The URL can be used to link to this page

Browse Search

Home My WebLink About800841.tiff RESOLUTION RE: APPROVAL TO SUBMIT ENERGY TECHNICAL ASSISTANCE GRANT APPLI- CATIONS AND AUTHORIZATION FOR CHAIRMAN TO SIGN THE SAME. 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, on April 9, 1980, the Board of County Commissioners of Weld County, Colorado awarded ARIX the bid concerning an energy conservation program contingent upon grant money being received from the State, and WHEREAS, applications for an Energy Technical Assistance Grant have been prepared (one for the Courthouse and one for the Centennial Center) for Board approval, and WHEREAS, after studying said applications, the Board deems it advisable to approve the applications. NOW, THEREFORE, BE IT RESOLVED by the Board of County Com- missioners of Weld County, Colorado that the Energy Technical Assistance Grant Applications be, and hereby are, approved for submittal to the State Department of Energy. BE IT FURTHER RESOLVED by the Board of County Commissioners that the Chairman of the Board is hereby authorized to sign said applications. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 2nd day of July, A.D. , 1980. 71/1 * ' BOARD OF COUNTY COMMISSIONERS 1Q ATTEST: ' WELD COUNTY, cOLORADO Weld County Clerk and Recorder ,A i1,-fi�/ (Aye) a rk to the Board C. W. Kitty, airman By: cLi eusimv � d rat (Aye) D puty Cou y Cler eonard L. Roe, Pro-Tem AP D AS TO FORM: (Aye) Norman Carlson (ABSENT) County Attorney Lydia Dunbar f:�Iir/!% Q,//J'li/�1/IA(Aye) Te K. Steee�� nmark DATE PRESENTED: JULY 7 , 1980 800841 • • • ,. a.:E.- l:�'. 038-8 04 02 ,. _6PANn PROGPA'5 FOR SCHOOLS AND HOSPITALS AVINN • r 'iILDINGS O'I QD BY UNITS OF LOCAL G3T'ERUM;NT , PUBLIC CARE INSTITUTIONS APPLICATION PART I: GENERAL INFORMATION IFEDERAL ASSISTANCE 2.CANT' a NUMBER 3. STATE S.MIAMI CANT'S CATION I O TYPE O PREAPPLICATION . APPU. h. DATE :DENTS. b.DATE ACTION APPLICATION CATION yen month day FIER ASSIGNED rear month dot IMer ap "80-31-6 19 (Mark° ❑ NOTIFICATION OF INTENT (Opt.1 am. prop bon O REPORT OF FEDERAL ACTION Blast ! 4. LEGAL APPLICANT/RECIPIENT 5. FEDERAL EMPLOYER IDENTIFICATION NO. a.APeI.A'rr Ne . ' Board of County Commissioners 84-6000-813 b. O rsemcnien u":t ' Weld County Government I c Street/P.O.in P.O. Box 758 6. d.Ow PRO. a.MUM►ER I B 1 I • ) D6 12 1 Greeley, ..c.,rm, , Weld GRAM b.TITLE I.Swiss ' Colorado q.DP Cedes 80631 (From Grant Prodrans for Schoo C k. Center,P.,,.,(Noma Federal and Hospitals and Buildings own `o d telephone Donald D. Warden eomla by units of Local Government a. I 7.TIT'S. ANC) DESCRIPTION OF APPLICANT'S PROJECT Public Care Institutions. 8.TYPE OF APPLICANT/RECIPIENT IL Grant Programs for Schools & Hospitals & Buildings A-5 , .M.Amos Avner B.Is Owned by Units of Local Government & Public Care C— L*^^ _ �`es;w ""'""" institutions. Check block(s): 0— Ceram is— Other E5arrtp' u _I Technical Assistance Program E— `^ I— Sweet Dawn i. _ Energy Conservation Measure • D— Dn' r"'"' Emrrapymrnaulnrr 0 9. TYPE OF ASSISTANCE OA— Rabic Grant D . Imurenc, I— Supplemental Greta E— Other Enter appm- u 10.AREA OF PROJECT IMPACT(Aetna° riurn roamin_ I C— Loon plate lno-rgt.h 'n II. ESTIMATED NUM• 12.TYPE OF APPLICATION Staten etc/ !ER OF PERSONS A— Ne. BENEFITING C— Revisits, E— Augmentaf n Wald Cnunty 120,000 I— Renee) D— Co ' tie^ Enter oppmpnav Irtrrr A 13. PROPOSED FUNDING I 14. CONGRESSIONAL DISTRICTS OF: 15.TYPE OF CHANGE(For IT c or JT r1 a. FEDERAL 1 s 6.177 .pct a.APPLICANT I b.PROJECT A— barns* Dollar. F— Other lSprciJT•1: b. APPUCANT 1 .00 4th 4th C— Decrease Dollars C— e r DYq,:M c 5747E 16. PROJECT START 17. PROJECT D 0— Decrease Duren.^ d LOCAL I 6 1-7 ,177 DATE Ye,, month day DURATION E— Cancellation Enrt — I I 1980-9-30 5 Month, plate ln:er(la+tnrl , I .. OTHER DD 1E. ESTIMATED DATE TO Year month day 19. EXISTING FEDERAL IDENTIFICATION NUMBER I. TOTAL $ 12.354 .m BE SUBMITTED TO FEDERAL AGENCY ► 1, 80-8-15 NA 20. FEDERAL AGENCY TO RECEIVE REQUEST (Name. City.State.ZIP code) 21. REMARKS ADDED Dept. of Energy, P.O: Box 26247, 'Belmar Branch;' Lakewood, CO 802261 t v., s j 22. e.To the belt of kre. my ns.l.dpe end belief, 6.H requited by OMa C:rculvr A-95 this a Gcoaen ear 'ubmin.d, D THE date in lid' Peeappl:maen/eppl:eet:.n :"muetfan therein, to a PP Putman, t. .po Amens( u APPUGNT are tree end correct, the document has lathed, appropriate dwripwavtn end all reopen,., en et. cponsr attached " CERTIFIES loo" duly senborised by the ge•anieq (I) 0 0 body► ,et the applicant end Me applicant w mill comply.irk am anaded steersmen. 12) NA 0 0 N the assistants is.po.e.d. 13) 0 0 • 23. e.TYPED NAME AND TITLE 6.SIGNATURE CERTIFYING C. W. Kirby, Chairman n c. DATE SIGNED U REPRE• • Trey month der w ISEnTATNE Board of County omm; sion rs ct Ta ieS0 7 24. AGENCY NAME 25. APPLICA- Year month der TION 26. ORGANIZATIONAL UNIT RECEIVED 19 1 27. ADMINISTRATIVE OFFICE 28. FEDERAL APPLICATION IDENTIFICATION ≤ 29. ADDRESS 30. FEDERAL GRANT IDENTIFICATION sa z ri 31. ACTION TAKEN 32, FUNDING Tear month 'der ISA. fern month tar c O a. AWARDED n. FEDERAL IS .DD 133. ACTION DATE as. 19 STARTING DATE It 5 ' 06 REJE-CTED 6. APPLICANT Ile ,DU 35. CONTACT FOR ADDITIONAL INFORMA. 36. Year month der ' D e RETURNED FOR c. STATE I 03 TION (Nome and telephone number) ENDING AMENDMENT A LOCAL I DATE tP g d. DEFERRED .0337. REMARKS ADDED P.•OTMER I .00 E, u e. WITHDRAWN :n f. TOTAL I f gD I Tye C N. 38. a. In feting above action. any aewm.MI reemood hen cl.eringw I6. FEDERAI AGEN A-9 aenJd..ed. If s su,I. OM, n OFFICIAL FEDERAL AGENCY Genie.A-4S• is km beam is icingd.. dodo. pe.b.on' el Pen I. OMI (Nome and telephone nn/ • A-95 ACTION mode. NA .7s_,D2 NA / - STANDARD FOR.r 421 PAGE ,rate. r_• D�nc T : • OMB NO. 038-R0402 ART I: GENERAL INFORMATION C. t. NOTE : If application is for more than one building, attach a separate "Remarks" section for each building. SECTION IV 39 .0 What is the name and address of the building? Weld County Centennial Center. 9th Street _and 9th Avenue. Greeley, CO 40.0 What type of building is it? (c) ® Building owned and primarily occupied by. Unit of Local (a) C7 School Facility Government (h) .p Hospital Facility (d) CD Building owned and primarily occupied by Public Care Institution 41 .0 What is the functional use of the building? (a) CD School (c) pa Local Government Building C7 Elementary CD Office O Secondary O Storage O College/University a Service .C Vocational C7 Library C7 Other, specify: C7 Other, specify: Sheriff (b) C Hospital (d) o Public Care Building • C] General O Nursing Home CD Tuberculosis C] Long-Term Care CD Other, specify: Cm Rehabilitation Facility CD Public Health Center • C7 Residential Child Care Ctr. CD Other, specify: 42 .n What is the size of the building? 137.333 gross sq. ft. a3.n Is the building a public or non-profit institution? (a) ® Public (h) C7 Non-profit 44 .0 What is the current building energy consumption rate? 474.992 BTU/sq. ft ./yr . 45 .1 What is the estimated or actual energy savings resulting from implementation of operations and maintenance procedures? (a) C3 Estimated (b) 164.000 BTU/sq. ft./yr. O Actual 45 .2 Where are the operations and maintenance procedures identified? (a) MI) Energy Audit (b) C7 Technical Assistance Project -,.z ne 9 STIXDaaD Apr W Plat}n... .. n 46.0 Eligibility Check Yes or No, or fill in blanks. If No, provide explanation . in the space provided on the following page. YES NO 46:.1 Has an energy audit been performed in accordance with the State • Plan? x _ • 46.2 Was a portion of the cost of the Energy Audit paid with Federal funds? x _ 46.3 Have all energy audit recommended maintenance and operating procedures been implemented? x 46.4 Was construction of the building, or any addition thereto, completed on or before April 20, 1977? x 46.5 The building owner of record is citizens of Weld County 46.6 Is this a severe hardship application? If yes, attach the • explanation of conditions of hardship as required in the special State instructions. (Complete 46. 7 through 46.10 for energy conserva- tion measure applications only. ) 46.7 Has a technical assistance program been performed in accordance with the State Plan? (Note : A copy of the program report must be attached if not previously submitted. ) N/A If the program report is not attached, provide date submitted to: State Energy Office DOE Regional Office 46.8 Have all technical assistance program recommended maintenance and operating procedures been implemented? N/A 46.9 Is the simple payback period of each energy conservation measure for which financial assistance is requested at least one year and not more than 15 years and less than the useful life of the building? N/A • Page 3 46.0 Eligibility continued YES NO 46. 10 Do you intend to close or dispose of this building within the simple payback period of any energy conservation measure for which funding is requested? If yes, explain. N/A EXPLAIN "NO" ANSWERS BELOW, OR ATTACH ADDITIONAL SHEETS, IF NECESSARY. (A negative response to questions 46.2, 46.6 and 46.10 requires no explanation. ) • Page 4 n 1.1 47.0 Complete for Technical Assistance Program Applications Only YES NO 47. 1 Are the results of the preliminary energy audit and energy audit attached? x If "No", provide date submitted to: (adds]. copy) State Energy Office 3/6/8o DOE Regional Office 47.2 Does the information on page 2, Building Data Sheet, corres- pond with the data in the EA? 47.3 Provide a brief description, by building, of the proposed technical assistance program. (Note: The proposed program must identify all proposed O&M changes and must include consideration of all possible energy conservation measures, including solar and other renewable resource measures. See 10 CFR 455.42. If additional space is required, attach separate sheets. ) - The Weld County Complex technical assistance audit will be conducted by a qualifies technical assistance analyst. The audit will consider measures identified in 10 CFR 455.52 and all other possible conservation measures, including solar or other renewable resource measures. The analyst will also report any operation and maintenance measures not included in the preliminary energy audit. At the conclusion of the technical assistance energy audit, the analyst shall prepare a final report according to federal rules 10CFR 455.42. 47.4 Complete the following milestones schedule for the proposed Technical Assistance Program: MILESTONE SCHEDULE TASK MONTH - DAY - YEAR Solicit quotations from qualified analysts 4/1/80 Sign contract with analyst 10/1/80 Work Begins 10/4/80 Project Completed 12/31/80 Draft TAP Report 1/14/81 Final TAP Report 2/12/81 Explain in the space below any milestone which gives the appearance of undue delay: Page 5 . • • O1.13 NO. 038-H040L /y PART II: PROJECT APPROVAL INFORMATION Item I. Does this assistance request require State, local, Name of Governing Body Board of County Cnmmiasione regional, or other priority rating? Priority Raring X Yes No Item 2. Does this assistance request require State, or local Nome of Agency or advisory, educational or health clearances? Board Board of County Commissioners • X Yes No (Attach Documentation) Item 3. Does this assistance request require clearinghouse (Attach Comments) • review in accordance with OMB Circular A-95? Yes—X---IIo Item 4. Does this assistance request require State, local, Name of Approving Agency Board of Co Cnmmi asinner regional or other planning approval? X Dote 6/30/80 -Yes No Item 5. • Is the proposed project covered by an approved compre. Check one: State 7 hensive plan? Local Regional -Yes No Location of Plan Weld County CPntrennial Cantor Otceley , Cul,,Ladu Item 6. Will the assistance requested serve a Federal Nome of Federal Installation installation? Yes X No Federal Population benefiting from Project Item 7. Will the assistance requested be on Federal land or Nome of Federal Installation installation? Location of Federal Land Yes X No Percent of Project • Item 8. Will the assistance requested hove on impact or effect See instructions for additional information to be on the environment? provided. Yes X No Item 9. Number of: Will the assistance requested cause the displacement Individuals of individuals, families, businesses, or forms? Families X • Businesses • Yes No Farms Item 10.. • Is there ether related assistance on this project previous, See instructions for additional information to be pending, or anticipated? provided. —Yes-- C No item 11 See instructions for additional Is the project in a designated flood information to be provided. hazard area? • Yes X No Pa ge .10 II. a6ed N _ 0 o $ > I -• a a. O N G • a < Z e »4 G » » G.• O O. mi.: E ea t i a •n »\ .z — � » O a ? M C W i • I-- < C 0 CC » » W p r r Z r — I U y n. I • » W I u 3 r ;i T d ' v I o l d I I L1 » i »Im ` I i i I � CC N z 1 j z F I - i ! a W II Cel VI N I� l i = » » w I I ^ 1 -_ KAI I t • i V I. \ 0 _ ' I • CC LI N Yy• - • - a E ;I �I V' 3 e S I' a V m _ e: .C.i Lw <— t .. a f,, o�jV 1Qf .. -• M y2 t1 - r O o' z. r H lad Si 8 o o .a- CI �' .` :. _ z I M a 1 d .j O Y .1 t �_ • i •.• ZI 952d N m 70— I g J a • 2 C r . I o r••• ^ m c N O • in 2u. V ' z _I • r r r r r O r •, r C a W a d v Wo _ M W ... a J 1 _ W a f O O O W W O C U r .. r r z G. • w J 2 r o +• < i © ` O W n N L C- LL n O U C w‘. W L o IL J l < c w OZ 0 - z . r.T O j _ 1"I N = • 0 O 6 c S C r r <� r .. W r r 3 I 2 rj W = •% o J O C F we N W •2 ` )Z+ O u n Hr•-• a- S r.. r n O ; > W 4 n r- < a ri n °. tL .. _ ; .� t.. C y .1 r• : V 8 C .-1 ,-4 en x CO f.. hi, 7. < 'O •O W r % �0 SON ..1 C ° < -24 2' WC W = a C < C I r I O I- T q Z r 1 •• C i LI 0 ---,--" "---,--" " WLL - 1 i <0.1 ZO L 2 : W U < I r 0 - U H t Z 0 V C 1 W 0 .-- C m > W t- Wn a < V yr > E c 7 ILI i .