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CDBG Combined Closeout Package
CDBG Award Number (fill in):
Checklist
I/we have completed the following forms. Check all that apply.
Closeout Certification
Acquired Property Inventory (if applicable)
Proof of ownership (e.g., vehicle registration, recorded grant deed, etc.) Disencumbrance of Funds Acknowledgment
Completion Report Acknowledgement
Completion Report
Section 3 Compliance Acknowledgement
Section 3 Closeout Report (if applicable)
Section 3 Qualitative Efforts (if applicable)
Affidavit of Posting Notice
Proof of postings (e.g., picture of the website posting with date stamp, photo of the document posted in a public place, etc.)
Meeting minutes or notes with comments any comments
If this award included a planning activity, ALL of the following are uploaded/attached:
Final Product(s)
Board Resolution accepting each/all final product(s)
If this award included construction activity, ALL of the following are uploaded/attached:
Recorded Notice of Completion
Photo(s) of completed project
CDBG Combined Closeout Package Signature
CDBG – Closeout Certification
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Closeout Certification
I (name of authorized representative), ________________________________, hereby certify that all activities undertaken by the Grantee with funds provided under CDBG Award Number _________________________ have, to the best of my knowledge, been carried out in accordance with the contract agreement; that proper provision has been made by the Grantee for the payment of all costs and claims; that the State of California is under no obligation to make further payment to the Grantee under the contract agreement; and that every statement and amounts set forth in all Financial Reports are to the best of my knowledge, true and correct.
The Grantee shall continue to comply with the State CDBG program income reporting requirements.
All costs incurred subsequent to the most recent annual audit period will be audited at the time the Grantee’s next annual audit is conducted in accordance with 2 CFR 200, Subpart F. The Grantee will resolve any audit findings relating to both the program and financial aspects of the award. In the event there are any costs which are disallowed by this audit or any subsequent audits which cover CDBG expenditures, and which are sustained by the Department of Housing and Community Development, the amount of such costs shall be returned to HCD.
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CDBG – Acquired Property Inventory
Acquired Property Inventory Complete the table below listing any property acquired in whole or in part with CDBG funds or CDBG Program Income in the table below in accordance with the provisions of 24 CFR Part 570.489(k) – Accountability of Real and Personal Property and 24 CFR Part 570.489(e) – Program Income of the HUD CDBG regulations pertaining to property management and program income. Include additional copies of the table if required. Future disposition of this property shall be carried out in accordance with CFR 24 Sec. 570.489(j) – Change of Use of Real Property for instructions.
Project/Program Name: Award Number:
In the table below in the Proof of Ownership column, enter the type of proof on record, e.g., title, deed, invoice receipt. In the % CDBG Funded column, enter the percentage of the property funded by CDBG award dollars or by CDBG Program Income.
Description of Property Acquisition Date Acquisition Cost Serial # or ID # Condition Status Location Proof of Ownership % CDBG Funded % % % % % %
CDBG – Disencumbrance of Funds
Disencumbrance of Funds Acknowledgement
This award has unused CDBG Grant Funds.
Yes
No (If “No”, skip to the Completion Report Acknowledgement form) Separate out Grant Funds from Program Income funds and report it on separate lines in the table below and mark whether the funds are Grant Funds or Program Income Funds.
Award Number Matrix Code Amount to be
Disencumbered Grant Funds ProgramIncome Funds
TOTAL
*Note: Unused Program Income (PI) dollars will be returned to the grantee’s PI balance Updated 7/25/2024 4
CDBG – Completion Report Acknowledgement
Completion Report Acknowledgement
I/We will upload a copy of the completed Completion Report concurrently with the submittal of this package.
Yes
No (Grantee will be unable to close out the project/program until report is provided.) Grantee should not initiate closeout until they can provide a Completion Report.
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CDBG – Section 3 Compliance Acknowledgement
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Section 3 Compliance Acknowledgement
The purpose of Section 3 of the Housing and Urban Development Act of 1968 is to ensure that employment and other economic opportunities generated by certain HUD financial assistance shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly those who are recipients of government assistance for housing, and to business concerns which provide economic opportunities to low- and very low-income persons.
Section 3 requirements apply to housing rehabilitation, housing construction, or other public construction projects when the total amount of housing and community development assistance for the covered project activity (not including general administration) meets or exceeds a funding threshold, generally $200,000.
Section 3 compliance requirements should have been established at project set up. Grantees who are uncertain whether Section 3 requirements apply to their project(s) should contact their HCD Representative or Grant Administrator.
1. This project/program was funded prior to November 30, 2020 and is required to comply with the prior HUD Section 3 Rule, found at 24 CFR 135.
Yes (Complete the Section 3 Closeout Report for Contracts Funded Prior to November 30, 2020 on the next page.)
No (If “No”, answer Question 2 on this form.)
2. This project/program is required to comply with the HUD Section 3 Final Rule, effective on November 30, 2020, and codified at 24 CFR part 75.
Yes (Complete the Section 3 Closeout Report for Contracts Funded on or After November 30,2020.)
No
If you answer “No” to both questions above, skip to the Affidavit of Posting Notice form.
CDBG – Section 3 Closeout Report (Prior to 11/30/2020)
Section 3 Closeout Report
(For Awards Funded Prior to November 30, 2020)
Grantee Name:
Award Number:
Project Name:
Project Location (Address):
County or Metropolitan Service Area (MSA)
Where Project is Located:
Report Date:
Please complete the tables below showing Section 3 hires for Grantee and any subrecipients and contracting opportunities for this project/program. Copy this page and attach to report if you need additional rows.
Job Category Number of
New Hires
Number of Section 3
New Hires
Number of Section 3
Trainees
Category Totals:
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CDBG – Section 3 Closeout Report (Prior to 11/30/2020)
1 Construction Contracts
Total dollar amount of construction contracts
awarded
2 Dollar amount of construction contracts awarded to
Section 3 businesses
3 Percentage of total construction contract dollars
awarded to Section 3 business (Row 2 divided by
Row 1)
4 Number of Section 3 businesses that received
construction contracts
1 Non-Construction Contracts
Total dollar amount of non-construction contracts
awarded
2 Dollar amount of non-construction contracts
awarded to Section 3 businesses
3 Percentage of total non-construction contract
dollars awarded to Section 3 businesses (Row 2
divided by Row 1)
4 Number of Section 3 businesses that received nonconstruction contracts *Non-construction contracts are often construction-related contracts for professional services like landscaping, pest control, accounting, architecture, legal services, engineering etc.
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CDBG – Section 3 Closeout Report
Section 3 Closeout Report
(For Awards Funded On or After November 30, 2020)
Grantee Name:
Award Number:
Project Name:
Project Location (Address):
County or Metropolitan Service Area (MSA)
Where Project is Located:
Report Date:
Please complete the table below showing labor hours on this contract and percentages as of the date of this report. Remember, if you have multiple projects under this contract, this report should show combined (roll-up) hours for the entire contract (program) as well as percentages based on these totals. Individual project information should be maintained in Grantee records.
For reference the Section 3 “safe harbor” benchmarks are:
Section 3 Workers make up at least 25% of the total project’s hours AND
Targeted Section 3 Workers make up at least 5% of the total project’s hours by the time of project closeout.
Hours Percent of Total
Labor Hours
Safe Harbor
Benchmark Met? (Y/N)
Total Labor Hours to Date:
Total Section 3 Labor
Hours to Date:
Targeted Section 3 Labor
Hours to Date:
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CDBG- – Section 3 Qualitative Efforts
Section 3 Qualitative Efforts Description
This form is only required for Grantees whose project was funded on or after November 30, 2020 and whose labor hour benchmarks for Section 3 Workers (25% of a total project’s hours) AND Targeted Section 3 Workers (5% of a total project’s hours) are not anticipated to be met by the time of project closeout. Grantees should maintain records for HUD review to document any efforts checked.
Award Number:
Grantee:
Please read the following list of qualitative efforts that may be undertaken to comply with Section 3 and check ALL that applied to your organization during the course of this CDBG project. Note that these actions are associated with your organization and do not need to be associated with the particular CDBG project. For more information consult the Community Planning and Development (CPD) Notice at
https://www.hud.gov/sites/dfiles/OCHCO/documents/2021-09cpdn.pdf.
Outreach efforts to generate job applicants who are Public Housing Targeted Workers Outreach efforts to generate job applicants who are Other Funding Targeted Workers Direct, on-the-job training including apprenticeships
Indirect training such as arranging for contracting for, or paying tuition for, off-site training
Technical assistance to help Section 3 workers compete for jobs (e.g., resume assistance, coaching)
Outreach efforts to identify and secure bids from Section 3 business concerns Technical assistance to help Section 3 business concerns understand and bid on contracts
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CDBG- – Section 3 Qualitative Efforts
Division of contracts into smaller jobs to facilitate participation by Section 3 business concerns
Provided or connected residents with assistance in seeking employment including drafting resumes, preparing for interviews, finding job opportunities, connecting residents to job placement services
Held one or more job fairs
Provided or connected residents with supportive services that can provide direct services or referrals
Provided or connected residents with supportive services that provide one or more of the following: work readiness health screenings, interview coaching, uniforms, test fees, and/or transportation
Assisted residents with finding childcare
Assisted residents to apply for or attend community college or a four-year educational institution
Assisted residents to apply for or attend vocational/technical training Assisted residents to obtain financial literacy training and/or coaching Bonding assistance, guaranties, or other efforts to support viable bids from Section 3 business concerns
Provided or connected residents with training on computer use or online technologies Other (Please describe below.)
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CDBG – Affidavit of Posting Notice
Affidavit of Posting Notice
I, (Name of Poster)__________________________, hereby certify that on the ________ day of ____________(month), ________ (year), the notice of public meeting to discuss closure and remittal of remaining funds, if any, under the California Department of Housing and Community Development, Community Development Block Grant Program was posted at the following _______(number) locations, and was available to the public from ____________________(date) to ____________________(date).
Location 1:
Location 2:
Location 3:
Location 4:
**If the notice was posted at additional locations, please check this box □and attach an additional page listing the additional locations.
Signature of Poster
Organizaton and Title of Poster
I, (name) _________________________, employee or officer of ________________________ (city, county, or jurisdiction name), State of California, hereby certify the above and foregoing is true and correct. Dated at ___________________________ ______ (date) day of _______________(month), 20______.
(location), California, this
Signature of Employee or Officer
Title of Employee or Officer
(Poster and Employee/Officer signatories must not be the same person) Updated 7/25/2024 12
CDBG – Combined Closeout Package Signature
CDBG Combined Closeout Package Signature
I, the undersigned, hereby certify that all representations made and/or information provided in this combined closeout package and any referenced uploads or attachments is, to the best of my knowledge, true. I further state that my signature below will serve as signature for each of the completed forms in this package as well as for the CDBG Combined Closeout Package taken as a whole.
Additionally, I certify to the best of my knowledge and belief that the information provided herein is true, complete, and accurate. I am aware that the provision of false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil, or administrative consequences including, but not limited to violations of U.S. Code Title 18, Sections 2, 1001, 1343 and Title 31, Sections 3729-3730 and 3801-3812.
Date: ____________
Name and Title of Official Authorized in the Resolution Signature of Official Authorized in the Resolution
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