26-1713 Authorizing Locally Funded FDOT Agreement - ST RD 434 Project RESOLUTION NO. 26-1713
A RESOLUTION OF THE CITY OF LONGWOOD, FLORIDA, APPROVING AND
AUTHORIZING THE EXECUTION OF LOCALLY FUNDED AGREEMENT BETWEEN THE
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION AND THE CITY OF
LONGWOOD CONCERNING STATE ROAD 434(FROM RANGELINE ROAD to 525'WEST
OF STATE ROAD 15/600/US 17-92) PROJECT; PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the State of Florida Department of Transportation ("FDOT") is constructing
improvements to State Road 434 (from Rangeline Road to 525' West of State Road 15/600/US 17-92)
project, which is described as the FDOT's FPN 443838-1-52-02 (the "Project"); and
WHEREAS, the City of Longwood ("City") desires to incorporate into the Project for FDOT's
contractor to perform the milling and resurfacing of certain City roads connecting to State Road 434; and
WHEREAS, the FDOT has requested the City of Longwood to execute and deliver to the FDOT a
Locally Funded Agreement to add the City's requested improvements to the aforementioned Project;
NOW,THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF LONGWOOD,
FLORIDA,that:
SECTION 1. The City Commission hereby approves and authorizes the Mayor or the City Manager of
the City of Longwood to execute and deliver to the State of Florida Department of Transportation the Locally
Funded Agreement for the aforementioned Project,a copy of which is either attached or was included in the
City Commission agenda package for review. This Resolution will be an exhibit to the Locally Funded
Agreement. Further,the City Manager is authorized to execute the related three-party escrow agreement
for the City.
SECTION 2. This Resolution shall take effect immediately upon its adoption.
PASSED AND RESOLVED this 2nd day of February, 2026, by the City Commission of the City of Longwood,
Florida.
APPROVED:
A gierI
Brian D. Sackett, M. 'or
ATTEST:
Liane Cartagena, City Clerk
Reviewed for legal sufficiency by:
Daniel W. Langley, City Attorney
Resolution 26-1713
Page 1
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Page 1 of 10
Agency: City of Longwood
Fund: LF
Financial Project No.:
Vendor No.: F591008196001
Contract Amount: $64,378.00
443838-1-52-02
LOCALLY FUNDED AGREEMENT
BETWEEN
THE STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
AND
THE CITY OF LONGWOOD
This AGREEMENT, made and entered into 02/05/2026 1 3:09 PM EST
by and between the STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION (hereinafter
referred to as the "DEPARTMENT") and the CITY OF LONGWOOD (hereinafter referred to as
the "LOCAL GOVERNMENT"),
WITNESSETH:
WHEREAS, the Parties have been granted specific legislative authority to enter into this
Agreement pursuant to Section 339.12, Florida Statutes; and
WHEREAS, the LOCAL GOVERNMENT, by Resolution, a copy of which is attached
hereto as Exhibit "C", and made a part hereof, has authorized its officers to execute this
Agreement on its behalf; and
WHEREAS, the DEPARTMENT is prepared, in accordance with its Adopted Five -Year
Work Program, to undertake the project described as: "State Road 434 (from Rangeline Road
to 525' WGat of State Road 15/600/US 17-92)", said project being known as Financial Project
Number (FPN) 443838-1-52-01, hereinafter referred to as the "Project"; and
WHEREAS, the Project is not revenue producing and is contained in the Adopted Work
Program; and
WHEREAS, the implementation of the Project is in the interests of both the
DEPARTMENT and the LOCAL GOVERNMENT and it would be most practical, expeditious,
and economical for the LOCAL GOVERNMENT to provide the funds to: extend the limits of the
milling and resurfacing along the north and south intersections of Grant Street, in Fiscal Year
2025/2026, said Project being known as FPN 443838-1-52-02, and said improvements shall
hereinafter be referred to as the "Additional Improvements"; and
WHEREAS, in order to maintain uniformity throughout the Project and to provide for the
Additional Improvements in a cost effective manner, the LOCAL GOVERNMENT desires to
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have said Additional Improvements made a part of the Project and to provide funding to the
DEPARTMENT to be used for the Additional Improvements as described in "Exhibit A".
