APPLICATION INSTRUCTIONS

2009 GUIDELINES & APPLICATION

Promoting Employment Across Kansas (PEAK)

Program Overview

The 2009 Legislature passed Senate Bill 97 enacting the Promoting Employment Across Kansas (PEAK) incentive program allowing for-profit qualified companies (company or companies) that are relocating jobs to Kansas from outside the state, to retain 95 percent (95%) of the payroll withholding tax of the relocated jobs over a period of five or more years. Per SB 97, the Secretary of Commerce is designated to determine the eligibility of companies relocating function(s) and jobs to Kansas. Final eligibility will depend upon the satisfaction of criteria for the number of PEAK jobs relocated and their wages. “PEAK eligible” jobs must be paid wages at or above the most recently published Kansas Department of Labor (KDOL) annual average wage (see Attachment A – revised annually in June) for the county in which the function will be located at the time of application. Applications are accepted throughout the year and must be received prior to relocating to Kansas PEAK jobs/employees and within 180 days of announcement to Commerce of the company’s decision to relocate a function(s) to Kansas.

PEAK jobs identified as PEAK eligible may not participate in the Kansas Department of Commerce (Commerce) Investment in Major Projects and Comprehensive Training (IMPACT) Program. Additionally, PEAK eligible jobs and/or employees for which a company is retaining payroll withholding taxes may not be considered when computing any job tax credits under K.S.A. 79-32,153 (Job Expansion & Investment Credit Act) or K.S.A. 79-32,160a (Enterprise Zone Program) nor may the payroll of these PEAK eligible employees be considered when computing any research and development credit (K.S.A. 79-32, 182b) on payroll expenditures.

PEAK includes two types of projects: Basic and High Impact.

Basic: To qualify, PEAK jobs performing the relocated function(s) must be paid an aggregate annual average wage of at least 100 percent (100%) of the most recently published annual average wage for the county in which the function will be located at the time of application. A minimum of five (in non-metropolitan counties) or ten (in designated metropolitan counties of Douglas, Johnson, Sedgwick, Shawnee or Wyandotte) PEAK jobs must be relocated to Kansas within two years from the PEAK agreement date. Only those PEAK jobs that pay at or above the county average wage are eligible for retention of withholding taxes.

High Impact: To qualify, PEAK jobs performing the relocated function(s) must be paid an aggregate annual average wage of at least 100 percent (100%) of the most recently published annual average wage for the county in which the function(s) will be located at the time of application. A minimum of five (in non-metropolitan counties) or ten (in designated metropolitan counties) PEAK jobs must be relocated to

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Kansas within two years from the PEAK agreement date. Additionally, to qualify as a High Impact project, the qualified company must relocate a minimum of 100 jobs within five years from the PEAK agreement date. Only those PEAK jobs that pay at or above the county average wage are eligible for retention of withholding taxes.

Program Requirements

Eligible applicant companies: Must be relocating to Kansas a business function(s) and jobs from an existing business facility, office,

department or other operation located outside Kansas. Additional “growth” jobs that do not currently exist for the relocated function(s), but result from the relocated function(s), may also be eligible to receive PEAK benefits. Consideration is given for growth jobs only when the initially relocated function(s) activities were not performed in Kansas prior to the initial relocation.

Must be organized as a “for-profit” business and Shall not have one of the following NAICS assignments:

o Industry group 7132 (Gambling Industries) or 8131 (Religious Organizations);o Sectors 44 & 45 (Retail Trade), 61 (Educational Services), 92 (Public Administration) or 221

(Utilities including water & sewer services);o Subsector 722 (Food Services and Drinking Places).

Shall not be a bioscience company (as defined in KSA 2008 Supp. 74-99b33 and amendments thereto).

Shall not be delinquent in the payment of taxes to any federal, state and/or local taxing entities. Shall not be under the protection of the federal bankruptcy code. May be classified as an international or national “headquarters” or “administrative/back office”

facility as approved by Commerce. Make available to full-time employees adequate health insurance coverage and pay at least 50

percent (50%) of the premium. Pay PEAK jobs an aggregate annual average wage of at least 100 percent (100%) of the county

average wage (CAW) per the most recent Kansas Department of Labor Annual Average Wage Report (see Attachment A) for the county in which the relocated function(s) will be located.

Create a minimum of five PEAK jobs in non-metropolitan (non-metro) counties and 10 PEAK jobs in designated metropolitan (metro) counties over a two-year period .

