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Illinois Manufacturing Innovation Voucher Application
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| | 5. | Company Street Address: | | |
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| | 12. | Number of full-time employees: | | |
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| | 14. | Identify Primary Stage of the Innovation: (select one) | | |
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| | 15. | Expected Business Growth Outcome: | | |
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| | 16. | Provide a brief description of your business and growth plan for the next 3-5 years. | | |
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| | 17. | What is the challenge or opportunity the voucher award will address? Explain the root cause/source of the problem, if known. | | |
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| | 18. | Describe the proposed project. | | |
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| | 19. | Explain why the proposed project is critical to execute your growth plan. | | |
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| | 20. | Duration of the Project (max. 9 months): | | |
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| | 21. | What outcomes will be measured to determine success of the project? (Sales increased/retained, cost savings, new investments, jobs created/retained, etc.) | | |
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| | 22. | Indicate the Total Project Cost: | | |
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| | 23. | Indicate the Requested Funding Amount: | | |
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| 24. | Check box if you need assistance identifying a potential service provider. | | |
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| 29. | Provider Phone Number: | | |
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| 30. | Submit project budget and service provider quote(s), if available |
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| | 31. | By checking this box, I certify to the best of my knowledge that the company meets the eligibility requirements for this funding and that all of the information provided herein and on the accompanying attachments is accurate as stated. I also understand that if awarded funding under the Illinois Manufacturing Innovation Voucher Program, that my organization will be responsible for providing 50% matching funds for the total project. The proposed project will be conducted in an Illinois facility. Please be advised that your company and project may be highlighted in a press release or other marketing platforms by IMEC. Company proprietary or trade secret information will not be disclosed. If you would like additional information concerning this, please contact Mary Mechler at mmechler@imec.org. | | |
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