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R-55-25 Approving the Village of Lemont to Enter into an Agreement with IDOT for State Street LAFO Resurfacing9-6-6-2,� TO: Village Board Meeting FROM: Ted Friedley, Public Works THROUGH: SUBJECT: A Resolution Approving the Village of Lemont to Enter into an Agreement with IDOT for State Street LAFO Resurfacing DATE: July 28, 2025 SUMMARY/BACKGROUND The Village is entering into an agreement with the Illinois Department of Transportation (IDOT) in order to use federal funding to resurface State Street from 127th Street to Cass Street. Funding will be 80% FHWA and the 20% Local match will come from the Infrastructure Fund. The Not to Exceed totals for Phase III Construction will be: • FHWA • Construction = $780,000.00 • Construction Engineering = $93,600.00 • Local Match • Construction = $195,000.00 • Construction Engineering = $23,400.00 ANALYSIS The State Street LAFO Resurfacing project is consistent with the Village's 5-year Capital Plan. $195,000 has been budgeted in the Infrastructure Fund in FY26 for State Street Resurfacing. $234,000.00 has been budgeted in FY26 in the Infrastructure Fund for Phase II and III State Street Resurfacing Engineering. Consistency with Village Policy 5-Year Capital Improvement Plan (if applicable) STAFF RECOMMENDATION Pass A Resolution Approving the Village of Lemont to Enter into an Agreement with IDOT for State Street LAFO Resurfacing BOARD ACTION REQUESTED Pass A Resolution Approving the Village of Lemont to Enter into an Agreement with IDOT for State Street LAFO Resurfacing ATTACHMENTS A Resolution Approving the Village of Lemont to Enter Into an Agreement with IDOT for State Street LAFO Resurfacing.pdf VILLAGE OF LEMONT RESOLUTION NUMBER R- -'D,J-25 A RESOLUTION APPROVING THE VILLAGE OF LEMONT TO ENTER INTO AN AGREEMENT WITH [DOT FOR STATE STREET LAFO RESURFACING JOHN EGOFSKE, Village President CHARLENE M. SMOLLEN, Clerk SAMUEL J. FORZLEY JANELLE KITTRIDGE KEN MCCLAFFER TY KEVIN SHA UGHNESSY RICK SNIEGOWSKI RON STAPLETON Trustees Published in pamphlet form by authority of the Village President and Board of Trustees of the Village of Lemont A -_ 025 RESOLUTION NO. R- -25 A RESOLUTION APPROVING THE VILLAGE OF LEMONT TO ENTER INTO AN AGREEMENT WITH IDOT FOR STATE STREET LAFO RESURFACING WHEREAS, the Village of Lemont, Counties of Cook, Will, and DuPage, Illinois ("the Village") is a municipality in the State of Illinois with full powers to enact Ordinances and adopt Resolutions for the benefits of the residents of the Village: and WHEREAS, the Village and IDOT wish to enter an agreement for State Street LAFO Resurfacing as further outlined in the Joint Funding Agreement for Federally Funded Construction (BLR 05310C) attached hereto as Exhibit A ("Agreement"); and WHEREAS, the President and Board of Trustees find that it is in the best interest of the Village to authorize the Agreement attached hereto as Exhibit A. NOW, THEREFORE, BE IT RESOLVED, by the President and Board of Trustees of the Village of Lemont, Counties of Cook, Will, and DuPage, Illinois as follows: SECTION 1: That the above recitals and legislative findings are found to be true and correct and are hereby incorporated herein and made a part hereof as if fully set forth in their entirety. SECTION 2: The President and Board of Trustees of the Village of Lemont hereby approve the Agreement with MOT in substantially the same form as attached hereto as Exhibit A, subject to attorney review. SECTION 3: The President and Clerk are hereby authorized respectively, to execute the Agreement with IDOT. SECTION 4: The Resolution, and all its parts, are declared to be severable and any section, subsection, sentence, clause, provision, or portion of this Resolution that is declared invalid such decision shall not affect the validity of any other portion of the Resolution, which shalt remain in full force and effect. SECTION 5: All Resolutions and Ordinances in conflict herewith are hereby repealed to the extent of such conflict. PASSED AND APPROVED BY THE PRESIDENT AND BOARD OF TRUSTEES OF THE VILLAG-F, OF LEMONT, _CgUNTIES OF COOK, WILL, AND DUPAGE, ILLINOIS, ON THIS 26 DAY OF I4-1 kA 2025. Samuel J. Forzley Janelle Kittridge Ken McClafferty Kevin Shaughnessy Rick Sniegowski Ron Stapleton ATTEST: PRESIDENT AND VILLAGE BOARD MEMBERS: AYES: NAYES: t� lljllmflnzl��� CHARLENE M. SMOLLEN Village Clerk �. OF It* �G O v 4 .J sum 17 ILL 1 \ca ABSENT: ABSTAIN: JOHN GOFSKE ��-Presidents r_ Exhibit A Joint Funding Agreement for Federally Funded Construction (BLR 05310C) Illinois Department Joint Funding Agreement for of Transportation Federally Funded Construction LOCAL PUBLIC AGENCY Local Public Agency County