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PROGRAM GUIDE

Micro-Business RESTART Grant Program

For Businesses with 4 or Fewer Employees

Local Goal

Provide small businesses impacted by COVID-19 with immediate financial business assistance in the form of grants using CDBG-CV funds.

Funding will be made available to businesses that are able to retain or add new employees that are low to moderate income individuals. Please refer to income levels below.

Funding Source City of West Allis CDBG-CV

Program Funding Amount

$60,500

Availability:

Open application period will commence on Friday, May 15, 2020, with applications due by close of business on Friday, May 22, 2020. Time of submittal is one factor that will be used as criteria for selection of the grant award.

Overview

• Provide up to $5,000 in the form of a one-time grant to for-profit

micro-businesses with 1-4 employees including the owner.

• Must retain or create a position for one or more full-time employee (FTE)

• Employees will self-certify that their household is low to moderate income. (see Income Levels and Family Chart (2019) on page 4 below. In order to do this

please complete the "Beneficiary Profile Report" located on pages 7 & 8

• Full-time Employee is defined as 40 hours

• Funds to be used to support business activities in the City that include: support

the cost of rent, utilities, payroll, inventory, etc.

Program Administration

• The Wisconsin Women’s Business Initiative Corporation (WWBIC) is responsible for the administration, tracking and reporting of this grant program.

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Eligible Businesses

Eligible Businesses will be Required to meet the following:

☐ Existing West Allis business that is in an industry outlined below

☐ Have a customer storefront (e.g. restaurants, salons, retail shops,

etc.) business with 1 - 4 FTEs at time of application (may include owner)

☐ Ability to verify an employee's household is low to moderate

income (income limits found on pg. 4 of Program Guide)

☐ Operating for at least 6 months or more in the City of West Allis

☐ Local franchisee without access to franchisor financial support

☐ Valid Commercial Occupancy Permit and in good standing with the City of

West Allis

Business must demonstrate the following:

1. The Company can demonstrate a loss because of the Emergency Orders 2. Have a bricks and mortar business located within the City of West Allis

3. The company needs working capital to support payroll expenses (in need of funds to retain or hire staff), utility expenses, or other similar expenses that occur in the ordinary course of business

Type of Businesses Eligible:

Retail Trade: General Merchandise Stores, Variety Stores, Food and Beverage/Event Places, Candy/Nut and Confections stores, Retail Bakeries, Apparel, and Accessory Stores, Florists, and Consignment/Resale Shops

Services: Dry Cleaners, Barbershops/Beauty Salons, Spas/Message, Nail Salons, Tattoo, Tanning Salons, Physical Fitness and Yoga/Dance Facilities, Photographers, Veterinary/Pet Groomers, Opticians, Printers, Day care, Driving Schools

Clinics of: Dentists, Osteopaths, Chiropractors, Podiatrists, Health and Wellness Practitioners, Acupuncturists

Ineligible Businesses for the Program

Types of Businesses Ineligible:

• Nonprofit Organizations

• Gas Stations, Banks, Mental Health Counselors / Psychiatrists, Physicians, Lawyers, Real Estate Agents, Insurance Agents, Accounting services, Computer services, Financial services, Auto Mechanics, Grocers, Professional Offices, Funeral Homes, Pharmacies, Thrift Stores, Used Car Sales & Tobacco/Vape

• Home-Based businesses

• Payday loan businesses, liquor and tobacco stores, pawn shops, firearm or other weapon dealers, adult entertainment, and passive real estate investments

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Required Documents

• Micro-Business Restart Program Application

• Completed IRS-W (W-9 form)

• Completed Required Assurance form

• Proof of employees at time of application (payroll register or equivalent)

• Employee Family Income form

• Lease agreements

Process

• Application submitted to Thalia Mendez, thalia.mendez@wwbic.com • Application reviewed for compliance and selection criteria • Grant Amount calculated

• Staff review of applications with recommendation forwarded to the City for approval.

• Staff prepares grant contract relating to the funds and for the business to sign • Disbursement of funds

Selection Criteria

1) Complete application with required additional documents: W-9, Required Assurances, and Proof of employees at time of application

2) Must be an eligible business 3) Must demonstrate losses based on mandated COVID closures

4) Ability to hire or retain Low to Moderate Income individuals - See Income Requirements on Page 4. If there is no low to moderate income individual at time of application, proof that one has been added to the payroll must be shown prior to disbursement of any grant dollars to the applicant.

5) Did the business receive any other CARES act funding or disaster relief?

6) Geographic diversity across areas of the City 7) Unique character of the applicant’s business and roles they play in the community 8) All things being equal, first come, first serve basis

Grant Amount Calculated

1) Grants will be limited to and based upon up to 2 months of eligible rental or rental

equivalent costs up to maximum grant of $5,000.

2) For owner operated businesses, a monthly rental equivalent will be calculated based on 2% of the 2019 assessed property value applicable to business operations up to $5,000.

Proposal Costs and Payment of Fees

The City and WWBIC are not liable for any costs incurred by an applicant to prepare the RESTART application and all costs associated with this application process are the responsibility of the applicant.

Right to Reject or Negotiate

The City reserves the right to reject any and all applications, if such a rejection is in the City’s best interest. Additionally, the City reserved the right to negotiate with selected applicants and may request additional information or modification from an applicant.

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Income Limits

Family Size and Income Levels (2019)

* Verification that an employee's household meets the Low to Moderate income limits is

required in order to be eligible for this grant

Income Level 1 person 2 person 3 person 4 person 5 person 6 person 7 person 8 person

Extremely Low

17,300

19,800

22,250

25,750

30,170

34,590

39,010

43,430

Low

28,850

32,950

37,050

41,150

44,450

47,750

51,050

54,350

Moderate

46,100

52,700

59,300

65,850

71,150

76,400

81,700

86,950

Non-

Low/Moderate

45,101+

52,701+

59,301+

65,850+

71,150+

76,401+

81,701+

86,951+

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CITY OF WEST ALLIS MICRO-BUSINESS RESTART PROGRAM APPLICATION

***Applications are on a first come, first serve basis***

BUSINESS INFORMATION

Name of Business:

DBA Name (if applicable):

Mailing Address:

City: State: Zip Code:

Phone: Email:

Street Address of Operations (if different):

City: State: Zip Code:

Website: Other:

Federal EIN: Located in the City of West Allis: Yes ☐ No ☐

[Business is ineligible if outside City of West Allis]

*DUNS Number: *If not available at time of application, the DUNS number will be

required at time of the grant award

Additional information on DUNS Number can be found by clicking the link below. Please know, clicking the link will redirect you from this page and your information

will be lost. https://www.dnb.com/duns-number/get-a-duns.html

Date of Incorporation: Number of Employees:

Has business ever been subjected to criminal or civil fines and penalties including from city code or

regulatory violations? Yes ☐ No ☐

BUSINESS TYPE: Corporation☐ LLC☐ Partnership☐ Sole Proprietor☐ Other☐

BUSINESS DESCRIPTION

555

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ADDITIONAL INFORMATION

Please describe the degree to which your business has been impacted by the COVID-19 pandemic.

Please describe the degree to which your business has been able to maintain employees during this COVID-19 pandemic and whether the grant will help your business do so.

Please describe how your business positively adds to the quality of life in the City of West Allis.

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FINANCIAL IMPACT

Month Gross Revenue Notes (if applicable)

January 2020

February 2020

March 2020

April 2020

EMERGENCY FUNDING REQUEST

Expense Category Amount Requested

Payroll (e.g., Wages, Related Taxes, etc.)

Occupancy (e.g., Business Rent/Mortgage, Utilities, etc.)

Insurance (e.g., Healthcare, General Liability, etc.)

Other: Please Describe

Other: Please Describe

Other: Please Describe

Total Amount Requested

[Maximum Request: $5,000] $ 0.00

APPLICATION(S) TO OTHER FUNDING SOURCES Additional information on these funding sources can be found on page 8

Amount Requested Request Status [Received, Pending, Denied]

Program/Funding Source Name [SBA Paycheck Protection Program, SBA Economic Injury Disaster Loan, U.S. Chamber of Commerce Foundation Save Small Business

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OWNER INFORMATION -list majority owner(s) first-

Owner Name:

Residential Street Address:

City: State: Zip Code:

Phone: Email:

18 or Older: Yes☐ No☐ Percent Ownership: 0% Industry Experience (years):

Race/Ethnicity: Hispanic/Latino: Yes☐ No☐ Veteran: Yes☐ No☐

Gender: Male☐ Female ☐ Single Head of Household: Yes☐ No☐

OWNER INFORMATION -list majority owner(s) first-

Owner Name:

Residential Street Address:

City: State: Zip Code:

Phone: Email:

18 or Older: Yes☐ No ☐ Percent Ownership: % Industry Experience (years):

Race/Ethnicity: Hispanic/Latino: Yes ☐ No ☐ Veteran: Yes ☐ No ☐

Gender: Male ☐ Female ☐ Single Head of Household: Yes ☐ No ☐

OWNER INFORMATION -list majority owner(s) first-

Owner Name:

Residential Street Address:

City: State: Zip Code:

Phone: Email:

18 or Older: Yes ☐ No ☐ Percent Ownership: % Industry Experience (years):

Race/Ethnicity: Hispanic/Latino: Yes ☐ No ☐ Veteran: Yes ☐ No ☐

Gender: Male ☐ Female ☐ Single Head of Household: Yes ☐ No ☐

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APPLICANT STATEMENT:

I, , hereby certify that the information

being supplied as part of this application is complete and accurate. I understand that the information

provided may be subject to further verification by the City of West Allis. If necessary, I will provide the

information required to verify this data (e.g. payroll records, tax fillings, bank account statements,

etc.). I, therefore, authorize such verification, and I will provide the supporting documentation, if

necessary.

SIGNATURE: Date:

Name (Please Print):

Title (Please Print):

SIGNATURE: Date:

Name (Please Print):

Title (Please Print):

Please proceed to complete the following required forms:

◼ Acknowledgment of Required Assurances form, Page 6

◼ Employee Family Income form, Pages 7 & 8

◼ IRS W-9 form, Page 9

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ACKNOWLEDGEMENT OF REQUIRED ASSURANCES This page must be signed and submitted with the application. Applications which do not contain a signed Acknowledgment of Required Assurances are ineligible for consideration. By submitting the accompanying application and signing this document, I understand and agree that any award resulting from this solicitation will require compliance with the signed agreement and with the regulations, requirements, and policies identified below, including but not limited to:

• Compliance with municipal ordinances and policies of City of West Allis, WI;

• Compliance with federal and state laws requiring the safeguarding and disclosure of confidential

information;

• Maintaining program and financial records for audit review, and providing access to

documentation upon request by the City;

• Submission of program and financial reports, as required by the City;

• Certification that the applicant is a for-profit business registered in the State of Wisconsin in

good standing;

• Certification that the firm, association, corporation, or any person in a controlling capacity or any

position involving the administration of federal, state, or local funds is not currently under

suspension, debarment, voluntary exclusion, or a determination of ineligibility by any agency;

has not been suspended, debarred, voluntarily excluded, or determined ineligible by any agency

within the past three (3) years; does not have a proposed debarment pending; has not been

indicted, convicted, or has not had a civil judgment rendered against said person, firm,

association, or corporation by a court of competent jurisdiction in any matter involving fraud or

misconduct with the past three (3) years;

