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Home My WebLink About20041277.tiff RESOLUTION RE: APPROVE TWO APPLICATIONS FOR FEDERAL ASSISTANCE FOR HEAD START AND MIGRANT HEAD START PROGRAMS 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 two Applications for Federal Assistance for Head Start and Migrant Head Start Programs between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,on behalf of the Department of Human Services, Family Educational Network of Weld County,and the U.S. Department of Health and Human Services,commencing January 1,2004,and ending December 31,2004,with further terms and conditions being as stated in said applications, and WHEREAS,after review,the Board deems it advisable to approve said applications,copies of which are attached hereto and incorporated herein by reference. NOW,THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County,Colorado,that the two Applications for Federal Assistance for Head Start and Migrant Head Start Programs between the County of Weld,State of Colorado,by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, Family Educational Network of Weld County,and the U. S. Department of Health and Human Services be, and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be,and hereby is,authorized to sign said applications. The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 3rd day of May, A.D., 2004, nunc pro tunc January 1, 2004. BOARD OF COUNTY COMMISSIONERS W LD COUNTY, COLORADO id%f(, L"f Robert D. Masden, Chair �e ,' t lerk to the Board - :`..,` . 1861 William H erke, Pro-Tem ♦�. , ®� _ - rk to the Board M. J. ile • APP13.1V D AST RM: / David E. Long ty Attorney EXCUSED Glenn Vaad Date of signature: -/Y-G 2004-1277 HR0075 cc ; is (0.2a2t)> cs"- l8'-oy ...:+.,:.,.,...... .;c.f.:.a....,7.ila.'.,..��:uria..•:t..aiyb*sv.-we+ao.u'ylpy- :. --"'°�'u�nx"^'°o�'.rsna..saw,w.aw.,.. L .i...ax:wla.::drfa4 abww..,;.........M.A.-..w....u.............«.........,........-....w ..........,..u�... APPLICATION FOR 2.DATE SUBMITTED: - i Applicant Identifier OBOHD01s • • FEDERAL ASSISTANCE • I 1.TYPE OF SUBMISSION 3.DATE RECEIVED BY STATE: State Application Identifier App(;�atior, Preapplicafton J DDTS:ileior L.J Construction 44.DATE RECEIVED BY FEDERAL AGENCY Federal identifier o8CHD019 I 17-0 Nor-Construction - Non-Constrdotlon i 5.APPIJC:AHT INFORMATION Legal Marrs: Weld County Division of Human Services Organlzational Unit Famliy Educational Network of Weld County Address give city,county,state,and zip code) Name and telephone number of the person to be contacted pn matters Involving L.� this 1551 North 17th Avenue Watt SpecJ:mar, (970)35�3800 P.O.Box 1605 • Greeleq,CC 80632 Weld • Executive Director,Wool-IS • 6.•EMPLOYER IDENTIFICATION NUMBER(E!N) 7.TYPE OF APPLICANT(enter appropriate letter in box) i B 1 I A.State H.Independent School Dist S� 4 ` mom0 j 0 0 8, 1 3 B.County I.Sate Controlled Ins :lion of Higher Learning C.Municipal J.Private'University S.T1'P=_Oi APPLICATIOND.Township' K.Indian Tribe \ - E.,NewConon J Revision A. L.Individual F.lntermunicipai M.Profit Organization•If Revision,enter appropriate letter(s7)in Lror.(es}tinuati C Spada!District N.Other(specify) A,I=ease Award B.Decrease Award C.Increase Duration 9.NAME OF FEDERAL AGENCY D.Darxease Duration Other(specify): USDHHSIAC'r1ACY=!Head Start { 11.DESCRIPTWETITLE OF APPLICANT'S PROJECT: 10.CATALOG OF FEDERAL DOMESTIC 1 9 13 S le i 5 i 0 0 L ASSISTANCE NUMBER.: 1 PY2004 TITLE:yesd Stall PA22 Head Start Basic Grant 1 Application for stipend grant for National Institute on Father involvement 12.AREAS AFFECTED BY PROJECT Weld County,Colorado 1 1's.PROPOSED PROJECT: 14.CONGRESSIONAL DISTRICTS OF: Start Date Ending Date a Applicant 4 b.Project 4 1/0112004 12/31/2004 15.ESTIMATED FUNDING '16.is APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS? a.YES•THIS PREAPPLICATIOI4/APPLICATION WAS MADE AVAILABLETO THE STATE a Federal $ 2,000 EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON • • ; . ' bAppicant $ 500 DATE a State AD ' 1 h NO n PROGRAM IS NOT COVERED BY E.O.12372 I I ), OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW • d Local 1 DO e Otter 1 $ .DD • 17.IS THE APPLICANT DELINQUENT ON ANY FEDERALDEBT? i f Program Income $ , .00 n No • i l Yes If°Yes,°attach an explanation. gToal $ 2,500 18.TO THE BEST OF MY KNOWLEDGE AND BELIEF,ALL DATA IN THIS APPLICATION ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED \\, ' b Tiitlea Typed Name of Authorized Representative c Telephone number 8L970`X50 40D0 . fro b er t U. Ma s d e R' �� hair,Weld Co.Board of Co.Commissioners ( ) b Signature of Authorized Rerese ve MAY 1 U 14 a Date Signed'L �: , ,ttlyh I� • J •1 �� '3i)71)7 Chairperson - Regional $3d Start SECTION C-NON-FEDERAL RESOURCES ` (a)Grant Program (b)Applicant (c)State (d)Other Sources (0)TOTALS e' PA20 $ 500 $ $ $500 9. 10. 11. ' 12. TOTAL (sum o/lines 8-11) $ 500 $ • $ $500 SECTION D-FORECASTED CASH NEED) • Total for 1st Year 1st Gustier 2nd Quarter 3rd Quarter 4th Guilder 13. Federal $ 2000 $ $ 2000 • $ $ 14. Non-Federal 500 500 15.TOTAL (sum of lines 13 and 14) $ $ $ 2500 $ $ SECTION E-BUDGET ESTIMATES OF FEDERAL'FUNDS NEEDED FOR BALANCE OF THE PROJECT.' •. (a)Grant Program FUTURE FUNDING PERIODS(Years) _ (b)First (c) Second (d)Third 1e)Fourth 16. pa 20 $ 2000 $ $ $ 17. 18. 19. 20. TOTAL (sum of lines 16-19) $ 2000 $ $ $ SECTION F- OTHER BUDGET INFORMATION 21. Direct Charges: 22. Indirect Charges: 23. Remarks: - • Authorized for Local Reproduction Standard Fenn 424A(Rev.7-97)Pags2 BUDGET INFORMATION - Non-Construction Programs OMB Approval No.u340-0041 �� - SECTION A- BUDGET SUMMARY w Grant Program Catalog of Federal Estimated (lnobllgated Funds rf w or Revised Budget Function Domestic Assistance .._..___...__...�.-_- or Activity Number Federal Non-Federal Federal Non-Federal Total (a) (b)_ (ci (d4 (a) (9________ (9) $ $ $ $ $ 1- PA 20 93.600 2000 500 2500 2. 1 ` 3. r 4. $ $ $ $ $ 5. Totals 20O0 500 2500 SECTION B=BUDGET CATEGORIES 6.Object Class Categories GRANT PROGRAM,FUNCTION OR ACTIVITY Total tt) PA20 (2) J (4) (5) a. Personnel $ $ $ $ $ b. Fringe Benefits c.Travel 2000 2000 d.Equipment e. Supplies f.Contractual I • g.Construction h.Other I.Total Dlreci Charges (sum of 6a-619 2O0O LL 2000 J. Indirect Charges k.TOTALS (sum of 61 and 611 $ 2000 $ :$ $ '$ 2000 7. Program Income $ J$ $ j$ _11 Authorized for Local Reproduction Standard Fonn 424A(rev.7-97) Previous Edition Usable Proscribed by OMB Circular A-10 BUDGET/MATCH NARRATIVE APPLICATION FOR STIPEND FOR NATIONAL INSTITUTE ON FATHER INVOLVEMENT TRAVEL; Estimated costs to send 2 staff to the conference; Conference registration—$300 each * 2 = $600 Airfare from Denver to Dallas-5301.50 each * 2 = $603 Hotel— single--$95/day*2 * 6days + 15% hotel tax= $1,311 or double $120/day *6+ hotel tax 15%= $828 Shuttle to hotel/airport—max $40 each way =$80 Per diem—$25*2*7=$350 Grand total maximum estimated expense= $2,944 The $500 match will be provided by local match funds. Conference Information Page 1 of 8 t Li'" Administration for Children >Families ACF Home ACF Services i Working with ACF I ACE Policy/Planning I About ACF I ACF News Head Start Bureau HSB Home I National Head Start Training and Technical Assistance Resource Ce Contact Us 1 Horn 1:Search Search a About the NRC The Father Factor: National Head a Head Start.Renew Pelorittes 't Start Institute on Father lo TICA Network nirectoryr A Calendar of Eiiinia Involvement -Head Start Boileau... ea Conferences M.atsgistration or ConferenceRaprouseas pialine e, June 14 - 18, 2004 w Menter•CaacbResources Dallas Convention Center, Dallas, Texas Institute Overview Registration Information Hotel Information Map of Downtown Dallas (PDF - 373 KB) Travel and Logistics Contact Information Call for Papers Abstract Cover Pace (PDF - 104 Call for Abstracts (PDF - 97 KB) Overview The National Head Start Institute on Father Involvement marks the first time that the Head Start Bureau (HSB) has brought together leaders of every Head Start and Early Head Start program in the nation to focus on enhancing father involvement. Through the Institute and other related activities, the Head Start Bureau will ensure that local Head Start program leadership, staff, and parents have the knowledge and skills needed to strengthen families and support the ongoing http://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 Conference Information Page 2 of 8 involvement of fathers in Head Start, and in the lives of their children. This, in turn, will contribute to the healthy development of and improved outcomes for children. The goals of the Institute are to- • Ensure that all Head Start programs and staff understand the beneficial impact of father involvement on the development and well-being of children • Facilitate the effective involvement of fathers in the lives