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Exhibit 10A – Project Monitoring Checklist For Public Works & Community Facilities Projects Community Development Block Grant Monitoring Checklist Project Type : 1. Recipient Name: 2. CDBG Project Number: 3. Project Title: 4. OBDD Staff Signature: 5. Date(s) of Review: 6. Review Type: Desk Review Site Review Community Development Block Grant Management Handbook – 2017 Page 1 of 54 Public / Community Facilities Public Works

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Page 1:  · Web viewGrant Management Handbook – 2017 Page 36 of 39 Community Development Block Grant Monitoring Checklist Project Type: Author Fumi Schaadt Created Date 01/03/2017 22:32:00

Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Community Development Block GrantMonitoring Checklist

Project Type:

1. Recipient Name:      

2. CDBG Project Number:      

3. Project Title:      

4. OBDD Staff Signature:      

5. Date(s) of Review:      

6. Review Type: ☐ Desk Review ☐ Site Review

Community Development Block Grant Management Handbook – 2017Page 1 of 39

Public / Community Facilities Public Works

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Overall Management and Project ProgressYES NO N/A Comments

1. Termination Date :      2. Will the project be completed by the termination

date?☐ ☐ ☐      

If not, explain why and what actions are being taken to expedite completion and provide a new estimated termination date.

     

3. Who is in charge of the day-to-day administration of the project?

     

4. Status of Project:      

Proposed Actual as of      

Accomplishments CDBG Budget Local / Other Funds CDBG $ Spent Local / Other

$ Spent                                                                                                                                                                                                                                                                                                  Total $0 $0 $0 $0

YES NO N/A Comments5. Are matching funds being spent as required by the

grant contract?☐ ☐ ☐      

If no, explain:      

6. Have all Special Conditions of the grant contract been met? (These are generally located in Exhibit B of the contract.)

☐ ☐ ☐      

If no, list the special conditions yet to be met:      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Comments7. For public works design and construction projects,

the recipient must provide a rate resolution that meets minimum rate requirement of the program and submit it to OBDD prior to administrative closure. During the on-site monitoring provide technical assistance about this requirement.

☐ ☐ ☐      

If recipient has passed the rate resolution, identify the resolution number and adoption date.

     

8. Conclusion: Is project being carried out as proposed?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Eligibility and National ObjectiveYES NO N/A Comments

1. Are the activities being carried out the same as those in the grant contract (as amended)?

☐ ☐ ☐      

If no, explain:      

2. Which National Objective has the recipient chosen to meet?a. Activities benefiting low- and moderate-income

(LMI) persons:☐ ☐      

Areawide Benefit ☐ ☐      Direct Benefit (Off-site infrastructure) ☐ ☐      Direct Benefit – Jobs Creation / Retention (Complete question 5 below

☐ ☐      

Limited Clientele(Complete question 3 below)

☐ ☐      

Location and Nature (Food bank projects) ☐ ☐      b. Activities which aid in the prevention or

elimination of slums or blight. (Complete question 4 below)

☐ ☐      

c. Activities designed to meet community development needs having a particular urgency.

☐ ☐      

3. For limited clientele project, describe the screening procedures and eligibility reviews used to meet this national objective:

a. Are these procedures acceptable? ☐ ☐      b. Is the documentation valid and reliable? ☐ ☐      4. Slums and Blight or Urgent Need.

Is there any evidence that the documentation submitted with the recipient’s application in support of the national objective claim is no longer applicable to the project?

☐ ☐      

5. If a site inspection is conducted, does it support the National Objective justification provided by the recipient?

☐ ☐ ☐      

Date of inspection:      6. Conclusion: Based on the monitoring visit, does it

appear that this project will meet the chosen National Objective?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Financial ManagementYES NO N/A Comments

1. Name / title of person responsible for financial records:      2. Financial Reporting, Accounting Records, and Budget Control:a. Does the recipient have financial records that are

current, accurate and consistent with the data provided in its cash requests?

☐ ☐      

b. How often are financial status reports produced by the recipient’s financial system for City Councils and County Commissioners?

☐ ☐      

c. Do the recipient’s financial records allow for comparison between budgeted activity costs and actual activity costs for the project?

☐ ☐      

3. Internal Control:a. Who authorizes costs and charges to the program?

(Name and title)     

b. Who records the transactions?(Name and title)

     

c. Who signs disbursements?(Name and title)

     

d. Based on responses to a, b, and c, is there a separation of power so that no one person controls more than one step?

☐ ☐ ☐      

4. Source Documentation:a. Are local accountings supported by invoices,

contracts, purchase orders, et cetera?☐ ☐ ☐      

b. Are direct salaries and wages of employees, which are chargeable to more than one grant program or other cost objective(s), supported by time distribution records?

☐ ☐ ☐      

5. Allowable Cost:Based on review of documentation submitted with cash requests and/or maintained in local accounting records, have you found the following to be true for each cost reviewed?

a. Necessary, reasonable and directly related to a line item in the state-approved grant budget?

☐ ☐ ☐      

b. Authorized by the recipient? ☐ ☐ ☐      c. All costs are eligible or not prohibited, under

federal, state or local laws and regulations?☐ ☐ ☐      

d. Community Development Block Grant expenditures are consistently treated like other expenditures?

☐ ☐ ☐      

e. The cost is net of all applicable credits? ☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Commentsf. Are Grant funds being used to pay recipient

employees who are already on the payroll for administration and/or force account work including, but not limited to, engineering, design and inspection services, construction labor and operation of locally owned equipment? P.L. 93-383.101(c)

☐ ☐ ☐      

If yes, did the recipient receive prior Oregon Business Development Department approval?

☐ ☐      

g. Is administration and force account labor, paid with non-Community Development Block Grant funds, being contributed as local match?

☐ ☐ ☐      

If yes, is the match documented by employee time records which show the hours worked on the grant project?

☐ ☐      

6. Cash Requests:How does the recipient minimize the time between receipt of the requested cash and disbursement of those funds? (Prefer 3 days between time of receipt of the funds by the recipient and the recipient’s disbursement to pay project related expenses.)

a. Uses local funds that are loaned or transferred to pay project bills. The local funds are reimbursed when the grant drawdown is received.

☐ ☐ ☐      

b. Releases checks when the grant drawdown is received.

☐ ☐ ☐      

7. Conclusion: Is the financial management system adequate?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

ProcurementContract / RFP / RFQ /Call for Bids, et cetera

(List by contractor if known)

Type of contract work

Contract Amount

Method of Procurement

Date received by OBDD for

review

Date executed or advertised

                                                                                                                                                                               Personal Services Contracts:

a) Small procurement ($3,000 or less)b) Intermediate Procurement ($3,000 - $150,000)c) Formal Procurement ($150,000 or more)d) Sole Source Procurementse) Emergencyf) Special Procurement

Architect, Engineering and Surveyor Contracts: (Must be Qualification Based Selection (QBS)

g) Direct Appointment ($25,000 or less)h) Informal Procurement ($25,000 to $150,000)i) Formal Procurement ($150,000 or more)

Public Construction Contracts:j) Emergency as allowed by ORS 279C.335(6)k) Intermediate Procurement ($100,000 or less)l) Formal Procurement ($100,000 or more)

Environmental Review Activities Covered Date of FindingCorrect Choice

Yes No

Environmental Exemption             ☐ ☐Categorical Exclusion not subject to 58.5             ☐ ☐

Categorical Exclusion subject to 58.5             ☐ ☐

Environmental Assessment             ☐ ☐Environmental Impact Statement             ☐ ☐

(Note: the recipient may have chosen to make a Finding of Exemption for certain activities allowed under 24 CFR 58, while undertaking additional review for other activities. In these cases, more than one line must be completed. Enter N/A for Not Applicable.)

YES NO N/A Comments1. Procurement System:a. Who administers contracts to ensure that

procurement requirements and contract terms are met? (Name and title)

     

b. Are records maintained sufficient to detail the significant history of each procurement?

☐ ☐ ☐      

2. Does the recipient follow procedures for procurement transactions that support “full and open” competition?

☐ ☐ ☐      

3. Is contract pricing always based on a method other than the “cost plus a percentage of cost” and “percentage of construction cost”?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Comments4. Personal Service Procurements:a. For small procurement of $3,000 or less, have

competitive quotes been obtained when feasible?☐ ☐ ☐      

b. For intermediate procurements over $3,000 and up to $150,000, has the recipient documented at least three competitive quotes?

☐ ☐ ☐      

c. For formal procurements of $150,000 or more, Formal Advertising and RFP / Qualifications:Solicitation of RFP / Qualifications? ☐ ☐ ☐      Request For Proposal (RFP)? ☐ ☐ ☐      

5. Architects, Engineers and Surveyor Procurementsa. Direct Appointment – Emergency projects are

contracts with a small fee not to exceed $25,000☐ ☐ ☐      

b. For informal procurements over $25,000 but less than $150,000 has the recipient documented receipt of informally solicited proposals / qualifications?

☐ ☐ ☐      

c. For formal procurements over $150,000, Formal Advertising and RFP / Qualifications.Solicitation of RFP / Qualifications? ☐ ☐ ☐      Request For Proposal (RFP)? ☐ ☐ ☐      Is the primary selection criterion qualifications, and not price?

☐ ☐ ☐      

Do the records for procurement involving architectural / engineering services show evidence that the recipient complied with the provisions of the Oregon “Model Rules for Public Contracting Agency Screening of Persons to Perform Architectural and Engineering Personal Services Contracts, and Qualification Based Selection (QBS)?”

☐ ☐ ☐      

For contracts with providers already on retainer, do the recipient’s records include justification for the contractor’s selection and the basis for the cost negotiated, and legal council documentation that the procurement met State law and the requirements of the CDBG program?

☐ ☐ ☐      

6. Public Construction Procurements:a. Emergency as allowed by ORS 279C.335(6) ☐ ☐ ☐      b. For intermediate procurements where the contract

price does not exceed $100,000 has the recipient documented receipt of informally solicited competitive quotes or bids?

☐ ☐ ☐      

c. For formal procurements where the contract price exceeds $100,000, formal solicitation and sealed bids are necessary. Has the recipient documented?

☐ ☐ ☐      

Invitation to bid? ☐ ☐ ☐      Has completed bid documents? ☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A CommentsReceipt of competitive sealed bids? ☐ ☐ ☐      

7. Has the recipient ensured that the required federal contract clauses are included in all contracts by submitting them to Oregon Business Development Department for review 10 days before they are distributed or executed or advertised?

☐ ☐ ☐      

8. Was appropriate environmental clearance documented (e.g., Finding of Exemption or ROF issued by the State) before all contracts were executed?

☐ ☐ ☐      

(If the appropriate environmental review was not conducted before contracts were executed, it is an environmental review finding, not a procurement finding.)

9. Conclusion: Does the recipient comply with procurement requirements?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Section 3YES NO N/A Comments

1. Grant Amount: $     

Note: If less than $100,000, Section 3 requirements do not apply to this project.2. Is the funded project any one of the following:a. A public works planning, design and/or

construction project?☐ ☐      

b. A public / community facility design and construction project?

☐ ☐      

c. An economic development revolving loan fund project, and the loan funds were used for construction activities that exceeded $100,000 per loan, or if any construction contractor has an aggregate of $100,000 of construction contracts funded with CDBG loan funds?

☐ ☐      

d. A housing rehabilitation revolving loan fund, in which a construction contractor has an aggregate of $100,000 of individual housing rehabilitation construction contracts under the CDBG grant?

☐ ☐      

If the answer to any one of a-d above is YES, the Section 3 requirements apply and the rest of this checklist must be completed.

3. The recipient submitted the required Section 3 plan prior to the first draw for non-construction funds?

☐ ☐      

Date received by OBDD?      Date of First Draw received by OBDD?      Date reviewed by OBDD?      

4. Is the Section 3 clause included in the covered contracts and subcontracts (construction and non-construction)?

☐ ☐      

5. Has recipient been submitting the required HUD-60002 form annually, no later than January 31 of each year?

☐ ☐      

6. Has the recipient submitted prior to the final drawdown for construction funds, or the final draw for non-construction activities the required final HUD 60002 form?

☐ ☐      

7. The regulation requires the recipient to meet the following numeric goals / requirements. Has the recipient met these requirements?

☐ ☐ If not, explain why and what actions they have taken to achieve compliance.

a. 30% of the aggregate number of NEW hires shall be section 3 residents;

     

b. 10% of the total dollar amount of all covered construction contracts shall be awarded to Section 3 business concerns; and

     

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Commentsc. 3% of the total dollar amount of all covered non-

construction contracts shall be awarded to Section 3 business concerns.

     

8. Conclusion: Has recipient satisfied the Section 3 requirements?

☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Limited English Proficiency (LEP) Plan(in effect since 2012)

YES NO N/A Comments1. Recipient submitted an OBDD approved LEP plan

prior to the first draw for non-construction funds?☐ ☐      

2. Date the plan was submitted      3. Date the plan was reviewed by OBDD      4. Conclusion: Has the recipient satisfied the LEP

requirements?☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Compliance with Section 504 Regulations – Nondiscrimination on the Basis of Disability

This section of the checklist is to be used only for projects involving any kind of construction, or rehabilitation of non-housing facilities. (Note: each project must complete and have on file a 504

checklist)

YES NO N/A Comments1. Project Design and Construction ☐ ☐      a. Type of project (check one in each column) ☐ New Construction

☐ Rehabilitation☐ Non-Housing

b. Non-Housing ProjectsNew Construction: Was this facility designed in compliance with the UFAS, (Uniform Federal Accessibility Standards according to the project designer?

☐ ☐ ☐      

If No, was the project designed in compliance with ANSI standards?

☐ ☐ ☐

Rehabilitation: Did the recipient make efforts to incorporate accessibility improvements into the rehabilitation plan for this facility?

If yes give two more examples of accessibility features in the project specs.

☐ ☐ ☐      

If not, was the following true:Was the building already accessible to individuals with disabilities?

☐ ☐ ☐      

Did the recipient determine that accessibility improvements would impose “undue financial and administrative burdens”?

☐ ☐ ☐      

2. Conclusion: Is the recipient insubstantial compliance with Section 504 requirements?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Actions to Affirmatively Further Fair HousingYES NO N/A Comments

1. Date first draw for non-construction funds was received by the Department:

2. Fair Housing Resolution      Date that the recipient’s most recent resolution was adopted:

     

Date of most recent publication (Must be within 6 months prior to the first draw):

     

3. Fair Housing Poster and Brochures

Recipient documented that they distributed and posted the fair housing poster and brochures at City Hall and/or the County Court House and other locations within the community within 6 months prior to the first draw for non-construction funds?

☐ ☐ Date documented:      

4. Recipient documented that they undertook and completed at least one additional fair housing activity for each grant prior to the final draw for grant funds?

☐ ☐ ☐      

N/A can be checked for item 4 above only if the grant recipient received more than one grant per program year, example P10005 and P10027, in these cases the grant recipient need only conduct one additional fair housing activity for both grants. If this is the case, document the open grant number:

Open Grant #:      

Open Grant #:      

Open Grant #:      5. Document which additional fair housing activity

was completed:     

a. Develop and adopt a comprehensive Fair Housing Action Plan, identifying specific actions and timetables. Document the analysis and make it available to the public. Develop a fair housing action plan with corresponding steps to address actions the recipient will undertake to promote fair housing;

☐ ☐ ☐      

b. Conducting or participating in an analysis of impediments to fair housing in the community. Document the analysis and make it available to the public. Develop a fair housing action plan with corresponding steps to address actions the recipient will undertake to promote fair housing;

☐ ☐ ☐      

c. Undertake a review of existing fair housing ordinances, zoning and land use practices for discriminatory policies and practices. Document the review and make it available to the public. Develop a fair housing action plan with corresponding steps to address discriminatory practices;

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

d. Support and participate in an educational program coordinated with local realtors, home builders, and/or mortgage lenders designed to provide information on fair housing rights;

☐ ☐ ☐      

e. Establish a fair housing complaint referral program that provides public information and assistance to persons who want to file a complaint with the federal government or the State of Oregon. Procedures for filing Housing Discrimination Complaints are described on the HUD website at http://www.hud.gov/complaints/housediscrim.cfm and at the Fair Housing Council of Oregon by calling 503) 223-8197 or 1-800-424-3247 (Voice and TTY);

☐ ☐ ☐      

f. Provide financial or other documented local support to state or local fair housing organizations that provide information, referral and other assistance in the community. Community Development Block Grant administration funds can be used for this without receiving prior approval from the state;

☐ ☐ ☐      

g. Host an informal fair housing session for local employers to encourage cooperation in efforts to find housing for their employees and to promote equal housing choices within the community;

☐ ☐ ☐      

h. Speak to an elementary school class about the fair housing rights of the children and their families;

☐ ☐ ☐      

i. Host and invite the Fair Housing Council of Oregon to have a discussion with group leaders or rental property owners and managers about their fair housing responsibilities

☐ ☐ ☐      

j. Adopt a resolution that supports government assisted housing programs in the community and print a notice or advertisement that appears in a prominent location of the local newspaper that states that the grantee is an active supporter of fair housing laws. The notice or advertisement must include the contact information for the recipients Fair Housing representative. See Exhibit 7A for a sample resolution;

☐ ☐ ☐      

k. Develop a community Fair Housing web-page which prominently displays the community’s commitment to further fair housing on the community web-site, including links to fair housing enforcement and education agencies; and,

☐ ☐ ☐      

l. Recipients may ask the state to approve other actions designed to further fair housing choice in their communities. Such as implementing the actions identified within the recipients Fair Housing Action Plan.

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

m. Other (describe)      

6. Conclusion: Has the recipient satisfied fair housing requirements?

☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Employment Practices & Minority Business EnterprisesYES NO N/A Comments

1. Does the recipient maintain records of any actions undertaken to assure equal employment opportunities to all persons regardless of race, color, national origin, sex or handicap, such as:

a. Including an EEO statement in all recruiting announcements?

☐ ☐      

b. Adoption of an equal employment opportunity resolution?

☐ ☐      

Date:      Resolution Number:      

c. Adoption of personnel policies stressing equal employment and nondiscrimination?

☐ ☐      

Date:      d. Other: ☐ ☐      

2. Have any equal employment opportunity complaints been filed against the recipient within the last five years?

☐ ☐      

If yes, has the recipient taken any affirmative actions to overcome the effects of prior discrimination?

☐ ☐ ☐      

3. Conclusion: Has the recipient satisfied equal employment opportunity requirements?

☐ ☐      

Minority Business EnterprisesNOTE - Data must be collected indicating the racial and ethnic character of each business entity that receives a contract or a subcontract of $10,000 or more paid in full or in part with CDBG funds. For each contract exceeding $10,000 the recipient must complete the Minority, Women and Emerging Small Business Activity Report.

1. Before final drawdown of grant funds, did the recipient complete and submit the Minority Women and Emerging Small Business Enterprise Contract and Subcontract activity report?

☐ ☐ ☐      

2. Conclusion: has recipient satisfied the Minority Business Enterprises requirement?

☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Records RetentionYES NO N/A Comments

1. Where are records / files being maintained?      2. Records Retention Policies:

Does the recipient have policies that cover records retention?

☐ ☐      

Are the policies consistent with the CDBG records retention requirements found in the grant contract?

☐ ☐      

3. Conclusion: Are the recipient’s records retention policies adequate?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Community Development Block Grant Program BenefitsYES NO N/A Comments

1. Direct Benefit Activities

Answer these questions for projects that have activities requiring persons or households to apply for assistance (housing rehabilitation, and job creation / retention,):

a. Does the recipient have a system for collecting data on the following characteristics of applicants and actual beneficiaries in Community Development Block Grant-funded activities: racial, ethnic origin, and the gender of the head of the household?

☐ ☐      

b. List direct benefit data collected to date for both applicants and actual direct beneficiaries. If the project is housing related, data should be for the head of household only:

Race: Total # Ethnicity: # of HispanicWhite            Black / African American            Asian            American Indian / Alaskan Native            Native Hawaiian / Other Pacific Islander            American Indian / Alaskan Native & White            Asian & White            Black / African American & White            American Indian / Alaska Native & Black / African American            Other Multi-Racial            Total Number of Persons Benefiting from Project 0 0

HEAD OF HOUSEHOLD

Female Head of Household            Male Head of Household            Total 0 0

YES NO N/A Commentsc. Based on a physical review of the project and the

recipient’s records, do the records accurately describe the level and type of benefits that were actually provided?

☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Commentsd. Were there any obvious differences in the level,

quality or type of actual benefits provided for minority versus non-minority beneficiaries?

☐ ☐      

If yes, explain:      

e. For projects involving direct hook ups of low- and moderate-income residents to Community Development Block Grant funded public works, are the income limits that are being used to qualify residents for grant paid hook ups consistent with Oregon Business Development Department-provided low and moderate income guidelines?

☐ ☐ ☐      

f. Is there any evidence of illegal discrimination against persons on the basis of age with regard to direct benefits from the Community Development Block Grant project?

☐ ☐ ☐      

2. Limited Clientele Activitiesa. What data does the recipient have about the race and ethnicity of beneficiaries of limited clientele activities:

Data describing the characteristics of the project area (e.g., Census data)?

☐ ☐ ☐      

Data collected from users of the assisted facility? (Note: this is not currently required, but is recommended.)

☐ ☐ ☐      

3. Area Wide Activitiesa. What data does the recipient have about the race

and ethnicity of beneficiaries of limited clientele activities

☐ ☐ ☐      

Source of data:      

b. Is there any evidence that area-wide benefits were denied to members of protected classes, or that areas not selected to receive benefits and having equivalent needs to areas benefited may have been overlooked because of race or ethnic characteristics?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Comments4. Conclusion: Does the recipient maintain the

required information about Program Benefits: ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Acquisition of Real PropertyUse this section only for projects that involve acquisition of real property,

permanent easements, temporary construction easements, donations and leases of 50 years or more.

YES NO N/A Comments

“Not Subject to” Acquisition1. Date of OBDD concurrence of “Request for

Acquisition Exemption”     

2. Entity with the power of eminent domain - Did the recipient, or acquiring entity, determine and inform the owner in writing, prior to negotiations, that it would not use its power of eminent domain if an amicable agreement could not be reached, and informing them of their basic rights?

Date of letter:      

☐ ☐ ☐      

3. Entity without the power of eminent domain - Did the agency inform the owner in writing, prior to negotiations, that it does not have the power of eminent domain and informing them of their rights?

☐ ☐ ☐      

4. Did fully informed owner sign donation agreement? (If yes skip to k below, if not continue with checklist.)

☐ ☐      

5. Was the owner informed of the recipient’s estimate of the fair market value of the property in writing before entering into a contract for sale?

☐ ☐ ☐ Date recipient was informed:     

6. Was the fair market value based on an appraisal? ☐ ☐ ☐      7. Was fair market value established by a person

knowledgeable in property values?☐ ☐ ☐      

8. If there was no appraisal because the recipient determined the value of the property to be less than $10,000, what documentation is there to support the determination?

☐ ☐ ☐      

9. Was the purchase price no more than the fair market value?

☐ ☐ ☐      

10. Date owner was provided Just Compensation and purchase offer letter:

     

11. Do the files include a copy of the purchase agreement and documents conveying the property?

☐ ☐ ☐      

12. Is there evidence of the owner(s) receiving payment (e.g., copies of canceled checks)?

☐ ☐ ☐      

13. Were the settlement costs paid by grant recipient? ☐ ☐      14. Was the title recorded? ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Comments

“Subject to” Acquisition1. Date of OBDD concurrence of “Request for

Acquisition Exemption)     

2. Was the owner given a written notice of the local government’s intent to acquire the property and a description of the property owner’s rights under the Uniform Act?

☐ ☐ ☐ Date of Letter:      

3. Did fully informed owner sign donation agreement? (If yes skip to #17 below, if not continue with checklist.)

☐ ☐ ☐      

Estimated fair market value is less than $10,000.4. Was fair market value determined by a person

knowledgeable in property values?☐ ☐ ☐      

Estimated fair market value is $10,000 or more, or where the value is less than $10,000 by the owner has requested an appraisal.

5. Recipient entered into an agreement with an appraiser?

☐ ☐ ☐      

6. Was the owner invited to accompany the appraiser?

☐ ☐ ☐ Date of Letter:      

7. The appraisal was conducted? ☐ ☐ ☐      8. Grant recipient received appraisal report? ☐ ☐ ☐ Date of report:      

Estimated FMV:      9. Recipient entered into agreement with the review

appraiser?☐ ☐ ☐      

10. Grant recipient received review appraisal report? ☐ ☐ ☐ Date of report:      Estimated FMV:      

11. Did the review appraiser agree with the original appraiser?

☐ ☐ ☐      

12. If no, was there satisfactory resolution to the disagreement?

☐ ☐ ☐      

13. Owner was provided Just Compensation and purchase offer letter?

☐ ☐ ☐ Date of Letter:      

14. Was the initial offer no less than the approved appraisal of the fair market value?

☐ ☐ ☐      

15. Did the offer includes:      a. Amount of just compensation? (must equal the

appraised fair market value)☐ ☐ ☐      

b. Description and location identification of the property?

☐ ☐ ☐      

c. Identification of buildings, structures, and improvements considered part of the real property?

☐ ☐ ☐      

16. Was the owner paid promptly? ☐ ☐ ☐      17. Do the files contain a copy of the purchase

contract and documents conveying property?☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Comments18. Is there a copy of the settlement agreement

identifying incidental expenses and evidence that the owner received net proceeds due from sale?

☐ ☐ ☐      

19. If the case/s involve eminent domain / condemnation action, do the files contain documentation that the process followed meets federal and state law?

☐ ☐ ☐      

20. Title was recorded ☐ ☐ Date Recorded:      Complete for donations

1. Was owner informed in writing of his/her rights under the Uniform Act prior to agreeing to donate the property?

☐ ☐ ☐      

a. Where the acquisition would be of the “Not Subject To” type, was the owner informed that the property could not / would not be condemned, that it was not the only suitable site for the project, and that the owner was entitled to be informed about the estimated fair market value prior to negotiating a sale or donation?

☐ ☐ ☐      

b. Where the acquisition would be of the “Subject To” type, was the owner informed of his/her right to just compensation, based on an appraisal?

☐ ☐ ☐      

2. Did the owner waive his/her rights to an appraisal or estimate of fair market value (based on an appraisal) in writing? For Subject To transactions only

☐ ☐ ☐ Date waived:      

If no, was an appraisal obtained: ☐ ☐ ☐      (NOTE: An appraisal is not required where the evaluation problem is uncomplicated and the fair market value does not exceed $10,000)

3. If there was no appraisal because the recipient determined the value of the property to be less than $10,000, what documentation is there to support the determination?

☐ ☐ ☐      

4. Did the owner provide written consent that includes a statement that the owner understands that under the Uniform Act, he/she cannot be required to sell the property for the Community Development Block Grant project, for less than its appraised fair market value?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A CommentsConclusion: Does it appear that the acquisition process was conducted in conformance with the requirements of the Uniform Act?

☐ ☐ ☐      

Summarize the reasons for your opinion:

     

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Guide for Monitoring RelocationUse this checklist if the project involves relocation of tenants, homeowners or businesses. When reviewing for possible tenant relocation issues, it’s possible that the owner could have evicted a tenant or failed to renew a lease in order to sell the property as ”vacant” for the project. Since such tenants are entitled to relocation benefits, the circumstances surrounding any move from

the property during a 12-month period prior to sale must be considered.

YES NO N/A Comments1. Were any households or nonresidential persons

(businesses) displaced as a result of this project? ☐ ☐ ☐      

If yes, continue with question 2. If no, skip to the next section.2. Has the recipient clearly designated staff

responsible for compliance with displacement and tenant assistance requirements?

☐ ☐ ☐ Name:      

Phone #:      

3. Does the recipient have a copy of all pertinent regulations, notices, information booklets and relocation claim forms?

☐ ☐ ☐      

4. Were all households and non-residential persons (businesses) occupying buildings to be affected by the Community Development Block Grant project informed about their rights at the time the recipient submitted its grant application to the Oregon Business Development Department?

☐ ☐ ☐ Date of Letter(s) / notice(s):      Date of Letter(s) / notice(s):      Date of Letter(s) / notice(s):      Date of Letter(s) / notice(s):      

5. Identification of Occupants. Occupants include households (families and individuals) and nonresidential personsa. Does the recipient have records identifying all

households (by name, number of members, gross income, rent and utility cost, and number of bed-rooms) and other persons occupying the property on date of owner submission of application to recipient?

☐ ☐ ☐

Number of households:      Number of non-residential persons:      

b. Does the recipient have records identifying all households (by name, number of members, gross income, rent and utility costs, and apartment size) and other persons who moved into the property after owner submission of application but before completion of project?

☐ ☐ ☐

Number of households:      Number of non-residential persons:      

c. Does the recipient have records identifying all occupants and pertinent rents after completion of the projects?

☐ ☐ ☐ Number of households:      Number of non-residential persons:      

d. Is there an acceptable explanation of the cause of the move of any person that permanently relocated but was not displaced by the project?

☐ ☐ ☐ Number of households:      Number of non-residential persons:      

6. Records on Displacements. Persons forced to move permanently are considered “displaced.” Review a random sample of case file. For each case reviewed, is there:

a. A copy of timely general information notice? ☐ ☐ ☐      b. A copy of timely notice of eligibility for relocation

assistance?☐ ☐ ☐      

c. A record of personal contacts and advisory services provided?

☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Commentsd. Evidence of referrals to comparable or suitable

(affordable) replacement housing?☐ ☐ ☐      

e. A copy of 90-day advance notice of date by which move is required, if appropriate?

☐ ☐ ☐      

f. Identification of actual replacement property, rent / utility costs (if dwelling, and date of relocation)?

☐ ☐ ☐      

g. A copy of replacement dwelling inspection report and date of inspection?

☐ ☐ ☐      

h. Evidence that tenant received Section 8 voucher / certificate or cash replacement housing assistance?

☐ ☐ ☐      

i. An approved claim for, and evidence of receipt of, payment for moving expenses?

☐ ☐ ☐      

7. Records on Persons Not Displaced. Review a random sample of cases.a. For each case reviewed, is there a copy of timely

notice explaining that persons would not be displaced and pertinent information on after rehabilitation rents?

☐ ☐ ☐      

b. Is there evidence that each eligible tenant received a Section 8 certificate or housing voucher?

☐ ☐ ☐      

c. If temporary relocation or move within property was required, was person reimbursed for out-of-pocket expenses?

☐ ☐ ☐      

8. Has the recipient monitored the actions of the property owner to ensure compliance with any requirements for which the owner is responsible?

☐ ☐ ☐      

9. Has the recipient responded appropriately to any appeals or complaints?

☐ ☐ ☐      

10. Conclusion: Does it appear that relocation benefits were provided in compliance with the requirements of Section 104(d) and/or the Uniform Act?

☐ ☐      

Summarize the reasons for your opinion.

     

Describe technical assistance provided during monitoring and the corrective actions the recipient must take, if any, to resolve issues related to relocation requirements.

     

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

104(d) One for One Replacement and Relocation AssistanceYES NO N/A Comments

1. One for One replacement of occupied or vacant occupiable low and moderate income dwelling units.a. Is the unit a low income unit? (Rent and utilities is

below affordable rent, applies to rental and owner occupied units) For owner occupied units it is the rent the unit would command if it were available on the rental market)

☐ ☐ ☐      

b. Will the unit be demolished or converted to another use?

☐ ☐ ☐      

c. Is the unit occupied or vacant occupiable? (Vacant occupiable - The unit is standard, vacant and suitable for rehabilitation, or dilapidated but has been occupied within the last three months)

☐ ☐ ☐      

d. If you answered “yes” to items a-c above the unit must be replaced. Describe how the recipient intends to replace this unit.

     

2. 104(d) Relocation Assistance is the provision of certain relocation assistance to any lower income person displaced as direct result of the demolition of any dwelling unit or the conversion of a low and moderate income dwelling unit to a use other than a low or moderate income permanent residence.

a. Is the household income of the displaced person low income? (Low income household (not family) – household whose income is below 80% of median. Use the LMI income chart for the CDBG program.)

☐ ☐ ☐      

b. Will the unit be demolished or converted to another use?

☐ ☐ ☐      

c. If you answered “yes” to items a and b above, 104(d) tenant assistance must be provided. Describe how the recipient will provide this assistance.

     

Notes:1. Residents that are not considered to be low income are still protected by URA and must be evaluated for

relocation benefits under URA.2. Residents eligible to receive 104(d) tenant assistance are still protected by URA and must be evaluated for

relocation benefits under URA.3. If both URA and 104(d) applies tenant / resident must get both sets of notices required by each regulation.

Persons eligible for relocation benefits from both URA and 104(d) must choose one program to receive benefits under. They cannot receive benefits from both programs.

Conclusion: has recipient complied with the requirements of 104(d)?

☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Environmental (Part 58) Procedures – Limited Review for Non-construction

YES NO N/A Comments1. Who is the recipient’s certifying officer? (Name and

title)     

2. If this person is not a chief elected official, is there a “paper trail” that shows he/she has been officially designated to act as the certifying officer?

☐ ☐ ☐      

When?      3. Does the scope of the recipient’s environmental

review cover all activities in the “project” including those that are paid for entirely with local or other funds?

☐ ☐      

Exempt Activities: Use only for projects that used or needed to use an environmental exemption (Non construction activities, Planning, design, see GMH Chapter 3 page 8)

4. For projects with activities exempt from environmental review, is there a signed Finding of Exemption?

☐ ☐      

5. Was the Environmental Exemption signed and dated by the certifying officer prior to commitment of funds for these cleared project activities?

