APPLICATION FOR FUNDING LOCAL RECIPIENT ORGANIZATION EMERGENCY FOOD AND SHELTER NATIONAL PROGRAM PHASE 35 ORANGE COUNTY, NEW YORK, JURISDICTION #6228

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APPLICATION FOR FUNDING LOCAL RECIPIENT ORGANIZATION EMERGENCY FOOD AND SHELTER NATIONAL PROGRAM PHASE 35 ORANGE COUNTY, NEW YORK, JURISDICTION #6228 Key Dates Activity Request for Application Released April 30, 2018 Application Due Date May 21, 2018 Anticipated Award Date June 18, 2018 Date Available Funding: Orange County has been chosen to receive $140,497.00 to supplement emergency food and shelter programs in the county. The selection was made by a National Board that is chaired by the U.S. Department of Homeland Security's Federal Emergency Management Agency and consists of representatives from American Red Cross; Catholic Charities, USA; National Council of the Churches of Christ in the USA; The Jewish Federations of North America, The Salvation Army; and United Way Worldwide. Eligibility To be eligible to apply and receive federal EFSP funds, an applicant organization must: 1. Be nonprofit or an agency of government. 2. Expend funds for food, meals, rent/mortgage assistance, and utility assistance only. 3. Expend funds to supplement existing food, meal, rent/mortgage assistance and utility assistance services, not as a substitute for other program funds or to start new programs and must be expended within the program year as to be defined by the National Board. 4. Provide services to residents and transients within Orange County, NY. 5. Provide services free of charge. 6. Serve needy people without discrimination (age, race, sex, religion, national origin, disability, economic status or sexual orientation), must be sensitive to the specialized needs of homeless individuals with mental and physical disabilities and the needs of those transitioning from temporary shelter to more permanent housing, and must facilitate access for homeless individuals to other sources of services and benefits. 7. All expenditures must be paid for LRO by check, LRO credit card, or LRO debit card payable to the vendor (e.g. food bank, landlord, utility company, etc.). No cash payments are allowed with EFSP funds. All payments must be made for the exact amount of the purchase at the time of purchase. No pre-paid accounts are allowed. 8. Have an accounting system or fiscal agent approved by the local board 9. Have a Federal employer identification number (FEIN) AND a DUNS number. 10. Conduct an independent audit (EFSP funds $50,000 or more) or independent financial review (EFSP funds $25,000 to $49,999) if EFSP funds exceed applicable guidelines. 11. Currently providing EFSP eligible services and utilize other agency resources in supporting these services. 12. Practice nondiscrimination in service provision, employment, and volunteer utilization. 13. Have a voluntary board if private, not-for-profit. 14. Have appropriate disaster recovery planning that ensures continuity of services and records retention in the event of a disaster. 15. Comply with any other restrictions on use of Federal funds for lobbying or other regulated activities. 16. Submit all required reports completely and on time. 1 of 6

Proposal Submission Please submit (2) two signed copies of your proposal and all required materials. All applications must be submitted via postal mail or hand delivered to in their entirety by 5:00 PM on Monday, May 21, 2018 to the address listed below: United Way of the Dutchess-Orange Region c/o Melissa Clark 75 Market Street Poughkeepsie, NY 12601 Please note: Applications submitted after the deadline will not be accepted or reviewed. Electronic submissions will not be accepted. Proposal Submission Questions related to this request for application should be submitted in writing to Melissa Clark at mclark@uwdor.org. EMERGENCY FOOD AND SHELTER CHECKLIST Required information is completed in full Application is signed by authorized representative Narrative of program is attached All required documents are attached: o Agency operating budget o Program budget(s) for areas requested above o Copy of most recent annual audit or financial statements (if request is over $25,000) o Roster of agency s volunteer board o Local Recipient Organization Certification o Counterterrorism form o Fiscal Agent Certification, if applicable Submit (2) two copies of proposal in its entirety 2 of 6

EMERGENCY FOOD AND SHELTER NATIONAL PROGRAM- PHASE 33 The Emergency Food and Shelter National Board Program has been entrusted through the Stewart B. McKinney Homeless Assistance Act of 1987 to supplement and expand ongoing efforts to provide shelter, food and supportive services for homeless and hungry individuals nationwide. Legal Name of Applicant Organization: Federal Employer ID: DUNS #: Federal Employer ID # of Fiscal Agent: Physical Address: Mailing Address (if different): Agency Phone: Fax: Website: Agency Executive Director: Phone Number: E-mail Address: EFSP Primary Contact: Phone Number: E-mail Address: Congressional District: Are you currently enrolled for electronic funds transfer? Yes No Have you received EFSP funding in previous years? Yes No If yes, please provide your agency s Local Recipient Organization (LRO) number: If no, please attach copy of IRS Certification 501(c)(3) to application. Please indicate whether your agency is: a non-profit a government agency Is your agency handicapped accessible? Yes No Is your agency debarred or suspended from receiving funds or doing business with the Federal government? Yes No Has agency returned EFSP funds for any reason in the last three years or submitted late documentation? If yes, explain amount and reasons: Signature of authorized agency representative: Date: 3 of 6

Please Indicate Amount Requested in whole numbers by category of service: FOOD: Total $ Requested: # of Meals Served: # of Unduplicated Persons Served (A) Expenditures for served meals (B) Expenditures for other food SHELTER: # of Nights: (C) Expenditures for mass shelter (D) Expenditures for other shelter SUPPLIES/EQUIPMENT: (E) Expenditures for supplies/equipment RENT/MORTGAGE: # of Bills Paid Expenditures for rent/mortgage TOTAL REQUEST: Narrative: Please answer each of the following questions in 1500 characters or less: 1. Please provide a succinct summary of the program for which you are requesting funding to include: (a) target population; (b) number of clients currently served (without EFSP funding); (c) a general description of the program activities and processes used by the agency to deliver proposed services 2. Please list towns or regions of the county served by your organization and the numbers served by town in the last year. If service area spans outside of Orange County please explain how you will track expenses specific to Orange County. 3. The EFSP is a needs-based program for which clients must qualify. Please describe your eligibility requirements. 4. Please describe the capacity of your organization to provide the service. 5. Describe how this funding will supplement and extend current available resources. 6. Please include measurable outcomes how do you know your services are effective and who is your target population? Required Attachments: 1. Agency operating budget 2. Agency budget for program area(s) requested listed above 3. Copy of most recent annual audit or financial review 4. Roster of agency s volunteer board, if non-profit or private, not-for-profit 5. Certification forms and anti-terrorism form. 6. Fiscal Agent Certification, if applicable. Eligibility Requirements and Ineligible Expenses as provided in the Emergency Food and Shelter National Board Program Manual 4 of 6

INELIGIBLE PROGRAM COSTS 1) Cash payments of any kind including checks made out to cash, or petty cash expenditures. 2) Payments made in any form, other than LRO check, LRO vendor issued (store) credit card, or LRO debit card to vendor, never a client. (LRO refers to local recipient organization the applying organization) 3) Reimbursements to staff, volunteers, or clients for program purchases. Cash back to client from gift certificates/vouchers. 4) Reimbursement to other LRO s or agencies including those agencies under LRO s serving as fiscal agent or fiscal conduit. 5) Fees: No bank fees for check replacements, membership fees to food banks, shopping clubs, etc. 6) Deposits of any kind. 7) Administrative cost reimbursement to state or regional offices of governmental or voluntary organizations. 8) Use of administrative funds for purposes other than administering EFSP. 9) Lobbying efforts. 10) Expenditures made outside jurisdiction s spending period. All award funds must be expended during the current phase begin and end dates. 11) No pre-payment for expenses or services not yet rendered or incurred (i.e., where no goods or services have been provided prior to payment during the program period). 12) Telephone costs, salaries, or office equipment by LRO, except as administrative allowance authorized by the Local Board, and limited to the total allowance of (2%) of the LRO s award. 13) Rental security deposit or revolving loan accounts. 14) Payments of more than one month s mortgage, first month s mortgage, or down payment on mortgage. 15) Purchase/lease of real property (and or buildings) of any kind. 16) Property taxes of any kind, escrow accounts, insurance, legal fees, or condo fees. 17) Late fees for rent, mortgage, or utility assistance. 18) Payment of more than one month s rent. 19) Payment of more than one month s portion of a utility bill. 20) Payment of more than $300 per item of essential equipment. 21) Lease/purchase agreement or equipment leases. 22) Emergency building code repairs or rehabilitation to government owned, profit-making facilities or leased facilities or any facility not owned by the LRO. 23) Routine maintenance of LRO facilities, routine maintenance or service contracts on equipment. 24) Construction, rehabilitation or remodeling for expansion of service. 25) Repairs of any kind to an individual s home or apartment. (Repairs can only be made to LRO owned facilities.) 26) Supplies or equipment purchases for an individual s home or private use. 27) Transportation of people not related to the direct provision of food or shelter (e.g., to another agency, another city, etc.). Also, transportation to a relative s or friend s home. 28) Gas or repairs for client-owned vehicles, maintenance or repairs to LRO-owned vehicles (e.g., oil, tires, etc.). Also, insurance for LRO-owned or client-owned vehicles. 29) Emergency assistance for disaster victims, supplies bought for or in anticipation of a natural disaster (i.e., fire victims, floods, tornadoes, etc.). 30) Prescription medication, medical supplies, or vitamins. 31) Clothing (except underwear/diapers for clients of mass shelters, if necessary). 32) An LRO may not operate as a vendor for itself or other LRO s, except for the shared maintenance fee for food banks. 33) Direct expenses associated with new or expanded services or to prevent closing. 34) Encumbrance of funds; that is, no pre-payments for goods or services not received or not rendered which are paid for prior to the end of the jurisdiction s program. 35) No payments on account. Funds cannot be placed on deposit with a vendor and drawn down. 36) Meal costs in excess of the normal daily basic meal cost. 37) Reserving or withholding funds in anticipation of a future need (e.g., holiday events, holiday baskets, special programs, celebratory events). 5 of 6

38) Staff events/functions/meals of any kind. 39) Supplementing foster care costs, where an LRO has already received payment for basic boarding and feeding of a client. Comprehensive foster care costs beyond food and shelter are not allowed. 40) LRO s may not charge fees for services provided with EFSP funds. 6 of 6