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OMB Approval No. 2577-0229
Expiration Date: 0
3/31/2011
F. Program Assessment and Reporting
The CA agrees to conduct or otherwise assist the applicant in assessing grant activities
based on 1) the performance measures in the applicant’s grant proposal submitted to
HUD and 2) any revisions to the assessment methodology made by the local HUD field
office. For Public Housing FSS applicants, the CA will ensure that the PHA meets its
PIC reporting requirements by reporting on the enrollment, progress, and exit of
individual families using the HUD-50058 addendum. The CA will ensure that reports
to HUD are made as required. All semi-annual financial and performance reports
prepared by the CA must be reviewed and approved by the applicant prior to submission
to HUD.
III. Contract Period
This contract is based on a period of time beginning ____________ and ending ___________ .
(NOTE: CAs must be retained for the full term of the grant.)
IV. Termination
Each party may terminate this agreement provided 60 calendar days of written notice is given
to the local HUD field office and the other party to this agreement. Applicants may terminate
this agreement based on non-compliance or non-cooperation by the CA. Termination may
only occur when all channels of resolution have been exhausted, including mediation
between the two parties. If all avenues for resolution have been exhausted, termination by
the applicant will require a two-thirds majority vote of the applicant’s Board of
Directors/Resident Council.
WITNESS OUR HANDS EFFECTIVE
Applicant Organization
Contract Administrator
Applicant Executive Director/
Executive Director
Other Authorized Representative
Date
Date
3
form HUD-52755 (12/2005)

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