Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
CAP 2014-04-29 Item 2A - Application for CDBG (Community Development Block Grant) for the Minor Home Repair Program
14:r-,,,1 = 4`�y City of Tukwila a A -r Jim Haggerton, Mayor 1'110 _ , , X90$ INFORMATIONAL MEMORANDUM TO: Mayor Haggerton, David Cline Community and Parks FROM: Evie Boykan, Human Services Manager DATE: April 21, 2014 SUBJECT: Authorization to submit CDBG Application for Minor Home Repair 2015 ISSUE King County must receive a Mayor's signed application, as authorized by the City Council, for the annual application to King County for Federal Community Development Block Grants. These funds target the Tukwila Minor Home Repair program. For 2015, we propose serving as the fiscal administrator for minor home repair in the cities of Tukwila, SeaTac, Des Moines, and Covington. This program successfully assists low and moderate income homeowners in maintaining their homes. We are applying for $130,000 for the 4 cities. -We estimate about $35,000 in-kind staff time from the respective 4 cities. This is estimated dollar value of the time the staff contribute to making this program work. Only one city, Des Moines, uses some of their construction money to pay for staffing costs. BACKGROUND The Office of Human Services has been administering this program in-house since 2005. In 2012 our contractors served 17 unduplicated Tukwila households with 83 hours of labor. While we are still spending on 2013 dollars, we expect to receive a contract this spring/summer for 2014 dollars. Tukwila's current budget for this program is $125,000 for the entire program with $28,000 for Tukwila. DISCUSSION This application competes county wide with other capital, federal applications from both cities and non-profit agencies. Tukwila sits at the table to recommend capital projects, but of course cannot vote on their own application. RECOMMENDATION We seek Council support for this application and request consideration for placement on the Consent Agenda at the May 5th Regular Meeting. ATTACHMENTS Part I Application-The full application is in process. W:12014 Info Memos-Council\CDBG2015.doc 1 { 2 PART I. APPLICATION TITLE PAGE 2015 CDBG Capital Application ., 1. Applicant Agency Name City of Tukwila Office of Human Services 2. Title of Proposed Project _Tukwila/SeaTac/Des Moines/Covington Minor Home Repair 3. Project Site Street Address Jurisdictional boundaries including, 98042, 98148, 98168, 98178, 98188 and 98198 Tax Parcel #: (For Mapping Purposes) (Zip Code Required) Congressional District: 8,9 4. Proposed Use of CDBG Funds (Summarize in one or two sentences how CDBG funds will be used.) Funds will be used to provide grants for housing repair and maintenance for income eligible homeowners within the jurisdictional boundaries of the above cities. Housing preservation and maintenance are the goals with safety and health needs prioritized. 5. 2015 King County Consortium CDBG Funds Requested: $_130,000 Matching funds (in-kind, local, private): in-kind $35,000 Other Grant, State Federal Fund Sources (detailed in Application) $ 0 Total Project Cost: $ $165,000 6. Can your project be funded at a reduced level if necessary? _x_yes no. If yes, what is the minimum amount of CDBG funding needed to still have the project go forward? $100,000 What would be changed to address the reduction of funds? Performance objectives would be changed. Less households would be served. TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE INFORMATION INCLUDED IN THIS APPLICATION HAS BEEN CAREFULLY EXAMINED. APPLICANT UNDERSTANDS AND AGREES TO COMPLY WITH THE POLICIES, RULES AND REGULATIONS REFERENCED IN THE APPLICATION IF FUNDING IS AWARDED. IT IS FURTHER UNDERSTOOD THAT INFORMATION PRESENTED IN THIS APPLICATION WILL BECOME A PART OF ANY SUBSEQUENT FUNDING CONTRACT. Applicant Contact Information X Authorized Signature of Applicant Evie Boykan, Human Services Manager Print or Type Contact Name and Title Evie Boykan, Human Services Manager Print or type Name and Title E-mail Address E-mail Address:_evie.boykan @tukwilawa.gov Phone and Fax# 206-433-7180, 206-433-7183 ATTENTION: Applications submitted by cities or towns must be signed, not stamped, by your Mayor or City Manager and authorized by your City Council. Applications submitted by nonprofit organizations or special districts must be signed by an authorized representative and authorized by your board. A copy of City Council or board minutes authorizing submittal of your application must be submitted n.with the application. Labeled Attachment No.1 eneral Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 3 PART I. APPLICATION TITLE PAGE 2015MGDBG Cap tal Application . If more than one application is submitted, the City Council or board minutes authorizing the applications must indicate priority order of proposal request. • PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 4 PART I. AGENCY INFORMATION : . • 2015 CDBG Capital Application #.. •v2. le° :ax's ," i, r ar; r ,a .,,, r "ra F' r- sit "i a t e r le ti° ci'at. Th s followingrp'age,pis for H b.' .pplIcation fTrac 4ng.-urposes, Only go.,..,,the next pager A qlicatio'ngNlodific�ation$'''(hICD Use'Onlyj • A ifilia.:.fio n Pagitg 4. 4 -174,,T ' � K [ , i',,. . ms , G; $�}g ,ii 't: aa ,s 4� 'A' • 4,, uv zr 7�� ,,-, U ode ♦ Y pk. Z } 1.51,, ' $$tle F g , . ^yit kgs . 6ir n LJate .•At pa. ._r� x m ir me Ria,42 , iftirMq i M t ti•&•i_.. . s t : _�k i• .a .: _5:«fy At,t_hta.-: 3 _r .,.,�iy , xa.w _ : _ " p v R m i g gg? :"zi.4. ' `v t3 z+ n$ e'e; iTt l;, y e 9 � nt -.�t Yi,� r.."*.(6 ' " t J" :i e i =fi+ r x'z:�t .1x . ��0� � >-k� ..1 ati g �i 4 u l�.ti : r�,. ., ik i1 «. . Y ' �1x tJ:. '_�, .t3 �, a ki k.t. . l q,,A ,'�F,A4",.` .0' TT�eu „ty'"i,' .sr,3' ';r`0:4:iT"S� �t-f.;' '.}',: ','' :_. 9`X0:4 r.v t,.,,'� �: '8,ii . z ,fit-x` ra7 t w x p t.. �e>-> �'i�z:�a ! j ^i` $�.,.,a..'��='v�.a� `, .� , *,s "'�'��c��asti�.�'€��, �,� -:es.1. E5�. �+ 5���Y'u �� �' fir.. -�„.�'��` ,46:.�t � '� Lf a,l '�"' i:K w y'4 - ,.t i,. "r s'*.u., a fi i1M n'u 5 %' ". "� f�" 1 Y*; � 'srw�-�'� ��:3 ;.,m'� 3�+a�J+�t�:,�,°. �;'� �, »�;��� �a. x�s'��'" :W "�°.����..�"'"; ",'.' �r' ��` ���.� ^� "`' s �i �`,�,�� � ra*€�''�. «'.??�..�� ...�?K:z? r >� sz • �' e s e - tea. a Fa^ a,- ..rn ., - n.ai . - y. - 7. �.. �F �,„.„ i'^^'..*. ,£f,3rFV,,,r.' '"a� - S"..t' „.. ``,- H -r,,,. s ',ki ,, . . Ar"d3 ,,,: Or.•.,,,�" ,N,,,,r�. .,,,,, - �i .F-.1 -s r > *'.. 7,t. -- - -a•F!4a".3,-, a r1,,:hFS ,x ,,?"�""1Fm•,.�.,..,,.i_ r-,F ..y.v., cY' 7,} '. ,.; " .' Y»r _n ,;,. r'4 , 7,� xyx.+ iv.,„�ie,t,Mil, . c^�.f" "!:''ire.*5 C M��aAV+�b.�, ,3� �'+��k"X=�Sr.. t �.-.ff 1. �, �� """a�?7 s at3 a� ��'�. ^<", '-v'. �'°;w p��i ,�c�.. �,'k6z`t r,S+ ''P. .�^`.�„''xs 6 i• t , it ,rc j ar: u;s - -. 'w .4 '"- �`R s'" - .� it .'�1:.�w,..[-",4;0: .,r; "a f ,, 41-010 •,,I ' '' °?rs" d. -;E�,�'"Y�d� t. y0, S:' �°, pw�� :?a#6: r�fi_ro"v,-'"�.`w'3�F��',R 39 j�;9�;?��;g,. °sJ'w n.Y�a ?a 5' t $";� y",; �.� '$i'; i^',„ -� .� 'P� :< �`M,t K. �»�i£. ,�t����. .