Allapplicationmaterialsmustbedeliveredtogarrett County Community Action Service Coordination

AllapplicationmaterialsmustbedeliveredtoGarrett County Community Action Service Coordination office at:

104 E Center Street

Oakland, Maryland 21550

Mailed,emailedor faxed application packetswillnotbe accepted.

AllapplicationmaterialsmustbedeliveredtoGCCAC’sService Coordination officeby 4:00PM on August16,2017.Pleasenotethe timeapplicationmaterialsaredue.Theyaredueby4:00PM onAugust16,2017.Applicationssubmitted afterthistimewillnotbeconsidered.

Allprojectswill bereviewed andscored ona givenpointscale.Thescoring detailsareprovided inthe

document“FY2017New ProjectRequestforProposals”.

ThresholdScore

Projectsthatscorelessthan 70%of themaximumpointspossiblewillnotbegiven furtherconsideration forfunding.TheGarrett County CoCreservestherighttoreject all proposals orrejectportionsofanyproposal.

Forquestionsor additionalinformation,pleasecontactCarrie DiSimone at r301-334-9431.

Thefollowingitemsmustbesubmittedto GCCACby 4:00 PM on August16,2017. Onlyonecopy ofeachitemisneeded.

Clearlylabel all attachments,using theattachmentnumbergiven,even if attachmentswillendup not beingnumbersequentiallyduetoanattachmentnot beingapplicable. If an attachmentdoesnotapply,placea(✓)

in the“NotApplicable” column.Onlyonecopyof each attachmentis required.Copiesofallmaterialssubmitted mustbesingle-sided only.Pleasedonotsubmitmaterials that areprinted double-sided.

Attached(✓) / NotApplicable
(✓)
Submission Checklist(thispage)
CompletedApplication(beingonpage3ofthispacket)
CompletedBudgetPages
CompletedMatchChart
CompletedLeverageChart
AttachmentNumber / AttachmentDescription
#1 / MostA-133audit
#2 / Mostrecentagencyfinancialaudit
SKIPATTACHMENT#3.CONTINUEATTACHMENTNUMBERINGWITH#4
#4 / MOU,BAA,orothersimilar agreementwithMedicaidbillableproviders(Question 13)
If monitored by HUD sinceJune2014: (Question 17)
#5 / Notification fromHUDthatprojectwill bemonitored
#6 / Monitoring reportfromHUD
#7 / Organization’sresponseto monitoring report
#8 / Documentation fromHUDthatmonitoring concernorfinding satisfied
#9 / Anyothermonitoring-relatedcorrespondence
#10 / Eviction prevention policies(Question18)
#11 / Copyofcurrent leaseorsub-lease in usebyacurrentprogramparticipant,withparticipation information redacted(Question 19)
#12 / Writtencommitmentofmatchidentified
#13 / Writtencommitmentofleveraging identified
Signature Page
Ifprojecthasbothrecipientandsub-recipient(s),itmayhavemorethanonesignaturepage.
#14 / SignedbyRecipient
#14 / SignedbySub-recipient(s)

TheGarrettCountyCoCreservestherighttorequestadditionalprojectororganizationalinformationatalaterdateifneeded.

ApplicantOrganization’sName:
ProjectApplicantAddress:Street:
City:State:ZIP:
ContactPerson ofProject Applicant
Name:Title: / Phone Number:Email:
Contactinformation forProjectApplicantExecutiveDirector(ifdifferentfromabove)
information same asaboveName: / PhoneNumber:Email:
ProjectName:
ProjectAddress:Street:
City:State:ZIP:
ProjectSub-recipientOrganization Name(Ifapplicable):
ProjectSub-recipient’sAddress
Street:
City:State:Zip:
ContactPerson ofProjectSub-recipient
Name:Title: / PhoneNumber:Email:

Applicantsshouldfullyrespond tothefollowingquestions.Pleasenotesomequestionshavespecificcharacterlimitations.Theselimitsmustbeadheredtoastheseare thecharacterlimits ineSNAPS. Questionswithoutacharacterlimitmustbe answered assuccinctlyas possible.

1.ApplicantExperience:Describe theexperienceoftheapplicantand potentialsub recipients(ifany),ineffectivelyutilizing federalfunds andperforming theactivitiesproposed in theapplication,givenfunding andtime limitations.Describewhythe applicant,subrecipients, andpartnerorganizations(e.g.,developers,keycontractors,subcontractors,serviceproviders)arethe appropriateentitiestoreceivefunding.Provideconcreteexamplesthatillustratetheirexperienceand expertise inthefollowing:(limit:6,000characters,withspaces,forentireanswer)

a.Workingwith andaddressing thetargetpopulation’sidentifiedhousing and supportiveservice

needs

b.Developing andimplementing relevantprogramsystems,and/orservices;

c.Identifying andsecuringmatching fundsfromavariety ofsources; and

d.Managing basicorganization operationsincluding financial accounting systems.

2.Collaborative Application: If this is acollaborativeapplication,pleaseclearlydescribe thedistinctrolesand responsibilitiesof eachentityidentifiedin theapplication. Ifthis is not acollaborativeapplication,respond“N/A”.(nocharacterlimit)

3.LeveragingExperience: Describe theexperienceoftheapplicantand potentialsub recipients(if any)inleveragingotherFederal,State,local,andprivatesectorfunds.Includeexperience withall Federal,State,localandprivatesectorfunds. Ifthe applicant andsubrecipienthaveno experienceleveragingotherfunds,include thephrase "Noexperienceleveraging other Federal, State,local,or privatesectorfunds."(limit:3,000characters,withspaces)

4.Organization ManagementStructure: Describethebasicorganization andmanagementstructureofthe applicantand subrecipients(ifany).Includeevidenceofinternalandexternalcoordinationandanadequatefinancial accounting system.Includetheorganization andmanagementstructureoftheapplicantand all subrecipients,making suretoinclude a descriptionof internalandexternalcoordinationandthe financialaccounting systemthatwillbe usedtoadministerthe grant. (limit:3,000characters,withspaces)

5.ProjectDescription:Provide a descriptionofthe projectthataddressesthe entirescopeof theproject,includingthefollowing:(no characterlimit)

a.Thetargetpopulation(s)to beserved. Ifthe projectisproposing to morenarrowlydefinethetargetpopulationotherthan chronicallyhomelessindividuals,providedataand rationalethatprovidesevidenceas to whyamorenarrowtargetpopulation is necessary;

b.Theplanforaddressingtheidentified needs/issuesofthe targetpopulation(s);

c.Projectedoutcome(s);

d.Coordinationwithothersource(s)/partner(s);

e.Capacityforassessing need;

Thenarrativeisexpectedtodescribetheprojectat full operationalcapacity.Thedescription should beconsistentwith andmakereferenceto otherpartsofthisapplication.

6.Participationin Coordinated AssessmentModel(CAM):Respond to thefollowing:

a.Howdidyouragencyparticipate in CAM over thepastyear?“Participation”isdefined assending/receiving referralsto/fromCAM,participatingin PSHmatchmeetings,attendingserviceproviderworkgroup meetingsor focus groups, or attendingotherCAM-relatedmeetings.

b.Describehowthisproject will workwith CAMto solelyreceivereferrals fortheseunits and tohelp ensurethereferrals received aresuccessfullyhoused.

7.Landlord Relationships: Describehowyourorganization reachesoutto,andengages withlocallandlordstorecruittheirparticipationin making theirunits availabletoprogramparticipants. In yourdescription,explainhow yourorganizationmaintainsan on-going positiverelationship andcommunicationwith landlordsrentingtoyourorganization’s programparticipants.(no characterlimit)

8.ProjectSchedule:Describetheestimatedschedulefortheproposedactivities,themanagement plan,and themethod forassuring effectiveandtimelycompletionof allwork.Providea scheduleanddescribeboth amanagementplan andimplementation methodologythatwillensure thatthe projectwill bereadytobegin housing activitieswithin6 months of receiving theaward letterfromHUD iffunded.(limit:3,000characters,withspaces)

