Spreadsheet: 09347cc7-a635-4970-909c-b3cc01600484
Sheet: Sheet1

CITY OF IRVINE
2014 Application for CDBG/HOME Funding
CAPITAL PROJECTS
 | Part 1. Agency Requesting Funding:
 | Name of Agency:
 | Agency Address:
 | Name of Project:
 | Project Address/Location:
 | Amount Requested:
 | Type of Funds Requested: |  |  |  |  |  |  |  | CDBG |  | HOME |  | CHDO
 | Prior Years City of Irvine CDBG/HOME Capital Funding:
 |  |  |  |  |  |  |  | 2010 |  | - |  |  |  | - |  |  |  |  |  | - |  |  | -
 | CDBG/HOME Awarded
 | Amount Expended
 | Agency Type: |  |  |  |  | Nonprofit* |  |  | For-profit |  |  |  | Public/Quasi Public |  |  |  |  | [NAME] |  | CBDO
 | (check one) |  |  |  |  | (*If nonprofit, attach verification of 501 c3 status)
 | Faith-based Organization? |  |  |  |  |  |  |  |  | Yes |  |  | No
 | Employer Federal ID#: |  |  |  |  |  |  |  |  |  |  |  |  | [NAME]#:
 | Contact Person for application (name, title, phone and email):
 |  |  |  | Name:
 |  |  |  | Title:
 |  |  |  | Phone:
 |  |  |  | [NAME]:
 | Contact person for administration of the project (name, title, phone and email):
 |  |  |  | Name:
 |  |  |  | Title:
 |  |  |  | Phone:
 |  |  |  | [NAME]:
 | Two officials authorized to sign contracts and expend funds for the organization:
 |  |  |  | Name:
 |  |  |  | Title:
 |  |  |  | Name:
 |  |  |  | Title:
 | Part 2. Statement of Applicant
 | The undersigned acknowledges the following:
 | 1. |  | That, by submission of this application, the organization agrees that the application will become a public document.
 | 2. |  | That, to the best of its knowledge and belief, all information provided is true and correct and all estimates are reasonable.
 | 3. |  | That no revised proposals/applications may be made in connection with this application once the deadline for applications has passed.
 | 4. |  | That the City may request or require additional supporting information to be submitted which it deems reasonable for any and all information provided and that the organization will cooperatively assist in the application review process.
 | 5. |  | That, if the project is recommended and approved by the City Council, the City reserves the right to fund less than the full amount requested. The City also reserves the right to reduce and/or cancel the allocation if federal entitlements are cancelled, reduced, or rescinded.
 | 6. |  | That the City reserves the right not to fund any applications received.
 | 7. |  | By submission of this application, the organization agrees to abide by federal regulations applicable to this project, including, at a minimum, all competitive bidding and prevailing wage requirements. The organization further agrees that City expenses for monitoring and/or enforcement of these regulations will be included as project costs.
 | 8. |  | The organization acknowledges and understands that past project and financial performance will be considered in reviewing this application.
 | 9. |  | That, if the project is funded, the City or a designated agency may conduct an accounting system inspection to review internal controls, including procurement and uniform administrative procedures, prior to issuance of payments for project expenditures.
 | 10. |  | That, if the project is funded, the City will perform a federally mandated environmental review prior to the obligation of funds. The cost for this review will be included as a project cost.
 | 11. |  | That, if the project is funded, a written agreement will be required that includes, among other matters, a statement of work, records retention and reporting, compliance with local and federal requirements, and circumstances that would trigger payment suspensions and terminations.
 | 12. |  | That, if the project is funded, a deed of trust and/or land use restriction will be recorded on legal title of the subject property for the loan or grant and/or project term.
 | 13. |  | That proof of insurance will be submitted to the City prior to receiving funds. Insurance requirements are outlined in the Notice of Funding Availability for this application.
 | 14. |  | That written signature authority from the organization's governing body indicating who can execute contracts and amendments on its behalf will be submitted to the City prior to receiving funds.
 | 15. |  | That the organization agrees to abide by the City's Conflict of Interest Policy. Items of concern would include Board of Directors of staff member's families having a monetary interest in any contract made by the City, and other matters that may give the appearance of a conflict of interest.
 |  | By signing below, the applicant acknowledges the above.
Name: |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Title:
Signature: |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date:
 | Part 3. Application Checklist
 | Please complete the following questionnaire/checklist, and make sure you attach the documentation requested.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Yes | No | N/A
 | 1. |  | Is the proposed project located within the City limits of [NAME]? (provide site map and 3X5 or 4X6 color photographs of the project area)
 | 2. |  | Do you own or otherwise have site control for the property? (provide proof and legal description)
 | 3. |  | If you do not own the property and your project includes property acquisition, do you have an agreement with the owner to acquire the property? (provide copy of the agreement)
 | 4. |  | Does your project meet current Irvine zoning and land use designations?
 | 5. |  | Does your target population meet program income guidelines for Orange County?
 | 6. |  | Does project budget include the required minimum 25% matching funds?
 | 7. |  | If housing rehabilitation, are all of the units currently vacant?
 |  |  | If no, will the project require temporary or permanent relocation?
 |  |  | If relocation will occur, have adequate funds been budgeted to cover the costs?
 | 8. |  | If housing rehabilitation, does your project include any units previously acquired and/or rehabilitated with CDBG/HOME funds? (if yes, provide explanation why funds are needed and provide documentation of prior expenditures)
 | 9. |  | For new construction, does your project comply with all applicable accessibility requirements, including the Architecture Barriers Act of 1968, the Fair Housing Act, and the Americans with Disabilities Act?
 | 10. |  | Is your project exempt from Davis-Bacon wage rates?
 |  |  | If no, is this cost (wage rates & monitoring) reflected in your project budget?
 | 11. |  | Do you already have a contractor selected for the project?
 |  |  | If yes, did you follow the federal competitive bidding procurement process?
 | Part 4. Project Information
 | This proposal is for (check all that apply):
 |  | Rental Housing: |  |  |  |  |  |  |  |  |  |  |  |  |  | Ownership Housing:
 |  |  | New Housing Construction |  |  |  |  |  |  |  |  |  |  |  |  |  | New Housing Construction
 |  |  | Property Acquisition |  |  |  |  |  |  |  |  |  |  |  |  |  | Property Acquisition
 |  |  | Rehabilitation/Conversion |  |  |  |  |  |  |  |  |  |  |  |  |  | Rehabilitation/Conversion
 |  | Other Housing: |  |  |  |  |  |  |  |  |  |  |  |  |  | Community Development:
 |  |  | Disabled Housing |  |  |  |  |  |  |  |  |  |  |  |  |  | Community Facility ADA Improvements
 |  |  | Senior Housing |  |  |  |  |  |  |  |  |  |  |  |  |  | Other
 |  |  | Supportive Transitional Housing
 |  |  | Supportive Permanent Housing
 | For the narrative questions that follow, you may either answer the questions in the space provided, or you may attach one page (no more) for each question, with a restatement of the question at the top of the page. If you choose to answer a question on a separate page, please indicate such following that question in the applicable form.
 | 1. |  | Describe your project. Explain how the project will benefit the community. Describe the target population in detail and note how many unduplicated households/individuals the project will serve, their incomes, and whether they are part of any priority special needs groups. For affordable housing, explain the proposed period of project affordability.
 | 2. |  | Describe how your project meets the goals of the Irvine CDBG and/or HOME programs, as detailed in the Consolidated Plan and outlined in the Notice of Funding Availability for this application.
 | 3. |  | How have you determined that there is a need for the project you are proposing? Please describe in detail the severity of the need(s) you will be targeting, how you have determined this severity, and the extent to which your project will address it.
 | 4. |  | If you are seeking funds for housing and/or public facility rehabilitation, what is the specific basis for your assessment of the repairs needed? Please provide documentation.
 | Part 5. Project Schedule & Financing
 | Project Schedule: General construction tasks are provided below; please add tasks as needed. If not applicable, write N/A.
 | Project Element |  |  |  |  |  |  |  |  |  |  |  |  | Begin Date |  |  |  |  |  | End Date
 | Define scope of work/finish design
 | Release bid package
 | Environmental clearance
 | Select contractor
 | Finalize contract
 | Obtain building permits
 | Labor compliance
 | Start construction
 | Complete construction
 | Project occupancy
 | If the project will not be completed by the end of the program year on June 30, 2015, please explain why.
 | Sources of Funding: Please list the sources of funding you anticipate using to complete development of this project. List the amount of CDBG and/or HOME funding you are seeking first, followed by other sources. Include the amount secured/sought, whether it is a loan, grant, or other type of funding (e.g. in-kind, donated materials/labor, owner equity, etc.) the terms if a loan, and the status of your request or application
 | Source (please write 'federal' if funding is from a federal source) |  |  |  |  |  |  | Amount |  |  |  | Type (Grant, Loan, other) |  |  |  | Loan Terms |  |  |  | Status (Not Yet Applied, Committed, In Hand, or Unknown)
 | CDBG/HOME (this application) |  |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Not Yet Applied
 |  |  |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Committed
 |  |  |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | In Hand
 |  |  |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Unknown
 |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  | 0
 | Please explain if the project depends on any other funding sources that are not already committed or in hand.
 | Does the project depend on receiving 100% of your CDBG/HOME funding request? If you are not approved for 100% of your funding request, how will you address the shortfall?
 | Use of Funding (You may substitute a comparable document in your agency's own format)
 | Activity |  |  |  |  |  |  |  |  |  |  |  |  | Cost |  |  |  | Funding Source
 | Acquisition Costs
 | Purchase price - land |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Purchase price - improvements |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Liens and other taxes |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Closing/recording costs |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Other: |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Acquisition Subtotal
 | Development Costs
 | Land use approvals |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Activity |  |  |  |  |  |  |  |  |  |  |  |  | Cost |  |  |  | Funding Source
 | Building permits/fees |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Market study |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Environmental reviews |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Property survey |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Marketing |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Insurance |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Fees
 | Architectural |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Engineering |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Legal |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Accounting |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Appraisals |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Construction loan fees |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Permanent loan fees |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Tax credit fees |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Closing fees |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Developer fee |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Consultant fee |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Other: |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Interest
 | Construction period |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Bridge loan |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Other: |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Reserves/Contingency
 | Lease up/operating |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Development |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Tenant relocation |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Other: |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Development Subtotal
 | Construction Costs
 | On-site infrastructure/utilities |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Residential construction/rehabilitation |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Common-use facilities construction/rehabilitation |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Laundry facilities |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Storage/garages |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Landscaping |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Construction contingency |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Davis-Bacon Monitoring |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Other: |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Other: |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Construction Subtotal
 | Total Project Costs
 | Describe the means you used to estimate or determine the above project costs.
 | Matching Funds: [NAME] below the amount of matching funds in your project, including the source of each amount. Each project must provide at least 25% non-federal match for the CDBG/HOME funds being requested.
 |  |  | Total CDBG/HOME funds sought: |  |  |  |  |  |  |  |  |  |  |  |  |  | $
 |  |  | Matching Funds target (25% of CDBG/HOME funding): |  |  |  |  |  |  |  |  |  |  |  |  |  | $
 |  |  | Total Matching Funds provided by project: |  |  |  |  |  |  |  |  |  |  |  |  |  | $
 | Matching Funds Source |  |  |  |  |  |  |  |  |  |  |  |  |  | Amount
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Total Matching Funds Provided by Project
 | Operating Income for Rental Projects: (You may substitute a comparable document in your agency's own format)
 | Operating Income |  |  |  |  |  |  |  |  |  |  | Monthly |  |  | Year 1 |  |  |  | Year 5 |  |  | Year 10
 | Rent for |  |  |  | bedroom units less |  |  |  |  | utilities |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Rent for |  |  |  | bedroom units less |  |  |  |  | utilities |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Rent for |  |  |  | bedroom units less |  |  |  |  | utilities |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Rent for |  |  |  | bedroom units less |  |  |  |  | utilities |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Less vacancy at |  |  |  |  |  |  | % |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Other income (laundry, etc.) |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Resident services income |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Total Operating Income
 | Operating Expenses
 | Taxes |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Insurance |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Advertising/Marketing |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Utilities (non-tenant paid) |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Property management fees |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Accounting/legal/other professional |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Grounds maintenance/repair |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Building maintenance/repair |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Cleaning/supplies |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Maintenance reserves |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Total Operating Expenses
 | Total Net Project Income
 | Debt Service
 |  |  | % on $ |  |  |  | for |  |  | years |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 |  |  | % on $ |  |  |  | for |  |  | years |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 |  |  | % on $ |  |  |  | for |  |  | years |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Total Debt Service
 | Total Cash Flow |  |  |  |  |  |  |  |  |  |  | 0 |  |  | 0 |  |  |  | 0 |  |  | 0
 | Debt Coverage Ratio (Total Net Project Income/Total Debt Service)
 | Describe the assumptions you used to estimate the above operating income and costs, including inflation factors. Indicate which utilities the tenants will be expected to pay.
 | Part 6: Applicant Information
 | Please list the members of your development team, along with phone numbers and email addresses. Please include resumes for all agency/owner and contracted professional who will have project responsibilities.
 | Role |  |  |  |  |  |  | Name |  |  |  |  |  | Phone |  |  |  |  |  | E-mail
 | Owner/Director
 | Owner/Development Staff
 | Owner/Development Staff
 | Owner/Development Staff
 | Owner/Development Staff
 | Architect
 | Engineer
 | Consultant
 | Contractor
 | Property Manager
 | Other:
 | Other:
 | Other:
 | Describe all similar projects your organization has carried out in the last five years. For each project, provide a reference name and telephone numbers from the local participating city and/or county that provided CDBG and/or HOME funding.
 | Describe in detail your organization's familiarity and experience with federal requirements for competitive procurement and Davis-Bacon Wages.
 | Please provide a copy of your most recent audited financial statement, or, if your organization is not required to perform audits, copies of your most recent balance sheet and income statement.
 | Identify and describe any audit findings, liens, investigations, or probation by any oversight agency in the past five years. If none, please state none.
 | If your project is for construction or rehabilitation of rental housing, describe your supportive services plan, who will provide the services, and the types of residents it will serve.
 | If your project is for home ownership housing, describe the services that will be provided to future owners and who will provide the services.
 | Describe any green building techniques that will be employed in carrying out your project.
 | For projects requesting $100,000+, please describe what you will do to assure that employment and/or job training opportunities for low income individuals are provided, per HUD Section 3 requirements.
 | Please describe what steps you will take to ensure that efforts to hire MBE or WBE businesses for your project are documented.
 | Please attach a letter from your Executive Director or Board President describing the need for your project and how the project will meet that need.