Nonprofit Organizations that are not currently receiving CDBG funds from the City

Transcription

1 CDBG FUNDING APPLICATION INSTRUCTIONS All organizations wishing to apply for Community Development Block Grant (CDBG) funds must complete a CDBG Funding Application in order to be considered. All applications must be received at Rialto Community Services Department, Attn: Frank Perez, Program Consultant, 214 North Palm Avenue, Suite 204, Rialto, California, by 12:00 p.m. on Thursday, January 17, Late applications will not be accepted. NO EXCEPTIONS. SUBMISSION REQUIREMENTS The completed application package shall be single-sided and bound with a binder clip or rubber band (no binders, comb/spiral binding, portfolio covers, staples, brads, etc.). The application package shall include one copy of the CDBG Funding Application Form and one copy of the supporting documents listed below, as applicable. All Applicants Submit the following documents: 1. A cover letter that introduces your organization and provides a summary of the proposed Program/Project; 2. A complete, signed CDBG Funding Application Form; 3. Continuation sheets for any of the narrative questions; and 4. Any additional information pertinent to your proposal which is not conveyed in the CDBG Funding Application Form (e.g. photographs, maps, marketing materials, etc.). Such materials shall not exceed 8 pages and shall be on single sided 8.5 x 11 paper. All Nonprofit Organizations In addition to documents 1-4 above, submit: 5. Most recently filed IRS-990; 6. A current list of your Board of Directors; and 7. A copy of a corporate resolution authorizing the Executive Director or Chief Executive to bind the corporation solely in contracts and to submit the application and to enter into an agreement with the City in the event that the application should receive funding from the City. Nonprofit Organizations that are not currently receiving CDBG funds from the City In addition to documents 1-7 above, submit: 8. IRS letter confirming your 501(c)(3) non-profit status; and 9. A copy of your Articles of Incorporation and Bylaws. CDBG FUNDING APPLICATION FORM The CDBG Funding Application Form is a five-page Microsoft Word document containing fillable form fields. Use the tab key to navigate the form fields. When filling in the application, do not exceed the space provided. Applicants are advised that this form was intentionally designed to limit the length of each response. Responses should be brief and should include the most pertinent information, as each narrative question identifies the allowable word count in RED allowed in your agencies response. The following sections provide information on each of the fields of the CDBG Funding Application Form. Page 1 of 4

2 Applicant Information (Pag e 1) 1. Provide the name of your organization. 2. Provide the name of the person in your organization that the City should contact with any questions regarding the application for CDBG funding. 3. Corporate Status: a. Check Nonprofit if your organization is a nonprofit organization recognized by the Internal Revenue Service. b. Check For-profit if your organization is a corporation, sole proprietorship or other type of forprofit organization. c. Check Public if your organization is a government agency (e.g. City, County, Special District, etc.). 4. Insert the Title for the contact person listed above. 5. (Organization Address) a. Insert the Number and Street name for your organization s principal place of business. This is the address where all correspondence will be sent. b. Insert the City, State, and Zip Code for your organization. This is the address where all correspondence will be sent. 6. Insert the Telephone number for the contact person listed above. Please include the area code followed by the phone number. You will need to enter any necessary punctuation. 7. Insert the name and tittle of the person who is authorized to sign contracts on behalf of your organization. If you are selected to receive CDBG funds, this name will appear as the person signing the contract between the City and your organization. 8. Insert your Federal Tax ID number. 9. Insert the address for the contact person listed above. 10. Insert your Data Universal Numbering System (DUNS) number. Pursuant to the Federal Funding Accountability and Transparency Act of 2006 (FFATA,) Effective October 1, 2010, this is a requirement for all CDBG-assisted subrecipients, contracts and subcontracts. For more information on how to obtain a DUNS number if your organization does not already have one, visit: Insert your System for Awards Management (SAM) number. The System for Award Management (SAM) is an official website of the U.S. government. SAM consolidated the capabilities of CCR/FedReg, ORCA, and EPLS. There is NO cost to use SAM. This is a requirement for all CDBG-assisted subrecipients, contracts and subcontracts. For more information on how to obtain a SAM number if your organization does not already have one, visit: Program/Project Information (Pag e 1) 1. Insert the title of your Program/Project. The title should be no more than six words in length and describe the project (e.g., Senior Center Facility Construction, Meals on Wheels, etc.) 2. Check the applicable Program/Project type. A new Program/Project is a Program/Project that is not currently offered in the jurisdiction or that has not previously been implemented. An existing Program/Project indicates the application is for continued funding of an existing CDBG Program or that additional funds are being requested for the completion of an existing CDBG Project. An expanded Program/Project indicates that the proposed Program/Project application is to expand or enhance an existing Program/Project, without regard to prior CDBG assistance. 3. Input the amount of CDBG funding being requested. Note that you do not need to insert the sign while inputting the information. The and all other punctuation will automatically be inserted for you. 4. Program/Project Site Address a. Insert the Number and Street name for the location of the proposed Project. For public right-of-way projects, attach a map with the locations where the work will take place. b. Insert the City, State, and Zip Code for the location of the proposed Program/Project. 5. Has your Organization previously received HUD or CDBG funds? (Check One): a. Check the box if you have received HUD or CDBG funds in prior years. b. Check the box if you have never received HUD or CDBG funds in prior years. Page 2 of 4

3 Narrative Questions (Pages 2 and 3) Provide a response to each of the five narrative questions. Do not exceed the allotted space in response to these questions. Type responses directly into the form fields provided. The document will not expand to accommodate your narrative entries, so please be brief and include the most pertinent information first. Each narrative question identifies the allowable word count in RED just after each question. Proposed Program/Project Operating Budget (by column) (Page 4) CDBG Funds Requested 1. Insert the amount of CDBG funds requested for personnel costs, including staff salaries and benefits. 2. Insert the amount CDBG funds requested for non-personnel costs, including items expenses such as supplies, consultants or other operating expenses. 3. For capital improvement projects only, insert the amount of CDBG funds requested for expenses such as acquisition, demolition, design, construction, etc. for a public facilities or infrastructure project or for construction/rehabilitation contract costs for rehabilitation programs. 4. Once you have entered the amounts in the first three rows, right click on the Total Budget cell and select the!update Field option to auto-calculate the totals for the column. This figure should match the amount of CDBG funds requested on Page 1. Leveraged Funds Leveraged funds are not required for Programs/Projects, but will enhance your proposal. Leveraged funds are the other non-cdbg funds that will be used in conjunction with CDBG funds to implement the Program/Project. Leveraged funds include, but are not limited to cash, gifts, in-kind gifts, or volunteer labor. These funds must be firmly committed to the Program/Project and immediately available. 1. Insert the amount of leveraged funds for personnel costs for the CDBG Program/Project. 2. Insert the amount of leveraged funds for non-personnel costs for the CDBG Program/Project. 3. Insert the amount of leveraged funds for capital improvement costs for the CDBG Program/Project. 4. Once you have entered the amounts in the first three rows, right click on the Total Budget cell and select the!update Field option to auto-calculate the totals for the column. Total Program/Project Operating Budget In this column, the totals will auto-calculate based on the amounts entered in the prior two columns. Once you have entered the amounts in the first two columns, right click on each cell of the Total Program/Project Operating Budget column and select the!update Field option to auto-calculate the totals for the cells and column. Total Organization Operating Budget In this column, enter your organization s annual budget for all personnel, non-personnel and budgeted capital improvements. This information is used to gauge the size of the proposed CDBG Program/Project in the context of your organization s overall operating budget. Once you have entered the amounts in the first two columns, right click on each cell of the Total Program/Project Operating Budget column and select the!update Field option to auto-calculate the totals for the cells and column. Sources of Funding (Page 4) List all of the sources of funding you anticipate using to implement the City CDBG Program/Project by source, amount and status. The amount of CDBG funding you are seeking in this application is listed in the first row. Fill in the remaining rows to indicate all other leveraged funds for the Program/Project. The total Page 3 of 4

4 of all sources listed in this table should equal the Total Program/Project Operating Budget in the Proposed Program/Project Operating Budget table. Public Service Program Accomplishments (Page 5) (Only complete this section if your application is for a Public Service Program) 1. First Column: Insert the number of City Residents that your Program served / will serve during the program year(s) indicated on the application form. Insert quantity even if you did not receive CDBG funds during that particular program year. If your program did not exist at the time, indicate zero. 2. Second Column: Insert the total number of unduplicated people or households that your Program served / will serve during the program year(s) indicated on the application form, inclusive of the number of City residents and non-city residents. Insert quantity even if you did not receive CDBG funds during that particular program year. If your program did not exist at the time, indicate zero. 3. Narrative Question: Describe how the program will benefit low- and moderate-income residents of the City. For Programs that previously received CDBG funds, discuss the number of unduplicated people or households served in prior years and provide the number expected to be served in the event that this application is fully or partially funded. Capital Improvement Project Implementation Schedule (Page 5) (Only complete this section if your application is for a Capital Improvement Project) 1. Column 1: Insert the target date for the completion of each milestone listed. 2. Column 2: Insert any comments concerning the milestone or date. Capital Improvement Project Special Requirements (Page 5) (Only complete this section if your application is for a Capital Improvement Project) 1. Check yes if you have successfully implemented a project during the last five years involving the prevailing wage requirements of the Davis-Bacon Act. 2. Check yes if your organization has successfully implemented a project during the last five years that was subject to the Equal Employment Opportunity and Women s/minority owned Business Requirements (W/MBE). 3. Check yes if your organization has successfully implemented a project during the last five years that was subject to the contracting, employment and training requirements of Section 3 of the Housing and Urban Development Act of Certification and Signature (Page 5) The application shall be signed and dated by the official authorized to enter into a contract with the City on behalf of your organization in the event that the proposed Program/Project is selected for CDBG funding. ADDITIONAL RESOURCES CDBG Program Regulations: 24 CFR Part 570, found at Current CDBG Income Limits: CDBG Low and Moderate Income Area Map REFERENCE MATERIALS Page 4 of 4

5

6 CITY OF RIALTO COMMUNITY DEVELOPMENT BLOCK GRANT FUNDING APPLICATION COMMUNITY SERVICES DEPARTMENT All organizations wishing to apply for Community Development Block Grant (CDBG) funds must complete an application form in order to be considered. All applications must be received at Rialto Community Services Department, Attn: Frank Perez, CDBG Program Consultant, 214 N. Palm Avenue, Suite 204, Rialto, California, by 12:00 noon on Thursday, January 17, Late applications will not be accepted. NO EXCEPTIONS. In order to be considered for funding, all sections of the application must be completed. Any sections that do not apply should be marked N/A. Organization Name: APPLICANT INFORMATION Contact Person: Corporate Status (Check One): Nonprofit For-Profit 1 Public (City Dept.) Organization Address: Address: City, State, Zip: Contact Title: Telephone No.: Name and Title of Person Authorized to Sign Contracts: Federal Tax ID No.: Address: DUNS No.: System for Awards Management (SAMs) No: Program/Project Title: PROGRAM/PROJECT INFORMATION This request is for a (Check One): New Program/Project Expanded Program/Project Existing Program/Project Amount of CDBG Funds Being Requested: Has your Organization previously received HUD or CDBG funds? (Check One): Yes No Program/Project Site Location Address: Address: City, State, Zip: 1 Pursuant to (c). For profit CDBG subrecipients may only apply for microenterprise activities found at (o). Page 1 of 5

7 NARRATIVE QUESTIONS 1. Provide a detailed description of the proposed Program/Project. Explain how the Program/Project will benefit the community, the characteristics of the people who will benefit from the Program/Project and how CDBG funds will be used to implement the Program/Project. (Limited to 1,400 words) Page 2 of 5

8 NARRATIVE QUESTIONS - CONTINUED 2. Describe the target population. Indicate the number of unduplicated people or households the Program/Project will serve, their income levels, and if the target population is limited to one or more special needs groups. (Limited to 300 words) 3. Does your Program/Project meet one of the City s Consolidated Plan Strategic Plan Goals? (Check the box that reflects the goal, and describe how it meets the goal). (Limited to 240 words) Community Facilities and Infrastructure Improvements Housing Preservation Public Services for Low Income Residents Fair Housing Services 4. Describe all similar Program/Projects your organization has carried out in the last five years. For each Program/Project, provide a reference name and telephone number from the HUD grantee that provided CDBG or other HUD funding. (Limited to 300 words) 5. Identify and describe any audit findings, liens, investigations, or probation by any oversight organization in the five years preceding this application. If none, so indicate. (Limited to 300 words) Page 3 of 5

9 PROPOSED PROGRAM/PROJECT OPERATING BUDGET Provide the anticipated operating budget for the proposed CDBG Program/Project. The CDBG portion of the budget must reflect only those costs of serving CDBG-eligible City residents. Indicate any leveraged funds to be used in conjunction with CDBG funds to implement the Program/Project. Additionally, provide the total operating budget for your organization for each type of operating expense. Please round up to the nearest dollar. (Note: once you have entered the amounts, right click on the Total Budget cell for each column and select the!update Field option to update the totals) Cost Category Personnel Costs (Salaries, Benefits, Other) Non-Personnel Costs (Supplies, Consultants, etc.) Capital Improvement Costs (Design, Construction, etc.) Proposed CDBG Program/Project Operating Budget CDBG Funds Requested* Leveraged Funds Total Program / Project Operating Budget Total Organization Operating Budget Total Budget *For public service programs, the City generally encourages the use of CDBG funds for personnel costs to reduce the amount of documentation required by the organization. Include all Program/Project costs and overall organization budget by the three cost categories listed. Leveraged funds are not required for Programs/Projects, but will enhance your proposal. Leveraged funds are other non-cdbg funds that will be used in conjunction with CDBG funds to implement the Program/Project. Leveraged funds include, but are not limited to, cash, gifts, in-kind gifts, or volunteer labor. SOURCES OF FUNDING If you have included leveraged funds in the section above, use the section below to list the sources of funding you anticipate using to implement the City CDBG Program/Project by source, amount, type and status below. The amount of CDBG funding you are seeking in this application is listed first. Fill in the remaining rows to indicate other leveraged funds. The total of all sources listed in the table below should equal the Total Program/Project Operating Budget in the table above. (Note: once you have entered the amounts, right click on the Total Budget cell for the column and select the!update Field option to update the totals) Source CDBG (this application) Amount Status (Not yet applied), Committed, Inhand, or Unknown) Unknown Comments Total Prog./Proj. Budget: Page 4 of 5

10 TO BE COMPLETED FOR PUBLIC SERVICE PROGRAM APPLICATIONS ONLY PUBLIC SERVICE PROGRAM ACCOMPLISHMENTS Indicate the number of unduplicated people/households served: Actually served during Program Year Expected to be served during the current Program Year Expected to be served during the upcoming Program Year City Residents Total Unduplicated People/HH Served Describe how the Program will benefit low- and moderate-income residents. For Programs that previously received CDBG funds, discuss the number of unduplicated people or households served in prior years and provide the unduplicated number expected to be served in the event that this application is fully or partially funded. (Limited to 300 words) TO BE COMPLETED FOR CAPITAL IMPROVEMENT PROJECT APPLICATIONS ONLY CAPITAL IMPROVEMENT PROJECT IMPLEMENTATION SCHEDULE Milestone Target Date Comments Phase 1: Preparation of Bid Document Phase 2: Pre-Bid Phase 3: Bid Opening Phase 4: Contract Award Phase 5: Pre-Construction / Notice to Proceed Phase 6: Mid-Construction Phase 7: Construction Completed Phase 8: Post Construction/Labor Clearance CAPITAL IMPROVEMENT PROJECT SPECIAL REQUIREMENTS Has your organization implemented a project within the last five years subject to the following requirements? The procurement and contracting requirements of 2 CFR Part 200 Yes No The prevailing wage requirements of the Davis-Bacon and Related Acts Yes No The Equal Employment Opportunity and Women s/minority-owned Business Requirements (W/MBE) Section 3 of the Housing and Urban Development Act of 1968 Yes No Yes No I hereby certify that the aforementioned statements are true and correct. PRINT NAME OF PERSON SIGNING CONTRACT SIGNATURE DATE Page 5 of 5