2017Grants to Green Assessment Grant Application Supplement

2017Grants to Green Assessment Grant Application Supplement

2017Grants to Green Assessment Grant Application Supplement

All character limitations include spaces.

Review the Instructions document found on our website for guidance on completing this Grant Application Supplement. Applicants must complete their Organizational Profile and Common Grant Application through the online portal and submit this Grant Application Supplement and all required attachments to be considered for funding.

Note: This supplement is only to be used for the March deadline.

Organization name:

General Information:

1. Is the organization a previous Grants to Green recipient? / (Choose One)Yes - Assessment OnlyYes - Implementation OnlyYes - Assessment & ImplementationNo
2. Does the organization provide religious services and/or education? / (Choose One)YesNo
If the organization is a religious organization, does the organization require participation in religious activity as a condition for receiving services? / (Choose One)YesNoNot Applicable
If the organization is a religious organization, are the spaces and systems in the buildings in request building dedicated to serving secular needs? / (Choose One)YesNoNot Applicable
3. Is the assessment for an existing building? / (Choose One)YesNo
4. What is the organization’s annual budget for capital improvement projects?

5. Building Details:

Building Address:
City: / Zip Code: / County: (Choose One)BarrowBartowButtsCarrollCherokeeClaytonCobbCowetaDeKalbDouglasFayetteForsythFultonGwinnettHallHenryMorganNewtonPauldingPickensRockdaleSpaldingWaltonOther
Building Name (if applicable):
Square footage: / Year Constructed: / Type of facility: (Choose One)Housing facilityParking facilityOffice facilityClassroom facilityMulti-purpose facilityOther

6. Building Information:

How many buildings does the organization own?
How many buildings does the organization lease?
Building in the request is: / (Choose One)OwnedLeased (entire building)Leased (tenant space)
Building in request: If leased, is the lease agreement five years or more with five years remaining? / (Choose One)YesNoNot Applicable
Building in request: Is the building in the request owned by a government agency? / (Choose One)YesNo
Does the organization have 12 months of utility data for the existing building it is requesting support for? / (Choose One)YesNoNot Applicable
Building in request: Most recent, consecutive 12 months total utility usage: / kWh
gallons
therms
Building in request: Most recent, consecutive 12 months total utility costs: / $
For the building in request, do you have control over the entire building’s electricity and water use systems? / (Choose One)YesNo
For the building in request, is the metering configured such that the consumption of utilities can be monitored and tracked by building? / (Choose One)YesNo
7. The building is (check appropriate box and fill in information where necessary):
  1. Owned by the organization with no debt
  2. Owned by the organization with a debt of $ with (#) years remaining on the loan
  3. Has an option to purchase for a term of (#) months, ending on (M/D/YYYY)
  4. Is leased from (Company Name). The current lease began on (M/D/YYYY), ends on (M/D/YYYY), and has (#) options to renew.

If applicable, does the board have a plan for eliminating the debt? / (Choose One)YesNoNot Applicable
Please explain.

8. Tenants:

Tenants of a larger building: Does the organization lease or own the entire building in the request? / (Choose One)YesNo
Lease space to other tenants: Does the organization lease space to tenants in the building in the request? / (Choose One)YesNo

Other Details:

9. Describe the physical building and the concerns with the building the organization would like to address with the assessment. (1,000 characters)
10. What will the value of the assessment be to the organization?(1,000 characters)
11. Explain the organization’s most recent experience with building improvements. (1,000 characters)
12. Does the organization have a list of deferred maintenance items?(1,000 characters)
13.Describe the capacity at which the organization’s board will be involved in the process.(1,000 characters)
14. Use this space to clarify any of the information provided in this grant application supplement. (1,000 characters)
Authorizing signatures:Typing in your name acts as your official signature and certifies that you have personally reviewed this application and its attachments, and that the information presented is complete and meets all eligibility criteria as outlined in the 2017Grants to Green Guidelines.
Lead Organization Staff Leader: / Date:
Lead Organization Board Chair: / Date:

Applications with blank or incomplete fields, those missing required attachments or those received after the deadline will not be considered.

All organizations that are a part of this application must have completed their Nonprofit Organizational Profiles and Common Grant Application through the online portal for the application to be reviewed.

Attachments Checklist – label your attachments using the letters provided (A-E) and upload with your Grant Application Supplement. See instructions document for more details. / Included?
  1. Current fiscal year operating budget as approved by the board of directors with year-to-date actual information: Be sure the document includes the entire FY budget (revenue and expenses) and YTD information.
  2. Two most recent audited or reviewed financial statements as dictated by budget size: Submit one copy of each of the two most recent audited or reviewed financial statements. Organizations with annual budgets over $250,000 must present audited financial statements; organizations with annual budgets between $100,000 and $249,999 must present reviewed or audited financial statements.
  3. The organization’s current strategic plan (send the Foundation the entire plan) that covers at least 24 months and the organization’s entire current fiscal year and includes the following:
  4. Mission statement
  5. Evidence of an environmental scan (an assessment of stakeholder and community needs)
  6. Stakeholder participation (staff, board, consumers/clients, volunteers, etc.)
  7. Strategic goals and measureable objectives
  8. Implementation plan showing action steps, a timeline and assigned staff and board responsibilities
  9. Quarterly, semi-annual or annual written assessment by staff and board to measure organizational progress towards goals
  10. Completed Board Information Form: Download the form from the Community Foundation website (cfgreateratlanta.org) and complete the document.
  11. Completed Green Champion Information Form: Download the form from the Community Foundation website(cfgreateratlanta.org) and complete the document.Please review the Green Champion Volunteer Description before selecting a Green Champion.
  12. Signed and dated deed proving building ownership or lease agreement proving long-term lease of at least 5 years or more at the time of submitting the application.
  13. Letter from the Board of Directors signed by the organization’s Board Chair that includes a statement agreeing to allow Southface to present an executive summary of the findings of services to the Board or a relevant Board subcommittee as a 20 minute agenda item during one of its regular meetings.

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