Threshold DRI/NYF

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).

Project City

Project State

Project ZIP Code. (please use ZIP+4 if known)

Project county or counties.

For more than one project location, please provide full address(es) for each location. If Not Applicable, indicate "NA".

Project Latitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)

Project Longitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)

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.)

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.)

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.)

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.

Is the applicant a DBA?

What is the applicant's DBA name?

Select an applicant ID type from the list below that you normally use to identify your organization on application forms.

Based on your selection from the previous question, enter the associated ID number.

If you are a business, have you been certified as a New York State Minority or Women-owned Business Enterprise (MWBE)?

Organization Legal Name

Applicant First Name

Applicant Last Name

Applicant Street Address

Applicant City

Applicant State

Applicant ZIP Code. (please use ZIP+4 if known)

Applicant Telephone Number (please include area code)

Applicant Email Address

Contact Salutation

Contact First Name

Contact Last Name

Contact Title

Primary Organization

Contact Street Address

Contact City

Contact State

Contact ZIP Code (please use ZIP+4 if known)

Primary Contact Phone Number. (please include area code)

Contact Email

Contract Salutation

Contract First

Contract Last

Contract Title

Authorized Organization

Contract Street

Contract City

Contract State

Contract Zip (please use ZIP+4 if known)

Contract Phone (please include area code)

Contract Email

Additional Salutation

Additional Project Contact First Name

Additional Project Contact Last Name

Additional Contact Title

Additional Organization

Additional Contact Street Address

Additional Contact City

Additional Contact State

Additional Contact ZIP (please use ZIP+4 if known)

Additional Contact Telephone Number (please include area code)

Additional Contact Email Address

Please select the primary sector or characterization that best defines this project.

Please select the secondary sector or characterization that best defines this project.

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.

Statement of need: Provide a brief summary of the need for the project in the geographic area proposed and the project's financing needs, including funding gaps of the proposed project.

Current State of Project Development (i.e. planning, preliminary engineering, final design, etc. You may enter N/A for non-project related applications)

Estimated Project Timeline: include project start/completion dates, estimates for design, permitting and construction or other major steps.

Select the for-profit entity of the applicant applying for funding:

Enter the applicant's 'Other' for-profit entity designation.

Select the not-for-profit entity of the applicant applying for funding:

Enter the applicant's 'Other' not-for-profit entity designation.

Select the government entity of the applicant applying for funding:

Enter the applicant's 'Other' government entity designation.

Does the applicant own the property?

Is the cost of acquisition of the property included in the budget?

Does the applicant have site control or written consent from the ownership entity?

Please upload an explanation, including the name of the entity that owns the property/site, and proof of site control or written consent from the ownership entity.

Please upload an explanation of how and when the applicant plans to have site control.

Upload a completed budget containing sources and uses, a jobs summary if applicable, and a current project schedule zipped together as a single file. A template was emailed to you by the regional office in which your project is located. If you cannot find it, please reach out to directly to the regional office or cfa-programs@ny.gov to obtain a new template.

Please upload any additional documents relevant to the application such as project renderings, an map of the proposed site, etc.

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 "View Help" for links to forms.

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.

What program and round is this project intake application being filled out for? This is single selection only.

What does the project involve in terms of product(s) or services(s) that will be provided at the project location? Please explain and quantify how the capital investment for which you are seeking funding will make it possible to reach business or organization goals such as changes to efficiency, profitability, productivity, market share, product offerings, or other measurable results relevant to your goals for the product(s) and service(s) that are/will be provided.

Does this project provide training and improvements to the workforce?

Will trainees earn any type of certification?

Indicate the type of certification and length of time to earn, as well as another other relevant information about the certification program.

Will there will be assistance provided for job placement upon completion of training.

Please indicate how assistance will be provided for job placement or advancement upon completion of training.

Please indicated any other relevant information to show how the project provides training and improvements to the workforce.

Does your project create new jobs in New York State or retain jobs that are otherwise in jeopardy? If yes, please ensure accurate job information is entered for questions relating to jobs on the Jobs tab.

