WIFIA PROGRAM LETTER OF INTEREST FORM CHECKLIST1 GENERAL ~ All questions are answered. Answers may be "not applicable" or "see attachment, file XX, pages XX." ~ All referenced attachments include the file name and relevant page numbers or chapter number. ~ Submitted attachments are complete documents (not excerpts). ~ Letter of Interest is submitted in form dated April 4, 2018 provided by EPA at https://www.epa.gOv/wifia/how-applv-wifia-assistance-0#materials. ~ Letter of Interest does not exceed 50 pages. ~ Confidential Business Information is clearly identified and labeled per the instructions provided in the Letter of Interest form. ~ If multiple projects are included in one letter of interest form, provide cost, scope and schedule information for each individual project being proposed. SECTION A ~ For private entities, documentation demonstrating public sponsorship is included. (Q. A-ll) ~ The organization chart provided clearly illustrates the relationships of all relevant parties. (Q. A- 10) SECTION B ~ Project description and purpose clearly explain the project to an audience with little to no previous knowledge of the project. (Q. B-4-5) ~ Accurate and clear project location information is provided, including a map or relevant street intersections. (Q. B-6) ~ Project schedule is documented in the key milestones table in Letter of Interest form and a more detailed schedule is provided as an attachment. (Q. B-ll) ~ All available planning documents, including preliminary engineering reports, feasibility studies, preliminary designs, siting studies, project plans, and detailed cost estimates, created in support of the project are attached. Documents may be draft. (Q. B-12) ~ If available, the system master plan and/ or asset management plans are included as attachments. (Q. B-14) ~ The status of and plans for state or Federal environmental reviews are clearly explained. If available, environmental information documents and cross-cutter consultation communications are included as attachments. (Q. B-17) 1 This checklist designed to be used in conjunction with the WIFIA Letter of Interest Form (OMB Control No. 2040- 0292) 1 of 2 ------- SECTION C ~ The estimated useful life of the project is provided. (Q. C-l) ~ Lifecycle costs or assessments are submitted as attachments, if available. (Q. C-2) ~ If a full plan is not available, an explanation of major topics to be included in the final plan or the plan's table of contents is submitted. (Q. C-2) SECTION D ~ The requested amount of the WIFIA loan and the total eligible project costs are clearly identified. (Q. D-l-2) ~ The total sources are equal to the total uses, minus ineligible costs. (Q. D-3) ~ If available, existing credit ratings are provided for senior debt and, in cases where WIFIA is being proposed as subordinate debt, subordinate debt. (Q. D-4) ~ The credit structure for WIFIA loan indicates whether debt will be issued under existing or new indenture and the proposed lien position. (Q. D-5) ~ The revenue pledged to repay the WIFIA loan is clear and any credit enhancement is noted. (Q D-5) ~ The financial pro forma is attached as an editable Excel document. (Q. D-8) ~ The financial pro forma includes at least all the applicable fields that are included in the Sample Financial Pro Forma and includes projections through the life of the loan. (Q. D-8) SECTION E ~ Responses address the selection criteria as described in Appendix C of the WIFIA program Handbook. SECTION F ~ Contact information is included for at least one staff member who works day-to-day on the project. (Q. F-l-2) SECTION G ~ The signed and scanned version of this section is included as an attachment. SECTION H ~ The signed and scanned version of this section is included as an attachment. Box is initialed only if you DO NOT want your materials shared with your state SRF program. 2 of 2 ------- |