Application of Inducement
Complete this application using the provided PDF context. Use the specified field types, options, and all required acknowledgment statements, then sign and date the form.
Applicant Information
Name of Applicant
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Trade Name or Brand Name
Applicant Type
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Please Select
Corporation
Limited liability company
Limited partnership
Partnership
Individual
State of Incorporation or Organization
Applicant Profit Status
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Please Select
For profit
Non-profit
Project Location and Contact Information
Project Address
*
Home Office Address
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Local Office Address
Contact Person Name
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First Name
Middle Name
Last Name
Contact Person Address
Contact Person Telephone
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Please enter a valid phone number.
Format: (000) 000-0000.
Contact Person Email
*
example@example.com
Project Use and Employment Impact
Project Use
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Manufacturing
Warehousing/Distribution
Other Uses
Project Use - Other Uses
Number of new full-time jobs to be created in the State within two years after project is placed in service
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Number of existing full-time jobs at Applicant’s facility to be preserved as a result of the Project
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Number of jobs to be moved to Project from other locations in the state
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Is Project located within a City? If so, identify the City.
Is the Project located in the unincorporated area of the County?
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Please Select
Yes
No
Is the Project an expansion of an existing facility owned by the Applicant?
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Please Select
Yes
No
Status of land for project
Is any building to be purchased?
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Please Select
Yes
No
If a building is to be purchased, will the building include any existing equipment?
Please Select
Yes
No
Is any used equipment (not purchased with any building) to be purchased?
*
Please Select
Yes
No
Project public benefit and employment impact description. Describe how this project will "develop and promote for the public good and general welfare, trade, commerce, industry and employment opportunities of Camden County and how the project "will increase or maintain employment" in Camden County.
Project description. Include projected dates of construction and completion.
Project Cost Breakdown
Land - Acres
Land - Cost
Building - Square Feet
Building - Cost
Building Addition - Square Feet
Building Addition - Cost
Used Building Rehabilitation - Cost
Paving & Landscaping - Cost
Trade Fixtures & Equipment - Cost
Contingencies / Soft Costs - Cost
Other Costs (including issuance costs) - Description
Other Costs (including issuance costs) - Cost
Total Cost of Project
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Amount of Total Cost of Project proposed to be financed with IDBs
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Bond Financing and Professional Contacts
Bonds to be purchased by Applicant or affiliate? For example, taxable "bonds for title."
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Yes
No
Bonds to be privately placed with a bank or insurance company?
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Yes
No
Bonds to be sold publicly through Bond Placement Agent or Underwriter. If yes, please provide contact information below.
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Yes
No
Bond Placement Agent or Underwriter Contact Information
Arrangements for Marketing or Placing Bonds not yet determined. Insert yes if none of above choices apply, or insert explanation if not applicable.
Bond Counsel - Name and Contact Information
Applicant’s General Counsel - Contact Information
Applicant’s Georgia Counsel (if different) - Contact Information
Bonds issued as variable rate demand bonds secured by a letter of credit. If yes, provide contact information below.
*
Yes
No
Letter of Credit Bank - Contact Information
Guarantor (if any) - Name and Contact Information
Acknowledgments and Signature
Terms and conditions- By execution of this Application, Applicant acknowledges and agrees to the following terms and conditions:
Agreed to
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Statement 1: Ad valorem tax exemptions, reductions or “abatements” on real or personal property are not automatic if IDBs are issued pursuant to this Application.
Statement 2: The Authority, the members of the Authority, its officers, agents and employees are under no circumstances to be exposed to personal liability, that Applicant must agree to hold it and them harmless from personal liability and that this recital must appear in the Inducement Letter and Resolution authorizing the Inducement Letter.
Statement 3: Bond Counsel must be acceptable to the Authority and such counsel must have substantial experience in the field. As a minimum, the bond counsel firm must be listed in the listing of Bond Attorneys in the “Red Book” (i.e., “The Bond Buyer’s Municipal Marketplace”) and the particular lawyers with the firm that are responsible for the engagement must be members of the National Association of Bond Lawyers.
Statement 4: In the event the Applicant applies for and receives an Inducement Letter, it will be responsible for the payment of all expenses of the Authority and the expenses and fees of the Authority’s Counsel and, in the event said issue does not close, the Applicant will nevertheless be responsible for the payment of all expenses of the Authority and the expenses and reasonable fees on an hourly basis of Authority’s Counsel.
Statement 5: Unless expressly waived or adjusted by the Authority, the Authority must be paid a fee of 1/8% of the principal amount of the bonds issued at the Closing of the Issue. This fee is payable in accordance with the Authority’s policies.
Statement 6: The regular monthly meeting of the Authority is on the fourth (4th) Thursday of every other month; the Authority may hold special meetings if absolutely necessary but no material or document will be considered at any meeting which has not been delivered to the Authority's Counsel at least seven (7) calendar days prior to the meeting at which it is to be considered. The contact information for the Authority is shown below.
Statement 7: The Authority will expect knowledgeable officials and/or representatives of the Applicant to appear at the Authority meeting at which the execution of an Inducement Letter is to be considered and to explain personally the project and answer questions about the Applicant.
Statement 8: The Applicant is responsible for obtaining all zoning, land use and building permits.
Statement 9: If IDBs are issued pursuant to this Application, they shall be repaid out of security pledged thereto, including revenues of the Project, and the proceeds of any letter of credit provided by the Applicant, but shall not be repaid in any event by the Authority or its parent jurisdiction or the State of Georgia.
Statement 10: The Applicant shall be responsible for compliance with all federal tax laws (if the bonds are federally tax-exempt bonds) and with all applicable federal and state securities law requirements relating to the bonds.
Submission Date - Day
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Submission Date - Month
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Submission Date - Year
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Applicant Name
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Signature on behalf of Applicant
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Signer Name
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First Name
Middle Name
Last Name
Signer Title
*
Signature Date
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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