Community Development Department
Neighborhood Services Division
9875 N. 85th Avenue
Peoria, AZ  85345
							Ph 623.773.5140
Fax 623.773.7245                                                                               
NEIGHBORHOOD GRANTS APPLICATION

1. Name of your neighborhood association 										
2. Are you a registered neighborhood with the City?   Yes	 No	
If not, you must register to be eligible to apply. Call 623-773-7250 for an application or register on-line at www.peoriaaz.gov/Neighborhood/Neighborhood_HOA_Form.asp
3. In what year were the properties in this neighborhood built?  								
4. Grant Project Boundaries (please list the specific streets, or name and address where your project will be located):
North 								South 							
East 								West  							
5. Name of proposed project: 												
6. Please indicate the amount you are requesting $									
7. Type of association:
	Condominium/Townhouse Association    
	Mobile Home Park Association		
	Traditional Neighborhood Association (NA)			
	Homeowner’s Association (HOA) – If you marked this section, answer questions a, b, and c below:
       a. Current board members have attended HOA education classes:  Yes    No 
       b. Our HOA has completed a reserve study:  Yes    No 
       c. Cash match?  Yes    No   If yes, indicate amount: $						
8. The project is located on:
	Public Right of Way
	Private Property
9. Primary contact for grant application:  (please print)
NAME															
ADDRESS														
PHONE 														
EMAIL															
10. Please describe your project (attach additional pages if necessary):

															
															
															
															
11. How will neighbors be involved in the planning and implementing of this project?  Describe how the project 
was chosen, and the process used to gather neighborhood support for the project (i.e., neighborhood meetings, door-to-door surveys, etc.)  
															
															
12. What specific issue(s) are you trying to address with this project?  How will the proposed project benefit the neighborhood?
															
															

13. Would you be able to complete this project without grant funds?  (Please explain).
															
															
14. Who will be responsible for maintenance?  (If applicable).
															
															
15. Estimated start date 					Estimated completion date 				
16. Has your neighborhood received grant money in the past?  If so, provide date(s) and amount(s) 
															
17. Required Items:
??Price quotes - Attach three (3) price quotes for work and materials (for physical improvements).
??Private Property Approval Form(s) – Attach all necessary private property permission forms for those property owners directly impacted by the project.
??Evidence of Neighborhood Support – Submit all collected results (signed minutes of meetings, ballots, petitions, etc.) of your neighborhood in support of this grant application request.
??HOA Board Resolution - If you are a homeowners’ association, you must attach a signed resolution of the board members authorizing the grant request.
??HOA Financial Statement – If you are a homeowners’ association and unable to meet the 50% cash match requirement, attach your most recent financial statement. 
??Miscellaneous Items – Please attach any other items – i.e. any recent newsletters or neighborhood flyers that show communication by the neighborhood regarding the grant project; special brochures or trade publications that visually depict the improvement you are seeking, and any other items (sketched plans, photographs) you may feel appropriate for this grant request.

NOTE:  If this project is approved, the City of Peoria will enter into an agreement with the grantee to ensure completion of the project, as described by this application.
All physical improvements, whether on private property or the city right-of-way, must be reviewed and comply with the city code and be in accordance with all federal, state, and local laws.
In addition, the undersigned understands and fully acknowledges that, to the fullest extent allowed by law, they shall indemnify and hold harmless the City of Peoria and its representatives, from and against all allegations, claims or damages arising from or resulting from any work or services with respect to the Neighborhood Grants Program project funding.
The undersigned certifies that the information in this application is true and complete and has been provided for the purpose of obtaining financial assistance from the City of Peoria for the project described.




 															                                                                             
Signature								Date

Submit this application and all attachments to:

City of Peoria
Community Development Dept.
Neighborhood Services Division
9875 N. 85th Avenue
Peoria, AZ  85345
Incomplete application will not be considered and will be returned to the neighborhood leader.
Questions?  Call 623-773-5140 or email neighborhoodgrant@peoriaaz.gov



Revised 1/3/08

NEIGHBORHOOD GRANT APPLICATION

Revised 1/3/08