APPLICATION FOR NEIGHBORHOOD DEVELOPMENT PROGRAMS

2012 NOTICE OF FUNDING AVAILABILITY

APPLICANT CRITERIA
These criteria are in addition to those already described in the NOFA.

The applicant must be a legal entity. If the applicant is a non-profit organization, 501(c)(3) status must be verified (a fiscal agent 501(c)(3) is acceptable). Documentation of such must be attached to the application.

The applicant must be in good financial standing and current on all taxes.
The applicant must demonstrate and submit documentation demonstrating how low or low to moderate-income persons, disabled persons and /or elderly persons will benefit as a result of the requested funding.

If no geographical service area exists, the applicant must have a system in place for verification of clients’ low-to moderate income status and be able to demonstrate that system.
The applying agency must have been in existence for one(1) year or longer.

Applicants for Neighborhood Improvements and Non-profit Facilities Improvement funding must demonstrate at least a 25 percent cash match from other financial sources. The match must be in place by the time the final contract is executed. There is no match requirement for Public Service applications.

The project for which funds being are requested, must not be completed or underway (acquisition is an exception, you may be pursuing a property but you cannot have closed on it).

ELIGIBLE ACTIVITIES
This application can be used for the following programs or activities:
Neighborhood Improvements (e.g. Parks, Playgrounds, Landscaping)
Non-Profit Facilities Improvements

Neighborhood Public Services
Applicants receiving grants will be required to attend a training session to be announced at a later date.

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Applicants are encouraged to contact the Office of Economic Development before filling out this application to discuss projects. This application is available on the City’s website at

Project Title/City Council District
Name of Applicant
Address of Applicant
Contact Person / Phone Number
Title / Tax ID:
DUNS No.:
E-Mail:
What national objective will this project meet? (Check One)
Low/Moderate Income / Slums/blight / Urgent Need
What type of project is this? (Check One)
Housing / Economic Development / Public Facility/Infrastructure / Public (Human) Service
Project Summary
How many people do you currently serve?
How many new people will you be able to serve through this grant award?
How many people will receive improved services through this grant award?
Total Project Cost / CDBG Funds Requested
$ / $ / Check Type: Loan Grant
Submitted by: (If application is from a nonprofit organization, signature of Board’s presiding officer is required)
Signature / Title
Print Name / Date

I.GENERAL INFORMATION

  1. Description of Proposed Project -

Project Address/Location: ______

Please briefly describe the project.

What will OED/CDBG funds be used for?

Who will benefit from the proposed project?

B.Agency description:

What is the mission of your agency?

What services do you offer?

What is the incorporation date of your agency?

Who are your clients? What type of populations do you serve? Do you primarily serve disabled, homeless or HIV/AIDS populations?

Do clients have to fill out any applications prior to receiving services?

Do clients have to qualify financially before receiving services? If so, what information is collected from the client?

Do you have a defined service area? If so, what are the geographical boundaries (i.e. streets)?

C.List the Neighborhood(s) which will be served by this grant:

Clearly explain why this project is necessary in the community. If the project is not in a target neighborhood (see Attachment X), explain why it is necessary in the neighborhood(s) listed above.

Please list any additional neighborhoods this project will serve:

B. How do your agency goals and objectives correspond to any of the following economic and neighborhood development components? Job creation, Asset Accumulation, Workforce & Human Capital Development, Affordable Housing, Business Development, Financial Education/Literacy, QualitySchools, Public Safety/Health and Environment and Access and Mobility.

III.SOURCE (S) OF FUNDS

A.List all public, private contributions/revenue by source and estimated dollar amount.

SOURCE / CONTACT INFO / COMMITTED
/PENDING / AMOUNT

TOTAL PROJECT BUDGET: $ ______

Your agency cash match (A minimum 25 % cash match is required): $______

Amount of funds you are requesting from OED: $______

  1. Will this project involve any volunteer labor/services/materials? If so, what is the estimated value of the services? And how did you arrive at this estimate?

C. What issues could possibly hinder project completion within one year of receiving funding?

IV.BUDGETS & TIMELINES

  1. Attach an estimatedbudget(Budget Worksheet is included as Attachment I)for the proposed project. Include information regarding how you came up with the estimate.
  1. Please attach an estimated project timeline.

V.PROJECT MAINTENANCE: CBDG program funding is generally only available for one year. Describe your organization’s plans for maintaining the project. How will this project affect your annual operating budget?

VI. PROJECT VIABILITY

  1. Is there a minimum amount of CDBG funding you need for the project to be viable?

If so, how much? Please be specific.

B.If the project is not awarded this amount of CDBG funding, how will it be affected?

C.What other agencies have been solicited for funding for this project?

D.Do you intend to request CDBG funds for the same project in future years?

(Please explain)

E.Has your agency ever had to return CDBG funds to OED for regulatory non-compliance, project non-performance, or other reasons? (If yes, please explain)

F.If your AGENCY has received CDBG funds from OED since 2003, list the project names and award amounts.

G.Is your agency receiving general fund, TANF, or other non- CDBG funds from the City and County of Denver during your current fiscal year? If so, list amount and purpose of funding.

VII.ORGANIZATIONAL EXPERIENCE

A.Describe your project manager’s experience administering CDBG funding. Please attach Project Manager’s Resume

B.Please check each item that already exists within your agency’s structure:

Client low-income eligibility documentation/verification

Client demographic data collection

Written employee conflict of interest policy

Staff salary tracking

Employee Conflict of Interest Policy

Non-Discrimination Policy

C.List the names and titles of all persons with the authority to sign contracts or other legal documents for your agency.

