32 Ill. Adm. Code 326.APPENDIX E
E Wording for Self-Guarantee Documents
Section 326
Section 326.APPENDIX E Wording
for Self-Guarantee Documents
a) A self-guarantee, as specified in 32 Ill. Adm. Code 326.130,
shall contain letters from the chief executive officer and the chief financial
officer containing the following provisions, except that instructions in
brackets are to be replaced with the relevant information and the brackets
deleted:
CHIEF EXECUTIVE OFFICER
I am the [chief executive officer or equivalent] of [name and address of
firm], a [insert "proprietorship," "partnership," or
"corporation"]. This letter is in support of this firm's use of the
financial test to demonstrate financial assurance, as specified in 32 Ill. Adm.
Code 326.
I hereby certify that [name of firm] is currently a going concern, and
that it possesses positive tangible net worth in the amount of $__________.
This firm [insert "is required" or "is not required"]
to file a Form 10K with the U.S. Securities and Exchange Commission for the
latest fiscal year. The fiscal year of this firm ends on [month, day].
I hereby certify that the content of this letter is true and correct to
the best of my knowledge.
[Signature]
[Below the signature, type or print that person's name and title]
[Date]
CHIEF FINANCIAL OFFICER
I am the [chief financial officer or equivalent] of [name and address of
firm], a [insert "proprietorship," "partnership," or
"corporation"]. This letter is in support of this firm's use of the
financial test to demonstrate financial assurance, as specified in 32 Ill. Adm.
Code 326.
[Complete the following paragraph regarding facility(ies) and associated
cost estimates or amounts specified in 32 Ill. Adm. Code 326.70. For each
facility, include its license number, name, address and current cost estimates
for the specified activities.]
This firm guarantees, through the self-guarantee submitted to demonstrate
compliance under 32 Ill. Adm. Code 326, the reclamation of the following
facility(ies) owned or operated by this firm. The current cost estimates or
amounts specified in 32 Ill. Adm. Code 326.70, so guaranteed, are shown for
each facility:
Name of Facility
Location of Facility
Cost Estimate or
326.70 Amounts
This firm
[insert "is required" or "is not required"] to file a Form
10K with the U.S. Securities and Exchange Commission for the latest fiscal
year.
The fiscal
year of this firm ends on [month, day]. The figures for the financial test
required by 32 Ill. Adm. Code 326.140 are derived from this firm's
independently audited, year-end financial statements and footnotes for the
latest completed fiscal year, ended [date].
[Insert
completed financial test applicable to licensee from subsection (c), (d) or (e)
of this Appendix.]
I hereby
certify that the content of this letter is true and correct to the best of my
knowledge.
[Signature]
[Below the
signature, type or print that person's name and title]
[Date]
b) A self-guarantee, as specified in 32 Ill. Adm. Code 326.130,
shall contain the following provisions, except that instructions in brackets
are to be replaced with the relevant information and the brackets deleted:
SELF-GUARANTEE
Self-guarantee
made this [date] by [name and address of licensee], a [insert
"proprietorship," "partnership," or
"corporation"] organized under the laws of the State of [insert name
of state], herein referred to as "licensee," to the Illinois Emergency
Management Agency (hereinafter called the Agency).
Recitals
1) The licensee has full authority and capacity to enter into
this guarantee [if guarantor is a corporation, add the following phrase
"under its bylaws, articles of incorporation, and the laws of the State of
[insert licensee's state of incorporation], its state of
incorporation."]. [If the licensee has a Board of Directors, insert the
following: "Licensee has approval from its Board of Directors to enter
into this guarantee."]
2) This guarantee is being issued to comply with regulations
issued by the Agency, pursuant to the Radiation Protection Act of 1990. The Agency
has promulgated regulations in 32 Ill. Adm. Code 326 that require that general
or specific licensees provide assurance that funds will be available when
needed for reclamation activities.
3) The guarantee is issued to provide financial assurance for reclamation
activities for [identify licensed facility(ies)] as required by 32 Ill. Adm.
Code 326. The reclamation costs are as follows: [insert the current cost
estimates or amounts specified in 32 Ill. Adm. Code 326.70 guaranteed for each
identified facility].
4) The licensee meets or exceeds the financial test criteria
specified in 32 Ill. Adm. Code 326.140 and agrees to comply with all
notification requirements as specified in 32 Ill. Adm. Code 326.
5) Reclamation activities as used in this Appendix E refers to
the activities required by 32 Ill. Adm. Code 330 for reclamation of
facility(ies) identified in this Appendix E.
6) The licensee guarantees to the Agency that it will:
A) Carry out the required reclamation activities as required by 32
Ill. Adm. Code 330; or
B) Upon written notification from the Agency, pay the reclamation
cost amount guaranteed for the facility(ies) to the Agency directed by the
Director.
