15-0818_CA DEPT OF TRANSPORTATION_Program Supplement Agreement No. 0N84PROGRAM SUPPLEMENT NO. N84 Adv Project ID Date: July 13, 2015
to 1215000127 Location: 12-ORA-Q-SJCP
ADMINISTERING AGENCY-STATE AGREEMENT Project Number: ATPL-5372(015)
FOR STATE FUNDED PROJECTS NO 004288 E.A. Number:
Locode: 5372
This Program Supplement, effectivebfS/'-^, hereby adopts and Incorporates into the Administering Agency-State
Agreement No. 00428S for State Funded Projects which was entered Into between the ADMINISTERING AGENCY and
the STATE with an effective date of 03/05/13 and Is subject to all the terms and conditions thereof. This PROGRAM
SUPPLEMENT Is executed In accordance with Article I of the aforementioned Master Agreement under authority of
Resolution No. i5 -08-/8-Oaapproved by the ADMINISTERING AGENCY on 6/ j8>/Z0 iS" (See copy
attached). ^
The ADMINISTERING AGENCY further stipulates that as a condition to the payment by the State of any funds derived
from sources noted below encumbered to this project, Administering Agency accepts and will comply with the Special
Covenants and remarks set forth on the following pages.
PROJECT LOCATION:
Various locations throughout the City of San Juan Capistrano
TYPE OF WORK: BIkeway gap closures
Estimated Cost State Funds Matching Funds
STATE $53,000.00 LOCAL OTHER
$60,000.00 $7,000.00 $0.00
CITY OF SA STATE OF CALIFORNIA
Departm^t of Transportation
By '-^/itu^ ^~4Y^
/^'X'Chief, bffice of Project implementation
/ Division of Local Assistance
Date-.J^M^<^ ..
hereby certify upon my personal knowledge that budgeted funds are available for this encumbrance:
8*-.. Date Accounting Officer.
APPROVED AS TO
V. • g u t-.'. I" $53,000.00
ivir
o
JefT'EaWng^'r, Oily Womey
Program Supplement 00-428S-N84- SERIAL Page 1 of 4
STATE OF CAllFORNIA. DEPARTMENT OF TRANSPORTATION
. PROGRAM SUPPLMENT AND CERTIFICATION FORM
PSCF (REV. 01/2010)
Page_1 of_1_
TO: STATE CONTROLLER'S OFFICE DATE PREPARED: PROJECT NUMBER:
Claims Audits 7/13/2015 1215000127
3301 "C" Street, Rm 404 REQUISITION NUMBER / CONTRACT NUMBER:
Sacramento, CA 95816 RQS# 121600000003
FROM:
Department of Transportation
SUBJECT:
Encumbrance Document
VENDOR/LOCALAGENCY:
City of San Juan Capistrano
CONTRACT AMOUNT:
$53,000.00
PROCUREMENT TYPE:
Local Assistance
CHAPTER STATUTES ITEM YEAR PEC / PECT TASK/SUBTASK AMOUNT
20 2013 2660-108-0042 2013-2014 2030720/100 2620/0000 $53,000.00
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For Individuals with sensory disabilities, this document is available in alternate formats. For information, call (915) 654-6410 of TDD (916) -3880 or write
Records and Forms Management, 1120 N. Street, MS-89, Sacramento, CA 95814.
'42-Ol^-O-SJCP
ATPL-5372(015)
SPECIAL COVENANTS OR REMARKS
07/13/2015
Chapter Statutes Item Year Program BC Category Fund Source AMOUNT
-
Program Supplement 00-428S-N84- SERIAL Page 2 of 4
^^12-ORA-O-SJCP
ATPL-5372(015) .
SPECIAL COVENANTS OR REMARKS
07/13/2015
1. A. This PROJECT will be administered in accordance with the appiicable CTC STIP
guidelines and the Active Transportation Program guidelines as adopted or amended, the
Local Assistance Procedures Manual (LAPM), the Local Assistance Program Guidelines
(LAPG), and this PROGRAM SUPPLEMENT.
B. This PROJECT is programmed to receive State funds from the Active Transportation
Program (ATP). Funding may be provided under one or more components. A
component(s) specific fund allocation is required, in addition to other requirements, before
reimbursable work can occur for the component(s) identified. Each allocation will be
assigned an effective date and identify the amount of funds allocated per Gomponent(s).
This PROGRAM SUPPLEMENT has been prepared to allow reimbursement of eligible
PROJECT expenditures for the Gomponent(s) allocated. Unless otherwise determined,
the effective date of the component specific allocation will constitute the start of
reimbursa'ble expenditures.
C. STATE and ADMINISTERING AGENCY agree that any additional funds made
available by future allocations will be encumbered on this PROJECT by use of a STATE-
approved Allocation Letter and STATE Finance Letter. ADMINISTERING AGENCY
agrees that STATE funds available for reimbursement will be limited to the amount
allocated by the California Transportation Commission (CTC) and/or the STATE.
D. Upon ADMINISTERING AGENCY request, the CTC and/or STATE may approve
supplementary allocations, time extensions, and fund transfers between components.
Funds transferred between allocated project components retain their original timely use of
funds deadlines, but an approved time extension will revise the timely use of funds criteria
for the Gomponent(s) and allocation(s) requested. Approved supplementary allocations,
time extensions, and fund transfers between components made after the execution of this
PROGRAM SUPPLEMENT will be documented and considered subject to the terms and
conditions thereof. Documentation will consist of a STATE approved Allocation Letter,
Fund Transfer Letter, Time Extension Letter, and Finance Letter, as appropriate.
E. This PROJECT is subject to the timely use of funds provisions enacted by the Active
Transportation Program guidelines, as adopted or amended, and by approved CTC and
State procedure's as outlme^d b'elcJw. Z ""^
Funds allocated for the environmental & permits (E&P), plan specifications & estimate
(PS&E), and right-of-way components are available for expenditure until the end of the
second fiscal year following the year in which the funds were allocated.
Funds allocated for the construction component are subject to an award deadline and
contract completion deadline. ADMINISTERING AGENCY agrees to award the contract .
within 6 months of the construction fund allocation and to complete and accept the
construction within 36 months of award.
F. Award Information shall be submitted by the ADMINISTERING AGENCY to the District
Program Supplement 00-428S-N84- SERIAL Page 3 of 4
„112-ORA-0-SJCP
ATPL-5372(015)
SPECIAL COVENANTS OR REMARKS
07/13/2015'
Local Assistance Engineer immediately after project contract award and prior to the
submittal of the ADMINISTERING AGENCY'S first invoice for the construction contract.
Failure to do so will cause a delay in the State processing of invoices for the construction
phase.
C. The"ADMINISTERING AGENCY shall invoice STATE for environmental & permits
(E&P), plans specifications & estimate (PS&E), and right-of-way costs no later than 180
days after the end of last eligible fiscal year of expenditure. For construction costs, the
ADMINISTERING AGENCY has 180 days after project completion or contract acceptance
to make the final payment to the contractor prepare the final Report of Expenditures and
final invoice, and submit to STATE for verification and payment.
hi. ADMINISTERING AGENCY agrees to submit the final report documents that
collectively constitute a "Report of Expenditures" within one hundred eighty (180) days of
PROJEGT completion. Failure of ADMINISTERING AGENCY to submit a "Final Report
of Expenditures" within 180 days of PROJECT completion will result in STATE imposing
sanctions upon ADMINISTERING AGENCY in accordance with the current LAPM and the
Active Transportation Program (ATP) Guidelines.
1. ADMINISTERING AGENCY agrees to comply with Office of Management and Budget
(0MB) Circular A-87,. Cost Principles for State and Local Governments, and 49 CFR,
Part 18, Uniform Administrative Requirements for Grants and Cooperative Agreements to
State and Local Governments. Notwithstanding the foregoing, ADMINISTERING
AGENCY will not be required to comply with 49 CFR, Part 18.36 (i), subsections (3), (4),
(5), (6), (8), (9), (12), and (13).
J. ey executing this PROGRAM SUPPLEMENT, ADMINISTERING AGENCY agrees to
comply with all reporting requirements in accordance with the Active Transportation
Program guidelines, as adopted or amended.
Program Supplement 00-428S-N84- SERIAL Page 4 of 4
DEPARTMENT OF TRANSPORTATION FINANCE LETTER Date' 09/10/2015 DIVISION OF ACCOUNTING Agency: 12-ORA-O-SJCP LOCAL PROGRAM ACCOUNTING BRANCH Proiect No: ATPL-5372(015) EANo: Attention: City of San Juan Capistrano FINANCE ITEMS PRO RATA OR TOTAL COST OF PART. COST STATE FUNDS LOCAL FUNDS OTHER FUNDS LUMP SUM WORK (ATP) Agency Preliminary Engineering Lump Sum $60,000,00 $60,000.00 $53,000,00 $7,000.00 $0,00 -PS&E Totals: $60,000.00 $60,000.00 $53,000.00 $7,000.00 $0.00 Fed. Partic: 100.00% This Finance Letter was created based on specific financial information provided by the responsible local agency. The following encumbrance history Is prepared by Local Assistance Accounting Office and Is provided here for local agency's Information and action. For questions regarding finance letter, contact: Title: HQ Local Assistance Area Engineer Printed Name : Patrick Louie Telephone No: (916) 653-7349 Remarks: Cycle 1 ATP MPO component proiect. CTC ATP ID 0749. Reimbursement ratio = 100%. ACCOUNTING INFORWiATIGN ATPL-5372(015) Cooperative Work Agreement ADV. PROJ. ID APPROP. STATE PROG. FED/STATE ENCUMBRANCE AMOUNT APPROP YEAR EXPENDITURE AMOUNT ENCUMBRANCE BALANCE REVERSION DATE "2030720100 ^ $53,000.00 1314 100 $53,000.00 06/30/19 APPROVED AMOUNT EXPIRATION DATE Page 1 of 1