HomeMy WebLinkAbout20060595.tiff RESOLUTION
RE: APPROVESTATEMENTOF GRANTAWARDAND CHANGE IN SIGNING AUTHORITY
FOR DOMESTIC VIOLENCE AND SEXUAL ASSAULT PROGRAM AND AUTHORIZE
CHAIR TO SIGN
WHEREAS,the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with a Statement of Grant Award and Change
in Signing Authority for the Domestic Violence and Sexual Assault Program between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,on
behalf of the 19th Judicial District Attorney's Office, and the Colorado Division of Criminal Justice,
commencing April 1,2006,and ending March 31, 2007,with further terms and conditions being as
stated in said grant award, and
WHEREAS,after review, the Board deems it advisable to approve said grant, a copy of
which is attached hereto and incorporated herein by reference.
NOW,THEREFORE,BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Statement of Grant Award and Change in Signing Authority for the
Domestic Violence and Sexual Assault Program between the County of Weld, State of Colorado,
by and through the Board of County Commissioners of Weld County,on behalf of the 19th Judicial
District Attorney's Office, and the Colorado Division of Criminal Justice be,and hereby is,approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said grant award.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 1st day of March, A.D., 2006.
♦ BOARD OF COUNTY COMMISSIONERS
tI WELD COJ' TY, COLORADO
ATTEST: gede �1� � 4C2 7 ec/
'•% �� . J. Geile, Chair
Weld County Clerk to the Cis
EXCUSED
BY: tt, ° { lz�^� �tiL ��•• David E. Long, Pro-Tem
De VI
ty Clerk to the Board,, n-c-Th r/4_,_-'
Wil ' m H. Jerke
AP D AS T
Robert D. Masden
ounty Atto y EXCUSED
3 I13k Glenn Vaad
ir
Date of signature:
2006-0595
DA0020
0 : 04 O3-m23-0&
COLORADO DIVISION OF CRIMINAL JUSTICE.
DCJ Form 4-B: CHANGE IN SIGNING AUTHORITY
SUBGRANTEE: District Attorney's Office, 19th Jud. Dist. GRANT NUMBER: 25-VW-19-23
PROJECT TITLE: Domestic Violence and Sexual Assault PROJECT DURATION
Program FROM: 04-01-06 TO: 3-31-07
PREPARED BY: Jo Ann Holden PHONE: (970) 356-4010 DATE: 2-27-06
A GRANT MODIFICATION IS NOT AUTHORIZED UNTIL IT IS APPROVED IN WRITING BY THE DIVISION OF CRIMINAL
JUSTICE. For change,submit two forms with original signatures. One approved copy will be returned for your records. See reverse side for
full instructions.
All other terms and conditions of the original grant with any approved modifications thereto remain in full force and effect. I,
hereby certify that the content of this form, other than the data ent require�d,/has not been altered.
Change requested by: ' "� �
SUBGR• T PROJ: T DIRECTOR Signature ATE
PROJECT DIRECTOR'S MAILING D► •ESS:
District Attorney's Office
PO Box 1167
Greeley, CO 80632
THE PURPOSE OF THIS REQUEST IS TO: CHANGE THE PROJECT DIRECTOR
CHANGE THE FINANCIAL OFFICER
X CHANGE THE AUTHORIZED OFFICIAL
Date Change Effective: 1-1-06
To: M. J. Geile,Chair
From: William H. Jerke
PRINT OR TYPE FULL NAME/TITLE
Agency Name Board of County Commissioners,Weld County,Colorado
Agency Name Board of County Commissioners,Weld County,Colorado ,-_`
P0 Mailing Address Box 758
Greeley,CO 80632-1167 ,,��� - /- /4/ `
Mailing Address PO Box 758 Telephone (970)336-7204 ext 42000 Fax (970)352-0242 1 `c O`
Greet CO 80632-1 7 1 IMI _
( 7\ � .'
!i �_/A�� �/ Email mgeile@co.weldco.us y�,"�
'ATTEST: f /U(L. A'9' r f
Original Sig re of new Official (required) ,
NVEL COUNTY CLERK TO THE BOARD
iBY: aL v i �iul X,40-1 1' i ci MAR 01 2006
DEr TY C ERK TO THE BOARD M. J. Geile, Chair
Reason fo' change: Chair for the Board of County Commissioners changed at the beginning of new year.
***Division of Criminal Justice Use Only***
THIS REQUEST IS Approved Denied, see attached
By:
PROGRAM SPECIALIST, DCJ DATE
Rev. 8-04 DCJ4Bw97.wpd
2006-0595
*� $ COLORADO DIVISION OF CRIMINAL JUSTICE
1876
STATEMENT OF GRANT AWARD (SOGA)
FEDERAL PROGRAM INFORMATION
CFDA Number 16.588
Federal Agency: U.S. Department of Justice
Federal Award Name&Number: S.T.O.P. Violence Against Women Act,
2005-WF-AX-0010
Subgrantee Agency Name: District Attorneys Office, 19th Jud. Dist.
Project Director: Ms. Jo Ann Holden
Project Director Address: P.O. Box 1167
Greeley, CO 80632
Grant Number 25-VW-19-23
Project Title: Domestic Violence and Sexual Assault Program
Grant Period: 4/1/06—3/31/07
Date Issued: 2/1/06
In accordance with provisions of the Colorado Revised Statutes§24-33.5-502, the Division of Criminal Justice hereby awards a
grant to the above-named subgrantee. The attached grant application (Exhibit A), including Special Provisions and Certified
Assurances, is incorporated herein as a part of this document.
APPROVED BUDGET
Budget Category Federal Cash Match In-Kind Match Total
Personnel $10,154 $3,385 $0 $13,539
Supplies and Operating $0 $0 $0 $0
Travel $0 $0 $0 $0
* Equipment $0 $0 $0 $0
* Professional Services $0 $0 $0 $0
TOTAL AWARD $10,154 $3,385 $0 $13,539
AMOUNT
* Purchase of equipment requires prior completion and approval of DCJ Form 13.
* Professional services require prior completion and approval of DCJ Form 16.
SPECIAL CONDITIONS:
1.
2.
3.
Page 1 of 3
Statement of Grant Award (SOGA)
INSTRUCTIONS
1. Grant activities must be based on the approved budget shown on page one of this Statement of Grant Award,and the approved
detailed budget(s) within the attached application, which supersedes any earlier budget request submitted, and which may be
different from the budget originally submitted in your application. The subgrantee must secure prior written approval from DCJ if
there is to be a change in any budget category(see DCJ Form 4-A).
2. The Financial Officer of the project must be provided a copy of this document in order to adequately prepare the necessary financial
reports.
3. The Subgrantee Agency affirms that the parties' agreement consists of a two-part document, the Statement of Grant Award
(SOGA),and Exhibit A,attached to the SOGA,which contains the Grant Application(including Project Summary,Budget and other
Documents), the Certifications, the State Special Provisions, the Grant Requirements, the Federal Certified Assurances, and
signatures of persons authorized to sign on behalf of the Subgrantee Agency on each part of the two-part document.
4. Review carefully the current applicable Administrative Guide of the Division of Criminal Justice for this grant program,that includes
procedures regarding this document, draw-down of grant funds, reporting requirements and requesting grant modifications.
5. This grant award shall be effective upon the final approval by the State Controller or designee. No payment shall be made pursuant
to the grant prior to State Controller approval.
6. This grant award may be voided in whole without further cause if it is not signed by the subgrantee's Authorized Official and
returned to the Division of Criminal Justice within 45 days of the date of issuance.
7. The signature of the Authorized Official below should be the same as the one on the grant application. The subgrantee must
promptly notify the Division of Criminal Justice of any changes in the Authorized Official, Project Director,or Financial Officer, by
completing and submitting DCJ Form 4-B. (If changes have already occurred, submit completed DCJ Form 4-B with this
document).
ADDITIONAL DCJ REQUIREMENTS
(1) Commencement within 60 Days. If the Division concludes that the project has not commenced within 60 days of the start date of
the grant period, the subgrantee must report the following by letter to the Division of Criminal Justice:
a. the steps taken to initiate the project;
b. the reasons for delay; and,
c. the expected starting date.
(2) Operational Within 80 Days. If the Division concludes that the project is not operational within 80 days of the original start date of
the grant period, the Division of Criminal Justice may begin termination or reduction in grant award proceedings as described in
"Special Provisions&Certified Assurances", Section entitled"Termination or Reduction in Grant Award."
(3) All subgrants are conditioned on the ability to report to the Division of Criminal Justice all the information contained on the DCJ
quarterly narrative and financial reporting forms, which are provided with this SOGA. Technical assistance is available upon
request.
(4) These funds cannot be guaranteed beyond the end date of the grant period on page 1 of this SOGA. Unexpended funds remaining
at the end of the grant period must be returned to the Division of Criminal Justice.
RETURN:
ALL SETS of the Statement of Grant Award with ORIGINAL SIGNATURES to: Division of Criminal Justice, Office of Victims
Programs, S.T.O.P. VAWA Program, 700 Kipling Street, Suite 1000, Denver, CO 80215. After other required signatures are
obtained, the white SOGA copy with approved application will be returned to your Project Director.
Page 2 of 3
THE PARTIE HERET HAVE EXE TED THI BI DI B RANT AWARD
SUBGRANTEE: STATE OF COLORADO:
District Attorney's Office, 19th Jud. Dist.
Weld County Board of Commissioners BILL OWENS, GOVERNOR
Legal Name of Subgrantee Agency
846000813
Agency FE (or Social Security) # //2� �,,
By 7 i 44a.' Byei..." ` & `�` 62 .01...e./
SIGNATURE of Authorized Official DIRECTOR Colorado Division of Criminal Justice
M. J. Geile, Chair Carol C. Poole, Acting Director
Print Name& Title of Authorized Official Print Name& Title of DIRECTOR
Date Signed: MAR 0 1 2006 Date Signed: 34 / „,
Provide signature of Corporate/Board Secretary or
equivalent,or Town/City/County Clerk,to certify that person
ATTEST BY: named as Authorized Official above has the legal authority STATE OF COLORADO LEGAL REVIEW:
to enter into binding legal contracts on behalf of this agency, See Contract Routing Waiver #46
MndAs
in f the rson who signed where indicated.
` (or, if not waived)
03/01/2006
Signature Clerk to the Board Date John Suthers, ATTORNEY GENERAL
"„ i t' I �ow n d Jt bY6 (970)356-4000
Title Deput Clerk to e Board Phone BY:
PLACE:lat• Tn,ve.i, ,
or illiklAl , Date Signed:
I
A i �� l ;•"- `/SUBGRANT AWARDS MUST BE APPROVED BY THE STATE CONTROLLER
k4\`:i 0ob-quires that the State Controller approve all state contracts. This subgrant award is not valid until the State
ii•mrr+lesuch assistant as he may delegate,has signed it. If performance begins prior to the date below,the State of
Colorado may not be obligated to pay for the goods and/or services provided.
