ESG 20 9
3. How long has the Organization had its 501 (c) (3) status? If your organization is a government entity, enter N/A.
___________________________________________________________________________________________
4. How many years has the Organization conducted the project/program for which it is requesting funding? _____
5. Provide the source and amount of funding commitments, as well as, additional funding awarded in the past three
years for this project. ____________________________________________________________________
Attach additional page(s) documents, if needed.
XVI. APPLICATION EVALUATION
• Upon receiving each application, the Homeless Division will verify that the application is complete, including required
attachments. Incomplete proposals will be considered non-responsive and will be issued a declination notice.
• Complete proposals will be evaluated and scored by the Homeless Division.
1. Agency/Municipality will engage in direct or modified, per local COVID-19 standards, client contact to conduct
client/household assessment.
2. Agency/Municipality will engage in client contact, per local COVID-19 standards, (in person or via telephone) and
provide appropriate supportive services to clients
3. The agency/municipality will engage in direct client contact, per local COVID-19 standards, to identify household’s
needs and appropriate interventions.
4. Agency/Municipality will utilize HMIS.
5. Agency/Municipality must be accessible to households experiencing homelessness, including the offering of flexible
hours (evenings/weekends) and methods, e.g. phone screening.
6. Agency /Municipality will make client records and HMIS data available for system performance and monitoring
purposes by Fulton County.
7. Agency/Municipality should ensure services provided are accessible to clients i.e. via phone or in person.
8. Agency/Municipality will provide service delivery and appointment times that meet the needs of clients including early
mornings, evenings, and weekends.
9. Agency/Municipality will provide case plans, as appropriate, that identify objectives and delineation of responsibilities.
XVIII. OPERATIONAL SPECIFICATIONS
The awardee will be required to submit a current Certificate of Declaration of Insurance, with Fulton County Government
added as an “Additional Insured”. Language reflecting “Fulton County Government as an “Additional Insured” must be
stated on the certificate.
All applicants are required to submit FORM F: Georgia Security and Immigration Contractor Affidavit and Agreement
and as applicable FORM G: Georgia Security and Immigration Subcontractor Affidavit.
Letter from an Authorized Certifying Official is attached with the following resolution that authorizes the submission of
the application.
Name of Applicant: _____________________________________________________________________________