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<br />Minnesota Public Facilities Authority <br />2018 Special Appropriation <br />APPENDIX C <br />JOB REPORTING FORM TEMPLATE <br /> <br /> <br />Minnesota Statutes Section 16A.633, subdivision 4, requires reporting on jobs created or <br />retained as part of the project. An example of the job reporting template is below. A form <br />specific for your project will provided to you after grant award. Contact your loan officer with <br />any questions about the job reporting requirements. <br /> <br />MN Jobs Reporting spreadsheet for capital projects funded thru the MN Public Facilities Authority <br />part 1. PFA project info: <br />Recipient Proj id Award dt Award Amts <br />Heron Lake CW0723 11/10/16 1,492,453$ <br />part 2. jobs reporting fields for MMB's database (blue-shaded fields to be completed by recipients): <br />Project Name <br />(must be unique within <br /> MMB's database) <br />Project <br />Start <br />Date <br />Project <br />End <br />Date <br />Main County <br />for the Project Job Type <br />Hourly <br />Pay Range <br />Number of <br />Hours Paid <br />for Jobs: <br />Created <br />Number of <br />Hours Paid <br />for Jobs: <br />Retained <br />Heron Lake PFA CW0723 Jackson Engineering/Oth Less than $10.00 <br />Engineering/Oth $10.00 - 15.00 <br />Engineering/Oth $15.01 - 20.00 <br />Instructions:Engineering/Oth $20.01 - 25.00 <br />Engineering/Oth $25.01 - 30.00 <br />Engineering/Oth $30.01 - 35.00 <br />Engineering/Oth $35.01 - 40.00 <br />Engineering/Oth more than $40.00 <br />Construction Less than $10.00 <br />-Project Start Date Construction $10.00 - 15.00 <br />-Project End Date Construction $15.01 - 20.00 <br />-Number of Hours Paid, by:Construction $20.01 - 25.00 <br />Category (jobs created / jobs retained)Construction $25.01 - 30.00 <br />Job type (Engineering/Other Professional; Construction; or Other Construction $30.01 - 35.00 <br />Hourly pay range Construction $35.01 - 40.00 <br />Construction more than $40.00 <br />Other Less than $10.00 <br />MN Public Facilities Authority Other $10.00 - 15.00 <br />1st National Bank Building * project loan officer:Other $15.01 - 20.00 <br />332 Minnesota St, Suite W820 Becky Sabie Other $20.01 - 25.00 <br />Saint Paul, MN 55101-1378 651 259-7470 Other $25.01 - 30.00 <br />mn.gov/deed/pfa Rebecca.Sabie@state.mn.us Other $30.01 - 35.00 <br />Other $35.01 - 40.00 <br />Other more than $40.00 <br />Only the blue-shaded columns need to be completed by recipients: <br />MPFA-CWRF-L-043-FY17 <br />Construction of a new influent lift station and rehabilitation of the existing wastewater stabilization pond system <br />Please return this completed worksheet (after project completion) by email to the <br />PFA project loan officer * <br />Clean Water SRF Bond Fund <br />Funding ID (s)Program Description (s) <br />Engineering <br />/Other <br />Professional <br /> <br /> <br /> <br />