MCE On-Bill Repayment Program Loan Information Request GENERAL BUSINESS INFORMATION Note: Please print or type all information. Use additional sheets if necessary. Applicant s name (legal business name) Street Address Mailing Address (if different) Phone no. ( ) Mobile phone ( ) Fax no. ( ) Preferred e-mail address Legal status of business Sole Proprietorship Nonprofit General Partnership Limited Partnership Subchapter S Corporation Corporation Limited Liability Company Annual sales: $ Tax ID number How long has your business been established? How long has current management been in place? Number of employees? Is business seasonal? Yes No If yes, when is the busy season? Slow season? Describe your product or service: Provide a summary of authorized officers, managers and/or directors of your business. NAME TITLE % OF OWNERSHIP Provide the contact information of key financial advisers. NAME FIRM PHONE Accountant ( ) Attorney ( ) Insurance Agent ( ) Business Loan Information Request Page 1 of 7 rev. 06-2013
OBR PROGRAM CREDIT REQUEST What is the cost of the [Energy Project] as provided on the [Energy Audit]? $ What is the amount of the [Energy Project] you wish to finance or borrow? $ What is the primary source of repayment of the loan*: What is the secondary source of repayment of the loan*: *Other income: alimony, child support, or separate maintenance income need not be revealed if applicant does not want to have it considered as a basis for repaying this obligation. Please describe the type of property which is subject to the Energy Project? Street Address: City: County: Commercial Retail Commercial Office Commercial Warehouse Commercial Mixed-Use Multi-Family Commercial Condo Other Estimated Value $ Source of valuation: Amount of First Lien $ Amount of Additional Liens $ [Energy Project] Specific Questions: What is the estimated monthly amount you expect to save following completion of the Energy Project? $ What is the estimated timeline (in weeks) for completion of the Energy Project? weeks Are county or other permits or approvals required in connection with the Energy Project? Yes No If yes, please describe: RELATED BUSINESS ISSUES If Applicant answers yes to any of the following questions, please describe circumstances in detail below or on an attached sheet. Has Applicant pledged inventory, accounts receivable or equipment to secure existing debt? Yes No If yes, please explain. Is Applicant a party to any claim or lawsuit? Yes No If yes, please explain. Has Applicant ever declared bankruptcy? Yes No Chapter? Date of filing Does Applicant owe any past due taxes? Yes No Amount Owed to: Is Applicant an endorser, guarantor or co-maker for any obligations (including taxes)? Yes No If yes, please explain: Business Loan Information Request Page 2 of 7 rev. 06-2013
BANK REFERENCES BANK TYPE OF ACCOUNT ACCOUNT NUMBER BALANCE NAME(S) ON ACCOUNT TRADE CREDITORS / OTHER CREDIT REFERENCES NAME CONTACT PERSON PHONE BUSINESS OBLIGATIONS INSTITUTION NAME COLLATERAL CREDIT LIMIT/HIGH CREDIT CURRENT BALANCE MONTHLY PAYMENT APPLICANT S REQUEST Applicant may apply for credit in Applicant s name alone, regardless of Applicant s marital status. This application is for a loan in: Applicant s name alone SIGNATURE / DATE By signing below, I agree to each of the following: to the best of my knowledge and belief, all answers to the questions in this loan information request and all information in the financial statements and other supporting documents in this loan information request are complete and true. I understand the Bank may take steps necessary to verify the accuracy of the information provided in this loan information request. Applicant s name along with whose separate personal financial statement is attached I understand the Bank is authorized to check my credit rating and credit history; and that all information provided will be kept confidential by the Bank and will be used only for the purpose of evaluating the creditworthiness of this loan request. Authorized Signature Date Authorized Signature Date Printed name and title Social Security Number Printed name and title Social Security Number Authorized Signature Date Authorized Signature Date Printed name and title Social Security Number Printed name and title Social Security Number Business Loan Information Request Page 3 of 7 rev. 06-2013
BUSINESS INFORMATION REQUIREMENTS During the application process you may be required to provide the following information and documentation: Requested Financial Information may include, but not be limited to: 1) [2] years of signed tax returns and business financial statements, inclusive of property operating statements 2) [2] years of signed personal tax returns and financial statements, inclusive of statements verifying liquidity, and real estate schedule 3) Interim property operating statement 4) Current property rent roll 5) Verification of property insurance 6) Copy of property tax bill Entity Formation Documents may include: For Corporations: Articles of Incorporation and all amendments Statement of Information and all amendments Bylaws and a listing of current corporate officers Fictitious Name Statement if applicable Evidence of Good Standing For Limited Liability Companies Operating Agreement and all amendments LLC-1 and all amendments Fictitious Name Statement if applicable Evidence of Good Standing List of current managers and members For Partnerships Partnership Agreement and all amendments GP-1, LP-1, LLP-1 (as applicable) and all amendments Evidence of Good Standing Fictitious Name Statement if applicable Listing of current general partners and limited partners (if applicable) Project Specific Information may include: Copy of the signed Energy Audit Copy of construction contract including schedule and description of proposed improvements Evidence of construction insurance and/or workers compensation insurance (if applicable) Evidence of permits or other regulatory approvals (if applicable) Copies of MEA energy bills IMPORTANT INFORMATION ABOUT YOUR OBR LOAN You are applying for a loan with River City Bank to finance certain energy efficiency improvements using the MCE On-Bill Loan Program to facilitate the payments of your On-Bill Repayment Loan (the OBR Loan ). This On-Bill Repayment Certification and Consent Form will be included in your executed loan documents with River City Bank. Business Loan Information Request Page 4 of 7 rev. 06-2013
