City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
1 City of Santa Ana
Community Development Block Grant
Biennial Public Service Nonprofit Application
DESCRIPTION OF COMMUNITY DEVELOPMENT BLOCK GRANT
The Community Development Block Grant (CDBG) is a U.S. Department of Housing and Urban Development (HUD) entitlement grant that the City receives on an annual basis to develop viable urban communities by providing decent housing and a suitable living environment, and by expanding economic opportunities, principally for low- and moderate- income persons. No more than 15% of the City’s CDBG grant funds may be used for the provision of public services (including labor, supplies, and materials) including but not limited to those concerned with employment, crime prevention, child care, health, drug abuse, education, fair housing counseling, energy conservation, welfare (but excluding the provision of income payments), homebuyer down payment assistance, or recreational needs. To be eligible for CDBG assistance, a public service must be either a new service or a quantifiable increase in the level of an existing service above that which has been provided by or on behalf of the City in the previous 12 calendar months. The City of Santa Ana Community Development Agency allocates these CDBG grant funds to nonprofit organizations through a transparent, competitive process for programs that most effectively serve the residents of the City. Interested and eligible organizations can apply on a biennial basis for this funding via the CDBG Biennial Public Service Nonprofit Application.
CDBG Biennial NOFA
Funding will be available to experienced nonprofit organizations for the provision of public services that include a priority on crime prevention, crisis-intervention, and/or suppression efforts for children, youth and/or families.
Priority funding will be awarded to programs that:
x Develop crime prevention and suppression programs that assist in the development of suitable living environments by targeting specific Santa Ana neighborhoods that have a long-standing history of crime involving children, youth and families. For example, crime prevention education programs or community-oriented policing programs such as establishing a neighborhood watch program.
x Develop programs that target victims of domestic violence, dating violence, sexual assault or stalking;
x Services that will benefit children (generally under age 13), including parenting skills classes;
x Health services addressing the physical health needs of residents; x Mental health services addressing the mental health needs of residents; x Youth services including during and after school programs that target teens (ages 13 to 19) and include recreational programs with a counseling/mentorship program on City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
2 healthy lifestyles, substance abuse prevention, crime prevention, dating violence and anti-bullying. Programs with current Memorandum of Understandings with Santa Ana Unified School District will have priority over other youth service programs; x Legal services that provide legal aid to low and moderate income residents; x Senior services for the elderly 62+ years.
Programs will be funded for a two-year period from July 1, 2024 through June 30, 2026.
x The minimum funding amount is $80,000 per program to ensure that CDBG programs make the greatest impact in our community.
x The maximum funding amount is $150,000 per program. However, organizations that submit a joint application may request a maximum of $300,000 per program.
Organization Requirement
The purpose of this NOFA is to review, compare and evaluate organizations that want to partner with the City to implement CDBG-funded projects, activities, and programs. The City will review your application together with a panel of appointed officials on the Community Development Commission to determine if your organization:
x Has the programmatic capacity to successfully design, implement, and report on a CDBG-funded project per the requirements of the United States Department of Housing and Urban Development (HUD) and the City;
x Has the fiscal capacity to accept, manage, and report on CDBG funds on a reimbursement basis in accordance with HUD and City requirements; x Demonstrates a solid track record and past experience in implementing similar activities and projects that are indicative of potential future success; x Implements proper controls and best management practices to ensure fair and ethical dealings in the areas of finance and accounting, procurement, and client and vendor grievances;
x Implements eligible activities and projects that may be funded by CDBG; x Has adopted a mission statement, goals, and objectives that closely align with those of the City (as expressed in its Consolidated Plan) and of HUD; x Nonprofit organizations must be in good standing and have no outstanding monitoring findings prior to a FY 2024-2026 CDBG award.
x All nonprofit applicants must be able to document 501(c)(3) status. Applicants whose status is pending at the time of application will not be considered for funding.
Nonprofit Organization Collaboration
Nonprofit organizations may submit a joint application with other nonprofit organizations.
Collaborating nonprofit organizations must meet all the application requirements.
Faith-Based Organizations
Organizations that are religious or faith-based are eligible, on the same basis as any other organization, to participate in the CDBG program. Organizations may not engage in inherently religious activities, such as worship, religious instruction, or proselytization, as a part of the City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
3 programs or services funded with CDBG funds. If the organization conducts such activities, the activities must be offered separately, in time or location, from the programs or services funded with CDBG funds, and participation must be voluntary for the beneficiaries of the CDBG-funded programs or services. Faith-based organizations may use space in their facilities to provide CDBG-funded services without removing religious art, icons, scriptures or other religious symbols. An organization that participates in the CDBG program shall not, in providing program assistance, discriminate against a program beneficiary or prospective program beneficiary on the basis of religion or religious belief. A religious organization’s exemption from the federal prohibition on employment discrimination based on religion, set forth in section 702(a) of the Civil Rights Act of 1964 is not forfeited when the organization participates in the CDBG program. Notwithstanding the foregoing, nondiscrimination requirements imposed by statute on all CDBG grantees shall apply to religious and faith-based organizations
Cost Reimbursement Agreement
Grants are provided through a Cost Reimbursement Subrecipient Agreement. Reimbursement requests are allowed on a quarterly basis. Therefore, organizations must have enough working capital to continue services until a reim bursement request can be processed by the City. Only allowable and allocable CDBG expenses will be reimbursed. The term of the agreement will be July 1, 2024 through June 30, 2026.
Insurance Requirement
Organizations approved for CDBG funding will be required to obtain a minimum of $1,000,000 general liability insurance, automobile Insurance not less than $1,000,000 per occurrence, and workers’ compensation insurance not less than $1,000,000 per occurrence, for the term of the agreement. In addition, the City must be listed as additionally insured via an endorsement with the endorsement stating that the insurance is primary and noncontributory.
Eligible Activities Requirement
Public service activities which are directed toward the improvement of the quantity and quality of community services principally benefiting persons of low- and moderate-income are eligible for funding. These activities include, but are not limited to, services concerned with employment, crime prevention, childcare, health, substance abuse counseling and treatment, education, fair housing counseling, energy conservation, welfare (excluding income payments) and recreational needs. Emergency grant payments for food, clothing, and shelter (rent, mortgage, utilities) needs are eligible activities as long as the payments do not exceed three months and the payments are made directly to the provider of such services on behalf of an individual or family.
The services funded must be either a new service or a quantifiable increase in the level of service above that which has been provided by or on behalf of the City in the previous 12 calendar months. Services that were originally funded as a new or increased level of service are eligible for continued funding.
Eligible costs include labor, materials, supplies, some operating and maintenance costs for the City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
4 portion of the facility in which the public service is located, and equipment necessary for the provision of the public service.
Ineligible costs include income payments, assistance for buildings used for the general conduct of government, general local government expenses, political and religious activities, and the purchase of equipment except equipment that constitutes all or part of a public service. Income payments are payments made to an individual or family to provide basic levels of food, shelter, or clothing but do not include emergency grant payments referenced above under eligible activities.
National Objective Requirement
The proposed program must meet the National Objective of activities that provide a benefit to low- and moderate-income persons. At a minimum, the program must serve 51% low- and moderate- income persons. Low- and moderate-income is defined as having an income equal to or less than 80 percent of the area median income, adjusted for household size. The specific household income limits are based on U.S. Census Bureau estimates, updated and issued by HUD annually http://www.huduser.org/portal/datasets/il.html. In general, to document compliance with the national objective requirement, funded programs will require the collection, calculation, and documentation of the participants’ family size and income.
Limited Clientele activity: This is the category most often used for public service activities.
Limited clientele activities are activities limited to a specific group of persons. At least 51 percent of those served must be low- and moderate-income persons. Services qualifying under this category serve a specific clientele, rather than providing service to all persons in a geographic area. Limited clientele activities may qualify as either a presumed benefit activity or a direct benefit activity. A presumed benefit activity is one that exclusively serves a specific group of people that HUD categorically considers low and moderate-income persons. These categories include: abused children, battered spouses, elderly persons, homeless persons, illiterate adults, persons living with AIDS, migrant farm workers, and severely disabled adults as defined by the Bureau of Census. The project sponsor must document that the activity is designed to be used exclusively by a category of persons presumed by HUD to be low- and moderate-income.
If the clientele served does not fall under one of the presumed benefit category of persons, it may qualify as a direct benefit activity which serves low- and moderate-income persons. The project sponsor must verify and maintain documentation regarding the family size and income of each person served. At least 51 percent of the clientele served must be low- and moderate- income persons or the activity funded must be limited exclusively to low- and moderate-income persons. The nature and location of the activity may also support a conclusion that primarily low- and moderate-income persons are served. To qualify under this definition, the service provided must be both of such nature and in such location that it may reasonably be concluded that the activity’s clientele will primarily be low- and moderate-income persons.
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
5 City of Santa Ana Consolidated Plan Priority Need Requirement Applications for fiscal year 2024-2026 must meet a FY 2020-2024 Consolidated Plan priority need. The Consolidated plan is available for review HERE.
Federal Requirements Resource Links
If funded, organizations will also need to comply with several federal requirements. For more information on these requirements, organizations may view the following websites.
Playing by the Rules - A Handbook for CDBG Subrecipients on Administrative Systems: HERE
Guide to National Objectives and Eligible Activities for CDBG Entitlement Communities: HERE
To view Uniform Administrative Requirement, Cost Principles, and Audit Requirements for Federal Awards, 2 CFR 200, visit: HERE
Additional Requirements
This application will be available for public display. Therefore, do not include any information that is subject to state or federal confidentiality regulations (i.e. an address to a domestic
violence shelter).
The attached application contains several questions regarding city residents. Residency of participants is determined by the last permanent address. The City will hold organizations accountable for the information included, such as expected service level.
Review of Applications
City staff will conduct a minimum threshold review of all applications received for completeness and to determine the eligibility of the proposed program. The Community Development Commission (CDC) will review and recommend public service funding levels to City Council. City Council will review the recommendations provided by the CDC for funding to determine which activities will be in the best interest of the community.
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
6 CDBG CRITERIA FOR ALLOCATING POINTS
2024 - 2026 CDBG Application Guidelines
COMMUNITY NEEDS
1. Did organization identify
nature of the program and
demonstrate community
need for the target
population group (i.e. youth,
seniors, disabled)
10 Points
Applicant identifies the nature of the program and
demonstrates need for the target population. = 10 Pts.
Applicant does not identify the nature of the program and did not demonstrate need for the target population. = 5 Pts. Applicant only identifies State or National data = 0 Pts.
2. Did applicant meet a specific
City Consolidated Plan goal and
priority and stated correlation
to proposed program?
10 Points
Applicant met a specific Consolidated Plan goal and priority and correlation to proposed program was clear= 10 Pts
Applicant met a specific Consolidated Plan goal and priority but did not clearly state the correlation to proposed
program= 5 Pts
Applicant did not meet any plan goal or priority= 0 Pts.
CAPACITY TO PROVIDE PUBLIC SERVICES
3. Did the organization provide
a summary and listing of the
admin and program staff?
20 Points
Organization provided summary and staff listing of all admin and program to fully execute proposed program=20 Pts
Organization did not provide both summary and staff listing of all admin and program staff =10 Pts
Organization provided summary and staff listing of all admin and program staff but does not have the capacity to fully execute proposed program=5 Pts
Organization did not provide summary and staff listing of all Admin and program=0 Pts
EXPERIENCE
4. Years of experience providing
the proposed program?
10 Points
5 or more years of experience providing proposed program=10 Pts
2-4 years of experience providing proposed program=5 Pts 1 year of experience providing proposed program=3 Pts 0 years of experience providing proposed program=0 Pts
5. Does the applicant have
experience administering
CDBG and/or any other
Federal Grants?
10 Points
Applicant has experience administering CDBG and other Federal Grant programs=10 Pts.
Applicant only has experience administering CDBG
programs=5Pts.
Applicant has no experience administering CDBG and/or Federal Grant programs=0 Pts.
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
7 6. Did organization meet
prior year's performance
and/or expenditure
goals.
10 Points
Applicant met 90% annual goals and/or expended all grant funds =10 Pts.
Applicant met 75% annual goals and/or expended all grant funds =5Pts.
Applicant met 50% annual goals and/or expended all grant funds for 1 of 3 years = 3 Pts.
Applicant did not meet annual goal and/or expended all grant funds = 0 Pts.