NOW, THEREFORE, in consideration of the mutual benefits to be derived from the joint
participation of this Agreement, the parties agree as follows:
1. The term of this Agreement shall begin upon the date of signature of the last
party to sign and shall remain in full force and effect through completion of all services required
of the LOCAL GOVERNMENT. The DEPARTMENT may, at any time and at any stage, amend
or terminate the Project in whole or in part if the DEPARTMENT determines that such action is
in the best interests of the public.
2. The DEPARTMENT shall cause the Additional Improvements described in
Exhibit "A" to be incorporated into the DEPARTMENT'S plans for the State Road 434 (from
Rangeline Road to 525' West of State Road 15/600/US 17-92) and to be constructed as a part
of said Project.
3. The DEPARTMENT shall perform necessary preliminary engineering, prepare
any and all design plans, acquire all necessary right-of-way, perform the construction, provide
all necessary engineering supervision, and otherwise perform all other necessary work, all as
may be applicable for the Project as previously defined. The Project as previously defined may
include some or all of the foregoing activities. Nothing in this Agreement may be construed as
requiring the DEPARTMENT to perform any activity which is outside the scope of the Project as
previously defined. Except as specifically stated otherwise in this Agreement, all such activities
shall be performed by such entities, at such times, in such manner, under such conditions, and
pursuant to such standards as the DEPARTMENT, in its sole discretion, deems appropriate.
The LOCAL GOVERNMENT shall not have any jurisdiction or control over the DEPARTMENT'S
activities, except as specifically stated in this Agreement. The LOCAL GOVERNMENT shall be
entitled to be advised of the progress of the Project at reasonable intervals upon request.
4. After construction is complete, the LOCAL GOVERNMENT agrees to inspect and
maintain the constructed improvements, in perpetuity as specified in Exhibit "A", Scope of
Services.
5. Participation by the LOCAL GOVERNMENT in the funds for the construction
phase of the Project shall be made as follows:
(A) The DEPARTMENT'S current estimate of cost for the Additional
Improvements is $64,378.00 (Sixty -Four Thousand, Three Hundred Seventy -Eight
Dollars and No/100). The DEPARTMENT'S performance and obligation to construct the
Project is contingent upon an annual appropriation by the Florida Legislature. The
parties agree that in the event funds are not appropriated to the DEPARTMENT for the
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Page 3 of 10
Project, this Agreement may be terminated, which shall be effective upon the
DEPARTMENT giving written notice to the LOCAL GOVERNMENT to that effect.
(B) The Project is being funded by the LOCAL GOVERNMENT in the amount
of $64,378.00 (Sixty -Four Thousand, Three Hundred Seventy -Eight Dollars and
No/100). Said funds are programmed under Financial Project Number (FPN) 443838-1-
52-02. As described in paragraph 5(C) below, the LOCAL GOVERNMENT agrees that it
will provide the balance of the funding necessary to complete the Project.
(C) The LOCAL GOVERNMENT agrees that it will, on or before but no later
than February 16, 2026, furnish the DEPARTMENT an advance deposit in the amount of
$64,378.00 (Sixty -Four Thousand, Three Hundred Seventy -Eight Dollars and
No/100) for full payment of the estimated project cost for Locally Funded project number
443838-1-52-02. The advance deposit shall be the total estimated project cost plus
allowances, including contingency. The DEPARTMENT shall utilize this deposit, as well
as any interest accrued, for payment of the costs of the project.
(D) If the accepted bid amount plus allowances is in excess of the advance
deposit amount, the LOCAL GOVERNMENT will provide an additional deposit within
fourteen (14) calendar days of notification from the DEPARTMENT or prior to posting of
the accepted bid, whichever is earlier, so that the total deposit is equal to the bid amount
plus allowances. The DEPARTMENT will notify the LOCAL GOVERNMENT as soon as
it becomes apparent the accepted bid amount, plus allowances, is in excess of the
advance deposit amount. However, failure of the DEPARTMENT to so notify the LOCAL
GOVERNMENT shall not relieve the LOCAL GOVERNMENT from its obligation to pay
for its full participation on final accounting as provided herein below. If the LOCAL
GOVERNMENT cannot provide the additional deposit within fourteen (14) days, a letter
must be submitted to and approved by the DEPARTMENT project manager indicating
when the deposit will be made. The LOCAL GOVERNMENT understands the request
and approval of the additional time could delay the project, and additional costs may be
incurred due to a delay of the project.
(E) If the accepted bid amount plus allowances is less than the advance
deposit amount, the DEPARTMENT will refund the amount that the advance deposit
exceeds the bid amount plus allowances if such refund is requested by the LOCAL
GOVERNMENT in writing.
(F) Should project modifications or changes to bid items occur that increase
the LOCAL GOVERNMENT share of total project costs, the LOCAL GOVERNMENT will
be notified by the DEPARTMENT accordingly. The LOCAL GOVERNMENT agrees to
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Page 4 of 10
provide, without delay, in advance of the additional work being performed, adequate
funds to ensure that cash on deposit with the DEPARTMENT is sufficient to fully fund its
share of the Project. The DEPARTMENT shall notify the LOCAL GOVERNMENT as
soon as it becomes apparent the actual costs will overrun the award amount. However,
failure of the DEPARTMENT to so notify the LOCAL GOVERNMENT shall not relieve
the LOCAL GOVERNMENT from its obligation to pay for its full participation during the
Project and on final accounting as provided herein below. Funds due from the LOCAL
GOVERNMENT during the Project not paid within forty (40) calendar days from the date
of the invoice are subject to an interest charge at a rate established pursuant to Section
55.03, Florida Statutes (F.S.).
(G) The DEPARTMENT intends to have its final and complete accounting of
all costs incurred in connection with the work performed hereunder within three hundred
and sixty days (360) of final payment to the Contractor. The DEPARTMENT considers
the Project complete when the final payment has been made to the Contractor, not when
the construction work is complete. All project cost records and accounts shall be subject
to audit by a representative of the LOCAL GOVERNMENT for a period of three (3) years
after final close out of the project. The LOCAL GOVERNMENT will be notified of the final
cost. Both parties agree that in the event the final accounting of total project costs
pursuant to the terms of this agreement is less than the total deposits to date, a refund of
the excess will be made by the DEPARTMENT to the LOCAL GOVERNMENT. If the
final accounting is not performed within three hundred and sixty (360) days, the LOCAL
GOVERNMENT is not relieved from its obligation to pay.
(H) In the event the final accounting of total project costs is greater than the
total deposits to date, the LOCAL GOVERNMENT will pay the additional amount within
forty (40) calendar days from the date of the invoice from the DEPARTMENT. The
LOCAL GOVERNMENT agrees to pay interest at a rate as established pursuant to
Section 55.03, F. S., on any invoice not paid within forty (40) calendar days until the
invoice is paid.
(1) The payment of funds under this Locally Funded Agreement will be made
directly to the DEPARTMENT for deposit and as provided in the attached escrow
agreement between LOCAL GOVERNMENT, DEPARTMENT and the State of Florida,
Department of Financial Services, Division of Treasury.
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(J) Contact Persons:
DEPARTMENT
District 5 Local Government Agreements
719 South Woodland Boulevard, M.S. 4-520
DeLand, Florida 32720-6834
(386) 943-5623
D5-LGACa)dot.state.fl.us
LOCAL GOVERNMENT
Shad Smith
Director of Public Works/City Engineer
City of Longwood - Public Works
907 East State Road 434
Longwood, Florida 32750
(407) 260-3447
ssm ith alongwo odfl. o rq
6. All tracings, plans, specifications, maps, models, reports, or other work product
prepared or obtained under this Agreement shall be considered works made for hire for the
DEPARTMENT and shall at all times be and remain the property of the DEPARTMENT without
restriction or limitation on their use. The LOCAL GOVERNMENT may, however, inspect those
materials upon providing reasonable advance notice to the DEPARTMENT.
7. In the event this Agreement is in excess of TWENTY-FIVE THOUSAND
DOLLARS ($25,000.00) or has a term for a period of more than one (1) year, the provisions of
Chapter 339.135(6)(a), Florida Statutes, are hereby incorporated as follows:
"The DEPARTMENT, during any fiscal year, shall not expend money, incur any
liability, or enter into any contract which, by its terms, involves the expenditure of
money in excess of the amounts budgeted as available for expenditure during
such fiscal year. Any contract, verbal or written, made in violation of this
subsection is null and void, and no money may be paid on such contract. The
DEPARTMENT shall require a statement from the Comptroller of the Department
that funds are available prior to entering into any such contract or other binding
commitment of funds. Nothing herein contained shall prevent the making of
contracts for periods exceeding one (1) year, but any contract so made shall be
executory only for the value of the services to be rendered or agreed to be paid for
in succeeding fiscal years; and this paragraph shall be incorporated verbatim in all
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Page 6 of 10
contracts of the DEPARTMENT which are for an amount in excess of $25,000.00
and which have a term for a period of more than one (1) year."
8. The DEPARTMENT may unilaterally cancel this Agreement for refusal by the
LOCAL GOVERNMENT to allow public access to all documents, papers, letters, or other
material subject to the provisions of Chapter 119, Florida Statutes, and made or received by
such party in conjunction with this Agreement.
9. This Agreement constitutes the complete and final expression of the parties with
respect to the subject matter hereof, and incorporates and includes all proper negotiations,
correspondence, conversations, agreements, or understandings applicable to the matters
contained herein. The parties agree that there are no commitments, agreements or
understandings concerning the subject matter of this Agreement that are not contained in this
document. Accordingly, it is agreed that no deviation from the terms hereof shall be predicated
upon any prior representation or agreements whether oral or written.
10. This Agreement shall be governed by and interpreted in accordance with the
laws of the State of Florida. Any provision herein determined by a court of competent
jurisdiction, or any other legally constituted body having jurisdiction, to be invalid or
unenforceable shall be severable and the remainder of this Agreement shall remain in full force
and effect, provided that the invalidated or unenforceable provision is not material to the
intended operation of this Agreement.
11. The DEPARTMENT and the LOCAL GOVERNMENT acknowledge and agree
to the following:
(A) The LOCAL GOVERNMENT shall utilize the U.S. Department of Homeland
Security's E-Verify system to verify the employment eligibility of all new employees hired
by the LOCAL GOVERNMENT during the term of the contract; and
(B) The LOCAL GOVERNMENT shall expressly require any contractors and
subcontractors performing work or providing services pursuant to the state contract to
likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the
employment eligibility of all new employees hired by the contractor/subcontractor during
the contract term.
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IN WITNESS WHEREOF, the LOCAL GOVERNMENT has executed this Agreement on
01'02 62&2(0 , and the DEPARTMENT has executed this Agreement on
02/05/202I 3:09 PM EST
STATE OF FLORIDA
CITY OF LONGWOOD DEPARTMENT OF TRANSPORTATION
�DoeuSigned by:
By: By: 7 9�'
Name: t //!1A ,bfr/ Name: James S. Stroz, Jr.. P.E.
Title: � nr 111/914 uj s l/� Title: Director of Transportation Development
tkr
Attest: Attest:
a•
01 ♦ _ DoouSigned by'.
bA20P.UD90F A
xecuive Tecretary
Legal Review: Legal Review:
-,1
DocuSigned by: 11 atris (ln,pl,t,(,1Ca{b
LOCAL GO MPIney DEPi `fWIcENT Attorney
Financial Provisions Approval by
Department of Comptroller on:
July 8, 2019
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EXHIBIT "A"
SCOPE OF SERVICES
Page 8 of 10
The intent of this project is to replace the bi-directional left turn lane with a 19-foot median and to
provide designated left -turn lanes. In addition to access management, the existing pavement will be
widened to accommodate U-turn loons at select locations, along with other signalization
improvements.
The LOCAL GOVERNMENT would like to extend the milling and resurfacing limits along the
north and south intersections of Grant Street to avoid leaving isolated sections of old pavement.
The northern limits extend from State Road 434 to the beginning of East Bay Avenue, and the
southern limits extend from State Road 434 to the beginning of East Evergreen Avenue. The
milling and resurfacing are intended to match the existing pavement seam.
The DEPARTMENT'S Contractor shall construct the Additional Improvements as part of the
construction contract for State Road 434 (from Rangeline Road to 525' West of State Road
15/600/US 17-92).
After construction is complete, the LOCAL GOVERNMENT shall at all times be responsible, at
their own cost and expense, for maintaining the Additional Improvements constructed under this
Agreement, in perpetuity, which includes clean-up, removal and disposal of debris from
catastrophic events or accidents as well as routine maintenance. The LOCAL GOVERNMENT
will respond to and handle any citizen complaints. If the Additional Improvements needs to be
rehabilitated and/or repaired at any time in the future, the DEPARTMENT is under no obligation
to restore, repair or replace the Additional Improvements.
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FPN: 443838-1-52-02
EXHIBIT "B"
ESTIMATE
Page 9 of 10
The estimate is based on Statewide and District Average Bid Price for the following items times
an escalation to bring the cost up to the construction fiscal year.
Cost Estimate
SR 434 from Ran eline Road to 525' West of SR 15/600/US17-92
443838-1-52-02
Pay Item
Item
Unit
Estimated
Number
Description
Unit
Quantity
Price
Cost
032770 6
MILLING EXISTING ASPHALT
SY
1919.00
$ 5.00
$ 9,595.00
PAVEMENT, 1 '/2" AVG DEPTH
0337 783
ASPHALT CONCRETE
FRICTION COURSE, TRAFFIC
TN
159.00
$ 300.00
$ 47,700.00
C, FC 12.5, PG 76-22
0706 1 3
RAISED PAVEMENT MARKER,
EA
36.00
$ 5.00
$ 1,80.00
TYPE B
0710 90
PAINTED PAVEMENT
LS
1.00
$ 5,000.00
$ 5,000.00
MARKINGS, FINAL SURFACE
0711 11124
THERMOPLASTIC, STANDARD,
WHITE, SOLID, 18" FOR
LF
32.00
$ 6.00
$ 192.00
DIAGONALS AND CHEVRONS
0711 16101
THERMOPLASTIC, STANDARD -
OTHER SURFACES, WHITE,
GM
0.012
$ 18,000.00
$ 216.00
SOLID, 6"
0711 16201
THERMOPLASTIC, STANDARD -
OTHER SURFACES, YELLOW,
GM
0.230
$ 6,500.00
$ 1,495.00
SOLID, 6"
*TOTAL COST
$64,378.00
"Does not calculate total based on Low Cost Alternate
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EXHIBIT "C"
RESOLUTION
Page 10 of 10
The Resolution, or other official authorization, authorizing entry into this Agreement is attached
and incorporated into this Agreement.
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RESOLUTION NO.26-1713
A RESOLUTION OF THE CITY OF LONGWOOD, FLORIDA, APPROVING AND
AUTHORIZING THE EXECUTION OF LOCALLY FUNDED AGREEMENT BETWEEN THE
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION AND THE CITY OF
LONGWOOD CONCERNING STATE ROAD 434 (FROM RANGELINE ROAD to 525' WEST
OF STATE ROAD 15/600/US 17-92) PROJECT; PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the State of Florida Department of Transportation ("FDOT") is constructing
improvements to State Road 434 (from Rangeline Road to 525' West of State Road 15/600/US 17-92)
project, which is described as the FDOT's FPN 443838-1-52-02 (the "Project"); and
WHEREAS, the City of Longwood ("City") desires to incorporate into the Project for FDOT's
contractor to perform the milling and resurfacing of certain City roads connecting to State Road 434; and
WHEREAS, the FDOT has requested the City of Longwood to execute and deliver to the FDOT a
Locally Funded Agreement to add the City's requested improvements to the aforementioned Project;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF LONGWOOD,
FLORIDA, that:
SECTION 1. The City Commission hereby approves and authorizes the Mayor orthe City Manager of
the City of Longwood to execute and deliver to the State of Florida Department of Transportation the Locally
Funded Agreement for the aforementioned Project, a copy of which is either attached or was included in the
City Commission agenda package for review. This Resolution will be an exhibit to the Locally Funded
Agreement. Further, the City Manager is authorized to execute the related three -party escrow agreement
for the City.
SECTION 2. This Resolution shall take effect immediately upon its adoption.
PASSED AND RESOLVED this 2"d day of February, 2026, by the City Commission of the City of Longwood,
Florida.
ATTEST: _
Li'ane Cartagena, Gty Clerk
Reviewed for legal sufficiency by:
Daniel W. Langley, City Attorney
APPROVED:
I certify this to be a true and correct
copy of the record in my office.
