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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
Clerk to the Board
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20150838.tiff
RESOLUTION RE: APPROVE APPLICATION FOR ENERGY AND MINERAL IMPACT ASSISTANCE PROGRAM GRANT FOR WELD COUNTY PARKWAY MASTER DRAINAGE STUDY (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 Application for the Energy and Mineral Impact Assistance Program Grant for the Weld County Parkway Master Drainage Study(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 Finance and Administration, 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 Application for the Energy and Mineral Impact Assistance Program Grant for the Weld County Parkway Master Drainage Study(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 Finance and Administration,to the Colorado Department of Local Affairs be,and hereby is,approved. BE IT FURTHER RESOLVED by the Board that the electronic submittal of this application be,and hereby is,authorized. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 30th day of March,A.D.,2015. BOARD OF COUNTY COMMISSIONERS WE COUNTY,COLO ADO ATTEST: d ara Kirkmeyer,C air Weld County Clerk to the Board __,t Mike Freeman, Pro-Tem BY: -+. �. Deputy CI'rk to the Boy's s I a� Sean P.Conway APPR�t� r � � , - �ia�� � � %� La( �O FOR t p __ .Cozad Co,,'yAttorney �� 1 Steve Moreno Date of signature:t3 Ct;:Arc —')i.1(E-12)3d 2015-0838 FI0060 Revised 2.20.15 DO LA COLORADO CO to • 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: Weld County Parkway Master Drainage Study 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: Barbara Kirkmeyer Title: Chair Mailing Address: 1150 O Street Phone: 970-356-4000 x4200 City/Zip: Greeley, CO 80631 Phone: E-Mail Address: bkirkmeyer@weldgov.com 4. Designated Contact Person (will receive all mailings)for the Application: Name: Barbara Connolly Title: Controller Mailing Address: 1150 O Street Phone: 970-356-4000 City/Zip: Greeley, CO 80631 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 $2,000,000) Tier 1 -$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.) This project involves developing a master storm drainage plan for an area where growth is expected in unincorporated Weld County at the confluence of the South Platte and Cache la Poudre Rivers. This area is approximately seven square miles between US Highway 34 to County Road 60.5 east of Greeley and northwest of Kersey along the new Weld County Parkway. This new roadway corridor is expected to be highly impacted by the oil and gas industry and will provide a way for these types of vehicles to bypass the Greeley area once completed in the fall of this year. This area incurred severe damage from the September 2013 Flood and is inadequately protected from future storm events. A drainage master plan for this area would provide a project list for the County to implement storm drainage improvements to reduce peak flows, mitigate flooding, and protect people and property. The tasks associated with this project include: • Review of existing information such as floodplain studies; • Analysis of existing survey and topographic information; • Conducting ground surveys to obtain information about existing structures and conveyance facilities; • Determining a baseline hydrology for the corridor using hydrologic and hydraulic models; • Identifying locations along the corridor that are prone to local flooding and drainage issues; • Determining a list of alternatives to help mitigate these problem areas including; • Benefit-Cost Analysis; • Identifying areas along the corridor that present opportunities for the installation of water quality facilities; • Creating a report summarizing all of this analysis and design work. 7. Local priority if more than one application from the same local government(1 of 2,2 of 2,etc.) 1 of 1 2015-0838 Page 1 of 9 Revised 2.20.15 B. DEMOGRAPHIC AND FINANCIAL INFORMATION. 1. Population a. What was the 2010 population of the applicant jurisdiction? 254,230 b. What is the current population? 283,767 (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? 329,759 What is the source of the projection? DOLA 2. Financial Information (Current Year): In the column below labeled"Applicant"provide the financial information for the municipality,county,school district or special district 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 being submitted(if applicable). Complete items "a through j"for ALL project types: Applicant Entity Entity a. Assessed Valuation (AV) Year: 2015 $8,969,895,330 b. Mill Levy 15.800 c. Property Tax Revenue (mill levy x AV) $141,724,346 d. Sales Tax (Rate/Estimated Annual Revenue) 0%/$0 %/$ %/$ e. Total General Fund Budget Revenue $135,110,244 f. Total Applicant Budget Expenditures (Sum of General Fund and all Special Funds) $307,031,089 g. General Fund Balance as of January 1 of this current calendar year. $12,000,000 h. General Fund Balance (Unrestricted) as of January 1 of this current