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78 <br /> <br />g. Indicate how facility will be operated. If the applicant will be leasing out the <br />facility, describe the terms of the proposed [ease and include a copy of the proposed <br />lease form. the lease form must be consistent with the requirements set forth in <br />Minnesota law. <br /> <br />h. Any other information relevant to support this application. <br /> <br />IV. Financial Information <br /> <br />The applicant must document fiscal responsibility and the ability to purchase, construct and/or <br />improve the structure. Provide the following information. <br /> <br /> a. A budget using a chart of accounts for the purchase, construction and/or <br />improvement of the land and structure showing the total project cost. Major categories should <br />include site and building acquisition, design fees, professional fees, site and building <br />construction, and furniture, fixtures, and equipment Present ways in which the project was <br />designed to be cost-effective. <br /> <br />b. A desgription of other sources of project funding, as well as monetary mounts <br />from each additional source. Please indicate whether each source is fully committed, <br />committed contingent upon receipt of state funds, or not committed. <br /> <br />c. A cash flow estimate comprised of a budget, schedule and funding sequence. <br />Also, explain the sources of funds that will be used to cover costs incurred prior to <br />completion of the project. <br /> <br />d. A detailed operating budget for the facility including proposed rents and other <br />income, staff'mg levels and salaries/benefits, supplies, building operation, and building <br />repair and maintenance. This should include income from all sources that will be used <br />to cover the costs of the facility. <br /> <br />e. Agency budgets for current year and first fully year of operation. If <br />constructing a new facility, necessary amount of increase relative to size of current <br />operating budget should be noted as well as how this increase will be met. <br /> <br />f. Income and expenditure projections for three years. <br /> <br />g. Annual financial statements for the last three years from the political <br />subdivision and all organizations which will be operating programs in the facility. This <br />should include information on management fiscal staff and organizational structure. <br /> <br />V'. Schedule Information <br /> <br />Provide a realistic, anticipated schedule for all stages of the project. Stages should include site <br />selection and acquisition, required actions necessary to secure funding and approvals from all <br />sources, designer selection, design development and approvals, construction and occupancy. <br />This schedule should include a funding and cash flow sequence. <br /> 13 <br /> <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br />.I <br /> I <br /> <br /> I <br />I <br /> I <br /> I <br /> I <br /> <br />I <br />I <br />I <br /> <br /> <br />