I



Section I - Agency InformationOrganization/Agency Name:Employer Federal I.D. Number:Website:Faith Based Organization? FORMCHECKBOX Yes FORMCHECKBOX NoMailing Address:City:State:Zip:Telephone: Fax:DUNS:CCR:Which program are you applying to (if you know): FORMCHECKBOX HOME FORMCHECKBOX CDBG FORMCHECKBOX PBV’S Are you a non-profit organization? FORMCHECKBOX YES FORMCHECKBOX NO Has this program received HOME funding or a commitment of it in the past? FORMCHECKBOX YES FORMCHECKBOX NOExecutive DirectorProject AdministratorFinance OfficerName:Title:Address:Phone:Fax:E-Mail:Section II - Project InformationName of Project:Location of Project:Census Tract(s):Section III - Project Funding Sources(also complete included financial worksheet)REQUESTED THIS APPLICATION $ OTHER FEDERAL$ OTHER CITY FUNDS$ STATE FUNDS$ PRIVATE FUNDS$ OTHER – LIHTC Equity, etc. $ TOTAL$ Section V – Completion ChecklistEach applicant must indicate if they possess the items indicated below. They will be required to be submitted to DHNP if their project is funded.YESNOOn FileN/AApplication Completed & Signed CertificationArticles of Incorporation and BylawsState and Federal Tax Exemption Determination LettersFederal Employment Identification NumbersList of Board of Directors, their Titles and Contact InformationBoard of Director’s Designation of Authorized Official Most Recent Organization ChartJob Description of Each CDBG/HOME Program Salaried PositionFinancial Statement and Most Recent Audit ReportMatching Funds Commitments DocumentationList of Collaborative Partners and their role504 Self Evaluation Plan (Americans with Disabilities Act) Agencies with 15 Employees or MoreProject Implementation Timeline & Additional Outcome ObjectivesAre your DUNS and CCR numbers on file?Section VI - Agency Narrative & Project Description Provide Project Information and Analysis in the chart below:ItemAmountExplanationAmount of DHNP funds requestedTotal housing units to be created or rehabilitatedNumber of units to receive HOME fundsTotal 1 BR unitsTotal 2 BR unitsTotal 3 BR unitsTotal 4 BR units# of Units to be affordable at60 % or below of AMI61-80% of AMI81-100% of AMI101-120% of AMI# of households by type to be served:Seniors (state minimum age)VeteransHomelessDisabledOther/multiple categories (describe)Total Project CostTotal project cost/unitBuilding cost only (exclude site, predevelopment, developer fee, etc)Building cost/unitDHNP proposed cost/unitDHNP cost/unit as a % of total cost/unitDebt coverage ratio if applicableProposed total debt/unitProposed total developer fee, if anyList other public or subsidized funding and amounts List any funding from foundations and amountsDescribe how the provision of the requested HOME funds for your project will create, preserve or enhance the affordability level of the units and/or the quality of the units. Describe the project and the proposed project timeline, including: What does the entire project consist of in terms of 1) total number of buildings 2) total number of units 3) total phases of construction 4) what phase of construction will units be part of 5) style of buildings 6) elevators or not 7) total ADA accessible units 8) specific detail on phasing of project 9) source of main funding 10) status of proposed location (owned, under option, etc.) 11) type of work- rehab; acquisition and rehab; or new construction 12) estimated finance closing date 13) estimated construction start and timeline 14) other agencies in partnership on project Describe the organization’s experience and capacity to carry out the project. Especially relevant is experience completing the same activity as you are requesting funds for. Include information about the financial capacity of your organization. Describe how the project will preserve or enhance the neighborhood or area in which it is proposed, and how the project is consistent with the Comprehensive Plan and any applicable area plans. Describe how the project is consistent with the city’s Consolidated Plan, Ten-Year Plan to End Homelessness, or other applicable plan. Summarize the key reasons, if not already stated above, that this project should be funded. Section VII- Budget Provide the basic project financial information on the separate finance worksheet. Provide any necessary narrative to fully explain the figures in the space below. You will also be required to complete a multifamily housing financial worksheet. Please request the template from Cindy M. Walters at 757-385-5754 or CWalters@ Describe the effect of non-provision of requested funding on the project. Will the project go forward, if not, why not, how will the project be affected? Please note that the following information must be provided upon DHNP’s decision to approve an award under this RFP. This information is necessary to complete the required Subsidy Layering Review.Sources and Uses of Funds StatementSources: List each source separately, indicate whether loan, grant, syndication proceeds, contributed equity, etc. Sources should generally include only permanent financing. If interim financing or a construction loan will be utilized, details should be included in a narrative (item 3 below).Uses: Should be detailed. Do not use broad categories such as “soft costs.” Acquisition costs should distinguish the purchase price from related costs such as appraisal, survey, titled and recording, and related legal fees. Construction and rehabilitation should include builder's profit and overhead as separate items.Narrative describing details of each funding source. For loans, details should include principle, interest rate, amortization, term, and any accrual, deferral, balloon or forgiveness provisions. If a lender, grantor, or syndicator is imposing reserve or escrow requirements, details should be included in the narrative. If a lender will receive a portion of the net cash flow, either as additional debt service or in addition to debt service, this should be disclosed in the mitment Letters from lenders or other funding sources evidencing their commitment to provide funding to the project and disclosing significant terms. Loan agreements and grant agreements are sufficient to meet this requirement.Appraisal Report. The appraisal should establish the “as is” value of the property, before construction or rehabilitation, and without consideration of any financial implications of tax credits or project-based voucher assistance. An appraisal establishing value after the property is built or rehabilitated is not acceptable unless it also includes an “as is” valuation.Stabilized Operating Proforma. Should include projected rental, commercial, and miscellaneous income, vacancy loss, operating expenses, debt service, reserve contributions and cash flow. The analysis must be projected over a 15 year period. Income and expenses must be trended at ____ percent. (Must reflect current trend.)Tax Credit Allocation Letter. Issued by the State tax credit allocation agency, this letter advises the developer of the amount of LIHTCs reserved for the project. Historic Tax Credits. Some projects in designated historical districts may receive an additional one time historic tax credit. When applicable, the amount of the historic tax credit should be disclosed. (If Applicable)Equity Contribution Schedule. If equity contributed to the project will be paid in installments over time, a schedule should be provided showing the amount and timing of planned contributions.Bridge Loans. If the financing plan includes a bridge loan so that proceeds can be paid up front when equity contributions are planned over an extended period, appropriate details should be provided.Standard disclosure and perjury statementIdentity of Interest StatementPHA commitment letter for project-based voucher assistanceProposed project-based voucher gross rent amountsSection VIII - Statement of ApplicantThe undersigned acknowledges the following:That, to the best of its knowledge and belief, all factual information provided is true and correct and all estimates are reasonable.That this request may be forwarded for consideration under other budget processes if it is determined that alternative sources may be appropriate.That no revised proposals/applications may be made in connection with this application once the deadline for applications has passed.That the applicant will participate in required interview for project assessment and cooperatively assist in the review process.The City of Virginia Beach reserves the right not to fund any submittals received.By submission of this application, the organization agrees to abide by the federal regulations applicable to this program. That, if the project(s) is funded, the organization agrees to abide by the City’s locally established policies and guidelinesThat past program and financial performance will be considered in reviewing this application.That, if the project(s) 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 projected expenditures. That, if the project(s) is funded, the City will perform an environmental review prior to the obligation of funds.That, if the project(s) is funded, a written agreement that includes a statement of work, records retention and reporting, program income procedures, local and federal requirements, circumstances that would trigger grant suspensions and terminations, and reversions of assets may be required between the organization and the City. Provide written signatory authority from the organization’s governing body indicating who can execute contracts and amendments on its behalf. Agrees to abide by the City of Virginia Beach’s Conflict of Interest policy. Items of concern would include staff members serving on the Board of Directors, staff members’ families serving on the Board of Directors, and other matters that may give the appearance of a conflict of interest.Agrees to comply with the following: Fair Housing Act, Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act of 1990, Davis Bacon Act, Section 3 and other Federal Regulations. PENALTY FOR FALSE OR FRAUDULENT STATEMENTU.S. Code Title 18, Section 1001, provides that a fine of up to $10,000 or imprisonment for a period not to exceed five years, or both, shall be the penalty for willful misrepresentation and the making of false, fictitious statements, knowing same to be false.By signature below, the applicant acknowledges the above on this ___day of ________, 2020.SignatureTitleOrganization ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download