HomeMy WebLinkAbout20100849.tiff RESOLUTION
RE: APPROVE APPLICATION FOR EMERGENCY SHELTER GRANT ASSISTANCE 2010
AND AUTHORIZE CHAIR TO SIGN
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 an Application for Emergency Shelter Grant
Assistance 2010 from the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Greeley/Weld County Housing Authority, to the
Colorado Division of Housing, with further terms and conditions being as stated in said application,
and
WHEREAS, after review,the Board deems it advisable to approve said application, 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, ex-officio Housing Authority Board, that the Application for Emergency Shelter
Grant Assistance 2010 from the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County, on behalf of the Greeley/l/Veld County Housing Authority,to
the Colorado Division of Housing be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 26th day of April, A.D., 2010.
BOARD OF COUNTY COMMISSIONERS
f r„,' LD COUNTY, COLORADO
N.5 LA
ATTEST: � itAnC-
t V_`, �. Radema her, Chair
��•Weld County Clerk to the Boar 1; . x
L—.P wiUZ / 1 U /� 2
ara Kirkmeyer,ro-Tem
Dep Clerk t t e Board
Sean P. Co
AP D AS M:
Willi . Garcia
ou Attorney EXCUSED
I
David E. Long•
•Date of signature: - 1p 10
cc 144. 2010-0849
HA0029
a
TO: Commissioner Rademacher Chair
Weld County Housing Authority
FROM: Thomas Teixeira, Director Irs
' RE: 2010-2011 Emergency Shelter Grant Application
C. DATE: March 30, 2010
COLORADO
Attached is Weld County Housing Authority's application for administrative funds to manager the grant funds
of the five non-profits that request funding each year.
These are :
Catholic Charities
Greeley Transitional House
Room at the Inn
A Woman's Place
Stepping Stones of Windsor
The turn around time on these grants is normally 30 days. Due to an E-mail error it is less than two weeks.
The total package consolidated and mailed by April 1, 2010. I should have all the non-profit applications by
tomorrow the 31'. At that time I have to do a Local Government summary page that will also require a
signature.
I am requesting that you sign the Housing Authority's application along with approval certificates for the five
above non-profits. I will prepare the Local Government summary page and have it to your office as early on
April 1, 2010 as possible.
2010-0849
Attachment A:
The Weld County Housing Authority due to deadline has submitted a consolidated
request to the State Division of Housing for Emergency Shelter Grant Assistance to
support five non-profits in Weld County. A local government summary page has been
completed. The non-profits and the amount they are requesting are as follows:
1. Catholic Charities $40,000
2. Greeley Transitional House $15,000
3. A Woman's Place Inc. $22,500
4. Room at the Inn $10,000
5. Stepping Stones of Windsor $ 8,000
6. Administration $ 3,000
Total $98,500
LOCAL GOVERNMENT SUMMARY PAGE
(TO BE COMPLETED ONLY BY LOCAL JURISDICTIONS WITH SUBGRANTEES)
EMERGENCY SHELTER GRANT ASSISTANCE 2010
APPLICANT INFORMATION
1. 'a, ix4: 2. CDH Project Number
Local Government Name: Weld County Housing Authority For CDH Use only
Local Government Address: P.O. Box 130 3. Date Received
City: Greeley State: CO Zip:80632 For CDH Use Only
4. ;4 c . s.J�t ?a :;W = S'sa4I-aja s . 5 fitrift 5.mime:e: 6. Fa: tom@greeley-weldha.orgr yo.)q Tai ,f,??AP (970) 353-7437 (970) 353-7463
SELECT ONE: Thomas Teixeira
TYPE OF ORGANIZATION
8. .i . i ± h tza a i ,: ❑ 9. .e _ %fl :
10. Val) e a�� (List counties served) 12. '8 erg s x 1 '>
(use drop down boxes)
Weld County 8 1 4 I 1 5 16 8 4 4 16
BUDGET SUMMARY-ALL Projects
Use Additional Sheets if Necessary
13. $ l .o�x i ,a ^ry. 14 :1)-nt tiq , 15 ari; k' 16. ,4 0 „ 17. Local
e : Government
Admin
Agency 1 Name 20,000 11,000 9,000
Catholic Charities
Agency 2 Name 15,000 7500
A Woman's Place Inc $0.00
Agency 3 Name 11,000 3,000 1,000
Greeley Transitional
House
Agency 4 Name 6,500 3,500
Room at the Inn $0.00
Agency 5 Name Stepping 8,000
Stones of Windsor $0.00 $0.00
Agency 6 Name
$0.00 $0.00 $0.00
18. flit! ': $52,500 $25,000 $18,000
19. 1,;),,. e. ' $3,000
$0.00 $0.00 $0.00
20. ISS'1° n t;VLlsla , :1: $98,500
SIGNATURE OF AUTHORIZED OFFICIAL OR AGENCY REPRESENTATIVE
21. la_ *3L 22. r +k.. !?#�3d u. ' .�`
. (use drop down box) g': Chair. Board of Commissioners Weld
SELECT ONE: Douglas Rademacher County Housing Authority
EMAIL: drademacher@co.weld.co.us
23. §dta., tc.
_taw .. _ ., 11QZ1 ec Pl)! 1} $tky : 24.IDS ':
/ 4/1/2010
' V l.t""P`n +0,-,peA"ltd
Application for Colorado Division of Housing (CDOH)
EMERGENCY SHELTER GRANT ASSISTANCE 2010
APPLICANT INFORMATION
1. APPLICANT 2. CDH Project Number
For CDH Use only
NAME: Weld County Housing Authority 3. Date Received
ADDRESS: P.O. Box 130 For CDH Use Only
CITY: Greeley STATE: CO ZIP: 80634 4. Current ESG Program Recipient?
CURRENT PRIOR NEVER
5 14 to of*Contactt" on fo`r'Application 6. Phone: 7 FAX: 8 E "
• >rts: (drop down box)
Mr. Thomas Teixeira 970 353-7437 970 353-7467 tom(a)greeley-weldha.orq
TYPE OF ORGANIZATION
9 MuSipality/County: O 10. I oasin Authority: ® 11 .. „r in% f l . on:* ❑
Please attach 501 (c) (3) ruling.
12. Federal Identifica" bin:Nninbet: Use dro down box
8 4 --- 1 5 6 8 4 4 6
13. Project Service Area: (List counties served)Weld County
14 (A) Row many year§has yn agenoylb ` 'q e;atib"n? 57
(B)Row many y ars ha y, , a eri a rece v :line 20
15. Population(s) Served (Check all that apply): Z Men ®Women ® Families ❑Youth ® Domestic Violence
16. Type and Characteristics of Programs for"ivliich.ESG Assissanee"is'It@„ : =di
❑ Emergency Shelter - Maximum Capacity per Night: 0 Maximum Stay: 0 Days ❑ or Months ❑
❑ Day Shelter - Maximum Capacity: 0 Average Number of Clients Served per Day: 0
❑ Transitional - Total Units: 0 Maximum Length of Stay: 0 Days ❑ or Months ❑ Average Stay: 0 Days
❑ or Months ❑
❑ Homeless Prevention: - Number of Families and/or Individuals expected to Serve with ESG and Match
Funds Each Year: 0
Are you requesting dollars for a new program in this request?NO If yes, program name:
SIGNATURE OF AUTHORIZED OFFICIAL OR AGENCY REPRESENTATIVE
17. Naive of Local E3eeted iref l or A xtlrifirizetl 18. Tit " ® '.{(34:0 _ "? ';tiff 1 t1fbi d
Agencinepresentative: (drop down box)
Mr. Douglas Rademacher Chair, Board of Commissioners Weld County Housing Authy
19. Signature of Autlotized Representative: 20. {t'
L �
Email: drademacher@co.weld.co.us
1
BUDGET
Litre Item Expense: 21. Operations: 22. Essential 23. Homeless 24.Administration
Services: Prevention! Local gov't w sub
grants:
$0.00 $0.00 $0.00 $3,000.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
25. SUBTOTAL $ 0.00 $ 0.00 $0.00 $3,000.00
26. TOTAL REQUEST: $3,000.00
27. Match Sourcatea 'houtit: Name: Weld County Hsg Amount:$3,000, Name Amount $0.00
(Additional Space on page 13)
PROPOSED PROJECT BUDGET
EXPLANATION AND DOCUMENTATION
28. Please provide 141;1:4, 4? ��] Y n 9 i!It°
need for requested ca' anies of Operatic, , a '®f1eFatzonsjEss h' ` . < ;; Pre'„ _ 1_t'itavention.
Please also provide the following:
• If you are requesting Operations, please identify any operating staff for which you are requesting funding.
• (b)lf you are requesting an increased level of funding or a new service under Essential Services, you
nntst demonstrate that a new/increased level of need exists and ESG funding will not replace
governmental funding.
• (c) If you are requesting Homeless Prevention funding, please explain how you will ensure that your
clients meet HUD requirements for homeless prevention assistance.
All requests should be eligible, necessary and reasonable. You may also use the following page for the budget if necessary.
(When typing below, please do not use the return (enter) key. Line will automatically wrap around)
BUDGET PAGE
EXPLANATION AND DOCUMENTATION
(2S CONTINUED)YOUMAYBEQT TYOU1 BUDGET Ti :tIOW'' '. $o''>v .x : (When typing below.
please do not use the return (enter) key. Line will automatically wrap around)
Adminstration: These funds will be used to fund the activities of the Housing Authority in Administration of the
Emergency Services Grant for the five Weld County non-profit agencies who are applying for funding. This includes
the review of grants of subgrantees. application for grant to the Division of Housing, review of payment request,
consolidation and submission of request, receipt of grant funds, disbursement of grant funds,consolidation of
quarterly financial reports, demographic reports and forwarding these reporting to Division of Housing
2
EXTENT AND URGENCY OF THE NEED
29. (A)What is the ,to,b6<iddiceeed$ i °.'oR f t , r f
1+ el�rer: 4'
n^rn waitth ,amber of clients.turnefl*a V x o ® ' e ig5
a nis. (When typing below, please do not use the return (enter) key. Line will automatically wrap
around)
The Housing Authority does not provide emergency assistance for homeless families at the Housing Authority. We do
refer families and individuals seeking emergency assistance to Catholic Charities,A Woman's Place Greeley
Transitional House. Room at the Inn, and Stepping Stones of Windsor. The waiting list for Weld County Section 8 anc
Greeley Section 8 are closed. The waiting list have been closed since the le of the year 2009 due to having 700 families
waiting for government subsidized housing. This request is funding for administration to allow the Housing Authority
to support the coordination and consolidation of payment request and reports for the above five non-profits. Current
Department of Housing and Urban Development regulations do not permit the expenditure of Section 8 administrative
funds to support non section 8 activities.
(B) Did you turn clients away in the period of January 1, 2009 thru December 31, 2009? YES If so how
many, 10 per week where did they accepted applications for public housing (86 units) referred to shelters
and project based housing providers, did you refer them to another agency? YES
PROJECT PLAN
330. Des i` be your pbi ect plan te-assist the targenoptt,;e 8 itxi . , . . -tam
Line 0. b 29. (When typing below, please do not use the return (enter) key. Line will automatically wrap
around). (Be sure to include the geographical areas and specific activities that you plan to provide).
If this proposal is requesting funding for more than one activity (Essential Services, Operations/Staff
Operations, Prevention), describe each separately.
Our activities will consolidate the reporting and payments for five non-profit agencies in Weld County which should reduce
DOH work load. At the same time we will act on behalf of DOH in providing support and acting as a clearing house for
questions,requirements and compliance..
PLAN FOR FINANCIAL STABILITY
31. Provide a plan£oOlie'£ifittire hnaneia( €h Ai ' . 1 � $va. Sekin
coitstintie in the futute if ESG funding fib no loneer info ed7,(When typing below,please do not use the
return (enter) key. Line will automatically wrap around)
If this proposal is requesting funding for more than one activity (Essential Services, Operations, Prevention)
describe each.
If ESG funding is no longer available the Housing Authority would not be needed to administer the program. We
would assist the non-profits in seeking alternative funding.
EXPERIENCE
3
32. Explain below any experience your organization or unit of local governnieni has in implementing the
activities that you have proposed in this application. (When typing below, please do not use the return
(enter) key. I,ine will automatically wrap around)
Specifically, include the years of experience of staff and/or organization that will be administering the
ESG funds. Where your organization and staff lack experience, explain how you will obtain the technical
assistance needed to administer and complete the project.
Thomas Teixeira has been Executive Director of the Greeley Housing Authority for 15 years and the Executive
Director of the Weld County Housing Authority for the past 10 years. He has been the responsible adminstrator for
County Emergency Shelter Grants since 1999. The combined budget of the Greeley/Weld Housing Authorities is
approximately 6 million dollars and the Authorties provide Housing/Housing Assistance to more than 1000 familes.
Judy Aguello has been the Greeley Housing Authority's chief finacial officer for twenty years. Her work/accounting
skills have received numerous positive comments from independent auditors and the Denver office of the Department
of Housing and Urban Development over the years. The Authority has an additional 8 office employees who are not
directly involved in the ESG program.
SHELTER REPORT
SHELTBSRECHARACTEE'MY S 2009=2010'ACTUAL From 2¢1tigrot P 0 v 1'"40 Prom
lTl4l ? HWS?
33. Beds (including cribs) 0 0
34. Sleeping Rooms 0 0
35. Total Families Served 380 310
•
36. Total Persons in Families 1007 930
37. Total Individuals Served 575 558
•
38. Total Shelter Nights 26,489 27,208
AVERAGE COST PER PERSON OR HOUSEHOLD SERVED WITH ESG FUNDING
39. What'is the averaEe eosi er, a„s&t s i.4ed'i 'la8k034ar ESG'f 14WJL$v t* $1.86
(Total Activity Budget/# Unduplicated Clients)
CLIENT PARTICIPATION REPORT
-
40. Client Paid Hours 0
41. Client;Unpaid Hours 0
CONTINUUM OF CARE COORDINATION
42. Are you aparticipating member o£.yotir local Conti'rr unf°fe r SELECT ONE:
4
SHELTER/ Who provides the following services in your Do you have a written
SUPPORTIVE SERVICES community? agreement to coordinate
(1) If it's your organization put an "X" in this column services?
beside the corresponding service; Use the drop down box to
TYPE OF SERVICE (2) If it's another organization, please list their name Answer"Yes" or"No"or"NA"
(Not Applicable)
43. Shelter Information and
Referral 0 Organization Name United Way 2111. Not Applicable
44. Emergency Shelter
❑ Organization Name Catholic Charities Greeley Yes
Transitional House A Woman's Place Room at the
Inn
45. Transitional Housing
0 Organization Name Greeley Transitional Yes
House
46. Permanent Housing(w/services)
® Organization Name Greeley/Weld Housing Yes
47. Soup Kitchen
Organization Name Salvation Army No
48. Case Management
❑ Organization Name Catholic Charities Greeley Yes
Transitional House A Woman's Place Room at the
Inn
49. Transportation
0 Organization Name United Way Bus Tokens No
50. Daycare i
___ ❑ Organization Name Weld Human Services No _
51. Medical treatment
0 Organization Name Sunrise Clinic, Monfort ! No
Family Clinic
52. Substance Abuse Counseling
0 Organization Name Island Grove Treatment No
Center. North Range Behavioral Health
53. Psychological
❑ Organization Name North Range Behavioral No
Health
54. Employment
�_❑.Organization Name Weld Human Services No
55. Life Skills/Budgeting ❑ Organization Name Room at the Inn No
56. Educational
❑ Organization Name District 6 Schools No
57. Security Deposit
0 Organization Name Catholic Charities, Yes
Stepping Stones Windsor
58. Eviction Prevention
❑ Organization Name Catholic Charities, Yes
Stepping Stones Windsor
59. Back Mortgage Payments
❑ Organization Name Catholic Charities, Yes
_ Stepping Stones Windsor
60. Utility Assistance Payments
❑ Organization Name Catholic Charities Yes
Stepping Stones Windsor
CONTINUUM OF CARE NARRATIVE
5
61. Explain how you coordinate homeless housing,essential services acrd ess o ivities
with other local nonprofit agencies and governmental service providers4tet e
ri
management, non-duplication of services AND access to rnazns'trleam re e' ¢",t; sue ,Food
Stamps,Housing Assistance,etc. within your community ortontinuumof Care. (When typing below,
please do not use the return (enter) key. Line will automatically wrap around)
THE HOUSING AUTHORITY MEETS MONTHLY WITH THE HOUSING AND EMERGENCY SERVICES
NETWORK, HOSTED BY UNITED WAY, WHOSE MEMBERS INCLUDE, CATHOLIC CHARITIES, A
WOMAN'S PLACE, GREELEY TRANSITIONAL HOUSE, ROOM AT THE INN, SALVATION ARMY
WELD FOOD BANK, WELD HUMAN SERVICES, CITY OF GREELEY, GREELEY INTERFAITH, NORTH
RANGE MENTAL HEATH, SUNRISE MEDICAL CLINIC, AND THE UNITED WAY. THIS ALLOWS US
TO SHARE INFORMATION, CURRENT TRENDS, SEEK COMMON SOLUTIONS
FINANCIAL CAPACITY -
62. Explain your organization's fi i b.' gency
will monitor its activities to ensure that E 2#ollatshr f iii'& (When typing below,
please do not use the return (enter) key. Line will automatically wrap around)
Weld County Housing Authority acts as a pass thru for ESG funds to the above mention five non-profit agencies.
Payment request are reviewed and consolidated prior to requesting funds from the Department of Housing. After
funds are received they are processed and payments to the non-profit are normally made in 3 days. The
Accounting procedures of the Weld County Housing Authority are regulated by HUD regulations. There is an
emphasis on seperation of duties for financial activities and requirement for two signatures on all checks. The
Housing Authority reports monthly to the Weld County Commisioners and the Board of Commisioners of the
Greeley Housing Authority financial statements are included as part of monthly reports. As an agency receiving in
excess of $100,000 in federal funds the Authority receives an annual independent audit of all activites including
ESG pass thru funds. Financial activities are electronically reported, including ESG activities, with in 60 days of
the end of the Authority's fiscal year (unaudited) to HUD. The Annual Audit is provided to the Board of
Commissioners and electronically reported to HUD.
6
ABILITY TO COMPLY WITH HOMELESS MANAGEMENT INFORMATION SYSTEMS (HMIS)
(When typing below, please do not use the return (enter) key. Line will automatically wrap around)
63. When and where''did your agency`staff receive training on Homeless Management; iYf tics _Systerm
(HMIS)?
