December 3, 2012 To: General Construction Contractors The West Central Texas Council of Governments is continuing to seek qualified, general contractors to join our vendor list for the Amy Young Barrier Removal Program. Qualified Contractors will get the opportunity to bid on our home rehabilitation projects for our region. The Amy Young Barrier Removal Program modifies the homes of people with disabilities who have limited income and would like for their home to be more accessible. The program provides a one-time grant for up to $20,000 per home. Up to 25% of each home’s total grant can be used for health and safety hazard removal. All services are free for eligible households. For more specific program information, please review the attached brochure. To be included on our current vendor’s list, please complete the attached application packet. Completed application packets may be mailed or delivered to: WCTCOG 3702 Loop 322 Abilene, TX 79602 ATTENTION: Amy Young Specialist All information received will be for the sole confidential and exclusive use and possession of the WCTCOG and our clients. Thank you in advance for your consideration in applying. Sincerely,

Michelle Parker Michelle Parker Director of Community Programs

3702 Loop 322 Abilene, Texas 79602

325-672-8544 Fax: 325-675-5214

Visit us on the web @ www.wctcog.org

The Amy Young Barrier Removal (AYBR)

program modifies the homes of people with

disabilities who have limited income and

would like their home to be more accessi-

ble. The program provides a one-time grant

for up to $20,000 per home. Up to 25% of

each home’s total grant can be used for

health and safety hazard removal.

All services are FREE for eligible

households. Rehabilitation services are

provided by licensed contractors.

The Amy Young Story

In May 2010, the Texas Department of Housing

and Community Affairs launched the Amy Young

Barrier Removal Program, named in honor of one

of the state’s most passionate and persuasive

advocates for Texans with disabilities, Amy Young.

Amy, a public policy analyst with the Texas Council

for Developmental Disabilities, passed away in

September 2008 after a sudden illness. The

program was created in part from recommendations

she had pushed for as part of an advocacy policy

workgroup. Amy not only gave shape to the much-

needed program, she also urged the Department to

offer the program through its state

funded Housing Trust Fund, which

would provide greater flexibility

and fewer regulatory restrictions

than federally funded

programs, making it an ideal

vehicle for this initiative.

The WCTCOG and WCTADRC are equal opportunity

employers and are committed to compliance with the

Americans with Disabilities Act. Equal access to

communications will be provided upon request. Funding for

the AYBR Program is provided through the Texas Department

of Housing and Community Affairs, Housing Trust Fund.

West Central Texas

Council of Governments

WHAT IS THE AMY YOUNG

BARRIER REMOVAL PROGRAM? The West Central Texas Council of

Governments partners with the West Central

Texas Aging and Disability Resource Center

(ADRC) to best serve West Texans with

information and assistance on issues

affecting people with disabilities of any age,

older adults, their family and caregivers.

Contact the West Central Texas

ADRC for more information on the

Amy Young Barrier Removal

Program or to learn about our

other programs.

325-793-8440

www.wctadrc.org

3702 Loop 322 - Abilene, Texas

Disability doesn’t have to stop you from living

in your home

WHAT COUNTIES ARE

COVERED?

If your county is not listed below,

call 325-793-8440

Call: 325-793-8440

Email: wctadrc@wctcog

Web: www.wctadrc.org

Visit us : 3702 Loop 322 * Abilene

ELIGIBILITY

Below are general guidelines of

eligibility. Additional information

may be required.

You or a person in the home has a

disability

Household income is 80% or less of

Area Median Family Income (see chart

below). Total income for everyone living

in the house.

Liquid Assets can not be more than

$20,000 for the household. Liquid

assets are considered your checking

and savings.

INCOME GUIDELINES*

Income verification is required for all

members of the household receiving an

income, regardless of age.

WHAT DOES

REHABILITATION INCLUDE?

Rehabi l i tat ion i s de f ined as home

m o d i f i c a t i o n s f o r i m p r o v e d

accessib i l i ty and safety for a person

with a d isabi l i ty l i v ing in the home.*

Modi f icat ions may inc lude:

Ramps

Handra i l s

Widening of

doorways

Access ib le

door or

f aucet handles

Adjust ing countertops and cab inets to

appropr iate heights

Access ib le k i tchen app l iances

Insta l l at ion of buzz ing or f l ash ing

dev ices for persons with v isua l or

hear ing impairments

Remove carpet and rep lace with

wood laminate , v iny l or t i le f loor ing

Insta l l access ib le showers

Access ib le s inks

E levated to i let s

Grab Bars

Shower wands

E levated to i let s

* Not a l l homes or appl icants are ap-

proved for rehabi li ta t ion due to the cost o f

the project exceeding the al lowable

budget . Income and el ig ibi l i ty guidelines

may change wi thout not ice.

# of People

in House

Maximum Income

for household

1 33,750

2 38,600

3 43,400

4 48,250

5 52,100

6 55,950

7 59,800

8 63,700

Make Your Home More

Accessible

Brown Mitchell

Callahan Nolan

Coleman Runnels

Comanche Scurry

Eastland Shackelford

Fisher Stephens

Haskell Stonewall

Jones Taylor

Kent Throckmorton

Knox Tom Green

1. Company Information:

2. ID #'s

3. Type of Ownership:

4. If Corporation, state of incorporation:  

5. If Corporation, a copy of the corporate resolution verifying authorized signatures is attached or is available to submit electronically.

 Contractor Profile

*Contact Name:

Company Name:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*Federal Tax ID #

DUNS#

Contractor License # (provide a copy)

*

 

*

*

 

Corporation 

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Yes 

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No 

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6. Owners: If the entity is a Corporation, include all officers If the entity is a Partnership, include all controlling partners

7. Owners:

8. Owners:

9. Owners:

*

Name:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*Name:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

Name:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

Name:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

 

10. Current State registration is attached or available to submit electronically

11. The number of years in business as this entity  

12. Has this company name changed? If No, go to question 14.

13. Previous names of entity

14. Average annual gross income for the last 2 years  

15. Number of employees on your Company's payroll  

 

*

*

*

 

*Company Name

Address

Dates

Company Name

Address

Dates

 

*

*

Yes 

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No 

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Yes 

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No 

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16. Has your company failed to complete any work or defaulted on an awarded contract?

17. Bank Reference

18. Bank Credit amount available  

19. Supply House credit amount available  

*

*Contact:

Bank:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*

*

Yes 

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No 

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If Yes, please explain 

55

66

20. Has your company done rehabilitation on houses in the past for federal or state funded government programs? If so, please explain

21. Please mark all the counties below in which you are willing to work

22. List 3 jobs under construction or completed in the past 12 months that totaled over $5,000. (1)

*

Name:

Company:

Address:

City/Town:

ZIP:

State:

Type of work performed

Phone Number:

Yes 

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No 

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Other experience 

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66

Brown 

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Callahan 

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Coleman 

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Comanche 

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Eastland 

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Fisher 

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Haskell 

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Jones 

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Kent 

gfedc

Knox 

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Mitchell 

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Nolan 

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Runnels 

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Scurry 

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Shackelford 

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Stephens 

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Stonewall 

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Taylor 

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Throckmorton 

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Tom Green 

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23. (2)

24. (3)

25. Additional Information: Is there other general background information, such as experience of co­workers, including officers, showing ability to work in rehabilitation, property improvements or construction?

*

Name:

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Type of work performed

Phone Number:

*

Name:

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Type of work performed

Phone Number:

Yes 

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No 

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(Please specify) 

55

66

26. Please list suppliers with whom you have credit accounts (1)

27. (2)

28. (3)

*

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

29. (4)

30. List Sub­contractors with whom your company has done business (1)

31. (2)

*

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*

Name:

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*

Name:

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

32. (3)

33. (4)

34. Has this entity or the owners ever filed for bankruptcy?

35. Does your company perform annual background checks on employees?

*

Name:

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

*Name:

Company:

Address:

Address 2:

City/Town:

ZIP:

State:

Email Address:

Phone Number:

Yes 

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No 

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If Yes, please explain 

55

66

Yes 

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No 

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36. Persons authorized to sign contracts, bids or contract changes

37. I hereby certify that the above statements are true and complete to the best of my knowledge. I further understand that the West Central Texas Council of Governments will keep all the information confidential and use such information only to verify the qualifications of the company listed above as a home improvement contractor. I authorize the West Central Texas Council of Governments to obtain a written credit report on both the individuals and the entity that is applying. I authorize any person, firm or corporation to provide the West Central Texas Council of Governments with any information requested in relation to the verification of this Contractor Profile.

*Name

Title

Name

Title

Name

Title

*

Signature:

Name:

Title:

Date: