HUD-funded Fair Housing Assistance Program 10/01/2017 to 09/30/2018 P.ctAENTo, U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
QP 'r o Region VII
ry�rl OFFICE OF FAIR HOUSING AND EQUAL OPPORTUNITY
�* _ "� *
Gateway Tower II, Q Floor
Za 11101II 400 State Avenue
G Kansas City, KS 66101-2406
9e'9N DEV0'
Mike Schrage, Interim Director
Salina Human Relations Department
300 West Ash — P O Box 736
Salina, KS 67402
Dear Mr. Schrage:
SUBJECT: FY2017 Cooperative Agreement
Enclosed please find a fully executed copy of the HUD-funded Fair Housing Assistance Program
(FHAP) Cooperative Agreement Number FF207K177004. The total amount of the agreement is
$48,700.00.
The effective date of the award is October 1. 2017. Your agency must obligate all FY2017 FHAP
Funds by September 30. 2018.
If you need additional information, please contact Andrea M. Carson, Equal Opportunity Specialist.
at (913) 551-5718. between 7:00 am and 4:30 pm, Monday through Friday
Sincerely.
Betty J. ottiger
Region VII Director
Office of Fair Housing and
Equal Opportunity
Enclosures
Phone(913)551-6958 Fax(913)551-5834
www.hudgo_v espanol.hu_d.gov
Assistance Award/Amendment U.S. Department of Housing
and Urban Development
Office of Administration
I.Assistance Instrument 2.Type of Action
®Cooperative Agreement ❑ Grant Award ® Amendment❑
3. Instrument Number 4.Amendment Number 5.Effective Date of this Action 6.Control Number
•
FT207K177004 09/01/2017
7. Name and Address of Recipient 8.HUD Administering Office
Salina Human Relations Department
Kansas City.Kansas Regional Office
300 West Ash—P 0 Box 736 Office of Fair Housing and Equal Opportunity
410 State Avenue
Salina- KS 67402 Kansas City,KS 66101-2406
8a.Name of Administrator 86.Telephone Number
Betty J. Bottiger 913-551-6857
10.Recipient Project Manager 9.HUD Government Technical Representative
Gary Hobbie. Director Kathryn A. Amaya
11.Assistance Arrangement 12. Payment Method 13.HUD Payment Office
Fon Worth Field Accounting.P.O.Box 2905
❑Cost Reimbursement ❑ Treasury Check Reimbursement Fort Worth.TX 76113-2905
0 Cost Sharing ❑ Advance Check
Z Fixed Price Z Automated Clearinghouse
14.Assistance Amount 15.HUD Accounting and Appropriation Data
Previous HUD Amount -0- ISa.Appropriation Number 15b.Reservation number
HUD Amount this action $48.700.00 8617/180144 FHEO-07-17-01
Total HUD Amount $48.700.00 .Amount Previously Obligated -0-
Recipient Amount -0- Obligation by this action $48.700.00
Total Instrument Amount $48.700.00 Total Obligation $48.700.00
16.Description:
This instrument authorizes the following funds to be obligated to the Agency.
Fund Code Description Amount Obligated in this Action
TIN Case Processing(Carryover Funds) -0-
TIN Case Processing(Current Funds) S 29,200.00
TIN Post-Cause Supplement(Carryover) -0-
TIN Post-Cause Supplement(Current Funds) $ 5,000.00
ADC Administrative Costs $ 7,000.00
TRG Training $ 7,500.00
PA1 Partnership -0-
SEE Special Enforcement Effort
Total S 48,700.00
The Cooperative Agreement/Amendment is comprised of the following documents:
. Cover Page—HUD-1044
2. 2017 Contributions Agreement CONFORMED COPY
3. Appendix A: FY2017 Statement of Work
4. Attachment A: FY2017 Criteria for Processing
5. Attachment B: FY2017 Standards for Timeliness
6. Attachment C: Payment Amounts for FHAP Case Processing
7. Attachment D: eLOCCS Security Procedures
The performance period for this Agreement begins 10/01/2017 and ends 09/30/2018.
The recipient must comply with all rules and regulations in accordance with the Fair Housing Assistance Program regulations(24 CFR§ 115),the
Memorandum of Understanding between the Recipient and HUD(including all subsequent addenda),and the FY2017 FHAP Guidance.
17.® Recipient is required to sign and return three(3)copies 18. 0 Recipient is not required to sign this document.
of this document to the HUD Administering Office
19.Recipient(By Name) �,7�4,okp�M9ft D. Seim? t 20. HUD(By Name)
^--•teeter �" ""/ CIT,"Wryer _ Betty J Bottiger,Regional Director
Signature&Title Date 09/ /2017) Signature&Title Date(09/ /2017)
1/4/7 ci L� 9 z/2a'7
form HUD-1044(8/90)
Applicant Assurances U.S. Department of Housing OMB Approval No.2501-0017
and Certifications and Urban Development (expires 01312016)
Instructions for the HUD-424-B Assurances and Certifications
As part of your application for HUD funding,you,as the official authorized to sign on behalf of your organization
or as an individual must provide the following assurances and certifications. By submitting this form,you are stating that to the
best of your knowledge and belief.all assertions are true and correct.
As the duty authorized representative of the applicant.I certify that the 5. Will comply with the acquisition and relocation
applicant[Insert below the Name and title of the Authorized Representative, requirements of the Uniform Relocation Assistance
name off Organization and the date of signature): and Real Property Acquisition Policies Act of 1970,
Name;�r(C/het 1) G{//7rj(R ,Title:IS?" / ' as amended(42 U.S.C.4601)and implementing
Organization C / ' 4C -j4- .Date: 7 ') . regulations at 49 CFR Part 24 and 24 CFR 42,
1. Has the legal authority to apply for Federal assistance,has the/ Subpart A.
institutional.managerial and financial capability(including funds to pay 6. Will comply with the environmental
the non-Federal share of program costs)to plan,manage and complete requirements of the National Environmental
the program as described in the application and the governing body Policy Act(42 U.S.C.4321 et seq.)and related
has duly authorized the submission of the application,including these Federal authorities prior to the commitment or
assurances and certifications,and authorized me as the official expenditure of funds for property acquisition and
representative of the applicant to act in connection with the application physical development activities subject to
and to provide any additional information as may be required. implementing regulations at 24 CFR parts 50 or 58.
2. Will administer the grant in compliance with Title VI of the Civil Rights 7. That no Federal appropriated funds have been
Act of 1964(42 U.S.C.2000(d))and implementing regulations(24 CFR paid.or will be paid,by or on behalf of the applicant.
Part 1),which provide that no person in the United States shall,on the to any person for influencing or attempting to
grounds of race,color or national origin,be excluded from participation influence an officer or employee of any agency,a
in.be denied the benefits of,or otherwise be subjected to discrimination Member of Congress,and officer or employee of
under any program or activity that receives Federal financial assistance Congress.or an employee of a Member of Congress.
OR if the applicant is a Federally recognized Indian tribe or its tribally in connection with the awarding of this Federal grant
designated housing entity,is subject to the Indian Civil Rights Act or its extension,renewal,amendment or modification.
(25 U.S.C. 1301-1303). If funds other than Federal appropriated funds have
3. Will administer the grant in compliance with Section 504 of the or will be paid for influencing or attempting to
Rehabilitation Act of 1973(29 U.S.C.794),as amended,and implement- influence the persons listed above.I shall complete
ing regulations at 24 CFR Part 8,and the Age Discrimination Act of 1975 and submit Standard Form-LLL,Disclosure Form to
(42 U.S.C.6101-07),as amended,and implementing regulations at 24 Report Lobbying. I certify that I shall require all sub
CFR Part 146 which together provide that no person in the United States awards at all tiers(including sub-grants and contracts)
shall,on the grounds of disability or age,be excluded from participation to similarly certify and disclose accordingly.
in,be denied the benefits of.or otherwise be subjected to discrimination Federally recognized Indian Tribes and tribally
under any program or activity that receives Federal financial assistance; designated housing entities(TDHEs)established by
except if the grant program authorizes or limits participation to designat- Federally-recognized Indian tribes as a result of the
ed populations,then the applicant will comply with the nondiscrimination exercise of the tribe's sovereign power are excluded
requirements within the designated population. from coverage by the Byrd Amendment,but State-
4. 1Aill comply with the Fair Housing Act(42 U.S.C.3601-19),as recognized Indian tribes and TDHEs established
amended,and the implementing regulations at 24 CFR Part 100,which under State law are not excluded from the statute's
prohibit discrimination in housing on the basis of race,color,religion, coverage.
sex,disability,familial status,or national origin;except an applicant These certifications and assurances are material
which is an Indian tribe or its instrumentality which is excluded by representations of the fact upon which HUD can rely
statute from coverage does not make this certification;and further when awarding a grant. If it is later determined that,
except if the grant program authorizes or limits participation I the applicant,knowingly made an erroneous
to designated populations,then the applicant will comply with the certification or assurance.I may be subject to
nondiscrimination requirements within the designated population. criminal prosecution. HUD may also terminate the
grant and take other available remedies.
form HUD-424-B(022004)
•
DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046
(See reverse for public burden disclosure.)
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract I la. bid/offer/application I 1 a. initial filing
b. grant Ib. initial award I b. material change
c. cooperative agreement c. post-award For Material Change Only:
d. loan year quarter
e. loan guarantee date of last report
f. loan insurance
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name
❑ Prime ❑Subawardee and Address of Prime:
Tier , if known:
Congressional District, if known: 4c Congressional District, if known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number, if applicable:
8. Federal Action Number, if known: 9. Award Amount, if known:
$
10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if
(if individual, last name, first name, Ml): different from No. 10a)
(last name, first name, MI):
11 trd maeon requested througti en form is«rnonzed by tie 31 U 5 C. section // Ale
1352. ins 0,sdosure of lop activities is a matenal representationSI nature: �/
lobbyingnsacti of tad g
non which reliance was pa0.b by the tier above wren to transaction was made Print Name: IC ' 2) -fe7%/i'7C�rC
«emaeo mo. This disclosure is received psrsuan to 3, U.S.0. 1352. This U/��/y�
roo ed dt wit ae avSnail be I«subject
to ni pen Any person who lass, tie the 1 Th f4J4 K C
reamed tits 510 0NAoreach be ttL^f dra penalty of not less than 510,OW and Title: rrvr/! C"// /V/
not mare Ulan 5100,000 I«each Such fedora,
Telephone No.:yeT-369-. 1-2a) 7/ /Date: !3'i)
Federal Use Only: Authorized for Local Reproduction
Standard Form LLL(Rev.7-97)
1 r
•
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity,whether subawardee or p. e Federal recipient,at the initiation or receipt of a covered Federal
action,or a material change to a previous filing,pursuant to title 31 U.S.C.section 1352. a filing of a form is required for each payment or agreement to make
payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress.an officer or employee of
Congress,or an employeeof a Member of Congress in connection with a covered Federal action.Complete all items that apply for both the initial filing and material
change report.Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported,enter
the year and quarter in which the change occurred.Enter the date of the last previously submitted report by this reporting entity for this covered Federal
action.
4. Enter the full name,address,city,State and zip code of the reporting entity.Include Congressional District,if known.Check the appropriate classification
of the reporting entity that designates if it is,or expects to be,a prime or subaward recipient.Identify the tier of the subawardee,e.g.,the first subawardee
of the prime is the 1st tier.Subawards include but are not limited to subcontracts,subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks-Subawardee,"then enter the full name,address,city, State and zip code of the prime Federal
recipient.Include Congressional District,if known.
