HomeMy WebLinkAboutResolution #5412 - IDOT; phase II preliminary engineering for reconstruction of pavement on Cherry Street110nois Department
of Transportation
Is this project a bondable capital improvement?
® Yes ❑ No
Resolution for Improvement
Under the Illinois Highway Code
Resolution Type Resolution Number Section Number
Supplemental 22 -00111 -00 -RP
BE IT RESOLVED, by the Council of the City
Governing Body Type Local Public Agency Type
of Canton Illinois that the following described street(s)/road(s)/structure be improved under
Name of Local Public Agency
the Illinois Highway Code. Work shall be done by Contract
Contract or Day Labor
For Roadwav/Street Improvements:
Name of Street(s)/Road(s)
Length
(miles)
Route
From
To
Cherry Street
0.04
IL78/9
Curve
For Structures:
Name of Street(s)/Road(s) Existing Route Location Feature Crossed
Structure No.
BE IT FURTHER RESOLVED,
1. That the proposed improvement shall consist of
Provide Phase II Preliminary Engineering for the reconstruction of the pavement on Cherry Street in the City of
Canton
2. That there is hereby appropriated the sum of seven thousand eighty eight and 50/100
Dollars ( $7,088.50 ) for the improvement of
said section from the Local Public Agency's allotment of Motor Fuel Tax funds.
BE IT FURTHER RESOLVED, that the Clerk is hereby directed to transmit four (4) certified originals of this resolution to the district office
of the Department of Transportation.
I, Andrea J. Smith!Walters City " Clerk in and for said City
Name of Clerk Local Public Agency Type Local Public Agency Type
of Canton in the State aforesaid, and keeper of the records and files thereof, as provided by
Name of Local Public Agency
statute, do hereby certify the foregoing to be a true, perfect and complete original of a resolution adopted by
Council of Canton at a meeting held on March 07, 2023
Goveming Body Type Name of Local Pubic Agency Date
IN TESTIMONY WHEREOF, I have hereunto set my hand and seal this 7th day of March, 2023
Day Month, Year
(SEAL, if required by the LPA) Clerk Si nature & Date
Approved
Regional Engineer Signature & Date
De artment of Transportation
Printed 03/08/23 Page 1 of 1 BLR 09110 (Rev. 01/18/23)
Instructions for BLR 09110 - Page 1 of 2
NOTE: Form instructions should not be included when the form is submitted.
This form shall be used when a Local Public Agency (LPA) wants to construct an improvement using Motor Fuel Tax(MFT) funds. Refer to
Chapter 9 of the Bureau of Local Roads and Streets Manual (BLRS Manual) for more detailed information. 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.
Is this project a bondable capital
improvement? Check Yes if the project was a bondable capital improvement, check no if it is not. An
example of a bondable capital project may include, but is not limited to: project development,
design, land acquisition, demolition when done in preparation for additional bondable
construction, construction engineering, reconstruction of a roadway, designed overlay
extension or new construction of roads, bridges, ramps, overpasses and underpasses, bridge
replacement and/or major bridge rehabilitation. Permanent ADA sidewalk/ramp
improvements and seeding/sodding are eligible expenditures if part of a larger capital
bondable project. A bondable capital improvement project does not mean the LPA was
required to sell bonds to fund the project, however the project did meet the criteria to be
bondable.
Resolution Number Enter the resolution number as assigned by the LPA, if applicable.
Resolution Type From the drop down box choose the type of resolution:
- Original would be used when passing a resolution for the first time for this project.
- Supplemental would be used when passing a resolution increasing appropriation above
previously passed resolutions.
- Amended would be used when a previously passed resolution is being amended.
Section Number
Insert the section number of the improvement the resolution covers.
Governing Body Type
From the drop down box choose the type of administrative body. Choose Board for County;
Council for a City or Town; President and Board of Trustees for a Village or Town.
LPA Type
From the drop down box choose the LPA body type. Types to choose from are: County,
City, Town or Village.
Name of LPA
Insert the name of the LPA.
Contract or Day Labor
From the drop down choose either -Contract or Day Labor.
Roadway/Street Improvements:
Name Street/Road
Insert the name of the Street/Road to be improved. For additional locations use the Add
button.
Length
Insert the length of this segment of roadway being improved in miles.
Route
Insert the Route Number of the road/street to be improved if applicable.
From
Insert the beginning point of the improvement as it relates to the Street/Road listed to the left.
To
Insert the ending point of the improvement as it relates to the Street/Road listed to the left.
Structures:
Name Street/Road
Insert the name of the Street/Road on which the structure is located. For additional locations
use the Add button.
Existing Structure No.
Insert the existing structure number this resolution covers, if no current structure insert n/a.
Route
Insert the Route number on which the structure is located.
Location
Insert the location of the structure.
Feature Crossed
Insert the feature the structure crosses.
1
Insert a description of the major items of work of the proposed improvement.
