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EXHIBIT A <br />METROPOLITAN COUNCIL ENVIRONMENTAL SERVICES <br />2013 CLEAN WATER FUND INFLOW & INFILTRATION (I &I) <br />GRANT APPLICATION FORM <br />NOTICE TO APPLICANTS: Submission of this application form confirms your city's intention to participate <br />in the Metropolitan Council Environmental Services (MCES) 2013 Clean Water Fund I/I Grant program <br />(Grantee Program). <br />Applicants must review the Program design and process details which, along with other valuable information on <br />the MCES Inflow and Infiltration (I &I) Program, can be found at the following link: <br />http: / /www. metrocou n c i l. o rt-1 W astewater- W aterIFunding- FinancelRates- Charge s /MCES - Inflow -and- <br />Infiltration-(I-I )-Pro rg am.aspx <br />Pre - qualification of individual projects is mandatory and becomes the basis for determining initial grant <br />agreement amounts. The pre - qualification information submitted, whether with this form or submitted <br />separately, becomes a part of Exhibit A. <br />Grant agreements will be sent for signature 1) when your city requests one, 2) when your city submits at least <br />15 pre - qualification requests that meet the requirements for funding, or 3) when the total amount of funding <br />available from the Clean Water Fund has been encumbered, whichever occurs first. Funds are available on a <br />`first qualified, first serve' basis. <br />MCES will accept and review pre - qualification requests from cities that have completed this application process <br />until all of the funds appropriated in 2013 from the Clean Water Fund have been encumbered. After the initial <br />grant agreement is signed, additional submittals will result in follow up letters from MCES which become part <br />of this Agreement specifying the additional amounts the Council will encumber. Grant agreements include an <br />Exhibit B which is the anticipated letter for readily adding additional pre - qualified projects (assuming funding <br />is available). <br />CITY NAME: <br />The City's designated authorized representative (all correspondence and city responsibility regarding <br />participation in the Grantee Program should be should be addressed to individual named below) is: <br />NAME: <br />TITLE: <br />STREET: <br />CITY, ZIP: <br />PHONE: <br />EMAIL: <br />A city resolution confirming this individual's authority and certification that s/he has read the <br />program details documents must be included when returning signed agreement. <br />