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HomeMy WebLinkAboutA006 - Financial Assistance Application to Iowa Economic Development Authority dated December 23, 2014 WA Debi V. Durham, Director Iowa Economic Development Authority tsusiness Financial Assistance Application t lcine,s Flntan�'E ( .,!�inc c (lryn!,-)ardent Division 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 g_aly those additional sections for the components to which the applicant is applying. STATE of IOWA— Financial Assistance Program High Quality Jobs Program (HQJP) ® Tax Credits ❑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/lowal-aw.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 4:00pm on the fourth Monday of the month. Applications will be reviewed by the IEDA Board on the third Friday of the following month. 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. SECTION A Applicant Information Date Application Submitted: 12-23-14 1. Name of Business: Barilla America, Inc. 2. Entity Name (for contracting purposes): Barilla America, Inc. 3. Address: 3311 East Lincoln Way 4. City, State & Zip Code: 50010 5. Contact Person: Larry L. Covington Title: Plant Director- Ames 6. Phone: 515-988-9020 Fax: 515-956-4465 Email:larry.covington@barilla.com 7. FEIN: 06-1400247 8. NAICS Code for primary business operations: 311824 9. US DOT Number: N/A 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: Fabio Pettenati Vice President Supply Chain Barilla America, Inc. 11. If the application was prepared by someone other than the contact person listed above, please complete the following: Name of Business: 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 Ames 13. Official Contact (e.g. Mayor, Chairperson, etc.): Ann Campbell Title: Mayor 14. Address: 515 Clark Avenue 15. City, State & Zip Code: Ames, IA 50010 16. Phone: 515.239.5105 Fax: 515.239.5320 Email: bobanncamp@aol.com 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: Ron Hallenbeck Title: Executive Vice President, Existing Business & Industry Address: 304 Main Street City, State & Zip Code: Ames, IA 50010 Phone: 515-232-2310 Fax: 515-233-3203 Email: ron@ameschamber.com If necessary, please list information on additional sponsors in an attachment. See Attachment A7 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. Barilla, originally established in 1877 as a bread and pasta shop in Parma, Italy, ranks as one of today's top Italian food groups. Barilla leads in the global pasta business, the pasta sauces business in continental Europe, the bakery products business in Italy and the crispbread business in Scandinavia. Barilla owns 30 production sites(14 in Italy and 16 outside Italy), of which 9 are directly managed mills that provide most of the raw materials for the production of its pasta and bakery products. Barilla's Ames facility produces dry pasta and includes an integrated Mill that provides 100% of the semolina requirements for Ames demand and over 60% of the requirement for our Avon, N.Y. production facility. Barilla exports to more than 100 countries. Every year about 1,700,000 tons of food products, with the brands Barilla, Mulino Bianco, Voiello, Pavesi, Academia Barilla, Wasa, Harry's (France and Russia), Misko (Greece), Filiz (Turkey), Yemina and Vesta (Mexico), are featured on dining tables the world over. Barilla has become one of the world's most esteemed food companies and is recognized worldwide as a symbol of Italian know- how by respecting its longstanding traditional principles and values, considering employees a fundamental asset and developing leading-edge production systems. 2. Business Structure: ❑ Cooperative ® Corporation ❑ Limited Liability Company ❑ Partnership ❑ S-Corporation ❑ Sole Proprietorship 3. State of Incorporation: ILL 4. Identify the Business' owners and percent ownership: Barilla G & R Fratelli ( 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. Ames - 162 7. What is the Business' worldwide employment? (Please include employees of parent company, subsidiaries, and other affiliated entities in this figure.) 8,000 Project Information 8. Project Street Address: 3311 East Lincoln Way Project City & Zip Code: 50010 Project County: Story 9. Type of Business Project: ❑ Startup ® Expansion of Iowa Company ❑ New Location in Iowa 10. Does the project site qualify as a "Brownfield" or "Grayfield" site? ❑ Yes ® No If yes, please explain and document as Attachment A6. 11. 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.) The company plans to install two production lines, raw material storage and the associated packaging/palletizing equipment to produce Gluten Free Pasta in the Ames, Iowa facility(Story County). Corporate approval granted on 10/30/2014 and planning work started. The plan is to have all building upgrades and equipment installations completed by 11/1/2015 with a phased start-up of the production in November and December of 2015. Full production is scheduled for January 1, 2016. The project spend is—$26.5 million dollars and will add -23 new employees in various roles to the Ames Plant. This is a key initiative for the company to add capacity locally to meet the demands for a growing Gluten free market in the U.S., Canada, South America and Australia 12. Project Timeline (add additional rows as needed) Beginning Activity Date Activity Completion Date Corporate Capital Expenditure Approval 10/30/2014 10/30/14 Ames- Planning for purchase and installation of 11/10/14 11/15/2015 Gluten Free production capacity Start-up curve for Production lines 11/15/15 1/1/2016 Full Production 1/1/2016 Ongoing 13. Has any part of the project started*? Yes ® No 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. 14. 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. N/A. There are no key competitor's for this category based in Iowa. 15. 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. N/A 16. Is the Business actively considering locations outside of Iowa? ® Yes ❑ No If yes, where and what assistance is being offered? For this project, Ames has been selected as the location after a vigorous "Make vs. Buy" analysis was completed. This analysis included Barilla locations in Parma, Italy; co-manufacturing in Italy and Barilla's Avon, New York location. Future expansion of the semolina side of the business (est$50M)will be awarded here in Avon New York or a greenfield site outside of Iowa. That decision is yet to be reached but it estimated to be decided within the next three years pending market growth and innovation. How the State of Iowa responds to this expansion will play a large role in how we are viewed for future expansions. 17. Please identify the company project management for the project location and experience. Barilla Engineering Team SECTION C Applicant's Project Budget 1. Does the Business plan to lease the facility? ❑ Yes x 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. Use of Funds Cost Source A Source B Source Source D Source E Source F C Base Rent 3 ears N / A Tenant Improvements N / A Land Acquisition N / A Site Preparation N / A Building Acquisition N / A Building Construction N / A Building Remodeling $6,672,000 $6,672,000 Mfg. Machinery& Equip. $19,352,000 $19,352,000 Other Machinery& Equip. $391 ,000 $391,000 Racking, Shelving, etc. $ 0 $ 0 Computer Hardware $8 5,0 0 0 $85,000 Computer Software $ 0 $ 0 Furniture& Fixtures N / A N / A Working Capital Research & Development $330,000 `Startup $330,000 Other—Building utilities $ 0 $ 0 TOTAL $26,830,000 $ $ $26,830,000 $ I $ $ 2. Please complete the budget below. Include only costs the company plans to incur directly: Racking,shelving and conveyor equipment used in distribution center projects only 3. Please complete the chart below with proposed financing for the project(tax benefits should be reflected as indirect financing under#5 below): PROPOSED FINANCING Source of Funds Form of Funds Conditions/Additional Information Amount (Loan,Grant, In- Rate and Commitment Include when funds will be Add additional lines as needed Kind,Donation,etc.) Term Status disbursed;If loan,whether payments are a level term, balloon,etc Source A: IEDA see#4 below) $ Source B: Local Government $ Source C: Business $26,830,000 Self-Funded Approved Dollars committed by Corporate Source D: Other Source $ Source E: Other Source $ Source F: Other Source $ TOTAL $ 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. . N/A Explain: No collateral,funding disbursed at the end of the 5-year contract ❑ Irrevocable letter of credit ❑ Dedicated certificate of deposit CD ❑ Surety bond ❑ Mortgage on real estate ❑ Corporate guaranty ❑ Personal guarantee ❑ * The IEDA Board has the final discretion on what collateral will be accepted. 5. Please complete the chart below with tax credits and other indirect financing expected for the project: TAX CREDITS AND INDIRECT FINANCING Source of Funds Amount Description Investment Tax Credit 522,180 2% ITC —Construction/Building Improvements & Industrial Machinery Sales, Service&Use Tax Refund 200,160 Construction Materials Research Activities Credit 3%/10% 42,750 3 YR Qualifying 9.5%Credit Local Property Tax Exemption Any increases in property tax as a result of this expansion would be expected to be exempt over a period of ten years. Tax Increment Financing 260E Job Training Funds 67,000 Start-up training costs In-kind Contribution Local Property Tax Abatement 217,895 Estimated 427B Other 37,674 New Jobs Tax Credit TOTAL $1,087,659 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. Barilla has become one of the world's most esteemed food companies and is recognized worldwide as a symbol of Italian know-how by respecting its longstanding traditional principles and values, considering employees a fundamental asset and developing leading-edge production systems. The company plans to install two production lines, raw material storage and the associated packaging/palletizing equipment to produce Gluten Free Pasta in the Ames, Iowa facility (Story County). Corporate approval granted on 10/30/2014 and planning work started. The plan is to have all building upgrades and equipment installations completed by 11/1/2015 with a phased start-up of the production in November and December of 2015. Full production is scheduled for January 1, 2016. The project spend is $26.5 million dollars and will add — 23 new employees in various roles to the Ames Plant. This is a key initiative for the company to add capacity locally to meet the demands for a growing Gluten free market in the U.S., Canada, South America and Australia. Barilla has chosen to make this investment in Ames vs. another location partially on the premise of communications with the State of Iowa representatives on a visit to Parma, Italy in the past 18 months. Like any other company making such a large investment, any financial aid in the form of tax incentives, rebates, energy rate reduction, training assistance for new employees, etc. is needed to augment the payback of this project. SECTION D 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. Option 1 Option 2 Option 3 80% single Coverage 50% Family coverage Monetary Equivalent Total Number of Pay 80%of premium costs Pay 50%of premium costs for Provide medical and pay the Employees in for a standard medical plan, a standard medical plan, monetary equivalent of Option Iowa single coverage. family coverage. 1 or Option 2 in supplemental 250+ $750 maximum deductible $1,500 maximum deductible employee benefits. 50-249 $1250 maximum deductible $2500 maximum deductible Benefits Counted Toward 0-50 $1750 maximum deductible $3500 Maximum deductible Monetary Equivalent:Medical coverage, Dental coverage, Vision insurance, Life insurance, Pension, 401(k) (company's Average contribution, Short-/long-term disability insurance, Child care services, Other nonwage com ensation 1. How many full-time, permanent employees does your company currently employ within the State of Iowa? 162 2. What is the total premium cost for a standard medical plan for single employee coverage? $6,338 a. What portion of this cost is paid by the business? 87% b. What is the deductible associated with this plan? $ 500 3. What is the total premium cost for a standard medical plan for family coverage? $ 18,728 a. What portion of this cost is paid by the business? 84% b. What is the deductible associated with this plan? $ 1500 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 yes, please provide the annual amount offered by the business, per employee in the chart below: Benefit Annual amount paid by the business (per employee): Dental Insurance—Single plan $206 Dental Insurance— Family plan $716 Pension (Use 3-year average calculated below) N/A Retirement Plan - i.e. 401(k) (Use 3-year average calculated below) $11,687 Profit Sharing Plan (Use 3-year average calculated below) N/A Childcare Services N/A Life Insurance coverage $649 —Disability Insurance coverage $489 Health Savings Account(HSA) contribution N/A TOTAL $13,747 5. Does the Business offer a pension plan, 401(k) plan, and/or retirement-plan? ® Yes ❑ No We match employee contributions dollar for dollar up to 6%. 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 employee. Year Ending Average Actual Match per Employee $ Three-year Average: Number is reflected in the table above: $11,687 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 emplo ee for that three year period. Year Ending Average Actual Share per Employee $ $ Three-year Average: N/A$ 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. SECTION E Project Jobs 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 Starting Wage at 36 months CREATED Jobs Hourly Wage following the award Maintenance Technician 1* $22.00 $28.61 Process Operator 6 $16.50 $22.29 Raw Material Supply/QA 3 $16.50 $22.29 Packaging Operator 12 $15.30 $20.06 Production Professional 1* $65,000/ r $71,500/ r • Please note the Maintenance tech and Production Prof. role will start at one and we will add one in more each based on volumes in —2018. Those are not included in the total Total Full-Time CREATED Jobs 23 Full-Time RETAINED Jobs Add additional rows as needed Number of Current Hourly Job Title (AT-RISK jobs only) RETAINED Wage Jobs Total Full-Time RETAINED Jobs 2. Is the hourly wage rate based on a 40 hour work week, 52 weeks per year? ® Yes No If no please explain: For this project, we will be operating on a 5 day a week/40 hours/week schedule but our normal operating schedule is a 12 hr schedule with built in overtime. Normally, our operators will work one 48 hr week and one 36 hr week. At the later stages of this project(2018-2020) or as volumes dictate, we will move to this 24/7 operating schedule. SECTION F Business Taxes IEDA is required to calculate the return on state and local government investments in this project. Data from other parts of the application will be combined with the estimates requested below to calculate the required return on investment information. Please read the following directions carefully: • IEDA is asking for a best estimate on the increase in taxes associated with this project. • Estimates should only include the expected increase in tax liability resulting from this project. • At minimum, IEDA needs estimates for the first three years of the project. • Show data as if no tax abatements or tax credits awarded for this project were taken. • For partnership forms of ownership (e.g. limited partnerships, s-corporations, LLC, etc.), please estimate the partners' increase in Iowa tax liability due to this project. • Sales and use taxes refer to the taxes paid on materials, etc. that the Business purchases, not taxes you collect from sales to your customers. • Applicants will not be held to these numbers with respect to any award from or contract with IEDA. • This page of the application will automatically be treated as confidential. Increase in Tax Collections Associated with this Project State Business Taxes Year 1 Year 2 Year 3 Year 4 Year 5 State Corporate Income Tax* 0 5000 5000 5000 5000 State Business Sales and Use Tax 504,000 336,000 0 0 0 * Insurance Companies: Provide State Insurance Premium Tax • Assumptions of— $12,000,000 @ 7% sales tax with 60% in 2015 and 40 % in 2016. Local Business Taxes Year 1 Year 2 Year 3 Year 4 Year 5 Local Real Estate Property Tax TBD TBD TBD TBD TBD Local Option Sales Tax N/A N/A N/A N/A N/A • There is an assumption at this time that Barilla will NOT see an increase in property taxes as a result of this project. Thus, the Local Real Estate Tax columns have been left blank. Ames City Assessor has been contacted and project described as mainly a building within a building. Assessor will work with Barilla to determine actual property taxes upon project completion. • We are not subject to local option sales Tax. • Regarding the States Business taxes, we assume a small increase in income tax of $5000/yr. The first year of the project is 2015 and no income will be generated in 2015 due to installation and start-up in the last half of Q4 ( December, 2015) SECTION G Attachments Please attach the following documents: Al Project Plan (Attached) 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) (Attached) • 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 (Attached) A4 Financial Information (Confidential, unless already publicly available) (Existing Businesses Only) (Attached) • 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) N/A A6 Brownfield or Grayfield site documentation (if applicable) N/A 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? ❑ 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, Chapter 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, I 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 furnished 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): See Attached Signature Page Signature Date Signature Date Fabio Pettenati—Vice President, Supply Chain Name and Title (typed or printed) Name and Title (typed or printed) IEDA will not provide assistance in situations where it is determined that any representation,warranty, or statement made in connection with this application is incorrect,false, misleading or erroneous in any material respect. If assistance has already been provided prior to discovery of the incorrect,false, or misleading representation, IEDA may initiate legal action to recover incentives and assistance awarded to the Business. Attachment: A7 Barilla Gluten-Free IEDA Financial Application Additional Sponsor organization contact: Name: Duane Pitcher Title: Director of Finance, City of Ames Address: 515 Clark Avenue City, State & Zip Code: Ames, IA 50010 Phone: 515-239-5113 Fax: 515-239-5320 Email: dpitcher@city.ames.ia.us 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? ❑ Yes x 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 x No 1 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 x 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 x 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 x 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, Chapter 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,I 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 furnished 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): Signature Dateignature Cate Fabio Pettenati--Vice President, Supply Chain Name and Title(typed or printed) Name and Title(type or prin d) IEDA will not provide assistance in situations where It is determined that any representation,warranty,or statement made In connection with this application is Incorrect,false,misleading or erroneous In any material respect.If assistance has already been provided prior to discovery of the Incorrect, false,or misleading representation,IEDA may initiate legal action to recover incentives and assistance awarded to the Business. Page 2 of 3 From: Duane R Pitcher [mailto:DPitcher@city.ames.ia.us] Sent: Tuesday, January 13, 2015 3:01 PM To: Ron Hallenbeck Subject: Rel Barilla Resolution/Mayor's Signature Ron, We need to get the finalized IIEDA application before with proceed with signatures. Please confirm that the version we have is t��e-fin-JT—v-e­rsian-g-6ing to the board. We'll scan and e-mail a copy of the signature page when signed by the mayor. Please send me the IEDA contact. Duane Duane Pitcher, CPA, CPFO Director of Finance City of Ames 515 Clark Avenue P.O. Box 811 Ames, Iowa 50010 Phone (515) 239-5114 -Ron Hallenbeck --ron@ameschamber.com= w --To: "Duane Pitcher (dpitcher(&city.ames.ia.us)" <dpitcher@city.ames.ia.us> From: Ron Hallenbeck <ron@ameschamber.com> Date: 01/13/2015 02:37PM Subject: Barilla Resolution/Mayor's Signature file://C:ADocuments and Settings\diane.voss\Local Settings\Temp\notesEIEF34\—web3705... 1/14/2015 i