MRRA Business Information Form

You may complete the application below, or you may download this PDF version to print and complete, then send in by mail or drop it off at MRRA’s offices at 15 Terminal Road, Brunswick, ME.

General Information

Company Name

Primary Contact and Title

Company Address

Phone

Fax

Email (required)

Website

Company has been in business since

If applicable, please provide the name and state (or country) of your parent company

Major markets and customers

Business products and/or services

Are your services sold...
Wholesale? yesno
Retail? yesno

Is this a manufacturaing operation? yesno

Does the company participate in international trade? yesno
If so, how?

Facility Information

What size facility is your company interested in?
square feet or square meters

Does your company need high clear-span ceilings? yesno
High door heights? yesno
Loading docks? yesno

Does your company have high water/sewer needs? If so please describe.

Does your company have any special electrical needs such as three phase? If so please describe.

Does your company have any special broadband needs? If so please describe.

Does your company have future expansion plans? yesno
If so, please describe your space needs and timeframe of expansion(s)

Please describe any other special facility needs your company may have

Financial Information

What is the anticipated dollar investment and timeframe related to the company’s immediate plans?
Building: $
Estimated move-in date:
Machinery & Equipment: $
Estimated date to be placed in service:

Does the company need or want financial assistance? yesno
If yes, how much financing is desired and what will the funds be used for? Please provide as much detail as possible. Attach a file if necessary.

Please attach a PDF, 1.5MB or smaller

Do you have clearly delineated product research and development activities? yesno

Employment Information

Does your company have any specific employment training needs? If so, please attach a description of the types of training you anticipate needing for both new and existing employees, including the anticipated cost for the training, if possible. If a proposed training plan has been developed, please attach a copy.

Please attach a PDF, 1.5MB or smaller

Does the company offer health insurance to employees? yesno
If so, does the company pay 50% or more of the premium cost for this insurance? yesno

Does the company provide an ERISA-qualified retirement plan to employees? yesno

What is your current number of employees?
Full-time:

Part-time:

Will your company be adding new positions over the next two (2) years? yesno
If so, please indicate the number of positions to be created for each of the next two years. Also, please provide anticipated job titles and wages for all net new, full-time jobs. Attach a file if necessary.

Please attach a PDF, 1.5MB or smaller
Year 1 Full-time: Part-time:
Full-time job title(s), with anticipated wages


Year 2 Full-time: Part-time:
Full-time job title(s), with anticipated wages

Environmental Information

To help determine if the Department of Environmental Protection needs to assist your company, please review the following.

Will any hazardous wastes be generated, stored or treated at this location?yesno

Does your process involve the use of coatings or solvents (e.g. printing,
painting, refinishing, cleaning)?yesno