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Allegany County Restaurant Relief Fund Grant

  1. Terms of Application: By completing this application, the applicant accepts the following terms: The following, are eligible expenses that the applicant are permitted to uses awarded grant funds towards: Working capital, such as rent, payroll, and job training. Purchase of equipment and services to expand outdoor dining, such as tents, heaters, warmers, and carts. Infrastructure improvements, such as HVAC system upgrades. Technology to support carryout and delivery. Purchase of PPE and disposable food containers and utensils. Sanitization services. All of the information set forth in the application is true and correct. The Grantee and the person signing below have the authority or right to sign this formal application and agree to its terms. The applicant is and will remain, in compliance with the laws of the Federal Government and the State of Maryland and its political subdivisions, including all laws prohibiting discrimination. If any information or certification in the application or any attachments to the application are false or materially misleading, the Grantee shall repay any awarded grant funds back to Allegany County, Maryland, in the full amount. *

  2. Applicant Information

  3. Type of Business*

  4. My business operates:*

  5. Do you own (with a mortgage), lease, or rent your business site?*

  6. Current number of employees:

  7. Business Structure:*

  8. All of the information set forth in the application is true and correct. *

  9. The Grantee and the person signing below have the authority or right to sign this formal application and agree to its terms. The applicant is and will remain, in compliance with the laws of the Federal Government and the State of Maryland and its political subdivisions, including all laws prohibiting discrimination. If any information or certification in the application or any attachments to the application are false or materially misleading, the Grantee shall repay any awarded grant funds back to Allegany County, Maryland, in the full amount. ​​

  10. Commerce Statistical Data

  11. Exhibit A: PLEASE TAKE A MOMENT TO COMPLETE THE FOLLOWING: These questions are for gathering statistical data only. The responses will be separated from the application and information provided in it will not be a part of the application process. Furnishing this information is voluntary; failure to do so will have no effect on the approval of the requested financial assistance.

  12. If the applicant will be providing the requested financial assistance to another recipient (e.g. a facility user or borrower), "Respondent" should be the recipient of the financial assistance.

  13. Is Respondent the

  14. Respondent does not wish to furnish this information

  15. If Respondent is a business organization:

  16. If Respondent is a business owned and controlled primarily by individuals who are identified in any of the following categories, please check all the categories that apply:

  17. Is the Respondent a State/Federal/Other certified Minority Business Enterprise?

  18. Respondent is a publicly held entity or other organization not classifiable as owned by individuals of a particular gender, race, ethnicity, or veteran status.

  19. If the Respondent is an individual:

  20. Is the Respondent Female?

  21. Is the Respondent of Hispanic or Latino origin?

  22. Is the Respondent a Veteran?

  23. Which of the following categories describes the Respondent (multiracial respondents may select all applicable racial categories):

  24. Leave This Blank:

  25. This field is not part of the form submission.