HomeMy WebLinkAbout20241624.tiffRESOLUTION
RE: APPROVE AMENDMENT #1 TO CONTRACT FOR CHILDREN, YOUTH, FAMILY
SERVICES GRANTS, AND AUTHORIZE CHAIR 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 Amendment #1 to the Contract for
Children, Youth, Family Services Grants between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Department of
Human Services, and the Colorado Department of Human Services, Behavioral Health
Administration, commencing August 31, 2023, and ending June 30, 2025, with further terms and
conditions being as stated in said amendment, and
WHEREAS, after review, the Board deems it advisable to approve said amendment, 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 Amendment #1 to the Contract for Children, Youth, Family Services
Grants between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, and the
Colorado Department of Human Services, Behavioral Health Administration, be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 19th day of June, A.D., 2024, nunc pro tunc August 31, 2023.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY
ATTEST: d.icticio 4e _ �v:vi
Weld County Clerk to the Board
BY: . lkia/t4()
Deputy Clerk to the Board
APP
County t orney
Date of signature:
zu/z4,
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Lori Sai
cc. %-ISTD, AcT(cP/co)
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2024-1624
HR0096
Cohiva t NA. S2lo o
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: Colorado Department of Human Services (CDHS) Behavioral Health Administration 1281
Grant Contract Amendment #1
DEPARTMENT: Human Services DATE: June 4, 2024
PERSON REQUESTING: Jamie Ulrich, Director, Human Services
Brief description of the problem/issue: In 2023 the Department was awarded the Behavioral Health
Administration 1281 Grant by the Colorado Department of Human Services (CDHS) and entered into a contract
to receive this funding, known to the Board as Tyler# 2023-2546. The purpose of this Contract is to
establish/expand services to address local behavioral health care needs along continuum of care, including
services for Children, Youth, and Family with severe needs.
Amendment #1 will renew the Agreement for FY25. This Amendment revises the FY24 budget to $256,570.83
and adds $470,085.09 in new funding for FY25. Additionally, this Amendment updates Exhibit B, Exhibit C,
Exhibit E, and Exhibit F.
What options exist for the Board?
Approval of the Colorado Department of Human Services (CDHS) Behavioral Health Administration
1281 Grant Contract Amendment #1.
Deny approval of the Colorado Department of Human Services (CDHS) Behavioral Health
Administration 1281 Grant Contract Amendment #1.
Consequences: WCDHS will not have a current contract with CDHS
Impacts: WCDHS will not receive the additional funding and will not be able to provide services to
address local behavioral health care needs.
Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years):
Total award = Fiscal Year 2024 = $256,570.83
Fiscal Year 2025 = $470,085.09
Total = $726,655.92
Funded through Colorado Department of Human Services Behavioral Health Administration
Pass -Around Memorandum; June 4, 2024 - CMS ID 8266
2024-1624
f A `
I 069
Recommendation:
• Approval of Amendment #1 and authorize the Chair to sign electronically.
Support Recommendation Schedule
Place on BOCC Agenda Work Session Other/Comments:
Perry L. Buck, Pro-Tem
Mike Freeman
Scott K. James
Kevin D. Ross, Chair r V�
Lori Seine
Pass -Around Memorandum; June 4, 2024 - CMS ID 8286
DocuSign Envelope ID: EA06320C-98EC-42AE-BB8A-D6095AC98377
CONTRACT AMENDMENT #1
SIGNATURE AND COVER PAGE
State Agency
Colorado Department of Human Set -vices
Behavioral Health Administration
Original Contract Number
24 IBEH 182001
Contractor
Weld County Department of Human Services
Amendment Contract Number
25 IBEH 189725
Current Contract Maximum Amount
Initial Term
State Fiscal Year 2024 $256,570.83
Extension Terms
State Fiscal Year 2025 $470,085.09
Total for All State Fiscal Years $726,655.92
Contract Performance Beginning Date
August 31, 2023
Current Contract Expiration Date
June 30, 2025
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment
and to bind the Party authorizing his or her signature.
CONTRACTOR
Weld County Department of Human Services
DocuSigned by:
kuun, V. rbss
DgFDF IF F...
By: Kevin D. Ross, Cria>r o tie bard of County
Date:
Commissioners
6/19/2024
STATE OF COLORADO
Jared Polis, Governor
Colorado Department of Human Services
Michelle Barnes, Executive Director
DocuSigned by:
Vatioultt, r. smlg.
G8461F337Ga8ve
By: Dannette R. Smith, Commiss>oner, 3ehavioral Health
Administration
Date:
6/20/2024
In accordance with §24-30-202 C.R.S., this Amendment is not valid until signed and dated below by the State Controller or an
authorized delegate.
By:
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
DocuSigned by:
*nowt: lealicbrovIOry
LH U bI�J Ib
Toni Williamson / Tetiy tieioni'Ainanda Rios
Amendment Effective Date:
6/20/2024
Amendment Contract Number: 25 IBEH 189725 Page 1 of 3
Rev. 1/14/19
1. PARTIES
This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover Page
for this Amendment (the "Contract") is entered into by and between the Contractor, and the State.
2. TERMINOLOGY
Except as specifically modified by this Amendment, all terms used in this Amendment that are defined
in the Contract shall be construed and interpreted in accordance with the Contract.
3. AMENDMENT EFFECTIVE DATE AND TERM
A. Amendment Effective Date
This Amendment shall not be valid or enforceable until the Amendment Effective Date
shown on the Signature and Cover Page for this Amendment. The State shall not be bound
by any provision of this Amendment before that Amendment Effective Date, and shall have
no obligation to pay Contractor for any Work performed or expense incurred under this
Amendment either before or after of the Amendment term shown in §3.B of this Amendment.
B. Amendment Term
The Parties' respective performances under this Amendment and the changes to the Contract
contained herein shall commence on the Amendment Effective Date shown on the Signature
and Cover Page for this Amendment and shall terminate on the termination of the Contract.
4. PURPOSE
The purpose of this Contract is to establish/expand services to address local behavioral health care
needs along continuum of care, including services for Children, Youth, and Family with severe
needs.
The purpose of this Amendment is to renew the Agreement for FY25. This Amendment reduces
the FY24 budget by $70,049.17 for a new FY24 total of $256,570.83, and adds $470,085.09 in
new funding for FY25. Additionally, this Amendment updates Exhibit B, Exhibit C, Exhibit E, and
Exhibit F.
MODIFICATIONS
The Contract and all prior amendments thereto, if any, are modified as follows:
A. The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Page is
hereby deleted and replaced with the Current Contract Expiration Date shown on the
Signature and Cover Page for this Amendment.
B. The Contract Maximum Amount table on the Contract's Signature and Cover Page is hereby
deleted and replaced with the Current Contract Maximum Amount table shown on the
Signature and Cover Page for this Amendment.
C. REPLACE Exhibit B, Budget, with Exhibit B-1, Budget.
D. ADD Exhibit B-2, Budget, attached and incorporated by reference.
E. REPLACE Exhibit C, Miscellaneous Provisions, with Exhibit C-1, Miscellaneous
Provisions, attached and incorporated by reference.
F. REPLACE Exhibit E, Supplemental Provisions for Federal Awards, with Exhibit E-1,
Supplemental Provisions for Federal Awards.
Amendment Contract Number: 25 IBEH 189725 Page 2 of 3 Rev. 1/14/19
G REPLACE Exhibit F, SLFRF Subrecipient Provisions, with Exhibit F-1, SLFRF
Subrecipient Provisions
5 LIMITS S OF EFFECT AND ORDER OF PRECEDENCE
This Amendment is incorporated by reference into the Contract, and the Contract and all prior
amendments or other modifications to the Contract, if any, remain in full force and effect except
as specifically modified in this Amendment Except for the Special Provisions contained in the
Contract, in the event of any conflict, inconsistency, variance, or contradiction between the
provisions of this Amendment and any of the provisions of the Contract or any pnor modification
to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and
control The provisions of this Amendment shall only supersede, govern, and control over the
Special Provisions contained in the Contract to the extent that this Amendment specifically
modifies those Special Provisions
THE REMAIN
IP
ER OF THIS PAGE W
S INTENT!
:S
NALLY LEFT (LANK
Amendment Contract Number 25 IBEH 189725 Page 3 of 3 Rev 1/14/19
Exhibit B-1
COLORADO
Behavioral Health
Administration
EXHIBIT B-1, FY24 ANNUAL BUDGET
Capacity Budget Template
BHA Program
Children, Youth,
Family Services Grants,
HB22-1281
Agency Name
Weld County Department of Human
Services
Budget Period
08/31/2023
- 06/30/2024
Project Name
WCDHS Wraparound Program
Contact Information
Program Contact Name, Title
Phone
Email
Julie Witkowski, Family Resource Division Head
970-400-6777
Fiscal Contract Name, Title
Phone
Email
Date Completed
witkowjx@weldgov.com
Tammy Maurer, Fiscal Division Head
970-400-6533
maurertkgweldgov.com
7/27/2023 revised
All budget numbers are estimates. Contract billing will be on a cost reimbursement basis for actual expenses incurred.
EXPENDITURE
CATEGORIES
Personnel
Services: Salary/Benefits
Annual Budget
Position Title
Description of Work
Gross or Annual
Salary
Fringe
Percent of
Time on
Project
Total Amount Requested
from BHA
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$
77,301.03
$27,055.36
25%
S
26,089.10
Wraparound Facilitator
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$
75,059.76
$26,270.92
25%
$
25,332.67
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$
75,825.08
$26,538.78
25%
S
25,590.97
Wraparound Facilitator
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$
79,051.67
$27,668.07
25%
S
26,679.94
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$
75,059.76
$26,270.92
85%
S
86,131.08
Wraparound
Supervisor
High Fidelity Wraparound Supervisor will serve as a systems
navigator and advocate in addition to supervising the
HFW team.
$
108,498.20
$37,974.36
25%
S
36,618.14
Family
Division
Resource
Head
The FRD Division Head supervises the Wraparound Supervisor and
is an ongoing resource and support to the WCDHS Wraparound
team, and will complete tasks such as time keeping, invoices, and
required reports.
$
124,602.78
$42,326.20
2%
S
3,338.58
Adoption
Resource
Coordinator
Support &
The Adoption Support & Resource Coordinator opens
families who live in Weld County & have adopted children,
the family's request resources & assistance with system
navigation & care coordination. They make referrals
Wraparound and will work with Wraparound Facilitators
managing referred cases.
cases with
when
to WCDHS
in
$
74,127.31
$25,944.56
1%
S
1,000.72
Page 1 of 5
Last update 05_31_2022
Exhibit 8-1
Adoption Support &
Resource
Coordinator
The Adoption Support & Resource Coordinator opens cases with
families who live in Weld County & have adopted children, when
the family's request resources & assistance with system
navigation & care coordination They make referrals to WCDHS
Wraparound and will work with Wraparound Facilitators in
managing referred cases
$ 74,127 31
$25,944 56
2%
$
2,001 44
Community Case
Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
1%
$
967 78
Community Coot
Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
1%
$
1967 78
Community Case
Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
1%
$
967 78
Community Case
Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
1%
$
967 78
Community Case
Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
1%
$
967 78
Community Case
Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
1%
$
967 78
Family Resource Case
Manager
The Family Resource Case Managers provide TANF case
management to families also involved with Child Welfare and
Prevention & who are in their last 12 months of receiving TANF
benefits They make referrals to WCDHS Wraparound and will
work with Wraparound Facilitators in managing referred cases
$ 68,767 60
$24,068 66
1%
$
928 36
Page 2 of 5
Last update 05_31_2022
Exhibit B-1
Family
Manager
Resource Case
The Family Resource Case Managers provide TANF
management to families also involved with Child
Prevention & who are in their last 12 months of receiving
benefits. They make referrals to WCDHS Wraparound
work with Wraparound Facilitators in managing referred
case
Welfare and
TANF
and will
cases.
$ 68,767.60
$24,068.66
1%
$
928.36
Wraparound
Coach
Wraparound Coach will serve as a support to the Wraparound
Supervisor to ensure all staff obtain and retain Colorado
Wraparound Credentialing
$ 104,586.00
$22,265.00
3%
$
3,805.53
Personnel Services -Hourly Employees
Annual
Budget
Position Title
Description of Work
Hourly Wage
Hourly Fringe
Total
Hours
Project
# of
on
Total Amount
from
Requested
BHA
S
-
Total Personnel Services
(including fringe benefits)
$
244,251.58
Client
Costs
Annual
Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
Telephones
-monthly
Ongoing expenses for cell
and desk phones -77.98 monthly x 1 set x12 months
$ 935.76
1
S
935.76
Supplies
Marketing
and
Materials
General office supplies and marketing material for customer and stakeholder
engagement.
$ 1,500.00
1
$
1,500.00
Total Client Costs
$
2,435.76
Contract/Consultants Services (Subawards
& Subcontracts)
Annual Budget
Name
Description of Work
Rate
Quantity
Total Amount
from
Requested
BHA
Michelle
Ammerman
Contracted
Intervention
parenting children
provider
Training
to prepare for and facilitate
and parent coaching (virtual
and youth who have experienced
Trust Based Relational
and in person) for caregivers
trauma.
$ 200.00
57
$
11,400.00
Total Contract Services
$
11,400.00
Occupancy
Annual
Budget
Item
Description of Item
Rate
Quantity
Total Amount
from
Requested
BHA
S
-
Total Occupancy
$
-
Operating
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount
from
Requested
BHA
Staff Training
Leading Teams
establish productive
and directive
customer will
processes of
leadership
each
(4
have
hours,
teams
their
team is
in person).
by assessing
to support
own team
essential
The
team
and
for
Wraparound
individual
development.
the development
program
tcam will learn
needs and applying
Each Wraparound
of goals, roles
success.
how
facilitative
and
to
work
$ 275.00
6
$
1,650.00
Staff
Training
Conflict Strategies:
team will learn
address
Navigating
how to identify
conflict.
conflict and
Others (3.5
escalating
Staff will examine
will practice conflict
hours,
conflict
in person). The Wraparound
and assess various options to
constructive and destructive
management skills.
$ 305.00
6
$
1,830.00
effectively
responses to
Page 3of5
Last update 05_31_2022
Exhibit B-1
Staff
Training
Navigating
learn how to
way that causes
defensive. Staff
will practice
others.
Critical Conversations (4
create a safe environment
them to feel seen and
will identify their and
navigating dialogue with
hours, virtual). The Wraparound team will
where all team members contribute in a
heard instead of becoming shut down or
others' default communication styles and
clarity, confidence and consideration for
$ 465.00
6
$
2,790.00
Staff Training
Leadership
apply the principles
Wraparound
and respect
Learning to
Wraparound
Essentials (6 hours, in person).
of leadership in order
team participants. They will
while demonstrating a systems
deliver and accept feedback will
teams.
The Wraparound team will learn and
to support, motivate and engage
practice modeling confidence, fairness
approach to team development.
be essential to creating effective
$ 29.00
6
$
174.00
Staff
Training
Connecting with Customers (1.5 hours, on demand). The
participate in this on demand course designed to equip professionals
skills and strategies necessary to forge meaningful connections
They will have an opportunity to practice listening, empathy
solving.
Wraparound team will
with the
with customers.
and problem
$ 29.00
6
$
174.00
Staff
Training
Conflict Self Management (6 hours, in person).
to identify their personal conflict patters and
constructively to interpersonal conflicts. Staff
and will practice creating options for mutual
their co-workers, supervisor or Wraparound
youth/family
The Wraparound team will learn
build skills to respond
will participate in self reflection
benefit when conflict arises with
participants.
$ 465.00
6
$
2,790.00
Staff Training
DEI and Unconscious Bias (4 hours,
unconscious bias and discuss examples
positive youth and family outcomes.
enhance the workplace and customer
create a more inclusive work and
virtual). Wraparound team will learn about
and the potential impact bias can have on
Staff will learn how equity and diversity can
outcomes and develop an action plan to
customer environment.
$ 465.00
6
$
2,790.00
Total Operating
$
12,198.00
Depreciation/Amortization
Annual Budget
Item
Description of Item
Total Amount Requested
from BHA
Total Depreciation/Amortization
$
-
Professional Fees
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
CANS
Recertification
Annual recertification for CANS Assessment
$ 15.00
6
$
90.00
Clinical Liability
Insurance
Annual liability insurance for LCSW for Medicaid Credentialing
$ 200.00
1
$
200.00
Total Professional Fees
$
290.00
Capital Costs
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
S
-
Total Capital Costs
$
-
TOTAL
DIRECT
COSTS
(TDC)
$
270,575.34
Exclusions
from Indirect
Cost Base expenses per OMB 2CFR § 200
Subaward in excess of $25,000
Rent
Equipment (over $5000)
Other
Unallowable
Expenses (not allowed
a direct
cost) such
as land, real estate purchase,
etc.
Total
Expenses per OMB
2CFR
§ 200
$
-
MODIFIED TOTAL
DIRECT COSTS (YITDC)
$
270,575.34
Page 4 of 5
Last update 05_31_2022
Exhibit B-1
Indirect
Costs
Annual Budget
Item
Description of Item
Percentage
Total Amount Requested
from BHA
S -
Total Indirect
$ -
Grand Total Expenses
$ 270,575.00
Match Requirement Chart:
Size of Organization & Award amount
Percentage Match Requirement on
Match Requirement
q
Organization Annual Budget Size
g g
grant award
SELECT YOUR MATCH
AMOUNT
large
org.
$20,000,000 or more
5%
small
less
than
$20.000.000
2.5%
5.0%
Award
of
less
$50,000 or
any size
0%
MATCH AMOUNT
REQUIRED
$ 13,529.00
Match Amount Required must be listed below in Revenue Offset and/ or Matching Funds
Revenue Offset
Annual
Budget
Client
Services
Medicaid
Fee for Service Cash
Medicaid
czlrzed
Capitation Encounters
at the C1.Nr Per Unit of Service per unit Cost Report of Negotiated Rates received front Regional .4c -countable F.ntity (RAF)*
BHA
Indigent
Encounters**
3rd
Party Insurance
Cash
Receipts
Medicare
Cash
Self-Pay/Client
Fees
Cash
from other
Sources: (Specify
below)
Total Client Services
$ -
*The
**Encounters
rate that your entity is receiving must be used to offset costs in this area
valued using the current year's fee for services schedule issued by BHA and not to exceed contract amount
Matching
Funds
Contracts
and Grants
Non
-Governmental
Contracts
Other
State Revenue/Accrual
Federal
Grant Funds/Accrual
Local
Funds/Accrual
Private Grant
Funds/Accrual
Public
Support
Private Support
In -Kind
Donations
Other
Funds
(Specify
below)
Match
funding
comes
from additional
staff who
work
with
the
Wraparound
team, including
Family
Resource Division Head,
S 14,004.17
Total Contracts and Grants
$
14,004.17
Grand Total Revenue Offset
$ 14,004.17
Net
Cost
$ 256,570.83
The
Parties may mutually
agree, in writing, to modify
the
Budget
administratively
using an BHA
Budget
Reallocation
form
Page 5 of 5
Last update 05_31_2022
Exhibit B-2
COLORADO
Behavioral Health
Administration
EXHIBIT B-2, FY25 ANNUAL BUDGET
1311.1 Program
Children, Youth, Family Services Grants,
EIB22-1281
:Agency Name
Weld County Department of Human
Services
Budget Period
07/01/2024
- 6/30/2025
Project Name
WCDHS Wraparound Program
Capacity Budget Template
Contact Information
Program Contact Name. Title
Phone
Email
Julie Witkowski, Family Resource Division Director
970-400-6777
Fiscal Contract Name, Title
Phone
Entail
witkowix@weld.gov
Tanya Geiser, Fiscal Division Director
970-400-6526
Date Completed
tgeiser@weld.gov
3/15/2024
All budget numbers are estimates. Contract billing will be on a cost reimbursement basis for actual expenses incurred.
EXPENDITURE CATEGORIES
Personnel Services: Salary/Benefits
Annual Budget
Position Title
Description of Work
Gross or Annual
Salary
Fringe
Percent of
Time on
Project
Total Amount Requested
from BHA
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$ 85,214.61
$18,022.89
50%
S 51,618.75
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$ 80,806.02
$30,144.91
50%
S 55,475.47
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
I
$ 76,763.85
$29,290.00
50%
S 53,026.93
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HEW process.
$ 83,230.20
$41,111.19
50%
S 62,170.70
Wraparound Facilitator
Wraparound Facilitator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via
the HFW process.
$ 78,304.92
$29,615.93
100%
S 107,920.85
Wraparound Supervisor
High Fidelity Wraparound Supervisor will serve as a systems
navigator and advocate in addition to supervising the HFW team.
$ 114,590.07
$24,235.80
50%
8 69,412.94
Family Resource Division
Head
The FRD Division Head supervises the Wraparound Supervisor
and is an ongoing resource and support to the WCDHS
Wraparound team, and will complete tasks such as time keeping,
invoices, and required reports.
$ 128,340.86
$42,326.20
5%
S 8,533.35
Adoption
Resource
Support
Coordinator
&
The Adoption Support & Resource Coordinator opens cases with
families who live in Weld County & have adopted children, when
the family's request resources & assistance with system
navigation & care coordination. They make referrals to WCDHS
Wraparound and will work with Wraparound Facilitators in
managing referred cases.
$ 74,127.31
$25,944.56
2%
S 2,001.44
Page 1 of 5
Last update 05_31_2022
Exhibit B-2
Adoption Support &
Resource Coordinator
The Adoption Support & Resource Coordinator opens cases with
families who live in Weld County & have adopted children, when
the family's request resources & assistance with system
navigation & care coordination They make referrals to WCDHS
Wraparound and will work with Wraparound Facilitators in
managing referred cases
$ 74,127 31
$25,944 56
2%
$
2,001 44
Community Case Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
2%
$
1,935 57
Community Case Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
2%
$
1,935 57
Community Case Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
2%
$
1,935 57
Community Case Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
2%
$
1,935 57
Community Case Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if the needs remain unaddressed They
provide resources & assistance with system navigation & care
coordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
2%
$
1,935 57
Community Case Manager
The Community Case Managers work within the Prevention Unit
and open voluntary Prevention cases to prevent child abuse &
neglect & to respond to other needs that could result in further
systems involvement if unaddressed ovide resources & assistancetheneeds with sysremaintem navigation &They care
coprordination They make referrals to WCDHS Wraparound and
will work with Wraparound Facilitators in managing referred
cases
$ 71,687 72
$25,090 70
2%
$
1,935 57
Family Resource Case
Manager
The Family Resource Case Managers provide TANF case
management to families also involved with Child Welfare and
Prevention & who are in their last 12 months of receiving TANF
benefits They make referrals to WCDHS Wraparound and will
work with Wraparound Facilitators in managing referred cases
$ 68,767 60
$24,068 66
2%
$
1,856 73
Family Resource Case
Manager
The Family Resource Case Managers provide TANF case
management to families also involved with Child Welfare and
Prevention & who are in their last 12 months of receiving TANF
benefits They make referrals to WCDHS Wraparound and will
work with Wraparound Facilitators in managing referred cases
$ 68,767 60
$24,068 66
2%
$
1,856 73
Page 2 of 5
Last update 05_31_2022
Exhibit B-2
Wraparound Coach
Wraparound Coach will serve as a support to the Wraparound
Supervisor to ensure all staff obtain and retain Colorado
Wraparound Credentialing
$ 110,273.34
$23,322.81
25%
$ 33,399.04
Personnel Services -Hourly Employees
Annual Budget
Position Title
Description of Work
Hourly Wage
Hourly Fringe
Total # of
Hours on
Project
Total Amount Requested
from BHA
$ -
Total Personnel Services
(including fringe benefits)
$ 460,887.75
Client Costs
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
Telephones
-monthly
Ongoing expenses for cell and desk phones -77.98 monthly x 1 set x 12 months
$ 935.76
1
$ 935.76
Supplies
Materials
and Marketing
General office supplies and marketing material for customer and stakeholder
engagement.
$ 2,995.00
1
$ 2,995.00
Total Client Costs
$ 3,930.76
Contract/Consultants Services (Subawards & Subcontracts)
Annual Budget
Name
Description of Work
Rate
Quantity
Total Amount Requested
from BHA
Michelle Ammerman
Contracted provider to prepare for and facilitate Trust Based Relational
Intervention Training and parent coaching (virtual and in person) for professionals
and caregivers parenting children and youth who have experienced trauma.
$ 200.00
100
$ 20,000.00
Total Contract Services
$ 20,000.00
Occupancy
Annual
Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
$
Total Occupancy
$ -
Operating
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
Staff Training
Creating Exceptional Customer Experiences (4 hours, in person). Second year
training for the Wraparound team to further discuss strategies that will create
customer service experiences that ensure youth/families are satisfied, feel
comfortable bringing forward concerns and ensure timely follow up and action to
address concerns.
$ 500.00
6
$ 3,000.00
Staff
Training
Lead Worker Training (4 hours, in person). Second year training
Wraparound team to review the expectations of their positions,
for the
balance competing
responsibilities
expectations and
families and other
$ 500.00
6
$ 3,000.00
demands and apply techniques to more effectively carry out their
within the Wraparound program. Staff will practice clarifying
communication strategies for successful interactions with youth,
Wraparound team participants.
Staff Training
Barriers to Effective Communication (1 hour, on demand). Second year training
for the Wraparound team to be empowered with the skills needed to identify and
overcome communication barriers, such as language, cultural differences and
emotional obstacles. They will also learn active listening and nonverbal
communication strategies to foster meaningful connections.
$ 40.00
6
$ 240.00
Staff Training
Problem Solving for Business (1.5 hours, on demand). Second year training for the
Wraparound team to learn the components of effective problem solving and how to
better tackle every day obstacles.
$ 40.00
6
$ 240.00
Page 3of5
Last update 05_31_2022
Exhibit B-2
Staff Training
Improve Team Workflow and Personal Effectiveness (4 hours, virtual). Second
year training for the Wraparound team to learn how identify inefficiencies, create
solutions for improved processes, implement flexible solutions to meet customers'
needs and create actionable efficiency plans to best serve our customers.
$ 400.00
6
$ 2,400.00
Staff Training
Foundations for Emotional Intelligence (6 hours, virtual). Second year training for
the Wraparound team to learn ways to deliberately use emotions to create optimal
results within the team and with wraparound customers. Staff will learn to define
the five core competencies of emotional intelligence in order to deepen self-
awareness and the impact of their own emotions on the outcomes of their
youth/families.
$ 660.00
6
$ 3,960.00
Total Operating
$ 12,840.00
Depreciation/Amortization
Annual Budget
Item
Description of Item
Total Amount Requested
from BHA
Total Depreciation/Amortization
$ -
Professional Fees
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount
from BHA
Requested
CANS Recertification
Annual recertification for CANS Assessment
$ 15.00
6
S 90.00
Clinical Liability Insurance
Annual liability insurance for LCSW for Medicaid Credentialing
$ 199.67
1
S 199.67
Total Professional Fees
$ 289.67
Capital Costs
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
$ -
Total Capital Costs
$ -
TOTAL DIRECT
COSTS
(TDC)
$ 497,948.18
Exclusions from Indirect Cost Base expenses per OMB 2CFR § 200
Subaward in excess of $25,000
Rent
Equipment (over $5000)
Other Unallowable Expenses (not allowed a direct cost) such as land, real estate purchase. etc.
Total Expenses per OMB 2CFR § 200
$ -
MODIFIED TOTAL DIRECT COSTS (MTDC)
$ 497,948.18
Indirect
Costs
Annual Budget
Item
Description of Item
Percentage
Total Amount Requested
from BHA
$ -
Total Indirect
S -
Grand Total
Expenses
$ 497,948.18
Match Requirement Chart: Size of Organization & Award amount
Match Requirement
Organization Annual Budget Size
Percentage Match Requirement on
grant award
SELECT YOUR MATCH
AMOUNT
large org.
$20,000,000 or more
5%
5.0%
small
less than
$20,000,000
2.5%
Award of $50,000 or less
any size
0%
MATCH
AMOUNT
REQUIRED
$ 24,897.00
Page 4 of 5
Last update 05_31_2022
Exhibit B-2
Match Amount Required must be listed below in Revenue Offset and/ or Matching Funds
Revenue Offset
Annual Budget
Client Services
Medicaid Fee for Service Cash
Medicaid Capitation Encounters
slued at the Cost Per Unit of Service per unit Cost Report of Negotiated Rates receired.from Regional Accountable Entity (RAE)*
BHA Indigent Encounters**
3rd
Party Insurance Cash
Receipts
Medicare
Cash
Self-Pay/Client Fees
Cash
from other
Sources: (Specify below)
I Total Client Services
$ -
*The rate that your entity is receiving must he used to offset costs in this area
**Encounters valued using the current year's leeJbr services schedule issued by BHA and not to exceed contract amount
Matching Funds
Contracts and Grants
Non -Governmental Contracts
Other State Revenue/Accrual
Federal Grant Funds/Accrual
,
Local
Funds/Accrual
Private Grant Funds/Accrual
Public
Support
Private Support
In -Kind Donations
Other
Funds
Specify
below)
Match
funding comes from additional
staff who work with
the
Wraparound
team, including Family Resource Division Head,
S 27,863.09
Total Contracts and Grants $
27,863.09
(;rand Total Revenue Offset, S 27,863.09
Net
Cost
$ 470,085.09
The Parties may mutually agree, in writing, to modify the Budget administratively using an BHA Budget Reallocation form
Page 5 of 5
Last update 05_31_2022
Exhibit C-1
Exhibit C-1
Miscellaneous Provisions
I. General Provisions and Requirements
A. Finance and Data Protocols
The Contractor shall comply with the Behavioral Health Administration's (BHA) most current
Finance and Data Protocols and the Behavioral Health Accounting and Auditing Guidelines, made
a part of this Contract by reference.
B. Marketing and Communications
The Contractor shall comply with the following marketing and communications requirements:
1. Reports or Evaluations. All reports or evaluations funded by BHA must be reviewed by
BHA staff, including program, data, and communications, over a period of no fewer
than 15 business days. The Contractor may be asked to place a report or evaluation on
a BHA template and the report or evaluation is required to display the BHA logo. The
Contractor shall submit the finished document to BHA in its final format and as an
editable Word or Google document.
2. Press Releases. All press releases about work funded by BHA must note that the work
is funded by the Colorado Department of Human Services, Behavioral Health
Administration. Press releases about work funded by BHA must be reviewed by BHA
program and communications staff over a period of no fewer than five business days.
3. Marketing Materials. Contractor shall include the current Colorado Department of
Human Services, Behavioral Health Administration logo on any marketing materials,
such as brochures or fact sheets, that advertise programs funded by this Contract.
Marketing materials must be approved by the Contract's assigned BHA program
contract over a period of no fewer than 5 business days.
4. All Other Documents. All other documents published by the Contractor about its BHA -
funded work, including presentations or website content, should mention the Colorado
Department of Human Services, Behavioral Health Administration as a funder.
5. Opinion of BHA. BHA may require the Contractor to add language to documents that
mention BHA reading: "The views, opinions and content expressed do not necessarily
reflect the views, opinions or policies of the Colorado Department of Human Services,
Behavioral Health Administration."
C. Start-up Costs
If the State reimburses the Contractor for any start-up costs and the Contractor closes the program
or facility within three years of receipt of the start-up costs, the Contractor shall reimburse the State
for said start-up costs within sixty (60) days of the closure. The Contractor is not required to
reimburse the State for start-up costs if the facility or program closure is due to BHA eliminating
funding to that specific program and/or budget line item.
Page 1 of 5
Exhibit C-1
D. Immediate Notification of Closures / Reductions in Force
If the Contractor intends to close a facility or program, it shall notify the BHA Contracts Unit at
least five business days prior to the closure. Similarly, if the Contractor, or any sub -contractor
provider, intends to conduct a reduction in force which affects a program funded through this
contract, the Contractor shall notify the BHA Contracts Unit at least five business days prior to the
layoffs.
E. Licensing and Designation Database Electronic Record System (LADDERS)
The Contractor shall use LADDERS (http://www.colorado.gov/ladders) as needed and/or as
required by rule to submit applications for BHA licensing and designation, keep current all provider
directory details, and submit policies and procedures.
F. Contract Contact Procedure
The Contractor shall submit all requests for BHA interpretation of this Contract or for amendments
to this Contract to the BHA Contract Manager.
G. The Contractor shall comply with all the provisions and requirements of RFP 2023*171 and
with Contractor's solicitation response thereto.
H. Continuity of Operations Plan
1. In the event of an emergency resulting in a disruption of normal activities, BHA may
request that Contractor provide a plan describing how Contractor will ensure the
execution of essential functions of the Contract, to the extent possible under the
circumstances of the inciting emergency ("Continuity of Operations Plan" or "Plan").
2. The Continuity of Operations Plan must be specific and responsive to the circumstances
of the identified emergency.
3. BHA will provide formal notification of receipt of the Continuity of Operations Plan to
the Contractor.
4. The Continuity of Operations Plan will not impact or change the budget or any other
provisions of the contract, and Contractor's performance will be held to the same
standards and requirements as the original Contract terms, unless otherwise specified in
the Continuity of Operations Plan.
a. Any submitted Continuity of Operations Plan will be ratified as an
amendment to the contract as soon as possible.
5. Contractor shall communicate, in a format mutually agreed upon by BHA and
Contractor staff, on a frequency that supports the monitoring of services under the
Continuity of Operations Plan. If adjustments are needed to the Plan, such adjustments
will be made in writing and accompanied by written notice of receipt from BHA.
a. As part of the BHA/Contractor communication during the emergency,
Page 2 of 5
Exhibit C-1
Contractor and BHA will evaluate whether the emergency has resolved such
that normal operations may be resumed.
b. Contractor and BHA will agree in writing when the emergency is sufficiently
resolved and agree to a closeout period that is four weeks or less.
c. BHA will submit notice accepting the termination of the Continuity of
Operations Plan to the Contractor as the final action for any qualifying
emergency response.
I. Cultural Responsiveness in Service Delivery
1. The Behavioral Health Administration expects funding dollars to support equity in
access, services provided, and behavioral health outcomes among individuals of all
cultures, gender identities, sexual orientations, races, and ethnicities. Accordingly,
Contractors should collect and use data to: (1) identify priority populations vulnerable
to health disparities encompassing the contractor's entire geographic service area (e.g.,
racial, ethnic, limited English speaking, indigenous, sexual orientation, gender identity
groups, etc.) and (2) implement strategies to decrease the disparities in access, service
use, and outcomes —both within those subpopulations and in comparison to the general
population.
2. One strategy for addressing health disparities is the use of the recently revised National
Standards for Culturally and Linguistically Appropriate Services in Health and Health
Care (CLAS). The U.S. Department of Health and Human Services (HHS) Think
Cultural Health website (https://thinkculturalhealth.hhs.gov) also features information,
continuing education opportunities, resources, and more for health and health care
professionals to learn about culturally and linguistically appropriate services, or CLAS.
3. Contractors providing direct behavioral health prevention, treatment, or recovery
services shall submit one of the following two documents to
cdhs BHAdeliverables@state.co.us by August 31 annually:
a. If a provider has completed an equity plan that identifies how they will address
health equity, they can submit the plan or;
b. Submit a completed CLAS checklist that follows this HHS format:
https://thinkculturalhealth.hhs. gov/assets/pdfs/AnImplementationChecklistfort
heNationalCLASStandards.pdf
J. Prohibition on Marijuana. Funds may not be used, directly or indirectly, to purchase, prescribe,
or provide marijuana or treatment using marijuana. Treatment in this context includes the
treatment of opioid use disorder. Funds also cannot be provided to any individual who or
organization that provides or permits marijuana use for the purposes of treating substance use
or mental disorders. This prohibition does not apply to those providing such treatment in the
context of clinical research permitted by the DEA and under an FDA -approved investigational
Page 3 of 5
Exhibit C-1
new drug application where the article being evaluated is marijuana or a constituent thereof that
is otherwise a banned controlled substance under federal law.
K. Monitoring Requirements
If the Contractor is a subrecipient of federal funds, the Contractor shall comply with
monitoring requirements indicated by the Contractor's risk level determined by the
subrecipient risk assessment form completed by Contractor, which may include but are not
limited to:
• Monthly/quarterly monitoring calls
• Invoice supporting documentation - e.g., timesheets, logs of travel, or wraparound
service costs.
• Routine programmatic reports
• Technical assistance and training
• Site visits
II. Use of Subcontracts.
A. Services described in this Contract may be performed by Contractor or by a subcontractor,
except where this Contract states explicitly that a service must not be subcontracted.
B. Contractor shall ensure that its subcontractors perform to the terms of this Contract as set forth
in the Contract provisions.
C. Any subcontract for services must include, at a minimum, the following:
1. A description of each partner's participation
2. Responsibilities to the program (policy and/or operational)
3. Resources the subcontractor will contribute, reimbursement rates, services to be included
and processes in collecting and sharing data and the most recent CDHS version of the
HIPAA Business Associates Addendum, if this Contract contains the HIPAA Business
Associates Addendum/Qualified Service Organization Addendum as an exhibit.
4. A copy of this Contract and all its terms and conditions.
D. The Contractor shall provide to BHA a copy of any proposed subcontract between the
Contractor and any potential provider of services to fulfill any requirements of this Contract, to
cdhs BHAdeliverables@state.co.us within 30 days of subcontract execution.
E. BHA reserves the right to require Contractor to renegotiate subcontracts where necessary to
adhere to the terms of this Contract.
F. Subcontractor/Partnership Termination. In the event where partnerships with a subcontractor
such as a treatment provider is terminated, the Contractor shall transition to a new partnership
no later than 30 days from termination to ensure continuity of care for all participants of the
program.
Page 4 of 5
Exhibit C-1
III.Financial Requirements
A. Funding Sources
The Contractor shall identify all funds delivered to subcontractors as state general fund, state
cash funds, or federal grant dollars in Exhibit B, "Budget." If federal grant dollars, the
Contractor shall communicate the CFDA number to all sub -contractors in their sub -contracts.
B. Program Income
Program income generated through grant funded programs are additive funding that must be
utilized for a consistent purpose as outlined in 2 CFR 200.307(e)(2). If Contractor charges and
receives fees for services, or otherwise receives income associated with the sponsored program,
this is considered program income and is required to be tracked and managed in accordance
with the conditions of the award.
C. Budget Reallocations
1. The Contractor may reallocate funds between the budget categories of this contract, up to
ten percent (10%) of the total contract amount, upon written approval by BHA, without a
contract amendment. Any allowable reallocation is still subject to the limitations of the
Not to Exceed and the Maximum Amount Available per Fiscal Year.
D. Payment Terms
1. The Contractor shall invoice monthly for services, no later than the 20th of the month
following when services are provided.
2. The Contractor shall utilize the invoice template(s) provided by BHA. Contractor shall
comply with the invoicing instructions contained within the invoice template, and requests
for supporting documentation.
3. All payment requests shall be submitted electronically to
CDHS BHApayment@state.co.us.
4. Year-end invoice estimates are due by June 15. Final invoice requests in excess of the
submitted estimates are payable contingent on available funds.
5. Final invoices are due no later than August 30.
6. If the Contractor is a recipient of Federal Funds, final invoices are due no later than 45 days
after the end date of the grant.
7. Invoices for the prior fiscal year received by August 30 which require revisions must be
final by September 10 or they may not be paid.
8. Any requests for payment received after September 10th for the prior state fiscal year cannot
be processed by BHA.
9. The State will make payment on invoices within forty-five (45) days of receipt of a correct
and complete invoice to CDHS_BHApayment@state.co.us. Consequently, the Contractor
must have adequate solvency to pay its expenses up to forty-five (45) days after invoice
submission to the State.
Page 5 of 5
Exhibit E-1
a
COLORADO
Financial Services
0e(aarl.�t of Mu'+�hn Semtes
(iiW1A{Ml ill t ootta0$ and Noe., ELY e,,t
EXHIBIT E-1 - Supplemental Provisions for Federal
Awards
For the purposes of this Exhibit only, Contractor is also identified as "Subrecipient." This Contract has been funded, in
whole or in part, with an award of Federal funds. In the event of a conflict between the provisions of these Supplemental
Provisions for Federal Awards, the Special Provisions, the Contract or any attachments or exhibits incorporated into and
made a part of the Contract, the Supplemental Provisions for Federal Awards shall control. In the event of a conflict
between the Supplemental Provisions for Federal Awards and the FFATA Supplemental Provisions (if my), and/or
exhibit regarding SLFRF Federal Provisions, the terms re FFATA and/or SLFRF shall control. If the source of the funding
of the Contract is a grant, these Federal Provisions are subject to the Award as defined in §2 of these Federal Provisions,
as may be revised pursuant to ongoing guidance from the relevant Federal or State of Colorado agency or institutions of
higher education.
1) Federal Award Identification
i. Subrecipient: Weld County dba Weld County Department of Human Services
ii. Subrecipient Unique Entity ID number: MKKXT9U9MTV5
iii. The Federal Award Identification Number (FAIN) is SLFRP0126
iv. The Federal award date is May 18, 2021.
v. The subaward period of performance start date is August 31, 2023, and end date is June 30, 2025
vi. Federal Funds:
Contract or
Fiscal Year
Amount of Federal funds
obligated by this Contract
Total amount of Federal
funds obligated to the
Subrecipient
Total amount of the
Federal Award committed
to Subrecipient by CDHS
FY24
ARPA
$256,570.83
$256,570.83
$256,570.83
FY25
ARPA
$470,085.09
$470,085.09
$470,085.09
vii. Federal award project description: To establish/expand services to address local behavioral Health needs
along continuum of care, including services for Children, Youth, and Families with severe needs.
viii. The name of the Federal awarding agency is U.S. Department of Treasury; the name of the pass -through
entity is the State of Colorado, Department of Human Services (CDHS).
ix. The Catalog of Federal Domestic Assistance (CFDA) number is 21.027, name is Coronavirus State and
Local Fiscal Recovery Funds, and dollar amount is $3,828,761,790.
x. This award not for research & development.
Supplemental Provisions for Federal Awards
Revised December 2021
Page 1 of 10
Exhibit E-1
xi. The indirect cost rate for the Federal award (including if the de minimis rate is charged per 2 CFR §200.414
Indirect (F&A) costs) is pre -determined based upon the State of Colorado and CDHS cost allocation plan.
2) All requirements imposed by CDHS on Subrecipient so that the Federal award is used in accordance with Federal
statutes, regulations, and the terms and conditions of the Federal award, are stated in Exhibit A, Exhibit B, Exhibit
C, Exhibit D, Exhibit E and Exhibit F.
3) Any additional requirements that CDHS imposes on Subrecipient in order for CDHS to meet its own responsibility to
the Federal awarding agency, including identification of any required financial and performance reports, are stated in
Exhibit A, Exhibit B, Exhibit C, Exhibit D, Exhibit E and Exhibit F.
4) Subrecipient's approved indirect cost rate is 0%.
5) Subrecipient must permit CDHS and auditors to have access to Subrecipient's records and financial statements as
necessary for CDHS to meet the requirements of 2 CFR §200.331 Requirements for pass -through entities, §§ 200.300
Statutory and National Policy Requirements through §200.309 Period of performance, and Subpart F —Audit
Requirements of this Part.
6) The appropriate terms and conditions concerning closeout of the subaward are listed in Section 16 of this Exhibit and
N/A.
7) Performance and Final Status. Subrecipient shall submit all financial, performance, and other reports to CDHS no
later than 30 calendar days after the period of performance end date or sooner termination of this Contract containing
an evaluation and review of Subrecipient's performance and the final status of Subrecipient's obligations hereunder.
8) Matching Funds
If a box below is checked, the accompanying provision applies.
i. ❑ Subrecipient is not required to provide matching funds.
Subrecipient shall provide matching funds as stated in Exhibit B. Subrecipient shall have raised the full
amount of matching funds prior to the Effective Date and shall report to CDHS regarding the status of such
funds upon request. Subrecipient's obligation to pay all or any part of any matching funds, whether direct or
contingent, only extends to funds duly and lawfully appropriated for the purposes of this Contract by the
authorized representatives of the Subrecipient and paid into the Subrecipient's treasury or bank account.
Subrecipient represents to CDHS that the amount designated as matching funds has been legally appropriated
for the purposes of this Contract by its authorized representatives and paid into its treasury or bank account.
Subrecipient does not by this Contract irrevocably pledge present cash reserves for payments in future fiscal
years, and this Contract is not intended to create a multiple -fiscal year debt of the Subrecipient. Subrecipient
shall not pay or be liable for any claimed interest, late charges, fees, taxes or penalties of any nature, except
as required by Subrecipient's laws or policies.
1. DEFINITIONS.
1.1. For the purposes of these Federal Provisions, the following terms shall have the meanings ascribed to them
below.
1.1.1. "Award" means an award of Federal financial assistance, and the Contract setting forth the terms and
conditions of that financial assistance, that a non -Federal Entity receives or administers.
1.1.1.1.1. Awards maybe in the form of
1.1.1.1.2. Grants;
1.1.1.1.3. Contracts;
Supplemental Provisions for Federal Awards Page 2 of 10
Revised December 2021
Exhibit E-1
1.1.1.1.4. Cooperative Contracts, which do not include cooperative research and development
Contracts (CRDA) pursuant to the Federal Technology Transfer Act of 1986, as amended (15 U.S.C.
3710);
1.1.1.1.5. Loans;
1.1.1.1.6. Loan Guarantees;
1.1.1.1.7. Subsidies;
1.1.1.1.8. Insurance;
1.1.1.1.9. Food commodities;
1.1.1.1.10. Direct appropriations;
1.1.1.1.11. Assessed and voluntary contributions; and
1.1.1.1.12. Other financial assistance transactions that authorize the expenditure of Federal funds by
non -Federal Entities.
1.1.1.1.13. Any other items specified by OMB in policy memoranda available at the OMB website or
other source posted by the OMB.
1.1.1.2. Award does not include:
1.1.1.2.1. Technical assistance, which provides services in lieu of money;
1.1.1.2.2. A transfer of title to Federally -owned property provided in lieu of money; even if the award
is called a grant;
1.1.1.2.3. Any award classified for security purposes; or
1.1.1.2.4. Any award funded in whole or in part with Recovery funds, as defined in section 1512 of
the American Recovery and Reinvestment Act (ARRA) of 2009 (Public Law 111-5).
1.1.2. "Contract" means the Contract to which these Federal Provisions are attached and includes all Award types
in § of this Exhibit.
1.1.3. "Contractor" means the party or parties to a Contract funded, in whole or in part, with Federal financial
assistance, other than the Prime Recipient, and includes grantees, subgrantees, Subrecipients, and
borrowers. For purposes of Transparency Act reporting, Contractor does not include Vendors.
1.1.4. "Unique Entity ID number" or "UEI" is the Unique Entity ID number established by the federal
government in the Unique Entity ID System to uniquely identify a business entity. For more, see:
www.sam.gov.
1.1.5. "Entity" means:
1.1.5.1. If the source of funding is a Grant:
1.1.5.1.1. a Non -Federal Entity;
1.1.5.1.2. a foreign public entity;
1.1.5.1.3. a foreign organization;
1.1.5.1.4. a non-profit organization;
1.1.5.1.5. a domestic for-profit organization (for 2 CFR parts 25 and 170 only);
1.1.5.1.6. a foreign non-profit organization (only for 2 CFR part 170) only);
1.1.5.1.7. a Federal agency, but only as a Subrecipient under an Award or Subaward to a
non -Federal entity (or 2 CFR 200.1); or
1.1.5.1.8. a foreign for-profit organization (for 2 CFR part 170 only).
Supplemental Provisions for Federal Awards Page 3 of 10
Revised December 2021
Exhibit E-1
1.1.5.2. If the source of funding is not a Grant:
1.1.5.2.1. all of the following as defined at 2 CFR part 25, subpart C;
1.1.5.2.2. A governmental organization, which is a State, local government, or Indian Tribe;
1.1.5.3. a foreign public entity;
1.1.5.4. a domestic or foreign non-profit organization;
1.1.5.5. a domestic or foreign for-profit organization; and
1.1.5.6. a Federal agency, but only a Subrecipient under an Award or Subaward to a non -
Federal entity.
1.1.6. "Executive" means an officer, managing partner or any other employee in a management position.
1.1.7. If the source of funding is a Grant, "Federal Awarding Agency" means a Federal agency providing a
Federal Award to a Recipient as described in 2 CFR 200.1. If the source of funding is not a Grant, "Federal
Award Identification Number (FAIN)" means an Award number assigned by a Federal agency to a Prime
Recipient.
1.1.8. "FFATA" means the Federal Funding Accountability and Transparency Act of 2006 (Public Law 109-282),
as amended by §6202 of Public Law 110-252. FFATA, as amended, also is referred to as the "Transparency
Act."
1.1.9. "Federal Provisions" means these Federal Provisions subject to the Transparency Act and Uniform
Guidance, as may be revised pursuant to ongoing guidance from the relevant Federal or State of Colorado
agency or institutions of higher education.
1.1.10. If the source of funding is a Grant, "Grant" as used herein is the Contract to which these Federal Provisions
are attached.
1.1.11. "Grantee" means the party or parties identified as such in the Grant to which these Federal Provisions are
attached if the source of funding is a Grant.
1.1.12. "Non -Federal Entity means a State, local government, Indian tribe, institution of higher education, or
nonprofit organization that carries out a Federal Award as a Recipient or a Subrecipient.
1.1.13. "Nonprofit Organization" means any corporation, trust, association, cooperative, or other organization, not
including IHEs, that:
1.1.13.1. Is operated primarily for scientific, educational, service, charitable, or similar purposes in the
public interest;
1.1.13.2. Is not organized primarily for profit; and
1.1.13.3. Uses net proceeds to maintain, improve, or expand the operations of the organization.
1.1.14. "OMB" means the Executive Office of the President, Office of Management and Budget.
1.1.15. "Pass -through Entity" means a non -Federal Entity that provides a Subaward to a Subrecipient to carry out
part of a Federal program.
1.1.16. "Prime Recipient" means a Colorado State agency or institution of higher education that receives an Award,
or, of the source of funding is a Grant it is that agency or institution identified as the Grantor in the Grant
to which these Federal Provisions are attached.
1.1.17. "Subaward" means an award by a Prime Recipient to a Subrecipient funded in whole or in part by a Federal
Award. The terms and conditions of the Federal Award flow down to the Subaward unless the terms and
conditions of the Federal Award specifically indicate otherwise in accordance with 2 CFR 200.101 or 2
CFR 200.38, as applicable. The term does not include payments to a contractor or payments to an individual
that is a beneficiary of a Federal program.
Supplemental Provisions for Federal Awards Page 4 of 10
Revised December 2021
Exhibit E-1
1.1.18. "Subrecipient" or, if the source of funding is a Grant, "Subgrantee" means a non -Federal Entity (or a Federal
agency under an Award or Subaward to a non -Federal Entity) receiving Federal funds through a Prime
Recipient to support the performance of the Federal project or program for which the Federal funds were
awarded. A Subrecipient is subject to the terms and conditions of the Federal Award to the Prime Recipient,
including program compliance requirements. The term "Subrecipient" includes and may be referred to as
Subgrantee. The term does not include an individual who is a beneficiary of a federal program.
1.1.19. "Subrecipient Parent UEI Number" means the subrecipient parent organization's 12 -digit Unique Entity
ID System (UEI) number that appears in the subrecipient's System for Award Management (SAM) profile,
if applicable.
1.1.20. "System for Award Management (SAM)" means the Federal repository into which an Entity must enter
the information required under the Transparency Act, which may be found at http://www.sam.gov.
1.1.21. "Total Compensation" means the cash and noncash dollar value earned by an Executive during the Prime
Recipient's or Subrecipient's preceding fiscal year (see 48 CFR 52.204-10, as prescribed in 48 CFR
4.1403(a), as applicable) and includes the following:
1.1.21.1. Salary and bonus;
1.1.21.2. Awards of stock, stock options, and stock appreciation rights, using the dollar amount
recognized for financial statement reporting purposes with respect to the fiscal year in
accordance with the Statement of Financial Accounting Standards No. 123 (Revised 2005)
(FAS 123R), Shared Based Payments;
1.1.21.3. Earnings for services under non -equity incentive plans, not including group life, health,
hospitalization or medical reimbursement plans that do not discriminate in favor of Executives
and are available generally to all salaried employees;
1.1.21.4. Change in present value of defined benefit and actuarial pension plans;
1.1.21.5. Above -market earnings on deferred compensation which is not tax -qualified;
1.1.21.6. Other compensation, if the aggregate value of all such other compensation (e.g., severance,
termination payments, value of life insurance paid on behalf of the employee, perquisites or
property) for the Executive exceeds $10,000.
1.1.22. "Transparency Act" means the Federal Funding Accountability and Transparency Act of 2006 (Public Law
109-282), as amended by §6202 of Public Law 110-252. The Transparency Act may also be referred to as
FFATA.
1.1.23. "Uniform Guidance" means the Office of Management and Budget Uniform Administrative Requirements,
Cost Principles, and Audit Requirements for Federal Awards, which, unless the source of funding is a Grant,
supersedes requirements from OMB Circulars A-21, A-87, A-110, and A-122, OMB Circulars A-89, A-
102, and A-133, and the guidance in Circular A-50 on Single Audit Act follow-up. The terms and
conditions of the Uniform Guidance flow down to Awards to Subrecipients unless the Uniform Guidance
or the terms and conditions of the Federal Award specifically indicate otherwise.
1.1.24. "Vendor" means a dealer, distributor, merchant or other seller providing property or services required for a
project or program funded by an Award. A Vendor is not a Prime Recipient or a Subrecipient and is not
subject to the terms and conditions of the Federal award. Program compliance requirements do not pass
through to a Vendor.
2. COMPLIANCE.
Supplemental Provisions for Federal Awards Page 5 of 10
Revised December 2021
Exhibit E-1
2.1. Contractor/Grantee shall comply with all applicable provisions of the Transparency Act and the regulations
issued pursuant thereto, all applicable provisions of the Uniform Guidance, including, but not limited to, all
applicable Federal Laws and regulations required by this Federal Award. Any revisions to such provisions or
regulations shall automatically become a part of these Federal Provisions, without the necessity of either party
executing any further instrument. The State of Colorado, at its discretion, may provide written notification to
Contractor/Grantee of such revisions, but such notice shall not be a condition precedent to the effectiveness of
such revisions.
3. SYSTEM FOR AWARD MANAGEMENT (SAM) AND UNIQUE ENTITY ID SYSTEM (UEI)
REQUIREMENTS.
3.1. SAM. Contractor/Grantee shall maintain the currency of its information in SAM until the Contractor/Grantee
submits the final financial report required under the Award or receives final payment, whichever is later.
Contractor/Grantee shall review and update SAM information at least annually after the initial registration, and
more frequently if required by changes in its information.
3.2. UEI. Contractor/Grantee shall provide its UEI number to its Prime Recipient, and shall update
Contractor's/Grantee's information in www.sam.gov at least annually after the initial registration, and more
frequently if required by changes in Contractor's/Grantee's information.
4. TOTAL COMPENSATION.
4.1. Contractor/Grantee shall include Total Compensation in SAM for each of its five most highly compensated
Executives for the preceding fiscal year if:
4.1.1. The total Federal funding authorized to date under the Award is $30,000 or more if the source of funding
is a Grant, or otherwise $25,000 or more if the source of funding is not a Grant; and
4.1.2. In the preceding fiscal year, Contractor/Grantee received:
4.1.2.1. 80% or more of its annual gross revenues from Federal procurement contracts and subcontracts
and/or Federal financial assistance Awards or Subawards subject to the Transparency Act; and
4.1.2.2. $30,000,000 or more in annual gross revenues from Federal procurement contracts and
subcontracts and/or Federal financial assistance Awards or Subawards subject to the Transparency
Act if the source of funding is a Grant or otherwise $25,000,000 or more in annual gross revenues
from Federal procurement contracts and subcontracts and/or Federal financial assistance Awards
or Subawards subject to the Transparency Act if the source of funding is not a Grant; and
4.1.2.3. The public does not have access to information about the compensation of such Executives through
periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15
U.S.C. 78m(a), 78o(d) or § 6104 of the Internal Revenue Code of 1986.
5. REPORTING.
5.1. If Contractor/Grantee is a Subrecipient of the Award pursuant to the Transparency Act, Grantee shall report
data elements to SAM and to the Prime Recipient as required in this Exhibit. No direct payment shall be made
to Grantee for providing any reports required under these Federal Provisions and the cost of producing such
reports shall be included in the Contract/Grant price. The reporting requirements in this Exhibit are based on
guidance from the US Office of Management and Budget (OMB), and as such are subject to change at any time
by OMB. Any such changes shall be automatically incorporated into this Contract/Grant and shall become part
of Contractor's/Grantee's obligations under this Contract/Grant.
6. EFFECTIVE DATE AND DOLLAR THRESHOLD FOR REPORTING.
6.1. If the source of funding is a Grant, Reporting requirements in §8 below apply to new Awards as of October 1,
2010, if the initial award is $30,000 or more. If the initial Award is below $30,000 but subsequent Award
modifications result in a total Award of $30,000 or more, the Award is subject to the reporting requirements as
of the date the Award exceeds $30,000. If the initial Award is $30,000 or more, but funding is subsequently
de -obligated such that the total award amount falls below $30,000, the Award shall continue to be subject to
the reporting requirements.
Supplemental Provisions for Federal Awards Page 6 of 10
Revised December 2021
Exhibit E-1
6.2. If the source of funding is not a Grant, Reporting requirements in §8 below apply to new Awards as of October
1, 2010, if the initial award is $25,000 or more. If the initial Award is below $25,000 but subsequent Award
modifications result in a total Award of $25,000 or more, the Award is subject to the reporting requirements as
of the date the Award exceeds $25,000. If the initial Award is $25,000 or more, but funding is subsequently
de -obligated such that the total award amount falls below $25,000, the Award shall continue to be subject to
the reporting requirements.
6.3. The procurement standards in §9 below are applicable to new Awards made by Prime Recipient as of December
26, 2015. The standards set forth in §11 below are applicable to audits of fiscal years beginning on or after
December 26, 2014.
7. SUBRECIPIENT REPORTING REQUIREMENTS.
7.1. If Contractor/Grantee is a Subrecipient, Contractor/Grantee shall report as set forth below.
7.1.1. To SAM. A Subrecipient shall register in SAM and report the following data elements in SAM for each
Federal Award Identification Number (FAIN) assigned by a Federal agency to a Prime Recipient no later
than the end of the month following the month in which the Subaward was made:
7.1.1.1. Subrecipient UEI Number;
7.1.1.2. Subrecipient UEI Number if more than one electronic funds transfer (EFT) account;
7.1.1.3. Subrecipient parent's organization UEI Number;
7.1.1.4. Subrecipient's address, including: Street Address, City, State, Country, Zip (+ 4 if source of
funding is a Grant or as otherwise directed per SAM directives for proper reporting), and
Congressional District;
7.1.1.5. Subrecipient's top 5 most highly compensated Executives if the criteria in §4 above are met;
and
7.1.1.6. Subrecipient's Total Compensation of top 5 most highly compensated Executives if the criteria
in §4 above met.
7.1.2. To Prime Recipient. A Subrecipient shall report to its Prime Recipient, upon the effective date of the
Contract/Grant, the following data elements:
7.1.2.1. Subrecipient's UEI Number as registered in SAM.
7.1.2.2. Primary Place of Performance Information, including: Street Address, City, State, Country, Zip
code + 4, and Congressional District.
8. PROCUREMENT STANDARDS.
8.1. Procurement Procedures. A Subrecipient shall use its own documented procurement procedures which reflect
applicable State, local, and Tribal laws and applicable regulations, provided that the procurements conform to
applicable Federal law and the standards identified in the Uniform Guidance, including without limitation, 2
CFR 200.318 through 200.327 thereof
8.2. If the source of funding is a Grant: Domestic preference for procurements (2 CFR 200.322). As appropriate
and to the extent consistent with law, the non -Federal entity should, to the greatest extent practicable under a
Federal award, provide a preference for the purchase, acquisition, or use of goods, products, or materials
produced in the United States (including but not limited to iron, aluminum, steel, cement, and other
manufactured products). The requirements of this section must be included in all subawards including all
contracts and purchase orders for work or products under this award.
Supplemental Provisions for Federal Awards Page 7 of 10
Revised December 2021
Exhibit E-1
8.3. Procurement of Recovered Materials. If a Subrecipient is a State Agency or an agency of a political subdivision
of the State, its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the
Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items
designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247, that contain the
highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of
competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during
the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that
maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement
of recovered materials identified in the EPA guidelines.
9. ACCESS TO RECORDS.
9.1. A Subrecipient shall permit Recipient/Prime Recipient and its auditors to have access to Subrecipient's records
and financial statements as necessary for Recipient to meet the requirements of 2 CFR 200.311-200.332
(Requirements for pass -through entities), 2 CFR 200.300 (Statutory and national policy requirements) through
2 CFR 200.309 (Period of performance), and Subpart F -Audit Requirements of the Uniform Guidance.
10. SINGLE AUDIT REQUIREMENTS.
10.1. If a Subrecipient expends $750,000 or more in Federal Awards during the Subrecipient's fiscal year, the
Subrecipient shall procure or arrange for a single or program -specific audit conducted for that year in
accordance with the provisions of Subpart F -Audit Requirements of the Uniform Guidance, issued pursuant to
the Single Audit Act Amendments of 1996, (31 U.S.C. 7501-7507). 2 CFR 200.501.
10.1.1. Election. A Subrecipient shall have a single audit conducted in accordance with Uniform Guidance 2 CFR
200.514 (Scope of audit), except when it elects to have a program -specific audit conducted in accordance
with 2 CFR 200.507 (Program -specific audits). The Subrecipient may elect to have a program -specific
audit if Subrecipient expends Federal Awards under only one Federal program (excluding research and
development) and the Federal program's statutes, regulations, or the terms and conditions of the Federal
award do not require a financial statement audit of Prime Recipient. A program -specific audit may not be
elected for research and development unless all of the Federal Awards expended were received from
Recipient and Recipient approves in advance a program -specific audit.
10.1.2. Exemption. If a Subrecipient expends less than $750,000 in Federal Awards during its fiscal year, the
Subrecipient shall be exempt from Federal audit requirements for that year, except as noted in 2 CFR
200.503 (Relation to other audit requirements), but records shall be available for review or audit by
appropriate officials of the Federal agency, the State, and the Government Accountability Office.
10.1.3. Subrecipient Compliance Responsibility. A Subrecipient shall procure or otherwise arrange for the audit
required by Subpart F of the Uniform Guidance and ensure it is properly performed and submitted when
due in accordance with the Uniform Guidance. Subrecipient shall prepare appropriate financial statements,
including the schedule of expenditures of Federal awards in accordance with 2 CFR 200.510 (Financial
statements) and provide the auditor with access to personnel, accounts, books, records, supporting
documentation, and other information as needed for the auditor to perform the audit required by Uniform
Guidance Subpart F -Audit Requirements.
11. CONTRACT/GRANT PROVISIONS FOR SUBRECEPIENT CONTRACTS.
11.1. In addition to other provisions required by the Federal Awarding Agency or the Prime Recipient,
Contractors/Grantees that are Subrecipients shall comply with the following provisions. Subrecipients shall
include all of the following applicable provisions in all subcontracts entered into by it pursuant to this
Contract/Grant.
Supplemental Provisions for Federal Awards Page 8 of 10
Revised December 2021
Exhibit E-1
11.1.1. [Applicable to federally assisted construction contracts.] Equal Employment Opportunity. Except as
otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted
construction contract" in 41 CFR Part 60-1.3 shall include the equal opportunity clause provided under 41
CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR
12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending
Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41
CFR part 60, Office of Federal Contract Compliance Programs, Equal Employment Opportunity,
Department of Labor.
11.1.2. [Applicable to on -site employees working on government -funded construction, alteration and repair
projects.] Davis -Bacon Act. Davis -Bacon Act, as amended (40 U.S.C. 3141-3148).
11.1.3. Rights to Inventions Made Under a contract/grant or agreement. If the Federal Award meets the definition
of "funding agreement"/ "funding Contract" under 37 CFR 401.2 (a) and the Prime Recipient or
Subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding
the substitution of parties, assignment or performance of experimental, developmental, or research work
under that "funding agreement,"/"funding Contract", the Prime Recipient or Subrecipient must comply with
the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small
Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing
regulations issued by the Federal Awarding Agency.
11.1.4. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-
1387), as amended. Contracts and subgrants of amounts in excess of $150,000 must contain a provision
that requires the non -Federal awardee(s) to agree to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution
Control Act as amended (33 U.S.C. 1251-1387). Violations must be reported to the Federal Awarding
Agency and the Regional Office of the Environmental Protection Agency (EPA).
11.1.5. Debarment and Suspension (Executive Orders 12549 and 12689). A contract award (see 2 CFR 180.220) must
not be made to parties listed on the government wide exclusions in the System for Award Management (SAM), in
accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986
Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension." SAM Exclusions
contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549.
11.1.6. Byrd Anti -Lobbying Amendment (31 U.S.C. 1352). Contractors that apply or bid for an award exceeding
$100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not
used Federal appropriated funds to pay any person or organization for influencing or attempting to influence
an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an
employee of a member of Congress in connection with obtaining any Federal contract, grant or any other
award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non -Federal funds that
takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to
tier up to the non -Federal award.
11.1.7. Never contract with the enemy (2 CFR 200.215). Federal awarding agencies and recipients are subject to
the regulations implementing "Never contract with the enemy" in 2 CFR part 183. The regulations in 2
CFR part 183 affect covered contracts, grants and cooperative agreements that are expected to exceed
$50,000 within the period of performance, are performed outside the United States and its territories, and
are in support of a contingency operation in which members of the Armed Forces are actively engaged in
hostilities.
11.1.8. Prohibition on certain telecommunications and video surveillance services or equipment (2 CFR 200.216).
Grantee is prohibited from obligating or expending loan or grant funds on certain telecommunications and
video surveillance services or equipment pursuant to 2 CFR 200.216.
12. CERTIFICATIONS.
Supplemental Provisions for Federal Awards Page 9 of 10
Revised December 2021
Exhibit E-1
12.1. Unless prohibited by Federal statutes or regulations, Recipient/Prime Recipient may require Subrecipient to
submit certifications and representations required by Federal statutes or regulations on an annual basis. 2 CFR
200.208. Submission maybe required more frequently if Subrecipient fails to meet a requirement of the Federal
award. Subrecipient shall certify in writing to the State at the end of the Award that the project or activity was
completed or the level of effort was expended. 2 CFR 200.201(3). If the required level of activity or effort was
not carried out, the amount of the Award must be adjusted.
13. EXEMPTIONS.
13.1. These Federal Provisions do not apply to an individual who receives an Award as a natural person, unrelated to
any business or non-profit organization he or she may own or operate in his or her name.
13.2. A Contractor/Grantee with gross income from all sources of less than $300,000 in the previous tax year is
exempt from the requirements to report Subawards and the Total Compensation of its most highly compensated
Executives.
14. EVENT OF DEFAULT AND TERMINATION.
14.1. Failure to comply with these Federal Provisions shall constitute an event of default under the Contract/Grant
and the State of Colorado may terminate the Contract/Grant upon 30 days prior written notice if the default
remains uncured five calendar days following the termination of the 30 -day notice period. This remedy will be
in addition to any other remedy available to the State of Colorado under the Contract/Grant, at law or in equity.
14.2. Termination (2 CFR 200.340). The Federal Award maybe terminated in whole or in part as follows:
14.2.1. By the Federal Awarding Agency or Pass -through Entity, if a Non -Federal Entity fails to comply with the
terms and conditions of a Federal Award;
14.2.2. By the Federal awarding agency or Pass -through Entity, to the greatest extent authorized by law, if an award
no longer effectuates the program goals or agency priorities;
14.2.3. By the Federal awarding agency or Pass -through Entity with the consent of the Non -Federal Entity, in
which case the two parties must agree upon the termination conditions, including the effective date and, in
the case of partial termination, the portion to be terminated;
14.2.4. By the Non -Federal Entity upon sending to the Federal Awarding Agency or Pass -through Entity written
notification setting forth the reasons for such termination, the effective date, and, in the case of partial
termination, the portion to be terminated. However, if the Federal Awarding Agency or Pass -through Entity
determines in the case of partial termination that the reduced or modified portion of the Federal Award or
Subaward will not accomplish the purposes for which the Federal Award was made, the Federal Awarding
Agency or Pass -through Entity may terminate the Federal Award in its entirety; or
14.2.5. By the Federal Awarding Agency or Pass -through Entity pursuant to termination provisions included in the
Federal Award.
EXHIBIT END
Supplemental Provisions for Federal Awards Page 10 of 10
Revised December 2021
Exhibit F-1
V.5
a
COLORADO
Financial Services
Ocpannumt d Human Services
Dlvisron or Contracts and Procuremerd
EXHIBIT F-1 - SLFRF SUBRECIPIENT PROVISIONS EXHIBIT
(CDHS)
This Exhibit and the Appendices hereto apply regarding the use of State and Local Fiscal Recovery
Funds (SLFRF) to comply with requirements established by the U.S. Department of Treasury and
the Colorado Department of Personnel & Administration, Office of the State Controller re the
Colorado Department of Human Services (CDHS).
This SLFRF Provisions Exhibit may supplement other Exhibit(s) to the instant Agreement. In the
event that terms on prior Exhibit(s) to the instant Agreement conflict with this SLFRF Provisions
Exhibit, this Exhibit shall control and take precedence.
The Contractor/Vendor/Other Agency entity with which the Colorado Department of Human
Services (CDHS) is contracting per this Agreement may be referred to as "Subrecipient" herein,
the designation per controlling law and mandates. This "Subrecipient" designation shall apply in
this context notwithstanding prior definition(s) of any entity to this agreement as "Contractor" or
any other title.
Subrecipient must agree to and comply with the terms of these SLFRF Provisions in order to
receive and use these funds. Subrecipient shall execute not only the instant Agreement, but also
specifically the Certification Agreement appendix to the instant Exhibit. A failure to also
separately execute the Certification Agreement appendix hereto shall not relieve Subrecipient of
the rules/obligations set forth herein; such a clerical error must be promptly remedied upon
discovery by notifying the CDHS office/program contact, who can then assist with the logistics of
mandatory signing, which shall retroactively apply.
In the event that Subrecipient is/was in receipt of SLFRF funding from CDHS prior to execution
of the instant Exhibit, Subrecipient understands that its obligations set forth herein with regards to
that funding shall retroactively apply.
The regulations and requirements surrounding receipt and use of SLFRF funding is an evolving
subject matter as established by the U.S. Department of Treasury and put into established policy
by the Colorado Department of Personnel & Administration, Office of the State Controller for use
with CDHS Agreements. As such, Subrecipient agrees to execute any additional
Agreements/Amendments as required by CDHS to establish and/or update these procedures.
Subrecipient agrees to accept written notice from CDHS of updates to these requirements and to
1
Exhibit F-1
V.5
comply with same forthwith, even if prior to or without a formal Amendment to the Agreement to
update this Exhibit or the rules/requirements established herein. Regardless, if CDHS requests that
Subrecipient execute an Amendment to formalize implementation of and/or acknowledgment of
updates to this Exhibit, Subrecipient shall promptly comply.
Subrecipient agrees to stay abreast of and comply with the most current iterations of the
requirements re SLFRF funding set forth on https://osc.colorado.gov/american-rescue-plan-act
(see SLFRF Grant Agreement Templates Tab).
APPENDIX 1 TO SLFRF EXHIBIT- BUDGET SUPPLEMENT
1. BUDGET BY US TREASURY EXPENDITURE CATEGORY
1.1 Expenditure Categories identified in this Appendix will determine what is reported on as
outlined in the all following Appendices to this Exhibit.
Project
Number
Project Title
US Treasury Expenditure Category
Number and Name
Budget
PHI340
FY24 Children, Youth, and
Family Behavioral Health
Services Grants
1.14 Other Public Services
$256,570.83
PHI340
FY25 Children, Youth, and
Family Behavioral Health
Services Grants
1.14 Other Public Services
$470,085.09
Total
$726,655.92
2. BUDGET BY FUNCTION
3. EXPENDITURE CATEGORY MODIFICATIONS
1.1 Increases or decreases in any Expenditure Category must be requested and approved by the
State Agency by using the SLFRF Expenditure Modification Form. This form can be found
at: https://osc.colorado.gov/american-rescue-plan-act (see SLFRF Grant Agreement
Templates Tab). In no event may this be used to modify the overall total of this Agreement
or otherwise any non SLFRF expenditures.
2
Exhibit F-1
V.5
APPENDIX 2 TO SLFRF EXHIBIT- FEDERAL PROVISIONS
SUPPLEMENT
1. APPLICABILITY OF PROVISIONS.
1.1. The Grant to which these Federal Provisions are attached has been funded, in whole or in
part, with an Award of Federal funds. In the event of a conflict between the provisions of
these Federal Provisions, the Special Provisions, the body of the Grant, or any attachments
or exhibits incorporated into and made a part of the Grant, the provisions of these Federal
Provisions shall control.
1.2. The State of Colorado is accountable to Treasury for oversight of their subrecipients,
including ensuring their subrecipients comply with the SLFRF statute, SLFRF Award
Terms and Conditions, Treasury's Final Rule, and reporting requirements, as applicable.
1.3. Additionally, any subrecipient that issues a subaward to another entity (2nd tier
subrecipient), must hold the 2nd tier subrecipient accountable to these provisions and
adhere to reporting requirements.
1.4. These Federal Provisions are subject to the Award as defined in §2 of these Federal
Provisions, as may be revised pursuant to ongoing guidance from the relevant Federal or
State of Colorado agency or institutions of higher education.
2. DEFINITIONS.
2.1. For the purposes of these Federal Provisions, the following terms shall have the
meanings ascribed to them below.
2.1.1. "Award" means an award of Federal financial assistance, and the Grant
setting forth the terms and conditions of that financial assistance, that a non -Federal
Entity receives or administers.
2.1.2. "Entity" means:
2.1.2.1. a Non -Federal Entity;
2.1.2.2. a foreign public entity;
2.1.2.3. a foreign organization;
2.1.2.4. a non-profit organization;
2.1.2.5. a domestic for-profit organization (for 2 CFR parts 25 and 170 only);
2.1.2.6. a foreign non-profit organization (only for 2 CFR part 170) only);
2.1.2.7. a Federal agency, but only as a Subrecipient under an Award or Subaward
to a non -Federal entity (or 2 CFR 200.1); or
2.1.2.8. a foreign for-profit organization (for 2 CFR part 170 only).
2.1.3. "Executive" means an officer, managing partner or any other employee in
a management position.
3
Exhibit F-1
V.5
2.1.4. "Expenditure Category (EC)" means the category of eligible uses as defined
by the US Department of Treasury in "Appendix 1 of the Compliance and
Reporting Guidance, State and Local Fiscal Recovery Funds" report available at
www.treasury.gov.
2.1.5. "Federal Awarding Agency" means a Federal agency providing a Federal
Award to a Recipient as described in 2 CFR 200.1
2.1.6. "Grant" means the Grant to which these Federal Provisions are attached.
2.1.7. "Grantee" means the party or parties identified as such in the Grant to which
these Federal Provisions are attached.
2.1.8. "Non -Federal Entity" means a State, local government, Indian tribe,
institution of higher education, or nonprofit organization that carries out a Federal
Award as a Recipient or a Subrecipient.
2.1.9. "Nonprofit Organization" means any corporation, trust, association,
cooperative, or other organization, not including IHEs, that:
2.1.9.1. Is operated primarily for scientific, educational, service, charitable, or
similar purposes in the public interest;
2.1.9.2. Is not organized primarily for profit; and
2.1.9.3. Uses net proceeds to maintain, improve, or expand the operations of the
organization.
2.1.10. "OMB" means the Executive Office of the President, Office of
Management and Budget.
2.1.11. "Pass -through Entity" means a non -Federal Entity that provides a Subaward
to a Subrecipient to carry out part of a Federal program.
2.1.12. "Prime Recipient" means the Colorado State agency or institution of higher
education identified as the Grantor in the Grant to which these Federal Provisions
are attached.
2.1.13. "Subaward" means an award by a Prime Recipient to a Subrecipient funded
in whole or in part by a Federal Award. The terms and conditions of the Federal
Award flow down to the Subaward unless the terms and conditions of the Federal
Award specifically indicate otherwise in accordance with 2 CFR 200.101. The term
does not include payments to a Contractor or payments to an individual that is a
beneficiary of a Federal program.
2.1.14. "Subrecipient" or "Subgrantee" means a non -Federal Entity (or a Federal
agency under an Award or Subaward to a non -Federal Entity) receiving Federal
funds through a Prime Recipient to support the performance of the Federal project
or program for which the Federal funds were awarded. A Subrecipient is subject to
the terms and conditions of the Federal Award to the Prime Recipient, including
program compliance requirements. The term does not include an individual who is
a beneficiary of a federal program. For SLFRF Grants, a subrecipient relationship
continues to exist for Expenditure Category 6.1 Revenue Replacement.
4
Exhibit F-1
V.5
2.1.15. "System for Award Management (SAM)" means the Federal repository into
which an Entity must enter the information required under the Transparency Act,
which may be found at http://www.sam.gov. "Total Compensation" means the cash
and noncash dollar value earned by an Executive during the Prime Recipient's or
Subrecipient's preceding fiscal year (see 48 CFR 52.204-10, as prescribed in 48
CFR 4.1403(a)) and includes the following:
2.1.15.1. Salary and bonus;
2.1.15.2. Awards of stock, stock options, and stock appreciation rights, using the
dollar amount recognized for financial statement reporting purposes with
respect to the fiscal year in accordance with the Statement of Financial
Accounting Standards No. 123 (Revised 2005) (FAS 123R), Shared Based
Payments;
2.1.15.3. Earnings for services under non -equity incentive plans, not including group
life, health, hospitalization or medical reimbursement plans that do not
discriminate in favor of Executives and are available generally to all salaried
employees;
2.1.15.4. Change in present value of defined benefit and actuarial pension plans;
2.1.15.5. Above -market earnings on deferred compensation which is not tax -
qualified;
2.1.15.6. Other compensation, if the aggregate value of all such other compensation
(e.g., severance, termination payments, value of life insurance paid on
behalf of the employee, perquisites or property) for the Executive exceeds
$10,000.
2.1.16. "Transparency Act" means the Federal Funding Accountability and
Transparency Act of 2006 (Public Law 109-282), as amended by §6202 of Public
Law 110-252.
2.1.17. "Uniform Guidance" means the Office of Management and Budget
Uniform Administrative Requirements, Cost Principles, and Audit Requirements
for Federal Awards. The terms and conditions of the Uniform Guidance flow down
to Awards to Subrecipients unless the Uniform Guidance or the terms and
conditions of the Federal Award specifically indicate otherwise.
2.1.18. "Unique Entity ID Number" means the twelve -character alphanumeric ID
assigned to an entity by SAM.gov to uniquely identify a business
entity. Information on UEIs can be found at: sam.gov/content/duns-uei.
5
Exhibit F-1
V.5
3. COMPLIANCE.
3.1. Grantee shall comply with all applicable provisions of the Transparency Act and the
regulations issued pursuant thereto, all applicable provisions of the Uniform Guidance,
and all applicable Federal Laws and regulations required by this Federal Award. Any
revisions to such provisions or regulations shall automatically become a part of these
Federal Provisions, without the necessity of either party executing any further
instrument. The State of Colorado, at its discretion, may provide written notification to
Grantee of such revisions, but such notice shall not be a condition precedent to the
effectiveness of such revisions.
3.2. Per US Treasury Final Award requirements, grantee programs or services must not
include terms or conditions that undermine efforts to stop COVID-19 or discourage
compliance with recommendations and CDC guidelines.
4. SYSTEM FOR AWARD MANAGEMENT (SAM) AND UNIQUE ENTITY IDENTIFIER (UEI)
REQUIREMENTS.
4.1. SAM. Grantee shall maintain the currency of its information in SAM until the Grantee
submits the final financial report required under the Award or receives final payment,
whichever is later. Grantee shall review and update SAM information at least annually.
4.2. UEI. Grantee shall provide its UEI Number to its Prime Recipient, and shall update
Grantee's information in SAM at least annually.
5. TOTAL COMPENSATION.
5.1. Grantee shall include Total Compensation in SAM for each of its five most highly
compensated Executives for the preceding fiscal year if:
5.1.1. The total Federal funding authorized to date under the Award is $30,000 or
more; and
5.1.2. In the preceding fiscal year, Grantee received:
5.1.2.1. 80% or more of its annual gross revenues from Federal procurement
Agreements and Subcontractors and/or Federal financial assistance Awards
or Subawards subject to the Transparency Act; and
5.1.2.2. $30,000,000 or more in annual gross revenues from Federal procurement
Agreements and Subcontractors and/or Federal financial assistance Awards
or Subawards subject to the Transparency Act; and
5.1.2.3. 5.1.2.3 The public does not have access to information about the
compensation of such Executives through periodic reports filed under
section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C.
78m(a), 78o(d) or § 6104 of the Internal Revenue Code of 1986.
6
Exhibit F-1
V.5
6. REPORTING.
6.1. If Grantee is a Subrecipient of the Award pursuant to the Transparency Act, Grantee
shall report data elements to SAM and to the Prime Recipient as required in this Exhibit.
No direct payment shall be made to Grantee for providing any reports required under
these Federal Provisions and the cost of producing such reports shall be included in the
Grant price. The reporting requirements in this Exhibit are based on guidance from the
OMB, and as such are subject to change at any time by OMB. Any such changes shall
be automatically incorporated into this Grant and shall become part of Grantee's
obligations under this Grant.
7. EFFECTIVE DATE AND DOLLAR THRESHOLD FOR FEDERAL REPORTING.
7.1. Reporting requirements in §8 below apply to new Awards as of October 1, 2010, if the
initial award is $30,000 or more. If the initial Award is below $30,000 but subsequent
Award modifications result in a total Award of $30,000 or more, the Award is subject
to the reporting requirements as of the date the Award exceeds $30,000. If the initial
Award is $30,000 or more, but funding is subsequently de -obligated such that the total
award amount falls below $30,000, the Award shall continue to be subject to the
reporting requirements. If the total award is below $30,000 no reporting required; if
more than $30,000 and less than $50,000 then FFATA reporting is required; and,
$50,000 and above SLFRF reporting is required.
7.2. The procurement standards in §9 below are applicable to new Awards made by Prime
Recipient as of December 26, 2015. The standards set forth in §11 below are applicable
to audits of fiscal years beginning on or after December 26, 2014.
8. SUBRECIPIENT REPORTING REQUIREMENTS.
8.1. Grantee shall report as set forth below.
8.1.1. Grantee shall use the SLFRF Subrecipient Quarterly Report Workbook as referenced
in Appendix 4 to report to the State Agency within ten (10) days following each quarter
ended September, December, March and June. Additional information on specific
requirements are detailed in the SLFRF Subrecipient Quarterly Report Workbooks and
"Compliance and Reporting Guidance, State and Local Fiscal Recovery Funds" report
available at www.treasury.gov.
EC 1— Public Health
All Public Health Projects
a) Description of structure and objectives
b) Description of relation to COVID-19
c) Identification of impacted and/or disproportionately impacted communities
d) Capital Expenditures
i. Presence of capital expenditure in project
ii. Total projected capital expenditure
iii. Type of capital expenditure
iv. Written justification
v. Labor reporting
7
Exhibit F-1
V.5
COVID-19 Interventions and Mental Health (1.4, 1.11, 1.12, 1.13)
a) Amount of total project used for evidence -based programs
b) Evaluation plan description
COVID-19 Small Business Economic Assistance (1.8)
a) Number of small businesses served
COVID-19 Assistance to Non -Profits (1.9)
a) Number of non -profits served
COVID-19 Aid to Travel, Tourism, and Hospitality or Other Impacted Industries (1.10)
a) Sector of employer
b) Purpose of funds
c)
EC 2 — Negative Economic Impacts
All Negative Economic Impacts Projects
a) Description of project structure and objectives
b) Description of project's response to COVID-19
c) Identification of impacted and/or disproportionately impacted communities
d) Amount of total project used for evidence -based programs and description of
evaluation plan (not required for 2.5, 2.8, 2.21-2.24, 2.27-2.29, 2.31, 2.34-2.36)
e) Number of workers enrolled in sectoral job training programs
f) Number of workers completing sectoral job training programs
g) Number of people participating in summer youth employment programs
h) Capital Expenditures
i. Presence of capital expenditure in project
ii. Total projected capital expenditure
iii. Type of capital expenditure
iv. Written justification
v. Labor reporting
Household Assistance (2.1-2.8)
a) Number of households served
b) Number of people or households receiving eviction prevention services (2.2 & 2.5
only) (Federal guidance may change this requirement in July 2022)
c) Number of affordable housing units preserved or developed (2.2 & 2.5 only)
(Federal guidance may change this requirement in July 2022)
Healthy Childhood Environments (2.11-2.13)
a) Number of children served by childcare and early learning (Federal guidance may
change this requirement in July 2022)
b) Number of families served by home visiting (Federal guidance may change this
requirement in July 2022)
Education Assistance (2.14, 2.24-2.27)
a) National Center for Education Statistics ("NCES") School ID or NCES District ID
b) Number of students participating in evidence -based programs (Federal guidance may
change this requirement in July 2022)
Housing Support (2.15, 2.16, 2.18)
a) Number of people or households receiving eviction prevention services (Federal
guidance may change this requirement in July 2022)
8
Exhibit F-1
V.5
b) Number of affordable housing units preserved or developed (Federal guidance may
change this requirement in July 2022)
Small Business Economic Assistance (2.29-2.33)
a) Number of small businesses served
Assistance to Non -Profits (2.34)
a) Number of non -profits served
Aid to Travel, Tourism, and Hospitality or Other Impacted Industries (2.35-2.36)
a) Sector of employer
b) Purpose of funds
c) If other than travel, tourism and hospitality (2.36) — description of hardship
EC 3 — Public Health — Negative Economic Impact: Public Sector Capacity
Payroll for Public Health and Safety Employees (EC 3.1)
a) Number of government FTEs responding to COVID-19
Rehiring Public Sector Staff (EC 3.2)
a) Number of FTEs rehired by governments
EC 4 — Premium Pay
All Premium Pay Projects
a) List of sectors designated as critical by the chief executive of the jurisdiction, if
beyond those listed in the final rule
b) Numbers of workers served
c) Employer sector for all subawards to third -party employers
d) Written narrative justification of how premium pay is responsive to essential work
during the public health emergency for non-exempt workers or those making over
150 percent of the state/county's average annual wage
e) Number of workers to be served with premium pay in K-12 schools
EC 5 — Infrastructure Projects
All Infrastructure Projects
a) Projected/actual construction start date (month/year)
b) Projected/actual initiation of operations date (month/year)
c) Location (for broadband, geospatial data of locations to be served)
d) Projects over $10 million
i. Prevailing wage certification or detailed project employment and local
impact report
ii. Project labor agreement certification or project workforce continuity
plan
iii. Prioritization of local hires
iv. Community benefit agreement description, if applicable
Water and sewer projects (EC 5.1-5.18)
a) National Pollutant Discharge Elimination System (NPDES) Permit Number (if
applicable; for projects aligned with the Clean Water State Revolving Fund)
b) Public Water System (PWS) ID number (if applicable; for projects aligned with
the Drinking Water State Revolving Fund)
9
Exhibit F-1
V.5
c) Median Household Income of service area
d) Lowest Quintile Income of the service area
Broadband projects (EC 5.19-5.21)
a) Confirm that the project is designed to, upon completion, reliably meet or exceed
symmetrical 100 Mbps download and upload speeds.
i. If the project is not designed to reliably meet or exceed symmetrical 100
Mbps download and upload speeds, explain why not, and
ii. Confirm that the project is designed to, upon completion, meet or exceed
100 Mbps download speed and between at least 20 Mbps and 100 Mbps
upload speed, and be scalable to a minimum of 100 Mbps download
speed and 100 Mbps upload speed.
b) Additional programmatic data will be required for broadband projects and will be
defined in a subsequent version of the US Treasury Reporting Guidance,
including, but not limited to (Federal guidance may change this requirement in July 2022):
i. Number of households (broken out by households on Tribal lands and
those not on Tribal lands) that have gained increased access to
broadband meeting the minimum speed standards in areas that
previously lacked access to service of at least 25 Mbps download and 3
Mbps upload, with the number of households with access to minimum
speed standard of reliable 100 Mbps symmetrical upload and download
and number of households with access to minimum speed standard of
reliable 100 Mbps download and 20 Mbps upload
ii. Number of institutions and businesses (broken out by institutions on
Tribal lands and those not on Tribal lands) that have projected increased
access to broadband meeting the minimum speed standards in areas that
previously lacked access to service of at least 25 Mbps download and 3
Mbps upload, in each of the following categories: business, small
business, elementary school, secondary school, higher education
institution, library, healthcare facility, and public safety organization,
with the number of each type of institution with access to the minimum
speed standard of reliable 100 Mbps symmetrical upload and download;
and number of each type of institution with access to the minimum
speed standard of reliable 100 Mbps download and 20 Mbps upload.
iii. Narrative identifying speeds/pricing tiers to be offered, including the
speed/pricing of its affordability offering, technology to be deployed,
miles of fiber, cost per mile, cost per passing, number of households
(broken out by households on Tribal lands and those not on Tribal lands)
projected to have increased access to broadband meeting the minimum
speed standards in areas that previously lacked access to service of at
least 25 Mbps download and 3 Mbps upload, number of households with
access to minimum speed standard of reliable 100 Mbps symmetrical
upload and download, number of households with access to minimum
speed standard of reliable 100 Mbps download and 20 Mbps upload, and
number of institutions and businesses (broken out by institutions on
Tribal lands and those not on Tribal lands) projected to have increased
10
Exhibit F-1
V.5
access to broadband meeting the minimum speed standards in areas that
previously lacked access to service of at least 25 Mbps download and 3
Mbps upload, in each of the following categories: business, small
business, elementary school, secondary school, higher education
institution, library, healthcare facility, and public safety organization.
Specify the number of each type of institution with access to the
minimum speed standard of reliable 100 Mbps symmetrical upload and
download; and the number of each type of institution with access to the
minimum speed standard of reliable 100 Mbps download and 20 Mbps
upload.
All Expenditure Categories
a) Program income earned and expended to cover eligible project costs
8.1.2. A Subrecipient shall report the following data elements to Prime Recipient no later
than five days after the end of the month following the month in which the Subaward
was made.
8.1.2.1. Subrecipient UEI;
8.1.2.2. Subrecipient UEI if more than one electronic funds transfer (EFT) account;
8.1.2.3. Subrecipient parent's organization UEI;
8.1.2.4. Subrecipient's address, including: Street Address, City, State, Country, Zip
+ 4, and Congressional District;
8.1.2.5. Subrecipient's top 5 most highly compensated Executives if the criteria in
§4 above are met; and
8.1.2.6. Subrecipient's Total Compensation of top 5 most highly compensated
Executives if the criteria in §4 above met.
8.1.3. To Prime Recipient. A Subrecipient shall report to its Prime Recipient, the
following data elements:
8.1.3.1. Subrecipient's UEI as registered in SAM.
8.1.3.2. Primary Place of Performance Information, including: Street Address, City,
State, Country, Zip code + 4, and Congressional District.
8.1.3.3. Narrative identifying methodology for serving disadvantaged communities.
See the "Project Demographic Distribution" section in the "Compliance and
Reporting Guidance, State and Local Fiscal Recovery Funds" report
available at www.treasury.gov. This requirement is applicable to all
projects in Expenditure Categories 1 and 2.
8.1.3.4. Narrative identifying funds allocated towards evidenced -based
interventions and the evidence base. See the "Use of Evidence" section in
the "Compliance and Reporting Guidance, State and Local Fiscal Recovery
Funds" report available at www.treasury.gov. See section 8.1.1 for relevant
Expenditure Categories.
11
Exhibit F-1
V.5
8.1.3.5. Narrative describing the structure and objectives of the assistance program
and in what manner the aid responds to the public health and negative
economic impacts of COVID-19. This requirement is applicable to
Expenditure Categories 1 and 2. For aid to travel, tourism, and hospitality
or other impacted industries (EC 2.11-2.12), also provide the sector of
employer, purpose of funds, and if not travel, tourism and hospitality a
description of the pandemic impact on the industry.
8.1.3.6. Narrative identifying the sector served and designated as critical to the
health and well-being of residents by the chief executive of the jurisdiction
and the number of workers expected to be served. For groups of workers
(e.g., an operating unit, a classification of worker, etc.) or, to the extent
applicable, individual workers, other than those where the eligible worker
receiving premium pay is earning (with the premium pay included) below
150 percent of their residing state or county's average annual wage for all
occupations, as defined by the Bureau of Labor Statistics Occupational
Employement and Wage Statistics, whichever is higher, OR the eligible
worker reciving premium pay is not exempt from the Fair Labor Standards
Act overtime provisions, include justification of how the premium pay or
grant is responsive to workers performing essential work during the public
health emergency. This could include a description of the essential workers'
duties, health or financial risks faced due to COVID-19 but should not
include personally identifiable information. This requirement applies to EC
4.1, and 4.2.
8.1.3.7. For infrastructure projects (EC 5) or capital expenditures in any expenditure
category, narrative identifying the projected construction start date
(month/year), projected initiation of operations date (month/year), and
location (for broadband, geospatial location data).
8.1.3.7.1. For projects over $10 million:
8.1.3.7.1.1.
Certification that all laborers and mechanics employed by
Contractors and Subcontractors in the performance of such
project are paid wages at rates not less than those prevailing,
as determined by the U.S. Secretary of Labor in accordance
with subchapter IV of chapter 31 of title 40, United States
Code (commonly known as the "Davis -Bacon Act"), for the
corresponding classes of laborers and mechanics employed on
projects of a character similar to the Agreement work in the
civil subdivision of the State (or the District of Columbia) in
which the work is to be performed, or by the appropriate State
entity pursuant to a corollary State prevailing -wage -in -
construction law (commonly known as "baby Davis -Bacon
Acts"). If such certification is not provided, a recipient must
provide a project employment and local impact report
detailing (1) the number of employees of Contractors and sub-
contractors working on the project; (2) the number of
12
Exhibit F-1
V.5
8.1.3.7.1.2.
8.1.3.7.1.3.
8.1.3.7.1.4.
employees on the project hired directly and hired through a
third party; (3) the wages and benefits of workers on the
project by classification; and (4) whether those wages are at
rates less than those prevailing. Recipients must maintain
sufficient records to substantiate this information upon
request.
A Subrecipient may provide a certification that a project
includes a project labor agreement, meaning a pre -hire
collective bargaining agreement consistent with section 8(f)
of the National Labor Relations Act (29 U.S.C. 158(f)). If the
recipient does not provide such certification, the recipient
must provide a project workforce continuity plan, detailing:
(1) how the Subrecipient will ensure the project has ready
access to a sufficient supply of appropriately skilled and
unskilled labor to ensure high -quality construction throughout
the life of the project; (2) how the Subrecipient will minimize
risks of labor disputes and disruptions that would jeopardize
timeliness and cost-effectiveness of the project; and (3) how
the Subrecipient will provide a safe and healthy workplace
that avoids delays and costs associated with workplace
illnesses, injuries, and fatalities; (4) whether workers on the
project will receive wages and benefits that will secure an
appropriately skilled workforce in the context of the local or
regional labor market; and (5) whether the project has
completed a project labor agreement.
Whether the project prioritizes local hires.
Whether the project has a Community Benefit Agreement,
with a description of any such agreement.
8.1.4. Subrecipient also agrees to comply with any reporting requirements established by the
US Treasury, Governor's Office and Office of the State Controller. The State of
Colorado may need additional reporting requirements after this agreement is executed.
If there are additional reporting requirements, the State will provide notice of such
additional reporting requirements via Appendix 5— SLFRF Reporting Modification
Form.
9. PROCUREMENT STANDARDS.
9.1. Procurement Procedures. A Subrecipient shall use its own documented procurement
procedures which reflect applicable State, local, and Tribal laws and applicable
regulations, provided that the procurements conform to applicable Federal law and the
standards identified in the Uniform Guidance, including without limitation, 2 CFR
200.318 through 200.327 thereof
13
Exhibit F-1
V.5
9.2. Domestic preference for procurements (2 CFR 200.322). As appropriate and to the
extent consistent with law, the non -Federal entity should, to the greatest extent
practicable under a Federal award, provide a preference for the purchase, acquisition,
or use of goods, products, or materials produced in the United States (including but not
limited to iron, aluminum, steel, cement, and other manufactured products). The
requirements of this section must be included in all subawards including all
Agreements and purchase orders for work or products under this award.
9.3. Procurement of Recovered Materials. If a Subrecipient is a State Agency or an agency
of a political subdivision of the State, its Contractors must comply with section 6002
of the Solid Waste Disposal Act, as amended by the Resource Conservation and
Recovery Act. The requirements of Section 6002 include procuring only items
designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part
247, that contain the highest percentage of recovered materials practicable, consistent
with maintaining a satisfactory level of competition, where the purchase price of the
item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal
year exceeded $10,000; procuring solid waste management services in a manner that
maximizes energy and resource recovery; and establishing an affirmative procurement
program for procurement of recovered materials identified in the EPA guidelines.
10. ACCESS TO RECORDS.
10.1. A Subrecipient shall permit Prime Recipient and its auditors to have access to
Subrecipient's records and financial statements as necessary for Recipient to meet the
requirements of 2 CFR 200.332 (Requirements for pass -through entities), 2 CFR
200.300 (Statutory and national policy requirements) through 2 CFR 200.309 (Period
of performance), and Subpart F -Audit Requirements of the Uniform Guidance.
11. SINGLE AUDIT REQUIREMENTS.
11.1. If a Subrecipient expends $750,000 or more in Federal Awards during the
Subrecipient's fiscal year, the Subrecipient shall procure or arrange for a single or
program -specific audit conducted for that year in accordance with the provisions of
Subpart F -Audit Requirements of the Uniform Guidance, issued pursuant to the Single
Audit Act Amendments of 1996, (31 U.S.C. 7501-7507). 2 CFR 200.501.
11.1.1. Election. A Subrecipient shall have a single audit conducted in accordance
with Uniform Guidance 2 CFR 200.514 (Scope of audit), except when it elects to
have a program -specific audit conducted in accordance with 2 CFR 200.507
(Program -specific audits). The Subrecipient may elect to have a program -specific
audit if Subrecipient expends Federal Awards under only one Federal program
(excluding research and development) and the Federal program's statutes,
regulations, or the terms and conditions of the Federal award do not require a
financial statement audit of Prime Recipient. A program -specific audit may not be
elected for research and development unless all of the Federal Awards expended
were received from Recipient and Recipient approves in advance a program -
specific audit.
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Exhibit F-1
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11.1.2. Exemption. If a Subrecipient expends less than $750,000 in Federal Awards
during its fiscal year, the Subrecipient shall be exempt from Federal audit
requirements for that year, except as noted in 2 CFR 200.503 (Relation to other
audit requirements), but records shall be available for review or audit by appropriate
officials of the Federal agency, the State, and the Government Accountability
Office.
11.1.3. Subrecipient Compliance Responsibility. A Subrecipient shall procure or
otherwise arrange for the audit required by Subpart F of the Uniform Guidance and
ensure it is properly performed and submitted when due in accordance with the
Uniform Guidance. Subrecipient shall prepare appropriate financial statements,
including the schedule of expenditures of Federal awards in accordance with 2 CFR
200.510 (Financial statements) and provide the auditor with access to personnel,
accounts, books, records, supporting documentation, and other information as
needed for the auditor to perform the audit required by Uniform Guidance Subpart
F -Audit Requirements.
12. GRANT PROVISIONS FOR SUBRECIPIENT AGREEMENTS.
12.1. In addition to other provisions required by the Federal Awarding Agency or the Prime
Recipient, Grantees that are Subrecipients shall comply with the following provisions.
Subrecipients shall include all of the following applicable provisions in all
Subcontractors entered into by it pursuant to this Grant.
12.1.1. [Applicable to federally assisted construction Agreements.] Equal
Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all
Agreements that meet the definition of "federally assisted construction Agreement"
in 41 CFR Part 60-1.3 shall include the equal opportunity clause provided under 41
CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment
Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as
amended by Executive Order 11375, "Amending Executive Order 11246 Relating
to Equal Employment Opportunity," and implementing regulations at 41 CFR part
60, Office of Federal Agreement Compliance Programs, Equal Employment
Opportunity, Department of Labor.
12.1.2. [Applicable to on -site employees working on government -funded
construction, alteration and repair projects.] Davis -Bacon Act. Davis -Bacon Act,
as amended (40 U.S.C. 3141-3148).
12.1.3. Rights to Inventions Made Under a grant or agreement. If the Federal
Award meets the definition of "funding agreement" under 37 CFR 401.2 (a) and
the Prime Recipient or Subrecipient wishes to enter into an Agreement with a small
business firm or nonprofit organization regarding the substitution of parties,
assignment or performance of experimental, developmental, or research work
under that "funding agreement," the Prime Recipient or Subrecipient must comply
with the requirements of 37 CFR Part 401, "Rights to Inventions Made by
Nonprofit Organizations and Small Business Firms Under Government Grants,
Agreements and Cooperative Agreements," and any implementing regulations
issued by the Federal Awarding Agency.
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12.1.4. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution
Control Act (33 U.S.C. 1251-1387), as amended. Agreements and subgrants of
amounts in excess of $150,000 must contain a provision that requires the non -
Federal awardees to agree to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the
Federal Water Pollution Control Act as amended (33 U.S.C. 1251-1387).
Violations must be reported to the Federal Awarding Agency and the Regional
Office of the Environmental Protection Agency (EPA).
12.1.5. Debarment and Suspension (Executive Orders 12549 and 12689). A
Agreement award (see 2 CFR 180.220) must not be made to parties listed on the
government wide exclusions in SAM, in accordance with the OMB guidelines at 2
CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189)
and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension." SAM
Exclusions contains the names of parties debarred, suspended, or otherwise
excluded by agencies, as well as parties declared ineligible under statutory or
regulatory authority other than Executive Order 12549.
12.1.6. Byrd Anti -Lobbying Amendment (31 U.S.C. 1352). Contractors that apply
or bid for an award exceeding $100,000 must file the required certification. Each
tier certifies to the tier above that it will not and has not used Federal appropriated
funds to pay any person or organization for influencing or attempting to influence
an officer or employee of any agency, a member of Congress, officer or employee
of Congress, or an employee of a member of Congress in connection with obtaining
any Federal Agreement, grant or any other award covered by 31 U.S.C. 1352. Each
tier must also disclose any lobbying with non -Federal funds that takes place in
connection with obtaining any Federal award. Such disclosures are forwarded from
tier to tier up to the non -Federal award.
12.1.7. Never Agreement with the enemy (2 CFR 200.215). Federal awarding
agencies and recipients are subject to the regulations implementing "Never
Agreement with the enemy" in 2 CFR part 183. The regulations in 2 CFR part 183
affect covered Agreements, grants and cooperative agreements that are expected to
exceed $50,000 within the period of performance, are performed outside the United
States and its territories, and are in support of a contingency operation in which
members of the Armed Forces are actively engaged in hostilities.
12.1.8. Prohibition on certain telecommunications and video surveillance services
or equipment (2 CFR 200.216). Grantee is prohibited from obligating or expending
loan or grant funds on certain telecommunications and video surveillance services
or equipment pursuant to 2 CFR 200.216.
12.1.9. Title VI of the Civil Rights Act. The Subgrantee, Contractor, Subcontractor,
transferee, and assignee shall comply with Title VI of the Civil Rights Act of 1964,
which prohibits recipients of federal financial assistance
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Exhibit F-1
V.5
from excluding from a program or activity, denying benefits of, or otherwise
discriminating against a person on the basis of race, color, or national origin (42
U.S.C. § 2000d et seq.), as implemented by the Department of Treasury's Title VI
regulations, 31 CFR Part 22, which are herein incorporated by reference and made
a part of this Agreement (or agreement). Title VI also includes protection to
persons with "Limited English Proficiency" in any program or activity receiving
federal financial assistance, 42 U.S. C. § 2000d et seq., as implemented by the
Department of the Treasury's Title VI regulations, 31 CRF Part 22, and herein
incorporated by reference and made part of this Agreement or agreement.
13. CERTIFICATIONS.
13.1. Subrecipient Certification. Subrecipient shall sign a "State of Colorado Agreement
with Recipient of Federal Recovery Funds" Certification Form in separate Appendix
hereto and submit to State Agency with signed grant agreement.
13.2. Unless prohibited by Federal statutes or regulations, Prime Recipient may require
Subrecipient to submit certifications and representations required by Federal statutes
or regulations on an annual basis. 2 CFR 200.208. Submission may be required more
frequently if Subrecipient fails to meet a requirement of the Federal award.
Subrecipient shall certify in writing to the State at the end of the Award that the project
or activity was completed or the level of effort was expended. 2 CFR 200.201(3). If
the required level of activity or effort was not carried out, the amount of the Award
must be adjusted.
14. EXEMPTIONS.
14.1. These Federal Provisions do not apply to an individual who receives an Award as a
natural person, unrelated to any business or non-profit organization he or she may own
or operate in his or her name.
14.2. A Grantee with gross income from all sources of less than $300,000 in the previous tax
year is exempt from the requirements to report Subawards and the Total Compensation
of its most highly compensated Executives.
EVENT OF DEFAULT AND TERMINATION.
14.3. Failure to comply with these Federal Provisions shall constitute an event of default
under the Grant and the State of Colorado may terminate the Grant upon 30 days prior
written notice if the default remains uncured five calendar days following the
termination of the 30 -day notice period. This remedy will be in addition to any other
remedy available to the State of Colorado under the Grant, at law or in equity.
14.4. Termination (2 CFR 200.340). The Federal Award may be terminated in whole or in
part as follows:
14.4.1. By the Federal Awarding Agency or Pass -through Entity, if a Non -Federal
Entity fails to comply with the terms and conditions of a Federal Award;
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Exhibit F-1
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14.4.2. By the Federal awarding agency or Pass -through Entity, to the greatest
extent authorized by law, if an award no longer effectuates the program goals or
agency priorities;
14.4.3. By the Federal awarding agency or Pass -through Entity with the consent of
the Non -Federal Entity, in which case the two parties must agree upon the
termination conditions, including the effective date and, in the case of partial
termination, the portion to be terminated;
14.4.4. By the Non -Federal Entity upon sending to the Federal Awarding Agency
or Pass -through Entity written notification setting forth the reasons for such
termination, the effective date, and, in the case of partial termination, the portion to
be terminated. However, if the Federal Awarding Agency or Pass -through Entity
determines in the case of partial termination that the reduced or modified portion
of the Federal Award or Subaward will not accomplish the purposes for which the
Federal Award was made, the Federal Awarding Agency or Pass -through Entity
may terminate the Federal Award in its entirety; or
14.4.5. By the Federal Awarding Agency or Pass -through Entity pursuant to
termination provisions included in the Federal Award.
THE REMAINDER OF THIS PAGE WAS INTENTIONALLY LEFT BLANK
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Exhibit F-1
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APPENDIX 3 TO SLFRF EXHIBIT- SUBRECIPIENT CERTIFICATION
AGREEMENT
AGREEMENT WITH SUBRECIPIENT OF FEDERAL RECOVERY FUNDS
Section 602(b) of the Social Security Act (the Act), as added by section 9901 of the
American Rescue Plan Act (ARPA), Pub. L. No. 117-2 (March 11, 2021), authorizes the
Department of the Treasury (Treasury) to make payments to certain Subrecipients from
the Coronavirus State Fiscal Recovery Fund. The State of Colorado has signed and
certified a separate agreement with Treasury as a condition of receiving such payments
from the Treasury. This agreement is between your organization and the State and your
organization is signing and certifying the same terms and conditions included in the
State's separate agreement with Treasury. Your organization is referred to as a
Subrecipient.
As a condition of your organization receiving federal recovery funds from the State, the
authorized representative below hereby (i) certifies that your organization will carry out
the activities listed in section 602(c) of the Act and (ii) agrees to the terms attached hereto.
Your organization also agrees to use the federal recovery funds as specified in bills passed
by the General Assembly and signed by the Governor.
Under penalty of perjury, the undersigned official certifies that the authorized
representative has read and understood the organization's obligations in the Assurances
of Compliance and Civil Rights Requirements, that any information submitted in
conjunction with this assurances document is accurate and complete, and that the
organization is in compliance with the nondiscrimination requirements.
Subrecipient Name:
Authorized Representative:
Title:
Signature:
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Exhibit F-1
V.5
AGREEMENT WITH SUBRECIPIENT OF FEDERAL RECOVERY FUNDS
TERMS AND CONDITIONS
1. Use of Funds.
a. Subrecipient understands and agrees that the funds disbursed under this award
may only be used in compliance with section 602(c) of the Social Security Act
(the Act) and Treasury's regulations implementing that section and guidance.
b. Subrecipient will determine prior to engaging in any project using this assistance
that it has the institutional, managerial, and financial capability to ensure proper
planning, management, and completion of such project.
2. Period of Performance. The period of performance for this subaward is shown on
page one of this Agreement. Subrecipient may use funds to cover eligible costs
incurred, as set forth in Treasury's implementing regulations, during this period of
performance.
3. Reporting. Subrecipient agrees to comply with any reporting obligations established by
Treasury as they relate to this award. Subrecipient also agrees to comply with any reporting
requirements established by the Governor's Office and Office of the State Controller. The
State will provide notice of such additional reporting requirements via separate Appendix
hereto — Reporting Modification Form.
4. Maintenance of and Access to Records
a. Subrecipient shall maintain records and financial documents sufficient to
evidence compliance with section 602(c), Treasury's regulations implementing
that section, and guidance issued by Treasury regarding the foregoing.
b. The Treasury Office of Inspector General and the Government Accountability
Office, or their authorized representatives, shall have the right of access to records
(electronic and otherwise) of Subrecipient in order to conduct audits or other
investigations.
c. Records shall be maintained by Subrecipient for a period of five (5) years after
all funds have been expended or returned to Treasury, whichever is later.
5. Pre -award Costs. Pre -award costs, as defined in 2 C.F.R. § 200.458, may not be paid
with funding from this award.
6. Administrative Costs. Subrecipient may use funds provided under this award to cover
both direct and indirect costs. Subrecipient shall follow guidance on administrative
costs issued by the Governor's Office and Office of the State Controller.
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Exhibit F-1
V.5
7. Cost Sharing. Cost sharing or matching funds are not required to be provided by
Subrecipient.
8. Conflicts of Interest. The State of Colorado understands and agrees it must maintain a
conflict of interest policy consistent with 2 C.F.R. § 200.318(c) and that such conflict of
interest policy is applicable to each activity funded under this award. Subrecipient and
Contractors must disclose in writing to the Office of the State Controller or the pass -
through entity, as appropriate, any potential conflict of interest affecting the awarded
funds in accordance with 2 C.F.R. § 200.112. The Office of the State Controller shall
disclose such conflict to Treasury.
9. Compliance with Applicable Law and Regulations.
a. Subrecipient agrees to comply with the requirements of section 602 of the Act,
regulations adopted by Treasury pursuant to section 602(f) of the Act, and
guidance issued by Treasury regarding the foregoing. Subrecipient also agrees to
comply with all other applicable federal statutes, regulations, and executive
orders, and Subrecipient shall provide for such compliance by other parties in any
agreements it enters into with other parties relating to this award.
b. Federal regulations applicable to this award include, without limitation, the following:
Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards, 2 C.F.R. Part 200, other than such
provisions as Treasury may determine are inapplicable to this Award and
subject to such exceptions as may be otherwise provided by Treasury.
Subpart F — Audit Requirements of the Uniform Guidance, implementing
the Single Audit Act, shall apply to this award.
ii. Universal Identifier and System for Award Management (SAM), 2 C.F.R.
Part 25, pursuant to which the award term set forth in Appendix A to 2
C.F.R. Part 25 is hereby incorporated by reference.
iii. Reporting Subaward and Executive Compensation Information, 2 C.F.R.
Part 170, pursuant to which the award term set forth in Appendix A to 2
C.F.R. Part 170 is hereby incorporated by reference.
iv. OMB Guidelines to Agencies on Government wide Debarment and
Suspension (Nonprocurement), 2 C.F.R. Part 180, including the
requirement to include a term or condition in all lower tier covered
transactions (Agreements and Subcontractors described in 2 C.F.R. Part
180, subpart B) that the award is subject to 2 C.F.R. Part 180 and
Treasury's implementing regulation at 31 C.F.R. Part 19.
v. Subrecipient Integrity and Performance Matters, pursuant to which the
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Exhibit F-1
V.5
award term set forth in 2 C.F.R. Part 200, Appendix XII to Part 200 is
hereby incorporated by reference.
vi. Government wide Requirements for Drug -Free Workplace, 31 C.F.R. Part
20.
vii. New Restrictions on Lobbying, 31 C.F.R. Part 21.
viii. Uniform Relocation Assistance and Real Property Acquisitions Act of
1970 (42 U.S.C. §§ 4601-4655) and implementing regulations.
ix. Generally applicable federal environmental laws and regulations.
c. Statutes and regulations prohibiting discrimination applicable to this award
include, without limitation, the following:
i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d et seq.) and
Treasury's implementing regulations at 31 C.F.R. Part 22, which prohibit
discrimination on the basis of race, color, or national origin under
programs or activities receiving federal financial assistance;
ii. The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42
U.S.C. §§ 3601 et seq.), which prohibits discrimination in housing on
the basis of race, color, religion, national origin, sex, familial status, or
disability;
iii. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §
794), which prohibits discrimination on the basis of disability under any
program or activity receiving federal financial assistance;
iv. The Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101 et
seq.), and Treasury's implementing regulations at 31 C.F.R. Part 23,
which prohibit discrimination on the basis of age in programs or activities
receiving federal financial assistance; and
v. Title II of the Americans with Disabilities Act of 1990, as amended (42
U.S.C. §§ 12101 et seq.), which prohibits discrimination on the basis of
disability under programs, activities, and services provided or made
available by state and local governments or instrumentalities or agencies
thereto.
Remedial Actions. In the event of Subrecipient's noncompliance with section 602 of
the Act, other applicable laws, Treasury's implementing regulations, guidance, or
any reporting or other program requirements, Treasury may impose additional
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Exhibit F-1
V.5
10. conditions on the receipt of a subsequent tranche of future award funds, if any, or
take other available remedies as set forth in 2 C.F.R. § 200.339. In the case of a
violation of section 602(c) of the Act regarding the use of funds, previous payments
shall be subject to recoupment as provided in section 602(e) of the Act and any
additional payments may be subject to withholding as provided in sections
602(b)(6)(A)(ii)(III) of the Act, as applicable.
11. Hatch Act. Subrecipient agrees to comply, as applicable, with requirements of the Hatch
Act (5 U.S.C.§§ 1501-1508 and 7324-7328), which limit certain political activities of
State or local government employees whose principal employment is in connection with
an activity financed in whole or in part by this federal assistance.
12. False Statements. Subrecipient understands that making false statements or claims in
connection with this award is a violation of federal law and may result in criminal,
civil, or administrative sanctions, including fines, imprisonment, civil damages and
penalties, debarment from participating in federal awards or Agreements, and/or any
other remedy available by law.
13. Publications. Any publications produced with funds from this award must
display the following language: "This project [is being] [was] supported, in
whole or in part, by federal award number SLFRF0126 awarded to the State of
Colorado by the U.S. Department of the Treasury."
14. Debts Owed the Federal Government.
a. Any funds paid to the Subrecipient (1) in excess of the amount to which the
Subrecipient is finally determined to be authorized to retain under the terms
of this award; (2) that are determined by the Treasury Office of Inspector
General to have been misused; or (3) that are determined by Treasury to be
subject to a repayment obligation pursuant to sections 602(e) and
603(b)(2)(D) of the Act and have not been repaid by the Subrecipient shall
constitute a debt to the federal government.
b. Any debts determined to be owed to the federal government must be paid
promptly by Subrecipient. A debt is delinquent if it has not been paid by the
date specified in Treasury's initial written demand for payment, unless other
satisfactory arrangements have been made or if the Subrecipient knowingly
or improperly retains funds that are a debt as defined in paragraph 14(a).
Treasury will take any actions available to it to collect such a debt.
15. Disclaimer.
a. The United States expressly disclaims any and all responsibility or liability to
Subrecipient or third persons for the actions of Subrecipient or third persons
resulting in death, bodily injury, property damages, or any other losses
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Exhibit F-1
V.5
resulting in any way from the performance of this award or any other losses
resulting in any way from the performance of this award or any Agreement,
or Subcontractor under this award.
b. The acceptance of this award by Subrecipient does not in any way establish
an agency relationship between the United States and Subrecipient.
16. Protections for Whistleblowers.
a. In accordance with 41 U.S.C. § 4712, Subrecipient may not discharge, demote,
or otherwise discriminate against an employee in reprisal for disclosing to any of
the list of persons or entities provided below, information that the employee
reasonably believes is evidence of gross mismanagement of a federal Agreement
or grant, a gross waste of federal funds, an abuse of authority relating to a federal
Agreement or grant, a substantial and specific danger to public health or safety,
or a violation of law, rule, or regulation related to a federal Agreement (including
the competition for or negotiation of an Agreement) or grant.
b. The list of persons and entities referenced in the paragraph above includes the
following:
i. A member of Congress or a representative of a committee of Congress;
ii. An Inspector General;
iii. The Government Accountability Office;
iv. A Treasury employee responsible for Agreement or grant oversight or
management;
v. An authorized official of the Department of Justice or other law
enforcement agency;
vi. A court or grand jury; or
vii. A management official or other employee of Subrecipient,
Contractor, or Subcontractor who has the responsibility to
investigate, discover, or address misconduct.
c. Subrecipient shall inform its employees in writing of the rights and remedies
provided under this section, in the predominant native language of the workforce.
17. Increasing Seat Belt Use in the United States. Pursuant to Executive Order 13043,
62 FR 19217 (Apr. 18, 1997), Subrecipient should encourage its Contractors to
adopt and enforce on-the-job seat belt policies and programs for their employees
when operating company -owned, rented or personally owned vehicles.
1. Reducing Text Messaging While Driving. Pursuant to Executive Order 13513, 74 FR
51225 (Oct. 6, 2009), Subrecipient should encourage its employees, Subrecipients, and
Contractors to adopt and enforce policies that ban text messaging while driving, and
Subrecipient should establish workplace safety policies to decrease accidents caused by
distracted drivers.
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Exhibit F-1
V.5
ASSURANCES OF COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS
ASSURANCES OF COMPLIANCE WITH
TITLE VI OF THE CIVIL RIGHTS ACT OF
1964
As a condition of receipt of federal financial assistance from the Department of the
Treasury, the Subrecipient provides the assurances stated herein. The federal financial
assistance may include federal grants, loans and Agreements to provide assistance to the
Subrecipient's beneficiaries, the use or rent of Federal land or property at below market value,
Federal training, a loan of Federal personnel, subsidies, and other arrangements with the
intention of providing assistance. Federal financial assistance does not encompass
Agreements of guarantee or insurance, regulated programs, licenses, procurement
Agreements by the Federal government at market value, or programs that provide direct
benefits.
The assurances apply to all federal financial assistance from or funds made available
through the Department of the Treasury, including any assistance that the Subrecipient may
request in the future.
The Civil Rights Restoration Act of 1987 provides that the provisions of the
assurances apply to all of the operations of the Subrecipient's program(s) and activity(ies), so
long as any portion of the Subrecipient's program(s) or activity(ies) is federally assisted in
the manner prescribed above.
1. Subrecipient ensures its current and future compliance with Title VI of the Civil Rights Act
of 1964, as amended, which prohibits exclusion from participation, denial of the benefits of,
or subjection to discrimination under programs and activities receiving federal financial
assistance, of any person in the United States on the ground of race, color, or national origin
(42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury Title VI
regulations at 31 CFR Part 22 and other pertinent executive orders such as Executive Order
13166, directives, circulars, policies, memoranda, and/or guidance documents.
2. Subrecipient acknowledges that Executive Order 13166, "Improving Access to Services
for Persons with Limited English Proficiency," seeks to improve access to federally
assisted programs and activities for individuals who, because of national origin, have
Limited English proficiency (LEP). Subrecipient understands that denying a person access
to its programs, services, and activities because of LEP is a form of national origin
discrimination prohibited under Title VI of the Civil Rights Act of 1964 and the
Department of the Treasury's implementing regulations. Accordingly, Subrecipient shall
initiate reasonable steps, or comply with the Department of the Treasury's directives, to
ensure that LEP persons have meaningful access to its programs, services, and activities.
Subrecipient understands and agrees that meaningful access may entail providing
language assistance services, including oral interpretation and written translation where
necessary, to ensure effective communication in the Subrecipient's programs, services,
and activities.
3. Subrecipient agrees to consider the need for language services for LEP persons when
Subrecipient develops applicable budgets and conducts programs, services, and activities.
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Exhibit F-1
V.5
As a resource, the Department of the Treasury has published its LEP guidance at 70 FR
6067. For more information on taking reasonable steps to provide meaningful access for
LEP persons, please visit http://www.lep.gov.
4. Subrecipient acknowledges and agrees that compliance with the assurances constitutes a
condition of continued receipt of federal financial assistance and is binding upon
Subrecipient and Subrecipient's successors, transferees, and assignees for the period in
which such assistance is provided.
5. Subrecipient acknowledges and agrees that it must require any sub -grantees, contractors,
subcontractors, successors, transferees, and assignees to comply with assurances 1-4
above, and agrees to incorporate the following language in every Agreement or
agreement subject to Title VI and its regulations between the Subrecipient and the
Subrecipient's sub -grantees, Contractors, Subcontractors, successors, transferees, and
assignees:
The sub -grantee, Contractor, Subcontractor, successor, transferee, and assignee shall
comply with Title VI of the Civil Rights Act of 1964, which prohibits Subrecipients of
federal financial assistance from excluding from a program or activity, denying benefits
of or otherwise discriminating against a person on the basis of race, color, or national
origin (42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury's
Title VI regulations, 31 CFR Part 22, which are herein incorporated by reference and
made a part of this Agreement (or agreement). Title VI also includes protection to
persons with "Limited English Proficiency" in any program or activity receiving federal
financial assistance, 42
U.S.C. § 2000d et seq., as implemented by the Department of the Treasury's Title VI
regulations, 31 CFR Part 22, and herein incorporated by reference and made a part
of this Agreement or agreement.
6. Subrecipient understands and agrees that if any real property or structure is provided or
improved with the aid of federal financial assistance by the Department of the Treasury, this
assurance obligates the Subrecipient, or in the case of a subsequent transfer, the transferee,
for the period during which the real property or structure is used for a purpose for which the
federal financial assistance is extended or for another purpose involving the provision of
similar services or benefits. If any personal property is provided, this assurance obligates the
Subrecipient for the period during which it retains ownership or possession of the property.
7. Subrecipient shall cooperate in any enforcement or compliance review activities by the
Department of the Treasury of the aforementioned obligations. Enforcement may include
investigation, arbitration, mediation, litigation, and monitoring of any settlement
agreements that may result from these actions. The Subrecipient shall comply with
information requests, on -site compliance reviews and reporting requirements.
8. Subrecipient shall maintain a complaint log and inform the Department of the Treasury of
any complaints of discrimination on the grounds of race, color, or national origin, and limited
English proficiency covered by Title VI of the Civil Rights Act of 1964 and implementing
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Exhibit F-1
V.5
regulations and provide, upon request, a list of all such reviews or proceedings based on the
complaint, pending or completed, including outcome. Subrecipient also must inform the
Department of the Treasury if Subrecipient has received no complaints under Title VI.
9. Subrecipient must provide documentation of an administrative agency's or court's
findings of non-compliance of Title VI and efforts to address the non-compliance,
including any voluntary compliance or other agreements between the Subrecipient and
the administrative agency that made the finding. If the Subrecipient settles a case or
matter alleging such discrimination, the Subrecipient must provide documentation of
the settlement. If Subrecipient has not been the subject of any court or administrative
agency finding of discrimination, please so state.
10. If the Subrecipient makes sub -awards to other agencies or other entities, the Subrecipient
is responsible for ensuring that sub-Subrecipients also comply with Title VI and other
applicable authorities covered in this document State agencies that make sub -awards
must have in place standard grant assurances and review procedures to demonstrate that
that they are effectively monitoring the civil rights compliance of sub- Subrecipients.
The United States of America has the right to seek judicial enforcement of the terms of this
assurances document and nothing in this document alters or limits the federal enforcement
measures that the United States may take in order to address violations of this document or
applicable federal law.
APPENDIX 4 TO SLFRF EXHIBIT- SLFRF SUBRECIPIENT QUARTERLY
REPORT REQUIREMENTS
1. SLFRF SUBRECIPIENT QUARTERLY REPORT WORKBOOK
1.1 The SLFRF Subrecipient Quarterly Report Workbook must be submitted to the State
Agency within ten (10) days following each quarter ended September, December,
March and June. The SLFRF Subrecipient Quarterly Report Workbook can be found
at: https://osc.colorado.gov/american-rescue-plan-act (see SLFRF Grant Agreement
Templates Tab).
1.2 The requirements set forth in this Appendix 4 do not apply if the instant Agreement is
between two Colorado State Agencies.
27
Exhibit F-1
V.5
APPENDIX 5 TO SLFRF EXHIBIT- SAMPLE SLFRF REPORTING
MODIFICATIONS FORM
Grantee:
Project Title:
Project Duration: I To: I
State Agency:
Grant Agreement No:
Project No:
From:
This form serves as notification that there has been a change to the reporting requirements set forth in the original
SLFRF Grant Agreement.
The following reporting requirements have been (add/ remove additional rows as necessary):
�`"� y*ec� Y�. `'l
P 'tt •.�
�w `�u'�`Yk,Ye� � �x� '� Y A4 3i.
By signing this form, the Grantee agrees to and acknowledges the changes to the reporting requirements set
forth in the original SLFRF Grant Agreement. All other terms and conditions of the original SLFRF Grant
Agreement, with any approved modifications, remain in full force and effect. Grantee shall submit this form
to the State Agency within 10 business days of the date sent by that Agency.
Grantee
State Agency Grant Manager
Date
Date
28
t ct F
Entity Information
Entity Name* Entity ID*
COLORADO DEPARTMENT OF @00003650
HUMAN SERVICES
Contract Name *
CDHS BHA CHILDREN, YOUTH, FAMILY (CYF) SERVICES
GRANT HB22-1281 HIGH FIDELITY WRAP TEAM
AMENDMENT #1
Contract Status
CTB REVIEW
Contract ID
8266
Contract Lead *
SADAMS
Q New Entity?
Parent Contract ID
20232546
Requires Board Approval
YES
Contract Lead Email Department Project #
sadams@weld.gov;cobbx
xlk@weld.gov
Contract Description *
CDHS BHA CHILDREN, YOUTH, FAMILY (CYF) SERVICES GRANT HB22-1 281 HIGH FIDELITY WRAP TEAM
AMENDMENT #1. TERM: JULY 1, 2024 THROUGH JUNE 30, 2025. UPDATE EXHIBIT B, C, E AND F. CHAIR WILL
SIGN ELECTRONICALLY VIA DOCUSIGN.
Contract Description 2
PA ROUTING THROUGH NORMAL PROCESS. ETA TO CTB IS 6/5/24.
Contract Type *
AMENDMENT
Amount*
$470,085.09
Renewable *
NO
Automatic Renewal
Grant
IGA
Department
HUMAN SERVICES
Department Email
CM-
HumanServices@weldgov.
com
Department Head Email
CM-HumanServices-
DeptHead@weldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY@WEL
DGOV.COM
Requested BOCC Agenda
Date *
06/12/2024
Due Date
06/08/2024
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be
included?
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date
Termination Notice Period
Contact Information
Review Date
04/30/2025
Committed Delivery Date
Renewal Date
Expiration Date*
06/30/2025
Contact Info
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
Approval Process
Department Head Finance Approver Legal Counsel
JAMIE ULRICH CHERYL PATTELLI BYRON HOWELL
DH Approved Date Finance Approved Date Legal Counsel Approved Date
06/10/2024 06/10/2024 06/10/2024
Final Approval
BOCC Approved Tyler Ref #
AG 061924
BOCC Signed Date Originator
SADAMS
BOCC Agenda Date
06/19/2024
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