Response to Questions - SHS and Homeownership Programs.pdf

Healthy Families. Strong Communities.

P.O. Box 1510, 13930 S. Gain Street, Oregon City, OR, 97045‐0510 Phone (503) 655‐8267 Fax (503) 655‐8676 TDD 503‐655‐8639 www.clackamas.us/housingauthority

Housing Authority of Clackamas County

Addendum #1

Housing Authority of Clackamas County RFEI Affordable Homeownership Scattered Site Acquisition Program & Recovery Oriented Services Scattered Site Acquisition Program

Contents Response to Questions Property Interest Form for Homeownership program Property Interest Form for SHS program Lobbying Certificate Debarment Certificate Form HUD 5369-B: Instructions to Offerors Non-Construction

P.O. Box 1510, 13930 S. Gain Street, Oregon City, OR, 97045‐0510 Phone (503) 655‐8267 Fax (503) 655‐8676 TDD 503‐655‐8639 www.clackamas.us/housingauthority

Housing Authority of Clackamas County

Response to Questions

Q: Please send a copy of the required forms.

A: Attached are the following forms:

1. Property Interest Form for Homeownership program

2. Property Interest Form for SHS program

3. Lobbying Certificate

4. Debarment Certificate

5. Form HUD 5369-B: Instructions to Offerors Non-Construction

P.O. Box 1510, 13930 S. Gain Street, Oregon City, OR, 97045-0510 • Phone (503) 655-8267 • Fax (503) 655-8676

TDD 503-655-8639 www.clackamas.us/housingauthority

Housing Authority of Clackamas County

Scattered Site Property Interest Form

Organization Information Applicant Organization Name:

Applicant Contact Name:

Contact Email and Phone Number:

Property Information Minimum and Maximum Number of Properties Requesting: __________min _________max

Address(es) of Properties, if known (list):

Overall Approach Property Characteristics. If uncertain about specific properties, list general parameters (i.e.

jurisdiction, bedrooms, size of properties potentially interested in purchasing):

- Minimum number of bedrooms:____________________________________________________________

- Minimum number of bathrooms:___________________________________________________________

- Maximum purchase price per unit:__________________________________________________________

- Location Preferences, describe any that are applicable:

o In an incorporated city or in unincorporated Clackamas County:_______________________________ o Close to transit? (list max distance from transit stop)_________________________________ o Close to amenities? (list what types):______________________________________________ o City or jurisdictional preference:__________________________________________________

- Multiple units near each other important:________________________________________________

- Single family or multiplex:_____________________________________________________________

- Number of individuals proposed to be served per property:__________________________________

- Any other relevant information for consideration:___________________________________________

Please list anything else relevant to property selection:______________________________________

P.O. Box 1510, 13930 S. Gain Street, Oregon City, OR, 97045-0510 • Phone (503) 655-8267 • Fax (503) 655-8676

TDD 503-655-8639 www.clackamas.us/housingauthority

Housing Authority of Clackamas County

Scattered Site Property Interest Form

Organization Information Applicant Organization Name:

Applicant Contact Name:

Contact Email and Phone Number:

Property Information Minimum and Maximum Number of Properties Requesting: __________min _________max

Address(es) of Properties, if known (list):

Overall Approach Property Characteristics. If uncertain about specific properties, list general parameters (i.e.

jurisdiction, bedrooms, size of properties potentially interested in purchasing):

- Minimum number of bedrooms:________________________________________________________

- Minimum number of bathrooms:_______________________________________________________

- Maximum purchase price per unit:_____________________________________________________

- Location Preferences, describe any that are applicable:

o In an incorporated City or in unincorporated Clackamas County:________________________ o Close to transit? (list max distance from transit stop)_________________________________ o Close to amenities? (list what types):______________________________________________ o City or jurisdictional preference:__________________________________________________

- Multiple units near each other important:________________________________________________

- Single family or multiplex:_____________________________________________________________

- Number of individuals proposed to be served per property:__________________________________

- Any other relevant information for consideration:___________________________________________

(For Recovery Oriented Properties) Describe planned services and potential service partnerships:

Please list anything else relevant to property selection:______________________________________

Lobbying Certificate The Undersigned certifies, to the best of his or her knowledge and belief, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person 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, the undersigned shall complete and submit Standard Form – LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all sub awards at all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly.

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 $10,000 and not more than $100,000 for each such failure.

Signature: Date:

Name:

Title:

NOTE: CONTRACTORS ARE REQUIRED, PURSUANT TO FEDERAL LAW, TO INCLUDE THE ABOVE

LANGUAGE IN SUBCONTRACTS OVER $100,000 AND TO OBTAIN THIS LOBBYING CERTIFICATE

FROM EACH SUBCONTRACTOR BEING PAID $100,000 OR MORE UNDER THIS CONTRACT

Debarment Certificate

Regarding Ineligible Contractors

CERTIFICATION OF LOWER-TIER PARTICIPANTS REGARDING

DEBARMENT, SUSPENSION, AND OTHER INELIGIBILITY AND VOLUNTARY

EXCLUSION

The Lower Tier Participant (potential sub-grantee or sub-recipient under a HUD project, potential third party contractor, or potential subcontractor under a major third party contract) certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

(If the Lower Tier Participant (potential sub-grantee or sub-recipient under a HUD project, potential third party contractor, or potential subcontractor under a major third party contract) is unable to certify to any of the statements in this certification, such participant shall attach an explanation to this proposal.)

THE LOWER TIER PARTICIPANT (POTENTIAL SUB-GRANTEE OR SUB-RECIPIENT

UNDER A HUD PROJECT, POTENTIAL THIRD PARTY CONTRACTOR, OR

POTENTIAL SUBCONTRACTOR UNDER A MAJOR THIRD PARTY CONTRACT)

CERTIFIES OR AFFIRMS THE TRUTHFULNESS AND ACCURACY OF THE

CONTENTS OF THE STATEMENTS SUBMITTED ON OR WITH THIS

CERTIFICATION AND UNDERSTANDS THAT THE PROVISIONS OF 31 U.S.C.

SECTIONS 3801 ET SEQ. ARE APPLICABLE THERETO.

_ Signature and Title of Authorized Official

CHECK APPROPRIATE BOX:

[ ] The undersigned chief legal counsel for _ hereby certifies that has authority under State and local law to comply with the subject assurances and that the certification above has been legally made.

_ Signature of Participant’s Attorney

Date

[ ] Bidder or offeror does not have a chief legal counsel.