☐ ☐      

6. Does the Finding correctly cite the subsections of 24 CFR 58.34 which make each activity exempt?

☐ ☐      

7. Does the finding correctly cite 24 CFR 58.34(12) for categorically excluded activities that “loop into exempt”?

☐ ☐ ☐      

8. Does the finding cover all project activities? ☐ ☐      If the answer to 8 above is yes, do not complete the rest of this environmental section.

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Construction

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Environmental (Part 58) Procedures – Limited Review for Construction

YES NO N/A Comments1. Level of Environmental Review – Please select onea. Categorical exclusions not subject to 24 CFR 58.5—

24 CFR 58.35(b)☐ ☐      

b. Categorical exclusions subject to 24 CFR 58.5—24 CFR 58.35(a)

☐ ☐      

c. Environmental Assessment (Finding of No Significant Impact)—24 CFR 58.36

☐ ☐      

d. Environmental Impact Statement (Finding of Significant Impact)—24 CFR 58.37

☐ ☐      

2. Completed the appropriate checklist based on the level of environmental criteria?

☐ ☐ ☐      

3. Has the checklist been signed by the certifying officer?

☐ ☐ ☐ Date:      

4. Does the recipient have the following:

a. Copy of a published or posted Notice of Intent to File a Request for Release of Funds (NOI-ROF) or combined notice along with affidavit of publication record and records of any comments received (if any)?

☐ ☐ ☐      

b. Request for Release of Funds and Certification (RROF)?

☐ ☐ ☐      

c. Release of Funds (ROF) issued from Oregon Business Development Department?

Date of ROF:

☐ ☐ ☐      

d. Date when the construction contract was executed ☐ ☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Commentse. Was the construction contract executed after the

ROF date?If the answer is No, please immediately contact PPC

☐ ☐ ☐      

Environmental Mitigation Measures

1. Are there any mitigation measures identified in the Environmental review process? If so, what are they? Have they been addressed? When? Document the activities.

Note: If a project completed an Environmental Assessment, make copy of the mitigation measures from the Environmental Revie Record to incorporate with this monitoring form, provide the information if they have been addressed, when, by whom and gather the appropriate document.

☐ ☐ ☐      

Summary / Conclusion:

27. Is there any change in the project scope after the ROF was released?

If so, has proper ER update and notices been done?

☐ ☐      

29. Have Environmental Review requirements been met?

☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Environmental (Part 58) Procedures – In-DepthFloodplains & Wetlands

YES NO N/A Comments1. Did the recipient determine that: the proposed

action is located in wetland and/or the 100 year floodplain (500 year floodplain for critical actions)? Or

☐ ☐      

That it has the potential to measurably affect or be measurably affected by a floodplain or wetland?

☐ ☐      

If No, skip to the next section.2. Does the Environmental Review Record indicate

the following required alternatives have been evaluated:

☐ ☐      

a. Alternative sites outside the floodplain or wetlands?

☐ ☐      

b. Alternative actions which serve the same purpose, but which have less adverse impact?

☐ ☐      

c. Alternative of no action? ☐ ☐      3. Does the analysis demonstrate that the location of

the project in the floodplain is the only practical alternative?

☐ ☐      

4. Has the recipient designed or modified its own project action so as to:

     

Minimize harm to or within the floodplain? ☐ ☐ ☐      Minimize the destruction, loss or degradation of wetlands?

☐ ☐ ☐      

Restore and preserve natural and beneficial floodplain values?

☐ ☐ ☐      

Preserve and enhance natural and beneficial floodplain values?

☐ ☐ ☐      

5. Were the two required public notices published? ☐ ☐ ☐      Date of First Notice:      Date of Second Notice:      In what newspaper were the notices published?      

6. Compliance with the 8-step requirements does not constitute compliance with the Section 404 requirements, even if a Section 404 permit was obtained for the project. Has the recipient made a determination of Section 404 compliance?

☐ ☐ ☐      

7. Conclusion: Is there compliance with floodplain and wetland requirements?

☐ ☐      

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Management of Real Property“Real property” is defined as “land, including land improvements, structures and appurtenances, thereto, excluding movable machinery and equipment.” This section does not cover acquisition of real property. See Acquisition of Real Property (Land).

YES NO N/A Comments1. Has the recipient purchased, or improved any real

property with Community Development Block Grant funds in excess of $25,000?

☐ ☐ ☐      

If No, skip to the next section2. Does the recipient maintain records covering all

real property purchased or improved with grant funds?

☐ ☐ ☐      

3. Identify the real property:      4. What is the date that Community Development Block Grant funds

were first spent to acquire the real property? (Refer to the date the first cash request for construction funds was released by the Department.)

     

5. Do the recipient’s records contain a description of the property that includes the following? (Many times this information can be found in as-builts, O&M Manuals, on purchase orders, invoices, et cetera.)

a. Property description ☐ ☐ ☐      b. Identification number (if applicable, on equipment) ☐ ☐ ☐      c. Funding source (grant number) ☐ ☐ ☐      d. Title holder ☐ ☐ ☐      e. Acquisition date and cost ☐ ☐ ☐      f. Percentage of federal participation in the original

acquisition cost of the property (on drawdowns)☐ ☐ ☐      

g. Location, use and condition of property ☐ ☐ ☐      h. If applicable, disposition data ☐ ☐ ☐      6. Conclusion: Regarding management and

disposition of real property subject to federal rules, does the recipient meet the management requirements for real and personal property?

☐ ☐ ☐      

Community Development Block Grant Management Handbook – 2017Page 34 of 39

Page 35:  · Web viewGrant Management Handbook – 2017 Page 36 of 39 Community Development Block Grant Monitoring Checklist Project Type: Author Fumi Schaadt Created Date 01/03/2017 22:32:00

Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Labor StandardsNote: Do not complete this Labor Standards section for non-construction grants.

