OMB Approval No. 2506-0133
exp. 12/31/2017
Detailed Project Budget & Housing Outputs (each organization)
Name of Harbor Homes, Inc.
organization:
Type: Grantee: [_]; Project Sponsor: BJ | If applicable: _| Faith based: [_] | Grassroots: L]
B. Eligible Activity HOPWA Request
Yr. I Yr. 2 r.3 Totals:
1. Acquisition Budget
+ & |Description:
3 3 : H# of Units
5. @ |2. Rehabilitation/Repair/Conversion Budget
£22 “oti =
gg Pssonption: Hof Units
a 3 (3. New Construction (Community Residences & SRO dwellings Budget
= 2 only) Description: .
‘os # of Units
eo
™ §& |Type of Facility: Short-term shelter (); transitional housing []; Community residence LJ; sro dwelling [[J; or other permanent
supportive housing oO
» |4- Operating Costs for Housing Facility
& g Description: Budget
3 : # of Units
Fs 2 is vane Budget
eseriprion: # of Units
6. Tenant-Based Rental Assistance Payments Budget $309,677 1$309,678 1$309,678 |$929,033
Description: 3] BR ] 31 AO
< # of Households
ee 7. Short-Term Rent, Mortgage & Utility Payments to Prevent Budget
7 a Homelessness
Description:
# of Households
n Budget
ué . .
2 = 8. Supportive Services Costs
& 5 (Description:
AD
H# of Households}
9. Housing Information Services Budget
g Description: Ht of Households
% {10. Permanent Housing Placement Services Budget $4,560 $4,560 [$4,560 $13,680
* soe
IDescnption:
a Hf of Households|* 4 4 12
E 11. Resource Identification to Establish, Coordinate, & Develop
© Housing Assistance
3 Description: Budget
5 12. Other Housing Costs (approved by HUD) Budget
Description: i of Units
® 13. Grantee's Administrative Costs
> .
& g |Description: Budget
# g 14. Project Sponsor's Administrative Costs
& |Description:
—a $21,996 $21,997 |$21,997
< Budget $65,990
15. Total HOPWA Request for this Organization
$1,008,703
Note: Service delivery costs such as salary and overhead costs to deliver a particular budget line item
should be represented in the funding amount requested for that particular budget line item.
Insert application package page number
Form HUD-40110-B (Expiration Date 12/31/2010)
