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Item G1
�s G.1 y;+ ' "tr, BOARD OF COUNTY COMMISSIONERS County of Monroe , Mayor Heather Carruthers,District 3 -�� {sJ ` °' Mayor Pro Tem Michelle Coldiron,District 2 The Florida.Keys` .I3 ��` Craig Cates,District 1 David Rice,District 4 w � Sylvia J.Murphy,District 5 County Commission Meeting September 3, 2020 Agenda Item Number: G.1 Agenda Item Summary #7312 BULK ITEM: No DEPARTMENT: County Administrator TIME APPROXIMATE: STAFF CONTACT: Lisa Tennyson (305)292-4444 N/A AGENDA ITEM WORDING: Discussion and approval of proposed Allocation Plan for CARES Act funding to Monroe County per funding agreement Y2287 with the Florida Division of Emergency Management. The Allocation Plan is attached. The Allocation Plan includes funds for a Rent/Mortgage Assistance Program and a Business Assistance Grant Program and the applications/ information for these programs are also included. ITEM BACKGROUND: In March, Congress passed the CARES Act providing over $150 billion in direct federal assistance to states and eligible local governments due to the COVID-19 pandemic. In June 2020 Governor DeSantis announced that the $1.275 billion of the $3.747 billion reserved for direct assistance to eligible Florida local governments would be distributed to Florida counties having a population less than 500,000 through a funding agreement with the Division of Emergency Management (DEM.) Pursuant to the CARES Act funding agreement between the County and DEM, the proposed Monroe County CARES Act Allocation Plan was developed. It is attached for Board approval. Key points: • The State is requiring that each County accepting CARES Act funds determine how they will use their CARES Act funding. The State has directed Counties to take into account the public safety and health expenses incurred local government entities within the County, specifically including municipalities and constitutional officers. • In addition to covering expenses incurred by local government entities, Treasury guidance allows funds to be utilized for economic relief to residents and businesses. • All programs and costs identified must strictly adhere to the CARES Act criteria and the US Treasury's most recent guidance on allowable activities and costs, and the requirements in the Funding Agreement between DEM and Monroe County. • The US Treasury advised that local governments receiving CARES Act funds will be audited, and that costs deemed unallowable will be subject to recoupment by the US Treasury. Packet Pg. 149 G.1 • Counties were further advised by the State that their state revenue sharing payments would be reduced by the amount of any costs deemed unallowable by the federal or state auditing entity. • Monroe County's current funding agreement with DEM is for the amount of an initial 25%advance payment of$3,250,835 ("Phase 1"). Thus,the proposed allocation plan reflects that amount: o Allocation toward the Public health/safety expenditures by Constitutionals: $1,300,000 o Allocation toward the Public health/safety expenditures by County and Cities: $ 680,000 o Allocation for Small Business Assistance Grants,up to: $1,000,000 o Allocation for Residential Rent/Mortgage Assistance,up to: $ 200,000* (*this is augmented with$638,000 in FHFC funding for rent/mortgage/utility assistance.) We have developed and attached the applications and program guidance for the Residential Rent/Mortgage/Utility Assistance program and the Small Business Assistance Grants program. These are attached for your review. While Monroe County's CARES Act total allocation from the State is projected to be $13,003,340, the current agreement makes no reference to the County's full allocation amount. Per the terms and conditions of the executed agreement with the State, the remaining 75% of the County's allocation ($9,752,505) will be available on a cost reimbursement basis. A cost reimbursement-based process will require Monroe County to expend its own funds first, and then request and wait for reimbursement of the expenditures made. Looking ahead to the Phase 2 funding, we are hopeful that DEM will amend the cost-reimbursement requirement(but DEM is focusing on Phase 1 right now, and is not yet working on that.) There is also the possibility that future federal legislation may amend the regulations for CARES Act funds to allow them to applied toward revenue losses; anticipated changes may also extend the deadline date for expenditure of all funds past December 30, 2020. Attached: • Monroe County CARES Act Allocation Plan • Monroe County CARES Small Business Assistance Grant Program Application • Monroe County CARES Small Business Assistance Grant Program Guidance and FAQ • Monroe County CARES Rent/Mortgage/Utility Assistance Program Additional Resources (hyperlinks): • U.S. Department of the Treasury CRF Information • U.S. Department of Treasury - Coronavirus Relief Fund Guidance for State, Territorial, Local, and Tribal Governments - 04/22/2020 • U.S. Department of Treasury - Coronavirus Relief Fund Guidance for State, Territorial, Local, and Tribal Governments - 06/30/2020 • U.S. Department of Treasury - Coronavirus Relief Fund Frequently Asked Questions - 05/28/2020 • U.S. Department of Treasury - Coronavirus Relief Fund Frequently Asked Questions - 06/24/2020 • U.S. Department of Treasury- Coronavirus Relief Fund Frequently Asked Questions - 07/08/2020 Packet Pg. 150 G.1 • U.S. Department of Treasury - Coronavirus Relief Fund Frequently Asked Questions - 08/10/2020 • CARES Act- Local Government Program Presentation • CARES Act Funding Overview Webinar- 7/9/2020 • Treasury Office of Inspector General Coronavirus Relief Fund Recipient Reporting Update - (7/31/2020) PREVIOUS RELEVANT BOCC ACTION: August 19, 2020: Approval of Funding Agreement with FHFC for rent/mortgage assistance funding. July 27, 2020: Ratification of Funding Agreement Y2287 with Florida DEM. July 15, 2020: Budget Resolution to allocate $200,000 for Rent/Mortgage Assistance Program. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATION: Approval. DOCUMENTATION: Monroe County Cares Act Allocation Plan- FINAL Monroe County CARES Business Assistance Application and Agreement- FINAL Monroe County CARES Small Business Grant Program Guidance and FAQ FINAL Monroe County CARES Act Rent Mortgage Utility Assistance Program Application and Information FINANCIAL IMPACT: Effective Date: Expiration Date: Total Dollar Value of Contract: Total Cost to County: Current Year Portion: Budgeted: Source of Funds: CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: If yes, amount: Grant: County Match: Insurance Required: Packet Pg. 151 G.1 Additional Details: REVIEWED BY: Christine Limbert Completed 09/01/2020 2:43 PM Bob Shillinger Skipped 09/01/2020 11:55 AM Budget and Finance Completed 09/01/2020 2:46 PM Liz Yongue Completed 09/01/2020 2:56 PM Board of County Commissioners Pending 09/03/2020 5:05 PM Packet Pg. 152 G.1.a MONROE COUNTY CARES Monroe County CARES Act Program .I MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Mayor Heather Carruthers Mayor Pro Tem Michelle Coldiron 2 Commissioner Craig Cates Commissioner David Rice Commissioner Sylvia Murphy 2 r- 0 OFFICE OF THE COUNTY ADMINISTRATOR SEPTEMBER 2020 Packet Pg. 153 G.1.a TABLE OF CONTENTS INTRODUCTION.................................................................................... 1 BACKGROUND..................................................................................... 2 MONROE COUNTY ALLOCATION AMOUNT............................................. 4 ELIGIBLE USE OF FUNDS....................................................................... 4 ALLOCATION PLAN FOR 25%ADVANCE("PHASE 1")............................... 5 CJ DESCRIPTIONS OF PHASE 1 ALLOCATIONS PUBLIC SAFETY AND HEALTH EXPENSES .......................................... 6 SMALL BUSINESS ASSISTANCE GRANT PROGRAM.............................. 7 CL RESIDENTIAL RENT/MORTGAGE/UTILITY ASSISTANCE PROGAM ....... 8 c CJ 0 CJ 2 C 0 1 P a g ;ter Packet Pg. 554 G.1.a INTRODUCTION The Monroe County CARES Act Program is a grant program funded by an allocation to Monroe County from the federal Coronavirus Aid,Relief,and Economic Security Act("CARES ACT"),through the State of Florida Division of Emergency Management, to be used in assisting local governments in the recovery process from the COVID-19 pandemic. Monroe County created the Monroe County CARES Act Program to distribute the County's initial award of CARES Act funds. BACKGROUN1? The pandemic necessitated Statewide and countywide measures to safeguard the public health to slow and stop the spread of the COVID-19. The County responded quickly to the unfolding health crisis by standing up our Emergency Operation Center, performing public health and safety measures, ensuring food and services to our vulnerable populations, securing PPE and other necessary equipment and shifting the County's workforce to telework. The municipalities and Constitutional Officers also took pro-active and protective steps, including implementing the ii critically important checkpoint to discourage visitors driving in from neighboring "hotspots"and mitigate the spread U of the virus in Monroe. All local government entities coordinated with ongoing emergency actions by the State, issuing guidance, complying with and enforcing the State's and County's emergency directives. w The State of Florida and Monroe County issued safer-at-home directives leading to the closure of all non-essential businesses, causing the loss of jobs in those businesses, acutely impacting the tourism industry, the Florida Keys' single most important industry. z The closures struck an immediate and significant blow to our entire economy, shuttering hotels,restaurants,bars, and M recreational and cultural enterprises for 10 weeks between March 23 and June 1. Monroe's domestic and international c- tourism stopped. Cruise ships halted operations and inbound passenger airline flights were virtually empty. After re-opening on June 1, businesses are active and tourists are returning but economy recovery is hampered by persistent and climbing infection rates. Monroe County's economy is tourism-based with approximately 35% of our jobs are in the tourism industry (State (n ofFlorida Office ofEconomic and Demographic Research, May 2020). The vast majority of our 14,000 tourism jobs are specifically in hotels,restaurants and bars. In terms of tourism employment as a percentage of total employment, Monroe County is number one in the State (Economic Impact of Tourism in the Florida Keys, TDC 2018). 0 Thousands of workers were suddenly without jobs. Monroe's unemployment rate,which was the lowest in the State in February at 2.8% shot to 8.4% in March. By April, it had climbed to 17.5%, and to 17.7% in May. These are 0 among the very highest rates in the State, and surpass the statewide unemployment rates. 0 Local government sales tax revenue receipts plummeted. Through the months of April, May and June, the County C experienced a sudden and profound revenue loss even as we continued to provide core services. E Recognizing the economic disruption of social distancing directives to communities across the nation, Congress passed the CARES Act on March 27, 2020, providing over $150 billion in direct federal assistance to states and eligible local governments due to the COVID-19 pandemic. In June 2020 Governor DeSantis announced that the $1.275 billion of the $3.747 billion reserved for direct assistance to eligible Florida local governments would be distributed to Florida counties having a population less than 500,000 ("Small County") through an agreement with the State Division of Emergency Management (DEM). Small County allocations are based on a methodology similar to that used for counties with a population greater than 500,000,who received their funds direct from the US Treasury. Each County accepting CARES Act funds must develop a plan for how they will use their CARES Act funding. The plan must take into account local government, municipalities and constitutional officers. 