HOME PROGRAM /AFORDABLE HOUSING TRUST FUND HOUSING APPLICATION 1. Profile* Applicant Type Non-Profit For Profit Partnership CHDO. APPLICANT NAME: CEO: ADDRESS: PHONE: Tax ID Number: DUNS Number: CITY: STATE: ZIP: E-Mail: Contact Name: Phone: I, (name/title) of the organization listed above, am authorized to sign for the applicant and certify that the information contained in this application is correct and accurate.* Title: Fax: Signature (*Attach board resolution authorizing the application and funding request) Additional Information Requested: Date Woman- Owned Joint Venture Minority Owned : (explain) 2. Project Site Location(s)*: Census Tract: Site Address/Location: Congressional District: Locality: State: PA Zip: Municipality * Attach a location map, description of specific street or natural boundaries bordering site and available photographs. Aerial shots are encouraged. If multiple sites, provide information for each address. 3. Brief Project Description: Is Project Located within one mile of a public transportation center? Yes No 1
4. How will the assistance be used? Check Appropriate Item. (HOME/AHTF Eligible Activities) Acquisition/Rehabilitation/Homeownership Acquisition/Rental Acquisition/Rehabilitation/Rental Homeownership - Homebuyers Acquisition Group Home Conversion New Construction/Homeownership New Construction/Rental Tenant Based Rental Assistance (TBRA) CHDO Operating Expenses 5. The project or program must meet one of the following priorities as outlined in the 2015-2019 Five Year Strategic Plan (Please check all that apply) Rehabilitation of the current housing stock. Expand rental housing stock. Expand homeownership. Strategically use Tenant-Based Rental Vouchers (TBRA) through the HOME/AHTF program to address the needs of homeless populations and/or special needs populations. 6. Target Population: Income (check all that apply) At or below 30 % of Median Income At or below 50 % of Median Income At or below 60% of Median Income Number of Household (indicate number for each income level) Occupancy At or below 80 % of Median Income Families with minor children Single Adults Seniors : 7. PROJECT FUNDING REQUEST Total All Project Costs: Units at Completion: YWH Assisted Units: (Your Way Home YWH) HOME/AHTF Assisted Units: Total 2018 Funding Request: Include the dollar amount of all funding sources. How many units will be created? Your Way Home units for homeless or formally homeless residents of Montgomery County. (Can be included in the total number of HOME units.) Of the units listed above, how many units will be assisted with the HOME/AHTF funding? County per unit Maximum Subsidy Limit applies. Total funds requested from the HOME/AHTF program. 8. Project Narrative Attach a comprehensive description of this project. The narrative must specifically address each cost item identified in the project budget. In general, the narrative must include: A. Brief description of applicant s general activities, qualifications, etc. (This should only be a few paragraphs. Please do not include a complete history of the applicants achievements.) Tell us who you serve, what services are provided and an example of recent a activity supporting these claims. B. Specific needs/priorities to be addressed or improvements to be financed with this application request. (Identify the problem(s) that need to be resolved. Applicants must utilize the County s 2015 Consolidated Plan, the Analysis of Impediments and check the Planning Commission interactive website at http://webapp.montcopa.org/planning/dataportal/introduction.asp. Include backup documentation to prove the need/priority described. 2
C. Project Description - What is the actual project? (What do you plan to accomplish with this project, and how do you plan to accomplish it.) How will the County funds be utilized and what priority will this activity address? 1. Is there public transportation, if so, what is available and where. 2. Is the project located near employment centers, if so, explain. 3. Specify exactly what the County funds will address. Include a detailed budget outlining expense by line item. 4. (CHDO ONLY) If salary reimbursement is requested, the County wants to see line items at an hourly rate, amount of hours per week requested, etc. D. Expected Outcomes (Outcomes should be measurable, obtainable, clear, understandable, and valid. Examples of measurable outcomes include people counseled, buildings acquired, housing units built, etc.) E. Project Schedule and Key Milestones and Dates; include other program funding with dates of application and/or commitment, if applicable. A detailed project schedule must accompany this application, including key milestones and dates. For new construction projects the following must be addressed: Attach project completion schedule. (See below the Suggested timetable for project completion.) 2018 Milestones (Regulatory Maximum - four years) Site Secured December 30, 2019 Units Constructed and/or Rehabbed August 1, 2020 Units Resold 3 Suggested Deadline Dates Nine (9) months from date available for purchase. Units Rented Fully Occupied within 18 months of completion Project Completed August 31, 2022 F. Project Readiness: List the Current zoning of the Project site: Ownership of property Do you have Site control? Market study Appraisal Have you obtained: YES NO N/A Zoning Approvals? Attach evidence that the site is properly zoned for the proposed use or if a variance or exception is required, evidence that a request has been filed and a hearing date has been scheduled. Community Support Provide documentation from Municipal Authority Cost estimates Building permits Utility service confirmation Environmental audit Architectural plans/specs Survey Land development plans Construction contracts Title insurance Payment/Performance Bond Builder's risk insurance Worker's compensation/ employee Liability Insurance Comprehensive general liability Insurance Management plan Affirmative Marketing plan Are any units currently occupied? Attach copies of all supporting documentation for above responses (i.e. deed, sales agreement, option, outstanding mortgages, preliminary plans and specifications, scope of work, cost estimates, permits, utility confirmation letters, environmental studies, studies, insurance binders, etc.
