Application for Grant Assistance for 501(c)(6) …...CARES Act Relief Funds: Grant Assistance Application for Eligible 501(c)(6) and 501(c)(4) Organizations Page 3 of 9 Economic Impacts

CARES Act Relief Funds: Grant Assistance Application for Eligible 501(c)(6) and 501(c)(4) Organizations Page 1 of 9

Application for Grant Assistance for 501(c)(6) Chambers of Commerce and Business League

Organizations, or any Non-lobbying 501(c)(4) with an Economic Development Driven Mission:

The CARES Act established the Coronavirus Relief Fund and appropriated funding to the fund for State and Local Government Relief. El Paso County received a direct allocation of federal funds from the CARES Act Relief Fund. El Paso County recognizes that its economic development partner organizations have also realized increased expenditures due to COVID-19 and has chosen to open a competitive application process for 501(c)(6) Chambers of Commerce and Business League organizations, or any non-lobbying 501(c)(4) with an economic development driven mission, as defined by IRS Publication 557, to assist them with their response and expenses related to COVID-19. Completed applications must be submitted via email to Sara Lobato [email protected] by 5:00 p.m. on Friday, May 29th. Under the CARES Act, the federal funds may only be used to cover costs that are necessary economic recovery expenditures incurred due to the public health emergency with respect to the Coronavirus Disease 2019 (COVID-19); and were incurred no earlier than March 1, 2020. The requirement that expenditures be incurred “due to” the public health emergency means that expenditures must be used for actions taken by an organization to respond to the public health emergency and any necessary economic recovery efforts the organization has implemented.

Organization Information

Name of Organization:

Doing Business As:

Organization EIN:

Year Organization Opened:

Organization Address:

Street Address

City State Zip Code

Number of voting members of the governing body:

Number of Individuals Employed by Organization:

Organization Type: 501(c)(6) Chamber of Commerce 501(c)(6) Business League

Non-Lobbying 501(c)(4) with an economic development driven mission

Executive Director Information

First Name: Last Name:

Phone:

Email:

mailto:[email protected]


Organization Mission and Activities

Please describe the organization’s mission and its most significant activities:


Economic Impacts of COVID-19

Please provide a brief explanation of the adverse economic impacts COVID-19 has had on the organization. Please note ways the organization has demonstrated adaptability by reconfiguring its operations during the COVID-19 economic disruption.


CARES Act Funds Request

What will the funds be used for?

An itemized schedule or breakdown of all cost relating to the expenditure of funds must be included – additional pages can be attached if necessary.

Line Item Budget Request: (Please be as specific as possible) Amount

Fixed Debts (rent, mortgage, insurance):

Payroll:

Accounts Payable:

Marketing/Education:

Innovative Programming in Response to COVID-19: (please specify below)

Total Assistance Funding Request:


COVID-19 Expenditures

Why are the expenditures noted above necessary, and how are the expenditures directly related to COVID-19 response and economic recovery efforts?


Additional Resources

Please list any additional COVID-19 relief assistance resources that you have applied for or received:

Funding Source: Status: Amount:

Applied for Received



Total COVID-19 Relief Resources:

Utilization of CARES Act Funds

What is the time period of when the funds are expected to be spent?


Economic Recovery Efforts

Please explain why these efforts and expenditures are critical to the economic recovery of our region.


Supporting Documentation

Please provide the following documentation. Please note, applications submitted without these documents will be deemed incomplete and will not be considered:

1. Most recent Form 990 annual return of the organization

2. Most recent audit and annual report of the organization

3. Organization’s Certificate of Good Standing from Colorado Secretary of State

Application Certifications of Compliance

I hereby certify by reading and initial each statement listed below that: Please Initial

I certify that my organization is a 501(c)(6) Chamber of Commerce/Business League Organization, or a Non-lobbying 501(c)(4) with an Economic Development Driven Mission.

I understand and agree that the CARES Act Funds may only be used to cover cost that: 1. Are necessary economic recovery expenditures incurred due to the public health

emergency with respect to the Coronavirus Disease 2019 (COVID-19); and2. Were incurred no earlier than March 1, 2020.

I understand that this federal funding may require additional reporting and financial disclosure regarding our organization’s financial audit.

I understand and agree that adequate documentation will be provided to El Paso County Economic Development upon request.

My organization’s activities are legal under Colorado and federal law.

I certify that my organization will be required to complete and submit a Completion and Economic Impact Report to El Paso County within 30 days of expending funds.

I certify that my organization will be required to provide documented receipts and other supporting documentation reflecting expenditure of grant funds.

I certify that my organization’s application submission will not be considered until a completed application and requested supporting documents have been submitted.


By signing this application, I certify that all information in this application, and submitted with the application, is true and correct to the best of my knowledge, and that I will submit truthful information in the future.

I certify that I have read, understand, and agree to comply with the requirements that are set forth in this Certification of Compliance. I will ensure that all funds requested are spent for the intended purpose and that the expenditures are necessary and related to the public health emergency with respect to COVID-19.

Organization Name:

Title: Date:

Signature:

Please submit applications by 5pm Friday, May 29th via email to: El Paso County, Economic Development Department

Sara Lobato, Senior Analyst [email protected]

mailto:[email protected]

Documents

Application for Grant Assistance for 501(c)(6) …...CARES Act Relief Funds: Grant Assistance Application for Eligible 501(c)(6) and 501(c)(4) Organizations Page 3 of 9 Economic Impacts