90175.1-CA Request for Closing on Completion Certificate of Constru

Capital Advance Mixed-Finance
Program

OMB Approval No. 2502-0470
(Exp. 08/31/2013)

U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
Office of Housing
FEDERAL HOUSING ADMINISTRATION

Request for Final Closing
Certificate of Other Secured Lien Holder(s), Mixed-Finance Owner and
General Contractor
(For Capital Advance Upon Completion only)

Project Name:

Project No.

Project Address:

Date of Commitment:

Date of this request:

Capital Advance Amount:

To the Department of Housing and Urban Development:
We hand you herewith the original credit instrument
drawn upon the form approved by you for use in the State in
which the above-captioned project is located in connection
with a Section 202/811 Capital Advance, evidencing a
capital advance to the undersigned mixed-finance owner,
together with three conformed copies thereof, and three
conformed copies of the Security Instrument of even date
securing the same recorded as shown thereon, also drawn,
upon the form approved by you for use in said State.
We also hand you (a) a certified and two conformed
copies of a Chattel Mortgage or Security Agreement and
Financing Statement recorded as indicated thereon from the
Mixed-Finance Owner covering all personal property in the
project not otherwise covered by the real estate mortgage
to be insured or (b) certificate of mixed-finance owner’s
Attorney that no chattel mortgage or security agreement and
financing statement are required to protect the interest of
the Secretary, Department of Housing and Urban Development
in respect to such personal property.
We understand that nothing herein contained or
contained in the said credit instrument or mortgage
securing the same, or in the other contract documents, is
to be deemed a waiver of any of the provisions of the 24
CFR Part 891, but all of said instruments are intended to
be subject thereto. We hereby agree to conform with and
abide by such Regulations in all matters with respect to
the aforesaid loan and the project insofar as they are
applicable to us.
Form HUD-90175.1-CA (2/2009)
Page 1 of 8

OMB Approval No. 2502-0470
(exp. 8/31/2013)
CERTIFICATE OF OTHER SECURED LIEN HOLDER(S)

We, the undersigned other lien holder, hereby
certify that:
1.
To the best of our knowledge and belief the project
has been completed, with the exception of the minor items
enumerated on the Exhibit attached hereto, strictly in
accordance with the Drawings and Specifications
heretofore approved by you except for such changes as
have heretofore been approved in writing by us and your
authorized representative.
2.
The project is fully covered by fire and other
insurance as required by the terms of the Capital Advance
mortgage in the form and amounts heretofore stipulated by
you; and that all insurance policies on the project have
attached thereto a standard mortgagee clause making the
loss payable to the Secretary and other secured lien
holder(s) as their interests may appear.
3.
We have received a guarantee against defects due to
faulty workmanship and defective materials in the form
of: (Check applicable paragraph(s))
a.
A Surety Bond on a form prescribed by you and in
an amount not less than ten percent (10%) of the cost
of construction, running for a period of not less than
two years from the date of substantial completion* of
the project, which bond has been assigned to HUD.
b.
By agreement between ourselves and the mixedfinance owner and contractor, we retain in our
possession or in a depository satisfactory to HUD for
a period of one year following the date of 100%
completion* of the project, a sum equal to two and
one-half (2 1/2%) percent of the principal amount of
the construction, in the form of cash which sum, upon
failure of the mixed-finance owner or the contractor
to cure any such defects due to faulty workmanship
and defective materials to the satisfaction of HUD
and your authorized representative, can be used for
the purpose of curing such defects, or can be applied
to the mortgage indebtedness with your consent.
c.
The general contractor used a performance bond
during construction that contains a guarantee against
Form HUD-90175.1-CA (2/2009)
Page 2 of 8

OMB Approval No. 2502-0470
(exp. 8/31/2013)
any defects due to faulty materials or workmanship
which appear within a period of one year following
completion.
* For this purpose the date of 100% completion is
construed as the date the HUD Representative signs the
final Representative's Trip Report, Form HUD-95379,
provided that the Construction Manager subsequently
endorses the trip report.
4.

We have received:

(Check applicable paragraphs)

- An Escrow Agreement guaranteeing the completion of
off-site utilities and streets. The mixed-finance
owner has made the deposit called for therein in
the form of cash.
- Evidence to the effect that required off-site
utilities and streets will be provided by the
public authorities having jurisdiction or by
public utility companies serving the project.
- An Escrow Deposit Agreement covering the incomplete
on-site improvements. The mixed-finance owner has
made the deposit called for therein in the form of
cash.
- A copy of the Escrow Agreement or other evidence is
delivered herewith.
6.
An Escrow Agreement evidencing the deposit by
the mixed-finance owner of cash in the amount of
$
as required by your Commitment to
meet minimum capital investment has been received by us
or a depository satisfactory to HUD. A copy of the Escrow
Agreement is delivered herewith.
7.
An Escrow Agreement evidencing the deposit by
the mixed-finance owner of cash in the amount of
$
as required by your Commitment to
meet the operating reserve account for the non-capital
advance assisted units. A copy of the Escrow Agreement is
delivered herewith.
8.
Beginning with the effective commencement of rental
assistance payments under the Project Rental Assistance
Contract or at such later date as may be agreed to by you
Form HUD-90175.1-CA (2/2009)
Page 3 of 8

OMB Approval No. 2502-0470
(exp. 8/31/2013)
in writing, we will require a monthly deposit with us or in
a depository satisfactory to HUD of one-twelfth (1/12) of
the sum set forth in your Commitment to Release Capital
Advance Funds Upon Completion constituting a “Reserve Fund
for Replacements” which fund will be subject to HUD’s
control and from which fund withdrawals may be made only
upon the receipt of your written permission. These funds
will be deposited with us by the mixed-finance owner in the
form of cash or in the form of obligations of or guaranteed
as to principal by the United States of America. We will,
upon appropriate request by the mixed-finance owner, permit
the conversion of the whole or a substantial part of such
cash deposits into the form of obligations of, or fully
guaranteed as to principal by, the United States of
America. Notice of any failure to receive the deposits
required herein will be forwarded to HUD within 60 days.
9.
In compliance with the provisions of the Commitment to
Release Capital Advance Funds Upon Completion issued with
respect to the above identified case, to its best knowledge
and belief no restriction upon the occupancy of the
mortgaged property, on the ground of race, color, or creed,
has been filed of record at any time subsequent to February
15, 1950, and prior to the recording of the capital advance
mortgage. This certification is based upon our examination
of the title evidence received by us.
10. We certify that we have not paid any kickback, fee or
other consideration, directly or indirectly, to any person
who has received payment or other consideration from any
other person in connection with this mortgage transaction,
including the purchase or sale of the mortgaged property,
except for compensation paid, if any, for the actual
performance of services and approved by you.

The Secured Lien Holder
ATTEST:
By ---------------------------(Signature and Title of Officer)
WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including
confinement for up to 5 years, fines, and civil and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802)

Form HUD-90175.1-CA (2/2009)
Page 4 of 8

OMB Approval No. 2502-0470
(exp. 8/31/2013)
CERTIFICATE OF MIXED-FINANCE OWNER

The undersigned mixed-finance owner hereby certifies that:
1.
The undersigned possesses the powers necessary for and
incidental to the ownership, construction, and operation of
a rental housing project as required by the provisions of
the Housing Act of 1959 or the National Affordable Housing
Act and the Regulations applicable thereto.
2.
The undersigned has read the items above and certified
to by the construction lender concurrently herewith and
to the best of its knowledge and belief considers them
correct.
3.
From the date of this certificate and for so long as
the mortgage is held by HUD:
a.
The Project books and records will be established
and maintained in accordance with the requirements of
HUD, and in such condition as to permit a speedy and
effective audit;
b.
Such books and records will be retained for
such period as may be prescribed by HUD;
c.
Such books and records will be available to HUD
and to the Comptroller General of the United States
for such examination and audits as they may desire
to make.
The undersigned further agrees that if the project has been
occupied prior to the date of this certificate, financial
reports covering the entire period of occupancy will be
furnished to HUD, if requested.
4.

Neither it nor anyone authorized to act for it will
refuse to rent, after the making of a bona fide offer, or refuse
to negotiate for the rental of, or otherwise make unavailable or
deny the property of a covered mortgage to any person because of
race, color, religion, national origin, sex (including sexual
orientation and gender identity), age, or disability; that any
restrictive covenant on such property relating to race, color,
religion, national origin, sex (including sexual orientation and
gender identity), or disability, is recognized as being illegal
and void and is hereby specifically disclaimed; and that civil
action for preventive relief may be brought by the Attorney

Form HUD-90175.1-CA (2/2009)
Page 5 of 8

OMB Approval No. 2502-0470
(exp. 8/31/2013)
General in any appropriate U.S. District Court against any
persons responsible for a violation of this certification.
5.
All funds escrowed with the construction lender as
enumerated in the Construction Lender’s Certificate, if
applicable, may be transferred to HUD and held for the
purposes indicated therein, or in the event of a default
may be applied to the accelerated Mortgage indebtedness.
6.
HUD and its authorized agents are hereby granted the
right to enter upon the mortgaged premises at any and
all times for the purpose of inspection.
7.
No material or equipment, for which capital advance
proceeds were made available, has been purchased on a
conditional sale contract or financed by a chattel
mortgage.
8.
The undersigned has not collected, nor will the
undersigned collect, from Project residents or from
prospective Project residents, admission fees, founders'
fees, life-care fees or similar payments pursuant to any
agreement, oral or written, whereby the undersigned
agrees to furnish accommodations or services in the
Project to persons making such payments.
9.
Further, in order to induce HUD to accept the credit
instrument, and with the intent that HUD rely upon the
statements hereinafter set forth, the undersigned makes
the following certifications:
a.
That it has received the sum of
$
, constituting the full mortgage
amount for this project, including any savings to
which the mixed-finance owner may be entitled.
b.
That construction of the project is
substantially complete and is in accordance with the
plans and specifications approved by HUD; that said
mortgage is a good and valid lien on the property
therein described; that the property is free and clear
of all liens other than that of subject mortgage
unless approved by HUD; that all outstanding unpaid
obligations contracted by or on behalf of the mixedfinance owner directly or indirectly, in connection
with the mortgage transaction, the acquisition of the
Form HUD-90175.1-CA (2/2009)
Page 6 of 8

OMB Approval No. 2502-0470
(exp. 8/31/2013)
property, or the construction of the project
are listed below:
1)
2)
3)

HUD-approved notes (copies
attached)
Due General Contractor
Other

$
$
$

c.
That, except for the amounts due on notes listed
in item 1) of paragraph b. above, the undersigned
agrees to pay the foregoing obligations in cash and to
furnish HUD receipts, or other evidence of payment
satisfactory to HUD within 45 days following the final
disbursement of capital advance proceeds.
Mixed-Finance Owner:

By (signature & Title)

Date:

*(NOTE: If the space provided is inadequate to list all unpaid
obligations, insert the total in each category and attach itemizations.
If there are no outstanding obligations, so state.)
WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including
confinement for up to 5 years, fines,
and civil and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802)

Public reporting burden for this collection of information
is estimated to average 1 hour per response, including the
time for reviewing instructions, searching existing data
sources, gathering and maintaining 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.

Form HUD-90175.1-CA (2/2009)
Page 7 of 8

OMB Approval No. 2502-0470
(exp. 8/31/2013)
CERTIFICATE OF GENERAL CONTRACTOR
(To be completed when there is an identity of interest
between the mixed-finance owner or developer and the
general contractor.)
Certificate of General Contractor

Project Number:
To the Department of Housing and Urban Development
The undersigned, as general contractor of the above
project, makes the following certifications:
1.
That construction is in accordance with the plans and
specifications, which were approved by HUD.
2.
That all outstanding unpaid obligations contracted by
or on behalf of the undersigned in connection with the
construction contract are listed below.
(If space below
is inadequate, continue listing on an attached sheet and
so note.)
a.

$

b.

$

c.

$

3.
That, except for unfinished work covered by an
approved escrow deposit, the undersigned agrees to pay the
foregoing obligations in cash and to furnish HUD receipts,
or other evidence of payment satisfactory to HUD, within
15 days following receipt of payment from owner.

General Contractor

By (signature & Title

Date

I/We, the undersigned, certify under penalty of perjury that the
information provided above is true and correct. WARNING: Anyone who
knowingly submits a false claim or makes a false statement is
subject to criminal and/or civil penalties, including confinement
for up to 5 years, fines, and civil and administrative penalties.(18
U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C.
§3729, 3802)

Form HUD-90175.1-CA (2/2009)
Page 8 of 8