HomeMy WebLinkAbout20031905 RESOLUTION
RE: APPROVE APPLICATION FOR FEDERAL ASSISTANCE FOR WELD COUNTY
YOUTH CONSERVATION CORPS, PAWNEE BUTTES TRAIL REPAIR 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 an Application for Federal Assistance for
the Weld County Youth Conservation Corps, Pawnee Buttes Trail Repair Project, from 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, to the U.S. Forest Service, Arapahoe
and Roosevelt National Forests, commencing September 1, 2003, and ending September 30,
2003, with further terms and conditions being as stated in said application, and
WHEREAS, after review, the Board deems it advisable to approve said application, 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 Application for Federal Assistance for the Weld County Youth
Conservation Corps, Pawnee Buttes Trail Repair Project, from 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, to the U.S. Forest Service, Arapahoe and Roosevelt National
Forests, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 23rd day of July, A.D., 2003.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: 414#126/21444 EXCUSED
_ vid E. Long, Chair
,��•`t Et to the Board \i,_ & J
✓fc '
• Robert D. Masden, Pro-Tem
' Oh le ���•re Board EXCUSED
> _y / , M. J. Geile
AP • b�.�'a'iRM:
Willis . Jerke IG
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roun ttor ey
Glenn Vaad `
Date of signature: Si!/
2003-1905
HR0074
(C. `• N k
APPLICATION FOR OMB Approval No.0348-0043
FEDERAL ASSISTANCE 2. DATE SUBMITTED Applicant Identifier
July 21 , 2003
1.TYPE OF SUBMISSION: 3.DATE RECEIVED BY STATE State Application Identifier
A cation Preapplication
Construction ❑ Construction 4.DATE RECEIVED BY FEDERAL AGENCY Federal Identifier
Q Non-Construction ❑X Non-Construction
5.APPLICANT INFORMATION
Legal Name: Board of Weld County Commissioners/ Organizational Unit:
_Employment Services of Wp]d County Weld County
Address(give city,county,State,and zip code): Name and telephone number of person to be contacted on matters involvinc
PO BOX ]805 this application(give area code)
155] N ]7th Avenue Ted A. Long
Greeley, CO 80X32 (970) 353-3800 ext 3400
6.EMPLOYER IDENTIFICATION NUMBER(EIN): 7.TYPE OF APPLICANT:(enter appropriate letter in box)
A.State H.Independent School Dist.
8.TYPE OF APPLICATION: B.County I.State Controlled Institution of Higher Learning
C.Municipal J.Private University
® New E Continuation ❑ Revision
D.Township K.Indian Tribe
If Revision,enter appropriate letter(s)in box(es) FI I E.Interstate L.Individual
F.Intermunicipal M.Profit Organization
A.Increase Award B. Decrease Award C.Increase Duration G.Special District N.Other(Specify)_______
D. Decrease Duration Other(specify):
9.NAME OF FEDERAL AGENCY:
USDA-FS
10.CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:
_fl I Weld County Youth Conservation Corps
Pawnee Buttes Trailrepair Project
TITLE:
12.AREAS AFFECTED BY PROJECT(Cities, Counties,States,etc.):
Weld County/Pawnee National Grasslands
13.PROPOSED PROJECT 14.CONGRESSIONAL DISTRICTS OF:
4th
Start Date Ending Date a.Applicant b.Project
Sep 03 Sep 03 4th 4th
15.ESTIMATED FUNDING: 16.IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE
ORDER 12372 PROCESS?
a.Federal $ D0
1 ,500 a.YES. THIS PREAPPLICATION/APPLICATION WAS MADE
b.Applicant S °° AVAILABLE TO THE STATE EXECUTIVE ORDER 12372
(in-Kind) 300 PROCESS FOR REVIEW ON:
c.State $ ,°p
DATE __
d.Local $ ,°0
b.No. ❑ PROGRAM IS NOT COVERED BY E.O. 12372
e.Other $ 03 ❑OR PROGRAM HAS NOT BEEN SELECTED BY STATE
FOR REVIEW
f.Program Income $ .°D
17.IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT?
