Forms

The following PDF forms have been designed for electronic completion and are fillable. In order to use these forms Adobe Reader version 8 or newer is needed. For questions about these forms email Toni Payseno at tpayseno@cityofsalem.net.

Davis-Bacon projects require specific information in the Bid Packet. Required forms are as follows:
* = Required in all bid and contract packets
** = Required in public housing and contract packets as applicable
*** = Required in HOME program and contract packets

APPLICATIONS
CDBG, Social Service, and HOME applications are available and must be submitted to Urban Development 350 Commercial St. NE no later than 5:00 pm December 15, 2009. If you have questions about the application process contact: Rena Peck or Toni Payseno at the Urban Development office , 350 Commercial Street NE, Salem, Oregon 97301; phone: 503.588.6178.

Most recent version:

Form Group : 01: Tenant, Rent and Income Information ‎(6)

S1-01

Income Limits & Rents new for 2009

Income requirements

S1-02

Allowances for Tenant-Furnished Utilities new for 2009

Allowances for Tenant-Furnished Utilities and Other Services 2009

S1-03

Salem Tenant Income Certification

Tenant verification of eligibility form

S1-04

Prohibited Lease Terms

Terms that are not permitted in leases

S1-04a

HOME Addendum

Annual Lease options

S1-04b

Tenant Based Rental Assistance

Set-Up form

Form Group : 02: Marketing Plan Information ‎(2)

S1-05

Multi-Family Affirmative Fair Housing Marketing Plan

Housing Outreach form

S1-06

Affirmative Fair Marketing Plan

Program Outreach form

Form Group : 03: Current Program or Project Information ‎(10)

S1-07

Quarterly Progress Report

Project/program update form

S1-07a

Quarterly Progress Report Housing Project

Rental housing project update form

S1-07b

Quarterly Progress Report - Social Services - new

Project/Program update form for Social Services

S1-08

CDBG Client Eligibility (English)-New

Verification of client eligibility form

S1-09

CDBG Client Eligibility (espanola)

Concesión de Paquete del Departamento del Desarrollo de la Comunidad

S1-10

Request for payment - New

Expense reimbursement form for programs.

S1-11

Draw Request Disbursement

Expense reimbursement form for construction

S1-12

Single-Family Program Contractor Change Order

Request for contract changes form

S1-13

Single Family Contractor

Application Form

S1-14

Annual Property Report

HOME assisted unit annual summary

Form Group : 04: Davis Bacon Required Bid Documents and Links ‎(6)

DB-01

* Fair Labor Standards Provisions #4010

Federal Labor Law

DB-02

* Wage Decisions

Department of Labor Wage Determination Link

DB-03

** General Conditions for small construction projects #5370 EZ

Projects over $2,000 and less than $100,000.

DB-03a

** General Conditions non-construction projects Sec. 1 #5370-C

Non-construction projects with or without maintenance work

DB-03b

** General Conditions non-construction projects Sec. 2 #5370-C

Non-construction projects with maintenance work.

DB-04

*** Supplemental Conditions #2554

HOME Program Housing Construction.

Form Group : 05: Davis Bacon Documents and Links ‎(9)

DB-05

Making Davis Bacon Work

A tool addressing requirements.

DB-06

Labor Relations Process

A snapshot of the process.

DB-07

Davis Bacon Regulations new

Summary of requirements web link

DB-08

Preconstruction Meeting

Items to review in preconstruction meeting.

DB-09

Checklist for Contractors

Items to include

DB-09a

Certified Payroll

Form fillable when typed.

DB-10

Payroll authorization

Staff permitted to sign payroll forms

DB-11

Request for additional classifications

Classifications for trades not listed on wage sheet

DB-12

Contractor Roster

List of project contractors and sub contractors

Form Group : 06: Documents applicable after bids are received ‎(5)

DB-13

Excluded Parties search for debarred contractors/sub contractors

Determination of non-debarred contractors web link

DB-14

Ineligible Oregon Contractor search

Determination of non-debarred Oregon contractor. Click "Ineligible Contractors" in left menu online.

DB-15

Onsite Notice to Employees poster

Job site postings

DB-16

Onsite project wage rate sheet

Optional onsite posting

DB-17

Apprentice website

Contact Information web link

Form Group : 07: Required Reports ‎(2)

DB-18

Reporting Equal Opportunity Employment new

Minority and women owned businesses

DB-19

Section 3 Summary Report

Employment opportunities for low income persons

Form Group : 08: Community Housing Development Organization (CHDO) Information ‎(2)

CH-01

Community Development Block Grant (CDBG) Checklist

Annual review form

CH-02

Board Income Documentation

Low Income Certification