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Project No. 2957 KPWSLFDivision of Environment Curtis State Office Bui lding l 000 SW Jackson St., Suite 400 Topeka, KS 66612-1367 Lee A. Norman, M.D., Secretary Martha A. Tasker, Director of Utilities City of Salina 300WAsh P.O. Box 736 Salina, KS 67402-0736 RE: KPWSLF Project No. 2957 Dear Ms. Tasker: May 21 , 2021 Phone: 785-296-1535 Fax: 785-559-4264 www.kdheks.gov Laura Kelly, Governor Enclosed is a copy of the approved Request for Disbursement for the referenced project. Payment has been processed and you will soon receive payment for the amount indicated on Line i. According to our pay request disbursement records the loan is approximately 95% drawn. Attached for your information is a Loan Payment History Record . The Payment History Record shows the beginning balance, amendments, payments, and the balance available. The record also shows, if applicable, any deductions made for the Reserve Account, and Interest and Service fees, if you have asked that they be accrued. If you should have questions, please contact this office. The member of our staff who is most familiar with this subject, Debbie Gehrt, can be reached at 785-296-5538 or by e-mail at Debra.Gehrt@ks.gov. BSD.dsg Enclosure pc: Shandi Wicks, City Clerk HOR, Jessica Adams-Weber File Sincerely yours, ~~ Brenda Diegel Bureau of Water R:\Admin\Loan Program\DW 5RF\Payments\Active Projects\5alina 2957\5alina Letter 2957 21-05-21.docx KANSAS DEPARTMENT OF HEAL TH AND ENVIRONMENT BUREAU OF WATER Recipient: City of Salina KPWSLF Project No: 2957 Date: May 21, 2021 Type of Payment: Classification a. Administrative Expense (loan admin services, publ. fees, attorney f!JeS, etc.) b. Engineering Services Expense c. LC1nd, Easements (not allowable under KWPCRF) d. Construction Contract Expense e. Equipment (by separate KDHE approved contract or procedure f. Miscellaneous Cost (not categorized above) ..... · · ............ , ~-~·· ........ v-;-, .. · .. :···--................ 1'1.:.-......... ,. -· --... ............ g. Total of Invoices Submitted (slim of lines a thru f) h. Deductions for other sources of PUBLIC WATER SUPPLY LOAN FUND DISBURSEMENT REQUEST BREAKDOWN Vendor: 0000063020 Location: 001 Address: Payment Request No: [ill [K] Interim; 0Final a) Total Amount b) Amount Approved c) Amount Approved Approved to Date Previous Request This Request o.oo 0.00 0.00 4,016,820.97 3,807, 167.97 209,653.00 0.00 0.00 •-·.····r-~ ' . . •.. .,.~ ....... "'="·"''· 'l'f.···--;,\ ......... ~."··----..·. -I ,. :~ ••.• ,-.:'./ -....... ~;. ,., .. _.~ . .•.,. --·····-···-·· ....... _ .. __ ···: ... 4,016,820.97 3,807,167.97 209,653.00 .. funding used (grants or cash on hand) ( ) ( ) ( 0.00) i. b. Total Disbursement Requested from KDHE (Lin~ g minus Line h) 4,016,820.97 3,807, 167.97 $ $ KDHE Concurrence to Exhibit E KDHE Representative Certifying to line 8.ri. C. Mazaza M!awali Signature of Authorized Certifying Official o.S:-2).... 