�,y,Pj,+ gOC �YzMattti5 gcle_ X40.1 7(8:51 ,u�� :� �w L� /�„rnountvotf F�uS ntimgRe ibest $. _.. >g-,. , �, i�}i i:l i't -..i10 -, .wit:< +5.�,d4 '"9'-'4:, 1,' G Sq,``. S'.'.,$'¢, ':la i .':/,'3 ``:';'r,::�`r. kP.b ' ,�„", t - k4- .10 �'„mow� �''.a �, .�,�k�",.',"}e s�fs`.5�� z,..+�,.--���.,,�.,-�� �, YMiis?K� �"tkiM�° Y'A 7?��w� 't :4_ ?�;"�c"g,`� �.('.,.. t�,x;,,. .�� a 3-�,3'i.�. :�y�' y�" -- `�R�_p... Ev� isa.o 3'4 �, g c_ o t,r ,4 't a uk «.k+ 'c3''., . " 5,; ` l: N a tY , .' w �.a� ?'�`k"� .,a-4 -* �p� „r ,#�,xs z�<,�;t�..�,Y+�""�'�a � a�� �°�,., 'r.�ls ,;i��'�",.xa -, .�.,.,.3y._ �.... E�`�„'h���.�,'�. ? 'r"F�'x.5: 'ar'�a3d*�':}_i��� +[�t3'Eli: biI ityt,Glitati :ri 57OMTLx,dtAtAA r.!•41 s � tegAi attonal ( b.e:ctlye. Cit�atio.n,,,20$: :: ,. ` z, 41 ,1, S.'S'- g �.A _.''� .�'K 'rP ��.��'�. �.. - S�.F.�m�vt. �. ;;� �A'°�i 240 -.� .iib'i .r$` � �� �}y�� .+x - �^ i,Ml� k r 9; , i . #. rm ? "i,,, r"0-e ; ;fi' fir... tta>. ., .l ,.*.5 VTii3a' .-'.5' f m a1 r> 'f��v 5__ �,��.. -k�r4�s. ..���s.`��� �' �ax�t�f�' -::-t '� �`' �"''���3 `'�', -,� Y,-'�,�..-�'''�.�`: '?`�,�,.::a's� �.^.��..'�s {}._' ,:�3.,-y`.£?�»;�4 �,.`�,�.�. ,�i�,,-�y,'��3�.�``.� ;� .� , S�'.$* itt 1*.3}. YX i..t4 !. ':'� t',:43;,4 rti"`�'.7s ••S ;r,"•<4 y.,H� 4,44- €u;"yNV* . ,.f7'�biA. �f. ,,,, .11444 n.,I�a-' 9 6•f't'.W ''"? ar•,: ?a` '`€r,d.h . ,x ,.c i S.tk a.; r,,,' . 00O z;,. f4� tI�I _ .'St514 dub R'2. 1.011,',•' F"'c .� ` � @" 3Con �lldatedP-Ian Strategy#.x � � �� �Nor�th/East�Sub, efgi �� � ,,g �',�. �, �„��, � � �� .s�,y ., rJ «r. �'4,�Ht�"r?^ �F�t,' �'�',� ., '� ( �.s't.8°�°3.. � ...�ht s g�'�'��4 �v,t ,.`�y�,�� 'p� ,,�ri�7rt-@^La t� v. ;fY• � "v y a ?�3r v�?iY ;it ,,„,01�u. ,5':�,. c' ..S .4 1`` e'S.1 .rw,<. ,.tF v*,9hi •2 :•:e ,_ _ ' G j. a3��$ , �'"s- ,y'{-..,- A "> ,,. ". �, ,}Gaa t; i,?.. ?g•:.F.tt :?;mil .{. 01,-..oio .`9 , ',";,44 ;�it '�yT''- `i .,:•*ie - p °* . . g i 4 z g^',,,�..s�s .�` . .. dN.,� � �C ::' '��a:£,:.?;5� *� e,:.�y �' �����' ,?<°',�,-� ,�'�fi �fi' �+ ?- " Cz �a^'�'��"_�� t _,�. u�8� ��. �r-v. x t �.`•.za s„ ,� �� . '� �*Fx � , .�`�`.� x ,�} 5 {1�m g ��`��w?'a s' T-r' � �y �t�`T', ,`� '� , Reviewed kand4confirmed eI)g1bllityy 4 ` i x : A6' 4;, 4 .". ;0 e.,pt, ;�,i- ', 4 �, �}'s�,-gi:' �'�- '. ���:. � r `L `�. ;}� '�'�"" �ki ",�i�Y�� - �'f':���'��,.i:,' 2 ��� �'��,#�`„��Rx "� y, sit,,,. �Z':x't''�`�±�,:3.5 l .�`.: ..� ;�`'x: 4 iSB,•ii,J.. `r,.�2.,'�j.m' '. 71,4-,, `.il '.''.U.CG , ",«.k- i 0 . .p s �"" ... . . 4044., ,M•ro., `:, *ir.,r..:0,,„a tt r. ;,��n.,a�...a;-A"'4 3- z�.x 4'e "x3..7r ��iv`�'.,,.r�t":.,'*iy`m*�`_��'� �'�w<u3{ -�� g�-^"�' :.. ��t'�� .«� 'zr `'.� ct�+ :e. "��' t's 't-- ,s.t, .<'t!,'t�.✓:. �.+..:. ,.:�", �£- ,ti`�`��z.l�-"` a`. t��r^,; �" t -�:.v�"� �ti'� .�-"� u'.m , �. F Y, ,� r ',5,. �, +� �'a^ ., 7.� ,5� k 't °N' � �-6� F iH,C® ;CD F�ian:ner: .lai f 41 4*:bCD,Y�Coord rie rii akiAS i , "`'t ,W 04.P,ro i-{0 ¢0M:ana er , ., �qM}w :� ��,,$t;��xr�� ���p .,,.fir � �y r,,.x�'��.k;�3�"��k:��2:`�.�.�.��__ .� t<u,„ ,:,,,.,rt- 1�� `#.y,.�°,��,�'�gy,,r���°'gp��.�• g�'.�,�.�.�� x��,g y ... .�$', �^ ��. A'L�k� `.t2 ill F.f 3 R^� �`:�.i. ^E y `f � ,k's 1.M �"ugieti et i r ..� J"e 3'E'ft vt O- >.,C°5'X t , " Th Y2 tti 'I? 4,.fi'1 y;� "am, 'c4' �..°' <� 'i s.`Ol a Igi= ..4 , T_N, 5'-x"M,,i a„del, ` ��. � s- »"� �"'*i,..,� �herv_�'3. ,.w_t k�uc S,._ v; �S�1.o.�. �si. p�".x aw7.b. �; .� .�7,,� �'...' ,X.t vi' • • • PART I General Information/Agency Information and Part II Federal Requirements' • 2015 CDBG Capital Application Page , 5 ... PART I. AGENCY INFORMATION 2015 CDBG Capital Application A. AGENCY CONTACT SHEET AND ORGANIZATION INFORMATION Grant Writer Contact Name: Evie Boykan Agency Name/Title: City of Tukwila, Human Services Manager E-Mail: evie.boykan @tukwilawa.gov Phone and Fax#: 206-433-7180, 206-433-7183 Web Site Address: General (Offices) Agency Name: City of Tukwila Mailing Address: 6200 Southcenter Blvd City/State/Zip: Tukwila, WA 98188 Phone and Fax#: 206-433-7180, 206-433-7183 Web Site Address: www.tukwilawa.gov Executive Director Name/Title: David Cline, City Administrator E-Mail: David.Cline @tukwilawa.gov Phone and Fax#: 206-433-1851, 206- 433-7191 Financial Staff Name/Title: Peggy McCarthy, Finance Director E-Mail: Peggy.McCarthy@tukwilawa.gov Phone and Fax#: 206-433-1838, 206-433-1833 Fiscal Information Applicant's Federal Taxpayer ID No. 91-_6001519 Applicant's Federal DUNS Number: 01-202-7504 NCAGE Number 47Z60 King County Vendor# _2097 B. AGENCY SERVICE INFORMATION B.1. What services does your agency provide? Describe the need or problem your program is designed to meet. What is the problem/need you are addressing? Quantify this need, using local or regional data that confirm or describe the problem or need. How much of the need are you currently serving? The City of Tukwila provides municipal services to a very diverse residential population of over 19,000 residents and 150-170,000 day individuals including visitors, employees, shoppers and students. Our median household income is less than King County's, and many other cities. Our poverty figures continue to climb, gaining national attention at the Brookings Institute's Metropolitan Policy program. Most of our housing stock was built prior to 1978 and many of our homeowners have difficulty in maintaining that housing. The majority of the housing repair clients served make 50% of median income and below. We continue to hear from homeowners around issues of unemployment, health related barriers, and skyrocketing utility and other basic need costs. We estimate that we are serving about 10% of the need. SeaTac homeowners are in similar situations. 17% of SeaTac's population is living at or below the poverty level, compared to 12.9% statewide. More than 40% speak a language other than English at home. Nearly 25% of their population lacks health insurance. In Covington, 44% of the housing stock was built prior to 1979. About 28% of the households meet median low income guidelines, with 13% of families having a female head of household below the poverty level. In Des Moines almost 14% of the population is below poverty level. 20-51% of Des Moines households experience a severe cost burden in meeting their housing needs. 