Business and Non-Profit Grant: McLeod County and Municipal Partners - CARES Act Coronavirus Relief Fund Application
IMPORTANT - RECEIPTS AND/OR QUOTES MUST BE ATTACHED OR PROVIDED FOR CONSIDERATION OF APPLICATION APPROVAL: THIS APPLICATION IS DUE ON OCTOBER 30, 2020 FOR PARTICIPATING CITY OR TOWNSHIP FUNDS; THIS APPLICATION IS DUE ON NOVEMBER 20, 2020 FOR COUNTY FUNDS. W-9 OR APPLICLABLE FORMS MUST BE ATTACHED UPON APPLICATION. ALL FORMS MUST BE SUBMITTED ELECTRONICALLY. To apply for funds available for COVID-19 related expenses at your business or organization, please complete the fields below and submit for consideration. All expenses and implementations of funds must occur/have occurred between March 1, 2020 and December 1, 2020 to qualify for grant consideration for the county's funding. For participating municipalities (cities and towns, listed below), the expenses and implementation of funds must occur/have occurred between March 1, 2020 and November 15, 2020. Any projects or expenses for which dollars are received must be completed and/or satisfied within the timeframes listed above. Receipt copies or proof of purchase/implementation for any outstanding expenses/projects must accompany this grant request, or be provided upon receipt of services or goods. Any funding not accompanied by receipt or proof of purchase/implementation by December 1, 2020 will be required to be returned to McLeod County by December 5, 2020. Late applications will not be considered; in the event the federal government guidelines change and allow extended timelines, that information will be updated on the McLeod County website at: www.co.mcleod.mn.us.
Date of Application
Name of Business or Organization
Organization Name Required
(Legal Name of Business or Organization if Different than Above)
I certify that this Business or Organization is in compliance and good standing with the Minnesota Secretary of State requirements for business filing as of today's date:
Not Applicable (Explain Below)
If you chose "Not Applicable" in the question above, please provide explanation below:
Type of Business or Organization
Primary Contact Email
Primary McLeod County Organization Location
Street Address Line 2
State / Province
Postal / Zip Code
Sub-Type of Grant Application (choose from options listed below relevant to your Business, Organization, or Municipality):
Community Resiliency (housing, food and financial assistance provided through a local partner)
Business or Non-Profit Assistance
Participating municipalities who have chosen to partner in the grant application process with McLeod County are listed below. Please check the box for any applicable municipality from which you are requesting to apply for their allocated funds (please choose all that apply). Please note that not all cities and townships have partnered with McLeod County for distribution of their funds; those not listed are not included at this time, this is subject to change throughout the grant application period. For more information on applying for grant funds from municipalities not listed, please contact those cities or townships directly. Your organization or business must be located in the municipality listed, or serve the municipality listed if applicable/allowed. Please check back at a later date as townships or cities may be added as their funds are received:
City of Brownton
City of Silver Lake
Hassan Valley Township
Type of Business or Organization
Federal EIN (if applicable)
State of Minnesota Tax ID (if applicable)
Phone number of Applicant
Mobile Phone number of Applicant
Was this organization conducting business in McLeod County before March 1, 2020?
Is this organization currently conducting business in McLeod County?
Will this organization continue to conduct business in McLeod County through at least December 31, 2020?
Has this organization received funds from any other source for the same amount of expense being applied for through this grant program?
Funds were received, but this amount does not include what was not covered by the funds received
No, but we have applied for other funding that would be used for the specified expense amount
In regards to your grant request item(s), was this expense incurred directly as a result of COVID-19, OR was your organization negatively impacted by COVID-19?
Requested amount to cover COVID-19 related eligible expenses (limit of $20,000):
Click below to attach receipts or proof of purchase (for paper copies, please attach to your application):
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Choose a file
Receipt(s)/Proof(s) of Purchase
Proposed Use of Funds (expenses must be incurred during eligible period for the municipality from which you're requesting funds; McLeod County eligibility period is March 1, 2020 through December 10, 2020; city and townships eligibility period is March 1, 2020 through November 15, 2020):
Mortgage, Rent or Facility Payments
New or Unexpected Staffing Costs due to COVID-19
Inventory or Purchase Costs
Personal Protective Equipment/Cleaning Supplies/Public Safety Items
Costs to Resume Business after Shutdown
Please summarize what this grant will be used for in the field below. Outline how your business or organization was negatively affected by COVID-19, and how the grant dollars would specifically be applied if received.
The information contained within this grant application is correct to the best of my knowledge at the time of application. By checking the box below, you confirm that you will not receive funding for the same portion of expenses being requested through this specific grant funding. All required fields must be complete for this application to be considered valid.
I confirmed the information contained in this application is correct. I confirm that we are not receiving funding from another source for the same portion of expenses for which I have applied.
Signature and Date of Individual Submitting Application on Behalf of Organization
Should be Empty: