20190827 Ver 1_Southdock_Acknowledgement_and_Acceptance_Form.doc_20190619

STATF
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER JAMES H. TROGDON, III
GOVERNOR SECRETARY
NOTICE TO PROCEED April 1, 2019
LIMITED SERVICES CONTRACT NUMBER: 7000016954
WBS Element: 15401.1048012
TIP Number: N/A 6300058711
County: Hyde P. O. Number for Invoicing
F. A. Project: NSA
Project Description: Installation of New Bulkhead and Groins on NC 12 — Southdock (North end
of Ocracoke Island)
CONTRACT WORK DESCRIPTION:
ITEM
DESCRIPTION
VALUE
10
Modeling & Design of Groins and Seawall
$414,605.20
TOTAL
$414,605.20
The Business Unit shown below has reviewed the final negotiated cost proposal and has determined that it is consistent with the
above -numbered LSC's salaries and rates reviewed/approved by NCDOT's Office of Inspector General. The Business Unit
shown below has also verified the computation of the Grand Total of the cost proposal.
Therefore, the Notice to Proceed is given for professional services related to the scope of work shown above or
attached; and cost proposal as outlined below.
COST PROPOSAL DATE: 12/21/2018 REVISED/FINAL PROPOSAL DATE: 3/26/2019
SPECIALNOTES/CONDITIONS/TERMS:
NOTICE to PROCEED AMOUNT: $414,605.20 Lump Sum
ORIGINAL/PREVIOUS PO/LINE ITEM
AMOUNT:
REVISED PO/LINE ITEM AMOUNT:
LINE ITEM 10 BALANCE (IF APPLICABLE)
A completed and signed Subconsultant Form RS-2 must accompany this form when returning it to the NCDOT
Contract Administer. The Subconsultant Form RS-2 can be found at:
hllps:Hconnect.ncdot. gov/business/Turnpike/Documents/Form%20RS-2%2OSubcontract.pdf
Acknowledgment and Acceptance:
18945 Moffat & Nichol
Firm Name ova igne y:
Jeff Sheldon, PE 11-01' 1 -1
Siggnnatory-Printed Name an WMMMAB...
4/IJ2019
Date
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
DIVISION ONE
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932
NCDOT Approval:
Ferry Division
Issuing Business Unit/Division � ��ig5. aye a
J.S. Abel, Jr.
�Z.
ND Approval Authority-Printe aif8Bgffd5riifiature
Date
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: www.ncdot.gov
Location:
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932