2009-088-RES-Approving application for water supply for commercial dairyRESOLUTION NO. 2009-088
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS, TEXAS;
APPROVI111G AN APPLICATIOIV FOR FUNDING THROUGH THE TEXAS
DEPARTMENT OF AGRICULTURE, OFFICE OF RURAL COMMUNITY
AFFAIRS FOR THE TEXAS CAPITAL FUND IIVFRASTRUCTURE GRANT
PROGRAM FOR INFRASTRUCTURE IMPROVEMENTS TO PROVIDE A
SUPPLY OF TREATED WATER FOR A COMMERCIAL DAIRY OPERATION
LOCATIIVG IN LAMAR COUNTY, TEXAS; AUTHORIZING THE EXECUTIOIV
OF ANY AND ALL DOCUMENTS NECESSARY FOR ACCEPTANCE AND
IMPLEMEIVTATION OF SAID GRANT UPO1V 1VOTICE THEREOF; MAKIIVG
OTHER FINDIIVGS AND PROVISIONS RELATED TO THE SUBJECT; AND
DECLARING AN EFFECTIVE DATE.
WHEREAS, the Texas Department of Agriculture/Office of Rural Community Affairs
through the Texas Capital Fund infrastructure grant Program provides funding for
infrastructure projects, and the City of Paris wishes to apply for up to $1,000,000 of grant
funds to provide infrastructure improvements to provide a supply of treated water from
the City's treated water system to a commercial dairy operation locating in Lamar County,
Texas; and,
WHEREAS, on August 24, 2009, following notice and publication as required by law,
the City Council of the City of Paris conducted a public hearing on the proposed submission
of an application to the Texas Department of Agriculture/Office of Rural Community
Affairs, Texas Capital Fund (TCF) Infrastructure Grant program for funding infrastructure
improvements to provide a supply of treated water from the City of Paris to Daisy Farms, a
new commercial dairy farm to locate in Lamar County, Texas, and having considered the
recommendations of staff and the testimony and evidence introduced at said public
hearing, found and determined that approving the aforesaid grant application would be in
the best interests of the citizens of the City of Paris.
WHEREAS, The City Council of the City of Paris is desirous of processing an
application to the Texas Department of Agriculture/Office of Rural Community Affairs for
the Texas Capital Fund (TCF) Infrastructure Grant Program in the amount of $1,000,000.00
to fund infrastructure improvements for a commercial dairy operation locating in Lamar
County, Texas and the City Manager should be authorized to execute any and all documents
necessary for acceptance and implementation of said grant upon notice thereof.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY
OF PARIS, TEXAS, THAT:
Section 1. The findings set out in the preamble to this resolution are hereby in
all things approved.
Section 2. The submission of an application to the Texas Department of
Agriculture, Office of Rural Community Affairs Texas Capital Fund Infrastructure Grant
Program be, and the same is hereby approved to provide infrastructure improvements for
a commercial dairy farm to locate in Lamar County, Texas, in the amount of $1,000,000.00
with $940,000.00 to be for the infrastructure project and $60,000.00 for the administration
of said grant.
Section 3. The City of Paris agrees to comply with all commitments and
assurances set forth in the grant application and, if funded, the award, and the City
Manager of the City of Paris be, and he is hereby authorized and directed to execute on
behalf of the City of Paris, an application for said grant.
Section 4. The City Engineer be, and he is hereby appointed as Project Director
and is hereby authorized and directed to execute and deliver, on behalf of the City of Paris
all reports, communications, assurances, and documents necessary for the completion of
said project.
Section 5. That the Director of Finance be, and he is hereby, authorized and
directed to serve as the Financial Officer for said project and to receive and distribute funds
for said infrastructure project.
Section 6. That the City Mayor, City Manager, the City Engineer and Finance
Director be authorized and directed to execute, on behalf of the City of Paris, and and all
documents necessary for acceptance and implementation of said grant upon notice of
award thereof by the Texas Department of Agriculture under the terms and conditions and
in the forms approved by the Ciry Attorney, and to proceed with the use of said funds upon
receipt thereof for purposes stated herein and in accordance with the grant conditions.
