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HomeMy Public PortalAbout10-8107 Resource Funding for Historic City Hall Sponsored by: City Manager Resolution No. 10-8107 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA, TO AUTHORIZE THE CITY MANAGER TO SUBMIT AN APPLICATION FOR FUNDS TO THE FLORIDA DEPARTMENT OF STATE, DIVISION OF HISTORICAL RESOURCES FOR FUNDING OF OPA-LOCKA HISTORIC CITY HALL IN THE AMOUNT OF THREE HUNDRED FIFTY THOUSAND DOLLARS ($350,000.00), FURTHER AUTHORIZING MATCHING FUNDS FOR THE GRANT AWARD IN AN AMOUNT NOT TO EXCEED FIFTY THOUSAND DOLLARS ($50,000.00), PAYABLE FROM ACCOUNT NUMBER , IN ADDITION TO THE CITY PROVIDING IN-KIND SERVICES; PROVIDING FOR INCORPORATION OF RECITALS; PROVIDING FOR AN EFFECTIVE DATE. WHEREAS,the City Commission of the City of Opa-locka desires to preserve the City of Opa-locka Historic City Hall; and WHEREAS,the Historic Preservation Category Grants-in-Aid Program provides assistance with the development, fabrication and installation of major museum exhibits that promote knowledge and appreciation of Florida's history; and WHEREAS, the Historic Preservation Special Category Grants-in-Aid Program will grant the City a maximum of Three Hundred Fifty thousand Dollars($350,000.00) for the rehabilitation of Opa-locka Historic City Hall; and WHEREAS,the City of Opa-locka will be required to provide matching funds not to exceed $50,000.00, as well as in-kind services, volunteer labor or donated materials; and Resolution No. 10-8107 WHEREAS, the City Commission of the City of Opa-locka authorizes the City Manager to submit an application to the Florida Department of State, Division of Historical Resources for funding of the City of Opa-locka Historic City Hall in the amount of Three Hundred Fifty Thousand Dollars ($350,000.00): NOW,THEREFORE,BE IT DULY RESOLVED BY THE CITY COMMISSION OF THE CITY OF OPA-LOCKA,FLORIDA: Section 1. The recitals to the preamble herein are incorporated by reference. Section 2. The City Commission of the City of Opa-locka hereby authorizes and directs the City Manager to submit an application to the Florida Department of State,Division of Historical Resources for funding of the City of Opa-locka Historic City Hall in the amount of Three Hundred Fifty Thousand Dollars($350,000.00),further authorizing matching funds for the grant award in an amount not to exceed Fifty Thousand Dollars($50,000.00),payable from Account Number , in addition to the City of Opa-locka providing in-kind services. Section 3. This resolution shall take effect immediately upon adoption. PASSED AND ADOPTED this 28 day of July, 2010. JdS ' L. EY AYOR Resolution No. 10-8107 Attest: Deborah Irby City Clerk Approved as to form and legal sufficient; P1414`/'>IJIcI'AI - eller, sq. ity A orney Moved by: JOHNSON ! Seconded by: HOLMES d$f Commission Vote: 4-0 Commissioner Holmes: YES Commissioner Johnson: OUT OF ROOM Commissioner Tydus: YES Vice-Mayor Taylor: YES Mayor Kelley: YES 1550351 v1 QP.LOCkO 6 I � Ia�M1`1:..T 0. Memorandum TO: Mayor Joseph L. Kelley Vice Mayor Myra L. Taylor Commissioner Timothy Holmes Commissioner Dorothy Johnson Ef-Y-A-4-1~-re. Tmissioner Rose Tydus FROM: Clarance Patterson, City Manager DATE: July 19,2010 RE: 2012 Historic Preservation Special Category Grants-in-Aid Application to Florida Department of State, Division of Historical Resources for funding for Historic City Hall. Request: APPROVAL OF A RESOLUTION TO AUTHORIZE THE CITY MANAGER TO SUBMIT AN APPLICATION FOR FUNDS IN THE AMOUNT OF THREE HUNDRED FIFTY THOUSAND DOLLARS ($350,000.00) WITH THE FLORIDA DEPARTMENT OF STATE, HISTORICAL RESOURCES DIVISION, FOR RESTORATION OF THE CITY HALL BUILDING, FURTHER AUTHORIZING MATCHING FUNDS FOR THE GRANT AWARD IN THE AMOUNT OF FIFTY- THOUSAND DOLLARS ($50,000.00), IN ADDITION TO THE CITY PROVIDING IN-KIND SERVICES. Description: The Historic Preservation Special Category Grants-in-Aid Program is available for the preservation of significant historic structures and to assist with the development, fabrication and installation of major museum exhibits that promote knowledge and appreciation of the history of Florida. Financial Impact: An award will grant the City a maximum sum of Three Hundred and Fifty Thousand Dollars ($350,000.00) for the rehabilitation of the Historic City Hall. A match greater than $50,000 or 50%of the requested grant is required. A minimum of 25% of the match must be cash on hand. The match may be cash, in-kind services, volunteer labor, or donated materials. Implementation Time Line: Immediately. Legislative History: None Recommendation(s): Staff is recommending the approval of the Resolution authorizing the City Manager to submit an application. Analysis: This grant will allow the City to move forward with the restoration of the City Hall Building Attachment(s): 2012 Special Category Grants-in-Aid Guidelines. Prepared By: Charmaine Parchment • Notice of Solicitation for 2012 Special Category Grants-in-Aid July 1,2010—August 31,2010 The purpose of this notice is to formally announce that the Florida Department of State,Division of Historical Resources,is currently soliciting applications for the Historic Preservation Special Category Grants-in-Aid Program. SPECIAL CATEGORY GRANTS PROGRAM The purpose of the Special Category Grants Program is to provide funding to assist major local,regional and state-wide efforts to preserve significant historic structures and archaeological sites,to assist major archaeological excavations,and assist in the development,fabrication and installation of major museum exhibits that will promote knowledge and appreciation of the history of Florida.For the purpose of this program,the term"major"means projects with grant funding needs in excess of$50,000.This program does not fund operational support for museums or historic preservation organizations. SOLICITATION PERIOD The solicitation period begins July 1,2010,and extends through August 31,2010. The online application is available at www.flheritage.com/grants. Online applications must be submitted by 11:59 p.m.on August 31,2010. In addition,one paper copy of the application and all required attachments must be delivered to the Bureau of Historic Preservation,R.A.Gray Building,500 South Bronough Street,Tallahassee,Florida 32399-0250 no later than 5:00 p.m.,August 31,2010 OR be clearly postmarked on or before August 31,2010,OR show evidence of submission to an express mail service on or before August 31,2010. If access to the online application is not available,arrangements for the submission of paper applications may be made by calling the Bureau at 850.245.6333 or toll free at 1.800.847.7278. FUNDS AVAILABLE Funding availability will depend upon legislative appropriation during the 2011 Legislative Session. Recommended grant awards will range from$50,000 to$350,000. WHO IS ELIGIBLE TO APPLY Eligible applicants include departments or agencies of the State of Florida(including state universities);units of county,municipal or other local governments;or any Florida not-for-profit corporation,institution,or organization. Religious organizations are eligible to apply for grant-in-aid assistance.However,eligible development activities involving religious properties are limited to work on the exterior of the property and only to those interior activities that are essential to the preservation of the structural integrity of the property. For clarification,"religious properties"include any real property and associated improvements owned by a religious institution such as churches,schools,meeting halls and parish houses and any real property,regardless of ownership,that is used as a place of worship. For historical museum projects,applicants must be a governmental or non-profit Florida history museum. A Florida history museum is an institution established permanently in Florida,promoting and encouraging knowledge and appreciation of Florida history through the collection,presentation,exhibition,and interpretation of artifacts and other historical items related to Florida history. The mission of the museum must relate directly to the history of Florida. PROJECTS ELIGIBLE FOR FUNDING 1.Acquisition of historic properties or archaeological sites; 2.Development activities,including:restoration,rehabilitation,preservation,and reconstruction,and site-specific planning required for these activities; 3.Archaeological excavation projects,including:research,field investigation,testing,analysis and publication of findings;and 4.Museum exhibit projects for Florida history museums,including:research,exhibit design,fabrication and installation. Museum Exhibit projects involve development and presentation of exhibitions and educational materials on the history of the human occupation of Florida through use of artifacts,graphics,audiovisual elements,text panels and educational materials. Projects must result in a tangible product related to Florida history. Property for which an applicant is requesting Special Category grant assistance does not need to be listed in the National Register of Historic Places. However,if a property is not listed in the National Register,the applicant must provide sufficient information to allow its historic significance to be fully evaluated. Such historical information for properties that are designated under a local historic 1 preservation ordinance may be contained in a local Designation Report. For other properties,this information may be contained in a historic sites survey report or other documentation. For those properties where this information is not available,the applicant may include historical research as one of the proposed grant work items. A portion of grant funding(up to$2,000)may be used to pay for this activity. It is not necessary to supply this information for historical museum exhibition projects,unless the museum is located in a historic building. All