STATE CONTROLLER:
a‘...--•"4--A
LESLIE M. SHENEFELT
BY `--1...--•" lA� 1. Q----
DATE 3 ft? l a
olel% -0695
Page 3 of 3
Reed by Dal
•
SECTION A: Agency Information(All Applicants) SLY 1 5 2005
Please do NOT change format of table or application.
1.APPLICANT AGENCY: District Attorney's Office,19"Judicial District DCJ USE ONLY
Division or Unit(if applicable): Victim Witness Assistance Unit App#25-VW- Ki - 23
Mailing Address: PO Box 1167
Street Address: 915 Tenth Street Grant# 35- V(n/- I Q- 3,1/43
City/Town: Greeley Zip Code: 80632 Award$ Ia / h y
County: Weld Judicial District: 19 New Applicant Agency
Phone#: 970 356-4010 Fax#: 970 356-4010 7, Continuation Applicant Agency
E-Mail Address: jholden@co.weld.co.us
Federal Employer I.D.Number: 84-6000813
2. CONTACT PERSON: JoAnn Holden Position: Victim Witness Coordinator
Phone# : 970 356-4010 X4747 I Fax# : 970 352-8023 Email: jholden@co.weld.co.us
3. FUNDS REQUESTED: $ 31,850
4. APPLYING FOR: (Please Check Only One Program Box)
VAWA n STATE VALE n VOCA
SECTION B:Protect Narrative
5. BRIEF PROJECT TITLE: Domestic Violence and Sexual Assault Program
6. BRIEF PROJECT SUMMARY:
The Domestic Violence Fast Track and Sexual Assault Program will provide immediate contact with victims,provide referrals,
discuss Victims'Rights and give Criminal Justice System information. This type of contact is crucial when working with victims to
effectively address their needs and to achieve ultimate success in prosecution.
7. DESCRIPTION OF PROJECT FOR WHICH FUNDS ARE BEING REQUESTED.
Weld County is the"fastest-growing"county in Colorado. "Since 2000,southwestern Weld County has grown at a faster rate than Douglas County
did in the 1990s"when it"was heralded as the fastest-growing county in the U.S.,according to the Denver Regional Council of Governments."
DENVER POST,Sunday,August 21,2005. The increasing population results in an ever increasing caseload of victims of crime needing services.
This project addresses two needs in Weld County:
1.Victims of felony domestic violence and sexual assault are not assigned a District Attorney Office Victim Assistant unless the case proceeds to
trial. These victims are kept advised of their rights and resources through notification letters and speak to someone only if they proactively call to
ask questions. Assigning a Victim Witness Assistant to this specific caseload will enhance victim services which ultimately effects the prosecution
of the case.
2.The Domestic Violence Fast Track Program which was modified in January 2005 when the new administration took office,needs a coordinator to
fully enhance this program to it greatest potential. This includes not only better serving victims of misdemeanor domestic violence,but identify law
enforcement training issues which resulting in better cases being filed in the court system ultimately more effective prosecution.
2005 VAWA Common App with Certs 2 Revised 06/03
•
SECTION C: VAWA Goals and Objectives
Please do NOT change format of table or application.
8. GOALS AND OBJECTIVES FOR THIS PROJECT(Important: See instructions firsti
TIC°J.USk Qtly
4/wGategori s E Pros icti Y5ery Courts Mtxetl ipiscretionary
VAWA APPLICANTS ONLY
8 a. Federal Purpose Areas and State Priorities:
f Bede a; ode yi eas eheck dl)`•€that a l State P riorities: check al l tl at a I )
�� p�Y) ( PPY
® Training for Officers,Prosecutors,Judges ® Judicial Education and Court-related Projects
Pi Specialized Units ® Access for Underserved Victims
Z Policies,Protocols,Orders ® Multidisciplinary,Specialized Training
0 Multidisciplinary Coordinated Response ® Specialized Advocacy
® Older&Disabled Women ® Coordinated Response to Sexual Assault
Victim Services ® Protection Order Enforcement
® Stalking ® Collaborative,Community-based System Improvement
❑ Indian Tribes Z Addressing Needs of Underserved Population
® Data Collection&Communication Systems ❑
❑ Training of Sexual Assault Forensic Personnel ❑
f] Assistance for Victims with Immigration Matters ❑
VAWA APPLICANTS
8 b. Need for the Project: (in the space provided,briefly list up to 5 reasons why there is a need for this project in your
community).
1. Need to contact victims of felony domestic violence and sexual assault reactively instead of proactively
2. Need to have more than minimal proactive interaction with victims of misdemeanor domestic violence.
3. Need due to increasing population in Weld County: 47% felony caseload of DV&Sexual Assault from 2003 to 2005.
4. Need due to increasing poulation in Weld County: 13% misdemenaor dv caseload from 2003 to 2005.
5. Need to provide on-going training to law enforcement on predominant aggressor,domestic violence investigations,and
victim dvnamirc
VAWA APPLICANTS ONLY
8 c.Victim Services Activities:
Estimate the number of Adult Female Victims to be served by this project for each Type of Crime,Service, and Underserved
Area. (Est#is the number of Adult Female Victims Only).
Esf# r Type o Crime EsE#'s lei vices Est'# 'iViderserved Area
20 Sexual Assault Crisis Hotline Previous Lack of Access
* Domestic Violence 700 Counseling/Support 650 Rural Women
Stalking 1300 Referral 10 Elderly Women
Dating Violence Shelter/Safehouse - Immigrant Women
Other Violent Crimes: 1435 Specialized Prosecution, 400 Cultural,Language,Ethnic
Law Enforcement or Minority
Probation Advocacy
*1425 Transitional 3 Disabled
Housing/Services
Civil Legal Advocacy Native American
1300 Assistance Obtaining Other:
Restraining Orders
Other:
2005 VAWA Common App with Ceps 3 Revised 06/03
1
VAWA APPLICANTS-Please do NOT change format of table or application.
8. (Continued) GOALS AND OBJECTIVES FOR THIS PROJECT:
8 d.VAWA APPLICANTS ONLY Training Activities and Topics of Training (Complete if applicable to your project)
'Est-# : _ Phe,hldtl}endf?TnUjvidualstloiS r„,00131Ipg
.. tfisaaphne'
Judges ❑ Sexual Assault
Other Court Personnel Z Domestic Violence
30 Law Enforcement(Officers or Deputies) ❑ Stalking
4 Law Enforcement(Victim Assistants) 0 Dating Violence
5 Prosecutors ❑ Protection Orders
2 Prosecution-Based Victim Assistants Z Other: Prosecution-based victim services
5 Non-Profit Victim Service Providers ❑
1 Probation Personnel 0
Parole Personnel ❑
Other: ❑
VAWA APPLICANTS ONLY
8 e.Systems Improvement Activities of Project (If applicable to your project,check any that apply)
O Specialized Law Enforcement Sexual Assault Unit
❑ Specialized Law Enforcement Domestic Violence Unit
® Specialized Domestic Violence Prosecution Unit
❑ Specialized Sexual Assault Prosecution Unit
O Specialized Domestic Violence Probation Unit
Multi-Disciplinary Coordination(i.e.,Task Forces,Coordinating Council,SART)
❑ Other (Specify):
VAWA APPLICANTS ONLY
8 f. CHECK ONE of the following: (See Instructions for additional details.)
O This is a CONTINUATION application requesting funding for the same project components as were funded for the
VAWA FFY2004 grant award period.
Z This is a CONTINUATION application requesting funding for the same project components as were funded for the
VAWA FFY2004 grant award period PLUS NEW PROJECT COMPONENTS which were not previously funded.
❑ This is a NEW application.My agency did not receive VAWA funding for the FFY2004 grant award period.
2005 VAWA Common App with Certs 4 Revised 06/03
VAWA APPLICANTS-Please do NOT change format of table or application.
8 g. (Continued) GOALS AND OBJECTIVES: LIST THE SPECIFIC GOALS AND OBJECTIVES FOR YOUR PROJECT
HERE.Please include no more than 3 goals with no more than 3 objectives each. Goals and Objectives should describe how you will
achieve the outcome/impact/product which will result from grant-funded activities. All goals and objectives must tit on this page
(Exception: multi-agency and multi-project applicants may attach additional page(s). Write the word"NEW"in front of any goals
and objectives associated with NEW project components.
Goal I: To provide direct assistance to victims of domestic violence and sexual assault by reinforcing safety planning,offering
information on counseling,Victim's Compensation, community referrals,Victims' Rights and the Criminal Justice System.
Objective I: By March 31,2007, services will be provided to 1300 misdeameanor domestic violence victims, 125 felony
domestic violence victims and 20 adult sexual assault victims. Underserved victims of cultural, language, or ethnic minority should
be 400. Achieve an 80%approval rating on returned victim surveys and on a quarterly basis,provide a summary of results of the
victim surveys evaluating client satisfaction and uncover positive and negative aspects of the programs and any need for change
Objective II. By March 31,2007,have"meaningful consultation"with 90%of misdemeanor domestic violence victims
the next working day after the crime.
Objective III: By March 31, 2007, achieve an 50%first appear disposition rate on misdeameanor domestic violence
cases. On a quarterly basis,provide a summary of results to prosecutors,law enforcement and judges.
Goal II: Improve the knowledge and enhance prosecution techniques in domestic violence cases.
Objective I: By March 31,2007, train 47 individuals in law enforcement officers&victim assistance,prosecutors,
prosecution based advocates,or non-profit victim service providers on predominant aggressor,domestic violence investigations,
and victim dynamics and the Domestic Violence Fast Track Program. Achieve an 80%approval rating from surveys of trainees.
Objective II. Quarterly,keep statistics of co-defendant and female defendant misdemeanor domestic violence cases.
Goal III: By March 31,2007,collaborate with Law Enforcement Agencies,Probation,and Victim Service Agencies to coordinate
efforts in serving victims of domestic violence.
Objective I: Participate in monthly meetings of Domestic Violence Coalition,Domestic Violence Fast Track,Coordinating
Committee for Victims of Crime, Sexaul Assault Resource Team,Catholic Charities. Include meet with a community agency that
provide services and interpretation for victims from diverse cultural and ethnic backgrounds and obtain literature when available to
continue our collaborative efforts.
•
2005 VAWA Common App with Cens 5 Revised 06'03
SECTION D:Budget Information(All Applicants)
Please do NOT change format of table or application.
Continuation Applicants fill out Sections 1,2 and 3. / New Applicants fill out Section 2 only.
9. BUDGET REQUEST nlIf e;Onit-;hr& hStiat[tE'25. -
Continuation Applicants ALL APPLICANTS Continuation
(Section 1) Applicants with
(Section 2) NEW project
New,continuation,and continuation applicants with new components
components describe 100%of your request in this section. (Section 3)
Current Grant Award REQUESTED BUDGET Note NEW costs
FFY 2004 VAWA FFY2005 VAWA in this column_
PERSONNEL PERSONNEL(Employees of the applicant agency)
Employee/Job Position Employee/Job Position
Patch, Corn Sry Coun 2 $ 3,063 NEW, Community Services Counselor II $ 7,466 $
Blakely,Com Sry Tech $ 2,240 NEW,Community Services Counselor II $ $ 15,950
Gailitis, Corn Sry Tech $ 1,045 $ $
Lopez,Corn Sry Tech $ 1,118 $ $
$ $ $
$ $ $
$ $ $
$ $ $
FICA,Ret.&Fringe $ 1,534 FICA,Retirement&Fringe Benefits $ 1,534 $ ,900
Subtotall$ 9,000 (o1 / 5'I Subtotals %O00- $ 22,850
SUPPLIES AND OPERATING SUPPLIES AND OPERATING EXPENSES(office supplies, Note NEW costs
EXPENSES computer software,training materials,conference registration in this column
fees,copying,rent,phone,postage,&other items under$5,000)
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
Subtotall$ Subtotalls $
IN-STATE TRAVEL IN-STATE TRAVEL(itemize transportation/per diem,etc.) Note NEW costs
$ $ $
$ $ $
$ $ $
Subtotall$ Subtotal i$ $
EQUIPMENT EQUIPMENT(items which cost over$5,000 each) Note NEW costs
$ $ $
S $ $
Subtotall$ Subtotal$ $
PROFESSIONAL SERVICES PROFESSIONAL SERVICES Note NEW costs
$ $ $
$ $ $
$ $ $
Subtotall$ Subtotal$ $
TOTAL FUNDS: $ 9,000 TOTAL FUNDS REQUESTED: $ 9,U0Wr/0j /51 ^ \ $ 22,8SU Of
2005 VAWA Common App with Certs 6 4P ( Ip�/ Revised 06103
VAWA APPLICANTS-Please do NOT change format of table or application.
10. MATCHING FUNDS BUDGET: List the total matching funds. ALL VAWA APPLICANTS ARE REQUIRED TO
PROVIDE LOCAL MATCHING FUNDS FOR THIS PROJECT. THERE ARE NO EXCEPTIONS TO THE MATCH
REQUIREMENT FOR VAWA APPLICANTS. STATE VALE APPLICANTS ARE NOT REQUIRED TO PROVIDE
MATCHING FUNDS. See instructions for more detail.
PERSONNEL(Employees of the applicant agency)
Employee/Job Position
NEW, Community Services Counselor II $ 11,708
FICA,Retirement&Fringe Benefits $ 4,217
Subtotal1$ 15,925
SUPPLIES AND OPERATING EXPENSES(communications,copying,rent,phone,tuition egistration fees&other items
under$5,000)
$
$
Subtotal$
ccOTHER:In-State Travel,Equipment and/or Professional Services (specify)
LiSubtotal$
TOTAL MATCHING FUNDS:$
'SOURCE OF MATCH: (CASH: $ 15,925 IN-KIND: $
11. GRANT BUDGET SUMMARY: This chart sum rizes all dollars by category. All applicants should fill out pertinent
sections.
BUDGET CATEGORIES Funding Requ t In-Kind Match Cash Match TOTALS
Personnel $ 31,850 $ $ 15,925 $ 47,774
Supplies and Operating $ $ $ $
Travel $ $ $ $
quipment $ $ $ $
rofessional Services $ $ $ $
OTALS $ $ $ $
Match Total
Funds equested (cash match+in-kind match) Total Project Cost
$ 1,850 $ 15,925 $ 47,774
P '
2005 VAWA Common App with Cent 7 ,\ Revised 06ar
VAWA APPLICANTS-Please do NOT change format of table or application.
12. BUDGET DETAIL AND JUSTIFICATION: (Do not exceed the two pages allowed for this budget narrative.) Please
provide the following information for each budget category:
PERSONNEL REQUEST: (Also,if you are using personnel or in-kind volunteers as match,please describe here.)
a. Please explain how you arrived at the cost of the salaries and benefits you are requesting:
As recommended by Weld County's Personnel Services,the salary and benefit costs for all positions are established by the Board of
County Commissioners. The County Commmissioners award a cost-of-livng raises and step-increases. These increases are
proposed but not approved at 3.5%for 2006. Benefits are calculated at 36.05%of the yearly salary.
NEW-Community Services Counselor II 1 FTE salary$35,123 +benefits$12,651 =$47,774/year X 66%VAWA =$31,850
b. Please provide the following ADDITIONAL information on the positions for which you are requesting funding.
Employee/Job Position Requested No.Hours :. . No.Hours If THIS grant funding If THIS grant funding
per week '" ! per week will not pay for the will not pay for the
requested 'i":. this position entire position,what is _ entire position,what is
from THIS 1.4 works in the SOURCE of other the AMOUNT of other
grant £jr total. funds that will be used to funds that will be used
funding. pay for the rest of this to pay for the rest of
position? this position?
NEW,Com Ser Counselor II 40 't 40 the new position will not the new position will not
t;
a6 he obtained he obtained
4E0 ll,,rp$1rggwSkS9:j..ob r � „Stil oelanswe tLeLd!(o»ing.s.
c.Fully explain and justify(using concrete data)any increase in dollars and/or positions requested. See instructions for
more detail.
If new request,is this a new position? If not,how was the position funded before? Have other funding sources been cut?
Explain impact of any funding cuts and,justify areas which could not sustain further cuts.
This is a new position to enhance victim services to 1300 misdeameanor domestic violence victims and provide proactive services
to 125 felony domestic violence victims and 20 adult sexual assault victims.
2005 VAWA Common App with Certs 8 Revised 06/03
VAWA APPLICANTS-Please do NOT change format of table or application.
12. BUDGET DETAIL AND JUSTIFICATION(CONTINUED)
d. SUPPLIES AND OPERATING REQUEST AND MATCH: Please see instructions,and fully explain and justify the need
for the current request and for any increase over the last year. Include and identify any supplies and operating used as cash
or in-kind match.
NOT APPLICABLE
e. TRAVEL REQUEST AND MATCH: Please see instructions,and fully explain and justify the need for the current request
and for any increase over last year. Include and identify travel used as cash or in-kind match.
NOT APPLICABLE
f. EQUIPMENT REQUEST AND MATCH: Please see instructions, and fully explain and justify the need for the current
request. Generally,very little equipment will be funded. Include any equipment used as cash or in-kind match.
NOT APPLICABLE
g. PROFESSIONAL SERVICES/CONSULTANTS REQUEST AND MATCH: Please see instructions, and fully explain
and justify the need for the current request and for any increase over last year. Include and identify any professional
services and consultants used as cash or in-kind match. Please note that professional services expenditures require prior
approval by DCJ(Form 16).
NOT APPLICABLE
h. DIFFERENCES FROM LAST YEAR'S REQUEST(Continuation Subgrantees only.) Please identify any new costs in
this request and briefly summarize the reasons for the differences between this year's request and your most recent/current
grant award.
Identify new costs and explain cause of increase or decrease from last years request by line items.
The$22,850 increase from VAWA Grant Funding received last year reflects the addition of new Victim Witness Assistant
to address two needs in the Weld County District Attorneys Office:
1. proactive services to vicitms of felony domestic violence and sexual assault;
2. an enhanced Domestic Violence Fast Track Program which will address better service to victims of misdemeanor
domestic violence,identifying law enforcement training issues,and ultimately create a more effective prosecution.
2005 VAWA Common App with Certs 9 Revised 06/03
VAWA APPLICANTS-Please do NOT change format of table or application.
13. TOTAL AGENCY VICTIM SERVICES FUNDING THAT YOUR AGENCY IS CURRENTLY RECEIVING.
FUNDING START DATE END DATE
AMOUNT
FEDERAL FUNDS: Month / Day / Year Month / Day / Year
VAWA funds: k $9,000 !4t 04 / 01 / 05 tiir 03 / 31 / 06
VOCA funds: d$t- $31,352 N tcr
01 / 01 / 05 I 12 / 31 / 05
FVPSA(ACT)funds: II $ , / / t}1 l
Other US Dept.of Justice funds such as ht;''�' i*}
Byrne(DCSIP),Juvenile Justice,COPS LA�p� $ / / / /
lik
Other Federal funds: rri $ gill? / / °pi; / /
STATE FUNDS:
State VALE funds: 4 $ >j / / !Pk / /
ii G pl' t
State DAAP funds: , $ 1 / /
Other State funds(e.g.general fund) Ir $ N ; / / / /
LOCAL GOVERNMENT FUNDS:
Local VALE funds: Judicial Dist.: 19 1, $77,721 '. 07 / 01 / 05 06 / 30 / 06
Judicial Dist.: 19 i'i �� $36,000 ai 01 / 01 / 05 '; 12 / 31 / 06
• Judicial Dist.: 19 , $70,000 Ea / / y / /
Iik
Judicial Dist: Wit;: $ a,j3, / / isi,'„' / /
Local Government funds: "la's $ 158,563 '11 01 / 01 / 05 ifr- 12 / 31 / 06
spii... t�I jj ,.PP
?x $ h``' / / PPP / /
PRIVATE OR OTHER FUNDS:
Private funds: i $ th / / Ni / /
Other funds: $ 'N t / / s„?, / /
14. DIVERSIFICATION OF FUNDING: In the remaining space,describe the steps you have taken to diversify your funding
sources,and/or incorporate this project into local funding sources,e.g.state or local government funding,and/or broad-based community
sunnort.
The Victim Witness Assistance Program in the Weld County District Attorney's Office utilizes grant funding from Local VALE,
VOCA and VAWA,Administrative Funds from VALE and Victim Compensation and County funding. The VW Unit has
increased its efforts in obtaining volunteer school interns to add more working hours to the many duties the Unit is responsible for
completing. Additional funding sources continue to be sought.
2005 VAWA Common App with Certs 10 Revised 06/03
•
SECTION E: Continuation Applicants Progress Report(Continuation Applicants only)
Please do NOT change format of table or application.
15. Please provide a summary of the progress made in your project during time periods 1 and 2 as defined below. See
instructions for more information.
For the following time periods,please briefly summarize the progress made in meeting your prior and current grant goals
and objectives,the specific services that have been provided,changes or improvements made and/or problems
encountered. See instructions prior to filling out this section.
a. VAWA time period 1: FFY 2003 April 1,2004-March 31,2005 if you received funding during this time period.
The Domestic Violence Court Project exceeded all of its goals and objectives.The project is effective in delivering prosecution-
based services to victims of domestic violence in at least the following ways: First,the project,in cooperation and collaboration
with the prosecutors,judges and other relevant professionals and agencies has developed and is in the process of enhancing the
policies,procedures, services and materials it uses to assist domestic violence victims. Second,the project's quick and
comprehensive response to domestic violence victims,including timely phone,mail and personal contacts with the victims, often
the day after the criminal incident, and offering crisis counseling,information and referral, education and safety planning,
emergency financial assistance. Third,before considering a domestic violence victim's request to have a restraining order modified,
a Victim/Witness staff member meets with the victim for the purpose of receiving extensive safety-planning assistance, including
risk-level inquiries, needs assessment, emergency financial assistance,information and referral. Fourth, as the project deals with
victims who live in a rural area and who include significant numbers of Hispanics/Latinos,bilingual staff has contact with most
reported victims of domestic violence and it is able to do this in a culturally and linguistically effective and sensitive manner. Weld
County District Attorney's Office Victim/Witness Assistance Program maintains an excellent working relationship with the
district's judicial system,22 law enforcement agencies,community groups( CVC Board, VALE Board,Domestic Violence
Coalition, Sexual Assault Resource Team,Long-Term Care Committee) and victim-service providers(public,private and
governmental), and with various state organizations(Colorado District Attorney's Council, Colorado Organization for Victim
Assistance,Division of Criminal Justice). In order to achieve effective coordination with this diverse group of individuals and
organizations,the District Attorney and his staff is actively involved by providing information and statistical data, offering ongoing
training and technical assistance, attending meetings,and participating on committees. Additionally, the District Attorney's Office
provides complete administrative,legal and clerical support for the Crime Victim Compensation Board and the VALE Board,and
the individuals and organizations served by these programs.
b. VAWA time period 2: FFY 2004 April 1,2005-Present (1"&2nd Quarters)if you are currently receiving funding.
The Domestic Violence Project provides domestic violence victims in Weld County,a large rural jurisdiction, with prosecution-
based direct services that will assist them with their emotional,physical and financial needs in order to stabilize their lives, to
provide for a measure of safety and security and to enhance their experience with the Criminal Justice System. Since January 2005,
changes have been made in the Domestic Violence Fast Track Program. The Victim Witness Unit strives to make phone contact
with each victim the next working day to explain what will happen in court to get their input on possible disposition and bond.
Because"meaningful consultations"are achieved with many victims in the morning, more cases reach a disposition in the
afternoon. This process makes the defendant accountable and placed into domestic violence treatment more quickly. Less cases
are now set for trial. Since our initial contact with victims is usually the day after the incident, issues regarding modifying
restraining orders are addressed early and less victims are requesting the restraining order later be modified. The Domestic
Violence Project continues to support victims who appear in court at the first hearing,other subsequent hearings,and trials. To
address the many changes occurring in the DV Fast Track Program,the District Attorney's Office and Law Enforcement meet
monthly to discuss issues which need to be addressed. Some of these issues have been:
1. Informing all law enforcement agencies that they must provide the Weld County Sheriff's Office with victim contact information
at the time a perpetrator is booked into jail and victim contacat information to the District Attorney's Office.
2.Training law enforcement agencies that the non-profit domestic violence agency in Weld County cannot act as a "law
enforcement advocate"or they will loose their confidentiality with the victim.
3.Updating the Victim Notice of Court Hearing to make it more victim-friendly and creating it in Spanish.
4. Identifying law enforcement agencies who would like domestic violence training from the District Attorney's Office and
providing this training.
5. Creating a VOICE brochure to explain to victims how the Jail Victim Notification System works.
2005 VAWA Common App with Ceres 11 Revised 06/0,
•
•
SECTION F: Community Support,Networking,Coordination,Cooperation,& Collaboration(All Applicants)
Please do NOT change format of table or application.
16. COMMUNITY SUPPORT,NETWORKING,COORDINATION AND COLLABORATION
a. LETTERS OF SUPPORT:DIRECTLY FOLLOWING THIS PAGE,PLEASE ATTACH 3 CURRENT LETTERS OF
SUPPORT from referral sources or other collaborating agencies that address these 4 ESSENTIAL ELEMENTS—1).The
need for and importance of the project; 2)Your agency's participation in the local service network; 3)Your agency's
capacity to perform the proposed activities; and 4)Past and current grant project impact. (Please see instruction for
Section F,Item 16a for important information about support letters).
AGENCY PERSON/POSITION DCJ USE ONLY
A Woman's Place Ellen Szabo, Executive Director
Sexual Assault Survivor's Inc. Anpeytu Raben, Executive Director
Probation Victim Services Sheri Mann, Victim Assistant Coordinator
DCJ USE ONLY
b. MEMORANDA OF AGREEMENT OR UNDERSTANDING: List the agencies with which you have active memoranda
of understanding or agreement regarding coordination and provision of services. If necessary,please summarize to fit
space. Do not attach the memoranda to the application, but have available upon request.
A Kid's Place/CARE Child Advocacy Resource Center Weld County Legal Services/Envision
A Women's Place/Adult Sexual Assault Program UNC
Partners/Catholic Charities/Colorado Legal Services
Greeley Police Department THE AGENCIES LISTED AS WELL AS THE DISTRICT
Sexual Assault Survivor's Inc/Area on Aging ATTORNEY'S OFFICE VICTIM WITNESS UNIT HAS
19th JD Probation Victim Services/Weld County Sheriffs A COODINATION AGREEMENT (SEE ATTACHED)
REFERRALS: (if applicable)
c. List the agencies/individuals who make referrals to your program: (List only the most frequently referring
agencies/individuals,no more than 10.)
Greeley Police Department,Victim Services Program
A Woman's Place,Inc.
Sexual Assault Survivor's Inc
A Kid's Place/CASA of Weld County
North Colorado Medical Center
Weld County Department of Social Services •
19th Judicial District Courts
19th Judicial Districe Probation Department Victim Services
Envision
d. List the agencies to which you make referrals for victims served by your agency: (List only the most frequently used,no
more than 10.)
A Woman's Place,Inc.
Catholic Charities,Northern
Child Advocacy Resource&Education(CARE)
Colorado Legal Services
19th Judicial District Probation Department,Victim Services Program
Sexual Assault Survivor's Inc
Weld County Department of Social Services
North Range Behavioral Health Center
Greeley Police Department
2005 VAWA W A Common App with Certs 12 Revised 06101
•
VAWA APPLICANTS-Please do NOT change format of table or application.
17. CULTURALCOMPETENCY PLAN: VAWA applicants are asked to supply a plan to provide culturally
competent services to meet identified needs of racial,cultural and ethnic minority populations. The definition of
cultural competence is: planning to effectively deliver services in a context that is meaningful to the individual's
culture. Please describe: 1)the diverse needs in your community,2)mechanisms you will utilize to assess and address
the needs identified,3)resources available to implement your plan; and 4)the minority population(s)in the
community you serve,the ethnicity of victims served, as well as ethnicity of staff,volunteers and/or board members.
See instructions for further information.
Latinos/Hispanics are a statistically significant minority in the 19th Judicial District at 27%of the population. To assure
sensitivity and relevancy in addressing the needs of Spanish speaking victims,the Victim Witness Unit has a fulltime
Spanish bilingual Victim Witness Assistant. Victim Witness Unit Staff are encouraged to take conversational Spanish classes
offered by Weld County so all staff can at least communicate minimally until the Spanish bilingual Victim Witness Assistant
is available. Positions open in the Unit give a hiring preference to Spanish bilingual applicants.The Victim Rights
Amendment Brochure,Victim Compensation information and other key letters have been translated into Spanish. The
Victim Witness Unit seeks to maintain cultural competency by actively participating in various community groups, education
that is relevant to cultural sensitivity and to proactively be involved in community efforts to assess and address issues and
needs related to cultural competency.
VAWA APPLICANTS
18. VICTIM RIGHTS ACT(See instructions for more information.)
a. Training: What training does your agency provide to direct services staff and volunteers about giving information
to the victim regarding their rights under the Colorado Constitution?
The previous supervisor of the Victim Witness Assistance Unit provided Victim Rights Act training to all new staff and
volunteers including requiring them to read copies of the Victim Rights Brochure and VRA statutes. New staff members
received VRA-specific training from a knowledgeable staff person and were strongly encourage to attend relevant state
b. Date of the last training: continual Training provided by: Jo Ann Holden
c. Does your agency have a statutory mandate to notify victims under the Victims Rights Act? Z Yes ❑ No
If yes,answer d& e.
d. How do you notify victims of their rights under the Victims Rights Act?
The Victim Witness Unit provides written or phone notifications to all victims designated in the Victim Rights Amendment
prior to each of the critical stages of the court system. Initial notices include VRA Brochures,Victim Compensation
information and community resource information.
e. How do you document that such notification has been given,if appropriate?
Documentation of all VRA notifications is maintained on the outside of the DA case file and in the database of DA's Office
including a screen for tracking VRA notices.
f. List the approximate number of notifications made by your agency each year. 20,000
g. Does your agency have a victims' rights brochure that is distributed to victims? ® Yes ❑ No
If yes,please attach one copy in the appendix of the grant application.
h. In what languages is your victims' rights brochure available?
English and Spanish
2005 VAWA Common App with Certs 13 Revised 06103
VAWA APPLICANTS-Please do NOT change format of table or application.
19. VICTIM COMPENSATION(See instructions for more information.)
a. How does your agency regularly inform victims of the Victim Compensation program and assist them in applying when
appropriate?
The Victim Witness Assistance Program provides information to victims concerning Crime Victim Compensation by distributing
Victim Compensation Brochures(English and Spanish)and application forms,referring to Victim Compensation in VRA
Brochures,providing Victim Compensation Training at law enforcement departments,victim service agencies and other local
groups, and explaining and helping victims to complete application forms.
•
b. Are there any major issues that hinder victim assistance programs in assisting crime victims in filing for Victim
Compensation benefits and understanding eligibility?
No
c. Are any of the services provided by your agency eligible for Victim Compensation reimbursement? ❑ Yes ® No
List services:
N/A
d. Please describe how your agency tracks funds and services to ensure that it is not using VAWA funds to provide services
which could be or have been paid for by Victim Compensation.
N/A
e. Does your agency regularly conduct/receive Victim Compensation training for direct services staff or volunteers?
® Yes D No
Date of last training: continua Training provided by: Karol Patch,Victim Compensation Administrator
2005 VAWA Common App with Certs 14 Revised 06/03
•
•
SECTION G:Evaluation(All Applicants)
Please do NOT change format of table or application.
20. EVALUATION: Describe how you will evaluate and measure the OUTCOME,IMPACT,or PRODUCT of this project.
(Please see instructions.)
VAWA Applicants-In this evaluation narrative,please be sure to address the following VAWA-required elements -
1. Specifically define the OUTCOME,IMPACT, or PRODUCT you intend to achieve; 2. Explain how you will document the
PROGRESS on your objectives; and 3.Explain how you will measure the degree to which your grant-funded activities are
achieving the intended OUTCOME,IMPACT, or PRODUCT.
OUTCOME
Providing services to 1300 misdeameanor domestic violence primary victims, 125 felony domestic violence primary victims,and 20
sexual assualt victims.
OUTCOME&IMPACT
Completing intial"meaningful consultation"to 90%of misdemeanor domestic violence victims within 24 hours of the criminal
episode which resulted in a 50%disposition rate at the defendant's initial hearing.
IMPACT
Gathering statistics of co-defendant and female defendant domestic violence cases to identify training issues which should be
addressed with law enforcement agencies on predominate aggressor,domestic violence investigations and victim dynamics.