2-\ Typed or Printed Name and Tille: Date Approved May 21, 2021 Telephone (Area Code, Number & ext.) 785-296-5504 209,653.00 $ 209,653.00 95% Complete Dept: 2645773401 Fund: 7968 Bud Unit: 8545 Program: 22731 Acct: 575550 PC Bus: 26400 Project ID: 2648545 Activity: Operations EXHIBIT E -REQUEST FOR DISBURSEMENT FROM KDHE REVOLVING LOAN PROGRAMS INDICATE WHICH LOAN PROGRAM THIS REQUEST IS FOR: KDHE PROJECT NUMBER (REFER TO LOAN AGREEMENT) KANSAS WATER POLLUTION CONTROL REVOLVING FUND KWPCRF PROJECT# C20 --- KANSAS PUBLIC WATER SUPPLY LOAN FUND v KPWSLF PROJECT# 2957 -- IS THIS THE FINAL DISBURSEMENT RECIPIENT INFORMATION REQUEST FOR THIS LOAN? v NAME : City of Salina, Kansas YES NO ---- PAYMENT REQUEST ADDRESS or PO box (include P.O.Box 736, Salina, KS 67402-0736 NUMBER : 12 City, State, Zip): The undersigned hereby requests that the following amounts be disbursed for the following Project Costs as defined in the loan agreement: Invoice amounts (Invoices must Invoiced from (list payee(s)) Description Classification be attached) a. Administrative expense (loan admin services, publication fees, attorney fees, etc.) b. Engineering services expense c. Land, easements (Not allowable under KWPCRF) d. Construction Contract Expense $ 209,653.00 1. Smoky Hill, LLC 1. Water Main Replacement Project No. 1 e. Equipment (by separate KDHE approved contract or procedure) f. Miscellaneous cost (not categorized above) Total of Invoices Submitted $ 209,653.00 RECEIVED g. (sum of lines a thru i) h. Deductions for other sources of MAY 1 ·3 2021 funding used (from grants or cash on hand) i. Total Disbursement Requested from $ 209,653.00 BUREAU OF WATER KDHE *(Line g minus line h) CERTIFICATION: I hereby state and certify that: (i) the amounts requested, are or were necessary and appropriate in connection with the purchase, construction and installation of the Project, have been properly incurred and are a proper disbursement of the proceeds of the Loan and that an inspection has been performed and all work is in accordance with the terms of the Loan; have been paid or are justly due as stated above; and have not been the basis of any previous requisition from the proceeds of the Loan; (ii) all representations made in the Agreement remain true as of the date of this request; and (iii) no adverse developments affecting the financial condition of the Recipient or its ability to complete the Project or to repay the Loan have occurred. RECIPIENT NAME: City of Salina, Kansas Signature of Authorized Certifying Official f11v.;;tL ~-;Jd-- Typed or Printed Name and Title - Martha A. Tasker, Director of Utilities Date Signed Telephone (Area Code, number & ext.) Email S-/J. zoz..t 785-309-5725 martha.tasker@salina.org Revised 10/2016 'Total Approved by KDHE will be shown on separate sheet LOAN PAYMENT HISTORY RECORD RECIPIENT NAME: City of Salina RECIPIENT NUMBER: 2957 LOAN AGREEMENT AMOUNT: $ 4,250,000.00 LOAN AMEND. NO. 2: AMT$ DATE: July 2, 2018 DATE: LOAN AMEND. NO. 1: AMT. $ -LOAN AMEND. NO. 3: AMT $ DATE: April 16, 2019 DATE: PAYMENT OBLIGATIONS/ PAYMENT OBLIGATIONS/ NUMBER UNPAID BALANCES 4,250,000.00 % NUMBER UNPAID BALANCES 1, 144,331.09 % DATE DATE Payment 1,114,213.38 Payment 237,641 .24 1 04/15/19 26% 9 09/04/20 79% BALANCE 3, 135, 786.62 BALANCE 906,689.85 DATE DATE Payment 208,044.57 Payment 2 06/10/19 31 % 10 11/06/20 146,847.10 82% BALANCE 2,927,742.05 BALANCE 759,842.75 DATE DATE Payment 368,393.81 Payment 3 07/29/19 40% 11 03/26/21 317,010.73 90% BALANCE 2,559,348.24 BALANCE 442,832.02 DATE DATE Payment 65,532.64 Payment 4 09/03/19 41 % 12 05/21/21 209,653.00 95% BALANCE 2,493,815.60 BALANCE 233,179.02 DATE DATE Payment 177,407.68 Payment 5 10/21/19 45% BALANCE 2,316,407 .92 BALANCE DATE DATE Payment 277,708.36 Payment 6 01/13/20 52% BALANCE 2,038,699.56 BALANCE DATE DATE Payment 588,131 .57 Payment 7 04/10/20 66% BALANCE 1,450,567 .99 BALANCE DATE DATE Payment 306 ,236.90 Payment 8 07/01/20 73% BALANCE 1,144,331.09 BALANCE