Create a minimum of 100 jobs over a five-year period to participate as a PEAK High Impact project. Shall not be participating in Commerce’s Investments in Major Projects and Comprehensive Training

(IMPACT) Program or any programs pursuant to K.S.A. 74-50,102; 79-32,153; 79-32,160a or 79-32,182b.

Provide required documentation to support eligibility in the program and timely file quarterly and annual reports.

Agree to provide Commerce and the Kansas Department of Revenue access to records for inspection concerning employment and wages of any PEAK jobs and/or employees.

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Application Process & Requirements

1. Company submits to Commerce a PEAK application with required supporting documents prior to relocating to Kansas PEAK jobs/employees and within 180 days of announcing their decision to relocate a function(s) to Kansas. Commerce reviews the application and supporting documents and, if approved, drafts an agreement establishing the date of the agreement, county average wage (CAW) to be met and reporting requirements for company’s review and notarized signature(s). Company returns two original agreements to Commerce for full execution by the Secretary of Commerce. Company has two years from the PEAK agreement date to relocate the minimum required jobs of five (non-metro counties) or ten (metro counties). Additionally, to participate as a High Impact project, companies must relocate 100 jobs within five years. Note: Withholdings cannot be retained until an Agreement is executed by the company and Commerce, and an “effective date” established in writing by the company.

2. Commerce returns one fully executed original to the newly qualified company and certifies to the Kansas Department of Revenue (KDOR): 1) that the company is eligible to receive PEAK benefits; 2) the number of PEAK jobs and any qualified PEAK growth jobs to be hired; and 3) the amount of wages being paid to each PEAK job.

3. Company must be registered by the Kansas Department of Revenue to remit Kansas payroll withholding taxes.

4. Company is required to report quarterly to Commerce starting on the effective date and due within 30 days from the end of each calendar quarter for the duration of the agreement. Quarterly reports will include a list of all PEAK jobs and approved PEAK growth jobs, Kansas start date, wages per hour, hours worked per week, the amount of payroll withholding taxes retained for the quarter and other information deemed necessary by Commerce. Company will submit copies of their KDOL Quarterly Wage Report & Unemployment Tax Return (Form K-CNS 100) and required monthly KDOR Withholding Tax Deposit Report (Form KW-5) with their PEAK quarterly reporting data. Additionally, the company will submit comparable KDOL reports from the origin state of the relocated function(s). Annual reports will be required on each effective date anniversary summarizing the quarterly report(s) data and certifying satisfaction of basic program eligibility criteria.

5. Company will identify in writing to Commerce an “effective date” from which the PEAK benefit period will commence. The effective date must be within one year of the date of the agreement and will be established on the 1st day of a calendar quarter. The average wage of PEAK jobs including approved PEAK growth jobs commencing work in Kansas, will be used annually to compare to the CAW to determine eligibility and length of the benefit period. The company must annually meet or exceed the CAW and satisfy basic program requirements to remain in the program.

6. Ninety-five percent (95%) of withholding taxes may be retained by the qualified company for PEAK eligible jobs (includes approved PEAK growth jobs that pay at least the CAW.) Withholding taxes for wages of PEAK jobs and PEAK growth jobs that do not meet the CAW and any other jobs that do not meet the program criteria must be remitted as required to the KDOR. This may include any PEAK job whose wages are uncertain to meet the CAW requirement. If at the end of the year it is determined that such PEAK job’s wages met the CAW requirement, PEAK eligible withholding taxes remitted will be returned to the company by the KDOR. (Visit the KDOR’s web site at

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http://www.ksrevenue.org/pdf/forms/whTaxRates.pdf to calculate estimated retained withholding tax benefit).

o PEAK jobs and approved PEAK growth jobs must be paying 100 percent (100%) of the CAW each year to remain in the program. If the combined average wage of PEAK jobs and PEAK growth jobs drops below 100 percent (100%) of the CAW or the required number of jobs to be relocated is not reached in two years, the company is immediately terminated from the program and may be required to remit to the State the aggregate amount of payroll withholding taxes retained by the company up to the date of termination.

7. For companies participating as a PEAK Basic project starting from the effective date: o if at the end of five years, the company has maintained an average wage for PEAK jobs and

approved PEAK growth jobs equal to or at least 110% of the CAW in each of the five previous years, an additional year shall be allowed for retention of payroll withholdings for PEAK eligible jobs;

o if at the end of six years, the company has maintained an average wage for PEAK jobs and approved PEAK growth jobs equal to or at least 120% of the CAW in each of the six previous years, an additional year shall be allowed for retention of payroll withholdings and terminating after the seventh year.

8. For companies participating as a PEAK High Impact project starting from the effective date: o if at the end of seven years, the company has maintained an average wage for PEAK jobs

and approved PEAK growth jobs equal to or at least 110% of the CAW in each of the seven previous years, an additional year shall be allowed for retention of payroll withholdings for PEAK eligible jobs;

o if at the end of eight years, the company has maintained an average wage for PEAK jobs and approved PEAK growth jobs equal to or at least 120% of the CAW in each of the eight previous years, an additional year shall be allowed for retention of payroll withholdings for PEAK eligible jobs;

o if at the end of nine years, the company has maintained an average wage equal to or at least 140% of the CAW in each of the previous nine years, an additional year shall be allowed for retention of payroll withholdings and terminating after the tenth year.

Please contact your regional Commerce project manager to obtain an application and free technical assistance or call 785.296.5298 for more details. Mail application and supporting documentation to:

PEAK Program ManagerBusiness Development Division

Kansas Department of Commerce1000 SW Jackson Street, Ste 100

Topeka, KS 66612-1354

12Nov09

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http://www.ksrevenue.org/%20pdf/forms/%20whTaxRates.pdf

PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK)Application

1. Company Legal Name & Address: ___________________________________________________________________

__________________________________________NAICS_____________________EIN___________________________

2. Company Contact & Title: _________________________________________________________________________

3. Contact Phone/Email/Fax or Cell: ___________________________________________________________________ Phone Email Cell

4. Parent Company Legal Name, Address & EIN: _________________________________________________________

_________________________________________________________________________________________________KANSAS RELOCATING PROJECT DATA

5. KANSAS Company Legal Name & Street Address: ______________________________________________________

__________________________________________NAICS_____________________EIN___________________________

6. Type of Ownership (circle one): LLP Sole Prop LLC LP GP S Corp C Corp Other ____________________

7. Contact & Title: __________________________________________________________________________________

8. Contact Phone/Email/Fax or Cell: ___________________________________________________________________

9. Describe the function(s) that is being relocated from an existing business facility, office, department or other operation outside Kansas: _______________________________________________________________________

__________________________________________________________________________________________________

10. Provide the company legal name and current physical address of the function(s) being relocated and reason for relocation:_________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

11. Describe the company’s products or services: _________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

12. What is the Kansas start date for the first relocated job? _________________________________________________

13. Will you be using a third party as your legal employer? Yes or No (Please attach copy of agreement)

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14. Total # of (relocated) PEAK jobs: _________ # Relocated/Year: Yr1______Yr2_______ Yr3________ Yr4________ Yr5________ (Complete Attachment B)

15. Total qualifying “growth” jobs resulting from the relocated function(s): _____________ (Complete Attachments C & D)

16. Total avg annual wage of PEAK jobs: $_______________ Total Project Capital Investment: $____________________

17. Does the company have existing KS operations? Yes or No (If “yes,” please list on a separate sheet each business’ legal name, address, EIN and employment level. Please include a corporate and related entity organizational chart )

18. If the relocated function (s) will be locating in an existing Kansas facility, what is your current employment level at that facility? ___________ (Attach copies of your last four KDOL Quarterly Wage Report & Unemployment Tax Return, Form K-CNS100)

19. Please specify if you are applying as a: Headquarters or Administrative/Back Office (Complete Attachment E or F)

20. Are you a “for-profit” company? Yes or No

21. Will a health care plan be offered to full-time employees? Yes or No (Please attach summary of benefits plan)

22. If so, will the company pay at least 50% of each full-time employee’s premium? Yes or No

23. Has the company filed for or does it intend to file for protection under the bankruptcy code? Yes or No

24. Is the company currently or ever been delinquent on any federal, state or local taxes? Yes or No (Attach copy of Kansas Tax Clearance Certificate. A Kansas Tax Clearance certificate may be obtained from the KDOR by completing an online request at http://www.ksrevenue.org/taxclearance.htm)

25. If your tax reports and withholding returns are prepared by a payroll service, please complete the following:

Payroll Service Name: ___________________________________________________EIN: _______________________________

Address & Phone: _________________________________________________________________________________________ (Street Address) (City) (State) (Zip) (Phone) 26. I have reviewed this application and attachments and certify that I am an authorized officer of the applicant

company and that all information contained herein is true and accurate and agree to allow representatives of Commerce and/or the Kansas Department of Revenue access to the property and applicable records as may be necessary to administer this program. (Please return Attachment G, Ownership Disclosure & Signature Statement with your PEAK application.)

Company Officer/Title:____________________________________________________________________________________

(print name & title) (signature) (date)

Notary:

12Nov09

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http://www.ksrevenue.org/taxclearance.htm

APPLICATION INSTRUCTIONS


Questions 1-4. Provide the legal name of the company you wish to be named on the PEAK Agreement and other data as requested.Questions 5-9. Provide the legal name of the existing Kansas company or relocating Kansas company, street address and other data as requested. Question 9. Please describe the relocating function(s) and existing facility/department/operations. Include the date the operations will close/closed and provide supporting documentation of closure (e.g. media releases, internal correspondence, etc.)Question 10. Provide the company name and address of the closing operations and explain why the company chose to relocate this function, including if the project is a result of consolidation of operations or facilities.Question 11. Describe the company’s overall products or services and include what will be produced/offered at the Kansas facility.Question 12. Provide the date your company plans to hire or relocate the first job to Kansas.Question 13. Circle the appropriate answer. If “yes,” attach a copy of the agreement between the company and the third-party legal employer. Question 14. Provide the number of PEAK jobs currently performing the function to be relocated and the “ramp up” to Kansas of these jobs over the first five years of the project. You must complete Attachment B and include with your application submission.Question 15. Provide the additional PEAK “growth” jobs to be hired as a direct result of the relocated function and complete Attachment C & D for consideration of approval.Question 16. Provide the aggregate annual average wage of the PEAK jobs. Please also provide the estimated total project capital investment including the purchases of long-term capital and/or fixed assets.

Question 17. Please circle the appropriate answer and provide any details on a separate sheet including each company name, address, EIN, current or average employment level and corporate organizational chart.Question 18. Please provide the current employment level for the existing Kansas facility in which the function(s) will be located and attach your last four KDOL K-CNS 100 quarterly reports to verify your response.Question 19. Circle the appropriate answer and return the completed corresponding questionnaire (Attachment E or F).Question 20. Circle the appropriate answer.Question 21. Circle the appropriate answer and provide a copy of the company’s Benefits Plan Summary.Question 22. Circle the appropriate answer and provide verification if not included in the Benefits Plan Summary.Question 23. Circle the appropriate answer.Question 24. Circle the appropriate answer and attach a copy of your Tax Clearance Certificate.Question 25. Please provide the requested data if using a payroll service company.Question 26. Please have an authorized company officer provide a notarized signature, date and return a copy of your KDOR “Ownership Disclosure and Signature Statement.”

Return your application prior to relocating PEAK jobs/employees to Kansas and within 180 days of announcing to Commerce your decision to relocate a function(s) to Kansas. Return application and documentation to:

Darla Price, PEAK Program ManagerBusiness Development Division

Kansas Department of Commerce1000 SW Jackson Street, Ste 100

Topeka, KS 66612-1354

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DEFINITIONS


Adequate Health Insurance: The company will provide health insurance coverage within one hundred eighty (180) days from date of employment for full-time employees. Minimum coverage will include hospital care, physician care, mental health care, substance abuse treatment, prenatal care and prescription drugs.

Administrative/Back Office: A qualified administrative/back office facility is operated by a business and provides ancillary support services to the business, but is not directly engaged in the business’s primary function. For the PEAK program, the administrative/back office will serve multiple company worksites either internationally or nationally/ regionally within the United States. Minimal outside revenue is generated from a qualified administrative/back office and the operation is capable of being located anywhere geographically, e.g. an insurance claims processing office.

Agreement Date: The date Commerce receives your PEAK application and which will appear in the upper right-hand corner of the PEAK agreement. PEAK jobs shall be hired on or after this date. The company has two years from this date to hire the minimum required jobs for the program. Also, the company has one year from this date to determine in writing an Effective Date.

Benefit Period: The benefit period references the timeframe during which the company will be allowed to retain withholding taxes for PEAK eligible jobs. The wages for PEAK jobs and approved growth jobs will be used to calculate the company’s PEAK annual average wage for comparison to the CAW to determine the benefit period.

County Average Wage (CAW): Generally, all companies with employees are required to report wages to the Kansas Department of Labor (KDOL) for unemployment insurance purposes. Annually, the KDOL compiles this wage data and produces a report listing an average wage for each county. The KDOL annual report is usually updated each June for the previous year’s wage data.

Current or Base Employment Level: If the applicant company is relocating a function(s) and PEAK jobs to an existing Kansas facility, a current or base employment level will need to be established. Typically, we will use the “3rd Month” employment level as reported on that facility’s most recent K-CNS 100 to KDOL.

Effective Date: The effective date commences the PEAK benefit period, quarterly reporting and establishes the PEAK annual anniversary reporting date. The effective date is designated in writing by the company to Commerce; and is within one year from the PEAK agreement date and commencing on the 1st day of a calendar quarter.

Headquarters: A qualified headquarters is where principal officers of the business are housed and from which direction, management and administrative support for transactions are provided. For the PEAK program, the headquarters will serve multiple company worksites either internationally or nationally/regionally within the United States. Minimal outside revenue is generated from a qualified headquarters and the facility is capable of being located anywhere geographically.

Kansas Department of Labor K-CNS 100: The majority of Kansas companies that have employees are required per K.S.A.

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44-710 to report wage data to the KDOL on a quarterly basis for unemployment insurance purposes. The K-CNS 100 form is used to report this data. For companies having multiple Kansas worksites reporting on one K-CNS 100, corresponding federal Multiple Worksite Reports (Form BLS 3020) may also be required.

Kansas Start Date: The date that the PEAK jobs and any approved growth jobs will commence work in Kansas.

PEAK Annual Average Wage: On each annual effective date anniversary, the qualified company will summarize quarterly reporting data in an annual report and submit to Commerce. The annual report will include a PEAK annual average wage as computed by dividing the total PEAK jobs and any approved PEAK growth jobs by the wages of the same. This PEAK annual average wage is used to determine continued program eligibility and the PEAK benefit period.

PEAK Eligible Jobs: Are PEAK jobs and approved PEAK growth jobs that are paid at least the CAW for the county in which the function(s) is relocated. PEAK eligible jobs are those that qualify for the company to retain 95 percent (95%) of payroll withholding taxes.

(PEAK) Growth Jobs: Are jobs that are not initially relocated from the existing business function(s); however result from or are directly related to growth of the initially relocated function(s), but only if the relocated function(s) was not performed in Kansas prior to initial relocation. For approval, PEAK growth jobs must also be at least part-time working 20 hours per week, year-round. Similar to the term “PEAK jobs,” PEAK growth jobs also include both those jobs paying at or above the CAW and those paying below the CAW. Once approved by Commerce, PEAK growth jobs that pay at or above the CAW are referred to as “PEAK eligible” and payroll withholding taxes may be retained. Wages for projected PEAK growth jobs are not included in the initial “PEAK jobs average wage” to qualify for the program. However, once approved, wages of PEAK growth jobs commencing work in Kansas are included in PEAK quarterly and annual reports determining the PEAK annual average wage that affects the PEAK benefit period.

PEAK Jobs: The jobs performing the business function(s) that is being relocated from outside of Kansas. PEAK jobs are used to determine if the company initially meets minimum job and average wage requirements of the program. PEAK jobs and wages are also used to determine a PEAK annual average wage affecting the PEAK benefit period. To qualify as a PEAK job, employees must be at least part-time working 20 hours per week, year-round.

PEAK Jobs Average Wage: The total wages of PEAK jobs divided by the total number of PEAK jobs as reported on Attachment B and used to determine initial PEAK eligibility of the relocating function(s).

Relocated (Relocating) Function: The function(s) for which an applicant company shall be relocating jobs to Kansas from an existing business facility, office, department, unit, production line, etc. which will then cease being performed outside of Kansas. In some instances, a facility that has recently closed in another state may qualify.

Third Party Employer: An unrelated entity which provides employees or performs services for a qualified company on a contractual basis (often referred to as a “Professional Employer Organization” or PEO.) The third party may contract with the applicant company to perform services whereby the third party serves as the legal employer of the new employees and such services are performed in Kansas. When contracting with a third party, the third party shall remit payments equal to the amount of Kansas payroll withholding taxes that the qualified company is eligible to retain to the qualified company and report such amount to the KDOR as required.

Wages: All compensation for services including commissions, bonuses, back pay, and the cash value of remuneration including benefits paid in any medium other than cash and as defined in K.S.A. 44-703(o).

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PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK) – ATTACHMENT A*2008 KDOL ANNUAL AVERAGE WAGES BY COUNTY

County Private

STATEWIDE$38,735

$18.62

ALLEN AL$28,670

$13.78

ANDERSON AN$24,840

$11.94

ATCHISON AT$31,104

$14.95

BARBER BA$29,172

$14.03

BARTON BT$35,080

$16.87

BOURBON BB$27,212

$13.08

BROWN BR$27,999

$13.46

BUTLER BU$31,196

$15.00

CHASE CS$24,892

$11.97

CHAUTAUQUA CQ$21,115

$10.15

CHEROKEE CK$32,573

$15.66

CHEYENNE CN$28,635

$13.77

CLARK CA$28,373

$13.64

CLAY CY$23,651

$11.37

CLOUD CD$24,584

$11.82

COFFEY CF$47,639

$22.90

COMANCHE CM$19,921

$9.58

COWLEY CL$31,225

$15.01

CRAWFORD CR$26,299

$12.64

DECATUR DC$23,719

$11.40

DICKINSON DK$27,492

$13.22

DONIPHAN DP$33,424

$16.07

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DOUGLAS DG$28,112

$13.52

EDWARDS ED$28,643

$13.77

ELK EK$17,884

$8.60

ELLIS EL$30,640

$14.73

ELLSWORTH EW$29,012

$13.95

FINNEY FI$32,645

$15.69

FORD FO$30,861

$14.84

FRANKLIN FR$30,323

$14.58

GEARY GE$28,089

$13.50

GOVE GO$25,804

$12.41

GRAHAM GH$30,594

$14.71

GRANT GT$40,762

$19.60

GRAY GY$33,909

$16.30

GREELEY GL$27,219

$13.09

GREENWOOD GW$27,157

$13.06

HAMILTON HM$29,558

$14.21

HARPER HP$29,689

$14.27

HARVEY HV$31,433

$15.11

HASKELL HS$36,457

$17.53

HODGEMAN HG$27,091

$13.02

JACKSON JA$24,058

$11.57

JEFFERSON JF$31,437

$15.11

JEWELL JW$23,969

$11.52

JOHNSON JO$48,092

$23.12

KEARNEY KE$31,454

$15.12

KINGMAN KM$31,761

$15.27

KIOWA KW$26,802

$12.89

LABETTE LB$25,203

$12.12

LANE LE$33,189

$15.96

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LEAVENWORTH LV$34,408

$16.54

LINCOLN LC$24,025

$11.55

LINN LN$39,795

$19.13

LOGAN LG$26,022

$12.51

LYON LY$28,086

$13.50

MARION MN$24,284

$11.68

MARSHALL MS$31,717

$15.25

MCPHERSON MP$34,539

$16.61

MEADE ME$35,435

$17.04

MIAMI MI$29,912

$14.38

MITCHELL MC$28,120

$13.52

MONTGOMERY MG$29,458

$14.16

MORRIS MR$25,257

$12.14

MORTON MT$40,018

$19.24

NEMAHA NM$29,451

$14.16

NEOSHO NO$32,362

$15.56

NESS NS$36,059

$17.34

NORTON NT$27,155

$13.06

OSAGE OS$21,421

$10.30

OSBORNE OB$22,029

$10.59

OTTAWA OT$24,622

$11.84

PAWNEE PN$26,316

$12.65

PHILLIPS PL$29,415

$14.14

POTTAWATOMIE PT$33,152

$15.94

PRATT PR$32,372

$15.56

RAWLINS RA$26,753

$12.86

RENO RN$30,644

$14.73

REPUBLIC RP$22,544

$10.84

RICE RC$31,025

$14.92

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RILEY RL$25,336

$12.18

ROOKS RO$31,002

$14.90

RUSH RH$30,318

$14.58

RUSSELL RS$29,977

$14.41

SALINE SA$32,938

$15.84

SCOTT SC$31,423

$15.11

SEDGWICK SG$42,042

$20.21

SEWARD SW$32,532

$15.64

SHAWNEE SN$37,098

$17.84

SHERIDAN SD$33,876

$16.29

SHERMAN SH$24,320

$11.69

SMITH SM$21,354

$10.27

STAFFORD SF$26,738

$12.85

STANTON ST$34,468

$16.57

STEVENS SV$35,281

$16.96

SUMNER SU$27,636

$13.29

THOMAS TH$28,320

$13.62

TREGO TR$30,534

$14.68

WABAUNSEE WB$42,611

$20.49

WALLACE WA$24,965

$12.00

WASHINGTON WS$22,671

$10.90

WICHITA WH$34,280

$16.48

WILSON WL$29,967

$14.41

WOODSON WO$27,698

$13.32

WYANDOTTE WY$41,862

$20.13

* Revised June 2009

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PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK) – ATTACHMENT BPEAK JOBS DETAIL

# of Approx. KS Wages Work Total AnnualJob Title & Description Positions Start Date Per Hr Hrs/Week Wages

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TOTAL POSITIONS & PAYROLL

PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK) – ATTACHMENT CPEAK GROWTH JOBS QUESTIONNAIRE

In some cases, the PEAK program allows “growth” jobs to be included for benefits. Growth jobs are additional jobs to be hired in Kansas that do not currently exist as part of the relocating function(s). Please complete this form and return to Commerce with your application if you wish to have growth jobs considered.

1. Why will the company hire additional jobs in Kansas that do not currently exist within the relocating function(s)?

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

2. How do these jobs relate to the function(s) that is relocating? ____________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

3. Is the function(s) to be relocated to Kansas currently being performed at a Kansas company , affiliate or subsidiary worksite? If so, please explain. _____________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

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__________________________________________________________________________________________________

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PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK) – ATTACHMENT DPEAK GROWTH JOBS DETAIL

# of Approx. KS Wages # of Work Total AnnualJob Title & Description Positions Start Date Per Hr Hrs/Week Wages

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TOTAL POSITIONS & PAYROLL

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PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK) – ATTACHMENT EQualifying International Or Regional Headquarters Questionnaire

A qualified headquarters is where principal officers of the business are housed and from which direction, management and administrative support for transactions of the business are provided. For the PEAK program, the headquarters will serve multiple company worksites either internationally or nationally/regionally within the United States. Minimal revenue is generated from a qualified headquarters and the facility is capable of being located anywhere geographically.

HEADQUARTERS

1) Company name and address of proposed worksite.

2) List the names and titles of the company officers located at the headquarters location.

3) In what non-revenue generating activities is this worksite involved for other worksites of the company and its affiliates?

4) How many company worksites are served by this HQ worksite?

5) How many affiliate and/or subsidiary worksites are served by this HQ worksite?

6) How much outside revenue is generated at this HQ?

INTERNATIONAL /NATIONAL/REGIONAL SCOPE

1) Provide the company’s approximate U.S. employment level and list each permanent company name and worksite address.

2) List each permanent affiliated/subsidiary company name and worksite address within the U.S.

3) Provide the company’s approximate international employment level and list each permanent company name and worksite address.

4) List each permanent affiliated/subsidiary company name and worksite address outside the U.S.

5) If traded on a major stock exchange, please show the trading symbols and list the exchange.

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6) Other considerations you wish to add.

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PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK) – ATTACHMENT FQualifying International Or Regional Administrative/Back Office Questionnaire

A qualified administrative/back office facility is operated by a business and provides ancillary support services to the business, but is not directly engaged in the business’s primary function. For the PEAK program, the administrative/back office will serve multiple company worksites either internationally or nationally/regionally within the United States. Minimal outside revenue is generated from the facility and the operation is capable of being located anywhere geographically (e.g. an insurance claims processing

office.)

ADMINISTRATIVE/BACK OFFICE

1) Company name and address of proposed worksite.

2) Is this a captive, in-house worksite that provides services only to the applicant company and its affiliates?

3) In what non-revenue generating activities is this worksite involved for other worksites of the company and its affiliates?

4) How many company worksites are served by this support worksite and where are they located?

5) How many affiliate and/or subsidiary worksites are served by this support worksite and where are they located?

6) How much outside revenue is generated at this worksite?

INTERNATIONAL/NATIONAL/REGIONAL SCOPE

1) Provide the company’s approximate U.S. employment level and list each permanent company name and worksite address.

2) List each permanent affiliated/subsidiary company name and worksite address within the U.S.

3) Provide the company’s approximate international employment level and list each permanent company name and worksite address.

4) List each permanent affiliated/subsidiary company name and worksite address outside the U.S.

5) If traded on a major stock exchange, please show the trading symbols and list the exchange.

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6) Other considerations you wish to add.

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PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK) – ATTACHMENT GOwnership Disclosure and Signature Statement

List ALL owners, partners, corporate officers and directors. Provide the personal information and signatures of all persons who have control or authority over how business funds or assets are spent. If more space is needed, attach additional pages.

Certification: To the best of my knowledge and belief the information on this application is true, correct, and complete. If the business fails to report or pay appropriate state taxes, any individual who is responsible for the tax authorizes the Secretary of Revenue or his/her designee to research the credit history of the business or that individual.

_______________________________________________________ __________________________________________________

Printed full proper name of owner, partner or corporate officer Signature of owner, partner or corporate officer Date

SSN:__________________________________________________ Title:______________________________________________

Home Address:________________________________________________________________________________________________

(Street Address) (City) (State) (Zip Code)

Home Telephone:________________________Email Address: _________________________________ Percent of Ownership: ___%

Do you have control or authority over how business funds or assets are spent? Yes No

Date that you became the owner, partner or corporate officer of this business: Month ________ Day ________ Year ________

_______________________________________________________ __________________________________________________


SSN:__________________________________________________ Title:______________________________________________

Home Address:________________________________________________________________________________________________





_______________________________________________________ __________________________________________________


SSN:__________________________________________________ Title:______________________________________________

Home Address:________________________________________________________________________________________________





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PROMOTING EMPLOYMENT ACROSS KANSAS (PEAK)Application Checklist

_____ 1) Completed PEAK Application and Checklist

_____ 2) Documentation of relocated function(s) closure outside of Kansas

_____ 3) If using a third party legal employer, agreement between applicant and third party employer

_____ 4) Attachment B listing PEAK jobs and wages to be relocated

_____ 5) For consideration of PEAK growth jobs, complete and return Attachment C and D

_____ 6) If qualifying as a headquarters, complete and return Attachment E

_____ 7) If qualifying as an administrative/back office, complete and return Attachment F

_____ 8) If applicant has existing Kansas operations, return a list of each facility including company name, address,

EIN, employment level and, if multiple operations, a corporate organizational/relationship chart.

_____ 9) If relocated function(s) will be at an existing Kansas facility, include last four KDOL quarterly UI reports

_____ 10) Copy of applicant’s health benefits plan summary and documentation that the applicant pays at least 50%

of premium

_____ 11) Tax clearance from origin state or Kansas

_____ 12) Attachment G, Ownership Disclosure and Signature Statement

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QUARTERLY REPORTS


Quarterly reports are required commencing on the “effective date” for your PEAK agreement. Quarterly reports are due 30 days from the end of each calendar quarter. You may submit quarterly reports in your own format, but reports must include the following information.

1. PEAK effective date: _________________________

2. PEAK reporting period: _______________________ to ________________________

3. County Annual Average Wage: _______________ (to be met per PEAK agreement)

4. A listing of PEAK jobs including:a) each employee nameb) job titlec) position # or social security numberd) Kansas start datee) Kansas termination date (if applicable)f) wages paid per hourg) hours worked per weekh) total wages for the quarteri) payroll withholding taxes retained for the quarterj) notation of “PEAK eligible” jobs

5. A listing of approved PEAK growth jobs including:a) each employee nameb) job titlec) position # or social security numberd) Kansas start datee) Kansas termination date (if applicable)f) wages paid per hourg) hours worked per weekh) total wages for the quarteri) payroll withholding taxes retained for the quarterj) notation of “PEAK eligible” jobs

6. Supporting documents:a) KDOL Quarterly Wage Report & Unemployment Tax Return (K-CNS 100) for the quarterb) KDOR monthly (payroll) Withholding Tax Deposit Reports (KW-5)c) Comparable KDOL Quarterly Wage Report & Unemployment Tax Return for origin state of relocated function(s)

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ANNUAL REPORTS


Annual reports are required at each anniversary of the PEAK effective date and due within 30 days from the end of the calendar quarter. Annual reports will summarize the quarterly reports and determine the company’s continued qualification to participate in the PEAK program. A PEAK annual average wage and evidence supporting satisfaction of basic program criteria will be provided to Commerce. The following information will be included:

1. PEAK Effective Date: _____________________

2. Annual Reporting Period: _____________________ to ______________________

3. County Annual Average Wage: _______________ (to be met per PEAK agreement)

4. Subtotal # of PEAK Jobs: __________

5. Subtotal Wages of Peak Jobs: ____________________

6. Subtotal # of (approved) PEAK Growth Jobs: ____________

7. Subtotal Wages of (approved) PEAK Growth Jobs: ____________________

8. Total # of PEAK Jobs & PEAK Growth Jobs: ____________

9. Total Wages of PEAK Jobs & PEAK Growth Jobs: _________________________

10. PEAK Annual Average Wage: ___________________ (Total Wages for PEAK Jobs & PEAK Growth Jobs ÷ Total # of Peak Jobs & PEAK Growth Jobs)

11. Total Capital Investment for the Period: ______________________________

12. Is an adequate health care plan offered to full-time employees? Yes or No (circle one and attach summary of plan)

13. If so, does the company pay at least 50% of each full-time employee’s premium? Yes or No (provide supporting documentation)

14. In the past year, has the company filed for or does it intend to file for protection under the federal bankruptcy code? Yes or No

15. Is the company delinquent on any federal, state or local taxes? Yes or No (attach copy of Kansas Tax Clearance Certificate)

16. Submit Attachment G, Ownership Disclosure and Signature Statement

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Documents

APPLICATION INSTRUCTIONS