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Instructions <br />1. Agency Name and Billing Address — Enter the Agency of primary interest which will <br />become a party to the agreement. <br />2. Project Number— Leave blank. This number will be assigned by WSDOT. <br />3. Agreement Number — Leave blank. This number will be assigned by WSDOT. <br />4. <br />a. Project Description — Enter the project name, total length of the project (in miles), <br />and a brief description of the termini. Data entered here must be consistent with the <br />name, length, and termini noted in the STIP and Project Prospectus <br />Example: (Name) "Regal Road", (Length) "1.2 miles", (Termini) "Smith Road to <br />Main Street" <br />b. Description of Work — Enter a concise statement of the major items of work to be <br />performed. Statement must be consistent with the description of work noted in the <br />STIP and Project Prospectus. <br />Example: "Overlay Regal Road; install curb, gutter, and sidewalk; illumination; and <br />traffic signal at the intersection of Regal Road and Dakota Avenue." <br />c. Project Agreement End Date — Enter your Project Agreement End Date. This date <br />is based on your projects Period of Performance (2 CFR 200.309). <br />For Planning Only projects — WSDOT recommends agencies estimate the end of the <br />project's period of performance and add three years to determine the "Project <br />Agreement End Date". <br />For PE and RW — WSDOT recommends agencies estimate when the phase will be <br />completed and add three years to determine the "Project Agreement End Date". <br />For Construction — WSDOT recommends agencies estimate when construction will <br />be completed and add three years to determine the "Project Agreement End Date" <br />d. Proposed Advertisement Date — At construction authorization only, enter the <br />proposed project advertisement date. <br />e. Claiming Indirect Cost Rate — Check the Yes box if the agency will be claiming <br />indirect costs on the project. For those projects claiming indirect costs, supporting <br />documentation that clearly shows the indirect cost rate being utilized must be <br />provided with the local agency agreement. Indirect cost rate approval by your <br />cognizant agency or through your agency's self -certification and supporting <br />documentation is required to be available for review by FHWA, WSDOT and /or <br />State Auditor. Check the No box if the agency will not be claiming indirect costs on <br />the project. See section 23.5 for additional guidance. <br />5. Type of Work and Funding (Round all dollar amounts to the nearest whole dollar) <br />a. PE — Lines a through d show Preliminary Engineering costs for the project by type <br />of work (e.g., consultant, agency, state services, etc.). <br />