2023 LCDBG Grantee Handbook and Exhibits

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FY 2023 LCDBG Grantee Handbook

Section A Exhibits
A-1 Sample Citizen Participation Plan	A-17 Worksheet for Preparing 24 CFR 58.5 Statutory Checklist	A-33 Verification of Professional Services Eligibility	A-49 Section 3 Worker and Targeted Worker Certification Form
A-2 Request for Release of Funds	A-18 Statutory Checklist for Compliance with 24 CFR 58.5	A-34 Architects Certification of Compliance with Minimum Standards	A-50 Section 3 Business Certification Form
A-3 Authorized Signature Form	A-19 Sample Notice of Intent to Request Release of Funds	A-35 Intergovernmental Cooperative Agreement	A-51 Subcontractor Utilization Report
A-4 Vendor Information Form	A-20 Environmental Assessment Signature Form	A-36 Application for Utility Line Connection on Private Property	A-52 Contractor/Subcontractor Project Workforce Report
A-5 IRS W-9 Form	A-21 Environmental Assessment Checklist	A-37 Sign Required at LCDBG Construction Site	A-53 Suggested Activities to Affirmatively Further Fair Housing
A-6 General Ledger Chart of Accounts	A-22 Combined Notice of Finding of No Significant Impact/Intent to Request Release of Funds	A-38 Contract Documents Guide	A-54 Fair Housing Assessment
A-7 Financial Statements	A-23 Notice of Finding of No Significant Impact	A-39 Sample Minutes of Bid Opening and Bid Tabulation	A-55 Fair Housing Assurance
A-8 Timesheet	A-24 Sample Historic Preservation Letter	A-40 Verification of Contractors Bond and Insurance	A-56 Section 504 Assurance
A-9 CDBG Request for Payment	A-25 Sample Floodplains and Wetlands Notice	A-41 Commonly Asked Questions Concerning Equal Opportunity	A-57 Sample Summary of Actions Taken to Achieve Compliance with Section 504
A-10 Budget Reconciliation Form	A-26 Sample Notice of Explanation	A-42 Qualification Certification for Resident Project Representative	A-58 OCD Language Access Plan
A-11 Budget Revision Form	A-27 Summary of Environmental Requirements	A-43 Construction Contract Checklist	A-59 Subrecipient Agreement
A-12 OCD ERR Checklist	A-28 Sample Procurement Policy	A-44 Final Labor Hours Compliance Report	A-60 Request for Program Amendment
A-13 Certification of Exemption for HUD Funded Projects	A-29 Sample Advertisement Requesting Proposals	A-45 City-Parish Employment: Workforce Analysis	A-61 Sample Authorization to Incur Costs Letter
A-14 Compliance Documentation Checklist	A-30 Components of Request for Proposals and Qualifications	A-46 Contract and Subcontract Activity
A-15 Certification of Categorical Exclusion (not subject to 58.5)	A-31 Sample Request for Qualifications for Engineering	A-47 Project Benefit Profile
A-16 Certification of Categorical Exclusion (subject to 58.5)	A-32 Sample Contract for Professional Services	A-48 Minority Participation Goals
Section B Exhibits
B-1 Appointment of Labor Compliance Officer	B-5 Verification of Wage Decision and Contractor Eligibility	B-9 Verification of Posting Requirements	B-13 Payroll Review Flowchart
B-2 Wage Decision Example	B-6 Notice of Contract Award	B-10 Record of Employee Interview Form	B-14 Payroll Deduction Authorization
B-3 Initial Wage Decision Request - Optional	B-7 Report of Additional Classification and Rate	B-11 Force Account Recordkeeping	B-15 Notice of Restitution Due
B-4 Ten Day Call Form - Optional	B-8 Wage Rate Sheet	B-12 Payroll Form and Statement of Compliance	B-16 Labor Standards Enforcement Report
Section C Exhibits
C-1 Sample Preliminary Acquisition Notice	C-9 Sample Invitation to Accompany Appraiser	C-17 Recommended Local Relocation Policy Grievance Procedure	C-25 Residential Claim for Moving and Related Expenses
C-2 Sample Statement for the Basis for Determination of Just Compensation	C-10 Short Appraisal Form for Servitude Takings	C-18 Relocation Assistance to Tenants Displaced from Home Brochure	C-26 Claim for Replacement Housing Payment for 90-Day Homeowner- Occupant (49 CFR 24.401)
C-3 Written Offer to Purchase	C-11 Review Appraisal Report	C-19 Relocation Eligibility and Benefits Chart	C-27 Claim for Downpayment Assistance
C-4 Statement of Settlement Costs	C-12 Voluntary Acquisition Policy	C-20 Notice of Eligibility for Relocation	C-28 Sample Letter of Acknowledgement for Services and Payment
C-5 Sample Notice of Intent NOT to Acquire Property	C-13 Acquisition Composite List	C-21 Sample Household Case Record	C-29 Format for Waiver of Relocation Assistance
C-6 Property and/or Servitude Acquisition Waiver	C-14 Real Property Acquisition Checklist	C-22 Sample Inspection Report Form	C-30 Relocation Composite List
C-7 Agreement for Appraisal Services - Acquisition	C-15 Residential Antidisplacement and Relocation Assistance Plan under 104D	C-23 Sample Letter to Relocate in a Substandard Unit	C-31 Relocation File Checklist
C-8 Uniform Appraisal Standards for Federal Land Acquisition	C-16 Residential Antidisplacement and Relocation Assistance Certification	C-24 Samples - 90 and 30 Day Notices to Vacate
Section D Exhibits
D-1 Written Agreement	D-3 Sample Resolution of the Board of Directors	D-5 Release of Funds Questions and Answers	D-7 Equipment Analysis
D-2 Sample Evidence of Assisted Business Commitment	D-4 Certification of Legally Binding Agreements	D-6 Davis Bacon Equipment Policy
Section E Exhibits
E-1 Sample State Monitoring Letter	E-3 Onsite Monitoring Checklist	E-5 Local Government Questionnaire	E-7 Example Audit Report Excerpts
E-2 Example Response to State Monitoring Letter	E-4 Desktop Review Checklist	E-6 Program Completion Report	E-8 Example Response to Audit Letter