City of Sacramento
Marginalized Community and Small Business Coalition Program COVID-19 Negative Economic Impact Self-Certification Form
I am completing this form and submitting it to the City of Sacramento to participate in the City of Sacramento-sponsored Marginalized Community and Small Business Coalition program. I own a small business that experienced a negative economic impact because of COVID-19. I base this statement on the following:
1. My business has no more than 500 employees or, if applicable, the size standard in number of employees established by the Administrator of the Small Business Administration for the industry in which my business operates, which is NAICS code ___________;
2. My business is independently owned and operated and is not dominant in its field of operation; and
3. My business has faced challenges in covering payroll, mortgage or rent, or other operating costs as a result of the public health emergency and measures taken to control the spread of COVID-19.
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