REQUEST FOR PROPOSALS (RFP)

Transcription

1 REQUEST FOR PROPOSALS (RFP) Department of Administration County of Dane, Wisconsin COUNTY AGENCY Department of Planning and Development, CDBG RFP NUMBER # RFP TITLE PURPOSE DEADLINE FOR RFP SUBMISSIONS Dane County Revolving Loan Fund Services The purpose of this document is to provide interested parties with information to enable them to prepare and submit a proposal for revolving loan fund underwriting and oversight services. 2:00 P.M. Central Time March 21, 2012 LATE, FAXED, ELECTRONIC MAIL OR UNSIGNED PROPOSALS WILL BE REJECTED SUBMIT RFP TO THIS ADDRESS SPECIAL INSTRUCTIONS DANE COUNTY PURCHASING DIVISION ROOM 425 CITY- COUNTY BUILDING 210 MARTIN LUTHER KING JR BLVD MADISON, WI Label the lower left corner of your sealed submittal package with the RFP number Place the Signature Affidavit as the first page of your proposal Submit one original and ( 4 ) copies of your technical proposal Submit one original and ( 1 ) copy of your cost proposal Submit one complete electronic copy in Microsoft Word or PDF format burned to a CD or DVD DIRECT ALL INQUIRES TO DATE RFP ISSUED: February 23, 2012 NAME TITLE Carolyn Clow Purchasing Agent PHONE # 608/ FAX # 608/ WEB SITE clow@countyofdane.com 1

2 TABLE OF CONTENTS 1.0 GENERAL INFORMATION 1.1 Introduction 1.2 Scope 1.3 Definitions 1.4 Clarification of the specifications 1.5 Addendums and or revisions 1.6 Calendar of events 1.7 Contract term and funding 1.8 Reasonable accommodations 2.0 PREPARING AND SUBMITTING A PROPOSAL 2.1 General instructions 2.2 Proprietary information 2.3 Incurring costs 2.4 Vendor registration 2.5 Submittal instructions 2.6 Required copies 2.7 Proposal organization and format 2.8 Multiple proposals 2.9 Oral presentations and site visits 3.0 PROPOSAL SELECTION AND AWARD PROCESS 3.1 Preliminary evaluation 3.2 Proposal scoring 3.3 Right to reject proposals 3.4 Evaluation criteria 3.5 Award and final offers 3.6 Notification of intent to Award 4.0 GENERAL PROPOSAL REQUIREMENTS 4.1 Introduction 4.2 Organization experience 4.3 Staff qualifications 4.4 Response time 4.5 Proposer references 5.0 TECHNICAL REQUIREMENTS 5.1 Loan Underwriting 5.2 Background Checks 5.3 Jobs Tracking 5.4 Loan Servicing 6.0 COST PROPOSAL 6.1 General instructions on submitting cost proposals 6.2 Format for submitting cost proposals 6.3 Fixed Price Period 7.0 SPECIAL CONTRACT TERMS AND CONDITIONS 7.1 Payment requirements 7.2 Living Wage requirements 7.3 Domestic Partner Equal Benefits requirement 7.4 Excluded Parties List System (EPLS) 7.5 Lobbying Certification 7.6 Equal Opportunity Clause (EO 11246) 7.7 Copyrights 7.8 Procurement 7.9 Record Retention 2

3 8.0 REQUIRED FORMS ATTACHMENTS A. Signature Affidavit B Vendor Registration Certification C. Reference Data Sheet D. Designation of Confidential and Proprietary Information E. Fair Labor Practices Certification F. Cost /Financial Proposal 9.0 STANDARD TERMS & CONDITIONS 10.0 APPENDIX A: FACT SHEET COMMERCIAL REVOLVING LOAN FUND 11.0 APPENDIX B: FACT SHEET ECONOMIC DEVELOPMENT REVOLVING LOAN FUND 12.0 APPENDIX C: APPENDIX A TO 24 CODE OF FEDERAL REGULATIONS, PART APPENDIX D: LOAN APPLICATION 14.0 APPENDIX E: INCOME SELF-CERTIFICATION AND JOBS TRACKING 3

4 1.0 GENERAL INFORMATION 1.1 Introduction The purpose of this Request for Proposal (RFP) is to provide potential vendors/proposers with the information they will need to prepare and submit a proposal to provide underwriting and oversight services for Dane County s Economic Development Revolving Loan Programs. The County intends to use the results of this process to award a contract(s) or issue a purchase order for the product(s) and or services(s) described in detail below. The contract resulting from this RFP will be administered by multiple Dane County departments including the Department of Planning and Development, Department of Human Services - CDBG. The contract administrator will be assigned after the contract is fully executed. This Request for Proposal (RFP) is issued on behalf of Dane County by the Purchasing Division, which is the sole point of contact for the County during the procurement process. 1.2 Scope of the Project Background Dane County currently funds and administers two special economic development revolving loan programs: the Commercial Revitalization Revolving Loan Fund (CRLF) and the Revolving Loan Fund (RLF). The CRLF was initially financed by a grant from the U.S. Department of Housing and Urban Development (HUD) Community Development Block Grant (CDBG) program. The Revolving Loan Fund (RLF) was initially financed by the WI Department of Commerce (also with HUD/CDBG monies), and is now under the auspices of the Wisconsin Economic Development Corporation. The attached fact sheets (Appendix A and B) provide a summary of each of the County s revolving loan fund programs. The primary goal of Dane County s two special economic development revolving loan programs is the creation or retention of jobs for low and moderate income (LMI) County residents. This goal is realized, in part, when Dane County loans funds to local individuals and businesses who will use the funds to create a new business or expand an already existing business. As part of their Loan Agreement with the County, borrowers must pledge to create (or in some cases, retain) a certain number of permanent jobs, at least 51% of which must be filled by low and moderate income persons. HUD has established guidelines for the underwriting and selection of the special economic development activities funded with CDBG monies. These guidelines are intended to ensure that the selected activities are financially viable and make the most effective use of the available economic development loan funds. Also referred to as the underwriting guidelines, they are published as Appendix A to 24 Code of Federal Regulations, Part 570. (Appendix A is attached hereto as Appendix C). Each loan application will be evaluated using these guidelines: Project costs are reasonable; All sources of project financing have been committed; To the extent practicable, CDBG funds are not substituted for non-federal financial support; Project is financially feasible; To the extent practicable, the return of the owner s equity investment will 4

5 not be unreasonably high; and To the extent practicable, CDBG funds are disbursed in a pro-rata basis with other finances committed to the project. In addition to underwriting each loan application, Dane County must also ensure that a certain level of public benefit is realized from the expenditure of the loan funds. This public benefit, which is described below, must be achieved in the aggregate (i.e., from the total of all loans made during a single year) and also realized from each individual project. This public benefit standard is mandatory and is described in detail at 24 C.F.R It may be summarized as follows: In the aggregate, the economic development loan program must create at least one permanent full-time equivalent job per $35, loaned. Each individual project must create at least one permanent full-time equivalent job per $50, loaned. Dane County has chosen to impose the $35, aggregate standard on each individual job creation/retention activity funded with CDBG dollars in ensure that the County meets the aggregate standard. Although job creation is the primary focus of the County s economic development revolving loan program, the funds may also be used to assist businesses that are located in areas where at least 51% of the residents are LMI. Loans to such businesses will satisfy the public benefit requirement if: In the aggregate, the value of the goods or services provided to LMI residents as a result of the loans is at least $ per LMI resident in the areas served by the assisted businesses. Each individual project will provide at least $1, in goods or services to each LMI resident served by the business. The Loan Review Subcommittee of the CDBG Commission reviews loan applications and submits its recommendations to the full CDBG Commission. Loan applications approved by the Commission are then referred, via a resolution process, to the County Board for approval. Once the application is approved by the County Board and all required documents have been executed by the County Executive and the borrower, the County will disburse funds as provided by the Loan Agreement and handle all subsequent collections and financial reporting. HUD imposes extensive reporting and record keeping requirements on the special economic development revolving loan program. Dane County must maintain records regarding the initial loan underwriting and eligibility determinations and the jobs created or retained or services provided as a result of the loans. For example, for each job created for a LMI person, the County must maintain records that list the title of the permanent jobs created, the efforts made to hire a LMI person for the job and the jobs offered to LMI persons. In order to verify the LMI status of each person hired, Dane County must obtain information on the size and annual income of the person s family prior to the time the person was hired for the job. The County must also obtain specific information, maintain records and provide reports regarding the jobs retained as a result of a loan and the persons who fill those jobs. In order to protect its financial interests, the County must also perform certain oversight and documentation functions over the life of the loan. (See section for a description of these additional loan servicing functions) Project Description Dane County wishes to contract for the following professional services to assist the County in the selection and oversight of its CDBG funded special economic 5

6 development revolving loan activities: 1. Financial underwriting; 2. Information gathering, verification, record keeping, and reporting related to the type and number of jobs created and retained as a result of funds loaned and the income status of the individuals who fill the jobs; 3. Additional loan servicing functions as the County determines necessary, including, but not limited to, oversight of the continuing viability of the businesses that receive loan funds during the life of the loan. Dane County will market the revolving loan program, work with loan applicants to gather the materials for a completed application, and conduct a pre-screening of applicants for basic eligibility. Financial Underwriting The County will forward the completed prescreened application packets to the selected Contractor for underwriting. The Contractor will conduct its underwriting analysis of the loan application pursuant to the HUD guidelines and any additional criteria deemed necessary by the County, including but not limited to, a thorough background check of each proposed borrower, and provide its underwriting analysis and conclusions, in writing, to the County in a format to by determined by the County. Contractor will attend the meeting(s) of the Loan Review Subcommittee of the CDBG Commission and present its findings and recommendations to the Subcommittee. The Loan Review Subcommittee may also require the Contractor to attend the CDBG Commission meeting where the loan may be considered. The Contractor s final written underwriting analysis must be provided to the County s Senior Program Analyst/Manager at least two (2) weeks prior to the Loan Review Subcommittee meeting at which the referenced loan will be reviewed. Please note that the underwriting analysis will also be provided to the applicants. A copy of the current Loan Application form is attached (See Appendix D). Job Creation/Retention Tracking After the loan has closed, the selected Contractor will be responsible for verifying that the required jobs are created or retained. Copies of the forms currently used to record required information may be found in Appendix E. The selected Contractor will compile and file required reports with the County at least quarterly until all jobs are filled and at least annually thereafter during the life of the loan. Occasionally loans are made for the development of commercial real estate and the selected Contractor will then work with the assisted developer to assure that lease agreements reflect the job creation requirements and that tenants provide the required reports and documentation. Additional Loan Servicing Functions The selected Contractor will provide additional loan servicing functions until the loan is repaid. These additional responsibilities will include, but are not limited to: Verifying that the business has not filed for dissolution nor is it delinquent with the Wisconsin Department of Financial Institutions; Verifying that the business and any guarantor(s) are not delinquent on business income taxes, property taxes, payroll and business taxes, or court-ordered judgments; Verifying that the business and any guarantor(s) have provided full disclosure of any outstanding litigation; Verification of continued financial solvency; Documentation that all permits, licenses, and any other required registrations are maintained; Verifying the maintenance of any fire and extended coverage insurance on 6

7 the covered property and chattel; Verifying maintenance of life insurance coverage of guarantors in the amounts specified; Verifying the existence and condition of inventory or other loan collateral; Conducting on-site visits to each assisted business at least annually or on a more frequent basis as determined by the County. The County will require the selected Contractor to fulfill each of the above listed oversight functions on an ongoing basis during the life of the loan and provide the County with documentation of its oversight on an annual or more frequent basis as determined by the County. In the event of a default on any of the loan terms, the selected Contractor will immediately notify the County s Senior Program Analyst/Manager and Corporation Counsel in writing Current Operations The County currently has a contract with Madison Development Corporation to provide underwriting services only. The Dane County Senior Economic Development Specialist currently is charged with the fund outreach, loan origination and processing, job creation/retention tracking, and performing the other loan servicing functions. The Senior Economic Development Specialist drafts the loan agreements and the County s Corporation Counsel reviews and approves the loan agreements and handles the UCC filings. Corporation Counsel is also responsible for working with the CDBG Commission to take action upon evidence of default. The current Dane County loan profile is as follows: Existing borrowers 13 Delinquent borrowers 2 Average Loan Applications per year 6 Average complete loans per year 0-4 Average re-structuring per year 0-4 Jobs are currently being tracked on 5 borrowers. 1.3 Definitions The following definitions are used throughout the RFP. County means Dane County County Agency means Department /Division utilizing the service or product Proposer/vendor means a firm submitting a proposal in response to this RFP. Contractor means proposer awarded the contract. 1.4 Clarification of the specifications All inquiries concerning this RFP must be directed to the person indicated on the cover page of the RFP Document. (electronic mail is the preferred method) Any questions concerning this RFP must be submitted in writing by mail, fax or on or before the stated date on the Calendar of Events (see Section 1.6) Proposers are expected to raise any questions, exceptions, or additions they have concerning the RFP document at this point in the RFP process. If a proposer discovers any significant 7

8 ambiguity, error, conflict, discrepancy, omission, or other deficiency in this RFP, the proposer should immediately notify the contact person of such error and request modification or clarification of the RFP document. Mailing Address: Dane County Purchasing Division Room 425 City-County Bldg 210 Martin Luther King Jr. Blvd Madison, WI Proposers are prohibited from communicating directly with any employee of Dane County, except as described herein. No County employee or representative other than those individuals listed as County contacts in this RFP is authorized to provide any information or respond to any question or inquiry concerning this RFP. 1.5 Addendums and/or Revisions In the event that it becomes necessary to provide additional clarifying data or information, or to revise any part of this RFP, revisions/amendments and/or supplements will be posted on the Purchasing Division web site at It shall be the responsibility of the proposers to regularly monitor the Purchasing Division web site for any such postings. Proposers must acknowledge the receipt / review of any addendum(s) at the bottom of the RFP Cover Page /Signature Affidavit. Each proposal shall stipulate that it is predicated upon the terms and conditions of this RFP and any supplements or revisions thereof. 1.6 Calendar of Events Listed below are specific and estimated dates and times of actions related to this RFP. The actions with specific dates must be completed as indicated unless otherwise changed by the County. In the event that the County finds it necessary to change any of the specific dates and times in the calendar of events listed below, it will do so by issuing a supplement to this RFP and posting such supplement on the Dane County web site at There may or may not be a formal notification issued for changes in the estimated dates and times. DATE February 24, 2012 March 2, 2012 March 5, 2012 March 21, 2012 April 2012 Late April 2012 May 15, 2012 EVENT Date of issue of the RFP Last day for submitting written inquiries (2:00 p.m. Central Time) Supplements or revisions to the RFP posted on the Purchasing Division web site at Proposals due from vendors Oral presentation by invited vendors, if needed Notification of intent to award sent to vendors Contract start date 1.7 Contract Term and Funding The contract shall be effective on the date indicated on the purchase order or the contract execution date and shall run for one (1) year(s) from that date, with an option by mutual agreement of the County and contractor, to renew for four (4) additional one (1) -year periods. 1.8 Reasonable Accommodations The County will provide reasonable accommodations, including the provision of informational material in an alternative format, for qualified individuals with disabilities upon request. If you 8

9 need accommodations at a proposal opening/vendor conference, contact the Purchasing Division at (608) (voice) or 608/ (TTY) 2.0 PREPARING AND SUBMITTING A PROPOSAL 2.1 General Instructions The evaluation and selection of a contractor and the contract will be based on the information submitted in the proposal plus references and any required on-site visits or oral interview presentations. Failure to respond to each of the requirements in the RFP may be the basis for rejecting a response. Elaborate proposals (e.g. expensive artwork) beyond that sufficient to present a complete and effective proposal, are not necessary or desired. 2.2 Proprietary Information All restrictions on the use of data contained within a proposal and all confidential information must be clearly stated on the attached Designation of Confidential and Proprietary Information form. Proprietary information submitted in a proposal, or in response to the RFP, will be handled in accordance with the applicable Wisconsin State Statute(s). To the extent permitted by law, it is the intention of Dane County to withhold the contents of the proposal from public view until such times as competitive or bargaining reasons no longer require non-disclosure, in the opinion of Dane County. At that time, all proposals will be available for review in accordance with the Wisconsin Open Records Law. 2.3 Incurring Costs Dane County is not liable for any cost incurred by proposers in replying to this RFP. 2.4 Vendor Registration All proposers wishing to submit a proposal must be a paid registered vendor with Dane County. Prior to the RFP opening, you can complete a registration form online by visiting our web site at or you can obtain a Vendor Registration Form by calling Your completed Vendor Registration Form and Registration Fee must be received for your bid to be considered for an award. 2.5 Submittal Instructions Proposals must be received in by the County Purchasing Division by the specified time stated on the cover page. All proposals must be time-stamped in by the Purchasing Division by the stated time. Proposals not so stamped will not be accepted. Proposals received in response to this solicitation will not be returned to the proposers. All proposals must be packaged, sealed and show the following information on the outside of the package: Proposer s name and address Request for proposal title Request for proposal number Proposal due date 9

10 2.6 Required Copies Proposers must submit an original and the required number of copies of all materials required for acceptance as instructed on the cover page of the RFP (Special Instructions). All hard copies of the proposal must be on 8.5 x11 individually securely bound. In addition, proposers must submit one complete electronic copy in Microsoft Word or PDF format burned to a CD or DVD. 2.7 Proposal Organization and Format Proposals should be organized and presented in the order and by the number assigned in the RFP. Proposals must be organized with the following headings and subheadings. Each heading and subheading should be separated by tabs or otherwise clearly marked. The RFP sections which should be submitted or responded to are: Introduction (See Section 4 of this RFP) Response to general requirements (See Section 4 of this RFP) Organizational qualifications Staff qualifications Response time References/Quality of Work Response to technical requirements (See Section 5 of this RFP) Cost proposal (See Section 6 of this RFP) Required forms (See Section 8 of this RFP) Attachment A Signature Affidavit Attachment B Vendor Registration Certification Attachment C Reference Data Sheet Attachment D Designation of Confidential and Proprietary Information Attachment E Fair Labor Practices Certification Attachment F Cost Summary Page Appendices (Additional Information the proposer submits) 2.8 Multiple Proposals Multiple proposals from a vendor will be permissible, however each proposal must conform fully to the requirements for proposal submission. Each such proposal must be separately submitted and labeled as Proposal #1, Proposal #2, etc. 2.9 Oral Presentations and Site Visits Top ranked selected proposers may be required to make oral interview presentations and/or site visits to supplement their proposals, if requested by the County. The County will make every reasonable attempt to schedule each presentation at a time and location that is agreeable to the proposer. Failure of a proposer to conduct a presentation to the County on the date scheduled may result in rejection of the vendor s proposal. 3.0 PROPOSAL SELECTION AND AWARD PROCESS 3.1 Preliminary Evaluation The proposals will first be reviewed to determine if requirements in Section 2.0 are met, and if additional mandatory requirements are met. (see Section 4.0). Failure to meet mandatory requirements will result in the proposal being rejected. In the event that all vendors do not meet one or more of the mandatory requirements, the County reserves the right to continue the evaluation of the proposals and to select the proposal which most closely meets the requirements specified in this RFP. 10

11 3.2 Proposal Scoring Accepted proposals will be reviewed by an evaluation team and scored against the stated criteria. This scoring will determine the ranking of vendors based upon their written proposals. If the team determines that it is in the best interest of the County to require oral presentations, the highest ranking vendors will be invited to make such presentations. Those vendors that participate in the interview process will then be scored, and the final ranking will be made based upon those scores. 3.3 Right to Reject Proposals and Negotiate Contract Terms The County reserves the right to reject any and all proposals and to negotiate the terms of the contract, including the award amount, with the selected proposer prior to entering into a contract. If contract negotiations cannot be concluded successfully with the highest scoring proposer, the County may negotiate a contract with the next highest scoring proposer. 3.4 Evaluation Criteria The proposals will be scored using the following criteria: Description Percent 1. General Requirements 35 a. Organizational Capabilities 5 b. Staff Qualifications 20 c. Response Time Technical Requirements 45 d. Loan Underwriting 20 e. Background Checks 5 f. Jobs Tracking 5 g. Loan Servicing Cost Award and Final Offers TOTAL 100 The award will be granted in one of two ways. The award may be granted to the highest scoring responsive and responsible proposer. Alternatively, the highest scoring proposer or proposers may be requested to submit final and best offers. If final and best offers are requested, they will be evaluated against the stated criteria, scored and ranked. The award will then be granted to the highest scoring proposer. 3.6 Notification of Intent to Award As a courtesy, the County may send a notification of award memo to responding vendors at the time of the award. 11

12 4.0 GENERAL PROPOSAL REQUIREMENTS 4.1 Introduction Provide a one page overview of your firm s interest in the project. Be sure to identify the contact person(s) for this application along with the vendor s DUNS number. 4.2 Organization Experience Describe the firm s experience providing similar services to those required. Be specific and identify projects, dates, and results. Identify and relevant licenses that are held. 4.3 Staff Qualifications Discuss how requests for services will be routed and assigned within your organization. Provide resumes describing the educational and work experiences for each of the key staff who would be assigned to the project. List any relevant licenses that are held. 4.4 Response Time Describe the expected response time in working days from the time that a request would be made for underwriting services to the time that the underwriting materials would be available for review by the County. 4.5 Proposer References Proposers must include in their RFPs a list of organizations, including points of contact (name, address, and telephone number), which can be used as references for work performed in the area of service required. Selected organizations may be contacted to determine the quality of work performed and personnel assigned to the project. 5.0 TECHNICAL REQUIREMENTS 5.1 Loan Underwriting List the factors that you will consider when conducting underwriting of loan applications and describe the steps you will take to assess each of the factors. Review the County s current loan application and suggest modifications needed to facilitate the underwriting that will be undertaken. Provide examples of the materials that will be provided to the County. 5.2 Background Checks List the factors that you will consider when conducting background checks of borrowers and principals and describe the steps you will take to assess each of the factors. Provide examples of the materials that will be provided to the County. 5.3 Jobs Tracking List the information that will be gathered and how you will work with businesses to collect this information. 5.4 Loan Servicing List the factors and describe the steps that will be taken in servicing each loan after closing. 12

13 6.0 COST PROPOSAL Discuss timelines as to the work that will be undertaken to address each existing loan, as well as, those that may be added to the portfolio in the coming year. Provide examples of the materials that will be provided to the County. 6.1 General Instructions on Submitting Cost Proposals Proposers must submit an original and the required number of copies of the cost proposal as instructed on the cover page of the RFP (Special Instructions). Cost proposal should be submitted in a separate envelope labeled Cost Proposal with the written proposal. (Refer to Cost Proposal Form) The proposal will be scored using a standard quantitative calculation where the most cost criteria points will be awarded to the proposal with the lowest cost. 6.2 Format for Submitting Cost Proposals The format found in Attachment F: Cost/Financial Proposal is to be used when submitting cost proposals. 6.3 Fixed Price Period All prices, costs, and conditions outlined in the proposal shall remain fixed and valid for acceptance for 90 days starting on the due date for proposals. 7.0 SPECIAL CONTRACT TERMS AND CONDITIONS 7.1 Payment Requirements Payment will be made upon delivery and acceptance by the County of the requested deliverable and within 30 days of presentation of an invoice acceptable to the County Controller. 7.2 Living Wage Requirement All employees working on this project are covered by the Dane County Living Wage Ordinance Section (d). See Section 28.0 Standard Terms and Conditions. The minimum living wage rate for 2012 is $ The successful proposer will be required to sign a Living Wage Certification upon completion of the contract. Details are available on the Dane County Purchasing Division web site at Domestic Partner Equal Benefits Requirement The contractor [or grant beneficiary] agrees to provide the same economic benefits to all of its employees with domestic partners as it does to employees with spouses, or the cash equivalent if such a benefit cannot reasonably be provided. The contractor [or grant beneficiary] agrees to make available for County inspection the contractor's payroll records relating to employees providing services on or under this contract or subcontract [or grant]. If any payroll records of a contractor [or grant beneficiary] contain any false, misleading or fraudulent information, or if a contractor [or grant beneficiary] fails to comply with the provisions of s , D. C. Ords., the contract compliance officer may withhold payments on the contract; terminate, cancel or suspend the contract in whole or in part; or, after a due process hearing, deny the contractor the right to participate in bidding on future County contracts for a period of one year after the first violation is found and for a period of three years after a second or subsequent violation is found. 13

14 7.4 Excluded Parties List System (EPLS) No contracts may be awarded to any party that is debarred or suspended or is otherwise excluded from participation on federal assistance programs. 7.5 Lobbying Certification Prior to entering into an agreement to provide services, the contractor will be required to sign a certification attesting to the following: 1. No federally appropriated funds have been paid, or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal contract, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2. If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete Standard Form-LLL, Disclosure Form to Report Lobbying, in accordance with its instructions. 3. The undersigned shall require that the language of this CERTIFICATION be included in the award documents for all sub-awards at all tiers (including subcontractors, subgrants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly. 7.6 Equal Opportunity Clause (EO 11246) During the performance of this contract, the contractor agrees as follows: 1. The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex or national origin. Such action shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. 2. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex or national origin. 3. The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency contracting officer, advising the labor union or workers' representative of the contractor's commitments under Section 202 of Executive Order of Sept. 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 14

15 4. The contractor will comply with all provisions of Executive Order of September 24, 1965, as amended by Executive Order of October 13, 1967 and with the rules, regulations, and relevant orders of the Secretary of Labor. 5. The contractor will furnish all information and reports required by Executive Order of September 24, 1965 as amended, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the contracting agency, County of Dane, HUD, and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. 6. In the event of the contractor s noncompliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, the contract may be cancelled, terminated, or suspended in whole or in part and the contract may be declared ineligible for further government contracts in accordance with procedures authorized in Executive Order of September 24, 1965 as amended, and such other sanctions may be imposed or remedies invoked as provided in Executive Order No of September 24, 1965 as amended, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. The contractor will include the provisions of paragraphs 1 through 7 in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order of September 24, 1965 as amended, so that such provisions will be binding upon each subcontract or vendor. The contractor will take such action with respect to any subcontract or purchase order as the contracting agency and/or County of Dane may direct as a means of enforcing such provisions, including sanctions for noncompliance. 7.7 Copyrights Per 85.34, the U.S. Department of Housing and Urban Development (HUD) reserves a royaltyfree, nonexclusive, and irrevocable license to reproduce, publish, or otherwise use, and to authorize others to use, for Federal Government purposes: (a) The copyright in any work developed under a grant, subgrant, or contract under a grant or subcontract; and Any rights of copyright to which a grantee, subgrantee, or a contractor purchases ownership with grant support 7.8 Procurement 1. Contractors of County CDBG funding will comply with the procurement standards under 24 CFR for governmental contractors and 24 CFR for contractors that are non-profit organizations, including the requirements for bonding in procurement. 2. The Contractor is the responsible authority, without recourse to HUD or the County regarding the settlement of all contractual and administrative issues arising out of the procurement entered in support of the award or other agreement. 3. The Contractor shall conduct all procurement in a manner to provide to the maximum extent practicable, open and free competition. Contractors that develop or draft specifications, requirements, statement of work, invitations for bids or requests for proposals shall be excluded from competing for a project. 4. General requirements for procurement include, but are not limited to: a. Contractors must maintain records to detail the significant history of procurement. These records include, but are not limited to: files on the rationale for selecting the method of procurement used, selection of the contract type, the contractor selection/rejection process, and the basis for the cost or price of a contract. b. Pre-qualified lists of vendors/contractors, if used, must be current, developed through open solicitation, include adequate numbers of qualified 15

16 sources, and must allow entry of other firms to qualify at any time. c. Steps should be taken to assure that women and minority businesses are utilized when possible as the sources of supplies, equipment, construction and services. d. Contractors must ensure that awards are not made to any party that is debarred or suspended or is otherwise excluded from or ineligible for participation in the Federal assistance programs under Executive Order e. There must be written selection procedures for procurement transactions. f. Contractors must not use cost plus a percentage of cost pricing for contracts. In addition, Contractors should use time and material type contracts only after a determination is made that no other contract type is suitable and the contract includes a ceiling price that the contractor exceeds at its own risk. g. Contractors must have protest procedures in place to handle and resolve disputes relating to their procurement and in all instances report such disputes to the County. h. There must be a documented system of contract administration for determining the consistency of contractor performance. i. Contractors must have a written code of conduct governing employees, officers, or agents engaged in the award or administration of contracts. 7.9 Record Retention Representatives of the COUNTY, HUD, and the Comptroller General of the United State, or of other authorized governmental agencies have the right of access to any pertinent records of SUBRECIPIENT to make audits, examinations, excerpts, and transcripts. SUBRECIPIENTs that are governmental entities (including public agencies) must comply with the following section of 24 CFR Part 85 Uniform Administrative Requirements for Grant and Cooperative Agreements to State and Local Governments, Section 85.42, Retention and access requirements for records except that the period shall be four years. SUBRECIPIENTs, except those that are governmental entities, shall comply with the following provision of the Uniform Administrative requirements of OMB Circular A-110 (implemented at 24 CFR Part 84, Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals and Other Non-Profits Organizations, Section (b), Retention and access requirements for records. Section (b) applies with the following exceptions: (A) The retention period referenced in Sec (b) pertaining to individual CDBG activities shall be four years; and (B) The retention period starts from the date of submission of the annual performance and evaluation report (CAPER), as prescribed in 24 CFR , in which the specific activity is reported on for the final time rather than from the date of submission of the final expenditure report for the award. 8.0 REQUIRED FORMS The following forms must be completed and submitted with the proposal in accordance with the instructions given in Section 2.0. Blank forms are attached. Attachment A Attachment B Attachment C Attachment D Attachment E Attachment F Signature Affidavit Vendor Registration Certification Reference Data Sheet Designation of Confidential and Proprietary Information Fair Labor Practices Certification Cost Summary Page 16

17 Attachment A Submit With RFP RFP COVER PAGE SIGNATURE AFFIDAVIT NAME OF FIRM: STREET ADDRESS: CITY, STATE, ZIP CONTACT PERSON: PHONE #: FAX #: In signing this proposal, we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition; that no attempt has been made to induce any other person or firm to submit or not to submit a proposal; that this proposal has been independently arrived at without collusion with any other proposer, competitor or potential competitor; that this proposal has not been knowingly disclosed prior to the opening of proposals to any other proposer or competitor; that the above statement is accurate under penalty of perjury. The undersigned, submitting this proposal hereby agrees with all the terms, conditions, and specifications required by the County in this Request for Proposal, and declares that the attached proposal and pricing are in conformity therewith. Signature Name (type or print Title Date Addendums -This firm herby acknowledges receipt / review of the following addendum(s) (If any) Addendum # Addendum # Addendum # Addendum # Attachment B Submit With RFP 17

18 VENDOR REGISTRATION CERTIFICATION Per Dane County Ordinance, Section 62.15, Any person desiring to bid on any county contract must register with the purchasing manager and pay an annual registration fee of $20. Your completed Vendor Registration Form and Registration Fee must be received for your bid to be considered for an award. Your bid/proposal may not be evaluated for failure to comply with this provision. Complete a registration form online by visiting our web site at You will prompted to create a username and a password and you will receive a confirmation message, than log back in and complete the registration. Once your registration is complete you will receive a second confirmation. Retain your user name and password for ease of re-registration in future years. Payment may be made via credit card on-line or by check in the mail or in person at the Purchasing Division office. If paying by check make check payable to Dane County Treasurer and indicate your federal identification number (FIN) on the subject line. CERTIFICATION The undersigned, for and on behalf of the PROPOSER, BIDDER OR APPLICANT named herein, certifies as follows: This firm is a paid, registered vendor with Dane County in accordance with the bid terms and conditions. Vendor Number # Paid until Date Signed: Officer or Authorized Agent Business Name 18

19 Attachment C Submit With RFP REFERENCE DATA SHEET Provide company name, address, contact person, telephone number, and appropriate information on the product(s) and/or service(s) used for three (3) or more installations/services with requirements similar to those included in this solicitation document NAME OF FIRM: STREET ADDRESS: CITY, STATE, ZIP CONTACT PERSON: PHONE #: FAX #: Product(s) and/or Service(s) Used: NAME OF FIRM: STREET ADDRESS: CITY, STATE, ZIP CONTACT PERSON: PHONE #: FAX #: Product(s) and/or Service(s) Used: NAME OF FIRM: STREET ADDRESS: CITY, STATE, ZIP CONTACT PERSON: PHONE #: FAX #: Product(s) and/or Service(s) Used: 19

20 Attachment D Submit with RFP Designation of Confidential and Proprietary Information The attached material submitted in response to this Proposal includes proprietary and confidential information which qualifies as a trade secret, as provided in Sect 19.36(5), Wisconsin State Statutes, or is otherwise material that can be kept confidential under the Wisconsin Open Records law. As such, we ask that certain pages, as indicated below, of this proposal response be treated as confidential material and not be released without our written approval. Attach additional sheets if needed. Section Page Number Topic Check mark : This firm is not designating any information as proprietary and confidential witch qualifies as trade secrete. Prices always become public information when proposals are opened, and therefore cannot be designated as confidential. Other information cannot be kept confidential unless it is a trade secret. Trade secret is defined in Sect. 134(80)(1)(c) Wis. State Statutes, as follows: "Trade secret" means information, including a formula, pattern, compilation, program, device, method technique or process to which all of the following apply: 1. The information derives independent economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by other persons who can obtain economic value from its disclosure or use. 2. The information is the subject of efforts to maintain its secrecy that are reasonable under the circumstances. In the event the Designation of Confidentiality of this information is challenged, the undersigned hereby agrees to provide legal counsel or other necessary assistance to defend the Designation of Confidentiality. Failure to include this form in the proposal response may mean that all information provided as part of the proposal response will be open to examination or copying. The County considers other markings of confidential in the proposal document to be insufficient. The undersigned agree to hold the County harmless for any damages arising out of the release of any material unless they are specifically identified above. Signature Name (type or print Title Date 20

21 Attachment E Submit with RFP FAIR LABOR PRACTICES CERTIFICATION Dane County Ordinance 25.11(28) The undersigned, for and on behalf of the PROPOSER, BIDDER OR APPLICANT named herein, certifies as follows: 1. That he or she is an officer or duly authorized agent of the above-referenced PROPOSER, BIDDER OR APPLLICANT, which has a submitted a proposal, bid or application for a contract with the county of Dane. That PROPOSER, BIDDER OR APPLLICANT has: (Check One) not been found by the National Labor Relations Board ( NLRB ) or the Wisconsin Employment Relations Commission ( WERC ) to have violated any statute or regulation regarding labor standards or relations in the seven years prior to the date this Certification is signed. been found by the National Labor Relations Board ( NLRB ) or the Wisconsin Employment Relations Commission ( WERC ) to have violated any statute or regulation regarding labor standards or relations in the seven years prior to the date this Certification is signed Date Signed: Officer or Authorized Agent Business Name NOTE: You can find information regarding the violations described above at: and For Reference Dane County Ord (28) is as follows: (28) BIDDER RESPONSIBILITY. (a) Any bid, application or proposal for any contract with the county, including public works contracts regulated under chapter 40, shall include a certification indicating whether the bidder has been found by the National Labor Relations Board (NLRB) or the Wisconsin Employment Relations Committee (WERC) to have violated any statute or regulation regarding labor standards or relations within the last seven years. The purchasing manager shall investigate any such finding and make a recommendation to the committee, which shall determine whether the conduct resulting in the finding affects the bidder s responsibility to perform the contract. If you indicated that you have been found by the NLRB or WERC to have such a violation, you must include a copy of any relevant information regarding such violation with your proposal, bid or application. 21