WITNESSETH my hand and official
sisal! of fhe City o" , (5Pwood, Florida,
this the r day
of _ 20 —2--11—
City Cllwnrk
Resolution 26-1713
Page 1
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THREE PARTY ESCROW AGREEMENT
THIS AGREEMENT is made and entered into by and between the State of Florida,
Department of Transportation ("FDOT"), City of Longwood ("Participant"), and the State of Florida,
Department of Financial Services, Division of Treasury ("Escrow Agent'), and shall become
effective upon the Agreement's execution by Escrow Agent.
WHEREAS, FDOT and Participant are engaged in the following project ("Project"):
Project Name: State Road 434 (from Rangeline Road to 525' West of
State Road 15/600/US17-92)
Project #: 443838-1-52-02
County: Seminole
WHEREAS, FDOT and Participant desire to establish an escrow account for the project.
NOW THEREFORE, in consideration of the premises and the covenants contained
herein, the parties agree to the following:
An initial deposit will be made into an interest bearing escrow account established
hereunder for the purposes of the Project. The escrow account will be opened
with the Escrow Agent on behalf of FDOT upon Escrow Agent's receipt and
execution of this Agreement.
2. Other deposits to the escrow account may be made during the life of this
agreement.
3. Deposits will be delivered in accordance with instructions provided by the Escrow
Agent to the FDOT for deposit into the escrow account. A wire transfer or ACH
deposit is the preferred method of payment and should be used whenever
possible.
4. FDOT's Comptroller or designee shall be the sole signatory on the escrow account
with the Escrow Agent and shall have sole authority to authorize withdrawals from
the account. Withdrawals will only be made to FDOT or the Participant in
accordance with the instructions provided to the Escrow Agent by FDOT's
Comptroller or designee.
Moneys in the escrow account will be invested in accordance with section 17.61,
Florida Statutes. The Escrow Agent will invest the moneys expeditiously. Income
is only earned on the moneys while invested. There is no guaranteed rate of
return. Investments in the escrow account will be assessed a fee in accordance
with Section 17.61(4)(b), Florida Statutes... All income of the investments shall
accrue to the escrow account.
Unless instructed otherwise by FDOT, all interest accumulated in the escrow
account shall remain in the account for the purposes of the Project.
7 . The Escrow Agent agrees to provide written confirmation of receipt of funds to
FOOT . FOOT agrees to provide a copy of such written confirmation to Participant
upon request.
8. The Escrow Agent further agrees to provide quarterly reports to FOOT concerning
the escrow account. FOOT agrees to provide a copy of such quarterly reports to
Participant upon request.
9. The Escrow Agent shall not be liable for any error of judgment or for any act done
or omitted by it in good faith , or for anything which it may in good faith do or refrain
from doing in connection herewith.
10 . Escrow Agent shal l have no liability for any claim , cost , expense , damage or loss
due to the acts or omissions of FOOT and Participant , nor f rom any separate
agreements between FOOT and Participant and shall have no responsibility to
monitor or enforce any responsibi lities herein or in any separate agreements
associa t ed with this Agreement between FOOT and Participant.
11 . This Agreement shall be governed by and interpreted in accordance with the laws
of the State of Florida .
12 . This Agreement may be executed in two or more counterparts , each of which shall
be deemed an original , but all of which together shall constitute one and the same
instrument.
13 . This Agreement shall terminate upon disbursement by the Escrow Agent of all
money held by it in the escrow account in accordance with the instructions given
by FOOT's Comptroller or designee and notification from FOOT to Escrow Agent
that the account is to be closed .
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IN WITNESS WHEREOF, the parties have duly executed the Agreement on the date(s)
below.
DocuSigned by: /J I ,
For - C (signature) For PARTICIPANT (signature)
Cheryl Morgan; Deputy Comptroller, GAO
Name and Title
59-3024028
Federal Employer I.D. Number
02/06/2026 1 1:15 PM EST
Date
FDOT Legal Review:
DocuSigned by:
clime JUA
For Escrow Agent (signature)
r
Name and Title
0z / 1 a s
Date
/J1111t9nD1114y?
Name and Title
5 - I nog q
Federal Employer I.D. Number
0� LU
Date