CDBG Handbook and Forms

CDBG Handbook

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CDBG Forms

Citizen Participation

  • FORM 1: Letter Authorizing Firm to Conduct Public Meetings       doc | pdf

Procurement

  • FORM 1: Sample Request for Proposal       doc | pdf
  • FORM 2: Sample Request for Proposal Publication       doc | pdf
  • FORM 3: Proposal Evaluation       doc | pdf
  • FORM 4: Sample Letter to Short Listed Firms       doc | pdf
  • FORM 5: Sample Letter to Firms Not Short Listed       doc | pdf
  • FORM 6: Interview Evaluation and Scoring Form       doc | pdf
  • FORM 7: Sample Letter to Selected Firm       doc | pdf
  • FORM 8: Sample Letter to Firm(s) Not Selected       doc | pdf
  • FORM 9: Sample Request for Qualifications       doc | pdf
  • FORM 10: Sample Request for Qualifications Publication       doc | pdf
  • FORM 11: Statement of Qualifications Evaluation       doc | pdf
  • FORM 12: Letter Short Listed Forms       doc | pdf
  • FORM 14: Interview Evaluation and Scoring Form       doc | pdf
  • FORM 16:  Letters to Firms not Selected       doc | pdf
  • FORM 17: Sample Invitation for Bid Publication      doc | pdf
  • FORM 18: Sample Bid Tabulation       doc | pdf
  • FORM 19: Cost Price Analysis       doc | pdf
  • FORM 20: Small Purchase Request for Quotation       doc | pdf

Environmental Review

  • FORM 1: Certificate of Exemption       doc | pdf
  • FORM 2: Certification of Categorical Exclusion (not subject to 58.5)       doc | pdf
  • FORM 3: Certification of Categorical Exclusion (subject to 58.5)       doc | pdf
  • FORM 4: Statutory Worksheet       doc | pdf
  • Instructions for FORM 4        pdf
  • FORM 5: Sample Notice of Intent to Request Release of Funds       doc | pdf
  • FORM 6: Request for Release of Funds and Certification       pdf
  • FORM 7: CDBG Environmental Review - Documentation Required by Agency (rev Jan. 2018)      doc | pdf
  • FORM 8: Format II Environmental Review Record        doc | pdf
  • FORM 9: Sample Notice of Finding No Significant Impact       doc | pdf
  • FORM 10: Notice to Public of No Significant Impact on the Environment and Notice to Public of Release of Funds       doc | pdf
  • FORM 11: Notice for Early Public Review of a Proposal to Support Activity in the 100-Year Floodplain or Wetland       doc | pdf
  • FORM 12: Notice of Explanation of Project Located in a Floodplain or Wetland       doc | pdf

Acquisition and Relocation

  • FORM 1: Acquisition File Checklist       doc | pdf
  • FORM 2: Property Acquisition/Relocation Questionnaire      doc | pdf
  • FORM 3: Initial Notice to Property Owner       doc | pdf
  • FORM 4: URA Brochure: When a Public Agency Acquires Your Property       pdf
  • FORM 4A: URA Brochure Receipt       doc | pdf
  • FORM 5: Property Appraisal Invitation       doc | pdf
  • FORM 5A: Property Appraisal Invitation Receipt       doc | pdf
  • FORM 6: Letter of Purchase Offer       doc | pdf
  • FORM 7: Waiver of Acquisition Rights with Full Donation After Appraisal       doc | pdf
  • FORM 8: Waiver of Acquisition Rights with Partial Donation After Appraisal       doc | pdf
  • FORM 9: Waiver of Acquisition Rights with Full Donation With No Appraisal       doc | pdf
  • FORM 10: Willing Buyer/Willing Seller Transaction Letter       doc | pdf

Financial Management

  • FORM 1: Federal Cash Control Register- Federal Fiscal Year     excel
  • FORM 2: Contract Obligation Control Ledger     excel
  • FORM 3: Contractor Expenditure Ledger     excel
  • FORM 4: Property Inventory Ledger     excel
  • FORM 5: Local Match Ledger     excel
  • FORM 6: Release of Funds Checklist      doc | pdf
  • FORM 6.4: Professional Service Providers       doc | pdf
  • FORM 6.6: Federal Funding Accountability      doc | pdf
  • FORM 7A: Claim Voucher Instructions      doc | pdf
  • FORM 7: Claim Voucher Sample      excel | pdf
  • FORM 7: Claim Voucher (State Form 11294)       excel | pdf
  • FORM 8: Program Income-Quarterly Report       doc | pdf
  • FORM 9: Authorized Signature Payment Request       doc | pdf
  • FORM 10: Federal Funding Accountability       doc | pdf

Contract Development and Modification

  • FORM 1: Applicant/Recipient Disclosure/Update Report       pdf
  • FORM 1.5: Request for Conflict of Interest Exception       doc | pdf
  • FORM 2: Category 1 Modification Request Letter: Sample Grant Completion Extension       doc | pdf
  • FORM 3: Category 1 Modification Request Letter: Sample Request of Category 1 (other than time extensions)        doc | pdf
  • FORM 4: Category 2 and/or Category 3 Modification Request Budget Modification       doc | pdf
  • FORM 5: Category 2 and/or Category 3 Modification Sample Request       doc | pdf
  • FORM 6: Category 2 and/or Category 3- Notice of Grant Modification: Sample Public Notice       doc | pdf
  • FORM 7: Category 3: Grant Modification Sample Resolution       doc | pdf

Civil Rights

  • FORM 1: Civil Rights/Section 3 Officer Notification       doc | pdf
  • FORM 2: Sample Fair Housing Ordinance       doc | pdf
  • FORM 3: Affirmatively Furthering Fair Housing (AFFH) CDBG File Checklist       doc | pdf
  • FORM 4: Sample Drug Free Workplace Ordinance       doc | pdf
  • FORM 5: Resident Employment Opportunity Data       doc | pdf
  • FORM 6: Certification for Business Concerns Seeking Section 3 Preference in Contracting       doc | pdf
  • FORM 7: Examples of Efforts to Award Contracts to Section 3 Businesses       doc | pdf
  • FORM 8: Section 3 Compliance Form       doc | pdf
  • FORM 9: Certification of Accessibility       doc | pdf
  • FORM 10: Community Sample Language Access Plan for Limited English Proficiency Persons       doc | pdf

Labor Standards

  • FORM 1: Labor Standards Officer Notification       doc | pdf
  • FORM 2: Initial Wage Determination Assignment Notice       doc | pdf
  • FORM 3: Pre-Bid Conference Sign-In Sheet       doc | pdf
  • FORM 4: Pre-Bid Conference Guide Acknowledgement       doc | pdf
  • FORM 5: Wage Determination Lock-In Notice       doc | pdf
  • FORM 6: Contractor/Subcontractor Verification       doc | pdf
  • FORM 7: Contract Award       doc | pdf
  • FORM 8: Preconstruction Conference Acknowledgement       doc | pdf
  • FORM 9: Wage/Fringe Benefit Certification        excel | pdf
  • FORM 10: Contractor's Certification       doc | pdf
  • FORM 11: Subcontractor's Certification       doc | pdf
  • FORM 12: Notice to Start Construction       doc | pdf
  • FORM 13: Monthly Payroll Report        excel | pdf
  • FORM 14: Record of Employee Interview        pdf
  • FORM 15: Final Wage Compliance Report       doc | pdf
  • FORM 16: Final Inspection/Project Completion        doc | pdf
  • FORM 17: Sample In-Kind Volunteer Labor Letter       doc | pdf
  • FORM 18: Persons Approved to Complete In-Kind Donation       excel | pdf
  • FORM 19: In-Kind Donation Tracking Sheet       excel | pdf

Reporting and Recordkeeping

  • FORM 1: Semi-Annual Report       doc | pdf
  • FORM 2: Subrecipient Semi-Annual Report       doc | pdf

Closeout and Monitoring

  • FORM 1: Grantee Performance Report       doc | pdf
  • FORM 1A: Planning Grant Monitoring Checklist       doc | pdf
  • FORM 2: Financial Settlement/Expenditure Report       doc | pdf
  • FORM 3: Administrative Closeout       doc | pdf