HomeMy WebLinkAbout20071834.tiff RESOLUTION
RE: APPROVE AMENDED APPLICATION FOR FEDERAL ASSISTANCE FOR WELD
COUNTY YOUTH CONSERVATION CORPS, AMERICORPS PROGRAM, AND
AUTHORIZE ELECTRONIC SUBMITTAL
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 Amended Application for Federal
Assistance for the Weld County Youth Conservation Corps, Americorps Program,from the County
of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,
on behalf of the Department of Human Services, to the Corporation for National and Community
Service, commencing September 10, 2007, and ending September 9, 2010,with further terms and
conditions being as stated in said amended application, and
WHEREAS, after review, the Board deems it advisable to approve said amended
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,that the Amended Application for Federal Assistance for the Weld County Youth
Conservation Corps, Americorps Program, from the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Department of
Human Services, to the Corporation for National and Community Service be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Deputy Clerk be, and hereby is,
authorized to submit said amended application electronically.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 2nd day of July, A.D., 2007.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: �a ,�CUSED
�` E. Long, Chair
Weld County Clerk to the Board p /
x1861
4y"�✓ +:'_��is _� l. . Je e, P .-Te
BY:
Deputy Cler o the Boar � ��r —'
F. Garcia
AP D • !,t Y YlO —
1
Robert D. Masden
ou Attorney t� c � L ��
7_ 1'-0 7 ouglasdemacher
CIA
Date of signature:
2007-1834
�1 Ic; J,iR0078
MEMORANDUM
DATE: June 28, 2007
TO: David E Long, Chair Board of Commissioners
VC FROM: Walter J. Speckman, Human Services Director
COLORADO SUBJECT: AmeriCorps Grant Renewal Unsolicited funds
Request
This memo seeks Board approval for the addition of unsolicited funds, provided by the
Governor's Commission on Community Service, which are to be added to the previously
approved continuation grant request for the operation of the Weld County Youth
Conservation Corps, AmeriCorps Program. These funds will be added to the existing
proposed budget in the following amounts and line items: $467.00 added to the Supplies
line item, and $12,133.00 added to the Evaluation line item to allow the Governor's
Commission to develop an evaluation study of the program. These additional funds will
allow the Weld County Youth Conservation Corps to continue to provide meaningful services
to the communities of Weld County.
Total funding requested for the Program is $163,800.00 for the period covering September
10, 2007 to September 9, 2008.
If you have any questions, please telephone me at 353-3800.
2007-1834
PART I - FACE SHEET
APPLICATION FOR FEDERAL ASSISTANCE 1.TYFE OF SUBMISSION:
Modified Standard Form 424(Rev.02/07 to confirm to the Corporation's eGrants System) Application[X] Non-Construction
2a.DATE SUBMITTED TO CORPORATION 3.DATE RECEIVED BY STATE STATE APPLICATION DENTIFER:
FOR NATIONAL AND COMMUNITY
SERVICE(CNCS): 14-DEC-06
2b.APPLICATION D: 4.DATE RECEIVED BY FEDERAL AGENCY: FECERAL DENTFER
07AC072335 06AFHCO0010004
5.APFLICATDN NFORMATCN _.
LEGAL NAME Board of Weld County Commissioners,Weld County Division of Hum NAME AND CONTACT NFORMATCN FOR PROJECT DIRECTOR OR OTHER
PERSON TO BE CONTACTED ON MATTERS NVOLV NG THIS APPLICATION(give
DUNS(LUMBER 075757955 area codes):
NAME Ted A.Long
ADDRESS(give street address,city,state,zip code and county): TELEPFIONEMBER: (970)353-3800 x3400
PO Box 1805
1551 N.17th Ave FAX NUMBER: (970)356-3975
Greeley CO 80632-1805 NTERNET E-MAL ADDRESS: tIong@co.weld.co.us
County:
6.EMPLOYER DENBFICATION NUMBER(EN): 7.TYPE OF AFPLCANT:
7a. Local Government-County
846000813
7b. Area Agency on Aging
8.TYPE OF APPLICATION(Check a mm
appropriate box). Community Action Agency/Community Action Program
NEW LJ NEN/PREVCUS GRANTEE
X CONTINUATION F-1 AMENDMENT
If Amendment,enter appropriate letter(s)in box(es):
A. AUGMENTATION B.BUDGET REVISCN
C.NO COST EXTENSION D.OTHER(specify below):
9.NAME OF FEDERAL AGENCY:
Corporation for National and Community Service
10a.CATALOG OF FEDERAL DOMESTCASSISTANCE NUMBER 94.006 11.a.DESCRPTIVE TITLE OF APPLICANT'S PROJECT:
10b.TITLE Amrercorps"State Weld County Youth Conservation Corps(WCYCC)
11.6.CNCS PROGRAM NfMTNE(F ANY):
12.AREAS AFFECTED BY PROJECT(List Cities,Counties,States,etc):
Weld County.Cobrado
13.PROPOSED PROJECT: START DATE 09/10/07 END DATE 09/09/10 14.CONGRESSIONAL DISTRICT OF: a.Applicant CO04 b.Program LCO 04-1
15.ESTIMATED FUNDNG: Year#: 2 16.IS AFFLICATCN SUBJECT TO REVEW BY STATE EXECUTIVE
-- -- ORDER 12372 PROCESS?
a.FEDERAL $ 163,800.00
❑ YES.THIS PREAPPLCATCWAPPLCATION WAS MADEAVALABLE
b APPLICANT $ 113,560.00 TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR
REVIEW ON:
c.STATE $ 0.00 DATE
d.LOCAL $ 0.00 D NO.PROGRAM IS NOT COVERED BY EO.12372
e.OTHER $ 0.00 - -
--
f.PROGRAMNCOME $ 0O0 17.IS THEAPPLCANT DE.NOUENT ON ANY FEDERAL DEBT?
❑ YES if"Yes,"attach an explanation. ® NO
g.TOTAL $ 277,360.00
18.TO THE BEST OF MY KNOWLEDGE AND BELEF,ALL DATA N THIS APFLICATION/FREAPFLICATION ARE TRUE AND CORRECT,THE DOCUMENT HAS BEEN
DULY AUTHORIZED BY THE GOVERNNG BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE
IS AWARDED.
a.TYPED NAME OF AUTHORIZED REPRESENTATIVE b.TIRE c.TE.EPH ONE NUMBER
Esther Gesick Off iceManager/Coord (970)356-4000 4226
d.SIGNATURE OF UTHORIZED REPRES ATNE e.DATE SIGNED:
(J1 12/14/06
Page 1
For Official Use Only
Narratives
Executive Summary
EXECUTIVE SUMMARY
WELD COUNTY YOUTH CONSERVATION CORPS
STAEMENT OF NEED
The continued growth of the at-risk youth population,the need for additional service opportunities for
youth as well as the increased need for parks/open space, trails and human services are ongoing
identified needs in Weld County. The Weld County Youth Conservation Corps (WCYCC) continues to
be positioned to positively and actively respond to these needs through its existing and emerging
relationships with local communities, agencies, community and faith based organizations.
As indicated in various federal (2000 Census, e.g.), State (Kids Count in Colorado, e.g.) and local
(Weld County Child Care and Youth Supervision Study, e.g.) reports it continues to be clear that Weld
County and its youth face a major social issue of an increasing population of at-risk, disenfranchised
youth. With continued high rates of poverty, drop outs, rates of adjudication and lower median
household incomes than other Front Range areas, Weld County continues to face immediate
challenges in positively effecting youth.
Since the City of Greeley's quality of life ballot issue, approved in 2002, numerous projects benefiting
area residents have been identified and put forward. The ballot issue continues to be the impetus for
community improvement projects. Identified projects include improving parks, developing open
space, constructing and improving trails as well as preserving and improving historic and community
sites. The communities surrounding Greeley have many similar community improvement agendas.
For Official Use Only
Page 2
For Official Use Only
Narratives
ACTIVITIES TO ADDRESS NEEDS
The WCYCC design enables Weld County at-risk youth ages 17-25 to have the opportunity to provide
valuable service to and be engaged in their community and addresses each of the above needs through
crew based service learning projects.
The WCYCC continues to provide its members the means to acquire valuable job, leadership and civic
skills through projects that have a lasting and visible benefit to their community. These include:
environmental projects, e.g. work in parks, construction and maintenance of trails, planting trees;
human services projects by providing services to community and faith based organizations; education
services by providing assistance and conflict resolution to elementary schools with high risk students;
and improving low income neighborhoods and historic preservation projects. Corps member
development activities have continued to include GED prep, citizenship training, conflict resolution,
first aid/CPR, HIV and STD awareness, diversity,journaling and team building activities.
ANTICIPATED OUTCOMES
The WCYCC has continued to make a positive impact on the development of corps members into
productive citizens while providing local governments, agencies and community and faith based
organizations in Weld County a valuable resource for meeting their needs.
Through participation in project and member development activities, members become more
productive and engaged citizens. In addition to the job skills acquired, training provides members the
ability to learn the rights and responsibilities and how to become contributing members of the
For Official Use Only
Page 3
For Official Use Only
Narratives
community and good citizens rather than a statistic in the juvenile arrest and conviction rates.
Utilization of the WCYCC saves communities and project sponsors money, in the past year this
amounted to over $130,000 in costs. Through our continued collaboration efforts, the WCYCC has
been able to benefit Weld County communities in obtaining funds for the development and
improvement of parks, trails, open space, etc. Members have benefited Head Start programs
throughout the County by assisting with facility maintenance and they have benefited teachers and
elementary schools by providing assistance and conflict resolution skills to high risk students. The
WCYCC will continue these efforts as well as pursue additional service opportunities.
Summary of Accomplishments
SUMMARY OF ACCOMPLISHMENTS
The Weld County Youth Conservation Corps (WCYCC) continues to target and recruit at-risk youth
to become members and those members are then assisted in gaining valuable work skills, a GED if
they have no diploma, a variety of life skills, and developing a productive relationship with their
community through civic engagement. During this program year, the WCYCC and its corps
members have continued to provide valuable service that meets the needs of the communities
throughout Weld County.
The WCYCC has an established goal for the 2006-2007 program year to complete a minimum of 24
projects that focus on conservation efforts(environmental and historical), improve the environment,
improve or create recreation areas including parks, trail, pools, etc. Additionally, the performance
goal calls for 85% of project sponsors to rate the services received as meeting or exceeding their
expectations. For the current corps program year,with only three months completed, the WCYCC
has completed a total of 15 projects of which 8 have been environmental projects, 3 were for faith
For Official Use Only
Page 4
For Official Use Only
Narratives
based organizations, 3 for United Way of Weld County, and one for a community based agency.
Examples of the projects completed to date include: packed 500 food boxes and helped prepare over
600 meals for a faith based organization; completed cleanup work around and in a building for
another faith based organization which included the removal of 1 ton of dirt; helped the community
prepare for a Presidential visit by performing cleanup which included the removal of over too feet of
construction fencing, removing metal t-posts and removing debris, rocks etc; prepared ground at
local historical museum for new tree planting; installed cabinets and moved furniture for a
community based organization; and over a two week project at a State park removed 5 tons of
tumbleweed(Salsola, Russian Thistle), and 6 tons of non-native species plants(Tamarisk and Russian
Olive), removed 2,000 feet of silt fence, constructed 800 feet of trail, and planted 6o trees and 500
shrubs.
All 15 project sponsors completed project evaluations and t00% of the sponsors rated services as
meeting or exceeding their expectations.
Members will be expected to recruit a minimum of 15 volunteers during this program year and this
will take place later in the program year. The WCYCC continues to be committed to including
individuals with disabilities in projects and therefore, recruitment of volunteers will take place with
local community based organizations that serve that population of individuals.
Another performance goal established for the program is to collaborate with local communities in 2-3
new project proposals to enhance the communities' ability to meet their needs. This goal includes
collaboration in proposals to expand trails and/or acquire open space for parks. Through
collaboration in these proposals, the WCYCC is able to demonstrate a cost benefit to communities
For Official Use Only
Page 5
For Official Use Only
Narratives
when they apply for these grants because by including the corps in their proposal, communities are
given extra points and thereby are more competitive and this increases their ability to receive funds to
meet their needs. To date the WCYCC has participated in one collaboration project with the City of
Greely to increase their ability to receive funds for a trail project.
Weld County communities continue to view the WCYCC as a valuable resource and it has been
recognized, as such, on several occasions. The Corps continues to respond to requests from
community agencies to address their needs and through the provision of a wide variety of services to
the communities of Weld County the WCYCC has continued to facilitate the success of many
community activities. The WCYCC was recognized twice by United Way of Weld County. The first
recognition was in 2005 as the Weld County united Way Community Partner of Year and then in
2006 the WCYCC was nominated as the Amazing Volunteer Organization.
The WCYCC is in the process of providing the corps member development activities in accordance
with the stated performance goals. There are three specific performance goals established and they
include member development activities in GED, Civic engagement, and the provision of a variety of
life skills.
This years WCYCC is comprised of 12 at-risk youth and 4 of these member did not possess a diploma
or GED at the time of enrollment. One member received his GED within a month of entering the
program and then chose to exit the program for a job offering higher pay. The remaining three
members are still in the process of preparing to take their GED test and will begin testing within the
next month. Each of the 4 members showed a grade level gain since enrolling in the program and
taking part in remediation/GED preparation activities.
For Official Use Only
Page 6
For Official Use Only
Narratives
Members have participated in 10 hours of citizenship training towards the goal of a minimum of zo
hours of training for the year. Once training is completed, members will be given the WCYCC
citizenship test to determine the number of members who achieve a passing score and will be asked to
register to vote and to complete the oath of affirmation as outlined in the performance measure.
I accordance with the performance measure for member development concerning life skills, members
have begun training in a variety of life skills activities and at this point in time have completed
diversity training and 6 hours of training under the America Reads program. Ten of the original 12
members have obtained certification in one activity at this point in the program towards the
established goal of three certificates for the year. Training activities still to be provided include CPR,
first aid, conflict resolution, team building, WAIT, disability awareness,budgeting, HIV and STD
awareness and a variety of career development activities.
Rationale and Approach
PROGRAM NARRATIVE
C. PROGRAM DESIGN
1. RATIONALE AND APPRAOCH
N/A. There are no changes in this area.
Member Outputs and Outcomes
2. MEMBER OUTPUTS AND OUTCOMES
The WCYCC is different from many national programs in that it specifically targets at-risk,
For Official Use Only
Page 7
For Official Use Only
Narratives
adjudicated and disenfranchised youth to become members. The WCYCC has never had an issue with
recruiting and adequate number of youth or meeting the required number of enrollments. However,
as a result of this target population the program has experienced some retention issues. For the last
year the WCYCC recruited and enrolled 12 members and seven members or 58% completed the
program and 5 earned the education award. This was an increase from the previous year and
increasing the retention of the high risk youth members of the WCYCC has been and continues to be
a focus of the WCYCC program.
To address this issue the interview process was changed and a formal member satisfaction survey was
implemented. Member satisfaction is a key point we are working to increase retention and member
feedback and satisfaction are important to the WCYCC management team. At least twice a year
members are asked to provide feedback in a formal manner when they receive their member
evaluation. At the completion of each project members are asked for feedback and feedback is always
welcome by the Director of the Corps. Plans for the remainder of this year and years to come will a
formal member satisfaction survey three times during the membership year and corps members are
and will continue to be included in recognition lunches held for Employment Services staff at various
times of the year.
The WCYCC strives to increase its retention of members through the provision of training and
providing members with the opportunity acquire useful job skills, to become valuable members of the
community as well as the attainment of beneficial life skills. Each crew member is provided the
opportunity to develop individual leadership skills by experiencing the role of assistant crew leader at
various times and through coordinating activities and serving as team leader on projects and in
developing projects. Members are also rewarded/recognized with certificates of completion and
For Official Use Only
Page 8
For Official Use Only
Narratives
plaques for completing the program.
Even though working with at-risk youth proves to be a challenge regarding retention, the WCYCC is
committed to increasing retention rates for this target population and will work towards continuous
improvement in this area.
Community Outputs and Outcomes
3. COMMUNITY OUTPUTS AND OUTCOMES
N/A. There are no changes in this area.
Organizational Capability
D. ORGANIZATIONAL CAPABILITY
N/A. There are no changes in this area.
Cost Effectiveness and Budget Adequacy
E. COST EFFECTIVENESS AND BUDGET ADEQUACY
N/A. There are no changes in this area.
Evaluation Summary or Plan
The WCYCC utilizes an independent evaluation of its program to determine strengths and areas of
opportunity. The Colorado Youth Corps Association conducts an accreditation review each year and
this review is what the WCYCC utilizes as its evaluation.
The accriditation review consists of a variety of standards which include the types of service projects
performed, identification if projects benfit the public sector, does the corps have an identity, is the
corps able to provide regional rersponsiveness, are there adequate insurance coverages, is the corps
For Official Use Only
Page 9
For Official Use Only
Narratives
true to its mission, a review of activities, risk management, fiscal mangement, etc.
Amendment Justification
This is a continuation request and there are not any ammendments being requested at this time.
For Official Use Only
Page 10
For Official Use Only
Performance Measures
Service Categories
GED/Dropouts Primary ❑ Secondary IY
Other Environment Primary ❑x Secondary ❑
GlvlcEn. ei ettt A tivlfies
Service Category: Other Environment
Measure Category: Participant Development
Needs and Activities
Briefly describe the need to be addressed (Max. 4,000 characters)
Twelve full time AmeriCorps members will annually participate in corps citizenship activities
designed to increase their knowledge of their roles, rights, and responsibilities as citizens. Members
will participate in at least 20 hours of training covering the 12 month period from September to
August the following year.
Briefly describe how you will achieve this result(Max 4,000 chars.)
Twelve AmeriCorps members will annually participate in 20 hours of citizenship training activities
that focus on their roles, rights, and responsibilities as citizens.
Activity Start Date:04 september 2006 Number of Members: 12
Activity Ind Date: 03 September 2007 Hours per Day (on average)t
Days per Week(on average)2
Results
Result: Output
Twelve AmeriCorps members will participate in citizenship training activities.
Indicator: Number of hours members participate in citizenship training activities
Target: Twelve AmeriCorps members w ill annually participate in 20 hours of citizenship training activities
that focus on their roles, rights, and responsibilities as citizens.
Target Value: 20
Instruments:WCYCC training logs
PM Statement: Tw elve AmeriCorps members w ill annually participate in citizenship training activities. Members w ill
participate in 20 hours of citizenship training activities that focus on their roles, rights, and
responsibilities as citizens.
Rev. Yrs. Data:Twelve full time AmeriCorps members completed over 20 hours of training in citizenship through the
i,We the People,curriculum and use of additional information such as Liberty Day Colorado which
provides information on the Constitution and the Bill of Rights.
Result: Intermediate Outcome
Participation in citizenship training activities will increase the corps members'knowledge of their
rights and responsibilities as citizens.
Indicator: Percentage of members who complete a minimum of 20 hours of traiing and who
achieve a passing score on the WCYCC citizenship test
For Official Use Only
Page 11
For Official Use Only
Result: Intermediate Outcome
Target: 80% of the members w ill complete a minimum of 20 hours of participation in citizenship training
activities and 80% of those members w ill achieve a passing score on the WCYCC citizenship
test.
Target Value: 80%
Instruments:WCYCC citizenship test
PM Statement: Participation in citizenship training activities w ill increase the corps memberst know ledge of their
rights and responsibilities as citizens. 80% of the members w ill complete a minimum of 20 hours of
participation in citizenship training activities and 80% of those members w ill achieve a passing score
on the WCYCC citizenship test.
Rev. Yrs. Data:Tw elve members completed 20 hours or more of training in citizenship activities designed to increase
their know ledge of their roles as citizens. Of the members who completed the program and w ere
available to take the post test, 100% (5 of 5) achieved a passing score on the WCYCC citizenship
test.
Result: End Outcome
Members will be better prepared citizens as a result of their participation in citizenship training
activities. They will understand their roles, rights, and responsibilities as citizens and thereby
become more productive members of their community.
Indicator: Percentage of members who register to vote and complete conmtment card
Target: 80% of completing members w ill make a commitment to register to vote and complete a pledge
card and oath of affirmation indicating their commitment to continue to volunteer in their
communities and to stay out of legal trouble.
Target Value: 80%
Instruments:WCYCC commitment form.
PM Statement: Members w ill be better prepared citizens as a result of their participation in citizenship training
activities. They w ill understand their roles, rights, and responsibilities as citizens and thereby
become more productive members of their conmunity. 80% of completing members w ill make a
commitment to register to vote and complete a pledge card and oath of affirmation indicating their
commitment to continue to volunteer in their communities and to stay out of legal trouble.
Rev. Yrs. Data:Twelve members completed 20 hours or more of training in citizenship activities designed to increase
their know ledge of their roles as citizens. Of the members who completed the program and w ere
available to take the post test, 100% (5 of 5) achieved a passing score on the WCYCC citizenship
test. 100%l of the completing members (5 of 5) registered to vote in addition to signing an oath of
affirmation that they would continue to volunteer and stay out of legal trouble.
Service Category: Other Environment
Measure Category: Needs and Service Activities
Needs and Activities
Briefly describe the need to be addressed (Max. 4,000 characters)
AmeriCorps members will provide meaningful service to project sponsors which; target conservation
efforts(environmental and historical), improve the environment, improve or create recreation areas
including parks, trails, pools etc, and which meet the identified needs of local communities.
Briefly describe how you will achieve this result(Max 4,000 chars.)
For Official Use Only
Page 12
For Official Use Only
Briefly describe how you will achieve this result(Max 4,000 chars.)
Twelve full time AmeriCorps members will provide meaningful service to the local communities in
Weld County for 35 hours per week covering the 12 month period from September to August of the
following year.
Activity Start Date:04 September 2006 Number of Members: 12
Activity End Date: 03 September 2007 Hours per Day (on average))
Days per Week(on average)0
Results
Result: Output
AmeriCorps members will provide meaningful service to project sponsors which; target conservation
efforts(environmental and historical), improve the environment, improve or create recreation areas
including parks, trails, pools etc, and which meet the identified needs of local communities.
Indicator: participants
Target: Twelve full time AmeriCorps members w ill provide meaningful service to the local communities in
Weld County for 35 hours per week covering the 12 month period from September to August of
the following year. Members w ill annually complete projects th
Target Value: 35
Instruments:Corps member time sheets and project tracking logs.
PM Statement: AmeriCorps members w ill annually provide meaningful service to project sponsors which; target
conservation efforts (environmental and historical), improve the environment, improve or create
recreation areas including parks, trails, pools, etc., and which meet the identified needs of
communities. Members w ill annually complete projects that focus on conservation efforts
(environmental and historical), improve the environment, improve or create recreation areas including
parks,trails, pools, etc.
Rev. Yrs. Data:Tw elve full time members completed meaningful service to the local communities, agencies, and
CBOts/FBOts in Weld County. Service activities focused on the identified needs of project
sponsors.
Result: Intermediate Outcome
Twelve full time AmeriCorps members will provide meaningful service to the local communities in
Weld County for 35 hours per week covering the 12 month period from September to August of the
following year.
Indicator: Number of environmental projects completed
Target: Members w ill annually complete a minimum of 24 projects that focus on conservation efforts
(environmental and historical), improve the environment, improve or create recreation areas
including parks,trails, pools, etc.
Target Value: 24
Instruments:Corps member time sheets and project tracking logs.
PM Statement: AmeriCorps members w ill annually provide meaningful service to project sponsors which; target
conservation efforts (environmental and historical), improve the environment, improve or create
recreation areas including parks,trails, pools, etc., and which meet the identified needs of
communities. Members w ill annually complete a minimum of 24 projects that focus on conservation
For Official Use Only
Page 13
For Official Use Only
Result: Intermediate Outcome
efforts (environmental and historical), improve the environment, improve or create recreation areas
including parks, trails, pools, etc.
Rev. Yrs. Data:Tw eNe full time members completed 74 projects benefiting 440,423 people (duplicated)through
meaningful service to the local communities, agencies, and CBOts/FBOts in Weld County. Service
activities focused on the identified needs of project sponsors.
Result: End Outcome
Service projects will improve/enhance existing recreation areas, increase the user's knowledge of
local history, and/or improve/conserve the local environment.
Indicator: Percentage of project sponsors rating services as meeting or exceeding expectations
Target: Annually, 20 of the 24 projects (85%), completed over the 12 month period from September to
August of the following year,w ill rate the services received as meeting or exceeding
expectations.
Target Value: 85%
Instruments: Project sponsor evaluations
PM Statement: Service projects w ill improve/enhance existing recreation areas, increase the userts know ledge of
local history, and/or improve/conserve the local environment. Annually,tw enty (20) of the twenty-four
(24) projects (85%), completed over the 12 month period from September to August of the following
year,w ill rate the services received as meeting or exceeding expectations.
Rev. Yrs. Data:The WCYCC provided service on a variety of projects that serve the citizens of Greeley, the residents
of Weld County, as w ell as other visitors to the Weld County area. Of the project sponsors who
responded to the project evaluation requests, 100% rated the services received as either meeting or
exceeding their expectations
)g_a Activia
Service Category: GED/Dropouts
Measure Category: Participant Development
Needs and Activities
Briefly describe the need to be addressed (Max. 4,000 characters)
Those AmeriCorps members who do not possess a high school diploma or GED at time of
enrollment will participate in educational activities designed to prepare them to take and obtain their
GED. Members will participate in these activities an average of to hours a week starting in
September and continuing until they obtain their GED.
Briefly describe how you will achieve this result(Max 4,000 chars.)
i00% of those AmeriCorps members that do not possess a high school diploma or GED at time of
enrollment will participate in educational activities for an average of 10 hours per week until they
obtain their GED.
Activity Start Date:04 September 2006 Number of Members:6
Activity End Date: 03 September 2007 Hours per Day (on averageg
Days per Week(on average)5
Results
Result: Output
For Official Use Only
Page 14
For Official Use Only
Result: Output
Members who do not possess a high school diploma or GED at time of enrollment will participate in
educational activities designed to prepare them to obtain their GED.
Indicator: participants
Target: 100% of those AmeriCorps members that do not possess a high school diploma or GED at time
of enrollment w ill participate in educational activities for an average of 10 hours per week until
they obtain their GED.
Target Value: 100%
Instruments: Lab participation logs
PM Statement: Members who do not possess a high school diploma or GED at time of enrollment w ill participate in
educational activities designed to prepare them to obtain their GED.
Rev. Yrs. Data:There w ere a total of seven (7) members who did not possess a high school diploma or GED at time
of enrollment. These members participated in educational activities designed to prepare them to take
and obtain their GED.
Result: Intermediate Outcome
Participation in educational activities will prepare members to take and obtain their GED.
Indicator: Percentage of participating members who show a grade gain
Target: 90% of participating members w ill show a grade gain in the educational components.
Target Value: 90%
Instruments: Lab participation logs
PM Statement: Participation in educational activities w ill prepare members to take and obtain their GED. 90% of
participating members w ill show a grade gain in the educational components.
Rev. Yrs. Data:100% of the members who w ere required to participate in the educational components showed a
grade gain. Members who used their time wisely realized the most benefit.
Result: End Outcome
Members who do not possess a high school diploma or GED at time of enrollment will obtain their
GED.
Indicator: Percentage of participating members who obtain their GED
Target: Three of the six (50%)of the members involved in this activity w ill obtain their GED.
Target Value: 50%
Instruments: GED test
PM Statement: Members who do not possess a high school diploma or GED at time of enrollment w ill obtain their
GED. Three of the six (50%) of the members involved in this activity w ill obtain their Gm.
Rev. Yrs. Data:Three members obtained their GED. The remaining members who w ere enrolled in this activity either
w ere relieved for cause or left the country.
Service Category: GED/Dropouts
Measure Category: Participant Development
Needs and Activities
Briefly describe the need to be addressed(Max. 4,000 characters)
Twelve full time AmeriCorps members will participate in a variety of life skill development activities
such as First Aid, CPR, Conflict Resolution, STD Awareness, WAIT training, Disability Awareness,
Diversity, Team Building,budgeting, and career development activities.
For Official Use Only
Page 15
For Official Use Only
Briefly describe how you will achieve this result(Max 4,000 chars)
8O% of the AmeriCorps members will participate in training activities in First Aid, CPR, Conflict
Resolution, STD Awareness,WAIT training, Disability Awareness, Diversity,Team Building,
budgeting, and career development activities.
Activity Start Date:04 September 2006 Number of Members: 12
Activity End Date: 03 September 2007 Hours per Day (on average)t
Days per Week(on average$
Results
Result: Output
Members will participate in a variety of training activities designed to increase their life skills.
Indicator: Percentage of members who participate in life skills activities
Target: 80% of the AmeriCorps members w ill participate in training activities in First Aid, CPR, Conflict
Resolution, STD Aw areness, WAff training, Disability Aw areness, Diversity, Team Building,
budgeting, and career development activities.
Target Value: 80%
Instruments:WCYCC training logs
PM Statement: Members w ill participate in a variety of training activities designed to increase their life skills. 80% of
the AmeriCorps members w ill participate in training activities in First Aid, CPR, Conflict Resolution,
STD Aw areness,WAIT training, Disability Aw areness, Diversity, Team Building, budgeting, and
career development activities.
Rev. Yrs. Data:100% of the members received 12 hours of instruction in First Aid and adult and infant CPR. Each
renter also received training in team building, conflict resolution, disability aw areness, diversity, and
budgeting activities. Completing members received career assessments, training in resume writing,
completing job applications, and participated in mock interviews.
Result: Intermediate Outcome
Members will participate in a variety of training activities designed to increase their life skills.
Indicator: Percentage of members who complete a minimum of 20 hours of training in a variety of
life skills activities
Target: 80% of the members w ill complete a minimum of 20 hours of training in a variety of activities
designed to increase their life skills.
Target Value: 80%
Instruments:WCYCC training logs
PM Statement: Participation in life skill training activities w ill help prepare members for life after AmeriCorps. 80% of
the members w ill complete a minimum of 20 hours of training in a variety of activities designed to
increase their life skills.
Rev. Yrs. Data:100% of the members participated in a minimum of 20 hours of training activities which included
Adult/Infant CPR, First Aid, conflict resolution,team building, WAff, disability awareness, diversity,
HN aw areness, STD aw areness, and budgeting.
Result: End Outcome
Members will participate in a minimum of 6 life skill training activities which would include First
Aid, CPR, Conflict Resolution, STD Awareness, WAIT training, Disability Awareness, Diversity,
Team Building, budgeting, and career development activities.
Indicator: Percentage of members who receive certificates of completion in 3 of 6 training activities
For Official Use Only
Page 16
For Official Use Only
Result: End Outcome
Target: 80% of the members w ill obtain certificates of completion in 3 out of the 6 training activities.
Target Value: 80%
Instruments:Certificates of Completion
PM Statement: Members w ill participate in a minimum of 6 life skill training activities which would include First Aid,
CPR, Conflict Resolution, STD Aw areness, WAIT training, Disability Awareness, Diversity, Team
Building, budgeting, and career development activities. 80% of the members w ill obtain certificates of
completion in 3 out of the 6 training activities.
Rev. Yrs. Data:100% of the members received certificates three training activities which w ere First Aid,Adult/Infant
CPR, and conflict resolution.
