HomeMy WebLinkAboutAGMT - OCTA (UK102097 Utility Agmt I-405 Improvement) and Amendment No 1ORANGE -COUNTY TRANSPORTATION AUTHORITY
FIRST AMENDMENT TO UTILITY AGREEMENT NO. UK102097
(UK102097-2)
DISTRICT
COUNTY
ROUTE
POST MILE
EA
PROJECT ID
12
Orange
I405
9.3—_24.2
12-OHIOO
I
120000.0180
FEDERAL AID NUMBER
OWN_ ER' S PLAN NUMBER
HPLULN-6071(043)
n/a
FEDERAL PARTICIPATION
n theproject Yhb 114U On Me Ounues
FIRST AMENDMENT TO UTILITY AGREEMENT NO. UK102097
(UK102097-2) DATE
WHEREAS, Orange County Transportation Authority, hereinafter called OCTA, and the City of Seal Beach,
hereinafter called OWNER, have entered into that certain Utility Agreement No. UK102097, dated March 14,
2017 (Agreement), which Agreement sets forth the terms and conditions pursuant to which OWNER has
performed plan review and construction inspection to accommodate OCTA's construction on Interstate 405,
Project No. 1200000180; and,
WHEREAS, in the performance of said work, increased costs over and above those estimated at the time of
the execution of said Agreement will be incurred due to the fact that OCTA's contractor must perform the
jack and bore for the sewer line a third time and OWNER must continue to perform plan review and
construction inspection while incurring additional costs; and,
WHEREAS, it has been determined that, costs will overrun the amount shown in said Agreement by .100%,
and when the increased cost exceeds by 25% the estimated amount set forth in said Agreement, said
Agreement shall be amended to show the increased cost of the work to OCTA; and,
WHEREAS, the estimated cost to OCTA of the work to be performed under said Agreement was $40,000,
and by reason of the increased costs referred to above, the amended estimated cost to OCTA :is $80,000.
NOW, THEREFORE, it is agreed between the parties as follows:
1. The estimated cost to OCTA of $40,000 as set forth on page 5 of said Agreement is hereby amended
to read $80,000.
2. All other terms and conditions of said Agreement remain unchanged.
1204732.1
FIRST AMENDMENT TO UTILITY AGREEMENT
Paget aft
FIR_ STAMENDMENT TO UTILITY AGREEMENT
NO. UK102097
SIGNATURE PAGE
TO
FIRST AMENDMENT TO UTILITY AGREEMENT NO.
UK102097
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Utility Agreement
No. UK102097 this 1.14" day of M-1 2"02-1-
OWNER
CITY OF SEAL BEACH, a charter city
ORANGE COUNTY
TRANSPORTATION AUTHORITY,
a public entity
APPROVED
I
;�Jw(A�
By. By.
Title: ;Glfi Nl qha(�✓ J s . Beil,
V E e tive Director.,
itaI Programs
Date:
'.�'�' � 1� � ?�22 Date:�-
APPROVED AS TO FOR
APPROVED AS TO,
// "� a B
By: By -
Title: CfaEgA. Steele Jajral
.-Donich
City Attorney GeCounsel
March 8, 2022
Date: Date:
1244732.1
CK 9411A q 1 •• • • •y u. a -•
DEPARTMENT OF TRANSPORTATION
DISTRICT 12
1750 EAST 4TH STREET, SUITE 100
SANTA ANA, CA 92705
PHONE. (657) 328-6000
FAX (657)328-6522
TTY 711
%Yww.dot.ca.gov/d12
December 27, 2018
City of Seal Beach
Ms. Jill R. Ingram
City Manager
211 Eighth Street
Seal Beach, CA 90740
Dear Ms. Ingram:
Making Conservation
a California Way of Life.
The California Department of Transportation (Caltrans) has completed the review of the City of
Seal Beach's submittal of encroachment permit application dated on December 13, 2018 for a
Caltrans Encroachment Permit to abandon an existing 18" sewer and install a new 18" PVC sewer
in a 30" steel casing westerly of the Interstate 405/Seal Beach Blvd. interchange within the State
Right of Way.
Your application as submitted has been conditionally approved with following requirements:
1. The Contractor, which will perform the sewer line relocation work for the City of Seal
Beach, shall provide the monitoring procedure to protect the existing pavement prior and
during jacking operations.
2. The Contractor, which will perform the sewer line relocation work for the City of Seal
Beach, shall provide material certification of 28" diameter casing to comply with Buy
America requirements.
3. The Contractor, which will perform the sewer line relocation work for the City of Seal
Beach, shall comply with the approved SWPPP plans of I-405 Improvement Project,
especially for the abandon work of the existing sewer manholes and/ or any dewatering
activities involved.
4. The Contractor, which will perform the sewer line relocation work for the City of Seal
Beach, shall provide the approved temporary traffic control plans that comply with the I-
405 Improvement Project prior.
Please contact me at (949) 279-8496 if you have any questions or concerns.
Sincerely,
Andrew Chuah, P.E.
Project Manager, Office of Corridor Management
District 12
"Provide a safe, sustainable, integrated and efficient lranspor cation system
to enhance California's economy and livabilip,"
EPMS: Print Permit
STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT
In compliance with (Check one):
E Your application of January 10, 2019
0 Utility Notice No. of
Page 1 of I
unit No.
12 -19 -N -UR -0027
a1ColRtelPM
2 -ORA -405, PM 22.9122.9
mit Approval Date
01/11/2019
e PaidDeposit
EA OH1004 / 8 EA OR1004 /
!00000180 200000180
0 Agreement No. of
and Company
❑ RM Contract No. of
and Number (1)
TO: CITY OF SEAL BEACH
211 EIGHTH STREET
SEAL BEACH, CA 90740
Attn: JILL R. INGRAM 562-431-2527 X 1300 ,PERMITTEE
and subject to the following, PERMISSION IS HEREBY GRANTED to:
0.00
ABANDON EXISTING MANHOLE AND EXISTING 18 -INCH SEWER LINE AND CONSTRUCT A NEW 18 -INCH PVC
SEWER LINE INSIDE 30 -INCH STEEL CASING WITHIN CALTRANS RIGHT-OF-WAY UNDERNEATH I-405 AT
SEAL BEACH BLVD. VIA JACK AND BORE METHOD IN THE CITY OF SEAL BEACH TO FACILITATE I-405
IMPROVEMENT PROJECT PERMIT p.12 -16 -N -OP -0634.
All performed work shall be in accordance with current Caltrans Standard Specifications
and Standard Plana, Section 500 (Specific Permits) of the Encroachment Permits Manual,
California MUTCD latest edition, the attached Provisions and Permit Plane stamp -dated
JANUARY 10, 2019.
Permittee shall contact Kauai Amuth, Caltrans Sr. Construction Engineer at (949)279-8688,
and Ali E1-Zaynab, Structural Engineer at (951) 232-3781 minimum of 10 working days prior
to the date of the pre -construction meeting. Failure to comply with this requirement will
result in suspension of this permit.
The following attachments are also included as part of this permit (Check applicable):
E Yes
ONO
General Provisions
In addition to fee, the permittee will
0 Yes
E No
Utility Maintenance Provisions
be billed actual costs for:
0 Yes
E No
Storm Water Special Provisions
0 Yes ONO Review
E Yes
0 No
Special Provisions
0 Yes ENO Inspection
0 Yes
ONO
A Cal -OSHA permit, if required: Permit No.
E Yes 0 No Field Work
0 Yes
ONO
As -Built Plans Submittal Route Slip for Locally Advertised Projects
0 Yes
E No
Storm Water Pollution Prevention Plan I Water Pollution Control Plan
(if any Caltrans effort expended)
0 Yes ONO The information In the environmental documentation has been reviewed and considered prior to approval of this permit.
This permit is void unless the work is completed before October 31, 2021
This permit is to be strictly construed and no other work other than specifically mentioned is hereby authorized.
No project work shall be commenced until all the other necessary permits and the environmental clearances have been obtained.
COPIES TO:
Pennines
File 19-0027
Kausi Amuth
Ali EkZaynab
Andrew Chueh
Mainlenarl
ra�2c0111a011
BY:
ADA Notice For Individuals with sensory disabilities, this document Is available in alternate formals. 6 r a ernale format information, contact the Forms
Management Unit at (916) 4451233, TTY 711, or write to Records and Forms Management, 1120N Street, MS -89, Sacramento, CA 95814.
FM 91 1436 (D12 Permit App.)
Director
http://epms.dot.ca.gov/bin/print_permit.php?id=224150 1/11/2019
STATE OF CALIFORNIA • OEPARTMENT OF TRANSPORTATION Page 1 of 3
STANDARD ENCROACHMENT PERMIT APPLICATION
TR -010 rananear PERMITNO. -.- r . 11M
- wn
- -•
2-1
+VIYK4 vr)Z— I
Please type or print cloarly your answers. Complete ALL fields, wrilo "NIA" It not appllcablo.
We application is not complete until all requirements have been approved.
p1S71Cp/gTEIP
I
Permission is requested to encroach on the State Highway rlghtcPNey as follows:
SIMPLEX STAMP
I.000NTY
2. ROUTE a. POffiMILE
Orange
405 '-22.9
4. ADDRESS OR STREET NAME
I S. CITY
Across 4405 between North Gate Rd and Old Ranch Pkwy
Seal Beach
5. CROSS STREET (Distance and direction from project alta)
T. POR71O OF R GHT-O - AY
DATE OF SIMPLEX STAMP
Seal Beach Blvd
I Mainline
A. WORK TO BE PERFORMED BY
S. ESTIMATED START DATE
10. ESTIMATED COMPLETION DATE
❑ OWN FORCES m CONTRACTOR
June 2019
October 2021
11.
MAX. DEPTH AVG. DEPTH
AVG. WIDTH
LENGTH
SURFACE TYPE
EXCAVATION
26' 22'
I
4'
-470'
AC/PCC Pavement
I2.ESTIMATED COST WITHIN STATE HIGHWAY RIGHT-OF-WAY
FUNDING SOURCE(S)
$ 1,708,142.00
❑ FEDERAL ❑ STATE 0 LOCAL ❑ PRIVATE
10,
PRODUCTTYPEDIAMETER
VOLTAGE I PSIG
14. CALTRANS' PROJECT CODE 00)
PIPES
PVC
renyaaoemcw,e
N/A
1200000180
15. ❑Doable Parmit ParentParmlt Number N/A
Applleenl's Reference Numbarl Utility Work Order Number N/A
10. Have your plana boon reviewed by another Caltrans branch? QNO ❑YES(if "YES") Who?
17. Completely describe work to be done within STATE Highway dghWfvvay:
Attach a complete sets of plans (fatded to a.5- a IT") and any appllcablo specifications, cslmla6ons, maps, ata
The existing City of Seal Beach (City) 18 -inch VCP sewer line crosses underneath t-405 perpendicular to
the freeway from North Gate Road on the south side, and then turns east on the north side of the freeway
before terminating at the end of Old Ranch Parkway. The existing sewer line was originally installed in 1961.
As part of the Orange County Transportation Agency's (OCTA) 1405 Improvement Project, existing utilities
within Caltrans right-of-way that are not in compliance with Caltrans encroachment policy need to be
brought into compliance. The current sewer alignment has an existing manhole that resides within Caltrans
right-of-way at the north end of the freeway crossing, right before the sewer line turns east towards Old
Ranch Parkway.
In order to be in compliance with Caltrans encroachment policy, the City proposes to abandon the existing
manhole that is within Caltrans right-of-way as well as the, existing 18 -inch sewer line, and construct a new
18 -inch PVC sewer line inside a 30 -inch steel casing underneath the freeway via jack and bore. Three new
sewer manholes will also be constructed. The attached drawings show the proposed improvements.
This Encroachment Permit does not supercede the previous property recording for this facility.
1E, Is s City, County or other public agency Involved In the approval of tele project?
(a YES (if "YES", check type of projeetAn attach environmental documentatlon and conditions of approval)
❑ COMMERCIAL DEVELOPMENT ❑BUILDING E3 GRADING m OTHER Public Sewer Main Improvements
❑ CATEGORICALLY EXEMPT ❑NEGATIVEDECLARATION QENVIRONMENTALVdPACTREPORT 13
(3 NO Of 'NO", places check the category belowwhich beat describes the projectAaG answer quasUons A -Kon page 2)
❑ DRAIEWAY OR ROAD APPROACH, RECONSTRUCTION, MAINTENANCE OR RESURFACING ❑ FENCE
❑ PUBLIC UTILITY MODIFICATIONS, EXTENSIONS, HOOKUPS ❑ MAILBOX
❑ FLAGS. SIGNS, BANNERS, DECORATIONS. PARADES AND CELEBRATIONS ❑ EROSION CONTROL
❑ OTHER ❑ LANDSCAPING
ALIA NOT IGE: For Individuals wllh sensory disabailles, Nis document Is available In alternate lormats. For infomuton, call (016)445-1233. TTY 711, orwrlts to Records
and Forma Management 1120 N Scott, MS49, Sacramento, CA 95614.
N
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION Page 2 of 3
STANDARD ENCROACHMENT PERMIT APPLICATION PERMIT NO ��
7R-0700 (REV. 0312015) 1�
.„ 9 .-IVU &0 2-7
The following questions must be completed when a City, County or other public agency ISNOT Involved In the approval of this project
Your answers to these questions will assist Departmental staff In Idemiying any physical, bldogical, social or economic resources that may be affected by your proposed
Project wllhln Stale Highway dght- f -way and M determine which type of anNronmental studies may be required to approve your application for an encroachment permit.
It is the applicant's responsibility for the production of all required environmental documentation and supporting studies and In some cases this may be costly and time
consuming. If possible, attach photographs of the location of the proposed project. Please answer these questions b the beat of your ability. Provide a description of
any 'YES' answers (type, name, number, ate.)
A Nig any existing vegetation sndfa landscaping within Stele Highway dgNONway be disturbed?
NIA
S. Are there waterways (e.g. river, peek post, natural pod or dry sbaambed) adjacent to awNdn the limits of the projed or Stale Highway right4-way7
N/A
C. Is the proposed project located within five miles of the meal Item?
NIA
D. IMI the proposed project generate contraction noise levels greater than 88 dBA(e.g. Jack -hammering, pile driving)?
N/A
E. Will the proposed project Incorporate lard from a public park, recreation area orwilgre refuge open to tiro puble?
NIA
F Are Nero any recreational bels a paths within the last, of the proposed project or State Hghwayrlght-dway?
NIA
0. NAI the proposed project impact my structures. buildings, hill Ines abridges within Stele Highway dght4-way?
NIA
H. NO the proposed project Impact access mazy businesses or residencas?
N/A
1, NO the proposed project Impact any existing public Whites or public services?
N/A
J. NO the proposed project Impact mrndng pedestrian besides, such as sidewalks, crosswalks or mum ossings?
NIA
K N11 now lighting be constructed whhtn or a4ecenl to Slate Higheay right4kvay7
NIA
19, NAZI this project rause a substantial change in the significance of a historical resource (49 years or older), or cultural resource? UYES NO
(If"YES", provide a deacripgon)
20. Is this project on an existing Stam Highway or street where the activity involves removal of a scenic resource Including a signiDcant has or stand of boss, a
rock outcropping or a historic building? []YES ONO (If-YES',provideadescdptlon)
21. aworkbemg done on the appllcanr's property7 [] YES m NO (If "YES', attach 9 complete sets of site and grading plans.)
