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Home My WebLink AboutWashington State Department of Commerce re: Community Development Block Grant (CDBG) CV Contract No. 20-6221C-114 Amendment D re: OlyCAP - CA signed 062623 (waiting for Commerce to sign)DocuSign Envelope ID: 796034BE-CF8A-4C23-9437-22553BD9E913 DocuSign Envelope ID: D033420D-02OD-4F20-9D6D-8F32931BF66B Amendment Face Sheet 9140F ( ()1111114 `1.(.(' Contract Number: 20-6221C-114 Amendment Number: D Washington State Department of Commerce Local Government Division Community Development & Assistance CDBG-CV1 and CDBG-CV2 1. Grantee 2. Grantee Doing Business As (optional) Jefferson County Auditor PO BOX 563 N/A PORT TOWNSEND, WA 98368-0563 3. Grantee Representative 4. COMMERCE Representative Judy Shepherd, Chief Accountant Lanee Egolf, Project Manager (360) 385-9383 PO Box 42525/1011 Plum St SE, Olympia, WA 98504-2525 jhepherd@co.jefferson.wa.us (360) 725-3058 1 lanee.egolf@commerce.wa.gov 5. Original Grant Amount 6. Amendment Amount 7. New Grant Amount $321,548.00 N/A N/A 8. Amendment Funding Source 9. Amendment Start Date 10. Amendment End Date Federal: ✓ State: Other: Date of Execution 12/30/2023 11. Federal Funds (as applicable): Federal Agency: CFDA# $321,548.00 U.S. Department of Housing 14.228 and Urban Development 12. Amendment Purpose: Six (6) month extension to provide more time to spend down. COMMERCE, defined as the Department of Commerce, and the Grantee, as defined above, acknowledge and accept the terms of this Grant As Amended and attachments and have executed this Grant Amendment on the date below to start as of the date and year referenced above. The rights and obligations of both parties to this Grant As Amended are governed by this Grant Amendment and the following other documents incorporated by reference: Attachment "A" —Scope of Work and Budget for Amendment D. A copy of this Grant Amendment shall be attached to and made a part of the original Grant between COMMERCE and the Grantee. Any reference in the original Grant to the "Grant" shall mean the "Grant as Amended". FOR GRANTEE /j FOR COMMERCE DocuSigned by: R0317B04Rfi5(:45R ark McCauley, Cor4y Administrator Mark K. Barkley, Assistant Director Local Government Division 6/27/2023 1 11:53 AM PDT Date Date APPROVED AS TO FORM ONLY Sandra Adix Assistant Attorney General 3/20/2014 Date DocuSign Envelope ID: 796034BE-CF8A-4C23-9437-22553BD9E913 DocuSign Envelope ID: D033420D-02OD-4F20-9D6D-8F32931 BF66B ATTACHMENT A — SCOPE OF WORK AND BUDGET Grantee: Jefferson County Contract No. 20-6221C-114 Amendment D Time Extension Section A: Project Description / Deliverable Jefferson County is awarded an additional $100,000 in CDBG-CV grant funds. Of these funds, the County will make $87,000 available to Olympic Community Action Programs as a grant subrecipient for Homeless Services. Jefferson County will reserve $13,000 for administration and subrecepient monitoring of Oly Cap. These funds will result in new and increased CDBG eligible public services for the Jefferson County CDBG-CV consortium service area, to help stabilize eligible households impacted by COVID-19. Combined with the County's CDBG-CV1 and CV2 award of $221,548, total CDBG-CV grant funds will be $321,548. This amended Scope of Work applies to the combined total award. Eligible public services will benefit a combined total of approximately 350 persons and target services to limited clientele with principally low- and moderate - incomes based on a LMI household qualification process. CDBG-CV funded activities will prevent, prepare for, and respond to coronavirus. Section B: Project Activities, Milestones and Budget CDBG Budget Project Activities Performance Budget Code Amount *Must complete each bulleted project activity to meet the corresponding milestone. Milestones 21A General $19,000 • Execute grant amendment with Commerce. Before first payment Admin. ■ Verify the subrecipient does not have an active exclusion record in the federal award system (SAM.gov), request include documentation in the CDBG file, and submit a copy to Commerce. ■ Establish/amend a subrecipient agreement that [includes the quarterly beneficiary reporting requirement. Submit a signed copy to Commerce. ■ Establish administrative, financial, reporting, and record keeping systems, including a system to prevent duplication of benefit. Payment requests: ■ Review subrecipient reimbursement requests and project costs and invoices against project budget and Not more than monthly contract start date. First payment request ■ Document local government's CDBG general administration costs. within 270 days from ■ Once costs are approved, prepare and submit payment request and project status report to Commerce. contract execution ■ Document receipt of grant funds and reimbursement of eligible costs. • Submit a CDBG Beneficiary Report within 30 days of end of each calendar quarter. 1/31, 4/30, 7/31, 10/31 ■ Complete applicable civil rights requirements. Prior to Commerce's ■ Conduct an on -site monitoring of the subrecipient to verify the grant is used according to CDBG on -site monitoring requirements and all costs reimbursed are allowable. ■ Resolve all monitoring issues with state CDBG program. Before requesting final ■ Accomplish all grant activities. 5% of CDBG award ■ Conduct a final public hearing to review project performance. ■ Submit a CDBG Contract Closeout Report. • List CDBG expenditures in your annual Schedule of Expenditures of Federal Awards and arrange an audit Before audit with the State Auditor's Office to meet the Uniform Guidance (2 CFR Part 200). DocuSign Envelope ID: 796034BE-CF8A-4C23-9437-22553BD9E913 DocuSign Envelope ID: D033420D-02OD-4F20-9D6D-8F32931 BF66B Section B: Project Activities, Milestones and Budget (continued) CDBG Budget Project Activities Performance Budget Code Amount *Must complete each bulleted project activity to meet the corresponding milestone. Milestones 05 Public • Complete the environmental review and prepare an environmental review record in compliance with Services NEPA requirements for CDBG. • Develop and establish CDBG-CV program's policies and procedures, including CDBG income qualification, COVID-19 impact verification, prevent duplication of benefits, and beneficiary reporting requirements. 05Q ■ Deliver the direct services identified in the CDBG application through the Olympic Community Action Approx. 50 LMI persons Subsistence $19,093.44 Partnership. receive direct services Payments Allocate and manage public services funds as established in the approved subrecipient agreement and by 12/30/2023 budget, and prevent duplication of benefits. • Meet the CDBG national objective of principally benefiting low- and moderate -income persons. ■ Accomplish HUD's outcome of increasing the availability and accessibility of services to achieve HUD's objective of creating suitable living environments. ■ Deliver the direct services identified in the CDBG-CV application with help from Olympic Community Action Programs. ■ Allocate and manage public services funds as established in the approved subrecipient agreement and LMI Aons 03T Homeless budget, and prevent duplication of benefits. g p p persons receive direct rex. eiv Services $283,454.56 ■ Meet the CDBG national objective of principally benefiting low- and moderate -income persons. services by 12/30/2023 ■ Accomplish HUD's outcome of increasing the availability and accessibility of services to achieve HUD's objective of creating suitable living environments. TOTAL: $321,548 DocuSign Envelope ID: 796034BE-CF8A-4C23-9437-22553BD9E913 DocuSign Envelope ID: D033420D-02OD-4F20-9D6D-8F32931BF66B . Washington State . Department of 460 Commerce For Commerce Internal Use Only Name/Title Routing Step Action Section Manager DS 1 (approval) E 6/22/2023 1 12:09 P Budget Authorization 2 (approval)Ej�S 6/22/2023 1 12:10 P Program Manager 1 (cc) N/A Grantee Contact 3 (cc) N/A Grantee Signatory 3 (signature) See Facesheet CDA Managing Director 4 (approval) DS ML /26/2023 11:18 PM Deputy Assistant Director 5 (approval) DS 14 /27/2023 17:17 AM Assistant Director 6 (signature) See Facesheet PDT PDT PDT i:111r