HomeMy WebLinkAbout20081447.tiff RESOLUTION
RE: APPROVE GRANT CONTRACT FOR THE PLATICAS PROJECT FOR BREAST HEALTH
AND AUTHORIZE CHAIR TO SIGN - SUSAN G. KOMEN BREAST CANCER
FOUNDATION, INC.
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 Grant Contract for the Platicas Project
for Breast Health between the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County,on behalf of the Weld County Department of Public Health
and Environment, and the Susan G. Komen Breast Cancer Foundation, Inc., commencing
May 1, 2008, and ending March 31, 2009,with further terms and conditions being as stated in said
grant contract, and
WHEREAS, after review, the Board deems it advisable to approve said grant contract, 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 Grant Contract for the Platicas Project for Breast Health between the
County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld
County, on behalf of the Weld County Department of Public Health and Environment, and the
Susan G. Komen Breast Cancer Foundation, Inc., be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said grant contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 14th day of May, A.D., 2008, nunc pro tunc May 1, 2008.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: )1114# ��, 4'. , �..• ,_1 / !,
illiam H. Jerke, Chair
Weld County Clerk to the`.- •
XCUSED
r�/2�/ w���l;Tr�i►:��� Robert D. Masden, Pro-Tem
BY.
As Deputy Cler /o the Board
Witt") F. Gar is
l�APPR-0-*
D F/ u
David E. Long
ounty Attorney 49%
Douglas Rademacher )'
Date of signature: 6/11/14
2008-1447
HL0035
(:0 f1/4_ Cr61-•-cf /)e,/o /SR'
Memorandum
TO: William H.Jerke, Chair
Board of County Commissioners
l C FROM: Mark E. Wallace, MD, MPH, Director Department-I Pub 'c e h and
Environmen nment(/1/` CA4
COLORADO DATE: May 12, 2008 ,im
SUBJECT: Susan G. Komen Breast Cancer
Foundation Contract for the Weld
County Pldticas Project for Breast
Health
Enclosed for Board review and approval is the contract between the Weld County
Department of Public Health and Environment and the North Colorado Affiliate of the
Susan G. Komen Breast Cancer Foundation, Inc. The contract period is May 1, 2008
through March 31, 2009 for the amount of the$10,000.00.
The grant will fund small group education classes and mammograms for low income, uninsured
and underinsured women who do not qualify for the Women's Wellness Connection Program
and who are at high risk for developing breast cancer.
I recommend your approval of this contract.
Enclosure
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i
2008-1447
2008 GRANT CONTRACT
•
Susan G.
women
TOE THE cure
THE NORTH COLORADO AFFILIATE OF THE
SUSAN G.KOMEN BREAST CANCER FOUNDATION,INC.
GRANT CONTRACT
PERIOD OF GRANT: May 1, 2008 -March 31, 2009
GRANTEE: Weld County Department of Public Health& Environment
PROJECT DIRECTOR: Olivia Martinez, Health Education Specialist, WWC
Program Outreach Coordinator
PROJECT TITLE: Weld County Platicas Project for Breast Health
The North Colorado Affiliate of the Susan G. Komen Breast Cancer Foundation, Inc.
("Komen Affiliate") does hereby grant Weld County Department of Public Health &
Environment ("Grantee")funds in the amount of$10,000 ("Grant Funds"or "Grant")
subject to the following terms and conditions ("Grant Contract"):
1. Use of Grant Funds:
A. Grant Funds are to be applied as set forth in the budget ("Budget")
in Grantee's grant application to Komen Affiliate ("Grant
Application"). A copy of the Grant Application is attached hereto
as Exhibit "A" and made a part hereof for all purposes. To the
extent that the terms of this Grant Contract conflict with the terms
of Exhibit"A," the terms of this Grant Contract shall prevail.
B. Grant Funds must be expended as set forth in the Budget, and no
changes or modifications to the Budget or to the breast cancer
project as described in the Grant Application ("Weld County
Platicas Project for Breast Health") may be made without the prior
written approval of Komen Affiliate.
C. Komen Affiliate shall receive copies of all materials created in
connection with the Breast Cancer Project at no charge. Grantee
grants Komen Affiliate and its affiliates a limited, non-exclusive
license to use such materials for their own non-commercial
purposes.
D. Unless otherwise specifically consented to in writing by Komen
Affiliate, the funds granted hereunder are not to be used for any
expenses beyond those listed in the budget.
E. Grantee shall use Komen printed materials in educational displays
in this Breast Health Project.
2. Termination and Early Termination of Grant:
A. This Grant Contract shall be effective as of the date hereof and shall
terminate on March 31, 2009, except that the provisions of Sections
5, 6, 7, 8, 9, 10, 12, 13 and 15 shall forever survive termination.
B. If either party should fail to perform or be in breach of any of the
terms, conditions, agreements, covenants, representations or
warranties contained in this Grant Contract, or anticipatorily
breach this Agreement, and such default is not curable, or if such
default is curable but remains uncured for a period of 30 days after
written notice thereof has been given to the defaulting party, the
other party, at its sole election, may immediately terminate this
Grant Contract by written notice thereof to the defaulting party.
The provisions of this Section 2.B will not preclude the parties from
seeking any other remedies that may be available under this Grant
Contract and applicable law.
3. Reports/Submission Items: Grantee shall submit to Komen Affiliate the
following:
A. A Progress Report shall be due on December 19, 2008, using the
outline attached to the Grant Contract as Exhibit "B" and made a
part hereof for all purposes. The Progress Report shall include, but
not be limited to, the following information: progress made toward
meeting objectives outlined in Grant Application,number of people
served, notice or receipt of other sources of support for the Breast
Cancer Project, copies or examples of any materials produced as a
result of the project, documentation of acknowledgment, a listing of
articles submitted for publication and the status of those articles,
and presentations made at scientific conferences regarding the
project;
B. Within 45 days following the expiration or early termination of the
Grant, a Final Report, using the outline attached to this Grant
Contract as Exhibit"C" and made a part hereof for all purposes. In
addition to the information referenced in Section 3.A, the Final
Report must include an accounting of the Grant Funds expended
during the term of this Grant Contract;
C. Any and all surveys or other items submitted by Komen Affiliate to
Grantee for completion regarding this Grant.
D. Notwithstanding the provisions of Sections 2.B and 4.B, in the
event that Grantee does not provide Komen Affiliate with the
above-referenced reports and surveys within the stated time
frames, Komen Affiliate shall be entitled to terminate this Grant
Contract immediately and receive a full reimbursement of the
Grant Funds from Grantee.
4. Grant Payments and Remittance of Unspent Grant Funds:
A. Grant Funds shall be payable in two equal installments of $5,000
each. The first payment shall be made to Grantee upon receipt by
Komen Affiliate of this Grant Contract fully executed, and the
second payment shall be made to Grantee after Komen Affiliate's
receipt of a timely and satisfactory six-month Progress Report.
B. Within 30 days after the expiration or early termination of this
Grant Contract, Grantee shall remit to the Komen Affiliate all
unspent Grant Funds.
5. Licensed Marks: Komen Affiliate has been granted by the Susan G.
Komen Breast Cancer Foundation, Inc., (the "Foundation") a non-
exclusive license to use the Susan G. Komen Breast Cancer Foundation
name and cameo logo (the "Licensed Marks") in connection with its
affiliation with the Foundation. Komen Affiliate grants Grantee a limited,
non-exclusive sub-license to use the Licensed Marks solely to
acknowledge Komen Affiliate's Grant hereunder. Komen Affiliate will
provide Grantee with camera-ready artwork of said Licensed Marks. It is
agreed and understood that Foundation retains all right, title and interest
in and to the Licensed Marks, both of which shall remain the exclusive
property of Foundation. Grantee is prohibited from transferring,
sublicensing or assigning its rights to use the Licensed Marks.
6. Publications:
A. Komen Affiliate may release information regarding this Grant to
the general public and news media. Grantee grants to Komen
Affiliate a non-exclusive license to include Grantee's name in
information pertaining to the Grant that is released to the public.
B. Grantee may release information regarding this Grant to the public
and news media, upon the following terms and conditions:
(1) Grantee must acknowledge Komen Affiliate as a funding
source on all publications related to this Grant in a clear,
unambiguous and readily-identifiable fashion, such as
"supported by a grant from the North Colorado Affiliate of
the Susan G. Komen Breast Cancer Foundation, Inc." Such
acknowledgment must be commensurate with the
acknowledgment provided to other grantors providing
similar grants.
(2) Grantee will present to Komen Affiliate for its approval,
prior to printing, distribution, publication, display, or use,
any and all promotional materials, publications, articles,
pictures, press releases and scripts of all statements, oral or
written, to be made by Grantee, its agents or spokespersons,
which use or refer to any Licensed Marks. Such materials
and statements must state that the Licensed Marks are
registered trademarks of the Foundation and must be of a
high quality consistent with Komen Affiliate's outstanding
public image;
(3) Copies of all other news releases, articles, pictures and any
and all other published material, which may be developed in
connection with this Breast Cancer Project or this Grant must
be furnished to Komen Affiliate by Grantee prior to
publication, or as soon thereafter as practicable.
7. Non-Guarantee of Additional Support: This Grant is accepted by Grantee
with the understanding that Komen Affiliate is not obligated to provide
any additional financial support, or other support, to Grantee, its agents
or spokespersons, in connection with the Grant, the Grant Contract, the
Breast Cancer Project or for any other reason.
8. Grantee Representations and Warranties: Grantee represents and
warrants that it is a tax-exempt organization under the Internal Revenue
Code. Grantee further represents that it has not and shall not receive any
duplicative funding in connection with the Breast Cancer Project.
Notwithstanding the provisions of Sections 2.B and 4.B, in the event that
Grantee breaches its representations and warranties, Komen Affiliate shall
be entitled to terminate this Grant Contract immediately and receive a full
reimbursement of the Grant Funds from Grantee.
9. Non-endorsement: It is expressly agreed and understood by the parties
hereto that Komen Affiliate's grant hereunder shall not constitute an
endorsement by Komen Affiliate or the Foundation of any entity,
organization, company or individual, nor the products, actions, behavior
or conduct of any entity, organization, company or individual and any
negligent or intentional misrepresentation by Grantee to the contrary, in
any context and in any forum, shall constitute a material breach of this
Agreement, and the same shall be grounds for immediate termination of
this Agreement by Komen Affiliate. In the event of any such
misrepresentation, Komen Affiliate may require Grantee to publicly
acknowledge the misrepresentation in a like forum in which the
misrepresentation was made. It is agreed that in the event of a breach of
this provision, damages may not be an adequate remedy, and Komen
Affiliate shall be entitled to whatever other remedies are available under
applicable law.
10. Governmental Compliance: Grantee will cooperate with Komen Affiliate
in supplying additional information to Komen Affiliate, or in complying
with any procedures which might be required by any governmental
agency in order for Komen Affiliate to establish that it has observed all
requirements of the law with respect to this Grant.
11. Authority: All persons and individuals executing this Grant Contract
certify and warrant that they have the capacity and have been duly
authorized to execute this Grant Contract on behalf of the entities so
indicated and that no additional authorization or approval is required.
12. Indemnity: Grantee acknowledges that it is solely responsible for any
liabilities that may arise in connection with the Breast Cancer Project. To
the extent not prohibited under the state and local laws which govern
each party, such party agrees to indemnify and hold the other harmless
from and against any and all costs, losses or expenses, including
reasonable attorneys' fees, that the other party may incur by reason of the
indemnifying party's negligence or misconduct or by reason of any third-
party claim or suit arising out of or in connection with the indemnifying
party's performance or failure to perform pursuant to this Grant Contract.
13. Dispute Resolution: In the event of any dispute arising out of this Grant
Contract, the parties shall use good faith efforts to resolve their differences
amicably. In the event they are unsuccessful, the parties agree not to
commence litigation until attempting to resolve their dispute through
mediation. Either party may initiate the mediation process with 30 days'
prior written notice to the other party. The dispute shall be submitted to
mediation in Greeley, Colorado. Costs of mediation shall be borne equally
by the parties. Mediation of the dispute shall be completed within 15 days
of commencement, unless the parties extend the time by mutual
agreement or unless the mediator declares the parties to be at an impasse.
Notwithstanding the above, in the event that Komen Affiliate believes that
immediate injunctive relief is required to protect the Licensed Marks,
Komen Affiliate may invoke immediate powers of the appropriate court
of law without the requirement to first mediate the dispute.
14. Entire Agreement: This Grant Contract supersedes any prior
understandings or oral agreements between the parties regarding the
subject matter hereof and constitutes the entire understanding and
agreement between the parties with respect to the subject matter hereof,
and there are no agreements, understandings, representations or
warranties among the parties other than those set forth herein.
15. Governing Law and Venue: This Grant Contract shall be governed by and
construed in accordance with the laws of the State of Colorado. Any
dispute arising out of or in connection with this Agreement that is not
resolved under Section 13 shall be filed and heard in the state or federal
courts of Greeley, Colorado, and the parties consent to the exclusive
jurisdiction of such courts.
This Grant is expressly conditional upon Grantee's acceptance of the terms
and conditions set forth above. The signature on this Grant Contract by an
authorized representative of Grantee represents Grantee's acceptance of this
award and agreement to comply with all of the above terms and conditions.
AGREED TO AND ACCEP FED BY:
The North Colorado Affiliate of
The Susan G. Komen Breast Cancer Foundation, Inc.
Affiliate President
Wel Copnly te rtme f P lie Health & Environment
U�Ili QA,
(Signature)
Name (print): Mark Wallace, MD, MPH Title: Director
✓L c GL
Attachments to grant contract:
EXHIBIT A: GrantA Application Chairman, Board of County Commissioners
pp 0 /14 20��y�{��R
EXHIBIT B: Outline for Progress Report ATTEST: �r 1Ce
EXHIBIT C: Outline for Final Report
WELD COUNTY CLERK TO T i' B•
��'' .O 86 ic i
BY: DEPU CLERK TO THEO11 i(
ATTST''"G TO B0iRD 0`r C0UIN
S'SidATL'RES OtiLY
c2�Z13'-/'/
GRANTEE PROGRESS REPORT OUTLINE (2008-2009 fiscal year)
Due Date: December 19, 2008
•
Susan C
women
--cure
GRANT PROGRESS REPORT TO THE
North Colorado Affiliate of the Susan G. Komen Breast Cancer Foundation
Please Type
PROJECT DIRECTOR:
AGENCY:
PROJECT TITLE:
PERIOD COVERED BY PROGRESS REPORT:
FROM: TO:
1. PROJECT PROGRESS REPORT: In this section, list progress of project toward meeting
objectives as outlined in Grant Application, including number of people served during this
period. (1 page)
2. PROPOSED CHANGES: In this section, please report any proposed changes in
project design, project personnel, or project budget. Please use the "Request for
Change/Amendment" form. (1 page per change, if any)
3. OTHER SOURCES OF SUPPORT: In this section, please list any notice or receipt of other
sources of support for this project received during the past six months. (1 page, if any)
4. PROJECT MATERIALS: In this section, please list and attach all published or produced
materials, pictures, etc. for the past six months. (1 page plus attachments)
5. ACCOUNTING OF GRANT FUNDS: Please attach a current accounting of grant funds using
the Budget Progress Report form. (1 page)
Signature of Project Director Date
BUDGET PROGRESS REPORT FORM
ACCOUNTING OF GRANT FUNDS FROM MARCH ,2008 TO OCTOBER 17,2009
MONTH/DAY/YtiAR MONTH/DAY/YEAR
ORIGINAL BUDGET ACTUAL EXPENSES
To••DATE
PERSONNEL
SUPPLIES(ITEMIZE BY CATEGORY)
EQUIPMENT(NOT TO EXUbEU 30%OF DIRECT COSTS)
PATIENT CARE COSTS
INPATIENT
OUTPATIENT
SUBTOTAL(DIRECT COSTS) $ $
INDIRECT COST ALLOCATION(NoT TO EXCEED 10% $ $
OF DIRECT COSTS)
TOTAL GRANT FUNDS EXPENDITURES S $
SIGNATURE: DATE REQUESTED:
(TYPED)PRINCIPAL INVESTIGATOR/PROJECT DIRECTOR
Tracking Number
Due Date: May 15, 2009
EXHIBIT C
FINAL GRANT REPORT TO THE:
North Colorado Affiliate of the Susan G. Komen Breast Cancer Foundation
Please Type
PROJECT DIRECTOR:
AGENCY:
PROJECT TITLE:
START DATE: END DATE:
1. PROJECT SUMMARY I: List each objective outlined in the original grant application.
2. WHAT PERCENTAGE OF OBJECTIVES WERE MET
SPECIFIC
AIMS: PERCENT COMPLETED:
1-25% 26-50'%% 51-75°/, 76-100°/u N/A
OBJECTIVE 1
OBJECTIVE 2
OBJECTIVE 3
OBJECTIVE 4
OBJECTIVE 5
Tracking Number
3. PROJECT SUMMARY II: In this section, please provide a short summary (200 words or less)
in lay language describing the outcomes and accomplishments of this project. Include a
statement of plans for the future of the program.
4. TYPES OF SERIVCES PROVIDED (CHOOSE ONLY THOSES THAT PERTAIN TO YOUR GRANT):
# of People Served # of People Served
CLINICAL TRIALS EDUCATION SCREENING MAMMOGRAPHY
TREATMENT ASSISTANCE EDUCATION/COUNSELING SESSIONS
WRITTEN MATERIALS PROVIDED CLINICAL TRIALS ENROLLMENT
DIAGNOSTIC SERVICES CLINICAL BREAST EXAMS
COMPLEMENTARY/ALTERNATIVE PSYCHOSOCIAL
OTHER
Tracking Number
5. NUMBER OF SCREENING MAMMOGRAMS PROVIDED WITH THIS GRANT(IF APPLICABLE):
6. NUMBER OF CLIENTS REFERRED OUT FOR FURTHER DIAGNOSIS:
7. NUMBER OF CLIENTS REFERRED OUT FOR MAMMOGRAMS(NOT PAID FOR BY KOMEN GRANT):
8. NUMBER OF BREAST CANCERS DETECTED:
9. OTHER SOURCES OF SUPPORT: In this section, please list any notice or receipt of other
sources of support for this project received during the past six months.
Organization Dollar Amount
10. PROJECT MATERIALS: In this section, please list all published or produced materials,
pictures,etc. for this grant project. Include copies of materials for Affiliate files.
11. ACCOUNTING OF GRANT FUNDS: Please attach a final budget for the entire term of the
grant period. (Use attached form)
Signature of Project Director Date
Permission is hereby granted to the Susan G. Kamen Breast Cancer Foundation to publish the above
information. Proper credit will be given to grantee where appropriate.
Tracking Number
BUDGET PROGRESS REPORT FORM
ACCOUNTING OF GRANT FUNDS FROM TO
MONTH/DAY/YEAR MONTH/DAY/YEAR
ORIGINAL BUDGET ACTUAL EXPENSES
To DATE
PERSONNEL
SUPPLIES(ITEMIZE BY CATEGORY)
EQUIPMENT(NOT TO EXCEED 30%OF DIRECT COSTS)
PATIENT CARE COSTS ^_
INPATIENT
OUTPATIENT
SUBTOTAL(DIRECT COSTS) $ $
INDIRECT COST ALLOCATION (NOT TO EXCEED 15% $ $
OF DIRECT COSTS)
TOTAL GRANT FUNDS EXPENDITURES $ S
SIGNATURE: DATE REQUESTED:
(TYPED)PROJECT DIRECTOR
June 30, 2008
In finalizing these mailings, I found that the check enclosed is only for ''/a of your
approved grant money. I will be sending an additional check in the next week with the
remaining money to equal '/z of the approved grant. I apologize for the inconvenience but
did not want to delay the disbursement any longer than necessary.
Please call me with any questions.
Thanks.
Cathy Kunisch
Co-chair grants
North Colorado Affiliate - Komen
970-350-6677
cathy.kunisch@bannerhealth.com
SUS011 G. •
women
FOR-cure
June 26, 2008
Weld County Department of Public Health and Environment
Weld Women's Health Consortium Breast Cancer
Olivia Martinez
RE: GRANT AWARD CHECK-1ST HALF OF FUNDING
Dear Ms. Martinez:
Enclosed is a check for$2500, the first half of your grant award from North
Colorado Komen Breast Cancer Foundation. Please confirm that you have received
the funds by letter or email. If you have questions or need assistance, please do not
hesitate to contact me at cathy.kunisch@bannerhealth.com or 970-350-6677.
S" erely
Cathy K .sch,Grants Co-Chair
North Colorado Affiliate of the Susan G. Komen Foundation
Enclosure
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