Please read this information carefully as it contains important information regarding the OBR Loan. NOTICE: 1) Monthly installment payments to your OBR Loan will be included as a separate line item on your monthly MCE Billing Statement; 2) While billed together, the OBR Loan is a separate obligation from your agreement and obligations with PG&E and MCE. 3) Failure to pay your monthly MCE Billing Statement in full each month, which includes PG&E and MCE energy amounts due and the OBR Loan payment due, can result in a short or delinquent payment to your OBR Loan. 4) If you become delinquent on any portion of an OBR Loan or the energy portion of your bill, all future payments will be applied on a pro-rated basis between the OBR Loan and the MCE portion of the billing statement. For example, if the MCE energy portion of your bill is $50.00 and the OBR Loan payment is $100.00 and you pay only $100.00, then $33.00 will be applied to the MCE energy portion and $67.00 will be applied to your OBR Loan. Short payment may result in penalty rates and constitute default under your OBR Loan agreement. 5) River City Bank may bill you separately for any delinquent or late charges due; these amounts are due and payable even if they are not included on the MCE Billing Statement. 6) If you are not delinquent and choose to repay your OBR Loan in full before the anticipated final installment, this payment must be made directly to River City Bank. 7) Your OBR Loan will be immediately due in payable in full if any of the following conditions occur: 1) You sell the property to which the improvements are made, 2) You no longer an MCE account holder, 3) The information provided in obtaining the OBR Loan was fraudulent and/or 4) You default under any term or condition of your OBR Loan. 8) The purpose of the OBR Loan is to fund energy efficient improvements as provided on a project summary energy audit (the Energy Audit ); you will be required to notify River City Bank immediately upon the discovery of any condition during installation or construction that would alter or increase the costs provided in the Energy Audit. BY SIGNING THIS LOAN INFORMATION REQUEST YOU HEREBY ACKNOWLEDGE AND AGREE: 1) I HAVE READ AND UNDERSTOOD THE INFORMATION IN THIS DOCUMENT; 2) I HEREBY AUTHORIZE PG&E AND MCE AND ITS AFFILIATES TO SHARE MY INFORMATION WITH RIVER CITY BANK 3) I HEREBY AUTHORIZE RIVER CITY BANK TO SHARE MY INFORMATION WITH PG&E, MCE AND ITS AFFILIATES 4) I UNDERSTAND THAT IF MY ENERGY PAYMENTS ARE DELINQUENT, THAT A DELINQUENCY COULD OCCUR UNDER OBLIGATIONS TO MCE AND RIVER CITY BANK I UNDERSTAND THAT I MUST NOTIFY RIVER CITY BANK OF ANY INCREASED COSTS ASSOCIATED WITH THE SCOPE OF THE WORK APPROVED BY RIVER CITY BANK. RIVER CITY BANK IS UNDER NO OBLIGATION TO FUND THE OBR LOAN IF THE INCREASED COSTS ARE NOT COVERED BY SOURCES OUTSIDE OF THE OBR LOAN. Business Loan Information Request Page 5 of 7 rev. 06-2013
PLEASE RETAIN THIS PAGE FOR YOUR PERSONAL RECORDS If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact River City Bank /Attn: Loan Center, 2485 Natomas Park Drive Suite 100, Sacramento, CA 95833 (916) 567-7200 within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal agency that administers compliance with this law concerning this creditor is: FDIC Consumer Response Center 1100 Walnut Street, Box #11, Kansas City, MO 64106 Telephone (877) 275-3342 Internet www.fdic.gov/consumers/consumer/ccc CUSTOMER IDENTIFICATION NOTICE IMPORTANT INFORMATION ABOUT PROCEDURES FOR A LOAN To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions obtain, verify, and record information which identifies each individual opening an account. What this means for you: when you apply for a loan, we will ask you to provide your full name (including middle initial), address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver s license or other identifying documents. By executing this form you acknowledge you are required to provide documentation acceptable to River City Bank to enable us to verify your identity, comply with the provisions of the Bank Secrecy Act, as amended by the USA Patriot Act, and complete the processing of your loan application and agree to provide the identifying documents requested. Business Loan Information Request Page 6 of 7 rev. 06-2013
HMDA DISCLOSURE REQUEST FORM THIS FORM IS ONLY APPLICABLE TO LOAN REQUESTS RELATING TO MULTI-FAMILY PROPERTIES (NOT COMMERCIAL PROPERTIES) Thank you for applying to River City Bank for credit. We greatly appreciate your expressed interest in River City Bank as the provider for your financing needs. The following information is requested by the federal government for certain types of loans related to a dwelling in order to monitor the lender s compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. You may select one or more designations for Race. The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this application in person, under federal regulations the lender is required to note ethnicity, race, and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check that box below. APPLICANT: I do not wish to furnish this information. ETHNICITY: Hispanic or Latino Not Hispanic or Latino RACE: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White SEX: Female Male CO-APPLICANT: I do not wish to furnish this information. ETHNICITY: Hispanic or Latino Not Hispanic or Latino RACE: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White SEX: Female Male I (we) acknowledge receipt of the request for information and have reviewed the above statement. I (we) understand that the requested information is optional and in no way required. Further, it is understood my (our) choice to provide or not provide the information will not impact the credit decision in any way. Name (Print): APPLICANT Signature: Date: Name (Print): CO-APPLICANT Signature: Date: Information Provided By: To Be Completed by Loan Originator In a Face-to Face Interview In a Telephone Interview By the Applicant and Submitted by Fax/Mail By the Applicant and Submitted Electronically Loan Originator: Direct Line: Signature/Date: Business Loan Information Request Page 7 of 7 rev. 06-2013