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Home My WebLink About20032387.tiff RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR WELD COUNTY YOUTH CONSERVATION CORPS AND AUTHORIZE CHAIR TO SIGN - U.S. DEPARTMENT OF AGRICULTURE 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 Notification of Financial Assistance Award for Weld County Youth Conservation Corps, for the Pawnee Buttes Trail Repair Project, 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, Employment Services of Weld County, and the U.S. Department of Agriculture, commencing upon full execution, and ending September 30, 2003, with further terms and conditions being as stated in said award, and WHEREAS, after review, the Board deems it advisable to approve said award, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Notification of Financial Assistance Award for Weld County Youth Conservation Corps, for the Pawnee Buttes Trail Repair Project, 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, Employment Services of Weld County, and the U.S. Department of Agriculture be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said award. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 18th day of August, A.D., 2003. BOARD OF COUNTY COMMISSIONERS WE COUNTY, COLORADO i __O®�/'vv ATTEST: I �� 'easy P vid E. o , Chair Weld County Clerk to the Board Robert Malden, Pro-Tem ,I j��,' •• �,Clerk to the Board . J. Geile r IBCI�.,>;.�- l!r T• • ' �: William Jerke tt. Li,u4 Glen Vaad Date of signature: W_ eg•P-O3 2003-2387 HR0074 United States Forest Arapaho and 240 West Prospect Road Department of Service Roosevelt NF's Fort Collins,CO \se- Pawnee NG 80526-2098 Agriculture File 1580-2 Date: 2 AUG 20S Code: Subject: Fek:al Financial Assistance Award Weld County Youth Conservation Corps Pawnee Buttes Trail Repair Project To: Ted Long, Weld County Youth Conservation Corps, Employment Services of Weld County Upon execution of this document, an award to Weld County Youth Conservation Corps, Employment Services of Weld County in the amount of$ 1,500.00 is made for the Weld County Youth Conservation Corps Pawnee Buttes Trail Repair Project under the terms of the National Forest-Dependent Rural Communities Economic Diversification Act of November 28, 1990, and accepted for the purpose of trail maintenance on the Pawnee National Grassland, as described in the attached "Application for Federal Assistance" and required documents which are incorporated and made a part of the award. The federal share of support for this project will be $1,500.00 or 80% of the total cost of the project. The Weld County Youth Conservation Corps share of support will be $375 or 20% of the total cost of the project. Your Federal identification number for this grant award is 03-DG-11021000-029. Please reference this number on any future correspondence. The starting date for this project is September 3, 2003. The proposed ending date for this project is September 30, 2003. Any costs incurred after this date cannot be reimbursed nor can any match be credited to the project without a written request for extension, which must be approved in writing prior to the grant expiring. This is an award of federal financial assistance and as such is subject to the Office of Management and Budget(OMB) Circular A-I02, Uniform Administrative Requirements for Grants and Cooperative Agreements with State, Local, and Indian Tribal Governments; OMB Circular A-87, Cost Principles for State, Local, and Indian Tribal Governments; and OMB Circular A-133, Audits of States, Local Governments, Institutions of Higher Education and Non-Profit Organizations. OMB Circulars A-102, A-87, and A-133 are implemented by the United States Department of Agriculture (USDA), Uniform Federal Assistance Regulations, 7 CFR 3015, 3016, 3017, and 3018. The following administrative provisions apply to this grant: INTERNATIONAL AIR TRANSPORTATION FAIR COMPETITIVE PRACTICES ACT. The Recipient organization shall comply with Section 5 of the International Air Transportation Fair Competitive Practices Act of 1974, 49 U.S.C. 1517 which requires: rfr Li ' Caring for the Land and Serving People Printed on Recycled Paper �� dc'CS -,233'y a. Any air transportation to, from, between, or within a country, other than the U.S., of persons or property, the expense of which will be assisted by USDA funding, to be performed on a United States flag carrier if service provided by such carrier is "available." b. For the purposes of the requirement: (1) Passenger or freight service by a certified air carrier is considered "available" even though: (a) Comparable or a different kind of service by a noncertificated air carrier costs less; or (b) Service by a noncertificated air carrier can be paid for in excess foreign currency; or (c) Service by a noncertificated air carrier is preferred by the Recipient organization contractor or traveler needing air transportation. (2) Passenger service by a certificated air carrier is considered to be "unavailable": (a) When the traveler, while enroute, has to wait 6 hours or more for an available U.S. carrier; or (b) When any flight by a U.S. carrier interrupted by a stop anticipated to be 6 hours or more for refueling, reloading repairs, and so forth, and no other flight by a U.S. carrier is available during the 6-hour period; or (c) When the flight by a U.S. carrier takes 12 or more hours longer than a foreign carrier. FOREST SERVICE ACKNOWLEDGED IN PUBLICATIONS AND AUDIOVISUALS. Forest Service support shall be acknowledged in publications and audiovisuals. FINANCIAL STATUS REPORT. A Financial Status Report, Form SF 269 shall be submitted quarterly. The final SF 269 shall be submitted either with your final payment request, or no later than 90 days from the expiration date of the instrument. INDIRECT COSTS. Specific indirect cost rates are approved in the initial instrument. If the rates change at any time during the performance period, the proposed adjustments shall be resubmitted to the Forest Service for verification, consideration, and approval, prior to the adjusted rates being billed. Approved rates shall be incorporated by written modification. ADMINISTRATIVE OFFSET AND CREDIT REPORTING. Pursuant to 31 U.S.C. 3716 and 7 CFR Part 3, Subpart B, any monies that are payable or may become payable from the United States under this instrument to any person or legal entity, not an agency or subdivision of a State or local government, may be subject to administrative offset for the 2 collection of a delinquent debt the person or legal entity owes to the United States. Information on the person's or legal entity's responsibility for a commercial debt or delinquent consumer debt owed the United States shall be disclosed to consumer or commercial credit reporting agencies. INTEREST, PENALTY, AND ADMINISTRATIVE COSTS. Pursuant to 31 U.S.C. 3717 and 7 CFR Part 3, Subpart B, an interest charge shall be assessed on any payment due the Government not made by the payment due date. Interest shall be assessed using the most current rate prescribed by the United States Department of the Treasury Fiscal Requirements Manual (TFRM-6-8020.20). Interest shall accrue from the date the payment was due. In addition, in the event the account becomes delinquent, administrative costs will be assessed. A penalty of 6 percent per year shall be assessed on any payment overdue in excess of 90 days from the payment due date. Payments will be credited on the date received by the designated collection officer or deposit location. If the due date(s) for any of the above payments, fees, or calculation statements falls on a non-workday, the charges shall not apply until the close of business of the next workday. RIGHT TO TRANSFER EQUIPMENT AND SUPPLIES. Equipment and supplies approved for purchase under this instrument are available only for use as authorized. The Forest Service reserves the right to transfer title to the Forest Service of equipment and supplies, valued over$2,500 per unit, purchased by the Recipient using any Federal funding. Upon expiration of this instrument the Recipient shall forward an equipment and supply inventory to the Forest Service, listing all equipment purchased throughout the life of the project and unused supplies. Disposition instructions will be issued by the Forest Service within 120 calendar days. MODIFICATION. Modifications within the scope of the instrument shall be made by mutual consent of the parties, by the issuance of a written modification, signed and dated by both parties, prior to any changes being performed. The Forest Service is not obligated to fund any changes not properly approved in advance. NONDISCRIMINATION. The recipient/cooperator shall comply with all Federal statutes relating to nondiscrimination and all applicable requirements of all other Federal laws, Executive orders, regulations, and policies. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d, 2000e-16), which prohibits discrimination on the basis of race, color, disability, 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; and Section 504 of the Rehabilitation Act of 1973 as amended (29 USC 794) which prohibits discrimination on the basis of disabilities. The nondiscrimination statement which follows shall be posted in primary and secondary recipient/cooperator offices, at the public service delivery contact point and included, in full, 3 on all materials regarding such recipients'/cooperators' programs that are produced by the recipients/cooperators for public information, public education, or public distribution: "In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. (Not all prohibited bases apply to all