UNIFORM APPLICATION FORM FOR MONTANA PUBLIC FACILITY PROJECTS

Transcription

1 UNIFORM APPLICATION FORM FOR MONTANA PUBLIC FACILITY PROJECTS SECTION A - CERTIFICATION (Please type or print legibly) To the best of my knowledge and belief, the information provided in this application and in the attached documents is true and correct. John Charles Fleming Name (printed): President Title (printed): Chief Elected Official or Authorized Representative Signature: Date: SECTION B - SUMMARY INFORMATION 1. Hebgen Lake Estates County Water and Sewer District NAME OF APPLICANT(S): 2. County Water and Sewer District TYPE OF ENTITY: FEDERAL TAX ID NUMBER: 4. Drinking Water TYPE OF PROJECT: 5. 32, 64 SENATE AND HOUSE DISTRICTS: Sen. Pat Flowers, Rep. Kerry White 5.a NAMES OF SENATOR(S) AND REPRESENTATIVE(S): POPULATION SERVED BY PROJECT: 6.a 151 NUMBER OF HOUSEHOLDS SERVED BY PROJECT: DUNS Number: 33

2 8. CHIEF ELECTED OFFICIAL OR AUTHORIZED REPRESENTATIVE: 9. PRIMARY ENTITY CONTACT PERSON: John Charles Fleming John Carstensen (Name) President (Title) (Name) Manager (Title) PO Box 225 PO Box 225 West Yellowstone, MT West Yellowstone, MT (406) PROJECT ENGINEER/ARCHITECT: Scott Bueker (Name of Engineer) AE2S (Name of Firm) 1288 N 14th Ave unit 103 Bozeman, MT (406) scott.bueker@ae2s.com 11. GRANT/LOAN ADMINISTRATOR: (Name) (Title) 12. LEGAL COUNSEL: 13. BOND COUNSEL: Art Wittich Robert Murdo (Name) Attorney, Montana Law Company (Title) (Name) (Title) (Name) (Title) 602 S Ferguson, Suite North Ewing 14. CLERK/CHIEF FINANCIAL OFFICER: 15. ACCOUNTANT: Myron Moore Terry Johnson (Name of Accountant) (Name of Firm) Attorney, Jackson, Murdo & Grant Bozeman, MT Helena, MT (406) (406) art@law-advisor.com Treasurer PO Box 225 Williams, Staker & Bartle 1700 W Koch St West Yellowstone, MT Bozeman, MT (406) (406) myronkarenmoore@aol.com news1@montana.com 34

3 16. BRIEF PROJECT SUMMARY: (Refer to instructions and examples) Historical Information - Hebgen Lake Estates County Water and Sewer District (District) formed in The District provides water and wastewater services to users within its boundary with a full buildout of 151 EDU. There are presently 96 lots developed, and about 60% of residents are full time. Problem - The water system is operating with one well, whereas two wells are required to meet the DEQ standards. The existing backup well on the system is manually isolated and does not meet the arsenic standard. Proposed Solution - Construct a second well in proximity to the existing supply well, where arsenic concentrations are compliant with the standard. Two candidate sites will be evaluated for capacity and quality prior to constructing the production well. New pumping equipment is also being purchased for the existing well. SECTION C - FINANCIAL INFORMATION 1. ESTIMATED TOTAL PROJECT COST: 412, PROPOSED FUNDING SOURCES (List loans and grants from same funding source separately) (Refer to the instructions and examples): Source Type of Funds Amount Status of Commitment Loan Rates and Terms SRF Loan $412,797 Uncommitted 2.5%, 20 yrs 35

4 3. FUNDING STRATEGY NARRATIVE Funding Strategy Narrative (Complete and attach) (Refer to the instructions. Answer each question individually.) a. What are the conditions on the use of each source of funds? b. When will each source of funds listed be available (month and year)? c. Is there any additional information on the level of commitment for each source of funds listed? d. How will funding sources be coordinated with each other? e. Will interim-loan funds be required as part of the project? If yes, how will they be used and coordinated with other funding sources? f. What other sources of funds from public and private sources have been considered for this project? Explain why they are not being pursued or used for this project. g. If a particular source of funding is not obtained, how will the applicant proceed? Explain how the funding strategy will change if a particular source of funding is not received. h. What is the level of local financial participation in the project and is that level the maximum that the applicant can reasonably provide? 4. PROJECT BUDGET FORM Project Budget Form (Complete form on next page) (Refer to the instructions and example) Project Budget Narrative (Complete and attach) (Refer to the instructions and example) SEE ATTACHED PAGE FOR RESPONSES TO SECTIONS 3 AND 4. 36

5 Hebgen WSD Uniform Application February 7, FUNDING STRATEGY NARRATIVE a. What are the conditions on the use of each source of funds? The funds will be used to pay for the Well #3 project. b. When will each source of funds listed be available (month and year)? The District desires June-July c. Is there any additional information on the level of commitment for each source of funds listed? No. d. How will funding sources be coordinated with each other? As there is only one funding source, no coordination is required. e. Will interim-loan funds be required as part of the project? None are under consideration at this time. If the funding agency were to offer/recommend use of these funds they may benefit project schedule. f. What other sources of funds from public and private sources have been considered for this project? The project is not considered sufficiently competitive to be awarded RRGL or TSEP grant funds. The SRF loan is the lowest interest rate available. g. If a particular source of funding is not obtained, how will the applicant proceed? If an SRF loan (or combination loan grant) is not obtained, the District may secure funds through a private lender or by re-applying to the SRF Program a second time. h. What is the level of local financial participation in the project? The loan will be paid 100% by District customers. 4. BUDGET NARRATIVE A detailed budget estimate and financial analysis is provided in the PER. The project budget items have been estimated based on vendor quotations, prior bidding data for similar projects, discussion with SRF Program staff, and engineering opinion. The budget is including a 10% contingency for engineering and construction.

6 M. Cunnane, PE Hebgen Lake Estates County Water and Sewer District Completed by: For: 2/7/2019 Date: ADMINISTRATIVE and FINANCIAL COSTS: SOURCE: SOURCE: SOURCE: SOURCE: SOURCE: TOTAL SRF Personnel Costs 3,000 Office Costs Grant & Loan Administration Services Legal Costs Audit Fees Travel & Training Loan Fees Loan Reserves Interim Interest Bond Counsel and Related Costs TOTAL ADMINISTRATIVE/FINANCIAL COSTS 0 1,551 7,000 1, ,000 46, ,000 74,638 ACTIVITY COSTS: Land Acquisition Engineering Basic Services Engineering Resident Project Representative Services Engineering - Additional Services Construction Contingency TOTAL ACTIVITY COSTS TOTAL PROJECT COSTS 0 27,912 31, ,190 31, , ,797 37

7 5. CURRENT DEBT (Refer to the instructions and example on pages 23-24) Year Issued Purpose Type of Bond/ Security Amount Maturity Date (mo/yr) Debt Holder Coverage Requirement Avg. Annual Payment Amount Outstanding Balance 2011 WWTP Revenue 279,000 7/2033 US Bank 120% 18, , CURRENT ASSETS (Indicate if assets are obligated.) (Refer to the instructions on pages ) Cash (Details) First Security Checking (12/31/2018) Investments (Details) Certificates of Deposit (Details) Accounts Receivable Water and Sewer Service (12/31/2018) (Details) Any other current assets not specifically indicated above (Details) Delinquent accounts assessed as taxes by Gallatin County 122, , , BALANCE SHEET (Submit if applying to RD; contact the other programs to determine if or when this information is needed.) Balance Sheet (Check if attached) 8. INCOME AND EXPENSE STATEMENT (Submit if applying to RD; contact the other programs to determine if or when this information is needed.) Income and Expense Statement (Check if attached) 38

8 SECTION D - CENSUS INFORMATION Do not fill in this section. The following information will be completed by the receiving agency using data supplied by the U.S. Bureau of the Census and the U.S. Department of Housing and Urban Development based on Census data. 1. MEDIAN HOUSEHOLD INCOME 2. LOW TO MODERATE INCOME PERSONS: The percent of the population at or below the level designated as low to moderate income. 3. POVERTY: The percent of the population characterized as at or below the level designated as poverty. $ % % SECTION E - SYSTEM INFORMATION (Refer to instructions) 55 Number of unimproved properties in jurisdiction: Complete and attach the System Information Worksheet. The figures required for the items listed below that are denoted with an are computed using the System Information Worksheet. The letter in parenthesis following the denotes the location in the worksheet to find the figure to be inserted. Current Projected 1. Total System Annual Revenue 23,880 54, Total System Annual Operation and Maintenance Costs 3. Total System Equivalent Dwelling Units* (e) for current and (k) for projected 23,880 29, Total Residential Equivalent Dwelling Units* (f) for current and (m) for projected 5. Annual Revenue from Residential Hookups 96 23, , Percent of Total Annual Revenue from Residential Hookups 7. Average Monthly Residential Rate 8. Other System Average Monthly Residential Rate 100% / 10.00** / Check box if this is a flat rate. Projected Average Monthly Residential Rate (w) or (x) * If this application is for a solid waste project, see instructions. ** Vacant EDUs pay $10/month. 39

9 SYSTEM INFORMATION WORKSHEET (Refer to instructions) SUBSECTION 1 EQUIVALENT DWELLING UNIT COMPUTATION Applicants with either a water and wastewater project must complete Section I, regardless of whether the applicant is served by a central water system or is planning to charge residential users a flat user fee. If the applicant is not served by a central water system, or it has water connections that provide service to multiple mixed uses, such as commercial and residential, refer to the instructions on page 26 for information on computing the number of EDU s. Applicants with solid waste projects are not required to complete Section I. Service connection diameters will be converted to EDU s according to the following table, with the exception of those situations noted on page 26: Service connection inside diameter (inches) EDU s ¾ or smaller " /2" " /2" " " " " PART A. CURRENT WATER HOOKUP SUMMARY Diameter (inches) Current Total Hookups* Current Residential Hookups (a) (b) (c) (d) Total EDU s per Total EDU s Diameter Number of EDU s Per Number of Hookup [(a) x (b)] (inches) Residential Hookup Hookups (from table) Hookups (from table) Total Residential EDU s [(c) x (d)] 3/ / Totals (e) (f) * Includes both residential and non-residential hookups 40

10 PART B. PROJECTED WATER HOOKUP SUMMARY Diameter (inches) Projected Total Hookups* Projected Residential Hookups (g) (h) (i) (j) Total EDU s per Total EDU s Diameter Number of EDU s Per Total Number of Hookup [(g) x (h)] (inches) Residential Hookup Residential Hookups (from table) Hookups (from table) EDU s [(i) x (j)] 3/ / Totals (k) 151 (l) 151 (m) * Includes both residential and non-residential hookups Projected average EDU s per residential hookup: 1 (n) [(m)/(l)] Provide the following information if applying to the USDA RUS/RD program Total water system flows (sales) last twelve months 3.7M [gallons or cubic feet (circle one) for all connections listed in (a) above] Total residential water flows (sales) last twelve months 3.7M [gallons or cubic feet (circle one) for all connections listed in (c) above] NOTE: In some cases it is necessary to provide a detailed monthly split of the residential and non-residential sales. A sample spreadsheet is available on the Montana USDA Rural Development website at SUBSECTION 2 PROJECTED AVERAGE MONTHLY RESIDENTIAL RATE COMPUTATION Will debt be used to finance the project? Yes No If no, skip to PART E. If yes, how will debt for the project be secured: A. Revenue Bond 100% (complete Part A) B. General Obligation Bond (complete Part B) C. Rural or Special Improvement District Bond (complete Part C) D. Other (explain) (complete Part D) Debt (Loan) Amount: $ Interest Rate: % Terms: 41

11 COMPLETE THE APPLICABLE SECTIONS BELOW PART A. REVENUE BOND SECURING DEBT OBLIGATION: 1. Debt election held? Yes No May 2019 If no, when will election be held (date) 2. Annual debt service for new loan, including coverage: 28,990 $ (i) 3. Monthly debt service for new loan, including coverage: (line i / 12) 2,416 $ (ii) 4. Total number of projected EDU s after completion of project: 151 (iii) 5. Average (per total projected EDU s) monthly debt service for new loan: (line ii / line iii) $ (iv) PART B. GENERAL OBLIGATION BOND SECURING DEBT OBLIGATION: 1. Debt election held? Yes No If no, when will election be held? (date): 2. Amount of outstanding General Obligation Bonds $ 3. Debt limitations of entity 4. Estimated average (per property) monthly assessment needed to repay debt (divide the annual assessment by 12 to obtain a monthly figure): $ PART C. RURAL OR SPECIAL IMPROVEMENT DISTRICT BOND SECURING DEBT OBLIGATION: 1. Type of special assessment: a. SID b. RID c. Other (specify) 2. Proposed method of assessment: a. Assessable Area b. Area c. Ad Valorem Tax d. Lineal Front Footage e. Combination of a. through d. above (explain) 3. Number of parcels in the district 4. What percentage of the property (based on the methods of assessment) within the district fits these descriptions? 42

12 TYPE OF PROPERTY PERCENT DEVELOPED PERCENT UNDEVELOPED Commercial Industrial Single-Family Residential Multi-Family Residential Agricultural 5. Number of property owners in district 6. Estimated average (per property) monthly assessment needed to repay debt (divide the annual assessment by 12 to obtain a monthly figure): $ PART D. OTHER TYPE OF DEBT INSTRUMENT SECURING DEBT OBLIGATION THAT IS NOT INDICATED ABOVE 1. Explain how debt will be secured: 2. Estimated average (per property) monthly cost to repay debt: $ PART E. CALCULATION OF THE PROJECTED AVERAGE MONTHLY RESIDENTIAL USER RATE: 1. Estimated increase in average monthly debt service (per projected EDU, monthly assessment per property for General Obligation Bond or SID, or per customer for solid waste projects) as the result of this project. Enter $0 if no increase is projected: $ (o) [From Part A, B, C, or D] 2. Estimated increase or decrease in total monthly operation and maintenance (O&M) costs (including depreciation and replacement reserves) as the result of this project: $ (p) 3. List and explain estimated increases or decreases in O&M costs, including depreciation and replacement reserves (Provide a reasonably detailed explanation regarding the reason for the increase or decrease): There is no increase in operation costs. The replacement reserve assumes 20yr life for the well pumps and controls, a 40yr life for infrastructure (pipes, valves), and 75yr for the well, based on inflation rate of 1.5%. 4. Estimated increase or decrease in monthly O&M costs (including depreciation and replacement reserves) (per projected EDU, monthly assessment per property for General Obligation Bond or SID, or per customer for solid waste projects) as the result of this project: $ 2.61 (q) [(p) / (k)] 5. Estimated increase or decrease in total monthly costs (per projected EDU, monthly assessment per property for General Obligation Bond or SID, or per customer for solid waste projects) as the result of this project: $ (r) [(o) + (q)] 43

13 6. Projected average EDU s per residential hookup: $ 1 (s) [(n)] 7. Estimated increase or decrease in total monthly costs per average residential hookup/customer as the result of this project: $ (t) [(r) x (s)] 8. Existing average monthly residential debt service, including coverage and bond reserve (subtract any existing debt service if the loan will expire before the completion of the project): $ 0 (u) 9. Existing average monthly residential O&M costs and replacement and depreciation reserves: $ / 10.00* (v) Note: (u) plus (v) should equal the current average monthly residential rate as stated in Section E, Line 7. If these amounts do not equal, provide an explanation of why the numbers differ. 10. Projected average monthly residential user rate after completion of this project: $ / (w) [(t) + (u) + (v)] 11. Projected flat user rate: $ / (x) The rate shown is an estimate based on the full amount of the project excluding test well work, but including the contingency. The District intends to review and revise the rate increase at the end of the project based on actual cost and reserve estimates. * The rate of occupied EDUs is presently $ The rate for vacant EDUs is $ Rates for occupied and vacant EDUs are also shown, respectively, in lines 10 and