HomeMy WebLinkAbout20211593.tiffRESOLUTION
RE: APPROVE GRANT APPLICATION FOR 2021 COMPREHENSIVE OPIOID,
STIMULANT, AND SUBSTANCE ABUSE SITE -BASED PROGRAM, AND AUTHORIZE
ELECTRONIC SUBMITTAL
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Grant Application for the 2021
Comprehensive Opioid, Stimulant, and Substance Abuse Site -Based Program from the County
of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,
on behalf of the Sheriff's Office, to the U.S. Department of Justice, Office of Justice Programs,
Bureau of Justice Assistance, with further terms and conditions being as stated in said application,
and
WHEREAS, after review, the Board deems it advisable to approve said application, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the Grant Application for the 2021 Comprehensive Opioid, Stimulant,
and Substance Abuse Site -Based Program from the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Sheriff's Office, to
the U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Assistance, be, and
hereby is, approved.
BE IT FURTHER RESOLVED by the Board that Sonja Kohlgraf, Sheriff's Office, be, and
hereby is, authorized to submit said application electronically and digitally sign such appropriate
declarations and certifications as required by the grant application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 21st day of June, A.D., 2021.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: des:C.0LN) Xp.ok
Weld County Clerk to the Board
County Attorney
Date of signature: �" �Co ( oft al
07/07/2(
2021-1593
SO0042
&7 vet lb # /257
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: FY 2021 Comprehensive Opioid, Stimulant, and Substance Abuse Site Based
Program Grant Application request (BJA — Federal)
DEPARTMENT: Sheriff's Office
DATE: 6/11/2021
PERSON REQUESTING: Sonja Kohlgraf, WCSO Budget Manager
Brief description of the problem/issue:
The WC Sheriff's Office requests approval to submit the FY 2021 Comprehensive Opioid, Stimulant, and Substance Abuse Site Based
Program Grant funding (COSSAP BJA — Federal Funding) application through JustGrants.gov.
The Weld County Sheriff's Office would like to apply for $8450.50 in funding to purchase additional Naloxone (Narcan) doses for
Patrol and Detentions Deputies. We are requesting that the BOCC delegate authority for the WCSO Budget Manager to submit the
grant application via justgrants.gov on the Chairman's behalf.
The application falls under the grant category 1, which covers local funding, and the purchase of Naloxone for Law Enforcement use
is an allowable in this category.
The WCSO received 200 doses for 2021 from the State of Colorado for distribution. Data shows that overdoses is on the rise within
the last year. For that reason, the Sheriff's Office would like to outfit every duty station in the jail with Naloxone and have an adequate
inventory supply for replenishing the patrol deputies, jail duty stations, the SOG team, and booking area in the jail.
The COSSAP grant purpose is to develop, implement or expand comprehensive efforts to identify, respond to, and support those
impacted by illicit opioids, stimulants, and other drugs of abuse.
Narcan is a nasal formulation of naloxone approved for the treatment of known or suspected opioid overdose. Designed for use in the
community, Narcan Nasal Spray is needle -free and used for the treatment of a known or suspected opioid overdose emergency with
signs of breathing problems and severe sleepiness or not being able to respond.
The WCSO proposes to apply for $8450.40 funding to purchase additional Narcan doses to be distributed to Patrol Deputies and
Detentions.
Sheriff Reams is in support of this application.
What options exist for the Board? (include consequences, impacts, costs, etc. of options):
• Authorize the Chair to sign the FY 2021 Comprehensive Opioid, Stimulant, and Substance Abuse Site Based Program Grant
funding application (COSSAP BJA — Federal Funding) in the amount of $8450.40, along with supporting grant documents.
• Deny the grant application. This may lead to increased general fund dollars spending to cover additional needed doses for the
WCSO operation.
« Schedule a work session to discuss further.
2021-1593
S000(
Recommendation:
Authorize the Chair to sign and approve the FY 2021 Comprehensive Opioid, Stimulant, and Substance Abuse Site Based Program
Grant funding application (COSSAP BJA — Federal Funding) in the amount of $8450.40.
Peny L. Buck
Mike Freeman
Scott K. James, Pro -Tern
Steve Moreno, Chair
Lori Saine
Approve
Recommendation
Schedule
Work Session
Other/Comments:
DRAFT
Weld County Sheriffs Office
1950 O Street
Greeley CO 80631
Bureau of Justice Assistance
Grants Opportunity Number: O-BJA-2021-94008
BJA FY 21 Comprehensive Opioid, Stimulant, and Substance Abuse Site -based Program
(COSSAP)
Competition Identification Number: C-BJA-2021-00092-PROD
Proposal Narrative
Description of the Issue
Weld County Sheriff's Office is located in Greeley, CO. Weld County is the third largest county
in Colorado, covering an area of 4,017 square miles (front range suburban and rural), with a
population of 331,893, in 2020. The Weld County Sheriff's Office staffs 345 total sworn
deputies; 244 in detentions, 87 in patrol, and 14 in administration. At any given time, a sworn
deputy may witness an opioid-related overdose. The State of Colorado recorded 564 opioid
overdose deaths in 2018 and 612 in 2019. This includes both prescription opioids and illegal
opioids. This number continues to rise. State data shows that rates of overdose deaths involving
synthetic opioids increased by 10% from 2017 to 2018. Fentanyl induced overdoses require a
higher dose of naloxone to be effective. This change suggests that carrying an increased dose of
naloxone is advisable to save lives. Currently, the Weld County Sheriffs Office receives
Naloxone for its patrol officers through a partnership with the State of Colorado Department of
Public Health & Environment. The Sheriff's Office is applying for federal funding under
category 1 (local applicants), subcategory 1 b (suburban area or medium size county with a
population between 100,000 and 500,000) through this grant.
J. ,
6
Project Design and Implementation
The agency requests $8,450.40 in project funding to purchase Naloxone for its detention and
patrol divisions. The project funding will address the naloxone availability for law enforcement
and first responders, addressing overdose prevention of incarcerated and other individuals. The
significant increase in opioid users, results in an increased chance that a deputy may encounter a
citizen experiencing an overdose emergency. Overdose emergencies can occur anywhere, at any
time: during a routine contact on the streets, during the booking process in the jail, in a housing
unit at the jail, or even in the lobby of the Sheriff's Office. Year to date, the patrol division has
been involved in five incidents and the detention division has been involved in one incident
where Naloxone was administered to a person suffering an opioid overdose. The K-9 unit has
located 146 fentanyl items, 50.9 grams of heroin, and 18.1 grams of black tar heroin. Every
interaction a deputy has with opioid products, especially fentanyl, has the potential to be an
accidental exposure through inhalation, percutaneous puncture, absorption, or ingestion. The
deliverable of this project is to have immediate accessibility to Naloxone giving every deputy the
ability to quickly react to an overdose or exposure situation, thereby saving lives.
Capabilities and Competencies
The purchased Naloxone will be received and distributed by the Weld County Sheriff's Office
Quartermaster. Naloxone will be distributed to the jail, supplying stations in the housing units,
booking area and the Special Operations Group (SOG) team, plus providing inventory for
replenishment. The Project Coordinator will be the Undersheriff, overseeing the ordering,
payment and distribution of the drug and reporting on the grant. The Weld County Sheriffs
Wage
Office will accommodate and support the work of a program evaluator to review the project in
the future.
Data collection and performance measures
Distribution of the Naloxone doses will be tracked, and its count reported throughout the grant
period.
31 Page
6/16/2021 Grant Package
Standard Applicant Information
Project Information
Project Title
Purchase of Naloxone doses for the Weld County
Sheriffs Office Patrol and Detention Officers to
address increasing emergencies due to opioid
overdose.
Federal Estimated Funding (Federal Share)
8450.40
Total Estimated Funding
8450.40
Proposed Project Start Date
9/1/21
Applicant Estimated Funding (Non -Federal
Share)
0.00
Areas Affected by Project (Cities, Counties, States, etc.)
Weld County
Type Of Applicant
Type of Applicant 1: Select Applicant Type:
B; County Government
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
Other (specify):
Application Submitter Contact Information
Application POC Prefix Name
Mrs.
Application POC First Name
Proposed Project End Date
12/31/21
Program Income Estimated Funding
0.00
Application POC Middle Name Application POC Last Name
Sonja Kohlgraf
Application POC Suffix Name
Organizational Affiliation
Weld County
Phone Number
970-400-2872
ORINumber
Title
Budget Manager
Fax Number
Email ID
skohlgraf@weldgov.com
https://justgrants. usdoj.gov/prweb/PRAuth/app/JGITS_/3yZ6Bxxi_IpDExTOT4XnAjzjAXmVNevW`/!TABTHREAD 1 ?pyActivity=PrintWork&Prompt=fa!s... 1/8
6/16/2021 Grant Package
Executive Order and Delinquent Debt Information
Is Application Subject to Review by State Under Executive Order 12372?
c. Program is not covered by E.O. 12372.
Is the Applicant Delinquent on Federal Debt?
No
SF424 Attachments (5)
Name
manifest.txt
Name
Form SFLLL_2_0-V2.0.pdf
Name
Form SF424_3_0-V3.0.pdf
Name
SF424_3_0-1234-Areas affected by project -
Sf-424 attachment.do+
Name
GrantAppiication.xml
Load More
Authorized Representative
Authorized Representative Information
Prefix Name
Date Added
6/7/21
Date Added
6/7/21
Date Added
6/7/21
Date Added
6/7/21
Date Added
6/7/21
First Name Middle Name Last Name Suffix Name
BARBARA — CONNOLLY —
Title
Controller
Verify Legal Name, Doing Business As, and Legal Address
Certification
The legal name + Doing Business As (DBA) and legal address define a unique entity in the system as represented in its entity profile. The profile
name and address is aoolicable to ALL anolications and awards associated to this fiscal agent.
https://justgrants.usdoj.gov/prweb/PRAuth/app/JG ITS_/3yZ6Bxxi_IpDExTOT4XnAjzjAXmVNevW*/!TABTH R EAD 1 ?pyActivity=PrintWork&Prompt=fals... 2/8
6/16/2021 Grant Package
1. If this information is correct confirm/acknowledge to continue with completion of this application.
I confirm this is the correct entity.
Signer Name
Sonja Kohlgraf
Certification Date / Time
06/08/2021 05:43 PM
2. If the information displayed does not accurately represent the legal entity applying for federal assistance:
a. Contact your Entity Administrator.
b. Contact the System for Award Management (SAM.gov) to update the entity legal name/address.
3. If the above information is not the entity for which this application is being submitted, Withdraw/Delete this application. Please initiate a new
application in Grants.gov with using the correct DUNS/SAM profile.
Proposal Abstract
The Weld County Sheriff's Office would like to utilize the requested $8,450.40 in project funding to buy Naloxone for its detention and patrol divisions. Each pi
deputy is currently issued two doses of Naloxone, through a partnership with the State of Colorado Department of Public Health & Environment. This project v.
provide issued doses, for quick access in an emergency, to each jail housing unit and to detention deputies assigned to work the area of the jail designated for the
of new arrestees, as well a minimal supply of replacement doses, when an issued dose is deployed. Having Naloxone readily available for deployment in the pal
detention settings, benefits the citizens of Weld County that experience an opioid overdose; patrol and detention deputies will be able to save lives.
Proposal Narrative
Name
Proposal Narrative.docx
Category
Proposal Narrative
Goals, Objectives, Deliverables, and Timeline
Goal Statement
Saving lives of people that overdose on opioids.
Objective
Created by
Sonja Kohlgraf
Application Number Date Added
6/16/2021 5:48 PM
Fiscal Year
Purchasing additional Naloxone to have adequate supply on hand to outfit all Patrol deputies areas in the jail.
Deliverable
Fiscal Year
2021
Quarter
Quarter
04
Report 2022 Q4
Goal Statement
https://justgrants. usdoj.gov/prweb/P RAuth/app/JGITS_/3yZ6Bxxi_IpDExTOT4XnAjzjAXmVNevW`/!TABTH READ 1 ?pyActivity=PrintWork&Prompt=fals... 3/8
6/16/2021 Grant Package
Objective
Fiscal Year
No items
Deliverable
Fiscal Year
No items
Goal Statement
x
Objective
Fiscal Year
No items
Deliverable
Fiscal Year
No items
Budget and Associated Documentation
Year 1
> Instructions
Travel
Purpose of Travel
Location
Type of Expense
Basis
Cost
Quantity
# Of
Staff
# Of
Trips
Total Cost
Quarter
Quarter
Quarter
Quarter
Non -Federal
Contribution
No items
Travel Total Cost
$0.00
Year 1
> Instructions
Equipment
Equipment Item
# of Items
Cost
Total Cost
Non -Federal Contribution
No items
Equipment Total Cost
$0.00
Year 1
> Instructions
Federal Reques
Federal Reque
https://justgrants. usdoj.gov/prweb/PRAuth/app/JG ITS_/3yZ6Bxxi_IpDExTOT4XnAjzjAXmVNevW*/!TABTH R EAD 1 ?pyActivity=PrintWork&Prompt=fats... 4/8
6/16/2021 Grant Package
Supply Items
1
Purpose of Supply Items
# of Items
Unit Cost
Total Cost
Non -Federal
Contribution
Naloxone Opioid Overdose Prevention
112.00
$75.45
$8,450.40
Federal Request
$8,450.40
Supplies Total Cost
$8,450.40
Additional Narrative
Weld County plans to purchase an additional 112 cartons (2 doses of 4mg each) at a First Responder price of $75.45 per carton. These applications will be
distributed as follows:
100 cartons for the detention unit, supplying the booking station, inmate housing units and the Special Operations Group in the jail.
12 cartons for dose replacement purposes.
Year 1
> Instructions
Construction
Purpose of Construction
Description of Work
# of Items
Cost
Total Cost
Non -Federal Contribution
No items
Construction Total Cost
$0.00
Year 1
> Instructions
Subawards (Subgrants)
Description
Purpose
Consultant
Country
State/U.S. Territory
City
Total Cost
Non -Federal Contribution
No items
Subawards Total Cost
$0.00
Add Consultant Travel
Year 1
Federal Request
Federal Request
> Instructions
Procurement Contracts
https://justgrants.usdoj.gov/prweb/PRAuth/app/JGITS_/3yZ6Bxxi_IpDExTOT4XnAjzjAXmVNevW*/!TABTHREAD1 ?pyActivity=PrintWork&Prompt=fals... 5/8
6/16/2021 Grant Package
Description
Purpose
Consultant
Country
State/U.S. Territory
City
Total Cost
Non -Federal Contribution
No items
Do you need Consultant Travel?
Yes
Procurement Cost
$0.00
Consultant Travel
Purpose of Travel
Location
COMPUTE THE COST OF EACH TYPE OF EXPENSE X THE NUMBER OF PEOPLE TRAVELING
Type of Expense
Cost
Duration or Distance
# of
Staff
Total Cost
Non -Federal
Contribution
No items
Consultant Travel Total Cost
0.00
Procurement Total Cost
$0.00
Year 1
> Instructions
Other Costs
Description
Quantity
Basis
Costs
Length of Time
Total Costs
Non -Federal
Contribution
Federal Request
Federal Request
No items
Other Costs Total Cost
$0.00
Year 1
> Instructions
Indirect Costs
Description
Base
Indirect Cost Rate
Total Cost
Non -Federal Contribution
Federal Reques
No items
Federal Reque
https://justgrants.usdoj.gov/prweb/PRAuth/app/JGITS_/3yZ6Bxxi_IpDExTOT4XnAjzjAXmVNevW*/!TABTHREAD 1 ?pyActivity=PrintWork&Prompt=fals... 6/8
6/16/2021 Grant Package
Indirect Costs Total Cost
$0.00
Additional Narrative
Budget Summary
Budget / Financial Attachments
Indirect Cost Rate Agreement
No documents have been uploaded for Indirect Cost Rate Agreement
Financial Management Questionnaire (Including applicant disclosure of high -risk status)
Name
Financial Questionnaire
completed June 2021.pdf
Category
Budget Financial Management
Questionnaire
Created by
Sonja Kohlgraf
Disclosure of Process Related to Executive Compensation
No documents have been uploaded for Disclosure of Process Related to Executive Compensation
Additional Attachments
No documents have been uploaded for Additional Attachments
Additional Application Components
Letters of Support
Application Number Date Added
6/16/2021 5:59 PM
No documents have been uploaded for Letters of Support
Research and Evaluation Independence and Integrity Statement
No documents have been uploaded for Research and Evaluation Independence and Integrity Statement
Additional Attachments
No documents have been uploaded for Additional Attachments
Other
Loading...
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U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
Approved: OMB No. 1121-0329
Expires 12/31/2023
Background
Recipients' financial management systems and internal controls must meet certain requirements, including those
set out in the "Part 200 Uniform Requirements" (2.C.F.R. Part 2800).
Including at a minimum, the financial management system of each OJP award recipient must provide
for the following:
(1)Identification, in its accounts, of all Federal awards received and expended and the Federal programs under
which they were received. Federal program and Federal award identification must include, as applicable, the
CFDA title and number, Federal award identification number and year, and the name of the Federal agency.
(2)Accurate, current, and complete disclosure of the financial results of each Federal award or program.
(3) Records that identify adequately the source and application of funds for Federally -funded activities. These
records must contain information pertaining to Federal awards, authorizations, obligations, unobligated
balances, assets, expenditures, income, and interest, and be supported by source documentation.
(4) Effective control over, and accountability for, all funds, property, and other assets. The recipient must
adequately safeguard all assets and assure that they are used solely for authorized purposes.
(5)Comparison of expenditures with budget amounts for each Federal award.
(6)Written procedures to document the receipt and disbursement of Federal funds including procedures to
minimize the time elapsing between the transfer of funds from the United States Treasury and the disbursement
by the OJP recipient.
(7) Written procedures for determining the allowability of costs in accordance with both the terms and conditions of
the Federal award and the cost principles to apply to the Federal award.
(8)Other important requirements related to retention requirements for records, use of open and machine readable
formats in records, and certain Federal rights of access to award -related records and recipient personnel.
1. Name of Organization and Address:
Organization Name: Weld County Government
Streetl: 1150 O Street
Streetl:
City: Greeley
.............. ...
State: CO
Zip Code: 80631
2. Authorized Representative's Name and Title:
Prefix: First Name: Steve Middle Name:
Last Name:
Moreno Suffix:
Title: Chairman, Weld County Board of County Commissioners Animpum
3. Phone: 970-336-7204 4. Fax: 970-336-7233
5. Email: bocc-contracts(c weldgov.com „a
6. Year Established: 7. Employer Identification Number (EIN): 8. DUNS Number:
11861 84-6000813 075757955 lir
9. a) Is the applicant entity a nonprofit organization (including a nonprofit institution of higher education) as
described in 26 U.S.C. 501(c)(3) and exempt from taxation under 26 U.S.C. 501(a)? 0Yes ® No
If "No" skip to Question 10.
I If "Yes", complete Questions 9. b) and 9. c).
Page 1 of 4
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
Approved: OMB No. 1121-0329
Expires 12/31/2023
AUDIT INFORMATION
9. b) Does the applicant nonprofit organization maintain offshore accounts for
the purpose of avoiding paying the tax described in 26 U.S.C. 511(a)?
Yes 11 No
9. c) With respect to the most recent year in which the applicant nonprofit
organization was required to file a tax return, does the applicant nonprofit
organization believe (or assert) that it satisfies the requirements of 26 C.F.R.
53.4958-6 (which relate to the reasonableness of compensation of certain
individuals)?
If "Yes", refer to "Additional Attachments" under "What An Application Should
Include" in the OJP solicitation (or application guidance) under which the
applicant is submitting its application. If the solicitation/guidance describes the
"Disclosure of Process related to Executive Compensation," the applicant
nonprofit organization must provide -- as an attachment to its application — a
disclosure that satisfies the minimum requirements as described by OJP.
®Yes No
For purposes of this questionnaire, an "audit" is conducted by an independent,
accepted auditing standards (GAAS) or Generally Governmental Auditing Standards
audit report with an opinion.
10. Has the applicant entity undergone any of the following types of audit(s)(Please
external auditor using generally
(GAGAS), and results in an
check all that apply):
"Single Audit" under OMB A-133 or Subpart F of 2 C.F.R. Part 200
Financial Statement Audit
Defense Contract Agency Audit (DCAA)
Other Audit & Agency (list type of audit)'
• None (if none, skip to question 13)
11. Most Recent Audit Report Issued: 0' Within the last Within the last NJ Over 2 years ago I N/A
12 months 2 years
Name of Audit Agency/Firm: Anderson & Whitney, Certified Public Accountant
AUDITOR'S OPINION ......___-- --.
12. On the most recent audit, what was the auditor's opinion?
Unqualified Opinion Qualified Opinion Disclaimer, Going Concern N/A: No audits as
or Adverse Opinions described above
Enter the number of findings (if none, enter "0":
Enter the dollar amount of questioned costs (if none, enter "$0"):
Were material weaknesses noted in the report or opinion?
NYes No
13. Which of the following best describes the applicant entity's accounting system:
Manual Automated ■ Combination of manual and automated
14. Does the applicant entity's accounting system have the capability to
identify the receipt and expenditure of award funds separately for each
Federal award?
J Yes No * Not Sure
15. Does the applicant entity's accounting system have the capability to
record expenditures for each Federal award by the budget cost categories
shown in the approved budget?
_ Yes ® No * Not Sure
16. Does the applicant entity's accounting system have the capability to
record cost sharing ("match") separately for each Federal award, and
maintain documentation to support recorded match or cost share?
Yes N No Not Sure
Page 2 of 4
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
Approved: OMB No. 1121-0329
Expires 12/31/2023
17. Does the applicant entity's accounting system have the capability to
accurately track employees actual time spent performing work for each federal
award, and to accurately allocate charges for employee salaries and wages
for each federal award, and maintain records to support the actual time spent
and specific allocation of charges associated with each applicant employee?
Yes No Not Sure
r 18. Does the applicant entity's accounting system include budgetary controls
to preclude the applicant entity from incurring obligations or costs that exceed
i the amount of funds available under a federal award (the total amount of the
I award, as well as the amount available in each budget cost category)?
❑ Yes No Not Sure
19. Is applicant entity familiar with the "cost principles" that apply to recent
and future federal awards, including the general and specific principles set out
in 2 C.F.R Part 200?
i- Yes $ No U Not Sure
PROPERTY STANDARDS AND PROCUREMENT STANDARDS
20. Does the applicant entity's property management system(s) maintain the
following information on property purchased with federal award funds (1) a
description of the property; (2) an identification number; (3) the source of
funding for the property, including the award number; (4) who holds title; (5)
acquisition date; (6) acquisition cost; (7) federal share of the acquisition cost;
(8) location and condition of the property; (9) ultimate disposition information?
- Yes MI No Not Sure
21. Does the applicant entity maintain written policies and procedures for
procurement transactions that -- (1) are designed to avoid unnecessary or
duplicative purchases; (2) provide for analysis of lease versus purchase
alternatives; (3) set out a process for soliciting goods and services, and (4)
include standards of conduct that address conflicts of interest?
Yes ® No Not Sure
22. a) Are the applicant entity's procurement policies and procedures
designed to ensure that procurements are conducted in a manner that
provides full and open competition to the extent practicable, and to avoid
practices that restrict competition?
Yes No Not Sure
22. b) Do the applicant entity's procurement policies and procedures require
documentation of the history of a procurement, including the rationale for the
method of procurement, selection of contract type, selection or rejection of
contractors, and basis for the contract price?
Yes No Not Sure
23. Does the applicant entity have written policies and procedures designed
to prevent the applicant entity from entering into a procurement contract
under a federal award with any entity or individual that is suspended or
debarred from such contracts, including provisions for checking the "Excluded
Parties List" system (www.sam.gov) for suspended or debarred sub -grantees
and contractors, prior to award?
J Yes No Not Sure
TRAVEL POLICY .
24. Does the applicant entity:
(a) maintain a standard travel policy? [] Yes D No
(b) adhere to the Federal Travel Regulation (FTR)? J Yes * No
SUBRECIPIENT MANAGEMENT AND. MONITORING
25. Does the applicant entity have written policies, procedures, and/or
guidance designed to ensure that any subawards made by the applicant
entity under a federal award -- (1) clearly document applicable federal
requirements, (2) are appropriately monitored by the applicant, and (3)
comply with the requirements in 2 CFR Part 200 (see 2 CFR 200.331)?
Yes No Not Sure
❑ N/A - Applicant does not make
subawards under any OJP
awards
Page 3 of 4
U.S. DEPARTMENT OF JUSTICE Approved: OMB No. 1121-0329
OFFICE OF JUSTICE PROGRAMS
Expires 12/31/2023
26. Is the applicant entity aware of the differences between subawards under
federal awards and procurement contracts under federal awards, including
the different roles and responsibilities associated with each?
O Yes ® No n Not Sure
® N/A - Applicant does not make
subawards under any OJP
awards
27. Does the applicant entity have written policies and procedures designed
to prevent the applicant entity from making a subaward under a federal
award to any entity or individual is suspended or debarred from such
subawards?
• Yes 0 No O Not Sure
® N/A - Applicant does not make
subawards under any OJP
awards
DESIGNATION AS 'HIGH -RISK' BY OTHER FEDERAL AGENCIES
28. Is the applicant entity designated "high risk" by a federal grant -making
agency outside of DOJ? (High risk includes any status under which a federal
awarding agency provides additional oversight due to the applicant's past
performance, or other programmatic or financial concerns with the applicant.)
If "Yes", provide the following:
(a) Name(s) of the federal awarding agency:
(b) Date(s) the agency notified the applicant entity of the "high risk" designation:
(c) Contact information for the "high risk" point of contact at the federal agency:
Name:
Phone:
Email:
(d) Reason for "high risk" status, as set out by the federal agency:
fl Yes ® No Not Sure
CERTIFICATION ON BEHALF OF THE APPLICANT ENTITY
(Must be made by the chief executive, executive director, chief financial officer, designated authorized
representative ("AOR"), or other official with the requisite knowledge and authority)
On behalf of the applicant entity, I certify to the U.S. Department of Justice that the information provided above is
complete and correct to the best of my knowledge. I have the requisite authority and information to make this
certification on behalf of the applicant entity.
Name: Barbara Conn
Title: 0 Executive Director O Chief Financial Officer
MI Other: Contolle
Chairman
Phone: 970-400-4445
Page 4 of 4
EXPIRES 05/31/2019
U.S. DEPARTMENT OF JUSTICE
CERTIFIED STANDARD ASSURANCES
On behalf of the Applicant, and in support of this application for a grant or cooperative agreement, I certify
under penalty of perjury to the U.S. Department of Justice ("Department"), that all of the following are true
and correct:
(1) I have the authority to make the following representations on behalf of myself and the Applicant. I
understand that these representations will be relied upon as material in any Department decision to make
an award to the Applicant based on its application.
(2) I certify that the Applicant has the legal authority to apply for the federal assistance sought by the
application, and that it has the institutional, managerial, and financial capability (including funds sufficient
to pay any required non-federal share of project costs) to plan, manage, and complete the project
described in the application properly.
(3) I assure that, throughout the period of performance for the award (if any) made by the Department
based on the application --
a.
b.
C.
the Applicant will comply with all award requirements and all federal statutes and
regulations applicable to the award;
the Applicant will require all subrecipients to comply with all applicable award
requirements and all applicable federal statutes and regulations; and
the Applicant will maintain safeguards to address and prevent any organizational conflict
of interest, and also to prohibit employees from using their positions in any manner that
poses, or appears to pose, a personal or financial conflict of interest.
(4) The Applicant understands that the federal statutes and regulations applicable to the award (if any)
made by the Department based on the application specifically include statutes and regulations pertaining
to civil rights and nondiscrimination, and, in addition --
a.
b.
the Applicant understands that the applicable statutes pertaining to civil rights will include
section 601 of the Civil Rights Act of 1964 (42 U.S.C. § 2000d); section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. § 794); section 901 of the Education Amendments
of 1972 (20 U.S.C. § 1681); and section 303 of the Age Discrimination Act of 1975 (42
U.S.C. § 6102);
the Applicant understands that the applicable statutes pertaining to nondiscrimination
may include section 809(c) of Title I of the Omnibus Crime Control and Safe Streets Act
of 1968 (34 U.S.C. § 10228(c)); section 1407(e) of the Victims of Crime Act of 1984 (34
U.S.C. § 20110(e)); section 299A(b) of the Juvenile Justice and Delinquency Prevention
Act of 2002 (34 U.S.C. § 11182(b)); and that the grant condition set out at section
40002(b)(13) of the Violence Against Women Act (34 U.S.C. § 12291(b)(13)), which will
apply to all awards made by the Office on Violence Against Women, also may apply to an
award made otherwise;
c. the Applicant understands that it must require any subrecipient to comply with all such
applicable statutes (and associated regulations); and
d. on behalf of the Applicant, I make the specific assurances set out in 28 C.F.R. §§ 42.105
and 42.204.
(5) The Applicant also understands that (in addition to any applicable program -specific regulations and to
applicable federal regulations that pertain to civil rights and nondiscrimination) the federal regulations
applicable to the award (if any) made by the Department based on the application may include, but are
not limited to, 2 C.F.R. Part 2800 (the DOJ "Part 200 Uniform Requirements") and 28 C.F.R. Parts 22
(confidentiality - research and statistical information), 23 (criminal intelligence systems), 38 (regarding
faith -based or religious organizations participating in federal financial assistance programs), and 46
(human subjects protection).
(6) I assure that the Applicant will assist the Department as necessary (and will require subrecipients and
contractors to assist as necessary) with the Department's compliance with section 106 of the National
Historic Preservation Act of 1966 (54 U.S.C. § 306108), the Archeological and Historical Preservation Act
of 1974 (54 U.S.C. §§ 312501-312508), and the National Environmental Policy Act of 1969 (42
U.S.C. §§ 4321-4335), and 28 C.F.R. Parts 61 (NEPA) and 63 (floodplains and wetlands).
(7) I assure that the Applicant will give the Department and the Government Accountability Office, through
any authorized representative, access to, and opportunity to examine, all paper or electronic records
related to the award (if any) made by the Department based on the application.
(8) If this application is for an award from the National Institute of Justice or the Bureau of Justice
Statistics pursuant to which award funds may be made available (whether by the award directly or by any
subaward at any tier) to an institution of higher education (as defined at 34 U.S.C. § 10251(a)(17)), I
assure that, if any award funds actually are made available to such an institution, the Applicant will
require that, throughout the period of performance --
a.
b.
each such institution comply with any requirements that are imposed on it by the First
Amendment to the Constitution of the United States; and
subject to par. a, each such institution comply with its own representations, if any,
concerning academic freedom, freedom of inquiry and debate, research independence,
and research integrity, at the institution, that are included in promotional materials, in
official statements, in formal policies, in applications for grants (including this award
application), for accreditation, or for licensing, or in submissions relating to such grants,
accreditation, or licensing, or that otherwise are made or disseminated to students, to
faculty, or to the general public.
(9) I assure that, if the Applicant is a governmental entity, with respect to the award (if any) made by the
Department based on the application --
a.
b.
it will comply with the requirements of the Uniform Relocation Assistance and Real
Property Acquisitions Act of 1970 (42 U.S.C. §§ 4601-4655), which govern the treatment
of persons displaced as a result of federal and federally -assisted programs; and
it will comply with requirements of 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 federal
assistance.
(10) If the Applicant applies for and receives an award from the Office of Community Oriented Policing
Services (COPS Office), I assure that as required by 34 U.S.C. § 10382(c)(11), it will, to the extent
practicable and consistent with applicable law --including, but not limited to, the Indian Self- Determination
and Education Assistance Act --seek, recruit, and hire qualified members of racial and ethnic minority
groups and qualified women in order to further effective law enforcement by increasing their ranks within
the sworn positions, as provided under 34 U.S.C. § 10382(c)(11).
(11) If the Applicant applies for and receives a DOJ award under the STOP School Violence Act program,
I assure as required by 34 U.S.C. § 10552(a)(3), that it will maintain and report such data, records, and
information (programmatic and financial) as DOJ may reasonably require.
I acknowledge that a materially false, fictitious, or fraudulent statement (or concealment or omission of a
material fact) in this certification, or in the application that it supports, may be the subject of criminal
prosecution (including under 18 U.S.C. §§ 1001 and/or 1621, and/or 34 U.S.C. §§ 10271-10273), and
also may subject me and the Applicant to civil penalties and administrative remedies for false claims or
otherwise (including under 31 U.S.C. §§ 3729-3730 and 3801-3812). I also acknowledge that the
Department's awards, including certifications provided in connection with such awards, are subject to
review by the Department, including by its Office of the Inspector General.
f I acknowledge that a materially false, fictitious, or fraudulent statement (or
concealment or omission of a material fact) in this certification, or in the application that
it supports, may be the subject of criminal prosecution (including under 18 U.S.C. §§
1001 and/or 1621, and/or 34 U.S.C. §§ 10271-10273), and also may subject me and the
Applicant to civil penalties and administrative remedies for false claims or otherwise
(including under 31 U.S.C. §§ 3729-3730 and 3801-3812). I also acknowledge that the
Department's awards, including certifications provided in connection with such awards,
are subject to review by the Department, including by its Office of the Inspector General.
SignerlD
Signing Date / Time
U.S. DEPARTMENT OF JUSTICE
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY
MATTERS; DRUG -FREE WORKPLACE REQUIREMENTS; LAW ENFORCEMENT AND COMMUNITY
POLICING
Applicants should refer to the regulations and other requirements cited below to determine the
certification to which they are required to attest. Applicants should also review the instructions for
certification included in the regulations or other cited requirements before completing this form. The
certifications shall be treated as a material representation of fact upon which reliance will be placed
when the U.S. Department of Justice ("Department") determines to award the covered transaction,
grant, or cooperative agreement.
1. LOBBYING
As required by 31 U.S.C. § 1352, as implemented by 28 C.F.R. Part 69, the Applicant certifies and assures
(to the extent applicable) the following:
(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the Applicant, to
any person for influencing or attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection
with the making of any Federal grant, the entering into of any cooperative agreement, or the extension,
continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement;
(b) If the Applicant's request for Federal funds is in excess of $100,000, and any funds other than Federal
appropriated funds have been paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a member of Congress, an officer or employee of
Congress, or an employee of a member of Congress in connection with this Federal grant or cooperative
agreement, the Applicant shall complete and submit Standard Form - LLL, "Disclosure of Lobbying
Activities" in accordance with its (and any DOJ awarding agency's) instructions; and
(c) The Applicant shall require that the language of this certification be included in the award documents
for all subgrants and procurement contracts (and their subcontracts) funded with Federal award funds
and shall ensure that any certifications or lobbying disclosures required of recipients of such subgrants
and procurement contracts (or their subcontractors) are made and filed in accordance with 31 U.S.C. §
1352.
2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS
A. Pursuant to Department regulations on nonprocurement debarment and suspension implemented at
2 C.F.R. Part 2867, and to other related requirements, the Applicant certifies, with respect to
prospective participants in a primary tier "covered transaction," as defined at 2 C.F.R. § 2867.20(a), that
neither it nor any of its principals --
(a) is presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial
of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any
Federal department or agency;
(b) has within a three-year period preceding this application been convicted of a felony criminal
violation under any Federal law, or been convicted or had a civil judgment rendered against it for
commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State, tribal, or local) transaction or private agreement or transaction;
violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, tax evasion or receiving stolen property,
making false claims, or obstruction of justice, or commission of any offense indicating a lack of business
integrity or business honesty that seriously and directly affects its (or its principals') present
responsibility;
(c) is presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal,
State, tribal, or local) with commission of any of the offenses enumerated in paragraph (b) of this
certification; and/or
(d) has within a three-year period preceding this application had one or more public transactions
(Federal, State, tribal, or local) terminated for cause or default.
B. Where the Applicant is unable to certify to any of the statements in this certification, it shall attach an
explanation to this application. Where the Applicant or any of its principals was convicted, within a
three-year period preceding this application, of a felony criminal violation under any Federal law, the
Applicant also must disclose such felony criminal conviction in writing to the Department (for OJP
Applicants, to OJP at Ojpcompliancereporting@usdoj.gov; for OVW Applicants, to OVW at
OVW.GFMD@usdoj.gov; or for COPS Applicants, to COPS at AskCOPSRC@usdoj.gov), unless such
disclosure has already been made.
3. FEDERAL TAXES
A. If the Applicant is a corporation, it certifies either that (1) the corporation has no unpaid Federal tax
liability that has been assessed, for which all judicial and administrative remedies have been exhausted
or have lapsed, that is not being paid in a timely manner pursuant to an agreement with the authority
responsible for collecting the tax liability, or (2) the corporation has provided written notice of such an
unpaid tax liability (or liabilities) to the Department (for OJP Applicants, to OJP at
Ojpcompliancereporting@usdoj.gov; for OVW Applicants, to OVW at OVW.GFMD@usdoj.gov; or for
COPS Applicants, to COPS at AskCOPSRC@usdoj.gov).
B. Where the Applicant is unable to certify to any of the statements in this certification, it shall attach an
explanation to this application.
4. DRUG -FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, as implemented at 28 C.F.R. Part 83, Subpart F, for
grantees, as defined at 28 C.F.R. §§ 83.620 and 83.650:
A. The Applicant certifies and assures that it will, or will continue to, provide a drug -free workplace by --
(a) Publishing a statement notifying emp►oyees that the unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance is prohibited in its workplace and specifying the actions that
will be taken against employees far violation of such prohibition;
(b) Establishing an an -going drug -free awareness program to inform employees about --
(1) The dangers of drug abuse in the workplace;
(2) The Applicant's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the
workplace;
(c) Making it a requiement that each employee to be engaged in the performance of the award be
given a copy of the statement required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a) that, as a condition of
employment under the award, the employee will --
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of the employee's conviction for a violation of a criminal drug statute
occurring in the workplace no later than five calendar days after such conviction;
(e) Notifying the Department, in writing, within 10 calendar days after receiving notice under
subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction.
Employers of convicted employees must provide notice, including position title of any such convicted
employee to the Department, as follows:
For COPS award recipients - COPS Office, 145 N Street, NE, Washington, DC, 20530;
For OJP and OVW award recipients - U.S. Department of Justice, Office of Justice Programs, ATTN:
Control Desk, 810 7th Street, N.W., Washington, D.C. 20531.
Notice shall include the identification number(s) of each affected award;
(f) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph
(d)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination,
consistent with the requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation
program approved for such purposes by a Federal, State, or local health, law enforcement, or other
appropriate agency; and
(g) Making a good faith effort to continue to maintain a drug -free workplace through implementation of
paragraphs (a), (b), (c), (d), (e), and (f).
5. LAW ENFORCEMENT AGENCY CERTIFICATION REQUIRED UNDER DEPARTMENT OF JUSTICE
DISCRETIONARY GRANT PROGRAMS ("SAFE POLICING CERTIFICATION")
If this application is for a discretionary award pursuant to which award funds may be made available
(whether by the award directly or by any subaward at any tier) to a State, local, college, or university law
enforcement agency, the Applicant certifies that any such law enforcement agency to which funds will
be made available has been certified by an approved independent credentialing body or has started the
certification process. To become certified, a law enforcement agency must meet two mandatory
conditions:
(a) the agency's use of force policies adhere to all applicable federal, State, and local laws; and
(b) the agency's use of force policies prohibit chokeholds except in situations where use of deadly force
is allowed by law.
For detailed information on this certification requirement,
see https://cops.usdoj.gov/SafePolicingEO .
The Applicant acknowledges that compliance with this safe policing certification requirement does not
ensure compliance with federal, state, or local law, and that such certification shall not constitute a
defense in any federal lawsuit. Nothing in the safe policing certification process or safe policing
requirement is intended to be (or may be) used by third parties to create liability by or against the
United States or any of its officials, officers, agents or employees under any federal law. Neither the safe
policing certification process nor the safe policing certification requirement is intended to (or does)
confer any right on any third -person or entity seeking relief against the United States or any officer or
employee thereof. No person or entity is intended to be (or is) a third -party beneficiary of the safe
policing certification process, or, with respect to the safe policing certification requirement, such a
beneficiary for purposes of any civil, criminal, or administrative action.
6. COORDINATION REQUIRED UNDER PUBLIC SAFETY AND COMMUNITY POLICING PROGRAMS
As required by the Public Safety Partnership and Community Policing Act of 1994, at 34 U.S.C. §
10382(c)(5), if this application is for a COPS award, the Applicant certifies that there has been
appropriate coordination with all agencies that may be affected by its award. Affected agencies may
include, among others, Offices of the United States Attorneys; State, local, or tribal prosecutors; or
correctional agencies.
I acknowledge that a materially false, fictitious, or fraudulent statement (or concealment or omission of
a material fact) in this certification, or in the application that it supports, may be the subject of criminal
prosecution (including under 18 U.S.C. §§ 1001 and/or 1621, and/or 34 U.S.C. §§ 10271-10273), and also
may subject me and the Applicant to civil penalties and administrative remedies for false claims or
otherwise (including under 31 U.S.C. §§ 3729-3730 and 3801-3812). I also acknowledge that the
Department's awards, including certifications provided in connection with such awards, are subject to
review by the Department, including by its Office of the Inspector General.
r I acknowledge that a materially false, fictitious, or fraudulent statement (or concealment or
omission of a material fact) in this certification, or in the application that it supports, may be the
subject of criminal prosecution (including under 18 U.S.C. §§ 1001 and/or 1621, and/or 34
U.S.C. §§ 10271-10273), and also may subject me and the Applicant to civil penalties and
administrative remedies for false claims or otherwise (including under 31 U.S.C. §§ 3729-3730
and 3801-3812). I also acknowledge that the Department's awards, including certifications
provided in connection with such awards, are subject to review by the Department, including by
its Office of the Inspector General.
SignerlD
Signing Date / Time
Declaration and Certification to the U.S. Department of Justice as to this
Application Submission
By [taking this action], I --
1. Declare the following to the U.S. Department of Justice (DOJ), under penalty of
perjury: (1) I have authority to make this declaration and certification on behalf of
the applicant; (2) I have conducted or there was conducted (including by the
applicant's legal counsel as appropriate, and made available to me) a diligent
review of all requirements pertinent to and all matters encompassed by this
declaration and certification.
2. Certify to DOJ, under penalty of perjury, on behalf of myself and the applicant, to
the best of my knowledge and belief, that the following are true as of the date of
this application submission: (1) I have reviewed this application and all
supporting materials submitted in connection therewith (including anything
submitted in support of this application by any person on behalf of the applicant
before or at the time of the application submission and any materials that
accompany this declaration and certification); (2) The information in this
application and in all supporting materials is accurate, true, and complete
information as of the date of this request; and (3) I have the authority to submit
this application on behalf of the applicant.
3. Declare the following to DOJ, under penalty of perjury, on behalf of myself and
the applicant: (1) I understand that, in taking (or not taking) any action pursuant
to this declaration and certification, DOJ will rely upon this declaration and
certification as a material representation; and (2) I understand that any materially
false, fictitious, or fraudulent information or statement in this declaration and
certification (or concealment or omission of a material fact as to either) may be
the subject of criminal prosecution (including under 18 U.S.C. §§ 1001 and/or
1621, and/or 34 U.S.C. §§ 10271-10273), and also may subject me and the
applicant to civil penalties and administrative remedies under the federal False
Claims Act (including under 31 U.S.C. §§ 3729-3730 and/or §§ 3801-3812) or
otherwise.
I agree with the above statements.
SignerlD
Signing Date / Time
Entity Name*
US DEPARTMENT OF JUSTICE
Entity ID*
'00004553
Contract Name*
BUREAU OF JUSTICE ASSISTANCE BJA FY2021
COMPREHENSIVE OPIOID, STIMULANT, AND SUBSTANCE
ABUSE SITE -BASED PROGRAM
Contract Status
CTB REVIEW
New Entity?
Contract ID
4857
Contract Lead*
SKOHLGRAF
Contract Lead Email
skohlgrafe.co.weld.co.us
Parent Contract. ID
Requires Board Approval
YES
Department Project
Contract Description*
APPLICATION SUBMISSION FOR COSSAP 2021 GRANT THROUGH JUSTGRANTS. PURCHASING ADDITIONAL NARCAN DOSES TO
COVER PATROL DEPUTIES, JAIL DUTY STATIONS, SOG TEAM AND BOOKING AREA. CATEGORY 1 W SUBCATEGORY] B MEDIUM
SIZE COUNTY
Contract Description 2
Contract Type
GRANT
Amount *
$8;450,40
Renewable*
NO
Automatic Renewal
Grant
YES
IGA
Department
SHERIFF
Department Email
CM-Sheriff@weldgov.com
Department Head Email
CM-Sheriff-
DeptHeadPweldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEYWELDG
OV.COM
Requested BOCC Agenda
Date*
05/16/2021
Due Date
0612 r2021
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
Grant Deadline Date
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
On Base
Effective Date
Review Date*
01 /01 S 2022
Renewal Date
Termination Notice Peri
Corttac
Purc asir
Purchasing Approver
Approval Proc
Department Head
DONNIE PATCH
DH Approved Date
O6/14/2021
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
06' 21 /2021
Originator
SKOHLGRAF
Committed Deliven/ Date
Finance Approver
BARB CONNOLLY
Expiration Date*
12/31/2021
Purchasing Approved Date
Finance Approved Date
06 15,, 2021
Tyler Ref #
AG 062121
Legal Counsel
BOB CHOATE
Legal Counsel Approved Date
06,15 2021
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