HomeMy WebLinkAboutItem 25 - Resolution Grant of the Santa Ana Civic Center Community Development Agency
www.santa-ana.org/community-development
Item # 25
City of Santa Ana
20 Civic Center Plaza, Santa Ana, CA 92701
Staff Report
May 2, 2023
TOPIC: Resolution Grant of the Santa Ana Civic Center
AGENDA TITLE
Adopt Resolution for State of California Grant and Approve Appropriation Adjustment
Recognizing $9,000,000 of State Grant Funds for the Modernization of the Santa Ana
Civic Center
RECOMMENDED ACTION
1. Adopt a resolution approving the submission of applications for specified grant funds
from the State of California and authorizing the City Manager to execute the necessary
grant contract and submit project applications for the use of $9,000,000.
2. Approve an Appropriation Adjustment recognizing State of California Grant Funds in
the amount of $9,000,000. (Requires five affirmative votes)
DISCUSSION
The State of California has authorized a grant of $9,000,000 to the City of Santa Ana for
the modernization of the Santa Ana Civic Center.
Currently, modernization efforts have begun throughout the Civic Center including a $400
million investment by the County of Orange for new headquarters, a $500 million multi-
agency investment for the OC Streetcar (Orange County’s first modern streetcar), and a
$34.5 million investment by the City towards the transformation of the Main Library.
Additionally, in an effort to obtain additional site control for the Civic Center, the City
recently acquired approximately 2.2 acres from the County of Orange via a land
exchange. This newly acquired area includes the Plaza of the Flags and a Japanese
Garden.
An area of interest for the City in the modernization of the Civic Center is the acquisition
and demolition of an obsolete State building located at 28 Civic Center Plaza. This 9-story
building is approximately 130,000 square feet on 0.5 acres in size and is surrounded by
City-owned property (Exhibit 1). The City has been in discussions with the State for the
potential acquisition since mid-2020. An appraisal conducted in December 2022 valued
the building at $3,826,000.
Resolution Grant for Modernization of Civic Center
May 2, 2023
Page 2
3
4
1
3
The $9 million from the State will provide the necessary funding for the acquisition and
demolition of the State building and additional modernization efforts for City Hall and the
Civic Center project area.
To receive the funds from the State, the City is required to adopt a Resolution (Exhibit 2).
Once the State receives the adopted Resolution, it will issue a Grant Contract to the City
of Santa Ana. Once the Grant Contract is executed, the State requires a Project
Application to be submitted with the project budget. A sample Grant Contract and Project
Application are attached as Exhibits 3 & 4.
Authorizing these items will enable staff to proceed with executing the grant contract with
the State and formally submit the applications for the specified projects. A Purchase and
Sale Agreement for 28 Civic Center Plaza will be presented for City Council consideration
at a later date.
FISCAL IMPACT
Approval of the appropriation adjustment will recognize a total of $9,000,000 in State
Grant funds to revenue account (41818002-52025 State Grant-Direct) and appropriate
same to the following expenditure accounts. Any remaining balances not expended at
the end of the fiscal year will be presented to City Council for approval of carryovers to
FY 2023-24.
Fiscal Year Accounting Unit-
Account Fund Description Accounting Unit, Account
Description Amount
FY 22-23 41818833-66200 CDA Capital Projects
Modernization of
SA Civic Center, Buildings &
Building Imp.