6. Enter the name of the Federal agency making the award or loan commitment.Include at least one organizationallevel below agency name,if known.For
example,Department of Transportation.United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance
(CFDA)number for grants,cooperative agreements,loans,and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g.,Request for Proposal(RFP) number;
Invitation for Bid (IFS) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number
assigned by the Federal agency).Include prefixes,e.g.,"RFP-DE-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan
commitment for the prime entity identified in item 4 or 5.
10. (a)Enter the full name,address,thy,State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting
entity identified in item 4 to influence the covered Federal action.
(b)Enter the full names of the individual(s)performing services,and include full address if different from 10(a).Enter Last Name.First Name,and
Middle Initial(MI).
11. The certifying official shall sign and date the form,print his/her name,title,and telephone number.
According to the Paperwork Reduction Act,as amended,no persons are required to respond to a collection of information unless it displays a valid OMB Control
Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is
estimated to average 10 minutes per response,including time for reviewing instructions.searching existing data sources,gathering and maintaining the data
needed.and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of
information,including suggestions for reducing this burden,to the Office of Management and Budget.Paperwork Reduction Project(0348-0046),Washington.
DC 20503.
Certification for U.S. Department of Housing
and Urban Development . OMB 2506-0112
a Drug-Free Workplaceexp.(12131/2018)
CRYf .5142-171/19o .5142-171/19Applican Jame
7i9MetiU A)
Program/Activity Receiving ederal Grant Funding
Acting on behalf of the above named Applicant as its Authorized Official, I make 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 (I) Abide by the terms of the statement: and •
to provide a drug-free workplace by:
(2) Notify the employer in writing of his or her convic-
a. Publishing a statement notifying employees that the un- tion for a violation of a criminal drug statute occurring in the
lawful manufacture. distribution, dispensing, possession, or use workplace no later than five calendar days after such conviction:
of a controlled substance is prohibited in the Applicant's work-
e. Notifying the agency in writing, within ten calendar days
place and specifying the actions that will be taken against
employees for violation of such prohibition. after receiving notice under subparagraph d.(2) from an em-
ployee or otherwise receiving actual notice of such conviction.
b. Establishing an on-going drug-Gee awareness program to Employers of convicted employees must provide notice, includ-
inform employees --- - ing position title, to every grant officer or other designee on
(I) The dangers of drug abuse in the workplace: whose grant activity the convicted employee was working,
unless the Federalagency has designated a central point for the
(2) The Applicant's policy of maintaining a drug-free receipt of such notices. Notice shall include the identification
workplace: number(s) of each affected grant:
(3) Any available drug counseling, rehabilitation, and f. Taking one of the following actions. within 30 calendar
employee assistance programs: and days of receiving notice under subparagraph d.(2). with respect
(4) The penalties that may be imposed upon employees to any employee who is so convicted ---
for drug abuse violations occurring in the workplace. (I) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
c. Making it a requirement that each employee to be engaged
in the performance of the grant be given a copy of the statement requirements of the Rehabilitation Act of 19T, as amended: or
required by paragraph a.: (2) Requiring such employee to participate satisfacto-
d. Notifying the employee in the statement required by para- rily in a drug abuse assistance or rehabilitation program ap-
eraph a. that as a condition of employment under the grant, the proved for such purposes by a Federal,State,or local health, law
employee will --- enforcement, or other appropriate agency:
g. Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs a. thru f.
2. Sites for\\'ork Performance. The Applicant shall list(on separate pages)the site(s) for the performance of work done in connection with the
HUD funding of the program/activity shown above: Place of Performance shall include the street address. city. county. State. and zip code.
Identify each sheet with the Applicant name and address and the program/activity receiving grant funding.)
Check here if there are workplaces on file that are not identified on the attached sheets.
I hereby certify that all the information stated herein. as well as any information provided in the accompaniment herewith. is true and accurate.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties.
(18 U.S.C. 1001,1010.1012; 31 U.S.C.3729,3802)
Name of Authorized Official Title
t1C*5 D cit1 e �y Ci?Y 4,141
ignature Date
X RV/apicr 21/3/7
form HUD-50070(3/98)
ref.Handbooks 7417.1.7475.13.7485.1 8.3