^ T I- L ,- r H q C O'..J - - W O_ < i > f• V C C L. W C/ I N U ; U C== _co C O O CO s +3 ICII y I q a W u v ? N L = v ¢ 2a W 43 r e— b)-r LI q 'Or ID ILI .. O i3-O ill r in CU I.. .4% i C C L U a O co...)E ; . J a u cu Loco < r <O • •H O_1--W ^ • t 0 p - ° E C r z r r 3 Z Q •1 _ A r r, Part III - Budget Information Section A - Budget Summary (p. 11 of Application) 1. Identify the source and amount of non-federal funds General Fund expenditure of $6,177 2. Are these funds available for this program without further authorization? x Yes No. If "No", provide explanation. Section B - Budget Categories (p. 11 of Application) Explain any entries on p. 11 (Section B) under line items a-h in the spaces provided below. Attach additional sheets if necessary. (a) PERSONNEL - Any task not actually performed by employees of an insti- tution should be entered under contractual . (i .e. contractual personnel costs will be included under contractual ). Enter only actual direct charges for this item including rate per hour, number of hours, or percent of time, task and position title. No figures will appear on this line unless institutions intend to use in-house personnel for conducting the TA or implementing ECM measures. (Volunteer labor can only be valued at a rate consistent with similar work in other activities of the grantee or the going rate for that particular occupation in the community. This time must also be documented by rate per hour, number of hours, task and position title. ) Page 13 • (b) FRINGE - Enter itemization of fringe in this space. This item is only allowable when attributable to actual personnel costs cited above. (c) TRAVEL - Itemize all travel costs. (Travel expenses of contractors are usually included in the amount of the contract cost. ) Include details of any travel in the performance of TA' s or ECM's by in-house personnel . Conferences & trips to the State Energy Office are not allowable. If you feel you have justified travel which should be allowed, give specific details and justification. (d) EQUIPMENT - Itemize equipment expenditures. The purchase of equipment by all Grantees of $300 or more with a useful life on one year is subject to prior Department of Energy approval . (The purchase of equipment of $500 or more with a useful life of more than two years by A-110 Grantees subject to CASB regultions require prior Department of Energy approval . ) IBGP Program regulations state that for TAs no equipment may be purchased in excess of $500. (e) SUPPLIES/MATERIALS - All supply/material costs must be itemized. This line item would normally be used to reflect the cost of supplies/materials for ECMs implemented with in-house staff. (f) CONTRACTUAL - Contractual costs should include all functions which will be contracted out, such as: personnel costs, ECM measures and materials, and the performance of the TA. These costs incude TA/ECM projects or A bid of $.04/sq. ft. was received for the Technical Assistance program which comes to a total of $6,177.00. Page 14 any portion thereof. These entries should be itemized to include, for example: engineering costs with rate, task and hours for each element of the work to be performed. (g) CONSTRUCTION - Do not use this object category for this program. No figures should be entered on this line. (h) OTHER - Any allowable costs not specifically identified on other lines must be itemized here. Page 15 • SIR-145 !' S FORM APPROVED OMB NO. 038-R0402 ' • PART V: ASSURANCES - Section A SPECIFIC INSTRUCTIONS • This part contains the certifications required of applicants for Federal grants. The applicant shall certify in its application for, and acceptance and use of Federal funds, that it will comply with the laws and regulations governing these grant programs. The Assurances section applies to the original application. and to any subsequent modification or amendments. • • The Applicent hereby •ssvres and certifies that he will comply with the regulations, pol.ci•s• guidelines, and ree,nresents, m• chiding OMB Circular No. A-102 and FMC 74-4, In they relate to the eppncation,acceptance and use of Federal funds for this fed• (welly ruined prtj•ct.t Also the Applicant assures and certifies with respect to the grant that: 1. It possesses legal authority to apply for the grant;that a 4. It will comply with requirements of the provisions resolution, motion or similar action has been duly of the Uniform Relocation Assistance and Real Property adopted or passed as an official act of the applicant's Acquisitions Act of 1970 (P.L. 91.646) which provides governing body, authorizing the filing of the application, for fair and equitable treatment of persons displaced as a including all understandings and assurances contained result of Federal and federally assisted programs therein, and directing and authorizing die person identi- 5. It will comply with the provisions of the Hatch Act fled as the official representative of the applicant to act which limit the political activity of employees in connection with the application and to provide such 6. It will comply with the minimum wage and maximum additional information as may be required. hours provisions of the Federal Fair Labor Standards 2. It will comply with Title VI of the Civil Rights Act of Act, as they apply to hospital and educational inriitu• 1964 (P.L. 88.352) and in accordance with Title VI of tion employees of State and local government. that Act, no person in the United States shall, on the 7. It will establish safeguards to prohibit employees from ground of race, color, or national origin, be excluded using their positions for a purpose that is or gives the from participation in, be denied the benefits of, or be appearance 'of being motivated by a desire for private otherwise subjected to discrimination under any pro- gain for themselves or others, particularly those with gram or activity for which the applicant receives Federal whom they have family,business, or other ties. 8. It will give the sponsoring agencyor the Comptroller financial assistance and will immediately take any meat- aura necessary to effectuate this agreement. General through any authorized representative the K- ass to and the right to examine all records, books, 3. It will comply with Title VI of the Civil Rights Act of . papers, or document related to the grant 1964 (42 USC 2000d) prohibiting employment discrimi• 9. It will comply with all requirement imposed by the nation where (1) the primary purpose of a•grant is to Federal sponsoring agency concerning special require- provide employment or 12) discriminatory employment ments of law, program requirement, and other ad- practices will result in unequal treatment of persons who are or should be benefiting from the grant-aided activity. ministrative requirement. 10. It will insure that the facilities under its ownership, lease or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of Violation Facilities and that it will notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under consideration for listing by the EPA. • • t The regulation which we wish to taring to your attention is tOCF Pt 455. 16 • ,•EIA-145 t'1 r-) FORM APPROVED OMB NO. 038-R0402 PART V: ASSURANCES Con't. 11. It will comply with the flood insurance purchase requirements of Section 102 (a,) of the Flood Disaster Protection Act of 1973, Public Law 93-234, 87 Stat. 975, approved December 31, 1976. Section 102 (a ) requires, on and after March 2, 1975, the purchase of flood insurance in communities where such insurance is available es a condition for the receipt of any Federal financial assistance for construction or acquisition purposes for use in any area that has been identified by the Secretary of the Department of Housing and Urban Development as an area having special flood hazards. The phrase "Federal financial assistance" includes any form of loan, grant, guaranty, insurance payment, rebate, subsidy, disaster assistance loan or grant, or any other form of direct or indirect Federal assistance. • 12. It rill assist the Federal grantor agency in its compliance • with Section 106 of the National Historic Preservation Act of 1966 as amended (16 U.S.C. 470), Executive Order 11593, and the Archeological and Historic Preservation Act of 1966 (16 U.S.C. 469a-1 et seq. ) by (a ) consulting with the State Historic Preservation Officer on the conduct of investigations, as necessary, to identify properties listed in or eligible for inclusion in the National Register of Historic Places that are subject to adverse effects (see 36CFR Part 800.8 ) by the activity, and notifying the Federal grantor agency of the existence of any such properties, and by (b ) complying with all requirements estabished by the Federal grantor agency to avoid or mitigate adverse effects upon such properties. • 17 • PART V - SECTION B - CERTIFICATIONS (A COPY OF THESE CERT-'FI- CAY'WS MUST BE A PART OF THIS APPP"cATION) The applicant hereby certifies that: 1 . It meets the eligibility requirements contained in 10 CFR 455.41 (for applications for Technical Assistance), or 10 CFR 455.51 (for applica- tions for Energy Conservation Measures) . 2. It has or will satisfy the requirements set forth in 10 CFR 455.60 3. It has implemented all energy conservation maintenance and operating procedures identified in an energy audit or its equivalent (for appli- cations for technical assistance) , or identified in an energy audit and technical assistance program or its equivalents (for applications for energy conservation measures) , with the following exceptions: I (Enter "none" or list specific , maintenance and operating pro- cedures not implemented and a I justification for not imple- - menting each procedure) . • Page 18 . 4. It will expend *'finds granted under 10 CFR Partr'15 for the purpose stated in this ,,,plication and in compliance witn the requirements of 10 CFR Part 455 and the approved State Plan. 5. It will obtain from the technical assistance analyst, prior to the analyst performing work in connection with a technical assistance program or energy conservation measure, a signed statement certifying that the technical assistance analyst has no conflicting financial interest and is otherwise qualified to perform the functions of a technical assistance analyst in accordance with the requirements set forth in the approved State Plan. 6. It will comply with all reporting requirements contained in 10 CFR 455.63. 7. It will not enter into any contract relating to an energy conser- vation measure, which requires or may require expenditure of more than $5,000 (excluding technical assistance program costs) that does not conform to the provisions of the Davis-Bacon Act* (40 USC Sections 276a to 276a-5) pertaining to minimum wages for construction in the applicant' s locality. 8. It will provide the required matching non-federal funds, including in-kind contributions (limited to the goods and services described in OMB Circular A-102) , and that such funds or contributions are directly related to the project. 9. It will comply with the Civil Rights requirements pursuant to 10 CFR 455.3(a) (8) . It will comply with the Title VI of the Civil Rights Act of 1964 (PL 88-352) , Section 16 of the Federal Energy Administration Act of 1974 (PL 93-438) , Title IX of the Education Amendments of 1972, as amended. (PL 92-318, PL 93-568, and PL 94- 482) , Section 504 of the Rehabilitation Act of 1973 (PL 93-112) , the Age Discrimination Act of 1975 (PL 94-135) , Title VIII of the Civil Rights Act of 1968 (PL 90-284) , the Department of Energy Organization Act of 1977 (PL 95-91 ) , and the Energy Conservation and Production Act of 1976, as amended, (PL 94-385). In accordance with the above laws and regulations issued pursuant thereto, the applicant agrees to assure that no person in the United States shall , on the ground of race, color, national origin, sex, age, or handicap, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity in which the applicant receives Federal assistance from the Department of Energy. " 1:lttt 7/2/1980 Signature - Autho ized, Certifying Date Representative Chairman. Weld County Board of County Commissioners Tit e * Davis-Bacon rates can be requested at any time after the Appli- cation is submitted. Page 19 P1 RANKING - Technical Assistance Complete For Technical Assistance Applications Only, using the "Application" packet as a guide. Attach additional sheets if necessary. Building Name Weld County Centennial Center BTU's consumed per gross sq. ft. per year 474,992 Energy costs per gross sq. ft. per year 1.28 BTU's consumed per gross sq. ft. per annual operating hour per year 101/hr. Past energy conservation activity. 26 % energy reduction for one year (Energy Consumption records must be attached - see "Application" booklet) Building Name BTU's consumed per gross sq. ft. per year Energy costs per gross sq. ft. per year BTU' s consumed per gross sq. ft. per annual operating hour per year Past energy conservation activity. % energy reduction for one year (Energy Consumption records must be attached - see "Application" booklet) Building Name BTU's consumed per gross sq. ft. per year Energy costs per gross sq. ft. per year BTU's consumed per gross sq. ft. per annual operating hour per year Past energy conservation activity. % energy reduction for one year (Energy Consumption records must be attached - see "Application" . booklet) - 20 - r"\ i. ENERGY CONSUMPTION WORKSHEET BUILDING CENTENNIAL CENTER/ JAIL GSF OF BUILDING 137,333 ACC. # 7062949364000015 ACC. # 01010422101 NOTE: Includes COMPLEX, JAIL, & MONTH - ELECTRICITY NATURAL GAS COURT HOUSE KWH DEMAND AVG D. COST COST CCF COST AVG D COSI 1979 JAN 300,400 680.0 $ 9,231.85 44,601 $ 8,639.49 FEB 253,600 640.0 8,360.19 25,324 , 4,921.56 MARCH 304,800 680.0 9,833.11 23,887 4,866.531 APRIL 298,400 720.0 10,420.87 21,368 4,805.31 MAY 293,600 720.0 10,068.08 25,265 5,681.151 JUNE 388,400 720.0 12,169.25 29,724 6,683.291 JULY 1320;000 720.0 11,147.92 34,610 7,822.66( AUG 1312,000 720.0 11,835.05 25,130 5,701.05 SEPT 277,600 720.0 9,980.91 16,122 3,614.661 OCT 257,600 1 700.0 10,232.39 20,457 5,397.04 NOV 1257,200 600.0 10,107.96 24,145 5,854.70 - Note: DEC 267,600 600.0 9,447.51 28,947 7,265.971 $18,825.E LS---31531,200 j 8 , C 52a TOTA $1z2,835.09 319,584 $ 71,253.41 83,952 C I OWE 111,600 = ANNUAL BTU ) PER GSF n„ r 4741992.