The financial assurance mechanisms set forth in Rule .1805 of this Section shall use the language provided in this Rule, and shall be in accordance with 40 CFR 258.74(l).
TRUST AGREEMENT
Trust Agreement, the "Agreement," entered into as of [date] by and between [name of the owner or operator], a [name of State] [insert "corporation," "partnership," "association," or "proprietorship"], the "Grantor," and [name of corporate trustee], [insert "incorporated in the State of [name of state]" or "a national bank"], the "Trustee."
Whereas, the Division of Waste Management, the "Division," an agency of the State of North Carolina, has established certain regulations applicable to the Grantor, requiring that an owner or operator of a solid waste management facility shall provide assurance that funds shall be available when needed for closure, post-closure care, corrective action programs, or potential assessment and corrective action of the facility,
Whereas, the Grantor has elected to establish a trust to provide all or part of such financial assurance for the facilities identified herein,
Whereas, the Grantor, acting through its duly authorized officers, has selected the Trustee to be the trustee under this agreement, and the Trustee is willing to act as trustee.
Now, therefore, the Grantor and the Trustee agree as follows:
In Witness Whereof the parties have caused this Agreement to be executed by their respective officers duly authorized and their corporate seals to be hereunto affixed and attested as of the date first above written: The parties below certify that the wording of this agreement is identical to the wording specified in 15A NCAC 13B .1806(1) as were constituted on the date first above written.
[Signature of Grantor]
[Title]
Attest: [insert name of Corporation's Senior Management]
[Title]
[Seal]
State of North Carolina
County of [Name of County]
On this [date], before me personally came [name of owner or operator] to me known, who, being by me duly sworn, did depose and say that she/he resides at [address], that she/he is [title] of [corporation], the corporation described in and which executed the above instrument; that she/he knows the seal of said corporation; that the seal affixed to such instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation, and that she/he signed her/his name thereto by like order.
Witness my hand and official seal this [Day] day of [Month], 20[Year].
[insert Signature of Notary]
Official Signature of Notary
[Notary's printed or typed name]
Notary Public
[Official Seal]
My commission expires: [insert Date of Commission Expiration]
[Or for no corporate seal, see 15A NCAC 13B .1805(c) and utilize the certification of acknowledgement below]
State of North Carolina
County of [Name of County]
I, [Name of Officer Taking Acknowledgment], a [Official Title of Officer Taking Acknowledgment], certify that [Name of Corporate Officer] personally came before me this day and acknowledged that he/she is [Title of Corporate Officer] of [insert Legal Name of Corporation], a corporation, and that he/she, as [insert Title of Officer], being authorized to do so, executed the foregoing on behalf of the corporation.
Witness my hand and official seal this [Day] day of [Month], 20[Year].
[insert Signature of Notary]
Official Signature of Notary
[Notary's printed or typed name]
Notary Public
[Official Seal]
My commission expires: [insert Date of Commission Expiration]
[Signature of Trustee]
[Title]
Attest: [insert name]
[Title]
[Seal]
State of North Carolina
County of [Name of County]
I, [Name of Officer Taking Acknowledgment], a [Official Title of Officer Taking Acknowledgment], certify that [Name of Corporate Officer] personally came before me this day and acknowledged that he/she is [Title of Corporate Officer] of [insert Legal Name of Corporation], a corporation, and that he/she, as [insert Title of Officer], being authorized to do so, executed the foregoing on behalf of the corporation.
Witness my hand and official seal this [Day] day of [Month], 20[Year].
[insert Signature of Notary]
Official Signature of Notary
[Notary's printed or typed name]
Notary Public
[Official Seal]
My commission expires: [insert Date of Commission Expiration]
Schedule A for Trust Agreement
[For Each Facility:]
Facility Name: [Facility Name]
Facility Address: [Facility Address]
Permit Number: [Permit Number]
Closure Costs: $ [Amount]
Post-Closure Care Costs: $ [Amount]
Corrective Action Program: $ [Amount]
Potential Assessment and Corrective Action: $ [Amount]
Total Aggregate Amount to be Funded by this Trust: $ [Amount]
Schedule B for Trust Agreement
[For Standby Trust]
Trust Property: This Fund shall consist of funds drawn from [insert type of mechanism] [ex. Letter of credit No.[insert number] dated [date] issued by [name of bank] at such time said funds are directly deposited into the Trust account.
[For Funded Trust]
Trust Property: This Fund shall consist of cash in the amount of $[insert cash amount]. [Aggregate full amount of closure, post-closure care, any corrective action program, and potential assessment and corrective action from Schedule A.]
OR, for pay-in period over the term of the initial permit or the remaining life of the solid waste management facility, include a payment schedule.
Trust Property: This Fund shall consist of annual cash payments made in accordance with the following schedule:
[For Funded Trusts: For Each Facility:]
Facility Name: [Facility Name]
Facility Address: [Facility Address]
Permit Number: [Permit Number]
Initial Payment of $[insert dollar amount] on [date of execution] for Cell 1 [insert date Agreement is executed.]
Subsequent payment of $[insert dollar amount], payable on [anniversary date of execution].
Subsequent payment of $[insert dollar amount], payable on [anniversary date of execution].
Subsequent payment of $[insert dollar amount], payable on [anniversary date of execution]
Subsequent payment of $[insert dollar amount], payable on [anniversary date of execution]
Subsequent payment of $[insert dollar amount], payable on [anniversary date of execution]
Account Information:
Account Number assigned to this Trust Agreement: [Account Number]
Amount of Deposit: [Amount of Deposit (zero dollars if used for a standby trust)]
Date: [Date]
Bank/Branch location for this trust account:
Bank/Branch Name: [Bank/Branch Name]
Location Address: [Location Address]
City & State: [City & State]
Contact Person at Bank:
Name: [Name]
Title: [Title]
Phone Number: [Phone Number]
Exhibit A for Trust Agreement
The following persons, acting singly or collectively, shall have the right to issue instructions to the Trustee pursuant to Section 14 of the Agreement:
Name: [insert name]
Position: [insert position]
PERFORMANCE BOND
Date bond executed:
Effective date:
Principal: [legal name and business address of owner or operator]
Type of organization: [insert "individual", "joint venture", "partnership", or "corporation"]
State of incorporation:
Surety(ies): [name(s) and business address(es)]
[For Each Facility]
Solid Waste Section Permit Number: [insert NCDEQ permit number]
Facility name: [insert facility name]
Facility address: [insert facility address]
Closure cost: [insert approved closure cost]
Post-closure care cost: [insert approved post-closure care cost]
Corrective action program cost: [insert current corrective action program cost]
Total penal sum of bond: $[insert total sum of bond]
Liability Limit: $ [insert bonding company's liability limit]
Surety's bond number: [insert issued bond number]
Know All Persons By These Presents, That we, the Principal and Surety(ies) hereto are firmly bound to the North Carolina Division of Waste Management (hereinafter called the Division), in the above penal sum for the payment of which we bind ourselves, our heirs, executors, administrators, successors, and assigns jointly and severally; provided that, where the Surety(ies) are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" only for the purpose of allowing a joint action or actions against any or all of us, and for all other purposes each Surety binds itself, jointly and severally with the Principal, for the payment of such sum only as is set forth opposite the name of such Surety, but if no limit of liability is indicated, the limit of liability shall be the full amount of the penal sum.
Whereas, said Principal is required, under 15A NCAC 13B as amended, to have a permit in order to own or operate each solid waste management facility identified above, and
Whereas, said Principal is required to provide financial assurance for closure, post-closure care, or corrective action programs as a condition of the permit, and
Whereas, said Principal shall establish a standby trust fund as is required when a surety bond is used to provide such financial assurance;
Now, Therefore, the conditions of this obligation are such that if the Principal shall faithfully perform closure, whenever required to do so, of each facility for which this bond guarantees closure, in accordance with the closure plan and other requirements of the permit, as such plan and permit may be amended, pursuant to all applicable laws, statutes, rules, and regulations, as such laws, statutes, rules, and regulations may be amended,
And, if the Principal shall faithfully perform post-closure care of each facility for which this bond guarantees post-closure care, in accordance with the post-closure care plan and other requirements of the permit, as such plan and permit may be amended, pursuant to all applicable laws, statutes, rules, and regulations as such laws, statutes, rules, and regulations may be amended,
And, if the Principal shall faithfully perform corrective action of each facility for which this bond guarantees corrective action, in accordance with the corrective action program and other requirements of the permit, as such program and permit may be amended, pursuant to all applicable laws, statutes, rules, and regulations as such laws, statutes, rules, and regulations may be amended,
Or, if the Principal shall provide alternate financial assurance and obtain the Division's written approval of such assurance, within 90 days after the date notice of cancellation is received by both the Principal and the Division from the Surety(ies), then this obligation shall be null and void, otherwise it is to remain in full force and effect.
The Surety(ies) shall become liable on this bond obligation only when the Principal has failed to fulfill the conditions described above.
Upon notification by the Division that the Principal has been found in violation of the closure requirements for a facility for which this bond guarantees performance of closure, the Surety(ies) shall either perform closure in accordance with the closure plan and other permit requirements or place the closure amount guaranteed for the facility into the standby trust fund as directed by the Division.
Upon notification by the Division that the Principal has been found in violation of the post-closure care requirements for a facility for which this bond guarantees performance of post-closure care, the Surety(ies) shall either perform post-closure care in accordance with the post-closure care plan and other permit requirements or place the post-closure care amount guaranteed for the facility into the standby trust fund as directed by the Division.
Upon notification by the Division that the Principal has been found in violation of the corrective action requirements for a facility for which this bond guarantees performance of corrective action, the Surety(ies) shall either perform corrective action in accordance with the corrective action program and other permit requirements or place the corrective action amount guaranteed for the facility into the standby trust fund as directed by the Division.
