Appendix 10-10 Sample

SUPPLEMENTAL AGREEMENT IN CONNECTION WITH COST OF

RELOCATING MUNICIPALLY OWNED FACILITIES
MAINTAINED FOR PUBLIC USE
(SUBDIVISION 24, SECTION 10, OF THE HIGHWAY LAW)

Project:

This agreement made the day of 20__, by and between

________________________________________(hereinafter referred to as ASponsor@),
________________________________ and the_____________________________________, a
Municipal Corporation in the County of ____________ and State of New York (hereinafter referred to as
AMunicipality@).

WHEREAS, the parties entered into a contract dated under which, among
other things, the SPONSOR agreed to reimburse the MUNICIPALITY for the cost of relocation of certain
municipally owned facilities maintained for public up to an amount not to exceed $ , except
as such sum might be increased by a supplemental agreement, and

WHEREAS, the said sum of $ set forth in the said agreement dated
is inadequate for the purposes thereof,

NOW, THEREFORE, in consideration of the mutual benefits moving to each of the parties hereto, it is
agreed as follows:
1. The amount of $ set forth in paragraph of the agreement dated
, is hereby increased to $____________
2. The MUNICIPALITY specifically agrees that this Supplemental Agreement shall be deemed
executory only to the extent of the moneys available and that no liability shall be incurred by
the SPONSOR beyond the moneys available for the purpose.
3. Except as provided in this Supplemental Agreement, the terms and provisions of the said
agreement dated , are and shall continue to be in full force and
effect.
IN WITNESS WHEREOF, the parties hereto have executed this agreement on the day and year
first above written.
This Agreement shall commence on , 20 , and shall expire year(s) from that date
unless a Supplemental Agreement is entered into extending the term of this Agreement.
Contract Number:
Agency Certification - “In addition to the acceptance of this contract, I also certify that original
copies of this signature page will be attached to all other copies of this contract.”

ASponsor@

By
Title ___________________________

Municipality
(Affix Seal)
By ________________________

Title ________________________
STATE OF NEW YORK )
) ss:
COUNTY OF )
On this day of 20 , before me personally came to me known, who being by me
duly sworn did depose and say that he resides in the ,New York; that he is the
of the, ,the municipal corporation described in and which executed the
above instrument; that he knows the seal of said municipal corporation, that the seal affixed to said
instrument is such corporate seal; that it was so affixed by order of the
of said municipal corporation pursuant to a resolution which was duly adopted on and to which a certified
copy is attached and made a part hereof; and that he signed his name hereto by like order.

_________________________
Notary Public

RESOLUTION

WHEREAS the State of New York acting by and through its Commissioner of Transportation has
offered to the ________________________________ the sum of ______________________________
for complete reimbursement for work performed by the _________________ pursuant to an agreement
between the _______________________ and said Commissioner, dated ________________ and
entitled, “Agreement in Connection with the Cost of Relocating Municipally Owned Facilities Maintained
for Public Use and Concerning that Particular Project known as: ________________________________

WHEREAS it is a condition precedent that the municipality deliver a release

NOW, THEREFORE, be it resolved by the _____________________________________of the

That the ______________________________of said ________________________________is hereby
authorized to complete all acts and execute any and all specifically the is empowered
to sign all releases necessary in order to obtain the sum previously mentioned.

This is to certify that I,____________________________________________, duly appointed

____________________, have compared the attached resolution with the copy of the original resolution
as entered in my minute book and find the same to be a true and accurate copy thereof. Such resolution
was offered at a duly called meeting on the ______________, at which meeting there were
______ present at roll call and on the proposition of the attached resolution and majority voted in favor of

Subscribed and sworn to

me this ________day of __________, 20____

___________________________
Notary Public