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Home My WebLink About20163587.tiffRESOLUTION RE: APPROVE ENERGY AND MINERAL IMPACT ASSISTANCE PROGRAM GRANT APPLICATION FOR INTERSECTION OF COUNTY ROADS 105 AND 390 AND APPROXIMATELY THREE (3) MILES OF COUNTY ROAD 105 FROM COUNTY ROAD 390 TO STATE HIGHWAY 14 (TIER 2 - PHASE 2) 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 Program Grant Application for Intersection of County Roads105 and 390 and approximately three (3) miles of County Road 105 from County Road 390 to State Highway 14 (Tier II — Phase 2) 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 Program Grant Application for Intersection of County Roads 105 and 390 and approximately three (3) miles of County Road 105 from County Road 390 to State Highway 14 (Tier 2 — Phase 2) 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 application be, and hereby is, authorized to be submitted electronically. Cc F z a� , COW BC) la/ts/(Co 2016-3587 EG0073 RE: ENERGY AND MINERAL IMPACT ASSISTANCE PROGRAM GRANT APPLICATION FOR INTERSECTION OF COUNTY ROADS 105 AND 390 AND APPROXIMATELY THREE (3) MILES OF COUNTY ROAD 105 TO STATE HIGHWAY 14 (TIER II - PHASE 2) PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 23rd day of November, A.D., 2016. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST; e:Mei) ,i,k, Weld County Clerk to the Board BY ap�,., c. uty Clerk to the Board AP".V/ DAS ounty Attorney Date of signature: l3/1(4/ Ifo Mike Freeman, Chair EXCUSED Sean P. Co bara Kirkmeyer Steve Moreno 2016-3587 EG0073 MEMORANDUM TO: Clerk to the Board DATE: November 22, 2016 FROM: Deanne Norris, Public Works SUBJECT: WCR 105 and WCR 105/390 Intersection DOLA Contract Tier II The attached DOLA contract is for Energy and Mineral Impact Assistance Funding (EIAF) for a Tier II grant for $1,000,000 to improve the intersection at WCR 105/390 and approx. 3 miles of WCR 105 from WCR 390 to SH 14. Staff recommends Board approval of the DOLA contract, which will help pay the cost of the materials for the improvements. The total material cost is estimated to be $2,068,878. This is a Haul Rout Project (HARP). The ROW purchases, design work and possible utility relocation will be done in 2017 and the construction will IP begin in the spring of 2018. McFrencie\AGENDA memos Agenda -Tiffany doe 2016-3587 Revised 8 18 2016 COLORADO 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 -You are Highly Encouraged to Work with your Regional Field Manager when Completing your Application - A. GENERAL AND SUMMARY INFORMATION 1. Name/Title of Proposed Project: WCR 105 & 105/390 Intersection 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 directlyparticipating political subdivisions: [ 3. Chief Elected Official (In the case of a multi -jurisdictional application, chief elected official of the "lead" political subdivision): Name: Mike Freeman Title: Chair Mailing Address: PO Box 758 Phone: 970-400-4200 City/Zip: Greeley, CO 80632-0758 E -Mail Address Mfreeman@weldgov.com 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, CO 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 II - $1,000,000 6. Description of the Project Scope of Work: (Project Description of the various tasks involved in the project nclud.ng specific data such as quantities. mileage, square feet, lineal ft. etc as well as specific_ff2Lect location within city and or county etc.) r Weld County requests funding to improve the intersection of WCR 390 and WCR 105 and to improve the approximately 3 miles of WCR 105 from WCR390 to SH 14. This will entail the right-of-way purchasing, design work and possible utility relocation in 2017 and the construction in spring of 2018. 7. Description: (Describe the problem, opportunity or challenge that resulted in the request.) In 2009, the Weld County Commissioners implemented Public Works' Oil & Gas Haul Route Program (HARP). The program uses direct distribution severance tax dollars on roads significantly impacted by oil and gas activity. However, even with these funds, the County struggles to keep up with road damage. The County cannot afford to pave every road and increased truck traffic is making it difficult to maintain existing roads. Therefore, Public Works is focusing efforts where the majority of traffic is, which are collector and arterial roadways. For this project, Public Works will use cement -treated base (CTB) to reinforce the subgrade (below the asphalt) in order to support truck traffic. By using CTB this will support the high truck traffic volumes along this corridor. Please see the attached map at the end of this application _ 8. Local priority if more than one application from the same local government (1 of 2, 2 of 2, etc ) 1 of 1 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. Page 1 of '0 Revised 8.18.2016 B. DEMOGRAPHIC AND FINANCIAL INFORMATION. 1. Population a. What was the 2010 population of the applicant jurisdiction? b. What is the current population? 254,230 294,556 (Current/most recent conservation trust fund/lottery distribution estimate is acceptable ; What is the source of the DOLA estimate? c. What is the population projection for the applicant in 5 years? What is the source of the projection? 348,648 DOLA 2. Financial information (Current Year): In the column below labeled "Applicant" provide the financial informat on for the municipality, county, school district or special dist•ict directly benefiting from the application. In the columns below labeled 'Entity" provide the financial information for any public entities on whose behalf the application is berm submitted if aonlicablel Complete items "a through k" for ALL project types: Lead Applicant Co -applicant Co -applicant a. Assessed Valuation (AV) Year: Most Recent $11,426,827,210 b. Total Mill Levy 15.80 c. Property Tax Revenue Generated (mill levy x AV / 1,000) $180,543,670 d. Sales Tax (Rate/Estimated Annual Revenue) %0 / $0 % i $ % / $ e. General Fund Budgeted Revenue $119,617,314 f. General Fund Budgeted Expenditures $118,161,264 g General Fund Balance as of December 31st of the previous year General Fund Balance: $25,970,664 Portion of General Fund which is Unassigned "" (meets the definition identified in the GASB h. statement below) $13,862,814 i. Total Budgeted Revenue (All Funds)* $420,525,439 j. Total Budgeted Expenditures (All Funds)* $326,544,222 k. Total Fund Balance (All Funds)* $105,550,000 I. Total Outstanding Debt (All Funds)** $0 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). ""Unassigned 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 link to locate GASB Fund Balance definitions) Page 2 of 10 Revised 8 18.2016 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 o": Complete items "I through p" for ALL project types: Identify the relevant Special Fund or Enterprise Fund: Public Works — Fund —Fund Fund m. Special or Enterprise Fund Budgeted Revenue $75,152,360 $ $ n Special or Enterprise Fund Budgeted Expenditures $101,184,933 $ $ o. Special or Enterprise Fund Outstanding Debt"" $0 $ $ p Special Fund Mill Levy (if applicable) 1.444 $ $ q. Special or Enterprise Fund Balance as of December 315, of the previous year $70,471,169 $ $ For Water and Sewer Project Only complete items "q through s": Complete items "q through s" 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 Revised 8. 18.2016 711 .. E a a V a) L 0 a) tS a I0 a) C 0 VI O 0) mi O nditures and sources of revenue for the I- W ca H U W O ce 0. U Funding Committed List Yes or No next to each line item o z o z Sources of Revenue (Dollar for Dollar Cash Match is Required. unless financial circumstance warrants a reduction) List the sources of matching funds and indicate either cash or documentable in -kind contribution. Total revenue must equal total expenditures Cash In -Kind U) o 0 o o o o 69 69 00 r-- 0 ao (o O fA 00 ti 0 00 0 O c.i. COI Energy/Mineral Impact Fund Grant Request r `Energy/Mineral Impact Fund Loan Request (If applicable) Weld County Cash TOTAL Expenditures List Budget Line Items (Examples: architect, engineering, construction, equipment items, etc.) Line Item Expenditures Line Item Costs $291,250 $472,120 $417,428 0 0 0 r` K) w 0 O 0 ID iA 0 O 0 INA 0 O 0 W 0 00 0 000 w ao r� C.I. CO Co O N fa Please attach a more detailed budget if available ROW, Design work, Construction Cement Treated Base (CTB)(513/@15" depth) Asphalt HMA PG 64-22 (3") Asphalt HMA PG 64-28 (2") ABC Class 6 Drainage and Erosion Control Traffic Control and Signage a) G U C 0) L. Other Minor Items & Contingencies TOTAL CD O N r T CU L U) Qa v, T a a a) a' m a) ( a O O nj c a C C m a N n C O @ O L a) C U O >, O U) ❑ o t) N �° w TT0 CU L • cc�3 O U) Q) C C QJ C tq C C O N +' U C C O a) O O Cu E z O O Q a) 6- U o) 0) ag o c 4) c > Revised 8. 18.2016 D. PROJECT INFORMATION. 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 enemy conversion of minerals and mineral fuels." 1. Demonstration of Need: a. Why is the project needed at this time? The project is needed to improve safety and completes the link on 390 from the Wyoming state line to SH 14. This intersection is in the Niobrara Play, which has experienced a lot of production/activity. Except for WCR 390 and WCR 77, all roads in the Niobrara Play are gravel, making the area difficult to maintain a reasonable level of service. In order to handle the very high truck traffic volumes this intersection and road are structurally deficient to support current traffic volumes and is in dire need of improvement. Weld County requests paving the 390/105 intersection and this section of 105 from the subgrade in order to support oIl and gas activity. b. How does the im_plementation of this project address the need? Implementation of this project addresses the immediate need for road safety improvements by widening and paving the intersection of 105 & 390 and also_p_ayin the currently gravel portion of 105 from WCR 390 to SH14. 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, this project addresses the identified need. This project includes the ROW purchases, design work, possible utility relocation in 2017 and the construction in the spring of 2018. d. What other implementation options have been considered? The County is using a significant amount of oil and gas property taxes and direct distribution severance funds for county -wide road improvements. This funding assists Public Works road improvements, which have increased significantly. In order to keep up with road improvements, Weld County has hired additional crews and acquired more equipment to help offset oil and gas impacts. e. What are the consequences if the project is not awarded funds? If funding is not awarded, this section will continue to deteriorate and become an even worse safety problem. Dust and soft spots will worsen and the County may have to reduce the speed limit and continue signing the area with "Road Damage Ahead" signs. 2. Measurable 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 means increasing the value and/or benefit in the areas that are commonly linked in community development such as jobs, housing, transportation, education, emergency mitigation, health and environment) Due to the limited amount of roads in the north, the value of WCR 390/105 is significant. The improvements will make the area safer for all motorists and add years of life to the existing roadway by using new technology at the sub rg ode level, which will help with truck traffic deterioration. b. How will the outcome of the project be measured to determine whether the anticipated benefits to this population actually occur? Upon completion, traffic counts will continue to be collected to determine if traffic increases c. Does this project preserve and protect a registered state historic building, facility or structure? If yes, please describe. Year of construction: NA, 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, by improving the intersection and road from gravel to paved, you significantly improve the air quality by reducing particulate emission matter generated from fugitive dust. 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 paving this road, in the future if we need to re -work the subgrade, we can uses the existing asphalt millings to reclaim them in with the existing subgrade to ensure a stronger foundation is in place 3. Relationship to Community Goals a. Is the project identified in the applicant's budget or a jurisdictionally approved plan (e.g. capital improvement plan, Page5 of 10 Revised 8.18 2016 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 Works general fund budget. 4. Local Commitment and Ability to Pay/Local Effort a. Why can't this project be funded locally? In anticipation of budget cutbacks from falling oil prices, Weld County cut back funds to the HARP Program, which means less roads can be improved. During PW CIP, the Commissioners said WCR 390/105 is a priority HARP project they would like completed by 2018. Therefore, in order to ensure completion, funding assistance is needed. b. Has this project been deferred because of lack of local funding? If so, how long? Yes, this project has been deferred many times. 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 project will be funded out of Public Works General Fund. The Commissioners typically fund the HARP program annually with $4 million, but reduced it to $2,800,000 in 2016. The HARP funds are direct distribution severance monies budgeted specifically to Public Works. 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. All motorists utilizing these roads recognize the value of this safety project. In addition, the road connects the towns of Herford, Grover, and Keota. Not only is WCR 390 a school bus route for Weld School District RE -12, but it is also a primary and secondary missile route for the US Air Force 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 ROW, Design, materials and labor to construct the improvements. Weld County crews will provide the equipment to complete the work. The grant cash match will be from Public Works' general fund. ii. Please list the value of the resources that each collaborator is bringing to the program 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 for ROW, design and possible utility relocation have been dedicated in the 2017 budget and construction will be dedicated in the 2018 budget. If awarded, Weld County will fund the cash match from Public Works' general fund f. Have the applicant's tax rates, user charges or fees been reviewed recently to address funding for the proposed project? Weld County has so many impacted roads that all available funding is going into the PW General Fund/HARP program to improve as many county roads as possible. The grant would help offset the cost of materials for this project. g. If the tax rate, user charges or fees were modified, what was the modification and when did this change occur? Weld County has been directing the revenues from the Specific Ownership Tax to Public Works 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, HARP roads are discussed at Weld County's Oil and Gas Working Group regular meetings. The O & G Working Group is made of industry partners where we discuss impacts affecting us all and problem solve how we can work together to minimize or mitigate 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 Weld 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 (_)Within 3 months, (X)3-6 months, (_)6-9 months or (_)9-12 months? What is the time frame for completion? Select One (_)Within 3 months, (_)3-6 months, (_)6-9 months, (_)9-12 months or (X_) >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 Revised 8 18.2016 application? The budget has been estimated by professional engineers. If the project exceeds the estimate, the County may need to reduce the project scope. 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. Planning and design is in progress. The environmental study is currently being done. i. What additional design work remains? Basic design is finished. Final design work will be done after the environmental study is finished. ii. How did the applicant develop project cost estimates? [—Estimates were developed using professional engineers and the historical costs of similar projects. iii. Is the project supported by bids, professional estimates or other credible information? Please attach a copy of any supporting documents. [ Professional engineering estimates, see attached. iv. Are any Local, State or Federal permits required before the project can proceed? If yes, please describe. No, additionalpermits are not required for this project. 6. Energy & Mineral Relationship 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 oil and gas activity for the entire state and therefore is extremely impacted. Much of the road's traffic is due to oil and gas trucks. 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. [ Companies with wells in the area include: Predominately Noble Energy and Whiting. 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 390 is a collector road. Traffic volumes range from approximately 200-334 vehicles per day with 78 percent being heavy truck traffic. (2016 count) 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 Department is recognized as a Tier 3 local government by the State and can manage all invoicing information through Banner Accounting System. In addition, Public Works will use the project management software PubWorks to assist in administering the project b. Describe the funding plan in place to address the new operating and maintenance expenses generated from the project? LWeld County will continue to utilize the Highway Users Tax Fund (HUTF) for maintenance expenses c. Describe the technical and professional experience/expertise of the person(s) and/or professional firms responsible to manage this project. Weld County Public Works has several engineers on staff and proven expertise in roadway improvement projects. Deanne Norris will be responsible for managing this project d. Does the project duplicate service capacity already established? Is the service inadequate? Has consolidation of services with another provider been considered? This is a safety project and does not duplicate service capacity, but creates it. Current service is inadequate and inefficient to meet existing traffic demands. Page 7 of 10 Revised 8 18.2016 E. HIGH PERFORMANCE 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 DOLA regional 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 you answered "yes" to questions 1, 2, 3, and if applicable, 4, then your project meets the HPCP applicability criteria. Complete the HPCP registration form and preliminary checklist and submit with this grant application. (See DOLA's HPCP web page for registration and checklist form.) ADDITIONAL 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 Revised 8.18.2016 F. TABOR COMPLIANCE. 1. Does the applicant jurisdiction have voter authorization to receive and expend state grants without regard to TABOR spending limitations? Yes(X ) 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( X ). Explain. I 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(X ) No(_}- Explain. I 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 levying of a greater amount of tax revenue than was levied from ad valorem taxation in the preceding year plus five percent (5%) except to provide for the payment of 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 Z Explain i No. 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. FIRM Panel 08123C1075E MSC.PBMP.PANEL NOT MSC.PBMP.PRINTED 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( X ) No(_). This proiect will improve public health air quality by eliminating fugitive dust particulate matter. 1 Page 9 of 10 Revised 8.18.2016 APPLICATION SUBMISSION INSTRUCTIONS AND OFFICIAL BOARD ACTION DATE (REQUIRED) Application and attachments must be submitted electronically in WORD .DOC (Preferred) or .PDF Format (Unsecured) to: ImpactGrantsastate.co.us Please Cc your DOLA Regional Manager all documents 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 submittal please call Denise Lindom © 303.864.7732 Attachments List (Check and submit the following documents, if applicable): N. Preliminary Engineering Reports ► Architectural Drawings ► Cost Estimates ► Detailed Budget ► Map showing location of the project ► Attorney's TABOR decision ► HPCP Registration, modification Or Waiver Form *****N******fN***********************N***M1**************M1*%N*1M****e*Yi*Nf•NrtN*************MN4h*RMN******N*********N ****** Official Board Action taken on NOV 2 3 MS Date Submission of this form indicates official action by the applicant's governing board authorizing application for these funds. Page 10 of 10 Hello