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Minnesota Business Assistance Form-View Form Page 1 of 6 3( <br /> _X' Minnesota <br /> Department <br /> of <br /> Employment <br /> and <br /> Economic <br /> Development <br /> Section 1 Grantor Information <br /> Date submitted:4/6/2011 10:25:00 AM <br /> Note:Modified by DEED on 9/28/2011 11:30:00 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:13065 Orono Parkway <br /> 4.City: Elk River <br /> 5.Zip code:55330 <br /> 6.County:Sherburne <br /> • 7.Phone number:7636351041 <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 <br /> affiliation.For example,a city EDA would check"City Government."):City government <br /> 12.Has your organization held a public hearing on and adopted criteria for awarding business <br /> subsidies in compliance with Minn.Stat. ❑116J.994?:Yes,prior to 2004 <br /> Hearing Date:5/1512006 <br /> Year Criteria Submitted:2006 <br /> 13.Has your organization signed any agreements to award a business subsidy or financial <br /> assistance from August 1, 1999 through December 31,2006, unless goals have been achieved and <br /> reported in a previous filed MBAF that is required to be reported under Minn.Stat. 0116J.993 and <br /> ❑116J.994?:Yes <br /> Section 2 Recipient Information <br /> 14.Name of business or organization receiving subsidy or financial assistance:The Bank of Elk <br /> 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 /> file://C:\Documents and Settings\cknoof\Desktop\DEED09.28.2011.htm 12/2/2013 <br />