Pitkin County Business Grant Application

PITKIN COUNTY

SMALL BUSINESS GRANT APPLICATION

The Pitkin County Board of County Commissioners (the BOCC) and county staff are very aware of the many negative economic impacts that the various COVID 19 public health orders have had on businesses operating in our county. As part of the county measures designed to help offset those impacts, the BOCC has authorized $1.28 million to be awarded as grants up to $25,000 to qualifying Pitkin County businesses most impacted by COVID-19 and public health orders.

The Pitkin County Business Grant program will be administered in conjunction with Aspen Community Foundation and is designed to distribute funds to those businesses most adversely affected by the health orders.

The grants will be used by qualifying businesses for legitimate business operating costs, such as payroll, rent/mortgage, insurance, and other business expenses that comply with all federal, state, and local laws.

It is important to note that requests for assistance may well exceed the amount of funding available, so not all eligible businesses will receive funding. Applications will be reviewed based on the selection criteria and a weighted scoring matrix will be utilized to make final selections. All eligible businesses may apply. Priority will be given to businesses that have been significantly impacted by the public health orders, such as restaurants, gyms and fitness centers, theaters, personal services, and event-related businesses.

Please contact pitkinbusinessgrants@aspencommunityfoundation.org with any questions.

ELIGIBILITY REQUIREMENTS
- Must be a business operating in Pitkin County that started operations on or before March 10, 2020.
- Must be a registered business, in good standing, with the Colorado Secretary of State's office.
- Business must have submitted a safety plan to Pitkin County and be in compliance with all statewide and local public health orders due to COVID-19, including capacity restrictions, and will continue into the future.
- Business has been adversely impacted by COVID-19, to be substantiated by the materials required in the application.
- Businesses with more than one physical location in Pitkin County may apply only one time for the grant program for one location only.
- Individually owned franchises operating in Pitkin County are eligible if an owner resides in the Roaring Fork Valley.
- A W-9 is required.
- Funding cannot be used for expenses already paid for by any other local, state, or federal grant funding.
- Business must use funding for its own regular operating costs [payroll, rent, mortgage, and other regular business expenses] only for the business operating in Pitkin County.
- Business has submitted a safety plan submitted to Pitkin County.
- Businesses are NOT eligible if they have received an NOV or closure notice for violation of the Public Health Order.
EXPENDITURE ELIGIBILITY

Funding has been made available under section 601(a) of the Social Security Act, as added by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”). Coronavirus Relief Funds can ONLY be used for costs that are in accordance with Section 5001(d) of the CARES Act.
Page 1

APPLICATION DETAILS

Application Release Date: Friday, January 29

Applications Closed: Applications will be reviewed on a rolling basis until all funds have been distributed.

Award Notifications: Applications will be reviewed on a rolling basis and grantees will be notified upon award determination.

Required Materials: Please review the list of required documents prior to starting your application. The information in your revenue and asset reports must match the answers in your application and must be uploaded in a PDF format and submitted with your application. We reserve the right to request tax returns or other applicable documentation.
1. Back up for 2020 revenue number — labeled ‘BusinessName_2020Revenue’. Acceptable documents:
  - Point of sale revenue reports
  - Accounting software reports
  - Copies of financial ledgers
2. Back up for 2019 revenue number — labeled ‘BusinessName_2019Revenue’. Acceptable documents:
  - Point of sale revenue reports
  - Accounting software reports
  - Copies of financial ledgers
3. A certificate of good standing from the Secretary of State. Business certificates can be looked up here
4. A completed W9 form — please ensure the form is complete and the mailing address is accurate to avoid delays. A blank W9 form can be found here .
SELECTION CRITERIA

Grants will be awarded to businesses most impacted by COVID-19 and public health orders, please review the scoring matrix and selection criteria below

EVALUATION AND SELECTION PROCESS

Applications for funding will be reviewed on a rolling basis by a citizen committee based on the information provided by businesses in regards to the criteria listed above. Please ensure all information provided is accurate and complete before submitting the application. Incomplete applications may be subject to removal from consideration for funding.

The information requested in the application is necessary to comply with the IRS guidelines and will be used to evaluate applicants through a specific, objective assessment of potential recipient needs, based on the potential recipient’s financial resources.

