Legal name of business(*)
Business Address(*)
UBI number(*)
Mailing address if different than physical address(*)
Preferred email contact(*)
Preferred phone number(*)
1. Do you have a current City of Edmonds business license? (If “NO” you will have to get a current City of Edmonds business license before any grant monies may be awarded.) (*)
2. What is your primary business activity:(*)
3. How many employees does your business employ?(*)
Creative District Businesses:
Please review the attached map to determine if your business is located within the boundaries of the Edmonds Creative District. ONLY IF located within the Creative District, please review the attached PDF and provide the appropriate NAICS Code here:
4. Is your business located within the area bounded by Caspers Street on the north, Pine Street on the south, 9th Avenue on the east, Puget Sound shoreline on the west? View map here.(*)
5. Please check all that apply:(*)
6. Has your business received more than $10,000 in grants, tax credits or other government grants, tax credits or financial assistance since the beginning of the COVID-19 pandemic? (*)
7. How much did you lose in business revenue in Fiscal Year 2020 compared with Fiscal Year 2019? (We may require documentation): (*)
8. How much are you requesting through this application up to $10,000?(*)
9. Please check all that apply:(*)
ATTESTATION:
I certify that the information submitted in this application is true and correct to the best of my knowledge and that I am an authorized representative of this business. I understand that the City of Edmonds will rely on the accuracy of the submittals and certifications made in conjunction with this application. Any misrepresentation or inaccurate information may result in a repayment of grant funds. I acknowledge that, if I am awarded a grant, I may be required to submit back-up documentation proving the accuracy of my answers. I also acknowledge that any grant I may receive will be in the form of a loan that will be forgiven by the City if my business remains open and operating after four months from receipt of a grant.
Enter signature below:(*)
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