TABLE OF CONTENTS INSTRUCTIONS FOR PREPARING AND SUBMITTING THE FY 2017 PROPOSAL 3 LETTER OF INTENT 4 PROPOSAL CHECKLIST 5 FY 2017 HIV HOUSING SERVICES PROPOSAL 6 Cover Page 6 Abstract 7 Organization Description 8 Staffing Description 9 Target Population 10 Program Data, Outcomes, & Evaluation 11 Agency/Program Specific Procedures 12 Service Description 13 I. Cost Effectiveness & Budget Justification ………………………………………..15 TABLES 15 C1. Organization Diversity Table Board and Staff 16 – Table C2. Organization Diversity Table Client Clients 17 – Table C3. Summary of HIV-Related Agency Funding 18 Table C4. HIV and Related Funding & Contracts 19 Table E. Target Population 21 Table H1. Program Linkages 22 Table H2. Service Delivery Table(s)............. 23 VI. ATTACHMENTS 30 Organizational Chart(s) BPHC Contract Forms Mission Statement Certificate of Authority Form Board of Directors List Available Appropriation Form Job Descriptions Federal Assurances Non Construction – Agency Licensure and/or Certifications Programs Form Budget(s) Federal Certifications Form Budget Justification Narrative(s) BPHC Business Associate Agreement Form Verification of 501(c)3 status Agency Annual Operating Budget Most Recent Single Independent Report Living Wage over $25K Agreement Form Collaborative Relationship Chart Collaborative Letters of Agreement Living Wage Reporting Form Ryan White Program Assurances Form W-9 Request Form Instructions for Preparing and Submitting The FY 2017 Proposal General Preparation Instructions One proposal must be submitted for each service category.
TABLE OF CONTENTS INSTRUCTIONS FOR PREPARING AND SUBMITTING THE FY 2017 PROPOSAL 3 LETTER OF INTENT 4 PROPOSAL CHECKLIST 5 FY 2017 HIV HOUSING SERVICES PROPOSAL 6 Cover Page 6 Abstract 7 Organization Description 8 Staffing Description 9 Target Population 10 Program Data, Outcomes, & Evaluation 11 Agency/Program Specific Procedures 12 Service Description 13 I. Cost Effectiveness & Budget Justification ………………………………………..15 TABLES 15 C1. Organization Diversity Table – Board and Staff 16 Table C2. Organization Diversity Table – Client Clients 17 Table C3. Summary of HIV-Related Agency Funding 18 Table C4. HIV and Related Funding & Contracts 19 Table E. Target Population 21 Table H1. Program Linkages 22 Table H2. Service Delivery Table(s)............. 23 VI. ATTACHMENTS 30 Organizational Chart(s) Mission Statement Board of Directors List Job Descriptions Agency Licensure and/or Certifications Budget(s) Budget Justification Narrative(s) Verification of 501(c)3 status Most Recent Single Independent Report Collaborative Relationship Chart Collaborative Letters of Agreement Ryan White Program Assurances Form BPHC Contract Forms Certificate of Authority Form Available Appropriation Form Federal Assurances – Non Construction Programs Form Federal Certifications Form BPHC Business Associate Agreement Form Agency Annual Operating Budget Living Wage over $25K Agreement Form Living Wage Reporting Form W-9 Request Form Instructions for Preparing and Submitting The FY 2017 Proposal General Preparation Instructions One proposal must be submitted for each service category.