HomeMy WebLinkAbout1998 Resolution No. 084• RESOl.UTION NO.~
SERIES OF 1998
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A RESOLUTION AV'niORIZING THE CITY OF ENGLEWOOD, COLORADO TO FILE
AN APP!.ICATION WJTH THE UNITED STATES ECONOMIC DEVELOPME NT
ADMINISTRATION: TITLE IX ECONOMIC ADJUSTMENT ASSISTANCE GRANT TO
FUND ASSIST Al "CE TO DEMOLISH A PORTION OF THE CONCRETE PARKING
STR CTURE ON THE Cf:)1DERELLA CITY SITE.
WHEREAS , the ~wood Neighborhood and Business :Jevelopment Dep artmen:·
des,r,,s ta a pply for funds through the L".S. Economic Development Administration : T>:,o IX
Eau iom ic Arljus1meru.Aasis tance Grant for the purpose of assisting in the funding for
demolition of a port101, of the concrete parking structure on the Cinderella City site: and
WH EREAS , the U.S. Eamamic Development Administration: Title IX Econom ic
Adjustment Aseiatana-Program provide s funds to impl ement econom ic adj ustment
st! ategies; and
WHEREAS , ta compete m the U.S . Economic Development Administration: Title IX
Economic Adjustment Auistance Grant Program , the Englewood Neighbarhr.od and
Business Developme·ni Depanment must submit an application:
WHEREAS, the Cn; of Englewood has received a notice of fund availability ; and
NOW , THEREFORE. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
ENGLEWOOD , COLOB..-'J)(), THAT:
~-The Nei¢borbood and BUSUless Development Department of the City of
Englewood, Colo rado ~ !hereby a uthoriud ta file a n application for a U.S . Economic
Development Admlllistratlon: Title IX Eco nomic Adjustment Assistance Grant for th e
purpose of B6 41 is · in dle fun ding for demolition of a portion of the concrete parking
s tru ct ure on the rtr :ie-re:lla City site in and fo r the City of Engl ewood.
S!:s:tism...2 . The Cit, Manager and City Clerk are authorized to sign and attest all
necessary forms , docum£nte . assurance s and certifi cations for the application for U.S.
Economk Development Adm.1.nis trati on: Titl e IX Eco nomic Adj ustment Assistan ce Grant for
and on behalf of the City Council and the Ci ty of Englewood .
ADOPTED A..'-0 APPROVED tlu• 20th day of July, 1998 .
~ ucrishiaA.EI~ 1~ (/Jo
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I, Loucrishia A. Ellis , City Clerk for,th,e City of Englewood ,
above is a true copy of Reso lution No .~ Series of 1998 .
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011u,, ..... ~ .. _........,,w .. _
I J"' J
l!'CONOMIC DEVELOPMENT ADMINISTRATION
4J'PLICATIO~ ~ fEDERAL ASSISTANCE
This applicmoo form is to be ~ for requesting financial assisWICC for programs funded by the Economic
Developmea Administtation .(EJ)A) Wider !he Public Works and Ecoaomic Developmcnt Act of lll6S, u
amended (PWEDA). The ~c application comains information , inslructiom, and documents which are
~ IDtall programs of EDJ\. Additional information, instruetlons, and documents applicable to specific
programs -iilE!uded in~ aaacbmem which are part of Ibis application. Those sbould be read and completed ,
as applicable,, submiacd u part of the overall application for funds. The ioviwion letttr identifi es the
specific •ttattannn which are applicable to the program under which you are applying for funding .
Attachment A: Non-Construction
11tle m of PWEDA
Planning Grants
Technical Assistance Grants
University Center Grants
Research and Evaluation Grants
ntle IX of PWEDA
Economic Adjusanent S!I11tegy Grants
Economic Adjustment Implemencation Grants
including Revolving Loan Funds
Attachment B: Construction
T1tle I of PWEDA
Public Works_ and Economic Devel opment Facilities Grapts
ntle IX or PWEDA
Economic Adjusttnent Consrruc tioo Grants
-----lrdal_al_il_.,,_ll.lbounpa-_iacladms,._dmol«min ......... _pdlodaa _.......,.--.w~andm,;..,i.,,..coJ1aooot--. 5""'.-,.,..11,.lhll
--~..,__. r.r-.,rbbbwdoa. 10: Eaxromkllnolopus -. lbd>atC. lloo..-lluildiq,
........ 11.C. 2Q131).lllllt, .. Olaal_.,......,Alftlrs.Qffk,of ~_.llud.._l/~D.C. llll0l .
Do Not Include This Page With The Complettd Application
APPLICATION PROCEDVUS .\ND INFOR.\UTION !1,
Al'PLICA TION PROCEDURES
AD ~ ibr fedml,,_.. 6111111d qj' Ibo f&alami;
Do..iopmm Allminlltrllion (£DA) under 1111 N,Uc Worb-aarl
Eaamc o...!0p1111111 Act of 196, (P .L 19-136), u -.i,
-• be made ot1 dlis form aft.er inviration ro apply 1111 been
received from EDA . While ......,. lllil applollb,.
applicanu should seek JUldance l'lom Ille EDA Ee-.
O...lopmcal Rcprescmative ~R) servinc Ille area.
t.ios ~ advised Clll:rwilc , ID oriaiml ml -c:opics
oldie Olllq)leood ~ ue 10 be 1111,miaed 11? lbe EDR wllo
wil claeJmiao if ii is c;ompletl:, belp molve 1/rf problems oot<d
ml Corwanl it ro Ibo apptopriarc Ofllcc . E:duoi1J lllould be
idotllifted by placiq Ille exlnl>lt 1lUlllber in dlO upper rip blad
""""" of Ille ftnt I'll" or each exllibit. &i,:.acliam lbr
caq,le!ion of """°"""exbihiu bave been in<orpolllld ia> Ibo
iex1 of the app lication . Prq,riDl,d forms such as civil ri&lm
assuraocc forms , oon-rcl oarion forms , current and projected
m,ploy<e dm l'orms . name cbecl: fonm. and lobbying/dcbamnt
forms •re provided u cxhibitJ ro the applicali011 ml cm be
rq,.oduced by Ibo appliam if multiple copies .,. n<ed<d .
Preprint,d forms ue idenlified by uterisks (").
Tbe AppliCllion for Fedenl Assiswic< requires ICClmicol
doc:wnemltion for CDlin<erinr , enviromnem . tiDance, l<pl, and
civil ri&}us issues wbich may require coordination with various
loc2J, Sllte and Federal ogeocies. IS well u with Ille privu,
se::tor .
In order ro properly a,mplerc the 1pplicotion and provide Ibo
rcquirt:d documeDlltion, you should desiprc a :maa person
wbo will be rcspoosible for puainJ roaelber all the various
compoacDtS of the •pplication and wbo wlll be res.,_iblt for
r .. tewtaa the docum-on ro insure that ii Is prejland
comaly. lncctq,lete or iu:orrett documemation m.iy delly the
processing of your application .
APPLICATION PROCESSING
A;,plit1tioos ue pror.essed i.:l the appropriate Office . Th,
lpplicam will be notified that the applitltion has been rccdved in
1be ,ppropriatc Ollice and wbether ii is ICtcpuble for proc<SJing .
An 1pplintion will 001 be ac;,;,ted for processing unlcts invited
in wrilina by ED A.
AppliCIDIS may be requested to provide arlditioml cw'..fying
information durma the rr vie w of the application . Should a
problem uisc during the re...,i cw which would scriuusly dela.y
,pproval , appllam, m.iy be requested ill withdraw the :pplication
pending the resolution of the problem and resubmit Ir • liter
tim:. Problems which cotm01 be resol --ed may lcaJ 10
CWip1)rovill of the applit1tion .
..... OVAL OF THE Fl/NJ>ING REQUEST
... ~is ..,,.....s by &DA.•!~....,.,__, •.
·•-ml I Pimaoil!Ad.-e AMnll will be torwa,dad
• a applicw. Upon lfflnlwloalac:ceptaDC.< of dlo Awanl
~ 1bc Swmrd Terms 1111d Conditi0111, Speclal
c:-ir.i.., al aay Olbet _,,,,,.... idem!Jled in a.,. Award)
llDds IFP""'ed will be tmde •nilable for dlsbunemem in
..__ with the terms and conditic,os of the A wan!.
!l
DA llEGIONAL omCES
111: EDA rc&ionsl oll!c=.s and the Swcs/:ireas they cover m :
.flillld■lpl,la Reci<-1 Office
lko.ni,, Ccma. lnd<;,ctxlct,ce Square w .. ~ Swte 140 Scurll,
1$! Fl<>o,, Pbil.lde!pila. PelDlSylvuiil 19106; Tr.lephoac : (21')
"1-lliOJ: serving Co=:..cut. Dcllwue, District o( Columbu ,
)Im. Maryland. ~wsochusens , New HampJhiro . New Jersey,
-Yadt. Pmarylvat.!1. Pucno Rico . Rhode lsllnd, Vermont,
Vqima. Virain L,w,cs , and West VirJini>.
.....11,p,nalomc.
40.! W. Peachtree Street, N.W .. Suite 182C. AIWIII, Geor&ia
JISOl.15 10; Te lephOll<: (404\ 730-3002 ; servmc Alab■ma,
Fait!&. Georgia. K.,=ky. Mis,issipp i. No rth C,rolim, South
c.roll'2. mid l'em,css,:. •
Oiicaeo Rqional Office
111 ~ Canal Sire:, Suite s,5 , Chngo, -""is 60606-7204 ;
Tciq,l,Doe: (312) 353. 7706 ; scrvmc Illinois . lndianl, Mithiam,
Milineun, Ohio , ml Wisco nsin .
MaiallepnalOffic,
Sam: U !, 903 Sm'""""° Bru!cvard, Austin . Texas 7!701-24,0;
Tclepllo<,c : (512) 916-5461; serving Arbn,u, !Auisima, New
Mexico , Oldahom.i. ml Teus .
l)m,,er Recional Office
ham 670 . 1244 Speer Boule vard , Il<:nvcr , Color>do 80204;
Tclept:'DDC : (303) 8,U-1714; servmc Colorado , low,, Kanw,
Missou:ri . Montam.. Neb....sla . North Dako ta, South DUOra,
a:1 Wyoming .
Seault Rccional Office
Room 1856. Jackson Fedenl Building , 91S Second Avemie ,
Scat!!.e . Wuhingtot 98174; Telephone : (206) 220-7660; servq
."1ub.. American S.moa. Arizona, Cllifornia, Commonwealth
of'lbc Sorthera Mar..Jaa Islands. F:dmted Stites of Micronesia ,
Guam, Hawaii, Idaho . :-levada , Orcaon. Republic of the Marshall
hlm!s . ml Wuhiq'.o n. •
Do Nor Include This Page Wah The Ccmplered Application
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I i'IGVUl
Slaadardl'onn424
APPLICATION FOR J
OMB_Na __
FEDERAL ASSISTANCE ...... ---,. ,.,,. ...... ~ &D.UIIIICINIDIYIUII ----. -•--c-~~ 4.DIIJl---lfllDIM&.ltl/8Cf --<, L :,-c-.. ' t. AJIJIUC,UfTttfllOMUTlON I .__, I' --I ........... ~-----,; .................... .,....,. ... ____ .....__
~ ... --.
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I. DIPlO'flR ~l10H JiUIIIIJI (EWJ. ··----· :~.......,._-.. ...,□ I CD-I I I I I I I I .... M.~1$o'IIIDll>Sl
L T'l''l 0, &PPUCA'I\ON: 1.c.um, I. SiaseConnllilc!Nl&IWlol ............ c.-·--=-□""""'"-□-0 . r__,_, IC . !l"oa'ITra
£.~aw L"'-I ·-M.""°"~ I DD G. Soc• Ou,c: ,,., On• 1Sotcty1
1Ae-l,oo,,«i*ICIOl'l)O"".-.-.atfllll"ID01t111l
4."'0"Nll•MI 1.o.cr-.... c.-....o..-. t
0. o.cn ... Ou,uci, 0,.../ro«Jlf/. t. NAMIOll'l'IOIIW.~
t .
"· CATALOG 0, ..allil. D0IIUTIC #US?&NCI HUIIUA: 11. IXSCQll'TIVI fflU 0, ,.,,_L.JCAN'n l'IIO.ilC'T:
[IJ-DIJ
mu.
I~ AUASAJ'FIC'TI.Dl'f,IIIC>rACT r::-,.eo...a..s-.ac i:
11 IJIIOPQSlD PJIOJI.C"r 114. CQNQAISIK»IAL 0IITIUC'TS 0,: I ,.,,_
IEl'ICllft;O< 1L-I . ....... I
11. UT111AnD "1HtaG: 11. e AJIIIUCATION SULSCT 'TO laWIW ft SIKl'I DIOfflft 011EE
LF_,. 1· 00 1ZJ72PIIOCDS1
1 Y'E S Tl-US PW ~TIOfr,W,Al'flUCATKlN WA.1 IIUDE Aw.u.ll,£ ··-I 00 TOM s· .&Ti. tXECIJT1VE OACE"R 12'7'2 PACXESS FCR
RF,'1EWON: ..... I' .,
OAT!e ., .... I' 00 ,.., 0 'AOGAAM IS NOT COYE RED BY E.0. 1zsn
'°"" I 00 C OR PROGRAM MlS NOT BEEN SE.iC'1cD IV STATE FQlt
REV IFN ·~~-I .,
11. IS TkE APPI.CAHTDELN11ENT~AlffJIEDUAI.CF.J'M
I G TOTAL I 00 □Y• l "'t'n."IDOIM....,_.,_ □IOo ~~== ~=:!',!E~:-,:r:,:=::~u~~OM~/~~~=~=I
AISIStANC:l IS AWAIIOC,,
a. r,,. """'9 ol Auf'IOf\UCI Q~,..
.. S.,,,..,,.o•~ecr ~.-UIIW ---.......... '--.___
lo T• 1·--
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.INSTltlrt.."llOl'IS FOR THE SF ~4 ,. ~
Public reponln1 bwdcn ror lllis collec1ials a,..., fl-ii..-.,._,, nnnwes per respon2. U1Clu~1 WM ror
rav .. wi.a1 &IIIU\ICUOAl. sarcmaa eiisua& dlla ~:..t:::s.. pablnlll ad maanwn1n1 Lhe data needea , and complcuna and
ff.viewan1 thccoUa::uon or 1nformailM.. S-c=-· ,f.11 ....... eie ti.rdef'I t111m• or any ext.er aspect of Lhu ::o!lc::aon
of ia.tonnalion. 1ncludan1 suaesLiou f• ~ dlis burden. to I.he Office of Mana1emen1 and Bud1et. Paperwork
Rcducllon Pn>ject (OJ48.00<l), -~ DC znal.
PLEASE DO i'IOT REl'IJRN YOUR COMft.ETID POaM TO TIIE OFnCE OF MANAGEMENT AND ai;oar:r,
Sl!ND rT TO THE -,_OVINII R 111& SPONSORING AGENCY.
This is a standard fmn llscd by applicams as a aqund facesbcer. far prapplicauons and applications subm1u.ed fer ?edera1
assiswu:e. h will be IIIOII by F«la>.I _.. •-IIIPlicanl a:nilic:ation Lh.11 Swes which have established J review and
commen1 procedun: la-a,~~ ll372ad --die p,ogrom 10 be included in llle11 pr=. llave
been given an opporwnuy lD rev t~ me applical"s sutnissioa.
It.em : EJUry:
I. Selr-expwia10ry.
2. O:ite :ippl iauon submtaed ID Federal asenr:? Sae if
:tppliCJble) & 1pphc1111's conuol number (if ~).
J. Sw. use only (ir applicable).
4. IJlhisapplbuonis10continueorfW,f111•---S
award . enter prcscnt Fedcr2J identifier~ If b' .a
new project. leave blank.
S. i..111 name or illJl)licw. name or pri-,, -izarim1I
unn which will undcnakc ltte isslSWU ~y. complete
Jddrcss of lhc :q:,pl ic:int. ~ name 3'W2 tdc;iilDne number
of the person l0 c.:onJ.X t on maucn rd:t.d 10 i:nu
:ipplic:u1on .
6. Ente r Emplo yer lde:nufiauon Numbc il"') m ass:i,ned
by lhe lmemal Revenue Scrv1c.c .
1. Eme r I.he .ippropn;Lt: letter in the SJ8Ce pro-,ldcrl.
8. Chccll app,opna,, boz and cm,;,-!lsla(s) in
lhe sp~e(s) prov ided;
.. New'" me:ans a new unsmnc::c ...,__
"Conunu:auon '" mcms an cxte:nsaOft bll!i a:14.iuon::il
funding/budge1 pcnod for, proJCC: ...., o :,r.,,e=d
completion daLt:.
.. Revision-me:ins any ctwice m dx FcdcraJ
Government ·s rmanci:al oblipDOfl or o:mn.aceza
liabili1y from an e.uson1 oblipuan.
9. Name or Federal igcncy fror., which am..mmc:e IS being
~quested Wllh I.has applic::auon.
10. Use Ille C.w01 or Ft<leral Domcst.c >.sm::m<:: IWfflbcr
and ulle or the pro~ under whch ~ is
n:qum:d.
11 . Em.er a bncr de:scriptivc titJe of lhe Pf'01C'CL af more
than on e program 1:s involved, you should -,i,cnd u ,
cxp lanuion on a~ shecL Ir~ Cc.., ..
ccwua,,,cuon or rel pn:,pcny proJCCLS ). ~ ~ ~
show1n1 project k>c.3tion . For~ 1&11: 1
SCpll1.u: sheet l0 provide a :summary dcs::r.;n.on of
lllis p!t))CCL
4
Iran : Enoy :
12. Lw onl y lhe W'gcst politicJJ enoucs affec:!::! 1~.; .. Swe.
w.intics . ClUCS).
13. Setr-<.<pWIIIOry.
14 . Lm the &pplian1 's ConareSStonaJ DLSaict ll'ld .in :--
Dmnc~s) .rtc:l<d by the ptOIRffl or proJCC C
IS . Amount reqUCSICd or ID be contributed dunng ~ti c !"int
[llldin&fbud&ct period by c,rh conaibu1or. Value or In,
land conlributions should be included on approp-we Unes
as ;applicable:. If the ac tion will re5uh in a dollar :!".ange 10
• c;usuna :.1w~ ~e w:Ltlle amount of the :."Lange .
Fo, ~tt.&KS. cnclc..se I.be amounu 1n parentheses . U both
basic ltld supplemcnLal :im oun u arc lricluded. show
ln3down on .in iuached sheet. For mulu ple pru~
fundini , use toWS and show brc.lkdown usm& same
ctcgories as iu:m 15 .
16. Applicants should conr.ac:t the Swc Single ?olnl oi
Conl3C t (S ?OC) for Fcdci.ll Executh·e Order 12372 t0
de lemun e whether the a.pphc:iuon is subJc:ct to the Swc
U,lCfiovemmcn1.:1.I review process .
I i . Th u qucs uo n applies to Lhe lpplic::un orpm,z.won . l10l
the person who s11ns .is r.hc authonzcd rtprc.,:n~u vc.
Dlegones or debt include dchnquent aud it dJs:ulo'Ni11ca,
loans311d w.cs .
18. To be signed b~ r.he aulhonzed rq,rcscnt:L!J vc o( U'.e
appliunL A cop:--or the governing body's aul.hori:zanon
for you ID sign thLS applic;mon .is official represencaavc
must be on file 111 the appliant's office. (Ce:wn Fede:1l
agenc ies ml:," rcqultC tha1 lilts authonz3uon be sutmwcd
z part or tne appliuuon.)
SF ,2, aaca !A.r "1:2)
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ALL ill'LICANTS
I. ,Wmll -aecated -Catllcadaa .......
.. .._. .Ji! Sulpemlae; Drus-l'rle Wartquce; ad
W:obbJiaa. All appllcanu for Fedlnl aai--
comply willl Ibo requiremoms UDdcr U CFR Pan 26,
reprdiag aovermnoDIWide dcbarmclll 11111 ~
(11011p'ocuremem) and aovenimcmwide requJrcmem for
drua-frec workplaces and IS CfR Pan 28, reprdlaa
mcictiom oo lobbying . Applica1111 must certifY Iba! Ibey
have 110( boon dcba<red or suspeudcd frcllll rec:eiviog Ill)'
typo al Federai assistance, lhal lboy will proylda drva•frec
wod:places and d11t Federal funds have DOI been used and
will 1101 be used for lobbying in comection with Ibis requesi
for Federal assisCIIICc. If ooofederal funds have been used
or arc planned to be used for lobbying in connection with
Ibis miucst for Federal assiswlce, a •"Dilclosure of
Lobbying Activities• fonn mu.st be completed.
[] Applicant's •"Ccrtifica1ions R•gardiog Debartocm.
