TOWN OF BARNSTABLE COVID-19 EMERGENCY SMALL BUSINESS GRANT PROGRAM

TOWN OF BARNSTABLE COVID-19 EMERGENCY SMALL BUSINESS GRANT PROGRAM
INTRODUCTION:
The Town of Barnstable and the Hyannis Main Street Business Improvement District (HMSBID) has established the COVID-19 Emergency Small Business Grant to assist in the stabilization of existing small businesses within the Barnstable that have had significant business disruption due to the impact of COVID-19. These grant funds will assist small and microenterprise businesses in the Town of Barnstable to cover wages, rent, utility bills, loss of inventory, and other fixed costs. Should the program be successful, potential to expand the grant to more businesses will be considered. Please apply by 5 pm on March 1, 2022 via email to elizabeth@hyannismainstreet.com or by dropping it off to 491A Main Street, P.O. Box 547, Hyannis, MA 02601.
ELIGIBLE APPLICANTS:
- Have a physical establishment within the Town of Barnstable with 5 or less employees.
- The business owner must be low- to moderate-income (see income thresholds below
- Have experienced a loss of revenue of 2% or more due to COVID-19 since March 10, 2020.
- Have less than $2,000,000 in gross annual receipts.
- Have no outstanding tax liens or legal judgments.
- Business owners must reside in and file their taxes in the United States.
INELIGIBLE APPLICANTS:
Ineligible applicants include, but are not necessarily limited to, franchisees of national or regional chain businesses, independent contractors, check cashing agencies, gun shops, pawn shops, liquor stores, adult entertainment businesses, smoke shops, and dollar stores.

The Town reserves the right to reject any application that is incomplete or does not meet the Program Requirements in the sole opinion of the Planning and Development Department. In addition, the Town may decide on a case-by-case basis to reject any application that does not meet and advance the goals of this Program.
APPROVED USES OF FUNDS:
Employee payroll costs, loss of inventory, rent, utility payments, and other fixed costs. Funds cannot be used for facade improvements, website design, or other non-emergency, non-fixed costs. The business owner will be required to provide supporting documentation and receipts for expenditures. Business owners must certify that they will not duplicate benefits. Once receipts are provided, the business will be reimbursed by the Hyannis Main Street Business Improvement District (HMSBID). Receipts cannot predate March 10, 2020.
FUNDING SOURCE:
Funding for this program will be provided through the Town's Community Development Block Grant funds (CDBG-CV), allocated by the United States Department of Housing and Urban Development (HUD).
AMOUNT OF FUNDING:
$10,000 maximum for 10 eligible businesses with demonstrated expenses greater than or equal to the amount requested.
REQUIRED SUBMISSIONS:
1.Completed application form (enclosed).

2.Copies of the 2019, 2020, and 2021 business returns with gross revenue

-Personal tax returns for all owners/principals with a 20% or greater ownership interest in the business.

-Tax documents for all members of the business owners household.

-Any information relating to additional income accounts i.e., retirement account information

-Demonstrate that the COVID-19 outbreak has caused at least a 25% decrease in revenue.

a.Documentation could include bank statements, profit & loss statements signed by an accountant, etc.

-Completed IRS W-9 form.
COMPLIANCE WITH FEDERAL FUNDS, LAWS, AND REGULATIONS:
Applicants must comply with all applicable laws, including being subject to an Environmental Review Request (ERR) per 24 CFR Part 58.
HUD ELIGIBILITY REQUIREMENT:
The CDBG Funding Pool for this program is based upon the HUD eligibility of Special Economic Development Activities under 24 CFR 570.203(b In order to be eligible for CDBG funding, each applicant must qualify as a low- to moderate-income individual as defined as making up to the below:
CONTACT INFORMATION:
For further information pertaining to this program or to obtain an application, please contact Elizabeth Wurfbain: (P): (508) 775-7982, elizabeth@hyannismainstreet.com or Elizabeth Jenkins at the Planning and Development Department: elizabeth.jenkins@town.barnstable.ma.us
Town of Barnstable COVID-19 Emergency Business Grant Program Application
Name

First Name Last Name
Home Address:
Street
City
State
Zip Code
Business Name:
Business Address:
Street
City
State
Zip Code
Phone Number
Please enter a valid phone number.
EIN
Email Address
example@example.com
Business Organization Type:

Sole Proprietor Corporation Partnership Limited Liability Company

Ownership/Management:

	Name	% Interest Owned	Title
Ownership/Management:
Ownership/Management
Ownership/Management

Please provide a brief narrative of the impact COVID-19 has had on your business:
Business Phone
Business Email
example@example.com
Are you a Women-Owned or Minority-Owned Business?

