuant to this
Agreement, the Grantee shall inspect and maintain the sidewalks or bike trails
constructed by this project in a condition reasonably safe to the public and, to the extent
allowed by law, shall indemnify and hold the Commission harmless from any claims
arising from the construction and maintenance of said sidewalks or bike trails. If the
Grantee fails to maintain the herein contemplated improvements, the Commission or its
representatives, at the Commission's sole discretion shall notify the Grantee in writing of
the Grantee's failure to maintain the improvement. If the Grantee continues to fail in
maintaining the improvement, the Commission may remove the herein contemplated
improvement whether or not the improvement is located on the Commission's right of
way. Any removal by the Commission shall be at the sole cost and expense of the
Grantee. Maintenance includes but is not limited to mowing and trimming between
shrubs and other plantings that are part of the improvement.
(14) PLANS: The Grantee shall prepare preliminary and final plans and
specifications for the herein improvements. The plans and specifications shall be
submitted to the Commission for the Commission's review and approval. The
Commission has the discretion to require changes to any plans and specification prior to
any approval by the Commission.
(15) REIMBURSEMENT: The cost of the contemplated improvements will be
borne by the United States Government and by the Grantee as follows:
(A) Any federal funds for project activities shall.only be
available for reimbursement of eligible costs which have been incurred by Grantee. Any
costs incurred by Grantee prior to authorization from FHWA and notification to proceed
from the Commission are not reimbursable costs. The federal share for this project will
be 100 percent not to exceed $176,449.40. The calculated federal share for seeking
federal reimbursement of participating costs for the herein improvements will be
5
. 1
determined by dividing the total federal funds applied to the project by the total
participating costs., Any costs for the herein improvements which exceed any federal
reimbursement or are not eligible for federal reimbursement shall be the sole
responsibility of Grantee. The Commission shall not be responsible for any costs
associated with the herein improvement unless specifically identified in this Agreement
or subsequent written amendments. The reimbursable eligible costs for this project are
shown on an attachment marked "Exhibit C' and incorporated herein by reference.
(B) The authority to advertise for bids shall be granted by the
Commission when all right-of-way clearances, environmental clearances, and the
approval of the Plans, Specification and Estimate (PS&E) have been completed. Any
costs incurred by the Grantee prior to authorization from FHWA and notification
to proceed from the Commission are not reimbursable costs.
(C) In the event the Grantee does not submit the PS&E for this project,
and the Grantee does not have construction authorization (authority to advertise for
bids), the Grantee agrees to reimburse the Commission for any monies previously
reimbursed to the Grantee under this Agreement. All monies previously programmed or
spent for this project shall be surrendered by the Grantee at this time. Any costs
incurred by the Grantee prior to authorization from FHWA and notification to
proceed from the Commission are not reimbursable costs.
(D) In the event the Grantee does not complete the project within the
timelines set forth in the Safe Routes to School Administrative Guidelines Issued
03/01/2010, all monies previously programmed or spent for this project shall be
surrendered by the Grantee,at.this time to the Commission. Any costs incurred by
the Grantee prior to authorization from FHWA and notification to proceed from
the Commission are not reimbursable costs.
(E) The Grantee shall complete the "SURVEY ABOUT WALKING AND
BIKING TO SCHOOL FOR PARENTS" (Survey) for each child in the grades
Kindergarten (K) through 8 of each school involved in the application. An example of
the Survey form is attached hereto as Exhibit D and incorporated herein by reference.
The Grantee shall complete the Survey prior to the .project beginning. The Grantee
shall complete the Survey again within 6 months following the completion of the project.
The Grantee shall complete the "SAFE ROUTES TO SCHOOL STUDENT ARRIVAL
AND DEPARTURE TALLY SHEET' (Tally Sheet) for each child in the grades of K-8 of
each school listed in the application prior to the project beginning and again within 6
months following the completion of the project. An example of the Tally Sheet form is
attached hereto as Exhibit E and incorporated herein by reference. The Surveys and
Tally Sheets are a requirement of the applicant per the Safe Routes to School
Administrative Guidelines Issued 03/01/2010. All costs incurred by the Grantee
for the Surveys or Tally Sheets are non-reimbursable. In the event that the
Grantee does not meet these requirements, all monies previously programmed or
spent for this project shall be surrendered by the Grantee at this time to the
Commission.
6
(16) USE OF FUNDS: Any employee of Grantee whose salary or wages are
paid in whole or in part with federal funds is prohibited from participating in certain
partisan political activities, including, but not limited to, being a candidate for elective
office pursuant to Title 5 United States Code (hereinafter, "U.S.C."), Sections 1501-
1508. If an employee of Grantee participates in activities prohibited by the Hatch Act,
Grantee shall no longer pay that employee's salary or wages with federal funds unless
the requirements of 5 U.S.C. Sections 1501-1508 are not applicable to that employee
pursuant to 5 U.S.C. Section 1502(c).
(17) PROGRESS PAYMENTS: The Grantee may request progress payments
be made for the herein improvements as work progresses but not more than once every
two weeks. Progress payments must be submitted monthly for amounts equal to or
greater than $10,000.00. The Grantee shall repay any progress payments which
involve ineligible costs.
(18) PERMITS: The Grantee shall secure any necessary approvals or permits
from any federal or state agency as required for the completion of the herein
improvements. The permits which may be required include, but are not limited to,
environmental, architectural, historical or cultural requirements of federal or state law or
regulation. If this improvement is on the right of way of the Commission, the Grantee
must secure a permit from the Commission prior to the start of any work on the right of
way. The Grantee shall comply with any additional conditions placed on the issuance of
the permit by the Commission, including, but not limited to any bonding requirements of
the Commission.
(19) INSPECTION OF IMPROVEMENTS AND RECORDS: The Grantee shall
assure that representatives of the Commission and FHWA shall have the privilege of
inspecting and reviewing the work being done by the Grantee's contractor and
subcontractor on the herein project. The Grantee shall also assure that its contractor,
and all subcontractors, if any, maintain all books, documents, papers and other
evidence pertaining to costs incurred in connection with the Safe Routes to School
Program Agreement, and make such materials available at such contractor's office at all
reasonable times at no charge during this Agreement period, and for three (3) years
from the date of final payment under this Agreement, for inspection by the Commission,
FHWA or any authorized representatives of the Federal Government and the State of
Missouri, and copies shall be furnished, upon request, to authorized representatives of
the Commission, State, FHWA, or other Federal agencies.
(20) CREDIT FOR DONATIONS OF FUNDS, MATERIALS, OR SERVICES: A
person may offer to donate funds, materials or services in connection with this project.
Any donated funds, or the fair market value of any donated materials or services that
are accepted and incorporated into this project shall be credited according to 23 U.S.C.
§323.
(21) DISADVANTAGED BUSINESS ENTERPRISES (DBE): The Commission
7
1
will advise the Grantee of any required goals for participation by DBEs to be included in
the Grantee proposal for the work to be performed. The Grantee shall submit for
Commission approval a disadvantaged business enterprise goal or plan. The Grantee
shall comply with the plan or goal that is approved by the Commission and all
requirements of 49 C.F.R. Part 26, as amended.
(22) VENUE: It is agreed by the parties that any action at law, suit in equity, or
other judicial proceeding to enforce or construe this Agreement, or regarding its alleged
breach, shall be instituted only in the Circuit Court of Cole County, Missouri.
(23) NOTICE TO BIDDERS: The Grantee shall notify the prospective bidders
that disadvantaged business enterprises shall be afforded full and affirmative
opportunity to submit bids in response to the invitation and will not be discriminated
against on grounds of race, color, sex, or national origin in consideration for an award.
(24) FINAL AUDIT: The Commission may, in its sole discretion, perform a final
audit of project costs. The United States Government shall reimburse the Grantee,
through the Commission, any monies due. The Grantee shall refund any overpayments
as determined by the final audit.
(25) OMB AUDIT: If the Grantee expend(s) five hundred thousand dollars
($500,000) or more in a year in federal financial assistance it is required to have an
independent annual audit conducted in accordance with OMB Circular A-133. A copy of
the audit report shall be submitted to MoDOT within the earlier of thirty (30) days after
receipt of the auditor's report(s), or nine (9) months after the end of the audit period.
Subject to the requirements of OMB Circular A-133, if the Grantee expend(s) less than
five hundred thousand dollars ($500,000) a year, the Grantee may be exempt from
auditing requirements for that year but records must be available for review or audit by
applicable state and federal authorities.
(26) FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT
OF 2006: The Grantee shall comply with all reporting requirements of the Federal
Funding Accountability and Transparency Act (FFATA) of 2006, as amended. This
Agreement is subject to the award terms within 2-C.F.R. Part 170.
[Remainder of Page Intentionally Left Blank]
8
IN WITNESS WHEREOF, the parties have entered into this Agreement on the
date last written below. p1
Executed by the Grantee this /0 day of , 20
n�1^&
Executed by the Commission this cO day of , 20 .
MISSOURI HIGHWAYS AND
TRANSPORTATION COMMISSION CITY OF CAP IRARDEAU
By
Title Chief Engineer
Title
ATTEST: ;
:dl
By
SqP et tot e Commission l'f�r tJjdF 2 a'
Title `�
Approved as to F rm: Approved as to Form:
is 'on o el
Title
Ordinance No
Lq
Ilk
9
FMIA-1773 Ela=on,c VM'on--Ma"Lh 10 1991
RCIUIRED CONTRACT PROVISIONS
FEDERAL-AID CONSTRUCTION CONTRACTS
Page V 6 Selection of Labor: During the performance of this contract,it*
I. General ....................................... 1 contractor shall not:
it. NondiscrkT inabion .......................: ..... t
Ill. Nonsegregated FaclWas ............. . 3 a. discriminate against labor from any other State,possession,
IV. Payment of Predetermined Minimum Wage........... 3 or territory of the United States(except for employment preference for
V. Statements and Payrofls ........................ 6 Appalachian contracts.when applicable,as specified In Attachment A).
VI. Record of Materials.Supplies,and Labor ............ 6 or
VII. Subletting or Assigning the Contract ................ 7
VIII. Safety. Accident Prevention ...................... 7 b. employ convict labor for any purpose within the limits of the
IX. False Statements Concerning Highway Projects ....... 7 project unless it is labor_perfomted by convicts who are on parole,
X. hhhplementation of Clean Air Act and Federal supervised release,or probation.
Water Pollution Control Act ......._. e
X1. Certiftcatlon Regards Debarment,Suspension,
Ineligiblly,and Voluntary Exclusion ................ S Il. NONDISCRIMINATION
XII. Certification Regarding Use of Contract Funds for
Lobbying ...................................... 9 (Applicable to all Federal-aid construction contracts and to all related
subcontracts of$10,000 or more.)
ATTACHMENTS
1. Equal Employe ent Opportunity. Equal employment opportu-
A. 'Employment Preference for Appalachian Corrtncts nity (EEO) requirements not to discriminate and to take affirmative
(Included in Appalachian contracts only) action to assure equal opportunity as set forth under laws,executive
orders,rules,regulations(26 CFR 35,29 CFR 1630 and 41 CFR 60)
and orders of the Secretary of Labor as modified by the provisions
1. GENERAL prescribed herein, and imposed pursuant to 23 U.S.C. 140 shall
constitute the EEO and_specific affirmative action standards for the
1.These contract provisions shall apply to all work performed on the cor&acWs project ac bvftks undertthm centrad The Equal OppoAunityy
contract by the eordracWs own organization and with the assistance of Construction Contract ins set forth under 41 CFR 60-4.3 and
workers under the contras Immediate superlhtendence and to all the proNatons of the American Disabilities Act of 1990 (42 U.S.C.
work performed on the contend by piecework, station work, or by 12101 st sem.)set forth under 28 CFR 35 and 29 CFR 1630 ars
subcontract. Incorporated by reiauvnce in this contract. In the execution of this
contract,the contractor'agrees to comply with the following minimum
2. Except as otherwise provided for In each section,the contractor specific requirement activities of EEO:
shall Inert In each subcontract at of the stipulations contained In these
Required Contract Provianw,and further require their mclusion in any e. The coft actor will work with the State highway agency(SNA)
lower tier subcontract or purchase order that may in tum be made. The and the Federal Government in carrying out EEO obligations and in their
Required Contract Provtebns shall not be incorporated by reference in review of thhOw activities under the contract.
any case. The prime contractor shell be responsible for compliance by
arty subcoMrador or lower tier subcontractor with these Required b.The contractor will accept as his opera"policy the fdbvwirhg
cortrsd Provisions. statement:
3. A breach of any of the stipulations contained in these Required "lit is the policy of this Company to assure that applicants are
Contract Provisions shall be sufficient grounds for termination of the employed, and that employees are treated during empboyment,
contract. without regard to their race,religion,sax,Color,national origin,age
or disability. Such action shall include:empioymerd,upgradN.
4. A breach of the following clauses of the Required Contract demotion,or transfer,recruitment or recruitment advertising;layoff .
Provision may also be grounds for debam>ent as provided in 29 CFR or termination;rates of pay or other forms of compensation:and
5.12 selection for training,Including apprenticeship,preapprenticesbip,
andlor on-the fob training.-
Section I,paragraph 2;
Section IV,paragraphs 1,2,3,4,and 7; 2. EEO Officer. The contractor will designate and make known to
Section V,paragraphs 1 and 2a trough 4 the SHA contracting officers an EEO Offioerwho will have the response-
bialy for and nest be capable of effectively admkvstering and Promoting
S. Disputes arising out of the labor standards provisions of Section an active contractor program of EEO and who must be assigned
IV(except paragraph 5)and Section V of them Required Contract adequate authority and re:sponslbW to do ao.
Provisions shaft not be subject to the general disputes clause of this
conVact. Such disputes shag be resolved in accordance with the 3. Dissemination of Policy: All members of the contractor's staff
pi *dures of the U.S.Department of Labor(DOL)as set forth in 29 who are authorized to hive,supervise,promote,and discharge employ-
CFR 5,S.and 7. Disputes wftNn the meaning of this clause Include ees,or who recommend such action,or who are substantially involved
disputes between the contractor(or any of Its subcontractors)and the in such action,will be made fully cognb2M of,and will imptentert,the
contracting agenoy,the DOL, or the contractor's employees or their contractor's EEO poncy and contractual responsibilities to provide EEO
representatives. in each grade and classification of employment. To ensure that the
above agreement will be met,the following actions will be taken as a
minimum:
F*g4 1
a. Periodic meetings of supervisory and personnel office C. The contractor will periodically review selected personnel
employees will be conducted before the start of work and then not less actions in depth to determine whether there is evidence of discrimi-
often than once every six months,at which time the contractors EEO nation. Where evidence is found,the cWtractor will promptly take
policy and Its kr4 to wrtatien will be reviewed and explained. The corrective action. If the review indicates that the discrirninstion may
meetings will be conducted by the EEO Officer. Wand beyond the actions reviewed,such corrective action shall include
all affected persons.
b.Alf new supervisory or personnel office employees vat be given
a thorough indoctrination by the EEO Officer,covering all major aspects d. The contractor wwn promptly investigate an complaints of
of the contractoes EEO obflgatfotrs withal thirty days Wowing their alleged discrimination made to the contractor in connection with his
reporttag for duty with the contractor. obligations under this contract,wiry attempt to resolve such complaints,
and win take appropriate corrective action vMn a reasonable time. if
c. An personnel who are engaged in direct recruitment for the the investigation indicstas that the discrimination may affect persons
project will be instructed by the EEO Officer In the contractors other than the complainant,such corrective action shall include such
procedures for locating and hiring minority group employees. other persons. Upon completion of each investigation,the contractor
d. Notices and posters setting forth the contractors EEO policy will inform a"complainant of all of his avenues of appeal.
win be placed in areas readily accessible to employees,applicants for
employmerrt and potential employees.
e. The contractors EEO policy and the procedures to implement 6. Training and Promotion:
such policy will be brought to the attention of employees by means of
meetings,employee handbooks,or other appropriate means. a.The contractorwlp assist In locating,qualifying,and increasing
the skills of ndnorityr group and women employees.and applicants for
4.Recruitment:When advertising for employees.thecontrarearwill employment,
mclyde in all advertisements for employees the rotation: 'An Equal
OppoRunny Employer" All such advertisements will be pieced in b. Consistent with the contractors work force requirements and
publications having a targe circulation among minority groups in the area as permissible under Federal and State regulations,the contractor shall
from which the project work force woad normally be derived. make fun as of training programs,i.e.,apprenticeship,and on-the-job
training programs for the geographical area of contract performance.
a. The contractor will,unless precluded by a valid bargaining Where feasible,25 percent of apprentices or trainees in each ocarpa-
agreement,conduct systematic and diad recruitment through pubife tion shag be in their Brat year of apprenticeship or training. In the event
end private arrrployes referral sources Maly to"Id qualified minortty a special provision for training is provided uncia this contract.this
group applicants. To meet this requirwriert,the corWaclor win identify subparagraph win be superseded as indicated in the specod provision.
sources of prtsntiai minority group employees,and establish with such
idertitkd sources procedures whereby minority group appy may c The contractor will advise employees and applicants for
be afarred to the cartractat for employment consideration. employment of available training progrena and entrance requirements
for each.
b. in the evert the contractor has a valid bargaining agreement
providing for exclusive tiring hag referrals,fie Is expected to observe the d. The contractor wit periock"lty review the hitning and
provisions of that agreement to the extent ihat the system Wrots the pranotion potential of minority group and women employeas and will
centradoes compliance with EEO Contract provisions. (The DOL has encourage eligible employees to apply for such training and promotion.
held that where implementation of such agreements have the effect of
discrimilirlating const minorities 4r women,or obligates the contractor 7. Unions: M the contractor relies in whole or in part upon unions as
to do the same,such unplementatien violates Executive Order 11246. a source of employees,the contractor will use hishmr best efforts to
as amended.) obtain the cooperation of such unions to increase opportunities for
minority groups and women within the unions,and to effect referrals by
c. The contractor will encourage lbs present employees to refer such urdons of minority and female employees. Actions by the
minority,group applicants for employment. information and procedures contractor either directly or through a contractors association acting as
with regard to referring minority group applicants will be discussed with agent will include the procedures set forth below:
employees.
a. The contractor will use beat efforts to develop.In cooperation
S. Personnel Actions: Wages,working conditions,and employee with the unions,joint training programs aimed toward qualifying more
benefits shag be established and administered,and personnel actions minority,group members and women for membership in the unions and
of every type,including hiring,upgrading,promotion,transfer,demotion, increasing the slabs of minority group employees and women so that
layoff, and termination, ehalt be taken without regard to race,color, they may qualify for higher paying ernployment.
religion,w national origin.age or disability. The following procedures
shall be followed: b. The contractor will use best efforts to incorporate an EEO
clause Into each union agreement to the end that such union will be
a.The contractor win conduct periodic irtspeeWm of project sftes contractually bound to refer applicants without regard to their rake,col-,
to Insure that vrorking conditions and employee facilities do not kK kite religion,sex,national origin,age or disability.
discriminatory treatment of project site personnel.
c. The contractor is to obtain information as to the referral
b. The contractor will periodreatly evaluate the spread of wages practices and policies of the labor union except that to the extent such
paid within each classffic:edon to determine any evidence of discrimbna- information Is within the exclusive possession of the labor union and
IM wage practices. such labor union refuses to fumish such Information to the contract-,
Me contractor shall so certify to the SHA and shall set forth what efforts
have been made to obtain such information.
