LOCAL GOVERNMENT VERIFICATION OF CONTRIBUTION - GRANT FORM AND LOAN FORMFLORIDA HOUSING FINANCE CORPORATION
LOCAL GOVERNMENT VERIFICATION OF CONTRIBUTION— GRANT FORM
Name of Development: Woodlawn Trail
Approximately 1000 feet west of the intersection of S Martin Luther King Jr. Ave & Woodlawn St. and
Development Location: approximately 400 feet north of Woodlawn St. Clearwater, FL
(At a minimum, provide the address number, street name and city, and/or provide the street name, closest designated intersection and either
the city (if located within a city) or county (if located in the unincorporated area of the county). If the Development consists of Scattered
Sites, the Development Location stated above must reflect the Scattered Site where the Development Location Point is located_)
The City/County of Clearwater commits $ 75,000.00 as a grant to the
Applicant for its use solely for assisting the proposed Development referenced above. The City/County does
not expect to be repaid or reimbursed by the Applicant, or any other entity, provided the funds are expended
solely for the Development referenced above. No consideration or promise of consideration has been given
with respect to the grant. For purposes of the foregoing, the promise of providing affordable housing does not
constitute consideration. The commitment for this grant must be effective as of the Application Deadline for
the applicable RFA, and is provided specifically with respect to the proposed Development.
The source of the grant is: General Fund Reserves
(e_g , SHIP, HOME, CDBG)
CERTIFICATION
I certify that the foregoing infonnation is true and correct and that this coumnitment is effective at least through
the date required in the applicable RFA.
14.1m4kti 1 / William B. Horne, 11
Signature Print or Type Name
City Manager
Print or Type Title
This certification must be signed by the chief appointed official (staff) responsible for such approvals, Mayor. City Manager.
County Manager/Administrator/Coordinator, Chairperson of the City Council/Commission or Chairperson of the Board of
County Commissioners. If the contribution is from a Laud Authority organized pursuant to Chapter 380.0663, Florida
Statutes, this certification must be signed by the Chair of the Land Authority. One of the authorized persons named above
may sign this form for certification of state, federal or Local Government funds initially obtained by or derived from a Local
Government that is directly administered by an intermediary such as a housing finance authority. a community reinvestment
corporation, or a state- certified Com nnun ty Housing Development Organization (CHDO). Other signatories are not
acceptable. The Applicant will not receive credit for this contribution if the certification is improperly signed. To be
considered for points. the amount of the contribution stated on this form must be a precise dollar amount and cannot include
words such as estimated, up to, maximum of, not to exceed. etc.
If the Application is not eligible for automatic points. this contribution will not be considered if the certification contains
corrections or `white -out' or if the certification is altered or retyped. The certification may be photocopied.
Please note: This form may be modified by Florida Housing Finance Corporation per Section 67- 60.005. F.A.C.
(Form Rev. 08 -16)
FLORIDA HOUSING FINANCE CORPORATION
LOCAL GOVERNMENT VERIFICATION OF CONTRIBUTION — LOAN FORM
Nam.- of Development: Woodlawn Trail
Approximately 1000 feet west of the intersection of S Martin Luther King Jr. Ave & Woodlawn St. and
Development Location: approximately 400 feet north of Woodlawn St. Clearwater, FL
(At a minimum, provide the address number, street name and city, and/or provide the street name, closest designated intersection and either
the city (if located within a city) or county (if located in the unincorporated area of the county). If the Development consists of Scattered
Sites, the Development Location stated above must reflect the Scattered Site where the Development Location Point is located.)
The City /County of City of Clearwater , cell-units $ 75,000.00 (which may be
used as an FHFC Non - Corporation Funding Proposal in an Application for FHFC funding if it meets the
required criteria) in the form of a reduced interest rate loan to the Applicant for its use solely for assisting the
proposed Development referenced above.
The value of the contribution based on the difference between the face amount of the above- referenced loan and
the net present value of its payment stream_ inclusive of a reduced interest rate and the designated discount rate
(as stated in the applicable RFA) is: $75.000.00
No consideration or promise of consideration has been given with respect to the loan. For purposes of the
foregoing, the proinise of providing affordable housing does not constitute consideration. The commitment for
this loan must be effective as of the Application Deadline for the applicable RFA, and is provided specifically
with respect to the proposed Development.
CERTIFICATION
I certify that the foregoing information is true and correct and that this comnitrment is effective at least through
the date required in the applicable RFA.
William B. Home, II
Signature Print or Type Name
City Manager
Print or Type Title
This certification must be signed by the chief appointed official (staff) responsible for such approvals, Mayor, City Manager,
County Manager iAdtninistrator/Coordinator, Chairperson of the City Council/Commission or Chairperson of the Board of
County Conunissioners. If the contribution is from a Land Authority organized pursuant to Chapter 380.0663, Florida
Statutes, this certification must be signed by the Chair of the Land Authority. One of the authorized persons named above
may sign this form for certification of state, federal or Local Government funds initially obtained by or derived from a Local
Government that is directly administered by an intermediary such as a housing finance authority, a community reinvestment
corporation, or a state- certified Community Housing Development Organization (CHDO). Other signatories are not
acceptable. The Applicant will not receive credit for this contribution if the certification is improperly signed. To be
considered for points, the amount of the contribution stated on this fore must be a precise dollar amount and cannot include
words such as estimated, up to, maximum of. not to exceed, etc.
If the Application is not eligible for automatic points, this contribution will not be considered if the certification contains
corrections or `white -out' or if the certification is altered or retyped. The certification may be photocopied.
Please note: This form may be modified by Florida Housing Finance Corporation per Section 67- 60.005, F.A.C.
(Form Rev. 08 -16)