2
Insert the dollar value of the resolution for the proposed improvement to be paid for with MFT
funds in words followed by in the same amount in numerical format in the ().
Printed 03/08/23 BLR 09110 (Rev. 01/18/23)
Instructions for BLR 09110 - Page 2 of 2
Name of Clerk
Insert the name of the LPA clerk.
LPA Type
Insert the type of clerk based on the LPA type. Types to choose from are: County, City,
Town or Village.
Name of LPA
Insert the name of the LPA.
Governing Body Type
Insert the type of administrative body. choose Board for County; Council for a City or Town;
President and Board of Trustees for a Village or Town
Name of LPA
Insert the name of the LPA.
Date
Insert the date of the meeting.
Day
Insert the day Clerk is signing the document.
Month, Year
Insert the month and year of the Clerk's signature.
Seal
The Clerk shall seal the document here, if required. If a seal is required, electronic signatures
should not be used.
Clerk Signature
Clerk shall sign here.
Approved
The Department of Transportation shall sign and date here once approved.
A minimum of three (3) certified signed originals must be submitted to the Regional Engineer's District office OR email PDF
completed form with electronic signatures to your local District LRS office.
Following IDOT's approval, distribution will be as follows:
Local Public Agency Clerk
Engineer (Municipal, Consultant or County)
District
Printed 03/08/23 BLR 09110 (Rev. 01/18/23)
Ilfinois Department
of Transportation
Local Public Agency
Engineering Services Agreement
Agreement For Agreement Type Numb
Using Federal Funds? El Yes Z No MFT PE Supplement 1
-------___ __-- �__—_ -______..LOCAL PUBLIC AGENCY ---_�__—_—__---_ ___.I
Local Public Agency Count _ Section Number Job Number
Canton I Fulton 22 -00111 -00 -RP
Project Number Contact Name Phone Number Email
Ron Robinson (309) 647-5022rrobinson@cantoncityhall.org
_ S_E_CT__ION P_RO_VIS__ION_S _ _______
Local Street/Road Name — Ke Route ^ — Length Structure Number _
Cherry Street IL
Location Termini Add Location
From IL78/9 to Curve(Entrance to Ameren Canton Operating Center Yard) Remove Location
Phase II Preliminary Engineering for the reconstruction of the pavement
Engineering Funding ® MFT/TBP ❑ State ❑ Other
Anticipated Construction Funding ❑ Federal ® MFT/TBP ❑ State ❑ Other
AGREEMENT FOR------_.__--__—_-----------------�_ 1
❑ Phase I - Preliminary Engineering ® Phase II - Design Engineering
_ ____ _ __
CONSULTANT
Prime Consultant Firm Name �— _ Contact Name --` Phone Number— Email —
Maurer -Stutz, Inc. Keith J. Plavec (309) 693-7615 kjplavec@mstutz.com
Address Citv State Zi Code
3116 N. Dries Ln; Ste 100 Peoria IL 61604
THIS AGREEMENT IS MADE between the above Local Public Agency (LPA) and Consultant (ENGINEER) and covers certain^ —
professional engineering services in connection with the improvement of the above SECTION. Project funding allotted to the LPA by the
State of Illinois under the general supervision of the State Department of Transportation, hereinafter called the "DEPARTMENT," will be
used entirely or in part to finance ENGINEERING services as described under AGREEMENT PROVISIONS.
Since the services contemplated under the AGREEMENT are professional in nature, it is understood that the ENGINEER, acting as an
individual, partnership, firm or legal entity, qualifies for professional status and will be governed by professional ethics in its relationship to
the LPA and the DEPARTMENT. The LPA acknowledges the professional and ethical status of the ENGINEER by entering into an
AGREEMENT on the basis of its qualifications and experience and determining its compensation by mutually satisfactory negotiations.
WHEREVER IN THIS AGREEMENT or attached exhibits the following terms are used, they shall be interpreted to mean:
Regional Engineer Deputy Director, Office of Highways Project Implementation, Regional Engineer, Department of
Transportation
Resident Construction Supervisor Authorized representative of the LPA in immediate charge of the engineering details of the
construction PROJECT
In Responsible Charge A full time LPA employee authorized to administer inherently governmental PROJECT activities
Contractor Company or Companies to which the construction contract was awarded
Completed 03/08/23 Page 1 of 9 BLR 05530 (Rev. 07/08/22)
AGREEMENT EXHIBITS��_
The following EXHIBITS are attached hereto and made a part of hereof this AGREEMENT:
Z EXHIBIT A: Scope of Services
® EXHIBIT B-. Project Schedule
® EXHIBIT C: Qualification Based Selection (QBS) Checklist
® EXHIBIT D: Cost Estimate of Consultant Services (BLR 05513 or BLR 05514 )
® EXHIBIT E : Direct Costs Check Sheet (attach BDE 436 when using Lump Sum on Specific Rate Compensation)
® Location Map
El
THE ENGINEER AGREES,
1. _ To perform or be responsible for the performance of the Scope of Services presented in EXHIBIT A for the LPA in connection
with the proposed improvements herein before described.
