HomeMy WebLinkAbout1 - Original Submission_ 20220426_869_Amendment 1 J1485 flatDOT Form 224-101
Revised 12/2020
Amendment To:
Project Review
Reimbursable Agreement
Applicant or Local Agency
Project Name
Previously Authorized Amount
$
Agreement Number
J
Region Amended Estimated Costs
$
State Route Mileposts Amendment Number New Total Authorized Amount
$
Reason for Amendment
Recitals
1. The parties hereto entered into original Agreement J- on the day
of , 20 , and
2. Costs have exceeded the original estimate,
Now, Therefore, pursuant to the terms, conditions and performances contained herein and/or attached hereto,
and by this reference made a part of this Agreement, it is mutually agreed between the Parties hereto as
follows:
1. The Parties agree to amend the estimated costs as shown above.
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In Witness Whereof, the Parties hereto have executed this Amendment as of the date last signed below.
REQUESTING ENTITY
WASHINGTON STATE
DEPARTMENT OF TRANSPORTATION
Signature: Signature:
By: By:
Print Name Print Name
Title: Title:
Date: Date:
1485 Olympic
N/A 1
City of Bremerton
Ostrich Bay Creek Culvert Replacements
19,850.80
3,649.20
23,500.00
Original agreement was for inspection services of the Kitsap Way culvert replacement completed in 2021. This project has culverts
being replaced at Price Road and Brentwood Drive in 2022. This amendment will cover inspection services for the voided slab
girders required for the project this year during construction at the manufacturer including, but not limited to: attendance at the
pre-production meeting, inspection of the culvert and materials, marking panels as accepted prior to
shipping, and documentation of the entire process/production on behalf of the City.
1485 5th
May 21
Thomas Knuckey
Director of Public Works and Utilities
4/26/2022
Joseph Perez
WSDOT Project Development Engineer
4/26/2022
DocuSign Envelope ID: 57FF1751-6C9D-4205-AEFD-9B5E72596B6A
--------- 5/11/2022 ----------5/12/2022