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RE 2020-0714.6 Dallas County CARES ActRESOLUTION NO. �—t? j 14. � A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF COPPELL, TEXAS, APPROVING FUNDING THROUGH PROGRAM GRANTS UNDER THE TERMS AND CONDITIONS AS SET FORTH IN EXHIBIT `A' WHICH IS ATTACHED HERETO AND INCORPORATED HEREIN FOR LOCAL BUSINESS IMPACTED BY COVID-19 PANDEMIC IN THE AMOUNT NOT TO EXCEED $1,650,000.00, WHICH IS ATTACHED HERETO AND INCORPORATED HEREIN AS EXHIBIT `A'; PROVIDING FOR A GRANT AGREEMENT BY AND BETWEEN COPPELL; AND, PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, the State of Texas through the Dallas and Denton Counties has committed funds from the United States Treasury Department under the Coronavirus Aid, Relief, and Economic Security Act also known as the "CARES Act"; and, WHEREAS, the City of Coppell is a local government defined by the Texas Government Code § 791.003(4)(A) and has been providing funding from Dallas and Denton Counties to administer and provide grants in conformity with Federal, State and County requirements and desires to enter into this Agreement within the qualifying entities by receiving funding; and, WHEREAS, the City of Coppell desires to provide funding from the Counties for the administration and distribution of a portion of funds to local social service agencies, childcare agency and local businesses as authorized by CARES Act; and, WHEREAS, the City Council of the City of Coppell finds it to be in the public interest to provide for local funding to qualified entities and business located and/or serving in Coppell, Texas. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF COPPELL, TEXAS, THAT: SECTION 1. That the City Council of the City of Coppell, Texas, hereby approves CARES Act COVID-19 funding through Program Grants under the terms and conditions as set forth in Exhibit "A", which is attached hereto and incorporated herein, for qualifying local businesses impacted by the COVID-19 pandemic, as authorized by CARES Act. SECTION 2. That the City Council of the City of Coppell approves the expenditure not to exceed $1,650,000.00 to the Program subject to execution of the appropriate documents with the qualifying entities or business as provided in the Program (Exhibit A). SECTION 3. That the City Council approves and authorize the City Manager or designee to administer said Program under the terms and conditions set forth herein; and, to make such accounting and administration that is necessary to fulfill the requirements of the TM 116626 CARES Act and any regulations or rules adopted. SECTION 4. This Resolution shall become effective immediately upon its passage. DULY RESOLVED AND ADOPTED by the City Council of the City of Coppell, Texas, on the day of July, 2020 i O HUNT, MAYOR TM 116626 EXHIBIT "A" (Following page) Coppell Cares Restaurant Assistance Grant Program Purpose: Due to COVID-19, numerous businesses in the City of Coppell were required to close their doors or limit their service offerings. As a result, these businesses have suffered financially. In order to help them in their recovery efforts, the City would like to expend some of the Cares Funding dollars to provide economic support to these businesses through forgivable grants. The Restaurant Assistance Grant Program is aimed at assisting the restaurants in Coppell, which add to the quality of life for the citizens but are unfortunately some of the businesses that have suffered the greatest financial distress during this time. The goal of this program is to increase the viability and longevity of Coppell's restaurants until business operations are enough to sustain them. The City of Coppell is dedicating $660,000 to the Coppell Cares Restaurant Assistance Grant Program. Grants will be awarded based on occupancy load. Restaurants that apply and meet the qualifying criteria will be awarded $55 per allowable occupant. To qualify, a restaurant: • Must be located within the city limits of Coppell and must be in current compliance with the City of Coppell Code of Ordinances, including all applicable zoning and land use ordinances; • Must not be in any litigation with the City of Coppell or the County in which they are located; • Must have a physical store front in Coppell; • Must demonstrate that they have endured a 25% or greater reduction in sales/business after March 1, 2020 due to the COVID-19 pandemic. The following documentation must be provided by the restaurant at the time of application: • A completed application. • A signed Affidavit of Eligibility and Liability Release Agreement. • A copy of the restaurant's Certificate of Occupancy. There will be a monthly application period with designated submission deadlines until all funds have been distributed. Any incomplete submissions will be denied for that grant period. Coppell Cares Restaurant Assistance Grant Program Application Date of Application: Name of Restaurant: Restaurant Address: Restaurant Phone Number: Restaurant Website: Number of Years in Service in Coppell: Owner Name: Owner Email Address: Owner Phone Number: General Manager Name: General Manager Email Address: General Manager Phone Number: Square Footage of Your Restaurant: Occupancy Load for Your Restaurant: Is the Restaurant Currently Open and Operating: If yes to the question above, in what capacity is it operating (please check all that apply): Curbside Pick -Up _ Delivery _ Patio Dining Dine -In Service Please list revenue for each of the following months for the past two years: Year January February March April May 2019 2020 Have you applied for any other program, loans and/or grants since March 1, 2020: Yes No If yes to the question above, please list all programs, loans and/or grants that have been applied for and the application status by indicating the following: a) received, b) denied or c) pending: Program/Loan/Grant Status Is Restaurant in current compliance with all City of Coppell Code of Ordinances, including all applicable zoning and land use ordinances: The information provided will be kept confidential. By signing below, you declare that you are authorized to apply for this grant on behalf of the restaurant and that all the information provided is truthful to the best of your knowledge. You also understand that if any of the information provided is determined to be incorrect after an award is granted, applicant may be required to repay the full amount of the grant. Applicant Signature Print Name Title E -Mail Address & Phone Number Date STATE OF TEXAS COUNTY OF DALLAS Affidavit of Eligibility and Liability Release Agreement BEFORE ME, the undersigned authority, on this day personally appeared , and upon his/her oath deposed and stated as follows: This Affidavit of Eligibility and Liability Release Agreement ("Affidavit/Release" or "Agreement") to the City of Coppell, Texas ("City") as a legal representative of (the "Company"), with the understanding that this Affidavit/Release will be relied upon by the City (and the other City Persons) in connection with the Company's application for financial assistance (the "Application") under the Coppell Cares Restaurant Assistance Grant Program (the "Program"). Company acknowledges and agrees that there is adequate, sufficient, and good and valuable consideration for this Affidavit/Release. Compliance: 1. Company is in compliance with, and will continue to comply with all the rules, regulations, terms and conditions set forth in the Application, and with all laws, rules and regulations pertaining to the Application and the Program; that all information provided to the City now and in the future has been and will be true, accurate, and complete. Company has not perpetrated and will not perpetrate any fraud or deception in connection with the Program. Company has not sought to influence the outcome of the Application and is submitting this Agreement as expressly required under the Program's criteria. 2. Company understands that the City or its agents may be required to advise the United States Internal Revenue Service of the value of any Program grant awarded to the Company, and in connection therewith, a completed Form W-9 is attached hereto. I acknowledge and agree that 1 may be subject to taxation in connection with a Program grant and will pay any and all such taxes when due. Release, Indemnity and Hold Harmless: 3. COMPANY HEREBY RELEASESS, WAIVE, ACQUITS, FOREVER DISCHARGES, AND COVENANTS NOT TO SUE THE CITY OR ANY OF THE CITY'S OFFICIALS, OFFICERS, EMPLOYEES, AGENTS OR VOLUNTEERS, IN EITHER THEIR OFFICIAL OR PRIVATE CAPACITIES (COLLECTIVELY, "CITY PERSONS"), FOR AND/OR FROM ANY AND ALL CLAIMS, LIABILITY, DEMANDS, LOSSES, HARM, ACTIONS, SUITS, JUDGMENTS, PENALTIES, FEES, COSTS AND EXPENSES WHATSOEVER, (COLLECTIVELY, "CLAIMS'-'), WHICH THE COMPANY MAY NOW OR HEREAFTER BE ENTITLED TO ASSERT, ARISING OUT OF, CAUSED BY, IN CONNECTION WITH, OR RELATED TO, THE PROGRAM, OR MY POSSESSION, ACCEPTANCE, USE, OR MISUSE THEREOF, OR ANY OF MY OTHER ACTS OR OMISSIONS IN CONNECTION THEREWITH, INCLUDING, BUT NOT LIMITED TO, DEATH, ILLNESS, INJURY, LOSS OF ENJOYMENT, PROPERTY DAMAGE OR DESTRUCTION, OR OTHER HARM OR LOSS OF ANY NATURE, AND ANY AND ALL ANY TAXES LEVIED, ASSESSED OR COLLECTED, AND FURTHER INCLUDING, WITHOUT LIMITATION, ANY AND ALL CLAIMS WHICH ARISE OUT OF, ARE RELATE TO, OR ARE CAUSED BY, IN WHOLE OR IN PART, ANY NEGLIGENT ACT OR OMISSION OF THE CITY OR ANY CITY PERSONS OR ANY OTHER PERSONS, OR ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. Company has voluntarily chosen to submit its Application and hereby accepts Program grant funds, subject to eligibility, and AGREES TO ASSUME ANY AND ALL RISKS with respect to any harm, damage, injury, incident, action, occurrence or activity which may occur in connection with or result from the Application and/or Program Grant, and/or Company's acceptance, use, misuse, or possession thereof. 4. FURTHER, COMPANY HEREBY AGREES TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CITY AND ALL CITY PERSONS FROM AND AGAINST ANY AND ALL CLAIMS, INCLUDING, WITHOUT LIMITATION, COURT COSTS AND ATTORNEY'S FEES (NOT TO EXCEED $350.00 PER HOUR), THAT MAY ARISE OUT OF, RESULT FROM, OR BE INCURRED DUE TO THE SUBMISSION OF COMPANY'S APPLICATION OR ITS PARTIPCATION IN THE PROGRAM, ACCEPTANCE OF A PROGRAM GRANT, ACCEPTANCE, USE, MISUSE OR POSSESION THEROF, OR ANY ACTS OR OMISSIONS IN CONNECTION THEREWITH. SUCH DEFENSE, INDEMNITY AND HOLD HARMLESS SHALL AND DOES INCLUDE CLAIMS ALLEGED OR FOUND TO HAVE BEEN CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, OR BY ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. 5. It is the Company's express intent that this Affidavit/Release shall bind the Company, its agents, heirs, assigns, successors and legal representative(s), and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the City and all other City Persons (identified herein, including paragraph 3 hereof) for any and all purposes. 