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

Home

17. Industry of recipient's facility (Mark one.): Cl Manufacturing Cl Services Cl Finance, Insurance, Real Estate Cl Retail Trade Cl Wholesale Trade Cl Construction 18. Did the recipient relocate as a result of signing this agreement? (Mark one.) Cl Other Cl Yes (Indicate city a/ld state of previous address and reason recipient did not complete this project at that address.) ~ity/State of previous address Reason project not completed at previous address' # Indicate total number of employees who ceased to be employed by recipient when the recipient relocated to become eligible for the business subsidy. . ClNo Go to uestion 19. 19. What would recipient have done without business subsidy or finanCial assistance? (Mark one): Cl Remain at previous location, but not exp'and Cl Remain at previous location but expand at the location Cl Relocate to different Minnesota location Cl Relocated outside Minnesota Cl Other 19A. Was the pro'ect a result oferriinent domain? . Cl Yes Cl No Section 3: A reement Information. 20. Total dollar value of business subsidy or financial assistance (please separate value by type in Questions 24 and 25.) 21. Date agreement signed (In addition to the agreement date, . indicate any dates the agreement was amended.) 22. Benefit date (Indicate the date the recipient receives the business subsidy. If the subsidy involves physical equipment, then the benefit date is the date the equipment is placed into service. Ifthebusiness subsidy involves property improvements, the benefit date is when the improvements are finished or when the business occupies the property).' . 23. Does the agreement provide a business subsidy or one of the four types of financial assistance (see Question 25) required to be reported? (Mark one.) . . Cl business subsid 24. If the. agreement provided a business subsidy, please indicate the type(s) and total dollar value for each type. Cl not applicable, agreement provided financial assistance Cl loan (only principal) Cl grant (Le., forgivable loan) Cl tax abatement Cl TIF or other tax reduction or deferral* Cl guarantee or payment Cl contribution of property or infrastructure Cl preferential use of governmental facilities Cl land contribution Cl other (Specify subsidy iype.) $- $- $- $- $- $ $- $- $- 26. If the assistance included tax increment financing, please indicate the type ofTIF district. (Mark one.) Cl not applicable, assistance was not in th~ form ofTIF Cl redevelopment Cl renewal and renovation Cl soils condition Cl economic development Cl mined underground space Cl hazardous substance subdistriCt 26 A. If assistance included JOBZ benefits, please indicate type of assistance.' (Mark all that apply and please also submit the JOBZ MBAFform.) . Cl JOBZ Cl JOBZ A Zone Cl Biozone Dfmancial assjstance 25. If the assistance was one of the four types offmancial assistance, . please indicate the type(s). Cl not applicable, agreement provided a business subsidy Cl assistance for property. by contaminants $ Cl assistance for renovating buil.ding stock or bringing it up to code, and assistance provided for designated historic preservation districts, when 50 percent orIess of total cost $ Cl assistance for pollution control or abatement $ Cl assistance fora TIF soils condition. districi $ 27. Are any other grantors providing abusiness subsidy or financial assistance to th.e same project? (Mark one.) Cl Yes (Specify each grantor a~d the value of their assistance below; attach an additional sheet ifnecessary. Grantor Value ($) Grantor Value ($) ClNo *For questions about TIF reporting requirements contact Arlin Waelti (651) 296-7676 at the Minnesota Office of the State Auditor. Page 2 of 5 Dept. of Employment and Economic Development Minnesota Business Assistance Form (3/25/08)