of Head Start children • Showcase and build on best practices regarding fatherhood • Present information and training that is based on research, grounded in practical application, and consistent with the cultural diversity of the Head Start community Participants include program leaders and father involvement or parent involvement specialists, as well as parents. These individuals play a key role in creating or enhancing effective father involvement plans in their local programs and bringing about system change which may be necessary to achieve that end. The Institute program is organized around Five Building Blocks for Father Involvement- • How Fathers Give Children a Head Start • Father Involvement in Head Start • Strengthen Your Foundation to Work with Fathers • Plan for the Success of Your Fatherhood Program • Bring Your Fatherhood Plan to Life To ensure that this national Institute is both informational and inspirational, the Head Start Bureau is committed to featuring the best speakers, teachers, researchers, and practitioners the fatherhood field has to offer. Registration for the National Head Start Institute on Father Involvement begins at Noon on Monday, June 14. The Opening Session begins at 4:00 p.m. on that day, followed by a Welcoming Reception. On Tuesday though Thursday, June 15-17, sessions will be held from 9:00 a.m. to 5:30 p.m. Each day will begin with a plenary session, followed by three 1.5 hour workshops. Optional evening networking activities are being planned for 6 to 8 p.m. on Tuesday through Thursday. Friday morning will be devoted to Regional Planning Sessions, followed by a keynote presentation and a Closing Luncheon. The Institute will end at 3:00 p.m. on Friday. It is important that a commitment be made to participate for the entire five-day event, since each day's work builds on the content and experiences of the previous day and also leads to the next day's http://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 Conference Information ?age 3 of x learning. Therefore, please make your travel arrangements for arrival no later than noon on Monday, June 14, and for departure after 5:00 p.m. on Friday, June 18. For more detailed information, review the Head Start Bureau's Information Memorandum on the National Head Start Institute on Father Involvement. [ACYF-IM-HS_044=01 National Head Start Institute on Father Involvement] Back,to Top Registration Information rDe 2004 ee:'$300.00 Information on how to register for the National Head Start Institute on Father. Involvement is coming soon. The registration fee entitles you to participate in the Opening Plenary and Welcoming Reception, daily Plenary Sessions, Workshops, Exhibits, and the Closing Luncheon. Please Note: With the exception of the Welcoming Reception and Closing Luncheon, meals will not be provided at the Institute. The Dallas Convention Center will provide participants with the opportunity to purchase breakfast and lunch in Exhibit Halls A and B throughout the week. Cancellations Cancellation of your Institute Registration must be received in writing to fatherhoodinstituteJ,pat-tech.com or to the National Head Start T/TA Resource Center, do Pal-Tech, Inc., 1000 Wilson Boulevard, Suite 1000, Arlington, VA 22209. Cancellations postmarked prior to May 28, 2004 are subject to a$75.00 administrative fee. There will be no refunds for cancellations after that date. All refunds will be issued after the Institute. Child Care Services If you would like to receive information about child care services and related fees, please check the appropriate box on the Institute Registration Form. Special Needs The Dallas Convention Center and all Institute hotels are in full compliance with public accommodation requirements of the Americans with Disabilities Act. Please indicate on the Institute Registration Form any special assistance you may require. http://www.hsnrc.org/confdetails.cfin?ConfID=12 03/08/2004 Conference Information Page 4 of S Spanish Interpretation Spanish Interpretation will be available at the Plenary Sessions during the Institute. Please indicate on the Institute Registration Form if you will require Spanish Interpretation. Continuing Education Units If possible, CEUs will be offered for successful completion of Institute assignments and experiences. Please check the appropriate box on the Institute Registration Form to receive more information. For More Information Please contact the National Head Start T/TA Resource Center via phone at (703) 243-0495 or via e-mail at fatherhoodinstitute tnr. pal- tech.com. Back to Top Hotel Information Reservation Deadline - May 10, 2004 Several hotels have set aside rooms for participants of the National Head Start Institute on Father Involvement. In order to secure a room with one of our participating hotels, please make reservations through the Fatherhood Institute Housing Bureau. Please click to view participating hotels, description and a tes..jPDF_- 72 KB) Please note- • All hotel room charges are subject to a 15 percent hotel tax. • A deposit equal to one night's room and tax is required to guarantee your reservation. Check, money order, American Express, Discover, Visa, or MasterCard are accepted for deposit. Credit cards will be charged immediately. Checks should be made payable to the Fatherhood Institute Housing Bureau. If a deposit is not provided, the reservation will not be processed. • Confirmations will be sent within 3-7 days of receipt of your Hotel Reservation Form via Internet, fax, or U.S. Mail. • The deadline for making hotel reservations at the listed rates is May 10, 2004. • To receive a full refund, cancellations must be received by May 10, 2004. After May 10, the hotels will refund your deposit less a $15 cancellation fee. DEPOSITS FOR RESERVATIONS CANCELLED WITHIN 72 HOURS OF THE ARRIVAL DATE ARE NON-REFUNDABLE. • Please make any changes or cancellations directly with the Fatherhood Institute Housing Bureau. • Daily shuttle service will be provided from Institute hotels to the Convention Center. http://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 HOTEL INFORMATION THE FATHER FACTOR: NATIONAL HEAD START INSTITUTE ON FATHER INVOLVEMENT RESERVATION DEADLINE -MAY 10, 2004 ''Hotels ,. ' t Sia 'i: 'Illouble -.Triple Quad, Adam's Mark Dallas 400 N. Olive Street $95 $95 $105 $115 Located approximately one mile from the Convention Center,the Adam's Mark Dallas Hotel will serve as the Institute Headquarters. The hotel is located in the center of Dallas'downtown arts and financial district,within walking distance of the Dallas Museum of Art,Meyerson Symphony Center, and the Majestic Theatre. The Adam's Mark,the largest hotel in Dallas, features five restaurants and amenities including a fully equipped heath club, indoor and outdoor pools, saunas, and whirlpools. The hotel is located approximately 22 miles from DFW International Airport and 12 miles from DAL Airport. Hyatt Regency Dallas �� 300 Reunion Blvd. / $95 ( $120 ) $145 $170 Located within two blocks of the C+nvention Center;tife Hyatt Regency Dallas features an I 8-story atrium,two lounges and three restaurants, including Antares, a revolving New American restaurant atop Reunion Tower. The hotel offers a newly- renovated fitness center,outdoor pool,and jacuzzi. An underground concourse connects the hotel to Union Station, providing access to various parts of Dallas via the light and commuter rail systems. The hotel is located approximately 23 miles from DFW International Airport and 10 miles from DAL Airport. Renaissance Dallas Hotel 2222 Stemmons Freeway $95 $95 $95 $95 The Renaissance Dallas Hotel is located in the heart of the Dallas Market Center, close to downtown and three miles from the Convention Center. The hotel features two restaurants and is located minutes from the West End Marketplace,Big"D" sporting arenas,and the Kennedy Museum. Amenities include a fully equipped health club, an outdoor heated pool,whirlpool, sauna, and steam room. The hotel is located approximately 15 miles from DFW International Airport and g miles from DAL Airport Wyndham Anatole 2201 Stemmons Freeway $95 $115 $135 $155 The Wyndham is approximately three miles from the Convention Center and is located on 45 lush acres just outside of downtown Dallas. The hotel features ten retail boutiques and shops,six lounges, and five restaurants,including the five-star Nana restaurant. Amenities include a full-service health club and spa, three swimming pools, and a private seven-acre park. The hotel is located approximately 18 miles from DFW International Airport and 8 miles from DAL Airport. Conference Information Page 5 of 8 Please download a Hotel Reservation Form (PDF - 41 KB) or make your Hotel Reservations On-line. For more information or to make reservations over the phone, please contact the