HomeMy Public PortalAboutGDOT BEACH RENOURISHMENT.pdfssell R. McMurry, P.E., Commissioner
September 7, 2017
The Honorable Jason Buelterman, Mayor
City of Tybee Island
P. 0. Box 2749
Tybee Island, GA 31328
RE: HAR00003700001 - Chatham
PID - T006668
Contract Amount - $150,000.00
Dear Mayor Buelterman:
GEORGIA DEPARTMENT OF TRANSPORTATION
One Georgia Center, 600 West Peachtree Street, NW
Atlanta, Georgia 30308
Telephone: (404) 631-1000
Transmitted herewith is a fully executed contract between the Department and the City of Tybee Island.
The contract is for a beach re -nourishment evaluation study. This letter will serve as your formal Notice
to Proceed with the project.
We look forward to working with you on this project. If you have any questions, please contact C. R.
Jackson, Intermodal Project Manager, at (404) 673-9119.
NCC:cam
Enclosure
Sincerely,
CyLL
Nancyjobb, Administrator
Division of Intermodal
DocuSign Envelope ID: 76EB623C-4A1F-43BC-9E08-09089F1162FF
AGREEMENT
FOR
BEACH RE -NOURISHMENT EVALUATION STUDY BETWEEN
DEPARTMENT OF TRANSPORTATION
STATE OF GEORGIA
One Georgia Center
600 W. Peachtree St., NW
Atlanta, Georgia
And
THE CITY OF TYBEE ISLAND
Project Number: HAR00003700001 Chatham County
PID — T006668
This Agreement, entered into 9/7/2017 , by and between the
DEPARTMENT OF TRANSPORTATION, an agency of the State of Georgia, hereinafter called
the DEPARTMENT" and the CITY OF TYBEE ISLAND, hereinafter called the "SPONSOR".
WHEREAS, the DEPARTMENT has authority for navigable harbors and waterways under
OCGA 32-2-2 (a) (18), and
WHERAS, the DEPARTMENT serves as the non -Federal sponsor for the Savannah Harbor
Federal Navigation Project, and
WHERAS, the Savannah Harbor Federal Navigation Project has or has had an adverse
impact on the shores of Tybee Island including loss of sand from the beach and the Tybee Shelf,
and
WHEREAS, Section 1037 of WRRDA 2014 authorizes the US Army Corps of Engineers
to participate in a determination as to whether Federal participation in a cost shared Beach Re -
nourishment project for an additional 15 years is technically feasible, economically justified, and
environmentally acceptable, and
WHEREAS, the SPONSOR desires to partner with the US Army Corps of Engineers to
participate in said Beach Re -nourishment Evaluation Study, and
WHEREAS, said Beach Re -nourishment Evaluation Study will be beneficial to Georgia's
Coastal Resources, and
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WHEREAS, the DEPARTMENT desires to provide one-time funding to the SPONSOR
for a feasibility study on strategies to mitigate man-made shipping channel impacts to shelf and
shoreline erosion under said Beach Re -nourishment Evaluation Study, and
WHEREAS, the SPONSOR has applied to the DEPARTMENT for financial assistance to
accomplish said Beach Re -nourishment Evaluation Study.
NOW THEREFORE, for and in consideration of the mutual promises and covenants herein
contained and other good and valuable consideration as set out hereinafter, it is agreed by and
between the DEPARTMENT and the SPONSOR that:
ARTICLE I
SCOPE AND PROCEDURE
The SPONSOR Shall perform or cause to be performed the scope of work as shown in
Exhibit A, hereinafter referred to as the "PROTECT", which is attached hereto and made a part
hereof the same as if fully set out herein, and for such work the DEPARTMENT shall compensate
the SPONSOR in the amount and fashion as required by the pertinent provisions set out below.
ARTICLE II
AUTHORIZATION AND APPROVAL
The SPONSOR shall perform the work as described in Article I Scope and Procedure,
commencing upon SPONSOR receipt of notice to proceed from the DEPARTMENT. Therefore,
the SPONSOR shall perform its responsibilities for the project until the maximum allowable cost
to the DEPARTMENT is reached or until July 31, 2019, whichever comes first.