Upon notification by the Division that the Principal has failed to provide alternate financial assurance and obtain written approval of such assurance from the Division during the 90 days following receipt by both the Principal and the Division of a notice of cancellation of the bond, the Surety(ies) shall place funds in the amount guaranteed for the facility(ies) into the standby trust fund as directed by the Division.
The Surety(ies) hereby waive(s) notification of amendments to closure and post-closure care plans, and corrective action programs, permits, applicable laws, statutes, rules, and regulations and agrees that no such amendment shall in any way alleviate its (their) obligation on this bond.
The liability of the Surety(ies) shall not be discharged by any payment or succession of payments hereunder, unless and until such payment or payments shall amount in the aggregate to the penal sum of the bond, but in no event shall the obligation of the Surety(ies) hereunder exceed the amount of said penal sum.
The Surety(ies) may cancel the bond by sending notice of cancellation by certified mail to the owner or operator and to the Division, provided, however, that cancellation shall not occur during the 120 days beginning on the date of receipt of the notice of cancellation by both the Principal and the Division, as evidenced by the return receipts.
The Principal may terminate this bond by sending written notice to the Surety(ies), provided, however, that no such notice shall become effective until the Surety(ies) receive(s) written authorization for termination of the bond by the Division.
[The following paragraph is an optional rider that may be included but is not required.]
Principal and Surety(ies) hereby agree to adjust the penal sum of the bond yearly so that it guarantees a new closure, post-closure care, or corrective action program amount, provided that the penal sum does not increase by more than 20 percent in any one year, and no decrease in the penal sum takes place without the written permission of the Division.
In Witness Whereof, The Principal and Surety(ies) have executed this Performance Bond and have affixed their seals on the date set forth above.
The persons whose signatures appear below hereby certify that they are authorized to execute this surety bond on behalf of the Principal and Surety(ies) and that the wording of this surety bond is identical to the wording specified in 15A NCAC 13B .1806(2) as was constituted on the date this bond was executed.
Principal
[Signature(s)]
[Name(s)]
[Title(s)]
[Corporate seal]
[For no corporate seal, see Rule .1805(c)]
Corporate Surety(ies)
[Names and address of contact]
State of incorporation: Surety's state of incorporation]
Liability limit: $ [Surety's liability limit]
[Signature(s)]
[Names(s) and title(s)]
[Corporate seal]
[For no corporate seal, see Rule .1805(c)]
[For every co-surety, provide signature(s), corporate seal, and other information in the same manner as for Surety above.]
Bond premium: $ [bond premium]
PAYMENT BOND
Date bond executed: [insert date of bond execution]
Effective date: [insert effective date]
Principal: [legal name and business address of owner or operator]
Type of organization: [insert "individual", "joint venture", "partnership", or "corporation"]
State of incorporation: [insert state of incorporation]
Surety(ies): [name(s), business address(es), and contact information]
[For Each Facility]
Solid Waste Section Permit Number: [insert NCDEQ permit number]
Facility name: [insert facility name]
Facility address: [insert facility address]
Closure cost: [insert dollar amount for closure]
Post-closure care cost: [insert dollar amount for post-closure care]
Total penal sum of bond: $[insert total cost of the bond]
Liability Limit: $[insert underwriting limit of the surety company]
Surety's bond number: [insert bond number issued by surety]
Know All Persons By These Presents, That we, the Principal and Surety(ies) hereto are firmly bound to the North Carolina Division of Waste Management (hereinafter called the Division), in the above penal sum for the payment of which we bind ourselves, our heirs, executors, administrators, successors, and assigns jointly and severally; provided that, where the Surety(ies) are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" only for the purpose of allowing a joint action or actions against any or all of us, and for all other purposes each Surety binds itself, jointly and severally with the Principal, for the payment of such sum only as is set forth opposite the name of such Surety, but if no limit of liability is indicated, the limit of liability shall be the full amount of the penal sum.
Whereas, said Principal is required, 15A NCAC 13B as amended, to have a permit in order to own or operate each solid waste management facility identified above, and
Whereas, said Principal is required to provide financial assurance for closure or post-closure care as a condition of the permit, and
Whereas, said Principal shall establish a standby trust fund as is required when a surety bond is used to provide such financial assurance;
Now, Therefore, the conditions of the obligation are such that if the Principal shall faithfully, before the beginning of final closure and post-closure of each facility identified above, fund the standby trust fund in the amount(s) identified above for the facility,
Or, if the Principal shall fund the standby trust fund in such amount(s) within 15 days after a final order to begin closure and post-closure care is issued by the Division or a U.S. district court or other court of competent jurisdiction,
Or, if the Principal shall provide alternate financial assurance and obtain the Division's written approval of such assurance, within 90 days after the date notice of cancellation is received by both the Principal and the Division from the Surety(ies), then this obligation shall be null and void; otherwise it is to remain in full force and effect.
The Surety(ies) shall become liable on this bond obligation only when the Principal has failed to fulfill the conditions described above. Upon notification by the Division that the Principal has failed to perform as guaranteed by this bond, the Surety(ies) shall place funds in the amount guaranteed for the facility(ies) into the standby trust fund as directed by the Division.