proposals for restoration or rehabilitation work must follow the Secretary of Interior's Standards for the Treatment of Historic Properties, and all proposals for archaeological excavations must follow the Secretary of Interior's Standards for Archaeological Documentation. Other preservation activities may also be eligible for grant assistance. If you have a question about the eligibility of a project or work element,please call the Bureau of Historic Preservation at 850.245.6333 or 1.800.847.7278. AWARD AMOUNT AND MATCH REQUIREMENTS The applicant shall request no more than$350,000 in a single application. The minimum grant request amount for the Special Category Grant Program is$50,000. The match requirement for the Special Category Grant Program shall be the greater of$50,000 or 50 percent of the requested grant amount unless as reduced for communities participating in the Rural Economic Development Initiative(REDI)program,administered by the Governor's Office of Trade and Economic Development.The match requirement shall be reduced to 10 percent of the requested grant amount for projects within rural communities designated as REDI-qualified in accordance with Sections 288.0656 and 288.06561,Florida Statutes.The community in which the project site is located must be a REDI community at the time of application. A list of REDI qualified counties and municipalities is available from the Department of State at http://www.dos.state.fl.us/grants/redi/. An applicant organization may submit only one(1)Historic Preservation Special Category Grant Application under a single application deadline.State,county or city governments,or universities may submit single applications from more than one division or department during any grant cycle,provided that those divisions or departments are separate and distinct budgetary units,and provided that applications do not address the same facility,project or site. Grantees may have no more than one(1)previously awarded Special Category grant open at the time of application.Applications from applicants with more than one open Special Category grant shall be declared ineligible by staff and such applications shall be returned to the applicant with a written explanation. In computing grant match,please note that,while direct administrative costs for conducting grant activities will be considered allowable expenditures,in aggregate,the amount of these costs(whether grant funded and/or part of the match)may not exceed 10% of the grant award request. In valuing in-kind services and donated materials,please be sure to use a value that reflects a typical fair market value you would pay if you were purchasing such services. Volunteer labor is typically valued at the current State of Florida minimum wage. Please be aware that you may not use expenditures of any kind made prior to the grant period as part of your match. Match must be fully documented in Attachment A of the application. This documentation will be reviewed in detail by staff. In review of applications,no preference will be given to projects with an overmatch. Match may be in the form of cash,in-kind services,volunteer labor,or donated materials. A minimum of 25 percent of the match must be cash on hand. The match must relate directly to the specific project for which grant funds are being requested and not to activities or expenditures involving other exhibits,or buildings or sites in an associated complex of historic buildings or archaeological sites. The match,as stipulated in the application,must be expended during the grant period on the described project and be fully documented. Any promised match that is not spent may result in reduction of the grant award by a proportional amount. It is important that an applicant document support for the project for which funding is requested. It is highly recommended that between 10 and 15 letters of support,endorsements,resolutions,and other documentation evidencing local,regional or statewide support for the project be included with the submission of the paper copy of the application. APPLICATION DEADLINE Applications will be accepted online between July 1,2010 and 11:59 p.m.on August 31,2010. In addition to the submission of the online application,to be considered for funding,one paper copy of the application plus attachments and signature forms must be delivered to the Bureau of Historic Preservation,Division of Historical Resources on or before 5:00 p.m.August 31,2010,OR be clearly postmarked OR show evidence of submission to an express mail service on or before August 31,2010. 2 APPLICATION REVIEW AND PROJECT SELECTION Eligible applications will be evaluated on a competitive basis by the Florida Historical Commission(FHC)in a public meeting scheduled for November 15 and 16,2010(subject to change). The Commission will review applications pursuant to criteria in Chapter 1A-39.008(8),Florida Administrative Code,and recommend those applications that should be forwarded to the 2011 Legislature for funding consideration in State Fiscal Year 2012. A level of funding(full or partial)will be recommended for each project. In accordance with the Government Performance and Accountability Act of 1994,the Division of Historical Resources is mandated to increase the number of historic and archaeological properties protected or preserved for public use. As a result,in order to meaningfully benefit as many properties as possible,projects may not be recommended for the full amount requested;rather,the Commission may recommend an amount intended as a significant contribution to the project. The Commission will also rank, in priority,those projects that it recommends. Unfunded projects included on the State Fiscal Year 2010-2011 Roll Over List will receive no advantage in the competition for 2012 Special Category grant funding. This solicitation is for a new and open competition for eligible applicants and projects. The Florida Historical Commission will recommend to the Secretary of State,the projects that should be forwarded to the Legislature to be considered for funding. This recommendation will not result in any immediate grant award. The award and level of funding for each Special Category project will be subject to specific legislative appropriation. The Commission will take into consideration which applicants appear best able to utilize funding within 24 months,beginning on 'July 1,2011 and ending on June 30,2013. In this reference,applicants should be careful not to request more funds than they could reasonably expect to expend within a 24-month period. It is important to keep in mind that,for large projects,five or six months may be required to develop satisfactory plans and specifications before actual work could begin. Plans,specifications,and all contracts must be submitted to the Bureau of Historic Preservation for review and approval before the implementation of any work. For projects receiving funding from the 2011 Florida Legislature,funds will become available after July 1,2011,which is the beginning of the 2011-2012 State Fiscal Year. The funds must be fully obligated(under contract)by June 30,2012. Any unexpended balance of grant funds will revert to the state at the end of the 24-month period,on June 30,2013. ADMINISTRATIVE REQUIREMENTS To receive grant funds,grantees will be required to sign a Grant Award Agreement containing specific administrative responsibilities. Grantees with rehabilitation or restoration projects will also be required to execute Restrictive Covenants that must be recorded with the property deed by the Clerk of Circuit Court in the county where the property is located. These covenants require that,in exchange for state grant funds,the grantee will not undertake modifications to the property(other than routine repairs and maintenance)for a period of ten years without review and approval of plans and specifications by the Division. Additional information regarding these covenants is available from the Bureau on request. For projects involving properties other than real property(e.g.aircraft, locomotive or marine vessel),the grantee must submit an executed and notarized Preservation Agreement in which the grantee and property owner shall commit to assuming the cost of maintenance and repair of the property,permit no alterations without prior permission from the Division,and allow the inspection of the property by the Division for a period of ten years. Detailed information about the Preservation Agreement is available from the Bureau upon request. ADDITIONAL INFORMATION If you have any questions regarding proposed projects or the online application form,please call staff of the Bureau of Historic Preservation at 800.847.7278 or 850.245.6333. Questions regarding architectural projects should be directed to Phillip Wisley,R.A.. Other questions regarding the Historic Preservation Special Category Grants Program can be directed to any member of the Bureau's Historic Preservation Grants staff. 3 1 Division of Historical Resources Special Category Historic Preservation Grant Application APPLICATION CHECKLIST A printed copy of your online application and all required attachments(as listed below)must be submitted to the Bureau of Historic Preservation and be postmarked by 11:59 p.m.EST on August 31,2010. All attachments must be labeled with the appropriate attachment designation. Please review this checklist and provide all applicable information. Please indicate which labeled attachments have been included in the application. All attachments should be printed on 8 1/2"x 11" paper,except as indicated for the digital images required in Attachment C and the architectural project schematics or construction documents,or museum exhibit and design documents in Attachment D. ❑ One Copy of Printed Special Category Application ❑ Attachment A: Documentation of Confirmed Match:This attachment must contain current documentation of all match listed in Question 15 and the totals in Questions 4 and 14. Documentation of availability and commitment of all match funds to the project must be included. • For Commitments of Cash Resources: The 25% cash match contribution must be cash-on-hand or pledged as indicated below and dedicated to the project as documented by resolution or minutes of board action. Availability of cash match contributions must be documented by a bank statement or letter from the applicants financial institution. For the purpose of this program, cash-on-hand includes funds identified in award letters or executed contracts from third parties, provided that those funds are expressly for the project for which the grant application is submitted. Note: Applicant staff salaries are not allowable cash contributions but are allowed as in-kind match contributions. Written Pledges committed to be paid by a donor over a defined time frame (e.g., two (2) $1,000.00 cash payments, the first to be made on January 31, 2012 and the second on January 31, 2013), with a donor's signature will be accepted as contributions to the required cash match. Anonymous pledges will not be accepted as match contributions. For local governments,a copy of the City Commission or Board of County Commissioners Resolution committing the funds must be submitted. • For Commitments of In-Kind Services,Volunteer Labor,or Donated Materials:A detailed explanation of all services,labor or materials to be provided,including: (a)Justification of the value assigned to the services or materials; (b)An explanation of how those services will be used to fulfill the objectives of the project;and (c)The numbers of work hours being pledged must be included. A signed statement from the individual or entity making the donation must verify each commitment. See notes in Question 14 of the Application for further detail regarding required match documentation. • Match that is not adequately documented will be disallowed,reducing the applicant's match as well as the amount of the recommended grant award,and possibly jeopardizing application eligibility. Special Category Grant Application Form HR3E0410705SM Effective October 14,2009 Reference:Rule IA-39.007(8), F.A.C. 2 ❑ Attachment B: Letters of Support,Endorsement,or Resolutions: In this attachment, provide letters of support from your Legislative Delegation,community leaders,civic organizations and local citizens. The purpose of this attachment is to demonstrate community support for the expenditure of public funds for your project. Individual letters are preferred. Form letters are discouraged. Typically,form letters do not effectively convey genuine local support for the proposed project. The number of letters submitted should not overwhelm the application in terms of volume. In most cases, 10 to 20 letters of support are sufficient for an applicant to make the case for broad community or regional support for the project. Applicants are strongly encouraged to include resolutions and letters of support with the submission of the printed copy of the application. Letters should be addressed as indicated below: Mr.Scott Stroh, Director Division of Historical Resources Bureau of Historic Preservation Grants and Education Section 500 South Bronough Street Tallahassee, Florida 32399-0250 Note that letters of support received by this office, independent from the application or after the application cycle deadline,will be filed with the original version of the application,which is retained by the Bureau of Historic Preservation. Such letters will not be transmitted to the Florida Historical Commission (FHC),the reviewing body, but will be available to the commission during its public meeting. Grants staff will make the commission aware of additional expressions of support received independent from the application or after the application cycle deadline. Please provide a coversheet for Attachment B that includes the following information for each letter of support,endorsement or resolution included in your application: name of author,type of communication (letter, petition, resolution, etc.), organization represented (if applicable),and date. ❑ Attachment C: Representative Photographs(required of all applicants): Include both photographic prints AND corresponding digital images. The photographs included in Attachment C are important to the reviewer's understanding of the historic integrity and physical condition of a historic or archaeolgical property. ✓ For Acquisition and Development Projects, minimum requirements include current photographs of all exterior elevations, principal interior spaces, and significant architectural features. If available, also provide historic photographs of the property. ✓ For archaeological excavation projects, photographs should include general views of the site,any visible archaeological features, and artifacts recovered from previous work,as applicable. ✓ For exhibits, please submit photographs of exhibit subject matter and the space in which the exhibit will be installed. Digital Photographs: The resolution and file type for the digital images must conform to the specifications indicated in the Florida Master Site File Photographic Documentation Policy which is available at http://flheritage.com/preservation/sitefile/. The digital images must be submitted on CD-R or CD-RW. Size/Resolution: 1600 x 1200 pixels at 300 ppi (pixels per inch)or larger. This is approximately 2 megapixels. Special Category Grant Application Form HR3E0410705SM Effective October 14,2009 Reference:Rule IA-39.007(8), F.A.C. 3 File Format:JPEG or uncompressed TIFF files are acceptable. Note that there are different levels of JPEG compression and that low or medium compression should be used when saving files in JPEG format. High JPEG compression may result in unacceptable image quality. Note:24-bit color JPEG images are the default image format for most digital cameras. Image resolution and compression are usually adjustable and should be checked prior to capturing images for submission. As of the date of this document, most cell phone cameras do not meet the minimum requirements for submission. Important:The applicant must designate one of the digital images as the principal view of the subject property or the image that best conveys the purpose of the project. Please label the image as your designated choice for the public presentation during the discussion of your application. Photographic Prints:Color photographic prints that are 4"x 6"or larger are preferred. Label all photographic prints with the property name, location, and the date of the image. For A& D projects,the quality of these photographs (resolution, exposure,texture,focus, etc.) must be sufficient to clearly depict architectural details,where applicable, and the condition of the structure. Such details include but are not limited to:ornamentation,window types, masonry patterns and materials,and distinctive roof materials. ❑ Attachment D: For Acquisition, Development or Museum Exhibit projects only: If completed, include architectural project schematics or construction documents,or preliminary exhibit design documents(ONE SET ONLY). Attach these documents as Attachment D to the original copy of your application. Documents must be at least 11"x 17" (maximum:24"x 36"),and all text must be clearly readable. Digital copies of these documents are not acceptable. Submit hard copies only. ❑ Attachment E:Updated Florida Master Site File Form (all site-specific projects must attach two copies of this form): If your historic property or archaeological site has been previously recorded in the Florida Master Site File,review the existing form and update it to reflect current conditions. If your property or site has not been recorded in the Florida Master Site File and you need assistance in meeting this requirement,you may contact the Florida Master Site File at(850)245-6440,or your may visit the Florida Master Site File web site at http://dhr.dos.state.fl.us/preservation/sitefile/to learn more about the site file functions and download site file forms for recording your site. Include two copies of the updated or new FMSF form, plus the required maps and photographs,with the submission of your printed application. (One copy of the form will be submitted to the Florida Master Site File on your behalf.) ❑ Attachment F:Appraisal and Purchase Documents (for Acquisition projects only): Include a complete summary appraisal prepared by a Florida State Certified General Real Estate Appraiser(two appraisals are required if the value of the first appraisal exceeds$500,000), an ownership and encumbrance search,an executed option or purchase agreement, property survey,and (if applicable)a copy of a professional archaeological survey if the property is being proposed for purchase as a significant archaeological site. This attachment only applies to projects that are seeking funds to acquire historic or archaeological properties. Check all included for Attachment F: ❑ APPRAISAL(S) ❑ PURCHASE AGREEMENT ❑ TITLE/OWNER SEARCH ❑ CERTIFIED LAND SURVEY ❑ ARCHAEOLOGICAL SURVEY REPORT Special Category Grant Application Form HR3E0410705SM Effective October 14,2009 Reference:Rule 1A-39.007(8), F.A.C. 4 If each of these items is not provided, the acquisition application will be determined to be incomplete and will not be considered for funding. ❑ Attachment G: Exhibit Supporting Documents (for Museum Exhibit projects only): Include curriculum vitae for all key project research and exhibit development personnel, if known. If objects are to be loaned from other institutions or individuals for exhibit, include letters of confirmation from lending institutions. If the exhibit is designed to travel, include letters of commitment from participating institutions. ❑ Attachment H:Archaeological Supporting Documents(for