Section Number Village of Lemont Cook 24-00060-00-RS Fund Type STU ITEP, SRTS, HSIP Numbers MPO Name MPO TIP Number N/A CMAP 06-20-0010 Construction State Job Number C-91-302-24 Pro'ect Number S3CF(665) ❑ Local Let/Day Labor ® Construction on State Letting ® Construction Engineering ❑ Utilities ❑ Railroad Work LOCATION Stationing Local Street/Road Name Key Route Length From To State Street FAU 2612 1.06 MI 01.00 02.06 Location Termini Cass Street to 127th Street Current Jurisdiction Existing Structure Number(s) Village of Lemont N/A Remove PROJECT DESCRIPTION 'P'/ (PHASE III) -Roadway resurfacing on State Street from Cass Street to Wrd Street in the Village of Lemont. Work includes HMA surface removal, HMA resurfacing, pavement patching, sidewalk and ADA ramp removal and replacement, curb and gutter removal and replacement, and pavement marking. Page 1 of 10 BLR 05310C (Rev. 05/09/24) Local Public Agency Section Number State Job Number Project Number Village of Lemont 124-00060-00-RS C9130224 S3CF(665) This Agreement is made and entered into between the above local public agency, hereinafter referred to as the "LPA" and the State of Illinois, acting by and through its Department of Transportation, hereinafter referred to as the "STATE". The STATE and LPA jointly proposes to improve the designated location as described in the Location and Project Description sections of this agreement. The improvement shall be constructed in accordance with plans prepared by, or on behalf of the LPA and approved by the STATE using the STATE's policies and procedures approved and/or required by the Federal Highway Administration, hereby referred to as "FHWA". GENERAL 1.1 Availability of Appropriation; Sufficiency of Funds. This Agreement is contingent upon and subject to the availability of sufficient funds. The STATE may terminate or suspend this Agreement, in whole or in part, without penalty or further payment being required, if (i) sufficient funds for this Agreement have not been appropriated or otherwise made available to the LPA by the STATE or the federal funding source, (ii) the Governor or STATE reserves funds, or (iii) the Governor or STATE determines that funds will not or may not be available for payment. The STATE shall provide notice, in writing, to LPA of any such funding failure and its election to terminate or suspend this Agreement as soon as practicable. Any suspension or termination pursuant to this Section will be effective upon the date of the written notice unless otherwise indicated. 1.2 Domestic Steel Requirement. Construction of the project will utilize domestic steel as required by Section 106.01 of the current edition of the Standard Specifications for Road and Bridge Construction and federal Build America -Buy America provisions. 1.3 Federal Authorization. That this Agreement and the covenants contained herein shall become null and void in the event that the FHWA does not approve the proposed improvement for Federal -aid participation within one (1) year of the date of execution of this agreement. 1.4 Severability. If any provision of this Agreement is declared invalid, its other provisions shall not be affected thereby. 1.5 Termination. This Agreement may be terminated, in whole or in part, by either Party for any or no reason upon thirty (30) calendar days' prior written notice to the other Party. If terminated by the STATE, the STATE must include the reasons for such termination, the effective date, and, in the case of a partial termination, the portion to be terminated. If the STATE determines in the case of a partial termination that the reduced or modified portion of the funding award will not accomplish the purposes for which the funding award was made, the STATE may terminate the Agreement in its entirety. This Agreement may be terminated, in whole or in part, by the STATE without advance notice: a. Pursuant to a funding failure as provided under Article 1.1. b. If LPA fails to comply with the terms and conditions of this funding award, application or proposal, including any applicable rules or regulations, or has made a false representation in connection with the receipt of this or any award. III. REQUIRED CERTIFICATIONS By execution of this Agreement and the LPA's obligations and services hereunder are hereby made and must be performed in compliance with all applicable federal and State laws, including, without limitation, federal regulations, State administrative rules and any and all license requirements or professional certification provisions. 2.1 Uniform Administrative Requirements Cost Principles and Audit Requirements for Federal Awards (2 CFR Part 200). The LPA certifies that it shall adhere to the applicable Uniform Administrative Requirements, Cost Principles, and Audit Requirements, which are published in Title 2, Part 200 of the Code of Federal Regulations, and are incorporated herein by reference. 2.2 Compliance with Registration Requirements. LPA certifies that it: (i) is registered with the federal SAM system; (ii) is in good standing with the Illinois Secretary of State, if applicable; (iii) have a valid DUNS Number; (iv) have a valid UEI, if applicable. It is LPA's responsibility to remain current with these registrations and requirements. 2.3 Bribery. The LPA certifies to the best of it's knowledge that it's officials have not been convicted of bribery or attempting to bribe an officer or employee of the state of Illinois, nor made an admission of guilt of such conduct which is a matter of record (30 ILCS 500/50-5). 2.4 Bid Rigging. LPA certifies that it has not been barred from contracting with a unit of state or local government as a result of a violation of Paragraph 33E-3 or 33E-4 of the Criminal Code of 1961 (720 ILCS 5/33E-3 or 720 ILCS 5/33E-4, respectively). 2.5 Debt to State. LPA certifies that neither it, nor its affiliate(s), is/are barred from receiving an Award because the LPA, or its affiliate(s), is/are delinquent in the payment of any debt to the STATE, unless the LPA, or its affiliate(s), has/have entered into a deferred payment plan to pay off the debt, and STATE acknowledges the LPA may declare the Agreement void if the certification is false (30 ILCS 500/50-11). 2.6 Debarment. The LPA certifies to the best of its knowledge and belief that it's officials: a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal department or agency; b. have not within a three-year period preceding this agreement been convicted of or had a civil judgment rendered against them 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; violation of Federal or State anti-trust statutes or Page 2 of 10 BLR 05310C (Rev. 05/09/24) Local Public Agency Section Number State Job Number Project Number Village of Lemont 24-00060-00-RS C9130224 0CF(665) commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements receiving stolen property; c. are not presently indicated for or otherwise criminally or civilly charged by a governmental entity (Federal, State, Local) with commission of any of the offenses enumerated in item (b) of this certification; and d. have not within a three-year period preceding the agreement had one or more public transactions (Federal, State, Local) terminated for cause or default. 2.7 Construction of Fixed Works. The LPA certifies that all Programs for the construction of fixed works which are financed in whole or in part with funds provided by this Agreement shall be subject to the Prevailing Wage Act (820 ILCS 130/0.01 et seq.) unless the provisions of that Act exempt its application. In the construction of the Program, the LPA shall comply with the requirements of the Prevailing Wage Act including, but not limited to, inserting into all contracts for such construction a stipulation to the effect that not less than the prevailing rate of wages as applicable to the Program shall be paid to all laborers, workers, and mechanics performing work under the Award and requiring all bonds of contractors to include a provision as will guarantee the faithful performance of such prevailing wage clause as provided by contract. 2.8 Criminal Convictions. The LPA certifies that neither it nor any managerial agent of LPA has been convicted of a felony under the Sarbanes-Oxley Act of 2002, nor a Class 3 or Class 2 felony under Illinois Securities Law of 1953, or that at least five (5) years have passed since the date of the conviction. The LPA further certifies that it is not barred from receiving an funding award under 30 ILCS 500/50-10.5 and acknowledges that STATE shall declare the Agreement void if this certification is false (30 ILCS 500/50-10.5). 2.9 Improper Influence. The LPA certifies that no funds have been paid or will be paid by or on behalf of the LPA to any person for influencing or attempting to influence an officer or employee of any government agency, a member of Congress or Illinois General Assembly, an officer or employee of Congress or Illinois General Assembly, or an employee of a member of Congress or Illinois General Assembly in connection with the awarding of any agreement, the making of any grant, the making of any loan, the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment or modification of any agreement, grant, loan or cooperative agreement. 31 USC 1352. Additionally, the LPA certifies that it has filed the required certification under the Byrd Anti -Lobbying Amendment (31 USC 1352), if applicable. 2.10 Telecom Prohibition. The LPA certifies that it will comply with Section 889 of the FY 2019 National Defense Authorization Act (NDAA) that prohibits the use of telecommunications or video surveillance equipment or services produced or provided by the following companies: Dahua Technology Company, Hangzhou Hikvision Digital Technology Company, Huawei Technologies Company, Hytera Communications Corporation, and ZTE Corporation. Covered equipment and services cannot be used as substantial or essential component or any system, or as critical technology as part of any system. 2.11 Personal Conflict of Interest - (50 ILCS 105/3, 65 ILCS 5/3.1-55-10, 65 ILCS 5/4-8-6) The LPA certifies that it shall maintain a written code or standard of conduct which shall govern the performance of its employees, officers, board members, or agents engaged in the award and administration of contracts supported by state or federal funds. Such code shall provide that no employee, officer, board member or agent of the LPA may participate in the selection, award, or administration of a contract supported by state or federal funds if a conflict of interest, real or apparent would be involved. Such a conflict would arise when any of the parties set forth below has a financial or other interest in the firm selected for award: a. the employee, officer, board member, or agent; b. any member of his or her immediate family; c. his or her partner; or d. an organization which employs, or is about to employ, any of the above. The conflict of interest restriction for former employees, officers, board members and agents shall apply for one year. The code shall also provide that LPA's employees, officers, board members, or agents shall neither solicit nor accept gratuities, favors or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The STATE may waive the prohibition contained in this subsection, provided that any such present employee, officer, board member, or agent shall not participate in any action by the LPA relating to such contract, subcontract, or arrangement. The code shall also prohibit the officers, employees, board members, or agents of the LPA from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. 2.12 Organizational Conflict of Interest - The LPA certifies that it will also prevent any real or apparent organizational conflict of interest. An organizational conflict of interest exists when the nature of the work to be performed under a proposed third party contract or subcontract may, without some restriction on future activities, result in an unfair competitive advantage to the third party contractor or LPA or impair the objectivity in performing the contract work. 2.13 Accounting System. The LPA certifies that it has an accounting system that provides accurate, current, and complete disclosure of all financial transactions related to each state and federally funded program. Accounting records must contain information Page 3 of 10 BLR 05310C (Rev. 05/09/24) Local Public Agency Section Number State Job Number Project Number Village of Lemont 24-00060-00-RS C9130224 S3CF(665) pertaining to state and federal pass -through awards, authorizations, obligations, unobligated balances, assets, outlays, and income. To comply with 2 CFR 200.305(b)(7)(i), the LPA shall use reasonable efforts to ensure that funding streams are delineated within LPA's accounting system. See 2 CFR 200.302. III. AUDIT AND RECORD RETENTION 3.1 Single Audits: The LPA shall be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 USC 7501-7507) and Subpart F of 2 CFR Part 200. If, during its fiscal year, LPA expends $750,000 or more in Federal Awards (direct federal and federal pass -through awards combined), LPA must have a single audit or program -specific audit conducted for that year as required by 2 CFR 200.501 and other applicable sections of Subpart F of 2 CFR Part 200. A copy of the audit report must be submitted to the STATE (IDOT's Financial Review & Investigations Section, Room 126, 2300 South Dirksen Parkway, Springfield, Illinois, 62764) within 30 days after the completion of the audit, but no later than one year after the end of the LPA's fiscal year. Assistance Listing number (formally known as the Catalog of Federal Domestic Assistance (CFDA) number) for all highway planning and construction activities is 20.205. Federal funds utilized for construction activities on projects let and awarded by the STATE (federal amounts shown as "Participating Construction" on Schedule 2) are not included in a LPA's calculation of federal funds expended by the LPA for Single Audit purposes. 3.2 STATE Audits: The STATE may, at its sole discretion and at its own expense, perform a final audit of the Project (30 ILCS 5, the Illinois State Auding Act). Such audit may be used for settlement of the Project expenses and for Project closeout purposes. The LPA agrees to implement any audit findings contained in the STATE's authorized inspection or review, final audit, the STATE's independent audit, or as a result of any duly authorized inspection or review. 3.3 Record Retention. The LPA shall maintain for three (3) years from the date of final project closeout by the STATE, adequate books, records, and supporting documents to verify the amounts, recipient, and uses of all disbursements of funds passing in conjunction with this contract. adequate to comply with 2 CFR 200.334. If any litigation, claim or audit is started before the expiration of the retention period, the records must be retained until all litigation, claims or audit exceptions involving the records have been resolved and final action taken. 3.4 Accessibility of Records. The LPA shall permit, and shall require its contractors and auditors to permit, the STATE, and any authorized agent of the STATE, to inspect all work, materials, payrolls, audit working papers, and other data and records pertaining to the Project; and to audit the books, records, and accounts of the LPA with regard to the Project. The LPA in compliance with 2 CFR 200.337 shall make books, records, related papers, supporting documentation and personnel relevant to this Agreement available to authorized STATE representatives, the Illinois Auditor General, Illinois Attorney General, any Executive Inspector General, the STATE's Inspector General, federal authorities, any person identified in 2 CFR 200.337, and any other person as may be authorized by the STATE (including auditors), by the state of Illinois or by federal statute. The LPA shall cooperate fully in any such audit or inquiry. 3.5 Failure to maintain the books and records. Failure to maintain the books, records and supporting documents required by this section shall establish presumption in favor of the STATE for recovery of any funds paid by the STATE under the terms of this contract. IV.. LPA FISCAL RESPONSIBILITIES 4.1 To provide all initial funding and payment for construction engineering, utility, and railroad work 4.2 LPA Appropriation Requirement. By execution of this Agreement the LPA attests that sufficient moneys have been appropriated or reserved by resolution or ordinance to fund the LPA share of project costs. A copy of the authorizing resolution or ordinance is attached as Schedule 5. 4.3 Reimbursement Requests: For reimbursement requests the LPA will submit supporting documentation with each invoice. Supporting documentation is defined as verification of payment, certified time sheets or summaries, vendor invoices, vendor receipts, cost plus fix fee invoice, progress report, personnel and direct cost summaries, and other documentation supporting the requested reimbursement amount (Form BLR 05621 should be used for consultant invoicing purposes). LPA invoice requests to the STATE will be submitted with sequential invoice numbers by project. 4.4 Financial Integrity Review and Evaluation (FIRE) program: LPA's and the STATE must justify continued federal funding on inactive projects. 23 CFR 630.106(a)(5) defines an inactive project as a project which no expenditures have been charged against Federal funds for the past twelve (12) months. To keep projects active, invoicing must occur a minimum of one time within any given twelve (12) month period. However, to ensure adequate processing time, the first invoice shall be submitted to the STATE within six (6) months of the federal authorization date. Subsequent invoices will be submitted in intervals not to exceed six (6) months. 4.5 Final Invoice: The LPA will submit to the STATE a complete and detailed final invoice with applicable supporting documentation of all incurred costs, less previous payments, no later than twelve (12) months from the date of completion of work or from the date of the previous invoice, whichever occurs first. If a final invoice is not received within this time frame, the most recent invoice Page 4 of 10 BLR 05310C (Rev. 05/09/24) Local Public Agency Section Number State Job Number Project Number Village of Lemont 24-00060-00-RS C9130224 S3CF(665) may be considered the final invoice and the obligation of the funds closed. Form BLR 05613 (Engineering Payment Record) is required to be submitted with the final invoice for engineering projects. 