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` w� 1.T -,..;.tam-a a-s,-_-.__�.-_--_____. _- _ ----- .mod <br /> . <br /> /ach of the following wage categories,indicate the number o 4th, a .firdIfaih `d 5 Isiii e hasbiiii5 fZafg:nc1' <br /> 6rattft ablrouxlyavlue ainrid pilo prp tidK laitt benefits for those jobs. (Full-time jobs are defined as new,permanent,non <br /> 0 asonal positions created subsequent to the business subsidy agreement in which employees are scheduled to work on average at least a <br /> / 40 hour work week. Part-time is defined as a new job in which an employee works for the recipient at a rate less than 40 hours per week <br /> / within a recipient location). Job retention is defined as jobs at a specific wage level that exist prior to the signing of the business subsidy <br /> agreement. There must be evidence that the retained jobs will be lost without business assistance or where job loss is specific and <br /> •/ demonstrable. <br /> Hourly Wage A.1(M)=1,74 B.(New)Part- C.Job Total Jobs Hourly Value Hourly Value <br /> (excluding time Job time Job Retention (A+B+C) of Health of Non-Health <br /> Benefits) Creation Creation Insurance Insurance <br /> Benefits <br /> less than$7.00 $ $ <br /> $7.00 to$8.99 $ $ <br /> $9.00 to$10.99 $ $ <br /> $11.00 to$12.99 7. 2- 20 to $ $ <br /> $13.00 to$14.99 1 7 S' $ $ <br /> $15.00 to$16.99 - I /D $ $ <br /> ' $17.00 to$18.99 3 / ) $ $ <br /> $19.00 to$20.99 2 3 6.- $ $ <br /> $21.00 to$22.99 1 , r.1 $ $ <br /> $23.00 to$24.99 2- 3 5" $ $ <br /> $25.00 to$26.99 `--^ 3 ,3 $ $ <br /> $27.00 to$28.99 2. / 3 $ $ <br /> $29.00 to$30.99 '--. re 1p $ $ <br /> $31,00 and � I $ $ <br /> higher '� <br /> 32. Has the recipient achieved all goals(see Question 29,30 and 31)and fulfilled all obligations stipulated in the agreement(Mark one.) <br /> D Yes ❑No <br /> Section 5: Recipients Failing to Fulfill Obligations <br /> (Do not complete this section(questions 33-39)((you completed it on another MBAF submitted to DEED. Please below note which MBAF <br /> includes the information.) <br /> 33,During the period January 1,2012 through December 31,2012,did your organization have any recipients who failed to report as required <br /> by Minn.Stat.§116,1,993 and§1161994? (Mark one.) <br /> ❑Yes(Indicate the name of each recipient falling to report and the value of subsidy or financial assistance awarded to that <br /> recipient. Attach additional pages if necessary.) <br /> . • Name of recipient: <br /> • Type of subsidy or assistance(See Questions 24&25.): <br /> • Value of subsidy or assistance: <br /> ❑No <br /> 34.Did your organization have any recipients who failed to achieve any goals or fulfill any other obligations under an agreement signed on <br /> August I,1999 through December 31,2012,that was required to be fulfilled by the time of this report? (Mark one.) <br /> ❑Yes(Complete the remainder of this section.) [J No(Stop here and submit form to DEED,) ■ <br /> Üpc/ac/ <br /> . <br /> (bri eC Ad isi, , <br /> ilk <br /> Minnesota Business Assistance Form(12/10/12) Page 4 of 5 Dept.of Employment and Economic Development <br /> 1 <br />