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TO: PROVIDERS OF HOUSING & PUBLIC SERVICES FOR VERY LOW AND LOW INCOME INDIVIDUALS AND FAMILIES The City of Campbell Housing and Community Development Block Grant (CDBG) Program receives approximately $135,000 in CDBG funds every July 1st. Of the total, approximately $30,000 is available for Public Services. The majority of the City’s CDBG funds are usually allocated to housing related programs as opposed to general community development programs because of the limited amount available to the City. Funds are extremely limited and the City of Campbell will evaluate proposals for their cost effectiveness, numbers of clients served, and leveraging of other non-CDBG funds. The Civic Improvement Commission (CIC) reviews the CDBG proposals in December, holds a public hearing in January and makes funding recommendations in February. These recommendations are forwarded to the City Council in March. For additional information regarding project eligibility and to receive an application, please contact the Housing & Community Development Department at (408)866-2137. You may also request the application via email to [EMAIL REDACTED]. On the next page is a sample application. ---PAGE BREAK--- Attachment D CITY OF CAMPBELL COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Fiscal Year APPLICATION FOR FUNDING (Due Date, 5:00pm) APPLICANT ORGANIZATION: Date: Agency Name: Street Address: City: State: PROJECT NAME: Brief Project Description: Priority Needs: Project Location: EXECUTIVE DIRECTOR: Signature: Phone No: Fax No: E-Mail: CONTACT PERSON/TITLE: (if different) Phone No: Fax No: E-Mail: CDBG FUNDS REQUESTED: $ Total Project Costs Cost Per Service Unit or Per Client: CDBG Funds Requested prior FY: CDBG Funds Received current FY: Check if: Public Service Project Other (please state) Number of total proposed Campbell unduplicated beneficiaries: Number of proposed Campbell unduplicated beneficiaries at or below current county-wide median income: 30% (Extremely low) 50% (Very low) 80% (low) ---PAGE BREAK--- Attachment D 1. PROJECT DESCRIPTION AND NUMBER OF UNDUPLICATED CLIENTS SERVED: Provide a brief description of specific project being proposed. This description should clearly state what the project intends to provide or accomplish and the specific activities for which CDBG funds will be used. It should describe the target population and geographic boundaries of target areas. Also indicate the specific type and number of total unduplicated project beneficiaries (e.g. 50 lower income families, 25 homeless persons, 100 lower income households, etc.). 2. PROJECT PURPOSE AND OBJECTIVES: Identify the specific jurisdictional needs that the proposed project is designed to address. Specify measurable objectives project intends to accomplish and identify desired outcomes. 3. AGENCY DESCRIPTION: Please give a brief general description of your agency and the services provided. Also provide a brief description of your agency’s experience in providing the proposed services. 4. AUDIT INFORMATION: Please provide the date of the most recent audit of your organization. Describe any findings or concerns which may have been cited in the audit or in any accompanying management letter particularly any pertaining to the use of CDBG funds. Also, describe any actions taken to correct identified finding or concerns. 5. OTHER SOURCES OF FUNDS ANTICIPATED FOR THIS PROJECT1: SOURCE ESTIMATED AMOUNT STATUS2 ESTIMATED TOTAL PROJECT (Should equal total on cover page) 1 Include all sources of funds including CDBG allocations. 2 Should indicate the status of commitment of funding source, i.e. secured, committed or application pending with anticipated dates.