FY13 CDBG PS APPLICATION by 4hMhFe

VIEWS: 32 PAGES: 379

									            INSTRUCTIONS FOR COMPLETING THE CITY OF JERSEY CITY'S
       COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES WORKSHEETS
General Instructions
      A. Only enter inf ormation into y ellow cells. Green cells are f or the City of Jersey City 's use. All other cells
           are protected.
      B. Some cells appear black based on data inputted in early sheets/cells. Do not f ill in blacked-out cells.
      C. Complete the f ollowing worksheets roughly in the order corresponding with their numbering:
                                                                                                0) Grant Application
                                                                                                Checklist
                                                                                                1) Application
                                                                                                2) Operating Budget
                                                                                                3) Other Sources of
                                                                                                Funding Justif ication
                                                                                                4) Cost
      D. All worksheets abov e must be completed. Inf ormation on each worksheet is linked to other sheets.
      E. To print this entire f ile, click on File>Print and select "Print Entire Workbook ".
0) Grant Application Checklist
      A. This sheet inf orms y ou of all the sections and required documents needed f or a complete application
      B. If applicable, select the "X" f rom the drop-down menu f or all items that are included with the application.
1) Application
      A. This is the general application f orm. It is f our (4) pages long.
      B. Fill in all applicable y ellow cells. Many sections will prompt y ou with drop-down menus. Some cells will
           initiallyy be blank a hard copy populated once sure havcaref ully readthe other worksheets in this on the f inal
           When ou print and will be of this f ile, be y ou to e completed and sign the certif ications workbook.
       C.  page.
       D.  Application Contents
                                                                                                  Agency Description:
                                                                                                  Concisely describe the
                                                                                                  purpose of y our agency ,
                                                                                                  targeted population and
                                                                                                  Staf f Qualif ications: List
                                                                                                  all positions to be paid
                                                                                                  by the grant. Select the
                                                                                                  Consolidated Plan Goal:
                                                                                                  Discuss how the project
                                                                                                  will help meetof Need(s):
                                                                                                  Assessment the needs
                                                                                                  Brief ly list the need(s)
                                                                                                  which document the
                                                                                                  reason f or the project.
                                                                                                  Community Needs
                                                                                                  Assessment: Describe
                                                                                                  y our agency 's most
                                                                                                  recent needs
                                                                                                  assessment. Please be
                                                                                                  Agency Collaborations:
                                                                                                  Describe any
                                                                                                  collaborations/partnershi
                                                                                                  ps y our agency has
                                                                                                  established f or the
                                                                                                  Source Documentation:
                                                                                                  Describe the process of
                                                                                                  collecting and prov iding
                                                                                                  Method(s): List the
                                                                                                  method(s) to be used to
                                                                                                  attain
                                                                                                  objectiv e(s)/outcome(s).
                                                                                                  Ev aluation: Brief ly
                                                                                                  describe how the project
2) Operating Budget                                                                               is to be self -ev aluated.
      A. Enter the line item under each category .
      B. Enter the requested CDBG-PS amount and Other Sources of Funding f or each corresponding line item.
      C. Prov ide a f ull budget of the program. This must include both the requested CDBG-PS f unds and f unds that
           hav e been committed by other sources.
3) Other Sources of Funding
       A. Enter thees" or "no" f rom the drop-down menu to answer if the corresponding f unds hav e been
           Select "y name of the f unding source.
       B. committed/secured.
       C. Enter the corresponding amount of f unds.
       D. Enter the corresponding code f rom the key listed on the worksheet.
4) Cost Justification
       A. Justif y all items and serv ices listed under the Operating Budget.
5) Income Guidelines and Calendar
       A. 2012 HUD Low- and Moderate-Income Guideline
       B. Calendar of CDBG-PS important dates.
6) DCD Evaluation Summary - FOR DCD USE ONLY
                                                                      COMMUNITY DEVELOMENT BLOCK GRANT - PUBLIC SERVICES
                                                                                 GRANT APPLICATION CHECKLIST

                                           This checklist includes requirements for completing a grant application for the FY2013 Community Dev elopment Block Grant
                                           - Public Serv ices (CDBG-PS). This checklist MUST ACCOMPANY your submission. Subgrantees must indicate those items
                                           that hav e been included in the submission by placing an "X" in the appropriate box.

                                           Agency Name:

                                           Proposed Proj ect Name:

                                                          Submitted
                                           DCD Use           by
                                            Only          Subgrante
                                                              e
                                                                          Application Cover Sheet

                                                                          Table of Contents

                                                                          Community Development Block Grant - PS Grant Aplication Checklist

                                                                          Agency Description/Staff Qualifications

                                                                          Needs and Objectives of Project/Outcomes

                                                                          Community Needs Assessment & Agency Collaborations

                                                                          Method(s) of Evaluation

                                                                                       Services and Operations Cost Summary

                                                                                       Other Sources of Funding

                                                                                       Schedule A: Personnel Costs

                                                                                       Schedule B: Consultant Services and Cost Justificiation

                                                                                       Schedule C: Other Costs Categories

                                                                                       Schedule D: Officers and Directors List

                                                                          Public Services Logic Model

                                                                          List of Board Directors

                                                                          Articles of Incorporation (Submit if FY12 funds were not received)

                                                                          Organizational Chart

                                                                          IRS Determination Letter (Submit if FY12 funds were not received)

                                                                          Agency By-Laws (Submit if FY12 funds were not received or if changes have been made)

                                                                          Most Recent Completed Audit Report and 990




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0)Grant Application Checklist
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0)Grant Application Checklist
        COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICES APPLICATION

                                                                                      Date of Submission:
    General Information
        Applicant Information
        Applicant Name:
        Street Address:
        City:                                               State:                        Zip:                   Ward:

        Contact Information
        Official Contact Person:                                                             Phone:
        Title:                                                               Email:
        Program Contact Person:                                                              Phone:
        Title:                                                               Email:
        Fiscal Contact Person:                                                               Phone:
        Title:                                                               Email:

    Project Information
        Proposed Project Title:
        Project Location (if Different from Applicant Address):
        Employee Identification Number (EIN)                                                     DUNS Number
        Consolidated Plan Priority:                                              Social Service Priority:
        Type of Request:                                                         Total Cost of the Project:
        CDBG-PS Requested Amount:                                                Funds From Other Sources
        Operating Schedule:           Beginning Date:                                  Ending Date:
        Days of Operation:                                                 Hours of Operation:
        Briefly describe the project for which you are seeking funds:




        Is there a fee for this service?
        If yes, please specify:

    Agency Description and Capacity
        Briefly describe your agency and staff qualifications for implementing the proposed project:




        Staff Qualifications
        List, justify and provide a description for all titles to be paid by the grant.
                 Position/Title                   Minimum Education                       Minimum Experience Qualificiations




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    Assessment of Need(s)
        Consolidated Plan Goal
        Please discuss how the proposed project will meet the needs defined in the Consolidated Plan




        Assessment of Need(s)
        List the need(s) which illustrate the reason for the project. Describe specifically the number of low and moderate
        income persons to be served.




        Community Needs Assessment
        Please describe the process and results of your agency's most recent community needs assessment.




        Agency Collaborations
        Please describe any collaborations or partnerships your agency has established for the proposed project.




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    Source Documentation
        Describe the process of collecting and providing source documentation verifying that the beneficiaries are low and
        moderate income persons.




        Please provide the following information on cost per client benefit to low and moderate income (LMI) persons:
        CDBG-PS Requested Funds                                    $0.00
        Total Project Budget                                       $0.00
        Total Organization Budget
        % of Program Budget                                       #DIV/0!
        % of Organization Budget                                  #DIV/0!
        Unduplicated Clients to be Served
        LMI Clients to be Served
        Total Program Cost Per Client                             #DIV/0!
        Total CDBG Cost Per Client                                #DIV/0!

    Method(s) and Evaluation of Project
        Method(s)
        List the method(s) to be used to attain objectives described above and estimated completion dates.




        Evaluation
        Describe how the project is to be evaluated.




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    Required Hard Copy Application & Attachments
        In addition to emailing this file to the appropriate DCD staff at cdbgpublicsrvs@jcnj.org, applicants must also submit
        a printed hard copy along with the following attachments:
                               a. Public Services Logic Model (http://jerseycitynj.gov/hedc.aspx?id=5578)
                               b. Officers and Directors List
                               c. Articles of Incorporation*
                               d. Organizational Chart
                               e. IRS Determination Letter*
                               f. By-Laws**
                               g. Most Recent Completed Audit and/or 990 Form
                              *Submit if FY12 funds were not received
                              **Submit if FY12 funds were not received or changes were made


    Applicant Certification
        I certify that submission of this application has been duly authorized by the governing body of the applicant and that
        all information contained in this application, to the best of my knowledge, is true and accurate.

        I understand that the City of Jersey City has no obligation to make a grant or loan to the applicant. I am aware that
        incomplete or late applications will not be accepted or considered for federal funding. I understand that awards will
        be made on a competitive basis and the City of Jersey City may award an amount less than requested.


        Applicant                                                     President/Board of Directors



        Printed Name                                                  Printed Name




        Signature                                                     Signature




        Title                                                         Title




        Date                                                          Date




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                                                                                                                                                     City of Jersey City
                                                                                                                                  Department of Housing, Econmic Development Commerce
                                                                                                                                           Division of Community Development




                                                   COMMUNITY DEVELOMENT BLOCK GRANT - PUBLIC SERVICES
                                                               ANNUAL OPERATING BUDGET

                Project Title:

  PERSONNEL COST                            CDBG-PS     Other Sources          Travel Expenses          CDBG-PS   Other Sources
  Salaries/Wages
  Fringe Benefits
  Total Personnel Costs                            $0            $0


  Consultant/Professional Services          CDBG-PS     Other Sources          Subtotal                      $0            $0

                                                                               Space Costs              CDBG-PS   Other Sources




  Subtotal                                         $0            $0

  Office Expenses                           CDBG-PS     Other Sources          Subtotal                      $0            $0

                                                                               Equipment Expenses       CDBG-PS   Other Sources




  Subtotal                                         $0            $0

  Program Expenses                          CDBG-PS     Other Sources          Subtotal                      $0            $0

                                                                               Other Costs              CDBG-PS   Other Sources




  Subtotal                                         $0            $0

                                                                               Subtotal                      $0            $0
  Total Costs
  CDBG-PS Funds                            $0.00
  Other Sources of Funding                 $0.00
  Total Project Budget                     $0.00




0c5848eb-da0a-4c1a-ba64-09944789b581.xls
                                                              City of Jersey City
                                           Department of Housing, Econmic Development Commerce
                                                    Division of Community Development




0c5848eb-da0a-4c1a-ba64-09944789b581.xls
                                                                                                                                                                                            City of Jersey City
                                                                                                                                                                         Department of Housing, Economic Development Commerce
                                                                                                                                                                                   Division of Community Development




                                                    COMMUNITY DEVELOMENT BLOCK GRANT - PUBLIC SERVICES
                                                                OTHER SOURCES OF FUNDING

                Project Title:

  Code all listed funding sources as either Federal Government (F), State Government (S), Local City/County Government (L), Program Income (PI), Fundraisers/Donations
                                                                           (D), Foundations (FD)
                                                    SOURCE                                                        ARE FUNDS             AMOUNT              CODE
                                                                                                              COMMITTED?(Y/N)




0c5848eb-da0a-4c1a-ba64-09944789b581.xls
                                                              City of Jersey City
                                           Department of Housing, Economic Development Commerce
                                                     Division of Community Development




0c5848eb-da0a-4c1a-ba64-09944789b581.xls
                                                  COMMUNITY DEVELOMENT BLOCK GRANT - PUBLIC SERVICES
                                                                       COST JUSTIFICATION
 Justify below all items or services listed on the Operating Budget. Justify the items/services in the same order as they are listed on the worksheet. Attach a copy of the
 lease agreement when requesting funds for rent. The cost allocation method should be included in the justification if a cost category is distributed among multiole
 funding sources. Attach additional sheets if needed.

                  Project Title:

                         Line Item                                                                        Cost Justification




FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
FY13 CDBG-PS APPLICATION
                COMMUNITY DEVELOMENT BLOCK GRANT - PUBLIC SERVICES
                     2012 HUD Low and Moderate Income Guidelines

    FAMILY SIZE              1           2          3          4          5           6          7        8
MAXIMUM INCOME           $41,250     $47,150    $53,050    $58,900     $63,650    $68,350     $73,050   $77,750

September 11, 2012
         Public Hearing to obtain citizen views on housing and community development needs and
         to inform the public about the availability of funds.

September 14, 2012
         Applications are available for interested organizations and citizens on the City's website.

October 4, 2012
          Technical assistance for all HUD Entitlement Grants

October 9 - 18, 2012
          Individual technical assistance sessions may be scheduled on Tuesdays, Wednesdays and
          Thursdays.

October 25, 2012
          Applications are due on Thursday, October 25, 2012 at 4:30 p.m.

January 2013
          Public hearing to receive comments on proposed projects and application.
          Recommendations are submitted to City Council for authorization.

February 15, 2013
          Application is submitted to the U.S. Department of Housing and Urban Development (HUD)
          for review.

April 2013
             Fiscal year begins for all grants.
             Actual contract awards projected to occur by June 2013.
Division of Community Development (DCD) Evaluation Summary
1. Consistency with
Consolidated Plan (10 points):

   a. How does project fit with
   Con Plan?
2. Assess the capacity of the
agency (25 points)
   a. Are qualified persons on
   staff?
   b. Demonstrates ability to carry
   out proposed project?
   c. Any problem/concerns
   current or past?

   d. Other info:

3. Assessment of needs
conducted by agency (25
points)
   a. Did agency conduct a needs
   assessment? If so, how
   recent?
   b. Demonstrates need for the
   project?
   c. Describes targeted
   propulation?

   d. Does agency
   collaborate/partner with other
   agencies?

   e.Does agency have sufficient
   methods in place to implement
   program and address
   objectives?

   f. Other info:

4. In-house monitoring
procedures (20 points)
   a. Is proper source
   documentation collected?
   b. Is cost per client
   reasonable?

   c. Does agency have sufficient
   self-evaluation tool in place?


   d. Other info:
5. Examine the sources & uses
(15 points)
   a. Is the project budget
   presented clearly?

   b. Are costs reasonable?

   c. Are cost justifications
   reasonable?
   d. Status of other funding
   commitments?

   e. Other info:

6. Required Documents (5
points)
   a. Did agency submit all
   required documents?

   b. Other info:




  Evaluation performed by:

                                Name   Title


Staff Notes                              Date Entered

								
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