CITY OF PASADENA
PROGRAM YEAR 2016-2017 REQUEST FOR PROPOSAL (RFP)
PUBLIC SERVICES
PASADENA COMMUNITY FOUNDATION
OFFICE LOCATION:
301 E. Colorado Blvd. Ste. 810 Pasadena, Ca 91101
TABLE OF CONTENTS
INTRODUCTION…………………………………………………………….…………….……1
Background
Funding Available
ELIGIBILITY REQUREMENTS………………………………………………………….……2
Project Eligibility
Public Service Eligible Activities
Ineligible Activities
EVALUATION CRITERIA & SELECTION PROCESS……………………….………….…3
Mandatory RFP Workshops
RFP Submittals
Application Process
Evaluation Criteria
GENERAL PROVISIONS AND CONDITIONS……………………………………….……..8
TERMS & REQUIREMENTS………………………………………...………………………10
DEFINITIONS…………………………………………………………………………….……10
Attachments
Insurance Requirements…………..………………….………………………Attachment A
HUD 2015 Income Limits…………..………………….………………………Attachment B
CDBG Benefit Service Area Map………………....….………………………Attachment C
RFP Application……...………………………………….………………………Attachment D
Appendices
Authorizing Resolution……………………………….………………….…….…Appendix A
Non-Collusion Affidavit……………………….……………………………….…Appendix B
Living Wage Compliance Certification……..………….………………………Appendix C
Assurance Conditions………………...………………….………………………Appendix D
Funding History Sheet……………..…………………….……………………….Appendix E
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I. INTRODUCTION
Background
This proposal packet provides a general overview of the process and applicable
requirements and is for information purposes only. It is not intended to be a full
disclosure of all applicable federal, state and/or local rules, regulations, procedures
and/or reporting requirements.
The Pasadena Assistance Fund (PAF) is a fund of the Pasadena Community
Foundation (PCF). This fund represents a partnership between the City of
Pasadena and PCF to serve the local community. All donations to the fund stay in
the local community.
The Pasadena Assistance Fund seeks to help Pasadena residents "Build Better
Lives" through grants to local human services agencies serving Pasadena.
Distributions from the fund supplement the Community Development Block Grants
(CDBG) program. Federal funding for these grants has declined in recent years, so
it is even more important to build a hometown source of funding to serve the
neediest families living in poverty.
Through a partnership with the City, the Fund is held and invested by the
Pasadena Community Foundation (PCF). PCF's investment strategy employs a
diversified global portfolio of equities, bonds, and other investment vehicles that the
City cannot use in the investment of public funds.
Pasadena Community Foundation has served Pasadena for 60 years as a
philanthropic resource. Its mission is to build hometown legacies - permanent
funds to support the critical services offered by non-profit organizations within our
community.
Since its inception in 1992, the City’s Human Services & Recreation Department,
and now the Housing & Career Services Department, has been responsible for the
programmatic management of the Pasadena Assistance Fund (formerly the Human
Services Endowment Fund) which has distributed over $2,787,696 in grants to
Pasadena area non-profits.
Funding Available
The City of Pasadena requests proposals from qualified agencies to apply for
Pasadena Assistance Fund grants under this Request for Proposal (RFP). The City
of Pasadena distributes approximately $50,000 annually in PAF funds. Funds are
awarded to agencies through the Pasadena Community Foundation at the
beginning of the program year.
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For program year 2016 (July 1, 2016 – June 30, 2017), proposals that are deemed
eligible will be scored through the RFP evaluation process. Applicants must
successfully complete an application and submit their proposal in order to be
considered for PY2016 PAF funding. Applicants that do not successfully submit
their completed proposal will not be eligible to participate in the RFP evaluation
process.
Through this RFP, the PCF will award two (2) grants in the amount of $25,000 in
PAF funds under the program category of Public Services for PY 2016 & PY2017
(pending continued performance of investments in the endowment fund).
Organizations are strongly discouraged from applying for funds unless they are
ready to implement the activity proposed for funding.
II. ELIGIBILITY REQUIREMENTS
Public or private non-profit organizations that service low and moderate-income
Pasadena residents are eligible to apply. Non-profit organizations must be
incorporated in the State of California. Faith-based organizations are allowed to
compete for PAF funds on the same basis as other non-profits; however funds
cannot be used to support worship, religious instruction or proselytization. Faith-
based organizations that participate shall not discriminate against a program
beneficiary on the basis of religion or religious belief.
