2018-2019 Community Compass_AppSumTemplate.xlsx

Instructions

Applicant Organization Name: Enter the legal name of the organization that is applying for funding via the FY 2019 Community Compass NOFA. This name must match the applicant's legal name on the Standard Form (SF) 424 submitted with the application.

Organization Description: Provide a brief description of the applicant organization in 350 words or less. Include in the description: organizational history, purpose and mission, years of service, housing-related technical assistance services provided, and agency web address for additional information. This description may appear in the press release issued by HUD announcing the awards in the event the applicant is funded through this NOFA.

Funding Source Requested by Fiscal Year: For each funding source, indicate “Yes” or “No” to note if the applicant is requesting funding for FY 2018 or FY 2019 or both years. The applicant must consider the funding sources and eligible activities that may or may not be available in FY2019, as per the direction in the NOFA.

Applicant Designation: Select “Yes” or “No” to the following designations related to the applicant: Disadvataged Business, Small Business, and Faith-Based.

New Applicant: Indicate with “Yes” or “No” whether or not the applicant organization has received a Community Compass TA award in the five (5) years prior to NOFA publication. Please consider only the awards where the applicant organization was a direct recipient.

Rating Factor 2 Responses: Review the four(4) Rating Factor 2 responses included with the application, and list each program/cross-cutting topic and corresponding HUD Office. Select the HUD Office first, and then select the program in the adjacent field.

Indirect Cost Rate (%): List the applicant's rate(s) from the Indirect Cost Rate attachment required by section IV.F. of the NOFA. If the applicant has never submitted an indirect cost rate proposal and wishes to use the de minimis rate, indicate 10% in this field.

Eligible Activity: For each eligible activity, indicate the number of activities completed in the five (5) years prior to the publication date of the NOFA.

For each HUD office and program/cross-cutting topic, select a number from "0" to "5", to indicate the capacity and the interest for the applicant organization as a whole. For this tab, “0” is no capacity or interest, and “5” is high capacity or interest. If the applicant has no capacity or interest in a particular topic, the applicant should indicate so with “0” instead of leaving the response blank.

List the staff persons, along with consultant and contractor persons with whom the applicant organization has entered a formal agreement to participate in an award under this NOFA. For each person identify the: name (first and last); organization name, city, state, zip, and DUNS; role (in relation to the applicant); and qualifications. For the qualifications narrative, provide a summary of the individual’s experience, expertise, and other qualifications relevant to the activities included in the Community Compass NOFA.

For each person listed, to add years of experience by HUD Office, use the '+' links above the column headers. This will expand and show the relevant programs/topics under that Office. To hide those programs/topics, use the '-' links.

Within each HUD Office, indicate the number of years of experience relevant to each program/topic. Include only whole numbers; do not include text or decimals. For this chart, one year means “10 months or more.” For instance, if a staff member has nine months of experience, that staff person would be considered to have zero years of experience; a contractor with 5 years 11 months of experience would be considered to have six years of experience; and a consultant with 3 years 4 months experience would be considered to have 3 years of experience.

Summary

Applicant Organization Legal Name (same as on SF-424)

Applicant Pre-award risk determination

Description of Applicant Organization

Total Funding Request Amount ($) (same as on SF-424)

New Applicant (Yes/No)

(depends on HUD Office selected)

Indirect Cost Rate (%)

Capacity and Interest

0 ERROR:#REF! ERROR:#REF! 0 0

0-5

0-5

0-5

0-5

0-5

0-5

Experience

Certifications

CERTIFICATIONS

The following certifications and assurances are agreed to by completing the Application for Federal Assistance, SF-424 line 21 which states: “By signing this application, I certify (1) to the statements contained in the list of certifications and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001).”

Failure to agree to the certifications and assurances using this template does not exempt the Authorized Officials or Applicant from making the appropriate certifications and assurance listed above.

Sheet1

Sheet6

image1.png