Application Form -PREVIEW

City of North Las Vegas
Land Development and Community Services Department
Emergency Solutions Grant COVID-19 CARES Act

CLOSED Deadline 5/30/2020

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Description [hide this]

The City of North Las Vegas (CNLV) has received Emergency Solutions Grant COVID 19 (ESG-CV) funding through the CARES Act from the U.S. Dept. of Housing and Urban Development (HUD) to support critical community services during the COVID-19 Pandemic. CNLV is seeking proposals from eligible certified nonprofits organization, that provide critical services that can prevent, prepare for, and respond to the coronavirus, under McKinney-Vento Homeless Assistance Act as Amended by S.896 HEARTH Act of 2009 for Homeless Services activities (24 CFR 576) which meet HUD National Objectives for citizens residing in the North Las Vegas area.

Only projects that meet the U.S. Department of Housing and Urban Development's (HUD) criteria for COVID-19 ESG-CV funding and meet the priorities outlined by the HUD Guidelines will be awarded funds through this application process.

CNLV Departments, eligible Participating Non-Profit Agencies may submit proposal(s) for projects serving residents of North Las Vegas impacted by the government restrictions to prevent or lessen the spread of the coronavirus, in turn, reducing the economic impact. In addition to the specific eligibility criteria of the CARES Funding, all other HUD ESG regulations apply unless otherwise specified in the CARES ACT.

Library [hide this]

Description	File Name	Date Uploaded	File Type
CARES ACT Sections 748-321 through 748-335	CARESActSection748-321through748-335.pdf	5/6/2020 3:15:18 PM	PDF
CNLV Ward Map	City-Council-Wards-Map.pdf	5/6/2020 3:16:14 PM	PDF
HUD Income Guidelines	HUDIncomeGuidelinesNorthLasVegas2020-2021.pdf	5/6/2020 3:16:36 PM	PDF
HUD Fair Market Rental Clark County 2020	HUDFairMarketRentalClarkCounty2020.pdf	5/7/2020 1:53:09 PM	PDF
CNLV ESG Application Manual	20-21ESGapplicationmanualfinalversion.pdf	5/7/2020 1:53:51 PM	PDF
HUD Mega Waivers for COVID Grant Programs	Availability-of-MegaWaivers-of-CPD-Grant-Program.pdf	5/7/2020 1:54:28 PM	PDF
ESG Quick Reference Guide	ESG-Program-Components-Quick-Reference.pdf	5/7/2020 1:56:08 PM	PDF
Opening Doors Best Practice Guidelines	USICH-Opening-Doors-2015-Amendment.pdf	5/7/2020 1:58:40 PM	PDF

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Financial Report: OVERDUE Report Totals

Summary

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No current exempt IRS record was found for IDN . (Due to the IRS data sharing policy, ZoomGrants is unable to verify your IRS information. This does not mean the information is invalid. You can continue to submit your application as the system will repeatedly verify your information).
You might try searching the list of organizations whose federal tax exemption was automatically revoked located at the IRS Select Check Site

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Instructions Show/Hide

All applicants should complete the quick analysis on this tab to ensure that the ESG COVID-19 CARES Act grant opportunity is a fit for your program.

The City of North Las Vegas has identified specifc goals for the using of this funding to support our community. These goals are to provide rental, utilities assistance, and avert food scarcity through meal programs and food bank assistance under the HUD COVID-19 guidelines.

ELIGIBILITY

1. Does your agency meet all of the basic eligibility qualifications? (All boxes must be checked)

	Agency is located in Clark County, NV and provides services to North Las Vegas Residents.
	Agency or its management is NOT currently prohibited from receiving government funding as a result of debarment.
	Agency is currently registered with Nevada Secretary of State to conduct business in Nevada.
	Agency is able to provide evidence of IRS non-profit status.
	Agency is requesting funding associated with COVID-19 related support activities.
	Agency or its management has no prior or pending legal judgments or liabilities against them.

COVID-19 CARES ACT

2. Does your agency understand the funding guidelines for ESG-CV CARES Act? (All boxes must be checked)

	Agency will use the funding provided to prevent the spread of and respond to the threat of COVID-19.
	Agency understands the funding has restricted use as outlined in the ESG-CV CARES Act.
	Agency will need to specifically document use of funding as related to ESG-CV CARES Act .
	Agency policies will need to be updated to reflect compliant use of ESG-CV CARES Act Funding.
	Agency understands the guidelines as outlined by HUD and supporting documentation listed in the grant application library.

3. Is your agency operating at full staff capacity? If not, please explain.

AGENCY AND PROGRAM OVERVIEW

4. What type of COVID-19 response related program does this application represent as related to the City of North Las Vegas priorities? (Check any box that applies)

	Food Delivery Services focused on Seniors or the Medically Fragile
	Food Scarcity Prevention such as Food Pantry Services
	Homeless Prevention Services such as Rent and Utility Assistance

5. Give a brief description of the program and how the program relates to the COVID-19 pandemic response.

6. What are the Days and Hours of the Program Operations during and after COVID-19 crisis?

7. Which Ward(s) in North Las Vegas would be your primary service location?

8. Which Census Tract(s) would be your primary target area?

Documents Requested *

Required?

Uploaded Documents *

-none-

* ZoomGrants™ is not responsible for the content of uploaded documents.

Submit Organization Information

Application Questions

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ORGANIZATION INFORMATION

1. Has your organization ever been awarded ESG funding from the City of North Las Vegas or other regional or municipal government agencies? Provide dates, amounts, and program titles and descriptions for the last three years.

2. Provide an organizational chart of your agency and list key programing and finance staff by name, position, and years of experience with the agency, who will be working on the program you are requesting ESG-CV CARES Act Funding.

3. Describe your organization's financial management system including reporting, record keeping, accounting systems, payment procedures, and audit requirements. Are your financial staff familiar with HUD Guidelines 2 CRF 200 and 2 CFR 576? If so, please describe.

4. Has your organization ever had grant funds recaptured (returned), left unspent, or reappropriated from your organization? Specifically, CDBG, ESG, COC, HOPWA, State, or Federal Funds. If yes, list the funds and circumstances involved and dollar amount.

PROGRAM INFORMATION

5. What is the status type of this program? (Select One)

6. Give a detailed description of your program. Expand on question 5 status type and on how your program addresses the ESG-CV CARES Act response, requirements, and scope.

7. HUD ESG-CV CARES Act funds do not require a match component. However, funds are not intended to support your entire program. Explain how your budget request may be supplemented with other funding such as: 1) Cash Donations 2) In-kind donations (volunteers, supplies, free rent, etc) 3) Other grant funding (Federal, State, or Private) 4) Other agency funding sources.

8. Give a detailed description of Performance Goals for the ESG-CV CARES Act Funding. (i.e. provide short term rental assistance to prevent homelessness and the spread of the coronavirus). Provide the number of unduplicated people anticipated to be served with the budget amount requested in this application.

OUTCOME PERFORMANCE MEASUREMENTS

9. HUD Objectives - What is the activity purpose? (Select One)
Emergency Solution Grants (ESG-CV) have the following limited eligible activities

	Emergency Shelter
	Homeless Prevention
	Rapid Re-Housing
	Street Outreach

10. Who will be benefiting from your program services? Identify the type of homeless/low-income population you plan to serve through your agency's program.

	Homeless Adults without Children
	Homeless Families with Children
	Homeless Single Parents with Children
	Homeless Youth
	Low Income Families/Individuals at imminent risk of homelessness
	Other

11. HUD ESG-CV CARES Act Funding Objectives - select all that apply

	Prevent the spread of COVID-19 by reducing the need to be out in public.
	Prevent the spread of COVID-19 by assisting individuals to stay in their homes.
	Protect the community from the spread of COVID-19 by reducing food scarcity.
	Protect the community from the spread of COVID-19 by preventing the need to gather in large groups.
	Protect the community from the spread of COVID-19 by helping reduce their exposure to citizens who maybe infected.

12. Your agency will be required to collect income verification, demographics, and household data on the North Las Vegas citizens served with the ESG-CV CARES ACT Funding. Please describe in detail how your agency plans to accomplish that task.

DOCUMENTATION PROCESS

13. Describe how your agency will carry out case management during the COIVD-19 Pandemic.
CNLV has applied for Mega Waivers through HUD. Descriptions are listed in the Library for ESG Waivers. Please note that HUD provides flexibility for this requirement.

14. Documentation - The HMIS system will be required to use to capture the required HUD data for annual reporting. In addition, describe what documentation is necessary for homeless prevention eligibility requirements for clients affected by COVID-19.
How will staff be securing the necessary paperwork for verification (circumstances leading to the housing crisis, eviction notice, utility shut off, income qualification, etc)?

15. For homeless prevention programs, describe the duration of assistance and criteria for ending assistance, and the method to ensure that the household remains in housing for at least 3 months after assistance has ended.

16. Regional collaboration is a requirement for HUD CoC and ESG Funding. Provide a brief description of how your agency collaborates with other agencies in the region.

Documents

Instructions Show/Hide

ESG REQUIRED EXHIBITS EXPLANATION Please label all attachments. All required documents listed in this tab must be uploaded into the documents tab.

DOCUMENTATION OF NON-PROFIT STATUS (ATTACHMENT III-A): Copy of IRS letter showing current 501 C (3) or (4) status. All ESG applicants must show proof of current non-profit status. This is done by submitting a copy of the letter from the Internal Revenue Service (IRS). No pending status will be accepted. Letters must be legible to be acceptable. Please call the IRS Exempt Organizations Div. at 1-877-829-5500 to request a free copy.

NEVADA SECRETARY OF STATE RECEIPT OF GOOD STANDING: All applicants must show proof of good standing status with the Nevada Secretary of State Office. You may submit a copy of the current years receipt or a printout from the Secretary of State’s Office website. The receipt must be dated no more than 12 months prior to the application date.

BOARD OF DIRECTORS: Submit a copy of the most recent list of the entire Board of Directors. Must have a volunteer Board of Directors of not less than five (5) unrelated members which meet at least quarterly.

CNLV BUSINESS LICENSE OR NON-PROFIT REGISTRATION VERIFICATION: Provide documentation to evidence Business License requirements have been met or registration verification.

BUDGET DETAIL SPREADSHEET: - Download the Budget Detail Spreadsheet Template enter your data, then save it and upload it with the other documents.

FEE SCHEDULE: Reasonable fees may be charged for program services. Submit a copy of agency’s fee schedule if applicable.

COMPLIANCE DOCUMENT: Download, complete, and sign the Compliance Document, then scan it and upload it with the other documents.

APPLICATION DOCUMENT: Download, complete, and sign the Compliance Document, then scan it and upload it with the other documents.

BUDGET SPREADSHEET: - Download the Budget Spreadsheet Template enter your data, then save it and upload it with the other documents.

CURRENT INSURANCE CERTIFICATE: Provide documentation to evidence of current insurance coverage.

ORGANIZATIONAL CHART: This chart should document the employees of the organization by name, title, and delegation of authority. If your program is part of a large organization, please also include a chart for your program.

Documents Requested *

Required?

Uploaded Documents *

DOCUMENTATION OF NON-PROFIT STATUS:

Required

-none-

NEVADA SECRETARY OF STATE RECEIPT OF GOOD STANDING:

Required

-none-

LIST OF BOARD OF DIRECTORS

Required

-none-

BUSINESS LICENSE OR CNLV NON-PROFIT REGISTRATION VERIFICATION:

Required

-none-

PROGRAM BUDGET DETAIL SPREADSHEET:

Download template: ESG Detail Budget COVID

Required

-none-

FEE SCHEDULE:

Required

-none-

CERTIFICATION AND COMPLIANCE:
Download template: CERTIFICATION _AND_COMPLIANCE_ESG

Required

-none-

CERTIFICATE OF APPLICATION:
Download template: Certificate of Application

Required

-none-

PROGRAM BUDGET SPREADSHEET
Download template: Program Budget

Required

-none-

Current Insurance Certificate

Required

-none-

Organizational Chart

Required

-none-

Performance Outcome Measures
Download template: Performance Outcome Measures ESG

-none-

* ZoomGrants™ is not responsible for the content of uploaded documents.

Ask a Report Question

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Instructions Show/Hide

Carefully, read and answer each question completely. Reports are due by the 10th business day of the following month. Total number of CNLV client(s) assisted for the month must equal the total of all clients accounted for in the Race and Income categories. Hispanic and Latino count is separate from Race. Hispanic count can vary in number but should not exceed number of Race in previous question. Example: (5 – White) in question 2 then “may” have (3 - White and Hispanic) in question 3 but not (7 - White and Hispanic).

Report 1: 5/14/2020 Report 2: 6/14/2020 Report 3: 7/14/2020 Report 4: 8/14/2020 Report 5: 9/14/2020 Report 6: 10/14/2020 Report 7: 11/14/2020 Report 8: 12/14/2020 Report 9: 1/14/2021 Report 10: 2/14/2021 Report 11: 3/14/2021 Report 12: 4/14/2021 Report 13: 5/14/2021 Report 14: 6/14/2021 Report 15: 7/14/2021 Report 16: 8/14/2021 Report 17: 9/14/2021 Report 18: 10/14/2021 Report 19: 11/14/2021 Report 20: 12/14/2021 Report 21: 1/14/2022 Report 22: 2/14/2022 Report 23: 3/14/2022 Report 24: 4/14/2022

Report 1: 5/14/2020

This report is OVERDUE. Submit Report 1

1. For the month, how many unduplicated clients were served by your program. (Zoomgrants will calculate the annual number).
Not all programs will add new clients monthly. If no new clients enter the program for the month then enter a zero.

	Unduplicated CNLV clients served
	Unduplicated Other clients served

2. Monthly CNLV clients served broken down by Race. The total number must match question 1 amount for Unduplicated CNLV Clients served. Each box must be filled with a number 0 - 1,000,000.

	White
	Black/African American
	Asian
	American Indian/Alaskan Native
	Native Hawaiian/Other Pac Islander
	American Indian/Alaskan Native & White
	Asian & White
	Black/African American & White
	American Indian/Alaskan Native & Black/African American
	Other Multi-racial

3. CNLV clients served who identify as Hispanic Ethnicity in addition to the race listed in question 2. The total number for each class specification can not exceed the identified race from question 2. Each box must be filled with a number 0 - 1,000,000.
This section may be less than the total number of CNLV clients served for the month as not all individuals identify as Hispanic Ethnicity.

	White & Hispanic
	Black/African American & Hispanic
	Asian & Hispanic
	American Indian/Alaskan Native & Hispanic
	Native Hawaiian/Other Pac Islander & Hispanic
	American Indian/Alaskan Native & White & Hispanic
	Asian & White & Hispanic
	Black/African American & White & Hispanic
	American Indian/Alaskan Native & Black/African American & Hispanic
	Other Multi-racial & Hispanic

4. Monthly CNLV Clients served broken down by the Median Income category (less than 30%, less than 50%, less than 80%). The total number must match question 1 amount for Unduplicated CNLV Clients served. Each box must be filled with a number 0 - 1,000,000.

	0 - 30% Extremely Low Income
	31% - 50% Low Income
	51% - 80% Moderate Income
	81% - 100% Non-low/Moderate Income

5. Monthly CNLV Clients served that are classified under the following categories. Each box must be filled with a number 0 - 1,000,000.
This section may be less or more than the total number of CNLV clients served for the month as not all individuals identify under these classifications or may identify in multiple classifications.

	Persons Affected by COVID-19 Pandemic
	Senior Citizens Assisted
	Single Parents Assisted
	Disabled Persons Assisted
	Abused Children (Foster Care, etc) Assisted
	Domestic Violence Assisted
	Persons living with AIDS Assisted
	Homeless Persons Assisted

6. Monthly CNLV Clients that are continuing to receive services and have been counted in previous months. This number may grow as your program progresses indicating continue success and steady operations.
Some programs are seasonal and may not add new clients monthly but the program stays consistent serving the same clients month after month throughout the grant cycle. Clients who are continuing in the program are counted here.

	CNLV Clients that are duplicated.

7. Are you experiencing difficulty reaching your goal of CNLV clients served for this reporting period? If yes, please give a brief explanation.

8. Do you have any CNLV Client accomplishments that you would like to highlight? If yes, please give a brief explanation.

Documents Requested *

Uploaded Documents *

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