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Home My WebLink AboutLocal Agency Agreement - WSDOT - SR 303 Adaptive Signals Local Agency Agreement Supplement Agency Supplement Number Project Number Agreement Number ALN. 20.205 - Highway Planning and Construction Federal Highway Administration (FHWA) Project Description Name Length Termini Description of Work No Change Yes Type of Work PE % Federal Aid Participation Ratio(s) for PE a. Agency Estimate of Funding (1) Previous Agreement/Suppl. (2) Supplement (3) Estimated Total Project Funds (4) Estimated Agency Funds (5) Estimated Federal Funds . Other . Other . State Services . Total PE Cost EstimateRW % Federal Aid Participation Ratio(s) for RW . Agency . Other . Other . State Services . Total R/W Cost EstimateCN % Federal Aid Participation Ratio(s) for CN . Contract . Other . Other . Other . Agency . State Services . Total CN Cost Estimate . Total Project Cost Estimate Title Washington State Department of Transportation DOT Form 140-041LP Revised 09/2025 Previous Versions Obsolete Page 1 SR 303 Adaptive Signals (Sheridan to Riddell)1.28 miles Sheridan Road to NE Riddell Road Construction obligation 06/01/2028 9/16/2026 City of Bremerton 02 CRRSAA-0303(017)LA10670 Mayor, City of Bremerton Agency Supplement Number Project Number Agreement Number ALN 20.205 - Highway Planning and Construction Federal Highway Administration (FHWA) VI. Payment and Partial Reimbursement VII. Audit of Federal Consultant Contracts IX. Payment of Billing VIII. Single Audit Act XVII. Assurances DOT Form 140-041LP Revised 09/2025 Previous Versions Obsolete Page 2 City of Bremerton 02 CRRSAA-0303(017)LA10670 Instructions Agency Supplemental Number Project Number Agreement Number Project Description Description of Work Reason for Supplement Indirect Cost Rate Project Agreement End Date For PE and RW For Construction Advertisement Date Type of Work and Funding (Round all amounts to the nearest whole dollar). Column 1 Column 2 Column 3 Columns 4 and 5 Signatures Note: DOT Form 140-041LP Revised 09/2025 Previous Versions Obsolete Local Agency Federal Aid Project Prospectus Route ( ) Federal Aid Project Number Local Agency Project Number WSDOT Use Only Date DUNS Number Federal Employer Agency CA Agency Yes No Federal Program Title 20.205 Other Project Title Start Latitude N End Latitude N Start Longitude W End Longitude W Project Termini From-To Nearest City Name Project Zip Code (+4) Begin Mile Post End Mile Post Length of Project Award Type Local Local Forces State Railroad Begin Mile Point End Mile Point City Number County Number County Name WSDOT Region Legislative District(s) Congressional District(s) Urban Area Number Phase Total Estimated Cost (Nearest Hundred Dollar) Local Agency Funding (Nearest Hundred Dollar) Federal Funds (Nearest Hundred Dollar) Phase Start Date Month Year P.E. R/W Const. Total Description of Existing Facility (Existing Design and Present Condition) Roadway Width Number of Lanes Description of Proposed Work Description of Proposed Work (Attach additional sheet(s) if necessary) Local Agency Contact Person Title Phone Mailing Address City State Zip Code Project Prospectus By Approving Authority Title Date DOT Form 140-101 Revised 0 /20 Previous Editions Obsolete ( ) Page 1 Agency Project Title Date Type of Proposed Work Project Type (Check all that Apply) New Construction Reconstruction Railroad Bridge Path / Trail Pedestrian / Facilities Parking 3-R 2-R Other Roadway Width Number of Lanes Geometric Design Data Description Federal Functional Terrain Posted Speed Design Speed Existing ADT Design Year ADT Design Year Design Hourly Volume (DHV) Through Route Urban Rural NHS Principal Arterial Minor Arterial Collector Major Collector Minor Collector Local Access Flat Roll Mountain Crossroad Urban Rural NHS Principal Arterial Minor Arterial Collector Major Collector Minor Collector Local Access Flat Roll Mountain Performance of Work Preliminary Engineering Will Be Performed By Others % Agency % Construction Will Be Performed By Contract % Agency % Class I - Environmental Impact Statement (EIS) Project Involves NEPA/SEPA Section 404 Interagency Agreement Class III - Environmental Assessment (EA) Project Involves NEPA/SEPA Section 404 Interagency Agreements Class II - Categorically Excluded (CE) Projects Requiring Documentation (Documented CE) Environmental Considerations DOT Form 140-101 Revised 0 /20 Previous Editions Obsolete Page 2 Agency Project Title Date Right of Way No Right of Way Needed * All construction required by the contract can be accomplished within the exi ting right of way. Right of Way Needed No Relocation Relocation Required Utilities No utility work required All utility work will be completed prior to the startof the construction contract All utility work will be completed in coordinationwith the construction contract Railroad No railroad work required All railroad work will be completed prior to the start ofthe construction contract All the railroad work will be completed in coordinationwith the construction contract Is any airport located within 3.2 kilometers (2 miles) of the proposed project? Yes No Remarks This project has been reviewed by the legislative body of the administration agency or agencies, or it’s designee, and is not inconsistent with the agency’s comprehensive plan for community development. Agency ByDate Mayor/Chairperson DOT Form 140-101 Revised 0 /20 Previous Editions Obsolete Page 3 February 26, 2026 Mr. Chance Berthiaume Interim Public Works Director City of Bremerton 100 Oyster Bay Avenue N Bremerton, Washington 98312 City of Bremerton SR 303 Adaptive Signals (Sheridan to Riddell) CRRSAA-CRPUM-0303(017) FSBE Goal & Training Hours Dear Mr. Berthiaume: Under the directions of WSDOT Office of Equity and Civil Rights, this project was evaluated for an FSBE goal under their established procedures and criteria. The results were that this project can support a set aside amount of Seven percent as an FSBE goal for this project. This evaluation of the FSBE is not a Condition of Award (COA) and cannot be utilized as a consideration in the award of this project. The Local Agency should monitor the prime contractor’s progress towards meeting the assigned FSBE goal and perform an on-site commercial useful function review of all identified FSBE subcontractors. It is required that the prime contractor submits GFE documentation at physical completion if the project’s assigned FSBE goal is not met. The agency must include the following special provision in the contract. APWA GSP 1-07.11 Option D In addition, a federal training goal of Zero hours were established for this project. If you have any questions, please contact Earl Key at 360.705.7095, or by email at earl.key@wsdot.wa.gov. Sincerely, Michele L. Britton, PE Asst. State Local Programs Engineer Local Programs MLB:jd:ml cc: Ned Lever, PE, Bremerton City Engineer Shane Weber, PE, PTOE, Managing Engineer Transportation Capital Isabel Servedio, Project Assistant John Ho, PE, Olympic Region Local Programs Engineer Local Programs Authorization Package Checklist Agency: City of Bremerton Project Title: SR 303 Adaptive Signals (Sheridan to Riddell) Fed Aid/State Project#: _C _R_R_SA_A_-_0 _30_3�(0_1_7�) _______________________________ _ By Phase (check all that apply) Funding Request PL* PE** RW New Phase Authorization □ □ □ Phase Modification □ □ □ *PL -Planning. Used for stand-alone planning and study projects. CN [2J □ Non-Funding Request De-Obligation Request □ □ **PE -Preliminary Engineering. This is the full design phase of a construction project. Once PE is authorized,Region HQ the construction phase must be completed, or all federal expenditures must be repaid. Check Check __ _____;,_ _ _____;,_____;,,___....;..__ _ _____,;_,_ ___ _____;;;......,.;...._-----,_,□ Miscellan eo us Items -WS DOT USE ONLY If authorizing a subsequent phase on an existing project, has at least one bill for the prior phase been fully processed by Local D Programs (Posted date is present in SPORT)? If not, supplement can't be processed. Has the scope changed (description of work, limits, staging, RW needs, etc.) since previous submittal? D If requesting >10% increase to a phase as a MODIFICATION ONLY, is there a documented justification? D If authorizing CN, is there excessive funding left in PE or RW? If so, Supplement cannot be processed. D Fed Project Prospectus(DOT Form 140-101 01/22) or Planning Prospectus(272-090 04/15) □ □ State Funded Prospectus (DOT Form 140-052 12/24) or Planning Prospectus (DOT Form 140-053 12/24)X _________...........,_ Are all pages (instructions removed) of the current form included? Find new form: HERE D Does information (title, termini, description, RW needs, cost, etc.) agree with STIP/LAA/NEPA-CE? D Is the project description written such that the project scope is clear to an average person? D Are all agency signature fields signed? All signatures must be electronic or signed in non-black ink.D If the LPE or an agency is acting as CA, enter CA agency name below or include copy of CA agreement (MOU, PAA, etc). DCA Agency: City of Bremerton OR D Olympic Region Local Programs Are the Latitude and Longitudes (decimal format) included and correct? D Are Congressional and Legislative Districts included and correct? D Does the Project Zip Code include the +4? D Are estimated costs and start dates included for all phases of the project? Rounded to nearest hundred dollars D Are the Functional Classification and Urban/Rural designation correct, if applicable? D Are the Right of Way, Utilities, and Railroad sections filled out? Are they accurate for the current phase? D iTypical Sections & Vicin ity Map -LAG Chapter 21 X D D .. W_.h_.e_n_n_e_c_e-ss_a_ry_,-a-re-th_e_V_i-ci-n-it_y_,,M_a_p_( ... s)_a_n_d_R_o_a_d_w_a_y._S _e _ct-io-n-(s_)_i -nc-1-ud_e_d_? __________________ __,..__.�-D Can someone unfamiliar with the project's location easily tell where it's located using the vicinity map? D Are the project termini and limits clearly visible & marked on the V icinity Map? D Does the section include all elements, with dimensions, of the roadway prism? D Are section changes, if applicable, throughout the project limits noted/displayed? D .. s_T_IP ..... /_Fu_n_d_i_n ..._g _D_o_c_um_e_n _ta_t_io_n_-_LA_G_C_ha_,P-.__t_e_r _1_2 ___________________ .__x__._D CJIs the currently approved STIP page included? D Does STIP information (termini, description, etc.) match the LAA and Prospectus? D Is the phase being authorized (or a later phase) programmed in the STIP? D Is funding from all requested programs shown in the STIP? D Are the requested funds supported by the STIP? D If funded through a HQ managed program (ex. Bridge, HSIP), is the award letter included when these are first obligated? D If funded through a HQ managed program, does the submitted scope match the project summary scope? D Local Agen cy Agreemen t (DOT Fo rms 140-039 09/25 & 140-041 09/25) □ □ State Funded Local Agency Agreemen t (DOT forms 140-087 12/24 or 140-087A 12/24) X --=------------------Agreements that require changes/corrections will be returned to the agency for resubmittal. Agencies may make Initialled changes to the form EXCEPT IN NUMERICAL FUNDING FIELDS. Is the agreement signed with a certified electronic signature or, if it's a scanned copy of an original signature, is it signed in non black ink? Scanned black ink signatures are no longer acceptable and will be returned for resubmittal. Was a new form pulled from the website? Is the most current form used? Find current form! HERE Are all pages of the Agreement (excluding Instructions) included? Are the Agency information, Project#, LAA#, Supplement#, and date of original agreement execution correct? WSDOT Olympic Region Local Programs Authorization Package Checklist REV 2/2026 *PREVIOUS VERSIONS OBSOLETE* □ □ □□ Region HQ PAGE 1 of 2 Local Programs Authorization Package Checklist Agency Check Check Lo cal Agen cy Agree ment (DOT Fo rms 140-039 12/2 4 & 140-041 12/2 4) (Continued) State Funded Lo cal Agen cy Agree ment (DOT fo rms 140-087 12/2 4 o r 140-087A 12/2 4) When not authorizing a new phase, is the end date the same as shown on the previous agreement? If not, is adequate justification (see LAG 22.3) included to support changing the end date? If authorizing a new phase, is the LAG guidance followed (add 3 years to anticipated end of phase)? Is the Advertisement Date (must include Month, Date and Year) within 6 weeks of estimated CN Authorization? (Must be a date on or after CN Authorization) If the ICR box is checked 'Yes', is the agency's current approved/self-certifed rate documentation provided? Must clearly show a single rate to be used, timeframe it covers, & actual signature of approval. Are all federal aid participation ratios being used listed? If de-obligating funds on any line, does it reduce obligation below expenditures? Are amounts calculated correctly and shown in the correct columns? Amounts must be rounded to whole dollars. Submittals with mathematical errors will be returned. □ □ □ □ □ □ □ □ �D �o�c�u_m�e_n�te�d�Co_s�t_E�s�ti_m_a �te.;....-_LA_G.;....2_2�.4_a�n_d�A-e�n_d_i_x _2_2�.5�6---------------L�x.;...J _n � Is a Documented Cost Estimate included for each phase requesting/changing funds? � Are total dollars on the LAA supported by the documented phase estimates? D Does the estimate sufficiently demonstrate how the costs were determined? D Right of Way -LAG C hapte r 25 X D 11 .. lf -a=u-th_o_r-iz-in_g_R�W-,-is-a-tr_u_e -co-s�t-e-st-im_a_t_e_s-um_m_a_ry_s_h_e_e_t -in_cl_u-de_d_?___________________________ D L.....J Does the true cost estimate summary sheet support RW amounts shown on the LAA? D If authorizing RW and Relocation is required, is the signature page of the approved Relocation Plan included? D If authorizing CN, is the Local Programs approved RW Certification included? D If RW acquired under the Government Acquisitions Provision, is approval documentation included? D .. E_n _vi _ro_n_m_e _nt_a_l _D_o_c _u _m _e_n _ta_t _io_n __ 7_A __ p __ p_ro_v_a_l ... (N_EP_A __ ) __ -_LA_G_C_ti_a_.p_t _e _r _2 4 ____________ ,__x__._r7 CJIs an approved NEPA package (at least signature page) included? "'1:]""" Does the description of work match the Prospectus/LAA/STIP? D Is the footprint of the project within the limits of the NEPA approval? D Do the NEPA-CE Part 3 RW responses agree with the STIP and Prospectus? D Is the approval date within the last 3 years AND after June 2022? D If "No" to the above, has the approval been re-evaluated by the environmental engineer? D FSBE Goals (LAG C hapte r 26) -Tied Bid (LAG C hapte r 44) -Lo cal Fo rces (LAG C hapte r 6 1) If using a fed funding for a consultant in any phase, is the FSBE goal letter/email included, or are the goals in SPORT? If authorizing construction, is the FSBE goal letter/e-mail included, or are the goals in SPORT? QD If construction includes a tied bid project, is the approved PIF included or noted in SPORT? If construction by Local Forces, is the approved PIF included or noted in SPORT? PROJECT NOTES (P ro vide add itional info rmation o r explanation as ne cessa ry) WSDOT Olympic Region Local Programs Authorization Package Checklist REV 2/2026 •PREVIOUS VERSIONS OBSOLETE• □ □ □ PAGE 2 of 2 COB ENGINEERING LABOR ESTIMATE CONSTRUCTION SR 303 Adaptive Signals {Sheridan to Riddell) Task# Tasks & Subtasks Billing Rates -1 Pre-Construction Pre-Construction meeting Submittal Review RAM/ROM documentation - -2 Construction -Project Management/Engineering Construction Inspection Progress Pay Estimates Training/Coordination with Econolite -3 Construction Meetings -Weekly Construction Mtg (10 wks) - -4 Project Closeout -Project closeout paperwork Project final progress payment Punch List Substantial Completion Physical Completion Task Total Hours Task Cost Avg Hrs/Wk Construction (T3+T4) QJ C "' .s::; V) � .0 QJ s Managing Engineer 