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CARES Act Comprehensive Business Stability Award Application, Round Two

  1. Businesses can apply for assistance to stabilize operation and pay for COVID-related expenses incurred from March 1, 2020 through December 30, 2020.
  2. Award funds may not be used to pay Jefferson County Real Property taxes.*
    The CARES Act prohibits the use of grant funds to replace County revenues. Requests for funding to offset property taxes will be denied.

    Awards will depend upon the number of applicants, availability of funds and demonstrated need. Considerations will be based on loss of revenue due to COVID-19 impact compared with 2019 financial statements and costs.

    Once funding decisions are made, successful applicants will receive an award notification which will outline the terms and conditions to receive funding.

  3. Please note, every question on the application must be completed. Please carefully review your application before submitting.
  4. Have you filled out the CARES Act Business Stability Assessment Worksheet?*
    You must fill this out before completing this application.
  5. Please save and upload within the Excel spreadsheet. If you use other spreadsheet software, please save and upload as a PDF file.
  6. Note: If you are a sole proprietor you may need to use your Social Security Number.
  7. Do you have a D-U-N-S#?*
  8. A D-U-N-S # is a FREE, unique, independently administered business identifier that is a requirement to receive federal funding, and this grant is supported by federal funds. You must receive and provide a valid D-U-N-S # before you can receive this award.
  9. Do you have a valid SAM (System of Award Management) #?*
  10. A valid SAM registration without restrictions is a requirement to receive federal funding, and this grant is supported by federal funds. We must verify your status in SAM before you can receive this grant.
    Note: Your SAM # may be the same as your D-U-N-S #, but this is not always the case.
  11. Note: Name of person should Jefferson County have questions regarding your application.
  12. Best number to reach you.
  13. Fill in the type of business or services you provide.
  14. Are you registered and in good standing with the Colorado Secretary of State? *
    Note: you must be in good standing with the Colorado Secretary of State to be eligible.
  15. Are you current with State of Colorado sales and withholding taxes?*
    Note: you must be current with State of Colorado sales and withholding taxes to be eligible.
  16. Is the entity that would receive the grant funds currently in bankruptcy proceedings or does the entity plan to file bankruptcy within the next six months?*
  17. Is your business located in Jefferson County?*
  18. Have you been in business in Jefferson County at least since December 1, 2019?*
  19. What are the impacts you've seen to your business resulting from COVID-19?*
    Please check all that apply.
  20. Has the change on November 20 to Level Red on the CDPHE COVID-19 Dial Framework required your business to change capacity?*
  21. If your business has been instructed to reduce capacity because of moving to Level Red, will you still be able to operate?*
  22. What purchases would you need to make to keep your operation open at the greatest possible capacity?*
    Select all that apply
  23. Signature Authority. If your application were approved, who would sign the agreement and what is that person’s title?
  24. Electronic Signature Agreement*
    By clicking "I agree" you represent that that information provided in this application is true, correct, and complete to the best of your knowledge. You further understand that any false or misleading statements may result in denial or revocation of the award. By clicking 'I agree' you also covenant and agree that you will comply with all the requirements for the award and sign an award agreement if your application is approved.

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