"Community Services Block Grant (Csbg) Disaster Supplemental - Stage 3, Longer Term Recovery Application Technical Assistance Template - Draft" - Florida

Community Services Block Grant (Csbg) Disaster Supplemental - Stage 3, Longer Term Recovery Application Technical Assistance Template - Draft is a legal document that was released by the Florida Department of Economic Opportunity - a government authority operating within Florida.

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Community Services Block Grant (CSBG)
Disaster Supplemental
Stage 3, Longer Term Recovery Application
Technical Assistance Template
Technical Assistance Notes: States apply for CSBG using the required form, CSBG State Plan,
OMB No.: 0970-0382. This form has been modified into this technical assistance template for
the purpose of the CSBG Disaster Relief Supplemental Funds under Public Law (P.L.) 116-20
(Additional Supplemental Appropriations for Disaster Relief Act,
2019).
To use this template, a state must have an accepted CSBG State Plan for federal fiscal year
2020 and have applied for and received a Stage 2 CSBG Disaster Supplemental grant.
Additional guidance regarding application requirements and instructions are provided in
CSBG
Information Memorandum (IM) 2020-156
and
CSBG Action Transmittal (AT) Disaster
Supplemental Stage 3 Application.
The disaster supplemental plan should not duplicate information from the CSBG State Plan
unless specifically requested.
An SF-424M, which is the official grant application form, must be provided as the cover page
for the application, in addition to the information outlined below.
Community Services Block Grant (CSBG)
Disaster Supplemental
Stage 3, Longer Term Recovery Application
Technical Assistance Template
Technical Assistance Notes: States apply for CSBG using the required form, CSBG State Plan,
OMB No.: 0970-0382. This form has been modified into this technical assistance template for
the purpose of the CSBG Disaster Relief Supplemental Funds under Public Law (P.L.) 116-20
(Additional Supplemental Appropriations for Disaster Relief Act,
2019).
To use this template, a state must have an accepted CSBG State Plan for federal fiscal year
2020 and have applied for and received a Stage 2 CSBG Disaster Supplemental grant.
Additional guidance regarding application requirements and instructions are provided in
CSBG
Information Memorandum (IM) 2020-156
and
CSBG Action Transmittal (AT) Disaster
Supplemental Stage 3 Application.
The disaster supplemental plan should not duplicate information from the CSBG State Plan
unless specifically requested.
An SF-424M, which is the official grant application form, must be provided as the cover page
for the application, in addition to the information outlined below.
Table of Contents
SECTION : CSBG Administrative Information...............................................................................3
1
SECTION : State Use of Funds......................................................................................................6
2
SECTION : Individual and Community Income Eligibility Requirements ....................................12
3
SECTION : CSBG Programmatic Assurances and Information Narrative ....................................14
4
SECTION : Federal Certifications ...............................................................................................31
5
SECTION 1: CSBG Administrative Information
Technical Assistance Note: Section 1 must be completed if the state’s administrative
information has changed since the Stage 2 application. If there have been no changes, the state
should indicate so and skip items 1.1 – 1.3.
State Administration Information (Check One)
 There has been no change to state administrative information for the CSBG Disaster
Supplemental (if applicable, bypass Section 1).
 The state administration information for the CSBG has changed (if applicable, please
complete Section 1).
1.1.
Designated Lead Agency: Provide the following information in relation to the lead
agency designated to administer CSBG in the state, as required by Section 676(a) of the
CSBG Act. The following information should mirror the information provided on the
Application for Federal Assistance, SF-424M.
1.1a. Lead Agency Florida Department of Economic Opportunity
1.1b. Cabinet or administrative department of this lead agency [Select one and provide
narrative where applicable]
 Community Affairs Department
 Community Services Department
 Governor’s Office
 Health Department
 Housing Department
 Human Services Department
 Social Services Department
 Other, describe:
1.1c. Cabinet or Administrative Department: Provide the name of the cabinet or
administrative department of the CSBG authorized official.
Florida Department of Economic Opportunity
3
1.1d. Authorized official of the lead agency
Instructional note: The authorized official could be the director, secretary,
commissioner etc. as assigned in the designation letter (attached under item
1.3). The authorized official is the person indicated as authorized representative
on the SF-424M.
Name
Mario Rubio
Title
Director of Division of Community Development
1.1e. Street Address
107 East Madison Street, Caldwell Building, MSC-400
Tallahassee
1.1f.
City
FL
1.1g. State
32399
1.1h. Zip Code
1.1i.
Work Telephone Number
(850) 717-8477
1.1j.
Fax Number
1.1k. Email Address
Mario.Rubio@deo.myflorida.com
1.1l.
Lead Agency Website
www.FloridaJobs.org
1.2.
Designation Letter: Attach the state’s official CSBG designation letter. If either the
governor or designated agency has changed, update the letter accordingly.
Instructional Note: The letter should be from the chief executive officer of the state
and include, at minimum, the designated State CSBG lead agency and title of the
authorized official of the lead agency who is to administer the CSBG grant award. The
letter may be the identical letter included in the accepted CSBG State Plan.
4
1.3.
Point of Contact: Provide the following information in relation to the designated state
CSBG Disaster Supplemental point of contact.
Instructional Note: The state CSBG point of contact should be the person that will be the
main point of contact for the CSBG Disaster Supplemental grant within the state.
Florida Department of Economic Opportunity
1.3a. Agency Name
1.3b. Point of Contact Name
Name
Debbie A. Smiley
Title
Bureau Chief
1.3c. Street Address
107 East Madison Street, Caldwell Building, MSC-400
1.3d. City
Tallahassee
1.3e. State
FL
1.3f.
Zip Code
32399
1.3g. Work Telephone Number
(850) 717-8467
1.3h. Fax Number
1.3i.
Email Address
Debbie.Smiley@deo.myflorida.com
5