VALLE VISTA REDRESS PROGRAM INSTRUCTIONS: The attached Application for Reimbursable Costs must be completely filled out. Please type or print legibly. All required documents must be submitted with this application. Failure to submit a complete application will delay its processing. The completed application must be sent to: Mohave County Attorney, Valle Vista Redress Program, P.O. Box 7000, Kingman, Arizona 86402-7000. This application will be used as the sole basis for determining the eligibility of Valle Vista lot owners to participate in the redress program established by the Federal Trade Commission and administered by the Mohave County Attorney. The Valle Vista Property Owners Association and any entity owned or controlled by the Valley Vista Property Owners Association are not eligible to participate in this redress program. No applications will be accepted after _________________ (one year from the effective date of the Amended MOU). REIMBURSABLE COSTS: A Valle Vista lot owner may apply for payment to Mohave Electric Cooperative of an amount not to exceed $8,000 per lot to offset "reimbursable costs" of electric utility installation by Mohave Electric Cooperative to their lots. An eligible lot owner may receive funds from the Utility Account for the installation of electric utilities to a maximum of three (3) lots over the duration of this redress program since its start in 1997. A separate Application for Reimbursable Costs must be submitted for each lot. Under this redress program, the "reimbursable costs" of electric utility installation for which an eligible Valle Vista lot owner may seek payment shall include the cost of extending electric power lines to the lot and the cost of installing a transformer and/or secondary box on the lot, but shall exclude the cost of the conduit, trenching, backfilling, electric wiring from the transformer or secondary box to the residence's electric meter, and electric wiring within the residence. "Reimbursable costs" shall not include any costs paid or incurred by the Valle Vista lot owner prior to August 20, 1997. NOTIFICATION: After the completed application has been submitted, the Mohave County Attorney will review the application and notify the applicant as to whether the application has been denied or approved. If the application has been denied, the Mohave County Attorney will inform the applicant of the reasons for such non-approval. If the application has been approved, the Mohave County Attorney will inform the applicant of the amount of funds that shall be paid to Mohave Electric Cooperative from the Utility Account. PAYMENT: After approval of the application by the Mohave County Attorney, the applicant must submit a copy of the signed "actual cost contract" with Mohave Electric Cooperative. Upon receipt of the actual cost contract, the Mohave County Attorney shall authorize the transfer of the specified amount of funds from the Utility Account to Mohave Electric Cooperative for full or partial reimbursement of the cost of installing electric utilities to the applicant's lot. ADDITIONAL PAYMENT: In some instances, after completion of the electric utility installation, Mohave Electric Cooperative may determine in an "adjustment to actual cost" that a further payment is due from the lot owner because the actual cost of electric utility installation is greater than the estimate set forth in the "actual cost contract." If the initial payment to Mohave Electric Cooperative was less than $8,000, the Mohave County Attorney will authorize a second transfer of monies from the Utility Account to Mohave Electric Cooperative, provided however, that the total payments from the Utility Account for the specified lot cannot be greater than $8,000 or total reimbursable costs, whichever is less. An "Application for Additional Payment" can be obtained from the Mohave County Attorney. The completed Application for Additional Payment, along with a copy of the "adjustment to actual cost," must be submitted to the Mohave County Attorney. APPLICATION FOR REIMBURSABLE COSTS Send completed application to:
1. Date of Application: ________________________________ 2. Valle Vista Lot Description: Lot No.:________ Parcel: _________ Unit:_________ 3. Name of lot owner(s): __________________________________________________ (As recorded on deed) __________________________________________________ 4. Current address: _____________________________________________________ _____________________________________________________ 5. Telephone Numbers: Home: _________________ Work: ____________________ Fax Number: ________________ Cellular Phone: _________________ 6. This Valle Vista Lot does / does not have household electric power available at the lot corner. (Place a check mark in the appropriate space.) 7. Mohave County Building Permit to build a single family residence: Date of application for permit:: ___________________________ Building Permit No. : ___________________ Date received: _________________ IMPORTANT: ATTACH COPY OF BUILDING PERMIT TO APPLICATION. 8. Foundation for single family residence: Date of completion of foundation:_________________________ Date of "pass" on inspection by County Building Inspector received:______________ IMPORTANT: ATTACH COPY OF INSPECTION APPROVAL TO APPLICATION. 9. Engineering Installation Estimate ("Engineering Service Contract for Design Services") with Mohave Electric Cooperative Date of "Engineering Service Contract":__________________________ Date advance paid by lot owner for Engineering Services: _____________________ IMPORTANT: ATTACH COPY OF ENGINEERING SERVICE CONTRACT TO APPLICATION. 10. RELINQUISHMENT OF RIGHTS TO CERTAIN REBATES AND REFUNDS. I (We), ____________________________________(print names), agree to relinquish, and assign to the Federal Trade Commission, all rights and interest to: (1) any rebates that may be due from Mohave Electric Cooperative as a result of the installation of electric utilities to my (our) lot; and (2) any refunds that may be due from Mohave Electric Cooperative to the extent that Mohave Electric Cooperative, upon completion of the electric utility installation, determines in an "adjustment to actual cost" that the actual cost of electric utility installation is less than the amount paid from the Utility Account for installation of electric utilities to my (our) lot. I(We) understand that all such rebates and refunds shall be deposited into the Utility Account or such other account as designated by the Federal Trade Commission. By ___________________________________ Date: ________________ By ___________________________________ Date: ________________ IMPORTANT: To be eligible for redress, the applicant(s) must agree to relinquish, and assign to the FTC, rights to the described rebates and refunds. 11. INFORMATION SUBMITTED UNDER PENALTY OF PERJURY I (We) _____________________________________(print names), acknowledge and attest that the information contained in this application is truthful and complete and that this application has been submitted under penalty of perjury. The applicant(s) is not the Valle Vista Property Owners Association or any entity owned or controlled by the Valle Vista Property Owners Association. By ___________________________________ Date: __________________ By ___________________________________ Date: __________________ IMPORTANT: To be eligible for redress, the applicant(s) must sign and date this acknowledgment. |