1 STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION REVIEW STATE WATER RESOURCES CONTROL BOARD Clean Water State Revolving Fund Division of Financial Assistance Water Recycling Funding Program P.O. Box 944212, Sacramento, CA 95814 Drinking Water State Revolving Fund
FINAL BUDGET APPROVAL CHECKLIST
Technical Review Checklist (Revised 5/27/2022)
1. General Project Information
Date Complete FBA Request received from Recipient: January 6, 2026 Date FBA – Davis Bacon package sent to SRF Administration: N/A Date FBA – DBE package sent to SRF Administration: N/A
Project No. 1000299-001C Contract No. (if known): D2202042 Recipient: City of Fresno
Project Title: Three Palms MHP Water Connection Project Primary Contractor (Low Bidder): Holloway Construction, Inc. (List multiple contractors below)
2. Bid Dispute Resolution
Have any protests regarding award of the construction contracts been received? ☐ YES ☒ NO If no, skip to section 3.
If yes, give date protests were resolved: Attach copies of the protests and resolutions. All protests must be resolved before FBA Approval.
Please provide a description of the dispute and our funding recipient’s resolution.
Explain:
Did the bid dispute resolution by our recipient result in the filing of a lawsuit by the contractor who filed the dispute? ☐ YES ☐ NO
Explain:
Will the lawsuit affect the recipient’s ability to repay the SRF financing? ☐ YES ☐ NO ☒ N/A Explain:
3. Final Project Budget Authority
Initial Financing Agreement amount: $392,461
What is the projects established credit limit amount? $392,461
Comments: Cost increase is needed above the initial agreement amount. Credit review was waived during initial agreement.
2 List initial and fina
l costs below:
ITEM DESCRIPTION INITIAL COSTS FINAL COSTS
A Construction $169,000 $330,280
B Pre-Purchased Material / Equipment $0 $0
C Real Property / Easement Acquisition $0 $0
D Change Order Contingency $66,000 $74,900
E Connection Fees $56,961 $56,961
F Force Account $0 $0
G Allowances (Soft Costs)
Planning $0 $0
Design $39,500 $40,887
Construction Management $41,000 $66,577
Administration $20,000 $60,000
Allowances Subtotal $100,500 $167,464
TOTAL $392,461 $629,605
Budget
1. Final Project Budget has increased above initial agreement amount? ☒ YES ☐ NO Explain: Final Project Budget has increased by $281,364 above the initial agreement amount. The City of Fresno is requesting a Budget increase to consolidate Three Palms Mobile Home Park a SAFER Failing system. Budget increase
makes the Total
Grant/PF Amount per residential service: $629,605/105 = $5,996, this is less than the maximum cost per connection limit per the Intended Use Plan.
☐ YES ☒ NO
☐ YES ☐ NO ☒ N/A
2. Final Project Budget has increased above the established credit review limit? Explain: No, credit review was waived per Memo for Cost Increases for Projects 100% grant/Principal Forgiveness funded projects
3. Has a new credit review limit been established?
☐ If yes, what is the new credit limit?
Explain: No, credit review was waived because the City was determined to be in good standing.
4. PM has attached a revised Financial Security Review Checklist showing that the applicant can afford the cost increases. ☐ YES ☐
NO ☒ N/A
Other Funding Sources
1. The financing plan for the pr
oject included other sources of potential funding in addition to SRF (WIFIA, SCG, USDA, etc.)? ☐ YES ☒ NO (List all final funding sources) Explain:
2. Have the additional sour
ces been secured? ☐ YES ☐ NO ☒ N/A
3. The Other funding source
amount was known during the initial funding agreement development? ☐ YES ☐ NO
4. Did the initial amount
of other funding change? ☐ YES ☐ NO
5. Does the change in other
funding affect the final SRF funding amount? ☐ YES ☐ NO Explain:
6. What is the total ot
her funding final amount? $
3 7. O
ther funding amount is accounted for in the construction budget above and in Exhibit A-FBA? ☐ YES ☐ NO
4. Plan and Specification Review
Pl
ans and Specifications (P&S)
D
ate P&S Submitted to DFA Staff:
1. Ar
e P&S developed in accordance with the project application and SRF Policy? ☒ YES ☐ NO a. Ar
e P&S consistent with the approved project description and project location? ☒ YES ☐ NO Comments: P&S is consistent with the approved project description and project location. b. E
ligible Design Parameters are consistent with the approved project? ☒ YES ☐ NO Comments: Design parameters is consistent with the approved project. 2 . Are P&S signed and stamped by a registered P.E. confirmed online (www.bpelsg.ca.gov)? ☒ YE S ☐ NO
P.E. Name: Logan A. Kearnan N umber : 95384 Ex p iration Date: Dec. 31, 2027 P.E. Name: Timothy M. Odom N umber : 8468 Ex p iration Date: Dec. 31, 2026 P.E. Name: Number: Expiration Date:
Plans Dated: 7/28/2025
Comments: No comments.
