WQ0022224_More Information (Received)_20220307

NORTH CAROLINA
JOHNSTON COUNTY
NORTH CAROLINA DEPARTMENT OF
TRANSPORTATION
UTILITY CONSTRUCTION AGREEMENT (UCA)
DATE: 8/25/2021
AND WBS Elements: 80074
TOWN OF CLAYTON
THIS AGREEMENT is made and entered into on the last date executed below, by and between the
North Carolina Department of Transportation, an agency of the State of North Carolina, hereinafter
referred to as the "Department" and the Town of Clayton, hereinafter referred to as the "Municipality."
WI TNESSETH:
WHEREAS, the Department has prepared and adopted plans to make certain street and highway
improvements under Project W-5704B, in Johnston County, said plans consists of relocating water
and sewer lines crossing U$ 70 at Shotwell road.; Johnston County; said project having a right-of-
way width as shown on the project plans on file with the Department's office in Raleigh, North
Carolina; and,
WHEREAS, the parties hereto wish to enter into an agreement for certain utility work to be performed
by the Department's construction contractor with full reimbursement by the Municipality for the costs
thereof as hereinafter set out.
NOW, THEREFORE, it is agreed as follows:
PRELIMINARY ENGINEERING
1. The Department shall use its utility limited service agreement for Project W-5704B, JOHNSTON
County.
2. The Municipality shall be responsible for the costs of the Preliminary Engineering Design. The
actual cost to the Municipality is $8,509.44 as shown on the attached cost estimate, Exhibit "B". It
is understood by both the Department and the Municipality that this is a final cost unless the
Municipality requests additional work not covered under this Agreement, or plan review by the
Agreement ID # 10968 1

Department and/or Municipality does not properly identify all existing conflicts or Department
revises highway plans before or during construction. Under this agreement, the Municipality
reserves the right to re -engineer plans due to the Department's plan revisions.
Upon the satisfactory completion of the utility construction plans covered under this Agreement,
the Municipality shall review and approve the plans, the associated estimated utility construction
cost and special provisions to be made part of the Department's roadway contract for highway
construction; the Municipality shall release the Department of any future responsibility for the
design of the utility construction plans. Said releases shall be deemed to be given by the
Municipality upon completion of the plans, estimate, special provisions and acceptance by the
Department and [Short Name] for the plans to be made part of the highway roadway contract.
CONSTRUCTION
4. The Department shall place provisions in the construction contract for Project W-5704B Johnston
County, for the contractor to adjust and relocate water and sewer lines. Said work shall be
accomplished in accordance with plan sheets, attached hereto as Exhibit "A", cost estimate
attached hereto as Exhibit "B", and project specific provisions, if applicable, attached hereto as
Exhibit "C".
5. The Municipality shall be responsible for water and sewer lines cost as shown on the attached
Exhibit "A". The estimated cost to the Municipality is $37,935 as shown on the attached Exhibit
"B". It is understood by poth parties that this is an estimated cost and is subject to change. The
Municipality shall reimburse the Department for said costs as follows:
REIMBURSEMENT TO THE DEPARTMENT — FINAL BILLING
6. The Municipality shall reimburse the Department for said costs as follows:
A. Upon completion of the utility construction plans, the Department shall submit an invoice to
the Municipality for 9osts inpurred. Billing will be based upon the negotiated cost and any
supplemental agreements rpade part of this agreement. Reimbursement shall be made by
the Municipality in one final payment within sixty (60) days of said invoice.
Agreement ID # 10968 2

B. Upon completion of the highway work, the Department shall submit an itemized invoice to the
Municipality for costs incurred. Billing will be based upon the actual bid prices and actual
quantities used.
C. Reimbursement shall be made by the Municipality in one final payment within sixty (60) days
of said invoice.
D. If the Municipality does not pay said invoice within sixty (60) days of the date of the invoice,
the Department shall charge interest on any unpaid balance at a variable rate of the prime
plus (1 %) in accordance with G.S. 136-27.3.
E. Said interest rate shall be set uponfinal execution of the Agreement by the Department. The
Municipality will be notified of the set interest rate by the Department's approval letter upon
receipt of the fully executed agreement.
F. Any cost incurred dye to additional utility work requested by the Municipality after award of
the construction contract, shall be solely the responsibility of the Municipality. The
Municipality shall re(mburse the Department 100% of the additional utility cost.
G. In the event the Municipality fails for any reason to pay the Department in accordance with
the provisions for payment hereinabove provided, North Carolina General Statute 136-41.3
authorizes the Department to withhold so much of the Municipality's share of funds allocated
to said Municipality by North Carolina General Statute, Section 136-41.1, until such time as
the Department has received payment in full.
H. At any time prior to final billing by the Department, the Municipality may prepay any portion of
the estimated cost by sending a check with the WBS Element noted to the below address.
The Department will provide a final billing based on actual costs, less any previous payments
that have been made.
REMITTANCE ADDRESS:
NC Department of Transportation
ATTN: Accounts Receivable
1514 Mail Service Center
Raleigh, NC 27699-1514
Agreement ID # 10968 3