ARTICLE III
COVENANT AGAINST CONTINGENT FEES
The SPONSOR shall comply with all relevant federal, state, and local laws, as well as those
regulations and requirements included in the Federal Office of Management and Budget Uniform
Grant Guidance, 2 CFR Part 200. The SPONSOR warrants that it has not employed or retained
any company or person, other than a bona fide employee working solely for the SPONSOR, to
solicit or secure that contract, and that it has not paid or agreed to pay any company or person,
other than a bona fide employee working solely for the SPONSOR, any fee, commission,
percentage, brokerage fee, gifts, or any other consideration, contingent upon or resulting from the
award or making of this contract. For breach or violation of this warrant, the DEPARTMENT
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shall have the right to rescind this contract without liability, or, in its discretion to deduct from the
contract price or consideration, or otherwise recover, the full amount of such fee, commission,
percentage, brokerage fee, gift, or contingent fee.
ARTICLE IV
SUBCONTRACT AND EMPLOYMENT RESTRICTIONS
Before subcontracting for any of the work required to be performed by the SPONSOR
under this Agreement, the SPONSOR shall obtain the DEPARTMENT's written approval of the
proposed subcontract. The SPONSOR shall not employ any person or persons in the employ of
the DEPARTMENT for any work required to be performed by the SPONSOR under this
Agreement, without the written permission of the DEPARTMENT except as may otherwise be
provided for herein.
ARTICLE V
REVIEW OF WORK
The SPONSOR shall submit to the DEPARTMENT written monthly status reports which
detail the work elements of the PROJECT, as set out in Exhibit A, performed during the reporting
period. All reports, drawings, studies, specifications, estimates, maps and computations prepared
by or for the SPONSOR shall be made available to representatives of the DEPARTMENT for
inspection and review at all reasonable times in the office of the SPONSOR. The SPONSOR shall
furnish to the DEPARTMENT copies of all correspondence, publications, and reports relating to
the PROJECT as they are produced during the course of the PROJECT. The SPONSOR shall
notify the DEPARTMENT of all meetings and hearings involving the PROJECT and this
notification shall be sufficiently in advance of said meetings and hearings that representatives of
the DEPARTMENT may attend. The DEPARTMENT has the right to participate in all such
meetings and hearings.
ARTICLE VI
RESPONSIBILITY FOR CLAIMS AND LIABILITY
To the extent allowed by law, the SPONSOR shall be responsible for any and all damages
to property or persons and shall save harmless the DEPARTMENT, its' officers, agents, and
employees from all suits, claims, actions, or damages of any nature whatsoever resulting from the
negligence of the SPONSOR in the performance of the work under this Agreement.
These indemnities shall not be limited by reason of any insurance coverage held by the
SPONSOR.
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To the extent allowed by law, the SPONSOR hereby indemnifies and hold harmless the
DEPARTMENT, its' officers, agents, and employees from and against any and ail claims,
damages, losses and expenses arising out of the SPONSOR's negligent acts, errors or omissions
in the performance of its' professional services under this Agreement and agrees any contract with
subcontractor or consultant will include such indemnification language.
ARTICLE VII
INSURANCE
Prior to beginning the work, the SPONSOR and any subcontractor or consultant shall
obtain and furnish certificates to the DEPARTMENT for the following minimum amounts of
insurance or proof of acceptable self-insurance.
1) Worker's Compensation Insurance in accordance with the laws of the
State of Georgia.
2) Public Liability Insurance in an amount no less than one hundred
thousand dollars ($100,000) for injuries, including those resulting in death
to any one person, and in an amount not less than three hundred thousand
dollars ($300,000) on an account of any one occurrence.
3) Property Damage Insurance in an amount not less than fifty thousand
dollars ($50,000) on an account of any one occurrence, with an aggregate
limit of one hundred thousand dollars ($100,000).
4) Valuable Papers Insurance in an amount sufficient to assure the restoration of any
plans, drawings, field notes, or other similar data relating to the work covered by
the PROJECT.
Insurance shall be maintained in full force and effect during the life of this Agreement.
ARTICLE VIII
CON? ENSAT.ION
The DEPARTMENT and the SPONSOR agree that the total allowable cost of the
PROJECT, as defined in Exhibit B, shall not exceed SIX HUNDRED THOUSAND and 00/100
dollars ($500,000.00).
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The DEPARTMENT'S participation in the PROJECT shall be limited to state funds in the
amount of ONE HUNDRED FIFTY THOUSAND and 00/100 dollars ($150,000.00). This amount
constitute 25% of the total allowable cost. It is further understood the sponsor's local share of the
project is in the amount of ONE HUNDRED FIFTY THOUSAND and 00/100 dollars
($150,000.00).
