Safe Room Rebate Program Form

SPAG Regional Safe Room Rebate Program

Step 1 of 3

This application packet contains application instructions, eligibility requirements, selection process methodology, and other programmatic information regarding the SPAG Regional Safe Room Rebate Program. Please take read the information thoroughly. Verified program eligibility entitles a homeowner, who constructs a certified and approved residential safe room, to a rebate of 50% reimbursement of eligible costs (not to exceed $3,000).

If you would like to participate in this program, click next.

Citizen Participation Acknowledgements:

Property owner Acknowledges participation in the SPAG Regional Safe Room Rebate Program is:

-Funded through federal funds (FEMA)
-On a voluntary basis
-May require additional agency's approval, if you are in a historic district or reside in a home built before 1972.
-May require additional information from you or your builder/installer prior to approval, if the safe room you chose to install is not prefabricated or of manufactured design.
-Requires adherence to all program rules including that construction, purchase or installation cannot begin until after you have received the official notification letter “Eligible to Participate” from SPAG stating you have been selected as a participant

Contracting on their own for construction or installation of a prefabricated Safe Room that meets the FEMA qualifications as documented on the Texas Division of Emergency Management 'Certificate of Installation/Inspection for Residential Safe Rooms' (see Exhibit E). The participant must ensure the contractor is aware of the certificate terms of compliance prior to signing a contract for a safe room.

Providing all required documentation when requesting a rebate following completion of their safe room installation. Required documentation includes but is not limited to:

a) Completed 'Safe Room Application Form' (Exhibit B) with all required information on the structure,
b) the Texas Division of Emergency Management 'Certificate of Installation and Inspection for Residential Safe Rooms' form and pictures of the safe room (Exhibit E). The citizen participant must submit the installer signed and notarized copy of the Texas Division of Emergency Management 'Certificate of Installation/Inspection for Residential Safe Rooms' form. No other certificate of installation is acceptable proof of compliance.,
c) Proof of ownership of the property, such as a current appraisal statement,
d) A Flood Insurance Rate Map and a statement from the local floodplain administrator assuring that the property is not located in the floodplain. This must include the latitude/longitude of the property to five decimal places,
e) Contractor invoices, building permits and any additional required permits, inspections, or certificate of occupancy.

Proof of payment is required for all costs claimed. The following items will be required:

- Copy of the front and back of cancelled check(s),
- Copy of the front of the check and bank statement showing it cleared,
- Bank image of the check with date it cleared, and
- Copy of bankcard statement showing debit/credit payment.
- Providing SPAG staff access to conduct a final safe room inspection of completed safe room,
- Releasing the safe room location information to emergency 911 databases for fire and police.
- Citizen participants should verify all responses and documentation are true and valid.

Please acknowledge you have read and agree to the requirement of the program.

Initials

Date

Included in this packet are the following SPAG Regional Safe Room Rebate Program forms:

1) Safe Room Rebate Program Checklist
2) Safe Room Application
3) List of Eligible and Ineligible Costs (Exhibit D)
4) Certificate of Installation/Inspection for Residential Safe Rooms *No other certificate of installation is acceptable proof of compliance
5) Citizen Participation Requirements
6) Instructions for obtaining SAMs clearance for a construction contractor. *You will only need to the obtain SAMS clearance verification if you are assigning the rebate payment to be disbursed directly to your contractor/installer. A printout of the verification form must be included with the cancelled check for each reimbursement request in order for funds paid to anyone other than the approved homeowner.
7) SPAG Regional Safe Room Rebate Program Floodplain Documentation - Information on Floodplains and determining if your property is located in a FEMA-designated floodplain

The following links provide useful information that will assist you in completing your Application Packet and answering any further questions:

Safe Room Publications and Resources

(Once you have contacted a contractor to install your safe room, please review this document with the contractor to evaluate if they are capable of complying with building your safe room per the design standards in this FEMA publication)

Please make sure you have included all of the required documentation with your application including the 'Application Checklist' - this will be your COMPLETE safe room rebate 'Application Packet'.

How to submit your Application Packet:

You may submit your safe room rebate 'Application Packet' to SPAG via:

1) mail to: PO Box 3730; Lubbock, Texas 79452,
2) e-mail to:  regional@spag.org   
3) you may opt to drop off your application in person at 1323 58th Street; Lubbock, Texas 79412. Please note, if you opt to drop off application staff will not be available to address questions regarding the rebate program. After you have thoroughly reviewed this information and need more information please contact P. Bryant at SPAG: 806-762-8721 or pbryant@spag.org.

Your application will be reviewed and you will receive written notification from SPAG regarding your eligibility status (eligible or ineligible). This written notification will be mailed or e-mailed (if provided) to you within 14 days of receipt of your 'Application Packet'.

Sincerely,
Kelly Davila
Director of Regional Services
South Plains Association of Governments

A. Home Owner Information

Name

First Last

Current Address

Street Address City State ZIP Code

County

Home Phone #

Work Phone #

Mobile/Cell Phone #

Email Address

B. Property Location-Legal Description

Subdivision or Survey Name

Section Acreage

Lot

Block

Reserve

Abstract

C. Property Address

Address

Street Address City State ZIP Code

D. Date Home Was Built

Date

E. Potential Safe Room Information--(Please Answer the Following) Safe Room

Anticipated Date of Installation

Safe Room Type

In-Ground

In-Residence

Exact Location of Safe Room

Name of Contractor

Contractor Debarment Status Verification Date

(If applicable, Fill Out Verification Form)

F. Specific Address Information - Please Complete And Sign The Following (Prior to reimbursement, the following information must be completed):

911 Address

"Latitude/Longitude as required by FEMA"

Latitude

Longitude

I hereby authorize the release of the safe room information to the local emergency first responders including but not limited to the fire department, police department, and emergency medical services providers to assist in location and rescue efforts.

Signature of Owner

Date

G. Please Read the Following:

•This form does not guarantee that your safe room application will be funded.

•If funded, this program provides a 50% rebate (up to $3,000 to eligible participants who install safe rooms).

•Qualifying safe rooms must be built/ installed, and certified by a builder or installer.

•I certify that my property is not located in a floodplain or a Coastal Surge Zone (V Zone).

•I understand that my participation in this program is completely voluntary.

•I have carefully reviewed this form and understand all the information herein. To the best of my knowledge, the answers hereto are true and correct.

Signature of Owner

Date

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SPAG Regional Safe Room Rebate Program Checklist

Name

First Last

Address

Street Address City State ZIP Code

*You must submit this Checklist Form with your Safe Room Application*.

Checking the Consent box below indicates the required items listed below are completed/signed on the Safe Room Application Form

Homeowner Consent Items

A. Home Owner Information
B. Property Location-Legal Description
C. Property Address
D. Date the home was built
E. Potential Safe Room Information
F. Specific Address Information
G. Homeowners signature on Section F and Section G

Documentation Items

Proof of Ownership (i.e. current appraisal statement)
Flood Zone Documentation (i.e. statement, letter, building permit)
SAMS Clearance of Contractor (*Only required if requesting the rebate payment be made directly to contractor)

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