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-Ira I vere Lif,AK n. r.,„L;,,e," <br /> i '4,:,-, <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 /> tchisrn@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 /> RECITALS <br /> This Agreement is entered into upon the basis of the following facts and circumstances: <br /> I1. I City(herein referred to as"City"or"Grantor"): [The City of Everett <br /> 2. Business <br /> ... �„ . �..:w.. __.._ tiw.w�,.M. r. _.... <br /> name(herein referred to as ,ate 2 ,,,221v/1/, Z.Aft. e+rba... <br /> "Business"or"Grantee"): <br /> b6A Z Z. ':EN/t Sre4 KBUJ e <br /> 3. Address: <br /> tie?fa e`tre7reet-) Rh"( <br /> very.d, kin r,g ei q <br /> 4. Phone: U;s 3 <br /> 5. Contact Person: \5 /) Nei-sc.f <br /> yo <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 Progpram ' Round 3 i page 1 <br /> WASNINC4TON b <br /> 1 <br />