Get Nc Dhsr Mcc: Construction And/or Refinancing Project - Ncdhhs

Filling out the NC DHSR MCC: Construction And/or Refinancing Project application online is a crucial step for obtaining financing assistance for healthcare facility projects in North Carolina. This guide will help users navigate the form with clear instructions and support throughout the process.

Follow the steps to fill out the form successfully.

1. Press the ‘Get Form’ button to access the application form and open it in the editor.
2. In section 1, enter the legal name of the applicant.
3. In section 2, provide the complete address of the applicant, including street and number, city, state, zip code, and mailing address if different.
4. Fill out section 3 with the name of the Chief Executive Officer, their phone number, fax number, and email address.
5. In section 4, provide the name of the project contact person along with their phone number, fax number, and email address.
6. Complete section 5 by specifying the organization details such as ownership and tax status.
7. In section 6, briefly describe the scope of the proposed project. If additional space is needed, attach a separate sheet.
8. Provide site information in section 6, including the geographic location, site acquisition status, and any descriptions of encumbrances in the attached explanations, if necessary.
9. Indicate any prior construction or renovation work completed that requires review in section 7.
10. Complete sections 9 through 12, addressing any outstanding licensure issues, regulatory concerns, or life safety issues, attaching explanations as needed.
11. In section 15, outline financial information pertaining to the project, specifying sources of funding and estimated project costs.
12. Complete the construction schedule estimates in section 16, listing target dates for key milestones including the start and completion of construction.
13. Fill out the equal employment certification in section 17.
14. List the bankers you plan to work with for financing the project in section 18.
15. Certify the application by providing the date, name, title, and signature of the responsible officer.
16. Ensure all required documents are included before submission.
17. Finally, save your changes, and choose to download, print, or share the completed form as necessary.

Begin completing your NC DHSR MCC application online today!