44% of the population is low to moderate income. From 2012 data showed that 62% of clients served in the minor home repair program were documented at 30% of median income or below. PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page PART I. AGENCY INFORMATION 2015 CDBG Capital Application In summary, the above cities are struggling economically. We are still seeing effects of the recession. Homeowners are struggling to maintain their housing in decent condition. The minor home repair program provides a boost to help ensure greater housing stability, and preservation of affordable housing. B.2. How do you determine eligibility (income screening, location of residence, eligibility in other government programs? Are you familiar with current CDBG income screening requirements? [PART III, VI and VII applicants will need to provide a copy of the tool used during the client intake process as an attachment per instructions.] The staff involved in delivering this program are seasoned and familiar with CDBG requirements. Tukwila started this program 9 years ago. Each city maintains confidential files that document the homeowners household income. Tool is attached in this application. B.3. Describe the process your agency uses to a) assess community needs, b) obtain input from clients on service delivery and c) ensure the services are delivered by culturally competent staff in a culturally competent manner. How often is this assessment completed? The City's 2012 strategic plan includes the most recent needs assessment. Our commitment to gaining public input has supported a Community Connectors program that has been instrumental in engaging community for input into the City's Comprehensive plan. These Community Connectors represent multiple language and cultural groups. They have been instrumental in both identifying needs and communicating city information. The Human Services Division collects on-going demographic and qualitative data substantiating need, and barriers to accessing services. We continue to work with consultants to improve our cultural sensitivity and awareness in working in one of the most diverse communities in the nation. The local school district has been very cooperative in sharing demographic data on the student population. PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 7 PART I. AGENCY INFORMATION 2015 CDBG Capital Application B.4 Agency Service Profile. If your agency provides direct services, use the table below to indicate the total number of individuals, including family members, served by your agency during 2013 and 2014 according to the applicable income category. Yearly Income 30% Median 50% Median 80% Median Total number of Categories Very Low-Income Low Income Moderate individuals Income served For year 2012 38 16 63 For year 2014 20 15 9 We are still in the 2013 contract year, so we do not have complete data. For this purpose I am sharing 2012 data, and data from the first two quarters of 2013. We are also counting households and not individuals. Also note that contract requires measurements of 31-50% and 51-80% which is not consistent with this table. C. AGENCY PROGRAM EXPERIENCE C.1. Describe the length of time the agency has operated, date of incorporation, the purpose of the agency, and the type of corporation. Describe the type of services provided, the agency's capabilities, the number and characteristics of clients served, and required licenses to operate (if applicable). The City of Tukwila incorporated in 1908 and serves the residential and business community within its boundaries. A wide range of municipal services are provided, both mandated and discretionary according to the identified needs in the city. C.2. Briefly describe the agency's existing staff positions and qualifications, its capacity to carry out this activity, and state whether the agency has a personnel policy manual with an affirmative action plan and grievance procedure. Evie Boykan, Human Services Manager has managed CDBG funds since 1991 and has been involved with minor home repair services since 1999. In 2005, the cities of Tukwila and SeaTac joined together to offer a minor home repair program to their residents. We found we were able to serve many more households than our prior contracted partner. Later the cities of Covington and Des Moines joined. All cities participate in an interlocal agreement. Tukwila maintains a personnel policy manual and is an equal opportunity employer, and assures equal employment regardless of race, creed, color, etc. The City also maintains policies and procedures regarding grievances. D. AGENCY BACKGROUND INFORMATION D.1. Provide Agency's current adopted Mission Statement or Vision Statement: Vision— The City of opportunity, the community of choice Mission—To provide superior services that support a safe inviting, and healthy environment for our residents, businesses and guests. D.2. Agency Financial Management Profile ,. D.2.1 Audit: - OMB A-133 Provide a copy of the most recent A-133 Audit. Label it Attachment 2 D.2.2 Did your agency receive a cumulatively amount of$500,000 or more in federal funds in 2013? x_Yes No (If yes, please provide a copy of the Schedule of Expenditures of Federal Awards (SEFA). Label it Attachment 2.a SEFA PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 8 PART I. AGENCY INFORMATION 2015 CDBG Capital Application D.2.3 Does your agency anticipate receiving a cumulative total of$500,000 or more in federal funds in 2014? _x Yes No Please describe the source and purpose. This is spelled out in the SEFA schedule including Department of Agriculture, Department of Justice, Department of Transportation for everything from child and adult care food program, to block grant, to state criminal alien assistance program, public safety, highway planning and construction, etc. OR Audit(s) - Miscellaneous Financial Report(s) D.2.4. If an audit is not available, then a financial statement(s) that include General Ledger and Balance Sheet detail for the most recent one year period is required. Label as Attachment . D.3. Organization Chart - Provide a chart that outlines the level of authority associated with the implementation of a project if funds are awarded. This should reflect the front line person through to the authority who signs the Application and the Contract. Label as Attachment 3 _; _ D.4 Non-Profits or Special Districts —Additional Required Attachments ❑ Current List of Agency Board Members Attachment No 4.1 L Provide a current list of Agency Board of Directors: Include name, position/title, city residence, length of time on the Board, and expiration of terms. Note any vacant positions. ❑ Current Bylaws; Articles of Incorporation Attachment No 4.2 ❑ Copy of Non-Profit IRS Letter of Designation Attachment No 4.3 E. PROJECT PARTNER SPONSOR INFORMATION: (Applies to King County Housing Authority and King County Department Sponsored Projects only) E.1. General Agency Name: Mailing Address: City/State/Zip: Phone and Fax#: Web Site Address: E.2 Executive Director Name/Title: E-Mail: Phone and Fax#: E.3. If King County: (Division Director) Name/Title: Department: E-Mail: Phone and Fax#: Assigned Staff Contact Name: E-Mail: Phone and Fax#: F. CULTURAL COMPENTENCY PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 9 PART I. AGENCY INFORMATION 2015 CDBG Capital Application Housing and Community Development is making efforts to achieve cultural competency in the delivery of social services to populations of diverse ethnic, racial, religious, linguistic and other backgrounds. Most local agencies are already serving the needs of these diverse populations with great success. The concept of cultural competency seeks to extend these efforts to even better serve the diversity of people in our communities. • Definition of Cultural Competency: An ongoing and evolving process that comprises knowledge attainment and the development of behaviors, attitudes, policies, and practices that come together in a system of care enabling agencies, programs, and individuals to increase access to services and to develop or adapt services that are appropriate to specific cultural needs. • Cultural competency implies a process, rather than a single point in time. Further, it requires the attainment of knowledge and skills that will help providers and programs work more effectively with people who have diverse backgrounds and experiences. Finally, cultural competence requires action to increase access and cultural adaptation based on what is learned about individuals and communities. • Cultural competency denotes a commitment to social change, accessibility to opportunity, and delivery of services that are relevant to the details of a household's particular cultural background. Please respond to the following questions: (Please answer all three questions one single page.) F.1 To the best of your ability please describe the diversity of people your agency currently serves in terms of the following categories: race, ethnicity, religious affiliations, language groups, sexual orientation, and disability (physical and psychiatric), We are one of the most diverse communities in the country. Over 70 languages are spoken in our school district. Non-Hispanic whites represent 54% of our population. We are home to people all over the world, being a popular resettlement community. We are home to multiple faith groups, and have one of the largest Mosques in the state. The disability information we have is from 2011-2012. 146 adults received disability lifeline assistance. We do not have data on sexual orientation. F.2 How are your agency's services constructed to meet the needs of its clients based upon their identity as a member of one or more of these groups? (Examples: give #'s of bilingual staff, access to interpreter services, or collaborations with specialized expertise from agencies that serve minority populations.) We work with specialized providers, language line and interpreters for city mandated interpretation and translation. We contract with providers such as Global to Local and Dynamic Language for targeted events and community engagement. We assist each other across departments to try and make our services as accessible as possible. F.3 Do you have a training strategy in place to achieve cultural competency? Please describe. We have received training from Cultures Connecting on cultural competency and awareness. We expect to continue receiving city-side training as well as individual departments taking advantage of department specific training. We have an internal, cross departmental working group that addresses this issue across the City. Resources: The following resources are available to increase your agency's ability to serve people of diverse backgrounds in a culturally competent manner: • Training opportunities are available through: minority Executive Directors Coalition (206) 325- 2542, or University of Washington School of Social Work. PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page PART I. AGENCY INFORMATION 2015 CDBG Capital Application On the web: http://cecp.air.orq/ • King County Resource: http://search.kingcounty.gov/search?utf8=%E2%9C%93&affiliate=kingcounty&query=cultural+c ompetency G. EQUITY AND SOCIAL JUSTICE King County, through the King County Strategic Plan, and U.S. Department of Housing and Urban Development (HUD), through Environmental Justice, strive to reach and serve citizens in a fair and equitable manner. "Equity" means all people have full and equal access to opportunities that enable them to attain their full potential. "Community" means a group of people who share some or all of the following: geographic boundaries, sense of membership, culture, language, common norms and interest. "Determinants of equity" means the social, economic, geographic, political and physical environment conditions in which people in our county are born, grow, live, work and age that lead to the creation of a fair and just society. Access to the determinants of equity is necessary to have equity for all people regardless of race, class, gender or language spoken. Inequities are created when barriers exist that prevent individuals and communities from accessing these conditions and reaching their full potential. For more information on Equity and Social Justice in King County, please visit: http://www.kingcounty.gov/exec/equity.aspx[Dm1] G.1 What methods or tools does your agency use to ensure that your service delivery is equitable? We have been pursuing multiple strategies to increase equitability in service delivery. The city's website is now available in multiple languages, and increasing numbers of departments are translating materials. We developed a Governing 101 training which has been used to train community members representing more language and culturally diverse residents to help them understand how the city works and how to get their needs met with different issues. We are increasing our community engagement efforts and sharing our success with local cities such as SeaTac. The parks and recreation department strategic plan is making some bold steps toward equitable services. They invited Project Feast, a small group that offers training to low income populations to learn food preparation and catering groups, to have an office at the Community Center. Their presence is introducing a new part of the community to the Community center.Our consultant from Cutlures Connecting is working with individual departments to identify the most appropriate training to be used. G.2 What steps could you take going forward to address barriers that could be identified that cause inequity in your service delivery? This is an on-going process that will take commitment, energy from representatives across all city departments. We expect that commitment to continue to be supported by Administration and City Council. • PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 11 PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application A. Eligibility Check Q the one activity that you have determined your project would best qualify under: HUD Priority CFR Matrix i Need I Check : Activity Citation Code Level Activity Community Facilities *Acquisition of Real Property 570.201(a) 001 Medium i ❑ Senior Centers I 570.201(c) I 03A High ❑ Handicapped Centers I 570.201(c) 03B .. . i High I 0 ` Homeless Facility (Not operation) I 570.201(c) I 03C High ; ❑ Youth Centers ; 570.201(c) 03D High ❑ Neighborhood Facilities I 570.201(c) 03E i High ❑ Child Care Centers 570.201(c) i 03M High i ❑ Fire Station/Equipment , 570.201(c) 030 -- ❑ Health Facilities 570.201(c) I 03P : High 1 ❑ Abused and neglected Children Facilities i 570.201(c) I 03Q -- ❑ Facilities for AIDS Patients (Not Operation) I 570.201(c) I 03S I -- ❑ Other-**Removal of Architectural Barriers 1 570.201 Parks Parks, Recreational Facilities , 570.201(c) i 03F High ❑ Tree Planting 570.201(c) I 03N ... i -- I ❑ Public Infrastructure Solid Waste Disposal Improvements 570.201(c) 03H ; High ❑ Flood Drainage Improvements 570.201(c) i 031 High ❑ . Water/Sewer Improvements 570.201(c) i 03J High i ❑ Street Improvements i 570.201(c) 03K High ❑ Sidewalks I 570.201(c) i 03L High I ❑ Other- **Removal of Architectural Barriers 570.201 Miscellaneous Minor Home Repair , 570.202 14A High Ei ©❑ Non-residential Historic Preservation 16B -- ❑ ED Direct Financial Assistance to For-Profits 570.203 1 18A -- ❑ Micro-Enterprise Assistance 570.203 I 18C : Medium j ❑ *Acquisitions of real property are for high priority facility and infrastructure projects and goals are contained within the goals for those two areas. **As associated with one of the activities noted above it.' A.1 Provide (in narrative) why you feel the project falls within that category. Self explanatory P 1 T I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application B. National Objective B.1 AREA BENEFIT L/M Income Area Benefit For these purposes, an Area Benefit activity is an activity that is available to benefit all the residents of an area that is primarily residential. In order to qualify as addressing the national objective of benefit to L/M income persons on an area basis, an activity must meet the identified needs of L/M income persons residing in an area where at least 51 percent of the residents are L/M income persons. The benefits of this type of activity are available to all residents in the area regardless of income. For example, typical Area Benefit activities include: ❑ Street improvements, ❑ Water and sewer lines, ❑ Neighborhood facilities, and ❑ Facade improvements in neighborhood commercial districts. The requirement that an area benefit activity must qualify on the basis of the income levels of the persons who reside in the area served by the activity is statutory. (See section 105(c)(2) of the Housing and Community Development Act of 1974 as amended.) This means that the activity may not qualify as meeting the L/M income area benefit national objective on any other basis. For example, if the assisted activity is a park that serves an area having a L/M income concentration that falls below the required percentage, the activity may not qualify even it there is reason to believe that the park will actually be used primarily by L/M income persons. Determining the Service Area The inclusion or exclusion of a particular portion of the grantee's jurisdiction can make the difference between whether the percentage of L/M income residents in the service area is high enough to qualify under the L/M Income Benefit national objective. The principal responsibility for determining the area served by an activity rests with the grantee. HUD will generally accept a grantee's determination unless the nature of the activity or its location raises serious doubts about the area claimed by the grantee. The area that the grantee determines will be served by an activity need not be coterminous with census tracts-or other officially recognized boundaries, but it is useful if it reasonably coincides with such boundaries because of the need to consider census data in the area, as discussed later in this section. It is critical, however, that the service area determined by the grantee be the entire area served by the activity. This means that, even though a predominantly L/M income neighborhood may be one of several neighborhoods served by an activity (e.g., a grocery store) the percentage of L/M income persons in the total area served by the activity is considered for this purpose. B.1.2 Define the service area. Briefly describe how the boundaries of the service area were determined. The service area includes the jurisdictional boundaries of the identified cities of Tukwila, SeaTac, Des Moines and Covington. Staff from these cities identified interest and the capacity to be able to implement the program. PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 13 • PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application B1. National Objective — Area Benefit There are two ways to qualify for Area Benefit. Check Q the box and provide the information which supports the method of qualification that demonstrates how your proposed activity meets this national objective: ❑ B.1.3. Area Benefit/Census Tract(s) \and Block Group(s) and number of residents in Service Delivery Area. (Consult with HCD Staff to obtain HUD formula census data.) List ALL applicable Census Tracts and Block Groups along with the pertinent number of low/mod persons associated with the area. PART Ill Excel Workbook -- TAB 1. "B.1.3 Census Data" 1) Provide the completed worksheet as hard copy labeled "TAB 1", and 2) Provide the entire Excel VVorkbcck as an attachment to your e-mail when you electronically submit your application to Kathy Tremper. (Kathy tremnerg kingcounty„.gov). Refer to Application Submittal Instructions ❑ B.1.4. Area Benefit/ Survey of Residents in Defined Service Delivery Area If a grantee has reason to believe that the available census data does not reflect current relative income levels in an area, or where the area does not coincide sufficiently well with census boundaries, HUD will accept information obtained by the grantee from use of a special survey of the residents of the area. The grantee must obtain HUD's approval of the survey instrument and other methodological aspects of the survey for this purpose. HUD will approve the survey where it determines that it meets standards of statistical reliability that are comparable to that of the Decennial Census data for areas of similar size. HUD requires documenting the following Survey Results in the Low and Moderate Income Worksheet to determine level of eligibility: Complete this table if the National Objective is determined via the Survey Instrument methodology. Action Required Expected (Assuming 95% Confidence Level) 1 Number of Families in Project Service Benefit Area 2 Number of families interviewed (surveyed) 3 Number of persons in the families interviewed 4 Number of persons in the families interviewed who are low and moderate-income persons 5 Divide Line 4 by Line 3 6 Multiply Line 5 by 100. This is % of LMI persons in ok service area * Assuming 2.59 persons per household PAR� 4 I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application B.2. National Objective - Limited Clientele Activities Benefiting Low/Moderate Income Persons A Low/Moderate income limited clientele activity is an activity which provides benefits predominantly to low to moderate-income persons rather than everyone in an area generally. It may benefit particular persons without regard to the area in which they reside, or it may be an activity which provides benefit on an area basis but only to a specific group of persons who reside in the area. In either case, at least 51% of the beneficiaries of the activity must be documented Low to Moderate income persons. Check Q the one box below in Section B.2 that supports the method of qualification that demonstrates how your proposed activity meets the Limited Clientele national objective ❑ B.2.1 Presumed Benefit- To qualify under this subcategory, a limited clientele activity must meet one of the following tests: Exclusively benefit a clientele who are generally presumed by HUD to be principally UM income persons. The following groups are currently presumed by HUD to be made up principally of L/M income persons: abused children, elderly persons, (defined as 62 years of age and older) battered spouses, homeless persons, adults meeting Bureau of Census' definition of severely disabled persons*, illiterate adults, persons living with AIDS, and immigrant farm workers. (Note: this presumption may be challenged in a particular situation, if there is substantial evidence that the persons in the actual group that the activity is to serve are most likely not principally L/M income persons.) * The census definition of"severely disabled" follows: Persons are classified as having a severe disability if they: (a) used a wheel-chair or had used another special aid for six months or longer; (b) are unable to perform one or more "functional activities" or need assistance with an "ADL or IADL"; (c) are prevented from working at a job or doing housework; or (d) have a selected condition including autism, cerebral palsy, Alzheimer's disease, senility or dementia, or mental retardation. Also, persons who are under 65 years of age and who are covered by Medicare or who receive SSI are considered to have a severe disability. Note: For purposes of this definition, the term "functional activities"includes seeing, hearing, having one's speech understood, lifting and carrying, walking up a flight of stairs, and walking. An ADL is an "activity of daily living" which includes getting around inside the home, getting in or out of bed or a chair, bathing, dressing, eating, and toileting. An IADL is an "instrumental activity of daily living"and includes going outside the home, keeping track of money or bills, preparing meals, doing light housework, and using the telephone. It should also be noted that the so-called "presumed" categories were modified in the regulations in 1995. A new group has been added: "persons living with AIDS." The former category of"handicapped persons" has been replaced with "severely disabled adults." This latter change was made for two reasons. First, the PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 15 PART U. FEDERAL REQUIREMENTS 2015 CDBG Capital Application word "persons" was replaced with "adults" to make it clear that an activity designed to treat handicapped children would not qualify for the presumption, because HUD has been unable to find evidence that the majority of handicapped (or even severely disabled) children are members of a L/M income family. Moreover, the term "handicapped" has been replaced with "severely disabled" (which now will use the census definition of that term). This change was made because the term "handicapped" has been used in so many different ways for different Federal programs and has taken on a much broader meaning than had been envisioned when it was originally introduced as a "presumed" L/M income group for CDBG purposes. A review of census data supports the presumption that adults (but not children, as mentioned above) having severe disability are predominantly L/M income persons. ❑ B.2.2. Self-Certification of Income. Require information on family size and income so that it is evident that at least 51% of the clientele are persons whose family income does not exceed the L/M income limit. (This includes the case where the activity is restricted exclusively to UM income persons). Reference:§570.208(a)(2)(i)(B)and(C) An example of the current HUD Income Guidelines are found in the following table. Income guidelines are adjusted annually by the United States Department of Housing and Urban Development. Please contact County staff for technical assistance and guidance if you need additional information or clarification of required report documentation if funds are awarded for your project. 2014 HUD INCOME GUIDELINES Median Family Income =$88,200 Effective January 1, 2014 30% MEDIAN 50% MEDIAN 80% MEDIAN FAMILY VERY MODERATE SIZE LOW-INCOME LOW-INCOME INCOME 1 $18,550 $30,900 $44,750 2 $21,200 $35,300 $51,150 3 $23,850 $39,700 $57,550 4 $26,450 $44,100 $63,900 5 $28,600 $47,650 $69,050 6 $30,700 $51,200 $74,150 7 $32,800 $54,700 $79,250 8 $34,950 $58,250 $84,350 ❑ B.2.3. Nature / Location. Be of such nature and in such location that it may reasonably be concluded that the activity's clientele will primarily be L/M income persons (e.g., a day care center that is designed to serve residents of a public housing complex). Reference:§570.208(a)(2)(I)(D) ❑ B.2.4. Removal of Architectural Barrier. Be an activity that serves to remove material or architectural barriers to the mobility or accessibility of elderly persons or of adults meeting the Bureau of the Census' Current Population Reports definition of "severely disabled," provided it is restricted, to the extent practicable, to the removal of such barriers by assisting: - the reconstruction of a public facility or improvement, or portion thereof, that does not qualify under the L/M income area benefit criteria; - the rehabilitation of a privately-owned nonresidential building or improvement that does not qualify under the L/M income area benefit criteria or the L/M income jobs criteria; or - the rehabilitation of the common areas of a residential structure that contains more than one dwelling unit and that does not qualify under the L/M income housing criteria. Reference: §570.208(a)(2)(ii) PA RGT I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application ❑ B.2.5. Self —Certification for Microenterprise. Be a microenterprise assistance activity carried out in accordance with the provisions of§570.201(o) with respect to those owners of microenterprises and persons developing microenterprises assisted under the activity during each program year who are low- and moderate-income persons. (Note that, for these purposes, once a person is determined to be L/M income, he/she may be presumed to continue to qualify as such for up to a three-year period. This would enable the provision of general support services to such a person during that three-year period, without having to check to determine whether the person's income has risen.) Reference: §570.208(a)(2)(iii) Because of certain statutory limitations, the regulations preclude the following kinds of activities from qualifying under the limited clientele category but qualify under the other statues: • Activities involving the acquisition, construction, or rehabilitation of property for housing, including homeownership assistance (these must qualify under the Housing subcategory, because of section 105(c)(3) of the authorizing statute); or • Activities where the benefit to L/M income persons is the creation or retention of jobs (these must qualify under the Jobs subcategory with certain exceptions as noted under the previous area benefit section, because of the different presumptions provided under sections 105(c)(1)(C) and (4) of the authorizing statute). Definitions Low/Moderate Income Limited Clientele Section 102(a)(20) of the HCDA defines the term low- and moderate income persons' as families and individuals whose incomes are no more than 80 percent of the median income of the area involved. The 'area involved' is determined for the CDBG program the same way it is determined for the Section 8 Housing program. The 80% of median income figure is determined by HUD based on a four-person family and is adjusted upward or downward for larger or smaller families. A family is defined in the Entitlement program as all persons living in the same household who are related by blood, marriage, or adoption. An individual living in a housing unit that contains no other person(s) related to him/her is considered to be a one-person family for this purpose. Adult children who continue to live at home with their parent(s) are considered to be part of the family for this purpose and their income must be counted in determining the total family income. A dependent child who is living outside of the home (for example, students living in a dormitory or other student housing) is considered for these purposes to be part of the family upon which he/she is dependent, even though he/she is living in another housing unit. A household is defined in the Entitlement program as all persons occupying the same housing unit, regardless of their relationship to each other. The occupants could consist of a single family, two or more families living together, or any other group of related or unrelated persons who share living arrangements. Persons vs. households: It is important to note that, for all but one of the subcategories under this national objective, the test of meeting the objective of Benefit to L/M Income Persons is to be met based on L/M Persons. Only with the subcategory of L/M Income Housing must the test be met based on L/M Households. Elderly or Senior Citizen: According to HUD, you must be at least 62 years of age and meet one of the following three situations in order to qualify as an elderly household. In the first situation, you must be living alone or be the head of household or spouse of the head of household. The second situation requires two or more elderly people living together. In the third situation, an elderly person has a live-in aide. If a household has elderly people who do not meet any of the above three scenarios, then HUD does not consider it an elderly household. PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 7 PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application C. Project Benefit The Agency will be required to ensure that services provided with funding under this award are made available to residents of jurisdictions participating in the King County CDBG Consortium: On Tab 2 of PART I Worksheet, indicate number of residents that will be served in each of the noted communities. ALERTs ❑ A minimum of thirty percent of the total population served must be CDBG Consortium residents for a project application that is multi jurisdictional, including both CDBG Consortium and non- consortium jurisdictions; ❑ A CDBG Consortium funding award will be proportionate to the percent of consortium residents to be served for a multi-jurisdictional project application that serves CDBG Consortium and non- consortium residents. Table C.1 — Service Delivery: PART I Excel Workbook — TAB 2. "C.1 Service Delivery" 1) Provide the completed worksheet as hard copy labeled 'TAB 2", and 2) Provide entire Excel Workbook as an attachment to your e-mail when you electronically submit your applicatior to Kathy Tremper(Kathy.tremper(c),kingcountv.aov). Refer to Application Submittal Instructions C.1 Describe the method and source(s) used for collecting the data in the project benefit worksheet. History of prior contracts and projections around increase in construction costs. C.2 Provide boundaries of service delivery area in narrative form (describing natural boundaries or site street names, roads, etc.). A map is included to delineate boundaries of service delivery. C.3 Provide a map that outlines the area that will be served. Label it "Attachment 5". 1, PA 8 I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application D. ENVIRONMENTAL REVIEW **Note on Choice-Limiting Activities: From your application submittal date until the ER completion date, no "choice limiting" activities (including but not limited to entering contracts for, or undertaking the following actions: (such as property acquisition, clearing, grading, site prep, etc.) may occur. Undertaking such activities after application submittal could void the project's eligibility. Current Conditions: D.1 What is the current use of the site? All single family homeownership D.2. What are the current site natural conditions (trees, ground surface, etc.)? How developed (buildings, roads, etc.) is the site? Describe the surrounding area (commercial, residential, wooded, etc.). NA D.3. Identify the nearest natural waterbody (stream, lake, etc.). How far, and in which direction, is it from the project site? NA Endangered Species Act: D.4 How much of a net increase in impervious surface (ex: concrete/asphalt) will occur (if applicable)? NA D.5 Does a current stormwater system exist at the project site? Please explain. NA Archaeology: D.6 Will the project excavate or otherwise disturb soil? If so, to what depth and horizontal dimensions? (length x width x depth)? NA D.7 Of the soil disturbance, how much will be previously-disturbed soil? Will you be able to document this previous disturbance (ex: invoices showing previous excavation as part of utility installation) NA Toxics: D.8 Has a Phase I Environmental Site Assessment (or equivalent toxics review) been completed? (These are normally completed upon property purchase.) If so, on what date? NA D.9 Do any underground storage tanks (used to store oil/fuel) exist on, or adjacent to, the property? Did any exist in the past? If yes, please explain, include size of the tank(s). NA D.10 What was the previous use of this property? NA D.11 What is the use of properties surrounding the project property? NA Other Environmental Factors: D.12 Is the project located in a(n): (check and respond to all that apply) ❑ D.12.1 FEMA-designated floodplain? If so, please specify whether it's 100-year floodplain, 500- year floodplain or floodway*. If so, does your agency have flood insurance (please provide covered items, dollar amount and duration)? (*CDBG funds may not be used for projects located in a FEMA-designated floodway unless it's a functionally-dependent use, such as a bridge). ❑ D.12.2 Wetland? ❑ D.12.3 Ecologically-sensitive area? ❑ D.12.4 Designated Historic neighborhood? PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 9 PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application D.13 Identify any other environmental reviews or studies completed for this site. Studies:[Title ] Date Completed: SEPA [ Title 1 Date Completed: Other: [ Title ] Date Completed: D.14 Provide and label pictures of project site as follows: ❑ D.14.1 North ❑ D.14.2 East ❑ D.14.3 South and ❑ D.14.4 West. Place them a Word document format and label as Attachment No. 6. D.15 Go to King County i-map and parcel viewer and provide site information. • http://www.kingcounty.gov/operations/GIS/PropResearch/Parcel Viewer.aspx • Enter parcel #or address, or zoom using magnifying glass cursor 4 click "Districts & Development Report" and "Assessor's Data Report", print both and mark as Attachment 7 � D.15 Attach a specific site plan - label it "Attachment 8". D.16 Climate Change & Sustainability. HCD Completes a King County Sustainable Scorecard (http://your.kingcounty.qov/solidwaste/greenbuildinq/scorecard.asp) for awarded projects, as required by County Ordinance. In order to help us prepare a Scorecard, please answer the following as best you can: D.16.1 Generally, what project construction practices and/or features will minimize climate impacts and promote environmental sustainability? (Examples: green building materials, energy efficient design, pervious surfaces installed, proximity to mass transit, etc.) Our contractors use the most appropriate cost effective environmentally friendly materials. We have clients with chemical sensitivities, so we ask this information as part of our intake process. Most of our repair/maintenance activities are small and would not be relevant to mass transit issues, pervious surface installment, energy efficient design. D.16.2 Do you plan to obtain a third-party 'green certification' for this project? (e.g. LEED, Built Green, etc.) If so, which one? For more information see: http://www.kingcounty.gov/property/permits/info/S iteSpecific/green/Resources.aspx no D.16.3 Does your agency/organization have a climate change plan (guidance on reducing impacts to, or adapting to the effects of, climate change)? If so, please explain Our Resolution 1649, passed in 2000 supports efforts to curb global warning and sets goals for reduction of green house gases.. If you need assistance with the Environmental Review Details section, please contact Randy Poplock at (206) 263-9099 or Randv.PoplockAkingcounty.gov. Continue to next page. PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 20 PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application E. RELOCATION DETAILS E.1 Is there Acquisition involved in any aspect of the project? ❑ Yes x❑ No (This includes Right of Way acquisition associated with infrastructure projects.) If your answer is No for E.I —move on to the next page of the application. E.2 Will this project involve: Residential tenant relocation? El Yes x❑ No Commercial tenant relocation? ❑ Yes x❑ No E.3 Type of Relocation Residential: ❑ Permanent El Temporary Commercial: El Permanent ❑ Temporary Briefly describe anticipated relocation needs and how they will be addressed E.4 What requirements or guidelines govern your relocation plan? (Check all applicable) ❑ Uniform Relocation Act ❑ Section104 [d] El Washington State Department of Transportation El Other (please specify): E.5 Are there tenants in the facility at this time? ❑ Yes❑ No E.6 Have you developed a relocation plan for this project? ❑ Yes El No E.7 How many tenants will need to be relocated in this project? Residential Commercial E.8 Have you provided notices to the tenants indicating the type El Yes ❑ No of displacement and benefits provided to tenants? E.9 Have you identified replacement or temporary units ❑ Yes El No for those who will be displaced? E.10 Have you determined the tenants' relocation benefits? El Yes El No E.11 Have you included the total relocation budget ❑ Yes El No in the development budget under relocation? Attachments (use colored separator sheets between documents) E.12 Attach copies of notices required indicating the type of displacement and benefits provided to the tenants E.13 -Attach URA Checklist [HCD/CD URA FORM 1] If you feel your project activity does not trigger the Uniform Relocation Act, please indicate such. If you are unsure, please contact Wendy DeRobbio for technical assistance at the following contact information and for documentation concurring with your interpretation. PART I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page 2 PART II. FEDERAL REQUIREMENTS 2015 CDBG Capital Application If you need assistance with the Relocation Details section, please contact Wendy DeRobbio, Relocation Specialist, 206-263-9070; or wendy.derobbio(c�kingcounty.gov or Kathy Tremper, CDBG Coordinator, 2060263-9097; or Kathy.tremper @kingcounty.gov. Continue to Application Forms. Complete PART I and II for ALL applications and attach it to the appropriate PART from the options below, depending on the category of your project. SELECT THE APPROPRIATE PART Answer associated questions pertinent to the type of project you are seeking funds to complete. Limit your response to no more than one page in length to each question. Do not leave any question unanswered. Indicate 'Not Applicable' rather than leave a question blank. PART I - Title Page w/Signature Block PART II - Federal Requirements, Agency Information *Excel Workbook, Tab 1(For LMA Qualification Only) Tab 1 is the same on all Excel Workbooks Tab-2 Applies to all of the Categories. Tab 2 is the same on all Excel Workbooks PART III - Community Facility Category *Excel Workbook for Community Facility Category, Tabs 3-7; 8 if Acquisition PART IV — Public Improvements Category *Excel Workbook for Public Improvements, Tabs 3-5; 6 if Acquisition PART V — Park Projects Category *Excel Workbook for Park Projects, Tabs 3-5; 6 if Acquisition PART VI — Economic Development & Microenterprise Activities *Excel Workbook Economic Development & Microenterprise, Tab 3-4 Part VII — Minor Home Repair *Excel Workbook for Minor Home Repair, Tab 3-5 *Only one Excel Workbook is completed and submitted for an Application, the number of Tabs in the Workbook (the individual worksheets) vary depending on the category of Application. Required Attachments for PART I & II: PART I ATT I. Board or Council Approval to submit CDBG Application — Label it Attachment 1 ATT I. D2.1/D.2.2 —OMB A-133; D.2.1 SEFA (SEFA) or ATT I.D.2.3 General Ledger and Balance Sheet) Label it Attachment 2 ATT I. D.3 — Organization Chart— Label it Attachment 3 ATT I. D.4 - Non-Profits or Special Districts—Additional Required Attachments D.4.1- Current List of Agency Board Members Attachment No: 4.1 D.4.2 - Current Bylaws; Articles of Incorporation Attachment No: 4.2 D.4.3 - Copy of Non-Profit IRS Letter of Designation Attachment No. 4.3 PART II ATT II. C.2 -A detailed map that shows project site and identifies service delivery area. Label it Attachment 5 ATT II. C.3 - King County i-map and parcel viewer Label it Attachment 6 ATT II. D.14— Pictures of project site. Label it Attachment 7 ATT II. D.15 — Site Plan (if applicable). Label it Attachment 8 PARS I General Information/Agency Information and Part II Federal Requirements 2015 CDBG Capital Application Page