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Eligibility, 2605(c)(1)(A), 2605(b)(2) - Assurance 2 5.1 Designate the income eligibility threshold used for the Weatherization component Add Household Size Eligibility Guideline Eligibility Threshold 1 All Household Sizes HHS Poverty Guidelines 200.00% 5.2 Do you enter into an interagency agreement to have another government agency administer a WEATHERIZATION component? Yes No 5.3 If yes, name the agency and attach a copy of the Internal Agreement or Contract. 5.4 Is there a separate monitoring protocol for weatherization? Yes No WEATHERIZATION - Types of Rules 5.5 Under what rules do you administer LIHEAP weatherization? (Check only one.) Entirely under LIHEAP (not DOE) rules Entirely under DOE WAP (not LIHEAP) rules Mostly under LIHEAP rules with the following DOE WAP rule(s) where LIHEAP and WAP rules differ (Check all that apply): Income Threshold Weatherization of entire multi-family housing structure is permitted if at least 66% of units (50% in 2- & 4-unit buildings) are eligible units or will become eligible within 180 days Weatherize shelters temporarily housing primarily low income persons (excluding nursing homes, prisons, and similar institutional care facilities). Other - Describe: Mostly under DOE WAP rules, with the following LIHEAP rule(s) where LIHEAP and WAP rules differ (Check all that apply.) Income Threshold Weatherization not subject to DOE WAP maximum statewide average cost per dwelling unit. Weatherization measures are not subject to DOE Savings to Investment Ration (SIR ) standards. Other - Describe: Some homes are weatherized using a combination of both DOE and LIHEAP funds for Incidental Repairs to maximize the effectiveness of the Energy Conservation Measures (ECMs). Eligibility, 2605(b)(5) - Assurance 5 5.6 Do you require an assets test? Yes No 5.7 Do you have additional/differing eligibility policies for : Renters Yes No Renters living in subsidized housing? Yes No Renters with utilities included in the rent? Yes No 5.8 Do you give priority in eligibility to: Older Adults? Yes No Individuals with a disability? Yes No Young Children? Yes No House holds with high energy burdens? Yes No Other? High Energy Use Yes No If you selected "Yes" for any of the options in questions 5.6, 5.7, or 5.8, you must provide further explanation of these policies in the text field below. Property Owners (landlords) must sign an agreement to not increase the rent costs for at least 12 months. Owners are encourged to contribute financially to overall weatherization projects. The Hancock Energy Software automatically assigns a WAP ranking based on criteria set in policy. Eligible households are awarded points for children age 17 and under, elderly age 60 and older, disability, high energy burden (25% of household total income used for energy cost), and number of months on the waiting list. Benefit Levels 5.9 Do you have a maximum LIHEAP weatherization benefit/expenditure per household? Yes No 5.9a If yes, what is the maximum? $0 5.10 Do you use an Average Cost per Unit (ACPU). Yes No 5.10a If so, what is the ACPU amount? $8,547 Types of Assistance, 2605(c)(1), (B) & (D) 5.11 What LIHEAP weatherization measures do you provide ? (Check all categories that apply.) Weatherization needs assessments/audits Energy related roof repair Caulking and insulation Major appliance repairs Storm windows Major appliance replacement Furnace/heating system modifications/repairs Windows/sliding glass doors Furnace replacement Doors Cooling system modifications/repairs Water Heater Water conservation measures Cooling system replacement Roof top solar Community solar projects Compact florescent light bulbs Other - Describe: Minor repairs/Weatherization readiness (i.e., electrical problems, leaks, patching, thresholds, weatherstripping, switch/outlet gaskets, replace broken window panes, repair windows and doors, etc.) If any of the above questions require further explanation or clarification that could not be made in the fields provided, attach a document with said explanation here.