A
ddenda
1. Are Addenda developed in accordance with project application and SRF guidelines? a. P
roject Location? ☒ YES ☐ NO
Deficiencies noted if any: None
b
. Project Description? ☒ YES ☐ NO
Deficiencies noted if any: None
c. E
ligible Design Parameters? ☒ YES ☐ NO
Deficiencies noted if any: None
2 . Addenda No. 1, 2, 3 complies with project application and SRF guidelines? ☒ YES ☐ NO ☐ N/A
3. D
ates Addenda issued respectively: 8/14/2025; 8/29/2025; 9/9/2025 June 24, 2025
4 Project Bidding and Award
a. Bid Opening Date: 9/15/2025
b. Award of Contract Date: To be awarded after City approves c. Construction Contract Fully Executed with Contractor: To be issued after City approves d. Notice to Proceed Date: To be issued after City approves
Comments: City is waiting for DFA approval prior to awarding and issuing construction contract and Notice to Proceed.
Fiscal Sustainability Plan
(For DWSRF, skip to next section)
1. The applicant has provided a certification that they have implemented a Fiscal Sustainability? ☐ YES ☐ NO Date signed:
2. The applicant certified that they will develop and implement the Fiscal Sustainability plan by the following date:
Comments:
Special Conditions
1. SRF financing agreement includes special conditions (see Exhibit D of finance agreement)? ☒ YES ☐ NO
2. Have all conditions that prohibit amending the finance agreement to include construction costs been resolved? ☐ YES ☐ NO
3. List the Special Conditions and indicate if they have been complied with. a.
DFA/DDW approval of Final P&S prior to bid ☒ YES ☐ ONGOING b. Submit final water system consolidation agreement ☒ YES ☐ ONGOING c. ☐ YES ☐ ONGOING
d. ☐ YES ☐ ONGOING
e. ☐ YES ☐ ONGOING
If needed, please attach a copy of finance agreement Exhibit D.
Comments: No other special conditions.
Bid Items – Form 259
1. Are all the bid line items eligible? ☐ YES ☒ NO
If no, list ineligible items below.
a. 10 - Existing Well #3 Destruction Percent Eligible 0 % b. Percent Eligible %
c. Percent Eligible %
Comments: Bid Item No. 10 – Existing Well #3 Destruction is ineligible because it is beyond the scope of work for this funding agreement.
Other Items
1. Is the Contractor(s) listed on the Federal Debarred List (www.sam.gov) ☐ YES ☒ NO Explain: No Matches found.
5 2. Is the Contractor(s) listed on a California or Water Board Debarred Lists? ☐ YES ☒ NO
The lists may be found at the following:
California State Water Resources Control Board:
https://www.waterboards.ca.gov/water_issues/programs/enforcement/fwa/dbp.html
California Department of Industrial Relations:
https://www.dir.ca.gov/dlse/debar.html
California Department of General Services:
https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/SB-DVBE-Program- Violations-and-Sanctions
Explain: No matches found.
3. Notice to Proceed, Purchase Order or Proposal approval dates entered in LGTS? ☐ YES ☒ NO
Explain: Notice to Proceed date will be added to LGTS once the City provides information.
5. FBA Checklist s and Attachments:
1. ☒ Attach completed FBA Form (Exhibit A-FBA document, which includes Construction Budget and Eligibility Determination) and place copy into LGTS.
2. ☐ Attach completed FBA Davis-Bacon and FBA DBE checklists and place copy into LGTS. ☒N/A
3. ☒ Attach completed Contractor Eligibility Spread Sheet (Form 259) and place copy into LGTS.
6. FBA Approval for Routing
Signature/Date PM Directions
Route FBA Package to Senior for Approval
Project Manager
Senior approves FBA-Technical Checklist
Senior
Note: Once approved by Senior, Project Manager should attach a copy of the FBA Technical checklist into LGTS and place a copy of all documents in Master File Tab 7: FBA Request Form, FBA Checklists, Exhibit A-1-FBA, Form 259, Debarment Check, Notice to Proceed, etc. and prepare route slip for agreement amendment.
1/29/2026
1/29/2026