HomeMy WebLinkAbout20173981.tiffRESOLUTION
RE: APPROVE ENERGY AND MINERAL IMPACT ASSISTANCE GRANT APPLICATION
FOR COUNTY ROAD 18 IMPROVEMENTS PROJECT (TIER I) AND AUTHORIZE
ELECTRONIC SUBMITTAL
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with an Energy and Mineral Impact Assistance
Grant Application for the County Road 18 Improvements Project (Tier I) from the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf
of the Department of Public Works, to the Colorado Department of Local Affairs, commencing
upon full execution, with further terms and conditions being as stated in said application, and
WHEREAS, after review, the Board deems it advisable to approve said application, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Energy and Mineral Impact Assistance Grant Application for the
County Road 18 Improvements Project (Tier I) from the County of Weld, State of Colorado, by
and through the Board of County Commissioners of Weld County, on behalf of the Department of
Public Works, to the Colorado Department of Local Affairs, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Department of Public Works be, and
hereby is, authorized to electronically submit.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 27th day of November, A.D., 2017.
BOARD OF COUNTY COMMISSIONERS
WELD CSJUNTY, CORADO
ATTEST: d.,,,th,„) deje:0;6k.
Weld County Clerk to the Board
BY: Cam.
puty Clerk to the Board
APPR• P'AS TO F
unty At orney
Date of signature: ( I I
ulie A. Cozad, Chair
EXCUSED
Steve Moreno, Pro -Tern
Sean P Conway
ke Freeman
XCUSED
Barbara Kirkmeyer
cc:Pwc£(2) GtcTcp,C)
dtrcaria
2017-3981
EG0074
Updated 10.20.201 7
-You a Lie
Department of Local Affairs
Division of Local Government
ENERGY AND MINERAL IMPACT ASSISTANCE PROGRAM APPLICATION
Tier I or Tier II
Applications Must Be Submitted Electronically - Directions on Last Page
Highly Encouraged to Work Rath y ur Rego+anal Field Manager when Cornplleidng your t-,ppiicatic n -
A. GENERAL AND SUMMA
Int)
Y INFORMATION
S;
1. Name/Title of Proposed Project:
Weld County Road 18 Improvements Project
2. Applicant: Weld County
(In the case of a multi -jurisdictional application, name of the "lead" municipality, county, special district or other political subdivision).
In the case of a multi -jurisdictional application, provide the names of other directly participating political subdivisions:
3. Chief Elected Official (In the case of a multi -jurisdictional application, chief elected official of the "lead" political
subdivision):
Name:
Mailing Address:
City/Zip:
E -Mail Address:
Julie Cozad
PO Box 758
Greeley, CO 80632-0758
jcozad@weldgov.com
Title: Chair
Phone: 970-400-4200
Alt Phone
4. Designated Contact Person (will receive all mailings) for the Application:
Name: Barbara Connolly Title: Controller
Mailing Address: PO Box 758 Phone: 970-400-4445
City/Zip: Greeley, C• 80632-0758 Alt Phone
E -Mail Address: bconnolly@weldgov.com
5. Amount of Energy/Mineral Impact Funds requested:
(Tier I; Up to $200,000 or Tier II; Greater than $200,000 to $1,000,000)
Tier I- $200,000
6. Description of the Project Scope of Work:
(Project Description of the various tasks involved in the project including specific data such as quantities, mileage, square feet, lineal ft. etc. as well as
specific project location within city and or county etc.)
Weld County is requesting funding to assist with road damage created from intense oil & gas truck activity on
WCR 18. The WCR 18 improvements project is approximately 4.3 miles long from WCR 49 to Market Street.
Public Works has been trying different maintenance methods to keep up with the increased corridor traffic. This
road was originally gravel, then chip sealed, and the RAP placed over the chipseal, but it continues to
deteriorate. Therefore, to ensure a consistent corridor is constructed, the sections from WCR 49 to WCR 53 will
be milled and overlayed and the section from WCR 53 to WCR 57 will be full depth reconstruction in order to
support the truck traffic.
7. Description: (Describe the problem, opportunity or challenge that resulted in the request.)
WCR 18 is within the core of Weld County's oil & gas operations. Due to the lack of east/west roads to the north
of WCR 18, this road is an extremely valuable and heavily utilized collector road connection sandwiched between
twit arterial roads, which makes it difficult to maintain. For this project, Public Works will use cement -treated
base (CTB) to reinforce the subgrade (below the asphalt) on the eastern 2 miles of the project in order to support
the significant truck traffic volumes along this roadway. Upon completion of the eastern 2 miles, then the entire
roadway would b= paved with 5" of asphalt providing a significant degree of resiliency.
8. Local priority if more than one application from the same local government (1 of 2, 2 of 2, etc.) 1 of 1
9. Is the project on a State registered historic site or in a State registered Historic District? Yes( ) No( X ).
If yes, please provide the registry number. . The department may need to seek a determination of effect
from the State Historic Society. For more on the Colorado State Register of Historic Properties, please click here.
QV)/ ,6 If/
Page 1 of 10
Updated 10.20.2017
B. DEMOGRAPHIC AND FINANCIAL INFORMATION.
1. Population
a. What was the 2010 population of the applicant jurisdiction?
b. What is the current population?
(Current/most recent conservation trust fund/lottery distribution estimate is acceptable.) What is the source of the
estimate?
c. What is the population projection for the applicant in 5 years?
What is the source of the projection?
254,240
304,803
DOLA
359,390
DOLA
2.
Financial
In the
benefiting
the application
column
from
Information
below labeled
the application.
is being
(Current
"Applicant"
In the
submitted (if applicable).
columns
Year):
provide the financial information for the municipality, county, school
below labeled "Entity", provide the financial information for
district or special
any public entities
district directly
on whose behalf
Con-:pletr,
items "a thrugh
k49
for ALL
project types:
Applicant
Lead
Co -applicant
Co -applicant
a. Assessed Valuation
(AV) Year:
Most
Recent
$899839975,390
b.
Total
Mill
Levy
15.80
c.
Property
(mill
Tax
levy
x AV
Revenue
/ 1,000)
Generated
$141,949827
d.
Sales
Tax
(Rate/Estimated
Annual
Revenue)
0% / $0.00
% / $
0/0/ $
a General
Fund
Budgeted
Revenue
$130,117,497
f. General
Fund
Budgeted
Expenditures
$129,8219749
g.
the
General
previous
Fund
year
Balance
as
General
of
Fund
December
Balance:
31st
of
$19,892,049
Portion
(meets
h. statement
of General
the
definition
below)
Fund
identified
which
is
in
Unassigned
the
GASB
AA
$12,295,748
i.
Total
Budgeted
Revenue (All
Funds)*
$427,155,575
j.
Total
Budgeted
Expenditures
(All
Funds)*
$3209175,402
k.
Total
Fund
Balance
(All
Funds)*
$125,2179000
I.
Total
Outstanding
Debt
(All
Funds)**
$0.00
* Sum of General Fund and all Special or Enterprise Funds
** Include the total outstanding liability from all multi -year debt obligations (lease purchase agreements, certificate of participation and
any other debt instruments).
nnunassigned fund balance - Amounts that are available for any purpose; these amounts are reported only in the general fund and
have not been committed by resolution, ordinance or contract and have not been budgeted for an intended purpose.
(Click this 1 i n _c to locate GASB Fund Balance definitions)
Page 2 of 10
Updated 10.20.2017
For projects to be managed through a Special Fund other than the General Fund (e.g. County Road and Bridge
Fund) or managed through an Enterprise Fund (e.g. water, sewer, county airport), complete items "k through
a
Complete items "I through p" for ALL project types:
Identify the relevant Special Fund or Enterprise
Fund:
m. Special or Enterprise Fund Budgeted Revenue
Public Works
Fund
$100,452,590
n. Special or Enterprise Fund Budgeted
Expenditures
$81,400,232
$
o. Special or Enterprise Fund Outstanding Debt**
$0.00
$
p. Special Fund Mill Levy (if applicable)
1.444
q. Special or Enterprise Fund Balance as of
December 31st of the previous year
$35,600,000
For Water and Sewer Project Only complete items "q through s":
Complet<<-~ items 56q through s99 for ALL project types:
Water
Sewer
r. Tap Fee
$
s. Average Monthly User Charge
(Divide sum of annual (commercial and residential) revenues by 12 and
then divide by the number of total taps served.)
NOTE: Commercial and Residential Combined
$
t. Number of total Taps Served by Applicant
** Include the total outstanding liability from all multi -year debt obligations (lease purchase agreements, certificate of participation
and any other debt instruments).
Page 3 of 10
Updated 10.20.201 7
Ca PROJECT BUDGET. List expenditures and sources of revenue for the project. The ttals on each side of the kdger must equal.
Expenditures
Sources of Revenue
(Dollar for Dollar Cash Match is Required, unless financial
circumstance warrants a reduction)
List Budget Line Items (Examples: architect, engineering, construction,
equipment items, etc.)
Line Item Expenditures
CR 13 lmprov rnents
TOTAL
Line Item Costs
$338,000
List the sources of matching funds and indicate either cash or
documentable in -kind contribution.
T,stal revenue must equal total expenditures
Energy/Mineral Impact Fund Grant
Request
Weld County Cash
$838,000
TOTAL
PIPase Attar'.h A mt1rca rhntaiInari Iii irincit if cnioilohlc
$2005000
$638,000
$838,000
Funding
Committed
List Yes or No
next to each
line item
Yes
No
(If the request is for planning, engineering or design, the following two questions may not be applicable)
°l u Please identify the contingency associated with the project budget.
a. Contingency Dollar value $
b. Contingency % of Budget. %
c. If a contingency has not been identified as part of the budget, please explain why not?
2. How recently was the budget and contingency determined for this project (month/year)? November 2017
Page 4 of 10
Updated 10.20.2017
D. PROJECT INFO: NATIN.
The statutory purpose of the Energy and Mineral Impact Assistance program is to provide financial assistance to
"political subdivisions socially or economically impacted by the development, processing or energy conversion of
minerals and mineral fuels."
1. Demonstration :• -f Nerd:
a. Why is the pro
ect needed at this time?
eld County is the #1 mst ctive :•lil and gas county in the State. NCR 18 is an imp*rtant east/west oil and gas
rind seMng the south central portion of Weld C.unty. ` -any of the existing paved riads were not originally
designed to ithstand the increased oil gas truck traffic and are deteriorating rapidly.
b. How does the implementation of this project address the need?
The WCR 18 imprvements pr
vidles a m
re resin
nt road connection serving the ill and gas industry.
c. Does this project, as identified in this application, completely address the stated need? If not, please describe
additional work or phases and the estimated time frame. Do you anticipate requesting Energy and Mineral Impact
Assistance funds for future phases?
Yes, the WCR 18 improvements addressed the safety need for this portion of the roadway. Weld County will n
be requesting additional funding for future projects on this portion of WCR 18.
d. What other implementation options have been considered?
eid Cunty is trying to be proactive regarding improvements to this oil and gas corridor. Weld County is using
a significant amount •=f oil and gas property taxes and direct distribution severance funds for county -wide
radway improvements. This funding assists Public floorks road improvement efforts which have significantly
increased. In order to keep up with needed road improvements, Weld Cr• unty has hired additinal crews and
acquired more equipment to assist in offsetting the substantial oil and gas impacts.
e. What are the consequences if the project is not awarded funds?
Of funding is not .ward
C.unty may then have,
ed, WCR 18 will c•:ntinue to deteriorate and bec':l;me an even worse safety issue. Weld
treduce the speed limit and add addititn I
"Road D mage" s&gnage alng the ro.'d
r
b�11
ay.
2. M asurable Outcomes:
a. Describe measurable outcomes you expect to see when implementation of this project is complete. How will the
project enhance the livability* of your region, county, city, town or community (e.g. constructing a new water plant will
eliminate an unsafe drinking water system and provide safe and reliable drinking water; the construction of a new
community center will provide expanded community services, or projects achieving goals regarding energy conservation,
community heritage, economic development/diversification, traffic congestion, etc.)?
*(Livability ns increasing the value and/or benefit in the areas that are comminly linked in community development such
s j bs, housing, transportation, education, emergency mitigatii1 n, health and environment)
•
This portion of WCR 18 is directly ccnnr cted tthe recently cimpleted WCR 49 pr•;ject. Weld C unty has seen
increased traffic and land use detel*pnt long this corridor. Due to the limited number f east -west paved
roads hi the vicinity the value of improving WCrt 18 increases significantly. The irnprvements will make the area
safer for ell motorists and add years of life to the existing roadwp y by using innvative technology at the
subgrade Tevel, which will help with truck traffic deteriorati • n. The impr•ved roadway w uld assist in activities
f the y\Afield Central R.E-3(J) Schol District as well as both the Hudson Fire Protecti.n District and the SE { .field
Fire Protecti n District.
'3
b. How will the outcome of the project be measured to determine whether the anticipated benefits to this population
actually occur?
Upon completion, Public Works will cntinu.o collect tr•jfil:ic cunts to determine if traffic increas
s.
c. Does this project preserve and protect a registered state historic building, facility or structure? If yes, please
describe. Year of construction:
N/A, no historic building, facility, or structure is involved in the project.
d. Will this project implement an energy efficiency/strategy that could result in less carbon footprint or conserve energy
use or capitalize on renewable energy technology? If yes, please describe.
Yes, Public Works .n, ill recycle the asphalt materials into the subgrade to create a more durable subgrade to
accomrnod hte heavy ESAL truck traffic.
\n,r
e. Will the project be constructed with "Resiliency Framework", which is to build and construct with a plan to reduce risks
by utilizing materials and constructing in areas to better withstand natural or man-made disasters, etc.? If yes, please
describe.
Yes, because we are making the entire corridor a consistent mc.terial ith 5" of asphalt. if, in the future there
aris s a need to rework the subgrade, we can use the existing asphalt millings to reclaim them in with the
existing subgrade V. ensure a stronger foundation is in place.
Page 5 of 10
Updated 10.202017
3. Relationship to C immunity Gials
a Is the project identified in the applicant's budget or a jurisdictionally approved plan (e.g. capital improvement plan,
equipment replacement plan, comprehensive plan, utility plan, road maintenance and improvement plan or other local or
regional strategic management or planning document)? What is its ranking?
Yes, this project has been identified in the Public rks general fund budget.
f•
4. cal Commitment and Ability to Pay/L• cal Effrt
a. Why can't this project be funded locally?
eld County reduced fu din the HA "P Program, which means less r, ids can be improved. With less funding
available, Weld County is trying to find other opportunities t. fund projects directly impacted by the :ill and gas
industry. In irder to acc t mplish this project, Weld County is licking for funds to assist with purchasing
additional materials, s% the county crews can construct the improvements rather than contracting them.
b. Has this pro
ect been deferred because of lack of local funding? If so, how long?
Yes, this project has been handled in a piece meal phasing and needs to be addressed as mne corridor.
c. Explain the origin of your local cash match. (Note: Whenever possible, local government cash match on a dollar for
dollar match basis is encouraged.) Are the local funds committed or pending? If there are pending funds, when will the
status of those funds be determined?
The pect will be funded •:u
f Public Nil
1"
rks 201 General Fund.
d. What other community entities, organizations, or stakeholders recognize the value of this project and are
collaborating with you to achieve increased livability of the community? Please describe how your partners are
contributing to achieve the improvement to the livability of the community through this project. If in -kind contributions are
included in the project budget, detailed tracking will be required on project monitoring report.
III motorists utilizing these roads recognize the value if this safety project especially in the Tt•wns of Hudson
and Keenesburg. This pr ject intersects the boundary between Hudson Fire Protectin District and the SE Weld
Fire Protection District so these imprvements will benefit them both. This project als`•: assists the Wald Central
RE -3(J) School District (Hudson — Keenesburg).
i. Please describe the level of commitment by each collaborator. (e.g. fee waivers, in -kind services, fundraising,
direct monetary contribution, policy changes.)
Weld county will use the grant funds to leverage the cost of materials to construct the inrprvements. Weld
County cr ws will provid the labor and equipment tcomplete the work. The grant cash match will be fry m
Public Works' General Fund.
