Grantee [State/Territory/Tribe]: _____________________________________
Subgrantee [State-level agency/City/County/Indian tribal government]:
_________________________________________________________________
Property Owner(s):_________________________________________________
Property Address: ________________________________________________
NFIP Policy Number: _____________ Repetitive Loss Number: ___________
This documents the formal Mitigation Offer of Assistance for the SRL program.
Section A. Property Acquisition
In order to receive pre-event market value for your property, you sign here to document your eligibility to receive that amount; otherwise, you will receive a Mitigation Offer based on appropriate purchase offer methodology (i.e. current market value, outstanding loans, original purchase price):
“I certify that I am a National of the United States or a qualified alien.”
_____________________________________________________________________
Signature of SRL Property Owner(s) Date
Your Final Mitigation Offer is based on adjusting the valuation of your purchase offer of $_________________ by applicable additions (e.g. supplemental housing payments) of $________________ and deductions (i.e., flood insurance, duplicated benefits, costs borne by you) of $___________________. The methodology used to calculate your property value (i.e. pre-event market value, current market value, outstanding loans, original purchase price) was____________________________.
Final Mitigation Offer: $ ___________________
Federal / non-Federal Cost Share (75 / 25 or 90 / 10): ______________
Cost borne by property owner: $ __________________
You are accountable for maintenance and insurance requirements for the property during the mitigation project (i.e., maintaining flood insurance through property transfer).
Your additional responsibilities may include, receiving funds in a bank account for the project, keeping receipts for the project in accordance with [State/City/County] grant and contract requirements, and other programmatic requirements e.g., timelines for vacating the property and as specified below by the [City/County].
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
At this time you must sign the attached Statement of Voluntary Participation.
Section B. For Mitigation Activities Other than Acquisition
Your Final Mitigation Offer amount is based on adjusting the cost of the mitigation activity of $______________ by applicable additions of $_______________and deductions (i.e., flood insurance, duplicated benefits, costs borne by you) of $_________________.
Final Mitigation Offer: $ ___________________
Federal / non-Federal Cost Share (75 / 25 or 90 / 10): _____________
Cost borne by property owner: $ __________________
You are accountable for maintenance and insurance requirements for the property during and after the mitigation project implementation (i.e., maintaining flood insurance on your property).
Your additional responsibilities may include securing a contractor, receiving funds in a bank account for the project, keeping receipts for the project in accordance with [State/City/County] grant and contract requirements, and other programmatic requirements as specified below by the [City/County].
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
You must sign the attached Model Acknowledgement of Conditions for Mitigation of Property in a Special Flood Hazard Area for elevation, mitigation reconstruction, or dry floodproofing activities.
6. All holders of recorded interest in the property have been notified of the final mitigation offer. The holders of recorded interest are:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
The local government and property owner will initial and date below to document each meeting related to the Mitigation Offer.
______________________________________________________________
Homeowner(s) Local Government Official(s) Date
______________________________________________________________
Homeowner(s) Local Government Official(s) Date
_______________________________________________________________
Homeowner(s) Local Government Official(s) Date
Accepting or Declining the Mitigation Offer
You have 45 days from the date of the Mitigation Offer Letter to accept or decline the mitigation offer of assistance by signing the appropriate section below and returning it to [City/County] in the attached envelope or in person at [City/County address]. Failure to respond to the Mitigation Offer within 45 days of the date on this Mitigation Offer constitutes declining the Mitigation Offer.
This offer of mitigation assistance remains open and available to you, even if you decline and/or appeal the offer, as long as the SRL program exists and funds are available.
Accepting the Mitigation Offer
Final Mitigation Offer: $ ______________________
Mitigation Activity: ______________________________________________
I, the property owner, accept this Mitigation Offer
___________________________________________________________________
__________________________________________________________________
Signature of [City/County] Representative Date
NFIP Policy Number: _______________ Repetitive Loss Number: ____________
Declining the Mitigation Offer
Mitigation Offer Declined: I do not accept this Mitigation Offer of Assistance. I understand that FEMA will notify me of the chargeable insurance premium rate increase for my property. FEMA will issue a Notice of NFIP Insurance Premium Rate Increase to me specifying the effective date of the insurance premium rate increase for my property. Generally, this increase will occur upon renewal of the insurance policy.
In addition, I understand that I have the right to appeal an increase in flood insurance premium rate only in certain circumstances and have received information from the subgrantee on the specific grounds for appeal and that process. Failure to respond to this offer within 45 days constitutes declining the Mitigation Offer of Assistance.
__________________________________________________________________
Signature of SRL Property Owner(s) or Authorized Representative(s) Date
_________________________________________________________________
Signature of SRL Property Owner(s) or Authorized Representative(s) Date
_____________________________________________________________________
Signature of [City/County] Representative Date
NFIP Policy Number: _______________ Repetitive Loss Number: ______________
Attachments: Appeal Fact Sheet and Process
Examples of Insurance Premium Rate Increases for Appeal
Statement of Voluntary Participation Form
Model Acknowledgement of Conditions for Mitigation of Property
in a Special Flood Hazard Area
Mailing Envelope with [City/County] Address
Last Modified: Monday, 14-Jan-2008 10:29:28 EST