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Wheat Ridge Small Business Stabilization Program Application - Round 2

  1. ALL APPLICATIONS ARE DUE JUNE 5 BY NOON and MUST INCLUDE THE FOLLOWING ITEMS AT TIME OF SUBMITTAL:

    W-9. (If selected, the grant applicant may be required to provide additional documentation.)

  2. Verification of Eligibility:

    Businesses with 0-25 full-time equivalent employees (prior to COVID-19 impacts); For-profit, independently owned local business in a property zoned Commercial or Industrial; Home-based business not eligible; Physical establishment within the City of Wheat Ridge; Business in operation as of January 1, 2020; Have a verifiable hardship directly due to COVID-19; Funds to be used for operational needs such as lease/mortgage payments, payroll, materials, supplies and services; Business is in good standing with the City of Wheat Ridge (e.g., no liens or judgments, etc.), Independently owned franchises with 1-25 employees within the applicants corporate holdings are eligible to apply.

  3. Maximum Grant Funding:

    Any single business is eligible to receive a maximum of $5,000 in grant funding between rounds one and two of this program. Previous grant awardees should deduct any previous award amounts from this request for a total not to exceed $5,000.

  4. Certification:

    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 that the City of Wheat Ridge may use any means necessary to collect on this debt.

  5. Contact Information

  6. Business Information

  7. Please list the names and share of ownership of all other business owners:

    If no ownership share, please put NA in the box

  8. Type of Buisness Entity:*

  9. Primary Business Activity*

  10. *This does NOT include locations owned and/or operated by other franchisees.

  11. Are you considered a booth renter or rent space in a common area of an active business (i.e. Hair, nail, massage, esthetician, antiques)?*

  12. Enter up to 300 characters. Include what the business produces and how it generates revenue.

  13. Days of the week and hours of operation

  14. Impact COVID-19

  15. Enter up to 1500 characters. Please address impacts on revenues, number of employees, modified business hours, etc. (verification may be required).

  16. Day/Month/Year

  17. What are the impacts to your business? (Check all that apply)*

  18. Financial Information

  19. Do you have active and current business license with the City of Wheat Ridge (While you may apply for grant funds without a business license, no funds will be distributed until such time a business license has been APPROVED by the City of Wheat Ridge)*

  20. Is the business compliant and fully paid for all City and County taxes, fees, and licenses?*

  21. Does the business or owner have any outstanding liens or judgments?*

  22. Is the business or business owner currently the subject of any litigation? *

  23. Grant Information

  24. A total of $5,000 can be awarded for both rounds of funding through this program. One application per business and/or individual.

  25. Supplemental Information

  26. Please attach the following required documentation.

    If selected to receive a grant, applicant may be required to provide additional documentation including most recent tax returns, 941s, etc. The City of Wheat Ridge reserves the right to review the status and use of grant funds and pursue legal action for misuse of funds

  27. Disclosure Information

  28. The City of Wheat Ridge understands and supports the public’s right to access public records. Information submitted through this application is a public record and is subject to disclosure under the Colorado Public Records Act (CORA). In addition, the City of Wheat Ridge may be required to disclose information by subpoena, civil-investigative demand, or court-ordered or court-authorized discovery. ** By submitting this application, applicant certifies that all information is true and correct. Applicant acknowledges that they may be required to provide additional documentation including most recent tax returns, 941s, credit report, lease agreement, etc.

  29. I agree that any information submitted through this application may be subject to disclosure under the Colorado Public Records Act or through another legal process*

  30. I agree that any violation of “all applicable local and state health orders” at the business is a basis for unilateral cancellation of the grant and acknowledgement on the part of the grantee that its failure to promptly repay the grant in that event will result in the filing of a lien on the property for recovery of the grant amount and the costs of collection.*

  31. Submit

  32. Applications may only be submitted electronically through this form. Call (720) 454-9040 with questions.

  33. Leave This Blank:

  34. This field is not part of the form submission.