2. MIDA Bond-Essentia Health - Laserfiche WebLink

CASS COUNTY MIDA BOND APPLICATION FORM 1. Name of applicant: Essentia Health 2. Telephone number of applicant: Bert Norman (763) 689-6122 3. Size of issue requested: $125,000,000 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 50 1 (c)(3) issue [Section 145] (e) Refunding issue (f) Other (specify type): Solid Waste Disposal [Section 142(a)(6)] 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(a)(12)(C)? Yes No 6. If type of issue check 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: February, 2008 8. Give a brief explanation of project, which explanation should include the location of the project, description of the use of the bond proceeds, and whether or not the project would create additional employment: Financing and refinancing acquisition of assets of Dakota Clinic, Ltd. and Dakota Specialty Institute d/b/a Innovis ("DCII") by Innovis Health, LLC. Assets include real and personal property consisting of hospital and clinic sites leased or owned by DCII in Fargo and Casselton in the County, and additionally in Jamestown, Valley City, Hankinson, Medina, Lisbon and Wahpeton, North Dakota. It is proposed that the County and those cities enter into a joint powers agreement related to the issuance of the bonds, and that the cities will each hold a public hearing and approve such agreement and the issuance of the bonds/ 9. Attached to the Application Form is a check in the amount of$1,000 which is the application fee, which fee is nonrefundable. 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 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 first $1,000,000 of the Bond issue and that there is no fee beyond the first $1,000,000. For refunding bond issues the issuance fee is one-half of the amount set forth above. Dated: December 10, 2007. BY~