Template for CHIPS Incentive Request |
|
|
|
|
|
|
Full Application stage |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
A) CHIPS Incentive Request Summary |
|
|
|
|
|
|
|
|
|
|
|
|
|
A1. CHIPS Direct Funding Request |
|
|
|
|
|
|
|
|
|
|
|
|
|
Funding Request |
|
|
|
|
|
|
Are you requesting Direct Funding? |
Select One |
|
|
|
|
|
Amount requested for CHIPS Direct Funding |
0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
A2. CHIPS Loan Request |
|
|
|
|
|
|
|
|
|
|
|
|
|
Funding Request |
|
|
|
|
|
|
Are you requesting a CHIPS Loan? |
Select One |
|
|
|
|
|
Amount requested for the CHIPS Loan |
0.00 |
|
|
|
|
|
Requested tenor for the CHIPS Loan |
|
|
|
|
|
|
Financing Structure2 |
Select One |
|
|
|
|
|
|
|
|
|
|
|
|
Provide other requested terms (e.g., details on amortization schedule, deferred interest option, pre-payment, seniority, collateralization, fixed vs floating interest rate type) for the requested CHIPS Loan. To the extent that requested terms differ from the baseline terms in Section I.B.8 of the NOFO, the summary should include a justification. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
A3. CHIPS Loan Guarantee Request |
|
|
|
|
|
|
|
|
|
|
|
|
|
Funding Request |
|
|
|
|
|
|
Are you requesting for a CHIPS Loan Guarantee(s) |
Select One |
|
|
|
|
|
Number of Loans to be Guaranteed |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
Loan Guarantee Summary (Calculated) |
|
|
|
|
|
|
Third-party Loans Guaranteed by CHIPS Program |
0.00 |
|
|
|
|
|
Unguaranteed portion of Third-Party Loans Guaranteed by CHIPS Program |
0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
CHIPS Loan Guarantee Request Details |
Loan 1 |
Loan 2 |
Loan 3 |
Loan 4 |
Loan 5 |
|
Total size of the Loan |
0.00 |
0.00 |
0.00 |
0.00 |
0.00 |
|
Amount of Loan requested to be guaranteed through CHIPS program (up to 80%) |
0.00 |
0.00 |
0.00 |
0.00 |
0.00 |
|
Requested tenor for the Loan |
|
|
|
|
|
|
Third Party Lender, if known (please include all if multiple) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Provide other requested terms (e.g., details on amortization schedule, deferred interest option, pre-payment, seniority, collateralization, fixed vs floating interest rate type) for the requested CHIPS Loan Guarantee(s). To the extent that requested terms differ from the baseline terms in Section I.B.8 of the NOFO, the summary should include a justification. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
B) Credit Rating Summary1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
Borrowing Entity and Corporate Parent Details |
Entity Name |
Entity Unique SAM.gov ID number (if available) |
Entity address (if available) |
Entity website (if available) |
|
|
Borrowing Entity for Project |
|
|
|
|
|
|
Corporate Parent / Sponsoring Entity (if applicable) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Credit Rating of Borrowing Entity |
Agency Providing Credit Rating |
Corporate Credit Rating |
Date of Rating |
|
|
|
Long-term Corporate Credit Rating 1 (if applicable) |
|
|
|
|
|
|
Long-term Corporate Credit Rating 2 (if applicable) |
|
|
|
|
|
|
Long-term Corporate Credit Rating 3 (if applicable) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Credit Rating of Corporate Parent / Sponsoring Entity (if applicable) |
Agency Providing Credit Rating |
Corporate Credit Rating |
Date of Rating |
|
|
|
Long-term Corporate Credit Rating 1 (if applicable) |
|
|
|
|
|
|
Long-term Corporate Credit Rating 2 (if applicable) |
|
|
|
|
|
|
Long-term Corporate Credit Rating 3 (if applicable) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Notes |
|
|
|
|
|
|
1: Provide the most recent credit rating for any agency which has provided a report for the borrowing entity and / or the corporate parent or sponsoring entity to the borrowing entity (if available) |
|
|
|
|
|
|
2: Corporate Finance implies debt is incurred at the parent of development company level, with debt secured at the development company level. Project Finance implies that debt is secured at the project company level to finance the project |
|
|
|
|
|