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APPLICATION FOR FEDERAL ASSISTANCE SF-424OMB Number: 4040 -0004 Expiration Date: 8/31/2016 Application for Federal Assistance SF-424 * 1. Type of Submission: Preapplication Application * 2. Type ❑ New Continuation of Application: * If Revision, select appropriate letter(s): 5: Other (specify) * Other (Specify): Application Changed /Corrected Substantial Amendment Revision * 3. Date Received: 4. Applicant Identifier: 5a. Federal Entity Identifier: 5b. Federal Award Identifier: 120492 State Use Only: 6. Date Received by State: 7. State Application Identifier: 1 8. APPLICANT INFORMATION: *a. Legal Name: City of Clearwater, Florida * b. Employer/Taxpayer Identification Number (EIN /TIN): * c. Organizational DUNS: 59- 6000289 0783073030000 d. Address: *Streets. Street2: * City: County /Parish: * State: Province: * Country: * Zip / Postal Code: 112 South Osceola Avenue Clearwater Pinellas FL: Florida I USA: UNITED STATES I 33756 -5106 e. Organizational Unit: Department Name: Division Name: Economic Deve'_opment /Hous'_ng Housing Division f. Name and contact information of person to be contacted on matters involving this application: Prefix: Middle Name: * Last Name: Suffix: 6r * First Name: Charles I - ane Title: Assistant Director Organizational Affiliation: * Telephone Number: 727 - 562 -4023 Fax Number: 727 - 562 -4037 * Emaii: Ic:_arles.'ane ryc'.earwater.co -. Application for Federal Assistance SF -424 * 9. Type of Applicant 1: Select Applicant Type: C: City or Township Government Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): * 10. Name of Federal Agency: US Department of Housing and Urban Development 11. Catalog of Federal Domestic Assistance Number: 14.239 CFDA Title: __one Investment Partnerships Program * 12. Funding Opportunity Number: *Title: 13. Competition Identification Number: Title: 14. Areas Affected by Project (Cities, Counties, States, etc.): Eligible Areas. jpg t,. ^,, aur;,3,4n�t Delete Attachment View Attachment * 15. Descriptive Title of Applicant's Project: Home Investment Partnerships Program Attach supporting documents as specified in agency instructions. Add Attachments 1 1 r;' elete s lto u i . r s � , enn ts . Application for Federal Assistance SF-424 16. Congressional *a. Applicant Districts Of: FL -013 * b. Program /Project FL -013 Attach an additional list of Program /Project Congressional Districts if needed. Add Attachment J Delete Attachment View Machsnent 17. Proposed * a. Start Date: Project: 10/01/2016 * b. End Date: 09/30/2017 18. Estimated Funding ($): *a. Federal * b. Applicant * c. State * d. Local I * e. Other *f. Program Income *g.TOTAL 285,328.00 I 265,110.00 2, 684, 960.00 3,235,398.00 * 19. Is Application a. This application b. Program Subject to Review By State Under Executive Order 12372 Process? was made available to the State under the Executive Order 12372 Process for review on is subject to E.O. 12372 but has not been selected by the State for review. is not covered by E.O. 12372. c. Program * 20. Is the Applicant Yes If "Yes ", provide Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) i No explanation and attach Del vte Attachment V e * g<;z; 21. *By signing herein are true, comply with any subject me to this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements complete and accurate to the best of my knowledge. 1 also provide the required assurances ** and agree to resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency 1 ** I AGREE ** The list of certifications specific instructions. Authorized Representative: Prefix: Middle Name: * Last Name: Suffix: vr. * First Name: William, D. iorne, II *Title: City vanaaer * Telephone Number: 727 -562 -4046 Fax Number * Email. wi 11 i am. iiorne @n yclearwater . CO^ * Signature of Authorized Representative: % IA) * Date Signed: ' i, _ -1.o 1 = -. 1A CERTIFICATIONS In accordance with the applicable statutes and the regulations governing the consolidated plan regulations, the jurisdiction certifies that: Affirmatively Further Fair Housing -- The jurisdiction will affirmatively further fair housing, which means it will conduct an analysis of impediments to fair housing choice within the jurisdiction, take appropriate actions to overcome the effects of any impediments identified through that analysis, and maintain records reflecting that analysis and actions in this regard. Anti- displacement and Relocation Plan -- It will comply with the acquisition and relocation requirements of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended, and implementing regulations at 49 CFR 24; and it has in effect and is following a residential antidisplacement and relocation assistance plan required under section 1 04(d) of the Housing and Community Development Act of 1974, as amended, in connection with any activity assisted with funding under the CDBG or HOME programs. Anti - Lobbying -- To the best of the jurisdiction's knowledge and belief: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of it, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan. the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement; 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, it will complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; and 3. It will require that the language of paragraph 1 and 2 of this anti - lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. Authority of Jurisdiction -- The consolidated plan is authorized under State and local law (as applicable) and the jurisdiction possesses the legal authority to carry out the programs for which it is seeking funding, in accordance with applicable HUD regulations. Consistency with plan -- The housing activities to be undertaken with CDBG, HOME, ESG, and HOPWA funds are consistent with the strategic plan. Section 3 -- It will comply with section 3 of the Housing and Urban Development Act of 1968, and implementing regulations at 24 CFR Part 135. Signature /Authorized Official Date 11 — i I (o Specific CDBG Certifications The Entitlement Community certifies that: Citizen Participation -- It is in full compliance and following a detailed