Sales and Use Tax Exemption Program APPLICATION

Sales and Use Tax Exemption Program APPLICATION BUSINESS RETENTION AND RELOCATION ASSISTANCE ACT P. L. 2004, c. 65 for _____________________________________________________________ (Company) PLEASE RETURN THE ORIGINAL WITH ONE (1) COPY OF THE COMPLETED APPLICATION WITH A NONREFUNDABLE FEE OF $1000. A COPY OF THE APPLICATION IN ELECTRONIC FORM IS ALSO REQUIRED. NEW JERSEY COMMERCE COMMISSION Sales and Use Tax Exemption Program P.O. Box 820 Trenton, New Jersey 08625 Attention: Lauren Moore Phone: (609) 292-1636 Fax: (609) 292-5509 Note: All application materials are due by the 15th of the month preceding the Commerce Commission’s regularly scheduled Board meeting, which is held the third Wednesday of every month at 10:00 AM. Date Received: Officer: (1/18/08) Page i NEW JERSEY COMMERCE COMMISSION BUSINESS RETENTION AND RELOCATION ASSISTANCE ACT SALES AND USE TAX EXEMPTION PROGRAM Dear Applicant, Thank you for your interest in the Sales and Use Tax Exemption Program that is established by the Business Retention and Relocation Assistance Act, P.L. 2004, c.65 (the "Act"). The sales and use tax exemption program ("Sales Tax Exemption Program" or "Program") is established as a Program under the jurisdiction of the New Jersey Commerce Commission and is administered by the Executive Director and of the Commission. The purpose of the program is to encourage economic development and to preserve jobs that currently exist in New Jersey. Qualifying businesses will be exempt from sales and use tax for eligible property located or placed at a business location for a construction and/or renovation project pursuant to the terms and conditions of an approval agreement. The sales tax exemption certificate, which applies only to property purchased for installation in that approved project, will allow the business to purchase machinery, equipment, furniture and furnishings, fixtures and building materials other than tools and supplies for placement at the project location without the imposition of sales and use tax until the new facility is functional. While preparing the application, please keep in mind the following statutory criteria for determining company eligibility. 1. A business shall have operated continuously in New Jersey, in whole or in part, in its current form or as a predecessor entity, for at least 10 years prior to filing an application with the Commission; A business must certify and represent that the availability of financial assistance from the State as would be provided under this program will be an important inducement to the business to undertake the project and to relocate full-time jobs in the State; A business shall satisfy at least one of the following four criteria: i. The business has 1,000 or more full-time employees in the State and the project involves relocating 500 or more full-time employees into a new business location or locations; The business is a life sciences business or a manufacturing facility and the project is:    constructing one or more new research and development facilities; constructing one or more new manufacturing facilities in this State; or relocating to a new headquarters in this State that will employ 250 or more full-time employees. 2. 3. ii. iii. The business is a life sciences business or a manufacturing business and the project is constructing a new property, or substantially rehabilitating a vacant property that will separately or collectively: (1) (2) (3) (4) Be predominantly a new research and development facility; Be predominantly a new manufacturing facility; House the headquarters of the business; or Separately or collectively be a combination of iii (1), (2) and (3) above; provided, that the new or substantially rehabilitated facility will house a minimum of 250 full-time employees. (Note: "Predominantly" means a majority of the employees housed in the new facility are engaged in that activity, or a majority of the square footage of the new facility is used in that activity; or a majority of the total value of the investment made will be employed in that activity; or another measure of activity as may be determined by the Executive Director that demonstrates that a critical concentration of research and development, manufacturing, or both, will occur at the new facility;) or Page ii iv. The business was, at the time of enactment of P.L. 2004, c.65, § 21, receiving a structured finance special guarantee pursuant to N.J.A.C. 19:31-2.1 (c) 3 iii (5) for the project. When determining a number of full-time employees, the eligible positions of a member of a controlled group of corporations, as defined pursuant to section 1563 of the Federal Internal Revenue Code of 1986, 26 U.S.C. §1563, shall be considered the eligible positions of a single employer. In addition to the eligibility criteria listed above, the project must be located at an approved site. 1. To be an approved site, the location for the project shall be situated in designated Planning Area 1 or 2, as defined in State Development and Redevelopment Plan adopted by the State Planning Commission (pursuant to P.L. 1985, c.398 (N.J.S.A. 52:18A-196 et al.)). Notwithstanding 1 above, a project involving the renovation or expansion