It is further understood that federal funds have been allocated to the US Army Corps of
Engineers in the amount of THREE HUNDRED THOUSAND and 00/100 Dollars ($300,000.00)
for the PROJECT as summarized in Exhibit B. However, if the sum total of the actual cost of the
PROJECT is less than the amounts indicated in Exhibit B, the DEPARTMENT shall be obligated
to pay its 25% of the actual Project cost as verified from the records of the SPONSOR.
ARTICLE IX
LUMP SUM PAYMENT
Payment by the DEPARTMENT shall be made in one lump sum upon the submission of
an itemized voucher by the SPONSOR to the DEPARTMENT requesting the state portion of
funding for the PROJECT as determined in Article VIII. The DEPARMENT shall make full
amount of the required funds available to the SPONSOR through any of the payment mechanisms.
It is further agreed that after completion of the work, the SPONSOR shall submit to the
DEPARTMENT a letter of acceptance by the SPONSOR specifying the PROJECT has been
completed satisfactorily and in accordance with the work defined in Exhibit A. The
DEPARTMENT, at its discretion, may conduct an audit of the PROJECT cost. However, if the
sum total of the actual cost of the PROJECT is less than the amounts indicated in Exhibit B, the
SPONSOR shall be obligated to reimburse the DEPARTMENT an amount equal to 25% of the
estimated Project cost as determined in ARTICLE VIII, minus 25% of the actual Project cost as
verified from the records of the SPONSOR.
The SPONSOR agrees that acceptance of this final payment shall be in frill and final
settlement of all claims arising against the DEPARTMENT for work done, materials furnished,
cost incurred, or otherwise arising out of this Agreement, and shall release the DEPARTMENT
from any and all claims of whatever nature, whether known or unknown, for and on account of
said Agreement, and for any and all work done, and labor and materials furnished in connection
with same.
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ARTICLE X
MAINTENANCE OF CONTRACT COST RECORDS
The SPONSOR shall maintain all books, documents, papers, accounting records, and other
evidence pertaining to costs incurred on the project and shall make such material available at all
reasonable times during this period of the contract, and for three years from the date of final
payment under the contract, for inspection by the DEPARTMENT, and any reviewing agencies,
and copies thereof shall be furnished upon request.
The SPONSOR agrees that the provisions of the Article shall be included in any
contracts it may make with any subcontractor, assignee, or transferee.
ARTICLE XI
TERMINATION
The DEPARTMENT reserves the right to terminate this Agreement at any time for just
cause or for any cause upon 30 days written notice to the SPONSOR, not -withstanding any just
claims by the SPONSOR, for payment of services rendered prior to the date of termination.
It is understood by the parties hereto that should the DEPARTMENT terminate this
Agreement prior to the completion of an element of work the SPONSOR shall be reimbursed for
such work element based upon the percentage work completed for said work element.
ARTICLE XII
PUBLICATION AND PUBLICITY
Articles, papers, bulletins, data, studies, statistics, interim or final reports, oral transmittals
or any other materials reporting the plans, progress, analyses, results, or findings of work
conducted under this Agreement shall not be presented publicly or published without prior written
approval by the DEPARTMENT.
IT IS FURTHER AGREED that all releases of information, findings, and
recommendations shall include a disclaimer provision and that all published reports shall include
that disclaimer on the cover and title page in the following form:
"The contents of this publication reflect the views of the author(s), who is (are)
responsible for the facts and accuracy of the data presented herein. The opinions, Endings,
and conclusions in this publication are those of the author(s) and do not necessarily reflect
the official views or policies of those of the Department of Transportation, or the State of
Georgia. This publication does not constitute a standard, specification or regulation."
IT IS FURTHER AGREED that any information concerning the PROJECT, its
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conduct, results or data gathered or processed shall not be released other than as required under
the Georgia Open Records Act, Section 50-18-70, et seq., O.C.G.A. Any request for information
directed to the SPONSOR, pursuant to the Georgia Open Records Act, for documents that are
either received or maintained by the SPONSOR in the performance of a service or function for or
on behalf of the DEPARTMENT shall be released pursuant to provisions of the Act. Further, the
SPONSOR agrees to consult with the DEPARTMENT prior to releasing the requested documents.
Should any such information be released by the SPONSOR other than as set out above and without
prior approval from the DEPARTMENT, the release of the same shall constitute grounds for
termination of the Agreement without indemnity to the SPONSOR.
ARTICLE XIII
SUBSTANTIAL CHANGES
If, prior to the satisfactory completion of the service under this contract, the
DEPARTMENT materially changes the scope, character, complexity or duration of the services
from those required under the basic contract, a supplemental agreement may be executed between
the parties. Minor changes in the proposal which do not involve increased compensation,
extension of time or changes in the goals and objectives of the parties may be made by written
notification of such change by either party with written approval by the other party.
ARTICLE XIV
CONTRACT DISPUTES
This Agreement shall be deemed to have been executed in Fulton County, Georgia, and all
questions of interpretation and construction shall be governed by the Laws of the State of Georgia.
ARTICLE XV
COMPLIANCE WITH APPLICABLE LAW
A. The undersigned certify that the provisions of the Official Code of Georgia Annotated,
Sections 45-10-20 through 45-10-28 relating to Conflict of Interest and State Employees and
Official Trading with the State have been complied with in full.
B. IT IS FURTHER AGREED that the SPONSOR shall comply and shall require its
subcontractors to comply with, the regulations for compliance with TITLE VI of the CIVIL
RIGHTS ACT OF 1964, as amended, and 23 C.F.Z. 200 as stated in Exhibit C of this
Agreement.
C. IT IS FURTHER CERTIFIED that the provisions of Section 50-24-1 through
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50-24-6 of the Official Code of Georgia Annotated, relating to the "Drug -Free Workplace
Act" have been complied with in full, as stated in Exhibit D of this Agreement.
D. Pursuant to O.C.G.A. Sec. 50-5-85, CONTRACTOR hereby certifies that it is not currently
engaged in, and agrees that for the duration of this contract, it will not engage in a boycott of
Israel.
E. IT IS FURTHER CERTIFIED that the provisions of Section 13-10-91 of the Official Code of
Georgia Annotated, related to the "Georgia Security and Immigration Compliance Act" have
been complied with in full, as stated in Exhibit 1 of this Agreement.
F. Exhibits D through I are attached hereto and incorporated herein by reference.
G. It is FURTHER AGREED that the SPONSOR shall comply and require its contractors,
subcontractors and consultants to comply with the requirements of Executive Order No.
13513, Federal Leadership on Reducing Text Messaging while driving, October 1, 2009, and
DOT Order 3902.10, Text Messaging While Driving, December 30, 2009.
The covenants herein contained shall, except as otherwise provided, accrue to the benefit
of and be binding upon the successors and assigns of the parties hereto.
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IN WITNESS THEREOF said parties have hereunto set their hands and affixed their seals the
day and year above first written..
DEPARTMENT OF TRANSPORTATION BY: EXECUTED ON BEHALF OF:
Docu9Igned by:
L
Touod�rLJ14m 4rM...
Commissioner
ATTEST
Docu9igned by:
CITY OF TYBEE ISLAND:
DATE: 8/25/2017
,-Doc ned by:
VAV6kEudaut...
Jason 8ueiterman
(SEAL) PRIN I'Ell NAME
THIS CONTRACT APPROVED BY:
CITY OF TYBEE ISLAND
AT A MEETING HELD AT:
Louncli i c.namoers, Puoiic safety Bui (ding
DATE: 8/25/2017
DocuSi ned b
tikkAAB40
72007
(SEAL)
FEDERAL ID/IRS#
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STATE OF GEORGIA
The City of Tybee Island (Political Subdivision)
BE IT RESOLVED by the City of Tybee Island and it is hereby resolved, that an
agreement, relative to BEACH RE NOURISHMENT EVALUATION STUDY for the City of
Tybee Island with the Department of Transportation, State of Georgia and that the Honorable Jason
Buelterman, as Mayor is hereby authorized and directed to execute the same for and on behalf of
the City of Tybee Island (Political Subdivision)
Passed and adopted, this 24 day of August , 20 17
A�Tuig d b
- ar Dr ri v4�. ,
Cier C o`i (Political Subdivision)
STATE OF GEORGIA
Jason Buelterman, Mayor
Contracting Official & Title
City of Tybee Island (Political Subdivision)
do hereby certify that I am custodian of the books and records of the City of Tybee Island, and that
the above and foregoing is a true and correct copy of the original resolution now on file in my
office and same was passed and adopted by the City of Tybee Island on the date indicated above.
Witness by band and official signature this 24 day of August , 20 17.
rpocuSi ned b :
£.,i bD7k,,D4004,eJ.
