HomeMy WebLinkAbout2022-03-30 Packet - Special MeetingPage 1 of 2
City Council
Special Meeting
AGENDA
(to be held both at the physical and virtual locations below)
Civic Center Council Chamber ♦ 300 Seminary Avenue ♦ Ukiah, CA 95482
To participate or view the virtual meeting, go to the following link: https://zoom.us/j/97199426600
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Alternatively, you may view the meeting (without participating) by clicking on the name of the meeting
at www.cityofukiah.com/meetings.
March 30, 2022 - 5:15 PM
1.ROLL CALL AND PLEDGE OF ALLEGIANCE
2.AUDIENCE COMMENTS ON NON-AGENDA ITEMS
The City Council welcomes input from the audience. If there is a matter of business on the agenda that you are interested in,
you may address the Council when this matter is considered. If you wish to speak on a matter that is not on this agenda, you
may do so at this time. In order for everyone to be heard, please limit your comments to three (3) minutes per person and not
more than ten (10) minutes per subject. The Brown Act regulations do not allow action to be taken on audience comments in
which the subject is not listed on the agenda.
3.NEW BUSINESS
3.a.Consideration and Adoption of Resolutions in Support of Grant Funding Application.
Recommended Action: Adopt resolutions in support of a grant application with the State Water
Resources Control Board and authorize the City Manager or designee to sign all related
application documents, and approve the corresponding budget amendment if the grant is
awarded.
Attachments:
1.Financial Application Package, Ukiah Final
4.ADJOURNMENT
Please be advised that the City needs to be notified 72 hours in advance of a meeting if any specific accommodations or
interpreter services are needed in order for you to attend. The City complies with ADA requirements and will attempt to
reasonably accommodate individuals with disabilities upon request. Materials related to an item on this Agenda submitted
Page 1 of 17
Page 2 of 2
to the City Council after distribution of the agenda packet are available for public inspection at the front counter at the
Ukiah Civic Center, 300 Seminary Avenue, Ukiah, CA 95482, during normal business hours, Monday through Friday,
8:00 am to 5:00 pm.
I hereby certify under penalty of perjury under the laws of the State of California that the foregoing agenda was posted on
the bulletin board at the main entrance of the City of Ukiah City Hall, located at 300 Seminary Avenue, Ukiah, California,
not less than 24 hours prior to the meeting set forth on this agenda.
Kristine Lawler, CMC/City Clerk
Dated: 3/29/22
Page 2 of 17
Page 1 of 1
Agenda Item No: 3.a.
MEETING DATE/TIME: 3/30/2022
ITEM NO: 2022-1516
AGENDA SUMMARY REPORT
SUBJECT: Consideration and Adoption of Resolutions in Support of Grant Funding Application.
DEPARTMENT: Water Resources PREPARED BY:
Jason Benson, Senior Civil Engineer, Dan Buffalo,
Finance Director, Sean White, Water Resources
Director
PRESENTER: Sean White, Water Resources Director
ATTACHMENTS:
1. Financial Application Package, Ukiah Final
Summary: Council will review and consider approval of resolutions in support of a grant application with the
State Water Resources Control Board and authorize the City Manager or designee to sign all related
application documents, and approve the corresponding budget amendment if grant is awarded.
Background: City Staff met with Carollo Engineers and California State Water Resources Control Board
(SWRCB) Staff in early November 2021. The topic of this meeting was to discuss the potential for a Prop. 68
and Infrastructure Grant to fully pay for the overall construction of the project. This would include the cost to
date expended by the City for the design, and may include City Staff costs during construction.
Discussion: Following recent amendments to the Carollo contract, Staff and our consultants worked to
update and finalize Phase 4 design and project cost estimates. Staff and Carollo then met with the SWRCB to
discuss final revisions. As a result of these discussions, the State has offered to contingently fund the project
pending final contract approval.
In order to comply with State funding terms, the City will need to update its Financial Security Package
(Attachment 1). The Financial Security Package, which is one component of the overall application package,
contains the subject resolutions, pages 12 and 13 of the pdf attached here as Attachment 1.
Recommended Action: Adopt resolutions in support of a grant application with the State Water Resources
Control Board and authorize the City Manager or designee to sign all related application documents, and
approve the corresponding budget amendment if the grant is awarded.
BUDGET AMENDMENT REQUIRED: Yes, if grant is awarded.
CURRENT BUDGET AMOUNT: $0
PROPOSED BUDGET AMOUNT: New grant revenue of $53,770,000 to fund 830.
FINANCING SOURCE: Grant
PREVIOUS CONTRACT/PURCHASE ORDER NO.: N/A
COORDINATED WITH: Finance Department: Procurement, Grants, and Special Projects Division
Page 3 of 17
STATE WATER RESOURCES CONTROL BOARD
Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 1 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
Financial Security Package Instructions
Applicant (Entity) Legal Name – Enter the full name of the entity that will be the legal signatory to a financing
agreement.
Proposed Security – Enter the revenues and fund(s) you will use to repay the CWSRF financing.
Project Title – Enter the title of the project.
Contact Person and Phone – Enter the name and phone number of the day-to-day contact for the project.
This person should be able to answer financial questions about the project and application.
1.Financing Amount Requested
Estimate the project costs to be funded with State Water Board CWSRF funds. This amount should match
the Amount of Assistance Requested in Section 1 of the General Information Package.
2.Term Requested
Indicate the financing term you are requesting: 20-year or 30-year (if eligible).
3.Other Project Funding Sources
Describe how the total project will be financed.
ü Enter the name(s) and type(s) of all funding sources.
ü Enter the amount of funds you expect to receive from each source.
ü Check the appropriate box to indicate whether the other sources of financing have been applied for,
approved by the funding agency, or received by the applicant.
ü Submit copies of other funding sources commitment or debt documents.
Example: CWSRF financing $1,000,000
USDA grant $ 500,000
Applicant Agency portion $ 250,000
4.Current Year Median Household Income: Determination by Division
Enter the estimated Median Household Income (MHI) for the proposed project service area, using the most
recent income survey. If an income survey is not available, MHI estimates may be found at the Census
Bureau website at http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml#none. Enter “Median
Household Income in the Past 12 Months” and the municipality name into the Quick Search box. If you cannot
locate data for your community, you may contact the Division at CleanWaterSRF@waterboards.ca.gov for
additional assistance. MHI determinations are considered preliminary and will be finalized once the
complete application is reviewed.
Attachment 1 (City of Ukiah)
Page 4 of 17
Financial Assistance Application Page 2 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
5. Current Year Estimated Population Served
Enter the estimated population of the wastewater system service area.
6. Active Service Connections
If active wastewater service connections are currently and directly served by the wastewater system, enter
the following for each applicable connection type:
ü Number of active wastewater service connections that are currently and directly served by the
wastewater system
ü Projected average monthly service charge that will be in place after the proposed project is
completed
ü Average monthly billing for the last 12 months
Rate increase effective date for projected monthly service charges – Enter the estimated date that the
projected monthly service charges will go into effect (if unknown, assume one year after construction
completion).
7. Projected Annual Operations and Maintenance Costs
Enter the estimated annual costs to operate and fully maintain the proposed project after it is complete.
Operations and maintenance costs include staff salaries, chemicals, utilities, warranties, routine repair and
replacement, laboratory services, billing and collection and life-cycle costs. The consulting engineer should
have included these costs in the Engineering Report. (Attachment T1).
8. Discussion of Material Events, Material Obligation Conditions, and Any Debt Limit
Identify any current, prior, or pending material events such as bankruptcy, defaults, litigation, grand jury
findings, unscheduled draws on reserve funds, substitution of insurers or their failure to perform,
unscheduled draws on credit enhancements, actions taken in anticipation of filing Chapter 9, rating
changes, relevant conditions in material obligations, and any local debt limit.
9. Wastewater Rate Study
Indicate whether a wastewater rate study has ever been performed on your wastewater system as well as
the date of the study and subsequent findings. If you respond yes, please submit a complete copy of the
Wastewater Rate Study.
ATTACHMENTS
F1- Audited Financial Statements: Provide COMPLETE audited financial statements for the most-recent
three fiscal years. If the applicant is not required to complete audited financial statements, the applicant should
provide the three most-recent years of Federal and State tax returns.
Identify any restricted funds and the reason for the restrictions as well as all sources of security to be pledged.
If using real property, provide at least two appraisals of the value, how the value was determined, and whether
the property is currently pledged as security on any other debt.
Attachment 1 (City of Ukiah)
Page 5 of 17
Financial Assistance Application Page 3 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
F2 - Budget Projections (Revenue/Expense): Provide projections for at least the next two fiscal years.
Sample of Projections
Operating Revenue Projections
2020/21
Projections
2021/22
Wastewater Sales $2,552,866 $2,680,509
Utility Billing Charges $830,000 $871,500
Wastewater Discharge Fee $15,000 $15,750
Connection Fees $475,000 $498,750
Other Income $25,000 $26,250
Other Non-Operating Revenue
Interest Income $7,000 $7,350
Property Tax $1,200,300 $1,260,315
Other Misc. Income $2,000 $2,100
Total Revenue $5,107,166 $5,362,524
Operating Expenses
Salaries $1,500,000 $1,575,000
Operating Supplies $500,000 $525,000
Repair and Maintenance $78,000 $81,900
Professional Fees $30,000 $31,500
Legal $20,000 $21,000
Lease/Rents $950,000 $997,500
Utility Billing Service $300,000 $315,000
Total Operating Expenses $4,578,000 $4,806,900
Net Revenue $529,166 $555,624
Existing Debt Service $93,000 $93,000
Total Net Revenue after Debt Service $436,166 $462,624
F3 – Tax Questionnaire: To be completed and submitted with an application for all loan projects
(except for privately-owned entities). The Tax Questionnaire provides basic information about project costs,
accounting, and who will own and operate the project. The applicant’s response to the Tax Questionnaire and
Reimbursement Resolution (below) are reviewed by the State Water Board’s CWSRF tax attorney to determine
whether the applicant is eligible to receive funds from tax-exempt revenue bond sales. This item is not required
if the applicant is applying for 100% percent grant/principal forgiveness funding.
F4 – Reimbursement Resolution: All loan applicants that are publicly-owned entities are required to submit
an adopted Reimbursement Resolution for review by the CWSRF tax attorney. The language may not vary
from the language provided in the template. The Reimbursement Resolution should be a stand-alone
resolution. This item is not required if the applicant is applying for 100% percent grant/principal forgiveness
funding.
Attachment 1 (City of Ukiah)
Page 6 of 17
Financial Assistance Application Page 4 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
F5a – Authorizing Resolution/Ordinance (for use by publicly owned entities): This resolution or ordinance
designates the Authorized Representative(s) for the project, who will have the authority to sign and submit the
CWSRF application materials, certify compliance with applicable state and federal laws, execute the financial
assistance agreement and amendments, and certify disbursement requests.
v To minimize the potential for problems, use the exact language in the template resolution.
v Enter the title of the Authorized Representative, NOT a person’s name.
v Do not modify the words financing or financial assistance to other terms such as “loan”, “grant”,
or “principal forgiveness”. Use of these terms will create legal complications; the terms
“financing” and “financial assistance” are broad enough to be applicable to all of the above.
F6 – Rate Adoption Resolution, Copy of Rates, and Public Notice of Proposition 218 Meeting: Attach a
copy of the most recent board resolution, ordinance, or similar document which approved the rates currently in
place, a copy of the rates, and a copy of the Proposition 218 pubic meeting notice.
F7 – Schedule of Related Debt and Debt Document Copies: Submit a schedule of all material debt secured
by the Pledged Revenues and Fund(s), along with a copy of each relevant debt document (e.g., loans, private
placements, bond indentures, installment sale agreements, etc.). If there are any pending debts, provide draft
or estimated information. This schedule will be an exhibit to the CWSRF financing agreement and will rank
related debt according to priority in relation to the proposed CWSRF debt (senior, parity, or subordinate tier). If
the applicant has no other debt (except other CWSRF debt), the Authorized Representative must provide a
letter stating this. In most cases, the CWSRF debt will be on parity with related debt.
F8- Debt Management Policy: Applicant needs to submit a copy of their debt management policy. Guidance
on Complying with SB 1029 Release Date: December 28, 2016-
http://www.treasurer.ca.gov/cdiac/sb1029/guidance.pdf (not applicable if 100% grant/principal forgiveness
funding).
F9 – New Special Tax, Assessment District, or service charge projections: If applicable, provide budget
projections based on proposed taxes, fees, charges or assessments (No template exists). Label the projections
as Attachment F9.
F10 – Relevant Service, Management, Operating, or Joint Powers Agreements: If applicable, provide a
copy of any relevant, service, management, operating or joint powers agreements and any amendments (No
template exists). Label the agreement as Attachment F10.
F11 – District Certification of Interim Report (For School Districts Only): School Districts should provide a
complete copy of their most-recent District Certification of Interim Report, including the signed Criteria and
Standards Review Section.
Attachment 1 (City of Ukiah)
Page 7 of 17
Financial Assistance Application Page 5 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
FINANCIAL SECURITY PACKAGE
(CONSTRUCTION)
Applicant (Entity) Legal Name:
Pledged Revenues And Fund(s) For The Project:
Project Title:
Contact Person: Phone:
1.Amount of Assistance Requested: $
2.Term Requested:20-Year 30-Year (If Eligible)
3.Other Project Funding Sources
Name and Type of
Funding Sources Amount Applied Approved Received
$
$
$
4.Current Year Median Household Income: $
5a. Current Year Estimated Population Served:
5b. Current Year Estimated Number of Residences:
5c. Current Year Estimated Number of Permanently Occupied Residences:
(Only required if applying for grant funding/principal forgiveness)
6.Active Service Connections Not Applicable
Service Connection Type Number of Service Connections
Average Monthly Billing
(Last 12 months)
Per Connection
Residential $
Commercial $
Industrial $
Other $
TOTAL $
Rate increase effective date for projected monthly service charges:
7.Projected Annual Operations and Maintenance Costs,
Including amortized replacement costs (upon
completion):
$
Attachment 1 (City of Ukiah)
Page 8 of 17
Financial Assistance Application Page 6 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
8. Discussion of Material Events, Material Obligation Conditions, and Any Debt Limit
Identify any current prior material events such as bankruptcy, defaults, litigation, grand jury findings, unscheduled draws on reserve
funds, substitution of insurers or their failure to perform, unscheduled draws on credit enhancements, actions taken in anticipation of
filing Chapter 9, rating changes, relevant conditions in material obligations, and any local debt limit.
9. Rate Study
Has a rate study been conducted for your system? Yes No
If yes, please submit a complete copy of the Rate Study.
10. Debt Management Policy
Please provide a copy of your Debt Management Policy (If Applicable).
ATTACHMENTS (Check the box next to each item attached to your application.)
F1 – AUDITED FINANCIAL STATEMENTS OR TAX RETURNS (3 Years)
F2 – BUDGET PROJECTIONS (REVENUE/EXPENSE) (2 years – or more if needed)
(See Sample in Application Instructions)
F3 – TAX QUESTIONNAIRE
F4 – REIMBURSEMENT RESOLUTION
F5a – AUTHORIZING RESOLUTION
F6 – RATE ADOPTION RESOLUTION, COPY OF RATES, AND PUBLIC NOTICE OF
PROPOSITION 218 MEETING
F7 – SCHEDULE OF ALL MATERIAL DEBT OR NO DEBT LETTER
(See Application Instructions)
F8 – DEBT MANAGEMENT POLICY (If Applicable)
F9 – NEW SPECIAL TAX, ASSESSMENT DISTRICT, OR SERVICE CHARGE
PROJECTIONS (If Applicable)
F10 – RELEVANT SERVICE, MANAGEMENT, OPERATING, OR JOINT POWERS
AGREEMENTS (If Applicable)
F11 – SCHOOL DISTRICT CERTIFICATION OF INTERIM REPORT (If Applicable)
Attachment 1 (City of Ukiah)
Page 9 of 17
Financial Assistance Application Page 7 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
Attachment F3
STATE WATER RESOURCES CONTROL BOARD
STATE REVOLVING FUND PROGRAM
TAX QUESTIONNAIRE (Version April 2015)
LEGAL NAME OF APPLICANT
State Use Only:
Project No. DATE/TIME REC’D BY
SWRCB
Instructions: Answer all and provide all information and documents requested. Begin typing in the shaded area and the space will
enlarge to accommodate the information that is typed. In lieu of typing in the shaded areas for any question, a separate page may be
attached to this Tax Questionnaire or an electronic file in Word format may be attached.
Certain Definitions: As used in this Tax Questionnaire, "Project" means the facilities and/or capital improvements that you described
in the Financial Assistance Application submitted to the State Water Board and constitutes those costs that will be funded by the State
Water Board under the Financing Agreement (a template Financing Agreement can be found on the State Water Board’s website),
“Governmental Entity” means a state, city, county, town, public school district, other special district or joint powers authority, and
"Non-Governmental Entity" means any person, partnership, corporation or other organization that is not organized as a state, city,
county, town, public school district, other special district or joint powers authority. The federal government constitutes a Non-
Governmental Entity. A Section 501(c)(3) organization constitutes a Non-Governmental Entity.
1. Briefly describe the Project, its functions and its principal components.
2. Indicate by principal components your current estimates of the costs of the Project, as follows:
a. Construction costs ............................................................................................... $
b. Equipment costs .................................................................................................. $
c. Land Purchase ..................................................................................................... $
d. Rehabilitation or renovation of facilities ............................................................. $
e. Site preparation costs .......................................................................................... $
f. Architectural/engineering, design and planning costs ......................................... $
g. Engineering and administrative costs during construction .................................. $
h. Surveys ............................................................................................................... $
i. Legal fees ............................................................................................................ $
j. Financing costs ................................................................................................... $
k. Commitment fees and deposits ........................................................................... $
l. Other construction costs (please specify) ............................................................ $
m. Other planning/design costs (please specify) ...................................................... $
3. Will any portion of the financing provided under the Financing Agreement be used to refinance other debt(s) (e.g.,
including any bonds, notes, leases or commercial paper) relating to the Project?
Yes No Not Applicable
4. If you answered “yes” to Question #3, please state the amount of financing provided under the Financing Agreement that is
expected to be used for refinancing purposes.
$
Attachment 1 (City of Ukiah)
Page 10 of 17
Financial Assistance Application Page 8 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
5.If you answered “yes” to Question #3, please specify the date(s) on which the financing provided under the Financing
Agreement will be used to redeem other debt(s) relating to the Project.
6.If you answered “yes” to Question #3, please provide the following information:
a.Name of the existing indebtedness to be refinanced:
b.Issue date of the existing indebtedness:
c.Par amount of the existing indebtedness:
d.Purpose(s) of the existing indebtedness:
e.Whether the existing indebtedness is immediately prepayable:
f.Whether the interest on the existing indebtedness is federally taxable or tax-exempt:
7.If you answered “yes” to Question #3, are any proceeds of the other debt(s) relatin g to the Project still unspent?
Yes No Not Applicable
If yes, please identify the amounts and the funds or accounts in which such proceeds are on deposit.
8.If you answered “yes” to Question #3, was the other debt(s) to be refinanced with the financing provided under the
Financing Agreement used to refinance other prior debt(s) relating to the Project?
Yes No Not Applicable
If yes, please provide the name of the original indebtedness, the issue date of the original indebtedness, the par amount of the
original indebtedness, the purpose(s) of the original indebtedness, and whether the interest on the original indebtedness was
federally taxable or tax-exempt.
9.Will any portion of the financing provided under the Financing Agreement be used for new financing of the Project?
Yes No Not Applicable
10. If you answered “yes” to Question #9, please provide the dates of expected commencement and completion of construction
of the Project.
Expected Commencement Date of Project: ............................
Expected Completion Date of Project: ....................................
11. If you answered “yes” to Question #9, please state the amount of the financing provided under the Financing Agreement
that is expected to be used for new financing purposes. If you answered “no” to Question #9, skip to Question #18 below.
$
12. If you answered “yes” to Question #9, please state the amount of Project costs to be newly financed under the Financing
Agreement that are expected to be paid within the following periods of time:
Please respond to this question using the expected initiation date of construction.
Project costs to be spent within 6 months ......................................................................... $
Project costs to be spent within 12 months (cumulative) .................................................. $
Project costs to be spent within 18 months (cumulative) .................................................. $
Project costs to be spent within 24 months (cumulative) .................................................. $
Project costs to be spent within 30 months (cumulative) .................................................. $
Project costs to be spent within 36 months (cumulative) .................................................. $
Project costs to be spent beyond 36 months (cumulative) ................................................. $
Attachment 1 (City of Ukiah)
Page 11 of 17
Financial Assistance Application Page 9 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
13. If you answered “yes” to Question #9, have you paid any costs of the Project prior to the date hereof?
Yes No Not Applicable
For each Project cost that has been previously paid, please provide an itemization of the following:
a. Amount of the payment .............................................................................................
b. Purpose of the payment ..............................................................................................
c. Date of the Payment ...................................................................................................
d. Source of payment of such cost (e.g., revenue,
federal or state grants, other financing, internal loan) ................................................
14. If you answered "yes" to Question #13, have you at any time adopted a resolution or other official action (e.g., a so-called
“reimbursement resolution”) relating to your intent to finance the Project with financial assistance from the State Water
Board or other indebtedness?
Yes No Not Applicable
If yes, please identify the date of such resolution or other document and attach a copy.
15. If you answered “yes” to Question #9, will any portion of the financing provided under the Financing Agreement be used
to pay administrative or engineering expenses directly relating to the construction of the Project?
Yes No Not Applicable
If yes, please state the amount expected to be so used and provide details as to its calculation (e.g., based on actual costs or a
percentage of construction).
16. If you answered “yes” to Question #15, will any portion of the administrative or engineering expenses directly relating to
the construction of the Project be incurred by the staff of the Applicant?
Yes No Not Applicable
If yes, please state the amount expected to be so used and provide details as to its calculation (e.g., based on actual costs or a
percentage of construction).
17. If you answered "yes" to Question #16, will the administrative or engineering expenses directly relating to the
construction of the Project be tracked by an accounting system, such as a cos t accounting system, that will allow them to
be differentiated from other charges for other work done by the applicant’s staff?
Yes No Not Applicable
If yes, please specify how charges will be tracked.
18. Does any Non-Governmental Entity own, or do you anticipate any Non-Governmental Entity owning, any portion of the
Project at any time during the term of the financing?
Yes No Not Applicable
If yes, identify the Non-Governmental Entity and provide all available details with respect to its ownership interest.
Attachment 1 (City of Ukiah)
Page 12 of 17
Financial Assistance Application Page 10 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
19. Does any Non-Governmental Entity lease, or do you anticipate any Non-Governmental Entity leasing, any portion of the
Project at any time during the term of the financing?
Yes No Not Applicable
If yes, identify the Non-Governmental Entity and provide all available details with respect to its lease interest.
20. Have you entered, or do you anticipate entering, into any inter-municipal contract or agreement(s) with any Governmental
Entity with respect to the Project (or any portion of the Project) during the term of the financing?
Yes No Not Applicable
If yes, please describe the purpose of each such agreement, and attach a copy of any existing or contemplated agreement.
21. Have you entered, or do you anticipate entering, into any contract or agreement any Non-Governmental Entity
contracting to operate, manage or provide any exclusive services with respect to the Project (or any portion of the Project)
during the term of the financing?
Yes No Not Applicable
If yes, please identify the Non-Governmental Entity and explain the arrangement. If an operations, management or exclusive
services contract currently exists, please attach a copy. Contracts that relate solely to services that are merely incidental to
the primary use of the Project need not be listed. Examples of incidental services are contracts for janitorial services, of fice
equipment repairs or billing services. If you are uncertain as to whether the contract is incidental or not, please describe the
contract and the services provided thereunder.
22. Does the Project provide, or do you anticipate the Project providing, water or wastewater services to any Non-
Governmental Entity other than on the basis of standard rates and charges which are generally applicable and uniformly
applied and are adjusted from time to time by the Applicant?
Yes No Not Applicable
If there are or will be any non-standard rates and charges, describe the rate structure, focusing on any special rate agreements
or charges for specific entities. An example of a non-standard rate is an industrial user paying a flat fee in a system where
the other users pay a rate based on usage.
23. Does any Non-Governmental Entity have, or do you anticipate any Non-Governmental Entity having, special priority
rights or other preferential rights to use the Project or the services of the Project pursuant to any contractual or other
arrangement?
Yes No Not Applicable
If yes, please identify the Non-Governmental Entity, and describe the special priority or preferential right(s).
24. Are the functions and services of the entire Project available, and do you expect the functions and services of the entire
Project will be available, for use by the general public on a first-come, first-served basis?
Yes No Not Applicable
If no, please explain and describe the portion of the Project that is not, or will not, be available for use by the general public.
For example, municipal water and wastewater systems used for residenti al, commercial, governmental and business purposes
are available for use by the general public; a specialized pollution control facility immediately adjacent to a private business
that is the sole user of the facility is not available for use by the genera l public.
Attachment 1 (City of Ukiah)
Page 13 of 17
Financial Assistance Application Page 11 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
25. Have you entered, or do you anticipate entering, into a “take” or “take-or-pay” contract with any Non-Governmental
Entity for use of any portion of the Project or the services of the Project?
Yes No Not Applicable
If yes, please identify the Non-Governmental Entity, and describe the arrangement therewith. If a take or a take-or-pay
contract currently exists, please attach a copy.
26. Will any Non-Governmental Entity guarantee or otherwise be directly obligated to repay the financial assistance provided
under the Financing Agreement?
Yes No Not Applicable
If yes, please identify the Non-Governmental Entity, and describe the guarantee arrangement therewith.
27. Have you received, or do you expect to receive, any grant or other form of assistance for financing of any portion of the
Project from the State of California, the federal government or any other entity or person?
Yes No Not Applicable
If yes, please explain.
28. Will any portion of the financing projected under the Financing Agreement be used as a substitute for other funds which
were otherwise to be used as a source of financing and which have been used or will be used to acquire, directly or
indirectly, other investment property?
Yes No Not Applicable
If yes, please explain.
APPLICANT ACKNOWLEDGEMENT AND SIGNATURE
I hereby certify that I am an authorized representative of the Applicant, and that I am authorized by
the Applicant to execute this Tax Questionnaire. I am charged with the responsibility to perform such
acts as are necessary and proper for the financing, construction, acquisition and/or improvement of
the Project, and am acting for and on behalf of the Applicant in executing this Tax Questionnaire. I
certify that I am familiar with the Project and that all information contained herein is true, correct and
complete to the best of my knowledge. I am not aware of any facts or circumstances that would
cause me to question the accuracy or reasonableness of any information contained in these
responses or attached documentation. I understand that the foregoing information and attached
documentation will be relied upon by the State Water Board and their counsel, in providing financing
with respect to the Project.
AUTHORIZED REPRESENTATIVE
SIGNATURE
PRINT NAME AND TITLE DATE
Attachment 1 (City of Ukiah)
Page 14 of 17
Financial Assistance Application Page 12 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
Attachment F4
REIMBURSEMENT RESOLUTION
WHEREAS, the __________________________________ (the "Agency") desires to finance the costs of
(Agency Name)
constructing and/or reconstructing certain public facilities and improvements relating to its water system, including certain
treatment facilities, pipelines and other infrastructure (the "Project"); and
WHEREAS, the Agency intends to finance the construction and/or reconstruction of the Project or portions of the Project
with moneys ("Project Funds") provided by the State of California, acting by and through the State Water Resources
Control Board (State Water Board); and
WHEREAS, the State Water Board may fund the Project Funds with proceeds from the sale of obligations the interest
upon which is excluded from gross income for federal income tax purposes (the "Obligations"), and
WHEREAS, prior to either the issuance of the Obligations or the approval by the State Water Board of the Project Funds
the Agency desires to incur certain capital expenditures (the "Expenditures") with respect to the Project from available
moneys of the Agency; and
WHEREAS, the Agency has determined that those moneys to be advanced on and after the date hereof to pay the
Expenditures are available only for a temporary period and it is necessary to reimburse the Agency for the Expenditures
from the proceeds of the Obligations.
NOW, THEREFORE, THE AGENCY DOES HEREBY RESOLVE, ORDER AND DETERMINE AS FOLLOWS:
SECTION 1. The Agency hereby states its intention and reasonably expects to reimburse Expenditures paid prior to
the issuance of the Obligations or the approval by the State Water Board of the Project Funds.
SECTION 2. The reasonably expected maximum principal amount of the Project Funds is $_____________.
{Remove this Note when completing the Resolution: Please include the maximum reasonable project amount. Your SRF
financing agreement will not exceed this amount under any circumstances.}
SECTION 3. This resolution is being adopted no later than 60 days after the date on which the Agency will expend
moneys for the construction portion of the Project costs to be reimbursed with Project Funds.
SECTION 4. Each Agency expenditure will be of a type properly chargeable to a capital account under general federal
income tax principles.
SECTION 5. To the best of our knowledge, this Agency is not aware of the previous adoption of official intents by the
Agency that have been made as a matter of course for the purpose of reimbursing expenditures and for which tax-exempt
obligations have not been issued.
SECTION 6. This resolution is adopted as official intent of the Agency in order to comply with Treasury Regulation
§1.150-2 and any other regulations of the Internal Revenue Service relating to the qualification for reimbursement of
Project costs.
SECTION 7. All the recitals in this Resolution are true and correct and this Agency so finds, determines and
represents.
AYES: _______
NOES: _______
ABSENT: _______
CERTIFICATION
I do hereby certify that the foregoing is a full, true, and correct copy of a resolution duly and regularly adopted at a
meeting of the _____________________________________________ held on __________________.
(Governing Board of the Agency) (Date)
(Name, Signature, and Seal of the Clerk or Authorized Record Keeper of the Governing Board of the Agency)
Attachment 1 (City of Ukiah)
Page 15 of 17
Financial Assistance Application Page 13 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
Attachment F5a
AUTHORIZING RESOLUTION/ORDINANCE
RESOLUTION NO: _____________________
WHEREAS _____________________________________________________________________________
(insert appropriate findings)
RESOLVED BY THE _______________________________________________________________OF THE
(insert name of Governing Board of the Entity)
________________________________________________________________ (the “Entity”), AS FOLLOWS:
(insert Entity name)
The ____________________________________________ (the “Authorized Representative”) or designee is
(insert Title of Authorized Representative)
hereby authorized and directed to sign and file, for and on behalf of the Entity, a Financial Assistance
Application for a financing agreement from the State Water Resources Control Board for the planning, design,
and construction of ___________________________________________________________ (the “Project”).
(insert Project Name)
This Authorized Representative, or his/her designee, is designated to provide the assurances, certifications,
and commitments required for the financial assistance application, including executing a financial assistance
agreement from the State Water Resources Control Board and any amendments or changes thereto.
The Authorized Representative, or his/her designee, is designated to represent the Entity in carrying out the
Entity’s responsibilities under the financing agreement, including certifying disbursement requests on behalf of
the Entity and compliance with applicable state and federal laws.
CERTIFICATION
I do hereby certify that the foregoing is a full, true, and correct copy of a resolution duly and regularly adopted
at a meeting of the ___________________________________________________________ held
(insert name of Governing Board of the Entity)
on ______________________.
(Date)
(Name, Signature, and Seal of the Clerk or Authorized Record Keeper of the Governing Board of the Agency)
Attachment 1 (City of Ukiah)
Page 16 of 17
Financial Assistance Application Page 14 of 14 Financial Security Package (Construction)
(Rev. 12/2019) Clean Water State Revolving Fund
Water Recycling Funding Program
Attachment F7
SCHEDULE OF SYSTEM OBLIGATIONS
Except for the following and the Obligation evidenced by this Agreement, the Recipient certifies that it has no outstanding
System Obligations and that it is in compliance with all applicable additional debt provisions of the following:
The following related debts are senior to the proposed CWSRF financing:
Name of Lender
and Title of Debt
or Loan Number
Debt Security or
Source of
Revenue
Debt Service
Coverage
Requirement
Original
Debt
Amount
Current
Balance
Payment
Amount
Interest
Rate
Debt Term &
Maturity Date
$$$/
$$$/
$$$/
The following related debts are on parity to the proposed Financing Agreement:
Name of Lender
and Title of Debt
or Loan Number
Debt Security or
Source of
Revenue
Debt Service
Coverage
Requirement
Original
Debt
Amount
Current
Balance
Payment
Amount
Interest
Rate
Debt Term &
Maturity Date
$$$/
$$$/
$$$/
$$$/
$$$/
The following related debts are subordinate to the proposed Financing Agreement:
Name of Lender
and Title of Debt
or Loan Number
Debt Security or
Source of
Revenue
Debt Service
Coverage
Requirement
Original
Debt
Amount
Current
Balance
Payment
Amount
Interest
Rate
Debt Term &
Maturity Date
$$$/
$$$/
$$$/
$$$/
$$$/
Attach copies of the debt documents associated with the above debts.
Attachment 1 (City of Ukiah)
Page 17 of 17