Program Questions:
Green CHIPS Community Investment Fund

Q_16849

Is this project application seeking funding for capital expenses?
  • Threshold
  • Yes
  • Yes/No

Q_15020

By answering YES to this question, you are acknowledging that your application will be shared by Empire State Development and Micron and may also be viewed by other third parties.
  • Threshold
  • Yes
  • Yes/No

Q_16501

Are you applying for at least $100,000?
  • Threshold
  • Yes
  • Yes/No

Q_15021

Does the proposed project budget include a 10% cash equity contribution from the Applicant?
  • Threshold
  • Yes
  • Yes/No

Q_928

Project Street Address: Please input the project street address (Street Number and Street Name only).

If the project has multiple locations, please input the primary street address of the project. If the project does not have a definite street address, please input the approximate street address of the project (Street Number and Street Name only).
  • Location
  • Yes
  • Short Answer

Q_565

Project City
  • Location
  • Yes
  • Short Answer

Q_972

Project county or counties.
  • Location
  • Yes
  • NYS County Multiple Choice

Q_568

Project State
  • Location
  • Yes
  • Single Choice Dropdown
  • AA,AL,AK,AZ,AR,CA,CO,CT,DE,FL,GA,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VT,VA,WA,WV,WI,WY,AS,DC,FM,GU,MH,MP,PW,PR,VI
  • AA

Q_1034

Project ZIP Code. (please use ZIP+4 if known)
  • Location
  • Yes
  • Zip Code
  • To locate a Zip Code, click HERE

     

     

Q_572

Project Latitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)
  • Location
  • No
  • Decimal

Q_573

Project Longitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)
  • Location
  • No
  • Decimal

Q_3527

US Congressional District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)
  • Location
  • No
  • Single Choice Dropdown
  • 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27
  • To determine the US Congressional District, click HERE

Q_184

NYS Assembly District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)
  • Location
  • No
  • Integer

Q_190

NY Senate District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)
  • Location
  • No
  • Integer

Q_549

Type of Applicant (select one)
Applicants will first select a single applicant type from the categories below and then a subtype based on their initial selection. Applicants should review the selections below which provides a list of subtypes by main applicant type.

1. For Profit entity options:
Limited Liability Corporation (LLC)
Limited Liability Partnership (LLP)
Sole Proprietorship
S Corporation
C Corporation
Limited Partnership (LP)
Other- applicant will be required to list their other for-profit designation.

2. Not-for profit entity options:
501(c)(1) Any corporation that is organized under an act of Congress that is exempt from federal income tax;
501(c)(2) Corporations that hold a title of property for exempt organizations;
501(c)(3) Corporations/funds/foundations that operate for religious/ charitable/ scientific/ literary/ educational purposes;
501(c)(4) Nonprofit organizations that promote social welfare;
501(c)(5) Labor, agricultural, or horticultural associations;
501(c)(6) Business leagues/chambers of commerce/etc. that are not organized for profit;
501(c)(7) Recreational organizations; and
Other- applicant will be required to list their other not-for-profit designation.

3. Government entity options:
Federal
State
County
City
Town
Village
Tribal
School District
County or Town Improvement District
District Corporation
Public Authority
Business Improvement District
Fire District
Board of Cooperative Education Services (BOCES)
Public Library
Association Library
Other- applicant will be required to list their other government designation.
  • Basic
  • Yes
  • Single Choice Dropdown
  • For-Profit, Not-for-Profit, Government
    1. If For-Profit is selected then Q_15475 will be displayed
    2. If Government is selected then Q_15478 will be displayed
    3. If Not-for-Profit is selected then Q_15477 will be displayed

Q_15475

Select the for-profit entity of the applicant applying for funding:
  • Basic
  • Yes
  • Single Choice Radio Button
  • Limited Liability Corporation (LLC), Limited Liability Partnership (LLP), Sole Proprietorship, S Corporation, C Corporation, Limited Partnership (LP), Other
    1. If Other is selected then Q_15483 will be displayed

Q_15483

Enter the applicant's 'Other' for-profit entity designation.
  • Basic
  • Yes
  • Short Answer

Q_15477

Select the not-for-profit entity of the applicant applying for funding:
  • Basic
  • Yes
  • Single Choice Radio Button
  • 501(c)(1) Any corporation that is organized under an act of Congress that is exempt from federal income tax, 501(c)(2) Corporations that hold a title of property for exempt organizations, 501(c)(3) Corporations/funds/foundations that operate for religious/charitable/scientific/literary/educational purposes, 501(c)(4) Nonprofit organizations that promote social welfare, 501(c)(5) Labor/agricultural/horticultural associations, 501(c)(6) Business leagues/chambers of commerce/etc. that are not organized for profit, 501(c)(7) Recreational organizations, Other
    1. If Other is selected then Q_15484 will be displayed

Q_15484

Enter the applicant's 'Other' not-for-profit entity designation.
  • Basic
  • Yes
  • Short Answer

Q_15478

Select the government entity of the applicant applying for funding:
  • Basic
  • Yes
  • Single Choice Radio Button
  • Federal, State, County, City, Town, Village, Tribal, School District, County or Town Improvement District, District Corporation, Public Authority, Business Improvement District, Fire District, Board of Cooperative Education Services (BOCES), Public Library, Association Library, Other
    1. If Other is selected then Q_15485 will be displayed

Q_15485

Enter the applicant's 'Other' government entity designation.
  • Basic
  • Yes
  • Short Answer

Q_12603

Is the applicant a DBA?
  • Basic
  • Yes
  • Yes/No
    1. If Yes is selected then Q_550 will be displayed

Q_550

What is the applicant's DBA name?
  • Basic
  • Yes
  • Short Answer

Q_556

Select an applicant ID type from the list below that you normally use to identify your organization on application forms.
  • Basic
  • Yes
  • Single Choice Radio Button
  • Charity Reg #, Duns Number, Federal Tax ID Number, NYS Unemployment Insurance Tax Number,NYS Vendor Identification Number (SFS),Employee Identification Number (EIN),Unique Entity Identifier (UEI)
  • Applicants will be required to provide the specified ID number upon request by the funding agencies.

Q_2655

Based on your selection from the previous question, enter the associated ID number.
  • Basic
  • Yes
  • Short Answer

Q_969

If you are a business, have you been certified as a New York State Minority or Women-owned Business Enterprise (MWBE)?
  • Basic
  • Yes
  • Single Choice Radio Button
  • Yes, No, N/A

Q_546

Organization Legal Name
  • Applicant Information
  • Basic
  • Yes
  • Short Answer
  • If applying in the name of a business please type in the name as it appears on your business papers. If applying as an individual insert your name here.

Q_5416

Applicant First Name
  • Basic
  • Yes
  • Short Answer

Q_5417

Applicant Last Name
  • Basic
  • Yes
  • Short Answer

Q_551

Applicant Street Address
  • Basic
  • Yes
  • Short Answer

Q_552

Applicant City
  • Basic
  • Yes
  • Short Answer

Q_553

Applicant State
  • Basic
  • Yes
  • State Dropdown

Q_554

Applicant ZIP Code. (please use ZIP+4 if known)
  • Basic
  • Yes
  • Zip Code
  • To look up a zip code, click HERE

Q_651

Applicant Telephone Number (please include area code)
  • Basic
  • Yes
  • Phone

Q_555

Applicant Email Address
  • Basic
  • Yes
  • Email

Q_5257

Contact Salutation
  • Basic
  • No
  • Single Choice Dropdown
  • Mr., Mrs., Ms., Dr.

Q_547

Contact First Name
  • Basic
  • Yes
  • Short Answer

Q_1049

Contact Last Name
  • Basic
  • Yes
  • Short Answer

Q_1050

Contact Title
  • Basic
  • No
  • Short Answer

Q_5490

Primary Organization
  • Basic
  • No
  • Short Answer

Q_3688

Contact Street Address
  • Basic
  • Yes
  • Short Answer

Q_3689

Contact City
  • Basic
  • Yes
  • Short Answer

Q_3690

Contact State
  • Basic
  • Yes
  • State Dropdown

Q_3691

Contact ZIP Code (please use ZIP+4 if known)
  • Basic
  • Yes
  • Zip Code

Q_562

Primary Contact Phone Number. (please include area code)
  • Basic
  • Yes
  • Phone

Q_3692

Contact Email
  • Basic
  • Yes
  • Email

Q_5475

Contract Salutation
  • Basic
  • No
  • Single Choice Dropdown
  • Mr., Mrs., Ms., Dr.

Q_5476

Contract First
  • Basic
  • Yes
  • Short Answer

Q_5477

Contract Last
  • Basic
  • Yes
  • Short Answer

Q_5478

Contract Title
  • Basic
  • No
  • Short Answer

Q_5491

Authorized Organization
  • Basic
  • No
  • Short Answer

Q_5479

Contract Street
  • Basic
  • Yes
  • Short Answer

Q_5480

Contract City
  • Basic
  • Yes
  • Short Answer

Q_5481

Contract State
  • Basic
  • Yes
  • State Dropdown

Q_5482

Contract Zip (please use ZIP+4 if known)
  • Basic
  • Yes
  • Zip Code

Q_5483

Contract Phone (please include area code)
  • Basic
  • Yes
  • Phone

Q_5484

Contract Email
  • Basic
  • Yes
  • Email

Q_5493

Additional Salutation
  • Basic
  • No
  • Single Choice Dropdown
  • Mr., Mrs., Ms., Dr.

Q_1052

Additional Project Contact First Name
  • Basic
  • No
  • Short Answer

Q_970

Additional Project Contact Last Name
  • Basic
  • No
  • Short Answer

Q_1051

Additional Contact Title
  • Basic
  • No
  • Short Answer

Q_5492

Additional Organization
  • Basic
  • No
  • Short Answer

Q_3693

Additional Contact Street Address
  • Basic
  • No
  • Short Answer

Q_3694

Additional Contact City
  • Basic
  • No
  • Short Answer

Q_3695

Additional Contact State
  • Basic
  • No
  • State Dropdown

Q_3696

Additional Contact ZIP (please use ZIP+4 if known)
  • Basic
  • No
  • Zip Code

Q_3697

Additional Contact Telephone Number (please include area code)
  • Basic
  • No
  • Phone

Q_561

Additional Contact Email Address
  • Basic
  • No
  • Email

Q_4199

Please select the primary sector or characterization that best defines this project.
  • Basic
  • Yes
  • Single Choice Dropdown
  • Agriculture, Arts/Culture/Cultural Institutions, Biomedical/Medical, Community Development, Education/College/University, Energy, Environment, Financial Services, Food/Beverage, Healthcare, Historic Preservation, Hospitality, Housing, Industrial/Manufacturing, Information Technology Services/Communications, Infrastructure, Municipal/Government, Office, Recreation,Research & Development, Tourism/Travel, Transportation, Water/Wastewater/Sewer, Waterfront Revitalization, Workforce Development,Business Development,Technology Commercialization

Q_4198

Please select the secondary sector or characterization that best defines this project.
  • Basic
  • Yes
  • Single Choice Dropdown
  • Agriculture, Arts/Culture/Cultural Institutions, Biomedical/Medical, Community Development, Education/College/University, Energy, Environment, Financial Services, Food/Beverage, Healthcare, Historic Preservation, Hospitality, Housing, Industrial/Manufacturing, Information Technology Services/Communications, Infrastructure, Municipal/Government, Office, Research & Development, Tourism/Travel, Transportation, Water/Wastewater/Sewer, Waterfront Revitalization, Workforce Development,Business Development,Technology Commercialization

