Home 5 Employers 5 When Natural Disasters Strike 5 Pajaro Disaster Assistance – Round 2 Beautification Request 5 Pajaro Disaster Fund Round 2 – Beautification New Business Application Pajaro Disaster Fund Round 2 – Beautification New Business Application Pajaro Small Business Beautification Request - Round 2 Application (New Business Applicant) SECTION 1. BUSINESS INFORMATION1. Preferred language for communication:(Required) English Spanish Other 2. Business name (Legal Entity and DBA):(Required)3. Date established (MM/DD/YYYY):(Required) MM slash DD slash YYYY 4. Business phone number:(Required)5. Business Address (on March 10, 2023):(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 6. Business website address: 7. Business owner's first, middle, last name:(Required) First Middle Last 8. Business owner's home address on March 10, 2023:(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 9. Business owner's phone number:(Required)10. Business owner's email address:(Required) 11. Primary contact's first and last name (if different from business owner): First Last 12. Primary contact phone number:13. Primary contact email address: SECTION 2. DISCLOSURES14. Was the business in operation prior to March 10, 2023?(Required) Yes No 15. What is the current status of your business?(Required) Fully open Open with restrictions Temporarily closed Permanently closed 16. Has the business received any funds from the following?(Required) Federal Emergency Management Agency (FEMA): Rental Assistance Federal Emergency Management Agency (FEMA): Personal Property Compensation Federal Emergency Management Agency (FEMA): Vehicle Compensation Insurance: Flood Insurance Compensation Insurance: Homeowners Insurance Compensation Insurance: Personal Property Compensation Insurance: Vehicle Compensation State Compensation/Assistance: CalFresh Disaster Assistance State Compensation/Assistance: Storm Assistance for Immigrants State Compensation/Assistance: Disaster Unemployment Assistance Small Business Administration (SBA) Non-Profit Assistance, Gift Cards, Cash and/or Donated Goods/Services County Assistance Programs I have NOT received any of the above listed assistance I have received a different type of assistance than what is listed above Check all that apply.16a. If you have received a different type of assistance than what is listed in #16, please specify:17. If you selected one of the options in question #16, how much financial assistance did the business receive in total?17a. How were the funds used?SECTION 3. GRANT REQUEST INFORMATION18. The business building is:(Required) Owned by the business owner Rented from a landlord If the business owner does not own the building, written approval from the landlord guaranteeing that the tenant will neither be evicted nor have rent increased after beautification is completed is required.19. Total amount requested for Round 2 - Beautification ($15,000 maximum):(Required)Please enter a number less than or equal to 15000.The amount entered must match the Beautification Request Form.20. What beautification work do you want to request funding for? Check all that apply.(Required) Exterior / Interior Painting Landscaping Fascia / Signage Lighting Security Cameras Driveway / Parking Lot Other (Please Specify) * All repairs and beautification work are required to be completed by a licensed contractor.20a. Please elaborate:SECTION 4. DOCUMENTATIONThe following documentation is required and must accompany your application. Please ensure that no documents are missing. Required documentation subject to change to allow as much flexibility as possible. Government-Issued Photo Identification such as Driver’s License, Identification Card, Passport / Passport Card, US Military Identification Card, etc. Utility Bill, Lease Agreement, or Credit Card Statement Valid on March 10, 2023 to verify that the business owner’s residence is either in Monterey County or within a 20-mile radius of Pajaro. 2022 Federal Tax Return Schedule C / Form 1040 to verify the business’ authenticity. Request for Taxpayer Identification Number and Certification / Form W-9 attesting the business’ information to enable payment. Withholding Exemption Certificate / Form 590 attesting the business’ headquarters location required by Monterey County Auditor-Controller to process payment to businesses. Vendor Data Record Form required by Monterey County Auditor-Controller to issue payment to approved businesses. Beautification Request Form accompanied by beautification quotes from licensed contractors that match the items and totals listed. Quotes from Licensed Contractors that match the items and totals listed for beautification work that has not yet been done. Written Approval from Landlord guaranteeing that the tenant will neither be evicted nor have rent increased after beautification if the business owner does not own the building. Upload your documentation here:(Required) Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 128 MB. SECTION 5. CERTIFICATIONI hereby certify that I am authorized to commit the business to legally binding contracts and agreements. I further certify that the information given as part of and attached to this application are accurate and true. I am aware that any false information or intended omissions may subject me to civil or criminal penalties for filing of false public records and/or forfeiture of any funds approved through this program. I attest that my business meets all the requirements listed below: Business is owned, operated, and located in Pajaro on one of the streets in either the evacuation or flood zone. Business was established and in operation prior to March 10, 2023. Business owner resided either in Monterey County and/or within a 20-mile radius of Pajaro prior to March 10, 2023 Business experienced financial losses and/or building damage as a result of the flood. Business is not requesting duplication of benefits previously received from FEMA, insurance, state compensation, nonprofits, etc. I understand and agree that: The Monterey County Workforce Development Board (MCWDB) exercises the right to share my business’ information with other agencies as needed to properly determine funding eligibility. All funds issued that are later determined to be a duplication of benefits or are not used for approved beautification are required to be repaid to the MCWDB within 60 days or may lead to litigation. Funding is not guaranteed as it is subject to availability of funds, meeting the eligibility requirements, and providing all requested documentation and information. The MCWDB is not authorized to provide legal and/or tax advice to applicants. All businesses requesting Phase 2 Beautification funding must undergo onsite inspections before and after completion of approved work by a licensed contractor. I declare under penalty of perjury that if awarded a grant, I commit to only using the funds for one or more of the following eligible expenses: Exterior/Interior Painting Landscaping Fascia/Signage Lighting Security Cameras Driveway/Parking Lot