22. NAI the proposed project require the dishrbenca of sell? OYES []NO
If NES', estimate the rues M&M Stale Highway right-of-way In squam feetAND cores: e..ua,rrnexa ran.xoaans (IP)AND (isms)
estimate the area outside of Sate Highway tight -of -way, in square NPI AND acres: (gr) AND
29. NO the proposed project require dewatering? O YES [] NO
If"YES'. asomata total gallons AND gallons/month, asemdrPwrttlliovl-l7-NUP.ae3e(gegons)AND (gellonNmonth)
SOURCE': []STORM WATER []NON -STORM WATER
('Sae Celeane SWMP for deMhbns of nmo-amrtn water discharge: htty:IAv.doL".goviWenv/stormwetemndechtm)
26, How will any storm water or ground water be disposed of from within or near the limits of the proposed protect?
[] Sierra Drain System [] Combined Sewer / Storm System [] Storm Water Retention Basin
❑� Other (eaalem): Sea Rider Permit No. 12 -17 -NDP -0535
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
STANDARD ENCROACHMENT PERMIT APPLICATION
TR -0100 (REV. 0312016)
Page 3 of 3
mn
The applicant, understands and herein agrees that an encroachment permit can be denied, endfor a bond required for non-payment of prior or
present encroachment permit fees. Encroachment Permit fees may stili be due when an application is withdrawn or dented, and that a denial
may be appealed, In accordance with the California Streets and Highways Code, Section 671.6. All work shall be done In accordance with the
California Department of Transportation's (Department) miss and regulations subject to inspection and approval.
The applicant, understands and herein agrees to the general provisions, special previsions and conditions of the encroachment permit, and to
Indemnity and hold harmless the State, Its officers, directors, agents, employees and each of them (Indemniteas) from and against any and all
claims, demands, causes of action, damages, costs, expenses, actual adornsys'fsea, judgments, losses and liabilities of every kind and nature
whatsoever (Claims) arising out of or In connection with the Issuance smaller use of this encroachment permit and the placement and subse-
quent operation and maintenance of said encroachment for. 1) bodily Injury and/or death to persons Including but nut limited to the Applicant,
the State and its officers, directors, agents and employees, the Indemnities, and the public; and 2) damage to property of anyone. Except as
provided by law, the indemnification provisions stated above shall apply regardless of the existence Or degree of fault of Indemnities. The Ap-
plicant, however, shall not be obligated to Indemnify Indemnities for Claims arising from the $ole negligence and willful misconduct of State, Its
officers, directors, agents or employees.
An encroachment permit Is not a property right and does not transfer with the property to a new owner.
COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT (ADA) OF 1980: All work within State Highway right-of-way shall be conducted in
compliance with all applicable Federal, State and Local Access Iowa, regulations and guidelines Including but not limited to the Americans with
Disabilities Act Accessibility Guidelines (ADAAG), the Public Rights -of -Way Guidelines (PROWG), the Department's current Design Information
Bulletin 82,"PedestrianAccessibllityGuidelines for Highway Projects", the Department's Encroachment Permits Manualand encroachment permit
DISCHARGES OF STORM WATER AND NON -STORM WATER: All work within State Highway right-of-way shall be conducted In compliance with
all applicable requirements of the National Pollutant Discharge Elimination System (NPDES) permit Issued to the Department, to govern the
discharge of storm water and non -storm water from its properties. Work shall also be In compliance with all other applicable Federal, State and
Local laws and regulations, and with the Department's Encroachment Permits Manual and encroachment permit. Compliance with the Depart-
ment's NPOES permit requires amongst other things, the preparation and submission of a Storm Water Pollution Protection Plan (SWPPPL
or a Water Pollution Control Program (WPCP), and the approval of same by the appropriate reviewing authority prior to the start of any work.
Information on the requirements may also be reviewed on the Department's Construction Website at:
26. NAME OF APPLICANT OR ORGANIZATION
City of Seal Beach
AnnRFCR nFAPPUCANTOR ORGANIZATIONVMIEREP RMITISTO BE MAILED (Include ClIv and Zip Code)
211
Jill R, Ingram
211 Eighth Street, Seal Beach,
562-431-2527 x1300
562-431-2527 x1300
BILLING ADDRESS MERE INVOICE(S) ISIARE TO BE MAILED (Include City and Zip Code)
❑ YES 0 NO
E-MAILAGORESS
PHONE NUMBER
FAX NUMBER
28-1NATUREb PPLICA
TORAUTXORIZED AGENT
1s. PRINT ORTYPENAME
30.TMF.
31.DA (�
3
`
Jill R. Ingram
City Manager
�5
yD ,
U
CITY OF SEAL BEACH
1219 -NUR -0027
JANUARY 11, 2019
In addition to the attached General Provisions (TR -0045), the following Special Provisions are applicable:
Permittee shall STATUS (call) scheduled work DAILY via District's 24-hour Communication Center (DCC) at
949-936-3600 and text 10-97,1098, or 10-22 status to the State permit inspector named on the permit
(Inspector's cell phone number will be provided during the pre job meeting). Status (call) using Closure ID
No(s) and Log No(s) provided by the State inspector when work begins (first cone down, 10-97), and again
when work is finished for the day (last cone removed, 10-98. If the work is cancelled on any scheduled day,
Permittee shall call Caltrans DCC at 949-936-3600 and relay; "(Closure ID No., Log No) is 10.22" (cancelled).
The can call shall be made no later than the scheduled 10-97 time. Any delay in picking up your
closure must be reported immediately to DCC at 949-936-3600 and State Permit Inspector. FAILURE TO
FOLLOW THESE INSTRUCTIONS WILL RESULT IN SUSPENSION OF PERMIT.
If any of the closures on these plans cause a delay or backup onto the freeway, then the closure hours are to
be reduced or moved to night work as determined by the Caltrans Permit Inspector.
The following advance notification procedure shall be followed for permitted work activities requiring Traffic Control
within the State Right of Way:
By Noon Monday, permittee shall submit a completed copy of the attached District 12 Closure Schedule Form to the
assigned Permit Inspector by email (as shown on the Closure Schedule Form) or by Fax (657-328-6501) for the
following week period, defined as Saturday through the following Friday. If Monday is a designated holiday, the schedule
shall be submitted on Tuesday. Incomplete, illegible or inaccurate information will be returned for correction and
resubmittal. Permittee/Permittee's contractor will be notified of disapproved closures or closures that require
coordination with other parties as a condition of approval. If email or fax is unavailable, the schedule may be called in by
calling the assigned Permit Inspector, and the completed Form be submitted to the Permit Inspector during the pre -job
meeting.
• ADA Compliance requirements shall be met at all times. (DIB 82-05) at
http://www.dot.ca.gov/hq/oppd/dib/dib82-06.pdf
• Permittee shall contact the LOCAL LAW ENFORCEMENT JURISDICTION at least 48 hours prior to implementing
traffic control measures. All closures shall conform to State standards and shall follow Chapter 8 of the Safety
Manual.
Except for installing, maintaining and removing traffic control devices, any work encroaching within 3 feet of the
edge of a travel lane for areas with a posted speed limit below 45mph, or 6 feet of the edge of a travel lane, for
areas with a speed limit posted at 45mph or higher, shall require closing of that travel lane. Any work encroaching
within 6 feet of the edge of the shoulder, shalt require closing of that shoulder. Permittee shall notify the
Department's Representative, and obtain approval of, all traffic control, lane closures or detours, at least seven (7)
WORKING DAYS prior to setting up of any traffic control." Orange vests and hard hats shall be worn at all times
while working within State right-of-way.
