HomeMy WebLinkAbout30. 15-512NOVEMBER 24, 2015 15-512 RESOLUTION
(CARRIED__7-0____LOST______LAID OVER______WITHDRAWN______)
PURPOSE: AUTHORIZE SUBMITTING APPLICATION TO WISCONSIN
ECONOMIC DEVELOPMENT CORPORATION FOR COMMUNITY
DEVELOPMENT INVESTMENT GRANT ON BEHALF OF THE
OSHKOSH COMMUNITY YMCA; ACCEPT FUNDS; APPROVE
AGREEMENT WITH YMCA FOR CITY’S ADMINISTRATION OF
COMMUNITY DEVELOPMENT INVESTMENT GRANT
INITIATED BY: COMMUNITY DEVELOPMENT DEPARTMENT
WHEREAS, the Wisconsin Economic Development Corporation (WEDC) has
grant funds available for projects to support local initiatives with a downtown emphasis
by providing financial incentives for projects that are downtown community driven; and
WHEREAS, local municipalities are an eligible applicant and can apply for said
grant funds on behalf of a local community organization; and
WHEREAS, the Oshkosh Community YMCA approached the City about applying
for said grant funds for its proposed renovation and expansion project at the downtown
YMCA building at 324 Washington Avenue.
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of
Oshkosh that the proper City officials are hereby authorized to submit a Community
Development Investment grant application to Wisconsin Economic Development
Corporation to obtain funds for said purpose.
BE IT FURTHER RESOLVED that if said grant funds are awarded, the proper
City officials are hereby authorized and directed to accept said funds, pursuant to the
terms of the grant application, and to execute any and all documents and assurances
which may be required for purposes of same.
BE IT FURTHER RESOLVED that the attached Agreement with Oshkosh
Community YMCA relative to the City’s administration of a Community Development
Investment grant for property at 324 Washington Avenue is hereby approved contingent
upon receiving said grant funds from Wisconsin Economic Development Corporation for
this project.
NOVEMBER 24, 2015 15-512 RESOLUTION
CONT’D
BE IT FURTHER RESOLVED by the Common Council of the City of Oshkosh
that the proper City officials are hereby authorized and directed to execute and deliver
the agreement in substantially the same form as attached, any changes in the execution
copy being deemed approved by their respective signatures, and said City officials are
authorized and directed to take those steps necessary to implement the terms and
conditions of the Agreement.
NOVEMBER 24, 2015 15-512 RESOLUTION
CONT’D
BE IT FURTHER RESOLVED by the Common Council of the City of Oshkosh
that the proper City officials are hereby authorized and directed to execute and deliver
the agreement in substantially the same form as attached, any changes in the execution
copy being deemed approved by their respective signatures, and said City officials are
authorized and directed to take those steps necessary to implement the terms and
conditions of the Agreement.
�
OJHKOlH
rnv n�e watEa
TO: Honorable Mayor and Members of the Common Council
FROM: Allen Davis
Community Development Director
DATE: November 24, 2015
RE: Authorize Submitting Application to Wisconsin Economic Development
Corporation for Community Development Investment Grant On Behalf of the
Oshkosh Community YMCA; Accept Funds; Approve Agreement with YMCA for
City's Administration of Community Development Investment Grant
BACKGROUND
Staff will be submitting a$250,000 Community Development Investment (CDI) grant
application to WEDC on behalf of Oshkosh Community YMCA to expand their downtown
Oshkosh location.
The Oshkosh Community YMCA is proposing a$15 million dollar investment in the downtown
YMCA that will renovate and expand the current facility at 324 Washington Avenue. If WEDC
awards the grant, the City would administer the grant funds and ensure compliance for use of
funds.
ANALYSIS
The Oshkosh Community YMCA is planning on renovating and expanding the building
extensively. The general schedule for the project is:
Start interior alterations and building addition in 2016.
Complete alterations and addition in 2017.
The WEDC funds and investor funds will be used largely in 2016-17 for:
• Interior alterations and building addition.
City staff has worked with representatives of The Oshkosh Community YMCA in preparing
the CDI grant application and agreement that will transfer the grant match fund requirements
and other grant requirements from the City to The Oshkosh Community YMCA.
FISCAL IMPACT
There are no City funds included in the CDI grant application or the implementation. The
Oshkosh Community YMCA will be paying for the City's staff time for grant administration,
namely the grant draws.
RECOMMENDATION
The City Council approves the submission of the WEDC CDI grant application, the
agreement with The Oshkosh Community YMCA, and accepts of the WEDC CDI grant funds
should it be awarded.
Approved,
�� � �
���-- �c�-z:��'—
City Manager
AGREEMENT
WHEREAS, The Oshkosh Community YMCA has a desire to redevelop its property,
located at 324 Washington Avenue and encompassing the parcel identification number
90400080000, located in the City of Oshkosh ("the Property") as shown on the attached Exhibit
A to this Agreement; and
WHEREAS, The Oshkosh Community YMCA will be expanding their organization once
redevelopment is completed; and
WHEREAS, the City of Oshkosh (the "City") desires to work with The Oshkosh
Community YMCA to facilitate the redevelopment of the Property; and
WHEREAS, it is desirabfe to prepare and submit an application for a Wisconsin
Economic Development Corporation (WEDC) Community Development investment Grant
Program (CDI) to assist with certain of the costs associated with the redevelopment of the
Property.
NOW, THEREFORE, the City of Oshkosh, hereinafter referred to as the "City", and The
Oshkosh Community YMCA hereinafter referred to as "The Y", agree as follows:
1. The City shall submit an application for a WEDC Community Development
Investment Grant Program (CDI) to assist with the redevelopment of the Property. The
application shall be for the purposes identified in and substantially in the same form as the
attached Exhibit B to this Agreement.
2. The City shall be responsible to complete all necessary requirements in relation
to this WEDC CDI grant Agreement and the WEDC CDI grant, if awarded.
3. The Oshkosh Community YMCA shal( be responsible for obtaining all required
permits and approvals for all work to be performed on the Property in relation to this
Agreement and the WEDC CDI grant, if awarded, including but not limited to permits and
approvals from the City of Oshkosh.
4. The Oshkosh Community YMCA shall be responsible for the Match Investment
identified in the WEDC CDI grant application and directly pay for all project costs including but
not limited to any permit or approval costs and fees, and any contractors' fees and consultants'
fees, relating to the performance of responsibilities under the WEDC CDI grant, if awarded.
5. The Oshkosh Community YMCA shall use WEDC CDI funds under the terms of
the activities outlined in Exhibit B. Failure to use the WEDC CIP funds on the terms of will
result in payment requests being denied.
6. The Oshkosh Community YMCA shafl submit to the City payment requests with
all necessary supporting documentation to allow the City to request reimbursement under the
terms of the WEDC CDI grant.
7. The Oshkosh Community YMCA shall pay to the City a fee of $500 per payment
request to reimburse the City for the City's costs of administering the WEDC CDI grant.
1
8. The Oshkosh Community YMCA shall comply with the requirements listed in the
agreement between the WEDC and the City.
9. The Oshkosh Community YMCA shall fully and completely cooperate with the
City, the City's attorneys, the City's Auditors or other representative of the City (collectively, the
"City") in connection with any internal or governmental Audit, with respect to matters relating to
this Agreement. Such cooperation may include, but shall not be limited to, responding to
requests for documents and/or other records, and making Contractor's employees available to
the City (or their respective attorneys or auditors) upon reasonable notice for: (i) interviews,
factual investigations, and providing declarations or affidavits that provide truthful information
in connection with any Audit; (ii) volunteering to the City all pertinent information related to any
Litigation or Audit; and (iii) providing information and legal representations to auditors in a form
and within a timeframe requested.
10. The agreement between The Oshkosh Community YMCA and the City shall
expire once the project is completed and upon completion of the grant requirements.
11. Subject to any limitations contained in Sec 893.80 and any similar statute, of the
Wisconsin Statutes, the City agrees to hold The Oshkosh Community YMCA, its officers,
officials, employees, and agents harmless from any and all liability, including claims, demands,
losses, costs, damages, and expenses of every kind and description (including death), or
damages to person or property arising out of the terms of this Agreement where such liability is
founded upon or grows out of the acts of omission of any City's officers, employees, or agents
while acting within the scope of their employment.
The Oshkosh Community YMCA agrees to hold the City, its officers, officials, employees, and
agents harmless from any and all liability, including claims, demands, losses, costs, damages,
and expenses of every kind and description (including death), or damages to person or
property arising out of the terms of this Agreement where such liability is founded upon or
grows out of the acts of omission of any Oshkosh Community YMCA's officers, employees, or
agents while acting within the scope of their employment.
Nothing in this Agreement is intended as a waiver of the City's right or opportunity to rely upon
the governmental limitations and immunities contained within Wisconsin law. Municipal
immunities and limitations include, but are not limited to, Sections 345.05, 893.80, and 893.83,
Wisconsin Statutes. Such damage limits, caps and immunities are intended to be preserved
and are incorporated into this agreement and shall govern all disputes, contractual or
otherwise, as they apply to the parties and their agents, officers, and employees.
The intention of this paragraph is that each party shall be responsible for its own actions and
inactions related to this Agreement.
Notwithstanding any other provision of this Agreement, it is further agreed that to the fullest
extent permitted by law The Oshkosh Community YMCA shall indemnify and hold harmless
the City, its employees, agents, contractors and consultants from and against all claims,
damages, losses and expenses, direct and indirect, or consequential damages, including but
not limited to attorneys' fees and all Court, arbitration or other dispute resolution costs, arising
out of, resulting from, or related to the presence and/or involvement of hazardous substances
or constituents, including hazardous waste, at or contiguous to the project site or contained in
samples collected by or received by the City or its contractors and/or consultants from the site.
