Page1 form HUD (07/2014)
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1 Part I: Summary Washington County HRA Capital Fund Program Grant No: MN46P Draft of CFFP: FFY of Grant: 2017 FFY of Grant Approval: 2017 Type of Grant Original Annual Statement Reserve for Disasters/Emergencies Revised Annual Statement (revision no: ) Performance and Evaluation Report for Period Ending: Final Performance and Evaluation Report Line Summary by Development Account Total Estimated Cost Total Actual Cost 1 1 Total non-cfp Funds Original Revised 2 Obligated Expended Operations (may not exceed 20% of line 21) 3 $90, Management Improvements Administration (may not exceed 10% of line 21) Audit Liquidated Damages Fees and Costs Site Acquisition Site Improvement Dwelling Structures Dwelling Equipment Nonexpendable Non-dwelling Structures Non-dwelling Equipment Demolition Moving to Work Demonstration Relocation Costs Development 4 1 To be completed for the Performance and Evaluation Report. 2 To be completed for the Performance and Evaluation Report or a Revised Annual Statement. 3 PHAs with under 250 units in management may use 100% of CFP Grants for operations. 4 RHF funds shall be included here. Page1 form HUD (07/2014)
2 Part I: Summary Washington County HRA Type of Grant Capital Fund Program Grant No: MN46P Draft of CFFP: FFY of Grant:2017 FFY of Grant Approval: 2017 Original Annual Statement Reserve for Disasters/Emergencies Revised Annual Statement (revision no: ) Performance and Evaluation Report for Period Ending: Final Performance and Evaluation Report Line Summary by Development Account Total Estimated Cost Total Actual Cost 1 Original Revised 2 Obligated Expended 18a 18ba 1501 Collateralization or Debt Service paid by the PHA 9000 Collateralization or Debt Service paid Via System of Direct Payment Contingency (may not exceed 8% of line 20) 20 Amount of Annual Grant:: (sum of lines 2-19) 21 Amount of line 20 Related to LBP $90, Amount of line 20 Related to Section Amount of line 20 Related to Security - Soft Costs 24 Amount of line 20 Related to Security - Hard Costs 25 Amount of line 20 Related to Energy Conservation Measures Signature of Executive Director Signature of Public Housing Director 1 To be completed for the Performance and Evaluation Report. 2 To be completed for the Performance and Evaluation Report or a Revised Annual Statement. 3 PHAs with under 250 units in management may use 100% of CFP Grants for operations. 4 RHF funds shall be included here. Page2 form HUD (07/2014)
3 Part II: Supporting Pages Washington County HRA Capital Fund Program Grant No: MN46P Draft CFFP (Yes/ No): Federal FFY of Grant: 2017 Scattered Site / Whispering Pines General Description of Major Work Categories Development Account No. Quantity Total Estimated Cost Total Actual Cost Status of Work Original Revised 1 Funds Obligated 2 Operations 1406 LS $90, Funds Expended 2 1 To be completed for the Performance and Evaluation Report or a Revised Annual Statement. 2 To be completed for the Performance and Evaluation Report. Page3 form HUD (07/2014)
4 Part II: Supporting Pages Capital Fund Program Grant No: CFFP (Yes/ No): Federal FFY of Grant: General Description of Major Work Categories Development Account No. Quantity Total Estimated Cost Total Actual Cost Status of Work Original Revised 1 Funds Obligated 2 Funds Expended 2 1 To be completed for the Performance and Evaluation Report or a Revised Annual Statement. 2 To be completed for the Performance and Evaluation Report. Page4 form HUD (07/2014)
5 Part III: Implementation Schedule for Capital Fund Financing Program Federal FFY of Grant: All Fund Obligated Original Obligation End Actual Obligation End Original Expenditure End All Funds Expended Actual Expenditure End Reasons for Revised Target s 1 1 Obligation and expenditure end dated can only be revised with HUD approval pursuant to Section 9j of the U.S. Housing Act of 1937, as amended. Page5 form HUD (07/2014)
6 Part III: Implementation Schedule for Capital Fund Financing Program Federal FFY of Grant: All Fund Obligated Original Obligation End Actual Obligation End Original Expenditure End All Funds Expended Actual Expenditure End Reasons for Revised Target s 1 1 Obligation and expenditure end dated can only be revised with HUD approval pursuant to Section 9j of the U.S. Housing Act of 1937, as amended. Page6 form HUD (07/2014)
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