22-Exhibit 1 - Application Form.pdf

Exhibit 1

APPLICATION FORM – EVICTION ADVOCACY PROGRAM

Contents Office of Housing and Community Empowerment – Eviction Advocacy Program

Organization Information

Section 1 – Application Attachments

Required Documents -

Section 2 – Organizational Capacity Evaluation

Section 3 – Historic Narrative

Section 4 – Program Work Plan and Activities

Section 5 – Program Evaluation

Section 6 – Budget and Budget Narrative

Section 7 – Additional Acknowledgements

Required Acknowledgements

Office of Housing and Community Empowerment – Eviction Advocacy

Program This form is intended for Proposers who are applying to serve as subrecipients to provide financial empowerment centers services. Proposers should review the Request for Proposals (RFP) to understand the required scope and services sought and for information on all required documents and submission.

There are no minimum or maximum numbers of characters for any of the questions included in this form.

Organization Information Organization Name Click or tap here to enter text.

Organization Website Click or tap here to enter text.

Application Contact Name Click or tap here to enter text.

Email Address Click or tap here to enter text.

Phone Number Click or tap here to enter text.

Secondary Contact Name Click or tap here to enter text.

Email Address Click or tap here to enter text.

Phone Number Click or tap here to enter text.

Organization Mission Click or tap here to enter text.

Note: This application form is only for a single service category. If requesting funds for multiple service categories, the proposer must submit a separate application form and budget worksheet for each.

Section 1 – Application Attachments

Required Documents -

Exhibit 2 – Budget Form ☐ Exhibit 3 – Organization Information ☐ Exhibit 4 – Board Information ☐ Exhibit 5 – Summary of Qualifications ☐ Exhibit 6 – Budget Revision Form ☐ Exhibit 7 – Statement of Services Form ☐ Federal Tax-Exempt Status Affirmation Letter / IRS

Determination

Articles of Incorporation, Bylaws ☐ Unaudited Financial Statements ☐ Audited Financial Statements ☐ Single/Program Audit ☐ Texas Secretary of State Business Search Database

Screenshot

Federal IRS Form 990 ☐ Certificate of Insurance (see Attachment C) ☐ Suspension/Debarment Certification Form (Exhibit 8-required upon award)

Organizational Chart/Structure (Entire Agency) ☐ Organizational Chart/Structure (Divisions/Section/Program

Level)

Board Minutes – 3 Prior Meetings ☐ Drug-Free Workplace Policy ☐

Section 2 – Organizational Capacity Evaluation Attach an agency-level organizational chart for your entire agency (if large or administering in multiple sites and locations) and a more detailed chart for program-level administration. For some agencies, a single chart may be sufficient. The organizational chart(s) document(s) should only list titles/functions and need not include individual staff names.

Provide the following information:

• Staff that are responsible for administering program and their qualifications (Required for consideration)

• How the organization or staff is uniquely qualified to provide the services

• Plan to fill any positions that need to be filled in order to administer programming

• Whether there are any state and/or local licenses required for the agency and/or staff to operate

• What training is required of and/or offered to the staff members providing services?

• How does the staff and leadership of the organization reflect the population being served?

• Does the organization meet the requirements set forth in the RFP?

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Application Evaluation Considerations for this Section:

• Does the organization demonstrate a track record sufficient to undertake the program?

• Does the organization have experience operating programming similar to that for which they are seeking funds?

• Does the organization have experience working with the population they intend to serve?

• Does the organization demonstrate that its staff and leadership reflect the population they intend to serve?

• Does the organization have the professional staff capacity to undertake and support the program services outlined in the application?

Section 3 – Historic Narrative Provide the following information:

• History and purpose of organization, including number of years in service

• Does the organization have at least 12 or 24 months experience of providing services similar to those sought in the solicitation?

• Past participation with the City on past or present City contracts

• List of past 5 years worth of contracts with the City and whether or not the organization met established targets for each; if targets not met, organization is welcome to provide an explanation

• Demographic information on past and current client population

• Experience working with the population to be served

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Application Evaluation Considerations for this Section:

• Does the organization demonstrate a track record sufficient to undertake the program?

• Does the organization have experience operating a grants administration program or grantmaking?

• Does the organization have experience working with the population they intend to serve?

• Does the organization have experience delivering the proposed programming?

• Does the proposal demonstrate that an investment in the organization will support leveraging of funds as outlined in the solicitation?

• Does the organization articulate the necessary collaborations and partners necessary for successful program implementation?

• Does the organization’s performance on past City contracts support awarding the organization funds?

Section 4 – Program Work Plan and Activities Provide the following information:

• Provide a narrative of the proposed Work Plan

• What are the program activities?

• What services will be delivered, and how do they align with the services sought in the RFP?

• Who are the eligible populations and how is this determined and confirmed?

• Who are the target populations and how will the service delivery prioritize required target populations?

• What is the best practice service delivery model or research-basis for the selected program design and how does the selected model best meet the needs of the target population?

• Include an outreach or marketing plans

• What is the timeline for service delivery?

• How will the organization layer or leverage funding received through this Proposal?

• Marketing and/or outreach plan to ensure client awareness of available programming

• Targeted populations, including service delivery location(s)

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Application Evaluation Considerations for this Section:

• Do the program activities and work plan demonstrate a plan that is reasonable and appropriate to deliver the proposed program services?

• Is it clear that the programming will deliver the desired scope of services and reach the desired target population(s) and communities?

• Does the Organization articulate a plan for outreach to potentially eligible clients with an emphasis on identified target populations?

• Did the organization outline client eligibility and how this is determined and confirmed?

• Did the organization articulate how the program targets the target populations identified in the solicitation?

• Does the organization outline outreach and marketing strategies to reach clients?

• Does the proposal demonstrate that an investment in the organization will support leveraging of funds – does the program layer with and leverage existing resources?

• Will the proposed program deliver services in community of concentrated poverty or high evictions risks/rates and/or in a way that is accessible to such communities?

• Did the organization articulate how the program prioritized individuals outlined as target population?

• Does the organization articulate how the program will minimize barriers to accessing assistance?

• Does the organization articulate the necessary collaborations and partners necessary for successful program implementation?

Section 5 – Program Evaluation Organization may choose to attach evaluation tools, intake forms and other documents in support of this section, including intake or client eligibility form. Additionally, the City will provide subrecipients with monthly and quarterly reporting forms.

Provide the following information:

• What are the organization’s target metrics for the proposed programs/services?

• Do the proposed target metrics (target outputs and target outcomes) align with the programming and demonstrate the impact of programming?

• What is the organization’s plan/process to document client eligibility / ensure programming is reaching eligible or targeted client populations?

• What is the organization’s plan to evaluate the effectiveness and impact of the program?

• Where relevant, the proposer may provide examples of evaluation tools or other documentation to demonstrate how the organization will track outputs, outcomes and performance

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Application Evaluation Considerations for this Section:

• Did the organization establish a set of output and outcome metrics and targets that are measurable, reasonable, and demonstrate the impact of the proposed programming and consistent with the requirements in the RFP?

• Did the organization submit an Evaluation Plan?

• Did the organization submit evaluation tools or other supporting documentation to demonstrate how it will track and report on outputs, outcomes and performance?

Section 6 – Budget and Budget Narrative Please provide the following information:

• Attach program budget (Exhibit 2)

• Include a written budget narrative that explains or justify by line item or cost category

• Include justifications for all staff fully or partially included within the budget

• Document budget alignment with outlined eligible expenses and applicable caps

• Will any funds be used to support evidence-based programming? If so, how much?

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Application Evaluation Considerations for this Section:

• Based on the Organization’s Program Budget, is the budget reasonable and appropriate to undertake and support the program services outlined in the Application?

• Are outlined expenditures eligible per RFP and program guidance?

• Did the organization agree to report in accordance with City requirements for this RFP? See below Required Acknowledgements.

• Will supporting the program contribute to the City’s collective goal of equitable service delivery?

Section 7 – Additional Acknowledgements In order to enable the aggregation of data across all partners and programs and to meet all applicable

Treasury reporting requirements, all Providers are required to report in multiple formats with varying frequencies. Similarly, the City is seeking to simplify outreach and application processes by utilizing a shared intake and application platform. The City will work with each Provider on the following items.

Please check each to affirm understanding of requirement:

Required Acknowledgements

Monthly Target Analysis dues monthly ☐ Direct Benefits / Demographics due monthly ☐ Request for Payments / Invoices due monthly ☐ Acknowledgement that services provided during periods of noncompliance or prior to contract execution may not be reimbursed