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2. Introduction
   Bayfield County has received a $250,000 CDBG-CV award from the Wisconsin Department of Administration to provide grants to eligible microenterprise businesses in Bayfield County. The funding targets eligible microenterprise businesses with five (5) or fewer employees, including owner(s). Applicants also must meet low to moderate income requirements.
4. These grants will reimburse costs that the business incurred resulting from the COVID-19 pandemic or go towards current/future costs resulting from the impact from or response to COVID-19. NOTE: These funds cannot be used to duplicate expenditures for which federal or state funds businesses have already received; however, this does not include federal stimulus payments that were sent to most Americans.
6. Instructions
   This application form must be completed by the business owner.
8. Business Owner's Contact Information:
10. First Name
11. Last Name
13. Owner's Mailing Address
15. City
16. State
18. Zip
20. Owner's Phone Number
22. Owner's Email Address *
24. Business Information:
26. Business Name*
28. Business Street Address
30. City
31. State
33. Zip
35. Business Phone Number*
37. Business Email Address *
39. Business Website Address
41. Business located in what county:

    1. Bayfield County
    2. Other
43. If not in Bayfield County, in what county is this business located?
45. List the Primary Business Activity
    Restaurant, Clothing Store, Retail, etc. (be as specific as possible).
47. Is your business currently in operation?

    1. Yes
    2. No

    Not permanently closed, out of business, or filed for bankruptcy.
49. Do you have an affiliated business?

    1. Yes
    2. No
51. In what county is the affiliated business located?*
52. Is the affiliated business run through the same S-Corp, LLC, Sole Proprietorship, etc.?

    1. Yes
    2. No
54. Will these grant funds be used for any past or future expenses related to the COVID-19 Pandemic that are/will be reimbursed by other aid?*

    1. Yes
    2. No

    This grant cannot duplicate/replace any other funds, and/or any funds from the following sources: Paycheck Protection Program, Unemployment Compensation benefits, Insurance claims/proceeds, Federal Emergency Management Agency (FEMA) funds, Small Business Administration funds, other Federal/State/Local funding, other nonprofit/private sector/charitable funding.
56. Business FEIN
    Federal Employee Identification Number
57. Documentation of Business*
    Please attach at least one of the following: 1. Articles of Incorporation of LLC 2. S-Corp or Certificate of Status (from Wisconsin Department of Financial Institutions) 3. Schedule C or Partnership Return
59. Today's Date
    Today's Date
60. Questions?
    Contact Sheldon Johnson, Executive Director, Northwest Regional Planning Commission at 715-635-2197 or sjohnson@nwrpc.com.
Leave This Blank:


62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit

* indicates a required field