Suspension and Other Rcspoosibilicy Maners; Drug-
Free Worl:placc Rcquiremcms and Lobbying" (CD-
S! I), is anacbed as Exhibit I .a.
[ ) Applicant's •"Disclosure of Lobbying Activities", if
any, is attached r,s Exhibit 1.1,.
A Pnmde evidence of compliance with E,O . 12372,
~ Sin&I< Point ol Coatad (SPOC). RcqueStS for EDA
assistaru must adhere 10 lhc SPOC process established by
the swe .
SAi Num ber: ___ Date assigned : ___ _
[ ] SPOC clcarancc /commcrus is/arc a1taehcd as Exhibit 2.
[] The Sc tc docs no1 have a project review process .
[ I ~" period has c,pircd and oo commcms received.
3. ln-r, .:nd Contributions . Ale ir.-kind comriburioos
inc luded as part of lhe nonfcdcral share of the project
funding ?
[) Yes . If yes, explain the narurc an1 the basis on which
they arc valued, .and attach as Exhibit 3.
[ I No
4. Other Fe<ieral Assistance. Idenrify any other Federal
AssLt.!B:e and !he narure ther eof recei ved or requested for
Ibis project and provide as Exhibit 4.
~ Non-profit/For-Profit Organizations
a. Provide a colDpleted •"Name Check" (CD-346)
(1 equited from applicants that are pri va 1e and public non-
5
pro& wjWlb:allwi, llrpt.e .... or iadMdlialsi C'l(1I'
required for dclt,mmd =-iF c-Jopmem DI.SlficQ)
campillld by acb officer, cuculive director arid chief
ftmoclal officer u EJdlibit S.t1.
b. Pit,,lcla anlcla al ilaapoarioll and By-uws u
Exhlbll5.b .
c. Provide a currear cmll!i:aR of r,od SlaDdinr !rem the
-in wlll,:b jbe orpalmim is lacorporaled ml in 7'bic"h
tile project will be impl~ if dit'l'erem (requir.d 0111y
fnm appllcam dl&I are ~ orpnizations er ;:nvate •
for profit !Inns) as EzJribiz 5.c.
6 . Pro-ride ua eucmed -..,.,.er•• Notlnloadon
Certlllcadaa", &hibil 6, rn. all employers and •:!litiei
providwg Ibo OCODOmic jasmicaaoo for dte EDA ,roject.
Genmlly, EDA fimDcjaJ aaimnce c;am,o1 be u.;cd dir:ctly
or indirecd.y 10 mist emplo)'as who transfer jobs fr cm one
commut',ng area 10 IDOlber .
7. Ar•: you requesting a gram rare whi~b will rec J.ir e a
walvet · Ill Ille DOIi-Federai sllare for this proj~ ·
[] Yes If yes, provide a aarrarive of how the ~Ucant
bas f~bauated ils cfkalve cuing and bar.owing
capacil}'; odler faclon . if any. which preve::i the
applicant from obGiml,g tbe required noo-F~eral
lhare; m:I tml revenues aDd OltpCDSCS projec:e:' :n !he
applicant 's current fisal year budger and ao,,h •~
Exhibu 7.
[] No .
8. Projects wblch will praaily or essenlially benefn a
smg)e !Inn or Industry {-which may rea.<ooar iy be
expected 10 use SO% or m= of tbe capacicy oi the ?:DA
lioaoced facilicy) and om.,rs "'UD EDA so dete:miD:s are
subjec110 EDA's requiremects on unfair compe:icc~ and
excess capacicy and may require the com pie:ioc and
submission of tho •"l'tfartte!ia& mil i:apacity Information
Report" (ED-220PB). Does lhc EDA proje:: ~:-:e a
single finn or industry?
[] Yes. If yes. co llti!et :-= EDR for ass l!'".anc: and
complc1e the •·Market:i=g and Capacicy lnio=ation
Repon • (ED-220PB ) am: attach as Exhibit 3.
[] No .
9. Civil Rights . The infonnmoo reques1ed in tills Section
is necessary for EDA to a.s5CSS the Civil Righ tS irnFa cr of
dlt pr.-s project a required by Tille VI of die ClMl
RlalD ACI ol 19M. 1811 rquJalions of die Oepanmaa of
c-ad 1-iDe., -dial dill:rimllmiaa doel
1101 occm ii EDA,_.. prajlcll.
1be ialbmmiaa reqiaead m qucslion 9a and 9b is subject
11 die ...,.. ,-iaioa,. Applicana Illa! employ more
111111 1,000 .--..i11 lllblail only for;the lllbdmlioa
apncy , am or~ dw will acnlllly adminiJler die
projca. ·0ar Paaia" wlx> will be =alb& and/or savina
15 or morc~jobs ua result of EDA wiscaocc,
and n ,pocifil:llly ~ in die applkalion u benefillina
from die project ar arc or will be loca1:d in an EDA
building. port faciliry or industrial, commercial or business
park prior to EDA 's final disbutsemem of funds awarded
for die project aoed ll 1lbmi information only for the site,
facilily or plllll KDIILy baas wisted.
a. A.ppa..r •, £mp1oytt Data . All applicanu for EDA
wuance 11111S1 camp1e1e Exhibit 9.a. ••curnat 1111d
Projected Em~ Dlila" (JID-lUl) or employmait ID
aKII r-11 dounaiDed by EDA .
b. "Odler ~ Employee Data and Assurance of
~-"Olber Parties" wbo will be creating and/or
savina 15 or IIIOlC jails as a result of EDA assiswx:e, aod
who = specificaly aamed in die application as benefiaing
from die projea or are or will be located in an EDA
building. pan faciliry . or indmlrial , commercial or business
park prior to EDA 's final disbursemem of funds awarded
for lbe project lllllSI complete Exhibit 9.b.J, ""Current
ud Pn.Jemd Employee Dala" (ED-612), aod "Other
Parties" must~ u Exhibit 9.b.2, •• Assurances of
Compllan<e. •
[ J Yes . 'Othe:-Pznies• ED~l2 anached as Exhibit 9.b.l
aod 'O!ber Parties• Asswance fonn(s ) act.ached as
ErJril,it9.b.2.
( I No . Tbe.e n 'ID •Omer Parties ' bcnefiaiq from the
ED A assiswa to lbe project .
c. If applicam's or "Other Partie s'· eiwting aod proj ected
wor kforce as idi,,,tified in the ED-612 completed as
6
Irzldbill 9.12, Olld 9.b.1 reflect a pattern of ie:;ous
underutiliz.ation of protected classes, EDA may =7.leSl ·
addilldllll in61rnwlan In die Jform IIIXl ,llWlllCr fr.;i;:; ,me
appllcam •or 'Odter Party ' u ,Ex/libite9 f to ,r~·y~ ;!lo
Issue . EDA will provide auJdance . or n
d, If appllcam or "Other Pirties '-bl.'S/have been r,,:,ived
in charges of discrimination in tmploymen: or tbe pr.r:lioft
of services during the 'two years previous to the !ti ot
submission of thb application , provide u Ewbit ; ;. a
detcripdoo of the Sllltl! ofany lawsuits , complaint, o:!!or
lbe re!A!la of compllance reviews and a staiemeru as = !IIY
admlntstnlive llndlngs made by a Federal or Staie l!=-7'·
[ I Yes . lnfonnarion on charges of discriminac~ ue
act.ached for : [ J Applicant [ J Other Parties
[] No . There hive been no charges of disr,-'r ·-,:,on
involving : [] Applicant [ ] Other Parti es
10 . Performance Measures . The Go,·e=,:u
Performanc e and Results /,ct (GPRA) of 1993 . :,-,;:=,s
EDA 10 repon the ourput•, and outc ome s of proje;:a , 5.
acrual job creation). Awardees will be requlred :c ~'-::tit
core indicators of perfonnance to EDA pe rlodit.ll::,-?S a
condit ion of the award . EDA ·s core indic ators = ,e
supplemented by ind ica tors you wou ld like 10 use . E.;;: :am
the additional performance indicators you pr opose = :,se •
and how they will sup plement the required progr,:::=ric
core indicators for th is project , and ,nach as E:r:hi:i.: ."'J
11. Is the applicant a special-purpose unit of local
goveinment (such as a Pon Authority , Water ai:d """"'er
Distr ict, etc .)?
( I Yes . If Yes , aaach as Exhibit 11. current 'Sta::=,nr
fr om Parent Loc al Goverrunem " as 10 wh y the S;e::al
Purpose Unit of Governm ent is the ben er ~ed
agenc y 10 mak e th is applica tio n and admirus-.!: :he
proposed proj ect.
[ I No.
•
ALL APPLICANTS • CBECU.lff or UHIBffl
Ecbecklist idemifies all of the Exhibits in die general section af Gle application. Exhibit illllllbers refer to the
fie item number in the application . Those wub asrmsb M are preprimed forms which are included .
the items and Exhibits submitted .
[ J 1.a -CD-511, Debarment, Lobbying, Suspension
[ ) 1.b •Disclosure oI Lobbying
[ ) 2 SPOC comments
[ J 3 In-kind exp!. m
[ I 4 Ot.her Feder..J Assistanee
[ I 5.a •CD-346 , Name Check
[ I 5. b Articles of Incorporation & By-Laws
I ] ;;,c Certificate of Good Staooing
[ ] 6 •Employer 's Nonrelocation Certification
[ I 6.a Explanation
[] 6.b Counsel 's Cenification
( ] 7 Waiver of Non-Federal Share
[ ] 8 •ED-220PB , Markering & Capacity Information
[ J 9.a •Applicant 's ED-612
[ J 9.b.l *"Other Parties " ED-612
[ I 9.b.2 *"Other Parties " Assurances
I I 9.c Corrective Action Plan
.6i,j 9 .d Starus of Su its/Complaints
• 10 Performance Measures
I ] 11 Local Government Comments
•
7
THIS PAGE INTENTIONALLY BLAi'IIK
•
8
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•
TI
EXHIBIT l.a
u.a. ~Jffllllft a, ClQlamlCI
CERTIFI CATIONS REGARDING DEBARMENT, SUSPENSION ,
AND OTHE .CI RESPONSBUTY MATTERS; DRUG-FREE WORKPLACE
RC-OUIIIEIIENTS AND LOBBYING
App Ucanll -,Jd ,.,., ..• ·'"' rogutalionl c:itld -ID -lhe conif!Wion 10 -h they '" required 10 attest Aoploeancs
llllould 1100 -111,o ,,,h,c1ions for --;,, 1111 regutllions befo re completing 11111 form . Sign1111re on 111,1 form
p,ovidn tor compbnce wittl ~ ~ ~ ... ,o., 15 CFR P111 28. ·Govemrnentwide Debarment ana Su10ension
(NonorocuremenW and ·Govemme""'°' ~ o Orug•Frw Workplace· and 15 CFR Part 28. •New Remc:icns on
Lobbying ,· The cettiflcalk>ns ShaU be 1rHtad • ~ rr.-w ~ ot fact upon which rfiiance will be placed Wften tne
Oepanment ol Commerce delermines to awan: lie ~ nnuction. grant. or c~ltiv• agtMmenL
D£8AIIIIINT, IUIPINll0tl ANO
O™ER RESPONSIKJTY MATTEIS
M t110U1t«1 Dy 1X9CutrYt On:llr' 12$19, Otlle'TNnt 1M ........,._
anaimotemenl!d at15CFR Ptrt21,ltr ~.....,.•l'I pr,INl"fCO\l'ltldnnu:tlOftS.111 --•''c::Ffll""".•·
S«::101'1129.105 and 28.110-
111 The~ \lf'l'TWf ~ C9l'IIN •-... d It
WWIIOQ9andbeilf.Nlltlf1dlll~
l•I Art no1 ~-...a,~~ tr~
OIC:a'tCI IMiig:l:w. or YCIU'llanly tlldUOICI '1a'n ~ ~
tJy"'fF---~or agenc:y.
(bl H..,.. not W!hn a,,,_...,..~ ~ 1111 ~ _,
ccr:vc:edOIOtF\allcMl~~~w.itor
o::rr.n'l&UIOn 01 fl'IIJO or a c:mW'III ct.,.. in cooneczr ..;;., 00CatW'I;,
•~ r, 0ClaW\ or pertcrm:,; a c-,rClc: (F---. S.t!! or 'GCal
!faris,n:,'10/C0nlrlel:unOlt l l).ltictr11\S1001'1:w:lmO"l:JfFtelrli
or Stall ¥twust ...,_ or c:orr:tr'll$SO' 01 ~'!flt Nft.
~. bnolry, taillfca.YI 01' aatn.00fl of -=:in:a. .., • .:,u'IQ 0'!.le
statemlftlS.Ol~1101enprcperty:
(Cl .t.t'I not p,tWr"Uy 1ra::eci !ct or c:r.erwtSe ~ or ~
cna,;tc :ry a Q(Mifflmtl'lial itnllfY {FeOeral. S:a r:r b::a"I di
COl'MIIUOnof¥"fof h ort.t\Ns~ .,.-u;~llM.Ol ct
i:ruscet:iflca1101T.and
(Cl \ HM not WIVWI I IVN·Y,lf pencd ~ hi
~o,roooult\adcw-..Otmor9outllc~~
St1tt0ftocal}tenT\ltlll«IIOt~M0tMfa..,t
(2 1 Where 7lt! ~t CM\IIY c.,rx:::..n ~ ~ 1:1 ~ :I
1/'!y of '111 NtemenU .f\ ,US C9l'tlflca~. SUC!\ ~ ~
snaJ 1r.acn an titM"&IIO'l ro 111ts 0fC0CSII.
2. ORUG ·FREE WORKPLACE AEOUIR c.MUITS
As ,eouire<: ey :ne Orug ,Free w croi.i:u:• .t.a r.:t Hl88. #IC
Ui'lt:'tfflltl'tttc I I l:!i CF:t P.:n 2~. S-..ccan F, fCr ·~ as cr-..-ee
I ! l:!i CFA Part 26. Sec-Jons 29.605 and 2! e~o-
A, Tht g,1ntH certhes Nl 1t or 'IWlil eontlt'lue 10 ~ ._ .::"l.lO·
lrN WC)"(C)lal,ij t,y:
(I ) P 1J011StWlg a siatemenl flOtrfyll'IQ tmCiOyffS ;nal :,,e ~J
m&nulr.l.ltt. Ol~JtlCl'I, OlsptflSl"IQ, DCSSHSO\. '¥ UN C1I I
COl'lll'OllfO kl~ IS O,OIUOlteO .., 1'e graniees ~ ~
~ '111 ~S lhl! WIii !)(' :a~tn If;~ ~ b'
Y'IOlatJOn Of sucn l)(CnlOltJOn;
(b) Establ11t11ng an Ol'IQOll'IQ ~•fr'N awarlMSS l)n)g ram :o intorm -lll>Cut-
(2) The Q:1,VIIH S :,,:i,c/ of ~119 I atU;·lrtt ~W:S:
('l n. pen.,_ Ni m.., c. lfflOCalO uoon ~ le. on.v
.,_. -..olMICN x:e..mg"' IN~
(Cl~ II I ~NI. 1acn trTIOICJ'/'l9 IO C. tr'1Q1011C1 fl,_
~:f t"!l;ritit 09Qrv9nleoQY of NN~~
oy ;:;.agracn 'It.
(d) NotiJyrno :re trn::,IC:yff ,., aie mttm1n1 requi,ea ~ Dataqracn f11
INt.. as I e.:inc,:icn d emOIOylTlel'lt unoe, tne gr1t1t. hi tmCIC)'ft ---
(2) Nollfy 1111 emccyet 11"1 Wl'lll•'!QofM01ntr convc.ion ler&
~ OIIC/'llTWl&IOl'IJOSCltuul,oca,n"WWJl'llnltWOl'\Cilce no
la&e!' ""'1 tnre 2r.c11 oays attar :iucn tonvc:cn:
(e ) ~ng 1\9 ._.,c:y 1ft Wfl1ll'9, W!lflln DWI CllencSat <Slys &,,er
~ l'IOOCI ..notf ' ~ (d)(2I trom 11'1 emUIOyNOt
~ r9C~ a::u;. l'ICtCe of SUCfl C0ffl/Ctl0n. Emp~ ct
CO"MCttd emg•cyNs mus-orovioe ~. inc::illdr'IQ OOSlllCII tiO.. 10
tne 0 1tttC?01', 01 ,'cl of FeoeraJ AUlstlnOI. Office ot ~
AsslsW'lc:9 ar.o \-t lf'lll!:tment Sucv:rt. HCMB Room 505-t, U.S.
Otoar.neni :t C;.-im•rce. wasninv:on. ~c 20230. Ne ~::, ~
inc:...c, tne ce .,~.:a.:xin numoen s1 of eacn .r.ec:ea Ql'&nt
(f) Taiur.g 0'1 9 ~i 'Te fc 'b ,ng ICX)t'IS, WIT"l:1 1 J O calenOI! Clys d
ree.,:vw,g nc:i:, A'W:ei ~ooar19tlDf'I (IJ l(2l. w,tt, re soec: tc v,y
~ .. I IOQl;vw;:ao -
(1 J alung a.::CfC;t'l.l!t ce'301'1t1el action aga,nsi an emCIC','ff,
uo:, 1110 ~ :itr.:'Unlllen, C0t1S1r.en1 w,th ','le reowemtn-.s ;f
J ,e ;(eriao-ta:::n .t.c: ct 1973. u am.,-.oeo: or
(2 1 ~ec .. n,ir,~ S\.c:, ll'T't:ICyte :o oanx:1 pa1e sa :isiac:cnty n 1 :n.;;
aOl.:se a.ssir<N'n QI ,ena:i mtaoc n P'OCJt&m ~ lo, s-..c:-:
~ ov .a Fecerat. State. 01 IOcal :ieaJtn. llw tnlcreemt nl o,
o,ier.aoorccn111.a.en.:-r.
(g , '.A ,1Jong 1 ;ooc •11:, !~rt :a concn ue 10 rna.ntai r, 1 on..o ·.,ee
~ tttrc-~ .mc!ementatlOl"I ot oaragra:,ns ta). lb :. IC), !OJ. je/
.,,. rn
B. The grantH sn111 lfl11n in me soace orev10aci 0ttow tne 11tt1 s1 •;r
IN oerlcffllar::e :1 #Cf'II Ca'lf! It\ COMeellO"I Wltrl !ne ,oeohc 9'lf'tt
EXHIBlTl.a (C---.),
Noe ct ltlftllfflWm: ~ ...._ 0/lf, oauw,, ,_, ZIP
C01.'lt):
"
...,_N.OtMINI ....................
As ~ t,y N 0n,g.,,_ ~ act of 1111, ll"ICI
~ • 15 Cl'III 29. 9'QWr I', far~·--•
15 CFR Pwt28, Secl0nl2t.l051f1d21.110-·
(A)ThegrwttNcnfla'-uaconclilonorlhlg,ntNo, ..
.. nct~N'llfie~~CIIIWUAO'l.~
___,..,OIUlllofacontalllcl----=eil CD'dYCln(lllf'f
~wnninegr.-.c:
(B)lfOOl'MCaloflcriffwlll()UQoftlnM~m)ffla"IOIIICW\
occurmg fMW'9 ,. conouct of .,, i,ll'C ~. ,. Of ....
NOOr1 lie CClnYQCWI, in tfflllnQ. ..rw, 10 ~ .. of l'I
CDtMCIOn.lDNDirlc:lr,Oflctof'tOlrll~Offlceof
,. ......... 0fflce al,._..~ ll"ICI MltllglrTWft
S..000,,. HCHI ""°"' ..... U.S. -d eam-,,.
Wurw,g1Cn, 0C 20230. When l"OIICI II ffllOI 10 ad'I a ~
l)0ln\ it ·-n::hM l'lt ~ IVl'Olrlt> ol _,. ___, ......
1 L081YINO
A1 tWQ\llll'9Cl r,y Sectl0tl 1352, Tittl J I of ltlt U.S. Coot. &nO
~ at 15 CFR Part 21. 10r t)ll10nl lmlfflll ~ A '"'1'-
COCIC)efll0'4 ~tor connct ~ s100,000. °' io., 011c&n
glMlr'IWe OY9" 1 150,000, a dllinlO • 15 CFR Pan 21. Gee,cna
28.1 05.,..:, 21.110, the IOOilC:lm ca'll'fiN NI ID f'lebtst al 1'111 OI
Mr knowtlogt .,,a tlelilef. "-t
111 No._.~ lundl MYe t11tn o,lid0ta be PMl
b)'OI --dlihl~l>ql)lrD'lb~o,
.Y..-."""9 ID influlnOt St Offc9r Cl ~ ot 11'1 IIQillnCY, a
Metnblt olCcrigrea.anott'ar01STICJIC'INofCongma.oran
lfflOIOyN 01 a Mimi. of eong,.. ll't CCl'W'eOOl'I Wlfl tne
aww,ng at any F.olrll can1ra:l h l'Nb'lg cl rrt Feceral v,an\.
l'lt~c.Aw,v, .... :O.,.N....-.ginlCIOl.,,,=---w
~..ON__..,CD'ltnul:lelf\,.........,._t/11
fflCIOA::ao'lof,,,,,,,....a,,ncl.WW'IC.!Oln.al~ -. "' . .,., ..... ______ _
•w~•~a-,-,o-~-»
.....,...,~o,~otlff'tlQllflC'/,8~al
«:Ofll'Wl,anoflmror__,..deo,g,.a.«e ..... ■a
...... CongrNliftCD'nCD'I ... ,.,__~_,..,
IDlr\ OICIKIDlfllll4 ........ N Ul'llllllllgral ... a::r-aaaW
MIINS..-.,~'"Dcloll.n'ormDllllrr.xr..i........, ..
i,80Clafdlncl_ill...,......,
(3) The Ul'ldnlgnlcl 1N11 ~ ,_ l'le ....... fll 9lil
~~~~~-W00affl9ffll~-~
~ al _.. (i'O.Onv &OCO"lnl::I. ----. ll"ICI c:cr.::ac:a uncw
~UIS.rd~ ....... -~. ---... --... .
nu.~11amanll~Oftac:,.:=o,~
rtiMce ... placed ...... nn-::ui_macit, ...eci
~ luOfflll;a0n of,_ er.iAclDon II a~~~ ar
S1teMQ i'II, ru, ll'W'IICll)"I lfflP0MO ey ll00fl lJIL ::a li, U.$.
Cooe.AnyClll'S)l'l'lfllh01ai1=!1e:w1---=~ll"atQe
aic,ec: 10 • CM l)lnlftV o1 noc -. Nr'I s,0.000 me -a rncr.
111,n Sl00.000 IO' NC'I M:f'I -.S,,..
St11an,a:M fat Loan QUlf9ll'INI; Md Loan 1"8Ut'lllat
11.,, Mdl ,,..._, CillCI or _. oe oao e .,,.:aaw:n ~
tlfl...-cng Ot aaetnOWlg :z, fll'Anra ., OfFaf' 0, ~ ::I ,,.,,
ao-,c:y,1MefflberolCon;res,.S1officerrl~al
Con;,N&.0t1t1~o!1Mtmoerol~ ro,~
Wllf\ !NI eommit,r,ent ~ fet 1'9 U,,-, sea. = d'lll.n 0,
gulfantee I loin, h unoetsll;nta tNil ~ &'IC aonl
Stanc111G Fcrm •LI.i.. N ~ Fenn = Atc01 i...=v-,;. • rn
aee::rcara With its inm.c.:ions.
Su0ffllUIOneltf'lll~l'tt JS•~lor~':11'~
imc a"III '1"ll'tlCtlOI' wnoc.o 0y s,r.:-:o'1 1352. :iu lt ..!.S C:oa,
any pencn \lllftO '-ti Ila h ~ ~ ,.._. a 9.0ICl
ti I CM ~ cl 1'101 "-~ $10.000 at'll na. ~ :-.&'I
s100.ooo tor eac:, sucn !Mn.
Al the duly authorizvcJ rep1e11nt.attve ot th1 applicant, I hereby certify that the appllcant -,,1 n ca~ty wfttl tt,e
above applicable certiflcatton(s).
NAME OF APPLJC.a.Nr
PR INTED NAME ANO TI TU OF AUTHORIZ ED REPRESENTA TIVE
SIGNATURE
10
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i
I
•
•
•
•
EXHIBIT l.b
DISQOSURE OF LOBBYING ACTIVmES °"""'""._ ___ _,.,. __ ,,_•:nu.s.c. 1lSl ---,-1111c--"
.. __ .__ .. ....,.._,,
□Prime c-.-n.. __ ,i/-.
I. ,..,_.ACll9a....._.,anonn :
s. w._,..-,1oNo.••---__ .,,,_
_,,......,.
CFDA Number, if Jpp/icVJI•:
9. AwlNAmaunt. ff.latowm
s
10. a. 7::,!';'~~~IJ:~;•+1"11.1\T b. ~tn!,~~Semces llfldudin1 addr.ss if
tiMM1M,lintn.am•.MI};
ol P-,-td»d: ,JI ti..: ,pply/: 13. T)P< o/ P,,--' /chocl: ,JI tJ,,r app ly/,
0 ,.:n,al CpllnMd LrewMf
11. ....._ ...... ....,_ ___________ J,u.S.C.
_ ua,._.__ • ......,. ........ __.. __ . .................. _....,.., ______ ... ____ __._.._.._ ..... ,.._.
flU.£.C.VSl.ftli9W-.. .... ~ ... c...,-__. ....., .................... ---....,. ___ ... _ ............................ .....,._ .. ... ______ ._, .................
b. one-time fee
s........, _____________ _
l'rinl"-nr. -------------
Tldc ---------------
• '.J't.;!' ___... ................ ..,.. .;~"' ~,-.w.
1 nan EXHIBIT l.b (ContlllDed)
INfflUCTlONS FOR COMPl.fTION Of SF·W. DISa~suu Of LOUYINC ACTMTllS •
lNlcltr.loolntam,tlullllecan,plnodi,,,lho_,.,1~.----. • ..-ledorll~uthe
-Ot llffipt ol I ....-d ,_ ICDOft, Ot I INtorill CN11p la a ..-.... --ID !Ille J1 UJ.C.
,_,1lS2.'l!lo .... ol '1fllffllll~farndl,,_o:¥••··*·•""-,.,_...,,....,.........,.,_
1-..,,,. o, 111empt1n1 to -WI ollh:or Ot ,.mploi,N <II ..,. ._.,;;,,,. • -ol c-po... • ..... 0t
....,.. of eon.,.... or.,_....,.. ol I Member ol '-t• in--•-,_ ac:1on.-.,..
., laL I c, ; ad1 lhu, ....... If ' ......... , ...... I • , ... ii .• ◄--ComP'•t• al iteffll dial
appli lot-.he iniclol 1IUfts aid~ cl--owpo,I. Refer ID the onpio-lins ....,_ ,-illlohad II' the Ofllca o/
__. ......... ,..,adcllioNI --
1. ldontify the type ot -,I "-"'-"" ac!lon lor whid, lobbyins IIC!M!y II -• -.-wd ID wlve.,ce the
-ol • -ir.denl ...: ... .,.
2. ldol,dly the.....,. of the CIJ¥effll --
J. 1-ly the ..--,late danilladon of this ,wpc,n. II dvs lo • lolJo.·"'11 --,I i,,, • material dw,ce to the
o,fCllfflllic>n ~ reported. .....,., the,,.., ...d quarter in which ine CNnl" -Into, the ewe ol the lat
~ Mlfflillod ropor! by this~....,.., lot 11ft -.d Federal -
4. fitter the ful -• addrn1. dly, sate ond zil) code ol the repor!!n~ llndude COftsT'e'u!ONI Omric:. ii
i.-. O,edt the appn,priate dmnatk I the ropo,!ins ontlty that • ii II II. o, oxpe<:11 to be. 1 prime
o, -nodpient. Identify the tier ol o .-, .... the llnt -_, Ille prifflc la Ille 111 lier.
-indu.-but -not llmilod ID Ul<Dft-......... and a,nnc,--pa.
S. 11 the....,...-llllnc the report ;n itom I d,ed,s "5ubowardee", then .,.,., the U-. addt-. dly, cute Wid
,ap code of the pflmo Fodenl NdpienL Include ConsmsioNI OISlricl. if -
I. =~~~~far~~i=.=:!.~cJ::t2donll
1. Enter the Fedenl p,.,.,.,., _,,. o, d~don lor the -Federw _, Ci,rem 1). If-. enter the ""'
c.i.los., -~ -(Cl'0Al ......, ... .-_,..... ..--. loans. 111d loan -a. Enlff the mort apPf'Ol'Ntt ~ Nlentilyins number-• lor !he ,..._._,identified in ftom 1 <..,..
...._ lor l"l'opcml (ltfl'l number: Imitation lor 11d (!Fl) nwnbor: sr-t _, number: the contnc1.
...,.L or loan -number. the ,pplladonl!ffl>posa/ COffl1'0I number ~ i., the fedenl '1f"Cl'), lndudo
inhes. ..... "lfl'.OE-90-001."
•
,. fo, • -Fedoril ,c!ion when: -hn beffl ,n awanl or loan _,,,_ by the Feder>J apncy, ontor the
,_..-, of the ,wvd/loa, -lo, the l'NM ffltlly '°"~ r::.:!· ..,<. t.,b,.;i i a, 0,...,J..,w,:.
10. (all!nter tloe fuf1 .-e, addrfts. dly, -• lftd zip code o# 11>. C/ia,· a ...... onsqed by"" ropoi'ti"S ontlty A<:.+ o->
Mlet\dffedinitemlromlluencethe_...._,.._ 1195
(bll!ntor the full 1WM1 o# the lndMdu>K1i ,,.._,,.. NMCn. lftd include .. -W -from 10 (I).
l!ntor Lat"'-•• Flm -_,d Mlddle lnl!la/ (Ml).
2. Olea the
l!>fCfy
1J. Olealhe
1 ◄. "'°"9de J
the Fedora offici ---ed.
16. 1ne cerd¥n1 offlcfal ,hall "I" and ewe the lonn, print-.,,..,,,., tllle. and ~<,,phone oumber.
Iv ..__......,. ... ""'.,.,.._.,............,.-..,od .. ____ ,_ ___ _..,._ ............ -..-.-.-..................... ..,.._.""' ______ _,_,..._., ---..... ·---.. ..,-_.,,,,.._., _ _..,. ........ ............ ""'-· "'""' 011a,., ................. ....,,__......._ __ ,_,....,_o ,c.111SG1
12
•
'1'.3MJ'", \ OMII Aoor(lvll No. OIOS-0001 l,o,n H1 -u.1.~,UNIWT'O,=--IICI 5:.--:-~ DO NOT CCIWI.Stl 1"11 IIC'nml --OAT'IO,..a,af ·-
APPLICANT FOR FUNDING ASSISTANCE □ -°""" 0 IDIIIMCA110N .._
~t."-111..,. Y tn'lldNtfV, lnb'mlllo'I ~--tie i.-ro-~or rllfflMI oermn·a«Ann't ctwlC9 nMir~. 1n
-•~11..,_,,,.C"-,a..rray,....aco,,ao,~orl\l'l'tO'ffllNIICNIONOll'ldr'IQIQll'lly0,1_.not,....,,..~
,.,. ,..,wia,,,m....,meveaa,a,app11c:110rtam11t.1dc;:,.n. ~ortoa11-=umynumD1r_.l'IOC .. )Q.I. .,....raid~ -. ....... ~ ..... -b'ffl.
,: -a,~CANT i#riowwod'-...,.."•fNMNJ. Alm li11""""'•~tlJUidJ. ' NAME AHO A00AESS OF ,_IW ""'°" Offiu.,... ,. nor IUlrClel'IIJ ._. _, ....... -
..,.,.. . ~NUMIE~OFFIAM 1· :I.EGoOHAL C,FQ:
l. .:»TEC-Ul'Tk ll. SOOALS!CUAl'T'I'~ •. u.s cmz!N"
Dru 0 Pel (rno,gr1<J9Mitf1 "9V'Jfttl0rl~
,uac:,...,..
i:a .. ,.c...,,riz..,,,....., --10 8iP..O'l'tR NAME AND CC>tMUTF. &OOAES!
I
'G ~ ILau !,...¥1/ ...,.. lC ~=i'E~ESS
•• -wt.vf"OJ E\191 aeNc::c:wvw::TE)~ A CRUHALOF"ENSE':Jfl IJIE CPIMIHAL c;.iAFIOES PEN0INQ AG.AIIISTYOU' ('(oi,t1Nyo,,w11M1111t 1nHic YI0/.1 -.,,ir to,
~ ,-i 1twlwilld QO OOo,,'eaJ
□-0 .NO rd~ PHI• tum,111 ct,11.,1, o,, ""',........, w, ct /1UJ /offll1,
"1 ~!5,l(FOEC( ~IIINQ,frrJ
• Wt::a ~ a ,a u.s.c 1001 ,,.., •2 u.s.c. lm wf'IICn prow:e o C'ltTW\II oeN1t1eS It/ m ma,uno ct !WN scntnW1U1 lflll '-'IQltSIOnlCI """'3y'
:rn&as-r.Nlab:',"l~tJ ~
--"""' I DATE
13
EXHIBIT 5.a (Coatlllued)
PRIVACY Ap ADVISORY STATEMENT
'TN Princy Act of 117'• (,.L Q.l?ll ,.....,. ,_, ................... • ------{I) 0 ,,_,..._tar I"~
IClliclillld Oft ,onn CO.JAi. OI (II) 0 T'M,..... fOryGW ... ....., __ .........,, ........,.10 .. ,...,..._,. Of the ACI. ---..
'MWTIOWTY8JIIIT'HIC0Li..K:1'1CNO#lMIOAT.t.• (C,•U.S.C.-. ,._~~'1)110111\NHIC>llolOATA'oMU...UIIDII:
-"-'ic ~. ,,, ,._,..,. a.-,
lnfonnlliao ii .-to ..-.n good chlrlctlf of principal
olliclra -lfflPO'INI of a,gani;lllons. lirml or recip11n11 or
~TI-lfWOAMATI0N$CU0'T'EOIS. -of c;rants, loons. or loan gunntM programa that
may -p,,s, loans. 01' au-tn,m Ille U.S . D ....,.,.""', □ """""'""' Daponrna,r of c:cmm.ce.
QUl!:sn()N 11 C:C 'IT'NJAT'IOH.
PREFATORY STATEMENT OF GENERAL ROUTINE USES
The foilowu,g rtl<Jtin1 uses apply to. and are ina>rporalad by .-.,.,., ,tO . each sys tem of record s set forth below :
1. In me event 111a1 1 system of records mtintaineo by !he oe-IOYl'D' ~ &n y incivicual subnumng a reo1;est for acens to
panment to carry out its tun<:tions 1ncliatH a VICll:bon or po-1M ree:rt: uncler tne Aa ltld 15 CFR Pan 40 .,. in thl SOIi
ttnnaJ v,otation of law or contract. whether CMI . ~ or ~1 cf the Oei::artmtnl. Clsdosure could have an 10•
regu latory ,n nature. and whtttlar arising by general Sta!Ul8 ...,. e.~K1 uoon a,e inaividu&l. under the prov,11on ol 5
o, part1cut1r program statute °' contract . or ru le . re,gutat>on . \J.S.C. 5521.(1} (3) and unpltimenting regutanons It 15 CFR
o, or1e1 1s1ued putSUlnt thereto, or the nec1SS1tY t0 oro-.ect 4b.6
an interest ol tJ"le Department. the f'Nvant reccrdS 1t1 IJ'le 7. OeieNc. Rese,vec. system .Jf rtconls m•y oe ,.,•rr~. as I routine r.n~. to tr.e
aocropnatt agency. whether federal , state, toc&l °' for1191 . a. A l'9C::::lrC 1n trbs system of recoros may be disclosed, as a.
charged wilh the responsibility of investigating Ot 01CMC'.1 · rtit.ttne .JM. to the Office of Mana;m&net ind 8c.:d;et in con-,
bng suet, vt0lalion or charged with enlorong Of ,mc,letnent,ng -=tJcn or,ru, tf'le rtvcew ol pnvaxe relief leg1s11t1 cn as Sel
the StlMt or contract. or rule . regulation or orcer 1sweo ou,• b'm in 0 MB CJ'CuW No. A·19 it any stite ol :n e :eg,s lativt
su&r1t thertto, or p,ctectmg tne lnte,est ot .ne Oeo&ttment. CCO'tfr.aucn ana ciurance p,ocass IS $el to,u, in that
2. A ri,cord trom tf'Hs system of records may be ~sdouc.. u 1 Cimw
routJ ne use , to a Federal. sttte or local agency m1uitairnng 2. A rec::::.r: 1n this sy s.em may be Glsc !osed , u I routine ~.
C1V1I , cn m1naJ or otner relevant e,,lorcement 1nf0tfflanon ::ir 10 me Ce:artmeni of .:usbce rn COMectlon with ceterm1ninc;
omer pertinent information, sucn u current !iclt1'ls«S 1f nr.:•s· wt"ll!U-..et c1sciosure tnereot 11 recu1red by U'le Freedom of
sa,y to octain rnlorrnation re'-'1ar.t to a Oeoartment ceosicn ~.ation ~ 5 U S C. 552 .
•
concerning tne hmng or retention ol an ,ncivKtual. .,. 10 A f'9COfC from mis system ol recc,as may bf' Jisctosed . as &
issuance ol a security clearance. the le tting ot a .:cntract or ""' use . to a c:ontr actcr ol tttt t.'ea:>aitmtnl hav,no need
Ult issuance ol i Uc ense. grant or other benefit. tor ~ rnformauc..n 1n the cerfcrmance of tne contract, !)ut
3. A recoro !rem ltus system may be disc!osftd. as a rouone not 001fl tl r19 a syste m ct recotas w11run the meanmg cl S
use. to a Feaeral. state . or IOca.1, or rntemaoo~ .-;ency. in us c ss,a1m ).
resoonse lo ,ts reQuest. m connectJOn w,th the au:;u nent I Oete:ec. AesetVed .
hmn g or 1ttent10n ol an ina1 v,a ual, the ,ssu.nce of I seeumy l2. >-rec:oro m ttus .1,ystem may De tran sferred . as I rou11ne use. clearance . tnt reporting of an Investigation ot an inc:Mc:'..:11.
the letting ot a ccntract. or the issuance ot I license grant. 10 ht Office at Ptrsonn,1 ~,me111 101 pertonntl ,..,
or or-er beneiit by the reciuesting ,genc-1 . to the evtent that ...ci curcos"1'. IS a 0 111 source fer manag emenl Infer-
ttut 1nlorm111on 1s re levant and necessary 10 ttte rtcuest1 "9 rnz,cn; !er the JtocJuction of tummar, descnpnve stibstic.s
agenc y°s deos,on on me r.,aner. md ~ybe&I studies en support of the tuncbon lor which the
rec::::::ir.:s &re collec!ed ana m•nlM'led: ~ lor rela1ea man-
4 A. record trc1n u,1s system of records m .. llsc:o-sea . IS a power stu c 1es.
rou tine use in !he coursu of prese11tin(, oer ce to a:oU't. 13 A --ea,,C: 1n tf"11s system ot records may be disclosed. as 1 mag1$t"alt or aam,mstrat1 ve lntlunal . inc "9 Ct5eCSL'f9! :!I
cppesmg counsel n tne course ol sert1e· ~-H nei;cn.tJOns l"CI:'. r e use . to tne Arch1v1!t of the Un11ed States . NauonaJ
5. A recoro u th1 s system of records m1y ce c,sc •a sec. IS 1
Arc::vves a. Reccrds Adm1mstranon (NARA), or his desu;nee.
Ol.l nng an msoectJon cl rec cras conducltd by NARA IS part
routine use . to a Memoer ol Congress suonuta ng • ·ecvest cl NI ll;ency's rescons1b1hty to recommend improvements
involvmg ui tnc!M Clual wnen the lnCl1V10 •1al has r91.,1,1estec rn rec:c rcs mMiai;eme"! cract1ces and programs. under
asS1sta11c1 !tom lhe Member w11h re~ecct to "8 su01ec 1 ~ of 44 U S.C. 2904 U\C 29015 . Suen cJ1sc !o sure shill
maner ol the record . te mac:e n accoraance w1tn tne NARA regulati ons govern-
6. A record en this syS!em ot records wn 1cn conta,ns mec1c~ 1n• .... s0ecnon ol reccrds tor tr11s pUrpose . and other relevll"lt
formation may be Cl 1 lCIOsec... IS a routine use . 10 the mec:iul (i.t ~ NARA or Comrntirce) direcave . $4Jch disc.lOsurt SNJI
nc:t oe used to make determ,nations aboul 1ncivtdua/1. •
14
IXJIDIIT6
EMJ'LOYER'S NONRELOCATION CERTIFlCATION
&..1, lmlndildion
'llll!F;.;........sbypmmry.....,&iarics o(Jrlalwiltulcellllderlbo Pub 'ic Worla and Ecoaomlc Developmom Act o( 1965, as amaida!
CPWEDA). Prilmry bemflciuy ls ddlDod u ID Clltily providq Ibo c:collOlllic juadftcadon (or Ibo snm ualswlce .
'Ill< Eooaomi: Dcwdopmtl Admims1nlicll's (EDA) re,ulatiom at 13 CFR 316 .4 prw,ibit EDA l'Jom maldlli IIDID<:laJ aasisw><e •vailalile
~ will be -11111111 m,ploylr1 wbo aansfer jot,l lhn 0llO C0llllllUlmJ area ID IIIOlber . A COllllllllDIII area (area) ls dw uu dcftmd
~ !lie clilaD:e pmple aavd., "orlt in die locality at die project receivina EDA llmncial aa11suDce. The aamelowion requiremem ,_
llbo>wc sb.Lll DOI ~ ID businellCI wbich:
(I) lteiocal<d ID die area prior ID the clau: o( applicant's requ,st for EDA aasiswice;
(l) lbw moved or will 1110ve ima the area primarily for rasom wbich bave DO CODDCCtiOD ID the EDA usisllDCe;
(J) Wiil apml employmcm in die area whero Ibo project is ID be locattd Nbstamially beyoad employment in Ille uu in .,lticll
Ibo busillesa bald oricmallY been localed;
(4) Ale idocatilla from teclllloloJially obsolete facilities ID be competitive ;
(5) Ale apmliDa it1c Ibo D<W area by addillc • braoch, allilwc , or subsidlary while mainlaimJii empl oyme ot levels in the old
area or areas; or
(6) Are do!Orminod by EDA ID be excr.,;,i.
Part l: Name al Applicom ·---------------
Part 3: Employer c-
Narv af Emp~r. ________ _ SlrwMdws: _______________ _
T,iq>l,,Jtw NwniHr.c_ _______ C'u;• S:,t ,, lip Cod,_·---,-..,.,---,-,------------
• :miry D.IIDCd above certifies J.Dd assures that:
(I) Except u explained iD the amcbed Ezhib1. • _____ , it is oot iu i.ntentioa t0 nm fer onc or more jobs from me:
commuf,a a,ea ., IDOlher . (If the employt.r 1w :tlr:ldy .,r 1w plms ID rcl0ca1e jobs from another COtmll1IDIIJ area, • full
aplamiaD is provid,d in Eml;it ____ ID ckmonsrnr< that the cimlmsWJCeS meet ooe of !he exceptions descnbcd in Pan
I above or provides O!her justilicatioo for EDA ID cktcnoio< .'W the bwincss is exempt fJom the nonreloation rcquimncll in this
cue.)
(l) It hu DOI located and that i1 will 001 locate in !he project area prior ID !he date or EDA ' s approval of the proposed finw:la!
usistaDC.e for dJe purpose of avoiding th..• resttictions of this oonrelocation requireme:u .
(3) The Ulldasip:d is illllhorized ID male, the '.oregoing certilicatioo aad assurances and ID eXCCUlC this Certificatioo on bebalf of the
Employer.
Ezzaud thu __ day of __________ , /9 __ try _____________ _
U tbe persoo si&mJll tbu form is not a corporate officer, the: company 's corporue officer or corpot..ue counsel aw; certify in 'Nl"itina
that the sisnarory is •utborized ID legall y bind the compaoy . Wrineo ceni!icatioo should be •=bed ro this fo1:n.
Attxhmaus
_ £.xJu.biI 6a : Expla.o.ation of pa.st or plaz:ulcd relocation of jobs fr om anolber commuting uca.
__ Ex>ulJiJ 6b : Corporate CoWlSel Certifiation.
WARNING
Jill': Section 710(•) of !he Public Works ml Economic Deve lopment Act o( 1965 , a, atllCDdod , provides that· "Wboever mu.es any W-knowinc it., be l',lse, or whoever willfully overvalue, any security . for the purpose of obwning for himself or fo r any appliam
lllrJ 1maDciaJ. mistaDCC or my ex.tension tbcreof\iy renewal, dcfermcnr or artion. or otherwise, or the acceprancc , re l~e. or substil:Wioo
of se::urily lberofor , or for tbe purpose of inllum±Ji ill any W"f the aaioa of the Secrewy or for !he purpose of ob~ !llDney , proprny .
ar lll)'ll,ina o(vu,e, ;mdor lbis Aa, shall be ?JI!Ubed by• tint or 001 mor< th.1JI SI0 ,000 or by imprisoomem for oot 1110re than fi ve yean , .. -.·
tl TIITTl
THJS PAGE INTENTIONALLY BLANK •
•
16
U.S.DEPAl'IMIINT OP COMMEICB e DIIVBLOPMEHT ADMINISrllATION
llOPB
ll9S)
N. Jlt,aml _,,,,,.,-,IN.,,,.,,,., ulm • co1.,,i..dfort11 w b11n ,.,,_ a USC tnU; U a. JIU; atl lJ U.S.C. llJ4$.
PIJIUC 111/RDKN INIOIIM.\TION
n. ._,.... am eaimlad. rwo bows 10 coq,11111. nm. may vuy def)eadila oa Iba IIIOds of lbl ind~-· AaJ c-a • .. IIIIDl:ll.ol ID DNded
■.,....ellll'ona lbould be_.,...,_, Compllanoc Rnicw --Dr, ........ --B7U19. ~ofC-,u,
W-.D.C.l0230,Uld0>dloOfllccofWo"""'°aUldRe.,.ia•a,yAft'&ln,Ofllccof~Uldlladpl.,..__l'n,joct(1)6lO-OOl2), W-. D.C. 20503 .
PRIMARY BENEFICIARY•
MARKETING AND CAPACITY INFORMATION REPOJr
• A PRJMAIY IINIF1CA.RY is deftncd u one or mo~ firms witbin cbc wne iadumy, u ldcali6ld. io dN: ,ppicaoc ~ 9-.b .., mmaably bit apcted m use
,0 pac:e: or llllm ~ me c:apacily of Ul EDA l'muad flcilhy [n order IO Clpand lbe supply of room or ,er,k.a sold in toallpliiiDa .. .., producen or Nppiitn
of sudl 1oods or services .
•
I APPLICANT NAME I DATE PREPAllED I EDA USE 01'11.Y
I I I PROJECT ~-· • 1 _____________ 1 ________ 1 -----
Provide Names ud Addn:ael for me f'ollowiq : (Prim or Type}
I PROJECT FACn.lTY
I
1-;;P;cRIMA="RY=sEN=E""FJ"'c"'IAR=Y""(H""udqu&rl,==-=n°'Onl=,:-i -----,-1 ::-PARENT=="'co"'MP=A"'NY=Of,,.....,,.,""',,--------
1 I I _________________ I ______________ _
PURPOSE or '!BE REPORT
Appigaonl for ftnm:W wilucc l&Ddtr 1M Public Worts and Ecooomic Oevdopmem Act of IM-', a.s ~. (Aa,) -illdladc mfomwioo on lbe produ:U's)
or sr:n lCC(s) IO be otrercd and~ plans proposed by che primuy btocfic:iuy , u de:ftnrd above . In ~a.. aD tad! bmdll::arin mwc pn,¥idt satisfa.c:cry
evdca dw lhe asmtlDCc woukl mcbr mirorddrimcml 1> exl.stina c.ompetitt.e ma:rprises, u required by Seema 71:Z I.I-N:L. Tblr Secdoa rads u fallows:
PREVENTION OF UNFAIR COMPETITION
Sec . 702. "No financial assi.sw,ce wider rhi.s Act shall be exu:ndcd 10 any project when the =t woald be ., iDcrease the productiou of
goods , ma>:rws , or commoditios , or the aY2ilabilil)' of services or ra.:ilities, wbco th,n, is 001 sufficiem domml for such fQOds, mau:rws ,
commodities. scrvices. or facilities , co employ the efficient capacity of existing competitive commerci:13 or imusaia.l enterprises.•
The aoalyticaJ criu:ria or Stctioo 702 pcrtaio 10 any primary bcocficiary iou:Ddi.og 10 expand capacity Jnd sales or co divenify illlo otw
products or services . The foUowing definitions are provided to clarify the coocq,ts of Secti on 702 .
Demand -the amounr of goods or services consumers in the market area arc willing to buy a.I currcm ;,rices .
Capacity • 1he maximum amounc of goo ds or se rv ices thac can be produced or supplied by existing cac;:,eCth-c enterprises using existing
fa cili ties.
Z!ci•nl Capacity -that pan of capaci l)' produced or supplied lb.rough the use or coou:mporuy m=ire:s. machincty and equipment , .gm and tccbnologies .
Exi:nin& Competitive Enterprise • an c.stablisbed facili ty which either produces the same produc t or "'i'Plia the same service 10 all or ,
substlJlliaJ pan or the market area .
17
CAPITAi) l'aOlltl"r SC11EOOLE
Iyo, ft siqly _.,."" re-csw(iJbiaa prO<NClion or sales 10 previous leveb, Check Hert ( j 11111 indlcate Ibo 1111 montn 111d yw tilfadlily __ ......,.
1--1 -1
1_1_1
_, !!le -11111 ,ar iD -.bich on-,iu: work ii expected 10 Stan.
1--1 -1
t_t_l
Sequence of EYOIIIS : (1111M omhs)
I. l _l _f To cmmmcncem<llllinitial iDcrease of opmliam {6nt1ales).
2. I_I_I F1ntsales lO !ally operuional c.apacity•.
l . f_l _l PROJECT DUIIATION (No . 1 + No . 2).
• Your facility willl'x l'ully operadonal wb,n equipped, inspected and approved for operation ac design capacity .
OPERA TING SCHEDm.ES
Enter lhe acrnw or pm,:1ffll opera1m1 rau: in your iDdusll)' 11111 your pllnncd schedule for chis facilicy :
INDUSTRY
Shi/is pe:<lla)'
Hounpe:.....t
Weeks pe: yar
PRODUCTS OR snvICES
FACIL/TY
De.s cri be each prodnc:! or se:vice which is 10 he marketed from chis facilicy as a re.sulc of cbe EDA·assisced project . Provide • co ncise
description 11w dism,pisl,es your prodllcr from its 1en,ric or 1f0UP identicy, q., Fumirure-Oflice, De.slts-Meul . Fumirure -Bedroom .
Hardwood .
Prod>.J<t/Sc rvic e A. ______________________ _
Product/Servi<e B.
Producl/Scrvice C .
Producl/Scrvice D. ______________________ _
GE:O.'ERAL l\l.\RK£11NG PLAN
Repon cbe follo,.ing"' • P=t of Expect,d Facility Sales :
I. Market Area(s l l.oa1 %
:,.;,tionaJ ---%
Regional %
Expon --%
f.
•
If yrur territory is scl:cinomJ. specify the a.a.mes of invo lved counties, states or multi -state areas, or. if more 1pproptutc. tbe approximate.
radiw of your sc:vr.:: area .
18
:. C-.JCUmll 0risiD11 E.quipmlm Mlllllll=nn (OEMl) __ 1l .,, Odler....__ " ·•
3. ~ Clumnoll
COMPETITORS
Wllolclalen ,.-
Dcallll/Jobbm -" RetailCOIIIUIDffl __ •
Olbor __ ,.
Dim:tSalea "
Door-<0-0o« -"
Mai!Order "
Mlllllflcmrm ~--" Rouiloulleu __ ,.
A "c:uq,ailor ' may be illlorpre,,d as my ezm:rprile llllrl«lilJc essamlly Ibo...,.,,. ot'praduct or serviu ro the same Wlivenc of end-
uscn . Ptodual mad,: o( emircly dlffaem mawiala, or lradc = « a:m:I-. offorq dilfcrcm iypcs o( services uc aot
comidmd a,mpctilivr.. ust your oompcliron.
A. NanK of COlrlpffllor LoazdAtt Suwlf y_. -Arm(s)
•
(List u,y addilioiw ccmpcliron on sepmi, sh<cl and uach.)
B. It u,y known ccmpclitor 1w slull down or orhcrwi.<c withdraMl from your :mrla:< m:a. specify iu twll<, location and rev J for
widldnwal .
C. Give rhc name and location of u,y oew ennie, or plumed cxpamiam whic!I would .ilfcct ccmpe~lion in your maslc<1 area(s).
D. ld.enn/y u,y tn le usocillion rcprcs,lllin& your indusay (your m=bcnmp " immalcrial) .
•
19
SASE AND f'(lltECAS'J' SALIS l , . :, ,
1116:a ruaJ 111d projtcwl wa ha only.., Cadll!J on the ro11ow111 !Ible. R,celpD IIIY bo lboWII ia Jbouw,ds of dollan (SIJOO).
ll'arp,ad' :oan ...,.;ms, use mo .-ro illdmay reponina measure (umu , poundl, ...... pllcm, i.11, ca:,). For eacb scrvice , • die
11111011r ! cwcomcr ..US . h cuc idomily each meuure II lbt cop of tbe eorrespoadina column.
Period
LIit full year I sooo
adina _,_,_ I Qty
nm full year I sooo
.from Swt of --
,.,,,,;.ct I Qty
Fir.a Year I SOOO
?zojcct Fully --
Operational I Qty
l'ast Pou I SOOO
.. {restoration) --
19_ I Qty
Product A
(la___)
Wlill
Prodw:t B
On___)
IIDill
Product C Product D
(in__) I (in__)
uaiu I will
I --------------·I----------
1
• Totals IIlllSt aa,.. with your proformas unless -rorecasu include unrewed ircns . If so , describe in the aarntive below the typcS
al faods or seM= and sales volume, which ICIXllllll l'or 1he di/fereoce between the illilOUllU enu,red .oove and your tow sales projectiCD.
A
-------------•
NAllATIVE/ADDENDUM
l'3c be space below or an illl3Chmolll to inr:ludc additioaal suppcning information . An addendum may be prepared to complete or c:laborue
a: DI'! o( the responses furnished above . Market or feas ibili ty srudics ue welcomed and may be enclosed with this submission .
Pkzse r · .,,,.ide the came and mmibcr of a sui table Contact Person .
Sz:n<: _________________ MaCode/Num!>cr (
CERTIFICA 1 ION
L tt undersigD:d. do bcreby certify lha.1 lbe informatioc reported on this form and iDY attachments hereto is, to tbe bes1 of my ~wledae ,
1 :ue reprcs eou.Con of the b.cu and an acau-ate .cfl .-.;tioa of the furure incentions of the primary beneficiary as o!' this date .
Same and Ti~, or Official (l>rin1 r., Type ) -.,-M-"1--::Cc-ode-:-and-:-N"'um-,,be_r ___ •
S1smwre of Official
20
•
EXHIBIT !I.a Appllcam
EXHIBIT !l.b.l Other Panles
,.,..IIMl,a U.S. 01:t'A"'"'-" a-~ 1, .... MIOA.DDllall O,OflCWC.&T'IOtt IDA t.m ONI.Y ------,-·-~-•-:
-I. ONIAMZA,TION&
CURRENT AND CJ ·-PROJECTED = CJ OTWUt•'-IIITY
EMPLOYEE DATA S. aJMIIHTTIWCIU.lf'r "-'C) , • .,..fM~ ··--··-~ T __ -------• cu--··· l. .......... _,,.._,_ L ~~
.me.-ASA .. $UI.T0,1MS"'°"9CT ......... _.,,... .... ,,, .. --· ..... ... ... -... ... ,..
,_ --1-, ... --:--, .... r .. ..,, 1 r-, .. =-=... -.... , ..... -.. -· ... =.:c --· ,~ ~i;-,.::.. '=' -------= --.. °"9"'> ---... M . I --_.. .. . I I
•· I I --I I .
' I I -. I . I I ............. . : I . I I ........
0.IOC... . I . I --. I I
' j I .......... -. I I I . I I I ,_ .. -. I I . I I I ....,.
M)Mlltl,(ffl4(JI . I I . I I ,.,. ..
I . ..... ,.,,. .. I
a. --:o,~~•IIIA = t . TMIIFONl~.tJII.DfY: CT-n-,~1 --.:::.. ,~ ---= a: -CTn-i"-•-J
Voa:>filt'OflCI Ol'AIIIIA
' ' ' ' ' IOM9-----Num-J
~0,,1,JtU,
' ' ' ' : =------en---,,. I [WUJl"(DfUl'UC,Uff 0111
'OTHIJI ~•IITr ' ' ' •.
OATI AlCI ~ 0, LAaOII IU..ME'T 04TA..: -1 ~,-... o...
NDturu.--o,ao.. blneftll "':',:..:. ~---3-;irrpm ..._._......, • aa,np9Wdand f'Md •~ ti¥ ~II• and ra,;vl.lUonl !12 U..S..C.
~I . .Q:U.S..C. l123. E.O. •:t.e, and Ui C.FR IW1 L 21 (;.fA .-,q_ UC =A pstl17).
21 -
1 ---
THIS PAGE INTENTIONALLY BLANK
•
lnslructlom fer Form ED-(il2
IIJJ,.0B CATEGORY DEFINfllONi
~ and~.~ llllplirillc admiilisaali••
pmollllOI wbo se1 broad paiiaa,-=-~ rapomibilil)'
for amllioa of lhclc policia. _,._. iodlvid&aal doplnmlz!U
or special phases of a arm·, .,........ IDcluda: Olllciall.
.......... -.,..,._,,.i. .... mam,m. 111d
•Ullffinu:ndems . salaried .--, -are mombcn or
mamacm,:m. pwamma....,.. mb.Jy=. md l:iDdRd workers.
Ptol-·Oa:uplliom--em:::collc1c JJadullion or
cxpericnce or such kind ml -a ., provide • c.,_.ble
bacqround . Includes : accoumra -Dlillln, aiipllDe pilots
aDd mviguors. architects., mists , d:l::zm.m . desilDCfS. clie:lil:wis,
editors , engineers. lawyen . libn::mzs. ma.dlematicims . camral
sc icmms . registered professaoaz[! manes. personnel IDd labor
n:WIDIIS ·Norlcm, pbysial sciems:s.~. social sciemists ,
teachers . and landred worke-:--s .
T echaiciaru • Qc;upanons ~ • combination of buic
scientific bowledge 1.0d m.un.t2!' uiD sm0 can be obtained
lhrough •bow 2 years of post inp sc!x,oi educ:uion S1ICh as iJ
oftered in =r i,clmic,J imwes ...i ju:mr colleaes , or tbJouah
cquivolem on-me-job training . lnd!uda: a,mputer pn,pmmcrs
and opcwors . drafteri . ~ a,dcs. junior CQliDeers,
awbcmtic ajdes, licensed pac:n.:a! or vocational nurses,
pholOlrlPl><rs , radio opcroors. ,c:,,:mmr; assisWIIS . sar,eyon.
iccbnic,J illw1r.11on. l<Chmci:ml, :,,,eoal, denw, clc<:tronic,
~ysic,J sc iecoe) and -wad:= .
... • Oc:upillioDS ~ ,obol.ly or primarily in direct
sellillg .1111:llldes : advertising areas.and -worken. imuraiu aaems ml brola:rs . real escw: 'I= mi l:lrolr:rrs. salcsworken,
demonsa.co rs. retail s:alesv.'Orke::i . IX sales cl erks , grocery
clerks and casrue:s, chec~:s. ad. kmcre::! workers .
Ofria, and Cluical • lnctudes ::k:r-0!-<)'J)C work !'Ojanilcss
or level of difficulry , wbere lhc aaivcia are predominaruly
DOarnai,ual !bough some IIWllal """"' -direclly involved wilh
•lltring or lrulSportilJ& lhc prmim is illcludcd . Includes :
bookla:epecs . c.uiu=. coi:c=n (l:illls mi JCCOULtS ), mcsscogers
and offi ct htlp<rs. offic:: mactime o;,,:ruors , shipping and
rcce ,vicg clerk,,•~-~-a:Jd sccre wies. IC!tgraph
aDd tclepbonc operators . md kim!c--Cl ...,--orkers .
Craft Workus (skill<d) • ~lml2l ""0Ik= of relative ly lligh skill
!eve ! ba vIDg a thorough ar.d ccq;:m:!l.::mve knowlcdJe of the
processes in volved in their '»'Mk. Exercise considerable
mpc:xjer.i judgment and usu.illy :u::eivc ui c.xtensive period of
rraining . includes : lhe building o::adcs, bcarl y paid supervisors
and leid ope:-a.ton (who a.rt: o:n me::c.i>ers of m.i.aagemcnt),
mechanic s and repairers . skilu-...:1 ~g occupation:;,
coi:npo:S i1ors and rypeseaers , elc:::r:nciam . cogravers. job scne rs
(m:ta.l). roocon p!Ctllre proJe:::oms::s . pa::..~ and mode l makers ,
stationary eog:uicers. lailors . a.!lC :i::ndrec workers .
Operadves (semi-skilled} • Wati:::n """ho operate machines or
f.er cquip a,en1 or pe::or::i :n:ic: factory-iypc duties or
raxdiat.:: skill lt:vd w~ can tie: :ms:te:"ed in a few v,:eeks and
quire only limited craining lncludes : apprenri ccs (auto
mechafl.ics . plum bers bnc.kbye:rs . cupc:ntcrs, e!c:aicians.
machinis ts . mechanic s. buildiI!g tr.ldes . mecalworkillg trades .
priming en.des . etc .). operatives.. ancdUlu (a uto servi ce and
parkmg ). blasters, chau.tfeurs . ~ workers, dressmllers and
23
sewm (uccp1 facuxy), dlycri , lwnacc worlws, bulln (IIICW),
laulldly 11111 dry cluaiq. opuativca, milliacrs . mint opcnti""
and lll>omJ, motor opcra10n, oiler, and l'Wffl (cscq,1 •uto),
pahan (ucep< conalNCtioo 111d mainiclllllCC), pboto1<>phic
procesa workers . boiler i,aders, INCk 11111 ll'Ktor drivers ,
wuvm (IClUUe), weldm IDd fwnccuru:r,, aod llindn:d worke:s
Laban,, (umkilltd) • Workers in IIWlll&J occupalioos which
1eocrally require oo sp,ciaJ iraioinll perform el<mcnwy duw
lhal may be lunlcd in a few day, and rcqul,e lht ,pplic,lioo ol
lilllc or oo iml<p<Ddtnt judamon1. lncludea: aaraae llhorcn, car
wubtrs and gmsers. 1ardeners (excep 1 farm) and
p<lUllllk,,cpm . sicvedores. wood cboppcn, laborors performina
liflm&, diuinl, DlWll!I , loadio1 and pullioa opcratioos , and ,
kindred workers .
Suvice Workers • Worla:rs in bolh prol<Clive and ll0lljlro1ecti\'e
service accupatioos . includes: aricodaou (bospilll and oll::r
instiwtions . profe ssi onal il!ld personal service. iDcludiaa aurs:s
a.ides and order li es ). barbers. charworkcrs and cleaners . cooks
(except bousehold ), coun1er and fowuain workers, elev...,,
open10n. 6refigh1ers aod fire proicction l'J3rds . 1oorkeepm.
su:wards, janitors, police officers and det.ectivC$, poncrs, wau:rs
and waitresses , UJd kindred workers.
MINORITY GROll' DEFINITIONS
Black (Not o( Hispanic oripn) • All persons havin& origim in
aoy or lhe Black racial 11roups or Atria.
m.i-,uc • All persom of Mexia.o. Pueno Ricao, Cuban, Cena-.!
or Soum American , or odlcr SpillWI cullurc or ori&in, regardless
or race .
Asiao or P:iciflc lsi2nden • All pe rsons havin& oriilll' in aoy or
lhc orisinaJ peoples or lhe Far Eut, Soulhcas1 Asi.a . me lodiao
Subcootineo1 or lhe Pacific Islands . This uca includes , for
=mplc. Cllina. Japan. lndil . Korea, lhc Philippint lslmds , wi
Samoa.
Am<rian lndwi or Alaskan NaiiYe • AD persoos having origins
in any of the original peoples of Nonh Amcrici , uMi who
maintain culrun .l identification lhrougb lribal ~tion or
community rccogni uon .
A. GE.'iERAL INSTRUCTIONS FOR INITIAL A.'"D
FOLLOW-Ll' SL"BMlSSION
I. Initial Submission Requirements . EDA Civil Rights
R::gulations est.1b li ~h the followini requiremcDLS for an
initial sub mimon of the ED-612 form by applicants and
·other Parues · th.at appl y for or will benefit from EDA
as sistacce . (Th :: meaning of the term "Other Pa.roe s· is
ducussed be low in the innructioru for item 2.) In rnos1
cases these requirements arc ued co the: combined tot.a.I
cumber of pcn:::ianent jobs to be crea1cd or uved by che
Appli caru or ·other Pil!ty" in lbe ir own workforce 11
reponed in i1eo 5 and 6 of the form . r Perman::ot jobs·
are dl:fined be low in !he iasauctions for it.em 3.) Except in
chose C.1Se s unde: (c) below when an "Other Party" is no1
id.entifi:d at the time of project app licltioo the form n:us1
be submirt ed 10 EDA as part of the proJect appUcation .
(a) Applicants creating or saving fewer than 15
pennane111 Jobi shall nu INI only ile!IIS I duou1b I
plw 13 lbrouah 15 of lhe form , 0 10
~) Appllcwi crcadn1 or iaviaa 15 or more pe111W1<ot
Job1 lhall ftll OUI lbe emlre form,
(c) "Odler Panles " c:tatlnJ or taYUII 15 or more
permannn jobs , and eidlcr spedllcally idefflilled u
IUCh lo Ille project -.ppllcalion ID EDA or locadnJ in
ID EDA usisled !Muslrial port, before EDA's llnll
disbunernent is made, 1ball fill our !be aJlire l'onn .
2. F~ Annulll Report 11,q-.,, EDA may require
.-or periodlc submlslioni 10 die ED-612 ,by Appllcams
and "Olber Panles" Illar fall UDder OENERAL
INSDUCTION Numbers l(b) IDd l(c) alJove . These
,ulJmiDIQo, sball c:oruain dall u ~Sltd by EDA.
3. EDA Cini Rl&htJ Evaluation. EDA Civil IUaJw
~ des<ribe the buis upon wbicb EDA evabwa an
ED-6U form . The oraanization mw, develop lllese
projc,:::ions wcing illlo account Ibo character of the local Labor
mm= as repon,d in i1t:111 8 of Ille form . Information obraiDed
in lb< E0-612 ••ill not be wed u lhe sole determimm of a
ooa::::,mplia= finding '
4. Limadons on Data Roqalml, EDA Civil IU&IJU
r<('.:lr.ion.s m the foUowiaa limitationi on Ille employment
infoc:mion required by EDA . Public Applicwi such as
tow::s . ci ties and counties that employ mire than 1.000
pcrs..,:is need only submit data (or the sub-d.ivisioa . a1ency,
unit. or department that ocrually administen Ibo yroject or
Wes d)e funds . ·other Parties• and DOD·govemmerual
A pp5ams for bwiness loans need only submit dall for the
site . bciliry or plant actually beiaa assisted .
S. Job C-.orie, The oiDe jo11 carqories on Ibo ED-612 form
(Ol1icials IIXI Mwaen. Pro:bsiomls, Technicians, e1e .) ase
lhe srmwd ones wed in Fed-.-nl reporting and are defined on
th< f;om of this paac .
6. ~ Groups. The four minority group designations wed
on ~ ED-61 2 form (Black. Hispanic , Asian or Pac ific
lslmder. and Am<ri can Indian or Alaskan Native) are th<
swx.ud designations adopted fo r Federal reporting and ire
defined on the from of this page . They are not scientific
defu:t!iom of anlbro pological origins . Employees should be
inclaled in li;e l!'Ollp with which they identify , or IO wbich
they m, n:prded as belonging by the community . No per,on
smll :,e counted in 1DOre than one minority group .
B. INSTlll'CTIONS FOR SPEcmc NUMBERED ITEMS
The fo!lowin g instructions iiipply to the initial submission of the
E0-6 1: form . If th.ere is oo information 10 enter for iii specific
iccm la,.·c the space blank .
ITEM I • Self Explana1ory .
I'TE:\1 l -Check ~me Box . -other Parties " arc organizatioru th.lt
do OOl re:::eivc El'A finiilncia1 wistm:e themselves. but indirec tly
benefit tan it perhaps by locating in an EDA usisted industrial
24
puttorbyusqmEl>A-= wace, line . ·oc:,, ?anies"
1ft d&Galll ~ lll I J CflD 17. I (b).
ITEM 3 • Include oaly pan-time seasonal ar.d :e::,porary
employees . Ooaotin<!Ddcpemllllt11cmployces. ,11 1 .. ,.
ITEM~-B~ jllll capy .DI sa, enter Ille minority ·.eoup dala
and .-(llmoriry pa IIIIIHIUIIOrily) ffl!IICSt.ed :er cumm ,
~•,.,._jallloaly. "Perm1DODt jobs " r:dcftni:d
here u ftdl.cime yea---ramd jabs of indd'Jlitc tenu. 7l:.!y mus1
bculaltllhouna-al lO-•y•ar. A;: ,±er jobs
will be c:omidered ,....,.,.. seasonal , or rampori~, and are
repontd only in ilom 3.
ITEM 5 • Emcr Ibo -of new pen,w,ent jobs :=ied IO
be creaaed IS a mu ol EDA assuwx:c or benefits . t-.... must
not includ< jobs ;Otaal ill iL:ms 3 or 5 , nor pan-u=. =ml
or temporary jobs .
ITEM 6 -Ent.er ch: ccz:Jbc: of current penna.nent ;c:-S :.h.iil.1 a.re
cxpecttd co be l01t tf ED.A assmanc:e or bene fits arc ::c: ::::ived.
ITEM 7 -Emer the c:;mbc:t of current employc :s :.:. ::iumn .S
plw """'jobs creal<d o column S.
ITEM I -All dall lD be =ed hen: mus1 cove, ::, Labor
Market ARa (L\CA). as defined by th< U.S. De,a.=:01 of
Labor and Ibo St>Z-~=t Service. in wbit!: :;: project
will be loa1od. IDmmr""'2S of the Unit.ed States. L\f.-'.J :onsis t
of one or more -aium:cs. metropOliw, and :;,,"',anized
L\!As usually are coe:m:isive with Sw:cwd ~1,:-opoliw,
Statistical Are:u (SMSAs ) as defincd t,y the 0:5,: or
Mamgemem iilll.d BIJCi::! aod :he Bureau of dlc C::-.si!.i .
ITEM 9 -The ~u forn, ID.IS! be s;j!IOd by ao i!!!:lOrized
official of the repon:il:q orpm.z.a..cioo except wbco it :.s r.l!lmincd
by EDA Appliwm z,. JD imgraJ pan of an ED .~ A;,phcation
form .
It is iillmost lJways ~ ::n: Wt dlc diilta rcquesccd h:~: :.s :cadily
available l'rom lhe loco! <>ffice of the St,,te Employme r.L s,~,iccs .
If ueccssa.7. EDA 's E.c:onocic Dc velopmcru Re;::.!e:naove
(EDR). loal arul S= pwmiog offices and co=s:o ns or
Ecooomic De..-c!opmc:::l Di.scna offices also can a.sus:.
As onted in GENEll-\1. INSTRUCTION Number 3. S=ion A.
above , Appliants arL ~Other Putic.s · must cake the:: :.ttil in10
accoum when they ~e their proje;oons for :::.e fururc
CIDf,Jloymem of minor.:i::s and women .
C. A. '1NUAL REPORTS
ED A ,my requir, pciodk repo rts . Specific da:., ~-,u be
rcquencd at 1:!»sc d:nc:s Follow.u p rcporu ar: rc qwre~ ~:-;,or to
6.oaJ disbu?sare:t froc: zpplicams and mose "other pa..-::s ~ wbo
were ide ntified prior ~ ~rojea: iiippro..-al and for thos e :o.titie.s
wb o have locaterl iI: j]e ~ .is trial park: or site sir.c: ;,reject
approval
•
•
:><ty,.
ASSURANeES OF COMPI;MCE
with Civil Rights and Other Legal Req,iimnenu
·•• (To Be Executed by "Other Partits')
EXRiBrr 9.bn r , ,.
·0tmer Party " is h~rein defined as an enticy which will be creating and/or saving 15 or more jobs as a resul1 of
die EDA assiSlallce and eilher is specifically named in lhe application as benefining from lhe projec1 or will locate
or is; ocated in an assisted building, port facility, or indusnial, commercial or business park prior 10 EDA's final
~cnt of funds for lhe project J.<
1
Pb= Number : _____________________________ _
The: .:i bligations incurre d under lhis form apply only 10 the facility or property receiving assistance from the
Ecocmmic De velopmem .-'>dministration (!:DA). This form is being executed by an "Olher Party " who satisfies
one-Clf the fo llowing co nd i1ions (check applicable section):
(]
•
'The "Olber Party " will be creating and/or saving 15 or more jobs (estimated No. _ ___) as a result of
!the EDA assistance , and (check a ar b)
I J la) is specifically named in lhe application for funcls as benefining from the project; or
[ J (b) will locate or is located ia an assisted building, port, facility , or industria l, commercial or busiriess
park be fo re EDA has made ilS final disbursemem of funds for lhe pr oject.
ASSlL'RANCES OF COMPLIA.\/CE WITH THE DEPARTMENT OF COMMERCE A.\/D THE ECONOMIC
DE-""£LOP~NT ADMINIS"ffiATION (EDA) REGULATIONS UNDER TITLE VI OF THE CIVIL RIGHTS
ACTOF 1964 ,SECTION 112 OF PUBLIC LAW 92-65 , SECTION 504 OF THE REHABILITATION ACT OF
19i': .. A.t'll) THE AGE DISCRIMINATION ACT OF 1975, all as amended .
:ie "Other Party" assures that it will comply wilb Title VI of the Civil Righ ts Act of 1964 , as amended (42
l ;_S-IC 2000d-2000d-4), lbe requirements imposed by or pursuant to regulati ons issued for lhe Deparnnent of
Commerce and designa1ed as 15 CFR Part 8. and any amendments thereto .
The "Other Party " agrees to comply with lbe provisi ons of Sectio n 11 2 of Public Law 92-65 (42 U.S.C . 3123 ),
the ~ments imposed by or pursuant m the regulations of the EDA pcomulga ted in 13 CFR Part 317 , ar.d
any aimendments lbemo .
Tne 'iOther Party " agrees to comply wilb Section 504 of lbe Rehabilitation Act of 1973 (29 U.S.C. 794) and 15
CFR Pan 8b (Regulations of lbe Deparonent of Commerce implementing Se ction 504 oi the Rehabilitation Act ).
and ::he Age Disc ril!linat io n Act of 19 75 (42 U.S.C . 6l0 I ~) and 15 CFR Part 20 (Regulations of lbe
Depanmcm of Commerce implementing the Age Discrimination Ac t of l975 , and lbe general age discrimination
regufrations at 45 CFR Part 90 ).
Such =eqmre ment s hold lbat no person in lbe United States sha ll on ~1e ground of race, color. narional orig in.
s.:x. illl!ndiop. or age be excluded from panicipation in . be denied r!1e benefits of. or be olberwise subjected to
disc ri::ninauon under. any program or activity fo r whicr Federal fir.a ,,cial as sistance has been extended .
' ao::ordance with these as,urances and wilbout lim iting lbe atove. the "Other Parry " agrees that these
assuwwee s shall be binding upon it. il5 grante~s. a~tio r _..,., -:.,,,,.,r~ \!"'
assunmces shall also be binding UlflJU~u ~•--•) ........ m, .... ..il,v u v, a..i1lC:llU1l1Clil LU uus proJeCt.
Tbe 'Odlcr Pany t aclcnowled1es tbal it is aware Illa if dim appean ID be a raiJure or lhrealencd faihue ID
C·Jmply with lhesc wurances, and if 111D uOIM i 5 4 or ~ IIOl!COIDPliance caDDOI be corrected by '
informal meaM, compliance may be effected by• ~a or lal1WlllioD of. or refusal 10 gram or 10
coorinue, Federal finaDCial wiswll:e, oc by my 01111:r -llllboriml by law . •
NOTICE
This form IDllSl be executed by an official au'.borized so make the aforememiGlled assurances colllaiDed ~i/l.
widl full authoriiy to bind the "Other Party" idemified baeia. If the "Olbcr Party" is a corporation, this form
lllllSl be exectucd by a corJ?Ol'IIC officer or person so aaboriz=I lO makl: lUCh assurances, aad the title block IDIISl
clearly indicate such authority . Assunnce forms =nm by employees other .than corporate officer, will n~t
be accepted unless they arc accompanied by a sqmaa: certification signed by a corporate officer or corporate
counsel stating the assurer has full authoriiy lO lepily billd the "Other Party' identified below. In the case of
an individual executing this assurance form as sole Cl'Sller, ~ must be indicated in the titl e bl ock. For
siluations other than those discussed herein, conaa die EDA regioaa.l office for instructions.
ACCEPTANCE OF ASSURANCES OF COMPLIANCE
'These assurances arc made binding for :
Name of "Other Party ": _________________________ _
Address :
Telephone Number :
By __ -=,-----=-~..,..,--,-
(Type or Print Name )
(Si gnarure of Official )
• (Tille of Corp orate Officer)
(Date)
• If the person signing th.is form is ooc a corporare officer , the company 's corrorate officer or corporate coun.5el
mUSI c:e rtify in writiLg that the signatory is authorize! to legally bind the company . Written cenificatior, should
be attached to this fonn .
False ~catemems or representations made in coime::tion wi th the • ASSURANCES OF COMPLIANCE " are a
vio lation of Federal la w punishable by a fine of !IC~ more than $10 ,000 or by impri sonment for not more than
fi ve ye ars, or both (see 42 l.i .S.C . 3220; 18 U.S.C 1001 ).
•
•
26
ATTACHMENT B: • CONSTRUCTION GRANTS
•
B-1
~
• • • -
BUDGET INFORMATION -Construcllon Programs OUII ........ M9 G4NlllM1
NOTE· C.n•kl F•ci,,1•1 •nlsr•nc• progr.m, 1equh 9Cktll011al a>mpulllllOfll fo .,; ... M .... Flldot# ,,..,. olp,ojrx;I eo,,. ~ l:w pa,KJp,.tlotl. U 11,di ,. W.. UHJ"DU ...... IIDflliNf
----------· I COST CLASSIF ICATION a. TOlalCc:I b. Cosl1 MDI Alowlble c. TDlal -Cools
lo< POlllclpotlon (Calumno-b)
I . Admlnl11,aliva and legal HpetlMI s .00 s . 00 • .00
' L■nd, I IJUC kJI .. , 11ghl1 01.,,,,. app,alul,. •to s .00 s .00 • "' ' .oo
.. fWoca'3n a 1penH1 and p ■ymentl s .00 ' .00 • ., ,00 r
• Aldt!INMII and 1nglnM1 in9 fNI s .00 • I' I. .00 • .: ~ .00
__,_ ... __. ...... ----~
• 0,,., .,,hhadl#aJ and w,elnNflng tt11 • .iio • .Clo ' I .00
L •'
• Pfota,d ln1pec11on IH1 ' .00 ' ,00 • ·: I .00 ...
1 SJNiwotk s .00 • .00 • .00 '
I . OemoHon and 11,nova, s .00 • .00 • !! .00
.. eon,......, s .00 • .00 • ~ l •· ' .00 '
10. E~..,, • .00 $ .00 $ • .00 '1
II . Mi1wl..-i.ou1 s .00 s .00 • .00 ..
I-
12. SUBTOTAL(tumollin .. 1-11) s .00 $ . 00 • .00
13 Conllngt,ndH s . 00 s .00 • .00
14. SUBTOTAL $ .00 • . 00 • .00
15. Profec:s (p,ogram) Income s .00 • .00 ' .00 ----.
" TOTAL PAOJF.C T COSTS(1ubuKt •15 lrom •t ◄) s .00 ' .00 s .00
FEOEOAL FUHOtNG
n F•dwlf HlilLMc.e r~•a.d. cak:tA ..... kllow1. EnlOf eiglN COIII lrom lne lie Wliplv X __ ...
(Con1..AI Fadet-11 a;ency to, Fedat_. pe,~• 1hlra) l , .00 Enlef lhe rflUll.lng Fedlinil •"-•· ---------------•----------. --
P11~1~11 1 iJuJ,111 l l1•LI• A1111tn1f•e tl l,•t I HFttl ll•tlt•;,kh•lb111 J!!:.~1.'.,~.1':ill'I ..
i
I! fi, f~-
ATTACHMENT ll : • CONSTRUCTION GRAf . rs
•
B-1
••
SF-424C Budget• Construction •
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BUDGET INFORMATION -Construction Programs c.a-,.....No 0)4 ....
NOTE· C.IUh F•dti,,., •• ,,,,.nc. prog,wn, l«JUh -'ditio,1a/a:tmpvl•ktf1t fo a,,"'9 ., ..,. Feddral llh .. OIPfo/«.! com~ lo, ,-,11opartx,. I/ weft it ... UN,-,.,. .. ..w.cf_ ------
c.TolalMowablilCoels 1 COST CL A SS IFIC ATION a. Total Cost b . Costs Not Alow.a-
to, Pa,Ucipellon (c....noa-1>)
1. Admlnl11,atwe and legal •lJ>«IHI $ .00 $ . 00 • ..,.
•-Land. ltruclUIH, rlgh l1-ol-way, apptlliuh. •IC $ .00 $ .00 $ ' .00 ;1
3. Reloc.,illon 91:pt!RIH and paymanll $ .00 $ ,00 $ .00
• Atchllectufaj and englnM ritt,g fN1 $ .00 $ . 00 • .00
• Othw a,chllKha'aJ and anglnNflnQ IN• $ .00 ' .00 • .00 .
• Project Vl1pec11on IHt $ .00 • ,00 • .00
7 SIMwo,k $ .00 ' ,00 $ .00
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.. Oemolllon and removlll ' .00 $ .00 $ '· .oo -. .. ConolNdlon $ .00 ' . 00 • . . .oo
10 E~t1nl ' .00 • .00 • . I '1 .00
" M11celenNu1 • ,00 I ,00 • -,1 i; iOII --------II 8UOfOlAl (lum oft!,,•• I Ill ' 00 $ ,00 I '. .oo
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13 Coning41nda1 ' .00 ' ,00 $ .00
"· SUBTOTAL $ .00 $ ,00 $ •; .oo
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15. Protac:1 tp,og,am) W1COffla ' .00 • .00 $ .00 .. ,. TOTAL f,'ROJECT COSTS (1ubcrac1115 lrOM 114) $ . 00 • .00 • ,00
FEDERAL FU NDING '
17 Fadw.r H1i11anc.e 1tque1 1ed, c.alculalti H kllowa: Enler llligtie COlfl from ... 16c ~ )( __ " ____ I $. -----------·-• .00
(Cona!Af F9daral ao-ncy lot" F.cteral p.,oan,-,. 1hara)
Ent.-lhe ra:.ultlng Fedwal lhata.
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P••~l.iut IJIU.:o R 11.iU• ~11ll11•1l•e1t lt•t I ttF 11I fl •~t •1t hn-1h111 J;::.'lili:,•Jlf~ l'I..
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FIG~4
Standard ~ ~ (~_'1DtlD1,1ed)
INSTRUCTIONS FOR TIIE SF 424C
l'llllllc ,q,onins-., ro, oJus co1kcDon cl infonnadcn is Cldma,,d ..• _ 180 11W1U1<S per resp0111C. includin( --
ft'Vicwiat insuucuons . searchinl uislin1 dam sources. plherln1 and maiataini11 the data DCCdcd , and eompledac ad
-lhe coll<cuon or inlormallon. Send commenu reprdina Ille bwden esu11111e or any oclltr upect ol dlis collcioe cl
ill..-. lnclMtlina su11esuons lor r«Sucln1 !has bt&rdcn. IO lllt: 011",cc ol Manqement and Buda•• l'lpttwOri< a......
Pn,joc1 (03o<l-00< l ). Wuhtnl"'". DC 20503 .
l't.£\SE DO NOT R£TIJRN YOUR COMPLETEI> FOIIM TO THE OPnCE OF MANAGEMENT AND IIIDGff.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Tlus sllttt is ,o be osed lor lhe loUow101 types ol applications: (I) "Ntw" (mt:IIIS • new [pm,1ous Wllttnded] wistm
awanl); (2) "C .. tilllwioo" (..-luodi"I in I SU<Ulldinl budcct period whid, unmed liom I pnor-=' IO luod); ...
(3) "Revued" (mans any chanses in Ille FodcaJ (OYaMICllt'i '"'-ill obliplioni or coatinptt liaoiliry lrom an ezi11in1
oblip!IOn). II there is no chanl• in Ille -amount there is no nttd ID cample,o lltis lonn. Cenain Federal agencies may
~uttt only an c;11planatory letter 10 the effect minor (no cosi) dlanses. (f you have questions pJease Con11Cl tbe Federal --CoiwM 1.-lr this 1S ~ application ror a .. New'" project.
GIia' Lhc t0tal csumued cou or each of the ucms li.swt on
Jines I Lhrou1h 16 (as applicable) under "COST
Q.ASS!FICATIOl'IS ."
U tbis 1.pptic.auon cnWls a ctw11c to an tJ.istina award.
enter Lhe eligible amounu approvt4 IUIIJ.cr tM prtviaiu
IIWOTd loc tht 11<1!\S under "COST CLASS!FICATION ."
ColwM b.-lf Uus r.S an .lpplic2U0n for a ''New'" pn:ijec t..
em.er L'W poruon of the con of cnch hem in Column a..
whJCh as not &Uowable for Federa.l w1s&:an«. ContX t 1he
Federa l 11ency for ass,nance in dc1ermin 1n, 1he
aUowability of spccifi: COSI.S .
If UUS apphcauon tn"1.1ls 3 chan1e to an c1isUn1 award .
enter the idJusunc:nt I • or (-)I to the p.ev1ously approved
cosu (fn::m column a.) rencctcd in th LS appl0Uon.
Colwnn c.-ThlS 1s the net of Imes I through 16 in columns
.. a.. .. &fld-i,_-
Linc I-Enter es11mated amounts needed 10 cov er
admmu:tn.uve CJ nses . Do not include cosu which arc
rew.cd ID the oonnal funcuons of aovcmmcnL Allowable
lepJ cosu are aenenlly only those a.ssoc 1at£d with the
purchue of land which is allowable for Federal
p;LtUcipauon :ind C:C::Wn services in suppon of consuucuon
o( tht P"'JCCI.
Linc 2-Entcr estimated sue and right (s)•or-way
ac(fumuon cc»:u (this include s purchase. lease . Jnd/or
ascmcnts).
Line 3--Enter esumated com ~lated to reloc.1tu:rt Jdv1SOry
uslStlnec , replaccmen1 housing . rclocuon payments ta
dliplaccd pc,sons and businesses, eu:.
Line 4--Entcr estimawj bas ic cn1mecrin1 fees rl1Wd .,
conszruction (this includes swt-up services w1 iftplRlial
ol projca pc:fonnancc woric plan).
Linc ~Enter esamatt.d ct1gineenng cosLS. such as SUl'\'eyS.
iesu. soil bonn&s, ,u:.
Linc ~Erner cstimao:d cn11r.c<rln1 impcction cosu .
Linc 7-Entcr esumatcd costs of si1c preparation and
rcst0ni tion which arc not included in the basic COnsauctlOII
COIUQ".L
Linc 9-Entu esumated ;:ost of the consuucoon conuxt
Linc 10-Emcr csum atcd :ost of office . shop , la.boraLOrJ,
s.:ifcty cqu1pmenL etc. 10 be used lt the facllity, if such CC:111
are not inc luded m the :.::mS' .. "UCUOn conuact
Line I I-Enter esumuc::::t mtScell.ailcous coits .
Line 12-TotaJ of itcms I though I l.
Line 1.3 -Enter csumatcd conun1enc y coSts. (Consult cbc
Federa l agenc y for the pcrcentaac of the csumated
connru::uon cos 1 to u.sc .)
Line 14-Entcr the row of lines 12 and 13 .
L.inc IS-Enter esr.imued pro1um in come to be earned
dunng the grant penod . e.g... salvaged matcna!s, cit .
Line 16-Subcr:act hnc IS from line 14,
Linc li-Ttus block i.s for the computation of tbc Fc:dc:r111
shan:. Muluply Ille IDCU allowable project tOJtS lrom line 16.
column ·,: by the Fcde:il perceniagc siw< (this may be "I'
10 100 percent : consult Federal agenc y for Federal
pcrcenggc share) and c111er the pr,Xucton line 17.
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flGtJRB 5 D I?
SladardForm424D
' ASSURANCES -CONSTRUCTION PROGRAMS
Pubuc rq,o,w,1 burden tor Ibis ~-al -is eswnau,d 11 •-e 1, mlnum per raponsc, lnc ludinl dme for
reviewina insuuwou. 1&11chin1 ulJWII ._ -.ca:. plhenn1 Md mainWnJna tbe dl1a needed . and completiftg and ,
re•iewio& Ibo colloaion o( 111ronnai'on. Sad -reprdin1 die _,, es1imm or any od>er &SJ)<Ct ol llus colleclion or
iAfomwion, incuidin1 suqations for """"'°I 11111s bs1ko, 10 Ille Olroa: of ~ and Bud1el P:lpe,worit Reducuon
Projcl (0348-00Cl), WISlliq,Dn , DC 205QJ
PLEASE llQ.llllI llJ:TURN YOUR COMfl.£1'ED FORM TO TII£ OFFICE OF MANAGE."1ENT AND BUDGET,:
SEND IT TO TII£ ADDRESS PROVIDED IIYTIII SPONSORING AGENCY.
NOTE: c....., ol---.... ...,_ m ycur pn,jea or pn>Jram. If you have quesuoru, plwe coniac1 Ille
-.. Apley, -----=-1 IF'ICia may n:qvi,e applican11 IC a,nily ID addi!DnaJ
assw:ances.lfsudlislbecase,yaawilallllfilied.
A, lheduly llllhonud r,:prae!lllli .. ollbe....,_ l iznify dW lheapplicanc
I. Has Ille legal ..ihority ID apply !'or ,,_ -· 8. Will comply will! lhe 1-govemmenral Personnel Act
and Ille instiwuoiw. manqmaI ,ad -~I)' of 1970 (42 U.S .C. It 47284763 ) rewin110 prescribed
(mcludin1 funds wfficicn1 10 pay Ille ,___ silar. --fo, ·.neri1 sysu:ms for ,m,IP"ffls funded unde:
of 5XOJ«l COSLS) u, ensure proper plaluu&,. ~1 oat ol 1.bc ~ scawra or regu.b.Uons spec ified 111
and completion of Lbe proJect de.sc ribed m dl 1s Appc:ndia A ofOPM's SWtdards for J Mcm Sm.em of
applic:ition . Pe!sonntl Admuu.~ (j C.F-~. 900 , Su bp iln F).
2. WiU 8"• Ille awading qency, IJle C~ C-=:J
of the United Swes. and if appropn11£. abc SU.:.:.
lhrou&JI any auLbonzcd rq,resenuuve. K..211" s ad =-:-
rig:ht to exam ine &U rec;ords. boots.. ..-.,ers. or
doctnents rewed ID die assis&n:c: and 'WiD. caabus:; J
properacC1>mun1 sysiem ill11CC01m11«.,...,....iJy
accepted a::counun1 s:tand.an1s or q:cncy ~
3. Will not dispose of. modify the use of. or d:an,e ~
i:mu of lhc real prcper.y Litle . or o<bcr :me:::;: '" :::
site and bciliues wilhou, perm iss io n JDd :asuucuocs
from the awardin1 11cncy. Will record me F:~J
interest in the title or real property in ~ w--..:.,
:1wan:tin1 agency directives and will indcrx a~
in lhc ulle of ~ pn:,pcrty acquired tn wtoe or m pa::
wuh Federal usisuncc funds to usmr:. noci -
discnm1nauon dunn1 the u.sc:ful life of the ;irtJ!e=.
Will co mpl y wnh the rcqu ireme nu of :AC i,:siswc:
aw lld ing agency w 11.h regard UJ the dnft:tq.. n:-••icw i-,;c
~proval of consu,.cuon plans .u\d spec 1fe&10tt:!:.
S. Will prov ide and maintain compc1cn1 me: Jil.O.cqu .. u :
cn ginccrina supcrv1S1o n at the con urv.c1.10m sue te
ensure that the complete wo rk conforms ""1th tf-<
approved pla ns and spec ific.at1ons inc •ili ~umis..,
progre:s.s ~ru and such oU'lcr infomwai l.5-ma y be
requu-cd by the a.ssuuncc awarding agenc y or~
6. Will 1n11ia1c an d :omplc tc th e wori: w1~:n in tl'::
:i;iplic..1blc umc fr.unc after receipt of 1;:,pr0"1 of !.l"L:
awan1in g a1cncy ,
7. Will csublish s.afegua.rds to pro h1bn em p-lC!!f e:::S (ror.-;
wang the ir porn.ions fo r l purpose tha t t.OClS.JWteS or
pre sents the appe:u;uv;:c of pc rso n:1 1 or orpr.::::;auoru.l
conflict of intt.rc.st. or pcnonal gain .
"wY-ldilian UMOle
9. Will comply with tbc Lead -Based ?2m1 ?01son :ng
Prevention Act (42 U.S.C. §§ J801 et seq .) wh ich
prmibiu me me of le-1 based pam, in constnicuon or
n:mbilhalioa ol residcnc.e sauaun:s .
10. W-UI comply with aJl Feda1I 111wes ~1.Jun1 10 non -
dm:riminaaon. nese include but are not llm1 1ed to: (a)
Tille VI of Ille Civil Ripes ACI of 1964 (P.l. 88 -)52)
which proh ibits discnm1nauon on the basi s of race .
e:oJor or n.allon:11 ori zin : (b) iit!e IX of t.i e Educat.1o n
AmcndmenU of 1972, as amended (20 U.S.C. I§ 168 I•
1683 . and 1685-1 686) whic h proh ibi cs discrimtnauon on
lbc basis of sex : (c) Section j:04 of the Rehabil ii.aoon
Act of 197 j, as amcnocd (29 L".S.C. § i9.t ) whi ch
proh1b 1ts discnmmauon of the basis of handicaps : (d)
tn e Age D1sc n mma11on Act of 1975. as 1mended
(.:: U.S.C. §§ 610 1·6 10 7) wh ich proh1b llS
dtscnm,na tion on th e bam o( age : (c) lhe Dru g Abuse
Office and TrC3lme nt Ac t of 19i2 (P.L. 9j-:S S). as
irncnded . rel.at.mg to no n-ch.scnmtna uon on :he basis of
drug abtl$C : (() the Co mp rehensive Alcoho l Abuse J.n d
Altoholism Prcve nuon . T~tment a.nd Re!ub iliu.uon
Ac ~ of 197() (P.L. 91-6l6j . u amended. re laung to
non d iscr1m1nau on on the bas is of alcohol abuse or
ilcoholism: (g ) !§ l2l and 52 7 of Ille Publoc Heollll
Sc:"Vice Act of 191 2 {42 U.S.C. 290 dd-j and 290 ec•3).
a.s amended. re!aung to confi dcnua.J ity of alcohol and
drug abuse pauem records ; (h) Title vm of lhe Civil
R,ghlS Act of 1968 (42 U.S.C. § 3601 Cl seq.). a,
amended. relaung to non -d1s rnm1n:auon 1n lhe sale .
re nt.al or fin an c ing of hous ing : (i ) an y other non -
dtsc,minaaon irovtS1ons in the specific sta CJLe{S J under
.. hich appl ic.11ion for Federal as.sistanc.e is be:ng madt.
md u) the ~uuemcnLS on an y oth er non-di.s.=immauon
SwuLC (s) which may app ly lO the appl.JC::auon .
St.,_.,.~ -t2•0 (Rn. "1t2)
P,-mllildt,yOWIOra,w1,..102
AuthanZad fer Local Reproduction
It
FIGURE5
Standard Form 4241> (Continued)
11. WIii comply, or has already compiled. whh the
requir1menu of Titles II and Ill or 1111 Uniform
a.lacouan AssiJwlcc and Ra! P),,pcny ""!uisllion
l'llllci• Aa of 1970 (P.I.. 91-646) wtlicll __ ,or
lair .. d oquilablc IIUIIMIII ol persons disi,IICld or --y is acquind ■ a resull o( Federal and
lakn.lly ISlislod pnJ1r1111S. These nqwr.mcnlS >pply
IO all inwcsis in real propcny acquilod for projec1
purposes regardless or Federal participation in
pun:h■os.
12 WW comply wilh lhe proviliam oC die !lab Ac1 (S
U.S.C. I§ 1501·1,al and mC-7328) which limil lhc
political activities or employees whose pnncipal
employment acuvuies are funded iD wbolc or in pan
wilhFcdcrollunds.
13 . Will cor.,ply, as IJlplic>ble. wilh Ille prOYisicns or Ille
Davis-Bacon Ac1 (40 U.S.C. H ?76a a, 2761 -7). lhc
Copeland Acl (40 U.S.C. ! 276c and 18 U.S.C. ! 87•).
111c Conll'ICI Won, Hows and Safety Stlndalds Acl (40
U.S.C. if 327-333) re1ard in 1 labor siandard s for
fedcnlly usisttd consu,,action sublgreemenL~
Nadonal Envilomaenlll Policy Aa d 1969 (P.I.. 91·
190) 11111 E.ucai,e 0.. (EO) ICJI~; ii>) 11D1i11caion
ol vlol1tln1 l1<il,itles ,.,. .... to liO 117JI: (c)
prot1ctlon or wctllllds pan..-ID !O 11990: (d)
cYlluadon or flood hamds in llaadplam in acmn11oce
wilh£011981:(c)..,_otpn,jlccammmc,,widl
Ille approved Swe IIIUlplldl p,asram dntloped
mider die Coaw Zone .._..,... Aa or 1"2 (16
U.S.C. ffl•51 ei,..j.); (l)..-...,a!~-
IOSlllO C0-Air) (,opl . l'llmsomdor5-
l76(c) oC Ille Clan Air Aa ol 19li. 11 -(•2 u.s .c. f f 7.001 « ,ai.); (&) praa::,m ol omdcrpt,und
soarces ol drinkiq--dlc Sa6 !lrinm1 Waicr
Acl or 1974. u .... -. (P.1.. 9:-523); ud (bl
po=ioa "'axlan&md _,.. -:lie Endaa,-1
Spcia AC1 ol 1973. as amended. (PL 9:-:105).
16. Will comply widl die W"tld and Sc=c l!i..,. Ac1 o(
1968 (16 U.S .C. ff l?71 el s,q.) rcmd 10 pn,1,,:1in 1
components or p0(Endal compone:a of :he l"JUOnal wi ld
and scenic nvers sysr=n.
14 Will comply with ,he Oood insurance purchase
requin:menlS or Section 102(a) of the Flood DLSUter
Proiection Ac, or 1973 (P.L. 93-234) which requires
recipients in a special flood bawd Ra to pa:rucip.lte
in Ille pn,rr>m and to pun:hasc flood inlwa,,:e if Ille
(OtaJ cost of msurablc consuuc:Lion and acquu111on 1s
SI0.000 or mon:.
17. Will wisl die awwdi:11 J1F11CY ill ....,_. compliance
wilh S..:uon 106 ol Ille Na""""1 !!islm:< ~on
"'' or 1966. as amended (1 6 u.s.c. i t •10>. eo 11593
(idontili=ion 111d pr,:sav■ioa ol las:l:nc ;,opmics),
and lhc An:1-lop:ai ad -~ Ac t o(
1974 (16 U. S.C.§ f '69o•l •s,q.). •
1.t Will comply with c,mronmenLDJ .s&andards wtuch ma y
be JnSCribcd punuaru tO lhe foUowU11: (a) insmuuon
of environrnenW quaJi1y conuol measwu under lhc
SIGNATURE OF AIJTHORIZEO CERTIFYlNC OF'FlCIAL
AP PLICANT ORGA.'llZATION
I TTTLE
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18. Will a use to be performed the re:;wre:: fir.anci aJ illld
compliance auciits m ~ w,:i !U Sinslc Audit
Ac1 or 198'.
19. WHI comply wilball appuablc ~=ofallolhcr
F'<dcral laws , E.t«:utivc Onlm. ~ons and policies
aovemin& this procr3ffi.
I o,TE sue Mrrr<..0 •
,U>DmONAL ASSURANCES
EDA CONSTRUCTION GRA.'l'TS
/u the duly authorized represaative of the applicant, I funher cenify that the applicant :
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Will openre and maimaiD llibe fz:ilily in accordaixe with at le.ast the minimum standards as may be required
or prescribed by the applicable Federal, SCl!e and local a~~ncies for the maintenance and operation of such
facilities .
Will require the facility ID be clesigDed to comply with the Americans With Disabilities Act of 1990 (ADA)
(P.L. 101-336) md the A.ccessibility Guidelines for Buildings and Facilities , as amended , (36 CFR Part
1191). Will be responsiblle for conducting inspections to insure compliance with these specifications.
In consideration of EDA makiDg a grant .llld/or loan for a project that is requested by an applicant which
is a businers enterprise , ii qr=s that for a period of rwo years after disbursement by EDA of said grant
and/or loan or any part tbc=>f, applicant will not employ or tender any office or employment to , or retain
for professional services, all}' person who, on the date such assistance is needetl or within one year prior
to said date, shall have serw,ed as an officer, anorney, agent or employee of EDA occupying a position or
engaged in activities ·wflicb EDA has determined involves discretion with respect to the granting of
assistance Wlder the Pubiic Waas and Economic Devel opment Act of 1965, as amended.
Will have no facilities UDder ownership, lease or supervision that are to be utilized for this project either
listed or under consideratilli!n (CK listing on EPA 's List of Violating Facilities .
Will comply with the EDA nonn:location regulations which generally prohibit use of EDA financial
assistance to assist empkr.Fers who transfer jobs from one commuting area to another . This includes an
affirmative duty on the pm of the applicam to inform EDA of any employer who will benefit from such
assistance who will tramfi::r jobs in connection with the EDA grant .
Will comply with Execu~ Order 12699 , Seismic Safety of Federal and Federally Assisted or Regulat:d
New Building ConsouctiOl:l, which imposes requirements that federally assisted facilities be designed ?.ad
construeted in accorda!u o.ith the 1991 iCBO Uniform Build ing Code; or 1992 Supplement to the BOCA
National Building Code ; clld/or 1991 Amendments to the SBCC Standard Building Code .
Will observe and comply "-iih Federal procurement rules, as defined in 15 CFR Part 24 and/or Offic~ of
Management and Budget Ci:rculars as applicable , for award of any contracts for architecrura! engineering
and/or grant administrariom service s and/or construction financed with grant funds .
Understands that atto rney'>' or co nsultants ' fees . whether direct or indirect , expended for securing or
obtaining EDA assiscance :'or this application are not eligible co sts .
Understands that conflict3 of inrerest or appearances of conflicts of interest are prob.Jbited and may
jeopardize this applicarioo or result in the forfeirure of grant funds . A confl ic t of interest occurs , for
example , where a represe=rive, official of the Federal . State or local government , ha• a direct or indirect
finan::ial interest in the acqcisirioo or furnishing of any materials , equipment or services to or in connect:on
with the project.
10 . Will compl y with the req,,rired ~rting requirements of the Gov ernment Performance and Results Act
(GPRA ) of I 993 for mea=ing and reporting projec t perfo rmance .
SI GNATURE OF AlJTHOR.CED CERTIFYlKG OFFICIAL m LE
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APPLIC AN!" ORGANIZKTI!O!'i DATE SUBMITTED
THIS PAGE I"ITENTIONALLY BLANlt
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rART,. a.ucAin-oo At'111t.>lliZA110N
.L.-Pnmde a .iultitlca~OD u Exhibit B-1. 1,Lfi 'r anY ' 9k IOIIIICC ~: 11, '
i'> 18 :1
2 . Is tbe applicant ~ ~ or pmat~ 'non-proftt
•&eel Au, .,~ ~ IIJe Redevelopment
Alea or 01ber specially desianaied area?
I J Yes . If yes, provide a oanative explaining
bow Ille IJlPlicant represems the inten:st of the
redevel opment area or, for Title I project, a
pan thereof, as Exhibit B-1. 2.
[ l No .
3. ~ Collllllfllts (Appllcal>le to Title
I cmly). Have the appropriate local governmental
uniis been given the opportunity to n:view and
commem on the project?
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Yes . If yes, provide the comments from either
the governmental unit with jurisdictional
authority over the involved area, or from the
unit having authority over the entire project
an:a. Comments are attached as Exhibit B-1. 3.
[ ) No . App licant is the only local governmental
unit with an interest in the project.
4 . Metropolitan Area Review Process (Section
204, "Demonstration Cities and Metropolitan
Ocveiopmeu Act. P .L. 89-754). Projects involving
the de\·e1opmem wi th in a mcunpalilao srarisrical area
(MSA ) of a hospital , airpon, library, water supply
and dismlmtion facilities , sewage and waste
treallIIClll "'·orx.s. highways, tranSportation facilities ,
water development or land conservation projects
n:quin: COOlllltnts from the metropolillill area
clearin~agency. Docs the project invol ve any
of the abo..-e identified development within an MSA?
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Ye:-. lf yes. pro vide the follow ing :
Comments fro m the respo nsible metropolitan
area clearinghouse /agenc y as Exhibir B-1.4 .a.;
or
Explanati on as to why comm , nts are not
available as Exhibir B-1. 4. b.; or
I I Tbe appllcadon wu llllde avallabl the
lr appropriate ~lltari ll'el C~
aaency ~ units of jederal locd '!immmem
for review on ______ ; and
I J A cerdficatlon from die applicant tbat I the
application has lain before 1h11 metropolif.an
clearinaJ!OIISCi~~encf fo r a period of ~ days
without comments or n:commendatlom made
as Exhib it B-l. 4. c.
11 No .
PART D • ARCHITECTURE/ENGINEERING
Arcfl.!t.ctural/Ea&lneering Infonnation . An
engineering report must be submiru:d and include . at
a minimum, the following informa:ion and is
attached as Exhibit B-//-1 .
I. Statement of proj ~c t components . Indic ate if it
will be a new facilit ,i', enlargemem , e.~pansion .
renovation, or replacement of an e.xisting facility .
Describe the existing facilities and proposed project
components in term s of dimensions, capacities .
quantities, etc .
2. Sket.:hes and/or schematics at a mllllIIlum ,
showing the general layout and location of the
components.
3. Feas ibili ty Analy sis . Include a n:view of existing
conditions . Discuss any potential problem s wllich
might delay construction and affec t project
components .
4. Identi fy the percentage of this oroject which will
be utilized by each beneficiary /"Other Panics "
identified as project justification .
5. Pro posed Method of Construction . Indica te
w;: ether the project will be constru~ted by
competiti ve ~id , single contract, multiple contrac!S .
Indicate if any porti on of the construction work is
proposed to be done by applicant's own fo rces .
6 . Estimate the useful li fe of the facility and the
basis on which it was determined .
1 .. JDCludl I Cllla. ,4-IJecl ~ caa
W 1i1Jr llc!l of die ~~jocl ,COIIIIII a II
111m1J1 ~. ,uutprk:ap lilll1 COIII.
8. ldclllify major colllllUClioa permits required far
tllil project, 11111 if my are pelldq1 psova dis
DIIIIOflbc~
L
9. Provide ID CSlimlll: of tbe IJlllllber of moadll for
T T J
B-10
.. .,Pffi9d-die~~
10. If~ 1119.iioct will be collltlUClal adjll:CIII ID or
in die viciaity"ck I fmetally ~lor ooerDc1A.
airfteld, IIIICh commena from liic 1ipproprlall-.,.
110 ~ 11111 die . will he
~.;Nilh die alrfleld ~~ ~'
for di: ~ject airfield u Ezhiblt B-U.2.' r--~.-T 0
•
•
PART ot : OWNDSBIP/OPD4~ANCJNG l1 ti u.
A ntle. Docs the applicanl(s) bold aood and merthalllablc tillt to all project facilities, aadcdJq 1&1111,
~ cuemems and riplls-of-way and Im! ID be Improved as put of the project parpcs? Provide
iabmalion on foreclosable liens and encumbrances .
II Yes .
( J No . If 110, explain below bow and when gijod and mercbanlable title will be obtained . Be ipe,cific , and
identify any existing liens and CDCUD1brances , the timing and procedure for obtaining men:1114:able title
to the real property including all CISCIIICIII.S, rights-of-way, or long term leases needed for coaiplaion of
Ille project; and wbo will own land to be improved aa put of the project ~ (such a,, an imlsttial or
commercial park).
2. Ownenbip. Will any of the facilities funded by EDA be owned by an entity other than the applam?
[) Yes . If yes, explain below . •
[] No.
3. Sale or Lease . Does the applicaru(s) inreoo to sell, lease , transfer , dcdicatc or otherwise convey any im.erest
in the project facilities , underlying land , or any land improved with EDA assistanee ?
[ ] Yes. If yes , explain below .
•
[] No .
4. ~ or Odair-Lila. Daa61 ..,UC. mlllld ro monpae or 11N lbe project flcilldes or uaderlyq ,
1111d to collarenlize any 10rt ofllllis:"r, ~ b&ada? ,I > 1~
[ I Yes . If yes, explaill below.·
Qrni
,Y
·I i'1 I J
II No .
5. Operation 1111d Malnteum. Will operation ml maimenmce mpons;1:Jities for the project be retained
by the applicant(s)?
[ J Yes.
[ j No . If no, explain bciow.
6. Potential Issues . Are there my issues such as pending or poteDlial litigation , environmental concerns, or
bonding requirements which could affect c:ompl.im:c with EDA requirements or the construction, financing ,
ownership or operation of the project'?
[ J Yes. If yes, explain below .
[] No .
7. Real Property Acquisition. Has tbcn: been or will there be any property including all casements and rights··
of.way, acquired for this project?
[] Yes . If yes , complete E:dribit B-m. 7, *"Calcnlation Of Estimated Relocation and Land Acquisition
Expenses ·, and enter the toal estimate for "CtlSls lncidenlal ro I.and Acquisition-Estimates" on line item
3, "Relocation exrc= mi payments" of the SF 424C Budget form, for costs incidental to land
acquisition. This is separa from the estimated purchase price of the property . If the project to be assisted
will cause the displaccmelll of individuals, families, businesses or farms , explain how the prr,ccdilre will •
comply with Federal Regubrions.
[] No .
B-i2
PART IV -En'1ro11Dmlt
afederal a1encia,, &nlJ i. llql!~ by law , to
WndepeDdcntly assess lhc expected enviromnemal
impacls assocud 111i!b,prop,sed Federal aclions.1 It
is eiamnely impollllll dial the illfonnation provided
be in suflicielll detail to pennit EDA to perform iu
evaluation . This infonnation request is designed to
obc&in an Ulldentalldinl of the an:a ' s pi:escnt
environmental condition and the project 's elemenl5
lbat will affect the environmem . Should you believe
that an item does not apply to the project, consult
wilh EDA's Economic Development Rq)reseDtative
{EDR) or 1be Regional Environmental Officer for
your ari:a before responding . In all cases when it is
assened that an item is not applicable, explain the
reasons for this assenion .
It is important to understand the comprehensive
nature of tbe information required to complete an
env ironmental review in acconlance with the
National Environmental Policy Act (NEPA).
Information must be provided for (a) tbe site(s)
.rbere the project facilities will be cousuucted and
9Je surrounding an:as affected by its operation, and
(b ) the areas to be affected by any primary
beneficiaries of the project. Toe information
submitted by the applicant must be sufficicDI to
enablr, an evaluation of all reasonable alternatives to
the proposed projec t, Ille direct and indirect
en vironmental impacts , as well as the cumulative
impacts on the e,Jvironment as defined in the
Regulations for Implementing the Procedural
Provisions of the NEPA (40 CFR pan ISOO). The
amount of detail should be commensurate with the
complexity and size of the project , and the
magnirude of the expected impact. (Previously
completed environmental impact documentation
(assessments, Impact Statements , etc.), fo r act ivities
in the area of this proposed project , may be used as
source material for the Environmental e:cbibit of this
ED A applicat ion ).
~tion A -Environmental Narrative
Pro vide responses to the fo llowing items in the order
listed and attach as Exh ibit B-N.A , "Environmental
Narrati ve":
(1) BaflclarieJ .., I JJ 1b, I
ldemify ID)' CDlliDg busillesses or major
developmcms ip,a ,riJJ be/!Ffit from the ~
lffl!iea. 111111 m0111 w11icb 1l'ill ·e~and or'l&cate m the
ma becaule of die JIR)jca . "
(2) Ana Daulpdla ,,
Describe Ille ,-:rat project area including
topography. econamic history , historic land usa1es ,
unique geologic feames , ete . In a ition to maps
which may have been submitted as preliminary
proposal exhibits , and whicll should be updated if
necessary. amch die following:
a. Ana.ch as EzJubir B-lV.A. l, FEMA ftoodplain
and USGS topaerapbic maps, with legend ,
showing the project location and boundaries,
existing and proposed project components and
location of all silll:s and/or companies benefiting
from this projca. The documem should be of
sufficicm size and clarity for adequate
imcrprewion of the applicant 's intentions
(originals are pre!c:mi) .
b. Provide site pbocos and/or an aerial
photograph of die site if availab le, as Exhibit
B-IV.A.2.
(3) Alternatives to die Proposed Project
Provide a descriptioo of altcmati v ,,~ions which
were cons ide red cturing projec: evelopmem
processes (i.e . altenmive locations, d•:s igns, other
projects having similar be!Jefits , a"Jd including a "no-
project " alternati ve). and explain why this
project/site was sc le::ted with re spect 10 other
choice s.
(4) Shorelines, Beaches and Dunes, Estuary,
Wetlands, F1oodplains
Identify any shore!~. beaches , du nes. estuaries ,
wetlands . or floodplz:n areas loca ted within or
adjacent to the projea sne(s). Indicate potential
impact from pro posed project activ ities . and speci fy
proposed ,neasures to miti gate pro bable impacts .
Contact the U.S. Army Corps of Engineers/U.S.
Fi sh and Wildli fe Se rvi ce conce rning any
presumable wetland resourc:s in or near the proje ct
location .
lllllica if applicant participates in the National
flooll airuice Prosram. GI' JI
ir
(5J ~ ad WDdDfe Resoarces
ldelllil'y aive vegetation and wlldll!I: folllld in the
pro;m -or its immcdiafe vicinity . (J
a. ldlllc:fy any designated state' or National Pub,
or N<aiaml Game Preserves, loc:aed on or in the
-.icillily or the proposed project activities.
b. Jdemf)' any Wilderness Areas, as designated or
propltlled Wlder the Wilderness Act, or wild or = rivers, as designated or prop,:ised under
the Wild and Scenic Rivers Act that are located
on air in the vicinity of the proposed project
~-
(6) Eadaa,ered Species
ldemi1':' ;any endangered or tbreatelled species of
plms or .animals , or critical habitats, that have been
i~ in the project area or its immediate
vicimry Contact !be U .S. Fish and Wildlife Service
and ~ comments on your proposal for Federal
fim:lmg..
(7) Lad Use and Zoning
Des:ribe :he present formal zoning designation, and = !zin use(s) of the specific project site(s) and
adjac= !land parcels. These areas include the site(s)
of c=ction activities , adjacent areas , and areas
affc=i ti;• the primary beneficiaries . Land use(s) to
be COllEdercd include , but are not limited to,
indumw., commercial, residential, agricultural ,
rer:re:aiimlal . woodlands, mines /quarries, and open
spaces .
ldcmify agriculrure land parcels designated as
"prime.'tl:liq uc agricultural lands• under the Federal
Farml:mds Protection Act or a local equivalent.
(8) Solid Waste Management
a. lndbte the types and quantities of solid wastes
10 be produced by the project facilities and
pr:mzry beneficiaries .
b . Oc=--llc local solid waste colli .don and disposal
met!nods, and their expected useful life.
B-1"-
c. Indicate if recycling or resource RCOvery
programs are or will be u,ed. ' ' ' ,,
(9) Hazardous or Tolle Substances •·
a. I Describe any toxic, hazardous, or radioactive
subslm:cs which will be'Utillzed or prodliced by
tbe project facilities and primary beoeftciaries .
b. Describe the manner in which these substaDCes
will be stored, wed or disposed.
c. Complete and sign •• Applicant Certification
Clause ' (ED-536), and attach as Exhibit B-
N.A.9.c.
(I 0) Water Resources
Describe surfac~ and/or underground water resources
in or near the~ reject area .
(11) Water SUJJJ)ly and Distribution Systems
llldicate the source, quality, and supply capacity of
local domestic and industrial/commercial water
resources, and the amount of water which project
facilities and primary beneficiaries are expected to.
utilize.
(I 2) W astewuter Collection and Treatment
Facilities
a. Describe all domestic class and/or process
wastewaters or other discharges associated with
the project facilities and its primary
beneficiaries ; and the expected composition and
quantities to be discharged either to a municipal
system or 10 the local environment.
b. Describe the wastewater treaanem facilities
available for processing the addi tional effluent
and indicate their design capacities and current
loading , and their adequacy in terms of the
degree and type of treaonem required . Indicate
all discharges which will require on-site
pretreatment. If local treaonem systems are or
will be inadequate or overloaded . describe the
steps being taken for necessary imp rovem ents
ana their completion dates . • c. Describe any induced changes in local surface
water runoff patterns, and the starus of
· SIOrmwarcr discharge permit process . I)
Ctn"rironmental Justice (Esecutln Orm
Will this projpth ~I in .d~roi>9rtio1F advax
bwnan health or enviionmenw impaclj relame 10
miaqrilY and low income po,Pulations? If so, plac
explain and elaborate .
(14) Stnets, Traffic, Parkin&
a. Briefly describe the local street/road sym:m
serving the project area and describe any -
traffic patterns which will arise because of lbe
project .
b. Indicate if area land use (s), such as rcsidcmial,
hospital , school or recreational will be affeczd
by these new traffic patterns .
c. Indicate if any existing capacities of these
transportation facilities will be exceeded as a
direct or indirect result of this project
•
implementation , panicularly in terms of car md
auck traffic .
(15) Air Quality
a. Is the proposed project area classified as a "OOD-
attainment " area for any criteria pollutants? If
yes, indicate types and quantities of air emiss ions
(including odors) to be produced by the projea
facili ties and ilS primary beneficiaries , and~·
measure s prop osed to mitigate adverse impaas.
b. Ind icate if any local topographical or
meteorological conditions hinder the dispersal of
air emissions .
(16) Noise
Will operation of project fac il ities or primary
beneficiarie s' facilit ies, increase local ambient noise
le vel s. If yes, indicate the area land uses to be
affected .
.17) Construction
Describe methods to be emplo yed to reduce adverse
impaclS from consauction, such as noise , dJJ.St
generati on/soi l erosion and siltation .
B-15
(18) Peraifts ! I ' Tl!. 'i
Identify any federal, state, or local pemilts of af
enviromnental oalllI'C which are needed for the
project (i.e . U.S. Army Corps M Engioeeh,"U.S .
EPA , Coastal Zone Management/Shoreline
Manag~. Ait Quality. Stafe Erlvironmemal
Polley Act, etc .), and die status of any such permit
process . Attach copies of any such permits which
have been received as Exhibit B-N.A .18.
(19) Public Notlftcadon/Controversy
a. Provide evidence of the community's awareness
oi the project, such as newspaper articles or
public notification and/or public me eting s, as
applicable .
b. If a formal public hearing has been held . artach
~ ~opy of the iranscript as Exhibit B·IV.A.19.b.
c. Descnlle any public controversy or objections
which have been made concerning thi s proposed
project.
Section B -Historic/ Archaeological Resources
Identify any known historic /arche ologic al res ources
within the project area that are either li sted on the
National Register of Historic Places or considered 10
be of local and State significance and perhaps
eligible for listing in the National Register .
ApplicanlS are required to prov ide the State Historic
Preservation Officer (SHPO) with (a) a narrative
description of the project 's elements and its location,
(b) a map of the area surrounding the project which
identifies the project site , adjacent streets and other
identifiable objects, (c) line drawings or sketches of
the project and . (d) photographs of the affected
properties if building demolition or renova ti on is
invol ved . This material should be submitted to
the SHPO prior to the submission of the
application to EDA. Add itionall y, the SIIPO mUSl
be requested to submit commenlS on the propos ed
project to the appropriate EDA Reg ional Office. If
the SHPO commenlS ha ve been recei ved , they
should be attached as Exh ibit B-IV.B.
Pil.T V. Pl'qject l'urpole, lmpllct, and,~
.......... , Ir"
S.S..A: General
I O} r-)
I . Project Purpole and lm.,act: Update project
a,.pme, UJlPICli employer's~. if chailpl since
lllbmission of 1[1111 proposal. ~'r~vidc as Exhibit B-
V..A . I .
2. Electric and Gu Facllltles . l,>ocs tbc Prl/ject
im:hlde eleclric or gas facilities other than occessary
sandby emergency electrical 11enerating equipment
or imenw facilities on the consumer's side of the
-?
( I Yes . If yes . provide the following as Exhibit B-
V.A .2:
a. An explanation of the limi!Ations of available
electric and/or gas energy supplies as they relate
ID the loss of jobs or the generation of new jobs .
b. Evidence that financing for the facilities is not
available from private lenders or other Federal
agencies.
c. Cop ies of s!Atements made by the appropriate
Stare or Federal regulatory body that the facility
to be financed, in whole or pan, by this grant
will not compete with an existing public utility
under their jurisdiction rendering such a service
to the public at rares or charges subject to
regulation by the state or Federal regulatory
body and if there is a determinatio n of
competi tion , that the existing public utiliti es are
unable or unwilling to meet the increase in
demand for such energy .
d. Information on whether such facility has been
authorized by Congress , if ~pplicable .
I I No.
3. Explain how minorities will share in the project
benefits and how minorities are served by ex isting
facili ties , if any, as Exhibir B-V.A.3.
4. Are minorities being displaced by this project?
B-16
I I Yes, explain as bhibit B-V.,U .
Sectilin B: ·(we I, Publk: Worb Olllf
I. Public Woru Impact l'nlp'a (PM!')
Projects . Is the project bcin& cOl!lmed for
funding Ulldcr the Public Works Impact Prop-am?
I I Yes . If yes complete the following :
a. How many days after a rUWJCial Alsiswlce
Award has been made will it UC w be&in
project consauction? __ days . Bow many
days will it take to complete consauaicm? _
days •
b. Estimate the project's labor intensity-. Onsitc
labor COSIS $, ______ divided by 10W
project cost 5, ______ equals __ %
labor intensity .
c. Estimate the number of constnll:l!fion
created : ___ _
d. Explain as Exhibit B-V.B. I . how !be project
improves the economic or aimmw~ry
environment in are.~s of severe economic
distress ; applicant 's plans for h:ring lbc
unemployed and UDdcremploycd from !be project
area to work on construction of the pro;ect; h<.•w
the project assists in providing long-term
empl oy ment opporrunities or other economic
be oefi ts for the unempioyed and undcrcnploycd
in the project area ; and ho w it will primarily
benefit low-income famil ies by pro viding
essential communiry servic es or satisfies a
pressing publi c need .
2. Economic Development Center Projects . ls
the proj ect loc ated in an Eco nomic Dc"Cl opment
Center ?
[] Yes . If yes , provide a signed =cut as.
Exhibit B-V.B.2, from th e Economic
De velopmc:nt District organizatio o which
inc ludes th,: following :
The project has bcl;n n:Yicwed by ~ 'Disttict
organization:
The pro~ will funber Ille obja:liva swed
1 in
Ille qED P pf the District in wlich it ~ to be
locaicd · '
c. The project will enhance the ea1110111ic: growth
potential of the District or rcsull in additioual
long-1erm employment opportunities
commensurate with the amown of Federal
1SsisW1Ce requested and iDdudes a plan
explaining how new employmt:CI opporrunities
for residents of nearby highly distressed
redevelopment areas will be prcwided ; and
d. The amount of Federal assisance requested is
reasonably related to the size . population and
economic needs of the District.
II No .
3. £.D.D. Bonus . (Only for an applicant
afl!Uesung a 10 percent Ecooomic De velopment
-istrict (EDD) bonus gram. omcrwise check not
applicable.) Does the project lie widrin a designated
ED l) aiXI is it eligible for a 10 pcr=t BollllS grant'
l l Yes . If yes. provide a sta= from the EDD
Organizaticn as E:chibiI B-V.B.J, whi ch includes
!he following :
a. Toe project is located to a designated
Redevelopment Area in a desiplated EDD:
b. The designated Rede velopment Area is
panicipating in the ec ooomk devel opmem
activities of the EDD ;
c. The EDD endorses the proj = and
d. Toe proje ct is co nsistent with me EDD OEDP .
[ J No . The project does 001 lie .. ithin a designate d
• EDD
I l Not applicable .
4. Revenue Producing Proj«ts (Only for an
B-17
applicant eligible !or a ararif Pue'in e~~
direct grapr rate 6f sp perceni P,IUS !be 10 ' t
Econoutjc Development Dlfuicf1bonus 1g\lam nta,
orb~ dbclr€0no.)'. Will' ibid project ,edmte
reve\mes ;;i#'-'anH ab6ve wbat is necessary ·to
amortize the local share of initial costs aJl(j p'rovide
for the successful operation and maintenance
including depreciation of the facilities? n t
[ J Yes . If yes, complete ••Revemte Producing
Projects-Fair User Charge lnfonnation" and
attach as Exhibir B-V.B. 4.a .
[ ) No . Toe grant rate requested is over the 50
percent exclusive of the 10 percem EDD bonus
but docs 001 generate any revenues in excess of
what is necessary to operate an.i maintain the
facilities . Explain , including operations and
maintt:nance costs to amortize local share as
Exhibu B-V.8 .4.b .
[ ) No . The grant rate requested is over 50 percent ,
exclusive of the 10 percent EDD bonus . but does
no! generate any revenues.
Section C: Title IX, Economic Adjustment Only
I. Economic Adjustment Implementation Grant .
Prov ide the Economic Adjus1ment Implementati on
Grant !';arrative as Exh ibir 8-V.C.J. The narrativ e
should include a discussion of !he acti viti es or
projects prop os ed for funding which sh ould be
identified as imegral and priority elements within !he
Economic Adjusonent Strategy prepared or updated
within the preceding two years fo r the eligible
area(s )
2. Pro vide a copy of the Ec onomic Adjusonent
Strateg y as Exhibir 8-V C. 2. The Economic
Adjusonent Strategy should addre ss at a minimum
the following :
a. An appropria tel y designed and conductec!
planning process ;
b. An understanding of !he economic proble ms
being addre ss ed ;
c. Aaamlyaiaofdlc~IOCtml~dlcf!Iml
widwl dlDm that comprise Ilic uea1s ecoDOlllic
bale, 11111 of die ~uiar ~ 11111
wcakllcsses of tho ua, dial ~iiuie ro , or
ckmct from, us cumm aud po1elltial ecooomic
comp-tiliveness
d . Sttap; objec;li~es that flow from tho ecollOlllic
analysis 111d cooclusiom aud focus on stimulatina
invcsmimtt in ncw aod/or expanding ecooomic
activilies lbll otrcr die best prospeca for
ima'llzatioaampum;md
e. Appropriale aud m:cesmy iaources in !be ua •
11111 elsewbm wblda baff been ldeudfted ill
are/will be CuiN 6 4 t 110 tllp!IOlt
implememalion of !be E.aD,mic Ad;l,tmem
Stratel)'.
•
B-18
ATIACBMENT B · CHECKLIST OF EXHIBITS
.ibis c hecknril ideorifies all the Exhibits identified in Attachment B: Coosttuction section of the application.
9ii>se wim Astcrislcs (") an: preprimcd forms . The Exhibit mimbcr refers to the part-section-item in the
applicatioa.. Check the i1:ems and Exhibits submitted.
Part 1-Afllllicaat and Autborizadoo
( ) B-1.1 Justification for Sole Source Procurement
I I B-1.2 Redevelopment Area Narrative
[ ] 8-1.3 Multi-jurisdictional Comments
I ] 8-1.4 .a Metropolitan Area Agency Comments
[ ] B-1.4 .b Explanation of Unavailability of Meuopolitan Area Agency Comments
[] B-1.4 .c Cenification of Metropolitan Area Agency Comments
Part D -Ardlitecture/EnKioeering
[ ] 8-II . I Preliminary Engineering Repon
[ J B-ll .2 FAA Comments
Part m -°"9ership/Operation/Financing
[ ] B-111 . 7 -Calculation of Estimated Relocation and Land Acquisition Expenses
Part IV-En..--ment
[) 8-IV .A Environmental Narrative (including the following):
..J B-IV .A. I FEMA Floodplain and USGS Topographic Maps
• B-IV .A.2 Site Photos and/or Aerial Pboto
[) B-IV .A.9 .c "Applicam Cen.ification Clause, ED-536
[ I B-IV .A.18 Permits
[ I B-IV .A.19 .b Public Hearing Transcript
[ I B-IV .B SRPO Clearance
Part V -Project Purpose and Impact
[]B-V.A.l
[] B-V.A.2
[] B-V .A.3
[] B-V -A.4
[] B-V .ll .l
[] B-V .B.2
[] B-V .B.3
[] B-V .B.4.a
[ I B-V .B.4 .b
[] B-V .C.l
[) ll -V.C.2
•
Purpose , lmpa.:t, Employer Starus Update
Electri<./Gas Facili ti es Explanation
Minori1y Participation
Minority Displacement
PWlP Employment Explanation
Economic Developmem Cenrer Project Cc -:i f cation
Economic Development District Bonus Certification
·Revenue Charge lnfom!1tion
Ex planation of O&M Costs
.oeo nomic Adjustment Implementation Grant Narrative
EcoMmic Adjustment Strategy
B-19
THIS PAGE INTENTIOSALLY BJ.ANK
B-20
'1u1 l L 111r. llqql In
8
(!
q
•
•
nioart-.... 1
CALCULATION OF ESTIMATED RELOCAT.1 1,N AND LANDACQVJSll'ION Dl'SNSIS
... I . COSTS INCIDENl'AL TO LAND ACQUISMON • BmMA\"1:,
~ of I.ml Tiimii:iiaiii lDYillwd (1aebllirs apCkD, ~ z1 dalllHf-wayJ! ----
-·~-,-.......,,..., ,._te,•,ua, "'""71, .........
---similar ,._.-sec,;m303(1) s -......,, OOIII-S<aicn1 303(2) s '
lal Property rua-SecdoD 303(3) s
-
Utipliao c:q,emes-Seclian 304(a) .. s
T• · Elrimalal cosa iDcidcma1 to lrUIS!'er of liltc s ---
rIEW 2. RELOCATION· ESTIMATES
L TENANTS· Eltimala : Number ofClaiml ----
r o> ......., Elpemcs , I·,_:::~-,--
• -Elpemcs .. S<aio:, 202(1)(1) s -
., _,, poymm:s-Sccti011 202(b) s
Teal s ·----CZ) llq,lacemcolbousina poymcm,: -----•• -poymems-ScctiO!l 204(1) s
-DDvn poymem-Scctioa 2C_!4(2) s
Teal s
(3) Tooal-Temm s
b. OWNER-OCCUPANTS· Ellimales : Number of Claims ___ _
{I) Movq !;xpeuscs: t /,
"Acmalcxpcmcs" -Sccti011202(1)(1) s
In lieu paymems-Sccti011 202(b) s
Toal s
(2) lttp!ac= homiD& paymcna :
Pm-clwc paymoms-Scction 203(1)(1) s ,_
R.casO!llblc replaccmcm C<JSts-ScctiO!I 203(aXl)(A) s
In=ascd in!ercs 1 costs-Section 203(a)(l)(B) s
ao.iag costs-Section 203(a)(l)(C) s
R.cmal paymcnts-Sccaon 204(1) s
Down paymcm-Sccti on 204(2) s -~ ~ Tow s
(3) Tow E.stima«d Owner-Occupants s
C"f.'CUii mON OF IS'l"Dl,\DD IIELOCATION AND LAND ACQV1SD'ION EXPENm
r,, IUIINIISS ,a.-: ..... ~a... ----
Ma¥i111Elpoma : WAIDTa•tlO"" '""'., • n J 'fl'"t!)'.J~l;.'l'i!I~ +I i,1
• Aaml" apom11 Seollala 1112(1)(1)
__ .,
s :o
"Aclllal" lau ofcartibk ,.,.__. 1-+w; C :lioa 7m(IX2) --s
·-· IOlldliaa "'!w::Ja-s.cdaa~ s --,
.~ .. "'"" -· ·---··--ID lieu paymoms-Secliaa 3l2(c) s 'r"
TOlll •&Ollllcdllali-s -· V'"
d. NONPROm OIWANIZAIDNS -~: Number of Claims ----
Movm,Elpemcs : ·-... •--,,
• Aaua1 • •xpe,ms-Sec1ioo 202(aXI) s
• Aaual" loss of lqiblo penoaal prapat)'.soaim 202(a)(2) s
"A<llli" ...... apemes-&aia Jll200(}) s
ID lieu paymoms-Section 202(cJ s
TOlll ·&1imaa:d Ncqm,l!IOrpllimilD s
e. FARM OPERATIONS · l:m!,ma: Number of Claims ___ _
MoYiDIE,pcn,es : .. ~ .. ~.!.:-
• -· .._.--. Wl(o)(l} s
• Aaual " kw of aqible penoml ~ 202{a)(2) s -·-·scan:11q ' s,Clia ~!3> s
ID lieu payn:om,-Sec1ioo 202 (c) s ~ Toul · Eslimmd Farm Opcruiom I s
f. J.L ''ISORY SERVICES · Cllimas: Number of Claims __ _
[roi'C Expenses of gramec,l,o--Scaim :lllS I s
1. ADM1. .;sTRATION • E=.-:ao:s: Number of Claii.,s ___ _
Ulllr.lCliDa will> individual, firm. ---. or~ 2U s
Agrec:m<m w/ Fcdcnl oc SW....,.........._ or iDsaumomality-scaioa 212 s
Tocal • Eslimal,,1 Admiaistralion s
ITEM 3. GRAND TOTAL
EDier the sum of Item I aod I= 2. pans • !luougb I in lhu Iran and also on lino 3 of the Dcuilcd Projca Budget. Flj\UO 4 of the
application .
GRAND TOTAL RELOCATION EXPENSES._ ____ _
B-22
7
•
•
nmm I-IV ~f~c ~
'GI! ,BD-,36 Ola0aal~G61C;il!J92
...... Da:12/WJ6
~ ..
,,. l, ,. , •. t' .,,,,_....,Jz...,....,,..,.;,o,aa• ~~~i-~i ~--°"*-o/"-.,......... ' -.
..,.__.Brundl. Email'cDo ht t ,I llqit • i!lSI , Ir._"",__,_...,;: 11/lJO.-t
•*Oflla~~-..,,_,....,..:«.!111.~~'l!!.!~!'!!li""1!1P.!!eY!~~' ,au~ • ........ D.C. 21JS01 ·. . ~• ., :·
APPLICANT CE'l'llFICATION CLAllSI!
1bo Applic:am rq,taemS ml cenl&s dw it bu ....S duo dllipl:c m dooamiao 11111 .. dampllcaot• a deoczibod 11orciD is
....... wilh1<Spea II die p,aa,ce or allleD:e of · · from IDlic or~-.. 1bo ,am·•· illcada die amre
r.opeofdle project, iD::ludma tl=rc pbua ofdle project ml all areu wbore.....,..wlll oc:ur.
I . & die sito cummly, or bas it ill die put fifty yean. beal med for my of 1111 __.._.......,. or
• a:lffllios:
I) aa,or1lion of baza.tdous IUbslm:es and/or....,.
b) llalllltm. ,u,,.... (ttmpOruy or pamlll"tll), or dispou1 of solid or--
and/or wa.stc
c) -. of petrOleam producu
d) us,:,1/wuto oil sU>t2gC or rcclam:llioo Ullits
c) man:11 or teslilla laboraU>I}'
f) ordum:e researcil, testing , production. or ...,.....
&) cbcmical tDltluflcturiD& or •ton1•
h) miliwy wcapoos or ummmitioll tt2imDa or testma
i) iron >1orks /fOUDdry
k) indwnul or mamibzturin& operation
OYES ONO
OYES ONO
OYES ONO
OYES ONO
OYES ONO
OYES ONO
O YES ONO
OYES ONO
OYES ONO
OYES ONO
0 YES ONO
A If m-t of !he above operaliom C't1 occumd II !ll< ri1e, and 'IJP'OPri.uc clcm,p or ocb.,r ac::iatl WU performed ill accordauc, with the
9>1. suu: and Federal laws, ~ of sutll clcam,p .
2. Do wells draw wau:r from an •,rl,:rl}'UII aquir.r U> provide die Io:.! domestic..,..~ OYES ON('I
B-23
J.. 1111 • Fodtnl, ,_ ar local rq,aillDry llllborlly m:r coam=d m envirolllllOIIIII -·
a,t I,......_ ar a pnllmlm,y ......,,,....,site lmpectloa. or similar amroameiaJ _ .,..,....llpOrt II Ibo a? 'lya prmr'rlc cl'4'its of roporu or raul1.
~ lla>e ,ay CIIYiroam ..r or OSHA ciradcu or llOdca of violaian t-.... iuuod III Ibo l'aclllly?
ilr 1"0, ~ L n1
" IBave ,ay 1lllpmllil, .:d r<loala of bazardous IWIIIIIICa occumd u llte facility which
-iD llll!iJla.daa Ill me EPA 's Nadoaal Rapome Ccma7
llfya • ...,,, PIS rhc WIR of dee rrtc:Nc"
111-... COIIWIUl-.rill cumady iD Ibo l'aclllly? lfya, dtst:ribc anc1 prmddt iafaanarioa
<l'IIX'ffllq mr and &den! rqnJm,y ....,._
-111111ore my equ1pmm <declrical ummbrmen. er:.> commma polychlorinaled blpbmy1s (1'CII)
<111 lllo slll!? If ya. dell:rtbe cmVdm «if the -.,lparm I eav !eati111 est
I. I . Ne IIJert \lllder""""4 ltmqe Wlb OD Ille site?
b. If so . bow many an, men,? ____ _
c. H.lve they been impectcd for Jeab wimin tbc put year? lf so . whar were rhc r:rs:nlu?
If DOl, providc rsplaoarion
, '.1111 dlO facility ll<cn tared for radaa?
!Ir ya. pmxtde a:mla
Ha>e m,n, been or an: there now my euviromDem.11 investiJalions by Federal . swe or local
prnmltlll aaencics which CCllll4 all'act Ibo site iD queaion?
If yes . provide axaiJabJc infnnnaticm
OYES
CYES CNO
llYES CNO
~YLS CNO
CYES ONO
CYES CNO
0 YES ONO
O YES ONO
O YES ONO.
Toe appliam acl:nov,'blces 1ba dlis cenilication r<gardina hawdous subsW>Ces ...Vor waste is a aw,riaJ n,presemation of r.ct upon
waudl dx Government relics when eXCC'UDltl mil award .
Th< Government n,serves lbe riaJ,t III termimte Ille awud . if " any lime during lbe useful life of Ibo project i1 becomes awan: 11w
-. subsiaaccs and/or waste an, presem thereon. or lha1 !'1JCh l!azardow rubsw,ces and/or waste bavc been impproprialdy bandied
moon. Funbcr . if it is determined at any lime 11w 11te pn,sence of l!azardow rubsWJCe.S and/or waste, or inappropriue baJldling !hereof,
!lalla:a misrq,resem,d. lbe Go vermDCDI will wi1ize ollter available lepl remedies apimt Ibo applicam .
.utboriu<!SillJl'llur• Till• & Date
•
B-24
EXHIBIT B-V.B.4.a
REVENUE PROUUCING PROJECTS• FA.Ill USER CHARGE INfORMATION
·• project will ae,ieraie revmie and/or die r..-far EDA lllilaace is in excess of $Cl percem of the toll! estimated
proja CClll. exwlmg Ecooomic Developmelll Dillrlcl (EDD) Bamm. die followin& iafornwion mllSI be provided . Fair USlll'
cliarpaan dellnod as revenue ru:eived trcm p,n:buen. ..__,or_, ofdle facillly's services less the c0111 for openlic,n
ml maintenance of the facility , reasonable deprecladoa ~. ml debt service .
I . Summarize the currem ml pt oboble IIJIJlber of aow ~ oc mas or we project 's services and their respective annual
vobae ofpwthases or ccmumption. (Describe volume uDi11 as pllom, cubic feet , kilowatt hours , acreage, toMa~e, squa:e
reer tor renw space, en:.>
NUMBER OF PURCHASERS/USERS AND CONSUMPTION
Ser, ICC Du1ory Cwmu uof Est New I Esz ..... Toal Toal Volume Volume 19 __ Is, YT lnlYT layr ltd YT h::yr 3rd YT
llaidenrw
c-w
laduarial
Odicr
2. I! there an existing facility? Yes[ J No[ I
ls it meiered? Yes[ J No[ J. If not metered, indicaie bow fl< •~lume is measured:
• Provide the r2tes charged per units or volume by dne comi,;u-ably sized communities or organizatio n, in your ar03 for
services similar co those provided by this project . (Copies of their fee scbedules will suffice if aaacbod bereco ):
4. Compleie !his summary of annual opeming swemem daa fur the existing fac ility W any) and the proposed project . Do
ooc inch.de r~venue, income, expenses , reserve or deb! service amoums attributable co nonreiated facilities or a;tiviries .
Exisiting Faciliry Existing & Proposed Project
Pis.2FiscalYr1 1st Yr 3rd Yr
--
19 __ 19 -19_ 19 ---
Gross Rcvmue Gcncnted ·-
Less Ooc n.un1 & Maint.cnance Con
Less Dcnr~:.ition R.cscrvc
• 1'1.cn Debt s,,..,;ce
Net Revenue
B-25
t"I 3U:Hl'I O~DJOO>!'I
THIS PAGE INTENTIONALLY BLANK •
•
B-26
•
•
COUNCIL COMMUNICATION
Dale Aganda Item Subject U.S. Economic
Development Administration:
TIiie IX Economic Adjustment
July 20, 19 98 11 C iv Assistance Grant
Initiated By
Neighborhood and Business Development
I Staff Source
S. Darren Hollingsworth , Busi ness Analyst
COUNCIL GOAL AND PREVIOUS COUNCIL ACTION
Commu n ity/ Economic Development: Supp ort the redevelopme of Cinderella City.
Community/ Economic Development: Leverage City resources ugh grant funding.
RECOMMENDED ACTION
Staff recommends tha t City Council authorize the City Manager to e,recute the application for funding
under the U.S. Econ omic Development Administration (EDA) TIiie IX Adjusiment Assista nce Grant.
BACKGR UNO, ANALYSIS , AND ALTERNATIVES IDENTIFIED
The purpose of the proposed grant is to provide fund in g assistance estir, 1ated to be S800 ,000 to
demolish a portion of the concrete park ing structure on the Cinderella City site . On July 15, 1997 staff
submitted a preapplicatio n for fund ing assistance , and on January 9. 1998 staff resubmitted the
preapplication with info :mation request ed from EDA .
The EDA has a strong in terest in funding this project ; however, project fund mg is conditioned upon
11dequate comr ,''!m ents and assurances from Wal-Mart . Wal -Man has provided the necessary
documents and comm itments .
Bas ed upon Wal -Mart 's commitment, the EDA has requested the submission of a formal applicatio n for
funding . This process is the final iteration of the grant approval process before the EDA provides
fo rmal funding commitments for S800 ,000 .
FINANCIAL IMPACT
The U.S. Econ o mic Development Adm inistration requires that the Ccry provi de 25 pe rce nt matching
funds to meet grant requ irements . Th is is derived fro m fund ing appr:,priated to the ex isting Cinderella
City redevelopme nt budget.
Grant funds from the EDA will le ve rag e City resources and provide funds necessa,y t o initiate the
dem oli tio n of Cindere lla City .
LIST OF ATTACHMENTS
Prop osed Res oluti on