Grant Number: - HUD Exchange



Grant Number: AK0004L0C001912Tax ID Number:?92-0151960DUNS Number:?148834422?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Anchorage Housing Initiatives, Inc. (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0004L0C001912 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0004L0C001912 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$113,712??h.Supportive services$9,700??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$6,399??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$129,811?$129,811?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Anchorage Housing Initiatives, Inc.?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0010L0C001912Tax ID Number:?13-3419755DUNS Number:?616926697?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Covenant House Alaska (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0010L0C001912 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0010L0C001912 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$0??h.Supportive services$154,922??i.Operating costs$72,560??j.Homeless Management Information System$0??k.Administrative costs?$13,580??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$241,062?$241,062?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Covenant House Alaska?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0011L0C001912Tax ID Number:?46-1156688DUNS Number:?79139522?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Anchorage Coalition to End Homelessness (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0011L0C001912 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0011L0C001912 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$0??h.Supportive services$0??i.Operating costs$0??j.Homeless Management Information System$159,995??k.Administrative costs?$15,999??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$175,994?$175,994?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Anchorage Coalition to End Homelessness?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0055L0C001904Tax ID Number:?92-0033876DUNS Number:?20247920?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Rural Alaska Community Action Program, Inc. (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0055L0C001904 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0055L0C001904 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$0??h.Supportive services$0??i.Operating costs$524,124??j.Homeless Management Information System$4,312??k.Administrative costs?$14,094??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$542,530?$542,530?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Rural Alaska Community Action Program, Inc.?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0058L0C001904Tax ID Number:?46-1156688DUNS Number:?79139522?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Anchorage Coalition to End Homelessness (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0058L0C001904 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0058L0C001904 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$0??h.Supportive services$70,546??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$7,054??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$77,600?$77,600?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Anchorage Coalition to End Homelessness?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0061L0C001904Tax ID Number:?92-0047291DUNS Number:?10192953?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Alaska Housing Finance Corporation (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0061L0C001904 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0061L0C001904 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$682,284??h.Supportive services$0??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$6,346??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$688,630?$688,630?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Alaska Housing Finance Corporation?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0068L0C001902Tax ID Number:?92-0082642DUNS Number:?361167000?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Anchorage Neighborhood Housing Services, Inc. dba NeighborWorks Alaska (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0068L0C001902 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0068L0C001902 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$581,844??h.Supportive services$208,153??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$54,214??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$844,211?$844,211?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Anchorage Neighborhood Housing Services, Inc. dba NeighborWorks Alaska?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0069L0C001902Tax ID Number:?92-0061049DUNS Number:?86830692?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Abused Women's Aid in Crisis, Inc. (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0069L0C001902 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0069L0C001902 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$81,312??h.Supportive services$72,158??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$6,266??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$159,736?$159,736?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Abused Women's Aid in Crisis, Inc.?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0072Y0C001901Tax ID Number:?13-3419755DUNS Number:?616926697?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Covenant House Alaska (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0072Y0C001901 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0072Y0C001901 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$0??h.Supportive services$273,000??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$27,000??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$300,000?$300,000?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Covenant House Alaska?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0073Y0C001901Tax ID Number:?74-2240098DUNS Number:?147659932?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Volunteers of America of Alaska (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0073Y0C001901 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0073Y0C001901 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$89,376??h.Supportive services$74,224??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$16,104??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$179,704?$179,704?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Volunteers of America of Alaska?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0074Y0C001901Tax ID Number:?13-3419755DUNS Number:?616926697?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Covenant House Alaska (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0074Y0C001901 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0074Y0C001901 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$156,780??h.Supportive services$70,827??i.Operating costs$0??j.Homeless Management Information System$5,000??k.Administrative costs?$15,724??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$248,331?$248,331?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Covenant House Alaska?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0075Y0C001901Tax ID Number:?92-0082642DUNS Number:?361167000?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Anchorage Neighborhood Housing Services, Inc. dba NeighborWorks Alaska (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0075Y0C001901 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0075Y0C001901 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$0??h.Supportive services$25,000??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$2,500??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$27,500?$27,500?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Anchorage Neighborhood Housing Services, Inc. dba NeighborWorks Alaska?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0078D0C001901Tax ID Number:?92-0061049DUNS Number:?86830692?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Abused Women's Aid in Crisis, Inc. (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0078D0C001901 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0078D0C001901 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance$121,092??h.Supportive services$0??i.Operating costs$0??j.Homeless Management Information System$0??k.Administrative costs?$5,944??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$127,036?$127,036?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Abused Women's Aid in Crisis, Inc.?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0081L0C001900Tax ID Number:?46-1156688DUNS Number:?79139522?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Anchorage Coalition to End Homelessness (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0081L0C001900 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0081L0C001900 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities$113,416??b.UFA costs??c.Acquisition??d.Rehabilitation??e.New construction??f.Leasing$0??g.Rental assistance??h.Supportive services??i.Operating costs??j.Homeless Management Information System??k.Administrative costs??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$113,416?$113,416?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Anchorage Coalition to End Homelessness?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date)Grant Number: AK0082D0C001900Tax ID Number:?92-0037322DUNS Number:?147658967?SPECIAL COVID-19?AMENDMENT TO THE??FY 2019 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT???This Amendment?to Grant Agreement is made by and between?the United States Department of Housing and Urban Development (HUD)?and?Catholic Social Services (the Recipient).?RECITALS???HUD and the Recipient entered into a Grant Agreement, having Grant No.?AK0082D0C001900 (the Grant Agreement).(Recitals?are below. One amendment can include more than one change, such as both a change in budget and adding an eligible activity.?Keep the?recitals that apply to the amendments?you are making and delete the?others. Delete this?paragraph?once you have read and understood it).?? (recitals for adding eligible activities - Delete section if not using)??The parties are desirous of amending the Grant Agreement to add eligible activities and to shift funds between eligible activities in response to the COVID-19 pandemic. HUD has determined that the change is?necessary to better serve eligible persons within the geographic area? and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.?? (recitals for shifting funds from one activity to another without adding eligible activities - delete section if not using)??The parties are desirous of amending the Grant Agreement?to shift more than 10% from one eligible activity to another?to assist in?the?response to the COVID-19 pandemic.??HUD has determined that the change is?necessary to better serve eligible persons within the geographic area?and to ensure that the priorities established under the Notice of Funding Availability in which the grant was originally awarded, or the most recent NOFA, are met.??AGREEMENTS?The Grant Agreement is hereby amended as follows:(if eligible activities are being added or funds are being shifted between BLIs include this – delete section if not using)1.(if the recipient is not a sole recipient or UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds for project number AK0082D0C001900 are now allocated as follows: (if the recipient is the sole recipient or an UFA use this) HUD’s total funding obligation for this grant remains the same, however the funds are now allocated as follows: Budget Line ItemsOriginal BudgetChangeAmended Budgeta.Continuum of Care planning activities??b.UFA costs??c.Acquisition$0??d.Rehabilitation$0??e.New construction$0??f.Leasing$0??g.Rental assistance$94,944??h.Supportive services$13,180??i.Operating costs$8,565??j.Homeless Management Information System$0??k.Administrative costs?$10,626??l.Relocation costs???m. HPC homelessness prevention activities:????Housing relocation and stabilization services$0 ?$0$0Short-term and medium-term rental assistance$0 ?$0$0?Total Award:$127,315?$127,315?(the rest of this form must appear in all amendments)This Amendment to Grant Agreement constitutes the entire agreement of the parties as to amendment of the Grant Agreement and will become effective only upon the execution hereof by all parties. The remaining terms of the Grant Agreement remain in full force and effect.???The parties, on the dates set forth below their respective signatures, hereby execute this Amendment to Grant Agreement, as follows:???UNITED STATES OF AMERICA,?Secretary of Housing and Urban Development??BY:_________________________________________________?? (Signature)?_________________________________________________?? (Typed Name and Title)?_________________________________________________?? (Date)???RECIPIENT?Catholic Social Services?BY:_________________________________________________?? (Signature of Authorized Official)?_________________________________________________?? (Typed Name and Title of Authorized Official)?_________________________________________________?? (Date) ................
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