MOBILE COUNTY CONSORTIUM COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM 2015 APPLICATION PACKAGE

MOBILE COUNTY CONSORTIUM COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM 2015 APPLICATION PACKAGE PROPOSAL DEADLINE: January 20, 2015 by 12:00 p.m. Mobile County Grants Department P.O. Box 1443 Mobile, AL 36633 If you have questions or require technical assistance, please contact the Mobile County Grants Department at (251) 5748099. 1

TABLE OF CONTENTS PAGE General Information 3 Application Deadline 3 2015 Program Year Calendar 4 Who May Apply 5 CDBG Capital, Public Service, and Economic Development Projects 6 CDBG Application Packages CDBG Capital Projects Applications 7 CDBG Public Service Applications 12 Appendix: Application Forms 22 W9 Form FFATA Report Form (All Applicants) Certifications (All Applicants) 2

GENERAL INFORMATION As a result of the 2000 census, Mobile County and the municipalities that elected to be part of the Mobile County Consortium were collectively identified as an entitlement by the Unites States Department of Housing and Urban Development (HUD). As such, the Consortium became the recipient of Community Development Block Grant (CDBG), Home Investment Partnerships (HOME), and Emergency Shelter Grant funds currently known as the Emergency Solutions Grant (ESG). These funds are primarily to assist low and moderate income persons, expand economic development opportunities, and provide decent housing and/or a suitable living environment. As lead agency of the Consortium, Mobile County allocates these funds to different activities to meet priority needs and the specific objectives identified in the County s Consolidated Plan. As of this print date, the upcoming 2015 Program Year funding allocations have not been announced. Mobile County is estimating level funding for 2015. Mobile County received the following in 2014: Community Development Block Grant (CDBG) $1,577,243 Home Investment Partnership (HOME) $ 534,992 includes Mandatory 15% Reserve for CHDO Emergency Solutions Grant (ESG) $ 134,250 Mobile County Commission proposes to deduct administration, planning and program costs from the amounts shown above. In anticipation of the 2015 funding, Mobile County Commission is accepting funding applications for the Community Development Block Grant and the HOME program. APPLICATION DEADLINE All CDBG proposals must be received by the Grants Department by 12:00 p.m. on January 20, 2015. Please submit all proposals to: Attn: Grants Department, Mobile County Commission, South Tower 8 th Floor, Mobile Government Plaza, 205 Government Street, Mobile, AL 366441800. This requirement is firm as to the place, date, and time. Mailed proposals should be posted in time to be received by the date and time at the above location. No faxed proposals will be accepted. Please provide the name of a contact person, along with telephone number and address. If you have questions or require additional information, please contact the Grants Administrator at (251) 5748099. All eligible proposals will be reviewed by the Project Review Committee. Submitting a request does not guarantee funding. A variety of factors are used to select projects for funding such as, eligibility, priority needs, funding availability, number of beneficiaries. 3

Program Year 2015 Calendar Application Package Available December 10, 2014 Public Hearing/Training Workshop December 10, 2014 Deadline for Proposal Submission January 20, 2015 Proposal Review by Review Committee January 29, 2015 Action Plan 30Day Comment Period Begins March 6, 2015 Commissioners approve Final Action Plan (CDBG/HOME/ESG) Letters of Approval/Denials sent April 13, 2015 After receipt of HUD Letter of Approval of Action Plan Funding Year Begins June 1, 2015 (The above dates are subject to change.) APPLICATIONS This Application Package is to be used in requesting Mobile County Consortium s Community Development Block Grant (CDBG) funds. The HOME Program addresses diverse local housing needs through loans for new construction of affordable homes and new construction of affordable rental housing. Mortgage assistance is available for eligible homebuyers for homes constructed with HOME program funds. In addition, HOME funds are available to provide homeownership opportunities for firsttime home buyers through downpayment assistance for existing homes. For detailed information about the Home program or to request an application, please call (251) 5745065. 4

WHO MAY APPLY FOR CDBG: A governmental unit that is a member of the Consortium, a forprofit business that wants to implement economic development and an incorporated notforprofit agency able to undertake approved programs that serve persons who reside within the geographic designation of the Mobile County Consortium, namely City of Bayou La Batre, City of Chickasaw, City of Citronelle, City of Creola, Town of Mount Vernon, City of Prichard, City of Saraland, City of Satsuma, City of Semmes and the unincorporated areas of Mobile County. Public service activities are primarily administered through notforprofit agencies. Applicants must demonstrate financial management and programmatic expertise to successfully develop, design, implement and monitor the proposed activities. This expertise can be demonstrated through previous experience in successfully developing programs similar to the one proposed, either by partners or key staff within the organization. Please note Federal guidelines require that funds are spent in a timely manner. Therefore, funded programs will need to be underway and all funds expended within twelve (12) months of execution of an agreement with the County, otherwise funds may be deobligated. All applicants will be required to submit the FFATA Report Form and the Certification Forms with their applications. Capital Project applicants will be required to submit the Designation of Responsible Officials Form. ELIGIBILITY To be considered for funding, a proposed program must be an eligible program and must meet the national objectives mandated by HUD of benefitting low and moderateincome persons. These are persons with household incomes that are at or below 80% of the median family income for the Mobile County Consortium Area. Income limits for 2015 should be available by March 2015. Current income limits for 2014 are: Family Size 1 2 3 4 5 6 7 8+ 80% $30,200 $34,500 $38,800 $43,100 $46,550 $50,000 $53,450 $56,900 (These limits change annually.) Some programs require agencies to verify and document household income of beneficiaries. 5

COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM CAPITAL PROJECTS The following activities are some examples of eligible uses of CDBG funds under HUD s guidelines: Road Resurfacing and Paving Construction and improvement to water and sewer facilities Flood and drainage improvements Construction and renovation of community, senior and health centers Removal of architectural barriers to accessibility Capital projects must benefit low and moderateincome persons, be located in an area that is predominantly (51%) inhabited by low and moderateincome residents. Please note: A survey may be required to determine eligibility. PUBLIC SERVICE PROJECTS The primary objective of the CDBG Public Service Program is to provide funding to agencies that provide services to income eligible persons. Services include but are not limited to assistance for prescription drugs, accessibility improvements, fair housing and homebuyer counseling, legal services, and abuse victim assistance. The proposed project must be a new service or a measurable expansion of an existing service. Program beneficiaries must be principally low or moderateincome persons. ECONOMIC DEVELOPMENT PROJECTS The primary objective is to promote means for job creation or retention of jobs for low/moderate income persons. For further information, please contact the Director of Grants Management at (251) 5745086. 6

CAPITAL PROJECT APPLICATION 7

Date: COMMUNITY DEVELOPMENT BLOCK GRANT CAPITAL PROJECT PY2015 APPLICATION FORM Please indicate type of organization: Municipality For Profit Not for Profit Summary of proposed project: (Please attach a detailed description of project and a cost estimate.) Cost estimate of construction projects should include all items to construct including engineering fees. Location of Proposed Site (Be Specific). Please provide detailed map. Address AMOUNT OF FUNDS REQUESTED: $ Estimated number of low/moderate income beneficiaries Authorized signature only: (Please Print Name Below) Submitted by: Name (Please Sign Name Below) Signature Organization Represented: Address: Telephone: DUNS Number: Has your agency been funded before? Y N If yes, complete the following: Years Amount *Name of Project Completion Status CDBG HOME ESG *Attach separate sheet if needed. 8

NOTE: Mobile County staff may contact you for additional information. Submitting a request does not guarantee funding. Submit applications to: Attn: Grants Department Mobile County Commission South Tower 8 th Floor Mobile Government Plaza 205 Government Street Mobile, Alabama 366441800 DO NOT WRITE BELOW THIS LINE. FOR USE BY MOBILE COUNTY STAFF ONLY. Census Track/Block Group %Low/Mod Eligible Activity? Estimated Cost Yes No $ Survey required: Yes No Ineligibility Reason 9

COMMUNITY DEVELOPMENT BLOCK GRANT CAPITAL PROJECTS CHECKLIST OF REQUIRED DOCUMENTS The following documents must be submitted before this request can be processed. Place a check mark next Nex to the items that are enclosed. If a document will not be available until later, please indicate availability date. 1. Articles of Incorporation, if applicable 2. By Laws, if applicable 3. Documentation that certifies that the agency is a not for profit 501(C)(3), if applicable. 4. The organization's budget for its 2015 fiscal year, if applicable 5. The organization s independently audited financial statements for its past two fiscal years. If an independent audit has not been conducted for those years, printouts from your accounting system or an accountant's compilation is acceptable. (if applicable) 6. A completed Form W9 (enclosed), if applicable 7. A resolution or certified copy of the minutes of the organization's governing body reflecting approval of the organization's entry into a contract with the Mobile County Commission and of the expenditures described in the program statement. (REQUIRED FOR ALL APPLICATIONS) 8. Designation of Responsible Officials Form. (REQUIRED FOR ALL APPLICATIONS) 9. FFATA Report Form. (REQUIRED FOR ALL APPLICATIONS) 10. Certification Forms (REQUIRED FOR ALL APPLICATIONS) 10

DESIGNATION OF RESPONSIBLE OFFICIALS FOR CDBG Applicant Project Name All general CDBG correspondence will be mailed to the Mayor/Chairperson at the applicant s official address. Please provide an email address for the Mayor/Chairperson if one is available or any special mailing instructions. Also, if correspondence is to be copied to a project management person, please complete the appropriate information below. MAYOR/CHAIRPERSON Name Address City/State/Zip Telephone Number EMail Address Name Address City/State/Zip CDBG MANAGEMENT PERSON Telephone Number EMail Address Name Address City/State/Zip DESIGNATION OF EQUAL OPPORTUNITY OFFICER Telephone Number EMail Address Name Address City/State/Zip DESIGNATION OF LABOR STANDARDS OFFICER Telephone Number EMail Address Signed Mayor/Chairman 11

PUBLIC SERVICE APPLICATION 12

COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICE PY2015 APPLICATION FORM Date: Legal Name of the Organization: Mailing Address: Phone: DUNS Number: Name and Title of Persons authorized to execute contracts on behalf of the Organization: Name: Title: Please indicate type of organization: Municipality For Profit Not for Profit Summary of proposed program: Location of Proposed Site or Service Area (Please Be Specific) Address: Amount of Funds Requested: $ Check one: New Program Expansion Beneficiary Information: Total number of beneficiaries in program: Estimated number of low/moderate income beneficiaries to be served: CDBG cost per low/moderate income person: Has your agency been funded by CDBG before? Y N 13

PUBLIC SERVICE APPLICATION FORM PAGE 2 If yes, complete the following: Years Amount *Name of Program Completion Status Authorized signature only: Submitted by: Name (Print) Signature NOTE: Mobile County staff may contact you for additional information. Submitting a request does not guarantee funding. Submit applications to: Attn: Grants Department Mobile County Commission South Tower 8 th Floor Mobile Government Plaza 205 Government Street Mobile, Alabama 366441800 DO NOT WRITE BELOW THIS LINE. FOR USE BY MOBILE COUNTY STAFF ONLY. Census Track/Block Group %Low/Mod Eligible Program? Estimated Cost Yes No $ Ineligibility Reason 14

COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICE Public Service Application Form Program Narrative (limit 5 pages) PROPOSAL CHECKLIST a. Project Description Describe the proposed project to be carried out with the funds requested. If the proposed project is ongoing, specify why the funds are needed. Discuss the costperbeneficiary in relation to private and other organizations delivering similar services. Please note what proportion of the proposed budget will support direct services. CDBG funds can only be used for expenditures which directly benefit CDBGeligible clients. b. Target Group Quantify the number of proposed unduplicated low and moderateincome persons to be served with CDBG funding. c. Outreach Discuss outreach efforts for the proposed program. d. Benefit/Need Discuss how the program provides benefit to lowincome persons. How does the proposed program respond to the critical needs of the community? Document the need for the program. e. Other Resources Identify other potential or actual sources of funds and collaborations. f. Organizational Capacity Summarize the organization's background and programmatic capacity. If the project has been funded before, what have been the primary accomplishments? Does your organization or proposed project fill a unique niche among clients who are not currently served or are underserved? Attach a list of the Board of Directors with their affiliations. Detailed Project Budget with signatures Budget Narrative a detailed expenditure of CDBG funds. Please format by budget category and provide detailed expenditure information. Checklist of Required Documents and related document attachments 15

COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICE CHECKLIST OF REQUIRED DOCUMENTS The following documents must be submitted before this request can be processed. Place a check mark next Nex to the items that are enclosed. If a document will not be available until later, please indicate availability date. 1. Articles of Incorporation 2. By Laws 3. Documentation that certifies that the agency is a certified not for profit 501(C)(3) 4. The organization's budget for its 2015 fiscal year. 5. The organization s independently audited financial statements for its past two fiscal years. If an independent audit has not been conducted for those years, printouts from your accounting system or an accountant's compilation is acceptable. 6. A completed Form W9 (enclosed). 7. A resolution or certified copy of the minutes of the organization's governing body reflecting approval of the organization's entry into a contract with the Mobile County Commission and of the expenditures described in the program statement. (REQUIRED FOR ALL APPLICATIONS) 8. FFATA Report Form. (REQUIRED FOR ALL APPLICATIONS) 9. Certification Forms (REQUIRED FOR ALL APPLICATIONS) 16

MOBILE COUNTY COMMISSION Page 1 of 5 GRANTS DEPARTMENT 205 Government Street CDBG Detailed Budget P.O. Box 1443 Explain computations in the Budget Narrative. Mobile, AL 36644 A. Personnel: Total number List each individual with salary of hours or (Time sheets are required % of Time Annual Cost allocated for reimbursement.) Devoted Income / to CDBG Name of Employee Position / Title Salary to CDBG Project Unit Cost Total $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ See Attachment 1 (Personnel) $ $ Salaries SubTotal $ Fringe Benefit Computation FICA $ $ SUI $ $ W/C $ $ Health Insurance $ 0 $ Life Insurance $ 0 $ Retirement $ 0 $ Other $ 0 $ Other $ 0 $ Other $ 0 $ Fringe SubTotal $ B. InKind Match (if applicable) Personnel Expense Fringe Benefit Expense Other inkind match (detail) Total CDBG Personnel Expenditures $ $ $ $ Total InKind Match C. Travel: Transportation & associated cost of project personnel. Mileage: $ Other: $ $ Total CDBG Travel $ 17

MOBILE COUNTY COMMISSION GRANTS DEPARTMENT 205 Government Street P.O. Box 1443 Mobile, AL 36644 D. Operating Expenses: Must be itemized CDBG Detailed Budget (continued) Page 2 of 5 $ $ $ $ $ $ $ $ Total CDBG Operating Expense $ E. Equipment Purchase: Must be itemized Item Qty Unit Price Total Item Cost $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Lease or Rental Equipment Equipment Purchase Total $ $ $ $ $ $ Lease or Rental Total $ Total CDBG Equipment Expense $ Total CDBG Project Costs $ Matching Contributions % $ MCCCPD 0% $ InKind Match % 0% $ Other 0% $ 18

