HomeMy WebLinkAboutR-24-69VILLAGE OF DEERFIELD
RESOLUTION NO. 2024- R-24-69
A RESOLUTION APPROVING AN AGREEMENT WITH CIVILTECH
ENGINEERING, INC OF ITASCA, ILLINOIS FOR
PHASE III ENGINEERING SERVICES
WHEREAS, the Village of Deerfield ("Village') is a home rule municipality in
accordance with Article VII, Section 6 of the Constitution of the State of Illinois of 1970;
and
WHEREAS, the Village desires to retain a qualified firm to provide Phase III
Engineering Services ("Services'); and
WHEREAS, the Village issued a request for qualifications for qualified firms to
complete the Services; and
WHEREAS, the Village has determined that the proposal submitted by Civiltech
Engineering of Itasca, Illinois ("Consultant'), is the most appropriate for the provision of
the Services; and
WHEREAS, the Village and Consultant desire to enter into an agreement for the
provision of the Services by Consultant ("Agreement'); and
WHEREAS, the Mayor and Board of Trustees have determined that entering into
the Agreement with Consultant will serve and be in the best interest of the Village and its
residents;
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE BOARD OF
DEERFIELD, LAKE AND COOK COUNTIES, ILLINOIS, as follows:
SECTION 1: RECITALS. The Village Board hereby adopts the foregoing recitals
as its findings, as if fully set forth herein.
SECTION 2: APPROVAL OF AGREEMENT. The Agreement by and between
the Village and Consultant is hereby approved in substantially the form attached to this
Resolution as Exhibit A, and in a final form and substance acceptable to the Village
Manager and the Village Attorney.
SECTION 3: AUTHORIZATION TO EXECUTE AGREEMENT. The Mayor and
the Village Clerk are hereby authorized and directed to execute and attest, on behalf of the
Village, the final Agreement upon receipt by the Village Clerk of at least one original copy
of the final Agreement executed by Consultant; provided, however, that if the executed copy
of the final Agreement is not received by the Village Clerk within 60 days after the effective
date of this Resolution, then this authority to execute and attest will, at the option of the
Mayor and Board of Trustees, be null and void.
(00120920.11
SECTION 4: EFFECTIVE DATE. This Resolution shall be in full force and effect
from and after its passage and approval according to law.
AYES: Benton, Berg, Goldstone, Jacoby, Oppenheim
NAYS: None
ABSTAIN: None
ABSENT: Metts-Childers
PASSED: October 7, 2024
APPROVED: October 7, 2024
RESOLUTION NO: R-24-69
Daniel C. Shapiro, Mayor
ATTEST:
)*J�1. 5��L
Kent S. 4treet, Village Olerk
100120920.11
EXHIBIT A
Ap,reement
{00120920.11
j Illinois Department
of Transportation
Agreement For
Using Federal Funds? ® Yes ❑ No Federal CE
LOCAL PUBLIC AGENCY
Local Public Agency
Engineering Services Agreement
Agreement Type Number
Original �J
Local Public Agency Count Section Number Job Number
Deerfield Lake 20-00108-00-PV C-91-150-24
Project Number Contact Name Phone Number Email
E4Y2(438) Tyler Dickinson, P.E. (847) 719-7463 tdickinson@deerfield.il.us
SECTION PROVISIONS
Local Street/Road Name Ke Route Length Structure Number
Hazel Avenue FAU 1263 0.96 049-6152
Location Termini Add Location
Wilmot Road to Waukegan Road Remove Location
The project consists of pavement widening and reconstruction. New B-6.12 curb and gutter will be provided from
Illinois Trail to Waukegan Road. The existing 4-foot carriage walk will be replaced with a 6-foot carriage walk
and the existing 4-foot sidewalk will be replaced with 5-foot sidewalk in its current locations. Also included are
drainage system improvements and replacement of the existing watermain. Other improvements will include
ADA sidewalk upgrades, spot sanitary improvements, bridge deck sealing, driveway improvements, as well as all
other incidental and collateral work necessary to completer the Droiect Der the plans and specifications.
Engineering Funding ® Federal ❑ MFT/TBP ❑ State
Anticipated Construction Funding ® Federal ❑ MFT/TBP ❑ State
® Other +REBUILD Illinois Bond Funds
® Other IREBUILD Illinois Bond Funds
AGREEMENTFOR
® Phase III - Construction Engineering
CONSULTANT
Prime Consultant Firm Name Contact Name Phone Number Email
Civiltech Engineering, Inc. James D. Ewers, PE (630) 735-3383 jewers@civiltechinc.com
Address Ci State Zip Code
Two Pierce PI, Suite 1400 Itasca IL 60143
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
Completed07124/24 Page 1 of 9 BLR 05530 (Rev. 07/08/22)
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
AGREEMENT EXHIBITS
The following EXHIBITS are attached hereto and made a part of hereof this AGREEMENT
® EXHIBIT A: Scope of Services
® EXHIBIT B: Project Schedule
® EXHIBIT C: Qualification Based Selection (QBS) Checklist
® EXHIBIT D: Cost Estimate of Consultant Services (CECS) Worksheet (BLR 05513 or BLR 05514 )
® BC 775
M
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 for Preliminary and/or Design Engineering: 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. To submit a completed BLR 05613, Engineering Payment Report, to the DEPARTMENT within three months of the completion of
the work called for in this AGREEMENT or any subsequent Amendment or Supplement. The form shall be submitted with the
final invoice.
8. 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.
9. 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.
10. For Construction Engineering Contracts:
(a) The ENGINEER shall be prequalified with the STATE in Construction Inspection. All employees of the ENGINEER
serving as the onsite resident construction supervisor or providing construction inspection shall have a valid
Documentation of Contract Quantities certification.