9.ObtainingMaintainingPermanentHousing:Describe howtheprojectapplicant will assistprojectparticipantsto obtainandremainin permanent housing.Theresponseshould addresshowtheapplicant will takeinto considerationthe needsof the targetpopulation andthebarriers thatarecurrentlypreventing them fromobtaining andmaintaining permanent housing.Theapplicantshoulddescribehowthoseneedsand barriers willbeaddressedthroughthe casemanagementand/orothersupportiveservicesthatwillbeofferedthrough theproject. If participantswillbe housed in unitsnotownedbytheprojectapplicant, thenarrativemustalsoindicatehowappropriateunits willbeidentified andhowtheprojectapplicantor subrecipientwill ensure thatrentsarereasonable.Established arrangementsand coordinationwith landlords andother homelessservicesprovidersshouldbedetailedinthenarrative.(nocharacterlimit)

10.IncreasingEmployment/Income:Describespecificallyhowparticipantswill beassistedtoincreasetheir employmentand/orincomeand to maximizetheirability to liveindependently.Describethesupportiveservicesthatwillbeprovidedtohelp projectparticipantslocateemploymentandaccessmainstreamresources sothat they aremorelikely tobe abletolive independently.(limit:3,000characters,withspaces)

11.CurrentPSHProvider:Doestheapplicantorsubrecipientcurrentlyprovide Permanent SupportiveHousing,eitherin theGarrettCountyCoCor a neighboring CoC?

Yes,andthoseproject(s)receiveContinuum of Carefunding

Yes,andthoseproject(s)donotreceiveContinuum of Carefunding

Yes,andsomeofthoseproject(s)receiveContinuum of Carefunding andsomedonot

No,neithertheapplicant norsub recipientcurrentlyprovidePSH

If “yes”, and theprojectisnot intheGarrettCountyCoC,identifywhichCoCtheprojectis located in:

12.HousingFirstExperience: Pleaserespond tobothpartsofthisquestion.

a.Doesyourcurrent project-based PSHproject(s)followa “Housing First” model?

YesforallofourcurrentPSHprojects(regardlessof funding source)

Yesforsome,butnotall ofourPSHprojects(regardless offunding source)

No,noneofourPSHprojectspracticeHousing First

N/A,we donotcurrentlyoperateanyPSH

b.Describehowyourorganization currentlyputsintopracticea Housing First model ofservicedelivery. Ifyourorganization doesnotcurrentlypracticeHousing First,describehowyou willimplement Housing First.

13.LeveragingMedicaid:Doestheapplicantand/orsubrecipientcurrentlyhave thecapacityto billMedicaid forMedicaid-billableservices?

Yes(if “yes”,answerquestion“a”below)

a.Explain howthisbilling arrangementworksandwhataspects of supportivehousing servicesyourorganization currentlybillsfor:

No(if“no”,answerbothparts ofquestion“b” below)

b.Doestheapplicantand/orsubrecipient currentlyhave a formalpartnership asevidenced by aMemorandum of Understanding (MOU)or BusinessAssociatesAgreement(BAA)orothersimilaragreementwithone ormoreMedicaid billableproviders(e.g.,FederallyQualifiedHealth Centers)?

YesNo

If “yes”,identifytheseprovidersand submit as Attachment#4a copyoftheMOU,BAA,or

othersimilaragreement:

14.EnrollingClientsin Medicaid:Describethespecificactivitiesthatare inplaceto enroll clients inMedicaid.

15.LinkingParticipants to MainstreamResources:Describe howyourorganization assistsclientswithaccessingmainstreamresources thathelp them toachievegreaterstability andintegrationintothecommunity.

16.PastOutcomes:Describesuccesses andoutcomestheapplicant and subrecipienthavehad in:

a.Assisting tenantsoftheircurrentPSHproject(s)toremainstablyhousedor to moveto otherpermanenthousing;AND

b.Assisting tenantsoftheircurrentPSHproject(s)withincreasing theirincomeandemployment(includesemployment incomeor benefits)

Theresponseshould includedataspecificto theoutcome(e.g.,“XX%of personsin projectremainedstably housedoverthelastprojectterm”).

17.CurrentContinuumofCare Grant(s)Issues:Respondtobothof thefollowing:

a.State whethertheapplicanthad any unexpendedfundsfromitsmostrecentlycompletedHUDContinuum of Caregrant(s),including howmuchwasunexpended andsteps beingtaken toensure all fundsareexpended for futuregrants. Iftherewerenounexpendedfunds,respond“N/A”;

b.If theorganization hasbeen monitoredbyHUDwithinthelastthreeyears(sinceJune2014),complete thefollowingtableand attach therequireddocuments.Iftheorganization hasnotbeen monitoredsinceJune2014,respond “N/A”.

