ذدà،±ل>‏ے :<‏ےےے9ےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےى¥ء7 ً؟× bjbjUU ,67|7|¥,ےےےےےےlششششککک¬تتت8 $¬ك> > T T T ttt^``````$ç ~„کtlptt„èششT T ™èèèt.شRT H8T ^èt^èBè*&"€*T 2 گL¨؛‰>ؤ¬ت¢F**4¯0ك*…è…*è¬¬ششششظSTATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD DIVISION OF FINANCIAL ASSISTANCE DISBURSEMENT REQUEST INSTRUCTIONS for the SMALL COMMUNITY WASTEWATER GRANT (SCWG) PROGRAM This document provides instructions for requesting disbursement for the Small Communities Wastewater Grant Program. WHEN TO REQUEST DISBURSEMENT Disbursement requests can be submitted to the Division of Financial Assistance (Division) monthly (every 30 calendar days) after the contract (or amendment, as appropriate) has been executed. DISBURSEMENT REQUEST FORM Disbursement requests must be submitted on Form No. 260, Request for Disbursement. Form No. 260 is transmitted to the loan recipient after the contract or amendment is executed. A copy of Form No. 260 is included as Attachment “A”. AUTHORIZED REPRESENTATIVE The grant application included a copy of the resolution by the governing body of the recipient designating its “Authorized Representative.” This person is authorized to sign documents and represent the agency relative to the grant program. Form No. 260 lists the name and title of the authorized representative. If your agency uses a “Designated Representative (Designee)” instead of the agency’s appointed Authorized Representative as executor, please provide a letter of explanation indicating NAME and TITLE of the representative. This letter must be signed and dated by the Agency’s appointed Authorized Representative. In the event that a new Authorized Representative is named, a resolution authorizing the new representative must be submitted. Note: If the authorizing resolution identified the Authorized Representative by title or position rather than name, a new resolution may not be required. In such cases, a formal letter of appointment will suffice. CERTIFICATION OF EXPENDITURES To comply with the 1986 Federal Tax Reform Act, recipients must “certify” that (1) costs claimed have been incurred and that these costs have been paid or will be paid within 30 days of receipt of the grant funds requested, (2) if the costs have not been paid within 30 days, funds remaining will be returned to the State Water Resources Control Board (SWRCB), and (3) that all prior funds received from the grant program have been disbursed within 30 days of receipt or have been returned to the SWRCB. COMPLETING FORM NO. 260 -- REQUEST FOR LOAN OR GRANT DISBURSEMENT (ATTACHMENT “A”) The Form No. 260 will be partially completed by the SWRCB staff before being sent to the recipient. The recipient must do the following: 1. Enter the submittal date. 2. Enter the Disbursement Request Number. 3. Enter total costs incurred to date in Column C, except construction costs. (For construction costs see the following section of these instructions titled Completing Form No. 259 -- Construction Contractor Spreadsheet.) Please refer to Attachment “B” for complete details on how to calculate the allowances. 4. For Construction Grants, enter total cumulative project costs for planning and design in Column C even though some or all of these costs may have already been claimed under earlier planning and/or design grants. Planning and design grants are based on estimated construction costs. Once the competitive bid process for construction is complete, planning and design allowances are adjusted in the construction grant based on actual bid costs. Grantees should claim total cumulative project costs for planning and design when requesting payment during the construction grant phase. Costs previously paid under the planning and design grants will be deducted from the “adjusted” planning and design allowances. 