(b) For all projects where testing is required, the ENGINEER shall obtain samples according to the STATE Bureau of
Materials. "Manual of Test Procedures for Materials," submit STATE Bureau of Materials inspection reports; and
verify compliance with contract specifications.
11. 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).
II. THE LPA AGREES,
Completed07/24/24 Page 2 of 9 BLR 05530 (Rev. 07108122)
1. To certify by execution of this AGREEMENT that the selection of the ENGINEER was performed in accordance with the following:
(a) Professional Services Selection Act (50 ILCS 510), The Brooks Act (40 USC 11), and the Procurement,
Management, and Administration of Engineering, and Design Related Services (23 CFR part 172). Exhibit C is
required to be completed with this AGREEMENT.
2. To furnish the ENGINEER all presently available survey data, plans, specifications, and project information.
3. For Construction Engineering Contracts:
(a) To furnish a full time LPA employee to be In Responsible Charge authorized to administer inherently governmental
PROJECT activities.
(b) To submit approved forms BC 775 and BC 776 to the DEPARTMENT when federal funds are utilized.
4. 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 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
shall be due and payable to the ENGINEER.
5. 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:
❑ 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.
Field Office Overhead Rates; Field rates must be used for construction engineering projects expected to exceed one
year in duration or if the construction engineering contract exceeds $1,000,000 for any project duration.
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.).
III. IT IS MUTUALLY AGREED,
1. No work shall be commenced by the ENGINEER prior to issuance by the IDOT of a written Notice to Proceed.
2. 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.
3. 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 save harmless the LPA, the DEPARMTENT,
and their officers, agents, and employees from all suits, claims, actions or damage 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
Completed07/24/24 Page 3 of 9 BLR 05530 (Rev. 07/08/22)
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.
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 material 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.
5. In the event that the DEPARMENT 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 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.
6. 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.
7. 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.
8. 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 (e) and
(g) has not within a three-year period preceding this AGREEMENT had one or more public transaction (Federal, State or
local) terminated for cause or default.
Where the ENGINEER or LPA is unable to certify to any of the above statements in this certification, an explanation shall be
attached to this AGREEMENT.
9. In the event of 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 include but are not limited to: acts of God or a
public enemy; act 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.
10. 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 or 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.
Completed07/24/24 Page 4 of 9 BLR 05530 (Rev. 07/08/22)
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 statue 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;
(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 project. 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.
11. 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.).
12. For Construction Engineering Contracts:
(a) That all services are to be furnished as required by construction progress and as determined by the LPA employee In
Responsible Charge. The ENGINEER shall complete all services herein within a time considered reasonable to the
LPA, after the CONTRACTOR has completed the construction contract.
(b) That all field notes, test records and reports shall be turned over to and become the property of the LPA and that
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.
(c) That any difference between the ENGINEER and the LPA concerning the interpretation of the provisions of this
AGREEMENT shall be referred to a committee of disinterested parties consisting of one member appointed by the
ENGINEER, one member appointed by the LPA, and a third member appointed by the two other members for
disposition and that the committee's decision shall be final.
(d) That in the event that engineering and inspection services to be furnished and performed by the LPA (including
personnel furnished by the ENGINEER) shall, in the opinion of the STATE be incompetent employed on such work
at the expense of the LPA.
(e) Inspection of all materials when inspection is not provided by the sources by the STATE Central Bureau of Materials,
and submit inspection reports to the LPA and STATE in accordance with the STATE Central Bureau of Materials
"Project Procedures Guide" and the policies of the STATE.
AGREEMENT SUMMARY
Prime Consultant (Firm) Name TIN/FEIN/SS Number J Agreement Amount
iCiviltech Engineering, Inc. 3 0636 6666 $1,154,493.00
Subconsultants TIN/FEIN/SS Number Agreement Amount
Midland Standard Engineering & Testing, Inc. 20-2435502 $92,330.01
Subconsultant Total $92,330.01
Prime Consultant Total $1,154,493.01
Total for all work $1,246,823.01
Completed07/24/24 Page 5 of 9 BLR 05530 (Rev. 07/08/22)
AGREEMENT SIGNATURES
Attest:
Deerfield
Local Public Agency Type Local Public
The Village I of Deerfield
1017ll.czy
Local Public Agenc T e
Village Clerk
(SEAL) .o`•,•.............��
o SEAL ,,� .
Executed by the ENGINEER:
Attest:
Prime Consultant Firm Name
Civiltech Engineering, Inc.
B (Signature & Date
09-24-2024
Title
Vice President
B Si nature & Date
1D�7�2o2y
Title
President
By (Signature & Date
09-24-2024
Title
President
Completed07/24/24 Page 6 of 9 BLR 05530 (Rev. 07/08122)
Local Public Agency Prime Consultant Firms Name County Section Number
Deerfield Civiltech Engineering, Inc. Lake 20-00108-00-PV
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
See attached Exhibit A
Completed07/24124 Page 7 of 9 BLR 05530 (Rev. 07108/22)
Exhibit A
Hazel Avenue Reconstruction
Village of Deerfield
Route:
FAU Route 1263
Local Agency:
Village of Deerfield
Section No.:
20-00108-00-PV
Proj. No.:
E4Y2 (438)
Job No.:
C-91-150-24
County:
Lake
Contract No.:
61xxx
SCOPE OF SERVICES
Civiltech will provide the following Scope of Services in conformance with the Illinois
Department of Transportation's Standard Construction Engineering Agreement.
• Provide contract management including but not limited to contractor communications,
utility coordination, and preparation / processing of pay requests and change orders.
• Act as resident construction supervisor and coordinate with the Village of Deerfield, Lake
County, and IDOT.
• Provide construction inspection service to ensure that the project is being constructed
according to specifications. .
• Provide material testing for the project to ensure compliance with the contract
specifications in accordance with the STATE BMPR "Project Procedures Guide" and the
STATE BMPR "Manual of Test Procedures for Materials". STATE BMPR Inspection
reports can include:
o Concrete
o Hot -Mix Asphalt
o Soils
o Aggregates
• Provide Quality Assurance services required by [DOT. Personnel shall have completed
the appropriate STATE BMPR QC/QA trained technician classes.
• Provide verification of construction layout (to be completed by the contractor).
• Prepare daily and weekly work reports per IDOT Standards.
• Keep construction documentation per IDOT requirements.
• Provide measurement and computation of pay items.
• Inspect and document the adequacy of the establishment and maintenance of the traffic
control.
• Complete all necessary shop drawing reviews.
• Provide plan revisions to reflect as built conditions.
• Close-out project records per the IDOT policies and procedures.
Local Public enc _ Prime Consultant 'Firm) Name County Section Number
Deerfield JCiviltech Engineering, Inc. Lake 20-00108-00-PV
EXHIBIT B
PROJECT SCHEDULE
See attached Exhibit B
Completed07/24/24 Page 8 of 9 BLR 05530 (Rev. 07/08/22)
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Local Public Agency Prime Consultant Firm Name county Section Number
Deerfield Civiltech Engineering, Inc. Lake 20-00108-00-PV
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
❑
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
❑
specifically Section 5-5.06 (e) of the BLRS Manual?
3
Was the scope of services for this project clearly defined?
❑
4
Was public notice given for this project?
❑
If yes Due date of submittal 02/21 /24
Methods] used for advertisement and dates of advertisement
Posted on the Village's website on 02/02/2024. The Village also has an email/text
sign up system to receive a notification when new postings are added.
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?
❑
Project Criteria
Weighting
Consultant Staff Experience
30%
Technical Approach
20%
Consultant Project Experience
20%
Quality Assurnace Procedures and Timely Services
30%
8
Do the written QBS policies and procedures discuss the method of selection?
❑
Selection committee ttitlesl for this
Director of Public Works, Assistant Director of PW, and Project Manager
Top three consultants ranked for this project in order
Civiltech Engineering, Inc.
Thomas Engineering Group, LLC
V3 Companies, Ltd.
9
1Was an estimated cost of engineering for this project developed in-house prior to contract negotiation?
❑
10
1were negotiations for this project performed in accordance with federal requirements.
❑
11
JWere 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).
®
❑
Completed07/24/24 Page 9 of 9 BLR 05530 (Rev. 07/08122)
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Local Public Agency County Section Number
Deerfield j Lake 20-00108-00-PV
Consultant / Subconsultant Name Job Number
Civiltech Engineering, Inc. C-91-150-24
PAYROLL RATES
EXHIBIT D COST ESTIMATE OF CONSULTANT SERVICES (CECS) WORKSHEET FIXED RAISE
MAXIMUM PAYROLL RATE 86.00
ESCALATION FACTOR 2.01%
CLASSIFICATION
IDOT
PAYROLL RATES
ON FILE
CALCULATED RATE
Res. En r. V
$63.39
$64.66
Res. En r. III
$45.75
$46.67
Res. En r. II
$38.65
$39.43
Field Technician 1
$31.25
$31.88
Chief Layout Specialist
$43.50
$44.37
Structural En r. IV
$48.50
$49.47
Senior Pro' Mn r (QA Rep)
$77.50
$79.06
BLR 05514 (Rev 02/09/23)
Printed 9/24/2024 5:36 PM RATES
Page 2 of 6
Local Public Agency County Section Number
C Deerfield I Lake 20-00108-00-PV
Consultant / Subconsultant Name Job Number
Civiltech Engineering, Inc. C-91-150-24
SUBCONSULTANTS
EXHIBIT D COST ESTIMATE OF CONSULTANT SERVICES (CECS) WORKSHEET
NAME
Direct Labor Total
Contribution to Prime
Consultant
IMidland Standard Enqineerinq & Testing 1 29,118.001 2,911.801
Total 29,118.00 2,911.80
NOTE: Only subconsultants who fill out a cost estimate that splits out direct labor may be listed on
this sheet.
BLR 05514 (Rev 02/09/23)
Printed 9/24/2024 5:36 PM SUBS
Page 3 of 6
Local Public Agency County Section Number
Deerfield Lake 20-00108-00-PV
Consultant / Subconsultant Name Job Number
Civiltech Engineering, Inc. C-91-150-24
DIRECT COSTS WORKSHEET
List ALL direct costs required for this project. Those not listed on the form will not be eligible for reimbursement by the LPA on this project.
EXHIBIT D COST ESTIMATE OF CONSULTANT SERVICES (CECS) WORKSHEET
ITEM
ALLOWABLE
QUANTITY
CONTRACT
RATE
TOTAL
Lodging
(per GOVERNOR'S TRAVEL CONTROL BOARD)
Actual Cost
Up to state rate maximums
$0.00
Lodging Taxes and Fees
{ per GOVERNOR'S TRAVEL CONTROL BOARD)Actual
Cost
$0.00
Air Fare
Coach rate, actual cost, requires minimum two weeks'
notice, with prior IDOT approval
$0.00
Vehicle Mileage
(per GOVERNOR'S TRAVEL CONTROL BOARD
Up to state rate maximum
$0.00
Vehicle Owned or Leased
$32.50/half day (4 hours or less) or $65/full day
735
$65.00
$47,775.00
Vehicle Rental
Actual Cost (Up to $55/day)
$0.00
Tolls
Actual Cost
$0.00
Parking
Actual Cost
$0.00
Overtime
Premium portion (Submit supporting documentation)
$0.00
Shift Differential
Actual Cost (Based on firm's policy)
$0.00
Overnight Delivery/Postage/Courier Service
Actual Cost (Submit supporting documentation)
$0.00
Copies of Deliverables/Mylars (In-house)
Actual Cost (Submit supporting documentation)
630
$0.89
$560.00
Copies of Deliverables/Mylars (Outside)
Actual Cost (Submit supporting documentation)
$0.00
Project Specific Insurance
Actual Cost
$0.00
Monuments (Permanent)
Actual Cost
$0.00
Photo Processing
Actual Cost
15
$10.00
$150.00
2-Way Radio (Survey or Phase III Only)
Actual Cost
$0.00
Telephone Usage (Traffic System Monitoring Only)
Actual Cost
$0.00
CADD
Actual Cost (Max $15/hour)
$0.00
Web Site
Actual Cost (Submit supporting documentation)
$0.00
Advertisements
Public Meeting Facility Rental
Actual Cost (Submit supporting documentation)
$0.00
Actual Cost (Submit supporting documentation)
$0.00
Public Meeting Exhibits/Renderings & Equipment
Actual Cost (Submit supporting documentation)
$0.00
Recording Fees
Actual Cost
$0.00
Transcriptions (specific to project)
Actual Cost
$0.00
Courthouse Fees
Actual Cost
$0.00
Storm Sewer Cleaning and Televising
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Traffic Control and Protection
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Aerial Photography and Mapping
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Utliity Exploratory Trenching
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Testing of Soil Samples
Actual Cost
$0.00
Lab Services
Equipment and/or Specialized Equipment Rental
Actual Cost (Provide breakdown of each cost)
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL DIRECT COSTS: ILR
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EXHIBIT D
•0-•. I -
•6 IS14,16A.-I, •
COST ESTIMATE OF CONSULTANT SERVICES (CECS) WORKSHEET
FIXED RAISE
Local Public Agency County Section Number
City of Deerfield Lake J 20-00108-00-PV
Prime Consultant Firm Name Prepared By Date
Civiftech Engineering, Inc. William Prigge 9/23/24
Consultant / Subconsultant Name Job Number
Midland Standard Engineering & Testing, Inc. C-91-150-24
Note: This is name of the consultant the CECS Is being completed for.
This name appears at the top of each tab.
Remarks
PAYROLL ESCALATION TABLE
CONTRACT TERM 12 MONTHS
START DATE 311 /25
RAISE DATE 311/26
END DATE 1 2/28126
ESCALATION PER YEAR
Year First Date Last Date Months
OVERHEAD RATE 135.00%
COMPLEXITY FACTOR 0
% OF RAISE
% Of
Contract
0 3/1/25 2/28/26 12 100.00%
The total escalation = 0.00%
BLR 05514 (Rev. 02/09/23)
Printed 9124/24 4:34 PM ESCALATION
Panes 1 of 1
Local Public Agency County Section Number
City of Deerfield I Lake 20-00108-00-PV
Consultant / Subconsultant Name Job Number
Midland Standard Engineering & Testing, Inc. C-91-150-24
PAYROLL RATES
EXHIBIT D COST ESTIMATE OF CONSULTANT SERVICES (CECS) WORKSHEET FIXED RAISE
MAXIMUM PAYROLL RATEI 86.00
ESCALATION FACTORI 0.00%
CLASSIFICATION
I DOT
PAYROLL RATES
ON FILE
CALCULATED RATE
Pdnci al Engineer
$65.63
$65.63
Project Manager
$65.63
$65.63
Proiect En ineer
$52.88
$52.88
Field Engineer
$43.27
$43.27
Technician D
$45.99
$45.99
Technician C
$43.49
$43.49
BLR 05514 (Rev. 02109123)
Printed 9/24/24 4:34 PM RATES
Page 1 of 1
Local Public Agency County Section Number
City of Deerfield 777771 11-ake j 20-00108-00-PV
Consultant / Subconsultant Name Job Number
Midland Standard Engineering_& Testing, Inc. C-91-150-24
DIRECT COSTS WORKSHEET
List ALL direct costs required for this project. Those not listed on the form will not be eligible for reimbursement by the LPA on this project
EXHIBIT D COST ESTIMATE OF CONSULTANT SERVICES (CECS) WORKSHEET
ITEM
ALLOWABLE
QUANTITY
CONTRACT
RATE
TOTAL
Lodging
(per GOVERNOR'S TRAVEL CONTROL BOARD
Actual Cost
;Up to state rate maximum)
$0.00
Lodging Taxes and Fees
(per GOVERNOR'S TRAVEL CONTROL BOARD)$0.00
Actual Cost
Air Fare
Coach rate, actual cost, requires minimum two weeks'
notice, with prior IDOT approval
$0.00
Vehicle Mileage
(per GOVERNOR'S TRAVEL CONTROL BOARD)
Up to state rate maximum
$O.DO
Vehicle Owned or Leased
$32.50/half day (4 hours or less) or $65/full day
46
$65.00
$2,990.00
Vehicle Rental
Actual Cost (Up to $55/day)
$0.00
Tolls
Actual Cost
$0.00
Parking
Actual Cost
$0.00
Overtime
Premium portion (Submit supportng documentation)
$23.00
$0.00
Shift Differential
Actual Cost (Based on firm's policy)
$0.00
Overnight Delivery/Postage/Courier Service
Actual Cost (Submit supporting documentation)
$0.00
Copies of Deliverables/Mylars (In-house)
Actual Cost (Submit supporting documentation)
$0.00
Copies of Deliverables/Mylars (Outside)
Actual Cost (Submit supporting documentation)
$0.00
Project Specific Insurance
Actual Cost
$0.00
Monuments (Permanent)
Actual Cost
$0.00
Photo Processing
Actual Cost
$0.00
2-Way Radio (Survey or Phase III Only)
Actual Cost
$0.00
Telephone Usage (Traffic System Monitoring Only)
Actual Cost
$0.00
CADD
Actual Cost (Max $151hour)
$0.00
Web Site
Actual Cost (Submit supporting documentation)
$0.00
Advertisements
Actual Cost (Submit supporting documentation)
$0.00
Public Meeting Facility Rental
Actual Cost (Submit supporting documentation)
$0.00
Public Meeting Exhibits/Renderings & Equipment
Actual Cost (Submit supporting documentation)
$0.00
Recording Fees
Actual Cost
$0.00
Transcriptions (specific to project)
Actual Cost
$0.00
Courthouse Fees
Actual Cost
$0.00
Storm Sewer Cleaning and Televising
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Traffic Control and Protection
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Aerial Photography and Mapping
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Utility Exploratory Trenching
Actual Cost (Requires 2-3 quotes with IDOT approval)
$0.00
Testing of Soil Samples
Actual Cost
$0.00
Lab Services
Actual Cost (Provide breakdown of each cost)
1
$6,020.00
$6,020.00
Equipment and/or Specialized Equipment Rental
Actual Cost (Requires 2-3 quotes with [DOT approval)
$0.00
Cylinder Strength
132
$20.00
$2,640.00
Sample Pickup
23
$115.00
$2,645.00
$0.00
$0.00
TOTAL DIRECT COSTS:
$14,295.00
BLR 05514 (Rev. 02109/23
Printed 9/24/24 4:34 PM DIRECT COST;
Page 1 of 1
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j Illinois Department
of Transportafion
Re ional Engineer
Jose Rios, P.E.
Department of Transportation
ono
Local Public Agency Resident Construction
Supervisor/ In Responsible Charge
Address
201 W. Center Ct.
city State Zip Code
Schaumburg IL �60196
Contract Number
61 xxx
District Lettinq Date
i� 11 /08/24
Municipality
Village of Deerfield
Route Coun
FAU 1263 (Hazel Ave.) Lake
Prolect Number
Job Number
E4Y2(438)
C-91-150-24
Section Number
20-00108-00-PV
❑ 1 recommend the following individual as a local public agency employee qualified to be resident construction supervisor and to be in
responsible charge of this construction project.
® 1 certify that I am in responsible charge as defined by the department of this construction project. Since the local public agency does
not have a local public agency employee qualified to be the resident construction supervisor, I am recommending a consulting
engineer to serve as resident construction supervisor.
Signature (for the local public agency) Date
1
Title
Assistant Director of Public Works
Applicants Name
David M. Bugaj
The following describes my educational background, experience and other qualifications to be resident construction supervisor of this
construction project for the Local Public Agency.
For Consultants: I certify that my firm is pre -qualified in Construction Inspection. Documentation of Contract Quantities certificate number
21-19001
Mr. David M. Bugaj of Civiltech Engineering will be the Field Inspecting Resident Engineer (F.I.R.E.) for this
project. Mr. Bugaj has completed multiple Federal projects that were Let through IDOT.
Signature ofApplicant Date
Job Title of Applicant
Field Inspecting Resident Engineer (F.I.R.E.)
Based on the above information and my knowledge of the applicant's experience and training, it is my opinion that the applicant is qualified
to serve as the resident construction supervisor on this construction project.
Re ional En ineer Signature Date roved
cc: Engineer of Local Roads and Streets, Central Bureau of Local Roads and Streets
Engineer of Construction, Central Bureau of Construction
Resident Construction Supervisor
Local Public Agency
Printed 07/24/24 Page 1 of 1 BC 775 (Rev. 11/09/20)
IllfinoisTranspDepartment
oortation
Reqional En ineer
Jose Rios, P.E.
Department of Transportation
Local Public Agency Construction Inspector
Address
201 W. Center Ct.
Cilly State ;196
Code
Schaumburg IL
Contract Number District Lettinct Date
61xxx t' J 11/08/24
Munici alit
Village of Deerfield
Route Coun
FAU 1263 (Hazel Ave.) I Lake
Proiect Number Job Number
E4Y2(438) I C-91-150-24
Section Number
20-00108-00-PV
I consider the following individual to be qualified as a local public agency construction inspector. In addition, I certify that adequate
instruction has been given this individual concerning the requirements of the contract, specifications and construction manual which
pertain to the work which he/she will inspect. This individual has been instructed on the proper procedures for any necessary tests.
Furthermore, if a consultant, this individual has a valid Documentation of Contract Quantities certification.
Approved
Sianatunre and Title of Resident Construction Supervisor Date
Applicants Name
David M. Bugaj
The following describes the educational background, experience and other qualifications of the named applicant to serve as an inspector
on this project.
For Consultants Employees: Documentation of Contract Quantities certificate number is 21-19001
Mr. David M. Bugaj of Civiltech Engineering will be the Field Inspecting Resident Engineer (F.I.R.E.) for this
project. Mr. Bugaj has completed multiple Federal projects that were Let through IDOT.
If the Resident from BC-775 is a consultant, the local public agency employee in responsible charge must also approve this individual.
