Before Starting the Project Application...FL-019 17. Proposed Project a. Start Date: 01/01/2018 b. End Date: 12/31/2019 18. Estimated Funding ($) a. Federal: b. Applicant: c. State:

Before Starting the Project Application

To ensure that the Project Application is completed accurately, ALLproject applicants should review the following information BEFOREbeginning the application.

Things to Remember:

- Additional training resources can be found on the HUD Exchange athttps://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources. - Program policy questions and problems related to completing the application in e-snaps maybe directed to HUD the HUD Exchange Ask A Question. - Project applicants are required to have a Data Universal Numbering System (DUNS) numberand an active registration in the Central Contractor Registration (CCR)/System for AwardManagement (SAM) in order to apply for funding under the Fiscal Year (FY) 2017 Continuum ofCare (CoC) Program Competition. For more information see FY 2017 CoC ProgramCompetition NOFA. - To ensure that applications are considered for funding, applicants should read all sections ofthe FY 2017 CoC Program NOFA and the FY 2017 General Section NOFA. - Detailed instructions can be found on the left menu within e-snaps. They contain morecomprehensive instructions and so should be used in tandem with onscreen text and thehide/show instructions found on each individual screen. - New projects may only be submitted as either Reallocated or Permanent Supportive HousingBonus Projects. These funding methods are determined in collaboration with local CoC and it iscritical that applicants indicate the correct funding method. Project applicants mustcommunicate with their CoC to make sure that the CoC submissions reflect the same fundingmethod. - Before completing the project application, all project applicants must complete or update (asapplicable) the Project Applicant Profile in e-snaps. - HUD reserves the right to reduce or reject any new project that fails to adhere to (24 CFR part578 and application requirements set forth in FY 2017 CoC Program Competition NOFA.

Applicant: Ft Myers/Cape Coral/Lee County CoC FL-603Project: Catholic Charities Bahkita House III - TH-RRH 149954

New Project Application FY2017 Page 1 09/15/2017

1A. SF-424 Application Type

1. Type of Submission:

2. Type of Application: New Project Application

If Revision, select appropriate letter(s):

If "Other", specify:

3. Date Received: 09/01/2017

4. Applicant Identifier:

5a. Federal Entity Identifier:

6. Date Received by State:

7. State Application Identifier:



1B. SF-424 Legal Applicant

8. Applicant

a. Legal Name: Lee County Board of County Commissioners

b. Employer/Taxpayer Identification Number(EIN/TIN):

59-6000702

c. Organizational DUNS: 013461611 PLUS 4:

d. Address

Street 1: 2440 Thompson Street

Street 2:

City: Fort Myers

County: Lee

State: Florida

Country: United States

Zip / Postal Code: 33901

e. Organizational Unit (optional)

Department Name: Human and Veteran Services

Division Name:

f. Name and contact information of person tobe

contacted on matters involving thisapplication

Prefix: Mrs.

First Name: Jeannie

Middle Name:

Last Name: Sutton

Suffix:

Title: Grants Coordinator

Organizational Affiliation: Lee County Board of County Commissioners

Telephone Number: (239) 533-7958



Extension:

Fax Number: (239) 533-7960

Email: [email protected]



1C. SF-424 Application Details

9. Type of Applicant: B. County Government

10. Name of Federal Agency: Department of Housing and Urban Development

11. Catalog of Federal Domestic AssistanceTitle:

CoC Program

CFDA Number: 14.267

12. Funding Opportunity Number: FR-6100-N-25

Title: Continuum of Care Homeless AssistanceCompetition

13. Competition Identification Number:

Title:



1D. SF-424 Congressional District(s)

14. Area(s) affected by the project (state(s)only):

(for multiple selections hold CTRL key)

Florida

15. Descriptive Title of Applicant's Project: Catholic Charities Bahkita House III - TH-RRH

16. Congressional District(s):

a. Applicant: FL-019

b. Project:(for multiple selections hold CTRL key)

FL-019

17. Proposed Project

a. Start Date: 01/01/2018

b. End Date: 12/31/2019

18. Estimated Funding ($)

a. Federal:

b. Applicant:

c. State:

d. Local:

e. Other:

f. Program Income:

g. Total:



1E. SF-424 Compliance

19. Is the Application Subject to Review ByState Executive Order 12372 Process?

b. Program is subject to E.O. 12372 but has notbeen selected by the State for review.

If "YES", enter the date this application wasmade available to the State for review:

20. Is the Applicant delinquent on any Federaldebt?

No

If "YES," provide an explanation:



1F. SF-424 Declaration

By signing and submitting this application, I certify (1) to the statementscontained in the list of certifications** and (2) that the statements hereinare true, complete, and accurate to the best of my knowledge. I alsoprovide the required assurances** and agree to comply with any resultingterms if I accept an award. I am aware that any false, fictitious, orfraudulent statements or claims may subject me to criminal, civil, oradministrative penalties. (U.S. Code, Title 218, Section 1001)

I AGREE: X

21. Authorized Representative

Prefix: Commissioner

First Name: John

Middle Name:

Last Name: Manning

Suffix:

Title: Chair, Board of County Commissioners

Telephone Number:(Format: 123-456-7890)

(239) 533-2224

Fax Number:(Format: 123-456-7890)

(239) 485-2155


Signature of Authorized Representative: Considered signed upon submission in e-snaps.