Attached (✓)
Attachment#5:
Notification letteroremailfromHUDthatyourorganizationwill bemonitored
Attachment#6:
Monitoring reportfromHUD(thereportthat identifies any concerns orfindings);OR
N/A:HUDhasnotyetprovided ourorganizationwith theirmonitoring report
Attachment#7:
If monitoring reportidentified concerns, findings,orotheritemsrequiring a response,provideyourorganization’sresponsetotheseitems;OR
N/A:Themonitoring reportdid notcontainany itemsrequiring ourorganization’s
response
Attachment#8:
Documentation fromHUD that amonitoringconcernor finding hasbeensatisfied;OR
N/A:HUDhasnotyetrespondedto ourorganization’sresponsetothemonitoring report
Attachment#9:
Anyothermonitoring-relatedcorrespondencebetweenyourorganization andHUD;OR
N/A:Noothercorrespondencetoprovide

If the applicantorganization doesnot currentlyreceiveHUDContinuum of Carefunding,respond

“N/A”.

18.Eviction Prevention:Describe howtheproject will preventevictions.Provide acopy oftheorganization’seviction prevention policiesasAttachment#10. Iftheorganization doesnothaveevictionpreventionpolicies, describehow theorganizationwill developsuchpolicies.(nocharacterlimit)

19.Lease Obligations:Tenantsin PSHshould have a leaseor sub-leasethat is identical to thatof anon-supportivehousingtenant.Theleaseshould havenoservicerequirementsnorlimitson length ofstayas longasthetermsofthelease aremet.Pleaserespond tothefollowing:

a.CurrentPSHproviders:Submit acopyof a leaseorsub-leaseagreement for aclient whoiscurrentlyresiding in one ofyour PSHprojectsasAttachment#11.ALLCLIENT IDENTIFYINGINFORMATIONMUST BEREDACTEDWHENSUBMITTING THISINFORMATION.This leasewillbereviewedtodeterminetheextenttowhichitmeetsthestandards givenabove.

b.NewPSH providers:Forapplicantsthatdonotcurrently operatePSH,describehow,iffunded, youwill develop leaseor sub-leaseagreementsthatmeetthestandardsgiven above.

20.Budget:Submittheappropriatebudgetchartsforthisprojectusing thechartsbelow.Thebudgetpagesdonotcounttowards any pageorcharacterlimit. Alsoanswerthisquestion:

a.Projectsarenotrequired torequestfundsforsupportiveservices.If theapplicantchoosestonot requestfundsforsupportiveservices,please demonstratehowthe applicantwillfund thesupportiveservicesnecessarytoallowprojectparticipantsto obtainandmaintain housing.Applicantsthat arerequesting supportiveservicesfunding mayrespondto thisquestionwith“N/A”.

Project-based PSHprojectsmayselectoneofthethreebudgetoptionsbelow.Notethateach budgetoptioncontainsdiffering lineitemsthattheprojectmayrequest.Select whichbudgetoption yourproject isrequesting, andcompleteon thefollowingpagesthecorresponding budgetlineitemcharts.

PSH: ProjectBasedOption #1 / PSH: ProjectBasedOption #2 / PSH: ProjectBasedOption #3
Projectmustrequestatleast:

Leasing

/ Projectmustrequestatleast:

Rental Assistance(TBRAor SBRA)

/ Projectmustrequestatleast:

Operating

Mayadditionallyrequestany ofthefollowing(although somelimitations mayapply):

Operating
SupportiveServices
HMIS
Admin

/ Mayadditionallyrequestany ofthefollowing(although somelimitations mayapply):

SupportiveServices
HMIS
Admin

/ Mayadditionallyrequestany ofthefollowing(although somelimitations mayapply):

Leasing
SupportiveServices
HMIS
Admin

Maynotrequest:

Rental assistance
Acquisition/Rehab/NewConstruction

/ Maynotrequest

Leasing
Operating
Acquisition/Rehab/NewConstruction

/ Maynotrequest:

Rental Assistance
Acquisition/Rehab/NewConstruction

Initial granttermrequested:

Mayonlyrequest a1year budgetforinitialgrantterm

/ Initial granttermrequested:

Mayonlyrequest a1year budgetforinitialgrantterm

/ Initial granttermrequested:

Mayonlyrequest a1year budgetforinitialgrantterm

Notethatthe followingbudgetlinemaynotbecombined ina singlePSHproject:

Rental Assistance+Leasing= NotAllowed
Rental Assistance+ Operating = NotAllowedAllbudgettermsarelimited to1year.

Thisapplicationis requesting thefollowingbudgetoption:

Option #1

Option #2

Option #3

Basedon thebudgetoption being requested, completethefollowingbudgetlineitem chartsbelow.

Note: If requesting sponsor-based rentalassistance,theproject musthaveidentified a sub-recipient(i.e.,sponsororganization)thatwill ownor leasetheunits.Thisorganizationmustbeidentified in question2.

Size ofUnit* / # ofUnitstobe SupportedbyGrant / FY2017FMR
BudgetmustbecalculatedusingFY2017FMRrates / 12
months / RentalAssistanceRequest
SRO / X / $434 / X / 12 / =
0 Bedroom / X / $578 / X / 12 / =
1 Bedroom / X / $701 / X / 12 / =
2 Bedroom / X / $911 / X / 12 / =
3 Bedroom / X / $1,207 / X / 12 / =
4 Bedroom / X / $1,300 / X / 12 / =
Totalunitsrequested: / TotalSponsor-BasedRentalAssistance
Request(1-Yearbudget):
↑
enteramountinline1ofsummarybudget
Size ofUnit* / # ofUnitstobe SupportedbyGrant / FY2017FMR
BudgetmustbecalculatedusingFY2017FMRrates / 12
months / RentalAssistanceRequest
SRO / X / $434 / X / 12 / =
0 Bedroom / X / $578 / X / 12 / =
1 Bedroom / X / $701 / X / 12 / =
2 Bedroom / X / $911 / X / 12 / =
3 Bedroom / X / $1,207 / X / 12 / =
4 Bedroom / X / $1,300 / X / 12 / =
Totalunitsrequested: / TotalTenant-Based RentalAssistance
Request(1-Yearbudget):
↑
enteramountinline2ofsummarybudget
Size ofUnit* / # ofUnitstobe SupportedbyGrant / FY2017FMR,
givenforreferenceonly / HUD PaidRentAmount
(maybeatorbelowFMR) / 12
months / LeasingRequest
SRO / X / $434 / X / 12 / =
0 Bedroom / X / $578 / X / 12 / =
1 Bedroom / X / $701 / X / 12 / =
2 Bedroom / X / $911 / X / 12 / =
3 Bedroom / X / $1,207 / X / 12 / =
4 Bedroom / X / $1,300 / X / 12 / =
Totalunitsrequested: / TotalLeasingRequest(1-Yearbudget):
↑
enteramountinline3ofsummarybudget

Applicantsshouldreference theCoCProgramInterim RuleRegulations(§578.55)fordetailson allowablecosts.

Eligible Costs / QuantityDescription
Forstaffingcostsrequested,indicatethenumberofFTEsincludedintherequest. / AnnualAmountRequested
(mayonlyrequest1year)
1. Maintenance/Repair
2. Property TaxesInsurance
3. ReplacementReserve
4. Building Security
5. Electricity,Gas,Water
6. Furniture
7. Equipment (leaseorbuy)
TotalAnnualAmount Requested (1-yearbudget)
↑
enteramountinline4ofsummarybudget

PSHprojectsmayonlyrequestthesupportiveservicescostsidentifiedbelow.ApplicantsshouldreferencetheCoCProgramInterimRuleRegulations(§578.53(e))fordetails on allowablecosts.

Eligible Costs / QuantityDescription
Forstaffingcostsrequested,indicatethenumberofFTEsincludedintherequest. / AnnualAmountRequested
1. Annualassessmentofserviceneeds
2. AssistancewithMoving Costs(limited totruckrentaland/orhiringamovingcompany)
3. CaseManagement
4. Food
5. Housing Searchand Counseling Services
6. Legal services
7. Life Skills
8. Outreachservices
9. Transportation
10.Utilitydeposits(eligiblecostonlyifnotincludedinrental/leasingagreement)
TotalSupportive ServicesRequest(1-yearbudget)
↑
enteramountinline5ofsummarybudget

Applicantsshouldreference theCoC ProgramInterim RuleRegulations(§578.57)fordetailson allowablecosts.

Eligible Costs / QuantityDescription
Forstaffingcostsrequested,indicatethenumberofFTEsincludedintherequest. / AnnualAmountRequested
(mayonlyrequest1year)
1. Equipment
2. Software
3. Personnel
TotalAnnualAmountRequested(1-yearbudget)
↑
enteramountinline6ofsummarybudget
Line / Eligible Costs / AmountRequested
(allrequestsarefora1yearterm)
1 / Sponsor-BasedRentalAssistance
2 / Tenant-BasedRentalAssistance
3 / Leasing
4 / Operations
5 / SupportiveServices
6 / HMIS
(sumoflines5and6maynotexceed30%ofline7)
7 / Sub-TotalAmountRequested
(addlines1through6)
8 / Administrative Costs
(Upto7%ofline7)
9 / TotalAssistance +AdminRequested
To CalculateMatch Requirement
10 / Multiplethesumof lines1,2,4,5,6,7 and8 by 25%(.25).Thisis thematchrequirement.Leasing costs(line3) donotrequirematch.
11 / TotalMatch
(shouldthesameasgiveninthematchchartbelow,andbegreaterthanorequaltoline10)

In thechartbelow,providethetotalbudgetforthisproject.Thesearecoststhatare usedtodirectlysupportthe implementationof the requestedproject.

(A) / (B) / (C) / (D)
Eligible Costs / CoCFundingRequest
(mustbe same asin summary chartabove) / MatchingFunds(mustbethe same asinthe matching chartbelow) / AdditionalFunding(thesearefundsinaddition tomatch;alsocompletetablebelow) / Total
(sumacrosstherows)
Acquisition/Rehabilitation/NewConstruction / $
RentalAssistance / $
Leasing / $
Operations / $
SupportiveServices / $
HMIS / $
AdministrativeCosts / $
Total(sumcolumnsA-C) / $ / $ / $
GRANDTOTAL
(sumofcolumnD) / $
AdditionalFundingDetail
In this table, providedetails onthesourcesofadditionalfunding, as given inthechartabove.NOTE:Thesearesourcesoffunding overand abovethe CoCfunding requestand thematch requirements.Do notincluding matchingfundshere;informationonmatching fundsshould begivenin the chartbelow.
NameofFundingSource(ie,XYZFoundation,privatedonations,etc) / Amountofactual/expected commitment / Actualorexpectedcommitmentfromthefundingsource?(selectone)
actualexpected
actualexpected
actualexpected
actualexpected
actualexpected

(addrowsasneeded)

In thechartbelow,identifythesources ofmatch forthisproject.Applicantsmayaddmore linesto the tables if needed.Applicantsthat providewrittencommitmentsofmatchwith theirprojectapplicationswill receivemorepoints.

ApplicantsshouldreferencetheCoCProgramInterimRuleRegulations(§578.73)fordetailsonmatch.

Nameofsource
(beasspecific aspossible) / Type ofcommitment / Type ofsource / Dateofwrittenorexpectedcommitment / Value ofwrittencommitment / Amountofcommitmentbeing usedasmatch forthisproject* / CopyofWrittenCommitmentsubmittedtoGCCACasAttachment
#12?
(ifyes)
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Total(should equalline 11 insummarybudgetchart

*An agencymaysplitup asourceofmatch/leverageamongmorethan oneproject.Forexample,if an agencyreceives$10,000 inprivatedonationsthat itwantsto useas matchforProject A andProjectB, itmaydividethis$10,000up as$6,000forProject A and $4,000forProject B.Anagencymaynot, however,usethetotalamountof thissourceforeach project(ie,itmaynotuseallof the$10,000asmatch forProject Aandallofthe$10,000asmatchforProjectB). TheRating andRanking Committeewill bereviewing thematching and leveraging sourcesacross allofan agency’sprojectapplicationsto ensureno onesource is used in totalasmatch/leverageformorethanone project.

