HomeMy WebLinkAbout20102975.tiff RESOLUTION
RE: APPROVE COMMUNITY FAMILY SUPPORT FUNDING AGREEMENT AND AUTHORIZE
CHAIR TO SIGN-UNITED WAY OF WELD COUNTY,ON BEHALF OF PROMISES FOR
CHILDREN
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 Community Family Support Funding
Agreement between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Public Health and Environment, and
United Way of Weld County, Promises for Children, commencing upon full execution, with further
terms and conditions being as stated in said agreement, and
WHEREAS,after review,the Board deems it advisable to approve said agreement, 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 Community Family Support Funding Agreement between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Department of Public Health and Environment, and United Way of Weld County,
Promises for Children, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 20th day of December, A.D., 2010.
BOARD OF COUNTY COMMISSIONERS
L�� ELD COUNTY, COLORADO
ATTEST: ' .•� � - c., f' - v c
r -� o la Radema he , Chair •
Weld County Clerk to the BoarF(; £ s 1„,
` n •ara Kirkmeyea•, Pro-Tem
BY: if L tli t;
Deputy/ erk rd cam— P.
Sean P. Conway
APPROVED A TQFORM: EXCUSED
am F. Garcia
Co nt6ttorney cyjkF J
David E. Long
Date of signature: ' H
1 o ricAEo Tub cti C C • LJ L P 2010-2975
I •ao i 1- 3 -II HL0037
Memorandum
ies; tic(
TO: Douglas Rademacher, Chair
Board of County Commissioners
WI I D FROM: Mark E. Wallace, MD, MPH, Director
O Department of Public Health and
• Environment �Y2v��' c>
�
COLORADO DATE: November 22, 2010
SUBJECT: United Way, Weld County's Early
Childhood Council, Promises for
Children Grant
Enclosed for Board review and approval is a funding agreement between the Weld County
Department of Public Health and Environment, Nurse Family Partnership Program and United
Way, Weld County's Early Childhood Council, Promises for Children.
The funds, $511.75, will be allocated by Promises for Children to purchase materials for Weld
County families in the Nurse Family Partnership program. We recommend your approval to
accept this funding.
Enclosure
2010-2975
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-Promises for Children
Weld County's Early Childhood Council
-CT'
November 1, 2010
Barbara Francisco, Nurse Family Partnership Program
Weld County Department of Public Health & Environment
1555 17th Street
Greeley, CO 80631
Dear Barb,
On behalf of the Promises for Children Community Family Support Committee (CFS), we are
pleased to inform you that Weld County's Early Childhood Council, Promises for Children has
approved your grant in the amount of$511.75. As stated in your RFP, the funds will be
allocated to purchase materials for families in your program.
Your proposal was one of 3 programs reviewed through our recent Request for Proposal process.
Promises for Children found your proposal meets our criteria and exemplifies the kind of
services we are committed to supporting and expanding for Weld County families.
Enclosed you will find the funding agreement and W-9 tax form. Please sign both copies and
return the original funding agreement and W-9 to United Way of Weld County, and keep a copy
for your records. As soon as the CFS Committee receives the funding agreement and W-9, the
check will be sent for the full amount of your award.
Promises for Children looks forward to working with you this year. We request you attend a
Community Family Support Meeting Wednesday, April 13, 2011 at 12:00 pm, here at United
Way of Weld County. Be prepared to give a 10 minute presentation to the committee on your
progress and report summary. Please refer to the final report to use as a guideline for your
presentation. Together we are strengthening the programs that support young children and their
families in Weld County. If you have any questions please call Jildi Gentry-Chacon at United
Way 304-6173.
Sincerely,
r
orb Schulte Cm hai J ldi Gentry-Chacon
Community Family Support ' oordinator
Promises for Children Promises for Children
United Way of Weld County
814 9th Street I PO Box 1944 I Greeley,Colorado 80632
tel 970.353 4300 I fax 970.353.4738 I toll free 1.800.569.5590
uwwc@unitedway-weld.org I www.unitedway-weld.org
Promises for Children
Weld County's Early Childhood Council
COMMUNITY FAMILY SUPPORT
FUNDING AGREEMENT
An agreement between United Way of Weld County on behalf of Promises for
Children hereinafter referred to as Promises and Nurse Family Partnership
hereinafter referred to as the Agency.
1. Agency is and shall remain a charitable non-profit organization or
government entity.
2. Agency agrees to be accountable for the funds provided and that such
funds will be used for the purpose stated in the grant award letter. The
Agency agrees to provide a report by April 13, 2011, and a committee
presentation providing a full accounting of how the funds were used.
Please refer to the report form.
3. Agency is required to keep accurate accounting records on file and be
made available upon request.
4. Agency agrees to work with the Community Family Support Committee if
possible to replicate family support programs in Weld County.
5. Agency agrees to give recognition to Promises for Children, Weld
County's Early Childhood Council for this financial support.
6. Promises for Children agrees to be available to Agency for advice and
consultation regarding the funded service support.
7. Promises for Children agrees to work with the Agency to strengthen
Family Support in Weld County.
Douglas Rademacher, Chair, Board The Board of Weld County Public
I of Weld County Commissioners on behalf of Health and Environment
Understand and agree to the above provisions.
(as WOcia DEC 2 0 2010
Signatthre of Aut orized Official Date
2 16
eila
eila Watson, Director, Promises for Children Date
D20/0-579 75
porn W-9 Request for Taxpayer Give form to the
(fire October 200➢ Identification Number and Certification requester.Do not
mawm.mati n.nwy send to the ins.
Revenue swore
Nate as shown on four income tax realm)
m WELD COUNTY GOVERNMENT
Business name,i1 deferent horn above
a P check appropriate box:❑ Indviduat/So:e proprietor 0 Corporation 0 Partnership
L`o ❑ United liability company.Enter the tax classification(o=dlsreearded emit',Cacdporatlm,P=pannershlp)h ® wye pr
g k' El Otrerlsee roostsa4 a GOVERNMENT
,€_ Address(number,street,and apt.or suite no.) Requesters name and address(eptbnag
n u P.O. BOX 758
y City,state.and ZIP code
ra' GREELEY, COLORADO 80632
AUsi account numbers)here mptinan
Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on Line 1 to avoid aodel security number
backup withholding.For individuals,this is your social security number(SSN).However,for a resident
siren,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other entities,It is
your employer identification number(EIN).If you do not have a number,see How to get a RN on page 3. or
Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer Identification number
'�ltflrnu..m.,b�e�r1t.o enter. 84 I 6000813
al Certification
Under penalties of perjury,I certify that:
1. The number shown on this form is my correct taxpayer identifmat'Ipn number(or I am waiting for a number to be issued to me),and
2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal
Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report ell interest or dividends,or(e)the IRS has
notified me that I em no longer subject to backup withholding,and
3. I am a U.S.citizen or other U.S.person(defined below).
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.
For mortgage Interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement
arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the Certification,but you must
provide your correct TIN.See the instructions on page 4. / p
Sign es.person // / :s, /1 3/ lo/
Here us.person• p(J W/InK/ Dee
General Instructions Definition of a U.S.person.For federal tax purposes,you are
considered a U.S.person If you are:
Section references are to the Internal Revenue Code unless •An individual who is a U.S.citizen or U.S.resident alien,
otherwise noted,
•A partnership.corporation,company,or association created or
Purpose of Form organized in the United States or under the laws of the United
A person who is required to file an information return with the States,
IRS must obtain your correct taxpayer identification number(TIN) •An estate(other than a foreign estate),or
to report,for example,income paid to you,real estate •A domestic trust(as defined In Regulations section
transactions,mortgage interest you paid,acquisition or 301.7701-7).
abandonment of secured property,cancellation of debt,or Special rules for partnerships.Partnerships that conduct a
contributions you made to en IRA trade or business In the United States are generally required to
Use Form W-9 only If you area U.S.person(including a pay a withholding tax on any foreign partners'share of Income
resident alien),to provide your correct TIN to the person from such business.Further,in certain cases where a Form W-9
requesting it(the requester)and,when applicable,to: has not been received,a partnership is required to presume that
1.Certify that the TIN you are giving is correct(or you are a partner is a foreign person,and pay the withholding tax.
waiting for a number to be issued), Therefore,if you are a U.S.person that is a partner in a
2.Certify that you are not subject to backup withholding,or partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
3.Claim exemption from backup withholding if you are a U.S. status and avoid withholding on your share of partnership
exempt payee.If applicable,you are also certfying that as a income.
U.S.person,your allocable share of any partnership income from The person who gives Form W-9 to the partnership for
a U.S.trade or business Is not subject to the withholding tax on purposes of establishing its U.S.status and avoiding withholding
foreign partners'share of effectively connected income. on its allocable share of net income from the partnership
Note.If a TIN,tyr gives you a form other 's Form m W-9 is
to conducting a trade or business in the United States is In the
request your you must use the requester's form If It is following cases:
substantially similar to this Form W-9. •The U.S.owner of a disregarded entity end not the entity,
Cat.Na.10231% Form W-9(Rev.10-200 7)
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