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,--1N Evere <br /> i „7, <br /> Grant Program <br /> CONTACT <br /> If you have any questions or need technical assistance with completing the form, please contact Tyler Chism by email <br /> tchism@everettwa.gov and include a phone number. <br /> INSTRUCTIONS <br /> This Report Form is a fillabie Adobe Acrobat PDF document. Please fill out each field shown below, marked in yellow.If the <br /> information requested is not applicable,please enter"none"in the field.Add sheets or duplicate sections as necessary. Read each <br /> component in full and provide the accurate infrrrmation, Prior to entering into an agreement,the City will require that you submit the <br /> attachments listed in Part 4 of the Duplication of Benefits Reporting Form on page 11. <br /> Please upload this completed packet here. <br /> GR <br /> r: c. R iq -/tN1T <br /> figs;. �f. '3`�rl is E M L. i <br /> RECITALS <br /> This Agreement is entered into upon the basis of the following facts and circumstances: <br /> 1, City(herein referred to as"City"or"Grantor"): The City of Everett <br /> 2. Business name(herein referred to as \QO ith West . e tL +r <br /> "Business"or"Grantee"): P--- , .i C <br /> ir <br /> 3. Address: <br /> x <br /> •— :\leif elt j aft- q .203 <br /> 4. Phone: "t D.5 --P,� --( 3G t <br /> 3 <br /> 5. Contact Person: ----� <br /> - ( .c[aVL.. <br /> 6. DUNS Number .., 31_. _ T <br /> 7. Title of Program being Funded: Everett CARES Round 3 Small Business Grant <br /> S. Time of Performance-Beginning: August 1,2020 <br /> Ending: July 31,2021 <br /> 9. Amount of Agreement/Grant Award: $20,000.00 <br /> 10, This Agreement/grant award and the rights and obligations of both parties hereto shall be subject to <br /> and governed by the following, incorporated by reference herein as is fully set forth: <br /> (1)Grant Budget attached hereto or Exhibit"A" <br /> (2)Expense Reporting Form attached hereto or Exhibit"B" <br /> The City has funds available,authorized by the City Council for helping businesses respond to the negative economic impact of the <br /> Coronavirus;and <br /> EEVERET <br /> WAsH� �O Everett CARES Small Business Grant Program Round 3 page 1 <br />