`.Z
ii. Please list the value of the resources that each collaborator is bringing to the program.
Weld Cijunty equipment and labor is significantly more thf,n half of the cost of the pr
ject.
e. Has the applicant dedicated the financial resources in their current budget, reserve funds and/or unused debt
capacity that are being used for the local matching funds? Explain if No
Yes, the funds have been dedicated in the 2018 budget for construction in 2118. If awarded,
fund the cash match from Public Works' General Fund.
unty will
f. Have the applicant's tax rates, user charges or fees been reviewed recently to address funding for the proposed
project?
Weld County his so many impacted oil and gas roads that all available funding is going into the PW General
Fund/VAR Y° prrogr r' to help mitiate the impacts to as many cunty roads as possible. The grant would allw
Public Works to complete a significant .0 and gas roadway, which wouldn't therwise be completed.
g. If the tax rate, user charges or fees were modified, what was the modification and when did this change occur?
Weld C
r
unty has been directing the revenues from the Specific Ownership Ta
i1.
to Public wrks since 1985.
h. Has the applicant contacted representatives from local energy or mineral companies to discuss the project? If yes,
when was the contact and what was discussed.
Yes, impacted roadways ar-1 discussed at Weld County's Oil and Gas Wirking Group regul r meetings. The ail &
Gas Working Group cinsists if industry partners discussing impacts affecting everyrne and problem solves
how we can II work t.t ethn to minimize or mitigate these problems.
i. Has the applicant requested financial support from the industry? If yes, when was the contact, what amount did you
request? What were the results? If no, why not?
Yes, but the industry typically helps `Feld County projects with in -kind support such as water hauling, gravel,
trucking and stock piling.
5. Readiness to Go
a. Assuming this project is funded as requested, how soon will the project begin? Select One (X) Within 3 months,
( )3-6 months, ( )6-9 months or (_)9-12 months? What is the time frame for completion? Select One (X)Within 3 months,
(J3-6 months, (_)6-9 months, ( )9-12 months or (_) >12 months.
b. Describe how you determined that the project can be completed within the proposed budget as outlined in this
Page 6 of 10
Updated 10.20.2017
application?
The budget has been estimated by pr
need to reduce the project scope.
fens i
i)
nal engineers. Of the project exceeds the es
mate,
he County may
c. Has the necessary planning and design been completed? How? What additional design work remains? How did the
applicant develop project cost estimates? Are any or permitting must still be completed, if any? When? How did the
applicant develop project cost estimates? Is the project supported by bids, professional estimates or other credible
information? Please attach a copy of any supporting documents.
1 _ he engin . ering required f •;r these pr jects ar all dine in -h use. In addition, Weld Cunty crews ctnstruct the
improvemenet. The purpsse of these funds is to acquire materials to pave the road. Weld County is extremely
proficient with kn .wing exactly how much material is need d for paving r•,ads, so n over or under runs are
anticipated.
•
e
i. What additional design work remains?
urinal design is nee
ed
f
r this p
ject and it is d
ne in-house.
ii. How did the applicant develop project cost estimates?
Estimates were developed by professional :engineers involved with the project esign.
iii. Is the project supported by bids, professional estimates or other credible information? Please attach a copy of any
supporting documents.
Weld County bids materials annually. This project is supported by those bid am•,unts.
iv. Are any Local, State or Federal permits required before the pro
ect can proceed? If yes, please describe.
dditional permits are required for this project because it will occur within the :-existing right-of-way limits.
6. Energy & Mineral Relatinship
a. Describe how the applicant is, has been, or will be impacted by the development, production, or conversion of energy
and mineral resources.
Weld County accounts for more than fifty percent of all il and gas activity f
extremely impacted. Significant p rtions of the roadways ffic are du- t
I„
r the entire state and ther
oil and gas trucks.
r
f
is
b. To further document the impact in the area, name the company or companies involved, the number of employees
(click to get # of employees) associated with the activities impacting the jurisdiction and other relevant, quantitative
indicators of energy/mineral impact.
mpani
s with oil and gas op
rations in the ar
a includ
An;:darko, N-••ble Energy, and Crestone Peak.
c. Cite actual use data that documents direct impact as it relates to the need for the project. For example, "heavy truck
traffic directly related to energy development activities is impacting County Road X. a traffic count done in May 2015
showed energy related truck traffic increased from 100 trips per day to 300."
WCR 18 is a collector r advvay. Current traffic count vlumes on WCR 18 ramie from 600 t 870 vehicles per day
(vpd) d..pending on which end of the corridor you are on. The truck traffic ranges frm 25% to 31%.
N
*
7. Management Capacity
a. How will you separate and track expenditures, maintain funds and reserves for the capital expenditures and
improvements as described in this project?
Weld County's Accounting ED
all inviicing information thr•�
management software PubW
p=trtment is recognized as a Tier 3 local government by the State and can manage
ugh tanner Accointing System. On additin, Public Works will use the project
rks to ' ssist in administering the project and grant.
b. Describe the funding plan in place to address the new operating and maintenance expenses generated from the
proect?
Weld County will c
\I
ntinue to utilize the
Highway Users Tax Fund (HUTF) f
r maintenanc
(S
exp
nses.
c. Describe the technical and professional experience/expertise of the person(s) and/or professional firms responsible to
manage this proect.
Id County Public Works has several tnghneers on staff and proven expertise- in roadway improvement
projects. Barbera Cc nnolly is the point of contact for this grant and Elizabeth Relford will be responsible f
managing the construction project.
\/
v, 1
d. Does the project duplicate service capacity already established? Is the service inadequate? Has consolidation of
services with another provider been considered?
This issafety protect and does not duplicate service capacity, but enh
and inefficient to meet existing truck traffic demands.
Ci
nces it. Current service is inadequate
Page 7 of 10
Updated 10.20.2017
E. HIGH PERFORMA
,S.
Y
CE CERTIFICATION (HPCP) PROGRAM COMPLIANCE.
Colorado Revised Statutes (C.R.S. 24-30-1305.5) require all new facilities, additions, and renovation projects that meet
the following applicability criteria to conform with the High Performance Certification Program (HPCP) policy adopted by
the Office of the State Architect (OSA) if:
The project receives 25% or more of state funds; and
The new facility, addition, or renovation project contains 5,000 or more building gross square feet; and
The building includes an HVAC system; and
In the case of a renovation project, the cost of the renovation exceeds 25% of the current value of the property.
The HPCP requires projects that meet the applicability criteria above to achieve third party verification with the target goal
of LEED Gold or Green Globes -Three Globes. Projects are strongly encouraged to meet the Office of the State
Architect's (OSA) Sustainable Priorities in addition to the LEED prerequisites. Projects funded through DOLA that meet
the above applicability criteria are required to complete the DOLA registration and tracking process. See DOLA's HPCP
web page for more information or contact your DOLregional manager.
In instances where achievement of LEED Gold or Green Globe -Three Globes certification is not achievable, an applicant
may request a modification of the HPCP policy or a waiver if certain conditions exist. DOLA staff will work with applicants
to identify workable solutions to meet the program's intent to maximize building energy efficiencies.
Please answer the following questions:
(Complete this section only if your project application is for a building project, both new construction as well as
renovation )
1. Is the applicant seeking state funding for 25% or more of the total project cost (including all phases, if
applicable)? Yes( ) No( )
(If no, the project does not meet the HPCP requirement and the rest of this section does not need to be completed)
Does the building include an HVAC system? Yes( ) No( )
If yes, please check whether the proposed project includes a HVAC upgrade or new HVAC
system.
2. Is this project (check all that apply): new construction renovation
new and renovation
New building square footage: SF Renovation square footage: SF
Is the building square footage (new construction and/or renovation) 5,000 SF or more? Yes( ) No( )
3. For building renovation projects:
What is the current property value? (Determine based on assessed or appraised value) $
What is the total project cost for the renovations? $
Does the cost of renovation exceed 25% of the current value of the property? Yes(_) No( )
4. If yu answered "yes99 tl•.i questions 1, 2, 3, and if applicable, 4, then your project meets the HPCP
applicability criteria. Complete the HPCP registration f rm and preliminary chi:ckhist and sub -it with
this gr& nt application. (See DOLA's HPCP web gage for registration and checklist form.)
ADDITIO:\IAL QUESTIONS:
5. Have you included any additional costs in this grant application for third party verification to comply with the
High Performance Certification Program? Yes( ) No( ) If yes, please specify the estimated cost for third
participation verification/certification:$
6. Will you need assistance locating resources, third party consultants, or technical assistance for HPCP third
party verification requirements, preparing cost estimates, or otherwise complying with the HPCP?
Yes( ) No( ) Explain
Note: If this application is for design services for a planned building project that meets the HPCP applicability criteria and the applicant
intends to seek state funding for 25% or more of the total project cost, then the design should maximize high performance building
certification standards (by completing the HPCP checklist) and build in anticipated project costs, as appropriate.
Page 8 of 10
Updated 10.20.2017
F. TABOR COMPLIANCE.
1. Does the applicant jurisdiction have voter authorization to receive and expend state grants without regard to TABOR
spending limitations? Yes( ) No( ). If yes, explain:
Yes
2. If the applicant jurisdiction receives a grant with State Severance funds, will the local government exceed the TABOR
limit and force a citizen property tax rebate? Yes( ) No( ). Explain.
No
3. Has the applicant jurisdiction been subject to any refund under TABOR or statutory tax limitations?
Yes( ) No ). Explain.
No
4. Has the applicant sought voter approval to keep revenues above fiscal spending limits? Yes( ) No( ). Explain.
Yes
5. Are there any limitations to the voter approved revenues? (e.g., Can revenues only be spent on law enforcement or
roads?) Yes(X ) No(). Explain.
All Weld County ad valorem tax levies for county purposes, when applied to the total valuation for assessment of
the County, shall be reduced so as to prohibit the levyinty of a greater amount of tax revenue than was levikd
from ad valorem taxation in the preceding year plus five percent (5%) except to pryid = f•;r the payment f bonds
and interest thereon.
6. If the applicant jurisdiction is classified as an enterprise under TABOR, will acceptance of a state grant affect this
status? Yes( ) No(X ). Explain.
Acceptance of grant funds will not affect Weld County as an enterprise under TA OR.
G. ENVIRONMENTAL REVIEW.
Indicate below whether any of the proposed project activities:
1. Will be undertaken in flood hazard areas. Yes( ) No( X ).
List flood plain maps/studies reviewed in reaching this conclusion. Describe alternatives considered and mitigation
proposed.
2. Will the project affect historical, archeological or cultural resources, or be undertaken in a geological hazard area.
Yes( ) No( X ).
If yes, describe alternatives considered and mitigation proposed.
3. Address any other public health or safety related concerns? Describe. Yes(_) No( X ).
Page 9 of 10
Updated 10.20.2017
APPLICATION SUBMISSION INSTRUCTIONS
AND
OFFICIAL BOARD ACTION E IRED)
Application and attachments must be submitted electronically in
WORD .DOC (Preferred) or .PDF Format (Unsecured) to:
r[rhpactGrants stateac `sous
Please Cc yur DOLA Re na0 Maunagi all dcuments as well to ensure receipt.
In email subject line include: :Applicant Local Government name and Tier for which you are applying
-example- Subject: Springfield County EIAF Grant Request, Tier 1
NOTE: Please do not submit a scanned application (scanned attachments ok).
(If you are unable to submit electronically please contact your DOLA Regional Manager)
For any questions related to the electronic submission process, please call Leah Smith @ 303.864.7757
Attachments List (Check and submit the following documents, if applicable):
® Preliminary Engineering Reports
® Architectural Drawings
Cost Estimates
Detailed Budget
Map showing location of the project X
® Attorney's TABOR decision
HPCP Registration, modification
Or Waiver Form
*********************************************************************************************************************************** *****
fficial Board Action taken on
'7\ i ��-.Z,,
275 .--,`1/
Date
Submission of this form indicates official action by the applicant's governing board
uthorizing pl °cation for these funds.
Page 10 of 10
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