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Home My WebLink About20192824.tiffDocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF CTGG1 NLAA 20193625 This Grant Award Letter modifies and replaces the Grant Award Letter executed on 07/01/2019 with a Performance Start Date of 07/01/2019. SUMMARY OF GRANT AWARD TERMS AND CONDITIONS State Agency Department of Local Affairs Encumbrance Number F 19S8929 CMS Number 140191 Grantee WELD COUNTY Grant Award Amount $200,000.00 Retainage Amount $10,000.00 Project Number and Name EIAF 8929 — Weld County Road 28 & 41 Improvements Performance Start Date 07/01/2019 Grant Expiration Date 11/30/2020 Project Description The Project consists of the reconstruction of one mile of Weld County Road (WCR) 28 west of WCR 41 and one mile of WCR 41 south of WCR 28. Program Name Energy & Mineral Impact Assistance Program (EIAF) Funding Source STATE FUNDS Catalog of Federal Domestic Assistance (CFDA) Number N/A DOLA Regional Manager Don Sandoval, (970) 679-4501, Funding Account Codes N/A (don.sandoval(&,state.co.us) DOLA Regional Assistant Robert Thompson, (970) 679-4503, VCUST# 14294 Address Code CN007 EFT (robert.thompson(&state.co.us) THE SIGNATORIES LISTED BELOW AUTHORIZE THIS GRANT DEPARTMENT OF LOCAL AFFAIRS PROGRAM REVIEWER —DocuSigned by: 'ran, 11(144 Date: `-9FA2A33AF12E49C. By: Tara Tubb, EIAF Program Manager 7/9/2019 I 1:20 PM MDT STATE OF COLORADO Jared S. Polis, Governor DEPARTMENT OF LOCAL AFFAIRS Rick M. Garcia, Executive Director —DocuSigned by: �F4C4CFA6FDAD405_. By: Rick M. Garcia, Executive Director Date: 7/9/2019 I 4:16 PM MDT In accordance with §24-30-202 C.R.S., this Grant is not va id until signed and dated below by the State Controller or an authorized delegate (the "Effective Date"). STATE CONTROLLER Robert Jaros, CPA, MBA, JD c—DocuSigned by: li p t- atzt `-9C3D102D5992427 By: Yingtse Cha, Controller Delegate Department of Local Affairs 7/10/2019 I 9:19 AM MDT Effective Date: CJYvthtiui)i ionq cc:Pw(Se,),GCTCBC( CO,) O1/ 9b / I9 ©trt.Co IIq aa/Q-8ag 6660'76 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements TERMS AND CONDITIONS 1. GRANT As of the Performance Start Date, the State Agency shown on the Summary of Grant Award Terms and Conditions page of this Grant Award Letter (the "State") hereby obligates and awards to Grantee shown on the Summary of Grant Award Terms and Conditions page of this Grant Award Letter (the "Grantee") an award of Grant Funds in the amount shown on the Summary of Grant Award Terms and Conditions page of this Grant Award Letter. By accepting the Grant Funds provided under this Grant Award Letter, Grantee agrees to comply with the terms and conditions of this Grant Award Letter and requirements and provisions of all Exhibits to this Grant Award Letter. 2. TERM A. Initial Grant Term and Extension The Parties' respective performances under this Grant Award Letter shall commence on the Performance Start Date and shall terminate on the Grant Expiration Date unless sooner terminated or further extended in accordance with the terms of this Grant Award Letter. Upon request of Grantee, the State may, in its sole discretion, extend the term of this Grant Award Letter by providing Grantee with an updated Grant Award Letter or an executed Option Letter showing the new Grant Expiration Date. B. Early Termination in the Public Interest The State is entering into this Grant Award Letter to serve the public interest of the State of Colorado as determined by its Governor, General Assembly, or Courts. If this Grant Award Letter ceases to further the public interest of the State or if State, Federal or other funds used for this Grant Award Letter are not appropriated, or otherwise become unavailable to fund this Grant Award Letter, the State, in its discretion, may terminate this Grant Award Letter in whole or in part by providing written notice to Grantee. If the State terminates this Grant Award Letter in the public interest, the State shall pay Grantee an amount equal to the percentage of the total reimbursement payable under this Grant Award Letter that corresponds to the percentage of Work satisfactorily completed, as determined by the State, less payments previously made. Additionally, the State, in its discretion, may reimburse Grantee for a portion of actual, out-of-pocket expenses not otherwise reimbursed under this Grant Award Letter that are incurred by Grantee and are directly attributable to the uncompleted portion of Grantee's obligations, provided that the sum of any and all reimbursements shall not exceed the maximum amount payable to Grantee hereunder. This subsection shall not apply to a termination of this Grant Award Letter by the State for breach by Grantee. C. Reserved. 3. AUTHORITY Authority to enter into this Grant Award Letter exists in the law as follows: A. Reserved. B. State Authority Authority to enter into this Grant exists in C.R.S. 24-32-106 and 29-3.5-101 and funds have been budgeted, appropriated and otherwise made available pursuant to C.R.S. 39-29-110 (Local Government Severance Tax Fund) and a sufficient unencumbered balance thereof Page 2 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements remains available for payment. Required approvals, clearance and coordination have been accomplished from and with appropriate agencies. This Grant Award Letter is funded, in whole or in part, with State funds. 4. DEFINITIONS The following terms shall be construed and interpreted as follows: A. Reserved. B. Reserved. C. "CORA" means the Colorado Open Records Act, §§24-72-200.1 et. seq., C.R.S. D. "Exhibits" means the following exhibits attached to this Grant Award Letter: i. Exhibit B, Scope of Project ii. Exhibit G, Form of Option Letter E. "Extension Term" means the period of time by which the Grant Expiration Date is extended by the State through delivery of an updated Grant Award Letter, an amendment, or an Option Letter. F. Reserved. G. Reserved. H. "Goods" means any movable material acquired, produced, or delivered by Grantee as set forth in this Grant Award Letter and shall include any movable material acquired, produced, or delivered by Grantee in connection with the Services. I. "Grant Award Letter" or "Grant" means this letter which offers Grant Funds to Grantee, including all attached Exhibits, all documents incorporated by reference, all referenced statutes, rules and cited authorities, and any future updates thereto. J. "Grant Expiration Date" means the Grant Expiration Date shown on the Summary of Grant Award Terms and Conditions page of this Grant Award Letter. Work performed after the Grant Expiration Date is not eligible for reimbursement from Grant Funds. K. "Grant Funds" or "Grant Award Amount" means the funds that have been appropriated, designated, encumbered, or otherwise made available for payment by the State under this Grant Award Letter. L. "Incident" means any accidental or deliberate event that results in, or constitutes an imminent threat of, the unauthorized access or disclosure of State Confidential Information or of the unauthorized modification, disruption, or destruction of any State Records. M. "Initial Term" means the time period between the Performance Start Date and the initial Grant Expiration Date. N. Reserved. O. "Other Funds" means all funds necessary to complete the Project, excluding Grant Funds. Grantee is solely responsible for securing all Other Funds. P. "Party" means the State or Grantee, and "Parties" means both the State and Grantee. Page 3 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements Q. "Performance Start Date" means the later of the Performance Start Date or the Execution Date shown on the Summary of Grant Award Terms and Conditions page of this Grant Award Letter. R. Reserved. S. Reserved. T. Reserved. U. "Project" means the overall project described in Exhibit B, which includes the Work. V. "Project Budget" means the amounts detailed in §6.2 of Exhibit B. W. Reserved. X. Reserved. Y. "Services" means the services performed by Grantee as set forth in this Grant Award Letter, and shall include any services rendered by Grantee in connection with the Goods. Z. "State Confidential Information" means any and all State Records not subject to disclosure under CORA. State Confidential Information shall include, but is not limited to State personnel records not subject to disclosure under CORA. AA. "State Fiscal Rules" means the fiscal rules promulgated by the Colorado State Controller pursuant to §24-30-202(13)(a) C.R.S. BB. "State Fiscal Year" means a 12 month period beginning on July 1 of each calendar year and ending on June 30 of the following calendar year. If a single calendar year follows the term, then it means the State Fiscal Year ending in that calendar year. CC. "State Records" means any and all State data, information, and records, regardless of physical form, including, but not limited to, information subject to disclosure under CORA. DD. Reserved. EE. "Subcontractor" means third -parties, if any, engaged by Grantee to aid in performance of the Work. "Subcontractor" also includes sub -grantees. FF. Reserved. GG. Reserved. MI. Reserved. II. "Work" means the delivery of the Goods and performance of the Services described in this Grant Award Letter. JJ. "Work Product" means the tangible and intangible results of the Work, whether finished or unfinished, including drafts. Work Product includes, but is not limited to, documents, text, software (including source code), research, reports, proposals, specifications, plans, notes, studies, data, images, photographs, negatives, pictures, drawings, designs, models, surveys, maps, materials, ideas, concepts, know-how, and any other results of the Work. "Work Product" does not include any material that was developed prior to the Performance Start Date that is used, without modification, in the performance of the Work. Any other term used in this Grant Award Letter that is defined in an Exhibit shall be construed and interpreted as defined in that Exhibit. Page 4 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements 5. PURPOSE The purpose of the Energy and Mineral Impact Assistance Program is to assist political subdivisions that are socially and/or economically impacted by the development, processing, or energy conversion of minerals and mineral fuels. The purpose of this Grant is described in Exhibit B. 6. SCOPE OF PROJECT Grantee shall complete the Work as described in this Grant Award Letter and in accordance with the provisions of Exhibit B. The State shall have no liability to compensate or reimburse Grantee for the delivery of any goods or the performance of any services that are not specifically set forth in this Grant Award Letter. 7. PAYMENTS TO GRANTEE A. Maximum Amount Payments to Grantee are limited to the unpaid, obligated balance of the Grant Funds. The State shall not pay Grantee any amount under this Grant that exceeds the Grant Award Amount shown on the Summary of Grant Award Terms and Conditions page of this Grant Award Letter. i. The State may increase or decrease the Grant Award Amount by providing Grantee with an updated Grant Award Letter or an executed Option Letter showing the new Grant Award Amount. ii. The State shall not be liable to pay or reimburse Grantee for any Work performed or expense incurred before the Performance Start Date or after the Grant Expiration Date. iii. Financial obligations of the State payable after the current State Fiscal Year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available. B. Erroneous Payments The State may recover, at the State's discretion, payments made to Grantee in error for any reason, including, but not limited to, overpayments or improper payments, and unexpended or excess funds received by Grantee. The State may recover such payments by deduction from subsequent payments under this Grant Award Letter, deduction from any payment due under any other contracts, grants or agreements between the State and Grantee, or by any other appropriate method for collecting debts owed to the State. C. Matching Funds. Grantee shall provide the Other Funds amount shown on the Project Budget in Exhibit B (the "Local Match Amount"). Grantee shall appropriate and allocate all Local Match Amounts to the purpose of this Grant Award Letter each fiscal year prior to accepting any Grant Funds for that fiscal year. Grantee does not by accepting this Grant Award Letter irrevocably pledge present cash reserves for payments in future fiscal years, and this Grant Award Letter is not intended to create a multiple -fiscal year debt of Grantee. Grantee shall not pay or be liable for any claimed interest, late charges, fees, taxes or penalties of any nature, except as required by Grantee's laws or policies. Page 5 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements D. Reimbursement of Grantee Costs The State shall reimburse Grantee's allowable costs, not exceeding the maximum total amount described in this Grant Award Letter for all allowable costs described in this Grant Award Letter and shown in the Project Budget in Exhibit B. i. Upon request of the Grantee, the State may, without changing the maximum total amount of Grant Funds, adjust or otherwise reallocate Grant Funds among or between each line of the Project Budget by providing Grantee with an executed Option Letter or formal amendment. E. Close -Out and De -obligation of Grant Funds Grantee shall close out this Grant no later than 90 days after the Grant Expiration Date. To complete close out, Grantee shall submit to the State all deliverables (including documentation) as defined in this Grant Award Letter and Grantee's final reimbursement request or invoice. Any Grant Funds remaining after submission and payment of Grantee's final reimbursement request are subject to de -obligation by the State. 8. REPORTING - NOTIFICATION A. Performance and Final Status Grantee shall submit all financial, performance and other reports to the State no later than the end of the close out period described in §7.E. B. Violations Reporting Grantee shall disclose, in a timely manner, in writing to the State, all violations of federal or State criminal law involving fraud, bribery, or gratuity violations potentially affecting this Award. 9. GRANTEE RECORDS A. Maintenance and Inspection Grantee shall make, keep, and maintain, all records, documents, communications, notes and other written materials, electronic media files, and communications, pertaining in any manner to this Grant for a period of three years following the completion of the close out of this Grant. Grantee shall permit the State to audit, inspect, examine, excerpt, copy and transcribe all such records during normal business hours at Grantee's office or place of business, unless the State determines that an audit or inspection is required without notice at a different time to protect the interests of the State. B. Monitoring The State will monitor Grantee's performance of its obligations under this Grant Award Letter using procedures as determined by the State. The State shall monitor Grantee's performance in a manner that does not unduly interfere with Grantee's performance of the Work. C. Audits Grantee shall comply with all State and federal audit requirements. Page 6 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements 10. CONFIDENTIAL INFORMATION -STATE RECORDS A. Confidentiality Grantee shall hold and maintain, and cause all Subcontractors to hold and maintain, any and all State Records that the State provides or makes available to Grantee for the sole and exclusive benefit of the State, unless those State Records are otherwise publically available at the time of disclosure or are subject to disclosure by Grantee under CORA. Grantee shall not, without prior written approval of the State, use for Grantee's own benefit, publish, copy, or otherwise disclose to any third party, or permit the use by any third party for its benefit or to the detriment of the State, any State Records, except as otherwise stated in this Grant Award Letter. Grantee shall provide for the security of all State Confidential Information in accordance with all policies promulgated by the Colorado Office of Information Security (http://oit.state.co.us/ois) and all applicable laws, rules, policies, publications, and guidelines. Grantee shall immediately forward any request or demand for State Records to the State's principal representative. B. Other Entity Access and Nondisclosure Agreements Grantee may provide State Records to its agents, employees, assigns and Subcontractors as necessary to perform the Work, but shall restrict access to State Confidential Information to those agents, employees, assigns and Subcontractors who require access to perform their obligations under this Grant Award Letter. Grantee shall ensure all such agents, employees, assigns, and Subcontractors sign nondisclosure agreements with provisions at least as protective as those in this Grant, and that the nondisclosure agreements are in force at all times the agent, employee, assign or Subcontractor has access to any State Confidential Information. Grantee shall provide copies of those signed nondisclosure restrictions to the State upon request. C. Use, Security, and Retention Grantee shall use, hold and maintain State Confidential Information in compliance with any and all applicable laws and regulations in facilities located within the United States, and shall maintain a secure environment that ensures confidentiality of all State Confidential Information wherever located. Grantee shall provide the State with access, subject to Grantee's reasonable security requirements, for purposes of inspecting and monitoring access and use of State Confidential Information and evaluating security control effectiveness. Upon the expiration or termination of this Grant, Grantee shall return State Records provided to Grantee or destroy such State Records and certify to the State that it has done so, as directed by the State. If Grantee is prevented by law or regulation from returning or destroying State Confidential Information, Grantee warrants it will guarantee the confidentiality of, and cease to use, such State Confidential Information. D. Incident Notice and Remediation If Grantee becomes aware of any Incident, it shall notify the State immediately and cooperate with the State regarding recovery, remediation, and the necessity to involve law enforcement, as determined by the State. After an Incident, Grantee shall take steps to reduce the risk of incurring a similar type of Incident in the future as directed by the State, which may include, but is not limited to, developing and implementing a remediation plan that is approved by the State at no additional cost to the State. Page 7 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements 11. CONFLICTS OF INTEREST Grantee shall not engage in any business or activities, or maintain any relationships that conflict in any way with the full performance of the obligations of Grantee under this Grant. Grantee acknowledges that, with respect to this Grant, even the appearance of a conflict of interest shall be harmful to the State's interests and absent the State's prior written approval, Grantee shall refrain from any practices, activities or relationships that reasonably appear to be in conflict with the full performance of Grantee's obligations under this Grant. If a conflict or the appearance of a conflict arises, or if Grantee is uncertain whether a conflict or the appearance of a conflict has arisen, Grantee shall submit to the State a disclosure statement setting forth the relevant details for the State's consideration. 12. INSURANCE Grantee shall maintain at all times during the term of this Grant such liability insurance, by commercial policy or self-insurance, as is necessary to meet its liabilities under the Colorado Governmental Immunity Act, §24-10-101, et seq., C.R.S. (the "GIA"). Grantee shall ensure that any Subcontractors maintain all insurance customary for the completion of the Work done by that Subcontractor and as required by the State or the GIA. 13. REMEDIES In addition to any remedies available under any Exhibit to this Grant Award Letter, if Grantee fails to comply with any term or condition of this Grant, the State may terminate some or all of this Grant and require Grantee to repay any or all Grant Funds to the State in the State's sole discretion. The State may also terminate this Grant Award Letter at any time if the State has determined, in its sole discretion, that Grantee has ceased performing the Work without intent to resume performance, prior to the completion of the Work. 14. DISPUTE RESOLUTION Except as herein specifically provided otherwise, disputes concerning the performance of this Grant that cannot be resolved by the designated Party representatives shall be referred in writing to a senior departmental management staff member designated by the State and a senior manager or official designated by Grantee for resolution. 15. NOTICES AND REPRESENTATIVES Each Party shall identify an individual to be the principal representative of the designating Party and shall provide this information to the other Party. All notices required or permitted to be given under this Grant Award Letter shall be in writing, and shall be delivered either in hard copy or by email to the representative of the other Party. Either Party may change its principal representative or principal representative contact information by notice submitted in accordance with this §15. 16. RIGHTS IN WORK PRODUCT AND OTHER INFORMATION Grantee hereby grants to the State a perpetual, irrevocable, non-exclusive, royalty free license, with the right to sublicense, to make, use, reproduce, distribute, perform, display, create derivatives of and otherwise exploit all intellectual property created by Grantee or any Subcontractors or Subgrantees and paid for with Grant Funds provided by the State pursuant to this Grant. 17. GOVERNMENTAL IMMUNITY Liability for claims for injuries to persons or property arising from the negligence of the Parties, their departments, boards, commissions, committees, bureaus, offices, employees and officials shall be controlled and limited by the provisions of the GIA; the Federal Tort Claims Act, 28 U.S.C. Page 8 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements Pt. VI, Ch. 171 and 28 U.S.C. 1346(b), and the State's risk management statutes, §§24-30-1501, et seq. C.R.S. No term or condition of this Grant Award Letter shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, or protections of any of these provisions. 18. GENERAL PROVISIONS A. Assignment Grantee's rights and obligations under this Grant are personal and may not be transferred or assigned without the prior, written consent of the State. Any attempt at assignment or transfer without such consent shall be void. Any assignment or transfer of Grantee's rights and obligations approved by the State shall be subject to the provisions of this Grant Award Letter. B. Captions and References The captions and headings in this Grant Award Letter are for convenience of reference only, and shall not be used to interpret, define, or limit its provisions. All references in this Grant Award Letter to sections (whether spelled out or using the § symbol), subsections, exhibits or other attachments, are references to sections, subsections, exhibits or other attachments contained herein or incorporated as a part hereof, unless otherwise noted. C. Entire Understanding This Grant Award Letter represents the complete integration of all understandings between the Parties related to the Work, and all prior representations and understandings related to the Work, oral or written, are merged into this Grant Award Letter. D. Modification The State may modify the terms and conditions of this Grant by issuance of an updated Grant Award Letter, which shall be effective if Grantee accepts Grant Funds following receipt of the updated letter. The Parties may also agree to modification of the terms and conditions of the Grant in either an option letter or a formal amendment to this Grant, properly executed and approved in accordance with applicable Colorado State law and State Fiscal Rules. E. Statutes, Regulations, Fiscal Rules, and Other Authority Any reference in this Grant Award Letter to a statute, regulation, State Fiscal Rule, fiscal policy or other authority shall be interpreted to refer to such authority then current, as may have been changed or amended since the Performance Start Date. Grantee shall strictly comply with all applicable Federal and State laws, rules, and regulations in effect or hereafter established, including, without limitation, laws applicable to discrimination and unfair employment practices. F. Order of Precedence In the event of a conflict or inconsistency between this Grant Award Letter and any Exhibits or attachment, such conflict or inconsistency shall be resolved by reference to the documents in the following order of priority: i. Any executed Option Letter ii. The provisions of this Grant Award Letter. iii. The provisions of any exhibits to this Grant Award Letter. Page 9 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements G. Severability The invalidity or unenforceability of any provision of this Grant Award Letter shall not affect the validity or enforceability of any other provision of this Grant Award Letter, which shall remain in full force and effect, provided that the Parties can continue to perform their obligations under the Grant in accordance with the intent of the Grant. H. Survival of Certain Grant Award Letter Terms Any provision of this Grant Award Letter that imposes an obligation on a Party after termination or expiration of the Grant shall survive the termination or expiration of the Grant and shall be enforceable by the other Party. I. Third Party Beneficiaries Except for the Parties' respective successors and assigns described above, this Grant Award Letter does not and is not intended to confer any rights or remedies upon any person or entity other than the Parties. Any services or benefits which third parties receive as a result of this Grant are incidental to the Grant, and do not create any rights for such third parties. J. Waiver A Party's failure or delay in exercising any right, power, or privilege under this Grant Award Letter, whether explicit or by lack of enforcement, shall not operate as a waiver, nor shall any single or partial exercise of any right, power, or privilege preclude any other or further exercise of such right, power, or privilege. K. Reserved. L. Digital Signatures If any signatory signs this Grant using a digital signature in accordance with the Colorado State Controller Contract, Grant, and Purchase Order Policies regarding the use of digital signatures issued under the State Fiscal Rules, then any agreement or consent to use digital signatures within the electronic system through which that signatory signed shall be incorporated into this Grant by reference. THE REST OF THIS PAGE INTENTIONALLY LEFT BLANK Page 10 of 10 Version 0717 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements EXHIBIT B - SCOPE OF PROJECT (SOP) 1. PURPOSE 1.1. Energy Impact. The purpose of the Energy and Mineral Impact Assistance Program is to assist political subdivisions that are socially and/or economically impacted by the development, processing, or energy conversion of minerals and mineral fuels. 2. DESCRIPTION OF THE PROJECT(S) AND WORK 2.1. Project Description. The Project consists of the reconstruction of one mile of Weld County Road (WCR) 28 west of WCR 41 and one mile of WCR 41 south of WCR 28. 2.2. Work Description. Weld County (Grantee) will purchase materials for a full depth reconstruction of one (1) mile of Weld County Road (WCR) 28 west of WCR 41 and one (1) mile of WCR 41 south of WCR 28, including asphalt paving. The County crews will complete construction and paving of the road with the materials acquired for the Project. Grantee will own the road. 2.2.1. A contract for the purchase or acquisition of materials, equipment, or vehicles shall be awarded by Grantee to a qualified vendor or firm through a competitive selection process with the Grantee being obligated to award the contract to the lowest responsive, responsible bidder meeting the Grantee's specifications. 2.3. Responsibilities. Grantee shall be responsible for the completion of the Work and to provide required documentation to DOLA as specified herein. 2.3.1. Grantee shall notify DOLA at least 30 days in advance of Project Completion. 2.4. Recapture of Advanced Funds. To maximize the use of Grant Funds, the State shall evaluate Grantee's expenditure of the Grant Funds for timeliness and compliance with the terms of this Grant. DOLA reserves the right to recapture advanced Grant Funds when Grantee has not or is not complying with the terms of this Grant. 2.5. Eligible Expenses. Eligible expenses shall include: costs incurred in the purchase of gravel, asphalt and cement products to be used for the full depth construction improvements to roads 28 and 41. 3. DEFINITIONS 3.1. Project Budget Lines. 3.1.1. "Equipment, Vehicles or Materials Acquisition" means vehicles, equipment and materials costs, freight costs, RFP/Bid advertisement costs, hardware, software and training costs, installation costs, and attorney's fees. 3.2. "Substantial Completion" means the Work is sufficiently complete in accordance with the Grant so it can be utilized for its intended purpose without undue interference. 4. DELIVERABLES 4.1. Outcome. The final outcome of this Grant is the full depth reconstruction of approximately one mile of Weld County Road (WCR) 28 from WCR 30 to WCR 41 and approximately one mile of WCR 41 from WCR 28 to WCR 26, resulting in a safer intersection at WCR 28 and 41. 4.2. Service Area. The performance of the Work described within this Grant shall be located in Weld County, Colorado. 4.3. Performance Measures. Grantee shall comply with the following performance measures: Milestone/Performance Measure/Grantee will: Ryl Put Project out to bid. Within 60 days after the Effective Date of this Grant Award Letter. Page 1 of 5 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements Award and finalize subcontract(s) and/or sub-grant(s). Within 90 days after the Effective Date of this Grant Award Letter. Provide DOLA with Project Timeline Within 60 days after the Effective Date of this Grant Award Letter. Provide DOLA with Project photographs with each Pay Request. See §4.5.2 below Submit Quarterly Pay Requests See §4.5.2 below Submit Quarterly Status Reports See §4.5.2 below Submit Project Final Report February 28, 2021 4.4. Budget Line Adjustments. 4.4.1. Grant Funds. Grantee may request in writing that DOLA move Grant Funds between and among budget lines, so long as the total amount of Grant Funds remains unchanged. To make such budget line changes, DOLA will use an Option Letter (Exhibit G). 4.4.2. Other Funds. Grantee may increase or decrease the amount of Other Funds in any one or any combination of budget lines as described in §6.2, or move Other Funds between and among budget lines, so long as the total amount of such "Other Funds" is not less than the amount set forth in §6.2 below. Grantee may increase the Total Project Cost with "Other Funds" and such change does not require an amendment or option letter. DOLA will verify the Grantee's contribution of "Other Funds" and compliance with this section at Project Closeout. 4.5. Quarterly Pay Request and Status Reports. Beginning 30 days after the end of the first quarter following execution of this Grant and for each quarter thereafter until termination of this Grant, Grantee shall submit Pay Requests and Status Reports using a form provided by the State. The State shall pay the Grantee for actual expenditures made in the performance of this Grant based on the submission of statements in the format prescribed by the State. The Grantee shall submit Pay Requests setting forth a detailed description and provide documentation of the amounts and types of reimbursable expenses. Pay Requests and Status Reports are due within 30 days of the end of the quarter but may be submitted more frequently at the discretion of the Grantee. 4.5.1. For quarters in which there are no expenditures to reimburse, Grantee shall indicate zero (0) requested in the Pay Request and describe the status of the Work in the Status Report. The report will contain an update of expenditure of funds by budget line as per §6.2 of this Exhibit B Scope of Project as well as a projection of all Work expected to be accomplished in the following quarter, including an estimate of Grant Funds to be expended. 4.5.2. Specific submittal dates. Quarter Year Due Date Pay Request Due Status Report Due 3rd (Jul -Sep) 2019 October 30, 2019 Yes Yes 4' (Oct -Dec) 2019 January 30, 2020 Yes Yes 1s' (Jan -Mar) 2020 April 30, 2020 Yes Yes 2nd (Apr -Jun) 2020 July 30, 2020 Yes Yes 3'd (Jul -Sep) 2020 October 30, 2020 Yes Yes 4th (Oct -Dec) 2020 January 30, 2021 Yes Yes 4.6. DOLA Acknowledgment. The Grantee agrees to acknowledge the Colorado Department of Local Affairs in any and all materials or events designed to promote or educate the public about the Work and the Project, including but not limited to: press releases, newspaper articles, op-ed pieces, press conferences, presentations and brochures/pamphlets. Page 2 of 5 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements 5. PERSONNEL 5.1. Responsible Administrator. Grantee's performance hereunder shall be under the direct supervision of Barbara Connolly, Controller, bconnolly(&weldgov.com, who is an employee or agent of Grantee, and is hereby designated as the responsible administrator of this Project and a key person under this §5. Such administrator shall be updated through the process in §5.3. If this person is an agent of the Grantee, such person must have signature authority to bind the Grantee and must provide evidence of such authority. 5.2. Other Key Personnel. Elizabeth Relford, Deputy Public Works Director, erelford(&weldgov.com. Such key personnel shall be updated through the process in §5.3. 5.3. Replacement. Grantee shall immediately notify the State if any key personnel specified in §5 of this Exhibit B cease to serve. All notices sent under this subsection shall be sent in accordance with §15 of the Grant. 5.4. DLG Regional Manager: Don Sandoval, (970) 679-4501, (don.sandoval(&state.co.us) 5.5. DLG Regional Assistant: Robert Thompson, (970) 679-4503, (robert.thompson(a,state.co.us) 6. FUNDING The State provided funds shall be limited to the amount specified under the "Grant Funds" column of §6.2, Budget, below. 6.1. Matching/Other Funds. Grantee shall provide at least 50% of the Total Project Cost as documented by Grantee and verified by DOLA at Project Closeout. Initial estimates of Grantee's contribution are noted in the "Other Funds" column of §6.2 below. Increases to Grantee's contribution to Total Project Cost do not require modification of this Grant Award Letter and/or Exhibit B. 6.2. Budget Budget Line(s) Total Project Cost Grant Funds Other Funds Other Funds Source Line # Cost Category 1 Equipment, Vehicles or Materials Acquisition $483,397 $200,000 $283,397 Grantee Total $483,397 $200,000 $283,397 7. PAYMENT Payments shall be made in accordance with this section and the provisions set forth in §7 of the Grant. 7.1. Payment Schedule. If Work is subcontracted or subgranted and such Subcontractors and/or Subgrantees are not previously paid, Grantee shall disburse Grant Funds received from the State to such Subcontractor or Subgrantee within fifteen days of receipt. Excess funds shall be returned to DOLA. Payment Amount Interim Payment(s) $190,000 Paid upon receipt of actual expense documentation and written Pay Requests from the Grantee for reimbursement of eligible approved expenses. Final Payment $10,000 Paid upon Substantial Completion of the Project (as determined by the State in its sole discretion), provided that the Grantee has submitted, and DOLA has accepted, all required reports. Total $200,000 7.2. Interest. Grantee or Subgrantee may keep interest earned from Grant Funds up to $100 per year for administrative expenses. Page 3 of 5 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements 8. ADMINISTRATIVE REQUIREMENTS 8.1. Reporting. Grantee shall submit the following reports to DOLA using the State -provided forms. DOLA may withhold payment(s) if such reports are not submitted timely. 8.1.1.Quarterly Pay Request and Status Reports. Quarterly Pay Requests shall be submitted to DOLA in accordance with §4.5 of this Exhibit B. 8.1.2. Final Reports. Within 90 days after the completion of the Project, Grantee shall submit the final Pay Request and Status Report to DOLA. 8.2. Monitoring. DOLA shall monitor this Work on an as -needed basis. DOLA may choose to audit the records for activities performed under this Grant. Grantee shall maintain a complete file of all records, documents, communications, notes and other written materials or electronic media, files or communications, which pertain in any manner to the operation of activities undertaken pursuant to an executed Grant. Such books and records shall contain documentation of the Grantee's pertinent activity under this Grant in accordance with Generally Accepted Accounting Principles. 8.2.1. Subgrantee/Subcontractor. Grantee shall monitor its Subgrantees and/or Subcontractors, if any, during the term of this Grant. Results of such monitoring shall be documented by Grantee and maintained on file. 8.3. Bonds. If Project includes construction or facility improvements, Grantee and/or its contractor (or subcontractors) performing such work shall secure the bonds hereunder from companies holding certificates of authority as acceptable sureties pursuant to 31 CFR Part 223 and are authorized to do business in Colorado. 8.3.1.Bid Bond. A bid guarantee from each bidder equivalent to 5 percent of the bid price. The "bid guarantee" shall consist of a firm commitment such as a bid bond, certified check, or other negotiable instrument accompanying a bid as assurance that the bidder shall, upon acceptance of his bid, execute such contractual documents as may be required within the time specified. 8.3.2.Performance Bond. A performance bond on the part of the contractor for 100 percent of the contract price. A "performance bond" is one executed in connection with a contract to secure fulfillment of all the contractor's obligations under such contract. 8.3.3.Payment Bond. A payment bond on the part of the contractor for 100 percent of the contract price. A "payment bond" is one executed in connection with a contract to assure payment as required by statute of all persons supplying labor and material in the execution of the work provided for in the contract. 8.3.4. Substitution. The bonding requirements in this §8.3 may be waived in lieu of an irrevocable letter of credit if the price is less than $50,000. 9. CONSTRUCTION/RENOVATION. The following subsections shall apply to construction and/or renovation related projects/activities: 9.1. Plans & Specifications. Construction plans and specifications shall be drawn up by a qualified engineer or architect licensed in the State of Colorado, or pre-engineered in accordance with Colorado law, and hired by the Grantee through a competitive selection process. 9.2. Procurement. A construction contract shall be awarded to a qualified construction firm through a formal selection process with the Grantee being obligated to award the construction contract to the lowest responsive, responsible bidder meeting the Grantee's specifications. 9.3. Subcontracts. Copies of any and all contracts entered into by the Grantee in order to accomplish this Project shall be submitted to DOLA upon request, and any and all contracts entered into by the Grantee or any of its Subcontractors shall comply with all applicable federal and state laws and shall be governed by the laws of the State of Colorado. 9.4. Standards. Grantee, Subgrantees and Subcontractors shall comply with all applicable statutory design and construction standards and procedures that may be required, including the standards required by Page 4 of 5 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements Colorado Department of Public Health and Environment, and shall provide the State with documentation of such compliance. THE REST OF THIS PAGE INTENTIONALLY LEFT BLANK Page 5 of 5 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements OPTION LETTER #Insert # Here SIGNATURE AND COVER PAGE State Agency Department of Local Affairs Encumbrance Number Insert DLG encumbrance number for this Project Option Letter CMS Number Insert CMS number for this Amendment Grantee Insert Grantee's Full Legal Name Previous CMS #(s) Insert CMS number for orig Agreement, and any prior chg docs Project Number and Name Insert DOLA's project number and name Grant Amount Initial Award: $ Option Letter ## and date effective/spendable: Option Letter ## and date effective/spendable: Insert orig award amt Total Grant Amount: $0.00 $0.00 $Insert total award to date DOLA Regional Manager Choose an item. DOLA Regional Assistant Choose an item. Prior Grant Agreement Expiration Date Month Day, Year Current Grant Agreement Expiration Date Month Day, Year THE PARTIES HERETO HAVE EXECUTED THIS OPTION LETTER Each person signing this Option Letter represents and warrants that he or she is duly authorized to execute this Option Letter and to bind the Party authorizing his or her signature. STATE OF COLORADO Jared S. Polis GOVERNOR Colorado Department of Local Affairs By: Rick M. Garcia, Executive Director Date: ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State contracts. This Option Letter is not valid until signed and dated below by the State Controller or delegate. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Yingtse Cha, Controller Delegate Effective Date: Page 1 of 3 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements I) OPTIONS: Choose all applicable options listed in §1 and in §2 ❑ a. Option to extend (use this option for Extension of Time) ❑ b. Change in the Grant Award Amount within the current term (use this option for an Increase or Decrease in Grant Funds, including Supplemental funding awards) ❑ c. Budget Line Adjustment(s) — reallocation of awarded Grant Funds to Budget Line(s) (use this Option to redistribute existing Grant Funds between budget lines) 2) REQUIRED PROVISIONS. All Option Letters shall contain the appropriate provisions set forth below: a. For use with Option 1(a): In accordance with Section 2(A) of the original Grant Award Letter between the State of Colorado, acting by and through the Colorado Department of Local Affairs, and Grantee's Name, the State hereby exercises its option for an additional term beginning Insert start date and ending on Insert ending _. Tables in Sections 4.3 and 4.5.2 of Exhibit B are deleted and replaced with the following: date Milestone/Performance Measure Put Project out to bid. Within _ days of the Effective Date of this Grant Award Letter. Award and grant(s). finalize subcontract(s) and/or sub- [give target date] Provide DOLA with Project Timeline Within _ days of the Effective Date of the subcontract(s). Contractor mobilization/begin Work. Within _ days of the Effective Date of the subcontract(s). Submit Quarterly Pay Requests See §4.5.2 below Submit Quarterly Status Reports See §4.5.2 below Submit Project Final Report [give date certain] Quarter Year Due Date Pay Request Status Report 2nd (Apr -Jun) 2019 July 30, 2019 Yes Yes 3"d (Jul -Sep) 2019 October 30, 2019 Yes Yes 4sh (Oct -Dec) 2019 January 30, 2020 Yes Yes V (Jan -Mar) 2020 April 30, 2020 Yes Yes b. For use with Option 1(b): In accordance with Section 7(A)(i) of the original Grant Award Letter between the State of Colorado, acting by and through the Colorado Department of Local Affairs, and Grantee's Name, the State hereby exercises its option to increase'decrease Grant Funds awarded for this Project in an amount equal to amt of increase or (decrease), from beginning dollar amt to ending dollar amt. The Grant Award Amount shown on the Summary of Grant Award Terms and Conditions page of this Grant Award Letter is hereby changed to ending dollar amt. The Budget table in Section 6.2 and the Payment Schedule in Section 7.1, both of Exhibit B, are deleted and replaced with the following: Budget Line(s) Total Project Cost Grant Funds Other Funds Other Funds Source Line Cost Category Architectural/Engineering Services S 0.00 Grantee Construction/Improvement Public Roadways of Grantee Total $ 0.00 S 0.00 S 0.00 Payment Amount Interim Payment(s) Paid written of eligible upon Pay receipt approved Requests of actual from expenses. expense the documentation Grantee for reimbursement and Page 2 of 3 DocuSign Envelope ID: 3F633327-04DF-40AF-BB9B-90EA9C0C3035 EIAF 8929 — Weld County Road 28 & 41 Improvements Final Payment the Paid determined required upon Grantee reports. Substantial by the has State submitted, Completion in its and sole discretion), DOLA of the has Project (as provided accepted, all that Total c. For use with Option 1(c): In accordance with Section 7(D)(i) of the original Grant Award Letter between the State of Colorado, acting by and through the Colorado Department of Local Affairs, and Grantee's Name, the State hereby exercises its option to re -allocate awarded Grant Funds within the Project Budget. The Budget table in Section 6.2 of Exhibit B is deleted and replaced with the following: Budget Line(s) "Total Project Cost Grant Funds Other Funds Other Funds Source Line # Cost Category Architectural/Engineering Services $ 0.00 Grantee Construction/Improvement Public Roadways of Grantee Total S 0.00 S 0.00 S 0.00 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or , whichever is later. THE REST OF THIS PAGE INTENTIONALLY LEFT BLANK Page 3 of 3 RESOLUTION RE: APPROVE ENERGY AND MINERAL IMPACT ASSISTANCE PROGRAM GRANT AGREEMENT FOR COUNTY ROADS 28 AND 41 IMPROVEMENTS PROJECT (TIER I) 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 an Energy and Mineral Impact Assistance Program Grant Agreement for County Roads 28 and 41 Improvements Project (Tier I) between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Works, and the Colorado Department of Local Affairs, commencing upon full execution, with further terms and conditions being as stated in said agreement, and WHEREAS, after review, the Board deems it advisable to approve said agreement, 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 Energy and Mineral Impact Assistance Program Grant Agreement for County Roads 28 and 41 Improvements Project (Tier I) between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Works, and the Colorado Department of Local Affairs, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Clerk to the Board is authorized to submit agreement electronically. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 15th day of July, A.D., 2019. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO dielt.A.) ATTEST: EXCUSED Barbara Kirkmeyer, Chair Weld County Clerk to the Board ounty At •rney Mike Freeman, Pro-Tem Stve Moreno Date of signature: 07/ Pw(SS I eR 1C H),GcTC Bcrcb) 2019-2824 EG0076 21 • • MEMO TO: Board of County Commissioners DATE: July 15, 2019 FROM: Stacey Swanson, Budget/Finance Manager SUBJECT: DOLA Contract EIAF 8929 Public Works is requesting the Board authorize the Chair's signature on this Tier I DOLA grant agreement in the amount of $200,000 for the Energy Impact Assistance Fund (EIAF) grant for the purchase of road construction materials used by our crews to reconstruct approximately 1 mile of WCR 28 from WCR 39 to WCR 41 AND 1 mile of WCR 41 from WCR 28 to WCR 26. The total cost to the county is estimated at $283,397. Staff recommends authorization of signature on the DOLA applications. I am available at your convenience t0 further discuss this matter. 2019-2824 sarriu Application Viewer Page 1 of 13 A ent of Local Affirs Division of Local Government FY 2019 April 1 EIAF Tier I or Tier II Grant Application Local Government/Organization: Weld County Status: Filed On: Filed By: Reviewed On: Reviewed By: Reviewer Notes: Application Overview Submitted 2019-03-28T07:46:14 SSWANSON You are Required to Wrk with your Regional Field Manager prior to Completing your Applicati n The Department of Local Affairs' (DOLA) Energy and Mineral Impact Assistance Fund (EIAF) prgram was created t assist political subdivisions that are socially and/or economically impacted by the development, processing, r energy conversion f minerals and mineral fuels. Funds come from the state severance tax on energy and mineral production and fr m a portion of the state's shire • f royalties paid tit the federal government for mining and drilling of minerals and mineral fuels •+:n fr-tderally-owned land. The creation of the fund is outlined in C.R.S. 3463-102 (Feder 1 „ ineral Lease) and C.R.S. 39-29-110 (Severance). Grant doll. rs are t; be awarded for the planning, design, cnstruction, and maintenance of public facilities and for the prvision of services by political subdivisions. NEYour application in this cycle requires that you dtnsw r TWO new questions. One question asks you to describe how your project addresses the Governor's key issues and the other question asks you to describe the outcomes your project will achieve. There are rya other pr: grammatic changes, just the addition . ,f these tw:i� questions. A. APPLICANT/CONTACT INFORMATION 1. Local Government/Organization: Weld County hi the case of a multi-ju iisdictional applic tion, select the other participating eligible organizations: 2. Principal Representative: (In the case of a multi -jurisdictional application, principal representative of the lead organization.) Honorific: First Na e: Middle Name: Last Name: Suffix: Role: Chief Elected Mailing Address: PO Box 758 Address 2: City: State: Zip Code: Commissioner Barbara Kirkmeyer Greeley CO 80632-0758 0/9, ,zgazil hops://dola.colorado.gov/grants_portal/portalApplicationResponseView.jsPid=3035c jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 2 of 13 Phon - #: 970-400-4200 Email Address: bkirkmeyer@weldgov.com 3. Responsible Administrator (will receive all mailings) for the Application: Honorific: First Name: Barbara Middle Name: Last Name: Connolly Suffix: Role: Fiscal Agent Mailing Address: PO Box 758 Address 2: City: Greeley State: CO Zip Code: 80632-0758 Phone #: 970-400-4445 Email Address: bconnolly@weldgov.com zx m .......a. -ra; Y/6 ugSi. i V. •Aa • x ^.4.n' b. VJ • W 'Vrit xn 45. b• r C• x B. CHIEF ELECTED OFFICIAL INFORMATION Please provide contact information for the chief elected official. as Name In the case of a multi -jurisdictional application, chief elected official of the "lead" political subdivision. Barbara Kirkmeyer b. Title Chair C. Street Address PO Box 758 d. City Greeley e. State Please use the two letter abbreviation CO f. Zip 80,632.00 g. Phone Use xxx-xxx-xxxx format 970-400-4445 https://dola.colorado.gov/grants_portal/portalApplicationResponseView.jsf?id=3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 3 of 13 h, Email Address bkirkmeyer@weldgov.com eaeX^A+ Sf4 a'd9d•Nef rota a xa. •.p .a sax • •MY.^ •+'Fro* • t( eee . • • . H.5 :6c roro0^lYa4a >J3.S(::.IV vF ... s,.... ,lf.:' .. jl'y'X' $s nt riptvic, • Ns,T;Y4o, leniskt.ok reams° k "Y4 t.vY war",•M A'A Brolly•• &ft • • $4 y i Co PROJECT DESCRIPTION AND DEMOGRAPHIC INFORMATION •v •iWC.aro Pia • •ea^ B•,.• pet.?• • —d • • . x a.w7 •eae a; ao Amount of grant funds requested The amount requested should equal "Grant Request Total" line from the project budget below. 200, 000.00 b. Description of the project scope of work Description of the various tasks involved in the project including specific data such as quantities, mileage, square feet, linear ft. etc. as well as specific project location within city and/or county etc. (word limit: 4,000 characters) Weld County requests funding to assist with full depth reconstruction (FDR) of approximately 1.0 mile of WCR 28 from WCR 39 to WCR 41 Et approximately 1.0 mile of WCR 41 from WCR 28 to WCR 26. Public Works will mill off the asphalt to a depth suitable for mixing into the subgrade, then use cement -treated base (CTB) to reinforce the subgrade and pave the roadway with 5" of asphalt to support truck traffic. em Describe the problem, opportunity or challenge that resulted in the request (word limit: 4,000 characters) With traffic continuing to increase, this roadway is on the County's HARP program list, which involves a 20 -year life roadway design. The FDR program uses direct distribution severance dollars on roads significantly impacted by oil and gas activity. However, the County struggles to keep up with road damage. The County cannot afford to pave every road and increased truck traffic is making it difficult to maintain existing roads. Therefore, Public Works uses cement -treated base in new road projects to reinforce the subgrade (below the asphalt) in order to support truck traffic. We call this program Full Depth Reconstruction (FDR). do Local Priority If more than one application from the same government (1 of 2, 2 of 2, etc.) 1 eo StatfY historic registry designation Is the project on a State registered historic site or in a State registered Historic District? No eo I State historic registry number If the project is on the state reigistry, please provide the registry number. The department may need to seek a determination of effect from the State Historic Society. fe 2010 population of the applicant jurisdiction 252,625.00 g. Current population Current/most recent conservation trust fund/lottery distribution estimate is acceptable. 323, 765.00 g.1 Current population estimate source DOLA • https://dola.colorado.gov/grants_portal/portalApplicationResponseView jsf'?id=3035&jfwid=5h 8hggp9nxFo4F... 3/28/2019 Application Viewer Page 4 of 13 h.5year p 379, 012.00 pulation projection he 1 Population projection source DOLA i °Have you contacted your DOLA regional manager to discuss this project? You are required to contact your DOLA regional manager prior to submitting your application. Please indicate the date and method of your contact with your regional manager. Y Date You are required to complete this field. 03/01/2019 la 2 Method of c•1 ntact You are required to complete this section. Phone j. Supporting documents Upload any supporting documents (PDF document). Jo\A/i . . )a DOLA Tier I EIAF Application WCR 28-41 Vicinity Map.pdf S'nvrx r : • •„� x x D. GOVERNOR'S KEY ISSUES r ^✓ 4 Oh' .r. vary, %L ei:W:7,4 n . :en -.. .. Ilex.• •• W. v w .xa .e sg rox• r• t)'W...n ' k' 00 Me* . • • a. Please descrioe how your project directly or indirectly addresses the Governor's key issues. Example of direct correlation: your project will implement the use of a renewable energy source that helps achieve your community's energy goals. Example of indirect correlation: Your project is for a wastewater treatment system improvement that indirectly preserves the natural resources of Colorado by ensuring the discharge permit for the system meets environmental regulations intended to protect the environment. The Governor's four goals are: 1. Providing every single child with quality early education; 2. Lowering the outrageous cost of health care; 3. Creating good -paying jobs in the clean -energy sector that can never be outsourced; and 4. Achieving true tax reform that reduces taxes for hardworking Coloradans instead of giving breaks to special interests while forcing families to pay more. (word limit: 4,000 characters) Our WCR 28/WCR41 project directly addresses the Governor's first two goals of Economy and Environment Et Renewables. Weld County's Smart Energy Program aligns with Governor Polis' goals by utilizing natural gas as a transportation fuel. Weld County is one of the top natural gas producing county's in the State, so it makes perfect sense to utilize this resource for not only power plants that serve the electric grid, but for transportation. Weld County will be using liquefied natural gas (LNG) trucks to construct the road improvements. Natural gas is a cheaper, greener, and more efficient fuel alternative. Natural gas as a transportation fuel eliminates 100% of particulate emissions and reduces greenhouse gases by 30%. In addition, one LNG truck is the air quality equivalent of removing 325 cars off the road. Weld County will also be using dedicated Compressed Natural Gas (CNG) tandem dump trucks as part of this construction project. This project directly addresses the Governor's Environment Et Renewable goals by improving air quality emissions with a https://dola.colorado.gov/grants_portal/portalApplicationResponseView.jsf?id=3035&jfwid=5h 8hggp9nxFo4F... 3/28/2019 Application Viewer Page 5 of 13 renewable resource, while supporting the Weld County Smart Energy Plan which has been in place since 2010. The WCR 28/WCR41 project also directly aligns with the Governor's Economy Goal. Weld County also supports fostering an economy that truly works for everyone. Weld County is proud of our diverse economy, which includes agriculture and farming. By improving the WCR 28 Et WCR 41 corridor, you are supporting our Right to Farm - Agriculture in Weld County. Weld County is an agricultural empire of 2.5 million acres of which 75% is devoted to farming and raising livestock. Weld County is Colorado's leading producer of beef cattle, grain, sugar beets, and is the state's leading dairy producer. Weld is the richest agricultural county in the United States east of the Rocky Mountains, leads the state in the value of agricultural products sold, and is typically in the top ten richest overall nationally. There are over 3,000 farms in Weld County. Over 20% of the farms have annual sales in excess of $100,000. In total, Weld's agricultural products annually create over $1 billion of market value. Fertile fields of green can be found in every part of the County. Every year over 875,000 acres of cropland are planted. Of the 875,000 acres, over 300,000 acres is planted with irrigated crops annually. Also, the county's ideal climate, ready feed availability, and quality water make it an ideal dairy county. Weld County is now the 21st largest dairy county in the nation and is expected to increase production in the coming years. The WCR 28/WCR 41 project supports our rich tradition of farming and ranching by improving this corridor for nearby dairies and farms. In addition, this project wisely utilizes our citizen's taxes by county staff performing the work, but most importantly it provides a safer travel to and from school for children. E. DEMONSTRATION OF NEED The statutory purpose of the Energy and Mineral Impact Assistance program is to provide financial assistance to "political subdivisions socially or economically impacted by the development, processing or energy conversion of minerals and mineral fuels." a. Demonstration f need Why is the project needed at this time? (word limit: 4,000 characters) WCR 28 is an important east/west collector roadway in Weld County. The road is busy due to numerous oil Et gas welts in the vicinity and a nearby oil ft gas process water injection well. WCR 41 is a North/South collector road that eventually connects to WCR 22. WCR 22 is an arterial road and route to the Weld County Highway and Interstate 76, and a main path to an oil Et gas hub, which is home to a polishing facility and a transload facility for oil Et gas trucks. bo Project implementation How does the implementation of this project address the need? (word limit: 4,000 characters) The completion of this project will serve the oil Et gas industry haul route with increased safety and an extended life of the road. It will also serve new development in the area east of Platteville and create a safer route for traveling between the town and the Weld County Highway, SH52 and 1-76. cm Does this project address the stated need Does this project, as identified in this application, completely address the stated need? If not, please describe additional work or phases and the estimated time frame. Do you anticipate requesting Energy and Mineral Impact Assistance funds for future phases? (word limit: 4,000 characters) Yes, paving WCR 28 Et WCR 41 addresses the safety need for this portion of the roadway. Weld County will not be requesting additional funding for future projects on this portion of WCR 28 or WCR 41. d5 What other implrmentation options have been considered? (word limit: 4,000 characters) Weld County is trying to be proactive on improving this oil Et gas haul route. e. What are the consequences if the project is not awarded funds? (word limit: 4,000 characters) WCR 28 ft WCR 41 are connected collector roads to WCR 22 and a main travel route to Platteville, the Weld https://dola.colorado.gov/grants_portal/portalApplicationResponseView.jsf?id=3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 6 of 13 County Highway, SH52 and Interstate 76. If funding is not awarded, this section will succumb to increased traffic, continue to deteriorate, and become an even worse safety problem than it currently is today. f. Current year financial information Please upload the completed current year financial information attachment (PDF format) Download EIAF Applicant Financials Weld County 2019.pdf g. Project budget Please upload the project budget worksheet (PDF) Download j DOLA Tier I EIAF Application Project Budget.pdf g.1 Project contingency Please identify the contingency associated with the project budget. 1. If a contingency has not been identified as part of the budget, please explain why not? 2. Contingency % of Budget. 3. Contingency Dollar value 1. Weld County will absorb any costs 2. 0% of Budget 3. $0.00 g02 How recently were the budget and contingency determined Month/Year 03/15/2019 F. MEASURABLE OUTCOMES ao Describe the expected measurable outcrt,mes How will the project enhance the livability* of your region, county, city, town or community (e.g. constructing a new water plant will eliminate an unsafe drinking water system and provide safe and reliable drinking water; the construction of a new community center will provide expanded community services, or projects achieving goals regarding energy conservation, community heritage, economic development/diversification, traffic congestion, etc.)? *(Livability means increasing the value and/or benefit in the areas that are commonly linked in community development such as jobs, housing, transportation, education, emergency mitigation, health and environment) (word limit: 4,000 characters) Construction of these roads will enhance the traveling public, increase the safe travel for oil/gas hauling, and benefit the oil Et gas hub and the water injection well. The improvements will make the area safer for all motorists and add years of life to the existing roadway by using innovative technology at the subgrade level, which will help with truck traffic deterioration. ba What specific outcome will your project achieve? Please note your outcome in the "do what, by when, and how many" method. For example, if your project will result in energy conservation in a building, note how much energy is anticipated to be conserved and by when. Or if your project converts wastewater treatment gas into fuel for vehicles, please note how much savings in fuel costs are anticipated and how much carbon would be reduced by a target date. (word limit: 4,000 characters) The purpose of this project is to create a 20 -year life -cycle for this road. This location is at the heart of the Wattenberg Energy Field which is greatly impacted with heavy truck traffic. By providing innovative technology, such as full depth reclamation using cement -treated base at the subgrade level of the road base, and recycling the current asphalt directly back into the road, this project will result in a safe, reinforced https://do la.colorrado.gov/grants—portal/portalApplicationResponseView.jsf?id-3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 7 of 13 roadway that wilt withstand the [SAL loads. With ever-increasing residential and industry growth in this area of Weld County, this improved route provides safety & longevity for all vehicles, including farm, ranch and dairy equipment, emergency responder vehicles, public and school buses, businesses and residents. c. Historic structure preservation Does this project preserve and protect a registered state historic building, facility or structure? If yes, please describe, intcuding year of construction. (word limit: 2,500 characters) N/A, no historic building, facility, or structure is involved in the project. d. Energy efficiency Wilt this project implement an energy efficiency/strategy that could result in less carbon footprint or conserve energy use or capitalize on renewable energy technology? If yes, please describe. (word limit: 2,500 characters) By utilizing Concrete -Treated Base (CTB) with a GPS-equipped grader it wilt reduce the number of grader passes, which reduces pollution and provide an improved air quality benefit. e. Resiliency framew.• rk Will the project increase the community's long-term resilience and ability to anticipate, withstand, and/or rebound from a natural or manmade hazard event? For example, will the project factor in natural design concepts and will construction utilize sustainable materials? If yes, please describe. (word limit: 4,000 characters) Yes, this project will be constructed with a Resiliency Framework by utilizing recycled asphalt materials into the subgrade to create a more durable subgrade to accommodate heavy ESAL truck traffic and provide a better substructure to withstand natural or man-made disasters for a long period of time. n"t K'd..N a.➢" is .=.5a, SaG�A� h..1M.r a+Y: L. h.., /r• a" . a>, to ..� nysas� . .r.. e. .::. ... .. .. xt. •'..vSr+ G. LOCAL EFFORT • a. Relationship to Community Goals Is the project identified in the applicant's budget or a jurisdictionally approved plan (e.g. capital improvement plan, equipment replacement plan, comprehensive plan, utility plan, road maintenance and improvement plan or other local or regional strategic management or planning document)? What is its ranking? (word limit: 4,000 characters) Yes, this project has been identified in the Public Works HRP budget. be Why can't this project be funded locally? (word limit: 2,500 characters) Weld County reduced funding the HARP Program, which means less roads can be improved. With less funding available, Weld County is trying to find other opportunities to fund projects directly impacted by the oil and gas industry. In order to accomplish this project, Weld County is looking for funds to assist with purchasing additional materials, so the county crews can construct the improvements rather than contracting them c. Has this project been deferred b,,cause of lack of local funding? If so, h w long? (word limit: 2,500 characters) Yes, this project has been deferred for a number of years. d. Explain the origin and status f your local cash match. (Note: Whenever possible, local government cash match on a dollar for dollar match basis is encouraged.) Are the local funds committed or pending? If there are pending funds, when will the status of those funds be determined? (word limit: 2,500 characters) iJ The project will be funded out of Public Works HRP Fund. e. Community partners https://dola.colorado.gov/grants_portal/portalApplicationResponseView.jsf?id=3035&jfwid=5h 8hggp9nxFo4F... 3/28/2019 Application Viewer Page 8 of 13 What other community entities, organizations, or stakeholders recognize the value of this project and are collaborating with you to achieve increased livability of the community? Please describe how your partners are contributing to achieve the improvement to the livability of the community through this project. If in -kind contributions are included in the project budget, detailed tracking will be required on project monitoring report. (word limit: 2,500 characters) Motorists utilizing these roads appreciate the value of this safety project. These roads are important collector connectors between Platteville and the Weld County Highway. fo Tax rate, usage charges, r fees Have the applicant's tax rates, user charges or fees been reviewed recently to address funding for the proposed project? Yes f. I Tax rate or usage charge modifications If the tax rate, user charges or fees were modified, what was the modification and when did this change occur? (word limit: 2,500 characters) Weld County has been directing the revenues from the Specific Ownership Tax to Public Works since 1985. gm Has the applicant contacted representatives from local energy or mineral companies to discuss the (word limit: 2,500 characters) Yes, HARP roads are discussed at Weld County's Oil and Gas Working Group regular meetings. The Oil Et Gas Working Group consists of industry partners discussing impacts affecting everyone and problem solves how we can all work together to minimize or mitigate these problems. ^•••01•431r • H. READINESS TO GO a, When will the p Select one Within 3 months ject begin be What is the time frame for completion Select one Within 3 months c. Is planning or design work a componrmt of this project? Y c.1 What additional design work remains? What percentage of design work is complete? (word count: 2,500 characters) None, nominal design is needed for this project and it is done in-house. cO2 How were project cost estimates determined? How did the applicant develop project cost estimates? (word count: 2,500 characters) Estimates were developed by professional engineers involved with the project design. cO3 Is the pr ject supported by bids, prfessional estimates or other credible information? Yes c.3ei Bids Please attach a copy of any supporting documents (PDF Document). https://dola.coloraclo.gov/grants_portal/portalApplicationResponseView.jsf?id=3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 9 of 13 c04 Are any Local, State or Federal permits required before the project can proceed? If yes, please describe and note the status of permit acquisition (word count: 2,500 characters). No additional permits are required for this project because it will occur within the existing right-of-way limits. .. s 1.., ✓"u v.,... •.c.,w . I. ENERGY Ft MINERAL RELATIONSHIP ae Community energy or mineral impact Describe how the applicant is, has been, or will be impacted by the development, production, or conversion of energy and mineral resources (word limit: 4,000 characters). Weld County is the #1 producing oil and gas county in the entire state and therefore is extremely impacted. Much of the road's traffic is due to oil and gas trucks. b. Use data Cite actual use data that documents direct impact as it relates to the need for the project. For example, "heavy truck traffic directly related to energy development activities is impacting County Road X. a traffic count done in May 2015 showed energy related truck traffic increased from 100 trips per day to 300." (word limit: 2,500 characters) WCR 28 is a collector road. Current traffic volumes on WCR 28 are 1, 551 vehicles per day (vpd) with 40% truck traffic. This count was taken on 10/25/2018. WCR 41 is also a collector road. Current traffic volumes on WCR 41 are 1,620 vehicles per day (vpd) with 44% truck traffic. This count was taken on 10/24/2018. s.2Nxx 4 r:. J. MANAGEMENT CAPACITY ao Fund management How will you separate and track expenditures, maintain funds and reserves for the capital expenditures and improvements as described in this project? (word limit: 2,500 characters) Weld County's Accounting Department is recognized as a Tier 3 local government by the State and can manage all invoicing information through Banner Accounting System. In addition, Public Works will use the project management software PubWorks to assist in administering the grant. b. Project sustainability Describe the funding plan in place to address the new operating and maintenance expenses generated from the project? (word limit: 2,000 characters) Weld County wilt utilize our HUTF funding in order to maintain this corridor. c. Expertise Describe the technical and professional experience/expertise of the person(s) and/or professional firms responsible to manage this project. (word limit: 2,000 characters) Weld County Public Works has several engineers on staff and proven expertise in roadway improvement projects. Barbara Connolly is the point of contact for this grant and Elizabeth Relford will be responsible for managing the construction project. d. Duplication of services Does the project duplicate service capacity already established? Is the service inadequate? Has consolidation of services with another provider been considered? (word limit: 2,000 characters) This is a safety project and does not duplicate service capacity but enhances it. Current service is inadequate and inefficient to meet existing truck traffic demands. https://dola.colorado.gov/grants_por-tal/portalApplicationResponseView.jsf?id=3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 10 of 13 4%4• R hFx•, - r iGdn'to'"se win . +.vx .xv✓ x a .. w y r kM • aant,~ ww r kx• •1m. x.x.✓;. •w'a.xxx.. K. HIGH PERFORMANCE CERTIFICATION (HPCP) PROGRAM COMPLIANCE Colorado Revised Statutes (C. R.S. 24-30-1305.5) require all new facilities, additions, and renovation projects that meet the following criteria to conform with the High Performance Certification Program (HPCP) policy adopted by the Office of the State Architect (OSA) if: • The project receives 25% or more of state funds; and ® The new facility, addition, or renovation project contains 5,000 or more building gross square feet; and ® The building includes an HVAC system; and • In the case of a renovation project, the cost of the renovation exceeds 25% of the current value of the propertya The HPCP requires projects that meet the criteria above to achieve third party verification with the target goal of LEED Gold or Green Globes -Three Globes. Projects are strongly encouraged to meet the Office of the State Architect's (OSA) Sustainable Priorities in addition to the LEED prerequisites. Projects funded through DOLA that meet the above applicability criteria are required to complete the DOLA registration and tracking process. See DOLA's HPCP web page for more information or contact your DOLA regional manager. In instances where achievement of LEED Gold or Green Globe -Three Globes certification is not achievable, an applicant may request a modification of the HPCP policy or a waiver if certain conditions exist. DOLA staff will work with applicants to identify workable solutions to meet the program's intent to maximize building energy efficiencies. Note: If this application is for design services for a planned building project that meets the HPCP applicability criteria and the applicant intends to seek state funding for 25% or more of the total project cost, then the design should maximize high performance building certification standards (by completing the HPCP checklist) and build in anticipated project costs, as appropriate. ao HPCP project details Is the applicant seeking state funding for 25% or more of the total project cost (including all phases, if applicable)? (If no, the project does not meet the HPCP requirement and the rest of this section does not need to be completed) No b. HV C details Does the building include an HVAC system? b.1 Type of HVAC v AC system Please select whether the HVAC is an upgrade or a new system from the following drop down: C. Project type Please select the type of construction project c.1 Square footage in excess of 5,000 square feet Is the building square footage (new construction and/or renovation) 5,000 SF or more? cat Building square footage What is the building square footage, indicate whether the square footage is new, renovation, or both. do Does the cst of renovation exceed 25% of the current value of the property? Select from the drop down list. https://dola.colorado.gov/grants_portal/portalApplicationResponseView.jsf?id=3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 11 of 13 d01 a What is the current property value? Determine based on assessed or appraised value. What is the total project cost for the renovations? Please provide both amounts in your response. ea Does this project meet the HPCP criteria? If yru answered "yes" t*. questions a, b, c, and d, then your project meets the HPCP applicability criteria. Complete the HPCP registration form and preliminary checklist and upload below. (See DOLA's HPCP web page for registration and checklist form.) 1 HPCP registration form and checklist If you answered yes above, please upload the HPCP registration and checklist form below. f. Third party verification Have you included any additional costs in this grant application for third party verification to comply with the High Performance Certification Program? f.1 Third party verification cost If you answered yes above, please specify the estimated cost for third participation verification/certification f.2 Third party verification resources Will you need assistance locating resources, third party consultants, or technical assistance for HPCP third party verification requirements, preparing cost estimates, or otherwise complying with the HPCP? f.2.i Third party verification resources required If you answered yes above, please describe the type of resource identification assistance you need. x+ r",a v.orr4 ... •,. zz-z':n+g,-xr X n7. .ar% <$' +as:m we. •m••. .> 4n IV, n *Oa .• • •.v S $0 •••r. we •• J"T . o - aratte XS m -an e.nc Me .. • L. TABOR COMPLIANCE AND ENVIRONMENTAL REVIEW as Voter authorization Does the applicant jurisdiction have voter authorization to receive and expend state grants without regard to TABOR spending limitations? No a.1 If yes, please explain (word limit: 500 characters) Weld County has a high enough TABOR revenue limit to accept the funds and still be under the TABOR revenue limit. b. State severance funds If the applicant jurisdiction receives a grant with State Severance funds, will the local government exceed the TABOR limit and force a citizen property tax rebate? No b.1 If yes, pie se explain (word limit: 500 characters) https://dola.colorado.gov/grants_portal/portalApplicationResponseView jsf?id=3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 Application Viewer Page 12 of 13 c2 TABR refunds No c.1 if yes, please explain do Has the applicant sought voter approval to keep revenues ab•ve fiscal spending limits? No do 1 If yes, please explain (word limit: 500 characters) N/A em Spending limits Are there any limitations to the voter approved revenues? (e.g., Can revenues only be spent on law enforcement or roads?) Y e. 1 If yes, please explain (word limit: 2,500 characters) All Weld County ad valorem tax levies for county purposes, when applied to the total valuation for assessment of the County, shall be reduced so as to prohibit the levying of a greater amount of tax revenue than was levied from ad valorem taxation in the preceding year plus five percent (5%) except to provide for the payment of bonds and interest thereon. f. Enterprise:° status If the applicant jurisdiction is classified as an enterprise under TABOR, will acceptance of a state grant affect this status? No 1. 1 Explain (word Limit: 2,500 characters) ,ft ,nt,,,..,, M. ENVIRONMENTAL REVIEW Indicate below whether any of the proposed project activities: as Will be und?: rtaken in flood hazard areas? N a.1 List flood plain maps/studies reviewed. Describe alternatives considered. (word limit: 1,000 characters) b. Will affect hist •rical, archaelogical, or cultural resources or be in a geological hazard area? Select from the drop down menu. N be 1 If yes, describe alternatives considered and mitigation proposed. (word limit: 1,000 characters) hops://dola.colorado.gov/grants_portal/portalApplicationResponseView Jsf?id=3035&jfwid=5h 8hggp9nxFo4F... 3/28/2019 Application Viewer Page 13 of 13 c. Address any other public health or safety related concerns n previously identified Select from the drop down menu N c.1 If yes, please explain. (word limit: 1,000 characters) This project will improve public health air quality by eliminating fugitive dust particulate matter. Z3r4MSAUCI.CKDf.:.dtlw. 0IW IK::G.•tt.• vSs .•n.uru.- ^.i.:....�..<2N.,•• fl • •G-rA`Wf• w•sw...••Tr.:. +.• • ..M1 •itn w •. a.ar.• .Yg.•.u• ZSi45v•i••• ^ - nw•.,• .r. .tln granr$ilwn5WaYYr1.:..N`Je.,AltNVnym .4A.'M•5• tr A • a. c.•r'.r.•C,r1: Lu.'ar)s4 S.sa .M 4,...1s•aa •fsv-c• •. .N%4:f t••..914locxc• b • •LuvhTaWn. NNNOV%NL .PCa.xae.nn+y1Y��C1�N9Lr. N. OFFICIAL BOARD ACTION a. Date of official board action Enter the date this project was approved for submission by the board 03/27/2019 https://dola.colorado.gov/grants_portal/portalApplicationResponseView.jsf?id=3035&jfwid=5h8hggp9nxFo4F... 3/28/2019 2. Financial Information (Current Year): 2019 In the column below labeled "Applicant" provide the financial information for the municipality, county, school district or special district directly benefiting from the application. In the columns below labeled "Entity", provide the financial information for any public entities on whose behalf the application is beinc,submitted (if applicable). Complete items 66a thr ugh k" for ALL prtject types: a. Assessed Valuation (AV) Year: Most Recent b. Total Mill Levy c. Property Tax Revenue Generated (mill levy x AV / 1,000) d. Sales Tax (Rate/Estimated Annual Revenue) e. General Fund Budgeted Revenue f. General Fund Budgeted Expenditures g. General Fund Balance as of December 31st o the previous year General Fund Balance: Portion of General Fund which is Unassigned AA (meets the definition identified in the GASB h. statement below) Total Budgeted Revenue (All Funds)* Total Budgeted Expenditures (All Funds)* k. Total Fund Balance (All Funds)* Total Outstanding Debt (All Funds)** Co -applicant Co -applicant * Sum of General Fund and all Special or Enterprise Funds ** Include the total outstanding liability from all multi -year debt obligations (lease purchase agreements, certificate of participation and any other debt instruments). A"unassigned fund balance - Amounts that are available for any purpose; these amounts are reported only in the general fund and have not been committed by resolution, ordinance or contract and have not been budgeted for an intended purpose. (Click this link to locate GASB Fund Balance definitions) For projects to be managed through a Special Fund other than the General Fund (e.g. County Road and Bridge Fund) or managed through an Enterprise Fund (e.g. water, sewer, county airport), complete items "k through o": Complete items "I through p" for ALL project types: Identify the relevant Special Fund or Enterprise Fund: Public Works Fund : F;und Fund m. Special or Enterprise Fund Budgeted Revenue $63,790,797 $ $ n. Special or Enterprise Fund Budgeted Expenditures $63,100,278 $ $ o. Special or Enterprise Fund Outstanding Debt** $0.00 $ $ p. Special Fund Mill Levy (if applicable) 1.647 $ $ q. Special or Enterprise Fund Balance as of December 31St of the previous year $45,000,000 $ $ For Water and Sewer Project Only complete items "q through s": Complete items "q through s" for ALL project types:. Water Sewer r. Tap Fee $ $ s. Average Monthly User Charge (Divide sum of annual (commercial and residential) revenues by 12 and then divide by the number of total taps served.) NOTE: Commercial and Residential Combined $ $ t. Number of total Taps Served by Applicant ** Include the total outstanding liability from all multi -year debt obligations (lease purchase agreements, certificate of participation and any other debt instruments C. PROJECT BUDGET. List expenditures and sources of revenue for the project. The totals on each side of the ledger must equal. Expenditures Sources of Revenue (Dollar for Dollar Cash Match is Required, unless financial circumstance warrants a reduction) Funding Committed List Budget Line Items (Examples: architect, engineering, construction, equipment items, etc.) Line Item Expenditures Line Item Costs List the sources of matching funds and indicate either cash or documentable in -kind contribution. Total revenue must equal total expenditures Cash -In-Kind..:°° List Yes or No next to each line item WCR 28 & WCR 41 FDR Improvements (WCR 28 from WCR 39 to WCR 41 & WCR 41 from WCR 28 to WCR 26) Energy/Mineral Impact Fund Grant Request $200,000 Yes Cement $ 80,668 *Energy/Mineral Impact Fund Loan Request (if applicable) No HMA (PG 64-28) (5") (26' width) $177,365 HMA (PG 64-22) (5") (26' width) $225,364 Weld County Cash $283,397 Yes TOTAL $483,397 TOTAL $483,397 $ New Contract RetitWst ❑ New Entity? Entity Name* Entity ID* COLORADO DEPARTMENT OF LOCAL @.00,003104 AFFAIRS tract Name* Contract I[ DOLA TIER. l GRANT AWARD -WELD COUNTY ROAD 28 & 41 2936 IMPROVEMENTS Contract Status CTB REVIEW Contract Lead* SSWAiSON Contract Lead Email sswanson@weldgov.com Parent Contract ID Requires Board Approval YES Department Project # GR-J3 Contract Description* COLORADO DEPARTMENT OF LOCAL AFFAIRS GRA S WELD COUNTY $200,000 TO PURCHASE MATERIALS FOR A FULL DEPTH RECONSTRUCTION OF ONE (1) MILE OF WELD COUNTY ROAD (WCR) 28 WEST OF WCR. 41 AND ONE (1) MILE OF V,./CR 41 SOUTH OF WCR 28, INCLUDING ASPHALT PAVING. Contract Description 2 WELD COUNTY CREWS WILL CO rIPLE I E CONSTRUCTION AND PAVING OF THE ROAD WITH THE MATERIALS ACQUIRED FOR THE PROJECT. GRANTEE WILL OWN THE ROAD. Contract Type CONTRACT Amount* 200,.00 Renewable NO Automatic Renewal NO ant YES County Attorney Email IGA BCHOATE@C O.WWELD.CO. US NO Department PUBLIC WORKS Department Email CM- PuE lic WorksPweldgev.com Department Head Email CM-Pul' cWorks- DepiHead @weld9cv. c O411 County Attorney BOB CHOATE Grant Deadline Date 11/3012020 if this is a renewal enter previous Contract U) If this is part of a MSA enter MSA Contract ID Requested &')CC Agenda Date* 07/15/2019 Mil a work Besse HAD Due Date 07/11/2019 Does Contract require Purchasing Dept. to be included? NO Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Co Effective Date' 07/01/2019 10131/2020 Renewal Date Termination Notice Period Committed Delivery Date Expiration Date 11/30/2020 Contact information fa Contact Name Purchasi chasing Approver Approval Process Department Head JAY MCDO iALD OH Approved Date 07/11/2019 .Approval .?CC Approved MCC Signed Date BOCC Agenda Date 07/15/2019 Originator SSWANSON Contact Type Contact Email Finance Approver BARB CONNOLLY Contact Phone 7 Contact Phone 2 Purchasing Approved Date Finance Approved Date 07/11/2019 Tyler Ref # AG071519 Legal Counsel BOB CHOATE Legal Counsel Approved Date 07/1112019 Hello