g.TOTAL $ ] 80O °D ❑Yes If"Yes,"attach an explanation. a No
18.TO THE BEST OF MY KNOWLEDGE AND BELIEF,ALL DATA IN THIS APPLICATION/PREAPPLICATION 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[S AWARDED.
a.Type Name of Authorized Representative b.Title Chair, Board of Weld c.Telephone Number
Robert D. _ asden Counnt_ Commissioners (970) 336-7204 ext 4200
d.Signature of Authorized Representative \\ " e.Date Signe
Previous Edition Usable Standard Form 424(Rev.7-97)
Authorized for Local Reproduction Prescribed by OMB Circular A-102
,D?Cd3-- /9e
INSTRUCTIONS FOR THE SF-424
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden,to the Office of Management and Budget, Paperwork Reduction Project(0348-0043),Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
This is a standard form used by applicants as a required facesheet for preapplications and applications submitted for Federal assistance. It
will be used by Federal agencies to obtain applicant certification that States which have established a review and comment procedure in
response to Executive Order 12372 and have selected the program to be included in their process, have been given an opportunity to review
the applicant's submission.
Item: Entry: Item: Entry:
1. Self-explanatory. 12. List only the largest political entities affected (e.g., State,
counties, cities).
2. Date application submitted to Federal agency(or State if
applicable)and applicant's control number(if applicable). 13. Self-explanatory.
3. State use only(if applicable). 14. List the applicant's Congressional District and any
District(s)affected by the program or project.
4. If this application is to continue or revise an existing award,
enter present Federal identifier number. If for a new project, 15. Amount requested or to be contributed during the first
leave blank. funding/budget period by each contributor.Value of in-
kind contributions should be included on appropriate
5. Legal name of applicant, name of primary organizational unit lines as applicable. If the action will result in a dollar
which will undertake the assistance activity,complete address of change to an existing award, indicate only the amount
the applicant,and name and telephone number of the person to of the change. For decreases,enclose the amounts in
contact on matters related to this application. parentheses. If both basic and supplemental amounts
are included,show breakdown on an attached sheet.
6. Enter Employer Identification Number(EIN)as assigned by the For multiple program funding, use totals and show
Internal Revenue Service. breakdown using same categories as item 15.
7. Enter the appropriate letter in the space provided. 16. Applicants should contact the State Single Point of
Contact(SPOC)for Federal Executive Order 12372 to
8. Check appropriate box and enter appropriate letter(s)in the determine whether the application is subject to the
space(s)provided: State intergovernmental review process.
•
--"New"means a new assistance award. 17. This question applies to the applicant organization, not
the person who signs as the authorized representative.
—"Continuation"means an extension for an additional Categories of debt include delinquent audit
funding/budget period for a project with a projected disallowances, loans and taxes.
completion date.
18. To be signed by the authorized representative of the
--"Revision"means any change in the Federal applicant.A copy of the governing body's
Government's financial obligation or contingent authorization for you to sign this application as official
liability from an existing obligation. representative must be on file in the applicant's office.
(Certain Federal agencies may require that this
9. Name of Federal agency from which assistance is being authorization be submitted as part of the application.)
requested with this application.
10. Use the Catalog of Federal Domestic Assistance number and
title of the program under which assistance is requested.
11. Enter a brief descriptive title of the project. If more than one
program is involved,you should append an explanation on a
separate sheet. If appropriate(e.g., construction or real
property projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary SF-424(Rev.7-97)Back
description of this project.
U.S. DEPARTMENT OF AGRICULTURE (Pg 1 of 2)
Certification Regarding Debarment, Suspension, and Other
Responsibility Matters - Primary covered Transactions
This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR Part
3017, Section 3017.510, Participants' responsibilities. The regulations were published as Part IV of the January 30, 1989,
Federal Register(pages 4722-4733). copies of the regulations may be obtained by contacting the Department of Agriculture
agency offering the proposed covered transaction.
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
(1) The prospective primary participant 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 covered transactions by any Federal department or agency;
(b) have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered
against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State or local) transaction or contract under a public transaction; violation of
Federal, State or local)transaction or contract under a public transaction; violation of Federal or State antitrust
statutes or commission of embezzlement, theft,forgery, bribery, falsification or destruction of records, making
false statements, or receiving stolen property;
(c) are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or
local)with commission of any other the offenses enumerated in paragraphs (1)(b) of this certification; and
(d) have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State or local)terminated for cause or default.
2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this proposal.
Weld County Youth Conservation Corps
Board of Weld County Commissioners Pawnee Buttes Trail Project
Organization Name PR/Award Number or Project Name
Robert D. Masden
Chair Pro-Tern, , Board of Weld County Commissioners
Name(s) and Title(s)of Authorized Representative(s)
JUL 2 3 2003
Signatu e(s) Date (mm/dd/yyyy)
1
Form AD-1047 (2/89)
Microsoft Word 2000
Instructions for Certification (Pg 2 of 2)
1. By signing and submitting this form, the prospective primary participant is providing the certification set out on the reverse
side in accordance with these instructions.
2. The inability of a person to-provide the certification required below will not necessary result in denial of participation in this
covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set
out on this form. The certification or explanation will be considered in connection with the department or agency's
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.
3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or
agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly
rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or
agency may terminate this transaction for cause or default.
4. The prospective primary participant shall provide immediate written notice to the department or agency to whom this
proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
5. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction,""participant,"
"person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded,"as used in this clause, have
the meanings set out in the Definitions and coverage sections of the rules implementing Executive Order 12549. You may
contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those
regulations.
6. The prospective primary participant agrees by submitting this form that, should the proposed covered transaction be
entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended,
declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the
department or agency entering into this transaction.
7. The prospective primary participant further agrees by submitting this form that it will include the clause titled "Certification
Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," provided by
the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions
and in all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered
transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it
knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the
eligibility of its principals. Each participant, may but is not required to, check the Nonprocurement List.
9. Nothing contained in the foregoing shall be constructed to require establishment of a system of records in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or
voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal
Government, the department or agency may terminate this transaction for cause or default.
10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily
excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the
department or agency may terminate this transaction for cause or default.
2 Form AD-1047 (2/89)
B. The grantee may insert in the space provided below the site(s)for the performance of work done in connection with the specific grant:
Place of Performance (Street address, city, county, State, zip code)
PO Box 1805
1551 N. 17th Avenue
Greeley, CO 80632
Check Li if there are workplaces on file that are not identified here.
Weld County Youth Conservation Corps
Board of Weld County Commissioners Pawnee Buttes Trail Repair Project
Organization Name Award Number or Project Name
Robert D. Masden
Chair pro-Tam: 21311, Board of Weld County Commissioners
Name and Title of Authorized Representative
JUL 2 3 2003
Signat re Date
Instructions for Certification
1. By signing and submitting this form,the grantee is providing the certification set out on pages 1 and 2.
2. The certification set out on pages 1 and 2 is a material representation of fact upon which reliance is placed when the agency awards the grant. If it is
later determined that the grantee knowingly rendered a false certification,or otherwise violates the requirements of the Drug-Free Workplace Act,the
agency, in addition to any other remedies available to the Federal Government,may take action authorized under the Drug-Free Workplace Act.
3. Workplaces under grants,for grantees other than individuals,need not be identified on the certification. If know,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.
4. Workplace identifications must include the actual address of buildings(or parts of buildings)or other sites where work under the grant takes place.
Categorical descriptions may be used(e.g.,all vehicles of a mass transit authority or State highway department while in operation,State employees in
each local unemployment office, performers in concert halls or radio studios).
5. If the workplace identified to the agency changes during the performance of the grant,the grantee shall inform the agency of the change(s),if it
previously identified the workplaces in question(see paragraph three).
