TriState Quality Metals, LLC_IEDA Financial Assistance ApplicationTHE CITY OF
Dui
Masterpiece on the Mississippi
Dubuque
band
AI- America City
11111r
2007 • 2012 • 2013
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: State of Iowa Business Financial Assistance Application for TriState
Quality Metals, LLC
DATE: October 10, 2013
Economic Development Director Maurice Jones is recommending approval of the
submission of a Business Financial Assistance Application to the Iowa Economic
Development Authority on behalf of TriState Quality Metals, LLC.
TriState Quality Metals, LLC is a sheet metal fabrication manufacturer formed in 2010 in
Peosta, Iowa. The company performs laser cutting of sheet metal, as well as plasma
cutting, bending, drilling, tapping, sawing and or /welding to create customized parts.
TriState Quality Metals also provides services including plating, machining, sheering,
and painting that are outsourced to other area manufactures. The company has grown
from a local customer base, to one that is regional, serving manufacturers in eastern
Iowa, northwestern Illinois, and southwestern Wisconsin. The largest customer, Rite
Hite, sells products to worldwide markets. In addition, TriState Quality Metals produces
parts for companies that ultimately sell to international manufactures such as John
Deere, Caterpillar and Volvo.
The company plans to relocate to the Dubuque Industrial Center South to allow for
expansion of production capacity necessary for continued growth. The City plans to sell
approximately five acres of land to TriState Quality Metals through a development
agreement later this year for the construction of a 40,000 square foot building. The
company currently has 13 employees but has committed to expanding its workforce to
23 employees. In exchange for the job growth, the City has plans to provide a ten year
tax increment rebate.
This application on behalf of the company will provide State financial assistance to
enable the company's proposed expansion. TriState Quality Metals is eligible for a
$74,000 investment tax credit and a $72,000 sales tax rebate, pending Iowa Economic
Development Authority approval of their application at the October 18, 2013 Iowa
Economic Development Authority Board Meeting and the City Council's subsequent
adoption. Local sponsorship of the application is required for approval. The local match
for the project will be the 10 -year tax increment rebate, valued at approximately
$580,000.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Michael C. Van Milligen
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Maurice Jones, Economic Development Director
Rick Dickinson, President & CEO, Greater Dubuque Development Corp.
2
Masterpiece on the Mississippi
Dubuque
All- America City
11111 I
2007 • 2012 • 2013
TO: Michael Van Milligen, City Manager
FROM: Maurice Jones, Economic Development Director
SUBJECT: State of Iowa Business Financial Assistance Application for TriState
Quality Metals, LLC.
DATE: October 7, 2013
INTRODUCTION
This memorandum presents for City Council review and approval a resolution
authorizing the submission of a Business Financial Assistance Application to the Iowa
Economic Development Authority (IEDA) on behalf of TriState Quality Metals, LLC.
BACKGROUND
TriState Quality Metals, LLC is a sheet metal fabrication manufacturer formed in 2010 in
Peosta, Iowa. The company performs laser cutting of sheet metal, as well as plasma
cutting, bending, drilling, tapping, sawing and or /welding to create customized parts.
TriState Quality Metals also provides services including plating, maching, sheering, and
painting that are outsourced to other area manufactures. The company has grown from
a local customer base, to one that is regional, serving manufacturers in eastern Iowa,
northwestern Illinois, and southwestern Wisconsin. The largest customer, Rite Hite,
sells products to worldwide markets. In addition, TriState Quality Metals produces parts
for companies that ultimately sell to international manfactures such as John Deere,
Caterpillar and Volvo.
The company plans to relocate to the Dubuque Industrial Center South to allow for
expansion of production capacity necessary for continued growth. The company has
determined that there is not a site suitable for such growth in Peosta. On September 3,
2013, the City Council executed an agreement with the City of Peosta, where in
accordance with urban renewal law, the Peosta City Council consented to the use of tax
increment financing by the City of Dubuque to incentivize the company. The City plans
to sell approximately five acres of land to TriState Quality Metals through a development
agreement later this year for the construction of a 40,000 square foot building. The
company currently has 13 employees but has committed to expanding its workforce to
23 emloyees. In exchange for the job growth, the City has planned to provide a ten
year tax increment rebate.
DISCUSSION
The application on behalf of the company will provide State financial assistance to
enable the company's proposed expansion. TriState Quality Metals is eligible for a
$74,000 investment tax credit and a $72,000 sales tax rebate, pending IEDA approval
of their application at the October 18, 2013 IEDA Board Meeting and the City Council's
subsequent adoption. Local sponsorship of the application is required for approval.