6. COMPANY UNDERSTANDS THAT THIS IS A LEGAL DOCUMENT AND THAT BY SIGNING IT, AMONG OTHER THINGS, COMPANY GIVES UP ITS RIGHT TO SUE OR OTHERWISE MAKE A CLAIM against the City and all other City Persons, as set forth herein. Representations: 7. I certify that I am a properly authorized official or agent of the Company and have the necessary legal authority to execute this Affidavit of Eligibility and Liability Release Agreement on the Company's behalf. 8. Company is not in any type or manner of litigation or contemplating litigation with the City or County of Dallas. 9. Company is currently operating with its principal place of business within the corporate limits of the City. Miscellaneous Provisions: 10. Company agrees to return, immediately upon demand by the City, any and all Program grant funds that have been or may be awarded if any statement, certification, or representation made in this Affidavit/Release is discovered or believed to be false or misleading, and Company acknowledges and agrees that all available legal, equitable and other rights and remedies may be pursued against it in connection therewith. Company represents and affirms that this Affidavit/Release does not conflict with any other commitments or obligations on its part. 11. Except for the Application and Program eligibility criteria, this Affidavit/Release constitutes the entire Agreement between Company and the City with respect to the matters described herein, and supersedes any and all other agreements and communications, oral or written, between Company and the City, any City Persons, or any other Persons. This Agreement may not be amended or supplemented except by a (paper) writing signed by the Company and the City. 12. The section and subsection headings contained herein are for convenience only and shall not be used in interpretation of this Agreement and are not intended to define or limit the scope of any provision of this Agreement. For purposes of this Agreement, "including" is a term of enlargement and not of limitation or exclusive enumeration, and use of the term does not create a presumption that components not expressed are excluded. 13. Company signs and makes this Affidavit/Release voluntarily, freely, and knowingly, and it has not relied upon any representations made by the City or any City Person in signing this Affidavit/Release. 14. This Affidavit/Release shall be governed by and construed according to the laws of the State of Texas (without reference to the choice of laws provisions of any jurisdiction), and venue for all matters, claims, or proceedings hereunder shall lie exclusively in Dallas County, Texas. 15. The provisions of this Affidavit/Release are severable, and if any provision hereof is held to be illegal, invalid or unenforceable under present or future constitution or laws, such provision shall be fully severable and this Affidavit/Release shall be construed and enforced as if such illegal, invalid or unenforceable provision is not a part hereof, and the remaining provisions hereof shall remain in full force and effect. COMPANY CERTIFIES IT HAS READ THIS AFFIDAVIT/RELEASE, HAS FULLY INFORMED ITSELF OF ITS CONTENTS BEFORE EXECUTION, AND UNDERSTANDS ALL OF ITS TERMS, PROVIISONS, AND CONDITIONS. COMPANY HEREBY REPRESENTS AND WARRANTS THAT ALL STATEMENTS MADE IN THIS AFFIDAVIT/RLEASE ARE TRUE, ACCURATE AND COMPLETE. Signature: Title: Name: Company address: Date: STATE OF TEXAS § COUNTY OF DENTON § Affidavit of Eligibility and Liability Release Agreement BEFORE ME, the undersigned authority, on this day personally appeared , and upon his/her oath deposed and stated as follows: This Affidavit of Eligibility and Liability Release Agreement ("Affidavit/Release" or "Agreement") to the City of Coppell, Texas ("City") as a legal representative of (the "Company"), with the understanding that this Affidavit/Release will be relied upon by the City (and the other City Persons) in connection with the Company's application for financial assistance (the "Application") under the Coppell Cares Restaurant Assistance Grant Program (the "Program"). Company acknowledges and agrees that there is adequate, sufficient, and good and valuable consideration for this Affidavit/Release. Compliance: 1. Company is in compliance with, and will continue to comply with all the rules, regulations, terms and conditions set forth in the Application, and with all laws, rules and regulations pertaining to the Application and the Program; that all information provided to the City now and in the future has been and will be true, accurate, and complete. Company has not perpetrated and will not perpetrate any fraud or deception in connection with the Program. Company has not sought to influence the outcome of the Application and is submitting this Agreement as expressly required under the Program's criteria. 2. Company understands that the City or its agents may be required to advise the United States Internal Revenue Service of the value of any Program grant awarded to the Company, and in connection therewith, a completed Form W-9 is attached hereto. I acknowledge and agree that I may be subject to taxation in connection with a Program grant and will pay any and all such taxes when due. Release, Indemnity and Hold Harmless: 3. COMPANY HEREBY RELEASESS, WAIVE, ACQUITS, FOREVER DISCHARGES, AND COVENANTS NOT TO SUE THE CITY OR ANY OF THE CITY'S OFFICIALS, OFFICERS, EMPLOYEES, AGENTS OR VOLUNTEERS, IN EITHER THEIR OFFICIAL OR PRIVATE CAPACITIES (COLLECTIVELY, "CITY PERSONS"), FOR AND/OR FROM ANY AND ALL CLAIMS, LIABILITY, DEMANDS, LOSSES, HARM, ACTIONS, SUITS, JUDGMENTS, PENALTIES, FEES, COSTS AND EXPENSES WHATSOEVER, (COLLECTIVELY, "CLAIMS"), WHICH THE COMPANY MAY NOW OR HEREAFTER BE ENTITLED TO ASSERT, ARISING OUT OF, CAUSED BY, IN CONNECTION WITH, OR RELATED TO, THE PROGRAM, OR MY POSSESSION, ACCEPTANCE, USE, OR MISUSE THEREOF, OR ANY OF MY OTHER ACTS OR OMISSIONS IN CONNECTION THEREWITH, INCLUDING, BUT NOT LIMITED TO, DEATH, ILLNESS, INJURY, LOSS OF ENJOYMENT, PROPERTY DAMAGE OR DESTRUCTION, OR OTHER HARM OR LOSS OF ANY NATURE, AND ANY AND ALL ANY TAXES LEVIED, ASSESSED OR COLLECTED, AND FURTHER INCLUDING, WITHOUT LIMITATION, ANY AND ALL CLAIMS WHICH ARISE OUT OF, ARE RELATE TO, OR ARE CAUSED BY, IN WHOLE OR IN PART, ANY NEGLIGENT ACT OR OMISSION OF THE CITY OR ANY CITY PERSONS OR ANY OTHER PERSONS, OR ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. Company has voluntarily chosen to submit its Application and hereby accepts Program grant funds, subject to eligibility, and AGREES TO ASSUME ANY AND ALL RISKS with respect to any harm, damage, injury, incident, action, occurrence or activity which may occur in connection with or result from the Application and/or Program Grant, and/or Company's acceptance, use, misuse, or possession thereof. 4. FURTHER, COMPANY HEREBY AGREES TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CITY AND ALL CITY PERSONS FROM AND AGAINST ANY AND ALL CLAIMS, INCLUDING, WITHOUT LIMITATION, COURT COSTS AND ATTORNEY'S FEES (NOT TO EXCEED $350.00 PER HOUR), THAT MAY ARISE OUT OF, RESULT FROM, OR BE INCURRED DUE TO THE SUBMISSION OF COMPANY'S APPLICATION OR ITS PARTIPCATION IN THE PROGRAM, ACCEPTANCE OF A PROGRAM GRANT, ACCEPTANCE, USE, MISUSE OR POSSESION THEROF, OR ANY ACTS OR OMISSIONS IN CONNECTION THEREWITH. SUCH DEFENSE, INDEMNITY AND HOLD HARMLESS SHALL AND DOES INCLUDE CLAIMS ALLEGED OR FOUND TO HAVE BEEN CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, OR BY ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. 5. It is the Company's express intent that this Affidavit/Release shall bind the Company, its agents, heirs, assigns, successors and legal representative(s), and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the City and all other City Persons (identified herein, including paragraph 3 hereof) for any and all purposes. 6. COMPANY UNDERSTANDS THAT THIS IS A LEGAL DOCUMENT AND THAT BY SIGNING IT, AMONG OTHER THINGS, COMPANY GIVES UP ITS RIGHT TO SUE OR OTHERWISE MAKE A CLAIM against the City and all other City Persons, as set forth herein. Representations: 7. I certify that I am a properly authorized official or agent of the Company and have the necessary legal authority to execute this Affidavit of Eligibility and Liability Release Agreement on the Company's behalf. 8. Company is not in any type or manner of litigation or contemplating litigation with the City or County of Denton. 9. Company is currently operating with its principal place of business within the corporate limits of the City. Miscellaneous Provisions: 10. Company agrees to return, immediately upon demand by the City, any and all Program grant funds that have been or may be awarded if any statement, certification, or representation made in this Affidavit/Release is discovered or believed to be false or misleading, and Company acknowledges and agrees that all available legal, equitable and other rights and remedies may be pursued against it in connection therewith. Company represents and affirms that this Affidavit/Release does not conflict with any other commitments or obligations on its part. 11. Except for the Application and Program eligibility criteria, this Affidavit/Release constitutes the entire Agreement between Company and the City with respect to the matters described herein, and supersedes any and all other agreements and communications, oral or written, between Company and the City, any City Persons, or any other Persons. This Agreement may not be amended or supplemented except by a (paper) writing signed by the Company and the City. 12. The section and subsection headings contained herein are for convenience only and shall not be used in interpretation of this Agreement and are not intended to define or limit the scope of any provision of this Agreement. For purposes of this Agreement, "including" is a term of enlargement and not of limitation or exclusive enumeration, and use of the term does not create a presumption that components not expressed are excluded. 13. Company signs and makes this Affidavit/Release voluntarily, freely, and knowingly, and it has not relied upon any representations made by the City or any City Person in signing this Affidavit/Release. 14. This Affidavit/Release shall be governed by and construed according to the laws of the State of Texas (without reference to the choice of laws provisions of any jurisdiction), and venue for all matters, claims, or proceedings hereunder shall lie exclusively in Denton County, Texas. 15. The provisions of this Affidavit/Release are severable, and if any provision hereof is held to be illegal, invalid or unenforceable under present or future constitution or laws, such provision shall be fully severable and this Affidavit/Release shall be construed and enforced as if such illegal, invalid or unenforceable provision is not a part hereof, and the remaining provisions hereof shall remain in full force and effect. COMPANY CERTIFIES IT HAS READ THIS AFFIDAVIT/RELEASE, HAS FULLY INFORMED ITSELF OF ITS CONTENTS BEFORE EXECUTION, AND UNDERSTANDS ALL OF ITS TERMS, PROVIISONS, AND CONDITIONS. COMPANY HEREBY REPRESENTS AND WARRANTS THAT ALL STATEMENTS MADE IN THIS AFFIDAVIT/RLEASE ARE TRUE, ACCURATE AND COMPLETE. Signature: Title: Name Company address: Date: Coppell Cares Restaurant Assistance Grant Program Application Checklist Please Check All Completed Items Included: Fully completed application A signed Affidavit of Eligibility and Liability Release Agreement for the County in which the restaurant is located A copy of the company's Certificate of Occupancy Coppell Cares Business Retrofit Grant Program Purpose: Due to COVID-19, numerous businesses in the City of Coppell were required to close their doors or limit their service offerings. As a result, these businesses have suffered financially. In order to help them in their recovery efforts, the City would like to expend some of the Cares Funding dollars to provide economic support to these businesses through grants. The Business Retrofit Grant Program is aimed at assisting business in Coppell retrofitting their physical and/or virtual space to meet public health and/or safety concerns. The goal of the program is to reimburse businesses that have incurred expenses through the extra precautions they have taken in retrofitting their business to protect the safety and health of the public from COVID-19. Items eligible for reimbursement include plexiglass barriers, cleaning supplies that are used to clean common contact surfaces, hand sanitizing stations, PPE supplies, costs to create an on- line purchasing system, contactless faucets, upgrading to a contactless payment system, upgrading sanitation systems (such as UV systems), antimicrobial furniture, cubicle height extenders, desk dividers or privacy panels, quick flex walls and costs to install plexiglass or protective barriers. All eligible expenses will be reimbursed after the receipt is submitted, and the grant will not exceed the amount spent by the business to retrofit their business. In all cases, the maximum grant amount each month will not exceed $5,000. The City of Coppell is dedicating $990,000 to the Coppell Cares Business Retrofit Grant Program. Grants will be awarded based on actual dollars spent by the business. All Coppell businesses are eligible to apply. To qualify, the business: • Must be located within the city limits of Coppell and must be in current compliance with the City of Coppell Code of Ordinances, including all applicable zoning and land use ordinances; • Must not be in any litigation with the City of Coppell or the County they are located in; • Must have a physical store front in Coppell; • Must be open to the public to conduct business. The following documentation must be provided by the business at the time of application: • A completed application. • A signed Affidavit of Eligibility and Liability Release Agreement. • A copy of the Coppell Certificate of Occupancy for the business. • Copies of all receipts if the expenses have already been incurred. There will be a monthly application period with designated submission deadlines until all funds have been distributed. Any incomplete submissions will be denied for that grant period. A business may apply more than once, but the maximum grant awarded each month will never exceed $5,000 and reimbursement will never exceed the expenses incurred by the business. Funds will not be distributed until receipts have been received by the City. Furthermore, businesses that have not previously received a grant will be given higher priority when considering applications. Coppell Cares Business Retrofit Grant Program Application Date of Application: Name of Business: Business Address: Business Phone Number: Business Website: Number of Years in Service in Coppell: Owner Name: Owner Email Address: Owner Phone Number: General Manager Name: General Manager Email Address: General Manager Phone Number: Is the Business Currently Open and Operating: Please detail eligible expenses incurred by business, cost and if the expense has already been completed/incurred or planned: Eligible Expense/Retrofit Cost Completed or Planned Have you applied for any other program, loans and/or grants since March 1, 2020: Yes No If yes to the question above, please list all programs, loans and/or grants that have been applied for and the application status by indicating the following: a) received, b) denied or c) pending: Program/Loan/Grant Status Is Business in current compliance with all City of Coppell Code of Ordinances, including all applicable zoning and land use ordinances: The information provided will be kept confidential. By signing below, you declare that you are authorized to apply for this grant on behalf of the business and that all the information provided is truthful to the best of your knowledge. You also understand that if any of the information provided is determined to be incorrect after an award is granted, applicant may be required to repay the full amount of the grant. Applicant Signature Print Name Title E -Mail Address & Phone Number Date STATE OF TEXAS COUNTY OF DALLAS Affidavit of Eligibility and Liability Release Agreement BEFORE ME, the undersigned authority, on this day personally appeared , and upon his/her oath deposed and stated as follows: This Affidavit of Eligibility and Liability Release Agreement ("Affidavit/Release" or "Agreement") to the City of Coppell, Texas ("City") as a legal representative of (the "Company"), with the understanding that this Affidavit/Release will be relied upon by the City (and the other City Persons) in connection with the Company's application for financial assistance (the "Application") under the Coppell Cares Business Retrofit Grant Program (the "Program"). Company acknowledges and agrees that there is adequate, sufficient, and good and valuable consideration for this Affidavit/Release. Compliance: . 1. Company is in compliance with, and will continue to comply with all the rules, regulations, terms and conditions set forth in the Application, and with all laws, rules and regulations pertaining to the Application and the Program; that all information provided to the City now and in the future has been and will be true, accurate, and complete. Company has not perpetrated and will not perpetrate any fraud or deception in connection with the Program. Company has not sought to influence the outcome of the Application and is submitting this Agreement as expressly required under the Program's criteria. 2. Company understands that the City or its agents may be required to advise the United States Internal Revenue Service of the value of any Program grant awarded to the Company, and in connection therewith, a completed Form W-9 is attached hereto. I acknowledge and agree that I may be subject to taxation in connection with a Program grant and will pay any and all such taxes when due. Release, Indemnity and Hold Harmless: 3. COMPANY HEREBY RELEASESS, WAIVE, ACQUITS, FOREVER DISCHARGES, AND COVENANTS NOT TO SUE THE CITY OR ANY OF THE CITY'S OFFICIALS, OFFICERS, EMPLOYEES, AGENTS OR VOLUNTEERS, IN EITHER THEIR OFFICIAL OR PRIVATE CAPACITIES (COLLECTIVELY, "CITY PERSONS"), FOR AND/OR FROM ANY AND ALL CLAIMS, LIABILITY, DEMANDS, LOSSES, HARM, ACTIONS, SUITS, JUDGMENTS, PENALTIES, FEES, COSTS AND EXPENSES WHATSOEVER, (COLLECTIVELY, "CLAIMS"), WHICH THE COMPANY MAY NOW OR HEREAFTER BE ENTITLED TO ASSERT, ARISING OUT OF, CAUSED BY, IN CONNECTION WITH, OR RELATED TO, THE PROGRAM, OR MY POSSESSION, ACCEPTANCE, USE, OR MISUSE THEREOF, OR ANY OF MY OTHER ACTS OR OMISSIONS IN CONNECTION THEREWITH, INCLUDING, BUT NOT LIMITED TO, DEATH, ILLNESS, INJURY, LOSS OF ENJOYMENT, PROPERTY DAMAGE OR DESTRUCTION, OR OTHER HARM OR LOSS OF ANY NATURE, AND ANY AND ALL ANY TAXES LEVIED, ASSESSED OR COLLECTED, AND FURTHER INCLUDING, WITHOUT LIMITATION, ANY AND ALL CLAIMS WHICH ARISE OUT OF, ARE RELATE TO, OR ARE CAUSED BY, IN WHOLE OR IN PART, ANY NEGLIGENT ACT OR OMISSION OF THE CITY OR ANY CITY PERSONS OR ANY OTHER PERSONS, OR ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. Company has voluntarily chosen to submit its Application and hereby accepts Program grant funds, subject to eligibility, and AGREES TO ASSUME ANY AND ALL RISKS with respect to any harm, damage, injury, incident, action, occurrence or activity which may occur in connection with or result from the Application and/or Program Grant, and/or Company's acceptance, use, misuse, or possession thereof. 4. FURTHER, COMPANY HEREBY AGREES TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CITY AND ALL CITY PERSONS FROM AND AGAINST ANY AND ALL CLAIMS, INCLUDING, WITHOUT LIMITATION, COURT COSTS AND ATTORNEY'S FEES (NOT TO EXCEED $350.00 PER HOUR), THAT MAY ARISE OUT OF, RESULT FROM, OR BE INCURRED DUE TO THE SUBMISSION OF COMPANY'S APPLICATION OR ITS PARTIPCATION IN THE PROGRAM, ACCEPTANCE OF A PROGRAM GRANT, ACCEPTANCE, USE, MISUSE OR POSSESION THEROF, OR ANY ACTS OR OMISSIONS IN CONNECTION THEREWITH. SUCH DEFENSE, INDEMNITY AND HOLD HARMLESS SHALL AND DOES INCLUDE CLAIMS ALLEGED OR FOUND TO HAVE BEEN CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, OR BY ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. 5. It is the Company's express intent that this Affidavit/Release shall bind the Company, its agents, heirs, assigns, successors and legal representative(s), and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the City and all other City Persons (identified herein, including paragraph 3 hereof) for any and all purposes. 6. COMPANY UNDERSTANDS THAT THIS IS A LEGAL DOCUMENT AND THAT BY SIGNING IT, AMONG OTHER THINGS, COMPANY GIVES UP ITS RIGHT TO SUE OR OTHERWISE MAKE A CLAIM against the City and all other City Persons, as set forth herein. Representations: 7. I certify that I am a properly authorized official or agent of the Company and have the necessary legal authority to execute this Affidavit of Eligibility and Liability Release Agreement on the Company's behalf. 8. Company is not in any type or manner of litigation or contemplating litigation with the City or County of Dallas. 9. Company is currently operating with its principal place of business within the corporate limits of the City. Miscellaneous Provisions: 10. Company agrees to return, immediately upon demand by the City, any and all Program grant funds that have been or may be awarded if any statement, certification, or representation made in this Affidavit/Release is discovered or believed to be false or misleading, and Company acknowledges and agrees that all available legal, equitable and other rights and remedies may be pursued against it in connection therewith. Company represents and affirms that this Affidavit/Release does not conflict with any other commitments or obligations on its part. 11. Except for the Application and Program eligibility criteria, this Affidavit/Release constitutes the entire Agreement between Company and the City with respect to the matters described herein, and supersedes any and all other agreements and communications, oral or written, between Company and the City, any City Persons, or any other Persons. This Agreement may not be amended or supplemented except by a (paper) writing signed by the Company and the City. 12. The section and subsection headings contained herein are for convenience only and shall not be used in interpretation of this Agreement and are not intended to define or limit the scope of any provision of this Agreement. For purposes of this Agreement, "including" is a term of enlargement and not of limitation or exclusive enumeration, and use of the term does not create a presumption that components not expressed are excluded. 13. Company signs and makes this Affidavit/Release voluntarily, freely, and knowingly, and it has not relied upon any representations made by the City or any City Person in signing this Affidavit/Release. 14. This Affidavit/Release shall be governed by and construed according to the laws of the State of Texas (without reference to the choice of laws provisions of any jurisdiction), and venue for all matters, claims, or proceedings hereunder shall lie exclusively in Dallas County, Texas. 15. The provisions of this Affidavit/Release are severable, and if any provision hereof is held to be illegal, invalid or unenforceable under present or future constitution or laws, such provision shall be fully severable and this Affidavit/Release shall be construed and enforced as if such illegal, invalid or unenforceable provision is not a part hereof, and the remaining provisions hereof shall remain in full force and effect. COMPANY CERTIFIES IT HAS READ THIS AFFIDAVIT/RELEASE, HAS FULLY INFORMED ITSELF OF ITS CONTENTS BEFORE EXECUTION, AND UNDERSTANDS ALL OF ITS TERMS, PROVIISONS, AND CONDITIONS. COMPANY HEREBY REPRESENTS AND WARRANTS THAT ALL STATEMENTS MADE IN THIS AFFIDAVIT/RLEASE ARE TRUE, ACCURATE AND COMPLETE. Signature: Title: Name Company address: Date: STATE OF TEXAS § COUNTY OF DENTON § Affidavit of Eligibility and Liability Release Agreement BEFORE ME, the undersigned authority, on this day personally appeared , and upon his/her oath deposed and stated as follows: This Affidavit of Eligibility and Liability Release Agreement ("Affidavit/Release" or "Agreement") to the City of Coppell, Texas ("City") as a legal representative of (the "Company"), with the understanding that this Affidavit/Release will be relied upon by the City (and the other City Persons) in connection with the Company's application for financial assistance (the "Application") under the Coppell Cares Business Retrofit Grant Program (the "Program"). Company acknowledges and agrees that there is adequate, sufficient, and good and valuable consideration for this Affidavit/Release. Compliance: 1. Company is in compliance with, and will continue to comply. with all the rules, regulations, terms and conditions set forth in the Application, and with all laws, rules and regulations pertaining to the Application and the Program; that all information provided to the City now and in the future has been and will be true, accurate, and complete. Company has not perpetrated and will not perpetrate any fraud or deception in connection with the Program. Company has not sought to influence the outcome of the Application and is submitting this Agreement as expressly required under the Program's criteria. 2. Company understands that the City or its agents may be required to advise the United States Internal Revenue Service of the value of any Program grant awarded to the Company, and in connection therewith, a completed Form W-9 is attached hereto. I acknowledge and agree that I may be subject to taxation in connection with a Program grant and will pay any and all such taxes when due. Release, Indemnity and Hold Harmless: 3. COMPANY HEREBY RELEASEES, WAIVE, ACQUITS, FOREVER DISCHARGES, AND COVENANTS NOT TO SUE THE CITY OR ANY OF THE CITY'S OFFICIALS, OFFICERS, EMPLOYEES, AGENTS OR VOLUNTEERS, IN EITHER THEIR OFFICIAL OR PRIVATE CAPACITIES (COLLECTIVELY, "CITY PERSONS"), FOR AND/OR FROM ANY AND ALL CLAIMS, LIABILITY, DEMANDS, LOSSES, HARM, ACTIONS, SUITS, JUDGMENTS, PENALTIES, FEES, COSTS AND EXPENSES WHATSOEVER, (COLLECTIVELY, "CLAIMS"), WHICH THE COMPANY MAY NOW OR HEREAFTER BE ENTITLED TO ASSERT, ARISING OUT OF, CAUSED BY, IN CONNECTION WITH, OR RELATED TO, THE PROGRAM, OR MY POSSESSION, ACCEPTANCE, USE, OR MISUSE THEREOF, OR ANY OF MY OTHER ACTS OR OMISSIONS IN CONNECTION THEREWITH, INCLUDING, BUT NOT LIMITED TO, DEATH, ILLNESS, INJURY, LOSS OF ENJOYMENT, PROPERTY DAMAGE OR DESTRUCTION, OR OTHER HARM OR LOSS OF ANY NATURE, AND ANY AND ALL ANY TAXES LEVIED, ASSESSED OR COLLECTED, AND FURTHER INCLUDING, WITHOUT LIMITATION, ANY AND ALL CLAIMS WHICH ARISE OUT OF, ARE RELATE TO, OR ARE CAUSED BY, IN WHOLE OR IN PART, ANY NEGLIGENT ACT OR OMISSION OF THE CITY OR ANY CITY PERSONS OR ANY OTHER PERSONS, OR ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. Company has voluntarily chosen to submit its Application and hereby accepts Program grant funds, subject to eligibility, and AGREES TO ASSUME ANY AND ALL RISKS with respect to any harm, damage, injury, incident, action, occurrence or activity which may occur in connection with or result from the Application and/or Program Grant, and/or Company's acceptance, use, misuse, or possession thereof. 4. FURTHER, COMPANY HEREBY AGREES TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CITY AND ALL CITY PERSONS FROM AND AGAINST ANY AND ALL CLAIMS, INCLUDING, WITHOUT LIMITATION, COURT COSTS AND ATTORNEY'S FEES (NOT TO EXCEED $350.00 PER HOUR), THAT MAY ARISE OUT OF, RESULT FROM, OR BE INCURRED DUE TO THE SUBMISSION OF COMPANY'S APPLICATION OR ITS PARTIPCATION IN THE PROGRAM, ACCEPTANCE OF A PROGRAM GRANT, ACCEPTANCE, USE, MISUSE OR POSSESION THEROF, OR ANY ACTS OR OMISSIONS IN CONNECTION THEREWITH. SUCH DEFENSE, INDEMNITY AND HOLD HARMLESS SHALL AND DOES INCLUDE CLAIMS ALLEGED OR FOUND TO HAVE BEEN CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE. OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, OR BY ANY ACT OR OMISSION OF THE CITY, ANY CITY PERSONS, OR ANY OTHER PERSONS, THAT WOULD GIVE RISE TO STRICT LIABILITY OF ANY KIND. 5. It is the Company's express intent that this Affidavit/Release shall bind the Company, its agents, heirs, assigns, successors and legal representative(s), and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the City and all other City Persons (identified herein, including paragraph 3 hereof) for any and all purposes. 6. COMPANY UNDERSTANDS THAT THIS IS A LEGAL DOCUMENT AND THAT BY SIGNING IT, AMONG OTHER THINGS, COMPANY GIVES UP ITS RIGHT TO SUE OR OTHERWISE MAKE A CLAIM against the City and all other City Persons, as set forth herein. Representations: 7. I certify that I am a properly authorized official or agent of the Company and have the necessary legal authority to execute this Affidavit of Eligibility and Liability Release Agreement on the Company's behalf. 8. Company is not in any type or manner of litigation or contemplating litigation with the City or County of Denton. 9. Company is currently operating with its principal place of business within the corporate limits of the City. Miscellaneous Provisions: 10. Company agrees to return, immediately upon demand by the City, any and all Program grant funds that have been or may be awarded if any statement, certification, or representation made in this Affidavit/Release is discovered or believed to be false or misleading, and Company acknowledges and agrees that all available legal, equitable and other rights and remedies may be pursued against it in connection therewith. Company represents and affirms that this Affidavit/Release does not conflict with any other commitments or obligations on its part. 11. Except for the Application and Program eligibility criteria, this Affidavit/Release constitutes the entire Agreement between Company and the City with respect to the matters described herein, and supersedes any and all other agreements and communications, oral or written, between Company and the City, any,City Persons, or any other Persons. This Agreement may not be amended or supplemented except by a (paper) writing signed by the Company and the City. 12. The section and subsection headings contained herein are for convenience only and shall not be used in interpretation of this Agreement and are not intended to define or limit the scope of any provision of this Agreement. For purposes of this Agreement, "including" is a term of enlargement and not of limitation or exclusive enumeration, and use of the term does not create a presumption that components not expressed are excluded. 13. Company signs and makes this Affidavit/Release voluntarily, freely, and knowingly, and it has not relied upon any representations made by the City or any City Person in signing this Affidavit/Release. 14. This Affidavit/Release shall be governed by and construed according to the laws of the State of Texas (without reference to the choice of laws provisions of any jurisdiction), and venue for all matters, claims, or proceedings hereunder shall lie exclusively in Denton County, Texas. 15. The provisions of this Affidavit/Release are severable, and if any provision hereof is held to be illegal, invalid or unenforceable under present or future constitution or laws, such provision shall be fully severable and this Affidavit/Release shall be construed and enforced as if such illegal, invalid or unenforceable provision is not a part hereof, and the remaining provisions hereof shall remain in full force and effect. COMPANY CERTIFIES IT HAS READ THIS AFFIDAVIT/RELEASE, HAS FULLY INFORMED ITSELF OF ITS CONTENTS BEFORE EXECUTION, AND UNDERSTANDS ALL OF ITS TERMS, PROVIISONS, AND CONDITIONS. COMPANY HEREBY REPRESENTS AND WARRANTS THAT ALL STATEMENTS MADE IN THIS AFFIDAVIT/RLEASE ARE TRUE, ACCURATE AND COMPLETE. Signature: Title: Name: Company address: Date: Coppell Cares Business Retrofit Grant Program Application Checklist Please Check All Completed Items Included: Fully completed application A signed Affidavit of Eligibility and Liability Release Agreement for the County in which the business is located A copy of the company's Certificate of Occupancy Copies of all receipts if the expenses have already been incurred