6.2 EDSR 12-16-2013 - Laserfiche WebLink

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rj�j 31. For each of the following wage categories,indicate the number of actual(new)jobs created and/or retained since the benefit date and " the actual hourly value of any employer provided voluntary benefits for those jobs. (Full-time jobs are defined as new,permanent,non seasonal positions created subsequent to the business subsidy agreement in which employees are scheduled to work on average at least a 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 40 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 agreement. There must be evidence that the retained jobs will be lost without business assistance or where job loss is specific and demonstrable. Hourly Wage A.(New)Full- B.(New)Part- C.Job Total Jobs Hourly Value Hourly Value (excluding time Job time Job Retention (A+B+C) of Health of Non-Health Benefits) Creation Creation Insurance Insurance Benefits less than$7.00 $ $ $7.00 to$8.99 $ $ $9.00 to$10.99 $ $ $11.00 to$12.99 $ $ $13.00 to$14.99 $ $ $15.00 to$16.99 $ $ $17.00 to$18.99 $ $ $19.00 to$20.99 $ $ $21.00 to$22.99 $ $ $23.00 to$24.99 $ $ $25.00 to$26.99 $ $ $27.00 to$28.99 $ $ $29.00 to$30.99 $ $ $31.00 and $ $ higher 32. Has the recipient achieved all goals(see Question 29,30 and 31)and fulfilled all obligations stipulated in the agreement(Mark one.) ❑Yes El No • Section 5: Recipients Failing to Fulfill Obligations (Do not complete this section(questions 33-39)if you completed it on another MBAF submitted to DEED. Please below note which MBAF includes the information.) 33.During the period January 1,2012 through December 31,2012,did your organization have any recipients who failed to report as required by Minn.Stat.*1161.993 and§1161.994? (Mark one.) ❑Yes(Indicate the name of each recipient failing to report and the value of subsidy or financial assistance awarded to that recipient. Attach additional pages if necessary.) • Name of recipient: • Type of subsidy or assistance(See Questions 24&25.): • Value of subsidy or assistance: ®No 34.Did your organization have any recipients who failed to achieve any goals or fulfill any other obligations under an agreement signed on August 1,1999 through December 31,2012,that was required to be fulfilled by the time of this report? (Mark one.) ❑Yes(Complete the remainder of this section.) ❑No(Stop here and submit form to DEED.) S Minnesota Business Assistance Form(12/10/12) Page 4 of 5 Dept.of Employment and Economic Development