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Housing Opportunities foe Person with AIDS (HOPWA) ', <br />Collsciladated Annual-Perforinance and Evaluation Repoet (CAPER) _ <br />x . ?. <br />Measui ing Performance Outputs and Outcomes <br />OMB Number 2506-0133 (Expiration Date: 10/3112014) <br />Part 1 ,Grantee Executive Summary <br />As applicable, complete the charts below to provide more detailed information about the agencies and organizations responsible <br />for the administration and implementation of the HOPWA program. Chart I requests general Grantee Information and Chart 2 is <br />to be completed for each organization selected or designated as a project sponsor, as defined by CFR 574.3. In Chart 3, indicate <br />each subrecipient organization with a contract/agreement of $25,000 or greater that assists grantees or project sponsors carrying <br />out their administrative or evaluation activities. In Chart 4, indicate each subrecipient organization with a contract/agreement to <br />provide HOPWA-funded services to client households. These elements address requirements in the Federal Funding and <br />Accountability and Transparency Act of 2006 (Public Law 109-282). <br />Note: Please see the definition section for distinctions between project sponsor and subrecipient. <br />Note: If any information does not apply to your organization, please enter N/A. Do not leave any section blank. <br />1. Grantee Information <br />HUD Grant Number Operating Year for this report <br /> From (inni/ddl*) To (nini/dd/yy) <br />Grantee Name <br />Business Address <br />City, County, State, Zip <br />Employer Identification Number (EIN) or <br />Tax Identification Number (TIN) <br />DUN & Bradstreet Number (DUNS): Central Contractor Registration (CCR): <br /> Is the grantee's CCR status currently active? <br /> ? Yes ? No <br /> If yes, provide CCR Number: <br />*Congressional District of Grantee's Business <br />Address <br />*Congressional District of Primary Service <br />Areas <br />*City(ies) and County(ies) of Primary Service Cities: Counties: <br />Area(s) <br />Organization's Website Address Is there awaiting list(s) for HOPWA Housing Subsidy Assistance <br /> Services in the Grantee service Area? ? Yes ? No <br /> If yes, explain in the narrative section what services maintain a waiting <br /> list and how this list is administered. <br />* Service delivery area information only needed for program activities being directly carried out by the grantee. <br />Previous editions are obsolete Page 1 form HUD-40110-D (Expiration Date: 10/31/2014) <br />25D-16