Fillable A complete application and all required attachments must (City of El Paso)

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A complete application and all required attachments must (City of El Paso)

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The A complete application and all required attachments must (City of El Paso) form is 8 pages long and contains:

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  • 21 check-boxes
  • 40 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of El Paso

BROWSE CITY OF EL PASO (TX) FORMS

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A complete application and all required attachments must be submitted by
5:00p.m. (MDT) on Monday, October 19, 2020. If you have any questions about
completing this application, please contact DCHD at
housingprograms@elpasotexas.gov
Incomplete applications will not be considered for funding.
1.
Applicant Information
Agency Legal Name
Agency Address
City
State
Zip Code
Employer Identification #
DUNS#
Type of Agency
____Public Entity ____ Non-Profit
If Non-Profit has been selected, provide the following information:
Date incorporated as a Texas Non-Profit Corporation Date of IRS Section 501 (c)3 Certification
Is the agency a faith-based organization?
_____Yes ____
No
Main Contact Person
(This person will serve as the main point of contact for any matters related to this grant application.)
Name Title
Phone E-mail
Title/Position Name
Phone
E-Mail
Executive Director
Program Director
Grant Writer
Cont. - Applicant Information
Agency Purpose/Mission Statement
Agency Capacity and Expertise
Explain your capacity to manage the proposed program and provide any relevant
information to demonstrate your experience or expertise managing a program such as the
one proposed. 300 words max.
Partner Supplement Form
Each Partner or Consultant that will be providing direct services as a part of this project and/or is projected to
receive $5,000 or more in funding must complete a Partner Supplement Form.
2.
Project Summary
Agency Legal Name
Project Name
Project Location (This is the main location where services will be provided.)
City State Zip Code
# DCHD total clients for project
# total clients for project
Amount Requested Total Project Budget
Project Description
Provide a short description of the proposed program. Please note that this summary will be used to describe your project in official
City documents. 250 word max.
CARES Act Alignment
Explain how the proposed project will help prevent, prepare for and respond to coronavirus (COVID-19) in El
Paso. Explain how the project outcomes will provide long-term stabilization for those assisted. 250 words max.
Budget Summary
Describe the budget for the project
.
Explain if leverage funding will support this project. 250 words max.
3.
Project Scope
Outcome Statement
Please use the Outcome Statement Worksheet to develop your Outcome Statement and insert it here. Please note that if your
project is selected for funding, this definition will be used in your contract. The Outcome Statement Worksheet was provided by
DCHD. Please contact housingprograms@elpasotexas.gov if you need a copy. 250 words max.
Project Narrative
The project narrative must include all the information requested in the Proposal Narrative Instructions page. When complete, attach
your Project Narrative, as PDF file, to this application.
Attachments Checklist
This is a checklist of attachments required for
All
Applicants.
I.
Proposal Narrative (Answer all the questions and attach your pdf file.)
II.
Outcome Statement Worksheet
III.
Proposal Budget Workbooks (1 each per funding source, 3 total)
a. Including
Site Breakdown for Multi-site Projects (if applicable)
IV.
Partner Supplement Form for all partners
V.
Job Descriptions (DCHD funded positions only)
VI.
Assurance A – Acceptance of Grant Conditions and Terms
VII.
Assurance B – Assurance of Applicant Eligibility for Non-Profit
Organizations. (Only applicable to non-profits)
VIII.
Assurance C – Assurance of Compliance with Ordinance 9779
IX.
Assurance D – Accessibility Letter of Assurance
X.
Status of Zoning Verification Letter
XI.
List of Current Board of Directors
XII.
Certified Audit
XIII.
Approval of Board of Directors
XIV.
Authorized Signatory Documentation
XV.
Certification of Account Status from the Texas Secretary of State
XVI.
Organization Bylaws
XVII.
IRS 501(c)(3) Certification Letter
1.
Signature of Authorized Representative
Executive Director/CEO/Board Chair Signature
Full Name and Title
Date
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A complete application and all required attachments must (City of El Paso)

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Completed 12 February 2021

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