City of Oakland
Community and Economic Development Agency
OAKLAND MULTIFAMILY HOUSING WEATHERIZATION PROGRAM
APPLICATION CHECKLIST
DATE APPLICATION SUBMITTED:
AMOUNT OF FUNDS REQUESTED1:
APPLICANT:
PROJECT NAME (IF ANY):
PROJECT ADDRESS:
NUMBER OF UNITS:
A. REQUIRED ITEMS
1.
Multifamily Housing Weatherization Program Application (see attachment)
2.
Statement of Need/Proposed Project (see instructions for requirements)
3.
Resume(s) of Key Staff (see instructions for requirements)
4.
Operating and Replacement Reserve Balances
B. OPTIONAL ITEMS
5.
Evidence of Income Eligibility 2
6.
Tenant Energy Burden 2
7.
Tenant Demographic Data 2
8.
Project Budget/Sources2
9.
Property Annual Operating Budget 2
10.
Property 20-Year Cash Flow 2
11.
Most Recent PNA/CNA 3
1
2
3
Final funding awards will be based upon available funds and results of an Energy Audit
Will be required before funding is awarded
Only if available
Rev. 12/09/10
City of Oakland
Community and Economic Development Agency
OAKLAND MULTIFAMILY HOUSING WEATHERIZATION PROGRAM
APPLICATION INSTRUCTIONS
Complete and submit all required items listed on the Application Checklist (see previous page).
Complete a copy of the checklist and submit it with your application.
Items listed as optional are not required at this time. However, they will be required before projects
receive funding.
Deliver completed applications to:
Community and Economic Development Agency
Oakland Multifamily Housing Weatherization Program
250 Frank Ogawa Plaza, Suite 5313
Oakland, CA 94612
attn: Housing Development Unit
APPLICATIONS MUST BE RECEIVED NO LATER THAN
FRIDAY, FEBRUARY 18, 2011 AT 5:00 PM
Applications will be reviewed on a first-come-first-served basis.
Rev. 12/09/10
A. REQUIRED ITEMS
All applicants are required to submit the following items for review:
1. Project Data & Applicant Information
Complete, to the best of your ability, the attached Program Application Form. Provide information
about the existing condition of the building in Section VI - “Initial Feasibility Assessment,” to the
best of your ability based on available information. You may provide the property’s most recent
PNA or CNA in lieu of completing this section.
2. Statement of Need/Proposed Project
Provide a brief summary stating the following:
1. Describe the property’s needs for energy efficiency improvements.
2. Describe any energy efficiency upgrades previously completed on the property.
3. Describe, to the best of your ability, the proposed energy efficiency scope of work and specify
how you believe funds from this program will be utilized. If the energy efficiency upgrades are
part of a larger rehab, describe the other rehab work and how you anticipate it will be funded.
(Note that the final scope of work for this program will be determined by the availability of
funding and the results of an Energy Audit).
3. Resume(s) of Key Staff
Submit resumes for the key staff who will be involved in this project. Specify one person who will
be responsible for managing the project (i.e., who will be the main point of contact for City staff,
energy auditors, contractors, etc.).
4. Operating and Replacement Reserve Balances
Provide current statements showing operating reserve and replacement reserve balances.
B. OPTIONAL ITEMS
The following items are not required at this time; however, projects selected for funding will be
required to submit all of the following before receiving a final award:
1. Evidence of Income Eligibility
Submit a current rent roll showing tenant income by unit which confirms the property contains 15 or
more units with households that have incomes at or below 75% of State Median Income (see
http://www.csd.ca.gov/Programs/EnergyIncomeGuidelines.aspx).
NOTE: You do not need to provide a rent roll if the subject property is on the HUD/DOE prereviewed list of eligible projects and therefore is categorically eligible under DOE Rule 71-CFR3847 (see http://www1.eere.energy.gov/wip/multifamily_guidance.html).
2. Tenant Energy Burden
Provide documentation of 12 months of tenant energy (electricity and gas) costs in one of the
following forms:
Rev. 12/09/10
a. For master metered properties, total energy costs prorated across units, or calculated energy
costs based on current HUD utility allowance rates.
b. For individually metered properties, provide individual PG&E account numbers for tenants
and consent for the City of Oakland to access tenant utility data directly from PG&E. (You
may also submit individual tenant utility bills for the preceding 12 month period, however,
please contact CEDA staff before collecting individual utility bills to review program
requirements.)
3. Tenant Demographic Data
Provide the number of tenants who fall in each of the following categories:
- Age 2 yrs. & under
- Ages 3-5
- Ages 6-18
- Elderly (60+)
- Disabled
- Native American
- Limited English Speaking
4. Project Budget/Sources
Provide a line-item budget for the proposed project. Indicate amount of each line item paid for by
this program versus other funds. See the Multifamily Weatherization NOFA for additional
information regarding Eligible Program Activities, or contact CEDA staff for guidance. A template
budget is available upon request.
5. Annual Operating Budget
Provide the current full year operating budget for the project. A template budget is available upon
request.
6. Property 20-Year Cash Flow
Provide a 20-year projection of the property’s cash flow (including- at minimum- income, vacancy
loss, operating expenses, debt service, and reserves). A template cash flow is available upon request.
7. Most Recent PNA/CNA
Provide the property’s most recent Physical Needs Assessment or Capital Needs Assessment. This
item is only required if the report is available – applicants are not required to complete a PNA or
CNA specifically for this program. However, if not providing a PNA or CNA, you must complete
Section VI - “Initial Feasibility Assessment” in the Program Application Form.
Rev. 12/09/10
City of Oakland
Community and Economic Development Agency
OAKLAND MULTIFAMILY HOUSING WEATHERIZATION PROGRAM
PROGRAM APPLICATION FORM
I. APPLICANT INFORMATION
1. Applicant Name
2a. Address
2b. City
2c. State
2d. Zip Code
CA
3a. Contact Person
3b. Title
3c. Email
3d. Phone
4a. Person who will manage project (if different than above)
4b. Title (if different than above)
3e. Fax
4d. Percentage of the person’s total workload that this project will occupy
%
II. PROPERTY INFORMATION
1a. Name (if applicable)
2a. Address
2b. City
2c. State
Oakland
CA
3. Age of Structure/Year Built
/
4. Parcel No.
6. Total Square Footage (if available)
sq ft
7. Commerical Square Footage (if applicable/available)
sq ft
8. Council District
9. Redevelopment Area (if applicable)
10. Target Population
2d. Zip Code
5. Number of Stories
11. Total Units
ex. "Family," "Senior," "SRO"
12. Number/Type of Units
XX Studio, XX 1BR, XX 2BR, XX 3BR
Rev. 12/09/10
13. % Affordable Units
III. PROPERTY MANAGEMENT INFORMATION
1. Property Management Company
2a. Address
2b. City
2c. State
2d. Zip Code
CA
3a. Contact Person
3b. Title
3c. Email
3d. Phone
IV. FUNDING INFORMATION
1. Estimated WAP Funds Requested
(final awards will be based on the results of an Energy Audit)
2. Estimated Total Cost of Project
$
$
3. Has project previously been awarded City or
Redevelopment Agency Funds?
Yes
No
4. Is project willing and able to take on debt?
5. List existing sources of financing on the property:
6. List expected sources of funds (if any) other than
this program:
(if other funds will be used to finance the project)
Yes
No
Don’t know
V. PROJECT INFORMATION
1. Will the project be occupied during construction?
Yes
No
2. Will the project require tenant relocation?
Yes
No
Don't know
3. Proposed construction start date:
4. Proposed construction completion date:
5. Will the project disturb hazardous materials (lead, asbestos)?
Yes
No
Don't know
6. Is project currently under development or anticipating rehab/renovation?
Yes
No
Rev. 12/09/10
VI. INITIAL FEASIBILITY ASSESSMENT
INSTRUCTIONS
Provide as much of the following information as possible about the current condition of the property. If
information is unknown or unavailable, leave blank or describe to the best of your ability in comments.
Describe any notable or extraordinary conditions. Items marked with an asterisk (*) are required.
CHECK HERE IF PROVIDING A PNA OR CNA IN LIEU OF COMPLETING THIS SECTION
METERING
Electrical Metering*:
Gas Metering*:
Master
Master
For master metered properties:
Est. average monthly elec. cost per unit:
Est. average monthly gas cost per unit:
ENVELOPE
Construction Type:
Wall Insulation:
Attic Insulation:
Condition:
WINDOWS
Glazing:
Individual
Individual
Comments:
Comments:
$
$
Comments:
Comments:
ex. "Wood," "Masonry," "Steel"
Yes
Yes
Good
No
No
Fair
Don't know
Don't know
Poor
Frame:
Weatherstripped:
Caulked:
Condition:
Approx. Age:
Double
Coated
Wood
Yes
Yes
Good
years
Single
Uncoated
Metal
No
No
Fair
DOORS
Weatherstripped:
Condition:
Approx. Age:
Yes
Good
years
No
Fair
DOMESTIC HOT WATER
Fuel Source:
Gas
Type:
Central
Condition:
Good
Pipe Insulation:
Yes
AFUE:
%
Approx. Age:
years
Rev. 12/09/10
Vinyl
Poor
Poor
Electric
Individual
Fair
Poor
No
Don't know
Don't know
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
SPACE HEATING
Fuel Source:
Type:
Condition:
Pipe Insulation:
Thermostats:
AFUE:
Approx. Age:
Gas
Electric
Central
Individual
Furnace
Boiler
Good
Fair
Yes
No
Programmable
%
Don't know
years
SPACE COOLING
Type:
None
Thru-Wall
Thermostats:
Condition:
Approx. Age:
Central
Window
Fan Coil
Manual
Programmable
Good
Fair
Poor
years
VENTILATION
Exhaust Fans:
Central
Areas Served:
Kitchen
Control:
Manual
Ducted to Outdoors:
Yes
Comments:
Comments:
Other Comments:
Poor
Comments:
N/A
Comments:
Manual Comments:
Comments:
Comments:
Individual
None
Bathroom
Other
Automatic
None
No
Don't know
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
LIGHTING
Indicate lamp wattage and type if known (e.g., 40W T12, 32W T8, 23W CFL)
Units
Type:
Energy Star:
Fluorescent
Yes
No
Hallways/Common Areas:
Type:
Fluorescent
Energy Star:
Yes
No
Control:
Manual
Timer
APPLIANCES
Refrigerators:
Ranges:
Clothes Dryers:
Clothes Washers:
Rev. 12/09/10
cu. ft.
N/A
N/A
N/A
Incandescent
Don't know
Comments:
Comments:
Incandescent
Don't know
Occupancy Sensor
Always On
Comments:
Comments:
Comments:
Comments:
Energy Star
Gas
Gas
Energy Star
Comments:
Electric Comments:
Electric Comments:
Comments:
VII. ATTACHMENTS
PLEASE ENSURE THE FOLLOWING REQUIRED DOCUMENTS ARE ATTACHED:
Statement of Need/Proposed Project
Resume(s) of Key Staff
Operating and Replacement Reserve Balances
VIII. SIGNATURE
I have read and understand the contents of the Oakland Multifamily Housing Weatherization Program NOFA
and Application. I understand that this program is subject to the regulations and authority of the U.S.
Department of Energy (DOE), American Recovery and Reinvestment Act (ARRA), California State Department
of Community Services and Development (CSD), and City of Oakland Community and Economic Development
Agency (CEDA). I understand that final awards will be based on availability of funds and the results of an
Energy Audit, and that additional information may be required before funding is awarded. I certify that the
information submitted in this application is true and correct.
Signature of Applicant
Print or Type Name
Rev. 12/09/10
Date
Title