2. Name *
4. Phone*
5. Email*
7. Address *
8. Is a business currently in the building?*

   1. Yes
   2. No
10. Business
12. Total Project Cost*
13. (The City will fund up to $10,000 of project costs on a reimbursement basis. Applicants must match a minimum of 25% of project costs. Ex: for a project costing $12,000 the City would reimburse 75% or $9,000)
15. Other Required Information
    Description of Need: (Use separate sheet(s) of paper) Other required Documents: 1. Well Developed Business Plan Including: a. Profit/Loss Statement and projections for future years 2. Personal Tax Statements for all principals of the business for the past 3 years 3. If an existing business, Federal Business tax returns for the past 3 years 4. Quotes from a Certified Contractor to complete the project 5. * If no business is currently in the building, lay out the plan for filling the building with a tenant and how this project will assist in that effort.
16. Upload Required Information*
18. Do you have a current City Business License and are you up to date on all utility bills and taxes? *

    1. Yes
    2. No
20. Agreement
    I have read the Small Business Incentive Plan and understand its purpose, intent, and that submission of this application does not guarantee funding. Should I be awarded a grant I also understand that I will be held to performance standards such as maintaining normal business hours, meeting with City officials bi-annually, and creating additional jobs within the community. I have also been made aware that the City reserves the right to perform background and credit checks as part of the application process. Finally, by signing below I understand that any false information given in this application or not following other terms will result in a violation of the agreement, which may require repayment of the awarded funds.
22. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
24. Electronic Signature
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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

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