YES NO N/A Comments1. Who is designated by the recipient to ensure compliance with

labor standards? (Name and title)     

2. Does the recipient maintain records that include the following?      a. Contract documents which contain:      

The correct wage rates? ☐ ☐      HUD 4010(Federal Labor Standards provisions)?

☐ ☐      

b. Evidence of Oregon Business Department review of draft bid / contract documents ten days before advertisement?

☐ ☐      

Date of review:      Date of advertisement:      

c. Evidence of wage rate verification with Oregon Business Development Department ten days

☐ ☐      

Date of Bid Opening:      Date of verification:      

d. Evidence that the general contractor was cleared with Oregon Business Development Department prior to contract award?

☐ ☐      

Date of clearance:      Date of Contract award:      

e. Evidence of preconstruction conference or meeting with general contractor?

☐ ☐      

Pre-construction conference notes were sent to OBDD on:

     

Date of Preconstruction conference / meeting:      Date OBDD was informed of pre-construction conference (should be ten days before the conference was held):

     

f. Notification of Contract Award and Start of Construction sent to Oregon Business Development Department?

☐ ☐      

Date Notice of Contract Award and Start of Construction issued by grant recipient to the prime contractor:

     

g. Signed Contractor / Subcontractor Agreement forms for every construction subcontract?

☐ ☐ ☐      

h. Documentation that the recipient verified the acceptability of any, non-third party, fringe benefit with Oregon Business Development Department?

☐ ☐ ☐      

i. Apprentice / Trainee registration records? ☐ ☐ ☐      

Community Development Block Grant Management Handbook – 2017Page 35 of 39

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Commentsj. Weekly certified payroll reports from all

contractors?☐ ☐ ☐      

Note: These must be appropriate HUD forms, or BOLI reports with a statement of compliance, or other form (computer generated) with statement of compliance. All alternate forms used must contain all the information contained on the HUD form.

k. Evidence that payrolls were reviewed in a timely manner?

☐ ☐ ☐      

l. Evidence that additional classifications were requested, as necessary?

☐ ☐ ☐      

m. Evidence that any use of volunteers meets federal requirements?

☐ ☐ ☐      

n. Evidence that worker interviews were conducted? ☐ ☐ ☐      3. Enforcement: Did the recipient’s compliance investigations include:a. Checking for posted wage rate determinations and

the Davis Bacon poster?☐ ☐      

b. Checking that all payrolls are signed by the employer or an authorized representative?

☐ ☐      

c. Checking the contractor’s / subcontractor’s weekly payroll reports for correct rates of pay, including fringes and overtime?

☐ ☐      

d. Conducting worker interviews on-site no less than once a month for each month the project is under construction. The minimum requirement is: 1) At least one worker from every contractor on the job site; and, 2) interviews must be collected from different worker classifications.

☐ ☐      

Number of months the job was under construction:      Number of HUD-11 forms in file:      Number of contractors represented:      Number of trades represented:      Number of contractors that worked on the job site      

e. Is there evidence that the recipient has compared information from the worker interviews with the payroll reports?

☐ ☐      

4. Investigation of Violations

a. Were investigations conducted in a timely manner? ☐ ☐ ☐      b. Were records and documentation sufficient to

support the findings?☐ ☐ ☐      

c. Were appropriate cases referred to Oregon Business Development Department?

☐ ☐ ☐      

Community Development Block Grant Management Handbook – 2017Page 36 of 39

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

YES NO N/A Comments5. Follow-up Procedures

If labor standards deficiencies have occurred, have follow up procedures been agreed on to correct or improve performance?

☐ ☐ ☐      

(Examples: deadlines for documentation; of prior efforts; tickler systems; follow up letters; Oregon Business Development Department intervention with contractor; additional Oregon Business Development Department technical assistance; stop payments?)

6. Weekly Payroll Reports: The chart on the following page is to be completed by the Oregon Business Development Department reviewer. Enter information for one or more employee classifications from weekly payroll reports (both prime contractors and subcontractors). Use additional pages if necessary.

7. Conclusion: Does the recipient meet labor standards compliance requirements?

☐ ☐      

Community Development Block Grant Management Handbook – 2017Page 37 of 39

Page 38:  · Web viewGrant Management Handbook – 2017 Page 36 of 39 Community Development Block Grant Monitoring Checklist Project Type: Author Fumi Schaadt Created Date 01/03/2017 22:32:00

Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Payroll Week Ending

Contractor Employee Work Classification

Base / Fringe Rate

Required

Base / Fringe Rate

Paid

Payroll OK / not

OK

1-27-2001 ABCD Construction Contracting Joe Doe

Power Eq. OperatorGrp-1Zone-3

B-26.91F-8.20Z-3.00T-38.11

B-29.50F-7.20Z-1.41T-38.11

OK

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

                                

B-     F-     Z-     T-0.00

B-     F-     Z-     T-0.00

     

Use additional sheets if necessary.B - Base Wage Rate Z - Zone PayF – Fringe T – Total

Community Development Block Grant Management Handbook – 2017Page 38 of 39

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Exhibit 10A – Project Monitoring ChecklistFor Public Works & Community Facilities Projects

Federal Labor Standards Compliance Worksheet

Prime Contractor

Sub-contractor(s)

(If there are sub-contractors

identify their prime contractor)

Subcontractor

Agreement(s) &

Evidence of Attachment

Applicable Wage Rate & Mod #

Pre-Constructi

on Conferenc

e Date

Notice of

Award Form?

Proper Weekly Payroll Reports Submitt

ed

Statement of

Compli-ance *

Fringe Benefit Form

Total HUD 11

Forms

Number of

Trades Covere

d

Payrolls OK?(fill in after

completing Payroll

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

                                                                                                                       

* Was payroll report signed by president / owner? If not, is there a delegation form? If alternate payroll forms are used, a statement of compliance must accompany them.

Community Development Block Grant Management Handbook – 2017Page 39 of 39