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HomeMy WebLinkAboutExhibit 37. Capital Fund Program Annual Statement/Performance and Evaluation Report and Replacement Housing Factor Not applicable to PHA FL145 Annual Statement/Performance and Evaluation Report Capital Fund Program and Capital Fund Program Replacement Housing Factor (CFP/CFPRHF) Part I: Summary PHA Name: Grant Type and Number Capital Fund Program Grant No: _ Replacement Housing factor Grant No: Federal FY at Grant: ❑Original Annual Statement ❑Performance and Evaluation ■Reserve for Disasters/ Emergencies []Revised Annual Statement (revision no: ) Performance and Evaluation Report Report for Period Ending:._ ❑Final Line No. Summary by Development Account Total Estimated Cost 'T Total Actual Cost_ Original Revised Obligated Expended 1 Total non-CFP Funds 2 1406•Operations _ _ 3 1408 Management Improvements 4 1410 Administration 5 1411 Audit 6 1415 Liquidated Damages 7 1430 Fees and Costs 8 1440 Site Acquisition 9 1450 Site Improvement 10 1460 Dwelling Structures 11 1465.1 Dwelling Equipment. Nonexpendahle 12 1470 Nondwelling Structures 13 1475 Nondwelling Equipment . 14 1485 Demolition 15 1490 Replacement Reserve 16 1492 Moving to Work Demonstration 17 1495.1 Relocation Costs 18 1499 Development Activities 19 1501 Collaterization or Debt Service . 20 1502 Contingency 21 Amount ofAnnual Grant: (sum of lines 2 — 20) 22 Amount aline 21 Related to LISP Activities 23 Amount of line 21 Related to Section 504 compliance 24 _... Amount of line 21 Related to Security — Soft Costs - 25 Amount of Line 21 Related to Security — Hard Costs• 26 Amount of line 21 Related to Energy Conservation Measures Page 11 of 16 form IUD-50075-SA (04/30/2003) 7. Capital Fund Program Annual Statement/Performance and Evaluation Report and Replacement Housini Factor Not applicable to PHA FL145 Annual Statement/Performance and Evaluation Report Capital Fund Program and Capital Fund Program Replacement Housing Factor (CFP/CFPRHF) Part it: Supporting Pages PHA Name: Grant Type and Number Capital Fund Program Grant No: Replacement Housing Factor Grant No: _ Federal FY of Grant: Development Number Name/HA- Wide Activities General Description of Major Work Categories Dev. Acct No. Quantity Total Estimated Cost Total Actual Cost Status of Work v Original Revised Funds Obligated Funds Expended _ _ i . . r: , Page 12 of 16 form HUT)-50075-SA (04/3012003) 7. Capital Fund Program Annual Statement/Performance and Evaluation Report and Replacement Housing Factor Not applicable to PHA FL145 Annual Statement/Performance and Evaluation Report Capital Fund Program and Capital Fund Program Replacement Housing Factor (CFP/CFPRHF) Part HI: implementation Schedule PHA Name: _ Grant Type and Number Capital Fund Program No: Replacement Housing Factor No: Federal FY of Grant: Development Number Name/HA-Wide Activities All Fund Obligated (Quarter Ending Date) All Funds Expended (Quarter Ending Date) Reasons for Revised Target Dates Original Revised Actual Original Revised Actual Page 13 of 16 farm HUD-50075-SA (04/30/2003) 8. Capital Fund P roeram Five -Year Action Plan Not applicable to PHA FL145 Capital Fund Program Five -Year Action Plan Part T: Summary PHA Name ❑Original 5-Year flan ❑Revision No: Development Number/Name/ HA -Wide Year 1 Work Statement for Year 2 FFY Grant: PHA FY: Work Statement for Year 3 FFY Grant: PHA FY: Work Statement for Year 4 FFY Grant: PHA FY: Work Statement for Year 5 FFY Grant: PHA FY: CFP Funds Listed for 5-year planning Replacement Housing Factor Funds Page 14of16 form FHUD _50075-SA (04/30/2003) R. Capital Fund Program Five -Year Action Plan Not applicable to PHA FL145 Capital Fund Program Five -Year Action Plan Part II: Su 'porting Pages —Work Activities Activities Activities for Year 1 for Year : Activities for Year: FFY Grant: PHA FY: FFY Grant: PHA FY: Development Name/Number Major Work Categories Estimated Cost Development Name/Number Major Work Categories Estimated Cost Total CFP Estimated Cost Page 15 of 16 form HUD-5075-SA (04/30/2003) 8. Capital Fund Program Five -Year Action Plan Not applicable to PHA FL145 Capital Fund Program Five -Year Action Plan Part II: Supporting Pages :Work Activities Activities for Year : Activities for Year: FFY Grant: PHA FY: FFY Grant: PHA FY: Development Name/Number Major Work Categories Estimated Cost Development Name/Number Major Work Categories Estimated Cost • • Total CFP Estimated Cost $ $ Page 16 of 16 form HI1D-50075-SA (04/30/2003)