2. The Classifications of the employees used in the work shall be consistent with the employee classifications and estimated staff
hours. If higher -salaried personnel of the firm, including the Principal Engineer, perform services that are to be performed by
lesser -salaried personnel, the wage rate billed for such services shall be commensurate with the payroll rate for the work
performed.
3. That the ENGINEER shall be responsible for the accuracy of the work and shall promptly make necessary revisions or
corrections required as a result of the ENGINEER'S error, omissions or negligent acts without additional compensation.
Acceptance of work by the LPA or DEPARTMENT will not relieve the ENGINEER of the responsibility to make subsequent
correction of any such errors or omissions or the responsibility for clarifying ambiguities.
4. That the ENGINEER will comply with applicable Federal laws and regulations, State of Illinois Statutes, and the local laws or
ordinances of the LPA.
5. To pay its subconsultants for satisfactory performance no later than 30 days from receipt of each payment from the LPA.
6. To invoice the LPA, The ENGINEER shall submit all invoices to the LPA within three months of the completion of the work called
for in the AGREEMENT or any subsequent Amendment or Supplement.
7. The ENGINEER or subconsultant shall not discriminate on the basis of race, color, national origin or sex in the performance of
this AGREEMENT. The ENGINEER shall carry out applicable requirements of 49 CFR part 26 in the administration of US
Department of Transportation (US DOT) assisted contract. Failure by the Engineer to carry out these requirements is a material
breach of this AGREEMENT, which may result in the termination of this AGREEMENT or such other remedy as the LPA deems
appropriate.
8. That none of the services to be furnished by the ENGINEER shall be sublet, assigned or transferred to any other party or parties
without written consent of the LPA. The consent to sublet, assign or otherwise transfer any portion of the services to be furnished
by the ENGINEER shall be construed to relieve the ENGINEER of any responsibility for the fulfillment of this AGREEMENT.
9. For Preliminary Engineering Contracts:
(a) To attend meetings and visit the site of the proposed improvement when requested to do so by representatives of the
LPA or the DEPARTMENT, as defined in Exhibit A (Scope of Services).
(b) That all plans and other documents furnished by the ENGINEER pursuant to the AGREEMENT will be endorsed by
the ENGINEER and affixed the ENGINEER's professional seal when such seal is required by law. Such
endorsements must be made by a person, duly licensed or registered in the appropriate category by the Department
of Professional Regulation of the State of Illinois. It will be the ENGINEER's responsibility to affix the proper seal as
required by the Bureau of Local Roads and Streets manual published by the DEPARTMENT.
(c) That the ENGINEER is qualified technically and is thoroughly conversant with the design standards and policies
applicable for the PROJECT; and that the ENGINEER has sufficient properly trained, organized and experienced
personnel to perform the services enumerated in Exhibit A (Scope of Services).
10. That the engineering services shall include all equipment, instruments, supplies, transportation and personnel required to perform
the duties of the ENGINEER in connection with this AGREEMENT (See DIRECT COST tab in BLR 05513 or BLR 05514).
THE LPA AGREES,_�--
1. To certify by execution of this AGREEMENT that the selection of the ENGINEER was performed in accordance with the
Professional Services Selection Act (50 ILCS 510) (Exhibit C).
2. To famish the ENGINEER all presently available survey data, plans, specifications, and project information.
3. To pay the ENGINEER:
(a) For progressive payments - Upon receipt of monthly invoices from the ENGINEER and the approval thereof by the
LPA, monthly payments for the work performed shall be due and payable to the ENGINEER, such payments to be
equal to the value of the partially completed work minus all previous partial payments made to the ENGINEER.
(b) Final payment - Upon approval of the work by the LPA but not later than 60 days after the work is completed and
reports have been made and accepted by the LPA and DEPARTMENT a sum of money equal to the basic fee as
determined in this AGREEMENT less the total of the amount of partial payments previously paid to the ENGINEER
Completed 03/08/23 Page 2 of 9 BLR 05530 (Rev. 07/08/22)
shall be due and payable to the ENGINEER.
(c) For Non -Federal County Projects - (605 ILCS 5/5-409)
(1) For progressive payments - Upon receipt of monthly invoices from the ENGINEER and the approval thereof
by the LPA, monthly payments for the work performed shall be due and payable to the ENGINEER. Such
payments to be equal to the value of the partially completed work in all previous partial payments made to
the ENGINEER.
(2) Final payment - Upon approval of the work by the LPA but not later than 60 days after the work is
completed and reports have been made and accepted by the LPA and STATE, a sum of money equal to
the basic fee as determined in the AGREEMENT less the total of the amount of partial payments previously
paid to the ENGINEER shall be due and payable to the ENGINEER.
