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COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION FOR FUNDING PROGRAM YEAR 2024 APPLICATION DEADLINE DATE: March 15, 2024 St. Thomas Office St. Croix Office 3202 Demarara Plaza, Suite 200 100 Lagoon Complex, Suite 4 St. Thomas, VI 00802-6447 Frederiksted, St. Croix, VI 00840 (340) 777-4432 (340) 772-4432 www.vihfa.gov CDBG PROPOSAL -1- INVITATION FOR PROJECT PROPOSALS The Community Development Block Grant Program invites the public to submit project proposals to be considered for funding from the 2024 grant allocation. To request an application, please call our St. Thomas or St. Croix office between the hours of 8:00 AM to 5:00 PM Monday through Friday, excluding holidays. The deadline for returning the proposals is Friday, March 15, 2024, at 3:00 P.M. Atlantic Standard Time. Please note that proposals will not be accepted after the deadline. Prospective applicants must attend one of the MANDATORY orientation sessions as follows: Applicant Orientation Session Information Session A Session B Date: Tuesday, February 13, 2024 Date: Thursday, February 29, 2024 Time: 5:30 P.M. Time: 10:00 A.M. Register in advance for this application orientation session using the link below: https://us02web.zoom.us/meeting/register/tZEvdu2vr DIvGtQEx88Ao8r1BsNEwztBcK7q After registering, you will receive a confirmation e-mail containing access information for joining the orientation via Zoom. Register in advance for this application orientation session using the link below: https://us02web.zoom.us/meeting/register/tZUsce6hqD MiHtKqsD9Mn-2qA78vHKI6AwAR After registering, you will receive a confirmation e-mail containing access information for joining the orientation via Zoom. For more information or assistance with the application, please call Ms. Jennifer Jones, CDBG Program Manager or Ms. Samalia Wyllis, CDBG Associate Planner I at (340) 777-4432 (St. Thomas/St. John) and Kalimah Henry, CDBG Associate Planner II at (340) 772-442 (St. Croix). CDBG PROPOSAL -2- Index and Instructions This application is to be completed by government agencies, non-profit and for-profit organizations interested in obtaining Community Development Block Grant funds for public facilities and services and other neighborhood and community development projects in the 2024-25 Program Year. The application consists of seven sections. Note: Complete and return only the sections that are applicable to your project. Separate applications should be submitted for a project to be undertaken within both districts. Separate applications should also be submitted where an applicant proposes to undertake both a public service program and a construction project. 1. Section 1 (pages 3–4) and Section 2 (pages 5-11) must be completed by each applicant. (Make sure to include your EIN and UEI, Unique Entity ID. Instructions to apply for a UEI through System of Award Management (SAM) are included as an attachment to this application. 2. Section 3 (pages 12 -14) should be filled out only if the applicant is seeking CDBG funds for the purchase of real estate or its lease for 15 years or more. Note that lease of a building for less than 15 years is considered rent and should be included in Section 2, sub-section F and Section 7 (Public Service). 3. Section 4 (pages 15-17) should be filled out only if the applicant is seeking CDBG funds for the construction, renovation, or rehabilitation of a building. 4. Section 5 (pages 18-19) should be filled out only if the applicant is seeking CDBG funds solely for the construction or improvements of roads, sidewalks, playgrounds, pipelines or other water and sewer facilities. Note that this does not include the construction or renovation of water and sewage facilities, or driveway and sidewalks associated with the construction or rehabilitation of a particular building, which would be included in Section 4. 5. Section 6 (pages 20-21) should be filled out only if the applicant is seeking CDBG funds to expand or operate a for-profit business. 6. Section 7 (pages 22-26) should be filled out only if the applicant is seeking CDBG funds to operate a public service program such as training, counseling, after-school programs, operation of a soup kitchen, etc. Note: If CDBG funds are requested to lease property for 15 or more years to operate a public service program, this should be included at Section 3 (Acquisition of Real Property). 7. Page 27: Instructions to apply for a UEI at SAM.gov. Effective April 4, 2022, the Dun & Bradstreet’s Data Universal Numbering System (DUNS) has become obsolete. Each organization is required to obtain a new Unique Entity ID (UEI) which is issued within the System of Award Management (SAM). Funded activities should be ready to start on January 1, 2025, and achieve completion within one year. If completion in a one-year period is not possible, the project should be divided into phases, each of which can be completed within one year. The CDBG program operates mostly on a reimbursement basis. The agency/organization incurs the cost and submits the original receipts with copies of cancelled checks (or other form of proof of payment, where applicable) in order to request reimbursement of these costs. Undocumented expenses will not be paid or reimbursed. Reimbursements will be issued only for encumbrances or commitments that occurred after the effective date of the agreement authorizing the use of the funds. CDBG funds cannot be used to pay or reimburse cost incurred prior to the effective date of the Sub-recipient Agreement/Memorandum of Agreement and the Notice to Proceed. A fillable electronic version of the CDBG application form is available on the VIHFA’s website at www.vihfa.gov or can be provided via e-mail upon request; however, the application may not be submitted electronically. The application must be submitted on paper, type-written and in the exact format of this original along with all required attachments. Two signed copies of the application must be submitted. An incomplete application will result in a low score during the final evaluations. No other cover sheet except the one included in this application shall be used. Application forms from prior years shall not be used. The CDBG Program reserves the right to disqualify from consideration any application which does not conform to the requirements outlined above. CDBG PROPOSAL -3- SECTION 1: APPLICANT INFORMATION This section is to be completed by all applicants. 1. Name of organization or agency: _______________________________________________ 2. Project Contact Person: _______________________ Position: _______________________ 3. Physical Address: ____________________________________________________________ 4. Mailing Address: _______________________________ Zip Code: _______________ (If different from above) 5. Daytime Phone No: ( ) ___________________ Cell No: ( ) _____________________ 6. Fax No: ( ) _______________________ E-mail Address: ______________________ 7. EIN/Tax ID # ________________________ Unique Entity ID (UEI)___________________ 8. Type of organization: ( ) Government ( ) For-profit, Sole Proprietorship ( ) For-profit, Corporation ( ) Not For-profit 9. Number of years the organization has been in operation: ____________ 10. Major purpose of the organization: ______________________________________________ _____________________________________________________________________________ 11. Describe the types of services the organization normally provides: _____________________________________________________________________________ 12. Identify clients normally served (for instance, high school drop-outs): _____________________________________________________________________________ 13. If the applicant is a governmental entity, please skip to Question #15. Please provide the following documents. Note: For any documents which are not included with the application, please also provide a separate narrative to indicate the dates by which the remaining documents will be submitted. ( ) Current business license (for-profit organizations only) ( ) Articles of Incorporation and By-laws (non-profit organizations only) ( ) Listing of current board members ( ) Minutes of the last three board meetings ratified by the President of the organization (non- profit organizations only) ( ) Certificate of Good Standing ( ) Most recent audit report (not more than three years old) ( ) Financial statements (not more than one year old) ( ) Formal organizational chart ( ) Resumes, or job descriptions, of the organization/program’s key personnel CDBG PROPOSAL -4- 14. Is the organization currently, or has it ever been, barred from participating in any federal or federally funded program or project (including CDBG): Yes ( ) No ( ) 15. Please list below all the federal funds (including CDBG) that the organization has received over the last 3 years: Funding Source Amt of Funds Received Purpose for which funds were used Finished or Ongoing Attach a separate sheet if additional space is required. 16. Is the organization current in its reporting on these grants? Yes ( ) No ( ) 17. Provide a letter from each of these funding sources to show that the organization is in compliance with its requirements. 18. Describe the organization’s fundraising activities within the last year and the amount of funds that were raised: _____________________________________________________ _______________________________________________________________________ (To be executed by organization’s head) I certify that the information contained in this application is true and correct. I agree to commit the agency to the implementation of this project if it is approved: By: ______________________________________ ______________________________________ Print Name Signature Title: ____________________________ Date:_______________________ CDBG PROPOSAL -5- SECTION 2: PROJECT SUMMARY This section is to be completed by all applicants. A. ELIGIBLE ACTIVITIES In order to be eligible for funding, a proposal must include one or more of the activities described in Title 24 Section 570.200 to 570.206 of the Code of Federal Regulations. Select from the listing below the activities that this proposed project entails. ( ) Acquisition of real property; ( ) Disposition of property acquired with CDBG funds; ( ) Acquisition, construction, reconstruction, rehabilitation, or installation of public facilities and improvements; ( ) Clearance, demolition, and removal of buildings and improvements; ( ) Provision of public services (including labor, supplies and materials) directed toward improving the community's public services and facilities, including but not limited to those concerned with employment, crime prevention, childcare, health, drug abuse treatment or prevention, education, fair housing counseling, energy conservation or recreation needs; ( ) Repairing of streets, sidewalks, parks, playgrounds, publicly owned utilities and public buildings, special garbage, trash, and debris removal in areas exhibiting signs of physical deterioration or in order to eliminate emergency conditions; ( ) Payment of the costs of completing an urban renewal project funded under Title I of the Housing Act of 1937, as amended; ( ) Relocation payments and other assistance for permanently and temporarily relocated individual families or businesses; ( ) Removal of architectural barriers; ( ) Acquisition, construction, reconstruction, rehabilitation or installation of the distribution lines and facilities of privately-owned utilities; ( ) Rehabilitation of privately-owned buildings for residential purposes, improvements to the exterior of commercial or industrial buildings or the rehabilitation, preservation, or restoration of historic properties; ( ) Acquisition, construction, reconstruction, rehabilitation, or installation of commercial or industrial buildings, structures, or the provision of assistance to for-profit businesses; ( ) Planning and survey CDBG PROPOSAL -6- B. Need and Appropriateness of Project 1. Describe the project/program for which CDBG funding is being requested. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 2. Why is this project necessary and appropriate for the community? _________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 3. Why are CDBG funds necessary and appropriate for the project? ___________________ ________________________________________________________________________ ________________________________________________________________________ 4. Can the project proceed without CDBG funding? Yes ( ) No ( ) 5. Indicate the beneficiaries, clients or persons for whom the project is intended (for instance, “the homeless”, “youth ages 6 – 12”, “residents of public housing”): ________________________________________________________________________ ________________________________________________________________________ CDBG PROPOSAL -7- C. National Objectives In order to be eligible for CDBG funding, a project must meet at least one of the national objectives of the CDBG Program outlined in Title 24, Section 570.208 of the Code of Federal Regulations. Select from below the national objective(s) to be met by this project. ( ) Elimination or amelioration of situations that threaten health and safety which have not been in existence for more than 18 months prior to seeking CDBG funds. ( ) Provision of employment or other benefits primarily to persons of low and moderate income ( ) Elimination of slums and blight - including historic restoration to remove conditions that threaten health and safety. Please note that the designation of areas of “slum and blight” must have been established by local law. D. Low/Moderate Income Benefits If the project will meet the low/moderate national objective above, please select one of the following beneficiary categories: ( ) Limited Clientele: Participation in the program would be limited to a specific group of persons and at least 51% of them qualify as low to moderate income. ( ) Presumed Benefits: The following persons are assumed to be of low to moderate income: elderly, severely disabled adults, homeless persons, illiterate adults, migrant farm workers, abused children, persons with AIDS or battered spouses ( ) Area-wide benefits to persons of low to moderate income (Note: This selection is applicable only if the project will be located in a neighborhood or census tract where more than 51% of the persons or households qualify as low to moderate income. Please refer to the census maps attached at the end of the application). E. Housing Rehabilitation Projects In order for a rental housing rehabilitation project to be eligible for CDBG funding, at least 51% of the rental units must be occupied by low and moderate-income households. For rehabilitation of owner-occupied units, 100% of the units must be occupied by low and moderate income households. (Note: New construction of housing is generally not eligible for CDBG funding). 1. Street address of project: ______________________________________________ 2. # of rental units: _______ Percentage occupied by low/mod income persons: ____% 3. # of owner-occupied units:______ Percentage occupied by low/mod persons: ____% Note: Documentation of household income will have to be provided for each tenant or owner household before the start-up of the project activity. CDBG PROPOSAL -8- F. Public Service Projects 1. Street Address of Project: ____________________________________________ 2. Number of persons or households to be directly served by the project _________ 3. Percentage meeting the definition of low/moderate income _________ % 4. Describe how you will ensure participation of low/moderate income beneficiaries: _______________________________________________________________________ _______________________________________________________________________ Note: If the public service project is seeking to qualify as limited clientele, documentation of family income will have to be provided for each participant before the start-up of the project activity. G. Economic Development, Public Facilities, and Infrastructure Projects 1. Name of Project/Facility:___________________________________________ 2. Street Address: ___________________________________________________ Identify location of proposed project on Estate Map included as an attachment 3. Neighborhood or census tract in which project is located__________________ Identify location of proposed project on Census Map included as an attachment 4. Number of persons or households residing here: ____ persons _____households 5. Percentage meeting the definition of low/moderate income : _________ % H. Consolidated Plan Compliance The federal funding agency (HUD) requires CDBG funding to be expended based upon a Consolidated Plan for housing, homelessness, and community development. At the present time, there is in effect a Consolidated Plan for the period 2020 – 2024. Indicate which of the 4 objectives of the Consolidated Plan is to be met by this project: 1. ( ) Increase and preserve the stock of affordable housing units Examples of projects meeting this objective include, but are not limited to, projects which entail acquisition, demolition, or preparation of sites for affordable housing; homebuyer direct financial and other assistance; and rehabilitation of owner- occupied housing. CDBG PROPOSAL -9- 2. ( ) Reduce and prevent homelessness Examples of projects meeting this objective include, but are not limited to, projects which entail construction of, or improvements to, emergency shelters, transitional facilities, or permanent supportive housing; operations of emergency shelters, transitional housing facilities, or permanent supportive housing; construction of other homeless facilities such as soup kitchens and outreach facilities; homeless prevention, rapid re-housing, and other services, including but not limited to outreach ,counseling, medical and mental assistance and case management. 3. ( ) Provide services and community support Examples of projects meeting this objective include, but are not limited to, projects which provide services that assist low-income households and neighborhoods; also, projects that assist special needs populations – e.g., youth, the elderly, disabled persons, the mentally ill, victims of domestic violence, and victims of substance abuse. 4. ( ) Support community and economic development Examples of projects meeting this objective include, but are not limited to, projects which entail acquisition, development, and rehabilitation of facilities for the delivery of public services; renovation of public facilities to provide handicap accessibility or other improvements; infrastructure improvements, and projects that support economic opportunities for low-mod income persons. I. Funding The Territory of the Virgin Islands receives a Community Development Block Grant allocation on an annual basis. The normal expectation is that each grant would be spent or liquidated before the next one is received; thus, each sub-grantee is expected to spend or liquidate each grant within 1 year. Failure to expend grant funds on a timely basis may result in the reprogramming of the funds to another project; it may also impact the organization’s ability to receive CDBG funding in subsequent years. Therefore, the organization should not apply for any more funds than it expects to expend within 1 year. If it is anticipated that the project may require more than one year to implement, it may be prudent to phase it over several years. 1. Amount of CDBG funding requested by this application: $ 2. Anticipated amount of CDBG funding required in subsequent years: $ 3. Total amount of CDBG funding required for the project: $ 4. Activities for which the funding in this application would be used: _____________________________________________________________________ CDBG PROPOSAL -10- PROJECT BUDGET BREAKDOWN - (Amounts on this page must match amounts stated elsewhere within the application) DESCRIPTION ESTIMATED COST OF PROJECT AMOUNT OF CDBG $$ BEING REQUESTED OTHER FUNDS AVAILABLE FOR THIS PROJECT 1. Acquisition or Lease of Real Estate. $ $. $. 2. Plans and Specs for new construction, rehabilitation, or restoration $ $ $ 3. New Construction, rehabilitation, or restoration $ $ $ 4. Engineering & design for installation of sewer lines, water lines, sidewalks, lights, etc. $. $. $. 5. Installation of sewer lines, water lines, sidewalks, lights, etc. $. $. $. 6. Operation of a program or provision of public services $ $. $. 7. Operation of a business $. $. $. 8. Other: (describe) $. $. $. 9. Other: (describe) $. $. $. 10. GRAND TOTAL $ $. $. 5. Explain source(s) of amounts listed under “Other Funds Available for This Project” above: ______ _____________________________________________________________________ 6. Please complete the schedule below in order to demonstrate that the organization will be able to spend the CDBG funds within 1 year: _____________________________________________________________________ _____________________________________________________________________ CDBG PROPOSAL -11- Quarter (2025) Activity(ies) Start Date Completion Date Quarterly Funds Expended Cumulative Funds Expended January- March April – June July – September October – December CDBG PROPOSAL -12- SECTION 3: ACQUISITION OF REAL PROPERTY Complete this section only if CDBG funds are required to acquire real estate or to lease real estate for a period of fifteen (15) or more years. Please note that assistance for the purchase of real estate is provided in the form of a conditional loan. This loan would be forgiven after the building is used for the intended purpose for a specific period of time in accordance with CDBG program regulations. A lien will be recorded against the property for a minimum of fifteen years, as required by HUD. 1. Description of Property (select one) ( ) Empty lot ( ) Residential structure ( ) Commercial structure ( ) Other (describe): __________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 2. Location of property (Island, Plot No., Parcel No., Estate Name) __________________ (Please identify location of proposed project on Estate Map included as attachment) _______________________________________________________________________ 3. Adjacent roads or landmarks: _______________________________________________ _______________________________________________________________________ 4. Description of lot: ________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 5. Lot size: _______________ acres /square feet (please circle unit of measure used) 6. Description of building (a) No. of floors: _______ (b) No of residential units (if any): ____ (c) No. of sq. ft: _________ 7. Present owner of record: ___________________________________________________ 8. Why was this particular site selected? _________________________________________ ________________________________________________________________________ ________________________________________________________________________ CDBG PROPOSAL -13- 9. Acquisition Cost $_____________ 10. Monthly or annual cost of lease (please circle appropriate period) $_____________ 11. Is the property to be purchased a historic property or eligible to be designated as a historic property? Yes ( ) No ( ) 12. If CDBG funds are not obtained, will the organization proceed with the purchase? Yes ( ) No ( ) 13. Submit a copy of the following documents, as applicable: (a) Lease Agreement (if applicable) (b) Offer to Purchase or Letter of intent to sell (c) Property Appraisal (d) Land contract or sales agreement (if available) (e) Other evidence of intent to acquire (describe) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 14. Is the property to be purchased currently occupied? Yes ( ) No ( ) If yes, is it occupied by [ ] the owner, [ ] residential tenant(s), [ ] commercial tenant(s)? Will any tenants be displaced as a result of this project? Yes ( ) No ( ) No. of tenant families _______ No. of business tenants __________ 15. Once the property has been acquired, what will be the funding source for the maintenance of the building and the cost of property insurance? _______________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 16. Purpose for which property will be used after it is purchased: ( ) Housing ( ) Public Facility (e.g., shelter for victims of abuse, counseling facility, community center) ( ) Education, Training and Counseling ( ) Infrastructure development or improvement ( ) Business and Economic Development ( ) Human Resource Development ( ) Other (describe) ____________________________________________________ ________________________________________________________________________ CDBG PROPOSAL -14- 17. No. of persons to be served annually: ________ 18. Estimated annual cost of services to be provided from the property after it is purchased: $ _____________ 19. Are the funds required for the provision of services in place? Yes ( ) No ( ) 20. If yes, identify the amounts and funding sources below: SOURCE AMOUNT _________________________________ $____________ _________________________________ $____________ _________________________________ $____________ 21. Does the organization have any written commitment(s) of these funds? Yes ( ) No ( ) If yes, attach letter(s) of commitment. If no, indicate date(s) by which commitment(s) will be secured: SOURCE DATE ________________________________ ____________ ________________________________ ____________ ________________________________ ____________ 22. Legal action(s) required in order to use the property for the intended purpose: Check as many as may apply: ( ) Zoning change ( ) Coastal Zone Permit ( ) Army Corps of Engineers Permit ( ) Legislative approval of lease (government-owned property only) ( ) Environmental Assessment ( ) Environmental Impact Statement 23. Attach pictures of the subject property or e-mail pictures of the subject property to jjones@vihfa.gov and swyllis@vihfa.gov, if the project is located in the St. Thomas/St. John District or khenry@vihfa.gov, if the project is located in the St. Croix District. . CDBG PROPOSAL -15- SECTION 4: CONSTRUCTION ACTIVITIES Complete this section only if CDBG funds are required for the construction of a new building or the renovation or rehabilitation of an existing one. Please note that if the construction or rehabilitation cost exceeds $25,000, a lien will be recorded against the property. This lien will be removed if the building is used for the intended purpose for a minimum of fifteen years, as required by HUD. 1. Location of site: (Please also identify location of proposed project on Estate Map included as attachment) _______________________________________________________________________ Island Plot # Parcel # Estate Name 2. Adjacent roads or landmarks: _______________________________________________ ________________________________________________________________________ 3. Lot size: _______________ acres /square feet (please circle unit of measure used) (a) Purpose for which property is presently being used: ___________________________ ________________________________________________________________________ Complete Item 4 below only if funds are required for renovation or rehabilitation of an existing building. If project does not entail renovation or rehabilitation, please skip to Item 5. 4. (a) Size of structure: __________ sq. ft. (b) No. of rooms: ____________ (c) Is the building currently occupied? Yes ( ) No ( ) If yes, indicate whether it is occupied by [ ] the owner, [ ] residential tenant(s), [ ] commercial tenant(s) (d) Will any tenants be displaced as a result of this project? Yes ( ) No ( ) No. of tenant families _______ No. of business tenants __________ (e) Was the property to be assisted built prior to 1978? Yes ( ) No ( ) If built before 1978, indicate whether the property has been tested for the presence of Lead- Based Paint: Yes ( ) No ( ) If yes, please submit a copy of the final report with this application. *If no, complete and submit the Lead Safe Housing Rule – Applicability Form found on page 35 of this application. CDBG PROPOSAL -16- 5. Please describe the scope of work needed in order to place the building in service for the proposed use: ___________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (Use additional sheets, if necessary) 6. Name of Present Owner of record: ___________________________ 7. If the applicant already has control of the property, please attach a copy of evidence of site control as applicable - e.g., property deed; land contract or sales agreement; Offer to Purchase, letter of intent to sell, or other evidence of intent to acquire; lease agreement 8. Select below the activities for which the CDBG funds will be used: Check as many as may apply: ( ) Development of plans and specifications ( ) Actual construction ( ) Construction management * Please note that CDBG funds cannot be used to pay or reimburse costs incurred prior to the issuance of the project’s Notice to Proceed. 9. Proposed Budget For projects which entail rehabilitation or renovation of an existing building, please attach a construction estimate prepared by an architect, engineer, or licensed contractor. Your application will be considered incomplete until the estimate is submitted. Category Total Cost Amount of CDBG Funds Required Amount of other Funds Available Project design & engineering services $ $ $ Construction Services $ $ $ Construction Management $ $ $ Other Project Cost 1. $ $ $ 2. $ $ $ 3. $ $ $ Total $ $ $ 10. Sources and amounts of other funds available or required to carry out the project listed under “Amount of Other Funds Available” above: CDBG PROPOSAL -17- SOURCES AMOUNTS __________________________ $ ____________ __________________________ $ ____________ __________________________ $ ____________ 11. Does the organization have any written commitment(s) of these funds? Yes ( ) No ( ) If yes, attach letter(s) of commitment. If no, date(s) by which commitment(s) will be secured: SOURCE DATE ________________________________ ____________ ________________________________ ____________ ________________________________ ____________ 12. Attach pictures of the subject property or e-mail pictures of the subject property to jjones@vihfa.gov and swyllis@vihfa.gov, if the project is located in the St. Thomas/St. John District or khenry@vihfa.gov, if the project is located in the St. Croix District. 13. Please indicate any work already completed on the project: Check as many as may apply: ( ) Engineering and Design completed ( ) Scope of work developed ( ) Preliminary construction estimate completed ( ) Permits in place ( ) Some construction completed 14. Legal actions required in order to develop and use the property for the intended purpose: Check as many as may apply: ( ) Zoning change ( ) Coastal Zone Permit ( ) Army Corps of Engineers Permit ( ) Environmental Assessment ( ) Environmental Impact Statement ( ) Legislative approval of lease (government-owned properties only) 15. Infrastructure required in order to develop and use the property for the intended purpose: Check as many as may apply: ( ) Access Roads ( ) Power lines ( ) Water lines ( ) Parking ( ) Handicapped Access ( ) Sanitary Sewer ( ) Storm Water Drainage ( ) Other (describe): ___________________________________________________ ________________________________________________________________________ CDBG PROPOSAL -18- 16. Estimated annual maintenance cost after the building has been rehabilitated or has been completed: $_____________________ 17. Are the funds required for maintenance of the building in place? Yes ( ) No ( ) If yes, please identify the amounts and funding sources below: SOURCE AMOUNT _______________________ $_______________ _______________________ $_______________ 18. Describe the purpose for which the structure will be used after renovation or rehabilitation: _______________________________________________________________________ _______________________________________________________________________ 19. No. of persons that the program will serve annually: _____ 20. Annual cost of the operation of this program: $___________ 21. Are the funds required to operate the program in place? Yes ( ) No ( ) If yes, identify the amounts and funding sources below: SOURCE AMOUNT _________________________________ $____________ _________________________________ $____________ CDBG PROPOSAL -19- SECTION 5: WATER, SEWER, AND SITE IMPROVEMENTS Complete this section only if CDBG funds are required for the construction or improvement of roads, sidewalks, playgrounds, pipelines or other water and sewer facilities. 1. Type of work to be performed (select one or more): ( ) Roads ( ) Water lines or water facilities ( ) Sanitary Sewer lines or sewer facilities ( ) Manholes ( ) Storm Sewer ( ) Sidewalks ( ) Streetscape improvements ( ) Playground ( ) Parking including ADA ( ) Telecommunications infrastructure 2. Identify the neighborhood(s) to be served: _____________________________________ _______________________________________________________________________ _______________________________________________________________________ 3. Please attach pictures of the subject property. 4. Number of construction jobs expected to be created/retained: __________ 5. Provide the information below, as applicable (a) Number of manholes to be installed: __________ (b) Total length of sewer lines to be installed: __________ (c) Total length of pipelines to be installed: ___________ (d) Length of sidewalk to be installed: ___________ (e) Length of road to be installed or improved: ___________ (f) Area of playground to be construction and improved: ___________ (g) Number of parking space to be created: ___________ (h) Number of residential customers provided with new or improved internet service _______ 6. Required Funding: (a) Total project cost: $___________ (b) Amount of CDBG funds required for this purpose: $_________ CDBG PROPOSAL -20- 7. Proposed Budget Category Total Cost Amount of CDBG Funds Required Amount of other Funds Available Project Design & Engineering $ $ $ Construction Services $ $ $ Construction Management $ $ $ Other Project Cost 1. $ $ $ 2. $ $ $ 3. $ $ $ 4. $ $ $ Total $ $ $ 8. Sources and amounts of other funds available or required to carry out the project listed under “Amount of Other Funds Available” above: SOURCES AMOUNTS __________________________ $ ____________ __________________________ $ ____________ __________________________ $ ____________ 9. Does the organization have any written commitment(s) of these funds? Yes ( ) No ( ) If yes, attach letter(s) of commitment. If no, date(s) by which commitment(s) will be secured: SOURCE DATE ________________________________ ____________ ________________________________ ____________ ________________________________ ____________ 10. Attach pictures of the subject property or e-mail pictures of the subject property to jjones@vihfa.gov and swyllis@vihfa.gov, if the project is located in the St. Thomas/St. John District or khenry@vihfa.gov, if the project is located in the St. Croix District. CDBG PROPOSAL -21- SECTION 6: BUSINESS AND ENTREPRENEURIAL DEVELOPMENT Complete this section only if CDBG funds are being sought to expand and/or operate a for- profit business. Please note that assistance to businesses will be provided as a loan unless there are extenuating circumstances. The applicant must demonstrate that the assistance is necessary and appropriate in order to create or retain jobs for low to moderate-income persons. The applicant must also demonstrate that the assistance is not available from another funding source. 1. In order to be eligible for CDBG funding under this category, the applicant must demonstrate extenuating circumstances which threaten the viability of the business. Select from below the justification(s) which applies to your business. Please attach supporting documentation as applicable: ( ) The returns to be realized for the business are too low to motivate the businessperson to proceed without assistance; ( ) The business does not have sufficient equity funds to proceed on its own, and private institutions will not lend any funds; and ( ) The area from which it is necessary for the business to operate in order to generate the desired public benefits will cost more than other available sites. 2. Total amount of financial resources required for the project to be feasible: $_______________ 3. Amount of CDBG funds required: $______________ 4. Purpose for which CDBG funds will be used: ___________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 5. Period of time over which CDBG funds will be used: _____ months 6. If the applicant is a for-profit organization, would the entity accept a loan? ( ) Yes ( ) No 7. Number of person(s) the business currently employs: __________ 8. Number of jobs expected to be created/retained: __________ 9. Please describe any other public benefit to be derived from the project: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ CDBG PROPOSAL -22- 13. Proposed Budget Category Total Cost Amount of CDBG Funds Required Amount of other Funds Available Supplies $ $ $ Equipment (for project execution) $ $ $ Salaries $ $ $ Rent $ $ $ Other Operating Costs 1. $ $ $ 2. $ $ $ 3. $ $ $ 4. $ $ $ Total $ $ $ 11. Sources and amounts of other funds available or required to carry out the project listed under “Amount of Other Funds Available” above: SOURCES AMOUNTS __________________________ $ ____________ __________________________ $ ____________ __________________________ $ ____________ 12. Does the organization have any written commitment(s) of these funds? Yes ( ) No ( ) If yes, attach letter(s) of commitment. If no, date(s) by which commitment(s) will be secured: SOURCE DATE ________________________________ ____________ ________________________________ ____________ CDBG PROPOSAL -23- SECTION 7: PROVISION OF SERVICES Complete this section only if CDBG funds are required to operate a program such as training, counseling, after-school programs, operation of soup kitchens, etc. Please note that a maximum of 15% of the Territory’s grant allocation may be used for public service projects. For the last several years, the average amount of funding provided to each public service project has been $20,000. 1. Describe the services to be provided: _________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 2. Physical address from which the services will be provided: ____________________________________________________________________ 3. Is the building properly zoned for the proposed use? Yes ( ) No ( ) 4. Hours of operation of the proposed program: _______________________________________________________________________ 5. Describe the number and common characteristics of the persons to be directly served by the program (e.g., 32 low-income youths between the ages of 17 and 22): ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 6. Describe other indirect beneficiaries: _________________________________________ ________________________________________________________________________ ________________________________________________________________________ 7. Is the applicant currently licensed by the Department of Human Services? Yes ( ) No ( ) * License will require if the proposed program will serve children under the age of 15. 8. Has the applicant previously provided the services being proposed? Yes ( ) No ( ) If yes, how long has the applicant been providing these services? ________________ CDBG PROPOSAL -24- 9. What was the program’s primary source of financing? ____________________________ ________________________________________________________________________ ________________________________________________________________________ 10. How many persons were served in each of the previous cycles? ___________ 11. How did the organization measure the success of its program? __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 12. How does the experience of the organization relate to its role in providing the proposed services? ________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 13. Describe the administrative, managerial, and operational capabilities of the organization’s staff. Please also identify those members of the staff that would be involved in providing the proposed services. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (Use additional sheets, if necessary) 14. Describe your program’s client screening, intake, and selection process – i.e., how, and when client assessment will be performed, and by whom: _________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 15. What distinguishes your program from other programs providing similar services? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ CDBG PROPOSAL -25- Complete Items 16 and 17 below only if the organization is currently providing the proposed services. If the organization is not currently providing the proposed services, skip to Item 18. 16. Will CDBG funds be used to increase the number of people served by your existing program? Yes ( ) No ( ) 17. List your current services and the additional services: CURRENT SERVICES ADDITIONAL SERVICES TO BE OFFERED BY PROPOSAL _______________________________ ______________________________ _______________________________ ______________________________ _______________________________ ______________________________ _______________________________ ______________________________ 18. Estimated cost of the services for which CDBG funds are being sought: $____________ 19. PROPOSED BUDGET CATEGORY CDBG FUNDS OTHER FUNDS (Identify other funds available or committed) Personnel Services $ $ Material & Supplies $ $ Travel $ $ Equipment $ $ Advertisement $ $ Rent $ $ OTHER (please specify) 1. Utilities $ $ 2. Insurance $ $ 3. ______________ $ $ 4. _______________ $ $ TOTAL $ $ CDBG PROPOSAL -26- 20. Sources and amounts of other funds available or required to carry out the project listed under “Other Funds Available” at Question 19 above: SOURCES AMOUNTS __________________________ $ ____________ __________________________ $ ____________ __________________________ $ ____________ 21. Does the organization have any written commitment(s) of these funds? Yes ( ) No ( ) If yes, attach letter(s) of commitment. If no, indicate date(s) by which commitment(s) will be secured: SOURCE DATE ________________________________ ____________ ________________________________ ____________ ________________________________ ____________ 22. If your program receives CDBG funds for this funding cycle, how will it continue to operate once the CDBG funding has been exhausted? _______________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ CDBG PROPOSAL -27- 23. Personnel to be paid with and without program funds Position Title #Of Persons Duration of Employment From To # of hours weekly Total # of hours Hourly Rate Total Payment Amount to be Paid from CDBG funds TOTAL 24. Describe the job duties for each position that will be participating in this program listed above (attach separate sheet(s) if necessary) _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ CDBG PROPOSAL -28- Request a Unique Entity ID through SAM.gov ▪ The Unique Entity ID (UEI) is a 12-character alphanumeric value. ▪ The Unique Entity ID (UEI) is issued by the federal government as part of SAM https://sam.gov/content/home You will need to provide the following information to get a Unique Entity ID: ✓ Legal Business/Entity Name ✓ Physical Address, City, State and Zip Code (No P.O. Boxes) ✓ Start Year or Year of Incorporation ✓ State of Incorporation ✓ National Identifier (Entities based outside the U.S.) ❖ Click on the Sign In button in the top right corner of the screen or the Get Started icon under Register Your Entity or Get a Unique Entity ID box to begin the process. o Please note: You don’t have to register to get a Unique Entity ID. . ❖ Select the option to obtain a Unique Entity ID only. ❖ Helpful tip: Play the “How to get a Unique Entity ID” video on the initial sam.gov/content/home page for steps to completing the + process. CDBG PROPOSAL -29- CENSUS MAP – ST. CROIX CDBG PROPOSAL -30- CENSUS MAP – ST. JOHN CDBG PROPOSAL -31- CENSUS MAP – ST. THOMAS CDBG PROPOSAL -32- ESTATE MAP - ST. CROIX CDBG PROPOSAL -33- ESTATE MAP - ST. THOMAS CDBG PROPOSAL -34- ESTATE MAP - ST. JOHN CDBG PROPOSAL -35- CDBG PROPOSAL -36- LEAD-SAFE HOUSING RULE –APPLICABILITY FORM Address/location of subject property: Regulation Eligibility Statements (check all that apply): ____ Property is receiving OR applying for federal funds ____ Unit was built prior to 1978. Note: If both Eligibility Statements above have been checked, continue with the Exemption Statements below. Otherwise, the regulation does not apply, sign and date the form. Regulation Exemption Statements [24 CFR 35.115] (check all that apply): ____ Emergency repairs to the property are being performed to safeguard against imminent danger to human life, health, or safety, or to protect the property from further structural damage due to natural disaster, fire, or structural collapse. The exemption applies only to repairs necessary to respond to the emergency. ____ The property will not be used for human residential habitation. Note: This exemption does not apply to common areas such as hallways and stairways of residential and mixed-use properties. ____ Housing “exclusively” for the elderly or persons with disabilities, with the provision that children less than six years of age will not reside in the dwelling unit. ____ An inspection performed according to HUD standards found the property contained no lead-based paint. ____ According to documented methodologies, lead-based paint has been identified and removed; and the property has achieved clearance. ____ The proposed rehabilitation will not disturb any painted surface. ____ The property has no bedrooms. ____ The property is currently vacant and will remain vacant until demolition. If any of the above Exemption Statements have been checked, the Regulation does not apply. In all cases, sign, and date the form. I, ________________________________, certify that the information listed above is true and accurate to the (Printed Name) best of my knowledge. _________________________________________ Date ____________________ Signature _________________________________________ Organization