Pre-Award Risk Assessment for For-Profit Business Entities
Per Minnesota Statute 16B.981, Minnesota Housing is required to conduct a pre-award risk assessment of potential grantees requesting grant awards of $50,000 or more. The information submitted by potential grantees will be used to assess the risk that a potential grantee cannot or would not perform the required duties of the grant. Minnesota Housing will review the potential grantee’s past performance, tax returns, audits, suspension/debarment status, principals, and standing with the Minnesota Secretary of State. 
Minnesota Housing will determine whether:
1.	The potential grantee would likely be able to perform the duties of the grant without additional conditions,
2.	The potential grantee would likely be able to perform the duties of the grant with additional technical assistance or conditions placed on the potential grantee, or
3.	There is a substantial risk that the potential grantee cannot or would not perform the required duties of the grant.
To complete this assessment, Minnesota Housing may request additional information, and that information must be provided by the potential grantee. If Minnesota Housing is unable to satisfy its concerns with a potential grantee that poses substantial risk, the potential grantee will be notified. This notification will include information on Minnesota Housing’s final decision and options for the potential grantee to challenge as a contested case, the final decision.
The results of this pre-award risk assessment will not impact the scoring of the potential grantee’s competitive application for grant funds.
Mandatory Documentation for For-Profit Business Entities
1.	Financial Documents. Submit the following financial documentation as required by Minnesota. Statute 16B.981 Subd. 2 paragraph 3: 
a.	Most recent Federal and State tax returns filed with the Internal Revenue Service (IRS)
b.	Current Financial Statements (such as: most recent audit, internal income statement and balance sheet, recent bank and brokerage statements)
NOTE: If your organization has not been in existence long enough to have a tax return with the IRS, submit the Internal Controls Certification, along with the current financial statements. 
2.	Evidence of good standing with the Minnesota Secretary of State: All business entities must submit evidence of good standing with the Minnesota Secretary of State. Submit a screenshot of your organization’s current standing from the Minnesota Secretary of State website. The screenshot should show the Business Record Details of your organization and must include all information above the Filing History. The Renewal Due Date must current as of the date the application is submitted. A copy of your current Certificate of Good Standing will be accepted but is not required.
Mandatory Organizational Review for For-Profit Business Entities
Respond to the following questions accurately and completely. This information will be used to determine whether a potential grantee is able to perform the duties of the grant with or without additional conditions and must be submitted in its entirety with your proposal. 
1.	List any state grants from the past three years that your organization has administered, including name of awarding agency, program, and dates of the grant. If none, write N/A.
	     
2.	Describe your organization’s recent history of performing work similar to the work proposed in your application for this grant opportunity. This may include a brief history of your organization and experience with similar grants from government or philanthropy.
	     
3.	How does the scale of your grant application compare to the organization’s budget for similar work the organization currently manages? In other words, describe how much the organization will need to grow to perform the duties of this grant, if awarded.
	     
4.	Based on the application you are submitting, will your organization need to make significant operational changes such as hiring additional staff, making changes to policies/procedures, making changes in management structure, etc.?
	 Yes; describe the changes that will occur to your organization’s operations and how those changes will be made.
	     
	 No
5.	Is your organization currently debarred or suspended from doing business with Minnesota Housing, the State of Minnesota, or the Federal Government? If you answer yes, this will result in disqualification.
	 Yes
	 No
6.	Is your business under bankruptcy proceedings?
	 Yes; provide an explanation and submit disclosure of bankruptcy proceedings.
	     
	 No
7.	Are there liens on any of your businesses’ assets?
	 Yes; provide an explanation and submit a disclosure of assets and corresponding liens.
	     
	 No
Certification of No Convictions of Felony Financial Crimes by a Principal
Minnesota Statute 16B.981, subd. 2, paragraph 6 requires that no current principals of a potential grantee have been convicted of a felony financial crime within the last 10 years. A principal is defined as a public official, board member, or staff (paid or volunteer) with authority to access funds or determine how funds are used. 
A full list of the principals for whom you are certifying must be included with your submission. Principals may include but are not limited to board members, officers of your agency, those who can access bank accounts, can sign checks, or authorize payments, have decision making authority about budgets and participate in voting on financial related decisions.
Check the box below that applies to your organization:
	 	I attest that no current principal of my organization has been convicted of a felony financial crime within the last 10 years. Submit a list of Board members and organizational chart (naming individuals, not positions only) or include a full list of the principals for which you are certifying.
	 	I cannot attest that no current principal of my organization has been convicted of a felony financial crime. Failure to attest will result in disqualification.
Certification
NOTE: This form can be signed digitally, electronically or via wet signature. 
By signing below, I certify I am an authorized representative or am otherwise authorized to sign contracts, financial documents, and legal documents on behalf of the organization. I also certify that the information contained in this document is true, correct, reliable, and complete.
I acknowledge that the submission of inaccurate or misleading information may be grounds for disqualification from a funding recommendation or award and may subject both me and my organization to suspension or debarment proceedings, as well as other remedies available to the State, by law.

     
Name of Potential Grantee 

	     
Authorized Signer Signature	Date

     	     
Authorized Signer Printed Name	Title

Submission Checklist 
Submit the following items requested earlier in this document with your application: 
	 Completed Pre-Award Risk Assessment Form for For-Profit Business Entities
	 Financial Documents: Tax Returns and Current Financial Statements and if applicable, Internal Controls Certification
	 Evidence of Good Standing with the Minnesota Secretary of State
	 List of Board members and organizational chart or full list of principals for whom you are certifying in the “Certification of No Convictions of Felony Financial Crimes by a Principal” section
	 Disclosure of bankruptcy proceedings (if applicable)
	 Disclosure of assets and corresponding liens (if applicable)
	 Refer to the Submission Checklist in Request for Proposals Instructions for additional items that must be completed and submitted for a complete application.