DAYTONA BEACH ENTERPRISE CENTER APPLICATION The Daytona Beach Enterprise Center was developed to assist tenant companies in the early stages of their development. It is expected that tenant companies will require incubation periods of 2-3 years. Tenant companies are expected to graduate within 3 years. Graduate planning will be a flexible process involving the tenant, consultants, other program business partners, and the Enterprise Center Director. Candidates for admission to the Incubator should meet the Enterprise Center s definition of a retail, service, or technology-based business. Further, if an approved applicant does not submit a business plan with their application, they will be required to complete a comprehensive business plan within six months of occupancy. The application process shall occur in the following four phases: 1. Submission of a completed application form (based on applicant s performance); 2. Interview and presentation of application before the Enterprise Center Advisory Board (two weeks); 3. Follow-up, refinement, and final selection decision (based on applicant s performance); 4. Business Launching (one week). This application form may be submitted via mail or fax. Interested parties should complete this form and submit it with supportive documentation. Should you have problems completing this application, you may call the Central Florida Community Development Corporation s for assistance at 1-877-258-7520. Please return your completed application with a $20 check for processing. The processing fee is non-refundable. f:\cfcdc\forms\form.616
BUSINESS INCUBATOR APPLICATION A. GENERAL INFORMATION Name of Business: Business Structure: Sole Proprietorship Partnership Corporation Federal Employment Identification Number (EIN): Type of Date Date Business: Established: Incorporated: No. Of Employees: Current: Planned: Name of Applicant: Social Security #: Address of Applicant: City: State: Zip Code: Phone: Fax: Email: Website: Bank: Location: Contact Person: Phone: B. INCUBATION ASSISTANCE REQUEST Lease Space: OFFICE RETAIL COMMERCIAL BAY (MANUFACTURING) SIZE OF SPACE REQUESTED: (average office dimension 150 square feet average retail space 250 square feet average commercial/manufacturing space 550 square feet) Note: spaces can be combined. Other Assistance: Please describe business needs that the Daytona Beach Enterprise Center can assist you with. f:\cfcdc\forms\form.616 2
C. MANAGEMENT List the name(s) of all owners, officers, directors, and/or partners. Provide the percent ownership. 1. Name and Title: Ownership % Net Worth $ Address: City State Zip Phone: Fax: Email: Annual Compensation: Current$ Projected$ Background Experience (Use additional paper if necessary) 2. Name and Title: Ownership % Net Worth $ Address: City State Zip Phone: Fax: Email: Annual Compensation: Current$ Projected$ Background Experience (Use additional paper if necessary) 3. Name and Title: Ownership % Net Worth $ Address: City State Zip Phone: Fax: Email: Annual Compensation: Current$ Projected$ Background Experience (Use additional paper if necessary) 4. Name and Title: Ownership % Net Worth $ Address: City State Zip Phone: Fax: Email: Annual Compensation: Current$ Projected$ Background Experience (Use additional paper if necessary) f:\cfcdc\forms\form.616 3
D. STATEMENT OF PERSONAL HISTORY To be completed by all owners (having 20% or greater interest), officers, directors, and/or partners. State name in full, including middle name(s). If no middle, state (NMN). List all former names used, and dates each name was used. Use separate sheet, if necessary. Name: Date of Birth: Place of Birth: City State Country U.S. Citizen? Yes No Social Security No.: Present Residence Address: From (Date): Street: City: State: Zip Code Home Telephone No.: ( ) Immediate Past Resident Address: From( Date) To (Date) Street: City: State: Zip Code: Describe any physical Disabilities or limitations: Be sure to answer the next eight questions correctly. The fact that you have an arrest or conviction record will not necessarily disqualify you, but a false answer will probably cause your application to be rejected. If you answer yes, furnish all detail ( on a separate exhibit), including name under which it occurred. 1. Are you presently under indictment, or on parole or probation? Yes No 2. Have you ever been charged with or arrested for any criminal offense, other than a minor motor vehicle violation? Yes No 3. Have you ever been convicted of any criminal offense, other than a minor motor vehicle violation? Yes No 4. Do you have any pending judgements against you? Yes No 5. Have you ever filed for bankruptcy? Yes No 6. Have you any past or pending lawsuits? Yes No 7. Do you owe the IRS any back taxes? Yes No 8. Is there a lien against your businesses, or you personally? Yes No
E. BUSINESS INFORMATION Do you have a business plan that addresses items 1 through 22 below? (Check one Yes or No ) If you checked YES, write see business plan in applicable the blank space. Skip items 1 through 22, sign the application on page 8, and remember to attach your business plan. If you checked NO, complete items 1 through 22 below and sign on page 8: 1. Describe your business. 2. List the products or services provided by your company (use additional sheet if necessary). Describe your products: MARKETING SECTION 3. Describe the people who will buy your products or services (i.e. 25 to 40 old car enthusiasts). 4. Describe where your customers are geographically located (i.e. Daytona Beach, St. Augustine, Deland...). 5. List your major customers.
