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Home My WebLink About930278.tiff RESOLUTION RE: APPROVE 1993 EMERGENCY SHELTER GRANT APPLICATION AND AUTHORIZE CHAIRMAN 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 the 1993 Emergency Shelter Grant Application to the Colorado Division of Housing, 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, ex-officio Board of Social Services, that the 1993 Emergency Shelter Grant Application to the Colorado Division of Housing be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chairman 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 31st day of March, A.D. , 1993. BOARD OF COUNTY COMMISSIONERS ATTEST: f/"Wu WE;p COUNTY, COLORADO Weld County Clerk to the Board >r5 eldreA,A Constance L. arbert,// hairman BY: f,LQh k' Th i / /�� Wt7,11 A -eputy Cl rk to the Board . Webster, P o-Tem APPROV AS TO VVVVFORM: W. AeorE. Baxte y- ounty Att rney '—Bale K. Hall /Barbara J. Kirkmcyer 930278 SSd© / 7 DEPARTMENT OF SOCIAL SERVICES P.O. 806 GREELEY,COLORADO 80632 Administration and Public Assistance(303)352-1551 Child Support(303)352-6933 C Protective and Youth Services(303)352-1923 3 Food Stamps(303)356-3850 • FAX(303)353-5215 COLORADO TO: Constance L. Harbert, Chairman, Board of County /�. /�' Commissioners ' t ' �t i/ FROM: Judy Griego, Director, Department of Social Service ohs SUBJECT: Emergency Shelter Grant Application for 1993 ;/ DATE: March 29, 1993 Enclosed for Board of Commissioner consideration is Weld County's Emergency Shelter Grant application for 1993. The application to the Colorado Division of Housing requests $35,325 to support operating costs for A Woman's Place, Greeley Transitional House and Catholic Community Services/Guadalupe Center. The State requests that the County prioritize the requests from the service providers to the County. The Homeless Housing Local Selection Committe consisting of United Way, the City of Greeley and Weld County has prioritized the service providers in the above order. It is our hope that the State will provide the authority to the County to determine funding levels for the service providers based on the formula as developed by the Homeless Housing Task Force. Staff recommends your approval of the Emergency Shelter Grants application for 1993. If you have any questions, please telephone me at 352-1551, Extension 6200. 930278 1993 EMERGENCY SHELTER GRANT PROGRAM APPLICATION TABLE OF CONTENTS APPLICATION FOR ESG SECTION A BUDGET SECTION B MATCHING FUNDS SECTION C RENOVATION/REHAB SECTION D LOCAL GOVERNMENT COORDINATION SECTION E MANAGEMENT CAPACITY SECTION F PROBLEM/NEED DESCRIPTION SECTION G MATCHING FUND DOCUMENTATION SECTION H ASSURANCES AND CERTIFICATIONS SECTION I 9208 a �< a ABASt'§s' s` Date Received Colorado DrYisio of flnrlsing 3 a ` ,t a w EMERoavc S swTEVIEW GRANT ASSISTANCE - _ - 7993 ♦ .w x tit3e 4uk'F3w x♦ AlL. 'o x.� .y.„vii'"°" 'gym N'asa ax ' .-_. - . ._.. ,=._ � ..- Prol.ct x AMOUA�- QflSslSTAMCS-REQUErTED- $ 35,325 RPPLIcA170NAVFORMATDON ^ .. .,, Applicant(Name and Address) Weld County Weld County Department of Social Services P.O. Box A Greeley, CO 80632 Chief Elected Official or Executive Director Phone No. 356-4000 Ext. 4200 Fedrel ID No. Constance L. Harbert 353-5215 84-6000813 Fax No. TNe Address P.O. Box 758 Chariman Greeley, CO 80632 Designated Contact Person for Application Title Phone No.352-1551 Ext. 6200 Judy A. Griego Director of Social Service. Panto- 353-5215 Address P.O. Box A Greeley, CO 80632 TYPEOF0RGAN/V41.bA .' ., t W.,TYPEOFPRAlEC7 r X Municipality/County/Consortia Operations Nonprofit(501(c)) Essential Services CHDO (Community Housing Development Organization) Prevention Public Housing Authority Other(Specify) .PROPOSED SUB-RECIPJEW S IfFAPP11C4S f AGENCY: Catholic Community Services/Northern AGENCY: Greeley Transitional House ADDRESS:ADDRESS: 1311 11th Street, Greeley, CO 80631 1202 6th Street, Greeley, CO 80631 PHONE. PHONE 352-3215 C0NTACT?? 53-6433 CONTACT??LE Mary Orleans/ Director Linda Akers/Executive Director AGENCY.• A Women's Place, Inc. AGENCY ADDRESS: ADDRESS: P.O. Box 71, Greeley, CO 80632 PHONE: 351-0712 PHONE- CONTACT/TITLE CONTACT/TITLE Carol Hunter/ Executive Director ATTACH SEPARATE SHEET FOR ADDITIONAL SU&RECIPIENTS 930 78 { � s to ....-a , w. .. .! > Ems.. >. .tS q,spootialMOS •COUNTY(IESI ` GITYMES) _ - EST.POPULATION -. . - . _._ _ - - ..Weld County . - . Greeley. I31,800 PROJECT DESCRIPTION A Women's Place A Women's Place provides emergency shelter, food and support services to abused women and their children who are homeless as a result of domestic violence. A Women's Place is the only shelter in the County which serves victims of domestic abuse. Emergency shelteer Grant funds will provide assistance with the operational costs of the shelter. See Attachment A) LOCAL GOVERNMENT PRIORITIES(for projects submitted through local governmental SUB-RECIPIENT NAME A Woman's Place #f of" #2 of 3 SUB-RECIPIENT NAME . Catholic Community NAME y Services/Guadalupe Center #30/ 3 — #4 of SUB-RECIPIENT NAME {�/f h 2 APPROVED: (/� .Q�!/l/LPi� L (ta t` 34 /993 LHIEP CTED OFFICIAL QV es yj DATE Chairman TITLE PRIOR STA'TEES&4 WARDS : ACTIVITIES % COMPLETED YEAR AMOUNT 79% 1992 $28,000 Operations 170 1991 31,430 Operations 100 1990 26,850 Operations 100 1989 10,000 Operations 100 1988 15,988 Operations/Renovation MANkBEMENTCkPAC1TYlAPM OOri XPER#NCENAliRA7NE _ .. atNion See attached narrative. 930278 Attachment A Project Description) (continued) CATHOLIC COMMUNITY SERVICES-NORTHERN/GUADALUPE CENTER The Guadalupe Center is an emergency overnight shelter (23 bed facility) for homeless individuals and families. The shelter includes sleeping facilities, morning and evening meals, personal hygiene supplies, laundry and shower facilities, information and referral. Emergency shelter grant funds will be used for the operational costs of the shelter. THE GREELEY TRANSITIONAL HOUSE The Greeley Transtional House is a eight bedroom facility which provides emergency shelter, food, support programs, case management, follow-up case management for homeless families of Weld County. Funds are requested to support the operations of the Transitional House. Emergency Shelter grant funds are critical for each of the shelters to maintain the current level of services. 930 278 1993-1994 Emergency Shelter Grant Narrative Summary The Greeley Transitional House A. MANAGEMENT CAPACITY/APPLICANT EXPERIENCE 1. Program Evaluation and Continuation The progression from crisis management to self-sufficiency is accomplished through an intensive case management program in which residents participate in setting realistic immediate and long range goals. Residents must be active participants in finding employment, participating in training programs, and pursuing affordable housing. Progress is monitored by case workers who encourage and support residents in accomplishing their goals. GTH has also implemented a follow-up case management program to continue to work with these families once they have left the initial 30-45 day program. Program evaluation is achieved through a variety of specific short and long range percentage goals regarding the homeless population served. In 1992, 82% of the resident families secured affordable housing, and 99% secured employment or training by the time they left the initial program. In 1992, 6682 nights of shelter were provided by the Greeley Transitional House. This number represents 55 families totalling 202 individuals (74 adults and 128 children) . This number grows every year, and we anticipate a 10% increase of homeless families for 1993. In 1992, 57 families were turned away due to lack of space. The primary goals for 1993 include maintaining the 82% of residents securing affordable housing, and striving, over the next three years, to aim for a 95% success rate in working toward affordable housing placement for residents. In addition, the Greeley Transitional House hopes to maintain a 99% success rate of resident families securing employment and/or training by the time they complete the initial 30-45 day program. The follow-up case management program has served 83 families since its inception in October of 1990. In 1992, 1052 visits were made by caseworkers, who tracked the following: -53 families were self-sufficient, stable and not on any assistance programs. -29 families were on some type of assistance program but stable and working towards becoming self-sufficient without help from assistance programs. -1 family that is self-sufficient and not receiving assistance, but still unstable. Follow-up services are a priority as they are critical in maintaining the success of the program. Much can be done to alleviate the immediate crisis in 30-45 days; however, long term changes require follow-up case management. It is imperative that families have a supportive and encouraging environment once they leave the initial program and move into permanent housing. Often families return to the same environment and fragmented support system which attributed initially to their homelessness. Without intervention, all the factors that led to their homelessness are still present and the cycle may very well begin again. The support network of the homeless families needs to be restructured and rebuilt. The follow-up case management family support system helps to empower the families to attain and maintain their maximum level of self-sufficiency. The children's room was completed in 1991 and has proven to be a very positive asset to the other programs. Currently, an intern from the University of Northern Colorado is developing and implementing a children's program and the Greeley Transitional House is seeking funding from several sources to implement this program on a permanent basis. 