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Big Sky Economic Development Trust Fund Program 2010 Category I – Economic Development Montana Department of Commerce 1 Appendix A APPENDIX A: APPLICATION FORM – ECONOMIC DEVELOPMENT PROJECTS MONTANA DEPARTMENT OF COMMERCE BIG SKY ECONOMIC DEVELOPMENT TRUST FUND (BSTF) CATEGORY I: ECONOMIC DEVELOPMENT This appendix should be the first item to appear in the application. Please reference the Application Guidelines for a complete explanation of required application information. Requirements: Submit 2 original copies (3-hole punched, including reference tabs and a table of contents, not spiral bound or double-sided) and 1 electronic copy of the application (CD or emailed) I. APPLICANT INFORMATION – LOCAL/TRIBAL GOVERNMENT Name of Local/Tribal Government Entity City of Missoula Federal Tax ID Number Chief Elected Official (Full Name & Title) John Engen, Mayor Contact Person (Full Name & Title) Cindy Wulfekuhle, Chief Grants Coordinator Address (Street, City and 9-Digit Zip Code) 435 W. Ryman Missoula, MT 59802 County Missoula Phone Number [PHONE REDACTED] Email Address [EMAIL REDACTED] Fax Number [PHONE REDACTED] II. ASSISTED BUSINESS INFORMATION Legal Name of Business to Receive Assistance Rivertop Renewables Address of Project Location 1121 E. Broadway Missoula, MT 59802 Full Legal Description of Project Location Contact Person (Full Name & Title) Mike Kadas, Chief Operations Officer Address (Street, City and 9-Digit Zip Code) 1121 E. Broaway Missoula, MT 59802-0008 Phone Number [PHONE REDACTED] Email Address [EMAIL REDACTED] Business NAICS or S.I.C. Code Business Federal EIN Business Project Status (Startup, Expansion, Relocation, etc.) Expansion III. PROJECT SUMMARY INFORMATION Total Project Cost 2,500,000 Amount of BSTF Funds Requested 195,000 Total Matching Funds 2,305,000 Use of BSTF Funds equipment purchase relating to Rivertop Renewables' pilot plant Senate and House Districts Total Number of New Jobs to be 26 ---PAGE BREAK--- Big Sky Economic Development Trust Fund Program 2010 Category I – Economic Development Montana Department of Commerce 2 Appendix A Created Total Number of New Eligible Jobs 26 IV. PARTNER ORGANIZATION(S) / SUB-RECIPIENTS (IF APPLICABLE) Economic development organizations may be involved in implementing and administering a project through a sub-recipient agreement, if the eligible applicant agrees to such an arrangement. If a sub-recipient organization is involved in the project, applicant must submit a draft sub- recipient agreement with the application. See Appendix B for a sample. Contact Person (Full Name & Title) Jessica Allred-Meyers, Economic Development Specialist Organization Missoula Area Economic Development Corporation Address (Street, City and 9-Digit Zip Code) 1121 E. Broadway, Suite 100 Missoula, MT 59802 Phone Number [PHONE REDACTED] Email Address [EMAIL REDACTED] Contact Person (Full Name & Title) Organization Address (Street, City and 9-Digit Zip Code) Phone Number Email Address V. BRIEF PROJECT SUMMARY Please provide a brief summary of this proposal which describes the nature of the proposed activity, the nature of the assisted business (if applicable) and what the BSTF financial assistance would be used for. Specify if outside professional services will be procured. Provide any relevant historical information on this project or the region it would support. Founded in 2008, Rivertop Renewables is a green chemicals startup company currently located in the Montana Technology Enterprise Center (MonTEC) incubator facility in Missoula, Montana. Rivertop has developed a way to make glucaric acid, glucarates and other biodegradable chemicals from renewable resources in abundant quantity and at a low cost. These and other renewable chemicals can reduce society’s dependence on oil, gas, and minerals and limit the amount of persistent chemicals in the environment. The company uses technology which was developed at The University of Montana. At present, Rivertop Renewables is in preparation to begin construction and outfitting of a pilot plant, which will also be located in the MonTEC facility. The pilot plant will enable the company to begin large-scale production of developed products, and to begin seeding identified markets such as detergents, cement and plastics with the Rivertop Renewables brand. The company's investment in equipping the plant will total $2.5MM and will create 26 new jobs within the next two years. All jobs are "living wage" as defined by the Montana Department of Commerce, specific to Missoula County. The company is ---PAGE BREAK--- Big Sky Economic Development Trust Fund Program 2010 Category I – Economic Development Montana Department of Commerce 3 Appendix A requesting $195,000 from the Big Sky Economic Development Trust Fund, which will match a $236,793.08 request from the Workforce Training Grant program and 2,068,206.95 of Venture Capital investment to complete the project. At the end of year 2, the company will support 37 employees with an average hourly wage of $48.82. Business’s Current Employment Level in Montana 10 Business’s Current Employment Level at the Project Site 10 Employee Benefits: Please list benefits and eligibility requirements provided by the assisted business Rivertop provides for health insurance for its employees and will pay seventy percent of the premium cost for the employee and the employee’s spouse and children. This benefit has an average annual estimated value of $5500 per employee. Rivertop will also contribute up to 3 percent of an employee’s salary to a qualified retirement plan provided the employee matches the contribution. Additional benefits include paid time off for holidays and sick leave as well as educational opportunities. VI. PROJECT ECONOMIC IMPACT STATEMENT Please provide a summary of the impact the project would have on the state, regional and community economy as well as any services or functions that the business provides to the community, region or state. Rivertop Renewables will create 26 direct new jobs and creates opportunity for Western Montana to attract similar green chemicals companies to the area. Please describe any negative impact of the project on the local, regional and/or state economy. There are no foreseen negative impacts at this time. VII. TABLE OF CONTENTS Please attach the following information to your application. See Section V of the Guidelines Application Requirement: Page Number/Tab 1. Appendix A: Application Form 2. Appendix B: Draft Sub-recipient Agreement (if applicable) 3. Appendix C: Draft Management Plan 4. Appendix D: Draft Business Assistance Agreement 5. Appendix E: Confidentiality Agreement and Affidavit (optional) 6. Business Plan (see Section V, part K for Business Plan elements) Business Description ---PAGE BREAK--- Big Sky Economic Development Trust Fund Program 2010 Category I – Economic Development Montana Department of Commerce 4 Appendix A Sales Generated Outside of Montana Management Resumes Business Market Appendix F: Sources and Uses of Funds Form Matching Funds Summary (Narrative) Financial Statements – 3 Most Recent Years of Operation Balance Sheet Profit and Loss Statement Cash Flow Statement Financial Projections – 2 years Projected Balance Sheet Projected Profit and Loss Statement Projected Cash Flow Debt Schedule Working Capital Needs Personal Financial Statements and Tax Returns (for owners with 20% or more ownership) Appendix G: Personal Credit Check Release Private and Public Sector Commitments for Funding (attach letters of commitment for each source of permanent and interim financing) Acquisition Narrative – Buy/Sell Agreement (if applicable) 7. Project Information (see Section V, part L for Project Information requirements) Project Description Appendix H: Project Budget Form Hiring and Training Plan Essential Services / Functions Project Timeline 8. Supporting Documentation: (Attach and Reference all additional Supporting Documentation) Map of Proposed Project Area Legal Counsel Name, Address, Phone Number ---PAGE BREAK--- Big Sky Economic Development Trust Fund Program 2010 Category I – Economic Development Montana Department of Commerce 5 Appendix A Community Support (attach letters of support from organizations or other businesses in the community) (Description) (Description) (Description) 9. Workers’ Compensation or Exemption Local or Tribal Government 10. Workers’ Compensation - Assisted Business ---PAGE BREAK--- Big Sky Economic Development Trust Fund Program 2010 Category I – Economic Development Montana Department of Commerce 6 Appendix A VIII. CERTIFICATION BY LOCAL GOVERNMENT AND BUSINESS As the responsible authorized agents of Local or Tribal Government Applicant: the City of Missoula, Sub-recipient: MAEDC and Applicant Business: Rivertop Renewables, we hereby submit this Big Sky Economic Development Trust Fund Application. The information presented in this application is, to the best of our knowledge, true, complete and accurately represents the proposed project. We understand that additional information and documentation may be required. In addition, we understand that the local or tribal government applicant and the assisted business receiving BSTF financial assistance are liable for the full amount of the award that is advanced by the Department if the assisted business: fails to create or maintain the number of net new eligible jobs as specified in the executed contract and assistance agreement, fails to inject the required amount of match into the project as specified in the executed contract and assistance agreement, or ceases operations at the Project Site. The Applicant designates Jessica Allred-Meyers, [PHONE REDACTED] (Name and Phone number) as the authorized contact for any additional Department requests for information regarding this application for BSTF funds. Local or Tribal Government Applicant: The City of Missoula will accept responsibility for management of the project and compliance with Big Sky Economic Development Trust Fund regulations. Applicant Sub-recipient: The Missoula Area Economic Development Corporation will accept responsibility for compliance with applicable Big Sky Economic Development Trust Fund regulations as specified in this application. Applicant Business: Rivertop Renewables will accept responsibility for compliance with applicable Big Sky Economic Development Trust Fund regulations as specified in this application. Name (typed): John Engen Local or Tribal Government Title (typed): Mayor City of Missoula Chief Elected Official Signature: X Date: Name (typed): Richard C. King Sub-recipient (if applicable) Title (typed): President/CEO MAEDC Authorized Representative Signature: X Date: Name (typed): James Stoppert Applicant Business Title (typed): CEO Rivertop Renewables Authorized Representative Signature: X Date: ---PAGE BREAK--- Big Sky Economic Development Trust Fund Program 2010 Category I – Economic Development Montana Department of Commerce 7 Appendix A