LETTER FROM CHIEF FINANCIAL OFFICER
Director
Illinois Environmental Protection Agency
C/O Bureau of Land #24
1021 North Grand Avenue East
Post Office Box 19276
Springfield, Illinois 62794-9276
Dear Sir or Madam:
I am the chief financial officer of ________________________________________________
This letter is in support of this firm's use of the gross revenue test and financial test to demonstrate financial assurance pursuant to 35 Ill. Adm. Code 811.715.
Owner or Operator:
Name: _________________________________________________________________
Address: _______________________________________________________________
City: __________________________________________________________________
Current cost estimate: $____________________________________________________
Owner or Operator:
Name: _________________________________________________________________
Address: _______________________________________________________________
City: __________________________________________________________________
Current cost estimate: $____________________________________________________
Please attach a separate page if more space is needed for all facilities.
Attached is an Owner's or Operator's Bond without Surety or an Owner's or Operator's Bond with Parent Surety for the current cost estimate for each site. (Strike inapplicable language.)
Gross Revenue Test
1. Gross revenue of the firm $_____________2. Gross revenue from waste disposal operation $_______________3. Line 2 divided by line 3_____________________ Financial Test Alternative I
1. Sum of current cost estimates (total of all cost estimates shown in paragraphs above) $______________________2. Total liabilities (if any portion of the cost estimates is included in total liabilities, you may deduct the amount of that portion from this line and add that amount to lines 3 and 4) $______________3. Tangible net worth $___________________4. Net worth $_____________________________5. Current assets $____________________________6. Current liabilities $________________________7. Net working capital (line 5 minus line 6) $_________________8. The sum of net income plus depreciation, depletion, and amortization $_____________________9. Total assets in U.S. (required only if less than 90 percent of firm's assets are located in the U.S.) $____________________________ Yes/No
10. Is line 3 at least $10 million?_________________________11. Is line 3 at least 6 times line 1?_______________________12. Is line 7 at least 6 times line 1?________________________13. Are at least 90 percent of firm's assets located in the U.S.? If not, complete line 14._______________________________________________________________14. Is line 9 at least 6 times line 1? ____________________15. Is line 2 divided by line 4 less than 2.0 ?_____________________16. Is line 8 divided by line 2 greater than 0.1 ?____________________17. Is line 5 divided by line 6 greater than 1.5 ?_______________________Signature__________________________________
Typed Name__________________________________
Title__________________________________
Date__________________________________
Financial Test Alternative II
1. Sum of current cost estimates (total of all cost estimates shown in paragraphs above) $__________________________________2. Current bond rating of most recent issuance of this firm and name of rating service__________________________________3. Date of issuance of bond__________________________4. Date of maturity of bond_______________________________5. Tangible net worth (if any portion of the closure and post-closure cost estimates is included in "total liabilities" on your firm's financial statements, you may add the amount of that portion to this line) $______________6. Total assets in U.S. (required only if less than 90 percent of firm's assets are located in the U.S.) $_________________________ Yes/No
7. Is line 5 at least $10 million?______________________________8. Is line 5 at least 6 times line 1?________________________9. Are at least 90 percent of firm's assets located in the U.S.? If not complete line 10. __________________________________10. Is line 6 at least 6 times line 1?______________________ Signature_____________________________________________________________
Typed name___________________________________________________________
Title________________________
Date_______________________
Ill. Admin. Code tit. 35, pt. 811, subpt. G, app A, ILLUSTRATION I
Amended at 35 Ill. Reg. 10842, effective June 22, 2011