5. Complete Column E. For Construction, these costs will be carried forward from the Column K of the Construction Contractor Spreadsheet (Form 259). Refer to Attachment “B” for allowance calculations. 6. Have the Authorized Representative sign and date the “Recipient Certification” portion of Form No. 260. No other entries or adjustments to the form should be made. A copy of the processed Form No. 260 will be sent to the recipient showing the date processed and the amount to be disbursed. COMPLETING FORM NO. 259 -- CONSTRUCTION CONTRACTOR SPREADSHEET (ATTACHMENT “C”) If disbursement is being requested for construction work, the recipient must include Form No. 259, “Construction Contractor Spreadsheet”. Form No. 259 is transmitted to the recipient as an enclosure to the letter transmitting Form No. 260 whenever construction costs are part of the grant contract. Form No. 259 will be partially completed by the Division. The recipient must: 1. Enter the submittal date. 2. Enter the Disbursement Request Number. 3. Enter costs incurred to date into Column H, Total Costs Incurred to Date. Once this information is entered, Column G will automatically be filled in with a percentage total work completed to date. 4. If there are materials on hand, enter this figure into the appropriate row towards the bottom of Column H. 5. Any retention withheld from the contractor should be entered into the appropriate row towards the bottom of Column H, unless the retention was deposited into Escrow or a Certificate of Deposit. The recipient must include a copy of the statement of deposit for any contractor retention funds that have been deposited into Escrow or a Certificate of Deposit. 6. If there is change order work that is approved by SWRCB staff, enter costs associated with the completed work into the appropriate row towards the bottom of Column H. 7. Total Eligible Costs Incurred to Date (Column K) are calculated by multiplying Column H times Column I, Eligible Percent, times the Median Household Income factor percentage. 8. Payment requests should reflect only completed, eligible, and approved change order work. Please use the Construction Change Order Summary, Form 259CCO (Attachment “D”) to compute the correct amount of eligible change order work to be claimed in Column J. 9. Total Column H. Enter this figure on the Form No. 260, Column C for construction costs. 10. Total Column K. Enter this figure on the Form No. 260, Column E for construction costs. Once Column H is completed, Columns K, L, and M will automatically be filled in. With the Form Nos. 259 and 260, the recipient must include a copy of the construction contractor’s pay estimate. The contractor’s pay estimate must be itemized by bid item for the project as outlined in the original bid in the Approval to Award. If the contractor’s pay estimate is itemized differently than what is outlined in the original bid document, then the recipient must provide documentation to show correlation between the contractor’s pay estimate and the original bid. The contractor’s pay estimate must be signed by both the grant recipient and the contractor. If applicable, invoices must also be submitted for costs associated with the following: Buy-In Land Purchase Utility Relocation WHERE TO SEND DISBURSEMENT REQUESTS Disbursement requests for the Small Community Wastewater Grants Program should be mailed to: State Water Resources Control Board Division of Financial Assistance Attention: Disbursement Coordinator 16th Floor, Administration Unit Post Office Box 944212 Sacramento, CA 94244-2120 Street Address for courier deliveries: 1001 I Street, 16th Floor Sacramento, CA 95814 PAGE 2 SCGINST.DOC Revised May 2004 8YZ|„´)E $ ! & K O P R ً X ب*…ٹب9جعmلçتظ^t»ر„ھz$ٍôپ ƒ ¥ ¦ § ¨ ® ¯ ° ± ² د × ِëِفعضزخخخجتجتتخختجتتجختجتتتتخببِء¾ء¶ء³CJ0JmHnHu0J j0JUH*>*5پ5پ>*5پCJ$CJ$\پCJ$CJ$OJQJWت^J5پ9پCJ$OJQJ\پ5پ9پOJQJ\پD8YZ|„´µ)F!%™ ً Y م *c:ّéّçهàààققققققققققققشششش „ذ„0‎^„ذ`„0‎$a$$¤<&dPئےa$$¤<a$¥ ر ش ض ‎‎‎‎:-أ÷cnê1ْhر{-1چê;|شـىùïùïيييïïçïïçïïïïيييغغغص ئàہ!„@„0‎¤x^„@`„0‎„0‎`„0‎ „ذ„0‎^„ذ`„0‎„ذ^„ذ%‚§ةï ( D E l ٹ ¤ ¥ ¦ § ² د ذ ‎‎ëëëëëëفرفء·‎¦‍‎ ئہ!¤$¤a$ ئ àہ!گ$¤ ¤5$7$8$H$ ئàہ!ذىdے¤< ئذىdے ئذىdے¤< ئذى„dے¤<^„ذ ر ز س ش ص ض × ‎‎‎‎‎‎َ ¤5$7$8$H$*00°ذ/ °à=!°"°#گ $گ %°° °> i<@ٌے<Normal¤ًCJ_HaJmH sH tH <A@ٍے،<Default Paragraph FontL>@ٍLTitle$¤ًa$$5پCJ0OJQJWتèٹ„ئ\پ^JaJ4@4Header ئàہ!¤ًaJDC@DBody Text Indent„ذ¤ً^„ذaJ&)@¢!&Page Number4J@24Subtitle$a$ 5پCJ \پ×ےےےےےےےےےےےےےے×ےےےےےےےےےے×6ےےےے8YZ|„´µ)F!%™ً Y م * c:-أ÷cnê1ْhر{-1چê;|شـى%‚§ةï(DElٹ¤¥¦§²دذرزشصطک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ک0€€ڑ@0€€ڑ@0€€ک@0€€ک@0€€ڑ@0€€ 0ڑ@0€€ 0ڑ@0€€ڑ€€+++.× :ذ × ض .!شے•€ً$ً _ًـ2ً$÷èàه]üع‌ن`–J-طےےےےےî"ً$ٍz@‘‡¤®(0ھ¨PےـNے\!ےےےےî"ً$k¹ر±E°^£$€¦êM~iے|ےےےےîً$ےî2ً$‘÷ïC`@هTKS·¤÷؟ےvےےےےî@ٌےےے€€€÷ً’ ًً0ً( ً ًًB ًSً؟ثے ?ًًHًً0ً( ً ً×.½؟¥ذرشط¬´ z¥ذرشط33ےےDarrin PolhemusRC:\Darrin\Current\SCG\2004 Guidelines\Final Version\App_D_SCWG_DisbursRqstInst.docDarrin Polhemus{C:\Documents and Settings\Administrator\Application Data\Microsoft\Word\AutoRecovery save of App_D_SCWG_DisbursRqstInst.asdDarrin Polhemus{C:\Documents and Settings\Administrator\Application Data\Microsoft\Word\AutoRecovery save of App_D_SCWG_DisbursRqstInst.asdDarrin PolhemusRS:\Agenda-resolutions\SCWG\Guidelines\Final Version\App_D_SCWG_DisbursRqstInst.docDarrin Polhemus{C:\Documents and Settings\Administrator\Application Data\Microsoft\Word\AutoRecovery save of App_D_SCWG_DisbursRqstInst.asdDarrin Polhemus{C:\Documents and Settings\Administrator\Application Data\Microsoft\Word\AutoRecovery save of App_D_SCWG_DisbursRqstInst.asdDarrin PolhemusRS:\Agenda-resolutions\SCWG\Guidelines\Final Version\App_D_SCWG_DisbursRqstInst.docDarrin PolhemusUS:\Agenda-resolutions\SCWG\Guidelines\Final Version\03_App_D_SCWG_DisbursRqstInst.docrindfliaUS:\Agenda-resolutions\SCWG\Guidelines\Final Version\03_App_D_SCWG_DisbursRqstInst.doc¤¥§دذطے@€؟؟`ï ؟؟×P@ےےUnknownےےےےےےےےےےےےGگ‡z €ےTimes New Roman5گ€Symbol3&گ‡z €ےArialQگTimes New Roman Bold"ٌˆًذhف[…Fl¢…†D$‍2!ً ´´پپ20d2ƒQًےےSTATE OF CALIFORNIADarrin Polhemusrindflia‏ےà…ںٍùOh«‘+'³ظ0„گک´ہطنً $ @L Xdlt|نSTATE OF CALIFORNIATATDarrin PolhemusarrarrNormal.dote rindfliate6ndMicrosoft Word 9.0@کق @[§7ؤ@ˆ‌¦‰>ؤ$‍‏ےصحصœ.“—+,ù®0hp€ˆگک ¨°¸ ہàنSWRCBF2 STATE OF CALIFORNIATitle ‏ےےے !"#$%&'(‏ےےے*+,-./0‏ےےے2345678‏ےےے‎ےےے;‏ےےے‏ےےے‏ےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےRoot Entryےےےےےےےے ہF€؛‰>ؤ=€1Tableےےےےےےےےےےےے…WordDocumentےےےےےےےے,6SummaryInformation(ےےےے)DocumentSummaryInformation8ےےےےےےےےےےےے1CompObjےےےےjObjectPoolےےےےےےےےےےےے€؛‰>ؤ€؛‰>ؤےےےےےےےےےےےے‏ےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےے‏ے ےےےے ہFMicrosoft Word Document MSWordDocWord.Document.8ô9²q