Town CrierWest Orange, New Jersey
← Back to search

Supporting Documentation · Jan 9, 2018

14-18 Exhibit-Application for Discharge Site Remediation Funds from HDSRF.pdf

Preserved file SHA-2564a8fe7bf142ec4be0a2f57a6521e9c7f62afa3036d78731b567bd90c245d7740

Indexed text

Page 8

New Jersey Department of Environmental Protection Site Remediation Program HDSRF APPLICATION – SUBROGATION OF RIGHTS – PART III THIS CERTIFICATION IS REQUIRED TO BE COMPLETED BY ALL APPLICANTS This certification shall be signed as follows: for a corporation, by a principal executive officer, at least the level of vice president; for a partnership, by a general partner; for a sole proprietorship, by the proprietor; for a public entity, the contact person (administrator, township manager, etc.); for other than above (i.e. homeowner/individual), the person with legal responsibility for the site. I hereby subrogate to the New Jersey Department of Environmental Protection all rights to recover remediation costs from an insurance carrier, discharger, or person in any way responsible for a hazardous substance discharge pursuant to subsection c. of section 8 of P.L. 1976, c. 141 (C.58:10-23.11g) and who does not have a defense to liability pursuant to subsection d. of that section, upon the failure of the recipient to repay the financial assistance to the State. I further certify that I have not relinquished, impaired, or waived, and do not intend to relinquish, impair, or waive, any right by the State to recover the costs of the remediation against an insurance carrier, discharger, or person in any way responsible for a hazardous substance pursuant to subsection c. of section 8 of P.L. 1976, c.141 (C.58:10-23.11g). Signature Name/Title Township of West Orange Company Sworn to and Subscribed Before Me On this date of Notary HDSRF Application Part III Page 1 of 1 Version 1.3 12/11/13

Page 9

New Jersey Department of Environmental Protection Site Remediation Program HDSRF APPLICATION – INNOCENT PARTY GRANT CERTIFICATION – PART IV THIS CERTIFICATION IS REQUIRED FOR ALL APPLICANTS APPLYING FOR AN INNOCENT PARTY GRANT This certification shall be signed as follows: for a corporation, by a principal executive officer, at least the level of vice president; for a partnership, by a general partner; for a sole proprietorship, by the proprietor; for other than above (i.e. homeowner/individual), the person with legal responsibility for the site. I hereby certify that A) I (the applicant) acquired the property prior to December 31, 1983; B) I (the applicant) own and will continue to own the property until NJEDA approves the grant; C) The hazardous substance or hazardous waste that was discharged at the property was not used by the me (the applicant) or by any person with permission to use the property; and D) I (the applicant), or any person I gave permission to use the property, did not discharge any hazardous substance or hazardous waste at an area where a discharge is or has been discovered. Signature Name/Title Company Sworn to and Subscribed Before Me On this date of Notary HDSRF Application Part IV Page 1 of 1 Version 1.3 12/11/13

Page 10

New Jersey Department of Environmental Protection Site Remediation Program HDSRF APPLICATION – 25% MATCHING GRANT REMEDIAL ACTION CERTIFICATION – PART V THIS CERTIFICATION IS REQUIRED FOR ALL PRIVATE ENTITY APPLICANTS APPLYING FOR A 25% MATCHING RA GRANT This certification shall be signed as follows: For a corporation, by a principal executive officer, at least the level of vice president; for a partnership, by a general partner; for a sole proprietorship, by the proprietor; for other than above (i.e. homeowner/individual), the person with legal responsibility for the site. I hereby certify that A) The requestor has a net worth of not more than $2,000,000 at the time the relevant costs are incurred; and B) The requestor will implement a remedial action using an innovative technology or a limited restricted or unrestricted use remedial action. Signature Name/Title Company Sworn to and Subscribed Before Me On this date of Notary HDSRF Application Part V Page 1 of 1 Version 1.3 12/11/13