Yes, women-owned Yes, minority-owned Both None
Do you rent or own your property?

Rent Own
Please provide a brief description of your business:
Please describe the decline in revenue your business experienced due to the COVID-19 pandemic and when that decline was at its most severe.
Business DUNS Number
You are not eligible for CARES Act assistance without a DUNS number. More information can be found here: https://www.grants.gov/applicants/organization-registration/step-1-obtain-duns-number.html. Please note, a DUNS number can take up to 3 days to obtain.
I confirm that I can and will spend the $10,000 grant for emergency small business assistance by December 30, 2022 and that I can provide receipts to support each of these expenses that kept my business running. I also confirm that I understand the funds will be recaptured if they are not spent on CDBG-CV eligible expenses.

Yes No
Years in Business
Years at Present Address
Type of Business
Average Gross Annual Receipts
Please indicated the square footage of the occupied space
Amount of Personal Funds Invested in the Business to Date
Grant Amount Requested
Present Number of Employees
Full-Time
Part-Time
Jobs Expected to be Retained as a Result of this Grant (Please designate Full Time or Part Time):
Full-Time
Part-Time
Lease Expiration Date:
Monthly Rent
Use of Funds: Please describe how the COVID-19 Small Business Resiliency Grant will be used to help your small business retain employees and keep your business operating during this challenging time? Please note supporting documentation i.e., a lease for rent payments, must be provided.
Use
$
Use
$
Use
$
Use
$
Use
$
Total $
What other sources of funding did you receive for COVID-19 relief (if any)? For example, PPP, EIDL or unemployment assistance. Please note, we need proof of this documentation in your application if you received other funding sources.:
While we understand that there is uncertainty, the Town of Barnstable hopes that businesses receiving a grant award will successfully persevere through the COVID-19 recovery. Please describe your plans and ability to persevere, and how you are taking measures to ensure the continued viability of your business:
Please describe the economic and/or community benefits your business creates for the Town of Barnstable. Please include any community involvement you participate in:
TOWN OF BARNSTABLE, MASSACHUSETTS INCOME CERTIFICATION FORM FOR ALL CDBG PROGRAMS
THIS SECTION IS TO BE COMPLETED BY APPLICANT
To the applicant: The Town of Barnstable is providing you assistance through funds from the United States Department of Housing and Urban Development (HUD Federal requirements ask that the following information be supplied. This information will be kept on hand at the Community Development Department for possible review by Federal agencies and will be kept confidential and not for public distribution. Your cooperation in the completion of this form is appreciated.

NOTE: The following information is subject to verification by government officials.
Are you a resident of the Town of Barnstable?

Yes No
What is your current residential address?
Please check the number of people in your family, including yourself:

1 - $54,450 2 - $62,200 3 - $70,000 4 - $77,750 5 - $84,000 6 - $90,200 7 - $96,450 8 - $102,650
Is your total family income for the last 12 months less than or equal to the amount indicated for the size of your family? (Please be sure to include all sources of family income)

Yes No
For reporting purposes only, please answer the following questions:
Sex:

Female Male
Handicapped:

Yes No
Single Family Head of Household:

Yes No
Please identify the appropriate racial and ethnic category below:

American Indian/Alaskan Native American Indian/Alaskan Native & Black/African American Asian Asian/Hispanic Black/African American Black/African American & White Black/Hispanic Native Hawaiian Other Pacific Islander White White/Hispanic Other Multi-Racial
I certify that the above information, to the best of my knowledge is accurate and true.
Business Name
Authorized Representative
Title
Date

Month Day Year
Date
Application / Eligibility Checklist:
maintains all proper licenses and permits for operation.

I confirm that my business is located within the Town of Barnstable and the business maintains all proper licenses and permits for operation. I certify that my revenue has declined by 25% or more as a result of COVID-19 since March 10, 2020 I certify that the average annual gross receipts of the business is less than $2,000,000 I have attached a copy of the most recent personal tax returns for owners with 20% or more ownership interest. I have attached a completed IRS W-9 Form. I agree to provide documentation to help verify the economic hardship suffered as a result of COVID-19, including financial statements, and other data as applicable. I agree to document and report the economic impact as a result of this grant, including but not limited to, jobs retained, increased sales, participation in other relief programs. Pursuant to Massachusetts General Law, Chapter 62C, Section 49A(b), I confirm that I have complied with all laws of the Commonwealth of Massachusetts and the Town of Barnstable and I am with all local, state, and federal taxes. I certify that I am authorized to submit this application and execute a grant agreement on behalf of the business entity listed. I certify that submitting this application in accordance with the below instructions constitutes an electronic signature.
SUBMISSION INSTRUCTIONS
BY EMAIL:
Completed application forms and all attachments should be sent via email to elizabeth@hyannismainstreet.com. You may also drop off a completed application to 491AA Main Sreet, P.O. Box 547, Hyannis, MAA02601. Please apply by 5 pm on March 1, 2022.

If you have questions about the application requirements or have any issues with submitting any of the required documents, please email elizabeth@hyannismainstreet.com or elizabeth.jenkins@town.barnstable.ma.us and someone will assist you.

The Town of Barnstable does not discriminate in its programs and activities on the basis of age, color, gender expression/identity, genetic information, marital status, national origin, physical or mental disability, pregnancy, race, religion, sex, sexual orientation, or veteran status, as applicable.
Duplication of Benefits Affidavit
Date

Month Day Year
Date
Business Name
DUNS Number
Part 1
This section identifies any sources of funds that the subrecipient has applied for or received other than insurance. A duplication of benefits (DOB) occurs when a person, household, business, government, or other entity receives financial assistance from multiple sources for the same purpose within the same time period, and the total assistance received is more than the total need. Within the CDBG-CV program, all grantees are bound by Section 312 of the Stafford Act, as amended by the Disaster Recovery Reform Act, and the OMB Cost Principles within 2 CFR part 200. Sources of funds include but are not limited to: federal, state and local loan/grant programs, private or bank loans, nonprofit donations or loans. Please mark any of the boxes below which apply to your business regarding any prior assistance:

I HAVE NOT applied for or received funding assistance from Federal, state, local programs or from other sources. I HAVE received funding assistance from the following programs to assist in responding to the impact of the Covid-19 Global Health Crisis:
1) Lender/Grant Program Name:
Amount requested:
Amount received:
Date received:

Month Day Year
Date
How funds are being used (please be specific):
2) Lender/Grant Program Name:
Amount requested:
Amount received:
Date received:

Month Day Year
Date
How funds are being used (please be specific):
3) Lender/Grant Program Name:
Amount requested:
Amount received:
Date received:

Month Day Year
Date
How funds are being used (please be specific):
I have APPLIED FOR funding assistance, and my application is PENDING from the following programs:
1) Lender/Grant Program Name:
Amount requested:
How funds will be used (please be specific):
2) Lender/Grant Program Name:
Amount requested:
How funds will be used (please be specific):
3) Lender/Grant Program Name:
Amount requested:
How funds will be used (please be specific):
Part 2: CERTIFICATION
As a recipient of CDBG funds under the applicable Agreement, I assert that:

1.I will not apply for more funding than needed for the eligible activity or project for which CDBG funds are provided. For example, if I have $100 available from another source towards each monthly gas bill and I am applying for SBG funds to pay for my total monthly gas bill of $500, SBG funds will be limited to $400 per month.

2.I understand that duplication of benefits (DOB) are prohibited under the federal Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act).

3.I will immediately report to the Town of Barnstable Planning & Development Dept. if I apply for or accept any financial assistance from other funding sources (federal, state, local or private) that constitute a duplication of benefits received.

4.I acknowledge that any duplication of funds may either have to be paid back to the Town or that the grant funds may be reduced by a corresponding amount.

5.I understand that this affidavit is appended to and part of the applicable Agreement executed with the Town for CDBG funds and is a condition of the receipt of such funds.

I certify that the information that I have provided above is an accurate and complete disclosure. I understand that to perjure myself in order to obtain assistance is a fraudulent offense for which I can be prosecuted.
Date

Month Day Year
Date
Business Applicant signature

Clear
Business Applicant printed name
Additional CDBG-CV Requirements

In addition to the terms and conditions in the Funding Approval/Agreement, the following requirements apply to Grantees receiving CDBG-CV funds in accordance with the Coronavirus Aid, Relief and Economic Security Act (CARES Act) (Pub. L. 116-136).

1) The Grantee agrees to comply with the requirements in the CARES Act that apply to CD BG-CV grants and must use the CDBG-CV grant funds to prevent, prepare for and respond to coronavirus.

2) The grantee agrees to comply with the requirements of the Housing and Community Development Act of 1974 (42 USC 5301 et seqand implementing regulations at 24 CFR part 570, as now in effect and as may be amended from time to time, and as modified by the rules, waivers and alternative requirements published by HUD from time to time. Rules, waivers and alternative requirements of Federal Register notices applicable to CD BG-CV grants are hereby incorporated into and made a part of the grant agreement.

3) The Grantee may use CDBG-CV funds as reimbursement for previously incurred costs, provided that those costs are allowable and consistent with the CARES Act's purpose to prevent, prepare for and respond to coronavirus.

4) The grantee agrees to establish and maintain adequate procedures to prevent any duplication of benefits as required by section 312 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5155), as amended by section 1210 of the Disaster Recovery Reform Act of 2018 (division D of Public Law 115-254; 132 Stat. 3442

5) The period of performance for the funding assistance specified in the Funding Approval/ Agreement ("Funding Assistance") shall be six years. It shall begin on the date specified in item 4 in the Funding Approval/Agreement and shall end six years later, on the month and day specified in item 4. The Grantee shall not incur any obligations to be paid with the Funding Assistance after this period of performance.

6) The Recipient shall attach a schedule of its indirect cost rate(s) in the format set forth below to the executed Funding Approval/Agreement that is returned to HUD. The Recipient shall provide HUD with a revised schedule when any change is made to the rate(s) described in the schedule. The schedule and any revisions HUD receives from the Recipient shall be incorporated herein and made a part of this Funding Approval/Agreement, provided that the rate(s) described comply with 2 CFR part 200, subpart E.

Administering Direct

Department/Agency Indirect cost rate Cost Base

_______________ ________% ______ ___

_______________ ________% ______ ___

_______________ ________% ______ ___

_______________ ________% ______ ___

_______________ ________% ______ ___
Should be Empty:

TOWN OF BARNSTABLE COVID-19 EMERGENCY SMALL BUSINESS GRANT PROGRAM

INTRODUCTION:

ELIGIBLE APPLICANTS:

INELIGIBLE APPLICANTS:

APPROVED USES OF FUNDS:

FUNDING SOURCE:

AMOUNT OF FUNDING:

REQUIRED SUBMISSIONS:

COMPLIANCE WITH FEDERAL FUNDS, LAWS, AND REGULATIONS:

HUD ELIGIBILITY REQUIREMENT:

CONTACT INFORMATION:

Town of Barnstable COVID-19 Emergency Business Grant Program Application

Home Address:

Business Name:

Business Address:

TOWN OF BARNSTABLE, MASSACHUSETTS INCOME CERTIFICATION FORM FOR ALL CDBG PROGRAMS

THIS SECTION IS TO BE COMPLETED BY APPLICANT

Application / Eligibility Checklist:

SUBMISSION INSTRUCTIONS

BY EMAIL:

Duplication of Benefits Affidavit

Part 1

Part 2: CERTIFICATION