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DocuSign Envelope ID:0741261 F-1 FEE-4493-8D4C-086A5F82251 C <br /> • September 2019 Revenue (Subsidiary ledger and verified by copy of NC DOR E-500 <br /> Sales and Use Tax Report) <br /> • September 2020 Revenue (Subsidiary ledger and verified by copy of NC DOR E-500 <br /> Sales and Use Tax Report) <br /> • Quarterly Tax and Wage Reports (Form NCUI 101 or IRS 941); business will redact all <br /> employee SSN <br /> • Bank Statements (from March-October 2020) <br /> • Copy of front and back of North Carolina driver's license or government-issued ID. <br /> Requirements to Receive a Grant <br /> • Grant Recipient shall endeavor to meet at least one of the following conditions for at <br /> least one year: <br /> a) Job Retention, within six months of the award retain at least 50% of the work force <br /> that existed on January 1, 2020 and retain 100% within one year of the award date; <br /> b) Living Wage, pay 90% of Borrower's work force a living wage of$15 per hour; or <br /> c) Community Participation and Involvement, in kind service, discounts or donation to <br /> first responders, healthcare and other front line workers in the amount of at least <br /> $250 annually for award recipients with net income of up to $100,000 and at least <br /> $500 annually for all others. Any value derived from discounts shall be the result of at <br /> least 15% off retail price. Determinations regarding qualifying recipients of in kind <br /> services or donations shall be at the sole discretion of the County. <br /> • Borrower shall supply evidence of compliance through NC Employment Commission <br /> reports, IRS 941 Payroll quarterly reports, Orange County Living Wage certificate or, if <br /> those are inapplicable, a notarized owner affidavit. <br /> • Grant recipients shall commit to a minimum of 2-hours of mentoring with the Small <br /> Business Technology Development Center within the 9-month period following the grant <br /> award. Grant recipients must provide proof of initial contact with SBTDC prior to the <br /> County transferring grant funds. <br /> SBTDC (Small Business & Technology Development Center) <br /> UNC Chapel Hill <br /> 1700 Martin Luther King Jr Blvd Suite 115 / CB# 1823, <br /> Chapel Hill, NC 27514 <br /> (919) 962-0389 <br /> http://www.sbtdc.org/offices/unc <br /> Eligible Uses of Funds <br /> Each of the eligible uses of funds below will be evaluated in the context of being necessary <br /> for businesses to provide services in a different manner due to "social distancing" requirements <br /> or mandated closures caused by COVID-19 <br /> • Fund working capital or operational funds to retain employees during the COVID-19 <br /> pandemic <br /> Esbfp 070120 v1 <br />