Form HUD-40090-2 Exhibit 2

Continuum of Care Homeless Assistance Grant Application

Exhibit2DRAFT

Continuum of Care Homeless Assistance Grant Application

OMB: 2506-0112

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OMB Approval No. Pending

Exhibit 2: HUD Homeless Programs Project Application

U.S. Department of Housing and Urban Development

OMB Approval No. Pending

Office of Community Planning and Development

(exp. _______)

The information collection requirements contained in this application have been submitted to the Office of Management and Budget (OMB) for review under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

Information is submitted in accordance with the regulatory authority contained in each program rule. The information will be used to rate applications, determine eligibility, and establish grant amounts.

Selection of applications for funding under the Continuum of Care Homeless Assistance are based on rating factors listed in the Notice of Fund Availability (NOFA), which is published each year to announce the Continuum of Care Homeless Assistance funding round. The information collected in the application form will only be collected for specific funding competitions.

Public reporting burden for this collection of information is estimated to 30 hours including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

To the extent that any information collected is of a confidential nature, there will be compliance with Privacy Act requirements. However, the Continuum of Care Homeless Assistance application does not request the submission of such information.

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

2007 Continuum of Care Application: Exhibit 2

Instructions

New in 2006, Exhibit 2 serves as the universal application for all projects applying under the Continuum of Care—including new and renewal Supportive Housing Program (SHP), new and renewal Shelter Plus Care (S+C), and new Section 8 Single-Room Occupancy (SRO) program applications. Former Exhibits 2, 2R, 3, 3R, and 4 have been consolidated into this single exhibit. The application is divided into four sections:

Section I: Project Summary Information
Section II: Project Budget Information
Section III: New Project Narrative
Section IV: Applicant Certification

Applicants should carefully read these instructions and complete only the charts applicable to the projects for which they are requesting funding.

Section I: Project Summary Information

Part A: General Project Information

All projects must complete the chart.

Part B: Project Summary Budget

B1. Supportive Housing Program (SHP) (All SHP Projects)

All Supportive Housing Program projects must complete this chart. If your project contains one structure or no structures, this is the only budget you need to fill out. If your project contains multiple structures (projects that request funds for acquisition, rehabilitation or new construction), please add up the SHP structure budgets (from Section 1, Part I4) and include those totals in column e of this chart. HUD will review this chart in relation to the proposed activities and the number of persons to be served to determine whether the project is cost-effective.

In section c., “Grant Term,” enter the number of years of supportive services, operations and/or leasing assistance desired. All new SHP projects may request funding for two or three years (dedicated HMIS may request one, two or three years). For new projects without funding for acquisition, rehabilitation or new construction, the grant term will be 1, 2 or 3 years. For new projects with funding for acquisition, rehabilitation or new construction, the grant term will be the 2 or 3 years, plus the time to acquire the property, complete construction activities and begin operating the project, which can be no longer than 39 months (for the full requirements of the timeliness standards refer to the NOFA, section III.C.3.i.).

A renewal of a SHP project may request funding for one, two, or three years. The period you select must be the same for supportive services, operations and leasing.

In column e., “SHP Dollars Request,” enter the amount of SHP funds requested by line item. Please note:

By law, SHP funds can provide no more than 50% of the total acquisition, rehabilitation, and new construction budget for the project.
By law, SHP funds can provide no more than 80% of the total supportive services and HMIS budget.
By law, SHP can pay no more than 75% of the total operating budget.
Applicants may request up to 5% of each project award for administrative costs, such as accounting for the use of the grant funds, preparing HUD reports, obtaining audits, and other costs associated with administering the grant. State and local government applicants and project sponsors must work together to determine the plan for distributing administrative funds between applicant and project sponsor (if different). Please refer to section III.C.3.c(2)(b) of the NOFA. If selected for funding, all applicants will be required to submit a plan for distributing administrative funds as part of the technical submission.

In column f., “Cash Match,” enter the amount of other cash match that will be contributed to the project for each proposed activity.

In column g., for each row, enter the sum of columns e and f. The required cash match amount plus the SHP request must equal the “Total Budget” amount for the project, as shown in the last column, “Totals.”

In row 11, column e, enter the total of lines 9 and 10. In row 11, column f, the amount in the “Total Cash Match” box should be the sum of items 4f and 6f through 8f. In row 11, column g, the “Total Budget” amount should be the sum total of 11e and 11f.

B2. Shelter Plus Care (S+C) (All S+C Projects)

All Shelter Plus Care projects applying for funding must complete this chart. Enter the component (only one component should be selected), the appropriate grant term, and the requested Rental Assistance Amount. See the “S+C Component Comparisons” chart below for guidance on component types.

S+C Component Comparisons

Element	TRA (Tenant-Based Rental Assistance)	SRA (Sponsor-Based Rental Assistance)	PRA (Project-Based Rental Assistance)	SRO (Single-Room Occupancy)
Entity Administering Rental Assistance	Recipient or other entity under contract to recipient	Recipient, nonprofit sponsor or other entity under contract to recipient	Recipient, other entity under contract to recipient	Public Housing Agency (PHA)
Type of Housing	Variety of types ranging from group homes to independent living units	Variety of types ranging from group homes to independent living units	Variety of types ranging from group homes to independent living units	SRO dwelling units
Living Requirements	Participants choose; recipient may require participant to live in a particular structure in first year and within a particular area in all years	Must live in structure owned or leased by sponsor	Must live in unit in particular property that is assisted	Must live in SRO structure
Eligible Participants	Homeless adults with disabilities and their families, if any	Homeless adults with disabilities and their families, if any	Homeless adults with disabilities and their families, if any	Homeless individuals with disabilities
Housing Quality Standards	24 CFR 982.401	24 CFR 982.401	24 CFR 982.401	24 CFR 882.803(b)
Rehabilitation	Not required	Not required	$3,000 minimum per unit for 10 years of assistance	$3,000 minimum per unit required
Term of Assistance	5 Years	5 Years	5 Years without rehabilitation; 10 Years with rehabilitation	10 Years

B3. Section 8 Single Room Occupancy (SRO) (All Section 8 SRO Projects)

All Section 8 SRO projects applying for funding must complete this section. Enter the requested SRO rental assistance amount. This should be the same as the total listed on the SRO budget chart.

Part C: Point in Time Housing and Participants Chart

(All Projects Except Dedicated HMIS Projects)

This chart is for recording the housing type, number of units, and number of beds/bedrooms and participants in the project. Information on all housing projects should be entered in these sections.

Section 1: Check the appropriate box to identify the housing type and if scattered site or project based. Housing Types: Multi-family (apartments, duplexes, SROs, other buildings with 2 or more units); Single-family; Congregate Facility (dormitory, barracks, shared-living).

Sections 2 and 3:

In column a., Current Level, enter the requested information for all items at a point in time (a given night).
In column b., New Effort or Change in Effort, enter the new number of beds and persons that will be served at a point in time if this project is funded.
In column c., Projected Level, enter the projected number of units, bedrooms, beds, or participants served that your project will attain at a point in time. Add columns 1 and 2 together and enter this amount in column e for each row.

Note: If your project is funded you will be responsible for achieving the numbers submitted.

Part D: Targeted Subpopulations

(All Projects Except Dedicated HMIS Projects)

HUD needs the information in this chart to respond to public and Congressional inquiries about program benefit. Responses from this section will also be used to measure compliance with the requirement that no less than 10 percent of the funds awarded are for projects predominantly serving individuals experiencing chronic homelessness. A project defined as one predominantly serving the chronically homeless is one in which at least 70 percent of the persons served meet HUD’s definition of chronic homelessness. If this is a #1 priority project, in order to receive permanent housing bonus funds, it must serve 100% chronically homeless persons, and you must indicate this in the chart.

Part E: Discharge Policy (Only State & Local Government Applicants)

Applicants who are state and local government entities must check “yes” or “no” in response to the question.

Part F: Project Leveraging Chart (All Projects)

HUD homeless program funding is limited and can provide only a portion of the resources needed to successfully address the needs of homeless families and individuals. HUD encourages applicants to use supplemental resources, including state and local appropriated funds, to address homeless needs. The total of the leveraging amounts contained in this project will be added to that of all other projects and the grand total will be included in Exhibit 1.

Provide information only for contributions for which you have a written commitment in hand at the time of application. A written agreement could include signed letters, memoranda of agreement, and other documented evidence of a commitment. Leveraging items may include any written commitments that will be used towards your cash match requirements in the project, as well as any written commitments for buildings, equipment, materials, services and volunteer time. The value of commitments of land, buildings and equipment are one-time only and cannot be claimed by more than one project (e.g., the value of donated land, buildings or equipment claimed in 2005 and prior years for a project cannot be claimed as leveraging by that project or any other project in subsequent competitions). The written commitments must be documented on letterhead stationery, signed by an authorized representative, dated and in your possession prior to the deadline for submitting your application, and must, at a minimum, contain the following elements: the name of the organization providing the contribution; the type of contribution (e.g., cash, child care, case management, etc.); the value of the contribution; the name of the project and its sponsor organization to which the contribution will be given; and, the date the contribution will be available. If you do not have a written agreement in hand at the time of application submission, do not enter the contribution. Please be aware that undocumented leveraging claims may result in a re-scoring of your application and possible withdrawal of your conditional award(s).

Identify the type of contribution being leveraged by the proposed project. Types of contributions could include cash, buildings, equipment, materials, and services, such as transportation, health care, and mental health counseling.
Enter the name of the source of the contribution, including mainstream housing and social service programs. Among many others, these can include: CDBG, HOME, United Way, Fannie Mae, Federal Home Loan Bank, and local or state general revenue funds.
Identify whether the contribution comes from government or private sources.
You must provide the date of the written commitment letter.
Enter the value of the contribution. Donated professional services should be valued at the customary rate; volunteer time should be valued at $10 per hour. Donated buildings should be valued at their fair market value or fair rental value minus any charge to the SHP, S+C, or SRO program.
Fill in the total amount (if multiple pages are being submitted, provide only a grand total at the end of the last page.)

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802).

Part G: Project Participation in Homeless Management Information Systems (HMIS) (All Projects Except Dedicated HMIS Projects)

No additional instructions.

Part H: Renewal Performance (All Renewal Projects)

Questions 1 and 2: No additional instructions.

Renewal Performance (Continued). All S+C, SHP-PH, SHP-TH, SSO, and SHP-Safe Haven renewals should complete questions 3, 4, and 5 as applicable.

The charts in this section will assess your project’s progress in reducing homelessness by helping clients move to and stabilize in permanent housing, access mainstream services and gain employment. For each applicable chart, provide information from the most recently submitted Annual Progress Report (APR) for the RENEWAL project. Note: If an APR has not yet been submitted for this renewal project, please check the N/A box and skip these questions.

Section II: Project Budgets

Part I: SHP Project Budgets

I1. SHP Leasing Budget (All SHP Projects with Leasing)

SHP funds may be used to lease space for supportive housing or supportive services. If you are requesting SHP leasing funds, fill out the appropriate part of the leasing chart. Housing and service space may be in the form of scattered-site leased units, or within a structure. The structures to be leased may be structures currently configured for, or structures to be converted to provide, supportive housing and/or supportive services. Please note that HUD will not award rehab funds to be used on leased space.

Leased Unit(s) for Housing and/or Services

This section should be filled out only if you will lease individual units or structures that are currently configured for housing and/or services. If your project proposes to lease units in more than one metropolitan or non-metropolitan area, complete one chart for each area with a different FMR or actual rent. You can reproduce this chart as needed to accommodate projects using more than one FMR or actual rent. If you have negotiated an actual rent(s) that is lower than the Fair Market Rent (FMR) in your area, please use that amount instead of the FMR. The actual rent may not exceed the FMR.

Renewal grant charts should be filled out using the actual rent or HUD paid amount. Since a renewal grant for leasing does not receive an annual increase, the amounts entered should not exceed the Annual Renewal Amount.

Under no circumstances may SHP leasing funds be used to lease units or structures owned by the grantee (the selectee), the project sponsor, or their parent organizations. This includes organizations that are members of a general partnership where the general partnership owns the structure.

Items a, b, and column c. No additional instructions.

Columns d, e, and f. Enter the number of unit(s) by the bedroom size to be leased, the lower of the actual rent, HUD paid amount or FMR (if applicable) as published in the Federal Register on or about October 1, 2006, and the number of months of the grant term. FMRs may be found using this web site: http://www.huduser.org/datasets/fmr.html. The space to be leased may be scattered-site (e.g., one-bedroom apartments in five different apartment complexes) or contained within a structure (e.g., a group home with six bedrooms).

Column g. Multiply the number of units by the FMR or actual rent, whichever is lower, by the length of the grant (# of units x FMR or actual rent x months based on grant term) and enter the result in the total column. For example, if your project were leasing 10 SRO units at $500/month for a 12-month grant term, you would enter $60,000 in the first row of column g.

Please note:

The FMR for a single room occupancy (SRO) unit is equal to 75% (0.75) of the 0-bedroom FMR. The FMRs for unit sizes larger than 4-bedrooms are calculated by adding 15% to the 4-bedroom FMR for each extra bedroom. For example, the FMR for a 5-bedroom unit is 1.15 times the 4-bedroom FMR, and the FMR for a 6-bedroom unit is 1.30 times the 4-bedroom FMR.

If your project has been approved for exception rents, use those amounts when completing this chart. Your current approval letter must be submitted with this document.

Item h. Enter the total for each column in the space given.

Leased Structure(s) for Housing and/or Services - No Applicable FMR. This section should be filled out only if you will lease a structure or portion of a structure for which an FMR is not applicable.

If you will lease a structure or portion of a structure for housing and/or services, fill out Leased Structure(s) for Housing and/or Services using a monthly leasing cost that is comparable to and no more than the rents being charged for similar space in the area. This applies to structures already configured for housing and for those that will be converted. If your project has more than two structures, add rows or reproduce the chart and fill it out starting with structure 3.

Multiply the monthly leasing costs by the number of months requested for funding and enter the result in the total column.

I2. SHP Supportive Services Budget (All SHP Projects as Applicable)

If your project is requesting the use of SHP funds for any supportive services, please complete the supportive services budget. Supportive services are designed to address the special needs of the homeless persons to be served by the project. Services may be provided directly by the project grantee or sponsor and/or through an arrangement with public or private service providers.

In the first column, the supportive service activity is given. Please enter the quantity of each supportive service in your project (see example below).

In the Year 1 column, enter the total amount of SHP dollars requested to pay for each eligible supportive service in the first year. If the grant is multi-year, also enter the amount of SHP funds needed for the second and third years in the Year 2 and Year 3 columns.

In the last column, enter the total amount of funds needed to pay for the full grant term for each supportive service. For each row, the amount entered in the “Total” column should be equal to Year 1 + Year 2 + Year 3.

Line 14. Total SHP supportive services dollars requested. Enter the total SHP request amounts for each year of the grant term.

Line 15. Total cash match to be spent on SHP eligible supportive service activities. Enter the cash match to be contributed for each year of the grant term. The cash match must be at least 20 percent of the total supportive services costs for each grant year that you request SHP funds.

Line 16. Total supportive services costs. Enter the total supportive services costs (SHP supportive services dollars (line 14) plus cash match (line 15) equals the total supportive services costs).

Please note:

By law, SHP funds may be used to pay for up to 80% of the total supportive services budget for each year of the grant term. This means that the grantee or project sponsor must make cash payment for at least 20% of the project’s total supportive services budget annually.

Identify any staff funding requests in terms of FTE (Full Time Equivalent) employees. If you are proposing a new project, you may use percentages to estimate the staff time associated with an SHP grant position. However, once the project becomes operational, the staff salary payments that you enter should be based on actual/incurred costs that are supported by signed and dated timesheets.

If a project sponsor’s staff will deliver a service, only the staff time directly related to the delivery of that service to the project is eligible for SHP funds. For example, if sponsor, ABC, Inc., will use 25% of its substance abuse counselor’s time for recovery planning for TH residents, then only 25% of the counselor’s salary may be paid for with SHP supportive service funds.

Example of a Supportive Services Budget:

Supportive Services Costs	Eligible SHP Costs
Supportive Services Costs	Year 1	Year 2	Year 3	Total
8. Education and Instruction – job training Quantity: 20 slots per year	$40,000	$40,000	$40,000	$120,000
11. Transportation Quantity: 1 Fifteen-Passenger Van @ $37,500 SS Van Driver .5 FTE @ $20,000/annual x 3 years = $60,000	$46,000	$16,000	$16,000	$ 78,000
Total SHP Request	86,000	56,000	56,000	198,000
Total Cash Match	21,500	14,000	14,000	49,500
Total Supportive Services Costs	107,500	70,000	70,000	247,500

I3. SHP Operating Budget (All SHP Projects with Operating Costs)

Complete the Operating Costs Chart for your project’s total operations budget. Operating costs support the day-to-day operations of the supportive housing project. Please remember that operating costs are ineligible for Supportive Services Only projects.

In the first column, the operating cost activity is given. Please enter the quantity (if applicable) for each operating item that will be paid for using SHP funds. For staff positions please include the job title, salary, % of time allocated for the position, and fringe benefits.

In the Year 1 column, enter the total amount needed to pay for each eligible operating cost in the first year. If the grant is multi-year, also enter the amount of SHP funds needed for the second and third years in the Year 2 and Year 3 columns.

In the last column, enter the total amount of funds needed to pay for the full grant term. For each row, the amount entered in the “Total” column should be equal to Year 1 + Year 2 + Year 3.

Line 11. Total SHP operating dollars requested. Enter the total SHP request amounts for each year of the grant term.

Line 12. Total cash match to be spent on SHP eligible operations activities. Enter the cash match to be contributed for each year of the grant term. The cash match must be at least 25 percent of the total operating costs for each grant year that you request SHP funds.

Line 13. Total operating costs. Enter the total operating costs (SHP operating dollars (line 11) plus cash match (line 12) equals the total operating costs).

Please note:

SHP funds can be used to pay up to 75% of the total operations budget for the housing project. This means that the project sponsor must make cash payment for 25% of the project’s operating budget annually.

Only the portion of the costs directly related to the operation of the housing project are eligible. For example, in cases of shared utilities, SHP operating funds may pay only for the portion of the utilities associated with the housing project, based on the square footage of the project’s space. If the housing project occupies 25% of the building’s space, then (up to) 25% of the monthly utility bill can be paid for using SHP operating funds.

Please identify any staffing funding requests in terms of FTE (Full Time Equivalent) employees. If you are proposing a new project, you may use percentages to estimate the staff time associated with an SHP grant position. However, once the project becomes operational, the staff salary payments that you enter should be based on actual/incurred costs that are supported by signed and dated timesheets.

SHP operating funds may not be used to pay for the following costs:

Operating costs of a supportive services only facility;
Administrative expenses such as audits and preparing HUD reports;
Rent of space for supportive housing and/or supportive services;
The payment of principal and interest on a loan for a facility currently being used as supportive housing and/or for the delivery of services; and
Depreciation, because it does not constitute an incurred cost that requires a cash outlay.

Example of an Operating Budget:

Operating Costs	Eligible SHP Costs
Operating Costs	Year 1	Year 2	Year 3	Total
1. Maintenance/Repair - Maintenance Engineer (salary, % time, fringe benefits) Quantity: $40,000/annually x .20 x 1.15 fringe benefits x 2 years = $18,400	$13,800			$13,800
3. Utilities Quantity: electric = $950/month; gas = $800/month; water = $2750/3 months	$24,000			$24,000
Total SHP Request	$37,800			$37,800
Total Cash Match	$12,600			$12,600
Total Operating Costs	$50,400			$50,400

I4. SHP New Project Multiple Structures Budget (All New SHP Projects as Applicable)

If the project contains only one structure or no structures, do not fill out the form. Please use the Project Summary Budget (Section I, Chart B) for these types of projects. However, if your project contains more than one structure (a project that requests funds for acquisition, rehabilitation or new construction), fill out the information requested on the SHP Multiple Structure Budgets Form for the number of structures proposed in your project. Do not fill out structure budgets for scattered site leasing projects. Please note that HUD will not award rehab funds to be used on leased space.

In the first column, the SHP activity is given.

In the second column (SHP Request), for each structure budget enter the amount of SHP funds requested, by line item. For leasing, supportive services, operations, and HMIS, the amounts you enter should be for two (2) or three (3) years, which is the SHP, grant term. The term you select must be the same for leasing, supportive services, operations, and HMIS.

In the third column (Total Budget), enter the total cost for each line item, which is the SHP request plus all other funds needed to pay for each line item, again, for two or three years. For your convenience, two structure budgets are provided. You may reproduce the chart if your project will have three or more structures; however, please attach the additional structure budgets to the chart and label them appropriately, starting with structure C. Enter administrative costs only on the Project Summary Budget (Section I, Chart B).

When developing your budget(s), please keep in mind that each structure can receive the maximum amount of funds according to the following per-structure limits:

For acquisition and/or rehabilitation, the SHP request for these activities combined is limited by law to between $200,000 and $400,000, depending on whether the structure is in a HUD-identified high-cost area for acquisition and rehabilitation. Contact your local HUD Field Office to determine if your project is in a high-cost area, and, if so, which of the following percentages or limits apply:

100% to 119%, the limit is $200,000
120% to 139%, the limit is $250,000
140% to 159%, the limit is $300,000
160% to 174%, the limit is $350,000
175% and up, the limit is $400,000

For new construction, the SHP request is limited by law to $400,000 per structure, regardless of where the structure is located. If you propose to acquire land in tandem with new construction, the $400,000 limit applies to both activities combined. Please note that you can apply for funding to construct and/or operate supportive housing; however, by law you cannot request either of these activities for supportive services only projects.

If you request funds for acquisition, rehabilitation, or new construction, the law requires that you match the requested amount with an equal amount of cash for the activities. Documentation of matching funds is not required in this application; however, you will be asked to submit it at a later date.

I5. SHP HMIS Budget (All SHP Projects with HMIS Costs)

Complete the entire HMIS Budget Chart for a dedicated HMIS project. A project for shared HMIS costs with other projects need only complete the “Subtotal” lines of the chart. HMIS costs are those costs associated with the implementation of an HMIS. If requesting SHP HMIS funds, only the portion of the costs directly related to the HMIS is eligible. In the personnel section, the number of staff positions in Full-Time Equivalents (FTEs) should be present for each category that your project has staff HMIS costs.

Example of Personnel Section of HMIS Budget:

Personnel	Year 1	Year 2	Year 3	Total
18. Project Management/Coordination 1- .5 FTE @$56,000/annual x 3 years = $84,000	$22,400	$22,400	$22,400	$67,200
19. Data Analysis 1- .25 FTE @$28,000/annual x 3 years = $21,000	$5,600	$5,600	$5,600	$16,800
22. Administrative Support Staff 1- .5 FTE @$16,000/annual x 3 years = $24,000	$6,400	$6,400	$6,400	$19,200
Total SHP Request	$34,400	$34,400	$34,400	$103,200
Total Cash Match	$8,600	$8,600	$8,600	$25,800
Total HMIS Costs	$43,000	$43,000	$43,000	$129,000

In the Year 1 column, enter the total amount of funds to be used to pay for the first year expenses.

If the grant is a multi-year grant, also enter the total funds to be used for the second and third years in the Year 2 and Year 3 columns.

In the last column (Total), enter the total amount of funds needed to help pay for the identified HMIS expenses for the full grant term. For each row, the amount entered in the “Total” column should be equal to Year 1 + Year 2 + Year 3.

Line 25. Total SHP HMIS dollars requested. Enter the total SHP request for each year of the grant term.

Line 26. Total cash match to be spent on SHP eligible HMIS activities. Enter the cash match to be contributed for each year of the grant term. The cash match must be at least 20 percent of the total HMIS costs for each grant year that you request SHP funds.

Line 27. Total HMIS costs. Enter the total HMIS costs (SHP HMIS dollars requested (line 25) plus cash match (line 26) equals the total HMIS costs).

Documentation of firm commitments of the cash resources for year 1 of your grant term will be required prior to grant execution. Please note that the match requirement for Year 2 and Year 3, if applicable, must be met by the end of each of those years.

Part J: Shelter Plus Care and Section 8 SRO Project Budgets

(All New and Renewal S+C or New SRO Projects as Applicable)

J1. Shelter Plus Care and Section 8 SRO Rental Assistance Budget

If you propose to provide rental assistance in more than one metropolitan or non-metropolitan area, complete the appropriate number of charts for each area with a different FMR. You can reproduce this chart as needed to accommodate projects using more than one FMR.

Items a, b and column d. Self-explanatory.

Item c. Please note that the amount you request cannot exceed the current FMR unless an Exception Rent approval letter is attached. Requests for rents above 100% but no more than 110% must be accompanied by a statement from the PHA that they have exercised their authority to set rents above the published amount. The PHA statement must cite at what level the rents are set, up to 110% of the FMR. Requests for rents exceeding 110% must be accompanied by an exception rent approval letter from HUD.

Columns e and f. Enter the number of units expected to be used in your program and the applicable existing fair market rents. Use either the FMRs as published in the Federal Register on or about October 1, 2006 or the actual rent requested. See preceding paragraph for documentation requirements for rents exceeding the FMR. Rents requested below the FMR will be awarded as such without any subsequent adjustment. FMRs may be found using this web site: http://www.huduser.org/datasets/fmr.html.

Columns g and h. Multiply the number of units by the FMR/actual rent by the length of the grant (# of units x FMR x months based on grant term) and enter the result in the total column.

Term for one-year S+C renewals = 12 months
Term for 5-year new S+C grants = 60 months
Term for new S+C PRA w/rehab and SRO = 120 months
Term for new SRO = 120 months

For example, a new S+C project proposal with 10 1-bedroom units at $750 each would enter: 10 x $750 x 60 = $450,000

Item i. Sum columns f, g, and h and enter in row i.

Please note:

For (S+C) Renewals, the amount of rental assistance requested for a renewal may not exceed the number of S+C units currently under lease at the time of application times the applicable FMR times 12 months, except that for S+C grants having been awarded one-year of renewal funding in 2006, the number of units requested for renewal this year may not exceed the number of units funded in 2006. If you received a one-year S+C renewal grant in 2006, please provide the number of units approved for funding that year. For first-time S+C/SRO renewals, the number of units must not exceed the number of units under grant agreement and Housing Assistance Payment (HAP) contract.

The FMR for each new S+C/SRO or SRO unit is equal to 75 percent of the 0-bedroom FMR times 120 percent (0-bedroom FMR x 0.75 x 1.20). Note: This year, for renewal of S+C/SRO, the FMR is equal to 75 percent of the 0-bedroom FMR. The SRO FMR should be rounded to the nearest whole number before multiplying by the number of units and the number of months (if 0.5 or above, round to the next higher whole number).

Please be advised that the actual FMRs used in calculating your grant will be those in effect at the time the grants are approved, and may be higher or lower than those found in the Federal Register Notice.

For S+C/SRO & Section 8 SRO (SRO) you may not request assistance for more than 100 units per project.

For S+C/SRO & Section 8 SRO (SRO) Certification Requirement for Non-PHA Applicants. For Non-PHA applicants you must submit a certification letter from the Public Housing Agency (PHA) that will administer the rental assistance. Please follow the letter format below:

(Date)

I, (name and title), authorized to act on behalf of (name of PHA), certify that this agency qualifies as a Public Housing Agency as specified in 24 CFR 882.802, is legally qualified and authorized to carry out this proposed project, and that if (name of applicant) is selected for an Shelter Plus Care SRO (or Section 8 SRO) award, this agency will administer the rental assistance.

(Signature of PHA official) (PHA number)

J2. New Shelter Plus Care Single Room Occupancy (S+C/SRO) and New Section 8 Single Room Occupancy (SRO) Project Budget

No additional instructions. Please see section III.C.3.e.(5)(c), Program-Specific Requirements, of the NOFA for information about the $3000 per unit rehab requirement.

In the rows provided, estimate your costs in developing the project.
In the rows provided, list the source and amount of commitments from public and private sources that will help cover the costs of developing the project.

Section III: New Project Narratives

Part K: General Project Narrative Information

All new projects should answer the applicable questions in this section.

Part L: Supportive Services the Participants Will Receive

(All new projects except Dedicated HMIS Projects)

No additional instructions needed.

Part M: Accessing Permanent Housing

No additional instructions needed.

Part N: Participant Self-Sufficiency

No additional instructions needed.

Part O: Experience Narrative

The experience narrative is a description of the experience of all the organizations involved in carrying out the proposed project. (Refer to section III of the program section of the NOFA for Project Applicant and Sponsor Eligibility and Capacity Standards.) A project sponsor must meet the same eligibility standards as applicants.

Part P: HMIS Narrative (Dedicated HMIS Projects Only)

No additional instructions needed.

HUD Homeless Programs Logic Model Instructions:

Use logic model form HUD-96010, which can be found at: http://www.hud.gov/offices/adm/grants/nofa06/grpcoc.cfm. The logic model is a method for illustrating a CoC’s goals and action steps planning. More information is available in the Logic Model Instructions included in the General NOFA and the CoC Questions and Answers Supplements on the HUD web site.

Complete the chart using the instructions found on the “Instructions” tab on the Excel spreadsheet.

File Type	application/msword
File Title	HUD Homeless Programs Project Application
Author	HUD
Last Modified By	HUD
File Modified	2006-11-29
File Created	2006-11-29

_a. _{SHP Program}		_{c. Grant Term* (}_{Check only one box}₎ 1 Year 2 Years 3 Years
b. Component Types (Check only one box) Safe Haven/TH TH PH SSO HMIS Safe Haven/PH
d. Proposed SHP Activities	e. SHP Dollars Request		f. Cash Match	g. Totals (Col. e + Col. f)
Acquisition
Rehabilitation
New Construction
Subtotal (Lines 1 through 3)
_{Real Property Leasing} From Leasing Budget Chart
Supportive Services From Supportive Services Budget Chart
Operations From Operating Budget Chart
HMIS From HMIS Budget Chart
SHP Request (Subtotal lines 4 through 8)			Total Cash Match	Total Budget (Total SHP Request + Total Cash Match)

Administrative Costs (Up to 5% of line 9)
Total SHP Request (Total lines 9 and 10)

Housing Type* (Check all that apply)	1a. Multi-family Single-family Congregate Facility		1b. Scattered Site Project Based
2. Units, Bedrooms, Beds	a. Current Level (Point-in-Time)	b. New Effort or Change in Effort (If Applicable)		c. Projected Level (column a + col. b)
Number of Units
Number of Bedrooms
Number of Beds
3. Participants Number of Households with Dependent Children
i. Number of adults
ii. Number of children
iii. Number of disabled persons
Number of Households without Dependent Children
i. Number of disabled persons
ii. Number of chronically homeless
*Housing Types: Multi-family (apartments, duplexes, SROs, other buildings with 2 or more units); Single-family; Congregate Facility (dormitory, barracks, shared-living).

1. Homeless Subpopulations	2. Approximate Percentages (%)
Chronically Homeless (as defined by HUD)
Severely Mentally Ill
Chronic Substance Abusers
Veterans
Persons with HIV/AIDS
Victims of Domestic Violence
Unaccompanied Youth (Under 18 years of age)

Type of Contribution	Source of Contribution	Identify Source as:	Date of Written Commitment	Value of Written Commitment
Type of Contribution	Source of Contribution	(G) Government* or (P) Private	Date of Written Commitment	Value of Written Commitment
Example: Child Care	CDBG	G	2/15/06	$10,000





*Government sources are appropriated dollars.			TOTAL:	$

1. Yes No	Are there any unresolved HUD monitoring findings, or outstanding audit findings related to this project? If “Yes,” briefly describe.
2. Yes No	Are there any significant changes in the project since the last funding approval? Check all that apply: Number of persons served: from _____ to _____. Number of units: from _____ to _____. Location of project sites. Line item or cost category budget changes more than 10%. Change in target population. Change in project sponsor. Change in component type. Other:______________________________________________________ Please explain changes:_____________________________________
H: Renewal Performance (Continued) (For all S+C, SHP-PH, SHP-TH, SHP-Safe Haven, and SSO Renewals):
Use information from the most recently submitted Annual Progress Report (APR) to answer questions 3, 4, and 5. If an APR has not yet been submitted for this renewal project, please check the N/A box and skip these questions. N/A
3. Permanent Housing (PH) Performance (To be filled out by all SHP and S+C renewal permanent housing projects, including both SHP-PH and SHP-Safe Haven permanent housing). Complete the following chart using data based on the most recently submitted APR Questions 12(a) and 12(b):
Number of participants who exited PH project(s)—APR Question 12(a)
Number of participants who did not leave the project(s)—APR Question 12 (b)
Of those who exited, how many stayed 7 months or longer in PH—APR Question 12(a)
Of those who did not leave, how many stayed 7 months or longer in PH—APR question 12(b)
Percentage of all participants in PH projects staying 7 months or longer [(c + d) divided by (a + b)] x 100 = e. Example: [(16 + 15) divided by (20 + 20)] x 100 = 77.5%		%
4. Transitional Housing (TH) Performance (To be filled out by all SHP renewal transitional housing projects, including both SHP-TH and SHP-Safe Haven transitional housing). Complete the following chart using data based on the most recently submitted APR Question 14:
a. Number of participants who exited TH project(s)—including unknown destination
Number of participants who moved to PH—from any destination identified as permanent housing
Of the number of participants who left TH, what percentage moved to PH? (b divided by a) x 100 = c Example: (14 / 18) x 100 = 77.7%.		%

5. Supportive Services - Mainstream Programs and Employment Chart (To be filled out by all S+C and SHP renewals, except dedicated HMIS projects) HUD will be assessing the percentage of clients in your renewal project who gained access to mainstream services and, especially, who gained employment. Based on responses to APR Question 11 complete the following:
1 Number of Adults Who Left (Use the same number in each row)	2 Income Source	3 Number of Exiting Adults with Each Source of Income	4 % with Income at Exit (Col. 3 ÷ Col. 1 x 100)
Example: 105	a. Social Security Insurance (SSI)	40	38.1%
105	b. Social Security Disability Insurance (SSDI)	35	33.3%
105	c. Social Security	25	23.8%
	a. SSI
	b. SSDI
	c. Social Security
	d. General Public Assistance
	e. TANF
	f. SCHIP
	g. Veterans Benefits
	h. Employment Income
	i. Unemployment Benefits
	j. Veterans Health Care
	k. Medicaid
	l. Food Stamps
	m. Other (please specify)
	n. No Financial Resources

Leased Unit(s) for Housing and/or Services
a. Name of metropolitan or non-metropolitan Fair Market Rent (FMR) area:
b. New Projects Only, check the appropriate box that relates your rent to the published FMR. For Renewal Projects, skip to items c-g. 1% to 99% of FMR 100% of FMR 101% to 110% of FMR (PHA approval letter must be attached). Greater than 110% (HUD approval letter must be attached).
c. Size of Units	d. Number of Units	e. HUD Paid Amount	f. Number of Months	g. Totals
SRO	x	x	=	$
0 Bedroom	x	x	=	$
1 Bedroom	x	x	=	$
2 Bedrooms	x	x	=	$
3 Bedrooms	x	x	=	$
4 Bedrooms	x	x	=	$
5 Bedrooms	x	x	=	$
6 Bedrooms	x	x	=	$
Other: _____	x	x	=	$
h. Totals:	x	x	=	$
Leased Structure(s) for Housing and/or Services - No Applicable FMR
Structure 1		X	=	$
Address:	Street: City: State: Zip:
Structure 2		x	=	$
Address:	Street: City: State: Zip:

Supportive Services Costs	SHP Dollars Requested
	Year 1	Year 2	Year 3	Total
1. Outreach Quantity:				s
2. Case Management Quantity:
3. Life Skills (outside of case management) Quantity:
4. Alcohol and Drug Abuse Services Quantity:
5. Mental Health and Counseling Services Quantity:
6. HIV/AIDS Services Quantity:
7. Health Related & Home Health Services Quantity:
8. Education and Instruction Quantity:
9. Employment Services Quantity:
10. Child Care Quantity:
11. Transportation Quantity:
12. Transitional Living Services Quantity:
13. Other (must specify *) Quantity:
14. Total SHP dollars requested: (lines 1 to 13)**
If not specified, the costs will be removed from the budget. *Total of Line 14 must match line 6, column e., on the Project Summary Budget. The amount of the SHP request entered must be no more than 80 percent of the Total Supportive Services Costs entered on Line 16.
15.Total cash match to be spent on SHP eligible supportive service activities:
16. Total supportive services costs: ***
*** The Total Supportive Services Costs includes the cash match entered on line 15, and the SHP dollars requested on line 14. The total of Line 16 must match line 6, column g., on the Project Summary Budget.

HMIS Costs	SHP Dollars Requested
HMIS Costs	Year 1	Year 2	Year 3	Total
Equipment
1. Central Server(s)
2. Personal Computers and Printers
3. Networking
4. Security
Subtotal:
Software
5. Software/User Licensing
6. Software Installation
7. Support and Maintenance
8. Supporting Software Tools
Subtotal:
Services
9. Training by Third Parties
10. Hosting/Technical Services
11. Programming: Customization
12. Programming: System Interface
13. Programming: Data Conversion
14. Security Assessment and Setup
15. On-line Connectivity (Internet Access)
16. Facilitation
17. Disaster and Recovery
Subtotal:
Personnel
18. Project Management/Coordination
19. Data Analysis
20. Programming
21. Technical Assistance and Training
22. Administrative Support Staff
Subtotal:
HMIS Space and Operations
23. Space Costs
24. Operational Costs
Subtotal:
25. Total SHP HMIS dollars requested: *
* Total of Line 25 must be no more than 80 percent of the Total HMIS Costs entered on Line 27.
26. Total cash match to be spent on SHP eligible HMIS activities:
27. Total HMIS Costs**
**The Total HMIS Costs includes the SHP dollars requested on line 25 and the cash match entered on line 26. The total on line 27 must match line 8, column g., on the Project Summary Budget.

a. Check the box to indicate the type of program: S+C Section 8 SRO
b. Name of metropolitan or non-metropolitan Fair Market Rent (FMR) area:
*c. Check the appropriate box that relates your rent to the published FMR:** 1% to 99% of FMR 100% of FMR 101% to 110% of FMR (PHA approval letter must be attached). Greater than 110% (HUD approval letter must be attached).
d. Size of Units	e. Number Of Units	f. FMR or Actual Rent**	g. Number of Months	h. Total
SRO	x	x	=	$
0 Bedroom	x	x	=	$
1 Bedroom	x	x	=	$
2 Bedrooms	x	x	=	$
3 Bedrooms	x	x	=	$
4 Bedrooms	x	x	=	$
5 Bedrooms	x	x	=	$
6 Bedrooms	x	x	=	$
Other: ____	x	x	=	$
i. Totals:	x	x	=	$

a. List below an estimate of the total costs of developing the S+C/SRO project:
Type	Amount
Total Rehabilitation Costs (Eligible and Ineligible):
Acquisition:
Other Costs (Eligible & Ineligible, e.g., furniture):
Total:	$
b. List any commitments from public and private sources that you are able to provide at this time to help cover the costs of developing the project:
Source	Amount




Total:	$

1. Indicate the type and frequency of the proposed supportive services that would fit the needs of the participants (regardless of the resources that will be used to pay for the services):
Supportive Service	Daily	Weekly	Bi-monthly	Monthly	Other
Outreach
Case management
Life skills (outside of case management)
Job training
Alcohol and Drug Abuse Services
Mental Health and Counseling Services
HIV/AIDS Services
Health Related & Home Health Services
Education and Instruction
Employment Services
Child Care
Transportation
Transitional Living Services
Other – specify: ____________________________

Form HUD-40090-2 Exhibit 2

Continuum of Care Homeless Assistance Grant Application

Exhibit2DRAFT

Continuum of Care Homeless Assistance Grant Application

OMB: 2506-0112

Section III: New Project Narrative

S+C Component Comparisons

Part E: Discharge Policy (Only State & Local Government Applicants)

Part F: Project Leveraging Chart (All Projects)

Leased Unit(s) for Housing and/or Services

Leased Structure(s) for Housing and/or Services - No Applicable FMR. This section should be filled out only if you will lease a structure or portion of a structure for which an FMR is not applicable.

Total

Operating Costs

Personnel

Part J: Shelter Plus Care and Section 8 SRO Project Budgets

(All New and Renewal S+C or New SRO Projects as Applicable)

(All new projects except Dedicated HMIS Projects)

d. Proposed

SHP Activities

a. S+C Program

TRA SRA PRA PRAR S+C/SRO

1 Year

Total S+C Rental Assistance Amount from S+C and SRO Budget Chart

$

a. SRO Program

Total SRO Rental Assistance Amount from SRO Budget Chart

Housing Type*

(Check all that apply)

Part F: Project Leveraging Chart (All Projects)

H: Renewal Performance (Continued)

(For all S+C, SHP-PH, SHP-TH, SHP-Safe Haven, and SSO Renewals):

Use information from the most recently submitted Annual Progress Report (APR) to answer questions 3, 4, and 5. If an APR has not yet been submitted for this renewal project, please check the N/A box and skip these questions. N/A

Example: 105

Structure 2

Total

Operating Costs

Equipment

Part J: Shelter Plus Care and Section 8 SRO Project Budgets

(All S+C and SRO Projects as Applicable)

J2. New Shelter Plus Care Single Room Occupancy (S+C/SRO) and New Section 8 Single Room Occupancy (SRO) Project Budget

Total:

$

b. List any commitments from public and private sources that you are able to provide at this time to help cover the costs of developing the project:

Source

Amount

Total:

$

Part L: Supportive Services the Participants Will Receive

(All New Projects Except Dedicated HMIS Projects)

Daily

Weekly

Bi-monthly

Monthly

Other

Part O: Experience Narrative (All New Projects)

Grant Number

Part P: HMIS Narrative (Dedicated HMIS Projects ONLY)

a. _{S+C Program}

a. _{SRO Program}