Orange County Continuum of Care – 2015CoC Renewal Application
Letter of Intent (LOI)/Part I Required Documents Checklist
DUE BYMay 22, 2015 at 12pm (noon) Pacific Standard Time
The following documents along with this checklist must be attached and submitted with a cover letter with your Part I/LOI Application.
Each Exhibit must be separated by dividers with tabs clearly labeled with the corresponding attachments:
☐Exhibit 1: Lead Agency Information Form
☐Attachment 1: Organizational Chart – includeBoard of Directors and their names and titles/positions. Note any changes in key members.
☐Attachment 2: Board of Director’s Roster and Resolution on renewing your Continuum of Care Homeless Assistance Programs award in the FY 2015CoC Program competition process. Roster should include homeless person.
☐Attachment 3: State Certificate of Status - May be obtained by accessing the Secretary of State, Business Programs Division, at:
☐Attachment 4: Organization’s Code of Conduct - Provide page listing your organization, available at: (If listed, you will not have to submit one, unless the name of the organization or authorized official has changed. Please include provisions on kickbacks, bribery and employee conduct).
☐Attachment 5: 501(c)3 certification
☐Attachment 6: Most recent HUD Monitoring letter and close out letter for all HUD projects
☐Exhibit 2: Terms and Conditions
☐Exhibit 3: Financial Assessment
☐Attachment 7: A-133 (if applicable)
☐Attachment 8: Two most recent agency financial audits by a certified CPA.
☐Attachment 9: Line of Credit Control System (LOCCS) screenshot for past 3 years
HUD Forms
☐SF424: Faith-Based EEO Survey (SF424 Supplement, Survey on Ensuring Equal Opportunities for Applicants)
☐2880: Applicant/Recipient Disclosure/Update Report (HUD form 2880)
☐SF-LLL: Disclosure of Lobbying Activities (SF-LLL)
☐50070: Drug-Free Workplace Certification (HUD form 50070)
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