CUMBERLAND COUNTY EMERGENCY FOOD AND SHELTER PROGRAM Jurisdiction #6372-00 Phase 34 Request for Funding Proposal United Way of Cumberland County Complete and submit ORIGINAL and 12 COPIES, no later than: 4:00 p.m. Friday, September 1, 2017 Instructions for Completing Phase 34 Emergency Food & Shelter Program Request for Funding Proposal Deadline for Submission: Submit the SIGNED original AND 12 copies no later than: 4:00pm, Friday, September 1, 2017 Please Note: Applications submitted after the deadline will NOT be accepted Submit To: Crystal Moore-McNair, Community Impact Director United Way of Cumberland County 222 Maiden Lane Fayetteville, NC 28301 Phone: (910) 483-1179 Fax: (910) 483-5913 crystalmmcnair@unitedway-cc.org 1
PLEASE READ THESE INSTRUCTIONS PRIOR TO COMPLETING PHASE 34 REQUEST FOR FUNDING PROPOSAL When completing the Phase 34 Request for Funding Proposal, it is important to be consistent with effectively and briefly describing your program. Please avoid the use of technical terms or acronyms. Each program for which the agency is seeking funding requires its own completed Request for Funding Proposal. Prioritize programs by numbering each proposal in ranking order. GENERAL INSTRUCTIONS: 1. Click in each field to type requested program information. 2. Please use your agency s fiscal year in reporting program information. All financials should reconcile with your agency s most recently completed audit or financial review. If they do not, please include an explanation regarding why they do not reconcile. 3. Submit Auditor s or CPA s Management Letter with audit and/or review. Audit Requirements: If your agency received more than $25,000 in EFSP Funds under Phase 33 Funding Cycle, you are required to submit a financial audit and a copy of the Management Audit Letter. If your agency received less than $25,000 in EFSP Funds under Phase 33 Funding Cycle, you are required to submit a financial review and a copy of the Management Review Letter. 4. Round all figures to the nearest dollar. 5. Number pages throughout the proposal. 6. If seeking funding for more than one program, please alphabetize programs when putting your Request for Funding Proposal packet together. 7. Materials should be arranged in the order provided on the checklist. 8. Please do not submit materials other than what is requested. Do not return documents provided as examples for completion of funding proposal. These documents will be indicated throughout the funding proposal. 9. Use front and back copies. 10. Submit ONE SIGNED ORIGINAL and12 THREE-HOLE PUNCHED COLLATED COPIES. 11. DO NOT BIND OR STAPLE COPIES. Application Instructions Mail or drop-off the signed original AND 12 copies to the United Way of Cumberland County office, 222 Maiden Lane no later than 4:00 pm, Friday, September 1, 2017. If you need assistance, call Crystal Moore McNair, Community Impact Director, at (910) 483-1179 or Email to: crystalmmcnair@unitedway-cc.org 2
SECTION 1: AGENCY INFORMATION This section should be completed with the information as indicated. Please provide the Name of the Agency, the Name of the Program, the Federal Employer Identification Number (FEIN), the agency s DUNS Number (if you do not have or know your agencies DUNS number please see attachment for instructions on obtaining DUNS number, the Executive Director s Name, The Contact Name & Title if different from Executive Director), the Program Physical Street Address, the Program Mailing Address if different, the City, State, and Zip Code for the Mailing Address, the Telephone Number, the Fax Number and the Email Address for the Contact. Please indicate the total Amount Requested for Phase 34 of the EFSP Funding Cycle. If you are submitting more than one Request for Funding Proposal, indicate the amount you are requesting for each program along with the overall total amount. Please initial indicating: the information in this Request for Funding Proposal is true, complete and accurate; that the governing body of your organization has duly authorized the enclosed documents; and that you understand that incomplete RFPs or RFPs submitted after the deadline will not be accepted or reviewed. Please initial indicating that you have attended the MANDATORY TECHNICAL ASSISTANCE WORKSHOP and have been fully advised of and agree to abide by the Responsibilities and Requirements mandated by the National and Local Emergency Food & Shelter Program Boards. The Request for Funding Proposal must be signed and dated to be accepted and reviewed by the Local Emergency Food and Shelter Program Board. By signing you agree to: 1) comply with all applicable federal, state and local requirements, including financial management; 2) understand funding decisions are based upon: the availability of resources awarded to Cumberland County; the need for the service/program provided by your organization in the community and the population your service/program will serve; 3) provide financial and budget data and overall program performance; and 4) you understand that the Local Emergency Food & Shelter Program Board, prior to final funding decisions, may request additional documentation and you agree to comply in a timely manner with any requests that are made. The Agency Contact Information is self-explanatory. The information is in table format. Simply click in the appropriate cell of the table to enter the information requested. Please provide all information requested. SECTION 2: EMERGENCY FOOD & SHELTER PROGRAM (EFSP) FUNDING REQUIREMENTS Emergency Food and Shelter funds must be used in accordance with the purpose of the program. EFSP mandates that funds are to supplement and expand existing resources; they are not to be used to substitute or reimburse ongoing programs and services; and are to be used for emergency food, feeding, and shelter programs for the homeless and at-risk families/individuals. Please answer yes or no to whether or not your program/service will continue at the conclusion of the Phase 34 funding cycle if there are no funds available from the Emergency Food & Shelter Program. If no please indicate what measures are or will be taken to attain services when people request assistance. SECTION 3: Program Description Please be consistent with effectively and briefly describing your program. Please avoid the use of technical terms or acronyms. 1. Answer YES or NO to whether or not your agency attempts to involve homeless individuals and families in the provision of emergency food and shelter services (through employment, volunteer programs, etc.). If your answer is YES. Provide an explanation how they are involved. If your answer is NO. Provide an explanation on how you plan to involve them through the funded program. 2. Provide the mission of your organization. 3
3. PROGRAM SUMMARY. Respond to each question with a brief summary statement of the program for which you are requesting funding. Use a separate and/or additional sheet if needed. A. MISSION OF PROGRAM. Provide a brief statement regarding the mission of the program for which you are requesting funding. B. ACTIVITIES/SERVICES PROVIDED. Provide a brief statement regarding the activities and/or services provided by the program for which you are requesting funding. C. TARGET POPULATION. Provide a brief statement regarding the target population the program for which you are requesting funding will serve. D. NUMBER OF CLIENTS CURRENTLY SERVED WITHOUT EFSP FUNDS. Provide the number of clients that are currently served by the program for which you are seeking funding. E. NUMBER OF CLIENTS ON WAITING LIST. Provide the number of clients that are currently on a waiting list of the program for which you are seeking funding. F. PROCESS USED TO PROVIDE CLIENT AWARENESS TO PROGRAMS/SERVICES. Provide the process used to provide client awareness to programs and/or services. G. HOW WILL THESE SERVICES BE COORDINATED WITH OTHER PROGRAMS WITHIN THE COMMUNITY? Provide a statement indicating how services provided by the program for which you are seeking funding will be coordinated with other programs within the community. 4. Provide a statement indicating how Phase 34 EFSP Funds will be used to expand and supplement the existing programs and services for which you are seeking funding. 5. Please list all of the proposed service locations for the program for which you are requesting funding. Include hours of operation, the number of staff members at each site, and their role in providing services. 6. Provide a brief statement regarding the eligibility criteria for clients requesting services and how the services are documented. (Please attach intake forms) 7. Provide a brief statement regarding how your organization measures the progress or impact of services provided to the community. Indicate 2016 Accomplishments, 2016 Failures and 2016 Challenges regarding service delivery. (Use a separate and/or additional sheet if needed) SECTION 4: PROGRAM/SERVICE EXPENDITURES (Eligible Program Costs) Complete the table that correlates to the program for which you are seeking funding. Refer to the EFSP Manual for eligible and ineligible expenditures. Provide only the numbers that will be covered with the use of EFSP Phase 34 Funding. 1. Provide Name of Program for which you are seeking funding under Phase 34 Funding Cycle. 2. Provide amount requested under Phase 34 Funding Cycle. 3A. If you are seeking Phase 34 funding for Food Services Complete Table 1. OTHER FOOD: Include food vouchers, bags of food, etc. SERVED MEALS: Include hot meals and feeding programs. In Column A: Indicate the estimated number of units or meals that will be served or provided using Phase 34 EFSP Funding. In Column B: Indicate the COST PER UNIT or PER DIEM RATE ($2.00 per meal). 4
In Column C: Indicate the Total Phase 34 EFSP Funding Request (Column A multiplied by Column B). This amount should match the Phase 34 request for this program on the cover page of this Request for Funding Proposal. 3B. If you are seeking Phase 34 funding for Shelter Services Complete Table 2. In Column A: Indicate the estimated number of beds per night that will be provided using Phase 34 EFSP Funding. In Column B: Indicate the COST PER UNIT or PER DIEM RATE ($12.50 per night) if your shelter provides case management. Attach a detailed list of services provided to clients beyond shelter each night. In Column C: Indicate the Total Phase 34 EFSP Funding Request (Column A multiplied by Column B). This amount should match the Phase 34 request for this program on the cover page of this Request for Funding Proposal. 3C. If you are seeking Phase 34 funding for Emergency Services (Rent/Mortgage and/or Utilities) Complete Table 3. In Column A: Indicate the estimated number of clients that will be served using Phase 34 EFSP Funding. In Column B: Indicate the Total Phase 34 EFSP Funding Request. This amount should match the Phase 34 request for this program on the cover page of this Request for Funding Proposal. 4. ADMINISTRATIVE FUNDING is completed by United Way of Cumberland County only for providing administrative functions to the Local Emergency Food and Shelter Board. 5. SUPPLEMENT AND EXPANSION OF RESOURCES (SOURCES OF FUNDING) The intent of the Emergency Food & Shelter Program is to supplement and expand current available resources and not to substitute or reimburse ongoing programs and services or to start new programs. Services for which funding is being requested must already be provided by your agency through other funding sources. On the chart provided please indicate in-kind donations and/or contributions. For each Program Area for which you are requesting funding under Phase 34, please list other sources of funding. Indicate source and amount of funding. Please see example provided in the Request for Funding Proposal. Completing 2017 Sources of Funding Chart Please complete only the section for the services for which you are seeking Phase 34 EFSP Funding. In Column A: Indicate the total amount of funds that you currently have available for this service without Phase 34 EFSP Funding. In Column B: Indicate the sources of current funds (without Phase 34 EFSP Funding). List name of source and amount of funding. In Column C: Indicate in-kind donations and contributions. List source and amount of donation and/or contribution. In Column D: Indicate Phase 34 Funding Request. (This number should be the same as the request on the cover of this Request for Funding Proposal) Indicate Total for each category for which you are seeking EFSP Phase 34 Funding. 6. Program Operating Budget. In order to be eligible to receive EFSP Phase 34 Funding your agency/organization must show that the activities you are applying for are on-going not new or start up. Complete each line item on the Phase 34 EFSP Program Operating Budget. Line items may be changed to reflect your organizations revenues and expenses. 5
In Column A: Indicate Requested Amount from EFSP Phase 34. In Column B: Indicate Current Cash/Revenue for each line item. In Column C: Indicate In Kind Support for each line item. 7. Agency Board of Directors Roster. Please complete the included 2017 Agency Board Roster. ADDITIONAL DOCUMENTATION: All agencies must submit one copy of the following: Most recently completed Audit or CPA Review Most recently completed Management Letter Agency s 501c3 certification (IRS & State Tax Exempt Letters) Most recently completed IRS 990 Most recent solicitation license Non discrimination policy Conflict of Interest Policy Client Authorization For Release of Information Form (3 rd Party Release Clause) Client Eligibility Form and/or Service Documentation Form PHASE 33 EFSP REQUEST FOR FUNDING PROPOSAL CHECKLIST The Final Checklist is found on the last page of the Phase 34 Request for Funding Proposal it will help reassure that you are submitting all of the requested materials in the correct format. Please sign, date and initial each item. 6