(c) To demonstrate that it meets the financial test under paragraph (b) of this section, the chief financial officer of the local government owner or operator, must sign, within 120 days of the close of each financial reporting year, as defined by the twelve-month period for which financial statements used to support the financial test are prepared, a letter worded exactly as follows, except that the instructions in brackets are to be replaced by the relevant information and the brackets deleted: Letter From Chief Financial Officer
I am the chief financial officer of [insert: name and address of the owner or operator]. This letter is in support of the use of the local government financial test to demonstrate financial responsibility for [insert: "taking corrective action" and/or "compensating third parties for bodily injury and property damage"] caused by [insert: "sudden accidental releases" or "nonsudden accidental releases" or "accidental releases"] in the amount of at least [insert: dollar amount] per occurrence and [insert: dollar amount] annual aggregate arising from operating [an] underground storage tank[s].
Underground storage tanks at the following facilities are assured by this financial test [List for each facility: the name and address of the facility where tanks assured by this financial test are located. If separate mechanisms or combinations of mechanisms are being used to assure any of the tanks at this facility, list each tank assured by this financial test by the tank identification number provided in the notification submitted pursuant to 40 CFR 280.22 or the corresponding state requirements.]
This owner or operator has not received an adverse opinion, or a disclaimer of opinion from an independent auditor on its financial statements for the latest completed fiscal year. Any outstanding issues of general obligation or revenue bonds, if rated, have a Moody's rating of Aaa, Aa, A, or Baa or a Standard and Poor's rating of AAA, AA, A, or BBB; if rated by both firms, the bonds have a Moody's rating of Aaa, Aa, A, or Baa and a Standard and Poor's rating of AAA, AA, A, or BBB.
Worksheet for Municipal Financial Test
Part I: Basic Information
1.Total Revenuesa. Revenues (dollars) Value of revenues excludes liquidation of investments and issuance of debt. Value includes all general fund operating and non-operating revenues, as well as all revenues from all other governmental funds including enterprise, debt service, capital projects, and special revenues, but excluding revenues to funds held in a trust or agency capacity.
b. Subtract interfund transfers (dollars)c. Total Revenues (dollars) 2.Total Expendituresa. Expenditures (dollars) Value consists of the sum of general fund operating and non-operating expenditures including interest payments on debt, payments for retirement of debt principal, and total expenditures from all other governmental funds including enterprise, debt service, capital projects, and special revenues.
b. Subtract interfund transfers (dollars) ________
c. Total Expenditures (dollars)3.Local Revenuesa. Total Revenues (from 1c) (dollars)________b. Subtract total intergovernmental transfers (dollars)________c. Local Revenues (dollars)________4.Debt Servicea. Interest and fiscal charges (dollars) ________b. Add debt retirement (dollars)________c. Total Debt Service (dollars)________5. Total Funds (Dollars)________ (Sum of amounts held as cash and investment securities from all funds, excluding amounts held for employee retirement funds, agency funds, and trust funds)6. Population (Persons)________Part II: Application of Test
7.Total Revenues to Populationa. Total Revenues (from 1c)________b. Population (from 6)________c. Divide 7a by 7b________e. Divide by 5,212________f. Multiply by 4.095________8.Total Expenses to Populationa. Total Expenses (from 2c)________b. Population (from 6) ________c. Divide 8a by 8b________e. Divide by 5,401________f. Multiply by 4.095________9.Local Revenues to Total Revenuesa. Local Revenues (from 3c)________b. Total Revenues (from 1c)________c. Divide 9a by 9b________e. Divide by .205________f. Multiply by 2.840________10.Debt Service to Populationa. Debt Service (from 4c)________b. Population (from 6)________c. Divide 10a by 10b________e. Divide by 1,038________f. Multiply by -1.866________11.Debt Service to Total Revenuesa. Debt Service (from 4c)________b. Total Revenues (from 1c)________c. Divide 11a by 11b________e. Divide by .259________f. Multiply by -3.533________12.Total Revenues to Total Expensesa. Total Revenues (from 1c)________b. Total Expenses (from 2c)________c. Divide 12a by 12b________e. Divide by .899________f. Multiply by 3.458________13.Funds Balance to Total Revenuesa. Total Funds (from 5)________b. Total Revenues (from 1c)________c. Divide 13a by 13b________e. Divide by 9.156________f. Multiply by 3.270________14.Funds Balance to Total Expensesa. Total Funds (from 5)________b. Total Expenses (from 2c)________c. Divide 14a by 14b________e. Divide by 6.409________f. Multiply by 3.270________15.Total Funds to Population________ a. Total Funds (from 5)________b. Population (from 6)________c. Divide 15a by 15b________e. Divide by 4,548________f. Multiply by 1.866________16.Add 7f + 8f + 9f + 10f + 11f + 12f + 13f + 14f + 15f + 4.937________I hereby certify that the financial index shown on line 16 of the worksheet is greater than zero and that the wording of this letter is identical to the wording specified in 40 CFR 280.105(c) as such regulations were constituted on the date shown immediately below.
[Date]
[Signature]
[Name]
[Title]