HomeMy WebLinkAboutR-24-75SECTION NUMBER: 20-00108-00-PV
JOB NUMBER: C-91-150-214
PROJECT NUMBER: E4Y2(438)
VILLAGE OF DEERFIELD
RESOLUTION NO. 2024- R-24-75
A RESOLUTION APPROVING A LOCAL PUBLIC AGENCY AGREEMENT
FOR FEDERAL PARTICIPATION FOR THE
HAZEL AVENUE INFRASTRUCTURE PROJECT
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 is the lead local public agency for Project Number
E4Y2(438), which project's improvements include roadway reconstruction, sidewalk
improvements, and utility upgrades on Hazel Avenue for a length of approximately 1.03
miles from Wilmot Road to Waukegan Road (IL 43) ("Project"); and
WHEREAS, the Project will necessitate the use of funding provided through the
Illinois Department of Transportation ("IDOT'); and
WHEREAS, to obtain funds from IDOT for the Project requires that the Village
enter into a joint funding agreement with IDOT ("Agreement'); and
WHEREAS, the Mayor and Board of Trustees have determined that entering into
the Local Agency Agreement with IDOT 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 IDOT 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 Local Public Agency Agreement on behalf of the Village.
SECTION 4: AUTHORIZATION OF APPROPRIATION. The Village Board
hereby approves the appropriation of Five Million Seven Hundred Ninety -Two Thousand
Two Hundred Sixty -Six and 00/100 Dollars ($5,792,266), or as much as may be needed to
match the required funding to complete the proposed improvements from the Village's
Infrastructure Replacement Fund and furthermore agrees to pass a supplemental
resolution if necessary to appropriate additional funds for completion of the project.
SECTION NUMBER: 20-00108-00-PV
JOB NUMBER: C-91-150-214
PROJECT NUMBER: E4Y2(438)
SECTION 5: 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: November 4, 2024
APPROVED: November 4, 2024
RESOLUTION NO: R-24-75
b--r
Daniel C. Shapiro, Mayor
ATTEST: k. ��TL
Kent S. Atreet, Village ClIrk
SECTION NUMBER: 20-00108-00-PV
JOB NUMBER: C-91-150-214
PROJECT NUMBER: E4Y2(438)
EXHIBIT A
Agreement
of Illinois Department
Transportation
LOCAL PUBLIC AGENCY
Local Public
Ilage of Deerfield
Joint Funding Agreement for
Federally Funded Construction
Countv Section Number _
Lake 20-00108-00-PV
Fund Type ITEPI RTS HSIP Numbers MPO Name MPO TIP Number
STU I N/A CMAP 10-23-0044 1
Construction
State Job Number Project Number
C-91-150-24 FE4Y2(438)
❑ Local Let/Day Labor ® Construction on State Letting ® Construction Engineering ❑ Utilities ❑ Railroad Work
LOCATION
Stationing
Local Street/Road Name CF�U7172
Route �Len th From To
Hazel Avenue 71 63 .03 miles 00.00 01.03
Wilmot Road to Waukegan Road
Current Jurisdiction Existing Structure Number s -
Village of Deerfield N/A Remove
PROJECT DESCRIPTION
'The proposed improvements consist of the roadway reconstruction of Hazel Avenue from Wilmot Road to
Waukegan Road. Also included in the scope of the project is the replacement of the storm sewer system,
pedestrian accommodations and upgrades, and watermain improvements
Page 1 of 10 BLR 05310C (Rev. 05/09124)
Local Public Agency. Section Number State Job Number Project Number
Village of Deerfield 20-00108-00-PV C9115024 �4Y2(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 Domestic 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 Severability. 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.
11. 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 200). 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 5/33E-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 Debarment. The LPA certifies to the best of its knowledge and belief that its 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 MenMency Section Number State Job Number Pro'ect Number
Village of Deerfield 11
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 Convictions. 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 Improper 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 I20-00108-00-PV I 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)(i), 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 books and records. 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 _ Section Number State Job Number _ Project Number
Village of Deerfield 120-00108-00-PV C9115024 ,! rE4Y2(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 specked 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 cant' 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 AcIency Section Number State Job Number fE4%(438)
ro't Number
Village of Deerfield —_ll2 000 108-00-PV J,C9115024
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
® 1. Division of Cost
® 2. Location Map
® 3. Risk Assessment
® 4. Attestations
® 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 Agency Section Number State Job Number Pro'ect Number
Village of Deerfield 20-00108-00-PV C9115024 E4Y2(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 Name)
Daniel C. Shapiro
Title of Official
Mayor
Si nature
Date
111412.0 �
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:
George A. Ta as P.E. S.E. Engineer of Local Roads & Streets Date
Stephen M. Travia P.E. Director of Highways PI/Chief Engineer Date
Michael Prater, Chief Counsel Date
. L
Vicki Wilson. Chief Fiscal Officer Date
NOTE: A resolution authorizing the local official (or their delegated 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 resolution.
❑ 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 AgencV Section Number State Job Number Proiect Number
Village of Deerfield [20-00108-00-PV C9115024 E4Y2(438)
SCHEDULE NUMBER 4
Attestation on Single Audit Compliance
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
LPA
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 & 60 ILCS 1180)?
❑ Yes ❑ No
b. For the current fiscal year, does the Village of Deerfield intend to comply with Subpart F of 2 CFR 200?
❑ Yes ❑ No LPA
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 Village of Deerfield
Si nature & Date
R&be rt- W. P!^-it i f>k
7/26/24
Page 10 of 10 BLR 05310C (Rev. 05/09/24)