Design Architect’s 
Certification	U.S. Department of Housing 
and Urban Development
Office of Housing
Federal Housing Commissioner	OMB Control NO. 2502-XXXX
(exp. xx/xx/xxxx)	
Public reporting burden for this collection of information is estimated to average 0.5 hour (30 minutes) per response, including the time for reviewing instructions, searching existing data sources, gathering and maintain the data needed, and completing and reviewing the collection of information.  HUD may not collect this information and you are not required to complete this form, unless it displays a currently valid OMB control number.

This information collection is necessary to ensure that viable projects are developed.  It is important to obtain information from applicants to assist HUD in determining if nonprofit organizations initially funded continue to have the financial and administrative capacity needed to develop a project and that the project design meets the needs of the residents.  The Department will use this information to determine if the project meets statutory requirements with respect to the development and operation of the project, as well as ensuring the continued marketability of the project.  This information is required in order to obtain benefits.  This information is considered non-sensitive and no assurance of confidentiality is provided.	

For use in HUD's Section 202 Supportive Housing for the Elderly and 
Section 811 Supportive Housing for Persons with Disabilities Programs

The following certification shall be submitted at the Firm Commitment Application stage of processing and shall be completed by the licensed professional executing the Owner-Architect Agreement (AIA Document B-181) with HUD Amendment (Form HUD 90169-CA).

Owner:		
		
HUD Project No.:		
		
Project Name:		
		
Project Address:		

		

I,                                      , Registered Architect, do hereby certify that I have personally prepared, reviewed and/or supervised the preparation of the Working Drawings and Specifications for this project.  I further certify that, to the best of my knowledge, the Working Drawings and Specifications comply with the applicable building codes specified below and have been prepared in accordance with HUD regulations, Handbook requirements and guidelines as identified below.

A.	The attached Working Drawings and Specifications are:

	1.  For the project identified above, which is described as follows:  (Describe project by indicating number and types of units, etc.)

	

	

	

Design Architect’s 
Certification			

2.  Identified as		

(Identify Working Drawings and Specifications by inserting information normally found in the Title Block of drawings.)	
	
3.  In compliance with Local, State or Model Building Code:             (Specify name and year.)	

	

	4.  In compliance with other Laws, Ordinances, Exceptions, Deletions, Waivers, Additions, etc., required or granted by the appropriate Local, State, and/or Federal authority (attached herewith).

	5.  In compliance with the (1) Uniform Federal Accessibility Standards and HUD's implementing regulations at 24 CFR Part 40;  (2) Section 504 of the Rehabilitation Act of 1973 and HUD's implementing regulations at 24 CFR Part 8; (3) Fair Housing Act of 1988 and HUD's implementing regulations at 24 CFR Part 100 for covered multifamily dwellings designed and constructed for first occupancy after March 13, 1991; and (4) the Americans Disabilities Act of 1990.

	6.  In compliance with HUD's (1) current Minimum Property Standards (Handbook 4910.1); (2) design and cost standards as contained in 24 CFR, Sections 891.120 applicable to both Section 202 and Section 811 projects), 891.210 and 891.220 (Section 202 projects only), 891.310 and 891.315 (Section 811 projects only); and (3) current Handbooks 4571.5 Section 202 Supportive Housing for the Elderly, 4571.4 Section 811 Supportive Housing for Persons with Disabilities and 4460.1 REV-1, Architectural Analysis and Inspections for Project Mortgage Insurance.

B.	Professional liability insurance in a minimum amount of $50,000 (Section 811) or 250,000 (Section 202) for the signatory/firm below covering errors and omissions is in force and will remain in force through the construction of the project and for a period of 3 years after project completion.

C.	Three sets of the Working Drawings and Specifications which are properly and legally dated, sealed and signed by the Design Architect and professional Engineer responsible for each design component, i.e., consultant's seal and signature for engineering divisions such as civil, structural, electrical, mechanical, plumbing, etc., are attached.  

Design Architect’s 
Certification			

Signature:		Date:		

	(Print or Type Name)			
				
Name of Firm:		

Business Address:		

		

		
Telephone No.:	  (     )	
		
License Number:		

											(SEAL)

WARNING:  Title 18 U.S.C., Sections 1001 and 1010, provides in part that whoever knowingly and willfully makes or uses a document containing any false, fictitious, or fraudulent statement or entry, in any matter in the jurisdiction of any Department or agency of the United States, shall be fined not more than $10,000 or imprisoned for not more than five years or both.  A false statement shall constitute a violation of Sections 1010 and 1010 of Title 18 U.S.C.