4. To pay the ENGINEER as compensation for all services rendered in accordance with the AGREEMENT on the basis of the
following compensation method as discussed in 5-5.10 of the BLR Manual.
Method of Compensation:
❑ Percent
❑ Lump Sum
❑ Specific Rate
® Cost plus Fixed Fee: Fixed
Total Compensation = DL + DC + OH + FF
Where:
DL is the total Direct Labor,
DC is the total Direct Cost,
OH is the firm's overhead rate applied to their DL and
FF is the Fixed Fee.
Where FF = ( 0.33 + R) DL + %SubDL, where R is the advertised Complexity Factor and %SubDL is 10% profit
allowed on the direct labor of the subconsultants.
The Fixed Fee cannot exceed 15% of the DL + OH.
5. The recipient shall not discriminate on the basis of race, color, national original or sex in the award and performance of any US
DOT -assisted contract or in the administration of its DBE program or the requirements of 49 CFR part 26. The recipient shall take
all necessary and reasonable steps under 49 CFR part 26 to ensure nondiscrimination in the award and administration of US
DOT -assisted contracts. The recipient's DBE program, as required by 49 CFR part 26 and as approved by US DOT, is
incorporated by reference in this agreement. Implementation of this program is a legal obligation and failure to carry out its terms
shall be treated as violation of this AGREEMENT. Upon notification to the recipient of its failure to carry out its approved program,
the Department 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.).
Ill. IT IS MUTUALLY AGREED,
1. To maintain, for a minimum of 3 years after the completion of the contract, adequate books, records and supporting documents to
verify the amount, 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 DEPARTMENT; the Federal Highways Administration (FHWA) or any authorized representative of the federal
government, and to provide full access to all relevant materials. Failure to maintain the books, records and supporting documents
required by this section shall establish a presumption in favor of the DEPARTMENT for the recovery of any funds paid by the
DEPARTMENT under the contract for which adequate books, records and supporting documentation are not available to support
their purported disbursement.
2. That the ENGINEER shall be responsible for any all damages to property or persons out of an error, omission and/or negligent
act in the prosecution of the ENGINEER's work and shall indemnify and save harmless the LPA, the DEPARTMENT, and their
officers, agents and employees from all suits, claims, actions or damages liabilities, costs or damages of any nature whatsoever
resulting there from. These indemnities shall not be limited by the listing of any insurance policy.
The LPA will notify the ENGINEER of any error or omission believed by the LPA to be caused by the negligence of the
ENGINEER as soon as practicable after the discovery. The LPA reserves the right to take immediate action to remedy any error
or omission if notification is not successful; if the ENGINEER fails to reply to a notification; or if the conditions created by the error
or omission are in need of urgent correction to avoid accumulation of additional construction costs or damages to property and
reasonable notice is not practicable.
3. This AGREEMENT may be terminated by the LPA upon giving notice in writing to the ENGINEER at the ENGINEER's last known
post office address. Upon such termination, the ENGINEER shall cause to be delivered to the LPA all drawings, plats, surveys,
reports, permits, agreements, soils and foundation analysis, provisions, specifications, partial and completed estimates and data,
if any from soil survey and subsurface investigation with the understanding that all such materials becomes the property of the
LPA. The LPA will be responsible for reimbursement of all eligible expenses incurred under the terms of this AGREEMENT up to
the date of the written notice of termination.
Completed 03/08/23 Page 3 of 9 BLR 05530 (Rev. 07/08/22)
4. In the event that the DEPARTMENT stops payment to the LPA, the LPA may suspend work on the project. If this agreement is
suspended by the LPA for more than thirty (30) calendar days, consecutive or in aggregate, over the term of this AGREEMENT,
the ENGINEER shall be compensated for all services performed and reimbursable expenses incurred prior to receipt of notice of
suspension. In addition, upon the resumption of services the LPA shall compensate the ENGINEER, for expenses incurred as a
result of the suspension and resumption of its services, and the ENGINEER's schedule and fees for the remainder of the project
shall be equitably adjusted.
5. This AGREEMENT shall continue as an open contract and the obligations created herein shall remain in full force and effect until
the completion of construction of any phase of professional services performed by others based upon the service provided
herein. All obligations of the ENGINEER accepted under this AGREEMENT shall cease if construction or subsequent
professional services are not commenced within 5 years after final payment by the LPA.
6. That -the ENGINEER shall be responsible for any and all damages to property or persons arising out of an error, omission and/or
negligent act in the prosecution of the ENGINEER's work and shall indemnify and have harmless the LPA, the DEPARTMENT,
and their officers, employees from all suits, claims, actions or damages liabilities, costs or damages of any nature whatsoever
resulting there from. These indemnities shall not be limited by the listing of any insurance policy.
7. The ENGINEER and LPA certify that their respective firm or agency:
(a) has not employed or retained for commission, percentage, brokerage, contingent fee or other considerations, any
firm or person (other than a bona fide employee working solely for the LPA or the ENGINEER) to solicit or secure
this AGREEMENT,
(b) has not agreed, as an express or implied condition for obtaining this AGREEMENT, to employ or retain the services
of any firm or person in connection with carrying out the AGREEMENT or
(c) has not paid, or agreed to pay any firm, organization or person (other than a bona fide employee working solely for
the LPA or the ENGINEER) any fee, contribution, donation or consideration of any kind for, or in connection with,
procuring or carrying out the AGREEMENT.
(d) that neither the ENGINEER nor the LPA is/are not presently debarred, suspended, proposed for debarment,
declared ineligible or voluntarily excluded from covered transactions by any Federal department or agency,
(e) has not within a three-year period preceding the AGREEMENT been convicted of or had a civil judgment rendered
against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain or
performing a public (Federal, State or local) transaction; violation of Federal or State antitrust statutes or commission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving
stolen property.
(f) are not presently indicated for or otherwise criminally or civilly charged by a government entity (Federal, State, or
local) with commission of any of the offenses enumerated in paragraph and
(g) has not within a three-year period preceding this AGREEMENT had one or more public transaction (Federal, State,
local) terminated for cause or default.
Where the ENGINEER or LPA is unable to certify to any of the above statements in this clarification, an explanation shall be
attached to this AGREEMENT.
8_ In the eventof delays due to unforeseeable causes beyond the control of and without fault or negligence of the ENGINEER no
claim for damages shall be made by either party. Termination of the AGREEMENT or adjustment of the fee for the remaining
services may be requested by either party if the overall delay from the unforeseen causes prevents completion of the work within
six months after the specified completion date. Examples of unforeseen causes included but are not limited to: acts of God or a
public enemy; acts of the LPA, DEPARTMENT, or other approving party not resulting from the ENGINEER's unacceptable
services; fire; strikes; and floods.
If delays occur due to any cause preventing compliance with the PROJECT SCHEDULE, the ENGINEER shall apply in writing to
the LPA for an extension of time. If approved, the PROJECT SCHEDULE shall be revised accordingly.
9. This certification is required by the Drug Free Workplace Act (30 ILCS 580). The Drug Free Workplace Act requires that no
grantee or contractor shall receive a grant or be considered for the purpose of being awarded a contract for the procurement of
any property or service from the DEPARTMENT unless that grantee or contractor will provide a drug free workplace. False
certification or violation of the certification may result in sanctions including, but not limited to suspension of contract on grant
payments, termination of a contract or grant and debarment of the contracting or grant opportunities with the DEPARTMENT for
at least one (1) year but not more than (5) years.
For the purpose of this certification, "grantee" or "Contractor' means a corporation, partnership or an entity with twenty-five (25)
or more employees at the time of issuing the grant or a department, division or other unit thereof, directly responsible for the
specific performance under contract or grant of $5,000 or more from the DEPARTMENT, as defined the Act.
The contractor/grantee certifies and agrees that it will provide a drug free workplace by:
(a) Publishing a statement:
(1) Notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a
controlled substance, including cannabis, is prohibited in the grantee's or contractor's workplace.
(2) Specifying actions that will be taken against employees for violations of such prohibition.
(3) Notifying the employee that, as a condition of employment on such contract or grant, the employee will:
(a) abide by the terms of the statement; and
(b) notify the employer of any criminal drug statute conviction for a violation occurring in the workplace
no later than (5) days after such conviction.
(b) Establishing a drug free awareness program to inform employees about:
(1) The dangers of drug abuse in the workplace;
Completed 03/08/23 Page 4 of 9 BLR 05530 (Rev. 07/08/22)
(2) The grantee's or contractor's policy to maintain a drug free workplace;
(3) Any available drug counseling, rehabilitation and employee assistance program; and
(4) The penalties that may be imposed upon an employee for drug violations.
(c) Providing a copy of the statement required by subparagraph (a) to each employee engaged in the performance of the
contract or grant and to post the statement in a prominent place in the workplace.
(d) Notifying the contracting, or granting agency within ten (10) days after receiving notice under part (b) of paragraph
(3) of subsection (a) above from an employee or otherwise, receiving actual notice of such conviction.
(e) Imposing a sanction on, or requiring the satisfactory participation in a drug abuse assistance or rehabilitation
program.
(f) Assisting employees in selecting a course of action in the event drug counseling, treatment and rehabilitation is
required and indicating that a trained referral team is in place.
Making a good faith effort to continue to maintain a drug free workplace through implementation of the Drug Free Workplace Act,
the ENGINEER, LPA and the Department agree to meet the PROJECT SCHEDULE outlined in EXHIBIT B. Time is of the
essence on this project and the ENGINEER's ability to meet the PROJECT SCHEDULE will be a factor in the LPA selecting the
ENGINEER for future projects. The ENGINEER will submit progress reports with each invoice showing work that was completed
during the last reporting period and work they expect to accomplish during the following period.
