Texas Water Development Board

Financial, Managerial and Technical Self-Assessment Questionnaire

As a part of your funding application through the Economically Distressed Areas Program your entity must complete this self-assessment. By authority of the 77th Texas Legislature, the Texas Water Development Board (TWDB) has the ability to require applicants of the Economically Distressed Areas Program (EDAP) to undergo a Financial, Managerial and Technical Capacity Assessment (FMT). The following self-assessment will help the TWDB to determine if the applicant possesses the FMT capabilities that are necessary to ensure a project will meet program requirements and the entity will be able to maintain financial viability. Upon completion of the assessment, the TWDB will determine if additional capabilities will be required prior to continuing with the project through the TWDB.

Entity Name:

Date:

Financial Assessment

Have water and sewer revenues covered annual expenses for the past five years?

Yes

No, if no, please explain.

Provide the growth rate for water and sewer system revenues for each of the past 5 years?

Does the entity have an established policy for reviewing rates?

Yes, if yes please explain or attach the policy.

No

When was the last rate increase adopted?

Date implemented How much was the rate increase?

Does the entity have a recently completed rate study?

Yes Date Completed: Please attach.

No

Does the system operate under an annual budget approved by the governing body?

Yes

No

Does the entity charge impact fees?

Yes, if yes, please explain.

No

Does the entity have a policy for the use of surplus funds?

Yes, if yes please explain or attach the policy.

No

How often are accounts reconciled?

Monthly

Bi-Monthly

Semi-Annually

Annually

What is the entity’s collection rate?

Greater than 95%

Less than 95%

Does the entity have written procedures for the handling of delinquent accounts?

Yes, if yes, please attach.

No

Does the entity have a positive net assets balance?

Yes

No

Does the entity carry insurance (liability, property, worker’s comp., bond insurance)?

Yes

No

Does the entity have an established investment policy?

Yes

No

Do the policies conform with the Public Funds Investment Act?

Yes

No

What is current debt to assets ratio? Total debt/Total Assets

Has the entity defaulted on debt?

Yes, if yes, explain

No

Does the entity have any authorized but unissued debt?

Yes If so, how much?

No

How often is budget compared to actual figures?

Monthly

Semi-Annually

Annually

Never

Utilizing the last four budget cycles, how often did the entity exceed the budget?

How are figures adjusted when actuals exceed the budgeted amounts?

What other funding sources are utilized?

What approvals are necessary?

How are estimated expenses calculated?

Does the entity have audited financial statements for the most recent completed fiscal year?

Yes

No

Are audits reviewed and approved by the entity?

Yes

No

Does the audits present fairly in accordance with accounting standards?

Yes

No

Do the audits identify any material/significant weaknesses?

Yes If so, have the weaknesses been addressed by the entity?

No

Please complete the Financial Projection Worksheet Attached

Managerial Assessment

Does staff and/or Board members attend training?

Yes If so, how often?

No

Does the entity have term limits for Board/Council Members?

Yes

No

How often are elections held?

Does the entity have established procedures for what authority has been delegated to staff and what requires Board/Council approval?

Yes

No

Does the entity have written policies and procedures?

Yes If so, how often are they updated?

No

Is staff required to attend training?

Yes

No

How are complaints handled?

Is a record of the complaint maintained?

Yes

No

What forms of notification are utilized when service is interrupted?

How are records maintained?

Does the entity have a capital improvement plan?

Yes If so, how far in the future does the plan forecast?

No

Does the capital improvement plan include any estimated rate increases?

Yes

No

Does the entity have written plans for disaster/catastrophic events?

Yes

No

Does the entity participate in the regional planning process?

Yes

No

What measures trigger the evaluation of system needs?

Does the entity have the required permits to operate the system?

Yes

No

Does the entity post notice of meetings according to the Open Meetings Act?

Yes

No

Is the entity currently being assessed fines for violations?

Yes Date of Notice of Violation:

No

How was the most recent improvement or major repair financed?

Cash on hand

Bond/Loan

Grant

Other

Does the entity have written procedures for the handling of unexpected repairs/expenses?

Yes

No

Technical Assessment

Water Systems:

Water System Information:

Water CCN No.: __________________

PWS ID No.(s): __________________

Type of Water Supply (i.e. – purchase treated water, groundwater, surface water, other?)

Type of water treatment?

No. of water connections:

Adopted plumbing ordinance, regulations or service agreements?

Does the entity have a current water conservation plan in effect?

Yes

No

When was the most current water loss audit conducted?

What is the current system-wide estimated water loss?

What steps are being taken to address water loss?

Wastewater Systems

Wastewater System Information:

Sewer CCN No.:

Discharge Permit No.:

No. of Sewer Connections:

Does the entity has any known or suspected Inflow/Infiltration (I/I) issues?

Yes

What steps have been taken to address I/I issues, if any?

No

What is the current average daily flow to the WWTP compared to permitted capacity?

Operations

Do you have an Operation and Maintenance (O&M) Program?

Yes

No

Who ensures compliance with the O&M program?

Is there an O&M Manual for each component of your system? (i.e., each treatment plant, pump stations, storage, collection lines and distribution system?)

Yes

No

How often is the O&M Manual revised?

Are there written safety procedures and who enforces them?

Are there any security procedures in place and who reviews and enforces them? (such as access to treatment plants, water sources, power supply, etc.)

Does the entity have maintenance and repair supplies and equipment on-hand or readily available?

What is the source of back-up power supply for the treatment plant(s)?

Who is responsible for the maintenance of records such as: maintenance/repair records, TCEQ permits and lab tests results, etc.?

Staffing Information:

Do you have written information about staffing needs (including job descriptions, qualifications for each position, organization charts)? How often is this information revised?

What type of operator’s license(s) are required?

What is the operator’s training schedule and what type of training is provided?

What license do the current operators have?

Regulatory Compliance:

What are the current regulatory permits for each component of your system?

What kind of federal and/or state reports are you required to submit on a regular basis?

Who is in charge of preparing federal and/or state reports?

Who is responsible for review of self reporting records?

Does the entity have any current TCEQ violations or enforcement actions?

What steps have been taken to address TCEQ violations, if any?

Who manages preparation and distribution of public notices, such as boil water notices?

Attachment 1