Section 5: Prepare and Submit the Agreement Assembly



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Document Type




Utility Adjustment Checklist

1 Electronic Copy

1 Electronic Copy

1 Electronic Copy

Transmittal Memo

1 Electronic Copy

1 Electronic Copy

1 Electronic Copy

Standard Utility Agreement

1 Electronic Copy with original or electronic signatures

1 Electronic Copy with original or electronic signatures

No agreement required

Utility Joint Use Agreement, Form ROW-U-JUA

1 Electronic Copy with original or electronic signatures **

1 Electronic Copy with original or electronic signatures **

1 Electronic Copy with original or electronic signatures (only for on-system projects) **

Affidavit (Form ROW-U-Affidavit)

1 Electronic Copy with original or electronic signatures and 1 copy of recorded instruments

Required only for Interstate replacement easement or right of way; otherwise, use documents shown for State.

1 copy with original or electronic signatures and 1 copy of recorded instruments

Form ROW-U-48(Statement of Contract Work)

1 Electronic Copy, if applicable

1 Electronic Copy, if applicable

TxDOT form is not required

Estimate & Schedule of Work

1 Electronic Copy

1 Electronic Copy

1 Electronic Copy


1 Electronic Copy

1 Electronic Copy

1 Electronic Copy

Supporting Documentation

1 Electronic Copy ***

1 Electronic Copy ***

1 Electronic Copy ***

* Under the LPA Process, utility agreements are not required when using the actual cost method.

** May be deferred until final billing stage

*** Supporting documentation may not be required for all agreement packages. Grant of Signature Authority only required for documents executed by non-company officers who do not already have signature authorization on file with TxDOT.

For State. The utility will prepare a plan and estimate to support its claim for reimbursement. Additionally, there must be a written agreement stating the separate responsibilities for accomplishing and financing the adjustment work. The Standard Utility Agreement was designed to fit this need. The utility should become familiar with the provisions of 23CFR Parts 645A and B, and amendments, since several provisions of the agreement form provide for compliance with this Federal regulation. The District will complete all spaces at the top of page 1 of the agreement form through the “Entity” section. No other sections of the Standard Utility Agreement apply for the State.

For LPA. On LPA projects with TxDOT cost participation, a written agreement between TxDOT and the utility is not required. However, if desired, the LPA may execute a separate written agreement with the utility .

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Statement of Work

A statement of work is to be provided in the appropriate space of the Standard Utility Agreement. The statement of work must be sufficiently written to provide a clear and general understanding of the work covered by the agreement. Do not use the phrase “see attached plans” in place of a complete statement of work. The description must be in narrative form and must represent the work appearing on the plans and in the estimate. If more space than provided is required, a separate sheet with the heading "Exhibit A" may be attached to the agreement. The statement "See statement of work described on exhibit A" should be inserted in the space provided on the agreement. Examples follow below. The statement of work must include:


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  • Adjust an existing 69 kV transmission line to clear Interstate Highway 10 at highway station 468+42 by installing two 80-foot H-frame suspension structures with double cross-arms, and remove three 50-foot single pole structures. Minimum clearance will be 30 feet over the roadway.
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  • Remove three 50-foot poles with appurtenances and 1,300 feet of 3-phase #4 ACSR wire. Install two 75-foot H frame structures and 3-75 foot single poles with appurtenances along with 1,700-feet of 3-phase #4 ACSR wire between Highway Station nos. 942+00 and 953+00.
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  • Lower approximately 100 feet of 10-inch steel high-pressure gas line at highway Station 182+00 and encase approximately 70-feet with 14-inch steel encasement. Minimum depth of cover under the pavement structure will be 42-inches with 30-inches of cover under ditches. Vent pipes will be placed at each right of way line.
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Methods of Cost Accumulation

The utility must designate on Attachment “B” of the Standard Utility Agreement the procedure by which the adjustment cost will be developed.

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  • Actual Cost Method of Accounting should be designated on Attachment “B” when:
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    • The utility accumulates costs under a work order accounting procedure prescribed by a Federal or State regulatory body; and
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    • The utility proposes to request reimbursement for actual direct and related indirect costs.
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  • Lump Sum Method of Accounting should be designated on Attachment “B” when the utility proposes to request reimbursement based on an agreed lump sum amount supported by a detailed cost analysis.
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Execution by Authorized Representative

Since TxDOT’s Standard Utility Agreement and other utility agreements are binding contracts between the utility and TxDOT, it is necessary that authorized representatives execute the agreements. These representatives of the utility must have been granted such authority under charter or by‑law provisions, a resolution, and/or governing documents of the utility company. The grant of signature authority by the utility ensures that the person signing on behalf of the utility has authority to bind the utility to the terms and conditions of the agreements and documents. Use form ROW-U-40 Signature Authority when obtaining signature authority from the utility company.

Utility companies may also grant signature authority to the authorized person who serves in a specific position at the utility company, rather than naming a particular individual. When a utility company authorizes a certain position of the utility company rather than naming an individual, regardless of who the person is who holds that position at the utility company, that position will continue to have authority to execute documents as an authorized representative of the utility company. Any changes in staffing at the utility company are resolved when the utility company names a position rather than an individual. This allows the signature authority granted by the utility company to remain valid despite the individual person who holds the position.

It is helpful to ask the utility company for a "blanket" authorization that grants signature authority to a specific individual, or a specific position, at the utility company to execute agreements and documents on all highway adjustment work included in the utility’s system. This blanket authorization should be furnished in writing so that it may be maintained in the permanent files of the ROW Program Office, filed with each applicable TxDOT project file, and attached to the Form U-40 Signature Authority. When obtaining a "blanket" authorization from the utility company, any resolutions, ordinances, by‑laws, etc. should be clearly worded to provide general signature authority on all utility adjustment work of the utility, rather than granting signature authorization for the execution of a single, specific agreement.

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Distribution of Assemblies

Upon receipt of the agreements and supporting documents, the Districts will:

Upon agreement approval, the District as executing office will:

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  • forward electronic copy of the executed agreement to the ROW Program Division for record
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  • forward one original agreement assembly to the Utility.

Upon receipt of the executed agreement assembly, the ROW Division will perform the administrative review of the agreement and will issue a review memo to the District. Any conditions mentioned in the ROW Division’s memo will be sent out to the District. A conditional approval requires the conditions to be addressed before any payment will be made. Major changes in the scope of work must be approved by the District in an amendment to the agreement.

The original assembly must be returned to the utility with the District’s letter of authority to proceed with the necessary adjustment work.

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District Letter of Authority

The District’s letter of authority must include the following:

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  • authorize the utility to proceed with the necessary adjustment work
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  • request notification of starting and completion dates
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  • request notification for inspection of salvage materials before disposal by sale or scrap
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  • include any desired special instructions concerning specifications attached or included in the agreement
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  • stress appropriate safety measures and compliance with TMUTCD to be observed
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  • designate the appropriate TxDOT personnel and other responsible parties to be contacted concerning the adjustment work
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  • Buy America Compliance.

Additionally, submissions of billings should include:

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