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HomeMy WebLinkAboutContract 63160CSC No. 63160 STATE OF TEXAS § COUNTY OF TARRANT § This contract ("Contract") is made and entered into by and between the City of Fort Worth (hereafter "City") and AIDS Outreach Center, Inc. (hereafter "Agency") a Texas non-profit corporation. City and Agency may be referred to individually as a "Party" and jointly as "the Parties". The Parties state as follows: WHEREAS, City receives grant monies from the United States Department of Housing and Urban Development through the Housing Opportunities for Persons with AIDS Program ("HOPWA") Program, Program No. TX-H-24-17002, Catalog of Federal Domestic Assistance No. 14.241; WHEREAS, the HOPWA program is intended to address the needs of eligible persons associated with the challenge of living with HIV/AIDS and their families; WHEREAS, Agency submitted a proposal to use HOPWA funds for an eligible program under the HOPWA Regulations whereby Agency will provide services to low and moderate income persons; WHEREAS, City citizens, the Community Development Council, and the City Council have determined that HOPWA programs are needed by the City's citizens; NOW, THEREFORE, the Parties understand and agree as follows: 1. INCORPORATION OF RECITALS City and Agency hereby agree that the recitals set forth above are true and correct and form the basis upon which the Parties have entered into this Contract. 2. DEFINITIONS In addition to terms defined in the body of this Contract, the terms set forth below shall have the definitions ascribed to them as follows: Area Median Income or AMI means the median family income for the Fort Worth -Arlington metropolitan statistical area as established annually by HUD. The 2024 income limits are attached hereto as EXHIBIT "A-1" — 2024 HUD Income Limits. Business Equity Ordinance or BEO means the City's Business Diversity Ordinance, Ordinance No. 25165-10-2021, as may be amended from time to time. OFFICIAL RECORD CITY SECRETARY Complete Documentation means the following documentation as applicable: FT. WORTH, Tx HOPWA PSA CONTRACT 2024-2025 Page 1 AIDS Outreach Center, Inc. Rev. 6-12-2024 • Attachments I, II, and III within Exhibit "D", with supporting documentation including: o Proof of expense: copies of timesheets, invoices, leases, service contracts, utility bill and/or other documentation showing that payment is due by Agency. o Proof of payment: cancelled checks, bank statements, or wire transfers necessary to demonstrate that amounts due by Agency were actually paid by Agency. o Proof of client eligibility: Source Documentation sufficient to show that clients participating in the Program are HOPWA Eligible Clients as described in Section 6, rental calculation worksheet as described as "Exhibit N", Housing Assistance Payment letter, Interim worksheet. Complete Documentation shall meet the standards described in the attached EXHIBIT "F"- Standards for Complete Documentation. • Any other document or record reasonably necessary to verify costs spent and client eligibility for the Program. DBE means disadvantaged business enterprise in accordance with 49 CFR Part 26. Director means the Director of the City's Neighborhood Services Department. Effective Date means March 1, 2025. HOPWA means Housing Opportunities for Persons with AIDS. HOPWA Eligible Client means a client whose annual income adjusted for family size does not exceed 80% of AMI using the most current HUD Income Guidelines and Technical Guidance for Determining Income and Allowances verified by Source Documentation. The client must also have a documented diagnosis of HIV/AIDS. HOPWA Funds means the HOPWA grant funds supplied by City to Agency under the terms of this Contract. HOPWA Regulations means regulations found at 24 CFR Part 574 et seq. HUD means the United States Department of Housing and Urban Development. IDIS means Integrated Disbursement Information System, HUD's project tracking system. Neighborhood Services Department means the City's Neighborhood Services Department. Neighborly Software means the Online database maintained by the City of Fort Worth through which Agency is required to submit monthly reimbursement requests. HOPWA PSA CONTRACT 2024-2025 Page 2 AIDS Outreach Center, Inc. Rev. 6-12-2024 OMB means the Office of Management and Budget. Program means the services described in EXHIBIT "A" — Program Summary. Reimbursement Request means all reports and other documentation described in Section 9. Resident Rent Payment means Except for persons in short-term supported housing, each person receiving rental assistance under this program or residing in any rental housing assisted under this program must pay as rent, including utilities, an amount which is the higher of- (1) 30 percent of the family's monthly adjusted income; (2) Ten percent of the family's monthly income; Source Documentation means documentation of full household income of any type described under the definition of annual income in 24 CFR Part 5.609, including but not limited to copies of paychecks, Social Security and disability verification letters, interest or rental income statements, retirement income statements, child support and alimony verification, unemployment benefit letters, and the like. Supportive Services means health, mental health, assessment, permanent housing placement, drug and alcohol abuse treatment and counseling, day care, personal assistance, nutritional services, intensive care when required, and assistance in gaining access to local, State, and Federal government benefits and services, except that health services may only be provided to individuals with acquired immunodeficiency syndrome or related diseases and not to family members of these individuals guided by CFR Part 574.300(b)(7). Unduplicated Clients means a count of HOPWA Eligible Clients served at least once in the Contract Term. HOPWA Eligible Clients served more than once in the Contract Term will only be counted the first time they are served when determining the total count of Unduplicated Clients. 3. TERM. The term of this Contract (Contract Term) begins on the Effective Date and terminates on September 30, 2025 unless earlier terminated as provided in this Contract. 4. DUTIES AND RESPONSIBILITIES OF CITY. 4.1 Provide HOPWA Funds. City will provide up to $ 326,718.00 of HOPWA Funds under the terms and conditions of this Contract. 4.2 Monitor. City will monitor the activities and performance of Agency and any of its contractors, subcontractors or vendors as necessary, but no less than annually. Monitoring by City will include determining whether Agency is meeting the requirements of the HOPWA Regulations during the term of this Contract. HOPWA PSA CONTRACT 2024-2025 Page 3 AIDS Outreach Center, Inc. Rev. 6-12-2024 4.2 Monitor. City will monitor the activities and performance of Agency and any of its contractors, subcontractors or vendors as necessary, but no less than annually. Monitoring by City will include determining whether Agency is meeting the requirements of the HOPWA Regulations during the term of this Contract. 5. DUTIES AND RESPONSIBILITIES OF AGENCY. 5.1 Required Services. Agency shall perform the services described in EXHIBIT "A" — Program Summary in accordance with the terms and conditions of this Contract. 5.2 Use of HOPWA Funds. 5.2.1. Compliance with HOPWA Regulations and Contract. Agency shall be reimbursed for eligible Program costs with HOPWA Funds only if City determines in its sole discretion that: 5.2.1.1 Costs are eligible expenditures in accordance with HOPWA Regulations. 5.2.1.2 Costs are in compliance with this Contract and are reasonable and consistent with industry norms. 5.2.1.3 Complete Documentation, as applicable, is submitted to City by Agency. 5.2.2 Budget 5.2.2.1 The HOPWA Funds will be paid on a reimbursement basis in accordance with EXHIBIT `B" - Budget. 5.2.2.2 During the term of this Contract, Agency may submit written requests to increase or decrease line -item amounts in the Budget, including an explanation of why such increases or decreases are necessary. All requests shall be approved by Director in writing, with such approval being in the Director's sole discretion. If the Agency's proposed Budget amendment is approved (as approved, the "Amended Budget"), then the Amended Budget shall be memorialized in a written amendment to this Contract. The Amended Budget take effect on the first day of the month following the month in which the Contract amendment is executed, unless otherwise specified in the amendment. All requests for Budget amendments must be submitted by June 30, 2025. HOPWA PSA CONTRACT 2024-2025 Page 4 AIDS Outreach Center, Inc. Rev. 6-12-2024 governing cost allocation. 5.2.3.2 Agency agrees to utilize the HOPWA Funds to supplement rather than supplant funds otherwise available for the Program. 5.2.4 Payment of HOPWA Funds to Agency. HOPWA Funds will be disbursed to Agency upon City's approval of Reimbursement Requests including submission of Complete Documentation to City in compliance with Section 9. If Agency expends all funds budgeted for the Program prior to September 30, 2025, City may hold back a small amount of the HOPWA Funds until the end of the term. During this interim period, Agency must continue to submit Attachment III — Client Data Report in EXHIBIT "D" — Reimbursement Forms monthly. It is expressly agreed by the Parties that any HOPWA Funds not spent or not approved for reimbursement to Agency shall remain with City. 5.3 Pro2ram Performance Milestones. 5.3.1 Agency represents that the Program will achieve the following milestones in accordance with EXHIBIT "A" — Program Summary and the table below: % Unduplicated Clients Served (as specified in 7MornthExpenditures EXHIBIT "A" — Program Summary) October - January 0% 0% February - March 15% 15% April -June 30% 30% July - September 55% 55% 7 100% 100% 5.3.2 Failure of Agency to meet these milestones or a material deviation from them as outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section, "material deviation" shall mean more than 10% lower than the specified goal. In the event of such breach, City reserves the right in its sole option to (i) delay or withhold payment of Reimbursement Requests, (ii) institute a Corrective Action Plan ("CAP") as described below, (iii) lower Agency's HOPWA PSA CONTRACT 2024-2025 Page 5 AIDS Outreach Center, Inc. Rev. 6-12-2024 5.3.2 Failure of Agency to meet these milestones or a material deviation from them as outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section, "material deviation" shall mean more than 10% lower than the specified goal. In the event of such breach, City reserves the right in its sole option to (i) delay or withhold payment of Reimbursement Requests, (ii) institute a Corrective Action Plan ("CAP") as described below, (iii) lower Agency's allocation of or deobligate all HOPWA Funds, (iv) terminate this Contract, or (v) any combination of the above options. 5.3.2.1 Policy. To ensure the Program meets the client goals provided by Agency and included herein, City will periodically review Program performance to ensure the expenditure of the funds is roughly proportional to the number of eligible, unduplicated clients being served, as described above in 5.3.1. City expects that most programs will expend funds in a proportional amount to clients served, but City reserves the ability to take into account unique program characteristics that may impact the ratio between expenditures and clients served. 5.3.2.2 Review. At the end of each quarter, City will review the information provided to City by Agency in its Exhibit D. City will review the amount of funds expended compared to the percentage of eligible, unduplicated clients served. If City believes in its sole discretion that Agency is (i) in danger of not spending the full amount of the funds allocated, (ii) in danger of expending all funds prior to serving 100% of the unduplicated client goal (meaning the percentage of funds expended relative to the overall funding allocated is not within 10% of the percentage of eligible, unduplicated clients served relative to the overall client goal), or is (iii) in danger of not otherwise meeting the performance goals within this Contract, City will notify Agency and set up a Program Review Meeting ("Review Meeting"). Failure by Agency to attend the Review Meeting is considered a breach of this contract and City may invoke any and all remedies included herein. During the Review Meeting, City and Agency will review the information provided, the Program, and discuss any concerns. If the City believes that no additional action is needed to ensure Agency's performance, no additional requirements will be put in place; however, if the City, in its sole discretion, believes that additional requirements are needed to ensure Agency's performance, City may require the Agency to enter into a Corrective Action Plan ("CAP") or may move forward with deobligating funds from the Contract. 5.3.2.3 Corrective Action Plans ("CAP") A CAP will be unique to the Agency and the Program and will be designed to ensure that the Agency (i) expends the funds allocated to it by the City, and (ii) serves the required number of unduplicated clients through the Program. A CAP may require additional outreach or marketing, additional reporting, additional monitoring, or any other mechanism that will reasonably ensure the Program goals are met and that expenditures are roughly proportional to the number of eligible, unduplicated clients served. HOPWA PSA CONTRACT 2024-2025 Page 6 AIDS Outreach Center, Inc. Rev. 6-12-2024 5.3.2.4 Deobligation of Funds If after any quarterly review the City determines that a CAP will not be sufficient to ensure that the Agency (i) expends the funds allocated to it by the City, and (ii) serves the required number of unduplicated clients through the Program, City shall be able to deobligate a portion of the funds provided to Agency that is at -risk of not being expended or that is the proportional amount of funds compared to the number of eligible, unduplicated clients that are anticipated to not be served. Any deobligation shall be in the form of a contract amendment. By way of example, if an agency was allocated $100,000 and was required to serve 100 unduplicated clients, if that agency was expected to only be able to serve 75% of its client goal, then City would allow agency to keep 75% of the allocated funding and deobligate 25% of the funds to correspond with the 25% of clients that are anticipated to not be served. 5.3.3 Failure to comply with the Corrective Action Plan (CAP) meet the Program Goals, or otherwise comply with serving 120 unduplicated clients may, in City's sole discretion, disqualify Agency for consideration under the City's Request for Proposals for the succeeding Program Year for federal grant funds. 5.3.4 Amendments to performance milestones regarding HOPWA funds must be approved by the Director in writing, with such approval being in the Director's sole discretion. If Director approves the Agency's proposed amended performance milestones (as approved, the "Amended Performance Milestones"), then the Amended Performance Milestones will take effect on the first day of the month following the month in which it was approved by Director, unless otherwise specified in the amendment. Except in extreme circumstances, Amendments will not reduce the number of Unduplicated Clients stated in Section 5.3.3 and in EXHIBIT "A" - Program Summary. In the event that an Amendment is approved for such purpose, the amendment will also likely result in and include a reduction of HOPWA funding for the Program. 5.4 Identify Program Expenses Paid with HOPWA Funds. Agency will keep accounts and records in such a manner that City may readily identify and account for Program expenses reimbursed with HOPWA Funds. These records shall be made available to City for audit purposes and shall be retained as required hereunder. 5.5 Program Subcontracts. Agency shall not enter into a subcontract with another agency, contractor, or vendor to provide a service to clients for any part of the Program that will be paid with HOPWA Funds without City's written consent. 6. CLIENT ELIGIBILITY VERIFICATION. 6.1 Client Eligibility. Agency will document the eligibility of all prospective clients. Agency may redact the HOPWA PSA CONTRACT 2024-2025 Page 7 AIDS Outreach Center, Inc. Rev. 6-12-2024 client's personal information and substitute a client number. Agency will document client eligibility as follows: 6.1.1 Income. Agency must verify all clients' income eligibility with Source Documentation upon start of the program year as well as upon recertification. Agency must use the annual income definition used by 24 CFR Part 5.609 to establish client income eligibility and must use the most current HUD Income Guidelines. 6.1.2 Diagnosis. Agency must submit a signed, dated statement that the client's file contains documentation of the client's diagnosis of HIV/AIDS. The HIV/AIDS diagnosis must be made by a licensed health care provider; a client's self -certification of diagnosis is not sufficient. Agency should not submit the actual diagnosis to City. 6.1.3 Emergency Need. For clients receiving short term rental, mortgage or utility assistance, Agency must also verify and document that the client has an emergency need, such as sudden loss of income, eviction, utility shutoff, or extraordinary and unexpected healthcare costs. Agency must submit its policy regarding documenting emergency need to City by May 4, 2025. 6.2 Submission of Complete Documentation. Agency must submit copies of documentation of client eligibility described in Section 6.1 with Attachment III in each month's Reimbursement Request for all Unduplicated Clients. 6.3 Maintain Documentation. Agency must maintain copies of all documentation required by Section 6 for 5 years following the expiration of the Contract term. This Section shall survive the earlier terminations or expirations of this Contract. 7. ADDITIONAL HOPWA REQUIREMENTS. Agency agrees to comply with all requirements of the HOPWA Program as stated in the HOPWA Regulations, including but not limited to the following: 7.1 Environmental Review. HOPWA Funds will not be paid, and costs cannot be incurred until City has conducted an environmental review and completed an Environmental Review Record as required by 24 CFR Part 58. The environmental review may result in a decision to proceed with, modify, or cancel the funding for the Program. Further, Agency will not undertake or commit any funds to physical or HOPWA PSA CONTRACT 2024-2025 Page 8 AIDS Outreach Center, Inc. Rev. 6-12-2024 choice limiting actions as described in any applicable federal regulations. Any violation of this provision will (i) cause this Contract to terminate immediately; and (ii) require Agency to repay City the HOPWA Funds it has already received and forfeit any future payments of HOPWA Funds. 7.2 Contract Not Constituting Commitment of Funds. Notwithstanding any provision of this Contract, the Parties agree and acknowledge that this Contract does not constitute a commitment of funds, and that such commitment of funds or approval may occur only upon (i) satisfactory completion of an environmental review and receipt by City of an authorization to use grant funds from HUD under 24 CFR Part 58, (ii) approval of City's 2024 -2025 Action Plan, and (iii) receipt by City of grant agreement from HUD. 7.3 Monitoring. 7.3.1 Agency understands and agrees that it will be subject to monitoring by City for compliance with terms and provisions of this Contract and the HOPWA Regulations for the term of this Contract. Agency is subject to such monitoring during the term of this Contract and for 5 years after the Contract term ends. Agency will provide reports and access to Program files as requested by City during this 5 year period. 7.3.2 Representatives of City, HUD, HUD Office of Inspector General, and the United States Comptroller General shall have access during regular business hours, upon 48 hours prior notice, to Agency's offices and records pertaining to the use of the HOPWA Funds, and to Agency's officers, directors, agents, employees, contractors, subcontractors and vendors for the purpose of such monitoring. 7.3.3 In addition to other provisions of this Contract regarding frequency of monitoring, City reserves the right to perform desk reviews or on -site monitoring of Agency's compliance with the terms and conditions of this Contract. City shall provide Agency with a written report of the monitor's findings after each monitoring visit. If the monitoring report notes deficiencies in Agency's performance, the report shall include requirements for the timely correction of said deficiencies by Agency. Failure by Agency to take the action specified in the monitoring report may be cause for suspension or termination of this Contract as provided herein. 7.3.4 Subsections 7.3.1 through 7.3.3 shall be applicable for the Contract term and for 5 years thereafter and shall survive the earlier termination or expiration of this Contract. 7.3.5 Agency shall provide City annually the results of any state or federal monitoring. Such results shall be submitted within 60 days of receipt of such state or federal monitoring report, or with the January Reimbursement Request, whichever is earlier. 7.4 Agency Procurement Standards. Agency shall comply with all applicable federal, state and local laws, regulations, and ordinances for making procurements under this Contract. In addition to the conflict of interest HOPWA PSA CONTRACT 2024-2025 Page 9 AIDS Outreach Center, Inc. Rev. 6-12-2024 provision in Section 14.13.3, Agency shall establish written procurement procedures to ensure that materials and services are obtained in a cost effective manner and that provides for full and open competition. When procuring materials and services for this Contract, Agency shall comply at a minimum with the procurement standards in 2 CFR Part 200.317 through 2 CFR Part 200.326. 7.4.1 Contracts in excess of $10,000.00 made by Agency using HOPWA Funds must address termination for cause and convenience including the manner by which such termination shall be effected and the basis for settlement of the terminated contract, if any, as required by Appendix II (B), 2 CFR Part 200. 7.4.2 Agency shall not make any contract with parties listed on the government wide System for Award Management, www.sam.gov ("SAM"). Agency must confirm by search of SAM that all contractors paid with HOPWA Funds are not listed by SAM as being debarred, both prior to hiring and prior to submitting a Reimbursement Request which includes invoices from any such contractor. Failure to submit such proofs of search shall be an event of default. 7.5 Cost Principles/Cost Reasonableness. Agency shall administer its use of HOPWA Funds in compliance with 2 CFR Part 200, as applicable. The eligibility of costs incurred for performance rendered shall be determined in accordance with 2 CFR Part 200.400 through 2 CFR Part 200.475. 7.6 Financial Management Standards. Agency agrees to comply with 2 CFR Part 200, as applicable. Agency also agrees to adhere to the accounting principles and procedures required therein, utilize adequate internal controls, and maintain necessary supporting and back-up documentation for all costs incurred in accordance with 2 CFR Part 200.302 and Part 200.303. 7.7 Uniform Administrative Requirements, Cost Principles, and Audit Requirements. Agency will comply with the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards in 2 CFR Part 200, as applicable, or any reasonably equivalent procedures and requirements that City may require. 7.8 Terms Applicable to Contractors, Subcontractors and Vendors. Agency understands and agrees that all terms of this Contract, whether regulatory or otherwise, shall apply to any and all contractors, subcontractors and vendors of Agency which are in any way paid with HOPWA Funds or who perform any work in connection with the Program. Agency shall cause all applicable provisions of this Contract to be included in and made a part of any contract or subcontract executed in the performance of its obligations hereunder including its obligations regarding the HOPWA Regulations. Agency shall monitor the services and work performed by its contractors, subcontractors and vendors on a regular basis for compliance with the HOPWA Regulations and Contract provisions. Agency must cure all violations of the HOPWA HOPWA PSA CONTRACT 2024-2025 Page 10 AIDS Outreach Center, Inc. Rev. 6-12-2024 Regulations committed by its contractors, subcontractors or vendors. City maintains the right to insist on Agency's full compliance with the terms of this Contract and the HOPWA Regulations and Agency is responsible for such compliance regardless of whether actions taken to fulfill the requirements of this Contract are taken by Agency or by Agency's contractors, subcontractors or vendors. Agency acknowledges that the provisions of this Section shall survive the earlier termination or expiration of this Contract and shall be applicable for 5 years after the Contract Term ends. 7.9 Copyright and Patent Rights. No reports, maps, or other documents produced in whole or in part under this Contract shall be the subject of an application for copyright by or on behalf of Agency. HUD and City shall possess all rights to invention or discovery, as well as rights in data, which may arise as a result of Agency's performance under this Contract. 7.10 Conflict of Interest Disclosure. In accordance with the requirements of Section 14.13.2.1 and 14.13.4, Agency shall establish conflict of interest policies for federal awards. Agency shall disclose to City in writing any potential conflict of interest. 7.11 Compliance with FFATA and Whistleblower Protections. Agency shall comply with the requirements of 2 CFR 300(b), including provisions of the Federal Funding Accountability and Transparency Act ("FFATA") governing requirements on executive compensation and provisions governing whistleblower protections contained in 10 U.S.C. 2409,41 U.S.C. 4712, 10 U.S.C. 2324,41 U.S.C. 4304 and 41 U.S.C. 4310. 7.11.1 Agency shall provide City with its DUNS number. 7.12 Internal Controls. In compliance with the requirements of 2 CFR Part 200.303, Agency shall: 7.12.1 Establish and maintain effective internal control over the HOPWA Funds that provides reasonable assurance that Agency is managing the HOPWA Funds in compliance with federal statutes, regulations, and the terms and conditions of this Contract. These internal controls shall be in compliance with guidance in "Standards for Internal Control in the Federal Government" issued by the Comptroller General of the United States or the "Internal Control Integrated Framework" issued by the Committee of Sponsoring Organizations of the Treadway Commission ("COSO"); 7.12.2 Comply with federal statutes, regulations, and the terms and conditions of this Contract; 7.12.3 Evaluate and monitor Agency's compliance with statutes, regulations and the terms and conditions of this Contract; HOPWA PSA CONTRACT 2024-2025 Page 11 AIDS Outreach Center, Inc. Rev. 6-12-2024 7.12.4 Take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings; and 7.12.5 Take reasonable measures to safeguard protected personally identifiable information and other information that HUD or City designates as sensitive or Agency considers sensitive consistent with applicable federal, state, local and tribal laws regarding privacy and obligations of confidentiality. 7.13 Required Certification of Completion of Training. At least 1 Agency employee must complete the HUD required training titled "Getting to Work Training Curriculum" by April 15, 2025 and submit the required certifications to City with the April 2025 Reimbursement Request, as further described in EXHIBIT "A-2" — Requirements for Completion of "Getting to Work Training Curriculum". 7.14 Housing Quality Standards. All housing assisted under this Contract must meet Housing Quality Standards (HQS) and habitability standards as required by 24 CFR 982.401, 24 CFR Part 574.310(b). City shall have the right to inspect to confirm compliance with these standards. 7.15. Violence Against Women Act Reauthorization Act of 2022 Requirements 7.15.1 Agency shall comply with the Violence Against Women Act Reauthorization Act of 2022 ("VAWA") and shall ensure that any property owner, manager, or facility assisted by the HOPWA Funds shall, at the time of application for services, provide all clients receiving rental assistance with a Notice of Occupancy Rights under the Violence Against Women Act in substantially the same form as the form attached and incorporated as Exhibit "J"-Notice of Occupancy Rights Under VAWA in compliance with VAWA and 24 CFR Part 574.604(a)(2), where applicable. 7.15.2 Agency agrees that no applicant for HOPWA assistance may be denied admission or assistance under the Program on the basis or as a direct result of the fact that they are or have been a victim of domestic violence, dating violence, sexual assault, stalking, or economic and technological abuse as long as they would otherwise qualify for the Program. 7.15.3 Agency shall be responsible for reviewing VAWA and 24 CFR Part 574.604 and shall respond to all emergency transfer requests in accordance with the requirements of those provisions. Agency may request that all clients requesting an emergency transfer under VAWA fill out the form attached and incorporated as Exhibit "K" - VAWA Emergency Transfer Request Form. 7.15.4 Agency shall document and report to City any VAWA emergency transfer request and outcome in compliance with 24 CFR Part 91.520 and 24 CFR Part 574 HOPWA PSA CONTRACT 2024-2025 Page 12 AIDS Outreach Center, Inc. Rev. 6-12-2024 8. RECORD KEEPING; REPORTING AND DOCUMENTATION REQUIREMENTS; AUDIT. 8.1 Record Keeping. Agency shall maintain a record -keeping system as part of its performance of this Contract and shall promptly provide City with copies of any document City deems necessary for the effective fulfillment of City's monitoring and evaluation responsibilities. Specifically, Agency will keep or cause to be kept an accurate record of all actions taken and all funds spent, with supporting and back-up documentation. Agency will maintain all records and documentation related to this Contract for 5 years after the Contract term ends. If any claim, litigation, or audit is initiated before the expiration of the 5 year period, the relevant records and documentation must be retained until all such claims, litigation or audits have been resolved. 8.2 Access to Records. Representatives of City, HUD and any duly authorized officials of the federal government will have full access to, and the right to examine, audit, copy, excerpt and/or transcribe any of Agency's records pertaining to all matters covered by this Contract for 5 years after the Contract term ends. Such access shall be during regular business hours and upon at least 48 hours prior notice. 8.3 Reports. Agency will submit to City all reports and documentation described in this Contract in such form as City may prescribe. Agency may also be required to submit a final performance and/or final financial report if required by City at the termination of this Contract in such form and within such times as City may prescribe. Failure to submit to City any report or documentation described in this Contract shall be an event of default of this Contract and City may exercise all of its remedies for default under this Contract. 8.3.1 Additional Information. Agency shall provide City with additional information as may be required by state or federal agencies to substantiate Program activities and/or expenditure eligibility. 8.4 Change in Reporting Requirements and Forms City retains the right to change reporting requirements and forms at its discretion. City will notify Agency in writing at least fifteen (15) days prior to the effective date of such change, and the Parties shall execute an amendment to the Contract reflecting such change if necessary. 8.5 Audit 8.5.1 Entities that Expend $1000,000 or more in Federal Funds Per Year HOPWA PSA CONTRACT 2024-2025 Page 13 AIDS Outreach Center, Inc. Rev. 6-12-2024 All non-federal entities that expend $1,000,000 or more in federal funds within 1 year, regardless of the source of the federal award, must submit to City an annual audit prepared in accordance with specific reference to 2 CFR Part 200.501 through Part 200.521. The audit shall cover the Agency's fiscal years during which this Contract is in force. The audit must be prepared by an independent certified public accountant, be completed within 6 months following the end of the period being audited and be submitted to City within 30 days of its completion. Agency's audit certification is attached hereto as EXHIBIT "C" — "Audit Certification Form" and "Audit Requirements". The Audit Certification Form must be submitted to City prior to or with the first Reimbursement Request. Entities that expend less than $1,000,000 a year in federal funds are exempt from federal audit requirements for that year, but records must be available for review or audit by appropriate officials of the federal agency, City, and General Accounting Office. 8.5.2 City Reserves the Right to Audit. City reserves the right to perform an audit of Agency's Program operations and finances at any time during the term of this Contract and for 5 years after the Contract Term ends if City determines that such audit is necessary for City's compliance with the HOPWA Regulations or other City policies. Agency agrees to allow access to all pertinent materials as described herein for such audit. If such audit reveals a questioned practice or expenditure, such questions must be resolved within fifteen (15) business days after notice to Agency of such questioned practice or expenditure. If questions are not resolved within this period, City reserves the right to withhold further funding under this Contract and/or any other contracts with Agency. IF AS A RESULT OF ANY AUDIT IT IS DETERMINED THAT AGENCY HAS FALSIFIED ANY DOCUMENTATION OR MISUSED, MISAPPLIED OR MISAPPROPRIATED HOPWA FUNDS OR SPENT HOPWA FUNDS ON ANY INELIGIBLE ACTIVITIES, AGENCY AGREES TO REIMBURSE CITY THE AMOUNT OF SUCH MONIES PLUS THE AMOUNT OF ANY SANCTIONS, PENALTY OR OTHER CHARGE LEVIED AGAINST CITY BY HUD BECAUSE OF SUCH ACTIONS. 9. REIMBURSEMENT REQUIREMENTS 9.1 Deadline for Submitting Reimbursement Requests. 9.1.1 Reimbursement Requests shall be submitted monthly to the City and must be received by the City on or before the 15th day of the month following the month expenses were paid by Agency. For example, the Reimbursement Request for June expenses must be received by July 15. In the event the 15th falls on a weekend or City holiday, Reimbursement Requests shall be due the next day that the City is open for business. Failure to submit a Reimbursement Request in a timely fashion will result in City taking the actions outlined in Section 11.1. NOTWITHSTANDING ANYTHING ABOVE, THE REIMBURSEMENT REQUEST FOR EXPENSES INCURRED FOR SEPTEMBER 2025 MUST BE RECEIVED BY OCTOBER 4, 2025. COMPLETE DOCUMENTATION FOR ALL SEPTEMBER 2025 EXPENSES MUST BE SUBMITTED BY OCTOBER 15, 2025. FAILURE TO SUBMIT A FINAL REIMBURSEMENT REQUEST WITH COMPLETE DOCUMENTATION BY HOPWA PSA CONTRACT 2024-2025 Page 14 AIDS Outreach Center, Inc. Rev. 6-12-2024 OCTOBER 15, 2025 WILL RESULT IN FORFEITURE OF PAYMENT OF THE SEPTEMBER REIMBURSEMENT REQUEST. 9.1.2 City will notify Agency by e-mail within fourteen (14) calendar days if a Reimbursement Request is lacking Complete Documentation or corrections are needed. Agency will have seven (7) business days from the date of the e-mail notice to submit any requested information or missing documentation. Agency may be penalized, at City's sole discretion, in the Request for Proposal for the following Program Year for any notifications received under this Section. If Agency fails to submit all the required information or missing documentation within seven (7) calendar days from the first e-mail, Agency may forfeit any payments otherwise due that month and failure to submit any requested information will be considered an event of default as outlined in Section 10.1.2. 9.2 Submission of Reimbursement Requests. Agency shall provide City with Complete Documentation and the following reports as shown in EXHIBIT "D" — Reimbursement Forms with each Reimbursement Request: 9.2.1 Attachment I — Request Summary This report shall contain the amount requested for reimbursement each month and the cumulative reimbursement requested to date (inclusive of that month's request). 9.2.1.1 Agency must submit a separate request summary for each activity type, i.e. Administration, Supportive Services, Short-term Rent, Mortgage and Utility Assistance ("STRMU"), and Tenant Based Rental Assistance ("TBRA"). 9.2.2 Attachment II — Expenditure Worksheet This report shall itemize each expense requested for reimbursement by Agency and shall include the Account corresponding the expense to a Budget line item. In order for this report to be complete the following must be submitted: 9.2.2.1 For payroll expenses, timesheets signed by employees and approved by supervisor for all payroll expenses listed. Timesheets must distinguish between HOPWA-funded time and non-HOPWA funded time and reflect actual time spent on HOPWA-funded activities. Agency may not submit payroll expenses dated sixty (60) calendar days prior to the date of the Reimbursement Request. 9.2.2.2 For non -payroll expenses, invoices for each expense listed with an explanation as to how the invoiced expense pertains to the Program. Agency may not submit invoices dated sixty (60) calendar days prior to the date of the Reimbursement Request. HOPWA PSA CONTRACT 2024-2025 Page 15 AIDS Outreach Center, Inc. Rev. 6-12-2024 9.2.2.3 Proof that each expense was paid by Agency. Proof can be satisfied by canceled checks, wire transfer documentation, paid receipts or other appropriate banking documentation. 9.2.3 Attachment III — Client Data Report. This report shall list each Unduplicated Client served during the month along with his or her demographic information. The Client Data Report must maintain a list of all clients served during the Contract term. If Agency, receives funds from the United States Department of Justice or the Victims of Crime Act, then Agency is prohibited from submitting the Client Data Report to the City. However, Agency must complete all required forms under Section 9.2.3 and maintain in client files in accordance with Section 8. In order for this report to be complete, the following must be submitted: basis. 9.2.3.1 Documentation of income verification for each Unduplicated Client the first time the client is served by the Program and upon recertification, which will be Source Documentation. 9.2.4 CAPER Report. Agency shall submit the CAPER report, attached hereto as EXHIBIT "G" — on an annual 9.2.5 Delivery of Reimbursement Request. Reimbursement Requests will be submitted through Neighborly Software by the designated due date, as outlined in Section 9.1. 9.3 Withholding Payment. CITY SHALL HAVE NO OBLIGATION TO PAY ANY REIMBURSEMENT REQUEST THAT IS NOT RECEIVED BY THE DUE DATE AS OUTLINED HEREIN. Failure to timely submit accurate and complete Reimbursement Requests and Complete Documentation along with any required reports shall be an event of default. 10. DEFAULT AND TERMINATION. 10.1 Failure to Submit Reimbursement Request or Required Documentation. 10.1.1 Failure to submit a Reimbursement Request in accordance with Section 9 and Exhibits "D" and "F" may in default of this Contract. If Agency has not provided the requested information or missing documentation within the seven (7) calendar day notice period as provided for in Section 9.1.2, City will provide Agency with a written "Default Notice." Agency will have five (5) calendar days from the date of the written Default Notice to submit information and documentation to cure the default. If Agency fails to cure the default within such time, Agency HOPWA PSA CONTRACT 2024-2025 Page 16 AIDS Outreach Center, Inc. Rev. 6-12-2024 shall forfeit any payments otherwise due that month and the failure to submit shall be considered an event of default that shall not be cured. 10.1.2 NOTWITHSTANDING THE PROVISIONS OF SECTION 10.1.1, IF AGENCY FAILS TO SUBMIT THE REIMBURSEMENT REQUEST DUE OCTOBER 4, 2025, OR IF THE SUBMITTED REIMBURSEMENT REQUEST FOR OCTOBER 4, 2025 IS LATE, INCOMPLETE OR OTHERWISE NOT IN COMPLIANCE WITH THIS CONTRACT OR THE HOPWA REGULATIONS AS DETERMINED BY CITY IN ITS SOLE DISCRETION, THERE WILL BE NO CURE PERIOD AND ANY REIMBURSEMENT WILL BE FORFEITED. 10.1.3 In the event of (i) an uncured default under this Section, City reserves the right at its sole option to terminate this Contract effective immediately upon written notice of such intent with no penalty or liability to City. 10.1.4 Notwithstanding anything to the contrary herein, City will not be required to pay any HOPWA Funds to Agency during the period that any Reimbursement Request, report or documentation is past due or is not in compliance with this Contract or the HOPWA Regulations, or during any period during which Agency is in default of this Contract. 10.1.5 In the event of termination under this Section 10.1, all HOPWA Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds. 10.2 Failure to Maintain Records or Submit Reports and Documentation. If Agency fails to maintain all records and documentation as required in Section 8, or if the maintained or submitted report or documentation is not in compliance with this Contract or the HOPWA Regulations as determined by City in its sole discretion, City will notify Agency in writing and Agency will have thirty (30) calendar days from the date of the written request to obtain or recreate the missing records and documentation or submit or resubmit any such report or documentation to City. If Agency fails to maintain the required reports or documentation, or fails to submit or resubmit any such report or documentation within such time, City shall have the right to terminate this Contract effective immediately upon written notice of such intent with no penalty or liability to City. 10.2.1 In the event of termination under this Section 10.2, all HOPWA Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds. 10.2.2 In the event of termination under Section 10.2, any HOPWA Funds paid to Agency must be repaid to City within thirty (30) days of termination. If such HOPWA Funds are not repaid to City within the thirty (30) day period, City shall exercise all legal remedies available under this Contract. 10.3 In General. HOPWA PSA CONTRACT 2024-2025 Page 17 AIDS Outreach Center, Inc. Rev. 6-12-2024 10.3.1 Subject to Section 10.2, and unless specifically provided otherwise in this Contract, Agency shall be in default under this Contract if Agency breaches any term or condition of this Contract. In the event that such a breach remains uncured after thirty (30) calendar days following written notice by City (or such other notice period as may be specified herein) or, if Agency has diligently and continuously attempted to cure following receipt of such written notice but reasonably requires more than thirty (30) calendar days to cure, as determined by both Parties mutually and in good faith, City shall have the right to elect in City's sole discretion to (i) extend Agency's time to cure, (ii) terminate this Contract effective immediately upon written notice of such intent to Agency, or (iii) pursue any other legal remedies available to City under this Contract. 10.3.2 City's remedies may include: 10.3.2.1 Direct Agency to prepare and follow a schedule of actions for carrying out the affected activities, consisting of schedules, timetables and milestones necessary to implement the affected activities. 10.3.2.2 Direct Agency to establish and follow a management plan that assigns responsibilities for carrying out the remedial activities. 10.3.2.3 Reprogram HOPWA Funds that have not yet been expended from affected activities to other eligible activities or withhold HOPWA Funds. 10.3.2.4 Any other appropriate action including but not limited to any remedial action legally available such as declaratory judgment, specific performance, damages, temporary or permanent injunctions, termination of this Contract or any other contracts with Agency, and any other available remedies. 10.3.3 In the event of termination under this Section 10.3, all HOPWA Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds, and any HOPWA Funds already paid to Agency must be repaid to City within thirty (30) days of the termination. Failure to repay such HOPWA Funds within the thirty (30) day period will result in City exercising all legal remedies available under this Contract. 10.4 No Funds Disbursed while in Breach. Agency understands and agrees that no HOPWA Funds will be paid to Agency until all defaults are cured to City's satisfaction. 10.5 No Compensation After Date of Termination. HOPWA PSA CONTRACT 2024-2025 Page 18 AIDS Outreach Center, Inc. Rev. 6-12-2024 Agency shall not receive any compensation for work undertaken after the date of the termination. 10.6 Rights of City Not Affected. Termination shall not affect or terminate any of the existing rights of City against Agency, or which may thereafter accrue because of Agency's default and this provision shall be in addition to any and all other rights and remedies available to City under the law. Such termination does not terminate any provisions of this Contract that have been expressly noted as surviving the term or termination of the Contract. No delay or omission by City in exercising any right or remedy available to it under this Contract shall impair any such right or remedy or constitute a waiver or acquiescence in any Agency default. 10.7 Waiver of Breach Not Waiver of Subsequent Breach The waiver of a default or breach of any term, covenant, or condition of this Contract shall not operate as a waiver of any subsequent default or breach of the same or any other term, covenant or condition hereof. 10.8 Civil, Criminal and Administrative Penalties Failure to perform all the Contract terms may result in civil, criminal or administrative penalties, including, but not limited to those set out in this Contract. 10.9 Termination for Cause 10.9.1 City may terminate this Contract in the event of Agency's default, inability, or failure to perform subject to notice, grace and cure periods. In the event City terminates this Contract for cause, all HOPWA Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately rescinded and Agency shall have no further right to such funds and any HOPWA Funds already paid to Agency must be repaid to City within thirty (30) days of termination. Failure to repay such HOPWA Funds within thirty (30) days will result in City exercising all legal remedies available to City under this Contract. AGENCY ACKNOWLEDGES AND AGREES THAT IF CITY TERMINATES THIS CONTRACT FOR CAUSE, AGENCY OR ANY AFFILIATES OF AGENCY SHALL NOT BE CONSIDERED FOR ANY OTHER CITY CONTRACT FOR HOPWA FUNDS FOR A MINIMUM OF 5 YEARS FROM THE DATE OF TERMINATION. 10.9.2 Agency may terminate this Contract if City does not provide the HOPWA Funds substantially in accordance with this Contract. 10.10 Termination for Convenience. In terminating in accordance with 2 CFR Part 200, Appendix II, this Contract may be terminated in whole or in part only as follows: HOPWA PSA CONTRACT 2024-2025 Page 19 AIDS Outreach Center, Inc. Rev. 6-12-2024 10.10.1 By City with the consent of Agency in which case the Parties shall agree upon the termination conditions, including the effective date and in the case of partial termination, the portion to be terminated; or 10.10.2 By Agency upon at least thirty (30) days written notification to City, setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. In the case of a partial termination, City may terminate the Contract in its entirety if City determines in its sole discretion that the remaining portion of the Contract to be performed or HOPWA Funds to be spent will not accomplish the purposes for which the Contract was made. 10.11 Dissolution of Agency Terminates Contract. This Contract shall terminate in the event Agency is dissolved or ceases to exist. In the event of termination under this Section, all HOPWA Funds are subject to repayment and/or City may exercise all of its remedies under this Contract. 10.12 Reversion of Assets. In the event this Contract is terminated with or without cause, all assets acquired by Agency with the HOPWA Funds including cash, interest payments from loans or otherwise, all outstanding notes, mortgages or other security instruments, any accounts receivable attributable to the use of the HOPWA Funds, and any real or personal property owned by Agency that was improved with the HOPWA Funds shall automatically transfer to City or to such assignee as City may designate. 11. REPAYMENT OF HOPWA FUNDS. All HOPWA Funds are subject to repayment in the event the Program does not meet the requirements of this Contract or in the HOPWA Regulations. If Agency takes any action that results in the City being required to repay all or any portion of the HOPWA Funds to HUD, Agency agrees it will reimburse City within thirty days of notice from the City for such repayment. Additionally, if Agency takes any action that results in City receiving a finding from HUD about the Program, whether or not repayment of all or any portion of the HOPWA Funds is required of City, Agency agrees City may require that 10% of the HOPWA Funds be repaid to City as liquidated damages. The Parties agree that City's damages in the event of either repayment to HUD being required or receiving a finding from HUD are uncertain and would be difficult to ascertain and may include an impact on City's HOPWA grant or other federal grant funds, in addition to the finding by HUD or a required repayment of funds to HUD by City. Therefore, the Parties agree that payment under this Section of 10% of the HOPWA Funds by Agency to City is liquidated damages and not a penalty. 