HomeMy WebLinkAboutMulti-Modal NYSDOTJOSEPH H~ BO.~DMAN
COMMISSIONER
STATE OF NEW YORK
DEPARTMENT OF TRANSPORTATION
ALBANY, N.Y. 12232
August 24, 2004
Mr. Joshua Y. Horton, Supervisor
Town of Southold
PO Box 1179
Southold, NY 11971
Dear Supervisor Horton:
This is to advise you that the Multi-Modal 2000 Program (MM 2000) project identified in
Schedule A of the attached Supplemental Contract Agreement has been fully executed and
approved by the State Comptroller, and reimbursement processes can continue.
A standard MM 2000 Sponsor's Payment Request form ("FIN421 mm") has been enclosed with
your Contract Agreement. At this time, y3u may complete, and begin to submit, a payment
request form for any eligible expenditures that have been made. Submission of your completed
form to your NYSDOT Regional or, ce MM 2000 representative will enable you to obtain
reimbursement for these expenditures. You may duplicate or otherwise reproduce this form as
often as needed: Reimbursements may not exceed the approved or actual eligible MM 2000
project costs, whichever is less. Eligible local cost disbursements made on or afterApril 1, 2000
which are associated with approved MM 2000 projects will qualify for reimbursement by the
State Comptroller.
I will be the, prime contact person for the MM2000 Program in the Region 10 office, and may be
reached at: (631)952-6944. The address is:
M. Tamarkin,_Planning Unit
New York State Department of Transportation
250 Veteran's Highway
Hauppauge, NY 11788
Respectfully yours,
Maria Tamarkin
Local Programs
Universal Supplemental Agreement Cover f~r all Local Agreements (UnivSup¢Cov.wpd)
SPONSOR: Town of Southold
PROJECT ID NO. MF??23.30A BIN~__
PHASE: per Schedules A
SUPPEEMENTAL AGREEMENT Schedule No. I to
MASTER AGREEMENT (Comptroller's Contract No. D018648 )
7Ttis Agreement, effective this,C_ day of /'l~¢.~ 200 ~ , is by and between:
the New York State Departme~ of TrartspodatJon ("NYSDO'P~, having its principal office in the
Administration and Engineering Building, 1220 Washington Avenue, State Campus, Albany, NY 12232,
and
the Town of Southold (the "MuniCipality")
acting by and through the Town Supervisor
with its office at Town Hall, P.O. '1179, Southold, NY 11,971.
This agreement supplements or amends the existing blaster Agreement between the parties that
consists of the agreements titled (check applicable cat,.~jodes):
MASTER Fede,~-al Aid/Local Aid (Non-Marchisell~ Project Agreement dated
[] MASTER Federal~'~ & Marchiselli Aid Project Agreement- MM1 dated ;
[] SUPERSEDING, MASTER Federal Aid & Marchiselli Aid Project Agreement - MM2
dated
[] MASTER Marchiselli'Aid Project AgreementlSu~rsedes pdor Federal Aid/Local Aid Project
Agreement - MM3 dated
[] Prior SUPPLEMENTAL AGREEMENT Nos. dated
· Multi-Modal 2000Project Agreement dated December 18, 2001
[] OTHER - "
in the following respects only (check applicable categories):
· Amends a prav~ously adopted Schedule or Supplements Master Agreement by Adding Schedule A,
in accordance with the provisions of such Master Agreement for such Supplemental Schedules (check applicable
categories):
l~ie~C~ng..a:~Ejffo~:..P.-ro]~: . . .:. ·
[] Amends Schedule A project description;
[] Amends Schedule A scheduled funding;
· Adds a project description under same D#
· Adds project funding under same D#
[] Amends Schedule A phase completion dQte; · Sets project completion date for same D#
[] Amends a previously adopted Schedule B [] Adds Schedule B under separate D#
[] (Amending the text of the Master Agreement as described below:
Complete Amendment fo Master Agreement Text here las applicable)
IN WITNESS WHEREOF, the padies have caused this agreement to be executed by its duly authorized
officials as of the date first above wriHen_
-1-
By: ~ r'&;m~nis'sioner of f[anspodation.
~}Je/ Su~ez'~ise[ Age.m/C~c~on:in addifDn to lhe acce¢~e
-. of fh2 conkacJ I al~ ce~ the ~igingl c~bs of
signature pa~ ~11 be ~Hach~ to alt 61her ex.cf
APPROVED AS TO ~ RM ~R~'A~ FORM
GENERAL: NYS A~ORN~'
By: By:
~lle: Assistant AttOrney GenerC/
NYS COMPTROLLER APPROVAL:
BY:
COUNTY OF~-~'~Jl~ )
On this ~ day of ~¢V~o.~ in the year 20et~ before me, the undersigned, personally
appeared .'x)or:~'~ ~ ~ p~ersonally known fo me or proved to me on the basis of
satisfactory evidence to be the individualJs) wh?se nameJs) is (are) subscribed to the within instrument
and acknowledged to me that he/she/they executed lhe same in his/herJtheir capacity(les) and that
by his/herJtheir signature(s) on the instrument, the individual(s), or the person upon behalf of which the
individual(s} acted, executed this instrument_
STATE OF NEW YORK }
COUNTY OF )
BARBARA ANN RUDDER
N~Ily Pub~, $1a~ of I',lew York
Ou~lEmd · 8utf~lk County..,
Notary Public
On this day of in the year 20 before me, 1he undersigned, personally
appeared , personally known to me or proved to me on the basis of
satisfactory evidence to be the individualJs) whose name(s) is (are) subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in his/her/their capaciJyJies) and that
by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the
individual(s) acted, executed this instrument_
Notary Public
-2-
Multi-Modal 2000 (MM2000) Municipal Project Schedule A
Municipal Sponsor Name: Town of $outhold
MULTI-MODAL 2000 PRO RAM - SCHEDULE A
(Use only for Municipally-owned Highw ay/Brfdge/A viaEon projects wi~h SIM or less in MM2000 Funding)
1. Name of Municipal Project Owner: Town of Southold
2. ProjectTitie: Street Signs throughoutTown of Soutflold
3. MM2000 PIN~: ME22.23_30A
4, Maximum MM2000 Reimbursement: $10,000
5. MASTER Municipal MM2000 OSC Contract #: D018648
6. Municipal Contact:
Name/Title:
Organization:
Address:
City/State/Zip:
Joshua Y. Horton, Supervisor
Town of Southold
PO Box 1179
Southeld, NY 11971-0959
7. Project Location: Town Roads abutting NYS Ri_ 25 Route/Name: Vadous
From: Laurel Lane, Laurel To: Lands End, Orient (except within the Villaqe of Greenport)
8. Project Description/Scope: Replace Road Name SiRns on Town roads abu~nq NYS Rt. 25 from Laurel Lane, Laurel to
Lands End, Odent; except within the Villa.qe of Greenport.
9. Project Schedule Beginning Date: 03/04 :. Project Ending Date: 10/05
t0. Project Cost Summary:
COST State Local Funding
SUMMARY MM 2000 Funding (Insert zero if none)
TOTAL: $10,000 $0
11. Eligible Project Type: (Please check
-- Highway Resurfaci~lg -- Bddge Rehab~ita~on -- New Hig hv~y Con$C
-- Hig hw~y Reconstruct~n -- Bridge Replacement -- In[erchanoe ConsL%ReconsL
X__C)ther (Please explain): S qnage
12. Signature of responsible Local Official:
/
13. Please print your Name & Title here: .~osl~ua ¥. t-Iort:on
Supervisor
-- New Bridge Const
__ Inlersec~on Impmvment
MM2OOOSchA.wpd (7/01)
TOWN CLERK
Town Hall, 53095 Main Eoad
P.O. Box 1179
Southold, New 'fork 11971
Fax (631) 765-6] 45
Telephone (631) 765-1800
southo]d~own.nor thfork.net
OFFICE OF TI-IE TOWN CLEI~K
TOWN OF SOUTHOLD
THIS IS TO CERTII~Y THAT TIlE FOLLOWING REFA)LIv'TION NO. 405 OF 2004
WAS ADOPTED AT THE REGULAR MEETING OF 'I'HE SOUTHOLD TOWN BOARD
ON MAY 18, 2004:
RESOLVED that thc Town Board of the Town of Southold hereby authorizes and directs
Suoervisor Joshua Y. Horton to execute a Sul~olemental Contract Agreement for the
Multi-Modal 2000 Prokq'am (MM 2000) r¢lat~ng to $10,000 in funding for the replacement of
multiple road signs on Town roads abutting Route 25, said agreement subject to the approval of
the Town Attorney.