For Official Use Only
Page 17
For Official Use Only
Required Documents
Document Name Status
Audit Sent
Evaluation Sent
For Official Use Only
Page 18
RPr_BGT_424
June 28,2007 3:58 PM
Weld County Youth Conservation Corps (WCYCC)
Board of Weld County Commissioners,Weld County Division of Human
Application ID:07AC072335 Services Budget Dates:
Total Amt CNCS Share Grantee Share
Section I.Program Operating Costs
A.Personnel Expenses 50,717 25,083 25,634
B.Personnel Fringe Benefits 18,269 9,035 9,234
C.Travel
Staff Travel 0 0 0
Member Travel 16,000 4,321 11,679
Total $16,000 $4,321 $11,679
D.Equipment 0 0 0
E Supplies 3,467 1,793 1,674
F.Contractual and Consultant Services 0 0 0
G.Training
Staff Training 0 0 0
Mentor Training 7,620 0 7,620
Total $7,620 $0 $7,620
H.Evaluation 12,533 12,133 400
I.Other Program Operating Costs
Travel to CNCS-Sponsored Meetings 2,000 0 2,000
Total $2,000 $0 $2,000
Section I.Subtotal $110,606 $52,365 $58,241
Section I Percentage 47% 53%
Section II.Member Costs
A.Living Allowance
Full Time(1700 hrs) 133,200 93,240 39,960
1-Year Half Time(900 hours) 0 0 0
Reduced Half Time(675 hrs) 0 0 0
Quarter Time(450 hrs) 0 0 0
Mnirnum Time(300 hrs) 0 0 0
2-Year Half Time(2nd Year) 0 0 0
2-Year Half Time(1st Year) 0 0 0
Total $133,200 $93,240 $39,960
B.Member Support Costs
FICA for Menbers 10,190 7,133 3,057
Worker's Compensation 0 0 0
Health Care 15,804 11,062 4,742
Total $25,994 $18,195 $7,799
Section II.Subtotal $159,194 $111,435 $47,759
Section II.Percentages 70% 30%
Section III.Administrative/Indirect Costs
A.Corporation Fixed Percentage
Corporation Fixed Amount 7,560 0 7,560
Conrrission Fixed Amount 0 0 0
Total $7,560 $0 $7,560
B.Federalty Approved hdirect Cost Rate
Section M.Subtotal $7,560 $0 $7,560
Section III Percentage 0% 100%
Section I+111.Funding Percentages 44% 56%
Budget Totals $277,360 $163,800 $113,560
Budget Total Percentage 59% 41%
Required Match 30%
#of years Receiving CNCS Funds 5
Form 424A Modified SF-424A(4/88 and 12/97)
Page 1
RPf BGT_424
June 28,2007 3:58 PM
Weld County Youth Conservation Corps (WCYCC)
Board of Weld County Commissioners,Weld County Division of Human
Services
Total MSYs 12.00
Cost/MSY $13,650
Form 424A Modified SF-424A(4/88 and 12/97)
Page 2
Budget Narrative for 07AC072335 Page 1 of 4
Budget Narrative: Weld County Youth Conservation Corps (WCYCC) for Board of Weld
County Commissioners, Weld County Division of Human Services
Section I. Program Operating Costs
A. Personnel Expenses
Position/Title-Qty-Annual Salary-%Time CNCS Share Grantee Share Total Amount
Director-1 person(s)at 53157 each x 10%usage 0 5,316 5,316
Team Leader:-1 person(s)at 39852 each x 30%usage 0 11,956 11,956
Crew Leader:-1 person(s)at 33445 each x 100%usage 25,083 8,362 33,445
CATEGORY Totals 25,083 25,634 50,717
B. Personnel Fringe Benefits
Purpose-Calculation-Total Amount CNCS Share Grantee Share Total Amount
Director-Fringe:36.02%of Salary Total Amount 0 1,915 1,915
Team Leader-Fringe:36.02%of salary Total Amount 0 4,307 4,307
Crew Leader-Fringe:36.02%of Salary Total Amount 9,035 3,012 12,047
CATEGORY Totals 9,035 9,234 18,269
C. Travel
Staff Travel
Purpose-Calculation CNCS Share Grantee Share Total Amount
N/A: 0 0 0
CATEGORY Totals 0 0 0
Member Travel
Purpose-Calculation CNCS Share Grantee Share Total Amount
Transportation to project sites,training,all corps day etc.:$1.10 per mile(cost 4,321 11,679 16,000
of van,gas,maintenance)x 14,546 miles
CATEGORY Totals 4,321 11,679 16,000
D. Equipment
Item/Purpose-Qty-Unit Cost CNCS Share Grantee Share Total Amount
https://egrants.cns.gov/espan/main/report.jsp?sid=c0a8020d30d53 a2c6004e5494990a3058... 6/28/2007
Budget Narrative for 07AC072335 Page 2 of 4
N/A:-0 x 5000 0 0 0
CATEGORY Totals 0 0 0
E. Supplies
Item-Calculation CNCS Share Grantee Share Total Amount
Member uniforms/member equipment/safety equipment: 12 members x$250 1,793 1,674 3,467
per member
CATEGORY Totals 1,793 1,674 3,467
F. Contractual and Consultant Services
Purpose-Calculation-Daily Rate CNCS Share Grantee Share Total Amount
N/A:-Daily Rate of 0 0 0 0
CATEGORY Totals 0 0 0
G. Training
Staff Training
Purpose-Calculation-Daily Rate CNCS Share Grantee Share Total Amount
State Commission Training,CYCA tng.,project site tng.:No cost to program- 0 0 0
Daily Rate of 0
CATEGORY Totals 0 0 0
Member Training
Purpose-Calculation-Daily Rate CNCS Share Grantee Share Total Amount
Basic Skills/GED preparation:4 members @$1,800 ea-Daily Rate of 10 0 7,200 7,200
1st Aid,conflict resolution,leadership,team building,HIV awareness,Aids
awareness,Environmental Education,Citizenship,etc.: 1st Aid tng. 12 0 420 420
members @$35 per member-Daily Rate of 0
CATEGORY Totals 0 7,620 7,620
H. Evaluation
Purpose-Calculation-Daily Rate CNCS Share Grantee Share Total Amount
Internal Evaluation by Board:Based on staff time to compile reports and data- 12,133 400 12,533
Daily Rate of 0
hops://egrants.cns.gov/espan/main/report.]sp?sid=c0a8020d30d53a2c6004e5494990a3058... 6/28/2007
Budget Narrative for 07AC072335 Page 3 of 4
CATEGORY Totals 12,133 400 12,533
I. Other Program Operating Costs
Purpose-Calculation CNCS Share Grantee Share Total Amount
Travel to CNCS-Sponsored Meetings: 0 2,000 2,000
CATEGORY Totals 0 2,000 2,000
SECTION Totals 52,365 58,241 110,606
PERCENTAGE 47% 53%
Section II. Member Costs
A. Living Allowance
Item-#Mbrs w/Allow-Allowance Rate-#Mbrs w/o Allow CNCS Share Grantee Share Total Amount
Full Time(1700 hrs): 12 Member(s)at a rate of 11100 each 93240 39,960 133,200
Members W/O allowance 0
1-Year Half Time(900 hours):Member(s)at a rate of each 0 0 0
Members W/O allowance
2-Year Half Time(1st Year):Member(s)at a rate of each 0 0 0
Members W/O allowance
2-Year Half Time(2nd Year):Member(s)at a rate of each 0 0 0
Members W/O allowance
Reduced Half Time(675 hrs):Member(s)at a rate of each 0 0 0
Members W/O allowance
Quarter Time(450 hrs):Member(s)at a rate of each 0 0 0
Members W/O allowance
Minimum Time(300 hrs):Member(s)at a rate of each 0 0 0
Members W/O allowance
CATEGORY Totals 93,240 39,960 133,200
B. Member Support Costs
Purpose-Calculation CNCS Share Grantee Share Total Amount
FICA for Members: 12 members @$11,100 x 7.65% 7,133 3,057 10,190
Worker's Compensation:Weld County is self insured and does not pay
insurance costs.Memebrs are covered for Worker's Compensation as well as 0 0 0
unemployment insurance under this self insured status
Health Care: 12 members @$1,317 per year(NASC) 11,062 4,742 15,804
CATEGORY Totals 18,195 7,799 25,994
https://egrants.cns.gov/espan/main/report.]sp?std=c0a8020d30d53 a2c6004e5494990a3058... 6/28/2007
Budget Narrative for 07AC072335 Page 4 of 4
SECTION Totals 111,435 47,759 159,194
PERCENTAGE 70% 30%
Section III. Administrative/Indirect Costs
A. Corporation Fixed Percentage
Item-Calculation CNCS Share Grantee Share Total Amount
Corporation Fixed Amount:5%x$151,200 0 7,560 7,560
Commission Fixed Amount: 0 0 0
CATEGORY Totals 0 7,560 7,560
B. Federally Approved Indirect Cost Rate
Calculation-Cost Basis-Cost Type-Rate Claimed-Rate CNCS Share Grantee Share Total Amount
CATEGORY Totals 0 0 0
SECTION Totals 0 7,560 7,560
PERCENTAGE 0% 100%
BUDGET Totals 163,800 113,560 277,360
PERCENTAGE 59% 41%
Total MSYs 12.00
Cost/MSY 13,650
Source of Funds
Section Description
Section I:Program Operating Costs-Match from WIA Youth,WIA Adult,
CSBG Section II:Member Costs-Cash from fee for service revenue
Section I.Program Operating Costs generated from projects.Some sponsors pay fee based on project and
others pay fee based on crew week.Section III:Administrative/Indirect
costs-Match from WIA Youth,Adult,and CSBG funds,and cash from fee
for service revenue generated from projects.
Section II Member Costs-Cash from fee for service revenue generated
Section II.Member Costs form projects.Some sponsors pay fee based upon project and others pay
fee based upon a crew week
Section III.Administrative/Indirect Costs Match funds from WIA Youth,Adult,and CSBG funds and cash funds
from fee for service revenue
https://egrants.cns.gov/espan/main/report.j sp?sid=c0a8020d30d53a2c6004e5494990a3058... 6/28/2007
ce
g
z
LL
O p
N c
D f..N4 _
_
C d
;
ct
6 *G 6
0
L L
LL O
y
N
C
Q
N
a
3
m
E
0
rn
c
v
c
v
m
2
d
U
d
▪ co
a m
L
9E
a m
r a
co
N �
OJ ..
N N
C L
C
oW
m
T
O
m
0
C
C
O
U
m
y
N
m
w
/ 0
)
{ |
a
o
\
o
/ f
/ j / ] ]
C_.) |
\ _ ) ce
{ � g a
\ f
( ] § � # 3 &
oco- U 4 f )
W � � � / \ on
P
\
0. / § \
re G �
C es
k eel 41
en
R ) / \ 3 ( ,N N
wo
) co) .N
C at es 7
C § en co 0
a. : ] j )
§tr, | ° ° §
CO N } o
\ 3 )
t
a § /
00 10 O
-Ca 0
/ 0 .,
0ce 6.
§ )
0 Y. ) /
\ ol 32 k To
o
a
) 0
U 0 ` \
» e to
= • on 3
®
to
.0 jen \ \ ) - .0 — t
00 m m m ) a. \
| J
\ f } col
A a. oa k k / *o k *C
te
en
o
o
o
O0
o b
0.
C
:I• \
C• a
C § f
k % t
g C a)
RI ko
3 2
a \ 0 \
\
Ta ) a
`6. bo b )
c cli
■ \ / {
E d 0 a §
u d
t.
§ 5
u I /
15 2 0 )
I01` 0 0co } Ca
14 / ta
cd
"
PLI 0 \ ce
- as \ \ j }
Assurances JJ�rnzaj
a.-L.cruntcut, m (Jag/girl)1 Page 1 oft
gizoith.
ASSURANCES
As the duly authorized representative of the applicant,I certify,to the best of my knowledge and belief,that the applicant:
• Has the legal authority to apply for federal assistance,and the institutional,managerial,and financial capability(including
funds sufficient to pay the non-federal share of project costs)to ensure proper planning,management,and completion of the
project described in this application.
• Will give the awarding agency,the Comptroller General of the United States,and if appropriate,the state,through any
authorized representative,access to and the right to examine all records,books,papers,or documents related to the award;
and will establish a proper accounting system in accordance with generally accepted accounting standards or agency
directives.
• Will establish safeguards to prohibit employees from using their position for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest,or personal gain.
• Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
• Will comply with the Intergovernmental Personnel Act of 1970(42 U.S.C.4728-4763)relating to prescribed standards for
merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration(5 CFR 900,Subpart F).
• Will comply with all federal statutes relating to nondiscrimination.These include but are not limited to:Title VI of the
Civil Rights Act of 1964(P.L. 88-352)which prohibits discrimination on the basis of race,color,or national origin;(b)Title
IX of the Education Amendments of 1972,as amended(20 U.S.C. 1681-1683,and 1685-1686).which prohibits
discrimination on the basis of sex;(c)Section 504 of the Rehabilitation Act of 1973,as amended(29 U.S.C. 794),which
prohibits discrimination on the basis of disability(d)The Age Discrimination Act of 1975,as amended(42 U.S.C.6101-
6107),which prohibits discrimination on the basis of age;(e)The Drug Abuse Office and Treatment Act of 1972(Pt.92-
255),as amended,relating to nondiscrimination on the basis of drug abuse;(f)The Comprehensive Alcohol Abuse and
Alcoholism Prevention,Treatment and Rehabilitation Act of 1970(P.L.91-616),as amended,relating to nondiscrimination
on the basis of alcohol abuse or alcoholism;(g)sections 523 and 527 of the Public Health Service Act of 1912(42 U.S.C.
290dd-3 and 290ee-3),as amended,relating to confidentiality of alcohol and drug abuse patient records;(h)Title VIII of the
Civil Rights Act of 1968(42 U.S.C.3601 et seq.),as amended,relating to nondiscrimination in the sale,rental or financing
of housing;(i)any other nondiscrimination provisions in the National and Community Service Act of 1990,as amended;
and(j)the requirements of any other nondiscrimination statute(s)which may apply to the application.
• Will comply,or has already complied,with the requirements of Titles II and III of the Uniform Relocation Assistance and
Real Property Acquisition Policies Act of 1970(P.L.91-646)which provide for fair and equitable treatment of persons
displaced or whose property is acquired as a result of federal or federally assisted programs.These requirements apply to all
interests in real property acquired for project purposes regardless of federal participation in purchases.
• Will comply with the provisions of the Hatch Act(5 U.S.C. 1501-1508 and 7324-7328)which limit the political activities
of employees whose principal employment activities are funded in whole or in part with Federal funds.
• Will comply,as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C 276a and 276a-77),the Copeland Act
(40 U.S.C 276c and 18 U.S.C. 874),and the Contract Work Hours and Safety Standards Act(40 U.S.C.327-333),regarding
labor standards for Federally assisted construction sub-agreements.
• Will comply,if applicable,with flood insurance purchase requirements of Section 102(a)of the Flood Disaster Protection
Act of 1973(P.L.93-234)which requires the recipients in a special flood hazard area to participate in the program and to
purchase flood insurance if the total cost of insurable construction and acquisition is$10,000 or more.
• Will comply with environmental standards which may be prescribed pursuant to the following:(a)institution of
environmental quality control measures under the National Environmental Policy Act of 1969(P.L.91-190)and Executive
Order(EO) 11514;(b)notification of violating facilities pursuant to EO 11738;(c)protection of wetlands pursuant to EO
11990;(d)evaluation of flood hazards in floodplains in accordance with EO 11988;(e)assurance of project consistency
with the approved state management program developed under the Coastal Zone Management Act of 1972(16 U.S.C 1451
et seq.);(f)conformity of federal actions to State(Clean Air)Implementation Plans under Section 176(c)of the Clean Air
Act of 1955,as amended(42 U.S.C.7401 et seq.);(g)protection of underground sources of drinking water under the Safe
Drinking Water Act of 1974,as amended(P.L.93-523);and(h)protection of endangered species under the Endangered
Species Act of 1973,as amended(P.L.93-205).
• Will comply with the Wild and Scenic Rivers Act of 1968(16 U.S.C 1271 et seq.)related to protecting components or
potential components of the national wild and scenic rivers system.
• Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966,
as amended(16 U.S.C.470),EO 11593(identification and protection of historic properties),and the Archaeological and
Historic Preservation Act of 1974(16U.S.C.469a-1 et seq.).
• Will comply with P.L.93-348 regarding the protection of human subjects involved in research,development,and related
hUps://egrants.cns.gov/ensmisc/eAssur.htm 6/28/2007
Assurances Page 2 of 2
activities supported by this award of assistance.
• Will comply with the Laboratory Animal Welfare Act of 1966(P.L. 89-544,as amended,7 U.S.C.2131 et seq.)pertaining
to the care,handling,and treatment of warm blooded animals held for research,teaching,or other activities supported by
this award of assistance.
• Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. §§4801 et seq.)which prohibits the use of
lead based paint in construction or rehabilitation of residence structures.
• Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984,
as amended,and OMB Circular A-I 33,Audits of States,Local Governments,and Non-Profit Organizations.
• Will comply with all applicable requirements of all other Federal laws,executive orders,regulations,application
guidelines,and policies governing this program.
https://egrants.cns.gov/cnsmisc/eAssur.htm 6/28/2007
Certifications Page 1 of 2
CERTIFICATIONS
Certification-Debarment,Suspension,and Other Responsibility Matters
This certification is required by the regulations implementing Executive Order 12549,Debarment and Suspension,34 CFR Part 85,Section
85.510,Participants'responsibilities.
A.As the duly authorized representative of the applicant,I certify,to the best of my knowledge and belief,that neither the applicant nor
its principals:
•Is presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from covered transactions
by any federal department or agency.
•Has,within a three-year period preceding this application,been convicted of,or had an adverse civil judgment entered in
connection with,fraud or other criminal offense in connection with obtaining,attempting to obtain,or performing a public
(federal,state or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or
commission of embezzlement,theft,forgery,bribery,falsification or destruction or records,making false statements,or
receiving stolen property.
•Is presently indicted for or otherwise criminally or civilly charged by a governmental entity(federal,state or local)with
commission of any of the offenses enumerated in paragraph(I)(b)of this certification,and
•Has not,within a three-year period preceding this application,had one or more public transactions(federal,state or local)
terminated for cause or default;
B. If you are unable to certify to any of the statements in this certification,you must attach an explanation to this application.
Certification-Drug-Free Workplace
This certification is required by the regulations implementing the Drug-Free Workplace Act of 1988,34 CFR Part 85,Subpart F.The
regulations require certification by grantees,prior to award,that they will maintain a drug-free workplace.The certification set out below is
a material representation of fact upon which reliance will be placed when the agency determines to award the grant. False certification or
violation of the certification may be grounds for suspension of payments,suspension or termination of grants,or government-wide
suspension or debarment(see 34 CFR Part 85,Section 85.615 and 85.620).
As the duly authorized representative of the grantee,I certify,to the best of my knowledge and belief,that the grantee will provide a drug-
free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture,distribution,dispensing,possession or use of a controlled
substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about-
•the dangers of drug abuse in the workplace,
•the grantee's policy of maintaining a drug-free workplace.
•any available drug counseling,rehabilitation,and employee assistance programs,and
•the penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;
C.Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required
by paragraph(A);
D.Notifying the employee in the statement required by paragraph(A)that,as a condition of employment under the grant,the employee
will:
•abide by the terms of the statement,and
•notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days
after such conviction.
E.Notifying us within ten days after receiving notice under subparagraph(D)from an employee or otherwise receiving actual notice of
such conviction;
F.Taking one of the following actions,within 30 days of receiving notice under subparagraph(D),with respect to any employee who is
so convicted-
•Taking appropriate personnel action against such an employee,up to and including termination;or
•Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such
https://egrants.cns.gov/cnsmisc/eCerts.htm 6/28/2007
Certifications Page 2 of 2
purposes by a federal,state,or local health,law enforcement,or other appropriate agency;
G.Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs(A)through(F).
Certification-Lobbying Activities
As required by Section 1352,Title 31 of the U.S.Code,as the duly authorized representative of the applicant,I certify,to the best of my
knowledge and belief,that:
• No federal appropriated funds have been paid or will be paid,by or on behalf of the applicant,to any person for influencing
or attempting to influence an officer or employee of any agency,a member of Congress,an officer of Congress in
connection with the awarding of any federal contract,the making of any federal loan,the entering into of any cooperative
agreement,or modification of any federal contract,grant,loan,or cooperative agreement;
• If any funds other than federal appropriated funds have been paid or will be paid 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 member of Congress in connection with this federal contract,grant,loan,or cooperative agreement,the
applicant will submit Standard Form-LLL,"Disclosure Form to Report Lobbying,"in accordance with its instructions;
• The applicant will require that the language of this certification be included in the award documents for all subcontracts at
all tiers(including subcontracts,subgrants,and contracts under grants,loans and cooperative agreements)and that all
subrecipients will certify and disclose accordingly.
Certification-Grant Review Process(State Commissions Only)
I certify that in conducting our review process,we have ensured compliance with the National and Community Service Act of 1990 as
amended,the Corporation's peer review requirements,and all state laws and conflict of interest rules.
https://egrants.cns.gov/cnsmisc/eCerts.htm 6/28/2007
Hello