9. Project Development Costs/Budget Attached as this Exhibit A (Indicate all project costs, including those not financed with Housing and Community Development funds. Please note that if the application is approved, the project budget becomes a binding part of the legal contract between the applicant and the County, so the projected figures must be as accurate as possible. Also, depending on the actual Housing and Community Development funding source, additional information may be required. ) Exhibit A (Provide completed form or similar type budget outline form) DEVELOPMENT COSTS TOTAL PER UNIT COST ACQUISITION Land Building Demolition : CONSTRUCTION General Appliances Structures Tap Fees Contingency RENOVATION General Construction SITE PREPARATION Parking Demolition Environmental Water/Sewer PROFESSIONAL SERVICES Builder Architect Legal Survey/Permits Engineering MISCELLANEOUS Appraisal 4
DEVELOPMENT COSTS TOTAL PER UNIT COST Market Study Credit Report Environmental Audit PHFA Fees Tax Fees Community Furnishings Rent-up Expenses CONSTRUCTION FINANCING Loan Interest Loan Fees Insurance PERMANENT FINANCING Loan Fee PROJECT RESERVES DEVELOPER S FEE OTHER OPERATING EXPENSES Salary Training COUNSELING TOTAL PROJECT COSTS 5
10. Sources of Funds - Attach this Exhibit B List the sources of financing and submit letter(s) of intent from the financial institution and any public entity providing the financing. Include source, amount, rate and term, and designate grant or loan. Date secured - when the secondary funds were granted. If secondary funds are not yet secured, please state the date of application and the word: PENDING and the date of application. Exhibit B (Provide completed form or similar type form) Sources of Funds Grant/Loan Amount Rate Term Date Applied Date Secured: Primary Financing Tax Exempt Bonds Taxable Bonds Conventional Applicant Contribution PHFA PennHOMES Secondary Financing CDBG State HOME Affordable Housing Trust Fund FHLBB PHFA - LIHTC* Foundations Grants CDBG State HOME Affordable Housing Trust Fund FHLBB Prior Year Grant Funds Syndication Proceeds General Partner Contribution Developers Fee Reinvested TOTAL SOURCES TOTAL PROJECT COST *LIHTC - Low Income Housing Tax Credits Miscellaneous please name the source Total sources should equal total project costs. 6
11. Basis of Costs Attach as Exhibit C Attach the appropriate items listed below to support your application. (Check all items enclosed.) Appraisal(s) Bids/Quotes Contractor Estimates Engineer Estimates Sales Agreement(s) Budget Justification Project Timeline Schedule 12 A. Income Projections (For Rental Housing provide the projections on chart below). If you have an income projection report/spreadsheet, please enclose your version instead of this chart. No. of B/R EFF No. of Units Avg. SF Monthly Rent Utility Cost Total Cost Housing (Includes Utilities) Income Target % Actual Tenant Payment Total Annual Income (Rental Revenue) 1 BR 2 BR 3 BR 4 BR Total 12. B Sustainability Attach sustainability chart (proforma) showing all years of affordability. All projections including maintenance, vacancy rates, contingencies, retainage etc. ) 13. Additional agency documentation (as applicable) Certification of Nonprofit (501 (3)) Articles of Incorporation By-Laws Partnership Type and Organizational Chart Most Current list of Board of Directors or Officers (CHDO s - include Directors information that can confirm required make-up of Board. If using a property address to certify please include census track and Block Group) Annual Operating Budget Affordability Period Sustainability Chart Most recent financial statement and audit For purchase property related documents (i.e., copy of agreement of sale, appraisal, inspections, site plan, floor plan, leases, photographs, zoning documents, etc.) For rehabilitation a copy of the deed, bids, relocation documents, etc. For rental - identify the entity that will be responsible for day-to-day management. The management agent should submit a resume that describes routine fair housing training provided to management staff. For rental A copy of the Owners, Developers or Sponsors Affirmative Marketing Plan 7
14. FOR CHDO USE ONLY: Is this a CHDO Project Activity? Yes No Name of CHDO? CHDO Tax ID: PROJECT TYPE What type of housing will you address? Type of Ownership: (Indicate who will own the unit/complex.) CHDO Activity Code: (Indicate if CHDO will own, sponsor or develop project) IS THIS REQUEST FOR A CHDO PROJECT LOAN: Yes No What is the Activity Type(s): 1-Rehab Only 2-New Construction Only 5-Acquisition & New Construction 3- Acquisition Only 4- Acquisition and Rehab 6- CHDO Operations Choose one: 1= Rental 2= Homeownership 3= Homeownership Rehab 1= Individual 2 = Partner 3 = Corp. 4 = Non-Profit 5 = Public 9 = 1 = Owned 2 =Sponsored 3 = Developer Is this activity in need of CHDO Operating Funds? Yes No CHDO OPERATING REQUEST Owner Address: Name: Total funds requested from the HOME/AHTF program. Attach all budget documentation, CHDO Board Affidavit, Recertification docs Address: City: State: Zip: Email Address: Phone: Property Address: (If different) Name: If scattered site, please include each address as a separate property. Attach additional site addresses to this form if known at time of application. Address: City: State: Zip: Phone: 15. Return Completed Application To: Denise Coletta Neuschwander, Program Coordinator Montgomery County Department of Health and Human Services Program Office: Housing and Community Development 1430 DeKalb Street, 5 th floor, Norristown, PA 19401 or PO BOX 311, Norristown, PA 19404-0311 Questions? Call (610) 278-3540 8