Elizabeth A. Neville
Southold Town Clerk
ACCOUNTING & ~ANCE DEPT.
John A. Cushman, Town Comptroller
Telephone (631) 7654333
Fax (631) 765-I366
E-mail: accoun tin g~. ~own.$out hold.ny.us
TOWN tIALL A2qNEX
Feather Hill, Buff`ding 10
620 TLaveler S~reet
P.O; Box 1179
$outhold, NY 1~.97i 0959
TOWN OF SOUTHOLD
OFFICE OF THE SUPERVISOR
May 17, 2004
Mada Tamarkin
DOT Regional Local Government Representative
New York State Department of Transportation
State Office Building
Veterans Memorial Highway
Hauppauge, NY 11788
Re: Multi-Medal 2000
Dear Ms. Tamarkin:
As requested in your letter of April 21, 2004 to Supervisor Joshua Y. Horton, enclosed
herewith please find the Supplemental (~ontract Agreement and Schedule A for the
replacement of road si0ns on Town Roads abutting NYS Route 25 project, as well as
the MM 2000 Sponsor's Project Payment Request documents for the Brushes Creek
Bridge and Culvert Replacement project.
Should you require any further information, please contact the undersigned.
Very truly yours,
/~.-~Joh n Cushman
Town Comptroller
cc: Peter Harris, Superintendent of Hig~;~vays
Elizabeth A. Neville, Town Clerk
STATE OF NEW YORK
DEPARTMENT OFTRANSPORTATION
ALBANY, N.Y. 12232
April 21, 2004
Mr. Joshua Horton, Supervisor
Town of Southold
Town Hall, P.O. Box 1179
Southold, NY 11971
Dear Supervisor Horton:
This is to advise you that the Multi-Modal 2000 Program (MM 2000) project identified in
Schedule A of the attached Supplemental Contract Agreement has been officially approved
for funding, The next step in the approval process is the joint execution of this
Supplemental Contract Agreement between NYSDOT and the project sponsor.
Reimbursement cannot occur before this contract is fully executed and approved by the
State Comptroller. NYSDOT does not require a Local Resolution under MM 2000 for the
funding of municipally-owned highway, bridge, or aviation mode projects of ~ 1,000,000 or
less. The enclosed contract agreement copy requires your signature. Please review the
agreement, and make 6 copies, then sign and date each copy on the signature page and
the "Scl~edule A" page and return them to the NYSDOT Regional Office MM 2000
representative listed below.
Aisc enclosed with your Supplemental Contract Agreement is a standard MM 2000
Sponsor's Payment Request form ("FIN421mm"). After you have received your returned
copy of the State Comptroller executed Agreement, complete the payment request form for
any eligible expenditures that have been made, Submission of your completed form to your
NYSDOT Regional Office MM 2000 representative will enable you to obtain reimbursement
for these expenditures, You may duplicate or otherwise reproduce this form as often as
needed. Reimbursements may not exceed the approved or actual eligible MM 2000 project
costs, whichever is ]ess. Eligible local cost disbursements made on or after April 1, 2000
which are associated with approved MM 2000 projects will qualify for reimbursement by
the State Comptroller.
will be the pr me contact person for the MM2000 Program ~e~Rb~io~] l+Qoff ce~a~d
may be reached at (631)952-6944 The address s: . i [~ ~ ! .
M. Tamarkin, Planning Unit
New York State Department of Transportation
250 Veteran's Highway
Hauppauge, NY 11788
Respectfully yours,
Multi-Modal 2000 (MM2000) Municipal Project Schedule A
Municipal Sponsor Name: Town of Southold
MULTI-MODAL 2000 PROGRAM - SCHEDULE A
(Use only for Municipally-owned Highway~Bridge~Aviation projects with SfM or less in MM2000 Funding)
3. MM2000 PIN~:
'i, Name of Municipat Project Owner: Town of Southoid
Street Signs throughout Town of Southold
ME2223.30A
4. Maximum MM2000 Reimbursement $10~000
5~ MASTER Municipal MM2000 OSC Contract #: D018648
6. Municipal Contact:
Organization:
Address:
City/State/Zip:
Joshua Y. Horton, Supervisor
Town of Southold
PO Box 1179
Southold, NY 11971-0959
7. Project Location: Town Roads abutting NYS Rt. 25
Route/Name: Various
From: Laurel Lane. Laurel To: Lands End, Orient (except within the Villaqe of Greenport)
0. Project Description/Scope: Replace Road Name Sians on Town roads abu[finq NYS Rt. 25 from Laurel Lane. Laurel to
Lands End. Odent; except within the Villaqe of Greenpott.
9. Project Schedule Beginning Date: 03104
10. Project Cost Summary:
COST State
SUMMARY MM 2000 Funding
TOTAL: $10,000
Project Ending Date:
10/05
Local Funding
(Insert zero if none~
$0
11. Eligible Projeat'l~pe: (Please check one}
t 3. Please print your Name & Title here;
SUPPEEMENTAL AGREEMENT Schedule No. I to
MASTERAGREEMENT (Comptrollers ContractNo. D018648 )
This Agreement, effective this day of 20 , is by and between:
the ;New York State Department cf Transportation ("NYSDOT'~, having its principal office in the
Administration and Engineering Building, 1220 Washington Avenue, State Campus, Albany, NY 12232,
the Town of Sou~hold (the "Municipality")
acting by and through the Town Supervisor
with its office at Town Hall, P.O. 1179, Southeld, NY 11971.
This agreement supplements or amends the existing Master Agreement between the parties that
consists of the agreements titled (check applicable categories):
[] MASTER Federal Aid/Local Aid (Non-Marchiselli) Project Agreement dated ;
[] MASTER Federal Aid & Marchiselli Aid Project Agreement- MMI dated
[] SUPERSEDING MASTER Federal Aid & Marchiselli Aid Project Agreement - MM2
dated
[] MASTER Marchiselli Aid Project Agreement/Supersedes prior Federst Aid/Local Aid Project
Agreement - MM3 dated ;
[] Prior SUPPLEMENTALAGREEMENT Nos. dated
· Multi-N~oda12000Project Agreement dated December 18, 200t
[] OTHER -
in the following respects only (cbeck applicable categories):
· Amends a previously adopted Schedule or Supplements Master Agreement by Adding Schedule A,
in accordance with the provisions of such Master Agreement for such Supplemental Schedules (check applicable
categories):
[] Amends Schgdule A project description;
[] Amends Schedule A scheduled funding;
[] Amends Schedule A phase completion date;
[] Amends a previously adopted Schedule B
· Adds a project description under same D#
· Adds project funding under same D#
M Sets project completion date for same D#
[] Adds Schedule B under separate D#
E] {Amending the text of the Master Agreement as described below:
Complete Amendment to Master Agreement Text here (as applicable)
IN WITNESS ~VHEREOF, the parties have caused this agreement to be executed by ifs duly authorized
officials as of the date firsi above wdt fen.