Date Signed: 09/01/2017



1G. HUD 2880

Applicant/Recipient Disclosure/Update Report - Form 2880U.S. Department of Housing and Urban Development

OMB Approval No. 2510-0011 (exp.11/30/2018)

Applicant/Recipient Information

1. Applicant/Recipient Name, Address, and Phone

Agency Legal Name: Lee County Board of County Commissioners

Prefix: Ms.

First Name: John

Middle Name:

Last Name: Manning

Suffix:


Organizational Affiliation: Lee County Board of County Commissioners

Telephone Number: (239) 533-2224

Extension:


City: Fort Myers

County: Lee

State: Florida

Country: United States

Zip/Postal Code: 33901

2. Employer ID Number (EIN): 59-6000702

3. HUD Program: Continuum of Care Program

4. Amount of HUD AssistanceRequested/Received:

$144,489.00



(Requested amounts will be automatically entered within applications)

5. State the name and location (street address, City and State) of theproject or activity.

Refer to project name, addresses and CoC Project Identifying Number (PIN) entered into theattached project application.

Part I Threshold Determinations

1. Are you applying for assistance for aspecific project or activity?

(For further information, see 24 CFR Sec. 4.3).

Yes

2. Have you received or do you expect toreceive assistance within the jurisdiction ofthe Department (HUD), involving the project

or activity in this application, in excess of$200,000 during this fiscal year (Oct. 1 - Sep.

30)? For further information, see 24 CFR Sec.4.9.

Yes

Part II Other Government Assistance Provided or Requested/ExpectedSources and Use of Funds

Such assistance includes, but is not limited to, any grant, loan, subsidy, guarantee, insurance,payment, credit, or tax benefit.

Department/Local Agency Name and Address Type of Assistance AmountRequested /

Provided

Expected Uses of the Funds

See Attached See Attached $0.00 See Attached

Note: If additional sources of Government Assistance, please use the"Other Attachments" screen of the project applicant profile.

Part III Interested Parties



You must disclose:1. All developers, contractors, or consultants involved in the application for the assistance or inthe planning, development, or implementation of the project or activity and 2. any other person who has a financial interest in the project or activity for which theassistance is sought that exceeds $50,000 or 10 percent of the assistance (whichever is lower).

Alphabetical list of all persons with areportable financial interest in the project or

activity (For individuals, give the last name first)

Social Security No.or Employee ID No.

Type ofParticipation

Financial Interestin Project/Activity

($)

Financial Interestin Project/Activity

(%)

See Attached See Attached See Attached $0.00 0%

Note: If there are no other people included, write NA in the boxes.

CertificationWarning: If you knowingly make a false statement on this form, you may be subject to civil orcriminal penalties under Section 1001 of Title 18 of the United States Code. In addition, anyperson who knowingly and materially violates any required disclosures of information, includingintentional nondisclosure, is subject to civil money penalty not to exceed $10,000 for eachviolation.

I certify that this information is true and complete.

I AGREE: X

Name / Title of Authorized Official: John Manning, Chair, Board of CountyCommissioners

Signature of Authorized Official: Considered signed upon submission in e-snaps.




1H. HUD 50070

HUD 50070 Certification for a Drug Free Workplace

Applicant Name: Lee County Board of County Commissioners

Program/Activity Receiving Federal GrantFunding:

CoC Program

Acting on behalf of the above named Applicant as its Authorized Official, Imake the following certifications and agreements to the Department of

Housing and Urban Development (HUD) regarding the sites listed below:I certify that the above named Applicant will or will continue toprovide a drug-free workplace by:

a. Publishing a statement notifying employees that the unlawfulmanufacture, distribution, dispensing, possession, or use of acontrolled substance is prohibited in the Applicant's workplaceand specifying the actions that will be taken against employeesfor violation of such prohibition.

e. Notifying the agency in writing, within ten calendar days afterreceiving notice under subparagraph d.(2) from an employee orotherwise receiving actual notice of such conviction. Employersof convicted employees must provide notice, including positiontitle, to every grant officer or other designee on whose grantactivity the convicted employee was working, unless theFederalagency has designated a central point for the receipt ofsuch notices. Notice shall include the identification number(s)of each affected grant;

b. Establishing an on-going drug-free awareness program toinform employees ---(1) The dangers of drug abuse in the workplace(2) The Applicant's policy of maintaining a drug-free workplace;(3) Any available drug counseling, rehabilitation, and employeeassistance programs; and(4) The penalties that may be imposed upon employees for drugabuse violations occurring in the workplace.

f. Taking one of the following actions, within 30 calendar days ofreceiving notice under subparagraph d.(2), with respect to anyemployee who is so convicted ---(1) Taking appropriate personnel action against such anemployee, up to and including termination, consistent with therequirements of the Rehabilitation Act of 1973, as amended; or(2) Requiring such employee to participate satisfactorily in adrug abuse assistance or rehabilitation program approved forsuch purposes by a Federal, State, or local health, lawenforcement, or other appropriate agency;

c. Making it a requirement that each employee to be engaged inthe performance of the grant be given a copy of the statementrequired by paragraph a.;

g. Making a good faith effort to continue to maintain a drugfreeworkplace through implementation of paragraphs a. thru f.

d. Notifying the employee in the statement required by paragrapha. that, as a condition of employment under the grant, theemployee will ---(1) Abide by the terms of the statement; and(2) Notify the employer in writing of his or her conviction for aviolation of a criminal drug statute occurring in the workplaceno later than five calendar days after such conviction;

2. Sites for Work Performance.The Applicant shall list (on separate pages) the site(s) for the performance of work done inconnection with the HUD funding of the program/activity shown above: Place of Performanceshall include the street address, city, county, State, and zip code. Identify each sheet with theApplicant name and address and the program/activity receiving grant funding.) Workplaces, including addresses, entered in the attached project application.Refer to addresses entered into the attached project application.

