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HomeMy WebLinkAboutC14-270 Colorado Division of Housing Grant ApplicationVersion 8-12 Page 1 of 28 0Jq_2'Ju Application for: Loan/Grant Assistance Private Activity Bonds for rental projects ' Project Based Rental Assistance (with RFA only) AMOUNT REQUESTED: $ Loan 464,579 Grant $ PAB Volume Cap z Organization Name and Address: Sub -grantee Name and Address, Eagle County Government if applicable: PO Box 850 / 500 Broadway Garfield County Housing Authority Eagle, CO 81631 1430 Railroad Ave. Rifle CO 81650 hief Elected Official, Executive Director, or President: Applicant Federal Tax ID #: 846000762 ame: Eagle County Board of Commissioners [Address DUNS #: 084024447 itle: To register: https://www.bpn.gov/ccr/default aspx (if different from above): same as above Phone M 970-328-8604 a Fax #: Email: eagleadmin@eaglecounty.us X Municipality/County/Consortia Designated Contact Person for Application: Nonprofit Name: Tori Franks CHDO (Community Housing Development Title: Housing Department Organization) Address (if different from above): same as above CBDO (Community Based Development Phone M 970-328-8775 Organization) Fax M Public Housing Authority Email: tori.franks@eaglecounty.us Private For -Profit Developer Project Name: Garfield County CDOH DPA Program 00 Project Location: Street Address: Prosect to be administered from GCHA offices 1430 Railroad Ave City Rifle County Garfield Zip 81650 # Acres '"Attach Legal Description. House District: 57 Senate District: 8 (refer to www.votesmart.org ) Version 8-12 Page 1 of 28 0Jq_2'Ju Rental New Construction X Homeownership Pre -Development Rental Assistance ___f_�CHDO Operating Group Home or Shelter X Down Payment Program Other (Specify) Acquisition Rehabilitation Tenant -Based Rental Assistance Project -Based Rental Assistance Other (Specify) DESCRIPTION (100 words or less): Eagle County is requesting grant funds in the amount of $54,579 on behalf of the Garfield County Housing Authority. $47,579 of the funds will be used for Down Payment Assistance loans (DPA) for families who make less than 80% of the Area Median Income. These DPA loans will be made available to families within the Roaring Fork Valley (Garfield, Pitkin, Gunnison and Southwestern Eagle Counties.) The remaining $7,000 will be used to cover some of the administration of the program. These funds were previously held by Mountain Regional Housing Corporation (MRHC) and were returned to the State when MRHC went out of business. GCHA worked closely with MRHC and share the same jurisdiction. Currently, there is a tremendous need for DPA funds within the communities GCHA serves. Low interest rates on mortgages combined with a large inventory of homes for sale, have created an affordable buyer's market. Based GCHA's DPA guidelines a grant of $47,579 would equate to 6-8 DPA loans. SITE CONTROL STATUS: OWNED UNDER_ LEASED (choose one and attach CONTRACT Term: documentation) Expiration Date: AND SITE PLAN STATUS: Site is presently zoned (fill in zoning type and attach documentation): Is the present zoning conforming? Yes No If nonconforming, when will zoning change or PUD be granted? (provide target date) the site plan for your project approved? Yes No not, when will site plan be approved? (provide target date) Version 5-12 Page 2 of 26 Is the present zoning conforming? Yes No If nonconforming, when will zoning change or PUD be granted? (provide target date) Is the site plan for your project approved? Yes No If not, when will site plan be approved? (provide target date) SERVICES TO SITE: Are utilities and infrastructure in place to service site? Street access? Yes ❑ No ❑ If no, expected completion date Gas? Yes ❑ No ❑ If no, expected completion date Electric? Yes ❑ No ❑ If no, expected completion date Water? Yes ❑ No ❑ If no, expected completion date Sanitary sewer? Yes ❑ No ❑ If no, expected completion date Storm sewer? Yes ❑ No ❑ If no, expected completion date COMMUNITY SUPPORT: Describe efforts made to build local support for this specific project and the results of those efforts. Garfield County Housing Authority (GCHA) has successfully marketed our existing DPA loan products to the Banks and Lending agencies within our service area. We have recently had several banks inquire as to when additional DPA funds will be available. GCHA has an active working relationship with lenders and realtors within our service area. **Attach a Consolidated Plan Consistency Letter from your local government (if it administers HOME or CDBG funds). **Attach letters of commitment for funds or services from local sources & any letters of support. LOWERING THE COST OF AFFORDABLE HOUSING: What speck steps has the local government taken to lower the cost of affordable housing and/or otherwise help the project? (Le. deferral of water tap fees, local funding, etc.) APPLICATIONS FOR PRIVATE ACTIVITY BONDS Rental Projects complete the following:. BOND ISSUANCE: Expected bond issuance date EXPERIENCE: Has the governmental issuer and/or the private party utilized PABs in the past? Yes ❑ No ❑ If yes, identify financings by issuer, date, purpose, amount issued and maturity schedule for the past two years. Issuer Date Purpose Amount Issued Maturity Schedule Version 8-12 Page 3 of 26 Version 8-12 Page 4 of 26 CREDIT ENHANCEMENT: Has the project received a preliminary commitment for credit enhancement? Yes ❑ No ❑ If yes, attach copies of all other funding commitment letters and any conditions. If no, when is the preliminary commitment anticipated? Please submit when received. APPLICATIONS FOR PROJECT BASED VOUCHERS Census Tract Number: Poverty Rate of Census Tract: % Total Proposed DOH PBV units: Other PBV units: Non-PSV units: Written Commitment for Other Agency PBV Units: Yes ❑ No ❑ TOTAL UNITS: PBV units serve special needs population? Yes ❑ No ❑ Population Served Version 8-12 Page 4 of 26 NARRATIVE Eagle County is requesting CDBG grant funds in the amount of $54,579 on behalf of the Garfield County Housing Authority. $47,579 of the funds will be used for Down Payment Assistance loans (DPA) for families who make less than 80% of the Area Median Income. Based GCHA's DPA guidelines a grant of $47,579 would equate to 6-8 DPA loans. These DPA loans will be made available to families within the Roaring Fork Valley (Garfield, Pitkin, Gunnison and Southwestern Eagle Counties.) The remaining $7,000 will be used to cover some of the administration of the program. These funds were previously held by Mountain Regional Housing Corporation (MRHC) and were returned to the State when MRHC went out of business. GCHA worked closely with MRHC and share the same jurisdiction GCHA currently administers two other DPA programs that serve the needs of families making up to 150% of AMI. In 2010 GCHA applied for and received a grant from the Colorado Realtors Association (CARHOF) of $25,000. GHCA was able to match the CARHOF grant and lend out $50,000 in DPA loans. Currently GHCA has 9 outstanding loans in its portfolio. In 2012 GCHA took over the administration of MRHC DPA program and portfolio. GCHA has a staff of 7 and the capacity to administer the DPA program. Additionally, GCHA will continue to use Funding