HomeMy WebLinkAboutContracts & Agreements_207A-2021Local Assistance Procedures Manual EXHIBIT 13-A
Short Form Right of Way Certification Local Assistance Project
Exhibit 13-A. Short Form Right of Way Certification Local Assistance Project
(Off -State Highway System Project)
CITY OF REDLANDS
NAME OF THE LOCAL PUBLIC AGENCY
NOTE:
This form is intended for projects that do NOT require
R/W acquisition, relocation assistance, have NO railroad
involvement, and the ONLY Utility Relocation
involvement is limited to utility cover adjustments.
For each item below, except Item 5, select the ONE
option most suitable to your project. If the chosen option
directs you to use Exhibit 13-B, please stop. This Short
Form is not applicable to your project.
RIGHT OF WAY CERTIFICATION No.1
1 STATUS OF REQUIRED PROPERTY RIGHTS
HSIPL-5083(020)
Project ID
Various locations within the City of Redlands
Project Location
Install emergency preemption devices at
signalized intersection
General Description
No acquisition of right of way is required. All proposed work is within existing right of way
❑ Right of way has been acquired in accordance with applicable policy and procedure covering the
acquisition of real property. LPA has legal and physical possession, right to enter and required
permits. If this box is checked, please use Exhibit 13-B.
2. STATUS OF AFFECTED OPERATING RAILROAD FACILITIES
• None affected.
❑ The Railroad has approved the proposed work, which is within their
Right of Way but does not require the adjustment of railroad facilities. The necessary clauses will be
placed in the contract special provisions. If this box is checked, please use Exhibit 13-B.
❑ The Railroad (and when needed, the Public Utilities Commission) has
approved the proposed work, which is within the railroad right of way and does require the adjustment
of railroad facilities. The railroad, or its contract forces, will provide the necessary labor, materials
and/or equipment to adjust their facilities. The necessary clauses will be placed in the contract special
provisions. If this box is checked, please use Exhibit 13-B.
3. MATERIAL SITE(S)
• None required.
❑ Material site(s) required. If this box is checked, please use Exhibit 13-B.
Page 1 of 5
January 2021
Local Assistance Procedures Manual EXHIBIT 13-A
Short Form Right of Way Certification Local Assistance Project
4. DISPOSAL SITE(S)
❑ None required.
❑ Disposal site(s) required. If this box is checked, please use Exhibit 13-B.
5. STATUS OF REQUIRED UTILITY RELOCATION (Check all that apply)
• No relocation required, therefore Buy America requirements do not apply Existing utilities located
within project limits are shown on Project Plan.
❑ Project is not covered by NEPA document; therefore, Buy America requirements do not apply
❑ Utility Agreements are not required on this project; therefore, Buy America requirements do not apply.
❑ Utility involvement is limited to adjusting UTILITY COVERS (manhole cover water valve cover
and box lids) to grade and said work is compliant with all terms and conditions under MAP-21
including Buy America requirements. If this box is checked, please complete page 5 of this form
entitled 'Utility Cover Adjustment Summary' and provide a copy of the Specific Authorization
if federally participating.
❑ All utility work (other than the adjustment of utility covers) has been completed. If this box is
checked, please use Exhibit 13-B.
❑ All utility work (other than the adjustment of utility covers) will be completed by a stated date prior to
award of the contract. If this box is checked, please use Exhibit 13-B.
❑ All necessary arrangements have been made for the completion of all remaining utility work (other
than the adjustment of utility covers) required to be coordinated with project construction.
Arrangements have been made with the owners of all utility encroachments which will remain within
the right of way of the project so that adequate control of the right of way will be achieved. If this box
is checked, please use Exhibit 13-B.
❑ Utility facilities (other than the adjustment of utility covers) will be relocated by the Project's
Contractor under bid items. If this box is checked, please use Exhibit 13-B.
6. RIGHT OF WAY CLEARANCE
• There are no improvements or obstructions located within the limits of this project.
❑ All right of way clearance work has been completed and there are no improvements or obstructions
remaining within the right of way area required for construction. If this box is checked, please use
Exhibit 13-B.
❑ All necessary arrangements have been made for remaining right of way clearance work to be
undertaken and completed as required for proper coordination with the construction schedule. If this
box is checked, please use Exhibit 13-B.
Page 2 of 5
LPP 20-01
Local Assistance Procedures Manual EXHIBIT 13-A
Short Form Right of Way Certification Local Assistance Project
7 AIRSPACE AGREEMENTS
• There are no airspace lease properties within the limits of this project.
❑ All necessary arrangements have been made with airspace lessee(s) and/or in Contract Provisions to
minimize conflicts between lessee's activities and contractor's operations. If this box is checked,
please use Exhibit 13-B.
❑ Airspace lease has been cancelled. If this box is checked, please use Exhibit 13-B.
❑ Other (If this box is checked, please use Exhibit 13-B)
8. COMPLIANCE WITH RELOCATION ASSISTANCE PROGRAM REQUIREMENTS
• Compliance was not required as there were no displacements for this project.
❑ Occupants who have not yet moved from the right of way will be protected against unnecessary
inconvenience and disproportionate injury or any action coercive in nature. If this box is checked,
please use Exhibit 13-B.
❑ LPA has complied with all the steps relative to the relocation advisory assistance and payments as
required by applicable policy and procedure, and no person has been required to relocate without at
least a 90 day written notice. If residential relocation was involved, all individuals and/or families have
been relocated to decent, safe and sanitary housing, or the LPA has made replacement housing
available to the displaces. If this box is checked, please use Exhibit 13-B.
9. COOPERATIVE AGREEMENTS
None Required.
❑ Agency Agreement No. (If checked, please attach a copy)
10. ENVIRONMENTAL MITIGATION
• No environmental mitigation parcels are required for this project.
❑ All environmental mitigation parcels on this project have been acquired. If this box is checked,
please use Exhibit 13-B.
❑ Acquisition of environmental mitigation parcels is ongoing. If this box is checked, please use
Exhibit 13-B.
Page 3 of 5
January 2021
Local Assistance Procedures Manual EXHIBIT 13-A
Short Form Right of Way Certification Local Assistance Project
11 CERTIFICATION
I hereby certify the right of way on this project as conforming to 23 CFR 635 309(c)(1), 49 CFR Part 24 and all
terms and conditions under MAP-21, including Buy America requirements The project may be advertised
with contract award being made at any time
12. INDEMNIFICATION BY LOCAL AGENCY
This Local Public Agency agrees to indemnify, defend, and hold harmless the Department of Transportation (Caltrans)
from any and all liabilities which may result in the event the right of way for this project is not clear as certified LPA
shall pay from its own non -matching funds, any costs which arise out of delays to the construction of the project
because utility facilities have not been removed or relocated, or because rights of way have not been made available
to LPA for the orderly performance of the project work
LOCAL PUBLIC AGENCY
Project ID HSIPL-5083(020)
Authorized Resolution No 7698
Dated 12/20/2016
CALTRANS ACCEPTANCE
The undersigned Caltrans Official has
reviewed this Right of Way Certification as to
form and content Based on the review of
the documents submitted, the Certificate is
accepted on behalf of the local public
agency It remains the sole responsibility of
the local public agency to ensure compliance
with the Uniform Act.
Accepted as to form and content.
By (/ �"— `� By
Title Mayor, City of Redlands Title Senior Right of Way Agent Local Programs
Date ! [ - 2 -2 I Date. 11/12/2021
Attest
nne Donaldson, City Clerk
Distribution 1) Local agency completes this form, signs and sends it to the DLAE
1) DLAE sends a copy to District Right of Way Local Programs Coordinator keeps a copy for his/her files and sends the signed
original back to the local agency
Page 4 of 5
LPP 20-01
RESOLUTION NO 7698
RESOLUTION OF THE CITY COUNCIL OF THE CITY REDLANDS, STATE OF
CALIFORNIA, AUTHORIZING THE MAYOR, OR ANY COUNCIL MEMBER, TO
EXECUTE STATE TRANSPORTATION PROGRAM DOCUMENTS REQUIRED FOR
HIGHWAY PROJECT GRANT FUNDING AND RESCINDING RESOLUTION NO
6934
WHEREAS, the City of Redlands (the "City") is eligible to receive State and/or
Fedeial funding for certain transportation projects through the California Department of
Transportation, and
WHEREAS, Master Agreements, Program Supplement Agreements, Fund Exchange
Agreements Fund Transfer Agreements and Right -of -Way Certifications with the California
Department of Transportation must be executed by an authorized City representative before
such funds can be obtained and expended by the City, and
WHEREAS, the city Council of the City wishes to authorize the Mayor or any
Council Member to execute all Master Agreements, Program Supplement Agreements, Fund
Exchange Agreements, Fund Transfer Agreements and Right -of -Way Certifications and any
amendments thereto, with the California Department of Transportation,
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
Redlands, State of California, as follows
Section 1 The City Council of the City of Redlands hereby authorizes the Redlands
Mayor or any Redlands City Council Member to approve, execute documents required to
receive funding for vanous transportation projects, including but not limited to right-of-way
certifications on behalf of the City Such documents, when duly executed by the Mayor or
any Redlands City Council Member shall be binding upon the City
Section 2 Resolution No 6934 of the City Council of the City of Redlands is hereby
rescinded
ADOPTED, SIGNED AND APPROVED this 20th day of December, 2016
ATTEST
.1 le Donaldson, City Clerk
1 \cclerk\Resolutions\Res 7600 7699\7698 Authorize Mayor to execute Federal Aid
documents docx
1, Jeanne Donaldson, City Clerk of the City of Redlands, hereby certify that the foregoing
resolution was adopted by the City Council at a regular meeting thereof held on the 20th day of
December, 2016 by the following vote
AYES Councilinembers Harrison, Gilbreath, Barich, Tejeda, Mayor Foster
NOES None
ABSTAIN None
ABSENT None
.Cizr)--J
can ne Donaldson, City Clerk