By acceptance of this permit, the permittee understands and agrees to reimburse the State for all costs incurred for
performing corrective work in the event that the permittee or permittee's representatives fail to install, replace, repair,
restore, or remove facilities to state specifications for the immediate safe operation of the highway and satisfactory
completion of all permit work. State forces may perform corrective work or it may be contracted out. Understood is
that the 9bove charges are in addition to permit fees, and an invoice will be sent to permittee for said charges after
satisfactory completion of all work. The issuance of the permit shall not set as precedence for other permits
approved in the future.
• It is the responsibility of the permittee, permittee's agents, or contractors to comply with all provisions of this permit
and instructions from the State permit inspector. Permittee shall keep the permit package or copies thereof, at the
Page t of 2
work site at all times and show it upon request to any Department representative or law enforcement officer. When
the permit package is not available, then immediate suspension of permit will occur.
• Permittee shall furnish the necessary inspection to provide for public safety and to insure that all work within or
affecting the State's right of way pursuant to this permit is in accordance with State Standards and requirements.
The State permit inspectors will monitor the work authorized under this permit and the work is subject to the
approval of the State permit inspectors.
• Permittee shall remain solely responsible for compliance with all requirements of this permit.
• Prior to performing any work pursuant to this permit, the permittee shall obtain all necessary permits and
authorizations required of other governmental agencies and by law. The permittee shall make the necessary
arrangements with the appropriate agencies to monitor and test performed work to ensure accordance with
requirements of those agencies.
• American National Standards Institute (ANSI) compliant Class II vests and hard hats shall be worn while working
within State's right-of-way. Workers working at night will be required to wear ANSI Class III warning garments. Class
III compliance can be achieved by combining ANSI Class E pants worn with an ANSI Class 11 vest.
• The State permit inspector must ascertain and agree to all work details and all aspects of traffic control or no work
shall begin on this permit.
• If a safe passage way cannot be provided, appropriate signs and barricades shall be installed at the limits and in
advance of construction at the nearest Crosswalk or Intersection to detour pedestrians to facilities across the
street.
• When the work area encroaches upon a sidewalk, walkway, or crosswalk area, special consideration must be
given to pedestrian safety. Protective barricades, fencing, handrails and bridges, together with warning and
guidance devices and signs must be utilized so that the passageway for pedestrians, especially blind and other
physically handicapped is safe and well defined and shown on the approved permit plan.
• Personal vehicles of the Contractor's employees shall not be parked on paved shoulders or traveled way within the
limits of this work.
• Unless otherwise approved by the State Permit Inspector no work that interferes with public traffic shall be
performed on weekdays between 6:00 AM and 9:00 AM, and between 3:00 PM and 6:30 PM.
• The full width of traveled way shall be open for use by public traffic on Saturdays, and designated legal holidays,
after 3:00 PM on Fridays and on the day preceding designated legal holidays, and when construction operations are
not actively in progress.
• Except as specifically provided herein, all requirements of the Vehicle Code and other applicable laws must be
complied with in all particulars.
• No lane may be closed or obstructed at any time unless specifically allowed per the encroachment permit, shown
in approved traffic control plans, and/or as directed by the Department's Representative.
• The Permittee's work shall be subordinated to any operations which the Department may conduct and shall not
delay, nor interfere with the Department's Forces or Department's Contractors.
• Should any deviation from these procedures or conditions be observed, all work shall be suspended until
satisfactory steps have been taken to ensure compliance.
• In the event of any discrepancy between Permittee's Permit Plans and these Permit Special Provisions, these
Special Provisions shall prevail.
Immediately following completion of the work permitted herein, Permittee shall fill out and fax the attached Work
Completion Notice to 657-328-6501 to initiate final permit processing.
Page 2 of 2
STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT GENERAL PROVISIONS
TR-0045 NNORM
t. AUTHORITY: The California Department of
Transportation (`Department') has authority to issue
encroachment permits under Division 1, Chapter 3, Article
1, Sections 660 through 734 of the Streets and Highways
Code.
REVOCATION: Encroachment permits are revocable on
five (5) business days' notice unless otherwise stated on the
permit and except as provided by law for public
corporations, franchise holders, and utilities.
Notwithstanding the foregoing, in an emergency situation as
determined by the Department, an encroachment permit
may be revoked immediately. These General Provisions -and
any applicable Special Provisions are subject to
modification or abrogation at any time. Permittees' joint use
agreements, franchise rights, reserved rights or any other
agreements for operating purposes in. State of California
("State's highway right-of-way are exceptions to this
revocation.
DENIAL FOR NONPAYMENT OF FEES: Failure to
pay encroachment permit fees when due may result in
rejection of future applications and denial of encroachment
permits.
ASSIGNMENT: No party other than the permittee or
pert» tree's authorized agent is allowed to work under this
encroachment permit
ACCEPTANCE OF PROVISIONS: Permittee
understands and agrees to accept and comply with these
General Provisions, the Special Provisions, any and all
terms contained in this encroachment pemrit, and all
attachments to this encroachment permit, for any work to be
performed under this encroachment permit.
BEGINNING OF WORK: When traffic is not impacted
(see General Provision # 35), the permittee must notify the
Department's representative two (2) business days before
starting permitted work Permittee must notify the
Department's representative if the work is to be interrupted
for a period of five (5) business' days or more, unless
otherwise agreed upon. All work must be performed on
weekdays during regular work hours, excluding holidays,
unless otherwise specified in this encroachment permit
STANDARDS OF CONSTRUCTION: All Work
performed within State highway right-of-way must conform
to all applicable Departmental 'construction standards
including but not limited to: Standard Specifications,
Standard Plans, Project Development Procedures Manual,
Highway Design Manual and Special Provisions.
Other than as expressly provided by these General
Provisions, the Special Provisions, the Standard
Specifications, Standard Plans, and other applicable
Departmental standards, nothing in these General
Provisions is intended to give any third party any legal or
equitable right, remedy, or claim with respect to these
General Provisions or any provision herein. These General
Provisions are for the sole and exclusive benefit of the
permittee and the Department.
Where reference is made in such standards to "Contractor"
and "Engineer," these are amended to be read as
"Permittee" and "Department's representative,"
respectively, for purposes of this encroachment permit
8. PLAN CHANGES: Deviations from plans, specifications,
and/or encroachment permit provisions are not allowed
without prior approval from the Department's
representative.
9. INSPECTION AND APPROVAL: All work is subject to
monitoring and inspection. Upon completion of work,
permittee must request a final inspection for acceptance and
approval by the Department The local public agency
Permittee must not give final construction approval to its
contractor until final acceptance and . approval by the
Department is obtained.
10. PERMIT AT WORKSITE: permittee must keep the
permit package or a copy thereof at the work site at all
times, and must show it upon request to any Department
representative or law enforcement officer. If the permit
package, or a copy thereof; is not kept and made available
at the work site at all times, the work must be suspended
11. CONFLICTING ENCROACHMENTS: Permittee must
yield start of work to ongoing, prior authorized work
adjacent to or within the limits of the permittee's project
site. When existing encroachments conflict with pemmittee's
work, the permittee must bear all cost for rearrangements
(e.g., relocation, alteration, removal, etc.).
12. PERMITS FROM OTHER AGENCIES: This
encroachment permit is invalidated if the permittee has not
obtained all permits necessary and required by law,
including but not limited to permits from the California
Public Utilities Commission (CPUC), California
Occupational Safety and Health Administration (Cal -
OSHA), or any other public agency having jurisdiction.
Permittee warrants all such permitshavebeen obtained
before beginning work under this encroachment permit
13. PEDESTRIAN AND BICYCLIST SAFETY: A safe
minimum continuous passageway of four (4) feet must be
maintained through the work area at existing pedestrian or
bicycle facilities. At no time must pedestrians be diverted
onto a portion of the street used for vehicular traffic. At
locations where safe alternate passageways cannot be
provided, appropriate signs and barricades must be installed
at the limits of construction and in advance of the limits of
construction at the nearest crosswalk or intersection to
detour pedestrians to facilities across the street. Attention is
directed to Section 7-1.04, Public Safety, of the
Department's Standard Specifications.
PUBLIC TRAFFIC CONTROL: As required by law, the
permittee must provide tra$c.connol protection, warning
signs, lights, safety devices, etc., and take all other measures
necessary for the traveling public's safety. While providing
traffic control, the needs of all road users, including but not
limited to motorists, bicyclists and pedestrians, including
Persons with disabilities in accordance with the Americans
with Disabilities Act, must be an essential part of the work
activity.
Lane and/or shoulder closures must comply with the
Department's Standard Specifications and Standard Plans
for traffic control systems, and with the applicable Special
Provisions. Where issues are not addressed in the Standard
Specifications, Standard Plans, and/or Special Provisions,
the Califomia Manual on Uniform Traffic Control Devices
(Part 6, Temporary Traffic Control) must be followed.
MINIMUM INTERFERENCE WITH TRAFFIC:
Permittee must plan and conduct work so as to create the
least possible inconvenience to the traveling public, such
that trafficis not unreasonably delayed. On conventional
highways, Permittee mist place properly attired flagger(s)
to stop or warn the traveling public in compliance with the
California Manual on Uniform Traffic Control Devices
(Chapter 6E, Magger Control).
STORAGE OF EQUIPMENT AND MATERIALS: The
storage of equipment or materials is not allowed within
State highway right-of-way, unless specified within the
Special Provisions of this encroachment permit If
encroachment permit Special Provisions allow for the
storage of equipment or materials within the State highway
right-of-way, the equipment and material storage must also
comply with Section 7-1.04, Public Safety, of the
Department's Standard Specifications.
CARE OF DRAINAGE: Permittee must provide alternate
drainage for any work mtm*ring with an existing drainage
facility in compliance with the Department's Standard
Specifications, Standard Plans, and/or as directed by the
Department's representative.
RESTORATION AND REPAIRS IN STATE
HIGHWAY RIGHT-OF-WAY: Permittee is responsible
for restoration and repair of State highway right-of-way
resulting from permitted work (Streets and Highways Code,
section 670 et seq.).
STATE HIGHWAY RIGHT-OF-WAY CLEAN UP:
Upon completion of work, permittee must remove and
dispose of all scraps, refuse, brush, timber, materials, etc.
off the State highway right-of-way. The aesthetics of the
highway must be. as it was before work -started or better.
20. COST OF WORK: Unless stated otherwise in the
encroachment permit or a separate written agreement with
the Department, the permittee must bear all costs incurred
for work within the State highway right-of-way and waives
all claims for indemnification or contribution from the
State, the Department, and from the Dhw-Vrs, officers, and
employees of the State and/or the Department
21. ACTUAL COST BILLING: When specified in the permit,
the Department will bill the permittee actual costs at the
currently set Standard Hourly Rate for encroachment
permits.
22.. AS -BUILT PLANS: When required, permittee must
submit one (1) set of folded as built plans within thirly (30)
calendar days after completion and acceptance of work in.
compliance with requirements listed as follows:
a) Upon completion of the work provided here*, the
permittee must submit a paper set of As Built plans to
the Department's representative.
b) All changes in the work will be shown on the plans, as
issued with the permit, including changes approved by
Encroachment Permit Rider.
c) The plans are to be prominently stamped or otherwise
noted `AS -BUILT" by the permittee's representative
who was responsible for overseeing the work Any
original plan that was approved with a Department
stamp, or by signature of the Department's
representative, must be used for producing the As -Built
plans.
d) If construction plans include signing or striping, the
dates of signing or striping removal, relocation, or
installation must be shown on the As -Built plans when
required as a condition of the encroachment permit.
When the construction plans show signing and striping
for staged construction on separate sheets, the sheet for
each stage . must show the removal, relocation, and
installation dates of the appropriate staged striping and
signing.
e) As -Built plans must contain the Encroachment Permit
Number, County, Route, and Post Mile on each sheet
f) The As -Built Plans must not include a disclaimer
statement of any kind that differs from the obligations
and protections provided by sections 6735 through
6735.6 of the California Business and Professions Code.
Such statements constitute nou-compliance with
Encroachment Permit requirements, and may result in
the Department retaining Performance Bonds or deposits
until proper plans are submitted. Failure to comply may
also result in denial of fixture encroachment permits or a
provision requiring a public agency to supply additional
bonding.
3. PERMITS FOR RECORD PURPOSES ONLY: When
work in the State highway right-of-way fs within an area
under a Joint Use Agreement (JUA) or a Consent to
Common Use Agreement (CCUA), a fee exempt
encroachment permit is issued to the permittee for the
purposeof providing a notice and record of work. The
permittee's prior rights must be preserved without the
intention of creating new or different rights or obligations.
"Notice and Record Purposes Only" must be stamped.
across the face of the encroachment permit.
BONDING: The permittee must file bond(s), in advance, in
the amounts) set by the Department and using forms
acceptable to the Department The bonds must name the
Department as obligee. Failure to maintain bond(s) in full
forcd and effect will result in the Department stopping all
work under this encroachment permit and possibly revoking
other encroachment pemtits). Bonds are not required of
public corporations or privately owned utilities unless
permittee failed to comply with the provisions and/or
conditionsof a prior encroachment permit The surety
company is responsible for any latent defects as provided in
California Code of Civil Procedure section 337.15. A local
public agency permittee also must comply with the
following requirements:
a) In recognition that project construction work done
on State property will not be directly funded and
paid by State, for the purpose of protecting stop
notice claimants and the interests of State relative to
successful project completion, the local public
agency permittee agrees to require the construction
contactor to fumish both a payment and
performance bond in the local public agency's name
with both bonds complying with the requirements
set forth in Section 3-1.05 Contract Bonds of the
Department's Standard Specifications before
Performing any project construction work-
b)
orkb) The local public agency permittee must defend,
indemnify, and hold harmless the State and the
Department, and the Directors, officers, and
employees of the State and/or Department' from all
project construction related chums by contractors,
subcontractors, and suppliers, and from all stop
notice and/or mechanic's lien claimants. The local
Public agency also agrees to remedy, in a timely
manner and to the Department's satisfaction, any
latent defects occurring as a result of the project
construction work
FUTURE MOVING OF INSTALLATIONS: Permittee
understands and agrees to relocate a permitted installation
upon notice by the Department. Unless under prior property
right or agreement, the permittee most comply with said
notice at the permittee's sole expense.
ENVIRONMENTAL:
a) ARCHAEOLOGICAL/HISTORICAL: If any
archaeological or historical resources are identified or
encountered in the work vicinity, the permittee must
immediately stop work, notify the Department's
representative, retain a qualified archaeologist who must
evaluate the site at pemtittee's expense, and make
recommendations to the Department's representative
regarding the continuance of work.
b) HAZARDOUS MATERIALS: If any hazardous waste
or materials (such as underground storage tanks,
asbestos pipes, contaminated soil, etc.) are identified or
encountered in the work vicinity, the permittee must
immediately stop work, notify the Department's
representative, retain a qualified hazardous
waste/material specialist who must evaluate the site at
pemiittee's expense, and make recommendations to the
Department's representative regarding the continuance
of work
Attention is directed to potential aerially deposited lead
(ADL) presence in unpaved areas along highways. It is
the permittee's responsibility to take all appropriate
measures to protect workers in conformance with
California Code of Regulations Title 8, Section 1532.1
"Lead," and with Cal -OSHA Construction Safety
Orders, and to ensure roadway soil management is in
compliance with Department of Toxic Substances
Control (DTSC) requirements.
27. PREVAILING WAGES: Work performed by or under an
encroachment permit may require permittee's contractors
and subcontractors to pay appropriate prevailing wages as
set by the California Department of Industrial Relations.
Inquiries or requests for interpretations relative to
enforcement of prevailing wage requirements must be
directed to the California Department of industrial
Relations.
28. LIABII1Ty, DEFENSE, AND INDEMNITY: The
permittee agrees to indemnify and save harmless the State,
the Department, and all Directors, officers, employees,
agents and/or contractors of the State and/or of the
Department, including but not limited to the Director of
Transportation and the Deputy Directors, from any and all
claims, demands, damages, costs, liability, suits, or actions
Of every name, kind and description brought for or on
account of property damage or injury to or death of any
person, including but not limited to members of the public,
the Permittee, persons employed by the permittee, and
Persons acting on behalf of the permittee, arising out of or
in connection with: (a) the issuance and/or use of this
encroachment permit, and/or (b) the work or other activity
conducted pmsuam to this encroachment permit, and/or (c)
the installation, placement, subsequent operation, and/or
maintenance of said encroachment, and/or (d) the failure by
the pemlittee or anyone acting on behalf of the permittee to
perform permittee's obligations under this encroachment
Permit in respect to maintenance or any other obligation,
and/or (e) a defect or defects in the work, or obstructions
related to the work, or from any cause whatsoever. The duty
of the permittee to indemnify and save'barmless includes
the duties to defend as set forth in Section 2778 of the Civil
Code.
It is the intent of the parties drat except as prohibited by
law, the permittee will defend, indemnify, and hold
harmless as set forth above regardless of the existence or
degree of fault or negligence, whether active or passive,
primary or secondary, on the part of the State, the
Department, the Directors, officers, employees, agents
and/or contractors of the State and/or Department, including
but not limited to the Director of Transportation and the
Deputy Directors, the permitiee, persons employed by the
permittee, and/or persons acting on behalf of the permittee.
The permittee waives any and all rights -to any type of
expressed or implied indemnity against the State, the
Departnent, the Directors, officers, employees, agents,
and/or contractors of the' State and/or of the Department,
including but not limited to the Director of Transportation
and the Deputy Directors.
The permittee understands and agrees to comply with the
obligations of Titles U and III of the Americans with
Disabilities Act in the conduct of the permitted activity, and
further agrees to defend, indemnify, and save harmless the
State, the Department, the Directors, officers, employees,
and/or agents of the State and/or of the Department,
including but not limited to the Director of Transportation
and the Deputy Directors,. from any and all claims,
demands, damages, costs, liability, suits, or actions of every
name, kind and description arising out of or by virtue of the
Americans with Disabilities Act.
Permittee understands and agrees the Directors, officers,
employees, and/or agents of the State and/or of the
Department, including but not limited to the Director of
Transportation and the Deputy Directors, are not personally
responsible for any liability arising from'or by virtue of this
encroachment permit
For the purpose of this section and all paragraphs herein,
"State's contractors" includes contractors and their
subcontractors under contract to the State and/or the
Department performing work within the same postmiie
limits as the work under this encroachment permit
This section and all paragraphs herein take effect upon
issuance of this encroachment permit, and apply both during
and after the work or other activity contemplated under this
enemachment permit, except as otherwise provided by
California law.
29. NO PRECEDENT ESTABLISHED: This encroachment -
Permit is issued with the understanding -.that it does not - ...
establish a precedent.
30. FEDERAL CI VII, RIGHTS R3•,ftti313WAWb?M_f.GR _ ----.
PUBLIC ACCOMMODATION:
a) As part of the consideration for being issued this
encroachment Permit, the Permittee, on behalf of
permittee and on behalf of permittee's personal
representatives, successors in interest, and assigns, does
hereby covenant and agree that-
i.
hat
i. No person on the grounds of race, color, or
national origin may be extiluded from
Participation in, be denied the benefits of; or be
otherwise subjected to discrimination in the use
of said facilities_
ii. That in connection with the construction of any
improvements on said lands and the furnishings
Of services thereon, no discrimination must be
Practiced in the selection and retention of first-
tier subcontractors in the selection of second-
tier subcontractors.
iii.. That such discrimination must not be practiced
against the public in their access to and use of
the facilities and services provided for public
accommodations (such as'eating, sleeping, rest,
recreation), and operation on, over, or under
the space of the State highway right-of-way.
iv. That the permittee must use -the premises in
compliance with all other requirements
imposed pursuant to Title 15, Code of Federal
Regulations; Commerce and Foreign Trade,
Subtitle A. Office of the Secretary of
Commerce, Part 8 (15 C.F.K Part 8) and as
said Regulations may be amended.
b) That in the event of breach of any of the above'
nondiscrimination covenants, the State and the
Department have the right to terminate this
encroachment permit and to re-enter and repossess said
land and the facilities thereon, and hold the same as if
said permit had never been made or issued.
31. MAINTENANCE OF HIGHWAYS: By accepting this
encroachment permit, the permittee agrees to properly
maintain any encroachment This assurance requires the
Permittee to provide inspection and repair any damage, at
permittee's expense, to State facilities resulting from the
encroachment
32. SPECIAL EVENTS: In accordance with subdivision (a) of
Streets and Highways Code section 682.5, the Department
is not responsible for the conduct or operation of the
permitted activity, and the applicant agrees to defend,
indemnify, and hold harmless the State, the Department,
and the Directors, officers, employees, agents, and
contractors of the State and/or of the Department, including
but not limited to the Director of Transportation and the
Deputy Directors, from anyand all claims, demands,
damages, costs, liability, suits, or actions of every name,
kind and description arising out of any activity for which
this encroachment permit is issued.
The permittee understands and agrees to comply with the
obligations of Titles 11 and III of the Americans with
Disabilities Act in the conduct of the event, .and fiuther
agrees to defend, indemnify, and save harmless the State
and the Department, and the Directors, officers, and
employees of the State and/or Department, including but not
limited to the Director of the Department and the Deputy
Directors, from any and all claims, demands, damages,
costs, liability, suits, or actions of every name, kind and
description arising out of or by virtue of the Americans with
Disabilities Act
PRIVATE USE OF STATE HIGHWAY RIGHT-OF-
WAY: State highway right-of-way must not be used for
Private purposes without compensation to the State. The
gifting of public property use and therefore public funds is
prohibited under the Califomia Constitution, Article 16.
FIELD WORK REIMBURSEMENT: Permittee must
reimburse the Department for field work performed on
permittee's behalf to correct or remedy hazards or damaged
facilities, or to clear refuse, debris, etc. not attended to by
the permittee.
NOTIFICATION OF CLOSURES TO DEPARTMENT
AND TRAFFIC MANAGEMENT CENTER (TMC):
The permittee must notify the Department's representative
and the Transportation Management Center (TMC) at least
seven (7) days before initiating a lane closure or conducting
an activity that may cause a traffic impact A confirmation
notification should occur three (3) days before closure or
other potential traffic impact In emergency situations when
the corrective work or the emergency itself may affect
traffic, TMC and the Department's representative must be
notified as soon as possible.
SUSPENSION OF TRAFFIC CONTROL
OPERATION: The permittee, upon notification by the
Department's representative, must immediately suspend all
lane closure operations and any operation that impedes the
flow of traffic. All costs associated with this suspension
must be borne by the permittee.