6. Definitions of terms in the Nonprocurement 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 U.S.C.812)and as further
defined by regulation(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 or 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;
(li)all"indirect charge"employees unless their impact or involvement is insignificant to the performance of the grant;and, (Hi)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 sued to meet a matching requirement;consultants or independent contractors
not on the grantee's payroll;or employees of subrecipients or subcontractors in covered workplaces).
1-2
Form AD-1049 (REV 5/90)
OMB APPROVAL NO.0991-0002
U.S. DEPARTMENT OF AGRICULTURE
CERTIFICATION REGARDING
DRUG-FREE WORKPLACE REQUIREMENTS (GRANTS)
ALTERNATIVE I - FOR GRANTEES OTHER THAN INDIVIDUALS
This certification is required by the regulations implementing Sections 5151-5160, of the Drug-Free Workplace Act of 1988
(Pub. L. 100-690, Title V, Subtitle D; 41 U.S.C. 701 et seq.), 7 CFR Part 3017, Subpart F, Section 3017.600, Purpose. The
January 31, 1989, regulations were amended and published as Pad II of the MAY 25, 1990, Federal Register (pages 21681-
21691). Copies of the regulations may be obtained by contacting the Department of Agriculture agency offering the grant.
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
Alternative I
A. The grantee certifies that it will or will continue to 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 an ongoing drug-free awareness program to inform employees about --
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and 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 the
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 in writing of his or her conviction for a violation of a criminal drug statute occurring in
the workplace no later than five calendar days after such conviction;
(e) Notify the agency in writing, within 10 calendar 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 on whose grant activity 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;
(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), (b), (c), (d), (e)and (f).
1-1
Form AD-1049 (REV 5/90)
Microsoft Word 2000
9. Will comply, as applicable,with the provisions of the Davis- 12. Will comply with the Wild and Scenic Rivers Act of
Bacon Act(40 U.S.C. §§276a to 276a-7), the Copeland Act 1968 (16 U.S.C. §§1271 et seq.) related to protecting
(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract components or potential components of the national
Work Hours and Safety Standards Act (40 U.S.C. §§327- wild and scenic rivers system.
333), regarding labor standards for federally-assisted
construction subagreements. 13. Will assist the awarding agency in assuring compliance
with Section 106 of the National Historic Preservation
10. Will comply, if applicable, with flood insurance purchase Act of 1966, as amended (16 U.S.C. §470), EO 11593
requirements of Section 102(a) of the Flood Disaster (identification and protection of historic properties), and
Protection Act of 1973 (P.L. 93-234) which requires the Archaeological and Historic Preservation Act of
recipients in a special flood hazard area to participate in the 1974(16 U.S.C. §§469a-1 et seq.).
program and to purchase flood insurance if the total cost of
insurable construction and acquisition is$10,000 or more. 14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
11. Will comply with environmental standards which may be related activities supported by this award of assistance.
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National 15. Will comply with the Laboratory Animal Welfare Act of
Environmental Policy Act of 1969 (P.L. 91-190) and 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et
Executive Order (EO) 11514; (b) notification of violating seq.) pertaining to the care, handling, and treatment of
facilities pursuant to EO 11738; (c) protection of wetlands warm blooded animals held for research, teaching, or
pursuant to EO 11990; (d) evaluation of flood hazards in other activities supported by this award of assistance.
floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management 16. Will comply with the Lead-Based Paint Poisoning
program developed under the Coastal Zone Management Prevention Act (42 U.S.C. §§4801 et seq.) which
Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of prohibits the use of lead-based paint in construction or
Federal actions to State (Clean Air) Implementation Plans rehabilitation of residence structures.
under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. §§7401 et seq.); (g) protection of 17. Will cause to be performed the required financial and
underground sources of drinking water under the Safe compliance audits in accordance with the Single Audit
Drinking Water Act of 1974, as amended (P.L. 93-523); Act Amendments of 1996 and OMB Circular No. A-133,
and, (h) protection of endangered species under the "Audits of States, Local Governments, and Non-Profit
Endangered Species Act of 1973, as amended (P.L. 93- Organizations."