Q_575

Project Description. Concisely describe the project, indicating the location, what will be planned, designed, acquired, and/or constructed, the issues/opportunities to be addressed, and expected outcomes and deliverables. Additional details will be collected later in the application process.
  • Project Description
  • Basic
  • Yes
  • Long Rich Text (HTML)
  • 1 - 1200
  • Please include details relevant to all programs on this application. Programs on this application are: {{program_list}}

Q_580

Provide a list of all federal, state, and local reviews, approvals, or permits needed or completed, including the dates when they are expected to be completed or were completed. If Not Applicable, indicate "NA".
  • Basic
  • Yes
  • Long Answer
  • 1 - 400

Q_12606

Does this project require State and/or Federal Environmental Review?
  • Basic
  • Yes
  • Yes/No
    1. If Yes is selected then these questions will be displayed:
      - Q_2364
      - Q_12607

Q_2364

What is the status of State and/or Federal Environmental Review?
  • Basic
  • No
  • Short Answer

Q_12607

Please indicate the lead agency (if applicable).
  • Basic
  • No
  • Short Answer

Q_12604

Has a National Environmental Policy Act (NEPA) Record of Decision been issued?
  • Basic
  • Yes
  • Yes/No
    1. If Yes is selected then Q_1054 will be displayed

Q_1054

Please explain decision and include date of Record of Decision.
  • Basic
  • No
  • Long Rich Text (HTML)
  • 0 - 850

Q_6062

Indicate how many existing full-time equivalent jobs the applicant employs in all NYS LOCATIONS.
  • Job Creation and Retention Questions: The following questions are for committed, direct jobs only. Note that if awarded funding, Applicant must document existing and new jobs via submission of NY-45 forms. Questions about other jobs, such as Indirect Jobs and Construction Jobs, follow this section.
  • Jobs
  • Yes
  • Integer
  • A Full-time equivalent job equals any combination of two or more part-time jobs that, when combined together, constitute the equivalent of a job of at least 35 hours per week.

Q_2199

Indicate the average annual wage for existing full-time equivalent employees the applicant employs in all NYS Locations as of the date this application is finalized.
  • Jobs
  • Yes
  • Money

Q_2195

Indicate how many existing full-time equivalent jobs the applicant employs in all NYS LOCATIONS.
  • Jobs
  • Yes
  • Integer
  • A Full-time equivalent job equals any combination of two or more part-time jobs that, when combined together, constitute the equivalent of a job of at least 35 hours per week.  NOTE: Your base employment for Excelsior is calculated using the prior 4 quarters from when you are accepted into the program.

     

Q_1365

Indicate how many of the total existing full-time equivalent employees in New York State are contract employees.
  • Jobs
  • Yes
  • Integer
  • A Full-time Contract Employee a full-time private sector employee (or self-employed person) who is not on the Recipient’s payroll but who works exclusively for the Recipient at the project location for a minimum of 35 hours per week for not less than four consecutive weeks, providing services that would otherwise be provided by a Full-time Permanent Employee. The position held by a Full-time Contract Employee must be a year-round position.

Q_2196

Indicate how many existing full-time equivalent jobs the applicant employs at all PROJECT LOCATION(S).
  • Jobs
  • Yes
  • Integer
  •  NOTE: A full-time equivalent job equals any combination of two or more part-time jobs that, when combined together, constitute the equivalent of a job of at least 35 hours per week. Please note if any of these positions are contract employees and if so, how many of the total are contract employees.

     

     

Q_1186

Indicate the average annual wage for the employees at the Project Location as of the date this application is finalized.
  • Jobs
  • Yes
  • Money

Q_1196

How many of the existing jobs at the project location(s) are at risk if the project does not go forward.
  • Jobs
  • Yes
  • Integer
  •  

    "At Risk" shall mean a permanent Full-time employee position currently located in New York State that is found by ESD to be at risk of being lost or moved out of state based on compelling information provided by the applicant.

     

Q_2175

What percentage of the project's employees are/will be residents of New York State?
  • Jobs
  • Yes
  • Integer

Q_1366

Indicate how many of the total existing full-time equivalent employees at the Project Location are contract employees.
  • Jobs
  • Yes
  • Integer
  • A Full-time Contract Employee is a full-time private sector employee (or self-employed person) who is not on the Recipient’s payroll but who works exclusively for the Recipient at the project location for a minimum of 35 hours per week for not less than four consecutive weeks, providing services that would otherwise be provided by a Full-time Permanent Employee. The position held by a Full-time Contract Employee must be a year-round position.

Q_2372

Will the proposed project result in the creation of construction jobs? If so, estimate the number of construction jobs to be created.

Enter zero if not applicable.

  • Jobs
  • Yes
  • Integer

Q_2178

Will any other non-construction jobs result from the project? If so, please estimate how many jobs, explain how these jobs will be created, and explain the method used to determine the job number estimate.

For example: This could include jobs created by tenants at an incubator or mixed-use development or as a result of the creation of a job training center.
  • Jobs
  • Yes
  • Long Answer
  • 0 - 1000

Q_3064

Net New Job Information (Enter Cumulatively) 1. Enter the type of job by general category.
2. Enter the gross annual wages for each job type.
3. List the number of net new jobs. Please enter CUMULATIVE job totals, i.e. if there are 10 jobs being created each year for 5 years, enter as 10, 20, 30, 40, 50.

Please note that if you are completing the URI Phase 1 - Intent to Propose, you are not required to complete the table below at this time as this information will be available to enter in during phase 2 of the application.
  • Jobs
  • No
  • Short Answer

Q_3065

Net New Job Information
  • Jobs
  • No
  • Money

Q_3066

Net New Job Information
  • Jobs
  • No
  • Integer

Q_3067

Net New Job Information
  • Jobs
  • No
  • Integer

Q_3068

Net New Job Information
  • Jobs
  • No
  • Integer

Q_3069

Net New Job Information
  • Jobs
  • No
  • Integer

Q_3070

Net New Job Information
  • Jobs
  • No
  • Integer

Q_3071

Net New Job Information Job Type/Category
  • Jobs
  • No
  • Short Answer

Q_3072

Net New Job Information 2 Avg Gross Wages/Job Type
  • Jobs
  • No
  • Money

Q_3073

Net New Job Information 2 Year 1 -
  • Jobs
  • No
  • Integer

Q_3074

Net New Job Information 2 Year 2 -
  • Jobs
  • No
  • Integer

Q_3075

Net New Job Information 2 Year 3 -
  • Jobs
  • No
  • Integer

Q_3076

Net New Job Information 2 Year 4 -
  • Jobs
  • No
  • Integer

Q_3077

Net New Job Information 2 Year 5 -
  • Jobs
  • No
  • Integer

Q_3078

Net New Job Information (Enter Cumulatively) Job Type/Category
  • Jobs
  • No
  • Short Answer

Q_3079

Net New Job Information (Enter Cumulatively) 3 Avg Gross Wages/Job Type
  • Jobs
  • No
  • Money

Q_3080

Net New Job Information (Enter Cumulatively) 3 Year 1 -
  • Jobs
  • No
  • Integer

Q_3081

Net New Job Information (Enter Cumulatively) 3 Year 2 -
  • Jobs
  • No
  • Integer

Q_3082

Net New Job Information (Enter Cumulatively) 3 Year 3 -
  • Jobs
  • No
  • Integer

Q_3083

Net New Job Information (Enter Cumulatively) 3 Year 4 -
  • Jobs
  • No
  • Integer

Q_3084

Net New Job Information (Enter Cumulatively) 3 Year 5 -
  • Jobs
  • No
  • Integer

Q_3086

Net New Job Information (Enter Cumulatively) Job Type/Category
  • Jobs
  • No
  • Short Answer

Q_3089

Net New Job Information (Enter Cumulatively) 4 Avg Gross Wages/Job Type
  • Jobs
  • No
  • Money

Q_3090

Net New Job Information (Enter Cumulatively) 4 Year 1 -
  • Jobs
  • No
  • Integer

Q_3091

Net New Job Information (Enter Cumulatively) 4 Year 2 -
  • Jobs
  • No
  • Integer

Q_3092

Net New Job Information (Enter Cumulatively) 4 Year 3 -
  • Jobs
  • No
  • Integer

Q_3093

Net New Job Information (Enter Cumulatively) 4 Year 4 -
  • Jobs
  • No
  • Integer

Q_3094

Net New Job Information (Enter Cumulatively) 4 Year 5 -
  • Jobs
  • No
  • Integer

Q_3095

Net New Job Information (Enter Cumulatively) Job Type/Category
  • Jobs
  • No
  • Short Answer

Q_3096

Net New Job Information (Enter Cumulatively) 5 Avg Gross Wages/Job Type
  • Jobs
  • No
  • Money

Q_3097

Net New Job Information (Enter Cumulatively) 5 Year 1 -
  • Jobs
  • No
  • Integer

Q_3098

Net New Job Information (Enter Cumulatively) 5 Year 2 -
  • Jobs
  • No
  • Integer

Q_3099

Net New Job Information (Enter Cumulatively) 5 Year 3 -
  • Jobs
  • No
  • Integer

Q_3100

Net New Job Information (Enter Cumulatively) 5 Year 4 -
  • Jobs
  • No
  • Integer

Q_3101

Net New Job Information (Enter Cumulatively) 5 Year 5 -
  • In the Table below, provide a breakdown by general category/job type to indicate how many new full-time equivalent employees the company will create cumulatively by year (using the definition in the question above). The total in the bottom right-hand corner needs to equal the number in the subsequent question that follows this table.

    1) Enter the type of job by general category.

    2) Enter the average gross annual wages for each job type.

    3) Enter CUMULATIVE job totals in the table below. Cumulative job totals mean that each subsequent year in the chart includes jobs created in all prior years. The job number in the bottom right-hand corner on the chart is the full number of jobs created over all five years and needs to equal the number in the subsequent question that follows this table.

    i.e. if there are 10 jobs being created each year for 5 years in one category, enter 10 for year 1; 20 for year 2; 30 for year 3; 40 for year 4; 50 for year 5.

    If awarded, your company or entity will be held to the job creation commitments as outlined in the table below and question above. For grants, should you fail to meet the job creation commitments, recapture provisions may apply. For Excelsior, each years job commitment is evaluated separately to determine if tax credits can be issued.
  • Jobs
  • No
  • Integer

Q_7506

Indicate how many new full-time equivalent employees (using the definitions at the top of the page) the company will create over 5 years. Please ensure this number is the same as the cumulative total number of jobs you entered for year 5 from the Net New Jobs table above this.

If awarded, your company or entity will be held to the job creation commitments as outlined in this question and table below. For grants, should you fail to meet the job creation commitments, recapture provisions may apply. For Excelsior, each years job commitment is evaluated separately to determine if tax credits can be issued.
  • Jobs
  • Yes
  • Integer

Q_4167

Indicate the year employment begins under Year 1 for your project for the Net New Job table above.
  • Jobs
  • Yes
  • Integer
  • Please reference job definitions at the top of this page.

    The base employment for Excelsior is calculated using the prior 4 quarters from when you are accepted into the program.

     

Q_15023

Using the appropriate budget template for either operating or capital grants, please attach an estimated budget with an outline of expenses.
  • Attachment
  • Yes
  • Attachment

Q_15217

Attach interim financials for 2024

For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide interim financials for 2024, certified by a company officer. For publicly traded companies, please provide the most recent Form 10-Q.
  • Attachment
  • Yes
  • Attachment
  • Financial statements should be audited or reviewed.  If the statements are only compiled, they must be accompanied by copies of signed Federal tax returns (3 yrs).  Financial statements should be provided by the parent company or any individual owning 50% or greater of the Applicant) unless the Applicant prepares separate audited or reviewed financial statements or files separate tax returns from the parent.

     

    For information about this requirement, contact your local ESD Regional Office. https://esd.ny.gov/regions

     

    If you are applying to the ONRAMP program, contact workforce@esd.ny.gov 

Q_15218

Attach 2023 financial documents

For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide audited or reviewed financials, or compiled financials with signed tax returns, for 2023. For-publicly traded companies, please provide Form 10-K for 2023.
  • Attachment
  • Yes
  • Attachment
  • Financial statements should be audited or reviewed.  If the statements are only compiled, they must be accompanied by copies of signed Federal tax returns (3 yrs).  Financial statements should be provided by the parent company or any individual owning 50% or greater of the Applicant) unless the Applicant prepares separate audited or reviewed financial statements or files separate tax returns from the parent.

     

    For information about this requirement, contact your local ESD Regional Office. https://esd.ny.gov/regions

    If you are applying to the ONRAMP program, contact workforce@esd.ny.gov 

Q_13592

Attach 2022 financial documents

For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide audited or reviewed financials, or compiled financials with signed tax returns, for 2022. For-publicly traded companies, please provide Form 10-K for 2022.
  • Attachment
  • Yes
  • Attachment
  • Financial statements should be audited or reviewed.  If the statements are only compiled, they must be accompanied by copies of signed Federal tax returns (3 yrs).  Financial statements should be provided by the parent company or any individual owning 50% or greater of the Applicant) unless the Applicant prepares separate audited or reviewed financial statements or files separate tax returns from the parent.

     

    For information about this requirement, contact your local ESD Regional Office. https://esd.ny.gov/regions

    If you are applying to the ONRAMP program, contact workforce@esd.ny.gov 

Q_2165

For Start-up companies, in addition to the documents listed above provide: 1) Financial projections (5 years) 2) Personal financial statements from a personal guarantor(s) of the start-up company 3) Principal resumes
  • Attachment
  • No
  • Attachment
  • For information about this requirement, contact your local ESD Regional Office. https://esd.ny.gov/regions

Q_6946

Please provide Letters of Support for your project (if applicable). All letters should be scanned into a single PDF file and their total size cannot exceed 30 Megabytes (MB).
  • Attachment
  • No
  • Attachment

Q_2331

Attach an organizational chart and/or description of ownership structure including the percentage of ownership for each individual entity.
  • Attachment
  • Yes
  • Attachment
  • For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide an organizational chart and/or description of ownership structure, including the percentage of ownership for each individual/entity. If the company is a parent, subsidiary and/or affiliate of another company, please provide a description of the relationship. Additional financial information may be requested

Q_5689

Attach a short or long Environmental Assessment Form

Project review pursuant to the State Environmental Quality Review Act (SEQRA) must be completed prior to the award of any state funds. For projects classified as Type I or Unlisted actions, submit a short or long Environmental Assessment Form. See "Click Here for Question Requirements" for links to forms.

Q_2333

If review of the project has been completed pursuant to State Environmental Quality Review Act (SEQRA) or National Environmental Policy Act (NEPA), please submit the Negative Declaration or Findings Statement, or Finding of No Significant Impact or Record of Decision.
  • Attachment
  • No
  • Attachment

Q_2334

Provide a list of all other federal, state, and local reviews, approvals, or permits needed or completed, including the dates when they are expected to be completed or were completed. If Not Applicable, please upload an attachment that indicates "NA".
  • Attachment
  • Yes
  • Attachment

Q_16505

Is a third party being used to complete this application such as consultant, accountant or attorney?
  • Standard Question
  • Yes
  • Yes/No

Q_16506

Provide the third party name and contact info. Enter N/A if not applicable.
  • Standard Question
  • Yes
  • Long Answer
  • 0 - 100

Q_16507

Select all topics addressed by this project.
  • Standard Question
  • Yes
  • Multi Choice
  • Workforce, Education, Community Investment, Housing

Q_16508

Briefly explain how your proposal addresses the selected topics.
  • Standard Question
  • Yes
  • Long Answer
  • 0 - 1000

Q_15025

How does your project align with the Immediate Priorities identified in the most recently published version of the Community Priorities Document?
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 1500

Q_15027

How does your project align with the Community Principles and Core Considerations detailed in the most recently published version of the Community Priorities Document?
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 1000

Q_16502

Please describe the readiness of this project and identify when grant funding would need to be made available. Include an estimated project timeline containing project start/completion dates, estimates for design, permitting and construction or other major steps.
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 1000

Q_15024

Describe the specific outcomes and goals of the project and how you will measure progress made towards these goals. How will the project have an impact on the population or community it will serve?
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 1000

Q_15026

Describe how this project benefits diverse or disadvantaged populations. Please specify which populations this project will serve.
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 1000

Q_1233

What tasks and steps need to be completed before the project can begin (e.g. obtaining permits, licenses, hiring staff, etc.)
  • Standard Question
  • Yes
  • Long Answer
  • any

Q_5590

Please provide a concise narrative describing the applicant’s history and current operations. Include information about company/organization size, products, services, market share, position within the industry, competitors and the year in which the company was formed, etc.
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 1000

Q_1339

Applicant website
  • Standard Question
  • No
  • URL

Q_16503

What is the organization’s experience with projects of similar size and scale to the one proposed in this application? Please give specific examples of results and successes that demonstrate the organization’s established track record.
  • Standard Question
  • Yes
  • Long Answer
  • 0 - 1000

Q_1409

What is the first project year? (e.g. the year equipment will be ordered or when first expenditures are expected to be made)
  • Standard Question
  • Yes
  • Short Answer

Q_12654

Has the applicant applied for and/or been awarded funding from other New York State or local entities for this project?
  • Standard Question
  • Yes
  • Yes/No
    1. If Yes is selected then these questions will be displayed:
      - Q_12655
      - Q_13264

Q_12655

Please detail the funding applied to for this project and the entity administering the funding. Do not include funding that has been awarded.
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 850

Q_13264

Please detail the funding awarded to this project and the entity administering the funding.
  • Standard Question
  • Yes
  • Long Answer
  • 0 - 850

Q_13265

Has the applicant applied to and/or been awarded funding from a local IDA?
  • Standard Question
  • Yes
  • Yes/No
    1. If Yes is selected then these questions will be displayed:
      - Q_13266
      - Q_13267

Q_13266

Please detail the funding applied for this project and the entity administering the funding. Do not include funding that has been awarded.
  • Standard Question
  • Yes
  • Long Answer
  • 0 - 850

Q_13267

Please detail the funding awarded to this project and the entity administering the funding.
  • Standard Question
  • Yes
  • Long Answer
  • 0 - 850

Q_4318

Provide any other information in support of the project or pertinent to the request.
  • Standard Question
  • No
  • Long Answer
  • 0 - 300

Q_3006

Qualified Investments
  • Standard Question
  • Yes
  • Money
  • 0
  • Excelsior Jobs Program: Qualified investments are tangible personal property, including a building or structural component of a building, owned by the applicant that is depreciable per IRC Section 164, has a useful life of 4 years or more, is acquired by purchase as defined in IRC Section 179(d), is located in NYS, and is placed in service on or after the date certified eligible for the Excelsior Jobs Program.

Q_3007

Qualified Investments Year 1
  • Standard Question
  • Yes
  • Money
  • 0

Q_3008

Qualified Investments Year 1
  • Standard Question
  • Yes
  • Money
  • 0

Q_3009

Qualified Investments Year 1
  • Standard Question
  • Yes
  • Money
  • 0

Q_3010

Qualified Investments Year 1
  • Standard Question
  • Yes
  • Money
  • 0

Q_3012

Qualified Investments Year 1
  • Standard Question
  • Yes
  • Money
  • 0
  • * Eligible investment for ESD Grant Funds; generally not eligible investment for Excelsior Jobs Program.

Q_3014

Qualified Investments Year 1
  • Standard Question
  • Yes
  • Money
  • 0

Q_3015

Qualified Investments Year 1
  • Standard Question
  • Yes
  • Money
  • 0

Q_3017

Qualified Investments Building Acquisition
  • Standard Question
  • Yes
  • Money
  • 0

Q_3018

Qualified Investments Building Renovation Year 2
  • Standard Question
  • Yes
  • Money
  • 0

Q_3019

Qualified Investments New Construction Year 2
  • Standard Question
  • Yes
  • Money
  • 0

Q_3020

Qualified Investments Production Machinery Year 2
  • Standard Question
  • Yes
  • Money
  • 0

Q_3022

Qualified Investments Furniture, fixtures Year 2
  • Standard Question
  • Yes
  • Money
  • 0

Q_3024

Qualified Investments Land Acquisition * Year 2
  • Standard Question
  • Yes
  • Money
  • 0

Q_3027

Qualified Investments Demolition Year 2
  • Standard Question
  • Yes
  • Money
  • 0

Q_3028

Qualified Investments Year 2
  • Standard Question
  • Yes
  • Money
  • 0

Q_3030

Qualified Investments Building Acquisition
  • Standard Question
  • Yes
  • Money
  • 0

Q_3031

Qualified Investments Building Renovation Year 3
  • Standard Question
  • Yes
  • Money
  • 0

Q_3032

Qualified Investments New Construction Year 3
  • Standard Question
  • Yes
  • Money
  • 0

Q_3033

Qualified Investments Production Machinery Year 3
  • Standard Question
  • Yes
  • Money
  • 0

Q_3034

Qualified Investments Furniture, fixtures Year 3
  • Standard Question
  • Yes
  • Money
  • 0

Q_3036

Qualified Investments Land Acquisition * Year 3
  • Standard Question
  • Yes
  • Money
  • 0

Q_3039

Qualified Investments Demolition Year 3
  • Standard Question
  • Yes
  • Money
  • 0

Q_3040

Qualified Investments Year 3
  • Standard Question
  • Yes
  • Money
  • 0

Q_3042

Qualified Investments Building Acquisition
  • Standard Question
  • Yes
  • Money
  • 0

Q_3043

Qualified Investments Building Renovation Year 4
  • Standard Question
  • Yes
  • Money
  • 0

Q_3044

Qualified Investments New Construction Year 4
  • Standard Question
  • Yes
  • Money
  • 0

Q_3045

Qualified Investments Production Machinery Year 4
  • Standard Question
  • Yes
  • Money
  • 0

Q_3046

Qualified Investments Furniture, fixtures Year 4
  • Standard Question
  • Yes
  • Money
  • 0

Q_3048

Qualified Investments Land Acquisition * Year 4
  • Standard Question
  • Yes
  • Money
  • 0

Q_3050

Qualified Investments Demolition Year 4
  • Standard Question
  • Yes
  • Money
  • 0

Q_3051

Qualified Investments Year 4
  • Standard Question
  • Yes
  • Money
  • 0

Q_3053

Qualified Investments Building Acquisition
  • Standard Question
  • Yes
  • Money
  • 0

Q_3054

Qualified Investments Building Renovation Year 5
  • Standard Question
  • Yes
  • Money
  • 0

Q_3055

Qualified Investments New Construction Year 5
  • Standard Question
  • Yes
  • Money
  • 0

Q_3056

Qualified Investments Production Machinery Year 5
  • Standard Question
  • Yes
  • Money
  • 0

Q_3057

Qualified Investments Furniture, fixtures Year 5
  • Standard Question
  • Yes
  • Money
  • 0

Q_3059

Qualified Investments Land Acquisition * Year 5
  • Standard Question
  • Yes
  • Money
  • 0

Q_3061

Qualified Investments Demolition Year 5
  • Standard Question
  • Yes
  • Money
  • 0

Q_3062

Qualified Investments Year 5
  • Project Costs by Year: Please enter the annual anticipated Project Costs based on the year that the investment will be made. These Project Costs should match the information in the Program Budget section.
  • Standard Question
  • Yes
  • Money
  • 0

Q_5719

Does the project site involve or is it substantially contiguous to a property listed or recommended for listing in the NY State or National Registers of Historic Places? Consult the National Register Information System to find out if a property is listed. Or use the Cultural Resource Information System (CRIS) tool .
See question requirements for more information on SHPO consultation.
  • Environmental and Historic Preservation Questions
  • Standard Question
  • Yes
  • Single Choice Radio Button
  • Yes, No, N/A
    1. If Yes is selected then Q_5721 will be displayed
  •  If "yes", the project requires consultation with the State Historic Preservation Office (SHPO). 

Q_5721

Please identify the name of the resource, explain the status of the SHPO consultation, and if consultation is complete, please provide a link to SHPO's Letter of Determination of No Adverse Effect or Letter of Resolution to Mitigate Adverse Effect.
  • Environmental and Historic Preservation Questions
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 600

Q_5720

Is the project site wholly or partially included within an identified archeologically sensitive area?
Consult the National Register Information System to find out if a property is listed. Or use the Cultural Resource Information System (CRIS) tool to identify archeologically sensitive areas.
See question requirements for more information on SHPO consultation.
  • Environmental and Historic Preservation Questions
  • Standard Question
  • Yes
  • Single Choice Radio Button
  • Yes, No, N/A
    1. If Yes is selected then Q_5722 will be displayed
  •  If "yes", the project requires consultation with the State Historic Preservation Office (SHPO). 

     

     

     

     

     

     

Q_5722

Please list the geographic information for the archeologically sensitive areas, explain the status of SHPO consultation, and if consultation is complete, please provide a link to SHPO's Letter of Determination of No Adverse Effect or Letter of Resolution to Mitigate Adverse Effect.
  • Environmental and Historic Preservation Questions
  • Standard Question
  • Yes
  • Long Answer
  • 1 - 600

Q_13611

The NYS Smart Growth Public Infrastructure Policy Act requires that a public infrastructure project meet the relevant smart growth criterion to the extent practicable. Public Infrastructure projects consist of construction or reconstruction of transportation, sewer, wastewater treatment, water, education, housing and other publicly supported infrastructure.Does the proposed project build new public infrastructure, expand public infrastructure or use, maintain, or improve existing public infrastructure?

If you are maintaining or improving existing public infrastructure, please answer “YES”. If you are building new public infrastructure or expanding public infrastructure, please answer "YES".

If this this is not applicable to your project, answer “NO”.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Yes/No
    1. If Yes is selected then these questions will be displayed:
      - Q_13612
      - Q_13613
      - Q_13614
      - Q_13615
      - Q_13616
      - Q_13617
      - Q_13618
      - Q_13619
      - Q_13620
      - Q_13621
      - Q_13622
      - Q_13623

Q_13613

Please explain the need to build new infrastructure instead of using or improving existing infrastructure. If n/a, please type N/A.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Long Answer
  • 0 - 1000

Q_13612

Explain how the proposed project will use, maintain, or improve existing infrastructure.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13614

Please explain how the proposed project is located in a municipal center.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer
  • Municipal Centers are areas of concentrated and mixed land use that serve as centers of various activities (civic, commercial, recreational, and residential, among others).  Specific examples include Central Business Districts; Brownfield Opportunity Areas (BOAs); Downtowns in Local Waterfront Revitalization Program (LWRP) Areas; Transit-Oriented Development, Environmental Justice Areas and Hardship Areas; in many instances, an entire city, village or hamlet can be considered a municipal center.  This definition can include development “adjacent to municipal centers” and a “future municipal center” – an area planned and zoned to be a municipal center.   

    For specific guidance on rail/port, aviation, and other transportation projects please refer to Smart Growth Public Infrastructure Policy Act
     

Q_13615

Please explain how the proposed project is located in a developed area or an area designated for concentrated infill development in a municipally approved comprehensive land use plan, local waterfront revitalization plan and/or brownfield opportunity area plan. Specifically, explain how your project advances infill development or redevelopment in existing developed areas consistent with an approved plan.  Infill development includes redevelopment, rehabilitation and new development between existing buildings on vacant or under-utilized sites.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13616

Please explain how the proposed project will protect, preserve and enhance the State's resources, including agricultural land, forests, surface and groundwater, air quality, recreation and open space, scenic areas, and significant historic and archeological resources. Beyond simply avoiding or minimizing negative environmental impacts, please indicate the resources that may be impacted by your project and how your project will preserve and enhance these resources.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13617

Please explain how the proposed project will foster mixed land uses and compact development, downtown revitalization, Brownfield redevelopment, the enhancement of beauty in public spaces, the diversity and affordability of housing in proximity to places of employment, recreation and commercial development and the integration of all income and age groups. Specifically, explain how your project advances these objectives and improves the quality of life in your community.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13618

Please explain how the proposed project will provide mobility through transportation choices including improved public transportation and reduced automobile dependency. There are many alternatives to automobile transportation.  Please explain how your project provides or complements alternatives to automobile travel such as bikes, pedestrians, public transit, air travel or rail travel.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13619

Please explain how the proposed project will involve coordination between state and local government and inter-municipal and regional planning. Identify any interaction between the applicant and any municipal and county governments, planning boards, regional planning associations or similar organizations. Document any outreach by the applicant to these organizations regarding the project and any relevant correspondence.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13620

Please explain how the proposed project will involve participation in community-based planning and collaboration. Specifically, explain how the project results from an inclusive, multi-stakeholder (including traditionally underserved populations) process of community-based planning and collaboration.  To assist with your explanation, identify any affected community groups or organizations with an interest in the proposed project and if the planning process involved outreach to citizens and stakeholders at all stages of development of the project.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13621

Please explain how the proposed project will ensure predictability in building and land use codes. Provide any additional relevant information.
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13622

Please explain how the proposed project will promote sustainability by strengthening existing and creating new communities which reduce greenhouse gas emissions and do not compromise the needs of future generations, by among other means encouraging broad based public involvement in developing and implementing a community plan and ensuring the governance structure is adequate to sustain its implementation. Specifically, explain how your project promotes sustainability.  For example, does your project include buildings and plans that seek to minimize consumption of fossil fuels (coal, petroleum), reduce water usage / consumption, and encourage the use of renewable energy (wind, solar, and geo-thermal).
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer

Q_13623

Please explain how the proposed project will mitigate future physical climate risk due to sea-level rise, and/or storm surges and/or flooding, based on available data predicting the likelihood of future extreme weather events, including hazard risk analysis data.

Specifically, explain how your project demonstrates that future physical climate risk due to sea-level rise, storm surge and flooding have been considered. For example, have you demonstrated consideration of the flood risk applicable to your specific structure type? Explain how the siting and design have evaluated flood-risk considerations, including, but not limited to, human health and safety, environmental effects, cost, funding-source requirements, feasibility and community impact.

For information on the State Climate Impacts Assessment visit:
https://nysclimateimpacts.org/about-the-assessment/what-is-the-assessment/

For information on implementation of the Community Risk and Resiliency Act visit:
https://dec.ny.gov/environmental-protection/climate-change/new-york-response/crra
  • Smart Growth Questions
  • Smart Growth
  • Yes
  • Short Answer
  •  

     

     

Q_7341

By entering your name in the box below, you certify, under penalty of perjury, that the information given herein is true and correct in all respects for the company or organization applying for funding (the "Company"), presently and for the past five years: -the Company is not a party to any litigation or any litigation is not pending or anticipated that could have an adverse material effect on the company's financial condition;

-the Company does not have any contingent liabilities that could have a material effect on its solvency;

-the Company, its affiliates or any member of its management or any other concern with which such members of management have been officers or directors, have never been involved in bankruptcy, creditor's rights, or receivership proceedings or sought protection from creditors;

-the Company is not delinquent on any of its state, federal or local tax obligations;

-No principal, officer of the Company, owner or majority stockholder of any firm or corporation, or member of the management has been charged or convicted of a misdemeanor or felony, indicted, granted immunity, convicted of a crime or subject to a judgment, or the subject of an investigation, whether open or closed, by any government entity for a civil or criminal violation for: (i) any business-related activity including, but not limited to, fraud, coercion, extortion, bribe or bribe receiving, giving or accepting unlawful gratuities, immigration or tax fraud, racketeering, mail fraud, wire fraud, price fixing or collusive bidding; or (ii) any crime, whether or not business related, where the underlying conduct relates to truthfulness, including but not limited to, the filing of false documents or false sworn statements, perjury or larceny;

-the Company or any of the Company's affiliates, principal owners or Officers has not received a violation of State Labor Law deemed "willful";

-the Company or any of its affiliates has never been cited for a violation of State, Federal, or local laws or regulations with respect to labor practices, hazardous wastes, environmental pollution or other operating practices;

-there are not any outstanding judgments or liens pending against the Company other than liens in the normal course of business.

-the Company or any of its affiliates, principal owners or officers the company has not been the subject of any judgments, injunctions, or liens including, but not limited to, judgments based on taxes owed, fines and penalties assessed by any governmental agency, or elected official against the Company.

- the Company or any of its affiliates, principal owners or officers the company has not been investigated by any governmental agency, including, but not limited to, federal, state and local regulatory agencies

-the Company or any of its affiliates, principal owners or officers the company has not been debarred from entering into any government contract; been found non-responsible on any government contract; been declared in default ore terminated for cause on any government contract; been determined to be ineligible to bid or propose on any contract; been suspended from bidding on any government contract; received an overall unsatisfactory performance rating from any government agency on any contract; agree to a voluntary exclusion from bidding or contracting on a government contract.

- the Company or any of its affiliates, principal owners or officers the company has not failed to file any of the required forms with any government entity regulating the Company. By entering your name in the box below, you agree to allow the Department of Taxation to share the Company tax information with ESD. By entering your name in the box below, you agree to allow the Department of Labor to share tax and employer information with ESD. Note: If any of the statements above are not true, in addition to entering your name, also include an explanation in the box below, indicating which issue you are addressing.
  • Certification
  • Yes
  • Short Answer

Q_1038

By entering your name in the box below, you certify that you are authorized on behalf of the applicant and its governing body to submit this application. You further certify that all of the information contained in this Application and in all statements, data and supporting documents which have been made or furnished for the purpose of receiving assistance for the project described in this application, are true, correct and complete to the best of your knowledge and belief. You acknowledge that offering a written instrument knowing that the written instrument contains a false statement or false information, with the intent to defraud the State or any political subdivision, public authority or public benefit corporation of the State, with the knowledge or belief that it will be filed with or recorded by the State or any political subdivision, public authority or public benefit corporation of the State, constitutes a crime under New York State Law.
  • Certification
  • Yes
  • Short Answer

Q_2365

By entering your name in the box below, you are acknowledging that ESD’s Contractor & Supplier Diversity policy will apply to this project. You are further acknowledging that you are aware of ESD’s agency-wide Minority and Women Business Enterprise (‘MWBE’) utilization goal of 30%. Please note that each project will be assigned an individual contract-specific goal, which may be higher or lower than 30%. Furthermore, you understand that, should this project receive a funding award, the Applicant shall be required to use good faith efforts to achieve the prescribed MWBE goals assigned to this project and failure to attain MWBE goal could result in grant amount being reduced.
  • Certification
  • Yes
  • Short Answer

Q_4182

By entering your name in the box below, you certify and agree that you are aware that your award will be reduced in proportion to the reduction of jobs and/or total project costs. Furthermore, you understand that, should this project receive a funding award, the Applicant will maintain such records and take such actions necessary to demonstrate such compliance throughout the completion of the project.
  • Certification
  • Yes
  • Short Answer