HomeMy WebLinkAboutN7Rehab Cost Estimate Worksheet (003)
N7Rehab Cost Estimate Worksheet
Project Name: ____________________________________________________________________________
Property Address:__________________________________________________________________________
Is a public access easement being provided for sidewalk and/or boulevard landscaping installation? Yes____ No____
Total Project Cost (attach cost estimates): $_____________ x 0.15 = Eligible grant award amount*:____________
1) Demolition Costs: $_____________ = SUBTOTAL 1
Description________________________________________________________________________________
__________________________________________________________________________________________
Have you assessed the buildings/site for presence of hazardous materials? Yes____ No____
2) Façade/Site Improvement Costs:
Itemized eligible improvements:
1. $________ Description _______________________________________________________
2. $________ Description_______________________________________________________
3. $________ Description________________________________________________________
4. $________ Description________________________________________________________
5. $________ Description________________________________________________________
6. $________ Description________________________________________________________
SUBTOTAL 2 $_________
3) Streetscape Enhance Costs:
Itemized eligible improvements:
1. $________ Description _______________________________________________________
2. $________ Description_______________________________________________________
3. $________ Description________________________________________________________
4. $________ Description________________________________________________________
SUBTOTAL 3 $_________
1) $___________ + 2) $___________ + 3) $___________ = $___________Total Eligible Costsâ€
*Not to exceed NSURB fiscal year cap or amount of funds available; FY 2011 cap is $50,000
†Generally, not to exceed 15% of total project cost
Construction Contractor Project Address__________________________
Name: _______________________________________________
Company Name: _______________________________________
Phone Number:_____________ E-mail:_____________________
Address:______________________________________________ City _______________ State ____ Zip __________
Has the above contractor or builder within the last 10 years ever failed to qualify as a responsible bidder, refused to enter
into a contract after an award has been made, or failed to complete a construction development contract? Yes ___ No___
If yes, please explain:
CERTIFICATION
I (we),________________________________________ ___________________________________________
printed name printed name
Certify that the statements and estimates within this Application as well as any and all documentation submitted as
attachments to this Application or under separate cover are true and correct to the best of my (our) knowledge and belief.
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Construction Contractor Project Address_________________________
Name: _______________________________________________
Company Name: _______________________________________
Phone Number:_____________ E-mail:_____________________
Address:______________________________________________ City _______________ State ____ Zip __________
Has the above contractor or builder within the last 10 years ever failed to qualify as a responsible bidder, refused to enter
into a contract after an award has been made, or failed to complete a construction development contract? Yes ___ No___
If yes, please explain:
CERTIFICATION
I (we),________________________________________ ___________________________________________
printed name printed name
Certify that the statements and estimates within this Application as well as any and all documentation submitted as
attachments to this Application or under separate cover are true and correct to the best of my (our) knowledge and belief.