The local match for the project will be the 10 -year tax increment rebate, valued at
approximately $580,000.
RECOMMENDATION
I recommend that the City Council authorize the submission of a State of Iowa Business
Financial Assistance Application on behalf of TriState Quality Metals, LLC for the
construction of a new facility and 10 new positions within the area. This project is
consistent with the City's goals to grow existing businesses in the area and further
diversify the economic base.
ACTION STEP
The action step for the City Council is to adopt the attached resolution.
attachment
F: \USERS \Econ Dev \TriState Quality Metals \20131007 IEDA application Council memo.docx
RESOLUTION NO. 308 -13
A RESOLUTION AUTHORIZING THE FILING OF AN APPLICATION FOR STATE
BUSINESS FINANCIAL ASSISTANCE ON BEHALF OF TRISTATE QUALITY METALS,
LLC.
Whereas, TriState Quality Metals, LLC has proposed making a $3.78 million investment
as part of a relocation to Dubuque, Iowa from Peosta, Iowa; 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 in Dubuque
County through the retention of 13 jobs and the creation of 10 jobs; and
Whereas, financial assistance from the Iowa Economic Development Authority is
designed to assist in the economic development efforts of local jurisdictions; and
Whereas, the City of Dubuque, Iowa must provide local sponsorship on behalf of
TriState Quality Metals, LLC for their Business Financial Assistance Application with the
Iowa Economic Development Authority.
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 Economic
Development Authority's Financial Assistance Program on behalf of TriState Quality
Metals, LLC is hereby approved.
Section 2. That a ten year tax increment financing local match identified in the
application will be provided, subject to further action by the City Council.
Section 3. That the Mayor is hereby authorized to execute and the City Manager is
hereby directed to submit said application to the Iowa Economic Development Authority
together with such documents as may be required.
Passed, approved, and adopted this 21st day of October, 2913.
Attest:
d
Kev" . Firnstahl, City erk
F: \USERS \Econ Dev \TriState Quality Metals\20131021 Resolution IEDA App Approval.docx
Roy D. Buol, Mayor
I( MA
economic development
Debi V. Durham, Director
Iowa Economic Development Authority
Business Financial Assistance Application
Business Finance - Business Development Division
Iowa Economic Development Authority
200 East Grand Avenue
Des Moines. Iowa 50309 -1819
www.iowaeconomicdevelopment.com
Telephone: 515.725.3134 Email: businessfinancena iowa.gov
Application Instructions
To Complete Electronic Form: Click on TEXT BOX to add text. Double click on YES /NO boxes and select "Checked ".
1. All applicants must complete the Business Financial Assistance Application and attach only those
additional sections for the components to which the applicant is applying.
STATE of IOWA — Financial Assistance Programs
❑ Enterprise Zone Program (EZ) High Quality Jobs Program (HQJP)
Supplemental info required— ® Tax Credits
Section G - EZ Supplement ❑ Direct Financial Assistance
2. Before filling out this application form, please read all applicable sections of the Iowa Code and Iowa
Administrative Code ( rules). www .legis.state.ia.us /IowaLaw.html
3. Only typed or computer - generated applications will be accepted and reviewed. Any material change to
the format, questions, or wording of questions presented in this application will render the application
invalid and it will not be accepted.
4. Complete the applicable sections of the application fully. If questions are left unanswered or required
attachments are not submitted, an explanation must be included.
5. Use clear and concise language. Attachments should only be used when requested or as supporting
documentation.
6. Any inaccurate information of a significant nature may disqualify the application from consideration.
7. The following must be submitted to Business Finance at IEDA in order to initiate the review process:
• One original, signed application form and all required attachments
• One electronic copy of the application form and all required attachments
Facsimile copies will not be accepted.
Applications must be submitted to IEDA Business Finance before 4:OOpm on the fourth Monday of the month.
Applications will be reviewed by the IEDA Board on the third Friday of the following month.
v.10.30.2012
Public Records Policies
During the application process, the information submitted by you to IEDA is exempt from disclosure under
the "industrial prospects" exemption found in Section 22.7(8). However, once you receive an award, the
industrial prospects exemption no longer applies and all documents submitted and generated during the
application and negotiation process become public records under Iowa's Open Records Law (Iowa Code,
Chapter 22), unless
1) The information belongs to one of the classes of records automatically treated as confidential; or
2) You have applied for and received written notice that your information will be treated as confidential.
