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Expires 06/30/207 Part I: Summary PHA Name: Housing Authority of the Town of Manchester, CT Grant Type and Number Capital Fund Program Grant No: CT026P02650-6 Replacement Housing Factor Grant No: N/A Date of CFFP: N/A FFY of Grant: 206 FFY of Grant Approval: 206 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 Total non-cfp Funds Original Revised 2 Obligated Expended 2 406 Operations (may not exceed 20% of line 2) 3,406 3 408 Management Improvements 2,000 4 40 Administration (may not exceed 0% of line 2) 37,400 5 4 Audit 6 45 Liquidated Damages 7 430 Fees and Costs 2,000 8 440 Site Acquisition 9 450 Site Improvement 9,000 0 460 Dwelling Structures 275,500 465. Dwelling Equipment Nonexpendable 9,000 2 470 Non-dwelling Structures 3 475 Non-dwelling Equipment 4 485 Demolition 5 492 Moving to Work Demonstration 6 495. Relocation Costs 7 499 Development Activities 4 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 00% of CFP Grants for operations. 4 RHF funds shall be included here. Page form HUD-50075. (07/204)

Expires 06/30/207 Part I: Summary PHA Name: Housing Authority of the Town of Manchester, CT Grant Type and Number Capital Fund Program Grant No: CT026P02650-6 Replacement Housing Factor Grant No: N/A FFY of Grant: 206 FFY of Grant Approval: 206 Date of CFFP: N/A 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 Original Revised 2 Obligated Expended 8a 8ba 50 Collateralization or Debt Service paid by the PHA 9000 Collateralization or Debt Service paid Via System of Direct Payment 9 502 Contingency (may not exceed 8% of line 20) 20 Amount of Annual Grant:: (sum of lines 2-9) 374,306 2 Amount of line 20 Related to LBP Activities 22 Amount of line 20 Related to Section 504 Activities 00,000 23 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 Date Signature of Public Housing Director Date 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 00% of CFP Grants for operations. 4 RHF funds shall be included here. Page2 form HUD-50075. (07/204)

Expires 06/30/207 Part II: Supporting Pages PHA Name: Housing Authority of the Town of Manchester, CT Grant Type and Number Capital Fund Program Grant No: CT026P02650-6 CFFP (Yes/ No): No Replacement Housing Factor Grant No: Federal FFY of Grant: 206 Development Number Name/PHA-Wide Activities All All General Description of Major Work Categories Operations: Utilities, fleet/ equipment upgrades and other associated AMP costs Management Improvements: Non-capital activities that are projectspecific or PHA wide improvements needed to upgrade or improve the operations and/or of the PHA s projects, to promote energy conservation, to sustain physical improvements at those projects, or correct management deficiencies, staff training/travel, safety improvements/corrections and office equipment upgrades Development Account No. 406 PHA Wide 408 PHA Wide Quantity Total Estimated Cost Total Actual Cost Status of Work Original Revised Funds Obligated 2 0,000 Funds Expended 2 Page3 form HUD-50075. (07/204) 2,000 All Mod Coordinator PHA Related Salary 40 36,000 All Architect, Engineering and other 430 PHA 2,000 Consultant Fees Wide 450 9,000 Office Parking Lot Upgrade AMP 460 5 32,500 Electrical Panel Upgrades AMP 460 3 2,000 Buildings 460 2 50,000 Buildings Annex 460 2 Buildings 50,000

AMP AMP Full Unit Accessibility Upgrade Full Unit Accessibility Upgrade Shower Reasonable Accommodation Shower Reasonable Accommodations Basement Door Upgrades Office Interior Upgrade 460 Unit 35,000 460 Unit 35,000 460 Unit 7,500 460 3 Units 22,500 460 30 5,000 470 9,000 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-50075. (07/204)

Expires 06/30/207 Part III: Implementation Schedule for Capital Fund Financing Program PHA Name: Housing Authority of the Town of Manchester, CT Federal FFY of Grant: 206 Development Number Name/PHA-Wide Activities All: Utilities, fleet/ equipment upgrades and other associated AMP costs All: Management Improvements: Non-capital activities that are project-specific or PHA wide improvements needed to upgrade or improve the operations and/or of the PHA s projects, to promote energy conservation, to sustain physical improvements at those projects, or correct management deficiencies, staff training/travel, safety improvements/corrections and office equipment upgrades All: Mod Coordinator PHA Related Salary All: Architect, Engineering and other Consultant Fees : Office Parking Lot Upgrade All Fund Obligated (Quarter Ending Date) Original Obligation End Date Actual Obligation End Date 2/3/6 03/3/7 2/3/6 03/3/7 2/3/6 2/3/7 2/3/6 3/3/7 06/3/6 2/3/6 Original Expenditure End Date All Funds Expended (Quarter Ending Date) Actual Expenditure End Date Reasons for Revised Target Dates Page5 form HUD-50075. (07/204)

AMP : Electrical Panel Upgrades AMP : : : Annex AMP : Full Unit Accessibility Upgrade : Full Unit Accessibility Upgrade AMP : Shower Reasonable Accommodation : Shower Reasonable Accommodations : Basement Door Upgrades : Office Interior Upgrade 06/3/6 2/3/6 2/3/6 06/30/7 2/3/6 06/30/7 2/3/6 06/30/7 2/3/6 06/30/7 Obligation and expenditure end dated can only be revised with HUD approval pursuant to Section 9j of the U.S. Housing Act of 937, as amended. Page6 form HUD-50075. (07/204)