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HomeMy WebLinkAbout20142385.tiff RESOLUTION RE: APPROVE APPLICATION FOR ENERGY AND MINERAL IMPACT ASSISTANCE PROGRAM GRANT FOR 2015 OIL AND GAS HAUL ROUTE ROADS (TIER II) 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 2015 Oil and Gas Haul Route Roads (Tier II) 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 2015 Oil and Gas Haul Route Roads (Tier II) 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 July, A.D., 2014. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTE#LeAsti frc r S IL �• �'k Nti a �Do�a Radema er, hair Weld County Clerk to the B 1 rd '� A 1/42 ..� -rbara Kirkmeyer, ro-Tem BY: Deputy Crrk to the Bo!' o 1 XCUSED t - Sean P. Conway APPROVED AS TO FORM: , �'1 - r A Mike Fre an 1)O, ou y Attorney V 1l /30 Wi Ham F. Garcia Date of sig ature: /%/ CC. Pie(c.fie.) 2014-2385 7-30-/$1 FI0059 Rev. 3/5/14 (For Use by State) State of Colorado - Department of Local Affairs 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 with Completing your Application- A. GENERAL AND SUMMARY INFORMATION 1. Name/Title of Proposed Project: Weld County 2015 Oil & Gas Haul Route Roads 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: Douglas Rademacher Title: Chair Mailing Address: 1150 O Street Phone: City/Zip: Greeley, CO 80550 Phone: 970-356-4000 E-Mail Address: drademacher@weldgov.com 4. Designated Contact Person (will receive all mailings) for the Application: Name: Barbara Connolly Title: Controller Mailing Address: 1150 O Street Phone: City/Zip: Greeley, CO 80550 Phone: 970-356-4000 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 2 -$2,000,000 6. Brief Description of the Project Scope of Work: (Give a brief introduction to the project in 100 words or less,including the various tasks involved in the project) Weld County request funding to assist with road damage created from intense oil & gas truck activity. In 2009, Weld County Commissioners implemented Public Works' Oil& Gas Haul Route (HARP) program. The program uses direct distribution severance dollars on roads significantly impacted by oil and gas activity. Oil and Gas development shifts locations throughout the county. The HARP program is dynamic enough to shift road improvements along with activity. However, due to record breaking O&G activity, Weld 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 now uses cement treated base in new road projects to reinforce the subgrade (below the asphalt) in order to support heavy truck traffic. We call this program, Full Depth Reclamation (FDR). This grant request is to reconstruct nine miles of CR 32 (4 miles) &CR 39 (5 miles) into FDR roads. 7. Local priority if more than one application from the same local government(1 of 2,2 of 2,etc.) 1 of 2 Page 1 of 8 Rev. 3/5/14 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? 276,076 (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? 319,286 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: 2013 $7,014,069,937 b. Mill Levy 16.804 c. Property Tax Revenue (mill levy x AV) $117,873,505 d. Sales Tax (Rate/Estimated Annual Revenue) 0°/0/$0 °/0/$ %/$ e. Total General Fund Budget Revenue $107,005,862 f. Total Applicant Budget Expenditures $255,832,866 (Sum of General Fund and all Special Funds) g. General Fund Balance as of January 1 of this $12,516,585 current calendar year. h. General Fund Balance (Unrestricted) as of January 1 of this current calendar year. $12,516,585 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 $55,581,423 I. Special or Enterprise Fund Multi-Year Debt $0 Obligations* m.Special or Enterprise Fund Balance as of $28,000,000 January 1 of this calendar year n. Special or Enterprise Fund Balance (Unrestricted) as of January 1 of this calendar $0 year o. Special or Enterprise Fund Lease-Purchase 1.639 and Certificate of Participation Obligations* p. Special Fund Mill Levy (if applicable) $0 For Water and Sewer Project Only complete items "q through s": q. Tap Fee r. Average Monthly User Charge (Divide sum of annual residential revenues by 12 and then divide by the number of residential taps served.) s. Number of 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 8 ( /\ z \ \ \ > 2 G _ E ° - ej k 0 \ � a) \ 75� / 6 ^ / — % a "cz, o = o a) j - \ CD CD \ \ a 26 k a = \ \ O � F- / \ C /\ _ e 2 / 0 o m _ 0 (0 2 c \ / \ _@ /\ 0 22 = 3 , =7 _ \ } / .I L 7 L.L. - a ' \ � \ \ 2 .O ( » k § / \ \ � / / 2 re ) S 2 — { 0- >. \ ■ 0j2g ± = 2 \ ` _ ao � � QZ & _ \ 2 0 f / / \ / � / \ � �ti 0 } § _ = 0 u = ° = $ / / \ Cr / CC / � k i . > ct \ 2 \ O O O $ E Tr CD c - $ CD Tr = 3 ° ® IN- 0 \ ) 2 In- CI) = R i \ —I _= /1 / O = 5 \ l ' > § 7 / § ® / rn ) \ E 0 # ` k 2 E f I 7 / x CO ~ = O a) 2 Ce -o m \ \ \ O § \ / m 04 E w z ± ® ® _ cp / 7 \ / / MS a. i CL 2 > d w \ � 0 0 2 E ) Rev. 3/5/14 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? This project is needed to improve safety. Weld County is the most active oil and gas county in the State. As a result, the impact to county roads is significant and therefore difficult to maintain. Weld County has more than 3,000 miles of road, of which 750 of those miles are paved. Many of the county's existing paved roads were not designed to withstand the increased oil and gas truck traffic and therefore; are deteriorating rapidly. In order to handle truck traffic, these roads need to be rebuilt from the subgrade level up. Weld County requests rebuilding 9 miles of the most deteriorated county roads supporting oil and gas activity. These roads include portions of WCR 39 (5 miles) and WCR 32 (4 miles) in the heart of the Wattenberg Energy Field. b. How does the implementation of this project address the need? Implementation of this project addresses the immediate need for safety improvements. 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. Once these roads are rebuilt the grant will be closed out. d. What other implementation options have been considered? The County is using a significant amount of oil and gas property taxes, direct distribution severance funds, and specific ownership taxes for county-wide road improvements. In addition, the Commissioners have committed to directing property taxes to Public Works to assist with construction and maintenance. 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 bought more equipment to help off-set oil and gas impacts. e. What are the consequences if the project is not awarded funds? If funding is not awarded,these roads will continue to deteriorate. Weld County may have to reduce the speed limit and continuing signing the area with "road damage" 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) These road improvements will make the roadway safer for all motorists and be constructed for a 20-year design life by using new technology at the subgrade level. 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) County Road 39 is an important north/south collector road carrying traffic volumes ranging from 1,758-2,006 vehicles per day,with 30%truck traffic. CR 32 is also an important east/west collector road carrying traffic volumes ranging from 2,324—1,353 vehicles per day,with truck percentages ranging from 26-30% of the traffic. c. How will the outcome of the project be measured to determine whether the anticipated benefits to this population actually occur? Traffic counts will continue to be collected to determine if traffic increases. d. Does this project preserve and protect a historic building, facility or structure? If yes, please describe. NIA 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. By utilizing Cement Treated Base (CTB)with a GPS motor grader it will reduce the number of grader passes, which reduces pollution therefore providing an improved air quality benefit. 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? Page 4 of 8 Rev. 3/5/14 Yes,this project has been identified in Public Works HARP budget. 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 and even with these supplements this project can't be entirely funded locally because the oil and gas impacts to the County are so widespread the Department cannot keep up with the demand on every county road. b. Has this project been deferred because of lack of local funding? If so, how long? Yes,this project has been deferred from last year's HARP program. Due to increased truck traffic,these roads have emerged with emergency repair needs that Public Works cannot solely address. 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 fund the Harp Program annually with $8 million dollars. The Harp Program funds are 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. All motorists utilizing these roads recognize the value of this safety project. 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. 