Elegant Report - Maryland Housing



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MEEHA-EmPOWER

Multifamily Energy Efficiency Improvement Funding

Application Form

Note: this application form is to be used for projects that are requesting MEEHA-EmPOWER funds without any other DHCD financing. For projects seeking MEEHA-EmPOWER funds in addition to other DHCD rental housing financing, requests should be made using DHCD’s Application Submission Package available at the following website:

In addition to submitting hard copies of this application, all applicants must also complete and submit an on-line application using the DHCD Portal at the Department’s website: . To receive an account name and password for accessing the DHCD Portal, e-mail your request to rentalhousing@.

The purpose of MEEHA-EmPOWER is to promote energy efficiency and affordability in the State’s multifamily rental housing developments. The program provides grants and flexible, low-interest rate loans to finance energy efficiency improvements in affordable multifamily rental housing developments.

Program funds may be used for the purchase and installation of equipment and materials for energy efficiency measures. Such items include, but are not limited to ENERGY STAR qualified: HVAC systems, insulation, windows, draft stopping and duct sealing, appliances and fixtures, and renewable energy generation and water heating equipment.

Only energy efficiency measures that produce electrical savings (kWh) are eligible for funding, except for projects locate in the BG&E service territory, where measures that produce natural gas savings are also eligible.

Application Submission Checklist:

Exhibit A: Application

Exhibit B: Energy Audit

Exhibit C: Property Information

1. 3 years’ operating statements

2. Regulatory Agreement, if applicable

3. Project Financing information (Monthly mortgage statement)

Application – PART A

|Type of Funding Requested: |

|( Energy Efficiency Improvements |

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|Part 1 - Applicant’s Information |

|Applicant Name: ______________________________________________________________________ |

|Organization Name: ___________________________________________________________________ |

|Mailing Address: ______________________________________________________________________ |

|City: ______________________ State: ____ Zip Code: _________ County ___________________ |

|Email Address: ____________________________________ Telephone: _________________________ |

|Position/Title: ________________________________________________________________________ |

|Immediate Supervisor: _________________________________________________________________ |

|*Contractor: ____________________________________ Point of Contact: _______________________ |

|Contractor Phone: __________________________ Contractor Email: ___________________________ |

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|* If contracting an audit/study, the energy auditor must be certified by the Residential Energy Services Network (RESNET), and/or the BPI, and |

|demonstrate a minimum of two (2) years experience completing energy audits on multifamily residential buildings. The energy auditor may also qualify by |

|documenting sufficient energy audit experience in multifamily or commercial building auditing. For more information, please contact DHCD. |

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|Part 2 - Property Information |

|Property Name: ______________________________________________________________________ |

|Street Address: _______________________________________________________________________ |

|City: ____________________________State _____ Zip Code: ________ County ______________ |

|No. of Bldgs. to undergo improvements:_____ Total Units:______ Total Sq Footage: _____________ |

|Property Owner: ______________________________________________________________________ |

|Building Supervisor: ___________________________________ Phone: _________________________ |

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|Please include proof of building eligibility* |

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|* Only affordable multifamily rental housing developments may receive funding under this program. “Affordable” means rental housing with existing income|

|or rent restrictions, or units that serve tenants with low to moderate incomes, as determined by DHCD. DHCD may require a copy of the regulatory |

|agreement, or other documentation demonstrating affordability. Eligible buildings may include apartment buildings, townhouses, single-family homes, |

|single room occupancy (SRO) and shared housing facilities with five (5) or more units. |

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|Part 3 (a) – Building Information |

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|Building # ___________ Address: _________________________________________________________ |

|Year built: _________ Year Last Rehabbed: __________Units: ________ Sq Footage: ____________ |

|How is this building metered: ____________________________________________________________ |

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|Utility Provider: |

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|( Baltimore Gas & Electric ( Delmarva Power ( Southern Maryland Electric Cooperative |

|( Potomac Electric Power Company ( Potomac Edison ( Other |

|*Please visit the MEEHA-EmPOWER Website to view the Utility Service Territory Map. |

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|Tenant Paid Utilities (mark all utilities to be paid by tenants) |

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|Household Electric |

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|Cooking (describe): |

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|Air Conditioning |

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|Heat (describe): |

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|Hot Water (describe): |

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|Other (describe): |

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|Utility Expenses (paid by owner in past 12 months) |

|Fuel Oil |

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|Electricity |

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|Gas |

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|Water |

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|Sewer |

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|Total Utility Expenses |

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|Please list any gas equipment used. Use additional sheet if necessary: |

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|Please list any fuel oil equipment used. Use additional sheet if necessary: |

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|What is your role on this project: _________________________________ |

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|Part 3 (b) – Project Description |

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|Building # ___________ Address: _________________________________________________________ |

|Please describe proposed energy improvements, including technical specifications and costs of equipment. Proposed items must meet the minimum energy |

|efficient criteria as determined by the current ENERGY STAR standard. Use additional sheet if necessary: |

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|Please describe estimated cost savings/increased energy efficiency from improvements, and how those savings will enhance affordability for tenants. |

|Include copy of energy audit, model, or study from qualified contractor (as described in Part 1). Use additional sheet if necessary: |

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|What is your role on this project: __________________________________ |

|DEVELOPMENT TEAM INFORMATION |

|Date: | | | | | | |

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|Management Agent |

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|Please attach a proposed project budget. Include any additional funding sources to be used, if any, and the status of those additional funding sources. |

|Part 5: Applicant Certification and Signature |

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|The undersigned applicant hereby makes application to DHCD for MEEHA-EmPOWER funding, as follows: |

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|Energy Efficiency Improvements in the amount of $________________ |

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|BY:_____________________________________________ |

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|Name:___________________________________________ |

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|Title:____________________________________________ |

Please return completed forms and supporting documentation by mail, e-mail, or facsimile to:

Attn: MEEHA-EmPOWER

Multifamily Housing Programs

Community Development Administration

Maryland Department of Housing and Community Development

100 Community Place

Crownsville, Maryland 21032

Tel: (410) 514-7477 or (410) 514-7441

Toll Free (Maryland Only): 800-543-4505

Fax: (410) 987-4097

E-mail: rentalhousing@

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