Qualification Questions

Is the business in good standing with the State of Maryland and Worcester County and registered with the state if required to do so by law as of March 9, 2020?

Visit https://dat.maryland.gov/businesses/Pages/Internet-Certificate-of-Status.aspx to obtain certificate of status.

Completed:

If applicable select one of the following:

Does the business employ 0-10 non-owner full time employees? (FTE = average of 40 hours or more per week)
Does the business employ 11-25 non-owner full time employees? (FTE = average of 40 hours or more per week)
Does the business employ 26 or more full time employees? (FTE=average of 40 hours or more per week)
Have you applied and received other COVID-19 funding grants to date (Federal, State, Local entities)?

If you answered YES to the question above, please advise the type and amount of COVID-19 funds/loans you have received:

Please advise the type and amount of COVID-19 funding you have received.

Please upload a file

About the business

Please fill out the following:

Do you own or lease your business site?
Business Structure
Is the Business Seasonal?

Impact of COVID-19

Please upload a file

Maryland Public Information Act Disclosure

I understand that any document deemed a public record by said law is subject to disclosure in response to a request under said law. (Please initial with your legal, inked signature).

By signing this application, I certify the following under penalty of perjury:

  1. The information contained in this application is true and complete to the best of my knowledge, information and belief.
  2. Grant funds may be utilized for qualifying expenditures:
    • 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
    • Facility readiness (social distancing preparedness, business modifications, etc.)
  3. I agree to maintain documentation following generally accepted accounting principles for how the funds are expended, including but not limited to financial records, payroll records, or receipts.
  4. I understand and agree that records of how assistance grant funds are used must be produced promptly upon receiving a request from the federal government, the State of Maryland or Worcester County and are subject to audit.
  5. I certify that I have the authority to legally bind the business.

If all of the above outlined requirements are not met in full or if any information provided on this application is found to be false or incorrect, the business will be deemed immediately in default and funds must be returned to the County within 30 days of written notification of default. I also agree that, if I accept a Workforce Back To Business COVID-19 Assistance Grant, I will be bound by the obligations and liabilities described in this application and that Worcester County shall have the right to enforce those obligations and liabilities in any manner provided by law.

The applicant also understands and agrees that Worcester County reserves the right to allocate funds on the basis of a lottery if the amount of funding requested exceeds the total amount of funds available.

By signing below, the applicant represents, warrants and certifies that the information provided herein is true, correct, and complete. I also understand that this application, combined with award of a Workforce Back To Business COVID-19 Assistance Grant, constitute a binding contract and shall be deemed a valid original instrument if delivered electronically (e.g., facsimile, PDF, ink or digital stamp, etc.). (Please sign with your legal, inked signature).

Sign above
Please sign this document

Required Supporting Documentation

Please upload a file
Please upload a file
Please upload a file

QUESTIONS? Review the Worcester County FAQ page or email chooseworcester@co.worcester.md.us