Automatically Confidential Records
IEDA automatically treats the following records as confidential and will withhold them from public inspection
even without a request for confidential treatment:
• Tax Records and Tax Liability Information
• Quarterly Iowa Employer's Contribution and Payroll Report prepared for the Iowa Workforce
Development Department
• Payroll Registers
• Business Financial Statements and Projections (unless those statements are already publicly
available elsewhere, e.g., 10 -K filings)
• Personal Financial Statements
Exemptions to the Open Records Law
If you wish to have additional information treated as confidential, you must fill out the confidential treatment
request form. Under the Open Records Law, IEDA may lawfully treat certain information as confidential if
that information falls within an exemption to the Open Records Law. The following exemptions represent
records which may lawfully be treated as confidential under the Open Records law and which are most often
applicable to the information submitted to IEDA:
• Release of information would give an unfair advantage to competitors — Iowa Code Sec. 15.118
• Trade secrets — See Iowa Code section 22.7(3), see also Iowa Code Ch. 550
• Information on an industrial prospect with which the IEDA is currently negotiating — See Iowa Code
section 22.7(8)
• Communications not required by law, rule or regulation made to IEDA by persons outside the
government to the extent that IEDA could reasonably believe that those persons would be
discouraged from making them to IEDA if they were made available for general public
examination — Iowa Code section 22.7(18)
Non - Confidential Information
Information that is submitted to IEDA as part of the application process or that is contained in a contract for
program benefits is generally considered material to the eligibility requirements of the program or to the
amount of incentives or assistance to be provided. Such information is generally not given confidential
treatment. Such information includes but is not limited to, the number and type of jobs incented, the wage
levels for the incented jobs, your company's employee benefit information, and your project budget.
Additional Information Available. Copies of Iowa's Open Record law and IEDA's administrative rules
relating to public records are available from the IEDA upon request.
IEDA — Business Financial Assistance Application
2 v.01.23.2013
SECTION A
Applicant Information Date Application Submitted:
1. Name of Business: TriState Quality Metals, LLC
2. Entity Name (for contracting purposes): TriState Quality Metals, LLC
3. Address: 8673 Kapp Dr
4. City, State & Zip Code: Peosta, IA 52068
5. Contact Person: Kenny LeGrand Title: Controller
6. Phone: 563- 582 -7400 Fax: 563 - 582 -7409 Email: Kenny @tsgmetals.com
7. FEIN: 27- 1473519
8. NAICS Code for primary business operations: 332322
9. US DOT Number: 2115004
10. Does the Business file a consolidated tax return under a different tax ID number?
❑ Yes (If yes, please also provide that tax ID number) ® No
a. Is the contact person listed above authorized to obligate the Business?
❑ Yes ®No If no, please provide the name and title of a company officer authorized to
obligate the Business: Gary Wilming, Member
11. If the application was prepared by someone other than the contact person listed above, please
complete the following:
Name of Business: N/A
Address:
City, State & Zip Code:
Contact Person: Title:
Phone: Fax: Email:
Sponsor Information (A sponsor organization is a city or county)
12. Sponsor Organization: City of Dubuque
13. Official Contact (e.g. Mayor,
Chairperson, etc.): Roy Buol Title: Mayor
14. Address: 50 W 13th St
15. City, State & Zip Code: Dubuque, IA 52001 -4805
16. Phone: 563 - 564 -5455 Fax: 563 - 589- 0890Email: rdbuol @cityofdubuque.org
17. If IEDA needs to contact the sponsor organization with questions, should we contact the person
listed above?
❑ Yes ® No, please contact the following person:
Name: Phil Wagner Title: Asst Economic Development Dir
Address: 50 W 13th Street
City, State & Zip Code: Dubuque, IA 52001
Phone: 563- 589 -4393 Fax: 563 - 589 -1733 Email: pwagner @cityofdubuque.org
If necessary, please list information on additional sponsors in an attachment.
IEDA — Business Financial Assistance Application
3 v.01.23.2013
SECTION B
Business Information
1. Provide a brief description and history of the Business. Include information about the Business'
products or services and its markets and /or customers.
TriState Quality Metals, LLC (TSQM) is a sheet metal fabrication manufacturer formed in 2010 to fill a market gap
perceived by the company's owner, Gary Wilming. TSQM provides its customers with high quality parts, superior
customer service and fast turnaround. In addition, TSQM one of few area wholesale parts manufacturers that laser
cuts material up to 1" thick. The company's focus on these market niches has yielded tremendous growth since its
inception. In the past year, a large portion (50 %) of TSQM's growth has come from companies outside of Iowa.
