Cottingham & Butler CEBA AppRESOLUTION NO. 106-01
A RESOLUTION AUTHORIZING THE FILING OF A COMMUNITY
ECONOMIC BETTERMENT ACCOUNT (CEBA) APPLICATION ON
BEHALF OF COTTINGHAM & BUTLER INSURANCE SERVICE, INC.
Whereas, Cottingham & Butler Insurance Service, Inc., a local insurance services company,
has proposed the expansion of its existing operations; and
Whereas, the City Council of Dubuque, Iowa has considered said proposal and has
determined that the proposed project will contribute to the local economy through the creation of
quality jobs for area residents; and
Whereas, the Iowa Department of Economic Development's Community Economic
Betterment Account (CEBA) was designed to assist in the economic development efforts of local
jurisdictions; and
Whereas, the City of Dubuque, Iowa is eligible to apply for funding from the Community
Economic Betterment Account program.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
DUBUQUE, IOWA:
Section 1. That the filing of an application for participation in the Iowa Community
Economic Betterment Account program on behalf of Cottingham & Butler Insurance Service, Inc.,
is approved.
Section 2. That the local match as identified in the application is hereby approved.
Section 3. That the Mayor is hereby authorized and directed to execute and submit said
application to the State of Iowa Economic Development Commission together with such documents
as may be required.
Terrance M. Duggan, Mayor
Attest:
Jeanne F. Schneider, City Clerk
Passed, approved, and adopted this 19th day of March, 2001.
/ ~ Terrance an, Mayor
F:\USERSB~nyhre\WPDOCS~LOANDOC\SECURITY~townclockcebaapp.res.wpd
CITY OF DUBUQUE, IOWA
MEMORANDUM
March 13, 2001
TO:
FROM:
SUBJECT:
The Honorable Mayor and City Council Members
Michael C. Van Milligen, City Manager
Cottingham & Butler Insurance Service, Inc.
Community Economic Betterment Account (CEBA) Application
Acting Commmtity and Economic Development Director Pam Mykre is recommending approval
of a Community Economic Betterment Account (CEBA) program application on behalf of
Cottingham & Butler Insurance Service, Inc.
I concur with the recommendation and respectfully request Mayor and City Council approval.
Michael C. Van Milligen -
MCVM/jh
Attachment
cc: Ban~ Lindahl, Corporation Counsel
Pamela Myhre, Acting Community and Economic Development Director
~ '8nbnqnd
CITY OF DUBUQUE, IOWA
MEMORANDUM
March 12, 2001
TO:
FROM:
SUBJECT:
Michael. Van M~.~
Pame~,ynre, Acting uomn~ty and Econon~c Development Director
COTTINGHAM & BUTLER Insurance Service, Inc.
Community Economic Betterment Account {CEBA) Application
INTRODUCTION
This memorandum presents for City Council review and approval a resolution authorizing the
submission ora Community Economic Betterment Account (CEBA) program application to the
Iowa Department of Economic Development on behalf of Cottingham & Butler Insurance Service,
Inc.
BACKGROUND
Cottingham & Butler, a local insurance services company, has announced an expansion project
involving the renovation of the historic Town Clock Building located at 835 Main Street, directly
across fi.om their Security Building. The total project is estimated to cost $2.64 million with
building renovation alone costing over $2 million. The company is also seeking a Downtown
Rehabilitation Loan of $300,000 to support the renovation project. That request is the subject of a
separate March 19t~ City Council agenda item.
DISCUSSION
Over the next two years, Cottingham & Butler will employ 60 new employees at an average
startIng wage of$11.01 per hour. To help fund th/s expansion project, Cottingham & Butler has
requested a partially forgivable CEBA loan of $180,000 which represents $3000 per new job
created.
The company's application states that this project will benefit the city in the following ways:
provide 60 new jobs
add over $1,375,000 in annual salaries to the area
provide local vendors and tradesmen income and job opportunities
restore and preserve a building that is significant to Dubuque history
increase commercial office space
enhance the downtown streetscape
CEBA requires local financial participation in the project. Approval of the company's request for
a $300,000 low-interest Downtown Rehabilitation Loan will serve as the public participation
element of the application.
RECOMMENDATION
I recommend that the City Council authorize the submission of a CEBA application for a $180,000
partially forgivable loan on behalf of Cottingham & Butler with the City's commitment of local
matching funds being a $300,000 Downtown Rehabilitation Loan.
This project will have a positive impact on the revitalization of the city's downtown as an existing,
vacant downtown landmark building will be renovated and reused. The project is consistent with
the City's goals to expand local business, increase the number of higher wage jobs and further
diversify our economic base.
ACTION STEP
The action step for the City Council is to adopt the attached resolution.
attachment
March 13, 2001
F:\USERS~myhm\WPDOC S~LOANDOC~SECURITY~towaclockceba.mem.wpd
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE 7
APPLICATION FOR FINANCIAL ASSISTANCE
APPLICANT INFORMATION:
1. APPLICATION TYPE (Please Check One):
[~/] SMALL BUSINESS GAP FINANCING
2. THE COMMUNITY, CITY OR COUNTY SPONSORING THE APPLICATION:
CITY OR COUNTY Dubuque
NAME OF MAYOR OR BOARD CHAIR Terry Du,q,qan
ADDRESS City Hall, 50 W. 13th Street, Dubuque, IA
CITY/COUNTY CONTACT PERSON Michael Van Milli,qen
TELEPHONE (319) 589-4110 FAX ( )
[ ] NEW BUSINESS OPPORTUNITY [ ] HEW PRODUCT DEVELOPMENT
ZIP CODE 52001
TITLE City Mana,qer
BUSINESS RECEIVING BENEFIT OF FUNDING:
BUSINESS Cottingham & Butler insurance Service, Inc.
NAME OF AUTHORIZED PERSON TO OBLIGATE THE BUSINESS
BUSINESS ADDRESS
300 Secudty Building
John E. Butler
ZIP CODE
BUSINESS CONTACT PERSON
TELEPHONE (319) 587-5215
BUSINESS FEDERAL ID #
Stephen J. Bonfi.q TITLE Treasurer
FAX (319) 583-7339
42-0198040
52001
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE
DESCRIBE THE ORGANIZATIONAL STRUCTURE OF THE BUSINESS, INCLUDING ANY PARENT COMPANIES,
SUBSIDIARIES, SISTER COMPANIES, ETC.
Cottingham & Butler Insurance Services, Inc. and its affiliated companies are highly involved in vadous facets of the
insurance business. Cottingham & Butler Insurance Services, Inc., provides insurance brokerage services for
commercial business. Self Insured Services Co. (SlSCO) provides claim services for self-funded medical and dental
plans, along with claims services for workers' compensation and liability claims. HealthCorp provides pre-
certification, utilization review and case management services. Safety Management Services Co. provides loss
prevention and safety training.
5. LIST THE NAMES OF THE BUSINESS OWNERS AND THE PERCENT OF OWNERSHIP HELD BY EACH.
John Butler 100%
6. LIST THE BUSINESS' PRIMARY AND SECONDARY STANDARD INDUSTRIAL CODES (SIC) CODES.
Primary 6411 Secondary 03
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE PAGE 10
7. DESCRIPTION AND HISTORY OF BUSINESS; (If complete description is attached, please summarize here.)
Cottingham & Butler was established in 1887 in Dubuque, Iowa. The company was founded by Dixon Cottingham,
great grandfather to the existing president, John Butler. The business first started as a general insurance brokerage.
In 1930, Ellis Butler joined the firm and moved the company in the direction of larger commercial insurance
accounts, which has remained our direction to this day. In the late 50's the current president, John Butler, joined the
business. John has accelerated the growth of CBISI through expansion and diversifying our services within the
insurance industry.