$3,900,000
FY 22-23 41818833-62300 CDA Capital Projects
Modernization of
SA Civic Center, Contract
Services
$5,100,000
Total Expenditures $9,000,000
EXHIBIT(S)
1. Location Map
2.Resolution
3.Sample Grant Contract
4.Sample Grant Application
Submitted By: Michael L. Garcia, Executive Director of Community Development
Approved By: Kristine Ridge, City Manager
EXHIBIT 1
LOCATION MAP
City Property State Building
28 Civic Center Plaza
Main
Library
City Hall
Plaza
of the
Flags
Japanese
Garden
Resolution No. 2023-XXX
Page 1 of 2
Resolution No: 2023-XXX
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
SANTA ANA APPROVING APPLICATION FOR SPECIFIED
GRANT FUNDS FROM BUDGET ACT 2022/23 (BUDGET
ACT OF 2022, AB179, CHAPTER 249, CONTROL SECTION
19.56, ITEM 3790-101-0001(K) OTHER COMMUNITY
SERVICES, (24) $9,000,000 TO THE CITY OF SANTA ANA
FOR THE MODERNIZATION OF THE SANTA ANA CIVIC
CENTER (SACC))
WHEREAS, the State Department of Parks and Recreation has been deleg ated
the responsibility by the Legislature of the State of California for the administration of a
grant to the City of Santa Ana (“Applicant”), for the Modernization of the Santa Ana Civic
Center project (“Project”), setting up necessary procedures governing application(s);
and
WHEREAS, said procedures established by the State Department of Parks and
Recreation require the applicant’s Governing Body to certify by resolution the approval
of project applications before submission of said applications to the State; and
WHEREAS, the applicant will enter into a contract with the State of California to
complete project.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Santa
Ana as follows:
Section 1. The City hereby:
A.Approves the filing of project applications for specified grant project; and
B.Certifies that said applicant has or will have available, prior to commencement of
project work utilizing specified grant funds, sufficient funds, including those
provided by this grant, to complete the project; and
C.Certifies that the applicant has or will provide sufficient funds to operate and
maintain the project; and
D.Certifies that the applicant has reviewed, understands, and agrees to the
Provisions contained in the contract in this Procedural Guide; and
E.Delegates the authority to the City Manager, or designee to conduct all
negotiations, sign and submit all documents, including, but not limited to
applications, agreements, amendments, and payment requests, which may be
necessary for the completion of the project scope(s); and
F.Agrees to comply with all applicable federal, state and local laws, ordinances, rules,
regulations and guidelines.
Section 2. This Resolution shall take effect immediately upon its adoption by
the City Council, and the City Clerk shall attest to and certify the vote adopting this
Resolution.
EXHIBIT 2
Resolution No. 2023-XXX
Page 2 of 2
Adopted this _____day of ______________, 20_______.
________________________________
Valerie Amezcua
Mayor
APPROVED AS TO FORM:
Sonia R. Carvalho, City Attorney
By:
Andrea Garcia-Miller
Assistant City Attorney
AYES: Councilmembers
NOES: Councilmembers
ABSTAIN: Councilmembers
NOT PRESENT: Councilmembers _
CERTIFICATE OF ATTESTATION AND ORIGINALITY
I, Jennifer Hall, City Clerk, do hereby attest to and certify the attached Resolution No.
2023-XXX to be the original Resolution adopted by the City Council of the City of Santa
Ana on May ___, 2023.
Date: _________________ _____________________
City Clerk
City of Santa Ana
EXHIBIT 2
EXHIBIT 3
1
IV.CONTRACT SECTION
The following section contains a sample CONTRACT, CONTRACT provisions, and a sample
status report form.
State of California – The Resources Agency
DEPARTMENT OF PARKS AND RECREATION
Grant Contract
Specified Grants
GRANTEE: Grantee
GRANT PERFORMANCE PERIOD is from July 1, 2022 through June 30, 2026
CONTRACT PERFORMANCE PERIOD is from July 1, 2022 through June 30, 2026
The GRANTEE agrees to the terms and conditions of this Contract, and the State of
California, acting through its Director of Parks and Recreation, pursuant to the State of
California, agrees to fund the total State grant amount indicated below.
The GRANTEE agrees to complete the PROJECT SCOPE(s) as defined in the
PROJECT SCOPE /Cost Estimate Form of the application(s) filed with the State of
California.
Total State grant amount not to exceed $ Grant amount
The General and Special Provisions attached are made a part of and incorporated
into the Contract.
STATE OF CALIFORNIA
DEPARTMENT OF PARKS AND RECREATION
By______________________________________
Date____________________________________
_______________________________________________
GRANTEE
By _________________________________________
(Typed or printed name of Authorized
Representative)
________________________________________
(Signature of AUTHORIZED REPRESENTATIVE)
Title _________________________________________
Date _________________________________________
CERTIFICATION OF FUNDING (FOR STATE USE ONLY)
AMOUNT OF ESTIMATE $ CONTRACT NUMBER FUND
ADJ. INCREASING ENCUMBRANCE $ APPROPRIATION
ADJ. DECREASING ENCUMBRANCE $ ITEM VENDOR NUMBER
UNENCUMBERED BALANCE $ LINE ITEM ALLOTMENT CHAPTER STATUTE FISCAL YEAR
T.B.A. NO. B.R. NO. INDEX PCA OBJ. EXPEND
I hereby certify upon my personal knowledge that budgeted funds are available for this encumbrance.
SIGNATURE OF ACCOUNTING OFFICER DATE
EXHIBIT 3
2
I. RECITALS
This AGREEMENT is entered into between the California Department of Parks and Recreation
(hereinafter referred to as “GRANTOR,” “DEPARTMENT” or “STATE”) and [Name of grantee]
(hereinafter referred to as “grantee”).
The DEPARTMENT hereby grants to GRANTEE a sum (also referred to as “GRANT MONIES”) not to
exceed $[grant amount], subject to the terms and conditions of this AGREEMENT and the [2022-
2023 California State Budget, AB 178, Chapter 45, Statutes of 2022, as amended by AB 179,
Chapter 249, Section 19.56 Item number – 3790-493-0001] (appropriation chapter and budget item
number hereinafter referred to as “SPECIFIED GRANT”). These funds shall be used for completion
of the GRANT SCOPE(S).
The Grant Performance Period is from July 1, 2022 to June 30, 2026.
II. GENERAL PROVISIONS
A. Definitions
As used in this CONTRACT, the following words shall have the following meanings:
1. The term “APPLICATION” means the individual project APPLICATION packet for a project
pursuant to the enabling legislation and/or grant program PROCEDURAL GUIDE requirements.
2. The term “CONTRACT PERFORMANCE PERIOD” means the duration of time during which this
CONTRACT is in effect.
3. The term “DEPARTMENT” or “STATE” means the California Department of Parks and
Recreation.
4. The term “DEVELOPMENT” means capital improvements to real property by means of, but not
limited to, construction, expansion, and/or renovation, of permanent or fixed features of the
property.
5. The term “GRANTEE” means the party described as the GRANTEE in Section I of this
AGREEMENT.
6. The term “GRANT PERFORMANCE PERIOD” means the period of time during which eligible
costs may be incurred by the GRANTEE and paid for by the DEPARTMENT, as specified in
the fully executed CONTRACT.
7. The term “GRANT PROJECT” means all real estate, leases, subleases, buildings, and other
property acquired or developed with GRANT monies.
8. The term “PROJECT SCOPE” means the items listed in the PROJECT SCOPE/Cost Estimate
Form found in each of the APPLICATIONS submitted pursuant to this grant.
9. The term “PROCEDURAL GUIDE” means the document identified as the “2022-23 Procedural
Guide for Specified Grants.” The PROCEDURAL GUIDE provides the procedures and policies
controlling the administration of the grant.
EXHIBIT 3
3
B. Project Execution
1. Subject to the availability of GRANT MONIES, the STATE hereby grants to the GRANTEE a
sum of money not to exceed the amount stated in Section I of this CONTRACT, in consideration
of, and on condition that, the sum be expended in carrying out the purposes as set forth in the
scope described in the enabling legislation and referenced in the APPLICATION, Section I of
this CONTRACT, and under the terms and conditions set forth in this CONTRACT.
The GRANTEE shall assume any obligation to furnish any additional funds that may be
necessary to complete the GRANT SCOPE(S).
During the CONTRACT PERFORMANCE PERIOD, the GRANTEE agrees to submit any
proposed change or alteration from the original GRANT SCOPE(S) in writing to the STATE for
prior approval. This applies to any and all proposed changes that will occur after STATE has
approved the APPLICATION. Changes in the GRANT SCOPE(S) must first be approved in
writing by the STATE.
2. The GRANTEE shall complete the GRANT SCOPE(S) in accordance with the time of the
Performance Period set forth in Section I of this CONTRACT, and under the terms and
conditions of this contract.
3. The GRANTEE shall comply with the California Environmental Quality Act (Public Resources
Code, Section 21000, et seq., Title 14, California Code of Regulations, Section 15000 et seq.).
4. The GRANTEE shall comply with all applicable current laws and regulations affecting
DEVELOPMENT projects, including, but not limited to, legal requirements for construction
contracts, building codes, health and safety codes, and laws and codes pertaining to individuals
with disabilities, including but not limited to the Americans with Disabilities Act of 1990 (42
U.S.C. §12101 et seq.) and the California Unruh Act (California Civil Code §51 et seq.)
C. Project Costs
1. GRANTEE agrees to abide by the PROCEDURAL GUIDE.
2. GRANTEE acknowledges that STATE may make reasonable changes to its procedures as set
forth in the PROCEDURAL GUIDE. If STATE makes any changes to its procedures and
guidelines, STATE agrees to notify GRANTEE within a reasonable time.
D. Project Administration
1. If GRANT MONIES are advanced for DEVELOPMENT projects, the advanced funds shall be
placed in an interest-bearing account until expended. Interest earned on the advanced funds
shall be used on the project as approved by the STATE. If grant monies are advanced and not
expended, the unused portion of the grant and any interest earned shall be returned to the
STATE within 60 days after project completion or end of the GRANT PERFORMANCE
PERIOD, whichever is earlier.
2. During the GRANT PERFORMANCE PERIOD, the GRANTEE shall submit written project
status reports within 30 calendar days after the STATE has made a specific request. All such
project status reports shall be signed and certified as complete and accurate by the authorized
representative of the GRANTEE. In any event, the GRANTEE shall provide the STATE a report
showing total final project expenditures within 60 days of project completion or the end of the
EXHIBIT 3
4
GRANT PERFORMANCE PERIOD, whichever is earlier. The GRANT PERFORMANCE
PERIOD is identified in Section I of this CONTRACT.
3. The GRANTEE shall make property or facilities acquired and/or developed pursuant to this
contract available for inspection upon request by the STATE.
E. Project Termination
1. Project Termination refers to the non-completion of a GRANT SCOPE. Any grant funds that
have not been expended by the GRANTEE shall revert to the STATE.
2. The GRANTEE may unilaterally rescind this contract at any time prior to the commencement of
the project. The commencement of the project means the date of the letter notifying GRANTEE
of the award or when the funds are appropriated, whichever is later. After project
commencement, this contract may be rescinded, modified or amended only by mutual
CONTRACT in writing between the GRANTEE and the STATE, unless the provisions of this
contract provide that mutual CONTRACT is not required.
3. Failure by the GRANTEE to comply with the terms of the (a) PROCEDURAL GUIDE, (b) any
legislation applicable to the ACT, (c) this CONTRACT or any other grant contracts, specified or
general, that GRANTEE has entered into with STATE or any other department, agency,
commission or other subdivision of California State government, may be cause for suspension
of all obligations of the STATE unless the STATE determines that such failure was due to no
fault of the GRANTEE. In such case, STATE may reimburse GRANTEE for eligible costs
properly incurred in performance of this CONTRACT despite non-performance of the
GRANTEE. To qualify for such reimbursement, GRANTEE agrees to mitigate its losses to the
best of its ability.
4. Any breach of any term, provision, obligation, or requirement of this CONTRACT by the
GRANTEE shall be a default of this CONTRACT. In the case of any default by GRANTEE,
STATE shall be entitled to all remedies available under law and equity, including but not limited
to: a) Specific Performance; b) Return of all GRANT MONIES; c) Payment to the STATE of the
fair market value of the project property or the actual sales price, whichever is higher; and d)
Payment to the STATE of the costs of enforcement of this CONTRACT, including but not limited
to court and arbitration costs, fees, expenses of litigation, and reasonable attorney fees.
5. The GRANTEE and the STATE agree that if the GRANT SCOPE includes DEVELOPMENT,
final payment may not be made until the work described in the GRANT SCOPE is complete and
the GRANT PROJECT is open to the public.
F. Budget Contingency Clause
If funding for any fiscal year is reduced or deleted by the budget act for purposes of this program,
the STATE shall have the option to either cancel this contract with no liability occurring to the
STATE or offer a contract amendment to GRANTEE to reflect the reduced grant amount. This
Paragraph shall not require the mutual CONTRACT as addressed in Paragraph E, subsection 2 of
this CONTRACT
EXHIBIT 3
5
G. Hold Harmless
1. The GRANTEE shall waive all claims and recourse against the STATE including the right to
contribution for loss or damage to persons or property arising from, growing out of or in any way
connected with or incident to this CONTRACT except claims arising from the concurrent or sole
negligence of the STATE, its officers, agents, and employees.
2. The GRANTEE shall indemnify, hold harmless and defend the STATE, its officers, agents and
employees against any and all claims, demands, damages, costs, expenses or liability costs
arising out of the ACQUISITION, DEVELOPMENT, construction, operation or maintenance of
the property described as the project which claims, demands or causes of action arise under
California Government Code Section 895.2 or otherwise except for liability arising out of the
concurrent or sole negligence of the STATE, its officers, agents, or employees.
3. The GRANTEE agrees that in the event the STATE is named as codefendant under the
provisions of California Government Code Section 895 et seq., the GRANTEE shall notify the
STATE of such fact and shall represent the STATE in the legal action unless the STATE
undertakes to represent itself as codefendant in such legal action in which event the GRANTEE
agrees to pay the STATE’s litigation costs, expenses, and reasonable attorney fees.
4. The GRANTEE and the STATE agree that in the event of judgment entered against the STATE
and the GRANTEE because of the concurrent negligence of the STATE and the GRANTEE,
their officers, agents, or employees, an apportionment of liability to pay such judgment shall be
made by a court of competent jurisdiction. Neither party shall request a jury apportionment.
5. The GRANTEE shall indemnify, hold harmless and defend the STATE, its officers, agents and
employees against any and all claims, demands, costs, expenses or liability costs arising out of
legal actions pursuant to items to which the GRANTEE has certified. The GRANTEE
acknowledges that it is solely responsible for compliance with items to which it has certified.
H. Financial Records
1. The GRANTEE shall maintain satisfactory financial accounts, documents, including loan
documents, and all other records for the project and shall make them available to the STATE for
auditing at reasonable times. The GRANTEE also agrees to retain such financial accounts,
documents and records for five years following project termination or final payment.
2. The GRANTEE shall keep such records as the STATE shall prescribe, including records which
fully disclose (a) the disposition of the proceeds of STATE funding assistance, (b) the total cost
of the project in connection with such assistance that is given or used, (c) the amount, source
and nature of that portion of the project cost supplied by other sources, and (d) any other such
records that will facilitate an effective audit.
3. The GRANTEE agrees that the STATE shall have the right to inspect and make copies of any
books, records or reports pertaining to this contract or matters related thereto during regular
office hours. The GRANTEE shall maintain and make available for inspection by the STATE
accurate records of all of its costs, disbursements and receipts with respect to its activities under
this contract, and shall provide copies of all such records to STATE in its certified status reports
upon request by the STATE. Such accounts, documents, and records shall be retained by the
GRANTEE for at least five years following final payment.
4. The GRANTEE shall use a generally accepted accounting system.
EXHIBIT 3
6
I. Use of Facilities
1. The GRANTEE agrees that the GRANTEE shall operate and maintain and retain full control of
the property acquired or developed with the GRANT MONIES, for the duration of the
CONTRACT PERFORMANCE PERIOD.
2. The GRANTEE agrees that, during the CONTRACT PERFORMANCE PERIOD, the
GRANTEE shall use the property acquired or developed with grant funds under this contract
only for the purposes of this grant and no other use, sale, assignment, transfer, mortgage, or
other disposition or change of the control or use of the property or of any interest in the
property to one not consistent with the grant purpose shall be permitted except as authorized
by the DEPARTMENT and the property shall be replaced with property of equivalent value
and usefulness as determined by the STATE.
3. The property acquired or developed may be transferred or assigned to another entity only if
the successor entity assumes the obligations imposed under this contract and only with the
prior approval of STATE.
4. Any real Property (including any portion of it or any interest in it, including any leases) may
not be used as security or collateral for any debt, loan or mitigation, without the prior written
approval of the STATE, provided that such approval shall not be unreasonably withheld as
long as the purposes for which the grant was awarded are maintained. Any such permission
that is granted does not make STATE a guarantor or a surety for any debt, loan or mitigation,
nor does it waive STATE’s rights to enforce performance under the CONTRACT.
5. All real property (including any portion or interest in it, including any leases), or rights thereto,
acquired with GRANT MONIES shall be subject to an appropriate form of restrictive title,
rights, or covenants approved by the STATE. If the project property is taken by use of
eminent domain, GRANTEE shall reimburse STATE an amount at least equal to the amount
of grant monies received from STATE or the pro-rated full market value of the real property,
including improvements, at the time of sale, whichever is higher.
6. If eminent domain proceedings are initiated against GRANTEE, GRANTEE shall notify
STATE within 10 days of receiving the complaint.
J. Nondiscrimination
1. The GRANTEE shall not discriminate against any person on the basis of race, religious
creed, color, national origin, ancestry, physical disability, mental disability, medical condition,
genetic information, marital status, sex, gender, gender identity, gender expression, age,
sexual orientation, or military and veteran status in the administration and in the use of any
property or facility developed pursuant to this contract.
2. The GRANTEE shall not discriminate against any person on the basis of residence except to
the extent that reasonable differences in admission or other fees may be maintained on the
basis of residence and pursuant to law.
3. All facilities shall be open to members of the public generally, except as noted under the
special provisions of this project contract or under provisions of the enabling legislation and/or
grant program.
EXHIBIT 3
7
K. Severability
If any provision of this CONTRACT or the application thereof is held invalid, that invalidity shall
not affect other provisions or applications of the CONTRACT which can be given effect without
the invalid provision or application, and to this end the provisions of this CONTRACT are
severable.
L. Liability
1. STATE assumes no responsibility for assuring the safety or standards of construction, site
improvements or programs related to the GRANT SCOPE. The STATE’S rights under this
CONTRACT to review, inspect and approve the GRANT SCOPE and any final plans of
implementation shall not give rise to any warranty or representation that the GRANT SCOPE
and any plans or improvements are free from hazards or defects.
2. GRANTEE shall ensure that any contractor hired has adequate liability insurance,
performance bond, or other security necessary to protect the GRANTEE interest and the
STATE’s interest against poor workmanship, fraud, or other potential loss associated with the
completion of the grant project.
M. Assignability
Without the written consent of the STATE, the GRANTEE’S interest in and control of any portion
of the GRANT PROJECT and responsibilities under this CONTRACT shall not be assignable or
transferable by the GRANTEE either in whole or in part.
N. Use of Grant Monies
GRANTEE shall not use any grant funds (including any portion thereof) for the purpose of
making any leverage loan, pledge, promissory note or similar financial device or transaction,
without: 1) the prior written approval of the STATE; and 2) any financial or legal interests created
by any such leverage loan, pledge, promissory note or similar financial device or transaction in
the project property shall be completely subordinated to this CONTRACT through a
Subordination Agreement provided and approved by the STATE, signed by all parties involved
in the transaction, and recorded in the County Records against the fee title of the project
property.
O. Section Headings
The headings and captions of the various sections of this CONTRACT have been inserted only
for the purpose of convenience and are not a part of this CONTRACT and shall not be deemed
in any manner to modify, explain, or restrict any of the provisions of this CONTRACT
P. Waiver
Any failure by a party to enforce its rights under this CONTRACT, in the event of a breach or
default, shall not be construed as a waiver of said rights; and the waiver of any breach or default
under this CONTRACT shall not be construed as a waiver of any subsequent breach.
EXHIBIT 3
8
III. SPECIAL PROVISIONS
On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding
Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions”
refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine,
as well as any sanctions imposed under state law. The EO directs state agencies to terminate
contracts with, and to refrain from entering any new contracts with, individuals or entities that are
determined to be a target of Economic Sanctions. This Executive order extends to recipients of
any State Grants (Grantee). Grantees include those who have contracted or will contract to
receive State grants funds. Accordingly, should the State determine that a Grantee is a target of
Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or
entities, that shall be grounds for termination of this agreement. The State shall provide the
Grantee advance written notice of such termination, allowing the Grantee at least 30 calendar
days to provide a written response. Termination of any contract found to be in violation of this
Executive Order shall be at the sole discretion of the State.
_____________________________________
GRANTEE
By:__________________________________
Signature of Authorized Representative
Title: _________________________________
Date: _________________________________
STATE OF CALIFORNIA
DEPARTMENT OF PARKS AND RECREATION
By: _________________________________
Date: _________________________________
EXHIBIT 4
1
State of California – The Resources Agency
DEPARTMENT OF PARKS AND RECREATION
Project Application Form
PROJECT NAME REQUESTED GRANT AMOUNT
$
PROJECT SITE NAME and PHYSICAL ADDRESS where
PROJECT is located (including zip code)
(Use latitude and longitude if there is no street address)
LAND TENURE ( all that apply)
Owned in fee simple by APPLICANT
Available (or will be available) under
a _________year lease or easement
NEAREST CROSS STREET
COUNTY OF PROJECT LOCATION
APPLICANT NAME AND MAILING ADDRESS
AUTHORIZED REPRESENTATIVE AS SHOWN IN RESOLUTION
___________________________________________________________________________________
Name (typed or printed) and Title Email address Phone
GRANT CONTACT - For administration of grant (if different from AUTHORIZED REPRESENTATIVE)
___________________________________________________________________________________
Name (typed or printed) and Title Email address Phone
GRANT SCOPE: I represent and warrant that this APPLICATION PACKET describes the intended use of the
requested GRANT to complete the items listed in the attached Project Scope/Cost Estimate Form. I declare
under penalty of perjury, under the laws of the State of California, that the information contained in this
APPLICATION PACKET, including required attachments, is accurate.
____________________
Signature of AUTHORIZED REPRESENTATIVE as shown in Resolution Date
Print Name
Title
EXHIBIT 4
2
Project Scope/Cost Estimate Form
GRANTEE: PROJECT Name:
Grant Scope (Describe the project in 30 words or less):
GRANT SCOPE ITEMS
ACQUISITION: List each parcel number, acreage, estimated date of purchase
and cost.
DEVELOPMENT: List each major project element and major support amenity. Estimated Cost
$
$
$
$
$
$
$
$
$
$
$
$
Total GRANT amount: $
AUTHORIZED REPRESENTATIVE Signature Date
Print Name and Title
The APPLICANT understands that this form will be used to establish ELIGIBLE COSTS, and that all of
the items listed on this form must be completed before the final PROJECT payment is processed as
specified in the Final Payments section of this guide.
EXHIBIT 4
3
State of California – The Natural Resources Agency
DEPARTMENT OF PARKS AND RECREATION Funding Sources
Grantee Name:_______________________________________
Project Name:________________________________________
PROJECTs funded by the program are not complete until all SCOPE items are complete
and open to the public.
If Specified GRANT funds will be used as part of the funding for a larger project, briefly
describe the scope of that larger project:
The total cost of the larger project that these GRANT funds will contribute to is
$____________
Anticipated completion date: _________________
List all funds that will be used:
Funding source Date Committed Amount
State of California 2022-23 Budget Act July 1, 2022 $
I represent and warrant that I have fully authority to execute this Funding Sources Form
on behalf of the GRANTEE. I declare under penalty of perjury, under the laws of the State
of California, that this Funding Sources Form, and any accompanying documents, for
the above-mentioned grant is true and correct to the best of my knowledge.
AUTHORIZED REPRESENTATIVE Signature Date
Print Name and Title
NOTE: Submit a revised Funding Sources Form should funding sources be modified.
EXHIBIT 4
4
State of California – The Resources Agency
DEPARTMENT OF PARKS AND RECREATION
CEQA Compliance Certification Form
GRANTEE:
Project Name:
Project Address:
Is CEQA complete? Yes No Is completing CEQA a PROJECT SCOPE item? Yes No
What document was filed, or is expected to be filed for this project’s CEQA analysis:
__________________________________
Date complete/expected to be completed: ___________________
Notice of Exemption (attach recorded copy if filed)
Notice of Determination (attach recorded copy if filed)
Other:
If CEQA is complete, and a Notice of Exemption or Notice of Determination was not filed, attach
a letter from the Lead Agency explaining why, certifying the project has complied with CEQA
and noting the date that the project was approved by the Lead Agency.
Lead Agency Contact Information
Agency Name:
Contact Person:
Mailing Address:
Phone: ( ) Email:
Certification:
I hereby certify that the above referenced Lead Agency has complied or will comply with the
California Environmental Quality Act (CEQA) and that the project is described in adequate and
sufficient detail to allow the project’s construction or acquisition.
I further certify that the CEQA analysis for this project encompasses all aspects of the work to
be completed with grant funds.
AUTHORIZED REPRESENTATIVE Signature Date
Print Name and Title
FOR OGALS USE ONLY
CEQA Document Date Received PO Initials
NOE NOD