Economic Development Revolving Loan Fund (RLF) Application

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Economic Development Revolving Loan Fund (RLF) Application

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General Information

1. Name of Applicant Firm(Required)

2. Date of Request(Required)

Contact Information

3. Firm Address(Required)

Street Address Address Line 2 City State ZIP Code

Firm Phone Number(Required)

Email Address(Required)

4. Names, addresses and email addresses of the principal officers, directors and members of the applicant(Required)

5. Name, address, phone number and email address for applicant’s attorney(Required)

Project Details

6. Estimated total project value (provide detailed breakdown of expected costs)(Required)

7. Amount being requested (should not exceed 10% of the total project cost)(Required)

8. Address of proposed project(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

9. Estimated project completion date(Required)

10. Estimated job creation and expected average wage of jobs created(Required)

11. Other sources of funding (secured vs. pending)(Required)

12. Summary of project, including construction to occur, future use of property, unusual demands for water/wastewater service and police/fire protection, etc.(Required)

13. Name, address, and phone numbers of general contractor, subcontractors, and architect/engineer.(Required)

14. Describe the organizational structure of applicant (proprietorship, partnership, limited liability company, corporation, etc.). Note relationship to a parent company.(Required)