Approved
Signature and Title of In Responsible Charce from BC-775 Date
Printed 07/24/24 Page 1 of 1 BC 776 (Rev. 11/16120)
Illinois Department
of Transportation
LOCAL PUBLIC AGENCY
Joint Funding Agreement for
Federally Funded Construction
Local Public Agency oun Section Number
Village of Deerfield Lake 20-00108-00-PV
Fund Tye ITEP SRTS HSIP Numbers MPO Name MPO TIP Number
STU N/A CMAP 10-23-0044
Construction
State Job Number Pro'ect Number
C-91-150-24 E4Y2(438)
❑ Local Let/Day Labor ® Construction on State Letting ® Construction Engineering ❑ Utilities ❑ Railroad Work
LOCATION
Stationing
Local Street/Road Name _ Key Route Length From To
Hazel Avenue 1FAU 1263 111.03 miles 00.00 01.03
Location Termini
lWilmot Road to Waukegan Road
Current Jurisdiction Existing Structure Number(s)
Village of Deerfield N/A Remove
PROJECT DESCRIPTION
proposed improvements consist of the roadway reconstruction of Hazel Avenue from Wilmot Road to
ukegan Road. Also included in the scope of the project is the replacement of the storm sewer system,
lestrian accommodations and upgrades, and watermain improvements
Page 1 of 10 BLR 05310C (Rev. 05/09/24)
Local Public Agency Section Number State Job Number Project Number
Village of Deerfield 20-00108-00-PV I C9115024 E4Y2(438)
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 the "STATE". The STATE and LPA jointly
proposes to improve the designated location as described in the Location and Project Description sections of this agreement. The
improvement shall be constructed 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, hereby referred to as "FHWA".
1. GENERAL
1.1 Availability of Appropriation: Sufficiency of Funds. This Agreement is contingent upon and subject to the availability of sufficient
funds. The STATE may terminate or suspend this Agreement, in whole or in part, without penalty or further payment being
required, if (i) sufficient funds for this Agreement have not been appropriated or otherwise made available to the LPA by the
STATE or the federal funding source, (ii) the Governor or STATE reserves funds, or (iii) the Governor or STATE determines that
funds will not or may not be available for payment. The STATE shall provide notice, in writing, to LPA of any such funding failure
and its election to terminate or suspend this Agreement as soon as practicable. Any suspension or termination pursuant to this
Section will be effective upon the date of the written notice unless otherwise indicated.
1.2 DQmesbc Steel Requirement. 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 Build America -Buy America provisions.
1.3 Federal Authorization. That this Agreement and the covenants contained herein shall become 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.
1.4 Severabili?y. If any provision of this Agreement is declared invalid, its other provisions shall not be affected thereby.
1.5 Termination. This Agreement may be terminated, in whole or in part, by either Party for any or no reason upon thirty (30)
calendar days' prior written notice to the other Party. If terminated by the STATE, the STATE must include the reasons for such
termination, the effective date, and, in the case of a partial termination, the portion to be terminated. If the STATE determines in
the case of a partial termination that the reduced or modified portion of the funding award will not accomplish the purposes for
which the funding award was made, the STATE may terminate the Agreement in its entirety.
This Agreement may be terminated, in whole or in part, by the STATE without advance notice:
a. Pursuant to a funding failure as provided under Article 1.1.
b. If LPA fails to comply with the terms and conditions of this funding award, application or proposal, including any
applicable rules or regulations, or has made a false representation in connection with the receipt of this or any award.
II. REQUIRED CERTIFICATIONS
By execution of this Agreement and the LPA's obligations and services hereunder are hereby made and must be performed in compliance
with all applicable federal and State laws, including, without limitation, federal regulations, State administrative rules and any and all
license requirements or professional certification provisions.
2.1 Uniform Administrative Requirements, Cost Principles. and Audit Requirements for Federal Awards (2 CFR Part 20W. The LPA
certifies that it shall adhere to the applicable Uniform Administrative Requirements, Cost Principles, and Audit Requirements,
which are published in Title 2, Part 200 of the Code of Federal Regulations, and are incorporated herein by reference.
2.2 Compliance with Registration Requirements. LPA certifies that it: (i) is registered with the federal SAM system; (ii) is in good
standing with the Illinois Secretary of State, if applicable; (iii) have a valid DUNS Number; (iv) have a valid UEI, if applicable. It is
LPA's responsibility to remain current with these registrations and requirements.
2.3 Bribery. The LPA certifies to the best of it's knowledge that it's officials have not been convicted of bribery or attempting to bribe
an officer or employee of the state of Illinois, nor made an admission of guilt of such conduct which is a matter of record (30 ILCS
500/50-5).
2.4 Bid Rigging. LPA certifies that it has not been barred from contracting with a unit of state or local government as a result of a
violation of Paragraph 33E-3 or 33E-4 of the Criminal Code of 1961 (720 ILCS 5133E-3 or 720 ILCS 5/33E-4, respectively).
2.5 Debt to State. LPA certifies that neither it, nor its affiliate(s), is/are barred from receiving an Award because the LPA, or its
affiliate(s), is/are delinquent in the payment of any debt to the STATE, unless the LPA, or its affiliate(s), has/have entered into a
deferred payment plan to pay off the debt, and STATE acknowledges the LPA may declare the Agreement void if the
certification is false (30 ILCS 500/50-11).
2.6 Debarmen The LPA 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
Page 2 of 10 BLR 05310C (Rev. 05/09/24)
Local Public AaenGy Section Number State Job Number Project Number
Village of Deerfield 20-00108-00-PV C9115024 E4Y2(438)
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements receiving
stolen property;
c. are not presently indicated 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.
2.7 Construction of Fixed Works. The LPA certifies that all Programs for the construction of fixed works which are financed in whole
or in part with funds provided by this Agreement shall be subject to the Prevailing Wage Act (820 ILCS 130/0.01 et seq.) unless
the provisions of that Act exempt its application. In the construction of the Program, the LPA shall comply with the requirements
of the Prevailing Wage Act including, but not limited to, inserting into all contracts for such construction a stipulation to the effect
that not less than the prevailing rate of wages as applicable to the Program shall be paid to all laborers, workers, and mechanics
performing work under the Award and requiring all bonds of contractors to include a provision as will guarantee the faithful
performance of such prevailing wage clause as provided by contract.
2.8 Criminal Conuicti_ans. The LPA certifies that neither it nor any managerial agent of LPA has been convicted of a felony under the
Sarbanes-Oxley Act of 2002, nor a Class 3 or Class 2 felony under Illinois Securities Law of 1953, or that at least five (5) years
have passed since the date of the conviction. The LPA further certifies that it is not barred from receiving an funding award
under 30 ILCS 500/50-10.5 and acknowledges that STATE shall declare the Agreement void if this certification is false (30 ILCS
500/50-10.5).
2.9 IM12roper Influence. The LPA certifies that no funds have been paid or will be paid by or on behalf of the LPA to any person for
influencing or attempting to influence an officer or employee of any government agency, a member of Congress or Illinois
General Assembly, an officer or employee of Congress or Illinois General Assembly, or an employee of a member of Congress
or Illinois General Assembly in connection with the awarding of any agreement, the making of any grant, the making of any loan,
the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment or modification of any
agreement, grant, loan or cooperative agreement. 31 USC 1352. Additionally, the LPA certifies that it has filed the required
certification under the Byrd Anti -Lobbying Amendment (31 USC 1352), if applicable.
2.10 Telecom Prohibition. The LPA certifies that it will comply with Section 889 of the FY 2019 National Defense Authorization Act
(NDAA) that prohibits the use of telecommunications or video surveillance equipment or services produced or provided by the
following companies: Dahua Technology Company, Hangzhou Hikvision Digital Technology Company, Huawei Technologies
Company, Hytera Communications Corporation, and ZTE Corporation. Covered equipment and services cannot be used as
substantial or essential component or any system, or as critical technology as part of any system.
2.11 Personal Conflict of Interest - (50 ILCS 105/3, 65 ILCS 5/3.1-55-10, 65 ILCS 5/4-8-6) The LPA certifies that it shall maintain a
written code or standard of conduct which shall govern the performance of its employees, officers, board members, or agents
engaged in the award and administration of contracts supported by state or federal funds. Such code shall provide that no
employee, officer, board member or agent of the LPA may participate in the selection, award, or administration of a contract
supported by state or federal funds if a conflict of interest, real or apparent would be involved. Such a conflict would arise when
any of the parties set forth below has a financial or other interest in the firm selected for award:
a. the employee, officer, board member, or agent;
b. any member of his or her immediate family;
c. his or her partner; or
d. an organization which employs, or is about to employ, any of the above.
The conflict of interest restriction for former employees, officers, board members and agents shall apply for one year.
The code shall also provide that LPA's employees, officers, board members, or agents shall neither solicit nor accept gratuities,
favors or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The STATE may waive
the prohibition contained in this subsection, provided that any such present employee, officer, board member, or agent shall not
participate in any action by the LPA relating to such contract, subcontract, or arrangement. The code shall also prohibit the
officers, employees, board members, or agents of the LPA from using their positions for a purpose that constitutes or presents
the appearance of personal or organizational conflict of interest or personal gain.
2.12 Organizational Conflict of Interest - The LPA certifies that it will also prevent any real or apparent organizational conflict of
interest. An organizational conflict of interest exists when the nature of the work to be performed under a proposed third party
contract or subcontract may, without some restriction on future activities, result in an unfair competitive advantage to the third
party contractor or LPA or impair the objectivity in performing the contract work.
2.13 Accounting System. The LPA certifies that it has an accounting system that provides accurate, current, and complete disclosure
of all financial transactions related to each state and federally funded program. Accounting records must contain information
Page 3 of 10 BLR 05310C (Rev. 05/09/24)
Local Public Agency Section Number State Job Number Project Number
Village of Deerfield 20-00108-00-PV C9115024 E4Y2(438)
pertaining to state and federal pass -through awards, authorizations, obligations, unobligated balances, assets, outlays, and
income. To comply with 2 CFR 200.305(b)(7)(1), the LPA shall use reasonable efforts to ensure that funding streams are
delineated within LPA's accounting system. See 2 CFR 200.302.
III. AUDIT AND RECORD RETENTION
3.1 Single Audits: The LPA shall be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31
USC 7501-7507) and Subpart F of 2 CFR Part 200.
If, during its fiscal year, LPA expends $750,000 or more in Federal Awards (direct federal and federal pass -through awards
combined), LPA must have a single audit or program -specific audit conducted for that year as required by 2 CFR 200.501 and
other applicable sections of Subpart F of 2 CFR Part 200. A copy of the audit report must be submitted to the STATE (IDOT's
Financial Review & Investigations Section, Room 126, 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.
Assistance Listing number (formally known as the Catalog of Federal Domestic Assistance (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 Schedule 2) are not included in a LPA's calculation of federal funds expended by the LPA for
Single Audit purposes.
3.2 STATE Audits: The STATE may, at its sole discretion and at its own expense, perform a final audit of the Project (30 ILCS 5, the
Illinois State Auding Act). Such audit may be used for settlement of the Project expenses and for Project closeout purposes. The
LPA agrees to implement any audit findings contained in the STATE's authorized inspection or review, final audit, the STATE's
independent audit, or as a result of any duly authorized inspection or review.
3.3 Record Retention. The LPA shall maintain for three (3) years from the date of final project closeout by the STATE, adequate
books, records, and supporting documents to verify the amounts, recipient, and uses of all disbursements of funds passing in
conjunction with this contract. adequate to comply with 2 CFR 200.334. If any litigation, claim or audit is started before the
expiration of the retention period, the records must be retained until all litigation, claims or audit exceptions involving the records
have been resolved and final action taken.
3.4 Accessibility of Records. The LPA shall permit, and shall require its contractors and auditors to permit, the STATE, and any
authorized agent of the STATE, to inspect all work, materials, payrolls, audit working papers, and other data and records
pertaining to the Project; and to audit the books, records, and accounts of the LPA with regard to the Project. The LPA in
compliance with 2 CFR 200.337 shall make books, records, related papers, supporting documentation and personnel relevant to
this Agreement available to authorized STATE representatives, the Illinois Auditor General, Illinois Attorney General, any
Executive Inspector General, the STATE's Inspector General, federal authorities, any person identified in 2 CFR 200.337, and
any other person as may be authorized by the STATE (including auditors), by the state of Illinois or by federal statute. The LPA
shall cooperate fully in any such audit or inquiry.
3.5 Failure to maintain The bmks-andfewala. 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 terms of this
contract.
IV. LPA FISCAL RESPONSIBILITIES
4.1 To provide all initial funding and payment for construction engineering, utility, and railroad work
4.2 LPA Appropriation Requirement. 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 Schedule 5.
4.3 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.
4.4 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
the STATE within six (6) months of the federal authorization date. Subsequent invoices will be submitted in intervals not to
exceed six (6) months.
4.5 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
Page 4 of 10 BLR 05310C (Rev. 05/09/24)
Local Public Agency
Village of Deerfield
Section Number State Job Number Project Number
20-00108-00-PV C9115024 E4Y2(438)
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.
4.6 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.
4.7 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.
V. THE LPA AGREES
5.1 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.
5.2 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.
5.3 To provide on -site engineering supervision and inspection during construction of the proposed improvement.
5.4 To retain jurisdiction of the completed improvement unless specified otherwise by schedule (schedule should be accompanied
by a location map). If the improvement location is currently under road district jurisdiction, a jurisdictional schedule is required.
5.5 To maintain or cause to be maintained the completed improvement (or that portion within its jurisdiction as established by
schedule) in a manner satisfactory to the STATE and the FHWA.
5.6 To provide if required, for the improvement of any railroad -highway grade crossing and rail crossing protection within the limits of
the proposed improvement.
5.7 To regulate parking and traffic in accordance with the approved project report.
5.8 To regulate encroachments on public rights -of -way in accordance with current Illinois Compiled Statutes.
5.9 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.
5.10 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.
5.12 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.
VI. THE STATE AGREES
6.1 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.
6.2 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.
6.3 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 Schedule 2.
Page 5 of 10 BLR 05310C (Rev. 05/09/24)
Local Public Agency Section Number State Job Number Project Number
Village of Deerfield l 20-00108-00-PV I IC9115024 E4Y2(438)
6.4 For agreements with federal and/or state funds in local let/day labor construction, 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.
SCHEDULES
Additional information and/or stipulations are hereby attached and identified below as being a part of this agreement.
®
1.
Division of Cost
Location Map
®
2.
®
3.
Risk Assessment
Attestations
®
4.
®
5.
Resolution*
'Appropriation and signature authority resolution must be in effect on, or prior to, the execution date of the agreement.
Page 6 of 10 BLR 05310C (Rev. 05/09/24)
Local Public Anency Section Number State Job Number Pro'ect Number
Village of Deerfield �20-00108-00-PV C9115024 I iE4Y2(438)
AGREEMENT SIGNATURES EXECUTION
The LPA agrees to accept and comply with the applicable provision set forth in this agreement including attached schedules.
APPROVED
Local Public Agency
Name of Official Print or Type Na
Daniel C. Shapiro
ayor
Si nature Date
I - ( 2 P
101112-021t
The above signature certifies the agency's TIN number is
366005842 conducting business as a Governmental Entity.
DUNS Number 068003185
UEI H484FGK3YQN5
APPROVED
State of Illinois
Department of Transportation
Omer Osman P.E. Secretary of Transportation Date
By:
Georae A. Ta as P.E., S.E., Engineer of Local Roads & Streets Date
Stephen M. Travia, P.E., Director of Hi hwa s PI/Chief Engineer Date
Michael Prater, Chief Counsel Date
Vicki Wilson Chief Fiscal Officer Date
NOTE: A resolution authorizing the local official (or their delegate) to execute this agreement and appropriation of local funds is
required and attached as Schedule 5. 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 mQluflon.
Please check this box to open a fillable Resolution form within this form.
Page 7 of 10 BLR 05310C (Rev. 05/09/24)
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Local Public
(Village of Deerfield
Section Number State Job Number
20-00108-00-PV I M 15024
SCHEDULE NUMBER 4
Attestation on Single Audit Compliance
Project Number
E4Y2(438)
1. In the prior fiscal year, did Village of Deerfield expend more than $750,000 in federal funds in aggregate from all
LPA
federal sources?
❑ Yes Pq No
2. Does the Village of Deerfield anticipate expending more than $750,000 in federal funds in aggregate from all
federal sources in the current Village of Deerfield fiscal year?
❑ Yes PQ No LPA
If answers to question 1 and 2 are no, please proceed to the signature section.
If answer to question 1 is yes, please answer question 3a.
If answer to question 2 is yes, please answer question 3b.
3. A single audit must be conducted in accordance with Subpart F of 2 CFR 200 if $750,000 or more in federal funds are expended in a
single fiscal year.
a. Has the Village of Deerfield performed a single audit for their previous fiscal year?
LPA
❑ Yes ❑ No
i. If yes, has the audit be filed with the Illinois Office of the Comptroller in accordance with 50 ILCS 310 (see also 55 ILCS 5 & 65
ILCS 5 & 601LCS 1/80)?
❑ Yes ❑ No
b. For the current fiscal year, does the Village of Deerfield
❑ Yes ❑ No
LPA
intend to comply with Subpart F of 2 CFR 200?
By completing this attestation, I certify that I have authority to sign this attestation on behalf of the LPA; and that the foregoing information
is correct and complete to the best of my knowledge and belief.
Name Title LPA
Robert W. Phillips, P.E. Dir. of PW&E lVillage of Deerfield
Si nature & Date
Rac--e t W. PkzUifiy
7/26/24
Page 10 of 10 BLR 05310C (Rev. 05/09/24)