Borough of Carlisle’s CARES Act Application Administered by Cumberland Area Economic Development Corporation HOW TO SUBMIT: Review the Borough of Carlisle’s CARES Act Application Guidelines prior to completing Application. Applications can be filled out below or downloaded and emailed to CarlisleCV@cumberlandbusiness.com, or mailed to: 53 W. South St., Suite 1, Carlisle PA 17013. GRANT SUBMISSION GUIDELINES: Be sure to READ THE GUIDELINES before submitting your CARES ACT application. GRANT SUBMISSION DEADLINE: September 28, 2020 at 4:30pm Date* MM DD YYYY Grant Application Legal Name: First Last Grant Application Mailing Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Business Location:*Primary Contact Name* First Last Contact Phone Number*Contact Email* Enter Email Confirm Email Date Business was Established* Date Format: MM slash DD slash YYYY Number of Current Full-Time Employees:*Number of Full-Time Employees Pre-COVID-19*Number of Current Part-Time Employees:*Number of Part-Time Employees Pre-COVID-19:*Select EIN or SSN:*Select which tax ID you wish to submit.EINSSNEIN*Fill in EIN.SSN*Fill in SSN.NAICS Code:*Select one.44 - Retail Trade71 - Arts, Entertainment, and Recreation72 - Accommodation and Food Services21 - Mining, Quarrying, and Oil and Gas Extraction22 - Utilities31 - Manufacturing42 - Wholesale Trade51 - Information52 - Finance and Insurance56 - Administrative and Support and Waste Management and Remediation Services81 - Other Services (except Public Administration)92 - Public Administration61 - Educational Services (K-12)23 - Construction48 - Transportation and Warehousing54 - Professional, Scientific, and Technical Services62 - Health Care and Social Assistance11 - Agriculture, Forestry, Fishing and Hunting53 - Real Estate and Rental and Leasing55 - Management of Companies and Enterprises61 - Educational Services (Higher Ed)Legal Structure*Choose one.C-CorpS-CorpLLCLLPPartnershipSole ProprietorshipGrant Purpose: (Please describe in 500 words or less how COVID-19 has affected your business and your need for grant assistance.)*Grant Amount Request:*$5,000 is the maximum.Please enter a number less than or equal to 5000.Use of Funds:* Working Capital Technical Assistance CDC Compliance Total Project Cost:*Current Banking Institutions Assisting with Financing:*How did you hear about the Borough of Carlisle’s CARES Act funding?*Has your business received a loan/grant from CAEDC, the Borough of Carlisle, or the Redevelopment Authority in the past?*YesNoPlease provide the names of any loans/grants.*Has your business stayed current and in compliance with the terms and conditions of those grants/loans?*YesNoDid your business operate during COVID-19?*YesNoIf yes, please describe in 1,000 words or less:*Did your business comply with the Governor’s Orders and CDC Guidelines during the red, yellow and green phases?*YesNoIf no, please describe below:*Has your business filed for bankruptcy within the past 10 (ten) years?*YesNoIs your business current with all local, state and federal taxes?*YesNoHas your business received any other COVID-19 funding?*YesNoIf yes, please provide the names and amounts of any loans/grants.*Does your business have a line of credit or cash reserves?*YesNoIf yes, how many months do you anticipate these resources to be able to keep your business operational:*Does your tax returns show your business as profitable?*YesNoPlease tell us the number of jobs either retained or created as a result of this grant opportunity.Upload your most recently filed tax return. If you are a Sole Proprietor, also upload your Schedule C in addition to your tax return.*(Total size of all files have a 75mb limit.) Drop files here or Upload proof of insurance.*(Total size of all files have a 75mb limit.) Drop files here or Acknowledgement and Authorization*I acknowledge that I have read the Borough of Carlisle’s Community Development Block Grant Program (CDBG-CV) grant submission guidelines and informational materials and hereby certify the following: • All information and statements contained in this application, and all documents and exhibits submitted with this application, to the best of the Applicant’s knowledge are true, accurate, complete and not misleading, as of the date of this application. • Upon request, Applicant will submit additional information and documentation in support of this application. Any further information or documentation submitted by Applicant in connection with this Application shall also be subject to these acknowledgements. • The expenses enumerated in this grant application occurred or will occur between March 1, 2020 and December 30, 2020. • The proposed use of funds included in this application represents an eligible use as identified in grant submission guidelines • The expenditures outlined in this application have not been reimbursed and will not be eligible for reimbursement from another federal program. • If successful, the grant will be treated as income and applicable taxes will be the responsibility of the Applicant and must be paid. • The Applicant has fully complied with, and will fully comply with, all federal, state, and local laws and regulations applicable to this grant and Applicant’s business, assets and/or operations, and the Applicant is not currently under investigation with respect to any violation of, or failure to comply with, any such applicable law or regulation. No funds will be used for any purpose or in any manner that violates federal, state, or local laws or regulations. • The Applicant will comply with all requirements of the Funding Approval Agreement between the U.S. Department of Housing and Urban Development (“HUD”) and the Borough of Carlisle, specifically those terms and conditions applicable to grantees of funds provided by the Borough of Carlisle from HUD and any amendments to those terms and conditions as well as applicable program Notices issued by or imposed by HUD. • The Applicant will adhere to all compliance requirements, including but not limited to all applicable audit requirements, internal controls and subrecipient monitoring requirements, as may be applicable. • If successful, program funding will be expended by December 30, 2020. • AVAILABLE FUNDS ARE LIMITED AND SIGNIFICANT INTEREST IS ANTICIPATED Applicant recognizes that there is no assurance that Applicant will be awarded any grant of any size, regardless of how well the Applicant may meet the criteria for awarding these grants and regardless of what the Applicant may have been told or read with respect to this grant program. • All decisions and recommendations with respect to this application and this grant are final and non-appealable. Applicant acknowledges that grant award determinations will be made based on both objective and subjective analysis of information available and that award determinations need not follow strictly or consistently the scoring methods utilized. The Applicant also acknowledges that the identity of funding and recipients, award amounts, and application scores and recommendations will become public information. • The person submitting this application has the authority of the Applicant to submit the Application on its behalf. • As a condition of the submission of this Application or receipt of grant funds, the Applicant hereby releases the Borough of Carlisle and CAEDC, their board members, elected officials, employees, agents and representatives of and from any claims and causes of action of any kind, type or nature in any way associated with the receipt and review of the Application, the administration of the Borough of Carlisle’s Community Development Block Grant Program (CDBG-CV) , the distribution of any program benefits, the decision not to provide program benefits and any other matter or thing in any way related to the program. 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