Village of Ashville, Ohio

Small Government Commission

Application Checklist

Use of the following checklist with the Applicants Manual will help ensure that your application is scored at its best competitive advantage. It will also assist with the timely release of the Project Agreement should your project be funded. This form is for your use and not a required submission. Various templates and forms are in this manual, on the Small Government webpage, and on the OPWC Application webpage.

[ X ]        Compliant certified authorizing legislation by applicant’s governing body (OPWC Application webpage)

                              Exhibit 7 of Round 33 District 17 Ashville’s Application

[NA]       Cooperative agreement if multi-jurisdictional (OPWC Application webpage)

                              NA

[ X ]        Compliant Chief Financial Officer’s Certification and Loan Letter (OPWC Application webpage)

                              Exhibit 4 of Round 33 District 17 Ashville’s Application

[ X ]        Funding commitment letters and or documentation for all non-OPWC matching funds

Exhibit 2 of Round 33 District 17 Ashville’s Application

Exhibit 3 of Round 33 District 17 Ashville’s Application

Attachment 5 Ashville’s Narrative

[ X ]        Signed/stamped registered professional engineer’s detailed cost estimate including in-kind costs (OPWC Application webpage)

Exhibit 1 of Round 33 District 17 Ashville’s Application

[ X ]        Signed/stamped professional engineer’s weighted useful life statement if not submitted with original application (cannot be modified)

Exhibit 1 of Round 33 District 17 Ashville’s Application

[ X ]        Small Government Engineer’s Plan Status Certification form (in this manual and on SG webpage)

New Exhibit A for Small Government Program of OPWC

[ X ]        Clear description of problem and scope of work with appropriate documentation

Attachment 2 of Round 33 District 17 Ashville’s Narrative

[ X ]        Source documentation for proof of age with year clearly visible or compliant letter from eligible public official {letter template in this manual}

New Exhibit B for Small Government Program of OPWC

[ X ]       Project site photos, if appropriate

Attachment 4 of Round 33 District 17 Ashville’s Narrative

New Exhibit C with updated photos for Small Government Program of OPWC

[ X ]        Map showing project location/site

Exhibit 6 of Round 33 District 17 Ashville’s Application

[NA]       Farmland Preservation Review Letter if any impact to farmland (OPWC Application webpage)                                                              NA

[ X ]        ADT report for Road, Bridge & Culvert Projects

Attachment 2 Number 12 on page 3 of Round 33 District 17 Ashville’s Narrative

New Exhibit D with updated ADT Information for Small Government Program of OPWC

               OR

Number of households/EDUs (with calculation) for Water, Wastewater, Storm Water Collection, Solid Waste Projects who directly benefit

Roads, Bridges/Culverts, Storm Water, Solid Waste Projects Only:

[ X ]        Auditor’s Certificate of Estimated Resources with line item detail unless applicant in State of Fiscal Emergency; also If Storm Water or Solid Waste project, the fund(s) typically used are identified {examples in back of this manual}

New Exhibit E for Small Government Program of OPWC

Water and Wastewater Projects Only:

[NA]       “Current” water and wastewater rate ordinances/resolutions for all entities providing services unless applicant in State of Fiscal Emergency

[NA]       Small Government Water & Wastewater Ability & Effort Supplemental form (in this manual and on SG webpage)

Scoring Worksheet