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Exhibrt 't po <br />Homelessness and Affordable Housing Funds <br />2O2t Notice of Funds Available Application Form <br />**Fields outlined in red are required** <br />PROJECT INFORMATION <br />Project Title: KVMA Cold Weather Shelter 202j-22 <br />Project Site Name(s): Cold Weather Shelter <br />Project Site Address(s): First United Methodist Church, 210 N Ruby St, Ellensburg, WA 9g926 <br />Which fund source is this proposal for? (select one, see Section 1 of the NOFA for details) <br />./ <br />Affordable Housing Funds <br />Homeless and Housing Assistance Funds <br />Totaf Project costs (including other funding and resources): $127,536.80 <br />Total Amount Requested (from Kittitas County Homeless Housing and Assistance or Affordobte <br />Housing funds): $22,469.00 <br />Time Frame for Utilization of Requested Funds: OCtObef 1, 2021-Apfil 90, 2022 <br />City, Town or Unincorporated Area to be served: Kittitas County <br />APPLICANT INFORMATION <br />Name of Applicant Organization: 14;11;1ss Valley Ministerial Association & HopeSource <br />Mailing Address: 700 E. Mountainview Ave STE 500 <br />City, State, Zip: EllenSbUrg, WA 98926 <br />Phone: 509-925-1448 <br />Fax: 509-925-1204 <br />Email Address: jrayffi ond@hopesource. uS