22 Attachment F Submit with RFP COST / FINANCIAL PROPOSAL NAME OF FIRM: Item Description/Deliverable Cost Basis Cost Initial background check and underwriting of new loan application and submittal of findings in writing (1 hard copy and one electronic copy) in a format acceptable to the County including attendance at one (1) Loan Review Subcommittee meeting and one (1) CDBG Commission meeting to present findings and recommendations. Subsequent attendance at a Loan Review Subcommittee meeting or a CDBG Commission meeting. Updated background check, underwriting of financials, and submittal of findings in writing (1 hard copy and one electronic copy) in a format acceptable to the County including attendance at one (1) Loan Review Subcommittee meeting and one (1) CDBG Commission meeting to present findings and recommendations for loans in which the borrower has requested a modification. On-site visit to borrower. Verification on a quarterly basis of the jobs created or retained and filled by low-and-moderate income persons for up to 24 months following the execution of a loan agreement. Annual loan servicing functions, including but not limited to: Verifying that the business has not filed for dissolution nor is it delinquent with the Wisconsin Department of Financial Institutions; Verifying that the business and any guarantor(s) are not delinquent on business income taxes, property taxes, payroll and business taxes, or court-ordered judgments; Verifying that the business and any guarantor(s) have provided full disclosure of any outstanding litigation; Verification of continued financial solvency; Documentation that all permits, licenses, and any other required registrations are maintained; Verifying the maintenance of any fire and extended coverage insurance on the covered property and chattel; Verifying maintenance of life insurance coverage of guarantors in the amounts specified; Verifying the existence and condition of inventory or other loan collateral. Documentation is to be provided in a format acceptable to the County on an annual basis. Per loan submitted for underwriting Per meeting Per loan submitted for underwriting Per visit Per approved loan Per outstanding loan 22

23 Dane County Commercial Revitalization Loan Fund APPENDIX A The Dane County Commercial Revitalization Loan Fund (CRLF) provides financing to businesses and real estate development projects that help revitalize downtown and commercial districts. The objectives of the CRLF are to: Promote infill development and commercial redevelopment in downtown and traditional business districts Encourage the creation or retention of employment opportunities for low and moderate-income County residents. Leverage new private investment in downtown business districts and traditional business districts. Promote developments that are pedestrian friendly, that encourage a range of transportation options, and that enhance civic life. Implement Dane County and local community revitalization goals and objectives; and Create jobs for low-to moderate income residents of Dane County Funding Source: Qualifying Applicants: Uses of Loans: Dane County Community Development Block Grant (CDGB) funds For-profit businesses, not-for-profit organizations Fixed assets, machinery and equipment, and working capital Minimum loan size is $25,000. Maximum is based on availability of funds The loan term will be equal to the useful life of the assets financed Two percent above prime. Lower rates can be negotiated based on need Loan Fee: One point of total loan amount Application Requirements: Promote infill development and commercial redevelopment in downtown business districts and other traditional commercial districts. Leverage a minimum of one dollar ($1.00) of private funds for every one dollar ($1.00) of loan funds requested. Demonstrate that the proposed project is viable and the business will have the economic ability to repay the funds. Be completed within 24 months from the date of the loan approval. Increase permanent employment or retain existing jobs that would have been lost locally, primarily benefiting low to moderateincome persons (51% of jobs created must go to low-to moderate income individuals). At least one full-time equivalent position must be created for every $35,000 of CDBG funds requested (documentation will be required). Selection Process: CRLF application Staff review. CRLF Loan Committee review and recommendations County Board of Supervisors, including CDBG Commission. For more information: Contact Olivia Parry at , or parry@co.dane.wi.us or visit: Dane County Economic Development Website 23

24 24 Revised: 03/13/2009

25 APPENDIX C APPENDIX A TO PART 570 GUIDELINES AND OBJECTIVES FOR EVALUATING PROJECT COSTS AND FINANCIAL REQUIREMENTS I. Guidelines and Objectives for Evaluating Project Costs and Financial Requirements. HUD has developed the following guidelines that are designed to provide the recipient with a framework for financially underwriting and selecting CDBG-assisted economic development projects which are financially viable and will make the most effective use of the CDBG funds. The use of these underwriting guidelines as published by HUD is not mandatory. However, grantees electing not to use these underwriting guidelines would be expected to conduct basic financial underwriting prior to the provision of CDBG financial assistance to a for-profit business. States electing not to use these underwriting guidelines would be expected to ensure that the state or units of general local government conduct basic financial underwriting prior to the provision of CDBG financial assistance to a for-profit business. II. Where appropriate, HUD s underwriting guidelines recognize that different levels of review are appropriate to take into account differences in the size and scope of a proposed project, and in the case of a microenterprise or other small business to take into account the differences in the capacity and level of sophistication among businesses of differing sizes. III. Recipients are encouraged, when they develop their own programs and underwriting criteria, to also take these factors into account. For example, a recipient administering a program providing only technical assistance to small businesses might choose to apply underwriting guidelines to the technical assistance program as a whole, rather than to each instance of assistance to a business. Given the nature and dollar value of such a program, a recipient might choose to limit its evaluation to factors such as the extent of need for this type of assistance by the target group of businesses and the extent to which this type of assistance is already available. IV. The objectives of the underwriting guidelines are to ensure: (1) that project costs are reasonable; (2) that all sources of project financing are committed; (3) that to the extent practicable, CDBG funds are not substituted for non-federal financial support; (4) that the project is financially feasible; (5) return on the owner s equity investment will not be unreasonably high; and (6) that to the extent practicable, CDBG funds are disbursed on a pro rata basis with other finances provided to the project. 1. Project costs are reasonable. i. Reviewing costs for reasonableness is important. It will help the recipient avoid providing either too much or too little CDBG assistance for the proposed project. Therefore, it is suggested that the grantee obtain a breakdown of all project costs and that each cost element making up the project be reviewed for reasonableness. The amount of time and resources the recipient expends evaluating the reasonableness of a cost element should be commensurate with its cost. For example, it would be appropriate for an experienced reviewer looking at a cost element of less than $10,000 to judge the reasonableness of that cost based upon his or her knowledge and common sense. For a cost element in excess of $10,000, it would be more appropriate for the reviewer to compare the cost element with a third-party, fair-market price quotation for that cost element. Third-party price quotations may also be used by a reviewer to help determine the reasonableness of cost elements below $10,000 when the reviewer evaluates projects infrequently or if the reviewer is less experienced in cost estimations. If a recipient does not use thirdparty price quotations to verify cost elements, then the recipient would need to conduct its own cost analysis using appropriate cost estimating manuals or services. ii. The recipient should pay particular attention to any cost element of the project that will be carried out through a non-armslength transaction. A non-arms-length transaction occurs when the entity implementing the CDBG assisted activity procures goods or services from itself or from another party with whom there is a financial interest or family relationship. If abused, non-armslength transactions misrepresent the true cost of the project. 2. Commitment of all project sources of financing. The recipient should review all projected sources of financing necessary to carry out the economic development project. This is to ensure that time and effort is not wasted on assessing a proposal that is not able to proceed. To 25

