1. MIDA Bond-Essentia Health - Laserfiche WebLink

CASS COUNTY MIDA BOND APPLICATION FORM 1. Name of applicant: Essentia Health, a Minnesota nonprofit corporation and an exempt organization under Section 501(c)(3)of the Internal Revenue Code 2. Telephone number of applicant:Robert(Bert)J.Norman, (218)786-3178 3. Size of issue requested: $50,000,000 4. Type of issue(check one): a. Small issue-$ 1,000,000(Section 144(a)) b. Small issue-$10,000,000(Section 144(a)(4)) c. Qualified residential rental project Section 142(a)(7)) d. X Qualified 501(c)(3)issue(Section 145) e. Refunding issue f. Other(specify type): 5. If type of issue checked was small issue ($1,000,000 or $10,000,000), is issue for a manufacturing facility as defined in Section 144(ax12)(c)?Yes_No— 6. If type of issue checked was qualified residential rental project,will project meet the low income requirements for tenants as set out in Section 142(d)?Yes_No_ 7. Estimated date of issue if approved by County: June 30,2014 8. Give a brief explanation of the project, which explanation should include the location of the project, description of the use of bond proceeds, and whether or not the project would create additional employment: Constructing and equipping a 125,000 square foot expansion to the in- patient hospital facilities owned by Innovis Health, LLC, a Delaware limited liability company, the sole member of which is Essentia Health, located at 3000 – 32nd Avenue South, Fargo, North Dakota, and related remodeling, in order to provide improved and enhanced diagnostic, treatment,registration and dietary services. 9. Attached to the Application Form is a check in the amount of $1,000 which is the application fee,which fee is non-refundable. If issue does close,the application fee shall be deducted from the issuance fee set out in paragraph 11. 10. Attached is a typed Initial Resolution giving the project preliminary approval and a Notice of Hearing,both in the form provided by the County Auditor's Office. The Initial Resolution and Notice shall have a hearing date which has been provided to the applicant by the County Auditor's Office. 11. The applicant understands that the issuance fee for a new MIDA bond issue is equal to 1%of the size of the issue,with a maximum fee of$10,000.