General application

Franklin County FCAHTF Oversight Committee

Affordable Housing Trust Fund (FCAHTF) Use Only

GENERAL APPLICATION

FOR ALL ACTIVITIES Project Name:

Project Number: FCAHTF Oversight Committee

c/o Benton Franklin Community Action Committee

720 W. Court St.

Pasco, WA 99301

[phone]

GRANT/LOAN GENERAL APPLICATION

FRANKLIN COUNTY AFFORDABLE HOUSING TRUST FUND

A. PROJECT SUMMARY:
1. Applicant:      

Contacts:       Phone:      

      Phone:      

E-mail:       Fax:      

Mailing Address:     

Street Address:      

2. Activity (s)Addressed:

      Acquisition, Rehabilitation, or Construction of housing projects or housing units

      Rental Assistance

      Operations& Maintenance (WA Housing Trust Fund projects only)

      Operations for emergency shelter or licensed youth shelter
3. Target Population(s):

     

4. Project Location(s):

     

5. Proposed Activity:

     

6. Estimated Beneficiaries: Number of Units            

Number of Persons             0-30% AMI 31-50% AMI

7. Proposed Time Frame for Completion of Project:

     

8. 
   Amount of FCAHTF Funds Requested: $      grant $      loan
   

The Signature below certifies that the applicant will conduct the proposed activity in the location, manner, time, and within the budget presented. The applicant also promises that FCAHTF funds will be used in the manner described and will be used only to reimburse those eligible costs described in the approved project budget and any other types (sources and amounts) of funds presented in the budget will be obtained and used for the project.

     

Signature of Authorized Official Title

           

Name (please print or type) Date

Type of Applicant       Organization’s Federal ID #:     

(Non-profit, for-profit, municipality, public agency, individual, other)

B. PROPOSED ACTIVITIES DESCRIPTION (Limited to 5 pages total, Arial 11 or Times 12 font):

1. 
   Project Description:
   

     

2. 
   Project Management: (For real estate projects, describe management during the project’s development and property management when it is completed).
   

     

3. 
   If the project intends to serve a specific target population (e.g. disabled, migrant workers, seniors), describe intended outreach activities.
   

     

4. 
   Project Outcomes/Results:
   

     

5. 
   What experience and/or qualifications does the applicant possess to carry out the project as proposed?
   

     

6. 
   Are these funds replacing other funding sources? If yes, please explain:
   

     

7. 
   Do these funds leverage other funding sources (providing match dollars)? If so, please identify:
   

     

8. 
   What will be the effect on the project if uncommitted funds are not received?
   

     

9. 
   How will the proposed project’s Operating and Maintenance expenses be met beyond the period that is requested?
   

     
C. ESTIMATED BUDGET

1. Proposed Project Activities	2. FCAHTF Funding Request	3. Other Funding Estimates (From Section I, below)	4. Total Estimated Funding (Sum of columns 2 & 3)
a. Acquisition
b. Rehabilitation
c. New Construction
Subtotal: Capital Project Costs (Sum of lines a - b)
d. Real Property Leasing
e. Supportive Services
f. Operations
g. Rental Assistance
Subtotal: Non-Capital Program Costs (Sum of lines d - g)
^h. Administrative Costs
TOTAL ESTIMATED BUDGET (Sum of funding totals for Capital, non-Capital, & Admin Costs)

D. ESTIMATED FUNDING/MATCH

Funding Source	A. COMMITTED/ CONDITIONAL	b. PROPOSED	C. TOTAL (A + B)
FCAHTF FUNDS	$	$	$
STATE FUNDS (Describe and name source):
1.	$	$	$
2.	$	$	$
3.	$	$	$
4.	$	$	$
FEDERAL FUNDS (Describe and name source):
1.	$	$	$
2.	$	$	$
3.	$	$	$
4.	$	$	$
OTHER LOCAL GOVERNMENT CONTRIBUTIONS (Describe and name source):
1.	$	$	$
2.	$	$	$
3.	$	$	$
4.	$	$	$
NONPROFIT/PRIVATE CONTRIBUTIONS (Describe and name source):
1.	$	$	$
2.	$	$	$
3.	$	$	$
4.	$	$	$
TOTAL STATE, FEDERAL, LOCAL AND PRIVATE FUNDS:	$	$	$

APPLICANT ASSURANCES

Read the Applicant Assurances (below) numbered 1 through 14 and sign where indicated. Submit the signed original with your application. Your signature indicates that you have read, understand, and agree to the 2007 FCAHTF Request for Proposals application instructions and program rules. These rules regulate the application, selection, fund allocation, and contracting process. Some of these rules may not apply to your individual activity.

1. 
   Applicant is an equal opportunity employer and/or provider of housing and/or services.
   

2. 
   Organizations and/or individuals that are selected for FCAHTF funding must have and maintain sound, acceptable, sufficient, and appropriate systems, including staff, to manage the fiscal, personnel, and project compliance responsibilities necessary to conduct the proposed activity.
   

3. 
   Organizations may not be able to use funds if they have an unresolved audit finding. Organizations are responsible for notifying the Benton Franklin Community Action Committee (hereafter the “Administrator”) prior to submitting an application (if they have an unresolved audit finding) to identify their efforts in correcting any noted deficiencies. Failure to do so will result in the immediate termination of the FCAHTF contract (if funded).
   

4. 
   Organizations and/or individuals agree to submit a copy of their most recent audit or current financial statement, signed and certified by an authorized representative of the applicant agency, with the FCAHTF application.
   

5. 
   City Councils and/or their designee(s), County Board of Commissioners and/or their designees(s), business owners or other legally designated corporate officers must approve of and agree to supervise (as appropriate or required under State laws or corporate bylaws) the proposed activity.
   

6. 
   Applications must propose an activity that will benefit very low-income residents of the cities, towns or unincorporated areas of Franklin County. Applications not complying with these requirements will be rejected and will not be eligible for funding.
   

7. 
   In submitting a signed application(s), the applicant/organization promises: 1) To conduct the proposed activity in the location, manner, time, and within the budget presented on the application form; 2) That the proposed activity addresses a priority need for the proposed beneficiaries; and 3) That FCAHTF funds will be used in the manner described and will be used only to reimburse those eligible costs described in the approved project budget and that any other types (sources and amounts) of funds presented in the budget will also be used for the project; or as an advance to defer bridge and construction financing costs.
   

8. 
   An eligible applicant may submit more than one proposal for consideration. Multiple applications must be marked with the order of their priority in regard to consideration for selection. Proposals that address several different needs or several problems and propose several activities should be submitted as separate proposals. The FCAHTF Oversight Committee reserves the right to select any or all proposals for funding consideration.
   

9. 
   Selected projects may be given either grants or loans based on the recommendations of the FCAHTF Oversight Committee and the Administrator. The FCAHTF Oversight Committee reserves the right to lend funds as either non-recourse or as recourse loans.
   

10. 
    All or part of an activity may be selected for funding. The level of funding recommended for a project may differ from the proposed budget based on FCAHTF Oversight Committee action. If an activity is funded at other than the requested amount, upon notification of the recommended funding level, the applicant must: a) certify that the activity can be conducted at that level, b) provide a revised budget reflecting the actual amount of FCAHTF funds awarded, and c) provide necessary revised application documents reflecting activity levels and beneficiary levels at the recommended funding amount. If, after reviewing this documentation and consulting with FCAHTF staff, the applicant, and/or other interested parties, it is determined that the activity can not be effectively conducted at the recommended funding level, the FCAHTF Oversight Committee reserves the right to withdraw its original funding recommendation and allocate those funds to other projects.
    

11. 
    An applicant to whom FCAHTF funds are awarded (known hereafter as “Recipient”) shall enter into a written contractual agreement with the Administrator and shall be subject to the terms and conditions of said agreement and the Administrator’s contract management procedures.
    

12. 
    Recipient will be required to agree to indemnification, insurance, and fidelity bond coverage in the following particulars:
    

1. 
   The Recipient shall hold harmless, indemnify and defend the Administrator, the FCAHTF Oversight Committee, Franklin County, City of Pasco, City of Connell, City of Mesa, City of Kahlotus, and all their officers, officials, employees and agents, from and against any and all claims, actions, suits, liability, loss, expenses, damages, and judgments of any nature whatsoever, including reasonable costs and attorneys' fees in defense thereof, for injury, sickness, disability or death to persons or damage to property or business, caused by or arising out of the Recipient’s acts, errors, or omissions in the performance of the contract. PROVIDED, that the Recipient’s obligation hereunder shall not extend to injury, sickness, death or damage caused by or arising out of the sole negligence of the Administrator, the FCAHTF Oversight Committee, Franklin County, City of Pasco, City of Connell, City of Mesa, City of Kahlotus, and/or their officers, officials, employees or agents.
   
2. 
   Recipient shall, at its own expense, maintain General Liability Insurance, Comprehensive Automobile Liability Insurance, and other such coverage, as may be required by law or regulation, in minimum limits of One Million Dollars ($1,000,000.00) per individual and per occurrence, Two Million Dollars ($2,000,000.00) annual aggregate for personal injuries death, and and property damage, worker’s compensation coverage in accordance with requirements of Washington State law. The Administrator shall have no responsibility for the reporting of insured occurrences or for the payment of any insurance premiums.
   
3. 
   The Administrator, the FCAHTF Oversight Committee, Franklin County, City of Pasco, City of Connell, City of Mesa, City of Kahlotus, and all their agents and employess shall not be liable to the Recipient or to any insurance company (by way of subrogation or otherwise) to insure the Recipient for any loss or damage to any person, building, structure, or tangible personal property of the other occurring as a result of activity under the contract, even though such loss or damage might have been occasioned by the negligence of the Administrator, the FCAHTF Oversight Committee, Franklin County, City of Pasco, City of Connell, City of Mesa, City of Kahlotus, and all their agents or employees, if such loss or damage is covered by insurance benefiting the Recipient suffering such loss or damage required to be covered by insurance under terms of the FCAHTF Agreement. Recipient shall cause each insurance policy obtained by it to contain this waiver of subrogation clause.
   
4. 
   Recipient shall be required to provide evidence of employee dishonesty (errors and omissions) coverage in a minimum cumulative amount of Five Hundred Thousand Dollars ($500,000.00) or the amount of the FCAHTF Agreement, whichever is less, which shall be conditioned upon the Recipient faithfully accounting for all funds received and further assuring that such funds are used for the purposes of the FCAHTF Agreement.
   

(The FCAHTF Oversight Committee recognizes that the insurance requirements may pose a barrier to some applicants. Increases in coverage and premiums to meet the requirements, covering a proposed project, are eligible project costs).

13. 
    Special project contingencies or implementation conditions may be included in final recommendations, based on Franklin County, FCAHTF Oversight Committee, or Administrator recommendations.
    

14. 
    Applications must be submitted only on the 2007 Franklin County Affordable Housing Trust Fund Application Forms.
    

15. 
    Attendance at the Applicant Workshop on Tuesday, December 20, 2006 is highly recommended but is not mandatory. However, all applicants are required to comply with all 2006 Request For Proposals requirements, including any newly instituted during current funding cycle.
    

I have read and understand the terms and conditions set forth above, and further, agree to the terms and conditions listed above.

Signature of Authorized Official Title of Authorized Official Date

Typed or Printed Name of Official

Rev. November 2006 A-