MOBILE COUNTY COMMISSION GRANTS DEPARTMENT 205 Government Street P. O. Box 1443 Mobile, AL 36644 SOURCE OF MATCH AND CONTINUATION PROJECTION Page 3 of 5 F. Source of Match Contribution: (Indicate source per instructions) Total Matching Contribution $ (Should agree with Matching Contribution on Page 2) G. Budget Summary and Projection: (APPLICATION IS INCOMPLETE WITHOUT THIS) (Total Budget of Applicant or Implementing Agency) Federal Funds Grants may only be used to supplement, not supplant entities budget. BUDGET CATEGORIES Prior Phase Without this grant Present Phase With this Grant Successive Phase A. Personnel (Salaries & Benefits) B. Travel (Transportation/Associated Cost) C. Supplies & Other Operating Expenses D. Equipment TOTAL BUDGET OF APPLICANT $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Duration of Project Phase (in months) 12 12 12 H. FEDERAL SUPPORT: Will other Federal support be available for any part of this project? Yes ( ) No ( ) If Yes, explain: 19

Page 4 of 5 INSTRUCTIONS FOR CDBG DETAILED BUDGET CDBG Detailed Budget: The budget form must be completed in detail with amounts rounded to the nearest dollar (no cents). A separate narrative should accompany it providing justification and detailing the basis for determining the cost of the items included in each budget category. Costs will be judged on reasonableness and allow ability based on the budget and program narrative. The budget should cover only the period for which this project will be funded. The cost of each item listed under the various budget categories should be shown. The cost of all items listed in each major budget category should be inserted in the Category Subtotal and Total space. Whenever the space for any budget category is inadequate to permit listing of all items, the notation See Continuation Sheet should be entered. Only the category total and subtotal should be inserted, and all items in the category should be listed on a continuation page. A. Personnel: (1) List the name of the employee, if available, position/title, salary, percent of time devoted to the project. Additional detailed information may be added in the Budget Narrative. (2) Indicate each type of fringe benefit included. Computation should be explained in the Budget Narrative. B. InKind Match (if applicable): C. Travel: Itemize travel expenses of project personnel by purpose; e.g. mileage, field interviews, advisory group meeting, to attend training seminars, etc. Show the basis for computation D. Supplies and Other Operating Expenses: (i) Direct Cost. Direct cost should be itemized within this category by major type (e.g. offices supplies, training materials, research forms, telephone, and postage) and show basis for computation ( X dollars per month for office supplies, Y dollars per person for training materials, telephone... long distance a Z dollars per month, etc.) Large items should be separately listed and identified (e.g. unusual supply items, special printing, or mailings required for project. E. Equipment: Each major item of equipment to be purchased or leased should be separately listed with unit costs. Total CDBG Project Costs: The Total Project Cost should be the sum of the Category Totals. This Total Project Cost should then be distributed to Matching Contribution (if applicable) and MCCCPD in accordance with the funding ratio allowable for the specific project. 20

Page 5 0f 5 F. Source of Matching Contribution: Indicate the cash matching contribution being committed and the source of the matching contribution (city, county, state, private agency, public agency, etc.). Match requires detailed documentation, the same as for the federal funds provided. G. Budget Summary and Projection: This is the total budget of applicant/implementing agency, as applicable, including this grant request. Federal guidelines require that funds provided are to supplement subgrantee funds, not to supplant them. Therefore, this section is to portray last years funding expenditure under the Prior Phase column. The Present Year column portrays the current budget of the subgrantee and should include this grant request. The Successive Phase is to portray the projected total budget for the forthcoming year. This information is needed to insure supplanting will not occur. H. Federal Support: When other Federal funds will be available for financing of components or parts of the project, the applicant should indicate and explain. This should be interpreted broadly and include notice of any related activities supported by other Federal programs. Director and Financial Officer must certify budget as submitted. Signature Date Signature Date **Please submit entire 5 pages of budget to Mobile County Commission** 21

APPENDIX: APPLICATION FORMS W9 FORM FFATA REPORT FORM CERTIFICATION FORMS 22

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FFATA REPORT Federal Funding Accountability and Transparency Act of 2006 (FFATA): The Transparency Act of 2006 requires that all Federal program recipients (or awardees) to report award information on any firsttier subawardees (or subrecipients) totaling $25,000 or more, and, in some cases, to report information on the names and total compensation of the five most highly compensated executives of the recipient and firsttier subrecipients. Further information regarding this subaward reporting can be found at www.fsrs.gov. This Act also requires all potential subrecipients to acquire and provide a Data Universal Numbering System (DUNS) numbe by, applying online at www.dnb.com. For projects using PY 2011 Funds or later: Subrecipient's Name: Subrecipient's Address: Federal EIN or W9: DUNS Number: Five Highly Compensated Officers: (Circle your answers) Does your agency receive more than 80% of its funding (revenues) from the Federal Government? If No STOP. You do not need to report. If Yes Go to next question. Does your agency receive more than $25M from the Federal Government annually? If No STOP. You do not need to report. If Yes Go to next question. Is the executive compensation information already available through reporting to the SEC? If Yes STOP. You do not need to report. If No Provide names & Compensation for each. 1. 2. 3. 4. 5. Total Compensation for Officers: $ 27

CERTIFICATION FOR A DRUGFREE WORKPLACE 2015 CDBG PROGRAM APPLICATION PROCESS A. Every person or Agency awarded a contract or grant by the Mobile County Commission for the provision of services shall certify to the County that it will provide a drugfree workplace. By signing and submitting this certification, the undersigned certifies that it and its subcontractors shall provide a drugfree workplace by doing all of the following: 1) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance is prohibited in the person s organization s workplace and specifying the actions that will be taken against employees for violations of the prohibition. 2) Establishing a drugfree awareness program to inform employees about all of the following: a) The dangers of drug abuse in the workplace. b) The person s or organization s policy of maintaining a drugfree workplace. c) Any available drug counseling, rehabilitation, and employee assistance programs. d) The penalties that may be imposed upon employees for drug abuse violations 3) Posting the statement required by Section A.1) of this certification in a prominent place at the Agency s main office. For projects large enough to necessitate a construction trailer at the job site, the required signage would also be posted at the job site. B. Agencies shall include in each subcontract agreement language which indicates the subcontractor s agreement to abide by the provisions of Sections A. 1) through 3) if this certification is inclusive of Section A. Agencies and subcontractors shall be individually responsible for their own drugfree workplace programs. C. This certification submitted to the Mobile County Commission is a material representation of fact upon which reliance was placed when entering into a contract agreement. If it later determined that the Agency knowingly rendered an erroneous certification, in addition to other remedies available, the Mobile County Commission may terminate the contract for default. Name of Agency Signature of Authorized Signing Official/Representative Date Print/Type Name of Authorized Signing Official/Representative 28

CERTIFICATION REGARDING COMPLIANCE WITH CIVIL RIGHTS ACT AND AMERICANS WITH DISABILITIES ACT 2015 CDBG PROGRAM APPLICATION PROCESS The organization listed below certifies that it complies with and prohibits discrimination in accordance with Title VI of the Civil Rights Act of 1964. Written documents outlining this organization s nondiscrimination policy are on file and available for review. (See 28 CFR 35) It is further certified that this agency has reviewed its projects, programs, and services for compliance with all applicable regulations contained in Title II, Americans with Disabilities Act of 1990. Written documentation concerning this review and corrective actions taken (if any) are on file and available for review. Name of Agency Signature of Authorized Signing Official/Representative Date Print/Type Name of Authorized Signing Official/Representative 29

