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application, the total benefit requested should include all costs to connect or reconnect services, except any other non- energy related charges. In the event a household is in transition, a Final Bill and proof of a new account, showing the total cost to restore services, should be used to provide assistance and calculate the benefit. The referenced bill should clearly state "Final Bill". A recent statement from the vendor, preferably on letterhead, within the past 30 days may be used to calculate a benefit payment. The intent of this provision does not arbitrarily substitute the mandatory Disconnect Notice, or cause any inconsistency with the LHC's established policy for LIHEAP crisis assistance. For equipment repair/replacement, the amount of the equipment plus installation, not to exceed $1000 per household. For disaster relief, the amount of the in-kind benefits, not to exceed $1000 per household. In the event that Supplemental funds are granted or available within the year due to unforeseen circumstances (i.e. public health emergencies, etc.), LHC reserves the right to develop a separate benefit matrix to deliver bill payment assistance that meets the need of the particular crisis based on the amount of funds awarded or still available. Applicants impacted by the crisis will be eligible for Supplemental funds in addition to eligibility for regular crisis assistance. In the event of unforeseen circumstances (i.e. public health emergencies, natural disaster, etc.), LHC reserves the right to allow past due balances to be included in the crisis assistance benefit payment. This right will be implemented by LA LIHEAP Notice and with a defined period only. Louisiana allows for community solar participants to receive a benefit using the same LA LIHEAP benefit calculation.

Crisis Requirements, 2604(c) 4.10 Do you accept applications for energy crisis assistance at sites that are geographically accessible to all households in the area to be served?

Yes No Explain. Per Section 3.3, A.1. of the Louisiana LIHEAP Service Delivery Guide, the Subgrantee must devise and plan to distribute service funds throughout the entire service delivery area. This process ensures a fair distribution of funds based on the percentage of eligible population in each geographic location. Subgrantee must be able to provide some type of weekly presence in each parish it serves. 4.11 Do you provide individuals who are individuals with a disability the means to: Submit applications for crisis benefits without leaving their homes?

Yes No If No, explain. Travel to the sites at which applications for crisis assistance are accepted?

Yes No If No, explain. Per Section 3.3, A.4. of the Louisiana LIHEAP Service Delivery Guide, the Subgrantee shall develop a fair and consistent means by which home-bound applicants may be provided the opportunity to apply for services. Subgrantee shall make provisions for home-bound and infirmed applicants in accordance with Section 2604I (3) (B) of Public Law 97-35 by either traveling to the applicant or may allow a homebound applicant to designate an authorized representative to apply for LIHEAP services on their behalf. A signed statement by the applicant that names the authorized representative is required. The designated person should sign all LIHEAP forms using their name and the applicant’s name (e.g. “Jane Doe for Mark Jones”). If you answered "No" to both options in question 4.11, please explain alternative means of intake to those who are homebound or physically disabled?

Benefit Levels, 2605(c)(1)(B) 4.12 Indicate the maximum benefit for each type of crisis assistance offered. Winter Crisis $0.00 maximum benefit Summer Crisis $0.00 maximum benefit Year-round Crisis $1,000.00 maximum benefit 4.13 Do you provide in-kind (e.g. blankets, space heaters, fans) and/or other forms of benefits?

Yes No If yes, Describe

Subgrantees may provide an in-kind benefit (in accordance with the Louisiana Disaster Relief Policy), not to exceed $1000 per household, in times of disaster relief. An explanation of the disaster should be included in the applicant's file. The cost for disaster relief will be reimbursed to the Subgrantee. The Subgrantee should expend the funds necessary to resolve the crisis situation in a timely manner. In the event that Supplemental funds are granted or available within the year due to unforeseen circumstances (i.e. public health emergencies, etc.), LHC reserves the right to develop a separate benefit matrix to deliver bill payment assistance that meets the need of the particular crisis based on the amount of funds awarded or still available. Applicants impacted by the crisis will be eligible for Supplemental funds in addition to eligibility for regular crisis assistance. Page 15 of 55