Common use of Eligibility Requirements for Rapid Re-housing Assistance Clause in Contracts

Eligibility Requirements for Rapid Re-housing Assistance. Rapid re-housing is available for persons who are homeless according to HUD’s definition. Individuals and families who meet one of the following criteria, along with the minimum requirements established in Section 5.1, are eligible under the rapid rehousing portion of ESG: • Sleeping in an emergency shelter; • Sleeping in a place not meant for human habitation, such as cars, parks, abandoned buildings, streets/sidewalks; • Staying in a hospital or other institution for up to 180 days but was sleeping in an emergency shelter or other place not meant for human habitation immediately prior to entry into the hospital or institution; • Graduating from, or timing out of a transitional housing program; and • Fleeing domestic violence. The numbers for the following questions are based on the number of persons served for Rapid Re-Housing and Housing Relocation/Stabilization services. Please select the appropriate quarter for this report. Quarter #1 (October - December) Quarter #2 (January – March) Quarter #3 (April – June) Quarter #4 (July – September) Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander American Indian/Alaskan Native & White Black/African American & White Am. Indian/Alaskan Native & Black/African American Other Multi-Racial Totals Unaccompanied 18 and over Male: Female: Totals: Unaccompanied under 18 Male: Female: Totals: Single 18 and over Male: Female: Totals: Single under 18 Male: Female: Totals: Signature of President/Executive Director/Board Chair Printed Name of President/Executive Director/Board Chair The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of congress an officer or employee of congress or an employee of a member of congress in connection with the awarding of any federal contract, the making of any federal grant, the making on any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person 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 employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Printed name of Authorized Individual Application or Contract Number Name and address of Organization: Any building for which ESG funds are used for conversation, major rehabilitation, or other renovation must meet state or local government safety and sanitation standards, as applicable, and the following minimum safety, sanitation, and privacy standards. Any emergency shelter that receives ESG funds for shelter operations must also meet the following minimum safety, sanitation, and privacy standards: 1. State and local requirements. Each contractor must ensure that housing occupied by a family or individual receiving ESG assistance is in compliance with all applicable state and local housing codes, licensing requirements, and any other requirements in the jurisdiction in which the housing is located regarding the condition of the structure and the operation of the housing or services.

Eligibility Requirements for Rapid Re-housing Assistance. Rapid re-housing is available for persons who are homeless according to HUDXXX’s definition. Individuals and families who meet one of the following criteria, along with the minimum requirements established in Section 5.1, are eligible under the rapid rehousing portion of ESG: • Sleeping in an emergency shelter; • Sleeping in a place not meant for human habitation, such as cars, parks, abandoned buildings, streets/sidewalks; • Staying in a hospital or other institution for up to 180 days but was sleeping in an emergency shelter or other place not meant for human habitation immediately prior to entry into the hospital or institution; • Graduating from, or timing out of a transitional housing program; and • Fleeing domestic violence. The numbers for the following questions are based on the number of persons served for Rapid Re-Housing and Housing Relocation/Stabilization services. Please select the appropriate quarter for this report. Quarter #1 (October - December) Quarter #2 (January – March) Quarter #3 (April – June) Quarter #4 (July – September) September)‌‌‌ Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander American Indian/Alaskan Native & White Black/African American & White Am. Indian/Alaskan Native & Black/African American Other Multi-Racial Totals Unaccompanied 18 and over Male: Female: Totals: Unaccompanied under 18 Male: Female: Totals: Single 18 and over Male: Female: Totals: Single under 18 Male: Female: Totals: Signature of President/Executive Director/Board Chair Printed Name of President/Executive Director/Board Chair The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of congress an officer or employee of congress or an employee of a member of congress in connection with the awarding of any federal contract, the making of any federal grant, the making on any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person 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 employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Printed name of Authorized Individual Application or Contract Number Name and address of Organization: Any building for which ESG funds are used for conversation, major rehabilitation, or other renovation must meet state or local government safety and sanitation standards, as applicable, and the following minimum safety, sanitation, and privacy standards. Any emergency shelter that receives ESG funds for shelter operations must also meet the following minimum safety, sanitation, and privacy standards: 1. State and local requirements. Each contractor must ensure that housing occupied by a family or individual receiving ESG assistance is in compliance with all applicable state and local housing codes, licensing requirements, and any other requirements in the jurisdiction in which the housing is located regarding the condition of the structure and the operation of the housing or services.