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.7 <br />Pans 3 of 4 <br />CIW112 (8197) <br />MB <br />ALTERNATIVE I <br />(Omit if using Ahemative 11) <br />1. <br />Speg ft amounts of cov®ra-ge-: Postclosure Maintenance Costs <br />orr Clive Action Costs <br />TOTAL COSTS $ <br />2. <br />Is the local government currefty in default on_anv outstanding general obligation bonds? ............ �Y s, <br />No <br />3. <br />Does the local government have any outstandinggeneraI obligation bonds rated lower than <br />Baa by MoodYs or BBB as issued by Standard and Poor's?................................ 0 Yes_ <br />No <br />4. <br />Has the local oovemment ooerated at a deficit equal to five percent or more of total annual <br />revenue in each of the past two fiscal years? .......................................... ❑ Yes <br />❑ No <br />5. <br />Has the local government received an adverse opinion disclaimer of opinion, or other qualified <br />opinion from the independent certified public accountant (or appropriate State agency) ailio its <br />financial statement as required under &22249(a)? ....................................... ❑ Yes <br />13 No <br />If 2 3 <br />4 or,5 YES STOP! The local government is NOT eligible to assure its obligations <br />under <br />§22249. <br />If 2,3,4. and 5 = NO, CONTINUE BELOW. <br />6. <br />Sum of costs assured under §22249 (total of all costs shown above and including the two <br />numbered paragraphs of the letter to CIWMB) ............................ $ <br />*7. <br />Total annual revenue ............................................. $ <br />"8. <br />Cash.................................................... ..... $ <br />19. <br />Marketable securities ..................................... . ... . ... 1 S <br />0 <br />10. <br />Sum of cash and marketable securities (line 8 + line 9) ..................... S <br />*11. <br />Total expenditures .............................................. $ <br />*12. <br />Annual debt service ............................................. $ <br />13. <br />43% Threshold Limit on Assured Costs: <br />Is line 6 = 43% or less of line 7? .................................... <br />❑ Yes ❑ No <br />14. <br />Liquidity Ratio: <br />E3 Yes 11 No <br />Is line 10 divided by line 11 greater than or equal to 0.05? ................... <br />15. <br />Debt Service Ratio: <br />❑ Yes ❑ No <br />Is line 12 divided by line 11 less than or equal to 0.20? ...................... <br />I hereby <br />certify that this letter is worded -as specified by the California Integrated Waste Management Board and is being <br />executed in accordance with the requirements of Title 27 California Code of Regulations Division 2, Subdivision 1, Chapter <br />6, section 22249. <br />Signature TYped or Printed Name <br />Title <br />Date <br />Pans 3 of 4 <br />CIW112 (8197) <br />MB <br />