2 1 P a g ;ter Packet Pg. 155 G.1.a All programs and costs identified in a plan must strictly adhere to the CARES Act criteria and the US Treasury's most recent guidance on allowable activities and costs,which includes but may not be limited to the following: • Medical expenses related to COVID-19, e.g., testing, emergency medical response expenses, public telemedicine capabilities. • Public health expenses related, e.g., communication and enforcement, purchase and distribution of PPE, disinfection of public areas or facilities,public safety measures, quarantining individuals. • Payroll expenses not budgeted and for certain individuals whose services are substantially dedicated to mitigating or responding to COVID-19 • Expenses of actions to facilitate compliance with COVID-19 related public health measures,e.g.,food delivery to certain populations, improvement of telework capabilities for public employees, paid sick, medical and family leave under specific circumstances. • Expenses associated with the provision of economic support in connection with COVID-19,e.g.,grants to small businesses,payroll support,unemployment costs if such costs will not be reimbursed by the federal government U- pursuant to the CARES Act or otherwise. i v) LU Specific unallowable costs include,but may not be limited to: e( • Replacement of lost revenues. • Non COVID-19 related expenditures. • Cost not accounted for in the budget prior to March 27,2020. �- • Cost incurred and paid between March 1, 2020 and December 30, 2020. a. • State Medicaid cost share. C 0 • Damages or costs paid or reimbursed from other sources. • Payroll for employees whose services/duties are not substantially dedicated to COVID-19. • Reimbursement of donated services or supplies. • Workforce bonuses. • Severance payments. • Legal settlements. CARES Act funded programs and costs must also adhere to the following criteria: cj 2 • A necessary expenditure incurred due to the public health emergency with respect to the COVID-19. C • Costs were not accounted for in the County's budget prior to March 27, 2020 (the date of enactment of the CARES Act). • Costs were incurred and paid during the period that begins on March 1, 2020 and ending December 30, 2020. E • Expenses not paid as of December 30 2020,will not be eligible for reimbursement and any unspent CARES 2 Act funds will revert back to the State. • Timely reporting to DEM on progress and expenditures. • Adherence to 2 CFR 200 in regards to all grant administration,procurement, contracting, audits, etc. The US Treasury advised that local governments receiving CARES Act funds will be audited, and that costs deemed unallowable will be subject to recoupment by the US Treasury. Counties were further advised that their state revenue sharing payments would be reduced by the amount of any costs deemed unallowable by the federal or state auditing entity. 3 1 P a g ;ter Packet Pg. 156 G.1.a MONROE'COUNTY'S ALLOCATION AMOUNT Monroe County's CARES Act total allocation from the State is projected to be $13,003,340. • The initial 25%is an advance payment of$3,250,835. • The remaining 75%, $9,752,505 will be available on a cost reimbursement basis. The State of Florida will oversee these CARES Act funds allocated to Monroe County and has implemented the following requirements: • The State released an advanced payment("Phase 1") of 25%, or$3,250,835,to Monroe County,upon execution of a sub-recipient funding agreement in late June 2020. • All further funds ("Phase 2") are reimbursement-based, as needed. The State will issue further guidance on the S release of the balance of funds. • The County will use the fund disbursement on eligible expenditures as defined by the CARES Act, and related guidance from the U.S. Department of the Treasury. et • The County agrees to repay the State of Florida any portion of the disbursed funds that is unused,or is not utilized LU in accordance with the CARES act stipulations. U • The County agrees to submit quarterly reports to FDEM detailing the expenditure of disbursed funds as well as projections of eligible expenditures. • All counties should provide funds to municipalities located within their jurisdiction on a reimbursement basis for expenditures eligible under the CARES Act and related guidance. a. • All funds must be fully expended (le, invoiced and paid) by December 30, 2020, and any unspent funds as of o December 30, 2020 shall revert to the State. c It is important to note that the FDEM's current CARES Act funding agreement with the County is specifically only for$3.25 million. The agreement makes no reference to the County's full allocation amount. Thus,the allocation plan accounts only for the receipt of$3,250,835 Per the terms and conditions of the executed agreement with the State, any further allocation will be a cost reimbursement-based process. A cost reimbursement-based process will require that Monroe County expend its own funds first, and then request and wait for reimbursement of the expenditures made. This requirement will be a :5 significant challenge given the County's COVID-19-related cash flow and budget constraints. U 2 C 0 ELIGIBLE USES OF FUNDS' The funds must be used in accordance with the requirements of the CARES Act, guidance from the United States Treasury, and the terms and conditions of the subrecipient agreement with the State of Florida Division of Emergency Management. Since passage of the CARES Act,the Treasury Department, the federal agency charged with oversight of the CARES Act,has released guidance documents in the form of Guidance and Frequently Asked Questions to expound upon and clarify allowable expenses. Per Treasury Guidance, expenditures must be used for actions taken to respond to the public health emergency and these include: o Expenditures incurred to allow the State or local government to respond directly to the emergency, such as by addressing medical or public health needs, protective supplies, public safety measures, payroll expenses for public safety,public health, health care, human services for services to mitigate or respond to the COVID-19 crisis, expenses related to telework for public employees, etc. 4 1 Pa ge Packet Pg. 157 G.1.a o Expenditures incurred to respond to second-order effects of the emergency, such as by providing economic support to those suffering from employment or business interruptions due to COVID-19-related business closures. Treasury guidance further makes clear that CARES Act funds to State and Local Governments may not be used to fill shortfalls in government revenue.Although a broad range of uses is allowed,revenue replacement is not a permissible use of CARES Act payments. MONROE'COUNT 'S'ALLOCATION PLAN FOR THE AMOUNT OF THE ADVANCE As previously noted,the State has advanced Monroe County 25%of its total allocation,or$3.25M. These funds have been deposited in our account and we may expend them as soon as we determine an allocation plan. The Board's CRF funding allocations for the initial 25% advance amount are necessary, appropriate and allowable, are outlined below: v) 1) ECONOMIC RELIEF TO RESIDENTS AND BUSINESSES throughout Monroe County, inclusive of the municipalities, suffering from COVID-19-related employment or business interruptions, specifically: z o Residential Rent,Mortgage and Utility Relief: $200,000 Up to $200,000 for residents throughout Monroe County who have been CL economically impacted by COVID-19, for example by being laid off, furloughed, o having their jobs eliminated, hours/wages reduced, etc.impacted by COVID-19 M related job loss or reduced hours. c o Small Business Assistance Grant Program: $1,000,000 Up to $1,000,000 for small businesses throughout Monroe County experiencing economic hardship as result of the closures and social distancing guidelines related to the COVID-19 pandemic. This assistance is intended to offset the significant, temporary loss of revenue to these qualified businesses during this pandemic. 0 2 2) PUBLIC HEALTH AND SAFETY COSTS INCURRED BY LOCAL GOVERNMENTAL ENTITIES for COVID-19 related response, mitigation and recovery efforts, and CARES Act program implementation and compliance costs. m o Constitutional Officers: $1,300,000 Sheriff, Clerk of the Court, Tax Collector, Supervisor of Elections o Monroe County and Municipalities: $680,000 Monroe County BOCC, City of Key West, City of Marathon, Village of Islamorada, City of Key Colony Beach and City of Layton. These funding allocations are described in further detail on the following pages. 5 P a g ;ter Packet Pg. 158 G.1.a PUBLIC SAFETY/PUBLIC HEALTH EXPENSES BY GENERAL GOVERNMENT PHASE 1 ALLOCATION: $1,980,000 PURPOSE Cover allowable expenses incurred by local government entities: Constitutional Officers, County, Municipalities, for the response, mitigation and recovery related to the COVID-19 pandemic, including CARES Act program implementation and compliance costs. • Constitutional Officers: $ 1,300,000 • County and Municipalities: $ 680,000 EXAMPLES OF ALLOWABLE EXPENSES Public health and public safety measures related to COVID-19, including communication and enforcement, �. purchase and distribution of PPE, disinfection of public areas and facilities, public safety measures, quarantining individuals. v) w Expenses of actions to facilitate compliance with COVID-19 for public health measures, including food delivery to certain populations,improvement of telework capabilities for public employees,paid sick,medical U W and family leave under specific circumstances. Medical expenses related to COVID-19, including testing, emergency medical response expenses, public telemedicine capabilities Payroll expenses not budgeted and for individuals whose services substantially dedicated to mitigating or responding to COVID-19. EXAMPLES OF UNALLOWABLE EXPENSES c Lost revenues Non COVID-19 related expenses Costs accounted for in the budget prior to March 27,2020 State Medicaid cost share Expenses reimbursed under any other federal program Damages covered by insurance Legal settlements 2 Only those costs specified in the CARES Act and further clarified by the US Treasury Guidance and Frequently C Asked Questions are allowable. All funds must be fully expended (le, invoiced and paid) by December 30, 2020, and any unspent funds as of W December 30, 2020 shall revert to the State. IMPLEMENTATION Monroe County OMB will administer. Work with Constitutionals and Municipalities to assess COVID-19 related expenses incurred by local government entities to be reimbursed from the CARES Act funds, determine future needs. Prepare and execute necessary certification forms and agreements to allocate CARES Act funds. Prepare audit-ready tally of expenses and submit Requests for Reimbursements ("RFR"s) to FDEM per requirements of funding agreement between Monroe County and FDEM. 6 1 Pa ge Packet Pg. 159 G.1.a SMALL BUSINESS EMERGENCY ASSISTANCE PROGRAM PHASE I ALLOCATION: $1,000,000 PURPOSE Provide economic support and relief to businesses of Monroe County(inclusive of municipalities)that are experiencing economic hardship as result of the closures and social distancing guildCOVID-19 pandemic. This assistance is intended to offset the significant, temporary loss of revenue to these qualified businesses during this pandemic, by covering expenses such as employee wages, vendor bills and rent/mortgage payments. BUSINESS RELIEF The Monroe County CARES Business Assistance Program consists of a one-time, fixed-amount grant to qualifying Monroe County-based for-profit small businesses with up to 25 employees to aid in their recovery from the COVID-19 pandemic and related business interruptions, closures, suspensions, reduced customer demand or increased expenditures. e( Monroe County has allocated up to $1 million for eligible small businesses to each receive a one-time grant: LU • Sole Proprietors: $2,500 • Businesses with 2-10 Employees: $5,000 W • Businesses with 11-25 Employees: $7,500 z ELIGIBILITY REQUIREMENTS For-profit business that is physically located in Monroe County. CL Must certify a COVID-19 related business interruption. o 1-25 full-time employees. Active state business registration and licensed to operate in Monroe County, or the Municipality located in. Can demonstrate ongoing business operations as of February 29, 2020 and commitment to resume normal operations. Self-employed,independent contractors, 1099s, sole proprietorships, C-Corps, S-Corps, LLC's are eligible. Home-based businesses are eligible if they are registered as businesses and are legally allowed to operate that business from the home. Publicly traded businesses not eligible. Not delinquent on local, state or federal taxes and is not operating in violation of any local, state, or federal laws. U Must provide completed application and required documentation. 0 MINIMUM REQUIRED DOCUMENTS Florida Division of Corp Business Registration number(sunbiz.org) Monroe County or Municipal business tax receipt number m Current W-9 Form Proof of Employee Count W-3 Summary, IRS Form 1096 or IRS Form 941 or sole proprietor statement Y( rY> p p ) Negative Impact Demonstration Tax return documentation IMPLEMENTATION Monroe County will make applications and Program Guidance Document/FAQ available online, and accept completed application packets directly online or by email. Monroe County OMB will administer. Application packets will be reviewed for eligibility and completion by County and then forwarded to Clerk's office for additional review and disbursement. Funding will be provided on a first come, first served basis. 7 1 P a g ;ter Packet Pg. 160 G.1.a RESIDENT EMERGENCY RENT/MORTGAGE/UTILITY ASSISTANCE PROGRAM PHASE I ALLOCATION: $200,000 PURPOSE Provide economic support and relief residents of Monroe County, inclusive of the municipalities, experiencing economic hardship from the loss of income, reduction in hours, or unemployment as a result of the COVID-19 pandemic. INDIVIDUAL RELIEF Financial assistance will be provided for overdue payments rent, mortgage, and/or utilities (electric, water, gas) for those who are residents of Monroe County and were actively employed prior to March 27, 2020. Payments will be made direct the property owner lessor mortgage com companies, and/or utility providers. Assistance may only be p p Y (lessor), p � Yp y y � provided for past due rent/mortgage payment and/or utilities due March 1,2020 to December 31,2020. The amount of assistance will be determined by need. Assistance will be provided until funding runs out, in the order of U_ completed applications received. v) • This allocation will be supplemented by an additional funding allocation from the Florida Housing Finance Corporation, which awarded Monroe County $638,000 in its first funding round, for rent/mortgage/utility assistance to residents negatively impacted by COVID-19. e( MINIMUM ELIGIBILITY REQUIREMENTS Applicant must: Reside in Monroe County, Florida c- Pay rent or mortgage (and are homesteaded)in Monroe County, Florida Have experienced job loss or reduction in hours/wages due to COVID-19 Have a lease or mortgage and other utilities in their or a household member's name Be U.S. Citizen or permanent legal resident Must not have received any other financial assistance for rent for the timeframe payment is requested MINIMUM REQUIRED DOCUMENTS Applicant must provide: Completed application c Photo I.D. for applicant(U.S. Government issued driver's license,passport, etc.) W Social Security Card for applicant,or a document from a government entity or verifiable institution that includes C full social security number c Proof of past due rent, mortgage or utility payments Certification of loss of income due to COVID-19 m IMPLEMENTATION Monroe County Department of Social Services will administer program. Application packets will be collected,reviewed for completion,and forwarded to Clerk for review, approval and payments. Payments will be made directly to the property owner(lessor),bank/mortgage company, and/or utility. Funding assistance will be provided on a first eligible-first served basis. 8 1 Pa ge Packet Pg. 161 G.1.b y BOARD OF COUNTY COMMISSIONERS ' Monroe County CARES y Ma or Heather Carrutha Mayor Pro Tem Michelle Coldir Business Assistance Program Commissioner Craig Cal Commissioner David R Applieation and Agreement Commissioner Sylvia Murp .4m. The Monroe County CARES Program is a grant program funded by an allocation to Monroe County from the feder Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), through the State of Florida Division of Emergenc Management, to be used in assisting local governments in the recovery process from the COVID-19 pandemic. Monroe County BOCC has deemed assistance to small businesses which have been negatively impacted by COVID-1 business interruptions a necessary response to the public health emergency. The Monroe County BOCC has created th Monroe County CARES Business Assistance Program to distribute a portion (up to $1 M)of the County's initial award c CARES Act funds for grants to eligible, local, small businesses who have suffered from business interruptions, required c voluntary closures, reduced demand or increased expenditures, or other hardships resulting from the COVD-19 public healt emergency or related Executive Orders issued by Governor Ron DeSantis or other state agencies ("Executive Orders"). The Monroe County CARES Business Assistance Program consists of a one-time fixed amount grant to qualifying Monro( County based small businesses with up to 25 employees to aid in their recovery from the COVID-19 public health emergenc, and related business interruptions. The grants are targeted specifically to help local businesses, with 25 employees or less located in Monroe County. The fixed amounts will be based on number of an applicant's employees as of February 29,2020. The definition of employe includes the owner of the business plus any person that is employed full-time, part-time,or on a seasonal basis by the grar applicant. The grant amounts, based on number of employees, areas follows: • Self-Employed, Sole Proprietors (1 employee): $2,500 0 • 2 - 10 employees: $5,000 • 11 -25 employees: $7,500 Please note, under Chapter 119, Fla. Stat., information included in this application and any documentation submitted as part of the application or throughout the application process may be subject to public records requests (there are limited exceptions). v, Fill out th is application completely and attach all required documents. Failure to submit a complete application with required documents attached, or failure to submit any additional supporting documents as requested may result in your in application being delayed or denied. Completed online applications and required documents may be emailed to BIZCARESa,MONROECOUNTY-FL.GOV Applications may also be completed and submitted directly online. To access the online application, go to VVVVW.MONROECOUNTY-FL.GOV/CARES. Do not start the application without having all required documents ready to attach or your online application may not save properly and you will have to begin again. Monroe County staff and/or the Clerk may request additional supporting documents including, but not limited to, bank statements, financial statements or information, receipts, and other financial documents. Any additional documents requested must be provided. r You must read the document "Monroe County CARES Program and Guidance" prior to completing the application. There o is important information and guidance that will be helpful in determining your business'eligibility to apply, understanding the rules and regulations guiding these funds, and compliance requirements of applicants. The Monroe County CARES Program Guidance document is available at VVWW.MONROECOUNTY-FL.GOV/CARES ® I have read the document Monroe County CARES Program and Guidance prior to completing this application. 0 I understand and agree that any information provided in this application that is not protected under an exemption to Chapter 119, Fla. Stat.may be subject to a public records request under Florida Law. (Please be sure include ALL SIX PAGES of this application with your submission.) Packet Pg. 162 G.1.b Business Owner Name Phone Email (Name must match that on required documents) Business Owner Name (if more than one,add second name, phone and email address here) CD Mailing address Street City State ZIP Code Business legal name Business operating name (DBA) Taxpayer ID Number on tax filings (FEIN,TIN,or if applicable SSN for Sole Proprietorships) Business address Street City State ZIP Code (Must be in Monroe County) Mailing address Street City State ZIP Code (On IRS W-9) Business type #of Employees as of 2/29/2020 (Ex:Restaurant,bar,cleaning service,etc.) (Self-employed enter"1") Does your business fall into either of these two categories? If you select the first or second option, please provide a brief explanation of the relationship with the owner and the position held by the owner. y Owned by a Monroe County officer, agent, or employee Owned by an immediate family member or partner of a Monroe County officer, agent, or employee Neither of these �+ Describe family relationship or partnership (if applicable) Eligible business must check ALL of the following boxes to be eligible NOTE:If all boxes are not checked then you are not eligible for this grant and should not complete or submit an application. 0 © Business has 25 or less total employees including the owner and all full-time, part-time, and seasonal employees wo © Business is physically located in Monroe County (including incorporated and unincorporated areas) © Business has been negatively impacted by COVID-19 © Business is not a publicly traded company E Business is registered with Florida Division of Corporations or reporting business income or expenses on IRS tax © returns (this includes home-based businesses.) © Business was in operation prior to February 29, 2020 and plans to resume operations after the emergency guidelin are lifted © Business is not delinquent on local, state, or federal taxes and has no outstanding code enforcement liens or active code enforcement cases. © Business is legally operating and has all required licensing to operate. Packet Pg. 163 G.1.b How many employees does your business have ( includes owner and full and part-timers; it shall not include 1099s)? Is the business physically located inside the boundaries of Monroe County? — Yes No Is your business current on all local, state, or federal taxes? r Yes r No Is your business currently operating even if your doors are currently closed or partially closed ? Yes No Does your business have any outstanding code enforcement fines/liens or active code enforcement cases? Yes f N Provide brief description of the business and services/products: I certify that my business is operating legally with all required licensing. Did you receive any of the following COVID-19 or other local, state or federal assistance or insurance for your COVID-19 E related impacts? If so, you may still be eligible to receive funding from the Monroe County CARES Program, however you cannot use CARES Program funds to pay for any expenses that have been or will be reimbursed by insurance or another local, state, or federal program. Select all that apply. 0 Paycheck Protection Program (PPP) © Unemployment Assistance (self-employed take note) 0 Economic Injury Disaster Loan (EIDL) ® Cares Act Mortgage/Rent Relief(home-based businesses take note) 0 Florida Bridge Loan © Any other federal or state funding © Insurance © None of these List what expenses were reimbursed by these sources (if applicable) M How was your business negatively impacted? Select all that apply. You will need to provide documentation supporting y negative impacts. Closed due to Executive Order from the 0 Governor's Office or the Department of 0 Increased expenses Business and Professional Regulation 0 Profit Margin too low © Temporarily closed due to safety concerns 0 PPE/cleaning supply expenses © Inability to get supplies/inventory 0 Other(describe) 0 © Decreased income 0 0 Choose the categories that are in your plan for using grant funds. Select all that apply. 0 Commercial lease, mortgage, or rent © Utilities 0 Inventory expenses or inventory destruction © Payroll Expenses related to new safety or © Other (describe) 0 sanitation precautions or guidelines 0 I certify that my business was negatively impacted by the COVID-19 pandemic. © I certify that all expenses for grant funds, if awarded, will be incurred between 3/1/2020 and 12/30/2020. Packet Pg. 164 G.1.b ***IMPORTANT*** Do not forget to include ALL required documentation with this application. Failure to include required documentation WILL result in your application either being delayed or denied. ALL of the following items that you are including with this application. Taxpayer ID on all documents must match (W-9, _ State registration, IRS forms). Please mark the boxes below to confirm their inclusion: 0 Copy of the front of the State-Issued driver's license or photo ID of the name of business owner entered on this application. (The name on the ID must match the name submitted on the application.) 0 Completed and signed IRS Form W-9. (All businesses are required to fill out items 1,3,4,5 and 6. Item 2 is required only when applicable. *Item 7 is not required. The information on the W-9 must match the information on your application.) 0 Completed Monroe County Vendor Request Form (Required in order for Monroe County Clerk to issue a payment to you. There is a link to this form on the County's CARES f E Business Assistance Grant Information page.) 0 Copy (screenshot or PDF)from Florida Division of Corporations showing that your business is "Active." OR If you are a sole proprietor and not required to register with Florida Division of Corporations, check this box: 0 Copy of current Monroe County Business Tax Receipt AND if located in an incorporated area, the Business Tax Receipt from that municipality (if applicable). 0 Copy of IRS Form 941 from 1st quarter 2020 (March 31, 2020)to show number of employees as of February 29, N 2020 OR If you are self-employed as a sole proprietor or independent contractor without employees please certify that th °N business has no additional employees by checking this box: 0 0 2019 IRS tax returns showing business income and expenses (or 2018 with current balance sheet or P/L statement UWj (EIN, TIN, or SSN on tax forms must match the Taxpayer ID number entered on this application, and the business owner enterer on the tax forms must match the business owner name entered on the application.) The form depends on your type of business: U 0 For Self-employed: Form 1040 or 1040 SR with Schedule C (or Schedule E for short term rental lodging) 0 For Corporations: Form 1120 or 1120-S 0 For Partnerships: Form 1065 0 Requirements for short-term rental establishments/short-term rental management companies: © Tourist development tax receipt or canceled check for the last monthly or quarterly payment made or proof tha reservation service paid the tax on your behalf AND © Proof of permitted operation (in unincorporated, this is your VR permit or VR exemption, in incorporated areas provide permit required by the municipality. Monroe County CARES Application and Agreement Packet,Pg. 165 0 Documentation that your business suffered negative impact since March 1, 2020 due to COVID-19 and rel closure regulations and/or social distancing regulations and guidelines. Check here if you were required to close due to Governor's Executive orders, you need not provide negative impact documentation. 0 If you were not required to close, but were nevertheless negatively impacted, please provide: • A brief explanation of impacts and documentation, including: • For year-round businesses provide financial information from the quarter prior to the closures as compares to the quarter during the closure, OR your schedule C from prior year. • For seasonal businesses (including short-term rentals establishments and short-term rental management entities) provide financial information from same quarter last year as the quarter of closures in 2020, OR your schedule E from prior year. • If you are using the funds for new or increased expenses related to sanitation, PPE and other necessar, safety measures, please provide documentation of expenditures made. • You may provide other documentation of negative impact (with explanation.) 0 I understand that I may be required to provide additional documentation or information as requested by Monroe County staff as part of the grant application process or as part of a post-grant compliance audit. Read carefully before submitting application. In this Agreement, the applicant will be referred to as"you" or "Applicant." Monroe County will be referred to as"County." This application, as completed by Applicant, including the terms of the Agreement, will be referred to as"the Application" or "this Application." Any award of funds from the Monroe County CARES Program to Applicant pursuant to this Application .2 and County's review and approval of the same will be referred to as"Award." In the event that Applicant receives an Award from the Monroe County CARES Program and in consideration of the Award, Applicant agrees to the all of the following: Applicant shall not use any of the Award to pay for any expenses that have been or will be reimbursed by insurance .N or other private sources or under any other local, state,or federal program, including but not limited to other CARES �+ Act programs (such as the Paycheck Protection Program, Economic Injury Disaster Loan, Florida Bridge Loan), or other federal program. Applicant acknowledges that it will be required to repay any Award funds that have been or will be reimbursed by any of the above-described sources and shall indemnify the County for any liabilities, losses,damages,and expenses incurred by the County arising out of Applicant's failure to abide by the terms of this Agreement and County's actions LU to recoup the funds from the Applicant, including attorney's fees and costs. Applicant acknowledges and agrees that all funds from the Award have been or will be used to pay for or reimburse business costs of Applicant that were incurred only between March 1, 2020 and December 30, 2020. 0 U Applicant further acknowledges that such costs were necessaryfor one or more of the following reasons: 1)closure or reduced operations of the Applicant's business as the direct result of an Executive Order issues by the Governor of the State of Florida relating to the COVID-19 public health emergency; 2)decreased customer demand as the c result the COVID-19 public health emergency or as the result of an Executive Order issued by the Governor of the State of Florida relating to the COVID-19 public health emergency; or 3)voluntary closure of Applicant's business to promote social distancing measures as the result of the COVID-19 public health emergency. In the event Applicant does not comply with all of the terms hereof, Applicant will be required to repay the Award to County. In the event the State of Florida or the federal government at any time demands the return of the Award paid to Applicant pursuant to this Agreement, Applicant shall be solely liable for any such amounts and shall return the full amount of the Award or funds in question to the County promptly upon demand. Applicant acknowledges that, in the event the CARES funding provided to County is terminated for any reason, County may cancel the Award to Applicant prior to issuance of the Award funds with no further obligation to Applicant. Monroe County CARES Application and Agreement Packet,Pg. 166 G.1.b Applicant shall provide any information or documentation required by Monroe County Clerk of Court, in order to receive payment of the Award. Applicant shall make its best efforts to return to normal business operations as soon as is practicable and safe after the effects of the COVID-19 public health emergency subside. Applicant acknowledges and agrees that County or its agent(s)or employee(s) shall be entitled to access any of Applicant's records and supporting documentation related to this Application during regular business hours and upon request as may be necessary to conduct a full and complete audit of the records, to prevent fraud in this grant process or to ensure compliance with federal requirements. Applicant shall fully cooperate with County or its agent(s) or employee(s)and shall timely respond to any requests for such records. Applicant shall retain all records and supporting documentation related to this Application for a minimum of five (5) years from the date of any Award.At the end of such five (5)year period, Applicant will allow County to copy all such records, if desired by County. If Applicant sells the business that is the subject of this Application, or otherwise ceases business operations prior the end of the five (5)year period, Applicant will provide County a copy of all such records prior to such sale or other cessation of business operations. , Applicant declares that he/she will comply with all of the requirements contained in this Application and the Agreement provisions contained herein. Applicant shall comply with all applicable federal, state and local laws, rules, and regulations, and County policies and regulations governing this Award and this Agreement, including but not limited to the Coronavirus Aid, Relief,and Economic Security Act (Public Law 116-136), and CARES Act Agreement Y2287 between the County and the Florida Division of Emergency Management. The failure of this Agreement to specifically reference a particular federal or state law, rule, regulation or policy shall not excuse Applicant from compliance with the same to the extent such law, rule, regulation or policy is applicable to the Award or this Agreement. Applicant also declares that he/she has read the foregoing Application and that the facts and statements contained therein are true, complete and accurate, and that the expenditures for any Award granted hereunder are and will be for the purposes and objectives as stated in this Application. Regardless of whether Applicant actually receives an Award, Applicant acknowledges that he/she is aware that any false, fictitious, or fraudulent information, or the v, omission of any material fact, may subject me to criminal, civil, or administrative penalties for fraud, false statements, y false claims or otherwise. ® I have read and agree to the terms in the above agreement. Please sign your full name, as it appears on your state-issued driver's license or photo ID,to acknowledge that you agree with all the terms and requirements of this Application and the above Agreement. Applicant Signature and Date CJ 2 C 0 U Monroe County CARES Application and Agreement Packet,Pg. 167 G.1.c .� Monroe County CARES BusinessrtProgram Program Guidance and Frequently Asked Questions __.. ... ` PLEASE READ THIS ENTIRE DOCUMENT BEFORE SUBMITTING AN APPLICATION. The State of Florida has a broad public records law. Applications and supporting documents are public records which Monroe County may be required to provide to the public pursuant to a request for documents. There are very limited exceptions to the requirement for public records. Financial documents and other documents with personal or business information required and provided as part of this application may or �? may not qualify for an exception. Please read the exception description on page 10 of this document. By submitting an application, you acknowledge, understand and agree that if the County receives a request for public records for your application, then your application and supporting documents will be disclosed without notice to you. INTRODUCTION The Monroe County CARES Program is a grant program funded by an allocation to Monroe County from the federal Coronavirus Aid, Relief, and Economic Security Act("CARES ACT"),through the State of Florida Division of Emergency Management,to be used in assisting local governments in the recovery process from the COVID-19 pandemic. Monroe County created the Monroe County CARES Program to distribute the County's initial award of CARES Act funds. Awards through the initial funding of the Monroe County CARES Business Assistance Program will be used to assist businesses whose principal address is located within the boundaries of Monroe County (unincorporated and 0 incorporated areas), as reported to the Florida Department of State, Division of Corporations ("Florida Division of CL Corporations") or other credible source documentation, in recouping costs associated with business interruption or expenses caused by required closures, suspensions of business, voluntary closures or decreased customer demand due to the COVID-19 public health emergency or related Executive Orders issued by Florida Governor Ron DeSantis or other federal, state or local agencies (`Executive Orders"). PROGRAM OVERVIEW As part of the CARES Act, the Monroe County Board of County Commissioners ("BOCC"), in partnership with the State of Florida Division of Emergency Management, will provide direct funds through the Monroe County CARES Business Assistance Program to local businesses who have suffered from business interruptions, closures, suspensions, reduced customer demand, or increased expenditures or other hardships resulting from the COVD-19 public health emergency or related Executive Orders. Monroe County BOCC has deemed assistance to small businesses to reimburse them for business interruptions related to the COVID-19 pandemic a necessary response to the public health emergency. 0 Monroe County is allocating up to $1 million of its initial CARES Act funding the Monroe County CARES Business U Assistance Program consists of a one-time, fixed-amount grant to qualifying Monroe County-based for-profit small businesses with up to 25 employees to aid in their recovery from the COVID-19 pandemic and related business interruptions, closures, suspensions, reduced customer demand or increased expenditures. 0 Additional CARES Act funding may be distributed to Monroe County at a future date. All CARES Act funds must be allocated completely on or before December 30, 2020. FUNDING AVAILABLE Monroe County has set aside up to $1 million for eligible small businesses to each receive a one-time grant: • Sole Proprietors: $2,500 • Businesses with 2-10 Employees: $5,000 • Businesses with 11-25 Employees: $7,500 1 Packet Pg. 168 G.1.c GRANT, NOT LOAN PROGRAM This is a grant program not a loan, therefore the funds do not need to be paid back. If you violate any of the terms of the grant agreement (included in the application), you may be required to pay back all or a portion of the grant funds. IS THE AMOUNT OF THE GRANT ENOUGH TO HELP OUR LOCAL BUSINESSES? The program is meant to serve as temporary financial reprieve for small businesses that suffered as the result of the impacts of the COVID-19 public health emergency. The goal is to help as many small businesses in Monroe County as U possible. We will continue to work with state and federal partners to help local businesses. ACCESSING AND SUBMITTING APPLICATIONS U Monroe CARES Small Business Grant applicants must submit a complete application (including signed agreement)and all required documentation. There are three ways to submit an application. You may complete and submit an on-line application OR you may download and complete a fillable form application, and save and submit that by email OR you may print that application form, fill it out by hand, scan and email to us. Due to current safety precautions, we are not accepting physical documents dropped off or delivered by hand. To access the application, please go to our CARES Act Business Assistance Grant Program website: wL monroecounty-fi.govtcares. You will find links to the online application and the fillable form or hard copy application. CHOOSE ONLY ONE. 0 • To begin your online application, click the appropriate link. You will submit this directly on-line. There will 0. be a prompt for you to attach and submit required documents. Do not start the application without having all required documents ready to attach or your online application may not save properly and you will have to begin again. y • To download a fillable form application click the appropriate link. Please email the completed application and required documents to this email address: bizcaresCamonroecounty-fi.gov • To download a hard-copy paper form, click the appropriate link. Print out the application, fill it out by hand, scan as a PDF and email the completed application and required documents to this email address: bizcaresCamonroecounty-fi.gov With any method of application, you are required to provide all required documentation at the time of application submittal in order for your application to be considered complete and ready for review. IMPORTANT: The application includes a mandatory AGREEMENT. This is a required part of the application. Please read this carefully, be sure to check the box acknowledging that you read terms of the agreement and sign it, and be 0) sure to include it with the application. Failure to include the signed agreement as part of your application will result in delay of review or denial of your application. APPLICATION TIMELINE Applications will be available beginning as soon as the program receives Board approval. Applications will continue to be funded until all qualified applicants have been paid or until the grant funds set aside for this Monroe County CARES Program are exhausted, whichever is sooner. 