of an existing facility that is not located in designated Planning Area 1 or 2 may be eligible to participate in the program, at the determination of the Executive Director, if all other applicable criteria are satisfied. A business located in an urban enterprise zone designated pursuant to the New Jersey Urban Enterprise Zones Act, P.L. 1983, c.303 (N.J.S.A. 52:27H-60 et seq.) as of June 30, 2004, shall not be eligible to participate in this program if the relocation project is from a facility within the urban enterprise zone to a facility outside and urban enterprise zone. Notwithstanding 3 above, if the relocation is to a facility already owned or leased by the same business and that business already employs at least the same number of persons as those being relocated from the urban enterprise zone, it may be eligible to apply. 2. 3. 4. Program eligibility further requires that a business shall provide evidence and certify that it is not in default with any other program administered by the State of New Jersey. A project may be completed in up to two phases provided that it will be the national headquarters of a life sciences or manufacturing company and will include a significant research and development or manufacturing facility or combination thereof and if: 1. The first completed phase will house at least 200 full-time employees and the second phase will house at least 100 additional employees; and The project is pre-approved for phases and that all phases are completed within 30 months of project approval. 2. Please note, to the extent the company (not an unaffiliated third party) has undertaken the construction of a new business location for the Project, the company must comply with the Commission's prevailing wage requirements (P.L. 2002, c. 78; N.J.S.A. 52:27C-73.1) and implementing regulations (N.J.A.C. 12A:2A-3 et seq.) The Commission also encourages the company, in constructing a new business location, to comply with the Commission’s set-aside program goals and targets set forth at N.J.A.C. 12A:10-1.1 et seq. and Executive Order 71 (October 2, 2003). The NJ Commerce Commission appreciates your interest in New Jersey. We look forward to working with your organization in processing this application. Please provide answers to all questions. Page 1 NEW JERSEY COMMERCE COMMISSION BUSINESS RETENTION AND RELOCATION ASSISTANCE ACT SALES AND USE TAX EXEMPTION PROGRAM APPLICATION COPY AND COMPLETE FOR EACH COMPANY/SUBSIDIATY THAT WILL BE HIRING ELIGIBLE EMPLOYEES AT THE PROJECT SITE SECTION A. Corporate Information 1. Name of Company a. b. c. d. e. f. 2. a. b. Corporate Name of Applicable New Jersey Taxpayer (if different from above) If controlled group of corporations (section 1563 IRC): list all entities in controlled group List total number of jobs to be relocated per entity Date of Incorporation Name of U.S. Parent Company (if different from above) State of Incorporation (if not New Jersey) Current Street Address, P.O. Box, City, State and Zip Contact Person for this project - Name and Title/Direct Address (if different from above) Telephone, Fax Numbers, and E-mail Address 3. Type of Industry/Business a. b. Four Digit SIC Code NAICS Code 4. 5. 6. 7. 8. Principal Products and Services New Jersey Tax Identification Number Federal Tax Identification Number Total Number of Current Employees in New Jersey Total number of years of operation in New Jersey. Include evidence that the business or a predecessor entity has been operating, in whole or in part, in this State for at least ten (10) years prior to filing the application. Include certification that the company applying for this program is not in default with any other program administered by the State of New Jersey. 9. 10. Certify that the availability of financial assistance from the State as provided in this program at the site proposed for approval is an important inducement to the business to undertake the project and to relocate the full-time jobs relating to the project in the State. Page 2 Section B. Project Information (Note: See Appendix B) 1. Provide and overall description of the proposed project. (Also, detail how the business meets the eligibility criteria. See N.J.A.C. 12A:2A-2.3) Provide current locations (addresses) and number of employees for each site that is subject to this application. Include multiple site locations. Using the following chart, please: a. b. Identify the location(s) for which employees will be moved. Include the number of eligible employees. Identify the location to which employees will be moved. Include the number of eligible employees. # Eligible Employees # Ineligible Employees # Consultants # BEIP Jobs Proposed Site # of Employees 2. 3. Current Site TOTALS 4. Describe the quality of the full-time jobs retained, including, but not limited to, the salaries and benefits provided to retained full-time employees. Describe any projected capital investments made by the business at the new business location(s). Identify the site of the new business location and its consistency with the smart growth goals, strategies and policies of the State Development and Redevelopment Plan established pursuant to section 5 of P.L. 1985, d.398 (C.52: 18A-200). Provide a project schedule that identifies projected move dates for each site. Provide a schedule of short-term and long-term employment projections of the business in the State based upon the relocation. Provide the terms of any lease agreements or details of the purchase or building of the new business location. 5. 6. 7. 8. 9. 10. Provide an estimate of the projected retained State tax revenues resulting from the relocation. (Note: "State tax revenue" includes all taxes the business pays to the State, including but not limited to, payroll withholding taxes.) 11. a. Provide a description of the type of contribution the business can make to the long-term growth of the State's economy and a description of the potential impact on the State's economy if the jobs are not retained. b. Describe how this project will affect any company-owned New Jersey facilities. c. Please provide an estimated value of the sales tax the company would have paid if it had not received the Sales and Use Tax Exemption Certificate. 12. Provide evidence of alternative relocation plans such as an analysis of the cost effectiveness of remaining in this State versus relocation under the alternative plans. 13. Summarize all local and/or state financial assistance being utilized in the proposed project, such as other grants (BEIP and etc.), low interest rate loans, infrastructure improvements, property tax abatements, exemption, and training assistance. Please specify program names, dollar amounts and terms as well as the status of applications and approvals. Page 3 C. Employee Information (Note: See Appendix C) 1. Provide a written certification that the employees who are the subject of this application are fulltime employees and receive health care benefits. Identify the number of employees at the project site that are included in a Business Employment Incentives Program (BEIP) grant calculation. Compare this to the number of employees that are subject to an application made under this program. Include the New Jersey Economic Development Authority (NJEDA) BEIP project identification number. From To # Relocated Jobs # BEIP Jobs # STX Jobs 2. Total 3. If the company is a BEIP grantee, provide evidence that the NJEDA has been notified of the applicant's potential relocation to another site within New Jersey. Certify and document that the applicant will maintain 95 percent of the retained full-time jobs for at least the first two (2) years of the commitment duration, and will maintain a minimum of 90 percent of the retained full-time jobs for the remainder of the commitment duration. (See “Commitment Duration” under Definitions - Appendix D) Note: if the company is unable to provide this certification and documentation, the company is ineligible to participate. Will relocated positions average at least 1.5 times the minimum hourly wage during the commitment duration? ____Yes ____No 4. 5. Page 4 Appendix A. Additional Corporate and Subsidiary Information Page 5 Appendix B. Capital investments proposed by the company at the new business location: 1. New Construction: 2. Renovation: 3. Leasehold Improvements: Page 6 Appendix C. Employee Information JOB COMMITMENT FORM Please refer to the attached list of definitions in Appendix D to determine if the project’s employees meet the criteria for full-time employees. Year 1 1. Total Number of Existing Employees: 2. Total Number of Existing Employees in New Jersey: Anticipated Number of Eligible Retained Employees: 3. 4. Average Annual Employees: Salary for Retained 5. Expected Number of Employees with Average Annual Salaries Ranging from: $0 to $18,000 $18,001 to $30,000 $30,001 to $50,000 $50,000 + 6. 7. Estimated Total Gross Payroll Estimated Total Gross State Withholdings Page 7 Appendix D: Definitions DEFINITIONS RELATIVE TO BUSINESS RETENTION AND RELOCATION ASSISTANCE ACT, Sales and Use Tax Exemption, FROM N.J.A.C. 12 A : 2A - 2 "Act" means the Business Retention and Relocation Assistance Act, P.L. 2004, c.65 "Agreement" or "Project approval agreement" means the project approval agreement between a business and the Commission governing the terms and conditions of the project approval for the sales tax exemption program. The Agreement describes the project, the date the commitment duration shall commence, the extent of sales tax exemption, the conditions and limitations of the sales tax exemption, the representations and reporting obligations of the business, and other such provisions which further the purposes of P.L.2004, c.65, 19-22 (C.34: 1B-185 through 188). "Application" means the application submitted by a business for the sales tax exemption program, pursuant to P.L.2004, c.65, 19-22. "Approved site" means the site of the project in the New Jersey Development and Redevelopment Plan designated Planning Area 1 or 2 locations; however, if the site of the project is not located in either of such Planning Areas, the project involves renovation or expansion of an existing facility, and the project satisfies all other criteria of the program as determined by the Executive Director, the site may also be an approved site. "Board of Directors" means the Board of Directors for the New Jersey Commerce Commission. "Business" means an employer located in this State that has operated continuously in