4.6 Project Closeout: The LPA shall provide the final report to the appropriate STATE district office within twelve (12) months of the physical completion date of the project so that the report may be audited and approved for payment. If the deadline cannot be met, a written explanation must be provided to the district prior to the end of the twelve (12) months documenting the reason and the new anticipated date of completion. If the extended deadline is not met, this process must be repeated until the project is closed. Failure to follow this process may result In the immediate close-out of the project and loss of further funding. 4.7 Project End Date: The period of performance (end date) for state and federal obligation purposes is five (5) years for projects under $1,000,000 or seven (7) years for projects over $1,000,000 from the execution date of the agreement. Requests for time extensions and joint agreement amendments must be received and approved prior to expiration of the project end date. Failure to extend the end date may result in the immediate close-out of the project and loss of further funding. V. THE LPA AGREES 5.1 To acquire in its name, or in the name of the STATE if on the STATE highway system, all right-of-way necessary for this project in accordance with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, and established State policies and procedures. Prior to advertising for bids, the LPA shall certify to the STATE that all requirements of Titles II and III of said Uniform Act have been satisfied. The disposition of encroachments, if any, will be cooperatively determined by representatives of the LPA, the STATE, and the FHWA if required. 5.2 To provide for all utility adjustments and to regulate the use of the right-of-way of this improvement by utilities, public and private, in accordance with the current Utility Accommodation Policy for Local Public Agency Highway and Street Systems. 5.3 To provide on -site engineering supervision and inspection during construction of the proposed improvement. 5.4 To retain jurisdiction of the completed improvement unless specified otherwise by schedule (schedule should be accompanied by a location map). If the improvement location is currently under road district jurisdiction, a jurisdictional schedule is required. 5.5 To maintain or cause to be maintained the completed improvement (or that portion within its jurisdiction as established by schedule) in a manner satisfactory to the STATE and the FHWA. 5.6 To provide if required, for the improvement of any railroad -highway grade crossing and rail crossing protection within the limits of the proposed improvement. 5.7 To regulate parking and traffic in accordance with the approved project report. 5.8 To regulate encroachments on public rights -of -way in accordance with current Illinois Compiled Statutes. 5.9 To regulate the discharge of sanitary sewage into any storm water drainage system constructed with this improvement in accordance with the current Illinois Compiled Statutes. 5.10 For contracts awarded by the LPA, the LPA shall not discriminate on the basis of race, color, national origin or sex in the award and performance of any USDOT - assisted contract or in the administration of its DBE program or the requirements of 49 CFR part 26. The LPA shall take all necessary and reasonable steps under 49 CFR part 26 to ensure nondiscrimination in the award and administration of USDOT - assisted contracts. The LPA's DBE program, as required by 49 CFR part 26 and as approved by USDOT, is incorporated by reference in this agreement. Upon notification to the recipient of its failure to carry out its approved program, the STATE may impose sanctions as provided for under Part 26 and may, in appropriate cases, refer the matter for enforcement under 18 U.S. C 1001 and/or the Program Fraud Civil Remedies Act of 1986 (31 U.S.0 3801 et seq.). In the absence of a USDOT - approved LPA DBE Program or on STATE awarded contracts, this agreement shall be administered under the provisions of the STATE'S USDOT approved Disadvantaged Business Enterprise Program. 5.12 That execution of this agreement constitutes the LPA's concurrence in the award of the construction contract to the responsible low bidder as determined by the STATE. Vt. THE STATE AGREES 6.1 To provide such guidance, assistance, and supervision to monitor and perform audits to the extent necessary to assure validity of the LPA's certification of compliance with Title II and III Requirements. 6.2 To receive bids for construction of the proposed improvement when the plans have been approved by the STATE (and FHWA, if required) and to award a contract for construction of the proposed improvement after receipt of a satisfactory bid. 6.3 To provide all initial funding and payments to the contractor for construction work let by the STATE. The LPA will be invoiced for their share of contract costs per the method of payment selected under Method of Financing based on the Division of Costs shown on Schedule 2. Page 5 of 10 BLR 05310C (Rev. 05/09/24) Local Public Agency Section Number State Job Number Project Number Village of Lemont 24-00060-00-RS � C9130224 S3CF(665) 6A For agreements with federal and/or state funds in local let/day labor construction, construction engineering, utility work and/or railroad work: a. To reimburse the LPA for federal and/or state share on the basis of periodic billings, provided said billings contain sufficient cost information and show evidence of payments by the LPA; b. To provide independent assurance sampling and furnish off -site material inspection and testing at sources normally visited by STATE inspectors for steel, cement, aggregate, structural steel, and other materials customarily tested by the STATE. SCHEDULES Additional information and/or stipulations are hereby attached and identified below as being a part of this agreement. ® 1. Division of Cost ® 2. Location Map ® 3. Risk Assessment ® 4. Attestations ❑X 5. Resolution* "Appropriation and signature authority resolution must be in effect on, or prior to, the execution date of the agreement. Page 6 of 10 BLR 05310C (Rev. 05/09/24) Local Public Agency Section Number State Job Number Project Number Village of Lemont 24-00060-00-RS C9130224 S3CF(665) AGREEMENT SIGNATURES EXECUTION The LPA agrees to accept and comply with the applicable provision set forth in this agreement including attached schedules. APPROVED Local Public Agency Name of Official Print or Type Name John Egofske Title of Official Si nature Date The abovd signature certifies the agency's TIN number is 366005969 conducting business as a Governmental Entity. DUNS Number 037044682 UEI G577EP37M6W3 APPROVED State of Illinois Department of Transportation Omer Osman, P.E., Secretary of Transportation Date By: George A. Ta as, P.E., S.E., Engineer of Local Roads & Streets Date Stephen M. Travia, P.E., Director of Highways PI/Chief Engineer Date Michael Prater, Chief Counsel Date Vicki Wilson, Chief Fiscal Officer Date NOTE: A resolution authorizing the local official (or their delegate) to execute this agreement and appropriation of local funds is required and attached as Schedule 5. The resolution must be approved prior to, or concurrently with, the execution of this agreement. If BLR 09110 or BLR 09120 are used to appropriate local matching funds, attach these forms to the signature authorization resolution. ❑ Please check this box to open a fillable Resolution form within this form. 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C 0 C6 0)c 0 0 °U p) U C U @ 0 T O O 0- (a C O-0 0 C U 0 �Qw U N O N 0 m _c U o [cD �.. 0 C U N 0) .� O �LS N°paa t� °a m E-0E�° �-� ��°°-0 R m�� Q d m m c Q ° a� a .o m m 0 Q -00 c° 0 ° N N Cn O Q- J N 0 0 w -°_ 0 N@- (D C1 c� U° U 3 V C 0 C O 0 U Y fn C (6 E > -0 (C6 W L C cn f6 0 C N 1 a'C., 'C U L U� ton N C6 C 'O L -C 'O '0 c 0 > @ E E S O C6 Q `�i C6 >L_. .: (6 °U -C 0 .N S O F f o 0 Co G OU 2!' 0 U 0 J in (6 ° u) O _ C O LL = m � = U CBL N, C a. f6 0 C .N- C_ LL C 0 C6 c c U' LL Q O 11. Local Public Aged—____. Section Number State Number Project Number _ _ - - - -- -- ..... --- - ----- -- Village of Lemont 24 00060 00-RS C9 W224 S3CF(665) SCHEDULE !NUMBER 4 Attestation on Single Audit Compliance 1. In the prior fiscal year, did Village of Lemont federal sources? ❑ Yes ❑ No 2. Does the Village of Lemont federal sources in the current Village of Lemont I❑ Yes ❑ No expend more than $750,000 in federal funds in aggregate from all anticipate expending more than $750,000 in federal funds in aggregate from all fiscal year? If answers to question 1 and 2 are no, please proceed to the signature section. If answer to question 1 is yes, please answer question 3a. If answer to question 2 is yes, please answer question 3b. 3. A single audit must be conducted in accordance with Subpart F of 2 CFR 200 if $750,000 or more in federal funds are expended in a single fiscal year. a. Has the Village of Lemont performed a single audit for their previous fiscal year? ❑] Yes ❑ No L If yes, has the audit be filed with the Illinois Office of the Comptroller in accordance with 50 ILCS 310 (see also 55 ILCS 5 & 65 ILCS 5 & 60 ILCS 1/80)? © Yes ❑ No b. For the current fiscal year, does the Village of Lemont intend to comply with Subpart F of 2 CFR 200? © Yes ❑ No By completing this attestation, I certify that I have authority to sign this attestation on behalf of the LPA; and that the foregoing information is correct and complete to the best of my knowledge and belief. Name _ Title _ _ LPA George Schafer Village Administrator Village of Lemont Si nature & D t 2 Page 10 of 10 BLR 05310C (Rev. 05/09/24)