7. Upon the satisfactory completion of the relocations and adjustments of the utility lines covered
under this Agreement, the Municipality shall assume normal maintenance operations to the said
utility lines. Upon completion of the construction of the highway project, the Municipality shall
release the Department from any and all claims for damages in connection with adjustments
made to its utility lines; and, further, the Municipality shall release the Department of any future
responsibility for the cost of maintenance to said utility lines. Said releases shall be deemed to
be given by the Municipality upon completion of construction of the project and its acceptance by
the Department from its contractor unless the Municipality notifies the Department, in writing, to
the contrary prior to the Department's acceptance of the project.
8. It is further agreed that the following provisions shall apply regarding the utilities covered in this
Agreement.
I. The Municipality obligates itself to service and to maintain its facilities to be retained and
installed over and along the highway within the Department's right-of-way limits in
accordance with the mandate of the North Carolina General Statutes and such other laws,
rules, and regulations as have been or may be validly enacted or adopted, now or hereafter.
J. If at any time the Department shall require the removal of or changes in the location of the
encroaching facilities which are being relocated at the Municipality's expense, the
Municipality binds itself, its successors and assigns, to promptly remove or alter said
facilities, in order to conform to the said requirement (if applicable per G.S. 136-27.1), without
any cost to the Department.
9. The other party to this Agreement shall comply with Title VI of the Civil Rights Act of 1964 (Title
49 CFR, Subtitle A, Part 21) and related nondiscrimination authorities. Title VI and related
authorities prohibit discrimination on the basis of race, color, national origin, disability, gender,
and age in all programs or activities of any recipient of Federal assistance.
10. A copy or facsimile copy of the signature of any party shall be deemed an original with each fully
executed copy of the Agreement as binding as an original, and the parties agree that this
Agreement can be executed in counterparts, as duplicate originals, with facsimile signatures
sufficient to evidence an agreement to be bound by the terms of the Agreement.
11. By Executive Order 24, issued by Governor Perdue, and N.C. G.S.§ 133-32, it is unlawful for any
vendor or contractor ( i.e. architect, bidder, contractor, construction manager, design professional,
Agreement ID # 10968 4

engineer, landlord, offeror, seller, subcontractor, supplier, or vendor), to make gifts or to give
favors to any State employee of the Governor's Cabinet Agencies (i.e., Administration,
Commerce, Environmental Quality, Health and Human Services, Information Technology, Military
and Veterans Affairs, Natural and Cultural Resources, Public Safety, Revenue, Transportation,
and the Office of the Governor).
Agreement ID # 10968 5

IN WITNESS WHEREOF, this Agreement has been executed, in duplicate, the day and year
heretofore set out, on the part of the Department and the Municipality by authority duly given.
L.S. ATTEST:
BY: - ►) nb
A -H O E BY:
TITLE ToLor\ CIList_ TITL
DATE: 'e�rrlbe c- r, ayO a I
N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State
Employee of any gift from anyone with a contract with the State, or from any person seeking to do
business with the State. By execution of any response in this procurement, you attest, for your entire
organization and its employees or agents, that you are not aware that any such gift has been offered,
accepted, or promised by any employees of your organization.
TOWN DPLAYTOC� ' n
'~ ATED1.
��rnRPD
BY:
This instrument has been pre -audited in the manner
required by the Local Government Budget and
Fiscal C• to�.
Federal Tax Identifipation Number
-‘eP/iov74r
Remittance Address:
Town of Clayton
A9' 7f
&5Y7 D,l� i�Go27Psr7p
DEPA gta4QgyTRANSPORTATION
7
L. k-aat...., 4.t.,.
DATE:
11/17/2021
DS
APPROVED BY BOARD OF TRANSPORTATION ITEM 0: 10/7/2021
(Date)
Agreement ID # 10968 6

04-AUG-202114:45
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CD
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0
Town of Clayton
653 Highway 42 West
P.O. Box 879
CLAYTON, NC 27520
VENDOR NO. 13066
NC DEPT OF TRANSPORTATION
MATERIALS & TESTING UNIT
1563 MAIL SERVICE CENTER
RALEIGH, NC 27699-1563
REFERENCE #
QUANTITY
1.0000
UNIT
Each
03
Town of Clayton
111 East Second Street
P.O. Box 879
CLAYTON, NC 27520
Purchase Order
No. 2022-00000267
DATE 09/10/2021
PURCHASE ORDER NUMBER MUST APPEAR ON
ALL INVOICES, SHIPPERS, BILL OF LADING AND
CORRESPONDENCE
DELIVER BY
SHIP VIA
FREIGHT TERMS
PAGE 1 of 1
ORIGINATOR: Kristie Germano
DESCRIPTION
Water/Sewer Items - Utility Construction Agreement
300-56-60-52 39 - Op Exp Maint and Repair - System 46,444.44
UNIT COST
46,444.4400
TOTAL COST
$46,444.44
SUBTOTAL
SALES TAX
TOTAL DUE
$46,444.44
$0.00
$46,444.44
Special Instructions
THIS INSTRUMENT HAS BEEN PREAUDI TED IN THE !MANNER REQUIRED BY THE LOCAL GOVERNMENT BUDGET AND FISCAL CONTROL ACT
B-y acceptance of this purchase order: vendors, contractors, and/or subcontractors affirm
they are not listed and will not utilize a Subcontractor listed on the Final Divestment List
or Iran Parent a.nd Subsidiary Guidance List created by the State Treasurer pursuant to
N.C.G.S_ 14 3-6A-4 Iran Divestment Act Certification.
FINANCE DIRECTOR

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
Date: November 24, 2021
WBS ELEMENT: 80074
COUNTY: Johnston
DESCRIPTION: US 70 BUS at Shotwell road improvements
Dear Mr. Baird:
SUBJECT: Utility Construction Agreement — Town of Clayton
County: Johnston
Project: 80074
Executed: November 17, 2021
J. ERIC BOYETTE
SECRETARY
Attached is a fully executed copy of the Utility Construction Agreement that covers the
adjustment and relocation of certain municipally -owned water and sewer lines.
Under the terms of the attached agreement, the municipality shall reimburse the Department in
one final payment within sixty (60) days of date of the invoice. The Department will charge
interest at the prime rate plus one percent (1%) on any unpaid balance. Based on the approval
date of this agreement by the NCDOT Board of Transportation, the prime rate of 3.25% will be
used to calculate payment on any unpaid balance due after sixty (60) days of said invoice.
Thank you for your assistance in the execution of this agreement. If you have any questions,
please email Kyle Pleasant, Utilities Engineer at [e-mail] or call [phone].
S1610g4N,by:
[±7, Pl&cvloPra.
5F7C536,F6E704F5...
Kyle Pleasant
Division Utilities Engineer
CC: Kevin Bowen, PE: Division Engineer
Corey McLamb, PE: Division Construction Engineer
Sam Lawhorn: District Engineer
Addison Gainey, PE: Project Development Engineer
Matt Daughtrey: Accounts Receivable
Mailing Address: Telephone: [phone] Location:
NC DEPARTMENT OF TRANSPORTATION Fax: [phone] WARD BOULEVARD
DIVISION FOUR OFFICE Customer Service: 1-877-368-4968 WILSON, NC 27895
POST OFFICE BOX 3165
WILSON, NC 27895
Website: www.ncdot.gov

V. SEPARATION DISTANCES
1. Provide the actual minimum separation distance (in feet) from the reclaimed water distribution system to each item listed in
accordance with 15A NCAC 02U .0403(h), (i), and (j):
Separation Parameter
Horizontal
Vertical
Required
Actual
Required
Actual
Any water line (feet)
1 0
N/A
1.5
N/A
Any well
50
N/A
N/A
Sewer lines (reclaimed over sewer)
2
N/A.
1.5
N/A
Final earth grade
N/A
2. Are the separation requirements listed above met? El Yes or No
If No, has documentation been provided to show that piping and integrity testing procedures meet water main standards in
accordance with 15A NCAC 18C? Yes or No
Note: In no case shall reclaimed water lines be closer than 25 feet to a private well.
VI. PUMP STATION INFORMATION
IF MORE THAN ONE PUMP STATION, PROVIDE ADDITIONAL COPIES OF THIS PAGE AS NECESSARY.
1. Are there any reclaimed water pump stations proposed as part of the distribution system? Yes or [E] No
,( If no, then skip the remaining items in Section VI.
2. Complete the table below by providing the required information regarding the reclaimed water pump station(s)
Pump Station Design
Plan Sheet
Number
Specification
Page Number
Internal dimensions (L xWxH or y x H)
ft
ft
ft
Volume
gallons
Inlet Elevation
ft
Outlet Elevation
ft
Number of pumps
Pump capacity
GPM
Lead pump on elevation
ft
Lag pump on elevation
ft
Lead pump off elevation
ft
Lag pump off elevation
ft
High water elevation
ft
Audible/Visual high water alarm
3. What is the 100-year flood elevation?
(ft)
4. Precautions to be taken to protect the pump station from flooding:
(ft)
FORM: RWDL 06-16
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