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5 <br />GOVERNOR'S INDUSTRIAL RECRUITMENT COMPETITIVE FUND <br />Check-0,~f Sheet for Applications <br />Company Name Barber g Ross Oranap~ (`nunt:y <br />Project Number <br />State Developer Name ,_g~ ~AndrewG Phone Number 919-7~~_a9gg <br />State Developer Signat~e 1 szsu~ <br />~- <br />Date ~ [Z, ~ t 9 9~ <br />The following information is essential for an application to be considered complete. Only <br />completed applications will be reviewed by the Competitive Fund Committee. A check below <br />indicates that the item is included in the application. <br />~_ Name of County <br />X Four-Digit SIC Code <br />X Product Description <br />X Value of Company Investment in the Project Over Three Years <br />X Job Creation Over Three Years <br />~_ Weighted Hourly Average Wage for New Jobs <br />X Company Financial Statements for Previous Three Years <br />X Pro Forma Balance Sheet Showing the Project's Financial Impact <br />X Signatory Statements Regarding Bankruptcies <br />X Environmental Checklist <br />-~ Signature of Company Office on Performance Agreement <br />Once an application is complete, it is sent with the check-off sheet to the Division Director and <br />Commerce Finance Center for evaluation according to the Competitive Fund evaluation system. <br />Authorized Signature Date <br />Authorized Signature Date <br />The application is evaluated The check-off sheet, application and results are sent to the Director <br />of the Business/Industry Development Division: <br />Director's Signature Date <br />Revised 6/99 <br />