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Murray City CDBG Hard Cost Application 39th Program Year - FY 2013/2014 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 # ---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. Please be succinct in your answers and only provide information that is relevant 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. ---PAGE BREAK--- 1. Program and Project Description: Describe the proposed project. Please specify what that CDBG funds will be used for. Where is the project located? Will the project serve a geographical area? If so, describe the area. Will the project create or retain jobs for Murray residents? ---PAGE BREAK--- 2. Need and Benefit: Describe the need for the project. How will the project impact the need? Why have you chosen to address this need? Why is there a need for CDBG funding? Does the need justify the costs? Is this an unduplicated service or program? Will the project enhance existing services, if so how? ---PAGE BREAK--- 3. Goals and Objectives: How will you know if the project is successful? How will you measure your project's effects? 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). ---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? ---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? ---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? ---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 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ---PAGE BREAK--- IV. Population Served by Jurisdiction: Describe the clientele that your program serves. How many clients do you serve, of those how many are Murray residents? How many of your clients are low to moderate income? How many new, unduplicated clients do you anticipate serving in 2013-2014? How many of your clients are seniors (62 and older), adults with disabilities, abused spouses, abused/neglected children or homeless? How many of your clients are White, African-American, American-Indian, Asian/Pacific Islander or Hispanic? How does your agency verify income and demographic data of your clients? How do you advertise your programs to ensure that individuals from all demographic groups are being served? Does your agency have a Language Assistance Plan? ---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. ---PAGE BREAK--- VI. Location of Project: (attach maps, pictures, etc)