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Request and Certifications

You are requesting that federal CARES Act funds be allocated toward the balance of up to 50% of your reimbursements due (in addition to the 50% that was provided to them under CARES Act separately from this) for reimbursable unemployment claims which were COVID-19 related.  This response must be received with an accurate and complete answer for each question to allow Delaware OMB time to allocate and transfer the funds.  As part of your request make the following good faith and wholly truthful certifications.  You will need your UI Employer Number and contact information and authorization to proceed on behalf of the Reimbursable Employer:

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* 1. Enter the name of the employer you are authorized to represent. (to be referred to as "Reimbursable Employer" in this submission)

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* 2. Enter your Delaware Unemployment Insurance Employer Number.

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* 3. Enter your first and last name, confirming that you are authorized to make this funding request on the Reimbursable Employer's behalf.

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* 4. Enter your phone number so that we can contact you, if necessary.

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* 5. Please provide your email address.

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* 6. I certify that I am the named person above and that I have the authority to request an allocation of funds from the Department of Labor, Division of Unemployment Insurance (the “Division of Unemployment Insurance”), which were received from the State of Delaware’s allocation of funds from the Coronavirus Relief Fund (“Fund”) as created in the CARES Act on behalf of the Reimbursable Employer above.

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* 7. I certify that I understand that the Division of Unemployment Insurance will rely on this certification as a material representation in allocating funds for necessary expenditures to or on behalf of the Reimbursable Employer above.

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* 8. I certify that I understand that the funds allocated pursuant to this certification will be used to reimburse to the Unemployment Insurance Trust Fund for qualifying benefit payments owed by the Reimbursable Employer above in lieu of unemployment tax assessments.

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* 9. I certify that the Reimbursable Employer's uses of the funds allocated pursuant to this certification will be used only to cover those costs that:

a.         Are necessary expenditures incurred due to the public health emergency with respect to the Coronavirus Disease 2019 (COVID-19) (“necessary expenditures”);

b.         Were not accounted for in the budget most recently approved as of March 27, 2020, for the above named Employer; and

c.         Were incurred during the period that begins on March 1, 2020 and ends on December 30, 2021.

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* 10. I certify, under consideration of penalties for an false or misleading statement to the state in order to obtain federal funds, that current financial condition of the Employer makes this request for federal funds necessary to support the ongoing operations of the Employer.  The Division reserves the right to request supporting documentation from the Employer to support this certification, either prior to or after allocation of funds to the Employer, and if the documentation of the need for these funds is determined by the Division in its sole discretion to be insufficient, the Employer shall refund the Division for the federal funds allocated to the Employer pursuant to this certification. (Note that requesters make this certification in good faith, considering their current business activity and their ability to access other sources of liquidity sufficient to support their ongoing operations in a manner that is not significantly detrimental to the business. For example, it is unlikely that a public company with substantial market value and access to capital markets will be able to make the required certification in good faith, and such a company should be prepared to demonstrate to Division of Unemployment Insurance, upon request, the basis for its certification.)

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* 11. Reimbursable employers seeking Fund allocations from the Division of Unemployment Insurance pursuant to this certification must adhere to official federal guidance and any State of Delaware guidance issued or to be issued on what constitutes a necessary expenditure. I understand that the Employer shall be solely responsible for the full amount of any recoupment, judgment, or award (including any applicable penalties, interest, and attorney fees) arising out of any enforcement action filed instituted by the Office of the Inspector General of the United States Treasury, the United States, or the State of Delaware.  Unless expressly prohibited by law, the Employer shall defend, hold harmless, and indemnify the State of Delaware, its agencies, officials, and employees from any liability arising out of the ineligibility, misuse, or misappropriation of funds proximately caused by the malfeasance, misrepresentation, fraud, deceit, or negligence of the Employer named herein, its officials, employees, and agents.  If the Office of the Inspector General of the United States Treasury, the United States Government or the State of Delaware determines that the Funds allocated to Employer are an ineligible expense under the CARES Act, the Employer must return such Funds to the Division of Unemployment Insurance, following notice to the Recipient of such ineligible use of Funds, and the determination of the federal government or State of Delaware that the Employer’s allocation of the Funds was ineligible shall be final, binding and non-appealable. The Employer may be subject to offset or recoupment for failure to return any Funds deemed to have been used for an ineligible expense.

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* 12. I hereby certify that the Reimbursable Employer has reviewed all available guidance memoranda issued by the State of Delaware Department of Justice, and hereby agree to review any subsequent revisions and additions, as may be located on the Delaware Department of Justice website.

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* 13. I understand that any reimbursable employer allocated funds pursuant to this certification shall retain documentation of all uses of the funds and the justification of the reimbursable employer’s need for the funds for a period of 6 years. Copies of such documentation shall be provided to the Division of Unemployment Insurance upon submission of a reimbursement request consistent with State guidance.

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* 14. I understand that any funds allocated pursuant to this certification shall not and may not be used as a revenue replacement for lower than expected tax or other revenue collections.

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* 15. I understand that allocations received pursuant to this certification shall not be used for expenditures for which a reimbursable employer has received any other emergency COVID-19 supplemental funding (whether state, federal or private in nature) for that same expense.

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* 16. I understand that allocations received pursuant to this certification shall not be used for expenditures for which a reimbursable employer has received or may in the future receive any insurance proceeds to cover losses experience by a reimbursable employer for that same expense.

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* 17. I understand that the Division of Unemployment Insurance will not provide allocation for expenditures in which a reimbursable employer has sub-granted funds to another entity, non-profit or other organization without express written approval.

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* 18. I understand that a reimbursable employer receiving funds pursuant to this certification must complete timely reporting as may be required by either the federal government or State of Delaware.

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* 19. I understand that reimbursable employers may be subject to ‘clawback’ (especially that a 'clawback' could be required if the US Treasury audits the Division and requires it to pay them back and thus the reimbursable employer will have the subsequent obligation to make payment to the Division) and other appropriate measures, including the possible reduction or elimination of other State funds due to any misrepresentation, misuse, or mishandling of these funds or this request.

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* 20. I understand that this certification shall be considered to remain valid pursuant to any subsequent relevant future federal or state law or guidance.

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* 21. I understand that this certification is offered to the State of Delaware as part a claim for funds held by the State of Delaware and I understand that any false statement contained within this certification shall be evidence of a violation of the State of Delaware False Claims and Reporting Act as set forth at 6 Del. C. § 1201, et seq..

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* 22. I understand that any transaction involving or expending funds obtained pursuant to or as a result of this certification shall comply with the public guidance regarding mandatory terms and conditions for Coronavirus Relief Fund expenditures as made available on the Delaware Department of Justice website.

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* 23. By typing your full first and last name, as done above, you certify that you have read the above certifications in questions 1 through 19 and are authorized by the Reimbursable Employer to execute this and to make those certifications.

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