{"text_format":"1","workbook":"xlsx","n_sheets":4,"sheets":["1. Request For Funds","2. Expenditure Report","3. Expenditure Details","RFF Version 06.2020"],"not_rendered":{"charts":0,"images":3,"macros":1,"external_links":0,"defined_names":3,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"1. Request For Funds","index":0,"n_rows":46,"n_cols":32,"rows_kept":46,"cut":false,"hidden":false,"merged":[[45,6,45,12],[15,1,15,6],[18,4,18,5],[18,6,18,7],[18,8,18,9],[18,12,18,13],[18,10,18,11],[41,0,41,8],[41,9,41,15],[42,0,42,15],[21,0,21,1],[21,2,21,3],[21,4,21,5],[21,6,21,7],[21,8,21,9],[40,9,40,15],[19,0,19,1],[19,2,19,3],[19,4,19,5],[19,6,19,7],[18,14,18,15],[19,12,19,13],[19,14,19,15],[19,10,19,11],[19,8,19,9],[15,10,15,15],[15,7,15,9],[16,0,16,9],[16,10,16,15],[18,0,18,1],[18,2,18,3],[17,0,17,15],[14,7,14,9],[0,0,0,5],[2,0,2,1],[3,0,3,1],[5,0,5,1],[13,1,13,6],[14,1,14,6],[7,0,8,15],[1,0,1,3],[10,1,10,6],[10,10,10,15],[10,7,10,9],[11,7,11,9],[12,7,12,9],[11,1,11,6],[12,1,12,6],[11,10,11,15],[12,10,12,15],[13,10,13,15],[14,10,14,15],[13,7,13,9],[20,14,20,15],[20,12,20,13],[21,14,21,15],[21,12,21,13],[21,10,21,11],[34,0,34,15],[22,14,22,15],[22,12,22,13],[22,0,22,1],[23,0,23,1],[23,2,23,3],[23,4,23,5],[20,0,20,1],[20,10,20,11],[20,2,20,3],[20,4,20,5],[20,6,20,7],[20,8,20,9],[23,12,23,13],[22,10,22,11],[23,10,23,11],[32,0,32,15],[47,13,47,15],[45,13,45,15],[46,13,46,15],[40,0,40,8],[22,2,22,3],[22,4,22,5],[35,0,35,15],[22,6,22,7],[22,8,22,9],[46,0,46,5],[46,6,46,12],[23,14,23,15],[43,13,43,15],[44,13,44,15],[43,0,43,5],[23,6,23,7],[23,8,23,9],[45,0,45,5],[44,0,44,5],[43,6,43,12],[44,6,44,12],[37,0,37,15],[38,9,38,15],[38,0,38,8],[39,0,39,8],[39,9,39,15],[25,0,25,15],[33,0,33,10],[33,11,33,15],[24,0,24,15],[26,1,26,7],[30,1,30,7],[29,1,29,7],[28,1,28,7],[27,1,27,7],[26,8,26,13],[26,14,26,15],[27,8,27,13],[27,14,27,15],[28,8,28,13],[28,14,28,15],[29,8,29,13],[29,14,29,15],[30,8,30,13],[30,14,30,15],[31,0,31,15],[36,0,36,15]]}
["DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT"]
["DIVISION OF STATE FINANCIAL ASSISTANCE"]
["STATE GRANT MANAGEMENT "]
["2020 West El Camino, 4th Floor "]
["Sacramento, CA  95833"]
["HHCIISGM@hcd.ca.gov"]
[]
["HOUSING FOR A HEALTHY CALIFORNIA (HHC) ARTICLE II PROGRAM \nREQUEST FOR FUNDS (RFF)"]
[]
["Last Revised:  08/11/2021"]
["HCD Contract Number:",null,null,null,null,null,null," RFF Number:",null,null,"Select One"]
["County Name:",null,null,null,null,null,null," Preparer  Name:",null,null,null,null,null,null,null,null,null,null,1,2,3,4,5,6,7,8,9,10]
["County Address:",null,null,null,null,null,null," Preparer Title:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND(K11=1, K21>0, K21<100),\"TRUE\",\"FALSE\")","v":"FALSE"}]
["County City:",null,null,null,null,null,null," Preparer E-mail:"]
["County State and Zip:",null,null,null,null,null,null," Preparer Phone #:"]
["Total HHC Article II Award:",null,null,null,null,null,null,"Max Admin Amount:",null,null,{"$f":"ROUND((0.1*B16),0)","v":0}]
["40% of total HHC Article II award (relevant for Long-Term Rental Assistance Projects and Administrative Costs):",null,null,null,null,null,null,null,null,null,{"$f":"ROUND((B16*0.4),0)","v":0}]
["EXPENDITURE BREAKDOWN"]
["Activity Name",null,"Approved Budget Amount",null,"Total Previously Drawn",null,"Draw Amount Requested This Period",null,"Total Drawn To Date ",null,"Percent of Activity Requested",null,"Budget Remaining",null,"HCD Approved Draw Amount This Period"]
["Acquisition, New Construction, Gap Funding, or Reconstruction and Rehabilitation ",null,null,null,null,null,null,null,{"$f":"SUM(E20+G20)","v":0},null,{"$f":"IF(C20,G20/C20,0)","v":0},null,{"$f":"SUM(C20-I20)","v":0}]
["Capitalized Operating Subsidy Reserve (COSR)",null,null,null,null,null,null,null,{"$f":"SUM(E21+G21)","v":0},null,{"$f":"IF(C21,G21/C21,0)","v":0},null,{"$f":"SUM(C21-I21)","v":0}]
["Long-Term Rental Assistance",null,null,null,null,null,null,null,{"$f":"ROUND(SUM(E22+G22),0)","v":0},null,{"$f":"IF(C22,G22/C22,0)","v":0},null,{"$f":"SUM(C22-I22)","v":0}]
["Administrative Costs                         *(up to 10% of total grant award)",null,{"$f":"ROUND(K16, 0)","v":0},null,null,null,null,null,{"$f":"ROUND(SUM(E23,G23),0)","v":0},null,0,null,{"$f":"SUM(C23-I23)","v":0}]
["TOTAL:",null,{"$f":"ROUND(SUM(C20:C23),0)","v":0},null,{"$f":"ROUND(SUM(E20:E23), 0)","v":0},null,{"$f":"ROUND(SUM(G20:G23), 0)","v":0},null,{"$f":"ROUND(SUM(I20:I23), 0)","v":0},null,{"$f":"IF(C24,G24/C24,0)","v":0},null,{"$f":"ROUND(SUM(M20:M23), 0)","v":0},null,{"$f":"ROUND(SUM(O20:P23), 0)","v":0}]
["COSR or Development Project",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"G24*0.05","v":0}]
["If Awarded funds for a COSR or development, you must identify a project(s) and provide documentation supporting the local governing body’s commitment before disbursement of funds will be approved. If not, skip to the next section. "]
["Project Name",null,null,null,null,null,null,null,"Documentation supporting the local governing body's commitment attached?",null,null,null,null,null,"Select One"]
["Project Name",null,null,null,null,null,null,null,"Documentation supporting the local governing body's commitment attached?",null,null,null,null,null,"Select One"]
["Project Name",null,null,null,null,null,null,null,"Documentation supporting the local governing body's commitment attached?",null,null,null,null,null,"Select One"]
["Project Name",null,null,null,null,null,null,null,"Documentation supporting the local governing body's commitment attached?",null,null,null,null,null,"Select One"]
["Project Name",null,null,null,null,null,null,null,"Documentation supporting the local governing body's commitment attached?",null,null,null,null,null,"Select One"]
["Expenditure Report and Expenditure Details Requirement"]
["If awarded for Administrative Costs and/or Rental Assistance, for any Request for Funds other than your first (RFF #1), please complete the Expenditure Report Form on Tab 2 and the Expenditure Details Form on Tab 3 of this workbook. You must demonstrate you have expended 80% of all previously disbursed funds. \n"]
["If this is RFF #2 or more, have you completed Tab 2 and 3?",null,null,null,null,null,null,null,null,null,null,"Select One"]
["CERTIFICATION"]
["*For administration costs and rental assistance, the Contractor may request a disbursement of up to 40% of total awarded Grant funds upon the execution of the standard agreement.  After initial disbursement, Contractor must demonstrate prior to each subsequent disbursement request, using the Expenditure Report form provided by HCD, that at least 80% of the Grant funds previously disbursed have been expended by the Contractor or otherwise awarded to Subrecipients pursuant to the terms of this Agreement.  Administrative costs related to the planning and execution of eligible activities shall not exceed 10% of total grant award."]
["**For development and COSR, the Awardee(s) must identify a project(s) and provide documentation supporting the local governing body’s commitment before disbursement of funds."]
["***By signing this request, I certify to the best of my knowledge and belief that the request is true, complete, and accurate, and the expenditures, disbursements and cash receipts will be for the purposes and objectives set forth in the terms and conditions of the State award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812)"]
["Name of Authorized Representative",null,null,null,null,null,null,null,null,"Title of Authorized Representative"]
[]
["Signature of Authorized Representative",null,null,null,null,null,null,null,null,"Date"]
[]
["HCD USE ONLY"]
["SGM Representative Printed Name",null,null,null,null,null,"Representative Signature",null,null,null,null,null,null,"Date"]
[]
["SGM Manager Printed Name",null,null,null,null,null,"Manager Signature ",null,null,null,null,null,null,"Date"]

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[]
[]
["HOUSING FOR A HEALTHY CALIFORNIA (HHC) ARTICLE II PROGRAM \n"]
["Expenditure Report"]
["Note: Contact information below will populate automatically with information from the Request for Funds tab. "]
["HCD Contract Number:",{"$f":"'1. Request For Funds'!$B$11","v":0},null,null," RFF Number:",{"$f":"'1. Request For Funds'!$K$11","v":"Select One"}]
["County Name:",{"$f":"'1. Request For Funds'!$B$12","v":0},null,null," Preparer  Name:",{"$f":"'1. Request For Funds'!$K$12","v":0}]
["County Address:",{"$f":"'1. Request For Funds'!$B$13","v":0},null,null," Preparer Title:",{"$f":"'1. Request For Funds'!$K$13","v":0}]
["County City:",{"$f":"'1. Request For Funds'!$B$14","v":0},null,null," Preparer E-mail:",{"$f":"'1. Request For Funds'!$K$14","v":0}]
["County State and Zip:",{"$f":"'1. Request For Funds'!$B$15","v":0},null,null," Preparer Phone #:",{"$f":"'1. Request For Funds'!$K$15","v":0}]
["Total HHC Article II Award:",{"$f":"'1. Request For Funds'!$B$16","v":0},null,null,"Max Admin Amount:",{"$f":"'1. Request For Funds'!$K$16","v":0}]
["Amount Expended "]
["Note: Information in the Approved Budget, Previously Drawn Advance(s) and percent Expended columns will populate automatically with information from the Request for Funds tab."]
["Activity Name",null,null,"Approved Budget","Previously Drawn Advance(s)","Amount of Advance Expended","Percent Expended"]
["Long-Term Rental Assistance",null,null,{"$f":"'1. Request For Funds'!$C$22","v":0},{"$f":"'1. Request For Funds'!$E$22","v":0},null,{"$f":"IF(E15,F15/E15,0)","v":0}]
["Administrative Costs                                                                                   *(up to 10% of total grant award)",null,null,{"$f":"'1. Request For Funds'!$C$23","v":0},{"$f":"'1. Request For Funds'!$E$23","v":0},null,0]
[null,"TOTAL:",null,{"$f":"SUM(D15:D16)","v":0},{"$f":"SUM(E15:E16)","v":0},{"$f":"SUM(F15:F16)","v":0},0]
["CERTIFICATION"]
["*For administration costs and rental assistance, the Contractor may request a disbursement of up to 40% of total awarded Grant funds upon the execution of the standard agreement.  After initial disbursement, Contractor must demonstrate prior to each subsequent disbursement request, using the Expenditure Report form provided by HCD, that at least 80% of the Grant funds previously disbursed have been expended by the Contractor or otherwise awarded to Subrecipients pursuant to the terms of this Agreement.  Administrative costs related to the planning and execution of eligible activities shall not exceed 10% of total grant award."]
["***By signing this request, I certify to the best of my knowledge and belief that the request is true, complete, and accurate, and the expenditures, disbursements and cash receipts will be for the purposes and objectives set forth in the terms and conditions of the State award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812)"]
["Name of Authorized Representative",null,null,null,"Title of Authorized Representative"]
[]
["Signature of Authorized Representative",null,null,null,"Date"]
[]
["HCD USE ONLY"]
["SGM Representative Printed Name",null,null,"Representative Signature",null,null,"Date"]
[]
["SGM Manager Printed Name",null,null,"SGM Manager Signature",null,null,"Date"]

{"sheet":"3. Expenditure Details","index":2,"n_rows":19,"n_cols":5,"rows_kept":19,"cut":false,"hidden":false,"merged":[[7,1,7,4],[19,0,19,4],[18,0,18,4],[17,0,17,4],[16,1,16,4],[15,1,15,4],[14,1,14,4],[13,1,13,4],[12,0,12,4],[11,1,11,4],[10,1,10,4],[9,1,9,4],[8,1,8,4],[2,0,2,4],[3,0,3,4],[4,2,4,3],[5,0,5,4],[6,0,6,4]]}
[]
[]
["HOUSING FOR A HEALTHY CALIFORNIA (HHC) ARTICLE II PROGRAM \n"]
["Expenditure Details Report"]
["County Name:",{"$f":"'1. Request For Funds'!$B$12","v":0},"Contract #:",null,{"$f":"'1. Request For Funds'!$B$11","v":0}]
[" Instructions: Please complete each form field relevant to your project's funded activities. "]
[" Describe the expenses with disbursed funds by activity"]
["Activity Name","Expenses\n(provide description of what the funds were used for, \ni.e. rental assistance, utility payments, computers, etc.)"]
["Acquisition, New Construction, Gap Funding, or Reconstruction and Rehabilitation"]
["Long-Term Rental Assistance"]
["Operating Subsidies "]
["Administrative Costs                                                                         *(up to 10% of total grant award)"]
["Describe any barriers encountered in assisting clients and course of action taken"]
["Problem / Delay","Course of Action"]
[]
[]
[]
["What actions have been taken to achieve program expenditure deadlines?"]
["Action Taken"]

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[]
[]
[null,null,"DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT\nDIVISION OF FINANCIAL ASSISTANCE \nSTATE GRANT MANAGEMENT \n2020 West El Camino, 4th Floor\nSacramento, CA  95833\nPhone: (916) 263-1501"]
[]
[]
[]
[]
[]
[]
[null,null,"PET ASSISTANCE AND SUPPORT (PAS) PROGRAM"]
[null,null,"REQUEST FOR FUNDS"]
[]
[null,null,"Contract Number:","Enter Contract Number here",null,null,null,null,null,"SGM Rep Name:"]
[null,null,"Project Name:","Enter Name of the Project here",null,null,null,null,null,"Funds Request #:"]
[null,null,"Applicant Name:","Enter Name of the Applicant here",null,null,null,null,null,"Preparer  Name:"]
[null,null,"Co-Applicant Name:","Enter Name of Co-Applicant here",null,null,null,null,null,"Preparer Title:"]
[null,null,"Project Address:","Enter physical Project's Address here",null,null,null,null,null,"E-mail:"]
[null,null,"Project City/State/Zip:","Enter Project's address City/State/Zip here",null,null,null,null,null,"Phone Number:"]
[]
[null,null,"EXPENDITURE BREAKDOWN"]
[]
[null,null,"Activity Name",null,"Approved Budget",null,"Total Previously Drawn",null," Amount Requested This Period",null,"Total Drawn To Date",null,"Percent of Approved Budget Drawn",null,"Budget Remaining",null,"HCD Approved Amount"]
[]
[null,null,"Pet Assistance And Support",null,0,null,0,null,0,null,{"$f":"SUM(G24+I24)","v":0},null,{"$f":"IF(E24,K24/E24,0)","v":0},null,{"$f":"SUM(E24-K24)","v":0},null,0]
[]
[null,null,"Food - Animals",null,0,null,0,null,0,null,{"$f":"SUM(G26+I26)","v":0},null,{"$f":"IF(E26,K26/E26,0)","v":0},null,{"$f":"SUM(E26-K26)","v":0},null,0]
[]
[null,null,"Veterinarian Services",null,0,null,0,null,0,null,{"$f":"SUM(G28+I28)","v":0},null,{"$f":"IF(E28,K28/E28,0)","v":0},null,{"$f":"SUM(E28-K28)","v":0},null,0]
[]
[null,null,"Staff (for assisting pets) ",null,0,null,0,null,0,null,{"$f":"SUM(G30+I30)","v":0},null,{"$f":"IF(E30,K30/E30,0)","v":0},null,{"$f":"SUM(E30-K30)","v":0},null,0]
[]
[null,null,"Liability Insurance (PAS)",null,0,null,0,null,0,null,{"$f":"SUM(G32+I32)","v":0},null,{"$f":"IF(E32,K32/E32,0)","v":0},null,{"$f":"SUM(E32-K32)","v":0},null,0]
[]
[null,null,"Independent Audit (PAS)",null,0,null,0,null,0,null,{"$f":"SUM(G34,I34)","v":0},null,{"$f":"IF(E34,K32M/K34,0)","v":0},null,{"$f":"SUM(E34-K34)","v":0},null,0]
[]
[null,null,"TOTAL:",null,{"$f":"SUM(E23:E34)","v":0},null,{"$f":"SUM(G23:G34)","v":0},null,{"$f":"SUM(I24,I26,I28,I30,I32,I34)","v":0},null,{"$f":"SUM(K24,K26,K28,K30,K32,K34)","v":0},null,{"$f":"IF(E36,K36/E36,0)","v":0},null,{"$f":"SUM(O24,O26,O28,O30,O32,O34)","v":0},null,{"$f":"SUM(Q24,Q26,Q28,Q30,Q32,Q34)","v":0}]
[]
[null,null,"CERTIFICATION"]
[null,null,"***By signing this request, I certify to the best of my knowledge and belief that the request is true, complete, and accurate, and the expenditures, disbursements and cash receipts will be  for the purposes and objectives set forth in the terms and conditions of the State award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812)"]
[]
[null,null,"Name and Title of Authorized Person ",null,null,null,null,null,null,null,"Date"]
[null,null,"     "]
[null,null,"Signature of Authorized Person"]
[]
[]
[null,null,"HCD USE ONLY"]
[null,null,"SGM Representative Signature                                                                "]
[null,null,null,null,null,null,null,null,null,null,"Date"]
[null,null,"SGM Manager Signature                                                                "]
[null,null,null,null,null,null,null,null,null,null,"Date"]