9.'0278 The long range funding goals for the Greeley Transitional House include a specific target for revenues and support over the next three years. This includes the following analysis of past percentage funding sources along with a three year goal to stabilize and further secure funding of the programs. 1991 1992 1993 3 YR Long Range United Way 18% 19% 16% 20% Federal Funds 32% 24% 13% 15% Foundation Support 20% 19% 25% 20% Local Contributions 14% 17% 20% 25% Fund-Raisers 16% 19% 25% 20% The Greeley Transitional House plans to anticipate the current funding trends over the long term with the goal of securing a realistic balance to maintain a healthy financial foundation. 2 Objectives ec of the City/County Comprehensive Housing Affordability Strategy (CHAS) Meeting CHAS objectives is a priority for the City of Greeley and Weld County. Both entities support emergency housing, transitional housing and related programs for homeless families. The emphasis is on the maintenance of the current network already established. These funds help to maintain a strong program, and this operating support is a major component of our community-based program. The integrity of the project is closely tied to the ability to meet the operating expenses year-in and year-out, while striving to provide effective services for homeless families through Weld County. 3. Range of Services Contained in the 1992-1993 Local Contract with Social Services The goals established in the 1992-1993 contract include the following: a. To develop/pursue the possibility of sharing case management services with WIRS, (Weld Information and Referral Service) , A Woman's Place, and Catholic Community Services. Referrals to A Woman's Place and to Catholic Community Services have been made on a consistent basis. Also, both of these agencies have made referrals to the Greeley Transitional House when appropriate for a family requiring a program that teaches skills to attain and maintain self-sufficiency. This is an intensive program requiring case management with families two to three times weekly. In addition, the Greeley Transitional House uses services provided by WIRS for rental assistance and securing affordable housing for client families. These families are also referred to WIRS upon admission to the program. b. To develop and share client profile information with WIRS, Catholic Community Services and A Woman's Place. Monthly statistics and client profile is turned into WIRS, and they compile a monthly report for agencies to review. c. To provide emergency shelter to 60 families between July 1, 1992 and June 30, 1993. July through February year-to-date, 48 families have been served. March through June it is estimated that at least 25 families will be served in the initial 30- 920278 45 day program, bringing the total to 73 families and thus not only accomplishing the goal but exceeding it. d. Targeting 85% of residents to secure employment, education, or training to families prior to leaving. 99% of the client families had secured employment and/or training upon completing the initial 30-45 day program, thus exceeding the goal. e. Maintain 80% of residents in the Greeley Transitional House follow-up program. 85% percent of our families after completing the initial 30-45 day program have self-selected to enroll in the follow-up program and have maintained this enrollment. Thus, this goal has been exceeded. f. 70% of those in the follow-up program will maintain stability 6 months after leaving the Greeley Transitional House. 69% of client families were able to become self-sufficient and did not require any form of public assistance within 6 months from leaving the Greeley Transitional House . Some of the families require more time. Since the inception of the follow-up program, 83 families have been served and 64% have become self-sufficient. Currently 35% of these families are working towards this goal. Lack of funding, and the use of University of Northern Colorado interns, who are not at a skill level sufficient to assist families reach self- sufficiency, were impediments to reaching the 70% goal. g. Maintain the current 85% of families securing permanent housing upon leaving the Greeley Transitional House. 82% of the families were able to secure affordable and permanent housing upon leaving the initial program. This goal was not attained due to the difficulties in housing large families. A significant number of large families (those with three or more children) were served, and affordable housing for these clients is almost nonexistent. Many of these families secured a one room apartment and found housing approximately 90 days after leaving the initial program. B. DESCRIPTION OF LOCAL GOVERNMENT COORDINATION OF COMPLEMENTARY ACTIVITIES AND SUPPORTIVE ACTIVITIES 1. Demonstrate Local Government and Non-profit Coordination of Complementary Activities and other Supportive Services Local government support includes the following: -administration of federal dollars to be utilized for the support of the homeless programs provided by community agencies; -a commitment from the City of Greeley in the amount of $6000 for support of the Greeley Transitional House; a commitment from Weld County $50,000 to support homeless services provided. These funds are to be divided by A Woman's Place, Catholic Community Services (Guadalupe Center) , and the Greeley Transitional House. The cooperative efforts within the network of community agencies continues to be a positive aspect of the program: -The Child Advocacy Resource and Education (C.A.R.E. ) program, which provides a trained facilitator to work with the client families parenting skills. -The Center for Educational Access and Outreach provides families with assessment and financial support to assist with educational pursuits from GED up through graduate education. -Employment, vocation and career planning is provided through Weld County Job Service. -Northern Colorado Family Medicine and a local dentist help by providing primary health and dental care to families who agree to seek to seek routine health care, and are enrolled in the follow-up case management program. -The Weld County Pro Bono Project provides professionals who offer counseling and family therapy at no cost. -A variety of professionals give educational training on topics such as resume writing, family planning, AIDS education, child development, nutrition, safety, maintaining a home, health education, budget counseling, and career exploration. This supportive network in Weld County also includes the much needed food, clothing, and transportation services for those who are homeless and in crisis. The Greeley Transitional House also works closely with the following agencies: a. Weld County Information and Referral Service (WIRS) Referrals from WIRS are made to the Transitional House, and referrals from the Transitional House are made to WIRS in cases where client families do not meet program criteria, or if the shelter is full. b. Catholic Community Services Referrals are made to Guadalupe Center when the Transitional House is full and visa versa. Agencies utilize each other for back-up as much as possible. c. A Woman's Place Referrals from A Woman's Place are made when families are involved with issues of domestic violence. Referrals are made from A Woman's Place when a family needs additional time to become self-sufficient and is no longer in danger. d. Salvation Army Referrals are made for emergency meals and shelter for one or two nights. However, this is dependent on their level of funds and is not always consistent. e. Weld Food Bank Referrals are made for food boxes, and the Greeley Transitional House will buy limited food items for emergencies. f. Weld Mental Health Referrals are made for emergency individual and family counseling. g. Weld County Department of Social Services Referrals are made for food stamps, AFDC and other assistance programs in which clients may be eligible for while attempting to attain self-sufficiency. h. Human Resources Job and program referrals are made to this agency. j . Consumer Credit Counseling Referrals are made for budget and credit counseling. k. United Way of Weld County The Greeley Transitional House works with the Volunteer Resource Bureau and also with United Way in a variety of capacities. 