HomeMy WebLinkAboutOTHER-2020-007 Application for the 2020 North Carolina Community Development Block Grant – Coronavirus CDBG Program - ..�Za w - cd'7
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ORANGE COUNTY H D
NORTH CAROLINA ORANGE COUNTY HOUSING & COMMUNITY DEVELOPMENT
Orange County , North Carolina
AppLication for the 2020
North Carolina Community
DeveLopment Block Grant -
Coronavirus ( CDBG - CV ) Program
Orange County Department of Housing I '
and Community Development
i
919 - 245 - 2490
http, / /oranciecountync ciov/ Housing
NC CDBG Coronavirus (CDB & CV) APPLICATION CHECKLIST
.
Use the following checklist as the table of contents for the CDBG - CV application . Make sure all the
required items are included . If any one of the required items is not included , the application will not
meet threshold nor be approved for funding .
A . Application Submission Requirements and Process Adherence
N Applicant must be an eligible non - entitlement general unit of local government .
N Applicants must submit two ( 2 ) complete originals of the application .
N Applications must be submitted to REDD in a three - ring binder organized with tabs .
N Application Summary Form and all forms requiring official signatures must appear in both
applications , complete , and have the original signature of the chief elected official or another
documented authorized certifying officer .
N Applications may not be submitted to REDD before Tuesday, September 1 , 2020 .
N The proposed project may address the Urgent Need National Objectives however, at least 51 % low -
to moderate persons must benefit for public services and public facilities and 70 % low -to -
moderate income persons must benefit from special economic development projects .
N The NC CDB &CV funding request must not exceed $ 900, 000 .
N Neither applicant nor any of its critical partners can appear on the Federal or State Suspension of
Funds List/ Debarment List .
N Applicant must clearly select one or more of the NC CDBG- CV activity categories .
Note : The NC CDBG - CV Program is an urgent needs program; therefore, a waiver is not required by the
NC Department of Commerce if current funding request exceeds $1, 250, 000 in applications for local
governments in any of the CDBG categories and demonstration programs.
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B . Required Attachments for NC CDB &CV Projects
ITEM TAB LOCATION
DOCUMENTATION OF SYSTEM FOR AWARD MANAGEMENT - SAM . GOV REGISTRATION Tab 6
❑ INITIAL ❑ ANNUAL UPDATE ( Please submit/ attach a printout of the SAM . gov Registration Information )
PROJECT DESCRIPTION Tab 2
SOURCES AND USES OF FUNDS Tab 2
PROJECT BUDGET Tab 2
NC CDBG - CV BENEFIT : LOW & MODERATE INCOME Tab 4
COMMUNITY DEVELOPMENT PLAN Tab 4
CONFLICT OF INTEREST FORM -CHECKLIST Tab 6
FEDERAL REQUIREMENTS : Tab 6
❑ A . FEDERAL CERTIFICATIONS
❑ B . DISCLOSURE REPORT FOR APPLICANTS REQUESTING $ 200, 000 OR MORE . ( NOTE : Not required for
applicants requesting less than $ 200, 000 in CDBG funds and not using other Federal assistance . )
DISCLOSURE REPORT Tab 6
STATE CDBG PROGRAM REQUIREMENTS : Tab 6
❑ A . REGULATIONS SIGNED AND DATED BY AUTHORIZED OFFICIAL
❑ B . DISCLOSURE OF CIVIL RIGHTS COMPLAINTS/ LAWSUITS SIGNED AND DATED BY CHIEF ELECTED
OFFICIAL
CERTIFICATION REGARDING DEBARMENT, SUSPENSION , AND OTHER RESPONSIBILITY MATTERS Tab 6
FLOOD PLAIN CERTIFICATION : Submit a letter or statement on the local government' s letterhead stating
the relationship of the site to designated flood zones . Recipients must provide REDD a certification signed
by the Chief Elected Official stating that the project area is not in a floodplain ; or with certification that the Tab 6
recipient participates in the floodplain insurance program , all properties assisted in the project will be
covered for floodplain insurance prior to beginning construction of the property, and all public facilities will
be constructed to comply with the applicable floodplain regulations .
IMPLEMENTATION SCHEDULE FORM ( 2 originals — one per application ) Tab 2
HUD IDIS : ACCOMPLISHMENTS & BENEFICIARIES FORM ( Form is also on www . nccommerce . com . ) Tab 4
THREE REQUIRED MAPS :
❑ Location Map must show the applicant' s jurisdiction . Major highways and roads must be shown
drawn to scale . The applicant must label the map , include a legend , and place a boundary line
around areas of minority concentrations and of low - and - moderate income families .
❑ Project Map must include the location of all project activities . It must also show all units bordering
the project area whether they are part of the project activities . Commercial units such as shopping Tab 5
centers must also be labeled . Mark all existing and proposed public infrastructure on one map to
indicate the relationship of public infrastructure to units to be constructed . The map must be to
scale and include a legend .
❑ Low- Moderate Income Map must illustrate the distribution /concentration of low - moderate
income persons in the jurisdiction .
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LETTERS OF COMMITMENT, CONDITIONAL COMMITMENT, AND EVIDENCE OF FUNDING APPLICATION Tab 2
from all other ( i . e . , non - CDBG ) sources of funds and /or resources .
CAPACITY, EXPERIENCE, AND ORGANIZATIONAL STRUCTURE
❑ List of Names and Duties for the Local Government Staff for the Proposed Project and Other
Essential Players
❑ Resume for each identified person associated with the proposed project Tab 3
❑ Organizational Chart Identifying the Reporting Relationship and/ or Interaction Among Key Players
for the Proposed Project
❑ Chart of Previous CDBG or other federal or state experience relevant to the proposed project . List
project name, CDBG funding amount, program category, and brief description .
RESOLUTION TO SUBMIT CDBG -CV APPLICATION AND EVIDENCE OF THE FIRST OF TWO REQUIRED PUBLIC
HEARINGS . Provide copies of the Board/Council Resolution to Apply, posted Public Hearing Notices, Tab 7
Certified Meeting Minutes for both Public Hearings, and evidence outreach efforts to inform the public of
each public hearing . The outreach efforts must be conducted as noted in the Citizen Participation Plan .
APPRAISALS are required for all CDBG - CV land acquisition activity only . N/A
PHOTOGRAPHS TO DOCUMENT EXISTING CONDITIONS N/A
DUPLICATION OF BENEFITS POLICY AND PROCEDURES Tab 4
PLAN TO MINIMIZE RESIDENTIAL DISPLACEMENT AND TO PROVIDE RELOCATION ASSISTANCE TO Tab 4
DISPLACED CITIZENS IN A TIMELY MANNER
ALL SPECIAL ECONOMIC DEVELOPMENT PROJECTS MUST PROVIDE THE FOLLOWING BELOW : N/A
❑ Employee Profile (Complete one per business included in the project. )
❑ Current NCUI 101 (Required for expansion/retentions projects. Forform, see https : //des . nc . gov/ need - help/forms -and -
documents)
❑ Articles of Organization / Incorporation or related - business incorporation documents .
❑ Legally Binding Commitment (Complete one per business included in the project. )
❑ Private Company Commitment Form (Complete one per business included in the project. )
❑ Limited Waiver of Confidentiality (Complete one per business included in the project. )
❑ Performance Indicators Form (Complete for the entire project. )
ALL PROJECTS WITH NEW CONSTRUCTION AND SUBSTANTIAL REHABILITATION REGARDLESS of FUNDING STREAM MUST
PROVIDE THE FOLLOWING BELOW :
❑ 10-Year Minimum Operating Pro forma
❑ Cost Estimates N /A
❑ Site and Architectural Plans and Renderings : Attach one copy each of site and architectural plans
for the proposed project . Identify any unit features designed to serve populations with special
housing needs ( e . g . , persons with disabilities, the elderly, large families, etc . )
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APPLICATION SUMMARY - NC CDBG CORONAVIRUS ( CDB & CV ) PROGRAM
1 . Applicant ' s name Orange County, NC 2 . Date
a . Mailing Address PO Box 8181
b . City and Zip Code Hillsborough, NC 27278 z Original
C . County Orange County dated .
d . Contact Person Erika Brandt
e . Telephone Number 919 -2454331 ❑ Amendment
£ Fax Number 91 M69 -3018 dated .
g . e- mail address ebrandt@oran . e�tync . gov
li . DUNS Number 0440417960000
� . Preparer' s Name N/A c . Telephone Number
a. Firm ' s Name
b . Mailing Address
c . City and Zip Code f. Fax Number
d . e -mail address
4 . Developer ' s Name N/A c. Telephone Number
a . Mailing Address
b . City and Zip Code a . Fax Number
5 . Development Name N/A
a . Street Address
b . City and Zip Code
c . Ownership Entity
6 . Program 7 . Project 9 . CDBG - CV Funds
Category Number g • Project Name Requested
CV 1 Emergency Housing Assistance $ 90000
10 . Certification by the Chief Elected Official
a) I certify that to the best of my knowledge and belief
1 . Data in this application is true and correct,
2 . Opportunities have been provided for citizen participation and access to information concerning the proposed
activities ,
3 . This document has been duly authorized by the governing body of the applicant and the applicant will
comply with the attached certifications and state standards if the assistance is approved
b ) I acknowledge that, if funded , this application is part of the Grant Agreement . e
a . Typed Name of Chief
f
Elected Official ➢ Penny Rich
b . Typed Title ➢ Chair, qmpge County B rd f ommissionett! . : I fd I Ijw
c . Signature ➢ t 1 ' 6r �' ;' '�
,x
d . Typed Date ➢ Octeber 8 , 2020
For REDD Use Only
Date Received . Application Number *
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NC CDBG- CV PROGRAM CATEGORY SELECTION FORM
AREAS OF FOCUS : Check applicable area (s) of focus.
® Support families and communities through telehealth support and public services .
® Protect the most vulnerable and high -risk populations .
ElAssist small businesses with economic recovery .
❑ Address testing, tracing, and trends .
® PUBLIC SERVICES : Check applicable activities.
Public Service Description
0 Subsistence Payments Provide up to three months emergency payments on behalf of
individuals or families, generally for the purpose of preventing
homelessness . Utility payments to prevent service disconnection and
rent/ mortgage payments to prevent eviction . Local governments may
partner with a non - profit service provider such as United Way .
❑ Employment Training Carry out job training to expand the pool of health care workers and
technicians that are available to treat disease within a community .
❑ Testing and Diagnosis Provide testing, diagnosis, or other services at a fixed or mobile
location .
❑ Equipment, Supplies, and Provide equipment, supplies, and materials necessary to carry - out a
Materials public service .
❑ Food Distribution Meal Delivery : Deliver meals on wheels to quarantined individuals or
individuals that need to maintain social distancing due to medical
vulnerabilities .
Food Bank/ Pantry Services : Provide support to food banks and food
pantries .
❑ Health Services Increase the capacity and availability of targeted health services for
infectious disease response within existing health care facilities .
❑ Mental Health Services Increase the capacity and availability of targeted mental health services
for individuals and families impacted by Coronavirus .
❑ Broadband and Communications Provide broadband services inclusive of internet access and
Support hardware/software purchases to connect individuals to jobs , schools,
financial institutions, and healthcare providers .
❑ Services for Special Needs Provide services for special needs populations that prevent, respond
Populations such as seniors, youth to, or prepare for COVID - 19 . Applicants must contact the CDB & CV
age 13 - 19 , and Manager for approval prior to submitting the application .
disabled /handicapped
❑ Other ( Please describe in the
description box to the right . )
❑ PUBLIC FACILITIES AND IMPROVEMENTS : Check applicable activities .
Note : Public Facilities are required to be owned by the local unit of government. However, Non -profits may also
own and operate the building if the building is open to the general public. Also, the local government will need to
have lien on the property and Legally Binding Commitment which includes the applicable contract provisions.
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Public Facility Activity Description
❑ Acquisition , Health Facilities may be created /supported by :
❑ Construction , • Constructing a testing and diagnosis, or treatment facility .
❑ Reconstruction , or • Rehabilitate a community facility to establish an infectious
❑ Installation of public works , facilities, disease treatment clinic .
and site or other improvements Acquiring and rehabilitating, or constructing, a group living
facility that may be used to centralize patients undergoing
treatment .
❑ Rehabilitation of building and Rehabilitate a commercial building or closed school building to
improvements ( including interim establish an infectious disease treatment clinic
assistance )
Acquire , and quickly rehabilitate ( if necessary ) a motel or hotel
building to expand capacity of hospitals to accommodate isolation of
patients during recovery .
Make interim improvements to private properties to enable an
individual patient or frontline health care workers to remain
quarantined on a temporary basis .
❑ Broadband and Communications Provide broadband services inclusive of infrastructure development,
Support internet access , wiring, and hardware and software purchases to
connect individuals to jobs, schools, financial institutions, and
healthcare providers .
❑ SPECIAL ECONOMIC DEVELOPMENT ASSISTANCE : Check applicable activities .
Proposed projects are subject to CDB &CV cost per job limits and the limit for this project is $ 85 , 000 per
full -time job or less . For example , a $ 850 , 000 grant must result in the creation of at least 10 new jobs
[ $ 850, 000 grant total/$ 85 , 000 per job = 10 jobs created ] . At least 70 % of the jobs must go to LMI
persons . In other words , out of 10 jobs, 7 must go to LMI persons .
Economic Development Activity Description
❑ Small Business and Microenterprise Provide grants to support new businesses or business expansion to
Assistance create jobs and manufacture medical supplies necessary to respond
to infectious disease .
Avoid job loss cause by business closures related to social distancing
by providing short-term working capital assistance to small
businesses to enable retention of jobs held by low -to - moderate
income persons .
Provide financial assistance to for- profit businesses to acquire
property, build , expand , or rehabilitate a building, lease space to
operate, or purchase equipment, or provide operating capital .
Retrofit workspaces for for- profit businesses to promote social
distancing .
❑ Microenterprise Assistance is defined Provide technical assistance and grants to establish , stabilize, and
as a commercial enterprise that has expand microenterprises that provide medical , food delivery,
five or fewer employees, one or more cleaning, and other services to support home health and
of whom owns the enterprise . quarantine .
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