HomeMy WebLinkAbout981163.tiff rs
;.DEPARTMENT OF PLANNING SERVICES
PHONE (303) 353-6100, EXT.3540
C. FAX ADMINISTRATIVE(303) 351-09 S
WELD COUNTY OFFICES
1400 N. 17TH AVENUE
GREELEY, COLORADO 80631
COLORADO
May 29, 1998
Monica Daniels-Mika
Director
Weld County Planning Services
1400 N 17th Avenue
Greeley, Co 80634
(970) 353-6100 Ext 3540
(970) 352-6312
USDA/RD
Attn : C&BP
655 Parfet Street, Rm E
Lakewood, Co 80215
RE: Intergovernmental Review Milliken Water Tank and Pipeline
The Board of County Commissioners reviewed the attached water tank and pipeline proposal for
the Town of Milliken. The Board finds that this application is located within the Town of Milliken's
municipal b sed on the information submitted this proposal will not adversely
influen weld county.
Should you have any questions concerning this review, I may be reached at the above address
and telephone.
Sincerely,
Mo ca Daniels-Mika, AICP
Director
milliken
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May 14, 1998
Board of Commissioners
Weld County
915 10th Street
Greeley, CO 80631
RE: Intergovernmental Review: Milliken Water Tank and Pipeline
Dear Commissioners,
The Town of Milliken is applying for a loan/grant with the USDA Rural Development. As part of their
regulations Rural Development is required, per Executive Order 12372, "Intergovernmental Review
of Federal Programs", to have proof that applicable federal, state, and local units of government
have been notified of the proposed financial assistance and direct development activities. Along
with this notification, we solicit your comments as they pertain to the proposed project. Your
comments will be greatly appreciated and will be considered prior to Rural Development making a
final decision on the proposal.
This process takes the place of the "Single Point of Contact" for the inter-governmental review of
federal programs which was administered by the Colorado Department of Local Affairs. Their
process was discontinued on June 1, 1995.
Enclosed please find a copy of SF 424.2 "Application for Federal Assistance", submitted by the
Town of Milliken. We respectfully request that you notify us concerning this project with your
comments by June 1st, and send a copy of the comments to USDA/RD, Attn.: C&BP, 655 Parfet
Street, Rm E126, Lakewood, CO 80215.
Should you have any questions, please call me at 587-4331.
We thank you for your prompt review of our application and your submittal of any comments you
may have.
Sincerely,
Gina C. Janett
Water Utilities Manager
Enc: SF 424.2
OMB Approval No.0348-0043
APPLICATION FOR t.DATE SUBMITTED Applicant Identifier
FEDERAL ASSISTANCE Mak 19/ I94
I. TYPE OF SUBMISSION: 3.DATE RECEIVED BY STATE State Application Identifier
Application Preapplicarson
1O Construction 51 Construction
A.DATE RECEIVED BY FEDERAL AGENCY Federal Identifier
❑ Non-Construction ❑ Non-Construction
S. APPLICANT INFORMATION
Legal Name Organizational Unit: Muni Municipality
1 t
Town of Milliken P y
Address(give city, county, state. and rip code): Name and telephone number of the person to be contacted on matters involving
this application (give area code)
P .O. Box 290 Gina C. Janett, Water Utilities Manager
Milliken, CO 80543 (970) 587-4331
(970) 587-2678 FAX
Weld County
a. EMPLOYER IDENTIFICATION NUMBER(EIN): 7. TYPE OF APPLICANT:(enter appropriate letter in box) 1.:17