113.00 26 2 16 8 46 40 6 10 10 6 2 2 2 88 $ 9,944 3.7 :c � � "' 0. "' :� 0 Project Manager 96.00 I I 128 8 80 40 265 225 40 30 30 61 40 10 8 2 1 484 $ 46,464 19.7 2 N "'� !!! C 0 "' u u. :t: u ·c� ·e Engineering Signal Tech IV Tech IV 69.00 48.00 I I 82 22 2 2 80 20 160 580 40 520 60 120 10 10 10 10 6 30 10 10 6 10 258 642 $ 17,802 $ 30,816 $ 11.3 39.3 "' z C "' > a: Project Assistant 52.00 24 4 20 115 105 10 20 20 22 16 4 1 1 181 - - - - - - - - - 9,429 9.0 f� f :::, Q 0 6 ::c .a iii !I 0 � I- I- 282 $ 23,188 18 176 88 1166 $ 75,498 370 560 116 120 80 $ 6,220 80 125 $ 9,549 68 26 26 3 2 1653 $ 114,455 $ (114,455) T:\PROJECT FILES\PROJECT-Transportation Files\315059-SR303 Adaptive Signals\100 FINANCIAL\2 LOANS AND GRANTS\4-Obligation-CN\20260706 CN Obligation Package\05 Agency� �264:03 PM Independent Estimate For Consultant Services Worksheet Agency: City of Bremerton I Federal Project No.: CRRSAA-0303(017) Project Name: SR 303 Adaptive Signals (Sheridan to Riddell) Prepared By: Olivia Paraschiv, P.E. Type of Services Construction Support Services (Transpo) Agency Supplied Materials (Econolite ASC) Reimbursable A.Travel and Per Diem B.Reproduction Expenses C.Computer Expense D.Communication E.Sampling and Testing F.Outside Consultants G.Other Contingency $0.00 Total ---------- loate: 8/4/26 Estimated Cost Comments $44,501.00 Previously executed agreement with Transpo $256,991.00 City will purchase after PIF approval by WSDOT $301,492.00 $0.00 $0.00 $0.00 $0.00 $15,000.00 3rd Party Material Testing -------$0.00 Total: $15,000.00 Sub-Total $316,492.00 5% Contingency $15,824.60 -------'----- Grand Total $332,317 Engineer's Opinion of Probable Project Costs City of Bremerton -SR-303 Adaptive System from Sheridan to Riddell Final Submittal 1.23328.00 August 4, 2026 Description of Work: This project involves the installation of traffic signal and ITS improvements in support of an adaptive signal control system, to be procured as part of a separate contract. The traffic signal improvements include new vehicle detection systems, while the ITS improvements include a new fiber opticcommunications system along SR 303, between Sheridan Road and NE Riddell Road, which will connect back to the City of Bremerton's communications room at Fire Station 3 via existing City copper along Sheridan Road and Olympus Drive NE. A secondary backhaul route utilizing existing KPUD fiber will also route to Fire Station 3 via a connection at SR 303 at Sylvan Way. For the purposes of this estimate, the adaptive signal control system costs are included under City Furnished. Assumptions: 1. Existing conduits will be used to the extent possible, such as at existing traffic signals and along SR 303. Conduits have been proofed and pull string has been installed. 2. New fiber optic cable will be primarily be routed through new cable vaults and existing junction boxes. 3. Existing surfaces will be restored to existing conditions. For example, existing concrete sidewalks will be restored with concrete. It is assumed that civil restorations will be limited to sidewalk and asphalt patches, and that new curb ramps will not be needed. Item No. Spec Section Item Description Quantity Unit Unit Price Total Price ITS PS&E -Detection and Communications Improvements 1 SP 1-04 Minor Change 1 EST $ 75,000 $ 75,000 2 SP 1-05 Roadway Surveying 1 LS. $ 25,000 $ 25,000 3 SP 1-05 Record Drawings (Minimum Bid $5,000) 1 LS. $ 5,000 $ 5,000 4 1-07 SPCC Plan 1 LS. $ 5,000 $ 5,000 5 2-01 Mobilization 1 LS. $ 122,500 $ 122,500 6 2-04 Traffic Control Supervisor 1 LS. $ 44,000 $ 44,000 7 2-04 Pedestrian Traffic Control 1 LS. $ 15,000 $ 15,000 8 2-04 Other Traffic Control Labor 440 HR $ 65 $ 28 ,600 9 SP 2-04 Project Information Sign 2 E.A. $ 1,000 $ 2,000 10 2-04 Sequential Arrow Sign 440 HR $ 15 $ 6,600 11 2-04 Portable Changeable Message Sign 672 HR $ 10 $ 6,720 12 2-04 Other Temporary Traffic Control Devices 1 LS. $ 31,250 $ 31,250 13 4-04 Crushed Surfacing Base Course 14 TON $ 250 $ 3,500 14 5-04 Commercial HMA 6 TON $ 350 $ 2,100 15 7-05 Combination Inlet 1 E.A. $ 2,750 $ 2,750 16 SP8-02 Roadside Restoration 1 LS. $ 5,000 $ 5,000 17 8-04 Cement Cone. Traffic Curb and Gutter 27 LF. $ 75 $ 2,025 18 SP 8-14 Cement Cone. Sidewalk 83 S.Y. $ 200 $ 16,600 19 SP8-20 Traffic Signal System Modification -SR 303 & Sheridan Rd 1 LS. $ 50,000 $ 50,000 20 SP8-20 Traffic Signal System Modification -SR 303 & Sylvan Way 1 LS. $ 50,000 $ 50,000 21 SP8-20 Traffic Signal System Modification -SR 303 & E Broad St 1 LS. $ 50,000 $ 50,000 22 SP8-20 Traffic Signal System Modification -SR 303 & Hollis St 1 LS. $ 57,500 $ 57,500 23 SP8-20 Traffic Signal System Modification -SR 303 & NE Riddell Rd 1 LS. $ 185,000 $ 185,000 24 SP8-20 Communications System 1 LS. $ 542,500 $ 542,500 25 SP 8-32 Potholing 8 E.A. $ 1,000 $ 8,000 Subtotal: $ 1,341,645 10% Contigencv: $ 134,165 Contractor Total: $ 1,475,810 Coty Furnished Item No. I Spec Section I Item Description Quantity I Unit I Unit Price Total Price ITS PS&E -Detection and Communications Improvements 1 I SP 8-20, Vendor RFP !Vehicle Detection Equipment 1 I LS. 1$ 125,000 $ 125,000 2 I Vendor RFP !Adaptive Signal Control Software 1 I LS. 1$ 73,100 $ 73,100 3 I Vendor RFP !Adaptive Signal Control Licensing (3-Year) 1 I LS. I$ 37,240 $ 37,240 Subtotal: $ 235,340 Tax/9.2%): $ 21,651 City Total: $ 256,991 Construction Total $ 1,732,801 i Page 1 of 1 MPO/RTPO: PSRC County: Kitsap Agency: Bremerton STIP ID: BRE-31 Y Inside Total Project Washington State S. T. I. P. 2026 to 2029 (Project Funds to Nearest Dollar) N Outside Fune Project Agency Project Imp Length Environmental RW Begin Cls Number PME Identifier Type Type Required Termini 03 0303(017) 24 0.000 No Sheridan Road SR 303 Adaptive Signals (Sheridan to Riddell) Install adaptive signal system at signalized intersections, including fiber optic cables and a central control system with servers. Funding Phase Start Date CN 2026 Expenditure Schedule Phase ALL Totals Federal Funds Federal Fund Code State Fund Code STBG(UM) 1,667,348 Project Totals 1,667,348 1st 2nd 1,927,570 0 1,927,570 0 End Termini Riddell Road State Funds 0 0 3rd 0 0 Total Est. Cost of Project 2,520,000 Local Funds 260,222 260,222 4th 0 0 August 5, 2026 Total 1,927,570 1,927,570 5th &6th 0 0 Page 1 STIP Amend. No. 2603 AdMod Puget Sound Regional Council 1011 WESTERN AVENUE, SUITE 500 \\\ SEATTLE, WA 98104·1035 ·:--,\ psrc.org: \ 206 ·464·7090 November 10, 2022 The Honorable Greg Wheeler City of Bremerton 345 6th Street, Suite 100 Bremerton, WA 98337 (p..A r'P, Dear Mayor eeler: Congratulations! I'm pleased to let you know that the City of Bremerton is receiving $2,068,230 in PSRC funding for the following project: PROJECT AWARD FUNDING FUNDING AMOUNT SOURCE DEADLINE SR 303 Corridor Improvements Phase 2 $468,230 FHWA August 15, 2024 $1,600,000 FHWA June 1, 2026 The projects are part of a $5.4 billion Regional Transportation Improvement Program for 2023-2026 that was adopted by PSRC's Executive Board in October. Final approval by the Governor and federal funding agencies is expected in early 2023. This program includes a wide variety of investments over the next four years, addressing the needs of transit, state and local roadways, bicycle and pedestrian facilities, maintenance and preservation, and others. Your project performed well in PSRC's merit-based project selection process, which identifies priority projects that will improve local and regional mobility and help achieve our long-range Regional Transportation Plan. Kudos to you and your staff for securing this funding. -� Thank you and your team for continuing to provide essential services to your community throughout the pandemic. I look forward to continuing to partner with you on efforts to help the region thrive for the long term. Sincerely, {��---Josh Brown Executive Director, Puget Sound Regional Council cc: Tom Knuckey, Public Works Director CE per PA 1/8/26 1/8/26 No Right-of-Way {ROW) Needed Verification Checklist This verification checklist is a tool to be used during the completion of the Project Prospectus to aid in determining if ROW is needed for a project. Please verify each of the following statements by comparing the ROW plan against the PS&E (refer to Appendix 25.174 & Appendix 25.175 for additional guidance): Yes N/A The project can be constructed, operated AND maintained entirely within the X acquiring agencys existing ROW, which was obtained under one or more of the following methods: 1.ROW acquisition occurred prior to July 1, 1971/the Uniform Act;X 2.ROW was certified under a previous federal aid project;X 3.ROW was purchased for a purpose other than this project, and is no longer X needed for its original purpose; and/or 4.ROW was obtained through normal dedication or exaction procedures not X related to this project (there was no unconstitutional taking). Early acquisition or donation was not obtained specifically for this project. X The acquiring agency does not need to obtain any interest in, or possession of, real X property (including temporary uses, easement, access rights, air rights and/or airspace) to construct, operate and maintain the proposed project. The acquiring agency solely needs temporary rights to perform work exclusively for X the benefit of the property owner and does not cause compensable damages, which work may not be done if agreement cannot be reached. Real property improvements are not encroaching into the existing ROW and/or X airspace. If all the answers to the above are "Yes" or "NA" then no ROW acquisition is X needed, sign the Design Approval Documentation form (Appendix 43.62) and place a copy in the project file. Shane Weber, P.E. By: Approving Authority Print Name Date Regulatory Definitions: Access rights mean the right of ingress to and egress from a property that abuts a street or highway. Acquiring agency means a State agency, other entity, or person acquiring real property for title 23 of the United States Code purposes. Acquisition means activities to obtain an interest in, and possession of, real property. Air rights mean real property interests defined by agreement, and conveyed by deed, lease, or permit for the use of airspace. Airspace means that space located above and/or below a highway or other transportation facility's established grade line, lying within the horizontal limits of the approved right-of-way or project boundaries. Damages means the loss in value attributable to remainder property due to severance or consequential damages, as limited by State law, that arise when only part of an owner's property is acquired. Donation means the voluntary transfer of privately owned real property for the benefit of a public transportation project without compensation or with compensation at less than fair market value. Early acquisition means acquisition of real property by State or local governments in advance of Federal authorization or agreement. Easement means an interest in real property that conveys a right to use a portion of an owner's property or a portion of an owner's rights in the property. Program or project means any activity or series of activities undertaken by a Federal Agency or with Federal financial assistance received or anticipated in any phase of an undertaking in accordance with the Federal funding Agency guidelines. Real property means land and any improvements thereto, including but not limited to, fee interests, easements, air or access rights, and the rights to control use, leasehold, and leased fee interests. Right-of-way means real property and rights therein used for the construction, operation, or maintenance of a transportation or related facility funded under title 23 of the United States Code. DOT 140-577 6/2021 Page 1 of 2 Uniform Act means the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended (Public Law 91-646, 84 Stat. 1894), and the implementing regulations at 49 CFR Part 24. DOT 140-577 6/2021 Page 2 of2