HomeMy WebLinkAbout20050605.tiff RESOLUTION
RE: APPROVE STATEMENT OF GRANT AWARD FOR DOMESTIC VIOLENCE COURT
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 Statement of Grant Award for the
Domestic Violence Court Project between the County of Weld, State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the 19th Judicial District
Attorney's Office, and the Colorado Division of Criminal Justice, commencing April 1, 2005, and
ending March 31, 2006, with further terms and conditions being as stated in said grant, and
WHEREAS, after review, the Board deems it advisable to approve said grant, a copy of
which is attached hereto and incorporated herein by reference.
NOW,THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Statement of Grant Award for the Domestic Violence Court Project
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the 19th Judicial District Attorney's Office, and the
Colorado Division of Criminal Justice be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said grant.
The above and foregoing Resolution was,on motion duly made and seconded, adopted by
ing vote on the 23rd day of February, A.D., 2005.
BOARD OF COUNTY COMMISSIONERS
aci sos,4;2 foad% WELD COUNTY, COLORADO
e. ` , William H. rke, Chair
my Clerk to the Board
BY:
��� /22VC) M. i e, Pro-Tem
Deputy Cler o the Board
D 'd . Lo
AP S T •
Rob D. Masd
ounty Att y
Glenn Vaad
Date of signatures=
�j�CiT
��
2005-0605
DA0020
EO�4 CO-?e>
'It;' tat COLORADO DIVISION OF CRIMINAL JUSTICE
V* */ STATEMENT OF GRANT AWARD (SOGA) ` �w � Us, '
/_876 .,-
FEDERAL PROGRAM INFORMATION MAR 1 0 2005
CFDA Number 16.588
Federal Agency: U.S. Department of Justice
Federal Award Name&Number: S.T.O.P.Violence Against Women Act,
2004 WF-AX-0032
Subgrantee Agency Name: District Attorney's Office, 19th Jud. Dist.
Project Director: JoAnn Holden
Project Director Address: P.O. Box 1167
Greeley, CO 80632
Grant Number: 24-VW-19-23
Project Title: Domestic Violence Court Project
Grant Period: 4/1/05—3/31/06
Date Issued: February 1, 2005
In accordance with provisions of the Colorado Revised Statutes§24-33.5-502,the Division of Criminal Justice hereby awards a
grant to the above-named subgrantee. The attached grant application,including Special Provisions and Certified Assurances,is
incorporated herein as a part of this document.
APPROVED BUDGET
Budget Category Federal Cash Match In-Kind Match Total
Personnel $9,000 $3,000 $12,000
Supplies and Operating
Travel
*Equipment
*Professional Services
TOTAL BUDGET $9,000 $3,000 $12,000.00
*Purchase of equipment requires prior completion and approval of DCJ Form 13.
*Professional services require prior completion and approval of DCJ Form 16.
SPECIAL CONDITIONS:
1.
2.
3.
Version 3-27-02 Page 1 of 3
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-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 60 Days. 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, S.T.O.P. VAWA Program, 700 Kipling Street, Suite 1000, Denver, CO 80215. After other required signatures are
obtained, the white SOGA copy with approved application will be returned to your Project Director.
Version 3-27-02 Page 2 of 3
AE PARTIES HERETO HAVE EXECUTED THIS BINDING SUBGRANT AWARD
SUBGRANTEE: STATE OF COLORADO:
District Attorney's Office, 19th Jud. Dist.
Weld County Board of Commissioners BILL OWENS, GOVERNOR
Legal Name of Subgrantee Agency
Agency FEIN(or Social Security) #846000813
By ` l t f �� B ���._ _ �L�,►
SIGNATURE of Authorized Official DIR TOR Colorado Division of Criminal Justice
William H. Jerke, Chair Raymond T. Slaughter, Director
Print Name& Title of Authorized Official Print Name& Title of DIRECTOR
Date Signed: 02/23/2005 Date Signed: 11 i 3 )
Provide signature of Corporate/Board Secretary or
equivalent,or Town/City/County Clerk,to certify that person
ATTEST BY: named as Authorized Official above has the legal authority STATE OF COLORADO LEGAL REVIEW:
to enter into binding legal contracts on behalf of this agency, See Contract Routing Waiver#46
i f. t t o who igned where indicated.
(or, if not waived)
f ` 02/23/2005
he Board Date , ATTORNEY GENERAL
(970) 356-4000
Ti, . , o the Board Phone BY:
PLACE AGENCY SEAL HERE
Or Date Signed:
Indicate No Seal Available .
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:
LESLIE M. SHENEFELT
BYE
DATE 1/ "710 c
Version 3-27-02 Page 3 of 3
L
SECTION A: Agency Information(All Applicants)
Please do NOT change format of table or application.
1.APPLICANT AGENCY:District Attorney's Office, 19'"Judicial District DCJ USE ONLY
Division or Unit(if applicable): Victim/Witness Program App#24-VW- (Q - 2:5
Mailing Address: P. O. Box 1167
Street Address: 915 Tenth Street Grant# 2 _ J _ _sal
City/Town: Greeley Zip Code: 80634 Award$ et Oen
County: Weld County Judicial District: 19'h New Applicant Agency
Phone#: (970)356-4010 Fax#: (970)352-8023 Continuation Applicant Agency
E-Mail Address: GRathke@co.weld.co.us
Federal Employer I.D.Number: 84-6000813
2. CONTACT PERSON: Gary L.Ratlike Position: Comm.Programs Administrator
Phone# : (970)356-4010,ext. 4747 I Fax#: (970)352-8023 Email: GRathke(2ilco.weld.co.us
3. FUNDS REQUESTED: I $9,000
4. APPLYING FOR: (Please Check Only One Program Box)
I ^I VAWA n STATE VALE n VOCA
SECTION B: Project Narrative
5. BRIEF PROJECT TITLE: I Domestic Violence Court Project
6. BRIEF PROJECT SUMMARY:
This project provides prosecution-based assistance,using a vertical-prosecution model,to victims of domestic violence involved in
the Criminal Justice System,especially those individuals having contact with the domestic violence"fast track"court. Using a staff
this is bilingual,in English and Spanish, and in cooperation and collaboration with law enforcement and other victim service agencies,
this project provides daily(M-F)assistance to domestic violence victims throughout the court process(e.g.,advisements,bond
hearings,pleadings, trials, sentencings, etc.), including outreach,education, support, communication facilitation(e.g., with
prosecutors,etc.), information and referral,restraining orders, safety planning, victim impact statements,restitution requests, et al.
7. DESCRIPTION OF PROJECT FOR WHICH FUNDS ARE BEING REQUESTED.
The Victim/Witness Program, in the Nineteenth Judicial District Attorney's Office,is the only prosecution-based program serving
victims of domestic violence involved in the Criminal Justice System in its jurisdiction,Weld County. The District Attorney's Office
uses a vertical-prosecution model in the domestic violence"fast track"court and the Victim/Witness staff,which is bilingual in
English and Spanish, works directly with the prosecutors and victims throughout the court process(e.g.,advisements,bond hearings,
pleadings,trials, sentencings, etc.). The proposed VAWA project will enable the Victim/Witness Program to maintain and enhance
its current level of service being provided to domestic violence victims,especially those individuals having contact with the dedicated
domestic violence court,by providing a portion of the total funding needed to support direct-services and volunteer-coordination
positions. Since the inception of the domestic violence court,the Victim/Witness staff has had regular direct contacts with domestic
violence victims,and many contacts are made with these victims within 24 hours after the criminal incident. Working in cooperation
and collaboration with local law enforcement,prosecutors, the Court and victim service agencies,the Victim/Witness staff provides
victims of domestic violence with comprehensive services, including the following: making outreach contacts with victims on the day
of the"in-custody"advisement and bond hearing;offering victims education and support throughout the court process;helping to
facilitate victim communication with the prosecutors,the courts, etc.;providing information and referral to victims concerning
available services, including shelter,legal aid,Crime Victim Compensation,etc.; informing victims about criminal and civil
restraining orders;helping victims with various issues related to personal safety;providing victims with victim impact and restitution
information and helping them to complete these forms, as requested; and offering other related services.
05 VAWA.app 2 Revised 06/03
x00 q 627
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SECTION C: VAWA Goals and Objectives
Please do NOT change format of table or application.
8. GOALS AND OBJECTIVES FOR THIS PROJECT(Important: See instructions first)
DCJ USE Only
%Categories LE Pros Victim Sery Courts ` Mixed _Discretionary
VAWA APPLICANTS ONLY
8 a. Federal Purpose Areas and State Priorities:
/ Federal Purpose Areas: (check all that apply) / State Priorities:(check all that apply)
Training for Officers,Prosecutors,Judges A/ Judicial Education and Court-related Projects
Specialized Units A/ Access for Underserved Victims
Policies,Protocols,Orders V Multidisciplinary,Specialized Training
^7— Multidisciplinary Coordinated Response —7— Specialized Advocacy
Older&Disabled Women \/ Coordinated Response to Sexual Assault
xi Victim Services J Restraining Orders Enforcement
Stalking V Collaborative,Community-based System Improvement
Indian Tribes J Addressing Needs of Underserved Population
J Data Collection& Communication Systems
Training of Sexual Assault Forensic Personnel
Assistance for Victims with Immigration Matters
VAWA APPLICANTS
8 b. Need for the Project:(in the space provided,briefly list up to 5 reasons why there is a need for this project in your
community).
1. Project is the only prosecution-based program working with domestic violence victims in the 19th J.D.,Weld County.
2. Project provides domestic violence victims with coordinated and comprehensive services throughout the court process.
3. Project has a key role in promoting a positive System response to dom. viol. (e.g.,defendant containment,victim safety, etc.).
4. Project serves a large rural area,with a sizeable Latino population, and helps to promote access to Court,prosecutors,etc.
5. Project provides training concerning victim services and domestic violence for agencies throughout the 19th Judicial District.
VAWA APPLICANTS ONLY
8 c.Victim Services Activities
Estimate the number of Adult Female Victims to be served by this project for each Type of Crime,Service,and Underserved
Area. (Est#is the number of Adult Female Victims Only).
Est# Type of Crime Est# Services Est#' Underserved Area
20 Sexual Assault Crisis Hotline Previous Lack of Access
1200 Domestic Violence 400 Counseling/Support 1200 Rural Women
Stalking 1200 Referral 10 Elderly Women
50 Dating Violence Shelter/Safehouse Immigrant Women
Other Violent Crimes: 1200 Specialized Prosecution, 400 Cultural,Language,Ethnic
Law Enforcement or Minority
Probation Advocacy
Transitional 5 Disabled
Housing/Services
Civil Legal Advocacy Native American
1200 Assistance Obtaining Other:
Restraining Orders
1800 Other: follow up, status,etc.
05 V A WA.app 3 Revised 06/03
VAWA APPLICANTS-Please do NOT change format of table or application.
8. (Continued) GOALS AND OBJECTIVES FOR THIS PROJECT:
8 d.VAWA APPLICANTS ONLY Training Activities and Topics of Training (Complete if applicable to your project)
Est # Est.#is the number Individuals to be Trained / Topic of Training(check all that apply)
Judges Sexual Assault
Other Court Personnel -‘,/ Domestic Violence
Law Enforcement(Officers or Deputies) Stalking
30 Law Enforcement(Victim Assistants) Dating Violence
1 Prosecutors -\/ Restraining Orders
5 Prosecution-Based Victim Assistants J Other:prosecution-based,victim services(incl.D.V.srvs.)
30 Non-Profit Victim Service Providers
1 Probation Personnel
Parole Personnel
5 Other:
VAWA APPLICANTS ONLY
8 e.Systems Improvement Activities of Project (If applicable to your project,check any that apply)
Specialized Law Enforcement Sexual Assault Unit
Specialized Law Enforcement Domestic Violence Unit
I/ Specialized Domestic Violence Prosecution Unit
Specialized Sexual Assault Prosecution Unit
Specialized Domestic Violence Probation Unit
-‘,/ Multi-Disciplinary Coordination(i.e.,Task Forces,Coordinating Council,SART)
Other (Specify):
VAWA APPLICANTS ONLY
8 f. CHECK ONE of the following:(See Instructions for additional details.)
.4 This is a CONTINUATION application requesting funding for the same project components as were funded for the
VAWA FFY2003 grant award period.
This is a CONTINUATION application requesting funding for the same project components as were funded for the
VAWA FFY2003 grant award period PLUS NEW PROJECT COMPONENTS which were not previously funded.
This is a NEW application.My agency did not receive VAWA funding for the FFY2003 grant award period.
05 VA WA.app 4 Revised 06/03
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VAWA APPLICANTS-Please do NOT change format of table or application.
8 u. (Continued) GOALS AND OBJECTIVES: LIST THE SPECIFIC GOALS AND OBJECTIVES FOR YOUR PROJECT
HERE.Please include no more than 3 goals with no more than 3 objectives each. Goals and Objectives should describe how you will
achieve the outcome/impact/product which will result from grant-funded activities. All goals and objectives must fit on this page
(Exception: multi-agency and multi-project applicants may attach additional page(s). Write the word "NEW"in front of any goals
and objectives associated with NEW project components.
