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'-‘1 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 /> 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 . <br /> RECITALS <br /> This Agreement is entered into upon the basis of the following facts and circumstances: <br /> 1. I City(herein referred to as"City"or"Grantor"): I The City of Everett <br /> 2. Business name(herein referred to as -der Tflici. � x uvl <br /> "Business" "Grantee"): <br /> or Gra : J <br /> ) <br /> 3. Add essj b eolbl <br /> five. <br /> rue re+#{ Q ,< 9 g .o <br /> 4. Phone: 4,0 _ c c)� " aiop@2 ) 3 u — (2.-9 5 ( C641) <br /> 5, Contact Person: kl bt1 iu5 (Qt, IN e.4- <br /> 6. DUNS Number <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: $10,000.00 <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 /> E V E R E T T Everett CARES Small Business Grant Program Round 3 page 1 <br /> WASHINGTON <br />