LOCAL GOVERNMENT VERIFICATION OF CONTRIBUTION - GRANT FORMFLORIDA HOUSING FINANCE CORPORATION
LOCAL GOVERNMENT VERIFICATION OF CONTRIBUTION — GRANT FORM
Name of Development Ashleigh Park
Development Location: 1511 S. Highland Avenue, Clearwater
(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 agrant 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 Funds
(e.g., SHIP, HOME, CDBG)
CERTIFICATION
I certify that the foregoing information is true and correct and that this commitment is effective at least through
the date required in the applicable RFA.
WA:4mA 6
William B. Home, I I
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 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 commrnity 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 o f 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 maybe modified by Florida Housing Finance Corporation per Section 67- 60.005, F.A.C.
(Form Rev. 08 -16)