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City of Santa Ana <br />Duplication of Benefits Certification for CDBG-CV funds <br />A duplication of benefits occurs when a person, household, business, government, or other entity receives financial <br />assistance from multiple sources for the same purpose, and the total assistance received for that purpose is more <br />than the total need for assistance. Duplication of benefits occurs when Federal financial assistance is provided to a <br />person or entity through a program to address losses and the person or entity has received (or would receive, by <br />acting reasonably to obtain available assistance) financial assistance for the same costs from any other source <br />(including insurance), and the total amount received exceeds thatotal need forthose costs. <br />The CARES Act requires HUD to ensure that there are adequate procedures in place to prevent any duplication of <br />benefits as required by section 312 of the Stafford Act, as amended by section 1210 of the Disaster Recovery Reform <br />Act of 2018 (division D of Public Law 115-254; 42 U.S.C. 5121 et seq.) and all applicable Federal Register notices, <br />including FR-6218-N-01. <br />HUD requires each grantee to have procedures in place to prevent the duplication of benefits when it provides <br />financial assistance with CDBG-CV funds. Grant funds may not be used to pay for a cost if another source of financial <br />assistance is available to pay forthe same cost. <br />This certification must be completed by any subrecipient, individual or family, business, direct beneficiary, or other <br />entity that receives assistance and serves to document compliance with the CARES Act requirement to ensure that <br />there are adequate procedures in place to prevent any duplication of benefits as required by section 312 of the <br />Stafford Act, as amended by section 1210 of the Disaster Recovery Reform Act of 2018 (division D of Public taw <br />115-254; 42 U.S.C. 5121 et seq.) and all applicable Federal Register notices, Including FR-6218-N-01. <br />I, I Pc1tIBOS G[Ci 14 P/GCz �CCN)esrNEG 1 21�,11/neti� ISy' <br />(Name/title of business owner(s), sub grantee (Public Social Service Entity), sub recipient, direct beneficiary, other entity) <br />Hereby certify that: <br />A. The Community Development Block Grant -CV Funds, awarded to: <br />through the Coronavirus Aid, Relief and Economic Security Act <br />(CARES Act) does not duplicate/replace any other funds, and/or any funds from the following sources: <br />1. The Paycheck Protection Program <br />2. Unemployment compensation benefits <br />3. Insurance claims/proceeds <br />4. Federal Emergency Management Agency (FEMA) funds <br />5. Small Business Administration funds <br />6. Other Federal, State or local funding <br />7. other nonprofit, private sector, or charitable funding, <br />B. Further, this executed certification serves to acknowledge that any subgrantee, subrecipient, individual <br />or family, business, direct beneficiary, or other entity understands and agrees that the CDBG-CV funds <br />must be repaid If it is determined that such assistance is determined to be duplicative. <br />�2 J �d2 <br />Signature and date of: <br />Business owner(s), sub grantee (Public Social Service Entity), subrecipient, direct beneficiary, or other entity <br />DH CD Original Version 9.2.2020 —This form maybe subject to change pending additional HUD guidance. <br />Exhibit F <br />