Section 7. The City has reviewed and hereby agrees not to participate in
program income recapture and will return all program income to the state to be placed in a
statewide Revolving Loan Fund to be used by the state to fund future economic
development awards. By agreeing to this measure, the City understands that it will be
eligible to receive as many Texas Capital Fund awards per program year as it has eligible
projects.
Section B. This resolution shall be effective immediately upon passage.
AYES: 7 NAYES: 0_ ABSENT:
DULY PASSED AND APPROVED this 24th day of August, 2009.
ATTEST:
. r
ice Ellis, City Clerk
APPROVED AS TO FORM:
,/aa
W. Kent Mc yar, ' Attorney
sse Jam Freelen, Mayor
Texas Capital Fund
Real Estate and Infrastructure
Application
Program Year 2009
Texas Department of Agriculture
1700 N. Congress
P.O. Box 12847
Austin, Texas 78711
2009 Page 1 of 55 1-30-09
Application/Review checklist for Texas Capital Fund
Infrastructure & Real Estate Development Programs
The following items must be included in the application in the order in which they are listed, and all documents must be originals.
Only one complete application should be submitted in a three-ring binder with tabs identifying each section. All documentation
must be placed in the appropriate section Failure to comply mav result in loss of application points, unnecessarv delav of
evaluation of the application and/or a more extensive deticiencv letter.
If the application is found to be substantially incomplete it will be denied without further consideration. Scores are reviewed and
finalized based on information contained in the application on the due date. Information and/or documentation received after the due
date will not be considered for scoring purposes. Applications in the funding range that have deficiencies will be given 10 business
days to satisfy those deficiencies before the evaluation process is continued. Failure to respond to deficiency requests may result in an
application being denied.
a indicates information that should generally be prepared/submitted by the applicant & the business(es)
b indicates information that should generally be prepared/submitted by the business(es)
~ indicates information that should generally be prepared/submitted by the appiicant
Applicant
use
TEXAS CAPITAL FUND
For Department
use only (All pages referenced are in the Application unless otherwise noted) Initial if
complete
A lication Contents NA if not
Complece Incomplete PP a (icable
D.o4n4inn nf Annl:ro+inn "
~N
1. Originals only
2. A lication resented in a three-rin binder with divider tabs
3. The following documentation must be laced in the immediate front of the binder:
a. A lication/Review checklist executed b business and a licant
b. Score Sheet - see a e 8 for 2009 version
c. All documentation to su ort the score ou claim in each cate o
Section A - Pro'ect Summaries °
1. A lication Information - see a e 9
2. Pro'ect Information - see a e 14
Section B- Employment Forms/Letters and Low and Moderate Income (LMI) Documentation b
Must be rovided b each business in "multi le business" a lications.
Y
1. Em loyment Forms
a. Em lo ment Pro'ections Form - see age 16
b. Job commitment letters from business(es) - see sam le pa es 17 and ] 8
c. Documentation to su ort 'ob retention
2. Low and Moderate Income (LMI) Documentation
a. Family Income/Size Certi acation form for created and/or retained jobs - see a e 19
b. Documentation to sup ort low/moderate income beneficiaries through census information.
Co..+;.,., f_ C.r..oe anrl TTePC anrl Rndaet inctifieatinns a
1. Sources and Uses of Funds Form and instructions - see ages 20 & 21
2. Budget Justifications (see Guidelines)
(All items listed below are required Tor 1Lr aoiiars requestea, matcn mjecL,u«, auu cyu,Ly 111je.,«G,,,
unless otherwise noted.) _
a. Land or building acquisition, building construction and/or improvements, or real estate
Appropriate value documentation of property
(i.e. current county tax appraisal or 3`d pariy state certified
Applicant
TEXAS CAPITAL FUND
use
For Department
Use only
(All pages referenced are in the Application unless otherwise noted)
tnitial if
complete
A lication Contents
PP
NA if not
a licable
Comple[e Incomplete
2. Lien Search (for e uity value documentation only)
3. Required documentation on unimproved land purchased no more than 90 days prior to the
application due date: i.e. canceled checks, settlement statements, receipts (match value only)
see Guidelines
4. Complete lep-al description _
b. En ineerin /Architectural Services
1. Descri tion of services and related costs
2. Name of individual/firm who re ared the 'ustification, date of reparation & engineer's seal
c. Infrastructure
1. Quantity/size
2. T e of material
3. Labor costs must include Davis-Bacon wage rates (if TCF funded)
4. Statement for minimum im rovements
5. Name of individuaUfirm re aring statement, date, & engineer's seal
6. Transcribed locations of each length of infrastructure to include To, From, Along, &
Distance in linear feet (see in Guidelines)
7. Sunnort Information for Infrastructure Projects - see pages 22-23
d Buildin Construction/Rehabilitation
1. Size of buildin and s ecifications
2. Itemized material/construction activity costs
3. Descri tion of construction/rehabilitation activities
4. Labor costs must include Davis-Bacon wage (if TCF funded)
5. Architectural and/or en ineerin costs and name of individuaUfirm
e Machiner and E ui ment (match onl )
1. T e and descri tion
2. Itemized rice/value listin for new urchases
3. A ro riate market value for existing MB (for e uit value only)
a. Itemized market value list for existin M/E
b. Invoice if urchased less than 1 ear revious to a lication
c. 3` party value appraisal with credentials (dated less than 1 year)
4. Required documentation on existing machinery & equipment; i.e. canceled checks, invoices,
and receipts. (see Guidelines)
5. Lien search (for eauitv value only)
£ Workin Capital (match only)
1. Description (inventory, salaries, o erational costs, etc.)
. Administration Costs
For Department
Use only
Complete Incomplete
EXAS CAPITAL FUND
(All pages referenced are in the Application unless otherwise noted)
Application Contents
Applicant
Use
lnitiat it'
complete
NA if not
a licable
Color Coded Infrastructure Site Plan/Map - With Key, drawn to scale, identifying
3
.
public/private infrastructure improvements (if applicable), (see Guidelines)
drawn to scale, identifying improvements and location
Color coded Project Site Plan - With Key
4
,
.
of all businesses and buildings benefiting from the improvements AND/OR site survey (if existing).
(see Guidelines)
5. Area Ma , drawn to scale, showing project site location in community (see Guidelines)
6. Business Financial Commitment Letter (see age 24 & Guidelines) All businesses.
7. Business Verifcation of De osit(s) (see a e 25 & Guidelines) All businesses.
8. Lender Commitment Letter (see age 26)
9. Other Financial Commitment Letter/Resolution
10. Other verification of De osit(s)
licant - Provide a letter addressing the inability to fund the project citing
Letter From A
11
pp
.
cnecific reasnns_ _
Section D- Business Plan b- see Appendix C
Must be provided by each business in "multiple business" applications.
Please have company provide detailed information on all business plan topics. A lack of adequate
information will result in a deficiency for that topic.
(include information on business strengths and business weaknesses, iegai
siness Histor
B
1
y
u
.
structure, owners, etc.)
t/Serv ices (include information on business strengths and business weaknesses, legal
2
P
d
uc
.
ro
structure, owners, etc.
total market, target market, competition, the
ket (include information on product demand
M
3
,
ar
.
niche of the business, etc.)
physical facility, area labar market, suppliers,
rations (include information on location
4
O
,
pe
.
employee training requirements, regulatory requirements, etc.)
(include information on how the business intends to market product, promotions,
tin
k
M
5
g
ar
e
.
advertising, distribution channels, customer conveniences, etc.)
6. Mana ement history and Or anization Chart
7. Descri tion of Proposed TCF Project
8. Business References
t include a resume for each person with 20 percent or more ownership and the
M
R
9
us
esumes (
.
management team.
its owners or majority stockholders own a 20 percent
our business
"Does
t
i
,
y
o
tten response
10. Wr
h
i
hi
your
p w
t
interest or mare in another business?" If yes, provide their names and relations
business along with the last fiscal year end's balance sheet and operating statement for each.
or use the services )f any concern in which someone in
sell to
ou bu
"D
t
,
y,
o y
o
ll. Written response
hi
i
l
d
"
ons
p
re
at
If yes, provide the name9s) an
your business has a significant financial interest?
