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Minnesota Business Assistance Form-View Form Page 1 of 4 30 <br /> r_ <br /> _ - <br /> _ _ _ _ <br /> DEPARTMENT OF EMPLOYMENT AND ECONOMIC DEVELOPMENT <br /> Section 1 Grantor Information. <br /> Date submitted:51191200910:62:00 AM <br /> Note:Modified by DEED on 9111/2009 11:49:55 AM <br /> 1.Name of grantor(funding entity):Elk River,City of <br /> 2.Name of person completing this form:Catherine Mehelich <br /> 3.Street Address:13066 Orono Parkway <br /> 4.City:Elk River <br /> 5.Zip code:65330 <br /> 6.County:Sherburne <br /> 7.Phone number:7636351041 <br /> 8.Fax number:7636351090 <br /> 9.E-mail address:cmehelich @ci.elk-river,mn.us <br /> 10.Is the person who should receive the MBAF different from the person in Question 2?No <br /> 11.Classification of grantor(If grantor is entity created by government agency,please Indicate affiliation.For example,a city EDA would <br /> check"City Government."):City government <br /> 12.Has your organization held a public hearing on and adopted criteria for awarding business subsidies in compliance with)Minn.Stat, <br /> :116J.994?:Yes,prior to 2004 <br /> Hearing Date:5115/2006 <br /> Year Criteria Submitted:2006 <br /> 13.Has your organization signed any agreements to award a business subsidy or financial assistance from August 1,1999 through <br /> December 31,2006,unless goals have been achieved and reported in a previous filed MBAF that Is required to be reported under Minn. <br /> Stat.0116J.993 and J116J.994?:Yes <br /> Section 2 Recipient Information <br /> 14.Name of business or organization receiving subsidy or financial assistance:The Bank of Elk River <br /> 15.Address where business subsidy or financial assistance will be used. <br /> Street Address:630 Main St <br /> City:Elk River <br /> State:MN <br /> Zip Code:55330 <br /> 16.Does the recipient have a parent corporation?:No <br /> 17.Industry of recipients facility:Finance,Insurance,Real Estate <br /> 18.Did the recipient relocate as a result of signing this agreement?No <br /> 19.What would the recipient have done without business subsidy or financial assistance?:Relocate to different Minnesota location <br /> 19A.Was the project a result of eminent domain?No <br /> Section 3-Agreement Information <br /> 20.Total dollar value of business subsidy or financial assistance:$300000 <br /> 21.Date agreement signed:4/17/2006 <br /> 22.Benefit date(Indicate the date the recipient receives the business subsidy or improvements were finished,equipment was placed into <br /> https://apps.deed.state.mn.us/Annual_MBAF_Reports/fetch report.asp 11/7/2013 <br />