Resolution - #09-01-009 - 01/13/2009

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10 EXHIBIT A BUSINESS ASSISTANCE APPLICATION A. APPLICANT INFORMATION Name of Corporation/Partnership Address Primary Contact Address Fax E-mail Phone . Type of business assistance requested(select one): o Tax Abatement DTax Increment Financi~g DRevolving Loan Fund Have you been, or are you currently, involved in any bankruptcy proceedings or lawsuits related to other development projects with which you have been involved? If yes, please provide an explanation. . . DYes DNo On a separate sheet, please provide the following: . Brief description of the corporation/partnership's business, including history, principal product or service, etc. Attach as Part 1. . List names of officers and shareholders/partners with more than five percent (5%) interest in the corporation/partnership. 'Attach as Part 2. . . Brief description of the proposed project. Attach as Part 3. . A but for analysis and narrative. Attach as Part 4. . Completed Revolving Loan Fund Application. Attacbas Part 5 if required. Attorney Name Address Phone Fax E-mail Contractor Name Address Phone Fax E-mail Engineer Name Address Phone Fax E-mail Architect Name Address Phone -Fax E-mail