This is a very competitive grant — the citizens' committee anticipates a high volume of applications of which only a limited number of applicants will be selected to receive funding from the Pitkin County Business Grant program. Committee recommendations will be reviewed by Pitkin County, which will make final decisions regarding the grants recipients. Grants will be administered by Aspen Community Foundation. The committee is not obligated to provide further details regarding decisions and reserves the right to suspend an application at any point in the process if criteria are not met, not accurate, not verified, or if new information pertinent to the selection criteria is brought to the attention of the committee.
Page 2

DISCLAIMERS
By completing, signing, and submitting this application, the applicant (business owner or a representative) is affirming that:

(i) the business meets the eligibility requirements for the Pitkin County Relief Grant described above and in the application;

(ii) the applicant and its related parties are not an officer or director of Aspen Community Foundation (ACF), a selection committee member, or a member of any such individual’s respective families or households, and any grant received will not benefit—either directly or indirectly—such individuals;

(iii) all the information provided is complete, correct, and true to the best of the applicant’s knowledge;

(iv) any losses the applicant may have suffered in connection with this emergency have not been covered to date by insurance, funds available through governmental or other agencies, federal or state relief funds, or readily available personal financial resources;

(v) the applicant understands that the applicant may be denied assistance if any of the above is false;

(vi) the applicant may be required to repay any assistance that it receives based on false or incomplete information;

(vii) the applicant agrees to provide required materials to corroborate application information;

(viii) the applicant understands that the application becomes the property of Pitkin County and Aspen Community Foundation when submitted;

(ix) the applicant understands that Aspen Community Foundation’s annual tax return is open to public inspection and that, if the applicant receives a grant, Aspen Community Foundation will be required by federal tax law to disclose on its annual return its identity and address, the grant amount and purpose; and

(x) the applicant understands that, if it receives a grant, Aspen Community Foundation will report on its annual tax return the business address it provided.

---
I, {firstName7}, {lastName8}, release and forever discharge and hold harmless the Pitkin County Business Grant (The Grant) citizen review committee and staff, the staff and Board of County Commissioners of Pitkin County, and the staff and Board of Directors of the Aspen Community Foundation and its successors and assigns (“Released Parties”) from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arises or may hereafter arise from my submitting this application, and providing the information requested by the application in order to review eligibility, and from any decision whether to provide me with The Grant. I understand and acknowledge that this Release discharges the Released Parties from any liability or claim of any kind or nature whatsoever that I may have against the Released Parties that may result from my application for The Grant. I further understand that the Released Parties do not assume any responsibility for or obligation to provide me with financial or other assistance or to keep the information I submitted confidential.
Signature

Clear
Page 3

APPLICANT INFORMATION:
Name of Business Applying for Grant *
First Name of Applicant *
Last Name of Applicant *
Applicant Email *
example@example.com
Applicant Phone Number *

Area Code Phone Number
Are You the Owner *

Yes No
Position
Name of Owner

First Name Last Name
Business Owner Email
example@example.com
Business Owner Phone Number

Area Code Phone Number
Owner's Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

REQUIRED MATERIALS
Required Materials: Please review the list of required documents prior to starting your application. The information in your revenue and asset reports must match the answers in your application and must be uploaded in a PDF format and submitted with your application. We reserve the right to request tax returns or other applicable documentation.
1. Back up for 2020 revenue number — labeled ‘BusinessName_2020Revenue’. Acceptable documents (just one is necessary):
  - Point of sale revenue reports
  - Accounting software reports
  - Copies of financial ledgers
2. Back up for 2019 revenue number — labeled ‘BusinessName_2019Revenue’. Acceptable documents (just one is necessary):
  - Point of sale revenue reports
  - Accounting software reports
  - Copies of financial ledgers
3. A certificate of good standing from the Secretary of State. Business certificates can be looked up here
4. A completed W9 form — please ensure the form is complete and the mailing address is accurate to avoid delays. A blank W9 form can be found here .
Back up for 2020 revenue number — labeled ‘BusinessName_2020Revenue’ *
Back up for 2019 revenue number — labeled ‘BusinessName_2019Revenue’ *
Certificate of Good Standing *
Completed W-9 Form *
Page 5

I certify that all statements in this application are true and complete. I agree and understand that any misstatements or omissions of material facts herein is grounds for immediate payback in full of any funds granted through this program, and the Pitkin County Business Grant Committee may use any means necessary to collect the debt.
Initial: *
Date: *
Page 7

Should be Empty:

BUSINESS INFORMATION

IMPACT OF COVID-19

IMPACT OF COVID-19: Short Answer Questions

REQUIRED MATERIALS