EFFECTIVE & EFFICIENT USE OF FUNDS
7. Are the majority of
unduplicated participants from
Santa Ana? (Q1a/Q1=___%)
10 Points
100% to 80% of program participants are City residents = 10 Pts. 79.9% to 60% of program participants are City residents = 5 Pts. 59.9% to 30% of program participants are City residents = 0 Pts.
8. Did the organization describe
the measurable performance
outcomes and how outcomes
will be qualitatively and
quantitatively tracked?
10 Points
Measurable performance outcomes with qualitatively and quantitatively tracking = 10 Pts.
Measurable performance outcomes but no qualitatively and quantitatively tracking = 5 Pts.
No measurable performance outcomes and qualitatively and quantitatively tracking = 0 Pts
9. Does the organization have
active partnerships and/or
collaborations in order to
effectively and efficiently carry
out proposed program?
10 Points
Organization partners and/or collaborates with 3 or more community organizations = 10 Pts.
Organization partners and/or collaborates with 2 community organizations = 5 Pts.
Organization partners and/or collaborates with 1 community organization = 1 Pts.
Organization partners and/or collaborates with 0 community organization = 0 Pts.
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application) 8 Anticipated
Timeline
If there is a question about any part of the application, please contact [email protected] or 714-667-2219.
2024- 2026 CDBG Public Service Application
Dates Actions
Wednesday, October 25, 2023 Community Development Commission - Application Review/ Ad Hoc Committee
Tuesday, November 7, 2023 City Council - Application Review and Approval Wednesday, November 8, 2023
Application Released for 45 days
* All potential subrecipients from contact lists
will be notified via email and Constant Contact.
A press release or social media post may also
be issued.
Tuesday , November 14, 2023 CDBG Application Training
Monday, December 18, 2023 Applications due at 5:00 PM
Tuesday, December 19, 2023 to
Thursday, December 21, 2023
Staff review of applications for CDBG
eligibility/National Objective compliance
Wednesday, January 10, 2024 1st review of applications by the Community Development Commission Ad Hoc Committee
Tuesday, January 23, 2024 and
Wednesday, January 24, 2024
Community Development Commission Special
Meeting/Non-Profit Presentations of Public
Service Programs
Thursday, February 1, 2024 2nd review of applications by the Community Development Commission Ad Hoc Committee
Wednesday, February 28, 2024 Community Development Commission funding recommendations
Tuesday, March 19, 2024
CDBG Public Hearing at City Council, with
recommendation for approval of CDBG
nonprofit funding.
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
9 APPLICATION FOR SUBRECIPIENT PROPOSALS
DUE DATE: Monday, December 18, 2023 at 5:00PM
Hard Copy Applications must be submitted by mail or hand delivered to:
City of Santa Ana
Attention: Brenda Vega, Community Development Analyst
20 Civic Center Plaza 6
th Floor
Santa Ana, CA 92701
NO LATER THAN 5 P.M., Monday, December 18 2023.
ABSOLUTELY NO LATE APPLICATIONS WILL BE ACCEPTED.
Submit one complete application for each proposed program.
A complete application must include the following:
1. Organizational Cover Letter
2. Application Form
3. 2024-2025 Proposed Program Budget (Attachment 1)
4. 2025-2026 Proposed Program Budget (Attachment 2)
5. Staff Listing (Attachment 3)
6. Certificates (Attachment 4)
7. Organization Chart
8. Board of Directors, By-laws and Articles of Incorporation
9. Financial Statements & Single Audit, (Single Audit required if organization expended more than $750,000 of federal funds within a program year), Form 990
10. IRS Nonprofit Designation Letter
11. Logic Model
NOTES:
Failure to provide ALL required information will cause this application to become invalid and will not be considered for funding. The City reserves the right to withdraw consideration of this application if evidence of compliance is not provided or if compliance status changes during the
application process. The City reserves the right to waive a requirement if it is determined to be in the best interest of the City.
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
10 PUBLIC SERVICE APPLICATION
DUE DATE: 5:00 p.m., Monday, December 18, 2023.
Legal Name of Organization*
_______________________________________________________
UNIQUE ENTITY ID Number*
A unique entity ID is a unique nine-character number used to identify your organization. The City uses the Unique Entity ID number to report how federal grant money is allocated. Unique Entity ID number lookup or registration.
