HomeMy WebLinkAbout2023-063AJOBS GRANT AGREEMENT BETWEEN INDIAN RIVER COUNTY
AND
MAROTECH USA, INC.
THIS INDIAN RIVER COUNTY JOBS GRANT AGREEMENT ("Agreement") is made as
of the 4a' day of April, 2023 (the "Effective Date") by and between Indian River County, a political
subdivision of the State of Florida, by and through its Board of Commissioners, hereinafter referred to
as COUNTY, and Marotech USA, Inc, a company authorized to do business in the State of Florida,
hereinafter referred to as COMPANY.
BACKGROUND RECITALS:
WHEREAS, it is the policy of COUNTY to stimulate economic growth in COUNTY by either
attracting new businesses to COUNTY or by encouraging the expansion of existing businesses within
COUNTY; and
WHEREAS, the creation of new employment opportunities for residents of COUNTY and the
increased tax revenues resulting from such business expansions or relocations within COUNTY is
beneficial to the local economy; and
WHEREAS, COUNTY has determined that offering a Jobs Grant Program encourages
businesses to expand within or new businesses to locate in COUNTY and thereby creates new
employment opportunities for the residents of COUNTY; and
WHEREAS, COUNTY, through its Board of County Commissioners, has created a Local Jobs
Grant Program; and
WHEREAS, COMPANY, in accordance with the COUNTY's Local Jobs Grant Program
criteria, is an Existing Business that will expand its business in COUNTY to create 10 additional full-
time jobs which pay at least 75% of COUNTY's average annual wage level; and
WHEREAS, COUNTY has determined that COMPANY is eligible to receive a Local Jobs
Grant; and
WHEREAS, COMPANY acknowledges that this Agreement shall be based upon compliance
with COUNTY Local Jobs Grant Program requirements; and,
WHEREAS, COUNTY finds and declares that it is in the public interest to award a Local Jobs
Grant to COMPANY pursuant to the terms of this Agreement.
NOW, THEREFORE, in consideration of the premises and mutual covenants hereinafter
contained, the parties do agree as follows:
1. Definitions. As used in this Agreement, the following terms shall mean:
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a. "Adjacent Counties" means Brevard, Osceola, St. Lucie, Okeechobee, and Martin
Counties.
b. "Annual Wage" - includes salary, bonuses, and commissions.
c. "Default" - failure to comply with the terms of this Agreement.
d. "Expanding Business" — shall be defined as a business expanding its operation
over and above its base employment amount at the time of jobs grant approval
by 5 or more new jobs to employ 5 or more new full-time employees in the
COUNTY within the term of the Grant.
e. "Full-time Equivalent Job" - shall be defined as a position that is scheduled for
at least 35 hours per week.
f. "Indian River County Average Annual Wage" — shall be defined as the average
annual wage per job in COUNTY as determined by Florida Agency for
Workforce Innovation, Labor Market Statistics Center, Quarterly Census of
Employment and Wages Program, in cooperation with the U.S. Department of
Labor, Bureau of Labor Statistics. Currently, the COUNTY's average annual
wage is $50,454 (effective January 11 2023 for the state QTI Tax Refund
Program). This dollar value shall be used for the duration of this Agreement for
determining local jobs grant incentives.
g. "New Business" —shall be defined as a business establishing 5 or more new jobs
to employ 5 or more new full-time employees in the COUNTY within the term
of the Grant (as such term is hereinafter defined), provided that such business
first begins operations on a site in the COUNTY clearly separate from any other
operation owned by the same business.
h. Commencement Date" — the date that the COUNTY begins tracking qualifying
jobs for potential local jobs grant payments. Such date shall start on one of the
following dates: January 1 St, April 11, July 1 St, or October 1 St of a year agreed to
by COUNTY as established within this Agreement or as otherwise modified in
accordance with this Agreement.
i. "Qualifying job" — a full-time equivalent job having an annual wage equal to or
greater than 75% of Indian River County's Average Annual Wage. Such jobs
must be filled by people who live in COUNTY or Adjacent Counties.
j. "Quarterly Reemployment Compensation Report (RT -6 form)" — Form from the
Florida Department of Revenue that businesses in the state of Florida must
complete and submit to the state on a quarterly basis. Information collected on
the form includes the names of employees, their social security numbers, and the
gross wages paid to each employee on a quarterly basis. The information is used
for reemployment compensation should employees cease to be employed. For
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purposes of this Agreement, this definition shall also include other similar
COUNTY approved certified forms from COMPANY or COMPANY's
professional employer organization.
k. "Relocation of a business" — a business relocating to COUNTY and employing
5 or more full-time employees in the COUNTY.
1. "Target Industry" — An industry identified within the Target Industry List of the
Economic Development Element of COUNTY's Comprehensive Plan (Policy
2.5 of the Economic Development Element).
2. Term; Termination. This Agreement shall be effective as of the date of this
Agreement stated on page 1 and shall automatically terminate after one of the
following has occurred (whichever occurs first), unless terminated earlier by
COUNTY because of a Default by COMPANY:
a. COUNTY has made the last payment to COMPANY;
b. COMPANY did not employ a minimum of 5 new Qualifying Jobs by the
Commencement Date, as may be modified; or
c. COMPANY failed, for a period of 3 consecutive years (12 quarters), to provide
required Quarterly Reemployment Compensation Reports (RT -6 form) to
COUNTY.
3. Grant Eligibility; Payment Schedule:
a. COMPANY will be eligible for total Jobs Grant Funding (hereinafter a "Grant")
in an amount of up to $35,200 if the COMPANY relocates within the Indian
River County / Vero Beach Enterprise Zone. COMPANY acknowledges and
agrees that the initial Grant under this Agreement is payable on a re-
imbursement basis. The number of jobs estimated to be provided is listed below.
Jobs grant payments are dependent upon the number of employees exceeding
the company's employment level at the time that this Agreement is approved by
the Indian River County Board of County Commissioners, and by the criteria
set forth below.
(i) For Phase I, 7 new qualifying jobs meeting the wage level in Section 5
of this Agreement shall be provided by the commencement date 1/01/24.
For each of the three successive annual periods that those jobs are
maintained at the required wage level, COMPANY shall receive the Grant
amount for those 7 jobs.
(ii) For Phase II, 3 new qualifying jobs meeting the wage level in Section 5
of this agreement shall be provided by the commencement date 04/01/25.
For each of the three successive annual periods that those jobs are
maintained at the required wage level, COMPANY shall receive the Grant
amount for those 3 jobs.
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(iii) It is understood that the quantity of jobs proposed above, their annual
wages, and dates of hire are estimates. Because of that, the quantity of jobs
provided may be less than 10, and the Commencement Date (for Grant
tracking) may be extended. Proposed jobs will remain eligible for Grant
incentives provided:
a. The minimum number of qualifying jobs provided in Phase I is
5.
b. The maximum number of jobs eligible for local jobs grant funds
for Phases I, and II is 10.
c. The maximum extension for a phase commencement date shall
be one year. Such commencement date extension may be
approved administratively by the County Community
Development Director or his designee provided the extension
date meets the requirements of Section 3 of this agreement. If
any of the 10 eligible jobs proposed for Phases I, and II are
created after the Phase II commencement date or, if applicable,
after an administratively approved extension to the Phase II
commencement date, those jobs shall not be eligible for local
jobs grant funds.
In no case shall the total Grant exceed $35,200.
(iv) Failure of COMPANY to maintain claimed jobs for at least 3 years at
required wage levels will result in the reduction of the Grant amount paid
to COMPANY, as set forth herein. If, by the end of any of the annual
periods, COMPANY has not maintained the total number of claimed jobs
required or if COMPANY has provided the total jobs required, but the
annual wage for any of those jobs is less than required for that year, the
Community Development Department Director, or his designee, will lower
the jobs grant award for the respective year by the amount allocated in such
year for each job for which the requirements of this agreement are not met.
