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<br />Example Waiver Certification <br />Minnesota Management and Budget <br />Certification- Waiver from Filing Requirements <br />State of Minnesota <br />General Obligation Bond Financed Property <br /> <br /> The undersigned has a fee simple, leasehold and/or easement interest in the real property located in <br />the County(ies) of _____________, State of Minnesota that is generally described or illustrated graphically in <br />Exhibit A attached and all facilities situated thereon (the “Restricted Property”) and acknowledges that the <br />Restricted Property is or may become State bond-financed property. To the extent that the Restricted <br />Property is or becomes State bond-financed property, the undersigned acknowledges that: <br /> <br />A. The Restricted Property is state bond financed property within the meaning of <br />Minn. Stat. Sec. 16A.695, is subject to the encumbrance created and requirements <br />imposed by such statute, and cannot be sold, mortgaged, encumbered or otherwise <br />disposed of without the approval of the Commissioner of Minnesota Management and <br />Budget; <br /> <br />B. The Restricted Property is subject to the provisions of the <br />_________________________________________________________ [title of grant or <br />loan agreement] between ________________________________ [State agency <br />providing the grant or loan] and _____________________________________ [name of <br />undersigned grantee or borrower], dated ________________, 20___; and <br /> <br />C. The Restricted Property shall continue to be deemed state bond financed <br />property for 125% of the useful life of the Restricted Property or until the Restricted <br />Property is sold with the written approval of the Commissioner of Minnesota <br />Management and Budget. <br /> <br />Date: __________________, 20____ <br /> <br />_____________________________________, a <br />________________________________ [name and <br />description of the grantee or borrower] <br /> <br />By: ________________________________ <br />Name: _______________________________ <br />Title: _______________________________ <br /> <br /> <br />By: ________________________________ <br />Name: _______________________________ <br />Title: _______________________________ <br />Minnesota Public Facilities Authority 2020 Special Appropriation Forms <br />26 of 28 October 2020