The following computer software/hardware components are required in order to
complete the PAF grant application:
- Adobe Acrobat Professional
- Google Chrome, Firefox, Mozilla, or Internet Explorer (web browsers)
- Scanner (used to convert hardcopies into electronic files for uploading)
A proposal will be deemed eligible if each requirement is address and the submittal
packet is complete in accordance to the requirements listed in this RFP.
Each proposed project must:
(a) Demonstrates compliance benefit to low/moderate-income (LMI) persons; and
(b) Target the priority needs of public services/non-homeless special listed in the
City of Pasadena 5-Year Consolidation Plan 2015-20191 (page 87); and
1 City of Pasadena 5-Year Consolidated Plan 2015-2019
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(c) Be located, primarily conducted, or serving the residents in the City of
Pasadena.
Project Eligibility
Agencies shall consider the following with regard to their proposed project:
1) Assistance with PAF grants are limited to City of Pasadena residents
and/or businesses located in the City of Pasadena.
2) Allocation of PAF grants will only be made to projects for $25,000.
Public Service Eligible Activities
The following eligible activities are examples under their specific categories of
emphasis2:
Public Services
Senior services, legal services, youth services, substance abuse
services, crime awareness and prevention, child care, food banks
Ineligible Activities
Building(s) for the General Conduct of Government (unless to remove
architectural barriers)
General Government Expenses
Political Activities
Furnishings & Personal Property
Income Payments (direct cash payments, )
New Housing Construction (except by CBDO’s)
Operating and Maintenance Expenses
Religious Activities
III. EVALUATION CRITERIA & SELECTION PROCESS
Mandatory RFP Workshops
All grant applicants are required to attend ONE (1) session of the mandatory RFP
Workshops listed below, regardless of current or past funding. All attendees must
sign-in and provide the proposed project name and agency affiliation as it will
appear on the RFP. Confirmation of mandatory attendance will be based on the
sign-in sheets and visual attendance. Workshops will start promptly at the times
2 This list does not include all possible public service activities, but is to be used as examples for reference.
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listed. Failure of an applicant/agency to attend a RFP Workshop will result in a
disqualification of the proposal. Applicants may attend either of the following
workshops:
LOCATION DATE & TIME
City of Pasadena
Housing and Career Services Department
649 N. Fair Oaks Ave. 2nd FL (Community Room)
Wednesday April 6, 2016
at 10:00 a.m.
City of Pasadena
Housing and Career Services Department
649 N. Fair Oaks Ave. 2nd FL (Community Room)
Wednesday April 6, 2016
At 2:00 p.m.
Requests for technical assistance should be directed to the Housing & Careers
Services Department at (626) 744-8321. The last day to receive technical assistance
is April 14, 2016.
RFP Submittals
A complete RFP submittal must include the following:
One (1) complete original hardcopy of the proposal
Three (3) hardcopies of the application
Two (2) complete electronic copies stored on 2 separate compact discs or flash
drives
As an option (not required of any applicant), your agency’s RFP submittal may also
include:
No more than two (2) 8.5” X 11” pages of exhibits (single-sided) that support
the application materials. These may be charts, pictures, conceptual
drawings within the two-page limit (black & white). They should be
captioned and referenced in the RFP or narrative, as appropriate.
NOTE: faxed, e-mailed or late RFP submittals will not be accepted.
In order to expedite the RFP process:
1. Do not use binders, folders or similar products to submit the RPF and
supporting documentation.
2. Do not 3-hole punch any RFP supporting documentation.
3. Do not staple any RFP sections and/or supporting documentation.
4. Use paper clips and/or binder clips to separate RFP material/documents from
one another.
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5. As needed, use a rubber band or such to keep all materials together and place
the RFP Submittal Checklist on top, prior to enclosing into an envelope.
6. Use strictly 8.5” X 11” paper and print using the portrait orientation setting,
single-sided.
7. Please clearly name all of the electronic files which are saved on a compact
disc (CD) or flash drive.
Place the complete RFP submittal package in one envelope and address it to:
City of Pasadena
Housing and Career Services Department
ATTN: Randy Mabson, Program Coordinator
649 N. Fair Oaks Ave. Suite 202
Pasadena, CA 91103
The RFP submittal packet may be hand-delivered or sent via US mail, taking the
deadline listed below into account.
The RFP submittal packet must be received by the Housing and Careers Services
Department on or before 5:00 p.m., April 21, 2016. Late submittals will not be
considered. Please note that any premature commitment or expenditure of funds
for proposed activities is prohibited.
Housing & Career Services Department Office Hours:
Monday – Tuesday 8:00a.m. – 1:00p.m.
Wednesday – Thursday 12:00p.m. – 5:00p.m.
Friday – Sunday Closed
Application Process
Prior to evaluation all proposals will be reviewed for completeness and eligibility.
Please note that there will be no opportunity to submit missing documentation.
Incomplete proposals may be disqualified. All proposals that are deemed eligible
will then be evaluated by a team represented of Human Services Commissioners
and City staff, which will be scored based on the evaluation criteria detailed in this
document. The Human Services Commission is the City’s advisory board for public
service activities. The Commission has the authority to make formal
recommendations to the City Council regarding program selection.
Each proposer will receive written notification by e-mail of their proposal rating.
Proposers will have the opportunity to submit a one (1) page written request, to the
Housing and Career Services Department, appealing their proposal rating. Appeal
must be sent within seven (7) days of the proposal rating notification letter.
Appeals may be made to the scoring of the agency’s proposal based on
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documentation originally provided in the submitted proposal. No new information
may be provided in the appeal letter.
The top two rated proposals will be granted awards from the Pasadena Assistance
Fund. The Pasadena Community Foundation will issues grant awards, and issue
checks in July 2016.
Evaluation Criteria
1. PROJECT DESCRIPTION & ACTIVITY SCOPE (30 Points)
Relationship to Consolidated Plan (max 20 points)
(a) Describe the proposed project to be carried out with the requested
funds. Describe what and how services are provided to clients.
Identify what is considered to be a received unit of service.
(b) Identify all program objectives of the proposed activity. Describe
barriers that the provided service will help clients to overcome.
Activity/Timeliness (max 10 points)
(c) Provide a clear description of the scope of activity. Detail specific tasks
to be accomplished in achieving the defined program objective(s), listed
in (1b) above.
(d) Provide a detailed implementation schedule of the scope of activity
from beginning to end, on a quarter basis.
2. SERVICE BENEFIT (20 Points)
(a) Describe the client intake process, and how clients will access the
services. Describe how clients are retained to receive services from
your agency throughout the entire program year.
(b) Provide the address(s) of each facility location and its relation to
providing services. Identify the service area of the program by census
tract(s).
(c) Identify the target group that will primarily benefit from the project,
and how many unduplicated low/moderate income clients will be
served during the program year (July 1- June 30). Divide $25,000 by
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the # of unduplicated clients served during the program year to
identify the cost per client.
3. UNMET NEEDS AND PROGRAM DEVELOPMENT (10 Points)
(a) Identify and describe the unmet need or problem that will be address
by the proposed project, the methods used to verify that this need
actually exists and is not currently being adequately met in the
community (use recent statistical studies and/or data to support your
answer).
4. OUTCOME (10 Points)
(a) Provide a clear description of each outcome to be achieved that
coincides with the scope of the proposed activity. Support each
outcome with qualitative and quantitative measurement methods.
5. ADMINSTRATIVE CAPACITY (10 Points)
(a) Summarize the organization’s background and staff experience with
the proposed or similar federally-funded project.
(b) Describe the financial system utilized by the agency, including details
on how grant funds will be tracked separately from other funding
sources.
6. BUDGET AND COST NARRATIVE (20 Points)
(a) Provide a detailed project budget identifying total activity cost for the
use of proposed funding and all other leverage funds. Identify what
cost will be covered by the PAF grant and what will be covered by any
leverage funds.
(b) Provide commitment, award or pledge letter(s) for all leverage funding
for the proposed project (letters from the funding source and should
identify amounts and funding period).
(c) Provide a budget narrative with a detailed explanation of each PAF
grant line item in the project budget. Include a job description for each
personnel position as it pertains to the proposed project.
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7. BONUS: ENDOWMENT DONOR
City employees who donate to the Pasadena Assistance Fund have to
opportunity to add one (1) point to each of their top two favorite agencies.
8. REQUIRED SUPPORTING DOCUMENTATION (0 Points)
There are no points awarded for this section, however, proposal may be
deemed ineligible if any of these items are missing:
- Articles of Incorporation/Bylaws
- W-9 forms
- Authorizing Resolution (Appendix A)
- Audited Financial Statement (Most Recent Year)
- Non-Collusion Affidavit (Appendix B)
- Resumes of all program staff
- Living Wage Compliance Certification (Appendix C)
- General Liability Insurance
- Funding History Sheet (Appendix D)
- Commitment Letters for Leverage Funds (if applicable)
- Agency Statement of Cash/Credit Reserves
- System of Award Management (SAM) Clearance (identifying
agency DUNS #)
IV. GENERAL PROVISIONS AND CONDITIONS
A. Pre-Contractual Expenses
Pre-contractual expenses are defined as any expense incurred by the proposer
in: (1) preparing its proposal in response to this RFP; (2) submitting that
proposal to the City; (3) negotiating with the City any matter related to this
RFP, including a possible contract; or (4) engaging in any other activity prior
to the effective award date, if any, of a contract resulting from this RFP. The
City shall not, under any circumstances, be liable for any pre-contractual
expenses incurred by the proposer(s), and proposer(s) shall not include any
such expense as part of their proposals.
B. No Commitment to Award
Issuance of this RFP and receipt of proposals does not commit the City to
award a contract. The City expressly reserves the right to postpone proposal
opening for its own convenience, to accept or reject any or all proposals
received in response to this RFP, to negotiate with more than one proposer
concurrently, or to cancel all or any part of this RFP.
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C. Authorizing Resolution
If the proposer is a non-profit organization or a corporation, formal proof of
the authority of the officer signing the proposal to bind the corporation must
be submitted with said proposal.
D. Withdrawal of Proposal
Any proposer may withdraw its proposal by written request at any time
following the submission deadline.
E. Documents to be Construed Together
The RFP, the proposal, the Non-Collusion Affidavit, and all documents
referred to in the complete specifications and the Contract to be entered into
between the proposer and the City, and all modifications of said documents,
shall be construed together as one document.
F. Errors and Omissions
Proposer shall not be allowed to take advantage of any errors in or omissions
in the RFP. Full instructions will be given if such error or omission is
discovered and timely called to the attention of the City.
G. Joint Offers
Where two (2) or more agencies desire to submit a single proposal in response
to this RFP, they should do so on a prime-subcontractor basis rather than as
a joint venture or informal team. The City intends to contract with a single
agency and not multiple agencies doing business as a joint venture.
H. Certificate of Insurance
Proof of the required insurance is required to be submitted with your
proposal.3
I. Reservations
The City reserves the right to reject any and all proposers and any item(s)
therein, and to waive any non-conformity of proposals with the RFP, whether
of a technical or substantive nature, as the interest of the City may require.
J. Request for Proposal (RFP) is not Contractual
Nothing contained in the RFP shall create any contractual relationship
between the proposer and the City. The City accepts no financial
responsibility for costs incurred by any proposer regarding this RFP.
K. Firm Commitment of Availability of Service
Once a proposal is opened, a proposer is expected to maintain an availability
of service as set forth in its proposal.
3 Refer to Attachment A for required insurance.
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L. System of Award Management (SAM) Clearance
SAM checks are required to ensure that sub-recipients and contractors are
not suspended or debarred from working on federally funded projects.
Clearance printouts may be obtained at www.sam.gov under search records
using an agency’s Data Universal Numbering System (DUNS) number. If
your agency does not have a DUNS number, one may be requested at
https://fedgov.dnb.com/webform.
M. Instructions and Questions
Do not contact any other City employee or official regarding this RFP.
Questions regarding the RFP should be directed only to the person(s)
designated below:
Randy Mabson, CDBG Program Coordinator
City of Pasadena, Housing and Career Services Department
(626) 744-8321
V. TERMS & REQUIREMENTS
1. Retention of records including financial, supporting documents,
statistical data, and all other records pertaining to the use of funds
provided under the sub-recipient agreement must be maintained for
a period of five (5) years.
2. The City will conduct periodic program monitoring reviews which
will focus on the extent to which the planned project has been
implemented in accordance with federal regulations.
VI. DEFINITIONS
Qualitative Measures
This type of measurement primarily relies on words as its unit of analysis
and its means of understanding.
Quantitative Measures
This type of measurement relies primarily on numbers as the main unit of
analysis.
Unit of Service
The amount/type of service received which demonstrate a client benefit in
order to be counted towards accomplishment goals.
City of Pasadena INSURANCE REQUIREMENTS
ATTACHMENT A
Include on one or two Acord forms with the coverage limits, policy numbers, and dates for: A. General Liability: Combined Single Limit of $1,000,000 per occurrence.
Additional Insured Endorsement form(s) Naming as Additional Insured (“City of Pasadena, its Council Members, Commissioners, officers, employees and agents.”) Please provide either this: CG 20 10 11 85; or both of these forms CG 20 10 XX XX (for ongoing operations) AND CG 20 37 XX XX (for completed operations).
Endorsement Waiver of the Right of Subrogation for General Liability against the City of Pasadena.
B. Auto Liability: $1,000,000 combined single limits unless vehicles are not involved.
C. Worker’s Comp in statutory amounts.
A separate certificate may be submitted. The City need not be named as additional insured.
Endorsement Waiver of the Right of Subrogation for Worker’s Comp against the City of Pasadena.
Note: The Specification or Request for Insurance may be amended by the City, to require less or greater requirements depending on the potential risk involved.
OTHER CRITICAL INCLUSIONS:
1. The City of Pasadena shall be given 30 days written notice of cancellation or material change. The certificate submitted will not be approved if it contains “best effort” modifiers or if it relieves the insurer from responsibility for failure to give notice.
7/1/13
ATTACHMENT B
FY 2015 Income Limits Summary
FY 2015 Income Limit
Area
Median
Income
FY 2015 Income Limit Category
Persons in Family
1 2 3 4 5 6 7 8
Los Angeles County $63,000
Very Low (50%) Income Limits ($) 29,050 33,200 37,750 41,500 44,850 48,150 51,500 54,801
Extremely Low (30%) Income
Limits ($)*
17,450 19,950 22,450 24,900 28,410 32,570 36,730 40,890
Low (80%) Income Limits ($)
46,500 53,150 59,800 66,400 71,750 77,050 82,350 87,650
* The FY 2015 Consolidated Appropriations Act changed the definition of extremely low-income to be the greater of 30/50ths (60 percent) of the Section 8 very low-income limit or the poverty guideline as established by the Department of Health and Human Services (HHS), provided that this amount is not greater than the Section 8 50% very low-income limit. Consequently, the extremely low (30%) income limits may equal the very low (50%) income limits.
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Legend2010 Census Tract Eligible Tract/Block Group
Created By: Pasadena GIS - DoITDate: April 2015
Source: US Census 2010, City of PasadenaCoordinate System:
State Plane California Zone V, FIPS 405 (Feet)Datum: NAD 1983The maps and associated data are provided without warranty of any kind.
Any resale of this information is prohibited. Copyright 2015, City of Pasadena.
CDBG Benefit Service AreaEligible Tracts/Block Groups ¯
0 0.5 10.25Miles
Department of HousingCity of Pasadena
ATTACHMENT
CITY OF PASADENA REQUEST FOR PROPOSAL
PY2016-17 PASADENA ASSISTANCE FUND (PAF) (PUBLIC SERVICE)
APPLICATION
REMINDERS:
ALL INFORMATION REQUESTED MUST BE ACCURATE AND COMPLETE. FAILURE TO INCLUDE ANY OF THE REQUESTED INFORMATION MAY RESULT IN THE REJECTION OF YOUR PROPOSAL.
ALL RESPONSES TO THE QUESTIONS SHOULD BE:
• COMPLETED IN THE SPACE PROVIDED. ALTERING THE DOCUMENT WILL RESULT IN THE
REJECTION OF YOUR PROPOSAL.
• PROPOSAL APPLICATION CAN BE DOWNLOADED FROM THE INTERNET AT http://ww5.cityofpasadena.net/housing/cdbg/rfps/
• CLEAR AND CONCISE
• INCLUSIVE OF THE REQUIRED ATTACHMENTS
ALL PROPOSALS MUST INCLUDE A ONE PAGE TRANSMITTAL LETTER. THIS LETTER SHOULD BE WRITTEN
ON AGENCY LETTERHEAD AND INCLUDE THE FOLLOWING:
• A BRIEF SUMMARY OF YOUR PROPOSED PROJECT • FUNDING AMOUNT REQUESTED • NAME, ADDRESS AND PHONE NUMBER OF THE AUTHORIZED AGENCY CONTACT PERSON(S)
GENERAL INFORMATION (0 POINTS) COVER SHEET
AMOUNT OF YOUR FUNDING REQUEST: $______________
PROJECT TITLE: _________________________________________________________________
LEGAL NAME OF THE PROPOSER: __________________________________________________
ADDRESS OF THE PROPOSER CITY, STATE, ZIP CODE: __________________________________________________________
EXECUTIVE DIRECTOR: ______________________________
TELEPHONE NUMBER: ______________________________
NANME & TITLE OF PRIMARY CONTACT: ____________________________________________
TELEPHONE NUMBER: ______________________________
E-MAIL: __________________________________________
THE ABOVE NAMED PROPOSER HEREBY SUBMITS A PROPOSAL TO RECEIVE FUNDING FROM THE CITY OF PASADENA PAF (PUBLIC SERVICES) PROGRAMS PURSUANT TO THE REQUEST FOR PROPOSAL. THE PROPOSER WARRANTS THAT ALL OF THE INFORMATION IN THE PROPOSAL PACKAGE IS TRUE AND CORRECT. THE PROPOSER FURTHER AGREES TO ABIDE BY ALL CONDITIONS AND REQUIREMENTS IN THE REQUEST FOR PROPOSAL. THE PROPOSER ALSO UNDERSTANDS THAT THIS PROPOSAL IS THE PROPOSER’S ENTIRE PROPOSAL AND CANNOT BE AMENDED AFTER SUBMISSION, EXCEPT AS PROVIDED FOR IN THE RFP. AUTHORIZED SIGNATURE: _____________________________________________________________________ TITLE OF AUTHORIZED SIGNATORY: __________________________________________________ TYPE NAME OF AUTHORIZED SIGNATORY: __________________________________________________ OFFICE USE ONLY: DATE RECEIVED: _______________________ BY: ___________________
GENERAL INFORMATION (0 POINTS) (a) Provide your agency’s mission statement and a brief executive summary.
SERVICE BENEFIT (20 POINTS) (a) Describe the proposed project to be carried out with the requested funds.
Describe what and how services are provided to clients. Identify what is considered to be a received unit of service.
(b) Identify all program objectives of the proposed activity. Describe barriers that the provided service will help clients to overcome.
SERVICE BENEFIT (20 POINTS) (c) Provide a clear description of the scope of activity. Detail specific tasks to be
accomplished in achieving the defined program objective(s), listed in (1b) above.
(d) Provide a detailed implementation schedule of the scope of activity from beginning to end, on a quarter basis.
SERVICE BENEFIT (20 POINTS) (a) Describe the client intake process, and how clients will access the services.
Describe how clients are retained to receive services from your agency throughout the entire program year.
(b) Provide the address(s) of each facility location and its relation to providing services. Identify the service area of the program by census tract(s).
(c) Identify the target group that will primarily benefit from the project, and how many unduplicated low/moderate income clients will be served during the program year (July 1- June 30). Divide $25,000 by the # of unduplicated clients served during the program year to identify the cost per client.
UNMET NEEDS AND PROGRAM DEVELOPMENT (10 POINTS)
(a) Identify and describe the unmet need or problem that will be address by the proposed project, the methods used to verify that this need actually exists and is not currently being adequately met in the community (use recent statistical studies and/or data to support your answer).
OUTCOME (10 POINTS)
(a) Provide a clear description of each outcome to be achieved that coincides with the scope of the proposed activity. Support each outcome with qualitative and quantitative measurement methods.
ADMINISTRATIVE CAPACITY (10 POINTS) (a) Summarize the agency’s background and staff experience with the proposed
or similar project.
(b) Describe the financial system utilized by the agency, including details on how grant funds will be tracked separately from other funding sources.
COST BUDGET AND NARRATIVE (20 POINTS)(a) Provide a project budget identifying use of proposed funding and all other leveraged
funds for the total activity cost (use whole numbers only, no signs or commas).
Proposed Project Budget
PROJECT COST PROPOSEDPAF FUNDS
LEVERAGESOURCE #1
LEVERAGESOURCE #2
LEVERAGESOURCE #3 TOTAL
PERSONNEL COSTSSALARIES/WAGESPERSONNEL BENEFITS & TAXESNON-PERSONNEL COSTSINSURANCE & BONDINGSUPPLIES & MATERIALSPRINTING & REPRODUCTIONADVERTISING & POSTAGETELEPHONEUTILITIESSPACE LEASEPROFESSIONAL SERVICESMILEAGE & TRAVELOTHER:CAPITAL OUTLAYSCONSTRCUTIONARCHITECTURAL/DESIGNPERMIT FEESREHABILITATION
TOTAL
(b) Identify any leveraged sources that will be utilized for the proposed project. Includeofficial commitment letter for each source in the Required Supporting Documentationsection.
Leverage Source #1Name: _______________________________________Amount: ____________________
Leverage Source #2Name: _______________________________________Amount: ____________________
Leverage Source #3Name: _______________________________________Amount: ____________________
COST BUDGET AND NARRATIVE (20 POINTS) (c) Provide a budget narrative with a detailed explanation of each PAF grant
line item in the project budget. Include a job description for each personnel position as it pertains to the proposed project.
Checklist
- Articles of Incorporation/Bylaws
- W-9 forms
- Authorizing Resolution (Appendix A)
- Audited Financial Statement (Most Recent Year)
- Non-Collusion Affidavit (Appendix B)
- Resumes of all program staff
- Living Wage Compliance Certification (Appendix C)
- General Liability Insurance
- Funding History Sheet (Appendix D)
- Commitment Letters for Leverage Funds (if applicable)
- Agency Statement of Cash/Credit Reserves
- System of Award Management (SAM) Clearance
(identifying agency DUNS #)
APPENDIX: A
AUTHORIZING RESOLUTION FROM BOARD OF DIRECTORS Name of Proposer: ________________________________________________________ Address: ________________________________________________________ Telephone: ___________________________
Be it resolved that the Board of Directors of __________________________________ resolved
at its meeting of ______________________________________ to authorize (Date)
_____________________________________, ______________________________ to submit (Name) (Title)
an application to the City of Pasadena for funding in the name of the organization. The amount
requested is $ _________________.
This Board authorizes __________________________________ as Executive Director (Name)
to execute any documents necessary for subject funding. If funded, the proceeds of the
funding will be utilized to:
I hereby certify that the foregoing resolution was approved by our Board.
_____________________________________________ _________________________ President of Board (Signature) (Date) _____________________________________________ Agency/Organization
APPENDIX: B
NON-COLLUSION DECLARATION
The undersigned declares:
I am ________________________________________________________________________________________,
_____________________________________________________________________________________________
(Insert "Sole Owner", "Partner", "President, "Secretary", or other proper title)
of___________________________________________________________________________________________
(Insert name of bidder)
The party making the forgoing bid/proposal submitted herewith to the City of Pasadena declares:
That all statements of fact in such bid/proposal are true;
That such bid/proposal was not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization or corporation;
That such bid/proposal is genuine and not collusive or sham;
That said bidder has not, directly or indirectly by agreement, communication or conference with anyone attempted to induce action prejudicial to the interest of the City of Pasadena, or of any other bidder or anyone else interested in the proposed contract; and further
That prior to the public opening and reading of bids/proposals, said bidder:
a. Did not directly or indirectly, induce or solicit anyone else to submit a false or sham bid/proposal;
b. Did not directly or indirectly, collude, conspire, connive or agree with anyone else that said bidderor anyone else would submit a false or sham bid/proposal, or that anyone should refrain frombidding or withdraw his or her bid/proposal;
c. Did not, in any manner, directly or indirectly, sought by agreement, communication, or conferencewith anyone to raise or fix the bid/proposal price of said bidder or of anyone else, or to raise or fixany overhead, profit, or cost element of the bid/proposal price, or of that of anyone else;
d. Did not, directly or indirectly, submit his or her bid/proposal price or any breakdown thereof, or thecontents thereof, or divulge information or data relative thereto, to any corporation, partnership,company, association, organization, bid depository, or to any member or agent, or to any individualor group of individuals thereof to effectuate a collusive or sham bid, except the City of Pasadena,and has not paid, and will not pay, any person or entity for such purpose or to any person orpersons who have a partnership or other financial interest with said bidder in his or her business.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder.
