• My business has a physical establishment within the City of Manchester.
• My business employs no more than 15 full-time equivalent employees.
• My business has less than $2,000,000 in gross annual receipts.
• My business can show a loss of revenue of 50% or more due to to the impact of the COVID-19 pandemic by comparing revenue from a similar time frame prior to the onset of the pandemic.
• My business has no outstanding tax liens or legal judgements and no outstanding City taxes and fees.
• I plan to use these grant funds in one of the following ways:

1. Rent, mortgage, utility bills, accounts payable, and other fixed costs for a small business.
2. Employee wages.
3. Resources to enhance online/digital accessiblity of my business (for example, revamp of website to make e-commerce or delivery available to customers).
4. Perishable inventory that was lost due to an interruption of business.
5. Increased costs to directly address COVID-19 (such as purchasing PPE).
6. Reimburse any of the above eligible expenses incurred since March 13, 2020 that no other federal, state, or local funding has previously covered.

• Due to the negative impact of COVID-19 on my business, receipt of these funds will help support the continued operation of my business, which will allow me to retain or create employee jobs.
  • Employee jobs retained/created must meet HUD criteria for supporting low to moderate income employees, which applicants can self-certify below.

Please note: if you selected option 2 or option 3 above, you must submit a seperate HUD income self-certification form signed by the employee that meets the applicable criteria.

HUD Employee Income Self-Certification Form

Email: smallbusinessgrant@manchesternh.gov

If you selected option 1 above, please complete the following demographic information. This information will be kept confidential and not for public distribution. If you selected option 2 or 3 above, you may skip this section and provide this information on the separate income self-certification form you must complete. Please note: this information should apply to the employee being used to fulfill HUD income criteria selected above.

The Manchester Small Business Resiliency Grant for which you are applying is part of the CARES Act funding for Community Development Block Grant Program  awarded to the City of Manchester, NH. In keeping with federal regulations, the City of Manchester, NH requires that recipients of CDBG-CV funds secure a DUNS number and complete a federal SAM registration.

To streamline the grant application process, applicants do not need their DUNS and SAM numbers to submit a grant application.

However, in order to be awarded a grant, you will need to provide your DUNS number prior to grant funds being disbursed.

Following the disbursement of grant funds, grant recepients are asked to complete the SAMs registration within 30 days.

You can request a DUNS number online at the following web address:

http://fedgov.dnb.com/webform/displayHomePage.do

(when you get to the home page, click on “Click here to request your D-U-N-S Number via the Web” option)

For detailed instructions on the DUNS and SAMs registration process, please see this instructional memo.

• Current IRS W-9 Form for your business (this document is needed to process your grant payment from the City of Manchester).
• Documentation that shows gross annual receipts of $2,000,000 or less and loss of revenue of 50% or more due to impact of COVID-19 pandemic. Acceptable documentation may include financial statements and summaries, profit and loss statements, and budget documents.
• Documentation supporting how these grants funds will be used. Funds may be used to cover any eligible expense from March 13, 2020 until date of application or current/future expenses with appropriate documentation. I.E. if applying towards employee wages, provide payroll records. If applying towards a purchase of supplies or inventory, provide receipt.
• Documentation fulfilling HUD income requirements.
  • If you are fulfilling HUD's requirement through OPTION #1, please include payroll documentation showing your business employs one employee with an annual income equal or less than $47,800.
  • If you are fulfilling HUD’s requirement through OPTION #2, request your employee to fill out the Income Self-Certification Form
  • If you are fulfilling HUD’s requirement through OPTION #3, please upload your personal 2019 Tax Return.

Authorization to Release Information

I/We hereby authorize the release to City of Manchester and/or assigns of any information they may require at any time for any purpose related to my/our transaction with them and further authorize City of Manchester and/or assign to release such information to any entity they deem necessary for any purpose related to my/our transaction with them.

I/We hereby certify that all information in this application and all information furnished in support of this application, herein or at a later date, is valid and correct to the best of my/our knowledge. I/We also acknowledge that the grant approval process through City of Manchester is a public process.

By Signing Below, the business owner(s) certify in good faith to all of the the following:

• Current economic uncertainty makes this grant request necessary to support the ongoing operations of my business.
• I certify that my business meets all of the eligiblity criteria for this program to the best of my knowledge, including the HUD low to moderate income requirements. I have provided accurate information and documentation on behalf of myself or one of my employees to meet this criteria.
• I agree that funds will be used as working capital to maintain payroll, make mortgage, lease, or utility payments, or purchase raw materials and inventory as required.
• I understand that I will be required to submit all associated paperwork to support the use of these funds including purchase orders, invoices, payroll records, or any other documentation as requested.
• I further certify that the information provided in this application and the information that I have provided in all supporting documents and forms is true and accurate. I realize that knowingly making a false statement to obtain this grant from the City of Manchester is considered fraud and will be pursued to the full extent of the law.
• I acknowledge that the eligible grant amount will be confirmed using business documents I have submitted.
• I acknowledge that any property taxes or fees, as well as all State and Federal taxes have been paid/ are current. Alternatively, I have included documentation of payment plans.
• I acknowledge that I am retaining or creating jobs based upon the income guidelines attached to the application.
• I certify that I have not received, nor reasonably anticipate receiving, duplicative funding assistance for any activities described in the application, and that I shall not receive funding assistance in excess of the cost of the activities described in the application.  I agree that, if I receive any duplicative or excess funding, I shall repay the City using non-governmental funds for the entire amount of the duplicative or excess funding.