Fill - Free fillable - Economic Development Application (Columbus Consolidated Government) PDF form

Columbus Consolidated Government

Community Development Block Grant Program

(CDBG)

Economic Development Project Application

__________________________________________________________________________________________

Applicant Agency

__________________________________________________________________________________________

Applicant’s Name and Title

Columbus Consolidated Government

Community Reinvestment Department

420 10

th

Street

Columbus, GA 31901

(706) 653-4613

(706) 653-4486 fax

2019-2020 CDBG Economic Development Project Application

1

Please return one hard copy of all application materials to the following:

Community Reinvestment Department

Attn: Ms. Marilyn Denson

420 10

th

Street

Columbus, GA 31901

In addition to the hardcopy, please submit an electronic copy of the application PDF (as well as any

additional pages used to answer application questions) to mdenson@columbusga.org.

The deadline for submitting all applications is: Wednesday, February 20 2019, 4:00 PM

(Applications received after this date and time will not be accepted. No exceptions will be made)

2

2019-2020 CDBG Economic Development Project Application

GENERAL AND COMPLIANCE ITEMS

Organizational Type;

☐ Governmental Unit of Columbus Consolidated Government

☐ Other governmental unit or authority

☐ Non-profit corporation; date of incorporation

___________________________________________

☐ For-profit Corporation; date of incorporation

___________________________________________

☐ Community Housing Development Organization

(CHDO; date of incorporation

___________________________________________

Type of Funding Requested;

☐ Grant ☐ Loan (Explain Below) ☐ Combination (Explain Below)

If this is a loan request or a combined loan/grant request, provide proposed repayment schedule and terms.

Please note that for-profit agencies are generally not eligible for grants. (Expand Space below as needed to

answer.)

________________________________________________________________________________________

Total Amount Requested:_______________________________________________________________

Total Matching Funds, if applicable:______________________________________________________

Is this project consistent with the

FY 2017 – FY 2021 Five Year

Consolidated Plan?

☐ Yes ☐ No

Is your agency a faith based

agency?

☐ Yes ☐ No

Is your agency minority owned?

☐ Yes ☐ No

Is your agency women owned?

☐ Yes ☐ No

2019-2020 CDBG Economic Development Project Application

3

APPLICANT INFORMATION

Organization’s Legal Name:_____________________________________________________________

DUNS #: _____________________________ Tax ID #: ___________________________________

Applicant Address:____________________________________________________________________

City:_______________________ State:____________________ Zip Code:__________________

Project Manager:______________________________________________________________________

Email:_______________________________________________________________________________

Telephone:________________________________ Fax:___________________________________

Chief Executive Officer Name:__________________________________________________________

E-mail Address:_______________________________________________________________________

Applicant Website Address:_____________________________________________________________

*The signature below must be from the person authorized in the resolution supporting the application.

__________________________________________ ________________________________________

Signature Date

__________________________________________

Title

click to sign

signature

click to edit

2019-2020 CDBG Economic Development Project Application

4

National Objective: (Check One)

CDBG requires that each activity funded, except for program administration and planning activities, must

meet one of the three national objectives outlined below. An activity that does not meet a national objective

is not compliant with CDBG requirements and is therefore ineligible for funding. Applicants are strongly

encouraged to consult the application guide for more detailed information.

☐ Primary Objective - Benefit to low- and moderate income (LMI) persons

This objective is known as the “primary” national objective because CDBG regulations require that

funding recipients expend 70% of their CDBG funds to assist low- and moderate-income persons. There

are four methodologies that can be utilized to meet this national objective as listed below:

1.) Area Benefit Activities – these activities must benefit all residents in a particular service

area, where at least 51% (for water, sewer, and flood control projects) or 50.3% (for capital

improvement projects) of persons in the service area are low- and moderate-income, per most

recent U.S. Census Data.

 The service area is determined based upon the nature of the activity, location of the

activity, accessibility issues, availability of comparable activities, and boundaries for

public facilities and public services. Service area must be determined prior to provision of

CDBG assistance.

 Examples of eligible activities include infrastructure, public facilities, and economic

development.

