HomeMy WebLinkAbout940415.tiff RESOLUTION
RE: APPROVE MASTER CONTRACT FOR TITLE II-A BETWEEN GOVERNOR'S JOB TRAINING
OFFICE AND HUMAN RESOURCES 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 a Master Contract for Title II-A
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Human
Resources, and the Governor's Job Training Office, commencing July 1, 1994, and
ending June 30, 1997, with further terms and conditions being as stated in said
contract, and
WHEREAS, after review, the Board deems it advisable to approve said
contract, a copy of which is attached hereto and incorporated herein by
reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Master Contract for Title II-A between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld
County, on behalf of the Weld County Department of Human Resources, and the
Governor's Job Training Office be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is,
authorized to sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following vote on the 9th day of May, A.D. , 1994.
Lumag., BOARD OF COUNTY COMMISSIONERS
ATTEST: WELD COUNTY, COj.ORADO -�q-�—,�,�
Weld County Clerk to the Board p � �/ 6o�m/ X�W. ebs er, Cha' man
BY: 'LZ.��C1: L �/ U t 7LiI i
Deputy Cl k to the Board K. Hall, P -Tem
APPROVED AS TO FORM: C 1x
George Baxter
-r1--/ 1/1CUSED
ount Attorn y Constance L. Harbert
EXCUSED DATE OF SIGNING (AYE)
Barbara J. Kirkmeyer
940415
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Agency # E E A
Routing #
Contract # WC- 1409
MASTER CONTRACT
THIS CONTRACT, made this 5th day of May, 1994 , effective July 1,
1994 by and between the State of Colorado, represented by the
Governor ' s Job Training Office, hereinafter referred to as GJTO,
or the State, and Weld County, hereinafter referred to as the
Contractor.
WHEREAS, authority exists in the Job Training Partnership Act
(JTPA) of 1982 , also known as P.L. 97-300 , as amended, and in the
Economic Dislocation and Worker Adjustment Assistance Act (EDWAA)
and the Governor has received a grant of federal funds thereun-
der; and
WHEREAS, the JTPA (Section 101 [a] [1] , requires the designation of
Service Delivery Areas (SDAs) by the Governor; and
WHEREAS, Executive Order D0010 83 of March 15 , 1983 , has
designated this SDA in accord with JTPA: and
WHEREAS, required approval, clearance and coordination has been
accomplished from and with appropriate agencies; and
WHEREAS, contract authority for Weld County resides in the Weld
County Board of County Commissioners; and
WHEREAS, authority exists in the law and funds have been
budgeted, appropriated, and otherwise made available and a
sufficient unencumbered balance thereof remains available for
payment in Fund Number 100, Appropriation Number 4Oo, 4a
Contract Encumbrance Number lAjP -409 ; and
WHEREAS, the Contractor has selected the entity which will
receive and administer funds from the state in accordance with
Section 104 (b) (1) and (2) of the JTPA.
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NOW THEREFORE, in consideration of the mutual promises hereinafter
set forth, the parties enter into the following agreement :
I. DEFINITIONS
A list of definitions to be used in the interpretation of
this Contract is attached hereto as Attachment 1 and by this
reference is incorporated herein.
II. STATEMENT OF WORK
The Contractor agrees to perform, in a professional and
workmanlike manner, the obligations and responsibilities set
forth in the "Allowable Programs" , Section II .A of the
Contract .
A. Allowable Programs
A. 1 The Contractor and its administrative entity have
prepared a two-year Job Training Plan (JTP) and a II-
B Plan in accordance with Section 104 of JTPA, and an
EDWAA plan in accordance with Section 311 of JTPA.
The 94-95 JTPs, by this reference are hereby
incorporated and made part of this Contract as if
fully set forth herein.
A. 2 GJTO shall provide funds to the SDA for activities
pursuant to the approved JTPs referenced in Section
II .A. 1 .
A. 3 In addition to the funds provided for the basic grant
activities identified in the approved JTPs, GJTO may
provide funds to the Contractor for the following
other activities :
A. 3 . a Training programs for older individuals (those
individuals 55 years or older) , (Section 124 of
JTPA) ;
A. 3 .b Incentive grants for superior performance,
training and technical assistance for staff and
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for serving hard to serve individuals (§
202 (6) (1) (8) JTPA, as amended) ;
A. 3 . c Training programs for dislocated workers (§ 301
and 302 of JTPA, as amended) , as specified by
EDWAA;
A. 3 .d Services for groups with special needs and
exemplary models pursuant to joint agreements
(§ 501 (a) of JTPA, as amended) ;
A. 3 . e Amendments and modifications of allocated funds
pursuant to § 109 and 202 (b) of the JTPA,
provided to the contractor; and
A. 3 . f Other funds for employment and training-related
programs .
A.4 GJTO shall provide funds for Summer Youth Employment
and Training Programs in accordance with Part 8,
Section 251 of JTPA, if such activities are not
originally included in the JTP by the Contractor.
B. Maximum Funding
B. 1 GJTO shall provide the Contractor an amount not to
exceed One Million, Three Hundred Seventy One
Thousand, Eight Hundred Fifty Five Dollars
($1, 371, 855) of funds awarded to the State of Colorado
for activities identified in Section II .A for the
period of July 1 , 1994 to June 30, 1997 .
B . 2 Funds authorized to be expended by the Contractor will
be limited to authorized funding received from the
Department of Labor or other sources . The authoriza-
tion to spend funds may be provided to GJTO in
increments . Therefore, GJTO shall limit the amount
requested by the Contractor for each Expenditure
Authorization (EA) to the amount in the GJTO Notice of
Fund Availability.
C. Expenditure Authorization Procedures
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C. 1 Prior to the expenditure of any funds identified in
Section II .B above, an EA or JTP must be submitted by
the Contractor and approved by GJTO.
C. 2 An EA is a document prepared by the Contractor which
shall include the following:
C. 2 .a Type of funds identified in Section II .A of
this Contract, which the Contractor is request-
ing;
C. 2 .b The Scope of work to be performed by the Con-
tractor:
C. 2 . c Period of Performance;
C. 2 .d A budget or budgets submitted on forms provided
by GJTO.
A separate budget will be required for each
type of funding received by the Contractor,
such as, but not limited to, those programs
identified in Section II .A above .
C. 2 .e Special Provisions; and
C. 2 . f Signature page signed by the Private Industry
Council (PIC) Chair, Local Elected Official
(LEO) , the SDA Director, and GJTO; if the total
amount of the EA is One Hundred Thousand
Dollars ($100 , 000) or more. The PIC may
authorize the SDA Director to sign in lieu of
the PIC Chair for EAs of less than One Hundred
Thousand Dollars ($100, 000) .
