8816-15 Authorize $676,500 loan with OPWC for Watermain Replacement Project

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OHIO PUBLIC WORKS COMMISSION APPENDIX E - DISBURSEMENT REQUEST FORM AND CERTIFICATION DISBURSEMENT REQUEST NUMBER: Statement requesting the disbursement of funds from the OPWC pursuant to Section 6 of the Project Agreement (the "Agreement ") executed behveen the Director of the Ohio Public Works Commission (tire "Director ") and City of Lakewood, (035 - 41664), Cuyahoga County (the "Recipient "), dated July 1, 2015, for the sole and express purpose of financing the capital improvement project defined and described in Appendix A of the Agreement (the "Project') and named and numbered as Watermain Replacement 2016, CA16S (LOAN). EXPENDITURES PROGRESS: (1) (2) (3) (4) USED PRIOR AS PER PAID PRIOR AS PART OF PAID TO DATE THIS DRAW AGREEMENT TO THIS DRAW THIS DRAW (Column 2 i 3) A) Project Engineering Costs $0 $ $ $ 1) Preliminary Engineering $10,000 $ $ $ 2) Final Design $115,000 $ $ $ 3) Construction Administration $125,000 $ $ $ B) Right -of -Way $0 $ $ $ C) Construction Costs $1,385,000 $ $ $ D) Materials Purchased Directly $0 $ $ $ E) Permits, Advertising, Legal $15,000 $ $ $ F) Construction Contingencies $0 $ N/A $ N!A $ N/A G) Totals $1,650,000 $ $ $ FINANCING PROGRESS: (1) (2) (3) (4) AS PER USED PRIOR AS PART OF USED TO DATE AGREEMENT TO THIS DRAW THIS DRAW (Column 2 + 3) H) OPIVVC Funds $676,500 $ $ $ I) Local Share 1) In -kind Contributions $0 $ $ $ 2) Public Revenues $973,500 $ $ $ 3) Private Revenues $0 $ $ $ 3) Other Public Revenues 1) ODOT/FHWA $0 $ $ $ 2) OEPA $0 $ $ $ 3) OWDA $0 $ $ $ 4) CDBG $0 $ $ $ 5) Other $0 $ $ $ I0 Total Local and Other Public Revenues $973,500 $ $ $ L) Totals (H +K for each column) $1,650,000 $ $ $ [NOTE: Column totals for Line L must be equal to the column totals for Line G.]