2
This indemnification extends to claims against the City or any of its employees, agents,
contractors or consultants which arise out of, are related to, or are based upon, the disposal,
discharge, escape, release, spillage or saturation of smoke, vapors, soot, fumes, acids, alkalis,
toxic chemicals, liquids, gases or any other material, irritant, contaminant or pollution in or into
the atmosphere, or on, onto, upon, in or into the surface or subsurface of soil, water or
watercourses, objects, or any tangible or intangible matter, whether such event or
circumstance is sudden or not. Nothing in this paragraph is intended to indemnify, or shall be
construed as indemnifying the City, its employees, agents, contractors or consultants with
respect to claims, losses, expenses or damages to the extent caused by the City or its
employees', agents', contractors' or consultants' own negligent acts or omissions.
12. This Agreement shall be construed under the laws of the State of Wisconsin.
13. This Agreement, and ail other documents or instruments that may be required by
this Agreement, may be executed in several counterparts, each of which shall be deemed an
original, but all of which shall constitute the same instrument.
3
: _.......... _._.._.. __ _.. _._ ._...... . _._..... _.._ _. __ _...... .. _....._.. _......
�._._.__.. �. ______�__.� w__ __�___. __...� .�......_. �._
(N WITNESS WHEREOF, the City of Oshkosh, Wisconsin, and The OshkosF�
Community YMCA have respectively caused this Agreement to be dufy executed on this
day of November, 2015.
___ _ _ _
CITY OF OSHKOSH Oshkoa
. By: __ _ _ _ _ ___ By:_
Mark Rohloff, City Manager �
And:
And:
Pamela R. Ubrig, City Clerk
Trena Iarson, Finance I}irector
STATE OF WISCONSIN )
) ss.
WlNNEBAGO COUNTY )
And:
_ .____ _ � ,
ri-ii�;:-.r.�
— �
� :� t
�
�R:r%�.,.� �,
Personally came before me this /�'�day of November, 2015, the above named
Tom Blaze and Judy Rehm, the officers of Oshkosh YMGA ta me known to be the persons
who executed the foregoing instrument and acknowledged same as and for said company, by
its authority.
STATE �F WISCONSIN )
� ss.
WINNEBAGO COUNTY �
.�""'��,
�P pi. J. F�•
� � .
,, •
� ; .••..., .• � ,
Notary Publ' , Winnebago Co fy, WI ••-�'r:
My Commission Expires: �� �,''� NOTAq}, :=
�--- � .
. , .
- v' .,�'UBLIG ' :
. ,,, : -. ,• -
.\'.
=9�'��>..... 0�,5 .
�"<,�fi'1+illS� .•
:
.,;�'���.
Personally came befare me this day of November,2015, the above named Tom
Blaze, President & CEO of The Oshkosh Gammunity YMCA to me known to be the persons
who executed the faregoing instrument and acknowledged same as and for said company, by
its authority.
Notary Publie, Winnebago County, W!
My Commission Expires:
4
Exhibit A
�,� �,�� _ _
OfHIt9iN COFtMUMTY`vMCA. _....,_.._ Y11 Yr�rSH3iWTi?ti A4€
�� � � �z.� � i�'' "� '�^
_. _.
� �� _ :�
�i! . _._ .. —
�j —'
� � °� N�. _� �. �
€ �, -
� [ ., -
_ _.., �...,...e .
` � ;
�,* . '� �' � i _
� F � � i
i "
��. �.,
—
t
. �ti.: —t'.
�
r
:F
� �._....�
��� rv.;� � .....
�
n.' �y �
� ��
C6c4ctuaitla
pdar
� ..�
"_"f___
.... _ f ....�.
q .,,,.
s i i
;.._;_.! ' ...J
€i
",,. ��...I " ;_
���
e. j .�_, ���_ .. , i
t `��- i
� �..` �
i � L ; -_
� , _.
z � �_ � � �� �� � � ' s i ; " (
'� - f ..._. �':: � :
t � .�3 -� 7 ..
_�.., ( q � � r t t
-_
1 1.--�;; . t, t i Y I
i j # + .,. { _�i P f � ?
F i .�_ _ � ,"' ; f
, _. - � ,; <i j .. 1 �. , c
l�r } tj ! )� �xr` �r�t � �7�s' �
i Y'� f 2� p.... � 7 Y D 7
t
i, p ;a 1 .,c � �j 1 � �,��f _ , .
� : 7�., `g � t ` 1
�.� , � ' � F ,,r��f � t r� " ._
t .,,,
1 r t � i � r 1 � ��� j°
3 P �
,
i E #,. i_ I '' r111 1�'�}' ��� � t+` �` 1�
_
.: : � {
" P ; �
_ : . . , -,. p , , t 2 p 7 J . j .'