26 the extent practicable, prior to the commitment of CDBG funds to the project, the recipient should verify that: sufficient sources of funds have been identified to finance the project; all participating parties providing those funds have affirmed their intention to make the funds available; and the participating parties have the financial capacity to provide the funds. 3. Avoid substitution of CDBG funds for non- Federal financial support. i. The recipient should review the economic development project to ensure that, to the extent practicable,cdbg funds will not be used to substantially reduce the amount of non-federal financial support for the activity. This will help the recipient to make the most efficient use of its CDBG funds for economic development. To reach this determination, the recipient s reviewer would conduct a financial underwriting analysis of the project, including reviews of appropriate projections of revenues, expenses, debt service and returns on equity investments in the project. The extent of this review should be appropriate for the size and complexity of the project and should use industry standards for similar projects, taking into account the unique factors of the project such as risk and location. ii. Because of the high cost of underwriting and processing loans, many private financial lenders do not finance commercial projects that are less than $100,000. A recipient should familiarize itself with the lending practices of the financial institutions in its community. If the project s total cost is one that would normally fall within the range that financial institutions participate, then the recipient should normally determine the following: A. Private debt financing whether or not the participating private, for-profit business (or other entity having an equity interest) has applied for private debt financing from a commercial lending institution and whether that institution has completed all of its financial underwriting and loan approval actions resulting in either a firm commitment of its funds or a decision not to participate in the project; and B. Equity participation whether or not the degree of equity participation is reasonable given general industry standards for rates of return on equity for similar projects with similar risks and given the financial capacity of the entrepreneur(s) to make additional financial investments. iii. If the recipient is assisting a microenterprise owned by a low- or moderate-income person(s), in conducting its review under this paragraph, the recipient might only need to determine that non-federal sources of financing are not available (at terms appropriate for such financing) in the community to serve the low- or moderate-income entrepreneur. 4. Financial feasibility of the project. i. The public benefit a grantee expects to derive from the CDBG assisted project (the subject of separate regulatory standards) will not materialize if the project is not financially feasible. To determine if there is a reasonable chance for the project s success, the recipient should evaluate the financial viability of the project. A project would be considered financially viable if all of the assumptions about the project s market share, sales levels, growth potential, projections of revenue, project expenses and debt service (including repayment of the CDBG assistance if appropriate) were determined to be realistic and met the project s break-even point (which is generally the point at which all revenues are equal to all expenses). Generally speaking, an economic development project that does not reach this break-even point over time is not financially feasible. The following should be noted in this regard: A. some projects make provisions for a negative cash flow in the early years of the project while space is being leased up or sales volume built up, but the project s projections should take these factors into account and provide sources of financing for such negative cash flow; and B. it is expected that a financially viable project will also project sufficient revenues to provide a reasonable return on equity investment. The recipient should carefully examine any project that is not economically able to provide a reasonable return on equity investment. Under such circumstances, a business may be overstating its real equity investment (actual costs of the project may be overstated as well), or it may be overstating some of the project s operating expenses in the expectation that the difference will be taken out as profits, or the business may be overly pessimistic in its market share and revenue projections and has downplayed its profits. 26

27 ii. In addition to the financial underwriting reviews carried out earlier, the recipient should evaluate the experience and capacity of the assisted business owners to manage an assisted business to achieve the projections. Based upon its analysis of these factors, the recipient should identify those elements, if any, that pose the greatest risks contributing to the project s lack of financial feasibility. 5. Return on equity investment. To the extent practicable, the CDBG assisted activity should provide not more than a reasonable return on investment to the owner of the assisted activity. This will help ensure that the grantee is able to maximize the use of its CDBG funds for its economic development objectives. However, care should also be taken to avoid the situation where the owner is likely to receive too small a return on his/her investment, so that his/her motivation remains high to pursue the business with vigor. The amount, type and terms of the CDBG assistance should be adjusted to allow the owner a reasonable return on his/her investment given industry rates of return for that investment, local conditions and the risk of the project. 6. Disbursement of CDBG funds on a pro rata basis. To the extent practicable, CDBG funds used to finance economic development activities should be disbursed on a pro rata basis with other funding sources. Recipients should be guided by the principle of not placing CDBG funds at significantly greater risk than non-cdbg funds. This will help avoid the situation where it is learned that a problem has developed that will block the completion of the project, even though all or most of the CDBG funds going in to the project have already been expended. When this happens, a recipient may be put in a position of having to provide additional financing to complete the project or watch the potential loss of its funds if the project is not able to be completed. When the recipient determines that it is not practicable to disburse CDBG funds on a pro rata basis, the recipient should consider taking other steps to safeguard CDBG funds in the event of a default, such as insisting on securitizing assets of the project. [60 FR 1953, Jan. 5, 1995] 27

28 Loan Application Commercial Revitalization Loan Fund (CRLF) and ED-RLF Appendix D SECTION A: APPLICANT INFORMATION Version: Business Legal Name: Doing Business As (DBA): Street Address: City/State/Zip: Municipality: Web Site: DUNS Number*: Contact Person Regarding this Application Name: Title/Position Function: Street Address: City/State/Zip: Phone Number: Alternate Phone: Fax Number: Address: *A Data Universal Numbering System (DUNS) number must be provided for each business. A business may contact Dun & Bradstreet at to register and obtain a free DUNS number. 1. Legal Structure (check one) SECTION B: BUSINESS INFORMATION Sole Proprietorship Corporation Limited Liability Company (LLC) General Partnership S-Corporation Limited Liability Partnership (LLP) Limited Partnership Other 2. Is there a written operating agreement, partnership agreement, or bylaws? Yes No 3. If an LLC, is the LLC managed by all members? Yes No. If no, who is the managing member? RFP

29 4. Date Business Originally Established 5. Number of Years Under Current Ownership 6. Type of Business (check all that apply): Architecture Consultant Construction Contractor Engineering Fabricator Finance Manufacturing Retail/Vendor Service Transportation Wholesale/Distributor Legal Broker Other (specify) 7. Certifications held by business (check all that apply): Minority Business Enterprise Section 3 Business Small Business Enterprise Women-Owned Business Enterprise 8. How many years have you been doing business under your present firm or trade name? years 9. Please list any other names under which this business may have operated: 10. Current number of employees: Full-time Part-time 11. How many hours per week does an employee work to be considered full-time? 12. Briefly describe the primary products and/or services of the business. 13. Briefly describe critical trends in the business/industry in which this business is operating. 14. Describe the existing and potential target customers of the business. RFP

30 15. Ownership of Business - Identify all owners; attach separate sheet if necessary. Personal financial statements will be required for each owner of 20% or more of the business. Name Address Latino or Ownership Hispanic (Y / N) Race* Gender* % Date Voting % * Demographic Options Gender: Race: (Indicate all that apply) Female Male African-American, Black (B) Asian (A) Native American (NA) Pacific Islander (PI) White, Caucasian (W) 16. If your business is incorporated please provide names of all officers. Board of Directors Title President Vice President Secretary Treasurer Latino or Hispanic Race* Gender* 17. Provide information on the key members of your management team. Please be sure to attach resumes. Management Team Title Latino or Hispanic Race* Gender* SECTION C: PROJECT AND FINANCING REQUEST 18. Provide a description of the location where the project will take place, indicate whether the site is leased or owned, and the current zoning. Attach a map to this application. Project Name: Street Address: RFP

31 City/State/Zip: Municipality: Owned or Leased: Current Zoning: 19. Provide a description of the proposed project. 20. Provide information on the site acreage, square footage of the facility currently used by your business (if any) and proposed facility, whether the business will own or lease each facility, and the current and proposed number of tenants in each facility. Facility Site Acreage Square Footage Own/Lease Number of Tenants Existing Facility New/Rehabbed Facility 21. If this project involves the purchase of land, provide a legal description of the property to be purchased. 22. If this project involves the purchase of land and/or existing building(s), provide a description of the current and any prior uses of the property. 23. If this project involves the purchase of land/or existing buildings, have any environmental studies been done? Yes No ( If yes, please attach one copy.) 24. Will the project require any change in zoning? Yes No 25. Will the project involve the demolition or conversion of any existing structures? Yes No 26. Provide a description of the sources and uses of funds for the project. Please note that a detailed budget showing the sources and uses of all funds for the project is required to be attached. Uses of Funds Dane County CRLF/RLF Funds Source 2 Name: Source 3 Name: Total Acquisition of Land or Buildings RFP

32 Uses of Funds Dane County CRLF/RLF Funds Source 2 Name: Source 3 Name: Total Rehab or remodeling New Equipment Inventory Working Capital Other, Total Total 27. Business Loan Terms. For each existing loan source identified in 26, please indicate the loan terms, original amount of the loan, the current outstanding balance, and the name and phone number of your contact person. Source Interest Rate Terms Original Amount Current Outstanding Balance Contact Name/ Phone Number 28. Collateral. Provide a description of the collateral for this proposed loan. (Please attach one copy of any appraisals that have been done.) Collateral Cost Appraised Value Source of Appraisal Other Lien Holder(s) 29. Describe the reason for requesting funds under the Dane County Commercial Revitalization Loan Program (Check all that apply and describe): Insufficient equity available for capital costs. Unable to pay market rates. Describe: Lender unable to commit more funds to project. Insufficient rate of return for business. 30. Project Timeline. Provide a timeline for this project. Milestones may be such items as securing all financing, bidding on construction, acquiring equipment, or hiring employees. Please customize this for your project. Milestone Timeline RFP

33 Milestone Timeline JOBS are the major inducement for the County to provide loan funds. One full-time equivalent (FTE) job must be created or retained for every $35,000 in CRLF funds loaned. At least 51 percent of those jobs (computed on a full-time equivalent basis) must be made available to or held by a low-and-moderate income person. A full time equivalent is a 40 hour per week or 2,080 hour per year job. If two persons are hired for 20 hours per week for 52 weeks per year, that is 1 full-time equivalent job. The following requirements must be met for jobs to be considered created or retained. a. For projects that create jobs, at least 51% of the jobs must be held by or made available to lowand-moderate income persons. b. For projects that retain jobs, there must be sufficient documentation that the jobs would be lost without this loan and that one or both of the following apply to at least 51% of the jobs: The job is currently held by a low-and-moderate income person; or The job can reasonably be expected to turn over within the following two years and steps will be taken to ensure that the job will be filled by, or made available to, a low-andmoderate income person. Created or retained jobs are only considered to be made available to low-and-moderate income persons when: Special skills that can only be acquired with substantial training or work experience or education beyond high school are not a prerequisite to fill such jobs, or the business agrees to hire unqualified persons and provide training; and The business takes actions to ensure that low-and-moderate income persons receive first consideration for filling such jobs, such as: o advertising the jobs to be filled with the Dane County Housing Authority, Centro Hispano of Dane County, Madison Apprenticeship Program, Madison Urban Ministry, Porchlight, and other non-profits serving low-and-moderate income populations; o conducting a job fair in a low-and-moderate income neighborhood; o listing the jobs to be filled with Job Service; o providing a listing of the jobs to be filled to the Associate Division Manager of Economic Assistance and Work Services Division (EAWS) of the Dane County Department of Human Services who will work to refer eligible applicants The business must track the persons interviewed for each position and maintain income self-certification forms from each applicant for review by the County, HUD, and the Office of Inspector General. For developments in which units or space will be leased or purchased by other tenants, such as a retail mall, the borrower/owner must ensure that the job creation and reporting requirements are incorporated into the lease or purchase agreements for each tenant. RFP

34 31. Jobs Created. For each job to be created and filled in the next 24 months, please list the job title, job type, whether it will be full time or part time, the number of employees to be hired, whether the position requires any special skills, training, or education beyond a high school level, the number of hours per week, the hourly wage, and whether the job will be made available to low-and-moderate income persons. Please attach additional pages as needed. Job title Job Type* Full-Time or Part Time (FT/PT) Number of Employees to be Hired Requires Special Training (Yes, No) Number of Hours Per week Number of Weeks Per Year Hourly Wage Job to be Made Available to LMI Person (Yes/No) * JobType: Officials and Managers Professional Technicians Sales Office and Clerical Craft Workers (Skilled) Operatives (Semi-Skilled) Laborers Service Workers RFP

35 32. For any jobs that require special skills, training, or education beyond high school prior to hiring and that will be made available to low-and-moderate income persons, please list by job title the actions that will be taken to assist low-and-moderate income persons to meet those requirements. 33. Describe the actions that will be taken to ensure that jobs are made available to low-and-moderate income persons. 34. Job Retention. In order to claim job retention, a business must provide clear, convincing, and objective evidence that without the CRLF loan, the jobs would be lost to Dane County within an immediate time frame. If this application is for the retention of jobs, please indicate which of the following statements apply and attach the supporting documentation to this application. Statement A notice of mass layoff or business closing has been filed with the Wisconsin Department of Workforce Development in the past 60 days. A notice has been given to employees of layoff or business closing within the past 60 days. Articles have appeared in a local newspaper or other trade publication related to employment loss. Financial statements demonstrate the need for funds and/or a deteriorating competitive position that will result in a reduction in the workforce or the business closing. Other, specify: Yes No 35. Jobs Retained. For jobs that are being claimed as created, please provide the job title, job type, full/part time status, number of hours per week, hourly wage, whether the job is held by a low-and-moderate income person, and whether the job can reasonably expect to turnover in the next two years. Please attach to this RFP

36 application, the most recent payroll in order to document current employment levels. The payroll should indicate whether each employee is part-time or full-time. Social security numbers and other sensitive identifiers should be redacted. Please note that for each employee who is being claimed as low-and-moderate income, an Employee Certification Form must be completed. Job title Job Type Full-Time or Part Time (FT/PT) No. of Hours Per Week Hourly Wage Number of Current Employees Who Are: Low and Moderate Income (LMI) Not LMI Is Job Expected to Turn over in Next 2 years (Yes/No) RFP

37 SECTION D: JOB PIRATING Job pirating is prohibited under Section 588 of the Quality Housing and Work Responsibility Act of The County is prohibited from providing assistance that will result in the relocation of a plant, facility, or operation from one Labor Market Area to another, within three years of the date of assistance, if such relocation will result in a significant loss of jobs in the labor market area from which the relocation occurs. A significant loss is defined as the loss of 500 or more jobs or equal to or greater than one-tenth of one percent of the total number of persons in the labor force of that Labor Market Area. 36. Will the project relocate jobs from one labor market to another? Yes No 37. If yes, how many jobs will be lost from the labor market area from which the jobs will be relocated? (Include jobs that will not be relocated to or replaced at the project site.) jobs. 38. From which location will the jobs be relocated or lost? City State SECTION E: ENVIRONMENTAL CERTIFICATION Prior to the County being able to commit funds to a project, an environmental review must be conducted, and if needed, approval for the release of federal funds must be obtained from HUD (Department of Housing and Urban Development). 39. This business understands and agrees that: Statement Yes No CRLF funds are provided under the Community Development Block Grant (CDBG) program which requires that projects obtain environmental clearance prior to any portion of the project moving forward or project funds will be rescinded and repaid to the County. The environmental review must cover the entire scope of the project as presented in this application. The project is defined and includes all line items listed in the application and all aspects necessary to successful completion of the project, including both private and public on and off-site investment by any party. It will assist the County in fulfilling it s environmental review requirements. Local and regional governmental and civic bodies and citizens must be notified of the project s potential effects on various aspects of the environment. In addition, the environmental review process may include coordination with several regulatory entities. These entities may have requirements such as archaeological studies, special permitting, and mitigation measures. Federal regulations may require that a public notice be published in a newspaper of general circulation and that a 15-day public comment period by observed. This process takes a minimum of 20 days and may take longer if public comments are received. Federal regulations may require that a approval for Release of Funds be obtained from HUD. This process takes a minimum of 20 days. If a purchase option is offered prior to the environmental review being completed, the option must contain contingency language indicating there will be no transfer of title to the purchaser until all environmental review procedures have been completed. Any deposits made must be nominal (less than $1,000) or refundable (if more than $1,000). RFP

38 SECTION F: LEGAL INFORMATION Statement Yes No Has the applicant or any owner been involved in any lawsuits or judgments in the last five (5) years of have any lawsuits pending? Has the applicant or any owner been involved in any bankruptcy or insolvency proceedings or have any proceedings pending? Has the applicant or owner had any civil or criminal charges in the last five (5) years or have any charges pending? Does the applicant or any owner have any outstanding tax liens or judgments? Is the property tax delinquent? Please attach a detailed explanation for any YES responses. SECTION G: CONFLICT OF INTEREST Immediate Family Ties Immediate family ties includes spouse (including fiancée/fiancé), parent (including step parents), child (including stepchildren), siblings (including step-brothers and step-sisters), grandparent, grandchild, and in-laws of a covered person. 40. For each owner of the business, please list any immediate family ties to any employees of Dane County, the County Board of Supervisors, or the CDBG Commission. Business Owner Name of Person to Whom the Business Owner has Immediate Family Ties Relationship RFP

39 SECTION H: CERTIFICATION The Applicant for loan funds certifies: a. To the best of my knowledge and belief, all information contained in this application is true and correct. b. No work on this project has been accomplished and that no work will be undertaken until environmental clearance has been received and a contract with Dane County has been executed. c. That the applicant is in compliance with all laws, regulations, ordinances, and orders of public authorities applicable to it. d. That the applicant is not in default under the terms and conditions of any grant or loan agreements, leases, or financing arrangements with its creditors. e. That the applicant has disclosed and will continue to disclose any occurrence or event that could have an adverse material impact on the project. Adverse material impact includes, but is not limited to, lawsuits, criminal or civil actions, bankruptcy proceedings, regulatory intervention, or inadequate capital to complete the project. f. Understands that unless it qualifies as trade secret, all information submitted to the County is subject to Wisconsin s Open Records Law. The applicant requests that the County treat the following items as TRADE SECRET: Item Yes No Not Applicable Personal financial statements Personal or business tax returns Historic business financial statements Business financial projections Business plan or study Other: g. I possess the legal authority to apply for this loan. Warning: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government. Signature Date Name (Typed or Printed) Title Signature Date Name (Typed or Printed) Title RFP

40 IDENTIFICATION NUMBERS Please list the FEIN for the business. Federal Tax Identification No: Please list the Social Security Numbers for: 1) each proprietor, or 2) each limited partner who owns 20% or more interest and each general partner, or 3) each stockholder owning 20% or more voting stock, or 4) any partner or entity providing a guaranty on the loan. Business Owner Name Social Security Number (SSN) RFP

41 APPLICATION CHECKLIST Each completed application to be submitted to the County of Dane shall consist of the following: Business Documents 1. Completed CRLF Loan Application 2. Business plan outlining management, marketing, competition, business history, and future potential (for new businesses and those in operation less than five (5) years.) 3. Detailed project budget 4. Balance sheets for the preceding three years. 5. Profit and loss statements for the preceding three years. 6. Federal income tax returns for the prior three years. 7. Three year projections of cash flow with the first year being on a month-to-month basis. Include an explanation of all assumptions. 8. Three year projections of income and expenses. Include an explanation of all assumptions. 9. Aging of accounts receivable and payables, even dated with the current financial statements. 10. If claiming jobs as retained, documentation that without this loan, that jobs would be lost. (See item 29)/ 11. If claiming jobs as retained, copy of most recent payroll. Personal/Individual Information 12. Current personal financial statement of: 1) each proprietor, or 2) each limited partner who owns 20% or more interest and each general partner, or 3) each stockholder owning 20% or more voting stock, or 4) any person or entity providing a guaranty on the loan. NOTE: A notarized statement from a certified accountant indicating the net worth of each business owner under this section may be substituted for the personal financial statements. 13. Resumes of all key management personnel. 14. In the case of stock option, copies of Private Placement Memorandum. Project Information 15. Map of project location. 16. Evidence of site control, such as a signed offer to purchase, current building lease, etc Copies of any estimates or quotes regarding work to be done or equipment to be purchased in connection with the project. 18. Appraisal of real estate, property, or other collateral. 19. Copy of any environmental studies done for the project. 20. If the project involves acquisition of land or buildings, new construction, or rehabilitation, a letter of support signed by the chief elected official of the municipality where the project is located. 21. Real estate projects must include at least 4 photographs of the site and adjacent land uses from all directions, including applicable street views. 22. If applicable, copies of building lease(s). Lender Documents 23. Commitment letter(s) from bank and/or other lenders that includes a description of the terms of the loan(s), a description of collateral and/or guarantees, listing of any co-signers, and a signed acceptance from borrower (s). The bank and other lenders should advise the County of all covenants and/or limitations relating to the loan(s). Additional materials may be requested by the County. Please consult with the County s Economic Development Specialist as to the required documents for your specific loan request. RFP

42 Closing Additional information will be required at the time of loan closing. This may include, but is not limited to: 24. Copies of Articles of Incorporation and Bylaws if a corporation; Articles of Organization and Operating Agreement if a LLC; or any written Partnership Agreement if a partnership. 25. Title Commitment/Equipment make, model, serial numbers 26. Appraisals 27. Environmental 28. Hazard Insurance 29. Life Insurance/Life Insurance Collateral Assignment Form 30. Proposed Lease Draft 31. Evidence of Equity Injection RFP

43 PERSONAL FINANCIAL STATEMENT Confidential Statement as of: Complete this form for: 1) each proprietor, or 2) each limited partner who owns 20% or more interest and each general partner, or 3) each stockholder owning 20% or more voting stock, or 4) any person or entity providing a guaranty on the loan. Name: Residence Address: Business Phone: Residence Phone: City, State, Zip Code: Business Name of Applicant/Borrower: Section 1: Disclosure of Ownership. Please list all businesses in which you have any financial interest. (Use attachments if necessary. Each attachment must be identified as part of this statement and signed.) Legal Name of Business: Trademark Name (DBA): Entity Type (Corporation, LLC, LP, etc.) Street Address: City, State Percent Ownership: Legal Name of Business: Trademark Name (DBA): Entity Type (Corporation, LLC, LP, etc.) Street Address: City, State Percent Ownership: Legal Name of Business: Trademark Name (DBA): Entity Type (Corporation, LLC, LP, etc.) Street Address: City, State: Percent Ownership: RFP

44 ASSETS Omit cents LIABILITIES Cash on hand and in banks $ Accounts Payable $ Savings Accounts $ Notes Payable to banks & others $ IRA or Other Retirement Accounts $ Installment Account (Auto) $ Mo. Payments $ Accounts & Notes Receivable $ Installment Account (Other) $ Mo. Payments $ Life Insurance Cash Surrender Value $ Loan on Life Insurance $ Stocks and Bonds (Describe in Sec. 3) $ Mortgages on Real Estate (Describe in Sec. 4) Real Estate $ Unpaid Taxes (Describe in Sec. 6) $ Automobile present value $ Other Liabilities (Describe in Sec. 7) $ Other Personal Property $ Total Liabilities $ Other Assets (Describe in Sec. 5) $ Net Worth $ Omit cents $ Section 2: Source of Income TOTAL $ TOTAL $ Contingent Liabilities Salary $ As Endorser or Co-Maker $ Net Investment Income $ Legal Claims & Judgments $ Real Estate Income $ Provision for Federal Tax Income $ Other Income (Describe below) $ Other Special Debt $ Description of other income in Section 1 (Alimony or child support payments need not be disclosed in Other Income unless it is desired to have such payments count toward total income. RFP

45 Section 3: Notes Payable (Use attachments if necessary. Each attachment must be identified as part of this statement and signed.) Name/Address of Note Holder(s) Original Balance Current Balance Payment Amount Frequency (Monthly, etc.) How Secured or Endorsed Type of Collateral Section 4: Stocks and Bonds (Use attachments if necessary. Each attachment must be identified as part of this statement and signed.) Name of Securities Number of Shares Cost Market Value Quotation/ Exchange Date of Quotation/ Exchange Total Value Section 5: Real Estate (List each parcel separately. Use attachments if necessary. Each attachment must be identified as part of this statement and signed.) Property A Property B Property C Type of Property Street Address City, State Date Purchased Original Cost Present Market Value Name of Mortgage Holder Address of Mortgage Holder Mortgage Account Number Mortgage Balance Monthly Payment/Year Status of Mortgage Section 6: Other Personal Property and Assets. ((Describe, and if any is pledged as security, state name and address of lien-holder, amount of lien, terms of payment, and if delinquent, describe delinquency) RFP

46 Section 7: Unpaid Taxes (Describe in detail as to type, to whom payable, when due, amount, and to what property, if any, a tax lien attaches). Section 8: Other Liabilities (Describe in detail.) Section 9: Life Insurance Held (Give face amount and cash surrender value of policies name of insurance company and beneficiaries. I authorize the County of Dane to make inquiries necessary to verify the accuracy of statements made and to determine my credit worthiness. I certify that the information contained in this Personal Financial Statement and any attachments are true and accurate as of the stated date(s). These statements are for the purpose of either obtaining a loan or guaranteeing a loan. I understand FALSE statements may result in forfeiture of benefits and possible prosecution. Signature: Date: Social Security Number: Signature: Date: Social Security Number: WARNING: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government. WISCONSIN RESIDENTS PLEASE COMPLETE AND SIGN THIS SECTION ALSO I am: Married Unmarried Legally Separated If married and my spouse is not signing the credit obligation, the name of my spouse is: And my spouse resides at the following address: Any obligation incurred by me will be in the interest of my marriage or family. Signature: Notice to Married Persons No provision of any marital property agreement, unilateral statement under , WI Statutes, or court decree under , WI Stats., adversely effects the interest of the creditor unless the creditor, prior to the time the credit is granted or an open-end credit plan is entered into, is furnished a copy of the agreement, statement of decree or has actual knowledge of the adverse provision. RFP

47 Beneficiary Self-Certification Form 2012 (For use beginning December 1, 2011) APPENDIX E Program Name: Program Date(s): This program has received assistance from Dane County through funds that were provided in part by the U.S. Department of Housing and Urban Development (HUD) which requires that the following information be completed. This information will be kept confidential. Last Name: First Name: Street Address: City, State, Zip Code: Family Size: Source(s) of Income: In the chart below, find your family size, then circle the income level for your family s current annual income. Total family income includes income from all sources (wages, unemployment, social security, public assistance, interest and dividends, worker s comp, etc.) for all members of your family who are at least 18 years of age. Family Size Extremely Low Income Limits Very Low Income Limits Low Income Limits 1 Person $17,400 or less $17,401-29,050 $29,051-45,500 2 Person 19,900 or less $19,901-33,200 $33,201 52,000 3 Person 22,400 or less $22,401-37,350 $37,351 58,500 4 Person 24,850 or less $24,851-41,450 $41,451 65,000 5 Person 26,850 or less $26,851-44,800 $44,801 70,200 6 Person 28,850 or less $28,851-48,100 $48,101 75,400 7 Person 30,850 or less $30,851-51,400 $51,401 80,600 8 Person 32,850 or less $32,851-54,750 $54,751 85,800 My family income is higher than the amounts listed above for my family size. (Check the box only if it applies) My family income is: $ I attest that the information provided is true and correct to my knowledge. I understand that the information listed on this form may be subject to verification by Dane County and/or by the U.S. Department of Housing and Urban Development (HUD), the Office of the Inspector General, or their authorized representatives. Signature Date WARNING: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government. RFP