______________________________
Name of second organization if doing a collaboration
______________________________
UNIQUE ENTITY ID number of second organization, if doing a collaboration A Unique Entity ID number is a unique ni ne-character number used to identify your organization. The City uses the Unique Entity ID number to report how federal grant money is allocations. Unique Entity ID number lookup or registration. _____________________________
Date Organization Founded*
_____________________________
Date of Nonprofit Incorporation*
_____________________________
SERVICE AND FUNDING
Q1. Total number of unduplicated individuals to be served during FY2024- 2025 and FY 2025-2026 by program*
2024-2025 _______________ 2025-2026 _______________
a. Percentage that are estimated to be low-income*
2024-2025 _______________ 2025-2026 _______________
Q2. Estimated yearly units of service*
(number of unduplicated individuals multiplied by service visits – i.e. 200 youth X 25 tutoring City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
11 sessions = 5,000 units of service)
2024-2025 _______________ 2025-2026 _______________
Q3. Total CDBG funds requested for FY 2024-2025 and FY 2025-2026* ($40,000 minimum)
2024-2025 _______________ 2024-2025 _______________
a. Minimum Willing to Accept to Administer Your Program* ($40,000 minimum)
2024-2025 _______________ 2025-2026 _______________
Q4. Cost per participant*
(Total CDBG funds requested divided by Total to be served)
___________________________________________________
Q5. Program History
a. Total number of Santa Ana residents actually served in 2021-2022 and 2022-2023 *
2021-2022 _______________ 2022-2023 _______________
b. Total years the program has been in existence
___________________________________________________
Q6. Name of Program*
______________________________________________________________________________
Q7. Provide a concise description of the proposed program* (300 character maximum)
______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
12 Q8. Provide a detailed description of the proposed program. Include the following in order*
a. Detailed description of services provided
b. Frequency of service delivery (i.e. daily, weekly, monthly); c. How the service is provided (i.e. one-on-one, classroom settings, home visits, phone referrals); and
d. Target population groups (i.e. youth in specific
neighborhoods)
(5,000 character maximum)
Q9. Describe your experience in providing the proposed program or similar programs*
Highlight accomplishments
(5,000 character maximum)
Q10. Will this program result in new service or increase the level on an existing service*
Yes
No
If yes, describe how the direct service proposed:
a. Is not a duplication of existing services available; or b. Demonstrates a quantifiable increase in access and/or the level of an existing service provided to the target population.
(5,000 character maximum)
Q11. Similar Services*
List similar services that are currently provided in the community and describe how the proposed program complements or fills an existing gap in services (2,000 character maximum)
Q12. Neighborhood Initiative Area*
An area that that has been adversely affected by disinvestment and decline is considered a Neighborhood Initiative area. The City’s target areas for this period are the Townsend/Myrtle Neighborhoods at Jerome Center and Cedar-Evergreen Neighborhood at Madison Elementary
School. Does the program serve residents of a Neighborhood Initiative area?
Choices
Yes
No
If yes, please describe below
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application)
13 If yes, please describe the area boundaries and reasons the area fits Neighborhood Initiative criteria.
(5,000 character maximum)
Q13. Describe the unmet need that the proposed program will address* (5,000 character maximum)
Q14. Will the program be conducted within the City of Santa Ana boundaries* Choices
Yes
No
If no, explain how Santa Ana residents will be served
(5,000 character maximum)
Q15. Organization Participation*
List Santa Ana neighborhood associations, local community organizations and/or civic groups the organization participates in and to what extent.
(5,000 character maximum)
Q16. List the benchmarks the organization will use to determine success of the program*
Provide intended outcomes.
(5,000 character maximum)
Q17. Track and Measure Performance*
Describe how the organization will track and measure performance outcomes qualitatively and quantitatively.
(5,000 character maximum)
Q18. List federal grants that the organization has received within the last 5 years*
Include grant amounts, services provided, and outcomes. (5,000 character maximum)
Q19. Summarize the qualifications of the organization’s staff* (Program & Administrative) that would allow the organization to provide the services stated and comply with regulatory requirements.
(5,000 character maximum)
City of Santa Ana Community
Development Block Grant FY 2024- 2026 (Nonprofit Application) 14
ATTACHMENTS
Please save complete packet to your desktop and then fill out. If you try to fill out the form from the download screen, the information will not be saved when you try to upload it. 2024-2025 Scope and Budget Exhibit A and B (Attachment 1) 2025-2026 Scope and Budget Exhibit A and B (Attachment 2) Staff Listing (Attachment 3)
(Include Admin and Program Staff working on the proposed program) Certifications Exhibit C, D and E (Attachment 4)
Logic Model
Using the template provided below by the University of Wisconsin, please attach a logic model that will summarize your proposed program on one page including the situation (community need) that you are going to address, the inputs you will use to address that need, your outputs of activities that you will undertake in your program, and the
outcomes (short - 3 months, medium - 6 months and long - 12 months), that you will achieve. Please ensure you are as detailed as possible to provide your logic of how you will achieve your stated
outcomes.
Logic Model from University of Wisconsin:
https://fyi.extension.wisc.edu/programdevelopment/designing-programs/ Name of Organization
Name of Funded Program
Annual Accomplishment Goal
1T O T A L Santa Ana Participants 0% Low Income Participants 0% Schedule of Performance
Quarter 1: JUL 1 - SEP 30
Quarter 2: OCT 1 - DEC 31
Quarter 3: JAN 1 - MAR 31
Quarter 4: APR 1 - JUN 30
0 Program and Funding Description
City of Santa Ana CDBG Scope of Work
Program Year 2024-2025 (July 1, 2024 - June 30, 2025)
Unduplicated Participants anticipated to be served during the 12-month contract period. -$
Unduplicated
Participants
Estimated
Invoicing(estimated)
EXHIBIT A
EXHIBIT A
Organization Name
Program Name
Expenditures
Funded By
Santa Ana
CDBG
Expenditures
Funded By
Other Sources
Program
Budget
Total
Organization
Budget
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0 $0 $0
Indirect Costs 10% $0 $0
$0 $0 $0 $0
* Indirect cost rate: 10%
TOTAL -$
0 FISCAL YEAR 2024-2025
PROGRAM BUDGET
0 0
EXPENDITURES
Enter budget categories and projected expenditures for the proposed program:
Category
Administrative Staff Salaries
Program Staff Salaries
Contractual/Professional Services
0 Funding Source Total must equal Program Budget Total listed above. 0 0
0 0
TOTAL Direct Costs
0 PROGRAM RESOURCES
LIST ALL OTHER PROGRAM RESOURCES FOR 2024-2025
TOTAL BUDGET
Non-Federal entity without federaly recognized negotiated indirect cost rate, will charge a de minimis rate of 10% of modified total direct costs.
FUNDING SOURCE
Santa Ana CDBG
AMOUNT
EXHIBIT B
ADMINISTRATIVE STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested Description
PROGRAM STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested Description
Type of Service
Contract
Amount
CDBG Funds
Requested Description
OTHER LINE ITEMS
Line Item
Program
Amount
CDBG Funds
Requested Description
2024-2025 CDBG BUDGET LINE ITEMS
CONTRACTUAL/PROFESSIONAL SERVICES
EXHIBIT B-1
Name of Organization
Name of Funded Program
Annual Accomplishment Goal
1T O T A L Santa Ana Participants 0% Low Income Participants 0% Schedule of Performance
Quarter 1: JUL 1 - SEP 30
Quarter 2: OCT 1 - DEC 31
Quarter 3: JAN 1 - MAR 31
Quarter 4: APR 1 - JUN 30
0 Program and Funding Description
City of Santa Ana CDBG Scope of Work
Program Year 2025-2026 (July 1, 2025 - June 30, 2026)
Unduplicated Participants anticipated to be served during the 12-month contract period. -$
Unduplicated
Participants
Estimated
Invoicing(estimated)
EXHIBIT A
EXHIBIT A
Organization Name
Program Name
Expenditures
Funded By
Santa Ana
CDBG
Expenditures
Funded By
Other Sources
Program
Budget
Total
Organization
Budget
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0
$0 $0 $0 $0
Indirect Costs 10% $0 $0
$0 $0 $0 $0
* Indirect cost rate: 10%
TOTAL -$
0 FISCAL YEAR 2025-2026
PROGRAM BUDGET
EXPENDITURES
Enter budget categories and projected expenditures for the proposed program:
Category
Administrative Staff Salaries
Program Staff Salaries
Contractual/Professional Services
0 Funding Source Total must equal Program Budget Total listed above. 0 0
0 0
TOTAL Direct Costs
0 PROGRAM RESOURCES
LIST ALL OTHER PROGRAM RESOURCES FOR 2025-2026
TOTAL BUDGET
Non-Federal entity without federaly recognized negotiated indirect cost rate, will charge a de minimis rate of 10% of modified total direct costs.
FUNDING SOURCE
Santa Ana CDBG
AMOUNT
EXHIBIT B
ADMINISTRATIVE STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested Description
PROGRAM STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested Description
Type of Service
Contract
Amount
CDBG Funds
Requested Description
OTHER LINE ITEMS
Line Item
Program
Amount
CDBG Funds
Requested Description
2025-2026 CDBG BUDGET LINE ITEMS
CONTRACTUAL/PROFESSIONAL SERVICES
EXHIBIT B-1
Staff Listing
(Include Admin and Program Staff working on the proposed program)
Name and Title Duties/Activities Performed Qualification for Duties/Activities CDBG Funded
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
EXHIBIT C
_______________________________________________________________________________ Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions
_______________________________________________________________________________ This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.5l0, Participants' responsibilities. The regulations were published as Part VII of the May 26, l988 Federal Register (pages l9l60-l92ll). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached)
(l) The prospective recipient of federal assistance fund s certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.
(2) Where the prospective recipient of federal a ssistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.
_______________________________________________________________________________ Name and Title of Authorized Representative
_______________________________________________________________________________ Signature Date
EXHIBIT C
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the pros pective recipient of federal assistance funds is providing the certification as set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Depa rtment of Labor (DOL) may pursue available remedies, including suspension and/or debarment.
3. The prospective recipient of federal assistance funds shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of federal assistance funds learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
4. The terms "covered transaction," "debarred," "s uspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary co vered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL.
6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it deter mines the eligibility of its principals. Each participant may, but is not required to check the List of Parties Excluded from Procurement or Non- Procurement Programs.
8. Nothing contained in the foregoing shall be cons trued to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.
9. Except for transactions authorized under paragra ph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lowe r tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily exclude d from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension and/or debarment.
EXHIBIT D
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contact, grant, loan or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontract, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Grantee/Contactor Organization
Name of Certifying Officer Signature Date
EXHIBIT D
SUBRECIPIENT warrants the following:
1. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights Act of 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR Part 1.
2. No person in the United States shall on the ground of race, color, religion, national origin, or sex, be excluded from participation in, or be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with community development funds made available pursuant to the ACT.
3. All laborers and mechanics, employed by contractors or subcontractors in the performance of construction work financed in whole or in part with community development funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as determined in accordance with the Davis-Bacon Act, as amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for which they volunteered; do not receive compensation for such services; or are paid expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise employed at any time in construction work.
4. SUBRECIPIENT will comply with all Federa l statutes applicable to projects funded with community development funds, except that (a) SUBRECIPIENT does not assume CITY'S environmental responsibilities described at 24 CFR 570.604; and (b) SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process under Executive Order 12372.
EXHIBIT E
Certification Regarding Drug-Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the U.S.
Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act
.
CERTIFICATION
A. The contractor certifies that it will provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor’s workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing a drug-free awareness program to inform employees about – (1) The dangers of drug abuse in the workplace;
(2) The contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counselin g, rehabilitation, and employee assistance program; and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;
(c) Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - (1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction.
(e) Notifying the U.S. Department of Housing and Urban Development within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction;
EXHIBIT E
(f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted -
( 1) Taking appropriate personnel action against such an employee, up to and including termination; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
B. The contractor shall insert in the space provided on the attached “Place of Performance” form the site(s) for the performance of work to be carried out with the grant funds (including street address, city, county, state, and zip code) .the contractor further certifies that, if it is subsequently determined that additional sites will be used for the performance of work under the contract, it shall notify the U.S. Department of Housing and Urban Development immediately upon the decision to use such additional sites by submitting a revised “Place of Performance” form.
Organization
Authorized Signature Date
EXHIBIT E
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG-FREE
WORKPLACE REQUIREMENTS
Name:
Date:
The Contractor shall insert in the space provided below the site(s) expected to be used for the performance of work under the contract covered by the certification:
Place of Performance (include street address, city, county, state, zip code for each site):