In thechart below,identifythesources ofleverageforthisproject.Applicantsmay addmorelinesto thetable if needed. Applicantsthat are abletodemonstrateleverage intheamountof atleast200%of theirbudgetrequestwillreceivemorepoints.

Applicantsshouldonly includeleverageforwhichtheyhave awrittencommitment atthetimeof application.TheGarrett CountyCoCisrequiring thesewrittencommitmentsto besubmittedwith theprojectapplication. If selected forfunding,thesewrittencommitmentswillneedtobeuploadedinto eSNAPSwiththeprojectapplication.

Nameofsource
(beasspecific aspossible) / Type ofcommitment / Type ofsource / Dateofwrittenorexpectedcommitment / Value ofwrittencommitment / Amountofcommitmentbeing usedasleverage forthisproject* / CopyofWrittenCommitmentsubmittedtoGCCAC asAttachment
#13?
(ifyes)
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Choose an item. / Choose an item.
Total

*An agencymaysplitup asourceofmatch/leverageamongmorethan oneproject.Forexample,if an agencyreceives$10,000 in privatedonationsthat itwantsto useas matchforProject A andProjectB, itmaydividethis$10,000up as$6,000forProject A and $4,000forProject B.Anagencymaynot, however,usethetotalamountof thissource foreach project(ie,itmaynotuseallof the$10,000asmatch forProjectAandallofthe$10,000asmatchforProjectB).TheGarrettCountyCoCwillbe reviewingthematching and leveraging sourcesacrossall ofan agency’sprojectapplicationsto ensureno onesource is used in totalasmatch/leverageformorethanone project.

Thispage isto besignedby theExecutiveDirectorof therecipientandsubrecipient agencyorhis/herauthorizedrepresentative.If a projecthasamorethan one subrecipient,thispagemaybeduplicatedwitheach sub recipientsigning thepage.

Mysignaturebelowaffirmsthefollowing:

1)If awarded ContinuumofCarefundsbytheU.S.Department ofHousing andUrban Development, thisproject willcomplywithallprogramregulations as foundin the Continuum of CareProgramInterim Rule24CFRPart578.

2)Theorganizationwill enter required projectand clientdataintotheHomelessManagement InformationSystem(HMIS) in accordancewith theHMISData Standards andHMISPoliciesProcedures.

3)Thefundedprojectwillparticipate inthe Coordinated AssessmentModel(CAM),oncethephase thatrelatestothetypeof projectbeing fundedhasbeen implemented.

4)Thedatasubmittedwiththisapplication (in boththe APRsubmittedtoHUDviaeSNAPSandanydatagenerated fromHMIS) iscomplete,accurate,andcorrect.

5)It isunderstood that,should thisprojectbeeligiblefor anappeal, noappealmaybemadeonthe basisofhaving initiallysubmittedincomplete,incorrect,or inaccuratedata. It isunderstoodthat detailson thecriteriaand processforwhichmyagencymay submit an appeal to theGarrettCountyCoCBoardarefound in theAppealsPolicy (attached), andthatanyappeals decisionsmadebytheGarrettCountyCoCBoard willbefinal.

6)It isunderstood thatrenewaland newprojectswillbesubmittedtoHUDin accordancewith theFY2017 ProjectRankingPoliciesand thatsuch projectrankingdecisionsare final.

7)It isunderstood thatshould theGarrettCountyCoCBoard decidetoreallocate arenewalproject in partor inwholetofund newproject(s),sucha decision is finaland cannotbeappealedto theGarrettCountyCoCBoard.

8)It isunderstood thattheGarrettCountyCoCBoard isresponsible formaking decisionsonwhichnewandrenewalprojectsaresubmittedto HUDeachyear as partof theannualCoCcompetition,andthat theultimatedecision in whetherornota projectis funded ismadebyHUD.It is furtherunderstoodthat24 CFR§578.35describescertain situations inwhichan agencymaysubmit an appealdirectlytoHUD. Itisagreedthatthesubmissionof anappealtoHUD, in accordancewith HUD’spoliciesand procedures,is thefinalrecoursethatmaybetaken for theproject.

Signed:Date:

(ExecutiveDirectororauthorized representative)

NamePrinted: