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DISBURSEMENT REQUESTS <br /> The following items MUST be checked(X) for compliance. If not in compliance, explain in the text of <br /> disbursement request letter. <br /> Indicate by checking below that: <br /> a. A current, separate project construction account fund exists. <br /> b. All unexpended loan funds are invested in an interest bearing account. <br /> _c. Adequate construction engineering is being provided. <br /> d. The engineering charges have been reviewed and the charges are reasonable, supported <br /> by documentation and in accordance with the approved engineering contract. <br /> e. No refunds, rebates or credits have been received by the borrower. <br /> f. Appropriate flood insurance under the national Flood Insurance Act of 1968, as amended, <br /> has been acquired and maintained. At the time of FINAL disbursement, evidence must <br /> be submitted showing required flood insurance has been purchased for all eligible <br /> construction. <br /> g. The sewer/water use ordinance and user rate ordinance incorporating the user charge <br /> system have been enacted and submitted prior to the first loan disbursement. <br /> _ h. The dedicated source of revenue has been enacted and submitted prior to the first loan <br /> disbursement. <br /> _ i. Executed construction contract documents have been submitted prior to the first loan <br /> disbursement. <br /> j Each prime contractor has current and appropriate insurance coverage including <br /> workmams compensation,public liability and property damage, fire,and extended <br /> coverage including A4I1 Risk@ype of Builder* Risk Insurance. <br /> _ k. If this is a FINAL disbursement request, a set of plans of record(including revised sheets <br /> to the plans for all change orders which have been issued)must be sent to the appropriate <br /> State Regional Office. Please send a copy of the transmittal letter to the Infrastructure <br /> Financial Assistance Section, Illinois Environmental Protection Agency. <br /> I hereby certify that this request for disbursement is, to the best of my knowledge and belief,a true and <br /> accurate request for disbursement;that it is made in accordance with the conditions of the loan for the <br /> project; and that I am authorized to request disbursements on behalf of the borrower. <br /> Authorized Representative Title _ <br /> (Name printed or typed) <br /> KS032002.sed <br />