TSQM currently leases a 10,000 square foot building to house its production operations and 5,000 square feet in a
separate facility for warehousing. Since opening, the company has added machinery to increase capacity and
capabilities. At this point, the company has reached its maximum production and storage capacity and has no
space available to further expand operations. The plant currently staffs its machinery over three shifts and typically
produces parts six days per week.
TSQM produces parts that are designed and ordered by other companies. Our manufacturing operations include
laser cutting of sheet metal then plasma cutting, bending, drilling, tapping, sawing and /or welding the material to
create the customer's part. In addition, we offer other services including plating, machining, sheering and painting
that are outsourced to other area manufacturers. Some of the outsourcing, such as painting (powder coating), is
shipped to manufacturers in other states due to insufficient capacity in eastern Iowa. (This project includes creating
powder coating capacity for our own production and to provide an in -state option for other area manufacturers.)
Two types of delivery services are offered to our customers. Many of them order a specific quantity of parts which
are produced and delivered when production is completed. However, the majority of our sales are for parts that are
ordered to cover the customer's manufacturing requirements for an extended period (blanket orders). For these
customers, we produce and stock enough parts to satisfy releases as required by their production operations (stock
and release programs). Additional parts are manufactured as stock and release parts are shipped.
When TSQM began operations, its customer base was primarily locally based. Since then the company has
expanded to a more regional territory and now services manufacturers in eastern Iowa, northwestern Illinois, and
southwestern Wisconsin. Even though we service several companies that are locally based, our largest customers
sell to international markets. The largest customer, Rite Hite, sells their products to worldwide markets. In
addition, we produce parts for companies that ultimately sell to international manufacturers like John Deere,
Caterpillar and Volvo.
2. Business Structure:
❑ Cooperative ❑ Corporation ® Limited Liability Company
El Partnership ❑ S- Corporation ❑ Sole Proprietorship
3. State of Incorporation: Iowa
4. Identify the Business' owners and percent ownership: Gary Wilming, 100%
5. Does a woman, minority, or person with a disability own the Business? ❑ Yes ® No
6. List the Business' Iowa locations and the most current number of employees at each location.
Peosta, IA — 12 employees
7. What is the Business' worldwide employment? (Please include employees of parent company, subsidiaries, and
other affiliated entities in this figure.) 12 Employees
Project Information
8. Project Street Address: Dubuque Industrial Center South
Project City & Zip Code: 52002 Project County: Dubuque
9. Type of Business Project:
❑ Startup
® Expansion of Iowa Company Cl New Location in Iowa
IEDA -- Business Fin :ncial Assistance A-)plication 4 ..01.23.20 3
10. Describe the proposed project for which assistance is being sought. (Include project timeline with dates,
facility size, infrastructure improvements, proposed products /services, any new markets, etc.)
TSQM is proposing to build a new building in the Dubuque Industrial Center South which is on Seippel Road in
the city of Dubuque, Dubuque County. The proposed project schedule is as follows:
Planned
Start
Current
11/01/13
12/01/13
11/15/14
11/15/14
11/15/14
12/07/14
12/01/15
11/15/15
12/01/15
11.
1.
2.
3.
4.
5.
6.
7.
8.
9. Purchase /Install New Brake Press
10. Interview /Hire Staff additions (Laser & Brake)
Activity
Secure Project funding
Purchase land
Construct 40,000 sq ft Building
Interview /Hire Staff Additions (Paint Line)
Purchase /Install New Painting Line
Purchase /Install New Computer /Office Equipment
Move into New Building
Purchase /Install New Laser
Planned
Finish
11/01/13
11/01/13
12/01/14
12/01/14
12/01/14
12/01/14
12/31/14
12/31/15
12/01/15
12/31/15
The purpose of the project is to allow for expansion of our own production capacity and capability as is necessary
for continued growth. This project will also benefit other area manufacturers buy providing an in -state option for
outsourced powder coating. (Currently, this area's primary supplier for powder coating is KVF in Moline, IL) This
project will allow for sales growth for existing customers and will allow for market expansion in Illinois and
Wisconsin.
Project Timeline (add additional rows as needed)
See Above
Beginning Activity Date
Activity Completion Date
12. Has any part of the project started *?
If yes, please explain.
* For IEDA's purposes, starting the project includes: the start of construction or rehabilitation, the purchase of a building, the execution of a lease, or
the installation of equipment to be used in the project.
13. Identify the Business' competitors. If any of these competitors have Iowa locations, please explain the nature of
the competition (e.g. competitive business segment, estimated market share, etc.) and explain what impact the
proposed project may have on the Iowa competitor.
TSQM's current operations are primarily based on sheet metal laser cutting with ancillary services such as
forming, sawing, grinding, drilling, tapping and welding. There are other Sheet Metal fabricators in the
company's market area such as Giese Manufacturing, Mi -T -M and EIMCO (Eastern Iowa Manufacturing
Company). Each for these companies appeal to slightly different markets which allows all of these companies
to flourish with limited competition for sales between them. Because of the different market appeals, it is not
possible to determine market share. Of these companies, TriState Quality Metals is by far the smallest in
facility size, capacity, and sales.
14. Will any of the current Iowa employees lose their jobs if this project does not proceed?
❑ Yes ® No
If yes, please explain why and identify those jobs as "retained jobs" in the Project Jobs Section E.
❑ Yes
® No
15. Is the Business actively considering locations outside of Iowa?
If yes, where and what assistance is being offered?
16. Please identify the company project management for the project location and experience.
The primary project manager is Gary Wilming, the owner of the company, who has over 35 years of
manufacturing experience. During his career, he has managed a facility relocation, building construction with
❑ Yes ® No
IEDA Busi
Finan
Assistance Ap=plication 5 v.01 .23 .2u
relocation and building expansion project all for another company. He also managed the startup project for his
current company, TriState Quality Metals.
Kenny LeGrand, CPA will assist Gary in managing the project. Kenny has managed building expansion and
equipment installation projects along with financial management of a variety of projects.
Applicant's Project Budget
SECTION C
1. Does the Business plan to lease the facility? n Yes ® No
If yes, please provide the Annual Base Rent Payment (lease payment minus property taxes, insurance, and
operating /maintenance expenses) for three years in the budget below, and only major renovation costs your
company expects to incur. Administrative rules require that the lease be in place for a minimum of five years.
2.
Use of Funds
Cost
Source A
Source B
Source C
Source D
Source E
Source F
Base Rent (3 years)
(Loan, Grant, In-
Kind, Donation, etc.)
Source A: IEDA (see #4 below)
$
Tenant Improvements
$
Source C: Business
$ 423,000
Land Acquisition
300,000
Pending
Approval of SBA loan n for 90%
source A & B
30,000
270,000
SBA backed loan
TBD
Site Preparation
Member personal guarantee
building and equipment as
collateral.
Source E: Other Source
$
Building Acquisition
$
TOTAL
$ 3,780,000
Building Construction
2,400,000
240,000
2,160,000
Building Remodeling
Mfg. Machinery & Equip.
1,000,000
100,000
900,000
Other Machinery & Equip.
Racking, Shelving, etc.'
Computer Hardware
20,000
2,000
18,000
Computer Software
Furniture & Fixtures
10,000
1,000
9,000
Working Capital
Research & Development
Other — Relocation Costs
50,000
50,000
TOTAL
$ 3,780,000
$
$
$ 423,000
$ 3,357,000
$
$
Racking, shelving and conveyor equipment used in distnbution center projects only
3. Please complete the chart below with proposed financing for the project (tax benefits should be reflected as indirect
•
financing unaer fa UGiuw /.
PROPOSED FINANCING
Source of Funds
Amount
Form of Funds
Rate and
Term
Commitment
Status
Conditions /Additional
Information
Include when funds will be
disbursed; If loan, whether
payments are a level term,
balloon, etc
Add additional lines as needed
(Loan, Grant, In-
Kind, Donation, etc.)
Source A: IEDA (see #4 below)
$
Source B: Local Government
$
Source C: Business
$ 423,000
Cash / Equity
N/A
Pending
Approval of SBA loan n for 90%
source A & B
Source D: Bank/SBA loan
$ 3,357,000
SBA backed loan
TBD
Initial
meetings
held, need to
File
Application
Member personal guarantee
building and equipment as
collateral.
Source E: Other Source
$
Source F: Other Source
$
TOTAL
$ 3,780,000
IEDA — Business Financial Assistance Application
6 v.01.23.2013
4. Direct financial assistance (loans /forgivable loans) must be secured with acceptable collateral. Please
select the type of collateral your company will pledge to secure the IEDA financing, and document its value
in Attachment A5. *
5.
No collateral, funding disbursed at the end of the 5 -year contract
Source of Funds
Explain:
•
N/A
Irrevocable letter of credit
•
Sales, Service & Use Tax Refund
Dedicated certificate of deposit (CD)
•
Research Activities Credit (3 %/10 %)
Surety bond
•
Local Property Tax Exemption
Mortgage on real estate
•
Tax Increment Financing
Corporate guaranty
•
260E Job Training Funds
Personal
•
In -kind Contribution
guarantee
* The IEDA Board has the final discretion on what collateral will be accepted.