Thus, the total jobs grant award could be less than $35,200 by the end of
this Agreement.
(v) If COMPANY changes the products or services it provides in such a
way that would make COMPANY no longer qualify as a "Target Industry"
or if COMPANY relocates outside of Indian River County, COMPANY
shall be in Default of this Agreement. COMPANY shall reimburse
COUNTY for payments made to COMPANY while COMPANY was not a
"Target Industry or while COMPANY was not located within Indian River
County."
(vi) During the Term of this Agreement, COMPANY shall have a majority
(greater than 50%) of its goods and services, attributable to the Indian River
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County location, sold or distributed outside of Indian River County.
COMPANY shall reimburse COUNTY for payments made to COMPANY
while COMPANY did not meet this requirement.
b. Performance Evaluation for Payment. Prior to the submittal of COMPANY's
1St Quarterly Reemployment Compensation Report COMPANY shall provide
to the COUNTY Community Development Director, or his designee, an
employee census and a copy of the Quarterly Reemployment Compensation
Report for the Effective Date of this Agreement. That employee census must
list employee name, job title, city and state in which the employee lives, annual
salary, location where employee works, and date of hire.
COMPANY's performance evaluation will be conducted on an annual basis
using the information provided on the Quarterly Reemployment Compensation
Report (RT -6 form) and COMPANY's quarterly updates to its employee
census. Each updated employee census must include the information referenced
above plus the date of termination for each employee (if the employee
terminates employment with the COMPANY). COMPANY shall supply
additional documentation to the Community Development Director, or his
designee, in a form acceptable to the Community Development Director, or his
designee, showing that positions for which Grant funds will be awarded are
filled by people who live in COUNTY or Adjacent Counties.
The Grant eligibility determinations will cover one-year periods, with each
yearly period beginning and ending as follows:
Phase Grant Eligibility Determinations
1st 2°d
3rd (final)
Begin End Begin End
Begin End
1 1/01/2025 12/31 /2025 1/01/2026 12//31 /2026
1/01/2027 12/31 /2027
11 1/01/2026 12/31 /2026 1/01/2027 12/31 /2027
1/01/2028 12/31 /2028
(i) Each job must meet the minimum wage requirements specified in this
Agreement. Payment of Grant funds shall be made based on the County's
current adopted payment calculation methodology (methodology approved
by the BCC on 10-24-2017) within forty-five (45) days after the date
COMPANY submits the latest Quarterly Reemployment Compensation
Report comprising the Annual Job Status Report (as defined in Paragraph
6), and this payment obligation shall survive the termination of this
Agreement. Notwithstanding the foregoing, should the date for filing the
last Quarterly Reemployment Compensation Report, as described above,
not coincide with the date that an eligibility determination is made,
COMPANY shall have the right to file a Quarterly Reemployment
Compensation Report, in a form substantially similar to a Quarterly
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Reemployment Compensation Report, and such Quarterly Reemployment
Compensation Report shall constitute the Annual Job Status Report, the
filing of which shall begin the running of the forty-five (45) -day period
within which payment shall be made.
If COMPANY applies for a Qualified Target Industry (QTI) Tax Refund
from the State of Florida and if COMPANY has that QTI Tax Refund
approved by the State, the Community Development Director or his
designee will reduce the Grant amount paid directly to COMPANY for each
eligibility determination in an amount sufficient to cover COUNTY's QTI
Tax Refund 20% contribution obligation to the State for COMPANY's QTI
Tax Refund agreement. The Community Development Director or his
designee will submit the 20% payment obligation to the State for placement
in the Florida Economic Development Trust Fund.
(ii) If at the time of performance evaluation for payment as described in
subsection 3.b COMPANY is not current on COUNTY Real Estate and
Tangible Personal Property Taxes, COUNTY shall withhold Grant
payments for that eligibility determination time period and COMPANY
shall automatically forfeit its right to collect Grant payments for that
eligibility time period. COMPANY shall remain eligible for any remaining
future Grant payments for future eligibility time periods provided
COMPANY is current on such taxes referenced above at the time of future
Grant eligibility determination time periods.
4. Job Creation Commitment. COMPANY estimates that it will provide 10 new
Qualifying Jobs within COUNTY as set forth in Exhibit `B", which is attached
hereto and made a part hereof. The exact number of jobs actually supplied and their
salaries, however, may vary. Grant funds will be awarded up to a maximum of
$35,200. The Grant award will be based on the following:
Category*
Amount Per Job
75% to 99.99% of Indian River County
$3,000
Average Annual Wage
100% to 149.99% of Indian River County
$5,000
Average Annual Wage
150% of Indian River County Average
$7,000
Annual Wage (or greater)
*One average annual wage category will be utilized consistent with Exhibit "D" and the
County's current adopted payment calculation methodology.
5. Wage Level Commitment. COMPANY estimates that it will pay 9 employees
whose jobs are eligible for a Grant hereunder an annual wage of not less than
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$37,840.50, will pay 1 employee an annual wage of not less than $50,454, and will
pay 0 employees an annual wage of not less than $75,681.00. The annual wage of
the positions will be determined without taking into account the value of any
benefits. COMPANY shall, in accordance with the provisions of paragraph 6
below, provide written verification of such wages satisfactory to the Community
Development Director or his designee.
6. Annual Job Status. COMPANY must provide the Community Development
Director or his designee with Quarterly Reemployment Compensation Reports
(Form RT -6) of its business operations within COUNTY on State form RT -6, as
amended, a sample of which is attached hereto and made a part hereof as Exhibit
"C". COMPANY must also provide the Community Development Director or his
designee with quarterly updates to its employee census for employees working at
its Indian River County location(s) (see section 3.b. of this Agreement). The
cumulative Quarterly Reemployment Compensation Reports required to be filed
for the annual period, correlated with each eligibility determination and the
corresponding quarterly employee census shall collectively comprise the Annual
Job Status Report. Quarterly, COMPANY must also provide the Community
Development Director or his designee a signed statement indicating the percent of
its total sales/services from the Indian River County location provided outside of
Indian River County for the jobs grant payment time period.
Starting with calendar quarter 1 in 2024, quarterly reports must be submitted for
Grant eligibility determination. Those quarterly reports must be submitted no later
than 60 days after the end of each quarter, until the termination of this Agreement.
Submittal deadline may be waived by the Community Development Director, for
good cause.
7. Default; Termination. Except as set forth herein, in the event that COMPANY
defaults in the performance of its guarantees and commitments as provided for in
this Agreement, COUNTY may, at its option, terminate this Agreement.
8. Indemnification. COMPANY shall indemnify and hold harmless and defend
COUNTY, its agents, servants, and employees from and against any and all claims,
liabilities, losses, and/or causes of action which may arise from any negligent act
or omission of COMPANY, its agents, servants, or employees in the performance
of services under this Agreement.
9. Forum; Venue. This Agreement shall be governed by the laws of the State of
Florida. Any and all legal action necessary to enforce the Agreement will be held
in Indian River County or the Federal District Court for the Southern District of
Florida. No remedy herein conferred upon any party is intended to be exclusive of
any other remedy, and each and every such remedy shall be cumulative and shall
be in addition to every other remedy given hereunder or now or hereafter existing
by law or in equity or by statute or otherwise. No single or partial exercise by any
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party of any right, power, or remedy hereunder shall preclude any other or further
exercise thereof. Parties hereby waive their right for a jury trial.
10. Lobbyist Certification. COMPANY warrants that it has not employed or retained
any company or person, other than a bona fide employee working solely for
COMPANY, to solicit or secure this Agreement and that it has not paid or agreed
to pay any person, company, corporation, individual, or firm, other than a bona fide
employee working solely for COMPANY, any fee, commission, percentage, gift,
or any other consideration contingent upon or resulting from the award or making
of this Agreement.
11. No Discrimination Certification. COMPANY warrants and represents that all of its
employees are treated equally during employment without regard to race, color,
religion, disability, sex, age, national origin, ancestry, marital status, or sexual
orientation.
12. Attorney's Fees. If any legal action or other proceeding is brought for the
enforcement of this Agreement, or because of an alleged dispute, breach, default or
misrepresentation in connection with any provisions of this Agreement, each party
shall bear its own costs.
13. Enforceability. If any term or provision of this Agreement, or the application
thereof to any person or circumstances, shall to any extent be held invalid or
unenforceable, the remainder of this Agreement, or the application of such terms or
provision, to persons or circumstances other than those as to which it is held invalid
or unenforceable, shall not be affected, and every other term and provision of this
Agreement shall be deemed valid and enforceable to the extent permitted by law.
The COMPANY's failure to maintain its job creation commitment or annual wage
level commitment for any one year will result in the decrease of the Grant amount
it was scheduled to receive for that year; however, such decrease will not preclude
the COMPANY's receipt of scheduled Grant amounts for those subsequent years
in which it is able to maintain its job creation and wage level commitment.
14. Assignment. ent. COMPANY shall not, directly or indirectly, assign or transfer any
of its rights or obligations under this Agreement, or any interest therein (the
foregoing herein collectively "Transfer'), without the express prior written consent
of the Community Development Director. The Community Development Director
shall not unreasonably withhold its consent to any Transfer. Any such attempted
Transfer without the express prior written Community Development Director
consent shall be null and void and may, at the option of the County Community
Development Director, be deemed a Default under this Agreement. COMPANY
acknowledges and agrees that the Community Development Director has the right,
in granting or withholding consent to any Transfer, to consider, among other things,
the financial responsibility and business reputation of the proposed assignee or
transferee (the foregoing herein collectively "Transferee"); and any other items that
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the COUNTY Community Development Director, in his sole discretion, deems
appropriate.
If COMPANY seeks the Community Development Director's consent for a
Transfer, COMPANY shall submit to the Community Development Director a
written request therefore, accompanied by the following documentation: (i) the
name, address, and telephone number of the proposed Transferee; (ii) a description
of the business and jobs, including wages, to be created in COUNTY; and (iii) a
financial statement or other reasonably detailed financial information concerning
the proposed Transferee. If the Community Development Director withholds the
consent to Transfer, COMPANY may appeal to the County Administrator. If the
County Administrator withholds the consent to Transfer, COMPANY may appeal
to the Board of County Commissioners. COMPANY acknowledges and agrees
that: (a) the County Administrator or his designee, or the Indian River County
Board of County Commissioners, has the right to request any additional
information deemed necessary to make the decision relating to consent to the
Transfer; and (b) if appealed to the Board of County Commissioners such request
for a Transfer is expressly subject to the approval of the Transfer by the Board of
County Commissioners, and such Transfer shall become effective only when
signed by the Transferee and approved by the Board, which consent shall not be
unreasonably withheld.
The foregoing covenant shall be binding on the permitted successors or assigns of
COMPANY. The prohibition on Transfers shall not prohibit a change in the form
in which COMPANY conducts business. COMPANY will be released from further
liability under this Agreement in the event of an approved Transfer; provided that
the COUNTY's consent to any Transfer will not otherwise relieve COMPANY
from any pre-existing obligation to COUNTY under this Agreement.
15. Conflict of Interest. COMPANY represents that it presently has no interest and
shall acquire no interest, either direct or indirect, which would conflict in any
manner with the performance of services required hereunder, as provided for in
Florida Statutes Part III, Chapter 112. COMPANY further represents that no
person having any interest shall be employed for said performance.
16. Notices. All notices required in this Agreement shall be sent by certified mail,
return receipt requested and if sent to COUNTY shall be mailed to:
Community Development Director
Indian River County
1801 27h Street
Vero Beach, Florida 32960
and if sent to COMPANY shall be mailed to (or current, official address):
5265 450' Street Suite 17
Vero Beach, FL 32967
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17. Entire Agreement. COUNTY and COMPANY agree that this Agreement sets forth
the entire Agreement between the parties, and that there are no promises or
understandings other than those stated herein. None of the provisions, terms and
conditions contained in this Agreement may be added to, modified, superseded or
otherwise altered, except by written instrument executed by the parties hereto.
18. No Pledge of Credit. COMPANY shall not pledge COUNTY's credit or make it a
guarantor of payment or surety for any contract, debt, obligation, judgment, lien, or
any form of indebtedness.
19. Public Records. COMPANY shall comply with the provisions of Chapter 119,
Florida Statutes (Public Records Law) in connection with this Agreement, as
modified by exemptions in Chapter 288, Florida Statutes.
20. Counterparts. This Agreement may be executed in one or more counterparts, each
of which shall be deemed to be an original copy and all of which shall constitute
but one and the same instrument.
21. General. The Background Recitals are true and correct and form a material part of
this Agreement.
22. TERMINATION IN REGARDS TO F.S. 287.135: COMPANY certifies that it and
those related entities of COMPANY as defined by Florida law are not on the
Scrutinized Companies that Boycott Israel List, created pursuant to s. 215.4725 of
the Florida Statutes, and are not engaged in a boycott of Israel. In addition, if this
agreement is for goods or services of one million dollars or more, COMPANY
certifies that it and those related entities of COMPANY as defined by Florida law
are not on the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, created pursuant to Section 215.473 of the Florida Statutes and are not
engaged in business operations in Cuba or Syria.
OWNER may terminate this Contract if COMPANY is found to have submitted a
false certification as provided under section 287.135(5), Florida Statutes, been
placed on the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, or been engaged in business operations in Cuba or Syria, as defined by
section 287.135, Florida Statutes.
OWNER may terminate this Contract if COMPANY, including all wholly owned
subsidiaries, majority-owned subsidiaries, and parent companies that exist for the
purpose of making profit, is found to have been placed on the Scrutinized
Companies that Boycott Israel List or is engaged in a boycott of Israel as set forth
in section 215.4725, Florida Statutes.
23. Contractor is registered with and will use the Department of Homeland Security's
E -Verify system (www.e-verify.gov) to confirm the employment eligibility of all
newly hired employees for the duration of this agreement, as required by Section
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448.095, F.S. Contractor is also responsible for obtaining proof of E -Verify
registration and utilization for all subcontractors.
IN WITNESS WHEREOF, the Board of County Commissioners of Indian River County,
Florida has made and executed this Agreement on behalf of COLTNTY and COMPANY has
hereunto set its hand the day and year above written.
• Oti1M1SS/
BOARD OF COUNTY COMMISSIONEIZ,St,��!.G
OF INDIA RIVER OUNTY
BY: ° �a
ae
Josep H. EaMaArehairman
••/',/SER COON
ATTE BY: Jeffre R. Smith, Clerk of Court and Comptroller
By:
Deputy Clerk
APPROVED:
Michael Zit , terim County Administrator
APPROVED AS TO FO D LEGAL SUFFICIENCY
Dylan Reingold, County Attorney
COMPA
BY: Title:
Typed Name
WITNESS:
Title:jq
Signature
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EXHIBIT "A" TO THE JOBS GRANT AGREEMENT
BETWEEN INDIAN RIVER COUNTY & MAROTECH USA, INC.
COMPANY Identification and Information:
Application received date: February 21, 2023.
COMPANY description:
MAROTECH USA, INC. is an existing manufacturer locating to the County that
manufactures, markets, and sells Hot Melt Coated Tapes in the packaging industry.
COMPANY'S current mailing address:
100. Rue de Naples.
Saint-Augustin-de-Desmaures Quebec, G3A2Y2
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EXHIBIT "B" TO THE JOBS GRANT AGREEMENT
BETWEEN INDIAN RIVER COUNTY & MAROTECH USA, INC
I. Target Industry Categories eligible for application:
COMPANY qualifies for the Jobs Grant Program under the
"Manufacturing/Warehouse/Distribution" category. Under the North American Industrial
Classification System (NAICS), COMPANY's activities are classified in the category of
"Plastics Material and Resin Manufacturing", NAICS Code #325211.
