HomeMy WebLinkAboutRESOLUTION - 53-22 - 11/15/2022 - Local Public Agency Agreement for Federal Participation with IDOTRESOLUTION NO. 53-22
A RESOLUTION APPROPRIATING FUNDS IN THE AMOUNT OF $1,294,372 FOR
THE CONSTRUCTION AND CONSTRUCTION ENGINEERING LOCAL MATCH
AND AUTHORIZING THE MAYOR TO EXECUTE A LOCAL PUBLIC AGENCY
AGREEMENT FOR FEDERAL PARTICIPATION BETWEEN THE VILLAGE OF ELK
GROVE VILLAGE AND THE ILLINOIS DEPARTMENT OF TRANSPORTATION
BE IT RESOLVED by the Mayor and Board of Trustees of the Village of Elk Grove
Village, Counties of Cook and DuPage, State of Illinois as follows:
Section 1: That the Mayor be and is hereby authorized to sign the attached document
marked "Joint Funding Agreement for State -Let Construction Work," a copy of which is attached
hereto and made a part hereof as if fully set forth and the Village Clerk is authorized to attest
said document upon signature of the Mayor.
Section 2: That the Mayor and Board of Trustees of Elk Grove Village authorized one
million, two hundred and ninety four thousand, three hundred seventy two ($1,294,372) or as
much may be needed to match Federal funds in the completion of Section Number 18-00066-00-
BR.
Section 3: That the Village Clerk of the Village of Elk Grove Village shall transmit five
certified copies of this Resolution to the Illinois Department of Transportation.
Section 4: That this Resolution shall be in full force and effect from and after its passage
and approval according to law.
VOTE: AYES: 5 NAYS: 0 ABSENT: 1
PASSED this 15th day of November 2022
APPROVED this 15th day of November 2022
APPROVED:
Mayor CrailZ B. Johnson
Village of Elk Grove Village
ATTEST:
Loretta M. Murphy, Village Clerk
INnois Department Joint Funding Agreement for
Of Transportation State -Let Construction Work
LOCAL PUBLIC AGENCY
Local Public Agency ........_.__ _.. County Section Number _
Village of Elk Grove Village Cook 18-00066-00-BR
Fund Type ITEP L SRT_S_ . HSIP Numbers MPO_N_ame MPO TIP Number
ITEP �143057 CMAP 103-21-0017 _ ---�
Construction
State Job Number Proiect Number
C-91-045-22 OLA3(176)
Z Construction on State Letting Z Construction Engineering ❑ Utilities ❑ Railroad Work
This Agreement is made and entered into between the above local public agency, hereinafter referred to as the "LPA" and the State of
Illinois, acting by and through its Department of Transportation, hereinafter referred to as "STATE". The STATE and LPA jointly propose to
improve the designated location as described below. The improvement shall be consulted in accordance with plans prepared by, or on
behalf of the LPA and approved by the STATE using the STATE's policies and procedures approved and/or required by the Federal
Highway Administration, hereinafter referred to as "FHWA".
LOCATION
Stationing
Local Street/Road Name Key Route Len th From To
Clearmont Pedestrian Bridge ff system) 0.11 Mi
(oQ�
at Salt Creek
Current Jurisdiction Existinq Structure Numbers Add Location
Village of Elk Grove Village /A Remove
PROJECT DESCRIPTION
The project consists of the removal and replacement of an existing pedestrian bridge over Salt Creek, PCC bike
path, lighting, embankment, sidewalk, pavement patching, HMA surface, curb and gutter, ADA ramps, storm
sewer, grading, signing, landscaping, maintenance of traffic, and restoration and all incidental and collateral work
necessary to complete the project. Engineer's project number 200852.60.
LOCAL PUBLIC AGENCY APPROPRIATION- REQUIRED FOR STATE LET CONTRACTS
By execution of this Agreement the LPA attests that sufficient moneys have been appropriated or reserved by resolution or ordinance to
fund the LPA share of project costs. A copy of the authorizing resolution or ordinance is attached as an addendum.