Clerk of (Political Subdivision)
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CITY OF TYBEE ISLAND
CHATHAM COUNTY
EXHIBIT A
SCOPE OF WORK
BEACH RE -NOURISHMENT EVALUATION STUDY
GDOT Project Number: HAR00003700001 Chatham
PID-T006668
Section 1037 of WRRDA 2014 authorizes the US Army Corps of Engineers to participate in a
determination as to whether Federal participation in a cost shared beach re -nourishment project
for an additional 15 years is technically feasible, economically justified, and environmentally
acceptable. A Beach Re -nourishment Evaluation Study is cost shared 50/50 under a Feasibility
Cost Sharing Agreement (FCSA), will be considered a new investment decision (but not a new
start), and will be categorized as a New Phase (NP). The City of Tybee Island will partner with
the US Army Corps of Engineers to provide a Beach Re -nourishment Evaluation Study as
follows:
1. Conduct an initial scoping meeting to determine age and quality of economic and
engineering data. If the latest data is sufficient to justify continued federal
participation update economics, level II, and update cost to establish section 902 limit
for new authorization for 15 year extension.
2. Review of NEPA for new endangered species or other issues since the last approved
NEPA Document.
3. Check current public access and parking and revise cost -sharing as needed.
4. Check for adequate borrow material, offshore or land based. Changes in borrow
source are within project authorization, but may require NEPA update.
5. No plan formulation or recommendation of new project. No expectation of revision
in periodic re -nourishment cycle optimization.
6. Determine if Future Without Project (FWOP) condition will be the same as section 934
studies, where the FWOP is the condition prior to initial project construction.
Significant alterations to the shoreline since initial construction not related to the
authorized coastal storm risk management project may require additional review of the
FWOP condition.
7. The SPONSOR shall provide all Real Estate necessary for this project. If it is
determined that no new real estate is expected to be required, the existing project
footprint should be reviewed for encroachments.
Exhibit A, Page 1 of 2
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8. In addition to normal agreement submittals, the SPONSOR should acknowledge the
1037 requirement to submit a plan for reducing risks to people and property.
9. The Beach Re -nourishment Evaluation Study must be completed as outlined in the
Federal Cost Share Agreement (FCSA) and / or the Project Partnership Agreement
(PPA) between the SPONSOR and the US Army Corps of Engineers; and Section
1037 of WRRDA 2014.
Deliverables: Deliverables will consist of a written status report to be provided to the
GEORGIA DEPARTMENT OF TRANSPORTATION by December 1, 2017; one (1) electronic
copy of the final Beach Re -nourishment Evaluation Study in PDF Format; and one (1) hard copy
of the Beach Re -nourishment Evaluation Study; copies of canceled check or bank drafts as proof
of payment to the US Army Corps of Engineers.
Exhibit A, Page 2 of 2
CITY OF TYBEE ISLAND
Chatham County
EXHIBIT 8
SCHEDULE OF PAY MENTS
HAR00003700001 - Chatham
PID-T006668
BEACH RE -NOURISHMENT EVALUATION STUDY
ELEMENT
DESCRIPTION
TOTAL COST
FEDERAL
FUNDS
%
GDOT FUN DS
%
LOCAL FUNDS
Tybee Island
%
1
Beach Renourishment Evaluation Study
$ 600,000.00
$ 300,000 .00
50%
$ 150,000.00
25%
$ 150,000.00
25%
TOTAL COST OF STUDY
S 600,000.00
$ 300,000 .00
$ 150,000 .00
$ 150,000.00
Fund Source
Total lusidmum State Funds this Contract; $ 160,000.00 01182
Indirect Co at Rate - NIA - Research and Developernent Contract - No
EXHIBIT B
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EXHIBIT C
NOTICE TO CONTRACTORS
COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964
During the performance of this Agreement, the Contractor, for itself its assignees and
successors in interest (hereinafter referred to as the "Contractor"), agrees as follows:
(1) Compliance with Regulations: The Contractor will comply with the
Regulations of the Department of Transportation relative to nondiscrimination in Federally
assisted programs of the Department of Transportation (Title 49, Code of Federal
Regulations, Part 21, hereinafter referred to as the Regulations [also 49 CFR Part 27]),
which are herein incorporated by reference and made a part of this contract.
(2) Nondiscrimination: The Contractor, with regard to the work performed by
it after award and prior to completion of the contract work, will not discriminate on the
grounds of race, color, national origin, or sex in the selection and retention of subcontractors
including procurement of materials and leases of equipment. The Contractor will not
participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the
Regulations, including employment practices when the contract covers a program, set forth
in Appendix B of the Regulations In addition, the Contractor will not participate either
directly or indirectly in the discrimination prohibited by 23 CFR 200.
(3) Solicitations for Subcontracts, Including Procurement of Materials and
Eauioment: In all solicitations, either by competitive bidding or negotiations made by the
Contractor for work to be performed under a subcontract, including procurement of
materials or equipment, each potential subcontractor or supplier shall be notified by the
Contractor of the Contractor's obligations under this contract and the Regulations relative to
nondiscrimination on the grounds of race, color, national origin or sex.
(4) Information and Reports: The Contractor will provide all information and
reports required by the Regulations, or orders and instructions issued pursuant thereto, and
will pennit access to its books, records, accounts, other sources of information, and its
facilities as may be determined by the State Department of Transportation or the Federal
Highway Administration to be pertinent to ascertain compliance with such Regulations,
orders and instructions. Where any information required of a Contractor is in the exclusive
possession of another who fails or refuses to furnish this information, the Contractor shall so
certify to the State Department of Transportation, or the Federal Highway Administration a
appropriate, and shall set forth what efforts it has made to obtain this information.
(5) Sanctions for Noncompliance: In the event of the Contractor's
noncompliance with the nondiscrimination provisions of this contract, the State Department
of Transportation shall impose such contract sanctions as it or the Federal Highway
Administration may determine to be appropriate, including, but not limited to:
EXHIBIT C-1
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(a) withholding of payments to the Contractor under the contract until the
Contractor complies, and/or
(b) cancellation, termination or suspension of this contract, in whole or in
part.
(6) incorporation of Provisions: The Contractor will include the provisions of
paragraphs (1) through (6) in every subcontract, including procurement of materials and
leases of equipment, unless exempt by the Regulations, order, or instructions issued
pursuant thereto. The Contractor will take such action with respect to any subcontract or
procurement as the State Department of Transportation or the Federal Highway
Administration may direct as a means of enforcing such provisions including sanctions for
noncompliance. Provided, however, that in the event a Contractor becomes involved in, or
is threatened with, litigation with a subcontractor or supplier as a result of such direction, the
Contractor may request the State to enter into such litigation to protect the interests of the
State, and, in addition, the Contractor may request the United States to enter into such
litigation to protect the interests of the United States.
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EXHIBIT D
CERTIFICATION OF SPONSOR
DRUG -FREE WORKPLACE
I hereby certify that I am the duly authorized representative of
city of Tybee Is and whose address is
_403 Butler Ave Tybee Island Ga 313281
it is also certified that:
(1) The provisions of Section 50-24-1 through 50-24-6 of the Official Code of Georgia
Annotated, relating to the "Drug -Free Workplace Act" have been complied with in
full; and
(2) A drug -free workplace will be provided for the consultant's employees during the
performance of the contract; and
(3) Each subcontractor hired by the Consultant shall be required to ensure that the
subcontractor's employees are provided a drug -free workplace. The Consultant shall
secure from that subcontractor the following written certification: "As part of the
subcontracting agreement with the Consultant, certifies to the Consultant that a drug -
free workplace will be provided for the subcontractor's employees during the
performance of this contract pursuant to paragraph (7) of subsection (b) of the
Official Code of Georgia Annotated Section 50-24-3"; and
(4) It is certified that the undersigned will not engage in unlawful manufacture, sale,
distribution, dispensation, possession, or use of a controlled substance or marijuana
during the performance of the contract.
8/25/2017
Date
TOocuSired by:
UAT1Z1J4 kuEGpr
Signature
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EXHIBIT E
CERTIFICATION OF SPONSOR
I hereby certify that I am the Mayor
the firm of City of Tybee Island
403 Butler Ave Tybee island GA 31328
knowledge and belief that:
and duly authorized representative of
whose address is
I hereby certify to the best of my
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any Federal agency, a Member of Congress, an officer or employee of
Congress, or any employee of a Member of Congress in connection with the
awarding of any Federal contract, the making of any Federal grant, the making of
any Federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal contract, grant,
loan or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
Federal agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit Standard
Form-LLL, Disclosure Form to Report Lobbying', in accordance with its
instructions.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making
or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00
and not more than $100,000.00 for each such failure.