Fatherhood Institute Housing Bureau at: Fatherhood Institute Housing Bureau 325 North St. Paul Street Suite 700 Dallas, TX 75201 Phone: 800-792-1029 or 214-571-1023 Fax: 214-571-1024 *Office hours are 8:00 a.m. - 5:00 p.m. CST, Monday - Friday. Back_t_o_Top Travel and Logistics Getting There Dallas is very accessible, regardless of where or how you are traveling. By Car, Bus, & Train Dallas is easy to access from most major cities in the region, thanks to its location at the intersection of a number of major crossroads. Dallas is conveniently accessed from four major highways, including US-75, I-45, I-35, and I-30. Greyhound long-distance buses operate from the 24-hour Greyhound bus terminal located at 205 S. Lamar. For more information, please call 800-229-9424 or visit www.gre_yhound_com. Amtrak services cover long-distance routes to Dallas via the Texas Eagle Train. The train station is located at 400 S. Houston Street. For more information, please call 800-872-7245 or visit www.amtrak.com. If traveling by train, please contact Amtrak and provide the following convention code for a discounted rate. Train Phone Number Convention Code Amtrak 800-872-7245 X94B-911 By Air Special discounted fares have been arranged for participants traveling round-trip to the National Head Start Institute on Father Involvement. isttp://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 Conference Information Page 6 of 8 To make your reservations, call your airline of preference, identify yourself as a participant in the Fatherhood Institute, and provide the group ID number that corresponds to the airline you are calling. Please call early to receive the lowest fare with the highest discount. Please note that some restrictions and service fees may apply. Two major airports serve the Dallas area. Dallas/Fort Worth International Airport, located approximately 18 miles from downtown, offers nearly 2,000 flights daily. Dallas Love Field Airport, located approximately 7 miles from downtown, offers 300 daily flights. When making airline reservations, please contact your airline of preference and provide the appropriate group ID number to ensure that you receive the discounted rate. Airline Phone Number Group ID Code American Airlines 800-433-1790 A7664AM America West Airlines 800-548-7575 8756 Continental Airlines 800-468-7022 VNRE9F Delta Airlines 800-241-6760 202470A Northwest Airlines 800-328-1111 NEPM5 US Airways 877-874-7687 25622988 Getting Around Taxi & Airport Shuttle Services Dallas/Fort Worth International Airport (D9El' . Taxi service is available from the upper le o e l-terminal. The average one-way fare to downtown Dallas is $38. SE'uttle bus service to or from DFW is provided 24-hours a day*b_y_SuperShuttle. The average one-way fare to downtown Dallas is $20. Twenty-four hour advance notice is required. For additional information, call 800-258- 3826 or visit www.supershuttle.com. Dallas Love Field Airport(DAL) Taxi service is provided on the upper level across the street from the baggage claim wing of the main terminal building. The average one- way fare to downtown Dallas is $18. Shuttle bus service to and from DAL is provided by SuperShuttle. The average one-way fare to downtown Dallas is $15. Twenty-four hour advance notice is required. For additional information, call 800-258-3826 or visit www.supershuttle.com. Car Rental hap://www.hsnrc.orgiconfdetails.cfm?ConfID-12 03/08/2004 Conference Information Page 7 of 8 The following car rental agencies are offering discounted rental rates to Institute participants- Rental Company Phone Number Group ID Code Hertz 800-654-2240 022Q1655 Enterprise 800-593-0505 09D2252 Local Transportation Public transportation is provided by the Dallas Area Rapid Transit (DART) light rail system. The 44-mile DART rail system provides fast, convenient service to the Dallas Convention Center, area hotels, and shopping and entertainment destinations. For route and schedule information, call the Transit Departments Customer Service Center at 1-214-979-1111 or visit www.dart.org. The Trinity Railway Express (TRE) transports visitors from downtown Union Station to DFW Airport. Shuttle routes operate CentrePort/DFW Airport Station, delivering passengers directly to their terminals. One route travels to Terminals A and C, the other serves Terminals B and E. Shuttles are scheduled to meet all trains, departing every 15 minutes, Monday through Saturday. No regularly scheduled service is available on Sunday. Union Station is located a few blocks from the Regency Hyatt in downtown Dallas. For more information, call the Transit Department's Customer Service Center at 1-214-979-1111 or visit www.dart.org. Back to Top Contact Information Institute Registration: National Head Start T/TA Resource Center c/o Pal-Tech, Inc. 1000 Wilson Blvd., Suite 1000 Arlington, VA 22209 Phone: 703-243-0495 E-mail: fatherhoodinstitute a,pal-tech.com Hotel Reservations: Fatherhood Institute Housing Bureau 325 North St. Paul Street Suite 700 Dallas, TX 75201 Phone: 800-792-1029 or 214-571-1023 Fax: 214-571-1024 http://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 Conference Information Page b of NRC Home I CDI Home }HSB Home I ACF Home } Site Map Health Institute Home I Facilities I Help} Privacy } Email (last modified:November 10, 2003) http://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 Select Your Outbound Flight Page 1 of 3 -- -c t.it� 'Sri 'Z A .se•-.u`�s r .-' tip.. Ti i+x - ., i S 4:77,--,-. 111.T'-•' Fri' .v q, �cis _ ,ar -a-• . �.# - Travei 0 C r 1- . 0.44 I-� l fr L y .� - zL :kg �,�-L a --.1.,-+.=.,,..,,_-.-----.,- . 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If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability(including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. will comply with the intergovernmental Personnel Act of 1970 (42 U.S.C. 4278-4763)relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM=s Standards for a Merit System of Personnel Administration (5 CFR 900, Subpart F). 6. Will comply with all Federal statutes relating to non-discrimination. These include but are not limited to: (a) Title Vi of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the bases of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended(20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended(42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972(P.L. 92-255), as amended, relating to non-discrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to non-discrimination on the bases of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912(42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of the alcohol and drug abuse patient records; (h) Title VII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to non-discrimination in the sale, rental or financing of housing; (I) any other non-discrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and(j) the requirements of any other non-discrimination statute(s) which may apply to the application. 17 7. Will comply, or has already complies, with the requirements of Titles iI and Ill of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or Federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply with the provisions of the Hatch Act(5 U.S.C. 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis-Bacon Act(40 U.S.C. 276a to 276a-7), the Copeland Act(40 U.S.C.276c and 18 U.S.C. 874), and the Contract Work Hours and Safety Standards Act(40 U.S.C. 327-333), regarding labor standards for Federally assisted construction subagreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is$10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order(EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c)protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972(16 U.S.C. 1451 et seq.); (t) conformity of Federal actions to State (Clear Air) implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended(42 U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523);and(h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205) 12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended(16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.). . 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.)pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. 4801 et seq.) which prohibits the use of lead based paint in the construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the single. Audit Act of 1984. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. 18 DRUG-FREE WORKPLACE REQUIREMENTS GRANTEES OTHER THAN INDIVIDUALS By signing and/or submitting this application or grant agreement, the grantee is providing the certification set out below. This certification is required by regulations implementing the Drug-Free Workplace Act of 1988, 45 CFR, Part 76, Subpart F. The regulations published in the January 31, 1989 Federal Register, require certification by grantees that they will maintain a drug-free workplace. The certification set out below is a material representation of fact upon which reliance will be placed when HHS determines to award the grant. False certification or violation of the certification shall be grounds for suspension of payments, suspension or termination of grants, or government-wide suspension or debarment. Workplaces under grants, for grantees other than individuals, need not be identified on the certification. If known, they may be identified in the grant application. If the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee must keep the identity of the workplace(s) on file in its office and make the information available for Federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee's drug-free workplace requirements. Workplace identifications must include the actual address of buildings (or parts of building) or other sites where work under the grant takes place. Categorical descriptions may be used (e.g. all vehicles of a mass transit authority of State highway department while in operation, State employees in each local unemployment office, performers in concert halls or radio studios). if the workplace identified to HHS changes during the performance of the grant, the grantee shall inform the agency of the change(s), it previously identified the workplaces in question (see above). Definitions of terms in the Nonprocurement Suspension and Debarment common rule and Drug-Free Workplace common rule app/y to this certification. Grantees' attention is called, in particular, to the following definitions from these rules: "Controlled substance" means a controlled substance in Schedules I through V of the Controlled Substances Act (21 USC 812) and as further defined by regulations (21 CFR, 1308.11 through 1308.15). "Conviction" means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the Federal of State criminal drug statutes; "Criminal drug statute"means a Federa/ or non-Federal criminal statute involving the manufacture, distribution, dispensing use, or possession of any controlled substance; "Employee" means the employee of a grantee directly engaged in the performance of work under a grant including: (i) All "direct charge" employees; (ii) all "indirect charge" employees unless their impact of involvement is insignificant to the performance of the grant; and (iii) temporary personnel and consultants who are directly engaged in the performance of work under the grant and who are on the grantee's payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement consultants or independent contractors not on the grantee's payroll; or employees of subrecipients or subcontractors in covered workplaces). The grantee certifies that it will provide a drug-free workplace by: a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; b) Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; 19 (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of be statement required by paragraph (a); d) Notifying the employee in the statement required by paragraph (a) that as a condition of employment under the grant, the employee will: (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; e) Notifying the agency in writing within ten days after receiving notice under subparagraph (d)(2), from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; t) Taking one of the following actions within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a) through (1). CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal program either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds in medicare of medicaid; or facilities where WIC coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing this certification, the offeror/contractor (for acquisitions) or applicant/grantee (for grants) certifies that the submitting organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. 20 The submitting organization agrees that it will require that the language of this certification be included in any sub awards which subrecipients shall certify accordingly. • 21 • CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS - PRIMARY COVERED TRANSACTIONS By signing and submitting this proposal, the applicant, defined as the primary participant in accordance with 45 CFR Part 76 certifies to the best of his or her knowledge and believe that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transaction by any.Federal Department or agency; (b) have not within a 3-year period preceding this proposal been convicted or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statement, or receiving stolen property; (c) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) have not within a 3-year period preceding this application/proposal had one or more public transaction (Federal, State or local) terminated for cause or default. The inability of a person to provide the certification required above will not necessarily result in denial of participation in this covered transaction. if necessary, the prospective participant shall submit an explanation of why it cannot provide the certification. The Department of Health and Human Services' (HHS) determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. The prospective primary participant agrees that by submitting this proposal, it will include the clause entitled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions,"provided below without modification in all lower tier covered transactions. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION- LOWER TIER COVERED TRANSACTIONS (TO BE SUPPLIED TO LOWER TIER PARTICIPANTS) By signing and submitting this lower tier proposal, the prospective lower tier participant, as defined in 45 CFR, Part 76, certifies to the best of its knowledge and belief that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in This transaction by any Federal department or agency. (b) where the prospective lower tier participant is unable to certify to any of the above, such prospective participant shall attach an explanation to this proposal. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause entitled "Certification Regarding Debarment, Suspension, ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without modification in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 22 • CERTIFICATION REGARDING LOBBYING FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned certifies to the best of his or her knowledge and belief, that: (1) No Federal appropriate funds have been paid or will be paid, by or on behalf of the undersigned, 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 awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person influencing or attempting to influence an officer or employee or an agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this Federal contract, grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty or not less than $10,000 and not more than $100,000 for each such failure. I hereby agree to the above certifications and assurances. ? p\k[ - — MAY 0 3 2004 - Signature of Certifying Official Date Robert D. Masden, Chair Title Weld County Board of Commissioners Applicant Organization 23 APPLICATION FOR 2.DATE SUBMITTED: Applicant Identifier . 90CM0136 FEDERAL ASSISTANCE 11/05/2003 • ' 1.TYPE OF SUBMISSION • 3.DATE RECEIVED BY STATE: State Application Identifier Application Preappffcation . O Construction � •Construction 4.DATE RECEIVED BY FEDERAL AGENCY Federal Identifier Non-Construction O Non-Construction ' 90CM0136 I_ { 5.APPLICANT INFORMATION Legal Name: Weld Co.Division of Human Services Organizational Unit Family Educational Network of Weld County Address(give city,county,state,and zip code) Name and telephone number ate person to be contacted on matters involving 1551 North 17th Avenue this P.O.Box 1805 Waft Specimen Greeley,CO 80632 Weld 97Q353-3800 Executive Director,WCDHS 6. EMPLOYER IDENTIFICATION NUMBER(EIN) 7.TYPE OF APPLICANT(enter appropriate letter In box) 614 um 1 6 I 0 [0 1 0 1 8 l 1 1 3 A.State H.independent School Dist. B.County 1.State Controlled institution of Higher Learning ' S.TYPE OF APPLICATION • C.Municipal J.Private University rbe I New a Continuation O Revision E.Township nte Individual al L irtdivirtual F.lntermunicipal N.Profit Organization 1f Revision,enter appropriate letter(s)in box(es): 0 0 G.Special District N.Other(specify) A.Increase Award B.Decrease Award C.Increase Duration S.NAME OF FEDERAL AGENCY D.Decrease Duration Other(seedy): USDHHS/ACF/ACYF/Migrant Branch i • 10.CATALOG OF FEDERAL DOMESTIC 11.DESCRIPTIVE TITLE OF APPLICANTS PROJECT: • ASSISTANCE NUMBER: 91 3 a 6 LO 0 PY2004 TITLE:Head Start Basic Migrant and Seasonal Grant Application Stipend Grant for National Institute 12.AREASAFFECTEDBYPROJECT On Father Involvement I State-wide Colorado ' 13.PROPOSED PROJECT: 14.CONGRESSIONAL DISTRICTS OF: Start Date Ending Date a Applicant 4 b.Project 1/01/2004 1231,2004 I ' 15.ESTIMATED FUNDING 16.IS APPLICATION SUBJECT TO REVIEW BY STATE ATE X' EECUTIVE ORDER 12372 PROCESS? a Federal $ 2000 12372 EXECUTIVE ORDER I ON WAS PROCESS FORREVIEW Of MADE AVAILABLE TO THE STATE N , b Applicant $ 500 DATE . c State $ 0.00 b NO n PROGRAM IS NOT COVERED BY E,O.12372 d Local a 0.00 n OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW e Other I 4 0.00 17.1$THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? I Program Income $ 0.00 n Yes If'Yes;attach an explanation. 0 No g Total $25007 18,TO THE BEST OF MY KNOWLEDGE AND BELIEF,ALL DATA IN THIS APPLICATION ARE TRUE AND CORRECT, THE DOCUMENT HAS BEEN DULY AUTHORIZED I BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED a Typed Name of Authorized Representative b Title c Telephone number Robert Ma s den Chair,Weld Co.Board of Co.Commissioners 970-356-4000 b Signature of Authorized Representativeli..$)‘.. ., a Date Signed MAY 0 3 2004 • SECTION C-NON-FEDERAL RESOURCES ` "• :. . (a)Grant Program (b)Applicant (c)State (d)Other Sources (e)TOTALS 8. $500 PA20 500 9. 10. 11. 12. TOTAL (sum o//ines 8-11) $ 500 $ . $ $500 SECTION D-FORECASTED CASH NEEDS • Total for let Year let Quarter 2nd Quarter 3rd Quarter 4th Quarter 13. Federal $ 2000 $ $ 2000 • $ 14. Non-Federal 500 500 15.TOTAL (sum oflines 13 and 14) $ $ $ 2500 $ $ SECTION E-BUDGET ESTIMATES OE FEDERAL.FUNDS NEEDED FOR BALANCE OF THE PROJECT (a)Grant Program _ FUTURE FUNDING PERIODS(Years) _ (b) First (c) Second (d)Third (e) Fourth 16. pa 20 2000 $ $ $ 17. 18. 19. • 20.TOTAL (sum of lines 16-19) $ 2000 $ $ $ SECTION F-OTHER BUDGET INFORMATION • 21. Direct Charges: 22. Indirect Charges: 23. Remarks: Authorized for li-octel Ileprotttiction Steetct9rd Foam.424A(nay.7.97)repee2 . BUDGET INFORMATION - Non-Construction Programs OMB Approvol No.v34e-0041 SECTION A-BUDGET SUMMARY _ Grant Program Catalog of Federal Estimated Unobligated Funds Itt'w or nevised Budget Function Domestic Assistance _ ___.__.. _._. _.-_.�._... ___.__-..____„-- __ _ _. ____ ___ or Activity Number Federal Non-Federal federal Non Federal fatal (a) (b) Sc) (d) _____ �� (f? (9) $ $ _ __ 1. PA 20 93.600 2000 $ $500 2500 2. a 1 4. $ 5. Totals 2000 500 2500 T SECTION IS s BUDGET CATEGORIES 6.Object Class Categorles GRANT pawn"FUNCTION OR ACTIVITY Total to PA24 r(?)._ t31 (I) (31 $ a.Personnel $ $ $ b. Fringe Benefits c.Travel 2000 2000 d.Equipment e.Supplies f. Contractual i g. Construction h.Other I.Total Direct Charges (sun?of 6a-619 2000 2000 J. Indirect Charges k.TOTALS (sum of 61 and 61) $ 2000 • $ $ $ 2000• --7. Program income $ $ $ - - 't 1 T Authorized for Local neploduction ;lm,dmri ron„474A(ilr.v.7.97) Previous Edition Usable I'wsrribrd by OMR Clrrrim A ir1 BUDGET/MATCH NARRATIVE APPLICATION FOR STIPEND FOR NATIONAL INSTITUTE ON FATHER INVOLVEMENT TRAVEL; Estimated costs to send 2 staff to the conference; Conference registration—$300 each * 2 = $600 Airfare from Denver to Dallas—$301.50 each * 2 = $603 Hotel—single--$95/day*2 * 6days + 15% hotel tax= $1,311 or double $120/day *6 + hotel tax 15%= $828 Shuttle to hotel airport—max S40 each way =580 Per diem—$25*2*7=$350 Grand total maximum estimated expense= $2,944 The $500 match will be provided by local match funds. Conference Information Page 1 of 8 Administration for Children : Families ACF Home ACF Services I Working with ACF I ACF Policy/Planning I About ACE I ACF News Head Start Bureau HSB Home l National Head Start Training and Technical Assistance Resource Ce Contact Us [ Home i Search ISearch •Abnut the NRC — The Father Factor: National Head ts Head Start BnraaetPrinrs Start Institute on Father a v nr3ITAtdnlwarkprnctcryr' a CalendarofEns qi.'��- Involvement Head startutdletb't '{ ar Conferences .`Registration Cimference Ftestancesttn,Sne June 14 - 18, 2004 .Mentor coaclls*Siiiirctes �� Dallas Convention Center, Dallas, Texas '; . Institute Overview Registration Information Hotel Information Map o_f Downtown Dallas (PDF - 373 Kla) Travel and Logistics Contact Information Call for Papers Abstract Cover Page(PDF - 104 KB) Call for Abstracts (PDF - 97 KB) Overview The National Head Start Institute on Father Involvement marks the first time that the Head Start Bureau (HSB) has brought together leaders of every Head Start and Early Head Start program in the nation to focus on enhancing father involvement. Through the Institute and other related activities,the Head Start Bureau will ensure that local Head Start program leadership, staff, and parents have the knowledge and skills needed to strengthen families and support the ongoing httn•//www hsnrc orQLc nfdetails.cfm?ConfID=12 03/08/2004 Conference Information Page 2 of 8 involvement of fathers in Head Start, and in the lives of their children. This, in turn, will contribute to the healthy development of and improved outcomes for children. The goals of the Institute are to- • Ensure that all Head Start programs and staff understand the beneficial impact of father involvement on the development and well-being of children • Facilitate the effective involvement of fathers in the lives of Head Start children • Showcase and build on best practices regarding fatherhood • Present information and training that is based on research, grounded in practical application, and consistent with the cultural diversity of the Head Start community Participants include program leaders and father involvement or parent involvement specialists, as well as parents. These individuals play a key role in creating or enhancing effective father involvement plans in their local programs and bringing about system change which may be necessary to achieve that end. The Institute program is organized around Five Building Blocks for Father Involvement- • How Fathers Give Children a Head Start • Father Involvement in Head Start • Strengthen Your Foundation to Work with Fathers • Plan for the Success of Your Fatherhood Program • Bring Your Fatherhood Plan to Life To ensure that this national Institute is both informational and inspirational, the Head Start Bureau is committed to featuring the best speakers, teachers, researchers, and practitioners the fatherhood field has to offer. Registration for the National Head Start Institute on Father Involvement begins at Noon on Monday, June 14. The Opening Session begins at 4:00 p.m. on that day, followed by a Welcoming Reception. On Tuesday through Thursday, June 15-17, sessions will be held from 9:00 a.m. to 5:30 p.m. Each day will begin with a plenary session, followed by three 1.5 hour workshops. Optional evening networking activities are being planned for 6 to 8 p.m. on Tuesday through Thursday. Friday morning will be devoted to Regional Planning Sessions, followed by a keynote presentation and a Closing Luncheon. The Institute will end at 3:00 p.m. on Friday. It is important that a commitment be made to participate for the entire five-day event, since each day's work builds on the content and experiences of the previous day and also leads to the next day's httn•//www hcnrr nra/rnnfdetailc cfm ConfID=12 03/08/2004 Conference Information Page 3 of S learning. Therefore, please make your travel arrangements for arrival no later than noon on Monday, June 14, and for departure after 5:00 p.m. on Friday, June 18. For more detailed information, review the Head Start Bureau's Information Memorandum on the National Head Start Institute on Father Involvement. [ACYF-IM-HS-04-01 National Head Start Institute on Father Involvement] Back to Top Registration Information Deadlinv44g3$, 2004 Fee: S300.00 Information on how to register for the National Head Start Institute on Father Involvement is coming soon. The registration fee entitles you to participate in the Opening Plenary and Welcoming Reception, daily Plenary Sessions, Workshops, Exhibits, and the Closing Luncheon. Please Note: With the exception of the Welcoming Reception and Closing Luncheon, meals will not be provided at the Institute. The Dallas Convention Center will provide participants with the opportunity to purchase breakfast and lunch in Exhibit Hails A and B throughout the week. Cancellations Cancellation of your Institute Registration must be received in writing to fatherhoodinstitute@pal-tech.com or to the National Head Start T/TA Resource Center, c/o Pal-Tech, Inc., 1000 Wilson Boulevard, Suite 1000, Arlington, VA 22209. Cancellations postmarked prior to May 28, 2004 are subject to a$75.00 administrative fee. There will be no refunds for cancellations after that date. All refunds will be issued after the Institute. Child Care Services If you would like to receive information about child care services and related fees, please check the appropriate box on the Institute Registration Form. Special Needs The Dallas Convention Center and all Institute hotels are in full compliance with public accommodation requirements of the Americans with Disabilities Act. Please indicate on the Institute Registration Form any special assistance you may require. ___ http://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 Conference Information Page 4 of 8 Spanish Interpretation Spanish Interpretation will be available at the Plenary Sessions during the Institute. Please indicate on the Institute Registration Form if you will require Spanish Interpretation. Continuing Education Units If possible, CEUs will be offered for successful completion of Institute assienments and experiences. Please check the appropriate box on the Institute Registration Form to receive more information. For More Information Please contact the National Head Start T/TA Resource Center via phone at (703) 243-0495 or via e-mail at fatherhoodinstitute al- tech.com. Back to Top Hotel Information Reservation Deadline - May 10, 2004 Several hotels have set aside rooms for participants of the National Head Start Institute on Father Involvement. In order to secure a room with one of our participating hotels, please make reservations through the Fatherhood Institute Housing Bureau. Please click to view participatin,�hotels, descriptions. and rat s.LPDF_, 72 KB) Please note- • All hotel room charges are subject to a 15 percent hotel tax. • A deposit equal to one night's room and tax is required to guarantee your reservation. Check, money order, American Express, Discover, Visa, or MasterCard are accepted for deposit. Credit cards will be charged immediately. Checks should be made payable to the Fatherhood Institute Housing Bureau. If a deposit is not provided, the reservation will not be processed. • Confirmations will be sent within 3-7 days of receipt of your Hotel Reservation Form via Internet, fax, or U.S. Mail. • The deadline for making hotel reservations at the listed rates is May 10, 2004. • To receive a full refund, cancellations must be received by May 10, 2004. After May 10, the hotels will refund your deposit less a $15 cancellation fee. DEPOSITS FOR RESERVATIONS CANCELLED WITHIN 72 HOURS OF THE ARRIVAL DATE ARE NON-REFUNDABLE. • Please make any changes or cancellations directly with the Fatherhood Institute Housing Bureau. • Daily shuttle service will be provided from Institute hotels to the Convention Center. htto://www.hsnrc.org/confdetails.cfm?ConfID=12 03/08/2004 HOTEL INFORMATION THE FATHER FACTOR: NATIONAL HEAD START INSTITUTE ON FATHER INVOLVEMENT RESERVATION DEADLINE - MAY 10, 2004 Hotels dingle Double Triple' Q`aad Adam's Mark Dallas . 400 N. Olive Street $95 I $95 $105 $115 Located approximately one mile from the Convention Center,the Adam's Mark Dallas Hotel will serve as the Institute Headquarters. The hotel is located in the center of Dallas' downtown arts and financial district,within walking distance of the Dallas Museum of Art, Meyerson Symphony Center, and the Majestic Theatre. The Adam's Mark, the largest hotel in Dallas, features five restaurants and amenities including a fully equipped heath club, indoor and outdoor pools, saunas, and whirlpools. The hotel is located approximately 22 miles from DFW International Airport and 12 miles from DAL Airport. Hyatt Regency Dallas i'T-, 300 Reunion Blvd. j�$95 1 $120 ) $145 I $170 Located within two blocks of the Convention Centel-the Hyatt Regency Dallas features an 18-story atrium, two lounges, and three restaurants, including Antares, a revolving New American restaurant atop Reunion Tower. The hotel offers a newly- renovated fitness center, outdoor pool, and jacuzzi. An underground concourse connects the hotel to Union Station, providing access to various parts of Dallas via the light and commuter rail systems. The hotel is located approximately 23 miles from DFW International Airport and 10 miles from DAL Airport. Renaissance Dallas Hotel 2222 Simmons Freeway $95 $95 $95 $95 The Renaissance Dallas Hotel is located in the heart of the Dallas Market Center, close to downtown and three miles from the Convention Center. The hotel features two restaurants and is located minutes from the West End Marketplace, Big "D" sporting arenas, and the Kennedy Museum. Amenities include a fully equipped health I club, an outdoor heated pool, whirlpool, sauna, and steam room. The hotel is located approximately 15 miles from DFW International Airport and 8 miles from DAL Ai tort. Wyndham Anatole 2201 StemmonsFreewa $95 $115 $135 $155 The Wyndham is approximately three miles from the Convention Center and is located on 45 lush acres just outside of downtown Dallas. The hotel features ten retail boutiques and shops, six lounges, and five restaurants, including the five-star Nana restaurant. Amenities include a full-service health club and spa, three swimming pools, and a private seven-acre park. The hotel is located approximately 18 miles from DFW International Airport and 8 miles from DAL Airport. Conference Information Page 5 of 8 Please download a Hotel Reservation Form (PDF - 41 KB) or make your Hotel Reservations On-line. For more information or to make reservations over the phone, please contact the Fatherhood Institute Housing Bureau at: Fatherhood Institute Housing Bureau 325 North St. Paul Street Suite 700 Dallas, TX 75201 Phone: 800-792-1029 or 214-571-1023 Fax: 214-571-1024 *Office hours are 8:00 a.m. - 5:00 p.m. CST, Monday - Friday. Back to Top Travel and Logistics Getting There Dallas is very accessible, regardless of where or how you are traveling. By Car, Bus, & Train Dallas is easy to access from most major cities in the region, thanks to its location at the intersection of a number of major crossroads. Dallas is conveniently accessed from four major highways, including US-75, 1-45, 1-35, and I-30. Greyhound long-distance buses operate from the 24-hour Greyhound bus terminal located at 205 S. Lamar. For more information, please call 800-229-9424 or visit www.gre_yhound.com. Amtrak services cover long-distance routes to Dallas via the Texas Eagle Train. The train station is located at 400 S. Houston Street. For more information, please call 800-872-7245 or visit www.amtrak.com. if traveling by train, please contact Amtrak and provide the following convention code for a discounted rate. Train Phone Number Convention Code Amtrak 800-872-7245 X94B-911 - By Air Special discounted fares have been arranged for participants traveling round-trip to the National Head Start Institute on Father Involvement. httn://www.hsnrc.ora/confdetails.cfm?ConfID=12 03/08/2004 Conference Information Page 6 of 8 To make your reservations, call your airline of preference, identify yourself as a participant in the Fatherhood Institute, and provide the group ID number that corresponds to the airline you are calling. Please call early to receive the lowest fare with the highest discount. Please note that some restrictions and service fees may apply. Two major airports serve the Dallas area. Dallas/Fort Worth International Airport, located approximately 18 miles from downtown. offers nearly 2,000 flights daily. Dallas Love Field Airport, located approximately 7 miles from downtown, offers 300 daily flights. When making airline reservations, please contact your airline of preference and provide the appropriate group ID number to ensure that you receive the discounted rate. Airline Phone Number Group ID Code American Airlines 800-433-1790 A7664AM America West Airlines 800-548-7575 8756 Continental Airlines 800-468-7022 VNRE9F Delta Airlines 800-241-6760 202470A Northwest Airlines 800-328-1111 NEPM5 US Airways 877-874-7687 25622988 Getting Around Taxi & Airport Shuttle Services Dallas/Fort Worth International Airport (Dy Taxi service is available from the upper 1- o e h)terminal. The average one-way fare to downtown Dalla is $38.'Muffle bus service to or from DFW is provided 24-hours a day-by..SuperShuttle. The average one-way fare to downtown Dallas is $20. Twenty-four hour advance notice is required. For additional information, call 800-258- 3826 or visit www.supershuttle.com. Dallas Love Field Airport (DAL) Taxi service is provided on the upper level across the street from the baggage claim wing of the main terminal building. The average one- way fare to downtown Dallas is $18. Shuttle bus service to and from DAL is provided by SuperShuttle. The average one-way fare to downtown Dallas is $15. Twenty-four hour advance notice is required. For additional information,-call 800-258-3826 or visit www.supershuttle.com. Car Rental http://www.hsnrc.ora/confdetails.cfm?ConfID=12 03/08/2004 Conference Information Page 7 of 8 The following car rental agencies are offering discounted rental rates to Institute participants- Rental Company Phone Number Group ID Code Hertz 800-654-2240 022Q1655 Enterprise 800-593-0505 09D2252 Local Transportation Public transportation is provided by the Dallas Area Rapid Transit (DART) light rail system. The 44-mile DART rail system provides fast, convenient service to the Dallas Convention Center, area hotels, and shopping and entertainment destinations. For route and schedule information, call the Transit Department's Customer Service Center at 1-214-979-1111 or visit www.dart.org. The Trinity Railway Express (TRE)transports visitors from downtown Union Station to DFW Airport. Shuttle routes operate CentrePort/DFW Airport Station, delivering passengers directly to their terminals. One route travels to Terminals A and C, the other serves Terminals B and E. Shuttles are scheduled to meet all trains, departing every 15 minutes, Monday through Saturday. No regularly scheduled service is available on Sunday. Union Station is located a few blocks from the Regency Hyatt in downtown Dallas. For more information, call the Transit Department's Customer Service Center at 1-214-979-1111 or visit www.dart.org. Back to Top Contact Information Institute Registration: National Head Start T/TA Resource Center c/o Pal-Tech, Inc. 1000 Wilson Blvd., Suite 1000 Arlington, VA 22209 Phone: 703-243-0495 E-mail: fatherhoodinstitute@pal-tech.com -Hotel Reservations: Fatherhood Institute Housing Bureau _325 North St. Paul Street Suite 700 Dallas, TX 75201 Phone: 800-792-1029 or 214-571-1023 Fax: 214-571-1024 htto;//www.hsnrc.orc/confdetails.cfm?ConfID=12 03/08/2004 Conference Information Page 8 of 8 NRC Home I CDI Home I HSB Home I ACF Home I Site Map Health Institute Home I Facilities j Hein j 0 ifft Privacy j Email (last modified:November 10,2003) httn-l/www.hsnrc.oralconfdetails.cfm?ConfiD=12 03/08/2004 • Select Your Outbound Flight Page 1 of 3 ,C ` — ....s .a ---mac_.i .. -,, ■ • ''-�-2 rcu yr ,max,c... m. -. r_. ..- —":`-'e1 4_ _ jilliF rave 0c•4 - = , Home Flights Hotels Cars/Rail Vacations Cruises Last Minute Deals Guides &Advice ( My Stuff Modify Your Search CD Select Your Outbound Flight Departure City: Denver, CODallas, Denver_COO to TX _ Arrival City: Departing Sun, Jun 13 tti. Xf 'Dallas,TX 4 Returning Sat, Jun 19 4 Adults £2E Departure Date/Time: Jun '13 _ J All fares are averaged in U.S.dollars per person,including taxes and fees(subject to availability and routing).All times An me city.The following prices are for e-tickets.if your itinerary requires a paper ticket,additional fees may apply. Return Date/Time: jimr, goyUnited ll Frontier 4 American Fr Airlines Airlines Airlines Results From Show Options Show Options Show Options Anytime _. _._ __ $301 from $301 from $301 from $301 Maximum Connections: El Departure *i Arrival Airline ID Travel Time Total Passengers:4 8:50am 11:36am unite d Nonstop Q age Passengers Denver,CO Dallas/Ft Worth,TX Airlines T .�_.,,_... . ... ._,:..._�._ (DEN) ; (DFW) Flight 708 i Travel r me: 1 hr 46min i!earch Nnw __ — ----..- _.. . — —.__—•-- .._ __�...�. . . Tiosto find iQwfar.e 10:15am 1:07pm if united Nonstop Denver,CO : Dallas/Ft Worth,TX(DEN) (DFW) Flight 81 7AirlinesTravel Time: 1 hr 52min ' !k . 12:25pm ! 3:15pm united Nonstop ( t Denver,CO Dallas/Ft Worth,TX Airlines Oktl - (DEN) ; (DFVV) Flight 490 Travel Time. 1hr 50min 3:30pm 6:20pm United Nonstop ` Denver,CO Dallas/Ft Worth,TX NV Airlines Travel Time: 1 hr 50min ; j , (DEN) (DRY) • Flight 450 6:30pm . 9:16pm united Nonstop Denver,CO Dallas/Ft Worth,TX WY Airlines Travel Time: 1 hr 46min (DEN) (DFW) Flight 1082 7:00am 9:45am .. Frontier Nonstop Denver,CO ' Dallas/Ft Worth,TX Airlines Travel Time: 1 hr 45min • (DEN) • (DFW) Flight 120 • • 11:50am ' 2:35pm Frontier Nonstop Denver,CO • Dallas/Ft Worth,TX Airlines p httn•//rdnc1_travelneity rnm/airinnthntmd.ctl?nrmmn nape=YRLhtl nkas=OFFRR&homena... 03/08/2004 Select Your Outbound Flight Page 2 of:.' (DEN) (DFW) • Flight 13s Travel Time: 1 hr 45min 1:25pm •4:10pm mg Frontier Nonstop Denver,CO : DallablFt Worth,TX Airlines (DEN) (DFW) Flight 126 Travel Time: 1hr 45min • • 3:20pm ' 6:05pm Frontier Nonstop Denver,CO Dallas/Ft Worth,TX = Airlines Travel Time: 1 hr 45min (DEN) (DFW) • Flight i2 6:55pm 9:40pm igi Frontier Nonstop Denver,CO Dallas/Ft Worth,TX II. Airlines (DEN) (DFW) Flight 1..a. Travel Time: 1 hr 45min • • 6:34am i 9:26am American Nonstop . Denver, CO : Dallas/Ft Worth,TX �. Airlines (DEN) : (DFW) ° Flight 1224 Travel Time: 1 hr 52min 7:25am 10:17am ik!tAmerican Nonstop Denver,CO Dallas/Ft Worth,TX Airlines (DEN) (DFW) Flight ._. Travel Time: 1 hr 52min 8:28am 11:17am . h American Nonstop Denver,CO Dallas/Ft Worth,TX MJ& Airlines (DEN) (DFW) Flight 23pB Travel Time: 1 hr 49min i 5:55am 8:50am A Delta Denver,CO Dallas/Ft Worth,TX Flight 4261 NOnStOp (DEN) (DFW) operated by Atlantic Travel Time: 1 hr 55min Southeast , • 11:45am 2:40pm Delta • i ' Nonstop Denver,CO Dallas/Ft Worth,TX Flight 4262 (DEN) , (DFW) operated by Atlantic Travel Time: 1 hr 55min Southeast 4 Delta 1:50pm 4:45pm Nonstop Denver,CO Dallas/Ft Worth,TX Flight 4241 Travel Time: 1 hr 55min (DEN) , (DFW) operated by Atlantic Southeast 4:00pm • 6:50pm vita • - 4Nonstop Denver,CO • Dallas/Ft Worth,TX Flight 4937 (DEN) ' (DFW) operated by Atlantic Travel Time: 1 hr 50min Southeast • • e= US 8:50am 11:36am Airways : Denver,CO , Dallas/Ft Worth,TX Flight 6628 httn://dDsl.travelocity.com/airloutbound.ctl?promo_page=Y&htl_pkgs=OFFER&homepa... 03/08/2004 Select Your Outbound Flight Page 3 of 3 (DEN) (DFW) operated by United Airlines Nonstop Travel Time: 1 hr 46min , Home flights Hotels Cars/Rail Vacations Cruises Last Minute Deals Guides&Advice Customer Care cry ©2002-2003 Travelocity.com LP.All rights reserved.Travelocity®.Travelocity.com®and the Travelocity skyline logo are E/!C trademarks and/or service marks of Travelocity.com LP. Use of this Web site constitutes acceptance of the Travelocity User connected Agreement and Pnvacy Nancy. httn•//final travelocity com/airloutbound.cf1?promo pace=Y&ht1 pkgs=OFFER&homepa... 03/08/2004 fr U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPENDIUM OF REQUIRED CERTIFICATIONS AND ASSURANCES SF 424B ASSURANCES-NON-CONSTRUCTION PROGRAMS Note: Certain of these assurances may not be applicable to your project or program. if you have questions,please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability(including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award;and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the intergovemmental Personnel Act of 1970 (42 U.S.C. 4278-4763)relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM=s Standards for a Merit System of Personnel Administration (5 CFR 900, Subpart F). 6. Will comply with all Federal statutes relating to non-discrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the bases of race, color or national origin; (b) Title lX of the Education Amendments of 197Z as amended(20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended(42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972(P.L. 92-255), as amended, relating to non-discrimination on the basis of drug abuse; (i) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to non-discrimination on the bases of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of the alcohol and drug abuse patient records; (h) Title VII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to non-discrimination in the sale, rental or financing of housing; (I) any other non-discrimination provisions in the specific statute(s) under which application for Federal assistance is being made;and(j) the requirements of any other non-discrimination statute(s) which may apply to the application. 17 • 7. Will comply, or has already complies, with the requirements of Titles II and Ill of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970(P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or Federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply with the provisions of the Hatch Act(5 U.S.C. 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis-Bacon Act(40 U.S.C. 276a to 276a-7), the Copeland Act(40 U.S.C. 276c and 18 U.S.C. 874), and the Contract Work Hours and Safety Standards Act(40 U.S.C. 327-333), regarding labor standards for Federally assisted construction subagreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is$10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order(EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c)protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972(16 U.S.C. 1451 et seq.); ( conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended(42 U.S.C. 7401 et seq.); (g)protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and(h)protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205) 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended(16 U.S.G. 470), ED 11593(identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974(16 U.S.C. 469a-1 et seq.). . 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.)pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. 4801 et seq.) which prohibits the use of lead based paint in the construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the single - Audit Act of 1984. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. 18 DRUG-FREE WORKPLACE REQUIREMENTS GRANTEES OTHER THAN INDIVIDUALS By signing and/or submitting this application or grant agreement, the grantee is providing the certification set out below. This certification is required by regulations implementing the Drug-Free Workplace Act of 1988, 45 CFR, Part 76, Subpart F. The regulations published in the January 31, 1989 Federal Register, require certification by grantees that they will maintain a drug-free workplace. The certification set out below is a material representation of fact upon which reliance will be placed when HHS determines to award the grant. False certification or violation of the certification shall be grounds for suspension of payments, suspension or termination of grants, or government-wide suspension or debarment. Workplaces under grants, for grantees other than individuals, need not be identified on the certification. If known, they may be identified in the grant application. if the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee must keep the identity of the workplace(s) on file in its office and make the information available for Federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee's drug-free workplace requirements. Workplace identifications must include the actual address of buildings (or parts of building) or other'sites where work under the grant takes place. Categorical descriptions may be used (e.g. all vehicles of a mass transit authority of State highway department while in operation, State employees in each /oca/ unemployment office, performers in concert halls or radio studios). If the workplace identified to HHS changes during the performance of the grant, the grantee shall inform the agency of the change(s), it previously identified the workplaces in question (see above). Definitions of terms in the Non procurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification. Grantees' attention is called, in particular, to the following definitions from these rules: "Controlled substance" means a controlled substance in Schedules I through V of the Controlled Substances Act (21 USC 812) and as further defined by regulations (21 CFR, 1308.11 through 1308.15). "Conviction" means a finding of guilt (including a plea of nob contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the Federal of State criminal drug statutes; "Criminal drug statute"means a Federal or non-Federal criminal statute involving the manufacture, distribution, dispensing use, or possession of any controlled substance; "Employee" means the employee of a grantee directly engaged in the performance of work under a grant including: (i) All "direct charge" employees; (ii) all "indirect charge" employees unless their impact of involvement is insignificant to the performance of the grant; and (iii) temporary personnel and consultants who are directly engaged in the performance of work under the grant and who are on the grantee's payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement; consultants or independent contractors not on the grantee's payroll; or employees of subrecipients or subcontractors in covered workplaces). The grantee certifies that it will provide a drug-free workplace by: a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; b) Establishing a drug-free awareness program to inform employees about (1) The dangers of drug abuse in the workplace; 19 (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of be statement required by paragraph (a); d) Notifying the employee in the statement required by paragraph (a) that as a condition of employment under the grant, the employee will: (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; e) Notifying the agency in writing within ten days after receiving notice under subparagraph (d)(2), from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; 0 Taking one of the following actions within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs(a) through (f). CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal program either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds in medicare of medicaid; or facilities where WIC coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing this certification, the offeror/contractor (for acquisitions) or applicant/grantee (for grants) certifies that the submitting organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. 20 The submitting organization agrees that it will require that the language of this certification be included in any subawards which subrecipients shall certify accordingly. • • 21 CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS - PRIMARY COVERED TRANSACTIONS By signing and submitting this proposal, the applicant, defined as the primary participant in accordance with 45 CFR Part 76 certifies to the best of his or her knowiedge and believe that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transaction by any Federal Department or agency; (b) have not within a 3-year period preceding this proposal been convicted or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery falsification or destruction of records, making false statement, or receiving stolen property,' (c) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) have not within a 3-year period preceding this application/proposal had one or more public transaction (Federal, State or local) terminated for cause or default The inability of a person to provide the certification required above will not necessarily result in denial of participation in this covered transaction. If necessary, the prospective participant shall submit an explanation of why it cannot provide the certification. The Department of Health and Human Services' (HHS) determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. The prospective primary participant agrees that by submitting this proposal, it will include the clause entitled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions,"provided below without modification in all lower tier covered transactions. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION- LOWER TIER COVERED TRANSACTIONS (TO BE SUPPLIED TO LOWER TIER PARTICIPANTS) By signing and submitting this lower tier proposal, the prospective lower tier participant, as defined in 45 CFR, Part 76, certifies to the best of its knowledge and belief that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (b) where the prospective lower tier participant is unable to certify to any of the above, such prospective participant shall attach an explanation to this proposal. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause entitled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without modification in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 22 CERTIFICATION REGARDING LOBBYING FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned certifies to the best of his or her knowledge and belief, that: (1) No Federal appropriate funds have been paid or will be paid, by or on behalf of the undersigned, 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 awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) if any funds other than Federal appropriated funds have been paid or will be paid to any person influencing or attempting to influence an officer or employee or an agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this Federal contract, grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Arty person who fails to file the required certification shall be subject to a civil penalty or not less than $10,000 and not more than $100,000 for each such failure. • I hereby agree o the above certifications and assurances. 2-3 & j cA MAY 0 3 2004 - Signature of Certifying Official Date Robert D. Masden, Chair Title Weld County Board of Comjnissionars Applicant Organization • 23 MEMORANDUM a DATE: April 28, 2004 WCiTO: Robert D. Masden, Chair, Board of Commissioners � FROM: Walt Speckman, Executive Director COLORADO SUBJECT: Application for Supplemental Funds for Both Head Start and Migrant Head Start Programs Enclosed for Board approval are two applications for Supplemental Funds to send two of our Regional Head Start and two of our Migrant Head Start staff to the National Head Start Institute on Father Involvement. Grant Reference Numbers: PY 2004 ;- PA22 Head Start Basic Grant 08CH0019 PY2004 Basic Migrant and Seasonal Grant 90CM136 n The Program is asking for $2,000.00 from each grant. If you have questions, please call Janet Flaugher at extension 3340 or myself at extension 3317. 2004-1277 Hello