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HOME INVESTMENT PARTNERSHIPS PROGRAM (HOME) APPLICATION (City of Pasadena, Texas)

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Applications Due: Thursday, April 2, 2020 at 4:00 P.M. CST
NO LATE APPLICATIONS WILL BE ACCEPTED
Applications may be either mailed or hand delivered to:
Office of the City Secretary
1149 Ellsworth Drive 2
nd
Floor
Pasadena, Texas 77506
Any applications received after the above stated time will be returned unopened.
Your application will not be evaluated if all of the submission requirements are not
met and the documentation is not attached.
CITY OF PASADENA
HOME INVESTMENT PARTNERSHIPS
PROGRAM (HOME)
APPLICATION
Jeff Wagner, Mayor
Table of Contents
Terms and Conditions ........................................................................................................................... 1
Application Instructions ........................................................................................................................ 5
Other Requirements .............................................................................................................................. 6
Evaluation Criteria ................................................................................................................................ 7
Evaluation Form ................................................................................................................................... 8
Application for Funding ...................................................................................................................... 13
Submission Requirements/Checklist .................................................................................................. 28
Application Submission Label ............................................................................................................ 29
Conflict of Interest .............................................................................................................................. 30
For Disadvantaged Businesses Enterprises Only ................................................................................ 31
Indemnity Clause ................................................................................................................................ 32
Non-Collusion Affidavit ..................................................................................................................... 33
Certification of Non-Debarment ......................................................................................................... 34
Solicitation Questionnaire ................................................................................................................... 35
Certificate of Interested Parties ........................................................................................................... 36
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TERMS AND CONDITIONS
This application does not commit the City of Pasadena to award a contract or to pay any costs incurred as a result of
preparing such a response. The City reserves the right to accept or reject any and all applications received in
response to this request, to negotiate with all qualified applicants or to cancel in part, or in its entirety, this
application if it is in the best interest of the City. The City may choose to proceed with any or all portions of this
application at its sole discretion. These instructions are standard for all contracts for commodities or services issued
through the City of Pasadena. General Requirements apply to all advertised bids/proposals/applications; however,
these may be superseded, whole or in part, by the SPECIAL CONDITIONS OR OTHER DATA CONTAINED HEREIN.
READ THIS ENTIRE DOCUMENT CAREFULLY. FOLLOW ALL INSTRUCTIONS. YOU ARE RESPONSIBLE FOR
FULFILLING ALL REQUIREMENTS AND SPECIFICATIONS. BE SURE YOU UNDERSTAND THEM.
1. CHANGES IN SCOPE OF WORK
The City may request changes in the Scope of Work to be performed. Such changes, including increase or
decrease in compensation must be mutually agreed upon and incorporated by written amendment to the
agreement.
2. ANTI-LOBBYING PROVISION
During the period between the publication date and the contract award, applicants, including their agents and
representatives, shall not directly discuss or promote their application with any member of the Pasadena City
Council, Community Development Advisory Board or City staff except in the course of City-Sponsored
inquiries, briefings, interviews or presentations unless requested by the City. This provision is not meant to
preclude respondents from discussing other matters with City Council Members, Community Development
Advisory Board Members or City Staff. This policy is intended to create a level playing field for all potential
applicants, assure that contract decisions are made in public and to protect the integrity of the application
process. Violation of this provision may result in rejection of the applicant’s application.
3. POTENTIAL CONFLICTS OF INTEREST
An outside consultant or contractor is prohibited from submitting an application for services on a City of
Pasadena project of which the consultant or contractor was a designer or other previous contributor, or was
an affiliate, subsidiary, joint venture or was in any other manner associated by ownership to any party that
was a designer or other previous contributor. If such a consultant or contractor submits a prohibited
application, that application shall be disqualified on the basis of conflict of interest, no matter when the conflict
is discovered by the City.
4. APPLICABLE LAW AND VENUE
Any agreement resulting from this application shall be construed according to the laws of the State of Texas.
The City and Agency’s agree that the venue for any legal action under this agreement shall be the Harris County,
Texas. In the event that any action is brought under any agreement resulting from the application in Federal
Court, the venue for such action shall be in the Federal Judicial District of Harris County, Texas.
5. IMMIGRATION REFORM and CONTROL ACT (IRCA)
The Immigration Reform and Control Act (IRCA), also Simpson-Mazzoli Act (Pub.L. 99-603, 100 Stat. 3359,
signed by President Ronald Reagan on November 6, 1986) is an Act of Congress which reformed United States
immigration law. The Act made it illegal to knowingly hire or recruit illegal immigrants (immigrants who do
not possess lawful work authorization), required employers to attest to their employees' immigration status,
and granted amnesty to certain illegal immigrants who entered the United States before January 1, 1982 and
had resided there continuously. The Act also granted a path towards legalization to certain agricultural
seasonal workers and immigrants who had been continuously and illegally present in the United States since
January 1, 1982.
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6. APPLICATION FORM COMPLETION
Unless otherwise specified, respondents must use the application form provided. Forms shall be completed
and submitted to the City Secretary’s Office. The contract will be binding only when signed by the City of
Pasadena, funds are certified by the City Controller, as applicable, and a Purchase Order issued.
7. SCANNED OR RE-TYPED RESPONSE
If in its application response, applicant either electronically scans, re-types, or in some way reproduces the
City’s published application, then in event of any conflict between the terms and provisions of the City’s
published application, or any portion thereof, and the terms and provisions of the application response made
by, the City’s specifications as published shall control. Furthermore, if an alteration of any kind to the City’s
published specifications is only discovered after the contract is executed and is or is not being performed; the
contract is subject to immediate cancellation.
8. APPLICATION RETURNS including ALTERNATE APPLICATIONS
Applicants shall submit six (6) unbound copies with “ORIGINAL” signatures in a sealed envelope or package
of comparable size. Please cut out and affix the application Label found on the “Application Submission
Label” to the outermost mailing envelope (UPS, USPS, FEDEX, etc.) of your application to ensure proper
delivery!
Applicants must return all applications to by the date and time specified:
City of Pasadena
City Secretary’s Office
1149 Ellsworth Drive, 2
nd
Floor
Pasadena, Texas 77506
Late applications will not be accepted, and will be returned to applicant unopened.
9. AWARD OF CONTRACT
The City of Pasadena anticipates entering into a contract to be most advantageous to the City. The respondent
understands that this application does not constitute an agreement or a contract with the City. An official
contract or agreement is not binding until applications are reviewed and accepted by the City and a written
agreement or contract is approved by both the City and the successful applicant. The City Council must award
the contract and the Mayor, or other person authorized by the Mayor, must sign the contract before it becomes
binding on the City of Pasadena or the bidders. Department heads are NOT authorized to sign agreements for
the City of Pasadena.
10. PROTESTS
10.1. All protests regarding the solicitation process must be submitted in written form to the Community
Development Manager within five (5) working days following the submission of the application. This
includes all protests relating to legal advertisements, deadlines, application submittals, and all other
related procedures under the Local Government Code, as well as any protests relating to alleged
improprieties or ambiguities in the specifications contained herein or in the contract documents.
10.2. Post-award protests must be submitted in written form to the Community Development Manager
within five (5) working days after award and must specify the grounds upon which the protest is based.
A valid protest shall;
10.2.1. Come from an actual respondent for the contract, and
10.2.2. Who claim to be the rightful awardee. That is, the protest is not valid if filed by a respondent who
cannot show they would be awarded the contract if their protest were accepted.
10.3. The Community Development Manager, having authority to make the final determination, will respond
within ten (10) working days to each substantive issue raised in the protest. Allowances for
reconsiderations shall be made only if data becomes available that was not previously known, or if there
has been an error of law or regulation.
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11. INDEPENDENT CONTRACTOR
It is expressly understood and agreed by both parties hereto that the City is contracting with the successful
applicant as independent contractor/subrecipient. The parties hereto understand and agree that the City shall
not be liable for any claims which may be asserted by any third party occurring in connection with the services
to be performed by the successful applicant under this contract and that the successful applicant has no
authority to bind the City.
12. INSURANCE
If required, specific insurance provisions will be included in the application process. A copy of an insurance
certificate must be submitted within ten (10) days from the date of the request made by the Community
Development Department. The successful applicant will be required to maintain, at all times during
performance of the contract, the insurance detailed in bid/proposal specifications. Failure to provide this
document may result in disqualification of the application.
13. WAIVER OF SUBROGATION
Applicant and applicant’s insurance carrier waive any and all rights whatsoever with regard to subrogation
against City of Pasadena as an indirect party to any suit arising out of personal or property damages resulting
from respondent’s performance under this agreement.
14. TERMINATION
The City of Pasadena reserves the right to terminate the contract for default if applicant breaches any of the
terms therein, including warranties of the applicant or if the applicant becomes insolvent or commits acts of
bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies which the City of
Pasadena may have in law or equity. Default may be construed as, but not limited to, failure to deliver the
proper goods and/or services within the proper amount of time, and/or to properly perform any and all
services required to the City’s satisfaction and/or to meet all other obligations and requirements.
15. TERMINATION-NOTICE
Either party may cancel the contract at any time after award. The City shall be required to give the applicant
notice thirty (30) days prior to the date of cancellation of the contract. The applicant shall be required to give
the City written notice sixty (60) days prior to the date of cancellation of the contract. The City of Pasadena
may terminate the contract without cause upon thirty (30) days written notice.
16. INDEMNITY
CONTRACTOR/SUBRECIPIENT covenants and agrees to FULLY INDEMNIFY and HOLD HARMLESS, the
CITY and elected officials, employees, officers, directors, and representatives of the CITY, individually
or collectively, from and against any and all costs, claims, liens, damages losses, expenses, fees, fines,
penalties, proceedings, actions, demands, causes of action, liability and suits of any kind and nature,
including but not limited to, personal injury or death and property damage, made upon the CITY,
directly or indirectly arising out of resulting from or related to bid activities under this bid, including
any acts or omissions of CONTRACTOR/SUBRECIPIENT any agent, officer, director, representative,
employee, consultant or subcontractor of CONTRACTOR, and their respective officers, agents,
employees, directors and representatives while in the exercise or performance of the rights or duties
under this CONTRACT, all without, however, waiving any governmental immunity available to the CITY
under Texas Law and without waiving any defenses of the parties under Texas Law. The provisions of
this INDEMNIFICATION are solely for the benefit of the parties hereto and not intended to create or
grant any rights, contractual or otherwise, to any other person or entity. CONTRACTOR/SUBRECIPIENT
shall promptly advise the CITY in writing of any claim or demand against the CITY or
CONTRACTOR/SUBRECIPIENT known to CONTRACTOR/SUBRECIPIENT related to or arising out of
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CONTRACTOR/SUBRECIPIENT’S activities under this CONTRACT and shall see to the investigation and
defense of such claim or demand at CONTRACTOR/SUBRECIPIENT’S cost. The CITY shall have the right,
at its option and at its own expense, to participate in such defense without relieving CONTRACTOR of
any of its obligations under this paragraph.
It is the EXPRESS INTENT of the parties to this contract, that the INDEMNITY provided for in this section,
is an INDEMNITY extended by CONTRACTOR/SUBRECIPIENT to INDEMNIFY, PROTECT and HOLD
HARMLESS the CITY from consequences of the CITY’S OWN NEGLIGENCE, provided however, that the
INDEMNITY provided for in this section SHALL APPLY only when the NEGLIGENT ACT of the CITY is a
CONTRIBUTORY CAUSE of the resultant injury, death, or damage, and shall have no application when
the negligent act of the CITY is the sole cause of the resultant injury, death, or damage.