�"'"'�'"�xs� � , � � 7 , �: } �. , ' pri
K
; �.. = ,.. � " ;. 1 ._.�r , . E NF� C&: �, F.. �.:; 7 a r � . .. ,.n u .,ar., _ hR�4 F _ i;9{�� !� � t
. ,.
; j'--, . . .. : , , { . r �.
Exhibit B
WISCONSIN ECONOMIC DEVELOPMENT CORPORATION
Community Development Investment Application
A. GRANT REQUEST
Grant Request: $250,000 + Applicant Leverage: $14,750,000 — Total Project Cost: $15,000,000
Name of WEDC Community Account Manager: Naletta Burr
C. LOCAL GOVERNMENT CONTACTS
Primary Contact:
Name: Allen Davis Title: Community Development Director
Address (if different):
Phone: (920) 236-5055
Name: Steve Cummings
Address (if different): ll24 Bay Shore Drive
Phone: (920) 410-8545 Email: scummings@ci.oshkosh.wi.us
Official Authorized to Sign Contracts:
Title: City Manager
Email: adavis@ci.oshkosh.wi.us
Elected Official:
Title: Mayor
Name: Mark Rohloff
Address (if different):
Phone: (920) 236-5002
Name: Allen Davis
Address (if different):
Phone: (920) 236-5055
Name: Keliy Nieforth
Address (if different):
Phone: (920) 236-5045
Email: mrohloff@ci.oshkosh.wi.us
Individual to Receive Grant Payments:
Title: Community Development Director
Email: adavis@ci.oshkosh.wi.us
Reporting Contact:
Title: Economic Development Specialist
Email:
wi.us
4
Rev. 9/30/2015
E. PROJECT AREA DETAILS
ject Location: � Cicy ❑ Town ❑ Village Of:
County: Winnebago
Project Site Address: 324 washington Ave
Is the project located in a TID? ❑ Yes � No If yes, creation date:
Is the project located in a State or Federally declared disaster area? ❑ Yes � No
If yes, was the declaration within the 24 months prior to submitting an application? ❑ Yes � No
If ves, date of declaration:
Does the applicant or end user currently own the property on which wark is to occur? � Yes ❑ No
If no, how do you have or expect to obtain ownership or access to the property?
❑ Condemnation
❑ Tax Delinquency
❑ Purchase (attach purchase agreement or option)
❑ Development Agreement
❑ Other:
Timeframe:
Timeframe:
Timeframe:
Timeframe:
Timeframe:
If applicant will not own the property, what entity will/does?
Current Site Ownership: Oshkosh YMCA Phone: 920-236-3380
Final Site Ownership: oshkosh YMCA
Phone: 920-236-3380
Ema11: info@oshkoshymca.org
Email: info@oshkoshymca.org
F. REDEVELOPMENT NARRATIVES (reference Required Supporting Documentation as needed)
1. Project Description and Impact on Community (three page limit): See At �achme:zt A
a. Describe the project, its implementation and the significance of this project to the community
b. Describe any public/private partnerships developed and the extent to which the applicant can
ensure that all of the activities outlined within this application will be undertaken? (e.g. capacity
of applicant and partners, conditions of loan agreements, status of development agreements,
etc.)
c. Which eligible activity (ies) does this project fall under?
� Building renovation � New construction
❑ Historic preservation
❑ Infrastructure reinvestment
❑ Demolition ❑ PrOfeSSlOrial Sel'V1Ces (planning request only)
d. Describe the potential of the project to enhance the economic viability of the community (e.g.
tax base increases, job creation, stimulation ofprivate investment). A response should detail the
potential for both temporary and permanent jobs at the project site as well as the potential for
job creation to occur in the area. To the extent possible, provide detail on the potential types of
jobs, wage rates and health benefits associated with the jobs that are identiiied.
e. Describe the potential for the project to promote economic development in the neighborhood,
community, county and/or region.
f. Describe the potential for the project to act as a catalyst for additional commercial development
or investment.
2. Financial Justification (two page limit): See Attac�men�- a
a. Describe the various methods that will be used to fund the project and include the progress of
establishing or receiving funds.
b. Describe the financial need for grant funding that cannot be met through private sector sources
(e.�. traditional financing, eauitv investment or donor support), public sector support (e.�. RLF
5
Rev. 9/30/2015
financing, TIF financing, and public borrowing) or a reduction in the scope of the project.
c. Explain why incentive assistance is needed to ensure this project will happen in Wisconsin.
3. Previous Planning Efforts (two page limit): See A`tar_hmert A
a. The extent to which this project is included in and/ar complements previous regional or
municipal planning efforts (please reference section and page numbers of the plan).
b. The extent to which the project supports best smart growth practices; best downtown
redevelopment practices; and has community wide support.
4. Readiness to Proceed (two page limit): See Attachment A
a. Describe past and planned project activities with timelines, including planning process, site
control, environmental condition, and a project implementation schedule.
b. Provide detailed descriptions of intended property transactions to occur over the next five years.
c. Describe financing commitments and any contingencies that apply.
G. PROJECT TIMELINE
Start Date: 6/1/2016 End Date: 6/1/2017
H. PROJECTED ECONOMIC DEVELOPMENT
How many jobs will likely be created as a result of this project? 109
a. Full-time (>35 hours/week):
Type of Positions Direct Indirect Avg. Base Hrly Healthcare
Group Exercise Director � ❑ $21.63 �
IT Director � ❑ $21.63 �
Program Coordinator � ❑ � ❑
❑ ❑ $ ❑
❑ ❑ $ ❑
b. Part-time (<35 hours/week):
Type of Positions
Lifeguard � ❑ $10.00 �
Child Care Staff � ❑ $10.00 �
Membership Staff � ❑ $8.50 ❑
❑ ❑ $ ❑
❑ ❑ $ ❑
c. Temparary (construction, etc.):
Type of Positions
Construction ❑ � $28.63 ❑
❑ ❑ $ ❑
❑ ❑ $ ❑
❑ ❑ $ ❑
❑ ❑ $ ❑
Current assessed value of the property or district in which work is occurring: EXempt
Projected assessed value of the property or district in which work is occurring: Exempt
6
Rev. 9/30/2015
A detailed justification of these estimates should be provided in the narrative requested in section l.d above.
L LEGAL INFORMATION YES/NO
Has the applicant, or any owner, ofiicer, subsidiary or affiliate, been involved in a lawsuit � yes � No
in the last 5 years?
Has the applicant, or any owner, officer, subsidiary or affiliate, ever been involved in a � yes � No
bankru tc or insolvenc proceeding or are any such roceedings pendin ?
In the last 5 years, has the applicant, or any owner, officer, subsidiary or affiliate, been
charged with a crime, ordered to pay or otherwise comply with civil penalties imposed, or ❑ Yes � No
been the subject of a criminal or civil investigation?
Does the applicant, or any owner, ofiicer, subsidiary or affiliate, have any outstanding tax � yes � No
liens?
Applicant certifies that they have completed a similar background review of the developer � yes � No
or any ass through recipient
Please attach a detailed explanation of any YES responses.
J. STATE REQUESTS FOR BID OR PROPOSAL
Are you aware of any State of Wisconsin request for bid or request for proposal to which the
applicant intends to respond or to which the applicant ar has recently responded? ❑ Yes � No
If yes, please provide the following:
a. Identify the bid or request for proposal (e.g., bid number, or general description or
title).
b. Identify the state agency or public entity to which you are submitting the bid or
proposal.
c. Explain the status of the bid or proposal (e.g., recently submitted; considering
submission; in current negotiations).
Please note that if you answer "yes", WEDC may not be able to discuss potential financial
assistance until the reauest for bid or request far proposal process has been completed.
Rev. 9/30/2015
K. REQUIRED SUPPORTING DOCUMENTATION CHECKI.,IST
Please include the following attachments: Included Attachment
✓ #
1. Map. A map indicating the project location within its municipal jurisdiction
and any specially designated federal, state or local economic or taxation zone � 1
encompassing the project site. Photographs of the site and surrounding area.
2. Redevelopment Plan. A copy of any applicable redevelopment plan � Z
pertaining to the project.
3. Budget Narrative. Narrative describing each line item included in the �
roject budget. The budget should only include eligible costs.
4. Cost Estimates. A copy of any cost estimates or bidding conducted for costs �
listed in the project budget, or an explanation of the basis for all costs.
5. Development Agreement. A copy of any applicable development agreement ❑
with private parties beneiitting from project implementation. (If unsigned,
signed copy must be submitted prior to first disbursement)
6. Financing Commitments. Documentation that demonstrates the success of
obtaining financing (e.g. commitment letters from lending institutions, � 5
municipal resolutions for financing or TID creation).
7. Organization. A chart illustrating the ownership, development, and
financing organization/structure of the project naming all entities committed
at the time of submission and showing ownership percentages for any
individual or entity involved. For any committed end users or partners � 6
having any ownership in the property, provide a history of the individual or
company's operations with resumes detailing relevant experience and
involvement and ercentage of ownership if a licable.
8. Individuals owning 20% or more of the project may be required to submit �
signed and dated personal financial statement.
L. OPTIONAL DOCUMENTATION HELPFUL IN PROJECT EVALUATION
Included Attachment
✓ #
1. Pro forma ❑
2. Municipal planning (relevant sections only) ❑
3. Statements from community, public and community development leaders �
that su port the project proposed far funding
Rev. 9/30/2015
M. REAL ESTATE PROFORMA INFORM.ATION (IF APPLICABLE)
1. What is the market rate for triple net* rent in the project's market?
2. What is the project's average triple net rent?
3. If the project's rent is less than general market conditions, please provide an explanation of why:
4. How much equity is the development entity investing in the project?
5. What is the anticipated vacancy rate?
6. How much debt can the project service at what rate and term with what minimum
Debt Coverage Ratio?
