Application for Brownfield Loan Assistance

Size: px

Start display at page:

Download "Application for Brownfield Loan Assistance"

Sharon Leslie Stephens
7 years ago
Views:

1 Niagara County Brownfield Development Corporation BOARD OF DIRECTORS Paul A. Dyster Chairperson William L. Ross Vice Chairperson Samuel M. Ferraro Secretary Amy E. Fisk President John M. Baird Treasurer Application for Brownfield Loan Assistance Before completing and returning the enclosed Application for Loan Assistance, you must receive written approval of your Qualifying Application for Brownfield Assistance from the Niagara County Brownfield Development Corporation (NCBDC). Program Fees As part of the application process, there is a one thousand dollar ($1,000.00) non-refundable application fee made payable to the Niagara County Brownfield Development Corporation when this application is submitted. APPLICATIONS WILL T BE CONSIDERED COMPLETE UNTIL THE APPLICATION FEE HAS BEEN SUBMITTED. Submission Requirements ONE (1) original hard copy and ONE (1) electronic copy ( is okay) of the completed Application for Assistance, and ONE (1) copy of the supporting documentation identified in Section VI should be mailed to: Ms. Amy E. Fisk, AICP, President Niagara County Brownfield Development Corporation Vantage Center Suite One 6311 Inducon Corporate Drive Sanborn, NY amy.fisk@niagaracounty.com Questions should be directed to Ms. Fisk at (716) Inducon Corporate Drive Sanborn, NY Fax Business Assistance Hotline

2 ELIGIBLE COSTS BCRLF USE OF FUNDS Preparing an analysis of brownfield cleanup alternatives Developing a Quality Assurance Project Plan Complying with public participation requirements Establishing an administrative record for the site All reasonable costs for equipment, work, and services for remediation on non-petroleum hazardous waste sites not yet performed at the time of loan or grant approval. Ensuring the cleanup complies with applicable state and federal laws Limited site characterization including confirming the effectiveness of the cleanup action COSTS THAT ARE T ELIGIBLE Remediation that has already been conducted Environmental site assessment activities (i.e. Phase I and II ESAs) Monitoring and data collection necessary to apply for, or comply with environmental permits unless the permit is required as part of the cleanup action Construction, demolition, and development activities that are not integral to the cleanup action Remediation of petroleum only contaminated sites. (Note, sites that have both petroleum and hazardous substances contamination are considered co-mingled and ARE eligible to apply for financial assistance for the BCRLF) Job training activities, lobbying, or fundraising To pay for a penalty or fine or for a response cost at a brownfield site for which the applicant is potentially liable under CERCLA 107 To pay a federal cost share requirement To pay a cost of compliance with any federal law, excluding the cost of compliance with laws applicable to the cleanup All administrative costs (Note: A few administrative type costs have been identified by EPA as being eligible programmatic costs for which grant funding can be used. Please see Section IV. Financial Administrative Requirements, (C) (2), in the grant Cooperative Agreement for details)

3 Niagara County Brownfields Cleanup Revolving Loan Fund (BCRLF) Niagara County Brownfield Development Corporation Vantage Center Suite One 6311 Inducon Corporate Drive Sanborn, New York (716) Fax (716) Application for Loan Assistance TO BE COMPLETED BY APPLICANT Municipality Where Project Is Located: Loan Amount Requested: FOR NCBDC USE ONLY Date Received: Date Approved: Project Number: Please answer all questions below and complete the certification forms. Information submitted as part of this application will not be made public until the Niagara County Brownfield Development Corporation Board of Directors reviews the project during a public board meeting. After such action, this information may be subject to disclosure under the New York State Freedom of Information Act. If disclosure of financial statements and/or business studies would cause substantial injury to the competitive position of the applicant, the applicant should identify what information needs to be kept confidential. SECTION I. APPLICANT INFORMATION 1. Company Name 2. Contact Person/Title 3. Address 4. City State Zip Code 5. Phone Fax 6. Legal Counsel Name 7. Address 8. City State Zip Code 9. Phone Fax Application Page 1

4 SECTION II. APPLICANT OWNERSHIP & MANAGEMENT 1. Ownership of applicant company (List all owners & stockholders with 25% or more of total ownership) 1. Name Title Percentage Owned List any subsidiary, associate, and/or affiliated companies of applicant. 3. Is the Company or management of the Company now a plaintiff or a defendant in any civil or criminal litigation? 4. Has any person listed in the ownership table above ever been convicted of a criminal offense (other than a minor traffic violation)? 5. Has any person listed above declared bankruptcy? 6. Have you ever been accused or subject to any penalties resulting from environmental noncompliance? If you answered yes to any of the above questions, please attach an additional page providing details Application Page 2

5 SECTION III. PROJECT SITE INFORMATION 1. Site Name 2. Address 3. City State Zip Code 4. Is the site enrolled in a New York State Brownfields Program? If yes, please provide name of the program and Site ID#. 5. Provide a detailed description of the remediation project Application Page 3

6 SECTION IV. PROJECT BUDGET 1. Complete the following budget table for the proposed remediation project. ACTIVITY COST Engineering $ Soil Remediation $ Groundwater Remediation $ Asbestos Abatement $ Other Remediation Expenses $ TOTAL COSTS $ LOAN AMOUNT REQUESTED $ 2. Have any of the environmental expenditures identified in the table above been incurred to date? If yes, please identify: 3. Has any funding been secured for the project to date? If yes, please complete the table below. Source of Funding Amount Status (pending, secured, etc.) SECTION V. PROJECT TIMING 1. Provide estimated start and completion dates for the remediation project Application Page 4

7 SECTION VI. SUPPORTING DOCUMENTATION REQUIRED The following information is required as part of application submission. Failure to include the following documents will render the application incomplete. 1. Evidence of fee simple title documenting site ownership. 2. If the site has been accepted into a New York State brownfields program, please include a copy of any approval correspondence between the applicant and New York State. SECTION VII. AUTHORIZATION THE UNDERSIGNED, in applying for financial assistance from Niagara County Brownfield Development Corporation, recognizes that prior to receiving any financial assistance he/she will agree to comply with all federal, state and local laws and regulations to the extent that such are applicable. The applicant certifies that it is not suspended, debarred, or otherwise declared ineligible to receive federal assistance. Company Name Print name of Company Representative and Title Signature/Title of Company Representative Date EQUAL CREDIT OPPORTUNITY ACT The Federal Equal Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided that the applicant has the capacity to enter into a binding contract); because all or part of the applicant s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal agency that administrates compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Room 500, 633 Indiana Avenue, NW Washington. DC Application Page 5

PROJECT INFORMATION: Describe the existing site conditions, including existing buildings and current uses.

PROJECT INFORMATION: Describe the existing site conditions, including existing buildings and current uses. BRLF-II GRANT / LOAN APPLICATION Name of Applicant Business Employer Identification # or SSN Street Address Telephone No. (include area code) Fax No. (include area code) Mailing Address (if different than