CONTRACTOR/SUBRECIPIENT further AGREES TO DEFEND, AT ITS OWN EXPENSE and ON BEHALF OF
THE CITY AND IN THE NAME OF THE CITY, any claim or litigation brought against the CITY and its
elected officials, employees, officers, directors and representatives, in connection with any such injury,
death, or damage for which this INDEMNITY shall apply, as set forth above.
16.1. PATENTS/COPYRIGHTS
The successful applicant agrees to indemnify and hold the City harmless from any claim involving
patent infringement or copyrights on goods supplied.
17. TAXES
The City of Pasadena is exempt from all federal excise, state and local taxes unless otherwise stated in this
document. The City of Pasadena claims exemption from all sales and/or use taxes under Texas Tax Code
§151.309, as amended. Texas Limited Sales Tax Exemption Certificates will be furnished upon written request
to the City of Pasadena Purchasing Department.
18. ASSIGNMENT
The successful applicant shall not sell, assign, transfer or convey this contract in whole or in part, without the
prior written consent of the City of Pasadena Community Development Department. Any such assignment or
transfer shall not release applicant from all contractual obligations.
19. CONTRACT RENEWALS
Renewals may be made ONLY by written agreement between the City of Pasadena and the applicant.
20. HOUSE BILL 914 DISCLOSURE OF CERTAIN RELATIONSHIPS
The Texas Ethics Commission adopted Form CIQ (Conflict of Interest Questionnaire) pursuant to H.B. 914.
Effective January 1, 2006, Chapter 176 of the Texas Local Government Code requires that any vendor or person
considering doing business with a local government entity disclose pertinent information in the Questionnaire
Form CIQ.
The questionnaire is to be filed in accordance with Chapter 176, Local Government Code by a person who has
a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the person
meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not
later than the 7th business day after the date the person becomes aware of facts that require the statement to
be filed. See Section 176.006, Local Government Code. A person commits an offense if the person knowingly
violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor.
The CIQ Form can be located at https://www.ethics.state.tx.us/forms/conflict/ (example on page 37 & 38)
21. CERTIFICATE OF INTERESTED PARTIES
The Texas Ethics Commission adopted Form 1295 (Certificate of Interested Parties) pursuant to H.B. 1295.
Effective September 1, 2015, Chapter 2252 of the Texas Government Code requires that a business entity (any
vendor or person) doing business with a local government entity may not enter into a contract unless the
business entity has first submitted a completed Certificate of Interested Parties Form 1295 to the government
entity. The 1295 Form can be located at: https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm
5
APPLICATION INSTRUCTIONS
The City of Pasadena receives Home Investment Partnerships Program (HOME) funds annually from the U.S.
Department of Housing and Urban Development (HUD) to fund activities that provide affordable housing
opportunities to benefit low- to moderate-income (LMI) households of Pasadena.
Each year the City uses a competitive application process to make a portion of HOME funds available to for-profit
and non-profit groups, subrecipients, developers and Community Housing Development Organizations (CHDO’s). A
minimum of 15 percent of HOME entitlement funds received each year but be set aside for specific activities to be
undertaken by a CHDO.
Note: The Community Housing Development Organization (CHDO) Certification Application must be completed to
qualify as an eligible CHDO activity.
Intent of the HOME Program
The HOME Program is authorized under Title II of the Cranston-Gonzalez National Affordable Housing Act, as
amended. Through the HOME Program, the City is provided with the opportunity to provide funding for activities
that build, buy and/or rehabilitate decent affordable housing for rent or ownership, or provide direct rental
assistance to low-income households.
Match Requirements
The HOME Program requires match contributions in an amount equal to no less than 25 percent of the total HOME
funds expended for project costs. The matching contributions must be from non-federal sources and be a permanent
contribution to affordable housing. For the specific match requirements, refer to HUD Regulations at 24 CFR 92.218-
222.
Eligible Activities
All activities must take place within the City of Pasadena. HOME funds may be used for:
Homeowner rehabilitation, to assist existing owner-occupants with repair, rehabilitation or reconstruction
of their homes;
Rental housing, to provide finding for the acquisition and/or rehabilitation of existing rental housing or the
construction of new rental housing;
Homebuyer activities, to provide financing for the acquisition and/or rehabilitation of new construction of
homes for homebuyers;
Direct financial assistance to homebuyers in the form of down payment assistance, closing costs and
mortgage loans;
Tenant-based Rental Assistance (TBRA), to provide financial assistance for rent, security deposits to eligible
tenants. Utility deposits may also be provided in conjunction with a security deposit or monthly rental
assistance program.
Income Limits
HOME Program activities must serve low- to moderate-income households with incomes at or below 80 percent of
the area median income, as determined by HUD. Each year, HUD publishes the applicable HOME income limits by
area, adjusted for family size on HUD Exchange. Current HOME income limits can be located at the link provided
https://www.hudexchange.info/programs/home/home-income-limits/
It is imperative that applicants anticipate and plan for the methods they will use to determine and document
the eligibility and incomes of all persons served by their HOME funded activities. Failure to adequately
6
document client data may result ineligibility of the activity, repayment of funds expended and cancellation
of any monies awarded.
Ineligible Activities
HOME funds may not be used for the development of public housing, operational costs associated with public
housing, or for Section 8 tenant-based assistance. Additionally, HOME Program funds may not be used to provide
non-federal matching contributions for other federal programs, for operational subsidies for rental housing, or for
activities under the Low-Income Housing Preservation Act.
OTHER REQUIREMENTS
Faith based Agencies: Faith-based agencies are eligible to apply. HUD issued a final rule amendment allowing faith-
based agencies to compete for HOME funding on the same basis as other non-profits, however, HOME funds cannot
be used to support worship or religious instruction. Religious activities must be offered separately from the HOME
supported activity. Faith based agencies may not use direct HOME funds to support inherently religious activities
such as worship or religious instruction. Faith-based agencies that participate in the HOME program shall not
discriminate against a program beneficiary on the basis of religion or religious belief. (Reference: CPD Notice 04-10)
Active Governing Body: Governance of the agency shall be vested in a responsible and active voluntary board,
which meets to establish and enforce policies. The Board shall be structured to be representative of the community
it serves.
Personnel: The agency must provide demonstration of adequate administration of the program to ensure delivery
of eligible services.
Non-Discrimination: Each agency receiving funds from the City is required to conduct its business in compliance
with the non-discrimination requirements of the City, State and Federal governments, as applicable. Equal
Opportunity in Employment policies are required.
DUNS number: Each agency is required to have a DUNS (Data Universal Numbering System) number generated
from Dun & Bradstreet. If you do not have a DUNS number for your agency one can be obtained free to apply for
federal funding. The website link to Dun & Bradstreet’s federal contract DUNS request service is
http://fedgov.dnb.com/webform. Regular business DUNS numbers require a fee.
WWW.SAM.GOV: The use of the DUNS (Data Universal Numbering System) number has been expanded to require
all applicant and grantee organizations to maintain an active registration in the System for Award Management
(SAM) Central Contractor Registry (CCR) database. The website link to the System for Award Management (SAM) is
https://sam.gov/SAM/
Accounting: Each agency shall maintain accounting records which are in accordance with Generally Accepted
Accounting Principles and Auditing Practices, as described in the Uniform Administrative Requirements, Cost
Principles and Audit Requirements for Federal Awards (2 CFR 200). The final guidance at 2 CFR 200 supersedes and
streamlines requirements from OMB Circulars A-21, A-87, A-110, and A-122; Circulars A-89, A-102, and A-133; and
the guidance in Circular A-50 on Single Audit Act follow-up. Agencies may be required to submit their accounting
systems to the City of Pasadena for approval before any funds are disbursed.
Insurance: Once an agency’s project has been approved, at the time of contract signing, the agency must provide
evidence of insurance, including, but not limited to, multi-peril property and liability, medical, workers’
compensation, automobile liability, and other coverage as deemed necessary by the City Attorney, with an
indemnification and hold harmless acceptable to the City. All certificates and endorsements are to be received and
approved by the City before project commences.
7
EVALUATION CRITERIA
Because the activities subject to funding by this application are specific in nature, the evaluation criteria must also
be specific to each activity type as outlined below. Minimum eligibility criteria for all applications are:
a. Nonprofit 501(c)(3) status for at least one (1) full year, or
b. Two (2) full years of operating experience under another non-profit entity, or
c. For-profit entity proposing to use funds for an eligible activity.
d. Demonstration of successful experience in undertaking comparable programs/projects.
e. Production and completion of projects previously awarded funds by the City of Pasadena.
*The form on the following page is a sample of the evaluation criteria used for grant
recommendation. It is an example and should not be completed by your agency.
**Please note that applicants who have previously received HOME funding from the City will also be
evaluated based on their past performance.
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EVALUATION FORM
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APPLICATION FOR FUNDING
[THIS PAGE INTENTIONALLY LEFT BLANK]
NEXT PAGE IS PAGE ONE OF APPLICATION
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COVERSHEET
HOME APPLICATION
FILL IN NAME OF YOUR ORGANIZATION IN SECTION BELOW:
ALL APPLICATIONS MUST BE TYPED AND SUBMITTED TO:
City of Pasadena
Office of the City Secretary
1149 Ellsworth Dr. 2
nd
Floor
Pasadena, Texas 77506
APPLICATION DUE: Thursday, April 2, 2020 at 4:00 pm
NO LATE APPLICATIONS WILL BE ACCEPTED
I have read and understand the application instructions prior to submitting.
I have THOUROUGHLY reviewed the 2020 APPLICATION WORKSHOP POWERPOINT.
I have read and signed the Terms and Conditions Section of this Application.
I HAVE READ AND EXECUTED THE CONFLICT OF INTEREST
DISCLOSURE FORM WITHIN THIS APPLIACTION.
Signature of Applicant Title Date
15
HOME Application
Organization Name:
Proposed Program Name:
DUNS Number:
Tax Identification Number:
Registered with
SAM.GOV
Organization’s Physical Address:
Organization’s Mailing Address:
Phone:
Fax:
Email:
Web Address:
Authorized Organization Official Signatory:
Phone:
Email:
*Primary Contact
Phone:
Email:
*Alternate Contact:
Phone:
Email:
*Both the primary and alternate contact (provided above) will serve as intermediaries between the agency and the
City of Pasadena Community Development Department. Therefore, the primary and alternate contact shall be
responsible for the distribution of information, provided by the City of Pasadena Community Development
Department, within the agency.
Type of Organization:
☐ Non-Profit ☐ For-Profit ☐ City Department ☐ Unit of Local Government ☐ General Partnership
☐ Limited Partnership ☐ Limited Liability Company ☐ Individual/D.B.A. ☐ Faith Based Organization
☐ Other: _____________________________
Proposed Activities (chose one):
☐ Housing Rehabilitation
☐ Homebuyer Assistance
☐ New Construction of Housing
☐ Community Development Housing
Organization (CHDO). Must complete CHDO
Certification Application.
☐ Acquisition of Vacant Land
☐ Site Improvements
☐ Other Necessary & Reasonable activities related to the
development of affordable housing. (Please Specify)
Program Funding
1) Requested Amount of HOME Funds
2) Other Funding Sources
3) Total Program Cost *
4) Percentage of HOME funds toward Total Program Cost **
*Total Program Cost: (Line 1 + Line 2 = Line 3)
**Percentage of City of Pasadena funds towards program/program cost: (Line 1 ÷ Line 3 = Line 4)
16
Project Match
Provide the amount and source of how the required HOME Funds Match Requirements (25% Match Required). (No
more than 5 lines)
Project/Program Delivery Description (Narrative) - if additional space is needed use Attachment D “Scope of Work”
Provide a complete description of the proposed activity to be undertaken with federal funds, including what
products or services are to be performed, where they are to be provided, for whom they are to be provided and how
they are to be provided. Explain how the project meets the criteria of the eligible activity selected.
Project Need – if additional space is needed use Attachment D “Scope of Work”
What unmet community need(s) will your project address? How will you determine that this need(s) exists? How
will your project address this need(s)?
17
Project Location and Service Area
Describe the physical area to be served by the project
Include a map with the boundaries of service labeled as: Attachment A - Service Area.
*If service area is the entire City of Pasadena jurisdiction, you do not need to submit an actual map, only the
attachment labeled: Attachment A – Service Area: Entire City of Pasadena Jurisdiction
Target Population
Describe how project benefits target population to be served, and if project currently serves this segment. Also
indicate number of unduplicated client and/or households expected to benefit from project. (No more than five
(5) lines).
Performance Measures: Objectives & Outcomes
HUD requires recipients of federal funds to assess the productivity and impact of their programs/projects. Please
select one of the following objectives that best suits your proposed activity as well as one expected output that relates
to the impact that program/project is expected to have on the community or person(s) benefiting from the activity.
OBJECTIVES (choose one)
OUTCOMES (choose one)
☐ Create a Suitable Living Environment
☐ Availability/Accessibility
☐ Affordability
☐ Sustainability
☐ Provide Decent Housing
☐ Availability/Accessibility
☐ Affordability
☐ Sustainability
☐ Creating Economic Opportunities
☐ Availability/Accessibility
☐ Affordability
☐ Sustainability
18
OBJECTIVES – Closely mirror the statutory objectives of the program. The objectives are framed broadly to capture
the range of community impacts that occur as a result of program activities.
Creating a Suitable Living Environment – This objective focuses on housing activities where the purpose is
to develop and maintain an adequate supply of safe, sanitary, decent housing that are affordable and
accessible to meet low income families or individuals needs by using housing activities that could be
undertaken with HOME funds.
Providing Decent Housing - This objective relates to activities that are intended to rehabilitate degrading
infrastructure to improve mobility and reduce hazardous conditions for LMI families.
Creating Economic Opportunities - applies to activities related to economic development, commercial
revitalization, or job creation.
OUTCOMES - helps further refine the activities objective and is designed to capture the nature of the change or the
expected result of the objective that an activity seeks to achieve. Outcomes correspond to the question “What is the
type of change the activity is seeking? Or what is the expected result of the activity?”
Availability/Accessibility applies to activities that make services, infrastructure, housing available or
accessible to LMI people, including persons with disabilities. In this category, accessibility does not refer only
to physical barriers, but also to making the basics of daily living available and accessible to LMI people where
they live.
Affordability applies to activities that provide affordability in a variety of ways to LMI people. It can include
the creation or maintenance of affordable housing, basic infrastructure hookups. Affordability is an
appropriate objective whenever an activity is lowering the cost, improving the quality, or increasing the
affordability of a product or service to benefit a low-income household.
Sustainability applies to activities that are aimed at improving communities or neighborhoods, helping to
make them livable or viable by providing benefit to persons of LMI or by removing or eliminating slums or
blighted areas, through multiple activities or services that sustain communities or neighborhoods.
Levels of Accomplishment – Goals & Performance Measures - if additional space is needed use Attachment D “Scope of Work”
Number of unduplicated clients/households expected to benefit from
project/program:
EXAMPLE: Program will provide 10 new single-family affordable housing units
Description of Services Provide a description of the services that will be provided.
EXAMPLE: Program will provide affordable housing
Units of Service Provide a definition of Units of Service - How will your organization determine the amount of
services rendered?
EXAMPLE: One unit of service is equal to 1 new single-family affordable housing unit
One unit of service is equal to :
Project Site Information (Rental Housing) – if additional space needed use Attachment D “Scope of Work”
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Owner:
Contact Person:
Title:
Phone Number:
E-mail Address:
If agency owns property, date acquired:
If agency leases property, date the lease expires:
Employment/Client Participation
Does your organization currently notify the public that your agency does not discriminate
based on race, color, religion, gender, sexual orientation, national origin, age or disabilities
in hiring practices or provision of services?
Yes
No
If No, is your agency is willing to adopt this practice?
Yes
No
Accessibility for Physically Disabled
Will the completed project meet ADA standards for accessibility by the
disabled?
Yes
No
N/A
If no, please describe accessibility problems and how you intend to correct them, including funding and
timetable:
Organization Capacity /Information Attachment B – Organization Information
Please check all that have been included with your application (Attachment B):
☐ Organizational Chart
☐ Articles of Incorporation
☐ Proof of Tax Exempt Status
☐ Current Year Budget
☐ List of Board of Directors
How many years has your organization been in business?
Has your organization received HOME funding from the City of Pasadena in the past two
years?
Yes
No
If yes, please provide a brief summary of the activity / amount funded:
Has your agency participated in this type of activity in the past?
Yes
No
20
In the space below describe your agency's past 5 years of experience with HOME or other federal grant programs.
Include number of years working with federal grants and the type/amount of each grant received:
(list individually) – if additional space needed use Attachment B “Scope of Work”
Year Amount Type of Grant
Does your organization currently or within the last five years have any litigation that is
pending or has been resolved?
Yes
No
If yes, please attach a summary of the litigation and its status; including any outstanding judgements
Has your organization filed a petition for bankruptcy or has a petition for bankruptcy been
filed against your organization?
Yes
No
If yes, please attach an explanation that includes the current status.
What level of financial review does your organization obtain from an independent source? Select from the
following options:
☐ Single Audit
☐ Reviewed Financial Statement
☐ No Independent Review
☐ Audited Financial Statements
☐ Compiled Financial Statements
☐ Other (Please Specify):
Will the proposed project/program sustain if requested funds are not awarded?
Yes
No
Scope of Work Attachment D – Scope of Work
Describe project/program in detail. Answer ALL of the following point within description:
What do you intend to do and why?
Explain how the project/program meets the criteria of the eligible activity selected.
How does the project/program meet a community need(s)?
Who is your project/program beneficiary population?
Describe your service delivery plans including:
o Hours of operation
o Intake system
o Outreach plan
Define how client eligibility will be determined and documented.
Provide a timeline for project/program execution and completion.
Give the program goals:
o Units of Service (quantify the assistance and/or service program participants will receive)
o Number of unduplicated clients you expect to serve
Do not give an overview of your agency – be project specific!
Must be submitted as a separate document labeled Attachment D – Scope of Work.
This document should be NO MORE THAN 3 PAGES.
21
Project/Program Team
Identify the name of the responsible party, job description and the experience of each staff member that will be
involved in the administration of this activity. Personnel identified after the application are subject to review. List
only those who will be working with HOME funds.
Staff Member
Job Description and Experience
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
22
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
Name
Title
Phone
Email
Supervisor
23
Please indicate which administrative systems you currently utilize:
Please check all that apply:
Formal personnel system with written procedures
Staff salary tracking system by funding source
Audit system incorporating formal written accounting procedures
Recordkeeping system that tracks each funding source separately
Formal written cash management practices that includes proper security measures
Hard copy files and computer records systems with security and back-up in place
Internal monitoring/evaluation system that follows written procedures
Client eligibility verification
Client demographic data collection and reporting system
Procurement policy governed by formal written procedures
Conflict of interest policies
Client grievance policies
Annual fundraising/revenue generation
24
Organization Board of Directors (City Departments – insert council members information)
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
25
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
Name
Business Affiliation
Title
Phone
Email
26
Financial Capacity & Budget Attachment E – Additional Budget Information
What is the amount of your current Annual Operating Budget?
Agency Financial System (choose one):
Cash Basis
Accrual Basis
Fiscal Year starts:
Fiscal Year Ends:
Project/Program Budget (HOME FUNDS REQUESTED PORTION ONLY)
Please explain how each expense is related to project delivery and indicate total cost of each line item.
Expense
Amount
Justification
Salaries/Wages (include title and
percentage of total salary budgeted
for each position)
Fringe Benefits
Total Personnel
Acquisition
Site Development
Demolition and Removal
Utilities
Plumbing
Equipment Rental
Electric
Other expenses (specify)
Other expenses (specify)
Total Non-Personnel
HOME Funds Budget Total
27
Note: Complete Budget Detail – Input personnel costs data in the table if staff costs are included in your
application.
Total Project/Program Budget (INCLUDING ALL FUNDING SOURCES & MATCH)
Category Breakdown
HOME FUNDS
REQUESTED
Match Funds
Source of Match
Funds
Total Funds
1. Personnel
Salaries
Total Personnel
2. Site Acquisition
Land/Building
Closing Costs
Other (Please Specify):
Other (Please Specify):
Total Site Acquisition
3. Construction
Site Development
Demolition and Removal
Construction
Contingency
Other (Please Specify):
Other (Please Specify):
Total Construction
4. Other (Soft Costs)
Other (Please Specify):
Other (Please Specify):
Other (Please Specify):
Other (Please Specify):
Other (Please Specify):
Total Other (Soft Costs)
Grand Total
28
SUBMISSION REQUIREMENTS/CHECKLIST
SUBMISSION REQUIREMENTS
NOTE: Your application will not be evaluated if all of the submission requirements are not met and the documentation is not
attached.
SUBMISSION CHECKLIST
I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT AND THAT IT
CONTAINS NO FALSIFICATIONS, MISREPRESENTATIONS, INTENTIONAL OMISSIONS, OR CONCEALMENT OF
MATERIAL FACTS. I FURTHER CERTIFY THAT NO CONTRACTS HAVE BEEN AWARDED, FUNDS COMMITTED,
OR CONSTRUCTION BEGUN ON THE PROPOSED PROGRAM AND THAT NONE WILL BE DONE PRIOR TO
ISSUANCE OF A RELEASE OF FUNDS BY THE CITY OF PASADENA.
SIGNATURE OF AUTHORIZED PERSON LISTED ABOVE DATE
PRINT NAME TITLE
Item
Note
Applicant’s Initials
1.
Terms and Conditions (pgs. 1-4)
I acknowledge reading and understanding the
Terms and Conditions.
2.
Applicants shall submit six (6) unbound copies with “ORIGINAL” signatures in a sealed envelope or package
of comparable size
3.
Cut out and affix the Application Label to the outermost mailing envelope (UPS, USPS, FEDEX, etc.) of your
application found on page 29.
DID YOU REMEMBER TO:
4.
Fill out, sign and return the HOME Application (pgs. 14-27).
5.
Fill out, sign and return the Community Development (HOME) Submission Requirements (pg. 28)
6.
Fill out, sign and return the Conflict of Interest (pg. 30)
7.
Fill out, sign and return the For Disadvantaged Business Enterprises Only Form (If applicable) (pg. 31)
8.
Fill out, sign and return the Indemnity Clause (pg. 32)
9.
Fill out, sign and return the Non-Collusion Affidavit MUST BE NOTARIZED (pg. 33)
10.
Fill out, sign and return the Contractor’s Certification of Non-Debarment (pg. 34)
11.
Solicitation Questionnaire. (pg. 35)
12.
Note: Certificate of Interested Parties (pg. 36) is contingent upon the approval of the submitted
application. Pursuant to the requirements of House Bill 1295, 84th Legislative Session, any contract approved
by Council is contingent upon the business entity's completion of the required Form 1295.
ATTACHMENTS:
Attachment A – Service Area
Attachment B – Organization Capacity/Information
Attachment C – WWW.SAM.GOV Proof of Registration )– The use of the DUNS (Data Universal Numbering
System) number has been expanded to require all applicant and grantee organizations to obtain a DUNS
number and maintain an active registration in the System for Award Management (SAM) Central Contractor
Registry (CCR) database. The website link to the System for Award Management (SAM) is www.sam.gov
Attachment D – Scope of Work
Attachment E – Additional Budget Information
NONPROFIT APPLICANTS ONLY:
20.
Community Housing Development Organization (CHDO) Certification Application, must be completed and
submitted with required documentation/attachments.
29
APPLICATION SUBMISSION LABEL
LATE APPLICATIONS WILL NOT BE ACCEPTED
Please cut out and affix the application label below to the outermost mailing
envelope (UPS, USPS, FEDEX, etc.) of your submission to ensure proper delivery!
Cut along dotted line.
SEALED BID/PROPOSAL/QUALIFICATIONS
PROGRAM: Home Investment Partnerships Program (HOME)
DESCRIPTION: 2020 Funding Application
DUE DATE: THURSDAY, April 2, 2020
DUE TIME: NO LATER THAN 4:00 P.M. CST
ORGANIZATION NAME:
30
CONFLICT OF INTEREST
All Applicants
No employee, officer, or agent shall participate in the selection, award, or administration of a contract supported by
federal funds if real or apparent conflict of interest would be involved. Such a conflict would arise when an employee,
officer, or agent, any member of his or her immediate family, his or her partner, or an organization which employs
or about to employ any of the parties indicated herein, has a financial or other interest in the firm selection for an
award.
The HOME regulations at 24 CFR 92.356(a)(b)(c) provide that no person who is an employee, agent, consultant,
officer, or elected official or appointed official of the recipient or subrecipients that are receiving HOME funds and
(1) who exercises or has exercised any functions or responsibilities with respect to activities assisted with HOME
funds; (2) or who are in a position to participate in a decision-making process or gain inside information with regard
to these activities, may obtain a financial interest from a HOME-assisted activity; (3) or have any interest in any
contract, subcontract, or agreement with respect thereto; (4) or the proceeds thereunder, either for themselves or
those with whom they have family or business ties, during their tenure or for one (1) year thereafter.
□ I certify that no conflict of interest exists between the City of Pasadena and _____________________________.
Subrecipient Agency
□ I certify that no conflict of interest exists between the City of Pasadena’s consultant and _____________________________.
Subrecipient Agency
□ I certify that no conflict of interest exists between the City of Pasadena and any subcontractors of
_____________________________.
Subrecipient Agency
IF THERE IS A CONFLICT, COMPLETE THE FOLLOWING:
□ I certify that a conflict of interest does exist between the City of Pasadena and _____________________________.
Subrecipient Agency
□ I certify that a conflict of interest does exist between the City of Pasadena’s consultant and _____________________________.
Subrecipient Agency
□ I certify that a conflict of interest does exist between the City of Pasadena and any subcontractors of
_____________________________.
Subrecipient Agency
Describe the nature of the conflict of interest below. Please identify the individual, employment, and the conflict or potential
conflict and their affiliation with your organization:
______________________________________________ ____________________
Signature Date
______________________________________________________________________________
Print Name and Title
31
FOR DISADVANTAGED BUSINESSES ENTERPRISES ONLY
The City of Pasadena recognizes the certifications of the State of Texas General Services Commission HUB Program.
All companies seeking information concerning DBE certification are urged to contact:
State of Texas HUB Program
General Services Commission
PO Box 13047
Austin, TX 78711-3047
(512) 463-5872
If your company is already certified, attach a copy of your certification to this form and return with your bid.
Firm Name Submitting Bid
Representative Title of Authorized Representative
Address City, State, Zip
Telephone Number Telefax Number
Indicate all that apply:
Minority-Owned Business Enterprise
Women-Owned Business Enterprise
Disadvantaged Business Enterprise
HUB Certification #:
32
INDEMNITY CLAUSE
THE CONTRACTOR SHALL DEFEND, INDEMNIFY AND SAVE HARMLESS
THE CITY AND ITS OFFICERS, AGENTS AND
EMPLOYEES FROM AND
AGAINST ANY AND ALL CLAIMS, DEMANDS, LIABILITIES, PENALTIES, DAMAGES, EXPENSES
AND JUDGMENTS OF ANY NATURE AND
HOWEVER CAUSED, ARISING OUT OF OR RELATING TO THE
CONTRACTOR AND ITS AGENTS, SERVANTS OR EMPLOYEES OPERATIONS IN THE CONCESSION AND
CATERING SERVICES
PERFORMED BY CONTRACTOR
UNDER THIS CONTRACT WITHIN THE CITY,
INCLUDING THOSE
CLAIMS, DEMANDS, PENALTIES, DAMAGES, EXPENSES AND JUDGMENTS
WHICH INVOLVE OR MAY
INVOLVE THE ACTUAL OR ALLEGED JOINT NEGLIGENCE OF:
(i)
THE CONTRACTOR OR ANY OF ITS EMPLOYEES, AGENTS, SERVANTS OR EMPLOYEES; AND
(ii)
THE CITY, ITS OFFICERS, AGENTS, OR EMPLOYEES
IT IS THE EXPRESSED INTENTION OF BOTH THE CITY AND THE
CONTRACTOR THAT THE INDEMNITY PROVIDED
FOR IN THIS SECTION
IS INDEMNITY BY THE CONTRACTOR TO INDEMNIFY AND PROTECT
THE CITY FROM THE
CONSEQUENCES OF THE NEGLIGENCE OF THE
CITY, ITS OFFICERS, AGENTS OR EMPLOYEES WHERE SUCH
NEGLIGENCE IS A CONCURRING CAUSE OF INJURY, LOSS, DEATH OR
DAMAGE. FURTHERMORE, IT IS THE
EXPRESSED INTENTION OF BOTH
THE CITY AND THE CONTRACTOR THAT THE INDEMNITY PROVIDED
FOR IN THIS
SECTION SHALL HAVE NO APPLICATION TO ANY CLAIMS,
LOSS, DAMAGE, CAUSE OF ACTION, SUIT OR LIABILITY
WHERE THE
INJURY, DEATH OR DAMAGE RESULTS FROM THE NEGLIGENCE OF THE CITY UNMIXED WITH THE
FAULT OF THE CONTRACTOR OR ANY OF ITS
EMPLOYEES. FOR PURPOSES OF THIS INDEMNIFICATION PROVISION,
ACTS AND/OR OMISSION OF THE CONTRACTOR'S OFFICERS, AGENTS,
SERVANTS, AND EMPLOYEES SHALL BE
CONSIDERED THE ACTS AND
OMISSIONS OF THE CONTRACTOR.
Company/Name of Agency
Mailing Address (PO Box or street)
City, State, and Zip Code
Name of Authorized Representative
Signature Title
Telephone # Fax #
33
NON-COLLUSION AFFIDAVIT
State of (State)
County of (County) §.
Being first duly sworn, deposes and says that:
He/She is the (Owner, Partner, Officer, Representative or Agent) of
(Company), the party that has submitted the attached
Proposal;
He/she is fully informed respecting the preparation and contents of the attached Proposal and of all pertinent
circumstances respecting such Proposal;
Such application is genuine and is not a collusive or sham application;
Neither the said applicant nor any of its officers, partners, owners, agents, representatives, employees or parties in
interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or indirectly, with
any other Proposer, firm, or person to submit a collusive or sham Proposal in connection with the Work for which
the attached Proposal has been submitted; or to refrain from bidding in connection with such Work; or have in any
manner, directly or indirectly, sought by agreement or collusion, or communication, or conference with any
Proposer, firm, or person to fix the price or prices in the attached Proposal or of any other Proposer, or to fix any
overhead, profit, or cost elements of the Proposal price or the Proposal price of any other Proposer, or to secure
through any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any
person interested in the proposed Work;
The price or prices quoted in the attached Proposal are fair and proper and are not tainted by any collusion,
conspiracy, connivance, or unlawful agreement on the part of the Proposer or any other of its agents, representatives,
owners, employees or parties in interest, including this affiant.
Authorized Representative’s Signature Company Name
Representative’s Name Representative’s Title
On this the day of , 20 , before me, the undersigned Notary Public of the State of Texas,
personally appeared the individual whose name is subscribed to within the instrument, and he/she/they
acknowledge that he/she/they executed it.
WITNESS my hand and official seal.
NOTARY PUBLIC
SEAL OF OFFICE:
____________________________________________________________
(Name of Notary Public: Print, Stamp, or Type as Commissioned)
34
CERTIFICATION OF NON-DEBARMENT
DATE:
NAME/ADDRESS OF APPLICANT ENTITY:
APPLICANT NAME:
CITY OF PASADENA
COMMUNITY DEVELOPMENT DEPARTMENT
P.O. BOX 672
PASADENA, TX 77501-0672
2020 funding application for HOME
(I) (We) certify that no individual, firm, partnership or association which is hereby bidding on the above-named project
is designated as not being debarred from contracting on federally-funded projects or as an ineligible contractor by the
Controller General of the United States pursuant to Section 5.6(b) of the Regulations of the Secretary of Labor, Part 5
(29 CFR, Part 5) or pursuant to Section 3(a) of the Davis-Bacon Act, as amended (10 U.S.C. 276u-2(a).
LEGAL NAME AND BUSINESS ADDRESS OF THE APPLICANT:
THE APPLICANT IS:
A SINGLE PROPRIETORSHIP
A CORPORATION ORGANIZED IN THE STATE OF:
A PARTNERSHIP
OTHER ORGANIZATION (DESCRIBE):
APPLICANT’S FEDERAL ID (DUNS) NUMBER:
____ - _______ - _______
NAME, TITLE AND ADDRESS OF THE OWNER, PARTNERS OR OFFICERS OF THE APPLICANT:
NAME
TITLE
ADDRESS
Name of Applicant:
Authorized Representative
Signature:
Name and Title:
STATE OF TEXAS §
COUNTY OF HARRIS §
BEFORE ME, the undersigned authority, on this day personally appeared ___________________________, know to me to be the
person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed the
same for the purposes and consideration herein expressed and in the capacity therein stated as the act and deed of said
_______________________________.
GIVE UNDER MY HAND AND SEAL OF OFFICE this the _____day of __________________, A.D., 20____.
NOTARY PUBLIC AND FOR THE STATE OF TEXAS
Name: __________________________________________
WARNING
U.S. Criminal Code, Section 1010, Title18, U.S.C., provides in part: “Whoever, Makes, passes, utters, or published any statement,
knowing the same to be false …. Shall be fined not more than $5,000 or Imprisoned not more than two years, or both.”
35
SOLICITATION QUESTIONNAIRE
The City of Pasadena constantly strives to improve competitive bidding. In order to facilitate these improvements,
we would like to know how you were informed that this application and how you may have received a copy of the
document.
How did you learn of this funding opportunity?
Direct Contact with Community Development Department
City of Pasadena Website www.pasadenatx.gov
Newspaper or trade publication
Chamber of Commerce
Other Means: Describe
How did you obtain your copy of the application document?
Direct Contact with Community Development
Department
Via Email Via Fax In Person
City of Pasadena Website www.pasadenatx.gov
Notification service
Other Means: Describe
36
CERTIFICATE OF INTERESTED PARTIES (EXAMPLE)
Pursuant to the requirements of House Bill 1295, 84th Legislative Session, any contract approved by Council is
contingent upon the business entity's completion of the required Form 1295, Certificate of Interested Parties.
37
38
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HOME INVESTMENT PARTNERSHIPS PROGRAM (HOME) APPLICATION (City of Pasadena, Texas)

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Completed 25 February 2021

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