Fillable COVID 19 Small Business Recovery Program Application Distributed (CITY OF HOPEWELL)

Fill Online, Printable, Fillable, Blank COVID 19 Small Business Recovery Program Application Distributed (CITY OF HOPEWELL) Form

Use Fill to complete blank online CITY OF HOPEWELL (VA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

COVID 19 Small Business Recovery Program Application Distributed (CITY OF HOPEWELL)

On average this form takes 16 minutes to complete

The COVID 19 Small Business Recovery Program Application Distributed (CITY OF HOPEWELL) form is 5 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 64 other fields

Country of origin: US
File type: PDF

U.S.A. forms for CITY OF HOPEWELL

BROWSE CITY OF HOPEWELL (VA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Office Use Only: Date & Time Received: _______________________
Received By: _______________________
Updated on July 23, 2020
City of Hopewell
COVID-19 Small Business Recovery Program
Grant Program:
The City of Hopewell, in partnership with the Hopewell Economic Development Authority is
launching the “City of Hopewell COVID-19 Small Business Recovery Program” to support
Hopewell small businesses who have been affected by COVID-19.
Grant funds are limited. Once the allocated funds are distributed, there is no guarantee of
additional funding from City Council for this program. The maximum grant amount is $3,000,
to provide immediate relief to small businesses who have lost income due to COVID-19 and
to prepare for reopening under the CDC and State of Virginia guidelines.
During the application process, applicants will have to demonstrate that they were
operational as of January 1, 2020, that they are an eligible City of Hopewell business, and
that they are suffering negative impacts from COVID-19.
The application process starts on Tuesday, July 20
th
and ends Friday, October 2
nd
at 5pm.
Grants will be awarded based on timely, complete applications. Applications will be
numbered and tracked as they come in. If funding for this program runs out before October
2
nd
at 5pm, there is no guarantee of additional funding for the program.
Grant Eligibility (All businesses must meet these criteria to be eligible for a grant):
Businesses must possess a valid City of Hopewell business license.
All Hopewell small businesses with 25 employees or less (national chain and/or
nationally franchised locations are not eligible).
Businesses must have been established and operational in Hopewell on or before
January 1, 2020.
Business must be in good standing with city taxes and city sewer and refuge
payments, or on an active payment plan.
Must be a for-profit business
Not a publicly traded company
Business must have a physical presence within the City of Hopewell
Office Use Only: Date & Time Received: _______________________
Received By: _______________________
Updated on July 23, 2020
Grant Evaluation:
Grants will be awarded to the majority business owner only.
Grants will be awarded based on timely, complete applications. Applications will be
numbered and tracked as they come in.
Total grant funds available for each award will not exceed $3,000.
Grant amounts vary by size of business, based on number of employees (documented
by payroll statements and federal employment records):
Businesses with 1-5 employees: up to $1,500
Businesses with 6-25 employees: up to $3,000
Funds must be used for operational capital to assist the business in sustaining
operations such as payroll, utilities, inventory, rent, and business mortgage.
Grant recipients will be determined eligible by the City Manager’s Office. Grants will
be issued by the Economic Development Authority (EDA).
Grant funds will be made payable to the business name as listed on IRS Form W-9.
All applications and materials submitted will be public records and subject to the
Freedom of Information Act (FOIA). Documents identified as propriety (i.e. tax
returns, social security numbers, financial documents, etc) are exempt under FOIA.
Application for the grant constitutes an unconditional agreement to and acceptance
of the Terms and Conditions. The Applicant is responsible for ensuring his or her
familiarity with the Terms and Conditions.
By submitting an application, the Applicant certifies that it is not under any
agreement or restriction that prohibits or restricts its ability to disclose or submit the
materials included in the application or otherwise to apply for a grant.
Applicants acknowledge and agree that the Applicant’s business name can used by
the City or the EDA in the promotion of the grant program and may be displayed
publicly showcasing selected businesses.
Grant Submittal:
• Please email grant applications to Stacey English, at senglish@hopewellva.gov AND
Debbie Pershing, at dpershing@hopewellva.gov.
• Grant applications can also be dropped off at City Hall. Please call (804) 541-2243 and
ask for Stacey English or Debbie Pershing to arrange drop-off.
Office Use Only: Date & Time Received: _______________________
Received By: _______________________
Updated on July 23, 2020
Grant Application:
Application Checklist (Please include the following documentation):
Copy of the payroll statement nearest March 17, 2020.
Copy of most recent payroll statement.
Copy of Hopewell Business License.
Copy of the business’s IRS Form W-9.
Business Information
Legal Business Name as listed on IRS Form W-9: _________________________________________________
_________________________________________________________________________________________________________
DBA: __________________________________________________________________________________________________
Business Address: ___________________________________________________________________________________
_________________________________________________________________________________________________________
Business Phone: _____________________________________________________________________________________
Years of Operation in Hopewell: ____________________________________________________________________
Business Email: ______________________________________________________________________________________
Website: ______________________________________________________________________________________________
Federal Tax ID# (EIN): ______________________________________________________________________________
Description of Business: ____________________________________________________________________________
_________________________________________________________________________________________________________
Ownership Information: Complete this section for the majority business owner.
Name: _________________________________________________________________________________________________
Home Address: _______________________________________________________________________________________
_________________________________________________________________________________________________________
Home Phone: _________________________________________________________________________________________
Cell Phone: ___________________________________________________________________________________________
Email Address: ______________________________________________________________________________________
Application Questionnaire: Program eligibility is limited to those businesses that meet the
following qualifications:
1. Has the business established & operational in Hopewell since January 1, 2020? ________
2. Total number of employees prior to March 17, 2020: _____________________________________
3. Total number of employees currently: _____________________________________________________
4. Total number of employees you plan to keep moving forward: __________________________
5. Total number of employees either laid-off or furloughed as a result of COVID-19:
_________________________________________________________________________________________________
Office Use Only: Date & Time Received: _______________________
Received By: _______________________
Updated on July 23, 2020
Statement Narrative: Please attach your answers to these questions if you need more space.
Identify how you plan to continue employment of all or certain employees and the
type of positions being retained in comparison to pre COVID-19 disruption.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Detail how you plan to use the grant funds to continue business operations
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Application Understanding: Each applicant must initial the following statements to indicate
that they understand and agree to the following conditions and certifications:
I certify and attest that I am the majority owner of this business. ________________________
I acknowledge that this completed and signed application is only an application for
the City of Hopewell COVID-19 Small Business Recovery Program expressed herein.
____________________________________
This application, even if favorably received does not constitute a commitment on the
part of the EDA to extend grant funds. ______________________________________________________
I agree to notify the EDA immediately in writing if any of the information contained
in this application materially changes in any respect. _____________________________________
I agree to hold harmless and indemnify the EDA, its board members, and associated
City employees against any claims, charges, suits, damages or other similar liability
and to further waive any claims against the EDA, its board members, and associated
City employees whether now existing or arising in the future regarding any damages,
losses, liability, costs or expenses (including reasonable attorney fees) incurred and
arising from this application. ________________________________________________________________
I understand that by submitting this application the EDA is under no obligation to
approve and/or extend an assistance grant. _______________________________________________
I understand that a false certification or false statement on this application will
subject the signatory and applicant to repayment of the grants funds and other
penalties under the law. _____________________________________________________________________
Office Use Only: Date & Time Received: _______________________
Received By: _______________________
Updated on July 23, 2020
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

COVID 19 Small Business Recovery Program Application Distributed (CITY OF HOPEWELL)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 3 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document