COVID-19 Layoff Aversion Fund Application
Beacon Council

In order to complete your registration, please enter the appropriate information in the fields below. When finished click Submit.

Business Profile

Business/Contractor FEIN:   
Business Legal Name:
Authorized Business Representative:
North American Industry Clasification System (NAICS) Code:

Address:
(Example: 7300 NW 19th Street)
Number: Direction: Street Name: Street Type: Ste:
(Ex: 7300) (NW) (19) (St)  
 
City: State:
Zip Code:
Email: Telephone: () -   

D/B/A Name:
Amount of Funds Requested:
Number of Employees:
Number of Affected Workers:
Average Hourly Wage of the Affected Workers:
Is the Business Affected by the COVID-19 Pandemic?:
If Yes, describe:
BACKGROUND: Provide a brief description of the company including the products and services, industry and occupations and any other relevant background information:
LAYOFF AVERSION PLAN: Provide a brief narrative of the layoff aversion plan including information on the specific needs of the employer, the layoff aversion activities, the timeline for the project and any other relevant information:

List Pre-Layoff Services Provided

The costs outlined below will help the organization support staff working from home to comply with State and Local orders, and will allow the agency to remain available to clients during COVID-19 emergency. Please attach a brief budget detail and narrative of the requested costs.
The Federal Workforce Innovation and Opportunity Act fund for layoff aversion activities is designed to prevent, or minimize the duration of, unemployment resulting from layoffs. To this end, CSSF will distribute Layoff Aversion Funds in Miami-Dade and Monroe Counties within the following parameters:
Request must be directly relative to business impacts from COVID-19. Layoffs or furloughs mast have happened after march 15, 2020 or be other wise imminent.
Funds may be spent on staff tools, supplies or staff wages/benefit to support ongoing work as a result of Covid19.

Line Item Amount Provide a detailed explanation and the basis for the budget amount requested. Include detailed description of item
Remote access tools for staff (laptops, monitors, internet service, software, work tables, etc.)
Tools to allow for on-site service delivery in compliance with social distancing rules
Staff wage/benefit to support layoff aversion
Other
Grand Total    
All receipts should be scaned and uploaded into 1 file.


Required Documentation (Upload)

Profit Organization:

At a minimum, a completed application must provide:
Copies of last two (2) completed business tax returns-2017, 2018, 2019 and/or Schedule C (Form 1040), Profit or Loss from Business statement.  
Copy of IRS 941 or the Florid Department of Revenue Employer’s Quarterly Report (RT-6) for 2019, covering the period of October to December.  
Copy of current lease agreement or Certificate of Use for “Home Business”.  
A copy of the organization’s W-9 form.  



Non-Profit Organization:

At a minimum, a completed application must provide:
Copies of last two (2) completed business tax returns-2017, 2018, 2019 and/or Form 990 Return of Organization Exempt From Income Tax.  
Copy of IRS 941 or the Florid Department of Revenue Employer’s Quarterly Report (RT-6) for 2019, covering the period of October to December.  
Copy of current lease agreement or Certificate of Use for “Home Business”.  
A copy of the organization’s W-9 form.  
Local/State/Federal grant applications (Statement of Work) detailing previous or current grant relationships in working with the following groups:
• Ex-offenders;
• Homeless individuals, including homeless children and youths;
• Youth offenders/youth at risk of court involvement/youth involved in the juvenile justice system;
• Individuals with disabilities, including youth with disabilities;
• and Migrant and seasonal farmworkers.
 



By clicking this box, you attest to the following: (1) that all the information submitted is true and accurate to the best of your knowledge; (2) except where specific information is exempt by state law, your application and all information contained therein shall be considered public records; and (3) you understand that any misrepresentation of material fact, omissions, falsification of documents, or if any other information makes you ineligible, your application will be denied.
Submit

For Questions and/or Comments: layoffaversion@careersourcesfl.com