7. What is the average rate of return for the first five years of the project once the
building is placed in service? Please define the formula utilized to determine the
rate:
If the project does not provide a return on investment, please explain how the development entity anticipates
covering the costs associated to the development:
*��I'riple net rent is the base rent that does not ine(ude ariy utility, comruon arezl, maintei�auce. inst�rance nor taxes.
Rev. 9/30/2015
N. `CERTLFICATI�N STATEMENT - . ; - : ;_
This application, and the information being submitted to WEDC, is true and carrect to the hest of my (our}
knowledge. This also certifies that:
1. The applicant certifies that to the best of its knowledge and belief, the information being subnnitted to
WEDC is true and correct.
2. The applicant understands submitting false or misleading information in connection with an
application may result in the applicant being found ineligible for financial assistance under the funding
program, and the applicant or its represen�ative may be snbject to civil and/or criminal prosecution.
3. The applicant certifies that it is in compliance with all laws, regulations, ordinances and orders of
public authorities applicable to it.
4. Tlae applicant certifies thai it is not in default under the terms and conditions of any grant or loan
agreements, leases, or financing arrangennents with its other creditors.
5. The applicant understands this application and o#her materials submitted to WEDC rnay constitute
public records subject to disclosure under Wisconsin's Public Records Law, § 19.31 et seq. The
applicant will mark documents "confidential" where appropriate for financial and other sensitive
materials ihat should be, to the extent possible, be kept in confidence. WEDC will notify the applicant
if it receives a public records xequest for materials marked confidential.
6. The applicant certiiies that WEDC is authorized to obtain a credit check and Dun and Bradstreet on
the applicant, the business and/ar the individual(s}.
7. The recipient of Community Development Investment Grant funds shall enter into a contract with
WEDC that may require, at the discretion of WEDC, a personal or business guarantee from any private
owner of the site with more than 20% ownership interest.
8, The recipient of Community Developrnent Investment Grant funds shall provide WEDC verified
statements, semi-annual project reports, financial reports, and a financial audit in accordance with the
contract between parties.
9. The applicant understands that grant eligibility is limited to only one non-planning or marketing
Community Development Investment Grant per fiscal year.
10. Funds received for remediation under the Community Development Investment Grant program shali
not replace funds from any other source including Agri-Chemical, Petroleum Environmental Cleanup
Aci and the Superfund.
I 1, Funds received under the Comnnunity Developzxzent Investment Grant program shall not be used for
environmental remediation costs where there is a known viable causer of contamination with
ownership interest in the property.
12. The applicant certifies that zt has disclosed and will continue to disclose any occurrence or event that
could have an adverse material impact on the project. Adverse matezial impact includes but is not
limited to lawsuits, criminal ar civil actions, bankruptcy proceedings, regulatory intervention or
inadequate capital to complete the project.
13. The applicant will provide signage, according to WEDC specifications, at the project site indicating
WEDC financial participation should grant funds be provided to the project.
14. The applicant is wili identify WEDC participation in planning and feasihility documents should grant
funds be provided to produce the documents.
15. WEDC financial assistance is needed to ensure the proiect will happen in Wisconsin.
Signature: � ��� Date: �� %'� Z D/ 5
(Arrtlrorized lZepresentalive)
Printed Name: Mark Rohloff Title: City of Oshkosh City Mana�er
10
o.,,, nr�nr�na�
s
0
F
�;
m'
0 0 0 0 0 0 0 0 0 0 0 0 �
o �
o �
Q o � .�
o z �
F � c � a
O 'n o �,
F. `"� a � -d .�
�
s� s�s �� z4 r� � sR 5�4 c� �s sR � � o �
w o 0 0 0 0 0 0 0 0 0 0 0 ^" � �
M Q �, O
Q -� U v� �.
z ti � � . �?
N
� o. � o si
U � � �
� � � �� �
� � o a- �
O v� � U pq
"� N Q bp
� O O O O O O O O O O O � 3� �•�
� O
z y,� � � �
� � � �
(_l.
O •� �
:.� ¢ V s�-� N O
U 0� � `a p w �
�
C
. � � +J �' bp �
CL
� � 6l4 6F3 � W � � � �' .
cd �"' y M
� W O O O O O O O O O O O ��. G� � ���
o � +� �• � u.
�w¢ y � o � Y a�i
a`, z r� G a) O p�
A v W � � � 'y � w �tl
Z � c.' Q j�U U� V] Q
� � � � v � � �
� � O � � � � p � Q c�? j
� p ,'� Q ,,.