2 Packet Pg. 169 G.1.c FIRST COME, FIRST SERVE Funds will be offered on a first-come, first-serve basis. The time of the submittal of an application will be based on the date and time that a COMPLETED application with all proper and any additional requested, supporting documentation is received by the County. .� QUALIFYING BUSINESSES Businesses are eligible if they meet ALL of the following criteria: • For-profit small businesses with 1-25 employees(this includes self-employed,sole proprietorships, independent contractors.) • Negatively impacted by the COVID-19 pandemic. • Physically located in Monroe County, inclusive of the municipalities of Key West, Marathon, Islamorada, Key Colony Beach and Layton. • Legally registered and fully licensed (as required by applicable law). • In operation on or before February 29, 2020 and plan to resume operations after the public health emergency guidelines are lifted. • Home-based businesses that are registered and licensed/certified and show business income and expenses. • Not publicly traded. • Not delinquent on any local, state or federal taxes. • No outstanding code enforcement liens or active code enforcement cases. • Not operating in violation of any state, federal or local laws. 0 A qualifying business must meet ALL of the eligibility requirements. CL WHAT CAN I USE THESE FUNDS TO PAY FOR? Eligible business expenses include: • Lease, rent, or mortgage costs for the business location _ • Payroll • Insurance and utility costs for the business location • Inventory expenses or loss • Expenses to comply with new sanitation precautions or guidelines. * Eligible expenses must have been incurred between March 1-December 30, 2020. g� 0 * These funds may be used only for legitimate business expenses resulting from business closure, business interruptions, reduced demand or increased expenditures, any of which must be necessary as the result of the COVID- 19 public health emergency or any related Executive Orders. * In addition, these funds may not be used to pay expenses that have been or will be reimbursed or paid from insurance, or under any local, state, or federal program, including but not limited to CARES Act funds for payroll protection, loans, m or other programs, or CARES Act funds received from another local government entity. * Funds that are used for personal expenses not related to the business may be a violation of state or federal law and could result in civil and criminal penalties up to and including criminal charges. 3 Packet Pg. 170 G.1.c WHAT ARE EXAMPLES OF INELIGIBLE EXPENSES? Ineligible expenses include: • Personal expenses • Expenses that were not necessary as a result of the COVID-19 public health emergency or any related Executive Orders issued by the Florida Governor or another state agency • Expenses that did not arise from business closure, suspension, business interruption, reduced demand or increased expenditures, arising from the COVID-19 public health emergency or any related Executive Orders • Expenses that have been or will be reimbursed or paid by insurance or under any local, state, or federal program, including but not limited to other CARES Act funds for payroll protection or loans • Any expenses incurred prior to March 1, 2020 or after December 30, 2020 �? • Refinancing existing debt • Down payment for other financing WHAT DOCUMENTATION DO I NEED TO PROVIDE AS PART OF MY APPLICATION? ALL of the following items are required to be included as attachments to your application. The taxpayer ID on all documents (W-9, State registration, IRS forms) must match. Documentation requirements vary a little for sole proprietors, so review carefully. You will be asked to mark the boxes next to each required document to help you be sure that you include everything required: • Copy of the front of the current State-Issued driver's license or photo ID of the applicant. The name on the ID must match the name submitted on the application as well as one of the names on the W- c 9, Florida Division of Corporation business registration, and tax returns. CL • Completed and signed IRS Form W-9. Review your W-9 form closely. All businesses are required to fill out items 1,3,4,5 and 6. Item 2 is required only y when applicable. *Item 7 is not required. The form must be completed correctly and each field you enter on your grant application must match the information on your W-9 exactly. You may download a blank IRS Form W-9 from IRS.gov. Make sure to complete and sign the form before uploading or sending with your application. • Completed Monroe County Vendor Request Form This is required in order for Monroe County Clerk to issue a payment to you. A link to this form is provided on the WV.MONROFCOUNTY-FL.GOWCARFS website. • Copy from Florida Division of Corporations showing that your business is "Active." This requirement is intended to provide proof that the business is active and in good standing and was in operation before February 29, 2020. The copy can be a screen shot or PDF. The State of Florida Division of cU Corporations and related filings can be found at www.sunbiz.org. 2 C Note for sole proprietors: Sole proprietors operating under the owner's legal name may not be required to file c with the Florida Division of Corporations, but all other entities/business structures (including those working under a DBA of fictitious name) are required to register/file with the Florida Division of Corporations. Sole proprietors will be able to prove their business operation by providing other required documents on this list (Schedule C of your IRS form and County Business Tax Receipt, and city's if applicable). • Copy of current Monroe County Business Tax Receipt AND if located in an incorporated area, the Business Tax Receipt from that municipality, if applicable. 4 Packet Pg. 171 G.1.c • Proof of Employee Count: We will need you to document the number of employees you have. You will need to provide IRS Form 941 from 1st quarter 2020 (March 31, 2020). The taxpayer ID (EIN, SSN, or TIN) on these documents must match both the W-9 and Sunbiz registration. • If you are self-employed as a sole proprietor or independent contractor without employees you do not have to provide documentation, however you will be asked to check a box to certify that your business _ has no additional employees. • Tax Returns:You are required to provide your most recent tax returns showing business income and expenses. We prefer 2019 returns but if you have not yet submitted 2019 returns, you may provide 2018 returns with current balance sheet or P/L statement. The taxpayer ID number (EIN, SSN, TIN) that you enter on the application form must match the numbers on your tax forms. The business owner name on the application form LU must match the name on the tax return. (NOTE: Regarding public record law, if you believe your financial information meets the definition of the trade secret exemption, please mark your financial information as "Confidential." See definition of trade secret law on p. 10 of this Guidance Document.) The type of return depends on your type of business: • For Self-employed: Form 1040 or 1040 SR with Schedule C (or Schedule E for short term rental lodging) • For Corporations: Form 1120 or 1120-S • For Partnerships: Form 1065 • For short-term rental establishments/management companies: please carefully review the eligibility requirements in the Guidance Document first to be sure you qualify. If you meet the requirements, please provide the following: • Tourist development tax receipt or canceled check for the last monthly or quarterly payment made or CL proof that a reservation service paid the tax on your behalf. AND • Proof of permitted operation (in unincorporated, this is your VR permit or VR exemption, in incorporated y areas provide permit required by the municipality.) • Negative Impact Demonstration: To be eligible for this grant, your business must have experienced a negative impact due to COVID pandemic and/or related closure regulations and/or social distancing regulations and guidelines. • If your business was required to close due to Governor's Executive orders, you need not provide LU negative impact documentation; it is inferred that if business was required to it incurred a negative impact. You will be required to certify that your business was negatively impacted by checking the appropriate box on the application, and by signing the application/agreement you are certifying this to be true. 0 • Even if your business was deemed an essential business and not required to close, you may U nevertheless have been negatively impacted. If so,we ask that you provide a brief explanation of impacts and the following documentation: 0 • For year- round businesses you may provide financial information from the quarter prior to the closures as compared to the quarter during the closure. • For seasonal businesses you may provide financial information from same quarter last year as the quarter of closures in 2020. ■ If you have a compelling reason to provide alternative documentation of negative impact you may do so, with an explanation of your impact. This may prompt a request for follow up information. • If you are using the funds for new or increased expenses related to sanitation, PPE and other necessary safety measures, please provide documentation of expenditures made. 5 Packet Pg. 172 G.1.c • You will be also required to certify that your business was negatively impacted by checking the appropriate box on the application, and by signing the application/agreement you are certifying this to be true. WHAT HAPPENS IF I DO NOT INCLUDE ALL OF THE REQUIRED DOCUMENTS WHEN I SUBMIT MY APPLICATION? Your application will not be considered complete if you do not submit all the required documents or if you submit incorrect documents. Your application will not be considered for funding, until it is a complete application. Only submit your application when you are able to provide the required and correct documents.Applications will only be considered when they are submitted in their entirety. Incomplete submissions will delay the process and could result in your application being delayed or denied. QUESTIONS ABOUT THE APPLICATION �? Monroe County is here to help answer questions about the application or eligibility. Email your questions to: bizcares(")a monroecounty-fi.q . Questions will be answered in the order in which they are received. Due to the widespread impact of the pandemic on our local community, the County anticipates a high volume of applications. Your local Chambers of Commerce are also committed to providing application assistance. You do not have to be a member. Here is the contact information: • Key West Chamber of Commerce: Dorothy Shmida, 305-294-2587, LommitteesCake�westchamber.orq • Lower Keys Chamber of Commerce: Dave Turner, 305-872-2411, exec utivedirector(`a,Iowerkeyschamber.Lom • Marathon Chamber of Commerce: Daniel Samess, 305-289-5848, Leo fioridakeysmarathon.Lom • Islamorada Chamber of Commerce: Judy Hull, 305-664-4503, directors islamoradaLhamber.Lom • Key Largo Chamber of Commerce: Eileen Eadie or Elizabeth Moscynski, 305-451-1414, CL presidentCke�largoLhamber.orq and viLepresident(")a ke�largoLhamber.org WHAT IS THE APPLICATION REVIEW AND APPROVAL PROCESS? Upon receipt by the County of a complete application with all required supporting documentation, the following process will take place: _ • Monroe County staff will notify the applicant by email of receipt of the application. • Monroe County staff will review submitted applications for completion. • Monroe County staff will contact applicants about missing attachments and documentation or if attachments are not properly signed, etc., but is NOT RESPONSIBLE for any delay of applications that do not include all of the required attachments and documentation. Please be sure to include a current, accurate email address and c, phone number. We are not responsible for communication failures with regard to incomplete applications. • Applications will not be marked complete, nor processed until all required documents, and any additional requested documents are received. This includes proper dates and required signatures all on documents. • Upon approval of a complete application, the application will be sent to the Monroe County Clerk of Court for funding. 0 • The Monroe County Clerk of Court will have the right to request additional documentation as necessary before releasing funds. • The Monroe County Clerk of Court will have the right to refuse funds if the Clerk determines that an application E that is illegal, untruthful, or otherwise contains incorrect information has been submitted as part of the application process. • Upon final approval of the Monroe County Clerk of Court, a grant payment will be issued. IF I'M APPROVED, HOW QUICKLY WILL I RECEIVE ASSISTANCE? 6 Packet Pg. 173 G.1.c Complete applications with all required documentation will be reviewed on a first-come, first-served basis. Depending on the number of applicants, it may take several weeks from the date of application submission until eligible business owners and individuals will receive the approved funding. WHAT IS THE DEFINITION OF "EMPLOYEE" FOR THIS PROGRAM? An employee is defined as the owner of the business (applicant) and an individual who receives a paid wage or salary from which employment taxes e. FICA, FUTA and income taxes are withdrawn and remitted to the IRS, as evidenced E ( g� ) by business tax returns filed. "Employee" includes the owner and any full-time, part-time and seasonal employees if they received a wage or salary from which employment and income taxes are withdrawn. HOW DO I SHOW HOW MANY EMPLOYEES ARE IN MY BUSINESS? The employee count is based upon what your business reported to the IRS via Form 941 or W-3 prior to February 29, �? 2020. Self-employed individuals do not have to submit payroll information, but the applicant must check the box on the application (under required documentation) certifying that the business has no additional employees. I EMPLOY 1099 WORKERS AT MY BUSINESS. DO THEY COUNT TOWARD MY 1-25 EMPLOYEES? No. For purposes of eligibility for this program, independent contractors/freelancers/1099 employees may not be counted as employees. Only regular employees (reported on W-2s) including full-time and part-time count toward your maximum of 25 employees. An employee is defined as an individual who receives a paid wage or salary which employment taxes (e.g. FICA, FUTA) and income taxes are withdrawn and remitted to the IRS, as evidenced by business tax returns filed. A company that solely employs independent contractors qualifies as a self-employed applicant for this program. 0 DO HOME-BASED BUSINESSES QUALIFY? Yes, a home-based business will qualify but it must have a current Monroe County Business Tax receipt, appropriate licensing and be operating legally as a business. If you received rental/mortgage/utility assistance through another program, take caution in applying for this grant. You may not use Monroe County CARES Program funds for any expenses that have been reimbursed by any other local, state, or federal programs including unemployment assistance funds. Expect to have to provide additional requested documentation either as part of your application review, or during post-grant compliance auditing that demonstrates that funds from both sources were NOT duplicative. DO SOLE PROPRIETORS QUALIFY? 0 U Yes, as the business owner you are considered the sole employee, and you qualify as long as you meet all other W program criteria. 0 DO 1099 CONTRACTORS QUALIFY? Yes, 1099 contractors are self-employed individuals and are eligible as long as they meet all other program criteria. ** Note to Sole Proprietors who enter their Social Security Number as their Taxpayer ID number on the application: All applicants are required to enter their Taxpayer Identification Number on the grant application, and this must match the number on their business tax filings. Sole proprietors have the option with the IRS to use their Social Security Number instead of a Federal Employer Identification Number. If this applies to you and you entered your Social 7 Packet Pg. 174 G.1.c Security Number on the application, please note that your Social Security Number information will be kept confidential and will be redacted in any public records request. AS A SELF-EMPLOYED PERSON, I RECEIVED CARES ACT FEDERAL PANDEMIC UNEMPLOYMENT COMPENSATION AM I ELIGIBLE TO RECEIVE THIS BUSINESS ASSISTANCE GRANT? Yes, however,we urge caution on this point. You may not use Monroe County CARES Program funds for any expenses that have been reimbursed by any other local, state, or federal programs including unemployment assistance funds. Expect to have to provide additional requested documentation either as part of your application review, or during post- grant compliance auditing that demonstrates that funds from both sources were NOT duplicative. IF I HAVE RECEIVED FUNDING FROM THE PAYCHECK PROTECTION PROGRAM (PPP), SBA ECONOMIC INJURY DISASTER LOAN (EIDL)OR OTHER FEDERAL OR STATE FUNDING, DO I QUALIFY FOR THIS GRANT? Yes. However, you may not use the Monroe County CARES Program funds for any expenses that have been or will be reimbursed by any other local, state, or federal programs such as PPP, EIDL, another COVID-19 or CARES Act related program, unemployment assistance funds, or any other local, state, or federal program, or insurance. Expect to have to provide additional documentation either as part of your application review, or during post-grant compliance auditing that demonstrates that funds from both sources are/were NOT duplicative. IF MY BUSINESS IS MOBILE AND I AM THE ONLY EMPLOYEE, DOES MY BUSINESS QUALIFY? Yes, a mobile business with only one employee (the owner/operator)with a valid Monroe County business tax receipt and license to operate is eligible. ARE CHARTER BOAT AND COMMERCIAL FISHING BUSINESSES ELIGIBLE TO APPLY FOR THIS GRANT? CL Yes, charter board and commercial fishing businesses are eligible, so long as you meet all of the other requirements. The owner should submit a copy of their captain's license and/or slip rental receipt to document location and type of business. Attach the captain's license and/or slip rental receipt under the"Active State Business Registration"category on the application. DO SHORT-TERM RENTALS QUALIFY? Yes, IF you meet ALL the following conditions: • You are a resident of Monroe County(inclusive of its municipalities) and • You have a separate investment structure that you own and • You are renting the entire separate stand-alone structure as a short-term rental property and • Your short-term rental stand-alone structure is located within Monroe County (inclusive of its municipalities) and c • You are collecting and remitting the tourist development tax as required by law and • Your short-term rental is legally operating under your local government vacation rental ordinance. 0 You must provide an IRS 1040 — Schedule E as part of your application, proof of payment of tourist development tax, and the appropriate permit/license from the county or municipality that the short-term rental structure is located in. If you claim the homestead exemption on your short-term rental property, you do not qualify. If you are renting a room or floor of your home that would not qualify. I AM A HAIR STYLIST THAT RENTS A CHAIR IN BARBER SHOP OR HAIR SALON, DO I QUALIFY? 8 Packet Pg. 175 G.1.c Yes, if you are renting a chair in a barber shop or salon, you are eligible. You will need to produce a copy of your professional license and a rent check paid to the salon. If you operate out of spare room in your home, then you must meet the requirements of a home-based business, with a current Monroe County Business Tax receipt, appropriate licensing and be operating legally as a business. DO NON-PROFITS QUALIFY? No. No 501c organizations qualify for this grant program at this time.We will have a separate funding program for non- profit entities. I OWN ONE OR MORE COMMERCIAL PROPERTIES THAT I RENT TO OTHERS FOR THEM TO CONDUCT BUSINESS ON THE PREMISES. DO I QUALIFY FOR A GRANT? No. Landlords do not qualify. I OWN MORE THAN ONE BUSINESS IN MONROE COUNTY. CAN I APPLY FOR MORE THAN ONE GRANT? No. Our goal is to disburse to as many business owners as possible. Therefore, in this current grant phase you may only apply for one business. If we hold a future round of business assistance funding, we will consider making multiple grants for additional businesses to single owners. 1 OWN ONE BUSINESS WITH MORE THAN ONE BUSINESS LOCATION IN MONROE COUNTY. CAN I APPLY FOR MORE THAN ONE GRANT? No. Only one grant per business will be awarded to those that qualify. CL I OWN MORE THAN ONE BUSINESS UNDER THE SAME NAME, ARE ALL BUSINESSES ELIGIBLE? No, companies with common ownership and/or common DBA will be treated as a single business. ONE OF THE STIPULATIONS IS THAT WE HAVE TO RESUME NORMAL BUSINESS OPERATIONS AFTER THE _ EXECUTIVE ORDERS ISSUED AS THE RESULT OF COVID-19 OR OTHER COVID-19-RELATED GUIDELINES ARE LIFTED. ALTHOUGH I INTEND FOR MY BUSINESS TO BE OPEN AGAIN, THE DOORS ARE CURRENTLY CLOSED. DOES THIS DISQUALIFY ME FOR THIS GRANT? Having your doors closed currently, either because of closure guidelines or due to profitability issues does not disqualify U you for the Monroe County CARES Program, so long as your business can resume operations after emergency guidelines are lifted. However, if you have filed for a Chapter 7 liquidation bankruptcy you are not eligible and may not apply. c, 2 r_ HOW DO I DETERMINE AND PROVE MY BUSINESS SUFFERED ECONOMIC DAMAGES FROM BUSINESS c INTERRUPTION CAUSED BY COVID-19 SINCE MARCH 1, 2020? All applicants must be able to attest that it suffered lost revenue and/or additional business expense since March 1, 2020 due to COVID-19. If your business was directly required to close due to Governor's Executive Orders, we know that your business was negatively impacted, and you need not provide any documentation proving impact. If your business was not specifically required to close, but was negatively impacted, we ask that you provide verifiable information documenting the impact. 9 Packet Pg. 176 G.1.c • A brief explanation of impacts and documentation, including: • For year-round businesses provide financial information from the quarter prior to the closures as compared to the quarter during the closure, OR your schedule C from prior year. • For seasonal businesses (including short-term rentals establishments and short-term rental management entities) provide financial information from same quarter last year as the quarter of closures in 2020, OR your schedule E from prior year. • If you are using the funds for new or increased expenses related to sanitation, PPE and other necessary safety measures, please provide documentation of expenditures made. .- • You may provide other documentation of negative impact (with explanation.) Please remember, Monroe CARES grants CANNOT be used to compensate for economic loss and additional expenses that have already been covered, paid or compensated for by insurance or by any federal program. I AM A COUNTY EMPLOYEE, OFFICER OR AGENT, OR A FAMILY MEMBER OR PARTNER OF COUNTY EMPLOYEE, OFFICER OR AGENT. MAY I STILL APPLY? You may apply as long as you are not a member of the Board of County Commissioners,or one of the County employees who developed the application and guidance document, or will be reviewing applications for grant awards, or will be monitoring grant awards for compliance. Even if you are not in one of those categories,the State Department of Emergency Management("DEM"), in conjunction with the U.S. Department of the Treasury("Treasury"), may still determine that you do not qualify forgrant funds because of a conflict of interest under Treasury rules. Unfortunately, the County does not know at this time how DEM or Treasury will decide this question. If you otherwise qualify for the grant funds, it is suggested that you submit an application. If DEM and Treasury decide that you have a 0 conflict, you will be notified at that time. If DEM and Treasury decide that that you do not have a conflict, your application will be processed and completed like all other applications. IS MY APPLICATION CONSIDERED PUBLIC RECORD? Yes. Under Chapter 119, Fla. Stat., information included in this application and any documentation submitted as part of the application or throughout the application process may be subject to public records requests. CAN I REQUEST THAT MY APPLICATION BE EXEMPT FROM PUBLIC RECORD? No. All information in the application is public record, unless covered under an exemption to Chapter 119, Fla. Stat., is subject to public records requests. 0 WHAT ARE THE EXEMPTIONS TO PUBLIC RECORD LAWS? "Certain "trade secret" information as defined in F.S. 812.081 is confidential and exempt from public records law in r_ accordance with F.S. 815.045. 