Sync South Bend Security Grant Application

Sync South Bend Security Grant Application

The Business Security Program gives grant money and resources to local businesses in South Bend for security enhancements.
Would you like to apply for Core reimbursement or a full security assessment grant?*

Grant ApplicationFusus Core Reimbursement

Thank you for your interest; however, the organization must be located within South Bend city limits to be eligible.

Business / Organization Information

Please share details about the organization applying to receive the grant or reimbursement.
Organization Name*
Please ensure this name matches the name that appears on your W9 form and your business license / 1023 tax form.
Owner Name

First NameLast Name
Owner Email*
example@example.com
Owner Phone Number*
Please enter a valid phone number.
Business Address (must be within South Bend city limits)*

Street Address

Street Address Line 2

CityState

Zip Code
Is your organization part of or a subsidiary of another company?*

YesNo
If yes, please provide the name of the parent company:
Please attach a copy of your business license or your 1023/1023-EZ form*

Cancelof
Please attach a copy of your receipt(s) from the Fusus Core purchase*

Cancelof

Is the organization owner the best contact person for the application process?*

YesNo

Application Contact Information

Please share the primary contact information for the best person to contact during the grant process.
Primary Contact Name*

First NameLast Name
Role / Job Title with Organization*
Email*
example@example.com
Primary Phone Number*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.

Business / Organization Information Continued
Which of these categories best describes your organization?*
Is this organization registered as a 501(c)(3) or other 501(c) status?

YesNo
Please select your organization's 501(c) status:

501(c)3Other
What kind of services or goods does your organization provide?*
How many years has your organization been in business?*
How many employees does your organization have?*
Is your organization a Disadvantaged, Minority, or Women Owned Business Enterprise? If so, select all that apply:*

Disadvantaged Business Enterprise (DBE)Minority Business Enterprise (MBE)Women Owned Business Enterprise (WBE)This does not apply to my organization

Grant Structure Information and Consent
I acknowledge and accept that installation of a fususCORE and connection to the City of South Bend's Real Time Crime Center is a requirement for participation in this Grant Program.*

Yes, I understand my camera(s) will be conntectedNo, I do not want my camera(s) connected
NOTE: Your organization can choose which and how many cameras are integrated with the Real Time Crime Center. For more information, please visit syncsouthbend.org

Thank you for your interest; however, to participate in this process your security system must be connected to the South Bend Police Department's Real Time Crime Center.

Please Briefly Share Your Security Needs

Consider your main security concerns when describing your needs. Note: if your organization is selected our Security Vendor Partner will be working with you to conduct a site visit, provide a quote, and perform installation.
Share below: *

Please share with us your reimbursement needs

Note: A site visit to confirm purchase and/or installation of a fususCORE will be required prior to reimbursement approval.
fususCORE Type*
Number of cameras connected*
Cost ($)*
Is your fususCORE already installed on your premises or will it need to be installed?*

Yes, already installedNo, needs to be installed

Screening Question