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Home My WebLink AboutCAG2001-0552 - Amendment - Public Works Board - Public Works Trust Fund PW-01-691-032 Final Voucher - 10/08/2003 October 3, 2003 Mr. Don Wickstrom City of Kent 220 Fourth Ave S Kent, WA 98032 RE: Completing the Final Voucher and Closeout Report for Public Works Trust Fund Construction Loan • Loan Number: PW-01-691-032 • Project Name: Tacoma's Second Supply Pipeline 5 Project Dear Mr. Wickstrom: Enclosed please find the Final Voucher and Close-Out Report for Public Works Trust Fund Construction Loan. These forms should be completed and sent to the Public Works Board as soon as possible after the project is finished. The forms should be sent to: Isaac Huang Public Works Board 210 11`"Avenue PO Box 48319 Olympia, WA 98504-8319 You will note that our office has completed the estimated expenditures by cost category. We have also identified the eligibility date, the total project allocation, and the amount drawn to date. The information was taken from the project loan file. Please review these items to ensure that they agree with your figures. If you have any questions, please contact me at 360-725-5009. Sincerely, Isaac Huang Client Services Representative Enclosures A\Cent PW-01-032 doc Public Works Board Public Works Trust Fund ( Construction Loan Program Project Close-Out Report Loan Agreement Number: PW-01-691-032 NOTE: This report shall serve as a contract AMENDMENT for determining the final loan amount, interest rate,and local share and shall be attached and incorporated into the loan agreement. The report accounts for funds associated with the Public Works Trust Fund Loan Agreement's Scope of Work. Costs outside of the Scope of Work are not accounted for by this report. City of Kent Jim White 220 Fourth Ave S Name of Chief Executive Officer: Kent, WA 98032 Mayor Title: NOTE: This document is to certify that the project,as described in the Public Works Trust Fund Loan Agreement's Scope of Work, is complete and has been designed and constructed to current standards. SECTION 1: Estimated and Actual Project Expenditures by Cost Cate or . COST CATEGORY ESTIMATED ACTUAL Preliminary Engineering A. $ 430,000.00 N. $ in design Environmental Review B. 500,000.00 O. In design Design Engineering C. 1,800,000.00 P. 1,428,000 Land/ROW Acquisition D. 240,000.00 Q. 4,000 Sales or Use Taxes E. 1,500,000.00 R. 1343,000 Other Fees F. 180,000 00 S. 208,000 Construction Inspection G. 1,500 000.00 T. 808,000 Start-Up Costs H. U. - Relocation Costs I. V. - Financmg Costs J. 750,000.00 W. - Contingency K 2,700,000.00 X. - Construction L. 18,400,000.00 Y. 15,992,000 TOTAL PROJECT COST M $ 28,000,000.00 Z. $ 19,783,000 SECTION 2: Attachments • If applicable,a signed A-19 voucher for the final loan draw. Please note:copies of clearance documents from the Department of Revenue and the Department of Labor and Industries are no longer required for close out. However, borrowers are still required to comply with all state regulations regarding public works contracts. SECTION 3: Certification The chief executive officer of the jurisdiction certifies that: • To the best of his/her knowledge,the data provided in this report is true and correct as of the date indicated below; • Records supporting the information provided in this report are on file and will be made available by the jurisdiction upon request; and • There are no outstanding liens against this project Sign of Pro,ect Engineer or C uktant Date Sign re of Chia f N%@..ww,P Q ffie.._ `,t Dn Date '•` f�•. Xb : 1 State o � County o On this day of ,20 0-1 J&4-OL�Q�� /Z)A� personally appeared before me, i whoGare]mown to me, whose identity I verified on the bases of whose identity I verified on the oath/affirmation of a credible witness, to be the signer/s of the foregoing document,and h�e she/they acknowledged that he/she/they signed it. a� 9. 94 .1 Notary Public (Sea] or Stamp)nf My Commission Expires:Or F ''••.......••��. �r A\Cent PW-01-032 doc Return this worksheet with Close-Out Report WORKSHEET FOR CALCULATING THE FINAL DRAW& LOCAL MATCH Unlike the first two vouchers, the Public Works Board staff is unable to calculate the amount of the final draw. Two variables essential to the calculation are known only by the jurisdiction, i.e.,the actual total eligible project cost and the interest earned on the PWTF funds. The worksheet provided here is designed to assist the jurisdiction in calculating the amount of the final draw. Worksheet: Step 1. Identify the Actual total eligible project cost. 1. 18,614,321.51 Step 2. PWTF contract's face amount. 2. 10,000,000 00 Step 3. Identify the Actual local funds used as match* Eligible costs may be considered local 3. 8,918,832.63 share from: <<12 months prior to Loan Agreement Execution Date>> Step 4. Identify other federal or state grants used for project costs. 4. 0 Step 5. Balance of eligible project cost(subtract line 4 from line 1). 5. 18,614,121.51 Step 6 Multiply Line 5 by 85%, 90%,or 95%,as defined in the "Disbursement of Loan Proceeds" �85% section of the loan agreement. 6. 15,822,173.28 Step 7. Identify interest earned on PWTF funds. 7. 279,983 13 Step 8. Subtract line from line 7 from line 6. 8. 15,542,190 15 Step 9. Enter the lesser of line 2 or line 8 (or a local option of an elective amount less than both line 2 and line 8). 9 10,000,000 00 Step 10. Amount drawn from the project's PWTF allocation to date. 10. 9,500,000.00 Step 11. To calculate the final draw amount for the project, subtract line 10 from line 9 (If this is a negative amount,this is the amount needed to refund to the Public Works Board 11. 500,000.00 within 30 days) Step 12. Percent of local share (divide line 3 by the sum of lines 3 &9). 12. 47.14% * Eligible Costs for LOCAL MATCH Local Funds Included: * Loans (state,federal,and local) * Locally generated revenue Local Funds Excluded: • Interest earned on PWTFfunds * All grants * PWTF Pre-Construction loan A Xent PW-01-032 doc FORM STATE OF WASHINGTON AGENCY USE ONLY A19-1 A AGENCY NO I CONTRACT NO OR GA AUTH NO INVOICE VOUCHER 103 1 PW-01-691-032 AGENCY NAME INSTRUCTIONS TO VENDOR OR CLAIMANT. Public Works Board In the absence of a detailed invoice,submit this form to claim payment 210 11'"Street or materials,merchandise or services Show complete detail for each item Post Office Box 48319 Olympia,Washington 98504-8319 Vendor's Certificate: I hereby certify under penalty of penury that the items and totals listed ierein are proper charges for materials,merchandise or services furnished VENDOR OR CLAIMANT(warrant is to be payable to) to the State of Washington,and that all goods fumished and/or services rendered have been provided without discrimination because of age,sex, naMal status,race,creed,color,national origin,handicap,religion,or City of Kent /ietnam era or disabled veteran statu 220 Fourth Ave S Kent, WA 98032 By ISRSign in ro131o3 (Title) (Date) FFEJDERAL I D NO OR SOCIAL SECURITY NO RECEIVED BY DATE RECEIVED 6001254 DATE DESCRIPTION QUANTITY UNIT PRICE AMOUNT PW-01-691-032 Final Voucher Loan Amount 10,000,000.00 Previous Draws 9,500,000.00 Balance 500,000.00 Total Final Voucher $ 500,000.00 PREPARED BY(Fiscal) DATE SERVICE AREA APPROVAL DATE DOC DATE CURRENT DOC NO REF DOC NO VENDOR NUMBER VENDOR MESSAGE M SUB TRANS O APPN PROGRAM SUB SUB INVOICE GENERAL SUF CODE D FUND INDEX INDEX OBJ OBJ CNTY CITY PROJECT AMOUNT NUMBER LEDGER APPROVED FOR PAYMENT BY FISCAL DATE WARRANT TOTAL A Xent PW-01-032 doc