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Agrivalue Processing Business Incubator Application for Lease Space I. GENERAL INFORMATION 1. Client: 2. Contact Person: 3. Address: 5. Phone: 6.Fax: 4. Postal Code: 7. E-Mail Address: II. BUSINESS OUTLINE 1. Products and Processes: 2. Intended Market Area: 3. Current Manufacturing Capabilities: 4. Current Distribution Capabilities: 5. Authorization for Credit Review Yes No Continued on second page III. PROJECT INFORMATION 1. Anticipated Space Requirements (in m2): a. b. c. d. Process: Dry Storage: Refrigerated Storage: Frozen Storage: Incoming: Raw: Raw: Finished: Finished: Finished: 2. Utility Requirements a. Power: Volt Phase b. Water (in litres/second): Hot: c. Steam: Kg/Hz d. Compressed Air: L/sec e. Other 3. Anticipated Duration of Tenancy (in months): Amp Cold: Pressure Pressure 60Hz KPa KPa Note: Clients requesting Incubator space will be required to provide a cover letter outlining scope of processing venture to accompany application. Also a detailed business plan will be requested for review prior to application acceptance. If the application is accepted, clients will be required to provide Worker’s Compensation Board account information and proof of minimum insurance requirements. Any processing in the Incubator must comply with all appropriate federal and provincial regulations. Signature: Date: The collection of personal information on this application is authorized by the Freedom of Information and Protection of Privacy Act. The personal information will be used to contact the applicant in matters related to this application. If you have any questions about the collection or use of this information, you can contact the Manager of the Agrivalue Processing Business Incubator 4301-65 Ave, Leduc, Alberta, Canada, T9E 8T2, phone (780) 986-4793, fax (780) 986-5138.