Housing

CFP Application

Housing - Reaching Home Funding Streams

This application is for Housing Services, Prevention and Shelter Diversion, Client Support Services, Capital Investments, and Coordination of Resources and Data.

"*" indicates required fields

Which stream are you applying for?

Reaching Home Non-Designated Indigenous Stream

Reaching Non-Designated Home Rural and Remote Stream

Please fill out separate applications for separate projects

Funding Streams

NON-DESIGNATED INDIGENOUS AND RURAL AND REMOTE

Executive Summary

Applicant Name*

Project Name

Project Location

Total Project amount

RH contribution request

Other contribution

Priority area

Housing Services

Prevention & Shelter Diversion

Client Support Services

Capital Investments

Project Details and Summary

Community Needs

Partnerships and Community Supports

Measurable and Achievable Outcomes

Sustainability of the Benefits of the Project

Process to Measure success

Program History and Successes

Past Reaching Home Partnerships and Brief History

Environmental Impacts

Part 1 1.1 Organization Identification

Organization type

Individual

Private

Not for profit

Municipal

Indigenous

Legal Name

Phone Number

Fax Number

Mailing Address

Website Address

Contact Name and Title

Phone Number

Language of Correspondence

English

French

Incorporation Number (Charters/letters patent)

Incorporation Date

Business Number

GST Number

PST Number

Registered Charitable Tax Number

Tax refund percentage (GST)

From among the organization staff affected by the proposed activities, is any staff unionized?

Yes

Have you obtained union concurrence?

Yes

It is not required

Copy of Union Concurrence

Max. file size: 30 MB.

Organization’s main activities and mandate

1.2 Legal signing officers

Contribution Agreement (according to Letters Patent or other incorporating documents)

Number of Signatures

How many signatures are required to bind the applying organization into a legal agreement?

Position Title

From among these authorized signatures, what is the position title of the officer(s) whose signature is always required bind the applying organization into a legal agreement?

Title 1

Name

Specimen Signature

Title 2

Name

Specimen Signature

Title 3

Name

Specimen Signature

Payment Claims and other reports submitted

Number of Signatures

How many signatures should appear on applications for payment or reports submitted?

Position Title

From among these authorized signatures, what is the position title of the officer(s) whose signature is always required on payment claims or reports submitted?

Title 1

Name

Specimen Signature

Title 2

Name

Specimen Signature

Title 3

Name

Specimen Signature

1.3 Accounting Practices

Accounting is done

Internally

Externally

Bookkeeper's Name

Name of the external firm

(if applicable)

Telephone number

System

Manual

Computerized

Name of software used

What is the fiscal year-end of your organization?

Does your organization contract external auditors to conduct financial audits?

Yes

In the past three (3) years, has your organization been reviewed, audited, or investigated by the federal government, provincial government or another public body created under the law of a province?

Yes

Were there any irregularities or issues regarding your organization’s’ financial management practices?

Yes

Have those issues been resolved and measures diligently put in place to prevent reoccurrence?

Yes

Do you have liability insurance?

Yes

Insurance amount:

Worker’s Compensation Premium Rate (per $100)

1.4 Amounts Owing to Canada

Do you owe any amount to a Government of Canada department or agency?

Yes

Amount Owing

Nature of the amount owing

(i.e. tax, penalty, overpayment)

Government department or agency to which the amount is owing

1.5 Lobbying Efforts / Involvement of Public Servants

Are you presently a registered lobbyist?

Yes

Applicants are responsible for ensuring that any person lobbying on their behalf is registered with the Office of the Registrar of Lobbyists pursuant to the Lobbyists Registration Act. In addition, applicants who seek outside assistance to solicit, negotiate or obtain a contribution from the department may not pay a contingency fee for such assistance.

At the agreement stage, applicants requesting funding of $25,000 or more will be asked to declare the above requirements concerning the registration of lobbyists and contingency fees have been met.

Lobbyists may register online with the Office of the Registrar of Lobbyists (www.orl-gdl.gc.ca) free of charge. For further information, please contact the Office of the Registrar of Lobbyists by telephone at (613) 957-2760 or email at [email protected]

Has there been any involvement of past federal government public servants in the preparation of this proposal?

Yes

Applicants are responsible for declaring involvement of past federal government public servants in the preparation of their proposals as per the Values and Ethics Code for the Public Service. The Values and Ethics Code for the Public Service can be found at: http://www.tbs-sct.gc.ca/pol/doc-eng.aspx?section=text&id=25049

Part 2 – Project Details

Project Name

Length of Project

1 year ending March 31, 2023

2 year ending March 31, 2024

Location of Project activities (if different than applicant's mailing address).

Please indicate if the facilities for Capital Investment projects are owned or rented/leased (If rented or leased, a minimum 5-year lease and letter of support for project activities from landlord are required). Please provide documentation.

Max. file size: 30 MB.

Population size of community where project activities are to take place.

Project areas of activity

Emergency shelter facilities

Transitional housing facilities

Supportive housing facilities

Non-residential facilities

Please check the type of expense that applies to this project

Housing Services

Housing Placement

Emergency Housing Funding

Housing set-up

Other

Please specify

Prevention & Shelter Diversion

Discharge Planning Services

Help obtaining or retaining housing

Advice on budgeting, credit counseling and debt consolidation

Legal advice, advocacy, and legal representation in order to avert eviction

Moving costs

Short-term financial assistance to help avert eviction or loss of housing with rent, rental arrears, utility deposits or payments

Other

Please specify

Client Support Services

General Client Supports

Clinical and treatment services

Economic integration services

Social and community integration services

Other

Please specify

Capital Investments

Renovation of emergency shelters, transitional housing, permanent supportive housing, or non-residential facilities

Repairs of damages resulting from housing placements

New construction of transitional or permanent support housing, or non-residential facilities

Purchase of transitional housing, permanent supportive housing, or non-residential facility

Purchase of furniture, appliances, machinery, electronic equipment, and vehicles

Professional fees

Other

Please specify

Project details and summary. Must include project activities and links to Project Areas of Activity selected in section "Population Size of Community"

Project timeline and work plan descriptions

Community Needs (what are your community needs and how your activities will meet these needs)

Partnerships and community supports on this project. Include at least 2 letters of support with the application.

Max. file size: 30 MB.

List any partner organizations, businesses, institutions, or other funding agencies that you have approached or will approach to provide funding for this project.

Measurable and achievable outcomes and outputs and expected results.

The sustainability plan must demonstrate how the benefits of the project will be sustainable and activities maintained after Reaching Home funding ends. If an exit strategy forms part of the sustainability action plan, then the exit strategy must demonstrate a minimum amount of disruption to clients.

Process to measure success.

Program History and Successes (description of specific program that is connected to proposed project and past successes of this program)

Please discuss past Reaching Home (formerly HPS) partnerships with brief project and funding details.

Environmental impacts (if applicable).

Part 3 – Beneficiaries

Please provide information on the client groups (those who are homeless and those at risk of homelessness) served as part of your project. Please check all that apply.

Housing Status

Chronically Homeless

History of Chronic Homelessness

Chronically Homeless – Individuals with a total of at least 6 months (1180 days) of homelessness over the past year or recurrent experiences of homelessness over the past 3 years, with a cumulative duration of at least 18 months (546 days)
History of Chronic Homelessness – must be currently permanently housed through a housing first program or exiting an institution

Gender

General population

Male

Female

Transgender

Ages

General population

Children (0-14)

Youth (15-30)

Adults (31-64)

Seniors (65+)

Special Needs

General population

People with addictions

People with disabilities or mental health issues

People with HIV/AIDS

Families

Victims of domestic violence

People who identify as LGBTQ

Reported % of total people served

Aboriginal peoples

Immigrants

Refugees

Veterans

Part 4 – For Capital Investment Projects Only

This section must be completed by all applicants seeking funding for capital investment projects to ensure that their application and sustainability plan address all the key elements required of an eligible capital project. This section contains elements that will be verified during the selection process by Community Advisory Board.

Long-term benefit for the community

Indicate how the purchased equipment or furniture, or renovated facility, will remain in the long term for the benefit of individuals who are homeless or at imminent risk of homelessness?

Operation for five years after the project ends

Indicate the operational impacts of the project (i.e., additional staff or services needed once the project is completed or additional demand for health and social services?).

What are the relevant and related operational costs identified for the project? (Include any costs related to additional staff and service requirements).

Show what operational funding sources will cover the total operating costs related to the project? (i.e., a balanced annual operating budget for five years following the end date of the project).

Identify all the partners and operational funding sources identified in the sustainability plan?

Have you read and do you understand the Capital Investment Sustainability Requirements from the Application Guide, and have you completed the Sustainability Checklist?

Yes

Legal Signatory Name

Title

Date

Consent

I hereby declare that the information provided is true and correct

Legal Signatory Name

Title

Date

Consent

I hereby declare that the information provided is true and correct

Legal Signatory Name

Title

Date

Consent

I hereby declare that the information provided is true and correct

Legal Signatory Name

Title

Date

Consent

I hereby declare that the information provided is true and correct

Part 5 – Project Funding Details

Reaching Home (formerly HPS) funding Contribution requested amount

Other sources of contribution

Total project amount

Contributors

Please name all matching cash and in-kind contributions to the project, summarize partner roles/responsibilities and financial or in-kind contribution value.

Include all partner organizations, government agencies (of any level – federal, provincial, municipal), businesses, non- profits, individuals, or others as well as partnership letters as per the Application Guide instructions. Do not include contribution partners of your organizations’ operational budget. Only include contributors or partners of the project proposed for Reaching Home funds.

Contributor

Type of Organization

Roles and Responsibilities

Financial or In-Kind Value

Total project amount of Financial and In-Kind Contributions from All Sources

Mandatory Supporting Documents required. Letter(s) of commitment are required to confirm contributions declared in this application form as part of the financial and/or activity reporting.

Part 6 – Budget Negotiation Notes

Legal Name of organization

Proposed Project Name

EXPENDITURE CATEGORIES

There are 8 cost categories for all project costs. All costs must be linked to project activities included in the proposal and to functions that are project specific. For example, wages/salaries of project staff are in Category 1(i.e., project managers, case managers, housing placement workers, data co-ordinator), and wages/salaries of head office management are in category 8 (payroll, HR, admin). Reimbursement will be supported by invoices (payroll and/or travel claims, as appropriate) and will be subject to monitoring and audit. Examples of costs for which a contribution can be considered include, but are not limited to:

6.1 Staff Wages

Staff Wages

Staff Wages includes Mandatory Employment Related Costs (MERCs) which refer to payments an employer is required by law to make in respect of its employees such as EI and CPP/QPP premiums, workers’ compensation premiums, vacation pay and Employer Health Tax.

Details

(i.e., hourly rate, number of hours, number of weeks, MERCs) by position.

Benefits

Benefits which refer to payments an employer is required to make in respect of its employees by virtue of company policy or a collective agreement. Examples of Benefits include contributions to a group pension plan or premiums towards a group insurance plan, extended illness and maternity leave, termination pay where warranted by provincial employment standards and organizational policies in existence at the time, severance pay where warranted by provincial labour standards, etc.

Details

Sub-Total 6.1: Staff Wages

6.2 – Professional Fees

Professional fees

Professional fees – sub-contracting contracted specifically to support the project (e.g., bookkeeping, janitorial services and supplies, community plan facilitator, information technology, equipment maintenance services and security. Legal fees are noted separately below); all fees related to the purchase, pre-development, construction, or renovation of facilities are noted in Category 5: Facilities.

Details

Legal fees

e.g., allowance for costs related to review of lease for new project site premises

Details

Sub-Total 6.2: Professional Fees

6.3 – Travel

Travel Costs

Staff and volunteer travel directly linked to assisting clients (e.g., housing placement or mobile counseling); travel for meetings and networking is noted in Category 7: Administrative Costs

Details

Provide details (i.e., means of transportation, number of kilometers, KM’s rate)

Sub-Total 6.3: Travel

6.4. Capital assets (except facilities)

Capital Assets

Capital assets of more than $1,000 (excluding taxes). By default, all capital assets remain the property of the Recipient at the end of the project, unless an agreement for their disposition is prepared. List all capital asset purchases.

Details

Provide list of individual assets and specify which will not remain with the recipient at the end of the project.

Furniture of more than $1,000 excluding taxes

Details

Appliances of more than $1,000 excluding taxes

Details

Sub-Total 6.4: Capital assets (except facilities)

6.5 Facilities (capital investments)

Proof of market values are required.

Cost of purchasing land and/or building(s)

Including refundable deposits

Details

Provide details of market value of property.

Construction or renovations to facilities

Costs of labour and materials, general contractors, professional fees for project management, site supervision and inspections

Details

Provide details of preliminary cost estimates for the construction or renovation and market value of property.

Pre-development costs

Property zoning and assessment fees, environmental assessments, architectural drawings and advice, engineering drawings and advice, building permits, licenses, and taxes

Details

Provide details of the different professionals involved and their fees

Sub-Total 6.5: Facilities (Capital investments)

6.6 Other Activity Related Project Costs

This includes costs directly associated with the project activities that are not included in any other budget category.

Rent, lease

Rent, lease (including applicant owned premises) and repairs, leasehold improvements

Details

Furniture costing $1,000 or less, excluding taxes

Details

Staff disability supports

Details

Staff training

Details

Conference attendance fees

Details

Conference costs

Meeting room rental, guest speakers, etc.

Details

Signage

Details

Utilities

Details

Equipment lease, rental, or purchase

Including computers, fax machines, etc.; meter charge for photocopies, repair and maintenance cost item are included in cost type 7: Administrative Costs

Details

Computer software and licenses

Computer software and licenses directly related to delivering project activities including those that support the use of a client tracking system

Details

Costs associated with use of applicant-owned assets other than premises

e.g., computers and other equipment, furniture, etc.

Details

Memberships

Professional and organizational, affiliation fees and business licenses and permits

Details

Advertising

Newspaper ads, flyer production, web page design etc.

Details

Reference materials

Books, periodicals, subscriptions, etc.

Details

Telephone and/or fax line installation and charges

Details

Internet installation and monthly fees

Details

IT maintenance

Details

Printing

Details

Staff professional development

Courses required by staff to ensure the success of the project, must not be part of the routine development courses required by the organization’s policies

Details

Postage

Details

Costs related to transition/wind-down

Termination and/or severance pay, other HR related costs, penalties for breaking leases, etc.

Details

Materials and supplies

e.g., food supplies, laundry supplies, cleaning supplies, personal or household items for facilities that house homeless people, office supplies for the facility

Details

Participant related costs:

Expenses associated with the participants/clients of a particular project.

Please note: for Reaching Home, these costs cannot be paid directly to clients (for example, in the case of a rent payment to avoid eviction, the recipient would reimburse the landlord directly). Reimbursement will be supported by invoices and will be subject to monitoring and audit. The following participant related costs are part of this expense category #6: Other Activity Related Costs, and may include, but are not limited to:

Housing Emergency assistance

e.g., rent and utilities

Details

Living expenses for individuals

e.g., vouchers for food, clothing, grocery, baby diapers, eyeglasses; items that remains with clients

Details

Disability related supports

Details

Disability related incremental costs

Details

Professional fees

Fees related to participants/clients- contracting, sub-contracting (e.g., vocational assessments, needs assessments)

Details

Dependent care

Details

Materials and supplies, household items that remain with the participant/client

Details

Travel associated with participants / clients

e.g., bus tickets

Details

Sub-Total 6.6: Other Activity Related Project Costs

6.7 Administrative Costs (Administration)

Insurance (fire, theft, liability) and extended warranties

Details

Telephone and/or fax line installation and charges

Details

Internet installation and monthly internet fees

Details

IT maintenance

Details

Postage and courier

Details

Operational printing contracted externally

Business cards, letterhead, printing of organizational or project brochures, etc.

Details

Equipment repair and maintenance

Equipment repair and maintenance associated with everyday upkeep not covered by a lease or service contract (includes photocopy meter charges)

Details

Staff professional development

Staff professional development - to cover basic training needs as per organization’s existing policies; employment related requirements, which can include, but is not limited to, health and safety, first aid, CPR, self-defense, crisis intervention, anti-racism, sensitivity, conflict resolution, etc.

Details

Office supplies

Pens, paper, envelopes, subscriptions

Details

Bank charges

Details

Other non-participant-based costs

e.g., staff and volunteer recognition

Details

Staff and volunteer travel for meetings or networking

Does NOT include monthly parking fees; travel to assist participants is noted in cost type 6 (Other Activity Related Project Costs

Details

Computer software and/or license renewals and upgrades

Details

Sub-total 6.7: Administrative Costs

6.8 Organizational Infrastructure Costs (Administration)

Also known as centralized administrative costs, these are expenses incurred for "main office", "head office", or "administrative office" of the Recipient, which guide and enable effective program delivery and contribute to the success of the project by providing support through overall organization governance, management, planning, finance, communications, human resources, and information technology. These are costs related to functions which are not project specific. For example, wages/salaries and related office costs of management or other staff whose time is not spent specifically on management or delivery of project activities (i.e., CEO, HR department, Finance group, Administration section etc.) Expenses associated with the project under this heading can be included in payments that are based on a formula.

Staff wages and MERCS for staff working only indirectly on the project

Details

Benefits and other HR costs

See Section 1 for $ details

Details

Rent, lease

Including applicant owned premises and minor repairs and leasehold improvements

Details

Utilities

Details

Furniture

Details

Signage

Details

Equipment purchase, lease, or rental (including computers)

Details

Costs associated with use of applicant-owned assets other than premises

e.g., computers and other equipment, furniture, etc.

Details

Equipment maintenance and repairs

Details

Computer software and licenses

Details

Professional fees – contracting

e.g., bookkeeping, janitorial services, IT, equipment maintenance services, security

Details

Staff disability supports

Details

Telephone costs

Details

Postage and courier

Details

Internet costs (web page design, etc.) and other IT requirements

Details

Printing costs

Details

Advertising costs

Details

General insurance

e.g., directors’ liability insurance

Details

Travel associated with staff of the head office and board members (based on travel claims)

Details

Training and development costs (volunteer and staff)

Details

Office supplies

Details

Bank charges

Details

Memberships and affiliation fees (professional, inter- and intra-organizational, etc.)

Details

Sub-total 6.8: Organizational Infrastructure Costs

TOTAL Reaching Home COSTS

OTHER SOURCES OF FUNDING

Detail the cash and in-kind contributions from other sources (Organizations, amount of contribution, nature and value of contribution, purpose of funding)

Cash

Details

In-Kind

Details

TOTAL OTHER SOURCES OF FUNDING

TOTAL PROJECT COSTS

TO BE COMPLETED BY COMMUNITY ENTITY

Are administrative expenses (Sub-totals 7 and 8) within the 15% of the HRSDC contribution?

Yes

Explanation

Are wages within the prevailing wage labour rate for this occupation in the community?

Yes

Comments

Part 7 – Submitting your Funding Application

A) Checklist

For your application to be considered for funding, it must include the following:

Application Form completed and signed by a Legal official representative(s) appointed by the organization

Budget Negotiation Notes Part 6

Letters of support from the community (Minimum of 2 letters)

Letters of commitment from funding partners. See Application Guide for sample letter

Property title or lease/rental agreement documentation including letter of support from landlord/property owner (for capital investment projects only)

B) Declaration

Must be signed by as many persons as required by the organization’s statutes or by-laws.

I declare that I am legally authorized to sign and submit this Application on behalf of the Organization named in Section 1.
I declare that the information provided in this Application and supporting documentation is true, accurate, and complete to the best of my knowledge.
I understand that if the information described above is false or misleading, I or the Organization may be required to repay some or all of the funding received.
I declare that the Organization and any person lobbying on its behalf is in compliance with the Lobbying Act, R.S.C., 1985, c. 44 (4th Supp.) and that no commissions or contingency fees have or will be paid directly or indirectly to any person for negotiating or securing this request for funding.

Declarations

Legal Signatory Name

Title

Date (dd-mm-yy)