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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 /> tics =;rnrgeverL ttota.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 herd. <br /> RANT AGREEME <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 Middleton Brewing <br /> "Business"or"Grantee"): <br /> 3. Address: 607 SE Everett Mall Way <br /> Suite 27-A <br /> Everett, WA 98208 <br /> 4. Phone: (425) 280-4530 <br /> 5. Contact Person: Geoff Middleton <br /> 6. DUNS Number 044447091 <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 /> EVE R E T T Everett CARES Small Business Grant Program Round 3 page 1 <br /> WASHINGTON <br />