UNDERGROUND SERVICE ALERT (USA)
NOTIFICATION: Any excavation requires compliance
with the provisions of Government Code section 4216 et
seq., including but not limited to notice to a regional
notification center, such as Underground Service Alert
(USA). The permittee must provide notification to the
regional notification center at least forty-eight (48) hours
before performing any excavation work within the State
highway right -of --way.
38. COMPLIANCE WITH THE AMERICANS WITH
DISABILITIES ACT (ADA): All work within the State
highway right-of-way to construct and/or maintain any
Public facility must be designed, maintained, and
constructed' strictly in accordance with all applicable
Federal Access laws and regulations (including but not
limited to Section 504 of the Rehabilitation Act of 1973,
codified at 29 U.S.C. § 794), California Access taws and
regulations relating to ADA, along with its implementing
regulations, Title 28 of the Code of Federal Regulations
Parts 35 and 36 (28 C.F.R, Ch, L Part 35, § 35.101 et seq.,
and Part 36, § 36.101 et seq.), Title 36 of the Code of
Federal Regulations Part 1191 (36 C.F.R., Cit )CI, Part
1191, § 1119.1 et seq.), Title 49 of the Code of Federal
Regulations Part 37 (49 C.F.R., Ch A, Part 37, § 37.1 et
seq.), the United States Department of Justice Title 11 and
Title III for the ADA, and California Government Code
section 4450 et seq, which require public facilities be made
accessible to persons with disabilities.
Notwithstanding the requirements of the previous
Paragraph, all construction, design, and maintenance of
Public facilities must also comply with the Department's
Design Information Bulletin 82, `Tedestrian Accessibility
Guidelines for Highway Projects.^
DISTRICT 12 LANE/SHOULDER CLOSURE REQUEST FORM'
THIS FORM MUST BE SUBMITTED BY NOON ON MONDAY PRIOR TO THE WEEK OF THE PLANNED RESTRICTION
COMPLETE FORM AND EMAIL TO THE EMAIL ADDRESS IN61CATED AT THE BOTTOM OF THE PAGE
4r" ' .1 stn nPn„! _PERMIT@TjEEtINFOF21VlAS7iONz� f .Lag
6�'✓ ...teee2w- m.
Today's Date: Time: Contractor:
Requestor:
Office Phone #:
Permit #:
Caltrans Inspector:
Field Contact:
Cell M
Email Address:
Emergency Phone Number:
A01'W MhlON Week of:Day(s): E] Saturday El Sunday El Monday [I Tuesday Wednesday Thursday El Friday
Existing Number of Lanes in the Direction of Travel: ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6
Direction: ❑ NB ❑ SB ❑ EB ❑ WB Lane* ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6
(Lane #1 is the lane adjacent to the roadway centerline)
❑ Bike Lane ❑ Shoulder ❑ Median ❑ AuxiliaryLane
COUNTY ROUTE PM DESCRIPTIVE LOCATION/CLOSURE TIME
FROM ❑ LA
TO ❑ ORANGE
Types of Closure, Closure Characteristics (Check all of the following that apply):
❑ Full Ramp Closure ❑ Full Street Closure ❑ 24-Hour/7-Day-Closure ❑ Detour Available
❑ Closure conforms to the 2014 California Manual of Uniform Traffic Control Devices (CA MUTCD) 2014, latest edition, copies
of which are available at hllla,il•n nv �t C9 cloy h (1/ ;oiGtpiitnclj
Estimated Delay: _ Minutes Type of Work Proposed:
, � o
Permittee shall call the Traffic Management Center (TMC) at 949-936-3600 and relay the Closure ID No(s),
Log No(s), and status code provided by the State Inspector when work begins (first cone down, status
code 10-97), and again when work is finished for the day (last cone removed, status code 10-98. If the
work is cancelled on any scheduled day, Permittee shall call TMC at 949-9363600 and relay; "(Closure ID
No., Log No.) is 10-22” (cancelled) no later than the scheduled 10-97 time. Any delay in picking up your
closure must be reported immediately to TMC at 949-936-3600 and State Permit Inspector. Permittee shall
text 10-97,10-98, or 10-22 status to the State permit inspector named on the permit (Inspector's cell phone
number will be provided during the pre -job meeting). FAILURE TO FOLLOW THESE INSTRUCTIONS WILL
RESULT IN SUSPENSION OF PERMIT.
PERMITTEE SHALL SUBMIT THE SIGNED ORIGINAL COPY AT THE PRE -JOB MEETING AND EMAIL A
COPY OF THE FORM TO LEAH.FORMANES@DOT.CA.GOV.
Name: Signature: Date:
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FERMRNO.
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SIGNATURE OF PERIImEE
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Dear Sir or Madam:
All workauthomed by Me above -numbered parmd nes
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SIGNATNRe OF PEPA1miEE
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ORANGE COUNTY TRANSPORTATION AUTHORITY
UTILITY AGREEMENT
DISTRICT COUNTY ROUTE POST MILE EA PROJECT ID
12 1 Orange 1-405 9.3-24.2 12 -OH 1000 1200000180
FEDERAL AID NUMBER OWNER'S PLAN NUMBER
HPLULN-6071(043) See Contract Plans — City of Seal Beach
FEDERAL PARTICIPATION
On the project ® YES ❑ NO On the Utilities ❑ YES ® NO
UTILITY AGREEMENT NO. UK102097 DATE
The Orange County Transportation Authority (OCTA) in cooperation with the California Department of
Transportation ("Caltrans") is proposing to improve Interstate 405 between State Route 73 and Interstate
605 (Project). OCTA and Caltrans have entered into Cooperative Agreement No. 12-697 relating to the
Project under which Caltrans will provide Project oversight and upon completion of the Project, Caltrans
will continue to own and maintain the Interstate 405.
City of Seal Beach
Hereinafter referred to as "OWNER", owns and maintains the following (the "Utility Facilities"):
• 18 inch diameter sewer pipe in 33 inch diameter concrete casing crossing the I-405, UK102097
within the limits of the OCTA Project which requires
relocation
to accommodate the OCTA Project.
It is hereby mutually agreed between OCTA and OWNER as follows:
I. WORK TO BE PERFORMED
In accordance with Notice to Owner No. UK102097 dated 1/5/2017, OCTA shall relocate
OWNER's "Utility Facilities" as shown on OCTA's contract plans for the improvement of
Interstate 405, EA 12-OH1000 which by this reference are made a part hereof. OWNER
hereby acknowledges review of OCTA's plans for work and agrees to the construction in the
manner proposed. Deviations from the plan described above initiated by either OCTA or the
OWNER, shall be agreed upon by both parties hereto under a Revised Notice to Owner. Such
Revised Notices to Owner, approved by OCTA and agreed to/acknowledged by the OWNER,
will constitute an approved revision of the plan described above and are hereby made a part
hereof. No work under said deviation shall commence prior to written execution by the
OWNER of the Revised Notice to Owner. Changes in the scope of the work will require an
amendment to this Agreement in addition to the revised Notice to Owner. OWNER shall have
the right to inspect the work during construction. Upon completion of the work by OCTA,
OWNER agrees to accept ownership and maintenance of the constructed facilities and
02-03-2016
UTILITY AGREEMENT (Cont.)
Page 2 of 6
UTILITY AGREEMENT NO.
UK102097
relinquishes to OCTA ownership of the replaced facilities, except in the case of liability
determined pursuant to Water Code 7034 or 7035.
IL LIABILITY FOR WORK
The existing facilities are lawfully maintained in their present location and qualify for
relocation at OCTA expense under the provisions of Section 703 of the Streets and
Highways Code.
III. PERFORMANCE OF WORK
OWNER shall have access to all phases of the relocation work to be performed by OCTA, as
described in Section I above, for the purpose of inspection to ensure that the work is in
accordance with the specifications contained in the OCTA's highway construction Contract;
however, all questions regarding the work being performed will be directed to OCTA's
Resident Engineer for their evaluation and final disposition.
Use of out-of-state personnel (or personnel requiring lodging and meal "per diem" expenses)
will not be allowed without prior written authorization by State's representative. Requests for
such authorization must be contained in OWNER's estimate of actual and necessary
relocation costs. Accounting Form FA -1301 is to be completed and submitted for all non -
State personnel travel per diem. OWNER shall include an explanation why local employee or
contract labor is not considered adequate for the relocation work proposed. Per diem
expenses shall not exceed the per diem expense amounts allowed under the State's California
Department of Human Resources (CaIHR) travel expense guidelines.
Work performed directly by OWNER's employees shall comply with Labor Code Section
1771. OWNER shall verify compliance with this requirement in the administration of its
contracts referenced above.
IV. PAYMENT FOR WORK
OCTA shall pay its share of the actual and necessary cost of the herein described work
within 45 days after receipt of OWNER's itemized bill, signed by a responsible official of
OWNER's organization and prepared on OWNER's letterhead, compiled on the basis of the
actual and necessary cost and expense. The OWNER shall maintain records of the actual
costs incurred and charged or allocated to the project in accordance with recognized
accounting principles.
It is understood and agreed that OCTA will not pay for any betterment or increase in
capacity of OWNER's facilities in the new location and that OWNER shall give credit to
OCTA for the salvage value of any material or parts salvaged and retained or sold by
OWNER.
DMIU INA
UTILITY AGREEMENT (Cont.)
04-04-2016
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Not more frequently than once a month, but at least quarterly, OWNER will prepare and
submit itemized progress bills for costs incurred not to exceed OWNER's recorded costs as
of the billing date less estimated credits applicable to completed work. Payment of progress
bills not to exceed the amount of this Agreement may be made under the terms of this
Agreement. Payment of progress bills which exceed the amount of this Agreement may be
made after receipt and approval by OCTA of documentation supporting the cost increase
and after an amendment to this Agreement has been executed by the parties to this
Agreement.
The OWNER shall submit a final bill to OCTA within 360 days after the completion of the
work described in Section I above. If OCTA has not received a final bill within 360 days
after notification of completion of OWNER's work described in Section I of this
Agreement, and OCTA has delivered to OWNER fully executed easement deeds, Consents
to Common Use or Joint Use Agreements for OWNER's facilities (if required), OCTA will
provide written notification to OWNER of its intent to close its file within 30 days.
OWNER hereby acknowledges, to the extent allowed by law, that all remaining costs will
be deemed to have been abandoned. If OCTA processes a final bill for payment more than
360 days after notification of completion of OWNER's work, payment of the late bill may
be subject to allocation and/or approval by the OCTA Board of Directors.
The final billing shall be in the form of an itemized statement of the total costs charged to
the project, less the credits provided for in this Agreement, and less any amounts covered by
progress billings. However, OCTA shall not pay final bills which exceed the estimated cost
of this Agreement without documentation of the reason for the increase of said cost from the
OWNER and approval of documentation by OCTA. Except, if the final bill exceeds the
OWNER's estimated costs solely as the result of a revised Notice to Owner as provided for
in Section I, a copy of said revised Notice to Owner shall suffice as documentation. In either
case, payment of the amount over the estimated cost of this Agreement may be subject to
allocation and/or approval by the OCTA Board of Directors.
In any event if the final bill exceeds 125% of the estimated cost of this Agreement, an
Amended Agreement shall be executed by the parties to this Agreement prior to the
payment of the OWNER's final bill. Any and all increases in costs that are the direct result
of deviations from the work described in Section I of this Agreement shall have the prior
concurrence of OCTA.
Detailed records from which the billing is compiled shall be retained by owner for a period
of three years from the date of final payment and will be available for audit by OCTA, State
and/or Federal auditors. In performing work under this Agreement, owner agrees to comply
with the Uniform System of Accounts for Public Utilities found at 18 CFR Part 101, 201, et
ah, and, to the extent they are applicable to owner doing work on the project that is the
subject of this agreement, the contract cost principles and procedures as set forth in 48 CFR,
Chapter 1, Part 31, et seq., 23 CFR, Chapter 1, Part 645, and 2 CFR Part 200 et al. If a
subsequent OCTA, State and/or Federal audit determines payments to be unallowable,
owner agrees to reimburse agency upon receipt of agency billing. If owner is subject to
UTILITY AGREEMENT (Cont.)
Page 4 of 6
UTILITY AGREEMENT NO.
repayment due to failure by OCTA to comply with applicable laws, regulations, and
ordinances then OCTA will ensure that owner is compensated for actual cost in performing
work under this agreement.
V. GENERAL CONDITIONS
All costs accrued by OWNER as a result of OCTA's request of 4/13/2016 to review, study
and/or prepare relocation plans and estimates for the project associated with this Agreement
may be billed pursuant to the terms and conditions of this Agreement.
If OCTA's Project which precipitated this Agreement is canceled or modified so as to
eliminate the necessity of work by OWNER, OCTA will notify OWNER in writing and
OCTA reserves the right to terminate this Agreement by amendment. The amendment shall
provide mutually acceptable terms and conditions for terminating the Agreement.
OWNER shall submit a Notice of Completion to OCTA within 30 days of the completion of
the work described herein.
Where OWNER has prior rights in areas which will be within the highway right of way and
where OWNER's facilities will remain on or be relocated on STATE highway right of way,
a Joint Use Agreement or Consent to Common Use Agreement shall be executed by the
parties.
It is understood that said highway is a Federal aid highway and accordingly, 23 CFR,
Chapter 1, Part 645 is hereby incorporated into this Agreement.
In addition, the provisions of 23 CFR 635.410, Buy America, are also incorporated into this
Agreement. The Buy America requirements are further specified in Moving Ahead for
Progress in the 21st Century (MAP -21), section 1518; 23 CFR 635.410 requires that all
manufacturing processes have occurred in the United States for steel and iron products
(including the application of coatings) installed on a project receiving funding from the
FHWA.
If, in connection with OWNER'S performance of Work hereunder, OCTA provides to
OWNER any materials that are subject to the Buy America Rule, OCTA acknowledges and
agrees that OCTA shall be solely responsible for satisfying any and all requirements relative
to the Buy America Rule concerning the materials thus provided (including, not limited to,
ensuring and certifying that said materials comply with the requirements of the Buy America
Rule).
OWNER will provide a no fee encroachment permit to OCTA's Design -Builder prior to
commencing construction of Project. Provided all conditions of such permit have been
fulfilled, the permits shall authorize Design -Builder to commence work within OWNER right
of way, or areas which affect OWNER facilities.
04-04-2016
UTILITY AGREEMENT (Cont.)
04-04-2016
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OWNER will review and/or the submitted Project plans within a period of four (4) weeks.
The terms of this Agreement shall be binding and inure to the benefits of the Parties hereto.
THE ESTIMATED COSTS TO OCTA FOR THE ABOVE DESCRIBED WORK IS
$40,000.
Signatures on Following Page
UTILITY AGREEMENT (Cont.)
SIGNATURE PAGE
TO
UTILITY AGREEMENT NO.
UK 102097
Page 6 of 6
UTILITY AGREEMENT NO.
IN WITNESS WHEREOF, the above parties have executed this Agreement on the dates below.
Owner:
CITY OF SEAL BEACH, a charter city
APPROVED
MOVIA no-MA1311
Date: al all
APPROVED
By:
Title: &rdig A. Steele
City Attorney
Date: Z ti `7 / I
04-04-2046
ORANGE COUNTY
TRANSPORTATION AUTHORITY,
a public entity
APPROVED
Lo
,r !ecutive Director,
(/Capital Programs
Date:
APPROVED AS TO FORM:
Date:
General Counsel