CoC NY-505 Monitoring Team Information Monitoring Staff: Date of Monitoring Visit: ______________________________________________________________ CoC Program Grantee: Agency and Program Information Agency: Program Name: Agency staff consulted: Grant Amount: Contract Number: ⎕PSH ⎕RRH Program Type: Number to be served: Number of chronic beds/units: ⎕ ⎕ ⎕ Program serves: Individuals Families Both Individuals and Families CoC Program grant funds are used for: ⎕ ⎕ Rental Assistance Leasing (no match required) ⎕ ⎕ Operations Admin ⎕ Supportive Services ⎕ ⎕ Is the agency a faith-based organization? Yes No ⎕ ⎕ ⎕ CoC Matching funds (25% required) are: Cash/Cash Equivalent In Kind N/A ⎕ ⎕ Is there an active restrictive covenant on one or more of the project properties? Yes No
CoC NY-505 Monitoring Team Information Monitoring Staff: Date of Monitoring Visit: ______________________________________________________________ CoC Program Grantee: Agency and Program Information Agency: Program Name: Agency staff consulted: Grant Amount: Contract Number: Program Type: ⎕PSH ⎕RRH Number to be served: Number of chronic beds/units: Program serves: ⎕ Individuals ⎕ Families ⎕ Both Individuals and Families CoC Program grant funds are used for: ⎕ Rental Assistance ⎕ Leasing (no match required) ⎕ Operations ⎕ Admin ⎕ Supportive Services Is the agency a faith-based organization? ⎕ Yes ⎕ No CoC Matching funds (25% required) are: ⎕ Cash/Cash Equivalent ⎕ In Kind ⎕ N/A Is there an active restrictive covenant on one or more of the project properties? ⎕ Yes ⎕ No
FY-2016-Monitoring-Tool-Final.docx