HUD 96008 Benchmark Standards (36 Months)

Application for Healthy Homes and Lead Hazard Control Grant Programs and Quality Assurance Plans

final 36 month benchmark.xls

OMB: 2539-0015

Document [xlsx]
Download: xlsx | pdf










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)





































































































































































































































































































































































































































































































































































































































































































































































































































































File Typeapplication/vnd.ms-excel
AuthorJohnnette Hawkins
Last Modified ByBailey Miller
File Modified2010-10-16
File Created2002-11-18

© 2024 OMB.report | Privacy Policy