(j) a business or organization that restricts patronage for any reason other than capacity;
(k) a speculative business; or
(l) a business or organization that is affiliated (as such term is defined in 13 C.F.R. § 121.103) with
another Applicant; or
(l) a business, franchise or location of which the undersigned has already applied for and received
a grant under the Program.
___ 8. The Applicant understands that it is ineligible to receive a grant under the Program if any officer
or board member of the Applicant: (i) has within the prior three-years been convicted of or had a civil
judgment rendered against such officer or owner, or has had commenced any form of parole or probation
(including probation before judgment), for (A) commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract
under a public transaction, (B) violation of federal or state anti-trust or procurement statutes, or (C)
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property; or (ii) is presently indicted for or otherwise criminally or civilly
charged by a government entity, (federal, state or local) with commission of any of the offenses
enumerated in subparagraph (i) above.
___ 9. The Applicant has not and will not apply for or receive any other grant through or under the
Program. Further, no executive director or equivalent senior managing officer of the Applicant has applied
for or received, nor will any executive director or equivalent senior managing officer of the Applicant apply
for or receive, any other grant through or under the Program on behalf of any other business and/or
organization for which such person is also an owner, executive director or equivalent senior managing
officer. The undersigned hereby represents and warrants, as the executive director or equivalent senior
managing officer of the Applicant, that the Applicant is the undersigned’s eligible organization with the
highest gross revenue. The Applicant agrees that if a second award is issued, then one or both awards will
be voidable at the discretion of the State, CalOSBA, GO-Biz and/or Lendistry, as applicable.
___ 10. Neither the Applicant nor its officers or directors are listed on the sanctions list for the Office of
Foreign Assets Control of the U.S. Department of the Treasury.
___ 11. The Applicant acknowledges and agrees that, if the Applicant is representing itself as being
women-led, veteran-led or led by one or more of the following racial or ethnic groups (as indicated on the
Applicant’s application) (i) African American/Black, (ii) Asian, (iii) Native American or Alaska Native, (iv)
Native Hawaiian or Pacific Islander, or (v) LatinX/Hispanic for the purposes of establishing status as
underserved for a grant under the Program, then, in each case, at least 51% of the Applicant’s organization
must be run on a daily basis by such persons to satisfy such priority requirement. The Applicant, in reliance
on the foregoing grant priority, certifies that it meets the foregoing priority requirements. (Please initial
if the Applicant is either relying on the foregoing priority requirement or if the foregoing priority
requirement is inapplicable to the Applicant.)
___ 12. The undersigned, on behalf of the Applicant, hereby authorizes the State of California and its
designated authorized representatives, including without limitation CalOSBA, GO-Biz and Lendistry, to
request access to, and to review, the Applicant and the Applicant’s tax return information and other
information related to the Applicant that may be requested by such representatives, which may include
