REQUEST FORM FOR CSFP USE AGREEMENT and NOTICE OF CONDITIONS PRECEDENT TO USE AGREEMENT Charter School: (Note: Use full legal name) Charter School s legal status: [ ] For-profit [ ] Non-profit [ ] IRS 501(c)(3) status [ ] Corporation [ ] Limited Liability Company [ ] Partnership Date of Charter Petition approval: Expiration Date of Charter Petition: Chartering Authority: Charter School is requesting the Use Agreement for: [ ] Advance CSFP funding OR [ ] Final CSFP apportionment A. Procedure: For Advance CSFP Funding 1. Charter School must request the Memorandum of Understanding ( MOU ) from Charter School Finance Authority ( CSFA ). 2. CSFA will prepare the MOU and transmit to LAUSD for signature. LAUSD will execute if there have been no changes to the template MOU previously approved by CSFA and LAUSD, and then transmit to Charter School for signature and delivery to CSFA. 3. In order to request the Use Agreement, Charter School must complete, execute and submit this Form to LAUSD together with information and documents, if any. If Charter School cannot provide the information typically required for the Use Agreement, the Use Agreement will be prepared with a notation Charter School to provide prior to Final Apportionment. 4. Charter School must execute three (3) original Use Agreements and return to LAUSD. 5. LAUSD will execute and return two (2) executed originals to Charter School for Charter School s submittal to CSFA. B. Procedure: For Final CSFP Apportionment 1. Charter School must complete and submit this Form to LAUSD together with the information and documents required below no later than simultaneously with Charter School s request to CSFA for final apportionment. 2. LAUSD will not close escrow nor accept conveyance of the real property and improvements from Charter School until all of the information and documents set forth below and such other requested information and documents arising from the specific real property and improvements have been delivered to LAUSD. 3. After LAUSD has received all information and documents required in Section C below and as requested: (i) LAUSD will provide closing instructions to escrow for the conveyance between Charter School and LAUSD and deliver such closing instructions to the escrow identified by Charter School; (ii) LAUSD will prepare and provide to Charter School and CSFA any draft amendments to the MOU, if applicable, and any draft amendments to the Use Agreement, if applicable. Request for CSFP Use Agreement and Notice of Conditions Precedent 1
C. Information and/or Documents Required for Advance CSFP Funding or Final CSFP Apportionment 1. In addition to the Form, all of the information and documents as required in the attached TABLE OF DOCUMENTS REQUIRED, Part I must be submitted to LAUSD as specified in the Table. Exception: If submitting for Advance CSFP Funding and information and documents are not available at this time, mark appropriate box as indicated on the Table. 2. Within 10 days of any change, Charter School is responsible to update all information and documents that have been provided to LAUSD. C. Information and/or Documents Required Prior to Use of the Facility 1. All of the following information and/or documents as required in the attached TABLE OF DOCUMENTS REQURED, Part II must be submitted to LAUSD. 2. Within 10 days of any change, Charter School is responsible to update all information and documents that have been provided to LAUSD. Charter School acknowledges that it has read and reviewed this Form and attests that the information and the required documents provided by Charter School, whether contained in this Form or transmitted by separate instrument, are true and accurate and may be relied upon by LAUSD. Charter School: Dated: By Name: Title: Dated: By Name: Title: Request for CSFP Use Agreement and Notice of Conditions Precedent 2
TABLE OF DOCUMENTS REQUIRED PART I DOCUMENTS REQUIRED FOR CSFP APPORTIONMENT All of the following information and/or documents must be submitted to LAUSD in a 3-ring binder (11.75-inches in height) with the Charter School s name and address of the real property on the spine of the binder. The binder shall have an original executed REQUEST FORM FOR CSFP USE AGREEMENT and NOTICE OF CONDITIONS PRECEDENT TO USE AGREEMENT in the front, followed by an index and tabs in the order set forth below. Exception: If submitting for Advance CSFP Funding and information and documents are not available at this time, mark appropriate box. Information or documents to be submitted to LAUSD with Charter School s request to CSFA. Original executed REQUEST FORM FOR CSFP USE AGREEMENT and NOTICE OF CONDITIONS PRECEDENT TO USE AGREEMENT Do you have access to the real property you will be acquiring? [ ] yes or [ ] no ADVANCE CSFP FUNDING FINAL CSFP APPORTIONMENT Binder submitted on to LAUSD. Tab #1 Have you started construction (including the delivery of supplies) to the real property? [ ] yes or [ ] no Table of Documents Required (this Tab #2 table) Address of Real Property [ ] Not available at this time. Tab #3 Notice of Pending Distribution Title Company (Name, Address, Tel. No., E-Mail Address, Mailing Address, and name of Title Officer) A copy attached to this Table. Written evidence of CSFA s determination that Charter School qualifies for disbursement of funds and CSFA s request for the executed Use Agreement. Written evidence of CSFA s determination that Charter School qualifies for Final CSFP Apportionment. Tab #4 [ ] Not available at this time. Tab #5 Table of Documents Required 1
Escrow Company (Name, Address, Tel. No., E-Mail Address, Mailing Address, and name of Escrow Officer) [ ] Not available at this time. Tab #6 Title Commitment [ ] Not available at this time. Issued no more than fifteen (15) days before the date of submittal to LAUSD; and three (3) days prior to closing, a written statement from the title company that there have been no changes to the title commitment from the title commitment previously provided to LAUSD. Tab #7 Title Proforma [ ] Not available at this time. Issued no more than fifteen (15) days before the date of submittal to LAUSD; and three (3) days prior to closing, a written statement from the title company that there have been no changes to the proforma from the proforma previously provided to LAUSD. Tab #8 Title Insurance [ ] Not available at this time. Required if Charter School did not obtain title insurance (acceptable to LAUSD) in its acquisition of the real property and improvements from its seller. Issued no more than fifteen (15) days before the date of submittal to LAUSD; and three (3) days prior to closing, a written statement from the title company that there have been no changes to the title insurance policies from the policies previously provided to LAUSD. Tab #9 Table of Documents Required 2
Estimated Closing Statement [ ] Not available at this time. Charter School is responsible to pay for all escrow fees, closing costs, and title insurance, if applicable, in favor of LAUSD. Tab #10 Escrow Instructions Between Seller and Charter School [ ] Not available at this time. Note: This must be set up as a back-to-back transaction to convey title to LAUSD. Tab #11 Escrow Instructions Between Charter School and LAUSD [ ] Not available at this time. See Note above. Tab #12 Person(s) Authorized to Act on Behalf of Charter School A copy of the authorization must be attached to this Table. A copy of the authorization must be included in the binder. Tab #13 Other funding sources that will be used for this transaction [ ] Not available at this time. Identify all other sources of funding, the amount of funds provided, and the date when such funding was provided or an agreement executed for such funding. Tab #14 Grant Deed from Charter School to LAUSD [ ] Not available at this time. Must be a form acceptable to LAUSD. Note: LAUSD to include a copy of the authorization of its Board of Education to accept title. Tab #15 Amendment to MOU [ ] Not available at this time. Must incorporate the real property and modify terms and conditions as may be appropriate for the specific property. Tab #16 Table of Documents Required 3
Amendment to Use Agreement [ ] Not available at this time. Must incorporate the real property and modify terms and conditions as may be appropriate for the specific property. Tab #17 Request for Notice If obtaining financing from lending institution, we require Request for Notice in favor of the District concurrently with the Deed. Tab #18 Performance Bond Tab #19 Table of Documents Required 4
PART II DOCUMENTS REQUIRED PRIOR TO USE OF THE FACILITY (Conditions Precedent) 1. The conditions precedent to the Use Agreement must be satisfied before Charter School may exercise the contractual right to use the Facility (as defined in the Use Agreement). 2. All of the following information and/or documents must be submitted to LAUSD: i) For inclusion in the 3-ring binder already submitted for Final CSFP Apportionment; with a new index, the appropriate tabs and 3-hole punched, or ii) In a separate 3-ring binder (11.75-inches in height) with the Charter School s name, address of the real property and the words Conditions Precedent on the spine of the binder, and this Table, an index and corresponding tabs. CSFP Application Permits and Approvals (i) Department of Education (CDE) (ii) California Environmental Quality Act (CEQA) (iii) Department of Toxic Substance Control (DTSC) (iv) Division of State Architect Grant Deed Including all amendments Tab #20 Site approval Tab #21 Copy of the approved CEQA and any mitigation plan(s) Tab #22 Copy of approval and any remediation plan Tab #23 Copy of approval and all plans and specifications upon which the approval was based, and final inspection Note: The plans and specifications may be submitted separate from the binder but may not be larger than half-sized Tab #24 Copy of the recorded deed Tab #25 Table of Documents Required 5
Charter School acknowledges that it has read and reviewed this Table and attests that the information and the required documents provided by Charter School, whether contained in this Form or transmitted by separate instrument, are true and accurate and may be relied upon by LAUSD. Charter School: Dated: By Name: Title: Dated: By Name: Title: Table of Documents Required 6