Attachment 1

eMERGENCY sOLUTIONS gRANTS checklist

PROVIDER NAME:______

PROJECT NAME: ______

FORMS REQUIRED WITH RESPONSE TO RFA

/

INFORMATION

/ / PAGE #

2017 ESGRFA CHECKLIST

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ATTACHMENT 1

PROJECT SUMMARY /

ATTACHMENT 2

DETAILED PROJECT BUDGET AND BUDGET NARRATIVE / ATTACHMENT 12
BOARD OF DIRECTORS LISTING(one copy for each agency) / ATTACHMENT 9
Independent Audit of Financial Statements (one copy for each agency) / ATTACHMENT 10
Annual Progress Report(from HMIS between06/30/16-7/1/17) -OR- REPORT FROM COMPARABLE DATABASE / ATTACHMENT 11

ACKNOWLEDGEMENT OF ADDENDA

/

ATTACHMENT 15

501 (C) (3) NOT-FOR-PROFIT DOCUMENTATION(one copy for each agency) /

ATTACHMENT 19

MIAMI-DADE COUNTY AFFIDAVIT(one copy PEr each agency) / ATTACHMENT 4
PREVIOUS CONTRACTUAL RELATIONSHIP FORM (AS APPLICABLE TO AGENCIES NOT CURRENTLY UNDER CONTRACT WITH THE HOMELESS TRUST) / ATTACHMENT 5
Memorandum of Agreement with partner agency(ies) - WHEN APPLICABLE / Attachment 14
scoring guidelines / attachment 26 / NA / NA
Housing first/low barrier self questionnarie / attachment 24
certification of a drug-free workplace / attachment 17
PRoject leveraging worksheet / Attachment 13
W-9 Form / Attachment 18
agency financial information worksheet / attachment 8
Application form / attachment 6

FOR PROVIDER USE ONLY – DO NOT RETURN

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INFORMATION

/ / PAGE #
OUTCOME/PERFORMANCE MEASURES /

ATTACHMENT 3

/ NA / NA

PROJECT SCORING CRITERIA

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ATTACHMENT 7

/ NA / NA

Responsiveness Checklist

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Attachment 20

/ NA / NA

COMMENTS:

A TEMPLATE FOR ATTACHMENTS 1-8, 13, 15, 17, 18 AND 24 ARE PROVIDED BY THE HOMELESS TRUST A PART OF THIS RFA

RESPONDENTS SHOULD LABEL ATTACHMENTS CLEARLY ON THE TOP RIGHT MARGIN OF THE PAGE OR ON TAB DEVIDERS

RESPONDENTS ARE REQUIRED TO SUBMIT ONE BOUND ORIGINAL OF ATTACHMENTS IN THE ORDER OUTLINED ABOVE (LABELLED “ORIGINAL”)except for attachments labeled “NA” on the Page # column

RESPONDENTS ARE REQUIRED TO SUBMIT SIX (6) COPIES OF ATTACHMENTS IN THE ORDER OUTLINED ABOVE.