EXIT Cuyahoga County Business Assistance Application Helping Small Businesses Navigate Uncertain Times Cuyahoga County has established a Small Business Resource Center and Stabilization Fund to support businesses impacted by COVID-19. *******AS OF 5:00PM EST ON 4/23 THE GRANT PORTION OF THIS APPLICATION IS CLOSED. YOU CAN CONTINUE TO COMPLETE THE APPLICATION TO POTENTIALLY QUALIFY FOR OTHER FINANCIAL RESOURCES THROUGH THE STABILIZATION FUND******** Please complete this application so that we can direct business resources and assistance to you as soon as possible. The application will also serve as a pre-screening tool for grants and loans from the Stabilization Fund and other community partners. About the Stabilization FundThe Stabilization Fund provides working capital to businesses impacted by COVID-19 for business related expenses, including payroll, accounts payable, fixed costs, inventory, rent, and utilities. Focuses of the Stabilization Fund include: Business Stabilization, Job Retention. Positioning for Long-term Recovery, and Support of Minority and Neighborhood-based Businesses. Small Businesses with less than 500 employees can apply for loans through the Stabilization Fund. Small businesses with less than 20 employees may be eligible for grants. *Not all eligible businesses will receive a grant or a loan About the Call Center and WebsiteThe Small Business Resource Center Website and Call Center provide technical assistance and information about resources to assist during these economic times. Businesses can reach live Call Center agents through the Small Business Resource Center Monday-Friday, 8 AM – 5 PM, at (216) 452 – 9714 to assist with: - Small Business Administration (SBA) Loan Applications - Business Consulting - Other Financial Assistance - Unemployment Benefits - Retaining and Retraining Employees Did You Know? SBA is offering Loans for small businesses up to $2 Million and $10,000 Advances? For detailed information on SBA programs, visit www.sba.gov/coronavirus *The Website Link to return to the Small Business Resource Center Website is listed at the end of the survey. Please copy the link to save. OK Question Title * 1. Business Contact Information First Name Last Name Business Name Business Address City/Town State/Province ZIP/Postal Code County Email Address Phone Number OK Question Title * 2. What County is your personal home address located in? OK Question Title * 3. Was your business registered in the State of Ohio on or before 04/17/2019? Yes No OK Question Title * 4. What is your current business need? Please select all that apply Application Assistance for Small Business Administration (SBA) Disaster Loan for up to $2 Million and $10,000 Advances Business Consulting and General Assistance Application Assistance for Unemployment Benefits Strategies to Retain and Retrain Employees Interest in applying for grants and loans through the Cuyahoga County Stabilization Fund Other (please specify) OK Question Title * 5. Have you applied for the Small Business Administration (SBA) Economic Injury Disaster Loan up to $2 Million, a $10,000 Advance, or any other SBA loan programs?***Visit www.sba.gov to apply for these programs No If Yes, please list the federal SBA loan program that you have applied to OK Question Title * 6. What type of business owner are you? Sole Proprietor Independent Contractor/Consultant Limited Liability Corporation (LLC) S Corporation Partnership C Corporation Other (please specify) OK Question Title * 7. What is your business industry? Food Industry: Restaurant/Bars Hospitality Personal Care Services & Cosmetology Neighborhood Healthcare Food Industry: Neighborhood Grocer General Contracting Construction or Landscaping Manufacturing IT Automotive Logistics and Distribution Aerospace Other (please specify) OK Question Title * 8. Can your business be defined as any of the following business types? Bank of Financial Services E-commerce Adult Entertainment Liquor Store Tobacco Store Cannabis Dispensary Franchise (that is not locally owned and independently operated) N/A OK Question Title * 9. Employee Status *There are financial benefits and resources available for businesses who keep their employees on payroll. Please share the following information about your employees How many employees do/did you have, including yourself? Have you laid off any employees? If so, how many? If you have not laid off any employees, do you intend to in the next 30-45 days? Do you intend to pivot your business into any new products, services or offerings? OK Question Title * 10. What percentage of your employees would you estimate live/lived in Cuyahoga County? 0% < 10 % 10 - 24% 25 - 50% 51 - 75% 76 - 100% OK Question Title * 11. What was your estimated gross revenue for your business in 2019? *** Please do NOT include any symbols like number signs, decimals or commas*** OK Question Title * 12. How much revenue have you lost? Please estimate any revenue decline you've experienced as a result of COVID-19 since March 17, 2020, if applicable. 0% < 10 % 10 - 20% 21 - 30% 31 - 40% 41 - 50% 51 - 60% 61 - 70% 71 - 80% 81 - 90% 91 - 100% Please briefly describe your business loss due to COVID-19 and your plan to reopen and/or recover OK Question Title * 13. If your business is closed, do you have a plan to reopen within the next 12 months? Yes No I need help creating a plan to reopen My business is still open OK Question Title * 14. What costs do you need financial assistance for, if at all? (please select all that apply) Employee compensation (salary, wage, commission, cash tip, or similar compensation) Payments required for the provisions of Employee group health care benefits, including insurance premiums Payments of interest on any mortgage obligation Rent (including rent under a lease agreement) Utilities Interest on any other debt obligations Liability insurance premiums N/A Other (please specify) OK Question Title * 15. Is your business currently in receivership or bankruptcy? Yes No OK Question Title * 16. Is your business current on all local Cuyahoga County real estate taxes? Yes No N/A If you owe any real estate taxes to Cuyahoga County, please list the amount that is unpaid OK Question Title * 17. Please identify if your business falls into any of these categories (select all that apply).*Business may be able to access certain resources if they fall into one of these categories that may help solve a business need. Woman-owned Minority-owned Veteran-owned EDGE certified entity Disadvantaged business entity N/A OK Question Title * 18. Have you received a grant or loan to assist with COVID-19 related losses from any other Cuyahoga County local government or private fund? Yes No If yes, please list the name of the organization that you have applied for funding from OK Question Title * 19. Are you interested in other services? (please check all that apply) Business Education Courses Business Preparedness (general) Financial Assistance Resources for Women Entrepreneurs Resources for Black Entrepreneurs Resources for Latinx Entrepreneurs Understanding City Rules and Regulations for Businesses Other (please specify) OK Question Title * 20. How did you hear about this interest form? Small Business Resource Center Help Line Live Agent Small Business Resource Center Help Line Website Other (please specify) OK Question Title * 21. I declare that, to the best of my knowledge and belief, the information herein is true, correct, and complete. I further acknowledge, that if I am approved for a grant or loan from the stabilization fund, I will complete the required post-funding survey within 30days of receiving funding. (Type your name below to serve as your signature) OK Return back to the Cuyahoga County Small Business Resource Center OK SUBMIT SURVEY - THANK YOU!