A. State H. Independent School Dist.
8 4 6 0 0 0 6 9 6 B County I. State Controlled Institution of Higher Learning
C. Municipal J. Private University
I. TYPE OF APPLICATION: D. Township K. Indian Tribe
(2I New O Continuation O Revision E. Interstate L. Individual
F Intermunicipal M Profit Organization i
It Revision,enter appropriate letter(s)in box(es): ❑ ❑ G.Special District N.Other(Speedy):
A Increase Award B. Decrease Award C. Increase Duration
D. Decrease Duration Other(specify): 9. NAME OF FEDERAL AGENCY:
Rural Development, Dept. of Agriculture
la. CATALOG OF FEDERAL DOMESTIC 1 0 ■ 7 6 0 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:
ASSISTANCE NUMBER:
Milliken Water Storage Tank
TITLE:
Rural Utilities Service Loan or Grant
12. AREAS AFFECTED BY PROJECT(cities, counties,states, etc.):
Milliken, Colorado
13. PROPOSED PROJECT: IA. CONGRESSIONAL DISTRICTS OF:
Start Date Ending Date a Applicant b. Protect
10/1/98 5/1/99 4th District, Bob Schaffer 4th District, Bob Schaffer
19.ESTIMATED FUNDING: 19.IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS,
a Federal f ,00 a. YES. THIS PREAPPLICATIONIAPPLICATION WAS MADE AVAILABLE TO THE
1,244,400 STATE EXECUTIVE ORDER 12372
PROCESS FOR REVIEW ON
b Applicant f .00 DATEPCLOa. 19, f q Q8
c State applica.s i ca.f 300,000 .00 b NO. O PROGRAM IS NOT COVERED BY E.O. 12372
pending
d Local f .00 0
OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW
e Other f .00
t Program Income f .00 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT,
Yes If "Yes.'attach an explanation. ® No
g TOTAL $ .00
1,544,400
is TO THE BEST OF MY KNOWLEDGE AND BELIEF.ALL DATA IN THIS APPLICATION.PREAPPLICATION ARE TRUE AND CORRECT,THE DOCUMENT HAS BEEN DULY
AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED
a Typed Name of Authorized Representative b Title c Telephone number
Ted J. Chavez Mayor (970)587-4331
d Signature of Authorized -.• sent we e Date Signed
/ wl I9, 1,O11
...-
Previous Editions Notr sle Siandard Form 424 (REV 4.881
PrescnDed by OMB Grcuiar A•102
Authorized for Local Reproduction 9s1103
INSTRUCTIONS FOR THE SF 424
This is a standard form used by applicants as a required facesheet for preapplications and applications submitted
for Federal assistance. It will be used by Federal agencies to obtain applicant certification that States which have
established a review and comment procedure in response to Executive Order 12372 and have selected the program
to be included in their process,have been given an opportunity to review the applicant's submission.
Item: Entry; Item: Entry:
1. Self-explanatory. 12. List only the largest political entities affected
2. Date application submitted to Federal agency(or (e.g.,State,counties,cities).
State if applicable) & applicant's control number
(if applicable). 13. Self-explanatory.
3. State use only(if applicable). 14. List the applicant's Congressional District and
4. If this application is to continue or revise an any District(s)affected by the program or project.
existing award, enter present Federal identifier
number. If for a new project, leave blank. 15. Amount requested or to be contributed during
5. Legal name of applicant, name of rimer the first funding/budget period by each
primary contributor. Value of in-kind contributions
organizational unit which will undertake the should be included on appropriate lines as
assistance activity, complete address of the applicable. If the action will result in a dollar
applicant,and name and telephone number of the change to an existing award, indicate only the
person to contact on matters related to this amount of the change. For decreases, enclose the
application. amounts in parentheses. If both basic and
6. Enter Employer Identification Number (EIN) as supplemental amounts are included, show
breakdown on an attached sheet. For multiple
assigned by the Internal Revenue Service.
program funding, use totals and show breakdown
7. Enter the appropriate letter in the space using same categories as item 15.
provided.
16. Applicants should contact the State Single Point
8. Check appropriate box and enter appropriate
letter(s)in the space(s)provided: of Contact (SPOC) for Federal Executive Order
12372 to determine whether the application is
—"New"means a new assistance award. subject to the State intergovernmental review
—"Continuation"means an extension for an process.
additional funding/budget period for a project
with a projected completion date. 17. This question applies to the applicant organi-
-"Revision"means any change in the Federal zation, not the person who signs as the
Government's financial obligation or authorized representative. Categories of debt
contingent liability from an existing include delinquent audit disallowances, loans
obligation. and taxes.
9. Name of Federal agency from which assistance is
18. To be signed by the authorized representative of
being requested with this application.
the applicant. A copy of the governing body's
10. Use the Catalog of Federal Domestic Assistance
number and title of the program under which authorization for you representativet sign s this application as
official must be on file in the
assistance is requested. applicant's office. (Certain Federal agencies may
11. Enter a brief descriptive title of the project. if require that this authorization be submitted as
more than one program is involved, you should part of the application.)
append an explanation on a separate sheet. If
appropriate (e.g., construction or real property
projects), attach a map showing project location.
For preapplications, use a separate sheet to
provide a summary description of this project.
SF 424 (REV 4-88) Back
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INSTRUCTIONS FOR THE SF-424C
This sheet is to be used for the following types of applications: (1) "New"(means a new[previously unfunded)
assistance award); (2) "Continuation" (means funding in a succeeding budget period which .,temmed from a
prior agreement to fund); and (3) "Revised" (means any changes in the Federal government's financial
obligations or contingent liability from an existing obligation). If there is no change in the award amount
there is no need to complete this form. Certain Federal agencies may require only an explanatory letter to
effect minor(no cost)changes. If you have questions please contact the Federal agency.
