Spreadsheet: ada67618-704b-4f17-bd2b-ecb85aa1ecb1
Sheet: Sheet1

CITY OF NEW BRAUNFELS - EVALUATION FORM | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13
FUNDING APPLICATION FOR COMMUNITY DEVELOPMENT BLOCK GRANT 2013
PROGRAM NAME:
APPLICANT NAME:
DATE OF EVALUATION:
[NAME]):
Allocate points based on what has been submitted by applicant.
[NAME] |  |  |  |  |  |  |  |  |  |  | Value |  | Score
[NAME] (20 points) |  |  |  |  |  |  |  |  |  |  | 20 |  | 20
1. - 20. | Subtract 1 point for each field left unanswered.  If not applicable, field should read "N/A".
 |  | # of empty fields |  |  |  | X 1 = | 0 | lost points
[NAME] INFORMATION (75 points)
1.  Brief summary of applicant's mission and goals. |  |  |  |  |  |  |  |  |  |  | 5 |  | 0
2.  Longevity  (>5 years-4 pts; 2-4 years-1 pt; <2yr-0 pts)
 | [NAME] of years applicant has been in business |  |  |  |  |  |  |  |  |  | 4 |  | 0
 | [NAME] has operated as a 501c (3) |  |  |  |  |  |  |  |  |  | 4 |  | 0
 | [NAME] this applicant operated under another name?* |  |  |  |  |  |  |  |  |  | 3 |  | 0
 | d.  Number of years applicant has conducted the program |  |  |  |  |  |  |  |  |  | 3 |  | 0
*If applicant answers "Yes" and fails to list all previous names, award zero points for Section B.2.c.
3.  Written Management Policies (Yes-2 pts; No-0 pts)
 | 1.  Personnel Policy |  |  |  |  |  |  |  |  |  | 2 |  | 0
 | 2.  Job Descriptions |  |  |  |  |  |  |  |  |  | 2 |  | 0
 | 3.  Purchasing Policy |  |  |  |  |  |  |  |  |  | 2 |  | 0
 | 4.  Code of Conduct |  |  |  |  |  |  |  |  |  | 2 |  | 0
 | 5.  American with Disabilities Act/Limited English Proficiency Policy |  |  |  |  |  |  |  |  |  | 2 |  | 0
 | 6.  Fiscal/Accounting Policy |  |  |  |  |  |  |  |  |  | 2 |  | 0
4.  Has the applicant been involved in any lawsuits? (Yes-1 pts; No-2 pts) |  |  |  |  |  |  |  |  |  |  | 3 |  | 0
5.  Are there any outstanding judgments against the applicant? (Yes-0 pts; No-2 pts) |  |  |  |  |  |  |  |  |  |  | 3 |  | 0
6.  Has the applicant filed a petition for bankruptcy or has a petition for bankruptcy
 | been filed against the applicant? (Yes-0 pts; No-2 pts) |  |  |  |  |  |  |  |  |  | 3 |  | 0
7.  Have concerns/findings identified on last year's monitoring report been corrected? (Yes-10 pts; No-0 pts) |  |  |  |  |  |  |  |  |  |  | 10 |  | 0
8.  Disclosure of Potential Conflict of Interest**
 | Are any of the Board Members or employees of the agency which will be carrying out this program, or members
 | of their immediate families, or their business associates:  (Yes/No-5 pts; No Answer or explanation-0 pts
 | [NAME] by the City of New Braunfels? |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | b.  Members of or closely related to members of New Braunfels City Council? |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | c.  Members of or closely related to members of the Community Development Advisory Board? |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | d.  Current beneficiaries or related to beneficiaries of the project for which funds are requested? |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | e.  Paid providers of goods or services to the program of having other financial interest in the program
 | or related to such individuals? |  |  |  |  |  |  |  |  |  | 5 |  | 0
**If the applicant answered "yes" to questions 8.a. - 8.e. and failed to provide an explanation, award zero points for
question B.8. Disclosure of Potential Conflict of Interest.
SUBTOTAL Section B. |  |  |  |  |  |  |  |  |  |  | 75 |  | 0
[NAME]  (70 points)
1.  Type of Project*
 | [NAME] points, if applicant indicated the type of project. |  |  |  |  |  |  |  |  |  | 2 |  | 0
 | [NAME] points, if applicant indicated the type of public service or selected N/A. |  |  |  |  |  |  |  |  |  | 2 |  | 0
 | [NAME] points, if applicant described how activity improved access or expanded its services to LMI persons
 | or selected N/A. |  |  |  |  |  |  |  |  |  | 6 |  | 0
2.  Program Description-Award 5 points if description includes what service CDBG funds will provide. |  |  |  |  |  |  |  |  |  |  | 5 |  | 0
3.  Service Area Description
 | Award 5 points if service area is restricted to Harlingen residents, 2 points if project serves |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | other cities.
4.  Demand for Service/Facility
 | a. Award 2 points if there are other organizations providing similar services or similar facilities within |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | the City of Harlingen, 5 points if project is not a duplicative service or facility.
 | [NAME]10 points if GAP in services is equal to or greater than 50 |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | Award  7 points if GAP in services is equal to or greater than 25
 | Award  4 points if GAP in services is equal to or greater than 10
[NAME], continued
5.  Beneficiary Data*
 | [NAME] points if the number of New Braunfels beneficiaries or service units will exceed 500 persons |  |  |  |  |  |  |  |  |  | 15 |  | 0
 | Award 12 points if the number of New Braunfels beneficiaries or service units will be 400-499 persons
 | Award 8 points if the number of New Braunfels beneficiaries or service units will be 300-399 persons
 | Award 6 points if the number of New Braunfels beneficiaries or service units will between 200-299 persons
 | Award 4 point if the number of New Braunfels beneficiaries or service units will between 100-199 persons
 | Award 3 point if the number of New Braunfels beneficiaries or service units will between 50-99 persons
 | Award 2 point if the number of New Braunfels beneficiaries or service units will between 1-49 persons
 | [NAME] points if the number of New Braunfels beneficiaries will increase in 2013, 0 points if not. |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | [NAME] points if the number of Low -Income New Braunfels beneficiaries will increase in 2013. |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | d.  Award 10 points if the percentage of Low-Income New Braunfels beneficiaries served in 2013 will be 100% |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | Award 7 points if the percentage of Low-Income New Braunfels beneficiaries served in 2013 will be at least 75%
 | Award 5 point if the percentage of Low-Income New Braunfels beneficiaries served in 2013 will be at least 51%
 | Award 0 points if the percentage of Low-Income New Braunfels beneficiaries served in 2013 will be less than 51%.  PROJECT IS INELIGIBLE!
*Renewal Service Projects must have either a quantifiable increase in the number of beneficiaries served or increase in the level of the existing service in order to be eligible for CDBG funds.  [NAME] to Section C.1.c. to determine whether there is an increase in the level of service.
SUBTOTAL Section C. |  |  |  |  |  |  |  |  |  |  | 70 |  | 0
[NAME] [NAME] (25 points)
1. Award 7 points if project is classifed under the correct HUD National Objective. |  |  |  |  |  |  |  |  |  |  | 7 |  | 0
Award 2 points if project is classified incorrectly.
If no objective is selected, award 0 points since projects must meet a National Objective to be eligible for funds.
2. Award 10 points if applicant accurately explains how their project addresses the national objective |  |  |  |  |  |  |  |  |  |  | 10 |  | 0
they selected.
3a-3d.  [NAME] points for every question answered "YES" or "N/A", 0 points for those answered "NO." |  |  |  |  |  |  |  |  |  |  | 8 |  | 0
SUBTOTAL Section D. |  |  |  |  |  |  |  |  |  |  | 25 |  | 0
[NAME]20 points)
1. Award 2 points for selecting the correct Priority Need Category. |  |  |  |  |  |  |  |  |  |  | 2 |  | 0
2. Award 2 points for selecting the correct Objective. |  |  |  |  |  |  |  |  |  |  | 2 |  | 0
3. Award 2 points for selecting the correct Service Activity. |  |  |  |  |  |  |  |  |  |  | 2 |  | 0
4. Award 5 points for typing in the number of person/households to be served. |  |  |  |  |  |  |  |  |  |  | 5 |  | 0
5. Award 2 points for selecting the correct Accomplishment Type. |  |  |  |  |  |  |  |  |  |  | 2 |  | 0
6. Award 2 points for selecting the correct Performance Indicator/Outcome. |  |  |  |  |  |  |  |  |  |  | 2 |  | 0
7. Award 5 points for selecting the correct  / appropriate number of Evaluation Tool(s). |  |  |  |  |  |  |  |  |  |  | 5 |  | 0
SUBTOTAL Section E. |  |  |  |  |  |  |  |  |  |  | 20 |  | 0
[NAME] (55 points)
1.  Attachment 1-Current Year Budget (Fiscal Year 10/1/2011 - 9/30/2012 or Calendar Year 1/1/2012 - 12/31/2012).
 | [NAME] was submitted and labeled appropriately. |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | [NAME] is clear with no obvious errors, has no deficit. |  |  |  |  |  |  |  |  |  | 10 |  | 0
2.  Attachment 2-End of the Year Budget (Fiscal Year 10/1/2010- 9/30/2011 or Calendar Year 1/1/2011 - 12/31/2011).
 | [NAME] was submitted and labeled appropriately. |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | [NAME] is clear with no obvious errors, has no deficit. |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | [NAME] a minimum of 3 months operating reserves (or 10%). |  |  |  |  |  |  |  |  |  | 5 |  | 0
3.  Request for CDBG Funds
 | a-b.  Award 5 points if Applicant specifically indicates what CDBG funding will be used for. |  |  |  |  |  |  |  |  |  | 5 |  | 0
4.  Leveraging |  |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | Award 10 points if Applicant lists the type, source, dollars requested, dollars awarded and purpose for at least 3 leveraging sources.
 | Award 7 points if Applicant lists the type, source, dollars requested, dollars awarded and purpose for 2 leveraging sources.
 | Award 3 points if Applicant lists the type, source, dollars requested, dollars awarded and purpose for 1 leveraging sources.
5.  Fundraising Efforts
 | Award 5 points if Applicant lists the type, source, dollars requested, dollars awarded and purpose for 1 fundraising event.
 | Award 0 points if Applicant lists no fundraising events. |  |  |  |  |  |  |  |  |  | 5 |  | 0
SUBTOTAL Section F. |  |  |  |  |  |  |  |  |  |  | 55 |  | 0
[NAME] (60 points)
1.  Project Revenue Table for FY 2013 (1/1/2013 - 12/31/2013)
 | [NAME] 1 point each time Applicant lists a revenue source, but not does not indicate whether funds |  |  |  |  |  |  |  |  |  | 15 |  | 0
 | are committed or not.
 | [NAME] |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | Award 10 points if leveraging ratio is at least 1 to 10.
 | Award 7 points if leveraging ratio is at least 1 to 5.
 | Award 3 points if leveraging ratio is at least 1 to 1.
 | Award 0 points if leveraging ratio is unable to calculate or less than 1 to 1.
2.  Project-Related Staff Table for FY 2013 (1/1/2013 - 12/31/2013)
 | [NAME] points if Applicant lists [NAME], number of positions, whether positions are full-time |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | or part-time and estimated salary or if field reads "N/A".
 | [NAME] points if percentage of City-Funded Salaries is less than or equal to 50%.
 | Total City-Funded Salaries/Total Salaries = |  |  |  |  | 0 | divided by | 0 | = |  | 10 |  | 0
3.  Project  Expense Table for FY 2013 (1/1/2013 - 12/31/2013)
 | [NAME] 1 point each time Applicant lists an expense, but not does not indicate whether expense |  |  |  |  |  |  |  |  |  | 15 |  | 0
 | is City-Funded or not (Field should read N/A if not City-Funded) and subtract 5 points if project
 | expenses exceed revenues.
 | b. Explanation of bidding process or procurement procedures. If N/A, award 5 points. |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | Award 5 points if Applicant provides an explanation or indicates no City funds will be used to purchase equipment or supplies.
 | Otherwise, award 0 points.
SUBTOTAL Section G. |  |  |  |  |  |  |  |  |  |  | 60 |  | 0
[NAME] CHECKLIST (55 points)
1.  Application Checklist |  |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | Award 10 points if Applicant completed the checklist.  0 points, if they did not.
Submission of Required Documentation Checklist
 | Award full points if Applicant submitted required document(s).  0 points, if they did not.
 | 1.  501 © 3 Letter from IRS or proof of public nonprofit status |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | 2.  Applicant's latest audit report WITH management Letter* |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | *(If Audit contains findings, reportable conditions, or recommnedations, a statement of corrective
 | action should be attached as well).
 | 3.  Most recent IRS Tax Form 990 (12/31/2010 or 12/31/2011) |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | 4.  Organizational chart identifying key personnel, their titles, # of personnel, and expiration date. |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | 5.  List of current Board of Directors with mailing and email addresses as well as term expiration dates. |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | 6.  Commercial Liability Insurance Certificate |  |  |  |  |  |  |  |  |  | 5 |  | 0
 | 7.  2 current Letters of Support from agencies/businesses with whom the Applicant collaborates with.** |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | **(Letters should be less than 1 year old and be program-specific.)
SUBTOTAL Section H. |  |  |  |  |  |  |  |  |  |  | 55 |  | 0
[NAME] (20 points)
1.  Did Applicant submit 1 original application, plus 1 copy of the application (including |  |  |  |  |  |  |  |  |  |  | 10 |  | 0
 | Attachments 1 and 2)? |  |  | Award 10 points, if "YES".  0 Points if "NO".
2.  Did Applicant submit 3 copies of the required documents? Award 10 points, if "YES".  0 Points if "NO". |  |  |  |  |  |  |  |  |  |  | 5 |  | 0
3.  Are required signatures in BLUE INK? |  |  |  |  |  |  |  |  |  |  | 5 |  | 0
SUBTOTAL Section I. |  |  |  |  |  |  |  |  |  |  | 20 |  | 0
 |  |  |  |  |  |  |  |  | MAXIMUM
SCORING |  |  |  |  |  |  |  |  | POINTS |  | SCORE
[NAME] (20 points) |  |  |  |  |  |  |  |  | 20 |  | 20
[NAME] INFORMATION (75 points) |  |  |  |  |  |  |  |  | 75 |  | 0
[NAME]  (70 points) |  |  |  |  |  |  |  |  | 70 |  | 0
[NAME] [NAME] (25 points) |  |  |  |  |  |  |  |  | 25 |  | 0
[NAME]20 points) |  |  |  |  |  |  |  |  | 20 |  | 0
[NAME] (55 points) |  |  |  |  |  |  |  |  | 55 |  | 0
[NAME] (60 points) |  |  |  |  |  |  |  |  | 60 |  | 0
[NAME] CHECKLIST (55 points) |  |  |  |  |  |  |  |  | 55 |  | 0
[NAME] (20 points) |  |  |  |  |  |  |  |  | 20 |  | 0
 |  |  |  |  |  | TOTAL SCORE |  |  | 400 |  | 20
COMMENTS: