HUD_Lead-Based Paint Hazard Control Grant Closeout0Q
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OFFICE OF HEALTHY HOMES AND
LEAD HAZARD CONTROL
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
WASHINGTON, DC 20410-3000
April 3, 2014
The HonorableRoy D. Buol
Mayor of Dubuque
350 West 6th Street Suite 312
Dubuque, IA 52001
Dear Mayor Buol:
In order that we may close-out your grant, IALx:04.6640, please provide the information
requested and complete the blocks below as appropriate. If more time is needed to complete all of
the elements outlined in your grant, please contact your Government Technical Representative, to
discuss and/or request a no -cost time extension.
A. Please submit a statement indicating whether or not you will have completed all elements of
performance and, if not, an explanation as to why not.
B. Please submit an inventory of any Government property acquired greater than $5,000 per
unit under this instrument, unless the disposition was previously agreed to, such as x-ray
fluorescence instruments. If there was none, so certify by checking the block below.
EJ Yes, list attached
No government property exceeding $5,000
per unit was acquired with assistance funds
C. Indicate if there were any patentable inventions developed under this instrument If there
was none, so certify by checking the block below.
Yes, (attach an explanation) o patentable inventions were developed
under this award
D. OMB Circular A-133, "Audits of States, Local Governments, and Non-profit
Organizations" applies to your grant if you expend $500,000 or more in a year in federal
awards. If this applies to you, you are required to complete an annual organization- wide
www.hud.gov espandhud.gov
audit in accordance with guidelines of OMB Circular A-133. In this case you need not send a copy
of the report, as we will receive it automatically. Please check the category below that applies to
you.
Organization is covered by the OMB Circular A-133
0 Organization is not covered by the OMB Circular A-133
We plan to closeout this instrument without requesting a separate audit. As the Federal
sponsoring agency, we reserve the right to recover any amounts due IUD should a subsequent audit
have findings affecting this award or if we discover any problems indicating a separate audit is
needed.
Your authorized official must sign the certification below. Your compliance with the above
close-out requirements is a legal obligation as was performance of the work. Should you have any
questions, please contact me at (202) 402-7563.
Please return your completed letter, via overnight,mail to:
Brittany M. Birdsong
U.S. Department of Housing and Urban Development
Office of Lead Hazard Control
451 Seventh Street, S.W., Room 8236
Washington, DC 20410
Sincerely,
'13xd----ains 60)
William Nellis
Grant Officer
I hereby certify that the above information is true and accurate.
April 7, 2014.
Date Signator
Mayor.
Title
Request for Release of Funds
and Certification
U.S. Department of Housing
and Urban Development
Office of Community Planning
and Development
OMB No. 2506-0087
(exp. 3/31/2011) '
This form is to be used by Responsible Entities and Recipients (as defined in 24 CFR 58,2) when requesting the release of funds, and
requesting the authority to use such funds, for HUD programs identified by statutes that provide for the assumption of the environmental
review responsibility by units of general local government and States. Public reporting burden for this collection of information is estimated
to average 36 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. This agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number.
Part 1. Program Description and Request for Release of Funds (o be completed by Responsible Entity)
1. Program Title(s)
Lead Based Paint Hazard Control Grant
2. HUD/State Identification Number
IALHB0466-10
3. Recipient Identification Number
(optional)
4. OMB Catalog Number(s)
14.900
6. For information about this request, contact (name & phone number)
Kevin Hirsch 563-589-1724
5. Name and address of responsible entity
City of Dubuque
350 West 6th Street Suite 312
Dubuque IA 52001
8. HUD or State Agency and office unit to receive request
HUD, Office of Healthy Homes and Lead Hazard
Control, 451 Seventh Street SW, Room
9245,Washington, DC 20410
7. Name and address of recipient (if different than responsible entity)
The recipient(s) of assistance under the program(s) listed above requests the release of funds and removal of environmental grant
conditions governing the use of the assistance for the following
9. Program Activity(ies)/Project Name(s) 10. Location (Street address, city, county, State)
Lead Based Paint Hazard Control GrantProgram City of Dubuque, Dubuque County,Iowa
11. Program Activity/Project Description
Program will perform lead hazard control work to reduce the number of lead poisoned
throughout the target area through evaluation of housing units for lead hazards and
eliminating the lead hazards in homes. The City will also provide training to individuals
for lead certification.
Previous editions are obsolete form HUD-7015.15 (1/99)