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a[y !a fi s�sg.ti rr � <br /> 1 ,, <br /> Everett <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 fillable 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 information. 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 /> GRANT AGREEMENT <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 Mad Anthony's Incorporated dba Anthony's Woodfire I <br /> "Business"or"Grantee"): Grill <br /> 3. Address: Mailing: PO BOX 3805 Bellevue,WA 98009 <br /> Physical: 1722 West Marine View Drive <br /> Everett,WA 98201 <br /> 4. Phone: 425-455-0732 <br /> 5. Contact Person: Joe Shmait <br /> 5. DUNS Number 06-167-9650 <br /> 7. Title of Program being Funded: Everett CARES Round 3 Small Business Grant <br /> 8. 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 /> EVERETT Everett CARES Small Business Grant d Program I Round 3 page <br /> WAs HiNGTOMe 1 <br />