I certify under penalty of perjury of the laws of the State of California that the above information is correct.
By: ______________________________________ Title: ________________________________
Date: ____________________________________
LIVING WAGE COMPLIANCE FORM This contract is subject to the City of Pasadena’s Living Wage Ordinance, Pasadena Municipal
Code Chapter 4.11. The Ordinance requires that contractors providing labor or services to the
City under contracts in excess of $25,000 comply with the information provided on the City
Website. Please review the information on the link below, as it may be revised on an annual
basis at:
http://www.cityofpasadena.net/Pasadena_Living_Wage.aspx The selected contractor will be required to evidence compliance with the Living Wage Ordinance by submitting payroll records as requested by the City. Each record shall include the full name of each employee performing labor or providing services under the contract; job classification; rate of pay and benefit rate. On August 4, 2008, the Pasadena City Council amended the Living Wage Ordinance such that the provisions of the Living Wage Ordinance may be waived in a bona fide collective bargaining agreement, but only if the waiver is explicitly set forth in clear and unambiguous terms. If this provision applies, you must provide a copy of the collective bargaining agreement to the City. I do hereby certify and declare under penalty of perjury that if awarded the contract for which this bid/proposal is made ________________________________________________will (Name of Company) comply with the requirements of the Pasadena Living Wage Ordinance, Pasadena Municipal Code Chapter 4.11 and the rules and regulations promulgated thereunder. I understand that failure to comply with the provisions of the Pasadena Living Wage Ordinance may result in termination of the contract as well as other penalties as stated in Pasadena Municipal Code Chapter 4.11. Contract Number: __________________________ ___________________________________________________________________________ (Name) (Title) ____________________________________________________________________________ (Signature) (Date)
Please return this form with your bid/proposal. Questions concerning the Living Wage
Ordinance should be directed to the Department of Finance – Purchasing Division 626.744.6755
APPENDIX: D
ASSURANCES AND CONDITIONS TO THE PROPOSAL
The authorized person(s) for each proposer organization must read the Assurances and Conditions outlined below and complete the signature block included below. Completion of the signature block acknowledges the proposer's understanding of and agreement with the following provisions. All federal regulations pertaining to U.S. Department of Housing and Urban Development (HUD) requirements include but are not limited to the following provisions:
1. Equal Opportunity in Contracting Ordinance: In submitting a proposal to perform work,provide services, or to supply goods, material, or equipment, under contract to the City ofPasadena, the proposer must comply with the requirement of the Pasadena EqualOpportunity in Contracting Ordinance, Chapter 4.09 of the Pasadena Municipal Code, andwith all state and federal equal employment laws.
2. Section 3 Compliance: Section 3 is a provision of the Housing and Urban DevelopmentAct of 1968 which requires that programs of direct financial assistance administered bythe U. S. Department of Housing and Urban Development (HUD) provide, to the extentpossible, opportunities for contracting with local businesses and the hiring and training oflow-income residents in connection with projects in their neighborhoods. This documentis provided for information purposes only. A separate form will be completed bysuccessful bidders at the time of contract.
3. Accurate Information: The proposal must set forth full, accurate, and completeinformation as required by the RFP. No changes or additions are allowed after theproposal deadline.
4. Davis-Bacon: Renovation or rehabilitation undertaken under this Request for Proposal(RFP) may be subject to the requirements of the Federal Labor Standard as listed in theDavis-Bacon Act and related Acts. These requirements are imposed upon the City by theU. S. Department of Housing and Urban Development.
Authorized Signature: ________________________________ Date: ___________________
Typed Name of Authorized Signatory:
Typed Title of Authorized Signatory:
Appendix E
Applicant Organization’s Funding History
This form is to be included in all proposals submitted.
Instructions: Please use the form below to report the City grant funding history of your organization. Please detail your organizations funding history as thoroughly as possible. It is required that the applicant agency report for no less than the last 5 year period. Please use N/A if there is no information available. Please use additional sheets if necessary.
Year(s) Funds Awarded
Total Amount Awarded
Amount for Administrative
Costs
Amount for Program Costs
Funding Source (CDBG, ESG, City Grants)
Program Name