HomeMy WebLinkAbout20030750.tiff RESOLUTION
RE: APPROVE GRANT CONTRACT FOR PLATICA PROJECT FOR BREAST CANCER
AND AUTHORIZE CHAIR TO SIGN -THE NORTH COLORADO AFFILIATE OF THE
SUSAN G. KOMEN BREAST CANCER FOUNDATION, INC.
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Grant Contract for Platica Project for
Breast Cancer between the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County, on behalf of the Weld County Department of Public
Health and Environment, and The North Colorado Affiliate of The Susan G. Komen Breast
Cancer Foundation, Inc., commencing April 1, 2003, and ending March 31, 2004, with further
terms and conditions being as stated in said contract, and
WHEREAS, after review, the Board deems it advisable to approve said contract, 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 Grant Contract for Platica Project for Breast Cancer between
the County of Weld, State of Colorado, by and through the Board of County Commissioners of
Weld County, on behalf of the Weld County Department of Public Health and Environment, and
The North Colorado Affiliate of The Susan G. Komen Breast Cancer Foundation, Inc., be, and
hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 26th day of March, A.D., 2003.
BOARD OF COUNTY COMMISSIONERS
WEtrt.STY COLORADO
ATTEST:
Y + D vid . Lon , Chair
Weld County Clerk to t .. .�
Robert . Masden, Pro-Tem
BY:
Deputy Clerk to the BB
. J. Geile
A OV AST M: ` .-(' V,
William . Jerke
un Attor e
Glenn Vaad Date of signature: 4/t
2003-0750
CO `-/� HL0030
GRAN] CON'I RA( I
The Susan BrFcundefl'on
THE NORTH COLORADO AFFILIATE OF THE
SUSAN G. KOMEN BREAST CANCER FOUNDATION, INC.
GRANT CONTRACT
PERIOD OF GRANT: April 1,2003- March 31,2004
GRANTEE: Weld County Department of Public Health and Environment
PROJECT DIRECTOR: Olivia Martinez,Community Outreach Coordinator
PROJECT TITLE: Weld County Platica Project for Breast Cancer
The North Colorado Affiliate of the Susan G. Komen Breast Cancer Foundation,
Inc. ("Komen Affiliate") does hereby grant Weld County Department of Public Health
and Environment ("Grantee")funds in the amount of$9,900("Grant Funds"or
"Grant") subject to the following terms and conditions ("Grant Contract"):
1. Use of Grant Funds:
A. Grant Funds are to be applied as set forth in the budget ("Budget ") in
Grantee's grant application to Komen Affiliate ("Grant Application: Weld
County Platica Project for Breast Cancer"). A copy of the Grant
Application is attached hereto as Exhibit "A" and made a part hereof for
all purposes. To the extent that the terms of this Grant Contract conflict
with the terms of Exhibit "A," the terms of this Grant Contract shall
prevail.
B. Grant Funds must be expended as set forth in the Budget, and no changes
or modifications to the Budget or to the breast cancer project as described
in the Grant Application ("Weld County Platica Project for Breast
Cancer") may be made without the prior written approval of Komen
Affiliate.
C. Komen Affiliate shall receive copies of all materials created in connection
with the Breast Cancer Project at no charge. Grantee grants Komen
Affiliate and its affiliates a limited, non-exclusive license to use such
materials for their own non-commercial purposes.
D. Unless otherwise specifically consented to in writing by Komen Affiliate,
the funds granted hereunder are not to be used, for any expenses beyond
those listed in the budget.
E. Grantee shall use Komen printed materials in educational displays in this
Breast Cancer Project.
2. Termination and Early Termination of Grant
A. This Grant Contract shall be effective as of the date hereof and shall
terminate on March 31, 2004, except that the provisions of Sections 5, 6, 7,
8, 9, 10, 12, and 13 shall forever survive termination.
B. If either party should fail to perform or be in breath of any of the terms,
conditions, agreements, covenants, representations or warranties
contained in this Grant Contract, or anticipatorily breach this Agreement,
and such default is not curable, or if such default is curable but remains
uncured for a period of 30 days after written notice thereof has been given
to the defaulting party, the other party, at its sole election, may
immediately terminate this Grant Contract by written notice thereof to the
defaulting party. The provisions of this Section 2 will not preclude the
parties from seeking any other remedies that may be available under this
Grant Contract and applicable law.
3. Reports/Submission Items: Grantee shall submit to Komen Affiliate the
following:
A. Progress reports every six months during the Grant period. Reports will
be due on October 1, 2003 using the outline attached to the Grant Contract
as Exhibit "B" and made a part hereof for all purposes. Reports shall
include, but not be limited to, the following information: progress made
toward meeting objectives outlined in Grant Application, number of
people served, notice or receipt of other sources of support for this Project,
copies or examples of any materials produced as a result of this project,
documentation of acknowledgment, a listing of artides submitted for
publication and the status of those articles, and presentations made at
scientific conferences regarding the project;
B. Within 90 days following the expiration date of the Grant, a Final Report,
using the outline attached to this Grant Contract as Exhibit"C" and made
a part hereof for all purposes. The Final Report must include an
accounting of the Grant Funds expended during the term of this Grant
Contract;
C. Any and all surveys submitted by Komen Affiliate to Grantee for
completion regarding this Grant.
D. In the event that Grantee does not provide Komen Affiliate with the
above-referenced reports and surveys in a timely manner, Komen shall be
entitled to a full reimbursement of the funds granted hereunder.
4. Grant Payments: Grant Funds shall be payable in two equal installments of
$4,950 each. The first payment shall be made to Grantee upon receipt by Komen
Affiliate of this Grant Contract executed by both parties, and the second payment
shall be made to Grantee after Komen's receipt of a satisfactory six-month
progress report.
5. Licensed Marks: Komen Affiliate has been granted by the Susan G. Komen
Breast Cancer Foundation, Inc. (the "Foundation") a non-exclusive license to use
the Susan G. Komen Breast Cancer Foundation name and cameo logo (the
"Licensed Marks") in connection with its affiliation with the Foundation. Komen
Affiliate grants Grantee a limited, non-exclusive sub-license to use the Licensed
Marks solely to acknowledge Komen Affiliate's Grant hereunder. Komen
Affiliate will provide Grantee with camera-ready artwork of said Licensed
Marks, which must be returned to Komen Affiliate upon completion of the Breast
Cancer Project or upon termination of this Grant Contract, whichever occurs
first. It is agreed and understood that Foundation retains all right, title and
interest in and to the Licensed Marks, both of which shall remain the exclusive
property of Foundation. Grantee is prohibited from transferring, sublicensing or
assigning its rights to use the Licensed Marks.
6. Publications:
A. Komen Affiliate may release information regarding this Grant to the
general public and news media. Grantee grants to Komen Affiliate a non-
exclusive license to include Grantee's name in information pertaining to
the Grant that is released to the public.
B. Grantee may release information regarding this Grant to the public and
news media, upon the following terms and conditions:
(1) Grantee must acknowledge Komen Affiliate as a funding source on
all publications related to this Grant in dear, unambiguous and
readily-identifiable fashion, such as "supported by a grant from the
North Colorado Affiliate of the Susan G. Komen Breast Cancer
Foundation, Inc." Such acknowledgment must be commensurate
with the acknowledgment provided to other grantors providing
similar grants.
(2) Grantee will present to Komen Affiliate for its approval, prior to
printing, distribution, publication, display, or use, any and all
promotional materials, publications, articles, pictures, press
releases and scripts of all statements, oral or written, to be made by
Grantee, its agents or spokespersons, which use or refer to any
Licensed Marks. Such materials or statements must state that the
Licensed Marks are registered trademarks of the Foundation and
must be of a high quality consistent with Komen Affiliate's
outstanding public image;
(3) Copies of all other news releases, articles, pictures and any and all
other published material, which may develop in connection with
this Breast Cancer Project or this Grant must be furnished to
Komen Affiliate by Grantee prior to publication, or as soon
thereafter as practicable.
7. Non-Guarantee of Additional Support This Grant is accepted by Grantee
with the understanding that Komen Affiliate is not obligated to provide any
additional financial support, or other support, to Grantee, its agents or
spokespersons, in connection with the Grant, the Grant Contract, the Breast
Cancer Project or for any other reason.
8. Grantee Representations and Warranties: Grantee represents and warrants
that it a tax-exempt organization under the Internal Revenue Code. Grantee
further represents that it has not and shall not receive any duplicative funding in
connection with the Breast Cancer Project. In the event that Grantee breathes its
representations and warranties under this Agreement, Grantee acknowledges
and agrees that this Agreement may be terminated early under Section 2 and the
funds granted hereunder subject to full reimbursement.
9. Non-endorsement It is expressly agreed and understood by the parties
hereto that Komen Affiliate's grant hereunder shall not constitute an
endorsement by Komen Affiliate or the Foundation of any entity, organization,
company or individual, nor the products, actions, behavior or conduct of any
entity, organization, company or individual and any negligent or intentional
misrepresentation by Grantee to the contrary, in any context and in any forum,
shall constitute a material breach of this Agreement, and the same shall be
grounds for immediate termination of this Agreement by Komen Affiliate. In the
event of any such misrepresentation, Komen Affiliate may require Grantee to
publicly acknowledge the misrepresentation in a like forum in which the
misrepresentation was made. It is agreed that in the event of a breach of this
provision, damages may not be an adequate remedy, and Komen Affiliate shall
be entitled to injunctive relief to restrain any such breach, threatened or actual,
with no minimal surety bond.
10. Governmental Compliance: Grantee will cooperate with Komen Affiliate in
supplying additional information to Komen Affiliate, or in complying with any
procedures which might be required by any governmental agency in order for
Komen Affiliate to establish that it has observed all requirements of the law with
respect to this Grant.
11. Authority: All persons and individuals executing this Grant Contract certify
and warrant that they have the capacity and have been duly authorized to
execute this Grant Contract on behalf of the entities so indicated and that no
additional authorization or approval is required.
12. Indemnity: Grantee acknowledges that it is solely responsible for any
liabilities that may arise in connection with the Breast Cancer Project. Each party
agrees to indemnify and hold the other harmless from and against any and all
costs, losses or expenses, including reasonable attorneys' fees, that the other
party may incur by reason of the indemnifying party's negligence or misconduct
or by reason of any third-party claim or suit arising out of or in connection with
the indemnifying party's performance or failure to perform pursuant to this
Grant Contract,
13. Arbitration: The parties will arbitrate any dispute, claim or controversy
relating to or arising out of this Grant Contract. Any party may initiate
arbitration by giving written notice to the other party of an intention to arbitrate
and by filing with the regional office of the American Arbitration Association
located in Greeley, Colorado three copies of such notice and three copies of the
Grant Contract together with the appropriate filing fee. Such notice shall contain
a statement setting forth the nature of the dispute and the remedies sought. The
arbitration shall be conducted in Greeley, Colorado in accordance with the rules
of the American Arbitration Association in effect at the time the notice to
arbitrate is served. The arbitrator's decision will be final and binding on the
parties. The parties acknowledge and agree that, notwithstanding the provisions
of this section, nothing in this Grant Contract shall be construed to require
Komen Affiliate (or the Foundation) to arbitrate any claim arising out of the
provisions of Section 5 and Section 9, which shall be enforceable by any court of
competent jurisdiction.
14. Entire Agreement This Grant Contract supersedes any prior understandings
or oral agreements between the parties regarding the subject matter hereof and
constitutes the entire understanding and agreement between the parties with
respect to the subject matter hereof, and there are no agreements,
understandings, representations or warranties among the parties other than
those set forth herein.
15. Governing Law: This Grant Contract shall be governed by and construed in
accordance with the laws of the State of Colorado.
This Grant is expressly conditional upon Grantee's acceptance of the terms
and conditions set forth above. The signature on this Grant Contract by an
authorized representative of Grantee represents Grantee's acceptance of this
award and agreement to comply with all of the above terms and conditions.
AGREED TO AND ACCEPTED BY:
The North Colorado Affiliate of
The Susan G. Komen Breast Cancer Foundation, Inc.
3/ic/U3
Julie Tru o Date
Affiliate President
<Weld County Department of Public Health and Environment»
C r -v3
David E. Long, Chair Date
Name (typed): David E. Long, Chair
Title:-,Chairman of the Board of County Commissioners
Attachments to grant contract
EXHIBIT A: Grant Application
EXHIBIT B: Outline for Progress Report WELD COUNTY DEPARTMENT OF
EXHIBIT C: Outline for Final Report Pll IC HEALTH,AN WHOM' EN7
BY: P"p`
Mark E. Wallace, MD, MPH•Director
2c0 3-6753
( ,R \\ 11 -f Ply'O( PO[ I °U l t IN[I
Due Date October 1,2003
MGHBIT B
GRANT PROGRESS REPORT TO THE
North Colorado Affiliate of the Susan G.Komen Breast Cancer Foundation
Please Type
PROJECT DIRECTOR:
AGENCY:
PROJECT TITLE:
PERIOD COVERED BY PROGRESS REPORT:
FROM: To:
1. PROJECT PROGRESS REPORT: In this section, list progress of project toward meeting
objectives as outlined in Grant Application, including number of people served during this
period. (1 page)
2. PROPOSED CHANGES: In this section, please report any proposed changes in
project design, project personnel, or project budget. Please use the "Request for
Change/Amendment" form. (1 page per change,if any)
3. OTHER SOURCES OF SUPPORT: In this section, please list any notice or receipt of other
sources of support for this project received during the past six months. (1 page,if any)
4. PROJECT MATERIALS: In this section, please list and attach all published or produced
materials,pictures,etc. for the past six months. (1 page plus attachments)
5. ACCOUNTING OF GRANT FUNDS: Please attach a current accounting of grant funds using
the Budget Progress Report form. (1 page)
Signature of Project Director Date
BUDGE-I" PROGRESS REPOIZT IR()IZ14
ACCOUNTING OF GRANT FUNDS FROM APRIL 1, 2003 TO SEPTEMBER 30, 2003
MONTH/DAY/YEAR MONTH/DAY/YEAR
ORIGINAL BUDGET ACTUAL EXPENSES
To DATE
PERSONNEL
SUPPLIES(ITEMIZE BY CATEGORY)
EQUIPMENT(NOT TO EXCEED 30% OF DIRECT COSTS)
PATIENT CARE COSTS
•
INPATIENT
OUTPATIENT
SUBTOTAL(DIRECT CosTs) $ $
INDIRECT COST ALLOCATION(NOT TO EXCEED 10% $ $
OF DIRECT COSTh)
TOTAL GRANT FUNDS EXPENDITURES $ $
SIGNATURE: DATE REQUESTED:
(TYPED)PRINCIPAL IN VESTJGATOR/PROJECT DIRECTOR
Tracking Number
GRANTEE FINA1.. RFPC)R 1 OUT! _INF_
Due Date:July 1, 2004
Ex-IIBrr C
FINAL GRANT REPORT TO THE:
North Colorado Affiliate of the Susan G. Komen Breast Cancer Foundation
Please Type
PROJECT DIRECTOR:
AGENCY:
PROJECT TITLE:
START DATE: END DATE:
1. PROJECT SUMMARY I: List each objective outlined in the original grant application.
2. WHAT PERCENTAGE OF OBJECTIVES WERE MET
SPECIFIC
AIMS: PERCENT COMPLETED:
1-25% 26-50% 51-75% 76-100% N/A
OBJECTIVE 1
OBJECTIVE 2
OBJECTIVE 3
OBJECTIVE 4
OBJECTIVE 5
L
86a
Tracking Number
3. PROJECT SUMMARY II: In this section, please provide a short summary (200 words or less)
in lay language describing the outcomes and accomplishments of this project. Include a
statement of plans for the future of the program.
4. TYPE OF SERVICE PROVIDED:
CLINICAL TRIALS SUPPORT SCREENING MAMMOGRAPHY
TREATMENT ASSISTANCE EDUCATION
DIAGNOSTIC SERVICES CLINICAL BREAST EXAMS
COMPLEMENTARY/ALTERNATIVE PSYCHOSOCIAL
OTHER
5. NUMBER OF MAMMOGRAMS PROVIDED(IF APPLICABLE):
6. NUMBER OF PEOPLE SERVED:
7. NUMBER OF MAMMOGRAMS REFERRED OUT FOR FOLLOW UP:
8. NUMBER OF BREAST CANCERS DETECTED:
86b
Tracking Number
•
9. OTHER SOURCES OF SUPPORT: In this section, please list any notice or receipt of other
sources of support for this project received during the past six months.
Organization Dollar Amount
10. PROJECT MATERIALS: In this section, please list all published or produced materials,
pictures,etc. for this grant project. Include copies of materials for Affiliate files.
11. ACCOUNTING OF GRANT FUNDS: Please attach a final budget for the entire term of the
grant period. (Use attached form)
Signature of Project Director Date
Permission is hereby granted to the Susan G.Komen Breast Cancer Foundation to publish the above
information.Proper credit will be given to grantee where appropriate.
86c
Tracking Number
BUDGET. PROC1RF'' RL['o1: 1 FORT
ACCOUNTING OF GRANT FUNDS FROM APRIL 1, 2003 TO MARCH 31,2004
MONTH/DAY/YEAR MoNTH/DAY/YEAR
ORIGINAL BUDGET ACTUAL EXPENSES
To DATE
PERSONNEL
SUPPLIES(rrEIvIIZE BY CATEGORY)
EQUIPMENT(NOT TO EXCEED 30%OF DIRECT COSTS)
PATIENT CARE COSTS
INPATIENT
OUTPATIENT
SUBTOTAL(DIRECT COSTS) $ $
INDIRECT COST ALLOCATION(NOT TO EXCEIU 10% $ $
OF DIRECT C.Ub 1S)
TOTAL GRANT FUNDS EXPENDITURES $ $
SIGNATURE: DATE REQUESTED:
(TYPED)PROJECT DIRECTOR
86d
Memorandum
CTO: David E. Long, Chair Board of County Commissioners
•
COLORADO FROM: Mark E. Wallace, MD, MPH, Director
Department of Public Health and
Environment ��AA
DATE: March 24, 2003 /k4
SUBJECT: Susan G. Komen Breast Cancer Foundation
Contract
Enclosed for Board review and approval is a contract between Weld County Department of
Public Health and Environment (WDPHE) and the Susan G. Komen Breast Cancer Foundation.
Earlier this year, the BOCC approved the Health Department's application to this foundation for
funding to provide one-on-one and small group education and information about breast cancer
prevention and screening. This contract in the amount of$9,900 is the result of that application.
The term of the agreement is from April 1, 2003 through March 31, 2004.
I recommend your approval of the contract.
Enclosure
2003-0750
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