2.) Limited Clientele Activities – At least 51% of the beneficiaries of the proposed project

activity must be low- and moderate-income. In contrast to the low-mod area benefit activity

category listed above, it is not the low- and moderate-income concertation of the service

activity that determines eligibility, but rather the actual number of low-and moderate-income

persons that will benefit from the activity. In order to qualify under this category, an activity

must satisfy one of the following criteria:

 Benefit a clientele that is generally presumed to be principally low- and moderate-income

including abused children, battered spouses, elderly persons, severely disabled adults,

homeless persons, illiterate adults, persons living with AIDS, and migrant farm workers

or

 Document household size and income which demonstrates that at least 51% of the

clientele are low- and moderate-income or

 Restrict income eligibility for the activity to low- and moderate-income persons or

 Be of such a nature and in such a location that it can be concluded that clients are

primarily low- and moderate-income

3.) Housing Activities – include that are undertaken for the purpose of providing or improving

permanent residential structures which, upon completion, will be occupied by at least 51%

low- and moderate-income households.

4.) Low-mod job creation or retention activities – these activities must be undertaken with the

purpose of creating or retaining permanent jobs, at least 51% of which (computed on a

fulltime equivalent basis) will be made available to or held by low-and moderate-income

persons.

☐ Aid in the prevention or elimination of slums or blight

Prevent or eliminate slum and blight or on an area basis, or eliminate specific conditions of blight or

physical decay on a spot basis that are not located in a slum or blighted area.

2019-2020 CDBG Economic Development Project Application

5

PROJECT INFORMATION

Project Title:_________________________________________________________________________

Project Address:______________________________________________________________________

Project Site Control: Indicate below if the organization has in place the items listed. For items not

currently in place, or partially in place, explain in the space below the listing why these are not in place.

☐ Applicant owns property: Date acquired:

___________________________________________

☐ Lease. Expiration Date:

___________________________________________

☐ Option to purchase. Expiration Date:

___________________________________________

☐ Other, please describe (Expand space as

needed to answer.)

___________________________________________

Project Site Compliance: If project operations are currently being carried at the site, indicate if site is

compliant, partially compliant, or is not compliant with the items listed. For items with which the site is

not compliant or partially compliant, explain in the space below what actions are planned to achieve

compliance.

Building Code compliance __________________________________________

Fire Code compliance, and date of last inspection __________________________________________

Health Code compliance, if applicable, and date

of last inspection

__________________________________________

Other, please describe (Expand space as needed

to answer)

___________________________________________

Zoning: Provide the zoning status of the project site. If zoning is not known, contact the Columbus

Consolidated Government’s Planning Department at (706) 653-4421

What is the current zoning classification of

project site? ___________________________________________

Is the site zoned correctly

for the proposed activity?

☐ Yes ☐ No ☐ Don’t know

If “No” or “Don’t know,” will the project need to obtain a zoning change,

special-use permit, or variance?

☐ Yes / ☐ No

If acquisition is required for this

project, is the property vacant?

☐ Yes ☐ No

If yes, please specify

how long property has

been vacant: __________

2019-2020 CDBG Economic Development Project Application

6

Eligible Economic Development Activities: Please check below the eligible economic development activities

that will be undertaken: (Check all that apply)

☐ Commercial/Industrial land acquisition/disposition

☐ Commercial/industrial infrastructure development

☐ Commercial/industrial building acquisition, construction, rehabilitation

☐ Other commercial/industrial improvements

☐ Direct financial assistance to for-profits

☐ Economic development technical assistance

☐ Micro-enterprise assistance

☐ Other; specify: ________________________________________________________________

Estimated Full-time Private Sector Jobs Created/Retained (if applicable)

# of new jobs to be created: _____________________________________________

# existing jobs to be retained: _____________________________________________

# of jobs to be available to low/mod

persons:

_____________________________________________

Types of Private Sector Jobs Created/Retained (If applicable)

Indicate the specific types of jobs to be created/retained, including the # of each type of job and the pay or

professional level. (Expand space below as needed to answer)

________________________________________________________________________________________

Estimated number of businesses Assisted (if applicable)

# of new businesses to be assisted _____________________________________________

# of business expansions to be assisted _____________________________________________

# of business relocations to be assisted _____________________________________________

For business relocations: Specify area/location from which business will move, and explain why relocation is

needed. (Expand space below as needed to answer)

________________________________________________________________________________________

2019-2020 CDBG Economic Development Project Application

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Describe the proposed project and designated project area (must be within Muscogee County): Provide a

detailed description of the project site and area that will benefit. If applicable, please provide any map or

other attachments at the end of this application that shows the project site and area that will benefit)

________________________________________________________________________________________

Summary of Project Need and Justification: Provide a concise summary of the need for the project and why

this project is a priority. Please indicate who is served or will be served by the facility, and include

information about the location of similar facilities; the demand for services in the surrounding area;

pedestrian, bicycle and public transit accessibility; and the applicant’s financial ability to operate and

maintain the facility. (If additional space is required, please include attachments.)

________________________________________________________________________________________

2019-2020 CDBG Economic Development Project Application

8

Detailed Project Description: Describe specifically what you propose to do with the requested funds, how

you propose to do it, and how you anticipate the City’s funding will be used. Describe any partnerships or

collaborations that are an integral part of the proposed project.

________________________________________________________________________________________

2019-2020 CDBG Economic Development Project Application

9

Leveraging other funding: If applicable, please describe how your municipality or agency will leverage other

funds, public or private, over the long-term to support similar projects and reduce reliance upon the City’s

CDBG funding.

________________________________________________________________________________________

2018 CDBG Economic Development Project Application

10

Timetable: Provide your timetable for execution of project activities, explaining any phasing or staging of

activities that will be required. Assume that the City’s funding will be available after June of the program

year from which funding is being requested. Timetable should include any needed design or bid preparation

activities, procurement actions, and all major components up to occupancy of the facility.

________________________________________________________________________________________

2018 CDBG Economic Development Project Application

11

BUDGET INFORMATION

(For Construction/Development Projects)

Budget: Complete the budget chart below. Include all items associated with implementing the proposed

activities. If the project has more than one distinct component – for example, a project that will be developing

two or three different cost items at each site – copy this budget form and complete a separate budget for each

separate component. Complete the heading below to indicate which component the budget covers.

☐ N/A; no components

Project component or site (name): ____________________________

Budget line item Total Project Cost $ City $s Requested

Acquisition/Land

Acquisition/Structures

Appraisals

Demolition

Site Preparation

Relocation

Architect/Engineering

Lead-Based Paint

Assessment/Abatement

Insurance/Bonding

1

Construction Management Fees

Builder/Developer Fees

Audit

2

Other (Specify):_______________

Construction (List below by

components):

____________________________

Grand Totals $

1

Note that General Liability Insurance or General Commercial Liability (1 million); Automobile Liability Insurance, Worker’s

Compensation, Fidelity Bond (100% of contract amount), and Payment and Performance Bonding are usually required for all

contractors. Builders’ Risk Insurance is required for all new construction. Costs for coverage should be included in this Budget

Summary. If you do not already have this coverage, it is an eligible CDBG expense. All policies must have endorsement specifically

naming Columbus Consolidated Government as additional insured.

2

All projects must have annual independent audit. Agencies with federal or federally-derived funded expenditures of $750,000 or

more must have an annual A-133 audit. Cost of conducting this audit is an eligible CDBG expense.

2018 CDBG Economic Development Project Application

12

Matching Funds, In-Kind Resources, and/or Donations from Other Sources: Complete the chart below to

show cash match, donated or in-kind physical match (such as free space, equipment, etc.) or in-kind

professional match. Also include other Federal, State, County, and City funding, as well as Low Income

Housing Tax Credits (LIHTC) if applicable.

NOTE: If project includes both capital and operational funding and agency is submitting request for funding

for both components, the same match cannot be used for both components.

Proposed Source C/IK

3

$ Value Status Code

4

Date that $/Resource will

be available to project

_________________________ ______ ___________ ______________ ______________________

Total $ Value

___________

3

Indicate whether Resource is being provided as Cash (C) or and In Kind (IK) Contribution.

4

Status Codes (See Below):

C = Committed: Attach documentation or provide timetable for subm

i

ssion of documentation. Professional in-kind match

is considered as Committed only with written documentation. For continuing-funding resources not yet

committed for next year, provide most recent award letters. Additional documentation may be submitted

as available through August. If committed but undocumented, explain in an attachment to this

application.

A = Applied for: Provide Status and estimated notification date in additional attachment.

TBR = To be Raised: Describe funding plan and timetable in additional attachment.

2018 CDBG Economic Development Project Application

13

BUDGET INFORMATION

(For Service/Operational Costs)

*Note: A project that has both physical improvement and operational components in the same project should complete both

budget sections. For Development/Construction projects, do not use this budget.

Summary Budget: Complete the budget chart below. Include all items associated with implementing the

proposed activities, regardless of funding source. Include only the costs associated with the proposed activity,

not all of the agency or organization expenses or resources.

Budget line item Total Project Cost $ City $s Requested

Staff Salaries

5

Staff Fringe Benefits

Staff Travel

Office/Program Communications

Office/Program Rental/Lease

Office/Program Utilities

Equipment Purchase

Printing and Reproduction

Office/Program Materials/Supplies

Insurance/Bonding

6

Contractual Services

Audit

7

Office/Program Maintenance and Repairs

Other direct Office/Program Cost

Direct client Cost

8

Indirect Costs

9

Grand Total $

5

Attach job descriptions of all staff members to be paid under this project.

6

Note that General Liability Insurance or General Commercial Liability (1 million); Automobile Liability Insurance, Worker’s

Compensation, Fidelity Bond (100% of contract amount), and Payment and Performance Bonding are usually required for all

contractors. Builders’ Risk Insurance is required for all new construction. Costs for coverage should be included in this Budget

Summary. If you do not already have this coverage, it is an eligible CDBG expense. All policies must have endorsement specifically

naming Columbus Consolidated Government as additional insured.

7

All projects must have annual independent audit. Agencies with federal or federally-derived funded expenditures of $750,000 or

more must have an annual A-133 audit. Cost of conducting this audit is an eligible CDBG expense.

8

Direct client costs Include those expenses that can be tied directly with a benefitting client or household, and those tangible items

that are supplied directly to clients. These costs can include: rental/lease of a housing unit; payment of utility bills for a housing unit;

MARTA Breeze cards; furniture or equipment for a housing unit; financial aid to prevent homelessness or to enable a family to move

into a permanent housing unit; clothing or hygiene supplies for clients; etc.

9

Under the OMB “Omni Circular” published 12-26-2013 (https://www.federalregister.gov/a/2013-30465), non-profit subrecipient

may include, in their project budgets, an Indirect Cost charge as appropriate given the funded project or activity. For subrecipient

entities with a negotiated indirect cost rate, their federally approved rate must be used. Subrecipient entities that have never

received a negotiated indirect cost rate, may elect to charge a de Minimis rate of 10% of modified total direct costs (MTDC) which

may be used indefinitely.

2019-2020 CDBG Economic Development Project Application

14

Matching Funds, In-Kind Resources, and/or Donations from Other Sources: Complete the chart below to

show cash match, donated or in-kind physical match (such as free space, equipment, etc.) or in-kind

professional match. Also include other Federal, State, County, and City funding, as well as Low Income

Housing Tax Credits (LIHTC) if applicable.

NOTE: If project includes both capital and operational funding and agency is submitting request for funding

for both components, the same match cannot be used for both components.

Proposed Source C/IK

10

$ Value Status Code

11

Date that $/Resource will

be available to project

_________________________ ______ ___________ ______________ ______________________

Total $ Value

___________

10

Indicate whether Resource is being provided as Cash (C) or and In Kind (IK) Contribution.

11

Status Codes (See Below):

C = Comm

i

tted: Attach documentation or provide timetable for submission of documentation. Professional in-kind match

is considered as Committed only with written documentation. For continuing-funding resources not yet

committed for next year, provide most recent award letters. Additional documentation may be submitted

as available through August. If committed but undocumented, explain in an attachment to this

application.

A = Applied for: Provide Status and estimated notification date in additional attachment.

TBR = To be Raised: Describe funding plan and timetable in additional attachment.

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