0 "Trade secret" means the whole or any portion or phase of any formula, pattern, device, combination of devices, or compilation of information which is for use, or is used, in the operation of a business and which provides the business an advantage, or an opportunity to obtain an advantage, over those who do not know or use it. The term includes any scientific, technical, or commercial information, including financial information, and includes any design, process, procedure, list of suppliers, list of customers, business code, or improvement thereof. Irrespective of novelty, invention, patentability, the state of the prior art, and the level of skill in the business, art, or field to which the subject matter pertains, a trade secret is considered to be: 1. Secret; 2. Of value; 3. For use or in use by the business; and 10 Packet Pg. 177 G.1.c 4. Of advantage to the business, or providing an opportunity to obtain an advantage, over those who do not know or use it when the owner thereof takes measures to prevent it from becoming available to persons other than those selected by the owner to have access thereto for limited purposes. Please mark your financial information attached to the application as "Confidential" if you feel that it falls under this statutory definition. The County is not liable for the disclosure of confidential trade secret information that is not properly marked as "Confidential". CAN I WITHDRAW MY APPLICATION? You can request that your application be withdrawn from consideration; however, once an application is submitted, it becomes public record and cannot be destroyed. ARE THESE GRANT FUNDS TAXABLE? Yes. Per the IRS the receipt of a government grant by a business generally is not excluded from the business's gross income under the Code and therefore is taxable. https:ttwww.irs.govtnewsroomlcares-act-coronavirus-relief-fund- freguently-asked-questions WILL MY BUSINESS BE REQUIRED TO REPORT HOW I SPENT FUNDS THAT ARE AWARDED? The County reserves the right to request such information. Also note that your business may be required to provide access to such records as may be necessary to prevent fraud or ensure compliance with federal requirements. DO I HAVE TO KEEP RECORDS? After receiving funds through the Monroe County CARES Program, grant recipients must retain all documents 0 applicable to the expenditures of the grant funds and submit any additional documentation required during the grant 0. compliance period. The grant compliance period is currently unknown. It will be set by state and federal agencies and may last for an extended period of time. Noncompliance with the grant agreement may require a grant recipient to return all funds provided through the Monroe County CARES Program to Monroe County. y HELPFUL TIPS FOR APPLICANTS • Don't rush to submit—the fastest way to get approved is to make sure your application and all documents are accurate and complete. • Make sure you answer every question on the application, check all appropriate boxes, and sign the agreement. Make sure your application and responses are clean and legible. • Use the required documents checklist on page 5 of the application. Make sure you attach all required documents. Attach the documents in the order of the checklist. Make sure your documents are legible. Double check that your documents are SIGNED where applicable. 0 0 11 Packet Pg. 178 G.1.d CORONAVIRUS RELIEF FUND (CRF) APPLICATION INSTRUCTIONS FOR APPLICATION General Instructions Read the instructions for this application. Please type OR use BLUE ink. Do not use pencil or other colors of ink. Please write legibly. All blanks must be completed or have N/A written in. All household members 18 years of age or older must sign and date the application. U Submit completed application with all required documentation to the following: US MAIL: 1100 Simonton Street#1-190, Key West, FL 33040 0 EMAILto: MCSS@monroecounty-fl.&ov FAX to: 305-295-4359 IN-PERSON DROP BOXES: Gato Building, Key West, outside South entrance door, labeled Social Services Senior Center/Meal Site, Marathon, 535 33rd Street, Marathon, FL 33050 Tradewinds Shopping Center, Key Largo, Social Services Office, Near K-Mart Itemized Instructions 1. APPLICANT INFORMATION: Provide your legal name, an address where you receive your mail, e-mail o address(if applicable), date of birth, marital status and all other fields. IMPORTANT NOTE:Dock fees/boat CL slip fees are not eligible for these funds. If you receive a Section 8 Voucher OR reside in Public Housing or other subsidized housing,you MAY not eligible for these funds. 2.CO-APPLICANT/OTHER HOUSEHOLD MEMBER INFORMATION: List all other members of the household y residing in the unit/house. Attach additional sheets if necessary. 3.ALTERNATE CONTACTS INFORMATION:This information is collected to assist us in the event that you move or are living temporarily in another location. List contacts who are able to help you through this process. 4. HOUSEHOLD COMPOSITION AND CHARACTERISTICS: List current Head of Household and all other members of household. I n d i c a t e relationship of each member to the Head of Household, gender, 0 date of birth and marital status. Indicate if any members are disabled and explain if there are any expected additions to the future household (i.e., birth of a child, adoption, legal custody ruling, etc.). 5. RACE AND ETHNICITY FOR HEAD of HOUSEHOLD:Collected for reporting purposes only. 6. ELIGIBILITY INFORMATION: Collected to determine eligibility related to emergency assistance. Provide information concerning eligibility on whether you or a household member was directly affected by COVID-19. 7. OTHER ASSISTANCE RECEIVED: Provide all information on other types of assistance received (financial or U otherwise), related to COVID-19. 8. INCOME INFORMATION: Provide information on all household income sources. Income includes: o Wages,salaries and tips,alimony,child support, military income,part-time or temporary income,TANF, 0) Social Security, other benefits, income for all household members aged 18 years or older. Food Stamp (SNAP) benefits are NOT considered income. o 9.ASSET INFORMATION: Provide information on assets for all household members. Typical assets include, but are not limited to: E • Cash held in savings,checking accounts, safe deposit boxes, homes,etc.; • Stocks, bonds,treasury bills, CDs, mutual funds, money market accounts, and other investment accounts; REVISED 8/5/2020 1 Packet Pg. 179 G.1.d • Individual retirement accounts, 401(k), Keogh accounts, and other similar retirement savings accounts; • Cash value of life insurance policies available to the holder before death; • Personal property that is held for investment purposes; • Equity in real property; • Retirement and pension funds; • Mortgage or deeds of trust held by the applicant Some items of personal property NOT counted as assets include: • Automobiles; • Jewelry; and/or • Term life insurance policies — 10. PUBLIC RECORDS DISCLOSURE AND ACKNOWLEDGMENT E Your signature on this form, and the signatures of each member of your household who is 18 years of age or older, authorizes Monroe County Board of County Commissioners/Monroe County Social Services to obtain information regarding your eligibility and continued participation in the CRF Program. Each adult member of the household must sign this form. 11. ELIGIBILITY RELEASE and VERIFICATION AGAINST FALSE STATEMENTS FORM: It is required that the applicant listed in section #1 of the application sign this ELIGIBILITY RELEASE and VERIFICATION AGAINST FALSE STATEMENTS form below,which allows the Monroe County Board of County Commissioners/Monroe County Social Services to request information concerning your eligibility and participation in this program. This ELIGIBILITY RELEASE and VERIFICATION AGAINST FALSE STATEMENTS CL form allows for income, assets, child support, etc. to be verified and documented. Additionally, all household members aged 18 or older must also sign this ELIGIBILITY RELEASE and VERIFICATION AGAINST FALSE STATEMENTS form. N Chapter 817 of the Florida Statutes provides that willful false statements or misrepresentation concerning income and assets or liabilities relating to financial condition is a misdemeanor of the first degree and is punishable by fines and imprisonment provided under§775.082 or 775.083. Applicant is hereby notified that by signing below and by all adults 18 or older in household signing below, intentionally or knowingly making a materially false or misleading written statement relating to the Program could result in ineligibility for benefits,action to recover any Program benefits paid to or on behalf of applicant, and/or a referral to criminal law enforcement. Applicant represents that all statements and representations made by applicant regarding Proceeds received by applicant have been and shall be true and correct. Applicant's Signature Date 0 Household Member Signature Date 2 Household Member Signature Date Household Member Signature Date Household Member Signature Date REVISED 8/5/2020 Packet Pg. 180 G.1.d Monroe County Board of County Commissioners Monroe County Social Services Monroe County, Florida CRF Duplication of Benefits Agreement with Recipient Whereas, is receiving Florida Housing Finance Corporation (Name of Applicant) (FHFC) Coronavirus Relief Funds (CRF) in the amount of$ to provide funding to: t� (Leave blank pending eligibility) W (_pay rent or pay mortgage or other: ) for the property located at: (Applicant's physical address) Now,therefore, Monroe County Board of County Commissioners/Monroe County Social Services (MCSS) has an option to recoup/recover financial assistance used on the property listed above upon the terms and conditions listed below: 0. >. Federal Benefits and Charitable Donations CIO Recipient agrees that if he/she receives additional federal benefits or charitable donations to pay any of the CD items listed above in connection with the COVID-19 response,the recipient will report receiving benefits by CL emailing MCSS@monroecounty-fl.gov or calling 305-292-4585 within one (1) month of receipt of additional benefits. If recipient fails to report additional federal benefits or charitable donations, then MCSS may require immediate repayment in full of the entire amount of assistance provided. Duplication of Benefits Recipient agrees that if any COVID-19 benefits are received after the receipt of these CRF funds (i.e. federal benefits or charitable donations), the following shall apply: 1. If the Award has been fully expended by the County, any subsequent duplication of benefits shall be CD m repaid by recipient to the County up to the amount of the award. 2. If no portion of the award has been expended by the County, any subsequent duplication of benefits o shall be paid by the recipient to the County and used to reduce the award. If the application of the subsequent duplication of benefits would reduce the award to zero, all subsequent duplication of benefits and any funds previously paid by the recipient to the County shall be returned to the recipient, and this agreement shall terminate. 3. If some portion of the award has been expended by the County, any subsequent duplication of benefits shall be used, retained and/or disbursed in the following order: (1) subsequent duplication of benefits shall first be aid b recipient to the Count to reduce the unex ended portion of the award; 2 if the p Y p� Y p p ( ) application of the subsequent duplication of benefits would reduce the unexpended award to zero, any remaining subsequent duplication of benefits shall be applied to expended portion of the award and o retained by the County; (3) if the application of the subsequent duplication of benefits reduces both the unexpended and the expended portions of the award to zero, any remaining subsequent duplication of benefits shall be returned to the recipient, and this agreement shall terminate. o 4. If the County makes the determination that the recipient does not qualify to participate in the program or the recipient decides not to participate in the program, the subsequent duplication of benefits and any funds previously paid by the recipient to the County that have not been used or obligated by the program shall be returned to the recipient, and this agreement shall terminate. 5. Once the County has recovered an amount equal to the award,the County will reassign to recipient any rights assigned to the County pursuant to this agreement. REVISED 8/5/2020 Packet Pg. 181 G.1.d Income Eligibility Recipient certifies that he/she has provided complete, accurate, and current information regarding household income to demonstrate recipient's eligibility to receive Coronavirus Relief Funds (CRF). Enforcement The Recipient and the Monroe County Board of County Commissioners/Monroe County Social Services (MCSS) acknowledge that MCSS has the right and responsibility to enforce this agreement. Whereas, if the recipient does not violate any of the terms listed in this agreement, then this agreement will be considered released on the 31"day of March 2021. IN WITNESS WHEREOF, the undersigned recipient(s) has/have affixed his/her signature(s) and seal(s)this day of 12020. E 0 Signed, sealed, and delivered in the presence of: 0 Witness Printed Name: Recipient Printed Name: CIO Witness Signature: Recipient Signature: CL STATE OF FLORIDA COUNTY OF MONROE y Subscribed and sworn to (or affirmed) before me, by means of❑ physical presence or ❑ online notarization, on (date) by (name of affiant). He/She is personally known to me or has produced (type of o identification) as identification. NOTARY PUBLIC CJ SEAL o CJ 2 C 0 REVISED 8/5/2020 4 Packet Pg. 182 G.1.d CORONAVIRUS RELIEF FUND (CRF) APPLICATION Application Number: Date/Time Application Received _ Application Rec'd By: Information Above This Line To Be Completed By Staff Only What type of housing assistance are you requesting? Circle all that apply Rent Mortgage HOA fees Electric Water Gas Other(Explain) E 0 1JO BE COMPLETED BY APPLICANT: (Head of Household) Full Name: 0 Current Address: Apt# City,State Zip: Daytime phone: Mobile Phone: o CL E-mail Address: Date of Birth: Marital Status: Age: y Employed? Yes No Self Employed? Yes No Landlord Name or Mortgage Co. Name m Landlord Phone#or Mortgage Co. Phone# 2JO BE COMPLETED BY CO-APPLICANT: Full Name: Daytime phone: Mobile Phone: E-mail Address: Date of Birth: Marital Status: Age: Employed? Yes No Self Employed? Yes No 0 3.Alternate Contact's Information o Name: Address: Phone Number: City,State,Zip REVISED 8/5/2020 5 Packet Pg. 183 4. HOUSEHOLD COMPOSITION,CHARACTERISTICS AND FAMILY STATUS: -As of today, list all other member G.1.d household. Indicate the relationship of each family member to the Head of Household (spouse,sibling, etc.) listed in Item#1. In addition, include any family members who will be added to the household within the next 60 days (i.e. newborn, adopted child, etc.). Relationship Is household Household Date of Marital Member Name to Head of Age girth Status member listed disabled? Employed HH Y/N Yes No CJ Yes No Yes No Yes No Yes No 5. RACE AND ETHNICITY FOR HEAD of HOUSEHOLD(Check one):-This information is being collected for reporting purposes only. 0 RACE (Check all that apply): ❑ American Indian or Alaska Native ❑ Asian ❑ Native Hawaiian or Other Pacific Islander ❑ White CIO ❑ Black or African American ❑ Other Multi-Racial 0 ETHNICITY(Check onel: CL ❑ Hispanic or Latino -A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish cultur or origin, regardless of race.The term "Spanish origin," can be used in addition to "Hispanic or Latino." ❑ Non-Hispanic or Latino -A person not of Cuban, Mexican, Puerto Rican, South or Central American, or other N Spanish culture or origin, regardless of race. 6. ELIGIBILITY INFORMATION:- If the answer to this question is NO,you are NOT eligible for assistance: Were you or a household member affected by COVID- ❑ YES ❑ NO 19? How many household members are/were affected by COVID-19? For each Household member affected by COVID-19, provide the following information: a. 1st household member affected by COVID-19 Name: Are they unemployed or underemployed due to COVID-19? ❑ YES ❑ NO Date the person became unemployed or under employed: Name and address of employer rior to being impacted b COVID-19: o p g � p Y 0 What was the annual gross income of this person prior to being affected by COVID-19 or March 1, 2020 whichever is m later? REVISED 8/5/2020 Packet Pg. 184 Current employer(if any): G. Current wages (if any): What was the projected annual gross income of this household after being affected by COVID-19? Is the person receiving unemployment benefits? ❑ YES ❑ NO If YES, how much are they receiving monthly$ Additional information about Hardship: b. 2nd household member affected by COVID-19 Name: E 0 Are they unemployed or underemployed due to COVID-19? ❑ YES ❑ NO Date the person became unemployed or under employed 0 Name and address of employer prior to being impacted by COVID-19: 0 What was the annual gross income of this person prior to being affected by COVID-19 or March 1, 2020 whichever is E later? 0 Current employer(if any): CL Current wages (if any): What was the projected annual gross income of this household after being affected by COVID-19? Is the person receiving unemployment benefits? ❑ YES ❑ NO If YES, how much are they receiving monthly$ m Additional information about Hardship: 0 0 For more household members, use additional sheets if necessary. Property Information Circle type of unit you live in: Mobile/Manufactured Home (pre-1994) Mobile/Manufactured Home (post-1994) Apartment House Other: U0 0 Please note that if you currently rem or owes a manufactured or mobile home constructed before.June 1994, a r- I-fousing Quality Standards Inspection (R°I S)may be required at no expense to you. Are you past due on your rent or mortgage? T ❑ YES ❑ NO m Did you request a COVID-related mortgage forbearance? ❑ YES ❑ NO Was it approved? ❑ YES ❑ NO 0 REVISED 8/5/2020 7 Packet Pg. 185 What is your monthly rent payment? G. What is your monthly mortgage payment? What is your monthly lot rent? What are the penalties/late fees due, if any? How many months of rent are due/past due? How many mortgage payments are due/past due? How many months of HOA fees are due/past due? How many months of lot fees are due/past due? Is your primary residence currently in foreclosure? ❑ YES ❑ NO 7. Did you apply for COVID-19 assistance to any other p YES p NO ca program or organization (financial or goods)? Name the organization(s) — E 0 Have you received any COVID related assistance? ❑ Yes ❑No Amount Approved? 0 Amount Received to date: List agency providing services 1 2 3 CIO 8. INCOME INFORMATION: Income includes: Wages from employment,salaries and tips, alimony, child support, military income, part-time income,temporary income,TANF,Social Security, Unemployment Benefits, Disability CL Income, any other benefits for ALL household members. List ALL household members and their incomes.Attach a separate sheet if you need more space. FOOD STAMPS ARE NOT CONSIDERED INCOME-Do NOT list food stamps. Full Time Source of Income payment Basis y Household Member Name Student? (include employer Rate of Pay (hourly,weekly, monthly, name) — Y/N etc.) If Applicable m 0 0 0 9. ASSET INFORMATION: Provide the requested information on any property you may own or assets you may have. Do you own any real estate other than your primary residence? ❑ Yes ❑ No If yes, provide address, city, and state of property(s): 0 0 What is the tax roll value of the property(s)? 0 0 If yes,what is the current balance owed on the mortgage(s)? m Do you have income from the property(s)? (rental income) ❑ Yes ❑ No Is this real estate asset currently in foreclosure? ❑ Yes ❑ No REVISED 8/5/2020 S Packet Pg. 186 List below the types and sources of any household assets. Provide both the current cash value and the estima G.1.d annual income from the asset. (A listing of examples is located in the instruction section.) Provide this information for all household members. Use additional sheets if necessary. Household Member Name Type &Source of Asset Cash Value of Asset Annual Income from ASSE E 10. PUBLIC RECORDS DISCLOSURE AND ACKNOWLEDGMENT: Your signature on this Public Records Disclosure and Eligibility Release,and the signatures of each member of your household who is 18 years of age or older, authorizes Monroe County Board of County Commissioners/Monroe County Social Services to obtain information regarding your eligibility and continued participation in the CRF Program. Each adult member of the household must sign this Eligibilit Release. 11. ELIGIBILITY RELEASE and VERIFICATION AGAINST FALSE STATEMENTS: It is required that you sign this form,which allows Monroe County Board of County Commissioners/Monroe County Social Services to request information concerning your eligibility and participation in this program. Information Covered: Inquiries may be made about anything on this application, including items initialed below by the Eu applicant. Information provided by the applicant(s) may be subject to Chapter 119, Florida Statutes, regarding Open CL Records. I certify that all the information in the application is true,to the best of my knowledge. By signing this application to verify the information contained, I,the applicant authorizes Monroe County Board of County Commissioners/Monroe 'y County Social Services to verify the information listed herein. APPLICANT MUST READ AND INITIAL EACH STATEMENT: I/We understand the information provided above is collected to determine if I/we are eligible to receive assistance under the CRF program. I/We hereby certify that all the information provided herein is true and correct, under penalty of perjury. o I/We understand that providing false statements or information for the purpose of obtaining assistance is grounds for termination of housing assistance and is punishable under Chapter 817 of the Florida Statutes as a first-degree misdemeanor. I/We authorize the above-referenced County and any of its duly authorized representatives to verify all information provided in this application. I/We understand that additional information will likely be required to move forward with this program. Applicant's Authorization: 1 authorize Monroe County Board of County Commissioners/Monroe County Social Services to obtain information about me and my household that is pertinent to determining my eligibility for participation in the Program. I acknowledge that: (1) A photocopy, scanned copy or faxed copy of this form is as valid as the original; AND m (2) 1 have the right to review information received using this form; AND (3) 1 have the right to a copy of information provided to Monroe County Board of County Commissioners/Monroe County Social Services and to request correction of any information I believe to be inaccurate; AND REVISED 8/5/2020 9 Packet Pg. 187 (4) All adult household members will sign this form and cooperate with Monroe County Board of County G.1.d Commissioners/Monroe County Social Services in the eligibility verification process. (5) Any applicant who falsified information to obtain assistance will be required to repay funds paid on behalf of the applicant to the program. Signature of Applicant: Date Signature of Co-Applicant: Date Household member: Date Household member: Date Household member: Date Household member: Date Warning: Chapter 817 of the Florida Statutes provides that willful false statements or misrepresentation concerning income and assets or liabilities relating to financial condition is a misdemeanor of the first degree and is punishable by fines and imprisonment provided under§775.082 or 775.083. o MCSS Intake Staff Signature Date 0 L_ CL c� MCSS Supervisor Signature Date y Applicant Checklist: Please provide the information listed below to ensure that your application will be processed in an expedited manner. ❑ Completed Coronavirus Relief Fund (CRF)Application; ❑ Properly executed Eligibility Release and Verification Against False Statements Form (#12); ❑ Copy of current driver's license, government ID, passport,or birth certificate for all household members; ❑ Notarized CRF Assistance Self-certification of Income Form for ALL household members 18 years of age and older(both#1 and #2 must be completed !!); ❑ Notarized CRF Duplication of Benefits Agreement with Recipient Form ❑ Copy of current lease or deed in applicant or co-applicant's name; ❑ For Homeowners: Most recent mortgage statement showing outstanding balance, monthly r_ mortgage amount, etc. o ❑ For Renters: Current lease preferred, or, if no current lease exists, a notarized statement from the landlord indicating past due amount owed each month is required. m REVISED 8/5/2020 10 Packet Pg. 188 MONROE COUNTY, FLORIDA G.1.d CRF ASSISTANCE SELF-CERTIFICATION OF INCOME FORM To be completed by each adult household member Household Member Local Government Address Phone# email 1. ❑ I hereby certify that I have been negatively impacted by the COVID-19 pandemic and am underemployed or unemployed. LL 2. 1 will receive income from the following sources over the next 12 months: (Circle Y(yes)or N(no)for each statement): Y N Wages from employment(including commissions,tips,bonuses,fees,etc.); $ Y N Net income from operation of a business; $ Y N Rental income from real or personal property; $ Y N Interest or dividends from assets; $ 0 Y N Social Security payments,annuities,insurance policies,retirement funds,pensions,or death benefits; $ Y N Unemployment; $ Y N Disability payments; $ Y N Public assistance payments; $ 0. Y N Periodic allowances such as alimony,child support,or gifts received from persons not living in my household; $ 0 Y N Sales from self-employed resources; $ CL Y N Any other source not named above; $ Y N I currently have no income of any kind and there is no imminent change expected in my financial status or employment status during the next 12 months. �+ 3.I will be using the following sources of funds to pay for rent and other necessities: I certify my anticipated gross annual income for the next 12 months to be(Total of section 2): $ m I will inform local government staff if my income changes during the period when I am receiving assistance. Under penalty of perjury, I certify that the information presented in this certification is true and accurate to the best of my 5 knowledge. The undersigned further understand(s)that providing false representations herein constitutes an act of fraud. False, misleading or incomplete information will result in the termination of benefits. The information provided is subject to verification by the county. Signature of Applicant Printed Name of Applicant Date: LU e( CJ FOR AN OATH OR AFFIRMATION.• 0 STATE OF FLORIDA U COUNTY OF MONROE 2 C Subscribed and sworn to (or affirmed) before me, by means of physical presence or online notarization, on this c day of , 2020 by (name of affiant). He/She is personally known to me or has produced (type of identification)as identification. E Notary Public Packet Pg. 189