Orange County Microbusiness Grant Application

Section 1: Business & Owner Information

Section 2

Section 3

Section 4: User Agreements

Section 5: Certification by Authorized Business Representative

I hereby certify that I am an authorized representative of the business named above, with the authority to commit the business to legally binding contracts and agreements. I further certify that the information given as part of this application is true and accurate. I am aware that any false information or intended omissions may subject me to civil or criminal penalties for the filing of false public records and/or forfeiture of any funds approved through this program.

This application does not constitute a contractual agreement. If any portion of the application is approved, a formal agreement between parties will be executed to obligate funds for the approved expenditures. Activities may not start prior to the effective date of the agreement.

By signing this application, I certify that I am authorized to enter into an agreement with the Orange County that includes my representation, warranty and covenant that I am eligible to receive federal funding, my organization is in good standing with the State of California, Unemployment Insurance (UI) taxes and are in good standing and I agree to submit receipts for all purchases made with funding received and provide acceptable form(s) of valid government-issued photo ID (state, domestic, or foreign) and documentation that includes the owner’s name and may include but is not limited to the following: a local business permit or license, a bank statement, a tax return, a trade account and Third-party verification.

A Special Thanks to our Community Partners