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Pima County Department of Community & Workforce Development Pima County Department of Community & Workforce Development (CWD) Pima County Community Development & Neighborhood Conservation FY2019-20 Community Planning Application CDBG ESG
By entering your initials here you certify this submission truthfully and accurately represents your application and is hereby submitted for review. Submission of this application does not, in any way, guarantee that your application will yield a favorable result.
Submission of this application also
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Program / Project Name
Amount Requested All CDBG and ESG requests must be above the minimum of $15,000. For Safe, Healthy & Green Set-aside requests, only a single award of a minimum of $100,000 and a maximum of $150,000 is available.
Applicant Information
First Name
Last Name
Telephone
Email
Address 1
Address 2
City
State/Province
ZIP+4/Postal Code
Country
Organization Information
(changes to this data will be reflected on all other applications for this organization)
Create an Organization
Your Pre-Application must be submitted AND approved before continuing.
Pre-Application
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All portions of the Pre-Application must be complete to submit. Applicants must submit the Pre-Application and receive approval from CDNC in order to access the Application, Budget, and Tables tabs. Approval of the Pre-Application does not guarantee approval of the full Application.
1. Describe your PROGRAM or PROJECT. Briefly describe your target population and how this PROGRAM or PROJECT will address their needs. Include the overall goal of the PROGRAM or PROJECT and expected outcomes.
2. Select the federal funding source for which you are applying.
3. What CDBG activity you are applying for that meets Community & Rural Development's priorities, goals, and objectives approved in Pima County's Five Year Consolidated Plan 2015-2019? If applying for multiple eligible activities, submit additional Pre-Application(s) for each.
4. What eligible ESG Program Component are you applying for? Select One. For “ESG Program Components” definitions, please see ESG Program Components Quick Reference: https://www.hudexchange.info/resources/documents/ESG-Program-Components-Quick-Reference.pdf
5. Public Service Applicants Only: Select the subcategory that best applies to your Program. Refer to the CDBG Matrix Codes & Definitions document in the Library for program details. If not applying for Public Service funding, select Not Applicable.
6. Subcontractors. Will your PROJECT or PROGRAM use subcontractors or 1099 employees to conduct proposed services. If yes, please provide a brief description.
7. Service / Target Area Pima County must prioritize HUD funding in Community Development Target Areas and within the jurisdictions as listed below. Please indicate which community(-ies) your PROGRAM or PROJECT proposes to primarily serve. Check all that apply.
8. Districts Served Check all that apply. Please copy and paste the following link for more information: http://webcms.pima.gov/UserFiles/Servers/Server_6/File/Map%20Room/SupervisorialDistricts/allpc_bosdist.pdf
9. Previous Year Pima County Federal Funding for this PROJECT or PROGRAM. Enter the amount of federal funding allocated to this Project or Program LAST YEAR (Fiscal Year 16-17). If not funded last year, enter "N/A."
10. Committed Match or Leveraged Funds Please enter dollar amount of match or leveraged funds committed to this Program or Project. PLEASE NOTE: ESG requests REQUIRE a 100% match budgeted to program. The Application Questions tab requests that other uncommitted resources be identified.
11. List the amounts and sources of matching funds for PROGRAM / PROJECT activities and budget line item(s). Include leveraged or matching funds.
12. Metrics. Please enter estimated number of unduplicated persons, households, families or businesses expected to receive/benefit from services/improvements with this specific funding request. Note that each HUD activity has a specific reporting unit. CDBG Public Service, Public Facilities, and Infrastructure units are "Persons." CDBG Home Repair units are “Households.”
CDBG Economic Development units are “Businesses” or “Jobs Created.”
ESG units are “Families."
13. If your AGENCY is applying to other Pima County funding sources for this PROGRAM or PROJECT, please list these sources and explain the reason(s) for multiple applications. Type "N/A" if question does not apply.
14. If you did not fully expend prior Pima County CDBG/ESG grant funds in the past three years, please provide the year, amount of unexpended funds, and a brief explanation. Type "N/A" if question does not apply.
15. Have you uploaded ALL required documents? Pre-Applications with missing or incomplete documents cannot be considered for approval. For school districts, fire districts, and government entities, upload a one page word document stating why organization is exempt from the 501(c)3 requirement
Current list of Board of Directors or Governing Body
Required
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501 (c)(3) Certification - Required for ALL nonprofit entities. (School and fire districts exempt).
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Evidence of Good Standing from the Arizona Corporation Commission - REQUIRED for all nonprofits. (Go to http://ecorp.azcc.gov/ and perform a search of your agency. Upload a screenshot of the "Corporate Status").
Required
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Certificate of Insurance (i.e. General Liability)
Required
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Fiscal Audit or Chart of Accounts
Required
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501(c)3 Exempt Statement
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* ZoomGrants™ is not responsible for the content of uploaded documents.
The Pre-Application deadline has passed.
This Pre-Application section must be submitted and Approved by the Administrator (not ZoomGrants) before you can fill out the rest of the application. Click the Submit Pre-Application button at the top or bottom of this tab to submit this section to be reviewed.
Your Pre-Application must be submitted AND approved before continuing.
Application Questions
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ALL sections of the Application, including the Budget and Tables tabs, must be complete. All applicable documents must be uploaded for Application to be considered for approval.
1. PROGRAM, PROJECT or SHG Set-Aside. Are you applying for a PROGRAM that provides services or a hard construction PROJECT?
*SHG Set-Aside is ONLY available to shelter and transitional housing providers assessed in Poster-Frost Mirto report. PROGRAMS include: All ESG components, Housing Rehabilitation, Public Service, Fair Housing, Relocation, and Economic Development. PROJECTS include Public Facilities, Infrastructure, Demolition, & Commercial Rehabilitation.
*See Library for details.
2. Has your agency conducted this PROGRAM in the past?
3. Provide a brief purpose statement summarizing your PROGRAM. Include target population, services provided, and expected outcomes. Please be clear and precise. If funded, this language will serve as the "Purpose Statement" in a Subrecipient contract with Pima County, and will be submitted to HUD's databases and the Board of Supervisors Agenda Summary.
4. PROGRAM NARRATIVE & SERVICE DELIVERY. Please provide a narrative describing how PROGRAM funds will address the target population’s needs and how they align with applicable HUD eligible activities. Describe the PROGRAM design, best practices employed/proposed, and why your organization selected this design for service delivery.
5. Briefly describe community outreach and recruitment efforts to effectively market the PROGRAM to the Target Population. Provide a description of the application process and how participants are prioritized to receive services.
6. Please describe your AGENCY'S collaboration efforts in the community that support this PROGRAM. Describe specific model.
7. Briefly describe your process to evaluate PROGRAM success and provide date of last program evaluation, if applicable. Please attach a copy of your last program evaluation template in the Documents tab.
8. Briefly describe your process to evaluate client satisfaction and provide date of last client survey, if applicable. All ESG and CDBG PROGRAMS are required to distribute client satisfaction surveys for federally funded services rendered. Please upload a client satisfaction survey template in the Documents tab.
9. Client Fees: Does PROGRAM charge fees for services to clients assisted. If "Yes," please upload applicable policy and fee schedule in Documents Tab.
10. Should this PROGRAM not receive the full funding amount requested, what measures will be taken to maintain the provision of services?
11. If PROGRAM is providing primary service delivery in the City of Tucson and the PROGRAM is not receiving City of Tucson funding, please describe why. Pima County must prioritize federal funding in unincorporated Pima County, City of South Tucson, and the Towns of Marana, Sahuarita, and Oro Valley. Investments in the City of Tucson must be justified.
12. In the last two years, has your PROGRAM undergone any substantial changes, or had any significant programmatic or fiscal monitoring findings? If yes, please provide an explanation and corrective actions. E.g., substantial changes to: facilities; management & key program/fiscal personnel; and, accounting, procurement, or program tracking systems. Significant findings identified in independent, single-audit/monitoring requiring corrective action.
13. A Picture is Worth 1,000 Words. Please provide a PROGRAM related client success story below and upload related pictures, as appropriate, in the Document Tab Section of this Application. Are pictures provided in the in the Document Tab of this Application? Please provide a brief client success story below that can be incorporated into federal reports:
14. PROGRAM Metrics Update. Estimate number of unduplicated served, per Area Median Income (AMI), that will benefit from your PROGRAM. NOTE: This submittal will serve as an update from the estimate provided in Pre-Application Question 11, Metrics. For housing PROGRMS enter Households served, for all others persons. The system will automatically total. See Library for description of HUD income guidelines. If funded, agency will be responsible to report quarterly on persons/households served.
15. Provide a brief purpose statement summarizing your PROJECT. Include target population that will benefit from capital improvements and expected outcomes. Please be clear and precise. If funded, this information will serve as the "Purpose Statement" in a Subrecipient contract with Pima County, directly inputted into HUD project setup databases, as well as, the Board of Supervisors Agenda Summary.
16. The 5-Year Service Commitment. CDBG requires agencies receiving funding for capital projects to conduct services or programing that benefit low- to moderate income persons for a minimum of 5 years. Describe the social services conducted at this facility receiving improvements or the households benefiting from public infrastructure upgrades.
17. PROJECT Persons Assisted Per Year. Estimate number of unduplicated persons, per Area Median Income (AMI), who will receive social services or programing at the facility. If funded, agency will be responsible to report quarterly on persons served. NOTE: This submittal will serve as an update from the estimate provided in Pre-Application Question, Metrics. The system will automatically total. See Library for description of HUD income guidelines.
18. Site Control. Does your agency own or rent the property where the PROJECT improvements will take place? If an "Other" arrangement, e.g. fire hydrants in public right-of-way, please elaborate in Question 21. A 5-year forgivable lien will be placed on the subject property to secure the federal investment and ensure programming. If renting, upload a letter from property owner acknowledging a commitment to a 5-year forgivable lien.
19. Subject Property Information. Provide the following information for the subject property where the PROJECT improvements will take place.
20. Existing Conditions. Describe current conditions at the Property that warrant this capital public improvement request.
21. A Picture's Worth a 1,000 Words. Provide and upload “before” pictures of facilities to be improved in the Document Tab Section of this Application. Did you upload pictures?
22. Property Map/Site Plan. Upload a Property Map, Site Plan, or Floor Plan clearly identifying project location/site of improvements relative to other buildings or rooms on site, it can be hand-drawn. Has the Property Map/Site Plan been uploaded into the Documents Tab section of this application?
23. Contractor Cost Estimate(s). CDBG facilities and construction projects require a "Cost Estimate" from a reputable contractor that incorporate Davis Bacon prevailing wages. Have you uploaded a Cost Estimate into the Documents Tab section? Note that if funded, you will be required to re-bid this project with the current wage decision for that time.
24. Scope of Work. List specific construction tasks, trade activities, and estimated costs to be completed if funded. (E.g. Electrical Panel Upgrade, $5000) E.g., Architectural and Engineering Services, Plans and Permits, Materials and Supplies, HVAC, Framing, Electrical, Plumbing, Installation of____,
25. Scope of Work. List specific PROGRAM activities for which funds are requested. If funded, this list will outline a the scope of work in a Subrecipient contract with Pima County. Note that listed activities should directly correspond to your proposed budget.
26. Project Time Line. Is the project shovel ready? Can it be completed within 9 months of the fully executed contract? Provide clearly-defined milestones for all activities. If the project needs building plans, what has the Agency done, to date, for this purpose? If the project needs building permits, where is the agency in the process of acquiring the permits?
27. Organizational Capacity. What is your organization’s experience and capacity procuring professional and contractor services per required Fair Labor Standards Act Provisions, i.e. Davis-Bacon prevailing wages Be sure to include your agency's experience and resources necessary to implement and manage the proposed rehabilitation project. Describe staff's roles, responsibilities, education, and identify the designated Project Manager for this project.
28. Operations and Maintenance. Describe agency's policies and procedures to operate and maintain improvements; in addition to, its long term maintenance plan for the on-going management of the property. Please upload any applicable sections of Board of Director's approved Operations and Maintenance Policies and Procedures in the Documents tab.
29. Capital / Replacement Reserve Plan. What is the agency’s plan to sustain and replace these improvements? Does agency have an adopted Capital Improvement Plan? Has it been regularly updated? Provide date plan was created or last updated. Outline the role of the Board of Directors has in overseeing capital facility investment policies. Upload applicable sections of approved Capital or Reserve policies and procedures in the Documents tab.
30. Should the proposed PROJECT not receive the full amount requested, how will your organization complete the PROJECT? Please describe briefly below.
31. Green Impacts to address Project Approach, Description, & Need. Describe how the SHG funds will be used to correct found deficiencies in the
PFM Assessment. How will the project impact the facility's affordability or sustainability? If there will be unmeet needs after a SGH investment, how will they be evaluated and prioritized by your organization.
32. Mass Shelter Housing Emphasis - Please provide the following information for Shelters only. For temporary, supportive, permanent, or affordable housing facilities please type "NA" in first field.
33. Temporary, Supportive, Permanent and Affordable Housing Emphasis - Please provide the following information for Non-Shelter facilities only. If apply for Mass Shelter facility type "NA" in first field. Please provide lead based paint information, if known.
34. SHG Collaborative Attendance facilitated by Habitat for Humanity Tucson. In the last 12 months, between October 1, 2016 and September 30, 2017, how many sessions has your agency staff attended?
35. Prior SHG Assistance. If previously funded please provide year, amount, facility name, and funder. E.g.: 2015 / $100,000 / The Community Shelter / City of Tucson
36. Will you subcontract any of the work for your program/project? If yes, upload the scope of work, contract details, and existing or proposed agreement.
Your Pre-Application must be submitted AND approved before continuing.
Budget
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Fill out ALL the below tables in relation to your ENTIRE PROGRAM or PROJECT Budget. Include all funding sources.
All Funding Sources and Revenue for PROGRAM/PROJECT
Item Description
Current FY 18-19
FY 19-20
Total $ 0.00
Total $ 0.00
PROGRAM Line Item Budget
For PROGRAMS ONLY, identify and budget for all anticipated costs for this request and other sources. Provide narratives for each budget line item request for funds in Tables Tab, PROGRAM BUDGET LINE ITEM DETAIL. If budgeting for indirect costs, please indicate in budget narrative if agency is using "de minimus" at 10% or an approved rate from a cognizant agency. Please upload approval from cognizant agency in the Documents tab. For construction PROJECTS, this table is not required. Type “N/A” into first budget line. However, there is a five-year commitment to provide services. Describe how your agency will meet this requirement to provide program services in the budget narrative below.
Item Description
THIS REQUEST
Other Sources Committed/Match
Other Sources Uncommitted
Total Program Budget
Total $ 0.00
Total $ 0.00
Total $ 0.00
Total $ 0.00
Budget Narrative (Discuss the items and amounts you entered above.)
For PROGRAMS, summarize each line item. This should match the items identified in PROGRAM expense budget. Identify number of FTE's created or retained as a result of funding. For PROJECTS, services are required for five years. Describe the services budget and how it accounts for personnel, operations, maintenance, etc., for that commitment.
Your Pre-Application must be submitted AND approved before continuing.
Tables
(answers are saved automatically when you move to another field)
To help you fill out the table below in relation to Outputs, please see Exhibit A in 'Exhibit A and B Output and Outcomes Definitions.' This document is listed under the Library section, above (scroll all the way up to top of page). To assist in completing this table, in the first column enter "Output Type," e.g. Childcare, Home Repairs, Public Facility Improvement. In the second column, enter "Unit of Measurement," e.g. hours, repairs, facility improvement. In the third column enter a numerical digit for the number of units, e.g. 22, 37, 420. In the fourth column, enter "Delivered to Whom," e.g. Unduplicated Individuals, Unduplicated Households. Finally, in the fifth column, enter numerical digit for those delivered services/improvements, e.g. 13, 1984, 8675309. The table will produce the product of (Number of Units) x (Number Delivered to Whom). **TOTALS ARE CALCULATED ON PAGE REFRESH** Enter your numbers, then use the Page Refresh button, above, to reload the page with calculated totals.
Note that all PROJECTS additionally require a Property Map/Site Plan, Project Construction Contractor Cost Estimates, Pictures, and Approved Operations and Maintenance Plans.
Property Map / Site Plan (For Improvement Project Only)
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Site Pictures (For Improvement Projects Only, but Program App pictures also welcome). For multiple pictures try consolidating into a PowerPoint and uploading that file. For those not uploading pictures, upload Word Doc titled, "Not Applicable."
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Program Evaluation Template
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Project Construction Contractor Cost Estimates
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Approved Operations & Maintenance Plans
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Approved Capital and or Replacement Reserve Plans
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Client Fee Policy and Fee Schedule
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Other
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Client Success Story Photos (optional). For multiple pictures try consolidating into a PowerPoint and uploading that file.
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Client Satisfaction Survey
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Subcontractor Supporting Documents
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* ZoomGrants™ is not responsible for the content of uploaded documents.
Extra
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If you are ready to have your answers reviewed,
add an entry to the Activity Log and request a Grant maker action.
Quarterly Report
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