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Home My WebLink About5.d. Consideration of a Business Relocation Claim from Gene and Sandra Capocasa dba Reno's Pizzai BUSINESS RELOCATION CLAIM FEBRUARY, 1993 RENO'S PIZZA i 13985 SOUTH ROBERT TRAIL ROSEMOUNT, MN PARCEL #34-02010-031-60 i i ROSEMOUN.T PORT AUTHORITY ARMORY SITE PROJECT i �CONW0RT�jlNC. CONWORTH, INC. 4725 Excelsior Blvd. Suite 200 Minneapolis, MN 55416 (612) 929-0044 February 22, 1993 John R. Miller Economic Development Coordinator Rosemount Port Authority 2875 145th Street West P.O. Box 570 Rosemount, MN 55068-5019 Subject: Payment in Lieu of Actual Moving Expenses for Reno's Pizza 13985 South Robert Trail #34-02010-031-60 Rosemount Port Authority Armory Site Project Dear Mr. Milder: Enclosed please find two executed copies of the Business Relocation Claim for the above -referenced concern. We have reviewed the claim documentation submitted by the business and have assembled the enclosed claim booklets. We believe all is in accordance with applicable relocation regulations, and request your review of the enclosed information. Upon your approval of this relocation claim, please make payment to Reno's Pizza in the desired amount as shown on the Summary Page at Exhibit 1 of the enclosed booklets. Thank you for your consideration of this request. We are submitting this claim at this time to enable the business to finance their move. No subsequent claims are anticipated. If You should have any questions, please do not hesitate to call. 1 Sincerely, Jacquelyne Wentworth Owner/Consultant sl Enclosures Redevelopment Acquisition/Relocation EXHIBITS 1) SUMMARY 2) MnDOT RELOCATION CLAIM FORM - FIXED PAYMENT IN LIEU OF ACTUAL MOVING AND RELATED EXPENSES 3) NARRATIVE REGARDING ELIGIBILITY FOR FIXED PAYMENT, AND INDIVIDUALIZED COMMENTS 4) NARRATIVE REGARDING AMOUNT OF FIXED PAYMENT, INDIVIDUALIZED COMMENTS, AND DOCUMENTATION 5) CLAIMANT'S CERTIFICATION REGARDING BUSINESS AND FINANCIAL STATEMENTS 6) NOTICE OF RELOCATION ELIGIBILITY 7) 90 -DAY VACATE NOTICE 8) RELEASE OF PROPERTY 9) RECEIPT FOR RELOCATION INFORMATIONAL BOOKLET 10) CERTIFICATION OF CLAIM 11) QUALIFICATIONS OF CONSULTANT CONWORTH, INC. SUMMARY Occupant. Name: Reno's Pizza Date and Type of Initial Occupancy: 1983 Business Owner: Gene and Sandra Capocasa Date Claimant Notified consultant of Move February 18, 1993 Business Description: A restaurant specializing in the retail sale of pizza. Type of Payment: Fixed Payment in Lieu of Actual Moving -Related Expenses Amount of This Claim: $17,899.50 Amount of Previous Claims: -0- Total Claims to Date: $17,899.50 Less Amounts Paid in Advance: -0- Total Dues $17,899.50 Send Payment To: Gene N. and Sandra L. Capocasa 13985 S. Robert Trail Rosemount, MN 55,068 CONVVORTH, INC. ID 25334 (1-74) STATE OF MINNESOTA DEPARTMENT OF HIGHWAYS COMPUTATION FOR AVERAGE ANNUAL NET EARNINGS I lame Reno's Pizza I?. Parcel #34-02010-031-60 'cd. No. county Dakota 'at. No. Owner Mr. & Mrs. Tourdot address 13985 S. Robert cit Trail Rosemount City ,ype of Acquisition N/A I --OR S7A7E USE ONLY Approved Amount S 17,899.50 Approved Acy. Engr, urRlw Approved Relo. Mgr. Date Application Approved Mail Check To: Net Earnings for the Year 1990 S 19,290.00 Net Earnings for the Year 1991 S 16,509-00 Average Annual Net Earnings S 17,899.50 Maximum payment may not exceed Xk%g= $20 } 000.00 TRAN VENDOR NUMBER YPE INVOICE NUMBER ORGANIZATION SEG. NO. SUFF EPT.PO/FONO OBJECT AMOUNT OF INVOICE DATE SUB ACT TASK UB TASK COST/CLIENT CODE FED REV I hereby certify that the goods or materials covered by thisclaim have been inspected and received or the services have been perfor- med, and are in accordance with specifications, and are in proper form, kind, amount, and quality, and payment therefor is hereby recommended. SYSTEM ASSIGN REF. NO. DEPT AUTH SIGNATURE 'Che term "average annual net earnings" means one-half of any netearnings of the business or farm before Federal, State and local xes during the two taxable years immediately preceding the taxable year in which the business or farm is displaced. "Average annual t earnings" includes any compensation paid by the business or farm to the owner, his spouse or his dependents during the two-year per - d. Such earnings and compensation may be established by Federal income tax returns filed by the business or farm and its owner, his oust, and his dependents during the two year period. 1, the undersigned, do hereby certify that the above information is true and correct and agree to accept the amount of S lieu of actual moving expenses. 1 further certify that the business or farm cannot be relocated without a substantial loss of existing patro- ge and is not a part of a commercial enterprise having at least one other establishment which is not being acquired by the State or the Uni- d States and which is engaged in the same or similar business. nil Claim To: atute )-,:;?3-�� Date FIXED PAYMENT ELIGIBILITY Business Name: Reno's Pizza Project Site Address: 13985 South Robert Trail,, Rosemount, MN There are six special eligibility tests which a business must pass to qualify for a fixed relocation payment based on its net earnings. These tests are listed below. The next page comments on the claimant business's ability to meet each of the criteria. Test 1 The business owns or rents personal property which must be moved in connection with such displacement and for which an expense would-be incurred in such move; and the business vacates or relocates from its displacement site. Reno's Pizza has inventory and equipment at the project site, as viewed by the Consultant. Test 2 The business cannot be relocated without a substantial loss of its existing patronage (clientele or net earnings). A business is assumed to meet this test, unless the Agency determines that it will not suffer a substantial loss of its existing patronage. Factors Related to Lost Patronage a. There is signage on the building advising of the business's existence. b. Loss of patronage is to be assumed, per the relocation rules. Remarks: It should be noted that the Uniform relocation regulations which apply to this project require that patronage be defined, not only as clientele, but also as net income. Therefore, an anticipated loss of income is also a factor to be considered under this test. Test 3 The business is not part of a commercial enterprise having more than three other establishments, which are not being acquired by the Agency, and which are under the same ownership and engaged in the same or similar business activities. Factors Consistent with Four or Fewer Entities Under the Same Ownership and Engaged in Same or Similar Business Activities' _-,) CONWORTH, INC. a. Reno's Pizza is the only store of that name in Rosemount or elsewhere as stated by the company president and others involved. b. The owner's notarized statement regarding same is attached at Exhibit 5. Test 4 The business is not operated at a displacement dwelling solely for the purpose of renting such dwelling to others. Reno's Pizza is not involved in this type of business. Test 5 The business is not operated at the displacement site solely for the purpose of renting the site to others. Reno's Pizza is not involved in this type of business. Test 6 The business contributed materially to the income of the displaced person during the two taxable years prior to displacement. Average Gross Receipts (1990 and 1991) $71,538.50 Average Net Income (1990 and 1991) $17,899.50 Remarks: The definition of "contributed materially" found in the relocation regulations is that the business: 1) had average annual gross receipts of at least $5,000.00; or 2) had average annual net earnings of at least $1,000 00; or 3) contributed at least 33-1/3 percent of the owner's average annual gross income. CONWORTH, INC. I j AMOUNT OF FIXED PAYMENT l A business qualifying for a fixed business relocation payment can be paid an amount equal to its average annual net earnings for the two taxable years prior to its displacement. However, the payment amount is limited to $20,000.00 if the net earnings average is greater; and the payment is a minimum of $1,000.00 if the average is less Per the Federal relocation rules: "The average annual net earnings of a business are one-half of its net earnings before Federal, State, and local income taxes during the two taxable years immediately prior to the taxable year in which it was displaced. If the business was not in operation for the full two taxable years prior to displacement, net earnings shall be based on the actual period of operation at the displacement site during the taxable year(s) prior to displacement, projected to an annual rate. Average annual net earnings may be based upon a different period of time when the Agency determines it to be more equitable. Net earnings include any compensation obtained from the business or farm operation by its owner, the owner's spouse, )- and dependents. The displaced person shall furnish proof of net earnings through income tax returns, certified financial statements or other reasonable evidence which the Agency determines is satisfactory." If the two taxable years prior to displacement are not representative of the business's financial status, then, a different time period can be used. For example, perhaps a business was out -of -operation temporarily because of a fire, or perhaps project activities the past year affected its income. If a business moved early in the calendar year, its financial records for the year just past may not be available. The finances for a business in operation for less than a year can be l "extended" for an annual basis utilizing the average monthly net profit or loss. The next page computes the amount of fixed relocation payment for which the claimant business is eligible, given the above factors, CONWORT�91C. FIXED PAYMENT AMOUNT Business Name: Reno's Pizza Project Site Address: 13985 South Robert Trail, Rosemount, MN Year of Displacement: 1993 Taxable Year 1990 Net Income: $19,290.00 Compensation toOwnerand Dependents: N/A Other Adjustments: -0- Net Earnings: $19,290.00 Taxable Year 1991 Net Income: $16,509.00 Compensation to Owner and Dependents: N/A Other Adjustments: -0- Net Earnings: $16,509.00 Average Net Earnings: $17,899.50 Recommended Payment: $17,899.50 Documentation Attached: Income Tax Forms CONWORTH, INC. cliedule C OMB No. 1545-0074 Form 1040) Profit or Loss From Business (Sole Proprietorship) Partnerships, Joint Ventures, Etc., Must File Form 1065. 1990 Fepartl entRev or the treasury Do -Attach to Form 1040 or Form 1041. ► See Instructions for Schedule C (Form 1040). Attachment 09 nlernaevcnue Service Sequence No. Name of proprietor Social security number (SSN) .GENE N. CAPOCASA AND SANDRA L. CAPOCASA 477-36-7874 Principal business or profession, including product or service (see instructions) 8 Enter principal business code RESTAURANT (from page 2) ► 3079 C Business name and address lo. RE NO ` S P I Z Z A D Employer IQ number (Not SSN) (include suite or room no.) 13 9 8 5 RO$ERT TRA I L r ROSEMOUNT MN 5 5 0 6 Accounting method: (1) ❑ Cash (2) ® Accrual (3) ❑ Other (specify) It _ _ _ _ _ _ F Method (s) used to (1) ❑ Cost (2) ® Lower of cost (3) ❑ Other (attach (4) ❑ Does not apply (if ' value closing inventory: or market explanation) checked, go to tine H) Yes No G Was there change in determining quantities, costs, or valuations between opening & closing inventory? (If ' Yes,' att. explanation) .. X H Are you deducting expenses for business use of your home? (if • Yes,' see Instructions for limitations.) .............................. X J Did you ' materially participate' in the operation of this business during 1990? (if ' No,' see Instructions for limitations on losses.) ....... X J If this is the first Schedule C filed for this business, check here . . 1'. ❑ A4 (. i Income 9 2 3 1 5 S !iF Gross receipts or sales. Caution: If this income was reported to you on Form W-2 and the 'Statutory employee' box on that form was checked, see the Instructions and check here ........................................ ► ❑ Returns and allowances .. Subtract line 2 from line 1. Enter the result here............................................................ Cost of goods sold (from line 38 on page 2) ............................ .. .... .. ......... Subtract line 4 from line 3 and enter the gross profit here ........ ............ .... ............ .... Other income, including Federal and state gasoline or fuel tax credit or refund (see Instructions) ......... I ............ Add lines 5 and 6. This is your gross Income .....................................................::.... ► 1 75,930 15 2 3 75,930 16a 4 29,207 16b 5 46,723 17 6 18 7 46,723 19 Pait lL', Expenses 20a 8 �9 0 11 12 Advertising ................. Bad debts from sales or services (see Instructions) ...... Car and truck expenses (attach Form 4562)........... Commissions and fees. .. Depletion .................. 8 148 21 22 23 24 a b Repairs and maintenance........................ Supplies (not included in Part 111) .................. Taxes and licenses ............................. Travel, meals, and entertainment: Travel ... .. . ............ ....... .... Meals and entertainment 21 294 9 248 22 23 4,565 10 783, 24a 11 ({ ; l 12 S '3 Depreciation and section 179 expense deduction (not included in Part III) (see Instr.) .. 4 Employee benefit programs (other than on line 19)......... 15 Insurance (other than health) ... 3 Interest: a Mortgage (paid to banks, etc.) .. b Other ..................... 17 Legal & professional services ... 3 Office expense .............. ,9 Pension & profit-sharing plans .. 20 Rent or lease (see Instr.): a Vehicles, machinery and equip. . b Other business property .......20b 13 7,886 14 15 895 16a 2, 550 16b 17 18 308 19 20a 6,600 28 Add amounts in columns for lines 8 through 27b. These are your total expenses ................................ ► 28 27,433 3 Net profit or (loss). Subtract line 28 from line 7. If a profit, enter here and on Form 1040, line 12. Also enter the net profit on Schedule SE, line 2 (statutory employees, see Instructions). If a loss, you MUST go on to line 30 (fiduciaries, see Instructions) ................... ................................................. 29 19,290 3 If you have loss, you MUST check the box that describes our investment in this activity 30a ❑ All investment is at risk. y ty (see Instr.) } 30b ❑ Some investment is not If you checked 30a, enter the loss on Form 1040, line 12, and Schedule SE, line 2 at risk. (statutory employees, see Instructions). If you checked 30b. you MUST attach Form 6198. or Paperwork Reduction Act Notice, see Form 1040 Instructions. Schedule C (Form 1040) 1990 SCHEDULE C Profit or Loss From Business OMB No. 1545-0074 (Form 1040) (Sole Proprietorship) 1991 Department of the Treasury ► Partnerships, joint ventures, etc., must file Form 1065. Attachment Internal Revenue Service ► Attach to Form 1040 or Form 104E ► See Instructions for Schedule C (Form 1040). Sequence No. 09 Name of Proprietor Social security number (SSN) GENE N. CAPOCASA 477-36-7874 A Principal business or profession, including product or service (Seo instructions.) B Enter principal business code 0 - RESTAURANT RESTAURANT 3079 C Business name 0 Employer ID number (Not SSN) RENO'S PIZZA E (suuiste%m-ao.Po)s►13985 ROBERT TRAIL, ROSEMOUNT, MN 55068 City town, state and ZIP code F Accounting method: (1 ) LJ Cash (2) X Accrual (3) Other (specify) lo - G Method(s) used a (1� Cost (2) M bower of cost 3 a Other (attach 4 Does not apply (ii value closing inventory: or market ( explanation) (� ❑ checked, go to line 1) Yes No H Was there any change in determining quantities, costs, or valuations between opening & closing inventory? tit 'Yes.' attach explanation.) X ( Did you 'materially participate' in the operation of this business during 1991? (11 'No,' see Instructions for limitations on losses.) X If this is the first Schedule C filed for this business, check hereTi P001 1 Incorne 1 Gross receipts or sales. Caution: if this income was reported to you on Form W-2 and the 'Statutory employee' box on that form was checked, see the Instructions and check here. . ► 1 2 Returns and allowances. , 2 3 Subtract line 2 from line 1 . . . 3 4 Cost of goods sold (from line 40 on page 2) . . . . . 4 5 Subtract line 4 from line 3 and enter the gross profit here . . . . . . . . 5 6 Other income, including Federal and state gasoline or fuel tax credit or refund (see Instructions) . 6 7 Add lines 5 and 6. This is your gross income ► 7 Part tt Expenses (Car,tinn' Fntnrn 67147 67147 26803 40344 A A'] A A 8 Advertising ._• 9 Bad debts from sales or services (see Instructions) 10 Car and truck expenses (see instructions (attach Form 4562) 11 Commissions and fees . . 12 Depletion . , 13 Depreciation and section 179 expense deduction (not included in Pari 111) (see Instructions) , 14 Employee benefit programs (other than on line 19) . . 15 Insurance (other than health) 16 Interest: a Mortgage (paid to banks, etc.) . b Other . . . . . . . 17 Legal and professional services . 18 Office expense . . . . 19 Pension & profit-sharing plans 20 Rent or lease (see Instructions)77 8 Vehicles, machinery and equip.. b Other business property. . 8 78 21 Repairs and maintenance , 21 22 Supplies (not included in Part III) 22 23 Taxes and licenses 23 24 Travel, meals, & entertainments a Travel . 248 b Meals and entertainment C Enter 20% of line 24b subject to limitations (see inst) d Subtract dine 24c from line 24b. 124d 5 25 Utilities . . . . . [�26_ 26 Wages (less jobs credit) 27a Other: DELIVERY 126 9 4300 10 734 11 12 13 4878 14 15 2357 1595 16a 605 23 ! :; 665 96 13 8 9:.::` 16b 598 17 350 OSTAGE 18 530 TELEPHONE 19 LAUNDARY 20a 20bl 6900 27b Total other expenses . 27b 28 Add amounts in columns for lines 8 through 27b. These are your total expenses before expenses for business use of your home . . . . . . . . . . . . . . . . ► 29 Tentative profit (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . 30 Expenses for business use of your home (attach Form 8829) . . . 31 Net profit or (loss). Subtract line 30 from line 29. Ila profit, enter here and on Form 1040, line 12. Also enter the net rof'.t on Schedule gE line.2 r tatutory employees, see Instructions). If a loss, you MUST go on to line 392 (i'iducianes, see fnslructioA. . 28 23835 29 16509 30 31 16509 32 If you have aloss, you MUST check the box that describes your investment in this activity (see inst.) If you checked 32a, enter the loss on Form 1040, line 12, and Schedule SE, line 2 (statutory �' employees, see Instructions). If you checked 32b, you MUST attach Form 619x. 32aAll 32b investment is at risk. Some investment is not at risk. For Paperwork Reduction Act Notice, see Form 1040 Instructions. Schedule C (Form 1040) 1991 0194 CLAIMANT'S CERTIFICATION We, Gene N. and Sandra L. Capocasa, representing Reno's Pizza,, do hereby certify that the following statements are true, complete, and correct to the best of our knowledge: 1. That we are principles in the ownership of Reno's Pizza, which business is currently located at 13985 South Robert Trail, Rosemount, Minnesota, and which is beingdisplaced by the Rosemount Port Authority; 2. That neither Reno's Pizza Inca nor the company own or operate more than three other businesses which are the same or similar to the business which is being displaced from 13985 South Robert Trail in Rosemount, Minnesota; and 3. That the Income Tax Returns and statements for the years of 1990 and 1991, made available to Conworth, Inc. to document this relocation claim, accurately reflect the income and expenses of Reno's Pizza for the years shown, and are true and correct copies of Reno's --Pizza's income tax returns submitted to the Internal Revenue Service for the years shown. a Gene N. Capocasa Andra L. Capocasa __ --,:? 3- 9 Date Subscribed and Sworn Before Me This ,2 ) &.1 Day of l 'v it d 44,2199 '3 No ry Public JACOUELYNE D. WENTWORTH NOTARY PUBLIC - MINNESOTA HENNEPIN COUNTY MY COMM"M M expires 12-28-96 CONWORTH, INC. 1d1303H Nun138 3I1S3WOa oes coe tss�: r I CO VV %-11X m 4725 Excelsior Blvd. Suite 200 pa3st a -- Minneapolis, MN 55416 C ..4. (612) 929-0044 — C Jfl !11 - 0.e cy CC N a Ln C r% December 16, 1992 m rr Reno's Pizza m 13985 South Robert Ti L66L L ; V !11 - 0.e cy CC N a Ln l� _ r% E rr (D o a R tL l L66L L L8£ wlod Sd F O By) einleug!s ;8 l Rosemount, MN 55068 --�_ se6L aunr oose W,aj sa RE: Notice of Relocation Eligibility Project Address: 13985 South Robert Trail Rosemount Armory Site Project PID #34-02010-031-60 Dear Business Owner: On October 30, 1992 the Rosemount Port Authority submitted a written offer to buy the building at 13985 South Robert Trail. The building is on the site of the planned Rosemount Armory Site Project. This is a NOTICE OF RELOCATION ELIGIBILITY. Our records indicate that you are an occupant of this building. To carry out our _plans to develop the Armory Site Project, it will be necessary for you to move However, YOU DO NOT NEED TO MOVE NOW. You will not be required to move without at least 90 days advance written notice of the date by which you must vacate. And when you "do move, you will be entitled to relocation payments and other , assistance in accordance with Federal regulations implementing the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (Uniform Act). The effective date of this Notice is October 30, 1992. You are now eligible for relocation assistance. As an owner of the property, you are eligible to receive a payment for the actual reasonable cost of moving your business. If you meet certain eligibility conditions, you may elect to receive a fixed payment in lieu of a payment for actual moving costs that is based on your average annual net earnings. The minimum fixed payment is $1,000; the maximum is $20,000. I am enclosing a booklet entitled, "Relocation, Your Rights and Benefits." Please read the booklet carefully. It will help you determine which of these payments is most advantageous to you. I�nr7 ..ni�r�mrr�4 /�nriifilinriQl��nn'?ftnrl / L ; V 0.e cy CC N a r% E r (D o a L L8£ wlod Sd F O By) einleug!s ;8 l Rosemount, MN 55068 --�_ se6L aunr oose W,aj sa RE: Notice of Relocation Eligibility Project Address: 13985 South Robert Trail Rosemount Armory Site Project PID #34-02010-031-60 Dear Business Owner: On October 30, 1992 the Rosemount Port Authority submitted a written offer to buy the building at 13985 South Robert Trail. The building is on the site of the planned Rosemount Armory Site Project. This is a NOTICE OF RELOCATION ELIGIBILITY. Our records indicate that you are an occupant of this building. To carry out our _plans to develop the Armory Site Project, it will be necessary for you to move However, YOU DO NOT NEED TO MOVE NOW. You will not be required to move without at least 90 days advance written notice of the date by which you must vacate. And when you "do move, you will be entitled to relocation payments and other , assistance in accordance with Federal regulations implementing the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (Uniform Act). The effective date of this Notice is October 30, 1992. You are now eligible for relocation assistance. As an owner of the property, you are eligible to receive a payment for the actual reasonable cost of moving your business. If you meet certain eligibility conditions, you may elect to receive a fixed payment in lieu of a payment for actual moving costs that is based on your average annual net earnings. The minimum fixed payment is $1,000; the maximum is $20,000. I am enclosing a booklet entitled, "Relocation, Your Rights and Benefits." Please read the booklet carefully. It will help you determine which of these payments is most advantageous to you. I�nr7 ..ni�r�mrr�4 /�nriifilinriQl��nn'?ftnrl / r Reno's Pizza December 16, 1992 Page 2 I want to make it clear that you are eligible for assistance to help you relocate. In addition to relocation payments, counseling and other services are available to you. If you have any questions please call me, your Relocation Counselor. I can be reached at 929-0044 or by writing to me at Conworth, Inc., 4725 Excelsior Boulevard, #200, St. Louis Park, Minnesota. We will certainly endeavor to answer your questions. Remember, do not move before we have a chance to discuss your eligibility for assistance. Please note also that. we will need timely advance notice of your move if you apply for reimbursement of your actual moving expenses. This letter is of importance to you and should be carefully filed for safekeeping. Sincerely, 3 � / ;J�acquelyne Wentworth Owner/Consultant sl Enclosure 27 (`()NT1A7n T'rLT TNT('' CONWORTH, INC. 4725 Excelsior Blvd. Suite 200 Minneapolis, MN 55416 (612) 929-0044 January 28, 1993 Gene and Sandra Capocasa Reno's Pizza 13985 S. Robert Trail Rosemount, MN 55068 Reference: 90 -Day Vacate Notice Address: 13985 S Robert Trail Rosemount Armory Site Project PID #34-02010-031-60 Dean Mr. and Mrs. Capocasa: The Rosemount Port Authority is in the process of purchasing the property at the above -referenced address. You will be required to move for these redevelopment activities. This letter shall serve as a ninety (90) day notice to you of the date by which you will be required to vacate your present location. The Port Authority is notifying you that you must move from the site address by May 1, 1993. You will be given a confirming notice 30 days prior to the final vacate date. You are entitled to relocation benefits, even if you move prior to the above-mentioned final vacate date. I will continue to work with you on your move. As always, we urge you to call me'if you should have any questions on relocation. I can be reached at 929-0044. Si cerely, ac4uelyne Wentworth Owner/Consultant sl RPriPvPlnnmPnt Acouisition/Relocation /� i RELEASE OF PROPERTY 1 This is to notify the Rosemount Port Authority that we, Gene N. and Sandra L. Capocasa, representing Reno's Pizza, will be vacating the property at 13985 South Robert Trail, Rosemount, i Minnesota, on May 1, 1993, and relinquish all rights to property, real or personal, left at that address i By i } By t r CONWORTH, INC. RECEIPT FOR RELOCATION INFORMATIONAL BOOKLET Date December 14, 1992 Name Reno's Pizza Address 13985 South Robert Trail Rosemount MN 55068 T_ have talked with my Relocation Counselor and understand that I may be required to move because of a government -assisted project called the Rosemount Armory Site Project We discussed: 1. Relocation Services Yes X No 2. Financial Benefits Yes X No 3 Claim Documentation Yes X No i 4 Grievance Process Yes X No 5. Information Release Yes X No I have received a copy of the booklet entitled "Relocation, Your Rights and Benefits," printed by the Minnesota Department of Transportation, and have looked it over with my Counselor. I understand that my eligibility for monetary benefits will depend on my cooperation in providing documentation to establish my claim. My signature on this receipt does not obligate me inany way. -Client's Signatur CONWORTH, 1NC. CERTIFICATION OF CLAIM S, the undersigned, do hereby certify the following: 1. That I have personally inspected the business movable property and its relocation claim herein; 2. That to the best of my knowledge and belief the statements contained in this report and upon which the opinions herein are based, are true and correct; 3. That this claim has been made in conformity with and is subject to the requirements of the Uniform Relocation Assistance and Real Properties Acquisition Act of 1970, as amended, and the regulations of the Department of Transportation. 4. That neither myself, the company, nor the employees have a present interest or a contemplated interest in the business involved or the real property it occupies; and 5. That neither the employment to make the claim nor the compensation for it are contingent upon the amount of eligible relocation compensation estimated herein. Ve cq 1y,�e Wentworth location Consultant Conworth, Inc. Date CONWORTH, INC. \,,_ QUALIFICATIONS Jacquelyne D. Wentworth PROJECT ASSIGNMENTS: Acquisition, Residential and Business Relocation Services EDUCATION: B.A./1969/Criminal Sociology; Minor in Psychology, University of Minnesota Continuing Education Courses sponsored by the International Right of Way Association, DHUD, NAHRO. Private pilot. Certified dance instructor. PROFESSIONAL AFFILIATIONS: International Right of Way Association, Minnesota Chapter 20, Past Chairman of Relocation Committee. Minnesota Chapter of the National Association of Housing &. Redevelopment Officials. Past Board President for Eastside Neighborhood Services. Counselor at Your Emergency Service. Aircraft Owners and Pilots Association. FORMED CONWORTH, INC.: 1989 RELATED EXPERIENCE: Minneapolis Housing & Redevelopment Authority (now MCDA) Residential relocation counselor for 6 years. Also training people from other public agencies in Minnesota, as well as Brazil: Supervisor of trouble shooting teamassignedto problem cases for 3 years. Instrumental in developing E.E.O. policies of Agency. - Showcased in training film produced by DHUD. Von Klug & Associates, Inc. ' Consultant for 11 years in residential and business relocation, as well as acquisition. Activities included work with cities, counties and states completing displacement funded by the Department of Housing & Urban Development, the Department of Transportation, the Urban Mass Transit Agency, local tax increment financing, and the Federal Aviation Administration. COMMENTS: Ms. Wentworth has been a guest speaker for the University of Minnesota Urban Studies Courses and the University Women's Auxiliary. She has also participated in instructing classes for local agencies, the Department of Housing & Urban Development (DHUD), the International Right of Way Association (IRWA) and theNationalAssociation of Housing & Redevelopment Officials (NAHRO). CONWORTH, INC.