Iete the chart below with tax credits and other indirect financing expected for the project:
ricaac �viiiN
TAX CREDITS AND INDIRECT FINANCING
Source of Funds
Amount
Description
Investment Tax Credit
74,400
HQJP program
Sales, Service & Use Tax Refund
72,000
Sales tax rebate
Research Activities Credit (3 %/10 %)
Local Property Tax Exemption
Tax Increment Financing
580,000
10 yr Prop Tax Refund
260E Job Training Funds
48,000
NICC training contract
In -kind Contribution
Other
TOTAL
$ 774,400
6. There are three justifiable reasons for providing assistance. Check the box next to the reason why
assistance is needed to complete this project.
® Financing Gap - A gap exists between the financing required and the financing on -hand and the provision of
tax incentives or assistance is necessary to fill the gap.
® Rate of Return Gap —The likely returns of the project are inadequate to motivate a company decision maker to
proceed with the project even if sufficient debt or equity can be raised to finance the project, and the project's risks
outweigh its rewards, making the provision of tax incentives or assistance necessary to reduce the project's risks.
❑ Location Disadvantage (Incentive) —The business is deciding between a site in Iowa ( "Iowa site ") and a site
in another state ( "out -of -state site ") for its project and the cost of completing the project at the out -of -state site is
demonstrably lower, making tax incentives or assistance necessary to equalize the cost differential between the
two sites. Note: The authority will attempt to quantify the cost differential between the sites.
7. Please provide a brief explanation of the need for assistance.
In order to develop powder coating operations to avoid taking the work to Illinois for processing and to offer these
services to other area manufacturers who also take this work out of state, the company will need to create
additional manufacturing space, purchase equipment and hire staff. However, an analysis (see Business Plan) of
this project suggests that it will take a couple of years to generate positive financial results. Once the process
becomes operational, area manufacturers will have a local option for their powder coating needs.
TSQM has begun to expand its marketing area to Wisconsin and Illinois where it has had success competing with
local manufacturers in these areas. However, TSQM is operating at capacity and needs to expand to be able to
take advantage of these out of state opportunities.
SECTION D
IEDA— Business Financial Assistance Application 7 v.01.23.2013
Employee Benefits
There are three options to meeting the sufficient benefit requirement. These options are detailed in the chart
below. Please complete questions 1 -3. If your company meets Option 1 or 2 no additional information is
required If you would like to utilize Option 3, please also complete questions 4 -6.
1. How many full -time, permanent employees does your company currently employ within the State of Iowa? 12
2. What is the total premium cost for a standard medical plan for single employee coverage? $ 4332 (1)
a. What portion of this cost is paid by the business? 65.1 %
b. What is the deductible associated with this plan? $ 1,500
3. What is the total premium cost for a standard medical plan for family coverage? $ 12,647 (2)
a. What portion of this cost is paid by the business? 65.1 %
b. What is the deductible associated with this plan? $ 1,500
No additional information required, in this section, if your company meets the requirement for Option 1 or Option 2
4. Does your company provide additional benefits to full time employees? Yes ❑No
If es lease provide the annual amount offered by the business, per employee in the chart below:
Y p
Benefit
Option 1
Option 2
Option 3
80% single Coverage
50% Family coverage
Monetary Equivalent
Total Number of
Employees in
Iowa
Pay 80% of premium costs
for a standard medical plan,
single coverage.
Pay 50% of premium costs for
a standard medical plan,
family coverage.
Provide medical and pay the
monetary equivalent of Option
1 or Option 2 in supplemental
employee benefits.
Benefits Counted Toward
250+
$750 maximum deductible
$1,500 maximum deductible
50 -249
$1250 maximum deductible
$2500 maximum deductible
Monetary Equivalent: Medical
0 -50
$1750 maximum deductible
$3500 Maximum deductible
coverage, Dental coverage,
Vision insurance, Life
insurance, Pension, 401(k)
(company's Average
contribution, Short -Hong -term
disability insurance, Child care
services, Other nonwage
compensation
1. How many full -time, permanent employees does your company currently employ within the State of Iowa? 12
2. What is the total premium cost for a standard medical plan for single employee coverage? $ 4332 (1)
a. What portion of this cost is paid by the business? 65.1 %
b. What is the deductible associated with this plan? $ 1,500
3. What is the total premium cost for a standard medical plan for family coverage? $ 12,647 (2)
a. What portion of this cost is paid by the business? 65.1 %
b. What is the deductible associated with this plan? $ 1,500
No additional information required, in this section, if your company meets the requirement for Option 1 or Option 2
4. Does your company provide additional benefits to full time employees? Yes ❑No
If es lease provide the annual amount offered by the business, per employee in the chart below:
Y p
Benefit
Annual amount paid by the
business (per employee):
Dental Insurance — Single plan
65.1%
$ 83 .
Dental Insurance — Family plan
65.1%
$ 658 (3)
Pension (Use 3 -year average calculated below)
Retirement Plan - i.e. 401(k) (Use 3-year average calculated below)
Simple IRA 3%
$ 1,078 (A)
Profit Sharing Plan (Use 3-year average calculated below)
Childcare Services
Life Insurance coverage
Disability Insurance coverage
Health Savings Account (HSA) contribution
TOTAL
$ 2,019 .
(A)
ear
2010 0 0 0 — New (None Eligible)
2011 3 3,431 1,144
2012 8 8,085 1,011
1,078
5. Does the Business offer a pension plan, 401(k) plan, and /or retirement -plan? ® Yes ❑ No
FDA Business Fina
sist mce ApplicatiG n v.01.23.2013
If yes, please indicate the amount contributed on a per employee basis by the Business to the plan for the last three
years. For 401(k) plans, please provide information on the company match and indicate the average annual match per
employ
y Year Ending
Average Actual Match per
Employee ($)
2010
$ 0
2011
$ 1,144
2012
$ 1,011
Three- Two -year Average:
$ 1,078
(4)
6. Does the Business offer a profit- sharing plan? ❑ Yes ® No
If yes, please indicate total amount paid out each year for the past three years and then, determine the average annual
bonus or contribution per employee for that three year period.
Year Ending
Average Actual Share per
Employee ($)
Job Title
$
Starting
Hourly Wage
$
Operator — Paint Line
$
Three -year Average:
$
Notes:
1. A qualified plan must be offered to all full -time permanent employees.
2. if you have multiple health insurance plans, please provide information on each plan.
(1) United Healthcare plan cost is rated by age of employee. The amount reported is the average paid for
all single plan participants.
(2) United Healthcare plan cost is rated by employee and spouse age and number of dependents covered.
Plan offers participation of spouse and children separately. The amount reported is the average paid
for each employee participating at a level above the single plan option.
(3) "Family" dental plan allows for different levels of participation including employee /spouse
employee /children and employee /souse /children. The amount reported is the average of ail
employees participating at a level above the single plan option.
(4) Year Company formed. No eligible employees due to 1 year waiting period.
Project Jobs
SECTION E
1. List the jobs that will be created and /or retained as the result of this project. (A retained job is an existing job that
would be eliminated or moved to another state if the project does not proceed in Iowa.) For jobs to be created,
include the starting and final hourly wage rate. For retained jobs, include the current hourly wage rate.
Full -Time CREATED Jobs
(Add additional rows as needed)
Job Title
Number of
CREATED Jobs
Starting
Hourly Wage
Wage at 36 months
following the award
Operator — Paint Line
2
14.00
16.00
Sprayer- Paint Line
2
13.00
15.00
Brake Operator
2
14.00
17.00
Shop Supervisor
1
22.00
23.00
Operator — Laser
1
15.00
18.00
Laborer
2
11.00
14.00
Total Full -Time CREATED Jobs
10
s Fir
5sisfance ipp!ication 9 v_01.23.2013
CONFIDENTIAL
IEDA — Business Financial Assistance Application
10 v.01.23.2013
SECTION G
Attachments
Please attach the following documents:
Al Project Plan
Please provide an executive summary for your project. This information should include, at a minimum,
expanded information about the company's products and services and any other project related information
that has not already been described in the application for financial assistance.
Please note, a traditional business plan, including an executive summary, market analysis, organization and
management structure, marketing and sales management, service and product line narrative, financial
projections, feasibility study and patent status, as well as any other relevant information, may be requested by
the Iowa Economic Development Authority to evaluate the feasibility of this project.
A2 Payroll Information (Confidential)
• Copies of the Business' Quarterly Iowa Employer's Contribution and Payroll Report for the past
year. This report should include the monthly employment totals.
