Clone of General Counsel Interview

1
Organization Name* This field is required.
2
Organization Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Contact Name* This field is required.
First Name
Last Name
Title
4
Phone Number* This field is required.
Area Code
Phone Number
5
Email* This field is required.
example@example.com
6
Organization Type* This field is required.
Small Business
Nonprofit Organization
Arts/ Cultural Organization
Other
7
Are you in good standing with the State of Colorado?* This field is required.
Yes
No
Not Applicable- Not a Business
8
Provide proof of good standing with the State of Colorado* This field is required.
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Max. file size: 10.6MB
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9
Your project is located in what Urban Renewal Area?* This field is required.Project must be within an Urban Renewal Area to be eligible.
Please Select
Please Select
Downtown Expanded
North Pueblo
Union Avenue
Lake Minnequa
Lower Westside
West Pueblo
Colorado Smelter
Mitchell Park South
Eastside
Dillon Drive
10
Site Ownership Status* This field is required.
Owner
Leaseholder
Written Permission from owner
Other
11
Please provide proof of selected status.* This field is required.
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12
LAUNCH Grant Fund Eligibility* This field is required.Funds must be used for physical improvements only by completing this application you attest that the project meets these criteria. If found to be inaccurate you may be ineligible for current and/or future funding considerations.
Code/ Life-safety upgrades
Facade or storefront improvement
ADA accessibility improvement
Public-facing lighting or signage
Streetscape or frontage improvement
Public art installment
Other
13
Brief Project Description* This field is required.Describe the project, the existing conditions, and what physical changes will be the result of this investment.
Huge
Large
Normal
Small
Ok
Ok
14
Community Benefit* This field is required.Describe how this project benefits the surrounding neighborhood, businesses, or community within the URA.
Huge
Large
Normal
Small
Ok
Ok
15
Conditions and RenderingsPlease provide photographs of the existing conditions and any project renderings.
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Max. file size: 10.6MB
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16
Project Budget* This field is required.Provide a summary of project costs below.
17
Project Funding Sources* This field is required.Provide a summary of project funding sources.
18
Project Gap* This field is required.Total Project Funding- Total Project Cost= Project Gap
19
LAUNCH Grant amount requested* This field is required.Must not exceed $25,000
20
Project Readiness* This field is required.When can construction or implementation begin?
Immediately
Within 30 Days
Within 60 Days
Within 90 Days
Other
21
Certification SignatureBy signing this form, you certify that all information provided is true and accurate, funds will be used only for eligible capital costs and will comply with all applicable laws and PURA requirements.
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