UPR Reimbursement Agreement Preliminary Engineering 06-10-2021DocuSign Envelope ID: BEBF4945-CA29-4CCA-BAF9-051051E55317
6/10/2021
2
DocuSign Envelope ID: BEBF4945-CA29-4CCA-BAF9-051051E55317
Tiecy Cotton
Exhibit A Project Description and Location
Project Description
City of Salina, KS proposes to remove the existing 470 ft. crossing surface and install new 470 ft. crossing surface at the crossing referred to below.
Location
Sid Ind. Ld.
DOT
814181G
Crossing Type
Public
Milepost Street Name
550.86 South 4th Street
DocuSign Envelope ID: BEBF4945-CA29-4CCA-BAF9-051051E55317
Exhibit B
Scope of Project Services
DocuSign Envelope ID: BEBF4945-CA29-4CCA-BAF9-051051E55317
Exhibit C
Billing Contact Information
Name
Title
Address
Work Phone
Cell Phone
Email
Agency Project No.
DocuSign Envelope ID: BEBF4945-CA29-4CCA-BAF9-051051E55317
Certificate Of Completion
Envelope Id: BEBF4945CA294CCABAF9051051E55317 Status: Completed
Subject: Please Review & Execute: PE > KS > SALINA > S 4TH STREET > DOT 814181G
Source Envelope:
Document Pages: 5 Signatures: 1 Envelope Originator:
Certificate Pages: 5 Initials: 0 Alex Campbell
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central America
acampbe@upcontractor.up.com
IP Address: 198.47.204.197
Record Tracking
Status: Original
6/2/2021 1:34:50 PM
Holder: Alex Campbell
acampbe@upcontractor.up.com
Location: DocuSign
Signer Events Signature Timestamp
Tiecy Cotton
TMCOTTON@UP.COM
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.47.204.138
Sent: 6/2/2021 1:38:03 PM
Viewed: 6/10/2021 12:37:37 PM
Signed: 6/10/2021 12:54:26 PM
Electronic Record and Signature Disclosure:
Accepted: 6/10/2021 12:37:37 PM
ID: 3566bf97-8b5b-4163-81ef-d413e533932e
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Dan Stack
Dan.stack@salina.org
Security Level: Email, Account Authentication
(None)
Sent: 6/10/2021 12:54:27 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Ryan Wright
rwright@upcontractor.up.com
Security Level: Email, Account Authentication
(None)
Sent: 6/10/2021 12:54:28 PM
Electronic Record and Signature Disclosure:
Accepted: 5/25/2021 9:33:39 PM
ID: e179c2c4-a41d-4c3f-8dd8-b507e385d1da
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 6/2/2021 1:38:03 PM
Certified Delivered Security Checked 6/10/2021 12:37:37 PM
Signing Complete Security Checked 6/10/2021 12:54:26 PM
Completed Security Checked 6/10/2021 12:54:28 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
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Electronic Record and Signature Disclosure created on: 10/10/2019 12:19:52 PM
Parties agreed to: Tiecy Cotton, Ryan Wright
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