Hertel Avenue Small Business Funds Application

The Hertel Business Assocition is accepting applications to give back to our Hertel Avenue Small Businesses. The HBA will have "Together We Are North Buffalo Strong" lawn signs and stickers for sale and the proceeds will go into a fund that we will be giving back to the small businesses on Hertel Avenue. The more signs we sell, the more businesses we can help!

In order to be eligible for the funds, you must have your business located on Hertel Avenue and fill out the application. All qualifying applications will go into a pool in which we will draw the "winners" out of a hat as to who will get the funds first.

The proceeds are here to help with some of those small bills as you are struggling to pay rent, employees and working capital. Our goal is to help with your internet bill, electric bill, security system, gas bill, insurance payment, monthly fee for Quickbooks, your website host, etc. At the bottom of the application there will be an areas to upload a copy of one bill in which you would like the HBA to pay with the proceed money.

Business Owner *

First Name Last Name

Business Name *

Contact Number *

Area Code Phone Number

E-mail *

example@example.com

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Description of Business / Services *

Total Years in Business *

Years Located on Hertel Avenue *

Are you a current Hertel Business Association Member? *

Yes No

What is the type of Business? *

Corporation Sole Proprietor Limited Liability Partnership

Annual Sales *

$0-$50,000 $50,000-$100,000 $100,000-$200,000 $200,000 +

Do you own or lease your business location *

Rent - have a lease Own - pay a mortgage

Has your landlord offered an extension on rent payments? *

Yes No n/a

Are you currently behind on bill payments? *

Yes No

Did you temporarily close due to COVID-19 *

Yes No

Were you still able to conduct business during the COVID-19 pandemic? (check all that apply) *

No Yes - are considered essential Yes - curbside Yes - online sales Yes - home delivery

How many employees (full time, part time, including yourself) did you have March 1, 2020 *

How many employees (full time, part time, including yourself) do you have working as of April 2020? *

Did you apply for any funding / aid / loans? *

No SBA - PPE SBA - EIDL LISC

Did you receive any funding or loans? From who and for how much? *

Additional comments that you would like us to know? *

Are you wiling to share, post, and encourage your followers to purchase the lawn signs? The more signs we sell, the money money we have to give back to Hertel Avenue's Small Businesses! *

Yes No

The proceeds are here to help with some of those small bills as you may be struggling to pay rent, employees and working capital. Our goal is to help with your internet bill, electric bill, security system, gas bill, insurance payment, monthly fee for Quickbooks, your website host, etc. Please upload a copy of one bill in which you would like the HBA to pay for with the proceed money.

Upload a bill statement *

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