METHOD OF FINANCING - (State -Let Contract Work Only)
Check One
❑ METHOD A - Lump Sum (80% of LPA Obligation )
Lump Sum Payment - Upon award of the contract for this improvement, the LPA will pay the STATE within thirty (30) calendar days of
billing. in lump sum, an amount equal to 80% of the LPA's estimated obligation incurred under this agreement. The LPA will pay to the
STATE the remainder of the LPA's obligation (including any nonparticipating costs) in a lump sum within thirty (30) calendar days of billing
in a lump sum, upon completion of the project based on final costs.
❑ METHOD B - Monthly Payments of due by the of each successive month.
Monthly Payments - Upon award of the contract for this improvement, the LPA will pay to the STATE a specified amount each month for
an estimated period of months, or until 80% of the LPA's estimated obligation under the provisions of the agreement has been paid. The
LPA will pay to the STATE the remainder of the LPA's obligation (including any nonparticipating costs) in a lump sum, upon completion of
the project based upon final costs.
® METHOD C - LPA's Share Remainder divided by estimated total cost multiplied by actual progress payment.
Progress Payments - Upon receipt of the contractor's first and subsequent progressive bills for this improvement, the LPA will pay to the
STATE within thirty (30) calendar days of receipt, an amount equal to the LPA's share of the construction cost divided by the estimated
total cost multiplied by the actual payment (appropriately adjust for nonparticipating costs) made to the contractor until the entire obligation
incurred under this agreement has been paid.
Printed 10,106/22 Page 1 of 6 BLR 05310C (Rev. 03131i22)
Failure to remit the payment(s) in a timely manner as required under Methods A, B, or C shall allow the STATE to internally offset, reduce,
or deduct the arrearage from any payment or reimbursement due or about to become due and payable from the STATE to the LPA on this
or any other contract. The STATE at its sole option, upon notice to the LPA, may place the debit into the Illinois Comptroller's Offset
System (15 ILCS 405/10.05) or take such other and further action as may be required to recover the debt.
THE LPA AGREES:
1. To acquire in its name, or in the name of the STATE if on the STATE highway system, all right-of-way necessary for this project in
accordance with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies
Act of 1970, and established State policies and procedures. Prior to advertising for bids, the LPA shall certify to the STATE that
all requirements of Titles II and III of said Uniform Act have been satisfied. The disposition of encroachments, if any, will be
cooperatively determined by representatives of the LPA, the STATE, and the FHWA if required.
2. To provide for all utility adjustments and to regulate the use of the right-of-way of this improvement by utilities, public and private,
in accordance with the current Utility Accommodation Policy for Local Public Agency Highway and Street Systems.
3. To provide for surveys and the preparation of plans for the proposed improvement and engineering supervision during
construction of the proposed improvement.
4. To retain jurisdiction of the completed improvement unless specified otherwise by addendum (addendum should be accompanied
by a location map). If the improvement location is currently under road district jurisdiction, a jurisdictional addendum is required.
5. To maintain or cause to be maintained the completed improvement (or that portion within its jurisdiction as established by
addendum referred to in item 4 above) in a manner satisfactory to the STATE and the FHWA.
6. To comply with all applicable Executive Orders and Federal Highway Acts pursuant to the Equal Employment Opportunity and
Nondiscrimination Regulations required by the U.S. Department of Transportation.
7. To maintain for a minimum of 3 years after final project close out by the STATE, adequate books, records and supporting
documents to verify the amounts, recipients and uses of all disbursements of funds passing in conjunction with the contract. The
contract and all books, records, and supporting documents related to the contract shall be available for review and audit by the
Auditor General and the STATE. The LPA agrees to cooperate fully with any audit conducted by the Auditor General, the STATE,
and to provide full access to all relevant materials. Failure to maintain the books, records, and supporting documents required by
this section shall establish presumption in favor of the STATE for recovery of any funds paid by the STATE under the contract for
which adequate books, records and supporting documentation are not available to support their purported disbursement.
8. To provide if required, for the improvement of any railroad -highway grade crossing and rail crossing protection within the limits of
the proposed improvement.
9. To comply with Federal requirements or possibly lose (partial or total) Federal participation as determined by the FHWA.
10. To provide or cause to be provided all of the initial funding, equipment, labor, material, and services necessary to complete locally
administered portions of the project.
11. (Railroad Related Work) The LPA is responsible for the payment of the railroad related expenses in accordance with the LPA/
railroad agreement prior to requesting reimbursement from the STATE. Requests for reimbursement should be sent to the
appropriate IDOT District Bureau of Local Roads and Streets Office. Engineer's Payment Estimates shall be in accordance with
the Division of Cost.
12. Certifies to the best of its knowledge and belief that it's officials:
a. are not presently debarred. suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered
transactions by any Federal department or agency;
b. have not within a three-year period preceding this agreement been convicted of or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a
public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State anti-trust
statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements receiving stolen property;
c. are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, Local)
with commission of any of the offenses enumerated in item (b) of this certification; and
d, have not within a three-year period preceding the agreement had one or more public transactions (Federal, State, Local)
terminated for cause or default.
13. To include the certifications, listed in item 12 above, and all other certifications required by State statutes, in every contract,
including procurement of materials and leases of equipment.
14. That execution of this agreement constitutes the LPA's concurrence in the award of the construction contract to the responsible
low bidder as determined by the STATE.
15. That for agreements exceeding $100,000 in federal funds, execution of this agreement constitutes the LPA's certification that:
a. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or
employee of congress, or any employee of a member of congress in connection with the awarding of any federal
contract, the making of any cooperative agreement, and the extension, continuation, renewal, amendment or
Printed 10,106/22 Page 2 of 6 BLR 05310C (Rev. 03131122)
modification of any Federal contract, grant, loan or cooperative agreement.
b. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress
or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement,
the undersigned shall complete and submit standard form - LLL, "Disclosure Form to Report Lobbying", in accordance
with its instructions.
c. The LPA shall require that the language of this certification be included in the award documents for all subawards
(including subcontracts, subgrants and contracts under grants, loans, and cooperative agreements), and that all
subrecipients shall certify and disclose accordingly
16. To regulate parking and traffic in accordance with the approved project report.
17. To regulate encroachments on public rights -of -way in accordance with current Illinois Compiled Statutes.
18. To regulate the discharge of sanitary sewage into any storm water drainage system constructed with this improvement in
accordance with the current Illinois Compiled Statutes.
THE STATE AGREES:
1. To provide such guidance, assistance, and supervision to monitor and perform audits to the extent necessary to assure validity of
the LPA's certification of compliance with Title II and III Requirements.
2. To receive bids for construction of the proposed improvement when the plans have been approved by the STATE (and FHWA. if
required) and to award a contract for construction of the proposed improvement after receipt of a satisfactory bid.
3. To provide all initial funding and payments to the contractor for construction work let by the STATE. The LPA will be invoiced for
their share of contract costs per the method of payment selected under Method of Financing based on the Division of Costs
shown on Addendum 2.
4. For agreements with federal and/or state funds in construction engineering, utility work and/or railroad work:
a. To reimburse the LPA for federal and/or state share on the basis of periodic billings, provided said billings contain
sufficient cost information and show evidence of payments by the LPA;
b. To provide independent assurance sampling and furnish off -site material inspection and testing at sources normally
visited by STATE inspectors for steel, cement, aggregate, structural steel, and other materials customarily tested by the
STATE.
IT IS MUTUALLY AGREED:
1. Construction of the project will utilize domestic steel as required by Section 106.01 of the current edition of the Standard
Specifications for Road and Bridge Construction and federal Buy America provisions
2. That this Agreement and the covenants contained herein shall became null and void in the event that the FHWA does not
approve the proposed improvement for Federal -aid participation within one (1) year of the date of execution of this agreement.
