(Note: If letters of recommendation are unavailable, other approved forms of verification can be substituted at the Commissioner's discretion.)
"[DCAC Name] will/will not (mark one) use the drycleaner environmental response program's reasonable rate schedule when invoicing [insert name of drycleaner owner, operator, or impacted third party] for expenses incurred in the investigation and/or cleanup of this site. On behalf of [Applicant's Name], [DCAC Name] will prepare and submit timely reimbursement requests in accordance with Chapter 0400-15-03, including subparagraph (7)(d) of Rule 0400-15-03-.08.
On behalf of [Applicant's Name], [Person's Name] will prepare and submit timely reimbursement requests in accordance with DCERP rules including subparagraph (7)(d) of Rule 0400-15-03-.08 which allows applications for payment to be submitted 60 days following initiation of work and at 60 day intervals thereafter in addition, subparagraph (7)(f) of Rule 0400-15-03-.08 requires that in order to be eligible for payment from the drycleaner environmental response fund, a reimbursement request must be received, by the drycleaner environmental response program, within one year from the date expenses were incurred regardless of the duration of the work phase.
(Without restriction as to whether covered by Workmen's Compensation Law)
$1,000,000 Each Occurrence
$2,000,000 Aggregate
$1,000,000 Each Occurrence
$2,000,000 Aggregate For DCACs who will only conduct work in the facility inspection or remediation oversight contractor categories, the pollution insurance requirement does not apply.
$1,000,000 Each Occurrence $2,000,000 Aggregate
$1,000,000 Each Occurrence
"I certify under penalty of law, including but not limited to penalties for perjury, that the information contained in this (select one or another term as appropriate: application, form, report, study) and on any attachments, is true, accurate and complete to the best of my knowledge, information, and belief. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for intentional violations."
Tenn. Comp. R. & Regs. 0400-15-03-.09
Authority: T.C.A. §§ 4-5-201, et seq., and 68-217-101, et seq.