Utah State Infrastructure Bank Application

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Utah Administration Rule R940-3-4 requires, "A public entity must submit a request for an infrastructure loan or infrastructure assistance using an application form provided by the department. The public entity must complete and submit the application according to the application instructions."

Email *

Public Entity Name *

Loan Amount Requested *

Term Length (Up to 15 years) *

Is the application for a loan or assistance as defined by Subsections 72-2-201(2) & (3)? *

Infrastructure Loan

Infrastructure Assistance

Project Type *

Improvements to a state or local highway

Improvements to a public transportation facility

Improvements to nonmotorized transportation facility

Construction of or improvements to parking facilities

Transportation reinvestment zone projects

Housing and transit reinvestment zone projects

Improvements to sewer or water infrastructure

Other:

Required

Description of Project *

Repayment Revenue Source *

Utah Public Treasurers' Investment Fund (PTIF) Number *

Proposed Project Benefits

1. Does the proposed project encourage, enhance, or create economic benefits to the state? (If yes, explain) *

2. Will the loan or assistance enable the project to proceed at an earlier date than otherwise possible? (If yes, explain) *

3. Will assistance from the SIB foster innovative public-private partnerships and attract private debt and equity investment? (If yes, explain) *

Please answer question 4a or 4b based on project type the SIB application is being summited for.

4a. Does the transportation project provide benefit to the state highway system, including safety or mobility improvements? (If yes, explain) *

4b. Does the sewer or water infrastructure project provide benefit to the state, county or city?

Option 1

Clear selection

5a. Does the project financing include local and private participation? *

Yes

5b. If yes, please describe the project financing . *

Please answer question 6a or 6b based on project type the SIB application is being summited for.

6a. Does the project provide intermodal connectivity with public transportation, pedestrian, or non-motorized transportation facilities? (If yes, explain) *

6b. Does the sewer or water infrastructure project increase services or mitigate the risk of service disruptions? (If yes, explain)

If your entity has a credit score or bond rating, enter it here. *

By entering your name below the applicant understands the statutory requirements outlined in Utah Code 72-2-204, and will comply prior to receiving loan proceeds.

Agrees

Authorized Entity Signature *

Send me a copy of my responses.

Submit

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