3. This agreement shall be binding upon the parties, their successors, and assigns.
4. For contracts awarded by the LPA, the LPA shall not discriminate on the basis of race, color, national origin or sex in the award
and performance of any USDOT - assisted contract or in the administration of its DBE program or the requirements of 49 CFR
part 26. The LPA shall take all necessary and reasonable steps under 49 CFR part 26 to ensure nondiscrimination in the award
and administration of USDOT - assisted contracts. The LPA's DBE program, as required by 49 CFR part 26 and as approved by
USDOT, is incorporated by reference in this agreement. Upon notification to the recipient of its failure to carry out its approved
program, the STATE may impose sanctions as provided for under part 26 and may, in appropriate cases, refer the matter for
enforcement under 18 U.S. C 1001 and/or the Program Fraud Civil Remedies Act of 1986 (31 U.S.0 3801 et seq.). In the
absence of a USDOT - approved LPA DBE Program or on state awarded contracts, this agreement shall be administered under
the provisions of the STATE'S USDOT approved Disadvantaged Business Enterprise Program.
5. In cases where the STATE is reimbursing the LPA, obligation of the STATE shall cease immediately without penalty or further
payment being required if, in any fiscal year, the Illinois General Assembly or applicable federal funding source fails to appropriate
or otherwise make available funds for the work contemplated herein.
6. Alf projects for the construction of fixed works which are financed in whole or in part with funds provided by this agreement and/or
amendment shall be subject to the Prevailing Wage Act (820 ILCS 130/0.01 et seq.) unless the provisions of the act exempt its
application.
FISCAL RESPONSIBILITIES:' ...., ..�,t ...1'�}
z
1. Reimbursement Requests: For reimbursement requests the LPA will submit supporting documentation with each invoice.
Supporting documentation is defined as verification of payment, certified time sheets or summaries, vendor invoices, vendor
receipts, cost plus fix fee invoice, progress report, personnel and direct cost summaries, and other documentation supporting the
requested reimbursement amount (Form BLR 05621 should be used for consultant invoicing purposes). LPA invoice requests to
the STATE will be submitted with sequential invoice numbers by project.
2. Financial Integrity Review and Evaluation (FIRE) program: LPA's and the STATE must justify continued federal funding on
inactive projects. 23 CFR 630.106(a)(5) defines an inactive project as a project which no expenditures have been charged
against Federal funds for the past twelve (12) months. To keep projects active, invoicing must occur a minimum of one time
within any given twelve (12) month period. However, to ensure adequate processing time, the first invoice shall be submitted to
Printed 10106'22 Page 3 of 6 BLR 05310C (Rev. 03/31122)
the STATE within six (6) months of the federal authorization date. Subsequent invoices will be submitted in intervals not to
exceed six (6) months.
3. Final Invoice: The LPA will submit to the STATE a complete and detailed final invoice with applicable supporting documentation
of all incurred costs, less previous payments, no later than twelve (12) months from the date of completion of work or from the
date of the previous invoice, whichever occurs first. If a final invoice is not received within this time frame, the most recent invoice
may be considered the final invoice and the obligation of the funds closed. Form BLR 05613 (Engineering Payment Record) is
required to be submitted with the final invoice for engineering projects.
4. Project Closeout: The LPA shall provide the final report to the appropriate STATE district office within twelve (12) months of the
physical completion date of the project so that the report may be audited and approved for payment. If the deadline cannot be
met, a written explanation must be provided to the district prior to the end of the twelve (12) months documenting the reason and
the new anticipated date of completion. If the extended deadline is not met, this process must be repeated until the project is
closed. Failure to follow this process may result In the immediate close-out of the project and loss of further funding.
5. Project End Date: The period of performance (end date) for state and federal obligation purposes is five (5) years for projects
under $1,000,000 or seven (7) years for projects over $1,000,000 from the execution date of the agreement.
Requests for time extensions and joint agreement amendments must be received and approved prior to expiration of the project
end date. Failure to extend the end date may result in the immediate close-out of the project and loss of further funding.
6. Single Audit Requirements: If the LPA expends $750,000 or more a year in federal financial assistance, they shall have an audit
made in accordance with 2 CFR 200. LPA's expending less than $750,000 a year shall be exempt from compliance. A copy of
the audit report must be submitted to the STATE (IDOT's Office of Internal Audit, Room 201, 2300 South Dirksen Parkway,
Springfield, Illinois, 62764) within 30 days after the completion of the audit, but no later than one year after the end of the LPA's
fiscal year. The CFDA number for all highway planning and construction activities is 20.205. Federal funds utilized for construction
activities on projects let and awarded by the STATE (federal amounts shown as "Participating Construction" on Addendum 2) are
not Included in a LPA's calculation of federal funds expended by the LPA for Single Audit purposes..