1. Additional The Executive Director and the Program Coordinator are currently participating members of Volunteer Resource Bureau, FEMA Advisory Board, Housing Coalition, Weld County Homeless Task Force, Greeley Interfaith Association, and Success By Six. 9a0278 O !iiiiiingagenitx < ''"x..'FrI Ysaoeoen \r a h 3`��ee..₹� �>.rQb Y f Y \� c,o \ "t. >....1. . ... d.. L... R :h,eM,Qm 1+. \\„� 4 ,_,ax :a": . .ws. .: x �y �. a ,<�o ..a" oYoxCo, ,yu ... c''aka .�..�CYaa ', �x`�a.3"�ry o^''t.�io'8' ' , QL' '17'Y';r� .,r, '` ��`7 3' '�s x.�. ..'''' '''''' • ESG OPERATING (specify) •• A Woman's Place Utilities Q2.050 Insurance 3.000 Telephone Ins Repairs and Maintenace _ 17c0 Audit I nsn Total L0.725 (Continued) ESG ESSENTIAL SERVICES (Specify) • ESG HOMELESSNESS PREVENTION (Specify) ESG OTHER (specify) • ESG SUBTOTAL 930278 (Continued) Catholic Community Services 1993 ESG BUDGET ESG Operating Utilities $3,500 Telephone 700 Sanitation Supplies 3,000 Salaries-operation staff 2,000 Repair and Maintenance 1,000 Food 1,000 Postage and Printing/Copying 200 Insurance 600 12,000 The Greeley Transitional House ESG Operating Utilities 4,400 Insurance 2,500 Repairs and Maintenance 2,000 Supplies 1,500 Telephone 2,200 12,600 TOTAL ESG FUNDS REQUESTED FROM WELD COUNTY $35,325 930278 umniamini b �n S 2Zp0`u,�Y'. gxc C<> >+` 'o,1yn�°(,,��Y•$$�..,��'yyyy�� wr¢a/�lMS,. 3`= �,''M�,t`,.(��Y 3Y�o[•. `"+'y�a.,ytaRa s r.i'A"p�, @" '� k .:O Y y,L .Ht.. hft6E,�..OKWES 'rA�ilsY 11� I 140t: •, tati 3„G�p y • :a:**:.' =3I �, a,K T > o ca c >r^ •z�^'.A �a`o.4Lwi tS.St ax 3>�₹§3 ° �Q >�+Y^@.aa sY� . ..^.; .,.,Y° r:I.:<.^ =yo£ >....r a , ,,,,. �':#;...`.tWO .,.....: r lO.. @`,.'�`�;•c:a;4>....S* sgzrs.„� ,.<.. .. R4 `fin =y3 x .'v' �> . w`..z«�Sra '_R. ra T9 ..ac t w�a'L'`o°d iu n'tL '1' as`,•:%4.`"-F4f3,- s aR4 e s: n A hs i 4 • O gG�xty a 5 =s> m» W x 'RaWwx+xex s x "' Ts ` s R.�3AMOWeri ; $Ailt °Afl`, , S4 QE&4ffi .. SO:*8 c :^ S M W'. '"x". 'cwai"'o" .EB@ MAFCI{:'MangionigimumaA Woman's Place Donations 14,637 45,345 N N Foodstamps 6,327 7,000 Y N Fund Raisers 11.377 Limn D' N First Congregational Church 1,000 500 Y N Littler Grant 2.SSR -n_ City of Greeley 10,500 13,500 Y Y ($500) COLTAF Fi9n 2,380 Y N ACT 3,875 5,000 Y N DAAP 8,783 9,000 Y Y($500) MIA -0- 4,040 N N VALE 22,000 22,379 Y N United Way 49,933 45,000 Y Y VOCA 11,487 9,000 Y N Weld County 40,000 17,000 N N Interest 656 450 N N Residential Fees 1,550 1,200 N N Counselling Fees 1,044 1,000 N N AMOUNT A Woman's Place 1993 TOTAL PROGRAM BUDGET(assume full ESG and/or ESCH funding) 205,218 206,684 1992 TOTAL PROGRAM COSTS '92-'93 CHANGE IN DOLLARS -1,466 '92-'93 PERCENT CHANGE -17 CONTINUE ON BACK OF THIS SHEEET IF NECESSARY 7� w��y 9.30v/LJ Non-ESG Agency Activities and Matching Funds Catholic Community Services Committed Pledges as Source "92 Amount "93 Amount (Y or N) ESG Match (Y or N) United Way $11,700 $10,000 N Y of Weld County FEMA 9,750 8,285 Y Y Membership 2,000 2,000 N Y Drive The Greeley Transitional House Committed Pledges as Source "92 Amount "93 Amount (Y or N) ESG Match (Y or N) Foundation $18,000 $15,000 Pending Y Grants Local 7,800 6,240 Y N Contribution Fundraising 5,319 8,000 Pending Y United Way 15,000 12,000 Committed by Y 03/31/93 City of -0- 6,000 Y Y Greeley Weld County 1,500 10,000 Committed Y by 04/15/93 Victims 4,520 6,600 Y N Assistance Law Enforcement (VALE) Other 400 500 Y N (Interest and Vending Machines Income) (Continued) The Greeley Transitional House Amount 1993 Total Program Budget $84,910 1992 Total Program Costs 80,892 1992-1993 Change in Dollars 4,018 1992-1993 Percent Change 5% Catholic Community Services 1993 Total Program Budget $73,667 1992 Total Program Costs 69,912 1992-1993 Change in Dollars 3,755 1992-1993 Percent Change 6% 920';75 a (�, y; ,L wist ram a \a 4,q�i h�lF Y s \4' S a �+... .n,. „ad > > ,qr �w`Y � � o\ ` n� Describe the extent and urgency of need for services to be provided. .. - A Woman's Place The study The Status Homelss Families in Metro Denver cite domestic violence as the leading precipitating cause of homelessness among families leaving their home. The women and their children who are victims of domestic abuse and need our services are often uneducated, have no self-esteem, have no job skills, have no money, and are completely at the mercy of their abuser or the system. Their choice is to become homeless or return to their abuser. A Woman's Place, the only safehouse in Weld County, works to offer each woman a chance to gain self-esteem and begin the healing process so they may become self sufficient members of our community. In 1992, 101 women were served by a Woman's Place, but 95 women were turned away. A total of 156 children were sheltered representing 4,447 nights: an increase of 8.7% over 1991. What impact do you expect to have on identified needs if you receive MG funding? A Woman's Place Funding for all social service programs has been cut due to the political climate not only at the Federal level but also at the State level. At the State level it is still unclear of what impact Amendment One will have. Locally, United Way and other sources are also having difficulty in reaching their own goals meaning that this funding resource which is critical toward the on-going services of all social services programs including homeless services, is negatively impacted. A Woman's Place has been forced to to reduce staffing for the women's counselor position. Desperately needed services to provide women the opportunity to heal, acquire self-esteem, to become self-sufficient members of the community have been diminished. The women's counsellor therapeutic services are needed to reduce recidivism and the intergenerational cycle of violence. Emergency Shelter Grant funds will serve as an alternative funding source for operational costs which would make it possible for A Woman's Place to rehire a women's counselor on at least a part-time basis. R£HAmLTrArCN&REPAIR.` W a .._... If applicable, what other sources of funds for rehabilitation end repair activities have you sought? Whet was their response to your request? Not Applicable 920 278 Extent and Urgency of Need (Continued) Catholic Community Services/Guadalupe Center In 1992, Guadalupe Center provided 5,315 nights of shelter to 765 homeless individuals. In 1992, 802 homeless persons were turned away due to inadequate space. The need for emergency shelter is increasing at an alarming rate. (See attachment) To give an example, in January, 1991, 176 nights of shelter were provided while in the same month, a year later, 620 nights of emergency shelter were provided. Greeley Transitional House The Greeley Transitional House provided 6,682 nights of shelter in 1992. This represents 55 families, consisting of 202 individuals. Of these 202 individuals, 74 were adults and 128 were children. Average length of stay was 26.5 days. Average family size was 3.7. This represents 29% increase from 1991. We also Fifty seven families were turned away who met Greeley Transitional House criteria, but due to the lack of space, were unable to serve. A 10% increase in the need is anticipated by the provider in 1993. A very critical need which is still unaddressed is the need for affordable housing for large families; housing for larger families is almost nonexistent in Weld County. 9Z10178 Project Impact (Continued) Catholic Community Services/Guadalupe Center Guadalupe Center is the only shelter in Weld County which accepts single males. Other shelters in the area, have very specific criteria for who they admit into their facilities. The Guadalupe Center many times serves as an interim shelter for those awaiting space in the Greeley Transitional House and A Women's Place. In 1992 there were 1,797 homeless people sheltered in Weld County. Guadalupe Center shelters 765 or 43% of these homeless persons. Emergency Shelter Grant funds will make it possible to continue to maintain the program by providing a revenue source for operating costs. Greeley Transitional House The Greeley Transitional House provides quality services to homeless families in need of temporary shelter, food, clothing and case management. Emergency Shelter Grant funds will continue to make it possible to maintain the current level of services by funding a portion of operational expenses of Greeley Transitional House. This support is critical to continuing to provide these needed services. 930T78 CCaRaAWfTJCS%4917111 4C$av,CE PWW7DERS ... ..,-.j IWhir is A.jewel of araiabdify of ho...a'.ts newest from arbor tonics pmvidrsi Explain r wwc.a far ino hominy an. coo,dnatad in your ant,if lb..is aussicsdon of sarriaa among agencies, asfain wny aud>duNianon it n. scary, A Woman's Place, Inc, 1) What is the level of availability of homeless services from other service providers? Greeley and Weld County have made an effort to increase the availability of homeless services. They have utilized existing governmental agencies including Weld County Social Services, Weld County Housing Authority, Greeley Housing Authority, Job Training Program Assistance, and Human Resources. The city and county have depended on volunteer agencies and nonprofit agencies to help with specific needs. Some of these agencies include United Way of Weld - County, Weld Information and Referral Services (WIRS) , Guadalupe Center, Transitional House, and A Woman's Place, Inc. To develop long range plans, the agencies have initiated two different programs. The first is the Comprehensive Housing Affordability Strategy (CHAS) which is approved by the Department of Housing and Urban Development. This five year strategy plan was developed for fiscal years 1992 through 1996. Each year they put out an annual report as to completion of projects and projections of future projects. The second program is the forming of the Housing Task Force. These programs coordinate efforts and focus awareness on housing issues in Weld County. A long term strategic plan is being developed in order to direct Weld County efforts on specific needs within the county. 2) Explain how services for the homeless are homeless are coordinated in your area. Coordination within our community is supplied by WIRS, Weld Information and Referral Services. They direct individuals and families to services that will help them with issues dealing with housing and with transportation, legal problems, alcohol and drug abuse, employment, youth and family services, mental health services, services for the disabled and elderly and health care. WiRS also provides a case management program for the homeless. This program sets up a plan of action, target dates and follows up both with clients and service providers to meet client needs. WIRS directs appropriate individuals and families to the various shelters/ safehouses available in Weld County. Transitional House and A Woman's Place, Inc. also provide casemanagement for their own clients. At A Woman's Place casemanagement takes into account the Safety issue for the woman and her children 3) If there is duplication of services among agencies, explain why such duplication is necessary. Safehouse/shelter services are not duplicated in Weld County. Guadalupe Center is an overnight shelter that provides the homeless with shelter on a first come, first serve basis. The Guadalupe Center also provides a supper and breakfast to those in need. Transitional House provides shelter, casemanagement, and counseling to homeless families for up to forty five days. A Woman's Place provides a safehouse for victims of domestic violence for up to thirty days. They also provide crisis counseling, casemanagement, support groups and a 24 hour crisis line for women and children dealing with domestic violence. 9-‘s-)02 78 O Catholic Community Services/Northern Guadalupe Center What is the level of availability of homeless services from other service providers? Explain how services for the homeless are coordinated in your area. If there is duplication of services among agencies, explain why such duplication is necessary. Guadalupe Center provides emergency, short tern overnight shelter for homeless single males, single females, and families. All individuals in need are eligible for service with the exception of those who pose a danger to other clients in the shelter. A Woman's Place provides shelter, counseling, support services and second step housing for battered women and their children. Greeley Transitional House provides 30 to 45 days of shelter, counseling, and support services to homeless families who meet their basic admission criteria. Basically, these families must have a history of self-sufficiency and the potential and motivation to again become self-sufficient. A Woman's Place and Greeley Transitional House are generally filled to capacity. Weld Food Bank provides food boxes and referrals are made through Weld County Information and Referral Services . Weld County Information and Referral Services provides homeless casemanagement services for homeless and tracks statistics on homeless and at risk of homeless. Disabled American Veterans provides shelter services, counseling, and support services for veterans. Services are coordinated through the Weld County Housing Coalition and Weld homeless/Housing Task Force which was initiated in 1992. Guadalupe Center has daily contact with Weld County Information and Referral Services and nearly daily contact with Greeley Transitional House regarding needs of specific clients. Comprehensive statistics are given to Weld County Information and Referral Services and Weld County Department of Social Services on a monthly basis. Over the past years, A Woman's Place, Greeley Transitional House, and Gradalupe have met on a regular basis to discuss shared services and resources as well as development of resources. Since November 1992 the three agencies have met several times with the City of Greeley, Weld County Social Services, and United Way to discuss services, needs, resources, and the possibility of County funding for homeless services. There are no areas of duplication of services due to the distinct target population, structures of the programs, Weld County Information and Referral Services tracking system, and networking among agencies. Greeley Transitional House The four programs providing shelter for the homeless in Weld County specifically target their population group. The existing shelters in the County coordinate services to assure that duplication of services does not occur. Many times shelters operate at full capacity, and rather than turning homeless families away without alternatives, another agency may be able to shelter the family on a short term basis. An example is the Guadalupe Center Family room which has been made available to client families until there is room at the Transitional House. Similar arrangements have been made with A Woman's Place. It is the intent of Weld County to coordinate the deliverance of services rather than compete in the duplication of services. 930278 Greeley Transitional House CLIENT SERVICE REPORT SERVICE.CATEGORY. 1992 1993(PROUECrED1, %CHANGE: 1992Z.COST/UNIT.: ; OFFSE RVICE Rat: '.R 92 Htvk�hWGetlno. SHELTER NIGHTS 6682 7350 10% SHELTER CLIENTS SERVED 202 222 10% $12.10 per ni lit NO. BEDS (incl. basinets) 26 26 --fa_ per individ. OCCUPANCY RATE: shelter nights/(no. beds x 365 days) x 70.4% 77.4% 7% 100 I NO. MEALS SERVED Clients prepareavwn Clients prepare own - CLIENT PARTICIPATION I Ili Paid hrs. —9— $ Unpaid hrs. 2828 3108 10% OTHER VOLUNTEER HOURS 10632 I 10650 I .01% 9a3YQv!® Catholic Community Services CLIENT SERVICE REPORT SERVICE CATEGORY 1992 1993 (PROJECTED) 1ft CHANGE 1992 COST/UNIT OF SERVICE Mow •92 wvfe.bud9 tf,a. f .. i •erwdl _. SHELTER NIGHTS 5 71 'c 7 Q75 SHELTER CLIENTS SERVED 765 000 74% q1 ?ft NO. BEDS find. basinets) 23 40 42% OCCUPANCY RATE; shelter nights/(no. beds x 365 days) x 100 63/ 70/ 10/ NO. MEALS SERVED 19 073 1 Qfl of CLIENT PARTICIPATION i Paid hrs. Unpaid hrs. 5 , 000 7 . 000 29% OTHER VOLUNTEER HOURS 1 , 696 2 , 000 15% 930178 \b A Woman' s Place CLIENT SERVICE REPORT SERVICE.CATEGORY 41992 $C'8,t 1993 (PRWECTED) •:≥ %CHANGE 1992COST/UNIT Rego> bed k57 13A P OFSERVICEftow ptYttre'stic Abus As.s#.st:astect Pt Dgsata) wv1cebuda.unu.' SHELTER NIGHTS 4447 **4250 — 4% 46 .48* SHELTER CLIENTS SERVED 2 5 7 260 + 1 % NO. BEDS (incl. basinetsl 20 20 0% OCCUPANCY RATE: shelter nights/Ino, beds x 365 days) x 100 60 . 92% 58 . 22% - 4 % NO. MEALS SERVED 13 , 341 12 , 750 - 4 % CLIENT PARTICIPATION • Paid hrs. -0- -0- Unpaid hrs. 547 . 5 547 . 5 -0- OTHER VOLUNTEER HOURS 5 , 626 . 75 7000 24 % * Sheltering clients is one service performed Crisis counseling/casemanagement /support and educational groups/ outreach and community education are included in our project . In support and educational groups and outreach a projected client contact of 2400 are served . **Decrease projected on first two months of statistics 90178 iI sn.mta.Fern REQUEST FOR TAXP4v.. IDENTIFICATION :Sande Oeoertmont of Adminnbsden W-9 NUMBER (T IN) VERIFICATION Do NOT send to IRS RETURN TO ADDRESS BELOW PRINT OR TYPE Name Weld County Second Name (Only if Doing Business As- D/B/A or if payment being sent in Care Of-C/Ol Address P.O. Box 758 (To receive payments from the State) City Greeley State CO ZIP 80632 9 Digit Taxpayer Identification Number (TINT: (Must check one) Individual (Individual's Social Security Number) ——— —— ---- NOTE 00 NOT use employer identification'.mnber'r.d for teem.941.940.720 0c 2290. Sole Proprietorship (Owner's Social Security Number) --- - -- ---- (You file Scrams C.Form 10401 NOTE DO NOT Lee employe identification cumber used foe fem.941.940.720 ee 2290 Partnership (Partnership's Federal Employer -- Identification Number (FEIN)) (you tii.Fenn 10661 Estate/Trust (Legal Entity's FEIN) —— Note:Do not furnish me idennfic.nen number of Or ereorul feoedmtadw or mates woes me legal entity itself is net de.gnoted in w snort title. Lao ern aide the name el the lee bra.selal.or person met. Corporation (Corporation's FEIN) tie,the Form 11201 —— Tax Exempt Organization (Organization's FEIN) -- - 6 0 4�Q.g� 3 Governmental/Non-Profit (Public Entity's FEIN) �-- Association/Club (Association/Club's FEIN) -- Check here if TIN number "applied for" Licensed Realtor Yes No Under penalties of perjury, I certify that: 1) The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me) AND 2) I am not subject to backup withholding because:(al I am exempt from backup withholding, or(b)I have not been notified by the Internal Revenue Service(IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends or lc)the IRS has notified me that I am no longer subject to backup withholding (does not apply to real estate transactions, mortgage interest paid, the acquisition of abandonment of secured property, contribution to an individual retirement arrangement (IRA), and payments other than interest and dividends). Certification Instructions: You must cross out item (2) above if you have been notified by IRS that you are currently subject to backup withholding because of underreporting interest or dividends on your tax return. (Also see signing the ertification on the reverse of e form.) Chairman -ter- / /93 Title (Print or Type) Signature � Constance L. Harbert Name (Print or Type) Date- hn,LIt & /99/3Telephone (356 ) 4000 ext 4290 DO NOT WRITE BELOW THIS LINE AGENCY USE ONLY boon N A A 1099 y N- VEND Addition COW.. .Action Com e pi.t. by Dee Tat 930`"78 sn.anin.:a„1 REQUEST FOR TAXP, .R IDENTIFICATION Colassie Oaawo°nwon at Adn""aaadan W-9 NUMBER (TIN) VERIFICATION Do NOT send to IRS RETURN TO ADDRESS BELOW PRINT OR TYPE The Greeley Transitional House Name Second Name (Only if Doing Business As- 01B/A or if payment being sent in Care Of -CO) Address 1202 6th Street I (To receive payments from the State) Ciw Greeley State CO ZIP 80631 9 Digit Taxpayer Identification Number (TIN): (Must check one) Individual (Individual's Social Security Number) --- -- ---- NOTE: 00 NOT me wonderer identification"'neat us�for forma 941.040,720 or 2280. Sole Proprietorship (Owner's Social Security Number) --- - -- ---- (You filo 8wtdo C.form 10401 NOTE: 00 NOT use employer Msefieanon rvneer, sd foe ferm 941,940.720 or 2280 Partnership (Partnership's Federal Employer -- Identification Number (FEIN)) IYw file Gem 10661 Estate/7rust (Legal Entity's FEIN) —— - Non:Oa not furnish tM identification rumor at the personal raorsnnanve at trustee unens trim lade matt'mod a not aeegmted in Me KCPIR mle. List d o ar0 me name at the lyal Wt.estate a pension mat- X Corporation (Corporation's FEIN) IYa.Iii Form 11201 _8 4 - 1 Q 4 111$ X Tax Exempt Organization (Organization's FEIN) - L .A a- Z.-- Governmental/Non-Profit (Public Entity's FEIN) -- Association/Club (Association/Club's FEIN) —— = Check here if TIN number "applied for Licensed Realtor Yes No Under penalties of perjury, I certify that: 1) The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me) AND 2) I am not subject to backup withholding because:(al I am exempt from backup withholding, or(hl I have not been notified by the Internal Revenue Service(IRS) that I am subject to backup withholding as a result of a failure to report ail interest or dividends or(c) the IRS has notified me that I am no longer subject to backup withholding (does not apply to real estate transactions, mortgage interest paid, ths acquisition of abandonment of secured property, contribution to an individual retirement arrangement (IRA), end payments other than interest and dividends). Certification Instructions: You must cross out item (2) above if you have been notified by IRS that you are currently subject to backup withholding because of underreporting interest or dividends on your tax return. (Also see signing the Certification on the reverse of the form.) Signature / T2Exe 111-1 VP Pirprrnr(Pint r ype) Linda S. Akers 3/15/93 Telephone ( 3031 352-3215 Name (Print or Type) Date CO NOT WRITE BELOW THIS LINE AGENCY USE ONLY Ag -a VA A 10911 Y N-� VEND Man —Charge __by Meat CanTwted Or Oa 9� 04179 • EMERGENCY SHELTER GRANTS PROGRAM • ASSURANCES AND CER77FICA77ONS Linda S. Akers (name of chief elected official or appropriate non-profit signatory) of The Greeley Transitional House (town,city,county or nonprofit organization) which is applying to the State of Colorado for funding through the Emergency Shelter Grant Program from the U.S. Department of Housing and Urban Development (HUD), hereby assures and certifies that: Amounts awarded under this program will sued only for these purposes: 1. Assist in the prevention of homelessness. 2. Renovate, rehabilitate, expand or convert (but not acquire) facilities for use as homeless shelters. 3. Assist in supporting the essential operating costs of shelters. 4. Assist in improving the quality of supportive services to the homeless. Projects will not require participation in religious services, as a condition for receiving assistance. All projects funded will develop and administer, in good faith, a policy designed to ensure the shelter is free from the illegal use, possession or distribution of DRUGS and ALCOHOL by it's beneficiaries. Political activities will be prohibited in accordance with subsection 675 (e) of the Community Services Block Grant Act of 1981. The town, city, county or nonprofit organization certifies that matching supplemental funds required by the regulations at 24 CFR 576.71 and 576.85(a)(3), as mentioned by the amendments to Items 415(a) and 415(c) of the Stewart B. McKinney Homeless Assistance Act made by Section 832(e) of the Cranston-Gonzalez National Affordable Housing Act of 1990 (Public Law 101-625, November 28, 1990) will be provided. The amendment exempts the first $100,000 from the matching requirement and requires that the benefit of the $100,000 exemption be provided to those recipients from the State that are least capable of providing the matching funds. The requirements of 24 CFR 576.21(a)(4)(ii) which provide that the funding of homeless prevention activities for families that have received eviction notices or notices of termination of utility services meet the following standards: (A) that the inability of the family to make the required payments must be the result of a sudden reduction in income; (B) that the assistance must be necessary to avoid eviction of the family or termination of the services to the family; (C) that there must be a reasonable prospect that the family will be able to resume payments within a reasonable period of time; (D) that the assistance must not supplant funding for preexisting homeless prevention activities from any other source. The requirements of 24 CFR 576.51(b)(2)(iii) concerning that submission by nonprofit organizations applying for funding of a certification of approval of the proposed project(s) from the unit of local government in which the proposed project is located. The requirements of 24 CFR 576.51(b)(2)(v) concerning the funding of emergency shelter in hotels or motels or commercial facilities providing transient housing. The requirements of 24 CFR 576.73 concerning the continued use of buildings for which Emergency Shelter Grant funds are used for rehabilitation or conversion of buildings for use of emergency shelters for the homeless; or when funds are used solely for operating costs or essential services, concerning the population to be served. 930 278 The building standard: equirement of 24 CFR 576.75. The requirements of 24 CFR 576.77, concerning assistance to the homeless. The requirements of 24 CFR 576.79, other appropriate provisions of 24 CFR Part 576, and other applicable Federal law concerning nondiscrimination and equal opportunity. The requirements of 24 CFR 576.80 concerning minimizing the displacement of persons, as a result of a project assisted with these funds. The requirements of 24 CFR 576.80 concerning the Uniform Relocation Assistance and Real Acquisition Policies Act of 1970. The requirement of the Cranston-Gonzalez National Affordable Housing Act (Public Law 101-625, November 28, 19900 contained in Section 832(e)(2)(C) that grantees develop and implement procedures the ensure the confidentiality of records pertaining to any individual provided family violence prevention or treatment services under any project assisted "under the Emergency Shelter Grants Program" will, except with written authorization of the person or persons responsible for the operation of such shelter, not be made public." The requirement that local government will comply with the provisions of and regulations and procedures applicable under section 104(g) of the Housing and Community Development Act of 1974 with respect to the environmental review responsibilities under the National Environmental Policy Act of 1969 and related authorities, as specified in 24 CFR Part 58, and as applicable to activities of nonprofit organizations. The requirement that no Federal appropriated funds have been paid, by or on behalf of the local government or nonprofit organization, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal loan, the entering into of any cooperative agreement, and modification of any Federal contract, grant, loan or cooperative agreement. The requirement that if any funds, other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan or cooperative agreement, the local government or nonprofit organization shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The requirement that the local govemment or nonprofit organization shall require that the language of the PROHIBITION OF THE USE OF FEDERAL FUNDS FOR LOBBYING CERTIFICATION be included in the award documents for all standards at all tiers including subcontracts. subgrants, and contracts under grants, loans, and cooperative agreements and that all subrecipients shall certify and disclose accordingly. The required certification that the submission of an application for any emergency shelter grant is authorized under applicable law and that the local government or nonprofit organization possesses legal authority to carry out emergency shelter grant activities in accordance with applicable law and regulations of the Department of Housing and Urban Development. Linda S. Akers; Executive Director (Name and Title) /q7 fl ' 3/15/93 Signature Date 930278 g .- --s -.. EMERGENCY SHELTER GRANTS PROGRAM ASSURANCES AND CERTIFICA77ONS (iCC .�R� /1jnp (name of chief elected official or appropriate non-profit signatory) of Cath Com Svcs/N (town,city,county or nonprofit organization) which is applying to the State of Colorado for funding through the Emergency Shelter Grant Program from the U.S. Department of Housing and Urban Development (HUD), hereby assures and certifies that: Amounts awarded under this program will sued only for these purposes: 1 . Assist in the prevention of homelessness. 2. Renovate, rehabilitate, expand or convert (but not acquire) facilities for use as homeless shelters. 3. Assist in supporting the essential operating costs of shelters. 4. Assist in improving the quality of supportive services to the homeless. Projects will not require participation in religious services, as a condition for receiving assistance: All projects funded will develop and administer, in good faith, a policy designed to ensure the shelter is free from the illegal use, possession or distribution of DRUGS and ALCOHOL by it's beneficiaries. Political activities will be prohibited in accordance with subsection 675 (e) of the Community Services Block Grant Act of 1981. The town, city, county or nonprofit organization certifies that matching supplemental funds required by the regulations at 24 CFR 576.71 and 576.85(a)(3), as mentioned by the amendments to Items 415(a) and 415(c) of the Stewart 8. McKinney Homeless Assistance Act made by Section 832(e) of the Cranston-Gonzalez National Affordable Housing Act of 1990 (Public Law 101-625, November 28, 1990) will be provided. The amendment exempts the first $100,000 from the matching requirement and requires that the benefit of the $100,000 exemption be provided to those recipients from the State that are least capable of providing the matching funds. The requirements of 24 CFR 576.21(a)(4)(ii) which provide that the funding of homeless prevention activities for families that have received eviction notices or notices of termination of utility services meet the following standards: (A) that the inability of the family to make the required payments must be the result of a sudden reduction in income; (B) that the assistance must be necessary to avoid eviction of the family or termination of the services to the family; (C) that there must be a reasonable prospect that the family will be able to resume payments within a reasonable period of time; (D) that the assistance must not supplant funding for preexisting homeless prevention activities from any other source. The requirements of 24 CFR 576.51(b)(2)(iii) concerning that submission by nonprofit organizations applying for funding of a certification of approval of the proposed project(s) from the unit of local government in which the proposed project is located. The requirements of 24 CFR 576.51(b)(2)(v) concerning the funding of emergency shelter in hotels or motels or commercial facilities providing transient housing. The requirements of 24 CFR 576.73 concerning the continued use of buildings for which Emergency Shelter Grant funds are used for rehabilitation or conversion of buildings for use of emergency shelters for the homeless; or when funds are used solely for operating costs or essential services, concerning the population to be served. 930278 V Tlie building standarL_ requirement.of 24 CFR 576.75.. The requirements of 24 CFR 576.77, concerning assistance to the homeless. The requirements of 24 CFR 576.79, other appropriate provisions of 24 CFR Part 576, and other applicable Federal law concerning nondiscrimination and equal opportunity. The requirements of 24 CFR 576.80 concerning minimizing the displacement of persons, as a result of a project assisted with these funds. The requirements of 24 CFR 576.80 concerning the Uniform Relocation Assistance and Real Acquisition Policies Act of 1970. The requirement of the Cranston-Gonzalez National Affordable Housing Act (Public Law 101-625, November 28, 19900 contained in Section 832(e)(2)(C) that grantees develop and implement procedures the ensure the confidentiality of records pertaining to any individual provided family violence prevention or treatment services under any project assisted "under the Emergency Shelter Grants Program' will, except with written authorization of the person or persons responsible for the operation of such shelter, not be made public." The requirement that local government will comply with the provisions of and regulations and procedures applicable under section 104(g) of the Housing and Community Development Act of 1974 with respect to the environmental review responsibilities under the National Environmental Policy Act of 1969 and related authorities, as specified in 24 CFR Part 58, and as applicable to activities of nonprofit organizations. The requirement that no Federal appropriated funds have been paid, by or on behalf of the local government or nonprofit organization, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal loan, the entering into of any cooperative agreement, and modification of any Federal contract, grant, loan or cooperative agreement. The requirement that if any funds, other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan or cooperative agreement, the local government or nonprofit organization shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The requirement that the local government or nonprofit organization shall require that the language of the PROHIBITION OF THE USE OF FEDERAL FUNDS FOR LOBBYING CERTIFICATION be included in the award documents for all standards at all tiers including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements and that all subrecipients shall certify and disclose accordingly. The required certification that the submission of an application for any emergency shelter grant is authorized under applicable law and that the local government or nonprofit organization possesses legal authority to carry out emergency shelter grant activities in accordance with applicable law and regulations of the Department of Housing and Urban Development. Ernest Giron , Executive Director p (Name and Title) rA 114t D3-16-93 ignature _._�'9!'•yi� +�7°�w w nit ->+-. �"s:� -" .:.- AC.atme Farm REQUEST FOR TARP. iR.IDENTIFICATION r --- - `ca>.dao.e.r'itat wArtvdevwm - ' W-9 NUMBER (TIN) VERIFICATION Do NOT send to IRS PRINT OR TYPE RETURN TO ADDRESS BELOW Name A Woman 's P1 Ara , Tnr .' Second Name .. - (Only if Doing Business As- D/S/A or if payment being sent in Care Of-CIO) Address P . O . Box 71 (To receive payments from the State) Ow Greeley State rn zip 80632 t 9 Digit Taxpayer Identification Number (TIN): (Must check one) Individual (Individual's Social Security Number) __ NOTE: 00 NOT W el aarar idemficmm ranter WNW Se forma Ml.940.720 or 2290. Sole Proprietorship (Owner's Social Security Number) ___ - __ - ____ rya.,file Sareue C.Fenn lose)NOTE: 00 NOT use amaaw elenaficaoen nano-iv tors to farm.941,MC.720 or 2290 Partnership (Partnership's Federal Employer __ - Identification Number (FEIN)) (Yeti file Farm 10ee1 Estate/Trust (Legal Entity's FEIN) __ Note;Oa not fvnen a'l.i .nalicatien nuance of the personal rawewntswa or ate. Wm me legs entity itself te not antenna in the eccpin nil.. List end=rue tow none of the lees tno4 MItan at peroian that. X Corporation (Corporation's FEIN) (You file farm'120) 8 4 . 0 8 1 1 5 9 6 Non-Profit 501 ( c ) 3 Tax Exempt Organization (Organization's FEIN) __ • Governmental/Non-Profit (Public Entity's FEIN) __- Association/Club (Association/Club's FEIN) __- 1-1 Check here if TIN number 'applied for' Licensed Realtor Yes No Under penalties of perjury, I certify that: 1) The number shown an this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me) AND 2) I am not subject to backup withholding because:(a) I am exempt from backup withholding, or(bl I have not been notified by the Internal Revenue Service(IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends or(c)the IRS has notified me that I am no longer subject to backup withholding (does not apply to real estate transactions, mortgage interest paid, the acquisition of abandonment of secured property, contribution to an individual retirement arrangement (IRA), and payments other than interest and dividends). Certification Instructions: You must cross out item (2) above if you have been notified by IRS that you are currently subject to backup withholding because of underreporting interest or dividends on your tax return. (Also see signing the fication on the reverse of the form.) 72/14---, e72/1, -'2Ailt A Executive Director Signature Title (Print or Type) Name (Print or Type) Carol A . Hunter Date 3 / 15 /93 Telephone ( 303) 351 -0476 CO NOT WRITE BELOW THIS LINE AGENCY USE ONLY •potty A A 1099Y 04_ 'EN0 bade, awn* Awa..e a Amon carnaetsd by pea re..In2 920 4378 .'1 I )~ .. ... .. - !l.. •.tr ..T._. "zzt . EMERGENCY SHELTER GRANTS PROGRAM ASSURANCES AND CER77HCA770NS Carol A . Hunter . Executive Director (name of chief elected official or appropriate non-profit signatory) of A Woman ' s Place . Inc . (town,city,county or nonprofit organization) which is applying to the State of Colorado for funding through the Emergency Shelter Grant Program from the U.S. Department of Housing and Urban Development (HUD), hereby assures and certifies that: Amounts awarded under this program will sued only for these purposes: 1 . Assist in the prevention of homelessness. 2. Renovate, rehabilitate, expand or convert (but not acquire) facilities for use as homeless shelters. 3. Assist in supporting the essential operating costs of shelters. 4. Assist in improving the quality of supportive services to the homeless. Projects will not require participation in religious services, as a condition for receiving assistance: All projects funded will develop and administer, in good faith, a policy designed to ensure the shelter is free from the illegal use, possession or distribution of DRUGS and ALCOHOL by it's beneficiaries. Political activities will be prohibited in accordance with subsection 675 (e) of the Community Services Block Grant Act of 1981. The town, city, county or nonprofit organization certifies that matching supplemental funds required by the regulations at 24 CFR 576.71 and 576.85(a)(3), as mentioned by the amendments to Items 415(a) and 415(c) of the Stewart B. McKinney Homeless Assistance Act made by Section 832(e) of the Cranston-Gonzalez National Affordable Housing Act of 1990 (Public Law 101-625, November 28, 1990) will be provided. The amendment exempts the first $100,000 from the matching requirement and requires that the benefit of the $100,000 exemption be provided to those recipients from the State that are least capable of providing the matching funds. The requirements of 24 CFR 576.21(a)(4)(ii) which provide that the funding of homeless prevention activities for families that have received eviction notices or notices of termination of utility services meet the following standards: (A) that the inability of the family to make the required payments must be the result of a sudden reduction in income; (B) that the assistance must be necessary to avoid eviction of the family or termination of the services to the family; (C) that there must be a reasonable prospect that the family will be able to resume payments within a reasonable period of time; (D) that the assistance must not supplant funding for preexisting homeless prevention activities from any other source. The requirements of 24 CFR 576.51(b)(2)(iii) concerning that submission by nonprofit organizations applying for funding of a certification of approval of the proposed project(s) from the unit of local government in which the proposed project is located. The requirements of 24 CFR 576.51(b)(2)(v) concerning the funding of emergency shelter in hotels or motels or commercial facilities providing transient housing. The requirements of 24 CFR 576.73 concerning the continued use of buildings for which Emergency Shelter Grant funds are used for rehabilitation or conversion of buildings for use of emergency shelters for the homeless; or when funds are used solely for operating costs or essential services, concerning the population to be served. 93®?78 The building standards requirement of 24 CFR 576.75. The requirements of 24 CFR 576.77, concerning assistance to the homeless. The requirements of 24 CFR 576.79, other appropriate provisions of 24 CFR Part 576, and other applicable Federal law concerning nondiscrimination and equal opportunity. The requirements of 24 CFR 576.80 concerning minimizing the displacement of persons, as a result of a project assisted with these funds. The requirements of 24 CFR 576.80 concerning the Uniform Relocation Assistance and Real Acquisition Policies Act of 1970. The requirement of the Cranston-Gonzalez National Affordable Housing Act (Public Law 101-625, November 28, 19900 contained in Section 832(e)(2)(C) that grantees develop and implement procedures the ensure the confidentiality of records pertaining to any individual provided family violence prevention or treatment services under any project assisted "under the Emergency Shelter Grants Program" will, except with written authorization of the person or persons responsible for the operation of such shelter, not be made public." The requirement that local government will comply with the provisions of and regulations and procedures applicable under section 104(g) of the Housing and Community Development Act of 1974 with respect to the environmental review responsibilities under the National Environmental Policy Act of 1969 and related authorities, as specified in 24 CFR Part 58, and as applicable to activities of nonprofit organizations. The requirement that no Federal appropriated funds have been paid, by or on behalf of the local government or nonprofit organization, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal loan, the entering into of any cooperative agreement, and modification of any Federal contract, grant, loan or cooperative agreement. The requirement that if any funds, other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan or cooperative agreement, the local government or nonprofit organization shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The requirement that the local government or nonprofit organization shall require that the language of the PROHIBITION OF THE USE OF FEDERAL FUNDS FOR LOBBYING CERTIFICATION be included in the award documents for all standards at all tiers including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements and that all subrecipients shall certify and disclose accordingly. The required certification that the submission of an application for any emergency shelter grant is authorized under applicable law and that the local government or nonprofit organization possesses legal authority to carry out emergency shelter grant activities in accordance with applicable law and regulations of the Department of Housing and Urban Development. Carol A . Hunter . Executive Dirprtnr A Woman ' c Place Inc (Name and Title) Signature Date 930278 l4- b. CERTIFICATION OF CONSISTENCY WITH COMPREHENSIVE HOUSING AFFORDABILITY STRATEGY Executive 1 Carol A . Hunter , Director , (name and title) authorized to act on behalf of Weld County (State, City, County, or Territory) certify that the activities proposed byA Woman ' s Place , Inc . (name of applicant or recipient) are consistent with the Comprehensive Housing Affordability Strategy submitted by Colorado on 1 0 / 16 /9 2 , to the Department of Housing and Urban Development. Carol A . Hunter , Executive Director , A Woman ' s Place , Inc . (Name and Title) 7 //X ',/. � f/i?/cam (Signature) (Date) 920278 sw.vu.F.an REQUEST FOR TAXF ER IDENTIFICATION Carole[leoruwee AMaauese W-9 NUMBER (TIN) VERIFICATION Do NOT send to IRS PRINT OR TYPE RETURN TO ADDRESS BELOW Name Catholic Community Services/Northern Second Name _ Only if Doing Business As- 0/8/A or if payment being sent in Care Of -C:0) Address 1311 11th Street (To receive payments from the State) City Greolev State op ZIP 80631 9 Digit Taxpayer Identification Number (TIN): (Must check one) Individual (Individual's Social Security Number) ___ - __ - ___ NOTE 00 NOT w.main.,identification mamas..d tor tarns eat,240.7:0 or 2290. Sole Proprietorship (Owner's Social Security Number) ___ __ ____ You 61.Sensors C.Fain 10401 NOTE 00 NOT tag ornery..idaaticanon runes Wed tot tarns ell,M0.]20 or 2 90 Partnership (Partnership's Federal Employer __ - Identification Number (FEIN)) (Tam tile Form 10661 Estate/Trust (Legal Entity's FEIN) __ - Not.:De net fvrn.n 0 e idwmtic.nen tuner of mg wear reawnanye a taute. win n..i.as.nary Itself is not aaaon.Ue in MN scant nee. Liet am a.a.Po nsrr of me legs trust.at.ta or porous Vac Corporation (Corporation's FEIN) (You lil.Form 11201 X Tax Exempt Organization (Organization's FEIN) 84 -0 6 8 6 6 7 9 Governmental/Non-Profit (Public Entity's FEIN) _—- Association/Club (Association/Club's FEIN) - Check here if TIN number "applied for" Licensed Realtor Yes No Under penalties of perjury, I certify that: 1) The number shown on this farts is my correct taxpayer identification number for I am waiting for a number to be issued to me) AND 2) I am not subject to backup withholding because:(al I am exempt from backup withholding, or(b) I have not been notified by the Internal Revenue Service(IRS) that I am subject to backup withholding as a result of a failure to report ail interest or dividends ar(c) the IRS has notified ma that I am no longer subject to backup withholding (does not apply to reel estate transactions, mortgage interest paid, the acquisition of aoandonment of secured property. contribution to an individual retirement arrangement (IRA), and payments other than interest and dividends). Certification Instructions: You must cross out item (2) above if you have been notified by IRS that you are currently subject to backup withholding because of underreporting interest or dividends on your tax return. (Also see signing the Certification on the reverse of the form.) c71..rn QY it/tear Ex ccL ; ve- Ljrrc 0r C. CSrU Signature Title (Print or Type) Name (Print or Type) Ernest Giros Date 3-16-93 Telephone (303 ) 484-5010 DO NOT WRITE BELOW THIS LINE AGENCY USE ONLY gray 11 A . 1000T N %/ENO holeer. Ci.a,p. Avereeue by Arson Coveraad by 9203'78 6n2 L._.IRGENCY SHELTER GRANTS PROGR.... ASSURANCES AND CER77fICA77ONS Constance L. Harbert (name of chief elected official or appropriate non-profit signatory) of Weld County (town,city,county or nonprofit organization) which is applying to the State of Colorado for funding through the Emergency Shelter Grant Program from the U.S. Department of Housing and Urban Development (HUD), hereby assures and certifies that: Amounts awarded under this program will sued only for these purposes: 1. Assist in the prevention of homelessness. 2. Renovate, rehabilitate, expand or convert (but not acquire) facilities for use as homeless shelters. 3. Assist in supporting the essential operating costs of shelters. 4. Assist in improving the quality of supportive services to the homeless. Projects will not require participation in religious services, as a condition for receiving assistance. All projects funded will develop and administer, in good faith, a policy designed to ensure the shelter is free from the illegal use, possession or distribution of DRUGS and ALCOHOL by it's beneficiaries. Political activities will be prohibited in accordance with subsection 675 (e) of the Community Services Block Grant Act of 1981. The town, city, county or nonprofit organization certifies that matching supplemental funds required by the regulations at 24 CFR 576.71 and 576.85(a)(3), as mentioned by the amendments to Items 415(a) and 415(c) of the Stewart B. McKinney Homeless Assistance Act made by Section 832(e) of the Cranston-Gonzalez National Affordable Housing Act of 1990 (Public Law 101-625, November 28, 1990) will be provided. The amendment exempts the first 5100,000 from the matching requirement and requires that the benefit of the $100,000 exemption be provided to those recipients from the State that are least capable of providing the matching funds. The requirements of 24 CFR 576.21(a)(4)(ii) which provide that the funding of homeless prevention activities for families that have received eviction notices or notices of termination of utility services meet the following standards: (A) that the inability of the family to make the required payments must be the result of a sudden reduction in income; (B) that the assistance must be necessary to avoid eviction of the family or termination of the services to the family; (C) that there must be a reasonable prospect that the family will be able to resume payments within a reasonable period of time; (D) that the assistance must not supplant funding for preexisting homeless prevention activities from any other source. The requirements of 24 CFR 576.51(b)(2)(iii) concerning that submission by nonprofit organizations applying for funding of a certification of approval of the proposed project(s) from the unit of local government in which the proposed project is located. The requirements of 24 CFR 576.51(b)(2)(v) concerning the funding of emergency shelter in hotels or motels or commercial facilities providing transient housing. The requirements of 24 CFR 576.73 conceming the continued use of buildings for which Emergency Shelter Grant funds are used for rehabilitation or conversion of buildings for use of emergency shelters for the homeless; or when funds are used solely for operating costs or essential services, concerning the population to be served. 9308 The building standa requirement of 24 CFR 576.75. The requirements of 24 CFR 576.77, concerning assistance to the homeless. The requirements of 24 CFR 576.79, other appropriate provisions of 24 CFR Part 576, and other applicable Federal law concerning nondiscrimination and equal opportunity. The requirements of 24 CFR 576.80 concerning minimizing the displacement of persons, as a result of a project assisted with these funds. The requirements of 24 CFR 576.80 concerning the Uniform Relocation Assistance and Real Acquisition Policies Act of 1970. The requirement of the Cranston-Gonzalez National Affordable Housing Act (Public Law 101-625, November 28, 19900 contained in Section 832(e)(2)(C) that grantees develop and implement procedures the ensure the confidentiality of records pertaining to any individual provided family violence prevention or treatment services under any project assisted "under the Emergency Shelter Grants Program" will, except with written authorization of the person or persons responsible for the operation of such shelter, not be made public." The requirement that local government will comply with the provisions of and regulations and procedures applicable under section 104(g) of the Housing and Community Development Act of 1974 with respect to the environmental review responsibilities under the National Environmental Policy Act of 1969 and related authorities, as specified in 24 CFR Part 58, and as applicable to activities of nonprofit organizations. The requirement that no Federal appropriated funds have been paid, by or on behalf of the local government or nonprofit organization, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal loan, the entering into of any cooperative agreement, and modification of any Federal contract, grant, loan or cooperative agreement. The requirement that if any funds, other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan or cooperative agreement, the local government or nonprofit organization shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The requirement that the local government or nonprofit organization shall require that the language of the PROHIBITION OF THE USE OF FEDERAL FUNDS FOR LOBBYING CERTIFICATION be included in the award documents for all standards at all tiers including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements and that all subrecipients shall certify and disclose accordingly. The required certification that the submission of an application for any emergency shelter grant is authorized under applicable law and that the local government or nonprofit organization possesses legal authority to carry out emergency shelter grant activities in accordance with applicable law and regulations of the Department of Housing and Urban Development. Weld County Constance L, Harbert, Chairman (Name and Title) �/ l�.4i/ 17' i Idf/LC') � /9 Signature 6W615/93 Date 920' 8 CERTIFICATION OF CONSISTENCY WITH COMPREHENSIVE HOUSING AFFORDABILITY STRATEGY I, Constance L. Harbert, Chairman , (name and title) authorized to act on behalf of Weld County (State, City, County, or Territory) certify that the activities proposed by Weld County (name of applicant or recipient) are consistent with the Comprehensive Housing Affordability Strategy submitted by Colorado on April 1, 1993 , to the Department of Housing and Urban Development. Constance L. Harbert,Chairman (Name and Title) LJflMM31. 1C7q' (Signature) C'//C5/q (Date) • 9:30178 Hello