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 will be included in the 2015 budget. f. Have the applicant's tax rates, user charges or fees been reviewed recently to address funding for the proposed project? Yes, Weld County is unique in the sense the Commissioners devote 100% of the Specific Ownership Tax directly to Public Works. In addition, by 2016,the Commissioners will double Public Works Road & Bridges mill levy in direct response to the County's oil and gas impacts. This grant will assist the County with leveraging monies to help accomplish more critical needs than can be solely funded internally. 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. As well as, the Commissioners have been allocating $8 million dollars annually to Public Works HARP Program for the past four years. 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. The HARP activities are discussed at Weld County's Oil and Gas Working Group bi-monthly meeting. The O&G Working Group is made up of industry partners who discuss impacts affecting us all in the field and problem solve how we can work together to minimize or remediate the problem. The industry typically helps Weld County projects with in-kind support, such as water hauling, gravel,trucking, and stock piling. 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, Weld County asked the industry for monetary support. However, over the past five years it has become apparent it is easier for the industry to provide in-kind support rather than monetary support. As a result,to further assist with financial support, Weld County continues to budget oil and gas royalties directly to Public Works. Therefore, the reciprocity of these relationships continues to improve and expand. Page 5 of 8 Rev. 3/5/14 5. Readiness to Go a. Assuming this project is funded as requested, how soon will the project begin? Select One(_)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, (X )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? By the time you can get this project under contract it will be winter and the asphalt plants will be closed. Therefore, Public Works will contract the project in the spring so construction can begin Summer of 2015. 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. This project includes contracting minor survey & design elements, such as drainage, which is included as Weld County's local match. The grant will cover the construction, which would also be contracted and is within the existing right-of-way limits. This is a construction project,which could be completed no later than fall of 2015. 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. The O&G activity continues to increase and so does ancillary uses associated with it. 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. County Roads 39& 32 is in the heart of the Wattenberg Energy Field, which is the 7th largest reserve in North America. 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 road is constructed,Weld 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 has proven expertise in roadway improvement projects. Elizabeth Relford, Transportation Planner/Engineering Supervisor with Weld County 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. E. HIGH PERFORMANCE CERTIFICATION (HPCP) PROGRAM COMPLIANCE. Colorado Revised Statutes (C.R.S. 24-30-1301 to 1307) require all new facilities, additions, and renovation projects funded with 25% or more of state funds to conform with the High Performance Certification Program (HPCP) policy adopted by the Office of the State Architect(OSA) if: • The new facility, addition, or renovation project contains 5,000 or more building square feet; and • The project includes an HVAC system; and Page 6 of 8 Rev. 3/5/14 • In the case of a renovation project, the cost of the renovation exceeds 25% of the current value of the property; and • The project has NOT entered the design phase prior to January 1, 2008. The HPCP requires projects achieve the highest possible LEED certification with the goal being LEED Gold. 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 are required to participate in the OSA's 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 certification is not practicable, an applicant may request a modification of the HPCP policy or a waiver if certain conditions exist. Please answer the following questions: 1. What is the total building square footage of the new facility, addition, or renovation? 2. Does the project include an HVAC system? Yes No 3. Is the project a renovation? (If no, please skip to Question 6 below.) Yes No 4. What is the current property value*? $ 5. What is the total project cost for the renovation? $ 6. Will you need assistance locating resources, third party consultants, or technical assistance for LEED requirements, preparing cost estimates, or otherwise complying with the HPCP? Yes No Explain F. TABOR COMPLIANCE. 1. Does the applicant jurisdiction have the ability to receive and spend state grant funds under TABOR spending limitations? 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. 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 No X List flood plain maps/studies reviewed in reaching this conclusion. Describe alternatives considered and mitigation proposed. 2. Will affect historical, archeological or cultural resources, or be undertaken in geological hazard area? Yes No X Describe alternatives considered and mitigation proposed. 3. 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Y.' a DG --J �- 11 • Domestic well ' Injecting I • ND i Plugged and Abandoned c • Producing — --- --� • Shut In • Temporarily Abandoned Map Disclaimer UN -- — — — — — VP This product has been developed solely for internal use only by Weld County • Waiting on completion The GIS database and data in the product is subject to constant change and the + Permit Location accuracy and completeness cannot be and is not guaranteed. The designation PW Proposed Not Built of lots or parcels or land uses in the data base does not imply that the lots or parcels Arsenal Service were legally created or that the land uses comply with applicable State or Local law. Local Service UNDER NO CIRCUMSTANCE SHALL THE PRODUCT BE USED FOR FINAL DESIGN PURPOSES. WELD COUNTY MAKES NO WARRANTIES OR Half and Half GUARANTEES, EITHER EXPRESSED OR IMPLIED AS TO THE COMPLETENESS, IIIIIIIIPArtenal ACCURACY, OR CORRECTNESS OF SUCH PRODUCT. NOR ACCEPTS ANY IIMMIDCollector LIABILITY. ARISING FROM ANY INCORRECT. INCOMPLETE OR MISLEADING Other INFORMATION CONTAINED THEREIN. No part of the product may be copied, Z Highway reproduced or transmitted in any form or by any means whatsoever, including, —Paved but not limited to. electronic, mechanical, photocopying, recording, scanning, — — Gravel or by any information retrieval system or any non-approved purpose without the express written consent of Weld County. Municipal. Paved Municipal. Gravel CCountyBoundary WELD COUNTY PUBLIC WORKS DEPARTMENT ENGINEERING COST ESTIMATE 1861 Project Name 39 from 28 to 38li — � Project Limits 5 miles DATE 3-Mar- 14 �L+GO U N T Y CONSTRUCTION SUBTOTAL $3,044,200 DESIGN & SURVEYING $131 ,250 CONSTRUCTION COSTS UNIT UNIT COST QUANTITY TOTAL FDR 15" @ 5% ;Buy and process cement; Ton $355 2 . 100 $745. 500 Milling (2 SY $3 70 ,400 $211 , 200 RCP 36" RCP (CIP) (3 pipe sections @ 70') LF $ 150 210 $31 . 500 ABC shoulders (2') Tons $25 3,000 $75 , 000 HMA ;grading G) 3" Ton $70 11 . 550 $808 . 500 HMA (grading S) 2" (PG 64-28) Ton $83 8 , 000 $664, 000 Mob LS $50, 000 1 $50 , 000 Paint p gal $50 350 $ 17, 500 Construction sign panel (Class A, each $52 15 $780 Flagging ;2 x 10 hour days = 30 days of work Hour $30 600 $ 18. 000 TCM Day $575 2 $ 1 , 150 TCI Day $ 160 30 $4, 800 Inspection cost (contracted) hour $80 240 $ 19, 200 Subtotal $2, 647, 130 add 15% $397, 070 TOTAL $3, 175,450 WELD COUNTY PUBLIC WORKS DEPARTMENT ENGINEERING COST ESTIMATE "l4. ...M Project Name 32 from 31 to 39 tiATr : a Project Limits 4 miles ✓��DATE 3-Mar- 14 U , c o_u N T Y, . 1 CONSTRUCTION SUBTOTAL $2,461 ,610 DESIGN & SURVEYING $105,000 r CONSTRUCTION COSTS UNIT UNIT COST QUANTITY TOTAL FDR 15" @ 5% (Buy and process cement) Ton $355 1 , 700 $603. 500 Milling (2") SY $3 56 , 000 $ 168. 000 RCP 36" RCP (CIP) (3 pipe sections @ 70') LF $ 150 210 $31 . 500 ABC shoulders (2') Tons $25 2 .400 $60 . 000 HMA (grading G) 3" Ton $70 9, 240 $646, 800 HMA (grading S) 2" ;PG 64-28; Ton $83 6.400 $531 . 200 Mob LS $50. 000 1 $50 . 000 Paint gal $50 280 $ 14, 000 Construction sign panel :Class A) each $52 15 $780 Flagging (2 x 10 hour days = 24 days of work Hour $30 480 $ 14,400 TCM Day $575 2 $ 1 , 150 TCI Day $ 160 24 $3 , 840 Inspection cost (contracted) hour $80 192 $ 15, 360 Subtotal $2, 140. 530 add 15% $321 . 080 TOTAL $2,566,610 Rev. 3/5/14 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 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 @ 303.866.4058 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 B. Attorney's TABOR decision Official Board Action taken on July 30, 2014 Date Submission of this form indicates official action by the applicant's governing board authorizing application for these funds. Page 8 of 8 Hello