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-•yw <br /> airy <br /> Consultant/Address/Telephone <br /> Local Agency <br /> Stantec Consulting Services, Inc. <br /> Standard Consultant 11130 NE 33rd Place, Suite 200 <br /> Agreement Bellevue, WA 98004-1465 <br /> ®Architectural/Engineering Agreement <br /> ❑ Personal Services Agreement <br /> Agreement Number <br /> OCSS 16 Project Title And Work Description <br /> Federal Aid Number On-Call Surveying Services <br /> Agreement Type(Choose one) <br /> ❑ Lump Sum <br /> Lump Sum Amount $ <br /> ❑ Cost Plus Fixed Fee <br /> Overhead Progress Payment Rate <br /> Overhead Cost Method DBE Participation <br /> ❑Actual Cost ❑ Yes ® No <br /> Federal ID Number or Social Security Number <br /> ❑Actual Cost Not To Exceed % 11-2167170 --� <br /> ❑ Fixed Overhead Rate % Do you require a 1099 for IRS? Completion Date <br /> Fixed Fee $ 0 Yes ® No December 31, 2016 <br /> ® Specific Rates Of Pay Total Amount Authorized $ 85,000.00 <br /> ® Negotiated Hourly Rate <br /> Management Reserve Fund $ 15,000.00 <br /> ❑ Provisional Hourly Rate <br /> O Cost Per Unit of Work Maximum Amount Payable$ 100,000.00 <br /> Index of Exhibits (Check all that apply): <br /> ® Exhibit A-1 Scope of Work 0 Exhibit G-2 Fee-Sub Specific Rates <br /> ® Exhibit A-2 Task Order Agreement 0 Exhibit G-3 Sub Overhead Cost <br /> ❑ Exhibit B-1 DBE Utilization Certification ® Exhibit H Title VI Assurances <br /> ® Exhibit C Electronic Exchange of Data ® Exhibit I Payment Upon Termination of Agreement <br /> ❑ Exhibit D-1 Payment-Lump Sum 0 Exhibit J Alleged Consultant Design Error Procedures <br /> ❑ Exhibit D-2 Payment-Cost Plus ® Exhibit K Consultant Claim Procedures <br /> ® Exhibit D-3 Payment-Hourly Rate 0 Exhibit L Liability Insurance Increase <br /> ❑ Exhibit D-4 Payment-Provisional ® Exhibit M-1 a Consultant Certification <br /> ❑ Exhibit E-1 Fee-Lump/Fixed/Unit ® Exhibit M-lb Agency Official Certification <br /> ® Exhibit E-2 Fee-Specific Rates ® Exhibit M-2 Certification-Primary <br /> ❑ Exhibit F Overhead Cost ® Exhibit M-3 Lobbying Certification <br /> ® Exhibit G Subcontracted Work 0 Exhibit M-4 Pricing Data Certification <br /> ❑ Exhibit G-1 Subconsultant Fee 0 App. 31.910 Supplemental Signature Page <br /> THIS AGREEMENT,made and entered into this 90•--- day of , 2016 , <br /> between the Local Agency of City of Everett ,Washington ereinafter called the"AGENCY", <br /> and the above organization hereinafter called the"CONSULTANT". <br /> DOT Form 140-089 EF Page 1 of 8 <br /> Revised 09/2013 <br />