7. Federal Registration: LPA's are required to register with the System for Award Management or SAM, which is a web -enabled
government -wide application that collects, validates, stores, and disseminates business Information about the federal
government's trading partners in support of the contract award and the electronic payment processes. To register or renew,
please use the following website: https://www.ssarn.aoviSAM/
8. Required Uniform Reporting: For work not included on a state letting, the Grant Accountability and Transparency Act (30 ILCS
708) requires a uniform reporting of expenditures. Uniform reports of expenditures shall be reported no less than quarterly using
IDOT's BOBS 2832 form available on IDOT's web page under the "Resources" tab. Additional reporting frequency may be required
based upon specific conditions or legislation as listed In the accepted Notice of State Award (NOSA). Specific conditions are based
upon the award recipient/grantee's responses to the Fiscal and Administrative Risk Assessment (ICQ) and the Programmatic Risk
Assessment (PRA)..
NOTE: Under the terns of the Grant Funds Recovery Act (30 ILCS 705/4.1), "Granter agencies may withhold or suspend the
distribution of grant funds for failure to file requirement reports" if the report is more than 30 calendar days delinquent, without
any approved written explanation by the grantee, the entity will be placed on the Illinois Stop Payment List. (Refer to the
Grantee Compliance Enforcement System for detail about the Illinois Stop Payment List. https.;l v✓ ryrllrn�s,gov/sitesl'(ATAf
Pages( Resyurc_ r r .aspx}
ADDENDA
Additional information and/or stipulations are hereby attached and identified below as being a part of this agreement.
®
1.
Location Map
2.
Division of Cost
®
3.
Resolution*
❑
4.
`Appropriation and signature authority resolution must be in effect on, or prior to, the execution date of the agreement.
Printed 10/06/22 Page 4 of 6 BLR 05310C (Rev. 03/31%22)
The LPA further agrees as a condition of payment, that it accepts and will comply with the applicable provisions set forth in this agreement
and all Addenda indicated above.
APPROVED
Local Public Agency
Official (Print or TVDe Name
Craig Johnson
Title of Official
Mayor
Si nature Date
The above signature certifies the agency's TIN number is
366009201 conducting business as a Governmental Entity.
DUNS Number 072316581
UEI H7UKAR6JK9B3
APPROVED
State of Illinois
Department of Transportation
Omer Osman. P.E.. Secretary of Transportation Date
P
1
i
By:
George A. Ta as. P.E., S.E. Engineer of Local Roads & Streets Date
Stephen M. Travia, P.E. Director of Highways PI/Chief Engineer Date
Yan su Kim, Chief Counsel Date
Vicki Wilson. Chief Fiscal Officer Date
3
NOTE:, A resolution authorizing the local official (or their delegate) to execute this agreement and appropriation of local funds is
required to be attached as an addendum. The resolution must be approved prior to, or concurrently with, the execution of this
agreement. If BLR 09110 or BLR 09120 are used to appropriate local matching funds, attach these forms to the signature
authorization resolution.
Please check this box to open a fillable Resolution Form within this Addenda.
Printed 10!06/22 Page 5 of 6 BLR 05310C (Rev. 03/31?22)
ADDENDA NUMBER 2
Local Public Agency Countv Section Number State Job Number Pro ect Number
Village of Elk Grove Village Cook 18-00066-00-BR C-91-045-22 OLA3(176)
DIVISION OF COST
Federal Funds
State Funds
Local Public Agency
Tvpe of Work
Fund Tvpe
Amount
Fund Type
Amount
%
Fund Type
Amount
%
Totals
Participating Construction
ITEP
$1,347.240.00
80%
$168.405 00
Local
S982.355.00
20 %
$2.498.000-00
Non -Participating Construction
Local
$2,000.00
100%
$2,000.00
Construction Engineering
ITEP
S134.720.00
80%
$16,840.00
Local
$158.457.00
20%
$310.017.00
Total
S1A81.960.00
Totall
S185.245.00
Total
$1142.812.00
$2.810.017.00
If fundino is not a percentage of the total place an asterisk ,) in the space provided for the percentage and explain below
Federal (ITEP) Participation 80% and not to exceed $1,481,960 per PPI
NOTE: The costs shown in the Division of Cost table are approximate and subject to change. The final LPA share is dependent on the final Federal and State participation The actual
costs will be used in the final division of cost for billing and reimbursement
Printed 10!0&,22 Page 6 of 6 BLR 05310C (Rev. 03131122)
Instructions for BLR 05310C Page 1 of 3
NOTE: Form instructions should not be included when the form is submitted.
