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10 <br />EXHIBIT A <br />BUSINESS ASSISTANCE APPLICATION <br />A. APPLICANT INFORMATION <br />Name of Corporation/Partnership Cam ix A ��l LQ <br />Address C\ iNAAC5A1V, \ - )\ a\°kO <br />Primary Contact�5 t �,g1, Address _L) `R4'c \‘i1 CAN \\s'\*\0 U1nUo <br />ITV ,- , Fax b,sm E-mail buyiyA $->e_Re C e.S 4q`k" <br />Phone <br />Type of business assistance requested (select one); <br />❑ Tax Abatement FITax Increment Financing ['Revolving Loan Fund ❑Other <br />Have you been, or are you currently, involved in any bankruptcy proceedings or lawsuits related to <br />other development projects with which you have been involved? If yes, please provide an <br />explanation. <br />0 Yes <br />On a separate sheet, please provide the following: <br />• Brief description of the corporation/partnership's business, including history, principal product <br />or service, etc. Attach as Part 1. <br />• List names of officers and shareholders/partners with more than five percent (5%) interest in <br />the corporation/partnership. Attach as Part 2. <br />• Brief description of the proposed project. Attach as Part 3. <br />• A but for analysis and narrative. Attach as Part 4. <br />• Completed Revolving Loan Fund Application. Attach as Part 5 if required. <br />Attorney Name <br />Address C ( ' (Q.`a'`��1�1 ' 6\ w N Cj`&9S\O <br />Phone 970. ,Z\Q22 Fax 8Q.\Q S, CLif E-mail `} CC6D\NeehS <br />Contractor Name <br />Cr\ , -\ <br />( <br />Address -1 O) --iN-'\\%,.i. Cchr\ 'ram 1) 1 W , SA, & <br />Phone 9 L,(;. 3 Fax Q`Q M0512 1 E-mail �S_`� Vc e wh ,AC ySN <br />Engineer Namem&ce\ ee c <br />Address M QC),_ — � Z j, cub,LIA 0,e 1c 1 <br />Phone L� , 12=) Fax E-mail 4 e \Peysce \el,f, r c --, <br />Architect NameCCC1\ _`'NP_AN'T <br />Address M 0(..._ �(' ii,.)\ L-)F1 <br />Phone CAL,ct2 Fax E-mail j . ', I L 4K.A0 `‘,s> , Co`c, <br />