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Department of
Economic &
Community Development
FastTrack Economic Development
Grant Program Application

I. COMMUNITY APPLICANT INFORMATION

Proposed Grantee: Rutherford County IDB
Address of Proposed Site:352 w Northfield Blvd, Unit 3, Murfreesboro, TN 37129
Company community is applying on behalf: TwelveStone Health Partners

Community Profile
County: Rutherford
Community FEIN#: XXXXXXXXXXXX
JECDB Compliant Yes [Z] NoO
Does the community have a Title VI implementation plan in place? Yes [Z] NoO

Project Contact Information

Chief Applicant Official: Shane Reeves Job Title: CEO

Mailing Address: 352 W Northfield Blvd., Unit 3 Murfreesboro, TN 37129

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Phone: 844-893-0012 Fax Number:

Signature: E-mail address: shane.reeves@12stonehealth.com

Application Prepared by: Brian Hercules Job Title: VP Economic Development

Mailing Address: 3050 Medical Center Parkway Murfreesboro, TN

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Phone: (615) 893-656f / Fax Number:
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Signature<6--y E-mail address: bhercules@rutherfordchamber.org

Local Contact: Brian Hercules Job Title: VP Economic Development

Mailing Address: 3050 Medical Center Parkway Murfreesboro, TN Fax Number:
Phone: 615-278-2393 E-mail address: bhercules@rutherfordchamber.org

Project Engineer: Rose Construction (David Curtze) Job Title: VP

Mailing Address 2217 NW Broad St. Murfreesboro, TN 37129 Fax Number:
Phone: 615-898-8370 E-mail address:

Grant Administrator: Rutherford County IDB/Sumner Bouldin Job Title: Attorney for IDB
Mailing Address: 103 N Maple Murfreesboro, TN 37130 Fax Number:
Phone: 615-893-9033 E-mail address: sumner.bouldin@bouldinreed.com
Company official responsible for infrastructure:
Shane Reeves Job Title: CEO
Mailing Address: 352 W Northfield Blvd, Unit 3 Murfreesboro, TN 37129 Fax Number:
Phone: 844-893-0012 E-mail address: sha ne.reeves@12stonehelath.com

Tennessee FastTrack Economic Development Grant Program Application: 1 7.2013