with your business along with the last fiscal year end's balance sheet and operating statement for
earh
Section E- Business Financial Information b
_ _ ..a,.a ,.,.,.w ti..,q;,,a~~ «,,,,,lr;,,le hncinPSS" annlications
1V1UJL UG 1VV ILLGU V Vn- UuJUv..aaa -
1. Last three year's finaneial statements
2. Last three year's tax returns, unless audited financial statements provided
3. Interim financial statement, dated within 90 days of a lication submission
4. Schedule of Debt to match interim financial statement (see age 27)
: quarterly cash flow and income for three years, plus
the followin
l
d
i
g
u
e
nc
5. Projections (must
assumptions/notes) (see pages 28 - 29)
6. Break-even analysis if business has been o erating for less than 3 years
7. Provide total salary amounts, location as resented in financial statement and rojections
For Department TEXAS CAPITAL FUND
L1se onty (All pages referenced are in the Application unless otherwise noted)
Complere Incomplete I Application Contents
Applicant
Llse
Initial if
complete
NA if not
aoolicable
~oecnon r- r inanciai inrormauon ui rriuc►pai .,w.tci n
(A lies to all rincipals and s ouses with a 20% ownershi interest or more)
>
r_r 1. Authorization to Investigate Credit and Disclosure Form - Individual (see page 31)
2. Current Personal Financial Statement, include s ouse (see pages 32 - 33)
3. Most recent federal income tax return
Section G- Business Structure b
Mnct hP nrnvirled hv ear.h husiness in "multinle business" 3DUI1C2t10riS
-
1. Cor orate Resolution (identi ing authorized individuals)
2. Cor orate Charter, Articles of Incor oration & Incor oratin By-laws
3. Cor orate/Partnershi Disclosure Form (see age 30)
4. Certificate of Good Standing from Com troller's Office
5. Assumed Name Certificate (dba form)
6. Partnershi Agreement
Section H- Applicant Representations and Forms `
1. A licant Resolution (see a e 34)
2. Executed Certifications
a. General Certifications (see a e 35)
Certification Regarding Lobbying for Contracts, Grants, Loans, and Cooperative Agreements
b
.
(see page 36)
3. i,ncal Citizen Comnlaint Procedures (see sample pages 37-40 & Guidelines)
Section I- Public Hearing/Notice `(see Guidelines )
1. Public Hearin Notice ublishers affidavit or tear sheet)
2. 2" Public Notice ( ublishers affidavit or tear sheet)
3. Listin of local or anizations notified of ublic hearin
Cnnt:nn T_ Annliranf Finanrials and Ruduet c
1. Communit Needs Assessment Questionnaire (see a e 41)
2. Most recent audited tinancial statement
3. Current year fiscal o eratin bud et w/ado tion resolution
Co..+:.... Y_ Urnrtram TnrnmP antl Fair RnncinQ c
v.......,.. . -
1. Pro ram Income Re ort (see age 42)
2. Fair Housin Activities Re ort (see age 42)
Section L- Disclosure Report ` with instructions (see pa es 43-47)
Applicant
use
TEXAS CAPITAL FUND
For Department
Use Only (All pages referenced are in the Application unless otherwise noted) Initial ir
complete
A lication Contents NA if not
PP applicable
Additional Items for Real Estate Development ProEram
Section M - Acquisition °
Earnest Money Contract for the proposed land and/or building that will be acquired with TCF
monies. This contract should be assignable or transferable to the Applicant, if initiated by another
entity.
Section N- Shared Ownership of Real Estate `(see Guidelines) Since the TCF program may not
provide sufficient funds far the needed real estate, a local economic/industrial development
organization may share in the ownership, if they provide a portion of the funding. In this case
rovide the following information for such organization.
1. Resolution by organization authorizin contribution/partici ation
2. Articles of Incorporation and By-laws - these must show ability to engage in economic
develonment activities
3. Evidence of financial ability/commitment, if not provided in Section C I I
Section O- Survey of Other Vacant Buildings ` Applicant must identify any other available
commercial buildings in the community and document suitability for business. This should include
size of building, location, type of structure, amenities, etc.
We, as applicants of the Texas Capital Fund, Certify that the information, exhibits, and schedules contained herein are true and
accurate statements, and represent fairly the financial condition as of the date stated herein:
Citv/Countv
Jesse Freelen
Typed or Printed Name
Signature
Ma or
Local Government Title
Date
Business(es)
Typed or Printed Name
Signature
Business Title
Date
Business(es)
David Sokolsk
Typed or Printed Name
Signature
Mana er
Business Title
Date
Typed or Printed Name
Signature
Business Title
Date
2009 Texas Capital Fund Application Scores
Name of Applicant
PLACE SUPPORT DOCUMENTATION IMMEDIATELYBEHIND THIS FORM. Support documentation must be
submitted or veri ecation ur oses otherwise the cate o will be scored 0.
,
Proposed
Communi Distress/Need (Max 40 Points)
Score
Unemployment Rate: Applicant's most recently available quarterly (most recent 3 months averaged)
counry rate. Score 5 points if this figure meets or exceeds the state average for the same time frame.
0
(Maximum 5 points)
Poverty Rate: Applicant's annual county poverty rate for individuals (from 2000 Census) is 16.35% .
Scare 5 points if this figure meets or exceeds the state average of 15.4%. Score 10 points if this figure
5
exceeds 17.7%. (Maximum 10 points)
Awarded Contracts: Score 10 points if the community has been awarded zero TCF contracts in the current
0
or the recedin 2 calendar years.
Community Size: Points are awarded to applying small cities and counties using 2000 census data. For
cities: score 5 points if the city is located in a county with a population of 35,000 or less; and score 5
0
additional points if the population of the city is less than 5,000. For counties: score 5 points if the county
population is less than 35,000 and score 5 additional points if the county population is less than 15,000.
Community population figures are net of the population held in adult/juvenile correctional institutions.
(Maacimum 10 points)
Per Capita Income: Award 5 points to applicant's that have a per capita income level below the state
S
average of $19,617, using 2000 Census data. (Maximum 5 points)
Jobs ax:35 oints
Job Impact: Business's (all businesses combined) job commitment, created &/or retained, 179 divided
by applicant's 2000 population 25,885 = job impact ratio .0069 . Score 5 points if this figure exceeds
S
.00485; score 10 points if this figure exceeds .00969 and score 15 points if this figure exceeds .01455.
(Maximum 15 points)
Cost per job: The total amount of the TCF award is $ 1,000,000 , including administration, divided by the
total number of jobs created/retained by all businesses 179 = Applicant's cost per job $ 5,586 . Score 10
10
points if the cost per job is less than $15,000; and score 5 points if the cost per job is less than $20,000.
(Maximum 10 points)
Wage Impact: Awarded by taking the business' average weekly wage commitment, for all jobs proposed to
be created and retained, and dividing by applicant's most recent county, quarterly, private sector average
10
weekly wage. Score 5 points if this figure exceeds 0.50 and score 10 points if this figure exceeds 0.60.
(Maximum 10 points)
Economic Em hasis (Max 25 points)
Primary Jobs: Awarded if the jobs to be created/retained are or will be employed by a benefiting businesses
with the following primary NAICS codes. This is based on the code reported on the business's Texas
20
Workforce Commission (TWC) Quarterly Contribution Report Form C-3, their Business IRS tax return, or
other documentation from the TWC. In a multi-business app, the majar employer's NAICS code determines
the eligible points. 20 points for NAICS category 31-33 Manufacturing
15 points for the followin NAICS cate ories:
I I I Crop Production
42 Wholesale Trade
112 Animal, milk, poultry & egg production
48-49 Transportation/Warehousing
113 Forestry/Logging
51 Information (excluding 512-theaters)
114 Commercial Fishing
5182 Data Processing, Hosting, & Related
115 Support Activities-Agriculture/Forestry
Services
21 I-213 Mining
62 Health Care
5 points for projects involving non-primary jobs, when the business offers a choice of inedical and
prescription drug benefits to employees, including covera e for the family
Small/HUB Businesses: Score 5 points if each benefiting business (in a"multiple business" application)
employs less than 100 people OR has been certified by the Texas Building and Procurement Commission
0
(TBPC) as a Histarically Underutilized Business (HUB). Provide current employee count for any/all
locations combined and related businesses (Max 5 points)
TOTAL SCORE (A minimum threshold score of 25 points is required)
nn nn • i~_ n..
SS
7.J,.1'..
Details for the individual score categories and resources may pe rouna on pages co-co I~ Li lC GuidCll, es.
2009 Page 7 of 55 1-30-09
APPLICATION INFORMATION FORM
TRACKING #
APPLICANT 1NFORMATION
Locality Name CITY OF PARIS
11 Digit Texas I.D. #
756000635
'PHYSICAL ADDRESS
Address (No P.O. Box)
135 S. E. lg` Street
City
State
Zip
County
Paris
TX
75460
Lamar
MAILING ADDRESS
Q
P.O. Box
0
Same
~
H
U
City
State
Zip
County
W
~
Short Description of Project: Construction of water line
Fiscal Year End 9/30
improvements to benefit Daisy Farms in Paris, Lamar County,
Texas.
Type of Project
Infrastructure z
Real Estate ❑
Infrastructure and Real Estate ❑
CHIEF
ELECTED OFFICIAL
Z Mayor.
First Name
M. I.
Last Name
❑ Judge
Jesse
Freelen
Primary Phone
(903) 784 - 9202 Ext.
Secondary Phone (optional)
Fax (optional)
Ext.
(903)785 - 8519 Ext.
z
0
F
Date of term expiration:
5/10
~
~
E-mail address required
Would you prefer to be contacted by E-mail?
kcarruth(-paristexas.gov
Z Yes ❑ No
'MAILING ADDRESS
Address
135 S. E. 15L Street
City
State
Zip
County
Paris
TX
75460
Lamar
2009 Page 8 of 55 1-30-09
LOCALITY CONTACT
E Mr. F~ MrS
First Name
M. I.
Last Name
❑ Ms. ❑ _
Kevin
Carruth
Title
Primary Phone
City Manager
(903) 784 - 9202 Ext.
v
Secondary Phone (optional)
Fax (optional)
z
( ) - Ext.
(903) 785 - 8519 Ext.
O
H
E-mail
Would you prefer to be contacted by E-mail?
W
~
kcarruth@paristexas.gov
E Yes ❑ No
MAILING ADDRESS
Address
same
City
State
Zip
County
' PREAWARD PERSON TO' CONTACT
~Mr. E Mr5.
First Name
M. L
Last Name
❑ Ms. ❑ _
Kim
A
Lacey
Title: Consultant
Primary Phone
E
Company name : Municipal Development Services
xt.
(972) 564 - 9298
A
Secondary Phone (optional)
Fax (optional)
z
(903) 715 - 2719 Ext.
(903) 782 - 9473 Ext.
~
E-mail
Would you prefer to be contacted by E-mail?
W
huehes.net
kimalacevn
~ Yes ❑ No
~
,
MAILING ADDRESS
Address
Same
City
State
Zip
County
FINANCE DIRECTOR
E Mr. ❑ Mrs.
First Name
M. I.
Last Name
❑ Ms. ❑ _
Gene
Anderson
Title
Primary Phone
Finance Director
(903) 784 - 9241 Ext.
W
Secondary Phone (optional)
Fax (optional)
z
( ) - Ext.
(903) 785 - 8519 Ext.
O
F~
E-mail
Would you prefer to be contacted by E-mail?
W
~
gandersonaparistexas. gov
~ 1'es ❑ No
MAILING'-ADDRESS
Address
same
City
State
Zip
County
` LEGISLATIVE NOTIFICATION 1NFORMATION DISTRICT NUMB
ERS
U. S. Representative
District #
telephone numbers: Washington Off- Regional Off-
State Senator
telephone numbers: Austin Off- Regional Off-
w
z
State Representative
0
~
h
W
elephone numbers: Austin Off- Regional Off-
V-1
State Representative
telephone numbers: Austin Off- Regional Off-
State Representative
telephone numbers: Austin Off- Regional Off-
r,,..,..io+o .,..o ..~..o fnr naeh hncinPCC in a«mnltinle husiness" annlications.
BUSINESS TYPE'
Please provide the following information on all the Operating Business(es) that will createhetain jobs and meet the LMI
goals for this Texas Capital Fund project.
Is the operating business: E Existing ❑ To be established. When?
E Corporation
❑ Limited Liability Co.
❑ Limited Partnership
❑ General Partnership
❑ Sole Proprietorship
~
Type of Business: PrimarY NAICS/S1C code of business:
z
o
' BUSINESS INFORMATION
V
Full legal business name (owner's name if sole proprietor - no aliases)
~
Daisy Brand, Inc.
