1. (a) Requests for reimbursement shall include the following:

   1. (1) For an owner’s initial request, a completed “Reimbursement Authorization Form” that includes the information required under Odb 403.02;
   2. (2) For paper submittals, upload submittals, or an initial web-based submittal a list or brief description of the information included in the reimbursement request submittal, in the form of a cover or transmittal letter;
   3. (3) For paper or upload submittals a summary of invoiced expenses which includes the information required under Odb 403.01;
   4. (4) A copy of the work scope approval notice under Odb 407.01(d), if applicable;
   5. (5) Copies of all contractor and subcontractor invoices and contractor personnel timesheets or timesheet summary;
   6. (6) Tabulation of bid item quantities, bid item price, bid item total cost, and total job cost for bid-based work, if applicable;
   7. (7) A copy of the contract under Odb 406.03 if applicable;
   8. (8) Employee payroll records, cost of employee benefits and equipment operating cost data when corrective action is performed by the owner;
   9. (9) Other insurance information required under Odb 405.02, if applicable;
   10. (10) A copy of the agreement stating a facility owner has a legal obligation to continue corrective action after ownership is conveyed, if applicable;
   11. (11) A copy of the final court order or court approved settlement for third-party damages;
   12. (12) For an initial request, facility compliance information, if applicable; and
   13. (13) For an initial request, a completed department “Alternate W-9 Form” to obtain a vendor number, if applicable.
2. (b) A re-submittal of information related to a request when the approved amount was less than the requested amount shall be re-submitted within 180 days of the action date and shall include an explanation of the basis of the re-submittal and a copy of the reimbursement approval notice issued under Odb 404.03(d) indicating which costs are being re-submitted.
3. (c) Reimbursement requests shall be submitted concurrently with the corrective action report, if applicable.
4. (d) No reimbursement request shall be submitted that includes costs incurred by an owner or applicant after corrective action is deemed complete by the department and a corrective action report was provided, if applicable.

Source. #8491, eff 11-22-05; ss by #9935-A, eff 9-1-11, EXPIRED: 9-1-19 New. #12942, eff 12-15-19