U S Environmental Protection Agency OMB Control No. 2040-0292
WIFIA Program EPA Form No. 6100-030
Letter of Interest Approval expires XX/XX/XXXX
A prospective borrower seeking Water Infrastructure Finance and Innovation Act (WIFIA) credit assistance must complete and submit this letter of interest form and provide requested attachments to the U.S. Environmental Protection Agency (EPA) by the deadline announced in the Notice of Funding Availability (NOFA). In its submittal, the prospective borrower:
Describes itself and its proposed project(s);
Provides key financial and engineering information and documents; and
Explains how the project meets the WIFIA selection criteria.
The prospective borrower should answer all questions in this form. Narrative answers can reference source documents by including the name of the document and relevant pages or sections and providing any referenced documents as attachments. The prospective borrower must sign Sections E and F in the appropriate spaces and submit a scanned version of the signature pages to EPA.
A prospective borrower may assert a Confidential Business Information (CBI) claim covering part or all of the information submitted to EPA as part of its letter of interest, in a manner consistent with 40 C.F.R. 2.203, 41 Fed. Reg. 36902 (Sept. 1, 1976), by placing on (or attaching to) the information a cover sheet, stamped or typed legend, or other suitable form of notice employing language such as trade secret, proprietary, or company confidential. The prospective borrower should also state whether it desires confidential treatment until a certain date or until the occurrence of a certain event. Information covered by a business confidentiality claim will be disclosed by EPA only to the extent and only by means of the procedures set forth under 40 C.F.R. Part 2, Subpart B. Information that is not accompanied by a business confidentiality claim when it is received by EPA may be made available to the public by EPA without further notice to the prospective borrower. More information about CBI is available in the WIFIA program handbook and frequently asked questions (FAQ) available at http://www.epa.gov/wifia.
The total length of the letter of interest form should not exceed 50 pages, excluding any attachments. Responses should be on single-spaced, standard-sized 8 ½” x 11” pages. Page margins should not be less than 1-inch. Font size should not be smaller than 11-point Calibri. There is no limit to the number or length of attachments provided. Attachments should be the most recent versions of the documents available at the time of submission and may be draft or preliminary. Attachments must be referenced in the letter of interest form to be considered.
The final letter of interest submission must include:
A completed version of this letter of interest form (in Microsoft Word)
Scanned signature pages (Sections E and F) (in PDF)
All attachments requested and referenced in the letter of interest form
When finished, the letter of interest form and attachments may be submitted either by:
Emailing the documents as attachments to wifia@epa.gov; or
Uploading the documents to EPA’s SharePoint site. To be granted access to the SharePoint site, the prospective borrower can request access to SharePoint by emailing wifia@epa.gov. Requests to upload documents must be made in advance of the deadline as outlined in the NOFA.
After EPA’s intake process is complete, it will provide a confirmation email to the contacts listed in Section D.
Additional instructions and resources for completing and submitting this letter of interest are available in the NOFA, WIFIA program handbook, and WIFIA website (www.epa.gov/wifia). Questions may be submitted to the WIFIA program office at wifia@epa.gov.
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Burden
The public reporting and recordkeeping burden for this collection of information is estimated to average 60 hours per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, included through the use of automated collection techniques to the Director, Regulatory Support Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. ___________________________________________________________________________________
Warning
Falsification or misrepresentation of information or failure to file or report information required to be reported may be the basis for denial of financial assistance by EPA. Knowing and willful falsification of information required to be submitted and false statements to a Federal Agency may also subject you to criminal prosecution. See, for example, 18 U.S.C. §1001.
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Additional information about the WIFIA program and the letter of interest form is available at https://epa.gov/wifia and by contacting wifia@epa.gov.
Provide the following information in this form or as narrative answers. Narrative answers can reference source documents (include the name of the document and relevant pages or sections). Provide any referenced documents as attachments.
Legal name of prospective borrower:
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Other names under which the prospective borrower does business:
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Project name (assign a short name to the project for purposes of identification):
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Provide a brief description of the project(s) seeking financing. Limit the description to the elements included in the estimated total projects costs in Question A-7. (Word Limit: 150).
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Describe the project’s or projects’ purpose(s) (including quantitative or qualitative details on public benefits the project will achieve). If the loan contains more than one project, the projects must serve a common purpose. Describe the common purpose that the projects share (i.e. addressing sanitary sewer overflows or improving drinking water quality). (Word limit: 150).
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Requested amount of the WIFIA loan (in dollars). This amount may be no more than 49% of the estimated eligible project costs provided in question A-7:
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Estimated total eligible project costs (in dollars):
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Identify the month and year the prospective borrower will submit an application. (Assume invitations to apply will be issued approximately 90 days from letter interest submission deadline).
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Identify the month and year the prospective borrower wants to close its WIFIA loan.
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Identify the type of entity that the prospective borrower is (pick one):
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