Backup Documents 05/12/2009 Item #16D 4
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ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPl ~ 0 4
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO '. .
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 as appropriate for additional signatures, dates. and/or infonnation needed. If the document is already complete with the
exce tion of the Chainnan's si nature, draw a line throu h routin lines #1 throu h #4, com lete the checklist, and torward to Sue Filson (line #5).
Route to Addressee(s) Office Initials Date
(List in routin order)
I C of {e. e.n ~\A4.- COuv-'\ b-' ~ 'Il/.eft
2.
3.
4.
5. Sue Filson, Executive Manager Board of County Commissioners
6. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCe approval. Nonnally the primary contact is the person who created/prepared the executive
summary. Primary contact infonnation is needed in the event one of the addressees above, including Sue Filson, need to contact staff for additional or missing
infonnation. All original documents needing the BCC Chainnan's signature are to be delivered to the BCe office only after the BeC has acted to approve the
item.)
Name of Primary Staff Margo Castorena Phone Number
Contact
Agenda Date Item was May 12,2009 Agenda Item Number 16D4
Aooroved bv the BCC
Type of Document Grant Number of Original 3
Attached Certifications/ Amendments/ Application for Documents Attached
Federal Assistance
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not
a ro riate. (Initial) A Iicable)
1. Original document has been signed/initialed for legal sufficiency, (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances, C,ffit1
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and ossibl State Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's NIr
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
3. The Chairman's signature line date has been entered as the date ofBCC approval of the 5"(
document or the final ne otiated contract date whichever is a licable.
4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's ~
si nature and initials are re uired.
5. In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Sue Filson in the BCC office within 24 hours of BCC approval. rJIPr
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of our deadlines!
6. The document was approved by the Bee on (2 Z(liL(enter date) and all changes
made during the meeting have been incorporated in the attached document. The
Count Attorne 's Office has reviewed the chan es, if a Iica ble.
I: Fonns/ County Fonns! BCC Fonns/ Original Documents Routing Slip WWS Onginal 9.~3.04, Revised 1.26.05. Revised 2.24.05 ~ ~\Ck-()p
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16D flt4
OMB Approval Number: 2506-0180
(Expiration Date: 9/30/2009)
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Grantees eligible to receive funds under the Homelessness Prevention and Rapid Re-
Housing Program (HPRP) are required to complete a substantial amendment to their
Consolidated Plan 2008 Action Plan. This form sets forth the required format for this
substantial amendment. A completed form is due to HUD within 60 days of the
publication of the HUD HPRP notice.
To aid grantees in meeting this submission deadline, the HPRP Notice reduces the
requirement for a 30-day public comment period to no less than 12 calendar days for this
substantial amendment. With this exception, HPRP grantees are required to follow their
Consolidated Plan's citizen participation process, including consultation with the
Continuum of Care (CoC) in the appropriate jurisdiction(s). Grantees are also required to
coordinate HPRP activities with the CoC's strategies for homeless prevention and ending
homelessness. To maximize transparency, HUD strongly recommends that each grantee
post its substantial amendment materials on the grantee's official website as the materials
are developed.
A complete submission contains the following three documents:
1) A signed and dated SF-424,
2) A completed form HUD-40119 (this form), and
3) Signed and dated General Consolidated Plan and HPRP certifications.
For additional information regarding the HPRP program, visit the HUD Homelessness
Resource Exchange (www.hudhre.info). This site will be regularly updated to include
HPRP resources developed by HUD and its technical assistance providers.
The information collection requirements contained in this application have been submitted to the Office of
Management and Budget (OMB) for review under the Paperwork Reduction Act of 1995 (44 U.S.c. 3501-
3520). This agency may not collect this information, and you are not required to complete this form, unless
it displays a currently valid OMB control number.
Information is submitted in accordance with the regulatory authority contained in each program rule. The
information will be used to rate applications, determine eligibility, and establish grant amounts.
Public reporting burden for this collection of information is estimated to be 16 hours, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. This information is required to obtain benefits. To
the extent that any information collected is of a confidential nature, there will be compliance with Privacy
Act requirements. However, the substantial amendment to the Consolidated Plan 2008 Action Plan does not
request the submission of such information.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil
penalties. (l8 U.S.C. 1001,1010,1012; 31 U.S.c. 3729,3802)
1 HUD-40 119
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160'4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
A" General Information
Grantee Name Collier County
Name of Entity or Department Housing & Human Services
Administering Funds
HPRP Contact Person Marcy Krumbine
(person to answer questions about
this amendment and HPRP)
Title Director, Housing & Human Services
Address Line 1 3301 Tamiami Trail East
Address Line 2 Building H, Suite 211
City, State, Zip Code Naples, FI 34112
Telephone 239-252-8442
Fax 239-252-2331
Email Address MarcyKrumbine@colliergov.net
Authorized Official Donna Fiala
(if different from Contact Person)
Title Chairman of the Board of County Commissioners
Address Line 1 3301 Tamiami Trail E
Address Line 2 Administration Building
City, State, Zip Code Naples, Fl 34112
Telephone 239-252-8097
Fax 239-252-3602
Email Address DonnaFiala@colliergov.net
Web Address where this Form is www.colliergov.net
Posted
Amount Grantee is Eligible to Receive* $ 888,850"00
Amount Grantee is Requesting $ 888,850.00
* Amounts are available at http://www.hud.gov/recovery/homelesspreventrecov.xIs
2 HUD-40 119
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. 16D "'4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
B, Citizen Participation and Public Comment
1. Briefly describe how the grantee followed its citizen participation plan regarding
this proposed substantial amendment (limit 250 words).
Response:
Collier County has complied with all aspects of our citizen participation plan. The
HPRP substantial amendment ad was posted on the official County website and
placed in the Naples Daily News, a newspaper of general circulation within Collier
County. The ad was placed in both English and Spanish versions to make citizens
aware of this substantial amendment and ensure the widest dissemination of HPRP
information. A public comment period was held from April 10-21, 2009. The
public meeting was held on April 16, 2009 in which public comments were
solicited. This public meeting was advertised on the Collier County official
website, and placed in the main administration building where public notices are
posted. In addition local non-profit agencies were notified of the public meeting. A
second public meeting was held on May 12, 2009 at the Collier County Board of
County Commissioners' meeting. At this meeting, the staff recommendation to
submit the HPRP substantial amendment to HUD was approved and the Chairman
was authorized to sign all documentation necessary for submission to HUD.
The attendees to the Public Comment Session asked many questions regarding the
grant that were answered. These questions included:
When will the RFP be released?
Answer: The RFP will be released the beginning of May for approximately one
week. There will not be a cure period.
Should non-profit agencies meet for technical assistance if they are proposing a
new project or have never been funded before?
Answer: Any organization can call HHS for a meeting or technical assistance
before the RFP is due.
Does the grant cover food vouchers?
Answer: No.
Are administrative costs available and can finance charges for a bridge loan be
reimbursed:
3 HUD-40 119
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16;01 i4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the - .1.1
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Answer: There is 5% allowed for admin that will be distributed between the sub-
recipients and HHS. There will be approximately $22,000 in administrative funds
available to distribute to the participating agencies. Finance charges cannot be
reimbursed.
Can the grant be used for supportive services?
Answer: Yes, the grant can be used for supportive services for the homeless and to
prevent those from being homeless.
Can the grant be used for more space or more equipment for an emergency shelter?
Answer: No, the grant cannot be used for those purposes.
Other public comments:
Bart Zino from Collier County Hunger and Homeless Coalition expressed concern
that the grant would be reimbursable and that local organizations did not have the
capacity to payout the monies and wait for the reimbursement. He suggested that
the County provide a bridge loan for organizations. It was noted that the F AQ' s of
the grant program mentioned that HUD does allow for a draw down before the
grant is expended. However, this is not the method by which the participating
jurisdiction does business.
Debra Mahr from Collier County Hunger and Homeless Coalition asked what kind
of program we were looking to institute for rapid re-housing. The various agencies
talked about how they each secure housing for their clients.
Steve Perkins, Administrator of the HMIS program in Collier County, explained
how he would provide assistance for organizations to get up and running with
HMIS in order to participate in the HPRP grant.
Additionally, 3 written Public Comments were submitted (see below):
From: Susan Golden, citizen
It is important to encourage partnerships and collaboration amongst local non-
Profits and I agree, not to reinvent the wheel, groups that are providing rental
assistance (ie. Coalition, Youth Haven, Catholic Charities, etc.) should take the
lead.
No written response requested.
From: Debra Mahr-Collier County Hunger & Homeless Coalition
4 HUD-40119
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16D f,
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Fund agencies with a proven track record for providing emergency rent assistance:
Collier County Housing Authority (TBRA),Collier County Hunger & Homeless
Coalition "Partnership for Prevention" program, Salvation Army, SVDP, Youth
Haven.
Encourage collaborative case management teams to provide support services.
Enclosed: Collier County Hunger & Homeless Coalition- Needs Assessment and
Ranking of Priorities. Exhibit 1
Written response requested.
From Essie Serrata Collier County Housing Authority
April 21, 2009
Re: HPRP Funding Public Comment
Dear Ms. Krumbine:
Please accept this as the Housing Authority's comments regarding the allocation of
Homelessness Prevention and Rapid Re-Housing Program funding.
It is our understanding this funding is primarily to provide assistance to homeless
or at-risk families, individuals and youth affected from the economic crisis. With
this purpose in mind we support the gaps and needs identified by the Collier
County Hunger and Homeless Coalition in a workshop held on March 10, 2009 and
provided to you during the April 16,2009 Public meeting.
As the countywide public housing authority who administers two federal rental
assistance programs we substantiate the top ranked need being rental assistance.
The Housing Choice Voucher Program provides rental assistance up to 440 low-
income families and the HOME Tenant Based Rental Assistance has provided
assistance with security deposit, utility deposits and rental subsidies for the
homeless, elderly and disabled since 2003. The waiting list for persons seeking
rental subsidies is over 800.
The needs assessment and ranking priority by the coalition, is timely and should
serve as a benefit to design the program and identify key resources already
available that could be augmented to provide further stability in the community.
It is our hope that the county will work cooperatively with the current local
providers that have a proven track record, the capacity and are the best fit to carry
out the initiatives of this funding.
I appreciate the opportunity to provide comment.
Esmeralda Serrata, PHM Executive Director
5 HUD-40 119
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160 '4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
No written response requested.
2. Provide the appropriate response regarding this substantial amendment by checking
one of the following options:
o Grantee did not receive public comments.
o Grantee received and accepted all public comments.
I2SI Grantee received public comments and did not accept one or more of the
comments.
3. Provide a summary of the public comments regarding this substantial amendment.
Include a summary of any comments or views not accepted and the reasons for
non-acceptance.
Response:
Public comments centered on questions and comments in the following areas:
1. Eligible activities allowed under HPRP
2. Procedures and timing of the competitive application process
3. Need for non-profit agencies to work together to maximize benefit ofHPRP funds.
4. Need to ensure local agencies already providing like services are encouraged to apply
for funding.
The public comment that was not accepted concerned advancing grant funds before
expending rather than reimbursing grant expenditures. Although allowable under 24 CFR
84.22 and 85.21, this participating jurisdiction notes the inherent risks involved in that
business practice and it is not supported by Collier County Finance Department.
C, Distribution and Administration of Funds
Reminder: The HPRP grant will be made by means of a grant agreement executed by HUD
and the grantee. The three-year deadline to expend funds begins when HUD signs the grant
agreement. Grantees should ensure that sufficient planning is in place to begin to expend
funds shortly after grant agreement.
1. Check the process(es) that the grantee plans to use to select subgrantees. Note that a
sub grantee is defined as the organization to which the grantee provides HPRP
funds.
6 HUD-40 119
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160 "
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
. Competitive Process
D Formula Allocation
D Other (Specify: )
2. Briefly describe the process (es) indicated in question 1 above (limit 250 words).
Response:
Collier County Housing and Human Services Department (HHS) will use a
competitive process as a basis for award to subrecipients for HPRP funding. HHS
has tailored its traditional competitive Request tor Proposal (RFP) process to
adhere to HPRP guidelines and timetables. This abbreviated RFP process will
comply with the requirements of the Collier County Citizen Participation Plan,
albeit on a shortened HPRP timetable.
The HHS competitive process commences with English and Spanish language
advertisements in local newspapers outlining the HPRP program, funding amounts,
preliminary budget, and eligible activities. The ads outline the public comment
period and dates for public meetings. The RFP process is then announced;
applications are made available through the HHS website, hardcopy and via email.
Application deadline is included in the application, as well as grading criteria.
Technical assistance is provided throughout the application period. Completed
applications (and required copies) are date and time stamped when received and
receipted by HHS personnel. The Application Review Committee is selected from
a variety of sources to include community members, HHS staff and County Grant
Personnel. Members review applications individually and as well as a whole;
applications are scored, scores are aggregated and projects ranked. Based on
ranking, selected projects are presented to the Collier County Affordable Housing
Advisory Committee for comment. Projects are then forwarded to the Collier Board
of County Commissioners for final review and approval prior to submission to
HUD.
3. Briefly describe the process the grantee plans to use, once HUD signs the grant
agreement, to allocate funds available to sub grantees by September 30, 2009, as
required by the HPRP Notice (limit 250 words).
Response:
Projects will be competitively selected and the sub-recipients will be notified. A
clear scope of work and budget should be developed and approved by Housing &
Human Services. Once HUD signs the HPRP grant agreement with the Collier
County Board of County Commissioners (BCC) HHS will already have in place
7 HUD-40 119
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Substantial Amendment to the Consolidated Plan 2008 Action Plan for tbJ. 6 0 ~.
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
agreement templates that have been modified to accommodate HPRP requirements.
The project scope section of the agreements are individualized to encompass the
activities to be performed by the sub grantee, budget, timeline, performance
measures as well as reporting requirements and payment reimbursement
instructions. The agreement templates along with their individualized scopes will
be signed by the sub grantees. Signed agreements will be presented to the BCC for
approval during September 2009. BCC approval of the agreements will obligate
HPRP funds by the September 30, 2009 HUD deadline.
4. Describe the grantee's plan for ensuring the effective and timely use ofHPRP grant
funds on eligible activities, as outlined in the HPRP Notice. Include a description
of how the grantee plans to oversee and monitor the administration and use of its
own HPRP funds, as well as those used by its sub grantees (limit 500 words).
Response:
Collier County Housing and Human Services (HHS) has established methodologies
for working with sub grantees from the time they are selected for funding until
contract close-out. These same methodologies will be used to ensure HPRP
requirements are met. Each sub grantee is assigned a grant coordinator who guides
them in understanding their agreement terms, performance measures,
reimbursement requirements, as well as any administrative and reporting
requirements. The grant coordinators along with the Grant Operations Manager
maintain active communication with the sub grantee via desk monitorings, phone
monitorings, monthly reports, and site visits. HHS in conjunction with the Clerk of
Courts and the Purchasing Department provide technical assistance to sub grantees
to ensure their pay requests comply with the terms of their agreement as well as all
applicable federal, state and local requirements. Eligibility requirements are
monitored throughout the life of the agreement by means of on-site monitoring of
participant files.
8 HUD-40119
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16D 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
D, Collaboration
1. Briefly describe how the grantee plans to collaborate with the local agencies that
can serve similar target populations, which received funds under the American
Recovery and Reinvestment Act of 2009 from other Federal agencies, including the
U.S. Departments of Education, Health and Human Services, Homeland Security,
and Labor (limit 250 words).
Response:
Collier County Housing and Human Services (HHS), as the Lead Agency for the
Continuum of Care, already partners with a number of local agencies, who receive
funding from a variety of federal sources. These agencies have implemented
programs and services to assist the homeless and those at risk of becoming
homeless. HHS works closely with the Hunger and Homeless Coalition (HHC),
which coordinates involvement of local agencies, as well as works with the Collier
County Public Schools liaison for homeless children. Youth Haven, another
Collier County non-profit organization receiving funding from the Department of
Health and Human Services, currently oversees a program called "Caring for
Families" which has previously been supported by this office. The David Lawrence
Mental Health Center also receives state and federal funds and offers supportive
housing for clientele with mental illness who are at risk of being homeless. In
addition, HHS works with the Collier County Housing Authority, the public
housing authority, who receives USDA funding, with tenant based rental
assistance. These agencies, and more, will be encouraged to submit applications
for funding.