calendar year. $12,000,000 i. Total Multi-year Debt Obligations (all funds*) $0 j. Total Lease-Purchase and Certificates of $0 Participation obligations* 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": Identify the relevant Special Fund or Enterprise Fund: k. Special or Enterprise Fund Budget Amount $84,449,304 I. Special or Enterprise Fund Multi-Year Debt Obligations* $0 m.Special or Enterprise Fund Balance as of January 1 of this calendar year $9,635,000 n. Special or Enterprise Fund Balance (Unrestricted) as of January 1 of this calendar $0 year o. Special or Enterprise Fund Lease-Purchase $0 and Certificate of Participation Obligations* p. Special Fund Mill Levy (if applicable) 1.839 For Water and Sewer Project Only complete items "q through s": q. Tap Fee r. 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 s. Number of total Taps Served by Applicant *Include the sum of the year-end principal amounts remaining for all multi-year debt obligations, lease purchase agreements or certificate of participation notes Page 2 of 9 I Lo N 7 cc) \ 2 O O = \ \ K o o CO ° E \ >- i.,_ 7 © _ E a) 2 / / 2 6 2 c < / \ C aa) ® / - o .c 7J 7 .@ a) / = c R / , _ Ul E � 0 •0 O / / r5 © o o oue § - -- / e 2 U) 2 = 2 § § \ # \ \ \ Q �\ (ti c° § » / u I— ® % 7 al �/ _ \ 3 ° 00 L \ — , [ s R / a = O e = � = .0 § _ ® c E a_ U) E 0 \ \ - - / O \ - ) 0 \ \ \ o_ . \ \ 2a = a) = ec = c 3 2 — 0 a ° al a) $ ° ® § - - \/ 3 •4 \ y � / m w ® ee { o = tea \ s § = = = \ 6 = cu % $ \\ / \ � / � j \ a. c . . a) § \ ) 00 a) E E f o 0 y^ o / O m © = g 9 _ �$ 2 = o k § \ \ U) in o) a) e c = , e 2 0 > / e O E _ $ C O- = _A U \ � g . x / o a \ a) = a 7 = 2 E/ \ \ \ \ 2 \ o / \ ES X co \ co E \ E - = D f '$ ° tv 0 _ \ a E R y = C >4 e w L 2 } 2 2 \ -) 2 3 0 = _ oIX _ ° -J \ = e O § $Q. f = � % d w \ \ � / Revised 2.20.15 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 energy conversion of minerals and mineral fuels." 1. Demonstration of Need: a. Why is the project needed at this time? Typically, Weld County has not conducted regional drainage master plans for river basins. The 2013 Flood exposed the vulnerability of this area,though less severe storms could cause localized flooding as well. New bridges over the South Platte and Cache la Poudre Rivers are under construction, but the hydrology of the area still needs to be studied to understand the impacts of the new road on the Rivers and surrounding properties and to identify potential stormwater management projects to mitigate flooding potential. b. How does the implementation of this project address the need? A regional drainage master plan will analyze the hydrology of the area and develop a list of stormwater projects necessary to mitigate potential flooding and protect life and property. 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? In order to address the need, improvements will need to be implemented, as outlined in the study. Work will likely be phased by priority and implemented as funding allows. It is not economically feasible for any community to completely eliminate the risk of future flooding, erosion, or land subsidence, but Weld County would like to be prepared for future events, take necessary precautions, and minimize risk to the extent feasible. d. What other implementation options have been considered? The County could do nothing, but that doesn't address the need for regional storm water management. If property develops, the County could require the developer to study the drainage of the area and implement improvements, but this puts an onus on one developer, which would effectively prevent development in the area, and means no improvements would occur. In addition, this area is predominately floodplain and would be expensive to develop. The more responsible, pro-active approach is for the county to address the issues to the extent feasible as soon as practically possible. e. What are the consequences if the project is not awarded funds? Since this is an atypical county project,the study may not occur without grant funding. More than likely, it will be delayed without grant funding, which would delay the opportunity for future improvements. Also, the County may have to reduce the area to be studied at this time, although this would give an incomplete picture of the hydrology of the area of need. Subsequent studies may be necessary, duplicating cost. Flood events that occur prior to improvements being implemented may again cause damage to roads, bridges, and private property, and threaten lives. 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) With the construction of the Weld County Parkway, a significant transportation improvement, this area will be highly marketable to the traveling public and the county anticipates increased residential, commercial, and industrial development. A regional drainage master plan will be the first step toward emergency mitigation, providing a list of stormwater management projects and cost estimates, and it will also help educate stakeholders and the public through a public process. Implementation of improvements will improve livability by protecting property, transportation infrastructure,the environment, and safety of the region. b. How many people will benefit from the project? (i.e., region, county, city, town, community, subdivision, households or specific area or group; or any portion thereof) Direct benefit of plan would be to property owners in the area and downstream, including the Greeley-Weld County Airport and local oil and gas facility operators. Larger portions of Greeley, Kersey, and unincorporated Weld would indirectly benefit. Implementing improvements ahead of flood events protects residents, commuters, and property, and is less expensive than dealing with a crisis after the fact. Businesses in Kersey and east Greeley could benefit if access by customers and employees is not disrupted. Development of the master plan would demonstrate the County and State's commitment to addressing flood issues in the area. c. How will the outcome of the project be measured to determine whether the anticipated benefits to this population Page 4 of 9 I Revised 2.20.15 actually occur? _ This plan will provide a regional benefit. Future storms will determine whether implementation of the plan had the desired effects. The County will ensure any future improvements are in compliance with local,state, and federal regulations. d. Does this project preserve and protect a historic building, facility or structure? If yes, please describe. Year of construction: If there are any historic properties, a regional storm water management plan will be an improvement to the area. e. 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. 4 I N/A 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, 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,the master plan is identified in the 2015 budget and would be considered a capital drainage improvement. The County would be ready to fund the project if the grant is approved. 4. Local Commitment and Ability to Pay/Local Effort a. Why can't this project be funded locally? Since 2009, the Commissioners have tripled the amount of revenue going to Public Works with the widening of WCR 49 being the highest priority investment. Even with the additional funding,the oil and gas impacts to the county are profound and any assistance towards analyzing drainage improvements is extremely helpful. b. Has this project been deferred because of lack of local funding? If so, how long? With the completion of the Parkway project this fall of 2015,the importance of this project puts the county in a situation where it cannot be deferred and must be done in a relatively short time frame. 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.) The Commissioners are funding this project through Public Works General Fund. Once the study is complete, the county could use drainage impact fees to help implement the plan. CIP is a compilation of Road Impact Fees, direct distribution severance monies, and property taxes budgeted specifically for 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. The surrounding property owners in the region will benefit from the study. 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 fund the cash match from Public Works General Fund. Public Works contracted an Owner's Representative for the project and it will take approximately four Project Managers to assist with construction. 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 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? Typically, studies cannot be funded with impact fees, but for capital improvements.Weld County charges a drainage impact fee of$0.10 per square foot of impervious cover of development. The fee is based on an impact fee study last updated in 2010. In 2015, only an inflationary(CPI) increase in fees will occur. 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,Weld County regularly meets with oil and gas companies. There are many wells and tank batteries adjacent within this study area, so it is imperative we work with all stakeholders and landowners. 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,the industry is focusing on assisting Weld County with the WCR 49 corridor widening project, and with the drop in the price of oil, many companies are telling us it is difficult to pay more. Page 5 of 9 Revised 2.20.15 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 (_)Within 3 months, (_)3-6 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 application? Are contingencies considered within the project budget? If the grant is approved, the County will put the study out to bid. If the submittals come in higher than budgeted, the project area or scope of work could be amended until it is in line with submittals. c. Has the necessary planning been completed? How? What additional design work 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. The drainage master plan will determine what permits are required. Cost estimates are based on Engineering staff's professional expertise. 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. b. To further document the impact in the area, name the company or companies involved, the number of employees associated with the activities impacting the jurisdiction and other relevant, quantitative indicators of energy/mineral impact. The subject area is in the heart of the Wattenberg Energy Field,which is the 7th largest reserve in North America. Producers in the general vicinity include Amoco Production Co., Basin Exploration, Inc., Bayswater Exploration and Production, Fountainhead Resources, Gerrity Oil & Gas Corp., Kerr-McGee Oil & Gas Onshore, Merit Energy, Monago Operation, Inc., Monahan Gas & Oil, Inc., Noble Energy, Inc., PDC Energy, Inc., Snyder Oil Corp., Southwestern Production Corp., Sunshine Valley Petroleum, Synergy Resources Corp., Triton Energy Services, Unioil, Valley Operating, Inc., and Wichita Industries, Inc. Suncor, Rose Rock Midstream Crude, DCP Midstream, and Heartland Biogas (EDF Renewables) also operate or own land in the vicinity to the south of the subject area. 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? Once the study is complete,future capital improvements will be prioritized and funding assisted with the drainage impact fee. c. Describe the technical and professional experience/expertise of the person(s) and/or professional firms responsible to manage this project. Weld County has several engineers on staff. Elizabeth Relford, Transportation Manager with Weld County Public Works, 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? No,this study does not duplicate existing service capacity, but creates it because nothing like this exists in the region. 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 eligibility 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. Page 6 of 9 Revised 2.20.15 The HPCP requires projects that meet the eligibility 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 eligibility 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) 2. 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. 3. 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 4. 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 5. If you answered "yes" to questions 1, 2, 3, and if applicable, 4,then your project meets the HPCP eligibility 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: 6. 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:$ 7. 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 eligibility 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. F. TABOR COMPLIANCE. 1. Does the applicant jurisdiction have voter authorization to receive and expend state grants without regard to TABOR spending limitations? 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? No 3. Has the applicant jurisdiction been subject to any refund under TABOR or statutory tax limitations? Explain. No 4. Has the applicant sought voter approval to keep revenues above fiscal spending limits? Explain. Page 7 of 9 Revised 2.20.15 Yes 5. Are there any limitations to the voter approved revenues? (e.g., Can revenues only be spent on law enforcement or roads?) 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? Explain. No G. ENVIRONMENTAL REVIEW. Indicate below whether any of the proposed project activities: 1. Will be undertaken in flood hazard areas. Yes X No List flood plain maps/studies reviewed in reaching this conclusion. Describe alternatives considered and mitigation proposed. FIRM panels: 080266-0635C, 080266-0637C, 080266-0645C 2. Will affect historical, archeological or cultural resources, or be undertaken in geological hazard area? Yes No X Describe alternatives considered and mitigation proposed. This study is not located in a geological hazardous area. 3. Address any other related public health or safety concerns? Describe. Yes No The drainage master plan will provide a list of priority projects for stormwater management in the area, which, when implemented,will improve health and safety for area residents/commuters by mitigating flood hazards. Additionally, pooling of stagnant water may be lessened, reducing breeding areas for mosquitoes. Page 8 of 9 Revised 2.20.15 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: ImpactGrants@state.co.us Please Cc your Regional Field 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 Bret Hillberry @ 303.864.7730 Attachments List(Check and submit the following documents, if applicable): P. Preliminary Engineering Reports ► Architectural Drawings D. Cost Estimates D. Detailed Budget ► Map showing location of the project X ► Attorney's TABOR decision ► HPCP Registration, modification Or Waiver Form Official Board Action taken on March 30, 2015 Date Submission of this form indicates official action by the applicant's governing board authorizing application for these funds. Page 9 of 9 -a C C O a) co U a, c O <TZz fill 0 + 0 -i p : •,,,/, -;"'iiiir;:'? 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