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PROJECT APPROVAL INFORMATION: <br />Yes <br />No <br />N/A <br />1. Does the applicant levy the following tax revenues? <br />Local Property (Ad Valorem) Tax: <br />❑ <br />❑ <br />❑ <br />Local Sales Tax Option <br />❑ <br />❑ <br />❑ <br />2. Does the assistance require State or local advisory clearance or review through the Texas Review and Comment <br />❑ <br />❑ <br />❑ <br />System: <br />3. Will the assistance requested serve or be located on a Federal Installation? <br />M <br />F-I <br />F-I <br />4. Will the assistance requested have any negative impact(s) or effect(s) on the environment? <br />1:1 <br />El <br />El <br />Note: All funded applications will have to comply with Federal regu/ations regarding environment dearance before funds are released. <br />5. Is the project in a desigated flood hazard area? <br />❑ <br />❑ <br />❑ <br />6. Will the assistance requested cause the displacement of families, individuals, farms, or businesses? <br />F-I <br />El <br />M <br />7. Will the applicant or the service provider in the application levy any tap fees, capital recovery fees, or access fees, <br />F-I <br />F-I <br />F-I <br />on the beneficiaries? <br />(Special assessmeni cosrs for low/moderate income persons mus[ be included in ihe TxCDBG application. At a <br />minimum, rhese costs musi be paid for very low income persons.) <br />8. Has the applicant obtained a ratified, legally binding agreement, contingent upon award, between the applicant <br />and the service provider that will operate the project for the continual operation of the improvements as proposed <br />in the application? <br />9. Does the applicant or service provider currently hold the Certificate of Convenience and Necessity (CCN) for the <br />❑ El ❑ <br />target area proposed in the application? <br />10. As evident through close-out reporting and monitoring, have the activities or services from past TxCDBG contracts <br />" <br />" <br />❑ ~ ~ <br />if there have been no prior contracts.) <br />N/A <br />been made available to low / moderate income persons? (Choose <br />11. The applicant certifies that financial records for the proposed project will be kept at an offically designated city / <br />county site, accessible by the public, and will be adequately managed on a timely basis using generally accepted <br />E] 1:1 El <br />accounting principles? <br />12. Has the applicant chosen local staff designated to administer or work on the proposed project? <br />F-I El El <br />Page 4 of 16 <br />. 000092 <br />