-1-
I MLINiCIPALITy: NYSDOT:
By7 Joshua Y, Horton
BY:
For Commissioner at Transportation
GENERAL:
By: By:
~itle: Assistant Attorney General
NYS COMPTROLLER APPROVAk:
DATE:
BY:
STATE OF NEW YORK )
)SS,:
COUNTY OF~I~ )
On this £~ day of ~-~-,,'~ in the year 20~[_ before me, the undersigned, personally
appeared, '~c~.,-~_ ~ ~ ]~ersonally known to me or proved fo me on the basis of
satisfadol¥ evidence to be the individual(s) whose name(s) is [are) subscribed to the within instrument
and acknowledged lo me that he/she/they exbcuted the same in his/her/their capacity(les) and that
by his/her/their signature(s} on the insffument, the individual{si, or the person upon behalf of which the
individual(s) acted, executed this instrument.
STATE OF NEW YORK )
COUNTY OF )
On this ~ . day of
appeared
in the year 20 before me, the undersigned, personally
~ personally known to me or proved to me on the basis of
satisfactory evidence to be the individual{s} whose name(s) is (are) subscribed to the within irlstrument
and acknowledged to me that he/she/they executed the same in his/her/their capacitylies) and that
by his/her/their signature(s) on the instrument, the individual(s}, or the person upon behalf of which the
individual(s) acted, executed this instrument.
Natal' Public
-2-
NYS DEPARTMENT OF TRANSPORTATION
Multi-Modal 2000 (MM 2000) Sponsor's Project Payment Request
FIN 421mm (6/01)
PAYEE ID 470379000000 NYS Contract No. D018648 Estimate or Request No. 1
For "Payee ID". Municipalities use OSC Municipal Code; Non-Municipalities use their Federal Employer iD Number.
IMPORTANT: List PIN#(s) & related data for individual project(s)-requested on reverse side!
WorkPeriodCovered(forthisestimate)FROM 4 / I /01 TO 8 / 8 /03
Payee/Proje¢ Sponsor Name
To~ of Slmthold
Street Address
53095 Route 2--3
PO Box 1179
City
S?uthold, NY 11971-0959
State
New York Zip Code 11971-0959
1. Total work~e,,por~ed on previous payment requests
{See Column B on reveme side)
2. Work reoorted on this payment request See Column 'A' on reverse side)
B. Total work repo~ted to date
,See Column "C" on reverse side)
4. Adjustments (for NYSDOT use only)
5. Previous payments
6. Payment requested or processed
Current Completion Date 8 /8 / 03
MIR Date / /
(completed by NYSDOT for approved M.A.P.)
Original MM2000 Contract Amount: $150,000.00
Current MM2000 Contract Amount: $150t000.00
Project Sponsor Prepares NYSDOT Use Only
0.00
150.o0o.oo
150,000.00
PROJECT SPONSOR CERTIFICATION
(Name) {TlfJe)
0.00
150~000.00
{DATE) (SIGNATURE) TELEPHONE
NO.
IN 421mm REVERSE
NYS DEPARTMENT OF TRANSPORTATION
Multi-Modal 2000 Sponsor's Project Payment Request
1~S223.30A
1st Project
2nd Project
3rd Project
4th Project
5th Project
6th Project
7th Project
Project ID MODE Current Total Combined MM2000
"PIN #" (H)wy or Reimbursement of all Payment(s) Project
(must be Bridge Amount Previous Due to Project Budget
9 digits (P)ort or
Ferry Requested Payments (Life-to-Date) Allocation
beginning with (R)ail "A .... B" "C" ('W' + "B") "D"
"ME", "MA", or (A)irport
"MS") [Line ¢Y2 on Other Sidel [Line #1 on Other Side] [Line ~3 on OUter Sidel
tso,ooo.oo $ o $ t5o,ooo.oo I $ zso,ooo.oo
$
Title/Description:
$
$ $
~50,000.00
8th Project
$
fitle/Description:
$ IS
Title/Description:
TOTAL WORK REPORTED ON THIS PAYMENT REQUEST [Se