HUD 96008 Benchmark Standards (36 Months)

OMB Approval Number 2539-0015 (exp MM/DD/201Y)

* Grant Number:

Grantee Organization:

* Period of Performance:

PERIOD ACTIVITY

Q1

Q2

Q3

Q4

Q5

Q6

Q7

Q8

Q9

Q10

Q11

Q12

Q13

Applicant Capacity (0-90 days)

Staff Hired

Approved Environmental Review and Release of Funds

Written Policies and Procedures

Number of Paint Inspections/ Risk Assessment Proposed:

< Enter Number of Units to be Assesssed

Paint Inspections/Risk Assessments:

Minimum Performance Standard

0%

2%

5%

15%

25%

35%

50%

65%

80%

95%

98%

100%

Proposed # Assessed

Actual # Assessed

Actual % Assessed

Units in Progress of Interventions

Number of Completed & Cleared Housing Units Proposed:

< Enter Number of Units to be Completed and Cleared.

Units Completed and Cleared:

Minimum Performance Standard

0%

1%

2%

5%

10%

25%

40%

55%

70%

85%

95%

99%

100%

Proposed # Completed

Actual # Completed

Actual % Completed

LOCCS DRAWDOWNS Grant Award Amount =

< Enter Requested OHHLHC Dollar amount.

LOCCS Drawdowns:

Minimum Performance Standard

2.50%

5%

10%

15%

25%

35%

45%

55%

65%

80%

90%

99%

100%

Drawdown Milestone

Proposed Dollars Drawn

Proposed Match Amount

Proposed Leverage

Proposed Healthy Homes Initiative Funding (if applicable)

Actual Drawdown

Actual Drawdown %

Actual Healthy Homes Initiative Funding (If applicable)

Actual Match Amount

Actual Leverage Amount

Community Outreach / Education/ Training

Community Outreach Milestone

Community Outreach Achieved

Education Milestone

Education Achieved

Skills Training Milestone

Skills Training Achieved

Close-Out

* Leave Grant Number and Period of Performance blank at time of application

form HUD 96008 (xx/xxxx)