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<br />135 <br />FIGURE 1 <br />Standard Form 424 <br /> <br /> <br />APPLICATION FOR OMS Approval No. 0348-0043 <br /> <br />FEDERAL ASSISTANCE 2.DAiESUBMrmD Appicantlclenå6er <br /> <br />10 TYPE OF SUBMISSION: . 3. DAiE RECEIVED BY STATE Stale Applic:aIion Identifier <br />Application . Preapplication <br />0 Construction . r&1 Construction 4. DJUE RB::EIYED BY FeJeRAL AœK::Y Federal ldenlifier <br />0 Non-Construction . 0 Non-Construction <br />5.' APPUCANT INFORMATION <br /> <br />legal Name: (',nrr;/'Ìnr Rllc:::;n""c:::c::: Tnnnv~t;nn.~ P" Unit ~ 'nor Rll¡:::;np.¡:::¡::: Tnr11h.ator <br />~ rg;... <ity. """""Yo _0 - zip Ø>IIe): NamE' and telephone number of person II) be comaaed on maaers invaMng this <br />¿1) W. San Antonio Street ~n~MR=*) <br />San Marcos, TX 78666 Dr. Johan S. Gervais <br />512- 392-4588 <br />6. EMPLOYER IDENTIFiCATION NUMBER (ElN): 7. TYPE OF APPUCANT: (enter approptiale Ielœr in t1oX) [Ñ] <br /> <br />rn - 12 17 111 0111 7 I 81 A.StaIe H. InclependentSchooIDist. <br />B. County 1. State ConlrOlled InsU1ution of Higller Learning <br />8. TYPE OF APPUCAllON: C. Municípa! J. PrivaIe UniYersity <br />IÜI. 0 Cominuanon q Re¥IsIo D. Township K. Indian Tribe <br />'N New n E. InrelStaIe L. lndMáual <br />F. lnœrmunicìpaJ M. Profit OrganizaJicn <br />. D 0 G. SøecaJ Disllict N. Other (Specify) NO p "E> r 0 f; t <br />If Revision. enter aøpRlpnaœ leuertS) I!'I boX(es) 501 ( c ) ( 3 ) <br /> <br />A. Increase Award So Decrease Award Co ~ DuraDon <br />DoDeaease DuratlOtl 0Iher (specify): 9. NAME OF FEDERAL. AGENCY: <br />Economic Development Admin. <br /> <br />10. CATAlOG OF FEDERA1. DOIIESTlC ASSISTANCE NUMBS!: 110 DESCRIPTIVE TITLE OF APPUCANT"S PROJECT: <br /> <br />, ~ - ~ Purchase and Renovation of BusineEs <br />11TLE: Pub1.1c Works lncuba tor Facili ty. <br />12. AREAS AFFECTED BY PROJECT {Cities. COunties. States. etC.}: <br />Counties of Hays, Caldwell, Guadalu¡: e, <br />Coma 1, Travis & Bastrop <br />13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: <br /> <br />Slart Daæ J ,Ending Date a. Applicant . II PIO eCI <br />July 19~8 Julv 1 ~qq 1L..tn : 14tl1 <br />15. ESTIMATED FUNDING: 160 IS APPUCATION SUBJECT TO REVIEW BY STATE EXECUT1YE ORDER <br />12372 PROCESS? <br />a. Federal $ 873 000 .00 <br />, <br />a YES. THIS PREAPPLlCATIONIAPPLICATtON WAS MACE AVAILABLE <br />b. Applicant $ .00 TO THE STATE EXECUTIVE ORDER 12372 PROCSSS FOR <br />REVIEW ON: <br /> <br />Co Slate S 00 <br />~TE Not applicable to proposal <br />d. Local $ .00 <br />II. NO. 0 PROGRAM IS NOT COVERED BY E.O. 14m2 <br />e. OIner $ 5 8 2 , 0 0 0 000 0 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR <br />REVIEW <br /> <br />I. Program tnaxne $ .00 <br />17, IS 'THE APPI.ICANT DaJNQUENT ON ANt ÆDERA1. DEBT? <br /> <br />g. TOTAl. S 1 4 5 5 000 .00 0 Yes If -Yes: aøadt an e.T.plallalÏoho ~ No <br />, , <br /> <br />180 TO THE BEST OF MY KNOWLEDGE AND BEU£f. AU. DATA IN THIS APPUCATIONJPREAPPUCATION ARE TRUE. AND CORRECT. THE DOCUMENT HAS <br />BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPUCANT AND THE APPUCANT WILL. COMPLY WITH THE A1TACHED ASSURANŒS IF 'THE <br />ASSISTANCE IS AWARDED. <br /> <br />a. Type Name 01 AuttIonzed RepresentatiYe II>. Tille Co Telephone Number <br />Dr. Johan S. Gervais I Executor Director 512- 3~2-4588 <br />c1. SignalUte 01 Aumonzed Reøresenlalllle e. Date Signed <br /> <br /> <br />-- EdiIion 1188- SI-.I Fonn 424 ~ 4C) <br />- tor Local Aitproduc:lion ~ .". OIlS ~ A-1G2 <br /> <br /> <br />3 <br />