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PART 3. GOVERNMENT, BANK AND OTHER FUNDING SOURCES <br /> Government,bank,and all other funding received by a business for COVID-19 Pandemic National Emergency related losses. Please <br /> identify any sources of funds that the business received as a result of the COVID-19 Pandemic National Emergency other than <br /> insurance.Sources of funds include but are not limited to: Federal,state and local loan/grant programs, private or bank loans, <br /> nonprofit donations or loans. <br /> Please indicate below the amount allocated to your business from any and all funding sources: <br /> Source of Funds#1 <br /> Lender/Grant Provider Name PPP Loan <br /> Purpose Replace lost sales to cover p/r expenses & rent <br /> Amount $75,042.00 <br /> ❑Government Loan 0 Government Grant Ni Government Forgivable Loan <br /> ❑ Nonprofit Grant 0 Nonprofit Loan 0 Nonprofit Forgivable Loan <br /> ❑ Private Loan 0 Other: <br /> Source of Funds#2 <br /> Lender/Grant Provider Name <br /> Purpose <br /> Amount <br /> ❑Government Loan Cl Government Grant 0 Government Forgivable Loan <br /> ❑ Nonprofit Grant 0 Nonprofit Loan 0 Nonprofit Forgivable Loan <br /> ❑ Private Loan 0 Other: <br /> Source of Funds#3 <br /> Lender/Grant Provider Name <br /> i <br /> Purpose <br /> Amount <br /> ❑Government Loan 0 Government Grant 0 Government Forgivable Loan <br /> ❑ Nonprofit Grant 0 Nonprofit Loan 0 Nonprofit Forgivable Loan <br /> ❑ Private Loan 0 Other: <br /> Source of Funds#4 <br /> Lender/Grant Provider Name <br /> Purpose <br /> Amount <br /> ❑Government Loan 0 Government Grant 0 Government Forgivable Loan <br /> ❑ Nonprofit Grant 0 Nonprofit Loan 0 Nonprofit Forgivable Loan <br /> ❑ Private Loan 0 Other: <br /> EVERETT Everett CARES Small Business Grant Program Round 3 page 10 <br /> WASHINGTON <br />