Small Business Sustainability Program Payment Application Instructions/Process

Transcription

1 Small Business Sustainability Prgram Payment Applicatin Instructins/Prcess Eligibility Requirements 1. Business must be lcated in the active cnstructin znes n Alum Rck Avenue between Highway 101 and Interstate 680 and n Santa Clara Street between 23 rd and 25th Streets. 2. Must be a Small Business--defined fr purpses f this prgram as emplying 25 r fewer emplyees and with annual revenues f less than $7.5 millin. 3. Business cannt have filed a claim against, litigated against, r previusly settled with VTA r the City f San Jsé regarding the Alum Rck-Santa Clara Bus Rapid Transit prject. 4. Fr Tier II applicants, business must have been in cntinuus peratin fr at least 12 mnths preceding July 13, 2015 r fr at least 90 days between January 1, 2015 and Octber 10, Applicatins must be submitted t the VTA Prject Infrmatin Office lcated at 1592 Alum Rck Avenue by December 11, Businesses entering the Tier II prcess must submit additinal dcumentatin demnstrating the extent and amunt f the declared financial impact by February 11, The VTA Prject Infrmatin Office is pen Mnday thrugh Friday frm 10:00 am t 4:00 pm and Wednesdays until 7:00 pm. 6. A business that initially submits a Tier I applicatin may chse t als enter the Tier II prcess prvided the Tier II applicatin is submitted by December 11, Additinal dcumentatin demnstrating the extent and amunt f the Tier II declared financial impact must be submitted by February 11, Tier I Financial Assistance Payments 1. Applicants must submit the fllwing dcuments by December 11, 2015: Fully cmpleted Tier I Financial Assistance Applicatin Frm Cpy f current r applicable City f San Jse Business Tax Certificate Prf f Small Business Sustainability Prgram revenue eligibility (as defined abve) any ne f the fllwing: Mst recent Incme Tax Return Mst recent Financial Statements Sales tax filings Other swrn/ntarized attestatin f eligibility (as last resrt if n ther dcumentatin available) Page 1 f 3

2 VTA SMALL BUSINESS SUSTAINABILITY PROGRAM PAYMENT APPLICATION INSTRUCTIONS/PROCESS Federal and State Withhlding Exemptin Certificates--W-9 and 590 Tier I Waiver Frm--Release f all past claims and acknwledgment f Tier I payment as a credit tward any future claims Nte: Applicatin Frm, Declaratin f Eligibility Frm, Withhlding Exemptin Certificates, and Tier I Waiver Frm are available at 2. Cmpleted applicatins must be submitted t the VTA Prject Infrmatin Office lcated at 1592 Alum Rck Avenue by December 11, The VTA Prject Infrmatin Office is pen Mnday thrugh Friday frm 10:00 am t 4:00 pm and Wednesdays until 7:00 pm. 3. Payment will be mailed t recipient within 7 business days frm VTA s cnfirmatin that the applicatin is cmplete. Tier II Financial Assistance Payments 1. Applicants must submit the fllwing dcuments by December 11, 2015: Fully cmpleted Tier II Financial Assistance Applicatin Frm Cpy f current r applicable City f San Jse Business Tax Certificate Prf f Small Business Sustainability Prgram revenue eligibility (as defined abve) any ne f the fllwing: Mst recent Incme Tax Return Mst recent Financial Statements Sales tax filings Other swrn/ntarized attestatin f eligibility (as last resrt if n ther dcumentatin available) Prf f cntinuus peratin fr at least 12 mnths preceding July 13, 2015 r fr at least 90 days between January 1, 2015 and Octber 10, 2015 Federal and State Withhlding Exemptin Certificates--W-9 and 590 Nte: Applicatin Frm, Declaratin f Eligibility Frm, and Withhlding Exemptin Certificates are available at 2. Tier II applicants wh als submitted a Tier I applicatin d nt need t re-submit their Business Tax Certificate cpy, prf f revenue eligibility, r Withhlding Exemptin Certificates. 3. Cmpleted applicatins must be submitted t the VTA Prject Infrmatin Office lcated at 1592 Alum Rck Avenue by December 11, The VTA Prject Infrmatin Office is pen Mnday thrugh Friday frm 10:00 am t 4:00 pm and Wednesdays until 7:00 pm Page 2 f 3

3 VTA SMALL BUSINESS SUSTAINABILITY PROGRAM PAYMENT APPLICATION INSTRUCTIONS/PROCESS 4. Applicants must submit the fllwing additinal dcuments by February 11, 2016: Dcumentatin demnstrating extent and amunt f financial impact any ne r mre f the fllwing: Mst recent Incme Tax Return Mst recent Financial Statements Sales tax filings Year-ver-year analysis f sales r ther supprting dcumentatin 5. Once the cmpleted applicatin and supprting dcumentatin have been received, they are then frwarded t the Independent Prgram Administratr (Administratr) fr validatin f financial impact. The Administratr evaluates the ttality f the circumstances presented by the applicant, including an in persn interview if apprpriate. The Administratr may request additinal supprting dcumentatin as necessary. Based n the evaluatin, the Administratr may apprve a financial assistance payment between $1,000 (fr businesses that demnstrate n mre than a minimal impact) and $50,000 (fr the mst extreme cnstructin delay-related impacts). Fr applicants that enter bth the Tier I and Tier II prcess, the Tier I payment f $1,000 will be deducted frm the apprved Tier II financial assistance payment. 6. Once the Administratr s evaluatin is cmpleted, thse applicants wh did nt als participate in the Tier I prcess will be ntified by mail f the recmmended financial assistance payment and will be required t sign a Tier II Waiver releasing all past claims, acknwledging the recmmended payment amunt, and acknwledging that $1,000 f any Tier II payment acts as a credit twards future claims. The Tier II Waiver must be signed within 30 days f the date f the ntificatin letter and returned t the VTA Prject Infrmatin Office either in persn r by mail. 7. The Prgram Administratr then frwards the apprved Financial Assistance Applicatin package t VTA fr payment prcessing. 8. Payment will be mailed t recipient within 7 business days frm receipt by VTA f Administratr apprved Financial Assistance Applicatin package Page 3 f 3

4 Small Business Sustainability Prgram Tier II Financial Assistance Applicatin Please Print r Type: Als applied fr Tier I? Amunt f requested payment: Yes $ N Business Name Business Legal Name (if different) FEIN/Tax ID Business Street Address San Jse CA City State Zip Owner Name Owner Owner phne number I hereby certify that neither I nr my business has filed a claim against, is currently in litigatin with, r has previusly been in litigatin with the Santa Clara Valley Transprtatin Authrity (VTA) r the City f San Jsé cncerning VTA s Alum Rck-Santa Clara Bus Rapid Transit Prject. I understand that if my business qualifies fr this prgram, any payment my business receives will nt exceed $50,000 and may be less than the requested payment amunt abve. Owner Signature Date

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12 Yu have the Optin t Have Yur Attrney Review this Befre Yu Sign Small Business Sustainability Prgram Tier II Waiver and Release Frm M PL E I, n behalf f myself and my business (the Business ), in exchange fr receiving any payment under the Santa Clara Valley Transprtatin Authrity Small Business Sustainability Prgram ( SBSP ), hereby cmprmise, settle, release, waive, discharge, and relinquish any and all past and present claims, demands, lsses, damages, rights, remedies, r causes f actin fr persnal injury, cmpensatry damages, prperty damages, business interruptin and disruptin damages, any and all ther damages, lsses, csts, and expenses, including attrneys and experts fees, whether based n trt, inverse cndemnatin, cntract, Califrnia s Gvernment Cde, r ther theries f recvery, against VTA, the City f San Jsé, and their respective bard members, cuncil members, fficers, emplyees, cnsultants, administratrs, agents, attrneys, predecessrs, and successrs in interest, and their respective heirs, and assigns frm same, arising frm r in any way related t VTA s Alum Rck-Santa Clara Bus Rapid Transit Prject (the Waiver and Release ). By signing this Waiver and Release, I accept withut qualificatin the Special Administratr s final decisin regarding my Tier II applicatin. SA This Waiver and Release des nt apply t claims that arise after the date that I sign this Waiver and Release. Hwever, t the extent the Business receives any payment frm the SBSP, the Business agrees that the first ne thusand dllars ($1,000) f any payment will perate as a credit tward any ptential future claims. I represent and warrant that I have authrity t bind the Business with respect t this Waiver and Release. Signature: Printed Name: Title: Business Name: Date: