CITY OF TUCSON/PIMA COUNTY
CITY OF TUCSON/PIMA COUNTY
HOME FUNDING APPLICATION
RENTAL DEVELOPMENT PROJECTS
The City of Tucson/Pima County HOME Consortia is now accepting proposals for the development of affordable rental housing. These funds will be made available at below market interest rates for rental housing production projects. Each proposal will be evaluated and funding will be determined on a case-by-case basis.
The purpose of the program is to increase the supply of affordable rental housing for low and very low –income families by establishing new public/private partnerships. The program can provide financial assistance to for-profit or non-profit developers.
The Rental Housing Partnership Program’s intent is to provide gap funding for acquisition of standard property, acquisition and rehabilitation of substandard property, rehabilitation of substandard units a developer already owns, or construction of new units. Loan repayment terms may range from 15 years to 40 years.
The goal of Rental Housing Partnership is to preserve and increase the supply of affordable rental housing through public/private partnerships
Proposals are being accepted on a first-come, first-serve basis, subject to direction from City/County management, until all funds have been awarded. To submit proposals, or if technical assistance is needed, please contact:
Glenn Moyer
City of Tucson
Division Administrator
Housing & Community Development Department, Planning & Community Development Division
(520) 837-5422 / Fax (520) 791-2529
email: Glenn.Moyer@
310 N Commerce Park Loop * P.O. Box 27210 * Tucson, AZ 85726-7210
Marcos Ysmael
Pima County
Housing Program Manager
Pima County Community Development & Neighborhood Conservation Department
Phone: (520) 724-2460 / Fax: (520) 791-6622
email: marcos.ysmael@
El Banco Housing & Barrio Sustainability Center, 801 W. Congress, Tucson, AZ 85745
| 1. PROJECT NAME: |For City/County Use Only: |
| |City Project ( |
| |County Project ( |
| |CHDO Project ( |
| |Date Received:____________ |
2. APPLICANT INFORMATION:
For-Profit CHDO Non-Profit
Project Name:
Applicant:
Contact Name: Title:
Address/City/State/Zip:
Telephone: Fax:
Email: Tax Identification Number:
NOTE: A list of Officers/Board of Directors, copy of Articles of Incorporation and By-Laws for your organization, Corporate Resolution approving this application, and recent Financial Audit are required to be submitted with this proposal.
2a. CO-APPLICANT INFORMATION
For-Profit CHDO Non-Profit
Co-Applicant:
Contact Name: Title:
Address/City/State/Zip:
Telephone: Fax:
Email:
Is the owner/applicant/co-applicant or anyone else associated with the proposed project a City of Tucson or Pima County employee? Yes No If Yes, please indicate relationship:
Employee: Department:
3. PROJECT INFORMATION
Project Name:
Project Address (if available):
Legal Description (if available):
Parcel ID Number(s) (attach Location Map):
If project involves purchase of an unidentified property, please explain:
Zoning (provide documentation on current zoning):
|Project Activity (check all that apply): |
| |Acquisition of Unimproved Land |
| |Demolition |
| |New Construction |
| |Acquisition of Existing Building(s) |
| |Substantial Rehabilitation (Over $25,000 per Unit) |
| |Moderate Rehabilitation (Under $25,000 per Unit) |
| |Other (explain) |
Amount of Funds Requested:
Funds are requested for: Acquisition Renovation New Construction
Other (explain)
Number. of units: Total Project Square Footage:
Number of Handicap Accessible units:
Property Address:
Was property previously financed, built or renovated with federal funds?
Yes No Don’t Know If Yes, please explain:
4. ENVIRONMENTAL ISSUES
|YES |NO | |
| | |Will any part of the project be undertaken in or adjacent to a floodplain? |
| | |Will any part of the project involve properties 45 years old or older? |
| | |Will any part of the project be undertaken in geological hazard areas, or affect historical, archaeological, or cultural resources? |
| | |Will any part of the project be undertaken near an airport or military airfield? |
| | |Will any part of the project be located within 1,000 feet of a major road, 3,000 feet of a railroad, or near some other noise hazard? |
| | |Will any part of the project be located within one-mile of above-ground storage tanks, transmission pipelines, or loading facilities for |
| | |explosive or fire-prone substances? |
5. HOME UNITS
|Total Number of Units: |0 Bed | |Total Number of HOME Units: |0 Bed | |
| |1 Bed | | |1 Bed | |
| |2 Bed | | |2 Bed | |
| |3 Bed | | |3 Bed | |
NOTE: If total # of HOME units exceeds 11, Davis-Bacon Wages apply for the entire Development.
HOME Units are Designated: Floating Fixed
Will all HOME and Market Units be Comparable? Yes No If no, please explain:
Rent: Number of Low HOME Rent Units: Number of High HOME Rent Units:
Utilities: Indicate which utilities the tenant will be responsible for:
|ELECTRICITY | |
|ELECTRIC HEAT | |
|ELECTRIC HOT WATER | |
|ELECTRIC COOKING | |
|EVAP. COOLING | |
|A/C | |
|GAS HEAT | |
|GAS HOT WATER | |
|GAS COOKING | |
|WATER/SEWER (City) | |
|TRASH (CITY) | |
|TRASH (COUNTY ONLY) | |
|REFRIGERATOR | |
|RANGE | |
|PROPANE HEAT | |
|PROPANE HOT WATER | |
|PROPANE COOKING | |
Utility Rates: Will all new construction or rehab units meet the Tucson Electric Power Energy Guarantee Standard?
Yes No
Income: Number of HOME Units Rented at or Below 50% of AMI:
Number of HOME Units Rented at or Below 60% of AMI: Number of HOME Units Rented at or Below 80% of AMI:
Total Development Cost Per Unit:
City/County HOME Cost Per Unit:
Other Federal Funds Per Unit: Source/Type:
Other Federal Funds Per Unit: Source/Type:
Affordability Period:
|Home Investment per Unit |Length of the Affordability Period |
|Less than $15,000 |5 years |
|$15,000 - $40,000 |10 years |
|More than $40,000 |15 years |
|New construction of rental housing |20 years |
Extended Affordability Period: years (Extended Period is generally the length of the Loan)
NOTE: HOME dollars may not be reinvested in a project during the affordability period.
6. PROJECT DEVELOPMENT BUDGET – SOURCES AND USES STATEMENT
Applicants should detail funding sources and the use of this funding during the construction phase. Include a separate budget for the permanent financing to be acquired by the applicant.
Income:
Please include all funding sources. If more space is needed, attach additional sheets. Please designate Match funds with an asterisk (*), and attach documentation verifying the level of commitment for this project. If funds have been applied for, but there is no commitment, that should be noted and explained.
| |Sources of Funds |Amount Committed: |
| | |(NC = not Committed) |
|State: | | | |
| | | | |
|Federal: | | | |
| | | | |
|City of Tucson: | | | |
| | | | |
|Other Public: | | | |
| | | | |
|Applicant: | | | |
| | | | |
|Private: | | | |
| | | | |
|Other: | | | |
| | | | |
| | | | |
**TOTAL FUNDING SOURCES:
**This figure must be the same amount as Total Project Cost on following chart.
7. USES OF FINANCING AND PROJECT BUDGET
|RENTAL HOUSING (MULTI- OR SINGLE-FAMILY OR TRANSITIONAL) |
|A |B |C |D |E |F |G |
|Activity |HOME |State Housing |Other Sources |Total Project Cost |Matching Fund Amount |Source |
| | |Fund | |(B+C+D) | | |
|Acquisition | |
|Land | | | | | | |
|Existing Structures | | | | | | |
|Other (specify) | | | | | | |
| | | | | | | |
|Site Improvements | |
|Off-site | | | | | | |
|On-site | | | | | | |
|Landscaping | | | | | | |
|Other (specify) | | | | | | |
| | | | | | | |
|Constrution Costs | |
|Demolition | | | | | | |
|Rehabilitation | | | | | | |
|Direct Construction | | | | | | |
|Cons. Contingency | | | | | | |
|Permits/Fees Not Paid by | | | | | | |
|Builder | | | | | | |
|Builder’s Profit | | | | | | |
|Builder’s Overhead | | | | | | |
|Cons. Supervision | | | | | | |
|Performance Bond | | | | | | |
|Lead Paint Abatement | | | | | | |
|Other (specify) | | | | | | |
| | | | | | | |
|Professional Fees | |
|Architectural Design | | | | | | |
|Architect Supervision | | | | | | |
|Engineering Fees | | | | | | |
|Soils Report | | | | | | |
|Environmental Review | | | | | | |
|Legal Fees | | | | | | |
|Consultant | | | | | | |
|Other (specify) | | | | | | |
| | | | | | | |
|Construction Loan Costs | |
|Loan Fee | | | | | | |
|Interest | | | | | | |
|Insurance | | | | | | |
|Credit Enhancement | | | | | | |
|Cons. Period Taxes | | | | | | |
|Credit Report | | | | | | |
|Title and Recording | | | | | | |
|Other (specify) | | | | | | |
| | | | | | | |
|Related Costs |
|Developer’s Fee | | | | | | |
|Appraisal | | | | | | |
|Building Permit fees paid by | | | | | | |
|Builder | | | | | | |
|Market Study | | | | | | |
|Attorney Fees | | | | | | |
|Operating Reserve | | | | | | |
|Perm Loan Orig. Fee | | | | | | |
|Project Audit | | | | | | |
|Other (specify) | | | | | | |
| | | | | | | |
|Relocation Costs |
|Temporary Relocation | | | | | | |
|Permanent Relocation | | | | | | |
|Permanent Loan Costs | | | | | | |
|Origination Fee | | | | | | |
|Credit Enhancement | | | | | | |
|Title and Recording | | | | | | |
|Other (specify) | | | | | | |
| | | | | | | |
|TOTAL: | | | | | | |
8. PROJECTED OPERATING BUDGET FOR RENTAL PROJECTS
RESIDENTIAL INCOME (Unit Type):
| |0 BR X | |Rent/Month X 12 = |………………… | |
| |1 BR X | |Rent/Month X 12 = |………………… | |
| |2 BR X | |Rent/Month X 12 = |………………… | |
| |3 BR X | |Rent/Month X 12 = |………………… | |
| |4 BR X | |Rent/Month X 12 = |………………… | |
| |4 BR X | |Rent/Month X 12 = |………………… | |
| |5 BR X | |Rent/Month X 12 = |………………… | |
|GROSS RESIDENTIAL INCOME | |
|Less Vacancy Loss (Projected Rate) % x Gross Residential Income = | |
|Total Residential Income. Gross Residential income - vacancy loss = | |
|Other Revenue (Identify): | |
|Other Revenue (Identify): | |
|TOTAL RESIDENTIAL INCOME: | |
|TOTAL GROSS INCOME (Other Revenue + Total Residential Income): | |
(If more space is needed, attach additional sheets)
9. HOME LOAN TERMS
Loan Amount: Percentage Rate: 2% Fully Amortized Annual Payment: (Payment Deferral Available)
15-YR: 30-YR: 40-YR: ** NOTE: HOME loan payment must be included on Proforma.
10. OPERATING EXPENSES
|Salaries & Personnel | |
|Contract Services/Utilities | |
|Administrative & Marketing | |
|Real Estate Taxes (501C3 exception) | |
|Insurance | |
|Repairs & Maintenance (Buildings & Grounds) | |
|Replacement Reserve | |
|Operating Reserve | |
|Management Fees | |
|Legal & Accounting Fees | |
|Other (specify): | |
|Other (specify): | |
|TOTAL OPERATING EXPENSES: | |
NET OPERATING INCOME (Total Gross income minus Total Operating Expenses):
PROJECTED DEBT SERVICE:
|1st Mortgage/Lien: | % |on |For | |
| | | | |Years = |
|2nd HOME Loan: | % |on |For |Years = |
|3rd Mortgage/Lien: | % |on |For |Years = |
|Debt Ratio: | % | | | |
| Projected Stabilized Cash Flow (First Year): |
11. PROGRAM EXPLANATION STATEMENTS (Use additional pages as needed)
11.1 Program Goals Description:
Please provide a description of the proposed project, and address the following (use additional pages as needed):
Program Goals – Briefly describe the program goals, including any special populations served. Will support services be offered to the residents through any other federal or non-federal programs?
Location – Is the project on a major arterial that has regular transit service? Is the project downtown, along the proposed modern streetcar line, in a target area, or within ¼ mile of services used by the proposed residents (e.g., grocery store, medical facilities, open/green space, daycare, school)?
Structure – Will green building techniques be utilized (TEP Energy Guarantee, City/County LEED Certification)? Will it be a high efficient energy performing home? Does the design of the structure embrace elements from the surrounding environment, both built and natural?
Site – Does the project have convenient access (pedestrian and vehicular) to areas outside of the project/neighborhood? Does the project have a compact urban form which conserves land and other natural and environmental resources and which respects natural topography and drainage patterns?
11.2 Use of HOME Funds:
Include an explanation outlining the proposed use of HOME funds, available match and other funds that are leveraged for the project. How will funding of this project assist in the provision of additional affordable rental or homeowner units?
11.3 Site Description:
If the property is already identified, describe the property, including the address of the property, the zoning for the property, including whether the property is properly zoned or when and how zoning issues are expected to be resolved, and describe the type of building (walkup, garden, elevator, number of stories, etc). What is the lot size? What is the square footage of the existing buildings? How many units are there? What is the bedroom distribution?
11.4 Project Team:
Resumes for each team member must be attached to this application.
|Project Manager |
Name Company
Job duties on this project
Number of years experience with similar projects
|Project Coordinator (day-to-day), if different from above |
Name Company
Job duties on this project
Number of years experience with similar projects
|Fiscal Manager |
Name Company
Job duties on this project
Number of years experience with similar projects
|Project Architect |
Name Company
Job duties on this project
Number of years experience with similar projects
|Construction Contractor/Builder |
Name Company
Job duties on this project
Number of years experience with similar projects
|Consultant |
Name Company
Job duties on this project
Number of years experience with similar projects
|Property Manager |
Name Company
Job duties on this project
Number of years experience with similar projects
|Other (specify) |
Name Company
Job duties on this project
Number of years experience with similar projects
11.5 Utilities Serving the Properties:
Provide information describing the utilities serving the property, outlining utilities paid for by the owner and which utilities are paid for by the tenants. State whether it is intended to change the utility arrangements through renovation of the property. If vacant land, is this property served by the public sewer system?
11.6 Market Demand:
All applicants must provide either a detailed Market Demand Analysis or an Abbreviated Market Demand Analysis. The applicant should focus on the demand for the project rather than the perceived need. Demonstration of a clear need will be a factor in the City/County’s underwriting of the application. Sources should be cited for all data presented. A professionally prepared Market Demand Study may not be submitted as a substitute for completing this narrative section.
Responses to questions in section A or B may be filled in space below, or may be attached on a separate sheet to the application.
Fill out section A, Abbreviated Market Demand Analysis, if:
Future tenants have already been identified; or
the project is entirely reserved for special population of clients of a social service provider.
the project is under five units.
Fill out Section B, Market Demand Analysis for all other projects. If the applicant is proposing that the City/County purchase completed units and market them through the City/County homeownership program, this section does not need to be filled out.
A. Abbreviated Market Demand Analysis:
1. If future tenants have been identified, provide sufficient documentation that shows the qualified tenants (eg. waiting lists).
2. If the project is entirely reserved for a special population of clients of a social service provider, provide documentation that the provider has sufficient clientele to fill the proposed project (eg. letter from service provider or a list of pre-qualified individuals).
3. If all future tenants have not been identified, identify the target group and describe efforts that will be made to market the project to the target group.
B. Market Demand Analysis:
1. Description of the Market Area. Please describe the geographic area from which potential tenants will be drawn. If the area is expansive, explain and document how the project will draw residents from the entire area.
2. Target Population. Identify the target population, including income ranges, family make up, special needs populations to be targeted, etc. Provide an analysis that shows that the proposed rents, with identified subsidies, will be affordable to the target population. Is there a big enough pool of renters to support the project?
3. Comparable Sales. Provide an analysis that shows the absorption rates for comparable projects recently entering the market. Identify the number of comparable units targeting the same population which are currently under construction or planned concurrently, which might adversely affect this project's potential market. This should include the number of recently issued building permits (or applications) for comparable units.
4. Current Waiting Lists. Identify the number of households currently on waiting lists held by the applicant, if any. This list should distinguish between households that are pre-qualified or are likely to qualify and those that are on an interest list.
11.7 Cost Estimate for Rehabilitation or New Construction:
Submit a work write-up and cost estimate prepared by a contractor, architect or other qualified person, for the anticipated property renovations or repairs which the property will need in order to meet other applicable codes such as Nation Electrical Code, National Fire Code, etc., and the local HOME Rehabilitation Standards including identification of major building systems in danger of failing and site improvements that may be required.
11.8 Construction History of the Property:
Provide the date of the original construction of the property. Is the property located in a Historic District, nominated for or identified on the Historic Register, or is the property more than 45 years old?
11.9 Property and Lien Documents (for rehabilitation or demolition of an existing property):
If the applicant is applying for HOME funds to assist in the rehabilitation of property already owned, and there is mortgage financing or other liens against the property, a copy of loan documents and an explanation of other liens is required to be submitted with this proposal. If the property is already owned by the applicant, a copy of the deed, evidencing site control, is required to be submitted with this proposal.
11.10 Site Acquisitions:
Describe: The current status of negotiations for site control of the proposed property including the proposed price and terms of a purchase contract, and the amount of any initial investment (earnest money, down payment, other initial investment) to be made by applicant in purchasing the property. Any contingencies involved with the purchase, and the types and amounts of financing which are proposed. Include any documentation of financial commitments from lenders that may have been obtained. If available, please provide a copy of any purchase contract and related documents with this proposal. Also state if there any business or familial relationship that has existed in the past, is now existing, or planned to exist in the future between the applicant and the current owner
11.11 Readiness to Proceed:
The proposal should demonstrate readiness to proceed. Does the project schedule and cash flow indicate that the project can be completed within two years of the contract execution date? Are the following tasks completed or in process: Site control, environmental studies, marketing plan, project entitlements, and design?
11.12 Section 3/Vicinity Hiring:
Please indicate how many new employees will be hired for this project, and how many subcontractors will be utilized for this project; 30% of all new hires shall be Section 3 residents and 10% of all subcontractors shall be Section 3 certified businesses, per HUD implementing regulations 24 CFR 135
11.13 Relocation:
Note: If any units are currently occupied, you must contact City or County staff before proceeding with application.
The following information is required to estimate any temporary and permanent relocation costs:
Describe the proposed number of units the property will contain and number of bedrooms per unit.
Identify which units are occupied as of the date of this proposal. Identify which units are vacant, stating how long the unit has been vacant. When submitting this application, the applicant must also provide verification that all existing tenants in the complex have received the General Information Notice under the Uniform Relocation Act, as stated in Handbook 1378, paragraph 2-3. Failure to submit Notice to existing tenants when this application is submitted to the City or County will result in the rejection of the proposal. This office must be contacted to obtain the necessary information on relocation.
11.14 Property Management:
Describe the plans for managing and maintaining the property, including the following information: Who will manage the property (owner-manager or management agent). Describe the types and amounts of management fees that are anticipated. State the name and qualifications of the management entity, including the names and addresses of other properties managed (indicate whether HUD-related) and the dates of managing this other property. Delineate staffing specifics (including working hours of office and maintenance personnel for this property). Describe the method of rent collection (where tenants are to pay rent, the policy for late payments, etc.). Describe the anticipated long-term maintenance and repair plan, taking into consideration any renovations proposed for the property. Include the method for addressing routine, preventative and emergency maintenance; the schedule for interior and exterior painting; replacement of major equipment and maintenance of common areas and grounds; pest control treatments; etc.
11.15 Applicant:
If the person submitting the proposal is different from the applicant, please explain the relationship between the applicant and the person submitting proposal.
11.16 Experience in Developing Low-Income Housing Projects:
Describe the experience of the applicant in developing and managing housing, particularly, housing for low and moderate income households.
11.17 Proposed Development Schedule:
Describe the proposed development schedule. Specifying, if applicable, when acquisition will occur and/or the anticipated schedule for starting and completing new construction or rehabilitation. Describe any barriers to a timely implementation which are anticipated. The timeline should begin 90 days after this proposal deadline date, to allow award and contract execution.
11.18 Financial Projections:
Provide Pro-forma for life of the HOME loan.
11.19 Attachments:
The following items are attached to this application:
site information for scattered sites
deed or title demonstrating site control
contract or option for purchase
zoning approval
architectural plans and specifications
line drawings of elevations and floorplans
work write-up and cost estimates for rehabilitation work
commitment letter(s) from other funding sources
abbreviated or full market demand analysis narrative
resumes for project team members
other
CERTIFICATION RELATING TO ARMS-LENGTH TRASACTIONS
The following certification is required to be completed and signed by the applicant.
IDENTITY OF INTEREST CERTIFICATIONS
The undersigned proposer hereby certifies that, except as noted below, there is not now, nor does the undersigned proposer contemplate that there will be, any identity of interest between:
a) The seller and the purchaser (applicant) of this project.
b) The proposed owner (applicant) and general contractor and/or any subcontractor, materials supplier, or equipment lessor, or
c) The proposed owner (applicant) and lender.
It is further certified that, except as noted below, there are not and have not been any such relationships between the seller of purchaser (applicant) of this project and the lender, general contractor and/or any subcontractor, materials supplier, or equipment lessors. The undersigned hereby agrees to immediately report to the City of Tucson, Community Services Department, any such identify of interest relationships which occur in the future with respect to this property even though such relationships are not now anticipated.
All references to “identify of interest” herein are made in the context of the definition below, which has been read by the undersigned.
“Identify of Interest” between the seller(s), the purchaser(s) (applicant), as parties of the first part, and the seller(s), lender(s), general contractor(s), subcontractor(s), materials supplier(s), or equipment lessor(s), as party(ies) of the second part, will be construed as existing under any of the following conditions:
1) When there is any financial interest of or family relationship between the party of the first part in the party of the second part;
2) When one or more of the partners, officers, directors or stockholders of the party of the first part is also a partner, officer, director, or stockholder of, or has financial interest in, the party of the second part;
3) When the seller, general contractor, subcontractor, materials supplier and/or equipment lessor advances any funds to the party of the first part;
4) When the party of the second part takes stock or any interest in the party of the first part as payment;
5) When any of the above stated interrelationships exist between the parties of the second part;
6) When there exist, or comes into being, any side deals, agreements, contracts or undertakings entered into or contemplated, which alter, amend, or cancel any of the costs related to the property purchase, rehabilitation work or other amounts used to calculate project costs,
7) When any relationship exists which would give the purchaser (applicant), seller, or lender, or general contractor control or influence over the cost of the rehabilitation contract, or the price paid to the subcontractors, materials suppliers or equipment lessors.
State below any exceptions to this certification regarding identities of interest: (If none, so state)
ENTITLES GOODS, SERVICES OR OTHER VALUE $ VALUE
I am aware that this certification by me may be used to induce the City of Tucson to make Federal funds available for this project under the HOME Program, and that under Title 18 U.S. Code, Sections 1001 and 1010, it is a crime to knowingly make false statements to an agency of the United States on this matter and that penalties upon conviction can include fine and imprisonment.
Applicant Name Title
Signed Date
Applicant Certifications
Assurances and certifications are hereby provided that:
1. The applicant will comply with the requirements of the Flood Disaster Protection Act of 1973 (42 U.S.C. 4001-4123) and the Coastal Barrier Resources Act (16 U.S.C. 3601).
2. The applicant will comply with the environmental laws and authorities at 24 CFR 50.4 and will (I) supply HUD with information necessary for it to perform any necessary environmental review of each property; (ii) carry out mitigating measures required by HUD or select alternate eligible property; and (iii) not acquire or otherwise carry out any program activities with respect to any eligible property until HUD approval is received.
3. The applicant will comply with the requirements of the Fair Housing Act (42 U.S.C. 360-19) and implementing regulations at 24 CFR Part 100, Part 109, and Part 110; Executive Order 11063 (Equal Opportunity in Housing) and implementing regulations at 24 CFR Part 107; and Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d) (Nondiscrimination in Federally Assisted Programs) and implementing regulations issued at 24 CFR Part 1, and will affirmatively further fair housing.
Indian tribes and IHA’s will comply with the requirements of the Indian Civil Rights Act (25 U.S.C. 1301 of sect.) when applicable. This Act applies to tribes when they exercise their powers of self-government and is applicable in all cases when an Indian Housing Authority (IHA) has been established by exercise of such powers. In the case of Indian tribes and IHAs, the applicant will comply with the requirement of the Indian Self-Discrimination and Education Assistance Act (sec 25 U.S.C. 45orb); S5 FR 24752-53 and 24755 (June 18, 1990), revising 24 CFR 905.165 (a) and (b) and 905.3601.
4. The applicant will comply with the Age Discrimination Act of 1975 (42 U.S.C. 6101-07) and implementing regulations at 24 CFR Part 146, which prohibits discrimination because of age in programs and activities receiving Federal financial assistance.
5. The applicant will comply with Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), as amended, and with implementing regulations at 24 CFR Part 8, which prohibit discrimination based on handicap in Federally-assisted and conducted programs and activities.
6. The applicant will comply with Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. 170lu) (Employment Opportunities for Lower Income Persons in Connection with Assisted Projects), and with implementing regulations at 24 CFR 135.
7. The applicant will comply with the requirements of Executive Order 11246 (Equal Opportunity) and the regulations issued under the Order at 41 CFR Chapter 60.
8. The applicant will comply with Executive Orders 11625, 12432, and 12138, which state that program participants shall take affirmative action to encourage participation by minority-and-women-owned business enterprises.
9. As applicable, the applicant will comply with the policies, guidelines, and requirements of OMB Circular Nos. A-87 (Cost Principles Applicable to Grants, Contracts and Other Agreements with State and Local Governments), 24 CFR Part 85 (Administrative Requirements for Grants and Cooperative Agreement to State, Local and Federally Recognized Indian Tribal Government), A-110 (Grants and Cooperative) Agreements with Institutions or Higher Education. Hospitals, and Other Nonprofit Organizations), A122 (Cost Principles Applicable to Grants, Contracts and Other Agreements with Nonprofit Institution), and audit requirements described in OMB Circular A-128 implemented at 24 CFR Part 44 and OMB Circular A-133 (Audits of Institutions of High Learning and Other Nonprofit Institutions).
10. The applicants will provide drug-free workplace in accordance with the Drug Free Workplace Act of 1988 and HUD’s implementing regulations at 24 CFR Part 24. Subpart F.
11. The applicant will comply with the requirements of the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4821, at sec.) and implementing regulations at 24 CRF Part 35.
12. The applicant will ensure that no person has been or will be displaced from his or her dwelling as a direct result of the program described in this application. This does not preclude termination of tenancy for violation of the terms occupancy of a unit.
13. The applicant will ensure that no Federally appropriated funds have been paid, or will be paid by or on behalf of the undersigned, for lobbying the Executive or Legislative Branches of the Federal Government. (Refer to the government-wide common rule governing the restriction on lobbying, published as an interim rule on February 26, 1990 (55 FR 6736) and supplemented by a Notice published June 15, 1990 (55 FR 24540). For HUD, the interim rule is codified at 24 CFR Part 87.
14. The applicant and its principals (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or involuntarily excluded from covered transactions (see 24 CFR 24.110) by any Federal department or agency: (b) have not within a three-year period preceding this application been convicted of or had a civil judgment rendered against them for commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statement or receiving stolen property; (c) are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in (b) of this certification; and (d) have not within a three-year period preceding this application had one or more public transactions (Federal, State or local) terminated for cause of default. Where the applicant is unable to certify to any of the statements in this certification, such applicant shall attached explanation behind this page.
15. The application shall ensure that it has not and will not receive assistance from the Federal government, a State, a unit of general local government, or any agency or instrumentality therefore, for activities for which funding is requested in the application.
The applicant will comply with conflict of interest provisions referred to in section 530 of the Notice of Amended Program Guideline dated January 14, 1992, and any amendments hereafter and final regulations for the program.
Signature of Legally Responsible Applicant Official
Title Date
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