Partners, as the programs' loan servicer. Currently, there is a tremendous need for DPA funds within the GCHA as there is no other active DPA program in the area. Low interest rates on mortgages combined with a large inventory of homes for sale, have created an affordable buyer's market. Because CDBG funds must be released directly to a government, Eagle County has agreed to act as the financial pass-through entity for GCHA CDOH DPA program to get these much need DPA dollars into the communities served by GCHA. Version 5-12 Page 5 of 26 PROJECT PROFORMA Replace this page with the DOH Project Proforma Excel Spreadsheet that can be found on the DOH website hl#:Z/dola.colorado.gov/doh-aDpucation. In addition to the submitted paper copy, send the proforma electronically to your Regional DOH Development Specialist. • If applicable, submit the completed Colorado Housing and Finance Authority's (CHFA) Tax Credit Application. Please note any variances from tax credit application must be explained. (Electronic submission is preferred). • For CHDO operating funds, please attach the operating budget and other documents requested on the website: htta://www.colorado.gov/cs/Satellite?c=Paae&childpaQename=DOLA- Main%2 FC BO NLayout&cid=1251596560269&pagename=CBONWrapper. • For Single-family Owner -occupied Housing Rehabilitation and Down Payment Assistance Programs, complete the DOH Program Spreadsheet at http://dola.colorado.gov/doh-application. Version &12 Page 6 of 26 HOUSING PROGRAMS SPREADSHEET Ask - Program Name: Down Payment Assistance Date: 6/27/2013 frousirlo Applicant: Garfield Co Housing Authority 16 Spreadsheet Version: 1 Down Payment Assistance Program Assessment Chart 7x r aria s Program pata Pirogram Portfolio Information Current # of loans In Portfolio 39 Average # of Loans / Year 4 Average Loan Amount 7,000 Percent & $ Value of Current Deferred Loans 0 Current Value of Loan Portfolio $289,000 Current Amount of Program/Misc. Income On -Hand 0 Projected Annual Program/Miscellaneous Income N/A Total # of Loans Since Program Inception 39 Percent Program Costs Covered by Program/Misc. Income none # of New Loans 7 # of New Loans From Program/Miscellaneous Income 0 # of New Loans From CDOH Grant 7 Loan Information Home Buyer Equity Maximum CDOH Loan Amount 10,000 Loan Term 15 ears Loan Rates shared a predation Market Information Qualifying Household Income under 80% AMI # of Affordable Homes for Sale 212 Maximum Purchase Price of Homes In Program 250,000 Average Price of Homes for Sale in Market 271,458 Number of ARplicants on Waiting List 3 Population / % Completed Projects) Other Criteria Energy -Efficiency Indicate Standard Administrative Costs / New Loan 1,000 CDOH Funding Eligibility CDBG Action Pian Priority medium Minimum Application Criteria yes Housing Needs Assessment Supports Project no Please see application Instructions for DOH ranges. n a) N V Rf N CL w t0 s U C O Q co N b ,a - (L a v c H Q c m m CL 3 O G1 REGULATORY INFORMATION Please answer the following questions to the best of your ability, so DOH may provide technical assistance on compliance with applicable federal regulations. For more information, contact your regional Housing Development Specialist. Relocation and 1 -for -1 Replacement Will the proposed project activity directly cause any demolition or conversion of any Yes ❑ If yes, attach existing residential or commercial units resulting in permanent, temporary or economic General Notice displacement of existing tenants? Na and Rent Ra(I See HUD Handbook 1378, 24 CFR 92.354 & DOLA CDBG Guidebook Sec V11 htto:llwww.hud.aovloff&W-cWibrarvhelocatbmbollcyandouldenoelhandbook1378 cfm If yes, are the displaced households considered low-income? Yes ❑ If yes, attach Residential Anti -displacement and Relocation Assistance Plan (Att. D) No ❑ describing the steps taken to minimize displacement, including what assistancelbenefits will be provided to displaced households and what plans have been developed to replace the units and ensure that they stay at or below Fair Market Rent for 10 years. Davis- Bacon Wages Does the project include Davis -Bacon wages? (see Att. F) Yes ❑ See HUD Guidebook 1344 & DOLA CDBG Guidebook Sec Vlll No ❑ Environmental Review Have you started the Environmental Release of Funds (ROF) Process? Yes ❑ See 24 CFR Parts 58 & DOLA CDBG Guidebook Sec IV & http:lldote.cotorado.00vladh/develo,a rs/do21L s/TA on ROF 22610-D&No ❑ Will the project be undertaken in flood hazard areas? Yes ❑ If yes, attach a For questions: Thuy Patton, Colorado Water Conservation Board, 303-866-3441 x 3230 description of All applicants must attach a flood plain map. No ❑ your mitigation plans Will the project be near a geological hazard area, or affect historical, archeological or Yes ❑ If yes, attach a cultural resources? description of For questions: Pat Rodgers, Colorado Geological Survey, (303) 866-2611, Dan Corson, No ❑ your mitigation State Historical Society, (303) 866-2673 plans Will the project be located within 1,000 feet of a major highway, 3,000 feet of a railroad, Yes ❑ If yes, attach a 15 miles of a commercial airport or near military airfields or some other major noise description of source? No ❑ your mitigation plans Will the project be located within one -mile of aboveground storage tanks, transmission Yes ❑ If yes, attach a pipelines or loading facilities for explosive or fire -prone substances? description of No ❑ your mitigation plans Version 8-12 Page 7 or 26 Lead -Based Paint If the property was built before 1978, is it exempt from lead-based paint abatement? Yes ❑ Attach record htW://edocket.access ono gov/cfr 2003Lgarotr/pdf/24cfr35115 odf Indicating year List reason No ❑ of construction or proof of exemption If no, has the property been evaluated? Yes ❑ Attach record indicating year No ❑ of construction and proof of exemption Does the property need remediation? Yes ❑ If yes, the regulations at 24 CFR Parts 35 apply httnYAWww hud gov/offrces,lead/l orylenforcementQ4CFR35 SubvartA p2df No ❑ Asbestos For projects involving rehabilitation, has there been an evaluation of asbestos hazards? Yes ❑ If Yes, attach a http://www.edr)he.state.co.uslaplasbestostrenodemo.pdf copy of the No ❑ report(s). Does property need Asbestos remediation? If yes, contact a state -certified asbestos Inspector. Yes ❑ No ❑ ADA Accessibility & Visitability Does the project have 5 or more units? Yes ❑ If yes, for new construction or substantial rehabilitation, at least 5% (or 1, whichever is greater) must be accessible to persons with mobility impairments and 2% (or 1, whichever is greater) must be No ❑ accessible to persons with sensory impairments. The remaining units must meet the accessibility requirements of the Federal and State Fair Housing Act, which require that all units in elevator buildings and ground units in other buildings be ADA accessible. htto /Aww hud my/offices/theo/disabllft&fhouidelings/fhefha5 cfrrtfksect3 Number of units for persons with mobility impairment? (5%) Number of units for persons with sensory impairment? (2%) Number of visitable units? See DOH Visitability policy httpYlVola colorado aov/cdh/statehousinaboardPndex htn*anchoolicies Send copy of Agency's Section 504 