1. (a) To obtain a disbursement for eligible work and equipment from the awarded funds, the recipient shall submit a written disbursement request to the department by mail, email, or fax using “Request for DWSRF Disbursement”, NHDES-W-03-206, November 2020, available at https://onlineforms.nh.gov/?FormTag=NHDES-W-03-206.

2. (b) The written request shall include the following, as applicable to the request:

   1. (1) The name and mailing address of the loan recipient;
   2. (2) The DWSRF project number;
   3. (3) Loan amount;
   4. (4) Disbursement request number;
   5. (5) Whether the request is partial or final;
   6. (6) The time period covered by the request;
   7. (7) The amount of SRF eligible costs for each category;
   8. (8) The amount of the previous request for each category;
   9. (9) The amounts for the current request for each category;
   10. (10) The total of each category covered by (7)-(9), above;
   11. (11) The percent of the loan previously disbursed;
   12. (12) The total percent of loan disbursed including the current request;
   13. (13) The name, title and signature of the authorized representative and the date the request was signed;
   14. (14) A summary list of the submitted invoices and construction payment requisitions, including invoice number, date, amount, and costs, separated into applicable classifications;
   15. (15) Invoices for equipment and materials delivered and properly stored;
   16. (16) Invoices for engineering or consulting services;
   17. (17) Payment requisitions from the contractor(s); and
   18. (18) Invoices for eligible work not covered under (15) through (17), above.

3. (c) The representative of the recipient who is authorized to submit the disbursement request shall sign the request, which shall constitute certification that:

   1. (1) The project costs incurred as indicated in the request are in accordance with this chapter and the loan agreement for the project, to the best of the signer’s knowledge and belief;
   2. (2) The disbursement requested represents the DWSRF share due which has not been previously requested; and
   3. (3) A thorough owner’s inspection has been performed and all work for which a disbursement is being requested has been performed satisfactorily.
4. (d) The department shall approve the request if it determines that the costs covered by the request are eligible under Env-Dw 1104.01 and the recipient’s financial assistance agreement.
5. (e) Upon approval of the request, the department shall authorize the disbursement to be made from the DWSRF, subject to Env-Dw 1107.08.
6. (f) The recipient shall not make disbursement requests more frequently than once per calendar month per loan.

Source. (See Revision Note #1 and Revision Note #2 at chapter heading for Env-Dw 1100) #13160, eff 1-20-21