Jse Pepe Diaz District 12 Miami-Dade Cunty Cmmissiner Mm And Pp Small Business Grant Prgram Applicatin Submit 1 riginal cmpleted applicatin with requested dcuments. We suggest yu keep a cpy fr yur recrds.
Attentin Business Owners Mm and Pp Small Business Grant Prgram Fr Miami-Dade Cunty District 12 Grant Mney Available! Up t $2,500 Per Business Applicatins available January 5, 2017 thrugh January 18, 2017 PICK UP APPLICATIONS AT: Cmmissiner Jse Pepe Diaz s District Office 8345 NW 12 Street Miami, FL 33126 Phne: 305-599-1200 Attn: Olga L Hernandez r Online January 5, 2017 at www.miamidade.gv/district12 There will be a mandatry meeting explaining the applicatin and requirements held n, January 18, 2017 at 6:30 p.m. at the Fire Fighters Memrial Bldg., 8000 NW 21 Street; Miami, FL 33122 Please be n time! Cmpleted applicatins will be accepted frm Jan. 19 Jan. 26, 2017 by 4:00pm Hand deliver applicatin t District Office N late applicatins will be accepted! Fr additinal infrmatin cntact: Ms. Glria Rice 305-756-0605 Neighbrs And Neighbrs Assciatin (NANA) Submit 1 riginal cmpleted applicatin with requested dcuments We suggest yu keep a cpy fr yur recrds!
CONTENTS Page Brief Descriptin 1 Guidelines 2 Infrmatin Meeting 3 Use f Funding 4 Applicatin Frms 5-8 Request fr Opinin 9 Jb Creatin 10-11
[- 1 -] 2016-2017 MOM AND POP SMALL BUSINESS GRANT PROGRAM Brief Descriptin The Miami Dade Cunty Mm And Pp Small Business Grant Prgram was created by Neighbrs And Neighbrs Assciatin, Inc. in 1999 t prvide financial and technical assistance t qualified small businesses that are apprved fr funding. This prgram has allwed small wned and perated businesses the pprtunity t interact with lcal gvernment under favrable cnditins, and this relatinship will ultimately bridge the gap between the tw entities. The prgram prvides financial assistance t further the ecnmic viability f recipients. Funding can be used t purchase inventry/supplies, business equipment, marketing/advertising, building/business insurance, minr interir/exterir renvatins, security systems, wrk vehicle (pick-up truck r carg van) prfessinal services, (CPA, business training, and events). Technical assistance is made available at n charge, t small businesses in rder t create a better wrking and business envirnment, prmte ecnmic develpment pprtunities, educate wners abut varius cunty-funded prgrams and prjects, frm/fster better wrking relatinships amng small business wners, retain and eventually create mre jbs, ffer the necessary training that small business wners s desperately need t becme mre efficient and cmpetitive, etc. The prgram is ffered in each 13 Miami Dade Cunty Cmmissin District, as a result, we recgnize that the needs f each district are different and ur gal is t address this diversity. In rder t receive the crrect guidelines t be cnsidered fr funding, yu must apply in the cunty district where yur business is lcated. T lcate yur district where yur business is lcated, please call 311 r visit www.miamidade.gv/cmmiss and click n Wh is my Cmmissiner? enter yur business address and submit. Applicatins and start date fr each district may differ, therefre, please be sure t pick up the apprpriate applicatin.
Mm and Pp Small Business Grant Prgram Miami-Dade Cunty [- 2 -] FY 2016-2017 Guidelines Cmmissiner Jse Pepe Diaz Mm and Pp Small Business Grant Prgram is ffering grant applicatins fr small business wners. A mandatry meeting will be held n January 18, 2017 at 6:30 p.m. at the Fire Fighters Memrial Bldg., 8000 NW 21 Street; Miami, FL 33122 All businesses must be lcated in District 12 and meet the fllwing eligible criteria: Business must be in peratin fr at least 1 year. Must be a fr-prfit business. Cannt have mre than ten (10) emplyees A physical address is required. N P.O Bx as mailing address allwed. Businesses lcated in the NRSA (Neighbrhd Revitalizatin Strategy Area) will be given special cnsideratin. Hme base businesses can apply. Required applicatin prcedures and attachments (please include the fllwing dcuments belw alng with yur applicatin): Submit ne riginal cmpleted applicatin typed r printed with all requested dcuments. Submit prf that the business has been perating fr at least 1 year. (Example: any ld license, State Crpratins, Sales Tax, r utility bill), prf must be in business name (include cpy nly). Submit a current cpy f Miami Dade Cunty Business Tax receipt r a paid receipt (include cpy nly). If license nt required by Miami-Dade Cunty, applicant must prvide written prf frm Miami Dade Cunty Tax Cllectr s Department. Submit City License if business is lcated in a City within the Cunty r paid receipt (include cpy nly). Submit a cpy f yur active State f Flrida Crpratin and/r Fictitius Name (print cpy by visiting sunbiz.rg), in additin, a FEIN # must be listed n sunbiz print ut if business is incrprated. Prvide cpy f picture ID (driver s license r State ID). Submit utside picture f business lcatin (building, hme ffice, r wrk vehicle). Businesses that cmplete jb creatin frms and receive the full amunt are required t create a new jb. If yu are an elected fficial and/r a Gvernment Bard Appintee yu must get written apprval stating n cnflict f interest frm the Miami-Dade Cunty Cmmissin n Ethics. The Selectin Cmmittee can cnsider special prjects. AUTOMATIC DISQUALIFICATION: Businesses that relcate ut f the district during the prcess. Applicatins will nt be accepted after deadline. Businesses that received funding tw (2) years in a rw must sit ut ne year. Nn-prfit agencies can nt apply. Mre than ne applicatin submitted fr the same wner(s), family member, r partners. Must nt be part f a natinal chain. **The Selectin Cmmittee has the right t request additinal infrmatin, accept, r reject any and all applicatins.
[- 3 -] PLEASE BE AWARE OF THE FOLLOWING: Mandatry Meeting All businesses that are applying fr funding must attend this meeting, which will explain the prgram requirements. Please be prepared t stay at least 2 hurs, all questins will be answered nly at that time. Attending the preliminary meeting des nt guarantee that yu will receive funding. Mandatry Meeting January 18, 2017 at 6:30 p.m. Fire Fighters Memrial Bldg., 8000 NW 21 Street; Miami, FL 33122 PLEASE BE ON TIME If yu plan t attend the meeting, please bring a cpy f the applicatin, cpies may nt be available. We recmmend that yu d nt cmplete the applicatin befre the abve meeting.
[- 4 -] ELIGIBLE USE OF FUNDING: Inventry / Supplies Business Equipment Marketing / Advertising Liability Insurance Minr Interir / Exterir Renvatins Security System Wrk Vehicle (pick up truck r carg van) Prfessinal Services (Accunting, Business Training, and Seminars, and events) Lease r mrtgage fr cmmercial space nly INELIGIBLE USE OF FUNDING: Rental Depsits Late Payment Fees Purchase f Alchl, Tbacc r Medicine Salaries Debts And any and all thers nt listed in the eligible use abve.
District 12 [- 5 -] FY 2016-2017 Applicatins Frms Mm and Pp Small Business Grant Prgram Date: A. Identifying Data Business Name (as it appears n incrpratin, r sunbiz) Business Address City & Zip Cde Business and Cell Phne # Email Address Kind f Business Operating President Name r Owner Name President r Owner Hme Address City & Zip Cde Data Universal Numbering System number, knwn as a DUNS number are REQUIRED at the time f applicatin please prvide. Apply via email at: http://fedgv.dnb.cm/webfrm/index.jsp. Print DUNS Number Here r via telephne at 1-866-705-5711 B. Amunt Requested Funding Request Amunt $
District 12 [- 6 -] C. Current Emplyee Rster 1. Number f emplyees? Full-time: Part-time: Nne: 2. Please prvide the fllwing infrmatin regarding yur current emplyees(s) add sheets if needed: Emplyee Name (Print) Date f Hire *Jb Title Full Time (FT) r Part Time (PT) **Race *Jb Title: Officials and Managers, Technicians, Craft Wrker (Skilled), Labrer (Unskilled), Sales Prfessinal, Office and Clerical, Operative (Semi-Skilled), Service Wrkers **Race W-White B-Black A-Asian AI-American Indian H-Hispanic O-Other I hereby certify that the infrmatin prvided is true and crrect. I further acknwledge that the infrmatin is subject t verificatin by authrized gvernment fficials. CERTIFICATION: President r Owner signature DATE:
District 12 [- 7 -] D. Business wners are required t prvide the fllwing infrmatin: 1. Hw lng have yu been in business? Number f years mnths 2. Have yu received Mm and Pp funding in the past? Yes N If yes, last time yu received funding (year) 3. Are yu r any f the sharehlders emplyed by Miami-Dade Cunty? Yes N If yes, what department? 4. Wuld yu be willing t participate in any ffered business wrkshp training? Yes N 5. If awarded the full amunt allwed by the prgram, knwing that the funding cannt be used fr salaries/payrll, wuld yu still be able t create a new jb? Yes N Will the new jb be full-time? Yes N If yes, cmplete page 11 and submit with the applicatin.
District 12 [- 8 -] E. BUSINESS INFORMATION 1. Describe yur Business: 2. What kind f gds r services yur business ffers t the cmmunity? 3. Briefly describe hw the funds, if awarded, will be used t help grw yur business: My signature belw indicates that I have read this dcument and fully understand its cntents. The infrmatin submitted n this dcument is true t the best f my knwledge. Signature Date
District 12 [- 9 -] Request fr Opinin frm Cmmissin n Ethics Acquiring Financial Interest I,, the wner r president f (Owner r President Name), whse business address is (Business Name), (Business Address, City, State, Zip) (Phne #) (Email) Include a shrt descriptin f the type f business perating Are yu currently an emplyee r bard member f any Miami Dade Cunty Bard? Yes N If yes, what Department r Bard? If yes, are yu seeking t cntract with Miami Dade Cunty? Yes N: I am being cnsidered fr funding thrugh the Mm and Pp Small Business Grant Prgram and request the clearance frm the Cmmissin n Ethics. Please review my request and frward t Neighbrs And Neighbrs Assciatin, Inc. t the attentin f Lery Jnes, Executive Directr, 180 NW 62 nd St., Miami, FL 33150 r fax (305) 756-6008. Thank yu in advance fr yur attentin t this very imprtant matter. Jse Pepe Diaz 111 NW 1 st Street Miami, FL 33128 This page must be cmpleted.
District 12 [- 10 -] The fllwing page must be cmpleted and returned with riginal applicatin ONLY if yur business will be able t create a new jb
District 12 [- 11 -] STATE OF FLORIDA) COUNTY OF MIAMI-DADE) JOB COMPLIANCE FORM Being duly swrn, n my ath declares: That, I, wner f agree t create ne new full-time r part-time jb fr a lw t mderate incme persn if awarded the maximum amunt under the Mm And Pp Small Business Grant Prgram within six mnths f my receipt f such award. If I fail t create the required new jb within the agreed upn time perid I will be in nn-cmpliance and will be required t pay the entire amunt f the grant back t Miami-Dade Cunty. IN WITNESS WHEREOF, I,, the undersigned Owner f, have signed this JOB COMPLIANCE FORM n this day f, 2017, and acknwledged the same t be my act. The freging instrument was acknwledged befre me this day f, 2017 by, wh persnally appeared Signature befre me at the time f ntarizatin, and wh is persnally knwn t me r wh prduced a FLORIDA DRIVER S LICENSE as identificatin. NOTARY PUBLIC: SIGN: PRINT: STATE OF FLORIDA AT LARGE