2013 Richmond CoC Supplemental Form for HUD CoC Applications
Agency Name
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Project Name
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HUD CoC Project Number
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Agency Background Information
Is the applying agency a nonprofit or entity of local government?
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Yes, non-profit
Yes, entity of local government
No
Agency Point of Contact
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Email Address for Point of Contact
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Office Phone Number for Point of Contact
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Additional Contact Phone Number for Point of Contact
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Project Request Information
Project Activity
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Please Select
Renewal- RRH
Renewal- PSH
New- PSH serving 100% chronically homeless
New- RRH project families with minor children
Renewal- Transitional
Renewal- Renewal- CoC planning
Renewal- HMIS
Renewal- Supportive services only
Amount of Request
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From which communities will the project accept and serve clients ?
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Chesterfield
Hanover
Henrico
New Kent
Goochland
Powhattan
Charles City
Richmond City
Does your agency have a signed agreement for participation in HCIS?
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Yes
No, we cannot participate in HCIS but have a signed data sharing agreement with Homeward.
Past Performance- for CoC Renewals of Active Projects Only
Has this project received a HUD monitoring in the past 12 months?
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Yes
No
If yes, please upload a copy of the report and the resulting action plan. Multiple documents should be combined into one pdf and attached.
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Project Narratives
Please provide a brief narrative of your project. The narrative should include an overview of project activities and services, target population to be served, a description of how clients will access services, and a general overview of program eligibility criteria.
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0/500
Please describe how the project supports the HUD CoC program goals, Opening Doors, the Virgina Homeless Outcomes Report, the goals of the Richmond Regional Ten Year Plan to Prevent and End Homelessness, and how the activities are housing focused.
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0/500
Does the project serve any of the following groups? Veterans, homeless youth, those fleeing domestic violence, those who are chronically homeless. (Please check all that apply.)
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Yes, our project serves veterans as a target population.
Yes, our project serves homeless youth as a target population.
Yes, our project serves those fleeing domestic violence as a target population.
We do not serve any of these groups as a target population.
Yes, we target chronically homeless single adults and/or families.
Please describe how your project prioritizes those experiencing chronic homelesness. Please note chronic homelesness includes both single adults and families with children. If your project does not target those experiencing chronic homeless please state "not applicable".
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Does this project use a housing first approach?
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Yes
No
Please describe how your project connects clients with mainstream services. Please list specific mainstream resources including Affordable Care Act, Medicaid, CHIP, TANF, SNAP, SSI, SSDI, etc.
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0/500
Please describe how your project connects clients with employment income.
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0/500
For projects serving families with minor children, please describe how your agency partners with local schools to ensure access to education services.
Additional Attachments
Please upload a PDF version of the project application submitted in e-snaps.
For projects currently serving clients, please upload a copy of the APR for October 1, 2012 to September 30, 2013. If you do not have a copy of your APR, please contact Tonya Harris.
Please upload a copy of the 2013 Supplemental CoC Funding Form. This form is available for download using the link http://tinyurl.com/2013rvasupp .
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If you have additional attachments, please upload them here. All attachements should be combined into one document.
Certification
Submit
Certification of Project Application: I certify that the information provided here is accurate and correct and reflects the information included in the agency’s APR (when applicable) . I certify that the proposed project complies with federal fair-housing standards and civil rights requirements. I certify that the proposed project complies with all HEARTH Act Regulations and CoC program rules and guidelines. I understand that this information and the requested supplemental materials will be used to by the ranking committee in prioritizing projects for funding.
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Should be Empty: