The City of Asbury Park has received Community Development Block Grant (CDBG) funds from the U.S. Department of Housing and Urban Development (HUD) to assist small businesses defray the cost of expenses associated with the COVID-19 pandemic.

These funds are to be used for the reimbursement of eligible expenditures incurred since the Governor’s Executive Order No. 103 went into effect on March 9^th 2020.

Grants in the amount of $2500.00 will be issued once evaluated and while funding is available.

ELIGIBILITY-BUSINESS MUST:

Have been affected by COVID-19
Be located in the City of Asbury Park
Have an active Asbury Park Mercantile Business License (minimum 12 months)
Have 10 or fewer employees including owner

The following documents must be provided with application:

W-9 Tax Form
New Jersey Business Registration Certificate
City of Asbury Park Mercantile License
WR-30 Tax Form (Employer Report of Wages Paid for 4^th Quarter 2019) or 1099 Tax Form
Itemized Reimbursement Form (attached)
Proof of payment includes invoices, receipts, billing statements, operating cost (such as rent, payroll, utilities-excludes mortgages).
Federal Tax I.D.# or IRS EIN (Employer Identification Number)
Proof of Business Insurance Policy

APPLICATION

Business Name (must match W-(9)

Business Phone Number

Business Fax Number

Owner's Telephone Number

Owner's E-Mail Address

W-9 (Upload copy)

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Federal Tax ID# or IRS EIN (Employer Identification Number)

FUNDING REQUEST Type of expense reimbursement requested, (check all that are applicable to request)

General working capital

Operational Costs

Employee Training (Covid-19)

PPE/Health Improvements Support/Business Sustainability

Social Distancing

Have you received any other grants or loans?

Yes

Name of the Agency, amount, and date received for other grants/loans.

Upload of any documents related to other grant/loans.

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Statement (300 words or less) describe how COVID-19 impacted your business.

REIMBURSEMENT FORM

Please click THIS LINK to download the "SBG Expenses Workbook" Excel file.

Please fill out the workbook, save it, and upload it below along with proof of payment (such as invoices, receipts, billing statements, etc).

Please upload the completed "SBG Expenses Workbook" here along with any invoices, receipts, statements, etc. that you may have.

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ACKNOWLEDGEMENTS

All acknowledgements must be accepted and agreed to in order for the application to be submitted.

I (We) certify that all of the information provided in this application and the supplemental required documents is true, accurate and complete to the best of my knowledge and belief. If it is discovered that any submitted information is intentionally inaccurate or misleading, I (we) may be subject to penalty.

I (We) certify there are no outstanding property taxes, fees, fines, judgements or liens to the State of New Jersey, Monmouth County, or City of Asbury Park.

I (We) that should the business ceased operations for more than a month due to a non-COVID -19 related public health order, or is sold within-1 year of receipt of funds from this program, the City of Asbury Park may seek partial repayment on a prorate basis.

I,(We) understand that (1) the request for funding will not be approved until all necessary information and documentation has been received and the application deemed complete by the City of Asbury Park; (2) the reimbursement will only be for eligible expenses; and (4) successful submission of this application does not guarantee funding by the County.

By electronically signing and submitting this application, I (We), the Applicant do hereby authorize and execute the City of Asbury Park Small Business Assistance Program Agreement.

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.