Bond Authorization Requested

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1 District r Charter Schl Cntact Persn: Address 1: Address 2: City: Zip Cde: Telephne: Address: Bnd Authrizatin Requested The maximum bnd authrizatin that may be requested per district r charter schl per allcatin year is the greater f either: 1) 5,000,000; r 2) {5,000,000 + [500 x ( Public Educatin Infrmatin Management System student enrllment 400)]}. The maximum bnd authrizatin that may be requested per district r charter schl per allcatin year may be increased by an additinal 5 percent if the district r charter schl cmmits t designing and cnstructing its prjects s that they receive certificatin under a high-perfrmance building standard such as: the Leadership in Energy and Envirnmental Design (LEED) Green Building Rating System; the Texas Cllabrative fr High Perfrmance Schls (TX-CHPS) Criteria; the Green Building Initiative's Green Glbes criteria; r an equivalent standard adpted by the municipality r cunty in which the prjects are lcated. Acknwledgement f intent t design and cnstruct prjects s that they receive certificatin under a highperfrmance building standard (please check if applicable) Numeric amunt f the bnd authrizatin requested: (Example: 5,250,000) Written amunt f the bnd authrizatin requested: (Example: Five millin tw hundred fifty thusand dllars) Applicant must cmmit t spend at least 10 percent f the prceeds within six mnths and 100 percent f the prceeds within three years f issue f the QSCB bnds: Anticipated issue date: Anticipated amunt f funds spent six mnths after issue: Anticipated amunt f funds spent three years after issue:

2 Prject Descriptin(s) CAMPUS NAME PROJECT TYPE (check ne bx nly fr each prject) ESTIMATED COST NARRATIVE DESCRIPTION Prject 1 Prject 2 Prject 3 Prject 4 with land acquisitin Additin(s) nly Additins and repairs r rehabilitatin Repairs r rehabilitatin nly with land acquisitin Additin(s) nly Additins and repairs r rehabilitatin Repairs r rehabilitatin nly with land acquisitin Additin(s) nly Additins and repairs r rehabilitatin Repairs r rehabilitatin nly with land acquisitin Additin(s) nly Additins and repairs r rehabilitatin Repairs r rehabilitatin nly Issuance csts (if any): Cannt exceed 2% f the bnd authrizatin amunt requested TOTAL PROJECT COSTS & ISSUANCE COSTS: Must equal the bnd authrizatin amunt requested This page may be reprduced t prvide additinal space as needed.

3 As used in this applicatin: "Agency" means the Texas Educatin Agency (TEA); "Applicant" means the entity eligible t apply fr bnd authrizatin. If the applicatin is apprved, applicant means the entity granted the bnd authrizatin. Statement f prvisins and assurances fr the bnd authrizatin requested in this applicatin: A. The applicant certifies that 100 percent f the prceeds f the qualified schl cnstructin bnds will be used fr sme r all f the fllwing qualified purpses: Cnstructin f public schl facilities; Rehabilitatin r repair f public schl facilities; Acquisitin f land n which public schl facilities will be cnstructed with prceeds f issuance; Equipment related t the prject(s) cnstructed r rehabilitated with the prceeds f issuance; r Issuance csts nt t exceed 2 percent f ttal bnd prceeds. Within six mnths f issuance, the applicant must have entered int cntract(s) fr use f prceeds equal t 10 percent f issuance. Additinally, 100 percent f the bnd prceeds are t be used fr a qualified purpse and must be spent within three years f the date f issuance. B. Debt instruments: A schl district applicant shall issue ne r mre f the fllwing fur types f debt instruments: General Obligatin Bnd - authrized under the authrity f the Texas Educatin Cde, Chapter 45, Subchapter A; Lease Purchase - authrized under the Texas Lcal Gvernment Cde, r ; Time Warrant - authrized under the Texas Educatin Cde, ; r Maintenance Tax Nte - authrized under the Texas Educatin Cde, A charter applicant shall issue nly the fllwing type f debt instrument: Revenue Bnd - as authrized under the Texas Educatin Cde, Chapter 53, Subchapter C. C. Cmpliance with the Davis-Bacn Act: The applicant certifies that all labrers and mechanics emplyed by cntractrs and subcntractrs n prjects funded directly by r assisted in whle r in part by and thrugh the federal gvernment pursuant t this authrizatin shall be paid wages at rates nt less than thse prevailing n prjects f a character similar in the lcality as determined by the secretary f labr in accrdance with 40 United States Cde (USC), Chapter 31, Subchapter IV. With respect t the labr standards specified in this sectin, the secretary f labr shall have the authrity and functins set frth in Rerganizatin Plan Numbered 14 f 1950 (64 Stat. 1267; 5 USC Appendix) and 40 USC, 3145 (Sectin 1606). The applicant certifies that all cntracts will include language that acknwledges that all cntractrs r subcntractrs must pay labrers and mechanics emplyed under the cntract n less than lcally prevailing wages fr crrespnding wrk n similar prjects in the area. The U.S. Department f Labr determines lcally prevailing wage rates. Wage determinatins: Texas wage determinatins are linked frm the fllwing site: D. The applicant certifies that the applicant will cmply with any arbitrage and rebate requirements that may be applicable n gvernmental tax-exempt bnds.

4 Statement f prvisins and assurances fr the bnd authrizatin requested in this applicatin (cntinued): E. N ther agreement, written r ral, purprting t alter r amend this applicatin shall be valid. F. The applicant certifies that the persn signing this applicatin has been prperly delegated this authrity. G. In the cnduct f the bnd authrizatin, the applicant shall be subject t Texas State Bard f Educatin rules and cmmissiner f educatin rules pertaining t schl facilities and the bnd authrizatin and t the laws f the State f Texas gverning this bnd authrizatin. This dcument cnstitutes the entire agreement between the agency and the applicant fr the bnd authrizatin. H. The agency may cnduct desk reviews r n-site mnitring reviews t determine cmpliance with the apprved applicatin and the applicable statute(s), law(s), regulatins, and guidelines. I. If the applicant, in the agency s sle determinatin, fails r refuses fr any reasn t perfrm any f its bligatins under this cntract, the agency may impse such sanctins as it may deem apprpriate. The cancellatin, terminatin, r suspensin f this bnd authrizatin, if impsed, shall becme effective at the clse f business n the day f the applicant s receipt f written ntice theref frm the agency. J. The applicant, t the extent permitted by law, shall hld the agency harmless frm and shall indemnify the agency against any and all claims, demands, and causes f actin f whatever kind r nature asserted by any third party and ccurring r in any way incident t, arising frm, r in cnnectin with any acts f the applicant, its agents, emplyees, and subcntractrs, dne in the cnduct f the bnd authrizatin. K. The applicant shall maintain its recrds and accunts in a manner that assures a full accunting fr all funds received and expended by the applicant in cnnectin with the bnd authrizatin. These recrds and accunts shall be retained by the applicant and made available fr prgrammatic r financial audit by the agency and by thers authrized by law r regulatin t make such an audit fr a perid f nt less than five years frm the date f the end f debt service. If an audit has been annunced, the recrds shall be retained until such audit has been cmpleted. L. The applicant certifies that n funds prvided under this bnd authrizatin shall be used t purchase supplies, equipment, r services frm any cmpanies fund t be guilty f unfair business practices within 12 mnths frm the determinatin f guilt. M. The applicant certifies that n funds will be used t pay fr religius wrship, instructin, r prselytizatin, r fr any equipment r supplies fr such, r fr any cnstructin, remdeling, repair, peratin, r maintenance f any facility r part f a facility t be used fr religius wrship, instructin, r prselytizatin (34 Cde f Federal Regulatins, and Public Law , 9505). N. The applicant certifies that any cnstructin r majr renvatin f an existing r new instructinal facility using funds btained by the applicant under this bnd authrizatin shall cnsider, in the design f the instructinal facility, security criteria develped by the Texas Schl Safety Center under the Texas Educatin Cde,

5 I certify that t the best f my knwledge, the infrmatin in this applicatin is true and crrect. I further certify that any ensuing prgram and activity will be cnducted in accrdance with all applicable federal and state laws and regulatins, applicatin guidelines and instructins, and the statement f prvisins and assurances cntained herein. Printed Name f Superintendent r Other Authrized District r Charter Schl Official X Original Signature (Blue Ink Preferred) f Superintendent r Other Authrized District r Charter Schl Official X Date Please return t: Texas Educatin Agency Dcument Cntrl Center, Rm ATTN: QSCB 1701 Nrth Cngress Avenue Austin, TX Fax r submissins will nt be accepted. Cmpleted applicatins will be cnsidered n a first-cme, first-served basis, with an applicatin deadline f 5:00 p.m. (CDT), June 30, Questins? Call Sam Lester f the State Funding Divisin at (512) r Gary Marek f the State Funding Divisin at (512)

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