12. CHANGE IN NON-PROFIT STATUS. Agency must provide City with written notification of any changes to its non-profit status HOPWA PSA CONTRACT 2024-2025 Page 20 AIDS Outreach Center, Inc. Rev. 6-12-2024 within 15 calendar days of being notified of the change. Regardless of notice by Agency, if the non-profit status of Agency changes after the date of this Contract, City may but is not obligated to, terminate this Contract. In the event of termination under this Section 12, all HOPWA Funds awarded but not yet paid to Agency pursuant to this Contract shall be immediately rescinded and Agency shall have no further right to such funds. City, in its sole discretion, may require that any HOPWA Funds already paid to Agency must be repaid to City within 30 calendar days of termination under this Section. 13. SURVIVAL. Any provision of this Contract that pertains to auditing, monitoring, indemnity obligations, client income eligibility, record keeping and reports, City ordinances, or applicable HOPWA requirements, and any default and enforcement provisions necessary to enforce such provisions, shall survive the termination of this Contract for 5 years after the Contract term ends and shall be enforceable by City against Agency. 14. GENERAL PROVISIONS. 14.1 Agency an Independent Contractor. Agency shall operate hereunder as an independent contractor and not as an officer, agent, servant or employee of City. Agency shall have exclusive control of, and the exclusive right to control, the details of the work and services performed hereunder, and all persons performing same, and shall be solely responsible for the acts and omissions of its officers, members, agents, servants, employees, contractors, subcontractors, vendors, clients, licensees or invitees. 14.2 Doctrine of Respondeat Superior. The doctrine of respondeat superior shall not apply as between City and Agency, or its officers, members, agents, servants, employees, contractors, subcontractors, vendors, clients, licensees or invitees, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Agency. City does not have the legal right to control the details of the tasks performed hereunder by Agency, its officers, members, agents, employees, contractors, subcontractors, vendors, clients, licensees or invitees. 14.3 Agency Property. City shall under no circumstances be responsible for any property belonging to Agency, or its officers, members, agents, employees, contractors, subcontractors, vendors, clients, licensees or invitees that may be lost, stolen or destroyed or in any way damaged and AGENCY HEREBY INDEMNIFIES AND HOLDS HARMLESS CITY AND ITS OFFICERS, AGENTS, AND EMPLOYEES FROM ANY AND ALL CLAIMS OR SUITS PERTAINING TO OR CONNECTED WITH SUCH PROPERTY. 14.4 Religious Organization. HOPWA PSA CONTRACT 2024-2025 Page 21 AIDS Outreach Center, Inc. Rev. 6-12-2024 Agency shall comply with all applicable requirements as more particularly described in 24 CFR Part 5.109. No portion of the HOPWA Funds shall be used in support of any sectarian or religious activity. In addition, there must be no religious or membership criteria for clients of a HOPWA-funded service. 14.4.1. Separation of Explicitly Religious Activities. Agency retains its independence and may continue to carry out its mission, including the definition, development practice, and expression of its religious beliefs, provided that it does not use HOPWA Funds to support or engage in any explicitly religious activities (including activities that involve overt religious content such as worship, religious instruction, or proselytization), or in any other manner prohibited by law. 14.4.2 Explicitly Religious Activities. If Agency engages in explicitly religious activities (including activities that involve overt religious content such as worship, religious instruction, or proselytization), the explicitly religious activities must be offered separately, in time or location, from the programs or activities supported by HOPWA Funds and participation must be voluntary for clients of a HOPWA-funded service. 14.4.3 Required Notices. If Agency constitutes a Faith -based organization under 24 CFR Part 5.109, Agency must provide all clients of a HOPWA-funded service with the notice attached as EXHIBIT "I" —Notice of Beneficiary Rights. Such notice shall be provided to the client prior to enrollment in any HOPWA-funded program or activity. In addition, if a client or prospective client of a HOPWA- funded service objects to the religious character of Agency, then Agency must promptly undertake reasonable efforts to identify and refer the client or prospective client to an alternate provider to which the client or prospective client has no such objection, as more particularly described in 24 CFR Part 5.109. 14.5 Venue. Venue shall lie in state courts located in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division for any action, whether real or asserted, at law or in equity, arising out of the execution, performance, attempted performance or non-performance of this Contract. 14.6 Governing Law. This Contract shall be governed by and construed in accordance with the laws of the State of Texas. If any action, whether real or asserted, at law or in equity, arises out of the execution, performance or non-performance of this Contract or on the basis of any provision herein, for any issue not governed by federal law, the choice of law shall be the laws of the State of Texas. HOPWA PSA CONTRACT 2024-2025 Page 22 AIDS Outreach Center, Inc. Rev. 6-12-2024 14.7 Severability. The provisions of this Contract are severable, and if for any reason a clause, sentence, paragraph or other part of this Contract shall be determined to be invalid by a court or federal or state agency, board or commission having jurisdiction over the subject matter thereof, such invalidity shall not affect other provisions which can be given effect without the invalid provision. 14.8 Written Agreement Entire Contract. This written instrument and the Exhibits, Attachments, and Addendums attached hereto, which are incorporated by reference and made a part of this Contract for all purposes, constitute the entire agreement by the Parties concerning the work and services to be performed under this Contract. Any prior or contemporaneous oral or written agreement which purports to vary the terms of this Contract shall be void. Any amendments to the terms of this Contract must be in writing and executed by the Parties. 14.9 Paragraph Headings for Reference Only, No Legal Significance; Number and Gender. The paragraph headings contained herein are for convenience in reference to this Contract and are not intended to define or to limit the scope of any provision of this Contract. When context requires, singular nouns and pronouns include the plural and the masculine gender shall be deemed to include the feminine or neuter and the neuter gender to include the masculine and feminine. The words "include" and "including" whenever used herein shall be deemed to be followed by the words "without limitation". 14.10 Compliance with All Applicable Laws and Regulations. Agency agrees to comply fully with all applicable laws and regulations that are currently in effect or that are hereafter amended during the performance of this Contract. Those laws include, but are not limited to: ➢ HOPWA Regulations found in 24 CFR Part 574 ➢ AIDS Housing Opportunity Act, as amended (42 USC 12901 et seq.) ➢ Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d et seq.) including provisions requiring recipients of federal assistance to ensure meaningful access by persons of limited English proficiency ➢ The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. Sections 3601 et seq.) ➢ Executive Orders 11063, 11246 as amended by 11375 and 12086 and as supplemented by Department of Labor regulations 41 CFR Part 60 ➢ The Age Discrimination in Employment Act of 1967 ➢ The Age Discrimination Act of 1975 (42 U.S.C. Sections 6101 et seq.) ➢ The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (42 U.S.C. Sections 4601 et seq. and 49 CFR Part 24) ("URA") HOPWA PSA CONTRACT 2024-2025 Page 23 AIDS Outreach Center, Inc. Rev. 6-12-2024 ➢ Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sections 794 et seq.) and 24 CFR Part 8 where applicable ➢ National Environmental Policy Act of 1969, as amended, 42 U.S.C. Sections 4321 et seq. ("NEPA") and the related authorities listed in 24 CFR Part 58. ➢ The Clean Air Act, as amended, (42 U.S.C. Sections 1251 et seq.) and the Clean Water Act of 1977, as amended (33 U.S.C. Sections 1251 et seq.) and the related Executive Order 11738. In no event shall any amount of the assistance provided under this Contract be utilized with respect to a facility that has given rise to a conviction under the Clean Air Act or the Clean Water Act. ➢ Immigration Reform and Control Act of 1986 (8 U.S.C. Sections 1101 et seq.) specifically including the provisions requiring employer verifications of legal status of its employees ➢ The Americans with Disabilities Act of 1990 (42 U.S.C. Sections 12101 et seq.), the Architectural Barriers Act of 1968 as amended (42 U.S.C. Sections 4151 et seq.) and the Uniform Federal Accessibility Standards, 24 CFR Part 40, Appendix A ➢ Regulations at 24 CFR Part 87 related to lobbying, including the requirement that certifications and disclosures be obtained from all covered persons ➢ Drug Free Workplace Act of 1988 (41 U.S.C. Sections 701 et seq.) and 24 CFR Part 23, Subpart F ➢ Executive Order 12549 and 24 CFR Part 5.105(c) pertaining to restrictions on participation by ineligible, debarred or suspended persons or entities ➢ Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act ➢ Guidelines of the Environmental Protection Agency at 40 CFR Part 247 ➢ For contracts and subgrants for construction or repair, Copeland "Anti -Kickback" act (18 U.S.C. 874) as supplemented in 29 CFR Part 5 ➢ For construction contracts awarded by Agency in excess of $2,000, and in excess of $2,500 for other contracts which involve the employment of mechanics or laborers, Sections 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327A 300) as supplemented by 29 CFR Part 5 ➢ Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), as amended by the Residential Lead -Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et seq.) and implementing regulations at 24 CFR Part 35, subparts A, B, M, and R ➢ Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, 2 CFR Part 200 et seq. ➢ Federal Funding Accountability and Transparency Act of 2006 ("FFATA") (Pub.L. 109-282, as amended by Section 6205(a) of Pub.L. 110-252 and Section 3 of Pub.L. 113-101) ➢ Federal Whistleblower Regulations, as contained in 10 U.S.C. 2409, 41 U.S.C. 4712, 10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310 ➢ The Build America, Buy America Act (BABA) enacted under Division G, Title IX of the Infrastructure Investment and Jobs Act (IIJA, Pub. L. No. 117-58) signed into law on November 15, 2021 HOPWA PSA CONTRACT 2024-2025 Page 24 AIDS Outreach Center, Inc. Rev. 6-12-2024 14.12 Prohibition Against Discrimination. 14.12.1 General Statement. Agency shall comply in the execution, performance or attempted performance of this Contract, with all non-discrimination requirements of 24 CFR Part 574.603 and Chapter 17, Article III, Division 4 — Fair Housing of the City Code. Agency may not discriminate against any person because of race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression, or transgender, nor will Agency permit its officers, members, agents, employees, or clients to engage in such discrimination. This Contract is made and entered into with reference specifically to Chapter 17, Article III, Division 3 - Employment Practices of the City Code, and Agency hereby covenants and agrees that Agency, its officers, members, agents, employees and contractors, have fully complied with all provisions of same and that no employee, or applicant for employment has been discriminated against under the terms of such ordinances by either or its officers, members, agents, employees or contractors. 14.12.2 No Discrimination in Employment during the Performance of This Contract. During the performance of this Contract Agency agrees to the following provision, and will require that its contractors and subcontractors also comply with such provision by including it in all contracts with its contractors: [Contractor's, Subcontractor's or Vendor's name] will not unlawfully discriminate against any employee or applicants for employment because of race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. [Contractor's, Subcontractor's or Vendor's name]will take affirmative action to ensure that applicants are hired without regard to race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender and that employees are treated fairly during employment without regard to their race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. [Contractor's, Subcontractor's or Vendor's name] agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause. [Contractor's Subcontractor's or Vendor's name] will, in all solicitations or advertisements for employees placed by or on behalf of [Contractor's, Subcontractor's or Vendor's name], state that all qualified applicants will receive consideration for employment without regard to race, color, sex, gender, religion, national origin, familial status, disability or HOPWA PSA CONTRACT 2024-2025 Page 25 AIDS Outreach Center, Inc. Rev. 6-12-2024 perceived disability, sexual orientation, gender identity, gender expression or transgender. [Contractor's, Subcontractor's or Vendor's name] covenants that neither it nor any of its officers, members, agents, employees, or contractors, while engaged in performing this Contract, shall, in connection with the employment, advancement or discharge of employees or in connection with the terms, conditions or privileges of their employment, discriminate against persons because of their age or because of any disability or perceived disability, except on the basis of a bona fide occupational qualification, retirement plan or statutory requirement. [Contractor's, Subcontractor's or Vendor's name] further covenants that neither it nor its officers, members, agents, employees, contractors, or persons acting on their behalf, shall specify, in solicitations or advertisements for employees to work on this Contract, a maximum age limit for such employment unless the specified maximum age limit is based upon a bona fide occupational qualification, retirement plan or statutory requirement. 14.12.3 Agency's Contractors and the ADA. In accordance with the provisions of the Americans With Disabilities Act of 1990 ("ADA"), Agency warrants that it and any of its contractors will not unlawfully discriminate on the basis of disability in the provision of services to the general public, nor in the availability, terms and/or conditions of employment for applicants for employment with, or employees of, Agency or any of its contractors. AGENCY WARRANTS IT WILL FULLY COMPLY WITH THE ADA'S PROVISIONS AND ANY OTHER APPLICABLE FEDERAL, STATE AND LOCAL LAWS CONCERNING DISABILITY AND WILL DEFEND, INDEMNIFY AND HOLD CITY HARMLESS AGAINST ANY CLAIMS OR ALLEGATIONS ASSERTED BY THIRD PARTIES, CONTRACTORS SUBCONTRACTORS, VENDORS OR AGENTS AGAINST CITY ARISING OUT OF AGENCY'S AND/OR ITS CONTRACTORS', SUBCONTRACTORS', VENDORS' OR AGENTS' OR THEIR RESPECTIVE EMPLOYEES' ALLEGED FAILURE TO COMPLY WITH THE ABOVE -REFERENCED LAWS CONCERNING DISABILITY DISCRIMINATION IN THE PERFORMANCE OF THIS CONTRACT. 14.13 Conflicts of Interest and Violations of Criminal Law. 14.13.1 Agency Safeguards. Agency shall establish safeguards to prohibit its employees, board members, advisors and agents from using positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business or other ties. Agency shall disclose to City any such conflict of interest or potential conflict of interest, immediately upon discovery of such. 14.13.2 General Prohibitions Against Conflicts of Interest. No employees, agents, consultants, officers or elected officials or appointed officials of City or of Agency who exercise or have exercised any functions or responsibilities with respect to HOPWA PSA CONTRACT 2024-2025 Page 26 AIDS Outreach Center, Inc. Rev. 6-12-2024 activities assisted with HOPWA funds or who are in a position to participate in a decision -making process or gain inside information with regard to these activities may utilize HOPWA services, may obtain a financial interest or benefit from a HOPWA-assisted activity, or have an interest in any contract, subcontract or agreement with respect thereto, or the proceeds thereunder, either for themselves or those with whom they have family or business ties, during their tenure or for 1 year thereafter. 14.13.2.1 Agency shall establish conflict of interest policies for federal awards including the HOPWA Funds and shall disclose in writing potential conflicts of interest to City as authorized by 2 CFR Part 200.112. 14.13.3 Conflicts of Interest Involving Procurement. The conflict of interest provisions of 2 CFR Part 200.318, shall apply in the procurement of property and services by Agency. In all cases not governed by those Sections, the provisions of 24 CFR Part 574.625 of the HOPWA Regulations shall apply. 14.13.3.1 As more particularly described in 2 CFR Part 200.318, Agency shall maintain and submit to City written standards of conduct covering conflicts of interest and governing the performance of its employees engaged in the selection, award, and administration of contracts. No employee, officer, or agent may participate in the selection, award, or administration of a contract supported by a federal award if he or she has a real or apparent conflict of interest. The standards of conduct must provide for disciplinary actions to be applied for violations of such standards by officers, employees, or agents of Agency. 14.13.3.2 The officers, employees, and agents of Agency shall neither solicit nor accept gratuities, favors, or anything of monetary value from contractors or parties to subcontracts. 14.13.3.3 Notwithstanding the prohibition contained in Section 14.13.3.2, Agency may set standards of conduct for situations in which the financial interest is not substantial or the gift is an unsolicited item of nominal value. Such standards of conduct must provide for disciplinary actions to be applied for violations of such standards by Agency's officers, employees or agents. 14.13.3.4 Agency shall maintain written standards of conduct covering organizational conflicts of interest. Organizational conflicts of interest means that because of relationships with a parent company, affiliate, or subsidiary organization, Agency is unable or appears to be unable to be impartial in conducting a procurement action involving a related organization. 14.13.3.5 Agency must maintain records sufficient to detail the history of HOPWA PSA CONTRACT 2024-2025 Page 27 AIDS Outreach Center, Inc. Rev. 6-12-2024 procurement. These records will include, but are not necessarily limited to the following: rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. 14.13.4 Disclosure of Conflicts of Interest. In compliance with 2 CFR Part 200.112, Agency is required to timely disclose to City in writing any potential conflict of interest. 14.13.5 Disclosure of Conflicts of Interest for Agency Clients. Agency understands that its clients will be receiving assistance partially or fully funded utilizing Housing and Urban Development (HUD) funds received by City. Agency will assist City in determining whether eligible clients have a potential relationship to the City that constitutes a conflict of interest by having clients fill out the Conflict of Interest Disclosure Form, attached hereto as Exhibit "L". In the event a conflict of interest exists, this may affect the client's eligibility to receive services. As a result, if a potential client provides information on the form that a conflict may exist, Agency must notify City for a determination prior to providing services. 14.13.6 Disclosure of Texas Penal Code Violations. Agency affirms that it will adhere to the provisions of the Texas Penal Code which prohibit bribery and gifts to public servants. 14.13.7 Disclosure of Federal Criminal Law Violations. In compliance with 2 CFR Part 200.113, Agency is required to timely disclose to City all violations of federal criminal law involving fraud, bribery or gratuity violations potentially affecting the Agency. 14.14 Subcontracting with Small and Minority Firms, Women's Business Enterprises and Labor Surplus Areas. 14.14.1 For procurement contracts $100,000.00 or larger that are paid for, in part or in full, with HOPWA Funds, Agency agrees to abide by City's policy to involve Minority Business Enterprises and Small Business Enterprises and to provide them equal opportunity to compete for contracts for construction, provision of professional services, purchase of equipment and supplies and provision of other services required by City. Agency agrees to incorporate the City's BDE Ordinance, and all amendments or successor policies or ordinances thereto, into all contracts and subcontracts for procurement larger than $100,000.00 or larger that are paid for, in part or in full, with the HOPWA Funds and will further require all persons or entities with which it so contracts to comply with said ordinance. 14.14.2 It is national policy to award a fair share of contracts to disadvantaged business enterprises ("DBEs"), small business enterprises ("SBEs"), minority business enterprises ("MBEs"), and women's business enterprises ("WBEs"). Accordingly, affirmative steps must be HOPWA PSA CONTRACT 2024-2025 Page 28 AIDS Outreach Center, Inc. Rev. 6-12-2024 taken to assure that DBEs, SBEs, MBEs, and WBEs are utilized when possible as sources of supplies, equipment, construction and services. 14.14.2.1 In order to comply with federal reporting requirements, Agency must submit the form attached hereto as EXHIBIT "H" — MBE Reporting Form for each contract or subcontract with a value of $25,000.00 or more paid or to be paid with the HOPWA Funds. Agency shall submit this form by the date specified in EXHIBIT "H" — MBE Reporting Form. 14.15 Other Laws. The failure to list any federal, state or City ordinance, law or regulation that is applicable to Agency does not excuse or relieve Agency from the requirements or responsibilities in regard to following the law, nor from the consequences or penalties for Agency's failure to follow the law, if applicable. 14.16 Assignment. Agency shall not assign all or any part of its rights, privileges, or duties under this Contract without the prior written approval of City. Any attempted assignment of same without approval shall be void, and shall constitute a breach of this Contract. 14.17 Right to Inspect Agency Contracts. It is agreed that City has the right to inspect and approve in writing any proposed contracts between Agency and any contractor or vendor engaged in any activity in conjunction with this HOPWA-funded Program prior to any charges being incurred. 14.18 Force Majeure If Agency becomes unable, either in whole or part, to fulfill its obligations under this Contract due to acts of God, strikes, lockouts, or other industrial disturbances, acts of public enemies, wars, blockades, insurrections, riots, epidemics, pandemics, earthquakes, fires, floods, restraints or prohibitions by any court, board, department, commission or agency of the United States or of any States, civil disturbances, or explosions, or some other reason beyond Agency's control (collectively, "Force Majeure Event"), the obligations so affected by such Force Majeure Event will be suspended only during the continuance of such event. Agency will give City written notice of the existence, extent and nature of the Force Majeure Event as soon as reasonably possible after the occurrence of the event. Failure to give notice will result in the continuance of Agency's obligation regardless of the extent of any existing Force Majeure Event. Agency will use commercially reasonable efforts to remedy its inability to perform as soon as possible. 14.19 IMMIGRATION NATIONALITY ACT. Agency shall verify the identity and employment eligibility of its employees who perform work under this Contract, including completing the Employment Eligibility Verification Form (I- HOPWA PSA CONTRACT 2024-2025 Page 29 AIDS Outreach Center, Inc. Rev. 6-12-2024 9). Upon request by City, Agency shall provide City with copies of all I-9 forms and supporting eligibility documentation for each employee who performs work under this Contract. Agency shall adhere to all Federal and State laws as well as establish appropriate procedures and controls so that no services will be performed by any Agency employee who is not legally eligible to perform such services. AGENCY SHALL INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY AGENCY, AGENCY'S EMPLOYEES, SUBCONTRACTORS, AGENTS, OR LICENSEES. City, upon written notice to Agency, shall have the right to immediately terminate this Contract for violations of this provision by Agency. 15. INDEMNIFICATION AND RELEASE. AGENCY COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND, AT ITS OWN EXPENSE, CITY AND ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER HIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED HEREIN, WHETHER OR NOT CAUSED IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY; AND AGENCY HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY OF CITY AND ITS OFFICERS, AGENTS, SERVANTS, AND EMPLOYEES FOR ANY AND ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER HINDS OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED HEREIN, WHETHER OR NOT CAUSED IN WHOLE OR IN PART BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY. AGENCY LIKEWISE COVENANTS AND AGREES TO AND DOES HEREBY INDEMNIFY AND HOLD HARMLESS CITY FROM AND AGAINST ANY AND ALL INJURY, DAMAGE OR DESTRUCTION OF PROPERTY OF CITY, ARISING OUT OF OR IN CONNECTION WITH ALL ACTS OR OMISSIONS OF AGENCY, ITS OFFICERS, MEMBERS, AGENTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, INVITEES, LICENSEES, OR CLIENTS, OR CAUSED, IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY. IT IS THE EXPRESS INTENTION OF THE PARTIES, BOTH AGENCY AND CITY, THAT THE INDEMNITY PROVIDED FOR THIS SECTION INCLUDES INDEMNITY BY AGENCY TO INDEMNIFY AND PROTECT CITY FROM THE HOPWA PSA CONTRACT 2024-2025 Page 30 AIDS Outreach Center, Inc. Rev. 6-12-2024 CONSEQUENCES OF CITY'S OWN NEGLIGENCE, WHETHER THAT NEGLIGENCE IS ALLEGED TO BE THE SOLE OR CONCURRING CAUSE OF THE INJURY, DAMAGE OR DEATH. AGENCY AGREES TO AND SHALL RELEASE CITY, ITS AGENTS, EMPLOYEES, OFFICERS AND LEGAL REPRESENTATIVES FROM ALL LIABILITY FOR INJURY, DEATH, DAMAGE OR LOSS TO PERSONS OR PROPERTY SUSTAINED IN CONNECTION WITH OR INCIDENTAL TO PERFORMANCE UNDER THIS CONTRACT, EVEN IF THE INJURY, DEATH, DAMAGE OR LOSS IS CAUSED BY CITY'S SOLE OR CONCURRENT NEGLIGENCE. AGENCY SHALL REQUIRE ALL OF ITS CONTRACTORS AND SUBCONTRACTORS TO INCLUDE IN THEIR CONTRACTS AND SUBCONTRACTS A RELEASE AND INDEMNITY IN FAVOR OF CITY IN SUBSTANTIALLY THE SAME FORM AS ABOVE. 16. WAIVER OF IMMUNITY BY AGENCY. If Agency, as a charitable or nonprofit organization, has or claims an immunity or exemption (statutory or otherwise) from and against liability for damages or injury, including death, to persons or property, Agency hereby expressly waives its rights to plead defensively such immunity or exemption as against City. This Section shall not be construed to affect a governmental entity's immunities under constitutional, statutory or common law. 17. INSURANCE AND BONDING. Agency will maintain coverage in the form of insurance or bond in the amount of $326,718.00 to insure against loss from the fraud, theft or dishonesty of any of Agency's officers, agents, trustees, directors or employees. The proceeds of such insurance or bond shall be used to reimburse City for any and all loss of HOPWA Funds occasioned by such misconduct. To effectuate such reimbursement, such fidelity coverage shall include a rider stating that reimbursement for any loss or losses shall name the City as a Loss Payee. Agency shall furnish to City in a timely manner, but not later than the Effective Date, certificates of insurance as proof that it has secured and paid for policies of commercial insurance as specified herein. If City has not received such certificates by the Effective Date, Agency shall be in default of the Contract and City may, at its option, terminate the Contract. Such insurance shall cover all insurable risks incident to or in connection with the execution, performance, attempted performance or nonperformance of this Contract. Agency shall maintain the following insurance coverage and limits: Commercial General Liabilitv (CGL) Insurance $ 500,000 each occurrence $1,000,000 aggregate limit Non -Profit Organization Liability or Directors & Officers Liability $1,000,000 Each Occurrence HOPWA PSA CONTRACT 2024-2025 Page 31 AIDS Outreach Center, Inc. Rev. 6-12-2024 $1,000,000 Annual Aggregate Limit Business Automobile Liability Insurance $1,000,000 each accident on a combined single -limit basis, or $ 250,000 Property Damage $ 500,000 Bodily Injury per person per occurrence $2,000,000 Aggregate Insurance policy shall be endorsed to cover "Any Auto", defined as autos owned, hired, and non -owned. Pending availability of the above coverage and at the discretion of City, the policy shall be the primary responding insurance policy versus a personal auto insurance policy if or when in the course of Agency's business as contracted herein. Workers' Compensation Insurance Part A: Statutory Limits Part B: Employer's Liability $100,000 each accident $100,000 disease -each employee $500,000 disease -policy limit Note: Such insurance shall cover employees performing work on any and all projects including but not limited to construction, demolition, and rehabilitation. Agency or its contractors shall maintain coverages, if applicable. In the event the respective contractors do not maintain coverage, Agency shall maintain the coverage on such contractor, if applicable, for each applicable contract. Additional Requirements Such insurance amounts shall be revised upward at City's reasonable option and no more frequently than once every 12 months, and Agency shall revise such amounts within 30 days following notice to Contractor of such requirements. Agency will submit to City documentation that it has obtained insurance coverage and has executed bonds as required in this Contract prior to payment of any monies provided hereunder. Where applicable, insurance policies required herein shall be endorsed to include City as an additional insured as its interest may appear. Additional insured parties shall include employees, officers, agents, and volunteers of City. Any failure on part of City to request certificate(s) of insurance shall not be construed as a waiver of such requirement or as a waiver of the insurance requirements themselves. HOPWA PSA CONTRACT 2024-2025 Page 32 AIDS Outreach Center, Inc. Rev. 6-12-2024 Insurers of Agency's insurance policies shall be licensed to do business in the state of Texas by the Department of Insurance or be otherwise eligible and authorized to do business in the state of Texas. Insurers shall be acceptable to City insofar as their financial strength and solvency and each such company shall have a current minimum A.M. Best Key Rating Guide rating of A-: VII or other equivalent insurance industry standard rating otherwise approved by City. Deductible limits on insurance policies shall not exceed $5,000 per occurrence unless otherwise approved by City. In the event there are any local, federal or other regulatory insurance or bonding requirements for the Program, and such requirements exceed those specified herein, the former shall prevail. Agency shall require its contractors to maintain applicable insurance coverages, limits, and other requirements as those specified herein; and Agency shall require its contractors to provide Agency with certificate(s) of insurance documenting such coverage. Also, Agency shall require its contractors to have City and Agency endorsed as additional insureds (as their interest may appear) on their respective insurance policies. Directors and Officers Liability coverage shall be in force and may be provided on a claims -made basis. This coverage may also be referred to as Management Liability, and shall protect the insured against claims arising out of alleged errors in judgment, breaches of duty and wrongful acts arising out of their organizational duties. Coverage shall protect not only the entity, but all past, present and future directors, officers, trustees, employees, volunteers and committee members. Notwithstanding any provision in this Contract to the contrary, when applicable, Agency shall comply with the requirements of 2 CFR 200.310 and shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired or improved with CDBG Funds as provided to property owned by Agency. 18. CERTIFICATION REGARDING LOBBYING. The undersigned representative of Agency hereby certifies, to the best of his or her knowledge and belief, that: No federal appropriated funds have been paid or will be paid, by or on behalf of Agency, 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 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. If any funds other than federally 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, member of Congress in connection with this federal contract, grant, loan or cooperative HOPWA PSA CONTRACT 2024-2025 Page 33 AIDS Outreach Center, Inc. Rev. 6-12-2024 agreement, Agency shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certificate is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. Section 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure. Agency shall require that the language of this certification be included in all subcontracts or agreements involving the expenditure of federal funds. 19. LITIGATION AND CLAIMS. Agency shall give City immediate notice in writing of any action, including any proceeding before an administrative agency, filed against Agency in conjunction with this Contract or the Program. Agency shall furnish immediately to City copies of all pertinent papers received by Agency with respect to such action or claim. Agency shall provide a notice to City within 10 days upon filing under any bankruptcy or financial insolvency provision of law. 20. NOTICE All notices required or permitted by this Contract must be in writing and are deemed delivered on the earlier date of the date actually received or the third day following deposit in a United States Postal Service post office or receptacle; with proper postage, certified mail return receipt requested; and addressed to the other Party at the address set out below or at such other address as the receiving Parry designates by proper notice to the sending Parry. City City Attorney's Office 100 Fort Worth Trail Fort Worth, TX 76102 Telephone: 817-3 92-7600 Copy to: Neighborhood Services Department 100 Fort Worth Trail Fort Worth, TX 76102 Attention: Kacey Bess Telephone: 817-3 92-7540 Copy to: Neighborhood Services Department 100 Fort Worth Trail Fort Worth, TX 76102 Attention: Julie C. Pena Telephone: 817-392-7538 HOPWA PSA CONTRACT 2024-2025 Page 34 AIDS Outreach Center, Inc. Rev. 6-12-2024 Auncy: AIDS Outreach Center, Inc. Contact: Terri Walker Burston Address: 400 N. Beach St. Fort Worth, TX 76111 Telephone: 817-3 34-1994 21. AGENCY HAS LEGAL AUTHORITY TO ENTER INTO CONTRACT. Agency represents that it possesses the legal authority, pursuant to any proper, appropriate and official motion, resolution or action passed or taken, to enter into this Contract and to perform the responsibilities herein required. 22. COUNTERPARTS. This Contract may be executed in multiple counterparts, each of which shall be considered an original, but all of which shall constitute one instrument which may be sufficiently evidenced by one counterpart. 23. PROGRAM INCOME. Parties agree that no program income as defined by HUD shall be earned as a result of this contract. 24. PROHIBITION ON CONTRACTING WITH COMPANIES THAT BOYCOTT ISRAEL. If Agency has less than ten employees, this contract is for less than $100,000, or Agency does not meet the definition of a "company" under the applicable section of the Texas Government Code, this provision shall not apply. Agency acknowledges that in accordance with Chapter 2270 of the Texas Government Code, the City is prohibited from entering into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. The terms "boycott Israel" and "company" shall have the meanings ascribed to those terms in Section 808.001 of the Texas Government Code. By signing this contract, Agency certifies that Agency's signature provides written verification to the City that Agency: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. 25. PROHIBITION ON BOYCOTTING ENERGY COMPANIES. Agency acknowledges that in accordance with Chapter 2276 of the Texas Government Code, the City is prohibited from entering into a contract for goods or services that has a value of $100,000 or more that is to be paid wholly or partly from public funds of the City with a company with 10 or more full-time employees unless the contract contains a written verification from the company that it: (1) does not boycott energy companies; and (2) will not boycott energy companies HOPWA PSA CONTRACT 2024-2025 Page 35 AIDS Outreach Center, Inc. Rev. 6-12-2024 during the term of the contract. To the extent that Chapter 2276 of the Government Code is applicable to this Agreement, by signing this Agreement, Agency certifies that Agency's signature provides written verification to the City that Agency: (1) does not boycott energy companies; and (2) will not boycott energy companies during the term of this Agreement. 26. PROHIBITION ON DISCRIMINATION AGAINST FIREARM AND AMMUNITION INDUSTRIES. Agency acknowledges that except as otherwise provided by Chapter 2274 of the Texas Government Code, the City is prohibited from entering into a contract for goods or services that has a value of $100,000 or more that is to be paid wholly or partly from public funds of the City with a company with 10 or more full-time employees unless the contract contains a written verification from the company that it: (1) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will not discriminate during the term of the contract against a firearm entity or firearm trade association. To the extent that Chapter 2274 of the Government Code is applicable to this Agreement, by signing this Agreement, Agency certifies that Agency's signature provides written verification to the City that Agency: (1) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will not discriminate against a firearm entity or firearm trade association during the term of this Agreement. 27. ELECTRONIC SIGNATURES. This Contract may be executed by electronic signature, which will be considered as an original signature for all purposes and have the same force and effect as an original signature. For these purposes, "electronic signature" mean electronically scanned and transmitted versions (e.g. via pdf file or facsimile transmission) of an original signature, or signatures electronically inserted via software such as Adobe Sign. [SIGNATURES APPEAR ON NEXT PAGE] HOPWA PSA CONTRACT 2024-2025 Page 36 AIDS Outreach Center, Inc. Rev. 6-12-2024 IN WITNESS WHEREOF, the Parties hereto have executed this Contract in Fort Worth, Tarrant County, Texas. �,op� FORTe��dd ATTEST: ao�� duo o=° 000 Q nEXA?o�p Jannette Goodall, City Secretary M&C: 24-0552 1295 Certification No. 2024-1124129 Date: June 25, 2024 RECOMMENDED BY: K" Kacey Bess, Neighborhood Services Director CITY OF FORT WORTH 'ball i &dl'q�lGiO By: Dana Burghdoff(Apr ,2025232 CDT) APPROVED AS TO FORM AND LEGALITY: i Jessika Williams, Assistant City Attorney Dana Burghdoff, Assistant City Manager Date: Apr 23, 2025 CONTRACT COMPLIANCE ADMINISTRATOR: By signing, I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements P. Julie C. Pena Title: Sr. Human Services Specialist AGENCY NAME: AIDS Outreach Center, Inc. S94 ,AA Kelly All ray (Apr 19,29Y5 08L41 CDT) Kelly Allen Gray, Executive Director OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX HOPWA PSA CONTRACT 2024-2025 Page 37 AIDS Outreach Center, Inc. Rev. 6-12-2024 EXHIBITS: EXHIBIT "A" — Program Summary EXHIBIT "A-1" — 2024 HUD Income Limits EXHIBIT "A-2" - Requirements for Completion of "Getting to Work Training Curriculum" EXHIBIT `B" — Budget EXHIBIT "C" — Audit Certification Form EXHIBIT "D" — Reimbursement Forms EXHIBIT "E" —Certification Forms E-1 Self- Certification Form -to be completed by Agency E-2 Certification of No or Limited Income Statement -to be completed by Client and Agency EXHIBIT "F" — Standards for Complete Documentation EXHIBIT "G" — CAPER Report EXHIBIT "H" — MBE Reporting Form EXHIBIT "I" — Notice of Beneficiary Rights EXHIBIT "J" — Notice of Occupancy Rights Under VAWA EXHIBIT "K" —VAWA Emergency Transfer Request Form EXHIBIT "L" — Conflict of Interest Disclosure Form EXHIBIT "M" — NSPIRE-Standard Template Guide EXHIBIT "N" — Rent Calculation Worksheet HOPWA PSA CONTRACT 2024-2025 Page 38 AIDS Outreach Center, Inc. Rev. 6-12-2024 AIDS Outreach Center The Housing Assistance Program PROGRAM SUMMARY (HOPWA) March 1, 2025 to September 30, 2025 PERIOD EXHIBIT "A" PROGRAM SUMMARY $326,718.00 AMOUNT Capitalized terms not defined herein shall have meanings assigned them in the Contract. PROGRAM: AIDS Outreach Center provides various programs to serve low -moderate income people living with HIV/AIDS. These programs are available to anyone living with HIV who meet the income guideline at or below 80% AMI for all counties served. • Administration- Administrative covers the costs of indirect personnel in decision -making on behalf of the program. • Supportive Services: Supportive services provides the household with the following including, but limited to, case management, behavioral health, housing, transportation, dental, food pantry, and insurance assistance. For each service provided to the client or household, a case note must document the service type. Supportive Services dollars will be used to pay for a portion of staff salaries and fringe benefits. • Short Term Rental, Mortgage and Utility Assistance (STRMU): The goal of the program is to provide to persons living with HIV/AIDS to maintain stable housing and reduce the risk of homelessness. Clients can receive up to 21-weeks of STRMU assistance and must not exceed the client's current monthly budget deficit caused by an unavoidable, unplanned, or documented emergency need consisted with HUD guidelines. Clients receiving other government housing assistance are not eligible for this program or TBRA. • Tenant Based Rental Assistance (TBRA): TBRA includes long-term monthly rental assistance. Clients must live in a rental unit that passes National Standards for the Physical Inspection of Real Estate (NSPIRE), and have an identified housing need as determine by the client's case manager. AOC is located at 400 N. Beach Street Ste. 100, Fort Worth, Texas 76111. Program staff are available to meet with clients on Monday -Thursday from 8:30am to 5:00pm, and Friday from 8:30am to 4:00pm. The program will provide services to eligible clients residing in Tarrant, Johnson, Parker, and Wise counties. HOPWA Funds will pay for direct rental assistance for TBRA and short-term rental, mortgage and utility assistance for STRMU clients and supportive services. HOPWA funds will be used to pay for a percentage of salaries. The staff position role is fully dedicated to the activities covered under the grant which aligns with the grant budget, FICA and fringe benefits for the Supportive Services staff at 400 N. Beach Ste. 100, Fort Worth, TX 76111. No more than 7% of the HOPWA Funds will be used to pay for a portion of administrative costs, including salaries and fringe benefits and HOPWA 2024-2025 — EXHIBIT "A" — PROGRAM SUMMARY Page 1 City -required insurance associated with the program. The percentage of any Program employee's salary will not exceed the percentage of HOPWA clients participaitng in the Program and shall be cost allocated in accordance with the amount applicable to the Program. Agency shall not change any locations without prior City approval. Costs incurred at any locations that have not been approved by City shall not be reimbursed. Service location revisions will trigger the City's Citizen Participation Plan and will require a 30-day public notice. Agency will submit documentation which verifies that 100% of all clients served by the Program are Income Eligible with current household incomes at or below 80% AMI and within the service delivery areas. Annual re -certifications will be conducted to determine rental payments. Agency will use the appropriate Utility Allowance Schedule for all TBRA initial rental calculations and re -certifications. REGULATORY CLASSIFICATION: 24 CFR 574.300(b)(10) -Administrative 24 CFR 574.300(b)(7) — Supportive Services 24 CFR 574.300(b)(6)- STRMU 24 CFR 574.300(b)(5)- TBRA PROGRAM GOALS: Minimum Number of Fort Worth Clients to be Served: The Program must provide Supportive Services to a minimum of 120 Unduplicated Clients. Unduplicated Clients must be residents of Tarrant, Johnson, Parker, and Wise counties as shown by the monthly reports on Attachment III. The Program will provide STRMU to 90 households and TBRA services to a minimum of 30 households. OTHER AGENCY REQUIREMENTS: Upon completion of the program year, Agency will provide, with the final reimbursement request, the results of the measures used to assess the program benefits to the client as described in B.12 of the Public Service Agency Request for Proposal application. HOPWA 2024-2025 — EXHIBIT "A" — PROGRAM SUMMARY Page 2 EXHIBIT "A-1" 2024 HUD INCOME LIMITS AMI 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 people 30% $21,400 $24,450 $27,500 $30,550 $33,000 $35,450 $37,900 $40,350 50% $35,700 $40,800 $45,900 $50,950 $55,050 $59,150 $63,200 $67,300 80% $57,050 $65,200 $73,350 $81,500 $88,050 $94,550 $101,100 $107,600 *Income limits are published at least annually by HUD. Effective 610112024 EXHIBIT "A-2" REQUIREMENTS FOR COMPLETION OF "GETTING TO WORK TRAINING CURRICULUM" HOPWA PSA CONTRACT 2023-24 Page 1 EXHIBIT "A-2" REQUIREMENTS FOR COMPLETION OF "GETTING TO WORK TRAINING CURRICULUM" Getting to Work: A Training Curriculum for HIV/AIDS Service Providers and Housing Providers At least 1 Agency employee must complete this required training curriculum by the deadline of April 15, 2023. Proof of completion must be submitted with the April reimbursement request. The Getting to Work Training Curriculum is divided into 3 online modules: Module 1: Understanding the Value of Work Module 2: Adopting an Employment and Training Mindset — Organizationally and Individually Module 3: Incorporating Employment into the HIV/AIDS Service Menu To view the modules: 1. Click the module title. 2. You will be prompted to either create or log into your HUD Exchange Learn account. 3. Follow this guidance when creating a HUD Exchange account: Step 1 of 2 screen: Fill out the required Personal Information, and Login Information sections. For the Organization Information, if you are not affiliated with a HUD program, choose None of the Above and I am an Individual. Step 2 of 2 screen: All HUD Program Experience fields on the Learner Profile page are optional. Click Update to complete the account creation process. 4. After creating an account or logging in, you will enter the HUD Exchange Learn system. 5. Click the Enroll button on the HUD Exchange Learn course description to access the course. 6. The module name will appear under Activities. Click the Module Name to access the course. 7. The module will launch in a new window, so please make sure your pop-up blockers are turned off. To receive credit for completing each module: 1. Take the completion quiz under Activities on the HUD Exchange Learn course description. Each module has a quiz. 2. Score 80% or better on the quiz. You may take the quiz multiple times. 3. After you pass the quiz, you will be able to print a completion certificate on the HUD Exchange Learn course description. You can access information about the modules by visiting the HUD Exchange website at www.hudexchan _ eg com or by using the following link: https://www.hudexchange.info/training- events/dol-hud- eg tting-to-work-curriculum-for-hiv-aids-providers. You may also contact your assigned contract administrator to get additional information. HOPWA PSA CONTRACT 2022-2023 Page 2 EXHIBIT "A-2" REQUIREMENTS FOR COMPLETION OF "GETTING TO WORK TRAINING CURRICULUM" Tarrant County Samaritan Housing, INC The following tables were created for the purpose of preparing, negotiating, and determining the cost reasonableness and cost allocation method used by the Agency for the line item budget represented on the first page of this EXHIBIT "B" — Budget. The information reflected in the tables is to be considered part of the terms and conditions of the Contract. Agency must have prior written approval by the City to make changes to any line item in the Budget as outlined in Section 5.2.2 in the Contract. The deadline to make changes to EXHIBIT "B" — Budget is June 30, 2025. SALARY DETAIL - ADMINISTRATIVE Position Title Annual Salary Est. Percent to Grant Amount to Grant Grant Adminstrator $ 69,000.00 14.7% $ 10,150.00 TOTAL $ 10,150.00 FRINGE DETAIL - ADMINISTRATIVE Percent of Payroll Amount Est. Percent to Grant Amount to Grant FICA 7.65% $ 5,278.50 14.7% $ 776.00 Life/Disability Insurance Health/Dental Insurance Unemployment -State Worker's Compensation TOTAL $ 776.00 MISCELLANEOUS - ADMINISTRATIVE Total Budget Est. Percent to Grant Amount to Grant Contract Labor -Accounting Mileage Insurance -Commercial Umbrella Liabili Insurance -Directors and Officers Insurance -Fidelity Bond or Equivalent TOTAL SALARY DETAIL - SUPPORTIVE SERVICES Position Title Annual Salary Est. Percent to Grant Amount to Grant Housing Manager $ 62,000.00 13.9% $ 8,592.00 Housing Assistance Manager $ 44,568.00 14.0% $ 6,222.00 TOTA I $ 106,568.00 1 27.8% $ 14,814.00 HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page I FRINGE DETAIL - SUPPORTIVE SERVICES Percent of Payroll Amount Est. Percent to Grant Amount to Grant FICA 7.65% $ 8,152.45 13.9% $ 1,133.00 Life/Disability Insurance Health/Dental Insurance Unemployment -State Worker's Compensation TOTA 1 $ 8,152.45 1 13.9%1 S 1,133.00 26,873.00 SUPPLIES AND SERVICES - SUPPORTIVE SERVICES Total Budget Est. Percent to Grant Amount to Grant Office/Medical Supplies Office Equipment Rental Postage Printing TOTAL $ - MISCELLANEOUS - SUPPORTIVE SERVICES Total Budget Est. Percent to Grant Amount to Grant Contract Labor -Nutritionist Food Supplies TOTAL FACILITY AND UTILITIES - SUPPORTIVE SERVICES Total Budget Est. Percent to Grant Amount to Grant Utilities (Electric, Gas, water, etc) #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! TOTAL HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 2 LEGAL, FINANCIAL AND INSURANCE - SUPPORTIVE SERVICES Total Budget Est. Percent to Grant Amount to Grant Professional Liability/Business Auto TOTAL DIRECT ASSISTANCE - STRMU Total Budget Est. Percent to Grant Amount to Grant Short -Term Rent Assistance $ 70,000.00 100.0% $ 70,000.00 Short Term Mortgage Assistance $ 7,000.00 100.0% $ 7,000.00 Short Term Utilities Assistance $ 14,845.00 100.0% $ 14,845.00 TOTA I $ 91,845.00 1 100.0% 1 $ 91,845.00 DIRECT ASSISTANCE - TBRA Total Budget Est. Percent to Grant Amount to Grant Tenant Based Rental Assistance $ 208,000.00 100.0% $ 208,000.00 TOTAL $ 208,000.00 $ 208,000.00 SALARY DETAIL - FACILITY BASED OPERATIONS Position Title Annual Salary Est. Percent to Grant Amount to Grant Property Manager Property Support - Admin. Assistant Driver/Maintenance Manager Driver/Maintenance Technician TOTAL FRINGE DETAIL - FACILITY BASED OPERATIONS Percent of Payroll Amount Est. Percent to Grant Amount to Grant FICA Life/Disability Insurance Health/Dental Insurance Unemployment -State Worker's Compensation Retirement TOTAL HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 3 MISCELLANEOUS - FACILITY BASED OPERATIONS Total Budget Est. Percent to Grant Amount to Grant Insurance -Commercial Property and TOTAL 326,718.00 HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 4 HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 5 HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 6 HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 7 HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 8 HOPWA PSA CONTRACT 2024-2025 EXHIBIT "B" - BUDGET AIDS Outreach Center, Inc. Page 9 AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS h Agency: C*R" Q-„ p� Fiscal Year Ending: September 30, 2025 During the fiscal year in which funds will be received, we will exceed the federal expenditure threshold of $1,000,000.00, We will have our Single Audit or Program Specific Audit completed and will submit the audit report described in 2 CFR Part 200 within 7 months after the end of the audited fiscal year or 30 days within its completion, whichever is the ❑ earlier date. During the fiscal year in which funds will be received, we will not exceed the $1,000,000.00 federal expenditure threshold required for a Single Audit or a Program Specific Audit to be performed this fiscal year. (Fill out schedule below) .Federal Expenditure Disclosure MUST be filled out if Sin le Audit or Program Audit is NOT re uired. Federal Grantor Pass Through Grantor Program Name & CFDA Number Contract Number Expenditures Total Federal Expenditures for this Fiscal Year: � U� �/ ? Signatory and Title lalL Da e Failure to submit this or a similar statement or failure to submit a completed single audit package as described in the federally required audit requirements described in 2 CFR Part 200, as applicable, by the required due date may result in suspension of funding and may affect eligibility for future funding. Notwithstanding the above, this certification acknowledges the agency's commitment to meet all other financial reporting, financial statements, and other audit requirements as may be set forth in the Contract. PSA CONTRACT - EXHIBIT "C" — AUDIT CERTIFICATION FORM Exhibit D Attachment I- Request Summary Agency: Address: City, State, Zip: Program: Month of Service: Tax ID Number: Contract Number: Case ID: P.O. Number: FID Number: IDIS Number: Program Account Amount Original Amount This Invoice Cumulative to Date Remaining Balance (Program Name) Case ID Salaries 1001 $ $ $ FICA 1002 $ $ $ $ Life/Disability Insurance 1003 $ $ $ $ Health/DentalInsurance 1004 $ $ $ $ Unemployment -State 1005 $ $ $ $ Worker's Compensation 1006 $ $ $ $ Office Supplies 1007 $ $ $ $ Food Supplies 1008 $ $ $ $ Insurance 1009 $ $ $ $ Accounting 1010 $ $ $ $ Contract Labor 1011 $ $ $ $ $ TOTAL $ $ $ $ Request Summary Budget Expenditure Percentage Spent qF Table Total $ $ #DIV/0! $ Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 $ - $ - $ - $ - $ - $ - Client Goals Goal Amount Cumulative Total Goal Met % Table Total 0 0 #DIV/0! 0 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 0 0 0 0 0 0 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 0 0 0 0 0 0 Agency: Program: ATTACHMENT II City of Fort Worth Neighborhood Services Department Expenditure Workshect Plracr moon like arrnnnt rnrlrc Line No. Check No. Date Payee Description/Job Title* Account Code (See Key to Right) Amount 5 6 7 x 9 to 1 12 13 14 15 16 17 IS 19 20 21 11 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 31 39 40 41 42 43 44 45 46 47 48 49 Total $ *For Sstatics, state employee's title under Deacription/Job Title. Rent most identify tenant Only highlighted codes can be reimbursed Expense Line Item Accomt EMERGENCY SHELTER ESSENTIAL SERVICES Salaries 1001 I Contract Labor I toll I PREVENTION Salaries 3001 FICA 3002 Life/Disability Insurance 3003 Health/Dental Insurance 3004 Unemployment -State 3005 Worker's Compensation 3006 Other() 3007 REHOUSING Salaries 4001 FICA 4002 Life/Disability Insurance 4003 Health/Dental Insurance 4004 Unemployment -State 4005 Worker's Compensation 4006 Other() 4007 FINANCIAL ASSISTANCE PREVENTION Rental Assistance 5001 Utility Payments 5002 REHOUSING Rental Assistance 6001 Security Deposits 6002 Utility Deposits 6003 Utility Payments 6004 Moving Costs 6005 Motcl/Hotel Vouchers 6006 HMIS HMIS Soflware Casts 7001 i I I EXHIBIT "E-I" SELF -CERTIFICATION OF INCOME FORM HOPWA PSA Contract 2024-2025 Page 1 City of Fort Worth SELF -CERTIFICATION OF INCOME STATEMENT Applicant Name: Current Address: City and Zip: Phone #: Household Members and Income (including applicant) Last Name First Name Age Monthly Income $$ Source of Income TOTAL NUMBER OF FAMILY MEMBERS Total Gross Annual Household Income: (Include Yourself, Spouse, Children, etc.) PERSONAL INFORMATION: (Check one in each item. This Information is Required for Federal Reporting Purposes) a. ❑ MALE ❑ FEMALE ❑ Gender Nonbinary ❑ Transgender Male ❑ Transgender Female ❑ Gender Not Disclosed b. ❑WHITE ❑BLACK/AFRICAN AMERICAN ❑BLACK/AFRICAN AMERICAN & WHITE ❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ ASIAN ❑ AMERICAN INDIAN/ALASKAN NATIVE & WHITE ❑ ASIAN & WHITE ❑ NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER ❑MULTIPLE RACES/OTHER ❑ AMERICAN INDIAN/ALASKAN NATIVE & BLACK/AFRICAN AMERICAN c. ETHNICITY d. DISABLED e. IS HEAD OF HOUSEHOLD FEMALE? ❑ HISPANIC ❑ YES ❑ YES ❑ NON -HISPANIC ❑ NO ❑ NO Certification: I certify that the information I am providing is true and could be subject to verification at any time by a third party. I also acknowledge that the provision of false information could leave me subject to the penalties of Federal, State and local law. Signature of Applicant Date WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT. ----------- P or use Household Size: Gross Annual Income: Applicable Income Limit: Is Applicant Eligible? Check if Applicant refused to provide demographic information: O Staff Assessment of Demographics: Person Making Determination: Date: NOTE: Address, income amounts and sources for ALL household members are required. HOPWA PSA Contract 2024-2025 Page 2 Ciudad de Fort Worth AUTOCERTIFICACION DE DECLARACION DE INGRESOS Nombre del Solicitante: Direcci6n de Actualidad: Ciudad y C6digo Postal: Telefono: Miembros Del Ho _ ag r e Ingresos _ Inclu endo el/la Solicitante Apellido Nombre Had Ingreso Mensual Origen de Ingresos * TOTAL NUMERO DE MIEMBROS DEL HOGAR (Incluyase Usted.) Total Anual de Ingresos del hogar: "INFORMACION PERSONAL: (Seleccione uno en cada articulo. Esta informaci6n es requerida por el Gobierno federal.) a. ❑ MASCULINO ❑ FEMININO ❑GENERO NO BINARIO ❑HOMBRE TRANSGENERO ❑MUJER TRANSGENERO ❑GENERO NO REVELADO b. ❑ BLANCO ❑ NEGRO/AFRICANO AMERICANO ❑ NEGRO/AFRICANO AMERICANO & BLANCO ❑ INDIO AMERICANO/NATIVO DE ALASKA ❑ ASIATICO ❑ INDIO AMERICANO/NATIVO DE ALASKA & BLANCO ❑ ASIATICO & BLANCO ❑ NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS ❑ BALANCE/OTRO ❑ INDIO AMERICANO / NATIVO DE ALASKA & NEGRO/AFRICANO AMERICANO c. ETHNICIDAD d. INCAPACITADO e. DES LA CABEZA DEL HOGAR MUJER? ❑ HISPANO ❑ SI ❑ SI ❑ NO-HISPANO ❑ NO ❑ NO Certificacion: Yo certifico que la informaci6n que yo estoy proporcionando es verdadera y puedo ser sujeto a verificaci6n a cualquiera hora por tercera parte. Yo tambien reconozco que la provision de informaci6n falsa puede dejarme sujeto a penalidades Federales, Estatales, y a ley local. Firma del Solicitante Fecha ADVERTENCIA: TITULO 18, SECCI6N 1001 DEL CODIGO DE LOS ESTADOS UNIDOS INDICA QUE UNA PERSONA ES CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMENTE HACER DECLARACIONES FALSOS O FRAUDULENTAS A CUALQUIER DEPARTAMENTO DE GOBIERNO DE LOS ESTADOS UNIDOS. -----------------Para use ae # De Miembros de Familia: Limite de Ingreso: ae to Ingreso Anual: �Es solicitante elegible?: Compruebe si el solicitante se neg6 a dar su informaci6n personal: Evaluaci6n del empleado sobre informaci6n personal: Persona haciendo la determinaci6n: Note: La direction de la casa y los ink HOPWA PSA Contract 2024-2025 Fecha: sus origenes) para todos los miembros del hogar, es Page 3 City of Fort Worth CERTIFICATION OF INCOME STATEMENT Occupant Name: Age: Current Address: Phone#: Relationship to Property Owner: City and Zip: Please write in the amount for each type of income you receive each month: Source Amount Source Amount Employment/Wages $ Workman's Compensation $ Long/Short Term Disability $ Annuity $ Severance Pay $ Unemployment $ VA Benefits $ TANF $ Child Support $ Alimony $ Insurance Settlement (installments) $ Pension (Private, Government or Military) $ Social Security, SSI, SSDI, RSDI, Survivor Benefits $ Recurring cash gifts from family members/friends/church/etc. $ Rental Income (from Real Property) $ Other- $ Please write in the amount for each type of self-employment income received in the past month: Source Amount Source Amount Babysitting $ Mowing lawns $ Hair dressing $ Construction $ Housekeeping/cleaning houses $ Other- $ Please write in the amount of any assets that you may own: Source Amount Source Amount Stocks, Bonds or CDs $ Income Tax Refund $ 401K $ Gambling or Lottery winnings $ Savings $ Other- $ Please write in the amount of any assistance that you receive each month: Source Amount Source Amount Food Stamps (SNAP) $ Assistance Paying Utilities $ Rental Assistance (Section 8, ESG, etc.) $ Assistance Paying for School (grants, $ loans, etc.) Assistance from family $ Other- $ members/friends/church to pay for rent, food, utilities, etc. Certification: I certify that the information I am providing is true and correct. I also acknowledge that the provision of false information could leave me subject to the penalties of Federal, State and local law. By signing this form I also authorize the City of Fort Worth and/or the U.S. Department of Housing and Urban Development to verify the above information. Signature of Occupant Date WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT. ** FOR STAFF USE ONLY ** Total Income: $ Amount Authorized to be Excluded, if any: $ Income Less Exclusions: $ Person Making Determination: Date: EXHIBIT "F" STANDARDS OF DOCUMENTATION HOPWA PSA CONTRACT -- EXHIBIT "F" -- STANDARDS OF DOCUMENTATION 2024-25 Documentation Standards for HOPWA Public Service Contract Items a. Employee Salaries and Benefits - City will only reimburse a percentage of any employee's salary and benefits who work directly with the HOPWA-funded Program. Percentages will be cost allocated and determined prior to the execution of the HOPWA Contract. Agencies requesting the reimbursement of 100% of any Agency employee will require prior City approval. Agencies must show calculation on how the HOPWA portion of employee salaries and benefits were calculated consistently with the HOPWA Contract. If an employee works on both a HOPWA eligible and non-HOPWA eligible program(s), the City will only reimburse for a reasonable portion of the employee's salary. Prior to the execution of the HOPWA Contract, the Agency will provide the City with a written statement on how each employee's time will be allocated. If an employee works 100% of their time directly with the HOPWA-funded Program, then 100% of the employee's salary maybe eligible for reimbursement. Agency must submit a written statement that 100% of the employee's time is spent working directly with the HOPWA-funded Program. Statements must be signed by a person authorized to sign on behalf of the Agency and will be submitted with the October invoice. Salaries X X Reimbursement requests must include a signed timesheet and work log that reflects the hours worked by the employee(s) working directly on the HOPWA-funded Program. For employees who are paid with multiple funding sources, timesheets must reflect all funding sources. If separate timesheets are kept for each funding source, all such timesheets must be submitted to City. Timesheets must be signed by employee and supervisor. Agency must show a calculation and documentation of how the employee's salary was calculated and invoiced to City. *If employees are paid by direct deposit rather than check, then the agency must submit both the direct deposit payment company's report (such as an ADT report) and a bank statement or check showing payment to the direct deposit company. FICA/Medicare X X X If the City pays gross salary, this is already included. If the City pays the employer portion, the Agency must provide proof that the Life Insurance x x x Health x x x Insurance employee is enrolled in the benefit plan, must show a calculation and documentation of how the invoiced amount was calculated, and must provide documentation showing payment. Invoice and proof of payment are only required with the first reimbursement request and Disability Insurance x x x at any time there are changes to amounts, enrollments, disenrollments, etc. Unemployment x x x Insurance If the City pays gross salary, this is already included. If the City pays the employer portion, the Agency must provide proof that the Retirement x x x employee is enrolled in the benefit plan, must show a calculation and documentation of how the invoiced amount was calculated, and must provide documentation showing payment. Invoice and proof of payment are only required with the first reimbursement request and at any time there are changes to amounts, enrollments, disenrollments, etc. Materials, Equipment, Goods and Supplies - City will only reimburse for the cost allocated percent or amount spent in support of the HOPWA-funded Program. Agencies requesting reimbursement for these items will require prior City approval. Agencies must show calculation on how the HOPWA portion of these expenses were calculated consistently with the HOPWA Contract. Office Supplies X X X Office Equipment X X H X X Rental Postage X X X Printing X X X Construction & Building X X X X This category is only available for the REACH Program and Habitat for Humanity. Materials Sport and Recreation X X X Equipment Cleaning X X X Supplies Teaching Aids X X X Craft Supplies X X X Food Supplies X X X This category is only available to the Program provided by Meals on Wheels. Rent, Utilities and Maintenance - City will only pay for a portion of these expenses. The portion of these expenses will be determined by the square footage attributable to the HOPWA-funded Program and shall be cost -allocated in accordance with the amount of space used for the HOPWA-funded Program. These expenses may only be in support of the HOPWA-funded Program. The items listed below require prior City approval and the Agency is required to identify any funding source that pays for the portion of the expenses that is not paid with HOPWA funds. Agencies must show calculation on how the HOPWA portion of these expenses were calculated consistently with the HOPWA Contract. Telephone X X Gas X X Water/Wastew X X ater Electric X X Solid Waste X X HOPWA PSA CONTRACT Exhibit "F" -- STANDARDS FOR COMPLETE DOCUMENTATION Facility Maintenance X X X X This item requires approval by the City prior to the execution of the HOPWA Contract. Repairs may be categorized as major/ and Repairs minor rehabilitation projects and must be approved through the full HUD Environmental Review. Rent X X X City will pay for a portion of the rent for the Program facility so long as its in proportion to the square footage attributable to the HOPWA-funded program. Miscellaneous This item requires prior approval by the City. Prior to the execution of the HOPWA Contract, the Agency must submit a written statement that lists the contract labor services to be used during the Contract term. Agency will submit a memo related to the Contract Labor X X X X X procurement of such services and will forward any information pertaining to the procurement process to City. This requirement applies to, but is not limited to, services retained for security services, legal, accounting, transportation providers, educational facilitators, custodial services, etc. Agencies may not use the contract services of any City of Fort Worth Department. City -required X X City will only pay for a percentage of the City -required insurance so long as it's in proportion to the square footage attributable to Insurance the HOPWA-funded program. City requires that the agency submit its fee schedule or formula on how the Agency calculates the childcare scholarship amount. The fee schedule/formula should demonstrate a breakout of income levels, and for each income level the schedule should demonstrate Childcare X X which portion of the expense is to be paid by the family and which portion of the expense is to be reimbursed by the City. A fee Scholarships schedule/formula must be submitted to the City prior to the first payment. Agency must submit documentation supporting that the client is income eligible and that the household is being charged in conformance with the fee schedule. If the fee schedule/formula changes at any time during the contract term, the Agency must immediately notify City on the date the new fee schedule/formula takes into effect. "$0" Income Agecies that are required to verify and provide proof of household income to determine eligibility, must require that anyone who is over Certifications the age of 18, living in the housohold, submit a $0 Income Certification. If an audit is required because federal funds exceed $750,000, then the cost should be split evenly by all grant funding sources. Audit Services X X X X Agency must show calculation on how the HOPWA portion of the accounting services were calculated. For example, if the HOPWA grant is 10% of your Agency's budget, then invoice shall not exceed 10% of the overall cost. Agency must show a calculation and documentation of how the invoiced amount was calculated, and must provide documentation showing payment. *Proof of payment effective October 1, 2024: Payments or Expenses must be documented in the following manner: A) Image of the check AND bank statement showing the check cleared the bank; OR, B) Image of the cancelled check (ex. At end of bank statement); OR, C) Payroll Check Stub, "Advice", or Statement AND Bank Statement indicating payroll; OR, D) For wire or e-transfers: Reciept or statement from payee/vendor OR bank statement. 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J F O d o W .0 O % C e .0 a '? i 4 n O « G O .l c£ �' 'B i D •O °�' •O �G T �, aa, 5 3 a, 3 ti❑ .yr°- £' .`e+ U ` y c m� o V `�' }0 w U '❑ «� o U W E,, y° U� h �° a O 3 Uo M 'o 3 k d c e 3 'L .. e c e o •o z 'Y a.. ° s \ o `� e �'z � � i ❑ � U o � a` � a.a o o EXHIBIT "I" NOTICE OF BENEFICIARY RIGHTS HOPWA PSA CONTRACT -- EXHIBIT "I" — NOTICE OF BENEFICIARY RIGHTS Page I Notice of Beneficiary Rights Name of Agency: Name of Program: Contact information for Program Staff (name, phone number, and e-mail address, if appropriate): Because this program is supported in whole or in part by direct Federal financial assistance from the Federal Government, we are required to let you know that: • We may not discriminate against you on the basis of religion, religious belief, a refusal to hold a religious belief, or a refusal to attend or participate in a religious practice; • We may not require you to attend or participate in any explicitly religious activities that are offered by us and any participation by you in these activities must be purely voluntary; • We must separate, in time or location, any privately funded explicitly religious activities from activities supported by direct Federal financial assistance; • If you object to the religious character of our organization, we must make reasonable efforts to identify and refer you to an alternative provider to which you have no such objection; and • You may report an organization's violations of these protections, including any denial of services or benefits, by contacting or filing a written complaint to HUD [or the intermediary, if applicable]. We must give you this written notice before you enroll in our program or activity, as required by 24 CFR 5.109. HOPWA PSA CONTRACT -- EXHIBIT "I" — NOTICE OF BENEFICIARY RIGHTS Page 2 NOTICE OF OCCUPANCY RIGHTS UNDER U.S. Department of Housing and Urban Development THE VIOLENCE AGAINST WOMEN ACT OMB Approval No. 2577-0286 Expires 06/30/2017 EXHIBIT "J" — Notice of Occupancy Rights Under VAWA [Insert Name of Housing Provider'''] Notice of Occupancy Rights under the Violence Against Women A& To all Tenants and Applicants The Violence Against Women Act (VAWA) provides protections for victims of domestic violence, dating violence, sexual assault, or stalking. VAWA protections are not only available to women, but are available equally to all individuals regardless of sex, gender identity, or sexual orientation.3 The U.S. Department of Housing and Urban Development (HUD) is the Federal agency that oversees that [insert name of program or rental assistance] is in compliance with VAWA. This notice explains your rights under VAWA. A HUD -approved certification form is attached to this notice. You can fill out this form to show that you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking, and that you wish to use your rights under VAWA." Protections for Applicants If you otherwise qualify for assistance under [insert name of program or rental assistance], you cannot be denied admission or denied assistance because you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. Protections for Tenants ' The notice uses HP for housing provider but the housing provider should insert its name where HP is used. HUD's program -specific regulations identify the individual or entity responsible for providing the notice of occupancy rights. z Despite the name of this law, VAWA protection is available regardless of sex, gender identity, or sexual orientation. s Housing providers cannot discriminate on the basis of any protected characteristic, including race, color, national origin, religion, sex, familial status, disability, or age. HUD -assisted and HUD -insured housing must be made available to all otherwise eligible individuals regardless of actual or perceived sexual orientation, gender identity, or marital status. Form HUD-5380 (12/2016) 2 If you are receiving assistance under [insert name of program or rental assistance], you may not be denied assistance, terminated from participation, or be evicted from your rental housing because you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. Also, if you or an affiliated individual of yours is or has been the victim of domestic violence, dating violence, sexual assault, or stalking by a member of your household or any guest, you may not be denied rental assistance or occupancy rights under [insert name of program or rental assistance] solely on the basis of criminal activity directly relating to that domestic violence, dating violence, sexual assault, or stalking. Affiliated individual means your spouse, parent, brother, sister, or child, or a person to whom you stand in the place of a parent or guardian (for example, the affiliated individual is in your care, custody, or control); or any individual, tenant, or lawful occupant living in your household. Removing the Abuser or Perpetrator from the Household HP may divide (bifurcate) your lease in order to evict the individual or terminate the assistance of the individual who has engaged in criminal activity (the abuser or perpetrator) directly relating to domestic violence, dating violence, sexual assault, or stalking. If HP chooses to remove the abuser or perpetrator, HP may not take away the rights of eligible tenants to the unit or otherwise punish the remaining tenants. If the evicted abuser or perpetrator was the sole tenant to have established eligibility for assistance under the program, HP must allow the tenant who is or has been a victim and other household members to remain in the unit for a period of time, in order to establish eligibility under the program or under another HUD housing program covered by VAWA, or, find alternative housing. Form HUD-5380 (12/2016) 3 In removing the abuser or perpetrator from the household, HP must follow Federal, State, and local eviction procedures. In order to divide a lease, HP may, but is not required to, ask you for documentation or certification of the incidences of domestic violence, dating violence, sexual assault, or stalking. Moving to Another Unit Upon your request, HP may permit you to move to another unit, subject to the availability of other units, and still keep your assistance. In order to approve a request, HP may ask you to provide documentation that you are requesting to move because of an incidence of domestic violence, dating violence, sexual assault, or stalking. If the request is a request for emergency transfer, the housing provider may ask you to submit a written request or fill out a form where you certify that you meet the criteria for an emergency transfer under VAWA. The criteria are: (1) You are a victim of domestic violence, dating violence, sexual assault, or stalking. If your housing provider does not already have documentation that you are a victim of domestic violence, dating violence, sexual assault, or stalking, your housing provider may ask you for such documentation, as described in the documentation section below. (2) You expressly request the emergency transfer. Your housing provider may choose to require that you submit a form, or may accept another written or oral request. (3) You reasonably believe you are threatened with imminent harm from further violence if you remain in your current unit. This means you have a reason to fear that if you do not receive a transfer you would suffer violence in the very near future. Form HUD-5380 (12/2016) 0 M You are a victim of sexual assault and the assault occurred on the premises during the 90-calendar-day period before you request a transfer. If you are a victim of sexual assault, then in addition to qualifying for an emergency transfer because you reasonably believe you are threatened with imminent harm from further violence if you remain in your unit, you may qualify for an emergency transfer if the sexual assault occurred on the premises of the property from which you are seeking your transfer, and that assault happened within the 90-calendar-day period before you expressly request the transfer. HP will keep confidential requests for emergency transfers by victims of domestic violence, dating violence, sexual assault, or stalking, and the location of any move by such victims and their families. HP's emergency transfer plan provides further information on emergency transfers, and HP must make a copy of its emergency transfer plan available to you if you ask to see it. Documenting You Are or Have Been a Victim of Domestic Violence, Dating Violence, Sexual Assault or Stalking HP can, but is not required to, ask you to provide documentation to "certify" that you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. Such request from HP must be in writing, and HP must give you at least 14 business days (Saturdays, Sundays, and Federal holidays do not count) from the day you receive the request to provide the documentation. HP may, but does not have to, extend the deadline for the submission of documentation upon your request. Form HUD-5380 (12/2016) You can provide one of the following to HP as documentation. It is your choice which of the following to submit if HP asks you to provide documentation that you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. • A complete HUD -approved certification form given to you by HP with this notice, that documents an incident of domestic violence, dating violence, sexual assault, or stalking. The form will ask for your name, the date, time, and location of the incident of domestic violence, dating violence, sexual assault, or stalking, and a description of the incident. The certification form provides for including the name of the abuser or perpetrator if the name of the abuser or perpetrator is known and is safe to provide. • A record of a Federal, State, tribal, territorial, or local law enforcement agency, court, or administrative agency that documents the incident of domestic violence, dating violence, sexual assault, or stalking. Examples of such records include police reports, protective orders, and restraining orders, among others. • A statement, which you must sign, along with the signature of an employee, agent, or volunteer of a victim service provider, an attorney, a medical professional or a mental health professional (collectively, "professional") from whom you sought assistance in addressing domestic violence, dating violence, sexual assault, or stalking, or the effects of abuse, and with the professional selected by you attesting under penalty of perjury that he or she believes that the incident or incidents of domestic violence, dating violence, sexual assault, or stalking are grounds for protection. • Any other statement or evidence that HP has agreed to accept. If you fail or refuse to provide one of these documents within the 14 business days, HP does not have to provide you with the protections contained in this notice. Form HUD-5380 (12/2016) 0 If HP receives conflicting evidence that an incident of domestic violence, dating violence, sexual assault, or stalking has been committed (such as certification forms from two or more members of a household each claiming to be a victim and naming one or more of the other petitioning household members as the abuser or perpetrator), HP has the right to request that you provide third -party documentation within thirty 30 calendar days in order to resolve the conflict. If you fail or refuse to provide third -party documentation where there is conflicting evidence, HP does not have to provide you with the protections contained in this notice. Confidentiality HP must keep confidential any information you provide related to the exercise of your rights under VAWA, including the fact that you are exercising your rights under VAWA. HP must not allow any individual administering assistance or other services on behalf of HP (for example, employees and contractors) to have access to confidential information unless for reasons that specifically call for these individuals to have access to this information under applicable Federal, State, or local law. HP must not enter your information into any shared database or disclose your information to any other entity or individual. HP, however, may disclose the information provided if- 0 You give written permission to HP to release the information on a time limited basis. • HP needs to use the information in an eviction or termination proceeding, such as to evict your abuser or perpetrator or terminate your abuser or perpetrator from assistance under this program. • A law requires HP or your landlord to release the information. Form HUD-5380 (12/2016) VAWA does not limit HP's duty to honor court orders about access to or control of the property. This includes orders issued to protect a victim and orders dividing property among household members in cases where a family breaks up. Reasons a Tenant Eligible for Occupancy Rights under VAWA May Be Evicted or Assistance May Be Terminated You can be evicted and your assistance can be terminated for serious or repeated lease violations that are not related to domestic violence, dating violence, sexual assault, or stalking committed against you. However, HP cannot hold tenants who have been victims of domestic violence, dating violence, sexual assault, or stalking to a more demanding set of rules than it applies to tenants who have not been victims of domestic violence, dating violence, sexual assault, or stalking. The protections described in this notice might not apply, and you could be evicted and your assistance terminated, if HP can demonstrate that not evicting you or terminating your assistance would present a real physical danger that: 1) Would occur within an immediate time frame, and 2) Could result in death or serious bodily harm to other tenants or those who work on the property. If HP can demonstrate the above, HP should only terminate your assistance or evict you if there are no other actions that could be taken to reduce or eliminate the threat. Other Laws VAWA does not replace any Federal, State, or local law that provides greater protection for victims of domestic violence, dating violence, sexual assault, or stalking. You may be entitled to Form HUD-5380 (12/2016) additional housing protections for victims of domestic violence, dating violence, sexual assault, or stalking under other Federal laws, as well as under State and local laws. Non -Compliance with The Requirements of This Notice You may report a covered housing provider's violations of these rights and seek additional assistance, if needed, by contacting or filing a complaint with [insert contact information for any intermediary, if applicable] or [insert HUD field office]. For Additional Information You may view a copy of HUD's final VAWA rule at [insert Federal Register link]. Additionally, HP must make a copy of HUD's VAWA regulations available to you if you ask to see them. For questions regarding VAWA, please contact [insert name of program or rental assistance contact information able to answer questions on VAWA]. For help regarding an abusive relationship, you may call the National Domestic Violence Hotline at 1-800-799-7233 or, for persons with hearing impairments, 1-800-787-3224 (TTY). You may also contact [Insert contact information for relevant local organizations]. For tenants who are or have been victims of stalking seeking help may visit the National Center for Victims of Crime's Stalking Resource Center at https://www.victimsofcrime.org/our- programs/stalking-resource-center. For help regarding sexual assault, you may contact [Insert contact information for relevant organizations] Victims of stalking seeking help may contact [Insert contact information for relevant organizations]. Attachment: Certification form HUD-5382 [form approved for this program to be included] Form HUD-5380 (12/2016) EXHIBIT "M" — Emergency Transfer Request Form CERTIFICATION OF U.S. Department of Housing OMB Approval No. 2577-0286 DOMESTIC VIOLENCE, and Urban Development Exp. 06/30/2017 DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING, AND ALTERNATE DOCUMENTATION Purpose of Form: The Violence Against Women Act ("VAWA") protects applicants, tenants, and program participants in certain HUD programs from being evicted, denied housing assistance, or terminated from housing assistance based on acts of domestic violence, dating violence, sexual assault, or stalking against them. Despite the name of this law, VAWA protection is available to victims of domestic violence, dating violence, sexual assault, and stalking, regardless of sex, gender identity, or sexual orientation. Use of This Optional Form: If you are seeking VAWA protections from your housing provider, your housing provider may give you a written request that asks you to submit documentation about the incident or incidents of domestic violence, dating violence, sexual assault, or stalking. In response to this request, you or someone on your behalf may complete this optional form and submit it to your housing provider, or you may submit one of the following types of third -party documentation: (1) A document signed by you and an employee, agent, or volunteer of a victim service provider, an attorney, or medical professional, or a mental health professional (collectively, "professional") from whom you have sought assistance relating to domestic violence, dating violence, sexual assault, or stalking, or the effects of abuse. The document must specify, under penalty of perjury, that the professional believes the incident or incidents of domestic violence, dating violence, sexual assault, or stalking occurred and meet the definition of "domestic violence," "dating violence," "sexual assault," or "stalking" in HUD's regulations at 24 CFR 5.2003. (2) A record of a Federal, State, tribal, territorial or local law enforcement agency, court, or administrative agency; or (3) At the discretion of the housing provider, a statement or other evidence provided by the applicant or tenant. Submission of Documentation: The time period to submit documentation is 14 business days from the date that you receive a written request from your housing provider asking that you provide documentation of the occurrence of domestic violence, dating violence, sexual assault, or stalking. Your housing provider may, but is not required to, extend the time period to submit the documentation, if you request an extension of the time period. If the requested information is not received within 14 business days of when you received the request for the documentation, or any extension of the date provided by your housing provider, your housing provider does not need to grant you any of the VAWA protections. Distribution or issuance of this form does not serve as a written request for certification. Confidentiality: All information provided to your housing provider concerning the incident(s) of domestic violence, dating violence, sexual assault, or stalking shall be kept confidential and such details shall not be entered into any shared database. Employees of your housing provider are not to have access to these details unless to grant or deny VAWA protections to you, and such employees may not disclose this information to any other entity or individual, except to the extent that disclosure is: (i) consented to Form HUD-5382 (06/2017) 2 by you in writing in a time -limited release; (ii) required for use in an eviction proceeding or hearing regarding termination of assistance; or (iii) otherwise required by applicable law. TO BE COMPLETED BY OR ON BEHALF OF THE VICTIM OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING 1. Date the written request is received by victim: 2. Name of victim: 3. Your name (if different from victim's): 4. Name(s) of other family member(s) listed on the lease: 5. Residence of victim: 6. Name of the accused perpetrator (if known and can be safely disclosed): 7. Relationship of the accused perpetrator to the victim: 8. Date(s) and times(s) of incident(s) (if known): 10. Location of incident(s): In your own words, briefly describe the incident(s): This is to certify that the information provided on this form is true and correct to the best of my knowledge and recollection, and that the individual named above in Item 2 is or has been a victim of domestic violence, dating violence, sexual assault, or stalking. I acknowledge that submission of false information could jeopardize program eligibility and could be the basis for denial of admission, termination of assistance, or eviction. Signature Signed on (Date) Public Reporting Burden: The public reporting burden for this collection of information is estimated to average 1 hour per response. This includes the time for collecting, reviewing, and reporting the data. The information provided is to be used by the housing provider to request certification that the applicant or tenant is a victim of domestic violence, dating violence, sexual assault, or stalking. The information is subject to the confidentiality requirements of VAWA. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid Office of Management and Budget control number. Form HUD-5382 (06/2017) FORT WORT CONFLICT OF INTEREST DISCLOSURE: FOR CITY OF FORT WORTH PROGRAMS ONLY The assistance you are applying for is funded using Housing and Urban Development (HUD) funds and because of this our office is requesting the following information in order to comply with the funding requirements. Please complete this form to the best of your ability, sign it, and return it to this Agency at your earliest convenience. NAME: ADDRESS: TELEPHONE: E-MAIL ADDRESS (if applicable) 1. Are you employed by the City of Fort Worth? ❑ YES ❑ NO 1 a. If yes, by which Department and Division: 2. Were you employed by the City of Fort Worth within the most recent 12-month period? ❑ YES ❑ NO 2a. If yes, by which Department and Division: 3. Are any members of your immediate family currently employed by the City of Fort Worth? (`Immediate Family" includes (whether by blood or adoption): the spouse, parent (including a stepparent), child (including a stepchild), brother, sister (including a stepbrother or stepsister), grandparent, grandchild, and in-laws.) YES NO 3a. If yes, please provide relative's name(s), Department(s), and Division(s): 4. If No, were any members of your immediate family employed by the City of Fort Worth within the most recent 12-monthperiod? YES NO 4a. If yes, please provide relative's name(s), previous Department(s), and Division(s): 5. Are you an elected or appointed official, or agent or consultant, of the City of Fort Worth? YES NO 5a. If yes, by which Department and Division: ❑ ❑ 6. Are any immediate family members an elected or appointed official, or agent or consultant of the City of Fort Worth? YES NO 6a. If yes, please provide relative's name(s), Department(s), and Division(s): Certification: I understand and agree that the City may/will contact the City of Fort Worth department including all supervisors in order to determine whether any of these persons' employment or official functions are or were related to the City's use of federal grant funds and whether federal funds can be provided. I certify that the information I am providing is true and could be subject to verification at any time by a third party. I also acknowledge that the provision of false information could leave me subject to the penalties of Federal, State and local law. WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT. Applicant/Prospective Applicant Signature Date For_City__5taff Only: Once this form is completed and if "Yes" is marked on any of the above questions, please return it to your Compliance Specialist as soon as possible for processing. If you have any questions, please contact Barbara Asbury, Grants Manager, Compliance Division, at 817-392-7331, or Charletta Moaning, Sr. Contract Compliance Specialist, at 817-392-7333 or at charlettamoaning@a fortworthtexas.goy. Neighborhood Services Department -Conflict Disclosure Form, Dated September 18, 2014-City Only U.S. DEPARTMENT OF ROUSING AND URBAN DEVEIA - t < -"Pi 11 it NATIONAL STANDARDS FOR THE PHYSICAL INSPECTION OF REAL ESTATE TITLE: States the title of the standard VERSION: States the version of the standard (e.g., V1.3) DATE PUBLISHED: Lists the date the version of the standard was published (e.g., 7/31/20) DEFINITION: Defines the standard PURPOSE: States the function, use, or purpose the item serves in the built environment, if applicable (i.e., if the standard refers to an item) NAME VARIANTS: Lists other possible names that refer to the item COMMON MATERIALS: Lists the most common materials that make up the item (e.g., wood, metal) COMMON COMPONENTS: Lists the most common components that make up the item (e.g., shower head, faucet, drain) LOCATION: ❑ Unit This box is selected if the applicable inspectable area is within the unit ❑ Inside This box is selected if the applicable inspectable area is within the interior area, but not the unit itself (e.g., common areas) ❑ Outside This box is selected if the applicable inspectable area is outside the dwelling MORE INFORMATION: States additional information that is relevant to the item DEFICIENCY I: Lists the deficiency applicable to the standard. Below, the boxes are selected to define whether the specific deficiency applies to the Unit, Inside, or Outside inspectable areas. LOCATION: ❑ Unit ❑ Inside ❑ Outside U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Page I of 3 OS. DEPAATMENT OF NOUNNO AND US-N DEVEEAPME t < -" p NATIONAL STANDARDS FOR THE PHYSICAL INSPECTION OF REAL ESTATE DEFICIENCY I — UNIT: States the name and location of the deficiency applicable to the standard corresponding to the numbered deficiency list on the previous page DEFICIENCY CRITERIA: Lists the criteria needed to be considered for the deficiency HEALTH AND SAFETY DETERMINATION: States the health and safety determination Briefly describes the health and safety determination, depending applicable to the deficiency (e.g., standard, on whether it is standard, life -threatening, severe non -life - life -threatening, etc.) threatening, or nonapplicable based on function and operability or condition and appearance CORRECTION TIMEFRAME: Lists the timeframe for correction (e.g., 30 days, 24 hours) HCV — CORRECTION TIMEFRAME: Lists the timeframe for correction under the Housing Choice Voucher (HCV) program RATIONALE: CODE CATEGORY TYPE DESCRIPTION EXPLANATION Lists the rationale Lists the category Lists whether the Provides a description for the Provides an explanation as to why the code applicable to of the applicable rationale is direct rationale code listed selected rationale applies to the deficiency the deficiency (see rationale code or indirect with Appendix A) (e.g., health, respect to its effect safety, sanitary, privacy, etc.) INSPECTION PROCESS: Describes the process for inspecting the deficiency OBSERVATION: States how to observe the deficiency REQUEST FOR HELP: States when to ask for assistance regarding the deficiency (e.g., if a test button is over 8 feet high) ACTION: States the action needed to be taken when the deficiency is observed More Information: Lists any additional information needed for evaluating the deficiency TOOLS OR EQUIPMENT: REQUIRED: Lists tools or equipment that is required when evaluating the deficiency USEFUL: Lists tools or equipment that is useful when evaluating the deficiency U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Page 2 of 3 V.S. DEPARTMENT OF NOUSWO AND UNEAN DEVELOPMENT 06 Pi 11 4 1 1 Appendix A: Rationale Codes and Descriptions NATIONAL STANDARDS FOR THE PHYSICAL INSPECTION OF REAL ESTATE CODE CATEGORY DESCRIPTION RI .....................................-......................................................................................................................................-.............................................................................................................................................................................................................................................................................................. Health Condition could affect resident's mental, or physical, or psychological state. R2 Safety Resident could be injured because of this condition — see HHRS Appendix B, 4 clauses. R3 Sanitary Special sub -set of health hazards related to hygiene. Resident cannot clean or dispose of .....................................-......................................................................................................................................-.............................................................................................................................................................................................................................................................................................. waste or does not have clean drinking water. R4 Security Resident cannot control access to unit or property because of this condition. R5 .....................................-......................................................................................................................................-.............................................................................................................................................................................................................................................................................................. Privacy Condition limits the resident's reasonable expectation of privacy in their dwelling. R6 Usability or Operability of Fixtures Because of this condition, the resident is unable to use certain fixtures, features, or appliances, which are reasonably assumed to be part of their rent. R7 Increased Monetary Impact to Resident Resident would incur additional costs because of this condition. ..................................... MI -...................................................................................................................................... Corrective Maintenance -............................................................................................................................................................................................................................................................................................. . It is reasonable to expect a tenant to report this deficiency, and for facilities management ..................................... -...................................................................................................................................... to prioritize a work order response to fix that deficiency. _................................................................................................................................................................................................................................................................... M2 Routine Maintenance It is reasonable to expect that this deficiency would be identified through routine daily observations and facilities management would prioritize work orders to fix this deficiency. M3 Preventative Maintenance This defect indicates that a property is not following preventative maintenance practices for the item or equipment. *This only applies to items that would normally have preventive maintenance plans. M4 ..................................... Capital Cost -..................................................................................................................................................................................................................................................................................................................................................................................................................................... This defect, on its own, is significant enough to be a capital cost to repair. M5 .....................................-..................................................................................................................................................................................................................................................................................................................................................................................................................................... Increased Monetary Impact to HUD HUD would incur additional costs due to this condition (e.g., such as energy inefficiency). M6 Structural This condition indicates potential structural failure of the building or a load -bearing component `May be linked to safety depending on location. PPI Market Appeal If this defect occurs, HUD or the property would suffer reputational harm *This defect is highly subjective. *This is applicable only in areas that can be seen by the public — either from the public way or as visitors to the property. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Page 3 of 3 Rent Standard and Rent Reasonableness Certification Form H Must be completed before rental assistance starts & annual eligibility recertifications. Must be completed if household residency, composition, or rent have changed. The gross rent of TBRA- or TSH-assisted units cannot exceed the rent standard. The gross rent must also be reasonable in relation to rents for comparable unassisted units in the private market and must not be in excess of rents charged by the owner for comparable unassisted units. Complete this form for each proposed unit. Client Name and/or ID Number: Housing Case Manager Name: Let's get started! Enter a client name and/or ID number. 1 Is this a TBRA or TSH certification? 2 Is this a shared housing arrangement? 3 What county is the proposed unit located in? 4 How many bedrooms are in the proposed unit? 5 How many bedrooms will the household use? 6 How many household members are in the household? a Per the (_) Occupancy Standards, the household qualifies for the following number of bedrooms: b Wil you grant an exception to the (_) Occupancy Standards? c Based on your assessment of the household's needs, how many bedrooms will you authorize? Rent Standard 7 What is the rent standard for a (_)-bedroom unit in (_) County? 8 What is the rent standard for a (_)-bedroom unit in (_) County? a What is the fiscal year of the rent standard table? b Are you using Fair Market Rent (FMR) as the rent standard or a community -wide exception rent standard? c Will you increase the rent standard by up to 10 percent? Rent Reasonableness 9 Assess the proposed unit. a Address: b Whit is the total unit rent for the proposed unit? i What is the household's share of the total unit rent for the proposed unit? ii What is the roommate's share of the total unit rent for the proposed unit? c Will the household require a utility allowance? d What is the applicable (_)-bedroom utility allowance for the proposed unit? 10 Compare the proposed unit to other similar (_)-bedroom units. a Comparison unit 1 i Address: Date: N $0.00 80.00 $0.00 $0.00 50.00 80.00 ii What is the total unit rent for comparison unit 1? $0.00 iii Would the household require a utility allowance? iv What is the applicable (_)-bedroom utility allowance for comparison unit 1? $0.00 b Comparison unit 2 i Address: ii What is the total unit rent for comparison unit 2? $0.00 iii Would the household require a utility allowance? iv What is the applicable (_)-bedroom utility allowance for comparison unit 2? $0.00 Notes Check Spelling DSHS Program Form 1 1 of 5 Previous versions are obsolete (09/01/22) Rent Standard and Rent Reasonableness Certification Form H DSHS Program Form 1 2 of 5 Previous versions are obsolete (09/01/22) Rent Standard and Rent Reasonableness Certification Form H Rent Standard Rent Standard $0.00 Attach the Fair Market Rent (FMR) table used. *Alternatively, Project Sponsors may use a HUD -approved community -wide exception rent standard if one is locally available. If using an exception rent standard, attach the exception rent standard table per the household's exception period and area. **On a unit by unit basis, Project Sponsors may increase the rent standard by up to 10% for up to 20% of the units that receive TBRA or TSH services. If using 110116, enter this value instead. Rent Reasonableness Criteria Proposed Unit Comparison Unit 1 Comparison Unit 2 Address Attach comparison unit values 0 0 0 Number of Bedrooms Square Feet 0 0 0 Type of Unit/Construction Housing Condition Location/Accessibility Amenities Unit, Property, Community Age in Years 0 0 0 Utilities Paid by Owner ❑ Heating ❑ Heating ❑ Heating Select the types paid by the owner or ❑ Cooking ❑ Cooking ❑ Cooking another source ❑ Other Electric ❑ Other Electric ❑ Other Electric ❑ Air Conditioning ❑ Air Conditioning ❑ Air Conditioning ❑ Water heating ❑ Water heating ❑ Water heating ❑ Water ❑ Water ❑ Water ❑ sewer ❑ Sewer ❑ sewer ❑ Trash Collection ❑ Trash Collection ❑ Trash Collection ❑ Other ❑ Other ❑ Other Utilities Paid by Household ❑ Heating $0 ❑ Heating $0 ❑ Heating $0 Select the types paid by the household ❑ Cooking $0 ❑ Cooking $0 ❑ Cooking $0 and enter a monthly allowance for each ❑ Other Electric $0 ❑ Other Electric $0 ❑ Other Electric $0 ❑ Air Conditioning $0 ❑ Air Conditioning $0 ❑ Air Conditioning $0 ❑ Water heating $0 ❑ Water heating $0 ❑ Water heating $0 ❑ Water $0 ❑ Water $0 ❑ Water $0 ❑ Sewer $0 ❑ Sewer $0 ❑ Sewer $0 ❑ Trash Collection $0 ❑ Trash Collection $0 ❑ Trash Collection $0 ❑ Range/Microwave $0 ❑ Range/Microwave $0 ❑ Range/Microwave $0 ❑ Refrigerator $0 ❑ Refrigerator $0 ❑ Refrigerator $0 ❑ Other $0 ❑ Other $0 R Other $0 Unit Rent $0.00 $0.00 $0.00 Utility Allowance $0.00 $0.00 $0.00 Attach utility schedule Gross Rent $0.00 $0.00 $0.00 Unit Rent + Utility Allowance Average gross rent of comparison units (Sum of comparison units 1 & 2 divided by 2) Certification Enter the lower of the rent standard or reasonable rent for the unit This unit has not been approved. Complete the screening and certification. $0.00 $0.00 DSHS Program Form 1 3 of 5 Previous versions are obsolete (09/01/22) Rental Assistance Worksheet Form I Must be completed before rental assistance starts & annual eligibility recertifications. Must be completed if household eligibility factors or rent have changed. Households receiving TBRA or TSH services must pay as rent, including utilities, an amount which is the higher of: (1) 30% of the household's monthly adjusted income (adjustment factors include the age of the individual, medical expenses, size of household and child care expenses and are described in 24 CFR §5.611); (2) 10% of the household's monthly gross income; or (3) if the household is receiving payments for welfare assistance from a public agency and a part of the payments, adjusted in accordance with the household's actual housing costs, is specifically designated by the agency to meet the household's housing costs, the portion of the payment that is designated for housing costs. The Determining Household Annual Adjusted Income Guide outlines acceptable forms of deduction verification and deduction calculation guidance. Client Name and/or ID Number: Housing Case Manager Name: Address: Section 1: Household Annual and Monthly Gross Income 1 HOUSEHOLD ANNUAL GROSS INCOME (Form C, Line 9) Date: Effective Date: $0.00 2 HOUSEHOLD MONTHLY GROSS INCOME (Line 1 divided by 12) $0.00 Section 2: Deductions Project Sponsors must attach documentation of all deductions claimed by the household. Only third -party verification is permitted. 3 $480 FOR EACH DEPENDENT 0 $0.00 Dependents include household members who are minors under 18 years of age, members of any age Number of Dependents who are disabled, or members who are full-time students, but not the head of household, co-head, spouse, sole member, foster children, or foster adults. 4 $525 FOR ELDERLY OR DISABLED HOUSEHOLDS This deduction is provided to any household whose head, co-head, spouse, or sole member is at least 62 years of age or is disabled. This deduction always applies to households with persons with HIV/AIDS if they are the head, co-head, spouse, or sole member. Households that are program eligible only due to a minor with HIV are not eligible for this deduction. 5 UNREIMBURSED MEDICAL EXPENSES These are expenses anticipated during the year that will not be reimbursed, to the extent the sum exceeds 10% of household annual gross income. The attendant care and auxiliary apparatus deduction may not exceed the earned income of household members 18 years of age or older who are able to work because of such attendant care or auxiliary apparatus. Attendant care expenses cannot be paid to another household member. a Unreimbursed medical expenses for elderly or disabled households b Unreimbursed reasonable attendant care and auxiliary apparatus expenses for each member who is elderly or disabled that enables that member or any other member to work c Total unreimbursed medical expenses (Sum of Lines 5a & 5b) d 10% of household annual gross income (Line 1 x 0.10) e Allowable medical expense deduction (Line 5c minus 5d) If result is a negative number, enter $0. 6 UNREIMBURSED CHILDCARE EXPENSES These are expenses anticipated during the year that will not be reimbursed for children 12 years of age and under that enable a household member to work, seek employment, or to further education. The childcare deduction may not exceed the earned income of household members 18 years of age or older who are able to work because of such childcare. Childcare expenses cannot be paid to another household member. Section 3: Household Monthly Adjusted Income 7 HOUSEHOLD MONTHLY ADJUSTED INCOME a Household annual gross income (Line 1) b Total deductions (Sum of Lines 3, 4, 5, & 6) c Household annual adjusted income (Line 7a minus 7b) If result is a negative number, enter $0. d Household monthly adjusted income (Line 7c divided by 12) Yes -------------- Meets Criteria? EKE 11 $0.00 ---------------- $525.00 ---------------- $0.00 ---------------- $525.00 $0.00 Line 5e $0.00 $0.00 Line 7d DSHS Program Form 1 4 of 5 Previous versions are obsolete (09/01/22) Rental Assistance Worksheet Form I Section 4: Household Monthly Rent Payment 8 HOUSEHOLD MONTHLY RENT PAYMENT TO OWNER $0.00 a 30% of household monthly adjusted income (Line 7d x 0.30) $0.00 Line 8f ---------------- b 10% of household monthly gross income (Line 2 x 0.10) $0.00 ---------------- c Household's monthly public assistance designated for housing costs $0.00 ---------------- d Household rent payment (Greater of Lines 8a, 8b, or 8c) $0.00 ---------------- e Utility allowance (Form H) $0.00 ---------------- A household must receive a utility allowance if they pay a separate utility vendor in addition to rent and utilities paid to the owner. If the allowance is greater than Line 8d, the adjusted household rent payment is $0 and the difference ("utility reimbursement') must be paid to the utility vendor. If the household does not qualify for a utility allowance, enter $0. f Household rent payment to owner less utility allowance (Lines 8d minus 8e) $0.00 ---------------- If result is a negative number, enter $0. 1 Section 5: Project Sponsor Monthly Rent Payment 9 PROJECT SPONSOR MONTHLY RENT PAYMENT TO OWNER $0.00 a Unit rent to owner per current lease agreement (Form H) $0.00 Line 9c ---------------- b Household rent payment to owner (Line 8f) $0.00 ---------------- c Project Sponsor rent payment to owner (Line 9a minus 9b) $0.00 If Line 9c is $0 or less, household does not qualify for rental assistance services. ---------------- 10 PROJECT SPONSOR MONTHLY UTILITY REIMBURSEMENT PAYMENT TO UTILITY VENDOR $0.00 If Line 8e is greater than 8d, the difference ("utility reimbursement") must be paid to the utility Line 10d vendor. Complete Lines 10a through 10d to determine the amount paid to the utility vendor. The sum of Lines 8, 9, and 10 cannot exceed the lower of the rent standard or reasonable rent for the unit. If Line 8e is not greater than line 8d, enter $0. a Lower of the rent standard or reasonable rent for the unit (Form H) $0.00 ---------------- b Lower less Project Sponsor rent payment to owner (Line 10a minus 9c) $0.00 ---------------- c Utility allowance balance (Line 8e minus 8d) $0.00 ---------------- If result is a negative number, enter $0. d Project Sponsor utility payment to utility vendor (Lesser of Lines 10b or 10c) $0.00 ---------------- Section 6: Prorated First and/or Last Month's Rent Will rental assistance pay the first month's rent? Will rental assistance pay the last month's rent? a Will the rent be prorated? a Will the rent be prorated? b What is the prorated rent? $0.00 b What is the prorated rent? $0.00 c What is the move -in date? c What is the move -out date? d Number of prorated days assisted: 0 d Number of prorated days assisted: 0 e Household prorated rent: $0.00 e Household prorated rent: $0.00 f Project Sponsor prorated rent: $0.00 f Project Sponsor prorated rent: $0.00 g Project Sponsor prorated utility reimbursement: $0.00 g Project Sponsor prorated utility reimbursement: $0.00 Section 7: Violence Against Women Act (VAWA) Lease Addendum Confirmation To receive TBRA or TSH services, a household's lease must include a VAWA Lease Addendum. If a lease does not include a VAWA Lease Addendum, a Project Sponsor cannot approve the unit for TBRA or TSH services. I have retained a copy of the VAWA Lease Addendum for this assisted unit in the household's record. If the lease agreement already included an addendum, then I have attached a copy. If it did not, then the lessor and lessee have completed the addendum, provided a copy to me, and I have attached it. This unit has not been approved. Complete Form H. DSHS Program Form 1 5 of 5 Previous versions are obsolete (09/01/22) M&C Review Page 1 of 6 A Official site of the City of Fort Worth, Texas CITY COUNCIL AGEND FORM Create New From This M&C DATE: 6/25/2024 REFERENCE NO.: M&C 24-0552 LOG NAME: 192024-2025 ACTION PLAN CODE: C TYPE: NON -CONSENT PUBLIC YES HEARING: SUBJECT: (ALL) Conduct Public Hearing and Approve the City of Fort Worth's 2024-2025 Annual Action Plan for the Use of Federal Grant Funds in the Amount of $13,036,747.00 to be Awarded by the United States Department of Housing and Urban Development from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant, and Housing Opportunities for Persons with AIDS Program, Authorize Collection and Use of Program Income, Authorize Execution of Related Contracts, Adopt Appropriation Ordinance, and Authorize Waiver of Indirect Costs (PUBLIC HEARING - a. Report of City Staff: Sharon Burkley; b. Public Comment c. Council Action: Close Public Hearing and Act on M&C) RECOMMENDATION: It is recommended that City Council: 1. Conduct a public hearing to allow citizen input and consideration of the City's 2024-2025 Annual Action Plan for use of federal grant funds to be awarded by the United States Department of Housing and Urban Development in the amount of $13,036,747.00 from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant, and Housing Opportunities for Persons with AIDS grant programs; 2. Approve the City's 2024-2025 Annual Action Plan for submission to the United States Department of Housing and Urban Development, including allocations of grant funds to particular programs and activities as detailed below; 3. Authorize the collection and use of an estimated $50,000.00 of program income which is expected to result from activities using prior years' Community Development Block Grant funds for the City's Priority Repair Program; 4. Authorize the collection and use of an estimated $50,000.00 of program income which is expected to result from activities using prior years' HOME Investment Partnerships Program grant funds for the City's Homebuyer Assistance Program, and authorize the use of 10 percent of the program income for administrative costs; 5. Authorize the City Manager or his designee to execute contracts for one-year terms with the agencies listed in Tables 1, 2, and 3 below for Program Year 2024-2025 for Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons with AIDS grant funds, contingent upon receipt of funding, and satisfactory completion of all federal regulatory requirements; 6. Authorize the City Manager or his designees to extend the contracts for up to one year if an agency or department requests an extension and such extension is necessary for completion of the program, or to amend the contracts if necessary to achieve program goals provided any amendment is within the scope of the program and in compliance with City policies and all applicable laws and regulations governing the use of federal grant funds; 7. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the Grants Operating Federal Fund in the total amount of $13,136,747.00 consisting of $7,006,875.00 in Community Development Block Grant funds, $2,763,144.00 in HOME Investment Partnerships Program funds, $614,768.00 in Emergency Solutions Grant funds, and $2,651,960.00 in Housing Opportunities for Persons with AIDS grant funds, plus estimated program income in the amount of $100,000.00, all subject to receipt of such funds; and 8. Authorize a waiver of the Neighborhood Services Department indirect cost of 28.10\%, estimated total of $341,260.45. http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 2 of 6 DISCUSSION: The City's 2024-2025 Annual Action Plan summarizes the major housing and community development activities and proposed expenditures for the program year beginning October 1, 2024 and ending September 30, 2025 for use of federal grant funds totaling $13,036,747.00 from the United States Department of Housing and Urban Development (HUD) from the Community Development Block Grant (CDBG), HOME Investment Partnerships Program (HOME), Emergency Solutions Grant (ESG), and Housing Opportunities for Persons with AIDS (HOPWA) grant programs. It also summarizes the use of program income resulting from activities using prior years' CDBG and HOME funds, the primary purpose of which is to benefit low -and moderate -income persons in Fort Worth. ESG funds primarily benefit persons experiencing homelessness, and HOPWA funds primarily benefit low -and moderate -income persons with HIV/AIDS. A Request for Proposals from social service agencies and nonprofit organizations seeking grant funding was published on February 1, 2024. All proposals were received on March 15, 2024. Staff reviewed all proposals and developed recommendations for the allocation of estimated funding from HUD based on the capacity of applicant organizations, grant experience, fiscal stability, and compliance with applicable federal regulations. One public hearing was held on April 10, 2024, to provide citizens the opportunity to participate in the development of the Annual Action Plan. Recommendations for award amounts were considered and adopted by the Community Development Council on May 8, 2024. A 30-day public comment period was held from May 15, 2024 to June 14, 2024. Notice of this public comment period was published in La Vida News on May 9, 2024; in the Fort Worth Star -Telegram on May 13, 2024; in Wise County Messenger on May 16, 2024; and in the Cleburne Times Review and the Weatherford Democrat on May 18, 2024. Any comments received are maintained by the Neighborhood Services Department in accordance with federal regulations. The City held two public hearings as a part of the HUD required citizen participation process. The first public hearing was held by staff on May 29, 2024, and the second public hearing is scheduled for the City Council on June 25, 2024. A summary of staff's final funding recommendations is provided below in Tables 1,2, and 3. A PowerPoint presentation listing funding recommendations is also attached. The 2024-2025 Annual Action Plan will be submitted to HUD by August 15, 2024. Indirect costs totaling approximately $341,260.45 could be charged to the CDBG grant, as the Neighborhood Services Department indirect cost rate is 28.10\% in the City's most recent Cost Allocation Plan. A waiver of these costs is requested to allow allocation of these funds to further support the programs and services to assist low -to -moderate income citizens. This amount is calculated based on the estimated salary expenses and other administrative costs for the CDBG program totaling $1,214,450.00. This amount multiplied by the indirect cost rate of 28.10\% equals $341,260.45. COMMUNITY DEVELOPMENT BLOCK GRANT For Program Year 2024-2025, it is recommended that the amount of $7,006,875.00 in CDBG funds and an estimated amount of $50,000.00 in CDBG program income totaling $7,056,875.00 be allocated as follows: Public Service Agencies - $1,051,031.00: Includes social services for low- and moderate -income persons, persons with disabilities, and disadvantaged persons Housing Programs - $2,930,000.00: Includes funding for the City's Priority Repair Program, Cowtown Brush -Up, and accessibility modifications for seniors and persons with disabilities Major Projects - $644,469.00: Includes funding for multifamily rental rehabilitation Program Delivery - $980,000.00: Includes program delivery costs for housing programs Administration - $1,401,375.00: Includes costs for administering the CDBG grant, including allocations for the Financial Management Services Department Estimated Program Income - $50,000.00: Includes up to $50,000.00 in funding for the City's Priority Repair Program. Any CDBG program income over the estimated amount not used for the Priority Repair Program will be allocated to priority activities in the City's Consolidated Plan, subject to the City Council approval. HOME INVESTMENT PARTNERSHIPS PROGRAM http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 3 of 6 For Program Year 2024-2025, it is recommended that the amount of $2,763,144.00 in HOME funds and an estimated amount of $50,000.00 in HOME program income totaling $2,813,144.00 be allocated as follows: Homebuyer Assistance Program - $72,358.00: Includes funding for down payment and closing cost assistance for low- and moderate -income homebuyers Community Housing Development Organizations (CHDOs) for affordable housing projects - $414,471.60: These funds will be used by Housing Channel for an affordable housing development in southeast Fort Worth called Mason Heights. Funds will be used for the acquisition of land and new construction of 248 residential units comprised of the following: 125 Single Family attached townhomes, 106 Single Family detached homes, and 17 cottages. An estimated 104 units (approximately 42\%) will be sold to low to moderate income households at or below 80\% Area Median Income (AMI). This funding is part of a multi -year commitment to Housing Channel for a total of five years. Major Projects - $2,000,000.00: Includes $1,000,000.00 allocated to the affordable housing project to be developed by Fort Worth Housing Solutions (FWHS) as a part of its Choice Neighborhood Initiative (CNI) grant and $1,000,000.00 allocated to the multifamily housing project, Columbia Renaissance - Phase III Administration - $276,314.40: Includes costs for administering the HOME grant Estimated Program Income - $50,000.00: Includes funding for the Homebuyer Assistance Program and HOME grant administrative costs. HUD allows the City to use 10 percent of any HOME program income towards the cost of administering the HOME grant. HOME program income over the estimated amount not used for the Homebuyer Assistance Program will be allocated to priority activities in the City's Consolidated Plan, subject to City Council approval. HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS For Program Year 2024-2025, it is recommended that the amount of $2,651,960.00 in HOPWA funds be allocated as follows: Public Service Agencies - $1,626,781.00 Neighborhood Services Department - $945,620.00 Administration - $79,559.00 EMERGENCY SOLUTIONS GRANT For Program Year 2024-2025, it is recommended that the amount of $614,768.00 in ESG funds to be allocated as follows: Public Service Agencies - $568,660.00 Administration - $46,108.00 CONTRACT RECOMMENDATIONS The Community Development Council and Neighborhood Services Department staff recommend that contracts be executed with the public service and CDBG subrecipient agencies for the amounts shown in the following tables: Community Development Block Grant Contracts TABLE 1: CDBG AGENCIES AGENCY CONSOLIDATED PLAN PROGRAM AMOUNT GOAL Housing Channel Affordable Housing Housing Counseling & $111,000.00 Education Meals -On -Wheels, Inc. of Tarrant County Aging In Place Nutrition Program $75,000.00 Increasing Access to Sixty and Better, Inc. Aging In Place Basic Needs for Senior $50,000.00 Adults AB Christian Learning Center Children and Youth Out of School Time $90' 000.00 Services Program $80,000.00 http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 4 of 6 Boys & Girls Clubs of Greater Children and Youth Youth Development at Tarrant County, Inc. Services lEastsideBranch Children and Youth Camp Fire First Texas Services Teens In Action $78,300.00 Girls Incorporated of Tarrant Children and Youth Girls Inc. of Tarrant $100,000.00 County Services County Junior Achievement of the Children and Youth Cradle to Career $50,000.00 Chisholm Trail, Inc. Services Initiative United Community Centers, Children and Youth Holistic Educational $90,000.00 Inc. Services Literacy Program Economic Empowerment Easter Seals North Texas, Inc. and Financial Resilience Employment Services $60,000.00 Taste Project Economic Empowerment Culinary Workforce $25,000.00 and Financial Resilience Development Program Tarrant County The Ladder Alliance Economic Empowerment Workforce $81,731.00 and Financial Resilience Development The Women's Center of Tarrant Economic Empowerment Employment Solutions $60,000.00 County, Inc. and Financial Resilience Your Harvest House, Inc. Economic Empowerment Client Aid Services $25, 000.00 and Financial Resilience Increasing Health Cancer Care Services Healthy Living and Wellness Equity by Decreasing $50,000.00 Health Disparities Tarrant Area Food Bank Healthy Living and Wellness Home Delivery $25,000.00 CDBG Public Services Agencies Total $1,051,031.00 Rehabilitation, Education and Advocacy for Citizens with Accessibility Improvements Project Ramp $165,000.00 Handicaps dba REACH, Inc. Fort Worth Area Habitat for Humanity, Inc. DBA Trinity Housing Preservation and Rehabilitation Cowtown Brush Up $455,000.00 Habitat for Humanity CDBG Subrecipient Agencies Total $620,000.00 TOTAL CDBG CONTRACTS $1,671,031.00 Housing Opportunities for Persons with AIDS Contracts TABLE 2: HOPWA AGENCIES AGENCY CONSOLIDATED PLAN GOAL PROGRAM AMOUNT AIDS Outreach Homelessness Prevention The Housing Assistance $326,781.00 Center, Inc. and Special Needs Program Support - Administration, Tenant - Based Rental Assistance (TBRA), Short -Term Rent, Mortgage, and Utility Assistance http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 5 of 6 (STRMU), Supportive Services I HOPWA Program - Administration, Tenant - Based Rental Assistance Tarrant County Homelessness Prevention (TBRA), Short -Term Samaritan Housing, and Special Needs Rent, Mortgage, and $1,300,000.00 Inc. Support Utility Assistance (STRMU), Supportive Services, Facility -Based Operations (FBO) TOTAL HOPWA CONTRACTS $1,626,781.00 Emergency Solutions Grants Contracts TABLE 3: ESG AGENCIES AGENCY CONSOLIDATED PLAN GOAL PROGAM AMOUNT The Presbyterian Night Shelter of Tarrant County, Homelessness Prevention and Shelter $127,345.00 Inc. Special Needs Support Operations/Services Lighthouse for the Homeless dba True Worth Homelessness Prevention and Day Shelter $138,851.00 Place Special Needs Support Operations/Services SafeHaven of Tarrant Homelessness Prevention and Shelter $75, 000.00 County Special Needs Support Operations/Services Center for Transforming Homelessness Prevention and Rapid Re -Housing $75,901.00 Lives Special Needs Support The Salvation Army Homelessness Prevention and Homelessness $151,563.00 Special Needs Support Prevention TOTAL ESG CONTRACTS $568,660.00 All figures have been rounded to the nearest dollar for presentation purposes. Each of these grants is an entitlement grant rather than a competitive grant received from the United States Department of Housing and Urban Development (HUD). Entitlement grants provide funds to agencies based on a formula, prescribed in legislation or regulation, rather than based on review. These specific grants are allocated to the City of Fort Worth based on population size and per capita income each year. The grants have been consistently awarded to the City since 1974 with the inception of the Community Development Block Grant (CDBG) through the Housing and Community Development Act of 1974. The Emergency Shelter (renamed Solutions) Grant (ESG) was authorized in 1987 through the McKinney-Vento Homelessness Assistance Act. The HOME Investment Partnerships Program (HOME) and the Housing Opportunities for Persons with AIDS (HOPWA) Program were authorized through the Cranston -Gonzales National Affordable Housing Act of 1990. With these grants, administrative and program delivery allocations support approximately 72 FTE positions in the Neighborhood Services Department, which is funded nearly 70\% with various grants including these entitlement grants. Positions funded with HUD Entitlement grants are subject to grant availability. In the event of a grant award being decreased or eliminated, Neighborhood Services Department would review programs and services funded by the grants and determine a level of service and staffing that aligns with the available funding. Alternatives to consider may include staff and program reductions or eliminations. These programs are available in ALL COUNCIL DISTRICTS. http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 6 of 6 FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that upon approval of the above recommendations and adoption of the attached appropriation ordinance, funds will be available in the current operating budget, as appropriated, of the Grants Operating Federal Fund. The Neighborhood Services Department (and Financial Management Services) will be responsible for the collection and deposit of funds due to the City. Prior to an expenditure being incurred, the Neighborhood Services Department has the responsibility to validate the availability of funds. These are reimbursement grants. TO Fund Department Account Project Program Activity Budget Reference # Amount ID ID Year I (Chartfield 2 FROM Fund Department I Account Project Program Activity Budget Reference # Amount ID ID Year Chartfield 2 Submitted for City Manager's Office by: Originating Department Head: Additional Information Contact: ATTACHMENTS Fernando Costa (6122) Kacey Bess (8187) Sharon Burkley (5785) Rhonda Hinz (2573) 19NS ACTION PLAN 2024 Agency Form 1295 Forms.pdf (CFW Internal) 2024-2025 Action Plan Secretary of State Filings.pdf (CFW Internal) Action Plan Budget -Staff Recommendations 052924.pptx (CFW Internal) IR 2024-2025 ACTION PLAN.docx (CFW Internal) ORD.APP192024-2025 ACTION PLANFY24 AO(r7).docx (Public) http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 1 of 6 A Official site of the City of Fort Worth, Texas CITY COUNCIL AGEND FORM Create New From This M&C DATE: 6/25/2024 REFERENCE NO.: M&C 24-0552 LOG NAME: 192024-2025 ACTION PLAN CODE: C TYPE: NON -CONSENT PUBLIC YES HEARING: SUBJECT: (ALL) Conduct Public Hearing and Approve the City of Fort Worth's 2024-2025 Annual Action Plan for the Use of Federal Grant Funds in the Amount of $13,036,747.00 to be Awarded by the United States Department of Housing and Urban Development from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant, and Housing Opportunities for Persons with AIDS Program, Authorize Collection and Use of Program Income, Authorize Execution of Related Contracts, Adopt Appropriation Ordinance, and Authorize Waiver of Indirect Costs (PUBLIC HEARING - a. Report of City Staff: Sharon Burkley; b. Public Comment c. Council Action: Close Public Hearing and Act on M&C) RECOMMENDATION: It is recommended that City Council: 1. Conduct a public hearing to allow citizen input and consideration of the City's 2024-2025 Annual Action Plan for use of federal grant funds to be awarded by the United States Department of Housing and Urban Development in the amount of $13,036,747.00 from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant, and Housing Opportunities for Persons with AIDS grant programs; 2. Approve the City's 2024-2025 Annual Action Plan for submission to the United States Department of Housing and Urban Development, including allocations of grant funds to particular programs and activities as detailed below; 3. Authorize the collection and use of an estimated $50,000.00 of program income which is expected to result from activities using prior years' Community Development Block Grant funds for the City's Priority Repair Program; 4. Authorize the collection and use of an estimated $50,000.00 of program income which is expected to result from activities using prior years' HOME Investment Partnerships Program grant funds for the City's Homebuyer Assistance Program, and authorize the use of 10 percent of the program income for administrative costs; 5. Authorize the City Manager or his designee to execute contracts for one-year terms with the agencies listed in Tables 1, 2, and 3 below for Program Year 2024-2025 for Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons with AIDS grant funds, contingent upon receipt of funding, and satisfactory completion of all federal regulatory requirements; 6. Authorize the City Manager or his designees to extend the contracts for up to one year if an agency or department requests an extension and such extension is necessary for completion of the program, or to amend the contracts if necessary to achieve program goals provided any amendment is within the scope of the program and in compliance with City policies and all applicable laws and regulations governing the use of federal grant funds; 7. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the Grants Operating Federal Fund in the total amount of $13,136,747.00 consisting of $7,006,875.00 in Community Development Block Grant funds, $2,763,144.00 in HOME Investment Partnerships Program funds, $614,768.00 in Emergency Solutions Grant funds, and $2,651,960.00 in Housing Opportunities for Persons with AIDS grant funds, plus estimated program income in the amount of $100,000.00, all subject to receipt of such funds; and 8. Authorize a waiver of the Neighborhood Services Department indirect cost of 28.10\%, estimated total of $341,260.45. http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 2 of 6 DISCUSSION: The City's 2024-2025 Annual Action Plan summarizes the major housing and community development activities and proposed expenditures for the program year beginning October 1, 2024 and ending September 30, 2025 for use of federal grant funds totaling $13,036,747.00 from the United States Department of Housing and Urban Development (HUD) from the Community Development Block Grant (CDBG), HOME Investment Partnerships Program (HOME), Emergency Solutions Grant (ESG), and Housing Opportunities for Persons with AIDS (HOPWA) grant programs. It also summarizes the use of program income resulting from activities using prior years' CDBG and HOME funds, the primary purpose of which is to benefit low -and moderate -income persons in Fort Worth. ESG funds primarily benefit persons experiencing homelessness, and HOPWA funds primarily benefit low -and moderate -income persons with HIV/AIDS. A Request for Proposals from social service agencies and nonprofit organizations seeking grant funding was published on February 1, 2024. All proposals were received on March 15, 2024. Staff reviewed all proposals and developed recommendations for the allocation of estimated funding from HUD based on the capacity of applicant organizations, grant experience, fiscal stability, and compliance with applicable federal regulations. One public hearing was held on April 10, 2024, to provide citizens the opportunity to participate in the development of the Annual Action Plan. Recommendations for award amounts were considered and adopted by the Community Development Council on May 8, 2024. A 30-day public comment period was held from May 15, 2024 to June 14, 2024. Notice of this public comment period was published in La Vida News on May 9, 2024; in the Fort Worth Star -Telegram on May 13, 2024; in Wise County Messenger on May 16, 2024; and in the Cleburne Times Review and the Weatherford Democrat on May 18, 2024. Any comments received are maintained by the Neighborhood Services Department in accordance with federal regulations. The City held two public hearings as a part of the HUD required citizen participation process. The first public hearing was held by staff on May 29, 2024, and the second public hearing is scheduled for the City Council on June 25, 2024. A summary of staff's final funding recommendations is provided below in Tables 1,2, and 3. A PowerPoint presentation listing funding recommendations is also attached. The 2024-2025 Annual Action Plan will be submitted to HUD by August 15, 2024. Indirect costs totaling approximately $341,260.45 could be charged to the CDBG grant, as the Neighborhood Services Department indirect cost rate is 28.10\% in the City's most recent Cost Allocation Plan. A waiver of these costs is requested to allow allocation of these funds to further support the programs and services to assist low -to -moderate income citizens. This amount is calculated based on the estimated salary expenses and other administrative costs for the CDBG program totaling $1,214,450.00. This amount multiplied by the indirect cost rate of 28.10\% equals $341,260.45. COMMUNITY DEVELOPMENT BLOCK GRANT For Program Year 2024-2025, it is recommended that the amount of $7,006,875.00 in CDBG funds and an estimated amount of $50,000.00 in CDBG program income totaling $7,056,875.00 be allocated as follows: Public Service Agencies - $1,051,031.00: Includes social services for low- and moderate -income persons, persons with disabilities, and disadvantaged persons Housing Programs - $2,930,000.00: Includes funding for the City's Priority Repair Program, Cowtown Brush -Up, and accessibility modifications for seniors and persons with disabilities Major Projects - $644,469.00: Includes funding for multifamily rental rehabilitation Program Delivery - $980,000.00: Includes program delivery costs for housing programs Administration - $1,401,375.00: Includes costs for administering the CDBG grant, including allocations for the Financial Management Services Department Estimated Program Income - $50,000.00: Includes up to $50,000.00 in funding for the City's Priority Repair Program. Any CDBG program income over the estimated amount not used for the Priority Repair Program will be allocated to priority activities in the City's Consolidated Plan, subject to the City Council approval. HOME INVESTMENT PARTNERSHIPS PROGRAM http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 3 of 6 For Program Year 2024-2025, it is recommended that the amount of $2,763,144.00 in HOME funds and an estimated amount of $50,000.00 in HOME program income totaling $2,813,144.00 be allocated as follows: Homebuyer Assistance Program - $72,358.00: Includes funding for down payment and closing cost assistance for low- and moderate -income homebuyers Community Housing Development Organizations (CHDOs) for affordable housing projects - $414,471.60: These funds will be used by Housing Channel for an affordable housing development in southeast Fort Worth called Mason Heights. Funds will be used for the acquisition of land and new construction of 248 residential units comprised of the following: 125 Single Family attached townhomes, 106 Single Family detached homes, and 17 cottages. An estimated 104 units (approximately 42\%) will be sold to low to moderate income households at or below 80\% Area Median Income (AMI). This funding is part of a multi -year commitment to Housing Channel for a total of five years. Major Projects - $2,000,000.00: Includes $1,000,000.00 allocated to the affordable housing project to be developed by Fort Worth Housing Solutions (FWHS) as a part of its Choice Neighborhood Initiative (CNI) grant and $1,000,000.00 allocated to the multifamily housing project, Columbia Renaissance - Phase III Administration - $276,314.40: Includes costs for administering the HOME grant Estimated Program Income - $50,000.00: Includes funding for the Homebuyer Assistance Program and HOME grant administrative costs. HUD allows the City to use 10 percent of any HOME program income towards the cost of administering the HOME grant. HOME program income over the estimated amount not used for the Homebuyer Assistance Program will be allocated to priority activities in the City's Consolidated Plan, subject to City Council approval. HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS For Program Year 2024-2025, it is recommended that the amount of $2,651,960.00 in HOPWA funds be allocated as follows: Public Service Agencies - $1,626,781.00 Neighborhood Services Department - $945,620.00 Administration - $79,559.00 EMERGENCY SOLUTIONS GRANT For Program Year 2024-2025, it is recommended that the amount of $614,768.00 in ESG funds to be allocated as follows: Public Service Agencies - $568,660.00 Administration - $46,108.00 CONTRACT RECOMMENDATIONS The Community Development Council and Neighborhood Services Department staff recommend that contracts be executed with the public service and CDBG subrecipient agencies for the amounts shown in the following tables: Community Development Block Grant Contracts TABLE 1: CDBG AGENCIES AGENCY CONSOLIDATED PLAN PROGRAM AMOUNT GOAL Housing Channel Affordable Housing Housing Counseling & $111,000.00 Education Meals -On -Wheels, Inc. of Tarrant County Aging In Place Nutrition Program $75,000.00 Increasing Access to Sixty and Better, Inc. Aging In Place Basic Needs for Senior $50,000.00 Adults AB Christian Learning Center Children and Youth Out of School Time $90' 000.00 Services Program $80,000.00 http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 4 of 6 Boys & Girls Clubs of Greater Children and Youth Youth Development at Tarrant County, Inc. Services lEastsideBranch Children and Youth Camp Fire First Texas Services Teens In Action $78,300.00 Girls Incorporated of Tarrant Children and Youth Girls Inc. of Tarrant $100,000.00 County Services County Junior Achievement of the Children and Youth Cradle to Career $50,000.00 Chisholm Trail, Inc. Services Initiative United Community Centers, Children and Youth Holistic Educational $90,000.00 Inc. Services Literacy Program Economic Empowerment Easter Seals North Texas, Inc. and Financial Resilience Employment Services $60,000.00 Taste Project Economic Empowerment Culinary Workforce $25,000.00 and Financial Resilience Development Program Tarrant County The Ladder Alliance Economic Empowerment Workforce $81,731.00 and Financial Resilience Development The Women's Center of Tarrant Economic Empowerment Employment Solutions $60,000.00 County, Inc. and Financial Resilience Your Harvest House, Inc. Economic Empowerment Client Aid Services $25, 000.00 and Financial Resilience Increasing Health Cancer Care Services Healthy Living and Wellness Equity by Decreasing $50,000.00 Health Disparities Tarrant Area Food Bank Healthy Living and Wellness Home Delivery $25,000.00 CDBG Public Services Agencies Total $1,051,031.00 Rehabilitation, Education and Advocacy for Citizens with Accessibility Improvements Project Ramp $165,000.00 Handicaps dba REACH, Inc. Fort Worth Area Habitat for Humanity, Inc. DBA Trinity Housing Preservation and Rehabilitation Cowtown Brush Up $455,000.00 Habitat for Humanity CDBG Subrecipient Agencies Total $620,000.00 TOTAL CDBG CONTRACTS $1,671,031.00 Housing Opportunities for Persons with AIDS Contracts TABLE 2: HOPWA AGENCIES AGENCY CONSOLIDATED PLAN GOAL PROGRAM AMOUNT AIDS Outreach Homelessness Prevention The Housing Assistance $326,781.00 Center, Inc. and Special Needs Program Support - Administration, Tenant - Based Rental Assistance (TBRA), Short -Term Rent, Mortgage, and Utility Assistance http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 5 of 6 (STRMU), Supportive Services I HOPWA Program - Administration, Tenant - Based Rental Assistance Tarrant County Homelessness Prevention (TBRA), Short -Term Samaritan Housing, and Special Needs Rent, Mortgage, and $1,300,000.00 Inc. Support Utility Assistance (STRMU), Supportive Services, Facility -Based Operations (FBO) TOTAL HOPWA CONTRACTS $1,626,781.00 Emergency Solutions Grants Contracts TABLE 3: ESG AGENCIES AGENCY CONSOLIDATED PLAN GOAL PROGAM AMOUNT The Presbyterian Night Shelter of Tarrant County, Homelessness Prevention and Shelter $127,345.00 Inc. Special Needs Support Operations/Services Lighthouse for the Homeless dba True Worth Homelessness Prevention and Day Shelter $138,851.00 Place Special Needs Support Operations/Services SafeHaven of Tarrant Homelessness Prevention and Shelter $75, 000.00 County Special Needs Support Operations/Services Center for Transforming Homelessness Prevention and Rapid Re -Housing $75,901.00 Lives Special Needs Support The Salvation Army Homelessness Prevention and Homelessness $151,563.00 Special Needs Support Prevention TOTAL ESG CONTRACTS $568,660.00 All figures have been rounded to the nearest dollar for presentation purposes. Each of these grants is an entitlement grant rather than a competitive grant received from the United States Department of Housing and Urban Development (HUD). Entitlement grants provide funds to agencies based on a formula, prescribed in legislation or regulation, rather than based on review. These specific grants are allocated to the City of Fort Worth based on population size and per capita income each year. The grants have been consistently awarded to the City since 1974 with the inception of the Community Development Block Grant (CDBG) through the Housing and Community Development Act of 1974. The Emergency Shelter (renamed Solutions) Grant (ESG) was authorized in 1987 through the McKinney-Vento Homelessness Assistance Act. The HOME Investment Partnerships Program (HOME) and the Housing Opportunities for Persons with AIDS (HOPWA) Program were authorized through the Cranston -Gonzales National Affordable Housing Act of 1990. With these grants, administrative and program delivery allocations support approximately 72 FTE positions in the Neighborhood Services Department, which is funded nearly 70\% with various grants including these entitlement grants. Positions funded with HUD Entitlement grants are subject to grant availability. In the event of a grant award being decreased or eliminated, Neighborhood Services Department would review programs and services funded by the grants and determine a level of service and staffing that aligns with the available funding. Alternatives to consider may include staff and program reductions or eliminations. These programs are available in ALL COUNCIL DISTRICTS. http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024 M&C Review Page 6 of 6 FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that upon approval of the above recommendations and adoption of the attached appropriation ordinance, funds will be available in the current operating budget, as appropriated, of the Grants Operating Federal Fund. The Neighborhood Services Department (and Financial Management Services) will be responsible for the collection and deposit of funds due to the City. Prior to an expenditure being incurred, the Neighborhood Services Department has the responsibility to validate the availability of funds. These are reimbursement grants. TO Fund Department Account Project Program Activity Budget Reference # Amount ID ID Year I (Chartfield 2 FROM Fund Department I Account Project Program Activity Budget Reference # Amount ID ID Year Chartfield 2 Submitted for City Manager's Office by: Originating Department Head: Additional Information Contact: ATTACHMENTS Fernando Costa (6122) Kacey Bess (8187) Sharon Burkley (5785) Rhonda Hinz (2573) 19NS ACTION PLAN 2024 Agency Form 1295 Forms.pdf (CFW Internal) 2024-2025 Action Plan Secretary of State Filings.pdf (CFW Internal) Action Plan Budget -Staff Recommendations 052924.pptx (CFW Internal) IR 2024-2025 ACTION PLAN.docx (CFW Internal) ORD.APP192024-2025 ACTION PLANFY24 AO(r7).docx (Public) http://apps.cfwnet.org/council_packet/mc review.asp?ID=32258&councildate=6/25/2024 7/8/2024