The liability of the Surety(ies) shall not be discharged by any payment or succession of payments hereunder, unless and until such payment or payments shall amount in the aggregate to the penal sum of the bond, but in no event shall the obligation of the Surety(ies) hereunder exceed the amount of said penal sum.
The Surety(ies) may cancel the bond by sending notice of cancellation by certified mail to the Principal and to the Division, provided, however, that cancellation shall not occur during the 120 days beginning on the date of receipt of the notice of cancellation by both the Principal and the Division, as evidenced by the return receipts.
The Principal may terminate this bond by sending written notice to the Surety(ies), provided, however, that no such notice shall become effective until the Surety(ies) receive(s) written authorization for termination of the bond by the Division.
[The following paragraph is an optional rider that may be included but is not required.]
Principal and Surety(ies) hereby agree to adjust the penal sum of the bond yearly so that it guarantees a new closure, post-closure care, or corrective action program amount, provided that the penal sum does not increase by more than 20 percent in any one year, and no decrease in the penal sum takes place without the written permission of the Division.
In Witness Whereof, the Principal and Surety(ies) have executed this Financial Guarantee Bond and have affixed their seals on the date set forth above.
The persons whose signatures appear below hereby certify that they are authorized to execute this surety bond on behalf of the Principal and Surety(ies) and that the wording of this surety bond has not been changed as were constituted on the date this bond was executed.
Principal
[Signature(s)]
[Name(s)]
[Title(s)]
[Corporate seal]
[For no corporate seal, see Rule .1805(c)]
Corporate Surety(ies)
[Name and address]
State of incorporation: [Surety's state of incorporation]
Liability limit: $[Surety's liability limit]
[Signature(s)]
[Name(s) and title(s)]
[Corporate seal]
[For no corporate seal, see Rule .1805(c)]
[For each co-surety, provide signature(s), corporate seal, and other information in the same manner as for Surety above.]
Bond premium: $[bond premium]
IRREVOCABLE STANDBY LETTER OF CREDIT
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, North Carolina 27699-1646
Dear Sir/Madam:
We hereby establish our Irrevocable Standby Letter of Credit No. [insert mechanism number] in your favor, at the request and for the account of [owner's or operator's name and address] up to the aggregate amount of [in words] U.S. dollars $[insert U.S. dollar amount], available upon presentation of
This letter of credit is effective as of [date] and shall expire on [date at least 1 year later], but such expiration date shall be automatically extended for a period of [at least 1 year] on [date] and on each successive expiration date, unless, at least 120 days before the current expiration date, we notify both you and [owner's or operator's name] by certified mail that we have decided not to extend this letter of credit beyond the current expiration date. In the event you are so notified, any unused portion of the credit shall be available upon presentation of your sight draft for 120 days after the date of receipt by both you and [owner's or operator's name], as shown on the signed return receipts.
Whenever this letter of credit is drawn on, under and in compliance with the terms of this credit, we shall duly honor such draft upon presentation to us, and we shall deposit the amount of the draft directly into the standby trust fund of [owner's or operator's name] in accordance with your instructions.
We certify that the wording of this letter of credit is identical to the wording specified in 15A NCAC 13B .1806(4) as were constituted on the date shown immediately below.
[Signature(s) and title(s) of official(s) of issuing institution], [Date]
This credit is subject to [insert "the most recent edition of the Uniform Customs and Practice for Documentary Credits, published by the International Chamber of Commerce," or "the Uniform Commercial Code"].
CERTIFICATE OF INSURANCE FOR CLOSURE OR POST-CLOSURE CARE
Name and Address of Insurer
(herein called the "Insurer"):
Name and Address of Insured
(herein called the "Insured"):
Facilities Covered: [List for each facility: The Solid Waste Section Permit Number, name, address, and the amount of insurance for closure or the amount for post-closure care (these amounts for all facilities covered shall total the face amount shown below).]
Face Amount: [insert dollar amount of face value]
Policy Number: [insert insurance policy number]
Effective Date: [insert effective date]
The Insurer hereby certifies that it has issued to the Insured the policy of insurance identified above to provide financial assurance for [insert "closure" or "closure and post-closure care" or "post-closure care"] for the facilities identified above.
The Insurer further warrants that such policy conforms in all respects with the requirements of 40 CFR 258.74(d) (July 1, 2010 edition) and 15A NCAC 13B .1805, as applicable and as such regulations were constituted on the date shown immediately below. It is agreed that any provision of the policy inconsistent with such regulations is hereby amended to eliminate such inconsistency.
Whenever requested by the North Carolina Division of Waste Management (Division), the Insurer agrees to furnish to the Division a duplicate original of the policy listed above, including all endorsements thereon.
I hereby certify that the wording of this certificate is identical to the wording specified in 15A NCAC 13B .1806(5) as were constituted on the date shown immediately below.