N/A
64. List Computer(s).and printers that are/can'be"detdttitttetT: liYt §' te# :Storage
Ckbacity
65. How do you ensure tkat client files'ar'e;kept coikidentit l?
66. Are you in compliance with HMIS? Please place an-X' in the box that best describes your current HMIS status
❑ I am a new applicant.
❑ My agency is entering all HUD-required HMIS data elements on a consistent basis.
❑ My agency is in discussions with my systems operator regarding my participation. We have not yet been trained on
the HMIS system.
❑ My agency is a new State ESG Applicant, but we enter HMIS information for another Federal grant.
❑ My staff has been trained on HMIS, but I am waiting to upgrade equipment and or training before we fully
participate.
❑ My agency is exempt from HMIS.
OTHER DOCUMENTS THAT YOU MUST
SUBMIT WITH THIS APPLICATION
(See attached pages)
a
ABILITY TO COMPLY WITH STATE'S INSURANCE REQUIREMENTS
The State requires various insurance. Please use drop down box in each section indicating YES
if you have the required insurance or NO if you do not. You may provide an explanation after
each section of challenges that you face.
1. "The Contractor shall obtain, and maintain at all times during the term of the agreement,insurance in the following kinds and
amounts:
a. Workers Compensation Insurance as required by state statute and Employer's Liability Insurance covering all of the
contractor's employees acting within the course and scope of their employment.
Yes l.a. Issues or Explanation:
b. Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalency, covering premises,
operations, fire damage,independent contractors, products and completed operations, blanket contractual liability,personal
injury, and advertising liability within minimum limits as follows:
i. $1,000,000 each occurrence
ii. $1,000,000 general aggregate;
iii. $1,000,000 products and completed operations aggregate; and
iv. $50,000 any one fire.
Yes 1.b. Issues or Explanation:
c.Automobile Liability Insurance covering any auto(including owned, hired and non-owned autos)with a minimum limit as
follows: $1,000,000 each accident combined single limit.
Yes l.c.Issues or Explanation:
2. The State of Colorado is named(or will be named within 7 business days of the effective date of the contract)as additional
insured on Commercial General Liability and Automobile Liability Insurance policies(leases and construction contracts will
require the additional insured coverage for completed operations on endorsements CD 2010 11/85, CG 2037 or equivalent).
Coverage required of the contract will be primary over any insurance or self-insurance program carried by the State of Colorado.
Yes 2. Issues or Explanation:
3. The Insurance includes(or will include within 7 business days of the effective date of the contract)provisions preventing
cancellation or non-renewal without at least 45 days prior notice to the State by certified mail;
Yes 3. Issues or Explanation:
4. The contractor will require all insurance policies in any way related to the contract, and secured and maintained by the
contractor, to include clauses stating that each carrier will waive all rights of recovery under subrogation or otherwise, against the
State of Colorado, its agencies, institutions, organizations, officers, agents, employees and volunteers.
Yes 4. Issues or Explanation:
5. All policies evidencing the insurance coverage required hereunder shall be insured by insurance companies satisfactory to the
State.
Yes 5. Issues or Explanation:
6. The contractor shall provide certificates showing insurance coverage required by the contract to the State within 7 business
d•i vs of the effective date of the contract.
l'cs f Issues or Explanation:
7. Notwithstanding subsection"a'of this section, if the Contractor is a"public entity" agrees,within the meaning of the Colorado
Government Immunity Act, CRS 24-10-101, et seq, as amended("Act"), the contractor shall at all times during the term of the
cant'act maintain only such liability insurance by commercial policy or self-insurance, as is necessary to meet its liabilities under
t ho act and show proof of insurance upon request.
11's 7. Issues or Explanation:
9
Instructions fordCompletion of Match Certification
All applicants are required to complete the Match Certification form. Eligible forms of match are
as follows:
• The value of salary paid to staff to carry out the ESG Program.
• The value of the time and services contributed by volunteers to carry out the program at a rate of
$5.00 per hour.
• Volunteers providing professional services such as medical or legal services valued at the
reasonable and customary rate in the community.
• The value of any donated material or building.
• The value of any building lease using a method to reasonably calculate fair market value.
• Award letters from foundations, organizations, private individuals, and other government sources.
**Note: These awards must overlap the ESG funding period to be eligible. **
10
MATCH CERTIFICATION
SOURCES OF LOCAL MATCH
(Attach supporting documentation for ava ilahle match. Documentation should reflect funding availability
during the ESG contract year.)
Other Federal (incliuding'pass-through funds,ea ti*.. i ( `
NAME AMOUNT
$0.00
$0.00
$0.00
State/Local Government Funding
NAME AMOUNT
Weld County $3000.00
$0.00
$0.00
Private (including recipient) Funding
Fund Raising/Cash $0.00
Loans $0.00
Building Value or Lease $0.00
Donated Goods $0.00
Donated Computers $0.00
New Staff Salaries $0.00
Volunteers ($5.00 per hour) $0.00
Volunteer Medical/Legal $0.00
other (specify) $0.00
1 certify that match funds have been identified and committed to support the proposed ESG project and have
t been used to match previous ESG awards (i.e. the value of a donated building used as match in a 2007
owerd cannot be used as match in 2009). This form is a description of the sources and amounts of such match
(` —Is, which are not being used as match for any other federal program.
c≥iketi 41' 3 bib nature/Ti e
11
Additional Funds Documentation
The list of all sources of additional funds not included as match to be used to carry out your
proposed project. Be specific.
Sources of Additional Funds Amount of Additional Funds
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Total Additional Funds Committed to the ESG Process $0.00
12
a
Weld County Housing Authority
P.O. Box 130
Greeley, CO 80632
will ilk
970 353-7437
COLORADO
CERTIFICATION OF LOCAL APPROVAL
BY LOCAL BOARD OF COMMISSIONERS
FOR NON-PROFIT ORGANIZATIONS
I Douglas Rademacher, Chair, duly authorized to act on behalf of Weld County hereby approve the
following project(s) proposed by A Woman's Place Inc., which is located in Weld County.
ATTEST: /—g, -e nn cAx--0�
Clerk to the Board 1861 3,- c‘ ` -) Dougl Radema her, Chair
r � Board of County Commissioners
B b .i/ an i Weld County, Colorado
De(utyCI= `to the Boa ' 'S ',Tt':l \V 03/31/2010
Date: 3l 3i l '6
(icftvbetsH. ,
Weld County Housing Authority
P.O. Box 130
Greeley, CO 80632
970 353-7437
"ilC.
COLORADO
CERTIFICATION OF LOCAL APPROVAL
BY LOCAL BOARD OF COMMISSIONERS
FOR NON-PROFIT ORGANIZATIONS
I Douglas Rademacher, Chair, duly authorized to act on behalf of Weld County hereby approve the
following project(s) proposed by Catholic Charities and Community Services of the Archdiocese of
Denver, Inc.,Weld County Regional Office,which is located in Weld County.ATTEST: MI- . .. . .)„,e4
�Hr
Clerk to the Board F ugl s Rade acher, Chair
of 8 oard of County Commissioners
By. !�_ . e''� eld County, Colorado
De y Cle o the Boa d (`pN. 9.. 03/31/2010
Date: 31311 DI C
a
Weld County Housing Authority
P.O. Box 130
1 Greeley, CO 80632
"it ilk
970 353-7437
COLORADO
CERTIFICATION OF LOCAL APPROVAL
BY LOCAL BOARD OF COMMISSIONERS
FOR NON-PROFIT ORGANIZATIONS
I Douglas Rademacher, Chair, duly authorized to act on behalf of Weld County hereby approve the
following project(s) proposed by Greeley Transitional House,which is located in Weld County.
• IE La s
ATTEST: --
Clerk ✓u.'.
leas ,, ��,ou la-�-ademac er, Chair
Clerk to the Board (emu g
3 a₹-
, 1,j=oard of County Commissioners
B /(�L, iJ .i 7 ./il[SI�4`� v t r , Weld County, Colorado
De, ty Cler ,r the Board / .i.). 03/31/2010
Date: 37 3112,01b
Weld County Housing Authority
P.O. Box 130
Greeley, CO 80632
970 353-7437
COLORADO
CERTIFICATION OF LOCAL APPROVAL
BY LOCAL BOARD OF COMMISSIONERS
FOR NON-PROFIT ORGANIZATIONS
I Douglas Rademacher, Chair, duly authorized to act on behalf of Weld County hereby approve the
following project(s) proposed by Room at the Inn,which is located in Weld County.
T
ATTEST: Clerk to the Dougl�(s Radema er, Chair
` Board of County Commissioners
g Weld County, ColoradoDty Cie o th 03/31/2010
Date: 3 31 3010
Kilt a
Weld County Housing Authority
P.O. Box 130
Greeley, CO 80632
"ilk
970 353-7437
COLORADO
CERTIFICATION OF LOCAL APPROVAL
BY LOCAL BOARD OF COMMISSIONERS
FOR NON-PROFIT ORGANIZATIONS
I Douglas Rademacher, Chair, duly authorized to act on behalf of Weld County hereby approve the
following project(s) proposed by Stepping Stones of Windsor,which is located in Weld County.
ATTEST: r•�\ t r-J Y
Ci
Clerk to the Board 861 �'""r Douglas Radema her, Chair
j�J / ;hoard of County Commissioners
By, n� O •a " .-' //Weld County, Colorado
De ty Cle o the Boar kilt 03/31/2010
j
Date: b 1 31 I'X(C
EMERGENCY SHELTER GRANTS PROGRAM
ASSURANCES AND CERTIFICATIONS
Douglas Rademacher (name of chief elected official or appropriate non-profit signatory) Chair Board
Commissioners of Weld County (town, city, county or nonprofit organization) which is applying to the State
of Colorado for funding through the Emergency Shelter Grant Program from the U.S. Department of Housing
and Urban Development (HUD), hereby assures and certifies that:
Amounts awarded under this program will be used only for these purposes:
1. Assist in the prevention of homelessness.
2. Assist in supporting the essential operating costs of shelters.
3. Assist in improving the quality of supportive services to the homeless.
Projects will not require participation in religious services, as a condition for receiving assistance.
All projects funded will develop and administer, in good faith, a policy designed to ensure the shelter
is free from the illegal use, possession or distribution of DRUGS and ALCOHOL by its beneficiaries.
Political activities will be prohibited in accordance with subsection 675 (e) of the Community Services Block
Grant Act of 1981.
The town, city, county or nonprofit organization certifies that matching supplemental funds required
by the regulations at 24 CFR 576.71 and 576.85(a)(3), as mentioned by the amendments to Items 415(a) and
415(c) of the Stewart B. McKinney Homeless Assistance Act made by Section 832(e) of the Cranston-Gonzalez
National Affordable Housing Act of 1990 (Public Law 101-625, November 28, 1990) will be provided. The
amendment exempts the first $100,000 from the matching requirement and requires that the benefit of the
$100,000 exemption be provided to those recipients from the State that are least capable of providing the
matching funds.
The requirements of 24 CFR 576.21(a)(4)(ii) which provide that the funding of homeless prevention
activities for families that have received eviction notices or notices of termination of utility services meet the
following standards: (A) that the inability of the family to make the required payments must be the result of a
sudden reduction in income; (B) that the assistance must be necessary to avoid eviction of the family or
termination of the services to the family; (C) that there must be a reasonable prospect that the family will be
able to resume payments within a reasonable period of time; (D) that the assistance must not supplant
funding fbr preexisting homeless prevention activities from any other source; (E) occur a week before eviction,
foreclosure or termination.
The requirements of 24 CFR 576.51(b)(2)(iii) concerning that submission by nonprofit organizations
applying for funding of a certification of approval of the proposed project(s) from the unit of local government
in which the proposed project is located.
The requirements of 24 CFR 576.51(b)(2)(v) concerning the funding of emergency shelter in hotels or
motels or commercial facilities providing transient housing.
The requirements of 24 CFR576.56(a)(3) concerning the provision of termination and/or grievance
procedures for an individual or family who violates program requirements.
The requirement of 24 CFR576.56(b) concerning the involvement of homeless individuals and families
in providing work or services pertaining to policy-making and in operations of facilities or activities assisted
under this part.
The requirement of 24 CFR576.57 concerning the prohibition of conflict of interest or financial interest
i a decision-making by elected officials, appointed officials, staff or board of directors except as may be granted
by HUD as provided in 570.611(d).
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The requirements of 24 CFR 576.73 concerning the continued use of buildings for which Emergency
Shelter Grant funds are used for rehabilitation or conversion of buildings for use of emergency shelters for the
homeless; or when funds are used solely for operating costs or essential services, concerning the population to
be served. The building standards requirement of 24 CFR 576.75.
The requirements of 24 CFR 576.77, concerning assistance to the homeless.
The requirements of 24 CFR 576.79, other appropriate provisions of 24 CFR Part 576, and other
.pplicable Federal law concerning nondiscrimination and equal opportunity.
The requirements of 24 CFR 576.80 concerning minimizing the displacement of persons, as a result of
a project assisted with these funds.
The requirements of 24 CFR 576.80 concerning the Uniform Relocation Assistance and Real
Acquisition Policies Act of 1970.
The requirement of the Cranston-Gonzalez National Affordable Housing Act (Public Law 101-625,
November 28, 1990 contained in Section 832(e)(2)(C) that grantees develop and implement procedures the
ensure the confidentiality of records pertaining to any individual provided family violence prevention or
treatment services under any project assisted "under the Emergency Shelter Grants Program" will, except
with written authorization of the person or persons responsible for the operation of such shelter, not be made
ublic."
The requirement that local government will comply with the provisions of and regulations and
procedures applicable under section 104(g) of the Housing and Community Development Act of 1974 with
espect to the environmental review responsibilities under the National Environmental Policy Act of 1969 and
related authorities, as specified in 24 CFR Part 58, and as applicable to activities of nonprofit organizations.
The requirement that no Federal appropriated funds have been paid, by or on behalf of the local
government or nonprofit organization, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a
: lumber of Congress in connection with the awarding of any Federal loan, the entering into of any cooperative
agreement, and modification of any Federal contract, grant, loan or cooperative agreement.
The requirement that if any funds, other than Federal appropriated funds have been paid or will be
laid to any person for influencing or attempting to influence an officer or employee of any agency, a member
' Congress. an officer or employee of Congress, or an employee of a Member of Congress in connection with
his Federal contract, grant, loan or cooperative agreement, the local government or nonprofit organization
=Ball complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its
i.,structions.
The requirement of disclosure specified in Subpart C of 24 CFR Part 12 regarding assistance from
et her HUD-funded programs.
The requirement that the local government or nonprofit organization shall require that the language
e the PROHIBITION OF THE USE OF FEDERAL FUNDS FOR LOBBYING CERTIFICATION be included
the award documents for all standards at all tiers including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements and that all subrecipients shall certify and disclose accordingly.
The requirement that(68 Fed. Reg. 43430) agencies receiving funding from the Emergency Shelter
C rant Program become compliant with Homeless Management Information System (HMIS) as required by the
I I apartment of Housing and Urban Development.
The required certification that the submission of an application for any emergency shelter grant is
uthorized under applicable law and that the local government or nonprofit organization possesses legal
a uthority to carry out emergency shelter grant activities in accordance with applicable law and regulations of
the Department of Housing and Urban Development.
I ouglas lRademacher Chair Weld County Board of Commissioners
\H e Title
C° irar 4/1/2010
gnatui�e Date
16
CDOH PERFORMANCE MEASUREMENTS AND OUTCOMES
All ESG proposals must comply with the CDOH Performance Measurements and Outcomes.
1 have read the performance and outcome measurements shown below and understand that these may differ
from measurements required by HUD. (Please Use Drop Down Box)
Y R,S Name: Douglas Rademacher Title: Chair, Weld County Board of Commissioners Date: 4/1/2010
Performance Measurements and Outcome Requirements
Objective: Serve the lowest income and hardest to serve individuals and families meeting critical housing
needs through state and federal initiatives by creating a suitable living environment or decent affordable
housing.
Funding Source: ESG Activity: ESG Funding
Objectives/Outcomes:
1. End chronic homelessness and move homeless families and individuals into permanent housing.
2. Availability/accessibility for the purpose of creating suitable living environments.
3. Promote self-sufficiency, efficient use of funds and effective program administration.
t DOH Performance Measures/Indicators (Applies to,all ES fund
• Number of homeless persons receiving case management who move into safe and stable housing.
• Average cost per person receiving ESG assistance.
• Recipient expended all ESG funds within the established grant timeframe.
• Recipient met the deadline for submitting their signed grant agreement.
• Recipient met the deadline for submitting evidentiary documents.
• Recipient met the deadline for submitting performance reports.
• Recipient meets required standards for documentation of homelessness.
• Recipient complies with required record keeping methods.
• Recipient complies with the due process of terminating ESG funded assistance of participant.
• :Amount of money leveraged.
• I1oes recipient have current non-corrected and/or corrected findings from previous compliance
reviews?
CDOH Performance Measures/Indicator's'specific to ES a 'iY'nded'S`helter,affi l`= t It(1
Housing:
• N umber of homeless persons receiving case management who move into safe and stable housing.
• Average cost per person receiving ESG assistance.
• The total number of adults and children served on an annual basis (reported under Residential
Services).
• The number of persons served by race and ethnicity.
C DOH Performance Measures/Indicators spcifxc,te Et. "itntie #sk se PzaveYl i4ri•
• N umber of persons assisted with ESG funds for eviction notices.
• umber of persons assisted with ESG funds for utility termination notices.
• N umber of persons assisted with ESG funds for security deposits and/or first month's rent.
• 'i he total number of adults and children served on an annual basis (reported under Non-Residential
S:°juices).
• ""ne number of persons served by race and ethnicity.
CDOH Performance Measures/Indicators specific to.ESG-I "tildg4Esse iti EISLitces
• amber of homeless persons that received ESG funded services concerned with employment.
• umber of homeless persons that received ESG funded services concerned with health.
• Number of homeless persons that received ESG funded services concerned with substance abuse.
• Number of homeless persons that received ESG funded services concerned with education.
• umber of homeless persons that become successfully independent of ESG funded services.
• umber of homeless persons that return to their prior living situation
• '', !is total number of adults and children served on an annual basis (reported under Non-Residential
<, rvices).
• 1 :U number of persons served by race and ethnicity.
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COPY OF YOUR 501 (c)(3) Ruling
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COPY OF YOUR MOST RECENT AUDIT
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Attached as a separate document in this packet
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