citizen participation plan that satisfies the requirements of 24 CFR 91.105. Community Development Plan -- Its consolidated housing and community development plan identifies community development and housing needs and specifies both short-term and long -term community development objectives that provide decent housing, expand economic opportunities primarily for persons of low and moderate income. (See CFR 24 570.2 and CFR 24 part 570) Following a Plan -- It is following a current consolidated plan (or Comprehensive Housing Affordability Strategy) that has been approved by HUD. Use of Funds -- It has complied with the following criteria: 1. Maximum Feasible Priority. With respect to activities expected to be assisted with CDBG funds, it certifies that it has developed its Action Plan so as to give maximum feasible priority to activities which benefit low and moderate income families or aid in the prevention or elimination of slums or blight. The Action Plan may also include activities which the grantee certifies are designed to meet other community development needs having a particular urgency because existing conditions pose a serious and immediate threat to the health or welfare of the community, and other financial resources are not available); 2. Overall Benefit. The aggregate use of CDBG funds including section 108 guaranteed Loans during program year(s) 2016 , (a period specified by the grantee consisting of one, two, or three specific consecutive program years), shall principally benefit persons of low and moderate income in a manner that ensures that at least 70 percent of the amount is expended for activities that benefit such persons during the designated period; 3. Special Assessments. It will not attempt to recover any capital costs of public improvements assisted with CDBG funds including Section 108 loan guaranteed funds by assessing any amount against properties owned and occupied by persons of low and moderate income, including any fee charged or assessment made as a condition of obtaining access to such public improvements. However, if CDBG funds are used to pay the proportion of a fee or assessment that relates to the capital costs of public improvements (assisted in part with CDBG funds) financed from other revenue sources, an assessment or charge may be made against the property with respect to the public improvements financed by a source other than CDBG funds. The jurisdiction will not attempt to recover any capital costs of public improvements assisted with CDBG funds, including Section 108, unless CDBG funds are used to pay the proportion of fee or assessment attributable to the capital costs of public improvements financed from other revenue sources. In this case, an assessment or charge may be made against the property with respect to the public improvements financed by a source other than CDBG funds. Also, in the case of properties owned and occupied by moderate- income (not low- income) families, an assessment or charge may be made against the property for public improvements financed by a source other than CDBG funds if the jurisdiction certifies that it lacks CDBG funds to cover the assessment. Excessive Force -- It has adopted and is enforcing: 1. A policy prohibiting the use of excessive force by law enforcement agencies within its jurisdiction against any individuals engaged in non - violent civil rights demonstrations; and 2. A policy of enforcing applicable State and local laws against physically barring entrance to or exit from a facility or location which is the subject of such non - violent civil rights demonstrations within its jurisdiction; Compliance With Anti - discrimination laws -- The grant will be conducted and administered in conformity with title VI of the Civil Rights Act of 1964 (42 USC 2000d), the Fair Housing Act (42 USC 3601- 3619), and implementing regulations. Lead -Based Paint -- Its activities concerning lead -based paint will comply with the requirements of 24 CFR Part 35, subparts A, B, J, K and R; Compliance with Laws -- It will comply with applicable laws. (0 B- 1if18- ifs Signature /Authorized Official Date ty Ma.nageY Title OPTIONAL CERTIFICATION CDBG Submit the following certification only when one or more of the activities in the action plan are designed to meet other community development needs having a particular urgency as specified in 24 CFR 570.208(c): The grantee hereby certifies that the Annual Plan includes one or more specifically identified CDBG- assisted activities which are designed to meet other community development needs having a particular urgency because existing conditions pose a serious and immediate threat to the health or welfare of the community and other financial resources are not available to meet such needs. � e464,14,(4_,---z it- l6- 1 b Signature /Authorized Official Date 2jl Manager Title Specific HOME Certifications The HOME participating jurisdiction certifies that: Tenant Based Rental Assistance -- If the participating jurisdiction intends to provide tenant -based rental assistance: The use of HOME funds for tenant -based rental assistance is an essential element of the participating jurisdiction's consolidated plan for expanding the supply, affordability, and availability of decent, safe, sanitary, and affordable housing. Eligible Activities and Costs -- it is using and will use HOME funds for eligible activities and costs, as described in 24 CFR § 92.205 through 92.209 and that it is not using and will not use HOME funds for prohibited activities, as described in § 92.214. Appropriate Financial Assistance -- before committing any funds to a project, it will evaluate the project in accordance with the guidelines that it adopts for this purpose and will not invest any more HOME funds in combination with other Federal assistance than is necessary to provide affordable housing; W ALA." (--t8-4 Signature /Authorized Official Date Cif 1 ii er Title APPENDIX TO CERTIFICATIONS INSTRUCTIONS CONCERNING LOBBYING: A. Lobbying Certification This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than S10,000 and not more than $100,000 for each such failure.