7) The licensee shall submit revised financial statements,
financial test data and an auditor's special report and reconciling schedule
annually within 90 days after the close of the licensee's fiscal year.
8) If, at the end of any fiscal year before termination of this
guarantee, the licensee fails to meet the financial test criteria, the licensee
shall send within 90 days after the end of the fiscal year, by certified mail,
return receipt requested, notice to the Agency that the licensee intends to
provide alternative financial assurance as specified in 32 Ill. Adm. Code
326.170. Within 120 days after the end of the fiscal year, the licensee shall
provide such financial assurance.
9) The licensee shall notify the Agency promptly if the ownership
of the licensee is transferred and shall maintain this guarantee until the new
parent firm or the licensee provides alternative financial assurance acceptable
to the Agency.
10) The licensee, as well as its successors and assigns, agrees
to remain bound jointly and severally under this guarantee notwithstanding any
or all of the following: amendment or modification of the license or Agency-approved
reclamation funding plan for that facility, the extension or reduction of the
time of performance of required activities, or any other modification or
alteration of an obligation of the licensee pursuant to 32 Ill. Adm. Code 326.
11) All bound parties shall be jointly and severally liable for
all litigation costs incurred by the Agency in any successful effort to enforce
this guarantee.
12) The licensee shall remain bound under this guarantee for as
long as the licensee must comply with the applicable financial assurance
requirements of 32 Ill. Adm. Code 326 for the previously listed facility(ies),
except that the licensee may cancel this guarantee by meeting the requirements
of 32 Ill. Adm. Code 326.170.
13) If the licensee fails to provide alternative financial
assurance as specified in 32 Ill. Adm. Code 326.170, the licensee shall make
full payment under this guarantee.
14) If the licensee files financial reports with the U.S.
Securities and Exchange Commission, then it shall promptly submit them to the Agency
during each year in which this guarantee is in effect.
I hereby
certify that the content of this guarantee is true and correct to the best of
my knowledge.
Effective date:_________________
[Name of licensee]
[Signature of chief executive officer or equivalent]
[Below the signature, type or print that person's name and title]
Signature of witness or notary:_________________________
c) Financial test documentation for self-guarantee for a
commercial company issuing bonds:
1) Current reclaiming and decommissioning cost estimates or
certified amounts
A)
Current reclaiming cost
estimate or certified amount for all decommissioning activities covered by
this self-guarantee
$
B)
Total reclaiming cost
estimates and certified amounts for all decommissioning activities covered by
other NRC or Agreement State guarantees, parent company guarantees or self-guarantees
$
C)
Total amounts for all
decommissioning activities under parent company guarantees, self-guarantees
and commitments to other regulatory agencies (e.g., USEPA)
$
Total for line 1
$
2) Current bond rating of
most recent unsecured issuance of this firm
Rating
Name of rating service
3)
Date of issuance of bond
4)
Date of maturity of bond
5)*
Tangible net worth** (if any
portion of the cost estimates for reclaiming or decommissioning is included
in total liabilities on your firm's financial statements, you may add the
amount of that portion to this line)
$
6)*
Total assets in United States
(required only if less than 90 percent of firm's assets are located in the
United States)
$
Yes
No
7)
Is line 5 at least 10 times
line 1?
8)
Are at least 90 percent of the
firm's assets located in the United States? If not, complete line 9
9)
Is line 6 at least 10 times
line 1?
10)
Is rating specified on line 2 "A"
or better
11)
Does the licensee have at
least one class of equity securities registered under the Securities Exchange
Act of 1934?
* Denotes figures derived from financial statements.
** Tangible net worth is defined as net worth minus goodwill,
patents, trademarks and copyrights.
d) Financial test documentation for commercial companies that
have no outstanding rated bonds:
1) Current reclaiming and decommissioning cost estimates or
certified amounts
A)
Current reclaiming cost
estimate or certified amount for all decommissioning activities covered by
this self-guarantee
$
B)
Total reclaiming cost
estimates or certified amounts for all decommissioning activities covered by
other NRC or Agreement State guarantees, parent company guarantees or
self-guarantees
$
C)
Total amounts for all
decommissioning activities under parent company guarantees, self-guarantees
and commitments to other regulatory agencies (e.g., USEPA)
$
Total for line 1
2)*
Total liabilities (if any
portion of the cost estimates for reclaiming or decommissioning is included
in total liabilities on your firm's financial statements, you may deduct the
amount of that portion from this line and add that amount to lines 3 and 4)
$
3)*
Tangible net worth**
$
4)*
Net worth
$
5)*
The sum of net income plus
depreciation, depletion and amortization
$
6)*
Total assets in United States
(required only if less than 90 percent of firm's assets are located in the
United States)
$
Yes
No
7)
Is line 3 greater than $10 million,
or at least 10 times line 1, whichever is greater
8)
Are at least 90 percent of the
firm's assets located in the United States? If not, complete line 9
9)
Is line 6 at least 10 times
line 1?
10)
Is line 5 divided by line 2
greater than 0.15?
11)
Is line 2 divided by line 4
less than 1.5?
* Denotes figures derived from financial statements.
** Tangible net worth is defined as net worth minus goodwill, patents,
trademarks and copyrights.
e) Financial test documentation for self-guarantee for hospitals
(Complete either Alternative 1 or Alternative 2):
Alternative 1
1) Current bond rating of most recent unsecured ,uncollateralized
and unencumbered issuance of this institution
Rating
Name of rating service
2)
Date of issuance of bond
3)
Date of maturity of bond
Yes
No
4)
Is the rating specified on
line 1 "a" or better
Alternative 2
1) Current
reclaiming and decommissioning cost estimates or certified amounts
A)
Current reclaiming cost
estimate or certified amount for all decommissioning activities covered by
this self-guarantee
$
B)
Total reclaiming cost
estimates and certified amounts for all decommissioning activities covered by
other NRC or Agreement State guarantees, parent company guarantees or
self-guarantees
$
C)
Total amounts for all
decommissioning activities under parent company guarantees, self-guarantees
and commitments to other regulatory agencies (e.g., USEPA)
$
Total for line 1
$
2)*
Total revenues
$
3)*
Operating revenues
$
4)*
Total expenditures
$
5)*
Total long-term debt
$
6)*
Net fixed assets**
$
7)*
Current assets
$
8)*
Depreciation fund
$
9)*
Current liabilities
$
Yes
No
10)
Is line 3 at least 100 times
line 1?
Guarantor shall meet each of
the following ratios:
Yes
No
11)
Is (line 2 minus line 4)
divided by line 2 at least 0.04?
12)
Is line 5 divided by line 6
less than or equal to 0.67?
13)
Is (line 7 plus line 8)
divided by line 9 at least 2.55?
* Denotes figures derived from financial statements.
** Net fixed assets is defined as fixed assets minus accumulated
depreciation.
f) A self-guarantee, as specified in 32 Ill. Adm. Code 326.130
and 326.140, shall include submission of an auditor's special report containing
the following provisions, except that instructions in brackets are to be
replaced with the relevant information and the brackets deleted:
AUDITOR'S CONFIRMATION OF CHIEF
FINANCIAL OFFICER'S LETTER
We have
examined the financial statements of [self-guarantor's name] for the year ended
[insert date], and have issued our report thereon dated [date]. Our
examination was made in accordance with generally accepted auditing standards
and, accordingly, included such tests of the accounting records and such other
auditing procedures as we considered necessary. [Self-guarantor's name] has
prepared documents to demonstrate its financial responsibility under the Illinois
Emergency Management Agency's financial assurance regulations, 32 Ill. Adm.
Code 326. This letter is furnished to assist the licensee [insert IEMA license
number and name] in complying with these regulations and should not be used for
other purposes.
The attached schedule reconciles the specified information furnished in
the chief financial officer's (CFO's) letter with the company's financial
statements. In connection therewith, we have:
1) Confirmed that the amounts in the column "Per Financial
Statements" agree with amounts contained in the licensee's financial
statements for the year ended [date];
2) Confirmed that the amounts in the column "Per CFO's
Letter" agree with the amounts in the chief financial officer's letter;
3) Confirmed that the amounts in the column "Reconciling
Items" are adequately explained in the attached schedule, that each
reconciling item represents an appropriate adjustment to the financial data,
and that the amount of each reconciling item is accurate; and
4) Recomputed the totals and percentages.
Because the
procedures in paragraphs (1)-(4) above do not constitute a full examination
made in accordance with generally accepted auditing standards, we do not express
an opinion on the manner in which the amounts were derived in the items
referred to above. In connection with the procedures referred to above, no
matters came to our attention that cause us to believe that the chief financial
officer's letter and supporting information should be adjusted.
Signature
Date
AUDITOR'S SCHEDULE RECONCILING
AMOUNTS IN CFO'S LETTER
[Name of self-guarantor]
Year ended [date]
Line
# in CFO'S Letter
Per
Financial Statements
Reconciling
Items
Per
CFO's Letter
6
Total
current liabilities
X
Long-term
debt
X
Deferred
income taxes
X
XX
Accrued
decommissioning cost included in current liabilities
X
Total
liabilities (less accrued decommissioning cost)
X
4
Net
worth
XX
Less:
Cost in excess of value of tangible assets acquired
X
XX
Accrued
decommissioning costs included in current liabilities
X
Tangible
net worth (plus decommissioning costs)
XX
(Balance of schedule is not illustrated.)
AGENCY NOTE: This illustrates
the form of schedule that is contemplated. Details and reconciling items will
differ in specific situations.