GOAL 1. This project will provide domestic violence victims in Weld County,a large rural jurisdiction, with prosecution-based
direct services that will assist them with their emotional,physical and financial needs in order to stabilize their lives,to provide for
a measure of safety and security and to enhance their experience within the Criminal Justice System.
OBJECTIVE 1. During the grant year,this project will provide direct services to at least 1,200 separate victims of domestic
violence.
OBJECTIVE 2. During the grant year,this project will provide domestic violence victims with at least 3,500 services,an
unduplicated count per service, including the following services: crisis counseling, follow up, information and referral(in person),
criminal justice support and advocacy,emergency financial assistance,Victim Compensation assistance,personal advocacy,
telephone contact and others(e.g.,cases status information,Victim Rights Act notices,etc.).
OBJECTIVE 3. During the grant year,this project will help approximately 300 domestic violence victims with extensive safety-
planning assistance,including risk-level inquiries,education(i.e.,Power and Control Wheel, Cycle of Violence, affects on children,
safety planning concepts,etc.),needs assessment,emergency financial assistance, information and referral and so forth.
GOAL 2. This project will work within the Criminal Justice System and community in order to ensure that comprehensive services
are readily available for domestic violence victims,to promote safety for domestic violence victims,to effectively contain domestic
violence perpetrators and to attain the effective and expeditious prosecution of domestic violence crimes.
OBJECTIVE 1. During the grant year,this project will continue to work with the Court,prosecutors, law enforcement and others
to foster open communication and to review policies and procedures in order to guarantee that domestic violence victims receive
comprehensive services,to assure that victim safety is a key consideration, to effectively contain domestic violence perpetrators and
to attain the effective and expeditious prosecution of domestic violence crimes.
OBJECTIVE 2. During the grant year, this project's staff will work in cooperation and collaboration with other community
groups(e.g.,Weld County Domestic Violence Coalition, Weld County Coordinating Committee for Victims of Crime,et al)and
agencies(e.g.,A Woman's Place, Inc., Sexual Assault Survivors,Inc.,et al) in their efforts to improve and coordinate the provision
of comprehensive and meaningful services for all crime victims, including domestic violence and sexual assault victims.
OBJECTIVE 3. During the grant year,in order to increase awareness and effectiveness in delivering services to all crime victims,
including domestic violence and sexual assault victims,the project's staff will provide training for at least 72 representatives of
various law enforcement,victim service and other agencies/groups.
GOAL 3. This project will strive to promote domestic violence victims' access to the Criminal Justice System through various
culturally sensitive efforts that seek to increase victim participation and cooperation in the court process and that guarantee victim
rights.
OBJECTIVE 1. During the grant year, about 1,200 notices,and unduplicated count,will be provided to victims of domestic
violence in English or Spanish,if requested, informing them of their rights as victims, soliciting victim impact and restitution
information,offering a detailed list of services available,explaining Crime Victim Compensation benefits,etc.
OBJECTIVE 2. During the grant year,bilingual, in English and Spanish, staff members will be available to all victims of
domestic violence in order to provide needed assistance, including providing all of the comprehensive services listed above;
furthermore,it is estimated that Spanish will be the primary language spoken by nearly 150 of the domestic violence victims served
and that about 400 of the total domestic violence victims served will be a cultural or ethnic minority,predominately Latino.
05 V A WA.app 5 Revised 06/03
SECTION D: Budget Information(All Applicants)
Please do NOT change format of table or application.
Continuation Applicants fill out Sections 1,2 and 3. / New Applicants fill out Section 2 only.
9. BUDGET REQUEST DCJ Use Only: Application#24-VW-
T.
Continuation Applicants v Continuation
(Section 1) ALL APPLICANTS F Applicants with
(Section 2) NEW project
New,continuation,and continuation applicants with new ?1€ components
components describe 100% of your request in this section. (Section 3)
Current Grant Award REQUESTED BUDGET Note NEW costs
FFY 2003 VAWA FFY2004 VAWA in this column_
PERSONNEL PERSONNEL(Employees of the applicant agency)
Employee/Job Position Employee/Job Position
Patch,Corn Sry Couns 2 $3,063 Karol Patch,Community Service Counselor II $3,063 $
Blakely,Corn Sry Tech $2,240 Corinna Blakely, Community Service Tech. $2,240 $
Gailitis, Corn Sry Tech $1,045 Christina Gailitis,Community Service Tech. $1,045 $
Lopez,Corn Sry Tech $1,118 Rose Lopez, Community Service Tech. $1,118 $
$ $ $
$ $ $
$ $ $
$ $ $
FICA,Ret.&Fringe $1,534 FICA,Retirement&Fringe Benefits $1,534 $
Subtotall$9,000 Subtotall$9,000 $
SUPPLIES AND OPERATING SUPPLIES AND OPERATING EXPENSES(communications, Note NEW costs
EXPENSES copying, rent,phone,tuition,registration fees& other items in this column
under$5,000)
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
Subtotal$ Subtotall$ $
IN-STATE TRAVEL IN-STATE TRAVEL(itemize transportation/per diem,etc.) Note NEW costs
$ $ $
$ $ $
$ $ $
Subtotall$ Subtotall$ $
EQUIPMENT EQUIPMENT(items which cost over$5,000 each) Note NEW costs
i$ $ $
$ $ $
Subtota $ Subtotall$ $
PROFESSIONAL SERVICES PROFESSIONAL SERVICES Note NEW costs
$ $ $
$ $ $
$ $ $
Subtotall$ Subtotall$ $
TOTAL FUNDS: $9,000 TOTAL FUNDS REQUESTED: $9,000 $
05 V AWA.app 6 Revised 06/03
VAWA APPLICANTS-Please do NOT change format of table or application.
10. MATCHING FUNDS BUDGET: List the total matching funds. ALL VAWA APPLICANTS ARE REQUIRED TO
PROVIDE LOCAL MATCHING FUNDS FOR THIS PROJECT. THERE ARE NO EXCEPTIONS TO THE MATCH
REQUIREMENT FOR VAWA APPLICANTS. STATE VALE APPLICANTS ARE NOT REQUIRED TO PROVIDE
MATCHING FUNDS. See instructions for more detail.
SONNEL(Employees of the applicant agency)
Emp ee/Job Position
K.Patch, mmunity Service Counselor II($1,021), C. Blakely, Community Service Tech. ($747), $
C.Gailitis, Co unity Service Tech. ($349)and R. Lopez,Community Service Tech.($373) $2,490
FICA,Retirement Fringe Benefits $510
Subtotalj$3,000
SUPPLIES AND OPERA G EXPENSES(communications,copying,rent,phone,tuition,registration fees&other items
under$5,000)
$
Subtota $
OTHER: In-State Travel,Equipment and/o rofessional Services (specify)
$
$
Subtotal$
TOTAL MATCHING FUNDS:$3,000
(SOURCE OF MATCH: non-federal governmental funds ICASH: $3,000 IN-KIND: $
11. GRANT BUDGET SUMMARY: This chart summarizes all lars by category. All applicants should fill out pertinent
sections.
BUDGET CATEGORIES Funding Request In-Kind M h Cash Match TOTALS
Personnel $9,000 $3,000 $12,000
Supplies and Operating
Travel
Equipment
Professional Services
TOTALS $9,000 $3,000 $12,000
Match Total
Funds Requested (cash match+in-kind match) Total Project Cost
$9,000 $3,000 $12,000
� .c` Xr�A.
.445r-
05VAWA.app 7 Revised 06/03
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VAWA APPLICANTS-Please do NOT change format of table or application.
12. BUDGET DETAIL AND JUSTIFICATION: (Do not exceed the two pages allowed for this budget narrative.) Please
provide the following information for each budget category:
PERSONNEL REQUEST: (Also,if you are using personnel or in-kind volunteers as match,please describe here.)
a. Please explain how you arrived at the cost of the salaries and benefits you are requesting:
The salaries and benefits for each of the positions in the Victim/Witness Program are set by the Weld County Government. In
addition, each year the costs of each position increase due to step raises,which are based upon one's duration of service, and due to
cost of living adjustment(COLA)increases, which are approved by the County Commissioners. Therefore, while the costs for each
of the positions listed are expected to increase,as a result of step and COLA increases,this VAWA grant request is identical to one
that was awarded to this project for FFY 2003 (Grant Year:04/01/04 to 03/31/05).
b. Please provide the following ADDITIONAL information on the positions for which you are requesting funding.
Employee/Job Position Requested No.Hours No.Hours If THIS grant funding If THIS grant funding
per week ! per week will not pay for the will not pay for the
requested this position entire position,what is entire position,what is
from THIS works in the SOURCE of other the AMOUNT of other
grant total. funds that will be used to funds that will be used
funding. pay for the rest of this to pay for the rest of
position? this position?
K. Patch,Comm. Srv. Couns. II 3 40 VOCA,VALE, CVC,etc $40,380
C. Blakely, Comm. Srv.Tech. 3 40 VOCA, VALE,CVC, etc $29,600
C.Gailitis,Comm. Srv.Tech. 2 20 VOCA,VALE,et al $11,500
R. Lopez,Comm. Srv. Tech. 2 20 VOCA,VALE, et al $11,400
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.
If new request,is this a new position? If not,how was the position funded before? Have other funding sources been cut?
Explain impact of any funding cuts and,justify areas which could not sustain further cuts.
NOT APPLICABLE
05 VAWA.app 8 Revised 06/03
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VAWA APPLICANTS-Please do NOT change format of table or application.
12. BUDGET DETAIL AND JUSTIFICATION(CONTINUED)
d. SUPPLIES AND OPERATING REQUEST AND MATCH: Please see instructions,and fully explain and justify the need
for the current request and for any increase over the last year. Include and identify any supplies and operating used as cash
or in-kind match.
NOT APPLICABLE
e. TRAVEL REQUEST AND MATCH: Please see instructions,and fully explain and justify the need for the current request
and for any increase over last year. Include and identify travel used as cash or in-kind match.
NOT APPLICABLE
f. EQUIPMENT REQUEST AND MATCH: Please see instructions, and fully explain and justify the need for the current
request. Generally,very little equipment will be funded. Include any equipment used as cash or in-kind match.
NOT APPLICABLE
g. PROFESSIONAL SERVICES 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. Please note that professional services expenditures require prior approval by DCJ(Form 16).
NOT APPLICABLE
h. DIFFERENCES FROM LAST YEAR'S REQUEST(Continuation Subgrantees only.) Please identify any new costs in
this request and briefly summarize the reasons for the differences between this year's request and your most recent/current
grant award.
Identify new costs and explain cause of increase or decrease from last years request by line items.
NONE
05 V A W A.app 9 Revised 06/03
VAWA APPLICANTS-Please do NOT change format of table or application.
13. TOTAL AGENCY VICTIM SERVICES FUNDING THAT YOUR AGENCY IS CURRENTLY RECEIVING.
FUNDING START DATE END DATE
AMOUNT
FEDERAL FUNDS: Month / Day / Year Month / Day / Year
VAWA funds: $ 9,000 04 / 01 / 2004 9' 03 / 31 / 2005
VOCA funds: $ 31,352 01 / 01 / 2004 12 / 31 / 2004
FVPSA(ACT)funds: $ / / / /
Other US Dept.of Justice funds such as
Byrne(DCSIP),Juvenile Justice,COPS • $ / / i / /
Other Federal funds: $ / / / /
STATE FUNDS:
State VALE funds: $ / / / /
State DAAP funds: $ / / / /
Other State funds(e.g.general fund) $ / / / /
LOCAL GOVERNMENT FUNDS:
Local VALE funds: Judicial Dist.: 19 $ 72,135 01 / 01 / 2004 12 / 31 / 2004
Local VALE admin. Judicial Dist.: 19 $ 31,178 01 / 01 / 2004 12 / 31 / 2004
Vict. Comp. admin. Judicial Dist.: 19 $ 20,785 01 / 01 / 2004 12 / 31 / 2004
Judicial Dist.: $ / / / /
Local Government funds:Weld County $146,063 01 / 01 / 2004 12 / 31 / 2004
$ / / / /
PRIVATE OR OTHER FUNDS:
Private funds: !. $ / / / /
Other funds: $ / / / /
14. DIVERSIFICATION OF FUNDING: In the remaining space,describe the steps you have taken to diversify your funding
sources,and/or incorporate this project into local funding sources,e.g.state or local government funding,and/or broad-based community
sunoort.
The Victim/Witness Program, in the 19th Judicial District Attorney's Office, works at maintaining a diverse funding base and
VAWA funding is an important part of that broad-based support. While the VAWA funds received are only a small part of the
program's total funding mix,they allow the program to maintain its enhanced level of services for domestic violence victims. Over
the years, with the exception of VAWA funding,the funding received from all of the sources described above has steadily
increased. One of these funding sources,Weld County Government,has provided significantly increased funding for the program
throughout the past decade in order to support mandated Victim Rights Act activities;however, at this time, any other significant
increases in funding for the program from Weld County will not be possible. At this time, another major source of funding for the
program,grants(i.e.,VAWA, VOCA and local VALE), is also very unlikely to provide any significant increases in funding and it
is possible that financial pressures on these funding sources will actually result in decreased program funding. Finally,due to
funding constraints in the other areas described,the program is being forced to become heavily reliant on VALE and Victim
Compensation administrative funds and, in recent years,has been spending down excess administrative funds accumulated in
previous years. Therefore,while the Victim/Witness Program maintains a diverse funding base, any decrease in financial support
from these funding sources will necessitate a staffing reduction and a corresponding service reduction. As the Victim/Witness
Program's costs increase every year, it is hoped that the prospects for increased funding will improve during the next couple of
years. In 2004,as anticipated increased funding was not achieved and as it was projected that the administrative reserves being
relied upon to balance the program's budget would have been insufficient, a full-time clerical position was reduced to part-time and,
therefore Victim/Witness was able to maintain the same level of direct-victim cervices
05 V A WA.app 10 Revised 06/03
SECTION E: Continuation Applicants Progress Report(Continuation Applicants only)
Please do NOT change format of table or application.
15. Please provide a summary of the progress made in your project during time periods 1 and 2 as defined below. See
instructions for more information.
For the following time periods,please briefly summarize the progress made in meeting your prior and current grant goals
and objectives,the specific services that have been provided,changes or improvements made and/or problems
encountered. See instructions prior to filling out this section.
a. VAWA time period 1: FFY 2002 April 1,2003-March 31,2004 if you received funding during this time period.
Throughout FFY 2002,April 1,2003 to March 31,2004,the Domestic Violence Court Project,at the 19th Judicial District
Attorney's Office,met or exceeded almost all of its goals and objectives. While there is no way that this project will know with a
certainty that it has impacted the incidence and/or severity of domestic violence,the total configuration of services being provided
to the victims of this crime seems reasonably likely to accomplish such results. First,the project,in cooperation and collaboration
with the prosecutors,judges and other relevant professionals and agencies(e.g.,A Woman's Place, Colorado Legal Services,
Probation,Weld Legal Services, etc.), has developed and has enhanced the policies,procedures, services and materials it uses to
assist domestic violence victims. Next,the project's quick and comprehensive response to domestic violence victims, including
timely phone,mail and personal contacts with the victims, often the day after the criminal incident(i.e.,within the first 24 hours),
and offering crisis counseling, information and referral,education and safety planning, emergency financial assistance,etc.,
provides these victims with easy access to needed support and services. Then,as the project deals with domestic violence victims
who live in a large rural area and who include significant numbers of Hispanics/Latinos,the project's central location in the
Criminal Justice System and its bilingual staff allows it to have contact with most reported victims of domestic violence and it is
able to do this in a culturally and linguistically effective and sensitive manner. Finally, one exciting service enhancement
developed during the grant year,with the support of the Court,Judicial District's staff and District Attorney's Office, was the
agreed upon policy and procedure that requires all domestic violence victims requesting a restraining order modification, a large
number of the total served,to meet with a Victim/Witness staff member for the purpose of receiving extensive safety-planning
assistance, including risk-level inquiries,needs assessment, emergency financial assistance,information and referral, and so forth.
During the grant year, the project reported serving 1,628 total domestic violence victims and 55 total sexual assault victims;
furthermore,the project recorded providing a duplicated total of 8,758 services to these crime victims.
b. VAWA time period 2: FFY 2003 April 1,2004-Present (1"r& 2nd Quarters)if you are currently receiving funding.
Throughout FFY 2003,April 1,2004 to March 31,2005,the Domestic Violence Court Project,at the 19`h Judicial District
Attorney's Office,continues to provide all of the previous year's services and expects to met or exceeded all of its goals and
objectives. Again, while there is no way that this project will know with a certainty that it has impacted the incidence and/or
severity of domestic violence, the total configuration of services being provided to the victims of this crime seems reasonably likely
to accomplish such results. First,the project,in cooperation and collaboration with the prosecutors,judges and other relevant
professionals and agencies(e.g.,A Woman's Place,Colorado Legal Services,Probation, etc.), has developed and is continually
enhancing the policies,procedures,services and materials it uses to assist domestic violence victims. Next,the project's quick and
comprehensive response to domestic violence victims, including timely phone, mail and personal contacts with the victims,often
the day after the criminal incident(i.e., within the first 24 hours), and offering crisis counseling,information and referral, education
and safety planning,emergency financial assistance, etc.,provides these victims with easy access to needed support and services.
Then,as the project deals with domestic violence victims who live in a large rural area and who include significant numbers of
Hispanics/Latinos,the project's central location in the Criminal Justice System and its bilingual staff allows it to have contact with
most reported victims of domestic violence and it is able to do this in a culturally and linguistically effective and sensitive manner.
Finally,one service that helps to assure more balance in attention being provided to the domestic violence victims, a service
developed with the support of the Court,Judicial District's staff and District Attorney's Office, is the agreed upon policy and
procedure that requires all domestic violence victims requesting a restraining order modification, a large number of the total served,
to meet with a Victim/Witness staff member for the purpose of receiving extensive safety-planning assistance, including risk-level
inquiries,needs assessment,emergency financial assistance, information and referral, and so forth. During the first quarter of the
grant year,April 1,2004 to June 30,2004,the project reported serving 409 total domestic violence victims and 13 total sexual
assault victims; furthermore,the project recorded providing a duplicated total of 1,598 services to these crime victims.
05 V A WA.app 11 Revised 06/03
SECTION F: Community Support,Networking,Coordination,Cooperation,&Collaboration(All Applicants)
Please do NOT change format of table or application.
16. COMMUNITY SUPPORT,NETWORKING,COORDINATION AND COLLABORATION
a. LETTERS OF SUPPORT: DIRECTLY FOLLOWING THIS PAGE,PLEASE ATTACH 3 CURRENT LETTERS OF
SUPPORT from referral sources or other agencies whose support is key to your project. Below,list the agency name and
person that provided the attached letters of support. PLEASE NOTE:Letters of support will be used to help assess the level
of Networking,Coordination,Cooperation,and/or Collaboration demonstrated by your agency. Proper letters of support
are an essential component of your application. (Please see instruction for Section F,Item 16 for important information
about support letters).
AGENCY PERSON/POSITION DCJ USE ONLY
A Woman's Place,Inc. Joelle France,Executive Director
Assault Survivors Assistance Program Deana Davies, Director
Sexual Assault Survivors,Inc. Anpeytu Raben,Executive Director
DCJ USE ONLY
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 and CASA of Weld County 19th Judicial District Courts
A Woman's Place,Inc. 19h Judicial District Probation Dept., Victim Services Program
Area Agency on Aging,Weld County Partners of Weld County
Assault Survivors Assistance Program,Univ. of No. Colo. Sexual Assault Survivors,Inc.
Colorado Legal Services South Weld Victim Services Program
Greeley Police Department, Victim Services Program Weld County Legal Services
REFERRALS: (if applicable)
d. List the agencies/individuals who make referrals to your program: (List only the most frequently referring
agencies/individuals,no more than 10.)
(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) 19th 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 agency: (List only the most frequently used,no more
than 10.)
(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) 19th 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.
05 VAWA.app 12 Revised 06/03
•
VAWA APPLICANTS-Please do NOT change format of table or application.
17. CULTURALCOMPETENCY PLAN: VAWA applicants are asked to supply a plan to provide culturally competent
services to meet identified needs of racial,cultural and ethnic minority populations. The definition of cultural competence
is:planning to effectively deliver services in a context that is meaningful to the individual's culture. Please describe: 1)the
diverse needs in your community,2) mechanisms you will utilize to assess and address the needs identified,and 3) resources
available to implement your plan. Please include the minority population(s)in the community you serve,the ethnicity of
victims served,as well as ethnicity of staff,volunteers and/or board members. See instructions for further information.
According to the most recent census, Latinos/Hispanics are the only statistically significant minority in the 19th Judicial District
(Weld County)and they are estimated to comprise 27%of the total population. Generally,the number of Latino victims served by
the Victim/Witness Program equals or exceeds the relative percentage present in the District. 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. Then,as Spanish is the primary language used by many of the victims served,
Victim/Witness has translated most of its brochures and other key documents into Spanish and it gives a hiring preference to
applicants who are bilingual in English and Spanish. (Note:At this time,about 27%of the Victim/Witness staff is bilingual in
Spanish and English and at least another 27%of the staff has a limited proficiency with Spanish.) Furthermore, while no other
statistically significant ethnic minority population exists in Weld County,the Victim/Witness Program makes 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 cultural sensitivity already described above,Victim/Witness seeks to maintain its cultural competency
in at least the following ways: staff members actively participate in various community groups, staff receive education(e.g.,
workshops, college courses,etc.)that is relevant to cultural sensitivity, administrative actions encourage cultural sensitivity,etc.
In conclusion,the Victim/Witness Program has had no complaints brought against it concerning its ability to respond to the diverse
needs of the District which it serves. Also,the program actives proactively within the community to assess and address issues and
needs related to cultural competency.
VAWA APPLICANTS
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 required to read the Colorado statutes pertaining the Victim Rights Act and they are all given
copies of a brochure that summarizes these rights. In addition, staff members are encouraged to attend at least once training outside
the Victim/Witness Program concerning VRA and victim rights,as such training is possible.
b. Date of the last training: ongoing Training provided by:
c. How do you notify victims of their rights under the Victims Rights Act?
(1)Initially,V/W provides written notices to all victims designated in VRA,including a notice concerning the filing of charges,a
brochure describing VRA,a request for victim impact and restitution information,et al. (2)Prior to each critical stage in the court
process,V/W notifies victims about the upcoming event. (3)At court, staff personally provide D.V. victims with VRA information
d. How do you document that such notification has been given,if appropriate?
Documentation of all VRA notifications is always maintained in at least one of the following ways: (1)on a log on the outside of
each criminal case,(2)within the case file for each criminal case,(3)in the data base of the DA's VRA tracking computer software,
and(4)within the DA's scanned computer records.
e. Does your agency have a statutory mandate to notify victims under the Victims Rights Act? Yes No
f. List the approximate number of notifications made by your agency each year. 15,000
g. Does your agency have a victims' rights brochure that is distributed to victims? V Yes ri No
*If 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
05 V A WA.app 13 Revised 06/03
VAWA APPLICANTS-Please do NOT change format of table or application.
19. VICTIM COMPENSATION(See instructions for more information,
a. How does your agency regularly inform victims of the Victim Compensation program and assist them in applying when
appropriate?
The Victim/Witness Program provides information to crime victims and others concerning Crime Victim Compensation in at least
the following ways: CVC brochures, in English and Spanish, are distributed with various agencies throughout the judicial district;
CVC training and forms are provided to law enforcement and victim service agencies in the district; a CVC brochure and other
information is sent to all victims receiving VRA notifications;crime victims are helped to complete CVC application forms,
whenever requested; if required,staff members help victims to receive emergency financial assistance from CVC;and, the
program's staff provides administrative,clerical and legal support for the CVC program
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 reimbursement? n Yes AI No
List services:
NOT APPLICABLE
d. Please describe how your agency tracks funds and services to ensure that it is not using VAWA funds to provide services
which could be or have been paid for by Victim Compensation.
NOT APPLICABLE
e. Does your a ency regularly conduct/receive Victim Compensation training for direct services staff or volunteers?
Yes No
Date of last training: ongoing Training provided by: Gary Rathke,Karol Patch and Corinna Blakely
05 VA WA.app 14 Revised 06/03
SECTION G: Evaluation(All Applicants)
Please do NOT change format of table or application.
20. EVALUATION: Describe how you will evaluate and report the OUTCOME,IMPACT,or PRODUCT of this project.
(Please see instructions.)
VAWA Applicants-In this evaluation narrative,please be sure to address the following 5 VAWA-required elements-
1. Specifically define the OUTCOME,IMPACT, or PRODUCT you intend to achieve; 2. Explain how you will document the
PROGRESS on your objectives; 3. Explain how you will collect the information regarding the OUTCOME, IMPACT,or
PRODUCT;4. Explain how you will provide a summary of this information to DCJ; 5. If you have victim service objectives,
describe how you will track the number of individuals seeking services who could not be served by this project.
(1) OUTCOME/IMPACT/PRODUCT. The Victim/Witness Program,in the Nineteenth Judicial District Attorney's Office, is
the only prosecution-based program serving victims of domestic violence involved in the Criminal Justice System in its
jurisdiction,Weld County. The District Attorney's Office uses a vertical-prosecution model in the domestic violence"fast
track"court and the Victim/Witness staff, which is bilingual in English and Spanish,works directly with the prosecutors
and victims throughout the court process(e.g.,advisements,bond hearings,pleadings,trials, sentencings, etc.). In its
position within the Criminal Justice System and community,the Victim/Witness Program and it Domestic Violence Court
Project will seek to produce certain outcomes and impacts with the domestic violence victims it assists, including at least
the following: First,this program and project will provide domestic violence victims in Weld County,a large rural
jurisdiction,with prosecution-based direct services that will assist them with their emotional,physical and financial needs
in order to stabilize their lives, to provide for a measure of safety and security and to enhance their experience within the
Criminal Justice System. Next,this program and project will work within the Criminal Justice System and community in
order to ensure that comprehensive services are readily available for domestic violence victims,to promote safety for
domestic violence victims, to effectively contain domestic violence perpetrators and to attain the effective and expeditious
prosecution of domestic violence crimes. Finally,this program and project will strive to promote domestic violence
victims' access to the Criminal Justice System through various culturally sensitive efforts that seek to increase victim
participation and cooperation in the court process and that guarantee victim rights.
(2) PROGRESS DOCUMENTATION. In it records and reports,the Victim/Witness Program will be able to provide
documentation of its progress in meeting its objectives(efficiency measures). In addition to these quantitative measures of
its success in accomplishing its objectives,the program will monitor the feedback received from the victims it serves in
order to evaluate the overall quality and effectiveness of the services it is providing.
(3) INFORMATION COLLECTION. At the end of the grant period,the accumulated documentation supporting the
accomplishment of the project's quantitative and qualitative objectives will be used to assess the Victim/Witness
Program's success in meeting its overall goals(effectiveness measures). Furthermore,the measures applied will be
interpreted to speculate concerning the significance(outcome)and impact of the project.
(4) SUMMARY REPORTS. First,the Victim/Witness Program will report the required quarterly financial and performance
data on the standard report forms(i.e.,DCJ Form 1-A and DCJ Form 2-VAWA). Next, each quarter the program will
report its progress in accomplishing its goals and objectives,providing quarterly and year-to-date information,noting any
significant issues impacting their accomplishment, and providing a summary analysis and evaluation. Finally, at the end
of the grant year,the program will provide an overall evaluation of the project that seeks to answer such questions as the
following: Did the project do what it thought it would do? What is different since conducting the grant funded activities?
Why the project thinks its services are making a difference?
(5) INDIVIDUALS NOT SERVED. All individuals seeking services from the Victim/Witness Program will receive some
services;therefore,there is no need for the program to track the number of individuals seeking services who could not be
served by the project.
05 V A WA.app 15 Revised 06/03
SECTION H: Financial Management (All Applicants)
Please do NOT change format or table or application.
21. FINANCIAL MANAGEMENT: Please answer the following questions.
a. Please provide the date of your last independent audit or financial review: 12/31/2003
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$500,000 from combined federal sources in a year? If"yes"please Yes V No
provide a copy of your most recent A-133 audit.
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. They are not intended to be
all inclusive and do not substitute for the agency's responsibility to meet all federal and state requirements for these grant
funds.)
Yes No Does your accounting system separate ALL revenues and expenditures by funding source?
Does your system track revenues and expenditures for each grant award separately
Yes No through a sub-ledger system?
Does your system allow expenditures to be classified by the broad budget categories listed
A/ Yes No in the approved budget in your grant,i.e.Personnel,Supplies and Operating,Travel,
Equipment and Professional Services?
V Yes No Do you reconcile sub-ledgers to your general ledger at least monthly?
7 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
Yes No paid by DCJ grant funds?
Yes No N/A Does your accounting system clearly identify the funds and amount used as a cash match?
If you are using in-kind match such as volunteer hours, have you clearly documented how
you are keeping track of the match that you are reporting on your quarterly financial 1-A
Yes No N/A report?
V Yes No Do you have written financial policies and procedures in place?
Do you have accounting internal controls in place,such as separation of duties,two
V Yes No signatures on certain checks,reconciliations or other reviews?
I For Continuation Applicants only.
1/ Yes No Do you use your accounting system data to prepare your quarterly financial reports for DCJ?
V 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
22. FEDERAL REPORTING INFORMATION: FY 2004 VAWA Subgrantees will be required to report statistical and
narrative progress data on the revised 2-VAWA quarterly report form.
05 V A WA.app 16 Revised 06/03
ISPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 1 of 9 I
Special Provisions&Certified Assurances must remain attached to the application
CHECK BELOW TO INDICATE WHICH CATEGORY BEST DESCRIBES YOUR AGENCY:
' Inter-Governmental Grant
Grant to a Colorado State Agency
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:
Ai Violence Against Women Act Funds (VAWA). From the United States Department of Justice, Office of Justice Programs, under federal
statutory authority 42 U.S.C., Chapter 46, Section 3711,et seq., as amended,and under applicable program rules and regulations established by the
federal program office.
A. STANDARD STATE SPECIAL PROVISIONS
Revised Date: April 5,2004
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 authorized 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 term or condition of this grant shall be construed or interpreted as a waiver, express or implied, of any of the
immunities, rights, benefits, protection, or other provisions for the parties, of the Colorado Governmental Immunity Act,
Section 24-10-101, et seq., C.R.S. or the Federal Tort Claims Act, 28 U.S.C. 2671, et seq. as applicable, as now or
hereafter amended.
SPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 2 of 9 I
Special Provisions&Certified Assurances must remain attached to the application
4. INDEPENDENT CONTRACTOR. 4 CCR 801-2:
(THIS PROVISION IS NOT APPLICABLE TO GRANTS TO COLORADO STATE AGENCIES):
THE SUBGRANTEE AGENCY SHALL PERFORM THE DUTIES FUNDED UNDER THIS GRANT AS AN INDEPENDENT
CONTRACTOR AND NOT AS AN EMPLOYEE OF THE STATE. NEITHER THE SUBGRANTEE 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, Title 39,CRS; (c) unpaid loans due to the Student Loan
Division of the Department of Higher Education; (d) owed amounts required to be paid to the Unemployment
Compensation Fund; and (e) other unpaid debts owing to the State or any agency thereof, the amount of which is
found to be owing as a result of final agency determination or reduced to judgment as certified by the controller.
8. EMPLOYEE FINANCIAL INTEREST.CRS§24-18-201 &CRS§24-50-507
The signatories aver that to their knowledge,no employee of the State of Colorado has any personal or beneficial interest
whatsoever in the service or property described herein.
9. SOFTWARE PIRACY PROHIBITION.(Governor's Executive Order D 002 00)
No state or other public funds payable under this subgrant shall be used for the acquisition, operation or maintenance of
computer software in violation of United States copyright laws or applicable licensing restrictions. The Subgrantee 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.
. ESPECIAL 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
DCJ Form 3 - Cash Request Procedures, and DCJ Form 1-A - Subgrant.Financial Report, which are hereby
incorporated by reference.
c. Advance payments cannot exceed 30-day operating expenses.
d. The Subgrantee assures that it shall maintain data and information 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 DCJ 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.
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:
I, SPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 4 of 9
Special Provisions&Certified Assurances must remain attached to the application
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$500,000 per year in combined federal funds, an audit
must be conducted in accordance with OMB Circular A-133 (Audits of States, Local Governments, and non-profit
organizations).
i. At such time as the audit or financial review is completed, ONE COPY OF THE REPORT, INCLUDING
THE CORRESPONDING MANAGEMENT LETTER, MUST BE FORWARDED TO THE DIVISION
OF CRIMINAL JUSTICE for clearance.
ii. The Subgrantee 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 DCJ 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 1, 1991-June 30, 1992. The files could be destroyed after 6/30/99);except,
ii. If an audit is in progress and/or the findings of a completed audit have not been resolved satisfactorily, then
records must be retained beyond the seven-year period until such issues are resolved.
c. The Subgrantee 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:
•
. ISPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 5 of 9 I
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.
8. DISPUTE RESOLUTION(THIS PROVISION APPLIES ONLY TO INTERAGENCY AGREEMENTS):
Any failure of either party to perform in accordance with the terms of this agreement shall constitute a breach of the
agreement. Any dispute concerning the performance of this agreement which cannot be resolved at the divisional level shall
be referred to superior departmental management staff designated by each department. Failing resolution at that level,
disputes shall be presented to the executive directors of each department for resolution. Failing resolution by the executive
directors, the dispute shall be submitted in writing by both parties to the State Controller, whose decision on the dispute will
be final.
C. FEDERAL CERTIFIED ASSURANCES
1. FEDERAL PUBLIC POLICY ASSURANCES
a. The Subgrantee hereby agrees that it will comply, and all of its contractors will comply with the applicable
provisions of:
i. Title I of the Omnibus Crime Control and Safe Streets Act of 1968,as amended;
ii. The Juvenile Justice and Delinquency Prevention Act and/or the Victims of Crime Act,as appropriate;
iii. All other applicable Federal laws,orders, circulars,regulations or guidelines.
b. The Subgrantee agency hereby agrees that it will comply, and all of its contractors will comply with the provisions
of 28 CFR applicable to grants and cooperative agreements including:
i. Part 18,Administrative Review Procedure;
ii. Part 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;
.' ISPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 6 of 9
Special Provisions&Certified Assurances must remain attached to the application
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.
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$500,000 per year in federal funds from all sources;
a) OMB Circular A-133,Audits of States,Local Governments and Nonprofit Organizations
b. The Subgrantee 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. PROHIBITIONS ON LOBBYING WITH FEDERAL FUNDS (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-LLL, "Disclosure of Lobbying Activities."
5. CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY
EXCLUSION(Subgrantees receiving$100,000 or more in total federal funds 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.
I. I SPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 7 of 9
Special Provisions'&Certified Assurances must remain attached to the application 1
6. CERTIFICATION REGARDING DRUG FREE WORKPLACE (See, 28 CFR Part 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.
7. CIVIL RIGHTS COMPLIANCE (See, 28 CFR Part 42)
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-DISCRIMINATION
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 IX of the Education Amendments of 1972;the Age Discrimination Act of 1975;the Department of
Justice Nondiscrimination Regulations 28 CFR Part 42, Subparts C, D, E, and G; and Executive Order 11246, as
amended by Executive Order 11375, and their implementing regulations, 41 CFR Part 60.1 et. seq., as applicable to
construction contracts.
9. NATIONAL ENVIRONMENTAL POLICY ACT(NEPA)AND NATIONAL HISTORIC PRESERVATION ACT
(NHPA)COMPLIANCE (42 USC§§4321-4370 and 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.
10. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (This provision applies only to entities that
provide medical care and treatment)
a. The Subgrantee acknowledges that it is a covered health care provider under the Health Insurance Portability and
Accountability Act,42 U.S.C. 1320d-1320d-8,and its implementing regulations and agrees to comply with the
requirements of HIPAA concerning any uses and disclosures of protected health information.
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.
, ISPECIAL PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 8 of 9
Special Provisions&Certified Assurances must remain attached to the application
a. The capacity for VAWA 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.
b. The Subgrantee certifies that the signing authorities, all staff and volunteers assigned to the VAWA-funded project
have read state laws and applicable rules of professional conduct related to issues of confidentiality and privilege,
particularly with respect to releasing identifying information about victims of crime, including but not limited to,
those found in. Section 13-90-107,C.R.S.
•
F 3F€1:1A! PROVISIONS AND CERTIFIED ASSURANCES SPCA Page 9 of 9
Special Provision!&Certified Assurances must remain attached to the application
26. 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 Robert D.Masden
Position Board Chair
Agency Board of County Commissioners,Weld County
Mailing Address P.O.Box 758
City,State,Zip Greeley,CO 80632
Telephone# (970)336-7204,ext.4200
Fax# (970)352-0242
E-mail Address RMasdencutco.weld.co.us
Signature Date
SEP 01 2004
FINANCIAL 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 DWar n co.weld.c .us
Signature Date
tett c E P 0 1 Ha
PROJECT DIRECTOR
Name Gary L.Rathke
Position Community Programs Administrator,Victim/Witness
Agency District Attorney's Office, 19th Judicial District
Mailing Address P.O.Box 1167
City,State,Zip Greeley,CO 80632
Telephone# (970)356-4010,ext.4747
Fax# (970)352-8023
E-mail Address GRathke eld.co.us
Signature Date
3067 )4 37
27. CERTIFICATION OF MATCHING FUNDS-(All VAWA Applicants)
PLEASE BE ADVISED that 19h Judicial District Attorney's Office and Weld County Government has appropriated
(unit of government,forfeiture fund,non-profit agency,or corporation)
funds in the amount of$ 3,000 to match federal funds for the Domestic Violence Court Project.
(project title)
The source(s)of these funds is non-federal governmental funds
These funds are made available as J CASH or IN-KIND match
Execution of this document represents a certification that said funds have been earmarked within the appropriation of budget
process, which by state or local government law or practice, binds and obligates the state/local unit of government or the
implementing agency to use such funds for purposes of this grant funded project, or permits such uses. The funds are, or will be
(within the project duration),actually provided for such purposes.
Signature must be by the individual
authorized to commit these funds on behalf I
I of the unit of government, forfeiture fund, j
non-profit agency or corporation. This
Sincerely, ' individual is either the Authorized Official I
on this grant or appropriate financial
controller of matching funds.
\\10 SEP 01 200`
Signature (9%\
RobertD. Masden T: �� ,, ��
DES7U,NTY CLERK TO HE BOARD
Typed Name
Chair, Board of County Commissioners, Weld County,Co j 'p p EPUTY CLE TO THE BO RD
Title rte,
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