Small Business COVID-19 Recovery Grant Application

**PLEASE DO NOT CLOSE YOUR BROWSER BEFORE COMPLETING THE FULL APPLICATION. IT WILL NOT SAVE.** U.S. Housing and Urban Development Department (HUD) requires that we obtain the following information from all applicants to the Grant. This information is used by the City to determine the eligibility of the applicant under HUD guidelines and is not shared with an outside party. You must be eligible in order to participate in the Grant. The information you provide on this form is kept in strict confidence. Please complete all applicable spaces on this document and be sure to sign the last page. Any incomplete applications will cause delay in your grant approval and contract. Before you start… • Make sure to have a copy of your lease or tax/mortgage bill • General costs/budget for how you will use the grant • A DUNS number. You can get a number or look yours up here: https://www.dnb.com/duns-number.html If you need assistance completing this application, please contact Pardis Saffari at psaffari@cambridgema.gov and someone will assist you.”

2. Did you apply to the City of Cambridge Small Business COVID-19 Relief Grant offered between March 26-May 1, 2020?*

At the end of this form, please attach terms, length, and expiration date of present lease (attach full lease)

10. Ethnicity

Choose only the one that applies to you:

11. Gender

Choose one or more that apply to you:

Select or enter value
Caret IconCaret symbol
Is your business women-owned?*
Is your business minority owned?*
13. Does the applicant or co-applicant owe any property taxes or fees to the City of Cambridge?*
14. Is the applicant or co-applicant involved in a political campaign?*
15. Is the applicant or co-applicant a candidate or public official or foreign official?*
16. Is the applicant or co-applicant an immediate family member of a political official?*
17. Is the applicant or co-applicant a business entity formed by or for the benefit of any public official?*
18. Is the applicant or co-applicant a member of a local board or committee?*
19. Has the applicant or co-applicant received or expected to receive, a financial interest or benefit from a CDBG-related activity or contract?*
20. Does the applicant or co-applicant have an immediate family member who received or expected to receive, a financial interest or benefit from a CDBG-related activity or contract?*
21. Does your business sell cannabis, cannabis products or use your property for the manufacturing, storing of cannabis?*
23. All of the following criteria must be met for participation in the Grant: must meet the HUD Eligibility Requirements to the Small Business COVID-19 Program in one of three ways:*

Note: view NRS area here: https://www.cambridgema.gov/-/media/Files/CDD/Maps/NRS/cdbg_nrs_map_2015.pdf

25. Number of family members/low-mod income

Definition of Family: All related, immediate family members living in the same household. e.g.: husband, wife, children, grandparents, aunts, uncles, cousins.

Explanation of how you plan on using this grant and documentation showing the costs associated with your need, such as rent, future inventory, or purchase of Personal Protective Equipment (PPE). Failure to include documentation that proves costs associated with your need will cause delay in application review. Accepted forms of supporting documentation include: copies of lease or mortgage agreement, invoices for inventory, or quotes for purchases. If invoices or quotes include costs that you do not want the grant to cover, you must highlight items you wish to have reviewed. Please upload no more than 6 separate items at the end of this form. If you have multiple invoices or quotes, please consolidate your items into a single document to demonstrate need.

If so, list below. If the business or its owner applies for such assistance or receives an award after the date of its application or award from the Cambridge Small Business COVID-19 Recovery Grant, it must immediately disclose such application and/or award. Please note – businesses cannot use awarded funds for the same items. For example, if you received a loan/grant to help you pay for June rent, you cannot use the Recovery Grant to also pay for June rent. Each fund should cover a different cost for your business. Please include the following: • Program/Agency • Date of Application • Amount of Application • Purpose of Application • Amount of Award

Do you run a brick and mortar, local, for-profit retail, restaurant, and personal services (e.g. hair salon or massage) business open to the public?*
Do you run a brick and mortar, local, for-profit business that is open for appointment or special services (e.g., medical services, insurance, real estate, day care)?*

Please upload the following documents: 1. Full Lease (refer to Question #9) 2. Two years of personal federal tax returns (refer to Question #24) 3. Proof of Need (refer to Question #29)

Drag and drop files here or

The undersigned hereby represents and certifies to the best of their knowledge and belief that the information contained on this statement and any exhibits or attachments hereto are true and complete and accurately describe the proposed project(s). The undersigned understands that no grant amount will be distributed until an electronic receipt of notice to proceed from the City. The City of Cambridge has the right to terminate any agreement under the Small Business COVID-19 Recovery Grant if a participant is found to be in violation of any conditions set forth in these guidelines or if the project has been started prior to an executed agreement with the City of Cambridge. Please type your signature here:

Powered by Smartsheet Modern Logo On Light
Privacy Notice|Report Abuse