Community Development Block Grant (CDBG) Request for Applications (RFA) for Public Services and Housing Projects

Similar documents
Request for Applications (RFA) for Homeless Outreach, Shelter, Homelessness Prevention and Rapid Re-Housing

COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICE GRANTS MOUNT VERNON URBAN RENEWAL AGENCY

COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICE GRANTS MOUNT VERNON URBAN RENEWAL AGENCY

The City of Sandusky. Community Development Block Grant Program (CDBG) Non-Profit Provider Application 501(c) 3 for Program Year 2015

The City of Perth Amboy Funding Application CDBG. For Program Year June 1, 2017 May 31, 2018

Mecklenburg County Community Development Block Grant (CDBG) FY 2018 Notice of Funding Availability

2018 BUSINESS ENTREPRENEURSHIP PROGRAM

COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) Subrecipient Workshop

2016 BUSINESS ENTREPRENEURSHIP PROGRAM

Horry County Community Development 1515 Fourth Avenue Conway, SC 29526

What is the Community Development Block Grant Program (CDBG)?

Hillsborough County Affordable Housing Services Department PY 2016 CDBG Application Instructions

Program Year 2019 Grant Application Overview

Community Development Block Grant (CDBG) Fiscal Year 2018 Request for Proposal (RFP) Application due January 31, 2018 by 5:00 pm

HOUSING AND COMMUNITY DEVELOPMENT DEPARTMENT. Request for Proposal CDBG COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FY2016 FUNDING INTERDEPARTMENTAL

Application Guidelines

APPLICATION FOR CITY OF MARIETTA. Community Development Block Grant Public Facilities Acquisition, Construction, and Renovation

REQUEST FOR PROPOSALS for Neighborhood Advisory Committee Program Funding

SUMMARY OF ELIGIBLE AND INELIGIBLE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM ACTIVITIES

New Castle County, Department of Community Services Consolidated Five Year Plan for

New York State COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM. Microenterprise Assistance PROGRAM GUIDELINES

PROPOSALS DUE: NOVEMBER 8, 12:00 PM

APPLICATION INSTRUCTIONS COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROGRAM Program Year 2017 July 1, 2017 June 30, 2018

FY COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING APPLICATION FOR FUNDING ASSISTANCE FISCAL YEAR

City of Urbana/Cunningham Township Application for Funding Packet Consolidated Social Service Funding Program Fiscal Year

You created this PDF from an application that is not licensed to print to novapdf printer (

HOUSING REHAB PROJECT PROPOSAL

APPLICATION FOR FUNDING FOR COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) AND EMERGENCY SOLUTIONS GRANT (ESG) FOR FISCAL YEAR

Emergency Solutions Grant Program

Pre-application Orientation

Kitsap County Coordinated Grant Application Process 2019 Notice of Funding Availability

FY Consolidated Plan Budget Development

Pasco County. "Bringing Opportunities Home" EMERGENCY SOLUTIONS GRANT PROGRAM. REQUEST FOR FUNDING Program Year

COMMUNITY DEVELOPMENT BLOCK GRANT APPLICATION PACKET

2016 Community Development Block Grant (CDBG) General Information

Hennepin County Community Development Block Grant 2018 Public Services Request for Proposals Guide

Address: Telephone #: FAX #: 3. Project Name: 4. CDBG Funds Requested ($15,000 Minimum Request): $

Managing CDBG. A Guidebook for Grantees on Subrecipient Oversight. U.S. Department of Housing and Urban Development

Community Development Block Grant Program Year Application Instruction Booklet

Community Development Block Grant (CDBG) Fiscal Year 2017 Request for Proposal (RFP) Application due January 27, 2017 by 5:00 pm

REQUEST FOR PROPOSALS

Consolidated Grant Process

City of Coeur d Alene Community Development Block Grant 2017 Community Opportunity Grant Application Guidelines

ANNE ARUNDEL COUNTY. ACTIVITY RECOMMENDATION FORM for CAPITAL PROJECTS LOCAL FISCAL YEAR 2017

How to Use CDBG for Public Service Activities

Applications Must Be Typed In Entirety No Applications With Any Handwritten Entries Will Be Accepted Excluding Signatures and Check Boxes