the State, in whole or in part, in its current form or as a predecessor entity for at least 10 years prior to filing an application to the program and which is subject to the provisions of N.J.S.A. 43:21-1 et seq. and may include a sole proprietorship, a partnership, or a corporation that has made an election under Subchapter S of Chapter One of Subtitle A of the Internal Revenue Code of 1986, or any other business entity through which income flows as a distributive share to its owners, limited liability company, nonprofit corporation, or any other form of business organization located either within or outside the State, such as a group of organizations under common control as defined in Section 414(b) or (c) of the Internal Revenue Code of 1986 and Federal Treasury regulations thereunder. For purposes of identifying full-time employees in eligible positions and retained State tax revenue, any such employees hired by or taxes paid by a professional employer organization (PEO) with which the business has entered into an employee leasing agreement shall be allocable to the business. "BEIP grant" means the grant made to a business by the New Jersey Economic Development Authority pursuant to the provisions of P.L. 1996, c. 26 (C.34: 1B-124 et al). "Commission" means the New Jersey Commerce Commission established pursuant to N.J.S.A. 52:27C61 et seq., and renamed and reorganized pursuant to Reorganization Plan 001-2007. "Commitment duration" means five years from the date specified in the project agreement entered into pursuant to sections 19-22 of P.L.2004, c.65 (C.34: 1B-185 through 188). "Completion date" generally means the earlier of the date of the issuance of a temporary certificate of occupancy with respect to an approved site or in cases where no temporary certificate of occupancy is issued, one year from the project commencement date, as specifically set forth in the project approval agreement. "Construction contract" means for purposes of undertaking the project, any contract for the acquisition, construction, improvement or installation of those portions of the project subject to sales tax or installation of eligible property. For purposes of this definitions, the term "installation" means installation by a contractor, which involves access to pipes or wires within walls or any other alteration or modification of the project, but shall not include the delivery, locating, relocating, moving, assembling or setting up of eligible property by the provider of such property for the business's employees or any installation of such eligible property (including but not limited to machinery, apparatus and equipment) if such installation is made pursuant to a purchase contract by the provider of such property. Page 8 "Director" means the Director of the Division of Taxation in the Department of the Treasury. "Eligible affiliate" means any person with respect to which the business: 1. Possesses, directly or indirectly, the power to direct or cause the direction of the management or policies of such person, whether through the ownership of voting securities by contract or otherwise; and Owns, either directly or indirectly, at least 51 percent of the voting stock or other equity or ownership interest of such person. 2. "Eligible property" means machinery, equipment, furniture and furnishings, fixtures, and building materials, but "eligible property" shall not include "motor vehicles" as defined pursuant to section 2 of P.L. 1966,c.30 (C.54: 32B-2), parts with a useful life of one year or less, or tools or supplies used in connection with the eligible property. Eligible property does not include machinery or equipment purchased, rented or leased by a project participant construction manager, contactor, or subcontractor under contract with the business for their own use on the project. "Executive Director" means the Executive Director of the New Jersey Commerce Commission. "Full-time employee" means a person who is employed for consideration for at least 35 hours a week, or who renders any other standard of service generally accepted by custom or practice as full-time employment, and who is determined by the Executive Director to be employed in a permanent position according to criteria as the Executive Director may prescribe. "Full-time employee" shall not include any person who works as an independent contractor or on a consulting basis for the business. "Full-time employee" shall not include a child, grandchild, parent or spouse of an individual who has direct or indirect ownership of at least five percent of the profits, capital, or value of the business. "Headquarters" of a business means the single location that serves as the national administrative center of the business, at which the primary office of the chief executive officer or chief operating officer of the business, as well as the offices of the management officials responsible for key business wide functions such as finance, legal, marketing, and human resources, are located. "Life sciences business" means a business engaged principally in the production of medical equipment, ophthalmic goods, medical or dental instruments, diagnostic substances, biopharmaceutical products; or physical and biological research; or biotechnology. "Manufacturing facility" means a business location at which more than 50 percent of the business personal property that is housed in the facility is eligible for the sales tax exemption pursuant to subsection a. of section 25 of P.L. 1980, c.105 (C.54:32B-8.13) for machinery, apparatus or equipment used in the production of tangible personal property. "New business location" means the premises that the business has either purchased or built or for which the business has entered into a purchase agreement or a written lease for a period of no less than eight years from the date of relocation. A new business location may also include the premises from which the business moves on a temporary basis due to the rehabilitation of permanent premises that also qualifies as reconstruction as "reconstruction" is defined in the Uniform Construction Code, N.J.A.C. 5:23-6.3. In that case, the move to the permanent premises will trigger availability of the sales and use tax exemption. "Program" means the sales and use tax exemption program established under the jurisdiction of the Commission and administered by the Executive Director, pursuant to P.L.2004, c.65, 19-22 and N.J.A.C.12A:2A-1. “Project" means an eligible affiliate of the business or any construction manager, contractor or subcontractor that performs acquisition, construction, installation or improvements for the project and any other entities working on the project that use the sales tax certificate. "Project participant" means an eligible affiliate of the business or any construction manager, contractor or subcontractor that performs acquisition, construction, equipping, installation or improvements for the project and any other entities working on the project that use the sales tax certificate. Page 9 "Research and development facility" means a business location at which more than 50 percent of the business personal property that is purchased for the facility is eligible for the sales tax exemption pursuant to section 26 of P.L.1980, c.105 (C.54: 32B-8.14) for property used in research and development; "Retained full-time jobs" means an eligible position that currently exists in New Jersey and is filled by a full-time employee but which, because of a relocation by the business, is at risk of being lost to another state or country. For the purposes of determining a number of retained full-time jobs, the eligible positions of the members of a "controlled group of corporations" as defined pursuant to section 1563 of the federal Internal Revenue Code of 1986, 26 U.S.C., 1563, shall be considered the eligible positions of a single employer. A retained full-time job is one that will not be included in the calculation of a BEIP grant subsequent to being moved to the approved project site. "Sales tax certificate" means the sales and use tax exemption certificate issued by the Director to the business upon approval by the Executive Director of the terms and conditions of the agreement. "Sales tax exemption" means the sales and use tax exemption approved under an agreement pursuant to the Act, and for purposes of this program, the sales tax exemption may be administered pro rata based on the number of retained full-time jobs relative to the number of total jobs located at an approved project site during the commitment duration period. “Sales tax repayment amount" means the sum of: 1. The amount of sales and use taxes which would have been payable on all eligible property purchased for the project if the property was not purchased with the sales tax certificate; provided that if repayment is the result of a default of the agreement during the commitment duration, this amount shall be reduced by an amount allocable to the proportionate amount of the sales and use tax that corresponds to the period of time in which the business was in compliance measured from the completion date until the date of default, Interest on the repayment amount referred to in 1. above at the rate equal to the statutory rate for sales tax deficiencies plus any statutory penalties; and All costs incurred by the Executive Director and the Division of Taxation in connection with the pursuit of the sales tax repayment amount (including, but not limited to, counsel fees, court costs and other costs of collection). 2. 3. Page 10 Appendix E: CERTIFICATION OF APPLICATION AND AUTHORIZATION TO RELEASE INFORMATION Please Note: Sections A, B and C of the application are designed to provide sufficient information regarding a proposed project to the staff and members of the New Jersey Commerce Commission. Eligibility for the Sales and Use Tax Exemption Program is determined by the information presented in the completed application. Any changes in the status of the proposed project from the facts presented herein could disqualify the project. Upon approval by the Executive Director of the Commission, after recommendation from the Commission’s Board of Directors, the applicant will be required to supply and certify the full names, job titles, and job location of existing employees in New Jersey to serve as an exhibit to the Project Agreement. CERTIFICATION OF APPLICATION AND AUTHORIZATION TO RELEASE INFORMATION I hereby represent and certify that I have reviewed the information contained in the application and that the foregoing information, to the best of my knowledge and belief, is true, complete and accurately describes the proposed project for which the sales and use tax exemption is being sought. I further agree to inform the Commission of any changes in the foregoing information which may occur prior to the time the applicant and the Commission execute a project agreement. The undersigned, on behalf of the applicant, understands and acknowledges that the information contained in this application, or which may hereafter be communicated to the Commission, may be subject to public disclosure during deliberations of the Commission at public meetings conducted pursuant to the Open Public Meetings Act, NJSA10: 5-1 et seq. and to the Open Public Records Act, NJSA 47A: 1-1 et seq. __________________________________________________________ DATE APPLICANT __________________________________________________________ DATE APPLICANT __________________________________________________________ DATE APPLICANT Page 11 Appendix F Businesses applying for Sales and Use Tax Exemption Program are subject to the Commission’s Disqualification/Debarment Regulations (the “Regulations”), which are set forth in N.J.A.C. 12A:4-12.1et seq. Applicants are required to answer the following background questions pertaining to the commission of certain offenses that can lead to disqualification from eligibility under the Regulations. All capitalized terms used in this Questionnaire, except those defined elsewhere herein, shall be defined at the bottom of this form. Has Applicant, any officers or directors of Applicant, or any Affiliates (collectively, the “Controlled Group”) been found guilty, liable or responsible in any Legal Proceeding for any of the following violations or conduct? (Any civil or criminal decisions or verdicts that have been vacated or expunged need not be reported). 1. Commission of a criminal offense as an incident to obtaining or attempting to obtain a public or private contract, or subcontract there under, or in the performance of such contract or subcontract. ____ Yes ____ No 2. Violation of the Federal Organized Crime Control Act of 1970, or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, perjury, false swearing, receiving stolen property, obstruction of justice, or any other offense indicating a lack of business integrity or honesty. ____ Yes ____ No 3. Violation of the Federal or State antitrust statutes, or of the Federal Anti-Kickback Act (18 U.S.C. 874). ____ Yes ____ No 4. Violation of any law governing the conduct of elections of the Federal Government, State of New Jersey or of its political subdivision. ____ Yes ____ No Violation of the “Law Against Discrimination” (P.L. 1945, c169, N.J.S.A. 10:5-1 et seq., as supplemented by P.L. 1975, c. 127), or of the act banning discrimination in public works employment (N.J.S.A. 10:2-1 et seq.) or of the act prohibiting discrimination by industries engaged in defense work in the employment of persons therein (P.L. 1942, c114, N.J.S.A. 10:10, et seq.). ____ Yes ____ No 6. To the best of your knowledge, after reasonable inquiry, violation of any laws governing hours of labor, minimum wage standards, prevailing wage standards, discrimination in wages, or child labor. ____ Yes ____ No To the best of your knowledge, after reasonable inquiry, violation of any law governing the conduct of occupations or professions of regulated industries. ____ Yes ____ No Debarment by any department, agency, or instrumentality of the State or Federal government. ____Yes ____ No 5. 7. 8. Page 12 9. Violation of any of the following prohibitions on vendor activities representing a conflict of interest, or failure to report a solicitation as set forth below: (i) No person shall pay, offer or agree to pay, either directly or indirectly, any fee, commission, compensation, gift, gratuity, or other thing of value of any kind to any Commission officer or employee or special Commission officer or employee, as defined by N.J.S.A. 52:13D-13b and e, with which such person transacts or offers or proposes to transact business, or to any member of the immediate family as defined by N.J.S.A. 52:13D-13i, of any such officer or employee, or partnership, firm, or corporation with which they are employed or associated, or in which such officer or employee has an interest within the meaning of N.J.S.A. 52:13D-13g. The solicitation of any fee, commission, compensation, gift, gratuity or other thing of value by any Commission officer or employee or special Commission officer or employee from any person shall be reported in writing by the person to the Attorney General and the Executive Commission on Ethical Standards. No person may, directly or indirectly, undertake any private business, commercial or entrepreneurial relationship with, whether or not pursuant to employment, contract or other agreement, express or implied, or sell any interest in such person to any Commission officer or employee or special Commission officer or employee having any duties or responsibilities in connection with the purchase, acquisition or sale of any property or services by or to the Commission, or with any person, firm or entity with which he or she is employed or associated or in which he or she has an interest within the meaning of N.J.S.A. 52:13D-13g. Any relationships subject to this subsection shall be reported in writing to the Executive Commission on Ethical Standards, which may grant a waiver of this restriction upon application of the Commission officer or employee or special Commission officer or employee upon a finding that the present or proposed relationship does not present the potential, actually or appearance of a conflict of interest. No person shall influence, or attempt to influence or cause to be influenced, any Commission officer or employee or special Commission officer or employee in his or her capacity in any manner which might tend to impair the objectivity or independence of judgment of the officer or employee. No person shall cause or influence, or attempt to cause or influence, any Commission officer or employee or special Commission officer or employee to use, or attempt to use, his or her official position to secure unwarranted privileges or advantages for the person or any other person. ___ Yes ___ No (If Yes, specify subsection) (ii) (iii) (iv) (v) Page 13 10. Has any member of the Controlled Group been found guilty, liable or responsible for the violation in any Legal Proceedings of any State or Federal law that may bear upon a lack of responsibility or moral integrity, or that may provide other compelling reasons for disqualification? (Your responses to the foregoing question should include, but not be limited to, the violation of the following laws, without regard to whether any monetary award, damages, verdict, assessment or penalty has been made against any member of the Controlled Group, except that any violation of any environmental law in category (v) below need not be reported where the monetary award, damages, etc. amounted to less than $1 million). (i) Laws banning or prohibiting discrimination or harassment in the workplace on the basis of gender, race, age, religion or handicapped status. Laws prohibiting or banning any form or forced, slave, or compulsory labor. Laws protecting workers who have reported the wrongdoing of their employers to governmental authorities, commonly referred to as “Whistleblower Laws”. Securities or tax laws resulting in a finding of fraud or fraudulent conduct. Environmental laws. Laws banning the possession or sale of, or trafficking in, firearms or drugs. Laws banning anti-competitive dumping of goods. Anti-terrorist laws. Criminal laws involving commission of any felony or indictable offense under State of Federal law. Laws banning human rights abuses. Laws banning the trade of goods or services to enemies of the United States. The New Jersey Conflicts of Interest Law 52:13D-1 et seq. ___ Yes ___ No (ii) (iii) (iv) (v) (vi) (vii) (viii) (ix) (x) (xi) (xii) 11. To the best of your knowledge, after reasonable inquiry, is any member of the Controlled Group a party to pending Legal Proceedings wherein any of the offenses or violations described in questions 1-10 above are alleged or asserted against such entity or person? ___ Yes___ No The terms set forth below shall be defined as follows: “Affiliates” means entities having an overt or covert relationship such that any one of them directly or indirectly controls or has the power to control another. “Legal Proceedings” means any State or Federal civil, criminal or administrative proceeding in a court or administrative tribunal in the United States or any territories thereof. The Commission reserves the right to require additional clarifying or explanatory information from the applicant (“Applicant”) regarding the answers given. If, at any time prior to Commerce Commission Board action on this application, or, at any time between the date of such action and the execution of an agreement with the Executive Director, the Applicant should become aware of any facts that materially alter or change such answers, or that render any of them incomplete, the Applicant shall have a duty to immediately report such facts to the Executive Director in writing. Page 14 Appendix G COPY AND COMPLETE ONE FOR EACH COMPANY/SUBSIDIARY THAT WILL BE HIRING/RETAINING ELIGIBLE EMPLOYEES AT THE PROJECT SITE RELEASE AUTHORIZATION I, , an officer of , hereby authorize the New Jersey Commerce Commission to contact the New Jersey Department of Labor and Workforce Development to conduct a review of our tax filing history to determine if there are currently any tax deficiencies and/or delinquencies. The New Jersey Department of Labor and Workforce Development may release their findings to the New Jersey Commerce Commission, Business Retention and Relocation Assistance Act, (P.L. 2004, c. 65), Business Retention and Relocation Assistance Grant, Tax Credit Program. Date Signature/Title Sworn to and subscribed before me this ______ day of ______________, 20_____. ________________________________ (Notary Public) (SEAL) NOTE: In order to receive benefits under the BRRAG program, the company will need to receive tax clearance from the NJ Division of Taxation. Has your company applied for and received tax clearance? ___ Yes___ No *Go to http://www.state.nj.us/treasury/taxation/index.html?busasst.htm~mainFrame for further details.