EMERGENCY FOOD AND SHELTER PROGRAM LOCAL BOARD
975 Corporate Center Parkway, Suite 160 Santa Rosa, CA 95407 (707) 528-4485x115
Application for
Phase 34 Funding
Emergency Food and Shelter Services
SonomaCounty (090800)
Sonoma County has received $73,652 for phase 34 funding. Applying agencies, referred to as Local Recipient Organizations (LRO), can request a minimum of $5,000 with no maximum amount set.
Instructions and Application Check Off List
A. ___Carefully review the following materials:
1. Local Recipient Organization's (LRO) Responsibilities
2. Eligible/Ineligible Costs
* The Local Board will not fund vouchers, emergency repairs/rehabilitation projects and utility assistance.
3. Application Scoring Criteria
4. Budget Form and Instructions
5. Instructions on obtaining a DUNS number
6. LRO Certification Form from Phase 33 for review only; signed version for Phase 34 will be submitted to staff, if funded, upon receipt of the award notification, not with proposal.
B. ___Fill in all applicable blanks. Use only the space provided. Incomplete applications will not be accepted. Agencies must usenothing smaller than 12 point type or font size,and a minimum margin size of .5 inches.
C. ___Round all amounts to the nearest dollar.
D. ___Submit your application materials:
___1. Application form (pages 4-6)
___2. Board of Directors roster
___ 3. Program Budget Form (Excel attachment provided)
___ 4. Current Agency Budget
___5. Original signed and completed LRO Certification Form
___6. Original signed and completed Certification Regarding Lobbying (if applicable)
___ 7. Proof of 501 (c)(3) status or IRS tax exempt letter.
___8. Most recent independent financial audit, including any management letters*
* If you do not have an audit, enclose financial statements. The Local Board will determine eligibility and rate agency's financial management system based on the information presented.
E. ___SUBMISSION DEADLINE
ALL APPLICANTS: All items listed in E. must be received bySeptember 8, 2017, 4:30 p.m., in the following manner:
Submit a PDF scanned version of all of the items listed above to the Google Drive folder that will be sent to you from . Please add this contact to your email so it does not go to your spam folder.
AND
Mail originalmaterials with postmark dated before or on September 8, 2017 to the following address:
Kelly Musca
United Way of the Wine Country
975 Corporate Center Parkway
Suite 160
Santa Rosa, CA
95407
All e-mail applications must be received by September 8, 4:30 p.m., to be eligible. Application must be both received by email AND postmarked on September 8, 2017 to be eligible for consideration.
If you need assistance completing this application, call Kelly Musca
at (707) 528-4485 or e-mail .
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EFSP Timeline
August 3rd- 4th , 2017 – RFPs are sent to the current LROs. RFP announcements are sent to other mailing lists. RFP information is also published in the local paper and on the UWWC website.
August 23rd –MandatoryApplicant Workshop
August 24th to September 8th– Technical Assistance provided by staff. Call 707-528-4485 x 115 or email
September 8th by 4:30 pm – Applications due
September 28th – Local Board meets to allocate funding
October 6th – Funding notifications sent to agencies (or within 5 days of Board meeting date)
October 17th – Appeals Deadline- If an agency would like to appeal the funding decision made by the Local Board, a written appeal must be filed with staff by 4:30 pm (or within 7 days of notification letter.)
Tuesday, October 24th – If no appeal needed, Local Board Allocations Plan will be submitted to the National Office for Approval.
Section 1 — Applicant
Agency:
FEINDUNS No.:
Program Name:
Physical Address:
Mailing Address:
Phone: Fax:E-mail:
Executive Director:
Board Chair:
Check to certify that the agency is not debarred or suspended from receiving federal funds or doing business with the federal government.
………………………………………………………………………………………………………………………
Section 2 — Request
Phase 34 Total Request ($5,000 Minimum, no maximum): $
Requested Food:$ Requested Shelter:$
We Request Per Diem Funding. (Recommended for Served Meals & Mass Shelter).
Our service site(s) are fully compliant with the Americans with Disabilities Act.
If you received funding last year, please answer the following:
Ph. 33 EFSP Funding: $ _____for
Received Food $ Received Shelter $
Meals Provided: # Shelter Bed Nights Provided #
Rent/Mortgage bills Pd. # n/a
If there is a change in the amount you are requesting for this year vs. what you received last year, please briefly describe below the reason for the change.
Section 3 — Program Information:
A. Please summarize the proposed program in 50 words or less.
B. Please note in 50 words or less any major changes in the proposed program since your last EFSP application.
…………………………………………………………………………………………………….
Section4 — Staff: List all paid staff of proposed program by title & FTE (full time = 1, half
time =.5), and identify the FTE, pay rate and total amount to be paid by this grant, if any.
Example: Position Program FTE Pay rate FTE to be paid by EFSP Total EFSP
Shelter Manager .8 FTE $20/hr. .3 FTE $12,480
Position / Program FTE / Pay Rate / FTE Pd by EFSP / Total EFSP $0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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Section 5 — Current Program Funding Sources:
A. Identify sources & amounts, and specify whether funding is ‘multi-year’ or ‘one-time-only’.
B. Describe any program funding changes (gains or losses) for 2016-17, and their effect on the program and agency.
Section 6 — Accounting System: Briefly describe agency accounting system and who maintains it.
………………………………………………………………………………………………………
Section 7 —Proposed Emergency Food and/or Shelter Services:
In 2 pages maximum, please:
1.)Briefly describe the service area and target population for the proposed program, including any special needs or circumstances.
2.)How many people will benefit, and how will they benefit from the requested funding, i.e. (a.) measurable process/output objectives (units of service), and (b.) projected client outcomes specifically related to the requested funds only (not the whole program).
3.)How will you accomplish these objectives? Include evidence of past performance.
4.)Identify collaborative partners & describe the nature of each relationship to prevent duplication, maximize coverage, or improve client outcomes.
5.)Under which Preference Criteria listed on the RFP is this proposed program eligible for EFSP funds?
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