Name of Agency Typed Name and Title of Agency Official Agency Official’s Signature Date of Signature Telephone Number of Agency Official e-Mail Address of Agency Official CDBG PROGRAM Project Proposal Checklist Program Year 2017-18 Organization: Project: Items to include for this application: Application Information / Documentation Check if Included CDBG Economic Development Application A Application Original and copies – B Application in Word format sent via email or other electronic means () – C Table I Adopted Budget for FY 2016-17 – D Table II Proposed Budget for FY 2017-18 – E Evidence of Insurance Coverage F Program Intake Policies and Procedures and Privacy Notice to include for each organization (Do not duplicate for each copy of each application.): Indicate Check if with which Included Organizational Information / Documentation Application with this Item is Application Included A Most Recent Audited Financial Statement B List of Board of Directors and Affiliations C Organizational Chart
Name of Agency Typed Name and Title of Agency Official Agency Official’s Signature Date of Signature Telephone Number of Agency Official e-Mail Address of Agency Official CDBG PROGRAM Project Proposal Checklist Program Year 2017-18 Organization: Project: Items to include for this application: Check if Included Application Information / Documentation CDBG Economic Development Application A Application – Original and copies B Application – in Word format sent via email or other electronic means () C Table I – Adopted Budget for FY 2016-17 D Table II – Proposed Budget for FY 2017-18 E Evidence of Insurance Coverage F Program Intake Policies and Procedures and Privacy Notice to include for each organization (Do not duplicate for each copy of each application.): Check if Included with this Application Indicate with which Application Item is Included Organizational Information / Documentation A Most Recent Audited Financial Statement B List of Board of Directors and Affiliations C Organizational Chart
CDBG_EconomicDevApp2017-18.docx