HomeMy WebLinkAbout20023092.tiff RESOLUTION
RE: APPROVE CERTIFICATION OF COMPLIANCE AND STATEMENT OF GRANT
AWARD FOR 2003 VOCA DOMESTIC VIOLENCE/SPECIAL POPULATIONS
PROJECT 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 Certification of Compliance and
Statement of Grant Award for the 2003 VOCA Domestic Violence/Special Populations Project
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the District Attorney's Office, 19th Judicial District,
and the Colorado Department of Public Safety, commencing January 1, 2003, and ending
December 31, 2003, 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 award, 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 Certification of Compliance and Statement of Grant Award for
the 2003 VOCA Domestic Violence/Special Populations Project between the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the District Attorney's Office, 19th Judicial District, and the Colorado Department of
Public Safety 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.
2002-3092
de , 94 DA0017
RE: CERTIFICATION OF COMPLIANCE AND STATEMENT OF GRANT AWARD
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 2nd day of December, A.D., 2002.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, C9LORADO
ATTEST: Mk% EL/ •d-�e-._.�A� I rd�.v�i a
`%GI Vaad, Chair
Weld County Clerk to the ' .a .
i
'$ avi . L g, Pro- e
BY: (a./i . .Ii!..n
Deputy Clerk to the Boa. l . J. Geile
APPROVED AS TO FORM: lil / A„w
/ Iliam H. Jerke
aunty Attorney ,
Robert D. Ma's1en
Date of signature: 4a�)
2002-3092
DA0017
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 is found on tie 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 tcthe Colorado Division of Criminal
Justice, 700 Kipling, Ste. 1000, Denver, CO 80215, within 45 days of the grant award begiining date.
Grant#21-VA-19-63 (CY2003) Grant Project Title:Domestic Violence/Special Populations Project
District Attorney's Office, 19th Judicial District
Subgrantee Name(Funded Entity):
Address: 915 10th Street, P.O. Box 1167, Greeley, CO 80632
Duration:Beginning date: 01/01/2003 End date: 12/31/2003 I Award: $29,859.00
Project Director's Name&Phone#: Gary L. Pathke (970-356-4010, ext. 4747)
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 RECIPIENT& 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 fcr persons with limited English proficiency.
*I certify that this agency will maintain data(and subnit 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 seq.; 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#13066).
*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)
A. M. Dominguez, Jr., District Attorney
District Attorney's Office, 19th Judicial District
P. O. Box 1167, Greeley, CO 80632 ore U. APPROPRIATE CERTIFICATION (L EMPLOYMENT OPPORTUNITY
B Cl orPLrCC2 bellow)that applies to this subgrantee agency dP)CERTIFICATIONS: Check the box furing the period of
ONE
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
(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
(CONTINUED ON REVERSE SIDE)
Colorado Division of Criminal Justice
Page 1 of 2 (Rev.m/4/2002)
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)
fl 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 bythe U.S.Department of Justice over an 18-month period that includes the above grant duration period.
Therefore,I hereby certify that the funded entityhas formulated an Equal Employment Opportunity Plan in accordance
with 28 CFR 42.301,et sue., subpart E,that it has been sigied 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 US.Department of Justice funds,but,it has nct been awarded more than$1
million cumulatively from all programs administered bythe U.S.Department of Justice over an 18-month period that
includes the above grant duration period.
Therefore,I hereby certify that the funded entitywill 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 entitywill 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 fa-the above Subgrantee,I certify,by my signature below,that I have read and am fully cognizant of
our duties and responsibilities under this Certifrcatiai.
12/02/2002
[Authorized O cia 's si [Date
Chair, Board of County Cormiissioners,
Glenn Vaad (12/02/2002) Weld County, Colorado
[Typed Name] [Title]
* * * * * * * * * *
This original signed form must be returned to the Colorado Dvision 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 1. DCJ will forward a copy to the Office for Civl Rights, Office of�Justice Programs, U.S. Department of
Justice.
Colorado Division of Criminal Justice Page 2 of 2 (Rev.I1/420021
COLORADO DIVISION OF CRIMINAL JUSTICE
DCJ Form 4-B: CIANapE IN SIGNING AUTHORITY
SUBGRANTEE:District Attorney's Office, 19 GRANT NUMBER: 20-VA-19-63 & 21-VA-19-63
PROJECT TITLE: PROJECT DURATION
Domestic Violence/Special Popuslations Pr .FROM:01/01/2003 TO: 12/31/2003
IPREPARED BY:Gary L. RathkePHONE: (976 356-4010, ext. 4747DAT. 11/25/2002
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.
Change requested by: ( t( 1-C70
—SUBGRANTEE PROJECT DIRECTOR Signature DATE
PROJECT DIRECTOR'S MAILING ADDRESS: District Attorney's Office. P. O. Box 1167.
lroclny. m Rf1G'37
THE PURPOSE OF THIS REQUEST IS TO: ri
CHANGE THE PROJECT DIRECTOR
El CHANGE THE FINANCIAL OFFICER
®CHANGE THE AUTHORIZED OFFICIAL
Date Change Effective: immediately
From: To: Glenn Vaad, Chair
PRINT OR TYPE FULL NAMF/ITfLE
Board of County Commissioners. Weld County, Colorado
Agency Name Agency Name
P. O. Box 758, Greeley, CO 80632
Mailing Address Mailing Address
970-336-7204 l 970-352-0242
Telephone Fax
GVaad@co.weld.co.us
email
Original Signature of new of Official 12/02/2002)
Reason for change: new chair
***Division of Criminal Justice Use Only"
THIS REQUEST IS _Approved _Denied,see attached
By:
PROGRAM SPECIALIST,DCJ DATE
Rev.12/00 DCJ4Ewp678.wpd
DETAILED INSTRUCTIONS FOR COMPLETING
DCJ Form 4-B-CHANGE IN SIGNING AUTHORITY
HEADING
Subgrantee: This is the agency to which the grant award was made.
Grant Number: This is the grant number assigned to the project by DCJ. It can be found on the Statement of Grant Award.
Protect Title: This is the name of the project which is identified on the Statement of Grant Award.
Duration: This is the period of the grant award. It can be found on the Statement of Grant Award, and is changed only if the project
requests and receives a grant extension.
Prenared bv: Name of person completing this form. Include this person's phone number.
Date: This is the date the Change in Signing Authority form is completed.
Protect Director's Signature and Address: The approved change will be sent to the Project Director at this address.
SIGNING AUTHORITY CHANGE,
Check which signing authority is changing. Submit a separate form for each person changed.
Indicate the date the change becomes effective. Supply the name of the person who will no longer hold the position of project director,
financial officer,or authorized official. Print or type the name,title,agency,mailing address,telephone and fax number, and email address
of the new person. The original signature of the new person is required.
Protect Director: The project director is the individual who will be in direct charge of the project. This should be a person who has
knowledge and experience in the project area and ability in administration and supervision of personnel. The project director will be
expected to devote a major portion of his/her time to the project.
Financial Officer: The financial officer is the person who will be responsible for fiscal matters relating to the project and in ultimate charge
of accounting,management of funds,verification of expenditures and grant financial reports. This must be an individual other than the
project director.
Authorized Official: This is the individual authorized to enter into binding commitments on behalf of the applicant agency. This must be
an individual other than the Project Director or Financial Officer. In local units of government,this individual will normally be a city
manager,district attorney,mayor and/or commissioner. At the state level,this individual will be a department or division head. For private
non-profit agencies,this individual will be the Chair of the Board of Directors,.
Examples of Authorized Officials Follow:
If the subgrantee is a: Then the Authorized Official is the:
State Agency Department or Division Director
An agency of/or a unit of local government:
City Mayor or City Manager
County Chairperson of the County Commissioners
Sheriff's Department Chairperson of the County Commissioners
Police Department Mayor or City Manager
Courts Chief Judge
District Attorney's Office District Attorney or Chair of the County Commissioners
Institution of Higher Education President of the institution or chair/dean of the appropriate
department
Private Non-Profit Agency President/Chairperson of the Board of Directors
School District Superintendent/Asst. Superintendent
REASON FOR CHANGE: Briefly state why the previous person no longer holds the position with this grant.
Send two signed forms,one with original signatures to DCJ. One approved copy will be returned for your records.
SECTION I: Fund-Soecific Information.
ALL APPLICANTS
22. VOCA GRANT SPECIFIC INFORMATION:.
SUBGRANT AWARD REPORT/APPLICATION INFORMATION
U.S.DEPARTMENT OF JUSTICE -OFFICE OF JUSTICE PROGRAMS -OFFICE FOR VICTIMS OF CRIME
The purpose of this report is to collect basic information on Subgrant recipients and their programs in a matter that is convenient to
report and analyze. This report must be completed in full and submitted by the State agency(grantee)within ninety(90)days from
the date of the award of a Subgrant to a local victim assistance program. A Subgrant Award Report must be completed for each
program receiving Victims of Crime Act funding.
1. I AgencyName: District AttoLney's Office, 19th Judicial District
Project Title: Domestic Violence/Special Populations Project
Mailing Address: p. O. Box 1167
City: Greeley, CO I Zip: 80632
I Telephone: 970-356-4010 I Fax: 970-352-8023E-MaliM.Rathke@netsca�e.net
2. Congressional District: I State Use Only-FEDERAL GRAN 1 F UMBER:
3. Purpose of VOCA Subgrant award: (check one)
— a. Start up a NEW victim services project.
X b. Continue a VOCA funded project funded in a previous year.
c. Expand or enhance an existing project NOT FUNDED by VOCA in a previous year.
— d. Start up a NEW Native American victim services project.
— e. Expand or enhance an existing Native American Project.
4. Stara Use Only-Crime Victim Assistance I $ 29,859
State Award Number: 1 21—VA-19-63 I Project begin date: 11/1/2003 I Project end date: 112/31/2003
5. State Use Only-Subgrant Match(Financial support from other sources)
Value of In-Kind Match: I I Cash Match: $ I 7,465 I Total Match:$ I 7,465
6. These VOCA funds will primarily be used to: a. Expand services into a new geographic area.
(Check only one) I b. Offer new types of services.
I c. Serve additional victim populations.
I X d. Continue existing services to crime victims.
I e. Other
7. For this victim services program please indicate: (Read instructions carefully.)
a. The number of volunteer staff(FTE): 10-1.25 b. Has this program received a 1--1Y I h l N
c. The number of VOCA-paid staff(F 1E): I 1.20 I .
Please provide a brief volunteer job description:
Victim/Witness volunteer may be assigned to assist with the Senior Project, the Court-
room Assistance Program (CAP) , Crie Victim Compensation Program, Victim Rights Act
notification area, and other duties related to helping victims and witnesses of crime.
8. Identify the amount of the VOCA grant that will be used to meet the priority and underserved requirements.
a. Child Abuse: I 8% $ 2,388 I Gray Boxes for State Use Only.
b. Domestic Violence 36% $ 10,749
c. Sexual Assault 1 % $ 299
d. Underserved:
I. DUI/DWI Crashes 118% $ 5,375
2. Survivors of Homicide Victims: I 1% $ 299
3. Assault: 2% $ 3.583 I
4. Adults Molested as Children: P % $
5. Elder Abuse: I % $
6. Robbery: I 1% $ 299
7. Other Violent Crimes: 23% $ 6,867
15
9. T e of Implementing Agency(Check the appropriate boxes.)
a. I Criminal Justice-Government:
_ Law Enforcement X Prosecution Probation
Court Corrections Other
b. E .
Non-Criminal Justice-Government:
Social Services r Mental Health Q Public Housing
Hospital Other
c. f Private Non-Profit:
Hospital Rape Crisis Religious Organization
Shelter Mental Health Agency Other
d. Native American Tribe or Organization:ON Reservation El
OFF Reservation
e. C Other:
10. For State Use Only
Please provide total amount of funding allocated to victim services based on the subgrantee's current Fiscal Year budget.
I FUNDING SOURCES CURRENT YEAR
I a. Federal(Excluding VOCA)
b. VOCA Funds 28,989
c. State
I d. Local 205,489
'Spiker
11. Identify the victim(s)to be served through this VOCA-Funded project(VOCA grant plus Match)by checking the type of
crime(s): (Please read instructions carefully!)
X Child Physical Abuse X Child Sexual Abuse X DUUDWI Crashes
X Domestic Violence X Adult Sexual Abuse X Elder Abuse
Adults Molested as Children X Survivors of Homicide Victims X Robbery
X Assault X Other Violent Crimes X Other
12. Check the services to be provided by this VOCA-Funded Project:
X Crisis Counseling X Criminal Justice Support/Advocacy
X Follow-up Contact X Emergency Financial Assistance
_ Therapy X Emergency Legal Advocacy
Group Treatment E Assistance in Filing Compensation Claims
Crisis Hotline Counseling X Personal Advocacy
Shelter/Safehouse X Telephone Contacts(Information and Referral)
X Information/Referral(in Person) X Other:
16
•
Division of Criminal Justice ��OF.coto� _
Office for Victims Programs Re%�° _
` - o
GOVERNOR DIVISION OF CRIMINAL JUSTICE **\, * —
Bill Owens Raymond T.Slaughter,Director r 4376
DEPARTMENT OF PUBLIC SAFETY OFFICE FOR VICTIM PROGRAMS
C.Suzanne Mencer,Executive Director Ms.Linda Jones,Manager
November 19, 2002
Gary Rathke
District Attorney's Office, 19th Jud. Dist.
915 10th Street =
Greeley, CO 80631
Re: Calendar year 2003 VOCA Assistance Grant Award
Grant Number: 21-VA-19-63 (CY 2003)
Dear Mr. Rathke:
The Victims' Compensation and Assistance Coordinating Committee's recommendation for second year -
funding has been approved by the Governor, the Director of the Division of Criminal Justice and the
Executive Director of the Department of Public Safety.
This packet includes several items which need your prompt attention and response. Enclosed are two
copies of the Statement of Grant Award(SOGA)for the above-named project. Be sure to read all Special
Conditions (bolded at the bottom of the first page) and Standard Conditions listed in your Statement -
of Grant Award. There are new Certified Assurances this year,so please make sure that you,your
Authorized Official and your Financial Officer review them very carefully prior to signing your
Statement of Grant Award.
DCJ staff took the five pages submitted by your agency during the recontracting process and created a =
Statement of Grant Award for calendar year 2003 (using pages from your Statement of Grant Award from
calendar year 2002).
Compare the Approved Budget as shown in the Statement of Grant Award with the budget pages submitted
to our office. Please note any changes made by DCJ staff to the five pages that were submitted during the a
re-contracting process. Also check grant duration dates.
Please read and complete the following process immediately to avoid a delayed start date. Refer to Grant
#21-VA-19-63 (CY2003) in all correspondence and reports. Thank you. -
Statement of Grant Award process: -
1. BOTH copies of the Statement of Grant Award must be signed by your Authorized Official and _
returned to this office NO LATER THAN DECEMBER 6,2002. Early responses are encouraged.
2. Please check the application signature page. If there are changes in the Authorized Official,
Financial Officer, and/or Project Director, please return two copies of DCJ Form 4-B Change in
Signing Authority, to our office. A blank form is included in this packet.
3. After signatures of the Director of the Division of Criminal Justice and the Controller of the
Department of Public Safety are obtained, one of the two copies of the Statement of Grant Award
will be returned to you. This is your VOCA contract. At that time, federal funds will be available for -
you to request.
4. A number of additional items need to be addressed in conjunction with the Statement of Grant
Award process. Please complete the following information and retum it to this office along with
2002-3092 1
November 19, 2002
Page 2
BOTH copies of the Statement of Grant Award. Only then can your Statement of Grant Award be
made available for signature by the Department of Public Safety.
a Enclosed is a Certification of Compliance with Reaulations(grey form), concerning Equal
Employment Opportunity Plans. It also includes new language concerning your
responsibilities pertaining to Limited Enalish Proficiency. This form must be completed
by your Authorized Official and returned with your signed Statement of Grant Award.
It is suggested you make a copy for your files and send a copy to the person in your agency
identified on the form as being responsible for reporting civil rights findings of
discrimination. The Division of Criminal Justice is required to forward the Certification to
the Office for Civil Rights, Office of Justice Programs.
a Please note that we have placed new Certified Assurances in your Statement of Grant
Award. The Certified Assurances are part of your contract with DCJ and contain important
federal and state requirements for the use of VOCA funds. Please read them carefully prior
to signing your Statement of Grant Award.
a The Signature page now requires an attestation. For State agencies, the attestor is
typically someone from the agency controller's office. For Local Government agencies and
District Attorney's Offices, the County Clerk and Recorder is the proper attestor. For non-
profit agencies, the Board Secretary is the proper attestor. If you have any further
questions, please contact our office.
a During the re-contracting process, several pages many have been revised. Several original
signatures are required on the Statement of Grant Award. Please note all of the "SIGN
HERE"stickers that have been placed throughout the Statement of Grant Award, and have
the appropriate individual sign where noted.
a An SAR form (yellow form) has been enclosed in this packet. The SAR form must be
completed and returned with the SOGA's. Please answer all of the questions (even if the
form states for State Use Only).
a Unlike prior years, an Administrative Guide will not be returned with your signed Statement
of Grand Award. The Administrative Guide, including all DCJ forms, is available on our
web site at http://dcj.state.co.us/ovp/. If you are unable to retrieve a copy of the
Administrative Guide off our website, please contact Ms. Pat Glick at(303)239-5719 or toll
free at 1-888-282-1080 and ask her to send you a copy.
Again, please refer to Grant#21-VA-19-63 (CY 2003) in all of your correspondence and reports. Thank you
in advance for your prompt attention to these matters.
Sincerely,
Rob Gallup
Colorado VOCA Ad inistrator
1-888-282-1080, (303)239-4529; robert.aallucn@cdos.state.co.us
oF.coto
ye� COLORADO DIVISION OF CRIMINAL JUSTICE
4,<________/*, STATEMENT OF GRANT AWARD (SOGA)
876
FEDERAL PROGRAM INFORMATION
CFDA Number: 16.575
Federal Agency Office of Justice Programs, U.S. Dept.of Justice
Federal Award Name&Number:Victims of Crime Act,Crime Victim
Asst.Program—20-VA-GX-0008,21-VA-GX-0008,22-VA-GX-0008
Subgrantee Agency Name: District Attorneys Office, 19th Jud. Dist.
Project Director: Mr. Gary Rathke
Address: 915 10th Street
Greeley, CO 80631
Grant Number: 21-VA-19-63
Project Title: Domestic Violence/Special Populations Project
Grant Period: 1/1/2003 to 12/31/2003
Date Issued: 11/15/2002
In accordance with provisions of the Colorado Revised Statutes§2433.5-502 the Division of Criminal Justice hereby awards a
grant to the above-named subgrantee. The attached grant application, including Special Provisions and Certified Assurances,
is incorporated herein as a part of this document.
APPROVED BUDGET _
Budget Category Federal I Cash Match I In-Kind Match I Total
Personnel I $29,859 $7,465 $37,324
Supplies and Operating $0
Travel I $0
*Equipment $0
*Professional Services I $0
TOTAL BUDGET $29,859 I $7,465 $0 $37,324
*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:
Version 11-19-02 Page 1 of 3
H:\DIANAG\VOCAISOGAs\21_22 SOGAS pg 1.doc
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 agrees that the attached grant application, including"Special Provisions and Certified Assurances", is hereby
incorporated by reference as part of this grant award. Review carefully the Special Provisions and Certified Assurances
contained in the approved grant application.
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 intended start date(as set out in the grant period shown on page 1 of this SOGA);
however final approval by the State Controller or designee,is required.
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 80 Dan. If a project is not operational 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 a 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, 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.
Version 11-19-02 Page 2 of 3
H:\DIANAG\VOCA\SOGAs\SOGA Pg 2 and 3.d®
Statement of Grant Award (SOGA)
THE PARTIES HERETO HAVE EXECIJTED THIS BINDING SIJBGRANT AWARD
SUBGRANTEE: STATE OF COLORADO:
District Attorney's Office, 19th Jud. Dist. BILL OWENS,GOVERNOR
Legal Name ofSubgrantee Agency
Agency FEIN(or Sold Security)# 84-6000813 �Q nBy B,
rS\� �' �4
SIGNATURE ofAutho ' cral KDI CTOR Colorado Divisio$of Criminal Justice
Glenn Vaad, Chair, Board of County Comnissiones,
Weld County, Colorado
Print Name&Title of Authorized Official Raymond T. Slaughter
`'
Date Signed: 12/02/2002 Date Signed: 1 g-I l ) C)cL
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#
and is in
fact the the who�signed where indicated.
i 4�/�GY/ C' (or, :fnatwaived)
,,7 lL� //L 12/02/2002
Signature Date , ATTORNEY GENERAL
Clerk to the Boardr•
Title I,„4"!..40014/,-.4a.:,156-4000't, t` Phone BY:
PLACE AGENCY SEAL HERE ,t, t 't? t. a
Or 1 X1 it Date Signed:
Indicate No Seal Available eyed �,a
`C
By: �i.- I�. ta. ! / �
Deputy Clerk to the .t'n.,io0
ALL CONTRACTS & SUBGRANT AWARDS MUST BE APPROVED BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all state contracts.This subgrant award is not valid until the
State Controller,or such 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:
L.BARNHART
BY
DATE I-1- It\ I IA—
Version 11-19-02 Page 3 of 3
H:\DIANAG\VOCA\SOGAs\SOGA Pg 2 and 3.doc
• SECTION A: A2encvInformation ')ITT 3 2002
ALL APPLICANTS—(Do not alter any cell or row eettings.)
1. APPLICANT AGENCY: STATE USE ONLY
Division or Unit(if applicable): District Attorney's Office, 19`x'Judicial District App# 1'A- - (CY2003)
Mailing Address: Victim/Witness Program Z1VYk*4,id3 (cy24O3) ",/
Street Address: 915 Tenth Street Award$ 1� 0 1 1
City or Town: Greeley Zip Code: 80632-1167
County: Weld County Judicial District: 19 New APPliCant Agency
Phone#: (970) 356-4010 I Fax#: (970)352-8023 3C Continuation Applicant Agency
E-Mail Address: GLRathke@netscape.net
Federal Employee I.D.Number: 84-6000813
2. CONTACT PERSON: Gary L. Rathke Position: Corn.Prog. Administrator,V/W
Phone#(if different): I Fax#(if different): E-Mail: GLRathke@netscape.net
3. FUNDS REOUESTED: $29,859
4. APPLYING FOR: (Please Check Only One Program Box.)
I X I VOCA n VAWA STATE VALE I SEX ASSAULT PREVENTION FUNDS
SECTION B: Project Narrative
15. BRIEF PROJECT TITLE: I Domestic Violence&Special Populations Project
_6. PROJECT SUMMARY:
This program is a prosecution-based project, serving all of Weld County(the 19`h Judicial District),
providing direct services to adult and child victims of domestic violence, victims of child sexual abuse
(primary and secondary), adult sexual assault victims, and "previously under-served" victim populations,
including elderly victims, assault victims, Spanish-speaking victims, at-risk-adult victims, et al.
7. DESCRIPTION OF PROJECT FOR WHICH FUNDS ARE BEING REOUESTED.
The Victim/Witness Program, in the Nineteenth Judicial District Attorney's Office, is the only prosecution-
based program serving victims and witnesses of crime in its jurisdiction, Weld County. The VOCA project
enables the Victim/Witness Program to provide enhanced services to crime victims, especially those
services being provided to victims of domestic violence and victims in other special populations (e.g.,
victims listed in the Victim Rights Act, elderly victims, Spanish-speaking victims, at-risk-adult victims, et
al). VOCA funds partially pay the salaries of four staff persons who provide direct and ongoing services to
victims, adult and child victims, in about 1,200 domestic violence cases being filed annually and to more
than 6,000 victims and witnesses of other violent crimes. Through their work with domestic violence
victims, during hearings in the District's dedicated domestic violence court and elsewhere, the
Victim/Witness staff provides needed direct services, such as personally providing VRA and Victim
Compensation information, facilitating victim's communication, in English or Spanish, with prosecutors
and the Court, etc., and many of these services are begun in less than 24 hours after the criminal incident.
In addition to the services being provided to domestic violence victims, staff members are offering
comprehensive services to all victims and witnesses of violent crime having contact with the District
Attorney's Office and its Victim/Witness Program. Amongst the comprehensive services provided by the
Victim/Witness staff are the following: crisis counseling, follow-up contacts, criminal justice education and
advocacy, personal support, information and referral, emergency financial assistance, Crime Victim
Compensation, HIV notices and education, Victim Rights Act notices, and other services (e.g., helping
victims with Victim Impact Statements and restitution requests, offering and staffing a separate waiting area
during court hearings, providing case status information, etc.).
1 revised 10/02
•
SECTION C: Goals and Objectives
•
8. GOALS AND OBJECTIVES FOR THIS PROJECT :(Important: See instructions first)
(VOCA ONLY): GOAL 1. This project will provide direct services that assist crime victims with emotional and physical needs to
stabilize their lives,provide for a measure of safety and security and/or enhance victims'experience with the criminal justice
system.
• VOCA Objective 1: Provide services to the following estimated unduplicated number of crime victims during the 12-month
grant period. (See instructions for examples.)
Count each victim ONLY ONCE,by predominant type of crime.
EST.# EST.#
VICTIMS TYPE OF CRIME VICTIMS TYPE OF CRIME(continued)
100 Child Physical Abuse 50 Survivors of Homicide Victims
350 Child Sexual Abuse 5 Economic exploitation and fraud crimes
2,000 Domestic Violence 650
Assault
50 Adult Sexual Assault(inc.adult survivors) 50 Robbery/Bank Robbery
Other violent crime such as hate and bias crime, 1,000 Victims of vehicular assault or homicide,
gang violence(specify): DUI/DWI crashes,or careless driving
resulting in death.
1,300 Other(Specify): Burg./Crm.Mschf.,Kidnapping, Federal Crimes(Specify):
Menacing,Theft,Traffic,Trespassing,Violation
of Restraining Order,misc.
TOTAL UNDUPLICATED VICTIMS ESTIMATED TO BE SEI.VED DURING THE 12-MONTH PERIOD: 15,555
♦ VOCA Objective 2: Provide the following types of services to the following estimated number of victims:
Count each victim ONLY ONCE for each applicable service, no matter how many times a particular service is performed.
Please see definitions of services in instructions.
VICTIMS SERVICES VICTIMS SERVICES
750 Crisis Counseling 2,800 Criminal Justice Support+Advocacy
2,500 Follow-up 20 Emergency Financial Assistance
Therapy Emergency Legal Advocacy
Group Treatment/Support 300 Victim Comp.Assistance-required
Crisis Hotline Counseling 10 Personal Advocacy
Shelter/Safehouse 1,800 Telephone Contact(Info/Ref)
Info/Referral in Person 1,500 Other(Be Specific): case status
100 information,VIS,restitution,et al
Percentage of Victims served by VOCA funds plus match dollars:
I am reporting the number of victims served with only VOCA funds and matching funds (100%)
X _I am reporting the total number of victims served by the agency's entire total victim assistance
budget. VOCA and matching funds represent approximately 11 % of the agency's total victim
assistance budget.
2 revised 10/02
ALL APPLICANTS
8. (Continhed.) GOALS AND OBJECTIVES: Please include no more than two or three goals with objectives. All goals and
objectives must fit on this page. See instructions for more information on Goals and Objectives.
GOAL 2: This project will provide, within the 1O Judicial District, unduplicated,prosecution-based services to all victims of
crime, including victims of domestic violence and other violent crimes, in such a manner as to meet their physical, emotional,
financial, and intellectual needs to the greatest extent possible.
•Objective 1: To provide 15,000 victims and witness of crime(a duplicated count) with a staffed and separate waiting area,trial
coordination, case-status information, court escort and support, and other services related to criminal prosecutions.
•Objective 2: To help at least 250 individual victims of domestic violence,child physical and sexual abuse, sexual assault(adult),
and other violent crimes(i.e., victims ofDUUDWAI crashes, homicide survivors,elder abuse victims, assault victims,robbery
victims, et al)to submit applications for Crime Victim Compensation.
•Objective 3: To help crime victims to receive emergency financial assistance,primarily through the Crime Victim Compensation
Program,for such things as replacing lost income or support, attending to immediate safety needs(e.g., replacing or upgrading
doors,locks,etc.)and so forth, when appropriate.
•Objective 4: To provide, related to the criminal prosecution of certain sex crimes, HIV education and notifications to about 20
victims of child sexual abuse and adult sexual assault.
•Objective 5:In relation to the filing charges and prosecution of criminal acts,to personally contact 65 elderly crime victims,and
to provide them with comprehensive services.
•Objective 6: To provide 15,000 Victim Rights Act notifications(a duplicated count),concerning each of the critical stages during
the judicial process(e.g.,filing charges, arraignments, motions, dispositions, sentencings, etc.), to all victims covered by the act.
GOAL 3: This project will strive, within the 19`"Judicial District, to facilitate crime victim's access to the criminal justice system
and the District Attorney's Office through various efforts to increase community awareness concerning the Victim Rights Act,
Crime Victim Compensation, victim impact statements, restitution, and other victim services;furthermore,this project will
encourage and support efforts,particularly within the Judicial District, to improve and coordinate the provision of comprehensive
and meaningful services to all victims of crime. .
•Objective 1: To provide representatives of at least 15 separate law enforcement and victim services agencies with information
and training concerning the Victim Rights Act, Crime Victim Compensation, victim impact statements, restitution, and other victim
services provided by the DA's Victim/Witness Program.
•Objective 2: To provide approximately 2,000 victims of crimes designated within the Victim Rights Act and victims of Careless
Driving with Injuries with information concerning the Victim Rights Act and Crime Victim Compensation,to request victim
impact statements and restitution information from these victims, and to offer these victims a comprehensive list of victim services
available in Weld County.
•Objective 3: To provide staff support and participation in various groups that seek to improve and coordinate the provision of
comprehensive and meaningful services to all victims of crime(e.g.,the Weld County Coordinating Committee for Victims of
Crime, Weld County Domestic Violence Coalition, et al).
3 revised 10/02
. SECTION D: Budget Information (All Applicants)
9. RE UES BUDGET T I DCJ Use Only:Application#21-VA-19-63-CY2003
Continuation Aoolicants ALL APPLICANTS
Continuation
(Section I) (Section 2) Applicants
Current Grant Award :z, REQUESTED BUDGET
Increase
(Calendar Year 2002) (Calendar Year 2003) Dec e r
se
PERSONNEL # PERSONNEL (Employees of the applicant agency) a* (+/-)
Employee/Job Position Employee/Job Position
I
Koeltzow,C.S.Couns II $6,366 Koeltzow,Community Svcs. Counselor II (15% , $ 6,668 u; $ 302
Soltes,C.S. Technician $4,831 Soltes,Comm. Svcs.Technician (31%) $ 4,831 "a. $
k J
Blakely, C.S.Tech. $9,662 !'' Blakely,Comm. Svcs.Tech. (33%) $ 10,122 $ 460
e..,-
Gailitis, C.S. T. $4,544 s{µ Gailitis, Conan. Srvs. Tech. (32%) $ 4,544 $
t
$
$
$ is $
i; 4..
$ $ $
$ $ $
d
FICA,Ret. &Fringe $3,586 a FICA,Retirement&Fringe Benefits $ 3,694 $ 108
Subtotal II$28,989 f'? Subtotal I$29,859 " ° $ 870
SUPPLIES AND OPERATING EXPENSES
SUPPLIES AND OPERATING ,
EXPENSES - „ (communications,copying,rent,phone,tuition,registration fe (+/-)
&other items under$5,000)
} 4yz
$ $ $
$ g ` ,
hf
$ $
$ $ d $
$ �., $ A'•�: $
$ $ 49 $
fi
Subtotal 1$ ` Subtotal I'$ $
xi
IN-STATE TRAVEL '>. IN-STATE TRAVEL (itemize transportation/per diem,etc.? 4 t (+/-)
$ $ « $
I_' 5y4
$ $ $
$ $ ' $,
Subtotal 1$ Subtotal II$ 4 $
EQUIPMENT EQUIPMENT (items which cost over$5,000 each) (+/-)
$
Subtotal I$ Subtotal II$ 1 $
PROFESSIONAL SERVICES PROFESSIONAL SERVICES (+I-)
$
$ a $ a $
Subtotal II$ ] Subtotal II$ 1 $
ITOTAL FUNDS: $28,989 TOTAL FUNDS REQUESTED: $29,859 1 $ 870
Project Director's signature: - / p ,A-- ---- .� Date: /6/(2, ! / a Y
/ / A
Financial Officer's signature: "'i�.�— Date: ,./1..V .-74,/C__
ALL APPLICANTS- Please do NOT change format of table or application.
10. MATCHING FUNDS BUDGET: List the total matching funds(if required). ALL VOCA PROJECTS MUST PROVIDE
MATCH. VAWA APPLICANTS THAT ARE NON-PROFIT,NON-GOVERNMENTAL VICTIM SERVICE AGENCIES ARE
NOT REQUIRED TO PROVIDE LOCAL MATCHING FUNDS FOR THIS PROJ ECT(unless dollars are being requested for
law enforcement or prosecution agencies.) STATE VALE AND SAPF APPLICANTS ARE NOT REQUIRED TO PROVIDE
MATCHING FUNDS. See instructions for more detail.
PERSONNEL (Employees of the applicant agency)
Employee/Job Position
Koeltzow/Community Services Counselor II (4%) . S , 1,.§67
Soltes, Sedillos&Blakely/Community Services Technicians (8%) $ 4,874
FICA,Retirement&Fringe Benefits I $ 924
Subtotal ILS7 465
SUPPLIES AND OPERATING EXPENSES (communications, copying,rent,phone,tuition,registration fees&other items
under$5,000)
•
$
Subtotal I$
OTHER: In-State Travel,Equipment and/or Professional Services (specify)
•
$
Subtotal II$
TOTAL MI T DING FUNDS: 57.46.5
I SOU-RC OF MATCH• Loyal VAT (ant R, ,.dminl R.C\IC adminl I CARA. R7 d65 � IN-K1NjI&_
11. GRANT BUDGET SUMMARY:This chart summarizes all dollars by category. All applicants should fill out pertinent
sections If your project does not have matching funds,leave match columns blank.
BUDGET CATEGORIES I Funding Request I Cash Match I In-Kind Match I TOTALS
Personnel $29,859 $7,465 $37,324
Supplies and Operating
Travel
Equipment
Professional Services
TOTALS $29,859 $7,465 $37,324
Funds Requested Match Total Total Project Cost
$29,859 $7,465 $37,324
'Project Director's signature: ` I Date: /a/`Z
Financial Officer's signature: WI, �J/J/��, /_I Date: /7:377.. /
9-4- 3
•
ALL APPLIANTS-Please do NOT change format of table 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:
I)'the salaries and benefits being requested are based upon the current costs established by the Weld County Personnel
Department for four positions that are currently receiving partial financial support from VOCA,a total cost(in 2001)of$76,840.
2)The additional cost of upgrading one of the part-time positions to full-time,including salary and benefits,has been estimated to
cost(in 2002)$17,333. 3)In 2002,the total cost of salaries and benefits for the four positions are expected to increase 4%for an
annual cost-of-living adjustment and 3%for scheduled step increases(i.e., about 107%of the cost in 2001). 4)Currently VOCA is
paying about 40%of the total costs for these four positions,and this rate has been used to arrive at the requested amount in 2002.
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 this will not pay for the entire will not pay for the
requested ({ position position,what is the entire position,what is
from THIS !i works in SOURCE of other funds the AMOUNT of other
grant l' total. that will be used to pay funds that will be used
funding. e'I for the rest of this to pay for the rest of this
•
`' position? position?
i
Koeltzow, Community Srvs.Couns.II 16 40 VALE/CVC grant&adm $24,769
Soltes,Community Services Tech. 8 € ; 20 VALE grant&adm funds $ 8,878
Sedillos,Community Services Tech. 8 20 VALE grant&adm funds $ 7,452
I Blakely,Community Services,Tech. 16 „I 40 VALE grant&adm funds $18,632(SUM=$59,731) 11
For EACH POSITION OR PORTION OF A POSITION you are requesting,also please answer the following:
c.Fully explain and justify(using concrete data)any increase in dollars and/or positions requested. See instructions for
more detail.
I)The salary and benefit figures for this project are based upon the rates established by the Weld County Personnel Department.
2)The 2001 rates have been increased by 4%in order to allow for the annual cost-of-living adjustment that the Personnel
Department anticipates applying beginning on January 1,2002. 3)The 2001 rates have also be increased an additional 3%in order
to cover the step increases in pay that Personnel policies and procedures require. 4)In January,2001,as a result of increased
VOCA funding,this program was able to add a half-time Community Services Technician,and, in 2002,so that no one position is
overly dependent on a single funding source,the funding distribution for the four positions receiving VOCA funding in the past
has been adjusted so that the level of VOCA support for each of these positions equals about 40%;therefore,this has resulted in a
significant increase in the level of salary support requested for the Community Services Counselor II position(i.e.,a total increase
of$7,303),but only minor changes in the wage support being requested for the three Community Services Technician positions
(i.e.,a net salary increase of$1,221). (Note: VOCA's total contribution to the entire program would continue to be about 14%.)
5)In 2002,$1,290 of the increase in the cost of benefits is the result of making one Community Services Technician position that
is currently part-time into a full-time position,and the remaining increase in the benefit support requested(i.e.,$2,398 totally)is
due to the combined impact of the various factors described above. 6)In 2002,in response to current and anticipated service
requests,one of the Community Services Technician positions,that presently funded for 20 hours per week,has been upgraded to
a full-time position with benefits; therefore,the salary expenses for this position will be more than twice as much as they are in
2001 (i.e., a 114%increase),and the cost of benefits are increased about 450%(see explanation and justification below).
The Victim/Witness Program has gained local recognition and support for upgrading one Community Services Technician position
from half-time to full-time status based upon at least the following facts: 1)The staff support associated with the dedicated
domestic violence court has significantly increased the work and services being provided by the Victim/Witness Program,
including providing staff support to victims at court hearings on every day of the week,seeking to establish phone contacts with
victims prior to"in-custody"hearings(usually less than 24 hours after the crime),personally informing victims attending hearings
about the Victim Rights Act,Crime Victim Compensation and other services,etc. 2)In the next two years the 19'"Judicial district
is scheduled to add two new District Court judges and courtroom,and increases in associated victim services are anticipated.
01 VOCAapp.wpd
6 Revised 3/01
ALL APPL ANTS-Please do NOT change format of table 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,if required.
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,if required.
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,if required.
NOV APPLICABLE.
g. PROFESSIONAL SERVICES 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 used as cash or
in-kind match,if required. 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 briefly summarize the
reasons for the differences between this year's request and your most recent/current grant award.
First, in financial terms,the primary difference between this VOCA request and the one granted last year relates to increased
personnel costs,including increased costs due to cost-of-living adjustments,step increases,re-distributing the funding mix,and
upgrading one position from half-time to full-time(for additional details, see#9 and#12, a,b and c). Next,as concerns direct
victim services,the same level of services currently being provided to crime victims and witnesses will be maintained and some
additional enhancements,particularly in responding to domestic violence victims,are planned(e.g.,making follow-up contacts
with domestic violence victims by phone and/or mail after"in-custody"hearings, et al). Finally,in a strategic plan,as the Judicial
District will be adding one new District Court division(i.e.,judge and courtroom)in 2002 and another in 2003,or a total of two
new judges and courtrooms in the next two years,the program is requesting a change in VOCA funding in order to help to pay for
the additional 20 hours of staff coverage(i.e.,upgrading one position from half-time to full-time)which will enable the program to
begin to respond to the increased demand for victim services associated with these additions to the district's judicial system.
•
01VOCAapp.wpd
7 Revised 3/01
t t,
ALL APPL ANTS-Please do NOT change format of table or application.
13. TOTAL AGENCY VICTIM SERVICES/SEXUAL ASSAULT PREVENTION FUNDING THAT YOUR AGENCY
IS CURRENTLY RECEIVING.
FUNDING START DATE END DATE
AMOUNT
FEDERAL FUNDS: Month / Day / Year Month / Day / Yea
VAWA funds: 1 $ gg / / 'dil I /
VOCA funds: : $27,609 00 01 / 01 / 01 3' 12 / 31 / 01
FVPSA(ACT)funds: LIP $ r / / / /
Other US Dept. of Justice funds such as
Byrne(DCSIP),Juvenile Justice,COPS,etc. $ '11
/ / / /
Sex Assault Prevention funds: $ ' / / I / /
Other Federal funds: ,, $ / / / /
STATE FUNDS:
State VALE funds: $ / / / /
State DAAP funds: M n; $ ig / l /
Other Sate funds(e.g. general fund) tau $ `, / / III / / II
LOCAL GOVERNMENT FUNDS:
Local VALE funds: Judicial 19 I ,1 $65,400.00 I 01 / 01 / 01 I 12 / 31 / 01
VALE admin funds Judicial 19 t $29393 50 ' t 01 / 01 / 01 ,I 12 / 31 / 01
Comp admin funds Judicial 19 '1 $29,393.50 I 01 / 01 / 01 12 / 31 / 01
Judicial i $ Ili / / I / /
Local Government funds:(Cash estimate-- $81,302.00 01 / 01 / 01 � 12 / 31 / 01
does not include support and facility costs) hIf:� $ I / / � I / /
PRIVATE OR OTHER FUNDS:
Private funds: III $ i / / / /
Other funds: $ , , / / / /
14. FUTURE 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 support.
The Victim/Witness Program,in the 19"'Judicial District Attorney's Office,has developed a diverse funding base,and the VOCA
funds being requested(i.e.,$39,821)are estimated to be about 14%of the program's total budget in 2002. While there are certain
funding limitations imposed on governmental programs such as the Victim/Witness Program, it has maintained a strong funding
mix over the years,including the following funding sources and their approximate percentage of the program's total funding in
2001: 1)local government funds(35%),2)local VALE grant funds(28%),3)VALE and Victim Compensation administrative
funds(25%),and 4)VOCA funds(12%). In recent years,as the program's costs have increased due primarily to rising personnel
costs and small staff increases,all funding sources have maintained their relative contribution levels. In the future,as the existing
and planned growth in the local judicial system adds to the corresponding demand for services from the Victim/Witness Program,
all of the funding sources listed above will be asked to share the cost of maintaining and expanding the Victim/Witness Program's
services. Traditionally,the Board of County Commissioners have been very reluctant to increase their relative level of support for
the Victim/Witness Program,but changes in the composition of the Board may make increased support from this source possible in
the future. In addition,even though other potential funding sources are very limited,new funding sources will be sought out
whenever possible in order to broaden the total funding mix.
01 VOCAapp.wpd
8 0.cv1sed 3101
•
•
SECTION E: Contifillation 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 oroiect durine time neriods 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. VOCA time period 1: January-December 2000(if you received funding for this period.)
During the first VOCA time period,January 1,2000 to December 31,2000,the Victim/Witness Program's Domestic Violence and
Special Populations Project exceeded most of the goals and objectives established in its VOCA grant application. First,during the
grant year the project exceeded two objectives relating to serving domestic violence victims,as direct services were provided to
1,241 domestic violence victims, 156%of the objective set,and 800 of these victims, 176%of the targeted amount,received one-
on-one information and referral to specific services and agencies. Second,the project met 355%of its overall objective for
working with"special populations"by providing direct services to 142 homicide survivors,elderly victims,disabled victims,and
victims of assault. Third,the project achieved 208%of another objective set for services provided to victims of child sexual abuse
and adult sexual assault, as a total of 52 victims of these crimes received such direct services as HIV notifications and education,
criminal justice education and support,Crime Victim Compensation assistance,etc. Fourth,in September,2000,the Judicial
District added three new family courts,including one court that is dedicated to hearing all domestic violence cases;as a result,
Victim/Witness staff members have seen an increase in the quality and quantity of their contacts with domestic violence victims,
including at least the following changes: 1)staff members attempt to make phone contacts with all victims of domestic violence,
usually the morning after the criminal incident,explaining the"in-custody"hearing scheduled,offering staff availability and
support during hearings,providing general information about the court process,describing other services available,etc.; 2)staff
members personally provide VRA information, liaison with the prosecutors,and other services at the time of certain court hearings
(e.g.,next-day,in-custody hearings,"weekend"arraignment hearings,and"trial confirmation/readiness"hearings);3)staff are able
to personally explain Crime Victim Compensation benefits to many victims,and can help them apply and seek emergency financial
assistance,when appropriate;4)when requested,staff arranges police escorts for victims in the area of the courthouse; and 5)staff
provides all of the comprehensive services offered to all victims and witness of crime within the Judicial District. In conclusion,
due in part to the VOCA funding received,the Victim/Witness Program was able to provide,in coordination with other service
agencies,comprehensive services to significant numbers of crime victims and witnesses,including victims of domestic violence
and those in other special populations.
b. VOCA time period 2:January-March 2001(1"Ouarter)
During the second VOCA time period,January 1,2001 to March 31,2001 (i.e.,the 1"Quarter of the current VOCA grant),the
Victim/Witness Program continued to provide the same comprehensive services to crime victims and witnesses,and specifically
focused on enhancing its services to domestic violence victims,as described above. First,as a result of the dedicated domestic
violence court,begun in September,2000,Victim/Witness staff members have been able to improve the effectiveness of the
services being provided to domestic violence victims,and during the first quarter direct services were provided to 482 victims of
this crime;therefore,as concerns its services to domestic violence victims,the project has already reached 38%of it VOCA
objective for the year. Second,the program's staff provided 138 victims in other"special populations"with direct services during
the period,and this level is 99%of the VOCA objective for 2001. Third,in a separate objective for working with elderly victims
of crime,34 elderly victims,or 81%of the total objective, received at least one personal contact from a staff member,offering
them information about the criminal justice system,victim services,and so forth. Fourth,another major objective for the program
relates to the services it provides to child sexual abuse and adult sexual assault victims,such as HIV notices,education and other
related services,and during the quarter 10 victims of these crimes(i.e.,6 children and 4 adults)were assisted in person(20%of the
project's VOCA objective for the year). In conclusion,the Victim/Witness Program is seeking to provide and track all of the goals
and objectives established in its 2001 VOCA grant application,and,after just one quarter,the program has exceeded 25%of the
performance levels project in most areas, often by a wide margin.