D.B.A. (if applicable)
Federal Taxpayer ID No.
DL1N's Number (required)
Physical Location of Project:
Census Tract:
Block Group:
PERSON TO CONTACT (Business)
~ Mr. R Mrs.
First Name
M. I.
Last Name
❑ Ms. ❑ _
David
Sokolsky
x
Title
Primary Phone
z
Owner
( ) - Ext.
O
U
Secondary Phone (optional)
Fax (optional)
( ) Ext.
_
( ) Ext.
W
~
E-mail
Would you prefer to be contacted by E-mail?
dsokolsky(d)daisvbrand.com
~ Yes ❑ No
MAILING ADDRESS
~
z
Address
O
~
W
City
State
Zip
County
~
JOB CREATION 1NFORMATION`
Total number of jobs to be created
179
z
0
Total number of jobs to be retained
o
E~
W
Total number of Low and Moderate Income jobs to be created
90
~
Total number of Low and Moderate Income jobs to be retained
0
SIGNATURES
The applicant and business(es), by and through their agent's signatures below (1) certify that all information provided in
connection with this application at any time is true and correct to the best of their knowledge; (2) acknowledge that any
misrepresentation or false statement made in connection with this application, whether intentional or not, will constitute
grounds for denial, pursuant to this application and/or assessment of monetary administrative penalties. If signed by an agent
(including employee) of the applicant or business(es), the person signing certifies that he or she is authorized to make the
preceding certifications.
Chief Elected Official (Printed Name)
Title
Jesse Freelen
Mayor
Applicant Signature
Date
x
Month day year
~
Business Representative (Printed Name)
Title
E,
David Sokolsky
Manager
U
~
Business Representative's Signature
Date
Month day year
Business Representative (Printed Name)
Title
Business Representative's Signature
Date
Month day year
Business Representative (Printed Name)
Title
Business Representative's Signature
Date
Month day year
PROJECT INFORMATION
Fill in the blanks and provide extra sheets where necessary.
1. Will the assistance requested have any negative impact(s) or effect(s) on the environment?
Yes No X Provide a brief description of potential environmental problems, if any.
Note: All applicants and businesses funded by the TCF will have to comply with federal regulations
regarding environmental clearance prior to spending TCF funds, as outlined on the Sources and Uses of
Funds form. See requirements and exceptions under environmental review in the program guidelines.
2. Will the assistance requested cause the displacement of individuals, families, businesses, or farms?
Yes No X
Number of: Individuals:
Families:
Businesses:
Farms:
3. Are you or your business(es) involved in any pending lawsuits?
Yes No X If yes, provide an explanation.
4. Has the business(es) or principal(s) included in this project ever been involved in bankruptcy or insolvency
proceedings? If yes, identify the specific business and or principal(s).
Chapter 7
Yes
No
X
Date
Chapter 11
Yes
No
X
Date
Chapter 13
Yes
No
X
Date
Other
Yes
No
X
Date
Note: Generally, business and/or principal bankruptcy disqualifies a project; on a case by case basis
extenuating circumstances will be evaluated. Provide an explanation and a description of the current legal
status.
5. Will this project assist "brownfields" being redeveloped? No
6. Has the business previously received assistance from the Community Development Block Grant program (in this state
or any other state)?
If yes, provide an explanation to include when, where, amount, purpose/use
Yes No X of funds, and contact information.
7. Is there sufficient other infrastructure (except as requested in this application) to support this project?
Yes X No
8. Discuss any existing or proposed financial incentives (i.e. tax abatement) being provided/offered by local government
to the business. Financial incentives are being negotiated at this time.
9. Is the applicant located in a Texas Water Development Board, Economically Distressed Areas Program (EDAP)
County?
Yes No X
If yes, Has the applicant adopted the Model subdivision Rules? If yes, when?
Yes X No
10. Does this project involve a relocation of any kind?
Yes No X
If yes, please explain the details of the relocation: (see Relocating Projects in Section 1 the Guidelines)
11. Will any additional business(es) benefit from or access the proposed infrastructure improvements?
Yes No X
If yes, please list the business(es) which will benefit from the proposed improvements. Also, please identify this
business(es) on a map in relation to the infrastructure improvements. If any business(es) will be benefiting from the
proposed improvements to be paid by TCF, the one (l) year tap-in requirement may apply. See Tap-In Requirement
page 30 in the Guidelines for more details.
12. Is the business a Historically Underutilized Business?
Yes No X
If yes, business must attach the Texas Building and Procurement Commission certification.
13. Do(es) the business(es) being assisted provide a product or service to the neighborhood or community?
Yes X No
14. Does this project involve building rehabilitation? If yes, how many?
Applicant Minority Hiring Information
Provide information on the current status of minority hiring within your city/county as follows and insert into the
appropriate area of the application.
Total Population
Minority Population
% Minority Population
25,885
Applicant Employment Level
Applicant Minority Employment Level
% Minarity Population
306
28
9%
Employment Projections Form
Applicant Name Business Name
BUSINESS INFORMATION
L Number of current employees (excluding principals) Daisy Brand
2. Please describe the CURRENT jobs this activity will retain
. JOB CATEGORY / GROUP #F/T #P/T
(see Appendix E for category definitions)
A. Officials and Managers
B. Professionals
C. Technicians
D. Sales
E. Office and Clerical
F. Craft Worker (skilled)
G. Operatives (semi-skilled)
H. Laborers (unskilled)
1. Service Workers
TOTALS:
AVG
ANNUAL
WAGE
3. Please describe the NEW jobs this activity will create
JOB CATEGORY / GROUP
(see Appendix E for category definitions)
A.
Officials and Managers
B.
Professionals
C.
Technicians
D.
Sales
E.
Office and Clerical
F.
Craft Worker (skilled)
G.
Operatives (semi-skilled)
H.
Laborers (unskilled)
I.
Service Workers
TOTALS:
#F/T
Please see
attached
lict
4 How was the level of new jobs determined? Please explain in detail. Daisy Brand determined the number
of iobs to be created based on their need for products as determined by their historic sales.
5. Does the business provide employer sponsored health care? If yes, how many of the created/retainedjobs
specified above will be covered? Yes The employer does provide health care. All full-time employees
will receive benefit.
#P/T AVG
ANN UAL
WAGE
Full-Time must be 35 hrs. or more and Part-Time must be 20 hrs. or more per week. All wages must be converted
to an annual basis.
SOURCES AND USES OF FUNDS
INSTRUCTIONS
The Sources and Uses of Funds form displays the total budget for all proposed activities and provides the total
projected expenditures for the TCF contract period. At a minimum, review the program requirements for the
following items: budget justifications, leverage requirements, equity requirements, eligible uses of funds,
ineligible uses of funds, selection criteria/scoring (under selection procedures), and environmental review.
1-6. Self Explanatory.
7. Sub-total each column vertically and horizontally.
8. Enter the applicant's costs for administration of this project.
9. Total each column both vertically and horizontally.
NOTE: Funds and costs, as outlined on the Sources and Uses of Funds form, may not be spent or incurred
prior to a contract award date from the TCF.
All dollar amounts should be rounded to the nearest one hundred dollars ($100).
If the applicant has Program Income from a previous CDBG award, contact Department for
clarification.
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SUPPORT INFORMATION FOR INFRASTRUCTURE PROJECTS
Provide the following information for any infrastructure activity (included on the Sources and Uses of Funds):
(1) Water Improvements
(a) Indicate when the treatment facility was constructed.
(b) If reconstruction or replacement of lines is involved, indicate when the existing line(s) were installed, the diameter(s)
of the existing line(s), the material type of the existing lines, and the previous history regarding line cleaning or TVed.
(c) Indicate the design flow and/or population capacity for the existing faciliTy before and after any proposed
improvements.
(d) Indicate the source of water for the system.
(e) Indicate the average daily and peak time demands for the existing jurisdiction before and after any proposed
expansion relating to this project.
( fl Indicate if any of the existing capacity/pressure improvements and any of the proposed improvements (such as
looping or gate valves) are primarily for fire protection. Indicate if fire hydrants currently exist and if any are being
proposed for this project. Does the applicant have an adequate water supply, adequate water pressure, and an
adequate number of fire hydrants to fight local fires?
(g) Indicate if acquisition of real property (including easements and rights-of-way) is needed for this project.
(h) Indicate if there are any special assessments, including service connection costs and fees, involved relating to this
project.