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The SF 424 is part of the CPMP Annual Action Plan. SF 424 form <br />fields are included in this document. Grantee 'information is linked <br />from the I CPMP.xls document of the CPMP tool. <br />Complete the fillable fields (blue cells) in the table below. The other items are pre -filled with values from the <br />Grantee Information Worksheet. <br />fier <br />Date Submitted Applicant Identifier <br />Type of Submission <br />Date Received by state State Identifier <br />Application Pre -application <br />Date Received by HLIQ Federal Identifier <br />Construction El. Construction <br />Non Construction Ej Non Construction <br />Applicant Information <br />County of Hawai'i <br />-11159999 HAWAII STATE PROGRAM <br />50 Wailuku Drive <br />D9-463-6073 <br />Suite 102 <br />Office of Housing & Community Development <br />Hilo lHawaii <br />Office of Management <br />96720 JU.S.A. <br />Housing <br />Employer Identification Number (EIN): <br />Hawai'i County <br />99-6000567 <br />Applicant Type: <br />Specify Other Type if necessary: <br />Local Government: County <br />Specify Other Type <br />U.S. Department of <br />Program Funding Housing and Urban Development <br />Catalogue of Federal Domestic Assistance Numbers; Descriptive Title of Applicant Project(s); Areas Affected by <br />Project(s) (cities, Counties, localities etc.); Estimated Funding <br />Community Development Block Grant <br />14.218 Entitlement Grant <br />CDBG Project Titles Hale Ohana Domestic Abuse Shelter <br />Renovations, West Hawaii Domestic Abuse Shelter <br />Renovations, West Hawaii Homeless Emergency Shelter <br />Improvements, Kulaimano Elderly Housing Renovations, <br />Hale Maluhia Men's Shelter Accessibility Improvements, <br />Kiheipua.Family Shelter Certified Kitchen Improvements, <br />Boys and Girls Club Accessibility Improvements, <br />Administration, Planning & Fair Housing <br />Description of Areas Affected by CDBG Project(s) <br />$CDBG Grant Amount $2,500,000.00 <br />Additional HUD -GLrant(§) Leveraged <br />$Additional Federal Funds Leveraged <br />$Additional State Funds Leveraged <br />$1-ocally Leveraged Funds <br />$Grantee Funds Leveraged <br />$Anticipated Program Income $100,000.00 <br />Other (Describe) <br />Total Funds Leveraged for CDBG-based Project(s) <br />SIM -am im FIRM <br />Home Investment Partnerships Program <br />14.239 HOME <br />HOME Project Titles Habitat for Humanity Puna Self, Help <br />Housing <br />Description of Areas Affected by HOME Project(s) <br />SF 424 Page 1 Version 2.0 <br />