- (CCF 1103,000 = ANNUAL BTU) BTU (Divide total annual BTU by GSF) COST PER GSF $ 1.28 (Divide total annual cost by GSF) RICHEST MEASURED DEMAND 720.0 MONTH APRIL - SEPT ANNUAL BTU (ELECT) 40,961,920,000 ANNUAL BTU (N. GAS) 24,270,096,000 NOTE: 65,232,016,000 COST INCREASE OVER 1978 = 11.8 % TOTAL ANNUAL BTU'S USAGE DECREASE OVER 1978 = 26 % ENERGY CONSUMPTION WORKSHEET BUILDING COMPLEX / JAIL GSF OF BUILDING 137,333 • ACC # 7062940364000015 ACC # 01010422101 MONTH ELECTRICITY NATURAL GAS 1928, KWH DEMAND KW COST CCF COST JAN 293,600 680.0 $ 8,170.80 33,077 $ 5,171,45 FEB 284,800 680.0, 8,385.89 29,049 , 4,578.64 MARCH 324,800 . 760.0 9,004.48 25,279 3,986.82 APRIL 339,600 760.0 9,321.54 22,614 3,426.38 MAY 341,600 780.0 9,608,90 28,171 4.373.85 JUNE 378,800 760.0 10,246.58 49,530 7,694.86 JULY 449,200 780.0 11,434.60 47,354 7,333.24 AUG 347,600 760.0 6,982.74 41 ,679 6,706.66 SEPT 393,600 760.0 9,988.93 26,301 4,471.23 OCT ' 302,400 740.0 8,308.34 24.665 4,679.99 NOV 321 ,200 720.0 8,972.86 30,512 5,788.72 DEC 280,400 640.0 7,923.96 36,997 7,152.70 4,057,600 108,349.32 395,228 65,364.54 (KWH X 11,600 = ANNUAL BTU ) 636'749 (CCF 1103,000 = ANNUAL BTU) BTU PER GSF (Divide total annual BTU by GSF) COST PER GSF $ 1,26 (Divide total annual cost by BTU) HIGHEST MEASURED DEMAND 780.0 MONTH MAY,JULY ANNUAL BTU (ELECT) 47,068,160,000 ANNUAL BTU (N. GAS)-40,708,484,000 TOTAL ANNUAL BTU'S 87,776,644,000 GP.INTS PROGRA'5 FOR SO100LS AND HOSPITALS AND "G• 038-R0402 q t• . reNILDINCS CANED BY UNITS OF LOCAL G31'EPNICNT fr."‘ ' PUBLIC CARE INSTITUTIONS APPLICATION _ PART is GENERAL INFORMATION . FEDERAL ASSISTANCE 2. APPLI• NDM{ER 3. STATE a rUM{f{ CANT'S • N AP/LEI• CATION 1. TYPE PREAPPLICATION A►PLI• S.DATE Year month day 'DE MI' S.OATS Of CATION ASSIGNED liar month de o ACTION APPLICATION 1980-11-6 FIER 19 (Mark op. CI NOTIFICATION OF INTENT (Opt.) Lew prapnatr bail C) REPORT OF FEDERAL ACTION Blasi 4. LEGAL APPLICANT/RECIPIENT 5. FEDERAL EMPLOYER IDENTIFICATION NO. e.Aperient Non ' Board of County Commissioners 84-6000-813 S.O.yanisc+:«Unit t Weld County Government 6 I r.�c Ss..n/P.o. M. : P.O. Box 758 no. e.NUM/ER I8i l I s I d5 [2 I d.Orr Greeley ..cmM y Weld GRAM S.TITLE Grant Programs for SchoD' i.Stern Colorado 9.Zip Coder 80631 (From and Hospitals and Buildings Owns Fed C h.Can Catal m toe Pant.(Name o) by units of Local Government al c• l ddlephoneNo.! : Donald D. Warden maJoE/ Public Care Institutions. 7.TITLE AND DESCRIPTION OF APPLICANT'S PROJECT ✓ 8.TYPE OF APPLICANT/RECIPIENT se A. Grant Programs for Schools & Hospitals & Buildings � ,, ` Ga..Nn arts Agency wl..Ed...ri....1 smme.e us Owned by Units of Local Government & Public Care a; ; etfy): institutions. Check block(s) : f— Co COT UI x Technical Assistance Program . t— Seal Deno 0-- Sessee . e I Energy Conservation Measure - 0...m Enter anrrnar.ktser OQ a 9.TYPE OF ASSISTANCE • i - A— Rosh Groat 0— Inwnnct z P-- SYPPl......tal Grent E— Other Enter apple-I C— teen phase kiting',h na L3 10.AREA OF PROJECT IMPACT(Names of tines minors. 11. ESTIMATED NUM- 12.TYPE OF APPLICATION 'n Stara etc.) tER OF BENEFITING ONS A— New C— Revision F— Avge..nta0on Weld County 1.20.900 I— bneeel D— Cen.Sw6o. Enter appropnare later D 13. PROPOSED FUNDING Id. CONGRESSIONAL DISTRICTS OF: 15. TYPE OF CHANGE(For 11e or 11 el a. FEDERAL I S 2,523 .co P.APPLICANT S.PROJECT A— Increase D.Ilen F— Other(Spree/u: I /— Demesne Dellen ' 6. APPLICANT .o0 4th 4th e— Menem Detection c STATE { 00 16. PROJECT START 17. PROJECT 0— Decrease Dvrarion E— Csnnllatien • DATE Year month day I d. LOCAL DURATION Enter appro.I 2,523 .w 19 80-9-30 5 Months Roam Wimp . I .. OTHER I .DD 18. ESTIMATED DATE 70 Year month day 19. EXISTING FEDERAL IDENTIFICATION NUMBER SE SUBMITTED TO I. TOTAL I S 5,046 SO FEDERAL AGENCY ► 1980-8-15 NA 20. FEDERAL AGENCY TO RECEIVE REQUEST (Name. City.State. ZIP code) 21. REMARKS ADDED Dept. of Energy, P.O: Box 26247, ?Belmar Branch;`Lakewood, CO 80226 14 Yes Ow. z 22. a To she best i kneeled end belief. 6. N Q e or P repaired by OMI o oppr A-95 this application was submitted,reap ,responses to No re• Reached e. THE state in this peePPl:.rtwn/oppiieatien infractions d..r.in, b e • APPLICANT '^ ewe and cancel. the d.cvn..ns has beech pprepiass .dwrinyMuser end ell rasper.Ss an Cl. sphere attached CERTIFIES Men fitly authorized ay the atneminp (1) 0 • 0 THAT 9 body of the applicant had the epprocani NA will comply whit the ed ne .d.ssar.nces 1�1 z . 0 0 _' if Mn tsu.bnci,n ape.ered. (3) 0 - 0 2 2r.3. I a.TYPED NAME AND TITLE S.SIGNATURE c DATE SIGNED W IREPRE INCA 1 C. W. Kirby, Chairman d fear month der I SENTATrvE Board of County Commissioners _ 1.text 19� 7 c2 '74. AGENCY NAME // 25. APPLICA• )'ear month der TION RECEIVED 19 26. ORGANIZATIONAL UNIT 27.ADMINISTRATIVE OFFICE 28. FEDERAL APPLICATION - IDENTIFICATION rl 29. ADDRESS 30. FEDERAL GRANT o IDENTIFICATION tz o• 131.ACTION TAKEN 32. FUNDING Year month 'day 3t Year mnnrh day e STARTING c ' D a. AWARDED a. FEDERAL IS - .00 33. ACTION DATE r 19 DATE 19 D b. R.-EJECTED le APPUCANT I .Op 135. CONTACT FOR ADDITIONAL 1NFORMA- 36. Year month der st r I TION (Name and telephone number' ENDING D c RETURNED FOR c. STATE DATE 19 = AMENDMENT d. LOCAL 1 .00 37.REMARKS ADDED S O d. DEFERRED ...OTHER .00 D r.. D N. u Da. WTTHDRAWN I. TOTAL S .00 N 38. a. In Shiny abs.. amen. Pay [assents r.e....6 free d.orinyMvns -.r. I b. PEDERAI AGENCY A-95 OFFICIAL o nsdered. If ern" response is Ave seder pra.i.:.m d P.m 1. OM{ (Na.,,and telephone na.) FEDERAL AGENCY Cnerier A_95,is hes been et is being mess. A-95 ACTION NA NA 1 Ay.-102 Pa na 1 STANDARD FORMr AJ.RAGE 1R?Aft e..771 OMB NO. 038-R0402 • ^ART I: GENERAL INFORMATION C t. NOTE : If application is for more than one building, attach a separate "Remarks" section for each building. SECTION IV 39 .0 What is the name and address of the building? Weld County Courthouse. 9th Avenue and 9th Street 40.0 What type of building is it? (c) ® Building owned and primarily occupied by Unit of Local (a) D School Facility .Government (h) .D Hospital Facility (d) D Building owned and primarily occupied by Public Care Institution 41 .0 What is the functional use of the building? (a) D School (c) ® Local Government Building D Elementary D Office D Secondary D Storage D College/University D Service D Vocational D Library D Other, specify: D Other, specify: Courts (b) D Hospital (d) D Public Care Building D General D Nursing Home D Tuberculosis D Long-Term Care D Other, specify: D Rehabilitation Facility p Public Health Center • Co Residential Child Care Ctr. D Other, specify: • 42 .0 What is the size of the building? 56,880 gross sq. ft . 43.0 Is the building a public or non-profit institution? (a) ® Public WED Non-profit 44 .0 What is the current building energy consumption rate? 248,175 BTU/sq. ft./yr. 45 .1 What is the estimated or actual energy savings resulting from implementation of operations and maintenance procedures? (a) ® Estimated (b) in,nnn BTU/sq. ft./yr. D Actual 45.2 Where are the operations and maintenance procedures identified? (a) ® Energy Audit (b) D Technical Assistance Project • Dana 7 TrM a PORN W PIO(7 M.. « • 46.0 Eligibility Check Yes or No, or fill in blanks. If No, provide explanation in the space provided on the following page. YES NO 46..1 Has an energy audit been performed in accordance with the State Plan? x _ • 46.2 Was a portion of the cost of the Energy Audit paid with Federal funds? x _ 46.3 Have all energy audit recommended maintenance and operating procedures been implemented? X 46.4 Was construction of the building, or any addition thereto, completed on or before April 20, 1977? X _ 46.5 The building owner of record is citizens of Weld County 46.6 Is this a severe hardship application? If yes, attach the • explanation of conditions of hardship as required in the special State instructions. _ X (Complete 46.7 through 46.10 for energy conserva- tion measure applications only. ) 46.7 Has a technical assistance program been performed in accordance with the State Plan? (Note: A copy of the program report must be attached if not previously submitted. ) N/A If the program report is not attached, provide date submitted to: State Energy Office DOE Regional Office 46.8 Have all technical assistance program recommended maintenance and operating procedures been implemented? N/A 46.9 Is the simple payback period of each energy conservation measure for which financial assistance is requested at least one year and not more than 15 years and less than the useful life of the building? x/A Page 3 • 46.0 Eligibility continued YES NO 46.10 Do you intend to close or dispose of this building within the simple payback period of any energy conservation measure for which funding is requested? If yes, explain. N/A EXPLAIN "NO" ANSWERS BELOW, OR ATTACH ADDITIONAL SHEETS, IF NECESSARY. (A negative response to questions 46.2, 46.6 and 46.10 requires no explanation. ) • Page 4 n 47.0 Complete for Technical Assistance Program Applications Only YES NO 47. 1 Are the results of the preliminary energy audit and energy audit attached? X (add'l copy) If "No", provide date submitted to: State Energy Office 4/2/8o DOE Regional Office 47.2 Does the information on page 2, Building Data Sheet, corres- pond with the data in the EA? x 47.3 Provide a brief description, by building, of the proposed technical assistance program. (Note: The proposed program must identify all proposed O&M changes and must include consideration of all possible energy conservation measures, including solar and other renewable resource measures. See 10 CFR 455.42. If additional space is required, attach separate sheets. ) The Weld County Courthouse technical assistance audit will be conducted by a qualified technical assistance analyst. The audit will consider measures iden- tified in 10CFR 455.52 and all other possible conservation measures, including solar or other renewable resource measures. The analyst will also report any operation and maintenance measures not included in the preliminary energy audit. At the conclusion of the technical assistance energy audit, the analyst shall prepare a final report according to federal rules 10CFR 455.42. 47.4 Complete the following milestones schedule for the proposed Technical Assistance Program: MILESTONE SCHEDULE TASK MONTH - DAY - YEAR Solicit quotations from qualified analysts 4/1/80 Sign contract with analyst 10/1/80 Work Begins 10/4/80 Project Completed 12/31/80 Draft TAP Report 1/14/81 Final TAP Report 2/12/81 Explain in the space below any milestone which gives the appearance of undue delay: Page 5 • • C;•9 NO. 038-R0402 • • • PART II: PROJECT APPROVAL INFORMATION • he_1. Does this assistance request require State, local, Nome of Governing Body Board of County Cntmmisstone' regional, or other priority rating? - Priority Rating Weld County X Yes No Item 2. Does this assistance request require State, or local Name of Agency or advisory, educational or health clearances? Board Board of County Cotmmigginnerc X Weld County Yes No (Attach Documentation) Item 3. Does this assistance request require clearinghouse (Attach Comments) review in accordance with OMB Circular A.95? • Yes X uo Item 4. Does this assistance request require State, local, Name of Approving Agency Board of rn Commigginner: regional or other planning approval? x Date 6/30/80 Yes No • Item S. Is the proposed project covered by an approved compre- Check one: State 7 hensive plan? - Local X Regional _ Yes No Location of Plan Item 6. Will the assistance requested serve a Federal Name of Federal Installation installation? Yes X No Federal Population benefiting from Project Item 7. Will the assistance requested be on Federal land or Nome of Federal Installation installation? Location of Federal Land Yes X No Percent of Project Item 8. Will the assistance requested hove an impact or effect See instructions for additional information to be on the environment? provided. Yes --X--No Item. 9. Number of: Will the assistance requested cause the displacement Individuals of individuals, families, businesses, or forms? Families X - Businesses • Yes No Farms Item 10. • Is there ether related assistance on this 'project previous, See instructions for additional information to be pending, or anticipated? provided. Yes X No item 11 See instructions for additional Is the project in a designated flood information to be provided. hazard area? Yes x No Page .10 • 11 a6ed cm C $ I R : 3 sn 0 0 a ,n a • Z • Ca O X Lk o •_ s a 3 : KIN • ; ] c Y CC W h. t C < 2 ! •. O C N W F la 1 UI _i II I II I 1 ll li U • W • I ssill w c t : _ I ] z I il I I CC U CI LW a. i ::::\11/4::\ =I — I I N MHis\s\:: O r : kJ N I I a W se oe » • se 4' • II to U c g V C 6 m yy o H < u C — Eon X. S _ YI A r .. air o S a � W $ 8 uI 3 .$- .1 °P oP M1I M 4 4 d V O 4 ell 4I .. .y 4 Zl 96 e ci cN a O J ^ _ a r M P 1 w<. ) .r - • • O in un N N a o G CO© r N N N ,.. . I... O •-oW Z + + C + + Y C Z a 0 el 7 - = 7. CC o W ? I r _ : z U. ,c 0 o C o T. W -o _ V W + Z s Q + c 1-1 m -J p o C N ill 0 P • Z •. G W 4i a CI u r .n z 2 CC IL n 0 C") C w W L a 0 la a O w b. CC Ea O in N'. 0 w 0 _ a C + .. a W + 1.1 J W Z ° Vo Z a L C r W^+ 0 W = Z W ►- CJ . FY 0 u Cr) C�1 H . 