0 1 V OCAapp.wpd
9 Revised 3/01
SECTION F:oordination. Suonort and Networking Applicants)
• Please do NOT change format of table or application.
16. COMMUNITY SUPPORT.COORDINATION AND NETWORKING
a. LETTERS OF SUPPORT: In the appendix(see#27)please attach 3 current letters of support from referral sources or other
agencies whose support is key to your project. Below,list the agency name and person that provided the attached letters of
support.
AGENCY PERSON/POSITION DCJ USE ONLY
I 19th Judicial District Attorney's Office A. M.Dominguez,Jr.,District Attorney
I A Woman's Place,Inc. Sharon Mitchell,Executive Director
I Greeley P.D.,Victim Services Program Cecil O'Farrell,Coordinator
b.SIGNED LETTER OF COORDINATION WITH VICTIM COMPENSATION; DCJ USE ONLY
(VOCA ONLY)Please attach in the Appendix. See instructions for example.
c. 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/CASA of Weld County Greeley Police Dept.,Victim Services Program
A Woman's Place,Inc. Partners of Weld County
Area Agency on Aging,Weld County 119th J.D. Probation Dept.,Victim Services Program
I ASAP(Asslt. Survivors Asst Prog),Univ of Northern Colo I Sexual Assault Survivors,Inc. (SASI)
I Child Advocacy Resource&Education(CARE) I South Weld Victim Services Program
I Colorado Legal Services I Weld County Legal Services
REFERRALS: (if applicable)
d. List the agencies/individuals who make referrals to your program for victim services: (List only the 10 most frequently
referring.)
(1) A Kid's Place/CASA of Weld County,(2)A Woman's Place,Inc.,(3)Colorado State Patrol,Victim Advocates,(4)Greeley
Police Department,Victim Services Program,(5) 19'Judicial District Attorney's Office,(6) 19th Judicial District Probation
Department,Victim Services Program,(7)North Colorado Medical Center,(8)Sexual Assault Survivors,Inc.,(9)Weld County
Department of Social Services,and (10)21 Law Enforcement Agencies in Weld County.
e. List the agencies to which you make referrals for victims served by your aeencv: (List only the 10 most frequently used.)
(1)A Woman's Place,Inc.,(2)Catholic Charities,Northern,(3)Child Advocacy Resource&Education(CARE),(4)Colorado
Legal Services,(5)Greeley Police Department,Victim Services Program,(6) 19'J.D. Probation Department,Victim Services
Program,(7)North Range Behavioral Health Center,(8)Sexual Assault Survivors,Inc. (SASI),(9)South Weld Victim Services
Program,and (10)Weld County Department of Social Services.
DCJ USE-(VOCA ONLY)LOCAL VALE COMMENTS:
O1 VOCAapp.wpd
10 Rcvixd 3/01
ALL APPL ANTS-Please do NOT change format of table application.
17. CULTURAL COMPETENCY PLAN:All 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)describe resources available to implement
your plan. Please include the minority population 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 are the only statistically significant minority in the 19'Judicial District,and they are estimated to comprise 27%of the
total population(according to the 2000 numbers from the U.S. Census Bureau),and the number of Latino victims served generally
equals or exceeds percentage represented in the general population. In order to guarantee sensitivity and relevancy in addressing
the needs of the Latino population,the Victim/Witness Program will strive to maintain some representation from this ethnic group
on its staff and boards. Furthermore,when hiring Victim/Witness staff,preference will be given to applicants who are bilingual in
English and Spanish. Currently,40%of the Program's staff is Latino and is bilingual in English and Spanish; furthermore,33%of
the Victim Compensation Board is Latino and at least 40%of the VALE Board is Latino.
While no other statistically significant ethnic minority population exists in the community,the Program's staff will continue to
make every effort to be relevant, accessible and sensitive to the culture,special needs and so forth of all minorities. In addition to
the approach to ethnic diversity described above,the"cultural competency"of the staff is maintained in at least the following
manner: through membership and participation in a diverse array of community groups(e.g.,Area Agency on Agency,
Coordinating Committee for Victims of Crime of Weld County,et al),through staff attendance at training sessions and workshops
that are related to"cultural competency,"through in-service training and administrative direction concerning identified needs in the
area of"cultural competency,"and so forth.
The Victim/Witness Program has no history of complaints concerning it ability to respond to the diverse needs of its community,
and the program initiates efforts with group and individuals in the community in order to assess and address issues and needs
related to"cultural competency."
18. VICTIMS 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 on their rights under the Colorado Constitution?
All staff,paid and volunteer,are asked to read the Colorado statutes concerning victim rights,and they are given copies of
pamphlets summarizing these rights as a resource. In addition,all staff members are asked to attend at least one training outside of
the Victim/Witness Program,as soon after employment as possible,concerning victim rights and the Victim Rights Act.
b. Date of the last 104/18/01 I Training provided by: II Cynthia Gessinger,COVA
c. How do you notify victims of their rights under the Victims Rights Act?
1)V/W provides written and/or phone notices to all victims designated in VRA prior to each of the critical stages in the judicial .
process, from the filing of charges through sentencing,and including hearings returned after an appeal. 2)Dom. violence victims' JII
notices are personally delivered at"in-custody"hearings. 3)Initial notices include VRA brochures and other information.
d. How do you document that such notification has been given,if appropriate?
Documentation of all VRA notifications is maintained in at least the following places: 1)on the outside of the criminal case file,
and 2)in the data base of the DA's computer system(i.e.,each criminal case filed by the DA's Office has a computer record, fll
including a screen for tracking VRA notices).
e. Does your agency have a statutory mandate to notify victims under the Victims Rights Act? X Yes n No
f. List the approximate number of notifications made by your agency each 118,500 I
g. Does your agency have a victims' rights brochure that is distributed to victims? X Yes n No
*/f yes,please attach one copy in the appendix of the grant application.
h. In what languages is your victims' rights act brochure available?
English and Spanish
0 1 V OCAapp.wpd
II Revised 3/01
ALL APPL ANTS-Please do NOT change format of table 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 Program provides information to crime victims concerning Crime Victim Compensation in at least the
following ways:brochures, in English and Spanish,are distributed at various locations throughout the Judicial District;
applications are provided to agencies throughout the District;applicants are helped to complete the application forms,whenever
requested;the program's staff helps,when appropriate,crime victims to receive emergency awards of Compensation;information
concerning Victim Compensation is sent to all victims when they receive their initial VRA notices;regular training concerning
Victim Compensation is provided to law enforcement and other victim services agencies;the program's staff responds to all
requests for information concerning Victim Compensation benefits; and the program's staff provides administrative, clerical and
legal support for the Victim Compensation Program and its Board.
b. Are there any major issues that hinder victim assistance programs in assisting crime victims in filing for Victim
Compensation benefits and understanding eligibility?
NONE.
c. Are any of the services provided by your agency eligible for Victim Compensation n Yes n No
List services:
NONE.
d. Please describe how your agency tracks funds and services to ensure that it is not using VOCA funds to provide
services which could be or have been paid for by Victim Compensation.
NOT APPLICABLE.
e. Does your agency regularly conduct/receive Victim Compensation training for direct services staff or volunteers?
n Yes n No
Date of last training: always Training provided by: I Gary Rathke,Karol Koeltzow,et al
01 VOCAapp.wpd
12 Revised 3/01
'SECTION G: Evaluation(All Applicants•)
Please do NOT change format of table or application.
20. EVALUATION:Describe how you will evaluate the efficiency and effectiveness of this project.(Please see instructions.)
The District Attorney's Victim/Witness Program will utilize both efficiency and effectiveness measures in evaluating the VOCA
funded Domestic Violence and Special Populations Project,as described below.
1)Efficiency Measures: In order to evaluate the significance and efficiency of the Victim/Witness Program and its VOCA funded
project,staff members will continue to compile key-statistical data on all clients served. Then, on a quarterly basis,the statistical
data collected will be analyzed and reported to federal,state and local administrators, funding sources,and other interested parties.
When these quarterly reports are to a funding source with whom goals and objectives have been established, such as the proposed
VOCA project,a detailed written analysis will evaluate whether the proposed activities and outcomes(e.g.,goals and objectives)
were accomplished in the expected time frame. In addition to a quarterly analysis of the program's statistical data,the overall
efficiency of the program will be evaluated each quarter in financial terms,in the following manner: On at least an annual basis,
the financial efficiency of the program will be evaluated using a simple cost/benefit analysis. In applying a cost/benefit analysis of
the program,total dollars received(i.e.,either total dollars from a specific funding source or gross income for the entire program)
are divided by the total number of victims served,and the figure derived will indicate the average cost of providing services to each
individual. If the average cost of serving a crime victim is in line with historical avenges,then the program will be determined to
be financially efficient;however,conversely,if the average cost per client served is greater than historical averages,the overall
efficiency of the program will be evaluated further.
2)Effectiveness Measures:Various subjective measures of the program's effectiveness will be applied throughout each quarter by
the project's administrator,and these measures will seek to evaluate the quality and effectiveness of the services clients are
receiving. In evaluating the effectiveness of the services being provided,the administrator will subjectively evaluate the quality
and effectiveness of the services being provided by using a number of devices. First,he will listen to antidotes from clients,staff
and others that describe their personal reactions to the services being provided. Second,client satisfaction surveys have been
developed for various aspects of the program,and these may be distributed to help evaluate the quality and general effectiveness of
the various services provided(e.g.,Crime Victim Compensation,training,agency-to-agency coordination,and criminal justice
support).
Ultimately,the data and reports generated using these efficiency and effectiveness measures will help the Victim/Witness
Program's administrator and others to evaluate the program's performance,and the need to refine,expand and add services.
Ol VOCAapp.wpd
13 Revised 3/01
SECaN H: Financial Management (All A1plicants)
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 112/31/99
Enclose one copy of your most recent audit or financial review,including any management report or other auditor
comments,with your set of applications.
b. Does your agency expend over$300,000 from combined federal sources in a year? n Yes 4 No
c. Please respond to the following questions about whether your accounting system meets the criteria for managing
federal/state grant funds. (These questions cover areas that will be monitored by DCJ staff during site visits or through
other reporting mechanisms. They are not intended to be all inclusive and do not substitute for the agency's responsibility
to meet al' federal and state requirements for these grant funds.)
Yes No Does your accounting system seperate ALL revenues and expenditures by funding source?
Does your system track revenues and expenditures for each grant award separately through a
Yes No sub-ledger system?
Does your system allow expenditures to be classified by the broad budget categories listed in
Yes No the approved budget in your grant,i.e.Personnel,Supplies and Operating,Travel,Equipment
and Professional Services?
X Yes No Do you reconcile sub-ledgers to your general ledger at least monthly?
X- Yes 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 by
Yes No DCJ grant funds?
-R i If your grant requires a match,does your accounting system clearly identify the funds and
Yes No N/A amount used as a cash match?
If your grant requires a match and 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
Yes No N/A quarterly financial 1-A report?
X- Yes No Do you have written fmancial policies and procedures in place?
7 Do you have accounting internal controls do you have in place,such as separation of duties,
Yes No two signatures on certain checks,reconciliations or other reviews?
For Continuation Applicants only.
X Yes No Do you use your accounting system data to prepare your quarterly financial reports for DCJ?
X 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.
NOT APPLICABLE.
01 VOCAapp.wpd
15 Revisal 3/01
SECTION I: Fund-Specific Information-VOCA only(All Applicants) •
• Please do NOT change format of table or application. r I_16_0
22. VOCA GRANT-FEDERAL REPORTING INFORMATION:
SUBGRANT AWARD xv,rUn1 / APPLICATION INFORMATION
US. DEPARTMENT OF JUSTICE- OFFICE OF JUSTICE PROGRAMS-OFFICE FOR VICTIMS OF CRIME
The purpose of this report is to collect basic information on Subgrant recipients and their programs in a matter that is convenient to
report and analyze.
1. I Agency Name:District Attorney's Office, 19th Judicial District
Project Title:Domestic Violence and Special Populations Project
Mailing Address: P. O.Box 1167
City: Greeley,CO I Zip: 80632-1167
Telephone: (970)356-4010 I Fax: (970)352-8023 j E-Mail: GLRathke@netscane.net orGRathke@co.weld.co.us
2. Congressional District: I DCJ Use Only-Federal Grant Number: 2_C$ V x ccoe
3. Purpose of VOCA Subgrant award (check one)
a. Start up a NEW victim services project.
X b. Continue a VOCA funded project funded in a previous year.
c. Expand or enhance an existing project NOT FUNDED by VOCA in a previous year.
— d. Start up a NEW Native American victim services project.
— e. Expand or enhance an existing Native American project.
4. DC. Use Only-Crime Victim Assistance Awarded: I Z& 9 59
State Award Number: I 2_(:)w... I`i• 43 I Project begin date: I (.I. oz.,' Project end date: I it.. 3 I. 0z
5. DCJ Use Only-Subgrant Match(Financial support from other sources)
Value of In-Kind Match: I $ j Cash Match: I $ -72y-I I Total Match: I $ ine 7 - 7
6. These VOCA funds will primarily be used to: I a. Expand services Into a new geographic area.
b. Offer new types of services.
I c. Serve additional victim populations.
(Check only one)
I X d. Continue existing services to crime victims.
I I e. Other
7. For this victim services program please indicate: (Read instructions carefully.)
I a.Number of VOCA-paid staff(FTE): 1.20 I b.Has this program received a volunteer waiver? I I Yes I XI No
I c.Number of volunteer staff(FTE): 9 ; I
8. Identify the amount of the VOCA grant that will be used to meet the prionty and underserved requirements.
a. Child Abuse: 10% I $ 2.8q1 Gray Boxes for DCJ Use Only.
b. Domestic Violence: 65% $ tuso
c. Sexual Assault 7 _% $ 7q a
d. Underserved: - I
1. DUI/DWI Crashes: 9% $y V ptI
2. Survivors of Homicide Victims: 1% $ ay
3. Assault 11% $3i8q
4. Adults Molested as Children: % $
5. Elder Abuse: I . ifoi
6. Robbery: i "/o $ g goo
7. Other Violent Crimes: 7/45% $so..
SI
iT
0l VOCAapp.wpd 16 xMM a 3/01
•
9. e of Implementing Agency(*eck the appropriate boxes.)
a. T Criminal Justice-Government:
Law Enforcement X Prosecution Probation
Court Corrections Other
b. 7 Non-Criminal Justice-Government: I�
Social Services Mental Health I t Public Housing
Hospital Other
c. IT Private Non-Profit:
_ Hospital Rape Crisis Religious Organization
Shelter Mental Health Agency Other
d. Native American Tribe or Organization:
ION Reservation In OFF Reservation
e. Q Other:
10. For DCJ Use Only
Please provide total amount of funding allocated to victim services based on the subgrante-t's current Fiscal Year budget.
FUNDING SOURCES CURRENT YEAR
a. Federal(Excluding VOCA)
b. VOCA Funds 2—B1 q k3Y
c. State
d. Local _205) 4 W9
e. Other
11. Identify the victim(s)to be served through this VOCA-Funded project(VOCA grant plus Match)by checking the type of
crime(s): (Please read instructions carefully!)
X Child Physical Abuse X Child Sexual Abuse X DUI/DWI Crashes
X Domestic Violence X Adult Sexual Abuse X Elder Abuse
Adults Molested as Children X Survivors of Homicide Victims X Robbery
X Assault X Other Violent Crimes X Other
12. Check the services to be provided by this VOCA-Funded Project:
X Crisis Counseling X Criminal Justice Support/Advocacy
X Follow-up Contact X Emergency Financial Assistance
Therapy X Emergency Legal Advocacy .
Group Treatment X Assistance in Filing Compensation Claims
Crisis Hotline Counseling X Personal Advocacy
Shelter/Safehouse X Telephone Contacts(Information and Referral)
X Information/Referral(in Person) X Other: education,restitution,et al
01 V OCAapp.wpd
17 Rcviscd 3/01
SPECiAL PROVISIONS AND CERTIFIED ASSURANCES SPCA PAGE 1 of 9
Special Provisions& Certified Assurances must remain attached to the application.
•
CHECK BELOW TO INDICATE WHICH CATEGORY BEST DESCRIBES YOUR AGENCY:,
XInter-Governmental Grant
Grant to a Colorado State Agency
A Grant to a Unit of Local Government,Tribal Government,or Special District.
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.
GOVERNING LEGISLATION FOR THIS:GRANT PROGRAM:
Victims Of Crime Act Assistance Funds (VOCA). From the United States Department of Justice, Office of Justice
•
Programs, under federal statutory authority Victims of Crime Act of 1984 (VOCA), as amended, Public Law 98-473,
Chapter XIV, 42 U.S.C. 10601, et seq., Section 1402, Section 1404, and under applicable program rules and regulation
established by the federal program office.
A. STANDARD STATE SPECIAL PROVISIONS
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 may be 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 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, or its employees, agents, subcontractors, or assignees pursuant to the
terms of this subgrant award.
FOR INTERGOVERNMENTAL GRANTS ONLY:
b. Indemnity: To the extent required by law, the Subgrantee 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, or its employees, agents, subcontractors, or
assignees pursuant to the terms of this subgrant award.
c. No teen 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.
Version 3/27/02
SPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA PAGE 2 of 9
Special Provisions& Certified Assurances must remain attached to the application.
' 4.u,n rra wv. .I T 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 NOR ANY AGENT, SUB-
CONTRACTOR,OR EMPLOYEE OF THE SUBGRANTEE SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF
THE STATE BY VIRTUE OF THIS SUBGRANT. SUBGRANTEE SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES
AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID PURSUANT TO THIS GRANT. SUBGRANTEE
ACKNOWLEDGES THAT THE SUBGRANTEE AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE
BENEFITS UNLESS THE SUBGRANTEE OR THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY
FOR OR OTHERWISE PROVIDE SUCH COVERAGE. SUBGRANTEE 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 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 SHALL BE SOLELY RESPONSIBLE FOR THE
ACTS OF ITS EMPLOYEES,INDEPENDENT SUB-CONTRACTORS AND AGENTS.
5.NON-DISCRIMINATION.
The Subgrantee 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 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, Tide 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 fmal 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.(Per Gov.Owens 3-13-00 E.O.#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 hereby certifies that,for
the term of this subgrant and any extensions,the Subgrantee has in place appropriate systems and controls to prevent such
improper use of public funds. If the State determines that the Subgrantee 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.
Version 3/27/02
SPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA PAGE 3 of 9
Special Provisions& Certified Assurances must remain attached to the application.
B. GRANT REQUIREMENTS
1. FINANCIAL&ADMINISTRATIVE MANAGEMENT
a. The Subgrantee 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 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 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 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.
b. The Division's requirements for invoice, advance payments, and cost reporting submissions are contained in the
DO Fonn 3 - Cash Request Procedures, and DO Form 1-A - Subgrant Financial Report, which are hereby
incorporated by reference.
c. Advance payments cannot exceed 30-day operating expenses.
d. The Subgrantee assures that it shall maintain data and infonuation to provide accurate quarterly program and
financial reports to the Division. Said reports shall be provided in such form,at such times,and containing such
data and information as the Division of Criminal Justice reasonably requires to administer the program.
e. The Subgrantee 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 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 DO Forms 4A, 4B, 4C,
and 4D,which are hereby incorporated by reference.
h. The Division may withhold payment in the event the Subgrantee fails to comply with conditions and
certifications contained in this grant award.
3. PROCUREMENT AND CONTRACTS
a. The Subgrantee 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 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 assures that contractors/vendors who assist the Subgrantee 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 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 has the right to use, duplicate and disclose, the above material in
whole or in part in any manner for any purpose whatsoever and authorize others to do so.
ii. If the material or invention is copyrightable, the Subgrantee may copyright such, but the Division of
Criminal Justice reserves a perpetual, royalty-free, non-exclusive and irreversible license to practice,
reproduce,publish and use such materials in whole or in part,and authorize others to do so.
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Special Provisibns& Certified Assurances must remain attached to the application.
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
Subgrantees 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 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 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 $300,000 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 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 DC 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 findings.
b. The Subgrantee 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 I, 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 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. Subgrantees will be
notified in advance of any on-site monitoring visit.
e. The Subgrantee 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 and to relevant books and records of subcontractors of the Subgrantee. It is the responsibility of the
Subgrantee to notify any of its project collaborators and subcontractors of these provisions.
f. The Subgrantee 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
a. The Subgrantee 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 against goals and performance standards required herein.
The Division will provide reasonable technical assistance to the Subgrantee concerning project goals, performance
standards and subgrant requirements; however, substandard performance as determined by the Division will constitute
noncompliance with this grant award. Substandard performance may result in termination or reduction of grant award as
follows:
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Special Provisions& Certified Assurances must remain attached to the application.
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, 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 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 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. The grant may be terminated by the Division if it is in the best interest of the state of Colorado to
terminate the grant.
iii. If the grant is terminated for convenience by either the Subgrantee or the state,the Subgrantee 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,
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 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 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
a. 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.
C. FEDERAL CERTIFIED ASSURANCES
1. FEDERAL PUBLIC POLICY ASSURANCES
a. The Subgrantee hereby agrees that it will comply, and all of its contractors will comply with the applicable
provisions of:
i. Tide 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 20, Criminal Justice Information Systems;
iii. Part 22,Confidentiality of Identifiable Research and Statistical Information;
iv. Part 23,Criminal Intelligence Systems Operating Policies;
v. Part 30 Intergovernmental Review of Department of Justice Programs and Activities;
vi. Part 42 Nondiscrimination/Equal Employment Opportunity Policies and Procedure;
vii. Part 61 Procedures of Implementing the National Environmental Policy Act;
viii. Part 63 Floodplain Management and Wetland Protection Procedures;and,
ix. Federal Laws or regulations applicable to Federal Assistance Programs.
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Special Provisions& Certified Assurances must remain attached to the application.
2. FINANCIAL&ADMINISTRATIVE MANAGEMENT
a. Subgrantee 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
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
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
iv. For each agency spending more than$300,000 per year in federal funds from all sources;
a) OMB Circular A-133,Audits of States,Local Governments and Nonprofit Organizations
b. The Subgrantee 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 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 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 certifies that federal funds made available under this grant
i. Will not be used to supplant state or local funds;
ii. That the Subgrantee'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 shall give a written explanation demonstrating that the Subgrantee'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. CERTIFICATION REGARDING LOBBYING (Subgrantees receiving $100,000 or more in total federal funds per
year. See 28 CFR Part 69.)
The prospective Subgrantee 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 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 shall
complete and submit Standard Form-La,"Disclosure of Lobbying Activities."
5. CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY
EXCLUSION(Subgrantees receiving$100,000 or more in total federal finds per year. See, 28 CFR Part 6)
a. The prospective Subgrantee certifies, by submission of this proposal, that neither it nor its principals,
subcontractors or suppliers are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
6. CERTIFICATION REGARDING DRUG FREE WORKPLACE(See, 28 CFR Pan 67, Subpart F)
a. The prospective Subgrantee 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.
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Special Provisions& Certified Assurances must remain attached to the application.
'7. CIVIL RIGHTS COMPLIANCE (See, 28 CFR Part 4Z)
a. Upon award, each Subgrantee 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-DISCRINIINATION
a. 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 seq. and Department of Justice Regulations on Disability Discrimination, 28
CFR Part 35 and Part 39;Title DC 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 16 USC§470)
a. The Subgrantee 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 either directly by the Subgrantee 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.
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 Subgrantee 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.
2.The capacity for VOCA funds to provide future continuation dollars for projects is undetermined at this time. Subgrantees
are advised to seek other funding sources, especially for personnel dollars.
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SPECIAL PROVISIONS AND CERl'1A'1hD ASSURANCES SPCA PAGE 8 of 9
Special Provisions& Certified Assurances must remain attached to the application.
3. The Subgrantee certifies that the signing authorities,all staff and volunteers assigned to the VOCA-funded project have
read and understood,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 C.R.S. §13-90-107.
4. Except as otherwise provided by federal law,no recipient of monies under VOCA shall use or reveal any research or
statistical information furnished under the program by any person and identifiable to any specific private person for any
purpose other than the purpose for which such information was obtained in accordance with VOCA. Such information,and
any copy of such information,shall be immune from legal process and shall not,without the consent of the person furnishing
such information be admitted as evidence or used for any purpose in any action,suit,or other judicial,legislative,or
administrative proceeding. See Section 1407(D)of VOCA codified at 42 U.S.C. 10604
•
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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 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 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 Glenn Vaad
Position Chair.
Agency Board of County Commissioners, inbld County, Colorado
Mailing Address P. O. Box 758
City,State,Zip Greeley, CO 80632
Telephone# (970) 356-7204, ext. 4200
Fax# (970) 352-0242
E-mail Address GVaad@co.weld.co.us
Signature Sal
Date
//r 12/02/2002
ANCIAL OFFICER
Name Donald D. Warden
Position Director of Finance and Administration
Agency Weld County Government
Mailing Address P. O. Box 758
City,State,Zip Greeley, CO 80632
Telephone# (970) 356-4000, ext. 4218
Fax# (970) 352-0242
E-mail Address DW @co,leld co.us 9
Signature /,,/G/fi�i�/ //L i����p( Date
47t "0/7 (l/G ('�%/ 12/02/2002
PROJECT DIRECTOR
Name Gary L. Ratlike
Position Community Programs Administrator, Victim/Witness
Agency District Attorney's Office, 19th Jud. Dist.
Mailing Address P. 0. Box 1167
City,State,Zip Greeley, CO 80632
Telephone# (970) 356-4010, ext. 4747
Fax# (970) 352-8023
E-mail Address GL tscape.net
Signature r` Date
(F i//c2.5/6,4—
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CERTIFICATION OF MATCHING FUNDS
If no match is required,you may disregard this page.
PLEASE BE ADVISED that Weld County Government has appropriated
(unit of government,forfeiture fund,non-profit agency,or corporation)
funds in the amount of$ 7,465.00 to match federal funds for the Dom. Viol./Sixeial Populations Project
(project title)
The source(s)of these funds is general revenue
These funds are made available as X CASH or_1N-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 j
behalf of the unit of government, ''.
forfeiture fund, non-profit agency or
Sincerely, corporation. This individual is either the
Authorized Official on this grant or
appropriate financial controller of
matching funds.
...219J/ti / /.�/�-� 12/02/2002
Signature t Date
Glenn Vaad
Typed Name
Chair, Board of County Commissioners,
Weld County, Colorado
Title
Version 2/1/02
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