Skokie Local Service Agency Support Program - Step 1

Introduction

In March 2021, The American Rescue Plan Act (ARPA) was signed into law by the president. An estimated $700,000 in funding is available to support local service agencies that help Skokie residents in need. Each eligible agency may be eligible to receive up to $25,000 in funding support to offset the costs related to COVID-19.

If your service agency supports Skokie residents and continues to be negatively impacted by COVID-19, please consider completing the Step 1 application for the Skokie Local Service Agency Assistance Program below.

Step 1 applications received by Friday, July 8, 2022, at 11:59 p.m. will be considered for Step 2 eligibility. Step 2 application scoring will include completeness of the Step 1 application, follow-up documentation, and responsiveness by the local service agency.

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* 1. My service agency has been negatively impacted by COVID-19 financially.

Yes

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* 2. My service agency is in good standing with Village of Skokie laws, regulations, and/or fees.

Yes

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* 3. My business began operating prior to March 11, 2021.

Yes

Note: If a business began operations on or after March 11, 2021, it may be considered on a case-by-case basis as long as funding is available.

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* 4. A grant up to $25,000 will help my service agency (recover from a shutdown/remain open/reopen) in accordance with State and local guidelines.

Yes

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* 5. Service agency size (number of employees) on March 11, 2021:

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* 6. Business City, State, ZIP Code

Skokie, IL 60076

Skokie, IL 60077

Evanston, IL 60203

Other (City, State, Zip)

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* 7. Service agency category:

Current Skokie CDBG grantee

Not-for-profit organization

Childcare center

Other (please specify)

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* 8. Business Information

Services Provided

Legal Name of Business

Business Address Number and Street

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* 9. Service agency authorize representative contact information

Name

Email Address

Phone Number

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* 10. As the abovementioned service agency representative, I certify that I am able to provide critical agency information which may include, but not be limited to, service agency DUNS (Dun and Bradstreet) Number in Step 2 of the application process.

Yes

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* 11. Service agency expenses that I may request to be reimbursed with proper documentation, such as expense reports/receipts, payroll reports, canceled checks, my business lease, a delinquent rent summary from my landlord, revenue loss summary, etc. (check all that apply):

Rent or mortgage payments

Payroll

Personal Protective Equipment (PPE) (masks, gloves, sanitizers, sneeze guards, partitions, etc.)

Other (please specify)

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* 12. Estimated grant amount to be requested (up to $25,000):

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* 13. COVID-related grants/loans for which I have applied since March 2020 (check all that apply):

Paycheck Protection Program (PPP)

Economic Injury Disaster Loan (EIDL)

Business Interruption Grants (BIG) Program

Other grants/loans (please specify)

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* 14. COVID-related grants/loans for which I have applied since March 2020 (check all that apply):

I was awarded funding for one or more applications selected in this question

I was not awarded funding for any of the applications selected in this question

I have not applied for grants/loans

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* 15. Insurance claims:

Yes, I filed a claim and received funding

Yes, I filed a claim but did not receive funding

No, I did not file a claim

Note: Other grants/loans/insurance payments may include other Federal, State, local, not-for-profit, private, and/or charitable funding sources. If you applied for other grants/loans, or had an insurance claim, additional information will be requested during Step 2 of the application process, including grant/loan/insurance provider, contact information, amount requested/received, etc.

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* 16. Other information relevant to this application (optional):

For more information regarding the ARPA Local Service Agency Assistance Program, please contact Carrie Haberstich, Planning Supervisor, at carrie.haberstich@skokie.org.