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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 None <br /> Purpose <br /> Amount <br /> ❑Government Loan ❑Government Grant ❑Government Forgivable Loan <br /> ❑Nonprofit Grant ❑ Nonprofit Loan ❑Nonprofit Forgivable Loan <br /> ❑Private Loan ❑Other: <br /> Source of Funds#2 <br /> Lender/Grant Provider Name <br /> Purpose <br /> Amount <br /> ❑Government Loan ❑Government Grant ❑Government Forgivable Loan <br /> ❑Nonprofit Grant ❑ Nonprofit Loan ❑Nonprofit Forgivable Loan <br /> ❑Private Loan ❑Other: <br /> Source of Funds#3 <br /> Lender/Grant Provider Name <br /> Purpose <br /> Amount <br /> ❑Government Loan ❑Government Grant ❑Government Forgivable Loan <br /> ❑Nonprofit Grant ❑Nonprofit Loan ❑Nonprofit Forgivable Loan <br /> ❑Private Loan ❑Other: <br /> Source of Funds#4 <br /> Lender/Grant Provider Name <br /> Purpose <br /> Amount <br /> ❑Government Loan ❑Government Grant ❑Government Forgivable Loan <br /> ❑Nonprofit Grant ❑ Nonprofit Loan ❑ Nonprofit Forgivable Loan <br /> ❑Private Loan ❑Other: <br /> EVERETT Everett CARES Small Business Grant Program Round 3 page 10 <br /> MIMI WASHINGTON <br />