The Contractor must comply with its own inter-
nal signature process . Should the internal
signature process be more restrictive than this
provision, it will prevail .
C. 3 The Contractor may include EA provisions (C. 1 and
C. 2) in its subcontracts . Upon approval by GJTO
of the Contractor ' s EA policy and procedures for
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its subcontractors, GJTO shall be a third party
beneficiary of such provisions . The Contractor
shall be obligated to GJTO for the enforcement of
such provisions .
D. Modification Procedure for EA Budget
The Contractor may modify the EA and its budget in
accordance with GJTO policies and procedures with prior
approval of both PIC and GJTO.
E. Property
To purchase property with JTPA funds, a Property Requisi-
tion and Authorization Form (PRAF) must be submitted to,
and processed by, GJTO. See Paragraph VI , General
Provisions .
F. Duration
The JTPs shall remain in full force and effect for the
entire Contract period, unless changes in labor market
conditions, funding, or other factors require substantial
modifications as provided in Section 104 (c) of JTPA. Such
a modification would require an amendment to this Con-
tract .
G. Annual Report
The Contractor shall submit an annual report by September
30, each year as required by § 104 (b) (13) of the JTPA, as
amended. The report shall include :
G. 1 A description of activities/services conducted during
the program year for Title II-A, II-C, Title III , and
5% Older Worker programs .
G.2 A list of client characteristics and the number of
each served;
G. 3 A list of occupations in which training took place and
the number of participants in each.
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G.4 A summary of the SDA' s performance in meeting feder-
al/state standards;
G. 5 Status of coordination agreements and description of
innovative coordination taking place which would be of
special interest to other SDAs, the Job Training
Coordinating Council, and the Governor;
G. 6 An evaluation of service providers which includes
ability to meet performance goals, cost, quality of
training, and characteristics of participants ; and
G. 7 A summary of the Contractor' s monitoring of subrecip-
ient contracts, corrective actions taken, and the
results of such corrective actions .
G. 8 Information on the extent to which the service
delivery area has met the goals of the area for the
training and training-related placement of women in
nontraditional employment and apprenticeships; and
G. 9 A statistical breakdown of women trained and placed in
nontraditional occupations, including information
regarding - -
G. 9 .a the type of training received, by occupation;
G. 9 .b whether the participant was placed in a job or
apprenticeship, and, if so, the occupation and
wage at placement;
G. 9 . c the age of the participant ;
G. 9 .d the race of the participant; and
G. 9 . e retention of the participant in nontraditional
employment .
If changes in labor market conditions, funding or other
factors require substantial deviation from an approved
job training plan, the private industry council and the
appropriate chief elected official or officials (as
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described in section 103 (c) ) shall submit a modifi-
tion of such plan (including modification of the budget
under subsection (b) (6) ) , which shall be subject to
review in accordance with section 105, JTPA § 104 (c) ,
and § 104 (b) (13 ) (E) .
H. Exhibits
The terms and conditions contained in the PY 94-95 JTP are
by this reference, incorporated herein. Exhibits A, B,
and C attached hereto, are incorporated and made a part
hereof .
Exhibit A - PY 94-95 JTP
Exhibit B - PY 94 II-B JTP
Exhibit C - PY 94 EDWAA JTP
III. PERIOD OF PERFORMANCE
The period of performance shall be from July 1, 1994 to June
30, 1997 .
IV. GENERAL PROVISIONS
The Contractor agrees to perform in accordance with, and to
comply with, the General Provisions, attached to this
Contract, and by this reference hereby incorporated into this
Contract .
V. SPECIAL PROVISIONS
The Contractor agrees to perform in accordance with, and to
comply with, the Special provisions attached to this Con-
tract .
VI. EOUAL EMPLOYMENT OPPORTUNITIES/AFFIRMATIVE ACTION
A. Equal Employment Opportunity Requirements
The Contractor shall insure Equal Employment Opportunities
(EEO) to all individuals and shall take Affirmative Action
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(AA) to insure adequate utilization of members of protect-
ed classes of workers who have been victims of past
discrimination.
EEO shall mean that no individual shall be excluded from
participation in, denied the benefits of, subjected to
discrimination under, or denied employment in the adminis-
tration of or in any program funded under this section
because of race, color, or national origin, age, handicap,
or political affiliation or belief .
Contractors shall be governed by the prohibitions against
discrimination on the basis of age under the Age Discrimi-
nation Act of 1975, on the basis of handicap under Section
504 of the Rehabilitation Act, on the basis of sex under
Title IX of the Education Amendments of 1972, or on the
basis of race, color, or national origin under Title VI of
the Civil Rights Act of 1976 . Programs and activities
funded under this Act are considered to be programs
receiving Federal financial assistance and are all subject
to all provisions of EEO.
VII. CERTIFICATION REGARDING LOBBYING
By signing this Contract, the undersigned certifies, to the
best of his or her knowledge and belief , that :
A. No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person
for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of
Congress in connection with the awarding of any Federal
contract, the making of any Federal grant, the making of
any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal ,
amendment, or modification of any Federal contract, grant,
loan, or cooperative agreement .
B. 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
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agency, a Member of Congress , an officer or employee of
Congress , or an employee of a Member of Congress in
connection with this Federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and
submit Standard Form-LLL, "Disclosure Form to Report
Lobbying" , in accordance with its instructions.
C. The undersigned shall require that the language of this
certification be included in the award documents for all
*subawards at all tiers (including subcontracts, sub-
grants, and contractors under grants, loans, and coopera-
tive agreements) and that all subrecipients shall certify
and disclose accordingly.
D. This certification is a material representation of fact
upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is
a prerequisite for making or entering into this transac-
tion imposed by Section 1352 , title 31, U. S. Code. Any
person who fails to file the required certification shall
be subject to a civil penalty of not less than $10, 000 and
not more than $100 , 000 for each such failure.
*Note : "All" applies to covered contract/grant transac-
tions over $100, 000 (per OMB) .
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GENERAL PROVISIONS
I . LEGAL AUTHORITY
The Contractor assures and guarantees that it possesses the
legal authority to enter into this Contract . The person or
persons signing and executing this Contract on behalf of the
Contractor do hereby warrant and guarantee that they have
been fully authorized by the Contractor to execute this
Contract on behalf of the Contractor.
II. PAYMENT CONTINGENCY
The parties hereto expressly recognize that the Contractor is
to be paid, reimbursed or otherwise compensated with funds
provided to GJTO by the United States Department of Labor
under the Job Training Partnership Act (JTPA) and/or Economic
Dislocation and Worker Adjustment Assistance Act (EDWAA) .
Therefore, the Contractor expressly understands and agrees
that all its rights, demands and claims to compensation
arising under this Contract are contingent upon receipt of
such funds and upon GJTO continuing to receive such funds .
If any part of the funds are not received by GJTO, for any
reason, GJTO may unilaterally terminate this Contract, or,
with the consent of the Contractor, modify the terms hereof .
Insofar as this contingency affects the Contractor, subreci-
pients or suppliers, for mutual protection of the parties ,
the Contractor agrees to include this contingency in all its
subcontracts .
III . TERMINATION
The performance of work under this Contract may be terminated
by GJTO in accordance with this clause in whole or in part .
A. GJTO may terminate this Contract when it has been deter-
mined that the Contractor has failed to provide any or all
of the services specified or failed to comply with any
Federal requirements or provisions contained within this
Contract . GJTO will notify the Contractor of such
unsatisfactory performance in writing. The Contractor has
thirty (30) working days, unless otherwise specified in
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the notice, after receipt in which to respond with a
written plan acceptable to GJTO for correction of defi-
ciencies . If the Contractor does not respond within the
appointed time with appropriate plans, GJTO shall serve a
termination notice on the Contractor.
B. GJTO may terminate this Contract if it is determined that
the Federal or State Government has debarred or suspended
the Contractor within a three year period preceding this
Contract, or debars the Contractor during the term of this
Contract, pursuant to 29 CFR 98 and 24-109-105 CRS .
C. GJTO may request a termination of this Contract for conve-
nience, giving a thirty (30) calendar day advance notice
in writing of the effective date of such termination. The
Contractor receiving notice shall be entitled to receive
just and equitable compensation for any allowable services
satisfactorily performed hereunder through the date of
termination.
D. GJTO may request in writing, a termination of this
Contract when both parties agree that continuation of the
services specified in Section II, Statement of Work, would
not produce beneficial results commensurate with the
further expenditure of funds.
E. After receipt of a notice of termination, the Contractor
shall :
E. 1 Stop work under the Contract on the date and to the
extent specified in the notice of termination.
E. 2 Place no further orders or subcontracts for materials,
services; or facilities, except as may be necessary
for completion of such portion of the work already
substantially performed under the Contract .
E. 3 Terminate all orders and subcontracts to the extent
that they relate to the performance of the work
terminated by the notice of termination.
E .4 Assign to GJTO all of the rights, title and interest
within the Contract . GJTO shall have the right , at
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its discretion, to settle or pay any or all claims
arising out of the termination of this Contract .
E . 5 Settle all outstanding liabilities and all claims
arising out of such termination of orders and subcon-
tracts in accordance with the provisions of this
Contract .
E. 6 Transfer title of all Contract property to GJTO (to
the extent that title has not already been trans-
ferred) and deliver in the manner and at a time
specified by GJTO.
E. 7 Take such action as may be necessary or as may be
directed, for the protection and preservation of the
property related to this Contract which is in the
possession of the Contractor and in which GJTO has or
may acquire an interest .
F. After receipt of a notice of termination, the Contractor
receiving notice shall submit to GJTO its completed and
acceptable fiscal closeout package in the form and with
the certification prescribed by GJTO. Such closeout
package shall be submitted promptly, but in no event later
than two (2) months from the effective date of termina-
tion, unless one or more extensions in writing are granted
by GJTO.
G. The Contractor shall have the right to appeal any unilat-
eral determination to terminate in accordance with JTPA.
In any case, where GJTO has made a determination of the
amount due, GJTO shall pay the Contractor the following:
G. 1 If there is no right of appeal hereunder or if no
timely appeal has been submitted, the amount so
determined by GJTO; or
G. 2 If an appeal has been submitted, the amount finally
determined on such appeal .
H. GJTO may, from time to time, under such terms and condi-
tions as it may prescribe, make partial payments on
account against costs incurred by the Contractor in
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connection with the terminated portion of the Contract
whenever, in the opinion of GJTO, the aggregate of such
payment shall be within the amount to which the Contractor
will be entitled hereunder.
IV. MANAGEMENT ACTIVITIES AND RECORD MAINTENANCE
A. In addition to any requirements imposed elsewhere in this
Contract , the Contractor shall ensure that sufficient,
auditable and otherwise adequate records that will provide
accurate, current, separate and complete disclosure of the
status of the funds received under the Contract are
retained for five (5) years . If a claim is instituted
involving the grant or agreement covered by the records,
the records shall be retained until resolution of the
claim or litigation, or until the end of the 5 year
period, whichever is later. Such records shall be
sufficient to allow the U. S . Department of Labor, firms
conducting audits of JTPA funds and GJTO to audit and
monitor the Contractor.
Accordingly, recipients/subrecipients shall maintain a
copy of the Participant Record which records any par-
ticipant ' s participation in the JTPA program, including
dates of entry, eligibility, participation and termination
and shall retain such records at least a minimum of five
years. The time necessary to resolve litigation, audit or
claim involving the grant or agreement covered by the
records, which was initiated prior to the end of the five-
year retention period does extend the retention period.
B. The Contractor shall ensure that it and its subrecipients
will comply with the provisions of GJTO' s Audit Policy and
Procedures . If the Contractor receives over Twenty-Five
Thousand Dollars ($25 , 000) of direct Federal financial
assistance from GJTO within the Contractor's fiscal year,
the Contractor shall submit an audit report in accordance
with the Single Audit Act and OMB Circulars A-128 or A-
133 , whichever is applicable, to GJTO within 10 days of
the Contractor' s receipt from its auditors, but no later
than one year after that fiscal year that was reported
upon. The Contractor shall establish an audit committee
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that engages the independent auditor, determines the
services to be performed, reviews the progress of the
audit and the final audit findings, and intervenes in any
disputes between management and the independent auditors .
The contractor shall also institute policy and procedures
for its lower-tier subrecipients that comply with these
audit provisions .
C. GJTO, the U.S. Department of Labor, GJTO' s auditors and
other representatives of GJTO shall, during business
hours, have access to inspect and copy books, records,
memoranda, correspondence, personnel staffing records,
independent audit workpapers and any other documents, and
shall be allowed to monitor and review through on-site
visits, all program activities, personnel staff, services
and programmatic and administrative practices, supported
with funds under this Contract to ensure compliance with
the terms of this Contract, and provisions of any subcon-
tracts funded in whole or in part through this Contract .
D. The Contractor shall review the findings of GJTO or
representatives and shall act promptly, as directed by
GJTO, to remedy deficiencies noted in such findings . If
corrective action is not taken and such deficiencies
persist , GJTO may terminate this Contract .
E. If corrective action requires repayment of JTPA funds
expended for unallowable purposes , stand-in costs may be
substituted for disallowed costs where : incurred during
the same program year, paid for with non-federal funds and
allowable under the same JTPA program title and cost
category as amounts disallowed. The availability or use
of stand-in costs must be reported to GJTO.
F. In the event that GJTO determines that the recordkeeping
system of the Contractor does not comply with Federal
guidelines , financial accounting may be done by GJTO, or
an accounting firm or bank approved by GJTO. The cost to
GJTO of any work shall be deducted monthly from the funds
allocated to the Contractor.
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V. SUBCONTRACTING
The Contractor shall not subcontract the performance of any
part of its duties in administration of the funds under this
Contract except in accordance with the terms of this Contract
or with the prior written consent of GJTO approving the
subcontractor.
VI . PROPERTY MANAGEMENT
The Contractor and its lower-tier subrecipients shall comply
with GJTO' s property management procedures and all relevant
JTPA Letters and Policy Guidance Letters (PGLS) . The
Contractor ensures that it will maintain proper inventory
control over all nonexpendable supplies and property
purchased with JTPA funds .
VII. ASSIGNMENT
The Contractor shall not assign this Contract to third
parties without the prior written consent of GJTO approving
both the assignment and the assignee .
VIII.SEVNRABILITY
To the extent that this Contract may be executed and perfor-
mance of the obligations of the parties may be accomplished
within the intent of the Contract, the terms of this Contract
are severable, and should any term or provision hereof be
declared invalid or become inoperative, such invalidity or
failure shall not affect the validity of any other term or
provision hereof . The waiver of any breach of a term hereof
shall not be construed as a waiver of any other term.
IX. CHANGES IN STATEMENT OF WORK
A. Modification by Operation of Law
This Contract is subject to such modification as may be
required by changes in federal or state law or regula-
tions . Any such required modification shall be incorpo-
rated into and be part of this Contract as if fully set
forth herein.
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B. Programmatic Modifications
The Contractor shall follow the revision procedures set
forth by GJTO.
B.1 The Contractor must submit a written request to GJTO
and obtain prior written approval for changes to the
Statement of Work, the objective of the Contract, or
dollar amount changes ,
B.2 In addition to the foregoing procedure, prior approval
for such changes must be authorized by the State in an
amendment to this Contract properly executed and
approved in accordance with applicable law under the
following circumstances :
B . 2 .a When an increase or decrease of Contract total
is desired; and
B. 2 .b When the Statement of Work or the objective of
the Contract changes substantially, as deter-
mined by GJTO.
Under such circumstances, GJTO' s approval is not
binding until the Contract amendment is executed.
X. PROGRAM INCOME
If program income is generated under this Contract , an
agreement providing for the use of such income subsequent to
termination of this Contract is required, prior to the
expenditure of such funds .
XI . INTEGRATION OF UNDERSTANDINGS
This agreement is intended as the complete integration of all
understandings between the parties . No prior or current
addition, deletion, or other amendment shall have any force
or effect whatsoever, unless embodied herein in writing. No
subsequent novation, renewal , addition, deletion, or other
amendment hereto shall have any force or effect unless
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embodied in a writing that is executed and approved pursuant
to the State Fiscal Rules and other applicable statutes and
regulations .
XII. ASSURANCES
A. The Contractor assures that it will fully comply with the
JTPA, regulations promulgated, and all other applicable
federal and state laws, rules and regulations .
B. The Contractor assures that in operating programs funded
under the Act, it agrees to comply with all GJTO issuances
and directives, such as JTPA letters and PGLs .
C. The Contractor assures that it will administer its
programs under the JTPA in full compliance with safeguards
against fraud and abuse as set forth in JTPA and the JTPA
regulations .
D. The Contractor agrees to abide by the provisions of
Section 144 of the JTPA which concerns grievance proce-
dures . Further, the Contractor agrees to follow Federal
Regulations governing grievance resolution of all com-
plaints, including those based on disabilities, but
excluding complaints alleging discrimination. All
discrimination complaints except those based on disability
must be filed initially at the U. S . Directorate of Civil
Rights . Finally, the Contractor agrees to follow all
pertinent Governor' s policy issuances concerning grievance
procedures .
E. No funds provided under this Act shall be used or proposed
for use to encourage or induce the relocation, of an
establishment or part thereof, that results in a loss of
employment for any employee of such establishment at the
original location.
No funds provided under this Act shall be used for
customized or skill training, on-the-job training, or
company specific assessments of job applicants or employ-
ees , for any establishment or part thereof, that has
relocated, until 120 days after the date on which such
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establishment commences operations at the new location, if
the relocation of such establishment or part thereof ,
results in a loss of employment for any employee of such
establishment at the original location (JTPA Section
141 (c) ) .
F. The Contractor assures and certifies that in administering
programs under JTPA:
F.1 It will comply with the provisions of the Uniform
Relocation Assistance and Real Property Acquisition
Act of 1970 (P . L. 91-646) which requires fair and
equitable treatment of persons displaced as a result
of Federal and Federally-assisted programs .
F.2 It will comply with the provisions of the Hatch Act,
where applicable, which limit the political activity
of certain State and local government employees .
F.3 For grant , subgrants, contract, and subcontracts in
excess of One Hundred Thousand Dollars ($100, 000) , or
where the grant officer has determined that orders
under an indefinite quantity contract or subcontract
in any year will exceed One Hundred Thousand Dollars
($100 , 000) , or if a facility to be used has been the
subject of a conviction under the Clean Air Act (42
U. S. C. 1857-8) (c) (1) or the Federal Water Pollution
Control Act (33 U. S . C. 1319 [C] ) and is listed by the
Environmental Protection Agency (EPA) or is not oth-
erwise exempt, the grantee assures that :
F. 3 . a No facility to be utilized in the performance
of the proposed grant has been listed on the
EPA list of Violating Facilities ;
F. 3 .b It will notify the Regional Administrator,
prior to award, of the receipt of any communi-
cation from the Directors, Office of Federal
Activities, U. S . EPA, indicating that a facili-
ty to be utilized for the grant is under con-
sideration to be listed on the EPA list of
Violating Facilities; and
weld.mas Page 18 of 27
940415
F. 3 . c It will include substantially this assurance,
including this third part, in every non-exempt
subgrant , contract or subcontract .
