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[ia mermd Wazoe Management Bond <br />State of caitomia <br />THIS PAGE INSTRUCTIONS ONLY <br />Letter From the Chief Financial Qfficer <br />Local Government Financial Lest for Postclosuro Maintenance andlor Co a Action <br />(a) A letter from the chief financial officer, as specified in Title 27 California Code of Regulations(gCR), Division 2. <br />ubdivi ion 1 Chanter 6 section 22249 shall be on the local government's letterhead t ' ne . It shall contain the original signature of the chief <br />financial officer and shall be worded as indicated on the attache dro oforma Form CIWMB 112 (6197). <br />(b) The letter from the chief financial officer shall be accompanied by the following items. as specified in 27 CCR section 22249. <br />Its A special letter from the local government's treasurer or auditor-controllercertifvino the relative size (43°%) threshold and public <br />notice requirements have been satisfied as specified in 27 CCR section 22249(e) and 22249(012). <br />L2 A copy of an independent certified public accountant's report on financial statements for the latest completed fiscal year. <br />U3 A copy of the financial statements for the latest completed fiscal year. <br />El A special report from the independent certified public accountant on the financial data in the letter as specified in 27 CCR section <br />22249 ' 4 . <br />0) A r»py of the comprehensive annual financial report (CAFR) used to compty wittt 27 CCR section 22249(ill(5) or cerfification_by <br />the local government's treasurer or auditor -controller that the reouirements of General Accounting ndard Board Statement 18 <br />have been met. <br />j6� if applicable, a copy of the bond rating on the bond rating service's tterhead stationery._ <br />If applicable, the guarantee with wording as specified in 27 CCR section22 249 5 <br />PRIVACY STATEMENT Ol <br />The information Practices Act (Cafifomia Civil Code Section 1798.171 and the Federal Privacy Act (5 U.S.C. 552a(e)13)) re uire that this notice be arovided <br />when collectingen rsonat information from individuals— <br />AGENCY REQUESTING INFORMATION: Caftmia Integrated Waste Management Board. <br />UNIT RESPONSIBLE FOR MAINTENANCE OF FORM: Financial Assurances Section, Cafifomia Integrated Waste Management Board. 8800 Cal Center <br />Drroe, Sacramento, CA 95826. Contact the Manager. Financial Assurances Section, at (9161255-2200. <br />AUTHORITY: Public Resources Code section 43600 et seg. <br />PURPOSE: The information provided will be used to verify adequate financial assurance of solid waste disposal facilities listed. <br />REQUIREMENT Completion of this form is mandatory. The consequence of not complefing this form is denial or revocation of a permit to operate a <br />solid waste disposal fag . <br />OTHER INFORMATION After review of this document, You maybe requested to provide additional information r ardin the acceptability of this <br />Mechanism. <br />ACCESS: Informationroo vided in this form maybe provided to the U.S. Environmental Protection Agencv,Sttate Attorney General Air Resources Board, <br />California Department of Toxic Substances Control. Enemv Resources Conservation and Development Commission Water ResourMlControl Board. and <br />California Regional Water Quality Control Boards For more information or access to your records. contact the California Integrated Waste Management <br />Board 8800 Cal Center Drive, Sacramento CA 95826, (91M 255-2200 <br />®, Psos t a 4 <br />9M/MB 112 IED <br />