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Murray City CDBG Hard Cost Application 37th Program Year - FY 2011/2012 PHYSICAL IMPROVEMENT (HARD COSTS) PROJECT (Construction, renovation, acquisition, economic development, planning) I. COVER SHEET Project Title: Name of Agency: Type of Agency: *Attach evidence of 501-C3 status, a current agency audit, and the approval of the agency’s governing board (minutes) for the activity funding requested. Address of Agency: Contact Person: Title: Phone Number: E-mail Address: Fax: Executive Project Summary (do not exceed this space) Total Project Cost CDBG Funds Requested $ $ Submitted by: Signature: Print Name: Title: Date: Agency Tax ID # Murray City CDBG Hard Cost Application 2011/2012 1/12 ---PAGE BREAK--- II. Detailed Project Description Provide a detailed explanation for the following items: 1. Program and Project Description 2. Need and Benefit 3. Goals and Objectives 4. Capacity and Sustainability 5. Budget and Leveraging 6. Other Considerations The description for these items should not exceed the space provided below. Please be succinct in your answers and only provide relevant information to this proposal. Proposals should show a nexus between the proposed action and the Salt Lake County Consolidated Plan. In addition, the proposal should quantify a need in our community that is not already being fulfilled. Murray City CDBG Hard Cost Application 2011/2012 2/12 ---PAGE BREAK--- 1. Program and Project Description: Describe the project in specific terms. Specify what the CDBG funds will pay for. What is the intent of the Project? What is the number of clients who will receive service? Describe how the activity will benefit low and moderate income persons residing in Murray City. Murray City CDBG Hard Cost Application 2011/2012 3/12 ---PAGE BREAK--- 2. Need and Benefit: Answer the question "Why?" Why do you want to do this project? Is this an unduplicated service or program? Will the project enhance existing services? Why have you chosen to address this need? Why is there a need for CDBG funding? Does the need justify the costs? Describe the clientele and the need your project will address. Report the total number of Murray citizens that are served by your program. Also identify the total number of clients that will be served with the requested funds and estimate the percent who are lower income. Does the agency have a Language Assistance Plan? Will the project serve a geographical area? If so describe the area. Murray City CDBG Hard Cost Application 2011/2012 4/12 ---PAGE BREAK--- 3. Goals and Objectives: How will you know if the project is successful? Show a tie to the Needs and Objectives identified in the Salt Lake County Consolidated Plan. Also show a tie to the HUD developed Performance Measurement System (Refer to the directions for more information on the Performance Measurement System). How will you measure your project's effects? Please refer to http://www.crd.slco.org/communityDev/plansReports.html for an electronic copy of the 2010 Consolidated Plan, a hardcopy is also available in the Murray Community and Economic Development office (4646 South 500 West, Murray, UT). Murray City CDBG Hard Cost Application 2011/2012 5/12 ---PAGE BREAK--- 4. Capacity and Sustainability: Describe past performance, staff capability, and expertise. Do you have prior experience in similar efforts? Is this an ongoing project or program? If so, how will you work to make the project sustainable in the future? If no further CDBG assistance was provided would the activity continue? How will you handle future operational or maintenance costs? Murray City CDBG Hard Cost Application 2011/2012 6/12 ---PAGE BREAK--- 5. Budget and Leveraging: Is the budget clear? Is it realistic? Are other funds committed to the project? Do you have a financial commitment to the activity? Is there a nonfinancial commitment? Have you sought assistance from other CDBG cities? If "no" why not? If full funding cannot be given what are your priorities for items or activities to be funded? Murray City CDBG Hard Cost Application 2011/2012 7/12 ---PAGE BREAK--- 6. Other Considerations: Is there anything else we need to know? Any conditions or contingencies that will need to be met before implementing the project? Identify if any of the following apply: Is your organization faith based, would your project relocate people or businesses, require the acquisition of property, lead-based paint removal, or historic preservation. If funds are requested to construct, reconstruct, renovate or rehabilitate your facility, do you own the building? If you do not own the building, you must have a minimum 5 year lease agreement in place. Will the owner allow a long term lien to be placed on the property by the City? Murray City CDBG Hard Cost Application 2011/2012 8/12 ---PAGE BREAK--- III. Housing/Public Facilities/Admin/Planning (Hard Cost) Project Budget Project Costs: Include all costs directly related to delivering this service or accomplishing this project. Identify sources of funding in the Budget Narrative. Expenditure and Revenue Sources Requested Total CDBG Other Funds Committed Other Funds Requested Other In- Kind Total Project Budget Land/Building Acquisition Architect, Engineering, and/or Design Costs Construction Costs (streets, parks, sidewalks, etc) Renovation or Rehabilitation Site Improvement/Landscaping Planning Administrative Salaries to Oversee and Monitor Grant Funds Project/Activity Delivery Costs Loans/Grants SUBTOTAL: Project Costs Other Costs (Describe any other necessary project costs in the narrative) GRAND TOTAL Murray City CDBG Hard Cost Application 2011/2012 9/12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ---PAGE BREAK--- IV. Population Served by Jurisdiction: Please provide a quantitative description of the number of clients served last fiscal year who lived in Murray, the number of clients who are low- and moderate-income and the number of new clients that will be served in 2010-2011 by your organization’s services. How does your organization track income information and the number of clients served? Murray City CDBG Hard Cost Application 2011/2012 10/12 ---PAGE BREAK--- V. Cost Estimates: Attach a qualified estimate of itemized costs and budgets. Construction projects must provide assurances that the activity can be accomplished within the set budget and that all applicable building/zoning code and Davis-Bacon compliance issues have been considered. Murray City CDBG Hard Cost Application 2011/2012 11/12 ---PAGE BREAK--- VI. Location of Project: (attach maps, pictures, etc) Murray City CDBG Hard Cost Application 2011/2012 12/12