Sample Promissory Note and Deed of Trust

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State of California
Governor
Arnold Schwarzenegger

Governor's Homeless Initiative
Development Funding for Supportive Housing
for the Chronic Homeless with
Severe Mental Illness
APPLICATION FOR FUNDING

NOFA Issuance November 15, 2005

( ) Original or ( ) Duplicate Revised 1/04/06
Page 2 of 99

State of California

Department of Housing and Community Development

Department of Mental Health

California Housing Finance Agency

Direct Correspondence to:

Department of Housing and Community Development
Division of Financial Assistance
Multifamily Housing Program
P.O. Box 952054, Room 390-5
Sacramento, California 94252-2054
1800 Third Street, Room 390-5
Sacramento, California 95814

Telephone: (916) 323-3178
Fax: (916) 445-0117
Web Site: http://www.hcd.ca.gov/fa/mhp/
Page 3 of 99
General Instructions

Please use the following instructions and the Application Index for submitting your application.

a. Application must be submitted in an appropriately sized, 3-ring binder with a sleeve on the spine for
insertion of information.

b. Use large lettered tabs and divide the binder into 7 sections: A, B, C, D, E,F, and G.

c. In each section set up dividers with numbered tabs to correspond to the Application Index, page 11.
Place completed forms and requested documents behind their corresponding tabs. The tabs must be
securely affixed to the divider pages.

d. For items that are not applicable to your application, place a sheet saying “Not Applicable” behind
the tab corresponding to the item number.

In order to be considered for funding, applications must be on forms provided or approved by the Department
(Section 7318 of the MHP Regulations). Application forms must not be modified. The application may be
downloaded from web site: www.hcd.ca.gov/fa/mhp. The Department must receive a complete original
application, plus two copies. No facsimiles, late applications, incomplete applications, or application revisions
will be accepted. Applications must meet all eligibility requirements upon submission. Applications containing
material internal inconsistencies will not be rated and ranked. Applications will be accepted beginning at 8:00
A.M., January 16, 2006 and continue until such time that the Department has received what it determines to be a
sufficient number of Applications to reasonably use all funds currently available or until July 14, 2006,
whichever is sooner.

Applications shall be subject to two sets of regulations (the MHP-specific Regulations, which includes the new
Article 6 Supportive Housing Loans section, and the Uniform Multifamily Regulations [UMR]). Applications
are also subject to the applicable statutory requirements (including those of Proposition 46 and SB 1227 of
2002), and the requirements specified in the NOFA and the Attachments.

Disclosure of Application

Information provided in this application will become a public record available for review by the public pursuant
to the Public Records Act. As such, any materials provided will be disclosable to any person making a public
records request. As such, we caution you to use discretion in providing us with information that is not
specifically requested, including but not limited to, bank account numbers, personal phone numbers and home
addresses. By providing this information to the Department, the sponsor is waiving any claim of confidentiality
and consents to the disclosure of all submitted material upon request.
Page 4 of 99
Section A Instructions

Item A 1 - Attach the Application Index and Application Item Checklist .
In addition to completion of the pertinent table(s), be sure to mark answers to questions #2 on page 14, #9
on page 15, and question #11 on page 18.

Item A 2 - Attach the Eligibility Criteria Section (pages 14 through 18).

Item A 3- Attach a narrative description of the proposed development. The narrative must be organized into titled
sections as indicated below:

1. Type of development (rehabilitation, new construction, etc.) and any significant design features
(subterranean garage, hillside development, scattered sites, etc.) that affect feasibility and
project cost.
2. Development experience of Sponsor. Describe roles, responsibilities and experience of Sponsor
and other entities that will be involved in project development and operations. For each entity
applying for development experience consideration, the narrative must specify both the
development responsibilities and ongoing operational responsibilities in the proposed project.

3. If your project contains units that are not reserved for the Target Population or other eligible
Special Needs Populations describe the target population for these units in terms of income and
household size. Please reference the description of the GHI Target Population in the Notice of
Funding Availability (NOFA) issued November 15, 2005 and the explanation of the GHI Target
Population and eligible Special Needs Populations that begins on page 33 of this Application.
Also, describe the services you propose to provide for these tenants, if any. (The target
population and services to be provided for Target Population and Special Needs Population
units will be described in Item B 17.)
4. Any particular issues associated with development and how they will be addressed, including
but not limited to:
- relocation requirements
- environmental issues (hazardous materials, noise, flood plain, etc.)
- historic considerations
- Article XXXIV of the State Constitution
5. Ultimate form of ownership organization. If there are multiple partners or affiliate
organizations, explain the role of each entity.
6. Current status of land ownership and how ownership will be held at project completion.
7. Describe the neighborhood and public transportation, shopping, medical services, public
recreation, schools, public parks, Job Center and other amenities (marked on the Scaled
Distance Map-Item B 14), particularly services that meet the needs of the target tenant
population. A Job Center is a concentration of employment opportunities reasonably available
to the tenants of the Project and will be located within one mile of the Project.

Item A 4 - Fill out, sign and attach the form Applicant Certification and Commitment of Responsibility (page 19 of the
application).

Item A 5 - Fill out, sign and attach the form No Defaults Statement (page 20 of the application).

Section B Instructions
Item B 1 - Complete and attach the Project Description Form (pages 22-24 of the application).
Item B 2 - Complete and attach the Sponsor Information Form (pages 25 and 26 of the application).
Page 5 of 99
Item B 3 - Reserved for Future Use.
Item B 4 - Attach a copy of the Relocation Plan, if available, or a Preliminary Relocation Plan and budget which
identifies the number of units affected and sources of funds for relocation.
Item B 5 - Submit a narrative detailing any proposed Tenant Selection Criteria, and describe the rationale for these
limits. Attach the Tenant Selection Plan as set forth in UMR Section 8305 , if available.
Item B 6 - Submit the Organizational Documents of the Sponsor, and the ultimate Borrower entity if formed, as
applicable to the type of entity(ies):
· Certified copies of the Articles of Incorporation · Partnership Agreements
· By-Laws · LP-1 and/or LP-2
· Secretary of State Certificate of Good Standing · Joint Venture Agreements
· Certificate of Incorporation · Articles of Organization
· Evidence of 501(c)(3) status · Operating Agreement

Item B 7 - Identities of Interest Disclosure. Submit a narrative identifying any persons or entities, including affiliated
entities, that will provide goods or services to the project either: a) in more than one capacity; b) that qualify as a
“Related Party” to any person or entity that will provide goods or services to the project, using TCAC’s definition of
“Related Party” (see Section 10302 of TCAC’s regulations available online at
http://www.treasurer.ca.gov/CTCAC/ctcac.htm).

Item B 8 – Submit a narrative description of your organization’s experience relevant to owning and developing
affordable rental housing. For each entity applying for development experience consideration, the narrative must
include information confirming the roles and responsibilities of that entity in the projects submitted to meet program
requirements and/or to receive points under Item D 3. Qualifying entities must have had primary responsibility for
development oversight in each project submitted for consideration.

The Department will evaluate all sponsors, including the roles of any general partner(s) in a limited partnership,
to determine if the sponsor's roles and responsibilities and benefits in the project development and operations
are commensurate with activities normally undertaken or controlled by project developers and owners. The
sponsor will be reviewed to determine if adequate staffing levels exist to undertake and complete the project.
This criteria will be applied in evaluating Sponsor experience for the purpose of eligibility threshold experience
and awarding points.
NOTE: If the Sponsor is a joint venture and qualifies as an eligible Sponsor based on the experience of only one
joint venture partner, that partner must have a controlling interest in the joint venture and a substantial and
continuing role in the project's on-going operations, as evidenced in the documents governing the joint
venture and included in Item B 6.

Item B 9 - Attach a copy of the document that provides evidence of site control as identified in Site Control
Requirements (number 11 of Eligibility Criteria on page 18).

Item B 10 - Attach a current preliminary (title) report (dated no more than six months before the application due date)
documenting that the entity conveying interest in the property holds title to the property.

Item B 11 - Attach the Governing Board Resolution from the Sponsor (unless the Sponsor is an individual) using one of
the Sample Resolutions provided as a guide. (Use the Sample, appropriate for the organizational structure of the
Sponsor, provided on pages 27 through 32 of the application).
Item B 12 - Attach a list of the names of officers and board members of the Sponsor's governing body.
Item B 13 - Attach all available Phase I or II Environmental Site Assessment Reports with any follow-up analysis (e.g.,
asbestos or lead based paint analysis, soils report, acoustical/noise study) or information on mitigation completed. It is
NOT necessary to include a copy of the Database Records Search section of the Assessment.
Page 6 of 99
Item B 14 - Attach the following maps:
a. A Parcel Map which clearly indicates the location of the site and,
b. A Scaled Distance Map showing the location of the project site and the location of the following amenities
within a two mile radius of the site:
· public transportation · public recreation
· shopping · public parks
· medical services · Job Center
· schools · other services (in relation to the needs of the
project's tenants)

NOTE: Map(s) must include information relative to Adaptive Reuse, Infill or Proximity to Site Amenity as per Item
D 7 Scoring Sheet in order to obtain points in that scoring category. More than one scaled distance map
may be submitted.

Item B 15 - Attach evidence of Article XXXIV of the State Constitution compliance, or its inapplicability.

a. Does the locality have sufficient Article XXXIV Authority to accommodate the project?
If yes, attach a copy of the document providing Authority.
b. If Article XXXIV Authority does not exist, submit a legal opinion letter explaining how the project
complies with Article XXXIV requirements.
c. The number of Assisted Units shall equal the number of Restricted Units to the extent allowed by the
requirements of Article XXXIV (Section 8304(c) of the Uniform Multifamily Housing Regulations).

Item B 16 - GHI Supportive Housing project Sponsors must complete and attach the GHI Supportive Housing Project
Plan Checklist. Please see the description of Governor's Homeless Initiative (GHI) Supportive Housing Projects on
page 33.

Item B 17 - GHI Supportive Housing project Sponsors must complete and attach the Supportive Housing Project Plan
(Plan). See Item B 17 for complete instructions on how to complete the Plan.

Section C Instructions

Item C 1 – Complete and attach the Local Approvals and Zoning/Land Use form (page 51 of the application).

Item C 2 - Complete and attach the Development Timetable (page 52 of the application).

Item C 3 – Complete and attach the Worksheet to Determine Maximum Allowable Loan Amount (page 53 of the
application).

Item C 4 – Complete and attach the Loan Limit Worksheet (page 54 of the application).
Page 7 of 99
Item C 5 - Complete and attach the Shared Cost Calculation Worksheet (page 55 of the application).
Item C 6 – Complete and attach the MHP Loan Amount Calculation Worksheet (page 56 of the application).
Item C 7- Complete and attach Project Financing (Sources of Funds) forms for both Construction and Permanent
financing and rental/operating subsidy, which provides a description of all construction and permanent financing
sources. Attach evidence of commitment status.
NOTE: To receive points in Point Categories A and B of Item D 6 Scoring Sheet, evidence of commitment
status for development funding (rental subsidies need not be committed for the purpose of point
awards) must be documented as follows:
Attach to Item C 7 copies of enforceable loan commitment letters (not interest letters) or, where available,
grant awards, subsidy contracts or loan documents. Financing commitments must contain the following
information:
a. The Sponsor or the ultimate owner is named as the borrower;
b. The project name;
c. The project site's address, assessor's parcel number, or legal description;
d. The amount, interest rate and terms of the financing being committed; and
e. The commitment must be fully executed by all parties.
To receive points, deferred-payment financing, grants, and subsidies must be committed in accordance with
TCAC requirements and are subject to the same exceptions as allowed by TCAC Regulations in Section
10325(e)(8)(E)(F). These exceptions include: (1) the Affordable Housing Program (AHP) provided by a
program of the Federal Home Loan Bank; (2) RHS Section 514, 515, or 538 programs; (3) California
Housing Finance Agency’s Proposition 1A School Facility Fee Reimbursement Program: (4) the
Department of Housing and Urban Development’s Supportive Housing Program (SHP); (5) the California
Department of Mental Health’s Supportive Housing Initiative Act Program (SHIA); or (6) projects that
have received a Reservation of HOME funds from the applicable Participating Jurisdiction.

Also attach any existing tax credit purchase offer or letter of interest.
Item C 8- Complete and attach the Development Budget (page 60 of the application).
NOTE: Developer fees included in the Development Budget must be calculated in accordance with UMR Section
8312. To assist applicants in determining developer fees, the bottom of page 60 contains two developer fee
worksheets. Worksheet #1 is for tax credit projects and worksheet #2 is for non-tax credit projects. These
worksheets are provided to assist you in determining the amount of developer fee which may be paid from
funding sources, deferred fees which may be taken as a priority payment from cash flow, and the portion of
the developer fee which must be taken from allowable distributions, pursuant to UMR Section 8314. The
worksheets are provided only as tools, and you are not required to complete a worksheet and you do
not need to include the worksheets with your application.

Item C 9 - Complete and attach the Unit Mix and Income Information form (pages 61 and 62 of the application). For
low income units, identify both the income level and source of the restriction in column (g) (e.g., MHP 'A', MHP 'B', or
MHP 'C', TCAC 60% AMI, etc).
NOTE: Pursuant to UMR Section 8304 , units restricted to the lowest income groups cannot be disproportionately
concentrated among the smaller units or differ in amenity level.
Item C 10 - Complete and attach the First Year Operating Budget and Cash Flow Analysis (page 63 of the
application) .
Item C 11 - Complete and attach the 15 -Year Pro Forma showing all revenue and expense projections using the
underwriting assumptions set forth in UMR Section 8310. Item C 11 (page 64 of the application) provides an
example of a pro forma format. The Department will accept a similar format using at least the same level of detail.
Page 8 of 99
NOTE: Projects dependent upon HUD Section 8 subsidies or other similar rent subsidies must demonstrate
financial feasibility in the event such subsidies become unavailable -- while retaining the very low rents for
a period of two years. A transition reserve account may be required for this purpose. (Section 7312(f)(2) of
the MHP Regulations).

Item C 12 - Service Coordination. The reasonable cost of on-site service coordination may be paid in the operating
budget of Department approved GHI Supportive Housing projects. However, service coordinators may not directly
deliver services, nor may they perform unrelated administrative duties or act as the Recreational or Activities Director
for the project. To the extent a full-time service coordinator position is not funded as a project operating expense, the
same staff person could be funded from other sources to undertake non-service coordinator job functions. Supportive
services costs other than on-site supportive services coordination are not allowed as operating expenses. The total
operating expense minimums specifically listed in California Code of Regulations, Title 4, Section 10327 must be met
exclusive of the cost of on-site supportive services coordination and property taxes.

Item C 13 - For new construction projects, attach the Budgeted Cost Estimate based on State Prevailing Wages.
Provide the name, phone number and qualifications of the person who prepared this estimate and a description of the
method used to determine the estimates on a separate page.

Item C 14 - Appraisal and Market Studies. Market Studies are required for projects where a bond allocation will be
needed. Appraisals are required for projects utilizing CalHFA funding or if needed for Leverage scoring points (Item
D5). Market Studies are required if needed to obtain points in Item D 2 scoring option D. Market Studies or
alternative market data reporting as approved by the State will be required in all projects where the State deems the
attainability of the proposed rents may be at issue. The State's experience indicates rent attainability is an issue in many
Supportive Housing Projects. Please contact your State Representative to help determine if market data will be required
for your project. Market Studies must be performed in accordance with the TCAC Market Study Guidelines published
March 31, 2004.

Item C 15 - Attach copies of planning approvals; variances; conditional use permits; density bonuses; and describe any
easements, deed restrictions or Covenants, Conditions and Restrictions (CC&R) that could restrict use.

Item C 16 - Attach copies of resumes or statement of qualifications for the project contractor and architect with a
description of all previous participation, if available.

Item C 17 - Attach copies of the Schematic Drawings of the site plan, floor plans, and building elevations, if available.

Item C 18 - For rehabilitation projects, Description of Current Condition of the structure(s) and a general description
of the overall scope of work. Include a discussion of any proposed modification to the unit configurations, unit mix,
need for seismic retrofit, or modifications in use (e.g., commercial/tourist hotel to SRO or studio apartments). Provide
copies of any available consultant reports, such as Capital Needs Assessment, Physical Needs Assessment, Replacement
Reserve Study, Feasibility Studies.
Page 9 of 99
NOTE: For all projects involving rehabilitation of existing structures, regardless of the extent of the planned
construction work, the Department requires the completion of a Physical Needs Assessment by a qualified
independent third party contractor, prior to start of construction.

Item C 19 - For rehabilitation projects, Provide a detailed proposed Scope of Work with line item estimate of
rehabilitation costs. List the name, phone number and qualifications of the person who prepared this estimate and
describe the method used to determine the figures.

Item C 20 - For rehabilitation projects, Attach a copy of the Current Rent Roll and tenant income and household size
information, submit by unit.

Item C 21- Attach Utility Allowance Estimates provided by either 1) a letter from the Housing Authority and the Utility
Allowance Schedule as provided by the respective county Housing Authority, or 2) a utility allowance schedule printed
from the Housing Authority's official website (the date of printing must be included on the print out). Sponsor must
indicate which components of the utility allowance schedule apply to the project.
Item C 22 - Attach a copy of the Letter Submitted to the Legislative Body of the local government, i.e., city or county,
in which the project site is located, notifying them of the Sponsor’s MHP application for funds.
Item C 23 - Operating Expense Comparables. Submit a minimum of three comparables for the most recent two years.
To the extent possible, the Operating Expense Comparables should be from other Supportive Housing or Special Needs
projects of similar design and similar tenant population. If the tenant mix is not 100% Supportive Housing, the tenant
mix should be as similar as possible to the subject project.

Section D Instructions

Section D contains the application Scoring Sheets (Items D 1 through D 9).

Each Item contains specific instructions on how to obtain scoring points and the documentation required.

Please refer to the Item D pages for instructions and call one of the Loan Officers listed on the Contacts
page if you have any questions.

Section E Instructions

Section E lists the additional items needed specific to projects if applying for CalHFA financing. If applying for
CalHFA financing, please be sure to indicate in the Checklist of Additional Items Required by CalHFA, Item E 1, the
items being submitted. In your binder, please tab the individual items to correspond with the numbers associated with
each item. It is suggested that these items be placed in a separate binder.

Section F Instructions

Section F includes the Special Funding for Capitalized Rent Subsidies Worksheet. Please complete the worksheet as
instructed in that section.

Section G Instructions

Section G contains an application summary along with some additional information which must be fully completed and
submitted as part of the application.
Page 10 of 99

Section A

Item
A 1. Application Index and Application Item Checklist
A 2. Eligibility Criteria
A 3. Narrative Description of Project
A 4. Applicant Certification and Commitment of Responsibility
A 5. No Defaults Statement
Page 11 of 99
Item A 1
APPLICATION INDEX AND APPLICATION ITEM CHECKLIST
(Must be completed and submitted with application)

Sponsor is to specify that each item is either Included or Not Applicable.

Section A.

Included/
Not applicable Item
A 1. Application Index and Application Item Checklist
A 2. Eligibility Criteria (pages 14 through 17)
A 3. Narrative Description of Project
A 4. Applicant Certification and Commitment of Responsibility
A 5. No Defaults Statement

Section B. MHP Threshold Information

Included/
Not applicable Item
B 1. Project Description Form
B 2. Sponsor Information Form
B 3. Reserved for Future Use
B 4. Relocation Plan or Preliminary Relocation Plan
B 5. Tenant Selection Criteria
B 6. Organizational Documents of Sponsor
B 7. Identities of Interest Disclosure
B 8. Organization's Experience
B 9. Evidence of Site Control
B 10. Current Preliminary (Title) Report
B 11. Governing Board Resolution
B 12. Names of Officers and Board Members
B 13. Environmental Reports
B 14. Scaled Distance Map and Parcel Map
B 15. Evidence of Article XXXIV Compliance
B 16. Governor's Homeless Initiative Supportive Housing Project Plan Checklist
B 17. Governor's Homeless Initiative Supportive Housing Project Plan

Section C. Project Feasibility

Included/
Not applicable Item
C 1. Local Approvals and Zoning/Land Use
C 2. Development Timetable
Page 12 of 99
Sponsor is to specify that each item is either Included or Not Applicable.

Included/
Not applicable Item
C 3. Worksheet to Determine Maximum Allowable Loan Amount
C 4. Loan Limit Worksheet
C 5. Shared Cost Calculation Worksheet
C 6. MHP Loan Amount Calculation Worksheet
C 7. Project Financing (Sources of Funds)
C 7. Enforceable Commitment Letter(s)
C 8. Development Budget
C 9. Unit Mix and Income Information
C 10. First Year Operating Budget and Cash Flow Analysis
C 11. 15 Year Pro Forma
N/A C 12. Documentation Justifying On-Site Services Coordination
C 13. Estimate of Unit Construction Costs Based on Prevailing Wage
C 14. Appraisal and Market Study
C 15. Copies of Planning Approvals
C 16. Copies of Resumes of the Project Contractor And Architect
C 17. Copies of Schematic Drawings
C 18. Description of Current Condition-rehabilitation projects only
C 19. Scope of Work-rehabilitation projects only
C 20. Current Rent Roll-rehabilitation projects only
C 21. Utility Allowance Estimates
C 22. Copy of Letter to Local Government
C 23. Operating Expense Comparables

Section D. Rating and Ranking Criteria

Included/
Not applicable Item
D 1. Scoring Sheet - Extent Project Serves Households at the Lowest Income Levels
D 2. Scoring Sheet - Extent Project Addresses the Most Serious Identified Local Housing Needs
D 2. Letter from City or County
D 2. Letter from department of local government
D 2. Attachment to Scoring Sheet - Comparable Market Rental Data Forms
D 2. Third Party Market Study attached as Item C 14
D 3. Scoring Sheets - Development and Ownership Experience of the Project Sponsor,
D 3. Attachment to Scoring Sheet -Development and Ownership Experience
Certification, and Appropriate Schedule(s)
D 4. Scoring Sheet -Percentage of Units for Families, Supportive Housing or Special Needs
Populations, or Special Needs Populations and "At-Risk" Rental Housing Developments
D 4. Attachment to Scoring Sheet - Checklist for "At-Risk" of Conversion,
and "At-Risk" of Conversion Supporting Documentation
Page 13 of 99
Sponsor is to specify that each item is either Included or Not Applicable.

Included/
Not applicable Item
D 5. Scoring Sheet - Leverage of Other Funds
D 5. Current Appraisal - attached as Item C14.
D 6. Scoring Sheet - Project Readiness
D 6. Enforceable commitments attached as Item C 7
Attachment to Scoring Sheet -Local Jurisdiction Verification of Project
D 6.
Readiness
D 6. Documents evidencing title and/or leasehold attached as
Item(s) B 9 and B 10
D 6. Letter from Project architect.
D 7. Scoring Sheet - Adaptive Reuse, Infill, or Proximity to Site Amenity
D 7. Narrative describing the Project and area.
D 7. Scaled distance map attached as Item B 14
D 8. Scoring Sheet - Negative Point Calculation Form-To be Completed by Department Staff -
Informational Only
D 9. Scoring Sheet - Total Ranking Points Earned

Section E. Additional Items Specific to Projects Applying for CalHFA Construction Financing

Included/
Not applicable Item
E 1. Checklist of Additional Items Required by CalHFA

Section F. Special Funding for Capitalized Rent Subsidies

Included/
Not applicable Item
F 1. Special Funding for Capitalized Rent Subsidies Worksheet

Section G. Summary Sheets

Included/
Not applicable Item
G 1. Application Summary
G 1. Application Summary - Co-Sponsor
G 2. Funding by Activity
G 3. Other Funding Sources
G 4. Project Information
G 5. Unit Information
G 6. Legislative Representatives
G 7. Special Needs Populations
Page 14 of 99

Item A 2
Eligibility Criteria

The following provides a summary of the eligibility requirements for the GHI Program. Only projects able to
demonstrate all the requirements specified in the GHI Supportive Housing NOFA dated November 15, 2005
shall be eligible. Projects must also document all the requirements specified in Items B 16 and B 17. The
eligibility criteria listed in this section contain references to Items which must be submitted with the GHI application.
Please refer to the Instructions section of this application for specific details on the documentation required in each
Item number.

Proposed projects are eligible only if:

1. Other development funding sources are insufficient to cover project development costs. (See Item C 3,
Worksheet to Determine Maximum Allowable Loan Amount ).

2. At the time of the application submission date, the construction or rehabilitation work has not commenced,
except for emergency repairs to existing structures required to eliminate hazards or threats to health and
safety (Section 7302 (a) of the MHP Regulations).
Does the Project meet these conditions? Yes No
3. The GHI Application is complete pursuant to Sections 7318 and 7320(a)(4) of the MHP Regulations.
Applicants must complete and submit the Application Index and Application Item Checklist .

4. The project site is free from severe adverse environmental conditions, such as the presence of toxic waste
that is economically infeasible to remove, pursuant to the MHP Regulations Section 7320 (a)(6) .
(Document in Item B 13 all available Phase I or II Environmental Site Assessment Reports with any
follow-up analysis (e.g., asbestos or lead based paint analysis or information on mitigation completed).

5. In relation to the needs of the project tenants, the project site is reasonably accessible to public
transportation, shopping, medical services, recreation, schools, and employment, pursuant to Section 7320
(a)(7) of the MHP Regulations . (Document in Item B 14)

6. The number of Assisted Units shall equal the number of Restricted Units to the extent allowed by the
requirements of Article XXXIV of the California Constitution (Health and Safety Code Section 37000).
(Document in Item B 15 Evidence of Article XXXIV of the State Constitution compliance or its
inapplicability).
7. Proposed projects involving new construction and requiring the demolition of existing residential Units are
eligible only if the number of bedrooms in the new Project is at least equal to the total number of
bedrooms in the demolished structures.
NOTE: The new Units may exist on separate parcels provided all parcels are part of the same rental
housing development (with common ownership, financing and management). In order to receive State
approval as a scattered site project, all sites in the project must be subject to similar tenant selection
procedures, rent restrictions, special needs groups to be served, and services to be provided. The sites will
usually be contiguous or in a close proximity to one another.
Page 15 of 99
Relocation Eligibility Requirements – UMR Section 8302 and Section 7315 of the MHP Regulations:

8. Prior to funding, the sponsor will be required to comply with the relocation requirements set forth in
Section 7315 of the MHP Regulations .

9. Will the project require tenants to vacate their units for any period of time; result in a rent increase; reduce
the number of units; or otherwise trigger federal or state relocation requirements?

Yes No

(If yes, attach as Item B 4, a copy of the Relocation Plan, if available or a Preliminary Relocation Plan and
budget which identifies the number of units affected and sources of funds for relocation).

Housing Development Experience - MHP Regulation Section 7303[c]

10. Threshold Eligibility Experience
In order to be eligible for MHP funding, a Project Sponsor (*see next page) must demonstrate experience
relevant to developing and owning one affordable rental housing project. There is no minimum number of
dwelling units needed to meet this threshold eligibility requirement. For the purpose of determining
eligibility, developing and owning a small shared housing project may be counted. (Please note, however,
project sponsors must demonstrate experience with projects containing 5 or more units to score points in
Item D 3 and to meet supportive housing requirements in Item B 17. Bedrooms in a single-family house
or apartment do not count as units of housing for these purposes.)

Primary Method of Demonstrating Threshold Eligibility Experience
A Project Sponsor can demonstrate experience based on organizational or staff experience as follows:
• Project Sponsor, or an affiliated entity or partner, has successfully developed and owned an affordable
rental housing project. An affiliated entity of the Project Sponsor is defined for these purposes as an entity
that is under common control with the Project Sponsor.
• Staff or principal employed by Project Sponsor, or an affiliated entity or partner, that has successfully
developed and owned an affordable rental housing project. In order for this experience to qualify, the staff
or principal must be the project manager and have comprehensive development responsibilities for the
proposed Project. (Experience of Board members of the Project Sponsor or an affiliated entity or partner
does not qualify under this provision unless they are also staff or principals as defined above.)

Project Sponsors using the Primary Method for Demonstrating Threshold Eligibility should complete the table below:

Qualifying Entity:

Project Name and Address Subsidy Source Qualifying Entity Qualified Entity Owned
(Including Tax Responsible for Project at Completion Date
Credits) Comprehensive (Indicate yes/no)
Development
Responsibilities of Project
(Indicate yes/no)
Page 16 of 99

* "Sponsor" means the legal entity or combination of legal entities with continuing control
of the Rental Housing Development. Where the borrowing entity is or will be organized as a
limited partnership, Sponsor includes the general partner or general partners who have
effective control over the operation of the partnership, or, if the general partner is controlled
by another entity, the controlling entity. Sponsor does not include the seller of the property
to be developed as the Project, unless the seller will retain control of the Project for the
period of time necessary to ensure Project feasibility as determined by the Department.

Alternative Method of Demonstrating Threshold Eligibility Experience
GHI Supportive Housing Sponsors may establish threshold eligibility using the Primary Method described above or
this Alternative Method. To qualify for the Alternative Method, at least 70% of the Project Units must be reserved for
the Target Population, or the Target Population and Special Needs Populations (and the Project must have met
threshold requirements that qualify it as a GHI Supportive Housing Project).

The Alternative Method of Demonstrating Threshold Eligibility is designed to accommodate the differing ways
Supportive Housing projects are sometimes developed and owned. It allows Project Sponsors to submit different
projects for development experience and ownership experience. It also allows the Project Sponsor to substitute the
development experience of a contracted developer or development consultant for its own and expands the criteria for
ownership by including "operation" experience as a replacement for ownership. (For these purposes, operation means
controlling a property under a long-term lease or other arrangement that involves all the responsibilities
commensurate with ownership.)

Under this method of demonstrating threshold eligibility, the Project Sponsor may qualify for development experience
by contracting with a developer or development consultant, provided that the Project Sponsor has contracted with the
developer or development consultant for comprehensive development services. Comprehensive development services
include: financial packaging, selection of other consultants, selection of the constructions contract and property
management agent, oversight of architectural design, construction management, and other major aspects of the
development process.

Under this Alternative Method, the Project Sponsor may substitute operation experience for ownership experience, as
long as the roles and responsibilities of the Project Sponsor in the projects submitted for such experience is
commensurate with the ownership role and responsibilities in the proposed Project.

The Project Sponsor may qualify for ownership/operation experience based on the Sponsor’s own experience or that
of its affiliated entities and partners (as defined above in Primary Method of Demonstrating Threshold Eligibility.)
The Sponsor also may qualify for ownership/operation experience based on the experience of Staff or principals
employed by the Project Sponsor or an affiliated entity or partner, as long as the staff or principal will be the project
manager and have comprehensive development responsibilities for the proposed Project. (The experience of Board
members of the Project Sponsor or an affiliated entity does not qualify under this provision unless they are also staff
or principals as defined above.)
Page 17 of 99
Project Sponsors using the Alternative Method for Demonstrating Threshold Eligibility should complete the tables
below:
Development Experience
List one affordable rental housing project completed within five years of the application due date by the developer or
development consultant with whom the Project Sponsor has a comprehensive development services contract and
attach a copy of the contract.

Contracted Developer/Development Consultant:

Ownership/Operation Experience
List one affordable rental housing project that the Project Sponsor, or Affiliate of the Project Sponsor, currently owns
or operates (i.e., involving all responsibilities commensurate with ownership). When substituting operation for
ownership experience, attach: (1) a narrative describing specific roles and responsibilities of the sponsor and how the
are commensurate with ownership roles and responsibilities; and (2) a copy of the long-term lease under which the
project is operated.

Qualifying Entity:

Project Name and Address Subsidy Source Qualifying Entity Qualified Entity Owned
(Including Tax Operates Project Project at Completion Date
Credits) Involving all (Indicate yes/no)
Responsibilities
Commensurate with
Ownership
(Indicate yes/no)

(Ownership and development experience is documented in Items B8 and D3 of this application, along with the
development experience necessary to accumulate points in Scoring Sheet Item D3).
Page 18 of 99
Site Control Requirements – UMR Section 8303:

11. Site control must be in the name of the sponsor or an entity controlled by the sponsor (the relationship
between the sponsor and any affiliated entity must be clearly documented in Item B 6) and evidenced by
one of the following (check one): (Evidence of site control to be submitted as Item B 9).

Check Appropriate Box
Yes Fee Title; Document in Item B 10 with a current preliminary (title) report; or

Yes a leasehold interest on the project property with provisions that enable the lessee to
make improvements on and encumber the property provided that the terms and
conditions of any proposed lease shall permit compliance with all program
requirements, including UMR Section 8316 requirements. Document with a copy
of a fully executed and valid lease; or

Yes an enforceable option to purchase or lease which shall extend, or may be extended,
through the anticipated date of the Program award. Document with a fully executed
and valid option agreement; or

Yes a Disposition and Development Agreement (DDA) with a public agency.
Document with a fully executed and valid DDA;

Yes an agreement with a public agency that gives the sponsor exclusive rights to
negotiate with that agency for acquisition of the site, provided that the major terms
of the acquisition have been agreed to by both parties. Document with a fully
executed and binding agreement; or

Yes a land sales contract, or other enforceable agreement for the acquisition of the
property. Document with a fully executed and binding contract of sale.

12. The project application must contain sufficient documentation to enable the Department to make a
determination that the project satisfies all supportive housing project requirements, as specified in Items B
16 and B 17.
Page 19 of 99
Item A 4

APPLICANT CERTIFICATION AND COMMITMENT OF RESPONSIBILITY

As the official designated by the governing body, I hereby certify that if approved by the Department for a
Multifamily Housing Program (MHP) loan, _________________________________ (Sponsor name) assumes the
responsibilities specified in the Department’s Notice of Funding Availability, dated _____________ , and in all
applicable program Regulations and statutes and certifies that:

A. It possesses the legal authority to apply for the MHP loan;

B. It has resolved any audit findings or adverse actions taken by the Department within the last three
years for prior Department or federally-funded housing or community development projects or
programs to the satisfaction of the Department or federal agency by which the funding was made;

C. It will comply with all statutes and regulations governing the MHP;

D. The information, statements, and attachments contained in the application are, to the best of my
knowledge and belief, true and correct. This application, if approved for funding, will be a part of
the Standard Agreement with the Department.

I authorize the Department of Housing and Community Development to contact any agency, whether or not
named in this application, which may assist in determining the capability of the applicant. All information
contained in this application is acknowledged to be public information.

Signature: Date:

Type
Name:
Title:

Please note: If this certification is signed by someone other than the person authorized in the Governing Board
Resolution (Item B 11), attach evidence which shows that the person signing has the legal authorization to sign.
Page 20 of 99
Item A 5

No Defaults Statement
Please respond to the seven questions below and if your answer to any question is “yes”, please explain the circumstances in
writing on a separate page attached to this form and sign and date this form below.
Yes No
(1) In the past five years, have you or any affiliate of yours, acted as a principal in
connection with any real estate project, which has experienced either of the
following:
(a) A default in the payment of the mortgage

(b) Foreclosure or delivery of a deed in lieu of foreclosure

(2) Have you, or any affiliate of yours, filed for bankruptcy?

(3) Are you, or any affiliate of yours, a defendant in any material pending civil or
criminal legal action?

(4) Are you or any affiliate of yours, subject to any unsatisfied judgments or
liens?

(5) Have you ever been charged with or convicted of a felony, fraud, or a
securities violation?

(6) Have you ever been convicted of a misdemeanor (other than a traffic
violation)?

(7) Are there any other conditions (financial/legal) not included above that would
affect your ability to complete the project?

I hereby authorize the Department of Housing and Community Development to contact any agency,
whether or not named in this application, which may assist in verifying the information contained in this
application.

Signature: Date:

Type
Name:

Title:

Please note: If this statement is signed by someone other than the person authorized in the Governing Board
Resolution (Item B 11), attach evidence which shows that the person signing has the legal authorization to sign.
Page 21 of 99

Section B

MHP Eligibility Threshold
Information

Item
B 1. Project Description Form
B 2. Sponsor Information Form
B 3. Reserved for Future Use
B 4. Relocation Plan or Preliminary Relocation Plan
B 5. Tenant Selection Criteria
B 6. Organizational Documents of Sponsor
B 7. Identities of Interest Disclosure
B 8. Organization’s Experience
B 9. Evidence of Site Control
B 10. Current Preliminary (Title) Report
B 11. Governing Board Resolution
B 12. Names of Officers and Board Members
B 13. Environmental Reports
B 14. Scaled Distance Map and Parcel Map
B 15. Evidence of Article XXXIV Compliance
B 16. Governor's Homeless Initiative Supportive Housing Project Plan Checklist
B 17. Governor's Homeless Initiative Supportive Housing Project Plan
Page 22 of 99
Item B 1

PROJECT DESCRIPTION FORM
A. Project Description

Identify Project

Name of Project:
Site Address:
City: State: Zip:
County: Census Tract:
Assessor's Parcel Number(s):

Geographic Location (check area that applies) –Section 7317 (c) of MHP Regulations :

Northern California Southern California Rural

NOTE: “Southern California” includes the counties of Kern, San Bernardino, San Luis Obispo, and all counties to the south.
“Northern California” includes all other counties of the State. “Rural” is defined to be consistent with the definition used by
TCAC for the tax credit program (Section 50199.21 of the Health and Safety Code), and a list of rural areas can be found in
TCAC’s Application Supplement on the TCAC website at http://www.treasurer.ca.gov/CTCAC/ctcac.htm.

Type of Project (check one):
Development and Construction of New Rental Housing

Rehabilitation of a Rental Housing Development

Acquisition and Rehabilitation of a Rental Housing Development

Conversion of a Nonresidential Structure to a Rental Housing Development

The project will be operated as: Permanent Transitional Housing Both permanent and Transitional Housing

Note: Only Non-Supportive Housing Units may be operated as Transitional Housing Units

Limitations on Project Occupancy (check if applicable):
Supportive Housing Eligible Households (Section 7301 of the MHP Regulations )[Identify in B 16]
Special Needs Population (Section 7301 of the MHP Regulations )[Identify populations in B 16]
Other (please describe): _________________________________

Project Square Footage:

Gross sq. footage of all residential units: Gross sq. footage NSSS
Gross sq. footage of all restricted units: Gross sq. footage common areas:
Gross sq. footage community room: Gross sq. footage childcare center:
Gross sq. footage commercial space: Gross sq. footage social service facility:
Gross parking structure sq. footage: Gross sq footage of all structures:
Gross Land sq. footage: Gross Land Area (acres):
Page 23 of 99

Scattered Sites? YES NO Is this project being developed in phases? YES NO

Complete for Acquisition/Rehabilitation Projects:

Age of Existing Structures: Number of Occupied Buildings:
Number of Existing Buildings: Number of Existing Units:
Number of Stories: Current Use:

Describe Project When Completed:

No. of Parking Spaces: Covered Uncovered Subterranean Garage

Number of Residential Buildings: Number of Other Buildings:
Number of Stories: Number of Elevators:
Total Number of Parking Spaces: 0 Number of Guest Parking Spaces:

Unit Design (i.e., garden apartments, semi-detached):

Describe below any existing or proposed commercial space (see UMR Section 8301(c)) for a definition of commercial space).
Identify tenants, and describe lease terms. Attach copy of lease, if available.

If the project will include childcare or social service facilities, describe the sources of operational funding for these facilities and
the eligibility criteria that must be met to access the services provided by them. Describe below any limitations on the ability of
MHP-Assisted Unit tenants to use the services (e.g., tenants must be agricultural workers to use the on-site health clinic). Attach
copies of contracts for funding, if available.
Page 24 of 99
AMENITIES INCLUDED IN THE RENT (check all amenities included in rent for all units):

Refrigerator Washer/Dryer Wet Bar Security Gated
Dishwasher Laundry Room(s) Tot Lot(s) Security Guard
Disposal Walk-in Closets Sauna(s)/Jacuzzi Lakes or streams
Range Vaulted Ceilings Pool(s) #_____ Hot Water
Microwave Wallpaper Tennis Court(s) Cold Water
Fireplace Paneling Basketball Court(s) Sewer
Air
Curtains/Blinds Volleyball Court(s) Garbage
Conditioning
Balcony/
Garage Picnic Area(s) Cable TV
Patio

UNIT AMENITIES:

Heating: Central Heat Wall Heaters Other
Heating Fuel: Gas Heating Electric Heating Other
Kitchen Countertops: Formica Tile Corian Fiberglass

Kitchen Sink: Cast Iron Stainless Steel Other
Kitchen sink type: Double Single

Bathroom Countertops: Formica Tile Corian Fiberglass

Shower/Tub: Tile Cast Iron Fiberglass Plastic

Roof Type: Flat Top Pitched Flat & Pitched

Roof Material: Concrete Tile Shake Wood Shingle
Clay Tile Hot Mop Composition Shingle

Siding Code: Stucco Masonry Wood

Structure Code: Frame – 1 or 2 Story Reinforced Concrete - 1-6 stories
Frame – 3 or More Stories Reinforced Concrete - 7 or more stories

Reinforced Masonry Unreinforced Masonry
Pre-Cast Reinforced

SITE FEATURES (check the applicable site features):

1% to 5% Retaining High Water Table
Grade Wall(s)
6% to 10% Cuts: Poor Drainage
Grade
11% to 20% Fills: Erosion Problems
Grade
Over 20% 100 Year Flood 500 Year Flood
Grade Zone Plain
Page 25 of 99
Item B 2

Sponsor Information Form

A.1. Sponsor Information

Does the project involve Co-Sponsorship? YES NO
If yes, submit this page in duplicate
Sponsor:
Legal Name:
Address:
City: State: Zip:
Phone: Fax:
E-mail Address:
Contact Person:
Title:
Phone: Fax:
E-mail Address:

Form of Legal Entity (check all that apply):
Individual General Partnership Indian Reservation or Rancheria
Limited Partnership Joint Venture Limited Liability Company
Nonprofit Corporation For-profit Corporation Other (specify)
Public Agency Limited Equity Housing Cooperative
Federal Tax ID Number :

A.2. Ultimate Owner/Borrower:
Legal Name:
Address:
City: State: Zip:
Phone: Fax:
E-mail Address:

Has this entity already been formed? YES NO

Contact Person:
Title:
Phone: Fax:
E-mail Address:

Form of Legal Entity (if entity has been formed, check all that apply):
Individual General Partnership Indian Reservation or Rancheria
Limited Partnership Joint Venture Limited Liability Company
Nonprofit Corporation For-profit Corporation Other (specify)
Public Agency Limited Equity Housing Cooperative
Federal Tax ID Number
Page 26 of 99

A.3. Ultimate Managing General Partner or Controlling Entity:
Does this project involve more than one General Partner? YES NO

If yes, submit this page in duplicate.

Legal Name:
Address:
City: State: Zip:
Contact Person:
Title:
Phone: Fax:
E-mail Address:

Has this entity already been formed? YES NO

B. Identify Development Team
(List those development team members that have been selected)

Architect: General Contractor:
Name: Name:
Address: Address:

Phone: Phone:
Attorney(s) and/or Tax Professionals: Investor(s):
Name: Name:
Address: Address:

Phone: Phone:
Consultant(s): Market Analyst:
Name: Name:
Address: Address:

Phone: Phone:
Fax:
Email:
Property Management Agent/Company: Other (please specify):
Name: Name:
Address: Address:

Phone: Phone:
Page 27 of 99

Sample for Item B 11

"SAMPLE" RESOLUTION OF THE BOARD OF DIRECTORS OF
[NAME OF CORPORATE BORROWER]

[All of the directors / A majority of the directors] of [Name of corporation], a California [nonprofit / public
benefit] corporation (the “Corporation”), hereby consent to, adopt and ratify the following resolutions:

Multifamily Housing Program

WHEREAS, the State of California, Department of Housing and Community Development (the “Department”)
has issued a Notice of Funding Availability (“NOFA”) under its Multifamily Housing Program (“MHP”) dated
__________________; and

WHEREAS, the Corporation is authorized to do business in the State of California and is empowered to enter into
an obligation to receive State funds for the new construction or rehabilitation of a rental housing development,
acquisition or rehabilitation of a rental housing development, or conversion of a nonresidential structure to a
rental housing development;

WHEREAS, the Corporation wishes to obtain from the Department a MHP loan for a rental housing
development; and

WHEREAS, the Corporation is an Eligible Sponsor under the Multifamily Housing Program.

NOW, THEREFORE, IT IS RESOLVED: That the Corporation is hereby authorized to submit an application to
borrow an amount not to exceed $______________ (the “MHP Loan”) in connection with the Department’s loan
of funds to the Corporation pursuant to the Notice of Funding Availability (NOFA) issued on [date] for use in the
County of ____________ [Name of County].

RESOLVED FURTHER: If the application is approved, the Corporation is hereby authorized to incur an
obligation for the MHP Loan. That in connection with the MHP Loan, the Corporation is authorized and directed
to enter into, execute, and deliver, a State of California Standard Agreement, and any and all other documents
required or deemed necessary or appropriate to carry into effect the full intent and purpose of the above
resolution, in order to evidence the MHP Loan, the Corporation’s obligations related thereto, and the
Department’s security therefore; including, but not limited to, a promissory note, a deed of trust and security
agreement, a regulatory agreement, a development agreement and certain other documents required by the
Department as security for, evidence of or pertaining to the MHP Loan, and all amendments thereto (collectively,
the “MHP Loan Documents”).

RESOLVED FURTHER: The Corporation is further authorized to request amendments, including increases in
amounts up to amounts approved by the Department, and to execute any and all documents required by the
Department to govern and secure these amendments.

RESOLVED FURTHER: That [Name(s) and Title(s) of Corporate Officer(s)] [is/are] hereby authorized to
execute an application for a MHP Loan, the MHP Loan Documents, and any amendment or modifications thereto,
on behalf of the Corporation.
Page 28 of 99
RESOLVED FURTHER: That this Resolution shall take effect immediately upon its passage.

Passed and adopted, effective as of _____________, 20___, by the consent of the Board of Directors of the
Corporation by the following vote: [Note: The Resolution adoption date must be between the NOFA
issuance date and the application due date.]

AYES: __________ NAYS: ___________ ABSTAIN: ____________ ABSENT: __________

CERTIFICATE OF THE SECRETARY

The undersigned, Secretary of the Corporation does hereby attest and certify that the [foregoing / attached]
Resolution is a true, full and correct copy of a resolution duly adopted at a meeting of said Corporation which was
duly convened and held on the date stated thereon, and that said document has not been amended, modified,
repealed or rescinded since its date of adoption and is in full force and effect as of the date hereof.

Secretary’s Signature Date

Type or Print Secretary’s Name
Page 29 of 99

Sample for Item B 11

"SAMPLE" RESOLUTION OF THE BOARD OF DIRECTORS OF
[NAME OF CORPORATE GENERAL PARTNER]

Multifamily Housing Program

WHEREAS, the State of California, Department of Housing and Community Development (the “Department”)
has issued a Notice of Funding Availability under its Multifamily Housing Program (“MHP”) dated
__________________; (“NOFA”) and

WHEREAS, the Corporation is authorized to do business in the State of California and it is in the best interests of
the Corporation and its [Members / Shareholders] for the Corporation to act as the [managing / sole] General
Partner of [Name of Limited Partnership Borrower], a California limited partnership (the “Limited
Partnership”);

WHEREAS, the Limited Partnership wishes to obtain from the Department a MHP loan for a rental housing
development; and

WHEREAS, the Limited Partnership is an Eligible Sponsor under the Multifamily Housing Program.

NOW, THEREFORE, IT IS RESOLVED: That the Corporation is hereby authorized to act as the [managing /
sole] General Partner of the Limited Partnership and to submit an application on behalf of the Limited Partnership
for a MHP loan to the Limited Partnership pursuant to the NOFA in an amount not to exceed $_____________
(the “MHP Loan”) for use in the County of _____________ [Name of County].

RESOLVED FURTHER: If the application is approved, the Corporation is hereby authorized to incur an
obligation for the MHP Loan on behalf of the Limited Partnership. That in connection with the Limited
Partnership’s MHP Loan, the Corporation is authorized and directed to enter into, execute, and deliver, as the
[managing / sole] General Partner of the Limited Partnership, a State of California Standard Agreement, and any
and all other documents required or deemed necessary or appropriate to carry into effect the full intent and
purpose of the above resolution, in order to evidence the MHP Loan, the Limited Partnership’s obligations related
thereto, and the Department’s security therefore; including, but not limited to, a promissory note, a deed of trust
and security agreement, a regulatory agreement, a development agreement and certain other documents required
by the Department as security for, evidence of or pertaining to the MHP Loan, and all amendments thereto
(collectively, the “MHP Loan Documents”).

RESOLVED FURTHER: The Corporation is further authorized on behalf of the Limited Partnership to request
amendments, including increases in amounts up to amounts approved by the Department, and to execute any and
all documents required by the Department to govern and secure these amendments.
Page 30 of 99
RESOLVED FURTHER: That [Name(s) and Title(s) of Corporate Officer(s)] [is/are] hereby authorized to
execute an application for a MHP Loan, the MHP Loan Documents, and any amendment or modifications thereto,
on behalf of the Corporation as the [managing / sole] General Partner of the Limited Partnership.

RESOLVED FURTHER: That this Resolution shall take effect immediately upon its passage.

Passed and adopted, effective as of _____________, 20___, by the consent of the Board of Directors of the

AYES: __________ NAYS: ___________ ABSTAIN: ____________ ABSENT: __________

CERTIFICATE OF THE SECRETARY

The undersigned, Secretary of [Name of Limited Partnership’s Corporate General Partner] does hereby attest
and certify that the [foregoing / attached] Resolution is a true, full and correct copy of a resolution duly adopted
at a meeting of said Corporation which was duly convened and held on the date stated thereon, and that said
document has not been amended, modified, repealed or rescinded since its date of adoption and is in full force
and effect as of the date hereof.

Secretary’s Signature Date

Type or Print Secretary’s Name
Page 31 of 99

Sample for Item B 11

"SAMPLE" RESOLUTION OF THE MEMBERS OF
[NAME OF LIMITED LIABILITY COMPANY GENERAL PARTNER]

[All of the managers / A majority of the managers] of [Name of limited liability company], a California
limited liability company (the “Limited Liability Company”), hereby consent to, adopt and ratify the following
resolutions:

Multifamily Housing Program

WHEREAS, the Limited Liability Company is authorized to do business in the State of California and it is in the
best interests of the Limited Liability Company and its [Members] for the Limited Liability Company to act as the
[managing / sole] General Partner of [Name of Limited Partnership Borrower ], a California limited
partnership (the “Limited Partnership”); and

WHEREAS, the Limited Partnership wishes to obtain from the Department a MHP loan for a rental housing
development; and

WHEREAS, the Limited Partnership is an Eligible Sponsor under the Multifamily Housing Program.
NOW, THEREFORE, IT IS RESOLVED: That the Limited Liability Company is hereby authorized to act as the [managing
/ sole] General Partner of the Limited Partnership and to submit an application on behalf of the Limited Partnership for a
MHP loan to the Limited Partnership pursuant to the NOFA in an amount not to exceed $_____________ (the “MHP Loan”)
for use in the County of ______________ [Name of County].

RESOLVED FURTHER: If the application is approved, the Limited Liability Company is hereby authorized to
incur an obligation for the MHP Loan on behalf of the Limited Partnership. That in connection with the Limited
Partnership’s MHP Loan, the Limited Liability Company is authorized and directed to enter into, execute, and
deliver, as the [managing / sole] General Partner of the Limited Partnership, a State of California Standard
Agreement, and any and all other documents required or deemed necessary or appropriate to carry into effect the
full intent and purpose of the above resolution, in order to evidence the MHP Loan, the Limited Partnership’s
obligations related thereto, and the Department’s security therefore; including, but not limited to, a promissory
note, a deed of trust and security agreement, a regulatory agreement, a development agreement and certain other
documents required by the Department as security for, evidence of or pertaining to the MHP Loan, and all
amendments thereto (collectively, the “MHP Loan Documents”).

RESOLVED FURTHER: The Limited Liability Company is further authorized on behalf of the Limited
Partnership to request amendments, including increases in amounts up to amounts approved by the Department,
and to execute any and all documents required by the Department to govern and secure these amendments.
Page 32 of 99
RESOLVED FURTHER: That [Name(s) and Title(s) of Limited Liability Company Officer(s)] [is/are]
hereby authorized to execute an application for a MHP Loan, the MHP Loan Documents, and any amendment or
modifications thereto, on behalf of the Limited Liability Company as the [managing / sole] General Partner of the
Limited Partnership.

RESOLVED FURTHER: That this Resolution shall take effect immediately upon its passage.

Passed and adopted, effective as of _____________, 20___, by the consent of the Managers of the Limited
Liability Company by the following vote: [Note: The Resolution adoption date must be between the NOFA
issuance date and the application due date.]

AYES: __________ NAYS: ___________ ABSTAIN: ____________ ABSENT: __________

CERTIFICATE OF THE SECRETARY

The undersigned, Secretary of [Name of Limited Partnership’s Limited Liability Company General
Partner] does hereby attest and certify that the [foregoing / attached] Resolution is a true, full and correct copy
of a resolution duly adopted at a meeting of said Limited Liability Company which was duly convened and held
on the date stated thereon, and that said document has not been amended, modified, repealed or rescinded since its
date of adoption and is in full force and effect as of the date hereof.

Secretary’s Signature Date

Type or Print Secretary’s Name
Page 33 of 99
Governor's Homeless Initiative
Supportive Housing Projects

In order to be approved as a Governor's Homeless Initiative (GHI) Supportive Housing Project: (1) the GHI
Supportive Housing Project Plan Checklist must be submitted as Item B16, and (2) the completed GHI
Supportive Housing Project Plan must be submitted as Item B17.

GHI Supportive Housing Projects must comply with the specific requirements contained in the GHI Supportive
Housing NOFA dated November 15, 2005 (the NOFA) and in the MHP and Uniform Multifamily Regulations
posted on HCD’s website. Please reference the NOFA for the definition of the "Target Population." Projects
shall be subject to the State's determination that the project has met all relevant requirements in order to qualify
as a GHI Supportive Housing Project.

Item B 16
Governor's Homeless Initiative (GHI)
Supportive Housing Project Plan Checklist

The GHI Supportive Housing Project Plan Checklist shall serve as a guide to ensure that the GHI Supportive
Housing Project Plan is complete. Note on the Checklist that each part and section of the plan (Item B 17) is
complete. Submit the Checklist as Item B 16.

Part 1. Populations to be Served
Section 1: Unit Calculation Tables
Section 2: Target Population Checklist
Section 3: Tenant Selection Narrative

Part 2. Supportive Services Plan
Section 1: Service Plan Summary
Section 2: Characteristics of Supportive Housing
Section 3: Verification from Appropriate Public or Non-profit Funding
Agency
Section 4: Supportive Service Chart
Section 5: Service Delivery
Section 5a: Staffing Structure Chart
Section 5b: Staffing Levels Table
Section 6: Tenant Engagement
Section 7: Measurable Outcomes and "Plan For Evaluation "
Section 7a: Measurable Outcomes Chart
Section 7b: Data Tracking and Evaluation Plan

Part 3. Supportive Services Budget
Section 1: Supportive Services Budget Table
Section 2: Supportive Services Cost Per Unit Table
Section 3: Funding and Service Commitments

Part 4. Project Sponsor and Service Provider Experience
Section 1: Project Sponsor Experience
Section 2: Service Provider Experience
Section 2a: Service Provider Experience Chart
Section 2b: Service Funding History

Part 5. Property Management Experience
Section 1: Property Management Experience
Section 2: Management Contract
Page 34 of 99
Item B 17
Governor's Homeless Initiative
Supportive Housing Project Plan

The State will make the determination that a project qualifies as a Governor's Homeless Initiative (GHI) Supportive
Housing Project based on the content and organization of the GHI Supportive Housing Project Plan to be submitted as
Item B 17.

Please note that applicants may apply for funding using this GHI Supportive Housing application for (1) projects
containing Target Population units only; or (2) projects containing a mix of Target Population and Non-Target Population
units. Non-Target Population units are housing units, including Special Needs Population units, in a development where
at least 35% of the units are Target Population units. For the purpose of this application, any project meeting the above
criteria is considered to be “GHI Supportive Housing.”

The GHI Supportive Housing Project Plan is organized into five parts shown below. Each part must be completed in full.

Part 1. POPULATIONS TO BE SERVED

Section 1. Unit Calculation Tables: Complete the unit calculation table below. For number of households, please
provide point-in-time information.
Unit Calculation Table
a. Total Project Units
b. Manager’s Unit (if applicable)
c. Total Units Less Manager’s Unit [a – b] 0

d. Number of Target Population Units
e. Number of Households to be Housed in Target Population Units

f. Number of Permanent Special Needs Population Project Units (if applicable)
g. Number of Transitional Special Needs Population Project Units (if applicable)
h. Total Special Needs Population Units (if applicable) [f + g]
i. Number of Households to be Housed in Special Needs Population Units (if applicable)

j. Total Target Population and Special Needs Population Project units [d + h] 0
k. Total Households to be Housed in Target Population and Special Needs Population Units [e + i]
l. Percentage of Target Population Units [d ÷ c] #DIV/0!
m. Percentage of Special Needs Population Project Units [h ÷ c] #DIV/0!
n. Percentage of Target Population and Special Needs Population Project Units [j ÷ c] #DIV/0!

Section 2: Target Population Checklist
GHI Target Population

Households eligible as the GHI Target Population must have a household income not exceeding 30% of AMI and must
include an adult or older adult member eligible for services under the Mental Health Services Act (MHSA) that is
chronically homeless.
Please check the following boxes to verify that the Target Population the project will serve in the GHI Supportive Housing
units consists of households:
Whose incomes do not exceed 30% of AMI (or 30% of State Median Income, if this is a greater amount); and
That include an adult or older adult member eligible for services under the MHSA: and
That include an adult or older adult member who is Chronically Homeless (as defined in the GHI NOFA
issued November 15, 2005).
Page 35 of 99

Special Needs Population Categories

Please indicate below which Target Populations that the project will serve in the Special Needs Population Project Units
(if applicable). Please note that prospective residents must qualify as a Special Needs Population member pursuant to
MHP Regulation Section 7301(r).

Mentally Disabled Households
Orthopedically Disabled Households (wherein a person's personal mobility is impaired)
Physically Disabled Households (wherein a person's ability to obtain employment is affected or a person requires
special care or facilities in the home)
Persons with HIV/AIDS
Developmentally Disabled Households
Agricultural Workers
Single-Parent Households
Survivors of Physical Abuse
Homeless (check all that apply)
Moving from an emergency shelter
Moving from transitional housing
Currently homeless (as defined in the Supportive Housing Regulations Section 7341(b)(3)
At Risk of Homelessness (check all that apply)
Households with incomes at or below 20% of SMI or AMI with no rental subsidy available.
Households with incomes above 20% but not exceeding the greater of 30% of SMI or AMI
that are subject to housing conditions listed in the Multifamily Housing Regulations,
Section 7341(c)(2).
Long-term Chronic Health Condition, meaning an individual or household having:
a. Eligibility under either of two Medicaid Waiver programs, the Multipurpose Senior Services Program
(MSSP) or the Assisted Living Waiver Pilot Project (or its successor)
b. Eligibility for 20 or more personal care hours per week under the In-Home Supportive Services Program
(IHSS)
c. Eligibility for services under the Program of All Inclusive Care for the Elderly (PACE)
Displaced Teenage Parents (or Expectant Teenage Parents)
Homeless Youth as Defined in Government Code 11139.5
Individuals Exiting from Institutional Settings
Chronic Substance Abusers
Page 36 of 99

Section 3. Tenant Selection Narrative
Please attach a narrative describing your tenant selection process, organized into the titled sections as shown below. The
tenant selection criteria must conclusively document that occupancy of the project will be limited to eligible households as
defined in the Multifamily Housing Program Regulations and the GHI NOFA.

(1) Threshold Eligibility Criteria:
Describe tenant eligibility criteria relating to income (% SMI/AMI), chronic homelessness status, eligibility for services
under MHSA (i.e. adults and older adults with a "serious mental illness") and any other special needs (if project contains
Special Needs units).
(2) Other Eligibility Criteria:
Describe eligibility criteria other than those indicated in section (1) above, i.e., information needed to determine if
applicant can comply with terms of a lease. (Please note: Selection criteria designed to assess anything other than the
ability to comply with the terms of a lease generally run afoul of fair housing laws designed to protect equal access to
housing for people with disabilities. Please see Between the Lines, A Question and Answer Guide on Legal Issues in
Supportive Housing , Chapter 5) 1

(3) Marketing/Outreach:
Describe marketing/outreach efforts to publicize units.

(4) Referral Sources:
For each target population, list agencies/organizations from which you expect to receive tenant referrals to your project.
(5) Application Process:
Describe the tenancy application process and waiting list protocol.
(6) Tenant Screening:
Describe tenant screening process, including who conducts screening and where, when, and how screening is conducted.
Also, indicate how you will obtain third-party verification of tenant threshold eligibility (i.e., income, chronic homeless
status, eligibility for MHSA services, and any other special needs.)
Note: If your project will be serving people who are disabled due to long-term chronic health conditions (i.e., eligibility
for PACE, MSSP, or 20 hours of IHSS personal care, etc.), you must indicate from whom and how you plan to obtain such
programmatic eligibility verification.

(7) Fair Housing:
Describe your reasonable accommodation policies and protocols as they relate to targeting and tenant screening and
selection.
1
Note: The Department may condition funding on the elimination of restrictions that it believes to be impermissible, or
reject an application where it determines that compliance with applicable law is not feasible. A useful resource on the
subject of legal issues in Supportive Housing is Between the Lines, A Question and Answer Guide on Legal Issues in
Supportive Housing , published by the Corporation for Supportive Housing. This document is available online at
www.csh.org.pub.html.
Page 37 of 99

Part 2. SUPPORTIVE SERVICES PLAN

Supportive Housing Projects shall be designed to provide affordable housing with access to an array of services and supports for
individuals who need supportive services to live independently. Applications for Supportive Housing must demonstrate that the project
is linked to services that assist the tenant retain the housing, improve his/her health, and maximize his/her ability to live, and where
possible, work in the community.

The State expects that projects applying for Supportive Housing funding will provide housing that incorporates the following as
characteristics of a Supportive Housing Project: (1) it is independent housing in which each tenant holds a lease or rental agreement in
his/her own name, is responsible for paying his/ her own rent; (2) has his/her own room or apartment; (3) it is permanent housing in
which each tenant may stay as long as he/she pays his or her share of rent and complies with the terms of his or her lease; (4) it is
tenancy housing, complying with applicable state and federal laws governing the landlord-tenant relationship; and (5) participation in
services or any type of services is not required as a condition of tenancy.

Pursuant to UMR Section 8301(o), residential treatment programs and licensed facilities that provide health care services may not be
eligible for funding. Board and care facilities are not generally considered to be supportive housing since these facilities do not
typically offer the level of services required to sustain the tenancy of the populations targeted under the MHP Supportive Housing
Program.

Section 1. Service Plan Summary
Provide a narrative summary of your service plan for Target Population (and Special Needs Populations, if applicable) tenants,
including a description of the primary service needs of the populations, services to be delivered and how they will be delivered, how the
services promote recovery and self sufficiency, identification of the lead service provider (include experience with the target
population) and other significant service partners, a description of the key services each will provide and how the project will be staffed
(including staffing ratios). Please include the strategies you will use to help tenants with their plan for resiliency and recovery. Be sure
to demonstrate that the essential service needs of the project's occupants will be met (i.e., mental health services for people with mental
illness, substance abuse services for people with co-occurring substance abuse). Outline how the project will be linked to the County
Mental Health Department's CSS/MHSA plan and how the monthly data will be gathered and reported - ensuring compliance with
State DMH requirements. Please limit your response to two pages.

Section 2. Characteristics of Supportive Housing
Section 7341 of the Multifamily Housing Program regulations provides a definition of Supportive Housing that includes the following
characteristics. Please confirm compliance by checking all of the characteristics that apply to the Supportive Housing units in your
project.
Tenant holds a lease in his/her name and is responsible for paying rent.
Tenant has his or her own room or apartment and is individually responsible for arranging any shared tenancy.
Tenant may stay as long as he/she pays his or her share of rent and complies with the terms of his/her lease.
Unit is subject to applicable state and federal landlord tenant laws.
Tenant's participation in services or any particular service shall not be required as a condition of tenancy.

Typically, all the characteristics listed above must be present in order for the project to be eligible for funding. However,
please explain mitigating circumstances for any missing characteristic.

Section 3. Verification from Appropriate Public or Non-profit Funding Agency
All applications shall include verification(s) indicating that the proposed services are appropriate to meet the needs of the Target
Population and Special Needs, if applicable, household(s). Verification(s) shall also endorse the primary service provider as a known
provider of services to the target population(s) the sponsor is proposing to serve.
For the Target Population, the verification must be provided by the County Mental Health Department.
If the project also includes Special Needs populations, the application shall include verification(s) from appropriate funding entity(ies)
(either public or non-profit) knowledgeable about the support service needs of the eligible households.
Please use the attached Supportive Service Verification form from the Appropriate Public or Non-Profit Agency. Please submit one
verification for each target population checked in Part 1, Section 2. If appropriate, a single funder may provide a verification for
multiple populations (i.e. a County Department of Health Services could provide a verification for a project serving individuals with
HIV/AIDS, Chronic Substance Abuse and Other Chronic Health Conditions). Please be sure to indicate on the verification form the
target populations to which each verification applies.
Please note: The project sponsor and/or service provider(s) are not eligible to provide the Funding Agency Verification unless the
County Mental Health Dept. is the service provider for the GHI Supportive Housing units.
Page 38 of 99
Item B 17
Part 2 Section 3
Supportive Services Verification from the Appropriate Public or
Non-Profit Funding Agency Form
To the project sponsor: Complete the project sponsor, service provider, project name and contact information, target
population, and name of Verifying Funding Agency information sections below. Then submit this form along with a copy
of the Supportive Housing Project Plan contained in the application to the appropriate funding agency (public or
nonprofit) knowledgeable about the supportive services needs of the targeted population(s). For projects serving
severely mentally ill people, the funding entity must be the County Department of Mental Health.

Submission of this form shall constitute certification by the sponsor that a true copy of the Supportive Housing Project Plan
submitted in the application has been submitted to the funding agency named below. The form may be submitted to more
than one agency or department if necessary.

PROJECT SPONSOR:
PRIMARY SERVICE PROVIDER:
PROJECT NAME:
PROJECT ADDRESS/SITE:
PROJECT CITY:
PROJECT COUNTY:
NAME OF VERIFYING FUNDING AGENCY:
TARGET POPULATION(S):

To the public or non-profit funding agency: The project sponsor named above is submitting an application to the State
requesting funding for the project named above under the Governor's Homeless Initiative (GHI). The application for funding
is subject to the State’s determination that the project qualifies as a Supportive Housing Project. The findings of your agency
will be considered in arriving at this determination. Review the attached copy of the GHI Supportive Housing Project Plan,
note your findings in the chart below, and complete the signature block below the chart. Attach comments for any “no”
and as otherwise necessary. Your cooperation is appreciated.

Yes No
We have reviewed the Supportive Housing Project Plan submitted for the project named above.

To the best knowledge of this funding agency, there are no known conditions that would preclude
the service provider from making accessible the services proposed in the Supportive Housing
Project Plan.
The services proposed in the Supportive Housing Project Plan are appropriate to meet the needs of
the target population(s) named above.
The project's primary service provider is a known provider of support services to the target
population(s) listed above.

Dated:

Statement Completed by (please print):

Signature:

Title:

Agency or Department:

Agency or Department Address:

Agency or Department Phone:
Page 39 of 99
ITEM B 17, PART 2, SECTION 4. SUPPORTIVE SERVICES CHART

Section 4. Supportive Services Chart: List all services to be provided to tenants of the Target Population and Special Needs Population Project units, if any. Please
complete only one chart, but be sure that that services listed address all the service needs of all the target populations listed in the Target Population Checklist (Part 1, Section
2). Industry practice indicates that Supportive Housing and Special Needs Populations generally require needs assessment and service coordination in order to maintain the
housing and live as independently as possible. If your Supportive Services Plan Chart differs from this industry practice, provide a narrative explanation. All service needs
must be addressed in the chart or in the narrative. If services will be provided by an entity other than the Sponsor, please attach written agreements, where available.

Supportive Service Target Population Service Description Service Provider(s) Relationship to Agreement Service Location
Sponsor
List each service Name the target Provide a description of Name the service Indicate relationship of If service will be Indicate if the service is
separately (e.g. case population(s) that will the service. provider(s) the service provider to provided by an entity to be provided on or off-
management, mental be receiving the service the sponsor (i.e. service other than the sponsor, site. For off-site
health services, listed provider is the sponsor, indicate the type of services indicate the
substance abuse provider is a separate agreement under which means by which
services, etc.). Use division of sponsor’s the service will be residents will access the
additional sheets if organization, provider provided (i.e., contract, service.
necessary. is a project partner, etc.) memorandum of
understanding (MOU),
letter of commitment,
verbal agreement).

Primary Service Provider: ______________________________________________

Indicate the primary service provider (i.e., entity responsible for providing services to the tenants eligible for MHSA services, and for overall implementation of the Supportive
Services Plan, including coordination between multiple service providers where applicable).
License: Licensing Agency:
Indicate here if the project is subject to licensing due to the service needs of the target populations. Indicate to which license the project is subject and which public agency
regulates it (e.g. Department of Health Services, Department of Social Services).
Page 40 of 99
ITEM B 17, PART 2, SECTION 5. SERVICE DELIVERY

Section 5a. Staffing Structure. List all staff positions which will provide services to the tenants of the Target Population units and Special Needs Population Project units.
Be sure to include project sponsor or primary service provider staff positions and also any staff positions of partnering organizations who have committed time to the
project. For each position, list the title, a brief description of the role and duties, the full-time equivalent (FTE), the organization under which the position resides, and the
location of the position (on-site or off-site). At the bottom of the FTE column, please be sure to provide a calculation of the total number of project staff. Do not include staff
which serve non-Special Needs or non-Target Population Units. If a staff position serves both tenants in Target Population/Special Needs Population Units and non-Target
Population Units/non-Special Needs, include only that portion (i.e., % FTE) of the staff position dedicated to Target Population and Special Needs Units.

Note: All staff positions listed here must be reflected in the Supportive Services Budget Table (Part 3, Section 1). If the cost for an On-Site Supportive Services Coordinator is
included as part of the project’s Operating Budget (as documented in Section C, Project Feasibility Items C10, C11 and C12) and the position will serve the Target Population
and any Special Needs units, that position (or portion serving the Target Population and Special Needs units) must be included in this chart.

Title Role/Duties* FTE Employing Organization of the Position Location of Work

List each staff position Briefly describe the roles and duties of each Indicate the percentage Name the employer organization of the position Indicate whether the
separately (use position of full-time equivalent (this could be the sponsor or a project partner) staff positions will be
additional sheets if the staff position will on or off site.
necessary) devote to this project
(i.e. a half-time position
would be 0.5 FTE)

1.
2.
3.
4.
5.
6.
7.
8.
TOTAL FTE 0

*Assessment and Service Coordination. Enter the staff position(s) listed above that will be responsible for assessing the service needs and coordinating the services of
the project’s tenants: ____________________________________________________________________
Page 41 of 99

Section 5b. Staffing Levels Table

No hard and fast industry standards exist for supportive service staffing levels. However, industry practice indicates a range of
10 to 15 tenant households per staff person for a project serving a target population likely to need intensive services (i.e.
homeless, dually-diagnosed individuals). A project serving a less service-intensive target population could be staffed by a
range of 15 to 25 tenant households per staff person.

Indicate the staffing level for your project by completing the calculation below. If your staffing level, as calculated below,
differs from these industry practices, please provide a narrative explanation. The project must meet or address the
industry standards.

a. Total Target Population and Special Needs Population Project Units (Unit Calculation Table - Part
1, Section 1j.) 0

b. Total FTE Support Service Staff (from FTE Column of Staffing Structure – Part 2, Section 5a) 0
c. Number of Target Population and Special Needs Population Project Units Per FTE Staff Person (a
÷ b) #DIV/0!

If the project serves multiple Target Population or Special Needs Population households within individual units, also indicate
the staffing level per household by completing the calculation below.

d. Total Target Population and Special Needs Population Households (Refer to Unit Calculation Table
- Part 1, Section 1(k)) 0

e. Total FTE Support Service Staff (from FTE Column of Staffing Structure – Part 2, Section 5a) 0
f. Number of Target Population and Special Needs Population Project Households Per FTE Staff
#DIV/0!
Person (d ÷ e)

ITEM B 17, PART 2, SECTION 6. TENANT ENGAGEMENT

Industry practice indicates that services to tenants in supportive housing should be voluntary. That is, participation in services
is not a requirement of tenancy. In order to elicit tenant participation in services, successful service providers develop and
implement plans for tenant engagement.

Provide a narrative description of how you will engage tenants in services during their tenancy in your project.
Note: The tenant engagement plan is distinct from your marketing and outreach efforts for attracting applicants to the project,
as described in the Tenant Selection Narrative.
Page 42 of 99

ITEM B17, PART 2, SECTION 7

To be eligible for GHI funding, projects must demonstrate a focus on measurable outcomes, the ability to track and evaluate
service utilization data, and a plan for evaluation.

Please be sure that the information provided in this section is consistent with and satisfies the California Department of Mental
Health's MHSA outcome reporting requirements for those engaged in full service partnerships (or, in the case of small counties,
the level of services commensurate with full service partnerships).

Section 7a. Measurable Outcomes Chart
Outcomes are what you expect to happen for the people served by your project. Outcomes are sometimes called results.
Outcome objectives are time-specific measurable goals that identify how you know if you are achieving your desired results.
Outcome objectives are sometimes called outcome benchmarks or indicators.

Measurable Outcomes Chart

Please categorize the outcomes for your project into three categories:

1. Residential stability: tenants maintain permanent housing.

2. Increased skills or income: tenants gain job-related skills, participate in job-related training and/or education, gain part-time
or full-time supported employment, gain access to mainstream service/income support programs for which they are eligible.

3. Greater self-determination: tenants gain daily living skills and ability to plan and advocate for themselves to maximize
independence and self-sufficiency.

Please complete the following chart. You may have multiple projected outcomes under a single category.

Category Outcomes Outcome Objectives
Residential Stability

Increased Skills and/or
Income

Greater Self-
Determination
Page 43 of 99

Examples:

Category Outcomes Outcome Objectives
Residential Stability Tenants will maintain affordable housing with xx# (representing xx%) of tenants will maintain
needed services. housing w/ needed services for xx years.

Increased Skills and/or Tenants will gain employment. xx# (representing xx%) of tenants will gain some
Income form of employment within xx months of becoming
housed.
Greater Self- Tenants will exercise more control over their xx# (representing xx%) of tenants will report
Determination lives. increased confidence and skills in advocating for
their own needs within xx months of becoming
housed.

Section 7b. Data Tracking and Evaluation Plan

Please attach a narrative describing your data tracking and evaluation plan, organized into the titled sections as indicated below:

1. Data Collection and Tracking

Describe how you intend to collect and track data on the effectiveness of your project, including:

(a) The outcomes projected in the chart in 7a. (Note: The GHI NOFA requires monthly data collection, evaluation and
reporting with a baseline established at move-in.)
(b) Pre- and post-occupancy service utilization data for tenants who were, or become during occupancy, incarcerated,
hospitalized or housed in a residential treatment or homeless facility. Be sure to indicate the systems of care that will be the
sources of the data (i.e. criminal justice, mental health, substance abuse, homeless facilities).

2. Evaluation

(a) Describe how you intend to analyze/evaluate the data on the effectiveness of your project, including the outcomes projected
in 7a and the service utilization data described above.
(b) Indicate who will analyze the data and perform your evaluation (e.g. staff, consultant, etc.)
Page 44 of 99

Part 3. SUPPORTIVE SERVICES BUDGET

Section 1. Supportive Services Budget Table. Provide a preliminary line item Supportive Services Budget for your project using the format
provided below. Complete both the income and expense portions of the budget. Please include all costs associated with implementing your
Supportive Services Plan as described in Part 2 above, including any in-kind services essential to your plan's success. Total expenses should not exceed
total income. Add expense item categories and lines as necessary.

If any expense line item is comprised of multiple expense items and exceeds $25,000, please provide additional detail by listing component expenses
separately as line items. (For example, if the "other expenses" category exceeds $25,000 and is comprised of telephone, postage & freight and
publications costs, please add lines under "other expenses" and list these line items separately.) Do not include costs associated with providing services
in non-Target Population or non-Special Needs Population Units. If costs are associated with both Target Population and Special Needs Population
and non-Target Population and non-Special Needs Population Units, include only that portion of the costs associated with Target Population and
Special Needs Population Units.

Note: If the costs for an On-Site Supportive Services Coordinator are included as part of the project's Operating Budget (as documented in Section C,
Project Feasibility Items C10 and C11) and the position will serve the Target Population and Special Needs units, this position and the dollars
associated with this position (or that portion of the position that will serve the Target Population and Special Needs units) must be included in this
Supportive Services Budget Table. These funds should be categorized as "Not Committed" in the Status column of this table.

INCOME SOURCE (Include the name and address of the AMOUNT TYPE STATUS (Committed, Intent to % OF TOTAL
agency/organization and a contact name and telephone (Cash or In- Fund or Provide, Not BUDGET
number) kind Services) Committed)

Income Source
Income Source
Add lines as necessary
Total Income

EXPENSE ITEM AMOUNT TYPE STATUS (Committed, Intent to % OF TOTAL
(Cash or In- Fund or Provide, Not BUDGET
kind Services) Committed)

Staff Salaries: List by title of position. (This list should
match the Staffing Chart in Part 2, Section 5a. above.)
Staff Position FTE:
Staff Position FTE:
Add lines as necessary
Fringe Benefits
Total Staff Expenses

Consultants: List by Function
Subcontractors or Partners :List by Entity & Type of Service
Equipment
Supplies
Travel
Office Rent/Occupancy Costs (Do not include rent or leasing
costs for supportive housing units)
Training
Other Expenses
Add lines as necessary
Total Expenses
Page 45 of 99
Section 2. Supportive Services Cost Per Unit: No hard and fast industry standards exist about supportive services cost per unit. However,
industry practice indicates a range between $5,000 - $10,000 per household unit, depending upon the intensity of the needs of the target population.

Complete the following calculation about supportive services cost per unit for your project. If your supportive services cost per unit, as calculated
below, differ from industry practice, please provide a narrative explanation. The project must meet/address the industry standard.

Supportive Services Cost Per Unit Calculation Table
a. Total Target Population and Special Needs Population Project Units:
$0
(Unit Calculation Table - Part 1, Section 1(j))
b. Total Supportive Services Costs:
$0
( Support Services Budget - Part 3, Section 1 "Total Expenses" line)
c. Total Supportive Services Costs per Unit:
#DIV/0!
(b ÷ a)

If the project will serve multiple Supportive Housing or Special Needs households within individual units, also indicate the supportive services cost per
household by completing the calculation below:

d. Total Target Population and Special Needs Population Households: (Unit calculation Table - Part 1, Section 1(k)
$0
e. Total Supportive Services Costs: (Support Services Budget - Part 3, Section 1 "Total Expenses " line)
f. Total Supportive Services Costs per Household:
#DIV/0!
(e ÷ d)

Section 3. Funding and Service Commitments: A minimum of 25% of the total Supportive Services Budget must be committed or supported by
a letter of intent in order to be eligible for funding as a GHI Supportive Housing project. GHI Supportive Housing Projects must include MHSA
funding for Supportive Services and must include MHSA funding for rental subsidies if those subsidies are needed to maintain financial feasibility.
To verify those commitments, the attached MHSA Funding Commitment Form must be completed by the County Mental Health Department and
submitted with the application.
Letters of commitment or intent to fund or provide in-kind services on agency/organization letterhead and include the following:

 Project Name;
Description of services to be funded or provided;
Value of funds or in-kind services. If cash is to be provided, state the source of funds.
Term of funding or service provision; and
A brief description and history of the agency/organization providing the funding or services.

Note that services/funding documented in this Part 3 must state the dollar value of the funding or in-kind services and must appear in Section 1
Supportive Services Budget Table above.
Page 46 of 99
Item B 17
Part 3, Section 3
MHSA Funding Commitment Form

To the project sponsor: Provide the project information indicated below. Submit this form to your county mental health department to provide a
verification of the funding commitment to this project.
Project Sponsor:
Primary Service Provider:
Project Name:
Project Address:
Project City:
Project County:

Name of verifying county mental health department:

To the county mental health department: Please complete the remainder of this form and the signature block below.

Firm Funding Commitment
We commit to provide Mental Health Services Act (MHSA) funding for supportive services for the duration of the state loan for tenants of the
affordable housing project described above, as follows:
Amount of funds committed: $

We also commit to provide on-going rental or operating subsides, with amounts estimated as
shown in the attached projections. Yes No

Initial Annual Amount to be
Commited: $

Commitment conditions (e.g. receipt of funds from the State):

This Project is a Priority Use of MHSA Funds
It is acknowledged that total revenues received from the State under the MHSA may vary from year-to-year. If they decrease, we will make this
project a priority use of remaining funds, and not reduce the funding provided to it.

Consistency with Community Services and Supports Plan
The commitment included herein is consistent with the Community Services and Supports Plan submitted
or to be submitted on (date of actual or projected submission of CSS Plan):

Statement Completed by (please print):
Signature:
Title:
Dated:

Agency or Department:
Agency or Department Address:
Agency or Department Phone:
Page 47 of 99
Part 4. PROJECT SPONSOR AND SERVICE PROVIDER EXPERIENCE

Section 1. Project Sponsor Experience Table: In order to meet the Sponsor experience requirement for Supportive Housing Projects, the project
Sponsor must document a minimum of 24 months experience in the ownership or operation (including long-term leasing) of at least one special needs
or supportive housing project of at least five or more dwelling units to qualify as a rental housing development. (Note: bedrooms in a single-family
house or apartment do not count as units of housing for demonstrating project sponsor experience.)
In order to document the requirement, complete and submit the table containing the information required below.
Note: meeting this requirement establishes only that the Project Sponsor qualifies as a Supportive Housing Project Sponsor. There are additional
requirements related to scoring. Refer to Item D 3 for an explanation of scoring related to Development and Ownership Experience of the Project
Sponsor, and complete all relevant exhibits in that Section.

Project Sponsor: _________________________________________________

Project Number of Ownership or Population(s) Service Provider References
Units Operation Term Served
Contained
Provide the name and Provide the beginning List each Provide contact name, Provide one reference able to verify the
address of the project and end dates of supportive address, and telephone role of the sponsor in the project
ownership or operation housing/special number if the provider is submitted for experience. Include the
needs population other than the Sponsor organization name and contact name,
served title, and telephone number.

If the project you are submitting as evidence of experience is a project you operate under a long-term lease or other arrangement that involves all the
responsibilities commensurate with ownership, also submit the following additional documentation[1]:

 A narrative description of the job title or position, roles, and responsibility of the project sponsor. This description shall provide HCD with
information sufficient to make a determination that the operation experience is commensurate with ownership experience.
 A copy of all supporting documentation (e.g. a copy of the long-term lease) clearly identifying the significance of the supporting documentation.

[1]
If the project you are submitting as evidence of experience is also documented in Item D3, Attachment 3a and 3b, you do not need to submit this
additional material here in Part 4, as it is already a required submission under Item D3.
Page 48 of 99
Section 2. Primary Service Provider Experience:
Complete tables 2a and 2b below to document service provider experience: Service Provider Experience Chart and Service Funding History Table.

2a: Service Provider Experience Chart
The primary/lead service provider (which may be the sponsor) must document at least 24 months in the successful provision of services to the Target Population. The
primary/lead service provider is the entity responsible for providing services to the tenants eligible for MHSA services, and for overall implementation of the service plan,
including coordination between multiple service providers, where applicable. Complete and submit the table containing the information required below:

Name of Proposed Primary/Lead Service Provider:

Number of Years Provider Has Been Providing Support Services To The Target Population:

Name of Number of Target Service Type/Description of Beginning and End Number of Name and Phone Number of
Program/Project Population Units in Services Provided Dates Services Unduplicated Clients Person Who Can Provide a
Project Provided Served Annually Reference Regarding the Services
Provided
(Reference person should not be
affiliated with the service
provider)
Page 49 of 99
Section 2b. Service Funding History Table: The purpose of this section is to document the funding history of the primary
service provider. The primary service provider shall document a history of securing supportive service funding sufficient for the
State to make a determination that the provider will be able to access funds from the programs that fund the services identified in the
Supportive Services Chart. List only funding obtained in the last five years.

Complete the table containing the information required below:

Funding History for:
(Name of Service Provider)
Source of Funds (Include reference Purpose of Award Amount of Award Date Population(s) Served
name and telephone number) (Use of Funds) Funds and Funding
Term

Part 5. Property Management Experience

Section 1. Property Management Experience:
Industry practice indicates that a Supportive Housing Project is best served by a property manager with experience in providing
property management in special needs or supportive housing projects.
The sponsor shall document that the proposed property manager has at least 24 months experience managing a special needs or
supportive housing project of five or more dwelling units to qualify as a Rental Housing Development. Where the proposed project
contains fewer than 20 units, the Department may approve a property manager with experience managing properties that do not
qualify as a rental housing development provided that the property manager has experience managing properties serving the proposed
target population. Complete and submit the table containing the information required below:

Proposed Property Manager:

Project Name and Number of Supportive Services Provided Dates Contact Name and
Address Units in the Housing/Special Needs Property Telephone Number for
Project Population(s) Served Management the Project
Began and Owner/Operator
Ended

Section 2: Property Management Contract: Where the project sponsor is contracting for property management services, the
sponsor must include a copy of the management contract or a letter of interest from the proposed property manager indicating a
willingness to enter into the contract for management services to the project.
Page 50 of 99

Section C

Project Feasibility

Item
C 1. Local Approvals and Zoning/Land Use Form
C 2. Development Timetable
C 3. Worksheet to Determine Maximum Allowable Loan Amount
C 4. Loan Limit Worksheet
C 5. Shared Cost Calculation Worksheet
C 6. MHP Loan Amount Calculation Worksheet
C 7. Project Financing (Sources of Funds)
C 8. Development Budget
C 9. Income Information
C 10. First Year Operating Budget and Cash Flow Analysis
C 11. 15 Year Pro Forma
C 12. Service Coordination
C 13. Estimate of Unit Construction Cost Based on Prevailing Wage Rates
C 14. Appraisal and Market Study
C 15. Copies of Planning Approvals
C 16. Copies of Resumes of the Project Contractor and Architect
C 17. Copies of Schematic Drawings
C 18. Description of Current Condition-rehabilitation projects only
C 19. Scope of Work-rehabilitation projects only
C 20. Current Rent Roll-rehabilitation projects only
C 21. Utility Allowance Estimates
C 22. Copy of Letter to Local Government
C 23. Operating Expense Comparables
Page 51 of 99

Item C 1

Local Approvals and Zoning/Land Use
Local Approvals Required
Identify Project Approvals Required or Indicate “Not Applicable”:

Application Estimated Actual
Date Approval Date Approval Date
CEQA Review
CEQA Negative Declaration
NEPA
Coastal Commission Approval
Article XXXIV Compliance
Site Plan
Design Review
Conditional Use Permit
Variance Approval

List any additional local governmental approvals required and status of approval:

ZONING/LAND USE (describe the following):

Current Land Use Designation:
Current Zoning and Maximum
Density:
Proposed Zoning and Maximum
Density:
Does this site have Inclusionary
YES NO
Zoning?
Will a variance or CUP be required:
YES NO

Are there any occupancy restrictions that run with title
to the land because of Conditional Use Permits or
Density Bonuses:
Building Height Limits:
Required Parking Ratio:
Is the site in a Redevelopment Area?
YES NO
Page 52 of 99
Item C 2
DEVELOPMENT TIMETABLE

Project Name:

Scheduled Date Actual Date
(Indicate Month/Year) (Indicate Month/Year)
SITE
Phase 1 or 2 Environmental Site Assessment
_______/_______ Completed _______/_______
_______/_______ Site Acquired _______/_______

LOCAL PERMITS/APPROVALS
_______/_______ Conditional Use Permit _______/_______
_______/_______ Variance _______/_______
_______/_______ Site Plan Review _______/_______
_______/_______ Grading Permit _______/_______
_______/_______ Building Permit _______/_______
_______/_______ Density Bonus _______/_______

CONSTRUCTION FINANCING
List of name of each lender and dates of enforceable commitments or awards
_______/_______ 1. _______/_______
_______/_______ 2. _______/_______
_______/_______ 3. _______/_______
_______/_______ 4. _______/_______
_______/_______ 5. _______/_______

PERMANENT FINANCING
Name of each lender, grant and dates of enforceable commitments or awards
_______/_______ 1. _______/_______
_______/_______ 2. _______/_______
_______/_______ 3. _______/_______
_______/_______ 4. _______/_______
_______/_______ 5. _______/_______

LOAN CLOSING
_______/_______ Construction Loan Closing _______/_______
_______/_______ Construction Start _______/_______
_______/_______ Construction Complete _______/_______
_______/_______ TCAC Placed In Service Application _______/_______
_______/_______ Occupancy of All Assisted Units _______/_______
_______/_______ MHP Permanent Loan Closing _______/_______
Page 53 of 99
Item C 3

WORKSHEET TO DETERMINE MAXIMUM ALLOWABLE
LOAN AMOUNT
MHP Regulation Section 7302 (b)

PERMANENT FINANCING
Total Project Cost $0
Less Net Syndication Proceeds/Investor Equity $0
Less Additional Owner/General Partner Equity $0
TOTAL ESTIMATED FINANCING NEED $0
Less Supportable Conventional or Bond Debt Financing $0
Less "Soft" Financing and Grants $0
FUNDING GAP = $0

Note:
Exclude any bridge loan from funding gap calculation.
Page 54 of 99
Item C 4

LOAN LIMIT WORKSHEET
(Section 7307 of MHP Regulations )
Enter unit sizes and rent restriction levels as shown on Item C9 of MHP Application. Enter corresponding loan amounts indicated on the current MHP Per Unit Loan Limits
chart. Unless project is a 9% LIHTC project, add an additional $30,000 to stated loan limits for Target Population units. Enter Manager's unit at 60% level.
A B C D E F G H I J K L M N O P

Per Unit Total Per Unit Per Unit
Loan Limit # of Allowed Loan Total Loan Per Unit Total Per Unit Total
for Restricted for Limit # of Allowed Limit # of Total Loan Limit # of Allowed Loan Limit # of Allowed
AMI Efficiency Efficiency Efficiency for Restricted for for Restricted Allowed for Restricted for for Restricted for
Level Unit Units Units 1 Br. 1 Br. 1 Br. 2 Br. 2 Br. for 2 Br. 3 Br. 3 Br. 3 Br. 4+ Br. 4+ Br. 4+ Br.
(B x C) (E x F) (H x I) (K x L) (N x O)

60% 0 0 0 0 0
55% 0 0 0 0 0
50% 0 0 0 0 0
45% 0 0 0 0 0
40% 0 0 0 0 0
35% 0 0 0 0 0
30% 0 0 0 0 0

MHP
Level

A 0 0 0 0 0
B 0 0 0 0 0
C 0 0 0 0 0

Column D G J M P TOTAL
Sum of Column $0 $0 $0 $0 $0 $0
Page 55 of 99
Item C 5
Shared Cost Calculation Worksheet

For Projects containing 100% (excluding the manager's unit) Restricted Units
A. Total eligible development cost $0

For Projects containing Market Rate Units
Pursuant to Section 7304 (c) of the MHP Regulations, the shared cost factor will be based on the ratio between the gross floor area
of the Restricted Units and the gross floor area of all Residential Units.

B. Gross Square Footage of Restricted Units 0

C. Gross Square Footage of all Residential Units 0

D. Factor, Divide B by C, Express as a Whole Number Percentage #DIV/0!

E. All Eligible Costs

F. Multiplied by Factor D Above x #DIV/0!

G. Maximum Program Loan Amount #DIV/0!

Note: The above is a safe harbor calculation. Sponsor may substitute a more precise calculation of costs associated exclusively
with Restricted Units, but must clearly illustrate its calculation methodology on a separate page(s) placed after this attachment.
The Sponsor’s calculation result should be placed on line F with a footnote that an explanation of the methodology used has been
attached.

For Projects Containing Commercial Space

Calculate proportion of total development costs attributable to restricted units pursuant to Section 7304 (c) of the MHP
Regulations . Clearly show calculation and attach to this page.

H. Portion of TDC attributable to Restricted Units:

For those projects containing commercial space, we recommend the Sponsor contact an MHP Representative for assistance.
Page 56 of 99
Item C 6

MHP
LOAN AMOUNT CALCULATION WORKSHEET

Loan Amount cannot exceed lesser of 1 through 4:

1. Item C 3: $0
(Funding Gap from Worksheet to Determine Maximum Allowable Loan Amount)

2. Item C 4 $0
(Total from Loan Limit Worksheet):

3. Item C 5 #DIV/0!
(Line A, G, or H from Shared Cost Calculation Worksheet)

4. Maximum Per Project MHP Loan: $7,000,000

5. MHP Loan Amount: #DIV/0!
(Enter the Lesser of 1 through 4 above)

6. Total Funding Request #DIV/0!
Page 57 of 99
Item C 7

PROJECT FINANCING (SOURCES OF FUNDS)
A. Construction Financing
List below all projected sources required to complete construction, ordered by their lien position. Attach
evidence of commitment status (e.g. commitment letters, grant awards, subsidy contracts or loan
documents). Attach extra sheets as necessary. To be considered an enforceable commitment for the
purpose of receiving Readiness Points in Item D 6, the commitment must be an enforceable
commitment as described on page 7 (Instructions for Item C 7).
Lien Name of Lender/Source Term in Months Interest Rate Amount of Funds
Position

Total Tax Credit Equity = $0
Total Funds for Construction = $0

1. Name of Lender/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Type of Financing
Commited Not Commited

2. Name of Lender/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Type of Financing
Commited Not Commited

3. Name of Lender/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Type of Financing
Commited Not Commited

Note:
Provide explanation if Construction Sources differ from Permanent Sources. Itemize costs that will be deferred until
permanent loan closing or thereafter.
Page 58 of 99
Item C 7, Continued

PROJECT FINANCING (Sources of Funds)
B. Permanent Financing
List below all projected sources of funds, include Grants, Land Donations, deferred fees, owner equity, etc, ordered by their Lien
position. Attach evidence of commitment status (e.g., commitment letters, grant awards, subsidy contracts or loan documents).
Attach extra sheets as necessary. To be considered an enforceable commitment for the purpose of receiving Readiness Points
in Item D 7, the commitment must be an enforceable commitment as described on page 7 (Instructions for Item C 7).

Lien Name of Lender/Source Term in Interest Amount of Annual Debt Type of Financing: i.e., Residual
Position Months Rate Funds Service Receipts, Deferred Pmt.

Total Permanent Financing = $0
Total Tax Credit Equity = $0
Total Sources of Project Funds = $0

1. Name of Lender/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Commited Not Commited
2. Name of Lender/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Commited Not Commited
3. Name of Lender/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Commited Not Commited

4. Name of Lender/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Commited Not Commited

Note: Where MHP is identified as a lender, make sure all MHP funds are included in the loan amount.
Page 59 of 99
Item C 7, Continued

PROJECT FINANCING (Sources of Funds)
C. Rent/Operating Subsidies
List below all projected sources of rent/operating subsidies. For MHSA rent subsidy commitments, attach the MHSA
Funding Commitment Form from Item B17, Part 3, Section 3. For other proposed rent/operating subsidies, attach evidence
of commitment status (e.g., application cover page/letter, commitment letters, grant awards, subsidy contracts, Section 8
AHAP/HAP contract or letter of certification by local public housing authority, etc.)

Name of Name of Rent/Operating Date Date of Expected No. of Units to $ Amount of Annual
Rent/Operating Subsidy Program and Application Award/Expecte term of Receive Assistance Requested
Subsidy Component (e.g., Shelter Submitted/To d Award Date subsidy in Requested or To Be Requested
Funder/Source Plus Care Project-Based be Submitted years Subsidy
Rental Assistance)
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
Totals 0 $ -

1. Name of Funder/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Committed Not Committed

2. Name of Funder/Source
Street Address
Contact Name
City/State
Phone Number
Fax Number
Email Address
Committed Not Committed

Continuum of Care Process
If one or more of the operating subsidy programs listed above is part of your local Continuum of Care process (i.e., Shelter
Plus Care, Supportive Housing Program, Section 8 Mod Rehab SRO, etc.), please complete the following Continuum of Care
information

Yes No
1. Has your community completed its Continuum of Care ranking process?

2. If you answered yes to question number one, is your project ranked within the
fundable range (i.e., within HUD's allocation for the applying jurisdiction?) Yes No

3. If you answered no to question number one, when will your community complete its
Continuum of Care ranking process?

If your project uses more than two rent/operating subsidy sources and /or uses more than one rent/operating subsidy source
that is part of the Continuum of Care process, please add additional pages.
Page 60 of 99
Item C 8
Development Budget
Total Project Residential Residential Costs Analysis
Item Costs Costs Per Unit Per SF Per Bdrm.
Land Cost or Value #DIV/0! #DIV/0! #DIV/0!
Demolition #DIV/0! #DIV/0! #DIV/0!
Legal #DIV/0! #DIV/0! #DIV/0!
Existing Improvements Value #DIV/0! #DIV/0! #DIV/0!
Off-Site Improvements #DIV/0! #DIV/0! #DIV/0!
REHABILITATION
Site Work #DIV/0! #DIV/0! #DIV/0!
Structures #DIV/0! #DIV/0! #DIV/0!
General Requirements #DIV/0! #DIV/0! #DIV/0!
Contractor Overhead #DIV/0! #DIV/0! #DIV/0!
Contractor Profit #DIV/0! #DIV/0! #DIV/0!
Subtotal Rehab $0 $0 #DIV/0! #DIV/0! #DIV/0!
Relocation Expenses #DIV/0! #DIV/0! #DIV/0!
NEW CONSTRUCTION
Site Work #DIV/0! #DIV/0! #DIV/0!
Structures #DIV/0! #DIV/0! #DIV/0!
General Requirements #DIV/0! #DIV/0! #DIV/0!
Contractor Overhead #DIV/0! #DIV/0! #DIV/0!
Contractor Profit #DIV/0! #DIV/0! #DIV/0!
Subtotal New Construction $0 $0 #DIV/0! #DIV/0! #DIV/0!
Total Architectural Costs #DIV/0! #DIV/0! #DIV/0!
Const. Interest &Fees #DIV/0! #DIV/0! #DIV/0!
Insurance #DIV/0! #DIV/0! #DIV/0!
Perm. Financing Costs #DIV/0! #DIV/0! #DIV/0!
Lender Legal Pd. by Applicant #DIV/0! #DIV/0! #DIV/0!
Other Legal - (SPECIFY) #DIV/0! #DIV/0! #DIV/0!
Capitalized Rent Reserves #DIV/0! #DIV/0! #DIV/0!
Capitalized Operating Reserve #DIV/0! #DIV/0! #DIV/0!
Capitalized Replacement Reserves #DIV/0! #DIV/0! #DIV/0!
Capitalized Rent Subsidy (CRS) Reserve #DIV/0! #DIV/0! #DIV/0!
Appraisal #DIV/0! #DIV/0! #DIV/0!
Survey and Engineering #DIV/0! #DIV/0! #DIV/0!
Construction Contingency #DIV/0! #DIV/0! #DIV/0!
TCAC App/Alloc/Monitor Fees #DIV/0! #DIV/0! #DIV/0!
Environmental Audit #DIV/0! #DIV/0! #DIV/0!
Local Dev. Impact Fees #DIV/0! #DIV/0! #DIV/0!
Permit Processing Fees #DIV/0! #DIV/0! #DIV/0!
Capital Fees #DIV/0! #DIV/0! #DIV/0!
Marketing #DIV/0! #DIV/0! #DIV/0!
Furnishings #DIV/0! #DIV/0! #DIV/0!
Other: Inspection/testing #DIV/0! #DIV/0! #DIV/0!
Other: (SPECIFY) #DIV/0! #DIV/0! #DIV/0!
Other: (SPECIFY) #DIV/0! #DIV/0! #DIV/0!
Developer Overhead/Profit #DIV/0! #DIV/0! #DIV/0!
Consultant/Processing Agent #DIV/0! #DIV/0! #DIV/0!
Project Administration #DIV/0! #DIV/0! #DIV/0!
Broker fees paid by owner #DIV/0! #DIV/0! #DIV/0!
Const. Mngmt Oversight #DIV/0! #DIV/0! #DIV/0!
Subtotal Developer Costs $0 $0 #DIV/0! #DIV/0! #DIV/0!

TOTAL PROJECT COST $0 $0 #DIV/0! #DIV/0! #DIV/0!
Total Developer Fee (equals Subtotal Developer Costs above): $0
Total Developer Fee allowed from Development Funding Sources:

Developer Fee to be paid from Development Funding Sources:
Amount of Deferred Developer Fee payable on a priority basis from
from Available Cash Flow:
Deferred Developer Fee payable from allowable 50% Distribution:
Notes:
1.
Per UMR Section 8312
2.
Per UMR Section 8314
Projected Developer Fee that TCAC will allow to be included in eligible basis:
Page 61 of 99
Item C 9

UNIT MIX AND INCOME INFORMATION

(BREAK OUT UNIT SIZES BY VARYING AFFORDABILITY LEVELS)
(A) (B) (C) (D) (E) (F) (G) (H) (I)
# of Bedrooms # of Units Proposed Monthly Rent Total Monthly Monthly Utility Monthly Rent % of Area Median Designate as GHI for Designate if
(not including Utility Rents Allowance includes Utility Income or MHP Level Target Population Subsidized
Allowance) Allowance (from (A, B or C) Units or SNP if Other Unit (Yes or
the MHP Max Rent Special Needs No)
Chart) Population Units *

(F - E) (B x C) (C + E)
Restricted Units
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
Total # Units 0 Total Mo. Rents $0

Will the Manager's unit(s) be Restricted to 60%
Manager's Unit(s)
AMI or less? YES NO
$0
$0
$0
Total # Units 0 Total Mo. Rents $0

Market Rate Units
$0
$0
$0
$0
Total # Units 0 Total Mo. Rents $0

* Use separate line entries for GHI or SNP Units.

AGGREGATE MONTHLY RENTS
FOR ALL UNITS $0
x 12

AGGREGATE ANNUAL
RENTS FOR ALL UNITS (column d): $0

Notes:

Income information must be consistent with income levels targeted in the application on Item D 1.
Page 62 of 99
Item C 9, Continued

UNIT MIX AND INCOME INFORMATION

Rental Subsidy Income/Operating Subsidy, if any:

Number of Units Receiving Assistance
Length of Contract (years)
Expiration Date of Contract

TOTAL PROJECTED ANNUAL RENTAL SUBSIDY

Miscellaneous Income:

Annual Income from Laundry Facilities
Annual Income from Vending Machines
Annual Interest Income
Other Annual Income (Specify)

TOTAL MISCELLANEOUS INCOME $0

TOTAL ANNUAL POTENTIAL GROSS INCOME $0
(From Residential Sources)

Commercial Income:
Annual Income from Professional Space
Annual Income from Commercial Space

TOTAL ANNUAL COMMERCIAL INCOME $0

Monthly Resident Utility Allowance by Unit Size (utility allowances must be itemized and correlated with the most current PHA utility
allowance schedule included in Item C21).

0 Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom ( ) Bedroom
Space Heating
Water Heating
Cooking
Lighting
Other (Specify)
TOTALS $0 $0 $0 $0 $0 $0

Name of PHA Providing Utility Allowances:
Page 63 of 99
Item C 10

FIRST YEAR OPERATING BUDGET AND CASH FLOW ANALYSIS

Avg. Avg. Percent of
Annual P/U/Y P/U/M Gross Income
INCOME:
Tenant Payments [or Underwriting Rents $0 #DIV/0! #DIV/0! #DIV/0!
pursuant to Section 7312 of the MHP
Regulations ]
Rent Subsidy (SPECIFY) $0 #DIV/0! #DIV/0! #DIV/0!
Commercial Income $0 #DIV/0! #DIV/0! #DIV/0!
Other Income - (SPECIFY) $0 #DIV/0! #DIV/0! #DIV/0!
GROSS SCHEDULED INCOME $0 #DIV/0! #DIV/0! #DIV/0!
LESS: #DIV/0!
Vacancy Rate - residential @ 5% $0 #DIV/0! #DIV/0! #DIV/0!
Vacancy Rate - commercial @ 50% $0 #DIV/0! #DIV/0! #DIV/0!
EFFECTIVE GROSS INCOME $0 #DIV/0! #DIV/0! #DIV/0!
EXPENSES: #DIV/0!
General Administrative #DIV/0! #DIV/0! #DIV/0!
Management Fee #DIV/0! #DIV/0! #DIV/0!
Utilities #DIV/0! #DIV/0! #DIV/0!
Payroll / Payroll Taxes #DIV/0! #DIV/0! #DIV/0!
Insurance #DIV/0! #DIV/0! #DIV/0!
Maintenance #DIV/0! #DIV/0! #DIV/0!
Water/Sewer #DIV/0! #DIV/0! #DIV/0!
Other: (SPECIFY) #DIV/0! #DIV/0! #DIV/0!
Other: (SPECIFY) #DIV/0! #DIV/0! #DIV/0!
Operating Expenses without property taxes and $0 #DIV/0! #DIV/0! #DIV/0!
On-Site Service Coordinator

Cost of On-Site Service Coordinator #DIV/0! #DIV/0! #DIV/0!
Commercial Expenses #DIV/0! #DIV/0! #DIV/0!
Property Taxes and Assessments #DIV/0! #DIV/0! #DIV/0!
Replacement Reserve Deposits #DIV/0! #DIV/0! #DIV/0!
Operating Reserve Deposits #DIV/0! #DIV/0! #DIV/0!
Other Reserves: (SPECIFY)_____________ #DIV/0! #DIV/0! #DIV/0!
Total Operating Expenses and Reserve Deposits $0 #DIV/0! #DIV/0! #DIV/0!

NET OPERATING INCOME $0 #DIV/0! #DIV/0! #DIV/0!

REQUIRED DEBT SERVICE
First Lender
MHP 0.42% #DIV/0!
Other (SPECIFY) ___________________
Total Debt Service #DIV/0!

Available Cash Flow #DIV/0!
Page 64 of 99
Item C 11

15 YEAR PRO FORMA

Project: 0

15 Year Cash Flow Growth
Factor Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12 Year 13 Year 14 Year 15
Rental Income 2.5% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Rent Subsidy 2.5% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Commercial Income 2.5% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Other Income (SPECIFY) 2.5% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Gross Scheduled Income $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Vacancy Loss - residential 5.0% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Vacancy Loss - commercial 50.0% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Effective Gross Income $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0

Operating Expenses 1 3.5% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Property Taxes 2.0% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
On-Site Service Coordinator 3.5% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Replacement Reserve 0.0% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Operating Reserve 0.0% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Other Reserves 0.0% $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Total OE and Reserves $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0

Net Operating Income $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0

First Lender $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
MHP (.42% Annual) #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Other (SPECIFY) ___________________ $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Total Debt Service #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

AVAILABLE CASH FLOW #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Debt Service Coverage #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Available Cash Flow #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Asset Mgmt./ Similar Fees #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Deferred Developer Fee #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Cash Available for Residual Receipts
Loans and Distributions #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Distributions 50% #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
MHP Residual Payment % #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Other Residual Payments % #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

NOTES:
1
Operating Expenses and Reserves must be in accordance with UMR Sections 8308, 8309 and 8310.
Page 65 of 99
Item C 13
Budgeted Cost Estimate for New Construction Using State Prevailing Wage Rates

Who prepared estimates?
Name Job Title

Date estimates prepared?
Basis for estimates?
The estimator states that, to the best of their knowledge, the construction estimates, and trade-item breakdown on this page are complete and accurate.
DIV Trade Item Amount Notes/Description if necessary
3 Concrete
4 Masonry
5 Metals
6 Rough Carpentry
6 Finish Carpentry
7 Waterproofing
7 Insulation
7 Roofing
7 Sheet Metal and Flashing
7 Exterior Siding
8 Doors
8 Windows
8 Glass
9 Lath & Plaster
9 Drywall
9 Tile Work
9 Acoustical
9 Wood Flooring
9 Resilient Flooring
9 Carpet
9 Paint & Decorating
10 Specialties
11 Special Equipment
11 Cabinets
11 Appliances
12 Blinds & Shades
13 Modular/Manufactured
13 Special Construction
14 Elevators or Conveying Syst.
15 Plumbing & Hot Water
15 Heat & Ventilation
15 Air Conditioning
15 Fire Protection
16 Electrical
Accessory Buildings
Other/misc
Subtotal Structural $0
2 Earth Work
2 Site Utilities
2 Roads & Walks
2 Site Improvement
2 Lawns & Planting
2 Geotechnical Conditions
2 Environmental Remediation
2 Demolition
2 Unusual Site Cond
Subtotal Site Work $0
Total Improvements $0
1 General Conditions
Subtotal $0
1 Builders Overhead
1 Builders Profit
TOTAL $0

Total Cost/total square foot: #DIV/0! Total Cost/residential square foot: #DIV/0!
Page 66 of 99

Section D
Rating and Ranking Criteria
SECTION 7320 OF THE MHP REGULATIONS

Item
D 1. Scoring Sheet - Extent Project Serves Households at the Lowest Income Levels - Section
7320(b)(1) of the MHP Regulations

D 2. Scoring Sheet – Extent Project Addresses the Most Serious Identified Local Housing Needs
–Section 7320(b)(2) of the MHP Regulations and Attachment to Scoring Sheet – Comparable
Market Rental Data Form

D 3. Scoring Sheets – Development and Ownership Experience of the Project Sponsor,
Attachment to Scoring Sheet – Development and Ownership Experience Certification, and
Appropriate Attachment(s)–Section 7320(b)(3) of the MHP Regulations

D 4. Scoring Sheet – Percentage of Units for Families, Supportive Housing or Special Needs
Populations, and “At-Risk” Rental Housing Developments–Section 7320(b)(4) of the MHP
Regulations, Attachment to Scoring Sheet - Checklist for “At Risk” of Conversion (if
applicable), and “At Risk” of Conversion Supporting Documentation (if applicable)

D 5. Scoring Sheet – Leverage of Other Funds –Section 7320(b)(5) of the MHP Regulations

D 6. Scoring Sheet – Project Readiness –Section 7320(b)(6) of the MHP Regulations and
Attachment to Scoring Sheet - Local Jurisdiction Verification of Project Readiness

D 7. Scoring Sheet – Adaptive Reuse, Infill, or Proximity to Site Amenity- Section 7320 (b)(7) of
the MHP Regulations

D 8. Scoring Sheet – Negative Point Calculation (Departmental Use Only)- Informational Only -
To be completed by HCD staff.

D 9. Scoring Sheet – Total Rating and Ranking Points
Page 67 of 99
Item D 1

SCORING SHEET

EXTENT PROJECT SERVES HOUSEHOLDS AT THE LOWEST INCOME LEVELS
Section 7320 (b) (1) of the MHP Regulations - 35 Points Maximum

Total Number of Restricted Units in the Project (do not A
include the manager's unit, unless it is Restricted)
0

Project must remain consistent with unit standards in UMR Section 8304.
B C D E F

Restricted Units Number of % Of Total Scoring Points
Designated for Restricted Restricted Units Factor Awarded
Households Units in this in this Category (D X E)
with Incomes of Category (D divided by A)
MHP Level A or less #DIV/0! 0.75 #DIV/0!
MHP Level B or less #DIV/0! 1.0 #DIV/0!
MHP Level C or less
(Adjusted) not to
#DIV/0!
Exceed 10% of #DIV/0! 1.5
Total Restricted
Units (not to exceed 15)
MHP Level C or less
(Adjusted # in
Excess of 10% of #DIV/0! 1.0 #DIV/0!
Total Restricted
Units
All point calculations will be rounded to the nearest one hundredth point.
* NOTE: Units may be counted in only one Rent Restriction level category.

Total Column G for Point Award (Maximum 35) #DIV/0!
Page 68 of 99
Item D 2
SCORING SHEET

EXTENT PROJECT ADDRESSES THE MOST SERIOUS IDENTIFIED LOCAL
HOUSING NEEDS
Section 7320 (b) (2) of the MHP Regulations - 15 Points Maximum

(A) Five (5) points will be awarded based on the attachment of either (1) or (2) below:

(1) a letter from the city or county in which the proposed project will be located. The letter must be signed by an
individual responsible for overseeing compliance with the housing policy documents (e.g., housing element,
consolidated plan for the locality).
The letter must include all of the following components:
- The local housing need that is identified in the local housing policy document
- The local housing policy document in which the need is identified
- A statement that this project addresses the need
- The letter must reference the subject property specifically; or

(2) for projects with a minimum of 70% of project units reserved for Supportive Housing or Special Needs
Populations (all documentation required of Supportive Housing or Supportive Housing and Special Needs
Population Projects must have been submitted in the application and approved by the Department in order for
points to be awarded), a letter from a department of local government responsible for delivery of
supportive services, stating that the proposed project will address a serious local housing need as it
relates to Supportive Housing or Supportive Housing and Special Needs Populations.

Enter five (5) points and attach the letter to this scoring sheet.

AND, choose ONE of the following three options; B, C or D:

(B) An additional ten (10) points will be awarded if

(1) at least 70% of the units are reserved for Supportive Housing or Supportive Housing and Special Needs
Populations (all documentation for Supportive Housing or Supportive Housing and Special Needs Populations
Projects must have been submitted in the application and approved by the Department in order for points to be
awarded); or

(2) at least 70% of the total project dwelling units have two or more bedrooms and are located in one of the
following counties: Alameda, Contra Costa, Los Angeles, Marin, Monterey, Napa, Orange, San Diego, San
Francisco, San Luis Obispo, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Solano, Sonoma or Ventura.

Enter ten (10) points in this category based on:

Supportive Housing or Supportive Housing and
Special Needs Location
OR

(see next page)
Page 69 of 99
Item D 2

SCORING SHEET CONTINUED

(C) Five (5) or ten (10) additional points may be awarded based on submitted Comparable Market Rental Data
Forms - Attachment to Scoring Sheet which supports the current vacancy rate for at least the five (5) nearest
competitive developments, pursuant to Section 7320(b)(2)(C ) of the MHP Regulations. The Department may
consult other public funding agencies to verify vacancy information for the competitive developments submitted
for point awards. A total of at least five (5) competitive developments must be submitted in order for
points to be awarded.

A B C D E
Number of Current Calculation
Project Name Project Address Units in Vacancy Factor
Project Rate CxD
0
0
0
0
0

F G H
Total of Column E Total of column C Weighted Average Vacancy Rate
(F divided by G)

0 0 #DIV/0!

Enter ten (10) point award if the weighted average vacancy rate is less than 3%.

Enter five (5) point award if the weighted average vacancy rate is at least 3% but less than or equal to 5%.

(D) Five (5) or ten (10) additional points may be awarded on the basis of the vacancy rate as determined by a market
study (Item C 14). If a market study is submitted, it must be performed by a qualified third party in accordance
with the Department's application of TCAC Market Study Guidelines, dated February 2002. HCD will
require that market studies submitted to HCD meet the criteria in those Guidelines that address purposes
relevant to MHP. If the proposed project is for the elderly, competitive projects must be limited to this
population.

Enter ten (10) point award if the vacancy rate based on the market study is less than 3%.

Enter five (5) point award if the weighted average vacancy rate is at least 3% but less than or equal to 5%.

Total Point Award (maximum 15 points) 0
Page 70 of 99
Item D 2
Attachment to Scoring Sheet
Comparable Market Rental Data Form
Use this form if you have selected scoring option C on page 68
COMPLETE ONE COPY OF THIS FORM FOR EACH OF THE FIVE (5) REQUIRED COMPETITIVE DEVELOPMENTS.

DATE OF SURVEY: DATE OPENED:

(If
of units
PROJECT NAME:

PROJECT ADDRESS:

PERSON TO CONTACT: PHONE #:

BUILDING SPECIFICATIONS: DISTANCE FROM PROPOSED MHP

Number of Bedrooms:
Rental Range:
Furnished:
Square Footage:
Price Per Sq.Ft. (Rent/Sq.Ft.):
Number of Bathrooms:
Townhouse/Flat/Split Level:
Total Number of Units:
PERCENT OF TOTAL MIX:

Utilities Paid by Gas Electric Water None
Tenant:
Rental Subsidies:
(Please describe)
SECURITY DEVICES UTILIZED:

Full-Time Guards: Yes No Part-Time Guards: Yes No
Dead Bolts: Yes No Other:

CURRENT VACANCY RATE: (Average over last 12 months and also insert into Column D of Item D 3)

BUILDING CONFIGURATION: 1 Story 2 Story Mix

TENANT PROFILE: (Elderly, Family)

RECREATION FACILITIES/PROJECT AMENITIES (Please list)

PARKING FACILITIES:

Spaces/Unit Enclosed Covered Uncovered _____

Guest or Street Parking Available Estimated Number of Vehicles Per Apartments
*This is an abbreviated version of the form used by the California Housing Finance Agency (CalHFA). Applicants may use copies of CalHFA's
form.
Page 71 of 99
Item D 3 Scoring Sheet - Instructions
DEVELOPMENT AND OWNERSHIP EXPERIENCE
OF THE PROJECT SPONSOR
Section 7320(b)(3) MHP Regulations - 20 Points Maximum

Primary Scoring Method - May be utilized by all Project Sponsors
Applications will be scored based on the number of affordable rental housing developments (including tax credit projects)
that the Project Sponsor has developed and completed ("completed projects") in the ten years preceding the application due
date.
Four points are awarded for each qualified completed project, up to a maximum of twenty (20) points.
To be counted towards points under this Primary Scoring Method, completed projects must contain ten or more units, with
one exception. When the proposed project contains less than fifteen units and at least 70% of the total units in the proposed
project are reserved for Supportive Housing and Special Needs Populations (and the Project has met threshold requirements
that qualify it as a Supportive Housing Project), a completed project may have five units. For scoring purposes, units must be
apartments or SROs; bedrooms within single-family houses and apartments will not count as units.

Qualified completed projects will count for experience points if:

1) The Project Sponsor or its affiliate (an entity under common control with the Project Sponsor) was the sole
developer; or
2) The Project Sponsor or its affiliate developed the project in partnership with another entity, provided that the
Project Sponsor or its affiliate:
a) effectively controlled most key aspects of the development process, as evidenced by partnership
agreement and other indicators of control as determined by the Department.
b) had sufficient staff to manage the development process for all of the developments that it was
involved with during the development period; and
c) received the majority share of the developer fee for the project; or
3) They were developed by staff currently employed by the Project Sponsor or its affiliate (or a principal of the
Project Sponsor or its affiliate), provided that this staff:
a) had primary responsibility for managing the entire development process for the completed
project; and
b) will serve as the project manager for the Project (or directly supervise the project manager), with
primary responsibility for managing the development process.
Experience of board members will not be considered, unless they are also staff or principals.
Where the Project Sponsor is a partnership, only the experience of one entity will be considered. This entity must have a
controlling interest in the partnership, primary responsibility for development activities, a controlling and continuing role in
long-term operations, and sufficient qualified staff to carry out these roles. It must also receive the majority share of the
developer fee for the Project.
The State will evaluate all sponsors, including the roles of any general partner(s) in a limited partnership, to
determine if the sponsor's roles and responsibilities and benefits in the project development and operations are
commensurate with activities normally undertaken or controlled by project developers and owners. The sponsor will
be reviewed to determine if adequate staffing levels exist to undertake and complete the project. This criteria will be
applied in evaluating Sponsor experience for the purpose of awarding points.
Page 72 of 99
Alternative Scoring Method - For Supportive Housing and Special Needs Population Project Sponsors
ONLY
Supportive Housing Population Project Sponsors may establish experience using the Primary Scoring Method
described above or this Alternative Scoring Method. To qualify for the Alternative Scoring Method, at least 70%
of the Project Units must be reserved for Supportive Housing and Special Needs Populations (and the Project
must have met threshold requirements that qualify it as a Supportive Housing Project).

The Alternative Scoring Method is designed to accommodate the differing ways Supportive Housing and Special
Needs Population projects are sometimes developed and owned. It allows Project Sponsors to submit different
projects for development experience and ownership experience. It also allows the Project Sponsor to substitute
the development experience of a contracted developer or development consultant for its own and expands the
criteria for ownership by including "operation" experience as a replacement for ownership. (For these purposes,
operation means controlling a property under a long-term lease or other arrangement that involves all the
responsibilities commensurate with ownership.)

Applications under this Alternative Scoring Method will be scored based on both the number of qualified
projects developed and completed in the ten years preceding the application due date, and those currently owned
or operated. Four points are awarded for each project or pair of projects that demonstrate development and
ownership or operation experience, up to a maximum of twenty points. For example, if a Project Sponsor or
affiliated entity documents five projects demonstrating development experience and four projects demonstrating
qualified operating experience (and includes the required supporting documentation), the Project would receive
16 points in this scoring category.

To be counted towards points under this Alternative Scoring Method, completed projects must contain ten or
more units, with one exception. When the proposed project contains less than fifteen units and at least 70% of
the total units in the proposed project are reserved for Supportive Housing and Special Needs Populations (and
the Project has met threshold requirements that qualify it as a Supportive Housing Project), a completed project
may have five units. For scoring purposes, bedrooms in a single-family house or apartment do not count as units
of housing.

As discussed above, under this method of scoring, the Project Sponsor may qualify for development experience
by contracting with a developer or development consultant, provided that the Project Sponsor has contracted
with the developer or development consultant for comprehensive development services. Comprehensive
development services include: financial packaging, selection of other consultants, selection of the construction
contractor and property management agent, oversight of architectural design, construction management, and
other major aspects of the development process.

Under this Alternative Scoring Method, the Project Sponsor may substitute operation experience for ownership
experience, as long as the roles and responsibilities of the Project Sponsor in the projects submitted for such
experience is commensurate with the ownership role and responsibilities in the proposed Project.
Page 73 of 99
The Project Sponsor may qualify for ownership/operation experience based on the Sponsor’s own experience or
that of its affiliated entities and partners (as defined above in Primary Scoring Method.) It also may qualify for
ownership/operation experience based on the experience of Staff or principals employed by the Project Sponsor
or an affiliated entity or partner, as long as the staff or principal will be the project manager and have
comprehensive development responsibilities for the proposed Project. (The experience of Board members of the
Project Sponsor or an affiliated entity does not qualify under this provision unless they are also staff or
principals as defined above.)

Instructions:
All Project Sponsors must complete the Development and Ownership Experience Certification form
(Attachment 1).

Project Sponsors establishing experience based on the Primary Scoring Method should complete Attachment
2. Project Sponsors establishing experience based on the Alternative Scoring Method should complete
Attachment 3a and include supporting documentation where required (i.e., copy of the contract for
comprehensive development services with development consultant or contracted developer); narrative
(Attachment 3b) describing Project Sponsor's roles and responsibilities for each project which it wishes to
substitute operation for ownership experience; and, a copy of long-term lease.

The Department may require the Project Sponsor to provide additional documentation in connection with
projects submitted for experience points.
Page 74 of 99
Item D 3 - Attachment 1
DEVELOPMENT AND OWNERSHIP EXPERIENCE CERTIFICATION
All Project Sponsors must complete this certification and submit with either Attachment 2 or Attachment 3 depending upon which scoring method it is using to
establish experience for scoring. (If a Project Sponsor includes more than one qualifying entity, each entity must complete this certification.)

1. Project Name Location (City)
2. Proposed Sponsorship Participants and other 3. Role of Each Entity 4. Expected % 5. Social Security
Entities Applying for Experience Consideration Ownership or IRS Employer
Number

CERTIFICATION
I (Meaning the individual who signs as well as the corporations, partnerships or other parties listed above who certify) hereby apply to the Department for approval to
participate in the Program based partially upon my following previous experience record and this certificate. By executing this certificate, I hereby authorize the
disclosure of information concerning my performance in any capacity listed herein.

I certify that all the statements made by me are true, complete and correct to the best of my knowledge and belief and are made in good faith, including the data contained
in Attachments 2, 3a and 3b, and exhibits signed by me and attached to this form.
A. I further certify that:
1. If using the Primary Scoring Method, Scoring Sheet, Item D 3 - Attachment 2 contains a listing of every rental housing project in which I have been
or am now a participant within the past five years before the application due date. If using the Alternative Scoring Method, Scoring Sheet, Item D 3 -
Attachment 3a contains a listing of every rental housing project in which I/we have been or am/are now a participant within the past five years
before the application due date.

2. Except as shown by me on Scoring Sheet, Item D 3, Attachment 2 or 3a:
a. I/we have not sold any project listed;
b. I/we have never been foreclosed upon for any project listed;
c. I/we have not experienced instances of non-compliance on any rental housing project; and,
d. To the best of my knowledge, there are no unresolved findings raised as a result of audits, management reviews or other investigations
concerning my/our projects.
B. Statements above (if any) to which I cannot certify have been deleted by striking through the words with a pen. I have initialed each deletion (if any) and have
attached a true and accurate signed statement (if applicable) to explain the facts and circumstances which I think help to qualify me as responsible for
participation in the program.

6. Name Signature Title, Role or Capacity Date
Page 75 of 99
Item D 3 - Attachment 2

Project Sponsors should complete this Attachment 2 when using the Primary Scoring Method for scoring development experience. List all subsidized rental
housing projects completed within ten years of the application due date for which the Project Sponsor expects to garner points. Include only the projects in
which the qualifying entity was responsible for overseeing or performing the full range of comprehensive development activities including: financial
packaging, selection of consultants, selection of the construction contractor and property management agent, oversight of architectural design, construction
management and other aspects of the development process. Submit a separate schedule for each qualifying entity. (Submit additional sheets as necessary.)

Qualifying Entity:

Subsidized Project Name and Address Subsidy Source The Qualifying Entity was Number of Date Project Completed as Evidenced
(Including Tax Responsible for Comprehensive Units in the by Notice of Completion, Placed in
Credits) Development Responsibilities of Project Service Date, Certificate of Occupancy,
the Project (yes/no) or Equivalent

Scoring
a. Number of Projects Demonstrating Development Experience and Completed within Five Years of the Application Due Date

b. Point Award (a. multiplied by four, up to a maximum of 20 points)
Page 76 of 99
Item D 3 - Attachment 3a
Supportive Housing and Special Needs Population Project Sponsors should complete this Attachment 3a when using the Alternative Scoring Method for scoring
development and ownership or operation experience. (Only Projects with at least 70% of Project Units reserved for Supportive Housing and Special Needs Populations are
eligible to use this method of scoring.)
Development Experience
List all subsidized rental housing projects completed within ten years of the application due date by the developer or development consultant with whom the Project
Sponsor has a comprehensive development services contract. Include only the projects in which the qualifying entity was responsible for overseeing or performing the full
range of comprehensive development activities including: financial packaging, selection of consultants, selection of the construction contractor and property management
agent, oversight of architectural design, construction management and other aspects of the development process. A copy of the contract must be attached to Item D 3.

Contracted Developer/Development Consultant:

Subsidized Project Name and Address Subsidy Source Qualifying Entity Responsible for Qualified Entity Number of Date Project Completed as
(Including Tax Comprehensive Development Owned Project at Units in Evidenced by Notice of
Credits) Responsibilities of Completion Date the Project Completion, Placed in Service
Project(Indicate yes/no) (Indicate yes/no) Date, Certificate of Occupancy, or
Equivalent

Ownership/Operation Experience
List all subsidized rental housing projects that the Project Sponsor, or Affiliate of the Project Sponsor, currently owns or operates (i.e., involving all responsibilities
commensurate with ownership). Submit a separate schedule for each qualifying entity. (Submit additional sheets as necessary.) For each project submitted for operation
experience, attach the following supporting documentation: a narrative describing the Project Sponsor's roles and responsibilities using the attached form and a
copy of the long-term lease.
Qualifying Entity:
Subsidized Project Name and Address Subsidy Source Qualifying Entity Operates Project Involving all Qualified Entity Owns Number of Units in
(Including Tax Responsibilities Commensurate with Ownership (Indicate Project (Indicate the Project
Credits) yes/no) yes/no and date of
completion)

Scoring

a. Number of Projects Documenting Contract Development or Development Consultant Experience

b. Number of Projects Documenting Ownership or Operation Experience
c. Point Award (Take the lesser of a. or b. and multiply by four , up to a maximum of 20 points)
Page 77 of 99

Item D 3 - Attachment 3b
NARRATIVE DESCRIPTION OF ROLES AND RESPONSIBILITIES
FOR EACH PROJECT SUBMITTED FOR OPERATION EXPERIENCE

Project Name:

Provide a narrative description of the job title or position, roles, and responsibilities of the Project Sponsor for
each project listed on the "Ownership/Operation" Experience component of Attachment 3a that documents
operation experience. The description should provide the Department with sufficient information to
determine that the operation experience is commensurate with ownership experience. Attach to this all
supporting documentation (i.e., long-term lease), clearly identifying the significance of the supporting
documentation and the specific project to which the supporting documentation is related.
Page 78 of 99
Item D 4
SCORING SHEET

PERCENTAGE OF UNITS FOR FAMILIES, THE TARGET POPULATION OR
SPECIAL NEEDS POPULATIONS, OR "AT-RISK" RENTAL HOUSING
DEVELOPMENTS
Section 7320 (b) (4) of the MHP Regulations - 35 Points Maximum

Applications will be scored based on the percentage of project units that will have two or more bedrooms, or that
are reserved for the Target Population or Special Needs Populations. Projects must have the greater of 5 units or
35 percent of total project units reserved for the Target Population to receive points for those units. A GHI
Supportive Housing Project Plan, (Item B 17) acceptable to the Department, must accompany the application in
order to receive points for Supportive Housing or Special Needs Units.

Points will be awarded as follows: (A) .2 points for each percent of total project units that have two bedrooms;
(B) .7 points for each percent of total project units that have three bedrooms; (C) 1 point for each percent of total
project units that are reserved for the Target Population or Special Needs Population(s); or (D) 35 points for
projects approved by the Department as "At-risk" Rental Housing Developments. Submit attached checklist for
"At-risk" of Conversion.

Project must conform to UMR Section 8304, Unit Standards.

A
Total Number of Project Units (Only include the manager's unit if included below)… 0

B C D E F

Number of % Of Total Project Points
Scoring
Unit Size or Designation Units in this Units in this Category Awarded
Factor
Category (C divided by A) (D x E)

2 Bedroom #DIV/0! 0.2 #DIV/0!
3+ Bedroom #DIV/0! 0.7 #DIV/0!
Units Reserved for the Target
Population or Special Needs #DIV/0! 1.0 #DIV/0!
Populations
Enter thirty-five (35) points here if the project is an “At-risk” Rental Housing Development,
as defined by TCAC Regulations. Attach checklist for 'At-risk Of Conversion', and "At-risk
Supporting Documentation.
Total Point Award (maximum 35)
Note: Units may not be included in both multiple bedroom and Supportive Housing or #DIV/0!
Special Needs Population categories

All point calculations will be rounded to the nearest one hundredth point.
Page 79 of 99
Item D 4

Attachment to Scoring Sheet
Checklist For “At Risk Of Conversion”

Project Name: Sponsor:

Under MHP the MHP Regulations, Section 7320(b)(4)(D) , a project approved by the Department as an “At-risk”
Housing Development, as defined by TCAC regulations, will receive 35 points (see Item D 4, Scoring Sheet).
TCAC regulations first mandate that to be considered “at-risk” housing, the project must meet the requirements of
the California Revenue and Taxation Code, subsection 10758 (c) (4), except as further defined in TCAC regulations
at Section 10325(g)(5)(B)(i), as well as meet additional TCAC requirements.

The applicant should complete this attachment confirming that the project meets the TCAC criteria, as well as attach
documentation to Item D 4 in support of the answers given. In the material included in Item D 4, please highlight
relevant sections and, in the margins, reference the number of the criteria it addresses. When filling out this
attachment, add explanatory comments as appropriate.

To be considered “at-risk of conversion” according to the California Revenue and Taxation Code, a project
must meet all of the following four criteria:

1. The project is presently owned by a housing sponsor other than a qualified nonprofit organization.
yes no

Explanation:

2. The project is a federally-assisted project for which the low-income use restrictions will terminate or
the project is eligible for incentives under Subtitle 13 of the Emergency Low Income Housing
Preservation Act of 1987 or under Section 502(c) of the Housing Act of 1949 (Federal project-based
rental subsidy), anytime in the two calendar years after the year of application to MHP and the
purchaser has received preliminary approval from the applicable federal agency for a maximum level
of incentives through a plan of action.
yes no

Explanation:

3. The entity acquiring the project will enter into a regulatory agreement that requires the project to be
operated in accordance with the requirements of the California Revenue and Taxation Code for a
period equal to the greater of 55 years or the life of the project.
yes no

Explanation:
Page 80 of 99
4. The project satisfies the requirements of Section 42(e) of the Internal Revenue Code regarding
rehabilitation expenditures, except that the provisions of Section 42(e)(3)(A)(ii)(I) shall not apply.

yes no

Explanation:

TCAC regulations allow one exception to the above:

5. The project meets the at-risk eligibility requirements under the terms of applicable federal and state
law, except that a project that has been acquired by a qualified nonprofit organization within the past
two years of the date of application to MHP with interim financing in order to preserve its affordability
and that meets all other TCAC requirements shall be considered at-risk. The project must be at-risk of
converting due to market or other conditions.
yes no

Explanation:

The additional TCAC threshold requirements at Section 10325(g)(5) of their regulations are:

6. The project must be subject to a minimum low-income use period of 55 years.
yes no

Explanation:

7. The project must currently possess or have had within the past two years from the date of application
to MHP, either federal mortgage insurance, a federal loan guarantee, federal project-based rental
assistance, or have its mortgage held by a federal agency, or be owned by a federal agency.

yes no

Explanation:

8. The applicant must have sought available federal incentives to continue the project as low-income
housing, including direct loans, loan forgiveness, grants, rental subsidies, renewal of existing rental
subsidy contracts, etc.
yes no

Explanation:

Identify funding source(s)
Page 81 of 99

9. The subsidy contract expiration or mortgage prepayment eligibility shall occur no later than two
calendar years after the year in which the application to MHP is filed.
yes no

Explanation:

10. The sponsor must agree to renew all Section 8 HAP contracts or equivalent project-based subsidies for
their full term and shall seek additional renewals throughout the project’s useful life, if applicable.

yes no

Explanation:

11. At least 70% of project tenants shall, at the time of application to MHP, have incomes at or below
60% of AMI.
yes no

Explanation:

12. The gap between total development costs (excluding developer fee) and all loans and grants to the
project (excluding tax credits) is greater than 15% of total development costs; and
yes no

Explanation:

13. A public agency shall provide direct or indirect long-term financial support of at least 15% of the total
project development costs, or the owner’s equity (includes syndication proceeds) shall constitute at
least 30% of the total project development cost.
yes no

Explanation:

This project meets the above TCAC criteria: yes no

If yes, attach supporting documentation.
Item D 5 Page 82 of 99
SCORING SHEET
LEVERAGE OF OTHER FUNDS
Section 7320 (b) (5) of the MHP Regulations - 20 Points Maximum
Applications will be scored based on the amount of non-MHP funds for permanent funding of the development costs attributable to the
restricted units, as a percentage of the requested amount of MHP funds. Deferred developer fees will not be counted as leveraged funds.
Land donations will be counted as leveraged funds where the value is established with a current appraisal.

For GHI Supportive Housing Projects: (1) projects containing at least 35% but less than 75% of total project units as Target Population
units will be awarded one half point for every full 5 percentage point increment above 50%; or (2) projects containing 75% or more of total
project units as Target Population units will receive one point for every full 5 percentage point increment above 50%

For example, a GHI Supportive Housing Project containing 35% of total project units as Target Population units: where other funds are
equal to 50% of requested MHP funds will receive zero (0) points; where other funds equal 100% will receive 5 points; where other funds
equal 150% will receive 10 points; where other funds equal 200% will receive 15 points; and where other funds equal 250% will receive the
maximum 20 points.

A B C
Permanent Non MHP Funding % of Total Non-MHP Funding Dollar Amount of Permanent Non-
Amount Amount Attributable to MHP Funds Attributable to
Restricted Units ** Restricted Units
(A X B)
100% $0
** From Item C 5, Shared Cost Calculation Worksheet, enter Percentage from line D, or enter percentage result of commercial calculation if
applicable.

D. MHP Funds Requested #DIV/0!
Point Award
GHI Supportive Housing Projects with at C divided by D (as a percentage) less 50 divided by 5, rounded down to
least 35% but less than 75% of total project the next whole number, x 0.5 will equal the point award, to a
units as Target Population Units maximum of 20 points
#DIV/0!

GHI Supportive Housing Projects with 75% C divided by D (as a percentage) less 50 divided by 5, rounded down to
or more of total project units as Target the next whole number will equal the point award, to a maximum of #DIV/0!
Population units 20 points

Applicable Leverage point award from above.

Total Leverage Point Score (Not to exceed 20 pts.)
Page 83 of 99
Item D 6
SCORING SHEET

PROJECT READINESS
Section 7320 (b) (6) of the MHP Regulations - 15 Points Maximum
Two and one half (2.5) points will be awarded to projects for each of the following circumstances as documented in the
application. Any application demonstrating that a particular category is not applicable to Project Readiness for the project
shall be awarded points in that category.

Points
Point Category Required Documentation
Awarded
A. Enforceable commitments for all construction financing, Construction financing commitments
not including tax-exempt bonds, 4 percent tax credits, and must be attached as part of Item C 7.
funding to be provided by another Department program. (See enforceable commitment
The other Department funds must be confirmed as instructions on page 7)
available concurrent with MHP funding.

B. Have all deferred-payment financing, grants and subsidies Deferred payment and grant
committed, in accordance with TCAC requirements and financing commitments must be
with the same exceptions as allowed by TCAC. attached as part of Item C 7. (See
enforceable commitment
instructions on page 7)

C. 1. All necessary environmental clearances (CEQA and 1. Document with Attachment to
NEPA), and Item D 7 (Local Jurisdiction
2. Completion of Phase I Environmental Site Assessment Verification)
2. Document in Item B 15
(Environmental Reports).

D. Local design review approval to the extent such approval is Document with Attachment to Item
required D6 (Local Jurisdiction
Verification)

E. All necessary ad discretionary public land use approvals, Document with Attachment to Item
except building permits and other ministerial approvals. D 6 (Local Jurisdiction
Verification)
F. Either: (specify which condition is documented in the 1. Document fee title in Item B 10
application) (preliminary title report) or document
a long-term lease in both Items B 10
1. ( ) sponsor has fee title ownership to the site or a long and Item B 9 (copy of the long term
term leasehold meeting the Department's leasehold lease).
requirements. 2. Document with a letter from the
2. ( ) sponsor can demonstrate that the working drawings project architect.
are at least 50 percent complete, as certified
by the project architect in an attached letter.

Total Points Awarded (maximum 15) 0
Page 84 of 99
Item D 6

ATTACHMENT TO SCORING SHEET Item D 6

LOCAL JURISDICTION VERIFICATION OF
PROJECT READINESS

To the applicant: Complete the Sponsor and project information section below. Then submit this form to the agency or
department of local government responsible for administration of the items listed. The form may be submitted to more than
one agency or department if necessary.

PROJECT SPONSOR:
PROJECT SPONSOR ADDRESS:
PROJECT SPONSOR CITY:

PROJECT NAME:
PROJECT ADDRESS/SITE:
PROJECT CITY:
PROJECT COUNTY:
ASSESSOR PARCEL NUMBER(S):

To the local jurisdiction: The applicant named above has submitted an application to the State requesting funding for the project named
above, under the Multifamily Housing Program (MHP). Projects submitted for program funding are subject to a competitive rating
process. Project readiness is a component of that process. Local jurisdiction verification of items listed below will be used in evaluating
applications.

Verified as Not Required
Complete and for this Project
date completed
All Environmental Clearance (CEQA and NEPA) is: CEQA
NEPA
All necessary and discretionary public land use approvals (e.g., site plan approval) except
building permits and other ministerial approvals* are:

Design review approval is:

* Ministerial approvals are approvals awaiting only routine documentation or processing and require no further judgment or
discretion.

Dated:

Statement Completed by (please print):

Signature:

Title:

Agency or Department:

Agency or Department Address:

Agency or Department Phone:
Page 85 of 99
Item D 7
SCORING SHEET

ADAPTIVE REUSE, INFILL OR PROXIMITY TO SITE AMENITY
Ten points will be awarded to projects that demonstrate any of the following conditions have been met: (1) the project qualifies
as an infill development; (2) the project qualifies as an adaptive reuse in an existing developed area served with public
infrastructure; (3) the project would qualify for points for proximity to public transit, public schools, or parks and recreational
facilities pursuant to TCAC Regulations, or the project is located within one mile of a job center. Check the box designating the
category for which the project will be applying for points. Attach the required documentation for the item. Projects not
documenting qualifications under any category will receive zero points in this category.

Point Category Required Documentation Points
Awarded
[ ] Infill Development 1. Attach a narrative describing the project and area in which the
project will be built. The narrative must confirm the project will be
located on vacant or soon to be vacant property, and in an established and
developed area; and

2. Attach a scaled distance map as Item B 14, including the area within at
least one mile of the project.
[ ] Adaptive Reuse 1. Attach a narrative describing the project and area in which the
project will be built. The narrative must confirm the project will consist
of the rehabilitation of a vacant or underused commercial or industrial
building(s). Structures such as residential hotels that are currently used
for housing will not be considered to be eligible in meeting the adaptive
reuse criteria. The narrative must also confirm the project site is located
within a developed area served with public infrastructure ; and

2. Attach a scaled distance map as Item B 14, including the area within at
least one mile of the project.
Proximity to Site Amenity 1. Attach a narrative naming and describing the site amenity selected
for point consideration and specifying the exact distance from the project
(select any one site amenity): to the site amenity; and
[ ] Public Transit

[ ] Public Schools 2. Attach a scaled distance map as Item B 14 with the project site and the
site amenity identified.
[ ] Parks and Recreational
Facilities
[ ] Job Center Note: The project must be able to qualify for points for proximity to
Public Transit, Schools, and Parks and Recreational Facilities under
TCAC Regulations, or the project must be within one mile of a Job
Center. ( A Job Center is a concentration of employment opportunities
reasonably available to the tenants of the Project and will be located
within one mile of the project.)

Total Point Score 0
Page 86 of 99
Item D 8
Scoring Sheet
Negative Point Calculation
To Be Completed By Department Staff
Section 7320 (b)(3)(F) of the MHP Regulations

Sponsor Name: Project Name:
Address: Address:

Co-Sponsor: Other Entity:
Address: Relationship:
Address:

Events occurring in connection with projects under the control of the sponsor shall be used as the basis for
point deductions. Such events shall have had a detrimental effect on the project or the department’s ability to
monitor the project, as determined by the department. Events shall not result in the deduction of points if
they have been fully resolved as determined by, or to the satisfaction of the department as of the application
date.

Five points will be deducted for each occurrence or event in the following categories, with a maximum deduction of
10 points per category and a maximum total deduction of 50 points.
( ) Removal or withdrawal under threat of removal as general partner.

( )
Failure to submit when due compliance documentation required under department programs.

( )
Use of reserve funds for department-assisted projects in a manner contrary to program
requirements or failure to deposit reserve funds as required by the department.

( )
Failure to provide promised supportive services to a special needs population or other
tenants of a publicly funded project.

( )
Other significant violations of the requirements of department programs, or of the programs
of other public agencies, such as the failure to adequately maintain a project or the books
and records thereof.

Negative Point Total Date
Department Representative:
Page 87 of 99
Item D 9
SCORING SHEET

TOTAL RANKING POINTS EARNED
Section 7320 (b) (1)-(7) of the MHP Regulation

Department
SECTION Self Score
Reviewer Score
Section 7320 (b) (1) of the MHP Regulation
Extent Project Serves Households at the Lowest Income Levels #DIV/0!
Maximum 35
Section 7320 (b) (2) of the MHP Regulation
Extent Project Addresses the Most Serious Identified Housing Needs 0
Maximum 15
Section 7320 (b) (3) of the MHP Regulation
Development and Ownership Experience of the Project Sponsor 0
Maximum 20
Section 7320 (b) (4) of the MHP Regulation
Percentage of Units for Families, the Target Population or Special Needs Populations
#DIV/0!
and "At-Risk" Rental Housing Developments
Maximum 35
Section 7320 (b) (5) of the MHP Regulation
Leverage of Other Funds
Maximum 20
Section 7320 (b) (6) of the MHP Regulation
Project Readiness 0.00
Maximum 15
Section 7320 (b)(7) of the MHP Regulation
Adaptive Reuse, Infill, or Proximity to Site Amenity 0
Maximum 10
Section 7320 (b) (3) (F) of the MHP Regulation
Negative Points-Assigned by Department Staff 0
Maximum 50

Total Point Score
Maximum 150

Self Scoring Total #DIV/0!

Department Reviewer Total 0.00
Page 88 of 99

Section E

Additional Requirements Specific to
Projects Applying for CalHFA
Construction Financing

Item
E 1. Checklist of Additional Items Required by CalHFA
Page 89 of 99
Item E 1
Checklist of Additional CalHFA Required Items for Projects Applying for CalHFA
Financing
(Must be completed and submitted with application. These items may be submitted in a separate binder.)

The project sponsor is to specify that each item is either Included, To Be Submitted Later (TBS), or Not
Applicable (N/A). If the item is Not Applicable, please attach an explanation. If the item is To Be
Submitted Later, please attach a timeline illustrating when the item is to be submitted.

Financial Information

Item
Specify the amount of CalHFA funds requested for the Construction Loan,
Acquisition/Rehab Loan, Bridge Loan, or Permanent Loan. For each loan, state the loan
1 term and whether the loan is tax-exempt or if taxable funds are requested.

Commitments: In addition to the commitments required in Item C7, include the following:

Item
2 Tax credit purchase offer or letter of interest with all applicable attachments
3 Letter from investor itemizing sources of syndication in TCAC-required format

Reports

Item
4 Phase I and (if required by the Phase I Report) Phase II Environmental
5 Market Study (if CDLAC bond allocation is needed)
6 Appraisal (See CalHFA's requirements on website for appraisals)
7 Soils Report
Acoustical/Noise Study (if required by Architectural Services following site visit and
8
review of plans)
9 Asbestos/Lead-Based Paint Analysis (if applicable)

Owner/Devbelopment Team Information

Item
10 Borrower resume
11 Contractor resume
12 Copy of contractor's license
13 Architect's resume (including copy of contract for services for supervising architect)
14 Resumes of other development team members
No defaults statement for each development team member. Description of any Identity of
15
Interest between any team members
16 Contact sheet for all development team members, including primary service provider
Page 90 of 99
17 Two years Profit and Loss Statement from each general partner or principal
Signed Credit Authorization Forms from each general partner or principal (Attach B-3 of
18
CalHFA application - Refer to CalHFA's website)

Organizational Documents for Each Separate Ownership Entity if the following items are not included
elsewhere in the application:

19 Articles of Incorporation
20 Authorizing Board resolution from each entity
21 Certificate of Good Standing
22 Partnership Agreements
23 Bylaws
24 Certificate of Corporation
25 LP-1 and/or LP-2
26 Evidence of 501(c)(3) status (if applicable)

Construction Information
Item
27 Construction Cost Breakdown
28 Plans and Specifications
29 Draft construction contract
30 Architect agreement
31 Draft construction schedule
Zoning and Planning Commission approvals, including conditional use permits, density
32
bonuses, deed restrictions, and CC&Rs
33 Preliminary Title Report, including legible copies of all exceptions on title
34 ALTA survey

Site Information

Item
35 8 ½ X 11 elevations of proposed site
36 Photos of site
37 Site topographic map
38 Site features

Building Information

Item
39 Description of proposed construction type
40 Unit design
41 Parking information
Page 91 of 99
42 Proposed type of:
42 a Heating
42 b Sinks/Tubs
42 c Roof (& material)
42 d Siding (& material)
42 e Structure Code
42 f Countertops

If Acquisition/Rehab Loan, also submit:

Item
43 Instructions for gaining access with contact phone number
44 Discussion of proposed modifications to unit configurations, mix or seismic retrofit
45 Interior photos
46 Recent rent roll
47 Replacement reserve analysis
48 Copy of financials for past two years of project
Page 92 of 99

Section F

Special Funding for Capitalized
Rent Subsidies (CRS)

Item
F 1. Special Funding for Capitalized Rent Subsidies (CRS) Worksheet
Page 93 of 99
Item F 1
Special Funding for Capitalized Rent Subsidies (CRS) Worksheet
(Revised January 13, 2006. This revised worksheet must be substituted for the worksheet supplied as Item F1 in the
Governor's Homeless Initiative Application Revised January 4, 2006)

A special set-aside of the Proposition 63 funding in the amount of $2 million will be made available until exhausted to projects
that qualify for funding under the Governor's Homeless Initiative (GHI) Notice of Funding Availablity issued November 15, 2005.
The funds will be made available as development funding for use as operating reserves for the purpose of providing rent subsidies
for sustaining the financial feasibility of the Governor's Initiative projects.

Qualifying projects will be awarded the funds in amounts equal to $7,500 per project unit that is reserved for the target population.

The amount of CRS funding awarded to projects is not intended to serve as an indicator of total need for operating reserves.
Projects may be required to capitalize reserves above the amount of the CRS funding.

Please complete the chart below to qualify for the funds.

Number of GHI CRS Total
Target Population Funding for
Units Units

$7,500 $0

.
Note: The funds will be made available until exhausted to the first qualifying projects. In the event qualifying projects do not
exhaust the $2 million in available funds, funding above the specified amounts may be made available to those qualifying projects
requesting funds.

Application Instructions for the Special Funding for Capitalized Rent Subsidies

1. Item C 3 - Include the CRS funds in Total Project Cost and "Soft" Financing and Grant line items.
2. Item C 4 - CRS funding is not MHP funding and will not be shown on the MHP Loan Limit Worksheet.
3. Item C 5 - Include the CRS funding in Sections A and E as the CRS is a part of the development cost.
4. Item C 6 - The CRS funds will not be included in the Loan Amount Calculation Worksheet as the CRS is not part of the MHP
loan.
5. Item C 7 - Include the CRS as Permanent Financing but do not include the CRS as Construction Period Financing.
6. Item C 7 - Do not include the CRS funding in the Rent/Operating Subsidies Chart. This chart is intended to evaluate non-
capitalized rent subsidies.
7. Item C 8 - The CRS is a development cost and will be included in the Development Budget.
8. Item C 9 - The CRS will not be included in the depiction of project income as reserve will be utilized for unforseen
circumstances.
9. Item C 10 - Do not include the CRS in the Operating Budget
10. Item C 11 - Do not include the CRS in the 15-Year Pro-Forma.
11. Item D 5 - Include CRS funding in the Leverage Calculation as other permanent development funding (CRS funds are not
MHP funds).
Page 94 of 99

Section G

Summary Forms

Item
G 1. Application Summary
G 2. Application Summary - Co Sponsor
G 3. Funding by Activity
G 4. Project Information
G 5. Unit Information
G 6. Legislative Representatives
G 7. Special Needs Populations
Page 95 of 99
California Department of Housing and Community Development

Application Summary
Multifamily Housing Program
1.a Sponsor Information

Name:
Address:
City:
State: Entity Type:
(Corp., Limited Partnership, General Partnership, etc.)
Zip Code:
County: Profit Status: For Profit Nonprofit Government

If there is a co-sponsor please provide duplicate of this page for the co-sponsor

1.b Authorized Representative Information

Mr. Mrs. Ms. Other

First Name: MI: Last Name:
Job Title:
Check if the information in this area is the same as Sponsor
Address:
City:
State: Zip Code:
Phone: Ext: Fax:
Email:
If there is more than one Authorized Representative please provide duplicate of this page

1.c Sponsor Contact Information
Check if the same as Authorized Representative; if so proceed to next section.

Mr. Mrs. Ms. Other

First Name: MI: Last Name:
Job Title:
Address:
City:
State: Zip Code:
Phone: Ext: Fax:
Email:
Page 96 of 99
California Department of Housing and Community Development

Application Summary
Multifamily Housing Program
1.a Co-Sponsor Information

Name:
Address:
City:
State: Entity Type:
(Corp., Limited Partnership, General Partnership, etc.)
Zip Code:
County: Profit Status: For Profit Nonprofit Government

1.b Authorized Representative Information

Mr. Mrs. Ms. Other

1.c Co-Sponsor Contact Information
Check if the same as Authorized Representative; if so proceed to next section.

Mr. Mrs. Ms. Other

First Name: MI: Last Name:
Job Title:
Address:
City:
State: Zip Code:
Phone: Ext: Fax:
Email:
Page 97 of 99
2. Requested Funding by Activity

Activity
New Construction
Rehabilitation
Acquisition/Rehabilitation
Conversion

Total Amount Requested $0

R
e

3. Proposed Other Funding Sources

Source Type (City or County, State
HCD, State Other, Federal, Redevelopment
Name of Source Agency, Tax Credit, Private or Other Dollar Amount
(Specify) )

0 $0

Proposed Other Funding Total $0
Page 98 of 99
4. Project Information

Project Name:
Site Address:
City: Zip Code:
County:
Census Tract No or Nos.:

Geographic Location : North South

Rural: Yes No

TCAC Project: Yes No

CHFA: Yes No

If yes, # of units
Is this an at risk project? Yes No at risk

# Special Needs Population Units: # Supportive Housing Units

Total Residential Cost:

Total Development Cost:

5. Unit Information

Activity
# Manager
# of Restricted Units # of Market Rate Units Total Units
Units

New Construction
Rehabilitation
Acquisition/Rehabilitation
Conversion
Total

# of # of 1 # of 2 # of 3 # of 3+
Efficiency Bedroom Bedroom Bedroom Bedroom Total Units
Units Units Units Units Units
Manager Units
Restricted Units
Market Rate Units
Total
Page 99 of 99
6. Legislative Representative Information ( for project site(s) )

District # First Name Last Name
Assembly
Senate
Congressional

7. Special Needs Population

Mentally Disabled Households
Orthopedically Disabled
Physically Disabled
Persons with HIV/AIDS
Developmentally Disabled Households
Agricultural Workers
Single-Parent Households
Survivors of Physical Abuse
Homeless Households
Households At-Risk of Homelessness
Displaced Teenage Parents (or Expectant Teenage Parents)
Homeless Youth
Individuals Exiting from Institutional Settings
Chronic Substance Abusers
Long-Term Chronic Health Condition

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