0 r 0 i c� l• a. Vl in V o o N N .7 a m LC)• F re-1a • • W I - V1 trio J i. < O j N N O «• - N N In C a W • V C C Z LL W !-- a' A I .. I + I 0 + O , Z V N 0 �+ •-1�• IL I j a H Z Y b.l O 2 : U. LL i r 0 Il w r. V It H0 Z 0 • NLI.1 ea N tu a Q V N :- E c 7 - W CU MS i N C01 I- L ^ r H 0 C C` 4J W a- <" .. ill + F- d C.. I CI 0 I U i u C = 1 Y y C C CO i 4-3 N U I I to VI L. Z S V! Q C 0 4.1 v L. Y F .-- is-r V rp '0I•.-'V W U w-ov N ` • r VI d L i C OS-L) I a5 OW .+ i i a + u pd N LQ U c1. r` < a V . I F- G.F-W Ca a O •- . • a • y a -. 1 4; 4; O - . — -I h h n • ^ e•-•••,, r1 Part III - Budget Information Section A - Budget Summary (p. 11 of Application) 1. Identify the source and amount of non-federal funds General Fund expenditure of $5.046 • 2. Are these funds available for this program without further authorization? x Yes __No. If "No", provide explanation. Section B - Budget Categories (p. 11 of Application) Explain any entries on p. 11 (Section B) under line items a-h in the spaces provided below. Attach additional sheets if necessary. (a) PERSONNEL - Any task not actually performed by employees of an insti- tution should be entered under contractual . (i .e. contractual personnel costs will be included under contractual ). Enter only actual direct charges for this item including rate per hour, number of hours, or percent of time, task and position title. No figures will appear on this line unless institutions intend to use in-house personnel for conducting the TA or implementing ECM measures. (Volunteer labor can only be valued at a rate consistent with similar work in other activities of the grantee or the going rate for that particular occupation in the community. This time must also be documented by rate per hour, number of hours, task and position title. ) Page 13 (b) FRINGE - Enter itemization of fringe in this space. This item is only allowable when attributable to actual personnel costs cited above. (c) TRAVEL - Itemize all travel costs. (Travel expenses of contractors are usually included in the amount of the contract cost. ) Include details of any travel in the performance of TA's or ECM's by in-house personnel . Conferences & trips to the State Energy Office are not allowable. If you feel you have justified travel which should be allowed, give specific details and justification. • (d) EQUIPMENT - Itemize equipment expenditures. The purchase of equipment by all Grantees of $300 or more with a useful life on one year is subject to prior Department of Energy approval . (The purchase of equipment of $500 or more with a useful life of more than two years by A-110 Grantees subject to CASB regultions require prior Department of Energy approval . ) IBGP Program regulations state that for TAs no equipment may be purchased in excess of $500. (e) SUPPLIES/MATERIALS - All supply/material costs must be itemized. This line item would normally be used to reflect the cost of supplies/materials for ECMs implemented with in-house staff. (f) CONTRACTUAL - Contractual costs should include all functions which will be contracted out, such as: personnel costs, ECM measures and materials, and the performance of the TA. These costs incude TA/ECM projects or A bid of $.08/sq. ft. was received for the Technical Assistance program which comes to a total of $5,046.00. Page 14 • EIA-145 ^ / 1 FORM APPROVED OMB NO. 038-RD402 PART V: ASSURANCES - Section A SPECIFIC INSTRUCTIONS • This part contains the certifications required of applicants for Federal • grants. The applicant shall certify in its application for, and acceptance and use of Federal funds, that• it will comply with the laws and regulations governing these grant programs. • The Assurances section applies to the original application. and to any subsequent modification or amendments. The Applicant hereby mutes and certifies that he .:11 comply with the regulations, policies, guidelines. and requuem•ents, m- eluding OMB Circular No. A-102 end FMC 741, al they relate to She application,acceptance end use of Federal funds for this fed. rally wilted project? Also the Applicant assures and cantinas with respect to the grant that: • 1. It possesses legal authority to apply for the grant;that a 4. It will comply with requirement of the provisions resolution, motion or similar action has been duly of the Uniform Relocation Assistance and Real Property adopted or passed as an official act of the applicant's Acquisitions Act of 1970 (P.L. 91.646) which provides governing body, authorizing the filing of the application, for fair and equitable treatment of persons displaced as a including all understandings and assurances contained result of Federal and federally assisted programs therein, and directing and authorizing the person identi- 5. It will comply with the provisions of the Hatch Act fied as the official representative of the applicant to act which limit the political activity of employees in connection with the application and to provide such 6. It will comply with the minimum wage and maximum additional information as may be required. hours provisions of the Federal Fair Labor Standards 2. It will comply with Title VI of the Civil Rights Act of Act, as they apply to hospital and educational institu• 1964 (P.L. 88.352) and in accordance with Title VI of tion employees of State and local government. that Act, no person in the United States shall, on the 7. It will establish safeguards to prohibit employees from ground of race, color, or national origin, be excluded using their positions for a purpose that is or gives the from participation in, be denied the benefits of, or be appearance Of being motivated by a desire for private otherwise subjected to discrimination under any pro- gain for themselves or others, particularly those with gram or activity for which the applicant receives Federal whom they have family,business, or other ties. financial assistance and will immediately take any mea• 8. It will give the sponsoring agency or the Comptroller aura necessary to effectuate this agreement General through any authorized representative the ac- cess to and the right to examine all records, books, 3. It will comply with Title VI of the Civil Rights Act of . papers,or document related to the grant • 1964 (42 USC 2000d) prohibiting employment discrimi• 9. It will comply with all requirement imposed by the nation where (1) the primary purpose of a-grant is to Federal sponsoring agency concerning special require- provide employment or (2) discriminatory employment menu of law, program requirement, and other ad- practices will result in unequal treatment of persons who are or should be benefiting from the grant-aided activity. ministrative requirement. 10. It will insure that the facilities under its ownership, lease or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of Violation Facilities and that it will notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating • that a facility to be used in the project is under consideration for listing by the EPA. t The regulation which we with to bring to your attention It 1 OCF R 451. • 16 any portion thereof. These entries should be itemized to include, for example: engineering costs with rate, task and hours for each element of the work to be performed. (g) CONSTRUCTION - Do not use this object category for this program. No figures should be entered on this line. (h) OTHER - Any allowable costs not specifically identified on other lines must be itemized here. Page 15 - EIA-145 /'\ ^ FORM APPROVED OMB NO. 038-R0402 PART V: ASSURANCES Con' t. 11. It will comply with the flood insurance purchase requirements of Section 102 (a,) of the Flood Disaster Protection Act of 1973, Public Law 93-234, 87 Stat. 975, approved December 31, 1976. Section 102 (a ) requires, on and after March 2, 1975, the purchase of flood insurance in communities where such insurance is available as a condition for the receipt of any Federal financial assistance for construction or acquisition purposes for use in any area that has been identified by the Secretary of the Department of Housing and Urban Development as an area having special flood hazards. The phrase "Federal financial assistance" includes any form of loan, grant, guaranty, insurance payment, rebate, subsidy, disaster assistance loan or grant, or any other form of direct or indirect Federal assistance. 12. It rill assist the Federal grantor agency in its compliance with Section 106 of the National Historic Preservation Act of 1966 as amended (16 U.S.C. 470), Executive Order 11593, and the Archeological and Historic Preservation Act of 1966 (16 U.S.C. 469a-1 et seq. ) by (a ) consulting with the State Historic Preservation Officer on the conduct of investigations, as necessary, to identify properties listed in or eligible for inclusion in the National Register of Historic Places that are subject to adverse effects (see 36CFR Part 800.8 ) by the activity, and notifying the Federal grantor agency of the existence of any such properties, and by (b ) complying with all requirements estabished by the Federal grantor agency to avoid or mitigate adverse effects upon such properties. • • 17 PART V - SECTION B - CERTIFICATIONS (A COPY OF THESE CERT'FI- CA NS MUST BE A PART OF THIS APR' CATION) The applicant hereby certifies that: 1 . It meets the eligibility requirements contained in 10 CFR 455.41 (for applications for Technical Assistance), or 10 CFR 455.51 (for applica- tions for Energy Conservation Measures) . 2. It has or will satisfy the requirements set forth in 10 CFR 455.60 3. It has implemented all energy conservation maintenance and operating procedures identified in an energy audit or its equivalent (for appli- cations for technical assistance) , or identified in an energy audit and technical assistance program or its equivalents (for applications for energy conservation measures) , with the following exceptions: I (Enter "none" or list specific maintenance and operating pro- cedures not implemented and a justification for not imple • - menting each procedure) . Page 18 4. It will expend finds granted under 10 CFR Partr`5 for the purpose stated in this 4pplication and in compliance with the requirements of 10 CFR Part 455 and the approved State Plan. 5. It will obtain from the technical assistance analyst, prior to the analyst performing work in connection with a technical assistance program or energy conservation measure, a signed statement certifying that the technical assistance analyst has no conflicting financial interest and is otherwise qualified to perform the functions of a technical assistance analyst in accordance with the requirements set forth in the approved State Plan. 6. It will comply with all reporting requirements contained in 10 CFR 455.63. 7. It will not enter into any contract relating to an energy conser- vation measure, which requires or may require expenditure of more than $5,000 (excluding technical assistance program costs) that does not conform to the provisions of the Davis-Bacon Act* (40 USC Sections 276a to 276a-5) pertaining to minimum wages for construction in the applicant' s locality. 8. It will provide the required matching non-federal funds, including in-kind contributions (limited to the goods and services described in OMB Circular A-102) , and that such funds or contributions are directly related to the project. 9. It will comply with the Civil Rights requirements pursuant to 10 CFR•455.3(a) (8) . It will comply with the Title VI of the Civil Rights Act of 1964 (PL 88-352) , Section 16 of the Federal Energy Administration Act of 1974 (PL 93-438) , Title IX of the Education Amendments of 1972, as amended. (PL 92-318, PL 93-568, and PL 94- 482), Section 504 of the Rehabilitation Act of 1973 (PL 93-112) , the Age Discrimination Act of 1975 (PL 94-135) , Title VIII of the Civil Rights Act of 1968 (PL 90-284) , the Department of Energy Organization Act of 1977 (PL 95-91 ) , and the Energy Conservation and Production Act of 1976, as amended, (PL 94-385) . In accordance with the above laws and regulations issued pursuant thereto, the applicant agrees to assure that no person in the United States shall , on the ground of race, color, national origin, sex, age, or handicap, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program • or activity in which the applicant receives Federal assistance from the Department of Energy. er7 /KAI 7/2/3980 Signature - Authzed, Certifying Date Representative Chairman, Weld County Board of County Commissioners Title * Davis-Bacon rates can be requested at any time after the Appli- cation is submitted. Page 19 r^ /1 fraillifr RANKING - Technical Assistance Complete For Technical Assistance Applications Only, using the "Application" packet as a guide. Attach additional sheets if necessary. Building Name Weld County Courthouse BTU's consumed per gross sq. ft. per year 248,175 Energy costs per gross sq. ft. per year .65 BTU's consumed per gross sq. ft. per annual operating hour per year 99.43/hr. Past energy conservation activity. -0- % energy reduction for one year (Energy Consumption records must be attached - see "Application" booklet) Building Name • BTU's consumed per gross sq. ft. per year Energy costs per gross sq. ft. per year BTU' s consumed per gross sq. ft. per annual operating hour per year Past energy conservation activity. % energy reduction for one year (Energy Consumption records must be attached - see "Application" booklet) Building Name BTU' s consumed per gross sq. ft. per year Energy costs per gross sq. ft. per year BTU's consumed per gross sq. ft. per . annual operating hour per year Past energy conservation activity. % energy reduction for one year (Energy Consumption records must be attached - see "Application" booklet) - 20 - Hello