programs.) To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call (202)720-5964 (voice and TDD). USDA is an equal opportunity provider and employer." If the material is too small to permit the full statement to be included, the material will at minimum include the statement, in print size no smaller than the text, that "This institution is an equal opportunity provider." RESTRICTION FOR DELEGATES. Pursuant to Section 22, Title 41, United States Code, no member of, or Delegate to, Congress shall be admitted to any share or part of this instrument, or any benefits that may arise therefrom. OBLIGATIONS. Nothing herein shall be considered as obligating the Forest Service to expend or as involving the United States in any contract or other obligations for the future payment of money in excess of funding approved and made available for payment under this instrument and modifications thereto. COST REIMBURSABLE PAYMENTS. Cost reimbursable payments are approved under this instrument. Only costs for those project activities approved in (1) the initial instrument, or(2)modifications thereto, are allowable. Requests for payment shall be submitted on Standard Form 270's, Request for Advance or Reimbursement, and shall be submitted no more than monthly. ELECTRONIC FUNDS TRANSFER. In accordance with U.S. Treasury Regulations, Money and Finance at 31 CFR 208, Federal payments are to be made by Electronic Funds Transfer(EFT) to the maximum extent possible. Before payment can be made, the Recipient shall designate a financial institution or an authorized payment agent through which a federal payment may be made. A waiver may be requested and payment received by check by certifying in writing that one of the following situations apply: a. The payment Recipient does not have an account at a financial institution. b. EFT creates a financial hardship because direct deposit will cost the payment Recipient more than receiving a check. c. The payment Recipient has a physical or mental disability, or a geographic, language, or literacy barrier. 4 To initiate receiving your payment(s)by electronic transfer, contact the National Finance Center (NFC) on the worldwide web at www.nfc.usda.gov, or call the NFC at 1-800-421- 0323, or(504) 255-4647. Upon enrollment in the program you may begin to receive payment by Electronic Funds Transfer directly into your account. AVAILABILITY OF FUNDS. Funding in the amount of$1,500.00 is currently obligated for performance cfthis instrument through September 30, 2003. The Forest Service's obligation for performance of this instrument beyond this date is contingent upon the availability of appropriated funds from which payment can be made. No legal liability on the part of the Forest Service for any payment may arise for performance under this instrument beyond September 30, 2003, until funds are made available to the Forest Service for performance and until it receives notice of availability. Contingent upon Forest Service approval of continuance of work, a written modification to the instrument shall be issued to include funding for the subsequent performance period as described in the approved operating or financial plan, or budget. COMMENCEMENT/EXPIRATION DATE. This instrument is executed as of the date of last signature and is effective for 5 years at which time it will expire unless extended. EXTEND TERM. The Forest Service,by written modification to the instrument, may extend the term for subsequent performance periods not to exceed a total duration of 5 years from the execution date of the instrument, including the subsequent performance periods. FLOW DOWN. Applicable requirements set forth in the United States Department of Agriculture Uniform Federal Assistance Regulations, 7 CFR 3016, 3017, 3018, 3019 and 3015, Forest Service award letters, and Forest Service General Provisions, International Grants With Foreign Entities, shall flow down to subrecipients in any subgrants or sub- cooperative agreements awarded under this instrument. PRINCIPAL CONTACTS. The principal contacts for this instrument are: Forest Service Contact Cooperator Contact Karen Roth Ted Long Arapaho & Roosevelt National Forest Employment Services of Weld County 240 West Prospect Road PO Box 1805 Fort Collins, CO 80526 1551 N. 17th Avenue Greeley, CO 80632 Phone: (970) 494-2719 Phone: (970) 353-3800 ext. 3400 FAX: (970) 494-2730 FAX: (970) 356-3975 E-Mail: kroth@fs.fed.us E-Mail: tlong@co.weld.co.us Forest Service Admin. Contact Cooperator Admin. Contact Carolyn Lumar Marilyn Carlino, Fiscal Officer Arapaho & Roosevelt National Forest Employment Service of Weld County 240 West Prospect Road PO Box 1805 Fort Collins, CO 80526 1551 N. 17`h Avenue 5 Greeley, CO 80632 Phone: (970) 498-1177 Phone: (970) 353-3800 FAX: (970) 498-1396 FAX: (970) 356-3975 E-Mail: clumar@fs.fed.us E-Mail: AUTHORIZED REPRESENTATIVES. By signature below,the cooperator certifies that the individuals hated in this document as representatives of the cooperator are authorized to act in their respective areas for matters related to this grant. b.-- C 8/18/2003 David E. Long , `tk J; Chair 1 ',if Board of Weld County Commis er NTY Y CLERK TOT 90A D 1861 - ,1 ' CL t 0 THE BOA 07 1 OWA x /203 . EDWELL Date USDA Forest Service, Forest Supervisor Enclosures cc: Roth Fiscal FOR FOREST SERVICE USE ONLY Grant or Cooperative Agreement#: 03-DG-11021000-029 Award Date: Program or Project Name: Weld County YCC Pawnee Buttes Trail Repair Recipient Name: Weld County YCC, Employment Services Recipient ID#: 84-6000813 Job Code: SPEA16 Obligation Amount: $1,500 Program Manager and Phone#: Karen Roth, 970-494-2719 Termination Date: 5 years from DOLS 6 Sent by: HUMAN SERVICES 19703563975; 07/30/2003 0:12; #837; Page 2/5 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: _ X9701 353-3800 ext 3400 Email: ilonq co.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: It the description of your project is lengthy, please attach it separately. The project will consist of constructing log wafer 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 lime 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, W4 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: $ 375 Total: $ Sent by: HUMAN SERVICES 19703563975; 07/30/2003 0:12; #837; Page 3/5 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;$ 1.500 Forest Service 80 % Grantee's Cost-Share: $ 375 Grantee 20 % Total $ 1275 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 %. X 1990 Form 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: 17 U.S.C. , Section i 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-shore required by authority What does success look like? At the end of this project 3/4 mile of the Pawnee Buttes Trail will have log water bars and sediment traps installed. This project will decrease soil erosion and decrease sediment loads in nearby water holes or streams. Name of Forest Service Technical Representative: Karen Roth Office: Arapahoe and Roosevelt Notional Forests and Pawnee Notional Grasslands, Supervisor 2fIS_e Telephone: „(970) 494-2719 Fax: 19701 494-2730 This is not a fund-obligation document. Send the proposal & all other documents submitted with this proposal to your Grants & Agreement Stott for final processing. APPLICATION FOR OMB Approval No.0348-0043C. FEDERAL ASSISTANCE 2.DATE SUBMITTED Applicant Identifier July 21, 2003 1.TYPE OF SUBMISSION: 3.DATE RECEIVED BY STATE State Application Identifier A —. plication Preapplication [1 Construction O Construction 4.DATE RECEIVED BY FEDERAL AGENCY Federal Identifier © Non-Construction ❑X Non-Construction 73-- 9.7,--c • 5.APPLICANT INFORMATION Legal Name: Board of Weld County Commissioners/ Organizational Unit: Employment Services 0f Weld County Weld County Address(give city,county,State,and zip code): Name and telephone number of person to be contacted on matters involving PO Box 1 805 this application(give area code) , ] 55] N 17th Avenue Ted A. Long Greeley, CO 80632 (.970) 353-38_00 _pxt 340(1 6. EMPLOYER IDENTIFICATION NUMBER(E1N): 7.TYPE OF APPLICANT:(enter appropriate letter in box) 8 '4 f _WfI) 1018 (1 L 3_ A.State H.Independent School Dist. B 8.TYPE OF APPLICATION: B.County 1.State Controlled Institution of Higher Learning C.Municipal J.Private University ® New ❑ Continuation ❑ Revision D.Township K.Indian Tribe If Revision,enter appropriate letter(s)in box(es) 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: Weld County Youth Conservation Corps ] 10 --161 7] 0 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 $ 00 1,500 a.YES. THIS PREAPPLICATION/APPLICATION WAS MADE b.Applicant $ D° AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 (in-Kind) 37-5 303' PROCESS FOR REVIEW ON: c.State $ 00 Mei C P11'tA.[-rtes' DATE ----- d. Local $ via fktCbtQ C 00 wl!►'I T �/ � b.No, ❑ PROGRAM IS NOT COVERED BY E.O. 12372 e. Other $ '5�f/gfi ii.00 ❑OR PROGRAM HAS NOT BEEN SELECTED BY STATE )-q-0 3 FOR REVIEW f.Program Income $ Al00 //// 17.IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g.TOTAL $ 00 t�� 4,80Q ❑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 IS AWARDED. _ a.Type Name of Authorized Representative 'b.Title Oa r, Board of Weld c.Telephone Number Robert D. Marsden, Chair o—Te County Commissioners 1970) 336-7204 ext 4200 d. Signature of Authorized Representative a` 1\V_tQ e.Date SignedJUL 3 2003 Previous Edition Usable 4t1?%/ Standard tl_Form 424(Rev.7-97) Authorized for Local Reproduction Prescribed by OMB Circular A-102 .J/1/) •—. /94C 0> Z BUDGET INFORMATION -Non-Construction Programs OMB Approval No 0348.0044 .-+ CT!(al A'-8UDt3Ef.SlI.MMARY .- Gran!Program I. Catalog of Federal Estimated Unobligated Funds New or Revised Budget c Function Domestic Assistance = or Activity Number Federal Non-Federal Federal Non-Federal Total z (a) (b) (c) (d) (el (f) (gi m 1. Trail Repair $ $ $ 1,500.00 375.00 $ 1,875.00 C) m 2. 0.00 cn 3. 0.0D 4. 0.0D 5. Totals $ 0,00 $ 0.00 $ 1,500.00 $ 375.00 $ 1,875.00 >=S E. e'.-ftUDGI 'I'CA0RIE,S 6.Object Class Categories GRANT PROGRAM,FUNCTION OR AC IVFTT Total (1) (21 (31 (41 (5) I 8 n a.Personnel $ $ 1,330.00 $ 100.00 $ 1,430.00 co rn rz b.Fringe Benefits 0.00 tD cn c. Travel 170.00 275.00 445.00 d. Equipment 0.00 e. Supplies 0.00 0 t. Contractual 0.00 c,3 o g.Construction 0.00 o o co h. Other 0.00 t o i.Total Direct Charges (sum of 6a-6h) 0.00 0.00 1,500.00 375.00 1,875.00 N j.Indirect Charges 0.00 m k.TOTALS (sum of 61 and 6j) $ 0.00 $ 0.00 $ 1,500.0O$ 375.00 $ 1,875.00 7. ,_.Program Income fs fs js is Is 0.00 p Authorized for Local Reproduction 5tendard Form 424A(Rev.7-97) Zo- Previous Edition Usab4a Presoribed by OMS Circular A.102 •. SECTIfJt!t:C=NQtt-.FEDERALRES0URCIErSR (a)Grant Program (b)Applicant (c)State (d)Other Sources (e)TOTALS c D Z 8. $ $ $ $ 0.00 m 9 r . 0.00 1;-1 m rn 10. 0.00 1 1. 0.00 12.TOTAL (sum cif Fines 8-11) $ O.0O $ 0.00 $ 0.00 $ 0.00 ... SECTION•D Fo g$41.p i1 H NEEDS Total for tat Year td Quarter 2nd Quarter 3rd Quarter 4th Quarter 13. Federal $ 0.00 $ $ $ $ go 14 Non-Federal 0.00 m w 15. TOTAL (sum of fines 13 and 14) $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 -4 I r - _ SEc flONN E i3UDGEF•EST M &OF FEDERAL FtN,OS NEEDED.Fat R UtAI.ANG OF THE'PRi4 C (a)Grant Program FUTURE FUNDING PERIODS(Years) 16. [!... (b)FirstSecond (d) Third (e)Fourth 16. $ $ $ o 17. 0 N O 18. W 1 19. O _ - - CJ 20.TOTAL (sum of lines 16-19) $ 0.00 $ 0.00 $ 0.00 $ 0.00 ac m to SE 11QNf .OTHER BUDGET IINFOA A.rtl0N 21.Direct Charges: 22.Indirect Charges: b tia 23 Remarks: cp _� Authorized for Local Reproduction Standard Form 424A(Rev.7-911 Page 2 ui • OMB APPROVAL NO.0991-000$. 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 Part 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 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 Greele , CO 80632 Check if there are workplaces on file that are not identified here. Weld County Youth Conservation Corps Board of Weld Coun Commissioners Organization Name Pawnee Buttes Trail Re air Project Award Number or Project Name Robert D. Masden Chair Pro--Tem, , Board of Weld Coun Commissioners Name and Title of Authorized Representative Signature JUL 2 3 2003 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 Free lace Act 3. Workplaces under grants,for grantees other than individuals,need not be identified on the certification. If know,they may be identified fi din 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; pi)all"indirect charge"employees unless their impact or involvement is insignificant to the performance of the grant;and,(iii)temporary and consultants who are directly engaged in the performance of work under the grant and who are on the grantee'spayroll. This definition does not include workers not on the payroll of the grantee(e.g., personnel subrecipients volunteers,or if sued into meet a orkplace requirement;consultants or independent contractors not on the e not hl;or employeesees of ( subcontractors if mt matching r 1-2 Form AD-1049 (REV 5/90) U.S. DEPARTMENT OF AGRICULTURE (Pg 1 of 2) E 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—Tem, Board of Weld County Commissioners Name(s) and Title(s)of Authorized Representative(s) JUL 2 3 2003 Signat e(s) Date (mmidd/m'y) 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. Exceptjortransactions 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) • 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, U) 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 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 Sectiu r 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 Chair Pro-T Weld Robert D. Masden �1 Board of Weld County Commissioners [APPLICANT ORGANIZATION DATE SUBMITTED j Board of Weld County Commissioners for July21, 2003 Employment Services of Weld County Standard Form 4248(Rev.7-97) Back MEMORANDUM ratDATE: August 14, 2003 ITO: David E. Long, Weld County Board of Commissioners— FROM: Walter J. Speckman, Executive Director On COLORADO SUBJECT: Federal Financial Assistance for Pawnee Buttes Trail work by Weld County Youth Conservation Corps Enclosed for Board approval is a Federal Financial Assistance Award between United States Department of Agriculture,US Forest Service and Employment Services of Weld County,Weld County Youth Conservation Corps (WCYCC)for the Pawnee Buttes Trail Project. This award provides funds in the amount of $1,500 to assist the WCYCC in completing the repair and restoration work on the Pawnee Buttes Trail. If you have any questions, please telephone me at 353-3800 ext. 3317. 2003-2387 Hello