Archaeological Excavation projects only): If available, previous archaeological site reports or surveys of the property that are the subject of the proposed archaeological excavation project should be submitted. Abstracts or summaries of findings and recommendations of previous reports will be transmitted to the Florida Historical Commission (FHC). The entire report will be available to the FHC in the application file for review. Also include curriculum vitae for Principal Investigator and other key personnel, if known. ❑ Attachment I: Documentation of Non-Profit Status(for Non-Profit Organizations only):This attachment applies to all non-profit organizations seeking funding and non-profit property owners(when not the applicant). In-state corporate entities must provide documentation of their active status as a Florida non- profit corporation with the Division of Corporations, Florida Department of State. Information on entities registered with the Florida Department of State's Division of Corporations can be obtained at: http://www.sunbiz.org by searching on the corporate name. Out-of-state corporate entities must include documentation from the Internal Revenue Services confirming that they are exempt from federal income tax under section 501(c) of the Internal Revenue Code. ❑ Attachment J:Optional Attachments:Applicants may use this attachment to document immediate threats to the property and to add materials not specifically requested by the Division of Historical Resources that support the application. An optional attachment may consist of examples of previous work or information about the site such an informational brochure. Please carefully select items that are most relevant to your project. All optional materials will be available in the Original Application file,should the FHC wish to review specific items. Exclusive of threat documentation, a maximum of ten pages (no larger than 11"x 17")will be scanned by the grants staff for inclusion in the digital application review materials provided to individual panel members (This may only include the covers and tables of contents of extensive documents). On the cover page for this Attachment, please list(with a short description)all included optional materials. Please Note: Be sure to include documentation of threats to property in this attachment,if applicable. All such documentation will be provided to members of the FHC. Special Category Grant Application Form HR3E0410705SM Effective October 14,2009 Reference:Rule 1A-39.007(8), F.A.C. 5 ❑ Signature Forms: Forms submitted in this section must be signed by the person duly authorized by the applicant organization,as applicable. Only original signature forms will be accepted. Blank forms are included with the online application materials. Please fill out those that are applicable to your project, print the forms,sign and submit to the Bureau of Historic Preservation along with the printed copy of your application. ✓ Applicant Certification form (All applicants must sign): This form certifies that all information in the Special Category grant application is true and correct to the best of the applicant's knowledge. ✓Civil Rights Assurance of Compliance form (All applicants must sign):This form must be executed by the duly authorized person for this applicant. Please ensure that the Applicant-Recipient is clearly identified, that the applicant's mailing address is provided and that the authorized original signature is dated. ✓ Project Archaeological Impact form (Only for Acquisition and Development Projects): This form notifies applicants of their responsibility to determine the presence of archaeological resources prior to work that might include ground disturbance and requires assurance that measures will be taken to protect those resources. ✓ Owner Concurrence form (Only for site specific projects): This form provides documentation that the applicant has the permission of the owner of record (if the property owner is not the applicant) to conduct the proposed project on the owner's property and that the owner is in concurrence with this application for grant funding. Note that, for other than acquisition or archaeological excavation projects, the owner must be a non-profit organization or agency of government. ✓ Agreement to Execute Restrictive Covenants or Preservation Agreement form (Only for Acquisition and Development projects or site specific archaeological projects): This form commits the applicant to recordation of restrictive covenants or execution of a preservation agreement (depending on the type of property assisted) requiring maintenance of, and Division approval of modifications to,the historic property or archaeological site (the subject of the grant funded project) for a ten year period from the date of execution of the agreement or covenants. Special Category Grant Application Form HR3E0410705SM Effective October 14,2009 Reference:Rule 1A-39.007(8), F.A.C.