Construction Program Application Fiscal Year –
San Bernardino County
Fiscal Year -
Construction Improvement Application
The following documents must be submitted in the order listed, please be sure to submit all attachments to your application.
Exhibit 1: Organization Information
Exhibit 2: Project Information
Exhibit 3: Project Characteristics
Exhibit 4: Priority Needs:
Exhibit 5: Project Budget & Sources
Exhibit 6: Proposed Goals and Milestones
Exhibit 7: Agency Capacity Narrative
Exhibit 8: Civil Rights Laws Compliance And HUD Good Standing Exhibit 9: Signatures And Assurances
Maintenance And Operations Agreement
Application Checklist
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Log Number
(Office Use Only)
1 ✔
2024 ✔
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2023 ✔
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2023 ✔
2024 ✔
BARS23CN-013 ✔
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Construction Program Application Fiscal Year –
Exhibit 1: Organization Information
Organization Name:
Organization Address:
City/State/Zip:
Phone:
Fax:
Email:
Applicant Type:
Authorized Person Name:
Authorized Person’s Title:
Address:
City/State/Zip:
Phone:
Fax:
Email:
Application Contact Person’s Name:
Application Contact Person’s Title:
Explain the Agency’s 1) Mission, 2) Purpose, 3) Population Served, 4) Number of years serving population, 5) Supportive Services, their Funding Sources, and Start/End Dates. 2 2024 17602555156
The mission of the City of Barstow is to provide quality public services, promote economic development, expanding and provide housing, education, recreation and community pride while celebrating our diverse culture history. The city is a progressive desert community with small-town advantages that preserves and promoted a quality environment in which to live, work, and play. The 2020 census indicates the population of Barstow to be 25,415 220 E. Mountain View Street Barstow / CA / 92311 Willie A. Hopkins Jr, 220 E. Mountain View Street Domingo D Gonzales (760)256-1750 City of Barstow / CA / 92311 [email protected] City of Barstow Engineering Services Administrator 2023 ConstructionCity Manager [email protected] (760)255-5101 Construction Program Application Fiscal Year –
Exhibit 2: Project Information
Project Title:
Address:
City /State/Zip:
County Supervisorial District where project will be located:
Project Type (Description):
If requesting additional funds for an existing CDBG project, provide prior CDBG project number? Eligible Block Group
Indicate eligible Block Group to be benefited by CDBG Funds requested.
Provide a map identifying the eligible census block as indicated in the Eligible Census Blocks. 3 1
st District 2nd District 3rd District: 4
th District 5th District
Is this a new construction project, or a request for additional funding to an existing CDBG Project? Barstow / Ca / 92311 X
2024 X
N/A
2023
Replacement of Chiller and heat exchanged units that will include Air-Purified Equipment with HEPA filters and UV light.
841 Barstow Road New Construction Project Cora Harper Fitness Center HVAC Replacement Project This project benefits and serves a community categorized as low-income in Census Tract 009500. The geographic boundaries of the program include the City of Barstow, as the surrounding areas, such as Hinkley, Daggett, and Yermo.
Construction Program Application Fiscal Year –
EXHIBIT 2A: Countywide Vision
Indicate Yes/No in the table below which countywide vision goals are pertinent to the proposed project.
Countywide Vision
Countywide Vision Yes/ No
Implement the Countywide Vision.
Create, Maintain and Grow Jobs and Economic
Value in the County.
Improve County Government Operations.
Operate in a Fiscally-Responsible and Business-Like
Manner.
Ensure Development of a Well-Planned, Balanced,
and Sustainable County.
Maintain Public Safety.
Provide for the Health and Social Services Needs of
County Residents.
Pursue County Goals and Objectives by Working
with Other Governmental Agencies.
Provide a brief narrative of how your project meets the Countywide Vision:
4 Yes No Yes Yes Yes Yes 2023 2024
The project meets the Countywide Vision since it serves a diversity of people and support the envision of a sustainable heathy community. The Community Center also host arts and cultural events that is part of the Countywide Vision to support the best of life has to offer.
Yes
Construction Program Application Fiscal Year –
Exhibit 3: Project Characteristics
Street address and nearest cross streets of the site where the program will be carried out:
Legal property owner:
What is the current zoning?
Is this use permitted in this zoning?
Is a conditional use permit required? Yes/No
Complete applicable items for all construction projects:
• Assessor's parcel number:
• Square footage of proposed building or building addition:
• Square footage of construction site parcel:
• Length of improvements if street, water or sewer project:
• Service capacity of existing facility:
• Improved service capacity of the facility:
• Age of structure:
• Is the structure registered as a historic landmark under state, federal or local Law? Describe the geographic boundaries of the neighborhood, community, or region to be served by this project. This description must include service area boundaries if land acquisition or structural improvements are proposed (attach a map):
5 The geographic boundaries of the program include the City of Barstow, as the surrounding areas, such as Hinkley, Daggett, and Yermo.
City of Barstow 2023 No N/A Yes 018314403 N/A 2024 >40 Years N/A PF Construction Program Application Fiscal Year –
Exhibit 4: Priority Needs:
Complete the table below by answering “Yes” or “NO”.
Public Facility’s Needs: Yes/ No:
Senior Center Improvements
Community Center Improvements
Child Care Center Improvements
Youth Center Improvements
Park & Recreation Improvements
Social Care Facility Improvements
Code Enforcement Needs
Code Enforcement
Demolition and Clearance
Blight Abatement
Infrastructure Needs
Water and Sewer Improvements
Drainage Improvements
Street Improvements
Sidewalk Improvements
Commercial/ Industrial Infrastructure Development
Accessibility Needs
Removal of Architectural Barriers
Historic Preservation Needs:
Historic Preservation Improvements
Other:
6 2024 No Yes Yes No No No No No No No No No No No No No No Yes No Yes 2023 Construction Program Application Fiscal Year –
Exhibit 4: Priority Needs (continued)
HUD Demographics: (Please indicate Yes/No)
• Does this project help prevent homelessness?
• Does this project help the homeless?
• Does this project help those with HIV or AIDS?
• Does this project primarily help persons with disabilities? Why this project is considered a priority?
Why this project is needed, Site the evidence to substantiate the need? Why must this proposed project be funded now versus receiving funding in future years?
What are the ramifications if this project is not recommended for funding in this fiscal year?
7 No
Programs such as basketball, gymnastics, cheerleading, judo, in-door soccer, programs for the elderly, and fitness gym will be closed or not available to the community.
No
According to San Bernardino County: Our Community Vital Signs, 2013 data report. Barstow had the highest death rates for the five major causes of death nationally in 20011 were heart disease, cancer, chronic lower respiratory diseases stroke, and accidents.
No 2024
The City wants to encourage a healthier community by providing programs that encourages active living.
2023
The HVAC system continuously needs repairs and the parts are becoming hard to find. This has resulted in the community center be closed due to extreme heat. Additionally, the city plans on improving the air quality with UV and HEAPA filters.
No
Construction Program Application Fiscal Year –
What is the project’s population to be served?
What is the projects accomplishment level?
Summarize the Scope of Work; include in your summary the number of units or activities the project will complete with CDBG funds.
Describe how the project preserves a low and moderate-income neighborhood, or provides other community benefits.
8 The census for City of Barstow is approximately 25,000 but surrounding adjacent communities increase the population to over 40,0000. The project will serve the disadvantaged community, the community, and visitors.
2023 2024
The majority of the city is considered disadvantage community based on the CalEnviroScreen tool. The facility provides fitness and sports activities and community events for these members. Provide a clean air to the facilities for all community members and visitors. Reduce the infection by providing filtration and air purification and create a enjoy able atmosphere for active living programs and youth/community activities.
The project will replace a chiller and Seven (7) the air handlers for the facility. At each air handler, an air purification system will also be installed.
Construction Program Application Fiscal Year –
Exhibit 5: Project Budget & Sources
Provide the estimated financial data for the project as requested below for the appropriate project group. Costs should be based on the best information available. When preparing this data, consider the following factors: (a) project should be completed in one phase if possible, or if phased, operational capability of the phases should be independent of each other: (b) a phased project should be prioritized and broken into distinct parts, with estimated cost and priority for each part; (c) apply federal prevailing wage rates to construction projects over $2,000.
Project Budget
SB County Share ($): Other Source ($):
Architectural and
engineering services
Site acquisition
Local Review application
Construction
Other:
Total
Overall Total Project Cost: (CDBG Share + Other Source) 9 $0.00 $332,500.00 $332,500.00 $292,600.00 $0.00 $0.00 $39,900.00 2023 2024 Construction Program Application Fiscal Year –
Exhibit 5A: CDBG Funds Requested and Leveraging Information Indicate the amount being requested by the city.
City Amount Requested ($)
(This amount should match the grand
total requested from CDBG Share)
10 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 building, equipment, materials, services and volunteer time.
Source of
Funding:
Type of Funding: (Grant Name,
EFSP Money)
Amount ($): Date
Available:
(11/22/2016)
Federal
Funding
State
Funding
County
Funding
Private
Funding
Other:
Total Leveraging Funds
Barstow
$0.00
N/A N/A
$0.00 $0.00 $0.00
N/A
2023
N/A
$332,500.00 2024
$0.00 $0.00
N/A
Construction Program Application Fiscal Year –
Exhibit 6: Proposed Goals and Milestones
Explain how the project will meet contract goals and milestones. For example, project expenditures and performance/accomplishment goals of 40% by September 30th, 50% by December 31st, 80% by March 31st, and 100% by June 30th.
Fill-in the table below with dates for submission of reimbursement claims and the estimated amount of each.
Date of
Reimbursement:
Amount ($):
Total Reimbursement:
11 $332,500.00 04/21/2023 $110,000.00 12/22/2023 $90,000.00 2024 $19,900.00 02/24/2023 01/20/2023 $90,000.00 $22,600.00 2023 11/17/2023 Design and Plans 100% by August 31, 2023Advertising and bidding by September 29, 2023Construction Started by November 6,2023Completed by February 23, 2023Project Close-Out by April 21, 2023
Construction Program Application Fiscal Year –
EXHIBIT 7: Agency Capacity Narrative
(Non-Profit Organizations Only)
• Describe the roles of key administrators, staff members, and volunteers within your agency that will implement the proposed project. In your description include experience, education, and licensing qualifications.
• Describe your agency’s experience in administering government and/or public funds. • Describe your method to sustain project viability over the multi-year process if funding decreases.
INSTRUCTIONS: Complete the table below by marking “YES” or “NO to the questions listed below.
Question: Yes/ No
Example: Have you received federal funds in the past five years? Yes In the past ten years, has your organization ever had its nonprofit status revoked or withheld by the IRS, the Secretary of State, the State Attorney General, or the Franchise Tax Board?
Has your organization been sued in the last five years? Are any of your managers or staff with fiscal responsibilities involved in litigation presently that has any bearing on fiduciary trust or employee relations?
Have any unfavorable rulings been handed down by any court against your organization or Executive Director the last five years? Does your organization currently have any unresolved fiscal, reporting, or program issues with any of its funding sources?
12 Yes No No
If funding is decreased, the project scope would be reduced and placed on a future project list.
Brad Merrell, Consultant City Engineer, PE; Domingo Gonzales, Engineering Services Administrator, Associate of Science, 32 years local government on Capital Improvement Project (CIP).
No
2023 2024
No
Since the incorporation of the City in 1947, the City has been managing CIP projects(CIP).
CIP projects are in an annual amount of approximately 2.5 million per year.
Construction Program Application Fiscal Year –
Exhibit 8: Civil Rights Laws Compliance And HUD Good Standing Answer the following questions:
Has your organization been a past recipient of assistance under a HUD McKinney Act program or the HUD Single Family Property Disposition Homeless Program? If you have been a recipient under either of these programs, has your agency experienced any project or construction delay, HUD finding or outstanding audit that HUD deems serious regarding the administration of HUD McKinney Act programs or the HUD Single Family Property Disposition Homeless Program?
If you answered “Yes”, please explain the circumstances and outcome below.
Applicants must be in compliance with applicable civil rights laws and Executive Orders. Applications will be rejected if your agency has any of the following: (1) Any pending civil rights lawsuit instituted by the U.S. Department of Justice; (2) Any noncompliance with civil rights statutes, Executive Orders or regulations as a result of formal administrative proceedings, unless the applicant is operating under a HUD-approved compliance agreement designed to correct the area of noncompliance or is currently negotiating such an agreement; (3) Any unresolved Secretarial charge of discrimination issues under Section 810(g) of the Fair Housing Act, as implemented by 24 CFR 103:400; (4) Any adjudication of a civil rights violation in a civil action brought against the Organization by a private individual, unless the applicant is operating in compliance with a court order designed to correct the area of noncompliance or the applicant has discharged any responsibility arising from such litigation; (5) Any deferral of the processing of applications from the sponsor imposed by HUD under Title VI of the Civil Rights Act of 1964, the Attorney General’s Guidelines (28 CFR 50.3) or the HUD Title VI regulations (24 CFR 1.8) and procedures, or under Section 504 of the Rehabilitation Act of 1973 and HUD Section 504 regulations (24 CFR 8.57). If one or more of these situations exists with your Organization, please attach a brief description.
13 2023 No No 2024
14 E-Signature Authorization
San Bernardino County
Community Development and Housing Departmemt
Community Development Block Grant
Martha Zepeda
Deputy Executive Officer
In order to comply with all applicable federal grant regulations, a hard-copy of this E-Signature Authorization containing an original wet signature must be filed with the San Bernardino County Community Development and Housing (CDH) in order for the applicant to electronically sign the Community Development Block Grant (CDBG) application documents online. This authorization may only be completed by a registered owner, partner, executive officer, or authorized employee (with proof of authorization) of the applicant submitting this form and must contain an original signature to be submitted to the CDH.
Authorization Agreement
I am an owner, partner, executive officer, or duly authorized employee of the below-listed applicant and have authority to enter into agreements on behalf of the below-listed applicant. CDH may rely on the receipt of such agreements executed and delivered by facsimile or other electronic means as if the original had been received. The undersigned agrees that the electronic signatures appearing on documents submitted from the below-listed applicant are the same as handwritten signatures for the purposes of validity, enforceability and admissibility. By signing this Electronic Signature Authorization Agreement, I authorize the CDH to accept, via electronic submission, documents submitted from the below-listed applicant as required by the CDH's CDBG - Funding Application.
I understand that CDH may change the CDBG application system from time to time. I agree that the below-listed applicant will electronically sign all documents requiring a signature related to the CDBG funding application.
My signature on this form certifies that:
I agree that entering my name in the CDBG funding application system constitutes my electronic signature. I understand that any information and documents submitted using my name is electronically certifying my signature. I understand that I am legally bound, obligated, and responsible by use of my electronic signature as much as I would be by my handwritten signature. I agree that I will protect my signature from unauthorized use, and that I will contact CDH immediately, upon discovery that my electronic signature has been compromised. I certify that my electronic signature is for my own use, and that I will not delegate it or share it with any individual.
This request is effective immediately upon receipt by the CDH and will remain in effect until the end of the - CDBG funding cycle or I choose to cancel this request via written notification to the CDH. I understand that it is my responsibility to update and/or cancel this request under all circumstances, including my departure or terminated association with the below-listed applicant.
By signing the E- Signature Authorization Form we certify that this agency will also comply with the following:
Non-discrimination
This organization will, through all possible means, ensure equal opportunity for all persons to receive services, to participate in the volunteer structure, and to be employed regardless of age, handicap, national background, race, religion, or sex. An existing sectarian nature of the agency shall not suffer impairment under this agreement, but participation in religious observances, rituals or services will not be required as a condition of receiving food, services, or shelter paid for by this grant.
Accountability
We commit this organization, if a grant is received, to provide all reports to the County as required; to expend monies only on eligible costs; to keep complete documentation (copies of all canceled checks, invoices, receipts, etc.) on all expenditures for a minimum of three years; to spend all funds and close out the program on the required date; to return any unused funds to the County to cooperate with monitoring or site visits, and; to provide complete documentation of expenses to the County, if requested, by the required date.
We affirm that all information in this application is true and correct to the best of our knowledge and that the applicant under our authority will execute its responsibility under the proposed contract and adhere to all other applicable rules and regulations to the fullest extent possible.
Non-collusion
This proposal is genuine, and not sham or collusive, nor made in the interest or in behalf of any person not herein named; the proposer has not directly induced or solicited any other proposer to put in a sham proposal, or any other person, firm or corporation to refrain from submitting a proposal; the proposer has not in any manner sought by collusion to secure for him/herself an advantage over any other proposer.
Applicant Information
Agency Name: Federal Tax ID No.:
Mailing Address: Phone No.:
Email Address: Fax No:
Authorized Signature
Print Name: Print Title:
Signature: Date:
- Application
Please send the signed copy of this one page agreement to:
San Bernardino County Community Development and Housing Department 215 North D Street, Suite 302, San Bernardino, CA 94215-0043 Attn: CDBG Application
[email protected] 220 E. Mountain View Street 2023 2023 2023 Willie A. Hopkins, Jr. Willie A. Hopkins Jr. 95-6000675 12/06/2022 (760) 255-4472 City Manager 2024 2024 2024 (760) 255-515_ City of Barstow City of Barstow Construction Program Application Fiscal Year -
Maintenance and Operations Agreement
Please keep in mind the Maintenance and Operations cost is ineligible for CDBG funds.
All capital improvements or facilities will require a Maintenance and Operation (M & O) contract. The MAINTENANCE AND OPERATION COMMITMENT must be signed by a representative of the M & O entity with authority to obligate the organization.
1) MAINTENANCE AND OPERATION COMMITMENT: The governing body of the below named public, quasi-public, or non-profit entity has the financial capacity and is willing to assume the Maintenance and Operation (M & O) responsibility and costs associated with the indicated community development project. This body has reviewed the "Estimated Annual Maintenance and Operation Budget" part of this section. To the best of this body's ability, it has determined this budget to be a true and accurate estimate of the annual M & O costs for the proposed project.
It is understood that without a commitment for maintenance and operation, the indicated project may not be considered for funding under the Community Development Block Grant program. Should this project be funded, a formal M & O contract shall be written and signed before any funds can be released.
NOTE: The Maintenance and Operation cost for capital improvements and facilities are not eligible for CDBG funding.
Proposed Project:
Legal/ Incorporated Name of Prospective M&O Entity:
Address:
Federal I.D. Number of M&O Entity:
Signature: ____________________________________ Title: _____________________ Print Name: ___________________________________ Date:
15 2023 2024
Construction Program Application Fiscal Year -
Maintenance and Operations Expenses
Utilities Amount ($):
Electric
Water
Gas
Telephone
Disposal Service
Other:
Sub-Total
Materials
Janitorial Supplies
Office Supplies
Recreational Supplies
Ground Supplies
Other:
Sub-Total
Maintenance – Capital Improvements
Building Repair
Maintenance of Equipment
Improvements to Property
Other:
Sub-Total
Insurance
Liability
Fire
Other:
Sub-Total
16 2023 $0.00 2024 $0.00 $0.00 $0.00
Construction Program Application Fiscal Year -
Personnel
Maintenance
Secretary
Administrator
Program Staff
Other:
Sub-Total
M& O Annual Expense Total
List out all sources and liabilities such as budget sources, membership, user fees, etc.
Revenue Sources: Amount ($):
Budgeted Revenue Total
Assets/ Liabilities Amount ($):
Budgeted Revenue minus M&O Expense
17 2024 $0.00$0.00 $0.00 2023 $0.00
Construction Program Application Fiscal Year -
CDBG Application Checklist
(Non-Profit Agency Only)
Community-based organizations are required to include one copy of the items listed below. If you are not submitting these items at this time, please notify Community Development and Housing at (909) 387-4705 to make other arrangements. The following information is required before any contract or reimbursement can be completed.
o Summary of agency’s current year General Operating Budget o List of agency’s Board of Directors, including names and addresses o Proof of existing non-profit/tax-exempt status (Letters from the Federal Internal Revenue Service and State Franchise Tax Board)
o Current certificate of insurance and amounts covered
o Organizational chart
o Minutes of last Board meeting
o Non- Profit agency’s must be Registered in the System of Award Management (SAM) website. Agency cannot be funded if they have been debarred in the past. o Provide board minutes/letter that authorizes the executive director or program manager to run the project.
If your application is funded you will be required to provide a copy of your last audit and your Articles of Incorporation and Bylaws must be on file.
18 2023 2024