I hereby certify that all the information statedherein, as well as any information provided in

X



the accompaniment herewith, is true andaccurate.

Warning: HUD will prosecute false claims and statements. Conviction may result in criminaland/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

Authorized Representative


First Name: John

Middle Name

Last Name: Manning

Suffix:



(239) 533-2224


(239) 485-2155






CERTIFICATION REGARDING LOBBYING

Certification for Contracts, Grants, Loans, and Cooperative Agreements

The undersigned certifies, to the best of his or her knowledge and belief,that:

(1) No Federal appropriated funds have been paid or will be paid, by or onbehalf of the undersigned, to any person for influencing or attempting toinfluence an officer or employee of an agency, a Member of Congress, anofficer or employee of Congress, or an employee of a Member of Congressin connection with the awarding of any Federal contract, the making of anyFederal grant, the making of any Federal loan, the entering into of anycooperative agreement, and the extension, continuation, renewal,amendment, or modification of any Federal contract, grant, loan, orcooperative agreement.

2) If any funds other than Federal appropriated funds have been paid orwill be paid to any person for influencing or attempting to influence anofficer or employee of any agency, a Member of Congress, an officer oremployee of Congress, or an employee of a Member of Congress inconnection with this Federal contract, grant, loan, or cooperativeagreement, the undersigned shall complete and submit Standard Form-LLL, ''Disclosure of Lobbying Activities,'' in accordance with itsinstructions.

(3) The undersigned shall require that the language of this certification beincluded in the award documents for all subawards at all tiers (includingsubcontracts, subgrants, and contracts under grants, loans, andcooperative agreements) and that all subrecipients shall certify anddisclose accordingly. This certification is a material representation of factupon which reliance was placed when this transaction was made orentered into. Submission of this certification is a prerequisite for makingor entering into this transaction imposed by section 1352, title 31, U.S.Code. Any person who fails to file the required certification shall besubject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure.

Statement for Loan Guarantees and Loan Insurance

The undersigned states, to the best of his or her knowledge and belief,that:

If any funds have been paid or will be paid to any person for influencingor attempting to influence an officer or employee of any agency, a Memberof Congress, an officer or employee of Congress, or an employee of aMember of Congress in connection with this commitment providing for theUnited States to insure or guarantee a loan, the undersigned shallcomplete and submit Standard Form-LLL, ''Disclosure of LobbyingActivities,'' in accordance with its instructions. Submission of thisstatement is a prerequisite for making or entering into this transactionimposed by section 1352, title 31, U.S. Code. Any person who fails to file



the required statement shall be subject to a civil penalty of not less than$10,000 and not more than $100,000 for each such failure.

I hereby certify that all the information statedherein, as well as any information provided in

the accompaniment herewith, is true andaccurate:

X

Warning: HUD will prosecute false claims and statements. Conviction mayresult in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31U.S.C. 3729, 3802)

Applicant’s Organization: Lee County Board of County Commissioners

Name / Title of Authorized Official: John Manning, Chair, Board of CountyCommissioners

Signature of Authorized Official: Considered signed upon submission in e-snaps.




1J. SF-LLL

DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C.

1352. Approved by OMB0348-0046

HUD requires a new SF-LLL submitted with each annual CoC competition and completing thisscreen fulfills this requirement.

Answer “Yes” if your organization is engaged in lobbying associated with the CoC Program andanswer the questions as they appear next on this screen. The requirement related to lobbyingas explained in the SF-LLL instructions states: “The filing of a form is required for each paymentor agreement to make payment to any lobbying entity for influencing or attempting to influencean officer or employee of any agency, a Member of Congress, an officer or employee ofCongress, or an employee of a Member of Congress in connection with a covered Federalaction.”

Answer “No” if your organization is NOT engaged in lobbying.

Does the recipient or subrecipient of this CoCgrant participate in federal lobbying activities

(lobbying a federal administration orcongress) in connection with the CoC

Program?

Yes

1. Type of Federal Action: Grant

2. Status of Federal Action: Application

3. Report Type: Initial Filing

4. Name and Address of Reporting Entity: Prime

Refer to project name, addresses and contact information entered into theattached project application on screen 1B.

Congressional District, if known: FL-019

6. Federal Department/Agency: Department of Housing and Urban Development

7. Federal Program Name/Description and(CFDA Number):

Continuum of Care (CoC) Program (14.267)

8. Federal Action Number: FR-5900-N-18B

9. Award Amount: $144,489.00

10a. Name and Address of Lobbying Registrant (if individual, last name,first name, MI):

Bill FergusonThe Ferguson Group, LLC1130 Connecticut Ave, NW Suite 300Washington, DC 20036



10b. Individuals Performing Services (including address if different fromNo. 10a) (last name, first name, MI):

N/A

11. Information requested through this form is authorized by title 31U.S.C. section 1352. This disclosure of lobbying activities is a materialrepresentation of fact upon which reliance was placed by the tier above

when this transaction was made or entered into. This disclosure isrequired pursuant to 31 U.S.C. 1352. This information will be available for

public inspection. Any person who fails to file the required disclosureshall be subject to a civil penalty of not less than $10,000 and not more

than $100,000 for each such failure.

I certify that this information is true andcomplete.

X

Authorized Representative


First Name: John

Middle Name:

Last Name: Manning

Suffix:



(239) 533-2224


(239) 485-2155






2A. Project Subrecipients

This form lists the subrecipient organization(s) for the project. To add asubrecipient, select the icon. To view or update subrecipient

information already listed, select the view option.

Total Expected Sub-Awards: $144,489Organization Type Sub-

AwardAmount

Catholic Charities, Diocese ofVenice, Inc.

M. Nonprofit with 501C3 IRS Status $144,489



2A. Project Subrecipients Detail

a. Organization Name: Catholic Charities, Diocese of Venice, Inc.

b. Organization Type: M. Nonprofit with 501C3 IRS Status

If "Other" specify:

c. Employer or Tax Identification Number: 59-2473176

* d. Organizational DUNS: 877686501 PLUS 4:

e. Physical Address

Street 1: 4235 Michigan Ave Link

Street 2: Elizabeth Kay Galeana Center

City: Fort Myers

State: Florida

Zip Code: 33916

f. Congressional District(s):(for multiple selections hold CTRL key)

FL-019

g. Is the subrecipient a Faith-BasedOrganization?

Yes

h. Has the subrecipient ever received afederal grant,either directly from a federalagency or through a State/local agency?

Yes

i. Expected Sub-Award Amount: $144,489

j. Contact Person

Prefix: Mr.

First Name: Charles

Middle Name:



Last Name: Anderson

Suffix:

Title: District II Director

E-mail Address: [email protected]

Confirm E-mail Address: [email protected]

Phone Number: 239-337-4139

Extension:

Fax Number:



2B. Experience of Applicant, Subrecipient(s), andOther Partners

1. Describe the experience of the applicant and potential subrecipients (ifany), in effectively utilizing federal funds and performing the activitiesproposed in the application, given funding and time limitations.

Established In 1988, three Catholic Charities locations in Lee County serve lowincome individuals and families providing low or no cost human services.Program Directors ensure that clients have knowledge and access to allCatholic Charities’ resources. Catholic Charities, Lee County has multiple anddiversified funding streams. Revenue includes federal, county, privatefoundation, individual donations, Diocesan subsidy, other Catholic institutionsand annual fundraising strategies. Fiscal year 2015-2016 Audit indicates thatCatholic Charities managed $1,454,009 in government contracts and grants,$303,024 in United Way Funds and $760,194 in other grants. Catholic Charitieshas received funding from Suncoast Partnership to Prevent Homelessness(COC for Manatee and Sarasota Counties) for two projects Our Mother’sHouse; and, Casa San Jose since 2006. The current CoC FL500 renewal award($80,788) addresses eight (8) units of special needs permanent housing withsupportive services. These projects participate in HMIS for the CoC. CatholicCharities has developed 96 units of farmworker housing, and other low tomoderate income housing projects through HUD and USDA, e.g. 30 units ofaffordable housing units in Sarasota, $685,000 CDBG funds for 5 transitionalhouses in North Port and $454,000 CDBG funds for renovation of 10,000 sq. ft.social service building (in process).

2. Describe the experience of the applicant and potential subrecipients (ifany) in leveraging other Federal, State, local, and private sector funds.

Catholic Charities has extensive experience in leveraging other Federal, State,Local and Private Sector Funds for housing and other projects; as example forCOC FL500 Suncoast Partnership, CCDOV was able to leverage a total of $1.2million for Casa San Jose (special housing for persons with disability(HIV/AIDS).

3. Describe the basic organization and management structure of theapplicant and subrecipients (if any). Include evidence of internal andexternal coordination and an adequate financial accounting system.

Catholic Charities is a 501(C)(3) non-profit organization. The agency isgoverned by a Board of Directors and led by an Executive Director who issupported by the Chief of Operations (COO). The leadership includes: FinanceDirector (with four support staff), Director for Performance Improvement andClient Information System (CIS), Director for Development, and Director forGrants and Immigration. The agency enjoys a four star rating by CharityNavigator and is preparing for its fifth Council on Accreditation (COA) re-



accreditation. Catholic Charities is audited annually by an independent firm. Theorganization serves ten southwest Florida Counties providing a variety ofhuman services that empower individuals and families to move from poverty toself-sustainability.

4a. Are there any unresolved monitoring oraudit findings for any HUD grants(includingESG) operated by the applicant or potential

subrecipients (if any)?

No



3A. Project Detail

1a. CoC Number and Name: FL-603 - Ft Myers, Cape Coral/Lee County CoC

1b. CoC Collaborative Applicant Name: Lee County Board of County Commissioners

2. Project Name: Catholic Charities Bahkita House III - TH-RRH

3. Project Status: Standard

4. Component Type: Joint TH & PH-RRH

5. Does this project use one or moreproperties that have been conveyed through

the Title V process?

No



3B. Project Description

1. Provide a description that addresses the entire scope of the proposedproject.

Catholic Charities is seeking $144,489 to purchase and renovate a duplex toprovide two, two bedroom units (four beds) for transitional housing withsupportive services for victims of human trafficking. The Florida Department ofChildren and Families reports the number of human trafficking cases in thestate increased 54 percent over the previous year, most of those involved sextrafficking of women and girls. Florida has the third-highest number of reportedcases in the nation. Source: http://jacksonville.com/opinion/editorials/2017-04-20/friday-editorial-strong-efforts-underway-end-sex-trafficking. Bakhita HouseIII is designed to provide homeless individuals and families who have beenvictims of human trafficking (Category 4 of Homeless Definitions) withtemporary housing and interim stability and support to successfully move to andmaintain permanent housing, i.e. joint transitional (TH) and rapid re-housinghousing (PH-RRH). Supportive services in the form of case management willbe provided for a period up to six months following exit from transitional housingto permanent housing (RRH).

Bahkita House III will provide transitional housing for an estimated 16individuals per year. The duplex can accommodate 4 clients at one time.Historically, the program averages 23 new clients per year. Victims may be anindividual or the individual and their immediate family members. Clients may bereferred from any area of Lee County consequently; consideration will be givento obtaining the best value for the funds available. Clients are referred throughlaw enforcement and any community partners. Clients may receive rentalassistance for a period lasting between 3 and 6months and can remain enrolledin the program for a period of up to 16 months. The program is staffed by aDistrict Director, Program Director, Program Coordinator and two full timecaseworkers. Families would have priority over an individual. Highest prioritywould be given to a victim with minor children. If program housing is notavailable, Client would be assisted in securing other housing. In this situation,the client would still be eligible for supportive services in the form of casemanagement which will be provided for a period up to six months following exitfrom transitional housing to permanent housing (RRH).

2. Describe the estimated schedule for the proposed activities, themanagement plan, and the method for assuring effective and timelycompletion of all work.

The project will commence with notification of the award and conclude withcompleted renovation and occupancy of the property. The contractor’sadherence to the work schedule and drawers will be monitored by the DistrictDirector, with oversight by the COO. The District Director will secure a realtorwithin two week of award announcement. The District Director and COO willoversee the selection and closing on the selected property within four months ofaward. The District Director and COO will obtain bids for property renovationwithin six weeks of closing, and award a contract for renovation within 4 weeks



after bid opening. It is estimated that the project will be completed within sixmonths of the start of renovation.

3. Will your project participate in a CoCCoordinated Entry Process?

Yes

* 4. Please identify the project's specific population focus.

(Select ALL that apply)Chronic Homeless Domestic Violence

X

Veterans Substance Abuse

Youth (under 25) Mental Illness

Families HIV/AIDS

Other(Click 'Save' to update) X

Other: Victims of Human Traficking

5. Housing First

a. Will the project quickly move participantsinto permanent housing

Yes

b. Does the project ensure that participants are not screened out based onthe following items? Select all that apply.

Having too little or little incomeX

Active or history of substance useX

Having a criminal record with exceptions for state-mandated restrictionsX

History of victimization (e.g. domestic violence, sexual assault, childhood abuse)X

None of the above

c. Does the project ensure that participants are not terminated from theprogram for the following reasons? Select all that apply.

Failure to participate in supportive servicesX



Failure to make progress on a service planX

Loss of income or failure to improve incomeX

Any other activity not covered in a lease agreement typically found for unassisted persons in the project’s geographic areaX

None of the above

d. Will the project follow a "Housing First"approach?

(Click 'Save' to update)

Yes

6. If applicable, describe the proposed development activities and theresponsibilities that the applicant and potential subrecipients (if any) willhave in developing, operating, and maintaining the property.

The project facility will be renovated according to County Code and zoningrequirements. Operations will be overseen by the project manager andmaintenance will be done by Catholic Charities maintenance staff to ensureproperty and equipment is habitable and in good order.

7. Will participants be required to live in aparticular structure, unit, or locality, at some

point during the period of participation?

Yes

Explain how and why the project will implement this requirement.

Housing units are acquired for use as transitional housing to facilitate themovement of the client into permanent housing. If space is not available in theprogram units, clients will be assisted by case manager to secure housing in ashelter or the housing marketplace.

8. Will more than 16 persons live in onestructure?

No



3C. Project Expansion Information

1. Will the project use an existing homelessfacility or incorporate activities provided by

an existing project?

No



4A. Supportive Services for Participants

1a. Are the proposed project policies andpractices consistent with the laws related toproviding education services to individuals

and families?

Yes

1b. Will the proposed project have adesignated staff person to ensure that the

children are enrolled in school and receiveeducational services, as appropriate?

Yes

2. Describe how participants will be assisted to obtain and remain inpermanent housing.

Joint TH-RRH is designed to provide homeless individuals and families whohave been victims of human trafficking (Category 4 Homeless) with temporaryhousing and interim stability and support to successfully move to and maintainpermanent housing. Supportive services in the form of case management willbe provided for a period up to 6 months following exit from transitional housingto permanent housing (RRH). There is a Program Director, ProgramCoordinator and two full time Case Managers. The program provides casemanagement services to all referred participants. Clients are referred throughlaw enforcement and community partners. Program policy requires client intaketo be conducted within 48 hours of referral. Clients may receive rentalassistance for a period lasting between 3 and 6 months. Clients can remainenrolled in the program for a period of up to 16 months. As a transitional homeit will not require 24 hour staff or oversight.

3. Describe specifically how participants will be assisted both to increasetheir employment and/or income and to maximize their ability to liveindependently.

Although clients who are certified may participate in the program for up to 6months, the average is 16 months. (if a client is pre-certified -- A foreign bornvictim before they have been officially recognized by the US government or aUS born victim (in the case of US born they are not identified as pre-certified,simply as domestic) – they can be enrolled and are eligible for all of the sameservices, pre-certified survivors are not eligible to work until certification, whichobviously makes the services for them a bit different- instead of focusing onwork the case manager focuses on ESL, orientation to US culture, etc)HTclients received services, including case management (unlimited sessions asneeded), job training housing assistance (up to 6 months), medical (as needed),



dental (as needed) , mental health services (as needed). Of the servicesprovided all of them except for case management were provided by communitypartners including: Abuse Counseling and Treatment, Family Health Centers,Naples Shelter, Clothes Closet, Goodwill, Literacy Council, Department ofChildren and Families, Lee Memorial Health, FGCU Human Trafficking Center,Florida Rural Legal Aid.

4. For all supportive services available to participants, indicate who willprovide them and how often they will be provided.

Click 'Save' to update.Supportive Services Provider Frequency

Assessment of Service Needs Applicant Bi-weekly

Assistance with Moving Costs Applicant As needed

Case Management Applicant Bi-weekly

Child Care Partner As needed

Education Services Partner As needed

Employment Assistance and Job Training Partner As needed

Food Applicant As needed

Housing Search and Counseling Services Applicant As needed

Legal Services Partner As needed

Life Skills Training Applicant As needed

Mental Health Services Partner As needed

Outpatient Health Services Partner As needed

Outreach Services Applicant Daily

Substance Abuse Treatment Services Partner As needed

Transportation Applicant As needed

Utility Deposits Applicant As needed

5. Please identify whether the project will include the following activities:

5a. Transportation assistance to clients toattend mainstream

benefit appointments, employment training,or jobs?

Yes

5b. Use of a single application form for fouror more mainstream

programs?

Yes

5c. Regular follow-ups with participants toensure mainstream

benefits are received and renewed?

Yes



6. Will project participants have access toSSI/SSDI technical assistance

provided by the applicant, a subrecipient, orpartner agency?

Yes

6a. Has the staff person providing thetechnical assistance completed SOAR

training in the past 24 months.

No



4B. Housing Type and Location

The following list summarizes each housing site in the project. To add ahousing site to the list, select the icon. To view or update a housing sitealready listed, select the icon.

TH RRH Total

Total Units: 1 0 1

Total Beds: 4 0 4

Housing Type Units Beds

Single family homes/townhou... 1 4



4B. Housing Type and Location Detail

1. Housing Type: Single family homes/townhouses/duplexes

Is this a private or semi private room? Yes

2. Indicate the maximum number of units and beds available for projectparticipants at the selected housing site.

a. Units: 1

b. Beds: 4

3. Address

Street 1: To be determined

Street 2:

City: Fort Myers

State: Florida

ZIP Code: 99999

*4. Select the geographic area(s) associated with the address. For newprojects, select the area(s) expected to be covered.

(for multiple selections hold CTRL key)

129071 Lee County



5A. Project Participants - Households

Households TableHouseholds with at

Least One Adultand One Child

Adult Householdswithout Children

Households withOnly Children

Total

Number of Households 4 8 0 12

Characteristics Persons inHouseholds with at

Least One Adultand One Child

Adult Persons inHouseholds without

Children

Persons inHouseholds with

Only Children

Total

Adults over age 24 2 6 8

Adults ages 18-24 2 2 4

Accompanied Children under age 18 4 0 4

Unaccompanied Children under age 18 0 0

Total Persons 8 8 0 16

Click Save to automatically calculate totals



5B. Project Participants - Subpopulations

Persons in Households with at Least One Adult and One Child

Characteristics

Chronically

HomelessNon-

Veterans

Chronically

HomelessVeterans

Non-Chronicall

yHomelessVeterans

ChronicSubstanc

eAbuse

Personswith

HIV/AIDS

SeverelyMentally

Ill

Victims ofDomesticViolence

PhysicalDisability

Developmental

Disability

Personsnot

represented bylisted

subpopulations

Adults over age 24 2

Adults ages 18-24 2

Children under age 18 4

Total Persons 0 0 0 0 0 0 8 0 0 0


Persons in Households without Children

Characteristics

Chronically

HomelessNon-

Veterans

Chronically

HomelessVeterans

Non-Chronicall

yHomelessVeterans

ChronicSubstanc

eAbuse

Personswith

HIV/AIDS

SeverelyMentally

Ill


PhysicalDisability

Developmental

Disability

Personsnot


subpopulations

Adults over age 24 6

Adults ages 18-24 2

Total Persons 0 0 0 0 0 0 8 0 0 0


Persons in Households with Only Children

Characteristics

Chronically

HomelessNon-

Veterans

Chronically

HomelessVeterans

Non-Chronicall

yHomelessVeterans

ChronicSubstanc

eAbuse

Personswith

HIV/AIDS

SeverelyMentally

Ill


PhysicalDisability

Developmental

Disability

Personsnot


subpopulations

Accompanied Childrenunder age 18

Unaccompanied Childrenunder age 18

Total Persons 0 0 0 0 0 0 0



5C. Outreach for Participants

1. Enter the percentage of project participants that will be coming fromeach of the following locations.

20% Directly from the street or other locations not meant for human habitation.

30% Directly from emergency shelters.

20% Persons at imminent risk of losing their night time residence within 14 days, have no subsequent housing identified, andlack the resources to obtain other housing.

0% Directly from safe havens.

0% Persons fleeing domestic violence.

30% Directly from transitional housing.

0% Persons receiving services through a Department of Veterans Affairs(VA)-funded homeless assistance program (Eligiblefor JOINT projects if from TH or Emergency Shelters).

100% Total of above percentages

2. Describe the outreach plan to bring these homeless participants intothe project.

The outreach plan to bring these homeless participants into the project involvesthe following steps:1. Since all of our clients are homeless we will continue our caseworkersoutreach to emergency shelters, transitional shelters, sober shelters and peopleliving on on the streets or in cars.2. The housing component will be complementary to the work our caseworkersdo in terms of outreach and identifying qualifying homeless clients forparticipation in the project.3. We will leverage our existing relationships with non-profit providers where ourprogram has preexisting memorandums of understanding and existingrelationships to identify qualifying homeless clients for participation in theproject.4. Given the fact that our human trafficking intensive casework program hasbeen in place since 2009 and helping homeless tracking victims since that time,it should not be difficult to find homeless participants for the project and placethem accordingly.



5D. Discharge Planning Policy

1. Has the state or local governmentdeveloped or implemented a discharge

planning policy or protocol to prevent orreduce the number of persons discharged

from publicly-funded institutions (e.g. healthcare facilities, foster care, correctional

facilities, or mental health institutions) intohomelessness or HUD McKinney-Vento

funded programs?

Yes



6A. Funding Request

1. Will it be feasible for the project to beunder grant agreement by September 30,

2019?

Yes

2. Is the project proposing to using fundsreallocated from the CoCs annual renewal

demand OR

is the project applying for funding throughthe permanent housing bonus?

Permanent Housing Bonus

3. Does this project propose to allocate fundsaccording to an indirect cost rate?

No

4. Select a grant term: 3 Years

* 5. Select the costs for which funding isbeing requested:

Acquisition/Rehabilitation/New Construction X

Leased Units

Leased Structures

Rental Assistance

Supportive Services

Operating

HMIS



6B. Acquisition/Rehabilitation/New ConstructionBudget

The following list summarizes the total request for each structure. To adda structure to the list, select the icon. To view or update a structurealready listed, select the icon.

Total Acquisition: $130,895

Total Rehabilitation: $13,594

Total New Construction: $0

Total Assistance Requested: $144,489

Name ofStructure

StreetAddress1

StreetAddress2

City State Zip Code TotalRequest

Acquisition

Rehabilitation

NewConstruction

BahkitaHouse III

To bedetermined

-- FortMyers

Florida 00000 $144,489 $130,895 $13,594 $0



Acquisition/Rehabilitation/New ConstructionBudget Detail

Complete the following fields related to the funds being requested foracquisition, rehabilitation, and/or new construction of the new project.

Name of Structure: Bahkita House III

Street Address 1: To be determined

Street Address 2:

City: Fort Myers

State: Florida

Zip Code: 00000

AssistanceRequested

1. Acquisition $130,895

2. Rehabilitation $13,594

3. New Construction $0

4. Total Assistance Requested $144,489

Click the 'Save' button to automatically calculate the Total AssistanceRequested.



6I. Sources of Match

The following list summarizes the funds that will be used as Match for theproject. To add a Matching source to the list, select the icon. To view orupdate a Matching source already listed, select the icon.

Summary for MatchTotal Value of Cash Commitments: $54,540

Total Value of In-Kind Commitments: $0

Total Value of All Commitments: $54,540

1. Does this project generate program incomeas described in 24 CFR 578.97 that will be

used as Match for this grant?

No

Match Type Source Contributor Date ofCommitment

Value ofCommitments

Yes Cash Private Private Donations 08/17/2017 $54,540



Sources of Match Detail

1. Will this commitment be used towardsmatch ?

Yes

2. Type of commitment: Cash

3. Type of source: Private

4. Name the source of the commitment:(Be as specific as possible and include the

office or grant program as applicable)

Private Donations

5. Date of Written Commitment: 08/17/2017

6. Value of Written Commitment: $54,540



6J. Summary Budget

The following information summarizes the funding request for the totalterm of the project. However, administrative costs can be entered in 8.Admin field below.

Eligible Costs Annual AssistanceRequested(Applicant)

Grant Term(Applicant)

Total AssistanceRequested

for Grant Term(Applicant)

1a. Acquisition $130,895

1b. Rehabilitation $13,594

1c. New Construction $0

2a. Leased Units $0 3 Years $0

2b. Leased Structures $0 3 Years $0

3. Rental Assistance $0 3 Years $0

4. Supportive Services $0 3 Years $0

5. Operating $0 3 Years $0

6. HMIS $0 3 Years $0

7. Sub-total Costs Requested $144,489

8. Admin (Up to 10%)

9. Total AssistancePlus Admin Requested

$144,489

10. Cash Match $54,540

11. In-Kind Match $0

12. Total Match $54,540

13. Total Budget $199,029

Click the 'Save' button to automatically calculate totals.



7A. Attachment(s)

Document Type Required? Document Description Date Attached

1) Subrecipient NonprofitDocumentation

No 501C3 Documentation 07/19/2017

3) Other Attachment(s) No HUD 2880 09/01/2017

2) Other Attachment(s) No Match and Leverag... 08/22/2017



Attachment Details

Document Description: 501C3 Documentation

Attachment Details

Document Description: HUD 2880

Attachment Details

Document Description: Match and Leverage Documentation



7D. Certification

A. For all projects:

Fair Housing and Equal Opportunity

It will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000(d)) and regulationspursuant thereto (Title 24 CFR part I), which state that no person in the United States shall, onthe ground of race, color or national origin, be excluded from participation in, be denied thebenefits of, or be otherwise subjected to discrimination under any program or activity for whichthe applicant receives Federal financial assistance, and will immediately take any measuresnecessary to effectuate this agreement. With reference to the real property and structure(s)thereon which are provided or improved with the aid of Federal financial assistance extended tothe applicant, this assurance shall obligate the applicant, or in the case of any transfer,transferee, for the period during which the real property and structure(s) are used for a purposefor which the Federal financial assistance is extended or for another purpose involving theprovision of similar services or benefits.

It will comply with the Fair Housing Act (42 U.S.C. 3601-19), as amended, and withimplementing regulations at 24 CFR part 100, which prohibit discrimination in housing on thebasis of race, color, religion, sex, disability, familial status or national origin.

It will comply with Executive Order 11063 on Equal Opportunity in Housing and withimplementing regulations at 24 CFR Part 107 which prohibit discrimination because of race,color, creed, sex or national origin in housing and related facilities provided with Federal financialassistance.

It will comply with Executive Order 11246 and all regulations pursuant thereto (41 CFR Chapter60-1), which state that no person shall be discriminated against on the basis of race, color,religion, sex or national origin in all phases of employment during the performance of Federalcontracts and shall take affirmative action to ensure equal employment opportunity. Theapplicant will incorporate, or cause to be incorporated, into any contract for construction work asdefined in Section 130.5 of HUD regulations the equal opportunity clause required by Section130.15(b) of the HUD regulations.

It will comply with Section 3 of the Housing and Urban Development Act of 1968, as amended(12 U.S.C. 1701(u)), and regulations pursuant thereto (24 CFR Part 135), which require that tothe greatest extent feasible opportunities for training and employment be given to lower-incomeresidents of the project and contracts for work in connection with the project be awarded insubstantial part to persons residing in the area of the project.

It will comply with Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), as amended,and with implementing regulations at 24 CFR Part 8, which prohibit discrimination based ondisability in Federally-assisted and conducted programs and activities.

It will comply with the Age Discrimination Act of 1975 (42 U.S.C. 6101-07), as amended, andimplementing regulations at 24 CFR Part 146, which prohibit discrimination because of age inprojects and activities receiving Federal financial assistance.



It will comply with Executive Orders 11625, 12432, and 12138, which state that programparticipants shall take affirmative action to encourage participation by businesses owned andoperated by members of minority groups and women.

If persons of any particular race, color, religion, sex, age, national origin, familial status, ordisability who may qualify for assistance are unlikely to be reached, it will establish additionalprocedures to ensure that interested persons can obtain information concerning the assistance.

It will comply with the reasonable modification and accommodation requirements and, asappropriate, the accessibility requirements of the Fair Housing Act and section 504 of theRehabilitation Act of 1973, as amended.

Additional for Rental Assistance Projects:

If applicant has established a preference for targeted populations of disabled persons pursuantto 24 CFR 582.330(a), it will comply with this section's nondiscrimination requirements within thedesignated population.

B. For non-Rental Assistance Projects Only.

15-Year Operation Rule.

For applicants receiving assistance for acquisition, rehabilitation or new construction: The projectwill be operated for no less than 15 years from the date of initial occupancy or the date of initialservice provision for the purpose specified in the application.

1-Year Operation Rule.

For applicants receiving assistance for supportive services, leasing, or operating costs but notreceiving assistance for acquisition, rehabilitation, or new construction: The project will beoperated for the purpose specified in the application for any year for which such assistance isprovided.

Where the applicant is unable to certify to any of the statements in thiscertification, such applicant shall provide an explanation.

Name of Authorized Certifying Official: John Manning

Date: 09/01/2017


Applicant Organization: Lee County Board of County Commissioners

PHA Number (For PHA Applicants Only):

I certify that I have been duly authorized bythe applicant to submit this Applicant

Certification and to ensure compliance. I amaware that any false, ficticious, or fraudulent

X



statements or claims may subject me tocriminal, civil, or administrative penalties .

(U.S. Code, Title 218, Section 1001).



8B. Submission Summary

Applicant must click the submit button once all forms have a status ofComplete.

Page Last Updated

1A. SF-424 Application Type No Input Required



1B. SF-424 Legal Applicant No Input Required

1C. SF-424 Application Details No Input Required

1D. SF-424 Congressional District(s) 09/01/2017

1E. SF-424 Compliance 08/30/2017

1F. SF-424 Declaration 08/30/2017

1G. HUD 2880 08/30/2017

1H. HUD 50070 08/30/2017

1I. Cert. Lobbying 08/30/2017

1J. SF-LLL 08/30/2017

2A. Subrecipients 09/01/2017

2B. Experience 08/30/2017

3A. Project Detail 08/30/2017

3B. Description 09/01/2017

3C. Expansion 08/30/2017

4A. Services 08/30/2017

4B. Housing Type 08/30/2017

5A. Households 08/30/2017

5B. Subpopulations No Input Required

5C. Outreach 08/30/2017

5D. Discharge Policy 08/30/2017

6A. Funding Request 08/30/2017

6B. Acq/Rehab/Const 08/30/2017

6I. Match 08/30/2017

6J. Summary Budget No Input Required

7A. Attachment(s) 08/30/2017

7D. Certification 08/30/2017



Documents

Before Starting the Project Application...FL-019 17. Proposed Project a. Start Date: 01/01/2018 b. End Date: 12/31/2019 18. Estimated Funding ($) a. Federal: b. Applicant: c. State: