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Home My WebLink About20112556.tiff RESOLUTION RE: APPROVE STATEMENT OF GRANT AWARD FOR 2011-2012 INTERNET CRIMES AGAINST CHILDREN (ICAC) TASK FORCE GRANT AND AUTHORIZE CHAIR TO SIGN -CITY OF COLORADO SPRINGS POLICE DEPARTMENT WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Statement of Grant Award for the 2011-2012 Internet Crimes Against Children (ICAC) Task Force Grant from the City of Colorado Springs Police Department, to the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Sheriff's Office and the Northern Colorado Regional Forensic Laboratory, commencing upon full execution, with further terms and conditions being as stated in said Statement of Grant Award, and WHEREAS, after review, the Board deems it advisable to approve and accept said Statement of Grant Award, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Statement of Grant Award for the 2011-2012 Internet Crimes Against Children (ICAC) Task Force Grant from the City of Colorado Springs Police Department to the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Sheriff's Office and the Northern Colorado Regional Forensic Laboratory, be, and hereby is, approved and accepted. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said Statement of Grant Award. /0 ;.)?�-i/ 2011-2556 SO0032 STATEMENT OF GRANT AWARD FOR 2011-2012 INTERNET CRIMES AGAINST CHILDREN (ICAC) TASK FORCE GRANT- CITY OF COLORADO SPRINGS POLICE DEPARTMENT PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 28th day of September, A.D., 2011. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLO$ADO ATTEST: / K nyeA —(NAY) arbara Kirkmeyer, air Weld County Clerk to the Board c=_ (AYE) Sean P. ay, Pro-Tem BY: �.J�s �.�,!�.:.ti � IG� Deputy Cle to the Boar. (j► � (AYE) isis1 km; qtITI F. Garcia APPR0D,B0 M: /• X9 (AYE) ,avid E. Long ounty Attorney '�r"` . a had' h (NAY) DougYas Rademalcher Date of signature: 1D - "D--1 - I I 2011-2556 SO0032 POLICE DEPARTMENT Richard W. Myers Chief of Police CITY OF COLORADO SPRINGS August 22,2011 Weld County Sheriff's Office Sheriff John Cooke 1950"O"Street Greeley,CO 80631 RE: Statement of Grant Award and Assurances Dear Sheriff John Cooke: On behalf of the City of Colorado Springs and the Colorado Springs Police Department,it is my pleasure to inform you that the Colorado Internet Crimes Against Children Task Force Unit has approved your sub-award for funding under the Internet Crimes Against Children Task Force Program,offered through the Department of Justice,Office of Justice Programs,Office of Juvenile Justice and Delinquency Prevention, in the amount of$22,716 for Weld County Sheriff's Office,on behalf of the Northern Region Lab Mini-task Force. Enclosed you will fmd the Grant Award and Special Conditions documents. This award is subject to all administrative and financial requirements,including the timely submission of all financial and programmatic reports,and the resolution of all interim audit findings. Should you not adhere to these requirements,you will be in violation of the terms of this agreement and the award will be subject to termination for cause or other administrative action as appropriate. Prior to expending any grant funds,a fully executed Statement of Grant Award must be returned to our office with the signature of the authorized recipient official. A fully executed Statement of Grant Award is accomplished when the sub recipient returns a signed original Statement of Grant Award and the Colorado Springs Police department returns a copy of the fully signed Statement of Grant Award back to the sub recipient.The original will be kept on file at the Colorado Springs Police Department. No expenses can be incurred on the grant funds until both parties have signed the Statement of Grant Award. Please return your signed SOGA to: Colorado Springs Police Department ICAC Unit,MC 1502 Attn Janet DeLuca,Program Coordinator 705 S.Nevada Avenue Colorado Springs,CO 80903 If you have questions regarding this award,please contact: -Task Force Specific Questions, Sgt. Bill Dehart,Colorado ICAC Task Force Commander at(719)444-7808,email: dehartbi(a ci.colospgs.co.us;and -Program/Grant Related Questions,Janet DeLuca,ICAC Program Coordinator,at(719)444-7560,email: delucaia@,ci.colospas.co.us. Congratulations,and we look forward to working with you. Sincerely, ft ad istio Lt. Jane Anderson Colorado ICAC Project Director Enclosures 2011-2556 POLICE DEPARTMENT Richard W. Myers Chief of Police CITY OF COLORADO SPRINGS August 22,2011 Weld County Sheriffs Office Sheriff John Cooke 1950"O"Street Greeley,CO 80631 RE: Grant Number 2009-MC-CX-K011 Supplement Number 2 Sub-Award: Weld County Sheriffs Office Dear Sheriff John Cooke: I am pleased to inform you that the Colorado Springs Police Department, Colorado Internet Crimes Against Children Task Force Unit has approved your sub-award for funding under the Internet Crimes Against Children Task Force Program,offered through the Department of Justice,Office of Justice Programs,Office of Juvenile Justice and Delinquency Prevention, in the amount of$22,716 for Weld County Sheriffs Office, on behalf of the Northern Region Lab Mini-task Force. The following budget categories for the aforementioned grant award are listed below: Budget Category Supplement from Balance from 2009- Award Amount from Total for Colorado ICAC 2011 Grant Funds 2011-2012 Grant 2011-2012 Grant Funds Police ICAC Overtime $0 $0 $0 $0 Travel/ICAC Training Airfare and Fees(Baggage) $1,100 $550 $0 $1,650 Per Diem $782 $391 $0 $1,173 Lodging $1,310 $655 $0 $1,965 Ground Transportation(Fuel, $150 $75 $0 $225 rental cars,parking) Registration Fees $0 $0 $0 $0 Computer $0 $576 $17,127 $17,703 Equipment/Supplies/Upgrades Products/Services/Software $0 $0 $0 $0 TOTAL $3,342 $2,247 $17,127 $22,716 BUDGET NARRATIVE SUMMARY: (2011-2012 Grant Allocation Amount$22,716) 1. Police ICAC Overtime—NA 2. Travel—ICAC related travel/training was based on attending the National ICAC Conference,a 4-day training and 2 travel days, for 3 travelers. Airfare and baggage fees are calculated at$550/traveler x 3 =$1,650;Per diem for this budget was calculated using an estimated cost of$71/day x 4 full days x 3 travelers=$852; travel days are calculated at 75%of the full day- $53.25/day x 2 travel days x 3 travelers=$319.50; Lodging is calculated at$131/night x 5 nights x 3 travelers=$1,965. Travel amounts may be adjusted based on actual costs,with the exception that lodging and per diem rates may not exceed the IRS rates for the training location. Ground transportation may include fuel,mileage,parking, shuttle/taxi type services and rental vehicles. 3. Computer Equipment/Supplies/Upgrades—Forensic Recovery of Evidence Data$11,104;Forensic Software/hardware at $4,523;EnCase Portable Unit at$1,500. All Computer Equipment/Supplies/Upgrades must be solely used for ICAC Program purposes only. 4. Products/Services/Software—NA If you have any questions regarding this award,please contact: -Task Force Specific Questions,Sgt.Bill Dehart,Colorado ICAC Task Force Commander at(719)444-7808,email: dehartbi(a ci.colosp2s.co.us;and -Program/Grant Related Questions,Janet DeLuca,ICAC Program Coordinator,at(719)444-7560,email: delucajaAci.colospgs.co.us. Congratulations,and we look forward to working with you. Sincerely, ant-t4d 3flA Lt. Jane Anderson Colorado ICAC Project Director I f•:'_ .A. r1:fW ",57S.1.157' Statement of Grant Award Page 1 of 8 O�+O \ MY Or COLOAA �_• 1A. RECIPIENT NAME AND ADDRESS (Including 3. AWARD NUMBER: 4. AWARD DATE: Zip Code) City of Colorado Springs 2009-MC-CX-K011 August 9, 2011 Colorado Springs Police Department )1," 705 S. Nevada Avenue Supplement Number 2 Colorado Springs,CO 80903 1B. GRANTEE IRSNENDOR NO.: 5. AMOUNT OF THIS SUB-AWARD: $22,716 846000573 2A.SUB-AWARD RECIPIENT NAME AND 6. PROJECT PERIOD: ADDRESS (Including Zip Code) FROM: TO: Weld County Sheriff's Office September 1,2011 March 31,2012 SherifJohn Cooke BUDGET PERIOD: 1950"O"Street FROM: TO: Greeley,CO 80631 September 1, 2011 March 31,2012 2B. SUB-AWARD GRANTEE CONTRACTNENDOR 7. CFDA NUMBER: NO.: A005046/023637 16.543 8. SPECIAL CONDITIONS: THE ABOVE SUB-AWARD GRANTEE PROJECT IS APPROVED SUBJECT TO SUCH CONDITIONS OR LIMITATIONS AS ARE SET FORTH ON THE ATTACHED PAGE(S). .._ 10. STATUTORY AUTHORITY FOR GRANT: This project is supported under FY 10 (OJJDP ICAO)42 USC 17611-1761 11. METHOD OF PAYMENT: Sub-Award Grantee will submit fully executed quarterly reimbursement requests, along with all required supporting documentation, within twenty(20) days following the end of each quarter according to the guidelines established under Special Conditions, as well as contained within the"Colorado ICAO Grant Guide Book"to: Colorado Springs Police Department ICAC Unit, MC 1502 Attn: Janet DeLuca, Program Coordinator 705 S. Nevada Avenue Colorado Springs, CO 80903 Payments to sub-award grantees shall be made via check mailed to Authorized Recipient Official listed below, and address provided In line 2A above. CSPD APPROVAL SUB-AWARD GRANTEE ACCEPTANCE 12. TYPED NAME AND TITLE OF APPROVING 13. TYPED NAME AND TITLE OF AUTHORIZED SUB- OFFICIAL AWARD GRANTEE OFFICIAL Chief Richard W. Myers Barbara Klrkmeyer, Colorado Springs Police Department Weld County Commissioner, Chair 14. SIGNATU ND DATE OF APPROVING OFFICIAL 15. SIGNATURE AND DATE OF AUTHORIZED SUB- / AW D RECIPIENT OFFI IAL a ,/ ( SEP 28 2011 SIGNATURE DATE GNATURE 1, DATE IAi II • Statement of Grant Award Page 2 of 8 } / OW\ CITY 01 CMCWOSPRINGP GRANT NUMBER: 2009-MC-CX-K011 AWARD DATE: August 9, 2011 SUB-AWARD GRANTEE: Weld County Sheriffs Office SPECIAL CONDITIONS PROJECT DESIGN AND IMPLEMENTATION The Colorado Springs Police Department(CSPD)is the lead agency and primary applicant for the Colorado Internet Crimes Against Children(ICAC)Task Force. CSPD has been awarded federal funds through the Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention (OJJDP), to carry out the CO-ICAC Task Force Program ("the project")and has received authority to make sub-award grants with these federal funds. The granting agency(City of Colorado Springs)and the sub-award grantee(Weld County Sheriff's Office)agree to the following conditions: COMPLIANCE WITH REGULATIONS The sub recipient agrees to comply with the financial and administrative requirements set forth In the current edition of the Office of Justice Programs(OJP) Financial Guide. The sub recipient acknowledges that failure to submit an acceptable Equal Employment Opportunity Plan(if recipient is required to submit one pursuant to 28 C.F.R. Section 42.302),that Is approved by the Office for Civil Rights, Is a violation of its Certified Assurances and may result In suspension or termination of funding, until such time as the recipient is in com pliance. The sub recipient agrees to comply with the organizational audit requirements of OMB Circular A-133,Audits of States, Local Governments, and Non-Profit Organizations, and further understands and agrees that funds may be withheld, or other related requirements may be imposed, If outstanding audit issues(if any)from OMB Circular A-133 audits(and any other audits of OJP grant funds)are not satisfactorily and promptly addressed, as further described in the current edition of the OJP Financial Guide, Chapter 19. Audits are due no later than 9 months after the close of each fiscal year during the term of the award. The sub recipient understands and agrees that it cannot use any federal funds, either directly or Indirectly, in support of the enactment, repeal, modification or adoption of any law, regulation or policy, at any level of government,without the express prior written approval of OJP,through the Colorado Springs Police Department. In accordance with Department of Justice Guidance pertaining to Title VI of the Civil Rights Act of 1964, U.S.C.§ 2000d, recipients of Federal financial assistance must take reasonable steps to provide meaningful access to their programs and activities for persons with limited English proficiency(LEP). For more information on the civil rights responsibilities that recipients have in providing language services to LEP individuals, please see the website at http://www.len.00v. In addition to these general prohibitions, an organization which Is a recipient of financial assistance subject to the nondiscrimination provision of the Omnibus Crime Control and Safe Streets Act(Safe Streets Act)of 1968,42 U.S.C. § 3789d(c),or other Federal grant program requirements, must meet two additional requirements:(1)comply with Federal regulations pertaining to the development of an Equal Employment Opportunity Plan (EEOP), 28 C.F.R.§42.301-.308, and(2)submitting to OCR Findings of Discrimination(see 28 C.F.R. §§42.205(5)or 31.202(5). C utcr -tf4 4„��, 41 i Statement of Grant Award Page 3 of 8 116 ( t`\ CITY Of COMO0S1OO GRANT NUMBER: 2009-MC-CX-K011 AWARD DATE: August 9, 2011 SUB-AWARD GRANTEE: Weld County Sheriff's Office SPECIAL CONDITIONS The sub recipient must properly refer to the DOJ OIG any credible evidence that a principal, employee, agent, contractor, sub recipient, subcontractor,or other person has either 1)submitted a false claim for grant funds under the False Claims Act; or 2.)committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct involving grant funds. This condition also applies to any sub recipient. Potential fraud,waste, abuse, or misconduct should be reported to the OIG by— Mail Office of the Inspector General U.S. Department of Justice Investigations Division 950 Pennsylvania Avenue, N.W. Room 476 Washington, DC 20530 Hotline: (contact information in English and Spanish): (800)869-4499 Or hotline fax: (202)616-9881 Additional information is available from the DOJ OIG website at www.usdoi.gov/oi9. The sub recipient understands and agrees that it cannot use any federal funds, either directly or indirectly, in support of any contract or sub award to either the Association of Community Organizations for Reform Now(ACORN)or its subsidiaries, without the express prior written approval of OJP, through the Colorado Springs Police Department. The sub recipient agrees to comply with the OJJDP approved ICAC Task Force Operational and Investigative Standards. The sub recipient agrees to comply with the approved current version of the Colorado ICAC Task Force Grant Guide. The sub recipient agrees to forward reports of ICAC Task Force Program Monthly Performance Measures by the 10th of each month to the ICAC Program Coordinator, Janet DeLuca, via email at: delucaia(&ci.colospos.co.us. No vendor whose name appears on the U.S. Government's Vendor Exclusion list (www.epls.00v) may be paid from a federal grant. No payment may be made to any organization or Individual listed on the U.S. Government's Terrorist Exclusion List(www.state.gov/s/ct/list). It will be the responsibility of the sub recipient to ensure all such searches for exclusion have been conducted. <104 �rcvy�r h a } 5y, Statement of Grant Award Page 4 of 8 '4Ot !OF raDRADO5?ZN(S GRANT NUMBER: 2009-MC-CX-K011 AWARD DATE: August 9, 2011 SUB-AWARD GRANTEE: Weld County Sheriff's Office SPECIAL CONDITIONS The sub recipient agrees to make a good faith effort to provide and maintain a drug-free workplace. The sub recipient agrees to report any other ICAC related reporting information as needed/requested by the Colorado ICAC Task Force Commander, Administrator or Program Coordinator, as needed to complete OJP/OJJDP requests. The sub recipient will accept any and all Investigative leads occurring in its jurisdiction that are received from the granting agency and/or the National Center for Missing and Exploited Children(NCMEC), and will report the disposition of pursuant investigations to the granting agency. The sub recipient will attend meetings and trainings of the Colorado ICAC Task Force when agency resources allow. The sub recipient agrees to submit Semi-annual progress reports to the Colorado ICAC Program Coordinator within ten (10)days'of the close of the reporting period. REIMBURSEMENT OF GRANT FUNDS AND USE OF GRANT FUNDS Any reimbursements under this grant shall be made In accordance with the guidance set forth In the Colorado ICAC Task Force Grant Guide once the fully executed Statement of Grant Award has been received by CSPD, along with a completed W-9 form by the sub recipient. A fully executed Statement of Grant Award is accomplished when the sub recipient returns a signed original Statement of Grant Award and the Colorado Springs Police department returns a copy of the fully signed Statement of Grant Award back to the sub recipient.The original will be kept on file at the Colorado Springs Police Department. The sub recipient agrees to submit fully executed,signed quarterly financial reimbursement requests,along with required supporting documentation within 20 days of the close of the reporting period. The granting agency(CSPD/City of Colorado Springs)will reimburse the sub recipient based on the current approved budget for expenditures made solely in the furtherance of the Project upon receipt of a fully signed and properly executed reimbursement form. The sub recipient will agree to expend grant funds pursuant to their approved grant award budget and the funds shall be used only to Implement the ICAC related project and for no other purpose. The granting agency(CSPD/City of Colorado Springs)will administer and resolve any issues with the grant program within the grant funding period. The sub recipient will retain all financial records, supporting documents and other pertinent records for this award for at least three (3)years following notification that the grant has been programmatically and fiscally closed, OR at least three (3)years following the closure of its audit report covering the entire award period, whichever is later. teen,:hot Chilahy4 LtteetiN Statement of Grant Award Page 5 of 8 Of MUD°SIV GS GRANT NUMBER: 2009-MC-CX-K011 AWARD DATE: August 9, 2011 . SUB-AWARD GRANTEE: Weld County Sheriffs Office SPECIAL CONDITIONS MONITORING Office-Based Reviews: Several office-based methods will be used to ensure that sub recipients are complying with fiscal and programmatic requirements. Invoices submitted by agencies requesting reimbursement under a grant must be accompanied by a signed certification that the information included is correct and all expenditures are properly documented; all copies are true and correct copies of the originals; the agency maintains a copy of and follows applicable financial guidelines associated with the grant award; and the agency tracks all applicable items with a purchase price greater than$5,000 per unit. The project director or designee will review Invoices from agencies requesting reimbursement under a grant to ensure the appropriate signed certification Is included. In addition, the project director will review each expenditure submitted for reimbursement to ensure all costs are allowable, conform to the approved grant budget, and that adequate supporting documentation has been submitted. Adequate supporting documentation includes information showing procurement was accomplished competitively or was justified as being done non-competitively in compliance with federal and agency guidelines. If documentation is not adequate, the expense will be denied reimbursement until the sub recipient supplies adequate documentation. If the sub recipient appears to have recurrent problems submitting adequate documentation, this will be noted and addressed with the sub recipient(including at a future on-site monitoring visit). The ICAC Program Coordinator will reconcile expenditures against the City's accounting system on a monthly basis. Other office-based monitoring will be conducted by the project director or designee periodically. The project director or designee will review financial and narrative reports, check project status, review compliance with certifications and assurances, and provide information and respond to questions throughout the grant period. If programmatic or operational problems are noted during the course of the grant period through reviews or contacts,the project director or designee will work to resolve them and the problems will be addressed In any future on-site visit. it • 4y 3 Statement of Grant Award Page 6 of 8 ' OR' Clf of OURADOIPINGS GRANT NUMBER: 2009-MC-CX-K011 AWARD DATE: August 9, 2011 SUB-AWARD GRANTEE: Weld Count Sheriff's Office SPECIAL CONDITIONS On-site Monitoring: A certain number of sub recipients will be selected for on-site monitoring each year based on the requirements of individual funding sources. A sub recipient will receive a formal on-site visit no more frequently than once per grant period and no less frequently than once every six consecutive years of funding. Thirty days in advance of the proposed on-site monitoring visit, the project director or designee will contact the sub recipient to schedule the upcoming visit and brief the sub recipient on what activities and discussions are planned for the visit. The sub recipient will then be provided with a read-ahead packet which will include a site-monitoring checklist the agency can use to prepare required documentation in advance of the visit. Monitoring staff from the department will address any problems or Issues noted through office-based monitoring in addition to a review of the following: Project implementation: timeline, project operations, rate of funds expenditure, performance measures, adherence to program-specific guidelines Equipment maintenance and property management systems Supporting documentation for the performance measures given In programmatic reports Within 15 days of the on-site monitoring visit, monitoring staff may conduct an exit interview with the sub recipient to identify Issues from the visit and to clarify any corrective action items. All sub recipients will receive a post-visit letter documenting issues and corrective actions whether they have an exit interview or not. If any outstanding issues are identified, the sub recipient is required to submit a corrective action plan within 30 days of the date of the post-visit letter, identifying the steps that are being taken to resolve the issues. Upon resolution of the issues, the sub recipient will send additional documentation explaining the final resolution of any Identified issues. RENEWAL OR EXTENSION This grant award may be renewed or extended under the same terms and conditions subject to the approval of the Chief of the Colorado Springs Police Department. The term of the renewed/extended grant award may not be longer than the term of the original grant award. (00 h l 's,0,� Statement of Grant Award Page 7 of 8 ORMS CDY Of COLORADO SPRING GRANT NUMBER: 2009-Mc-CX-K011 AWARD DATE: August 9, 2011 SUB-AWARD GRANTEE: Weld County Sheriff's Office SPECIAL CONDITIONS TERMINATION FOR CONVENIENCE This grant award may be terminated, in whole or in part, by the granting agency whenever and for any reason that the granting agency determines that such termination is in the best interest of the granting agency. Termination shall be effected by delivery to the sub recipient of a Termination notice, specifying the extent to which such termination becomes effective, The sub recipient shall be compensated for completion of the Project properly done and documented prior to the effective date of termination. The Granting Agency will not be liable for work on the Project performed after the effective date of termination. NOTICE TO PARTIES Whenever any notice, statement or other communication is required under this grant, it shall be sent to the following addresses, unless otherwise specifically advised: Notices to the Granting Agency shall be sent to: Janet DeLuca, Program Coordinator Colorado ICAC Task Force Unit 705 South Nevada Avenue—MC 1502 Colorado Springs, CO 80903 Notices to the sub recipient shall be sent to: Name: Ronald Arndt Organization: Weld County Sheriff Office Mailing Address: 1950 O Street City, State, Zip: Greeley, CO 80631 Phone Number: (970) 356-4015 x 3638 E-Mail Address: rarndt@co.weid.co.us efr�* y CC"" ,'"ft,a',"*”.... Statement of Grant Award Page 8 of B eRJ34.4.Ai4. / ORM' nON CIX01ADOVNINIiS GRANT NUMBER: 2009-MC-CX-K011 AWARD DATE: August 9, 2011 SUB=AWARRGBANT�E Weld County Sheriff's Office by and through the Board of Weld County Commissioners SPECIAL CONDITIONS NON-COLLUSION AND ACCEPTANCE The undersigned attests,subject to penalties for perjury, that he/she is the properly authorized representative, agent, member or officer of the sub recipient, that he/she has not, nor has any other member, employee, representative, agent or officer of the sub recipient, directly or Indirectly, to the best of the undersigned's knowledge, entered into or offered to enter into any combination, collusion or agreement to receive or pay, and that he/she has not received or paid any sum of money or other consideration for the execution of this Grant other than what appears upon the face of this Grant, In Witness Whereof, the sub recipient and the City of Colorado Springs have,through their duly authorized representatives, entered Into this Grant. The parties, having read and understood the foregoing terms of this Grant, do by their representative signatures dated below hereby agree to the terms thereof. (Sub recipient): Board of Weld County Commissioners on behalf of Legal Name of sub recipient Agency: Wel County Sheriff' Office Signature of Authorized Official: Printed Name and Title of Authorized Official: Barbara Kirkmeyer, Weld County Commissioner, Chair_,,, Date Signed: SIP 2 8 71111 City of Colored p By: Chief Richard W. Myers, Colorado wings Police Department Date: /t —/('—// atd-a55& EXHIBIT A COLORADO ICAC TASK FORCE SIGNATURE CARD (Authorized Signatories Designation Form) Agency: cis C.ouK4a Govw Address to which payment should be sent: I 15r) s-k- -(- G�� Co 8063 ( The-indivielua3slistedbelow-are-designated as-authorized-signateries-for-submitting-invaieesirequest for payment under the 2011-2012 ICAC Grant. (At least two (2) signatories required.) Authorized signatories acknowledge below that they have read and understand the administrative and financial requirements listed in the Award Conditions, Name: 130RQflP-A CON N01-Ly Name: ai--O 41"r Title: C0NTR0LLEC Title: I_ab D a cro2 Phone: qiv '.10-"C(.w )4445 Phone: 9'7o• 3n, 1/6/5- x 363r E-mail: beDn lo LIS 00, 60.U5 g-comwo2�-@Go, Wel . co. us Signatur R.a ..Qia o..a Signature: -fyl L. Name r' fY A- I\oer'-C-- Name: 4rrl if13Ll.0—Y- Title: t>(?- cerrech Title: ma._ymo,O {L Phone: Gflr) $ Qgc)--I Phone: al'{© BS Co'I.- p-- a9'O14 Lsatick E-mail: ‘c -`2 Cd e t-�P`3".- C C�,� E-mail: Vein-%% cv-ke�yG �O�Cot - eV CO,OS) Signature:t—Bc1r �Jk0( a (1.a Signature: cl,`-(i,.,1 {I 'J[ I CERTIFY THAT THE SIGNATORIES LISTED ABOVE ARE THE INDIVIDUALS AUTHORIZED TO SUB IT REQUESTS FOR PAYMENT UNDER THE 2011-2012 ICAC GRANT, (Signature of City/C ty Au c rizing Official) SEP 2 8 2011 Barbara Klrkmeyer, Chair. (Printed Name,Title) (Date) Received by CSPD on: By: ccri/ a5s6 AGENCY PER DIEM DOCUMENTATION FORM This form should be completed and signed by someone working in the agency's finance unit/department. 1.Agency: WELD Couwrt c OVeRNMENT 2.Agency per diem policy effective as of August 22,2011 (check one): 14 Meals/incidentals reimbursed atactual cost based on receipts. If so, indicate maximum amount that may be reimbursed per day: n Meals/incidentals reimbursed at a given rate regardless of the actual expenses. If so,which rate does your agency use: U IRS rate ❑GSA rate ❑ Local/other rate. If so, what amount per day: Does your agency pay the full rate for travel days:❑Yes,Always ❑No, Never ❑Sometimes If"No" or"Sometimes" how is the travel day amount figured? 3. Does your agency anticipate changing its policy or rate in the foreseeable future? ❑Yes. Probable timeframe/date of change: Anticipated change: [24'No. Policy or rate changes should be brought to the attention of the ICAC Program Coordinator as soon as possible. I certify that the information reported on this form is accurate to the best of my knowledge and belief. Printed Name: TARBQi9 eOKNOLLy Title: CON TROLL EIZ f —a �i� Signature: G2-t-L2 � Q Date: cl!J`aeo/`f Hello