Fillable COUNTY OF RIVERSIDE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (City of Murrieta)

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COUNTY OF RIVERSIDE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (City of Murrieta)

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COUNTY OF RIVERSIDE
COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM
APPLICATION FOR CITY OF
2020 - 2021 COOPERATING CITY ALLOCATION
I. GENERAL INFORMATION
Applicant Name:
Type of Organization: Non-Profit Organization Faith Based Organization
For-Profit Organization Institution of Higher Education
Cooperating City
Address:
City: Zip Code:
Mailing Address:
City: Zip Code:
Telephone Number: Fax Number:
Executive Director/City Staff:
Telephone Number: E-mail:
Program Manager:
Telephone Number: E-mail:
Grant Writer:
Address (If different from above):
Telephone Number: E-mail:
II. ORGANIZATIONAL HISTORY (This is applicable only if you are a non-profit organization)
Date Organization founded:
Date Organization incorporated as a non-profit organization (Attach Articles of Incorporation and Bylaws):
Federal identification number:
DUNS Number:
Organization Web Address:
1
Does your Organization expend $750,000 or more a year in federal funds? Y or N
Number of paid staff:
Number of volunteers:
Members/Board of Directors (Attach):
III. PROJECT ACTIVITY
A. Name of Project:
B. Specific Location of Project
(Attach Project Map - include street address; if a street address has not been assigned provide APN)
Street or APN:
City: Zip Code:
C. CDBG Funds Requested: (total amount for the project only)
D. Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves
a new or existing facility, what is the proposed service/benefit area for the facility?
E. In which City (ies)/Communities does the activity occur?
City (ies):
Community (ies):
NOTE: EDA will make the final determination of the appropriate service area of all proposals.
F. If this project benefits residents of more than one community or jurisdiction, have requests been
submitted to those other entitlement jurisdictions? (i.e., County district(s) 1
st
, 2
nd
, 3
rd
, 4
th
, and/or 5
th
, City of
Palm Springs, City of Moreno Valley, City of Riverside, etc.)
2
G. Check ONLY the applicable category your application represents.
Public Service
Homeless Activities
Real Property Acquisition (Must consult with EDA prior to submitting application)
Housing
Rehabilitation/Preservation (please provide picture of structure)
Public Facilities (construction)
Infrastructure (i.e. Streets, Sewer, Sidewalk, etc.)
Other: (provide description) ________________ __
H. Respond to A & B only if this application is for a public service project.
(a) Is this a NEW service provided by your agency? Yes No
(b) If service is not new, will the existing public service activity level be substantially increased or
improved? ________________ __
IV. PROJECT NARRATIVE
A. Provide a detailed Project Description. The description should only address or discuss the specific
activities, services, or project that is to be assisted with CDBG funds. If CDBG funds will assist the entire
program or activity, then provide a description of the entire program or activity.
3
B. Provide a detailed description of the proposed use of the CDBG funds only (e.g. construction design,
purchase of specific equipment, rent, supplies, utilities, salaries, etc.):
C. What are the goals and objectives of the project, service, or activity? How will you measure and
evaluate the success of the project to meet these goals and objectives (measures should be
qualitative)?
D. Please identify the project milestones using an Estimated Timeline for Project Implementation:
4
V. PROJECT BENEFIT
A. Indicate the number of people or households that will directly benefit from your proposal using CDBG
funds: Note: This is based on the expected number of clients to be served if the County funds your project for the
requested amount.
B. Indicate the number of unduplicated clients that will be served (An unduplicated client is counted only once,
no matter how many direct services the client receives during a funding year):
C. Length of proposed CDBG-funded activities or service (weeks, months, year):
D. Service will be provided to (check one or more):
Men Seniors
Women Severely Disabled Adults
Children (Range of children’s ages :__________) Migrant Farm Workers
Homeless (Number of beds at facility :________) Families
5
E. What methods will be used for community involvement to assure that all who might benefit from the
project are provided an opportunity to participate?
F. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue
the work (project) after the CDBG funds are expended?
VI. National Objective
All CDBG-funded activities must meet at least one of the following National Objectives of the CDBG
program. Indicate the category of National Objective to be met by your activity.
CATEGORY A: Benefit to low-moderate income persons (must be documented). Please choose either
subcategory 1 or 2:
1. Limited Clientele:
The project serves clientele that will provide documentation of their family size, income, and ethnicity.
Identify the procedure you currently have in place to document that at least 51% of the clientele you
serve are low-moderate income persons.
6
2. Clientele presumed to be principally low- and moderate-income persons:
The following groups are presumed by HUD to meet this criterion. You will be required to submit a
certification from the client (s) that they fall into one of the following presumed categories.
The activity will benefit (check one or more)
Abused children Homeless persons
Battered spouses Illiterate adults
Elderly persons Persons living with AIDS
Severely disabled adults Migrant Farm workers
a. Describe the clientele above to be served by this activity:
b. Discuss how this project directly benefits low- and moderate- income residents:
CATEGORY B: Area Benefit - The project or facility serves, or is available to, ALL persons located within
an area where at least 51% of the residents are low/moderate-income. (Applicant is welcome to contact a
County of Riverside, EDA CDBG Program Manager for Census Information)
2010 Census Tract and Block Group numbers:
(must use 2011-2015 ACS data pursuant to HUD Notice -C&D-19-02)
https://hud.maps.arcgis.com/apps/webappviewer/index.html?id=ffd0597e8af24f88b501b7e7f326bedd
_______________
_______________
_______________
_______________
Total population in Census Tract(s) / block group(s):_______________________
Total percentage of low-moderate population in Census Tract(s) / block group(s):________
7
CATEGORY C: Activities undertaken to create or retain permanent jobs, at least 51% of which will be
made available to or held by low/moderate-income persons.
Proposed Job Creation/Retention
Total Jobs Expected to Create: ______________________________________________
Total Jobs Expected to Retain: ______________________________________________
CATEGORY D: Activities that provide assistance to micro-enterprise owners/developers who are
low/moderate-income.
Proposed Assistance to Businesses
New Businesses expected to assist: ______________________________________________
Existing Businesses expected to assist: ___________________________________________
Enter Total Businesses expected to assist: _________________________________________
VII. FINANCIAL INFORMATION
A. Proposed Project Budget
Complete the following annual program budget to begin July 1, 2020. If your proposed CDBG-funded
activity will start on a date other than July 1, 2020, please indicate starting date. Provide total Budget
information and distribution of CDBG funds in the proposed budget.
The budgeted items are for the specific activity for which you are requesting CDBG funding - NOT for the
budget of the “entire” organization or agency. (Note: CDBG funds requested must match amount requested in
Project Activity, C above.)
(EXAMPLE: The Valley Senior Center is requesting funding for a new Senior Nutritional Program. The total cost of
the program is $15,000 and $10,000 in CDBG funds is being requested for operating expenses associated with the
proposed activity. The total Activity/Project Budget will include $5,000 of other non-CDBG funding and $10,000 in
CDBG funds for a Grand Total of $15,000).
TOTAL ACTIVITY/
PROJECT BUDGET CDBG FUNDS
(Include non-CDBG Funds REQUESTED-Only
and CDBG Funds)
I. Personnel
A. Salaries & Wages $____________________ $__________________
B. Fringe Benefits $____________________ $__________________
C. Consultants & Contract Services $____________________ $__________________
PERSONNEL SUB-TOTAL $____________________ $__________________
8
II. Non-Personnel
A. Space Costs $____________________ $__________________
B. Rental, Lease or Purchase of
Equipment $____________________ $__________________
C. Consumable Supplies $____________________ $__________________
D. Travel $____________________ $__________________
E. Telephone $____________________ $__________________
F. Utilities $____________________ $__________________
G. Other Costs $____________________ $__________________
NON-PERSONNEL SUB-TOTAL: $____________________ $__________________
III. Other
A. Architectural/Engineering Design $____________________ $__________________
B. Acquisition of Real Property $____________________ $__________________
C. Construction/Rehabilitation $____________________ $__________________
D. Indirect Costs $____________________ $__________________
E. Other $____________________ $__________________
OTHER SUB-TOTAL: $____________________ $__________________
GRAND TOTAL: $____________________ $__________________
B. Leveraging
List other funding sources and amounts (commitments or applications) which will assist in the
implementation of this activity. Current and pending evidence of leveraging
commitments/applications must be submitted with application. (Attach)
TYPE
AMOUNT
AMOUNT
SOURCE
AMOUNT
TOTAL
FEDERAL
STATE/LOCAL
PRIVATE
OTHER
TOTAL: ___________________
C. What type of long-term financial commitment is there to the proposal? Describe how you plan to
continue the work (project) after the CDBG funds are expended?
9
D. Provide a summary by line item of your organization’s previous year’s income and expense
statement. (Attach)
E. Does this project benefit residents of more than one community or jurisdiction, have requests been
submitted to those other jurisdictions? Yes No
If yes, identify sources and indicate outcome. ________________________________________
If no, please explain. ____________________________________________________________
F. Was this project or activity previously funded with CDBG? Yes No
If yes, when? ________________________________________
Is this activity a continuation of a previously funded (CDBG) project? Yes No
If yes, explain: ________________________________________
VIII. MANAGEMENT CAPACITY
A. Describe your organization’s experience in managing and operating project or activities funded with
CDBG or other Federal funds.
10
B. Management Systems
Does your organization have written and adopted management systems (i.e., policies and
procedures) including personnel, procurement, property management, record keeping, financial
management, etc.?
C. Capacity
Please provide the names and qualifications of the person(s) that will be primarily responsible for the
implementation and completion of the proposed project.
11
IX. APPLICATION CERTIFICATION
Undersigned hereby certifies that (check box after reading each statement and digitally sign the document):
1. The information contained in the project application is complete and accurate. ___ __
2. The applicant agrees to comply with all Federal and County policies and requirements imposed upon the
project or activity funded by the CDBG program. ___ __
3. The applicant acknowledges that the Federal assistance made available through the CDBG program
funding will not be used to substantially reduce prior levels of local, (NON-CDBG) financial support for
community development activities. ___ __
4. The applicant fully understands that any facility built or equipment purchased with CDBG funds shall be
maintained and/or operated for the approved use throughout its economic life, pursuant to CDBG
regulation. ___ __
5. If CDBG funds are approved, the applicant acknowledges that sufficient non-CDBG funds are available or
will be available to complete the project as described within a reasonable timeframe. ___ __
6. On behalf of the applying organization, I have obtained authorization to submit this application for CDBG
funding. (DOCUMENTATION ATTACHED Minute Action and/or written Board Approval signed by the Board
President) ___ __
DATE: ____________________
Signature: ___________________________________________
Print Name/Title
Authorized Representative: ____________________________________________
12
CHECK-LIST:
The following required documents listed below have been attached. Any missing documentation to the
application will be cause for the application to be reviewed as INELIGIBLE.
Yes No ATTACHMENT
1. Members/Board of Directors
2. Articles of Incorporation and Bylaws
3. Project Activity Map
4. Project Benefit, Category B, Low Mod Area Maps (Attach if applicable)
5. Leveraging (Current evidence of commitment)
6. Income and Expense Statement
7. Management Capacity (Detailed organizational chart)
8. Board Written Authorization approving submission of application
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COUNTY OF RIVERSIDE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (City of Murrieta)

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Completed 14 July 2020

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