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Name of Organization: <br />Name of Funded Program: <br />DUNS # <br />Contact Name and Address: <br />ESG 2015 -2016 <br />Scope of Work <br />Interval House <br />Rapid Re- housing Program <br />113510176 <br />caroi Hnne yvnuams, Executive Urector <br />P.O. Box 3356, Seal Beach, CA 90740 <br />Street Outreach Shelter Homeless Prevention Rapid Re- Housing X <br />HMIS Coordinated Assessment /Centralized Intake <br />What is the total unduplicated number (both Santa Ana residents and Non -Santa Ana residents) that this <br />program plans to serve during 2015 -2016? <br />30 <br />What is the total unduplicated number of Santa Ana residents that this program plans to serve during <br />12 <br />Program and Funding Description <br />Description of Work - In the space below, describe the program to be funded during the 12 -month contract <br />period. What specific activities will be undertaken during the contract period. Please be concise in your <br />response. Only the viewable space will print. <br />1) Short- and medium -term rental assistance. Based on previous experience, the average assistance is <br />anticipated to be 3 months at an average rent of $1,100 per month (actual assistance will be based on <br />applicant need). <br />2) Housing Relocation and Stabilization — Financial Assisance: May include applicant's security deposits, <br />first and last month's rent and moving costs. <br />3) Housing Relocation and Stabilization Services: <br />• Case Management <br />• Housing Search and Placement <br />• Legal Services <br />• Financial Management/Credit Repair <br />Schedule of Performance /Goal Outcomes <br />Estimate the number of ONLY unduplicated Santa Ana participants to be served by the funded program <br />during the 12 -month contract period per quarter. (Enter number of new Santa Ana Participants served <br />each quarter. If they were served in quarter <br />Quarter 1: July 1 - September 30 <br />Quarter 2: October 1 - December 31 <br />Quarter 3: January 1 - March 31 <br />Quarter 4: April 1 -June 30 <br />em again in quarter 2) <br />Participants <br />Participants <br />Participants <br />Participants <br />Total Santa Ana Participants to be served. <br />Schedule of Invoicing <br />Estimate the amount of grant funds to be requested during the 12 -month contract period on a quarterly bas <br />Quarter 1: July 1 - September 30 <br />Quarter 2: October 1 - December 31 <br />Quarter 3: January 1 - March 31 <br />Quarter 4: April 1 -June 30 <br />$ 5,000.00 <br />$ <br />5,000.00 <br />$ <br />5,000m <br />$ <br />5,000.00 <br />$ <br />20,000.00 <br />Exhibit A <br />Page 1 of 1 <br />Total Grant <br />