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APPLICATION (Macon-Bibb County, Georgia)

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1
APPLICATION
for
Macon-Bibb County
Economic & Community Development Department
Community Housing Development Organization Program (CHDO)
PROGRAM YEAR 2021
Deadline is April 12, 2021 at 5:00 p.m.
(Application Submittal –One Original and One Digital Copy Required… Applications
must mirror each other)
HOME/CHDO funding is made possible by the US Department of HUD and is administered by the Local
government, Economic and Community Development Department.
ECONOMIC AND COMMUNITY DEVELOPMENT DEPARTMENT
200 Cherry Street, Suite 100
Macon, Georgia 31201
(478) 751-7190, TDD (478) 803-2306, FAX (478) 751-7390
HOME/CHDO Applications are available on-line.
http://www.maconbibb.us/economic-community-development/
2
CHDO Application Package
HOME INVESTMENT PARTNERSHIPS ACT (HOME)
COMMUNITY HOUSING DEVELOPMENT ORGANIZATION (CHDO)
GENERAL INFORMATION
Federal regulations specify a 15% set-aside of all Home Investment Partnerships Act (HOME)
funds for private nonprofit organizations, which meet the criteria and have been approved as
Community Housing Development Organizations (CHDO). These funds must be used for
specific project-related expenses associated with housing to be developed, sponsored, or
owned by the organization. This can be housing developed for long-term rental, or
homeownership.
All projects costs for participating jurisdictions (PJs) must be entered into a legally binding
HOME written agreement, signed and date required, with developers, owners, contractors,
subrecipients or state recipients or CHDOs, to use a specified amount of HOME funds. Failure
to commit and use the funds within the specified timeframe of twelve months may result in a
loss of the funds.
The HOME regulations are very specific in determining whether an organization qualifies as a
CHDO. The applicant must have a demonstrated track record and have true accountability to
the communities and residents it serves. This accountability extends to the Board of Directors
and requires low-income representation on that Board.
Listed below is language from the HOME regulations, which define how an organization may
qualify as a CHDO and eligible activities for the use of HOME CHDO funds.
To be funded as a CHDO, a community-based non-profit affordable housing development
organization must meet and provide the following criteria:
1) Is organized under state or local laws.
2) Has no part of its net earnings inuring to the benefit of any member, founder, contributor,
or individual.
3) Is neither controlled by, nor under the direction of, individuals or entities seeking to derive
profit or gain from the organization. A community housing development organization may
be sponsored or created by a for-profit entity, but:
(i) The for-profit entity may not be an entity whose primary purpose is the development
or management of housing, such as a builder, developer, or real estate management
firm;
(ii) The for-profit entity may not have the right to appoint more than one-third of the
membership of the organization's governing body. Board members appointed by the
for-profit entity may not appoint the remaining two-thirds of the board members; and
(iii) The community housing development organization must be free to contract for
goods and services from vendors of its own choosing.
3
4) Has a tax exemption ruling from the Internal Revenue Service under section 501(c)(3) or
(4) of the Internal Revenue Code of 1986.
5) Does not include a public body (including the participating jurisdiction). An organization
that is State or locally chartered may qualify as a community housing development
organization; however, the State or local government may not have the right to appoint
more than one-third of the membership of the organization's governing body and no more
than one-third of the board members may be public officials. Board members appointed
by the State or local government may not appoint the remaining two-thirds of the board
members.
6) Has standards to financial accountability that conform to 2 CFR Part 200 and 2 CFR Part
215.21 “Standards for Financial Management Systems."
7) Has among its purposes the provision of decent housing that is affordable to low-income
and moderate-income persons, as evidenced in its charter, articles of incorporation,
resolutions or by-laws.
8) Maintains accountability to low-income community residents by:
(i) Maintaining at least one-third of its governing board's membership for residents of
low-income neighborhoods, other low-income community residents, or elected
representatives of low-income neighborhood organizations. For urban areas,
"community" may be a neighborhood or neighborhoods, city, county or metropolitan
area; for rural areas, it may be a neighborhood or neighborhoods, town, village,
county, or multi-county area (but not the entire State); and
(ii) Providing a formal process for low-income, program beneficiaries to advise the
organization in its decisions regarding the design, siting, development, and
management of affordable housing.
9) Has a demonstrated capacity for carrying out activities assisted with HOME funds. An
organization may satisfy this requirement by hiring experienced accomplished key staff
members who have successfully completed similar projects, or a consultant with the same
type of experience and a plan to train appropriate key staff members of the organization.
10) Has a history of serving the community within which housing to be assisted with
HOME funds is located. In general, an organization must be able to show one year of
serving the community (from the date the participating jurisdiction provides HOME funds to
the organization). However, a newly created organization formed by local churches,
service organizations or neighborhood organizations may meet this requirement by
demonstrating that its parent organization has at least a year of serving the community.
4
Eligible CHDO Activities - General
The following activities are eligible for consideration only. While an activity may be eligible,
funding is not guaranteed.
(A) Eligible activities
(1) HOME funds may be used by a participating jurisdiction to provide incentives to
develop and support affordable rental housing and homeownership affordability
through the acquisition, (including assistance to homebuyers) new construction,
reconstruction, or moderate or substantial rehabilitation of non-luxury housing with
suitable amenities, including real property acquisition, site improvements,
conversion, demolition, and other expenses, including financing costs, relocation
expenses of any displaced persons, families, businesses, and organizations. The
housing must be permanent or transitional housing, and includes permanent housing
for disabled homeless persons, and single-room occupancy housing.
(2) Acquisition of vacant land must be undertaken only with respect to a particular
housing project intended to provide affordable housing. CHDOs should first consult
with the Macon Bibb County Land Bank Authority when interested in acquiring
properties. The Land Bank works in conjunction with Macon Bibb in acquiring
properties with the intent of not holding on to the properties but having developers
develop the properties.
(3) Demolition can only be undertaken when new construction is a part of the overall
scope of the project.
(4) Conversion of an existing structure to affordable housing is rehabilitation, unless the
conversion entails adding one or more units beyond the existing walls, in which
case, the project is new construction of purposes of this part.
HOME projects must provide housing assistance to low and moderate-income households, as
defined by HUD's HOME Income Limits See attached current Income Limits). HOME
Regulations allow for CHDOs to receive funds for specific project-related expenses.
(B) Leverage Requirements
HOME funds will be used as a gap financing subsidy that is necessary to help make a project
or development cost effective for the intended low-to moderate income beneficiary. HOME
funds may not be used to replace other available County, State or Federal funds, therefore, a
detailed budget outlining all other funds associated with the project must be submitted along with
the application. When a project includes other funding sources, supporting documentation must be
provided of the awarded funding and amounts from other entities (grants, Low Income Housing Tax
Credits, bank financing, donors, etc.) when making an application for assistance.
5
Macon-Bibb County CHDO Application
HOME Investment Partnership
COMMUNITY HOUSING DEVELOPMENT ORGANIZATION (CHDO)
Part I
APPLICATION SUMMARY OF REQUEST
I. Name of agency or organization (as stated exactly on Articles of Incorporation or other
legal organizational documents): _______________________________________
Agency Director____________________________________________________
II. Federal Identification #: ____________________DUNS#____________________
III. Address: ___________________________________________________________
IV. Telephone: ( ___) ______ Fax: ( ___) _________________
V. Email Address: _____________________________________
VI. Contact Person: ___________________________________
Title: _____________________________________________
Telephone: ( ___) ______ Fax: ( ___) _________________
VII. Board Chair: _______________________________________________________
Address: __________________________________________________________
Telephone: ( ) Fax: ( )
Board President: _______________________________________________________
Address: __________________________________________________________
Telephone: ( ) Fax: ( )
VIII. Mission Statement:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
6
PART II
ORGANIZATION
I. Define Capacity
1. Give the name and title of the individual(s) that will be responsible for the success of
this development or project. Please list experience and qualifications of individuals
carrying out activities assisted with HOME funds or related housing development, as
evidenced by:
___ resumes and/or statements that describe the experience of key staff members who
have successfully completed projects similar to those to be assisted with HOME funds,
OR
contract(s) with consultant firms or individuals who have housing experience similar
to projects to be assisted with HOME funds, to train appropriate key staff of the
organization.
2. Please describe your organization’s abilities and expertise regarding financial
management.
3. Please describe your organization’s abilities and expertise regarding construction
project management. Describe your organization’s history and experience in completing
similar projects or developments? Please quantify how successful your organization has
been in conducting these programs or projects.
II. Who will manage the project if key personnel leave your organization?
7
PART III
AFFORDABLE HOUSING DEVELOPMENT PLAN
I. PROJECT NARRATIVE
Please provide a general overview of the proposed project. Please include the type of
activity to be undertaken (single-family new construction, single-family rehabilitation, land
acquisition, etc.) the income range of the target population to be served, the proposed
location, if acquisition of land and/or structures will be involved, the proposed financing, a
detailed summary of the implementation strategy and the role(s) your agency will play in
the overall project.
Please include the following in the program description:
a. Total amount of HOME Funds requested
b. Type of Activity proposed and location
c. Total project cost
d. Use of funds
e. Housing unit information
f. Expected household income level
g. Proposed rents and utility allowances
h. Proposed sales prices for homeowner projects
i. Existing tenant information (for acquisition, rehabilitation projects)
j. Other financial resources secured
8
II. Program/Project Management
Please address the following:
1. Staffing Requirements. Must have paid staff, full-time, part-time or contracted.
First year CHDO can demonstrate capacity with a consultant to train CHDO staff.
Have at least one year of experience serving the community. Have financial
accountability standards that conform to 24 CFR Part 84.21.
2. Schedule. Provide a detailed schedule of the project or development from start
to finish.
3. Site Control. Have the site(s) been identified and secured, or will they have to be
acquired? Examples of site control include a property deed, a sales contract, or a
written option to purchase the property. Is the site in full zoning compliance for
the proposed project, or will a re-zoning or variance be required?
4. Professional Cost Estimates. Has a professional cost estimate been performed
(i.e., by an Architectural and Engineering firm, contractor, or other certified expert?)
If so, please provide the estimate being used as the basis for the project budget
and name the firm that performed it.
5. Preliminary Design Specifications. Have any preliminary designs or
specifications been developed for the project prior to the submittal of this
application? If so, please name the developing firm.
9
DEVELOPMENT TEAM Identify and attach resumes.
A.
Architect:
Contact: ___________
Address:
City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
B.
General Contractor:
Contact:
Address:
City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
C.
Appraiser:
Contact:
Address:
City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
D.
Engineer: Contact:
Address: City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
E.
Cost Estimator: Contact:
Address: City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
F.
Project Attorney: Contact:
Address: City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
10
G.
Property Manager: Contact:
Address: City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
H.
Syndicator or Underwriter: Contact:
Address: City: State: Zip:
Phone:( ) ______________ Fax:( )_________________________
Is there a direct or indirect, financial, or other, interest with other team members or
the applicant? Yes No If yes, describe relationship(s) between entities
and/or principals:
Type of Applicant (Check all that apply and provide documented proof)
( ) Applicant is an existing entity
( ) Applicant is a new entity formed for the purpose of receiving financing from ACC
HCD
( ) Corporation ( ) General Partnership ( ) Limited Partnership
( ) Limited Liability Company ( ) Joint Venture ( )For-Profit ( ) Non-Profit
( ) Housing Authority ( ) Developer ( ) Contractor
( ) CHDO(If CHDO, is agency acting as __owner, ___sponsor, and/or ___developer?)
( ) Other (specify)
11
PRINCIPALS OF APPLICANT
Provide contact-information and ownership stake for Managing Partner,
General Partners and all Corporate Officers:
Name Address Phone/Email Title %
Managing Entity
President/Director
Project Manager
Secretary/Treasurer
Other Officer(s) or
Partners
CO-APPLICANT INFORMATION (If applicable)
Name
Address
Mailing Address (if different)
City
State & Zip
Federal Identification #
Phone & Fax
E-mail address
Does applicant and/or co-applicant have or is applicant and/or co-applicant delinquent on
local,
federal and/or state debt? ( )Yes ( )No
Has applicant and/or co-applicant ever filed in bankruptcy court? ( )Yes ( )No If yes,
which court and when. Discharge date? .
Does applicant and/or co-applicant have unresolved local, federal, or State findings? ( )Yes ( )No
Is applicant and/or co-applicant delinquent on the filing of any federal or State tax returns?
( )Yes ( )No (If the answer to any of these questions is “yes”, please provide explanation and
attach an additional sheet if more space is needed.)
12
EVIDENCE OF SITE OR PROPERTY CONTROL
(Provide this information for each address on which you will be completing your project)
Identify and attach
supporting documentation.) Applications submitted without this information will not be considered.
Address:
Checklist:
_____Warranty Deed (recorded)
_____Contract for Deed
_____Purchase Option
_____In Escrow
_____Earnest Money
_____Contract
_____Long term Contract for Lease
______
Long term Option to Lease
_____Notice to Purchase
:
Expiration of Contract or Option: / /
Expiration of Feasibility Contingency: / /
(applies to pre-development loans only)
Expiration of Financing Contract:
Anticipated Closing Date:
/
/
/ /
13
DESCRIPTION OF PROJECT
TYPE (check all that apply)
____
Multifamily Rental
____Residential Condominium
____Townhouse Units
____Duplexes
____Single Floor (flats) Unit
____Congregate Care
Elderly Housing
____Emergency Shelter
____Transitional Housing
____Detached Single Family Residences: New Construction, scattered site
____Detached Single Family Residences: Rehabilitation, scattered site
____
Detached Single Family Residences: Subdivision
____Attached Single Family Residences: New Construction
____Rehabilitation
____Other: (specify)
SITE DESCRIPTION
Size: ______acres or square feet of proposed structure(s)
Is the property zoned for intended use? ___Yes ____No
Is the present use non-conforming under existing zoning restrictions? ___Yes ___
No
Is
the property in the process of rezoning? ____Yes ____No
Current zoning (or describe permitted uses):
Flood Zone Designation:
(
Describe)
Topography
Mark all proposed or existing off-site facilities.
( )Electric ( )Gas ( )Storm Drains ( )Water - Public
( )
Water - Private ( )Sidewalks
( )Street Lights ( )Fire Hydrants
( )
Sewers-public ( )Sewers-private ( )Paved Streets
( )Concrete Curbs
( )
Rolled Curbs ( )Well ( )Septic
Expected date of availability: / /
14
DESCRIPTION OF IMPROVEMENTS
(Acquisition, rehabilitation, resale- rental projects only)
Total # Units: # Buildings: # Floors: Age: years
Current vacancies: as of / / # Program Units: Net Residential Sq. Ft.:
Common Area Sq. Ft. Non-Residential Sq. Ft.: Gross Sq. Ft.
For Housing Unit Rehab projects identify and attach a detailed, line by line work write-up for
each unit on
which you propose to complete work.
CONSTRUCTION SPECIFICATIONS
Please provide a complete listing of your construction specifications.(See examples below.)
Wood Frame Steel Frame Masonry
Poured
-in-place Concrete
Forced Air Unit
Central Heat & Air
Heat Pump System
INTERIOR FEATURES & SPECIFICATIONS
Continue listing of your construction specifications. ( See examples below.)
Range & Oven
Hood & Fan
Garbage Disposal
Dishwasher
Refrigerator
Microwave
Washer & Dryer
Wash/Dry Conn.
ON-SITE AMENITIES – Rental Developments Only
Continue listing of your construction specifications. ( See examples below.)
Community Room
Recreation Room
Crafts Room
Tennis Court
Common Dining
Residential Kitchen
VALUATION INFORMATION
Required if funds are used for the acquisition of single family lots. List for each property
under
consideration. If appraisal is complete, please attach.
APPRAISED VALUE
Property Address:
Land Only: $______________________________ Date of Valuation:
Existing Building (as is): $___________________ Date of Valuation:
Proposed Building (as completed): $_____________ Date of Valuation:
Appraiser: Name ____________________________________________________________________
Address: _________________________________________________________________
City: ______________ State: __________ Zip:__________ Telephone: ( ) ____________________
ASSESSED VALUE
Property Address:
Land Only: $______________________________ Date of Valuation:
Existing Building (as is): $___________________ Date of Valuation:
Proposed Building (as completed): $_____________ Date of Valuation:
All OTHER SOURCES OF FUNDS(if additional space is necessary, attach information directly behind this page)
15
PART IV
PROPOSED FINANCING
Please list all project funds, their source, their terms and conditions (grant/loan rate and
term) and then allocate these funds appropriately.
Pro forma
All applicants must submit a well-documented pro forma supporting the financing and
ongoing
maintenance of the project. In addition to the pro forma, information to be
submitted includes any of the
following as applicable:
•
all sources of secured financing and a description of the financing;
•
documentation of all projected expenses;
•
rental rates;
•
for homeownership projects, projected sale prices.
Additional Comments:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
16
CERTIFICATION
I certify that (Organization Name) is in
good standing with all Departments of Macon-Bibb County Government, including, but
not limited to, the Tax Assessor, Public Utilities, Central Services and Building
Inspections.
I understand that the following documentation and/or certifications are required to receive
a HOME Investment Partnership Loan from Macon Bibb County:
•
Articles of Incorporation & Bylaws
•
Non-profit determination (if applicable)
•
List of Board Members
•
Designation of Authorized Official(s)
•
Board Resolution Authorizing Grant Signatories
•
Annual Financial Statements
•
Signed Anti-lobbying Certification
•
Signed Drug Free Workplace Certification
Signature and Title Date
17
CERTIFICATION
In accordance with the applicable statutes and the regulations governing the consolidated
plan regulations,
I certify that (Organization Name):
Drug Free Workplace -- Will or will continue to provide a drug-free workplace by:
1.
Publishing a statement notifying employees that the unlawful manufacture,
distribution,
dispensing, possession, or use of a controlled substance is prohibited
in the grantee's workplace
and specifying the actions that will be taken against
employees for violation of such prohibition;
2.
Establishing an ongoing drug-free awareness program to inform employees about -
(a)
The dangers of drug abuse in the workplace;
(b)
The grantee's policy of maintaining a drug-free workplace;
(c)
Any available drug counseling, rehabilitation, and employee assistance
programs; and
(d)
The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
3.
Making it a requirement that each employee to be engaged in the performance
of the grant be
given a copy of the statement required by paragraph 1;
4.
Notifying the employee in the statement required by paragraph 1 that, as a
condition of
employment under the grant, the employee will -
(a)
Abide by the terms of the statement; and
(b)
Notify the employer in writing of his or her conviction for a violation of a
criminal drug statute occurring in the workplace no later than five calendar
days after such conviction;
5.
Notifying Macon-Bibb County in writing, within ten calendar days after receiving
notice under
subparagraph 4(b) from an employee or otherwise receiving actual
notice of such conviction. Employers of convicted employees must provide notice,
including position title, to every grant officer or other designee on whose grant
activity the convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice shall include the
identification number(s) of each affected grant;
6.
Taking one of the following actions, within 30 calendar days of receiving notice
under
subparagraph 4(b), with respect to any employee who is so convicted -
(a)
Taking appropriate personnel action against such an employee, up to
and including
termination, consistent with the requirements of the
Rehabilitation Act of 1973, as
amended; or
18
(b)
Requiring such employee to participate satisfactorily in a drug abuse
assistance or
rehabilitation program approved for such purposes by a
Federal, State, or local health, law enforcement, or other appropriate
agency;
7. Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs 1, 2, 3, 4, 5 and 6.
Anti-Lobbying -- To the best of the jurisdiction's knowledge and belief:
1.
No Federal appropriated funds have been paid or will be paid, by or on behalf of it,
to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan, or
cooperative agreement;
2.
If any funds other than Federal appropriated funds have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal contract,
grant, loan, or cooperative agreement, it will complete and submit Standard Form-
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions;
and
3.
It will require that the language of paragraph 1 and 2 of this anti-lobbying
certification be
included in the award documents for all sub-awards at all tiers
(including subcontracts, sub-
grants, and contracts under grants, loans, and
cooperative agreements) and that all sub-recipients
shall certify and disclose
accordingly.
Section 3 (organization name) will
comply with section 3 of the Housing and
Urban Development Act of 1968, and
implementing regulations at 24 CFR Part 135.
Signature/Authorized Official Date
Title
CHDO BOARD MEMBER
CERTIFICATION
Signature: ___________________________________ Date: ______________________
Printed Name: _____________________________________________________________
Title: ____________________________________________________________________
Select Only One:
( ) Public Official or Employee
I am a public official or a public employee because I represent one of the following positions:
___elected official – council members, aldermen, commissioners, state legislators, members of
school board, etc.
___appointed public officials-members of a planning or zoning commission, or of any other
regulatory and/or advisory boards or commissions that are appointed by a PJ official.
___public employees-all employees of public agencies (including the schools) or departments
of the PJ’s government (e.g., a clerk in the water and sewer department, a public official (as
described above) to serve on the CHDO board.
___appointed by a public official-any individual who is not necessarily a public official, but who
has been appointed by a public official (as described above) serve on the CHDO board.
( ) Member of Low-Income Household
I am a member of a household of____persons that has a combined total expected income for year
_____, which is less than 80% of the area median income for a household of this size. (see Income
Limits below)
( ) Resident of Low Income Area
I reside in census tract/block group number___________which in the 2010 census had at least
51% of its households with incomes less than 80% of the area median income.(see Income Limits
below)
( ) Elected Representative of Low-Income Group
I am elected by the membership of an organization whose membership is open to all resident of
a defined neighborhood in which the 2010 census shows that more than 50% of the households
have incomes less than 80% of the area median income and my position on our governing body
is primarily as a representative of that neighborhood group.
The group name is and the census tract/block
group numbers served by the neighborhood group are .
( ) Not a Low Income Representative
80% of Median Income Limits by Household Size
*See the attached HOME Income Limits
HOME PROGRAM
CHDO BOARD OF DIRECTORS COMPOSITION
Board Member Name
Occupation
Address
Member of
Low-Income
Household
Resident
of Low
Income
Area
Elective
Representative
of a Low-Income
Group
Not a Low-
Income
Representative
Public
Official
1
2
3
4
5
6
7
8
Total
• Public representatives cannot be qualified as low-income representatives, even if they meet the qualifying criteria. No more
than1/3 of the Board Members may be Public Officials.
• CHDO’s must be accountable to the low-income residents of its service area by maintaining at least one-third of its governing
body representing the established service area.
• The one-third low-income resident and public officials’ representations are based upon the total maximum number of board
members identified in the by-laws. Vacancies in the board membership do not reduce these requirements.
HUD Income Limits
HUD is required by law to set income limits that determine the eligibility of applicants for HUD’s assisted programs. According to HUD, Household Income is
the sum of money income received in the previous calendar year by all household members who are 15 years old and over, including household members
not related to the householder, people living alone, and others in non-family households. Under HUD’s income policies low-income families are defined as
families whose incomes do not exceed 80 percent of the median family income for the area. Very low-income families are defined as families whose incomes
do not exceed 50 percent of the median family inco
me for the area. Extremely low-income families are defined as families whose incomes do not exceed 30
percent of the median family income.
FY 2020 INCOME LIMITS DOCUMENTATION SYSTEM
FY 2020 Income Limits Summary*
(Effective Date April 1, 2020)
FY 2020 Income Limit
Area
Median
Income
FY 2020 Income Limit
Category
Persons in Family
1
2
3
4
5
6
7
8
Bibb County $59,000
Very Low (50%) Income Limits
($)
20,350 23,250 26,150 29,050 31,400 33,700 36,050 38,350
Extremely Low Income Limits
($)*
12,760 17,240 21,720 26,200 30,680* 33,700* 36,050* 38,350*
Low (80%) Income Limits
($)
30,200 34,500 38,800 43,100 46,550 50,000 53,450 61,4 00
*Subject to Change
Macon-Bibb County Consolidated Plan
2020 - 2024
Decent Housing Objectives
Objective: Increase the number of affordable housing units for potential low-to-moderate
income (LMI) homeowners and renters and provide training and educational classes to assist
those LMI families in housing-related matters.
Strategy: Through contractors, build new affordable housing units for LMI homeowners and
renters with an emphasis on construction in existing neighborhoods and areas targeted for
revitalization.
Strategy: Through contractors, acquire and rehabilitate vacant housing units, returning them
to the housing stock as quality, affordable, owner-occupied housing.
Strategy: Through contractors, provide housing-related training and educational classes to
existing and potential LMI homeowners to reduce foreclosures and evictions.
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Part V
ADDITIONAL SUPPORT DOCUMENTS
Checklist: Please mark the forms enclosed in this application. Only submit forms which are
relevant to the agency or the program for which this application is written. (Delete irrelevant
forms to maintain pagination.)
______ Resolution of Application (Required for all applications)
______ Conflict of Interest Forms from each member of the Board of Directors (Required for
all applications)
______ Conflict of Interest Disclosure Forms (Required, if relevant)
______ Conflict of Interest Disclosure Form Attachments (Required, if relevant)
______ Acknowledgement of Religious Organization Requirements (Required for all
applications from religious organizations.)
HOME Investment Partnership Program
Community Housing Development Organization
Macon-Bibb County - Economic & Community Development Department
PROGRAM YEAR 2020
APPLICATION
RESOLUTION
I, the Certifying Representative of
(name and title) authorize the application for_______________________(name of nonprofit)
and use of funds from the Macon Bibb County Economic and Community Development
Department for activities described in the proposal and, if awarded funds, shall implement the
activities in a manner to ensure compliance with all applicable federal and local laws and
regulations.
Signature of Certifying Representative Date
Printed Name of Certifying Representative Telephone Number
Job Title of Certifying Representative
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HOME Investment Partnership Program
Community Housing Development Organization
Macon-Bibb County - Economic & Community Development Department
Program Year 2020
APPLICATION
CONFLICT OF INTEREST
Federal Law (24 CFR 85.36 for governments, 24 CFR 84.42 for private non-profits) prohibits persons
who exercise or who have exercised any functions or responsibilities with respect to the Emergency
Solutions Grant…or who are in the position to participate in a decision making process or to gain inside
information with regard to such activities, may obtain a financial interest or benefit from an assisted
activity…either for themselves or those whom they have family or business ties, during their tenure or
for one year thereafter.
I hereby certify that the information provided on the Conflict of Interest Disclosure Form(s) is true and
accurate to the best of my knowledge. I also certify that to the best of my knowledge and belief, no staff
member of the Board of Director’s, nor officer of _____________________________ (agency) is
currently, nor has been within one year of the date of this application, employed by the local government
or as an employee of the Economic and Community Development Department, nor serves as an elected
official of the local government (Macon Water Authority, Board of Commissioners, Court Clerk, Judge,
etc.). In cases where an elected official may serve on the board of the agency, the officials department
and position will need to be disclosed on the Conflict of Interest Document Disclosure form.
I further attest that no staff member, member of the Board of Director's, nor officer of the applicant
agency, is a business partner or immediate family member of a County employee, a member of the
Economic and Community Development Department, or an elected member of the local government.
Funds requested will not be used to pay the salaries of any of the applicant agency's staff nor will the
applicant agency award a subcontract to any individual who is or has been within one year of the date of
this application a county employee, a member of the Economic and Community Development
Department, or a member of the local government.
Name: _____________________________________ Signature: ______________________________
Title: _____________________________________ Date: ___________________________________
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CONFLICT OF INTEREST DISCLOSURE FORM
Conflict of Interest Regulation. No persons who exercise or have exercised any functions or responsibilities with respect to
activities assisted with federal funds or who are in a position to participate in a decision making process or gain inside
information with regard to these activities, may obtain a financial interest or benefit from an assisted activity, or have an
interest in any contract, subcontract or agreement with respect thereto, or the proceeds there under, either for themselves or
those with whom they have family or business ties, during their tenure or for one year thereafter.
Name: ____________________________________ Program Name: _____________________________________
Address: ____________________________________ Program Client #: __________________________________
City, State, Zip: _____________________________ Contractor/Vendor#: ____________________________
The purpose of this document is to assist in the determination of whether additional restrictions, oversight, or other conditions
might be advisable prior to execution of any contract, funding or providing assistance. The term “Conflict of Interest” refers to
situations in which financial or other personal considerations may compromise or have the appearance of compromising
professional judgment in following the rules and regulations of the program. Please check the appropriate box for each
question and complete the attachment if indicated. This form (with Attachments, if required) must be completed and returned
to your Program Representative.
A. Family Relationships:
Do you have a family member directly or indirectly involved or employed with YOUR ORGANIZATION that creates a
conflict of interest or the appearance of a conflict under the Conflict of Interest Regulation provided above?
YES NO (if YES, please complete Part A of the Attachment)
B. Program Relationships:
Are you involved in any other activity directly or indirectly with YOUR ORGANIZATION that may create a conflict of
interest or the appearance of a conflict under the Conflict of Interest Regulation provided above?
YES NO ( if YES, please complete Part B of the Attachment)
C. Business Relationships:
Are you or a family member (spouse, child, stepchild, parent, sibling, or domestic partner) involved as an investor, owner,
employee, consultant, contractor, or board member with an entity that has a contractual relationship with YOUR
ORGANIZATION to provide goods or services, sponsor development activities and/or receive referrals from YOUR
ORGANIZATION?
YES NO (if YES, please complete Part C of the Attachment)
D. Gifts for Personal Use:
To the best of your knowledge, have you or your family members accepted gratuity gifts, or special favors from someone that
is doing business with or proposing to do business with YOUR ORGANIZATION?
YES NO (if YES, please complete Part D on Attachment)
To the best of your knowledge, have you or your family members made any donations or gifts, or provided special favors to
YOUR ORGANIZATION or any employee of the YOUR ORGANIZATION who exercises or may exercise any functions or
responsibility with respect to the activities involving your award, contract or program assistance.
YES NO (if YES, please complete Part D on Attachment)
E. Legal Proceedings and Debarment
Have you been involved in any fraud, antitrust or criminal proceedings as a defendant (other than a minor traffic offense) or
been debarred, suspended or otherwise excluded by a duly authorized regulatory agency or had a transaction with any such
agency terminated for any reason?
YES NO (if YES, please complete Part E on Attachment)
I have read and understand the Conflict of Interest Disclosure Form and have disclosed all information required by this
disclosure, if any, in an attached statement. I agree to comply with any conditions or restrictions imposed by the agency to
reduce or eliminate actual and/or potential conflicts of interest. I will update this disclosure form promptly if relevant
circumstances change. I understand that this Disclosure Form is not a confidential document.
Print Name: ________________________________ Date: ____________________________
Signature: ________________________________ Date: ____________________________
CONFLICT OF INTEREST DISCLOSURE FORM
ATTACHMENT
Conflict of Interest Regulation. No persons who exercise or have exercised any functions or responsibilities with respect to
activities assisted with federal funds or who are in a position to participate in a decision-making process or gain inside
information with regard to these activities, may obtain a financial interest or benefit from an assisted activity, or have an
interest in any contract, subcontract or agreement with respect thereto, or the proceeds there under, either for themselves or
those with whom they have family or business ties, during their tenure or for one year thereafter.
Name: _________________________________ Program Name: ________________________________
Address: _____________________________ Program Client #: ______________________________
City, State, Zip: _____________________ Contractor/Vendor#____________________________
If you answered YES to any question on the previous page, please complete the relevant section(s) below. If you answered
No to All questions, you may discard this attachment. Give your completed form to your Program Representative.
PART A: FAMILY RELATIONSHIPS
1. Name of your family member (s) directly or indirectly involved or employed at YOUR ORGANIZATION:
2. Do any of your family members work in the program area? _________________________
3. Are any of your family members elected officials or members of the Local Housing Authority Board of Commissioners?
_________________________________________________________________________________________
4. Relationship to you: ____________________________ Position: _______________________________
Department: __________________________________ Supervisor: _____________________________
PART B: PROGRAM RELATIONSHIPS
1. Activities: Name and describe the activity and/or program that you are directly or indirectly involved with:
2. Have you used the name of YOUR ORGANIZATION, or their resources (facilities, personnel, or equipment), or confidential
information in connection with the activity and/or program?
YES NO if YES, describe the resource used:
PART C: BUSINESS RELATIONSHIPS
Please complete this section for each business relationship or attach a separate explanation of business and research activities.
1. Name of business: ______________________________________________________________________
2. Categorize the business’ relationship with YOUR ORGANIZATION.
Consultant or advisor
Research activities
Business or referrals
Other contractual or business relationship
Briefly, describe the business, or licensing activity:
3. Have you used YOUR ORGANIZATION’s name, resources (facilities, personnel, or equipment), or confidential information
in connection with the activity?
YES NO if YES, describe the resource used:
4. Who is involved with the business? Check all that apply:
Yourself
Your family member (name and relationship) ______________________________________________________
Describe the position or involvement (check all that apply):
Owner/Investor
Board Member
Employee/Manager
Other ______________________________________________________________________________________
5. Are you receiving any type of compensation? No Yes: If yes, describe _______________________________
_________________________________________________________________________________________________
6. Who at YOUR ORGANIZATION oversees the relationship with this business?
Name: _____________________________________ Title: _________________________________________
Department: ________________________________ Phone: ________________________________________
PART D: GIFTS FOR PERSONAL USE:
1. What was the dollar value of the gift (s) you or your family member received or donated? _____________________
2. Who was the donor or donee of the gift? _____________________________________________________________
3. What is the donor’s or donee’s relationship with YOUR ORGANIZATION?
______________________________________________________________________________________________
PART E: LEGAL PROCEEDINGS AND DEBARMENT
Describe any legal proceedings or debarment situations: ____________________________________________________
Print Name: _________________________________________ Date: ___________________________
Signature: __________________________________________ Date: ___________________________
ACKNOWLEDGEMENT OF RELIGIOUS ORGANIZATION REQUIREMENTS
1. In accordance with the First Amendment of the United States Constitution - "faith-
based principles set forth at 24 CFR 576.406," - HOME assistance may not, as a
general rule, be provided to primarily religious entities for any activities, including
secular activities.
2. The following restrictions and limitations therefore apply to the use of HOME funds
by any provider which represents that it is, or may be deemed to be, a religious or
denominational institution or an organization operated for religious purposes which
are supervised or controlled by, or operates in conjunction with, a religious or
denominational institution or organization.
3. Any religious entity that applies for and is granted HOME funds for public service
must agree to the following:
a. It will not discriminate against any employee or applicant for employment on the
basis of religion and will not limit employment or give preference in employment to
persons on the basis of religion.
b. It will not discriminate against any person applying for such public services on the
basis of religion and will not limit such services or give preference to persons on
the basis of religion.
c. It will provide no religious instruction or counseling, conduct no religious worship
or service, engage in no religious proselytizing, and exert no other religious
influence in the provision of such public services.
d. HOME funds may not be used for the acquisition of property or the construction or
rehabilitation (including historic preservation or removal of architectural barriers)
or structures to be used for religious purposes or which will otherwise promote
religious interests.
4. HOME funds may be used to rehabilitate buildings owned by primarily religious
entities which are to be used for a wholly secular purpose under the following
conditions:
a. The building (or portion thereof) that is to be improved with HOME assistance
has been leased to an existing or newly established wholly secular entity (which
may be an entity established by the religious entity);
b. The HOME assistance is provided to the lessee (and not to the lessor) to make
improvements;
c. The leased premises will be used exclusively for secular purposes available to all
persons regardless of religious affiliation;
d. The lease payments do not exceed fair market value of the premises as they
were before the improvements were made;
e. The portion of the cost of any improvements that also serve a non-leased portion
of the building will be allocated to and paid by the lessor;
f. The lessor enters into a binding agreement that unless the lessee, or a qualified
successor lessee, retains the use of the leased premises for a wholly secular
purpose for at least the useful life of the improvements, the lessor will pay to the
lessee an amount equal to the residual value of the improvements;
g. The lessee must remit the amount received from the lessor to the recipient or
sub-recipient from which the HOME funds were derived.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THE SPECIFIC REQUIREMENTS
CONTAINED IN THIS ATTACHMENT, AND THAT ELIGIBILITY OF MY
ORGANIZATION'S PROJECT DEPENDS UPON COMPLIANCE WITH THE
REQUIREMENTS CONTAINED IN THIS ATTACHMENT.
____________________________________________ ____________________
SIGNATURE DATE
______________________________________________________________________
NAME / TITLE OF SIGNATURE
_____________________________________________________________________
NAME OF ORGANIZATION
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APPLICATION (Macon-Bibb County, Georgia)

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Completed 24 July 2021

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