Page 11

New Jersey Department of Environmental Protection Site Remediation Program HDSRF APPLICATION – MUNICIPAL QUESTIONNAIRE – PART VI THIS INFORMATION IS REQUIRED FOR ALL PUBLIC ENTITIES APPLICANTS In order to expedite the processing of grant or loan application for public entities at the NJEDA, complete this Preliminary Questionnaire and return it to the NJDEP as part of the HDSRF application. NJDEP will forward this information to the NJEDA once your application has been approved. If you have any questions about available financial assistance, call the NJEDA at (609) 341-2723. 1. Applicant: Township of West Orange Project Name: SELECTO FLASH INC 2. Indicate the estimated project start date. Start Date: 02/12/2018 3. List the current owner of the project site: Township of West Orange 4. If you are not the owner, do you hold a tax sales certificate for the property? .............................................. Yes No When was the tax sale certificate obtained? Date: ______________________ PROVIDE A COPY OF PROPERTY OWNERSHIP, SUCH AS TAX SALE CERTIFICATE, FORECLOSURE PAPERS, ETC. WITH THIS APPLICATION. Please see the attached foreclosure documentation. If the municipality does not currently own the property or hold a tax sale certificate, has the municipality passed a resolution indicating an intent to acquire the property? ............................................. Yes No When was the resolution passed? Date: ____________________ 5. Describe any pending or threatened litigation related to the project site. None 6. Describe any other pending issues that could delay grant/loan closing. None 7. If the financial assistance for which you are applying will not cover the full cost of your project, such as the removal of underground storage tanks, identify other funding sources: N/A Issuance of Bonds $ ____________________ Capital Budget Expenditure $ ____________________ Other, please describe: ______________________________________________________________ HDSRF Application Part VI Page 1 of 2 Version 1.3 12/11/13

Page 12

LOAN APPLICANTS, ANSWER QUESTIONS 8 THROUGH 11: N/A - seeking grant funding only 8. Indicate the length of term, up to ten years, you desire for this loan. (Note that this term must be coterminous with all additional project financing.) ___________ Years 9. Indicate if your municipality will need Local Finance Board Approval to participate in this program (i.e. are you within your legal debt limit?) ........................................................................................................ Yes No If “Yes,” please state reason below. 10. If you currently hold a tax sale certificate or have acquired the site through foreclosure, do you intend to sell the remediated property and return it to your tax rolls within the next two years?................. Yes No 11. If you answered yes to question 10, indicate whether you would like a moratorium on principal and interest payments up to a maximum of two years. ................................................................. Yes No If “Yes,” I request a payment moratorium of ____________ years 12. Provide additional comments in the space below. Certification: By their signature below, the undersigned, a duly authorized representative of the above unit of local government, hereby certifies on behalf of the local government that the information contained herein is true, complete and correct in all respects as of the date hereof. Signature: Date: Name (print): Title: HDSRF Application Part VI Page 2 of 2 Version 1.3 12/11/13

Page 13

New Jersey Department of Environmental Protection Site Remediation Program HDSRF APPLICATION CHECKLIST – PART VII This following checklist has been provided to assist you in preparing a HDSRF application for each specific grant and/or loan offered by the program. Please review the checklist for the applicable grant and/or loan to verify all required documentation has been included as part of the application package. PUBLIC ENTITIES Brownfield Development Area (BDA) Grant HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal and itemized cost estimate Comprehensive redevelopment plan or resolution (indicating a realistic opportunity exists to develop within three years following completion of the remediation) Resolution that public entity authorized to apply to HDSRF for the remediation of a discharge/suspected discharge One original and one copy of the HDSRF application packet PA/SI/RI Grant HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal and itemized cost estimate Proof of ownership interest (tax sale certificate, deed, or resolution to acquire property by voluntary conveyance) Resolution that public entity authorized to apply to HDSRF for the remediation of a discharge/ suspected discharge Comprehensive redevelopment plan or resolution (indicating a realistic opportunity exists to develop within three years following completion of the remediation) One original and one copy of the HDSRF application packet 75% Recreation and Conservation Grant HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal and itemized cost estimate Resolution that public entity authorized to apply to HDSRF for the remediation of a discharge/suspected discharge Documentation indicating the property is to be preserved for recreation/conservation by conveyance of a development easement, conservation easement, or other

Page 13

a discharge/suspected discharge Documentation indicating the property is to be preserved for recreation/conservation by conveyance of a development easement, conservation easement, or other restriction/easement permanently restricting development Comprehensive plan for the development or redevelopment of the subject property One original and one copy of the HDSRF application packet 75% Renewable Energy Grant HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal and itemized cost estimate Resolution that public entity authorized to apply to HDSRF for the remediation of a discharge/suspected discharge HDSRF Application Part VII Page 1 of 3 Version 1.3 12/11/13

Page 14

75% Renewable Energy Grant (continued) Documentation indicating the property is to be redeveloped for a project that will generate renewable energy. Comprehensive plan for the development or redevelopment of the subject property One original and one copy of the HDSRF application packet 50% Affordable Housing HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal and itemized cost estimate Resolution that public entity authorized to apply to HDSRF for the remediation of a discharge/suspected discharge Copy of the deed for the property indicating the inclusion of the appropriate restrictions for Affordable Housing Comprehensive plan for the development or redevelopment of the subject property One original and one copy of the HDSRF application packet 25% RA Matching Grants Remedial Action (Limited Restricted Use/ Unrestricted) HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal with detailed description of remedial action and itemized cost estimate Proof of ownership of the subject property (copy of the Deed) Resolution that public entity authorized to apply to HDSRF for the remediation of a discharge/suspected discharge Comprehensive redevelopment plan or resolution (indicating a realistic opportunity exists to develop within three years following completion of the remediation) One original and one copy of the HDSRF application packet 25% Matching RA Grants Innovative Technology HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal with description of the innovative technology and itemized cost estimate Proof of ownership of the subject property (copy of the Deed) Resolution that public entity authorized to apply to HDSRF for the remediation of a discharge/suspected discharge Comprehensive redevelopment plan or resolution (indicating a realistic opportunity exists to develop within three years following completion of the remediation)

Page 14

arge/suspected discharge Comprehensive redevelopment plan or resolution (indicating a realistic opportunity exists to develop within three years following completion of the remediation) One original and one copy of the HDSRF application packet Loans HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Municipal Questionnaire (Part VI) Detailed remediation Work Proposal and itemized cost estimate Comprehensive redevelopment plan or resolution (indicating a realistic opportunity exists to develop within three years following completion of the remediation) One original and one copy of the HDSRF application packet HDSRF Application Part VII Page 2 of 3 Version 1.3 12/11/13

Page 15

PRIVATE ENTITIES Innocent Party Grants HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) HDSRF Innocent Party Grant Certification (Part IV) Proof of ownership of the subject property (copy of the Deed) Detailed remediation Work Proposal with detailed description of remediation and itemized cost estimate One original and one copy of the HDSRF application packet 25% Matching Grants Remedial Action (Limited Restricted Use/ Unrestricted) HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) HDSRF 25% Matching Grant RA Certification (Part V) Proof of ownership of the subject property (copy of the Deed) Business and personal financial statements for the last three years Detailed remediation Work Proposal with detailed description of remedial action and itemized cost estimate One original and one copy of the HDSRF application packet 25% Matching Grants Innovative Technology HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) HDSRF 25% Matching Grant RA Certification (Part V) Proof of ownership of the subject property (copy of the Deed) Business and personal financial statements for the last three years Detailed remediation Work Proposal with description of the innovative technology and itemized cost estimate One original and one copy of the HDSRF application packet Loans HDSRF Application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Proof of ownership of the subject property (copy of the Deed) Denial letters from two lending institutions Three previous years of federal tax returns Detailed remediation Work Proposal with detailed description of remediation and itemized cost estimate One original and one copy of the HDSRF application packet NON-PROFIT ORGANIZATIONS PA/SI/RI Grant HDSRF application form (Part I) HDSRF General Certification (Part II) HDSRF Subrogation of Rights (Part III) Proof of ownership interest of the subject property (Deed or resolution to acquire property by voluntary conveyance) Documentation indicating status as a 501(c)3 non-profit

File revisions (1)