9 HUD-40 119
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16)~ If
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
2. Briefly describe how the grantee plans to collaborate with appropriate
Continuum(s) of Care and mainstream resources regarding HPRP activities (limit
250 words).
Response:
Collier County Housing and Human Services (HHS) is the Lead Agency for the
Collier County Continuum of Care (CoC) and actively participates in, and supports
the priorities established by the CoCo HHS is tied not only by its active
participation in the CoC with its partner social service agencies, but also
electronically via the Homeless Management Information System (HMIS).
Included in the public comment period and public workshop, agencies which
participate in the CoC will be contacted to assist HHS with an assessment of
current needs and gaps in service that can be addressed with HPRP funding. The
Collier County Sherriffs Office (CCSO) assists HHS in this collaboration by
assigning a deputy to work with the homeless population to improve their access to
care and educate them on existing resources. Collier County's two homeless
shelters: St Matthew's House/Immokalee Friendship House and The Shelter for
Abused Women and Children are both active members of the CoC and work
closely with HHS to ensure the widest dissemination of information regarding
available resources.
3. Briefly describe how HPRP grant funds for financial assistance and housing
relocation/stabilization services will be used in a manner that is consistent with the
grantee's Consolidated Plan (limit 250 words).
Response:
Collier County's FY 2006-2010 Consolidated Plan states the county will utilize a
"Continuum of Care" model in which homeless individuals move from
homelessness to permanent housing via a spectrum of services which encompass
outreach/intake/assessment to emergency sheltering then progress to transitional
housing and finally to supportive and/or permanent housing. This "Continuum of
Care" model utilizes an array of supportive services aimed at locating suitable
housing, assist with rent and utility deposits, and finally continue rental payments
and utility assistance for a reasonable period until the individual is stabilized in
permanent housing and is able to assume financial responsibility for their own
housing. The financial assistance and relocation/stabilization services outlined as
eligible activities of the HPRP will fit seamlessly in Collier County's "continuum
of care" model to transition homeless individuals and families to permanent
housing.
10 HUD-40 119
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160 ,
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the . ,
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
E, Estimated Bude:et Summary
HUD requires the grantee to complete the following table so that participants in the citizen
participation process may see the grantee's preliminary estimated amounts for various
HPRP activities. Enter the estimated budget amounts for each activity in the appropriate
column and row. The grantee will be required to report actual amounts in subsequent
reporting.
HPRP Estimated Budget Summary
Homelessness Rapid Re- Total Amount
Prevention housing Budgeted
Financial Assistance1 $ 569,408.00 $ $569,408.00
Housing Relocation and $ $ 250,000.00 $250,000.00
Stabilization Services2
Subtotal $ $ $819,408
(add previous two rows)
Data Collection and Evaluation3 $ 25,000.00
Administration (up to 5% of allocation) $ 44,442.00
Total HPRP Amount Budgeted4 $888,850,00
IFinancial assistance includes the following activities as detailed in the HPRP Notice:
short-term rental assistance, medium-term rental assistance, security deposits, utility
deposits, utility payments, moving cost assistance, and motel or hotel vouchers.
2Housing relocation and stabilization services include the following activities as detailed in
the HPRP Notice: case management, outreach, housing search and placement, legal
services, mediation, and credit repair.
3Data collection and evaluation includes costs associated with operating HUD-approved
homeless management information systems for purposes of collecting unduplicated
counts of homeless persons and analyzing patterns of use ofHPRP funds.
4This amount must match the amount entered in the cell on the table in Section A titled
"Amount Grantee is Requesting."
11 HUD-40 119
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16"1] i4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
F, Authorized Si2nature
By signing this application, I certify (1) to the statements contained in the list of
certifications and (2) that the statements herein are true, complete, and accurate to the best
of my knowledge. I also provide the required assurances and agree to comply with any
resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent
statements or claims may subject me to criminal, civil, or administrative penalties. (U.S.
Code, Title21~~1) d-~. ..
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Signature/ Autho zed OffiCIal Date
Title Donna Fiala, Chairman
Board of County Commissioners,Collier County, Florida
Approved as to form & legal sufficitncy
,
Gull€i:-;i1 Greene,
Assistant County Attomey -
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160 '.
GENERAL CERTIFICATIONS FOR STATE OR LOCAL GOVERNMENT FOR THE
HOMELESSNESS PREVENTION AND RAPID RE-HOUSING PROGRAM (HPRP)
In accordance with the applicable statutes and the regulations governing the consolidated plan
regulations, the state, territory, or local government certifies that:
Affirmatively Further Fair Housing -- The state, territory, or local government will
affIrmatively further fair housing, which means it will conduct an analysis of impediments to fair
housing choice within the jurisdiction or state, take appropriate actions to overcome the effects of
any impediments identified through that analysis, and maintain records reflecting that analysis and
actions in this regard.
Drug-Free Workplace - It will or will continue to provide a drug-free workplace by:
1. Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the grantee's
workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
2. Establishing an ongoing drug-free awareness program to inform employees about:
(a) The dangers of drug abuse in the workplace;
(b) The grantee's policy of maintaining a drug-free workplace;
(c) Any available drug counseling, rehabilitation, and empl<;?yee assistance programs;
and
(d) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
3. Making it a requirement that each employee to be engaged in the performance of the grant
be given a copy of the statement required by paragraph 1;
4. Notifying the employee in the statement required by paragraph 1 that, as a condition of
employment under the grant, the employee will -
(a) Abide by the terms of the statement; and
(b) Notify the employer in writing of his or her conviction for a violation of a criminal
drug statute occurring in the workplace no later than five calendar days after such
conviction;
5. Notifying the agency in writing, within ten calendar days after receiving notice under
subparagraph 4(b) from an employee or otherwise receiving actual notice of such
conviction. Employers of convicted employees must provide notice, including position
title, to every grant officer or other designee on whose grant activity the convicted
employee was working, unless the Federal agency has designated a central point for the
receipt of such notices. Notice shall include the identification number(s) of each affected
grant;
6. Taking one of the following actions, within 30 calendar days of receiving notice under
subparagraph 4(b), with respect to any employee who is so convicted _
(a) Taking appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
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(b) 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;
7. Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs 1,2,3,4,5 and 6.
Anti-Lobbying - To the best of the state, territory, or local government's knowledge and belief:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of it, 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
Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, 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, it
will complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions; and
3. It will require that the language of paragraphs 1 and 2 of this certification be included in
the award documents for all subawards at all tiers (including subcontracts, subgrants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients shall
certify and disclose accordingly.
Authority of Local Government, State, or Territory - The submission of the consolidated plan
is authorized under state law and local law (as applicable) and the jurisdiction or state possesses
the legal authority to carry out the programs under the consolidated plan for which it is seeking
funding, in accordance with applicable HUD regulations.
Consistency with Plan -- The housing activities to be undertaken with HPRP funds are consistent
with the strategic plan.
Section 3 -- It will comply with section 3 of the Housing and Urban Development Act of 1968,
and implementing regulations at 24 CFR Part 135.
;JJ~ J~. Ma, I ~ 2oe) ((
Signature/Authorized Official I
Date
; ~ 1/ '-(1.
Tille Donna Fiala, Chairman' .'.-1/(,
Board of County CommiSSioners, Collier courity; ,Fl']jQ~icff\'
Approved as to form & legal sufficiency ~ ~ . ,-'" ': ,
(:
CiJf~ 0 .
Colleen Greene.
Assistant County Attorney
"'"."-'..~ -,..,.--'''"....~,''-,' ,.."....,,~"" ,'-,- __ AU -"_"'_,A""'''._",,,
160 .
APPENDIX TO CERTIFICATIONS
INSTRUCTIONS CONCERNING LOBBYING AND DRUG-FREE WORKPLACE REQUIREMENTS:
A. Lobbying Certification
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.
B. Drug-Free Worlqllace Certification
1. By signing and/or submitting this application or grant agreement, the grantee is providing the
certification.
2. The certification is a material representation of fact upon which reliance is placed when the agency
awards the grant. If it is later detennined that the grantee knowingly rendered a false certification, or
otherwise violates the requirements of the Drug-Free Workplace Act, HUD, in addition to any other
remedies available to the Federal Government, may take action authorized under the Drug-Free
Workplace Act.
3. Workplaces under grants, for grantees other than individuals, need not be identified on the
certification. If known, they may be identified in the grant application. If the grantee does not identifY
the workplaces at the time of application, or upon award, if there is no application, the grantee must
keep the identity of the workplace(s) on file in its office and make the information available for
Federal inspection. Failure to identifY all known workplaces constitutes a violation of the grantee's
drug-free workplace requirements.
4. Workplace identifications must include the actual address of buildings (or parts of buildings) or other
sites where work under the grant takes place. Categorical descriptions may be used (e.g., all vehicles
of a mass transit authority or State highway department while in operation, State employees in each
local unemployment office, performers in concert halls or radio stations).
5. If the workplace identified to the agency changes during the performance of the grant, the grantee
shall inform the agency of the change(s), if it previously identified the workplaces in question (see
paragraph three).
6. The Grantee may insert in the space provided below the site( s) for the performance of work done in
connection with the specific grant:
Place of Performance (Street address, city, county, state, zip code)
3301 Tarniarni Trail East, Naples, Collier County! Florin.::!, FT.14112
3050 North Horseshoe Drive. Naples. Collier County, Florida, FL14104
Check _ if there are workplaces on file that are not identified here.
The certification with regard to the drug-free workplace is required by 24 CFR part 24, subpart F.
7. Definitions of terms in the Nonprocurement Suspension and Debarment common rule and Drug-Free
Workplace common rule apply to this certification. Grantees' attention is called, in particular, to the
following definitions from these rules:
-,..,.- - 11'"' .'V V . ~_"~n_"'" _,_.",~_~_,o,.~__",_
16D "-
"Controlled substance" means a controlled substance in Schedules I
through V of the Controlled Substances Act (21 v.S.C. 812) and as further
defined by regulation (21 CFR 1308.11 through 1308.15);
"Conviction" means a finding of guilt (including a plea of nolo
contendere) or imposition of sentence, or both, by any judicial body
charged with the responsibility to determine violations of the Federal or
State criminal drug statutes;
"Criminal drug statute" means a Federal or non-Federal criminal statute
involving the manufacture, distribution, dispensing, use, or possession of
any controlled substance;
"Employee" means the employee of a grantee directly engaged in the
performance of work under a grant, including: (i) All "direct charge"
employees; (ii) all "indirect charge" employees unless their impact or
involvement is insignificant to the performance of the grant; and (iii)
temporary personnel and consultants who are directly engaged in the
performance of work under the grant and who are on the grantee's payroll.
This definition does not include workers not on the payroll of the grantee
(e.g., volunteers, even ifused to meet a matching requirement; consultants
or independent contractors not on the grantee's payroll; or employees of
subrecipients or subcontractors in covered workplaces).
4__'_~ <<'-"',-, - .. "".i"'"''''';''~~'''''_.''''''"'''_"_''' "'""'-""'-'-'.~'---
'-",~," "....
160 It.
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Certifications
The HPRP Grantee certifies that:
Consolidated Plan - It is following a current HUD-approved Consolidated Plan or
CHAS.
Consistency with Plan - The housing activities to be undertaken with HPRP funds are
consistent with the strategic plan.
Confidentiality - It will develop and implement procedures to ensure:
(1) The confidentiality of records pertaining to any individual provided with assistance;
and
(2) That the address or location of any assisted housing will not be made public, except to
the extent that this prohibition contradicts a preexisting privacy policy of the grantee.
Discharge Policy - A certification that the State or jurisdiction has established a policy
for the discharge of persons from publicly funded institutions or systems of care (such as
health care facilities, foster care or other youth facilities, or correction programs and
institutions) in order to prevent such discharge from immediately resulting in
homelessness for such persons.
HMIS - It will comply with HUD' s standards for participation in a local Homeless
Management Information System and the collection and reporting of client-level
information.
IL d~ Mlt'i /2. r 20<.;1
Signature/Authorized Official Date
Tille Donna Fiala, Chairman
Board of County Commissioners, Collier County, Florida
'I "
'.
Approved as to form & legal sufficiency ATTEST; , !
~ ~~-
Assistant County Attorney
- ~ i 1 III ",,.,,,,,,,~,,,..,',... 'Il . ~ 10 a'll,' ~
'",~".--"" ---
16[] 4
OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
*1. Type of Submission: *2. Type of Application * If Revision, select appropriate letter(s)
o Preapplication ~New
~ Application o Continuation *Other (Specify)
o Changed/Corrected Application o Revision
3. Date Received: 4. Applicant Identifier:
5a. Federal Entity Identifier: *5b. Federal Award Identifier:
State Use Only:
6. Date Received by State: I 7. State Application Identifier:
8. APPUCANT INFORMATION:
*a. Legal Name: Collier County Board of County Commissioners
*b. EmployerlTaxpayer Identification Number (EINlTIN): *c. Organizational DUNS:
59-6000558 076997790
d. Address:
*Street 1: 3301 Tamiami Trail East
Street 2:
*City: NaDles
County: Collier
*State: Florida
Province:
*Country: United States of America
*Zip I Postal Code 34112
e. Organizational Unit:
Department Name: Division Name:
Housing and Human Services Public Services
f. Name and contact infonnatlon of person to be contacted on matters involvIng this application:
Prefix: Ms. *First Name: Maroo
Middle Name: A.
*Last Name: Castorena
Suffix:
Title: Grant Operations Manager
Organizational Affiliation:
Collier County Housing and Human Services Department
*Telephone Number: (239) 252-2912 Fax Number: (239) 252-2331
*Email: margocastorena@colliergov.net
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~-, .~ >M~""..~....,.. .._~~,.,.u". ,
~lL~
Expiration Date: 0113112009
Application for Federal Assistance SF-424 Version 02
*9. Type of Applicant 1: Select Applicant Type:
a.County Government
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
*Other (Specify)
*10 Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number:
14.257
CFDA Title:
Homelessness Prevention and RaDid Re-HousinQ Prooram
*12 Funding Opportunity Number:
*Title:
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
Collier County, FL
*15. Descriptive Title of Applicant's Project:
Homelessness Prevention and Rapid Re-Housing Program (HPRP) Initial Submission Application
........- ",_",_,-<,.,"''''a.'"",~",,~~~>,_ .... .- .. . ,,.,,,,,,,,..,....,..,,"'._,., _,,~',"'O""'___<<'"'~'''~'_~~_~__
'"""'~"'__'__"'''___M
l~uller: 4040'4
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
16. Congressional Districts Of:
*a. Applicant: 14 *b. Program/Project: 14
17. Proposed Project:
*a. Start Date: September 1,2009 *b. End Date: September 1,2011
18. Estimated Funding ($):
*a. Federal 888,850
*b. Applicant
*c. State
*d. Local
*e. Other
*f. Program Income
*g. TOTAL 888,850
*19. Is Application Subject to Review By State Under Executive Order 12372 Process?
o a. This application was made available to the State under the Executive Order 12372 Process for review on _
o b. Program is subject to E.O. 12372 but has not been selected by the State for review.
I8l c. Program is not covered by E. O. 12372
*20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes", provide explanation.)
DYes I8l No
21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply
with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject
me to criminal, civil, or administrative penalties. (U. S. Code, Title 218, Section 1001) .
I8l ** I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or
agency specific instructions
Authorized Representative:
Prefix: Ms. *First Name: Donna
Middle Name:
*Last Name: Fiala
Suffix:
*Title: Chairman, Board of County Commissioners, Collier County, Florida
*Telephone Number: (239) 252-8097 , Fax Number: (239) 252-3602
* Email: donnafiala@colliergov.net/fl / _
*Signature of Authorized Representative: ^j/~. ~~,. 1 *Date Signed: 5-/Cf...() t}
I,
Authorized for Local Reproduction .... Standard Fonn 424 (Revised 10/2005)
Approved as to form & legal sufficiency ~ ( . ., Prescribed by OMB Circular A-I 02
AT. e.ST. . .:.