[Authorized signature for Insurer]
[Name of person signing]
[Title of person signing]
Signature of witness or notary:
[Date]
CORPORATE FINANCIAL TEST
[Date]
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section Chief
1646 Mail Service Center
Raleigh, NC 27699-1646
Dear Sir/Madam:
I am the chief financial officer of [name and address of firm]. This letter is in support of this firm's use of the corporate financial test to demonstrate financial assurance for closure, post-closure care, corrective action programs, and potential assessment and corrective action (if applicable), as specified in the Solid Waste Management Act, North Carolina General Statute 130A-295.2(f) and 40 C.F.R. 258.74(e) (July 1, 2010 edition).
[For each solid waste management facility, including its permit identification number, name, address, and closure, post-closure care, corrective action programs, and potential assessment and corrective action (if applicable) cost estimates. Identify for each cost estimate whether it is for closure or post-closure care, corrective action programs, or potential assessment and corrective action.]
The firm is the owner or operator of the following solid waste management facilities for which financial assurance for closure, post-closure care, corrective action programs, and potential assessment and corrective action (if applicable), is demonstrated through the corporate financial test. The current cost estimates for closure, post-closure care, corrective action programs, and potential assessment and corrective action (if applicable), covered by the test are shown for each facility:
Name: [insert legal entity /principal name]
Office Address: [insert physical address of legal entity/principal]
Facility Address: [insert physical address of permitted facility]
Permit No.: [insert NCDEQ issued permit number]
Closure Cost Estimate: [insert dollar amount for closure]
Post-Closure Care Cost Estimate: [insert dollar amount for post-closure care]
Corrective Action Program Cost Estimate: [insert dollar amount for current corrective action program]
Potential Assessment and Corrective Action Cost Estimate: [insert dollar amount for potential assessment and corrective action]
Identify any underground injection control (UIC) facilities under 15A NCAC 02D .0400 and 15A NCAC 02C .0200, petroleum underground storage tank (UST) facilities under 15A NCAC 02N .0100 through 02N .0800, polychlorinated biphenyl (PCB) storage facilities under 15A NCAC 02O .0100 and 15A NCAC 02N .0100, and hazardous waste treatment, storage, and disposal facilities (TSDF's) under 15A NCAC 13A .0109 and 13A .0110 that are owned by either the owner/operator or the guarantor and/or are facilities that are covered by a financial test or corporate guarantee. Provide a separate description for each type of facility, if applicable (if not applicable write "None").
Name: [insert legal entity/principal name]
Office Address: [insert physical address of legal entity/principal]
Facility Address: [insert physical address of permitted facility]
Permit No.: [insert NCDEQ issued permit number]
Closure Cost Estimate: [insert dollar amount for closure]
Post-Closure Care Cost Estimate: [insert dollar amount for post-closure care]
Corrective Action Program Cost Estimate: [insert dollar amount for current corrective action program]
Potential Assessment and Corrective Action Cost Estimate: [insert dollar amount for potential assessment and corrective action]
This firm [insert "is required" or "is not required"] to file a Form 10K with the Securities and Exchange Commission (SEC) for the latest fiscal year.
The fiscal year of this firm ends on [month, day]. The figures for the following items marked with an asterisk are derived from this firm's independently audited, year-end financial statements for the latest completed fiscal year, ended [date].
Fill in all applicable parts of the Financial Test and either Alternative I, or Alternative II, or Alternative III below.
Financial Test
If "No", and you have provided a report from the independent CPA that the environmental obligations have been recognized as liabilities in the audited financial statements, then go to Item 9(a).
If the financial data provided for items 3 through 7 above differs from what was provided in the audited financial statements, a special report from the certified public accountant shall be provided as described in 40 CFR 258.74(e)(2)(i)(C).
Alternative I
Alternative II
Alternative III
As evidence that [Firm] meets the conditions of the Corporate Financial Test, attached hereto is a copy of the following:
Please check applicable responses.
() 1. Independent CPA's unqualified opinion of our financial statements for our latest completed fiscal year.
() 2. Special report from CPA, if financial data in this letter is different than in audited financial statements. [See 40 CFR 258.74(e)(2)(i)(C)].
() 3. Report from CPA (if answer to item #9 of the financial test is No) verifying all of covered environmental obligations covered by test have been recognized as liabilities in the audited financial statements, how the obligations were measured and reported, and that tangible net worth of the firm is at least $10 million dollars plus the amount of any guarantees not recognized as liabilities. [See 40 CFR 258.74(e)(2)(i)(D)]
I hereby certify that [name of firm] meets the requirements of [Fill in Alternative I, Alternative II, or Alternative III] in support of [name of facility(s)] use of the corporate financial test to demonstrate financial assurance as required by the Solid Waste Management Act, North Carolina General Statute 130A-295.2(f) and 40 C.F.R. 258.74(e) (July 1, 2010 edition).
[Signature]
[Name]
[Title]
[Date]
LETTER FROM CHIEF FINANCIAL OFFICER
[Address to the Department of Environmental Quality, Division of Waste Management, Solid Waste Section, 1646 Mail Service Center, Raleigh, North Carolina 27699-1646.]
I am the chief financial officer of [name and address of unit of local government]. This letter is in support of this unit of local government's use of the financial test to demonstrate financial assurance, as specified in 15A NCAC 13B .1805(e)(6).
[Fill out the following paragraph regarding the solid waste management facilities and associated cost estimates. For each facility, include its permit number, name, address and current closure, post-closure care, corrective action program, or potential assessment and corrective action cost estimates. Identify each cost estimate as to whether it is for closure, post-closure care, or a corrective action program.]
This unit of local government is the owner or operator of the following facilities for which financial assurance for closure, post-closure care, corrective action programs, or potential assessment and corrective action is demonstrated through the financial test specified in 15A NCAC 13B .1805(e)(6). The current closure, post-closure care, corrective action programs, or potential assessment and corrective action cost estimates covered by the test are shown for each facility:
[For Each Facility]
Solid Waste Section Permit Number: [insert NCDEQ issued permit number]
Facility name:[insert facility name]
Facility address: [insert physical address of facility]
Closure cost: [insert dollar amount of closure]
Post-closure care cost: [insert dollar amount of post-closure]
Corrective action program cost: [insert dollar amount of current corrective action]
Potential assessment and corrective action cost: [insert dollar amount of potential assessment and corrective action]
Total Costs to be Assured: [Total Costs to be Assured by this test - include costs for all facilities]:
The fiscal year of this unit of local government ends on [month, day, year]. The Indicators of Financial Strength section below is based off of the local government's financial strength of the previous year, as indicated by general accounting practices.
[Local Government completing the Local Government Test are to either complete the Ratio Indicator of Financial Strength or the Bond Rating Indicator of Financial Strength section below.]
RATIO INDICATORS OF FINANCIAL STRENGTH
Solid Waste Management Facilities under 15A NCAC 13B: $ [insert dollar amount]
Hazardous waste treatment, storage, and disposal facilities under 15A NCAC 13A .0109 and 13A .0110: $ [insert dollar amount]
Petroleum underground storage tanks under 15A NCAC 02N .0100 - 02N .0800: $ [insert dollar amount]
Underground injection control system facilities under 15A NCAC 02D .0400 and 15A NCAC 02C .0200: $ [insert dollar amount]
PCB commercial storage facilities under 15A NCAC 02O .0100 and 15A NCAC 02N .0100: $ [insert dollar amount]
Total assured environmental costs: $ [insert total dollar amount]
Circle either "yes" or "no" to the following questions.
BOND RATING INDICATOR OF FINANCIAL STRENGTH
Solid Waste Management Facilities under 15A NCAC 13B: $ [insert dollar amount]
Hazardous waste treatment, storage and disposal facilities under 15A NCAC 13A .0109 and 13A .0110: $ [insert dollar amount]
Petroleum underground storage tanks under 15A NCAC 02N .0100 - 02N .0800: $ [insert dollar amount]
Underground injection control system facilities under 15A NCAC 02D .0400 and 15A NCAC 02C .0200: $ [insert dollar amount]
PCB commercial storage facilities under 15A NCAC 02O .0100 and 15A NCAC 02N .0100: $ [insert dollar amount]
Total assured environmental costs: $ [insert dollar amount]
Circle either "yes" or "no" to the following question.
I hereby certify that the wording of this letter is identical to the wording specified in 15A NCAC 13B .1806(7) as such rules were constituted on the date shown immediately below. I further certify the following:
[Signature]
[Name]
[Title]
[Date]
CORPORATE GUARANTEE
[Date]
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section Chief
1646 Mail Service Center
Raleigh, NC 27699-1646
Dear Sir/Madam:
I am the chief financial officer of [name and address of guarantor]. This letter is in support of this firm's use of the corporate guarantee to demonstrate financial assurance on behalf of [owner or operator name, address, permit number] for current closure, post-closure care, corrective action program, and potential assessment and corrective action cost estimates (if applicable), as specified in the Solid Waste Management Act, North Carolina General Statute 130A-295.2(f) and 40 C.F.R. 258.74(g) (July 1, 2010 edition).
[For each solid waste management facility, including its permit identification number, name, address, and current closure, post-closure care, corrective action program, or potential assessment and corrective action cost estimates (if applicable). Identify for each cost estimate whether it is for closure, post-closure care, corrective action programs, or potential assessment and corrective action.]
This firm guarantees, through the corporate guarantee attached to this letter as Exhibit A, the current closure, post-closure care, corrective action program, and potential assessment and corrective action cost estimates (if applicable), of the following facilities owned or operated by the guaranteed party. Financial assurance for current closure, post-closure care, corrective action program, and potential assessment and corrective action cost estimates (if applicable), for the listed facilities are demonstrated through the corporate financial test. The current closure, post-closure care, corrective action program, and potential assessment and corrective action cost estimates (if applicable), so guaranteed are shown for each facility:
Name: [insert name of legal entity/principal]
Office Address: [insert physical address of legal entity/principal]
Facility Address: [insert physical address of facility]
Permit No.: [insert NCDEQ issued permit number]
Closure Cost Estimate: [insert dollar amount for closure]
Post-Closure Care Cost Estimate: [insert dollar amount for post-closure care]
Corrective Action Program Cost Estimate: [insert dollar amount for current corrective action]
Potential Assessment and Corrective Action Cost Estimate: [insert dollar amount for potential assessment and corrective action]
The guarantor firm identified above is (please check the applicable relationship):
() The direct or higher-tier parent corporation of the owner or operator.
() Owned by the same parent corporation as the parent corporation of the owner or operator.
(please attach a description of the value received in consideration of the guarantee)
() Engaged in a substantial business relationship with the owner or operator.
(please attach a written description of the business relationship and the value received in consideration of the guarantee and a copy of the contract establishing such relationship)
Identify any underground injection control (UIC) facilities under 15A NCAC 02D .0400 and 15A NCAC 02C .0200, petroleum underground storage tank (UST) facilities under 15A NCAC 02N .0100 through 02N .0800, polychlorinated biphenyl (PCB) storage facilities under 15A NCAC 02O .0100 and 15A NCAC 02N .0100, and hazardous waste treatment, storage, and disposal facilities (TSDF's) under 15A NCAC 13A .0109 and 13A .0110 that are owned by either the owner/operator or the guarantor and/or are facilities that are covered by a financial test or corporate guarantee. Provide a separate description for each type of facility, if applicable (if not applicable write "None").
Name: [insert name of facility]
Facility Address: [insert physical address of facility]
Permit No.: [insert associated permit number]
Closure Cost Estimate: [insert dollar amount for closure]
Post-Closure Care Cost Estimate: [insert dollar amount for post-closure care]
Corrective Action Program Cost Estimate: [insert dollar amount for current corrective action]
Potential Assessment and Corrective Action Cost Estimate: [insert dollar amount for potential assessment and corrective action]
This firm [insert "is required" or "is not required"] to file a Form 10K with the Securities and Exchange Commission (SEC) for the latest fiscal year.
The fiscal year of this firm ends on [month, day]. The figures for the following items marked with an asterisk are derived from this firm's independently audited, year-end financial statements for the latest completed fiscal year, ended [date]
Fill in all applicable parts of the Financial Test and either Alternative I, or Alternative II, or Alternative III below.
Financial Test
If" No", and you have provided a report from the independent CPA that the environmental obligations have been recognized as liabilities in the audited financial statements, then go to Item 9(a).
If the financial data provided for items 3 through 7 above differs from what was provided in the audited financial statements, a special report from the certified public accountant shall be provided as described in 40 CFR 258.74(e)(2)(i)(C) and (g)(1).
Alternative I
Alternative II
Alternative III
As evidence that [firm] meets the conditions of the Corporate Financial Test, attached hereto is a copy of the following: Please check applicable responses
() 1. Independent CPA's unqualified opinion of our financial statements for our latest completed fiscal year.
() 2. Special report from CPA [If financial data in this letter is different than in audited financial statements] [See 40 CFR 258.74(e)(2)(i)(C) and (g)(1)].
() 3. Report from CPA [if answer to item #9 of the financial test is No] verifying all of covered environmental obligations covered by test have been recognized as liabilities in the audited financial statements, how the obligations were measured and reported, and that tangible net worth of the firm is at least $10 million dollars plus the amount of any guarantees not recognized as liabilities. [See 40 CFR 258.74(e)(2)(i)(D) and (g)(1)]
I hereby certify that [name of firm] meets the requirements of [Fill in Alternative I, Alternative II, or Alternative III] in support of [name of facility(s)] use of the corporate financial test to demonstrate financial assurance as required by the Solid Waste Management Act, North Carolina General Statute 130A-295.2(f) and 40 C.F.R. 258.74(e) (July 1, 2010 edition).
[Signature]
[Name]
[Title]
[Date]
Exhibit A
Corporate Guarantee Terms For
Closure, Post-Closure Care, Corrective Action Program, and/or
Potential Assessment and Corrective Action
For [Owner/Operator], [Permit Number]
Guarantee made this [date] by [name of guaranteeing entity], [address and state of guaranteeing entity], herein referred to as guarantor. The guarantee is made on behalf of the [owner or operator name] of [business address], which is [one of the following: "our subsidiary"; a subsidiary of [name and address of common parent corporation" or "an entity with which the guarantor has a substantial business relationship"] to the North Carolina Division of Environmental Quality (NCDEQ).
Recitals:
Name: [insert facility name]
Facility Address: [insert facility address]
Permit No.: [insert NCDEQ issued permit number]
Closure Cost Estimate: [insert dollar amount for closure]
Post-Closure Care Cost Estimate: [insert dollar amount for post-closure care]
Corrective Action Program Cost Estimate: [insert dollar amount for current corrective action]
Potential Assessment and Corrective Action Cost Estimate: [insert dollar amount for potential assessment and corrective action]
Effective date: [insert mechanism effective date]
[Name of Guarantor]
[Corporate Seal]
[For no corporate seal, see Rule .1805(c)]
[Authorized signature for guarantor]
[Name of person signing]
[Title of person signing]
[Telephone Number]
[Email Address]
State of North Carolina
County of [Name of County]
On this [day] day of [month], [year], before me personally came [name signing for Guarantor] to me known, who, being by me duly sworn, did depose and say that she/he resides at [Guarantor address], that she/he is [title at Guarantor Firm] described in and which executed the above instrument; that she/he knows the seal of said corporation; that the seal affixed to such instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation, and that she/he signed her/his name thereto by like order.
Witness my hand and official seal this [Day] day of [Month], 20[Year].
[insert Signature of Notary]
Official Signature of Notary
[Notary's printed or typed name]
Notary Public
[Official Seal]
My commission expires: [insert Date of Commission Expiration]
SPECIAL REPORT
INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT'S REPORT
ON APPLYING AGREED-UPON PROCEDURES
The Board of Directors
[Name of Company]
[Mailing and location address]
[Permit No.]
We have performed the procedures enumerated below, which were agreed to by management of [Name of Company] pursuant to the Solid Waste Management Act, North Carolina General Statute 130A-295.2(f) and 40 C.F.R. 258.74(e) (July 1, 2010 edition) with respect to the letter dated [insert date] from the [insert Corporate Official name and title] to the North Carolina Department of Environmental Quality, solely to assist you in filing the Letter (prepared in accordance with the criteria specified therein) for the year ended [insert date of end of corporate fiscal year]. [Name of Company] is responsible for this Letter. This agreed-upon procedures engagement was conducted in accordance with attestation standards established by the American Institute of Certified Public Accountants. The sufficiency of the procedures is solely the responsibility of [Name of Company] and the North Carolina Department of Environmental Quality. Consequently, we make no representation regarding the sufficiency of the procedures described below either for the purpose for which this report has been requested or for any other purpose.
The procedures, which were limited solely to the identified item numbers, are as follows:
We compared the amounts in Item Nos. 3, 5, and 7 of the Financial Test in the CFO's Letter to corresponding amounts reported as total liabilities [amount], Tangible Net Worth [amount], and total assets [amount], respectively, in the audited financial statement as of [insert date of end of corporate fiscal year] and found them [insert either, "not to be in agreement" or "to be in agreement"].
We computed the amounts in Item Nos. 4 and 6 of the Financial Test in the CFO's Letter as of [insert date of end of corporate fiscal year] based on amounts reported as Net Worth [amount] and the net income plus depreciation, depletion, and amortization [amount] in the audited financial statements as of [insert date of end of corporate fiscal year], compared them to the amounts in the CFO's Letter and found them [insert either, "not to be in agreement" or "to be in agreement"].
We computed the amount of environmental obligations (as determined by current closure, post-closure care, corrective action program, and/or potential assessment and corrective action cost estimates or guarantees) which are recognized as liabilities in the amount of [amount] in the audited financial statement as of [insert date of end of corporate fiscal year], compared them to the amounts in the CFO's Letter and found them [insert either, "not to be in agreement" or "to be in agreement"].
We compared the amount in Item No. 7 of the Financial Test in the CFO's Letter and the Company's total assets located in the United States in the amount of [insert amount] in the audited financial statement as of [insert date of end of corporate fiscal year] and found them [insert either, "not to be in agreement" or "to be in agreement"].
[If not in agreement, describe the procedures performed in comparing the data in the CFO's letter derived from the audited financial year-end financial statements for the latest fiscal year with the amounts in such financial statements, the findings of that comparison, and the reasons for any differences.]
We were not engaged to and did not conduct an examination, the objective of which would be the expression of an opinion on the selected financial information included in the Letter. Accordingly, we do not express such an opinion. Had we performed additional procedures, other matters might have come to our attention that would have been reported to you. This report is intended solely for the use of management of the Company, and is not intended to be and should not be used by anyone other than these specified parties.
[Date]
[Name of Accounting Firm]
CAPITAL RESERVE FUND RESOLUTION
ESTABLISHMENT AND MAINTENANCE
OF THE [FACILITY NAME]
CAPITAL RESERVE FUND
Whereas, there is a need in [insert location of facility as City, County] to provide funds for [closure, post-closure care, corrective action programs, or potential assessment and corrective action] for the [permit number], [facility name]; and
Whereas, the [location] shall bear the cost of [closure, post-closure care, corrective action programs, or potential assessment and corrective action] for the solid waste management facility at an estimated cost of [cost estimate].
Now, therefore, be it resolved by the governing board that:
[Signature of County Commissioner]
[Signature of Chief Financial Officer]
[Date]
15A N.C. Admin. Code 13B .1806
Eff. July 1, 2020.
Adopted by North Carolina Register Volume 35, Issue 03, August 3, 2020 effective 7/1/2020.