DESCRIBE IN DETAIL THE PROPOSED ~PROJECT": (e.g., company relocation, plant expansion, remodeling, new
product line, refinancing, etc.) (If complete description is attached, please summarize here.)
Cottingham & Butler has been growing substantially for the past 10 yearn. To accommodate that growth, there is a
need for additional space for our expanding employee population.
The Town Clock Building, located at 835 Main Street, is directly across the plaza from Cottingham & Butler. The
plan is to restore and remodel the building within histodc preservation guidelines. This historic building has
approximately 17,000 square feet of space and the potential to house 100 employees. Our plan is to relocate some
of our current divisions to the new space to allow for growth of these services and, at the same time, to allow for the
further growth of services remaining in the Security Building. This expansion is projected to accommodate the
addition of 60 new positions over the next 2 years.
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE 11
WILL THE PROJECT INVOLVE A TRANSFER OF OPERATIONS OR JOBS FROM ANY OTHER IOWA FACILITY
OR REPLACE OPERATIONS OR JOBS CURRENTLY BEING PROVIDED BY ANOTHER IOWA COMPANY? IF
YES, PLEASE INDICATE THE FAClLITIY (S) AND/OR COMPANY(S) AFFECTED.
None
10. WHAT PERCENTAGE OF THE COMPANY'S SALES WILL BE OUTSIDE THE STATE OF IOWA?
Approximately 40%
11. DESCRIBE THE BUSINESS' ANTICIPATED IN-STATE CUSTOMERS AND THE PRODUCT/SERVICE THAT WILL
BE PROVIDED TO EACH.
Our current and potential customers vary from very large to small business operations who require services for
coverage and self insured exposures. For more detail on the services provided by CBISl, read the answer to #4 and
the enclosed Corporate Brochure.
12. WHAT PERCENTAGE OF THE COMPANY'S TOTAL OPERATING EXPENDITURES (INCLUDING WAGES AND
SALARIES) WILL BE SPENT WITHIN THE STATE OF IOWA?
100%
13. WHAT DATE WILL THE PROJECT BEGIN? May I, 2001
BE COMPLETED? February 1, 2002
(NOTE: Funds are not normally distributed to the business until approximately two months after DED's actual
approval.)
14. HAS ANY PART OF THE PROJECT BEEN STARTED? ~/
Minor clean up and demolition of the facilities has been started.
YES
__ NO (If yes, please describe:)
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE PAGE
15. HOW MANY EMPLOYEES ARE CURRENTLY EMPLOYED BY THE COMPANY? (Total employment including all
locations, subsidiaries, divisions, affiliates, etc., worldwide) 280
IF THIS COMPANY HAS MORE THAN ONE IOWA FACILITY, HOW MANY FULL-TIME EMPLOYEES ARE THERE
AT THE FACILITY AFFECTED BY THIS PROPOSAL? N/A
OTHER IOWA FACILITIES? Location(s) Davenport, IA
No of Employees at each 2
HOW MANY TOTAL INDIVIDUALS HAVE BEEN EMPLOYED BY THE COMPANY AT THESE FACILITIES
DURING THE PAST YEAR? 2
16. IF AWARDED FUNDS, HOW MANY NEW, FULL-TIME MEPLOYEES WILL YOU ADD TO THE PAYROLL WITHIN
12, AND 24, MONTHS OF THE AWARD DATE? The business acknowledges if it fails to create the jobs pledged
below by the end of the project pedod (usually 24 months from the date of the CEBA award), it will reimburse CEBA
funds for the employment shortfall. The preparer of this application should ensure that the business is aware of this
provision before asking the business to sign the application form.
FULL-TIME: PART-TIME:
12 MONTHS 25 12 MONTHS 0
Cumulative Cumulative
FULL-TIME PART-TIME
24 MONTHS 60 24 MONTHS 0
Cumulative Cumulative
17. WHAT IS THE ESTIMATED ANNUAL PAYROLL FOR THE NEW EMPLOYEES RESULTING FROM THIS
PROJECT?