• Certification that the firm is not bankrupt or under an administration appointed by the Court, or

under proceedings leading to a declaration of bankruptcy; and provide any pending or known

legal actions against the company;

• Certification that, in the past seven (7) years, the organization has not had any bankruptcy

proceedings initiated against the Contractor (whether or not closed) and that there are no

bankruptcy proceedings pending by or against the Contractor regardless of the date of filing;

• All pending or known litigation/court action(s) have been disclosed in the application;

• Certification that the business applicant will use the requested funds, if awarded, in the manner

through which it has requested them in the attached application. The City of West Allis reserves the

right to exercise all legal authority available to it to recapture the awarded funds should the

funding be used in a manner other than that which was presented in this application.

Application Approval and Signature: The signatory declares that he/she is an authorized official of the applicant organization, is authorized to make this application, is authorized to commit the organization in financial matters, and will assure that any funds received as a result of this application are used for the purposes set forth herein.

SIGNATURE:

PRINTED NAME & TITLE:

BUSINESS:

DATE:

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Employee Family Income Form

West Allis is able to offer this service/program through a grant from the federal government. One requirement of this grant

is that the City keeps track of all the individuals this program assists by family size and income level. To help with this

requirement, we ask for your assistance. Please complete the information required below so that we may track the

individuals we are assisting through this program. Please be aware the information is completely confidential and will not

be released but is for record keeping and required federal reporting purposes only.

Thank you for your cooperation.

Name:

Address:

Phone Number:

Email:

Race (You MUST mark one):

☐ American Indian/Alaskan and Black/African

American

☐ Black/African American

☐ American Indian/Alaskan Native ☐ Black/African American and White

☐ American Indian/Alaskan Native and White ☐ Native Hawaiian/Other Pacific Islander

☐ Asian ☐ White ☐ Asian and White ☐ Other: Multi-Racial

Ethnicity (You MUST mark one):

☐ Hispanic

☐ Non-Hispanic

Family Size and Income Levels (2019)

Below you will find a chart listing the various household income levels. Find your family size along the top of each column.

Check ✓ the lowest amount which exceeds your family income.

Income Level 1 Person 2 Person 3 Person 4 Person 5 Person 6 Person 7 Person 8 Person

Extremely Low

$17,300

☐

$19,800

☐

$22,250

☐

$25,750

☐ $30,170

☐

$34,590

☐

$39,010

☐

$43,430

☐

Low $28,850

☐

$32,950

☐

$37,050

☐

$41,150

☐ $44,450

☐

$47,750

☐

$51,050

☐

$54,350

☐

Moderate $46,100

☐

$52,700

☐

$59,300

☐

$65,850

☐ $71,150

☐

$76,400

☐

$81,700

☐

$86,950

☐

Non-Low/ Moderate

$46,101+

☐

$52,701+

☐

$59,301+

☐

$65,850+

☐

$71,150+

☐

$76,401+

☐

$81,751+

☐

$86,951+

☐

“Family” means all persons residing in the same household

“Income” means that of all members of the family over 18 years of age. However, unearned income (such as income from trust funds or

investments) must be included regardless of the age of the beneficiary. Income includes wages, pensions, social security benefits, rents, and

interest from any asset.

Female Head of Household? ☐ Yes ☐ No

I understand that the information provided in this certification is subject to verification by the City of West Allis and/or HUD

Name: Signature:

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Employee Family Income Data Form

Employer:

After the new and current employees have complete the :Employee Income Certification Form”, please provide the

following information for all employees (new, current, retained, terminated) that were hired as a result of the Economic

Development Project/Loan Program project.

1. Employer Information

Name:

Address:

City: State: Zip:

2. Employee Information

Name:

Address:

City:

State:

Zip:

3.

Employee Identification Number or Social Security Number:

4. Job Title:

5. Date Hired:

5a. Date Terminated, if applicable:

5b. Date Retained:

5c:

Date Replacement Hired, if applicable:

6.

Average Hours Worked Per Week:

☐Full Time ☐Part Time

7. When hired, was the employee LMI (Low and Moderate Income)? ☐Yes ☐No

Are there employer sponsored healthcare benefits? ☐Yes ☐No

Was employee unemployed prior to employment? ☐Yes ☐No

8. Category of work (Check ✓ One):

☐ Office & Manager ☐

Craft Workers (Skilled)

☐ Technicians ☐

Operators (Semi Skilled)

☐ Sales

☐ Laborers

☐ Office & Clerical

☐ Service Worker

Social security number

Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a

resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other – – entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. or

Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.

–

Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.

General Instructions Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following.

• Form 1099-INT (interest earned or paid)

• Form 1099-DIV (dividends, including those from stocks or mutual funds)

• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)

• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)

• Form 1099-S (proceeds from real estate transactions)

• Form 1099-K (merchant card and third party network transactions)

• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)

• Form 1099-C (canceled debt)

• Form 1099-A (acquisition or abandonment of secured property)

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later.

Cat. No. 10231X Form W-9 (Rev. 10-2018)

Sign Here

Signature of

Employer identification number

Part I

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. Form W-9 (Rev. October 2018)

Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

▶ Go to www.irs.gov/FormW9 for instructions and the latest information.

Give Form to the

requester. Do not

send to the IRS.

1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.

2 Business name/disregarded entity name, if different from above

3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes.

Individual/sole proprietor or C Corporation S Corporation Partnership Trust/estate

single-member LLC

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ▶

Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner.

4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):

Exempt payee code (if any)

Exemption from FATCA reporting

code (if any)

(Applies to accounts maintained outside the U.S.)

Other (see instructions) ▶

5 Address (number, street, and apt. or suite no.) See instructions. Requester’s name and address (optional)

6 City, state, and ZIP code

7 List account number(s) here (optional)

ADDITIONAL FUNDING SOURCES

Please refer to the City of West Allis website for other funding and technical resources. https://www.westalliswi.gov/1706/For-Businesses

U.S. Small Business Administration (SBA) Paycheck Protection Program (PPP) The Paycheck Protection Program has provided $349 billion in forgivable loans to support small businesses and preserve employment. The Federal government is currently working to replenish funding for the program. Once additional funds are budgeted, small businesses can contact participating SBA-approved banks, credit unions, and community development financial institutions (CDFIs).

U.S. Small Business Administration Economic Injury Disaster Loans (EIDL) The Federal government is currently working to replenish funding for the program. Once additional funds are budgeted. The Economic Injury Disaster Loans are provided by applying directly through SBA. Please note SBA’s EIDL Application web portal may not be activated to accept applications until the Federal government has approved new funding. However, small business can use this time to visit the following link, learn more about the program, and determine what is needed to apply: https://www.sba.gov/sites/default/files/resource_files/how_to_disaster_app_March_2020. pdf

U.S. Chamber of Commerce Foundation Save Small Business Fund The U.S. Chamber of Commerce Foundation has launched a new national grant initiative that offers up to $5,000 per awardee to provide short-term relief for small businesses that have 3-20 employees and have been financially impacted by COVID-19. To learn more about this program and apply, please visit: https://savesmallbusiness.com/

Please review your application to ensure you have completed all necessary areas.

NOTE: Staff may follow-up with applicants for additional information and documents, as necessary

By clicking Submit, you will be directed to email the documents listed below to the Development

Department: - Application

- Acknowledgment of Required Assurances

- Employee Family Income Form

- W9

IMPORTANT NOTICE: To your email, you are also required to attach the following:

- Payroll documentation showing the number of employees as of the date of the

application

- Lease Agreements

You will have the ability to attach these documents to your email, after clicking the Submit button below.

To properly use the PDF form, please make sure you have Adobe

Acrobat installed on your device. Please email the completed form to

Thalia.mendez@wwbic.com