6. List your major competitors. 7. Describe how your company compares with your competitors company. 8. How does your product or service compare with others? 9. Describe your method of pricing ( How did you come up with your price? and How competitive are your prices). 10. Describe how you will attract customers. 11. Describe your sales strategy. Sales Projection in Units Product 1 2 3 4 5 6 7 8 9 10 11 12 Total
12. List your key employees or independent contractors (attach resumes for each). 13. Estimate the number of hours per week you think would be required to operate your business. What hours and days will the business be open? 14. Describe how your accounting and record-keeping functions will operate. 15. Do you have an attorney? Yes or No. Have you discussed your plans with him/her? Yes or No. If yes, give his/her name, address and phone number. 16. Do you have an accountant? Yes or No. Have you discussed your plans with him/her? Yes or No. If yes, give his/her name, address and phone number. 17. Have you ever been in business before? Yes or No If yes, when? What other types of businesses were you in? Why aren t you still involved with the business(es)?
FINANCIAL MANAGEMENT SECTION 18. What are your projected start up costs? $ 19. How much of your money will you invest for start up? $ 20. List all of the required licenses for this business to operate. 21. What are your financial projections (estimates) for the upcoming year of operations. (See Attachment A) Gross Sales: $ Cost of Sales: $ Gross Profit: $ Fixed Expenses: $ Net Profit: $ (See Attachment B) Total Assets: $ Total Liabilities: $ Net Worth: $ (See Attachment C) Total Current Assets: $ Total Current Liab. $ Breakeven in Units: Breakeven in Sales $ This is to certify that the above information includes estimates based on sound research. No information has been provided without reasonable evaluation of collected data. Additionally, no information regarding the principal owner(s) has been falsely represented. Print Company s Name Sign Applicant s Name Print Applicant s Name Date
Risk Evaluation Explain in your own words why you believe that this is or can be a successful venture. What are the major problems facing your business? What, in your opinion, are your company s major opportunities? How will you take advantage of them? REQUIRED DOCUMENTATION The following documents are required for a complete evaluation of your application. Do not submit the application until all applicable documents are included. Attachments Current Personal Financial Statement of all principals (use SBA Form) Personal Tax Returns for the last three years of all principals Business Tax Returns for the last three years Business Fiscal Year End Statement for the last three years Interim Financial Statement of the business, not older that 60 days Licenses to operate business Listing of Bank References Listing of Customer References Personal History - Education/ Resume, for all participants Listing of Supplier References Others (List) Check if Attached When this application is completed, please return it to: Central Florida Community Development Corporation 847 Orange Avenue Daytona Beach FL 32114
Attachment A PROFORMA INCOME STATEMENT Revenue Sales Gross Revenue Cost of Sales Material Labor Total Cost of Sales Gross Profit Expense Salaries Salaries Expense (FICA, Fringe...) Contracted Services Advertising Office Expense Rent/CAM Printing Other Other Other Total Expense Net Income
Attachment B ASSETS PROFORMA BALANCE SHEET CURRENT ASSETS Cash Accounts Receivables TOTAL CURRENT ASSETS FIXED ASSETS Building Land Equipment Depreciation (Building/Equipment) TOTAL FIXED ASSETS TOTAL ASSETS LIABILITIES CURRENT LIABILITIES Accounts Payable Accrued Liabilities TOTAL CURRENT LIABILITIES LONG-TERM LIABILITIES rtgage TOTAL LONG-TERM LIABILITIES
EQUITY Retained Earnings Net Income TOTAL EQUITY TOTAL LIABILITIES AND EQUITY ATTACHMENT C WORKING CAPITAL: CURRENT ASSETS CURRENT LIABILITIES = WORKING CAPITAL BREAK-EVEN: SALES (REVENUE) PRICE PER UNIT COST OF SALES PER UNIT = GROSS PROFIT PER UNIT FIXE EXPENSES / GROSS PROFIT PER UNIT = BREAK-EVEN