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STATE OF WASHINGTON
County of Jefferson
In the Matter of:
Certification of Compliance
for CDBG Public Services Grant
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RESOLUTION NO. 84-06
WHEREAS, Jefferson County is applying to the State Office of Community
Development for funding assistance; and,
WHEREAS, it is necessary that certain conditions be met as part of the
application; and,
WHEREAS, John Fischbach, County Administrator, is authorized to submit this
application to the State of Washington, on behalf of Jefferson County; and,
NOW, THEREFORE, BE IT RESOLVED, that the Board of Jefferson County
Commissioners authorizes submission of this application to the State Office of Community
Development to request $145,865.00 to fund public service activities in coordination with the
Olympic Community Action Programs, and certifies that, if funded, it:
~ Will comply with applicable provisions of Title I of the Housing and Community
Development Act of 1974, as amended and other applicable State and federal laws;
~ Has provided opportunities for citizen participation comparable to the State's
requirements (those described in Section 104(a)(2)(3) ofthe Housing and Community
Development Act of 1974, as amended); has complied with all public hearing
requirements and provided citizens, especially low- and moderate-income persons, with
reasonable advance notice of, and the opportunity to present their views during the
assessment of community development and housing needs, during the review of available
funding and eligible activities, and on the proposed activities;
~ Has provided technical assistance to citizens and groups representative of low- and
moderate-income persons that request assistance in developing proposals;
~ Will provide opportunities for citizens to review and comment on proposed changes in
the funded project and program performance;
~ Will not use assessments against properties owned and occupied by low- and moderate-
income persons or charge user fees to recover the capital costs of CDBG- funded public
improvements from low- and moderate-income owner-occupants;
~ Will establish a plan to minimize displacement as a result of activities assisted with
CDBG funds; and assist persons actually displaced as a result of such activities, as
provided in the Uniform Relocation Assistance and Real Property Acquisition Policies
Act of 1970, as amended;
Page 1 of2
RESOLUTION NO. 84-06 re: Certification of Compliance for CDBG Public Services Grant
~ Will conduct and administer its program in conformance with Title VI of the Civil Rights
Act of 1964 and the Fair Housing Act, and will affirmatively further fair housing, (Title
VIII of the Civil Rights Act of 1968); and
~ Has adopted and enforce a policy prohibiting the use of excessive force by law
enforcement agencies within its jurisdiction against any individuals engaged in
nonviolent civil rights demonstrations; and has adopted and implemented a policy of
enforcing applicable State and local laws against physically barring entrance to or exit
from a facility or location which is the subject of such nonviolent civil rights
demonstrations within its jurisdiction, in accordance with Section 104(1) of the Title I of
the Housing and Community Development Act of 1974, as amended; and
~ Will provide, upon request, and prior to any obligation of funds being made, a complete
and accurate CDBG Federal Funds Disclosure Report detailing the required
applicant/grantee information, and as appropriate other government assistance provided
or applied for, interested parties and expected sources, and uses of funds.
BE IT FINALLY RESOL VED, that the Board of Jefferson County Commissioners,
designates the County Administrator, as the authorized Chief Administrative Official and
authorized representative to act in all official matters in connection with this application and
Jefferson County's participation in the Washington State CDBG Program.
APPROVED AND ADOPTED this
11th day of December
2006.
"
JEFFERSON COUNTY
BOARD F MMISSIONERS
r'1~, CIne
Julie Matthes, CMC
Deputy Clerk of the Board
u/// .~
Da~liv~
~~
atrIck M. Roagers, Member
Page 2 of2
COSG Project Summary Form
2007 Public Services Grant
Read instructions before you fill out this form. Some questions may not apply to your grant.
1. Type of D Community Investment Fund D Imminent Threat
D General Purpose Grant D Planning-Only Grant
D Housing Enhancement rg] Public Services Grant
D Housing Rehabilitation
2. Jurisdiction: Jefferson County Phone: 360-385-9383
Email: jfischbach@co.jefferson.wa.us Fax: 360-385-9382
Address: P.o. Box 1220 City/Zip: Port Townsend 98362
Tax ID#: 91-6001322 County(ies): Jefferson
SWV#:
3. Contact Karen Bednarski Title: Grant Coordinator
-
Address: po Box 563 City/Zip: Port Townsend 98368
Phone: 360-385-9121 Fax: 360-385-9228
Email: kbednarski@cojefferson.wa.us
4. Subrecipient: Olympic Community Action Programs Title: Executive Director
Contact Timothy Hockett Phone: (360)385-2571
-
Email: thockett@olycap.org Fax: (360)385-5185
Address: 803 West Park Avenue City/Zip: Port Townsend W A 98368
5. Consultant: Phone:
Email: Fax:
Address: City/Zip:
6. Fiscal Year: From January 1. 2007 to December 31. 2007
7. State Legislative District: 24th
Congressional District: 6th
To provide public services to low-income persons in the counties
8. Project listed above (2).
Summary:
Did a CDBG Planning-Only grant lead to this
9. application?
(does not apply to Planning-Only applications)
Project I 0 C . F '1" 0 P bl' F '1"
C t ommumty aCl ltIes u lC aCl ltIes
a egory:
(check all that apply) 0 Comprehensive 0 Housing
DYes
rg] No
10.
o Economic Development
o Planning
rg] Public Services
2007 Public Services Grant Application Handbook
October 2007
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COSG Project Summary Form
2007 Public Services Grant
Read instructions before you fill out this form. Some questions may not apply to your grant.
11. National Objective: Principally benefits low- and moderate-income (LMI) persons or
households, 100 %
o Prevents or eliminates slums or blight.
o Meets urgent community development needs that pose a serious and
immediate threat to public health or safety.
12. Project Budget: CDBG $ 145,865
CSBG $ 55,788
TOTAL: $ 198,653
13. Project # 11 ,000 Describe how these numbers of
Beneficiaries: Persons: beneficiaries were determined?
#LMI 11 ,000
Persons:
# 5,200
Households:
#LMI 5,200
Households:
14. Location: Community Action Agency
Census Tract:
9506.01
Block Group:
6023
15.. Certification of County's Chief Administrative Official:
Signature
Date
John F.Fischbach
County Administrator
Print Name
Title
2007 Public Services Grant Application Handbook
October 2007
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Selected Outcomes Achieved for 2006
Employment
1. 89 unemployed people obtained jobs with assistance from OlyCAP
2. 71 employed people gained increased income
3. 49 attained to "living wage"
4. 1667 enrolled in one of our employment training classes - 1500 completed!
5. 12 completed GED/ABE with OlyCAP help
6. 9 participants accessed child care in support of employment
7. 38 people accessed reliable transportation or got their driver's license reinstated in
support of their need for stable employment
8. 164 people accessed health care in support of employment
9. 141 people obtained affordable housing in support of employment
10. 103 people received food in support of employment stability
Community Improvement and Revitalization
1. 60 housing units were improved by OlyCAP efforts in weatherization or
rehabilitation.
2. South Seven Senior Village opened in April 2006 and units are filled with 3
people currently on the waiting list.
3. A dental clinic for low-income people was in full operation that serves also as a
training center for dental hygiene students. A full time Dentist was hired affording
the clinic to offer more services. In '06 over 1,800 patients will be seen in 4,800
appointments.
4. Our Job Lift Program operated 3 vans on the West End carrying up to 48 people
each day.
Civic Investment
1. 20,880 volunteer hours were donated to OlyCAP programs
2. 86,370 volunteer hours were posted by seniors enrolled in RSVP - to many,
many programs throughout Jefferson and Clallam Counties.
3. 35,000 volunteer hours were devoted to area food banks supported by OlyCAP
4. 59 low-income persons participated at some level in the decision-making process
affecting their futures
Selected OlyCAP Outcomes 2006 1
Partnerships
1. OlyCAP had 100 partnership agreements in place in 2006.
Broadening the Resource Base
1. OlyCAP's budget reflects heavy leveraging of federal and state dollars
a. CSBG Block Grant
b. Non-CSBG Federal Programs
c. State Programs
d. Local Public Funding
e. Private Sources
f. Value of Volunteer Time
TOTAL
$76,571
$4,073,520
$2,908,744
$293,471
$2,202,519
$751.419
$10,306,244
Independent Living
1. 727 seniors maintained an independent living situation with OlyCAP's help
2. 332 disabled persons maintained their independence with OlyCAP's assistance
Emergency Assistance
1. 12,609 persons received food from the network of food banks that OlyCAP
supports
2. 2,600 households received emergency energy assistance payments
3. 74 people were provided over 7,211 bednights of emergency shelter by OlyCAP
4. 235 people accessed emergency medical care
5. 369 people received assistance with transportation
6. 20 people were provided disaster relief
7. 1540 people accessed our dental services
8. Over 1,200 persons received various levels of emergency aid through the Home
Fund
Child and Family Development
1. 204 infants and children received appropriate immunizations, medical and dental
care
2. 238 children experienced improved health and physical development due to
adequate nutrition
3. 185 children participated in Pre-school activities to develop school-readiness
skills
Selected OlyCAP Outcomes 2006 2
o (l ~ ~ f.:,:are n -f> I~I / I}O ~
CDBG Project Summary Form
2007 Public Services Grant
Read instructions before you fill out this form. Some questions may not apply to your grant.
