Attachment E-Sample Referral Form.pdf
PDF 63 KB Posted
- Attached to
- Oregon Royalty Fund (ORF) Loan Referral Services
- Solicitation number
- S-12300-00011882
- Issued by
- Oregon
About this file
This is a sample Oregon Royalty Fund (ORF) Loan Referral Form from Business Oregon, which serves as a template for referring businesses for potential funding through the Oregon Royalty Fund program. The form is structured in three main sections: Referring Entity information, Business Being Referred details, and Project Background. The document requires basic contact information from both the referring entity and the business being considered for funding, including names, addresses, phone numbers, email addresses, and preferred contact methods.
The Project Background section requires details about the proposed funding amount, purpose, project location (including county), and project description. The form also includes fields for information about other current investors, including investment firm details and primary contact information. The completed form must be submitted to amy.will@biz.oregon.gov, and includes a field for the submitter's signature and date. The form specifically asks whether the business being referred is considered traded sector per OAR 123-092-0020, indicating this may be a requirement for funding consideration.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment C-Reference Check Form~1.doc | DOC document | |
| C2019273 Notice of Intent to Award 28Apr2025.pdf | ||
| Attachment A-Proposer Information and Certification.pdf | ||
| Attachment B-Disclosure Exemption Affidavit.doc | DOC document | |
| C2019273 Notice of Intent to Award 04Apr2025~1.pdf | ||
| Attachment D-Sample Contract.pdf | ||
| 00011884_Albany TSP_ITA.docx | DOCX document | |
| ORF Loan Referral RFQ.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT E — Sample ORF Loan Referral Form Business Finance
Oregon Royalty Fund (ORF) Loan Referral
2024-10-21 H:\Finance\DOCUMENTS, FORMS & TEMPLATES\ORF\BizOR ORF Referral Form.docx
p. 1 of 2
Referring Entity Referring Entity’s Name:
Referrer’s Name:
Mailing Address:
Physical Address (if mailing address is a PO Box):
Direct phone:
Cell phone:
Email address:
Brief description of the relationship/prior activity with the business being referred:
Business Being Referred Business Entity’s Name:
Contact Name:
Website:
Mailing Address:
Physical Address (if mailing address is a PO Box):
Direct phone:
Cell phone:
Email address:
Preferred contact method:
Is this business considered traded sector per OAR 123-092-0020?
Briefly describe business activities:
Commented [DB1]: To be consistent with RFQ
ATTACHMENT E — Sample ORF Loan Referral Form Business Finance
Oregon Royalty Fund (ORF) Loan Referral
2024-10-21 H:\Finance\DOCUMENTS, FORMS & TEMPLATES\ORF\BizOR ORF Referral Form.docx
p. 2 of 2
Project Background Amount of proposed funding:
Purpose of the proposed funding:
Project location (include county):
Briefly describe the project:
Are there other investors currently involved in this project? If yes, enter details.
Investment firm/group:
Primary investor contact:
Phone number:
Email:
Comment about other investing activities, if applicable:
Other Comments
Please email completed form to amy.will@biz.oregon.gov
Name, Submitter – Signature & Date
Commented [DB2]: Formatting seems off here.
Recommend cleaning up.
Commented [DB3]: Formatting seems off here.
Recommend cleaning up.
mailto:pamela.brunell@biz.oregon.gov
| Referring Entity |
| Business Being Referred |
| Project Background |
| Other Comments |
File details come from the government source that posted it. Updated .