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, PROPOSED DEBARMENT, INELIGIBILITY AND OTHER RESPONSIBILITY MATTERS 2015 CDBG PROGRAM APPLICATON PROCESS 1. By signing and submitting this certification, the undersigned certifies to the best of its knowledge and belief, that it and its principals: a) Are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; b) Have not within a threeyear period preceding this award, have been convicted of or had a civil judgment rendered against them for: commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property; c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in 2. of the certification; d) Have not within a threeyear period preceding this award, had one or more contracts (Federal, State, or local) terminated for cause or default; e) Will not knowingly enter into any subcontract with a person who is, or organization that is, debarred, suspended, proposed for debarment, or declared ineligible from award of contracts by any Federal agency; and f) Will require that the language of this certification to be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. 2. Principals, for the purposes of this certification, means officers; directors; owners; partners; and, persons having primary management or supervisory responsibilities within a business entity. 3. Where the undersigned is unable to certify to the statements listed in section (1) in this certification, an explanation shall be attached. The Contractor shall provide immediate written notice if, at any time prior to or during the negotiated contract period, the Contractor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (1) of this provision. The knowledge and information of Contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 5. This certification submitted to the Mobile County Commission is a material representation of fact upon which reliance was placed when entering into a contract agreement. If it later determined that the Contractor knowingly rendered an erroneous certification, in addition to other remedies available, the Mobile County Commission may terminate the contract for default. Name of Agency Signature of Authorized Signing Official/Representative Date Print/Type Name of Authorized Signing Official/Representative 30

CERTIFICATION REGARDING LOBBYING 2015 CDBG PROGRAM APPLICATION PROCESS By signing and submitting this certification, the undersigned certifies to the best of its knowledge and belief that it and its principals shall be in compliance with the following: 1) Agency shall not use, and require its subcontractors not to use, any of the funds, personnel, or materials received in connection with any agreement (contracts, grants, cooperative agreements) awarded by the Mobile County Commission to influence or attempt to influence any governmental decision or election in any manner whatsoever. This prohibition shall apply to any decision of any kind to be made by any electorate, legislative body, agency, bureau, board, commission, district, or any other instrument of federal, state, or local government. The term influence or attempt to influence shall mean the making, with the intent to influence, any communication to or appearance before any officer, employee, or appointee of any governmental entity, as well as any communication made to any electorate, regarding any ballot measure or candidate election. 2) Agency acknowledges that federal funds received from the Mobile County Commission for individual program(s) have been provided pursuant to a federal grant, and shall comply with the laws set forth at 31 USC section 1352 (1989) and 24 CFR 87. 3) Agency shall disclose any funds from any other source which have been paid by Contractor or its principals and agents within the last year to influence or attempt to influence decisions of the federal government by completing, signing, and submitting Standard Form LLL, Disclosure of Lobbying Activities. (24 CFR 87, Appendix B) Contractor understands that the duty to disclose lobbying activities is a continuing requirement, and therefore shall make such disclosures at the end of each calendar quarter in which there occurs any event requiring disclosure. 4) Agency shall require the language of this certification be included in the award documents for all subawards at all tiers (including subagreements, subcontracts, subgrants, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly This certification submitted to the Mobile County Commission is a material representation of fact upon which reliance was placed when entering into a contract agreement. If it later determined that the Agency rendered an erroneous certification, in addition to other remedies available, the Mobile County Commission may terminate the contract for default. Name of Agency Signature of Authorized Signing Official/Representative Date Print/Type Name of Authorized Signing Official/Representative 31

(NONPROFIT AGENCIES) CERTIFICATION REGARDING COMPLIANCE WITH MINORITY BUSINESS ENTERPRISE (MBE), WOMEN S BUSINESS ENTERPRISE (WBE), AND SMALL BUSINESS CONTRACTING REQUIREMENTS 2015 CDBG PROGRAM APPLICATON PROCESS A. The organization listed below certifies that it will comply with 24 CFR Part 84.44(b), as follows: The organization will take all necessary affirmative steps to assure that minority firms, women s business enterprises, and labor surplus area firms are used when possible. Affirmative steps shall include: Positive efforts shall be made by the organization to utilize small businesses, minorityowned firms, and women s business enterprises, whenever possible. Recipients of CDBG funds shall take all of the following steps to further this goal. 1) Ensure that small businesses, minorityowned firms, and women s business enterprises are used to the fullest extent practicable. 2) Make information on forthcoming opportunities available and arrange time frames for purchases and contracts to encourage and facilitate participation by small businesses, minorityowned firms, and women s business enterprises. 3) Consider in the contract process whether firms competing for larger contracts intend to subcontract with small businesses, minorityowned firms, and women s business enterprises. 4) Encourage contracting with consortiums of small businesses, minorityowned firms and women s business enterprises when a contract is too large for one of these firms to handle individually. 5) Use the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Department of Commerce s Minority Business Development Agency in the solicitation and utilization of small businesses, minorityowned firms and women s business enterprises. B. The organization further certifies that it will submit to the Mobile County Commission at the time of project completion a report of the MBE and WBE status of all subcontractors to be paid with CDBG funds in a format to be provided by the County. Name of NonProfit Agency Signature of Authorized Signing Official/Representative Date Print/Type Name of Authorized Signing Official/Representative 32

(GOVERNMENTAL AGENCIES) CERTIFICATION REGARDING COMPLIANCE WITH MINORITY BUSINESS ENTERPRISE (MBE), WOMEN S BUSINESS ENTERPRISE (WBE), AND SMALL BUSINESS CONTRACTING REQUIREMENTS 2015 CDBG PROGRAM APPLICATON PROCESS A. The organization listed below certifies that it will comply with 24 CFR Part 85.36(e), as follows: The organization will take all necessary affirmative steps to assure that minority firms, women s business enterprises, and labor surplus area firms are used when possible. Affirmative steps shall include: i. Placing qualified small and minority businesses and women s business enterprises on solicitation lists; ii. Assuring that small and minority businesses, and women s business enterprises are solicited whenever they are potential sources; iii. Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority business, and women s business enterprises; iv. Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority business, and women s business enterprises; v. Using the services and assistance of the Small Business Administration, and the Minority Business Development Agency of the Department of Commerce; and vi. Requiring the prime contractor, if subcontracts are to be let, to take the affirmative steps listed in paragraphs A.(i) through (v) of this section. B. The organization further certifies that it will submit to the Mobile County Commission at the time of project completion a report of the MBE and WBE status of all subcontractors to be paid with CDBG funds in a format to be provided by the County. Name of Governmental Agency Signature of Authorized Signing Official/Representative Date Print/Type Name of Authorized Signing Official/Representative 33

CERTIFICATION REGARDING SECTION 504 OF THE REHABILITATION ACT OF 1973 2015 CDBG PROGRAM APPLICATION PROCESS Section 504 of the Rehabilitation Act of 1973 prohibits discrimination against persons with disabilities in the operation of programs receiving federal financial assistance. HUD regulations implementing Section 504 contain accessibility requirements for new construction and rehabilitation of housing as well as requirements for ensuring that the programs themselves are operated in a manner that is accessible to and usable by persons with disabilities. Both individual units and the common areas of buildings must be accessible under Section 504. Section 504 states that "no qualified individuals with a disability in the United States shall be excluded from, denied the benefits of, or be subject to discrimination under" any program or activity that receives Federal financial assistance. Requirements common to these regulations include program accessibility; effective communication with people who have hearing or vision disabilities; and accessible new construction and alterations (See 24 CFR Part 8). Further information concerning compliance with any of these requirements may be obtained through the HUD web page: http://portal.hud.gov/portal/page/portal/hud/programdescription/sec504. Signature and Certification: The undersigned certifies that it has read and understands all of its obligations under the Section 504 requirements. The undersigned acknowledges that this certification will be relied upon by the Mobile County Commission in its review and approval of proposed funding and any misrepresentations of information or failure to comply with any conditions stated in this certification could result in disqualification of the application, disallowance of reimbursement requests, or termination of CDBG contract. The undersigned also agrees to cooperate in any compliance review and to provide reasonable access to the premises of all places of business and employment and to records, files, information and employees therein to Mobile County Commission for reviewing compliance with Section 504 requirements. Good faith selfcertification Not in compliance with Section 504/ADA requirements, but seeking CDBG funds to address Section 504 issues Not in compliance with Section 504/ADA requirements, but in compliance with Cityapproved Compliance Plan Name of Agency Signature of Authorized Signing Official/Representative Date Print/Type Name of Authorized Signing Official/Representative 34