II. Employment Commitment:
The COMPANY is receiving this Grant based upon its representation that it will bring the
following employment opportunities to COUNTY:
1) 9 # of new, full-time employees whose annual wages are between 75% and
99.9% of Indian River County's average annual wage.
2)—L— # of new, full-time employees whose annual wages are between 100% and
149.99% of Indian River County's average annual wage
3) 0 # of new, full-time employees whose annual wages are 150% or greater of
Indian River County's average annual wage
III. Maximum Potential Grant Amount
Category
Qualified Jobs
Amount per Job
Total
75% of county average wage
y
$3,000
$27,000
100% of county average wage
1
$5,000
$5,000
150% of county average wage
1
$7,000
$0
10% additional grant located within
Indian River County / Vero Beach
Enterprise Zone
$3,200.00
Sub -Total Grant Amount
$3,200
*The actual amount of the grant will depend upon the actual number of jobs provided and the salary paid for those
jobs. In no case shall the total amount of the grant exceed $35,200. As noted in the agreement, incremental payments
will be made for qualified jobs based upon phase dates and actual company performance in meeting local jobs grant
requirements.
F:\Community Development\Economic DevelopmentVNCENTIVES & FUNDINGVOBS GRANT PROGRAMWCTIVE JOBS GRANTS\Marotech USA
Inc\Proposed Jobs Grant Agreement - Marotech, Inc.docx
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City..+St21P pay tax due in installments. funds electronically.
1
Mail Reply To:
Reemployment Tax
Florida Department of Revenue
5050 W Tennessee St Bldg L
Tallahassee FL 32399-0180
Social security numbers (SSNs) are used by the Florida Department of Revenue as unique
identifiers for the administration of Florida's taxes. SSNs obtained for tax administration
purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not
subject to disclosure as public records. Collection of your SSN is authorized under state
and federal law. Visit our website at www.Wloridacom/dor and select 'Privacy Notice'
for more information regarding the state and federal law governing the collection, use, or
release of SSNs, including authorized exceptions.
Please save your instructions!
Quarterly Report instructions (RT-6N/RTSI are only mailed
with new accounts or when there are changes. If you misplace
your instructions, you can download them from
www.myflorida.com/dor
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Florida Department aRevenue Employer's QuarterlyReport
RT-6 L Employers
quarterly ge regardlessaen whether any due. R. 01/15
Use Black Ink to Complete
This Farm
QUARTER ENDING
EMPLOYERS NAME
RT ACCOUNT NUMBER
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10. EMPLOYEE'SSOCWLSECURnYNUMBER
11. EMPLOYEFSNAME(pleaseponirsttwelvecherwersoflestnamesM6rst
eipls tlwactets of &V nen■ m boxes)
12a. EMPLOYEES GROSS WAGES PAID TFNSQUARTER
12b. EMPLOYEES TAXABLE WAGES PAID THS QUARTER
------- ----------
on* the lfrs $7.000 padto eerb enpbyee P■ Weller YMr IS UX".
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73a. Total Gross Wages (add Lines 120 only). Total this p �Y•
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and additional pages page
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13b. Total Taxable Wages (add Lines 12b only). Total this page only.
Include this and totals from additional pages in Line 4 an page 1.
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DO NOT
Mail Reply To:
Reemployment Tax
Florida Department of Revenue
5050 W Tennessee St Bldg L
Tallahassee FL 32399-0180
Social security numbers (SSNs) are used by the Florida Department of Revenue as unique
identifiers for the administration of Florida's taxes. SSNs obtained for tax administration
purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not
subject to disclosure as public records. Collection of your SSN is authorized under state
and federal law. Visit our website at www.Wloridacom/dor and select 'Privacy Notice'
for more information regarding the state and federal law governing the collection, use, or
release of SSNs, including authorized exceptions.
Please save your instructions!
Quarterly Report instructions (RT-6N/RTSI are only mailed
with new accounts or when there are changes. If you misplace
your instructions, you can download them from
www.myflorida.com/dor