This form shall be used when a local public agency (LPA) project involves Federal -Aid, with or without state funds and this standard form is
sufficient to describe all details of the agreement. For more information refer to the Bureau of Local Roads and Streets (BLRS) Manual,
Chapter 5. For signature requirements refer to Chapter 2, Section 3.05(b) of the BLRS manual. When filling out this form electronically, once a
field is initially completed, fields requiring the same information will be auto -populated.
Local Public Agency
Name of LPA Insert the name of the LPA.
County Insert the name of the county in which the LPA is located.
Section Number Insert the section number applied to this project.
Fund Type Insert the funding type(s) being used for this project (e.g. STU, STIR, ITEP, etc.).
ITEP, SRTS, HSIP, Number Insert the ITEP. SRTS, HSIP number assigned to this project.
MPO Name From the drop -down choose the MPO in which the project is located. If the project is not located within
an MPO, select N/A. Types to choose from are:
Bi-State Bi-State Regional Commission
CMAP Chicago Metropolitan Planning Organization
CUUATS Champaign/Urbana Urban Area Transportation Study
DATS Danville Area Transportation Study
DMATS Dubuque
DSATS DeKalb/Sycamore Area Transportation Study
DUATS Decatur Urbanized Area Transportation Study
EWGCG East-West Gateway Council of Governments
KATS Kankakee Area Transportation Study
MCRPC McLean County Regional Planning Commission
PPUATS Peoria/Pekin Urban Area Transportation Study
RPC Region 1 Planning Council
SRTS Springfield Area Transportation Study
SEMPO South East Metropolitan Planning Organization
SIMPO Southern Illinois Metropolitan Planning Organization
SLATS State Line Area Transportation Study
MPO Tip Number Insert MPO Tip Number assigned to this project, this is required for all projects located within the MPO
planning boundaries if applicable. If not, insert "NIA"
Construction
Job Number
Insert the job number assigned for the construction portion, the number will begin with a "C"
Project Number
Insert the project number assigned to the construction portion of this project.
Construction on State Letting
Check this box if the construction portion of this project will be on a state held letting.
Construction Engineering
Check this box if the construction portion of this project will involve construction engineering.
Utilities
Check this box if the construction portion of this project will involve utility work.
Railroad Work
Check this box if the construction portion of this project will involve railroad work.
Location
Use the add location button to add additional locations if needed for up to a total of five locations. If there
are more than five locations, use various.
Local Street/Road Name
Insert the local street/road name.
Key Route
Insert the key route of the street road listed above.
Length
Insert the length in miles as it pertains to the location listed above. For a structure insert 0.01.
Station
From
Insert the beginning station of the project as it pertains to the key route for this location for this project
To
Insert the ending station of the project as it pertains to the key route for this location for this project.
Location Termini
Insert the beginning and ending termini as it pertains to this location for this project.
Existing Structure Number(s)
Insert the existing structure number(s) for this project.
Add Location
Use this button to add additional locations. A total of four additional locations can be added. If there are
more than 5 locations, do not add each location. Instead insert "Various" in the first location field.
Project Description
Insert a description of the work to be accomplished by this project.
Method of Financing
This area is for state -let contract only. Check one.
Method A
If this box is checked, insert the dollar amount equal to 80% of the LPA's total obligation.
Method B
If this box is checked, insert the number of monthly payments needed to repay 80% of the LPA`s
estimated obligation.
Printed 10 06.!22
BLR 05310C (Rev. 0131/22)
Instructions for BLR 05310C Page 2 of 3
Method C If this box is checked, insert the dollar amount of the LPA's share of the construction costs for this
project.
For State -Let Construction Projects
Addenda
Within the addenda table, check the box as applicable. Insert the item number of the addenda and a description of the item.
1. Location Map — Attach a location map to this agreement showing all locations being improved by this project.
2. Division of Cost — Insert the division of cost age (see separate instructions for completing this document).
3. LPA Resolution — The LPA must pass an appropriation resolution covering the local share of the project and must grant
signature authority to the signee. Attach the resolution as Addendum 3. if BLR 09110 or BLR 09120 are used to appropriate
local fund, attach these forms to the signature authorization resolution.
4. IDOT Fiscal Approval Signature Page.
Approved
Local Public Agency The appropriate LPA official shall insert their name, sign, and date. Insert the LPA's TIN number, DUNS
Number, and the UEI (note the UEI will be replacing the DUNS Number hit s , �sam ggvfcantent"dun uei).
Illinois Dept. of Transportation The appropriate IDOT official shall sign and date here.
Division of Cost Table
When the LPA desires to use one or more lump -sum amounts before the federal percentage is calculated, specify the order in which it should
be used and the "not to exceed" amount. The following provides an example of the wording that may be used:
Lump -sum $60,000 TARP funds not to exceed 50% of final cost of project credited to the project to be utilized first.
Lump -sum to be utilized second not to exceed $20,000 EDP funds.
Lump -sum to be utilized third not to exceed $40.000 SMA funds.
These specified amounts will be used in sequence, with the federal and local percentages calculated after they are deducted.
When the LPA desires to use a percent "not to exceed" commitment, the federal and state funds will be used concurrently at the specified
percentages up the the "not to exceed" amount.
Example: Maximum STR participation 80% not to exceed $100,000.
Lump -sum SMA not to exceed $20,000 to be used as a match to the federal funds.
Be advised that the "not to exceed" amount specified under a percentage commitment will be tied up and unavailable for programming until
the project is closed out and a documentation review has been completed by IDOT or FNWA, if required.
Division of Cost Table
Use a separate line for each type of work as it relates to the fund type for federal, state and/or LPA funds.
Type of Work Choose the type of work from the drop -down list. Types to choose from are: Participating Construction,
Non -Participating Construction, Construction Engineering, Railroads, Utilities, and Materials.
Federal Funds
If federal funds are being used on this project complete the following for federal funds.
Fund Type
Choose the type of federal fund type from the drop -down.
Amount
Insert the amount of federal funds for the type of listed under fund type.
%
Insert the percentage of federal funds for this type.
State Funds
If state funds are being used on this project complete with following for state funds.
Fund Type
Choose the type of state fund type from the drop -down.
Amount
Insert the amount of state funds for the type of listed under fund type.
%
Insert the percentage of state funds for this type.
Local Public Agency Funds
Fund Type Choose the type of LPA funds from the drop -down.
Amount Insert the amount of LPA funds for the type of listed under fund type.
% Insert the percentage of LPA funds for this type.
Explanation Insert any necessary additional information as to how the funding is being applied for this project.
A minimum of three (3) originals executed by the LPA must be submitted to the District through it s Regional Engineer's Office.
Distribution will be as follows:
District file
Bureau of local Roads Central Office (2)
Printing Instructions For the document to print properly, please make sure "Orientation" is set to "Auto" (see image below)
within the print dialog window. If this setting is not chosen, then some pages may be cut off during the
printing process.
Orientation:
-7%• Auto 0 Portrait (:)Landscape
Printed 10I06i22 BLR 05310C (Rev. 03.'31/22)
C53)
gt
N.T.S. 0
Woodfield Mall
Medinah
3m
Ned Brown
Preserve
(Busse Woods)
FlAt
z
C' D2
A Pd Mt Prospect
W Golf Rd
T
77 -1
Elk Grove
Village JJ
803
D.31 ,
PROJECT LOCATION
Bensenville
F.A.P SECTION COUNTY
VILLAGE OF ELK GROVE VILLAGE RTE. 18-00066-00-BR COOK—
CLEARMONT PEDESTRIAN BRIDGE LOCATION MAP