Provincial Métis Housing Corporation Reaching Home: Canada’s Homelessness Strategy Non-Designated Indigenous Homelessness Funding Stream Application Form

PROJECT INFORMATION

Project Name

Your project name should relate to your project activity. It may reflect the facility, group, or community that would benefit from the project. Do not use Reaching Home: Canada’s Homelessness Strategy (CHS) nor your organization’s name for the project name.

Length of Project

Your project must be completed within the current fiscal year, before March 31, 2020. Projects cannot begin until a contribution agreement has been signed with the Provincial Métis Housing Corporation. If the final completion of your project is anticipated to occur past March 31, 2020, please indicate the funding plan for subsequent phases and rough timelines including landscaping for capital project.

Location of Project activities

Funding is provided by location of activities. Please indicate if the mailing address is different than the location of project activities.

Please provide population size of community where project activities are to take place

Make note that the target population must be Indigenous people residing outside Saskatoon/Regina and off reserve

Project Areas of Activity

Please include the location of the facility and/or capital project activities, intended clientele, the accessibility of the service to the proposed client types and accessibility to other services potentially needed by the client. Refer Eligible Projects and Activities to better understand the areas of activity for this question.

Community Needs

Clearly demonstrate the need for the proposed activity through identification of a gap in services for the target population identified in the proposal. Please provide a description of your community needs and how your proposed activities will meet these needs. Note: please attach all sufficient evidence (i.e. need assessment, homelessness study etc.)

Project Objectives

Please provide the details of the intended outcomes of the project.

Project Activities and Timelines

The timelines of the project activities must include prospective dates of activities (e.g.; October, 2019-get quotes from various contractors to carry out the project renovation plans). Ensure that proposed activities and timelines are realistic.

Organization Capacity

What is the capacity of your organization and the people involved in carrying out the project activities in terms of experience, resources, and to ensure the project will be successfully implemented?

Measurable and achievable outcomes

Include identification of measurable and achievable short, medium or long-term outcomes to meet the needs of the homeless population as per Reaching Home: Canada’s Homelessness Strategy funding requirements (# of emergency shelter beds created, # of clients targeting to be housed, etc.) What do you hope to achieve or change by doing the proposed activities

Evaluation Strategy

Your evaluation strategy should reflect your plan on how you will measure the impact that your proposed activities have had on your clients and/or community. How will you know that your outputs or outcomes have been met? What data collection methods will you use?

Sustainability

An explanation as to how the project will continue to be sustainable after the Reaching Home: Canada’s Homelessness Strategy contribution agreement end. You must show evidence that the proposed activity has a plan in place to be operational for a five-year period after the end of the (CHS) funded project. For capital projects, please explain how the project will be sustainable for at least 5 years following the project build

PROJECT FUNDING DETAILS

Please fill out the detailed budget component attached to the application form. Indicate any other sources of funding for the project, if applicable.

DECLARATION

Must be signed by as many persons as required by the organization’s statutes or by-laws.

• I declare that I am legally authorized to sign and submit this Application on behalf of the organization named in Section 1.
• I declare that the information provided in this Application and supporting documentation is true, accurate, and complete to the best of my knowledge.
• I understand that if the information described above is false or misleading, I or the organization may be required to repay some or all of the funding received.
• I declare that for the duration of the project as it relates to Reaching Home funding should any of the board members and/or authorized signing authorities change It is my responsibility to notify PMHC via email as soon as possible.

4. SUBMITTING YOUR FUNDING APPLICATION

The checklist is a tool that will ensure your project proposal is complete. Please check to make sure that you have included all necessary information. Incomplete applications will not be accepted.

CONFLICT OF INTEREST IDENTIFICATION STATEMENT

Please provide a conflict of interest identification statement in place and abide by the guidelines below and ensure all agents, officers and employees follow accordingly as a condition of employment or engagement through the sponsor. PMHC in its sole discretion may disqualify a proposal and its sponsor if it is determined that a potential for a conflict of interest exists.

(I) or (We) understand and agree the Provincial Metis Housing Corporation as the funding agency of the Reaching Home: Canada’s Homelessness Strategy will consider a Conflict of Interest Identification Statement to exist between the candidate and any organization, partner, officer, employee, or agent involved with the Project Development and/or Operating Team (Team). A Team member includes any partner, project developer, general contractor, architect, engineer, lawyer, accountant or any other entity involved with the project.

Conditions for a Conflict of Interest to exist are:

• When there is any financial interest of the candidate in a Team;
• When one or more of the agents, officers, directors, shareholders or partners of the sponsor is also an agent, officer, director, shareholder or partner of the Team;
• When any agent, officer, director, shareholder or partner of the candidate has any financial interest whatsoever in the Team;
• When any agent, officer, director, shareholder or partner of the Team advances any funds to the candidate , other than an interim lender advancing funds to enable the Sponsor to pay for construction and other Project costs;
• When the Team provides and pays on behalf of the candidate for any project costs;
• When the Team takes stock or any interest in the candidate as part of the consideration to be paid them;
• When there exists or comes into being any side deals, agreements, contracts, or undertakings entered into, which create or will create a conflict of interest as set forth above.

(I) or (We) certify that for the Reaching Home funding Application 2019-2020 there is not now, nor will there be, a Conflict of Interest between the candidates and the Project Development and/or Operating Team, or any of their agents, officers, directors, shareholders, or partners or beneficiaries without prior written identification to the Aboriginal Homelessness Advisory Board

Provincial Métis Housing Corporation Reaching Home: Canada’s Homelessness Strategy Non-Designated Indigenous Homelessness Funding Stream Application Form

CONFLICT OF INTEREST IDENTIFICATION STATEMENT

Please provide a conflict of interest identification statement in place and abide by the guidelines below and ensure all agents, officers and employees follow accordingly as a condition of employment or engagement through the sponsor. PMHC in its sole discretion may disqualify a proposal and its sponsor if it is determined that a potential for a conflict of interest exists.

(I) or (We) understand and agree the Provincial Metis Housing Corporation as the funding agency of the Reaching Home: Canada’s Homelessness Strategy will consider a Conflict of Interest Identification Statement to exist between the candidate and any organization, partner, officer, employee, or agent involved with the Project Development and/or Operating Team (Team). A Team member includes any partner, project developer, general contractor, architect, engineer, lawyer, accountant or any other entity involved with the project.

Conditions for a Conflict of Interest to exist are:

• When there is any financial interest of the candidate in a Team;
• When one or more of the agents, officers, directors, shareholders or partners of the sponsor is also an agent, officer, director, shareholder or partner of the Team;
• When any agent, officer, director, shareholder or partner of the candidate has any financial interest whatsoever in the Team.
• When any agent, officer, director, shareholder or partner of the Team advances any funds to the candidate, other than an interim lender advancing funds to enable the Sponsor to pay for construction and other Project costs;
• When the Team provides and pays on behalf of the candidate for any project costs;
• When the Team takes stock or any interest in the candidate as part of the consideration to be paid them;
• When there exists or comes into being any side deals, agreements, contracts, or undertakings entered into, which create or will create a conflict of interest as set forth above.

(I) or (We) certify that for the Reaching Home funding Application 2019- 2020 there is not now, nor will there be, a Conflict of Interest between the candidates and the Project Development and/or Operating Team, or any of their agents, officers, directors, shareholders, or partners or beneficiaries without prior written identification to the Aboriginal Homelessness Advisory Board.

Provincial Métis Housing Corporation Reaching Home: Canada’s Homelessness Strategy Non-Designated Indigenous Homelessness Funding Stream Application Form

For this Reaching Home Application 2019-2020 , we hereby provide authorization for Provincial Metis Housing Corporation to contact each funding source representative as listed above