Workforce Stability Grant Application (Mare Island Dry Dock) Step 1 of 4 25% This application is for Solano County small businesses impacted by the Mare Island Dry Dock closure in Vallejo and is intended to support business stabilization and layoff aversion efforts. Applicants are encouraged to review the Funding Program Details prior to submission and ensure all required fields and documentation are completed at the time of submission. Please have all required documents ready to upload before proceeding. Incomplete applications may not be reviewed.Business InformationPlease provide the following information about your business. All fields are required unless otherwise noted.Legal Business Name(Required) DBA: (if applicable) Primary Contact Name(Required) First Last Title Primary Contact Phone(Required)Primary Contact Email(Required) Is the primary contact listed above authorized to sign agreements on behalf of the business?(Required) Yes No Authorized Signer(Required) First Last Title Authorized Signer Phone(Required)Authorized Signer Email(Required) Secondary Contact NamePlease provide a secondary contact who can respond promptly if we need to reach you for clarification or additional information. Selected applicants will have a limited response timeframe. First Last Title PhoneEmail Local Business Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Is your mailing address different from the business address listed above?(Required) Yes No Mailing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Does your business have a main office located at a different address than the Solano County location listed above?(Required) Yes No Main Office Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Month & year business established(Required) Is the business currently open and operating?(Required) Yes No Business Legal Structure(Required)Select oneSole Proprietorship (1 or more employees, not incl. owner)PartnershipLimited Liability Company (LLC)Corporation (C-Corp or S-Corp)Industry that best aligns with your business.(Required)Select oneAccommodation & Food ServiceAdministrative & Business Support (e.g., office support, staffing, janitorial)Agriculture, Forestry, Fishing & HuntingArts, Entertainment & RecreationConstruction & Skilled TradesEducation & Training ServicesFinance & InsuranceHealth Care & Social Assistance (incl. childcare)Information & TechnologyManufacturing & ProductionProfessional Services (e.g., legal, accounting, consulting)Real Estate & Property ServicesRetail (Storefront or Online Sales)Utilities & EnergyWholesale TradeOtherEIN (Employer Identification Number)(Required)Enter your EIN (XX-XXXXXXX). Social Security Numbers (SSNs) are not accepted. CA Employer Account Number (EDD)(Required)Enter your EDD Employer Account Number (XXX-XXXX-X) Is your business in good standing and not subject to any federal or state debarment, suspension, or restrictions that would prevent receipt of public funds?(Required) Yes No Upload Copy of Business License(Required)Accepted file types: pdf, jpg, gif, png, Max. file size: 5 MB.Upload Completed W-9 Form(Required)Accepted file types: pdf, jpg, gif, png, Max. file size: 5 MB.Description of Business(Required)Describe your business, including the products or services you offer and your primary operations. Please do not include information about how your business has been impacted, as this will be addressed in a later section. Impact EligiblityPlease provide the following information about how your business was impacted. All fields are required unless otherwise noted.Type of Business Impact (select all that apply)(Required) Revenue decline Loss of contracts or clients Reduction in employee hours or wages Layoffs have already occurred Anticipated layoffs within the next 6 months Supply chain discruption or vendor loss Impact not listed Number of Employees Prior to Closure(Required) Full-Time Part-Time Number of Employees Currently Impacted(Required) Full-Time Part-Time At risk of layoff (next 6 months) Describe your business connection to the Mare Island Dry Dock closure and how your business has been impacted.(Required)Be specific and include details such as loss of revenue, customers, contracts, or operational changes. Applicants must upload documentation demonstrating business impact. Applications submitted without supporting documentation or an approved self-attestation explanation may be considered incomplete. Acceptable documentation includes: Financial records (profit & loss statements, sales reports, bank statements, or accounting system screenshots) Invoices, contracts, or proof of business activity tied to impacted companies or industries Payroll records or documentation showing reduced hours, wages, or staffing levels Emails, order cancellations, or other communications demonstrating loss of business Other relevant documentation You may upload multiple files.Self-Attestation Option I am unable to provide the supporting documentation listed above. If your business is unable to provide formal supporting documentation, please explain in detail why the documentation is not available. By submitting this explanation, you certify that the information provided is true and accurate to the best of your knowledge. The Workforce Development Board will review self-attestation on a case-by-case basis, may request additional information, and reserves the right to deny funding if the explanation provided is insufficient to establish business impact. Explanation:(Required)Certification:(Required) I certify that the explanation provided above is true and accurate to the best of my knowledge and understand that it may be subject to verification. Upload Supporting Documentation (multiple files okay)(Required) Drop files here or Select files Accepted file types: pdf, jpg, jpeg, png, doc, docx, xls, xlsx, Max. file size: 100 MB. Has your business received or applied for any other funding (grants, loans, or financial assistance) related to the Mare Island Dry Dock closures?(Required) Yes No If yes, please provide the following:(Required) Source of Funding Amount of Funding What is/was the funding being used for?(Required) Funding Request & Layoff Aversion PlanAll proposed activities must directly support business stabilization and layoff aversion and align with allowable uses.Total Funding Request (up to $10,000)(Required)Please enter a number from 0 to 10000.Proposed Use of Funds (select all that apply)(Required) Business pivot (e.g., new products or services) Technology upgrades or software implementation Equipment or machinery purchases Workforce training or upskilling Process or operational improvements Marketing or business development activities Other Provide a detailed layoff aversion plan describing how the requested funding will be used to prevent layoffs or reduce workforce impacts, including specific activities and expected outcomes:(Required)Estimated # of employess to be retained as a result of this funding:(Required) Full-Time Part-Time Commitments & CertificationsI am authorized to complete and submit this application, including all certifications, on behalf of the business. All information provided in this application and any attachments is true, accurate, and complete to the best of my knowledge. The business is in good standing and not subject to any federal or state debarment, suspension, or restrictions that would prevent receipt of public funds. The business commits to retaining at least 50% of employees for six (6) months following receipt of funds. The business will participate in required reporting and follow-up activities and provide documentation upon request to verify eligibility, use of funds, and outcomes. Grant funds will be used only for approved, allowable activities that support business stabilization and layoff aversion and will not be used for duplicate or overlapping costs covered by another funding source. If self-attestation is provided in lieu of supporting documentation, the explanation is true and accurate to the best of my knowledge and may be subject to verification. Additional documentation may be requested and may be required for full consideration of this application. Submission of this application does not guarantee funding. If approved, a formal agreement will be required, and no costs may be incurred prior to execution of that agreement. Providing false or misleading information, or misuse of funds, may result in denial, termination of funding, repayment of funds, and/or other penalties.Signature(Required)Are you interested in receiving no-cost business advising through Solano-Napa Small Business Development Center? If yes, a representative of SBDC will reach out to you to discuss available services and next steps.(Required)Are you interested in receiving no-cost business advising through Solano-Napa Small Business Development Center? If yes, a representative of SBDC will reach out to you to discuss available services and next steps. Yes Not at this time
