HUD-40076-HBCU Historically Black Colleges and Universities

Historicall
y Blac
k Colleg
es
Historically
Black
Colleges
and Univer
sities
Universities
OMB Approval No. 2528-0235 (exp. 4/30/2007)

The information collection requirements contained in this application have been approved by the Office of Management
and Budget (OMB) 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 requested in accordance with the regulatory authority contained in each program rule. The information
will be used to rate applications, determine eligibility, and to establish grant amounts.
Selection of applications for funding is based on rating factors listed in the Notice of Fund Availability (NOFA), which
is published each year. 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 average 44 hours per response, 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.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties.
(18 U.S.C. 1001, 1010, 1012;

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31 U.S.C. 3729, 3802)

form HUD-40076-HBCU (04/2003)

Factor 4 Response Format

OMB Approval No. 2528-0235 (exp. 4/30/2007)

(Use this form or type on separate pages)
RESPONSE SHEET
Applicant Name: _____________________________________________________________
Factor 4 - Leveraging Resources (maximum points: 10). The information that the applicant
supplies on this form will be used in conjunction with the narrative response and other documentation
to rate Factor 4.
Name of Provider (Donor)

Cash or
In-Kind

Dollar Value
Provided

To Be Applied
To Task No.

Commitment
Letter Page No.

$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
$
Total
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$
form HUD-40076-HBCU (04/2003)

OMB Approval No. 2528-0235 (exp. 4/30/2007)

RESPONSE SHEET
Applicant Name: _____________________________________________________________
Budget-By-Activity The information that the applicant supplies on this form will be reviewed in
conjunction with the narrative response and other documentation for the budget submission
requirement.
Activity
No.

List Activity
and Tasks for Each Activity

HUD HBCU
Grant

Other
Federal

Source of Funds
State
Local

Private

Total

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

Subtotal

$

$

$

$

$

$

Costs of Administering Grant

$

$

$

$

$

$

Percent of Total

%

%

%

%

%

%

*Total

$

$

$

$

$

$

*Must equal amounts on SF-424.

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form HUD-40076-HBCU (04/2003)

OMB Approval No. 2528-0235 (exp. 4/30/2007)

RESPONSE SHEET
The information requested below is to be provided by Previously-funded HBCUs only.
Applicant should duplicate this page as necessary.
Performance Narrative. The following information is to be provided for HUD HBCU grant(s). The
information will be reviewed in conjunction with the two latest progress reports for the grant(s) which
are also to be submitted in response to this subfactor.
The following information is requested for each HUD/HBCU grant that you have received since 1991.
Applicant Name

_____________________________________________________________________

Grant Number

___________________________

Grant start date (grant agreement, HUD-1044, executed)

___________________________

Grant end date

___________________________

Amount of HUD Grant funds awarded

$ ________________________________________

Amount of HUD Grant funds expended

$ ________________________________________

Balance of Grant funds to be spent

$ ________________________________________

Total cost of project

$ ________________________________________

Amount contributed by partners

$ ________________________________________

Partner percentage of total cost

Partner Name

________________________ %

_________________________________________________________________

Amount Contributed $ ____________________________________
Partner Name

_________________________________________________________________

Amount Contributed $ ____________________________________
Partner Name

_________________________________________________________________

Amount Contributed $ ____________________________________
Partner Name

_________________________________________________________________

Amount Contributed $ ____________________________________
Grant Goals and Objectives

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form HUD-40076-HBCU (04/2003)

OMB Approval No. 2528-0235 (exp. 4/30/2007)

RESPONSE SHEET
Applicant Name

_____________________________________________________________________

Performance Narrative. (continued)
Were / are Grant Goals and Objectives being met? Yes ____

No ____

Total number of Grant tasks

____________

Total number of persons to be served by completion of this Grant
For the following questions, please enter a date that is no earlier than the publication date of this
SuperNOFA.
Total number of Grant tasks completed as of (enter date)

____________

Percentage of Grant tasks completed as of (enter date)

____________

Total number of persons served as of (enter date)

____________

List measurable results as of (enter date)

Were / are Grant Target dates and Schedules being met?

Yes ____

No ____

Impediments or delays in implementation encountered

Other comments:

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form HUD-40076-HBCU (04/2003)

RESPONSE SHEET
Applicant Name

_____________________________________________________________________

Performance Narrative. (continued)
Total number of HUD / HBCU Grants you have received
Grant Number

____________
Amount of Grant

__________________________________

$ _____________________

__________________________________

$ _____________________

__________________________________

$ _____________________

__________________________________

$ _____________________

__________________________________

$ _____________________

__________________________________

$ _____________________

Total

$ _____________________

Briefly describe the impact that the total amount of HUD/HBCU funds listed above have had on your
community.

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form HUD-40076-HBCU (04/2003)

Budget Summary

OMB Approval No. 2528-0235 (exp. 4/30/2007)

Federal Share
Name and Address of Applicant: _________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Detailed Description of Budget
Category
1. Direct Labor

Position or Individual

Estimated
Hours

Rate/
Hour

Estimated
Cost

Total
Cost

Rate

Base

Estimated
Cost

Total
Cost

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Total Direct Labor Cost

Category
2. Fringe Benefits

Total Fringe Benefits Cost

Category
3. Materials

Item

Total Materials Cost

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form HUD-40076-HBCU (04/2003)

Budget Summary (con't.)

Federal Share
Detailed Description of Budget
Category

Mileage

Rate/
Mile

Estimated
Cost

Total
Cost

Trips

Fare

Estimated
Cost

Total
Cost

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Days

Rate/
Day

Estimated
Cost

Total
Cost

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Days

Rate/
Day

Estimated
Cost

Total
Cost

4. Travel

a. Transportation

(1) Local Private Vehicle

4. Travel

a. Transportation

(2) Air/Destination

4. Travel

a. Transportation

(3) Other/Item

4. Travel

b. Per Diem or Subsistence

Total Travel Cost

Category
5. Equipment

Item

Total Equipment Cost

Category
6. Consultants

Type

Total Consultants Cost

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form HUD-40076-HBCU (04/2003)

Budget Summary (con't.)

Federal Share
Detailed Description of Budget
Category
7. Subcontracts List individual subcontracts

Estimated
Cost

Total
Cost

Total Subcontracts Cost

Category
8. Other Direct

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Rate

Base

Estimated
Cost

Total
Cost

Item

Total Other Direct Cost

Category
9. Indirect

Type

Total Indirect Cost
Total Estimated Costs

Previous versions obsolete

form HUD-40076-HBCU (04/2003)

Budget Summary

OMB Approval No. 2528-0235 (exp. 4/30/2007)

Non-Federal Share
Name and Address of Applicant: _________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Detailed Description of Budget
Category
1. Direct Labor

Position or Individual

Estimated
Hours

Rate/
Hour

Estimated
Cost

Total
Cost

Rate

Base

Estimated
Cost

Total
Cost

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Total Direct Labor Cost

Category
2. Fringe Benefits

Total Fringe Benefits Cost

Category
3. Materials

Item

Total Materials Cost

Previous versions obsolete

form HUD-40076-HBCU (04/2003)

Budget Summary (con't.)

Non-Federal Share
Detailed Description of Budget
Category

Mileage

Rate/
Mile

Estimated
Cost

Total
Cost

Trips

Fare

Estimated
Cost

Total
Cost

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Days

Rate/
Day

Estimated
Cost

Total
Cost

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Days

Rate/
Day

Estimated
Cost

Total
Cost

4. Travel

a. Transportation

(1) Local Private Vehicle

4. Travel

a. Transportation

(2) Air/Destination

4. Travel

a. Transportation

(3) Other/Item

4. Travel

b. Per Diem or Subsistence

Total Travel Cost

Category
5. Equipment

Item

Total Equipment Cost

Category
6. Consultants

Type

Total Consultants Cost

Previous versions obsolete

form HUD-40076-HBCU (04/2003)

Budget Summary (con't.)

Non-Federal Share
Detailed Description of Budget
Category
7. Subcontracts List individual subcontracts

Estimated
Cost

Total
Cost

Total Subcontracts Cost

Category
8. Other Direct

Quantity

Unit
Cost

Estimated
Cost

Total
Cost

Rate

Base

Estimated
Cost

Total
Cost

Item

Total Other Direct Cost

Category
9. Indirect

Type

Total Indirect Cost
Total Estimated Costs

Previous versions obsolete

form HUD-40076-HBCU (04/2003)

Sample Letter of Commitment
Use the Commitment Provider’s Letterhead
(Insert Date)
Processing and Control Branch
Office of Community Planning and Development
Department of Housing and Urban Development
451 7th Street SW, Room 7251
Washington, DC 20410-3500
Attn: (State appropriate program name)
Re: HUD Notice of Funding Availability, FR-

for (state appropriate program name)

To Whom It May Concern:
If this proposal is funded, (provider name) commits $(amount) (or) (type of in-kind
contribution) valued at $(amount) to (applicant name) for (type of activity) to be made
available for recipients of the program.
These funds will be made available on (date mm/dd/yyyy) for the following grant
activity(ies):(list)

Sincerely,
(Signature of Authorized Representative)
(Title)

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form HUD-40076-HBCU (04/2003)

HUD Consolidated Plan-Revitalization Strategies and HBCUs
States and units of local government may provide Community Development Block Grant
(CDBG) assistance to institutions of higher education which have a demonstrated capacity to
carry out activities which are eligible under the Housing and Community Development Act (HCDA).
(This is provided for at §105(a)(22) of the HCDA.) While not mentioned in the Act, Historically
Black Colleges and Universities are included as institutions of higher education.
HBCUs can demonstrate capacity to carry out CDBG-eligible activities in a variety of ways,
since the list of CDBG-eligible activities is quite broad. For example, housing counseling services, public services, assistance to microenterprises, technical assistance to businesses, rehabilitation of housing, and construction of public facilities such as buildings are all CDBGeligible; these are activities in which colleges and universities are frequently involved, either in
the community or on their own campuses. The Act does not require that they must have already
received CDBG funding to demonstrate capacity. Successful implementation of projects using
HUD HBCU funding, foundation grants, or other state/local/nonprofit funding can also serve as
evidence of capacity.
It is important to remember, however, that HUD does not make this determination of capacity. In the CDBG program, funds are provided to units of local government. In the Entitlement
CDBG program (for larger cities and counties), HUD makes grants directly to the city or county;
in the State CDBG program, HUD makes grants to states, which award funds to smaller communities that do not qualify for direct Entitlement funding. It is up to the unit of local government
to select activities for funding; and, in the State CDBG program, it is up to the state to decide
which activities it will fund. The local government (and the State, where applicable) would determine that the college or university has demonstrated capacity to carry out CDBG-eligible activities. Thus, an HBCU should work closely with its local government officials to seek and obtain
CDBG funding.
All eligible activities in the CDBG Program must meet one of three statutory objectives
specified in the CDBG legislation. This means that the activity must either benefit low- or moderate-income persons, aid in the prevention of slums and blighted conditions, or meet other
community development needs having a particular urgency. Many HBCUs are located in (and
have a long history of serving) neighborhoods with concentrations of low- and moderate-income persons. HBCU campuses are often located in neighborhoods which have suffered from
disinvestment and show physical signs of blight. An institution which wishes to carry out CDBG
activities should be prepared to demonstrate to the unit of local government how its activities
will meet one of the three national objectives.
In recent years, HUD’s Office of Community Planning and Development (CPD) has stressed
a coordinated marshalling of resources to facilitate grantees’ ability to engage in comprehensive community revitalization strategies. Comprehensive neighborhood/community revitalization strategies seek to create partnerships among Federal and local governments, the private
sector, community organizations and local residents. The Department seeks to create communities of opportunity in distressed areas by stimulating the reinvestment of human and economic capital and by economically empowering low-income residents.
The Department recognizes the fundamental necessity of partnering in problem-solving in
order to achieve much greater success in community revitalization efforts. HUD believes that
no effort will succeed without the support of all of the community actors. Successful revitalization strategies are those that bring together the community’s stakeholders to forge partnerships
that:
o obtain commitments to community building;
o

make communities attractive for investments, thereby creating a market for profits;

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form HUD-40076-HBCU (04/2003)

o

generate community participation to ensure that the benefits of economic activity are
reinvested in the community for long-term development;

o

support the use of nonprofit intermediary institutions (e.g., Community Development
Corporations, Community Development Financial Institutions, and Historically Black
Colleges and Universities (HBCUs) to bridge gaps between local government agencies,
the business community, community groups, and residents;

o

foster the growth of resident-based initiatives to identify and address their housing, economic and human services needs;

o

coordinate the delivery of various local, state and Federal resources; and

o

support initiatives to move unemployed people from public assistance into jobs.

To encourage this approach, HUD has established in the CDBG program the option for units
of local government to develop a Neighborhood Revitalization Strategy. (In the State CDBG
program, this is called a Community Revitalization Strategy). Once a unit of local government
develops and receives approval of a Revitalization Strategy, activities which it carries out to
implement the strategy can take advantage of certain incentives built into the CDBG program
regulations. These incentives make it easier for units of local government to demonstrate that
CDBG-funded activities meet one of the national objectives.
HUD believes HBCUs can play a vital role in the development and implementation of revitalization strategies in the communities they serve. The HBCU can provide its facilities and expertise to bring community residents and local government officials together to identify problems
and solutions. The HBCU can provide its facilities and expertise to produce the written document. Similarly, the institution could monitor and evaluate implementation of the strategy. (The
institution could contract with the local government to perform these functions and receive CDBG
administrative funds to pay for them; the institution could pay for these out of its own resources,
as evidence of its financial commitment to the initiative; or it could use funds from its HUD
HBCU award to perform these functions).
As a stakeholder in the community, the HBCU should play an active role in identifying neighborhood/community needs and problems. Likewise, as a stakeholder and community partner, it
should establish an active role in implementing the revitalization strategy. Examples of roles
HBCUs could play in community implementation of the strategy include:
o

Carrying out activities, pursuant to the locality’s Consolidated Plan strategy, with its own
funds;

o

Receiving CDBG funds from the unit of local government to carry out activities pursuant
to the Consolidated Plan strategy;

o

Using HUD HBCU funding to carry out activities pursuant to the Consolidated Plan
strategy;

o

Serving as an intermediary/facilitator to put funding sources together with entities carrying out activities;

o

Providing technical assistance to businesses, community groups and nonprofit organizations on how to implement projects to which they have committed; and

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form HUD-40076-HBCU (04/2003)

o

Foster the formation of other nonprofit/intermediary organizations to implement portions of the strategy, when the lack of such organizations is an identified barrier to strategy implementation.

As HBCUs explore how to link their HBCU funding to CDBG revitalization strategies, HBCUs
should first contact local government officials to learn if the locality has considered adopting the
revitalization strategy approach, to get more specific information on revitalization strategy requirements, and to get more specific information about their community’s CDBG program. HBCUs
located in smaller (nonentitlement) communities should also contact the State agency which
administers the CDBG program in their State.

Previous versions obsolete

form HUD-40076-HBCU (04/2003)