205).
18. Will comply with all applicable requirements of all other
Federal laws,executive orders, regulations, and policies
governing this program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
itaChair Pro—Tem
Robert D. Masden - Board of Weld County Commissioners
APPLICANT ORGANIZATION DATE SUBMITTED
Board of Weld County Commissioners for July 21, 2003
Employment Services of Weld County
Standard Form 424B(Rev.7-97)Back
OMB Approval No.0348-0040
ASSURANCES - NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing
instructions, searching-existing data sources, gathering and maintaining the data needed,and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden,to the Office of Management and Budget, Paperwork Reduction Project(0348-0040),Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
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 Act of 1973, as amended (29 U.S.C. §794), which
and the institutional, managerial and financial capability prohibits discrimination on the basis of handicaps; (d)
(including funds sufficient to pay the non-Federal share the Age Discrimination Act of 1975, as amended (42
of project cost)to ensure proper-planning, management U.S.C. §§6101-6107), which prohibits discrimination
and completion of the project described in this on the basis of age; (e) the Drug Abuse Office and
application. Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug
2. Will give the awarding agency,the Comptroller General abuse; (f) the Comprehensive Alcohol Abuse and
of the United States and, if appropriate, the State, Alcoholism Prevention, Treatment and Rehabilitation
through any authorized representative, access to and Act of 1970 (P.L. 91-616), as amended, relating to
the right to examine all records, books, papers, or nondiscrimination on the basis of alcohol abuse or
documents related to the award; and will establish a alcoholism; (g) §§523 and 527 of the Public Health
proper accounting system in accordance with generally Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee
accepted accounting standards or agency directives. 3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the
3. Will establish safeguards to prohibit employees from Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
using their positions for a purpose that constitutes or amended, relating to nondiscrimination in the sale,
presents the appearance of personal or organizational rental or financing of housing; (i) any other
conflict of interest, or personal gain. nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
4. Will initiate and complete the work within the applicable made; and, (j) the requirements of any other
time frame after receipt of approval of the awarding nondiscrimination statute(s) which may apply to the
agency. application.
5. Will comply with the Intergovernmental Personnel Act of 7. Will comply, or has already complied, with the
1970 (42 U.S.C. §§4728-4763) relating to prescribed requirements of Titles II and III of the Uniform
standards for merit systems for programs funded under Relocation Assistance and Real Property Acquisition
one of the 19 statutes or regulations specified in Policies Act of 1970 (P.L. 91-646) which provide for
Appendix A of OPM's Standards for a Merit System of fair and equitable treatment of persons displaced or
Personnel Administration(5 C.F.R. 900,Subpart F). whose property is acquired as a result of Federal or
federally-assisted programs. These requirements apply
6. Will comply with all Federal statutes relating to to all interests in real property acquired for project
nondiscrimination. These include but are not limited to: purposes regardless of Federal participation in
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) purchases.
which prohibits discrimination on the basis of race,color
or national origin; (b) Title IX of the Education 8. Will comply, as applicable, with provisions of the
Amendments of 1972, as amended (20 U.S.C. §§1681- Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328)
1683, and 1685-1686),which prohibits discrimination on which limit the political activities of employees whose
the basis of sex; (c)Section 504 of the Rehabilitation principal employment activities are funded in whole or
in part with Federal funds.
Previous Edition Usable Standard Form 4248(Rev.7-97)
Authorized for Local Reproduction Prescribed by OMB Circular A-102
Grant Proposal Submittal Form
This page should be completed by the prospective Grantee.
Name of Organization: Employment Services of Weld County, Weld County Youth Conservation Corps
Contact Name: Ted Lone Telephone: (970)353-3800 ext 3400
Email: tlonqaco.weld.co.us Fax# : (970) 356-3975
Address: Employment Services of Weld County
PO Box 1805
Greeley. CO 80632
Project Title: Weld County Youth Conservation Corps Pawnee Buttes Trail Repair Project
Project Description:
If the description of your project is lengthy, please attach it separately.
The project will consist of constructing log water bars and log sediment traps on the approximately three-
quarters of a mile section of the Pawnee Buttes Trail. Currently, precipitation runs off the Pawnee Buttes
and takes a direct path down the trail causing soil and trail erosion. The Weld County Youth Conservation
Corps (WCYCC),with the guidance and assistance of the Pawnee National Grassland staff,will install
barrier logs to decrease the erosion rate. The barrier logs will be stabilized using pre-cut rebar. The funds
provided under this grant proposal will provide for the fee for service costs of the WCYCC. The WCYCC
will provide a crew of 8-10 crew members and one full time crew leader for this project. The WCYCC
anticipates that at least 240 service hours will be provided on this project. At the completion of this
project, %mile of the Pawnee Buttes trail will have log water bars and sediment traps to decrease soil
erosion and decrease sediment loads in nearby water holes or streams.
Funding Requested by Grantee from the Forest Service: $ 1,500
Grantee Cost-Share: $ 300
Total: $ 1,800
Grant Proposal Submittal Form Page 2
This page is to be completed by-the Forest Service Technical Representatives.
Funding:
Amount to be awarded by the Forest Service: $ Forest Service
Grantee's Cost-Share: $ Grantee cto
Total $ Total Project: 100 %
Forest Service Job Code(s):
Authority under which grant will be awarded:
Cooperative Forestry Assistance Act of July 1, 1978, P.L. 95-313,92 Stat. 365 as amended,
(16 U.S.C. ,Section_) Fund Code: CFDA Number 10.664
Cost-share required by authority %.
1990 Farm Bill (Agricultural Development and Trade Act of 1990; National Forest-Dependent Rural
Communities Economic Diversification Act of November 28, 1990). (P.L. 101-624,Title XV, Chapter 5, 104
Stat. 3632: (7 U.S.C. , Section ) Fund Code: , CFDA number 10.670
Cost-share required by authority %.
Other Authority:(Identify Authority Name, P.L.,Statute, U.S. Code, and Section Numbers)
Cost-share required by authority %.
What does success look like?
Name of Forest Service Technical Representative:
Office:
Telephone: Fax:
This is not a fund-obligation document. Send the proposal &all other documents submitted with this
proposal to your Grants &Agreement Staff for final processing.
DEPARTMENT OF HUMAN SERVICES
ADMINISTRATION
1551 NORTH 17TH AVENUE
PO BOX 1805
Illik
GREELEY, CO 80632
WEBSITE:www.co.weld.co.us
(970)353-3800
FAX(970)356-3975
COLORADO
July 22, 2003
Karen Roth
Environmental Planner
Arapahoe and Roosevelt National Forests
and Pawnee National Grasslands
240 West Prospect Road
_ Ft. Collins, CO 80526
Dear Ms Roth:
This is to inform you that the following person(s) are authorized to sign our cash requests/invoices for the
grant funds received from you for the Weld County Youth Conservation Cor Pawnee Buttes Trail Repair
Project.
1 1 �2�. n- l/Marilyn Carlino, Fiscal Officer ���'
• � l
ely,n-
e,
David E Long
Chair
Board of Weld County Commiss ers
MEMORANDUM
DATE: July 18, 2003
CTO: David E. Long, Weld County Board of Commissioners
FROM: Walter J. Speckman, Director ; )'-
COLORADO SUBJECT: Pawnee National Grasslands Grant Request
Enclosed for Board approval is a grant proposal submitted to the U.S. Forest Service,
Arapahoe and Roosevelt National Forests and Pawnee National Grassland by Employment
Services of Weld County for work to be completed by the Weld County Youth Conservation
Corps (WCYCC),AmeriCorps Program. This grant requests$1,500.00 to assist the WCYCC
in completing work repair and restoration work on the Pawnee Buttes Trail.
If you have any questions, please telephone me at 353-3800.
2003-1905
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