10. Due to the physical location of the project, certain work classifications may be subject to the Prevailing Wage Act (820 ILCS
130/0.01 et seq.).
11. For Preliminary Engineering Contracts:
(a) That tracing, plans, specifications, estimates, maps and other documents prepared by the ENGINEER in accordance
with this AGREEMENT shall be delivered to and become the property of the LPA and that basic survey notes,
sketches, charts, CADD files, related electronic files, and other data prepared or obtained in accordance with this
AGREEMENT shall be made available, upon request to the LPA or to the DEPARTMENT, without restriction or
limitation as to their use. Any re -use of these documents without the ENGINEER involvement shall be at the LPA's
sole risk and will not impose liability upon the ENGINEER.
(b) That all reports, plans, estimates and special provisions furnished by the ENGINEER shall conform to the current
Standard Specifications for Road and Bridge Construction, Bureau of Local Roads and Streets Manual or any other
applicable requirements of the DEPARTMENT, it being understood that all such furnished documents shall be
approved by the LPA and the DEPARTMENT before final acceptance. During the performance of the engineering
services herein provided for, the ENGINEER shall be responsible for any loss or damage to the documents herein
enumerated while they are in the ENGINEER's possession and any such loss or damage shall be restored at the
ENGINEER's expense.
AGREEMENT SUMMARY
Prime Consultant (Firm) Name TIN/FEIN/SS Number
Agreement Amount
Maurer -Stutz, Inc. 27-1013849
1$7,088.50
Subconsultants
TIN/FEIN/SS Number
Agreement Amount
Subconsultant Total
Prime Consultant Total
$7,088.50
Total for all work
$7,088.50
Completed 03/08/23 Page 5 of 9 BLR 05530 (Rev. 07/08/22)
AGREEMENT SIGNATURES
Executed by the LPA:
Local Public Agency Type
Attest: The City I of
B Si nature & Date
Local Public A-gency Local Public Agency Type
Canton City Clerk
(SEAL)
Executed by the ENGINEER:
Attest: IMaurer-Stutz, Inc.
B Si nature & Date
Title
Senior Project Engineer
APPROVED:
Reclional Engineer, Department of Transportation (Signature & Date
B Si nature & Date
Title
Mayor
B Si nature & Date
Title
Principal
Completed 03/08/23 Page 6 of 9 BLR 05530 (Rev. 07/08/22)
Prime Consultant (Firm) Name
Irl --4. - IlMaurer-Stutz. Inc. IIFulton 1122 -00111 -00 -RP I
EXHIBIT A
SCOPE OF SERVICES
To perform or be responsible for the performance of the engineering services for the LPA, in connection with the PROJECT herein before
described and enumerated below
Make/complete general and detailed plans, special provisions, proposal and estimate of cost.
Completed 03108/23 . Page 7 of 9 BLR 05530 (Rev. 07/08/22)
Section Number
(Canton IlMaurer-Stutz, Inc. IlFulton 1122 -00111 -00 -RP
. EXHIBIT B.
PROJECT SCHEDULE
Project Begins: May 15, 2022
Complete PS&E: February 10, 2023
Anticipated Letting Date: March 27, 20232
Proiect Completion Date:ADril 30.2023
Completed 03/08/23 Page 8 of 9 BLR 05530 (Rev. 07/08/22)
Name
Canton JlMaurer-Stutz, Inc. JIFulton 1122 -00111 -00 -RP
Exhibit C
Qualification Based Selection (QBS) Checklist
The LPA must complete Exhibit D. If the value meets or will exceed the threshold in 50 ILCS 510, QBS requirements must be followed.
Under the threshold, QBS requirements do not apply. The threshold is adjusted annually. If the value is under the threshold with federal
funds being used, federal small purchase guidelines must be followed.
❑ Form Not Applicable (engineering services less than the threshold)
Items 1-13 are required when using federal funds and QBS process is applicable. Items 14-16 are required when
using State funds and the QBS process is applicable.
No Yes
1
Do the written QBS policies and procedures discuss the initial administration (procurement, management
❑
❑
10
and administration) concerning engineering and design related consultant services?
❑
❑
2
Do the written QBS policies and procedures follow the requirements as outlined in Section 5-5 and
❑
❑
12
specifically Section 5-5.06 (e) of the BLRS Manual?
❑
❑
3
Was the scope of services for this project clearly defined?
1:11
❑
4
Was public notice given for this project?
❑
❑
5
Do the written QBS policies and procedures cover conflicts of interest?
❑
❑
6
Do the written QBS policies and procedures use covered methods of verification for suspension and
❑
❑
debarment?
7
Do the written QBS policies and procedures discuss the methods of evaluation?
I❑
❑
Project Criteria
Weighting
8 JDo the written QBS policies and procedures discuss the method of selection? I ❑ I ❑
9
Was an estimated cost of engineering for this project developed in-house prior to contract negotiation?
❑
❑
10
Were negotiations for this project performed in accordance with federal requirements.
❑
❑
11
Were acceptable costs for this project verified?
❑
❑
12
Do the written QBS policies and procedures cover review and approving for payment, before forwarding
the request for reimbursement to IDOT for further review and approval?
❑
❑
13
Do the written QBS policies and procedures cover ongoing and finalizing administration of the project
(monitoring, evaluation, closing -out a contract, records retention, responsibility, remedies to violations or
breaches to a contract, and resolution of disputes)?
❑
❑
14
QBS according to State requirements used?
❑
15
Existing relationship used in lieu of QBS process?
❑
16
LPA is a home rule community (Exempt from QBS).
®
❑
Completed 03/08/23 Page 9 of 9 BLR 05530 (Rev. 07/08/22)
Instructions for BLR 05530 - Page 1 of 3
Form instructions are not to be submitted with the form
This form shall be used for a Local Public Agency (LPA) to enter into an agreement with an Engineering firm in connection with a project
funded with Federal, State, and/or Motor Fuel Tax (MFT) funds. Based on the selection of type of engineering agreement and funding
type, the form will change. For more information refer to the Bureau of Local Roads and Streets Manual (BLRS) Chapter 5. For signature
requirements refer to Chapter 2, Section 3.05(b) of the BLRS manual.
This form can also be used for structure inspections.
When filing out this form electronically, once a field is initially completed, fields requiring the same information will be auto -populated.
Using Federal Funds? The user must select yes or no. Based on the selection, a drop-down menu will appear. The language
of the form changes based on the selection.
Selecting yes indicates federal funds will be used to fund all or a portion of the engineering for this
phase of this project.
Selecting no indicates no federal funds will be used to fund any engineering for this phase of the
project.
Agreement For
Agreement Type
Number
Local Public Agency
Local Public Agency
County
Section Number
Job Number
Project Number
Contact Name
Phone Number
Email
Section Provisions
Location
Local Street/Road Name
Key Route
Length
Structure Number
Location Termini
Add Location
Remove Location
Project Description
Engineering Funding
If yes was selected for using Federal Funds, select Federal PE or Federal CE from the drop-down.
If no was selected for using Federal Funds, select MFT PE, MFT CE, or MFT PE -CE.
From the drop down, select the type of agreement, types to choose from are: Original or Supplemental
If the agreement is for a supplemental, insert the number of the supplemental using number 1 for the
first supplemental, and increase the numbering as the supplementals increase.
Anticipated Construction Funding
Insert the name of the LPA. This field value is used to populate the LPA name in the
Agreement Signatures and the Exhibit pages.
Insert the name of the county in which the LPA is located.
Insert the section number applied to this project without dashes, dashes are automatically
inserted.
Insert the job number assigned for the project, if applicable.
Insert the project number assigned for this project, if applicable.
Insert the name of the LPA contact for this project.
Insert the phone for the LPA contact listed to the left without dashes.
Insert the email for the LPA contact listed to the left.
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.
Insert the local streettroad name.
Insert the key route of the streettroad listed to the left, if applicable.
Insert the length in miles as it pertains to the location listed to the left. For a structure insert
0.01.
Insert the existing structure number(s) for this project.
Insert the beginning and ending termini as it pertains to this location for this project.
Use this button to add additional location.
Use this button to remove a location added in error. Please note that at least one location is
required.
Insert a description of the work to be accomplished by this project.
Check all boxes that apply, if type other is checked, insert the type of other funding in the box
following "other." The form will change based on the box(es) checked.
Check all boxes that apply, if type other is checked, insert the type of other funding in the box
following 'other."
Completed 03108/23 BLR 05530 (Rev. 07/08122)
Instructions for 131-1105630 - Page 2 of 3
Agreement For
Select the check box for the type of engineering the agreement is for. Phase I for Preliminary
Engineering, Phase II for Design Engineering, Phase III for Construction Engineering. When
Federal Funds are used, Phase I and Phase II can be selected when the agreement is for
Federal PE. When Federal CE is selected, only Phase III can be selected. For MFT, the
Phases can be selected based on the original selection at the top of the form for the
agreement type.
Consultant
Primary Consultant (Firm) Name
Insert the name of the primary consultant firm that will be executing this agreement. This field
value is used to populate the consultant name in the Agreement Summary, Agreement
Signatures and the Exhibit pages.
Contact Name
Insert the name of the contact for the firm listed to the left.
Phone Number
Insert the phone number for the contact listed to the left, without dashes.
Email
Insert the email of the contact listed to the left.
Address
Insert the address of the firm listed to the left.
City
Insert the city of the firm listed to the left.
State
Insert the state of the firm listed to the left.
Zip Code
Insert the zip code of the firm listed to the left.
Agreement Exhibits
Check all that apply, for boxes checked that do not have a description, insert the name of the
exhibit.
Exhibit A
Insert the scope of services covered by this agreement/ project. This exhibit is required.
Exhibit B
Insert the project schedule that applies to this agreement/ project. This exhibit is required.
Exhibit C
Qualification Based Selection (QBS) Checklist process must be followed when the value of
engineering will meet and/or exceed the threshold in 50 ILCS 510. If the process does not
apply, check the form not applicable checkbox on the top of the exhibit page. If the process
applies and using federal funds, complete items 1 through 13. If the process applies and
using state funds, complete items 14 through 16.
Exhibit D
Cost Plus Estimate of Consultant Services (CELS) Worksheet (BLR 05513 or BLR 05514). If
the method of compensation was checked (under LPA Agrees item 4) as Cost Plus Fixed
Fee (Anniversary Raise or Fixed Raise) in the agreement, then this exhibit is required and
the correct BLR form: BLR 05514 for Fixed Raise or BLR 05513 for Anniversary Raise.
Exhibit
Use the remaining boxes and lines to add additional exhibits as needed.
LPA Agrees
Method of Compensation Select the method of compensation for this agreement by checking the applicable box.
If Percent is checked (this is only available when agreement is for MFT funds.), insert in the
box the applicable percentage.
If Lump Sum is checked, complete the box after lump sum showing the lump sum
compensation amount. For agreements funded with federal funds the lump sum shall be
determined by using the Cost Plus Fixed Fee formula.
If Specific Rate is checked, insert the specific rate in the box. The specific rate cannot
exceed $150,000. For a federal project this is limited to testing services only.
If Cost Plus Fixed Fee is checked, select the type of raise the agreement will use:
Anniversary or Fixed. If this method is selected, BLR 05513 or BLR 05514 must be included
in the exhibits.
Completed 03/08/23 BLR 05530 (Rev. 07/08/22)
Instructions for BLR 05530 - Page 3 of 3
Agreement Summary
Prime Consultant (Firm) Name Field populated from the Prime Consultant (Firm) Name entered on the first pages of the
Executed by the Engineer
Prime Consultant (Firm) Name Field populated from the Prime Consultant (Firm) Name entered on first pages of the
agreement.
By The person(s) authorized to sign this agreement from the engineering firm will sign and date
here.
Title Insert the title of the person signing above.
For Agreement using MFT or State Funds only:
Regional Engineer Upon approval the Regional Engineer will sign and date here.
A minimum of four (4) signed originals must be submitted to the Regional Engineer's District office.
Following approval, distribution will be as follows:
Central Office (only for Projects using State and/or Federal Funds)
District
Engineer (Municipal, Consultant or County)
Local Public Agency Clerk
Completed 03/08/23 BLR 05530 (Rev. 07/08/22)
agreement.
TIN/FEIN/SS
Insert the Prime Consultants Taxpayer Identification Number (TIN), Federal Employer
Identification Number (FEIN) or Social Security Number (SS).
Agreement Amount
Insert the maximum agreement amount.
Subconsultant(s)
As applicable, insert the name of each subconsultant engaged in this agreement/ project.
Subconsultants are defined as any firm that is required to complete a Cost Estimate of
Consultant Services (CECS) Worksheet.
TIN/FEIN/SS
Insert the Subconsultants Taxpayer Identification Number (TIN), Federal Employer
Identification Number (FEIN) or Social Security Number (SS).
Agreement Amount
Insert the maximum agreement amount for the subconsultant listed to the left.
Add Subconsultant
If additional lines are needed for additional subconsultants, insert lines as needed and
complete the required information.
Subconsultant Total
This field is automatically completed, it is the sum of all the agreement amounts for all
subconsultants listed.
Prime Total
This field is automatically completed, it is the amount of the prime consultant fee as listed
above.
Total for All
This field is automatically completed, it is the sum of the subconsultant and the prime total.
Agreement Signatures
Executed by LPA
Local Public Agency Type
From the drop down, select the type of LPA. Types to choose from are: City, County, Town,
or Village.
Local Public Agency
Field populated from the Local Public Agency entered on the first pages of the agreement.
By
The LPA clerk will sign here.
By
The LPA official authorized to sign this agreement will sign and date here.
Seal of LPA
The LPA will seal the document here.
Title
Insert the title of the LPA official who signed above.
Executed by the Engineer
Prime Consultant (Firm) Name Field populated from the Prime Consultant (Firm) Name entered on first pages of the
agreement.
By The person(s) authorized to sign this agreement from the engineering firm will sign and date
here.
Title Insert the title of the person signing above.
For Agreement using MFT or State Funds only:
Regional Engineer Upon approval the Regional Engineer will sign and date here.
A minimum of four (4) signed originals must be submitted to the Regional Engineer's District office.
Following approval, distribution will be as follows:
Central Office (only for Projects using State and/or Federal Funds)
District
Engineer (Municipal, Consultant or County)
Local Public Agency Clerk
Completed 03/08/23 BLR 05530 (Rev. 07/08/22)