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VIII.NEIGHBORHOOD SUPPORT

Describe Neighborhood Support: (attach documentation of support – i.e. petitions, letters, etc.)

IX.ACKNOWLEDGEMENT

The statements and data in this application are correct and true to the best of my knowledge, and its

submission has been authorized by the governing body of the applicant. I understand that OED may verify any or all statements contained in this application, and that any false information or omission may disqualify my agency from further consideration for Community Development Block Grant funding. I also understand that, upon submission, this application becomes the property of OED and will not be returned to my agency in whole or in part.

Signed ______Date ______

Authorized Signature/Title

Required Attachments:

Three references from previous funders

Current agency or department budget

Tax certification (Non-Profit agencies)

IRS W-9 Form

Certificate of Good Standing from State of Colorado

Organizational Chart

Client Application Form

Project Budget

Project Timeline

Project Manager’s Resume

List of Board of Directors (Non-Profit agencies) including board appointment dates, term expiration dates and whom each board member represents.

Optional Attachments:

Agency brochures or fliers outlining services available

Site map and/or photographs

Letters of support

Other relevant documentation

This application will help City staff and officials make a decision regarding the funding of your project through the CDBG program. It will be used for the preliminary review of your funding request. Completion and submission of this application does not obligate the City of Denver to allocate CDBG funds to your activity

Please complete the budget form in Attachment I and the appropriate project specific questionnaire. If a project requires construction, also fill out the construction budget form in Attachment II.

Left Intentionally Blank

NON-PROFIT FACILITY IMPROVEMENT PROJECTS

1. Does your agency own the facility? The property owner must agree to sign a 7 year Promissory Note and Deed of Trust (OED will not a fund a project unless the owner signs a Deed of Trust). If your agency does not own the property is the current owner willing to sign a Promissory Note and Deed of Trust?

2. What year was the building constructed?

  1. Will the size of the building be increased by more than 25% as a result of this project?
  1. Will the proposed project result in a change of use from the most recent use of the building/property?
  1. Will a fee be charged for use of the facility or for services provided at the facility? If so, how much?

NEIGHBORHOOD IMPROVEMENTS PROJECTS

1. How long will the facility be used for its intended purpose?

2. Are funds in place to operate the facility after improvements?

3. What days and times will the facility be open to the public?

4. Does your agency own the facility you will be renovating? If no, do you plan to purchase it?

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ACQUISITION PROJECTS

(NOTE: If CDBG funds are used for acquisition, federal relocation requirements may be applicable)

1. Has a site been selected? (If no, skip the next four questions, if yes or tentative, answer all questions)

2. Does the site require rezoning?

3. Has your agency made an offer to purchase the property?

4. Has your agency executed a contract to purchase the property?

5. Will persons or businesses be displaced by the acquisition?

6. How long will the site be used for its intended purpose?

7. Does your agency have funds in place to operate the facility after its acquisition?

8. Will your agency charge a fee for services provided at the facility? If so, how much?

9. What days and times will the facility be open to the public?

10. How many clients do you serve in your current location? How many will you be able to serve in your new location?

11. Is the property vacant?

12. Will the proposed project result in a change of use from the most recent use of the building/property?

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ATTACHMENT I: Project Budget for Public Service Projects
Expenditures and Revenue Sources / Source: CDBG / Source: / Source: / Source: / Total Project Budget
PROJECT COSTS (Include all costs directly related to delivering this service or accomplishing this project. Bases for project costs must be documented. Please include a Budget Narrative explanation of projected costs).
Salaries & Wages
Employee Benefits
Contracted Services
Insurance, Legal & Financial Services
Direct Client Assistance
(include detailed costs of goods/services in narrative)
Travel/Training
Office Expenses
(include detail for rent, utilities, postage, printing supplies, etc. in narrative)
Construction Costs
(complete and attach separate construction budget; place totals here-do not duplicate line items)
SUBTOTAL: Project Costs
OTHER COSTS (include other costs needed to implement this service or project)
List here and describe in Budget Narrative
SUBTOTAL: Other Costs
GRAND TOTAL
ATTACHMENT II:Construction Budget
Source: CDBG / Source: / Source: / Source: / Total Project Budget
ADMINISTRATION
Personnel Services
Supplies
Communications
Printing/Duplication/Postage
Other Administration
TOTAL ADMINISTRATION
LAND/BLDG./ACQUISITION
Land
Existing Structure
Demolition
Homebuyer’s Assistance
TOTAL LAND/BLDG./ACQUISITION
SITE WORK
Site Work
Off-site Improvement
Environmental
Other
TOTAL SITE WORK
CONSTRUCTION AND REHAB
New Building
Rehabilitation
Accessory Structures
Other
TOTAL CONSTRUCTION AND REHAB
PROFESSIONAL WORK & FEES
Architect Design
Architect Supervision
Attorney, Real Estate
Engineer/Surveyor
Other
TOTAL PROFESSIONAL WORK & FEES
CONSTRUCTION BUDGET
Source: CDBG / Source: / Source: / Source: / Total Project Budget
CONSTRUCTION INTERIM FEES
Hazard & Liability Insurance
Credit Report
Construction Interest
Origination Points
Discount Points
Inspection Fees
Title & Recording
Legal Fees
Taxes
Other
TOTAL CONSTRUCTION INTERIM FEES
PERMANENT FINANCING FEES
Credit Report
Discount Points
Origination Fees
Title & Recording
Legal Fees
Prepaid MIP
Other
TOTAL FINANCING FEES
PROJECT RESERVES
Rent-Up Reserve
Operating Reserve
Replacement Reserve
Escrow
Other
TOTAL PROJECT RESERVES
GRAND TOTAL PROJECT COSTS

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