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remodeling of facility; upgrading, replacing, or buying new equipment.): Construction/ Renovations: $ 50, 000 in 2020 Possible building purchase in 2021, $ 850, 000 Manufacturing Equipment, $ 1, 000,000 in 2020 and $ 2, 000, 000 in 2021 Miscellaneous equipment such as computers office, and furniture, $ 100, 000 in 2020 and $ 200, 000 in 2021. B. Identify whether the Project will be located in a/ an: Leased space with renovations or build out Newly constructed building(s) on newly acquired land Newly constructed building(s) on previously acquired land Newly acquired existing building(s) with renovations Addition to previously acquired existing building(s) Other ( please describe in 4A above) Please contact the Economic Development Council of Okaloosa County prior to completing this application. The Economic Development Council must formally present these documents to the respective zoverninz bodies with 0 completed/siened DR -418 and exemption schedule from the PronerN Annrai.ser Economic Development Ad Valorem Tax Exemption Supplemental Application C. New construction value: D. What year will renovations or construction for this project end? 2021 E. Value of new equipment or machinery: $ 3, 000, 000 F. What year will the last piece of equipment be purchased? 2021 SIGNATURES The undersigned person hereby affirms that he or she has been duly authorized and empowered to verify, execute and deliver this Application, that he or she has read this Application ( including all attachments hereto) and he or she has knowledge of all of the facts stated herein, and that this Application, and all information submitted in connection herewith, is complete and accurate and contains no misstatements, misrepresentations, or omissions of material facts, to the best of his or her knowledge and belief. Confidential at this time Signature Date Confidential at this time Name Phone Number Confidential at this time Title E- mail Address Confidential at this time C1 anv RENEWAL PR INFORMATION Please identify the contact information for the EDATE Annual Renewal Process ( individual responsible for renewal process) TBDTBD Name Title Phone Number E - Mail Address MailingMailing AddressAddress Please be sure to attach the proper incentive attachment sheet( DR- 418)*** Please contact the Economic Development Council of Okaloosa County prior to completing this application. The Economic Development Council must formally present these documents to the respective governing bodies with a completed/signed DR -418 and exemption schedule ( r- om the Property Appraiser. Print Form ECONOMIC DEVELOPMENT AD VALOREM PROPERTY TAX EXEMPTION DR -418 Chapter 196. 1995, Florida Statutes R. 12/ 99 To be filed with the Board of County Commissioners, the governing boards of the municipality, or both, no later than March 1 of the vear the exemption is tipmirerl fn tnk,. Affant 1 Business name American Elite PPE Mailing address 5680 John Givens Road 2 Please give name and telephone number of owner or person in charge of this business. Crestview Florida 32539 Name Robert Sires 203 543- 7978 Telephone number 2035437978 3 Exact Location (Legal Description and Street Address) of Property for which this return is filed 4 Date you began, or will 161 Hill Ave Ft Walton Beach Florida begin, business at this facility 8/ 1/ 2020 5 Description of the improvements to real property for which this exemption is requested Date of commencement of Extrusion line, Air compressors, support system construction of improvements 8/ 1/ 2020 6 Description of the tangible personal property for which this exemption is requested and date when property was, or is to be purchased APPRAISER' S USE ONLY Date of Taxpayer's Estimate of Class or Item Age Purchase Original Cost Cond* Fair Market Rent Cond* Extrusion line 2 yr 8/ 15/ 20;3 $ 350000 good $ 350000 $ Air compressors used 8/ 15/ 20;3 $ 50000 good $ 50000 $ Auxilary Equipment new 8/ 15/ 20ik $ 150000 good $ 150000 $ Electrical Work new 8/ 15/ 20ih $ 50000 good $ 50000 $ Mold new 8/ 15/2021 $ 150000 good $ 150000 $ Is $ $ Average value of inventory on hand: * Condition: good, avg ( average), or poor Any additional personal property not listed above for which an exemption is claimed must be returned on form DR -405 (Tangible Personal Property Tax Return) and a copy attached to this form. 7 Do you desire exemption as a [ new business or expansion of an existing busines 9 Trade levels ( check as many as apply) 8 Describe type or nature of your business Manufacture of PPE materials 10 Number of full- time employees to be employed in Florida IFZ] Q Retail Z Wholesale Service Q Office Manufacturing DOther, specify: Professional If an expansion of an existing business: Net increase in employment Increase in productive output resulting from this expansion 11 Sales factor for the facility requesting exemption: Total sales in Florida from this divided Total sales everywhere from this 2, 500, 000 7, 500, 000 facility -one ( 1) location only by facility -one ( 1) location only 10, 000, 000 12 For office space owned and used by a Date of incorporation lNumber of full- time 6/ 10/ 2020 50 corporation newly domiciled in Florida in Florida employees at this location 1 hereby request the adoption of an ordinance granting an exemption from ad valorem taxation on the above property pursuant to Section 196. 1995, Florida Statutes. I agree to furnish such other reasonable information as the Board of County Commissioners, the governing authority of the municipality, or the Property Appraiser may request in regard to the exemption requested herein. I hereby certify that the information and valuation stated above by me is true, correct, and complete to the best of my knowledge and belief. (If prepared by someone other than the taxpayer, his declaration is based on all information of which he has any knowledge.) Date 7/ 2/ 2020 Signature, preparer Preparer's address Signature, taxpayer j Title Preparer' s telephone number Property Appraiser's Use Only I Total revenue available to the county or municipality for the current fiscal year from ad valorem tax sources I1 Revenue lost to the county or municipality for the current fiscal year by virtue of exemptions previously granted under this section III Estimate of the revenue which would be lost to the county or municipality during the current fiscal year if the exemption applied for were granted and the property for which the exemption is requested would otherwise have been subject to taxation IV Estimate of the taxable value lost to the county or municipality if the exemption applied for was granted Improvements to real property $ Personal property $ V I have determined that the property listed above meets the definition, as defined by Section 196. 012( 15) or (16), Florida Statutes, as a

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