Column a. — If this is an application for a "New" Line 4 — Enter estimated basic engineering fees
project, enter the total estimated cost of each of the related to construction (this includes start-up
items listed on lines 1 through 16 (as applicable) services and preparation of project performance
under"COST CLASSIFICATIONS." work plan).
If this application entails a change to an existing Line 5— Enter estimated engineering costs, such as
award, enter the eligible amounts approved under surveys,tests,soil borings,etc.
the previous award for the items under "COST Line 6 — Enter estimated engineering inspection
CLASSIFICATION." gi g p
costs.
Column b. —If this is an application for a "New" •
project,enter that portion of the cost of each item in Line 7 — Enter estimated costs of site preparation
Column a. which is not allowable for Federal assis- and restoration which are not included in the basic
tance. Contact the Federal agency for assistance in construction contract.
determining the allowability of specific costs. Line 9 — Enter estimated cost of the construction
If this application entails a change to an existing contract.
award, enter the adjustment [+ or (-II to the Line 10 — Enter estimated cost of office, shop,
previously approved costs(from column a.) reflected laboratory, safety equipment, etc. to be used at the
in this application. facility, if such costs are not included in the
Column c. —This is the net of lines 1 through 16 in construction contract.
columns"a."and"b." Line 11 —Enter estimated miscellaneous costs.
Line 12—Total of items 1 though 11.
Line 13 — Enter estimated contingency costs.
Line 1 — Enter estimated amounts needed to cover (Consult the Federal agency for the percentage of the
administrative expenses. Do not include costs which estimated construction cost to use.)
are related to the normal functions of government.
Allowable legal costs are generally only those Line 14—Enter the total of lines 12 and 13.
associated with the purchase of land which is Line 15 — Enter estimated program income to be
allowable for Federal participation and certain earned during the grant period, e.g., salvaged
services in support of construction of the project. materials,etc.
Line 2 — Enter estimated site and right(s)-of-way Line 16—Subtract line 15 from line 14.
acquisition costs (this includes purchase, lease,
and/or easements). Item 17 — This block is for the computation of the
Federal share. Multiply the total allowable project
Line 3—Enter estimated costs related to relocation costs from line 16, column "c." by the Federal
advisory assistance, replacement housing, percentage share (this may be up to 100 percent;
relocation payments to displaced persons and consult Federal agency for Federal percentage
businesses,etc. share)and enter the product on line 17.
SF 424C (4-88) Back
q$ Il(o1)
11. Will comply, or has already complied, with the Environmental Policy Act of 1969 (P.L. 91-190)
requirements of Titles II and III of the Uniform and Executive Order (EO) 11514; (b) notification
Relocation Assistance and Real Property of violating facilities pursuant to EO 11738; (c)
Acquisition Policies Act of 1970 (P.L. 91-646) protection of wetlands pursuant to EO 11990; (d)
which provides for fair and equitable treatment evaluation of flood hazards in floodplains in
of persons displaced or whose property is accordance with EO 11988; (e) assurance of
acquired as a result of Federal and federally project consistency with the approved State
assisted programs. These requirements apply to management program developed under the
all interests in real property acquired for project Coastal Zone Management Act of 1972(16 U.S.C.
purposes regardless of Federal participation in $$ 1451 et seq.); (f) conformity of Federal actions
purchases. to State (Clean Air) Implementation Plans under
Section 176(c) of the Clean Air Act of 1955, as
12. Will comply with the provisions of the Hatch Act
amended(42 U.S.C. $ 7401 et seq.); (g) protection
(5 U.S.C. If 1501-1508 and 7324-7328) whicho
limit the political activities of employees whose the Safe Drinking n of eri Act of 1974,4 as
principal employment activities are funded in Safe Water Act ion as
whole or inpart with Federal funds. amended, (P.L. 93-523); and (h) protection of
endangered species under the Endangered
13. Will comply, as applicable, with the provisions of Species Act of 1973,as amended,(P.L. 93-205).
the Davis-Bacon Act(40 U.S.C. $$ 276a to 276a- 16. Will comply with the Wild and Scenic Rivers Act
7), the Copeland Act (40 U.S.C. $ 276c and 18 of 1968 (16 U.S.C. $$ 1271 et seq.) related to
U.S.C. $ 874), the Contract Work Hours and protecting components or potential components
Safety Standards Act (40 U.S. $$ 327-333) of the national wild and scenic rivers system.
regarding labor standards for federally assisted
construction subagreements. 17. Will assist the awarding agency in assuring
14. Will comply with flood insurance purchase compliance with Section 106 of the National
requirements the Section ) of the Flooe Historic Preservation Act of 1966, as amended
(16 U.S.C. 470), EO 11593 (identification and
Disaster Protection Act of 1973 (P.L. 93-234)
which requires recipients in a special flood Arpreservation of historic properties), and the
hazard area to participate in the program and to 1974(16 16lU.S.Cal and -H1 et seq.).
c Preservation Act of
purchase flood insurance if the total cost of 1974 U.S.C. 469a-1 et
insurable construction and acquisition is $10,000 18. Will cause to be performed the required financial
or more. and compliance audits in accordance with the
Single Audit Act of 1984.
15. Will comply with environmental standards
which may be prescribed pursuant to the 19. Will comply with all applicable requirements of
following: (a) institution of environmental all other Federal laws, Executive Orders,
quality control measures under the National regulations and policies governing this program.
Environmental Policy Act of 1969 (P.L. 91-190)
and Executive Order(EO) 11514;(b)
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
Mayor
APPLICANT OR ANIZATION DATE SUBMITTED
Town of Milliken 41 /9 1998
P.O. Box 290, Milliken, CO 80543 (/ t
-U.S.GowrnnntPriningOMd: 1995-86&03020019 SF 4240 (4 88) Back
987163
OMB Approved NO.0348-0042
ASSURANCES - CONSTRUCTION PROGRAMS
Note: Certain of these assurances may not be applicable to your project or program, If you have quJstions,
please contact the Awarding Agency. Further,certain federal assistance awarding agencies may require
applicants to certify to additional assurances. If such is the case,you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal 8. Will comply with the Intergovernmental
assistance, and the institutional, managerial and Personnel Act of 1970 (42 U.S.C. §§ 4728-4763)
financial capability (including funds sufficient to relating to prescribed standards for merit systems
pay the non-Federal share of project costs) to for programs funded under one of the nineteen
ensure proper planning, management and statutes or regulations specified in Appendix A of
completion of the project described in this OPM's Standards for a Merit System of Personnel
application. Administration(5 C.F.R. 900, Subpart F).
2. Will give the awarding agency, the Comptroller 9. Will comply with the Lead-Based Paint Poisoning
General of the United States, and if appropriate, Prevention Act (42 U.S.C. §§ 4801 et seq.) which
the State, through any authorized representative, prohibits the use of lead based paint in
access to and the right to examine all records, construction or rehabilitation of residence
books, papers, or documents related to the structures.
assistance; and will establish a proper accounting
10. Will comply with all Federal statues relating to
system in accordance with generally accepted
non-discrimination. These include but are not
accounting standards or agency directives.
limited to: (a) Title VI of the Civil Rights Act of
3. Will not dispose of, modify the use of, or change 1964 (P.L. 88-352) which prohibits discrimination
the terms of the real property title, or other on the basis of race, color or national origin; (b)
interest in the site and facilities without Title IX of the Education Amendments of 1972, as
permission and instructions from the awarding amended (20 U.S.C. §§ 1681-1683, and 1685-
agency. Will record the Federal interest in the 1686) which prohibits discrimination on the basis
title of real property in accordance with awarding of sex; (c) Section 504 of the Rehabilitation Act of
agency directives and will include a covenant in 1973, as amended (29 U.S.C. § 794) which prohibit
the title of real property acquired in whole or in discrimination of the basis of handicaps; (d) the
part with Federal assistance funds to assure Age Discrimination Act of 1975, as amended (42
nondiscrimination during the useful life of the U.S.C. §§ 6101-6107) which prohibits discrimi-
project. nation on the basis of age; (e) the Drug Abuse
4. Will comply with the requirements of the Office and Treatment Act of 1972 (P.L. 93-255), as
assistance awarding agency with regard to the amended, relating to non-discrimination eon
n the
drafting, review and approy of construction basis of drug abuse; (f) the Comprehensive
plans and specifications. Alcohol Abu_ nd Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (P.L.
5. Will provide and maintain competent and 91-616), as amended, relating to nondiscrimi-
adequate engineering supervision at the nation on the basis of alcohol abuse or alcoholism;
construction site to ensure that the complete work (g) §§ 523 and 527 of the Public Health Service
conforms with the approved plans and specifica- Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as
tions and will furnish progress reports and such amended, relating to confidentiality of alcohol and
other information as may be required by the drug abuse patient records; (h) Title VIII of the
assistance awarding agency or State. Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.),
6. Will initiate and complete the work within the as amended, relating to non-discrimination in the
applicable time frame after receipt of approval of sale, rental or financing of housing; (i) any other
non-discrimination provisions in the specific
the awarding agency. '
statute(s) under which application for Federal
7. Will establish safeguards to prohibit employees assistance is being made, and U) the requirements
from using their positions for a purpose that on any other non-discrimination Statute(s) which
constitutes or presents the appearance of personal may apply to the application.
or organizational conflict of interest, or personal
gain.
Standard Form 424D 14.881
Prescribed by OMB Circular A-102
Authorized for Local Reproduction
9g/163
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