Page 2
d. In the event the union is unable to provide the contractor with M, NONSEGREGATED FACILITIES
a reasonable flow of minority and women referrals within the time limit
get forth in the collective bargaining agreement,the contractor will, (Applicable to all Federal aid-construction contracts and to all related
through independent ro«ultmeM efforts,fill the employment vacancies subcontracts of$10,000 or more.)
without regard to we, color. religion, sex, natlonai origin, age or
disabW,,makkgfulleoatoobtain qualified and/or qualifiable minority a. By submission of this bid, the execution of this contract or
group persons and women. (The.DOL has held that a shell be no subcontract,or the consummation of this material sup pty agreement or
excuse that the union with which the contractor has a collective purchase oder,as appropriate,the bidder.Federal-old construction
bargaining agreement providing for exclusive referral failed to refer contractor,subcontractor,material supplier,or vendor,as appropriate,
rrdnordy employees) in the evert the urhion referral practice prevents certifies that the firm does not maintain or provide for its employees any
the contractor from mooting the obligatlau purauant to Executive Order segregated facNtdes at any of its establishments,and that the firm does
11248,as amended,and these special provisions,such contractor shall not permit its employees to perform their services at any location,under
Immediately notify the SHA - its control,where segregated fadfities are maintained. The firm agrees
that a breach of this certification is a violation of the E£0 prowsions of
8. Selection of Subcontractors.Procurement of Matertals and this contract: The firm further certifies that no employee will be denied
Lee"of Equipment: The contractor shall not discriminate on the access to adequate facilities on the basis of sex or disability.
grounds of race,color,religion,sex,national origin,age or disability in
the selection and retention of subcontractors,including proaxernent of b. As used in this certification,the term'segregated facilities"
materiels and teases of equipment means any waiting rooms, work areas, restroome and washrooms,
restaurants and other eating areas,tirnectodts,locker rooms,and other
a. The contractor shad notify all potential subcontractors and ataraga or dressing areas,parking lobs,drinking fountains,recreation or
suppliers of h,;amer EEO obligations under this contract. entertainment areas,transportation:and housing facilities provided for
employees which aro segregated by explicit directive,or are,in fact,
b. Disadvantaged buslness enterprises(DBE),as defxmd In 49 segregated on the basis of race,color,religion,national origin,age or
CFR 23, shall have equal opportunity to compete for and perform disability, because of habit, focal custom, or otherwise. The only
subccntraeta which the contactor enters Into pursuant to this contract exception will be for the disabled when the demands for accessibility
The contractor YA use its treat efforts to solicit bids from and to utilize override(e.g.disabled parking).
DBE suboor+treCtors or subcontractors with mawkWul rw>oity group
and fatnats representation among their employees. Contractors Shari- c. The Contractor agrees that it has obtained or will obtain
obtain lists of DBE eorntnictlon firms from SHA personnel. identical certification from proposed subcontractors ormatwistsuppOws
prior to award of subcontrscts or consuirAntion of material supply
c.The cottrador wwid use his beat aftots to ensure subcontractor agreements of S t 0,000 or more and that twill retain such certifications
compliance with their EEO obligations. In Its ties.
9. Records and Reports: The contractor shad keep such records ,
as nary to dowrot corrollance with the EEO requirements. IV. PAYMENT OF PREDETERMINED MIMMUM WAGE
Such records std be retairied for a period of three years following
completion of to contract worts and shall be available at reasonable (Applicable to ell Federat-ald construction contracts exceeding
times and places for inspection by authorized representatives of the $2,000 and to all rebated subcontracts,except for projects located on
SHA and the FHWA. roadways classified as local roads or rural mirror oollectos,which are
exempt.)
a. The records kept by the contractor shad document the
following: t. General:
(1)The number of minority and non-mhrorky group members a.All mechanics and laborers employed or vrortdng upon the site
and women employed in each wok dassiflcatton on the prged; of the work will be paid urmnditionady and not less often than once a
week and without subsequent deduction or rebate on any account
(2)The progress and efforts being made in cooperation with jexoW such payroll deductions as are permitted by regulations(29 CFR
unions, when applicable, to Inuease employment opportunities for 3)Issued by the Secretary of Labor under the Copeland Ad(40 U.S.C.
mou rifles and woman, 275c))the full amounts of wages and bona fide fringe benefits(or cash
equivalents thereof)due at time of payment. The payment shall be
(3) The progress and efforts being made In loafing,tiuvig, computed at wage rates not less than those contained in the wage
training,qualifying,and upgrading minority and female employees:and determination of the Secretary of Labor(herelnefter"the wage detcrmF
nation')which is ached hereto and made a part hereof,"rdiess of
(4) The progress and efforts being made in securing the any contractual relationship which may be alleged to exist between the
services of DBE subcontractors or subcontfactors wlth meaningful contractor or its subcontractors and such laborers and mechanics.The
minority and female representation among their employees. wage determination(maludhig any additional dasssftcations and wage
rates conformed under paragraph 2 of this Section IV and the DOL
b. The contractors will submit an annual report to the SHA each poster(WH-1321)or Farm FHWA-t 495)shatl be posted at all times by
July for the duration of the project,indicating the number of minority, the contractor and ds subcontractors at the site of the worts In a
women,and non-minority group employees currently engaged In each prominent and accessible place where it can be easily seen by the
wok classification required by this contras!wort. This Information Is to workers. For this purpose of ttta Sectton,contributions made or costs
be reported on Form FHWA-1391. If orn-the-Jab training Is being reasonably anticipated for bona fide fringe berefts under Seaton
required by special provision,the contractor will be required to ccliect t(b)(2)of the Davis-Bacon Act(40 U.S.C.276a)on behalf of laborers
and report trairdng data. or mechanics are considered wages paid to such laborers or mechan-
ics,subject to the provisions of Section IV,paragraph 3b,hereof. Also,
for the purpose of this Section, regular conttibutions made or costs
incurred for more than a weekly period(but not Less often than quarterly)
under plans, funds, or programs,which cover the particular weekly
period,are deemed to be constructively made
Page 3
or incurred durhng such weekly period. Such laborers and mechanics from the first day on which work is performed in the classification.
shall be paid the appropriate wage rate and fringe benefits on the wage
detarminatim for the classification of work adualy performed,without 3. Payment of Fringe Benefits:
regard to skill,except as provided In paragraphs 4 and 5 of this Section
IV. a. Whenever the minimum wage rate prescribed in the contact
for a Gass of laborers or mechanics includes a fringe benefit which is
b. Laborers or mechanics performing work In more than one not expressed as an hourly rate,the contractor or subcontractors,as
Gassfficatlon may be compensated at the rate specified for each appropriate,shall either pay the beneM as stated In the wage determina-
cla"ditcation for 0%time achaally waited therein, provided,that the tion or shag pay another bona fide fringe benefit or an hourly case
employer's payroll records accurately set forth the time spent In each equivalent thereof.
classification in which work is performed.
b. if the contractor or subcontractor,as appropriate,does not
c. Alf rulings and interpretations of the Davis-Bacon Act and make payments to a trustee or other third person,he/she may consider
related acts contained in 29 CFR 11,3,and 5 are herein incorporated by as a part of the wages of any taborer or mechanic the amount of any
reference to this contract. costa reasonably anticipated In providing bona fide fringe benefits under
a plan or program,provided,that the Secretary of Labor has found,upon
2. Ctas sification: the written request of the contractor,that the applicable standards of the
Davis-Bacon Ad have been met The Secretary of Labor may require
a_ The SHA contracting officer shall requite that any clase of the contractor to set aside in a separate account assets for the meeting
laborers,or mechanics employed under the contract,which is not listed of abligatiore under the plan or program.
in the wage determination,*wU be classified In conformance with the
wage determination. 4. Apprentices and Trainees(Programs of the U.S.OOL)and
Helpers:
b. The contracting officer shall approve an addpional clasaffies-
tian,wage rate and fringe benefits only when the following entam have a. Apprentices:
been mat
(1) Apprentices will be permitted to work at less than the
(1) the wank to be performed by this adMWW GasWlcatlon pradetemmied rate for the work they performed when they are employed
requested is not performed by a classification in the wage determination; punsuatt to and r4rodually registered in a bona fide apprenticeship
program regWersd with the DOL,Empbymerl and Training Adrmimistrs-
(2) the additional classification Is utilized In the area by the tion,Bureau of Apprenticeship and Training,or with s Stale apprentice-
construction industry; ship agency recognized by the Bureau,or if a person Is employed In
his/her fust 90 days of probationary employment as an apprentice in
(3) the proposed wage rate,including my bore fide hMe such an apprenticeship program,who is not individually,registered in the
berteffts,bears a reasonable relationship to the wage tabs contained in program.but who has been certified by the.Bureau of Apprenticeship
the wage determination;end and Training or a Stade aipprenfusstilp agency(where appropriate)lobe
eligible for probationary employment as an apprentice.
(4) with respect to helpers, when such a classification
prevails in the area in which the work is performed. (2) The allowable ratio of"VeMices to journeyman-level
employees on the job site in any craft classification shiers not be greater.
c.ifths contractor or subcontractors.as appropriate.the laborers thein the ratio permitted to the contractor as to the entire work force
and mechanics(if known)to be employed in the additional clasetfication under the negistered program. Any employee fisted on a payroll at an
or their representatives, and the contracting afitcer agree on the apprentice wage rate,who is not registered or otherwise employed as
ctasarficabon and wage rate(mciuding the amour/designated for fringe stated above,shall be paid not less than the applicable wage rate Wed
benefits where appropriate),a report of the action taken shag be sent by in the wage detemnination for the classification of work actually per-
the contracting officer to the DOL.Administrator of the Wage and Hour formed. In additiorn,any apprentice performing work on its job site in
D'r vision, Employment Standards Adminretration, Washington, Q.C. excess of the ratio permitted under the registered program shag be paid
20210. The Wage and f•lourAdministrator,or an authorized represents- not lead than the applicable wage rats on the wage determination for the
tive,will approve,modify,or disapprove every additional classification work actually performed. Whore a contactor or subcontractor is
action within 30 days of receipt and so advise the contrac&V officer or performing construction an a project in a locality other than that in which
will notify the contracting officer within the 30-day period that additional Its program is registered, the ratios and wage rates (expressed in
time is necessary. percentages of the pumeyman-levet houry rate) specified in the
conlractoe's or subcw**does registered program shall be observed.
d. In the event the owrtraetor or subcontractors,as appropriate,
the laborers or mechanics to be employed len the additional classification (3) Every apprentice must be paid at not lead than the nate
or their representatives,and the contracting officer do not agree on the specified In the regidetad program forthe apprehtice's level of progress,
proposed dassificadion and wage rats(including the amount designated expressed as a percentage of the journeyman-level hoary rate specified
for hinge benefits,where appropriate),the contracting officer shall refer in the applicable wage determination. Apprentices shall be paid fringe
Me questions, inctudmg the views of sit interested parties and line benefits in accordance with ttne provisions of the apprenticeship
recommendation of the corlracting officer, to the Wage and Hour program.Iftheapprenticeshipprogram does net specify fringebenefils.
Administrator for detemnimabon, Said Admilstrotot,or an su wkeed apprenticed,must be paid the fun aroma of fMnge benefits fisted on the
represenhOve,will issue a determination w RtM 30 days of receipt and wage determination for the applicable classification.Ifthe Administrator
so advise the contracting officer or will notify the contracting officer for the Wage and Hour Division determined that a different practice
within the 30-day period that additional time is necessary prevails for the spoicable apprentice classification,ftirges shad be paid
in accordance with that determination.
e. The wage rate(including fringe berients wheis approprfats)
determined pursuant to paragraph 2c or 2d of this Section IV shag be
paid to all workers performing work In the additional classification
Pap A
(d) In the symt the Bureau of Apprenticeship and Tralning, 6. Wtthhoidin9:
or a State apprenticeship agency recognized by the Bureau,withdraws
approval of an apprenticeship program,the contractor or subcontractor The SHA shall upon as own action or upon written request of an
will no longior be permitted to utilize apprentices at less flan the authorized representative of the DOL withhold,or cause to be withheld, ----
oWnable pnedstennined rate for the comparable work performed by from the contractor or subcontractor under this contract or any other
regular employees until on acceptable program is approved. Federal contract with the same prime contractor,or any other Federally-
assisted contract subject to Davis-Bacon prevailing wage requirements
b. Trainees: which is held by the same pnme contractor,as much of the accrued
payments or advances as may be cowdered necessary to pay laborers
(1) ExcW as provided in 29 CFR 536.6.trainees wAl not be and mechanics,including apprentices,trainees,and helpers,employed
permitted to work el less than the predetermined rate for the wok by the contractor or any subcontractor the full amount of wages required
performed unless they are amptaim pursuant to and individually by the contract. In the event of failure to pay any taborer or mechanic,
registered in a program which has received prior approval,evidenced by including any apprentice,trainee,or hetper,.employed or working on the
formal certification by the DOL;Employment and TraiNng Atlrrtinistra- site of the work,all or pet of the wages required by the contract,the
tion. SHA contracting officer may,after written notice to the contractor,take
such action as maybe necessaryto cause the suspension of any further-
(2) The rano of trahu*e to)ouuneymafWwel employees on payment, advance, or guarantee of funds urhrili such violations have
the job ads shsA not be greeter than permitted under the plan approved ceased.
by the Employment and Tralr ft Admh4stro0on. Any employee listed
on the payroll at a trainee rate who Is not registered and participating in 7. Overtime Requirements:
a treintng Flan approved by the Employment and Training Admirvatration
shad be paid not less than the applicable wage rate on the wage determi- No contractor or subcontractor contracting for any part of the
nation for the classification of work actually perforrmd. In addition,any contract work which may require or involve the employment of laborers,
traln is pedormming work an the job sift in excess of the ratio permitted mechanics,watchmen,or guards(including apprentices.trainees,and
under the registered program shad be paid not less than the applicable helpers described M paragraphs d and 5 above)shall require or permit
wage rate on the wage determination for the work actually performed. any taborer,mechanic,watchman,or guard in any workweek In which
he/she Is employed on such work,to work in excesa of 40 hours in such
(3) Every trainee must be paid at not less than the rate workweek unless such taborer,mechanic,watchman,or guard receives
specified in the approved program for hWw level of progress. compensation it a rate not less Chan one-and-onofiatt times"4w
e:peseed as a percentage of the)oumeyrh level hourly rata spactfled basic rate of pay for all hours worked in excess of 40 trocars in such
In the appticable wag* deWminat(on. Trainees shad be paid fringe workweek.
b" to In accordance with the provisions of the trainee program. H Me
trainee program does not mention fringe benefits,trainees shall be paid
the full amount of fringe benefits listed on the wage determination unless S. Violation:
.the Admhvstrator of the wage and Har Division determines that there
is an apprerft"hIp program associated with the corresponding Liability for Unpaid Wages;Liquidated Damages: In the event of
wage rate on the wage determlnatton which provides any violation of the clause set forth in paragraph 7 above,the contractor
for less than full Mrge bene is for apprentices,in which case such and any subcontractor responsible thereof shoe be liable to the affected
trahiees shall receive the same fringe berteflte as apprentices. employee far his/her unpaid wages. In addition,such contractor and
subcontractor shad be liable to the United States(in the case at work
(4)In the event the Employment and Training Administration done under comract for the District of Columbia or a territory.to such
withdraws approval of a training program.the contractor or suhcontrau} District or to such territory)for kquidated damagst. Such liquidated
for rill no longer be pemdttecito utilize trainees at leas than the applica- damages shad be computed with respect to each individual taborer.
ble predeterm(ned rate for the wok performed until an acceptable mechanic,watchman.or guard employed in violation of the clause set
program Is approved. forth in paragraph 7,in the sum of$10 for each calendar day on which
such employes was required or permitted to wait In excess of the
c. Helpers: standard work week of 40 hours without payment of the overtime wages
required by the clause set IoM in paragraph 7.
Helpers will be permitted to work on a project If Ce helper
ciasaffkation is specIfiedanddefinad on the applicable wage determine- 9. Withholding for Unpaid Wages and Ligiddated Damages:
tin or Is approved pursuant to the conformance procedure sat forth in
Section IV.2 Any worker Rated on a payroll at a helper wage rate,who The SHA shall upon its own action or upon written request of any
is mot a helper under a approved definition,ahafl be paid not less than authorized represerdstive of the DOL withhold,or cause to be withheld,
the applicable wage rate on the wage determination for the clasaiticahon from any monies payable an account of work performed by the contrac-
of wok actually performed. for or subcontractor under any such contract or any otter Federal
contract with fie some pr(me contractor,or any other Federally-assisted
S. Approttttc*s and Trainees(Prograrns of the U.S.DOT): contrect subject to the Contract Work Hours and Safety Standards Act,
wtdch is held by the some prime contractor,such sums as may be
Apprentices and trainees working under afrprenCcestup and skin determined to be necessary to satisfy any IfebcTitles of such contractor
training programe which have bean certified by the Secretary of or subcontractor tux unpaid wages and tiquidated damages as provided
Tronsportltiom as promoting EEO in connectiorh rrtth Federal-eld m the clause set font in paragraph 8 above.
hhghhaay coratruMon progrims are nrot subject to the requirements of
paragraph 4 of this Section IV. The straight time hourly wage rates for
appn>rntices and katness trader such programs will be established bythe V. STATEMENTS AND PAYROLLS
particular programs. The rata of apprentices and trainees to journey-
man shall not be grestaf then permitted by the terms of the paAkAAw (AppimbletoaliFederai-aidconstruction contracts exceeding S2,000
program. and to all related subcontracts,except for projects located on roadways
classified as local roads or ural collectors,which are exempt.)
