CDBG Capital Improvement (CI) Project Forms, Packets and Guidelines

The forms required for capital improvement construction projects are listed below.  Please note that prior to procuring or starting any CDBG Capital Improvement construction project the following forms must be completed and approved by Cook County’s Department of Planning and Development (DPD) staff. ***Please do not fill out these forms in your browser. Before downloading the forms to your personal computer, please scroll down the page and review our downloading instructions if you are having difficulty.  In addition, for each awarded CDBG project an assigned DPD staff person will provide detailed instructions. 

Procurement and Construction Forms (Engineering, Construction, etc.):
(A publication is required for all projects $25K or over; projects under $25K must show proof of bid solicitation via regular mail, email, call list, etc.)

  • Form 4A (Labor Standards Compliance) – The project’s hired engineer must prepare construction specifications and submit to assigned DPD staff for review and approval. It is imperative that all specification packets include the Special Provisions for Federally-Funded and Cook County CDBG-Funded Projects and Davis-Bacon Wage Determination. (Details will be provided by DPD staff.)  

    Form 4A

  • Form 4A1 - Labor Standards Compliance 

    Form 4A1

  • Form 4B (Invitation to Bid) – Please use this “Invitation to Bid” template for bid publication guidance. (Upon DPD staff signature approval of the Form 4A, please proceed with Bid Publication to include scheduled bid-opening date.)  

    Form 4B

  • Form 4D1 (Bid/Contract Approval – Professional Services Only) – Prior to awarding professional services (engineering, architect, etc. – under $25K) these services must be reviewed and approved by DPD assigned project staff. Please attach copies of the three lowest responsible bid proposals to be reviewed and signature approved by DPD staff.

    Form 4D1 (Bid/Contract Approval – Professional Services Only)

  • Form 4D (Bid/Contract Approval – Construction Services Only) – Prior to awarding construction services (contractors – $50K or over) these services must be reviewed and approved by DPD assigned project staff. Please attach copies of the three lowest responsible bid proposals to be reviewed and signature approved by DPD staff.

    Form 4D (Bid/Contract Approval – Construction Services Only)

  • Form 4CO (Change Order for Construction Only) – All changes must be approved by DPD staff and should not exceed original CDBG project award. 

    Form 4CO (Change Order for Construction Only)

  • Form 4E (Project Completion/Closeout) – Subrecipient and their hired engineer must complete and submit the Form 4E to include all supporting documentation as noted on this form.

    Form 4E (Project Closeout - Rev)

  • Form HUD 11 (Record of Employee Interview) – This form must be completed for at least one employee from each trade working on the CDBG awarded project. 

    Form HUD 11 (Record of Employee Interview)

  • Certified Payroll Review Form – This form must be completed and attached to each payroll submission. The CDBG awarded Subrecipient or hired engineer (Project Manager) must sign, date and return all required certified payroll forms, along with copies of each payroll being reviewed to the DPD assigned project staff prior to submitting drawdown requests.  

    Certified Payroll Review Form

  • HUD & Cook County Required Reporting Forms:

  • HUD 2516 (Contract and Subcontract Activity Form) 

    HUD 2516 (Contract and Subcontract Activity Form)

  • HUD 60002 (Section 3 Summary Report – Economic Opportunities for Low – and Very Low Income Persons) 

    HUD 60002

  • Required Certifications:
    • Equal Employment Opportunity Certification
    • Certification of Bidder Regarding Equal Employment Opportunity
    • Debarment & Suspension Certification
    • Certificate Regarding Lobbying
  • (Details regarding completing and returning these forms will be discussed during the preconstruction meeting.)

    Additional Required Packets:

  • Special Provisions for Federally-Funded & Cook County CDBG-Funded Projects (Must be included as part of the Bid Specification) 

    Special Provisions - CDBG - Rev2019

  • Cook County Davis-Bacon Construction Packet (Reviewed during preconstruction meetings.) 

    Cook County Davis-Bacon Construction Packet-Rev2019

***Instructions for downloading the CDBG CI Forms:

  1. PLEASE DO NOT FILL OUT OUR FORMS IN YOUR BROWSER.  In order to use the fillable forms, you must have Adobe 9.0 Reader or above on your computer. If you do not have Adobe Reader 9.0 or above, please go to the linkhttp://get.adobe.com/reader/ and download the latest version of Adobe Reader onto your computer for FREE.
  2. Download the blank forms to your computer and open in your Adobe Reader 9.0 or above.
  3. Fill out each form.
  4. Once you complete filling out each form, please use the SAVE feature and save the completed form with the new name and keep your electronic copy on your computer. (In order to save the completed pdf, it must have a different name than the name of the blank pdf you downloaded.)
  5. Return your completed forms to your assigned DPD staff person.

If you have any questions or concerns, please contact:  sylvia.parham@cookcountyil.gov or dominic.tocci@cookcountyil.gov with Cook County Department of Planning and Development.