OUTCOME
Does training correlate with a reduction of co-defendant cases and female defendant cases?
IMPACT: Victim Surveys
a.Did victims feel their contact with the court system was positive under the circumstances?What could have been done better?
b. Did victims feel that Victim Witness Unit Staff was accessible by phone?
c.Did victims feel that what would happen at court hearings was explained adequately to them?
2005 VAWA Common App with Certs 15 Ream 06/03
•
SECTION H: Financial Management (All Applicants)
Please do NOT change format or table or application.
21. FINANCIAL MANAGEMENT:Please answer the following questions.
a. Please provide the date of your last independent audit or financial review: 12-31-04
Has a copy been previously submitted to DCJ? ❑YES / ® NO.
If YES,to which program? NEW AUDIT
Include one copy of your most recent audit or financial review.including any management report or other auditor
comments in the appendix. Also,if there were findings,please attach the audit resolutions and/or corrective action plan.
b. Does your agency expend over$500,000 from combined federal sources in a year? If"yes" please ❑ Yes ® No
attach a copy of the A-133 audit,including audit resolutions and/or corrective action plan.
c. Please respond to the following questions about whether your accounting system meets the criteria for managing
federaUstate grant funds. (These questions cover areas that will be monitored by DCJ staff. They are not intended to
be all inclusive and do not substitute for the agency's responsibility to meet all federal and state requirements for these
grant funds.)
® Yes ❑ No Does your accounting system separate ALL revenues and expenditures by funding source?
Does your system track revenues and expenditures for each grant award separately through
® Yes ❑ No a sub-ledger system?
Does your system allow expenditures to be classified by the broad budget categories listed in
the approved budget in your grant,i.e.Personnel,Supplies and Operating,Travel,
® Yes ❑ No Equipment and Professional Services?
® Yes ❑ No Do you reconcile sub-ledgers to your general ledger at least monthly?
® Yes 0 No Do you mark your invoices with the grant number?
Do you maintain time sheets,signed by the employee and supervisor for each employee paid
® Yes ❑ No by DCJ grant funds?
• Yes ❑ No ❑ N/A Does your accounting system clearly identify the funds and amount used as a cash match?
If you are using in-kind match such as volunteer hours,have you clearly documented how
you are keeping track of the match that you are reporting on your quarterly financial 1-A
® Yes O No ® N/A report?
® Yes ❑ No Do you have written financial policies and procedures in place?
Do you have accounting internal controls in place,such as separation of duties,two
® Yes 0 No signatures on certain checks,reconciliations or other reviews?
For Continuation Applicants only.
® Yes ❑ No Do you use your accounting system data to prepare your quarterly financial reports for DCJ?
® Yes ❑ No Do you reconcile your accounting system data with your quarterly financial reports for DCJ?
d. If you answered NO to any of the questions above,please provide an explanation.
N/A
22. SECTION I: FUND SPECIFIC INFORMATION—Federal Reporting Information:FFY 2005 VAWA Subgrantees
will be required to report statistical and narrative progress data on the revised 2-VAWA quarterly report form.
2005 VAWA Common App with Certs 16 Revised o6/u3
Special Provisions and Certified Assurances Page 1 of 9
Special Provisions&Certified Assurances must remain attached to the application
CHECK BELOW TO INDICATE WHICH CATEGORY BEST DESCRIBES YOUR AGENCY:
Inter-Governmental Grant
f Grant to a Colorado State Agency
Grant to a Unit of Local Government,Tribal Government, or Special District.
n Grant to a Non-Profit,Private Organization(Non-Governmental)
The applicant certifies by signing that the project described in this application meets all the requirements of the applicable governing
legislation as indicated below; that all information contained in the application is correct; that there has been appropriate coordination
with affected agencies; and,that the applicant will read, understand and comply with all provisions of the governing legislation and all
other applicable federal and state laws, rules and regulations that have been or may hereafter be established. The applicant further
understands and agrees that any subgrant award received as a result of this application shall be subject additionally to the grant
conditions set forth in the Statement of Grant Award, and in the current applicable Administrative Guide of the Division of Criminal
Justice.
GOVERNINGLEGISLATION FOR THIS GRANT PROGRAM:
Violence Against Women Act Funds(VAWA). From the United States Department of Justice, Office of Justice Programs, under federal statutory
authority 42 U.S.C., Chapter 46, Section 3711,et seq., as amended, and under applicable program rules and regulations established by the federal
program office.
A. STANDARD STATE SPECIAL PROVISIONS
Revised Date: March 2005
1. CONTROLLER'S APPROVAL.CRS§24-30-202(1)
This subgrant award shall not be deemed valid until it has been approved by the Controller of the State of Colorado or such
assistant as maybe designated.
2. FUND AVAILABILITY.CRS§24-30-202(5.5)
Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose
being appropriated,budgeted,and otherwise made available.
3. INDEMNIFICATION.
FOR NON-INTERGOVERNMENTAL GRANTS ONLY:
a. The Subgrantee Agency shall indemnify, save,and hold harmless the State, its employees and agents, against any and all
claims, damages, liability and court awards including costs, expenses, and attorney fees incurred as a result of any act or
omission by the Subgrantee Agency, or its employees, agents, subcontractors, or assignees pursuant to the terms of this
subgrant award.
FOR INTERGOVERNMENTAL GRANTS ONLY:
b. Indemnity: To the extent authorized by law, the Subgrantee Agency shall indemnify, save, and hold harmless the State
against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees incurred as a
result of any act or omission by the Subgrantee Agency, or its employees, agents, subcontractors, or assignees pursuant
to the terms of this subgrant award.
c. No term or condition of this grant shall be construed or interpreted as a waiver, express or implied, of any of the
immunities,rights, benefits,protection, or other provisions for the parties, of the Colorado Governmental Immunity Act,
Section 24-10-101, et seq., C.R.S. or the Federal Tort Claims Act, 28 U.S.C. 2671, et seq. as applicable, as now or
hereafter amended.
Special Provisions and Certified Assurances Page 2 of 9
' Special Provisions&Certified Assurances must remain attached to the application
4. INDEPENDENT CONTRACTOR. 4 CCR 801-2:
(THIS PROVISION IS NOT APPLICABLE TO GRANTS TO COLORADO STATE AGENCIES):
THE SUBGRANTEE AGENCY SHALL PERFORM THE DUTIES FUNDED UNDER THIS GRANT AS AN INDEPENDENT
CONTRACTOR AND NOT AS AN EMPLOYEE OF THE STATE. NEITHER THE SUBGRANTEE AGENCY NOR ANY AGENT,
SUB-CONTRACTOR, OR EMPLOYEE OF THE SUBGRANTEE AGENCY SHALL BE OR SHALL BE DEEMED TO BE AN
AGENT OR EMPLOYEE OF THE STATE BY VIRTUE OF THIS SUBGRANT. SUBGRANTEE AGENCY SHALL PAY WHEN DUE
ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID PURSUANT
TO THIS GRANT. SUBGRANTEE AGENCY ACKNOWLEDGES THAT THE SUBGRANTEE AGENCY AND ITS EMPLOYEES
ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE SUBGRANTEE AGENCY OR THIRD
PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH
COVERAGE. SUBGRANTEE AGENCY SHALL NOT HAVE AUTHORIZATION, EXPRESS OR IMPLIED,TO BIND THE STATE
TO ANY AGREEMENTS,LIABILITY,OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. IF THIS GRANT
PROVIDES FUNDS FOR ANY PERSONAL SERVICES, SUBGRANTEE AGENCY SHALL PROVIDE AND KEEP IN FORCE
WORKERS COMPENSATION (AND SHOW PROOF OF SUCH INSURANCE) AND UNEMPLOYMENT COMPENSATION
INSURANCE IN THE AMOUNTS REQUIRED BY LAW. SUBGRANTEE AGENCY AGENCY SHALL BE SOLELY
RESPONSIBLE FOR THE ACTS OF ITS EMPLOYEES,INDEPENDENT SUB-CONTRACTORS AND AGENTS.
5. NON-DISCRIMINATION. •
The Subgrantee Agency agrees to comply with the letter and the spirit of all applicable state and federal laws respecting
discrimination and unfair employment practices.
6. CHOICE OF LAW.
The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,
execution, and enforcement of this subgrant. Any provision of this subgrant,whether or not incorporated herein by reference,
which provides for arbitration by any extra-judicial body or person or which is otherwise in conflict with said laws, rules, and
regulations shall be considered null and void. Nothing contained in any provision incorporated herein by reference which
purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any
action at law whether by way of complaint, defense, or otherwise. Any provision rendered null and void by the operation of
this provision will not invalidate the remainder of this subgrant to the extent that the subgrant is capable of execution. At all
times during the performance of this subgrant, the Subgrantee Agency shall strictly adhere to all applicable federal and State
laws,rules,and regulations that have been or may hereafter be established.
7. VENDOR OFFSET.CRS 24-30-202(1)&CRS §24-30-202.4
(THIS PROVISION APPLIES TO NON-INTERGOVERNMENTAL GRANTS ONLY)
Pursuant to CRS 24-30-202.4 (as amended),the State Controller may withhold debts owed to State agencies under the
vendor offset intercept system for: (a) unpaid child support debt or child support arrearages; (b) unpaid balance of
tax, accrued interest, or other charges specified in Article 21, Title 39, CRS; (c) unpaid loans due to the Student Loan
Division of the Department of Higher Education; (d) owed amounts required to be paid to the Unemployment
Compensation Fund; and (e) other unpaid debts owing to the State or any agency thereof, the amount of which is
found to be owing as a result of final agency determination or reduced to judgment as certified by the controller.
8. EMPLOYEE FINANCIAL INTEREST.CRS§24-18-201 & CRS§24-50-507
The signatories aver that to their knowledge, no employee of the State of Colorado has any personal or beneficial interest
whatsoever in the service or property described herein.
9. SOFTWARE PIRACY PROHIBITION.(Governor's Executive Order D 002 00)
No state or other public funds payable under this subgrant shall be used for the acquisition, operation or maintenance of
computer software in violation of United States copyright laws or applicable licensing restrictions. The Subgrantee Agency
hereby certifies that, for the term of this subgrant and any extensions, the Subgrantee Agency has in place appropriate
systems and controls to prevent such improper use of public funds. If the State determines that the Subgrantee Agency is in
violation of this paragraph, the State may exercise any remedy available at law or equity or under this subgrant, including,
without limitation, immediate termination of the Subgrant and any remedy consistent with United States copyright laws or
applicable licensing restrictions.
10. FEDERAL FUNDING
This subgrant is subject to and contingent upon the continuing availability of federal funds for the purposes hereof.
Special Provisions and Certified Assurances Page 3 of 9
Special Provisions&Certified Assurances must remain attached to the application
B. GRANT REQUIREMENTS
1. FINANCIAL &ADMINISTRATIVE MANAGEMENT
a. The Subgrantee Agency assures that fund accounting, auditing, monitoring, evaluation procedures and such records
as necessary will be maintained to assure adequate internal fiscal controls, proper financial management, efficient
disbursement of funds received, and maintenance of required source documentation for all costs incurred. These
principles must be applied for all costs incurred whether charged on a direct or indirect basis.
b. All expenditures must be supported by appropriate source documentation. Only actual, approved, allowable
expenditures will be permitted.
c. The Subgrantee Agency assures that it will comply with the provisions of the current applicable Administrative
Guide of the Division of Criminal Justice which is hereby incorporated by reference. However, such a guide cannot
cover every foreseeable contingency, and the Subgrantee Agency is ultimately responsible for compliance with
applicable state and federal laws,rules and regulations.
2. PAYMENT&REPORTING
a. The Division of Criminal Justice will pay the Subgrantee Agency the reasonable and allowable costs of
performance, in accordance with current Colorado State Fiscal Rules, not to exceed the amount specified herein as
the Total Award Amount,as identified in the Statement of Grant Award.
b. The Division's requirements for invoice, advance payments, and cost reporting submissions are contained in the
DCJ Form 3 - Cash Request Procedures, and DCJ Form 1-A - Subgrant Financial Report, which are hereby
incorporated by reference.
c. Advance payments cannot exceed 30-day operating expenses.
d. The Subgrantee Agency assures that it shall maintain data and information to provide accurate quarterly program
narrative and financial reports to the Division. Said reports shall be provided in such form and contain such data and
information as the Division of Criminal Justice reasonably requires to administer the program.
e. The Subgrantee Agency assures that quarterly financial and narrative reports shall be submitted within 30 days of
the end of each calendar quarter and shall be current and actual.
f. The Subgrantee Agency further assures that final financial and narrative reports shall be submitted on the forms
provided by the Division of Criminal Justice within 45 days of the end date of the subgrant.
g. The Division reserves the right to make and authorize modifications, adjustments, and/or revisions to the Grant
Award for the purpose of making changes in budget categories, extensions of grant award dates, changes in goals
and objectives, and other modifications which do not change the total amount of the Grant Award. The Division's
requirements for such grant adjustments are contained in the procedures for DCJ Forms 4A, 4B, 4C, and 4D, which
are hereby incorporated by reference.
h. The Division may withhold payment in the event the Subgrantee Agency fails to comply with conditions, including
all financial reporting requirements and certifications contained in this grant award.
3. PROCUREMENT AND CONTRACTS
a. The Subgrantee Agency assures that open, competitive procurement procedures will be followed for all purchases
under the grant. All contracts for professional services, of any amount, and equipment purchases over five thousand
dollars (per item, with a useful life of at least one year) must receive prior approval by the Division of Criminal
Justice.
b. The Subgrantee Agency assures that no contract or agreement will be made for execution of project activities or
provisions of services (other than purchase of supplies or standard commercial or maintenance services) that is not
incorporated in the approved application or approved in advance by the Division of Criminal Justice.
c. The Subgrantee Agency assures that contractors/vendors who assist the Subgrantee Agency to develop
specifications, requirements, statements of work and/or Request For Proposal for a proposed procurement shall be
excluded from bidding or submitting a proposal to compete for the award of such procurement.
d. The Subgrantee Agency assures that where activities supported by this subgrant produce any discovery or invention,
original computer programs, writing, sound recordings, pictorial reproductions, drawing or other graphical
representation and works of any similar nature,the following requirements apply:
i. The Division of Criminal Justice reserves a royalty-free, non-exclusive, and irrevocable license to
reproduce, publish, or otherwise use, and authorize others to use, for Federal government purposes: The
copyright in any work developed under an award or subaward: and 2) Any rights of copyright to which a
recipient or subrecipient purchases ownership with support.
ii. If any program produces patentable items, patent rights, processes or inventions, in the course of work
sponsored by the Federal award or subaward funds, such facts must be promptly and fully reported to the
awarding agency,Division of Criminal Justice. The awarding agency shall determine whether protection
-
Special Provisions and Certified Assurances Page 4 of 9
Spacial Provisions&Certified Assurances must remain attached to the application
on the invention or discovery shall he sought. The awarding agency will also determine how rights in the
invention or discovery (including rights under any patents issued thereon) shall be allocated and
administered in order to protect the public interest pursuant to published Presidential and government
memorandums and guidelines, and the regulations promulgated by the Department of Commerce in 37
CFR Part 401.
iii. When issuing statements, press releases, requests for proposals, bid solicitations, and other published
documents describing projects or programs funded in whole or in part with these grant funds, all
Subgrantee Agencies must clearly:
a) State the percentage of the total cost of the program or project, which will be financed with this
grant money;
b) State the dollar amount of state or federal funds for the project or program;
c) Use the phrase-"This project was supported by grant# , issued by the Colorado Division of
Criminal Justice."
e. The Subgrantee Agency may not assign its rights or duties under this grant without the prior written consent of the
Division of Criminal Justice.
4. AUDIT,RECORD-KEEPING,AND MONITORING/INSPECTION
a. The Subgrantee Agency assures that it will procure an audit or financial review by a CPA or licensed public
accountant incorporating the subgrant. If the agency expends more than $500,000 per year in combined federal
funds, an audit must be conducted in accordance with OMB Circular A-133 (Audits of States, Local Governments,
and non-profit organizations).
i. At such time as the audit or financial review is completed, ONE COPY OF THE REPORT, INCLUDING
THE CORRESPONDING MANAGEMENT LETTER, MUST BE FORWARDED TO THE DIVISION
OF CRIMINAL JUSTICE for clearance.
ii. The Subgrantee Agency accepts responsibility for the costs of a financial program audit to be performed by
the Department of Public Safety in the event that the audit report or financial review:
a) does not meet the applicable A-133 or DO standards;
b) is not submitted in a timely manner; or,
c) does not provide an audit response plan with corresponding corrections made sufficient to satisfy
any audit fmdings.
b. The Subgrantee Agency assures that:
i. It will retain all project records,as will facilitate an effective audit,for seven years after the end of the state
fiscal year that includes the end date of the grant. (For example if the grant ended 9/30/91, the state FY
would be July 1, 1991-June 30, 1992. The files could be destroyed after 6/30/99);except,
ii. If an audit is in progress and/or the findings of a completed audit have not been resolved satisfactorily,then
records must be retained beyond the seven-year period until such issues are resolved.
c. The Subgrantee Agency assures that it will keep copies of all documents, correspondence, and required receipts
related to this subgrant in a separate file bearing the project title and grant number.
d. The Division may periodically request submission of supporting financial and programmatic documentation,
subcontracts, general and sub-ledgers for the purpose of monitoring compliance with the grant award via desk
review, or in preparation for an on-site monitoring visit. Routine or special on-site visits may be conducted at the
subgrant agency, and at the location of any collaborating entities, for the same purpose. Subgrantee Agencys will be
notified in advance of any on-site monitoring visit.
e. The Subgrantee Agency assures that the Division of Criminal Justice, Colorado Department of Public Safety, shall
have access for purposes of monitoring, audit and examinations to any bonds, documents,papers and records of the
Subgrantee Agency and to relevant books and records of subcontractors of the Subgrantee Agency. It is the
responsibility of the Subgrantee Agency to notify any of its project collaborators and subcontractors of these
provisions.
f. The Subgrantee Agency assures that signatories of the application and subgrant award and personnel employed
through this subgrant will appear when requested at any administrative hearing, monitoring site visit, conference or
meeting conducted by the Division of Criminal Justice.
5. COLORADO VICTIM RIGHTS ACT
The Subgrantee Agency assures that the application signatories, all staff and all volunteers assigned to the funded project
have read and understand the rights afforded to crime victims pursuant to § 24-4.1-302.5 C.R.S., and the services delineated
pursuant to §§ 24-4.1-303 and 24-4.1-304 C.R.S.,commonly known as the Victim Rights Act, and enabling legislation.
6. TERMINATION or REDUCTION IN GRANT AWARD
The Division will monitor the performance of the Subgrantee Agency against goals and performance standards as found in
the application required herein. The Division will provide reasonable assistance to the Subgrantee Agency in the
Special.Provisions and Certified Assurances Page 5 of 9
Special Provisions&Certified Assurances must remain attached to the application
development of project goals, performance standards and subgrant requirements. Any determination of substandard
performance on the part of the Subgrantee Agency shall be within the discretion of the Division, based upon the Division's
review of the terms and conditions of the Grant Award,the application and project summary, the grant terms and assurances,
and the requirements of applicable law. Substandard performance, as determined by the Agency, shall constitute non-
compliance,which may result in termination for cause, or reduction of the Grant Award for cause, as follows:
a. Reduction In Grant Award Amount for Cause
i. The Division may reduce the total Statement of Grant Award amount for cause, without compensation for
reduction costs.
ii. If the state reduces the grant amount for cause, it will first give ten (10) days written notice to the
Subgrantee Agency, stating the reasons for reduction, steps taken to correct the problems, and the date the
subgrant award amount will be reduced in the event problems have not been corrected to the satisfaction of
the Division.
iii. In the event this grant is reduced for cause, the Division will only reimburse the Subgrantee Agency for
acceptable work or deliverables received up to the date of reduction.
iv. In the event this grant is reduced for cause, final payment to the Subgrantee Agency may be withheld at the
discretion of the Division until completion of final Division review.
b. Termination for Convenience:
i. Either party may terminate the grant with thirty days written notice of intent to cancel or terminate.
ii. If the grant is terminated for convenience by either the Subgrantee Agency or the state, the Subgrantee
Agency shall be paid the necessary and allowable costs incurred through the date of termination, but not
exceeding a prorated amount based on the number of days of project operation prior to the date of
termination.
c. Termination for Cause:
i. The Division may terminate the grant for cause without compensation for termination costs.
ii. If the state terminates the grant for cause, it will first give ten (10) days written notice to the Subgrantee
Agency, stating the reasons for termination, steps taken to correct the problems, and the date the subgrant
will be terminated in the event problems have not been corrected to the satisfaction of the Division.
iii. In the event this grant is terminated for cause, the Division will only reimburse the Subgrantee Agency for
acceptable work or deliverables received up to the date of termination.
iv. In the event this grant is terminated for cause, final payment to the Subgrantee Agency may be withheld at
the discretion of the Division until completion of final Division review.
d. Any equipment purchased under this grant would revert, at the option of the Division, to the Division of Criminal
Justice upon termination of the grant for any of the above reasons.
7. ORDER OF PRECEDENCE
Any inconsistency or conflict in this grant shall be resolved by giving precedence in the following order: (a) Special
Provisions and Certified Assurances,(b) Statement of Grant Award;and,(c)the final approved Subgrant Application.
8. DISPUTE RESOLUTION(THIS PROVISION APPLIES ONLY TO INTERAGENCY AGREEMENTS):
Any failure of either party to perform in accordance with the terms of this agreement shall constitute a breach of the
agreement. Any dispute concerning the performance of this agreement which cannot be resolved at the divisional level shall
be referred to superior departmental management staff designated by each department. Failing resolution at that level,
disputes shall be presented to the executive directors of each department for resolution. Failing resolution by the executive
directors, the dispute shall be submitted in writing by both parties to the State Controller, whose decision on the dispute will
be final.
C. FEDERAL CERTIFIED ASSURANCES
1. FEDERAL PUBLIC POLICY ASSURANCES
a. The Subgrantee Agency hereby agrees that it will comply, and all of its contractors will comply with the applicable
provisions of:
i. Title I of the Omnibus Crime Control and Safe Streets Act of 1968, as amended;
ii. The Juvenile Justice and Delinquency Prevention Act and/or the Victims of Crime Act, as appropriate;
iii. All other applicable Federal laws, orders, circulars,regulations or guidelines.
b. The Subgrantee Agency hereby agrees that it will comply, and all of its contractors will comply with the provisions
of 28 CFR applicable to grants and cooperative agreements including:
i. Part 18,Administrative Review Procedure;
ii. Part 22,Confidentiality of Identifiable Research and Statistical Information;
Special.Provisions and Certified Assurances Page 6 of 9
• Special Provisions&Certified Assurances must remain attached to the application
iii. Part 23, Criminal Intelligence Systems Operating Policies;
iv. Part 30 Intergovernmental Review of Department of Justice Programs and Activities;
v. Part 35,Nondiscrimination on the Basis of Disability in State and Local Government Services:
vi. Part, 38,Equal Treatment for Faith Based Organizations;
vii. Part 42 Nondiscrimination/Equal Employment Opportunity Policies and Procedure;
viii. Part 61 Procedures of Implementing the National Environmental Policy Act;
ix. Part 63 Floodplain Management and Wetland Protection Procedures;and,
x. Federal Laws or regulations applicable to Federal Assistance Programs.
2. FINANCIAL&ADMINISTRATIVE MANAGEMENT
a. Subgrantee Agency assures that it will comply with appropriate federal cost principles and administrative
requirements applicable to grants as follows:
i. For state,local or Indian tribal government entities;
a) OMB Circular A-87, Cost Principles for State, Local&Indian Tribal Governments
b) OMB Circular A-102, Common Rule-Uniform Administrative Requirements for Grants and
Cooperative Agreements to State and Local Governments
c) 28 CFR 66, Uniform Administrative Requirements for Grants and Cooperative Agreements to
State and Local Governments
ii. For non-profit organizations;
a) OMB Circular A-122, Cost Principles for Non-Profit Organizations
b) OMB Circular A-110, Uniform Administrative Requirements for Grants and Agreements with
Institutions of Higher Education,Hospitals and Other Nonprofit Organizations
c) 28 CFR 70, Unfbrnt Administrative Requirements for Grants and Cooperative Agreements with
•
Institutions of Higher Education, Hospitals, and other Non-Profit Organizations
iii. For colleges and universities;
a) OMB Circular A-21, Cost Principles for Educational Institutions
b) OMB Circular A-110, Uniform Administrative Requirements for Grants and Agreements with
Institutions of Higher Education, Hospitals and Other Nonprofit Organizations
c) 28 CFR 70, Uniform Administrative Requirements for Grants and Cooperative Agreements with
Institutions of Higher Education, Hospitals, and other Non-Profit Organizations
iv. For each agency spending more than$500,000 per year in federal funds from all sources;
a) OMB Circular A-133,Audits of States, Local Governments and Nonprofit Organizations
b. The Subgrantee Agency assures that it will comply with the provisions of the Office of the Comptroller, Office of
Justice Programs OC Financial Guide for Grants,current edition. (For practical purposes,the requirements pertinent
to the management of these funds have been extracted from the above documents and are contained in the current
applicable Administrative Guide of the Division of Criminal Justice, which is hereby incorporated by reference.
However, such a guide cannot cover every foreseeable contingency, and the Subgrantee Agency is ultimately
responsible for compliance with applicable state and federal laws,rules and regulations.)
3. NON-SUPPLANTING OF FUNDS (Governmental Agencies Only)
a. The Subgrantee Agency certifies that any required matching funds used to pay the non-federal portion of the cost of
this subgrant are in addition to funds that would have otherwise been made available for the purposes of this project.
b. The Subgrantee Agency certifies that federal funds made available under this grant:
i. Will not be used to supplant state or local funds;
ii. That the Subgrantee Agency's expenditures for the purpose described in this application for the annual
period are as great as for the preceding year plus the average annual increment in such expenditures for the
past two,three,four or five years;OR
iii. Where the certification above(3bii) cannot be made, and there is a reduced or unchanged local investment,
then the Subgrantee Agency shall give a written explanation demonstrating that the Subgrantee Agency's
reduced or unchanged commitment would have been necessitated even if federal financial support under
this federal grant program had not been made available.
4. PROHIBITIONS ON LOBBYING WITH FEDERAL FUNDS (Subgrantee Agencies receiving$100,000 or more in total
federal funds per year. See 28 CFR Part 69.)
The prospective Subgrantee Agency certifies,by submission of this proposal,that:
a. No federal funds received through this subgrant 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 the making of any federal grant, the entering into of any cooperative
agreement, and the extension, continuation,renewal, amendment, or modification of any federal grant or cooperative
. Special,Provisions and Certified Assurances Page 7 of 9
Special Provisions&Certified Assurances must remain attached to the application
agreement;and,
b. If any funds other than funds through this subgrant 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 subgrant, the prospective Subgrantee Agency shall
complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities."
5. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY
EXCLUSION (Subgrantee Agencies receiving$100,000 or more in total federal funds per year.See, 28 CFR Part 67.)
The prospective Subgrantee Agency certifies, by submission of this proposal, that neither it nor its principals, subcontractors
or suppliers:
a. Are presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal
benefits by a State or Federal court, or voluntarily excluded from participation in this transaction by any Federal
department or agency;
h. Have not within a three-year period preceding this application been convicted of or had a civil judgment rendered
against them for commission of fraud or a 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 of
records,making false statements, or receiving stolen property;
c. Are not 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(5)(b) of this certification; and
d. Have not within a three-year period preceding this application had one or more public transactions(Federal,State, or
local)terminated for cause or default;and
e. Where the prospective Subgrantee Agency is unable to certify to any of the statements in this certification,he or she
shall attach an explanation to this application.
6. CERTIFICATION REGARDING DRUG FREE WORKPLACE (See, 28 CFR Part 67, Subpart F.)
The prospective Subgrantee Agency certifies, by submission of this proposal, that it will comply with the Drug Free
Workplace Act of 1988, as implemented at 28 CFR Part 67,Subpart F.
7. CIVIL RIGHTS COMPLIANCE (See, 28 CFR Part 42.)
a. Upon award, each Subgrantee Agency will be provided DCJ's Form 30, entitled"Certification of Compliance with
Regulations Regarding Federal Civil Rights Requirements and Equal Employment Opportunity Plans (EEOP), and
will be required to do the following:
i. The Project Director must submit the form to the Subgrantee Agency's Authorized Official for this grant;
ii. The Authorized Official must review the form in conjunction with subgrant agency personnel responsible
for reporting civil rights findings of discrimination;
iii. The Authorized Official must accurately complete the required information and provide all information
requested;
iv. The Authorized Official must provide an original signature on the form as indicated; and,
v. The DCJ 30 Form with original signature must be returned to the Division with the Statement of Grant
Award(SOGA).
b. Any subgrant agency findings of discrimination must be reported to the Division of Criminal Justice within 45 days
of receipt of this grant award, and to the Office for Civil Rights, Office of Justice Programs, U.S. Department of
Justice.
8. NON-DISCRIMINATION
The following federal non-discrimination cites apply in particular: the nondiscrimination requirements of the Omnibus
Crime Control and Safe Streets Act of 1968, as amended; Title VI of the Civil Rights Act of 1964; Section 504 of the
Rehabilitation Act of 1973, as amended;Subtitle A,Title II of the Americans with Disabilities Act of 1990,42 U.S.C. 12101,
et. seg. and Department of Justice Regulations on Disability Discrimination, 28 CFR Part 35 and Part 39;Title IX of the
Education Amendments of 1972; the Age Discrimination Act of 1975; the Department of Justice Nondiscrimination
Regulations 28 CFR Part 42, Subparts C, D, E, and G; and Executive Order 11246, as amended by Executive Order 11375,
and their implementing regulations,41 CFR Part 60.1 et.seq., as applicable to construction contracts.
9. NATIONAL ENVIRONMENTAL POLICY ACT(NEPA)AND NATIONAL HISTORIC PRESERVATION ACT
(NHPA)COMPLIANCE (42 USC§§4321-4370 and 16USC§470)
a. The Subgrantee Agency agrees to assist the Division of Criminal Justice and the Office of Justice Programs, U.S.
Department of Justice, in complying with the National Environmental Policy Act, the National Historic Preservation
Act(NHPA) and other related federal environmental impact analyses requirements in the use of these grant funds
. Special Provisions and Certified Assurances Page 8 of 9
Special Provisions&Certified Assurances must remain attached to the application
either directly by the Subgrantee Agency or by a subcontractor. As long as the activity needs to be undertaken in
order to use these grant funds,this NEPA requirement first must be met whether or not the activities listed below are
being specifically funded with these grant funds.The activities covered by this special condition are:
b. New construction;
c. Minor renovation or remodeling of a property either listed on or eligible for listing on the National Register of
Historic Places,or located within a 100-year flood plain;
d. Renovation, lease or any other proposed use of a building or facility that will either result in a change in its basic
prior use, or significantly change its size.
e. Implementation of a new program involving the use of chemicals other than chemicals that are either purchased as
an incidental component of a funded activity and traditionally used, for example, in office, household, recreational
or educational environments.
10. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (This provision applies only to entities that
provide medical care and treatment)
The Subgrantee Agency acknowledges that it is a covered health care provider under the Health Insurance Portability and
Accountability Act, 42 U.S.C. 1320d-1320d-8, and its implementing regulations and agrees to comply with the requirements
of HIPAA concerning any uses and disclosures of protected health information.
11. Uniform Relocation Assistance and Real Property Acquisitions Act of 1970(Government Entities Only)
The prospective Subgrantee Agency certifies,by submission of this proposal, that it will comply with the requirements of the
Uniform Relocation Assistance and Real Property Acquisitions Act of 1970, which govern the treatment of persons displaced
as a result of federal and federally-assisted programs.
12. Political Activity of Certain State and Local Employees (5 U.S.C. §§ 1501-08 and §§ 7324-28 —applies to Government
Entities Only)
The prospective Subgrantee Agency certifies, by submission of this proposal, that it will comply with requirements of 5
U.S.C. §§ 1501-08 and §§ 7324-28, which limit certain political activities of State and local government employees whose
principal employment is in connection with an activity financed in whole or part by federal assistance.
D. PROGRAM SPECIFIC REQUIREMENTS
The following program specific requirements are imposed by the Federal or State sponsoring agency concerning special
requirements of law,program requirements,and other administrative requirements which must be passed on to subgrant
award recipients. These requirements are more likely to change from year to year than the special provisions and federal
certified assurances shown above, and usually vary across offices within the Division.
1. The capacity for VAWA funds to provide future continuation dollars for projects is undetermined at this time.
Subgrantee Agencies are advised to seek other funding sources,especially for personnel dollars.
2. The Subgrantee Agency certifies that the signing authorities, all staff and volunteers assigned to the VAWA-funded
project have read state laws and applicable rules of professional conduct related to issues of confidentiality and
privilege, particularly with respect to releasing identifying information about victims of crime, including but not
limited to,those found in. Section 13-90-107,C.R.S.
•
Special Provisions and Certified Assurances Page 9 of 9
Special Provisions&Certified Assurances must remain attached to the application
SIGNATURE PAGE ->->-> TO BE COMPLETED BY ALL APPLICANTS
(ORIGINAL SIGNATURES REQUIRED-Please sign in BLUE ink. See instructions for description of proper signatories.)
The Subgrantee Agency and responsible signatories certify by signing that they have read the Application including the Special Provisions and
Certified Assurances,and are fully cognizant of their duties and responsibilities for this project.The Subgrantee Agency understands and agrees that
any subgrant award received as a result of this application shall incorporate by reference the information contained herein. Responsibility for
narrative and fiscal reporting requirements are delegated to the designated Project Director, who will sign all such reports. This delegation is for
purposes of reporting to the Division and for operational ease, and in no way limits the authority and responsibility of the Authorized Official. In
accordance with the Colorado Revised Statutes 24-72-202.6,information supplied in this application is considered a public record.
AUTHORIZED OFFICIAL
Name William H.Jerke
Position Board Chair
Agency Board of County Commissioners,Weld County
Mailing Address PO Box 758
City,State,Zip Greeley,CO 80632
Telephone# (970)336-7204 ext.4200
Fax# (970)352-0242
E-mail Address wjerke@co.weld.co.us
Signature Date
9/14/2005
FINANCIAL OFFICER
Name Donald D.Warden
Position Director of Finance and Administration
Agency Weld County Government
Mailing Address PO Box 758
City,State,Zip Greeley,CO 80632
Telephone# (970)356-4000 ext.4218
Fax# (970)352-0242
E-mail Address dward @co.weld.co.us
Signature y p Date
Z G/ .4 !�,t 7/ 1 9/14/2005
PROJECT DIRECTOR
Name JoAnn Holden
Position Community Programs Administrator\Victim Witness Coordinator
Agency 19TH Judicial District Attorney's Office,Victim Witness Assistance Unit
Mailing Address PO Box 1167
City,State,Zip Greeley,CO 80632
Telephone# (970)356-4010 ext 4747
Fax# (970)352-8023
E-mail Address jholden@co.weld.co.us
Signature Date
27. CERTIFICATION OF MATCHING FUNDS-(All VAWA Applicants)
PLEASE BE ADVISED that Weld County Government has appropriated
(unit of government,forfeiture fund,non-profit agency,or corporation)
funds in the amount of$_15,925 3I 3 to match federal funds for the Domestic Violence and Sexual Assault
Program P r�
// (project title)
The source(s)of these funds is non-federal governmental funds
These funds are made available as M CASH or IN-KIND match
Execution of this document represents a certification that said funds have been earmarked within the appropriation of budget
process, which by state or local government law or practice, binds and obligates the state/local unit of government or the
implementing agency to use such funds for purposes of this grant funded project, or permits such uses. The funds are, or will be
(within the project duration),actually provided for such purposes.
Signature must be by the individual
authorized to commit these funds on behalf
of the unit of government, forfeiture fund,
non-profit agency or corporation. This
Sincerely, •
Sindividual is either the Authorized Official
on this grant or appropriate financial
controller of matching funds.
tiVtri' 9/14/2005
Signature Date
William H.Jerke
Typed Name
_Chair. Board of County Commissioners,Weld County
Colorado
Title
M:\WPPILES\AVW\G-VAWA\2005 VAWA Common App with Certs.doc ,4G4 -(5-91C-2
_
DCJ FORM 30
CERTIFICATION OF COMPLIANCE WITH REGULATIONS
OFFICE FOR CIVIL RIGHTS,OFFICE OF JUSTICE PROGRAMS
FOR SUBGRANTS ISSUED BY THE COLORADO DIVISION OF CRIMINAL JUSTICE
INSTRUCTIONS: Complete the identifying information, which isfbund on the Statement of Grant Award(SOGA), in the
table below. Read the form completely, identifying, under "I,"the person responsible for reporting civil rights findings;
and checking only the one certification under "II"that applies to your agency. Have your Authorized Official sign at the
bottom of page 2,forward a copy to the person you identified under "I"and return the original to the Colorado Division of
I Criminal Justice, 700 Kipling, Ste. 1000, Denver, CO 80215, within 45 days of the grant award beginning date.
Grant# 25—VW-19-23 Grant ProjectTitlepomestic Violence & Sexual . Assault Program
SubgranteeName (FundedEntity): District Attorney' s Office, 19th Judicial District
Address:
PO Box 1167 , Greeley, CO 80632
Duration: Beginning date: 04-01-06 End date: O3-31—O7 Award: $ 10 . 154 .00
Project Director's Name& Phone#:
JoAnn Holden 970-356-4010 x4747
AUTHORIZED OFFICIAL'S CERTIFICATION: As the Authorized Official for the above Subgrantee, I certify,by my
signature below, that I have read and am fully cognizant of our duties and responsibilities under this Certification.
I. REQUIREMENTS OF SUBGRANT RECIPIENTS: All subgrant recipients(regardless of the type of entity or the amount
awarded)are subject to prohibitions against discrimination in any program or activity, and must take reasonable steps to
provide meaningful access for persons with limited English proficiency.
♦I certify that this agency will maintain data(and submit when required)to ensure that: our services are delivered in an
equitable manner to all segments of the service population; our employment practices comply with Equal Opportunity
Requirements, 28 CFR 42.207 and 42.301 et sea.; our projects and activities provide meaningful access for people with
limited English proficiency as required by Title VI of the Civil Rights Act, (See also, 2000 Executive Order#13166).
♦I also certify that the person in this agency or unit of government who is responsible for reporting civil rights findings of
discrimination will submit these findings, if any, to the Division of Criminal Justice within 45 days of the finding,and/or if
the finding occurred prior to the grant award beginning date, within 45 days of the grant award beginning date. A copy of
this Certification will be provided to this person, as identified here:
Person responsible for reporting civil rights findings of discrimination: (Name, address &phone)
Pat Persichino, Director of Personnel Services/HR
PO Box 758
Greeley, CO 80634
97.0 970-336-7220
II. EQUAL EMPLOYMENT OPPORTUNITY PLAN (EEOP)CERTIFICATIONS: Check the box before ONLY THE ONE
APPROPRIATE CERTIFICATION(A, B, Cl or C2 below) that applies to this subgrantee agency during the period of the
grant duration noted above.
O CERTIFICATION "A" [NO EEOP IS REQUIRED if(1),(2)or(3), below,apply.] This is the Certification that
most non-profits and small agencies will use. Check(1),(2)and/or(3)as they apply to your entity. (More than one may
apply.)
This funded entity has not been awarded more than$1 million cumulatively from all programs administered by the U.S.
Department of Justice over an 18-month period that includes the above grant duration period,and
(1) is an educational, medical or non-profit institution or an Indian Tribe; and/or
(2) has less than 50 employees; and/or
X (3) was awarded through this grant from the Colorado Division of Criminal Justice less than$25,000 in
federal U.S. Department of Justice funds.
Therefore, I hereby certify that this funded entity is not required to maintain an EEOP, pursuant to 28 CFR 42.301,et
sue.
(CONTINUED ON REVERSE SIDE)
Colorado Division of Criminal ustice Page 1 oft (Rev 8/16/2004)
DCJ FORM 30:
CERTIFICATION OF COMPLIANCE WITH REGULATIONS,
OFFICE FOR CIVIL RIGHTS,OFFICE OF JUSTICE PROGRAMS (Continued)
II. EQUAL EMPLOYMENT OPPORTUNITY PLAN(EEOP)CERTIFICATIONS: (Continued)
0 CERTIFICATION "B" (EEOP MUST BE ON FILE)
This funded entity,as a for-profit entity or a state or local government having 50 or more employees, was awarded,
through this grant from the Colorado Division of Criminal Justice,more than$25,000,but less than$500,000 in federal
U.S. Department of Justice funds. Also, it has not been awarded more than$1 million cumulatively from all programs
administered by the U.S. Department of Justice over an 18-month period that includes the above grant duration period.
Therefore,I hereby certify that the funded entity has formulated an Equal Employment Opportunity Plan in accordance
with 28 CFR 42.301, et seq., subpart E,that it has been signed into effect by the proper authority and disseminated to all
employees, and that it is on file for review or audit by officials of the Division of Criminal Justice or the Office for Civil
Rights, Office of Justice Programs as required by relevant laws and regulations.
0 CERTIFICATION "Cl" (EEOP MUST BE SUBMITTED) This funded entity,as a for-profit entity or a state or
local government having 50 or more employees,was awarded, through this grant from the Colorado Division of
Criminal Justice,more than$500,000 in federal U.S. Department of Justice funds,but, it has not been awarded more
than$1 million cumulatively from all programs administered by the U.S. Department of Justice over an 18-month period
that includes the above grant duration period.
Therefore,I hereby certify that the funded entity will submit,within 45 days of the award,an EEOP or an EEOP Short
Form,that will include a section specifically analyzing the subgrantee(implementing) agency.
0 CERTIFICATION "C2" (EEOP MUST BE SUBMITTED) This funded entity, having 50 or more employees,has
been awarded more than$1 million cumulatively from all programs administered by the U.S. Department of Justice,
including this subgrant from the Div. of Criminal Justice,over an 18-month period that includes the above grant
duration period.
Therefore,I hereby certify that the funded entity will submit,within 45 days of the award, an EEOP or an EEOP Short
Form, that will include a section specifically analyzing the subgrantee(implementing) agency. (If you have already
submitted an EEOP applicable to this time period, send a copy of the letter received from the Office for Civil Rights
showing that your EEOP is acceptable.)
As the Authorized Official for the above Subgrantee, I certify,by my signature below, that I have read and am fully cognizant of
our duties and responsibilities under this Certification. I, hereby, also certify that the content of this form, other than the data entry
required, has not been a red.
MAR O 1 ZOOS
[Ant oK rz/6Offrcial's signature] [Date]
1
M.J. Geile Chair, Weld County Board of
[Typed Name] [Title] County Commissioners
* * * * * * * * * *
This original signed form must be returned to the Colorado Division of Criminal Justice, 700 Kipling, Ste. 1000, Denver, CO
80215, within 45 days of the grant award beginning date. You must also forward a signed copy to the person you identified
under "I"on page I. DCJ will forward a copy to the Office for Civil Rights, Office of Justice Programs, U.S. Department of
Justice.
Colorado".....on ofcnm,aanusuce Page 2 of 2 (Rev.8/16/2004)
Hello