Volunteers of America 4/12/2022 - Laserfiche WebLink

2020 CDBG-CV Agreement Exhibit C City of Everett Community Development Block Grant Program CARES Funds (CDBG-CV) Duplication of Benefits Reporting Form The Duplication of Benefits (DOB) Reporting form is used to assist the City of Everett in administering the Community Development Block Grant-CV to subrecipients. Forms will help to verify all funding an agency has received for COVID-19 Pandemic National Emergency in order to eliminate any duplication of benefits. You should only report on the information related to the program supported by this agreement. Instructions: Identify below all sources of active federal, state, or other public fund awards that the agency has received as a result of the COVID-19 Pandemic National Emergency to support the program within this agreement. If you received COVID-19 funds and they do not support the program receiving City of Everett CDBG-CV funds, please do not list them below. Source of Funds#1 Lender/Grant Provider Name EFAP Supplemental Equip. & Capacity Purpose Purchase of a new tractor for the redbarn community garden Amount $25,000 ❑Government Loan ® Government Grant ❑Government Forgivable Loan ❑ Nonprofit Grant ❑Nonprofit Loan ❑Nonprofit Forgivable Loan ❑Private Loan ❑Other:Click or tap here to enter text. Source of Funds#2 Lender/Grant Provider Name City of Sultan Purpose Updates needed to the food bank building in Sultan Amount $10,000 ❑Government Loan ® Government Grant ❑Government Forgivable Loan ❑ Nonprofit Grant ❑Nonprofit Loan ❑Nonprofit Forgivable Loan ❑Private Loan ❑Other:Click or tap here to enter text. Source of Funds#3 Lender/Grant Provider Name Click or tap here to enter text. Purpose Click or tap here to enter text. Amount Click or tap here to enter text. ❑Government Loan ❑ Government Grant ❑Government Forgivable Loan ❑ Nonprofit Grant ❑Nonprofit Loan ❑Nonprofit Forgivable Loan ❑Private Loan ❑Other: Click or tap here to enter text. Duplication of Benefits Reporting Form