CHRISTIAN COUNTY
CARES Act Small Business Relief Program
The Christian County Commission recognizes the negative impact that COVID-19 has had on small businesses in our
community. We have established a grant relief program in order to assist you during these difficult times. Every
business is important to us.
Christian County has received Coronavirus Relief Funds and is making available a portion of those funds, on an
application basis, to eligible entities for necessary expenditures incurred due to the public health emergency. The
maximum funds available is $10,000 per request. The minimum application threshold is $150. Funds may only be used
to cover costs that:
are necessary expenditures incurred due to the public health emergency with respect to the Coronavirus
Disease 2019 (COVID19);
were incurred during the period that begins on March 1, 2020, and ends on December 30, 2020.
The requirement that expenditures be incurred “due to” the public health emergency means that expenditures must be
used for actions taken to respond to the public health emergency such as the purchase of PPE, sanitizing supplies and
equipment or social distancing modifications undertaken.
Program Eligibility
The program funds will be allocated to eligible and qualified small businesses based on availability. Applications and
supporting documentation are required for review and approval. All grants will be processed on a first-come, first-
reviewed basis to qualified applicants.
To be eligible, businesses must meet the following requirements:
Must be a for-profit, independently owned business or independently-operated franchise, or non-profit
organization geographically located within the borders of Christian County, MO and established prior to
1/1/2020.
Must possess a current city, county, and state license or permit to operate, as applicable.
Must employ between 1 and 19 full-time or part-time employees, including owner.
Must provide receipts or paid invoices for expenditures necessitated by COVID-19 (i.e. purchase of
added safety items, added expenses due to COVID-19, etc.).
Must use reimbursed funds for operational needs, such as employee safety expenses, lease/mortgage payments,
utilities, materials, supplies and services.
Must be in compliance with local, state, and federal non-discrimination policy, and overall good standing
with city and county service providers as of February 1, 2020 (e.g., current on utility bills, no liens or
judgments, and prior year(s) property taxes, state and federal taxes).
In order to receive assistance with lease/mortgage payments or utilities the applicant must not have taken a
Paycheck Protection Program loan or similar program under the CARES Act.
REVENUE REPLACEMENT IS NOT A PERMISSIBLE USE OF FUND PAYMENTS.
Please complete the attached application and provide applicable copies of required documentation. If
your business is within city limits, please obtain the city's signed approval of your application before
submittal.
Please submit completed application and required documentation by email, or mail to:
caresact@christiancountymo.gov
Christian County
CARES Act Committee
1106 W. Jackson St.
Ozark, MO 65721
The following businesses will not be considered eligible to request assistance under the
relief program:
Lending and investment institutions
Sporting venues
Corporately Owned Chain Stores
Nonexclusive examples of ineligible expenditures:
Expenses for the State share of Medicaid
Damages covered by insurance
Payroll or benefits expenses.
Expenses that have been, or will be reimbursed under any federal program, such as the
reimbursement by the federal government pursuant to the CARES Act of contributions by States
to State unemployment funds
Reimbursement to donors for donated items or services
Legal settlements
Christian County CARES Act Small Business Reimbursement Application No.:__________________
Business Legal Name
Business Address
Total Amount Requested $
Business TIN (EIN, SSN)
Primary Contact
Number of Employees
(including owner)
Email Address
Business Phone
Full-time
Part-time
DBA or Tradename (if applicable)
Type of Request (select all that apply)
Applicant Ownership Please list all owners of the business. Attach separate sheet if necessary
Owner Name
Title
Ownership % Address
Question YES NO
1.) Has the Applicant received a Paycheck Protection Program loan or similar program?
If yes, what amount? $ ______________
Use(s) of funds? _________________________________________________________________________________
2.) Is the Applicant or any owner of the business presently suspended, disbarred, proposed for disbarment, declared
ineligible, voluntarily excluded from participation in this transaction by any Federal department or agency, or
presently involved in any bankruptcy?
3.) Has the Applicant, any owner of the business, or any business owned or controlled by any of them, ever obtained
a direct or guaranteed loan from SBA or any other Federal agency that is currently delinquent or has defaulted in the
last 7 years and caused a loss to the government?
c
c
c
c
c
c
Please Describe how COVID-19 has impacted the business
c PPE c Physical modifications c Rent/Utility assistance
To what extent were business operations impacted during the “Stay at Home” Orders?
c Completely shut down operations/closed to public
c Partially shut down operations/limited to low public contact
c Remained open but incurred additional expenses to meet social distancing requirements
Please provide documentation which supports the request being made. At a minimum, the following documents should be
included:
Copy of valid business license (City or County)
Copies of receipts for any PPE, sanitizing supplies or physical modifications made to protect employees/patrons
Copies of utility bills
Copies of most recent rent/mortgage payment
Additional documentation may be required to verify your request.
Supporting Documentation
c I/we confirm that my business is engaged in activities that are regulated within Christian County and I/we have the required permits
or license associated with that regulation.
Certifications and Signature
c I/we acknowledge and agree that, to the fullest extent permitted by law, I shall forever Release, Hold Harmless, Discharge and Agree to
Defend and Indemnify, the County of Christian, MO from any liabilities, claims, demands, or causes of action that they may hereafter
have, without limitation, for personal, bodily, or mental injuries, property damages, economic losses, attorney’s fees, or any other type of
injury or damage arising out, resulting from, or in connection with, this application.
c I/we agree to provide additional documentation upon request to help verify the economic hardship suffered as a result of the
COVID-19 emergency, including tax returns, financial statements, and other financial data.
c I/we hereby certify that the information provided, contained herein and attached hereto is accurate and correct to the best of my
knowledge.
SIGNATURE DATE
County Official Verification (County use only)
City Official Verification (City Hall use only)
SIGNATURE DATE
City Business License # ____________________________________
Is this license current and valid? _________
Current on County Taxes c
Merchant’s license # (if applicable) _________________________________