F.4 It will comply with appropriate labor standards as set
forth in Section 143 of the JTPA (20 CFR 627 . 603 and
627 . 604 ) ;
F.5 All grievances concerning the conduct of the Con-
tractor shall follow the grievance procedures set
forth in 20 CFR 627 . 500 et seq;
F. 6 It will comply with the Child Labor laws;
F.7 It will comply with the Safety Standards of Occupa-
tional Safety and Health Act (OSHA) ;
F. 8 It will comply with the Davis Bacon Act;
F. 9 It will comply with the Wagner-Peyser Act;
F. 10 It will comply with Part C of Title IV of the Social
Security Act ;
F. 11 It will comply with the Military Selective Services
Act ;
F.12 It will comply with Section 665 , Title 18 , United
States Codes ;
F.13 It will comply with the Fair Labor Standards Act of
1938 ;
F. 14 It will comply with the Colorado Revised Statutes
Section 18-8-301 C.R. S . , as amended (Bribery and
Corrupt Influence;
F.15 It will comply with Colorado Revised Statutes Sec-
tion 18-8-401-408 C.R.S . , as amended (Abuse of
Public Office) ; and
F.16 It will comply with PGL #93-02-AD1, Procurement
Policy, where appropriate .
weld.mas Page 19 of 27
940415
G. The Contractor assures that it will comply with bonding
and insurance requirements as follows :
G.1 The Contractor shall maintain JTPA funds in cash
depositories which have Federal Deposit Insurance
Corporation (FDIC) coverage. When the Contractor' s
account balance exceeds the FDIC maximum coverage on
deposits, JTPA funds shall be collaterally secured on
a daily basis .
G.2 Upon written request to the Contractor being made by
the State, the Contractor shall maintain during the
life of the Contract Bodily Injury and Property Damage
Insurance, acceptable to the State covering the
services hereunder and all operations in connection
herewith, and whenever any of the services covered in
the Contract is to be subcontracted, the Contractor
shall obtain insurance coverage acceptable to the
State, such as Contractor' s Contingent or Protective
Liability and Property Damage insurance to protect its
interest and those of the State, if any.
G. 3 Whenever the work covered by the Contract shall
involve the use of vehicular equipment, the Contractor
shall maintain during the life of the Contract,
Automotive Bodily Injury and Property Damage Insurance
for business use with limits not less than One Hundred
and Fifty Thousand Dollars ($150 , 000) personal
liability to any one person in any one accident, Four
Hundred Thousand Dollars ($400 , 000) for an injury to
two or more persons in any single occurrence, and Four
Hundred Thousand ($400 , 000) for property damage to
protect the Contractor from any and all claims arising
from the use of the following in the execution of the
services included in the Contract :
G. 3 . a Contractor ' s own vehicles;
G. 3 .b Hired vehicles ;
G. 3 . c Vehicles not owned by the Contractors ; and
weld.mas Page 20 of 27
940415
G. 3 . d The State shall not be in the policy as a named
insured.
G.4 Upon written request to the Contractor being made by
the State, the Contractor shall maintain during the
life of this Contract ; Physical Damage or Loss
Insurance protecting against loss caused by the perils
of fire, smoke, theft, burglary, vandalism, and storm
acceptable to the State, covering the services
hereunder and all operations, equipment and materials
furnished or used in connection therewith. The cash
bond in an amount to be determined by the State may be
given to meet this requirement as regards State
property.
G. 5 Excepting the Insurance required by Paragraph G. 2
above, one certified copy of the foregoing policies
and three copies of a certificate evidencing the
existence thereof shall be delivered to the State
within twenty (20) days of such written request being
made by the State . Certified copies of the policies
required by said Paragraph G.2 and three copies of the
certificate evidencing the existence thereof shall be
delivered to the State before use of vehicular
equipment is undertaken, as described in said Para-
graph G. 2 . Each copy and certificate must bear the
following special endorsement by the agent of the
proposed insurance carrier;
"This policy shall not be altered, materially changed
or canceled without giving 15 days prior written
notice, by certified mail , to GJTO. "
G. 6 A valid receipt showing payment or obligation for the
payment of the premium for all such insurance,
accepting the insurance required by said Paragraph
G.2 , shall be submitted to the State by the Contractor
when it provides the insurance documentation to the
State for acknowledgement of receipt and adequacy by
the proper State officials . Receipts showing payment
or obligation, for the payment of premium for the in-
surance required by said Paragraph G. 2 shall be
submitted to the State with the policies and cer-
weld.mas Page 21 of 27
940415
tificated to which the receipts refer before use of
the vehicular equipment involved is undertaken by the
Contractor.
H. The Contractor assures that it, and its subcontractors,
shall comply with the Workmen' s Compensation Act of
Colorado and shall provide compensation insurance to
protect the Contractor, its subcontractors and the
State from and against any and all Worker ' s Compensa-
tion claims arising from performance of services under
the Contract . The State shall be furnished, upon
request, one copy of the certificate or certificates
evidencing such insurance to be in effect .
I. The Contractor assures that prior to the initial
disbursement of funds to the Contractor it shall ensure
that every officer, director, agent, or employee
authorized to act on behalf of the Contractor in
receiving or depositing funds into program accounts; or
in issuing financial documents, checks, or other
instruments of payment for program costs shall obtain
a fidelity bond to provide protection against loss .
The coverage shall be equal to Twenty-five Percent
(25%) of the Contract amount received from GJTO.
If the fidelity bond of any employee of the Contractor
is canceled or coverage is substantially reduced, the
Contractor shall notify GJTO and GJTO shall not
disburse any funds thereafter until GJTO receives and
acknowledges assurance from the Contractor that
adequate insurance coverage has been obtained.
J. The Contractor assures that every reasonable course of
action will be taken by the Contractor to maintain the
integrity of this expenditure of public funds and to
avoid any favoritism or questionable or improper
conduct . The contract will be administered in an
impartial manner, free from personal financial , or
political gain. The Contractor, its executive staff
and employees, in administering this Contract, will
avoid situations which give rise to a suggestion that
any decision was influenced by prejudice, bias,
special interest , or personal gain.
Weld.mas Page 22 of 27
940415
K. The Contractor assures and certifies that it and its
principles :
K. 1 Are not presently debarred, suspended, proposed
for debarment, declared ineligible, or voluntarily
excluded from covered transactions by any federal
department or agency;
K.2 Have not, within a three-year period preceding
this Contract, been convicted of or had a civil
judgement rendered against them for commission of
fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a
public (federal, state or local) transaction or
contract under a public transaction; violation of
federal or state antitrust statutes or commission
of embezzlement, theft, forgery, bribery, falsi-
fication or destruction of records, making false
statements, or receiving stolen property;
K.3 Are not presently indicted for or otherwise crimi-
nally or civilly charged by a government entity
(federal, state or local) with commission of any
offenses enumerated in paragraph (K. 2) of this
certification; and
K.4 Have not within a three-year period preceding this
Contact, had one or more public transactions
(federal , state, or local) terminated for cause or
default .
Where the Contractor is unable to certify to any of
the statements in this certification, such Contractor
shall attach an explanation to this proposal .
L. The Contractor certifies that pursuant to the Drug Free
Work Place of 1988 , 45 CFR Part 76 , Subpart F, the
Contractor will provide a drug-free workplace .
M. The Contractor certifies that it will comply with 49
CFR, Part 20, and JTPA Letter #90-12, Lobbying Certifi-
cation.
weld.mas Page 23 of 27
5111,0111
N. To the extent authorized by law, the contractor shall
indemnify, save and hold harmless the State, its
employees and agents , against any and all claims,
damages , liability and court awards including costs,
expenses, and attorney fees incurred as a result of any
act or omission by the contractor, or its employees,
agents, subcontractors, or assignees pursuant to the
terms of this contract .
O. No funds available under this Act shall be used for
employment generating activities, economic development
activities, investment in revolving loan funds,
capitalization of businesses, investment in contract
bidding resource centers, and similar activities . No
funds under title II or III of this Act shall be used
for foreign travel . (JTPA, §141 (q) .
P. As a condition to the award of financial assistance
under JTPA from the Department of Labor, the grant
applicant assures, with respect to operation of the
JTPA-funded program or activity, and all agreements or
arrangements to carry out the JTPA-funded program or
activity, that it will comply fully with the nondis-
crimination and equal opportunity provisions of the Job
Training Partnership Act of 1982 , as amended (JTPA) ,
including the Nontraditional Employment for Women Act
of 1991 ; title VI of the Civil Rights Act of 1964 , as
amended; section 504 of the Rehabilitation Act of 1973 ,
as amended; the Age Discrimination Act of 1975 , as
amended; title IX of the Education Amendments of 1972 ,
as amended; The Americans with Disabilities Act , and
with all applicable requirements imposed by or pursuant
to regulations implementing those laws, including but
not limited to 29 CFR part 34 . The United States has
the right to seek judicial enforcement of this
assurance .
weld.mas Page 24 of 27
940415
Q. Contractors and subcontractors of GJTO, SDAs, the sub-
state grantees (SSG) and their subgrantees, contractors
and other subrecipients are expressly prohibited from
the exclusivity of patents, copyrights or trademarks on
material that has been developed with the use of
federal or state funds . Such material is considered by
GJTO to be in the public domain.
Weld.mas Page 25 of 27
940415
SPECIAL PROVISIONS
CONTROLLER'S APPROVAL
This contract shall not be deemed valid until it shall have been approved by the Controller of the State of Colorado or such assistant as he may designate.This
provision is applicable to any contract involving the payment of money by the Slate.
FUND AVAILABILITY
2. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated.budgeted.
and otherwise made available.
BOND REQUIREMENT
3. If this contract involves the payment of more than fifty thousand dollars for the construction,erection, repair. maintenance,or improvement of any building,
road, bridge,viaduct,tunnel,excavation or other public work for this State, the contractor shall,before entering upon the performance of any such work included
in this contract,duly execute and deliver to the State official who will sign the contract, a good and sufficient bond or other acceptable surety to be approved by
said official in a penal sum not less than one-half of the total amount payable by the terms of this contract.Such bond shall be duly executed by a qualified corporate
surety conditioned upon the faithful performance of the contract and in addition, shall provide that if the contractor or his subcontractors fail to duly pay for any
labor,materials,team hire.sustenance.provisions,provendor or other supplies used or consumed by such contractor or his subcontractor in performance of the work
contracted to be done or fails to pay any person who supplies rental machinery,tools,or equipment in the prosecution of the work the surety will pay the same in
an amount not exceeding the sum specified in the bond,together with interest at the rate of eight per cent per annum. Unless such bond is executed,delivered and
filed,no claim in favor of the contractor arising under such contract shall be audited,allowed or paid.A certified or cashier's check or a bank money order payable
to the Treasurer of the State of Colorado may be accepted in lieu of a bond.This provision is in compliance with CRS 38-26-106.
INDEMNIFICATION
4. To the extent authorized by law, the contractor shall indemnify, save, and hold harmless the State. its employees and agents, against any and all claims.
damages. liability and court awards including costs.expenses. and attorney fees incurred as a result of any act or omission by the contractor, or its employees.
agents. subcontractors,or assignees pursuant to the terms of this contract.
DISCRIMINATION AND AFFIRMATIVE ACTION
5. The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957, as amended. and other applicable law respecting
discrimination and unfair employment practices (CRS 24-34-4021, and as required by Executive Order, Equal Opportunity and Affirmative Action,dated April 16.
1975.Pursuant thereto,the following provisions shall he contained in all State contracts or sub-contracts
During the performance of this contract,the contractor agrees as follows:
(a) The contractor will not discriminate against any employee or applicant for employment because of race, creed, color, national origin, sex,
marital status. religion,ancestry,mental or physical handicap,or age.The contractor will take affirmative action to insure that applicants are employed,and that
employees are treated during employment. without regard to the above mentioned characteristics. Such action shall include, but not be limited to the following:
employment upgrading.demotion.or transfer,recruitment or recruitment advertisings: lay-offs or terminations: rates of pay or other forms of compensation: and
selection for training, including apprenticeship.The contractor agrees to post in conspicuous places.available to employees and applicants for employment,
notices to be provided by the contracting officer setting fonh provisions of this non-discrimination clause.
(bl The contractor will. in all solicitations or advertisements for employees placed by or on behalf of the contractor. state that all qualified applicants will
receive consideration for employment without regard to race.creed,color.national origin,sex.marital status.religion,ancestry,mental or physical handicap,
or age.
c) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or
understanding,notice to be provided by the contracting officer,advising the labor union or workers' representative of the contractor's commitment under the
Executive Order.Equal Opportunity and Affirmative Action.dated April 16. 1975.and of the rules.regulations.and relevant Orders of the Governor.
(d)The contractor and labor unions will furnish all information and reports required by Executive Order.Equal Opportunity and Affirmative Action of April
16, 1975, and by the rules, regulations and Orders of the Governor, or pursuant thereto, and will permit access to his books, records. and accounts by the
contracting agency and the office of the Governor or his designee for purposes of investigation to ascertain compliance with such rules.regulations and orders.
(e)A labor organization will not exclude any individual otherwise qualified from full membership rights in such labor organization.or expel any such individual
from membership in such labor organization or discriminate against any of its members in the full enjoyment of work opportunity because of race,creed,color.
sex.national origin,or ancestry.
If) A labor organization.or the employees or members thereof will not aid, abet, incite, compel or coerce the doing of any act defined in this contract to be
discriminatory or obstruct or prevent any person from complying with the provisions of this contract or any order issued thereunder:or attempt.either directly
or indirectly.to commit any act defined in this contract to be discriminatory.
Form 6-AC-02B
Revised 1/93
395-53-01-1022
page 26 of pages
940415
In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such rules,regulations, or orders,
this contract may be canceled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further State contracts in
accordance with procedures, authorized in Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975 and the rules, regulations, or
orders promulgated in accordance therewith,and such other sanctions as may be imposed and remedies as may be invoked as provided in Executive Order,
Equal Opportunity and Affirmative Action of April 16, 1975. or by rules, regulations, or orders promulgated in accordance therewith, or as otherwise
provided by law.
(h)The contractor will include the provisions of paragraphs (a) through (h) in every sub-contract and subcontractor purchase order unless exempted by
rules,regulations,or orders issued pursuant to Executive Order,Equal Opportunity and Affirmative Action of April 16, 1975,so that such provisions will
be binding upon each subcontractor or vendor.The contractor will take such action with respect to any sub-contracting or purchase order as the contracting
agency may direct,as a means of enforcing such provisions, including sanctions for non-compliance; provided,however,that in the event the contractor
becomes involved in,or is threatened with,litigation,with the subcontractor or vendor as a result of such direction by the contracting agency,the contractor
may request the State of Colorado to enter into such litigation to protect the interest of the State of Colorado.
COLORADO LABOR PREFERENCE
6a.Provisions of CRS 8-17-101 & 102 for preference of Colorado labor are applicable to this contract if public works within the State are undertaken hereunder and
are financed in whole or in part by State funds.
b.When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference against a non-resident bidder from
a state or foreign country equal to the preference given or required by the state or foreign country in which the non-resident bidder is a resident.If it is determined by
the officerresponsible for awarding the bid that compliance with this subsection.06 may cause denial of federal funds which wduld otherwise be available or would
otherwise be inconsistent with requirements of Federal law, this subsection shall be suspended,but only to the extent necessary to prevent dental of the moneys or to
eliminate the inconsistency with Federal requirements(CRS 8-19-101 and 102)
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation. execution, and enforcement of this
contract.Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra-judicial body or person or which
is otherwise in conflict with said laws. rules,and regulations shall be considered null and void. Nothing contained in any provision incorporated herein by reference
which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint,
defence,or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the es tent that the
contract is capable of execution.
8. At all times during the performance of this contract,the Contractor shall strictly adhere to all applicable federal and state laws, rules, and regulations that have
been or may hereafter he established.
9. The signatories aver that they are familiar with CRS 18-8-301,et. seq., (Bribery and Corrupt Influences)and CRS 18-8-401, et. seq., (Abuse of Public Office).
and that no violation of such provisions is present.
10.The signatories aver that to their knowledge, no state employee has any personal or beneficial interest whatsoever In the service or propeny described herein
IN WITNESS WHEREOF,the parties hereto have executed this Contract on the day first above written.
Contractor. Weld County
tr-ull Legal Name) Weld County Board of
STATE OF COLORADO
County Commissioners ROY ROMER, GOVERNOR
ft y•
Po.itmn r-nnu 05/11/94 •s FxECurrvuolReCTUN
Chairman Leslie S. Franklin
84-6000813
S,wiu ty,Number or F cral10 !TIN,
If Corporation I DEPARTMENT
OF
Attest)Seal) a44; Governor's Job Training Office
XX3FXXXX XXICXXXXXXKip1�X/Cttanb sleek to Board
APPROVALS
ATTORNEY GENERAL
CONTROLLER
By
By
•
Form 6-AC-02C
Revised 1193 Page _2..I which is the last of22_ pages
395-53-01-1030 •See instructions on reverse side,
940415
Substitute Fonn RE JEST FOR TAXPAYER IDENTIK ATION ColoradoDcpaasmentuf Adminigration
W-9 NUMBER(TIN) VERIFICATION Do NOT send to IRS
PRINT OR TYPE RETURN TO ADDRESS BELOW
Legal Name
Weld County, Colorado
DO NOT ENTER THE BUSINESS NAME OF A SOLE PROPRIEtOHSHIP ON 1105 UNE-Sam Re ene far Important Infornudon
Trade Name
COMPLETE ONLY IF DOING BUSINESS AS(D/BM)
Primary Address 915 10th Street
City,State,Zip, Greeley, CO 80631
RemitAddress-Optional P.O. Box 758
City,State,Zip, Greeley, CO 80632
Order Address -Optional
City,State,Zip,
Check legal entity type and enter 9 digit Taxpayer Id umber Z}`below:
(SSN=Social Security Number FEIN=Federal Emplo t Nttm `.`
Individual / t idual N) - -
NOTE:If m name is circled en a lam Accountwhen Mee more tonthe la -- -- ----
$ole'Proprietorship(Owner's u}e \ x) —
Partnership O General r'Lifnued (Patine stup'5 FEle } —
Estate/Trust ) ' .° .i (Legal Entity's FEI}�4Lr
NOTE Do not Noma the identification amber of TM palm'romuentauxc or mate unless the kgal aims tar u not deugwtd in the
man= e nMk.List andk dt name of pMHO nut Hakey,or pedimrua . r'� —
1 ,
Other Groups of Individuals • ' (En)rty'S1P- N) i _
(GmiedLiability Company.douu Vemve: Clu
Corporation Do you provide medical'e,rvices9 ayes- ea' (Corpels TIN) t;" -
(Includes munition NA'PGng mldaat SRNs tiriofal .�«.� .2
Government(or Gov OperatedPEnttty -` `' I` _(E Uty's FEIN)! 8 4 — 6 0 0 0 8 1 3
Organization Exempt from Tax uncle[Section 5Q1(a),sr. . a (Org$EIN) —
Do you provide medical service3't,,❑Yd'sru Nth; 'L. r. -=
Check Here if you do not have a SSN or FEIN,but hive-applied-for one. See reverse for information on How to Obtain A TIN
Licensed Real Estate Broker? ❑Yes ❑No
Under Penalties of perjury,I cenify that:
(I) The number listed on this form is my correct Taxpayer Identification Number(or 1 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(b)I have not ben 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(IPA).and payments other than interest and dividends).
CERTIFICATION INSTRUCTIONS-You must cross out item(2)above if you have been notified by the IRS that you arc currently subject to backup withholding be-
cause or under reponing interest or dividends on your tax return.(See Signing the Certification on the teverse of this form.) Chairman, Weld County
NAME(Prinl or Type) W. H. Webster 'TITLE(Print or Type) Board of Commissioners
AUTHORIZED SIGNATURE / lel.' DATE 05/09/94 PHONE( 303 ) 356-4000 x422`
DO NOT WRITE BELOW THIS LINE
AGENCY USE ONLY
Agency _r—' Approval By Date
1099 Y N
VEND Addition Change_ Action Completed By Date 940415
395-53-07.6066(R I I/92)
NAME AND TAX IDENTIFICATION NIJMBEtt(IlN) •«• ; '
INDJVICSUAI S `Enter First and last name EXACTLY as it appears on your Socha!Security Card.However,if you have changed your
last name;Tor instance,_due to'marriage,without informing the Social Security-Administration of the name change,please enter your
first nathe and both the last name shown on your social security card and your new last name(IN THAT ORDER).For your TIN,enter
your Social Sentdty Number(SSN).
•
SOLE PROPRIETORSHIPS: Enter the individuals name on the first line;on the second name line you may enter the business name.
YOU MAY NOT ENTER ONLY THE BUSINFS.S NAME. For the TIN,enter either the Social Sentrity Number or the Federal
Employer Tax Identification Number(FEIN).
ALL OTHER ENTITY'S: Enter the name exactly as originally registered with the IRS.The correct TIN is the Federal Employer Iden-
tification Number(FEIN).
HOW TO OBTAIN A TIN
If you do not have a TIN,you should apply for one immediately.To apply for the number,obtain Form SS-05,Application for a Social
Srrurity Number Card(for individuals).or Form SS-4,Application of Employer Identification Number(for businesses and all other en-
tities),at your local office of the Social Security Administration or the Internal Revenue Service.Complete and file the appropriate
• form according to its instructions.
To complete Form W-9 if you do not have a TIN,check"Applied For"box-in the space indicated on the front,-sign and date the form,
and give it to the requester. For payments that could be subject to backup withholding,you will then have 60 days to obtain a TIN and
furnish it to the requester.During the 60-day period,the payments you receive will not be subject to the 20%backup withholding,un-
less you make a withdrawal.However f the requester does not receive your TIN from you within 60 days,backup withholding,if ap-
plicable,will begin and continue until you furnish your TIN to the requester.
Note: Writing "Applied For"on the form means that you have already applied for a TIN OR that you intend to apply for one in the
near future.
Assoon as you receive your TIN,complete another Form W-9, include your new TIN,sign and date the form,and give it to the re-
quester. -
SIGNING 1 HE.CERTIFICATION
(1) Interest,Dividend,and Barter Exchange Accounts Opened Before 1984 and Broker Accounts That Were Considered Active
During 1983. -You are not required to sign the certification;however, you may do so.You are required to provide your correct TIN.
(2) Interest,Dividend,Broker and Barter Exchange Accounts Opened After 1983 and Broker Accounts That Were Considered
Inactive During 1983. -You must sign the certification or backup withholding will apply. If you are subject to backup withholding
and you are merely providing your correct TIN to the requester, you must cross out item (2) in the certification before signing the form.
(3) Real Estate Transactions-You must sign the certification. You may cross out time(2)of the certification if you wish.
(4) Other Payments-You arc required to furnish your correct TIN,but you are not required to sign the certification unless you have
been notified of an incorrect TIN.Other payments include payments made in the course of the requester's trade or business for rents,
royalties,goods(other than bills for merchandise),medical and health care services, payments to a nonemployec for services(includ-
ing attorney and accounting fees), and payments to certain fishing boat crew members.
(5) Mortgage Interest Paid by You,Acquisition or Abandonment of secured Property,or IRA Contributions.-You are required
to furnish your correct TIN,but you arc not required to sign the exnificttion.
(6) Exempt Payees and Payments.- If you are exempt from backup withholding, you should complete this form to avoid possible er-
roneous backup withholding. Enter your correct TIN in LEGAL BUSINESS DESIGNATION section,and write"EXEMPT'above
your signature,sign and date the form. If you are a nonresident alien or foreign entity not subject to backup withholding,give the re-
quester a completed Form W-8, Certificate of Foreign Status.
OTHER
Signature.-The signature should be an authorized signature,generally the persons whose name is on the top line of the form,a
partner in the partnership,or an officer of the corporation.For a joint account, only the person whose TIN is shown in LEGAL BUSI-
NESS DESIGNATION should sign the form.
Privacy Act Notice.-Section 6109 requires you to furnish your correct taxpayer identification number(TIN)to persons who must file
information returns with IRS to report interest,dividends,and certain other income paid to you,mortgage interest you paid,the acquisi-
tion or abandonment of centred property,or contributions you made to an individual retirement arrangement(IRA). IRS uses the num-
bers for identification put penes and to help verify the accuracy of your tax return.You must provide you TIN whether or not you arc
required to file a tax return. Payers must generally withhold 20%of taxable interest,dividend,and certain other payments too payee
who does not furnish a TIN to a payer.Certain penalties may also apply. 94U415
.0 mEmoRAnDum
Weld County Board of Commissioners
T.W.H. Webster, Chairman Date May 9, 1994
COLORADO From Walter J. Speckman, Human Resources Executive Director / / /401—
subject: Title IIA Master Contract
Enclosed for Board approval is the Master Contract between the Governor's Job
Training Office and the Weld County Division of Human Resources, through the
Board of Weld County Commissioners, to enable Weld County to operate various
programs and expend funds under the Job Training Partnership Act.
The Contract covers the period of July 1, 1994, through June 30, 1997. The
Contract covers various procedures, rules, and regulations for administration of
the programs.
If you have any questions, please telephone me at 353-3816.
940415
Hello