Economic Revitalization (Commercial Hardening/Small Business)

Economic Revitalization (Commercial Hardening/Small Business) - Competitive Selection Application

General Description Form for Applicant
Applicant Name, Contact Person’s Name, Address, Phone Number, and E-mail address
Applicant Name*

PrefixFirst NameLast Name
Contact Person Name*

PrefixFirst NameLast Name
Physical Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Mailing Address*

Street Address or P.O. Box

Street Address Line 2

CityState

Zip CodeCountry
Phone Number*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email*
example@example.com

Please select one of following program activities:*

Commercial Hardening and Financing- are project activities geared to upgrade eligible commercial, industrial, and private buildings and return them to business use and ensure the ability for such facilities to operate during emergencies. Additionally, alternate harbor, marinas, and port sites are eligible for program funding.Small Business Mitigation-The goal of the program is intended to reduce/eliminate operational downtime to accelerate small business recovery from a natural or manmade disaster. Project activities under this program include dry floodproofing, emergency power, and communication resilience.
Project location. List property tax id number for the property related to the project activity.*

Name, Address, Phone Number and Email Address of Architectural/Engineering Firm: (if applicable)
Name: Architectural/Engineering Firm
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address

Street Address or P.O. Box

Street Address Line 2

CityState

Zip CodeCountry
Phone Number
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email
example@example.com

Name, Address, Phone Number and Email Address of Environmental Firm: (if applicable)
Name: Enviromental Firm
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address

Street Address or P.O. Box

Street Address Line 2

CityState

Zip CodeCountry
Phone Number
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email
example@example.com
Upload recent Environmental Review Record (if applicable).

Needed for coordination efforts related to the project design
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Project Competitive Selection Requirements:

Project Description – 15 Points (Information to be uploaded in this section)

Disclaimer: A satisfactory score does not determine eligibility for project funding

Describe in a narrative how your project meets the definition of a mitigation activity (per 84 FR 45840). Supporting documents may be included but not limited to photos, and other means of validation as a mitigation project.

Note: the following questions are to be answered within this subsection. If the subsection questions does not apply to your project, you may enter non-applicable. (add note and questions)
Briefly explain how the proposed project addresses the current and future risks identified in the THMP.*
Indicate how the proposed project will result in measurable and verifiable reductions in the risk of loss of life and property from future disasters and yield community development benefits. Support with measurable qualitative and quantitative data. *
How extensive is the proposed construction? What changes are to be made to the structure/land outlined in the application?*
Identify the proposed improvements, location of the proposed improvements and/or project (making sure to answer who owns the property, what is near and around i.e. landmarks, and where located), current size/capacity of and area served by the project, etc.*
Describe the existing conditions of the project site and how the project relates to existing infrastructure. *
Are there green infrastructure or other sustainability design components? For the purpose of completing this section, green infrastructure is defined as the integration of natural systems and processes, or engineered systems that mimic natural systems and processes, into investments in resilient infrastructure. Green Infrastructure takes advantage of the services and natural defenses provided by land and water systems such as wetlands, natural areas, vegetation, sand dunes, and forests, while contributing to the health and quality of life of those in recovering communities*
Describe how the project will focus on benefiting vulnerable lower-income people and communities and targeting the most impacted and distressed areas. Indicate whether the benefits will be direct and/or indirect. *
Identify who will retain ownership of the system/project deliverables after the completion of the project. Describe the method by which the applicant can ensure that adequate revenues will be available for long-term operation and maintenance of the proposed project. Please attach a draft of the O&M plan that identifies the sources and the estimated amount of funds that will be generated for this purpose for the useful life of project. *
If the property was built before 1978, is it exempt from lead-based paint abatement? If yes, list reason. If no, has the property been evaluated? Please indicate if the property needs remediation. Note: Attach record indicating year of construction and proof of exemption. (Below)*
File Upload

Attach record indicating year of construction and proof of exemption.
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For rehabilitation projects, has there been an evaluation of asbestos hazards? Does the property need Asbestos remediation? Note: Provide a copy of reports (Below)*
File Upload

Provide a copy of reports
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Project Impact – 15 points (Narrative to be uploaded in this section)

Disclaimer: A satisfactory score does not determine eligibility for project funding
How will this project benefit the town, a community or individual businesses?

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Project Plan – 15 Points (Narrative to be uploaded in this section)

Disclaimer: A satisfactory score does not determine eligibility for project funding
Describe the project plan and the long-term vision for the community. The narrative may also include mitigation measures/eco-friendly or environmentally aware/community lifeline.

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Project Viability – 15 Points (Narrative to be uploaded in this section)

Disclaimer: A satisfactory score does not determine eligibility for project funding
Evidence that the project can begin quickly and be completed within 24 months of contract approval and that those managing the project are qualified.

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Community Support – 15 Points (Documents to be uploaded in this section based on selection of A or B)

Disclaimer: A satisfactory score does not determine eligibility for project funding
Select one of the following:*
File Upload

(Documents to be uploaded in this section based on selection of A or B)
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Cost Estimate – 10 Points (Documents to be uploaded in this section contractor cost estimates minimum of 3)

Disclaimer: A satisfactory score does not determine eligibility for project funding

Note: CDBG-MIT will conduct a cost-reasonableness analysis to verify cost-estimates.
File Upload

(Documents to be uploaded in this section contractor cost estimates minimum of 3)
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Sustainability - 15 Points (Both A & B are to be uploaded)

Disclaimer: A satisfactory score does not determine eligibility for project funding
(A) Provide an outline of how program activities will continue to have positive impact after the end of the project and meet the identified Community Lifeline.

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(B) Provide a maintenance plan that details sustainability for 8 years after project-completion. High Level Budget

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Compliance and Monitoring (CAPACITY ASSESSMENT)
Business License and/or Corporate Documents

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Deed of Ownership and/or Letter of Authorization of Site Control

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If Applicable, BusinessCorporationGovernment Policies and Procedures

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Data Universal Numbering System (DUNS) (if applicable)
Unique Entity ID (if applicable)

Overall Budget Format (Enter Overall Budget in Table Below)*

	Amount	Funding Source	Status of Funds
CDBG-MIT
Local Funds
Private Funds
Insurance Proceeds
Federal Funds
Other Funds

TOTAL FUNDS

Detailed Budget Information (Enter Detail Budget Information below)*

	CDBG-MIT BUDGET	OTHER SOURCES OF FUNDS (PT 1)	OTHER SOURCES OF FUNDS (PT 2)	OTHER SOURCES OF FUNDS (PT 3)	TOTAL COST
Project Cost Direct
-
-
-
-
-
Subtotal Project Cost (Direct)
-
-
-
Total Project Cost
-
-
-
-
-
-
TOTAL

AUTHORIZATION
In the event that the VIHFA or HUD determines that any funds were expended by the Subrecipient for unauthorized or ineligible purposes or the expenditures constitute disallowed costs in any other way, then VIHFA or HUD may order repayment of the same. The Subrecipient shall remit the disallowed amount to VIHFA within thirty (30) days of written notice of the disallowance.

I certify that all information provided as part of this application is true and correct to the best of my knowledge. I agree to substantially abide by the above budget in the utilization of funds provided under this Subricipeint Agreement. I certify under penalty of perjury that: (1) the information provided in this Community Development Block Grant Mitigation Project application is true and correct as of this date and that any intentional or negligent misinterpretation may result in civil liability, including monetary damages, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et. seq.; and (2) the property will not be used for any illegal or prohibited purpose or use.
Organizational Head
Name*

First NameLast Name
Official Title*
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Economic Revitalization (Commercial Hardening/Small Business) - Competitive Selection Application

AUTHORIZATION

Organizational Head