. DWI~HT E. SROCk, ~ik
Col/eenGree"'. ~
Assistant County Attomey sy. . '"Y5i m ~'-m.. _.'___
~~....,- -_._- '<I ""'<f
160 4
OMB Number: 4040-0004
Expiration Date: 0113112009
Application for Federal Assistance SF-424 Version 02
*Appllcant Federal Debt Delinquency Explanation
The following should contain an explanation if the Applicant organization is delinquent of any Federal Debt.
Not Applicable
<.~"".<>.,,,,^,---- T""'_'_"'~'<l1"l"'W _'..n 1''' ,,'-""_"'"".,.,~,-,.~,. -""'~-"""""'.~ ,-,,~ ~._,._-_.,~~----,-- ..---...---
16U 4
OMB Approval Number: 2506-0180
(Expiration Date: 9/30/2009)
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Grantees eligible to receive funds under the Homelessness Prevention and Rapid Re-
Housing Program (HPRP) are required to complete a substantial amendment to their
Consolidated Plan 2008 Action Plan. This form sets forth the required format for this
substantial amendment. A completed form is due to HUD within 60 days of the
publication of the HUD HPRP notice.
To aid grantees in meeting this submission deadline, the HPRP Notice reduces the
requirement for a 30-day public comment period to no less than 12 calendar days for this
substantial amendment. With this exception, HPRP grantees are required to follow their
Consolidated Plan's citizen participation process, including consultation with the
Continuum of Care (CoC) in the appropriate jurisdiction(s). Grantees are also required to
coordinate HPRP activities with the CoC's strategies for homeless prevention and ending
homelessness. To maximize transparency, HUD strongly recommends that each grantee
post its substantial amendment materials on the grantee's official website as the materials
are developed.
-...r
A complete submission contains the following three documents:
1) A signed and dated SF-424,
2) A completed form HUD-40119 (this form), and
3) Signed and dated General Consolidated Plan and HPRP certifications.
For additional information regarding the HPRP program, visit the HUD Homelessness
Resource Exchange (www.hudhre.info). This site will be regularly updated to include
HPRP resources developed by HUD and its technical assistance providers.
The information collection requirements contained in this application have been submitted to the Office of
Management and Budget (OMB) for review under the Paperwork Reduction Act of 1995 (44 U.S.c. 3501-
3520). This agency may not collect this information, and you are not required to complete this form, unless
it displays a currently valid OMB control number.
Information is submitted in accordance with the regulatory authority contained in each program rule. The
information will be used to rate applications, determine eligibility. and establish grant amounts.
Public reporting burden for this collection of information is estimated to be 16 hours, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. This information is required to obtain benefits. To
the extent that any information collected is of a confidential nature, there will be compliance with Privacy
Act requirements. However, the substantial amendment to the Consolidated Plan 2008 Action Plan does not
request the submission of such information.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil
penalties. (18 U.S.c. 1001,1010,1012; 31 V.S.C. 3729,3802)
1 HUD-40 119
,-- ~~""- -'~-"-""'--'--~ " ,.~.- ~ AA_',._~..____.."_"_____".,__,~""_,.__ __._.... --,~~.., ,
160 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
A. General Information
Grantee Name Collier County
Name of Entity or Department Housing & Human Services
Administering Funds
HPRP Contact Person Marcy Krumbine
(person to answer questions about
this amendment and HPRP)
Title Director, Housing & Human Services
Address Line 1 3301 Tamiami Trail East
Address Line 2 Building H, Suite 211
City, State, Zip Code Naples, Fl34112
Telephone 239-252-8442
Fax 239-252-2331
Email Address MarcyKrumbine@colliergov.net
Authorized Official Donna Fiala
(if different from Contact Person)
Title Chairman of the Board of County Commissioners
Address Line 1 3301 Tamiami Trail E
Address Line 2 Administration Building
City, State, Zip Code Naples, Fl34112
Telephone 239-252-8097
Fax 239-252-3602
Email Address DonnaF iala@colliergov.net
Web Address where this Form is www.colliergov.net
Posted
Amount Grantee is Eligible to Receive* $ 888,850.00
Amount Grantee is Requesting $ 888,850.00
* Amounts are available at http://www.hud.gov/recoverylhomelesspreventrecov.xIs
2 HUD-40 119
",.'~- -----'. _.......~..- ~....,"'.,' "",,,.~~,~~"~,--~~~.~-~.__..,. ~ .-.- _._,--~---,---~.~_.._-"~-~~
16D 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
B. Citizen Participation and Public Comment
1. Briefly describe how the grantee followed its citizen participation plan regarding
this proposed substantial amendment (limit 250 words).
Response:
Collier County has complied with all aspects of our citizen participation plan. The
HPRP substantial amendment ad was posted on the official County website and
placed in the Naples Daily News, a newspaper of general circulation within Collier
County. The ad was placed in both English and Spanish versions to make citizens
aware of this substantial amendment and ensure the widest dissemination of HPRP
information. A public comment period was held from April 10-21, 2009. The
public meeting was held on April 16, 2009 in which public comments were
solicited. This public meeting was advertised on the Collier County official
website, and placed in the main administration building where public notices are
posted. In addition local non-profit agencies were notified of the public meeting. A
second public meeting was held on May 12, 2009 at the Collier County Board of
County Commissioners' meeting. At this meeting, the staff recommendation to
submit the HPRP substantial amendment to HUD was approved and the Chairman
was authorized to sign all documentation necessary for submission to HUD.
The attendees to the Public Comment Session asked many questions regarding the
grant that were answered. These questions included:
When will the RFP be released?
Answer: The RFP will be released the beginning of May for approximately one
week. There will not be a cure period.
Should non-profit agencies meet for technical assistance if they are proposing a
new project or have never been funded before?
Answer: Any organization can call HHS for a meeting or technical assistance
before the RFP is due.
Does the grant cover food vouchers?
Answer: No.
Are administrative costs available and can finance charges for a bridge loan be
reimbursed:
3 HUD-40119
,~..,- -~".~ -. ,,,,,.,,~.-,-.,.. q.,-".~ o~o
160 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Answer: There is 5% allowed for admin that will be distributed between the sub-
recipients and HHS. There will be approximately $22,000 in administrative funds
available to distribute to the participating agencies. Finance charges cannot be
reimbursed.
Can the grant be used for supportive services?
Answer: Yes, the grant can be used for supportive services for the homeless and to
prevent those from being homeless.
Can the grant be used for more space or more equipment for an emergency shelter?
Answer: No, the grant cannot be used for those purposes.
Other public comments:
Bart Zino from Collier County Hunger and Homeless Coalition expressed concern
that the grant would be reimbursable and that local organizations did not have the
capacity to payout the monies and wait for the reimbursement. He suggested that
the County provide a bridge loan for organizations. It was noted that the F AQ' s of
the grant program mentioned that HUD does allow for a draw down before the
grant is expended. However, this is not the method by which the participating
jurisdiction does business.
Debra Mahr from Collier County Hunger and Homeless Coalition asked what kind
of program we were looking to institute for rapid re-housing. The various agencies
talked about how they each secure housing for their clients.
Steve Perkins, Administrator of the HMIS program in Collier County, explained
how he would provide assistance for organizations to get up and running with
HMIS in order to participate in the HPRP grant.
Additionally, 3 written Public Comments were submitted (see below):
From: Susan Golden, citizen
It is important to encourage partnerships and collaboration amongst local non-
Profits and I agree, not to reinvent the wheel, groups that are providing rental
assistance (ie. Coalition, Youth Haven, Catholic Charities, etc.) should take the
lead.
No written response requested.
From: Debra Mahr-Collier County Hunger & Homeless Coalition
4 HUD-40 11 9
~"'..,,',.,.., ...."...-..-- C"~.""_" ,,_ '~J._~ _ ,-,'- ,...", -.-.-..
160 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Fund agencies with a proven track record for providing emergency rent assistance:
Collier County Housing Authority (TBRA),Collier County Hunger & Homeless
Coalition "Partnership for Prevention" program, Salvation Army, SVDP, Youth
Haven.
Encourage collaborative case management teams to provide support services.
Enclosed: Collier County Hunger & Homeless Coalition- Needs Assessment and
Ranking of Priorities. Exhibit 1
Written response requested.
From Essie Serrata Collier County Housing Authority
April 21, 2009
Re: HPRP Funding Public Comment
Dear Ms. Krumbine:
Please accept this as the Housing Authority's comments regarding the allocation of
Homelessness Prevention and Rapid Re-Housing Program funding.
It is our understanding this funding is primarily to provide assistance to homeless
or at-risk families, individuals and youth affected from the economic crisis. With
this purpose in mind we support the gaps and needs identified by the Collier
County Hunger and Homeless Coalition in a workshop held on March 10, 2009 and
provided to you during the April 16,2009 Public meeting.
As the countywide public housing authority who administers two federal rental
assistance programs we substantiate the top ranked need being rental assistance.
The Housing Choice Voucher Program provides rental assistance up to 440 low-
income families and the HOME Tenant Based Rental Assistance has provided
assistance with security deposit, utility deposits and rental subsidies for the
homeless, elderly and disabled since 2003. The waiting list for persons seeking
rental subsidies is over 800.
The needs assessment and ranking priority by the coalition, is timely and should
serve as a benefit to design the program and identify key resources already
available that could be augmented to provide further stability in the community.
It is our hope that the county will work cooperatively with the current local
providers that have a proven track record, the capacity and are the best fit to carry
out the initiatives of this funding.
I appreciate the opportunity to provide comment.
Esmeralda Serrata, PHM Executive Director
5 HUD-40 119
-" '" . .<~.,.- ."."",,-,.,," ~",. ...0.
160 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
No written response requested.
2. Provide the appropriate response regarding this substantial amendment by checking
one of the following options:
o Grantee did not receive public comments.
o Grantee received and accepted all public comments.
[8] Grantee received public comments and did not accept one or more of the
comments.
3. Provide a summary of the public comments regarding this substantial amendment.
Include a summary of any comments or views not accepted and the reasons for
non-acceptance.
Response:
Public comments centered on questions and comments in the following areas:
1. Eligible activities allowed under HPRP
2. Procedures and timing of the competitive application process
3. Need for non-profit agencies to work together to maximize benefit ofHPRP funds.
4. Need to ensure local agencies already providing like services are encouraged to apply
for funding.
The public comment that was not accepted concerned advancing grant funds before
expending rather than reimbursing grant expenditures. Although allowable under 24 CFR
84.22 and 85.21, this participating jurisdiction notes the inherent risks involved in that
business practice and it is not supported by Collier County Finance Department.
C. Distribution and Administration of Funds
Reminder: The HPRP grant will be made by means of a grant agreement executed by HUD
and the grantee. The three-year deadline to expend funds begins when HUD signs the grant
agreement. Grantees should ensure that sufficient planning is in place to begin to expend
funds shortly after grant agreement.
1. Check the process{es) that the grantee plans to use to select subgrantees. Note that a
sub grantee is defined as the organization to which the grantee provides HPRP
funds.
6 HUD-40 119
~~. "'-~,".,-,_._- ,""~". --, "..",,,.-,., ' ._~~ -~~.~
16D 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
. Competitive Process
D Formula Allocation
D Other (Specify: )
2. Briefly describe the process (es) indicated in question 1 above (limit 250 words).
Response:
Collier County Housing and Human Services Department (HHS) will use a
competitive process as a basis for award to subrecipients for HPRP funding. HHS
has tailored its traditional competitive Request for Proposal (RFP) process to
adhere to HPRP guidelines and timetables. This abbreviated RFP process will
comply with the requirements of the Collier County Citizen Participation Plan,
albeit on a shortened HPRP timetable.
The HHS competitive process commences with English and Spanish language
advertisements in local newspapers outlining the HPRP program, funding amounts,
preliminary budget, and eligible activities. The ads outline the public comment
period and dates for public meetings. The RFP process is then announced;
applications are made available through the HHS website, hardcopy and via email.
Application deadline is included in the application, as well as grading criteria.
Technical assistance is provided throughout the application period. Completed
applications (and required copies) are date and time stamped when received and
receipted by HHS personnel. The Application Review Committee is selected from
a variety of sources to include community members, HHS staff and County Grant
Personnel. Members review applications individually and as well as a whole;
applications are scored, scores are aggregated and projects ranked. Based on
ranking, selected projects are presented to the Collier County Affordable Housing
Advisory Committee for comment. Projects are then forwarded to the Collier Board
of County Commissioners for final review and approval prior to submission to
HUD.
3. Briefly describe the process the grantee plans to use, once HUD signs the grant
agreement, to allocate funds available to sub grantees by September 30, 2009, as
required by the HPRP Notice (limit 250 words).
Response:
Projects will be competitively selected and the sub-recipients will be notified. A
clear scope of work and budget should be developed and approved by Housing &
Human Services. Once HUD signs the HPRP grant agreement with the Collier
County Board of County Commissioners (BCC) HHS will already have in place
7 HUD-40 119
~-,,_.... .- ,.---
160 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
agreement templates that have been modified to accommodate HPRP requirements.
The project scope section of the agreements are individualized to encompass the
activities to be performed by the sub grantee, budget, timeline, performance
measures as well as reporting requirements and payment reimbursement
instructions. The agreement templates along with their individualized scopes will
be signed by the sub grantees. Signed agreements will be presented to the BCC for
approval during September 2009. BCC approval of the agreements will obligate
HPRP funds by the September 30, 2009 HUD deadline.
4, Describe the grantee's plan for ensuring the effective and timely use of HPRP grant
funds on eligible activities, as outlined in the HPRP Notice. Include a description
of how the grantee plans to oversee and monitor the administration and use of its
own HPRP funds, as well as those used by its sub grantees (limit 500 words).
Response:
Collier County Housing and Human Services (HHS) has established methodologies
for working with sub grantees from the time they are selected for funding until
contract close-out. These same methodologies will be used to ensure HPRP
requirements are met. Each sub grantee is assigned a grant coordinator who guides
them In understanding their agreement terms, performance measures,
reimbursement requirements, as well as any administrative and reporting
requirements. The grant coordinators along with the Grant Operations Manager
maintain active communication with the sub grantee via desk monitorings, phone
monitorings, monthly reports, and site visits. HHS in conjunction with the Clerk of
Courts and the Purchasing Department provide technical assistance to sub grantees
to ensure their pay requests comply with the terms of their agreement as well as all
applicable federal, state and local requirements. Eligibility requirements are
monitored throughout the life of the agreement by means of on-site monitoring of
participant files.
8 HUD-40 119
--."...,.. ~.< "'4'1._.......".,0 ~^-- . .....-..
160 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
D. Collaboration ,
1. Briefly describe how the grantee plans to collaborate with the local agencies that
can serve similar target populations, which received funds under the American
Recovery and Reinvestment Act of 2009 from other Federal agencies, including the
u.s. Departments of Education, Health and Human Services, Homeland Security,
and Labor (limit 250 words).
Response:
Collier County Housing and Human Services (HHS), as the Lead Agency for the
Continuum of Care, already partners with a number of local agencies, who receive
funding from a variety of federal sources. These agencies have implemented
programs and services to assist the homeless and those at risk of becoming
homeless. HHS works closely with the Hunger and Homeless Coalition (HHC),
which coordinates involvement of local agencies, as well as works with the Collier
County Public Schools liaison for homeless children. Youth Haven, another
Collier County non-profit organization receiving funding from the Department of
Health and Human Services, currently oversees a program called "Caring for
Families" which has previously been supported by this office. The David Lawrence
Mental Health Center also receives state and federal funds and offers supportive
housing for clientele with mental illness who are at risk of being homeless. In
addition, HHS works with the Collier County Housing Authority, the public
housing authority, who receives USDA funding, with tenant based rental
assistance. These agencies, and more, will be encouraged to submit applications
for funding.
9 HUD-40 119
'~"...~,." ""',"",,~--"--"'- "'^"~-, ~.."',," _"'_OH"""'" - ,..,--'<~~-~ M ,,_.~-. . -,-.-,- "--,-~.. --
160 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
2. Briefly describe how the grantee plans to collaborate with appropriate
Continuum(s) of Care and mainstream resources regarding HPRP activities (limit
250 words).
Response:
Collier County Housing and Human Services (HHS) is the Lead Agency for the
Collier County Continuum of Care (CoC) and actively participates in, and supports
the priorities established by the CoCo HHS is tied not only by its active
participation in the CoC with its partner social service agencies, but also
electronically via the Homeless Management Information System (HMIS).
Included in the public comment period and public workshop, agencies which
participate in the CoC will be contacted to assist HHS with an assessment of
current needs and gaps in service that can be addressed with HPRP funding. The
Collier County Sherriff s Office (CCSO) assists HHS in this collaboration by
assigning a deputy to work with the homeless population to improve their access to
care and educate them on existing resources. Collier County's two homeless
shelters: St Matthew's House/Immokalee Friendship House and The Shelter for
Abused Women and Children are both active members of the CoC and work
closely with HHS to ensure the widest dissemination of information regarding
available resources.
3. Briefly describe how HPRP grant funds for financial assistance and housing
relocation/stabilization services will be used in a manner that is consistent with the
grantee's Consolidated Plan (limit 250 words).
Response:
Collier County's FY 2006-2010 Consolidated Plan states the county will utilize a
"Continuum of Care" model In which homeless individuals move from
homelessness to permanent housing via a spectrum of services which .encompass
outreach/intake/assessment to emergency sheltering then progress to transitional
housing and finally to supportive and/or permanent housing. This "Continuum of
Care" model utilizes an array of supportive services aimed at locating suitable
housing, assist with rent and utility deposits, and finally continue rental payments
and utility assistance for a reasonable period until the individual is stabilized in
permanent housing and is able to assume financial responsibility for their own
housing. The financial assistance and relocation/stabilization services outlined as
eligible activities of the HPRP will fit seamlessly in Collier County's "continuum
of care" model to transition homeless individuals and families to permanent
housing.
10 HUD-40 119
._"._....__.,-<~,~-, .-,."....,- -..,-. -- --- -.-.".." ,~
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the 16 D 4
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
E. Estimated Bude:et Summary
HUD requires the grantee to complete the following table so that participants in the citizen
participation process may see the grantee's preliminary estimated amounts for various
HPRP activities. Enter the estimated budget amounts for each activity in the appropriate
column and row. The grantee will be required to report actual amounts in subsequent
reporting.
HPRP Estimated Budget Summary
Homelessness Rapid Re- Total Amount
Prevention housing Budgeted
Financial Assistancel $ 569,408.00 $ $569,408.00
Housing Relocation and $ $ 250,000.00 $250,000.00
Stabilization Services2
Subtotal $ $ $819,408
(add previous two rows)
Data Collection and Evaluation3 $ 25,000.00
Administration (up to 5% of allocation) $ 44,442.00
4 $888,850.00
Total HPRP Amount Budgeted
lFinancial assistance includes the following activities as detailed in the HPRP Notice:
short-term rental assistance, medium-term rental assistance, security deposits, utility
deposits, utility payments, moving cost assistance, and motel or hotel vouchers.
2Housing relocation and stabilization services include the following activities as detailed in
the HPRP Notice: case management, outreach, housing search and placement, legal
services, mediation, and credit repair.
3Data collection and evaluation includes costs associated with operating HUD-approved
homeless management information systems for purposes of collecting unduplicated
counts of homeless persons and analyzing patterns of use of HPRP funds.
4This amount must match the amount entered in the cell on the table in Section A titled
"Amount Grantee is Requesting."
11 HUD-40 119
-~~--~---.,_._--_. ~ ->~'~,--, lI' . ~.,._- _.~-"~ "" .,. ]7 III.... _'M..~
16D 4
Substantial Amendment to the Consolidated Plan 2008 Action Plan for the
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
F. Authorized Silmature
By signing this application, I certify (1) to the statements contained in the list of
certifications and (2) that the statements herein are true, complete, and accurate to the best
of my knowledge. I also provide the required assurances and agree to comply with any
resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent
statements or claims may subject me to criminal, civil, or administrative penalties. (U.S.
Code, Title 218, Section 1001)
4J~ .J~ -.
D~t\'1 f ~ 20cfj
,
Signature/Authorized Official
Title Donna Fiala, Chairman
Board of County Commissioners,Collier County, Florida
!\pproved as to form & legal sufficiency (~ ,
;' ~!
C~f.~!!,/PAJL ,
Bv. .
~"i; "'"t County Attorney " . }-""- '. ~
Attest ..-:te a..
,""" "f
.19ftIt.... '.',""
J .
,J 'J
HUD-40 119
12
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160 4
GENERAL CERTIFICATIONS FOR STATE OR LOCAL GOVERNMENT FOR THE
HOMELESSNESS PREVENTION AND RAPID RE-HOUSING PROGRAM (HPRP)
In accordance with the applicable statutes and the regulations governing the consolidated plan
regulations, the state, territory, or local government certifies that:
Affirmatively Further Fair Housing -- The state, territory, or local government will
affirmatively further fair housing, which means it will conduct an analysis of impediments to fair
housing choice within the jurisdiction or state, take appropriate actions to overcome the effects of
any impediments identified through that analysis, and maintain records reflecting that analysis and
actions in this regard.
Drug-Free Workplace - It will or will continue to provide a drug-free workplace by:
1. Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the grantee's
workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
2. Establishing an ongoing drug-free awareness program to inform employees about:
(a) The dangers of drug abuse in the workplace;
(b) The grantee's policy of maintaining a drug-free workplace;
(c) Any available drug counseling, rehabilitation, and emp1<;>yee assistance programs;
and
(d) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
3. Making it a requirement that each employee to be engaged in the performance of the grant
be given a copy of the statement required by paragraph 1;
4. Notifying the employee in the statement required by paragraph I that, as a condition of
employment under the grant, the employee will -
(a) Abide by the terms of the statement; and
(b) Notify the employer in writing of his or her conviction for a violation of a criminal
drug statute occurring in the workplace no later than five calendar days after such
conviction;
5. Notifying the agency in writing, within ten calendar days after receiving notice under
subparagraph 4(b) from an employee or otherwise receiving actual notice of such
conviction. Employers of convicted employees must provide notice, including position
title, to every grant officer or other designee on whose grant activity the convicted
employee was working, unless the Federal agency has designated a central point for the
receipt of such notices. Notice shall include the identification number(s) of each affected
grant;
6. Taking one of the following actions, within 30 calendar days of receiving notice under
subparagraph 4(b), with respect to any employee who is so convicted -
(a) Taking appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
-,~"~ ^'~'~-~ "----- ---~---_._-----
16D 4
(b) 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;
7. Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs I, 2, 3, 4, 5 and 6.
Anti-Lobbying -- To the best of the state, territory, or local government's knowledge and belief:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of it, 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
Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, 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, it
will complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions; and
3. It will require that the language of paragraphs I and 2 of this certification be included in
the award documents for all subawards at all tiers (including subcontracts, sub grants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients shall
certify and disclose accordingly.
Authority of Local Government, State, or Territory -- The submission of the consolidated plan
is authorized under state law and local law (as applicable) and the jurisdiction or state possesses
the legal authority to carry out the programs under the consolidated plan for which it is seeking
funding, in accordance with applicable HUD regulations.
Consistency with Plan -- The housing activities to be undertaken with HPRP funds are consistent
with the strategic plan.
Section 3 -- It will comply with section 3 of the Housing and Urban Development Act of 1968,
and implementing regulations at 24 CFR Part 135.
fi I M C\, 12 , 2t'()~
~$~
Signature/ A onzed Official Date
Tille Donna Fiala, Chairman' ",,/ .,'
Board of County Commissioners, Collier cO~ey-, '~~ldr4da
Approved as to form & legal sufficiency , _ 'I.':, ' :'f 7:::>, . :~~
r~ A-r-rEst~/-> -:~
DWIGHT E. SAOC
Assistant County Attorney
.-.,.'-" .- ~"'-~- ""'<"-' --.^ -_..__..'"-",_",~,,= --
160 4
APPENDIX TO CERTIFICATIONS
INSTRUCTIONS CONCERNING LOBBYING AND DRUG-FREE WORKPLACE REQUIREMENTS:
A. Lobbyine: Certification
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.
B. Drue:-Free Workplace Certification
1. By signing and/or submitting this application or grant agreement, the grantee is providing the
certification.
2. The certification is a material representation of fact upon which reliance is placed when the agency
awards the grant. If it is later determined that the grantee knowingly rendered a false certification, or
otherwise violates the requirements of the Drug-Free Workplace Act, HUD, in addition to any other
remedies available to the Federal Government, may take action authorized under the Drug-Free
Workplace Act.
3. Workplaces under grants, for grantees other than individuals, need not be identified on the
certification. If known, they may be identified in the grant application. If the grantee does not identify
the workplaces at the time of application, or upon award, if there is no application, the grantee must
keep the identity of the workplace(s) on file in its office and make the information available for
Federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee's
drug-free workplace requirements.
4. Workplace identifications must include the actual address of buildings (or parts of buildings) or other
sites where work under the grant takes place. Categorical descriptions may be used (e.g., all vehicles
of a mass transit authority or State highway department while in operation, State employees in each
local unemployment office, performers in concert halls or radio stations).
5. If the workplace identified to the agency changes during the performance of the grant, the grantee
shall inform the agency of the change(s), if it previously identified the workplaces in question (see
paragraph three).
6. The Grantee may insert in the space provided below the site(s) for the performance of work done in
connection with the specific grant:
Place of Performance (Street address, city, county, state, zip code)
3301 Tamiami Trail East, Naples, Collier County, Flnrini'l, F'T.':l4112
3050 North Horseshoe Drive. Naples. Collier County. Florida, FL34104
Check _ if there are workplaces on file that are not identified here.
The certification with regard to the drug-free workplace is required by 24 CFR part 24, subpart F.
7. Definitions oftenns in the Nonprocurement Suspension and Debarment common rule and Drug-Free
Workplace common rule apply to this certification. Grantees' attention is called, in particular, to the
following definitions from these rules:
160 4
"Controlled substance" means a controlled substance in Schedules I
through V of the Controlled Substances Act (21 V.S.C. 812) and as further
defined by regulation (21 CFR 1308.11 through 1308.15);
"Conviction" means a finding of guilt (including a plea of nolo
contendere) or imposition of sentence, or both, by any judicial body
charged with the responsibility to determine violations of the Federal or
State criminal drug statutes;
"Criminal drug statute" means a Federal or non-Federal criminal statute
involving the manufacture, distribution, dispensing, use, or possession of
any controlled substance;
"Employee" means the employee of a grantee directly engaged in the
performance of work under a grant, including: (i) All "direct charge"
employees; (ii) all "indirect charge" employees unless their impact or
involvement is insignificant to the performance of the grant; and (iii)
temporary personnel and consultants who are directly engaged in the
performance of work under the grant and who are on the grantee's payroll.
This definition does not include workers not on the payroll of the grantee
(e.g., volunteers, even if used to meet a matching requirement; consultants
or independent contractors not on the grantee's payroll; or employees of
subrecipients or subcontractors in covered workplaces).
,".,'.- _.c.__ ~,~ " _.,.~-~ , ."~~...._" ..,......."...;,"'" c..___...." --
160 4
Homelessness Prevention and Rapid Re-Housing Program (HPRP)
Certifications
The HPRP Grantee certifies that:
Consolidated Plan - It is following a current HUD-approved Consolidated Plan or
CHAS.
Consistency with Plan - The housing activities to be undertaken with HPRP funds are
consistent with the strategic plan.
Confidentiality - It will develop and implement procedures to ensure:
(1) The confidentiality of records pertaining to any individual provided with assistance;
and
(2) That the address or location of any assisted housing will not be made public, except to
the extent that this prohibition contradicts a preexisting privacy policy of the grantee.
Discharge Policy - A certification that the State or jurisdiction has established a policy
for the discharge of persons from publicly funded institutions or systems of care (such as
health care facilities, foster care or other youth facilities, or correction programs and
institutions) in order to prevent such discharge from immediately resulting in
homelessness for such persons.
HMIS - It will comply with HUD's standards for participation in a local Homeless
Management Information System and the collection and reporting of client-level
information.
~d~ M G\.'j l2 , 'l-b<..fj
Signature/Au orized Official Date '
Title Donna Fiala, Chairman
Board of County Commissioners, Collier County, Florida
Approved as to form & legal sufficiency "' ,/ ';
...
(Ifi)tJtJ~~.tJ-"lM. Q ~
Colleen Greene, 191': '
Assistant County Attorney Attest It te
l1gutn.""
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16D 4
OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
*1. Type of Submission: *2. Type of Application * If Revision, select appropriate letter(s)
o Preapplication 181 New
181 Application o Continuation *Other (Specify)
o Changed/Corrected Application o Revision
3. Date Received: 4. Applicant Identifier:
5a. Federal Entity Identifier: *5b. Federal Award Identifier:
State Use Only:
6. Date Received by State: I 7. State Application Identifier:
8. APPUCANT INFORMATION:
*a. Legal Name: Collier County Board of County Commissioners
*b. Employerlfaxpayer Identification Number (EINIfIN): *c. Organizational DUNS:
59-6000558 076997790
d. Address:
*Street 1 : 3301 Tamiami Trail East
Street 2:
*City: NaDles
County: Collier
*State: Florida
Province:
*Country: United States of America
*Zip I Postal Code 34112
e. Organizational Unit:
Department Name: Division Name:
Housing and Human Services Public Services
f. Name and contact information of person to be contacted on matters involving this application:
Prefix: Ms. *First Name: Marao
Middle Name: A.
*Last Name: Castorena
Suffix:
Title: Grant Operations Manager
Organizational Affiliation:
Collier County Housing and Human Services Department
*Telephone Number: (239) 252-2912 Fax Number: (239) 252-2331
*Email: margocastorena@colliergov.net
.. ~_._-------~--~-_._--~--_.__._.__...~.__.__. ._---_...._~----,.._._...- ____._____._____w.,_.__..._ --.----..-------..-.--------..-."..-
160 4
OMB Number: 4040-0004
Expiration Date: 0113112009
Application for Federal Assistance SF-424 Version 02
*9. Type of Applicant 1: Select Applicant Type:
B.County Government
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
*Other (Specify)
*10 Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number:
14.257
CFDA Title:
Homelessness Prevention and RaDid Re-Housina PrO<;lram
*12 Funding Opportunity Number:
*Title:
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
Collier County, FL
*15. Descriptive Title of Applicant's Project:
Homelessness Prevention and Rapid Re-Housing Program (HPRP) Initial Submission Application
"~~'" -"--~'~--,-'-~""'-"'~ ..~,-, "'~.""._~ ---_. ~~'"''' ,...,--
oluQerQ04o-ooft
Expiration Date: 01131/2009
Application for Federal Assistance SF-424 Version 02
16. Congressional Districts Of:
*a. Applicant: 14 *b. Program/Project: 14
17. Proposed Project:
*a. Start Date: September 1 , 2009 *b. End Date: September 1,2011
18. Estimated Funding ($):
*a. Federal 888,850
*b. Applicant
*c. State
*d. Local
*e. Other
*f. Program Income
*g. TOTAL 888,850
*19. Is Application Subject to Review By State Under Executive Order 12372 Process?
D a. This application was made available to the State under the Executive Order 12372 Process for review on_
D b. Program is subject to E.O. 12372 but has not been selected by the State for review.
t8J c. Program is not covered by E. 0.12372
*20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes", provide explanation.)
DYes [81 No
21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply
with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject
me to criminal, civil, or administrative penalties. (U. S. Code, Title 218, Section 1001) .
t8J ** I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or
agency specific instructions
Authorized Representative:
Prefix: Ms. *First Name: Donna
Middle Name:
*Last Name: Fiala
Suffix:
*Title: Chairman, Board of County Commissioners, Collier County, Florida
*Telephone Number: (239) 252-8097 I Fax Number: (239) 252-3602
* Email: donnafiala@colliergov.net /(J J
*Signature of Authorized Representative: ;' ! ,I ~. l;J1'/)/ I *Date Signed: .:5 -/ '('(/ 9
'\ L.J.o- ~
f ?,: ~
Authorized for Local Reproduction " . Stl'\.l1dard Form 424 (Revised 10/2005)
, / i!
Approved as to form & legal sufficiency Prescribed by OMB Circular A-102
~~
Colleen Greene,
Assistant County Attorney
--",,--.. .._,~,->. .~~.._,-_...._._,._._-,...---"~~,.,._,---~-~.-~.. ""-,,
160 4
OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
*Applicant Federal Debt Delinquency Explanation
The following should contain an explanation if the Applicant organization is delinquent of any Federal Debt.
Not Applicable
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