Does the project foster economic growth through cultural activity, higher education activity, agribusiness initiatives, other local or regional initiatives, improvements to facilities in distressed areas (census tracts), commercial revitalization activities in central business districts or commercial strips, tourism activity, or other types of projects that may not have direct job creation goals but do foster economic development within the area the project will occur?

Please explain how the project will result in a benefit to the viability of the area it is located in and how it will lead to increased economic activity.

Does your project include a mixed-used property/building?

What is the total square footage of the entire project?

Indicate the number housing units to be included in the mixed-used building.

How many of the planned housing units are considered affordable?

Affordable housing in New York State is generally defined as:
Housing that costs about one-third or less of household income.
Housing that consumes less than 30 percent of household income.
Units that were built with some form of government subsidy.
Units that are limited to households making below certain income thresholds.

Please indicate the location of the building in reference to the downtown, other developments going on, etc.

Does the project improve access to high quality childcare?

Please detail how the project will improve access to childcare and the need in the community for a new or expanded childcare facility, whether the project is located in a childcare desert (Search the NYS Child Care Deserts Map below), and the populations that will likely utilize the services.

Is this an existing childcare which you will be expanding or a new childcare center?

What is the square footage of the existing childcare facility only?

What is the square footage of the childcare expansion only? Please do not include the square footage of the existing facility's footprint.

Please indicate the total square footage of the new facility.

Please indicate the number of existing childcare spots.

How many of the existing childcare spots are considered market rate?

Please indicate the number of new childcare spots.

How many of the new childcare spots are considered market rate?

Childcare Spots Breakdown Existing Childcare Spots Affordable Spots Only (intended for families receiving assistance)

A third party completing this application is required to disclose their name, company and contact name. Is a third party completing this application?

Provide the third party name and contact info.

Applicant website

Indicate the principal North American Industrial Classification System (NAICS) Code of the Company.

Indicate the Primary North American Industrial Classification System (NAICS) Code associated with the activity of the business at the project location.

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.

Has the applicant applied for and/or been awarded funding from other New York State or local entities for this project?

Please detail the funding applied to for this project and the entity administering the funding. Do not include funding that has been awarded.

Please detail the funding awarded to this project and the entity administering the funding.

Has the applicant applied to and/or been awarded funding from a local IDA?

Please detail the funding applied for this project and the entity administering the funding. Do not include funding that has been awarded.

Please detail the funding awarded to this project and the entity administering the funding.

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.

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.

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.

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.

Does your application contain 1) trade secrets, (2) information that, if disclosed, would cause substantial injury to the competitive position of your organization, or (3) critical infrastructure information? (All efforts should be made to provide such Information in the questions marked as “restricted.”)

Please identify the Question # and specific language for those portions of your application and accompanying documents you believe fall under these exemptions, and provide a detailed justification for the exemption from disclosure. See 'Click Here for Question Requirements' for formatting and additional information.

1. Is the Company presently the subject of any litigation, or is any litigation threatened, pending or anticipated which could have an adverse material effect on the company's financial condition?

2. Has the company of any of its affiliates ever been involved in bankruptcy, a creditor's rights or receivership proceeding, or sought protection from creditors?

3. Has the Company ever settled a debt with a lending institution for less than the full amount outstanding?

4. Has any senior manager or principal of the Company ever been convicted of any felony or misdemeanor, other than a minor traffic violation, or are any such charges pending?

5. Has the company of any of its affiliates been cited for a violation of federal, State or local laws or regulations with respect to labor practices, hazardous wastes, environmental pollution or operating practices?

6. Are there any outstanding judgement or liens pending against the Company other than liens in the normal course of business?

7. Is the Company delinquent on any New York State, federal, or local tax obligations?

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 (the "Company"), presently and for the past five years:

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

-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, 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.

**Please 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.

By entering your name in the box below, you certify that you are authorized on behalf of the grantee and its governing body to submit this intake. You further certify that all of the information contained in this submission 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 submission, 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.

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% and ESD's agency wide Service-Disabled Veteran-Owned Business ('SDVOB') utilization goal of 6%. Please note that each project will be assigned an individual contract-specific goal, which may be higher or lower than the 30% and 6%, respectively. 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 and SDVOB goals assigned to this project and failure to attain MWBE and SDVOB goals could result in grant amount being reduced.

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.