2016GES Healthy Food Challenge

Request for Information

LoanPre-Application

City and County of Denver

Office of Economic Development

Housing and Neighborhood Development

201 West Colfax Avenue

Denver, Colorado 80202

(720) 913-1999

(720) 913-1568 (TDD)

Business/Organization Information

Business/Organization Name:
Federal Tax ID Number:
Legal Structure:
Address:
Name of Executive Director or President:
Contact Person
Name:
Title:
Organization, if different:
Phone:
E-Mail:

Project Information

Project Name:
Project Address:
Brief Project Description
Amount of Funds Requested:
Total Project Cost:
Sources of Other Funds:
Number of Jobs Created:
How Will Funds be Utilized:

Required Attachments

Summary of Business, which includes:

  • Brief business description
  • Description of services or products (include relevant supply chain partners)
  • Description of facility and/or proposed facility
  • Description of current and/or proposed equipment or other significant property
  • Business goals and financial targets

Summary of Market Analysis, which includes:

  • Description of target market(s) and service area
  • Brief summary of marketing strategy

Summary of Staffing Plan, which includes:

  • Organizational Chart showing all key staff roles
  • Current Staff (Names, Titles, Brief Bio, and Description of Role)

Financial Data, which includes:

  • Current year and prior year financial statements for the business, including profit and loss statements and balance sheets
  • Projected financial statements for a minimum of three years (balance sheets, profit and loss statements, and cash flow statements, or equivalent). Monthly cash flow statement should be provided for first year. Assumptions should be clearly specified
  • Schedule and uses of debt that includes all current and proposed sources and uses of debt
  • Schedule of equity and potential collateral for requested debt
  • Current personal financial statements for all owners with 20% or greater ownership stake

Authorized Signature Sheet

Approved officer(s)or other appropriate signatory of the organization or corporation must complete below.

To the best of my knowledge and belief, statements and data in this application, the attached tables and other documentation, are true and correct.

Name / Name / Name
Title / Title / Title
Date / Date / Date

Please save a copy for your records. Email the completed form as an

attachment to GESFoodChallenge@denvergov.org

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