• A copy of the most recent payroll report for one pay period. The copy of the most recent payroll
report for one pay period must be in Excel format and include the following information:
o Company name, date of payroll and source of payroll information
o Employee name and /or employee identification number
o Current hourly wage - do not include bonuses or other benefit values
o Indicate if the employee is full time (40 hours per week, 52 weeks per year) or part time.
o A sample Excel spreadsheet can be found at
http: / /iowaeconomicdevelopment .com /BusinessDev /application
A3 Affidavit that states the Business has not, within the last five years, violated state or federal statutes, rules,
and regulations, including environmental, worker safety regulations and antitrust laws, or, if such violations
have occurred, that there were mitigating circumstances or such violations did not seriously affect public health
or safety or the environment. A sample affidavit can be found at
http: / /iowaeconomicdevelopment .com /BusinessDev /application
A4 Financial Information (Confidential, unless already publicly available) (Existing Businesses Only)
• Profit and loss statements and balance sheets for past three year -ends;
• Current YTD profit and loss statement and balance sheet;
• Schedule of aged accounts receivable;
• Schedule of aged accounts payable; and
• Schedule of other debts.
A5 Collateral documentation (If requesting direct financial assistance only)
Enterprise Zone Supplement —
EZ -1 Application Supplement for Enterprise Zone applications only
1. Enterprise Zone detail:
a. In which Enterprise Zone will this project occur (include the zone's name, number, size in acres,
and date certified)?
b. Please list any additional requirements adopted by the local Enterprise Zone Commission and
how the Business will meet each requirement
2. The following documentation must also be submitted:
a. Legal description of the business site on which the project will occur
b. Detailed map (no larger than 11"x17") showing the business site in relation to the boundaries of the
certified Enterprise Zone
c. Proof that the local Enterprise Zone Commission meeting, during which this application was approved,
was open to the public (i.e. public notice which was published and /or posted)
IEDA — Business Financial Assistance Application
11 v.01.23.2013
d. Meeting minutes from the local Enterprise Zone Commission meeting, during which this application was
approved
e. Resolution by the local Enterprise Zone Commission approving this application
SECTION H
Certification & Release of Information
1. Are there any judgments or court actions completed or pending against the applicant entity, or any current or
prospective officer, principal, director, or owner? El Yes ® No
2. Has any current or prospective officer, principal, director, or owner been accused or convicted of any wrongdoing or
crime, other than a simple misdemeanor? ❑ Yes ® No
3. Have there been any current or past bankruptcies on the part of the applicant entity (or predecessor entities), or on
the part of any current (or prospective) officer, principal, owner or in any business dealings of current (or
prospective) officers, principals, or owners of the applicant entity? ❑ Yes ® No
4. In the last five years have there been, or are there currently any investigations of potential violations of public
health, safety (including workplace safety) or environmental laws by the applicant entity, or any current or
prospective officer, principal, director, or owner? ❑ Yes ® No
5. In the last five years have there been, or are there currently any violations of antitrust laws by the applicant entity,
or any current or prospective officer, principal; director, or owner? ❑ Yes ® No
6. If yes to any of the above, please provide additional explanation:
I hereby give permission to the Iowa Economic Development Authority (IEDA) to research the Business' history, make credit checks,
contact the Business' financial institutions, insurance carriers, and perform other related activities necessary for reasonable
evaluation of this application. I also hereby authorize the Iowa Department of Revenue to provide to IEDA state tax information
pertinent to the Business' state income tax, sales and use tax, and state tax credits claimed.
I understand that all information submitted to IEDA related to this application is subject to Iowa's Open Record Law (Iowa Code,
Chdpter 22), unless specifically marked as confidential section.
I understand that IEDA reserves the right to negotiate the financial assistance.
I understand this application is subject to final approval by IEDA and the Project may not be initiated until final approval is secured.
Furthermore, 1 am aware that funds will not be disbursed until a contract has been executed and the appropriate terms have been
met.
I hereby certify that all representations, warranties, or statements made or fumished to IEDA in connection with this application are
true and correct in all material respect. I understand that it is a criminal violation under Iowa law to engage in deception and
knowingly make, or cause to be made, directly or indirectly, a false statement in writing for the purpose of procuring economic
development assistance from a state agency or subdivision.
For the Business:
For the Sponsor(s):
Gary Wilminq, Member
Name and Title (typed or printed)
Date Signature / Date
Roy Buol, City of Dubuque Mayor
Name and Title (typed or printed)
Please use the following if more than one sponsor is required. (For example, use this if a signature from the local
Enterprise Zone Commission is required in addition to the signature from the Mayor of the sponsoring city.)
Signature
Date Name and Title (typed or printed)
IEDA — Business Financial Assistance Application
12 v.01.23.2013
IEDA will not provide assistance in situations where it is determined that any representation, warranty, or statement
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