$1,375,OOO
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE 13
18. WHAT IS THE STARTING AVERAGE HOURLY WAGE RATE (NOT INCLUDING FRINGE BENEFITS
PROJECTED TO BE FOR THE NEW EMPLOYEES? $11.01
FOR EXISTING EMPLOYEES? $16.35
LIST POSITIONS AND HOURLY RATES FOR EACH JOB CLASSIFICATION TO BE CREATED AND RETAINED.
See next page. An example is typed in the first line.
HOW MANY OF THE BUSINESS' CURRENT EMPLOYEES ARE EARNING AN HOURLY WAGE, EXCLUDING
BENEFITS, OF AT LEAST THE COUNTY THRESHOLD WAGE? 180
(CONTACT A CEBA PROJECT MANAGER AT IDED FOR CURRENT FIGURES.)
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE PAGE 14
18. Cont.
LIST OF POSITIONS AND HOURLY RATE FOR CREATED AND RETAINED POSITIONS
(Use Additional Sheets if Needed)
No. Hours
Create Retain Position Title Per Week Hourly Rate of Pay
10 0 Assembler 40 $9.00
2 0 Client Service Rep, C & B 40 $12.02
3 0 Account Executive 40 $21
2 0 Benefit Services Rep 40 $13.46
2 0 Claims Supervisor 40 $12.02
3 0 Claims Auditor 40 $10.00
3 0 Workers Comp Adjuster 40 $13,46
1 0 P & C Claims Adjuster 40 $13,46
1 0 Safety Analyst 40 $21.64
2 0 Nurse Case Manager 40 $16,83
3 0 Specialized Transportation 40 $14.43
Sales Rep
4 0 Account Administrator 40 $13,00
12 0 Medical Claim Examiner 40 $8,50
8 0 Indexer 40 $7.75
10 0 Customer Service Rep 40 $8.75
1 0 Account Assistant 40 $9,00
1 0 Word Processor 40 $9.00
2 0 Enrollment 40 $8,50
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE
19. WILL ANY OF THE CURRENT EMPLOYEES LOSE THEIR JOBS IF THE PROJECT DOES NOT PROCEED?
YES ~/ NO
20. IF YES, HOW MANY?
EXPLAIN WHY:
21. WHAT IOWA COMPANIES DO YOU EXPECT TO SELL TO WHICH CURRENLTY BUY FROM NON-IOWA
COMPANIES? WHAT PERCENTAGE OF YOUR SALES WILL FALL INTO THIS CATEGORY?
We are currently working with many Iowa companies that purchase insurance products and self-insured services
from large national brokerage firms located outside of Iowa. Many of these Iowa-based businesses will purchase
insurance and processing services from Cottingham & Butler Insurance Services, Inc. We anticipate that close to
15% of our new business will fall into this category.
22. WHAT OTHER IOWA COMPANIES COULD BE CONSIDERED TO BE YOUR COMPETITORS?
Kirk Van Orsdale (KVI)
Holmes Murphy
Seabury & Smith
Any other Third Party Administration company, also any commercial insurance agency/brokerages.
23. HOW WILL THIS PROJECT BENEFIT THE CITY/COUNTY, ETC.
This project will increase the tax base for the City and the County. The project will also:
· Provide 60 new jobs.
· Add over $1,375,000 in salades to the area
· Provide local vendors and tradesmen income and job opportunities
· Restore and preserve a building that is significant to Dubuque history.
· Increase commercial office space.
· Enhance the downtown street-scape.
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE
24. IN WHAT FORM IS THE BUSINESS CONTRIBUTION TO THE PROJECT?
PLEASE EXPLAIN CLEARLY. (i.e., SALE OF STOCK, EQUITY INVESTMENTS, SUBORDINATED DEBT, ETC.)
Governmental funds/grants
Internal financing
25. IDENTIFY ALL AGENCIES OR INSTITUTIONS INVOLVED IN THE PROJECT, AND WHAT THEIR INVOLVEMENT
IS:
None
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE 17
SUMMARY OF PROJECT COSTS AND PROPOSED
FINANCING SOURCES
26.
USE OF FUNDS SOURCES
(Summarize All Sources from Question 27)
ACTIVITY COST SOURCE A SOURCE B SOURCE C SOURCE D SOURCE E SOURCE F
1. LAND
ACQUISITION $0
2. SITE
PREPARATION $62,500 $62,500
3. BUILDING
ACQUISITION $0
4. BUILDING
CONSTRUCTIO $0
N
5. BUILDING
REMODELING $1,975,817 $180,000 $1,495,817 $300,000
6. MACHINERY
& EQUIPMENT $230,000 $230,000
7. FURNITURE &
FIXTURES $370,000 $370,000
8. PERMANENT
i WORKING $0
CAPITAL
(detail:) i!iii iiiiiiill :~ i::ill i i !::i?~!!~i}ii::i?:i~i?~i::iI
9. OTHER $
10. OTHER $
TOTAL: $2,638,317 $180,000 $2,158,317 $300,000 $ $ $
27.
TERMS OFPROPOSEDFINANCING
CODE: SOURCE (include all soumes in Question 26) AMOUNT TYPE (1) RATE TERM
Source A: STATE ASSISTANCE (CEBA) $180,000 ,,~ 0% 5 years
Source B: Internal Funding $2,158,317 Equity
Source C: City of Dubuque (Downtown Rehab) $300,000 TIF
Source D:
Source E:
Source F-
I TOTAL: $2,638,317
(1) For et<ample: Forgivable Loan, Direct Loan, Grant, Equity, etc,
.,~ $90,000 zero percent loan for five years, then 3%; $90,000 forgivable.
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE PAGE
28. EXPLAIN WHY ASSISTANCE IS NEEDED FROM THE STATE, AND WHY IT CANNOT BE OBTAINED
ELSEWHERE. SPECIFIC SUPPORTING DOCUMENTATION EVIDENCED BY CASH FLOW STATEMENTS,
INCOME STATEMENTS, ETC., IS REQUESTED.
Due to the magnitude of this project, we are estimated to spend over $2.2 million. Corporate finances will not allow
ail funding to come from one source. CBISl is exploring all avenues of funding with primary emphasis on grants, Iow
interest loans and internal financing.
29. EXPLAIN THE NEED FOR SPECIFIC TYPE OF ASSISTANCE (LOCATIONAL OR FINANCIAL OR RATE OF
RETURN). CAN CONVENTIONAL FINANCING BE OBTAINED FOR ALL PROJECT COSTS? IF CEBA
PROVIDED A MARKET RATE LOAN COULD THE PROJECT PROCEED? LOW OR NO INTEREST LOAN? IF
NOT, WHY?
Due to the size of the expenditure and the affect it would have on the "bottom line" of the company, only Iow or no-
interest financing are acceptable. Current interest rates on the amount needed would greatly affect corporate
financial performance.
30. WHAT TYPE OF SECURITY AND IN WHAT AMOUNT WILL THE ASSISTED BUSINESS PROVIDE THE STATE?
IF NO SECURITY IS OFFERED, AN EXPLANATION MUST BE PROVIDED. NOTE: AS A GENERAL RULE, FOR
THOSE BUSINESSES NOT PUBLICLY TRADED, PERSONAL GUARANTEES ARE REQUIRED IN ADDITION TO
OTHER PLEDGED BUSINESS ASSETS. ALSO, FOR THOSE BUSINESSES WHO ARE SUBSIDIARIES OF
LARGER BUSINESSES, CORPORATE GUARANTEES ARE NORMALLY REQUIRED FROM THE HOLDING OR
PARENT COMPANY.
MORTGAGE Yes $_
WHAT SENIORITY OR POSITION?
LIEN ON Building $
WHAT SENIORITY OR POSITION?
PERSONAL GUARANTEE No $
CORPORATE GUARANTEE Yes $
OTHER $
NONE (If none, please explain)
31. GENERALLY A DECISION BY THE DEPARTMENT OF ECONOMIC DEVELOPMENT ON THIS APPLICATION CAN BE EXPECTED WITHIN 30 DAYS OF RECEIPT OF THE APPLICATION. IS THERE AN URGENT NEED
FOR A MORE IMMEDIATE DECISION (I.E., 1 - 2 WEEKS) ON THIS APPLICATION?
__ YES ~/ NO
IF SO, WHY?
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE PAGE 19
32. DOES THE BUSINESS CERTIFY THAT HIRING PREFERENCE WILL BE MADE TO IOWA RESIDENTS?
~/ YES NO
33. DOES THE BUSINESS CERTIFY THAT HIRING PREFERENCE WILL BE MADE TO FORMER EMPLOYEES OF
ANY BUSINESS MERGED OR ACQUIRED BY THE COMPANY WITHIN THE LAST THREE YEARS?
YES NO
34. DOES THE BUSINESS CERTIFY THAT AT LEAST TEN (10%) PERCENT OF THE POSITIONS TO BE CREATED
WILL BE MADE AVAILABLE TO QUALIFIED PROMISE JOB PARTICIPANTS?
YES NO
35. HAS THE BUSINESS BEEN CITED OR CONVICTED FOR VIOLATIONS OF ANY FEDERAL OR STATE LAWS OR
REGULATIONS WITHIN THE LAST FIVE YEARS (INCLUDING ENVIRONMENTAL OR SAFETY REGULATIONS)?
YES ~ NO. IF YES, PLEASE EXPLAIN THE CIRCUMSTANCES OF THE VIOLATION(S).
36. WILL YOUR BUSINESS BE UTILIZING, OR BE LOCATED ON PROPERTY ON WHICH IS LOCATED,
UNDERGROUND TANKS (WHETHER OR NOT IN CURRENT USE) FOR THE STORAGE OF PETROLEUM
PRODUCTS, AGRICULTURAL OR OTHER CHEMICALS, WASTE OIL OR OTHER LIQUID WASTE, OR ANY
OTHER INFLAMMABLE, CORROSIVE, REACTIVE OR EXPLOSIVE LIQUID OR GAS?
YES "/ NO IF YES, PLEASE SPECIFY.
37. WILL YOU BE STORING ABOVE-GROUND ON OR ABOUT YOUR BUSINESS PREMISES, IN TANKS OR
OTHERWISE, FOR ANY LENGTH OF TIME OR FOR ANY PURPOSE, ANY LIQUID OR GAS INCLUDED IN
QUESTION 36 ABOVE OR ANY INFLAMMABLE, CORROSIVE, REACTIVE OR EXPLOSIVE SOLID, EXCLUDING
ORDINARY REFUSE?
YES ~/ . NO IF YES, PLEASE SPECIFY.
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE 20
38. WILL YOU BE TREATING, TRANSPORTING OR DISPOSING OF ANY LIQUID, GAS OR SOLID INCLUDED IN
QUESTIONS 36 OR 37 ABOVE, EITHER ON OR ABOUT YOUR BUSINESS PREMISES OR AT A LANDFILL OR
OTHER TREATMENT FACILITY, OR UPON ANY PUBLIC STREET OR HIGHWAY, OR ON ANY WATERWAY OR
BODY OF WATER, OR IN ANY AIRCRAFT? YES ~/ NO
IF YES, PLEASE SPECIFY THE SUBSTANCE AND WHAT YOU WILL BE DOING WITH IT.
39. IF THE BUSINESS GENERATES SOLID OR HAZARDOUS WASTE, IT IS REQUIRED TO SUBMIT AN AUDIT
AND MANAGEMENT PLAN TO REDUCE THE AMOUNT OF THE WASTE AND TO SAFELY DISPOSE OF THE
WASTE. FOR THE PURPOSES OF MEETING THIS REQUIREMENT; THE BUSINESS IN LIEU OF PROVIDING
IN-HOUSE AUDITS, MAY SUBMIT AUDITS COMPLETED BY EITHER THE WASTE MANAGEMENT AUTHORITY
OF THE DEPARTMENT OF NATURAL RESOURCES OR OTHE IOWA WASTE REDUCTION CENTER AT THE
UNIVERSITY OF NORTHERN IOWA. IF AN AUDIT AND MANAGEMENT PLAN IS NOT SUBMITTED, THE
DEPARTMENT SHALL NOT PROVIDE ASSISTANCE UNTIL IT IS SUBMITTED.
40. WILL ANY PART OF THE PROJECT TAKE PLACE IN A 100 YEAR FLOOD PLAIN? YES ~/ NO
41. DOES THE BUSINESS PROVIDE AT LEAST 80% OF STANDARD MEDICAL AND DENTAL INSURANCE FOR
FULL-TIME EMPLOYEES? ~/ YES NO
42. DOES THE COMMUNITY HAVE A COMMUNITY BUILDER PROGRAM IN PLACE? ~/ YES
NO
43. REQUIRED ATTACHMENTS. CHECK OFF EACH ONE SUBMITTED. IF NOT SUBMITTED, EXPLAIN WHY IT IS
NOT SUBMITTED.
CBISI is a privately held family-run organization. Due to this fact, much of the company's financial information is
considered strategic and confidential in nature. Profit and loss statements, financial arrangements with our lenders
and payroll information will not be supplied at the time of this application. A three-year balance sheet is included.
COMMUNITY RESOLUTION AUTHORIZING THE APPLICATION
~ ~:~e,.--- PLaN (IF NEW BUSINESS)
N/A PROFIT AND LOSS STATEMENTS (3 YEAR HISTORICAL AND 2 YEAR PROJECTIONS)
N/A
__BALANCESHEETS(3YEARHISTORICALAND2YEARPROJECTIONSINCLUDING AGED
ACCOUNT RECEIVEABLESCHEDULE, AGEDACCOUNTSPAYABLESCHEDULEANDA
SCHEDULE OF OTHER DEBT)
N/A LETTERS OF COMMITMENT OF PROJECT FUNDS, (FROM BANKS, APPLICANT, ETC.)
DESCRIPTION OF FRINGE BENEFITS PROVIDED TO EMPLOYEES
CEBA APPLICATION FOR BUSINESS FINANCIAL ASSISTANCE
PAGE
N/A COPIES OF THE COMPANY'S QUARTERLY IOWA "EMPLOYER'S CONTRIBUTION AND PAYROLL
REPORT" FOR THE PAST YEAR AND A COPY OF THE MOST RECENT MONTHLY PAYROLL
REGISTER.
MAP INDICATING THE LOCATION OF THE PROJECT WITHIN THE COMMUNITY.
A'1-1'ACH COST ESTIMATES FOR CONSTRUCTION, MACHINERY/EQUIPMENT, PERMANENT
WORKING CAPITAL AND PURCHASES.
CERTIFICATE OF GOOD STANDING FROM THE IOWA SECRETARY OF STATE OR AN
AUTHORIZATION TO CONDUCT BUSINESS IN IOWA.
CERTIFICATE OF INCUMBENCY LISTING THE CURRENT BOARD OF DIRECTORS AND CURRENT
OFFICERS IF A CORPORATION OR A LISTING OF THE GENERAL PARTNERS IF A PARTNERSHIP.
CORPORATE RESOLUTION AUTHORIZING THE APPLICATION FOR CEBA FUNDS.
CORPORATE SIGNATORY AUTHORIZATION NAMING AN OFFICER TO EXECUTE THE CEBA
APPLICATION AND CEBA LOAN DOCUMENTS, IF APPROVED..
OTHER
44. EXPLANATION/OTHER COMMENTS: