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COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICES PROGRAM & (Brevard County Board of Commissioners)

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COMMUNITY DEVELOPMENT BLOCK GRANT
PUBLIC SERVICES PROGRAM & CORONAVIRUS PROGRAM
REQUESTS FOR PROPOSAL
BREVARD COUNTY BOARD OF COUNTY COMMISSIONERS
HOUSING AND HUMAN SERVICES DEPARTMENT
Request for Proposal Number:
2021 Community Development Block Grant Public Services
2021 Community Development Block Grant Coronavirus Program
Under the authority of the Brevard County Board of County Commissioners and subject
to the availability of funds, the Housing and Human Services Department will accept
applications from eligible Organizations in response to this Request for Proposal with a
receipt date of:
Wednesday, February 17, 2021 at 11:00 AM
Applications received after this date/time will not be accepted.
Ian Golden, Director
Housing and Human Services Department
TABLE OF CONTENTS
NOTICE TO POTENTIAL APPLICANTS .............................................................................................. 4
BACKGROUND AND PRIMARY OBJECTIVES........................................................... 4
COMMUNITY DEVELOPMENT BLOCK GRANT ORGANIZATIONS FUNDING
PROGRAM ................................................................................................................... 5
APPLICATION SUBMISSION ...................................................................................... 6
TECHNICAL ASSISTANCE ......................................................................................... 6
PROTEST PROCESS .................................................................................................. 6
DESIGNATED LIAISONS ............................................................................................ 6
TERMS AND CONDITIONS ......................................................................................... 6
COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICE
REQUIREMENTS ...................................................................................................... 10
PART I - DISQUALIFYING CRITERIA ....................................................................... 11
PART II - APPLICATION CHECKLIST ....................................................................... 13
PART III- APPLICATION COVER PAGE AND KEY AGENCY STAFF INFORMATION
................................................................................................................................... 15
PART IV – PROGRAM DESCRIPTION ..................................................................... 18
PART V – AGENCY PROFILE ................................................................................... 19
PART VI - PROGRAM LOGIC MODEL AND EVALUATION PLAN ........................... 20
PART VII – AGENCY FINANCIAL PROFILE & AGENCY WIDE BUDGET ................ 21
PART VIII – PROGRAM BUDGET ............................................................................. 23
ATTACHMENT A SWORN STATEMENT OF PUBLIC ENTITY CRIMES .................. 25
ATTACHMENT B CONFLICT OF INTEREST CERTIFICATION ............................... 27
ATTACHMENT C 2021 PROGRAM CERTIFICATION .............................................. 28
ATTACHMENT D SUSPENSION/DEBARMENT CERTIFICATION ........................... 29
ATTACHMENT E PROGRAM LOGIC MODEL FORM ............................................... 32
ATTACHMENT F EVALUATION PLAN FORM .......................................................... 34
ATTACHMENT G PROGRAM BUDGET INFORMATION .......................................... 35
ATTACHMENT H PROGRAM BUDGET INFORMATION FORM .............................. 37
ATTACHMENT I PROGRAM BUDGET JUSTIFICATION FORM .............................. 38
ATTACHMENT J AGENCY WIDE BUDGET .............................................................. 40
ATTACHMENT K REVIEW CRITERIA ....................................................................... 41
ATTACHMENT L PUBLIC SERVICES OR CORONAVIRUS PROGRAM ................. 42
ATTACHMENT M DEFINITIONS ............................................................................... 44
ATTACHMENT N COMMUNITY DEVELOPMENT BLOCK GRANT REQUIREMENTS
AND NATIONAL OBJECTIVES.................................................................................. 46
ATTACHMENT O 2016-2020 CONSOLIDATED PLAN - PRIORITY NEEDS
SUMMARY ................................................................................................................. 50
ATTACHMENT P HOUSING AND URBAN DEVELOPMENT (HUD) 2020 AREA
MEDIAN INCOME (AMI) LIMITS PROGRAM ............................................................ 51
4
NOTICE TO POTENTIAL APPLICANTS
The purpose of this Request for Proposal is to provide services to Brevard County
Residents consistent with Brevard County Board of County Commissioners’ approved plans
and strategies. Funding for this Request for Proposal will be provided through Brevard
County’s Community Development Block Grant Program. The County anticipates receiving
$216,202.00 for Community Development Block Grant Public Services in Fiscal Year 2021, as
well as Community Development Block Grant Coronavirus Program up to $628,422.00 for the
Prevention, Preparation and Response to Coronavirus.
The Brevard County Board of County Commissioners is interested in funding a wide
range of services for the residents of Brevard County. Programs must be consistent with the
priorities approved by the Brevard County Board of County Commissioners, as outlined below.
Brevard County Board of County Commissioners Priority Areas for Public Services
• Anti-Crime Services
• Child Services (0 to 12 years old)
• Employment Training
• Health Services
• Senior Services
• Substance Abuse Counseling
• Mental Health Counseling Services
• Transportation Services
• Youth Services (13 to 17 years old)
Brevard County Board of County Commissioners Priority Areas for Coronavirus
Program
• Health Services
• Community Nutrition Program
• Child or Adult Day Care Services
• Education Services
• Substance Abuse Services
BACKGROUND AND PRIMARY OBJECTIVES
The Community Development Block Grant Program was established by Congress
through the Housing and Community Development Act of 1974, as amended, to provide local
governments and residents with the funds needed to work in a comprehensive manner
towards the improvement of the quality of life in low- and moderate-income areas. It allows for
local flexibility in determining needs and to develop strategies to address those needs.
Community Development Block Grant Program funds are distributed to areas and agencies
which are determined eligible for funding.
Each Community Development Block Grant Program activity must address one of three
national objectives:
• Benefit low- and moderate-income persons;
• Aid in the prevention or elimination of slums or blight; or
• Meet community development needs having a particular urgency.
Any activity available to residents in an area, where at least 51% of the residents are
low-and moderate-income persons is considered an area benefit activity. The service area
must be primarily residential, and meet the identified needs of low-and moderate-income
5
persons. Client services are limited to residents from the unincorporated areas of Brevard
County outside the boundaries of the cities of Titusville, Cocoa, Melbourne and Palm Bay.
Low to moderate income residents of the incorporated municipalities included in the
2019-2021 Housing and Urban Development and Brevard County Interlocal Agreement are
eligible. These are Cocoa Beach, Indialantic, Indian Harbour Beach, Melbourne Village, Palm
Shores, Rockledge and Satellite Beach.
The service area must be primarily residential, and meet the identified needs of low-and
moderate-income persons. Examples include: public services for the homeless, meals on
wheels for the elderly and vocational training for youth and adults.
Brevard County is interested in funding Community Development Block Grant Public
Services programs and Community Development Block Grant Coronavirus programs for
eligible residents. Programs must enhance, expand, or create new services and meet one of
the Community Development Block Grant National Objectives and be consistent with the
Neighborhood Strategy Area Priorities in the Consolidated Plan. Coronavirus programs must
prevent, prepare for or respond to the Coronavirus.
All applications will be initially reviewed for disqualifying criteria by Housing and Human
Services staff. All applicants requesting funding under this Request for Proposal will be
considered on the basis of their overall merit as determined by the Advisory Board and the
Brevard County Board of County Commissioners review processes.
This application contains information and the required forms for potential applicants to
apply for grant awards. The Brevard County Housing and Human Services Department will be
accepting funding applications from January 20, 2021 through February 17, 2021.
All meeting places are handicap accessible. In accordance with the Americans with
Disabilities Act and Section 286.26, Florida Statutes, persons needing accommodations or an
interpreter to participate in the proceedings must notify the Housing and Human Services
Department, Brian Breslin, no later than forty-eight hours prior to the meeting at (321) 633-
2076.
Applicants are prohibited from contacting members of either the Advisory Board
or the Brevard County Board of County Commissioners regarding the application
process during the period that the applications are being reviewed by the Advisory
Board and being approved by the Brevard County Board of County Commissioners.
Any contact with the Brevard County Board of County Commissioners or the Advisory
Board will disqualify your application.
COMMUNITY DEVELOPMENT BLOCK GRANT ORGANIZATIONS FUNDING PROGRAM
The Housing & Human Services Department operates under the direction of the
Brevard County Manager’s Office and the Brevard County Board of County Commissioners.
The Housing and Human Services plans for the organization, development and evaluation of
Board sponsored programs designed to protect the health, safety and welfare of the general
public, one of which is the Community Development Block Grant Program.
In accordance with the direction of the Brevard County Board of County
Commissioners, the Community Development Block Grant Program was designed to ensure
accountability of organizations awarded funding consistent with the Community Development
6
Block Grant Program National Objectives, to provide a fair and equitable means to establish
and award funding to organizations that are working creatively on "need-based" issues and
concerns of Brevard County Citizens, and to assist in empowering organizations to effectively
plan and implement solutions to a wide range of needs which affect Brevard County citizens.
APPLICATION SUBMISSION
A maximum of two applications for Public Services will be accepted from each
agency. A separate application must be submitted for each program. A maximum of one
application for Coronavirus Program will be accepted from each agency.
Applications must be received on or before February 17, 2021 at 11:00 AM at:
Brevard County Housing and Human Services Department
Attention Request for Proposal:
Number 2021 Community Development Block Grant Public Services or Community
Development Block Grant Coronavirus
2725 Judge Fran Jamieson Way, B-106, Viera, Florida 32940
TECHNICAL ASSISTANCE
A mandatory Technical Assistance Workshop is scheduled prior to the application
deadline on Wednesday, January 27 and Wednesday February 3, 2021 9:00 AM to 12:00
PM at the Brevard County Government Center, Commission Chambers, Building C, 1st
Floor, 2725 Judge Fran Jamieson Way Viera, Florida 32940. Applicants are required to
attend ONE Technical Assistance Workshop in its entirety. We are requesting everyone
R.S.V.P. for one meeting by contacting Iva Mulla at iva.mulla@brevardfl.gov or 321-633-
2007 with your preferred date. We are further requesting that you limit attendees to 2
people per agency to maintain social distancing protocols.
PROTEST PROCESS
Any bidder who is allegedly aggrieved in connection with the solicitation or pending
award of a contract must file a formal written protest with the Assistant Director and
Purchasing Manager within five business days of the posted award recommendation. A
complete copy of this procedure can be found on the Housing and Human Services website at
Brevard Housing and Human Services Department's Website.
DESIGNATED LIAISONS
If you have any questions or require assistance concerning this application contact Alan
Woolwich, Community Planner at alan.woolwich@brevardfl.gov, or Siphikelelo Chinyanganya,
Contracts Administrator at siphikelelo.chinyanganya@brevardfl.gov or via telephone at (321)
633-2076.
TERMS AND CONDITIONS
1. Applicants acknowledge that all information contained within the response is
public record to the extent required by State of Florida Public Records Laws. Sealed
Proposals are exempt from public record until the agency provides notice of decision or within
ten days after Proposal opening, whichever is earlier. Financial statements, if required, are
exempt from disclosure under 119.071(l)(b)(c), Florida Statutes.
7
2. Applications may be made only by the governing bodies of 501(c)(3), not-for-
profit organizations and public agencies. This program is not a pass-through grant program.
The applicant will be legally, administratively, and fiscally responsible for the grant.
3. Providers of services must be in compliance with all city, county, state licensing
and/or accreditation/certification and regulatory requirements. Additionally, all applicants must
provide verification regarding past suspensions/debarments. Without documentation of
licenses/accreditation (or a statement as to why licensure is not required) and past explanation
of suspensions/debarment, applications will be considered ineligible and will not be considered
for review. These certifications must be submitted with the application,
Suspension/Debarment Certification (Attachment D).
4. All applicants must read, sign, and comply with the Sworn Statement of Public
Entity Crimes (Attachment A) prior to entering into a Contract with Brevard County (the
County).
5. The County will not reimburse applicant for any costs associated with the
preparation and submittal of any responses to this Request for Proposal.
6. The awards made pursuant to this Request for Proposal are subject to the
provisions of Chapter 112, Part 111, Florida Statutes, Conflict of Interest Certification
(Attachment B). All applicants must disclose with their responses the name of any officer,
director, or agent who is also an employee of the County. Further, all applicants must disclose
the name of any County employee who owns, directly or indirectly, any interest of five percent
or more in the applicant’s firm or any of the applicant’s branches/subsidiaries.
7. Applicants, their agents, and associates shall refrain from discussing or soliciting
any County official regarding this Request for Proposal during the selection process. Failure to
comply with this provision will result in disqualification of the applicant. Only the designated
liaisons listed in this response may be contacted.
8. Applicant must not discriminate as to race, sex, color, creed, age, handicap, or
national origin in the operations conducted under this engagement.
9. Due care and diligence has been exercised in the preparation of this Request for
Proposal. The responsibility for determining the full extent of the services required rests solely
with those making responses. Neither the County nor its representatives shall be responsible
for exercising the professional judgment required in determining the final scope of services
which may be required.
10. Each applicant is responsible for full and complete compliance with all laws,
rules, and regulations including those of the Federal Government, State of Florida, and
applicable local ordinances. Failure or inability on the part of the applicant to have complete
knowledge and intent to comply with such laws, rules, and regulations shall not relieve any
applicant from its obligation to honor its response and to perform completely in accordance
with its response.
11. The County, at its discretion, reserves the right to waive minor informalities or
irregularities in any responses, request clarification of information from applicant, reject any
and all responses in whole or in part, with or without cause, and accept any response, if any,
which in the County's judgment, will be in the County's best interest.
8
12. Any interpretation, clarification, correction, or change to the Request for Proposal
will be made by written addendum issued by the Brevard County Housing and Human
Services Department. Any oral or other type of communication concerning the Request for
Proposal shall not be binding.
13. Any proposals submitted before the deadline may be withdrawn by written
request received by the County before the time fixed for receipt of Proposals. Withdrawal of
any Proposal will not prejudice the right of the applicant to submit a new or amended Proposal
as long as Brevard County receives the Proposal by the deadline as provided herein.
14. For good and sufficient reason, the County may extend the response deadline.
Should an extension occur, all parties who received a Request for Proposal will receive an
addendum setting forth a new date and time for the response deadline. Notice will be provided
by email and the addendum will be posted on the Housing and Human Service’s website.
Applicants are responsible for ensuring they have received all addenda.
15. All applicants must read, sign, and comply with the 2020-2021 Program
Certification and Suspension/Debarment Certification (Attachments C and D).
16. Applicants must apply for a minimum of $25,000.
17. Applicants must identify a minimum of a twenty-five percent program match
(cash, grants or in-kind service) for Public Services. Match requirements are waived for
Coronavirus programs. The match cannot be from other federal sources of funding.
18. Applicants must demonstrate a community need for the proposed activity through
the use of existing community studies or priorities identified in the 5 Year Consolidated Plan or
by the Board of County Commissioners.
19. Applicants must demonstrate the ability to generate and/or acquire funding
needed to carry out the proposed activity in its entirety.
20. If your agency has been monitored by any funding agency (other than Housing
and Human Services) within the past 12 months, please provide a copy of the monitoring
report. If never monitored, please provide an explanation (Appendix 1).
21. Applicants must not utilize requested funding to supplant other funds.
22. The Advisory Board reserves the right to make funding recommendations at or
below the amount requested by the applicant.
23. All awards are contingent upon funding availability from the Board of County
Commissioners.
24. The successful applicants shall be required to submit copies of all current
Licenses/Certifications required to provide the services outlined in this Request for Proposal
(Appendix 6).
25. The successful applicants shall be required to enter into a cost reimbursement
contract that will be provided by the County that incorporates the requirements of this Request
for Proposal.
26. The successful applicants shall hold harmless, indemnify and defend the County,
its Commissioners, employees, representatives and agents against any claim, action, loss,
9
damage, injury, liability, cost and expense of whatsoever kind of nature arising out of or
incidental to applicant’s services under this Agreement. Consideration for this indemnification
provision will be included in the applicant’s hourly rate.
27. Applicants awarded funding to provide services under this agreement will be
required to procure and maintain, at their own expense and without cost to the County, until
final acceptance by the County of all products or services covered by the purchase order or
contract, the following types of insurance. The policy limits required are to be considered
minimum amounts. Applicants, prior to the signing of a contract and before starting any work
on this project, shall be required to submit any applicable Certificate of Insurance for Program
Activities (Appendix 7) as follows:
a. Worker's Compensation – the insurance required by this section shall comply with the
Florida Worker’s Compensation Law and include employer’s liability insurance with
limits of not less than those required by the State of Florida or local jurisdiction,
whichever is higher.
b. Comprehensive General Liability – in an amount of no less than those required by the
State of Florida or local jurisdiction, whichever is higher, including coverage for
operations, products completed operations, broad form property damage, and bodily
personal injury, insuring the Contractor and any other interests, including but not limited
to, any associated or subsidiary companies involved in the project. The Comprehensive
General Liability Insurance shall include contractual liability insurance applicable to the
Contractor’s obligations under the Rehabilitation Construction Agreement.
c. Liability Insurance - in an amount not less than $1,000,000 for bodily injuries, including
wrongful death to any one person, and subject to the same limit for each person, in an
amount not less than $1,000,000 for damages on account of all accidents. Policies
shall name the Brevard County Board of County Commissioners as an additional
insured, only in respect to liability arising out of operations on behalf of the Brevard
County Housing and Human Services Department.
d. Auto Liability Insurance - which includes coverage for all owned, non-owned, and rented
vehicles with a $1,000,000 combined single limit for each occurrence, if applicable.
e. In the event that the contract involves professional or consulting services, in addition to
the aforementioned insurance requirements, the applicant shall also be protected by a
Professional Liability Insurance Policy in the amount of $1,000,000 per claim.
f. The applicant shall provide certificates of insurance to the County demonstrating that
the aforementioned insurance requirements have been met prior to the commencement
of work under this contract. The certificates of insurance shall indicate that the policies
have been endorsed to cover the County as an additional insured and that these
policies may not be cancelled or modified without thirty days prior written notice to the
County.
g. The insurance coverage enumerated above constitutes the minimum requirements and
shall in no way lessen or limit the liability of the applicant under the terms of the
contract.
10
COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICE REQUIREMENTS
Program Processes and Required Supporting Documents
Annually, a Request for Proposal process is conducted to allow organizations the
opportunity to competitively apply for funding for eligible public service activities.
All organizations applying for funding shall provide proof of all required insurance
necessary for carrying out the proposed activity (i.e., general liability, comprehensive liability,
etc.)
1. Unallowable Cost
The following expenditures are not allowed. Community Development Block Grant
Public Service funds cannot be applied to these items directly or indirectly.
a. Costs incurred prior to April 1, 2021 for Public Services. Costs incurred prior to
April 1, 2021 for Coronavirus Program. One exception is for an annual audit that
is billed after October 1, 2020. Costs of the organization-wide audit must be
prorated among the various funding sources that require such an audit.
b. Outlay for Capital Projects, including acquisition of real property.
c. Costs associated with services that have a sectarian religious component or
basis.
d. Local mileage reimbursements in excess of $0.56 per mile. If the agency has a
higher rate, it should be charged to other funds of the agency to cover the
difference. However, no out-of-county or out-of-state travel reimbursement is
allowed.
e. Bad debts, fines, penalties, bonuses, and commissions.
f. Organization's reserve accounts.
g. Contributions or donations.
h. Expenses associated with entertainment. This exclusion does not include an
organization's regular recreational functions that are part of the organization's
established client programming.
i. Lobbying or other associated legislative expenses whether incurred for purpose
of legislation or executive direction.
j. "Miscellaneous" or "Other" line items.
k. Legal expenses for the prosecution of claims against any public entity.
l. Expenditures that are not applied to specific services. If county funds are
requested to be applied to activities of the entire agency, e.g., rent, utilities,
insurance, administrative salaries, etc., then these funds must be allocated
proportionately to specific services or programs.
m. Costs incurred by organizations in responding to this application.
n. Memberships, dues, and paid subscriptions will not be reimbursed. National
dues to a parent organization will not be reimbursed.
11
o. Fund raising expenses.
p. Construction and renovation cost.
2. Ineligible Funding Requests
a. Organizations whose primary function is fund raising for other agencies.
b. Organizations that coordinate and distribute funds to local organizations with no
direct services are not eligible for funding under this program.
c. Proposals from any organization that does not have a non-profit incorporation
and 501(c)(3) designations, and has not filed I.R.S. 990, and not received an
audit conducted by an independent auditor. Financial statement is acceptable if
agency audit is not required.
d. Proposals from organizations that do not meet one of three national Community
Development Block Grant objectives.
PART I - DISQUALIFYING CRITERIA
An application will be disqualified if it contains any of the disqualifying criteria
listed below. The following criteria will disqualify an application.
• If the application is not consistent with the following technical requirements:
• Applicants must submit; one original printed and signed application,
seventeen application copies, that are a minimum 12 point in font, single-
spaced, two-sided, have one-inch margins, three-hole punched on the left
side, with numbered tab dividers for each part, attachments and
appendices. All pages must be numbered, and tab dividers must be legible
and be included in a table of contents at the beginning of the Request for
Proposal. Submitted applications and supporting documents must be
bound using single binder clips ¾ inch or larger per copy. Applications
shall not include undersized clips, staples, rubber bands or ring binders.
The original application copy shall be provided on a flash drive in a labeled
and secured envelope or sleeve.
• If an agency does not submit one original response and all required attachments
and appendices to the Request for Proposal.
• If an application is not formatted with the outline, headings and subheadings as
identified in this Request for Proposal.
• If all required attachments and appendices are not completed and submitted with
the application.
• If an agency contacts anyone regarding this Request for Proposal other than the
Housing and Human Services Designated Liaisons listed on page 6.
• If an agency submits more than the maximum of two applications for Public
Services and the maximum of one for Coronavirus Program, all will be
disqualified.
• If all page limitations identified in this Request for Proposal are not met.
12
• If an application is not submitted by due date and time of Wednesday, February
17, 2021, 11:00 AM.
• If an application does not clearly demonstrate a twenty-five percent match for
Public Services applications.
• If any requested information is missing, then the application is disqualified.
• If an application is missing the current forms provided within this application.
• If an applicant does not attend and sign in at mandatory ONE Technical
Assistance Workshop in its entirety.
• If an applicant requests less than the minimum ($25,000).
• If the amount requested on Cover Page (Page 16) does not match the amount
requested on the Program Budget Form (Page 37).
I acknowledge that I have read and understand the Disqualifying Criteria listed
above. I further acknowledge that all of the required items listed on the checklist are
included in this application.
Agency Name: ________________________________________________________
Name/Title: ________________________________________________________
Signature: ________________________________________________________
Date: ________________________________________________________
13
PART II - APPLICATION CHECKLIST
Agency Name: _________________________________________________________
PARTS I and II: TABLE OF
CONTENTS, DISQUALIFYING
CRITERIA AND CHECKLIST
A: Disqualifying Criteria
B: Application Checklist
PART III: COVER PAGE AND KEY
AGENCY STAFF FORM
A: Cover page
B: Key Agency Staff
PART IV: PROGRAM DESCRIPTION
A: Statement of Need
B: Scope of Service
C: Program Promotion
D: Organizational Chart
E: Job Description
F: Collaboration Narrative
PART V: AGENCY PROFILE
A: Profile
B: Trends/Changes
C: List of Partners, etc.
PART VI: PROGRAM LOGIC MODEL
AND EVALUATION PLAN
A: Program Logic Model
(Attachment E)
B: Evaluation Plan (Attachment F)
PART VII: AGENCY FINANCIAL
PROFILE & AGENCY WIDE BUDGET
A: Agency Financial Profile
B: Agency Wide Budget
(Attachment J)
PART VIII: PROGRAM BUDGET
A: Program Budget (Attachment H)
B: Program Budget Justification
(Attachment I)
C: Program Budget Narrative
ADDITIONAL ATTACHMENTS & APPENDICES TO APPLICATION
• Attachment A: Sworn Statement of Public Entity Crimes*
• Attachment B: Conflict of Interest Certification*
• Attachment C: 2020-2021 Program Certification*
• Attachment D: Suspension/Debarment Certification*
• Appendix 1: Monitoring Reports other than Housing and Human Services*
• Appendix 2: 501(c)(3) Certification*
• Appendix 3: Recent IRS Form 990*(signature page only)
• Appendix 4: Job Descriptions, Resumes/Biographical Sketches of key employees
and contractors
• Appendix 5: Signed Board Minutes/Letter Approving Application Submittal and
Signature Authority*
• Appendix 6: Licenses/Certifications*
• Appendix 7: Certificate of Insurance for Program Activities*
• Appendix 8: Leverage Documentation
14
• Appendix 9: Letters of Commitment (for funding or in-kind services) – not Letters
of Recommendation. Shall include detail on contribution amount.
• Appendix 10: Organization Chart
• Appendix 11: Articles of Incorporation/By-Laws
• Appendix 12: List of Board of Directors
• Appendix 13: 2019 Audit Report and Management Letter, or Financial
Statement* (Financial Statement is acceptable if agency audit is not required.)
• Appendix 14: Balance Sheet & Income Statements. Last year to present.
*Include those items indicated by (*) in the one original application packet only.
Page 15
PART III- APPLICATION COVER PAGE
AND KEY AGENCY STAFF INFORMATION
COMMUNITY DEVELOPMENT BLOCK GRANT
PUBLIC SERVICE PROGRAM AND CORONAVIRUS PROGRAM APPLICATION
Agency Legal Name: ____________________________________________________________
Agency dba (if applicable): _______________________________________________________
Street Address: ________________________________________________________________
Mailing Address: _______________________________________________________________
Agency Web Address: __________________________________________________________
Federal Identification Number: _____________________________________________________
Main Telephone: ______________________ Main Fax: ____________________________
Program Name:
Program site(s):
Primary Geographic Service Area:
North Central South County-wide
Application Submittal: Public Services Coronavirus Program
Application Type: New Continuing
Amount Requested for Funded Program FY 2019-2020
FY 2021
Will Community Development Block Grant Public Service
funds be used to leverage funds from another source?
Yes
No
Will Community Development Block Grant Public Services
funds be used to match funds from another source? (Match
waived for Coronavirus Program)
Yes
No
0.00%
16
CHECK WHICH BREVARD COUNTY BOARD OF COUNTY COMMISSIONER
PRIORITY THE PROGRAM WILL ADDRESS:
PUBLIC SERVICES
Anti-Crime Services Services for Individuals with Disabilities
Child Care Services (0 to 12 years) Substance Abuse Services
Employment Training Transportation Services
Health Services Youth Services (13 to 17 years)
Senior Services Homelessness
CORONAVIRUS PROGRAM
Health Services Child or Adult Day Care
Education Services Substance Abuse Counseling
Mental Health Counseling Services
17
KEY AGENCY STAFF
Chief Professional Officer (CPO):
Name & Title: ___________________________________________________________________
Length of service: ___________________ Email: ___________________________________
Telephone: ________________________ Fax: ____________________________________
Lead Agency Program Staff Person (if other than CPO):
Name & Title: ___________________________________________________________________
Length of service: ___________________ Email: ___________________________________
Telephone: ________________________ Fax: ____________________________________
Fiscal Officer:
Name & Title: ___________________________________________________________________
Length of service: ___________________ Email: ___________________________________
Telephone: ________________________ Fax: ____________________________________
Chief Volunteer Officer:
Name & Title: ___________________________________________________________________
Length of service: ___________________ Email: ___________________________________
Telephone: ________________________ Fax: ____________________________________
18
PART IV– PROGRAM DESCRIPTION
Program Description (Maximum three pages): The Program Description should be
specific, clearly established and directly related to the goals and objectives of the program.
Applicant must complete Sections A through F for each program request.
1. Statement of Need: What is the need or problem to be addressed and how is it
consistent with one or more of the Brevard County Board of County Commissioners’ priorities and
Community Development Block Grant Programs National Objectives? Describe how the specific
problem or need was identified
2. Scope of Service: Highlight your proposed program purpose, target population and
proposed number of clients to be served (unduplicated), activities and services to be provided and
goals and objectives of the program.
3. Program Promotion: Describe the efforts and methods used to promote this
program, to ensure that appropriate individuals and/or families are aware of these services.
4. Organizational Chart: Provide copy of organizational chart. (Appendix 10).
5. Job Description: Describe the specific functions of the personnel, consultants, and
collaborators. Identify job titles of persons responsible for managing the project and staff devoted
to service provision. Provide job descriptions for the program(s) in which you are seeking funding
(Appendix 4).
6. Collaboration Narrative: Provide a description of how the proposed program(s) will
be coordinated with other service providers and list top five collaborative partners and their contact
information below:
Agency
Executive Officer
Contact Number
Contact E-mail
If not, please explain:
click to sign
signature
click to edit
19
PART V – AGENCY PROFILE
Agency Name _________________________________________________________________
1. Profile – Maximum two pages:
Provide a narrative that will assist staff and Board Members in understanding the
overall agency operations and provide a broad view of the context in which the program for
which funding is requested operates. Narrative shall include information regarding the
following:
a. Mission.
b. Service area and target populations.
c. Brief summary of programs offered, excluding program(s) for which funding is
sought.
d. Examples of past performance and achievements over the last 3 years.
2. Trends/Changes – Maximum one page:
What are the most significant trends and/or changes that are currently affecting the
organization’s operation, the people served, the type of programs offered, etc? Are there
anticipated changes that will have significant impact in the foreseeable future, such as over
the next two to three years?
3. List of partners, affiliates or subsidiaries:
Include subsidiaries, affiliates, and/or partners, programs supported, funding source
and amount. For example:
Partners, Affiliates or Subsidiaries Program Supported Funding Source Amount
ACB Local Pantry Food Bank Community $1,000
State Child Welfare Child Care State $1,000
20
PART VI - PROGRAM LOGIC MODEL AND EVALUATION PLAN
Instructions:
Use the Program Logic Model (Attachment E) and Evaluation Plan (Attachment F)
included and provide an overview of how you will achieve its intended results and/or
outcomes during the six-month contract period. (Applicant must complete Attachments E
and F for each program request.)
1. PROGRAM LOGIC MODEL: Describes how the program flows or works from resources to
goals. It should be a breakdown of your scope of services.
Program Resources – list various resources included in the program. These
resources may include, but are not limited to, Service Provider(s), Program Setting,
Collaborations, Service Technologies, Funding Sources, and Participants.
Activities – list program activities relating to resources.
Units of Service/Outputs – how many will be served (duplicated or unduplicated) by
how much service, number and type of participants, activities provided, and the
durations. For example, ninety parents will receive parenting classes in three
sessions during a six-week workshop.
Outcome(s) – expected result based on program activities for a six-month period.
What difference does this program make in the life of your clients?
Goal(s) – overall aim of the program, the end result that activities will achieve and the
outcomes describe.
2. EVALUATION PLAN: Describes how the agency will measure and track program outcomes
and attain the defined goals.
Outcome(s) – expected result based on program activities. What difference does this
program make in the life of your clients?
Indicators – number and percentage of what is being measured. Indicators will
determine whether or not measurable outcomes are being met. Examples of
indicators are action words such as increase, decrease, maintain and expand.
Baseline Measure – starting point for evaluation of the program. For example,
number of meals delivered last year, number of students at target school who are
reading at below grade level, etc.
Measurement Tool/Approach – way in which the program will determine a change
has occurred, i.e. number of meals distributed, assessment of nutrition levels for
individuals on the meal program, pre and post reading level tests.
Sampling Strategy and Sample Size – how will program determine who to
measure, such as all participants, 20% of participants?
Frequency & Schedule of Data Collection – when will data be collected, such as
pre- and post-testing, key points during the program, quarterly, or monthly.
21
PART VII – AGENCY FINANCIAL PROFILE & AGENCY WIDE BUDGET
1. Agency Financial Profile:
Respond to the following:
a. What is the percentage of program cost in relation to total agency budget?
b. What is the percentage of Community Development Block Grant Public
Service or Coronavirus program funding requested in relation to total program
funding?
c. Does your agency have at least three months operating reserves available? If
not, why?
d. Does your agency provide subsidies, scholarships or a sliding fee scale? If
yes, provide a brief explanation. If no, what is your referral procedure for
clients who do not qualify for services?
e. Does your agency follow General Accepted Accounting Practices?
f. Does your agency have internal accounting procedures for revenue and
expenses? If no, explain:
g. Does your board review financial activity at each meeting?
h. Does your agency have a strategic and/or long-range plan?
22
i. Does your agency have any areas of noncompliance with funding, regulatory
or licensing bodies?
2. Agency Wide Budget:
Attach your agency wide budget, which will be referred to and labeled as Attachment
J in your application, to include last years and current year’s revenue and expenses, for
your agency’s fiscal year.
23
PART VIII – PROGRAM BUDGET
1. PROGRAM BUDGET (Attachment H):
When completing the Program Budget, include all identified potential expenses
required to achieve successful completion of programs. Please submit a six-month budget
for the period of April 1, 2021 through September 30, 2021.
2. PROGRAM BUDGET JUSTIFICATION (Attachment I):
Enter program and local match information and a detailed budget with justification for
each budget category on the required forms. The budget justification should address each
of the major costs’ categories, as well as any additional categories. A thorough written
budget justification will explain both the necessity and the basis for the proposed costs.
3. PROGRAM BUDGET NARRATIVE:
Answer the following questions in the numerical order as noted below. Do not repeat
the entire question; only repeat numbers. All questions must be answered.
a. What percent of your total program budget will go for direct services versus
administration?
b. Describe your required match for Public Services Application. Match
requirement is waived for Coronavirus program. Is it cash, grants, or in-kind?
(Attachment M - Definitions). If an award is made, all funds identified as
dedicated to this program (including funds used for match/in-kind) will
be subject to applicable cost principles, auditing, and reporting
requirements (OMB #’s A-110, A-122, and A-133).
c. If applicable, describe additional resources that will be utilized to implement
this program.
d. List all other funding entities for which you have applied for funds to support
this program.
e. List other funding sources that have already committed resources for this
program.
f. Funding Reduction: Explain in detail what will happen to the program if less
than the requested amount of Community Development Block Grant Public
Service or Coronavirus funding is received?
g. Has your award ever been recaptured by another funding entity due to non-
performance of contract provisions? If yes, please explain?
24
h. Will Community Development Block Grant Public Services funding be used to
leverage (see definition in Attachment M) funds from another source (i.e.
federal, state)? If so, what is the source (i.e. federal, state) and amount of
funding that will be leveraged using Community Development Block Grant
Public Services funds? Provide Leverage Documentation, Appendix 8.
Documentation to include copies of contract or application stating use of
leveraged funds. Leveraging requirements are waived for Coronavirus
programs.
i. Describe the agency’s long-term plan (3 to 5 years) to conduct this program
and provide the service(s), with reduced or no County funding.
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ATTACHMENT A
SWORN STATEMENT OF PUBLIC ENTITY CRIMES
Request for Proposal Number:
2021 Community Development Block Grant Public Service or Coronavirus Program
SWORN STATEMENT UNDER SECTION 287.133(3) (a) FLORIDA STATUTES ON
PUBLIC ENTITY CRIMES
(To be signed in the presence of a Notary Public or other officer authorized to
administer oaths.)
State of _______________________
County of _____________________
Before me, the undersigned authority, appeared _________________________ who,
being by me first duly sworn, made the following statement:
1. The business address of applicant or contractor is:
___________________________________________________________________________.
2. My relationship to applicant or contractor is ______________________________
(relationship such as sole proprietor, partner, president, vice president, etc.).
3. I understand that a public entity crime as defined in Section 287.133 of the
Florida Statutes includes a violation of any State or Federal law by a person with respect to
and directly related to the transaction of business with any public entity in Florida or with an
agency or political subdivision of any other State or with the United States, including, but not
limited to, any bid or contract for goods or services to be provided to any public entity or such
an agency or political subdivision and involving antitrust, fraud, theft, bribery, collusion,
racketeering, conspiracy, or material misrepresentation.
4. I understand that “convicted” or “conviction” is defined by the statute to mean a
finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in
any Federal or State trial court of record relating to charges brought by indictment or
information after July 1, 1989, as a result of a jury verdict, non-jury verdict, non-jury trial, or
entry of a plea of guilty or novo contend.
5. I understand that “affiliate” is defined by the statute to mean (1) a predecessor or
successor of a person or a corporation convicted of a public entity crime, or (2) an entity under
the control of any natural person who is active in the management of the entity and who has
been convicted of a public entity crime, or (3) those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in the management of an
affiliate, or (4) person or corporation who knowingly entered into a joint venture with a person
who has been convicted of a public entity crime in Florida during the preceding 36 months.
26
6. Neither the applicant or contractor nor any officer, director, executive, partner,
shareholder, employee, member of agent who is active in the management of the applicant or
contractor nor any affiliate of the applicant or contractor has been convicted of a public entity
crime subsequent to July 1, 1989.
(Draw a line through Paragraph 6 if Paragraph 7 applies)
7. There has been a conviction of a public entity crime by the applicant or
contractor, or an officer, director, executive, partner, shareholder, employee, member or agent
of the applicant or contractor who is active in the management of the applicant or contractor or
an affiliate of the applicant or contractor. A determination has been made pursuant to Section
287.133(3) by order of Division of Administrative Hearings that is not in the public interest for
the name of the convicted person or affiliate to appear on the convicted vendor list. The name
of the convicted person or affiliate is ____________________________________________.
A copy of the order of the Division of Administrative Hearings is attached to this
Statement (with a line through Paragraph 6 if Paragraph 7 applies).
_____________________________ _________________________
Type Authorized Official’s Name Authorized Official’s Title
_____________________________ _________________________
Authorized Official’s Signature Date
Sworn to and subscribed before me in the State and County first mentioned above by means
of ☐ physical presence or ☐ online notarization, on this ______ day of _____________, 2020.
Affix Seal:
Notary Public: ____________________________
My commission expires_____________________
27
ATTACHMENT B
CONFLICT OF INTEREST CERTIFICATION
Request for Proposal Number: _______________________
Applicant must execute either Section I or Section II relative to Florida Statute
112.313(12). Failure to execute the appropriate section may result in rejection of this proposal.
Section I
I hereby certify that no official or employee of the Brevard County Board of County
Commissioners requiring the goods for services described in these specifications has a
material financial interest in this company.
___________________________________ ____________________________________
Signature Company Name
___________________________________ ____________________________________
Type or Print Name of Official Business Address
Section II
I hereby certify that the following named Brevard County Board of County
Commissioner’s official(s) and employee(s) having material financial interest(s) (in excess of
5%) in this company and have filed Conflict of Interest statements with the Brevard County
Housing and Human Services Department, prior to bid opening.
Name Title or Position Date of Filing
__________________________ _________________________ ________________
__________________________ _________________________ ________________
__________________________ _________________________ ________________
__________________________ _________________________ ________________
_____________________________________
Signature
_____________________________________
Type or Print Name of Official
_____________________________________
Company Name
_________________________________________
Business Address
28
ATTACHMENT C
2021 PROGRAM CERTIFICATION
PROGRAM CERTIFICATION
I do hereby certify that all facts, figures, and representations made in the
application are true and correct, and that the purpose of this request is consistent with
our organization’s Article of Incorporation, By-Laws and Mission. Furthermore, all
applicable statutes, terms, conditions, regulations and procedures for program
compliance and fiscal control will be implemented to ensure proper accountability of
grant funds. I certify that the funds requested in this application will not supplant funds
that would otherwise be used for the purposes set forth in this project.
The filing of this application has been authorized by the Agency Board of
Directors, and I have been duly authorized to act as the representative of the agency in
all matters in connection with this application. I also agree to follow all terms, conditions,
and applicable federal and state statutes.
______________________________ __________________________
Type or Print Authorized Official’s Name Authorized Official’s Title
_________________________________ __________________________
Authorized Official’s Signature Date
29
ATTACHMENT D
SUSPENSION/DEBARMENT CERTIFICATION
1. Certification Regarding Debarment and Suspension
The undersigned (authorized official signing for the applicant organization)
certifies to the best of his or her knowledge and belief, that the applicant, defined as the
primary participant in accordance with 45 CFR Part 76, and its principals:
a. are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any
Federal Department or agency; and
b. have not within a 3-year period preceding this proposal been convicted of
or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State, or local) transaction or contract under
a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen
property; and
c. are not presently indicted or otherwise criminally or civilly charged by a
governmental entity (Federal, State, or local) with commission of any of
the offenses enumerated in paragraph (b) of this certification; and
d. Have not within a three-year period preceding this application/proposal
had one or more public transactions (Federal, State, or local) terminated
for cause or default.
Should the applicant not be able to provide this certification, an explanation as to
why should be placed after the assurances page in the application package.
The applicant agrees by submitting this proposal that it will include, without
modification, the clause titled "Certification Regarding Debarment, Suspension,
Ineligibility, and Voluntary Exclusion--Lower Tier Covered Transactions" in all lower tier
covered transactions (i.e., transactions with sub- grantees and/or contractors) and in all
solicitations for lower tier covered transactions in accordance with 45 CFR Part 76.
2. Certification Regarding Drug-Free Workplace Requirements
The undersigned (authorized official signing for the applicant organization)
certifies that the applicant will, or will continue to, provide a drug-free workplace in
accordance with 45 CFR Part 76 by:
a. 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; and
b. Establishing an ongoing drug-free awareness program to inform
employees about--
(1) The dangers of drug abuse in the workplace;
(2) The grantee’s policy of maintaining a drug-free workplace;
30
(3) Any available drug counseling, rehabilitation, and employee
assistance programs;
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace; and
c. 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 (a) above; and
d. Notifying the employee in the statement required by paragraph (a), above,
that, as a condition of employment under the grant, the employee will--
(1) Abide by the terms of the statement;
(2) 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; and
(3) Making a good faith effort to continue to maintain a drug-free
workplace through implementation of paragraphs (a), (b), (c), and
(d).
3. Certification Regarding Environmental Tobacco Smoke
F.S. 386.201–212, the Florida Clean Indoor Air Act, has as its purpose to protect
the public health, comfort, and environment by creating areas in public places and at
public meetings that are reasonably free from tobacco smoke by providing a uniform
statewide maximum code. This part shall not be interpreted to require the designation
of smoking areas.
a. "Public place" means the following enclosed, indoor areas used by the
general public:
(a) Government buildings; (b) Public means of mass transportation and
their associated terminals not subject to federal smoking regulation; (c)
Elevators; (d) Hospitals; (e) Nursing homes; (f) Educational facilities; (g)
Public school buses; (h) Libraries; (i) Courtrooms; (j) Jury waiting and
deliberation rooms; (k) Museums; (l) Theaters; (m) Auditoriums; (n)
Arenas; (o) Recreational facilities; (p) Restaurants which seat more than
50 persons; (q) Retail stores, except a retail store the primary business of
which is the sale of tobacco or tobacco related products; (r) Grocery
stores; (s) Places of employment; (t) Health care facilities; (u) Day care
centers; and (v) Common areas of retirement homes and condominiums.
b. "Public meeting" means all meetings open to the public, including
meetings of homeowner, condominium, or renter or tenant associations
unless such meetings are held in a private residence.
c. "Common area" means any hallway, corridor, lobby, aisle, water fountain
area, restroom, stairwell, entryway, or conference room in any public
place.
By signing the certification, the undersigned certifies that the applicant
organization will comply with the requirements of the Act and will not allow
smoking within any portion of any indoor facility used for the provision of
services as defined by the Act.
31
The applicant organization agrees that it will require that the language of
this certification be included in any sub-awards, which contain provisions
for services and that all sub-recipients shall certify accordingly.
The Housing and Human Services Department strongly encourages all
grant recipients to provide a smoke-free workplace and promote the non-
use of tobacco products.
________________________________________
Signature Title of Authorized Certifying Official
________________________________________
Title
________________________________________
Applicant Organization
________________________________________
Date Submitted
32
ATTACHMENT E - PROGRAM LOGIC MODEL FORM
Agency Name: ______________________________________________________________________________________
Program Name: ______________________________________________________________________________________
Focused Care Area: ______________________________________________________________________________________
PROGRAM
RESOURCES
ACTIVITIES
OUTPUTS/UNITS OF
SERVICE
OUTCOMES
GOALS
SERVICE PROVIDERS:
PROGRAM SETTING:
COMMUNITY
FACTORS:
33
PROGRAM
RESOURCES
ACTIVITIES
OUTPUTS/UNITS OF
SERVICE
OUTCOMES
GOALS
COLLABORATIONS:
SERVICE
TECHNOLOGIES:
FUNDING SOURCES:
PARTICIPANTS:
34
ATTACHMENT F – EVALUATION PLAN FORM
Agency Name: ________________________________________________________________________________
Program Name: ________________________________________________________________________________
Focused Care Area: ________________________________________________________________________________
Have you made any changes to the evaluation plan? Yes No Date Revised: _________________________
OUTCOMES
INDICATORS
MEASUREMENT
TOOL/APPROACH
BASELINE
MEASURE
SAMPLING
STRATEGY & SIZE
FREQUENCY &
SCHEDULE OF DATA
COLLECTION
35
ATTACHMENT G - PROGRAM BUDGET INFORMATION
INSTRUCTIONS FOR COMPLETION
Each section of the PROGRAM(S) - BUDGET INFORMATION must be
completed. The following information will assist you with providing the required
information for each section of the form.
Section A – Program Budget Summary:
Community Development Block Grant Public Service Program or
Coronavirus Program - enter the name of the program for which you are requesting
funding from the Brevard County Board of County Commissioners. Please enter your
fund request for a six-month period starting April 1 through September 30. If you are
requesting funds for more than one program, please submit a separate budget for
each program.
Community Development Block Grant Public Service Match – (for Public
Services ONLY) enter the amount of match for each program. Applicants are required
to provide a minimum twenty-five percent match for Public Services. This amount
should equal Match in Section E. Match requirements are waived for Coronavirus
Program.
Total – enter the total amount of your Community Development Block Grant
Public Service fund request and Community Development Block Grant Public Request
match. (Fund Request + Match = Total).
Section B – Program Budget Categories to Be Funded by Community
Development Block Grant Public Service or Coronavirus Program:
Program – amount for each budget category that will be provided by Community
Development Block Grant Public Service funding. Include eligible identified expenses
required to achieve successful completion of the program. Any category of expense not
applicable to your budget may be deleted and any category of expense that is not listed
can be inserted. Section B should coincide with the Budget Justification.
Section C – Unit Cost Budget Breakdown Information: Enter the description of the
unit, the number of units, the cost per unit and the total unit program cost for your
program. The unit cost is the amount of funds required to provide one given unit of
service. For example, a fifteen-minute Unit of Case Management Services costs
$12.50. This amount is based on staff salary/time, allotted facility costs, etc.
Section D – Cost per Unit Justification: List program Units of Service and their costs.
Enter the expenses that total the cost per unit and/or justify the cost per unit.
Section E – Community Development Block Grant Public Service Match:
Community Development Block Grant Public Service match must be at least 25%.
(Provide Additional Form for Multiple Match Sources). {Match requirement waived for
Coronavirus Program}.
36
Program Name - enter the name of the program for which you are requesting
funding from the Brevard County Board of County Commissioners.
Unrestricted Agency Cash – funds contributed by the agency that have not
been designated for any other program or purpose.
In-Kind Goods and Services – goods or services (i.e. donated items, volunteer
time) that will be contributed as an integral part of this program.
Other Sources Restricted Non-Agency Funds – funds provided by another
source (i.e. state grant) that will be dedicated to this program.
Totals – total of all sources of Community Development Block Grant Public
Services match.
37
ATTACHMENT H - PROGRAM BUDGET INFORMATION FORM
Section A – Public Services Program Budget Summary
Program Name
Community Development
Block Grant – Public
Service or Coronavirus
Program Fund Request
Community Development
Block Grant – Public Service
Match ONLY (Section I)
Community Development
Block Grant – Public
Service + Match
$
$
$
Section B – Program Budget Categories to be Funded by Community Development Block Grant
Public Service or Coronavirus Program
Budget Categories
Program Amount per Category
a. Personnel
$
b. Fringe Benefits
$
c. Travel
$
d. Equipment
$
e. Supplies
$
f. Contractual
$
g. Other
$
h. Total Community Development Block Grant Public Service or
Coronavirus Program Funds
$
Section C – Unit Cost Budget Breakdown
Description of Unit
# Units
Cost per Unit
Unit Program Cost
Requested Community Development Block Grant
Public Service or Coronavirus Program Funding Total
Section D – Cost Per Unit Justification
List program Units of Service and their costs:
Section E - Community Development Block Grant – Public Service Match
Program Name
Unrestricted
Agency
Cash
In-Kind
Goods and
Services
Other Sources
Restricted Non-
Agency Funds
Totals
$
$
$
$
$
$
$
$
38
ATTACHMENT I
PROGRAM BUDGET JUSTIFICATION FORM
PROGRAM: ____________________________________________________________________
Local Match (for Public Services ONLY):
Year
Total Program
Cost
Funds Requested
(County)
Local Match
(25% minimum)
Source:
Personnel:
Job Title
Name
Annual
Salary
Level of
Effort
Salary
Requested
Subtotal Personnel Costs
Justification:
Fringe Benefits:
Subtotal Fringe Benefits
Justification:
Travel:
Description
Method of Calculation
Requested
Amount
Subtotal Travel
Justification:
39
Equipment:
Description
Method of Calculation
Requested
Amount
Subtotal Equipment
Justification:
Supplies:
Type
Cost
Subtotal Supplies
Justification:
Contractual:
Type
Service Provided
Requested
Amount
Subtotal Equipment
Justification:
Other:
Type
Cost
Subtotal Other
Justification:
Total Direct Charges:
Page 40
ATTACHMENT J
AGENCY WIDE BUDGET
PLEASE PROVIDE YOUR AGENCY WIDE BUDGET.
41
ATTACHMENT K
REVIEW CRITERIA
1. REVIEW PROCESS
The Review Process for this Request for Proposal consists of five stages:
a. Initial staff reviews of submitted applications for disqualifying criteria.
b. Advisory Board reviews applications.
c. Organizations present on their application to the Advisory Board (Limit of 5
Minutes) and are available for questions.
d. Advisory Board makes funding recommendations to the Brevard County
Board of County Commissioners.
e. Brevard County Board of County Commissioners approves, denies or
modifies funding recommendations.
2. SCORING
All applications will be initially reviewed for disqualifying criteria by Housing and
Human Service staff. All applicants requesting funding under this Request for Proposal
will be considered on the basis of their overall merit as determined by the advisory
board, and the Brevard County Board of County Commissioners’ review processes.
Each organization’s application will be scored based upon the following criteria:
• Program Description
• Program Logic Model
• Program Evaluation Plan
• Agency Financial Profile
• Program Budget/Narrative
A more detailed description of each section can be found in Attachment L,
Public Services and Coronavirus Program Score Sheet.
42
ATTACHMENT L
PUBLIC SERVICES OR CORONAVIRUS PROGRAM
SCORE SHEET
AGENCY: __________________________________________________________
PROGRAM: __________________________________________________________
☐ PUBLIC SERVICES ☐ CORONAVIRUS PROGRAM
Description
Points
Available
Points
Awarded
Program Description 1-25
• Has the agency clearly defined its scope of work and is it
directly related to the goals and objectives of the program?
• Was a specific problem or need identified?
• Does the agency have the organizational capacity to
successfully undertake proposed program(s)?
• Did the agency include the number of anticipated,
unduplicated clients to be served by program?
• Did the agency provide a description of how the agency
collaborated with identified partners?
• Did Agency meet the National Objective of Urgent Need by
demonstrating services will prevent, prepare for or respond
to the Coronavirus?
Please provide comments for a score less than 15
Program Logic Model 1-10
• Did the agency provide specific program resources?
• Did the agency describe the specific activities of the
program?
• Did the agency clearly define the units of service to include;
# and types of participants and the duration of the identified
service?
Please provide comments for a score less than 6
Program Evaluation Plan 1-10
• Did the agency clearly define its expected outcomes?
• Did the agency define the indicators in terms of number and
percentages that will determine the outcome is being met?
• Did the agency clearly define the tools and approach to be
used to measure the program?
• Did the agency clearly define the baseline for the evaluation
of the activity/activities?
• Did the agency identify the sampling strategy and size?
• Did the agency identify how data will be collected?
43
Please provide comments for a score less than 6
Agency Financial Profile
1-25
• Does the agency have the financial capacity,
staff, administrative and fiscal systems in
place to carry out proposed program?
• Does the agency have internal accounting
procedures for revenue and expenses?
• Does the agency have any areas of
noncompliance with funding, regulatory or
licensing bodies?
• Does the agency have at least 3 months of
operating Reserve?
Please provide comments for a score less than 15
Program Budget/Narrative
1-30
• Did the agency provide detailed (agency wide
and program) budget information?
• Is the budget directly related to the scope of
services (see program description)?
• Is the cost per unit reasonable and justified?
• Did the agency identify the percentage of the
total program budget to be used for direct
services and for administration?
• Did the agency identify additional resources
available to implement the program?
• Did the agency apply for funding through
other entities?
• Has an award to the agency been recaptured
due to non-performance of contract
provisions?
• Did the agency describe its long term plan to
conduct the program with reduced or no
County funding?
• Is it clear how the agency would implement
the program if less funding is awarded than
was originally requested?
Please provide comments for a score less than 18
TOTAL AVAILABLE POINTS - 100
Board Member Name: ____________________________________________________
Board Member Signature & Date: ____________________________________________________
44
ATTACHMENT M
DEFINITIONS
Administrative costs – costs required to cover general agency administrative
expenses, such as executive director, financial staff, clerical staff, and similar items not directly
related to the services provided by the agency.
Baseline – number of units provided in the previous program year.
Cash match - un-obligated agency funds set aside for the program.
Core services – priorities areas as defined by the Brevard County Board of County
Commissioners as matching the “core goals” of Brevard County Government.
Coronavirus - any of a group of ribonucleic acid viruses that cause a variety of
diseases in humans and other animals.
Direct service costs – costs required to cover the provision of services directly to the
intended recipients. This cost may include costs of case manager or other staff that works
directly with clients, materials needed to provide the service, or physical space for the service.
Financial Statement – a formal record of the financial activities of a business, person
or other entity.
IRS 990 – also titled "Return of Organization Exempt from Income Tax." This form is
submitted by tax-exempt organizations and non-profit organizations to provide the Internal
Revenue Service with annual financial information.
In-kind match – match provided through use of agency staff, volunteer service, or
donated goods and services. The dollar value of an “in-kind” match can be included in the
match requirement.
Letter of Commitment – a letter from a group stating active collaboration/participation
in your agency’s program/project. The letter specifies the resources the group will commit to
the program/project and identifies what role the group and/or resources will play in bringing the
program/project to a successful conclusion.
Leverage – funding an agency will be able to obtain that is only available if Community
Development Block Grant Public Service funding or other source is committed to the program.
The greater the amount of funds committed to the program, the greater the amount of funding
that is drawn in from another source. For example, for every $1.00 the Soup Kitchen provides,
the United States Department of Agriculture will provide $5.00 in bulk food stuffs. Therefore
$1,000 brings in $5,000; $2,000 brings in $10,000, as so on. The United States Department of
Agriculture will not provide any food stuffs to the Soup Kitchen if no leverage funds are
provided.
Match – funding provided by an agency out of its own resources that will be part of the
program budget. For example, the Soup Kitchen’s total program budget is $10,000, of which
they are requesting $7,500. The Soup Kitchen will provide the remaining $1,875 from its own
resources as match for the program. Match can be either “in-kind”, “cash” or “grants”.
45
Unit Cost – the amount of funds required to provide or produce one unit of a service or
product based.
46
ATTACHMENT N
COMMUNITY DEVELOPMENT BLOCK GRANT
REQUIREMENTS AND NATIONAL OBJECTIVES
1. Consolidated Plan & Annual Action Plan
The Brevard County Consolidated Plan is a five-year (FY 2016-2020)
collaborative process whereby a community establishes a unified vision for community
development actions with one-year Annual Action Plan updates. See Attachment “O”.
Consolidating the submission requirements offers local jurisdictions a better chance to
shape the various programs into effective, coordinated neighborhood and community
development strategies. It also creates the opportunity for strategic planning and citizen
participation to take place in a comprehensive context, and to reduce duplication of
effort at the local level.
2. Background
The Community Development Block Grant Program was established by
Congress through the Housing and Community Development Act of 1974, as amended,
to provide local governments and residents with the funds needed to work in a
comprehensive manner towards the improvement of the quality of life in low and
moderate income areas. It consolidated the old categorical funding programs to allow
for local flexibility in determining needs and to develop strategies to address those
needs.
Community Development Block Grant funds are distributed to areas and
agencies which are determined eligible for funding. Therefore, everyone in Brevard
County benefits from community development activities. Not only does community
development enhance the quality of life, but it also provides a stepping-stone to public
improvements in all types of community issues.
Basic Federal Role
• Enact program and raise money to fund it.
• Allocate program funds among communities based on a formula.
• Establish minimum federal standards for the use and administration of
program funds, including standards on eligibility, national objectives,
citizen participation, equal opportunity, environmental protection, etc.
• Monitor to ensure federal standards are met.
Basic Local Role
Accomplish the following with citizens' involvement:
• Identify the development and housing needs of the community;
47
• Set short and long-term community development objectives that are in
accordance with the primary objective and the requirements of Title I;
• Set local priorities in deciding which of the large number of eligible
activities are to be carried out;
• Administer the implementation of the chosen activities in a manner
consistent with national standards; and
• Monitor the use of program funds and the relationship of such use to the
local and national objectives.
3. Overview of the Program Primary Objectives
The primary objective of the Community Development Block Grant program is
the development of viable urban communities. The Housing and Human Services
Department works toward meeting this objective by providing decent housing, a suitable
living environment and expanding economic opportunities, principally for persons of low
and moderate income.
National Objectives: Each CDBG activity must address one of three national
objectives:
• Benefit low- and moderate-income persons;
• Aid in the prevention or elimination of slums or blight; or
• Meet community development needs having a particular urgency.
• For the Coronavirus Program-All activities must prevent, prepare
for or respond to coronavirus.
• Is the activity designed to alleviate existing conditions?
• Does the condition pose a serious and immediate threat to
the health or welfare to the community that is of recent origin
or that recently became urgent?
4. Activities to Benefit Low and Moderate Income Persons
The activity must meet one of the following qualifying criteria:
a. An activity, available to all the residents in a particular area, where at least
51% of the residents are low-and moderate-income persons is considered
an area benefit activity. The service area must be primarily residential,
and meet the identified needs of low-and moderate-income persons.
Examples include: street improvements; water and sewer lines;
neighborhood facilities; and facade improvements in neighborhood
commercial districts.
48
b. Activities which benefit a specific group of persons where at least 51% of
whom are low and moderate income persons meet qualifications for
funding. Examples include: Construction of a senior center; public
services for the homeless; meals on wheels for the elderly; and
construction of job training facilities for the severely disabled adults.
Additional criteria for this type of benefit are as follows:
(1) The activity must benefit a clientele that is generally presumed to
be principally low and moderate income such as abused children,
battered spouses, elderly persons, severely disabled adults,
homeless persons, illiterate adults, or persons living with AIDS, and
migrant farm workers; or
(2) Be a special project directed for removal of material and
architectural barriers, which restrict mobility and accessibility of
elderly or handicapped persons to publicly and privately-owned
non-residential buildings, facilities, improvements and the common
areas of residential structures containing more than one dwelling
unit.
(3) Information must be required on family size and income to
document that at least 51% of the clientele are persons whose
family income does not exceed Section 8 low and moderate income
limits.
(4) The activity must have income eligibility requirements which limit
the activity exclusively to low and moderate income persons.
(5) The activities must be of such nature and in such location that it
may be concluded that the activity’s clientele will primarily be low
and moderate-income persons.
5. Activities which aid in the prevention or elimination of slums or blight:
a. An activity which aids in the prevention or elimination of slums or blight
outside a slum or blighted area. Examples include elimination of faulty
wiring, falling plaster, or other similar conditions which are detrimental to
all potential occupants; historic preservation of a public facility; and
demolition of a vacant deteriorated, abandoned building. The activity must
meet the following qualifying criteria:
(1) The activity must be designed to eliminate specific conditions of
blight or physical decay on a spot basis.
(2) The activity must be limited to acquisition, clearance, relocation,
historic preservation, and/or rehabilitation of buildings.
Rehabilitation is limited to the extent necessary to eliminate specific
conditions detrimental to public health and safety.
49
6. Activities designed to meet community development needs having a
particular urgency. Examples include major catastrophes or emergencies.
The activity must meet the following qualifying criteria:
a. Pose a serious threat to the health or welfare of the community;
b. Are of recent origin or recently became urgent;
c. The grantee is unable to finance on its own; and
d. Other resources of funds are not available
7. Eligible Activities
Consistent with the objectives stated within this Attachment, the federal
assistance provided in this program can be used for the support of community
development activities, as seen in the Code of Federal Regulations, which are available
for review in the Housing and Human Services Office and at: Housing and Urban
Development's Community Development Block Grant Laws and Regulations
click to sign
signature
click to edit
50
ATTACHMENT O
2016-2020 CONSOLIDATED PLAN - PRIORITY NEEDS SUMMARY
POPULATION
PRIORITY LEVEL
Victims of Domestic Violence
HIGH
Low Income Mentally Ill Residents
HIGH
Unaccompanied Youth Residents
HIGH
Chronic Homelessness
HIGH
Low Income Families with Children
HIGH
Moderate Income Large Families
HIGH
Persons with HIV/AIDS
HIGH
Individuals with Chronic Substance Abuse
HIGH
Low Income Elderly Residents
HIGH
Low Income Military Veterans
HIGH
Public Housing Resident Families with Children
HIGH
CORONAVIRUS PROGRAM PRIORITY AREAS
POPULATION
PRIORITY LEVEL
Health Services
HIGH
Child or Adult Day Care
HIGH
Education Services
HIGH
Substance Abuse Counseling
HIGH
Mental Health Counseling Services
HIGH
51
ATTACHMENT P
HOUSING AND URBAN DEVELOPMENT 2020
AREA MEDIAN INCOME LIMITS PROGRAM
UP TO 30% AMI
(EXTREMELY
LOW)
UP TO 50% AMI
(VERY LOW)
UP TO 80% AMI
(LOW)
1 PERSON
$0 to $14,550
$14,551 to $24,250
$24,251 to $38,750 (Over
$38,751 Ineligible)
2 PERSONS
$0 to $17,240
$17,241 to $27,700
$27,701 to $44,300 (Over
$44,301 Ineligible)
3 PERSONS
$0 to $21,720
$21,721 to $31,150
$31,151 to $49,850 (Over
$49,851 Ineligible)
4 PERSONS
$0 to $26,200
$26,201 to $34,600
$34,601 to $55,350 (Over
$53,351 ineligible)
5 PERSONS
$0 to $30,680
$30,681 to $37,400
$37,401 to $59,800 (Over
$59,801 Ineligible)
6 PERSONS
$0 to $35,160
$35,161 to $40,150
$40,151 to $64,250 (Over
$64,251 Ineligible)
7 PERSONS
$0 to $39,640
$39,641 to $ 42,950
$49,951 to $68,650 (Over
$68,651 Ineligible)
8 PERSONS
$0 to $44,120
$44,121 to $45,700
$45,701 to $73,100
(Over $73,101 Ineligible)
NOTE: **HOUSING AND URBAN DEVELOPMENT INCOME GUIDELINES CHANGE
ANNUALLY**
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COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICES PROGRAM & (Brevard County Board of Commissioners)

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Completed 25 January 2021

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