Community Development Block Grant Citizen Participation Plan City of Richmond, California

Executive Summary Consolidated Plan

NOTICE OF FUNDING AVAILABILITY

CDBG/SSG Pre-Application Meeting. August 24, 2017

CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM

Housing Rehabilitation Program Administration

CITY OF NORTH LAS VEGAS Community Development Block Grant Program Program Year CONSTRUCTION/REHABILITATION APPLICATION

EMERGENCY SOLUTIONS AND COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION FOR FUNDING PROGRAM YEAR FY 18/19

Mississippi Development Authority. Katrina Supplemental CDBG Funds. For. Hancock County Long Term Recovery CDBG Disaster Recovery Program

Jefferson Parish Department of Community Development Application Guidelines for FY-2018 Funding Fiscal Year July 1, 2018 to June 30, 2019

State of Louisiana Disaster Recovery Unit. CDBG-DR Economic Development Programs

COSCDA Federal Advocacy Priorities for Fiscal Year 2008

EMERGENCY SOLUTIONS GRANT APPLICATION PACKET FY 2018 OCTOBER 1, SEPTEMBER 30, 2018

Micro Enterprise Assistance Program District 2 Guidelines FY

HOME Investment Partnership Program RFP Community Housing Development Organization (CHDO) Certification Year 44 ( )

Invitation to CDCs to apply for: Advancing Equitable Development in Milwaukee HUD Section 4 Capacity Building Grants

CITY OF LONG BEACH Department of Development Services

APRIL 2009 COMMUNITY DEVELOPMENT BLOCK GRANTS/STATE S PROGRAM NORTH CAROLINA SMALL CITIES CDBG AND NEIGHBORHOOD STABILIZATION PROGRAM

City of Mission Viejo Community Development Block Grant (CDBG) Program Year Public Service Grant Application

PROGRAM GUIDELINES AND APPLICATION MANUAL

COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG) 2017 CDBG Application and Instructions for 2018 Funding

CDBG & HOME Proposed Programming for the FY 2018 Annual Action Plan

II. PROPOSED PROGRAM YEAR 2018 ACTION PLAN SUMMARY:

SPRINGS. City Hall Broadway Saratoga Springs, New York Tel: x.2575 fax:

JEFFERSON COUNTY, ALABAMA. Program Year 2018 EMERGENCY SOLUTIONS GRANT APPLICATION APPLICANT:

Genesee County. Metropolitan Planning Commission. Community Development Block Grant Program Group 3 Construction Projects Application

COMMUNITY PLANNING AND DEVELOPMENT MONITORING HANDBOOK. Departmental Staff and Program Participants HANDBOOK REV-6

Nevada County Board of Supervisors Nevada County Adult & Family Services Commission. Community Service Block Grant 2018/2019 Request for Funding

Communities of Color Nonprofit Stabilization Fund Request for Applications Application deadline: October 5, 2018

GOVERNOR S OFFICE OF ECONOMIC DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM 2016 APPLICATION. H. Ranking of this Application: Rank of

FISCAL YEAR 2018/2019 APPLICATION FOR FUNDING

CDBG PUBLIC SERVICES

Community Land Trust Loan Fund

CITIZEN PARTICIPATION PLAN

2018 Community Development Block Grant (CDBG) General Information

Clinical Dental Education Innovations Grants

SUBCHAPTER 19L - NORTH CAROLINA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM SECTION GENERAL PROVISIONS

COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM HOME INVESTMENT PARTNERSHIPS PROGRAM FISCAL YEAR 2016 APPLICATION PACKAGE

HOME CHDO Program OPERATING EXPENSE GRANT PROGRAM

Genesee County Metropolitan Planning Commission

COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM OVERVIEW. Town of Union CDBG Program

City of Trenton Department of Housing & Economic Development

Department of Children and Families Office on Homelessness

City of Alameda Program Guidelines for CDBG FY18-19

Communities of Color Nonprofit Stabilization Fund Request for Applications Application deadline: October 5, 2018

Subject: Guidance on Submitting Consolidated Plans and Annual Action Plans for Fiscal Year (FY) Purpose:

GWINNETT COUNTY, GEORGIA APPLICATION MANUAL FOR HUD ENTITLEMENT GRANT PROGRAMS

Office of Community & Economic Development Fiscal Year 2019 Budget Presentation

Florida Community Development Block Grant Disaster Recovery (CDBG DR) Hurricane Irma

COMMUNITY DEVELOPMENT BLOCK GRANT

Community Development Block Grant Frequently Asked Questions

County of Union We re Connected to You!

COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM CAPITAL PROJECT FUNDING APPLICATION

Mississippi Development Authority. Katrina Supplemental CDBG Funds. For. Hancock County Long Term Recovery CDBG Disaster Recovery Program

Transcription:

2015-2016 Community Development Block Grant (CDBG) Request for Applications (RFA) for Public Services and Housing Projects ORANGE COUNTY Housing and Community Development Division

ORANGE COUNTY ANNUAL ACTION PLAN FISCAL YEAR 2015-2016 Request for Applications (RFA) for Community Development Block Grant (CDBG) Public Services and Housing INTRODUCTION The purpose of this Notice is to solicit applications from entities seeking to conduct eligible public service activities under the Community Development Block Grant (CDBG) Program. Projects funded under this program will be limited to activities that are consistent with the priorities and goals identified in the Orange County Five Year Consolidated Plan. The Annual Action Plan will include specific public service activities to be implemented between October 1, 2015 and September 30, 2016. Viable activities/projects are selected for funding at the conclusion of a competitive application process open to participation by all eligible entities. WHAT IS THE CONSOLIDATED PLAN? The Orange County Consolidated Plan identifies community development needs, and strategies to address those needs. The Plan focuses on the proposed uses of the following three U.S. Department of Housing and Urban Development (HUD) entitlement grants for the 2011-2016 planning period: Community Development Block Grant (CDBG), Emergency Solutions Grant (ESG) and HOME Investment Partnership (HOME) programs. Each year, Orange County prepares an Annual Action Plan that identifies the goals, strategies and activities that the county will implement during the grant year to accomplish the goals established within the Five Year Consolidated Plan. COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) The primary objective of the CDBG Program is to create a suitable living environment, provide for decent housing, and expand economic opportunities for low- to moderate-income persons. Orange County intends to use no less than 70 percent of its CDBG allocation for activities that benefit low to moderate income households (up to 80 percent of the area s median income). CDBG NATIONAL OBJECTIVES The CDBG national objectives are found at 24 CFR 570.208. All funded projects and activities must meet one of the following three CDBG national objectives: 1. Benefit low- to moderate-income persons- This category is met if the activity meets one of four subcategories: Area benefit activities that benefit all residents in an area that is at least 51 percent low income Limited Clientele Activities that benefit the persons participating in the activity that are presumed to be low to moderate income and the activity has eligibility requirements in which income must be documented. Housing Activities that benefit low to moderate income persons. Job Creation or Retention activities designed to create or retain permanent jobs for low to moderate income persons. 2. Aid in the prevention or elimination of slums or designated blighted areas. 3. Meet an urgent need defined as an existing condition that poses a serious threat to the community. Revised 1/15 1

CDBG PUBLIC SERVICES CDBG funds may be used to provide a public service, provided that the service is: A new service A quantifiable increase in the level of a service previously subsidized with CDBG funding The amount of CDBG funds to support public service activities may not exceed 15 percent of the total award to Orange County in a fiscal year. The estimated amount of funding available for public services in FY 2015-2016 is $783,340. The County s CDBG program has also adopted a 20 percent cap on the available funding for homeless services. The estimated amount of funding available for homeless services under the CDBG program is $156,668. Public Service Priorities The 2011-2016 Consolidated Plan identifies the following goals and statutory objectives: Consolidated Plan Goal #2: Utilize capital projects, affordable housing and public services as a platform to improve the quality of life of low and moderate income residents. Objective 2.6: Support public services benefiting low income persons, especially those services addressing elderly, youth, disabled and homeless individuals. Objective 2.7: Support public services related to job training and placement of low income individuals. CDBG HOUSING PROJECTS CDBG funds may be used for housing projects that benefit low income persons. The estimated amount of funding available for CDBG housing projects in FY 2015-2016 is $500,000. CDBG Housing Priorities The 2011-2016 Consolidated Plan identifies the following goals and statutory objectives: Consolidated Plan Goal #1: Work in collaboration with local government, County departments, nonprofit organizations and industry partners to stabilize low to moderate income communities through redevelopment, infill and affordable housing initiatives. Statutory Objective 1.4: Support the preservation of affordable housing stock through housing rehabilitation, weatherization and accessibility programs to enable low income homeowners to remain in their homes. Note: All CDBG beneficiaries must meet income guidelines established by HUD. The CDBG program is designed to serve individuals at or below 80 percent of the area s median income (AMI); however, Orange County s emphasis is on individuals that are very low-income individuals (50 percent AMI or below). Applicants approved for CDBG funding shall verify eligibility and maintain income documentation for all beneficiaries. HOW PROJECTS ARE SELECTED FOR FUNDING AND FUNDING REQUIREMENTS The Public Notice published in the Orlando Sentinel on February 1, 2015 announced the anticipated federal funding for the Orange County 2015-2016 Action Plan beginning October 1, 2015 and ending September 30, 2016. The Request for Applications (RFA) process begins on February 1, 2015 for eligible nonprofit organizations seeking funding under the CDBG program. Eligible nonprofit organizations may submit project proposals until March 20, 2015 at 5:00 pm. Staff of the Housing and Community Development Division will review the applications and make recommendations for funding to the Community Development Revised 1/15 2

Advisory Board (CDAB). Once a consensus is reached, the recommendations will be submitted to the Orange County Board of County Commissioners (BCC) for approval. The CDAB is comprised of Orange County residents appointed by the BCC who serve on a volunteer basis. Additionally, Applicants should note that final budget/program funding recommendations will be subject to funding availability; therefore there is no guarantee that any or all projects will receive funding. Since funds generally support only a limited number of projects, some projects may not be funded. Funding recommendations will be submitted for approval to the BCC in or before August 2015 as part of the Annual Action Plan. All funding recommendations are contingent upon HUD s approval of our Annual Action Plan and the availability of federal funds. All agencies awarded funding from the CDBG Program will enter into a Project Administration Agreement with the County and will be subject to all federal and local laws, regulations and guidelines. Sound financial management is essential to a well-run CDBG program. Organizations receiving CDBG funding are required to maintain adequate records and comply with the applicable requirements of 24 CFR 85 and OMB Circulars. The financial records that must be maintained include, but are not limited to accounting journals and ledgers, source documentation of costs eligible for payment (invoices, purchase orders, canceled checks), bank account records, financial reports and audits, and time sheets for all employees paid by CDBG funds. Funded projects are paid on a reimbursement basis. Orange County reserves the rights to accept or reject any or all applications, with or without cause; to waive technicalities; or to accept applications, which, in its sole judgment, best serve the interests of Orange County citizens. APPLICATION INSTRUCTIONS 1. APPLICATION PREPARATION Applicants must include ALL of the information listed in this application to be considered for funding. Cover Table of Contents Application Cover Sheet Narratives for the following: Project Description Organizational Capacity and Experience Approach Outcomes Project Budget and Justification Attachments (Organizational Documents) 2. APPLICATION SUBMISSION Applications must follow these guidelines: All pages are to be numbered, including attachments. There is no limit to the number of project requests an organization may submit. However, each application must be submitted and packaged separately with all requested forms and attachments. Applicants are requested to submit two (2) unbound originals of the Application, with required attachments, and three (3) unbound copies of the Application (no attachments) for each proposed project. Applications should be submitted in sealed envelopes or boxes. The applicant s name and address should be indicated on the outside of each envelope or box. Submission by facsimile machine or via e- mail will not be accepted. Applications must be received no later than 5:00 p.m. on Friday, March 20, 2015 at: Housing and Community Development Division Attn.: Community Development RFA 525 East South Street Orlando, FL 32801 Revised 1/15 3

Late Applications will not be accepted. No exceptions will be made. Applications without a signed Cover Sheet will be disqualified. 3. E-DOCUMENTS The Orange County Consolidated Plan is available in PDF format for downloading from the County s website at: http://www.ocfl.net/neighborshousing/commu nitydevelopment.aspx. 4. APPEALS Limited resources and anticipated budget cuts are expected to limit the number of projects that can be selected for funding during the 2015-2016 fiscal year. An Applicant may submit a request to receive information addressing the reasons why the project proposal was not funded or to request technical assistance for future applications. Applicants may initiate an appeal, except for the following reasons: 1. The proposed activity is ineligible under CDBG regulations. 2. The Applicant failed to meet federal and Orange County eligibility requirements for this grant. 3. The Application is incomplete (missing narratives, documentation or an explanation of why the required documentation is not available. Please refer to the Application Content. 4. The Applicant is dissatisfied with the amount of the recommended award. To appeal a recommendation, an applicant must provide a written notice to the Manager of the Housing and Community Development Division no later than 5:00 p.m. on the third business day after the agencies have been notified of the funding recommendations. Agencies will be notified on or before May 29, 2015. The written notice should be addressed to: Mr. Mitchell Glasser, Manager Housing and Community Development Division 525 East South Street Orlando, FL 32801 An appeal committee comprised of the following individuals will review appeals and render a decision: One individual serving on the Community Development Advisory Board One Staff person from the Housing and Community Development Division One independent person to be appointed by the Director of the Community Environmental Development Services Department The Manager of the Housing and Community Development Division or his designee. 5. QUESTIONS A Technical Assistance Session for CDBG public services and housing applicants will be held on Monday, February 16, 2015 at 9:30 a.m. until 11:00 a.m. at the Orange County Administration Building, BCC Chambers, 201 S. Rosalind Ave., Orlando, FL 32801. The purpose of the session is to give prospective applicants an opportunity to ask questions regarding the application. Attendance is highly recommended. This will be the only session held on this solicitation. To RSVP, please e- mail: Elizabeth.Rico@ocfl.net Additional questions or concerns regarding this Request for Applications must be submitted in writing referencing the specific section of the Application to: Nancy.Sharifi@ocfl.net Questions related to the RFA will be accepted (in writing) until March 6, 2015. APPLICATION CONTENT Applicants are requested to include the following information in the application. APPLICATION COVER The application must have a cover with the name of the project and the organization submitting the request. Applicants are asked not to bind applications (originals and copies). Revised 1/15 4

APPLICATION CHECK LIST For your convenience, an Application checklist has been provided. Please include as part of your submission package. APPLICATION COVER SHEET Complete the Application Cover Sheet included in this RFA. The applicant s Executive Director or designee must sign the Application Cover Sheet. Applications without signed cover sheets will not be considered for funding. TABLE OF CONTENTS Each section must be identified by name and page number in the table of contents. NARRATIVES A. Project Description - (20 points maximum. Do not exceed 3 pages) 1. Provide a problem statement, need, or severity of a problem to be addressed by the service to be provided. Describe the target population and number of people that will have access to this public service. 2. Explain how this activity addresses the Consolidated Plan and the program objectives of the CDBG program, including how the agency determines the clients eligibility to receive services. 3. Is proposed project a new service or a quantifiable increase of a previous CDBG- funded service? If a quantifiable increase, please state how many new clients will access the proposed services. 4. Describe outreach and marketing initiatives that will be implemented to inform potential clients, and how the clients will access the service logistically and geographically. B. Organization s Experience and Capacity- ( 25 points, Do not exceed 3 pages) 1. Provide information to justify your agency s capacity to conduct this project. Include the fiscal and staff resources (include consultants and volunteers, if applicable) with skills, experience and/or appropriate credentials that will be working on the proposed project. 2. Discuss facilities, equipment, materials, and other physical resources applicable to the project. If license(s) are required for the proposed facility, provide copies of the license(s) or evidence that the applicant can meet license requirements prior to the award of funds. 3. Describe the project s fiscal management system, ability to identify/track CDBG funds and how it will comply with federal requirements for the program including OMB Circular A-87. 4. Provide documentation/information that confirms successful past project performance completing similar projects. 5. Provide a recent project performance evaluation for this project or similar projects (other than CDBG). If an evaluation is not available, please explain why. How will your agency evaluate performance of this project? C. Approach (20 points maximum) 1. The Application shall include a work plan with the estimated timeline for implementation, tasks and specific activities to be accomplished. 2. Provide the number of low income clients that will be served and explain the specific client documentation that is collected, verified and retained in records. Revised 1/15 5

3. Identify the specific services that clients will receive. Are clients charged for the service? 4. Identify any cooperative approaches with other organizations and describe how these collaborations will benefit the clients and performance of the project. D. Outcomes (15 points maximum) 1. The Application shall clearly identify and describe one or more measurable project outcomes. These must be consistent with the identified need goals, objectives, and project approach. 2. Indicate how the outcome will have a significant impact on the population and/or the community affected by the unmet need. 3. Indicate if the proposed outcomes are connected to an existing project or a new project. For an existing project, indicate how the proposed outcomes will be achievable for new clients within the fiscal year. E. Budget Justification and Leverage of Funds (20 points maximum) 1. Provide a Project Budget using the Project Budget forms included in the RFA. 2. Explain and justify each proposed budget line item and why CDBG funds are required. 3. Identify how the project will be leveraged with other programs and funds and the amount / percentage of leverage for each CDBG dollar. If the project is currently being funded by a resource other than CDBG, explain why CDBG funds are needed. Identify fundraising activities, and/or other sources of funding expected for the program. 4. Provide details of any other contributions, grants, donations or awards that your organization receives from Orange County for this or other projects. 5. Explain other necessary project budget expenditures not being proposed for CDBG funding. 6. If the project was previously funded by CDBG indicate the year, amount of funding, if the funding was utilized in a timely manner, and what more will be accomplished with the proposed award. 7. Identify if there is a contingency plan in place that is intended to ensure continuity of the program beyond the current CDBG funding period. Provide details. F. Required Documents The Application must include all documents identified in the Application checklist as attachments. If a document is not available, please provide an explanation. EVALUATION CRITERIA The evaluation criteria attached to this Request for Applications will be used to rank each Application submitted. Each Application will be ranked and scored based on five criterion elements, evaluation and submission of the required documents identified in the Application checklist. Revised 1/15 6

EVALUATION CRITERIA The evaluation criteria identified in the Application will be used to rank each Application submitted. Each criterion element will be rated separately. Applications may receive up to the maximum points allowed based on the response to each criterion element. ALL APPLICATIONS WILL BE EVALUATED IN ACCORDANCE WITH THE FOLLOWING CRITERIA: Maximum Points Criteria I Project Description 20 Criteria II Organizational Capacity 25 Criteria III Approach 20 Criteria IV Outcomes 15 Criteria V Budget Justification and Leverage of Funds 20 TOTAL POINTS 100 Application must include required organizational documents identified in the checklist as attachments, and evidence of approval of the grant request. Points will be deducted for missing documents. Revised 1/15 7

Non-profit Organization Name: Address: APPLICATION COVER SHEET FOR CDBG PUBLIC SERVICES and HOUSING Contact Person: E-mail: Date Designated as 501(c)(3): Telephone ( ) Fax: ( ) Federal Identification Number: Please provide proof that the 501(c)(3) is active: Agency DUNS # (requirement): Application for (Check One): Public Services Housing Name of Project: Location of Project: Brief Description of Project Activities (Include need to be addressed and how CDBG funds will be used.): Is the project currently funded by CDBG? Yes No Amount: For a Public Service, Indicate the Public Service Priority (Please check one): Senior Services Low income Children/Youth Persons with Disabilities Homeless (limited funding) Job Training and Placement for low income clients Other (non-priority) : For a Housing Project, Indicate the Priority (Please check one): Weatherization or Minor Repairs Other rehabilitation (i.e. accessibility), please specify : Indicate if Application(s) is being submitted in partnership or collaboration with other nonprofit organization(s): Yes No List other organization(s) by name: Requested CDBG Funding: $ Other Contributions/Leverage: $ Total Project Costs: $ Revised 1/15 8

Continuation CDBG Public Services and Housing RFA Please check all that apply: I acknowledge that 100 percent of CDBG funds must be used for households at less than 80 percent of median income with an emphasis on very low income families (below 50 percent of the area s median income). I acknowledge that if funded, the agency is required to document eligibility status for individuals served with CDBG funds. I acknowledge that if funded, the agency is required to submit monthly programmatic reports and supportive documentation for expenditures. I acknowledge that if funded, the agency must comply with applicable federal requirements including the Federal Fair Housing Act of 1968. PLEASE SIGN BELOW. APPLICATIONS WITH AN UNSIGNED COVERSHEET WILL BE DISQUALIFIED I certify to the best of my knowledge, that the information provided in this application reflects accurate information and data regarding need, and appropriate estimates of planned services. This application was considered and approved for submission by the following: Board of Directors on (date), and/or Meeting minutes (date), and/or Letter, dated certifying authority of agency Director to submit application. By signing this application, the undersigned agrees that if the application is accepted, items or services for which prices are quoted will be provided, subject to final negotiation and acceptance by Orange County, and subsequent contract award. Signature of Executive Director (or designated representative) Date Print Name Title Revised 1/15 9

APPLICATION CHECKLIST AND REQUIRED ORGANIZATIONAL DOCUMENTS Application Cover Sheet Table of Contents Application Narratives (Sections A-E) Required Documents (Section F) The following documents must be provided, in addition to required narratives, in order for your project to be considered for funding. Please provide ALL of the following required documents as Attachments to this application. 501(c) (3) Certificate (showing that the organization has been in existence for a minimum of two years) Organization s Mission Statement Organizational Chart (Completed and dated) Current Board of Directors Roster (including terms & dates, position on Board & occupation) Articles of Incorporation (with recorded date of approval, letter from Secretary of State, etc.) By-Laws (with recorded date of approval, letter from Secretary of State, etc.) Interim Financial Statements Audited Financial Statements for the previous two years (with Management Letter, as applicable) Current (Most Recent) Federal Tax Form 990 Project Position Descriptions Resumes Current (CEO, CFO, key fiscal staff, and all Programmatic staff) Project Performance Evaluation (not from a previous CDBG grant) Evidence of Insurance Conflict of Interest Disclaimer Provide a copy or describe the agency s confidentiality and record keeping procedures. Location Map Board Resolution or, meeting minutes approving submission of the grant application, or, a letter certifying that the agency s Director has the authority to submit the grant application. Applications that do not meet this requirement will be disqualified. Revised 1/15 10

PROJECT BUDGET REQUEST (Only costs associated with the delivery of CDBG services are allowed) ACTUAL FISCAL YEAR (CURRENT) Oct 2014-Sept 2015 PROPOSED FISCAL YEAR Oct 2015- Sept 2016 DIRECT COSTS Personnel Salaries for service delivery personnel TOTAL PROJECT BUDGET CURRENT CDBG SUPPORT TOTAL PROJECT BUDGET CDBG FUNDING REQUEST (no fringe benefits) Utilities/ Maintenance Audit Rent Insurance Supplies (Specify) Telecommunications (if applicable) Local Travel (if applicable) Other Project Delivery costs Specify: TOTAL BUDGET NOTE: The Total Project Budget means the total cost of conducting the project in Orange County (CDBG funds requested included). CDBG budget request should reflect the portion of the total budget to be funded by Orange County. Revised 1/15 11

AGENCY/ORGANIZATION BUDGET PROJECT: 2014-2015 TOTAL AGENCY BUDGET 2014-2015 CURRENT CDBG SUPPORT 2015-2016 TOTAL AGENCY BUDGET 2015-2016 CDBG FUNDING REQUEST DIRECT COSTS Administration/ Personnel Costs Operational Costs Rent/Mortgage Space Utilities/ Maintenance Audit Insurance Equipment Purchase/Lease Supplies Telecommunications Printing/Copying Postage Travel (local only & at County rate) Other (Explain) Total Direct Costs Other Indirect Costs TOTAL BUDGET $ $ NOTE: The Total Agency Budget means the total cost of conducting the agency s business in Orange County (CDBG funds requested included). CDBG budget request should reflect the portion of the total budget to be funded by Orange County. Revised 1/15 12