UST Form Appendix 4
  • All fields should be properly filled out.
  • Signed and dated by the Claimant (Owner Authorization/Direct Pay Certification when claimant is not current UST owner)
  • Accompanied with Appendix 4a spreadsheet
  • Proof of Payment-Invoices
  • Other supporting documentation

Appendix 4a Spreadsheet

  • Properly completed with invoice number, invoice date, date paid, task codes (one summation per task code per invoice), quantity claimed for the task code claimed, and amount claimed per task code.
  • As of 12/23/2010, an electronic version of the Appendix 4A spreadsheet must be submitted electronically to dorust@dor.state.ma.us.

Proof of Payment

  • Both sides of a cancelled check, signed payment affidavit on contractor payee letterhead with date paid for invoices.

Invoices

  • Containing breakdown of charges, no unsupported unit costs, no unsupported lump sums, and properly line item task coded with line item dates of service to correspond to the Appendix 4a spreadsheet.
  • All subcontractor invoices/receipts.
  • Invoice backup information which includes but is not limited to:
    •Complete reports, DEP transmittal forms, sufficient evidence of field events and/or purchased items, permits, bills of lading/manifest to support contaminated soils/water disposal, off site access letters, bioremediation calculations, site maps, results, etc.

Other Supporting documentation

  • Well logs to support boring/drilling events.
  • Chain of Custody to support lab invoices.
  • Reports with DEP transmittal forms to support report charges claimed (or an explanation that the report is in progress with an estimated completion date).
  • If a BID item is being claimed, provide the Appendix 5 BID form with supporting documentation for Bid's.

 


Frequently Asked Questions


  1. What are the requirements for use of an Owner Authorization?
    • Must be submitted whenever Claimant or Applicant is not the Owner of the UST System.
    • Must be submitted for each Application and be original signatures.
    • Date of Authorization (Not date of signature) must match the date the Application was signed.

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  2. What will be the affect of a Department of Environmental Protection's issuance of a Notice of Non-Compliance (NON) on my reimbursement?
    Will result in charges being deemed ineligible if:
    • Work performed is determined to be not cost effective, reasonable, or necessary; or
    • Work causes Fund to incur costs that it would not have incurred but for the issuance of the NON.
    • Mere issuance of an NON does not automatically equate to costs being deemed ineligible.

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  3. What is the policy for filing Proof of Payment where payment was issued via a Retainer Check?
    • Costs covered by retainer checks shall be considered timely from the work completion date (Dates of service for work being claimed) not by the check's cash date or the invoice date.
    • To be eligible, costs associated with a retainer check must be submitted within 365 days of work being performed as documented through invoices, timesheets etc.,

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  4. What happens if my Certificate of Compliance is Revoked?
    • If a COC has been revoked, costs associated with the Release during the period of revocation will be deemed ineligible.

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  5. What are the reasons that a COC may be revoked for?
    • Failure to Pay Fees
    • Failure to Renew
    • Failure to Maintain Compliance
    • Failure to repay monies owed to Fund

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  6. What are the requirements for filing a Request for Reconsideration?
    • A Request for Reconsideration shall be filed with the Board by submitting a clear and concise written statement of the matter as to which the Claimant seeks the Board to reconsider its final determination or other final action, and the reason the Board should make a favorable determination on such Request for Reconsideration. Such statement shall set forth either new evidence that was not reasonably available at the time of initial consideration or the reason or reasons why the Board's initial decision was inconsistent with 503 CMR 2.00.

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  7. When do I use Task Code 22.1.9?
    • Task 22.1.9 is for install only for a system or system component(s) that has been purchased under the 3-BID process for the task 22.0 series of task codes.

    • The maximum reimbursable amount under this Task Code is $7,500 per occurrence*

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  8. Where is it appropriate to use Task Code 21.13.4?
    • Task 21.13.4 is for install only for a system or system component(s) that has been purchased under the 3-BID process for the task 21.0 series of task codes.
    • The maximum reimbursable amount under this Task Code is $7,500 per occurrence*

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  9. At what time is it appropriate to use Task Codes 22.1.6 and 21.10?
    • Task 22.1.6 (surface components of remediation systems including portable, skid-mounted and stand alone system components) and 21.10 (NAPL and groundwater pumping systems) are for removal and reinstallation of system components taken from another site (e.g. not purchased or BID).
    • The maximum reimbursable for Task Code 22.1.6 is $10,000 per occurrence
    • The maximum reimbursable for Task Code 21.10 is $7,500 per occurrence*
    *Contractor and subcontractor oversight and labor are included under this maximum.

    *Occurrence as defined under 503 CMR 2.00 is an event which results in a Release regardless of the date of discovery. A Release caused by several sources or an unidentified source, which require only a single Response Action shall be considered as one Occurrence. A subsequent Release from a new or different source at the same Facility where the Response Action has not been substantially completed shall not be a separate Occurrence.

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  10. When do I use Task Code 9.8 versus 11.7?
    • Task 9.8 is a Professional Utility Survey and must include:
    • Above and underground utilities
    • Inverts
    • Reference to NGVD and Drafting.
    • A Professional Land Surveyor (PLS) stamped drawing is required as supporting documentation for this task code. Task 11.7is a Ground Penetrating Radar Survey and is utilized to locate underground utilities, tanks or other anomalies underground. Proper backup required are time sheets, field notes and/or subcontractor invoices.

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  11. When do I use Task Code 9.7.1 versus Task Code 9.7.2?
    • If the document (usually a drawing or figure) is stamped by a Professional Land Surveyor (PLS), then all charges associated with that document shall be coded to the 9.7.2 series of codes.
    • If the document produced is not stamped by a PLS, the charges should be coded to the 9.7.1series of codes.
    • Please note that a Professional Engineer stamp is not equivalent to a Professional Land Surveyor stamp.

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  12. What is the proper use of Task Code 18.5.1.5?
    • Task Code 18.5.1.5 is for the purchase of power wire only. It is not to be used for labor.

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  13. What supporting documentation is required for Task Code 18.0's?
    • A map with scale or subcontractor invoices indicating the footage of pipe used or trench installed.

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  14. Do we need to supply the breakdown of drilling rigs used on a well by well basis under Task Codes 8.0, 9.0 and 19.0?
    • Yes, especially in cases where there may be multiple drilling methods used. Providing as detailed information, as possible will allow for greater efficiency in the claims processing.

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  15. Should units of measure or number of events be used on Task Codes 18.0 and 11.0?
    • Unit of measure.

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  16. What is the difference between Task Code 23.4.3.2.1 and Task Code 22.1.1.1?
    • Task Code 23.4.3.2.1 is for the transportation, disposal, labor and equipment to re-bed a carbon vessel.
    • This Task Code falls under the operation and maintenance category.
    • Task Code 22.1.1.1 is for the purchase and installation of liquid phase carbon canisters.

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  17. Is Administration or Coordination time eligible for reimbursement?
    • Administration or Coordination time may be eligible if it is Task Coded to the event it is associated with, however, it is not in addition to the event's Task Code maximum allowable amount.
    • If there is no event, it will be deemed ineligible.

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  18. Are signature stamps acceptable for Proof of Payment Verifications, Owner Authorizations, and Applications for Reimbursement etc.?
    • No, all documents must be original signature.
    • Faxed copies should be followed up with original documentation.

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  19. What are the parameters to be followed when seeking reimbursement for the use of an Air Knife under Task Code 28.18.4.2?
    • Claims seeking costs for the use of Air Knifing should be accompanied by documentation sufficiently demonstrating the reasons for its use, including, but not limited to, site maps and affirmations as to the proximity of the utilities.

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  20. When costs are being claimed for gauging/sampling events, what is the need for additional items such as groundwater contour maps where back up for the event already includes field notes and/or work order; Liquid Level Data Sheet w/gauging information; and a sales & rental that includes bailers and vehicle charges?
    • This information is not required in all field events. It is requested on a case by case basis where the adjuster may have information that indicates the presence of ineligible UST's (or other ineligibles) and further information is needed to determine eligibility of charges.

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  21. Why are site maps that include the recent installation of monitoring wells or completion of borings needed where back up for the event includes field notes and/or work order, boring/drill logs, and subcontractor invoice charges?
    • These items are requested generally based on information that is provided either via reporting (i.e. Phase II Report) or past site history that indicates possible ineligibles.
    • Drilling/Boring logs do not always indicate where monitoring wells are being installed or whether installation occurred on or off site or in the vicinity of ineligible areas.
    • Drilling Logs are not always filled out properly (i.e. correct drilling method/drilling dates).

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  22. There are cases where a site is classified one way, which results in the start of a specific type of report and then circumstances such as new data cause the consultant to change the site direction.
    • The Fund should allow costs to be reimbursed on a case-by-case basis where effort on one report can be incorporated into a second report.
    • If the report was never completed, all costs are denied. If one report was started, but never completed because an RAO was submitted, costs may be coded towards the RAO. There are no partial Task Code Maximums for unfinished reports.
    • Costs will be denied for unfinished reports if the consultant does not indicate that the work was performed toward completing an RAO or where the consultant merely indicates that the report was never completed.

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  23. When there are unusual circumstances at a site that would create a situation where charges exceed the 21J-fee schedule, is there a mechanism for payment of the overage? Would these situations be handled case by case via pre-approval or regardless of the situation is the contractor/consultant expected to remain below the task maximum?
    • Pursuant to 503 CMR 2.00 Reasonable and appropriate Reimbursements shall be determined by the Appendix 3 Reimbursement Fee Schedule or for activities not covered by the Reimbursement Fee Schedule, the Claimant shall obtain bids.

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  24. Will charges incurred in trying to obtain an access agreement be allowed where the access was denied or delayed?
    • Charges will be allowed, however, a copy of the letter will be required as well as proof of mailing and receipt.

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  25. If a Catox system at a site breaks down and the cost of repair is $9,500, but to purchase a new one is $24,000 can I get the cost of the new system?
    • If the original Catox was purchased you, would only be able to claim $3,000 as this represents the annual maximum allowance for system repair under Task Code 23.3.
    • If a second purchase for reimbursement were submitted, it would be denied.

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