2015 Community Development Block Grant (CDBG) Letter of Intent

2015 Community Development Block Grant (CDBG) Letter of Intent Letters of Intent (LOI) must be received by Friday, July 22, 2016 at 12:00 p.m.

Please limit responses to the area provided. LOI’s can be hand delivered, mailed or emailed. Regardless of whether submitting hard or electronic copies please ensure the LOI is signed and dated. Also, make sure the Conflict of Interest form and all the attachments are included. A confirmation email will be sent to the contact person once the LOI is received.

Hand delivered LOI’s should be brought to:

9500 Civic Center Drive Planning Front Counter (1-story brick annex behind City Hall – west door)

Mailed LOI’s must be received by Friday, July 22, 2016 and should be addressed to:

City of Thornton Attention: Neighborhood Services – 2015 CDBG LOI 9500 Civic Center Drive Thornton, CO 80229

Emailed LOI’s should be sent to: [email protected] 2015 CDBG Letter of Intent

ORGANIZATION INFORMATION

Organization Name:

Address:

Name of Contact Person for this Letter of Intent:

Phone:

Email:

Agency Status:

Nonprofit organization Quasi-Governmental Agency

Housing Authority Community Housing Development Organization (CHDO) Governmental Agency

Provide a brief description of your organization’s purpose/mission:

GENERAL PROJECT INFORMATION

Amount of CDBG funds requested: $___

Provide a description of the project or program for which you are seeking funds, the project timeline and how you plan to expend funds. The Thornton community has identified which types of projects are a high priority (most important to address) and which are a low priority (not as urgent to address). Which priority need(s) does your project address? You may check more than one box if your project meets multiple priorities.  Housing Support the construction of new affordable housing (High)

Acquire housing for rehabilitation (High)

Rehabilitate owner-occupied housing (High)

Rehabilitate multi-family housing (High)

Provide financial assistance to purchase a home in Thornton (High)

Improve energy efficiency in existing housing (Low)

Support or develop housing for homeless (Low)

 Public Services Support employment training (High)

Support improved transportation services (High)

Support improved health services (High)

Increase or improve services for specific populations. (High)

Please identify which population(s) below: Seniors

People with disabilities

Homeless or near–homeless

Abused and neglected youth

Victims of domestic violence

People with substance abuse issues

Provide improved services for youth or childcare (Low) Screen for lead based paint hazards (Low)

Provide legal services (Low)

Education of crime awareness or prevention services (Low)

Provide housing counseling (Low)

Provide rental assistance counseling (Low)

 Public Infrastructure Flood and drainage improvements in a low-income residential neighborhood (i.e. retention ponds, catch basins) (High) Water and/or sewer improvements, must be to affordable housing or in low- income residential neighborhoods (Low) Residential street improvements i.e. lighting for safety (Low)

Streetscape improvements i.e. landscaping in rights of way (Low)

Residential sidewalk improvements i.e. missing sections, wheelchair accessibility (Low)

 Public Facilities

Acquire, construct or rehabilitate facilities for specific populations (Low)

Please identify which population(s) below:

Seniors

People with disabilities

Homeless or near–homeless

Abused and neglected youth

Victims of domestic violence People with substance abuse issues

Acquire, construct or rehabilitate health facilities i.e. physical or mental health

Acquire, construct or rehabilitate centers for youth or child care (Low)

Develop or improve recreational/library facilities or parks (Low)

 Economic Development that Results in New Jobs

Provide small business development assistance (Low)

Rehabilitate public or private commercial/industrial facilities (Low)

Develop commercial/industrial infrastructure (Low)

How many unduplicated Thornton residents are anticipated to be served with this project or program?

How many unduplicated Thornton residents at or below 8 0 % o f t he A r ea M ed ian I nc o m e are anticipated to be served with the funding requested?

Of the total participants that are anticipated to be served, what percentage will be Thornton residents?

List the types, amounts and status (i.e. applied for, received, etc.) of other funding sources that will be used for this project, including any County or State funds, if applicable. Provide information about the organization’s capacity to use CDBG or other federal funds for the proposed project. Include examples of past programs or projects that have used these funding sources, if applicable.

THORNTON CONFLICT OF INTEREST

The City of Thornton is careful about identifying and avoiding conflicts of interest, especially with grants awarded through the City. A conflict of interest arises when a person’s self-interest and professional interest or public interest intersect. In this situation, there is the potential for biased professional judgment and lack of objectivity which creates a serious conflict when one of the interests can benefit financially or personally from actions or decisions made in the official capacity. A conflict of interest exists whether or not decisions are affected by a personal interest; there only needs to be the possibility of bias for a conflict.

Organizations applying for grants awarded by the City of Thornton must provide a list of their board members and staff members with grant applications. Also, executive staff or Board presidents whose organizations are applying for funding are asked to sign this form and disclose any known actual or potential conflicts of interest.

If your organization knows of a possible conflict of interest with your application for funds and a City of Thornton employee, Council, board or selection committee member, please disclose that information here. Names of all Council members currently serving can be found at www.cityofthornton.net. SIGNATURE AND CERTIFICATION

I certify that all information provided in this grant application is true and complete. I authorize the confirmation of any or all statements contained in this application and any other information pertinent to this application and my organization and its employees, officers and board members. I understand that any false information or omission may disqualify my organization’s application for grant funding. I have read, understand, and by my signature, agree with the above statements.

Authorized Representative (please print) Title

Signature Date

Attachments - Please include the following with your LOI:

 Proof of nonprofit status;  Most current financial audit conducted on the agency and the results of the audit. If the agency is required to complete a single audit (A-133), that audit must be included as well;  Proposed project budget; and  List of current board members and key staff