EDA Site Certification Form

OMB Control No. 0610-0096
Expiration Date: xx/xx/20xx

ECONOMIC DEVELOPMENT ADMINISTRATION
CERTIFICATE AS TO PROJECT SITE, RIGHTS-OF-WAY, AND EASEMENTS
Part One
Certificate of Architect/Engineer
Description of Property Requirements for EDA project
I,

  (Name of Architect/Engineer)

familiar with the design of the
being constructed by

, the undersigned Architect or Engineer, certify that I am

(Name or Type of Facility)
(Name of Owner)

as part of EDA Award Number
and that all of such
facilities will be constructed wholly within the land, leasehold interest and rights-of-way and/or
existing public streets and roads described below. I further certify that the land, leasehold
interest, and rights-of-way being purchased as hereinafter described are sufficient, but not in
excess of actual needs for the Project as planned and approved by the Owner.
Note: Depending on the project, Items 1, 2 or 3 may not be applicable. Use Item 1 for acreage
parcels, such as tracts and lots; Use Item 2 for easements and right-of-way; Use Item 3 for property
that is associated with a permit (i.e. railroad; state highway, etc.).

1. The Owner holds or will hold fee title or a long-term leasehold interest on the following
property. (Aboveground Project elements should be constructed on land to which the Owner
possesses fee simple title. Describe each tract, whether presently owned or to be acquired, and
indicate what Project element is to be constructed on each (i.e., tank site, pumping station,
treatment plant, etc.). If more space is needed, please attach additional documentation and
label each additional page “Exhibit 1A”). Provide a map that shows the property relative to
the project components.

2. The following easements and rights-of-way are required for this Project. (Describe each
easement and/or right-of-way, whether presently owned or to be acquired, by name of current
owner and by metes and bounds, including the area in acreage. If more space is needed, please
attach additional documentation and label each additional page “Exhibit 1B”). Provide a map
that shows the property relative to the project components.

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3. The following state, railroad, highway, or other permit(s) are required for this project.
(Describe the location for which any permit will be needed and the name of the permitting
entity. If more space is needed, please attach additional documentation and label each
additional page “Exhibit 1C”). Provide a map that shows the property relative to the project
components.

WITNESS MY HAND, this the

day of

, 20

.

Registered Professional Architect’s or Professional
Engineer’s Signature
Address
City

State

Telephone

(This “Certificate of Architect/Engineer” is to be completed by the Owner’s Architect/Engineer and
forwarded to the Owner’s Attorney).

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Part Two
Title Opinion

I,

(Name of Attorney-at-Law)

, Attorney-at-Law, representing
(hereinafter the “Owner”) do hereby certify that:

1. I have examined the public records of
County, State
of
from the period of
,
to
, 20
(which period of time should be at
least 40 years). Based upon said examination, I find and am of the opinion that
is vested with marketable, fee simple title to the land
referenced in Part One hereof as being required in fee, subject only to the following liens,
encumbrances, and objections.
(If additional space is needed, please attach additional documentation and mark each page
“Exhibit 2A.” If there are no encumbrances on the Owner’s fee simple title, please write
“None”).

Any encumbrances or objections to the fee simple title listed above will not, in my opinion,
restrict or interfere with the contemplated construction, use or purpose of the aforesaid EDA
Project.
2. This is to further certify that: (i) all long-term leases needed for the Project as described in
Part One above have been acquired by the Owner; and (ii) all easements or rights-of-way
needed for the Project as described in Part One above have been entered into by the Owner.
In addition, I have examined the instruments creating the long-term leases, easements, and/or
rights-of-way described in Part One; and it is my opinion that said instruments are valid as to
form and substance for the purposes intended and provide the Owner with sufficient interest
to construct and maintain the Project facilities.
I certify that I have examined the public records to ascertain that said easements and/or rights-ofway have been obtained from the record owner(s).
3. The extent of said title examination and/or public record search is sufficient for the purpose of
establishing the validity of the title to said property and for the purpose of determining
outstanding restrictions, liens, encumbrances, and ownership interests pertaining thereto.

4. All permits required for the Project as described in Part One above have been obtained. I
have examined all of said permits and am of the further opinion that said permits are valid as
to form and substance for the purposes intended.
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5. Remarks and Explanations. (If additional space is needed, please attach
additional documentation and mark each page “Exhibit 2B”).

WITNESS MY HAND, this the

day of

, 20

Attorney’s Signature

Address

City

State

Telephone
It is the sole responsibility of the Recipient of the EDA Award to provide a legal opinion
verifying that the Recipient has good title to all property required for completion of the Project as
defined by the grant award.
 A long term leasehold interest is acceptable only if held by the Recipient of the EDA Award
for a period not less than the estimated useful life of the Project and only if lease provisions
adequately safeguard EDA's interest in the Project.
 Only legal descriptions of the property described herein should be attached to this form.
 If this title opinion is based on a title insurance policy, any exceptions listed on the policy
should be explained and resolved in #5 above.
 EDA relies on this title opinion and does not make independent findings regarding title to the
property described herein.

  Economic Development Administration
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Part Three
Owner’s Certification Regarding Eminent Domain
I,

the undersigned

(Insert Name)

of the Owner,

(Insert Title)

referenced in Part One above, do hereby certify and confirm that:
1. The Owner will not use any available power of eminent domain (including the
commencement of eminent domain proceedings) for the purpose of advancing the economic
interests of private parties in connection with any property comprising the Project.
2. To the best of my knowledge and belief, prior to the Effective Date of this Certification, the
Owner has not exercised any available power of eminent domain (including the commencement
of eminent domain proceedings) for the purpose of advancing the economic interests of private
parties in connection with any property comprising the Project.
3. The Owner was or will be required to properly use an available power of eminent domain in
connection with the following aspects of the Project. (If more space is needed, please attach
additional documentation describing the location and purpose of the Owner’s proper use of
eminent domain as an attachment and label each additional page “Exhibit 3A”. If the use of
eminent domain is not anticipated, please mark this section “N/A”).

4. If an available power of eminent domain may be used in connection with the Project, the
Owner will immediately contact the EDA regional office.
5. I am authorized on behalf of the Applicant to make this Certification which is binding on the
Applicant.
WITNESS MY HAND, this the

, 20

day of

Owner's Signature
Address

City

State

Telephone
Economic Development Administration
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