1. Type of D Community Investment Fund D Imminent Threat
D General Purpose Grant D Planning-Only Grant
D Housing Enhancement ~ Public Services Grant
D Housing Rehabilitation
2. Jurisdiction: Jefferson County Phone: 360-385-9383
Email: j fischbach@co.jefferson. wa. us Fax: 360-385-9382
Address: P.O. Box 1220 City/Zip: Port Townsend 98362
Tax ID#: 91-6001322 County(ies): Jefferson
swv#:
3. Contact Karen Bednarski Title: Grant Coordinator
-
Address: PO Box 563 City/Zip: Port Townsend 98368
Phone: 360-385-9121 Fax: 360-385-9228
Email: kbednarski@cojefferson.wa.us
! 4. Subrecipient: Olympic Community Action Programs Title: Executive Director
Contact Timothy Hockett Phone: (360)385-2571
-
Email: thockett@olycap.org Fax: (360)385-5185
Address: 803 West Park Avenue City/Zip: Port Townsend W A 98368
5. Consultant: Phone:
Email: Fax:
Address: City/Zip:
6. Fiscal Year: From January 1. 2007 to December 31. 2007
7. State Legislative District: 24th
Congressional District: 6th
To provide public services to low-income persons in the counties
8. Project listed above (2).
Summary:
Did a CDBG Planning-Only grant lead to this
9. application?
(does not apply to Planning-Only applications)
DYes
~No
Project
Category:
(check all that apply)
10.
D Community Facilities D Public Facilities
D Economic Development
D Comprehensive D Housing
D Planning
~ Public Services
2007 Public Services Grant Application Handbook
October 2007
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COSG Project Summary Form
2007 Public Services Grant
Read instructions before you fill out this form. Some questions may not apply to your grant.
11. National Objective: C8J Principally benefits low- and moderate-income (LMI) persons or
households, 100 %
o Prevents or eliminates slums or blight.
o Meets urgent community development needs that pose a serious and
immediate threat to public health or safety.
12. Project Budget: CDBG $ 145,865
CSBG $ 55,788
TOTAL: $ 198,653
13. Project # 11,000 Describe how these numbers of
Beneficiaries: Persons: beneficiaries were determined?
#LMI 11 ,000
Persons:
# 5,200
Households:
#LMI 5,200
Households:
14. Location: Community Action Agency
Census Tract:
9506.01
Block Group:
6023
15.. Certification of County's Chief Administrative Official:
tif 'f. ~ J!J--P-
Signature
Date
John F.Fischbach
Count Administrator
Print Name
Title
2007 Public Services Grant Application Handbook
October 2007
.... 'i -:
Applicant/Recipient
Disclosure/Update Report
U.S. Department of Housing
and Urban Development
OMS Approval No. 2510-0011 (exp. 12/31/2006)
Instructions. (See Public Reporting Statement and Privacy Act Statement and detailed instructions on next
page.)
A plicantlRecipient Information
1. ApplicanVRecipient Name, Address, and Phone (include area code):
Jefferson County
PO Box 563. Port Townsend, WA 98368
(360) 385-9121
3. HUD Program Name
W A State Community Development Block Grant I Public Services Grant Program
Indicate whether this is an Initial Report X or an Update Report 0
2. Social Security Number or
Employer ID Number:
91-6001322
4. Amount of HUD Assistance
Requested/Received
$145,865
5. State the name and location (street address, City and State) of the project or activity:
Part I Threshold Determinations
1, Are you applying for assistance for a specific project or activity? These
terms do not include formula grants, such as public housing operating
subsidy. (For further information see 24 CFR Sec. 4.3).
X Yes X No
2. Have you received or do you expect to receive assistance within the
jurisdiction of the 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 o No.
If you answered "No" to either question 1 or 2, Stop! You do not need to complete the remainder of this form.
However, you must sign the certification at the end of the report.
Part II Other Government Assistance Provided or Requested I Expected Sources and
Use of Funds. Such assistance includes, but is not limited to, any grant, loan, subsidy, guarantee, insurance, payment,
credit, or tax benefit.
DepartmenUState/Local Agency Name and Address Type of Assistance Amount Expected Uses of the Funds
Requested/Provided
None
(Note: Use Additional pages if necessary.)
Part III Interested Parties. You must disclose:
1. All developers, contractors, or consultants involved in the application for the assistance or in the 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 the assistance is sought that exceeds $50,000 or 10 percent
of the assistance (whichever is lower).
Alphabetical list of all persons with a reportable financial interest Social Security No.
in the pro'ect or activi (For individuals. ive the last name first) or Em 10 ee ID No.
Olympic Community Action Programs (OlyCAP)
91-0814319
Contractor
$142,865
(Note: Use Additional pages if necessary.)
Certification
Warning: If you knowingly make a false statement on this form, you may be subject to civil or criminal penalties under Section 1001 of Title 18
of the United States Code. In addition, any person who knowingly and materially violates any required disclosures of informatiCln, including
intentional non-disclosure, is subject to civil money penalty not to exceed $10,000 for each violation.
I certify that this information is true and complete.
Signature: Date: (mmldd/yyyy)
**Note: This certification must be signed by the Chief Administrative Official (mayor,
county commission chair, county administrator, or city manager)
+-~
12}/fJoG.
X
2007 Public Services Grant Application Handbook
28
October 2007