Region 6 – Central Texas Bastrop Bell Blanco Bosque Brazos Burleson Burnet Caldwell Coryell Falls Fayette Freestone Grimes Hamilton Hays Hill Lampasas Lee Leon Limestone Llano Madison McLennan Mills Robertson San Saba Travis Washington Williamson Region 7- East Texas Anderson Angelina Bowie Camp Cass Cherokee Delta Franklin Gregg Hardin Harrison Henderson Hopkins Houston Jasper Jefferson Lamar Marion Morris Nacogdoches Newton Orange Panola Polk Rains Red River Rusk Sabine San Augustine San Jacinto Shelby Smith Titus Trinity Upshur Van Zandt Wood Region 8 – Texas Archer Baylor Clay Collin Cooke Cottle Dallas Denton Ellis Fannin Foard Grayson Hardeman Hood Hunt Jack Johnson Kaufman Montague Navarro Palo Pinto Parker Rockwall Somervell Tarrant Wichita Wilbarger Wise Young Proposed Project Services Briefly describe the Proposed Project. Be specific in your answer and include the Who, What, Where, and When of the Project. Briefly describe how Beneficiaries will access and/or be provided with Project services by your organization. Be specific in your answer and include the How of the Project. Need Identified What is the community need(s) or existing service gap(s) that the Proposed Project will address? Be specific in your answer and sufficiently describe the need that your service area faces to include the Why of the Project. How did you identify the community need(s) or problem(s)? Be specific in your answer and sufficiently describe any methods used to identify that the need described above in Need Identified #1 is present in your service area. Include references to data that may substantiate and support that this need exists in your service area. How will the Proposed Project address the identified need(s) or problem(s)? Be specific in your answer and sufficiently describe how the components of the Proposed Project as described above in Proposed Project Services #1 will assist in attempting to resolve the need described above in Need Identified #1.
$ Total Other Grants/Contracts Awards Provide a brief narrative for each TVC (non-FVA) contract that is listed in the above table. Fiscal Management Answer each question below and do not leave any item unanswered. What software does your organization used to record accounting transactions? QuickBooks Sage MIP Fundware Other (If other, list software) Does your organization have written accounting policies and procedures for the following? Please be aware that you may be asked to provide copies of the below policies and procedures to FVA staff should you be awarded a grant. Do not list N/A. YES NO Procurement Vendor Payments Payroll Grants Administration Cash Management Travel Capitalization and Equipment Indicate if each statement is true or false for your organization. Do not list N/A. TRUE FALSE There has been no staff turnover or reorganization in the past 6 months. The organization uses a Chart of Accounts. Time sheets are approved and signed by supervisory personnel. An A-133 Single has been performed in the past 2 years. Travel receipts are submitted for travel reimbursement requests. At what amount does your organization capitalize equipment? $ Performance Reporting What type(s) of data collection tools will your organization use to document Beneficiaries receiving services, the number of home modifications completed, and any other additional performance measures in Beneficiaries #3 a., b., and c.? How will your organization consolidate the collected data to ensure that beneficiaries that are reported to the FVA are unduplicated? Part III – Budget Tables and Budget Narratives The budget is broken up into Direct and Indirect Costs. Within Direct Costs there are seven allowable sections. Indirect Costs has one section. Each section represents a Budget Category that will make up your Total Grant Amount Request. The total grant amount request must equal the Amount Requested checked in Part I – Proposed Project.
$ $ $ $ $ $ Total Table E $ Provide a description for each item of supply listed in the Table above and explain why each supply item is necessary to accomplish the Proposed Project. Narrative must also include a calculation to demonstrate how the cost was determined. If this is a continuation request and your organization was previously awarded funding for the Proposed Project, note each item of supply listed in the Table above that was also requested as part of a previously funded application and explain why it is being requested again. Examples of such items of supply may include laptops, projectors, printers, and phones. Client Services List each client service and the cost of each service. Client Services may include, but is not limited to, participant support such as rental assistance, transportation assistance for Veterans in shelters, household set-ups for Veterans provided with housing, mileage for staff to transport a client, and any contract personnel that will be providing services to Beneficiaries. An itemized break-out of each client service is required, and extra lines may be inserted into this table. For Home Modification assistance projects, typical Client Services costs include contract labor and supplies. Please note that the maximum amount H4TXH funding for home modification assistance per Veteran household is $15,000. Grantees may utilize other revenue streams in addition to H4TXH funding to fund additional projects on a home modification. F Client Service Average Cost per Client No. of Clients to be Served Total Cost $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Total Table F $ Provide a description for each Client Service listed in the Table above and explain why each cost is necessary to accomplish the Proposed Project. Include, if applicable, the maximum amount of assistance to be provided to clients. Narrative must also include a calculation to demonstrate how the cost was determined. For Home Modification Projects, narrative calculation must include estimated contract and supplies costs used to determine the average home modification cost per Veteran household. Construction The FVA grant does not cover the cost of construction. This line is blank.