Q a� O O O O O O O O O O O � �¢, Y���
C/1 A� p O��.� O�
¢, � in
v�z a_' > � ° � a a�
a � � � '� H Q v��, o°�n � � �
�o�q � � �a �ws�
�J v Y v i�
OC�� � � � � ��,� �
p� C� f/4 69 � �� b o��
o� � � • � � -o
�' o 0 0 0 0 0 0 0 0 0 0 0 � o�� a °.,'
F- � o '" U� v, .n •� c
o y � a�
� � � > � � � �n
Q O .Ci Y� bA � O N
� cC 4.
z r o ��� � o U ¢
� .v � co ... > ..o � �
U ¢ ~ ci � � Y ' � o .n
� U 4� s c � 'x � �
� � � � � � � �
v�. �+ srg ss ,v Z � a� ._ �� c
� ��
� � � a �
0 0 0 0 0 0 0 0 0 0 0 0 4' ;� �, y� o�
F" c o -o Y ;o " °' �
W o C� �� o� o�
� Q N � O y a� s-�
A W � � pp � b
�, � r� � cC 7
� 3 �-�.�b � �
� ����o�
Y ,w 3 � 4.
U �s `� � � ° ' � � °n
Y � a -o
''W� a '� �>'>���.°
a W �„� � E" �, � � � a' ;� �a
a. "" O W � � N��3°'��
� ►� E-� z o o ?' � �
A F' E.+ ,- Y >' :a ' �
F�] � N W �+ � „ �, .c on .�'�' �
�. �, F- '
O v � < � � y o � � ��:�
� : E� � � � .� . � � F-
p, Q � � � V ' � ':� ':: � °' �, ril
O � a � � d�� '>>���F-
a w c� o�> a°� ����� � oz
� o W ¢ ¢¢�:-,...
c �-
� �� o � x� ���o���
Q a '� �° U � a`'i a�i a�i a`'i E" p, a'"i a�i � . .' Q'Y •� ��¢
i�L �� N � Y � .�.+ � a't+ C O .� ,S". �.-. N M '�7 � �-' � C' G� O W
a� f� Z'v� O O O O a O O � a" ��' < U a
�
0
N
�
�
>
a�
�
Dnublc Click {i! 9 Objecf for fr/!able jorm m�d ir�s7���clions.
� ■■"� R�q138�tL�Df TBXp�dy�T crreFo.mtott�e
�m,•. 000Qatr.�ott} requealer. �o �ot
�,,,,,od�„��, (dentlficatt�n Numtrer �nd Certlf���tfon �„a���s,
irkmd Fiwonn SWm
�
�
�.
0
x�
��
� a
€
�
1�'
�
rt ja[lrovt%i ffi1�ti11� ltrfwm � q� tryi �q � Ilo[ 1�/al4�a Bn
of Oshko.sh
s rnx+uppopmoe�s�ad�r��m�a��ya..da,�ra�mwnomms ♦ ��i� 7�r+�+
❑ w,� � Q ❑ c a�+ ❑ s c��, ❑ r�o-�w,� o�m � o� .��o'�.�
st�gbmant+a [S.c
❑ur�uda,eerywc�rry.c7rorowucdn+eac.m,�cvrpor�n,ssoapQS�tr4+�t,�nr[H� �`Q�'�a4wat�iRr+fi�
Hn�_ttra9�munh�rllCRrt�tAagado4tlnml�ocKll�tlttxY7DUpprcgSyfohocfitro6nz�awlor �"p'tr'�omFnrra�
uw we oWewnrrnm or no at,�a�anmr oraiw. ooao � a?S'!
�oaKrpwi�au:U�vt►� (',nvornmont }�nYitv Yldra�a�+.,d�:rx�.msT
�c
WI 54903-1128
6rta ycxr 71N In tha a�ptepttate bat_ Ti�s 71N prnvldetl m�t rnatc3t tte nente ghES� on Gne i fio avWd
�eu�,r,t,nr,dat,g. r� ir�cmu�, m s �s Qe„�y your � sefxnry �.,mcx� tssrg. �ver, r� B
ra�ient are�t, r�ae �prtemr, ord�sreyarua;! emrty, mee ttse asrt �&�strcctkrrs art paga a. Fcf amer
ertWea, tt Is ynir anpiv� k1e„ntfc�,hrn ntrn� �Eld). It you tla not na,re a n�neer, aee Nnw tu gei e
7nV on p� a.
Nats.19 the a�oirR �� mrxe ltiati cne nama. eee fie Ir�atru�tlma tcr tlna 1 an[S 1he sh�t m pege d�r
gt3�de6nea m 1�bose n.nt6er to ef�er.
or
Utxler E+erdtlse cAP�1�'Y. tca�ry ttut:
7. Tha number El�wn on tt� Tiorm �. my carEet Gixpayc�r lderihlica�tm numDer{oi 1�m vtet¢�op fu s nuntrer to be fssuetl tl me�; a1►�
2 � am nd s�,q�t tu naclu� nfa�td�r� bec�usa: {y 1 am e�npt mnm r�acwsp w�it�hacfl,ag, «{n) � r�ave not aeen nofineu try �e l�aemel Flever.�a
na���i �t � g� wt�m�ac� a�&,g as � res�tt ot a tel€�re to �epert � m�est or rrnder�ds. «(� n,e tRS tws nosnen me mat � em
b+9� �'� �W �
s. � am a u.s. cmzen or oit,er u_5 Pecson (a�a �; ana
a. ine FATC�, coae(s} entaeetl on ltys krrn pt arr�j tiar,aang ltmt 1 em �mpt 9nm FwZGA repn�tr�g la carmct
CerhlMatfun 1�ln�cllops. You ntlst ctcss aut Item 2 abErrt31/ ycw have �eEtt tiafl9e�i trf the iR5 $ie! yat sce cttTenily ett?Ject to beck�p �nStlY7ddttg
bacal tse ybu heve Salled to reg�of[ et! In1etBAt encl �4iden�s vn yauc te�c Teh.im. F[e �oei 6Htahe trensa[�w�, ttem 2 doea nd eQpty. Far mM�a
e,tgest peltl. a�qWamrn oranenvorment vr securea p�r.periy, c��auon cX dEOt, c�wnrt�stnors m an ondt47vai �en,emerrt aRnnge�ni {IRAI. ecx7
generety. PHSA�� n45er [t�n hxleresi end m�k7ers� ?�ou are not req�lred tc� slg� ii� c�ai[an, but yar must proaf�a yar cor[ect 11N. �ee fhe
6zsU'17Cf1ott5onpe�e2. ��
��' I � �.° R ,����,�'1��
+C�eneral losiru�tians
Sar3lo�t f��afv�om Ot� tO Cto FdmYi Ha.van G7,do W�PM1; DVIbW ktl fYJAd
FUh�o A�rubfa� Ytlorrtidlon a6a:d dvan�ovYS imGifnq FOn[1 W-Q {szll
m Lgp4lon ms�kd s7mrvea rot+mc � l� at r�vnr.Fs1,qori7rU.
Purpase of Form
nn t� � o:ny �mn w-v ta�wd�cr) xtn le r�qiaod �o aw .. nummm
whmwtll� 4w tfi8 �a! cbmin �ur �aracl Sm}�y'� ltriTYtmla� nmhw (f7ll}
vR�thmrymYurncrGilsuctrHfnxnEar hd�iiult �aSaMncRYR;�1on
fYfrtUGf QTZtl�. stiytlm'�1[�v 1111140f [Ailt{, Or mlFfu�v
m,crtnn�, rummr (�h}. to mport o, a, nammf� �rn u,anaa,t �dd m
ywt a dt� vmutliopqiaUam ai hlvmmlm raFfm EXan�os UR3RXma3fal
�cna�n tira,m; cut vuno�ynn� fa, �w lo6anr�
� T�am t�GG7tVY �i4m! curwd v �kY
+ Fmn toOGLN �.fdorMZ ixl�9 vnmt(ma sbobar mNwY Lrtd�j
• Fmn tQW-MFSC{wrnu�c t?P°m ��"�� FT4� 11ed'L a 9�� PQ`�3i
• Fam t000$ �lodf Of M1x.hd lfid eda efii t�tatl �IQ'Ynin,aG�kRp hyf
traYrr�
+Tmn. tOW-3lpoeeeds Grm emF� tronaecmns)
• Farta TOGOJC �narahont md md tl'ts! priy notrorR trs�ac.�
�.
•Fvmt408.�anu�ittucs! t ��ldwibmh7am1A1�6-.T
��
� Fam 4i�6'L. �a�cat'tl Aada1J
• Fsm trD90-A �c[µt�ltlrl ar�-damcrt bt � prapvt�
l7eo Fam W-Y mi� 6�u �rv l U.B. pa:at (hc#MYg a m9Oxie�t�, {p
ptoNtloyur cwraca 7H�1
lfyovd,rxv,sih,�.r�mw-smea„�qws�xndenTVl y,xrmq�ems,epce
fa hich.p � apa N4�Y 6�' G�ch�p �nVUqt15�-m}+ap i
g�! nL�Aag yyo �„e ,... p� Yot�
f, taCry see 7tn nn ym tic gnt�g e,mauct � y�w aio w�tt,� f�x rxmcnr
bu do S$w�f.
2: a�cry tunf yrou aa not 9,t}a� w mxuprnmw#cj, ar
a. a�n �mpam im, mclip,.rt,rnait,g i�.v e u,s, omm{r pryoa n
n�noaq �a, so arso cavrysx3 7r,ct m a u�8 Fa�on, lan' mnem� sxa u
�'9' f10�°��P hcamn 4om a il.s. 6neo �••••,••^�_ � rct iut�ce m ha
V12ttY1e1�"a tai Cti �4P�'1 �Itrl�f!' Gtwv Ut Wf4uflvi�r �I�da[S ICOIRO. atd
�. Lvtly tlwl F71T�lcad�(� p�ud rn lhls imo Nmli �� � y� �
az4t�! Arn4 Cw FATCA�v�At�g N omcrit 8w N[�i Ts FA7'G mp�EtgT on
�41ah�1wbk�t
C�. Fh.147S1 %
12
Fam