HomeMy WebLinkAbout20192343.tiffChloe Rempel
From:
Sent:
To:
Cc:
Subject:
Amanda Petzold
Monday, July 15, 2019 12:05 PM
CTB
HS Contract Management; Karina Amaya
FW: WORK Act Cycle 5 application (Information)
Good Morning Ladies,
Please note the communication below, denial of the Work Act Grant Application (2019-2343).
Thank you.
Amanda J. Petzold
Contract Management and Compliance Coordinator
Administration Support Unit (ASU)
Weld County Department of Human Services
Direct: (970) 400-6603
Team: (970) 400-6556
Fax: (970) 353-5215
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
Vision:
The people of Weld County are connected to the resources needed to thrive in the community
and feel safe and empowered.
Mission:
Engaging and partnering with the community to improve the safety, health and well-being of
individuals and families through the delivery of responsive and collaborative services.
From: Karina Amaya
Sent: Monday, July 15, 2019 8:30 AM
To: HS Contract Management <HS-ContractManagement@co.weld.co.us>
Cc: Cecilia Moreno <cgarcia-moreno@weldgov.com>
Subject: FW: WORK Act Cycle 5 application (Information)
Good morning,
It looks like we are not moving along in the application process.
Thanks,
Karina Amaya
Youth and Adult Employment and Training Manager
CQ n;cc -h orLS
OFsiacol i9
1 aoiq-a3(13
Employment Services of Weld County
Weld County Department of Human Services
315 N. 11th Avenue, Building B
Greeley, CO. 80631
tel: 970-400-6763
cell: 970-415-2602
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Cecilia Moreno
Sent: Friday, July 12, 2019 4:06 PM
To: Tami Grant <tgrant@weldgov.com>; Karina Amaya <kamaya@weldgov.com>
Subject: FW: WORK Act Cycle 5 application
Bummer...
CeCe Moreno
Business Services Manager
Employment Services of Weld County
315 N 11 Ave B Greeley, CO 80631
970-400-6756
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: McGee - CDLE, Brenda <brenda.mcgee@state.co.us>
Sent: Friday, July 12, 2019 3:00 PM
To: Cecilia Moreno <cgarcia-moreno@weldgov.com>
Subject: WORK Act Cycle 5 application
2
Caution: This email originated from outside of Weld County Government. Do not click links or open attachments unless you recognize the
sender and know the content is safe.
Good afternoon,
This email is to notify your organization that CDLE has completed the initial review of your organization's application for
the WORK Act Cycle 5 grant. The application was reviewed and eligibility was determined based solely on on the written
application and the responses to the mandatory features in the Request for Applications.
Based on this initial review, CDLE has determined that your organization's application will not move forward in the
evaluation process.
You may request a debriefing by contacting me via email at brenda.mcgee@state.co.us. At this time, this debrief will
only include information about your organization's application as the evaluation process for WORK Act Cycle 5 has not
been completed.
Regards,
Brenda
Brenda McGee, CPPB
Procurement and Contract Services
Credit Card Program Manager
CDLE
COLORADO
Department of
Labor and Employment
We Keep Colorado Working.
P 303.318.8059 1 F 303.318.8068
633 17th St., Suite 1100, Denver, CO 80202
brenda.mcgee®state.co.us I www.colorado.gov/cdle
This electronic mail transmission may contain confidential or legally privileged information, intended only for the
person(s)name. Any use, distribution, copying, or disclosure by another person is strictly prohibited.
3
RESOLUTION
RE: APPROVE GRANT APPLICATION FOR SKILLED WORKER TRAINING PROGRAMS
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 a Grant Application for Skilled Worker
Training Programs from 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, to the
Colorado Department of Labor and Employment, commencing October 18, 2019, and ending
May 31, 2021, 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 Skilled Worker Training Programs from 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, to the Colorado Department of Labor
and Employment, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 19th day of June, A.D., 2019.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: dotitev .1O,vi
Weld County Clerk to the Board
eputy Clerk to the Board
orney
Date of signature: 0((o1i/19
Barbara Kirkmeyer, Chair
Steve Moreno
Mike Freeman, Pro-Tem
c.c.: I-lSO
-/d-I9
2019-2343
H R0090
PRIVILEGED AND CONFIDENTIAL,
MEMORANDUM
DATE: June 18, 2019
TO: Board of County Commissioners — Pass -Around
FR: Judy A. Griego, Director, Human Services
RE: Employment Services of Weld. County (ESWC)
Request for Submission of a Grant Application
Please review and indicate if you would like a work session prior to placing this item on the
Board's agenda.
Request Board Approval of the Department's Employment Services of Weld County
(ESWC) Request for Submission of a Grant Application. Emp yment Services of Weld
County (ESWC) became aware of the grant opportunity on June A.22019, which requires a tight
timeline for submission. The Skilled Worker Outreach, Recruitmet'ff, and Key Training Act
(WORK Act), established by HB15-1276 and extended by HB18-1316, is seeking applications
from entities that offer, or plan to offer, a skilled worker training program and partner with
industry to offer, or fund a skilled worker training program for Coloradoans. This grant will meet
dynamic industry needs through leveraging strategic industry and workforce development
partnerships.
The amount of funding ESWC would like to apply for is $66,507.00. The performance period for
potential awarded funds is estimated for October 18, 2019 — May 31, 2021.
I do not recommend a Work Session. I recommend approval for submission of the grant
application and authority for Chair to sign.
Sean P. Conway
Mike Freeman, Pro-Tem
Scott James
Barbara Kirkmeyer, Chair
Steve Moreno
.4/941
Approve Schedule
Recommendation Work Session
Other/Comments:
Pass -Around Memorandum; June 18, 2019 — Not in CMS
Page 1
oat)/9-02343
Karla Ford
From:
Sent:
To:
Subject:
Barbara Kirkmeyer
Tuesday, June 18, 2019 3:18 PM
Karla Ford
Re: RUSH -Pass Around Employment Services of Weld County Request for Submission
of Grant Application
Approve
Sent from my iPhone
> On Jun 18, 2019, at 12:31 PM, Karla Ford <kford@weldgov.com> wrote:
> Barb,
> Do you approve recommendation? They need this added to tomorrow's agenda. Please advise. Thanks!
> Karla Ford-
> Office Manager, Board of Weld County Commissioners
> 1150 O Street, P.O. Box 758, Greeley, Colorado 80632
> :: 970.336-7204 :: kford@weldgov.com<mailto:kford@weldgov.com>
www.weldgov.com<http://www.weldgov.com/>
> My working hours are Monday -Thursday 7:00a.m.-4:00 p.m.
> Friday 7:00a.m. - Noon
> [WC Logo Color]
> Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only
for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
> From: Esther Gesick
> Sent: Tuesday, June 18, 2019 12:22 PM
> To: Karla Ford <kford@weldgov.com>
> Subject: FW: Employment Services of Weld County Request for Submission of Grant Application
> From: Scott James
> Sent: Tuesday, June 18, 2019 10:51 AM
> To: Esther Gesick <egesick@weldgov.com<mailto:egesick@weldgov.com»
> Cc: Judy Griego <griegoja@weldgov.com<mailto:griegoja@weldgov.com>>; Barbara Kirkmeyer
<bkirkmeyer@weldgov.com<mailto:bkirkmeyer@weldgov.com>>; Don Warden
<dwarden@weldgov.com<mailto:dwarden@weldgov.com>>; Bruce Barker
<bbarker@weldgov.com<mailto:bbarker@weldgov.com>>; Jamie Ulrich
<ulrichjj@weldgov.com<mailto:ulrichjj@weldgov.com»
> Subject: Employment Services of Weld County Request for Submission of Grant Application
> Good Morning, Esther!
1
COLORAD
Department of
Labor and Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, CO 80202-3660
ATTACHMENT F - Skilled. Worker Outreach, Recruitment, and Key Training Act: WORK Act
Matching Grant Program (1 -1B15 -1276/11B17-1357/111318-1316) - Application for New & Existing Skilled
Worker Training Programs
Cycle Five (5) Performance Period: October 18, 2019 — May 31, 2021 (estimated.) .a flDA 2019000304
Part 1: Co.,,, r Sheet and Signature
a) Grant Applicant: Employment Services of Weld County
b) Fiscal Agent: County of Weld
c) Fiscal Agent previously awarded a WORK Act Grant? NO
d) Applicant Mailing Address: 315 N 11 Ave Bldg. B Greeley, CO 8063:1
e) Applicant Physical Address: 3:15 N 11 Ave Bldg. B Greeley, CO 80631
fj Grant Administrator — Name and Title: Cecilia Moreno; Business Services Managers
g) Phone: 970-400-6756
h) Email: cgarcia-moreno@weldgov.com
i) Grant Amount Requested: (Total Program Proposed Budget, from Part 7) $66,507.00
j) Select the type of skilled worker training program: occupational education training
i. If "similar training program" or "pm -apprenticeship" is selected from the list above,
provide a description here. Address the connection to a Registered Apprenticeship
program, if applicable: NJA
ii. If "apprenticeship" is selected from the list above, is the program registered with the
United States Department of Labor's Office of Apprenticeship? Choose an option
k) The skilled worker training program will award upon completion: or similar evidence of
achievement
i. If "similar evidence of achievement" is selected from the list above, provide a
description here: N/A
1) Using the Colorado Key Industries table below, identify the key industry (ies) that is/are
targeted by the applicant: Advanced Manufacturing and Health & Wellness
Colorado Key Industries
Advanced Manufacturing (e.g. Industrial Maintenance), Aerospace, Bioscience, Creative. Industries (e.g. Cultural),. Defense & Homeland
Security, Electronics, Energy & Natural Resources, Financial Services, Food & Agriculture, Health & Wellness, Infrastructure
Engineering (e.g. Construction). Technology & Information, Tourism (e.g. Culinary), Outdoor Recreation, Transportation & Logistics
The signature below constitutes assurance that the information provided in this Application accurately
represents the applicant's plans, activities and projected goals; and acknowledges the applicant understands
that the above -mentioned, along with the approved budget, will be incorporated by reference in the Grant
Agreement with the Colorado Department of Labor and Employment
Name: Cecilia Moreno
02-0/9- o? 5 4/5
LtJtJ '`
C rOL � •R A C
Department of
Labor and Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, co 80202-3660
Title: Business Services Manager
Executive Summary & Hied Worker Training Pegra in Hi tort
a) Describe the history and mission of the applicant organization, and how this skilled
worker training program aligns with that mission. Word Count Limit: 450 approx.
Summary:
Employment Services of Weld County (ESWC) is a comprehensive American Job Center. Our mission is
"to keep the workforce system responsive to employers, employees and job seekers". ESWC's vision and
goals, in collaboration with our workforce system partners, is to develop and operate employment and
training programs in innovative, adaptive and customer driven ways that are:
Understandable to our customers and easy to use
Administered locally
Focused on outcomes and performance
Supportive to individual's growth to become productive employees
Flexible and pro -active in changing resources to meet customer needs
ESWC, with oversight provided by the Weld County Board of Commissioners and the Weld County
Workforce Development Board (WCWDB), has effectively operated and administered a wide variety of
employment and training programs for approximately 40 years. ESWC focuses on aligning program
services with local and regional labor market needs, as well as on providing quality, customer -driven
employment and training programs and services to business owners, job seekers and other
stakeholders. The WORK Act will allow for further development of related training instruction and work -
based learning programs through Aims Community College and select employers in the manufacturing
and health care sectors.
b) Describe the program (Word Count Limit: 650):
Curriculum, program operational costs, location of skilled worker training
program training facilities, anticipated length of time for traditional completion,
and skills taught. Describe jobs for which the completer is prepared, and career
pathways linked to opportunities for advancement in the industry. Describe
current and intended staff responsibilities related to the training program.
• If program is not new, address program history, including number of years in
operation. Include a comparison of the number of program enrollees versus the
number of program completers over the last five years.
Summary:
COLOR D
Department. of
Labor and Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, Co 80202-3660
It is the goal to have completers advance within the company that their work -based learning and/or
related training instruction are given. A current employer, TOLMAR, has a one -page hand out that
illustrates the career pathway to include job titles and earnings. This will be replicated among other
manufacturing and health employers that will participate in this program. If for some reason, a
completer decides to move onto another company within that industry, they will have portable skills
and/or a nationally recognized credential. It is the expectation that the related training will be no more
than six montns, but flexibility is crucial in ensuring employers' needs have been met.
Current ESWC staff work with employers and educational providers to develop curriculum and complete
any documentation to become registered apprenticeships with the United States Department of Labor.
Intended staff responsibilities will be to recruit additional employers within the manufacturing and
health care sectors as well as unemployed or underemployed individuals to participate in this program.
Additionally, ESWC has entertained the idea of having a designated employee to assist employers with
understanding and navigating work based learning and related training instruction paperwork,
specifically within the realm of Registered Apprenticeships. If granted, this funding can meet this need at
the one stop center.
art 3 Skilled Worker Training Program Outreach and Recruitment Plan
Provide a thorough description that addresses each item below. Applicants are encouraged to
refer the RFC 's Glossary section for definitions of relevant terms. Stated figures for recruitment,
enrollment, completion, and employment will be used for application scoring as well as
measuring success throughout the granting cycle (see section S in RFA.) Word Count Limit Per
Question: 250 approx.
a) Program performance will be measured, in part, by the underserved, underrepresented,
and economically distressed populations the program plans to reach. Describe the target
audience, and staffs expertise regarding the barriers these populations might face.
As a region, Weld has had a longstanding commitment to serving those with barriers and has been
fortunate not to have to implement a tiered system wait list for the Workforce Innovation and
Opportunity Act (WIOA) program.
Weld has historically engaged out -of -school youth. This made the transition from the Workforce
Investment Act (WIA) to WIOA seamless. Moreover, this model supports the 2Gen approach,
strengthening relationships with the Temporary Assistance for Needy Families (TAN F) work program and
Child Welfare case managers. Being housed on the Human Service campus has proven successful with a
warm hand off and continued communication between programs.
?` Li'1, A D
Department of
Labor and Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, CO 80202-3660
In Program Year 17, Weld County's Adult Priority of Services was praised and recognized by the Colorado
Department of Labor and Employment (CDLE) for enrolling individuals with statutory and/or governor
barriers at a tune of 95.56%. During the same time, the WIOA Groups with Barriers report shows 100%
of Adult and Dislocated Worker clients were enrolled with one or more of the following barriers:
Public assistance recipient; Individual and Family income; Homeless; Foster Child; Individual with
disability income; Free Lunch; Basic skills deficient; Underemployed and low income; English language
learners; Displaced homemakers; Older individuals; Ex -offenders; Hispanic Ethnicity; Native
American/Indian/Hawaiian; Youth aged out of foster care system; Eligible migrant and season
farmworkers; Individuals within 2 years of exhausting TANF; Single parents; Long-term unemployed;
Individuals with disabilities; SSI; Layoff/Ui/Unlikely to Return; Plant Closure, Substantial Layoff; Self -
Employed and Business closed; Ul Profiled; Veterans; Military Spouse; Transitioning Military Member;
and Recently Separated Veterans.
b) Beyond recruitment of trainees, describe how the grant will be used to reach stakeholders
(parents, family, friends, teachers) who may influence program enrollment.
As with all funding, the Workforce Development Board (WDB) will spread the word and participate in
this initiative. Additionally, each member of the WDB is encouraged to be involved on one of the three
standing Board Committees. These committees include the: Awareness Committee, the Partner
Committee, and the Youth Committee. Each has differing areas of focus and consist of multiple
community -based partners not just that of the WDB or those mandated by WIOA.
As the first high performing board in Colorado, WDB Members and ESWC staff have been exceptional in
attending various community events as representatives of the one stop. These outreach efforts have
had a positive impact on program enrollments for many years. As evident by being granted the high
performing status.
c) The goal of the WORK Act is to increase awareness of and enrollment in skilled worker
training programs, through outreach and recruitment. Describe applicant's expertise in
marketing, or plans to engage an external organization to market the program to the target
audience as described above.
Through strategic partnerships, ES\JIC will combine marketing efforts with Aims Community College and
Sector Industries. A marketing plan utilizing the method of passive recruitment will be entertained in
addition to communications and outreach such as press releases, resource fairs, word of mouth, etc.
Weld County has a dedicated Communications Specialists that has been influential in revitalizing
program marketing material not only for Employments Services but with the Department of Human
Services (DHS) as a whole. Their input will be a driving force when increasing awareness and enrollment
in skilled worker training programs.
Staffs dedicated efforts to reach new stakeholders will be the primary focus as in person conversations
have shown a better return on investment. It has been recognized that without employer "buy in", pre-
COLORADO
Department of
Labor and Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, Co 80202-3660
apprenticeship, apprenticeship and registered apprenticeship programs have lacked enrollment, and
this would only become worse without the support of Employment Services.
i. State passive recruitment goal and describe measurable passive recruitment
strategies.
Although passive recruitment is a strong way to recruit students, these decisions are not always
available for Employment Services to make. The Weld County Commissioners are the individuals able to
make the decisions regarding social -media presence and website communication. As mentioned above,
the Communications Specialist will play a significant role in the recruitment process. If it is decided that
Employment Services can utilize social -media through Weld County, the number of shares, views, likes
etc. will be tracked and reported.
It is important to note that Employment Services will distribute flyers and brochures via email, at
community events and provide presentations when available. The collection of this information could
ultimately be passively shared by our partners on their social media. in which case we would ask if
tracking could be reported.
ii. State active recruitment goal and describe measurable active recruitment
strategies.
Active recruitment happens throughout the community via our mandatory partners and other
community -based organizations. Potential clients act on the information that is given to them by calling,
emailing, asking questions of staff, etc. When individuals seek services through the Resource Room,
Wagner Peyser staff actively recruit and share program information with those individuals and will often
provide a warm hand-off with a program specific case manager. This type of recruitment strategy can be
difficult to measure. Cicent referrals often come to the program and do not recall how they were
referred. This grant could potentially assist with a strategic plan and/or development on how to track
and measure active recruitment.
d) Program performance will be measured, in part, by increasing the number of program
enrollees. All applicants: State enrollment goal and describe how enrollment will be
tracked. If applicant is applying with an existing program, define a significant increase in
enrollment over a recent, comparable time period (increases not applicable for new
programs).
If a State program code is not provided for this funding source, Employment Services will create a local
code which will be used in the sub activity code section in Connecting Colorado. This method would
work well across all programs, Adult, Dislocated Worker, Veterans Service to Career and Trade
Adjustment Assistance (TAA).
e) Program performance will be measured, in part, by increasing the number of program
completers. All applicants: define "program completer," state completer goal, and
describe how completion will be tracked. If applicant is applying with an existing
SR`..
Department of
Labor and .Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, Co 80202-3660
program, define a significant increase in completion over a recent, comparable time
period (increases not applicable for new programs).
Following the method used by WIOA programs, Weld County will capture the following performance
measures: Employment Rate for Quarter 2 and 4, Median Earnings, Credential Rate, and Measurable
Skill Gains. These reports are generated in Connecting Colorado and will also provide further data for
this cohort of completers if necessary.
f) State the number of program cornpleters who will be employed within the timeframe of
the grant. If participants willnot be employable in that timeframe, explainwhy not.
Describe how students will be tracked from program completion to employment.
As this is Weld County's first experience with the Work Act, we anticipate 15 corpleters during the
participation period. Weld will maximize efforts to increase enrollments and explore multiple cohorts
thus students may still be in process when the grant has ended.
Part 4 Partnerships
a) Complete the chart below describing program relationships with Colorado business and
industry partners, and Colorado workforce development/community partners. Include
both existing and anticipated partnerships; attach signed MOUs when they exist. In
"Partner Contribution" and "Grantee Contribution" sections, include cash and in -kind
contributions, and specify amounts. Refer to the Application Assistance attachment for an
example chart.
Industry
Partners
Nature
Relationship
of
Grantee
Contribution
Contribution
Partner
Duration
Partnership
(Dates)
of
Signed
MOU?
Manufacturing
Partnership
NOC,
Workforce
(Sector)
Development
As
established
partnership,
continue
recruitment
presentati
this
already
Kind
forms
events,
etc.
is
will
hi
of
an
the
r1s
In-
In
through
facilitation
meetings
input
industry
curriculum
training
-kind
continue
from
will
the
and
needs.
the
on
and
of
2013 to
present
NO
COLORADO
Department of
Labor and Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, CO 80202-3660
Colorado
Partnership
Northern
Sector
Health
Workforce
(Sector)
Development
As
established
partnership,
continue
recruitment
presentations
this
already
Kind
forms
events,
etc.
is
will
in
of
an
the
Ina
through
facilitation
meetings
input
industry
curriculum
training
In -Kind
continue
from
will
the
and
the
on
and
needs.
tf
2013
to
present
NO
Click here
enter
to
text.
Click
enter
here to
text
Click
here to
enter text.
Click
enter
here
text
to
Click
enter
here
text.
to
Choose
an
option
Click here
enter
to
text.
Click
enter
here to
text.
Click
enter
here to
text .
Click
enter
here
text.
to
Click
enter
here to
text
Choose
an option
}►}Y�
1#133R�'Sd.BIIi
J�eXi t
111LLL g app T
d. y
sill
ers
Relationship
Nature
of
M1 o
gym
Grantee
Cot trthutio
app
a o
Partner
O, p
Contribution
Duration of
Partnership
(Dates)
a
Signed.
MOU?
M`tX 'V c
Development/
�y�{'
Community
W✓
Workforce
Part°.
Achieving
Community
Excellence
(ACE)
Infrastructure
Division
serves
on
Board.
Head
the
co,
assist
curriculum
employer
industry
.nections
Hi
with
"buy
to
and
2015 to present
NO
Aims
Community
College
Education
Refer to M; :U
Refer to MOU
1979 to
present
YES
Click
enter
here to
text
Click
enter
here to
text
Click here to
enter text.
Click here
enter text.
to
Click
enter
here to
text.
Choose
an
option
Click
enter
here to
text,
Click
enter
here to
text.
Click
enter
here
text
to
Click
here
enter text.
to
Click
enter
here to
text
Choose
an
option
b
D O L ';'`�3 R A O
Department of
Labor and Employment
Workforce Devetopment Programs
633 17`11 Street, Suite 201
Denver, CO 80202-3660
'\ arrative - Expand upon the information in the chart above, including how partners will
help applicant succeed in the granting cycle. Word Count Limit Per Question: 250
approx.
i. Describe how the applicant worked with industry partners to identify gaps for skilled
workers and how the offered training meets their need.
Summary:
As a support to the NOCO Manufacturing Partnership, Employment Services of Weld County
(ESWC) suggested that a Regional Advisory Discussion (RAD) be instituted. The RAD is hosted
by ESWC and brings together employers, workforce, educators, and public partners in one
moderated discussion about the skills gaps which employers face. The RAD is a 'highest and
best use' approach to the time of employers and all participates by addressing common issues in
one collaborative meeting. The RAD began in 2016 and at the request of the NOCO
Manufacturing SP continues to be held annually. The national moderator for 2019 identified this
local event as the most progressive in the United States to data
By the end of 2019, the Northern Colorado Health Sector Partnership will have worked through the
following goals: A Behavioral Health committee to implement workforce goals, apprenticeships,
internships and to conduct an improved survey of critical occupations and largest workforce gaps.
ii. Provide current, area -targeted data illustrating gaps in the workforce that program
completers will be eligible for and qualified to fill.
Summary:
According to EMSI (Economic Modeling Specialists Intl.) this year (2019) both the health and
manufacturing sectors will grow. The below illustrates that there will be positions available for qualified
candidates with the opportunity to earn substantial wages.
Hndustry
Change in
2018 Jobs 2019 Jobs Jobs (2018-
2019)
2018 Earnljngs
Change
Per Worker
Government
Manufacturing
Construction
Retail Trade
Health Care and Social Assistance
18,095
13,719
13,307
10,858
10,315
18,591
14,114
14/008
11,180
10,704
496
395
701
322
389
3%
3%
5%
3%
4%
$51,222
$63,724
$64,740
$37,161
$55,137
iii. Describe how partners will provide input on curriculum, completer job readiness, and
changes in the industry, including participation on advisory boards.
Summary:
)epartr ent of
Labor and Erraptoyment
Workforce Development Programs
633 17`fi' Street, Suite 201
Denver, Co 80202-3660
The partners in the above charts were strategically chosen as dialogue has fostered the creation of
new and innovative career pathways to address gaps in the skills market. Educational partners
bring their expertise to the table, while Employment Services works to shape it into the needs that
Sectors have identified.
Tami Grant, Division Head, was recently appointed to be a member of the ACE board. Her
working and historical knowledge of the Workforce in Weld County will serve the board well.
Additionally, there continues to be strong representation at several advisory boards, such
participation has resulted in the first Sterile Processing Technician Certification program in the
State!
iv. Describe how staff coordinate with specific workforce and community partners to
provide supportive services for participants.
Summary:
The WCWDB and ESWC have adopted a supportive services policy to ensure that services are provided on
a consistent and equitable basis for those individuals who need such services to assist them in obtaining or
retaining employment, or to participate in and complete career or training services and who are unable to
obtain such services through other program means. The supportive services that may be provided are:
transportation, child care/dependent care, job related medical expenses, special clothing, license costs,
assistance to secure bonding, books and supplies for training and work tools. When needed, additional
sources such as Veterans Service to Career and Community Services Block Grant funding may be utilized.
Pan` , S usta naba1ity Plan for Skilled Worker .Training Program
Describe the applicant's plan for long-term sustainability. How will partnerships and other
funding streams be utilized to sustain recruitment, outreach, and training efforts after applicant's
Cycle 5 WORK Act awarded grant funds are expended? Continued support from the WORK Act
should not be included in the Sustainability Plan. Word Count Limit: 400 approx.
Summary:
Funding can be unpredictable; Weld County is intentional with braiding funding and diligently ensures
services are not duplicated through other programs. This long-standing practice provides a long-term
sustainability plan utilizing Wagner Peyser and Employment Support Fund (ESF) for future recruitment
outreach while direct client costs (i.e. training) could be supported through WIOA. Over and above that,
leadership consistently searches out other funding opportunities, such as this to continue workforce
development efforts.
Ravi ,'�}(� �y`f'� rat
rw ,aj Partner
{� y� Match
f'� ?]��C�
RarlL 6 y .�:l anitee '. P +�rtn:�v .'f M atch
COLOR DO
Department of
Labor and. Employment
workforce Development Programs
633 17th Street, Suite 201
Denver, CO 80202-3660
Directions: Complete the following table for matching funds as requested. Note: Match shall not
be used for tuition subsidies or to reduce tuition for a skilled worker training program. Refer to
Application Assistance Attachment H for an example chart.
Match
Description
Type
Total
Cash
-Kind
Grantee
Match
a. Cash
managers
recruiter.
weeks.
h. Valuation
basic
wages
office
to take
20
supplies.
hours
of
through
classroom
on clients
a week
WIOA
from
at
space
S25
for
and
case
the
for 52
a.
b.
$ $26,000°00
$ $4,500.00
Total
a.
b. In
Total
a. Cash
b. In -Kind
Partner
Match
a. N/A
related
apprenticeship
to the
completion
of
paperwork
a.
b.
$
Varies
...I/A
per
$30,500
business
b. Time
registered
Total:
Part 7: Proposed Budget
a) Using the applicant's below proposed budget, what is the hard cost to the organization for
one participant to complete the training/s? (Total Proposed Budget divided by Completer
goal) $4,433.80
b) Using the applicant's below proposed budget, what is the hard cost to the organization
per participant for recruitment and outreach? (All recruitment and outreach costs from
Proposed Budget divided by Completer goal) $3,819.33
c) Complete the following table for grant budget requested. The proposed grant budget must
identify the costs that will be invoiced to CDL_,E for reimbursement. Budget Categories
shown are examples, utilize the categories that apply and specify additional categories
under "Other." Note: Grant award shall not be used for tuition subsidies or to reduce
tuition for a skilled worker training program. Budgets that primarily request funds for
outreach and recruitment with minimal operating/programmatic costs are preferred. Refer
to Application Assistance Attachment H for an example chart.
Description
f
Cost
COLORADO
Department of
Labor and Employment
Workforce Development Programs
633 17th Street, Suite 201
Denver, CO 80202-3660
Personnel
a.
b.
c.
Recruiter
Click
Click
here
here
(ETE)
to
to
enter
enter
text.
text.
40 hours
weeks.
a week at
S25/hour for 52
$52,000.00
Operating
a.
Personnel)
b.
c.
Infrastructure
Click
Click
here
here
to enter
to enter
(Ion-
text.
text.
Ge
center,
utilities
and
contribution.
; eral
technology.
such
and
operation
as
maintenance,
rental
of
the
of
one
the
equipment
to
-stop
facilities,
JVSG
S8,692.00
Equivalent
Travel*
as 2,000 miles
at $0052 per mile
a. $1,040.00
a.
b.
c.
Mileage
Motel
Click
reimbursement
here to enter
text.
bo Up
necessary
to 5 nights
in a hotel if
b. 5525000
Supplies
a. n/a
b. Click
c. Click
here to enter
here to enter
text.
text.
Inkind
Click
text.
here to enter
Printing
Business Cards, Pamphlets,
S500O00
Flyers,
a. Marketing
b. Click
c. Click
here to
here to
Materials
enter
enter
text.
text.
Banner etc.
Technology
a. n/a
b. Click
c. Click
here to enter
here to enter
text.
text.
Incl
,+ding
in peraing
Click
text.
here
to enter
Contracting
a. n/a
b. Click
c. Click
here to enter
here to enter text.
text.
Weld
does not utilize
contractors
Click
text.
here to enter
Other Marketing
Creation
a) 150
house
hours at $25/hour for in
communications
S3,750.00
Other
Click
here to enter
text.
Click
here to enter
text.
Click
here to enter
text.
Other
Click
here
to enter
text.
Click
here
to enter
text
Click here to enter
text.
O L, R : =, Da
Department of
Labor and Employment
Workforce Development Programs
633 17th Street; Suite 201
Denver, CO 80202-3660
Other
Click
here
to enter text.
Dick here to enter text.
Click
text.
here
to enter
Proposed
yyyy yr
Budget
g q(-'�`
. ,) f l; +''�{ry,�( U:,.
.��°�iuyto 4 `^
$ W�L'TiY45® / o`V®
TotalProgram
*Travel expenses shall only be reimbursed at the State 's then current per diem rate and mileage
rate.
ATTACHMENT A
Colorado Department of Labor and Employment
KADA 2019000304
Model Grant Agreement and Insurance Affirmation
Company Name (must match Solicitation Signature Page): Employment Services of
Weld County
Applicants responding to this solicitation must affirm that they agree to the Model Grant
Agreement (Exhibit A). If Applicants do not agree to the Model Contract, they are to
provide alternate language for the legally unacceptable sections.
• Applicant hereby affirms that they have read and agree to all the insurance
requirements listed in the Model Grant Agreement (Exhibit A).
Yes IZ No *
If an Applicant cannot provide insurance, please use the space below to indicate the
specific insurance requirements and why. If additional space is needed, attach
additional pages as necessary.
1) Insurance Requirement:
Reasoning:
* Applicant hereby affirms that they have read and agree to all the terms and
conditions of the attached Model Grant Agreement.
Yes 19 No *
*If Applicant checks "No", please complete the following section.
If an Applicant takes exception to any of the Model Grant Agreement Provisions,
please use the space below to indicate the specific clause citation, provide alternate
language, and provide justification for the exception. If additional space is needed,
attach additional pages as necessary.
1) Model Grant Agreement term and condition:
Alternate language:
Justification:
2) Model Grant Agreement term and condition:
Alternate language:
Justification:
2
ATTACHMENT A
Colorado Department of Labor and Employment
KADA 2019000304
Model Grant Agreement and Insurance Affirmation
Company Name (must match Solicitation Signature Page):
3) Model Grant Agreement term and condition:
Alternate language:
Justification:
* As a reminder, the Colorado Department of Labor and Employment (CDLE) is not
required to accept nor agree to alternate or additional terms and conditions. *
Signature of individual authorized to represent vendor (wet signature)
Typed or printed name of individual authorized to represent vendor
Title of individual authorized to represent vendor
2
ATTACHMENT B
Colorado Department of Labor and Employment
Risk Assessment Form
Request for Applications (RFA) KADA 2019000304
TO BE FILLED OUT BY THE GRANT APPLICANT
Any questions that remain unanswered, including explanations and any answers that do not address
the question asked will be assessed the highest risk rating for that question.
Full legal name of Subrecipient: County of Weld, Colorado
Name and title of person completing this form: Leonard Bottorff, Fiscal Manager, Weld County
Department of Human Services
Amount of funding requested on this grant application: $190,000.00
**If Subrecipient has completed this form in the past twelve months, please submit a completed form
with any updated information**
OPERATION CONSIDERATION
The significant aspects of Sub -recipient's operations, the failure of which could impact Sub -recipient's
ability to perform and account for the grant deliverables.
1) Sub -recipient's total annual operating budget: $43,972,495
2) Total number and dollar amount of all state, Federal and private grants Subrecipient will receive
in its current fiscal year: 34 and $34,914,684
3) Total dollar amount of all grant funding Subrecipient will receive from CDLE in its current fiscal
year: Budgeted at $2,435,490
4) Percentage of the CDLE grant applied for that the Subrecipient is sub -awarding? 0%
5) Total dollar amount of Federal funds Subrecipient received in its previous fiscal year: $2,475,464
EXPERIENCE CONSIDERATION
Sub -recipient's experience and history with the same or similar Federal awards or grants.
6) How many years has Subrecipient been in existence? 157 Years
7) Has Subrecipient administered programs similar to this grant? X Y N. If yes, please list and
explain. The Employment Services Division, within Weld County Government, has administered
the Workforce Innovation and Opportunity Act (WIOA) since its inception, prior to that
administered the Workforce Investment Act (WIA), from its inception and prior to that the Job
Training and Partnership Act (JTPA).
8) Has Subrecipient failed to satisfactorily meet any State, Federal or private grant deliverables in
the past? X Y N. If yes, please explain what deliverables were not met and why
Subrecipient was unable to meet them: During the PY16 Annual monitoring, ESWC had a
compliance finding due to Dislocated Worker (DW) being at a 49% expenditure rather than above
1
55%. ESWC agreed DW funds did not meet the required threshold however, believe there were
mitigating circumstances which had an impact. ESWC successfully implemented SP-NEG in Weld
County, and in addition to expending 100% of the initial allocation, accepted two additional
allocations to support statewide programmatic goals.
FINANCIAL CONSIDERATION
Sub -recipient's financial stability and ability to comply with the grant's financial reporting requirements.
9) Does Subrecipient have a time and effort reporting system in place or maintain paper timecards
to account for 100% of each employee's time (both salaried and hourly employees) broken down
by time spent per funding source (or grant), with evidence of supervisory approval? X Y N.
If no, explain how Subrecipient intends to document each employee's time by funding source.
10) Does Subrecipient have an accounting system to track expenditure activity by funding source (or
grant), with mechanisms to track multiple activities within the grant, if necessary? X Y N.
If no, explain how Subrecipient intends keep CDLE's grant segregated from other activities of the
Subrecipient.
11) Does Subrecipient maintain time records (timesheets or personnel activity reports) for all
employees when their effort cannot be specifically identified to a particular program or cost
objective: for example, general administrative staff such as accountants? X Y N. If no, does
Subrecipient have an approved alternative system to account for time distribution of overhead
salaries and when was it adopted? We utilize both methodologies. Our Random Moment
Sampling methodology is administered by the Colorado Department of Human Services and has
been in place for over twenty years. Likewise, our County Indirect Cost Plan has been in place for
multiple years.
12) Does Subrecipient have a cost allocation plan that spreads all common costs, such as phone, rent,
utilities, etc. among all funding sources based on a systematic metric; for example, FTE or square
footage? X Y N. If no, describe how Subrecipient allocates common costs. Attached are the
Weld County Indirect Cost Plan and the Weld County Department of Human Services' cost
distribution methodology.
MONITORING AND AUDIT RESULT CONSIDERATION
Results of Sub -recipient's previous audits or monitoring visits.
13) Has Subrecipient received an audit under the Single Audit Act/Uniform Administrative
Requirements, 2 CFR Part 200, Subpart F (Government Auditing Standards)? X Y N. If yes,
provide a copy (electronic preferred) of its most recent audit report. This has been provided to
the CDLE Audit Unit, previously.
2
14) Has Sub -recipient received an annual financial statement audit under Generally Accepted
Auditing Standards (GAAS)? Y X N. If yes, provide a copy (electronic preferred) of its most
recent audit report. Our independent auditor, Anderson and Whitney, follows Government
Auditing Standards, as required by the Single Audit Act
15) Are there any outstanding audit findings from prior audits? y X N. If yes, identify the
following:
N umber of Outstanding Control Deficiencies
Nature of Outstanding Control Deficiencies
N umber of Outstanding Significant Deficiencies
Nature of Outstanding Significant Control Deficiencies _
N umber of Outstanding Material Weaknesses
Nature of Outstanding Material Weaknesses
INTERNAL CON T R:1L CONSIDERATI N
Sub -recipient's ability to safeguard its assets and resources, deter and detect errors, fraud and theft,
ensure accuracy and completeness of accounting data, produce reliable and timely financial and
management information, and ensure adherence to its policies and plans.
16) Has Subrecipient updated any of its policies and procedures within the last two years? XV
N. If no, please indicate when policies and procedures were last updated.
17) Does Sub -recipient's accounting system allow it to segregate all assets, liabilities, revenues and
expenditures by funding source, and produce a balanced trial balance by funding source or grant?
X Y N. If no, explain how the Subrecipient intends to segregate this grant from its other
activities.
18) Does Subrecipient have an active oversight committee/board, and is it provided financial reports
and information on a regular basis? X y N
19) Does Subrecipient have fidelity bond insurance coverage (or any other form of insurance
coverage) to protect itself from fraudulent acts of its employees, at a minimum all employees who
handle cash? X Y N
IMPACT CONSIDERATION
3
Potential impact of Sub -recipient's non-compliance to the overall success of the program objectives.
20) If any portion of this grant will be disbursed on a cost reimbursement basis, does sub -recipient
have sufficient liquidity to enable it to manage its finances between the time costs are incurred
and reimbursed? X Y N. If no, explain how Subrecipient intends to cover its costs prior to
receiving reimbursement. The Human Services Fund Balance at December 31, 2017 equals
$1,278,347, The total Fund Balance for Weld County Government equals $191,850,164. We
believe that this is an amount sufficient to cover costs we will incur through this program, prior
to reimbursement.
21) Has Sub -recipient had any significant changes in its key personnel (e.g. Controller, Executive
Director, Accounting Manager, Program Manager, etc.) or its time keeping or accounting systems
in the last year? Y X N. If yes, explain the changes.
22) Does Sub -recipient have any potential conflicts of interest in accordance with State of Colorado
policy which includes any potential or actual situations where any employee's objectivity,
professional judgment, professional integrity or ability to perform work related to procurements
is compromised by financial, personal or familial interests (see
https://www.colorado.gov/pacific/sites/default/files/Procurement%20Conflicts%20of1201nte re
st%20Policy.pdf and 2CFR §200.338)? Y X N. If yes, explain the potential conflict of
interest.
**Sub -recipient should retain a copy of this completed form in its records for any additional funding
applications within a twelve month periods**
Please Sign and Date below:
Executive Director (or authorized delegee) Date
Signature
Financial Director Signature Date
4
("2-0l9a 0231/3
ATTACHMFNT B
Colorado Department of Labor and Employment
(CDLE) RFA KADA 2019000050
Solicitation Signature Page and W9
Conflict -of -Interest Section
Applicants must state whether there currently are, or potentially could be, organizational or
other conflicts -of -interest regarding this solicitation, their application, their staff or their
proposed subcontractors, related business with the State of Colorado, or with CDLE employees.
The CDLE, Procurement and Contract Services (PCS) office reserves the right to make a
non -responsive determination on an applicant's application or cancel the award if there is
a conflict, a perceived conflict, or if a conflict or appearance is disclosed from any other
source.
Page 2 of 2
Form W-9
State of Colorado
Substitute rev.0415
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
N
N
oi
co
a
o
o
c c
a•. u ra
.
O `
C 1.0-;
r.
O.�
:a
0
f)
W
co
Name (as shown on your income tax return)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
Individual/Sole Proprietor or C Corporation S Corporation Partnership Trust/estate
single member LLC
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) >
Note. Fora single -member LLC that Is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the
single -member owner.
Other (see instructions) > Government
Exemptions
entities, not
page 3):
Exempt payee
Exemption
code (if any)
(Applies to ascuunts
(codes apply only to certain
individuals; see instructions on
code (if any)
from FATCA reporting
maintained outside the U.S.)
Address (number, street, and apt. or suite no.)
Purchase Cider address if different (optional)
City, state, and ZIP code
List account number(s) here (optional) Contact name Contact Email
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line
to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
Social security number
Employer identification number
UM Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below), and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.
Sign
Here
Signature of
U.S. person
Date
Have you ever worked for the State of Colorado?
Have you ever worked for a PERA Employer?
Business Types (check all that apply):
CO Location/HQ in CO
CO Location/HQ out of CO
No CO Location/HQ in US
No CO Location/HQ out of US
Has Paid Compensation Tax
Has Not Paid Compensation Tax
African American
Asian Pacific American
Subcontinent Asian American
Hispanic American
Native American
CDOT Certified Emerging Small Business
CDOT Certified Disadvantaged Small Business
Women Owned
Woman Business Enterprise
❑ Yes No
O Yes No
IMMO
NOR
Veteran Owned
Disabled Vet Business Enterprise
Disadvantaged Veteran Enterprise
Service Disabled Veteran
Vietnam Veteran
Veteran Business Enterprise
Disadvantaged Business Enterprise
Small Disadvantaged Business
Disabled Owned
8(A) Designation
HUBZone Certified
Labor Surplus
Historical Black Colleges & Universities
Small Business
Airport Concession Disadvantaged Business
ATTACHMENT C
Colorado Department of Labor and Employment (CDLE)
Grant Applicant Signature Page
Request for Application (RFA) KADA 2019000080
:om
(FL, December 20141
3spatmt04 9000 haarun
manta Renew w Sawice
Nsneimenwn:4yvor aroma
WELD COUNTY
Request for Taxpayer
identification Number and Certification
Give Form t0 the
requester. Do not
wad to the MS.
ri 2 Sue LOW laregar9090000y
7'eld County 00100mtt
is romee0 90900 Snc m not 49aroe 910
anent
0001, oppoop'lole too for Warm lea oaaaln4Won: =hook only moot the lokUmoo seven !96%88'.
C hofnifeLeirmie proprietor of 0 C Corporation O S Cortoo otor O F annetatap ,C Tn;w noon
efngre-mt o, tt4
0 14944,3 tl Oo nleany. Enter die ter Maad'.eatfal is C corpora fir.. SoS corporation, Pnp;;9prshipt®
Otbts. FN a stnge-rnemtnr L:;: a`at 0 esanNnrda 0. dp not 9:00 614111nd ( ^'a 9ppooprtate sex n pod One oboe for
a'3 tux ciam:Seofon of eye angle -member enoee.
03900 entruc-mil00 GoVetnment
S 9009.0 a "mbar Bian8t) and apt. or oo0
1100 "Y?" Street, P.O. Fox 7118
6 Ode. agate. andZIP pada
Greeley, CO 60531
t Lpe
4 Ea9Alptors (cedes apply ordy to
aert00, ena0es, net 1^.cy, 00101000
:90000 01000 7R O04a 3)'
Exempt peyee code (amyl
Sampan. rave FATCA reporenq
made fe awn
Or.. c.bcmra
Sooueate0s mum and odekepb (tesflara9
Colorado Dept. of Labor and Employment
63317th Street
Denver. CO 0820.2-3631
U
Taxpayer
ffcation Number in
Enter your 11(4 in the appropriate box. The TIN prcwlae0 must match re name given on Roo 1 to avoid
backup warnWting. For individuate, ON to general), your social society :amber tsNi). However, tor e
rescana alien, sole proprietor, or disregarded entry, one the Pad inseuc0or+s on page 3. For other
entities, is your employer aemifcatian number 1E1N1. If you pb no! nave a number, sae How ea gee
710 on page 3.
&analee9rfrxr tember
or
Hole. It the egoonot 0 no mere ;haft one neme, sea toe -vatrucrlons 'or Rite I and the chart on page a for l E490,0hw ide0t9l00 a me,rper
guidelines on whose number to enter
Pd t fl
-
6
Certification
pl el DI 9j 11i
Under penalties of perhay. r coney that
I. The number shown on Iha form to my correct taxpayer dertniootion Dumber (or 1 em waiting he a naxslbar to pa 10.4450110 MC and
2. ,aft root au0 00 to bacc'tnp withheld eld rig because; Seim exempt from backup weak -aiding, or By I nova not been notilted by the Internal Revenue
Senr0 0 (RN that I MO subject to backup withholding as a meant of a failure to report all interest or d&TAends, or (o) the IRS has notified me that 1 ado
ND longer sup)ect to backup wrthhotd:np and
3. f am a U.S. citizen or other U.S. persow (defined betow); and
4. The. FATCA code(s) entered or. this form to any) indicating -hat ram axernpt front FATCA. reporting Is correct.
Certification inetnacttens. You 00800 use out lee 2 above if you have been notified by the 121S that you are a.r enty subject to backup withholding
became you have failed to report all interest and diwdonds a, your tee return. For real estate Owen:lions, item 2 does not apply. For mortgage
interest paid, acrputsition or abandonment of snowed property, cancellation of debt, cpalrbuttons to an IflOMOUalmtlyanyany arrangement gRAt, and
generally, payments Mhef then intrroot and dioMends, you are not 'squired to Sign the cetltfrcaaor, but you must provide your correct The. See the
instructions on page 3.
Here as.
Drta►
General Instructions
Seaton neatences are to file bkeurer Remora Cana'rxeas 911100:08 09004.
neere donsberneres. 104omanion about decalcomania electing Form Wag ;mach
as egtai41110 enacted attar wambease it) la at www.ira,poW19o9.
Purpose of Form
An iodMew1 wentity frprmOr-91errvestert 0000000000)0 d to Pte an001000et0On
ret rowan the RS mum owes ye, correct taxpayer kdentificaton reenter MN)
0011+0 may bo your 00,0E eacwity number 600), rndlaldual laxp9110 iffemlfaatIon
number 111114), Moolion falfOlfAIO• klertt1Men00r rq,mbe, (ATM1, or enpgyar
Idoreeoal:En Nerve. MEINI, to move on an Inrormsttan raum re amou,1 paw to
you, or other ampran rgw0Q bfe on an 010rmalkn room. Er.arnWea of 1n'Or,nOtton
retW00+000440, out are not 149484 to. the IdioWMtn
• 000tH 1099-INT (Informal aemad ar gene
• Form ,899-014 (aividenda, 000019ing 110008 Worn cocks or mutual funrh,l
• Foot 1299.00184 (venous types of Intone. press, award. or groom 010099da)
0, 1009 it (stook of mutt4l funa 09101 and cefral0 0100 000 9901100 Ny
brofara)
O FO(,T0 1099.0 ()n000ce trom roOl 0 010 trantectlonsi
° 'arm '092.K Merchant nerd and third parry 001.9,10 tennaaetrpn01
• Form 1098 throes mon9990Mteroop, rp80-0 (000109 Jam uncle 41, wear
tllntpr l
° Form 10199.0 (caromed debt}
farm 1089-2 (aaarleaon or aoald0nate l of seared property)
um Form W-3 artyyou eh a U.S. 00000 &docent a nateev 0 Axe. to
provide state canto TIN.
2you do not arum form W -a Onnartnostof with 0010, you )115001 GCauejepl
to aaatvp w11hn00dirry, Sea Whet is oeekop orthhotling7 on pane O
By 019001901911.09.90 form, you;
1. Coney that the 704 You are 4ivro 0 =fowl for you are wa0lrg for number
to 00 leauec,
2 Certify that you are ho10000 . le backup 0i,F010141 e6, br
s. caatm exemption tan Oaekup w4hrwtong 0 you as a U.S. exempt map, 01
0000009 O, you fro alyo anty'®g 1119100 a 4.S, moon, you 0000eb',e Sham of
any permerahip :t n.wtie from a 003. trade or busloret :snot mbiecl to the
'oNdrotdlrg tax col foragn pmNwre' Moro of 9ff01Nety eennected Income. and
4. Certify that PATIO coddle seared m1 his Worm 11 errs) bailcalhg that you are
exempt from hire (ATCh reporting, la oonot. Sea what la FATCA rep00Bg7
page Mr firths. Inforrneyon.
Cal. No. +4131%
Page 2 o f 3
Fenn, W-9 (ter. 1240141
ATTACHMENT D
Colorado Department of Labor and
Employment (CDLE) RFA KADA 2019000304
Solicitation Signature Page and W9
Solicitation Name: Skilled Worker Outreach, Recruitment, and Key Training (WORK
Act) Grant Program Cycle 5
(Please print or type information)
Is your company registered with the Colorado Secretary of State?*
*If you answered "yes" please include a copy of your Certificate of Good Standing.
Applicant's Tax ID Number (FEIN)** 84-6000813
Applicant's DUNS Number 075757955
Company Name County of Weld, Colorado
Contact Name Cecilia L. Moreno
Company Address 315 N 11 Ave Bldg. B Greeley, CO 80632
Contact's Telephone
Contact's Fax
970-400-6756
970-346-7981
Contact's E-mail cgarcia moreno@weldgov.com
JUN I92019
gnature of personal legal authorized tbind the Applicant — MUST BE SIGNED IN INK
Barbara Kirkmeyer
Typed or printed name of person legally authorized to bind the Applicant
Chair, Board of Weld County Commissioners
Title of person legally authorized to bind the Applicant
Payment Terms
(Terms of less than 30 days will not be considered)
The signature above constitutes assurance that the information provided in this Application
accurately represents the applicant's plans, activities and projected goals.
PARENT COMPANY. An applicant, owned or controlled by a parent company, must provide
thename, main office address and parent company's tax identification number on a copy of this
form. The tax identification number provided must be that of the applicant's parent company
who will be legally responsible for performing services under the contract resulting from this
solicitation.
THIS FORM MUST ACCOMPANY ALL APPLICATIONS (Page with original signature
must be included with the Application). A PERSON LEGALLY AUTHORIZED TO BIND
THE APPLICANT MUST SIGN THIS FORM IN INK.
Page 1 of 2
O2b/c oz3h
ATTACHMENT E
Colorado Department of Labor and Employment (CDLE)
Fiscal Agent Certification Form
Request for Application (RFA) KADA 2019000304
Skilled Worker Outreach, Recruitment, and Key Training (WORK Act) Grant
Program Cycle 5
(Please print or type information)
TO BE FILLED OUT BY FILLED OUT BY FISCAL AGENT
REQUIRED ONLY IF DIFFERENT FROM GRANT APPLICANT
Entity's Tax ID Number (FEIN)* 84-6000813
Entity's DUNS Number
075757955
Entity Name County of Weld, Colorado
Contact Name Cecilia L. Moreno
Entity Address 315 N 11 Ave Bldg. B Greeley, CO 80632
Contact's Telephone 970-400-6756
Contact's Fax 970-346-7981
Contact's E-mail cgarcia-moreno(a�weldgov.com
Signature of personal legally authorized to act on behalf of the Entity — MUST BE SIGNED IN
INK
Typed or printed name of person legally authorized to act on behalf of the Entity
Title of person legally authorized to act on behalf of the Entity
*PARENT COMPANY. A vendor, owned or controlled by a parent company, must provide the
name, main office address and parent company's tax identification number on a copy of this form.
The tax identification number provided must be that of the vendor's parent company who will be
legally responsible for performing services under any Contract resulting from this solicitation.
THIS FORM MUST ACCOMPANY ALL QUOTES (Page with original signature must be
included in the copy marked "ORIGINAL"). A PERSON LEGALLY AUTHORIZED TO
BIND THE COMPANY MUST SIGN THE PROPOSAL IN INK.
Page 1 of 3
aSo/ 9- aa�3
ATTACHMENT E
Colorado Department of Labor and Employment (CDLE)
Fiscal Agent Certification Form
Reg s ≥ est for Application
(NIA)
KA
. A
2019000304
Form
Substitute
State of
2007
=9
Form
Colorado 9-
dent
is
Request
ton
um
for
Cert c f�
Give
requester.
send
form
to the
to
Do
IRS.
the
not
r
Taxpayer
an
a)
ca.
>,
F— :t---5
o
4
o •
co
up
m
a)
0)
cu
0-
Name
Business name, if different from above
Check
appropriate box:
Individual/ Sole Proprietor f Corporation �;
P P a
Exempt from backup withholding
Partnership
Other
®.....................
C
O
C
o
L
c
S
Q)
v
'
L---',
I
Address (number, street, and apt. or suite no.
Requester:
Colorado
633
Denver,
17th
Street
CO
Dept.
of
80202-3631
Labor
and
Employment
City, state, and ZIP code.
List Account number(s) here (optional)
Phone Number:
. F[�.,,:
Taxpayer
Identification Number
(TIN)
Enter your TIN in the appropriate box. For individuals, this is your social security
number (SSN) However, for a resident alien, sole proprietor, or disregarded
entity, see the Part i instructions on page 3. For other entities, it is your
employer identification number (EIN). If you do not have a number, see How to
get a TIN on page 3.
Note: If the account is in more than one name, see the chart on page 3 for
guidelines on whose number to enter.
Social
Security number
Employer
identification number
Pa,,�F.
Certification
1.
to
currently
return.
secured
payments
correct
Under
The
be
2. I
been
failure
3. I
Certification
penalties
issued
am
withholding,
am
For
TIN.
number
not
notified
to
a U_S_
subject
real
property,
other
to me),
subject
report
person
instructions.
estate
than
,See
of
shown
and
to
cancellation
the
by
backup
perjury,
all
interest
instructions
and
to
the
transactions,
on
backup
interest
(including
this
Internal
You
withholding
I certify
form
or
of
and
withholding
must
debt,
dividends,
on
Revenue
dividends,
a
item
that:
is
U.S.
cross
contributions
page
my
because
2
correct
resident
does
3.;
because.
Service
or (c)
out item
you
not
you are
taxpayer
alien).
apply.
to
(IRS)
the
2
have
not
(a) I
IRS
above
failed
For
an individual
required
identification
am
that
has
if
you
mortgage
exempt
I am
notified
have
to report
retirement
to sign
subject
number
from backup
to
me that
been notified
all interest
interest
arrangement
the Certification,
backup
paid,
I
(or
am
and
I
withholding,
withholding
no
by
dividends
acquisition
am
the
but
longer
(IRA),
waiting
IRS
you
for
or
as
subject
that
on your
or abandonment
and
must
(b)
you
a number
I
a result
to
are
tax
generally,
provide
have
backup
not
of a
of
your
Sign
Here
Signature
U.S.
person
of
Pr Date Pc -
Page 2of3
ATTACHMENT E
Colorado Department of Labor and Employment (CDLE)
Fiscal Agent Certification Form
Request for Application (RFA) KADA 2019000304
Minority and Women -owned Businesses (M/WBEs) Self Certification (Please check all boxes that apply)
In an effort to track levels of participation by women and minorities doing business with the State of Colorado, the
following information is requested. Please indicate the appropriate category of ownership for your company. "Owned"
in this context means a business that is at least 51 percent owned by an individual(s) who also control(s) and
operate(s) it. `Control" in this context means exercising the power to make policy decisions. "Operate" means actively
involved in the day-to-day management. If your business Is jointly owned by both men and women or is a large
publicly held corporation, please check the box labeled "Not Applicable."
Gender Information.
❑ Female -Owned
❑ Male -Owned X Not Applicable
Owner Ethnicity Information:
❑ African American ❑ Asian/Pacific American ❑ White (non -Hispanic) X Not Applicable
❑ Hispanic American
Small Business Information:
Native American El Other:
Small Business (a business that is organized for profit, is independently owned and operated, and has 25 or fewer full
time equivalent employees.)
❑ Yes X No
THIS FORM MUST ACCOMPANY ALL PROPOSALS (IN ORIGINAL PROPOSAL
ONLY). AN AUTHORIZED OFFICER OR AGENT OF THE VENDOR MUST SIGN
THE PROPOSAL IN INK.
RETURN THESE THREE (3) PAGES WITH YOUR RESPONSE
Page 3 of 3
Contact Type
County Director
Contact Purpose
County Director contact will be used for general
Director's communications, including funding, policy
feedback, County Incentives and Grants, and memos
Contact Availability
Department staff
First Name Last Name
Judy
Secondary Directors
Secondary Director contacts will be included on all
County Director communications
Department staff
Jamie
Griego
rirr��
Ulrich
Position Title
N/A
Email Address
Deputy Director
g_riegojaeweidgov.com
ulrichjj@weldgov.com
Phone
970-400-6510
970-400-6581
Memo Series Contacts
Who else would you like to receive HCPF Memo Series
communications?
Department staff
Escalation contact for Connect Who should be contacted for case updates during Open Department staff, Connect for Health
for Health Enrollment? Colorado, Brokers, Partner Agencies
contract management
Team
hs-contractmanagerrient@co.weld.co.us
Member Escalation Contact for Who should HCPF contact when a member's case needs
HCPF use to be updated?
Department staff
Who should OIT & other counties contact to complete or Department staff, OIT & other
InterCounty Transfer Contact
for questions on an inter -county transfer? counties
MA Site Liaison
Who should an MA site contact to provide additional
information about a case?
Department staff and Medical
Assistance Sites
Long Term Services and Who should communications or member escalations for Department staff, Single Entry Points,
Supports - Financial Eligibility Long Term Care cases go to? Community Centered Boards
Child Welfare Supervisor & Who should communications or escalations for Child
Leads Workers Welfare cases go to?
Financial Audits
Eligibility Audits
Local Public Health Liaison
Who should HCPF contact regarding county financial
audits?
Department staff
Department staff and external
auditors
Who should HCPF contact for county eligibility audits?
Who should Public Health contact at the county?
Department staff and external
auditors
Department staff and Local Public
Health Agencies
Address Confidentiality
Program
Who should the Department contact to make sure there
are only two ACP users per county (unless waiver
submitted)?
Department Staff
County Address
Physical Address
Mailing Address
Weld County
Area Agency on
Aging
2019-2020 Budget
Service
Description
Total
2018-19
(Includes
Carryover)
Budget
Prior
Budget 2019-20
Estimated
Carry -Over
State
Homestead
Act
Funds
Increase/
(Decrease)
Title III
Funding
Other
Funding
Description
of "Other
Funding Source
Total
FY 2019-20
Budget
Federal
State
Federal
Other
General Administration
$291,668
$227,969
$100,000
$0
$327,969
$36,301
$193,089
$122,529
$0
$12,351
County Match
Total
General Administration
$291,668
$227,969
$100,000
$0
$327,969
$36,301
$193,089
$122,529
$0
$12,351
CCN (Hispanic Senior Outreach
)
$20,000
$20,000
$0
$4,000
$24,000
$4,000
$20,000
$4,000
$0
$0
CCN (Case Management)
$130,000
$130,000
$0
$6,000
$136,000
$6,000
$0
$136,000
$0
$0
NRBH
(Peer
Counseling)
$105,000
$95,000
$0
$5,000
$100,000
($5,000)
$21,000
$79,000
$0
$0
$90,000
$90,000
$0
$20,000
$110,000
$20,000
$10,000
$100,000
$0
$0
SRS
(Transportation)
CLS
(Legal)
$63,000
$63,000
$0
$7,000
$70,000
$7,000
$63,000
$7,000
$0
$0
Part
B Ombudsman
$215,082
$223,509
$25,000
$0
$248,509
$33,427
$140,845
$107,664
$0
$0
$623,082
$621,509
$25,000
$42,000
$688,509
$65,427
$254,845
$433,664
$0
$0
Total Part B
Nutrition
Program
$215,937
$178,737
$47,000
a
$0
$225,737
$9,800
$225,737
$0
$0
$0
$115,000
$115,000
$0
$0
$115,000
$0
$115,000
$0
$0
$0
Transportation
UNC
(Congregate Meals)
$362,407
$356,041
$0
$68,959
$425,000
$62,593
$132,993
$81,407
$47,100
$163,500
NSIP
/
Donations
Total
Part
C-1
$693,344
$649,778
$47,000
$68,959
$765,737
$72,393
$473,730
$81,407
$47,100
$163,500
Meals
on
Wheels (Home
Delivered
Meals)
$215,394
$173,245
$16,755
$0
a
$190,000
($25,394)
$167,553
a
$22,447
$0
$0
Shelf
Stable
Meals
$2,500
$2,500
$0
$0
$2,500
$0
$0
$2,500
$0
$0
Total
Part
C-2
$217,894
$175,745
$16,755
$0
$192,500
($25,394)
$167,553
$24,947
$0
$0
Health
Promotions
(State)
$94,471
$89,525
$0
$0
$89,525
($4,946)
$0
$89,525
$0
$0
Part
D (Federal)
$21,912
$18,580
$1,853
$0
$20,433
($1,480)
$20,433
$0
$0
$0
$116,383
$108,105
$1,853
$0
$109,958
($6,426)
$20,433
$89,525
$0
$0
Total
Part
D (Health
Promotions)
Caregiver
(including Grandparenting)
$51,421
$35,885
$3,309
$0
$39,194
($12,227)
a
$39,194
$0
$0
$0
Respite
(Voucher)
$94,475
$92,395
$7,238
$0
$99,634
$5,159
$77,634
$22,000
$0
$0
Total
Part
E
$145,896
$128,280
$10,547
$0
$138,827
($7,069)
$116,827
$22,000
$0
$0
$8,549
$7,064
$0
$0
$7,064
($1,485)
$7,064
$0
Title
VII
$0
$0
Special
Ombudsman
Elder Abuse
$2,094
$2,076
$0
$0
$2,076
($18)
$2,076
$0
$0
$0
Title
VII
$10,643
$9,140
$0
$0
$9,140
($1,503)
$9,140
$0
$0
$0
Total Title VII
DentalNision/Hearing
Program (Vouchers)
$82,000
$80,000
$0
$0
$80,000
($2,000)
$0
$80,000
$0
$0
DentalNision/Hearing
Program
$52,000
$50,025
$0
$0
$50,025
($1,975)
$0
$50,025
$0
$0
Information & Assistance
$148,697
$135,977
$0
$0
$135,977
($12,720)
$0
$135,977
$0
$0
Chore Program (Vouchers)
$46,500
$28,797
$0
$16,203
$45,000
($1,500)
$0
$45,000
$0
$0
Chore Program
$21,000
$27,386
$0
$0
$27,386
_ $6,386
$0
$27,386
$0
$0
State
Education (Strong
People)
$24,991
$11,037
$0
$0
$11,037
($13,954)
$0
$11,037
$0
$0
State Part
E Match
$7,208
$7,252
$0
$0
$7,252
$44
$0
$7,252
$0
$0
In -Home Services (Vouchers)
$151,175
$125,175
$12,518
$26,000
$163,693
$12,518
$38,575
$122,500
$0
$0
In -Home Services Program
$44,909
$60,883
$0
$0
$60,883
$15,974
$0
$63,500
$0
$0
Page 1 of 2
Weld
County Area Agency Aging
on
2019-2
20
u dget
`
Service
Description
(Includes
Total
2018-19
Carryover)
Budget
Prior
Budget
2019-20
Estimated
Carry -Over
Homestead
State
Act
Funds
Total
FY
2019-20
Budget
(Decrease)
Increase /
Title
III
Funding
Other
Funding
Description
Funding
of "Other
Source
Federal
State
Federal
Other
Visually
Impairment
$25,372
$25,527
$0
$0
$25,527
$155
$0
$25,527
$0
$0
$552,059
$12,518
$42,203
$606,779
$2,927
$38,575
$568,204
$0
$0
Total
Internal
-Only Programs
$603,852
$2,472,584
$213,673
$153,162
$2,839,419
$136,656
$1,274,192
$1,342,276
$47,100
$175,851
Sub
-Total
AAA
$2,702,762
Other
Funds:
Single
Entry
Point
(SEP)
$2,173,469
$2,173,469
$0
$0
$2,173,469
$0
$0
$0
$1,086,735
$1,086,735
HCPF-Medicaid
HCA
$48,980
$46,799
$77,376
$0
$124,175
$0
$124,175
$0
$0
$0
$0
($17,250)
$0
$0
$0
$0
TEFT
$17,250
$0
$0
$0
$0
($85,874)
$0
$0
$0
$0
LTC
Grant
$85,874
CCT
$23,843
$0
$4,317
$0
$4,317
($19,526)
$0
$0
$0
$4,317
CCT
$0
$19,508
$0
$19,508
$8,069
$0
$0
$0
$19,508
CCT - Options
CCT-Options
$11,439
CHF
$65,000
$0
$55,244
$0
$55,244
($9,756)
$0
$0
$0
$55,244
CHF
Adult
Protection
$685,258
$716,345
$0
$0
$716,345
$0
$0
$0
$0
$716,345
VALE
$10,000
$5,000
$0
$0
$5,000
($5,000)
$0
$0
$0
$5,000
VALE Grant
Grand
otal Funds
$5,823,875
$5,414,197
$370,118
$153,162
$5,937,477
$7,320
$1,274,192
$1,342,276
$1,133,835
$2,187,175
Page 2 of 2
Hello