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2. COMMUNITY DEVELOPMENT BLOCK GRANT APPLICATION

   The application required by this announcement must include the following information:

4. CDBG Application
   Click here for the complete application
5. Notice of Funding Opportunity (NOFO)
   Click here for complete information about the opportunity
7. Proof of 501(c) status documentation to support nonprofit eligibility, if applicable:
9. A. PARTICIPANT PROFILE
11. 1. Name, address, and Unique Entity Identifier (UEI) from SAM.gov for the applicant organization
13. Name*
15. Address*
17. Unique Entity Identifier (UEI) from SAM.gov*
18. SAM.gov
    Click here for SAM.gov
20. 2. Name, telephone number, and email address of the applicant's PRIMARY CONTACT person
22. Name*
24. Phone*
25. Email*
27. 3. The name(s) of the person(s) responsible for managing the proposed activities
29. Please list at least one*
31. 4. TYPE OF ORGANIZATION (e.g., nonprofit, for profit, community-based development organization, or institute of higher learning, if carrying out Community Development Block Grant activities, community development financial institutions, and faith-based organizations, developers, contractors):
33. Type of organization*
35. 5. Applicant's federal tax identification number
37. Federal tax identification number*
38. IRS.gov
    Click here for IRS.gov
40. B. EXECUTIVE SUMMARY AND STRATEGIC PLAN
42. Upload as attachment: An executive summary of the organization's overall strategic plan that includes the following:*
44. CDBG Application
    Click here for description
45. 1. A description of the organization's mission;
    2. A description of the applicant’s prior grant or CDBG experience, including the applicant’s management and administrative capability and an explanation of the organization’s strategic planning process and how it identifies priorities;
    3. A description of the need/problem to be addressed consistent with priorities established in the City of Minot’s CDBG Consolidated Plan/Action Plan;
    4. A description of how the applicant’s proposed CDBG activities fit into that overall strategy;
    5. The population/area served, the estimated number of low- to moderate-income clients and measurable outputs;
    6. A description of the work to be completed, and who will complete it;
    7. Proposed schedule of work;
    8. A statement on how eligibility and National Objective requirements will be met;
    9. An explanation for why Federal funding assistance is needed and why the applicant is unlikely to carry out the proposed program without assistance;
    10. A discussion of the applicant’s efforts at developing collaborative partnerships;
    11. A summary of any organizations affiliated with the applicant, including parent organizations, subsidiaries, and partnerships; and description of the other Federal funding;
    12. A detailed budget which includes all funding sources.
47. C. ORGANIZATIONAL INFORMATION

    Required documents to be uploaded as attachments:

49. 1a. Articles of Incorporation and*
51. 1b. Bylaws to include the governance structure; and*
53. 2a. Organizational Chart, and*
55. 2b. List of the governing body or Board of Directors; *

    (must include the name, telephone number, address, occupation or affiliation of each member and must identify the principal officers);

57. 3. Certificate of Good Standing with the State;*
59. 4. Designation of Authorized official;*

    (signed letter from the Chairperson of the governing body providing the name, title, address, and telephone number of each authorized individual);

61. 5a. Resumes of Program Administrator and*
63. 5b. Resume of Fiscal Officer;*
65. 6. Personnel/Staff Capacity;*

    The list of personnel must reflect qualified staff for all the necessary functions associated with the proposed activities. If qualified staff are not available, a statement of how the organization plans to fill the gaps in personnel must be provided in order to assure compliance with CDBG program regulations.

67. 7. Annual Financial Statement and Audit;*
69. 6. Financial Capacity;*

    A description of the organization’s financial management and personnel policies and procedures to include all necessary controls that conform to the prescribed standards in 2 CFR 200 Part 200. Recipients must ensure that management controls are fully addressed.

71. 7. Non-Profit Determination:*

    Non-profit organizations must submit tax-exemption determination letters from the Federal Internal Revenue Service and the State Franchise Tax Board;

73. 8. Documentation of Compliance with National Objectives;*
74. IDIS CDBG National Objectives
    Matrix Code Table
76. 9. Signed Conflict of Interest Disclosure/Certification:*
77. Conflict of Interest
    Disclosure/Certification Form
78. Conflict of Interest
    Click here for the Policy
80. 10. Copy of the written manual for procedures for financial management and personnel.*
82. D. ACTIVITY/ACTIVITIES

    The majority of the activities must be within the city limits of Minot.

84. Upload as attachment: A document answering sections D-F:*
86. CDBG Application
    Click here for description
87. 1. A description of each proposed activity that reflects the requested budget and states how the activity is designed for, and used by, a segment of the population that is presumed to be principally low- and moderate-income or;
       1. The nature, and if applicable, the location of the activity that primarily benefits low -
       2. and moderate- income people; or
       3. The data showing the size and annual income of the family of each person receiving the benefits; or
       4. Data showing that the activity is a special project removing accessibility barriers in the limited cases above.
    2. A description of the expected results and the overall long term strategic goals to be advanced by the proposed activity for the ensuing 3–5-year period;
    3. For each proposed activity, provide a market assessment and strategy that discusses the organization or entity’s goals to provide decent housing and a suitable living environment and/or expand economic opportunities principally for low-and-moderate-income people. Provide a description of the situation, constraint(s)/opportunity(ies), and the strategy proposed to overcome constraints or take advantage of the opportunities;
    4. A summary of the past performance and results achieved from grants and activities undertaken to provide decent housing and a suitable living environment and/or expand economic opportunities principally for low and moderate-income people;
    5. Provide historical experience; including the amount of funding that was awarded, the amount of funding that was expended, and a description of obstacles that prevented the expenditure of the award.
89. E. CONSTRAINTS
91. 1. A description of the constraint impeding the opportunity to provide decent housing and a suitable living environment or expand economic opportunities of low-to-moderate-income individuals.
    2. A description of the performance metrics/indicators against which future success in addressing the constraint will be measured. Every constraint must include at least one performance measure.
93. F. PROGRAMMATIC CAPABILITY AND PAST PERFORMANCE

95. Applicants should submit a list of federally funded assistance agreements (assistance agreements include Federal grants and cooperative agreements but not Federal contracts) that your organization performed within the last three years (no more than five agreements) and describe:

    1. whether, and how, you were able to successfully complete and manage those agreements; and
    2. your history of meeting the reporting requirements under those agreements including whether you adequately and timely reported on your progress towards achieving the expected outputs and outcomes of those agreements (and if now, explain why not) and whether you submitted acceptable final reports under the agreements; and
    3. your organizational experience and plan for timely and successfully achieving the objectives of the proposed project, and your staff expertise/qualifications, staff knowledge, and resources or the ability to obtain them, to successfully achieve the goals of the proposed project.
97. ELECTRONIC SIGNATURE AGEREMENT*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I AGREE.
99. ELECTRONIC SIGNATURE*
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101. 1. Receive an email copy of this form.
102. Email address

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