PpaS
1. Compliance with Copeland Regulations(29 CFR s): (3)that each taborer or mechanic has been paid not less that
the applicable wage rate and fringe benefits or cash equivalent for the
The contractor shall ow"with the Copeland Regulations of the classification of worked performed,as specified in the applicable wage
Secretary of Labor which are herein incorporated by reference. determination incorporated Into the contract.
2 Payrolls and Payroll Records. e.The weekly submission of a property executed certification set
forth on the two-se side of Optional Form WH-347 shall satisfy the
a. Payrolls and basic records rek&V thersto shall be main- requirement for submission of the"Statement of Compliance"required
tained bythe contractor and each subcontractor during the course of the by paragraph 2d of this Section V.
wc*and preserved for a period of 3 years from the data of completion
of the contract for all laborers, mechanics, apprentices, trainees, I. The falsification of any of Ute above certifications may subject
watchmen,helpers,and guards working at the site of the work the contractor to civil or criminal prosecution under 18 U.S.C.1001 and
31 U.S.C.231
b. The payroll records shag contain the name,social security
member, and address of each such employee; his or her correct g. The contractor or subcontractor shall make the records
Classification;hourly rates of wages paid(Including rates of eontribu• required under paragraph 2b of this Section V available for inspection,
tions or costs anticipated for bona ride frhtge benefits or cash equivalent copying,or transcription by aut ortzed representatives of the SHA,the
thereof the types described in Section I(b)(2)(B)of the Davis Bee-on FHWA,or the DOL,and shah permit such representatives to interview
Act);daily and weekly number of hours worked;deductions made;and employees during working hours on the job. If the contractor or
actual wages paid. In addition,far Appalachian contracts,the payroll subcontractor!sits to submit the required records or to niake them
records shag contain a notation tridicating whether the emp"Wee, available,the SHA,the FHWA,the DOL,or ail may,after written notice
or does not,normally reside In the labor area as defined in Attachmert to the contractor,sponsor,applicant,or owner,take such actions as
A,paragraph 1. Whenever the Secretary of Labor,pursuant to Section may be necessary to cause the suspension of any further payment,
IV,paragraph 3b,has found that the wages of any laborw or mechanic advance,or guarantee of funds. Furthermore,failure to submit the
include the amount of any casts reasonably anticipated in l rovid ng required records upon request or to make such records available may
benefits under a plan or program described In Section I(bn(B)of the be gfoumda for debarment action pursuant to 29 CFR 5.12.
Davis Bacon Act,the contractor and each subcontractor shag maintain
records which show that the commitment to provide such bereft is
enforceable,that the plan or program is financially responsible,that the Vt. RECORD OF MATMUALS,SUPPLIES,AND LABOR
plat or program has been communicated in writing to the laborers or
mechanics adected,and show the cost anticipated or the actual cost 1. On all Federal-aid contracts on the National Highway System,
Incurred in providingbereft.Contractors or subcontractors employtng. except those which provide solely for the installation of protective
apprentices of trainees carder approved programs stag maintain wrtiten devices at railroad grade crosstrgs,those wltfch are constructed on a
evidence of the reg'rsh oW of apprentices and trainees,and ratios and farce accourtt or direct labor basis,highway beautification contacts,and
wage rates prescribed in the applicable programs. contracts for which the Mfal,Ural construction cost for roadway and
bridge is less than$1,000,000(23 CFR 833)the contractor strap:
c. Each contractor and subcortractor shell fumish,each week in
which any contract worts Is pertormed,to the SHA resident engineer a s. Become familiar with the flat of specific materiels and
payroll of wages paid each of its employees(Including apprentices, supplies contained in Form FHWA-47,"Statement of Materials and
trainees,and helpers,described in Section IV,paragfaphs.4 and 5,and Labor Used by Contractor of Highway Construction involving Federal
watchmen and guards engaged on work during the preceding weeldy Funds,"prior to the commencement of work wider ties contract.
payroll period). The payroll submitted shag set out accurately and
completely all of the Information required to be maintained under b. Maintain a record of the total coat of sp materials and supplies
paragraph 2b of this Section V. This inforrrotion may be submitted in purchased for and incorporated In the work,and also of the quantities
any form desired. Optional Form WH-3347 Is available for Unis purpose of those specific materials and supplies fisted on Form FHWA-47,and
and may be purchased from the Superintendent of Documents(Federal in the units shown on Form FHWA-47.
stock number 0294 )5-00141), U.S. Government Pftfng Office,
Washington.D.C.20402. The prime contractor is responsible for the e, Furnish,upon the completion of the contract,to the SHA
submission of copies of payrolls by all subcontractors. resident engineer on Form FHWA-47 together with the data required in
paragraph t b relative to materials and supplies,a final labor summary
d. Each payroll submitted shall be accompanied by a"Statunertt of all contract wok indicating the total hours worked and the total
of Compliance,"signed by the contractor or subcontractor or hialhen amount earned.
agent who pays or supervises the permit of the persons employed
under the contract and shag certify the fotbwing: 2. At the prime contractor's option,either a single report covering ail
contract worts or separate reports for the contractor and for each
(1) that the payroll for the payroll period contains the subcontract shall be submitted.
infarnation required to be maintained under paragraph 2b of this Section
V and that such information is correct and complete;
Vie. SUBLETTING OR ASSIGNING THE CONTRACT
(2)that such laborer or mechanic(including each helper,
apprentice,and trainee)employed on the contract during the payroll 1 The corttactor shall perform with its own organization contract
period has been paid the fug weeklywages earned,without rebate,either work amoutrtig to not less than 30 percent(or a greater percentage if
directly or Indirectly,and that no deductions have been made either specified elsewhere in the contact)of the totat original contract price,
directly or indirectly from the full wages earned,other than permissible excluding any specialty Rema designated by the State. Specialty items
deductions as set forth in the Regulations,29 CFR 3; may be performed by subcontract and tete amount of any such specialty
Rema performed may be deducted from the total original contract price
before computing the amount of work required to be performed by the
contractor's own organization(23 CFR 635).
vny.e
A. "Its own organization" shall be construed to Include only engineers,contractors,suppliers,and workers on Federal-aid nhghway .:
workers employed and paid directly by the prime contrectot and projects, d is essentiat that all persons•concerned wdh the project
equfpri*M owned or Forted by the pane contractor,with or without perforin their functions as carefully, thoroughly, and honestly as
operators. Such term does net ksolude amployeos or equipment of a possible. Willful falsification, distortion, or misrepresentation with
subcontractor,assignee,or agent of the prime contractor. reaped to arty facts rotated to the ptojed is a violation of Federal law.
To prevent any misunderstanding regarding the sariousness of these
b. -Specialty Items"shall be construed to be limited to work that and anular ads,the following notice shag be posted on each F ederal-aid
requires highly specialized knowledga, abititiaa, or equilxnert not highway project(23 CFR 635)in one or more places where d is readily
ordirwrily avaltsble in the type of contracting orgentzatfans qualified and available to all persons concerned with the project.
aspected to bid on the cortnct as a whole and in general are to be
limited to minor corr"wrts of the overall contract.
NOTICE TO ALL PERSONNEL ENGAGER ON FEDERAL-AID
2. The contract amount upon which the requirements set forth In HIGHWAY PROJECTS
paragraph 1 of Section Vhf is computed includes the cost of material end
manufactured products which are to be purchased or produced by the 18 U.S.C.1=nods at follows:
oortractar under the contract provisions.
'Wiroshror fraby an officer.agent,orenVoyee of Me United States,
3. The contractor shall furnish(a)a competent superintendent or orof any Stare or rarntory,orwrheever,whether s penton,assodation,
supervisor who is employed by the firm, has full aufhor`dy to direct Arm. or coporedon, knowingfy makes any false statement, false
performance of the work In accordance with thio contract requirements. ropnsentsdon.or False report as to the character,quality,quenbly,or
and is In charge of all construction operations (regardless of who Cost of the metariat used or to be used,or the quanta or quality of the
performs the work) and (b) such other of Its own organizationsl work perforated or to be pertbmred.or the cast thereof it connection .
resources(supervision,managemont,and ongfreoring services)as the with Che suorntseton of piens,maps,specitfcadons,contracts,or costs
SHA contracting officer determines is necessary to assure the Wor- afconstruceananany highway orrelatedprojectsubmfttedforapproval
mance of the owftct. to Ma Secretary of TranspoRetkn;or
4. No portion of the contract shag be sublet,assigned or otherwise Whoeverknowfn0rnakss anyfelse statement Miss representation,
disposed of except with the written consent of the SHA contracting false ropoff or !else daunt wo respect to the character, quadry,
offlcaf,or authorized reprssent>atve,and such ronaert when given shall quanlity,or cost of any work performed onto be pedomied.ormetedefr
not be construed to rafiwa Me contractor of any responait 4 for the furnished or to be Famished.in ootfnocftn wkh the constrt ton of any
luffigmeM of the contract. Written consent will be given only after the hV wayorroWedpraled approvedbyfhe So tirtoryof irarrspoRat)oA
SHA has assured that each subcortred Is"Wenced in writing and that or
tt contains all partinert provisions and requiniments of the prime
contract. Whoever knowfngfy makes any lilts staferrnrif or False nepre`
santedon as to mate"fact in any sfaterrNmt. cordffcate, or report
submitted pursuant to provision of*the Federo4aM Roads Act
VW. SAFETY:ACCIDENT PREVENTION approved July 1,1916,(39 Stat.355).as amended and supplemented
1.to thio perforrt»nce of Oft contract the contractor shall cottpiy with She#be snot not mors tW$10,00 or imprisoned not more than 5
ail applicable Federal,State,and local laws goaea tnq safety,health,and years or both.'
Bard lalkm(23 CFR 835). The contactor shall provkM all safeguards,
safety devices and protective equipment and take any other needed X, IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL
actions as R detemdrdes, or as the SHA contracting officer may !NATER POLLUTM CONTROL ACT
delmmhte.to be reasonebty necessary to protect the life and health of
smployeesonthe job and the safety of the public and to protect pr+ ry (Applicable to all Federal-aid cohstrudion contracts and to all related'
in connection with the performance of the work covered by the cortred. subcontracts of 2100,000 or more)
2. R Is a condition of this contract,and shag be made a corumton of By submission of this bid or the execution of this contract or sutcon-
each subcontract,which the contractor orders Into pursuant to this tract,as appropriate,tie bidder,Padetal-old construction contractor.or
contract,that thecotractor and any sul=rtrador shall riot permit any eubconbsctor, as appropriate,will be deemed to have stipulated as
amptoyes,In performance of the contract,to work In surroundings or Mews:
under conditions wWh are unsanitary, hazardous or dangerous to
Mager health or safety,as determined under corstrucbm safely and 1. That any fscilAy that is or will be utilized In the perfomance of this
health standards(29 CFR I 9 promulgated by the Secretary of Labor, contract.untees such nordtract Is exempt under the Clean Air Act,as
In accordance with Section 107 of the Contract Work Hours and Safety amended(42 U.S C.1857 et M.,as amended by Pub.l.lit-WAI),and
Standards Act(40 U.S.C.333). under the Federal Water Pdlution Control Act,as amended(33 U.S.C.
1251 at sent.,as amended by Pub.L.92-500),Executive Order 11738,
3. Pursuant to 29 CFR 1828.3,It is a eondttlon
of this contract that and regulations in impiementation thereof(40 CFR IS)is not listed,on
the Secretary of Labor or autrrortzed representative thereof,shag have the date of contract award, on the U.S. Environmental Protection
right of entry to any aIle of contact performance to Inspect or investigate Agency(EPA)List of Violating Facilities pursuant to 40 CFR 15.20.
the matter of compliance with the consbucWn safety and health
standards and to carry out the duties of the Secretary under Section 107 2 That the firm agrees to comply and remain in compliance with of fire
of the Contract Work Hours and Safety Standards Act(40 U.S.C.333). requirements of Section 114 of the Clean Air Ad and Section 306 of the
Federal Water Pofludion Control Ad and all regufatiam and guidelines
Wed thereunder.
IX. FALSE STATEMENTS CONCERNWO HIGHWAY PROJECTS
3. That the firm shall promptly notify the SHA of the receipt of any
In order to assure hNgh quality and durable construction in conformity comma kation from the Director, Office of Federal Activities, EPA,
with approved plans and specifications and a high degree of reflabdity on mdkxrtng that a factilty that Is a will be uftzed for the contact is under
statements and representations mode by consideration to be listed on the EPA List of Violating Facilities.
Page 7
i
4. That the fine agrees to include or cause to be included the require- frequency by which it determom the eligibility of Ks principals. Each
inerts of paragraph 1 through 4 of this Sedlon X in every nonexempt participant may, but is not required to, check the nonprocurement
subcontract,and further agrees to take such.action as the government. portion of the"Lists of Parties Excluded From Federal Pmeurement or
may dirvat as a meansof enforcirig such requirements. Nonprocurarrim Programs'(Nonprocurement List)which is compiled
by the General Services Administration.
7U. CERTIFICATION RIIEGARDING DEBARMENT,SUSPENSION, i.Nothing contained In the foregoing shag be construed to require
INELIG181LITY AND VOLUNTARY EXCLUSION establishment of a system of records in order to render in good faith the
certification required by this clause. The knowledge and information of
1. Iruitruct>ions tar Certification-Primary Covered Transac- participant is not required to exceed that which is normally possessed
tions: by a prudent person in tri ordinary course of business dealings.
(Applicable to all Fader 4d-contracts-49 CFR 29) - j. Except for transactions authorized under paragraph f of these
instrudione,it a participant In a covered transaction knowingly enters
a. By signing and submitting this proposal, the prospective into a lower tier covered transaction with a person who is suspended•
primary participant is providing the certifitcation set out below. debarTed, ineligible, or voluntariy,excluded from participation in this
transaction. In addition to other remedies available to the Federal
b. The Inability of a person to provide the certification set out Government,the department or agency may terminate this transaction
below will not necessarily result in denial of pancipation in this covered for cause or default.
transaction. The prospective participant small submit an explanation of
why it cannot provide the certification not out below. The certification or •.
explanation will be considered in.connecdon with the department or
agency's ddernination whetner to enter into V*transaction.However, Certtficatfon Regarding Debarment,Suspension,Inellgibdfiy
failure of the prospective primary participant to famish a certification or and Voluntary Exetusion—Primary Covered Transactions
an expisnation shaft disqualify such a person from penfcipation in this
transaction. 1. The prospective primary participant certifies to the best of its
knowledge and befief,that It end Its principals:
c. The certification in this clause Is a material representation of
tact upon which reliance was placed when the department or agency a. Are not presentty debarred, suspended, proposed for
determined to enter into this transaction. If 9 Is Mier deterr fined that the debarment, declared ineligible,or voluntarily included from covered
prospective primary pant lamvrkgly rendered an eminaous transactions by any Federal department or agent
certification, in addition to other remedies available to the Federal
Gov t,the department or agency may Wirmi ate this tra tsection b. Have net whit.a 3-year period preceding Itis proposal been
for cause or default convicted of or hod a ctW judgement rendered against them far
cornmission of fraud or a crurynel offense in connection with Obtaining.
d. The proapective primary participant shag provide Immediate . attentp*g to obtain,or performing a public(Federal,State or tical)
written notice to the depatimont a agency to whom this proposal is transaction or contrect under a public transaction:violation of Federal or
submitted if arty time the prospective primary participant lesms that lea State antitrust statutes or commission of fit,theft,forgery,
certiflcetlon was erroneous when submitted or has become erroneous bribery,falsification or destruction of records,malting false statements,
by reason of changed circumstances. or receiving stolen property.
a- The terms"covered transaction,""debarred,"'suspended:
"Ineggible; "lower tier covered transaction," "participant," "person,' c. Are rot presently indicted for or otherwise criminally or civilty
"primary covered transaction,""pnnc#W, 'proposal,"and"voluntargy charged by a governmental entsy(Federal,State or local)with commis-
excluded:as used In this clause.have ft mean"set out in the sion of any of the offenses enumerated In paregtaph I of this cedifica-
Definitions and Coverage sections of rules hnplementing Executive tion;and
Order t 2549. You may contact the department or agency to which this
proposal is submitted for assistance in obtaining a copy of those d. Have not within a 3-year period preceding this applice-
regulations. tionlpmposst had one or more public transactions(Federal,State of
local)tsrmnnated for cause or default.
f. The prospective primary participant agrees by submitting tNa
proposal that,shouid the proposed covered transaction be entered Into, 2. Where the prospectiveprimary is unable to certify to
d sh all not knowingly enter into any lower tier covered be. ction warn any of the statermrits�'s ceRiticatb such tprospecttve participant
a person who is debarred,suspended,declared ineligible,u voluntarily shall attach an explanation to this proposal.
excluded from participation in this covered transaction,unless tutho-
rized by the department or agency enterlrng into this trensaclon. ....
9• The prospective primary participant bather agrees by 2. Instructions for Certification-Lower Tier Covered Transac-
submitting this proposal that it will include the elsu9e fitled'Certtfication tions:
Regarding Debarment,Susperision,IneGgibrldy and Voluntary Fxckaft,
Lower Tier Covered Transaction,'provided by Ikdepartment or agency (Applicable to all subcontracts,purchase orders and other lower tier
entering Into this covered transaction,without modillcation,In all lower haneactions of 325,0DD or more-49 CFR 29)
tler covered transactions and in all solicitations for lower tier covered
transactions. a. By signing and submitting this proposal,the Prospective lower
tlw is providing the certification set out below.
h. A participent in a covered transactlon may rely upon a
cediflcadon of a prospective parscipa tt in a lower tier covered transac-
tion that M not debarred,suspended,helWA,or volurtwily excluded
from Ise covered transaction,unless K knows that the certification M
erroneous. A participant may decide the method and
Page a
b. The certification in this clause is a material representation of Certification Regarding Debarment,Suspension,Ineligibility
fact upon which reliance was placed when this transaction was entered and Voluntary Exclusion—Lo*er Tier Covered Transactions:
into. If it Is later determined that the prospective lower ter pantdpant
knovftly rendered an wmneous certification, in addition to other 1.-The prospective lower tier participant certifies,by submission of
remedies available to the Federal Covemmsnt, the department, of this proposal,that neither it nor its principals is presendty debarred,
agency with which this transaction originated may pursue available suspended.proposed for debarment,declared inetigrble,or voluntarily
remedies,Including s asp xtalon srtdtor debarment. excluded from participation in this transaction by any Federal depe-
mend or agency.
e. The prospective lower der participant shall provide Immediate
written notice to the person to which this propyl Is submitted If at any 2. Where the praapedtw lower tier participant is unable to Centfy to
time the prospective lower tier participant Warns that its certification was any of the statements in this certification,such prospective participant
erroneous by reason of changed circumstances. shall attach an explanation to this proposal.
d. The terms'covered transaction,"'debarred,""suspended," - •• - -
"Ineligible,' "primery covered.transaction,' 'participant," 'person"
"prtncipak,"'propoesl,'end"volurrtattiyexclWed,'ssused i this clause, XIL CERTIFICATION REGARDING USE OF CONTRACT FUNDS
have the meanings set out It the Dentitions and Coverage sections of FOR LOBBYING
Mas Impiernenting Executive Order 12549. You may contact the
person to which Oft proposal is sutxNtted for assistance In obtaining a. (Applicableto all F Wnai-aid construction cortracts and to alt rented
copy of those regulations. subcontracts which exceed$100,000-49 CFR 20)
a.The prospective lower tier participant ogress bysubmfidngthis 1. The prospecf a participant certifies,by signing and subft Mng
p apaui that,should the proposed covered transaction be entered into, this hid or proposal,to Urs best of his or her kraMedge and bettaf,that:
9 shall not knovMgly enter into any lower tier covered transaction with
a person who to debarred,suspended,declared ineligible,or voluntarily a. No Federal appropriated funds have been paid or w+h be paid,
oxcweed from participation In this covered transaction.unless autho- by or on b*W of the undersigned,to any person for knfluenefng or
Azad by the department or agencywith which thistransection originated. attempting to influence an officer or employee of any Federal agency,a
Member of Congress. on officer or employes of Congress. or an
f. The prospective Iowa tier participant further agrees by employee of a Member a l.Congirsaa in emamctfon with the awarding of
submMitg this proposal that A wfil irtdude ttds clause titled"Cerbfication any Federal contract,the making of any Federal grant,the nuking of any
Regal Susper ion,IteWtiNtyandVoluntaryEtxhraion- Federal loan,the entering Into of any cooperative agreement,and the
Lower Tler Covered Transaction;without modification.In all lower tier extension,corthmboR renewal, amendment,or modification of any
covered Canadian end In dl solicitations for lower tier covered Federal contract,grant.ban,or cooperative agreement.
transections.
b. If any funds otter than Federal appropriated funds have been
g. A participant in a covered hansacflon may rely upon a paid or will be paid to any person fdr influencing or attempting to
artlltcailon of a prospective participant in a lower tier covered transac- Influence an officer or employee of any Federal agency,a Member of
tion that is mat debarred,suapended,ineligible,or voluntarily excluded Congress,an officer or employee of Congress, or an employee of a
from Cie covered transaction.Mess it knows that the certification is Member of Congress in connection with this Federal contrad,grant,
erroneous. A paMGpant may decide the method and frequency by loan,or cooperative agreement,the undersigned shaft complete and
which 9 determines the sSgWty of its principals. Each participert may, submit Standard Form-LLL,"Disclosure Form to Report Lobbying,-in
but is not required to,check the Nanprocurement List accordance with its instructions.
h. Nothing contained In the foregoing shall be construed to 2. This eeAlFlcation is a material representation of fact upon which
require establishment of a system of morda in order to render in good reliance was placed when this transaction was made.or entered into
forth the certification required by this clause. The knowledge and Submission of Oft certification is a prerequialte for making or entering
inforration of participant is not required to exceed that which is normally into this transaction imposed by 31 U.S.C.1352. Any person who fails
possessed by a prudent person in the ordinary course of business to Ale tie required Certification shall be subject to a civil penalty of not
dealings. less than$10,000 and not more than$100,000 for each such failure.
I. Except for transactions sutiwrized under paragraph a of mese 3 The prospective participant also agrees by submitting his or her
inatructions.H a participant in a covered transaction knawmgty enters bid or proposal that he or she shall require that the language of this
Into a lower ter covered transaction with a person who is suspended, certification be included in all lower tier suboontrects,which exceed
debarred, ineligible, or voluntarily exetuded from participation in this $100,000 and mat all such recipients shall certify and disclose accord-
Kansaction, In addition to other remedles syndable to the Federal Nty
Govemmant, the departrnent or agency wtM which this transaction
orlgiruted may pursue available remedies,including suspension andlor
debarment.
Pop.9
ATTACHMENT A- EMPLOYMENT PREFERENCE FOR (c)the date on which he estimates such employees all be required,end
APPALACHIAN CONTRACTS (d)any other pertinent Information required by the State Employment
(Applicable to Appalachian contracts only.) Service to complete the job order form. The job order may be placed
with the State Employment Service in writing or by telephone. 11 during
1.During the perkirmance of this contract,the contractor undertaking the course of the contract work, the Information submitted by the
to do work which is,or reasonably may be,done ss on-site work,shall contractor in the original job order is substantiefly modified,he shalt
give preference to qualified parsons who regularly reelde in the labor promptly notify the State Employment Service.
area as designated by the DOL wherein the contract work Is situated,or
the subregion, or the Appalachian counties of the State wherein the 3. Then contraetar shall give fun consideration to an qualified job
contract wo*to situated,swept: applicants referred to him by the State Employment Service The
a. To Cite extent that qualified lo residing in the in is not required to grant employment to any job applicants who,
4 persons regu dy ng opinion,ars not qualW to perform the classification of work
area are not available. required.
b. For the reasonable needs of the contractor to employ 4. If, within 1 week following the placing of a job order by the
supennaory or specially experienced pwsonn.l necessary to assure an contractor with the State Employment Service,the Stats Employment
efficient execution of the contract work. Service to unable to refer any qualified job applrcaft to the contractor,
or less than the ry umber requested,the State Emptoymennt Service will
c. For the obligation of the contractor to offer employment to forward a certificate to ft contractor inclicating the unavaitabilty of
present or former employees as the result of a tawful collective bargain- applicants_ Such carttficate shag be made a part of the contractors
ing contract,provided that the number of nonresident persons employed permanent project records. Upon receipt of this certificate, the
under this subparagraph 1 c shag not exceed 2l)percent of the total contractor may employ peraone who do not normally reside in the labor
number of employees employed by the contrector on the contract work, area to fill positions covered by the certificate, notwMstanding the
except as provided in subparagraph 4 below. provisions of subparagraph t c above.
2. The contractor shall place a job order with the State Employment S. The coritrec tw shall include the provisions of Sections t through
Service indicating(a)the classification of the laborers,mechanics and 4 of this Attachment A In every subcontract for worts which is, or
atrw employees required to perform the contract work.(b)the number reasonably may be,done as onsite work.
of employees required In each clasw k stion,
Pago 10
City of Cape Girardeau
Project:Estimate(max 25 points)
For tracking purposes,if there are multiple schools benefiting from this grant, the estimate needs to be broken
out and detailed as to how the money will be distributed to each school on the Project Estimate Detail sheet. List
all items for the first school, leave a blank line between the first and second school,etc. Otherwise, an even
distribution will be assumed. The applicant will need to show total costs with this project including right of way
acquisition, design/preliminary engineering,utility relocations,materials costs, construction/labor costs,and
construction inspection on this page. This estimate shall not be increased in the future. There is a $20,000
limit per project.
Line Item Detail Quantity Item Cost Total Per Line SRTS Funds
Item Requested
1. Right of Way Acquisition 0 $0.00 $0.00 $0.00
2. Design/Preliminary
Engineering (No more than 1 $13,070.33 $13,070.33 $13,070.33
10% of items 3-5 below)
3. Utility Relocation 0 $0.00 $0.00 $0.00
4. Materials 1 $41,706.00 $41,706.00 $41,706.00
5. Labor/Construction 1 $88,997.25 $88,997.25 $88,997.25
6. Construction Engineering
(No More than 15% of items 1 $19,605.49 $19,605.49 $19,605.49
3-5 above)
7. Construction Contingency
(No More than 10% of items 1 $13,070.33 $13,070.33 $13,070.33
3-5 above)
TOTAL $176,449.40
Exhibit D
-
tt� E P
Mkr ¢ice arent Survey About�Walking andng toi SchgRV,4
?r:' _t>..,�z..: F �W
Dear Parent or Caregiver,
Your child's school wants to learn your thoughts about children walking and biking to school. This survey will take about 5 - 10 minutes to
complete.We ask that each family complete only one survey per school your children attend. If more than one child from a school brings a
survey home, please Fill out the.survey for the child with the next birthday from today's date.
After you have completed this survey, send it back to.the school with your child or give it to the teacher: Your responses will be kept
confidential and neither your name nor your child's.name will be associated with any results.
Thank you for participating in this survey!
+ SCAPI<TAL LETTERS ONLY' BIUE ORBLACKxINK ONLY t
School Name:
1.What is the grade of the child who brought home this survey? m Grade(PK,K,1,2,3...)
2.Is the child who brought home this survey male or female? 1:1 Male Female
3. How many children do you have in Kindergarten through 8u'grade? m
4.What is the street intersection nearest yourhome?(Provide the names of two intersecting streets)
and
�Pface'�a`�clear�X xinst�de box If ou make�a mistakes zftll>the enttre�boz;�and,#hen mark the c_o_r_r_ect box�_ ��
S.How far does your child live from.school?
11 Less than '/a mile 1/2 mile up to 1 mile More than 2 miles
E '%a mile up to 'f2 mile ® 1 mile up to 2 miles Don't know
Place a clear`X n'ir side bo If you make a mEstake fillYthe_enttre box,and then mask the coi rect f oxwoo +
6.On most days,how-does your child arrive:and leave.for school?(Select one choice per column,mark box with X)
Arrive at school Leave from school
Walk Walk
® Bike ® Bike
School Bus School Bus
0 Family vehicle(only children in your family) Family vehicle(only children in your family)
® Carpool.(Children from other families) Carpool(Children from other families)
Transit(city bus, subway, etc.) ® Transit(city bus,subway, etc.)
® Other(skateboard, scooter, inline skates, etc.) El Other(skateboard, scooter, inline skates, etc.)
♦ I xPlace a clear X'tiistde boz�If yourmake a mistake,fillthe entre b`ox and�then,mak the correct box Y� '= +
7.How long does it normally take your child to get to/from school?(Select one choice per column, mark box with X)
Travel time to school Travel time from school
Less than 5 minutes 0 Less than 5 minutes
E] 5— 10 minutes ® 5— 10 minutes
® 11 —20 minutes 11 —20 minutes
More than 20 minutes More than 20 minutes
Don't know/Not sure El Don't know/Not sure
+
8. Has your child asked you for permission to walk or bike to/from school in the last:.year? Yes No
9.At what grade would you allow yourchild to walk or bike.to/from school without an adult?
(Select a grade between PK,K,i,2,3...) grade (or) I would not feel comfortable at any grade
lace,a clear„X inside box,If you make a,�m�5take,fill the entire ybox,and�then mark the�correct:box�,�w;,� ,�;..
10.What of the following issues affected your decision to 11.Would you probably let your child walk or bike to/from
allow,,or not allow,your child to walk or bike to/from school if this problem were changed.or improved?(Select one
school?(Select ALL that apply) choice per line,.mark box with X)
My child already walks or bikes to/from school
Distance............................................................................:.:....:......................... 1:1 Yes n No n Not Sure
Convenience of driving..,.................................................................................. Yes No El Not Sure
Time.................................................................................................................. 0Yes No Not Sure
Child's before or after-school activities..............................................
Yes No Not Sure
Speed of traffic along route.............................................:...........................:...... Yes No Not Sure
Amount of traffic along route...............:..........................::..................:............ E] Yes No ® Not Sure
® Adults to walk or bike with.;......... ............... El Yes 11 No n Not.Sure .
Sidewalks or pathways..............................:....................................................... 0 Yes: 11 No ® Not Sure
11 Safety of intersections and crossings............................................................... El Yes El No 11 Not Sure
ElCrossing.guards.........................................................................................,....... 11 Yes No El Not Sure
11
Violence or crime.............................................................................................. 11 Yes El No ® Not Sure
Weather or:climate............................................................................................. ® Yes: El No El Not Sure
t NPlacea clear`X'a�i side box"If ouhmake a mistake fill the entire box;and then mark the correct liox ;.„ �z
12.In your opinion,how much does.your.chiId's school encourage or.discourage walking:and bikingto/from school?
® Strongly Encourages Encourages Neither Discourages. Strongly Discourages
13. How much fun is walking or biking to/from school for your child?
Very Fun Fun Neutral Boring Very Boring
14. How healthy is walking or biking to/from school for your child?
Very Healthy Healthy Neutral Unhealthy, Very Unhealthy
-F Place aclear`X'��nside box gIf you�make'a mistake,fill the enflre box;andgthen mrkthecorrect boxlN -}-
1.5.What is the highest grade oryearof school you completed?
Grades.1 through 8(Elementary) College. 1 to 3 years(Some college or technical school)
Grades 9 through 11 (Some high school) College 4 years or more(College graduate)
Grade 12 or GED(High school graduate) Prefer not to answer
16.Please provide any additional comments below.
+ G !G,!_/
,"', t v r ti r� z -j■T� -:i„ m ay;' 'i*Z a-.} _ <4 .2F
�S`��a�e -�O��eS�.vO� "av f fi''4. �� �:.3 � •i � � -��,. s^`��FJ
�' �x Sch�I�St�udents�Arr�ua'I��and a Departu red
- 4 = �£.1�YZ � F � .� „3,� t,,�z '��i�,y�} �b� �Y. �l£��g "�'h,�t-: ,Y.-t�'i-•-� �..t �.,/x x�r ,y r4��.� mac.
F- ���•F„x;.. x -..:.t,_�,.-�a>�_ _,.. .:. ,..e.=� F --^r. ,,..,`.;4fr'*..,-<.,>..,!g .��� .e,ti r �: �r>�� S.;f4�' ; i r � x y,
CAPITAL LEtTEFtS ONLYBAC
LUEOR,BLK}INKOPlLY, � �F Uml +
School Name: Teacher's First Name: Teacher's Last Name:
LJ
Grade: (PK,K,1,2,3...) Monday's Date(Week count was conducted) Number of Students Enrolled in Class:
m ID 1111 ® M
D 2 M M D D Y Y 1 r i 5
•Please conduct these counts on two of the following three days Tuesday,Wednesday,or Thursday.
(Three days would provide better data if counted)
• Please do not conduct these counts on Mondays or Fridays.
•Before asking your-students to raise their hands, please read through all possible answer choices so they will know their choices. Each
Student may only answer once.
•Ask your students as a group the question"How did you arrive at school today?"
•Then, reread each answer choice and record the number of students that raised their hands for each. Place just one character or
number in each box.
*-Follow the same procedure for the question"How do you plan to leave for home after school?"
•You can conduct the counts once per day but during the count please ask students both the school arrival and departure questions.
• Pleaseconduct this count regardless of weather conditions(i.e., ask these questions on rainy days, too).
Step 1. Step 2.
Fill in the weather conditions and AM-"How did you arrive at school today?"Record the number of hands for each answer.
number of students in each class PM-"How do you plan to leave for home after.school?"Record the number of hands for
each answer.
Weather Student Walk Bike School Bus Family Carpool Transit Other
Tally Vehicle
Key S=sunny
R=rainy Number in Only with Riding with City bus, Skate-board,
O=overcast class when - - - Children from children from subway,etc. scooter,etc.
SN=snow count made your family otherfamilies '
-
SampleAM S N 2 0 ,> _ 2 3 •r i 8 ,; � 3 3 g i
s. y},- r" .3• z. ' #�'r, -6 ` o'a'f t
,_ ,. s „`.•�i�"r.n-.�-.,i '`"` i'�'fyN
Sample PM R _ 1 9 ¥ 3 r 3 8 1 S G g 2 �t��.���
a�; trs`k ,��„- d"�` .erg 2
������� � ��Ybi`��w �r t s•U^' -�,"q `v`��:s `�`'s" -t��',•-5 ,tea a.''�'f a :r -g.az-� 'fir -Y�•'q v_.
�-eNct ..c a�'n.�;'A ��.5r�it=.�;�':�,s�5sf'`'<�".�s�3:�e��� a�•�`�'�t :- k3�,wd,r��:. --' �'r�s =e.i''..si;n�'.":�'.�i:�'=�r;,->.__.z
IN
�'9'a .}'.c^e hr» �x=(. ^t"�.. aT'x;fir- .y)•,aa,« `' i. r- q 'xi '"
a.
s
's-s
Tues PMr e f * s
-"�i�'TW#st
Wed. AM
Wed. PM �Axh; , - � `.
J 13 idla
Thurs. AM ;a MIR ,fix ?
1 _v}rx .,. .R}w�+:, .,R, '{.','x "..r'3.� ,3.�=4 .'p '' 2`t , 5 st• u-w. ' } a+'dr
.,�w. � 3T � - -- _ v."� �r.:s�'.z ��g� ..�-: �,-c+� � 'zr�°` ;= .� :° w•a-.,z�-'.�s{sr-� '�`
Thurs. PM "; ., E rw'
� et �� ! �
Please list any disruptions to these counts or any unusual travel conditions to/from the school on the days of the tally.
Vf
L ,� S
SUB-RECIPIENT INFORMATIONAL FORM
Federal Funding Accountability and Transparency Act 2006
Sub-Recipient Information
SUB-RECIPIENT NAME AND ADDRESS
Name:
Address:
City: State:
Zip:
Sub-Recipient.DUNS Number:
Sub-Recipient WIN Number CCR Registration number):
Sub-Recipients Annual Gross Revenues Exceed
80%or more in Federal Awards r- Yes C No
Sub-Recipients Annual Gross Revenues Equal or
Exceed$25,000,000 1. Yes r`No
Sub-Recipient Highly Compensated Officer Officer Name Officer Compensation
COMMENT
PREPARED BY: DATE:
Name:
Title:
Email:
MoDOT Form 1590