New Markets Tax Credit

New Markets Tax Credit Application Form Note: This questionnaire relates only to the eligibility of the project for the NMTC program. It is not a commitment to lend or an indication of terms.

Project Name:

The federal New Markets Tax Credit (NMTC) Program was created by Congress in 2000 to encourage private sector investment in businesses and economic activities in low-income communities. Investors receive tax credits in return for providing equity to community development entities that then use the capital to make investments in or loans to qualified projects located in low-income communities, typically at concessionary rates and/or terms.

Development Fund of the Western Reserve, Inc. (“DFWR”) uses the NMTC for projects with substantial and meaningful community development impact. Projects must be able to demonstrate their need for use of our tax credits relating to community and/or economic development. While there are many projects which meet the NMTC program requirements, not all will meet our requirements. Demand exceeds availability, therefore DFWR will generally provide an allocation of up to $10 million for a given project. Projects requesting more than $10 million allocation may be considered on a case-by-case basis.

The NMTC program is both innovative and complex. NMTC financing transactions may take longer than ordinary transactions to approve and close. Additionally, it should be noted that there may be increased costs associated with closing such transactions (e.g. legal fees).

For a project to be considered for NMTC, it must be located in a qualified census tract. Please visit the Novogradac & Company LLP website (http://www.novoco.com/new_markets/resources/maps_data.php) and, using the 2006-2010 ACS Data Map, enter the address (Number, Street, City, State, and Zip Code) into the NMTC Qualifying Census Tracts Mapping Tool to determine if it is in a qualified census tract.

If the project is located in a qualified census tract, please complete this questionnaire to the best of your ability, and submit it to the DFWR for initial review.

Part I: General Information Contact for Follow Up Information: Name:

Phone Number:

E-Mail Address:

Borrowing Entity:

DFWR Project Application Form 1 Project Name: ______Project Description: Please provide a description of the project. (You may attach additional information as necessary.) If applicable, please describe the use of the real estate (office, retail, industrial, housing, community facility and the projected tenant mix.) (Maximum Response: 3,000 characters)

Project Location

Street: City: State: Zip Code:

Please visit the Novogradac & Company LLP website (http://www.novoco.com/new_markets/resources/maps_data.php) and, using the 2006-2010 ACS Data Map, enter the address (Number, Street, City, State, and Zip Code) into the NMTC Qualifying Census Tracts Mapping Tool to determine if it is in a qualified census tract.

Census Tract #: ______Is the project located in a census tract qualified for NMTC financing? Yes ______No ______

Project Location – Distressed Criteria

Please place an "X" in the appropriate boxes to indicate whether the project meets any of the following "Targeted Distressed Community" criteria listed below. Please mark all that apply. WE ARE LOOKING FOR MAXIMUM IMPACT TO TARGETED AREAS.

Must have at least 1 of the following from Section A: Yes No Census tract with poverty rate greater than 30% Census tract with median family income 60% or less of area median income A Census tract with unemployment rate at least 1.5 times the national average Non-metropolitan census tract Projects serving qualified Targeted Populations

OR Must have at least 2 of the following from Section B: One of the following: Census tract poverty rate greater than 25% Census tract with median family 70% or less of area median income Census tract with unemployment rate at least 1.25 times the national average Federal-designated Empowerment Zone, Enterprise Community or Renewal Community State Enterprise Zone, Community Reinvestment Area or other state/local programs targeted toward particularly economically distressed communities SBA designated HUB Zone (to the extent QLICI will support HUB Zone certified businesses) B State- or Federal-designated Brownfield (as defined under 42 U.S.C. 9601 (39)) Encompassed by HOPE VI redevelopment plan Federally designated Medically Underserved Area (to the extent QLICI will support health related services in the area) Counties for which FEMA has (a) issued a major disaster declaration and (b) determined that the county is eligible for individual and public assistance, provided the initial investment was made within 24 months of the disaster declaration Food Desert Businesses certified by the Department of Commerce as eligible for assistance under the Trade Adjustment Assistance for Firms (TAA) Program

DFWR Project Application Form 2 Project Name: ______Project Description

Nature of project for which financing is being requested: Real Estate (Refer to “TIP” below.) Business Other (e.g. community facility)

TIP: Per the CDFI Fund, “real estate” projects refer to entities whose predominant business activity is the development (including construction of new facilities and rehabilitation/enhancement of existing facilities), management or leasing of real estate. Entities with other predominant business activities will fall into one of the other categories regardless of how the business intends to use the proceeds of the transaction or whether the business intends to use any real estate owned as collateral for a loan.

Borrowing Qualification

1. Are any of the following businesses conducted by the borrower or at the subject real estate? Please place an “X: in the appropriate boxes. Please mark an answer for each business type. Yes No Massage parlor Hot tub facility Suntan facility Country club Racetrack or other facility used for gambling Store whose principal purpose is the sale of alcoholic beverages for consumption off premises Development of holding of intangibles for sale Private or commercial golf course

Note: If you answered “Yes” to any of the above business activities, the project is NOT eligible for NMTC financing. Yes No 2. Do any revenues of the borrowing entity come from residential rental property (apartments or live/work units)?

If yes, estimate the percentage for each building from the borrower’s pro-forma or underwritten revenues:

Note: Revenues from residential rental real estate must be 80% or less of each building’s total revenues to qualify for NMTC.

Borrower’s Project Team Information

Please provide us information on your internal and external team members for this project. If a team function is not applicable to this project, please indicate so using “N/A”. If a team member has not yet been identified or selected, please indicate so using “TBD” (To Be Determined). These consultants represent the borrower, not the DFWR. DFWR will engage separate consultants.

FIRM OR INTERNAL POSITION RESPONSIBLE LEAD STAFF/CONTACT NAME Architect General Contractor Construction Manager Owners Representative Leasing Agent/Broker Property Manager Accountant - Reporting Compliance/Community Impact Reporter NMTC Accountant NMTC Attorney

DFWR Project Application Form 3 Project Name: ______Developer's Historical Track Record - What is the developer's involvement in this or similar communities? (Maximum Response: 3,000 characters)

Part II: Identification of Financing Sources

Total Project Cost:

NMTC Allocation Amount Being Requested (See “Note” below) Estimated Amount of net NMTC Benefit (20% of request)

Note: Demand exceeds availability, therefore DFWR will generally provide an allocation of up to $10 million for a given project. Projects requesting more than $10 million allocation may be considered on a case-by-case basis.

Please provide the type (see options below), amount, source and status (see options below) of other project financing.

Status Type Amount Source

Type:Debt - Commercial / Debt - Government / Debt - Other / Grant - Government / Grant - Other / Equity - Owner / Equity - Historic Tax Credit / Equity - Other

Disbursed / Commitment Letters / Term Sheet / Committee or Board Approvals / Public Approval Processes / Application Status: Pending / Estimate / Other

Project Pro Forma Details - In order to better understand the project level financing, please provide the project budget, basic pro forma or underwriting details for each of the sources of capital detailed above, or attach a pro forma analysis.

DFWR Project Application Form 4 Project Name: ______Project Assumptions (if real estate): Lease Term (Yrs): Lease Status (LOIs, executed leases): Please Describe:

Project Need for NMTC Financing NMTC program guidance includes a provision that projects financed would not otherwise occur without the benefit of the NMTC financing subsidy. Please detail the following.

How is the NMTC subsidy essential to the project’s success? (Detail how the project would not move forward or could not provide the degree of services/community impacts without the benefits of the credits) (Maximum Response: 3,000 characters)

Part III: Description of Community Impacts A major component of the NMTC Program is to provide financing that will generate significant impacts to benefit Low-Income Communities and low- income persons. Please address the following questions and provide any supplemental information that would be helpful in evaluating the community impact of the project.

1. Demonstrated Support of Local Community (You may attach additional materials as necessary such as community letters of support.) (Maximum Response: 3,000 characters)

2. Does the project have explicit government subsidies as a part of its capital or operating plan (i.e. grants or tax abatements) that demonstrate the commitment of the government unit? (Maximum Response: 3,000 characters)

3. Contribution to Long Term Development of Community (Please indicate how this project contributes to other community and regional development initiatives.) (Maximum Response: 3,000 characters)

DFWR Project Application Form 5 Project Name: ______4. Is this project likely to catalyze additional investment in the community? (Please explain.) (Maximum Response: 3,000 characters)

5. Environmental Soundness – Please indicate the extent to which the project will be developed in and operated in an environmentally sound matter.

Don’t Yes No Know Does the project create environmentally sustainable outcomes through green building concepts, location near mass transit, adaptive reuse of existing building or materials, etc.?

If so, please explain (Maximum Response: 3,000 characters):

Don’t Yes No Know Will your project include LEED-certifiable features? Will you seek LEED Certification? If so, to what LEED Level (i.e. Platinum, Gold, Silver, etc.)

6. Job Creation/Retention (Please populate chart below. For Permanent FT or PT jobs to be created, indicate the number to be created within 36 months of project completion.)

Full Time Part Time

FT: Full-time/PT: Part-time Local Low-Mod Local Low-Mod Total Residents Income Total Residents Income # of Permanent FT Jobs Likely to be Created by Project # of Permanent FT Jobs Likely to be Retained Due to Project # of Permanent PT Jobs Likely to be Created by Project # of Permanent PT Jobs Likely to be Retained Due to Project # of Construction Jobs Likely to be Created by Project

7. Will the project provide vital community services to residents of the low-income community (grocery store where one doesn’t exist, day care for workers in the area, cultural venue, etc.)? (Please explain.) (Maximum Response: 3,000 characters)

DFWR Project Application Form 6 Project Name: ______8. What enhanced or additional goods or services will be available to the community? (daycare slots, patients served, etc.)? (Please explain.) (Maximum Response: 3,000 characters)

9. What additional (if any) benefits does the project/business provide to the low-income community or low-income residents? (Please explain.) (Maximum Response: 3,000 characters)

10. Does the project provide space for locally owned, minority or women-owned businesses or non-profit tenants? Is there an explicit set- aside for such tenants? (Please explain.) (Maximum Response: 3,000 characters)

11. Square Footage of Commercial Space (excluding housing units):

Please indicate the value of this outcome to low-income communities or residents. If applicable, please try to address the following (Maximum Response length: 3,000 characters):  What specific tenants (or types of tenants) are expected to occupy the commercial space, and how will the jobs they generate and / or goods & services they provide help the local community?  To what extent will the project provide vital community services to residents of the low-income community (grocery store where one doesn’t exist, day care for workers in the area, cultural venue, etc.)?  Will the project provide space for locally-owned, minority- or women-owned businesses or nonprofit tenants? Is there an explicit set-aside for such tenants?  What, if any, community services will be provided by the project?

12. Square Footage of Community Facility (excluding housing units): Capacity or Number of Persons Served by Community Facility as Described Below:  If the project financed includes an educational facility, report the number of student seats available in the school.  If the project financed includes a childcare facility, report the number of childcare slots available in the facility.  If the project financed includes a healthcare facility, report the projected number of patients served per year.  If the project financed includes an arts center, report the capacity of the arts center. DFWR Project Application Form 7 Project Name: ______Example: If the project is a theater, report the seating capacity.  If the project financed is a community facility that serves a purpose other than education, childcare, healthcare, or arts, report the capacity related to that other purpose.

Please explain the basis for this projection (Maximum Response: 3,000 characters):

13. Number of Housing Units Produced:

Please indicate whether these units will be rented or sold and explain the significance of the housing to revitalizing the local community. (Maximum Response: 3,000 characters)

14. Number of Affordable Housing Units Produced:

Please indicate whether these units will be rented or sold and explain the significance of the housing to revitalizing the local community. Please also indicate the level of affordability. (Maximum Response: 3,000 characters)

Part IV: Project Readiness

Site Control: Owned Under Contract (Expires:______) In Negotiations Anticipated Sale to Related Entity Other: ______

Please explain as needed (Maximum Response length: 3,000 characters):

Due Diligence: Yes No Date Completed or Target Date Not Needed Phase I Environmental Phase II Environmental No Further Action Letter Geotechnical/Soils Study

DFWR Project Application Form 8 Project Name: ______Market Study/Assessment Acquisition Appraisal “As Built” Appraisal

If any item is “Not Needed,” please explain why (Maximum Response: 3,000 characters):

Entitlements: Target Yes No Date

Zoning Approval or As of Right Development

Building Permits

Design Development: % Complete Underway Complete

Schematic/Concept Plans

Full Architectural Drawings

Construction Drawings

Construction Contracting and Budgeting: In Yes No Progress

Construction Contract?

Will this be a Guaranteed Maximum Price Contract?

If there will not be a Guaranteed Maximum Price Contract, please describe what type of contracting arrangement will be used. (Maximum Response: 3,000 characters)

Yes No Will There Be A Payment and Performance Bond?

If not, please describe why (Maximum Response: 3,000 characters):

Developer Estimate Architect Estimate Contractor Estimate* Basis of Hard Cost Estimate

*Please Indicate % Completion of Construction Drawings Used For Estimate: Date Obtained: DFWR Project Application Form 9 Project Name: ______Part V: Transaction Timing 1. What is the earliest date by which this transaction could be ready to close and latest date by which it must close?

Earliest Date: Latest Date:

Please explain what is driving the target closing date as needed (Maximum Response: 3,000 characters):

Part VI: Submission Acknowledgment

As an authorized agent of the Applicant Company, I hereby submit this Project Application. I understand that any false statement in this record may subject the Applicant Company and signer to criminal prosecution. I understand that additional information will be required. I also understand that this document in no way constitutes a commitment of funds by the Development Fund of the Western Reserve and any of its loan programs. This is also an acknowledgment that I have been provided a copy of the “Preferred Contractor Policy” of the Development Fund of the Western Reserve.

______Signature

______Printed name, Title Date

DFWR Project Application Form 10 Project Name: ______