The prospective participant also agrees by submitting its bid the it shall require that the language of
this certification will be included in all lower tier subcontracts which exceed $10,000.00 and that all
such sub -recipients shall certify and disclose accordingly.
I also certify that neither I nor the above firm I here represent has:
(a) employed or retained for a commission, percentage, brokerage contingent fee, or
other consideration, any firm or person (other than a bona fide employee working
solely for me or the above consultant) to solicit or secure this agreement.
(b) agreed, as an express or implied condition for obtaining this contract, to employ or
retain the services of any firm or person in connection with carrying out the
Agreement, or
EXHIBIT E-1
DocuSign Envelope ID: 76EB623C-4A1F-43BC-9E08-09089F1162FF
(c) paid or agreed to pay, to any firm, organization or person (other than a bona fide
employee working solely for me or the above consultant) any fee, contribution,
donation, or consideration of any kind for, or in connection with, procuring or
carrying out the agreement;
except as here expressly stated (if any):
I acknowledge that this certificate is to be furnished to the Department of Transportation and the
Federal Aviation Administration, U.S. Department of Transportation, in connection with this
Agreement involving participation of Federal -aid aviation fiords, and is subject to applicable State
and Federal laws, both criminal and civil.
8/25/2017
Date
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50AF021 4E06 E...
°ig�lnature
DocuSign Envelope ID: 76EB623C-4A1F-43BC-9E08-09489F1162FF
EXHIBIT F
CERTIFICATION OF DEPARTMENT OF TRANSPORTATION
STATE OF GEORGIA
I hereby certify that I am the Commissioner of the Department of Transportation of the State of
Georgia, and that the above airport sponsor, consulting firm, or its representative has not been
required, directly or indirectly as an express or implied condition in connection with obtaining or
carrying out this Agreement to:
(a) employ or retain, or agree to employ or retain, any firm or person, or
(b)
pay, or agree to pay, to any firm, person, or organization, any fee, contribution,
donation, or consideration of any kind; except as here expressly stated, (if any):
I acknowledge that this certificate is to be furnished to the Federal Aviation Administration, U.S.
Department of Transportation, in connection with this Agreement involving participation of
Federal -aid Aviation Funds, and is subject to applicable State and Federal Laws, both criminal and
civil.
Date Commissioner, Georgia Department of Transportation
DocuSign Envelope ID: 76EB623C-4A1F-43BC-9E08-09089F1162FF
EXHIBIT G
PRIMARY CONTRACTOR
CERTIFICATION REGARDING DISBARMENT, SUSPENSION,
AND
OTHER RESPONSIBILITY MATTERS
I hereby certify that I am the mayor
authorized representative of City of iybee Island , whose address is
403 Butler Ave Tybee Island GA 31328 , and I certify that I have read and
nnderstand the attached instructions and that to the best of my knowledge and
belief the firm and its representatives:
and duly
(a) Are not presently debarred, suspended, proposed for debarment,
declared ineligible or voluntarily excluded from covered
transactions by the Georgia Department of Transportation and by any
Federal department or agency;
(b) Have not within a three year period preceding this Agreement been
convicted of or had a civil judgement rendered against the firm or
its representatives for commission of fraud or a criminal offense
in connection with obtaining, attempting to obtain or performing a
public (Federal, State, or Local) transaction or contract under a
public transaction in violation of Federal or State antitrust
statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements,
or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly
charged by a governmental entity (Federal, State or Local) with
commission of any of the offense enumerated in paragraph (b) of
this certification;
(d) Have not within a three year period preceding this Agreement had
one ore more public transaction (Federal, State or Local)
terminated for cause or default; and
(e) That the farm will include the clause titled "Certification
Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transaction" as attached hereto and
without motivation, in all lower tier covered transactions and in
all solicitations for lower tier covered transactions.
I acknowledge that this certification is provided pursuant to Executive
Order 12549 and 49 CFR Part 29 and that this firm agrees to abide by the rules
and conditions set forth therein for any misrepresentation that would render
this certification erroneous, including termination of this Agreement and other
remedies available to the Georgia Department of Transportation and Federal
Government.
I further acknowledge tnat this certificate is to be furnished to the
Georgia Department of Transportation, in connection with this Agreement
involving participation of Federal -Aid Aviation Vunds, and is subject to
applicable State and Federal laws, ' "in.daq,iortiinal and civil.
8/25/2017 t::
Date
,-60cuR eol°, s iunature
ters ri w4u94R9
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(SEAL)
EXHIBIT G-1
DocuSign Envelope ID: 76EB623C-4A1 F-43BC-9E08-09089F1162FF
Instructions for Appendix G Certification
Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered
Transactions (Consultants)
1. By signing and submitting this contract the Consultant i8 providing the certification set out
in Appendix C.
2. The inability of the Consultant to provide the certification required may not necessarily
result in denial of participation in this covered transaction. The Consultant shall then submit an explanation
of wiry it cannot provide the certification. The certification or explanation will be considered in connection
with the Departments determination whether to enter into this transaction. However, failure of the
Consultant to furnish a certification or an explanation shall disqualify such person or faro from participation
in this transaction.
3. The certification, Appendix C, is a material representation of fact upon which reliance is
placed by the Department before entering into this transaction. If it is later determined that the Consultant
knowingly rendered an erroneous certification, in addition to other remedies available to the Federal
Government, the Department may terminate this transaction for cause of default
4. The Consultant shall provide immediate written notice to the Department if at any time the
Consultant learns that it certification was erroneous when submitted or has become erroneous by reason of
changed circumstances.
5. The terms "covered transaction", "debarred", "suspended",
"ineligible", "lower tier covered transaction", "participant", "person", "pthnaiy covered transaction",
"principal", "proposal", and "voluntarily excluded", as used in these instructions and the certification, have
the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order
12549. You may contact the Department for assistance in obtaining a copy of those regulations.
6. The Consultant agrees by submitting this proposal/contract that shed the proposed
covered transaction be entered into, it shall not knowingly enter into a lower tier covered transaction with a
person/thin who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in
this covered transaction unless authorized by the Department
7. The Consultant further agrees by submitting this proposal/contract that it will include the
clause titled "Certification Regarding Debarment Suspension, Ineligibility and Voluntary Exclusion -
Lower Tier Covered Transaction", as provided by the Department without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
8. A Consultant in a covered transaction may rely upon a certification of a prospective
participant in lower tier covered transaction that it is not debarred, suspended, ineligible or voluntarily
excluded from the covered transaction; unless it knows that the certification is erroneous. The Consultant
may decide the method and frequency by which it determines the eligibility of its principals.
9. Nothing contained in the foregoing shall be construed to require establishment of a system
of records in order to render in good faith the certification required by these instructions. The knowledge
and information of Consultant is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
10. Except for transactions authorized under paragraph 6 of these instructions, if the Consultant
in a covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction in addition to
other remedies available to the Federal Government, the Georgia Department of Transportation may
terminate this transaction for cause or default.
EXHIBIT G-2
DocuSign Envelope ID: 76EB623C-4A1 F-43BC-9E08-09089F1162FF
or Project Description:
•
Georgia Department of Tranaportatiar:
GEORGIA SECURTTY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT
Contractor's Name:
CITY OF TYBEE ISLAND
NaJ Call No. 1T006668-HAR0000I700001 - BEACH R -NOURISIIMENT EVALUATION STUDY
CONTRACTOR AFFIDAVIT
By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating
affirmatively that the individual, entity or corporation which is engaged in the physical performance of services on behalf of the
Georgia Department of Transportation has registered with, is authorized to use and uses the federal work authorization program
commonly known as E -Verify, or any subsequent replacement program, in accordance with the applicable provisions and
deadlines established in O.C.G.A. § 13-10-91.
Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the
=tract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such
contract only with subcontractors who present an affidavit to the cen4xctor with the information required by O.C.G.A. § 13-10-
91(6). Contractor hereby attests that its federal work authorization user identification number and date of
authorization are as follows:
72007 12/06/2007
Federal Work Authorization User Identification Number
MEWS -Verify Company Identification Number)
City at Tybee Island
Name of Contractor
I hereby declare under penalty of perjury that the
foregoing is true and correct
Jason auelterman
Date of Authorization
Mayor
Prhicsarif clef Authorized Officer or Agent of Contractor) Title (of Authorized Officer or Agent of Contractor)
8/25/2017
Si Sgnaturc (o 4 n�zed Officer or Agent) Date Signed
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE
25 August 17
_DAY OF 20
Docusigned by:
carigiglie
December 5, 2019
My Commission Expires:
[NOTARY SEAL]
EXHIBIT I
Rev. 11/01/15