Compliance plan See 24 CFR Part 8 & DOLA CDBG Guidebook Sec V ha ANWw_ ab/a _5431p_ co. us64 /fg aZQft�f2ulcfebook/PFQ7CIVILRIGHTSIXH-Cpdf Version 8-12 Page 8 of 26 Fair Housing Has the agency established Steps to Affirmatively Further Fair Housing? Yes X❑ See 24 CFR 570.487(b) & 24 CFR 92.351 See Att. N hOZAvww hud aov/olgr admAgdclins/%mrslfrles/935-2a pdf No ❑ Procurement Will DOH funds be used for purchasing goods or services? Yes ❑ If yes, which procurement policies will be followed? See DOLA CDBG Guidebook Sec 11 No X❑ hftn://dola colomdo aov/dialfa/odba&db{.gutdebook htmt#pecHon 11 Will DOH funds be used for construction? Yes ❑ If yes, the Debarred Checklist applies See httos:/tivww.evls.gov/& DOLA CDBG Guidebook Sec Vlll No X❑ Will there be over $200,000 of federal funds in the project? Yes ❑ No X ❑ Financial Management Does the applicant's financial management comply with Yes X❑ OMB Circular A-87 & 24 CFR Parts 85 & DOLA CDBG Guidebook Sec 11-C? No ❑ Does the applicant's audit/records comply with Yes X ❑ OMB Circular A-133 & 24 CFR 570.490(d) & DOLA CDBG Guidebook Sec 117 No ❑ Program Income Will the project generate Program Income? Yes If yes, indicate which: ❑HOME X❑CDBG No ❑ Examples of program income include, but are not limited to: revenue from the loans made through Down Payment Assistance (DPA) programs and Single-family Owner -occupied rehab (SFOO) programs. Projected Program Outcomes NIA ENERGY STANDARDS: List the Energy Efficiency Standard the project will follow? How many units will meet Energy Star Standards or standard listed above? SPECIAL NEEDS: Number of units designated for persons with disabilities? HOMELESSNESS: Number of units designated for homeless persons? Of those, number of units designated for the chronically homeless? HIVlAIDS: Number of units designated for persons with HIV/ AIDS? Of those, number of units for chronically homeless with HIV/AIDS? Version &12 Page 9 of 26 AUTHORIZED SIGNATURE SHEET ! certify to the best of my knowledge and belief, statements and data in this application, including the required Statement of Assurances and Certifications (Attachment A), attached tables and other documentation, are true and correct r Signa a Signature Signature Name (Typed or Printe Name (Typed or Printed) Name (Typed or Printed) `i# f kt n vk��.1 Title Title Title __e,� Date Date Date Signature Signature Signature Name (Typed or Printed) Name (Typed or Printed) Name (Typed or Printed) Title Title Title Date Date Date The above must be signed by the Chief Elected Official of the governmental unit, officer of the private corporation or other appropriate and authorized signatory for the applicant. Documentation proving signer is authorized must be provided In the case of multi - jurisdictional applications for CDBG funds, an executed Intergovernmental Agreement must be submitted, designating a lead governmental agency as the applicant and administrator of any award. If an IGA is not available, the Chief Elected Official of EACH local government must sign. Version 8-12 Page 10 of 26 ATTACHMENT A APPLICANT STATEMENT OF ASSURANCES AND CERTIFICATIONS The application must adhere to the following assurances and certification, that it: possesses legal authority to apply for the loan/grant and to execute the proposed project, and its governing body has duty adopted or passed as an official act a resolution, motion or similar action authorizing the filing of the application, including all understandings and assurances required, and directing and authorizing the applicant's chief executive officer and/or other designated official representatives to act in connection with the application and to provide such additional information as may be required; will give the State, the U.S. Department of Housing and Urban Development (HUD),. and any state authorized representatives access to and the rights to examine all records, books, papers or documents related to the application and grant; has provided for and encouraged citizen participation, with particular emphasis on participation by persons of low and moderate income who are residents of areas in which CDBG, HOME, HDG and HDLF funds are proposed to be used; by: 1. providing citizens with reasonable and timely access to local meetings, information, and records relating to its proposed and actual use of CDBG, HOME, HDG and HDLF funds; II, furnishing citizens information concerning the amount of funds available for proposed housing activities and the range of activities that may be undertaken„ Including the estimated amount proposed to be used for activities that will benefit persons of low and moderate income. Its plans for minimizing displacement of persons as a result of activities assisted with CDBG, HOME, HDG and HDLF funds and its plan for assisting persons actually displaced as a result of such activities; III, publishing a proposed project pian/application in such a manner to afford citizens an opportunity to examine its content and to submit comments on the proposed project plan/application and on the community development performance of the jurisdiction(s); IV. holding one or more public meetings, to obtain citizens view and responses to proposals and questions related to community development and housing needs, proposed activities and past CDBG, HOME, HDG, and HDLF performances. All meetings were halt no sooner than five days after notice, at times and locations convenient to potential or actual beneficiaries, and with accommodation for the handicapped. V. providing for a timely answer to written complaints and grievances, within 15 working days where practicable; and VI. Identifying how the needs of non-English speaking residents will be met in the case of public meetings where a significant number of non-English speaking residents can be reasonably expected to participate. Signae, Chief Elected 0616.07Executive Director/President Date Version 8-12 Page 11 of 26 ATTACHMENT B Intentionally Omitted Version 8-12 Page 12 of 26 ATTACHMENT C SUGGESTED FORMAT FOR LEGAL NOTICE This legal notice must be published as a legal notice in a newspaper of general circulation In the area of the project for one day at least five days prior to the public meeting. If applicant is applying to the local jurisdiction for matching funds, a combined public notice may be published although it must distinguish each funding request separately. in the case of a multi jurisdictional application, a legal notice must be published In each participating municipality or county. If a project is awarded CDBG funds, a post -award legal notice must be published upon project closeout (Replace this sample with notarized proof of publication as Attachment C) The (Name of Applicant) will submit an application to the Colorado Division of Housing (DOH). The purpose of this application Is to request LAmount of DOH Funding Request) to develop (Number of Units) of rental or homes for purchase at (Street Address of Property). The request of funding from DOH is to benefit persons with low and moderate incomes by increasing the availability of affordable housing In _ (Name of Communis It Is not the Intent to cause displacement from any existing housing; however, if persons are displaced from their existing residences reasonable housing alternatives shall be offered. All interested persons are encouraged to contact the applicant for further Information. Written comments should be sent application prrooceess (Mailis. less of Applicant) or (email address) and will be forwarded to DOH for consideration during the a Members of the public may request a public meeting and should arrange a request with the Applicant. Applicant shall post notice of meeting (Date, Time, and Location) to ensure other members of the public are aware of meeting. If reasonable accommodations are needed for persons attending the public meeftng, please contact the Applicant. NIA Vemlon 8-12 Page 13 of 26 Ad Name: 10278154A Customer: Eagle County Housing & Develop - Your account number is: 8798803 ENTERPRISE PROOF OF PUBLICATION STATE OF COLORADO ) )SS. COUNTY OF EAGLE I, Pam Boyd, do solemnly swear that I am a qualified representative of The Eagle Valley Enterprise, that the same weekly newspaper printed, in whole or in part and published in the County of Eagle, State of Colorado, and has a general circulation therein; that said newspaper has been published continuously and uninterruptedly in said County of Eagle for a period of more than fifty- two consecutive weeks next prior to the first publication of the annexed legal notice or advertisement; that said newspaper has been admitted to the United States mails as a periodical under the provisions of the Act of March 3, 1879, or any amendments thereof, and that said newspaper is a weekly newspaper duly qualified for publishing legal notices and advertisements within the meaning of the laws of the State of Colorado. That the annexed legal notice or advertisement was published in the regular and entire issue of every number of said weekly newspaper forthe period of 0 consecutive insertions; and that the first publication of said notice was in the issue of said newspaper dated 6/13/2014 and that the last publication of said notice was dated 6/13/2014 in the issue of said newspaper. 1n witness whereof, I have here unto set my hand this day, 06/17/2014. (rt.ti Cid Pam Boyd General Manager/Publisher/Editor Eagle Valley Enterprise Subscribed and swom to before me, a notary public in and for the County of Eagle, State of Colorado this day 06/17/2014. �0 �01-`I=10 Pamela J. Schultz„ Notary Public My Commission expires- ber 1, 2015 Ppv a�Br gyp:... •••ter PAMELAJ. i SCNl1f.R,,rp,�'p ar C-- Edea IlAraou Eagle County Government is In the process of submigirtg an epplicadon to the Colorado Division of Housing The ppurpose of the application is to request 955,000 for we In a Down Payment As - lingmom Proram which will be avalfir a to fami- Ues ma ng 110% or teas of Area Median Income to purchase howM1noo In Garflaltl Caunry and the por- tions of ElVir, Pff. I and Gunnison counties in the Roaring Fork Valley. Aft Interested parties are en- courapel 10 contact the EaCk CountyHousing Do - Pertinent located a125 MITI Loft, Suite 20O, Ed. wards, CO 81832 or via telephone at 970.328.8775, for further Information or to request a pudic hosting. Published In the Vail Daily on Juno 131h, 2014 00278154 ATTACHMENT D �/A RESIDENTIAL ANTIDISPLACEMENT AND RELOCATION ASSISTANCE PLAN The _ (City, Town or County) will replace all occupied and vacant occupy -able low/moderate income dwelling units demolished or converted to a use other than as low/moderate Income housing as a direct result of activities assisted with CDBG funds, as required by Section 104(d) of the Housing and Community Development Act of 1974, as amended (the Act), and implementing regulations at 24 CFR 570.496a. All replacement housing will be provided within three years of the commencement of the demolition or rehabilitation relating to conversion. Before obligating or expending funds that will directly result In such demolltion or conversion, the (City, Lown or County) will make public and submit to the State the following information in writing: 1. Description of the proposed assisted activity; 2. The general location on a map and approximate number of dwelling units by size (number of bedrooms) that will be demolished or converted to a use other than as low/moderate dwelling units as a direct result of the assisted activity; 3. A time schedule for the commencement and completion of the demolition or conversion; 4. The general location on a map and approximate number of dwelling units by size (number of bedrooms) that will be provided as replacement dwelling units; 5. The source of funding and a time schedule for the provision of replacement dwelling units; and, 6. The basis for concluding that each replacement dwelling unit will remain In a low/moderate income dwelling unit for at least 10 years from the date of initial occupancy. The (Clty, Town or County will provide relocation assistance, as described In 570.496a(b)(2), to each low/moderate income household displaced by the demolition of housing or by the conversion of a low/moderate Income dwelling to another use as a direct result of assisted activities. Consistent with the goals and objectives of activities assisted under the Act, the ACity, Town or County) will take the steps indicated below to minimize the displacement of persons from their homes:" The following are examples of steps to minimize displacement. The first two are required. The others are optional. Only check those which are appropriate for the project and local circumstances. Add other steps as necessary or appropriate. X Consider all practical alternatives to any proposed project that may result in residential displacement. Alternatives to be considered include other sites for the proposed facilities/project. Also to be considered are the costs and benefits, both financial and nonfinancial, of each aitemative. X Provide counseling and referral services to assist displacees find altemadve housing in the community. 3C Work with area landlords and real estate brokers to locate vacancies for households facing displacement. Stage rehabilitation of assisted housing to allow tenants to remain during and after rehabilitation, working with empty buildings or groups of empty units first so they can be rehabilitated.first and tenants moved in before rehab on occupied units or buildings Is begun. Establish temporary relocation facilities in order to house families whose displacement will be of short duration, so they can move back to their neighborhoods after rehabilitation or new construction. _ Evaluate housing codes and rehabilitation standards in reinvestment areas to prevent their placing undue financial burden on long-established owners or on tenants of multi-famlly buildings. Version 8-12 Page 14 or 26 _ Develop displacement watch systems in cooperation with neighborhood organizations to continuously review neighborhood development trends, identify displacement problems, and identify individuals facing displacement who need assistance. Signature of Chief Elected Official Date NOTE: EACH MUNICIPALITY AND COUNTY DIRECTLY PARTICIPATING INA MULTI -JURISDICTIONAL APPLICATION IS REQUIRED TO HAVE,A RESIDENTIAL ANTI DISPLACEMENT AND RELOCATION ASSISTANCE PLAN. Version 6-12 Page 15 of 26 ATTACHMENT E W!A ACQUISITION OF LAND AND/OR BUILDINGS SUGGESTED FORMAT FOR LETTER TO OWNER (Replace this form with your signed letter on agency letterhead) Date: Owner Name: Owner Address: Re: Property at (list address here) Purchase Price: Buyer. (agency, developer, or community name) This is to inform you that (buyer) would like to purchase the property listed above. We have offered you the purchase price listed above for clear title to the property under the conditions described in the contract of sale. Because Federal funds may be used in the purchase, however, we are required to disclose to you the following information: 1. This sale Is voluntary. If you do not wish to sell, (buyer) will not acquire your property. (Insert buyer's name) does not have the authority to acquire your property by force. 2. We estimate the fair market value of the property to be $ : (value). Since the purchase would be a voluntary, arm's length transaction, you would not be eligible for relocation payments or other relocation assistance under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (URA), or any other law or regulation. If you have any questions about this matter, please contact (contact person) at (phone number). Sincerely, Applicant signature: Date: I have read the above and agree with the statements therein: Owner signature: Date: XC] Check here in this is nota pts_ Ilcable to your project Reason: DOWN PAYMENT ASSISTANCE Version 8-12 Page 16 of 26 ATTACHMENT F VIA A DAVIS-BACON EXCEPTION CHECKLIST EXCEPTIONS The Applicant _ (Name) affirms that (part/all) of its CDBG/HOME project is excepted from Davis -Bacon Prevailing Wage Rate Provision because: _,_._ (a) The prime construction contract funded In whole or in part with CDBG/HOME funds is less than $2,000. (b) The entire project consists solely of demolition. (CDBG Only) ® (c) CDBG funds will be used for rehabilitating property that was designed for fewer than eight (8) households (See Note` Below) ,_ (d) HOME funds will be used for construction or rehabilitating property that was designed for fewer than 12 HOME- designated units (See Note" Below) ____ (e) Part/all of the project consists solely of dekvery of goods or services. (No construction contract.) (f) Part/all of the project will be done through a force account. (See Note" Below) — (g) There are no federal monies In the construction contract. — (h) All or a portion of the CDBG/HOME funds shall be used for the purchase of equipment: 1) Installation of equipment is incidental (less than 13%) of the total cast (equipment PLUS Installation - this requires a separate quote for equipment and the installation); 2) NO installation costs are included in the purchase of equipment. (i) Proceeds of the CDBG/HOME loan shall be used for working capital ONLY. (j) The CDBG funds are used for acquisition ONLY and there is no construction. NOTE: 'Any employees hired through a force account for a CDBG funded project will be considered Section 3 employees. "Grantee should confirm with their state monitor regarding this option. Clarification is necessary because some housing type projects will qualify as PUBLIC facilities and not as HOUSING. NO EXCEPTIONS – DAVIS BACON APPLICABLE ❑ If there is no exception, check here if Davis -Bacon is leR cable to your project Reason Davis -Bacon is triggered: Are Davis -Bacon wages included in construction cost estimates? ❑ YES ❑ NO Lead Agency to monitor compliance with Davis- Bacon Signature, Chief Elected Official/Executive Director/President Date Version 8-12 Page 17 of 26 ATTACHMENT G VIA IMMIGRATION POLICY Federal and State laws require Grantees to verify lawful presence of beneficiaries of public funds. The requirements to ensure lawful presence vary by the funding sources used to finance projects, as follows: Federal HOME Investment Partnership or Community Development Block Grant Programs If the funding is HOME or CDBG, the Welfare Reform Act does not require a non-profit charitable organization to determine, verify or otherwise require proof of lawful presence. if the managing member is a non-profit or if the general partner of a LIHTC ownership entity is a non-profit, this also applies. If the funding is provided to a for-profit, government, or quasi-govemment entity, all adult family members will have to sign a Declaration of Residency form. State of Colorado funds (HDG and HDLF) If the funding is State of Colorado Housing Development Grant (HDG) funds or Housing Development Loan Funds (HDLF) Grantees must confirm that any Individual natural person 18 years of age and older is lawfully present in the United States pursuant to CRS 24-76.5-101, et seq., when each individual applies for public benefits by requiring the applicant to: a) produce: 1.) a valid Colorado driver's license or a Colorado identification card, issued pursuant to Article 2 of Title 42 CRS; or 2.) a U S military or a military dependent's identification card; or 3.) a US Coast Guard Merchant Mariner card; or 4.) a Native American Tribal Document; or 5.) a document as described in 2.1.2 and 2.1.3 in the Colorado Department of Revenue's Rules for Lawful Presence section on Identification. b) and execute an Affidavit of Legal Residency stating: 1.) That he or phe is a United States citizen or legal permanent resident; or 2.) That he or she is otherwise lawfully present in the US pursuant to Federal law. SAMPLE FORM 1 AFFIDAVIT OF LEGAL RESIDENCY 1, (aaalicant) swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): ❑ I am a United States citizen, or i ❑ I am a Permanent Resident of the United. States, or ❑ I am lawfully present in the United States pursuant to Federal law. I that this swom statement is required by law because I have applied for a public benefit or I am a sole proprietor entering Into a contract or purchase order with the State of Colorado. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit or prioi to entering into a contract with the State. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this swom affidavit Is punishable under the criminal laws of Colorado as perjury in the second degree under CRS §1 M-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received. Signature of Applicant Date I agree tovid a maintair{ legal sident requirements as described above �-__� Sig e, Chief Elected Offic ecutive Director/President Date v47/a, &2 Page 18 of26 ATTACHMENT H STANDARD INSURANCE REQUIREMENTS State of Colorado insurance requirements are as follows and apply to all DON -funded projects. Grantee and its sub -grantees and subcontractors shall obtain and maintain insurance as specified in this section at all times during the term of this Grant: All policies evidencing the insurance coverages required hereunder shall be issued by insurance companies satisfactory to Grantee and the State. Grantee Public Entities If Grantee is a "public entity" within the meaning of the Colorado Governmental Immunity Act, CRS §24-10-101, at seq., as amended (the Governmental Immunity Act"), then Grantee shall maintain at all times during the term of this Grant such liability insurance, by commercial policy or self-insurance, as is necessary to meet its liabilities under such Act. Grantee shall show proof of such insurance satisfactory to the Department, if requested by the Department. Grantee shall require each grant or contract with a sub -grantee or subcontractor which is a public entity, providing Goods or Services in connection with this Grant, to include the insurance requirements necessary to meet sub -grantees liabilities under the Act. Non -Public Entities If Grantee is not a "public entity" within the meaning of the Governmental Immunity Act, Grantee shall obtain and maintain during the tern of this Grant insurance coverage and policies meeting the same requirements with respect to sub -grantees and sub -contractors which are not "public entities". Sub -grantees and Subcontractors Grantee shall require each contract with a sub -grantee or subcontractor, other than those that are public entities, providing Goods or Services in connection with this Grant to include insurance requirements substantially similar to the following: Worker's Compensation Worker's Compensation insurance as required by State statute, and Employer's Liability insurance covering all of sub -grantee or subcontractor employees acting within the course and scope of their employment. General Liability Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10193 or equivalent, covering premises operations, fire damage, independent contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: • $1,000,000 each occurrence; $1,000,000 products and completed • $1,000,000 general aggregate; operations aggregate; and • $50,000 any one fire. If any aggregate limit is reduced below $1,000,000 because of claims made or paid, sub -grantee or subcontractor shall immediately obtain additional insurance to restore the full aggregate limit and furnish to Grantee a certificate or other document satisfactory to Grantee showing compliance with this provision. Automobile Liability Automobile Liability Insurance covering any auto (including owned, hired and non -owned autos) with a minimum limit of $1,000,000 each accident combined single limit. Additional Insured Grantee and the State shall be named as additional insured on the Commercial General Liability and Automobile Liability Insurance policies (leases and construction contracts require additional insured coverage for completed operations on endorsements CG 2010 11/85, CG 2037, or equivalent). Primacy of Coverage Coverage required of the sub -grantee or subcontractor shall be primary over any insurance or self-insurance program carried by Grantee or the State. Cancellation The above insurance policies shall include provisions preventing cancellation or non -renewal without at least 45 days prior notice to the Grantee and the State by certified mail. Subrogation Waiver All insurance policies in any way related to the Grant and secured and maintained by Grantee's sub -grantees or subcontractors as required herein shall include clauses stating that each carrier shall waive all rights of recovery, under subrogation or otherwise, against Grantee or the State, Its agencies, institutions, organizations, officers, agents, employees, and volunteers. Malpractice/Professional Liability Insurance Professional Liability Insurance Policy may apply in the minimum amount of $1,000,000 per occurrence and $3,000,000 in the aggregate, written on an occurrence form, that provides coverage for Its work undertaken pursuant to this Grant. If a policy written on an occurrence form is not commercially available, the claims -made policy shall remain in effect for the duration of the Grant and for at least two years beyond the completion and acceptance of the work under the Grant, or, alternatively, a two year extended reporting period must be purchased. Certificates Each of Grantee's subcontractors and subgrantees shall provide certificates showing insurance coverage required hereunder to Grantee within seven business days of the Effective Date, but in no event later than the commencement of the Services or delivery of the Goods under the subcontract or subgrant. No later than 15 days prior to the expiration date of any such coverage, each subcontractor or subgrantee shall deliver to Grantee certificates of insurance evidencing renewals thereof upon request by the Department or at any other time during the term of a subcontract or subgrantee, Version 8-12 Page 19 of 26 L rantee may request in wnnng, ano the suocontractor or suograntee snau tnereupon wrtrnn -1 u nays suppry to urantee, evidence satisfa to Grantee and the Dgp2r#'[`ftnt of compliance with the provisions of this section. I agree to provide m t msur as'desc ' ed above e Signature, Chielqplled Official/Executive Dir resident Date Version 8-12 Page 20 of 21 Certzfzcate of Participatzon Colorado Counties Casualty and Property Pool (CAPP) For the Coverage Period January 1, 2014 through December 31, 2014 EAGLE COUNTY Colorado Counties Casualty and Property Pool (CAPP) hereby certifies that Eagle County is a participating Member of CAPP for the period beginning January 1, 2014 through December 31, 2014. The coverages, conditions of membership, and other provisions applicable to members of CAPP are as described in CAPP's Bylaws and intergovemmentai Agreement and in the applicable excess policies, policy statements and endorsements thereto, copies of which have been or will be provided to Eagle County. The types and monetary limits of the coverages provided to Eagle County through membership In CAPP, in consideration of the payment of its contrlbutions, are limited, as of the date of this certificate, to those which are shown below. The scope, terms, conditions and limitations of coverages are governed by the aforementioned agreement and policies. 1) The types of coverages, subject to the ilmit on CAPP's liability In Section II below, aro as follows: A) Property (including EDP, mobile equipment, and auto physical damage) B) Liability 1) Bodily injury, Property Damage (General Liability, Auto Uabli ty) 2) Wrongful Acts committed In the conduct of duties (Public Entity Management Liability) 3) Bodily Injury, Property Damage, Personal Injury (law Enforcement Liability) 4) Enron or omisslons In the administration of an Insured's employee benefits (Employee Benefits Liability) 5) Injury resulting from healthcare professional services rendered by any Insured who is not a medical doctor, psychologist, psychotherapist or nurse practitioner. (Healthcare Professional Liability). C) Crime 1) Monies and Securities (Inside) 2) Monies and Securities (outside) 3) Employee Fidelity D) Boiler and Machinery E) Network Security Uability II) CAPP Retention, Aggregate Limits, and Member Deductible* For the coverages described In Section I. CAPP shall be liable only for payment of the self-insured retention and only to a total annual aggregate amount for members of CAPP as a whole of the amount of the CAPP lose fund for the coverage period. CAPP's per daimloccunence retentions are limited to the following for the foregoing coverages: A) $150,000 per dalmioccurrence property — County deductible $500 B) $250,000 per claimloccurrence liability (per coverage line) —(:ounty deductible $0 except in certain claims - See CAPP Policy Statements. C) $150,000 per dalmloccurrence dime — County deductible $500 D) $5,000 per lose boiler and machinery — County deductible $500 E) $150,000 per dalm/occurrence network security liability — County deductible $0 CAPP 2014 Certificate of Participation There Is a maintenance deductible of $500, which apples to each of the Countys first party claims/occurrences/losses (property claims). Payment of the deductible reduces the amount otherwise payable under the applicable CAPP retention. Pertaining to all lability losses. CAPP has purchased aggregate retention protection with a pool self-insured retention of $6 million In any one policy year. Coverages in excess of the foregoing pool retentions are provided only by the excess Insurers In applicable excess polcles, and are payable only by those excess insurers. The limits of coverage provided by the excess insurers are as Wows: A. Liability From $260,000 per clalm/occurrence to $10 million per claim/occurrence except for auto, which is non - aggregated, subject to the following: Ali liability coverages are provided on a Balms -made coverage form. in no event shall the maximum per claimloccurrence payment exceed the following for general liability, auto liability, public entity management liability, law enforcement liability, employee benefits liability or healthcare professional liability claims subject to the Governmental Immunity Act: $350,000 per person and $9W,000 per occurrence. Additional limits, sublimits and aggregates apply as provided In the applicable excess policies. B. Crime From $150,000 to $1 million each occurrence. Additional limits, subllmits and aggregates apply as provided In the applicable excess policies. C. Boilerand Machinery From $5,000 to the cost of repair/replacement for each actual loss sustained up to $100 million. Additional limits, sublimits and aggregates apply as provided In the applicable excess policies. D. Property From $150,000 to $100 million each occurrence. "All Risk' basis with subllmits of $10 million newly acquired property, $5 million new construction each occurrence and $1 million unscheduled locations. Subilmits of $5 million for property In Flood Zone A and $50 million for property In all other flood zones. Newly acquired property must be reported within 90 days. Additional limits, sublimits and aggregates apply as provided In the applicable excess policies. E. Network Security Liability Each claim from $150,000 to $1,000,000 Aggregate Network Security and Privacy Liability Limit with sublimity: $500,000 Digital Asset Damage, $500,000 Date Breach Fund (nobllcationlcredit monitoring), $500,000 PCl/Reguiatory Fines/Penalties. Additional limits, sublimate and aggregates apply as provided In the applicable excess policies. The excess Insurers for the coverage period are One Beacon and Lexington insurance Co., Hiscox and ACE. Information concerning the CAPP loss fund for the coverage period may be obtained by contacting CAPP through its Administrator, County Technical Services, Inc. (CTSI). Colorado Counties Casualty and Property Pool Alien E. Chapman, CTSI Executive December 6, 2013 CAPP 2014 Certificate of Participation ATTACHMENT I NIA_ INTERGOVERNMENTAL AGREEMENT FOR COMMUNITY DEVELOPMENT BLOCK GRANT PROJECT (Sample) THIS AGREEMENT, made this day of . 20_-, by and among the following: WHEREAS, the parties to this Agreement have the authority pursuant to Article XIV, Section 18 of the Colorado Constitution and Section 29-1-201, et. seq., Colorado Revised Statutas, to enter into intergovernmental agreements for the purpose of providing any service or performing any function which they can perform Individually. WHEREAS, the parties to thls Agreement desire to cooperate in developing and carrying out a Community Development Block Grant (CDBG) project, the purpose of which is to: NOW THEREFORE, the parties hereby mutually agree as follows: Designation of Leadegrty. _(Lead Party) shall act as the lead party In developing and carrying out said proposed CDBG project. Responsibit'rties of Lead Party. In its capacity of lead party, (Leadty) shall by the lead Jurisdiction in making applicallon to the State Department of Local Affairs (State) for CDBG funds and shall be the grantee of the State for such funds, If awarded. As the grantee of the State, it shall be fully and solely responsible to the other parties to this Agreement for compliance with all financial management, environmental review, labor standards, civil rights, record-keeping, reporting and other requirements of the CDBG program contained In the Applicant Statement of Assurances and Certifications, and in the grant contract with the state, except those specified in Paragraph 3 hereinafter. Responsibilities of All Parties. Each party to this Agreement shall be individually responsible for compliance with the following requirements of the CDBG program: a) adopting a required Citizen Participation Plan, and providing to its citizens information and opportunities to comment as required by the State in developing an application and substantially changing project activities; b) identifying its community development and housing needs, Including the needs of low and moderate Income persons, and the activities to be undertaken to meet such needs; and C) adopting a required Antidlsplacement and Relocation Assistance Plan which calls for replacement of demolished or converted low/moderate income housing units and provision of necessary relocetlon assistance; and, d) taking actions to affirmatively further fair housing. Furthermore, each party shall provide documentation to (Lead Party) demonstrating its compliance with the requirements specified in the Paragraph 3 and (Lead Party) shall retain such documentation and other required records and documents for the period of time specified by the State. Contracting. (Lead Party) shall contract with or, with other eligible Individuals or entities to carry out all or any portion of the responsibilities assumed by Version 5-12 Page 21 of 2 (Lead Party) under tnls Agreement and its grant contract with the State. 6. Term of Agreement. This Agreement shall remain in full force and effect for so long as the parties to this Agreement are pursuing CDBG funding for said proposed project or. If awarded, carrying out such project activities. Any party to this Agreement may, however, terminate its participation in this Agreement six months after providing written notice of such termination to the other parties of this Agreement. This Agreement may be terminated at any time by agreement of all parties to this Agreement unless a grant contract Is in effect with the State. In this case, the State.must approve such termination and arrangements for completing the project. 6. Modification and Changes. The terms of this Agreement may be modified or changed at any time by agreement of all parties to this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day first above written. (Lead Party) By PBSition (Party) By Position (Party) By Position (Party) By Position (Party) By Position (Party) By Position Version 8-12 Page 22 of 2 ATTACHMENT J W-9 STATE OF COLORADO VERSION http:Ndola.colorado.siov/cdh/section8/W9Docs/W-9.odf shilowhob REQUEST PM WMAYEB. MENTEWAIM 5nb of cahm ado W-9 NUUM VZMWATWN nu NOr seas 6 M PXDU QLTYK tur+>anTfs m+oe,w u►wa sertu,aasae,eaau ,eaapri �we.rw rr« W►=WITMTMe-UD4=% 6aFAS=PROPKrt9SWQ(TfmLM.s.a...e.I.I.M..uFf.,..V. lc Con NV l- r -n WXY& Tbde New oelyjfthti� a: (wBrA) Beit Addrais -Po vx 5-015roadwrzf, le Co 1-021 1 Poicbm GirderAddress - Opriond PAITa tea Fm a bwAmr a agarCSS afFam Chad l aiCiud �.' fW and attar 9 ftk Tas pgwlslepptomd=NaWw CW bebw: +. aaC7t ffrrrY�aaNt6�rasYr ar.Yrrim a-amwRwaWrMt�.M-I4M-rYlfib 6arribt. --- —"'" "'•.•.�— Now Bert both 6e coon's SSNndthebmiumEN(ifyoamre indwhawme) w —_^---- du Wwhri rfOdirerr-wb 0--d�r�n..� �ralre� %W .6r, kW MAm and Yrrew IW LIIY W& b--aMb �•—�—•••.�— Q�dter I�md Ia�[Vmumawkmt. M tel• -- --�--mow. 7m 9 aiEdi[al �° Ye'13 Ne (Cap4 as ) ,o�Oa-m°vaiea cslsteicw 13 Yes ❑ No ----------- LJ ch -k aamat i ynm mo mr km a aen ar mv, bR amra apphad fiw ora. See Mersa fw mea m Jil#W m 3G;.A' Licensed Beal Emu Brdwl ❑ yes O No the (1)'rLFmWrtitfda��itaymerrsTb�CNomiwr(QI®s�etmafaakw`bMismidbma).QIIf (i) I meat snbjart b wri�,otYleL� bmooac (� I m tatmmpt fem belnp,mittiotimF ar (b) Ilbn a•t b•tm andfimd h dr hat®d Ircoot. s.roSu M60Immabjwbbodopaidt elftmanentofafbnbspatasebad•t&WAmdycc(c)Ib•IISshuanafiedmeimImanfemyar tatbjaet m baelmp aeidtLwft (ioa as apptyb nal *1001 tmoedwre woopp home p" ar ugmtmma Qabdammmt of uemr pamfwny, t btaiimbielllnlltmmit fRAi.aadtrraameG&W Itshomtd ). C�Ilt>:lI1lCiipNs-Yocammow•wtitm(2),lwwiiyaftmwen.aati6.at,ttaarstaeym,n sa6jtabtmdmpv*AWdma brsudmlaraparosmtmtrcwEa�r�o�tramba(6•mlfyriErCmf�r�mmalf•mmrmmFdisrmm.) NAME Oftew w Typ) TATZ Chm a Type AVMXIM UGNATURE DAn pwI� ( J DO Igor WE m =AM Tam We ff f= COPD:1 TOA AfI+ " AVMY o—_ AMMI dby Dtoe 1099: yes No Acta= Completed by Deme VE MM- Adaitim- Cbmp e1542aa-7= (R AW) Version 8-12 Page 23 of 21 ATTACHMENT K Commissioner TA S moved adoption of the following Resolution: BOARD OF COUNTY COMMISSIONERS COUNTY OF EAGLE, STATE OF COLORADO RESOLUTION NO. - O5S RESOLUTION CONCERNING APPROVAL OF APPLICATION RESOLUTION AND SIGNATORY AUTHORITY FOR ROARING FORK DOWN PAYMENT ASSISTANCE PROGRAM WHEREAS, the Board of County Commissioners of the County of Eagle, State of Colorado (hereinafter the "Board"), has approved an grant application to the Colorado Department of Local Affairs/Division of Housing for funds totaling $54,579 for a Down Payment Assistance Loan Program (the "Grant Application") that will be targeted at families making less than $0% of Area Median Income within the Roaring Fork Valley (Garfield, Pitkin, Gunnison and Southwestern Eagle Counties;) and WHEREAS, the Board certifies the Eagle County Manager has full signatory authority in regard to all Eagle County contracts of up to $25,000, and desires to grant the County Manager full signatory authority with respect to all documents associated with the Grant Application. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF EAGLE, STATE OF COLORADO: THAT, the Board supports the application and implementation of this new Down Payment Assistance Program; and THAT, if the grant is awarded, the Board hereby authorizes the Eagle County Manager to sign the Grant Agreement associated with the Grant Application and all reports and documents associated with the associated grant from the Colorado Division of Housing. MOVED, READ AND ADOPTED by the Board of County Commissioners of the County of Eagle, State of Colorado, at its regular meeting held the day of VL --A 2014 VP PP COUNTY OF EAGLE STATE OF COLORADO, By and Through Its BOARD OF COUNTY COMMISSIONERS ATTEST: Commissioners Sara. Fisher C missio r , r X ( f Kathy Ch ler-Henry i Commissioner Commissioner s 4-4 .1n , r� t u yj seconded the adoption of the forgoing resolution. The roll having been called, the vote was as follows: Commissioner Ryan V-" Commissioner Fisher Commissioner Chandler -Henry This resolution passed by 5/0 vote of the Board of County Commissioners of the County of Eagle, State of Colorado. CHECKLIST FOR REQUIRED DOCUMENTS Please Submit In Order Below (use all check lists that apply to application) c a°f t a°/ I c a i Cr I 1 E s I a 121 e epi 1 m - o Z c a. Lq S A 4 1Z a o°I yJ 'i a Applicable Received ATTACHMENTS REQUIRED FOR INITIAL APPLICATION REVIEW Att. A— Statement of Assurances X X X X X X X X X Yes ❑ Att. B —Intentionally Omitted All. C -- Proof of Pre-app®cation Legal Notice X X X X X X X X Yes ❑ Att. D— URAIROftelion Plan X X X X X X X X Yes ❑ Att. E —Acquisition of Land or Building X X X X X Yes ❑ Alt. F— Davis-Bacon Exception Checklist X X X X X X X X Yes ❑ All. G— Immigration Policy X X X X X X X X X Yes ❑ Ali. H— Insurance Requirements X X X X X X X X X Yes Q Att I — intergovernmental Agreement X X X Yes ❑ All. J— W-g, Tax Payer Identification 8 X X X X X X X X X Yes ❑ Ali. K— Doc. of Signatory Authority & Board Resolution Authorizing application _ X X X X X X X X X Yes ❑ SUPPORTING DOCUMENTS REQUIRED FOR INITIAL APPLICATION REVIEW IRS Determination Letter (Nan-profits only) X I X X X X X X X X Yes ❑ Most Recent Audit (A-133, If applicable) X X X X X X X X X Yee ❑ Staff Allocation Pian (f not In Budget) X X X Yes ❑ Site Control Documentation wl legal deacdptlon X X X X _ X Yes ❑ Zoning and Site Plan Approval X X X X Yes ❑ Floodplain Map X X X X X Yes ❑ Environmental Studies (Phase 1, Lead Based Palnt & Asbestos) X X X X Yes ❑ Architectural Drawings/Photos (via emall) X X X X Yes ❑ Construction Cost Estimates X X Yes ❑ Capital Needs Assessment & Cost Estimate X X Yes ❑ Market Study/Needs Assessment X X X X Yes ❑ Appraisal (or date on comparables) X X X X Yes ❑ Copy of Tax Credit Application X X I X Yes ❑ Letters of Funding Commitment X X X X X X X X X Yes ❑ Letters of Local Government Funding Commitment X X X X X X X X Yes ❑ Relocation: General Notice to Tenants and Proof of Delivery X X Yes ❑ Relocation: Current Rent Roll with Residents' Incomes X X Yes ❑ Relocation Plan (only if relocation will occur) X X Yes ❑ OPA/Rehab Local Program Guidelines X X Yes ❑ Issuer PAB Application X Yes ❑ Inducement Resolution X Yes ❑ Credit Enhancement X Yes ❑ Bond Counsel Opinion I I X Yes ❑ Assignments of PAB Cap X Yes ❑ Application Fee tE X Yes ❑ 8328 IRS filing or Relinquish to Statewide Balance X Yea ❑ Version 8-12 Page 25 of; CHECKLIST FOR REQUIRED DOCUb1ENTS Please Submit In Order Below (use all check lists that apply to application) i 0 aEj o La e d @c to at 4 � .. m Appllcable Received az o°3¢ z 14a al U az a say ATTACHMENTS REQUIRED BEFORE CONTRACT Att. L— Agency's 504 Self Certification X X X X FF X X X X X Yes ❑ Att. M— Steps to Further Fair Housing X X X X X X X Yes ❑ Att. N— Affirmative Fair Housing Marketing X X X X X X Yes ❑ Att. 0—Sub-recipientAgreement (CDBG) X X X X X X X X Yes ❑ AIL P— Citizen Participation Plan (CDBG) X X X X X X Yes ❑ Att. Q— Excessive Force Policy (CDBG) X X X X X X Yes ❑ SUPPORTING DOCUMENTS REQUIRED BEFORE CONTRACT Final Legal Property Description of any changes since X X X X X Yes ❑ WWI application) I Consolidated Plan Consistency tetter (d local govt X K X X X X X X Yes ❑ receives CDBG or HOME funds) Letters From Service Providers (for 30% AMI units) X X X X Yes ❑ Partnership Agreements X X X X Yes ❑ Evidence of insurance with DOH as additlonai Insured X X X X X X X X Yes ❑ (see Aft. H) Version 8-12 Page 26 of 2