HomeMy WebLinkAboutCOUNCIL - AGENDA ITEM - 08/15/2000 - FIRST READING OF ORDINANCE NO. 96, 2000, APPROPRIA AGENDA ITEM SUMMARY ITEM NUMBER: 15
FORT COLLINS CITY COUNCIL DATE: August 15, 2000
STAFF: Frank Bruno
SUBJECT:
First Reading of Ordinance No. 96, 2000, Appropriating Unanticipated Grant Revenue in the
General Fund for Fort Collins Build a Generation.
RECOMMENDATION:
Staff recommends adoption of the Ordinance on First Reading.
FINANCIAL IMPACT:
The attached grant application (a portion of the complete document) has been awarded to the Fort
Collins Build a Generation.The total award for the fiscal year starting July 1,2000 is $43,400. The
title of the project is Fort Collins Prevention Initiative for Healthy Youth Development. This is the
third grant year in which the City of Fort Collins has been the Subgrantee Agency. All funds are
40 disbursed from the Colorado Department of Criminal Justice to the City of Fort Collins. The City
in turn deposits the grant funds for recording purposes then writes a check to the Fort Collins Build
a Generation. All funds are deposited through the financial officer, Diane Hogarty, with the Fort
Collins Community Foundation.
EXECUTIVE SUMMARY:
Fort Collins Build a Generation (FCBG), in collaboration with Healthier Communities Coalition,
is committed to using risk-focused prevention and the results of its planning process as the primary
tool to determine what strategies,programs,policies, and resources should be deployed to decrease
risk and enhance protection for Fort Collins' youth. FCBG's risk assessment conducted in 1996
indicated that family management problems, family conflict, and the early initiation of problem
behavior put youth in Fort Collins at risk for becoming pregnant,dropping out of school, engaging
in delinquent behavior, using and/or abusing drugs and alcohol and witnessing or engaging in
violent behaviors. Build a Generation will use this funding year to finalize the development and
implementation of a comprehensive, strategic prevention plan. This plan will be developed and
implemented to: (1) address gaps identified from its data assessments; (2) promote the
implementation of research-based programs; (3) build upon what already exists in programs and
services; (4) promote awareness of risk and protective factors; (5) use as leverage when applying
for and making recommendations regarding resources; (6) influence public policy regarding the
prevention of adolescent problem behaviors; and (7) increase cohesiveness among existing
resources.
ORDINANCE NO. 96, 2000
OF THE COUNCIL OF THE CITY OF FORT COLLINS
APPROPRIATING UNANTICIPATED GRANT REVENUE IN THE GENERAL FUND
FOR FORT COLLINS BUILD A GENERATION
WHEREAS,the Fort Collins Build a Generation(the"Recipient")has been awarded a grant
from the Colorado Division of Criminal Justice for$43,400; and
WHEREAS,the Recipient is part of a state-wide initiative designed to reduce youth violence,
delinquency, school drop-out, pregnancy and substance abuse; and
WHEREAS, the City must serve as a pass-through agent by receiving the grant funds and
then passing the grant funds to the Recipient to comply with the grant; and
WHEREAS,Article V,Section 9,of the Charter of the City of Fort Collins permits the City
Council to make supplemental appropriations by ordinance at any time during the fiscal year,
provided that the total amount of such supplemental appropriations,in combination with all previous
appropriations for that fiscal year,does not exceed the then current estimate of actual and anticipated
revenues to be received during the fiscal year.
NOW, THEREFORE,BE IT ORDAINED BY THE COUNCIL OF THE CITY OF FORT
COLLINS that there is hereby appropriated from unanticipated revenue in the General Fund the sum
• of FORTY THREE THOUSAND FOUR HUNDRED DOLLARS ($43,400)for expenditure in the
General Fund for Fort Collins Build a Generation.
Introduced and considered favorably on first reading and ordered published this 15th day of
August, A.D. 2000, and to be presented for final passage on the 5th day of September, A.D. 2000.
Mayor
ATTEST:
City Clerk
Passed and adopted on final reading this 5th day of September, A.D. 2000.
Mayor
ATTEST:
• City Clerk
DIVISION OF CRIMINAL JUSTICE
PROGRAM: BUILD A GENERATION INITIATIVE ! ^rJ
State General Funds
JUN 1 :3 MO
AmokSubgrantee Agency Name: City of Fort Collins
-Project Director. Sandra Collins
Project Director Address: —c/o Community Partnership
Fort Collins. CO 80524
Grant Number: 21-BG-12-14
Project Title: Ft. Collins Prevention Initiative for Healthy Youth Development
Grant Period: July 1. 2000 To June 30, 2001
Date Issued: May 25, 2000
In accordance with the provisions of P. L. 100-690, the Division of Criminal Justice hereby awards a grant to the above-named
subgrantee. The attached grant application, including the Certified Assurances and Special Provisions are incorporated herein as
a part of this document.
APPROVED BUDGET
Source of Funds
Award
Budget Category In-Kind Match Cash Match Total
Budd A Generation
Personnel 0.00 16,072.00 0.00 16,072.00
Supplies 3 Operating 6.000.00 6,400.00 0.00 12,400.00
Travel 1,400.00 0.00 806.00 2,206.00
Equipment 0.00 0.00 0.00 0.00
Contracted/Professional 36,000.00 0.00 0.00 36,000.00
Services
TOTAL BU ET 0.06 22 47200 806.00 88 678.00
Purchase of equipment requires the prior written approval of the Division of Criminal Justice.
Special Condition(s)
1. The Project Director is responsible to have all staff and volunteers assigned to this funded project read and understand the rights afforded to crime
victims pursuant to Colorado Victim Rights Act and its enabling legislation,24-4.1.302.5,244.1-303 and 24-1-304,Colorado Revised Statutes.
2 The Budd a Generation 3-Year Comprehensive Prevention Plan must be completed by March 31,2001.
3. Report quarterly on efforts to enhance the Community Prevention Policy Board to better reflect the ethnic,age and cultural diversity of your community.
4. Report in quartery narratives the aches of your Community Prevention Policy Board. Do not send monthly agendas or minutes.
Build A Generstionsoge.frm Page 1 of 3
(Rev.5100) BAG
Statement of.Grant Award ..,
INSTRUCTIONS
1. Grant activities must be based on the approved budget shown on page one of this Statement of Grant Award, which
supersedes any earlier budget request submitted, and which may be different from the budget originally submitted in your
application. The subgrantee must secure prior written approval from the Division of Criminal Justice if there is to be r
change in any budget category.
2. The Financial Officer of the project must be provided a copy of this document in order to adequately prepare the necessary
financial reports.
3. Review carefully the Certified Assurances and Standard Conditions contained in the approved grant application.
4. Review carefully the"Administrative Guide for Federal Justice Grant Programs Administered by the Colorado Division of
Criminal Justice,"which includes procedures regarding this document, drawdown of grant funds, reporting requirements
and requesting grant modifications.
5. This grant award may be voided without further cause if it is not signed by the subgrantee's Authorized Official and returned
to the Division of Criminal Justice within 45 days of the date of Issuance.
6. The signature of the Authorized Official below should be the same as the one on the grant application. If there has been
a change In the Authorized Official, please submit a letter with this document so stating, and appropriate documentation
in the case of private agencies.
Standard Conditions:
(1) Commencement within 60 Days. If a project is not operational within 60 days of the original starting date of the grant
period,the subgrantee must report by letter to the Division of Criminal Justice the steps taken to initiate the project, the
reasons for delay, and the expected starting date.
(2) Operational Within 90 Days. If a project is not operational within 90 days of the original starting date of the grant period,
the subgrantee must submit a second statement to the Division of Criminal Justice explaining the implementation delay.
Upon receipt of the 90-day letter, the Division of Criminal Justice may cancel the project, or where extenuatim
circumstances warrant, extend the implementation date of the project past the 90-day period.
(3) When issuing statements,press releases,requests for proposals,bid solicitations,and other documents describing projects
or programs funded in whole or in partwtth federal money,all subgrantees receiving federal funds,including but not limited
to state and local governments,shall clearly state(1)the percentage of the total cost of the program or project which will
be financed with federal money,and(2)the dollar amount of federal funds forthe project or program and(3)usethe phrase:
.."through the Division of Criminal Justice, Department of Public Safety."
(4) Either party may terminate the grant with thirty days written notice of intent to cancel or terminate. The grant may be
terminated if the services are not satisfactorily performed by the subgrantee or if it is in the best interest of the State of
Colorado to terminate the grant. If the grant is terminated by either the subgrantee or the State, the subgrantee shall be
paid the necessary and allowable costs incurred through the date of termination,but not exceeding a prorated amount based
on the number of days of project operation prior to the date of termination. Any equipment purchased under this grant would
revert to the Division of Criminal Justice upon termination of the grant.
(5) The State will pay the subgrantee the reasonable and allowable costs of performance, in accordance with applicable
financial OMB circulars and Colorado State Fiscal Rules, not to exceed the amount specified herein as the Total Award
Amount. The State's requirements for invoice,advance payment and cost reporting submissions are contained in the DCJ
Form 3 Cash Request Procedures and DCJ Form 1A Subgrant Financial Report, which are hereby incorporated by
reference.
(6) These funds cannot be guaranteed beyond the end date of this grant period.
baB tog Page 2 of 3
(Rev. 1W97) RAG/fide V
Statement of Grant Award
THIS GRANT AWARD WHICH SERVES AS THE CONTRACT BETWEEN THE DIVISION OF CRIMINAL JUSTICE AND THE
GRANTEE SHALL NOT BE DEEMED VALID UNTIL IT SHALL HAVE BEEN APPROVED AND SIGNED BY THE WkE=77R OF
.THE DIVISION OF CRIMINAL JUSTICE OR SUCH DIRECTOR'S DESIGNEE, AND BY THE CONTROLLER OF THE STATE OF
COLORADO OR SUCH CONTROLLER'S DESIGNEE.
This grant is accepted by:
Signature of AuthorizedOfficial' ate
STATE OF COLORADO
BILL OWENS, GOVERNOR
ey t, t f u-�
Dirdoo,, Dlyision of Criminal Justldb Date
DepartmeKof Public Safety
APPROVED
STATE CONTROLLER
.ARTHUR L. BARNHART
By I16I 10
Dan Frelund Date
Return BOTH SETS of the Statement of Grant Award with ORIGINAL SIGNATURES to: Division of Criminal Justice, Office of
Juvenile Programs, 700 Kipling Street, Suite 1000, Denver, CO 80215.
Build A GeaerariomogMan page 3 of 3
(Rcv.5100) BAG
COLORADO BUILD A GENERATION®
APPLICATION FOR FUNDS
ROJECT DURATION DATES: From:July 1,2000 To: June 30,2001 Page 1 OF 13
PROJECT TITLE: Fort Collins Prevention Initiative for Healthy Youth Develeoment
APPLICANT AGENCY:
Legal Title of Applicant Agency: City of Fort Collins.Attn:Frank Bruno,Assistant City Manager
Address: P.O.Box 580
City,State,Zip: Fort Collins.CO 80522 Phone:.(970) 22"763
Federal Employer ID Number: 8445000587
LOCATION OF AGENCY: U.S.Congresskonal District: 4 State Judicial District: 8 County: Larimer
TYPE OF AGENCY:(Check one): XX Cityfrown Government O County Government
O Indian Tribe O Private Non-Profit O Other(Specity)
FUNCTION OF AGENCY:(Check the one that best describes):
O Unit of Local Government O Law Enforcement O Recreation O Youth Serving Agency
❑ Social Services O Family Service O Education
O Religious Organization 0e Other. (Specify) Municigalily
AMOUNT BEING REQUESTED: Amounts must equal totals on the Budget Form,Page 4.
Requested S 43,400 + Cash and/or in-kind match 23,278 = $ 66678& ( 53%ofRequ�ested Amount) TotaIMP roj
PE OF APPLICATION:(Check appropriate type and description.)
New Start a new project not previously Build A Generation funded.
Expand,or enhance an existing project not previously Build A Generation funded.
X Continuation: X Continue a project which has previously received Build A Generation funds.
Expand,or enhance an existing project which has previously received Build A Generation funds.
If this is a continuation application,provide prior Build A Generation funding information:
Grant Number. 97-JV-12-21 Amount: 58 009 Duration: Ju 1l 1998—Se 1ember 15 1999
Grant Number. 9 -12- 1 Amount 1 8 Duration: a tern r 15 1 — une
Grant Number: 98-JV-12-29 Amount: 5.1 5 Duration: 5spitember 15, 1999—June 30,2000
PROJECT DIRECTOR: The Project Director is considered to be the primary contact person,and the person who is directly responsible for ensuring
that the project is Implemented. All correspondence from the Colorado Division of Criminal Justice wilt be sent to this person.
Project Director. Kay Collins Title: Protect Director
Mailing Address: Fort Collins Build a Generation
1024 South Lemav Avenue
Fort Collins.CO 80524
Phone: (970 ) 495-7503 Fax:(970) 495-7617 E-mail: skCl0libre.ovh.ora
LOCAL COORDINATOR:If the local coordinator is someone other than the Project Director,complete contact information for that person,If available.
Local Coordinator. (same) Title:
Mailing Address:
Phone: ( ) Fax:( ) E-mail:
BUDGET FORM
Use this Budget Form to list expenses anticipated for the project. Refer to the category descriptions and instructions for calculating match in the application instructions.
Do not deviate from the format provided. ROUND ALL AMOUNTS TO THE NEAREST WHOLE DOLLAR—do not use decimals. Breakout the total of each row into the
source of funding in the"Funding Source Breakdown"columns.
1. PERSONNEL (1) (2) (3) (4) (5) Funding Source Breakdown
Annual Full- Annual Frinna sub- %of Time fnr TATAI
Requested$ Cash Match In-Kind Match
a
t
+ = x %
Community Prevention Policy Board + = x % ;$0,687 _ $13,687
Key Leaders/Community Members + = x % $121385 $ 2,385
PERSONNEL TOTAL $16,072 $16,072
2. SUPPLIES AND.OPERATING Funding Source Breakdown
Requested$ Cash Match In-Kind Match
Office space,cleaning,office supplies,telephone, FAX, desk, and chair $ 6,400 $6,400
Maintenance and Repair of Machines $ 500
Printing and Promotional Supplies $ f 1�
,4alE�a'a"m'f� ' �,� $1,500 a
a
Postage($83/month) $ 41h1 8 .
ti�m1� a. $ 800
Food and Beverage Supplies($50/month) $ �600 $ 500
Organized Meals $ 1`;500 $1.500
Community Foundation Operating $ 600
Internet Access($14/month)and Dedicated Telephone Line($36/month) $ !Sw $ 600 x
SUPPLIES AND OPERATING TOTAL $ 12,400 $6,000 $6.400
t
f
1
BUDGET FORM (con't)
3. TRAVEL(Designate specifically in-state and out-of-state travel) Funding Source Breakdown
TOTAL
Requested; Cash Match In-Kind Match
Travel Out of Fort Collins Area $ 1,400 $1,400
Travel In the Fort Collins Area $ 806 ' $ 806
$
TRAVEL TOTAL $ 2,206 $1,400 $ 806
4. EQUIPMENT Funding Source Breakdown
TOTAL
y
Requested; Cash Match In-Kind Match
r.Rr: F Sfk .r .isw-` #is r:'3x; k
a
EQUIPMENT TOTAL
5. CONTRACTED,CONSULTANT AND PROFESSIONAL SERVICES Funding Source Breakdown
TOTAL
Requested; Cash Match In-Kind Match
Contracted services through Poudre Health Services, Inc. (Poudre Valley Hospital) $ 32,000 : $ 32,000
As the implementing agency who employees the Project Director, Kay Collins iv
Contracted services for technical assistance (see attached budget and narrative) $ 41000,r $ 4,000
CONTRACTED,CONSULTANT AND PROFESSIONAL SERVICES TOTAL $ 36,000 $ 36,000
6. TAL OF ,LL,PR(: ECTCOSTS(1 through 5) ' TOTAL $ ;, 66,678 $ 43,400 $ 806 $ 22.472
Section 3. BUDGET NARRATIVE
1. PERSONNEL: $16,072
Requested Funds S 0: In-Kind Match S16,072
Community Prevention Policy Board: In-Kind Match $13.687
(Note: 15 members on the board, but using 10 for full calculation of meeting time)
The in-kind services contributed by the board members will be for attending monthly
board meetings; two members to attend outside Build A Generation event; administrative
responsibilities; and assistance with other board functions and events.
BAG Board Meetings: 10 members x 12 months x 2.0 hrs.x$13.25/hr. _ $ 3,180
BAG Special Committees: 10 members x 10 months x 4.0 hrs.x$13.25/hrs. _ $ 5,300
Bag Members also on HCC Board: 5 members x 12 months x 2.0 hrs.x S13.25/hrs. = S 1,590
HCC Special Committees: 5 members x 12 months x 3.0 hrs.x$13.25/hrs. = S 2,385
BAG Communities Committee
in Fort Collins during October. 15 members x 1 month x 3.0 hrs.x $13.25/hrs. = S 596
2 Board Members to BAG event: 2 members x 1 time/year x 12 hrs.x S 13.25/hrs. _ $ 318
2 Board Members Overnight 2 members x 1 time/year x 12 hrs.x$I3.25/hrs. _ $ 318
ESTIMATED TOTALS $13,687
• Kev Leaders/Community Members: In Kind Match $2.385
Various Key Leaders and community members will be contributing time for functions
and events throughout the year.
ESTIMATED TOTAL 15 hours x 12 months x$13.25= S 2,385
2. SUPPLIES AND OPERATING: $12.400
Requested Funds are$6,000. In-Kind Match is $6,400
Occupancy, Cleaning Services, Office Supplies: In-Kind Match $6,400
Poudre Health Services,Inc. places a value of 20%of the salary for the use of space,
telephone, fax,desk, chair, general office supplies and cleaning.
Maintenance and Repairs: $500
Maintenance and repair of computer and other equipment.
Printing and Promotional Supplies: $1,500
Printing will include photocopies of maps,reports, and plans. Promotional supplies will
include marketing materials necessary for publishing the comprehensive strategic plan
and other materials necessary for community forums relating to BAG business.
Postage: $800
Minutes of monthly meetings are sent by e-mail to most of the board members. The
postage will be used for community events, focus groups, key leaders, and mailing
documents completed this fiscal year.
Food and Beverage Supplies: S500
Provide food and beverage for Community Prevention Board meetings and other Key
Leader and BAG Community meetings.
Organized Meals: S1,500
This includes special Key Leader luncheon's and breakfasts plus food for BAG related
community forums.
Community Foundation Operating: S600
The Fort Collins Community Foundation,our fiscal agent,requested amount for handling
and maintenance of the fund.
Internet Access and Dedicated Phone Line: S600
Internet access and an additional phone line is needed for telecommuting from home.
3. TRAVEL: S2.206
Requested Funds$1,400. Cash Match $806
The Project Director will travel to three Communities Committee meetings per year plus
attend the annual Information Exchange meeting. Overnight stays may be necessary due
to the distance of other Build A generation communities. Travel is calculated at$.20 per
mile for funds requested from the Criminal Justice system.
Communities Committee meetings and
Annual Informational Exchange: 4 x.32 x 500 miles = S 640
Training and DO events in Denver: 4 x.32 x 150 miles = S 192
2 Board members to community event: 2 x.32 x 500 miles = S 320
Overnight lodging and per diem: $83/night x 3 nightslyear = S 248
Travel Outside Fort Collins Area S1,400
Travel Inside Fort Collins: 50 miles x 52 weeks x.31/mile - (Cash Match) S 806
5. CONTRACTED,CONSULTANT AND PROFESSIONAL SERVICES: S36 WO
• Requested Funds: $36,000
Contracted Services with Poudre Valley Health System, Inc: Requested Funds $32 000
Contracted Services with Poudre Valley Health System, Inc. (Poudre Valley Hospital)for
employment of Kay Collins, Project Director of Fort Collins Prevention Initiative for
Healthy Youth Development(Fort Collins Build A Generation). A Project Director
oversees Build A Generation and Healthier Communities Coalition simultaneously. By
combining these reorganizations,we begin to build the basis for an ongoing position in
our community when the grant is no longer available to Fort Collins. This collaboration
reduces duplication, creates more cost efficiency and assures effective coordination in
reaching common goals using risk-focused prevention. Please see the budget and
narrative for the Poudre Valley Health System,Inc. contract to explain the breakdown of
salary and benefits for the Project Director.
Contract Services for Technical Assistance: Requested Funds$4 000
Technical assistance is requested based on need to update the data and resource
assessment, re-evaluated the original gaps analysis, and create the strategic plan by June
30, 2001. We need assistance in this process as well as board development and training.
The requested fund amount is based on the budget and narrative submitted for technical
assistance. Please see the attached documents.
•
_ . -, - •^�w�+ +*n.asm,-- . a, ^...- - wnMnrrc,r.�wy�4- o-,yvemw»
Section 3. BUDGET NARRATIVE—IMPLEMENTING AGENCY
5. CONTRACTED, CONSULTANT AND PROFESSIONAL SERVICES• $32,000
Requested Funds$32,000.
Contracted Services with Poudre Valley Health Systems Inc: Requested Funds$32,000
The Project Director is employed by Poudre Valley Health System, Inc. (Poudre Valley
Hospital) for 32 hours per week. The breakdown will be 25 hours (7874) devoted to
Build A Generation activities and 7 hours (2126) to Healthier Communities Coalition.
The following description will identify the split financially between the two entities.
PERCENT OF TIME DEDICATED TO
BAG HCC TOTALS"
(@.7874) (@.2126)
Salary: $25,197 + $ 6,803 - $32,000
Benefits: 6,803 + 1,837 = 8,640
Total $32,000 + S 8,640 s $40,640
The detail description is to identify that the request of$32,000 will pay only for time the
Project Director will spend on Fort Collins Prevention Initiative for Healthy Youth
Development. Since the numbers are the same, Build A Generation will pay the $32,000
of the salary and Healthier Communities Coalition will pay the$8,640 of the benefits
versus each paying part salary and part benefits. The fringe benefits,paid through the
benefit package of Poudre Valley Health System,Inc. (a member of HCC), are 27%of
the salary, including health insurance, FICA, social security, workers compensation,and
all other benefits afforded through the Poudre Valley Health System, Inc.package. The
$8,640 was not identified as in-kind match since this amount represents the time the
Project Director will work for Healthier Communities Coalition. The salary of the project
director has been raised 6.67%over last fiscal year for a merit and cost of living increase.
The Project Director plays a key role in assisting with oversight, leadership and
management of the Build A Generation process on the local level. The job description
outlines the roles and responsibilities of the Project Director.
(**) Based upon Poudre Valley Health System, Inc. standards, the salary range for this
type ofposition is$29,943-$39,924 (not including benefits).
1m01.EmEnir,rE aa�l'Sc..
Section 3. BUDGET NARRATIVE—IMPLEMENTING AGENCY
• 5. CONTRACTED,CONSULTANT AND PROFESSIONAL SERVICES 4 000
Requested funds: $4,000
Contracted Services for Technical Assistance: Requested Funds: $4,000
Technical assistance has been made for updating data and resource assessments,
re-evaluate the original gaps analysis,then create the strategic plan by June 30, 2001.
The Project Director is still fairly new,not completely trained in the model, and needs
assistance (along with the board)in completing the above objectives. Based on the
technical assistance required during the 1999 -2000 grant year,the following calculations
determined the requested funds:
82.85 hours for the year @$40 per hour = $3,314
Expense reimbursement(copies,phone calls, etc.) = 436
Travel reimbursement for mileage to Fort Collins = 250
Total Estimated Expenses $4,000
Sound Financial Management:
Financial Record Keeping:
All financial records for the Department of Criminal Justice Grant(s) are maintained at the Fort
Collins Community Foundation(FCCF). All records regarding the income and expenses of the
grant(s) are maintained in conjunction with the records of the FCCF. All records of the FCCF
(including the grant records) are made available to an independent auditor each year. The record
keeping policies and procedures for the FCCF include the maintenance of income and expenses,
including all paid invoices. The personnel records for the staff person are keep at the Poudre
Valley Health System, Inc., the implementing agents. More detail records are kept at the office of
the Project Manager.
Programmatic Record Keeping:
All grant documents are maintained at the FCCF and the office of the Project Director. Specific
programs of the grant are monitored by the Build A Generation Board of Directors. All records
regarding the carrying out of the gram programs are also maintained at the FCCF and Project
Director's office.
Personnel Policies:
The personnel policies are the same as those followed by all Poudre Health Services,Inc. (Poudre
Valley Hospital) employees. A full copy of these policies are available upon request.
Travel Policies:
All employee related travel is monitored by the personnel policies and the budgeted amounts for
specific training and/or business related travel.
Procurement Policies:
All purchases over$5,000.00 require a minimum of three sealed and written bids. Also,as
indicated in the DO grant documents,all purchases of equipment require the prior written
approval of the DCJ.
Checks and Balances:
The FCCF is subject to an assessment of the internal control structure during the annual audit. In
regards to the specifics of the DO grant,all checks are approved by the Project Director,yet the
custodial control including the balancing of the checking account, is performed by the Finance
Director and the Finance Assistant at FCCF.
Board Involvement:
The Build A Generation Board of Directors reviews, on a quarterly basis, the income and
expenses of the DO Grant.
Governmental Accounting Standards Board:
All applicable financial pronouncements(including FASB,GASB, SOP and SAS)are fully
complied with.
�t�
BUILD AERATION COMMUNITY PREVENTION POLICY BOARD MARSHIPITRAINING ROSTER If more space is nee&J,a,p) this page aia e10 Inge ea
Name of Community Fort Collins Prevention Initiative for Healthy Youth Development
Addleaa "TrainingReceived Etheic.
} Phone I
1 2 3 4
1.0"Abeyta-Goneakn: 77re Women's Center dyd Am S&eey Salve 201,Fe Collins,80521 970-484-1902 X H
2. Art Bevaso Poudre Heath Services 120 Br&decone Dritr,FL Chiller 80524 970-224-5209 X C
3. Dane Brace 2143 Ammon Staeti Fit Collins 80526 970-266-9982 X X X X C
4. Jim compain Pomdre School Dkirld 2407 Wat LaPorte Avenue,FL Collins 80521 970-416.8141 X X X C
S. John Ddhes 1824 Valleyview Lane,FL Collins 80524 970a82-0999 X C
6. Nary Grove Lorlerer Conn&DepL of 1525 Blue Spruce Drive,FL Collins 80524 970-498-6753 X C
Heabb A Environment
7. Chuck HaSemebter Offke of
Disrrid 123 N.College,Suite 303,FL Copies 8OS24 970-498-7216 X C
Attorney
8. Jim Hawkins D rt Collins Police 300 LaPorte Avenue,FL CoWns 80521 970-224-6020 (new) C
mromw
9. Steve Hayes Reohy Ewcudves 208 South ColkgeAvenue,FL Collins 80524 970-472-8888 (new) C
10. Joe Hendrickson Poudre School District 2407LaPorteAvenue,FL Collins 80521 970-1903213 X C
11. Browsle McGraw �Atiorney's 749 Sandpiper PoM4 FL Collins 80525 970-498-7216 X C
12. Dave Moalk CIV of FL CnXW 214 North Howes,Fit COMM 80521 970-I16-1736 (new) C
13. Bob Parish Colorado State Patrol 3832 South 1-25,FL Collhrs 80515 970-224-3027 X C
14. Linda Proton BASE Camp 134 Wat Harvard,#S,FL Collins 80525 970-266-1734 X C
I& AverB Strand Larhna County DepL of 1525 Blue Spruce Drive,FL COMM 80524 970-498-67" X C
mean A Environment
16.
17.
IS.
19.
20.
21.
'TabdagReceived-1 I-Key Leader Orientation 2-Board Orientation 3-Risk and ReaonreeAsseamatWAning H Promising Approaches Training
PROJECT NARRATIVE:
A. Executive Summary
In one paragraph or less,summarize what you want us to fund
The Fort Collins Prevention Initiative for Healthy Youth Development (for the purpose of this grant,
referred to as FCBAG) requests funds to maintain a staff person at 25 hours per week and the
administrative supports (operating expenses) necessary to provide the infrastructure of the local CPPB
board, to coordinate the board's activities surrounding the goals and objectives of this grant, to maintain
collaborative efforts with Healthier Communities Coalition and other initiatives in the community, and to
coordinate and monitor the implementation of the Communities That Care risk-focused prevention model.
B. Statement of Need
ProWde a clear and concise statement as to the needs or probtenn this project is addressing this year. Include the
radonalefor seekbg these fMI&
The Fort Collins Prevention Initiative for Healthy Youth Development has identified two needs that this
project seeks to address:
1) the need to continue risk-focused prevention in our community.
2) the need to continue as a catalyst for coordination of efforts with other youth-focused
coalitions within the community.
(1) The need to continue risk-focused prevention in our commtm_rtv.
Healthy childhood development is of great concern to our community and to FCBAG . As a single,
coordinated planning body, we are committed to using risk-focused prevention and the results of our
planning process as the primary tool to determine what strategies, programs, policies and resources should
• be deployed to decrease risk and enhance protection
Our risk assessment conducted in 1996 (currently being updated) indicated that Family
Management Problems, Family Conflict, and Early Initiation of the Problem Behavior put youth in Fort
Collins at risk for becoming pregnant, dropping out of school, engaging in delinquent behavior, using
and/or abusing drugs and alcohol and witnessing or engaging in violent behaviors.
The 1999 Kids Count in Colorado reports that 2 in 10 babies bom in Latimer County are bom to
single moms, and 20% of pregnant women in the county are not receiving prenatal care early in their
pregnancies. Other alarming trends include a 37% increase in the juvenile crime rate per 1,000 annually
from 1994 to 1996. Hispanic/Latino students drop out of school at twice the rate of Caucasian students
and school official's report that the attendance and truancy referral load has increased by 411% during the
last six years. Statistics for the 8i' Judicial District reveal that Latinos represented 36% of the youth in
juvenile corrections. Over representation of this population in our juvenile justice system has created
controversy and animosity among the various populations in our community.
These trends clearly demonstrate that the community of Fort Collins needs continued support to
work towards reducing these risks in a coordinated, strategic manner. An assessment of our original
resources and gaps indicated that Fort Collins has identified five areas that need our attention:
• increased need for bilingual services and resources
• increased need for prevention programs and strategies from early childhood to preteen
• increased need for cohesion among existing services and resources
• increased need for volunteer recruitment far mentoring(Larimer County Partners)
• need for opportunities for all children in our community to participate in recreational activities.
We believe that focusing our efforts on enhancing existing services and addressing identified gaps
is much more cost effective for our community than building another juvenile detention facility or creating
expensive social service networks for youth.
a�.
In order to advance in the process, the FCBAG will use the 2000-2001 funding year to finalize the
development and implementation of a comprehensive, strategic prevention plan. This plan will be
developed and implemented to: 1) address the gaps listed above, 2) to promote the implementation of
research based programs, 3) to build upon what already exists in programs and services, 4) to promote
awareness of risk and protective factors, 5) to use as leverage when applying for and making
recommendations regarding resources, 6) to influence public policy regarding the prevention of adolescent
problem behaviors, and 7)to increase cohesion among existing resources.
(2) The need to continue as a catalyst for coordination of efforts with other youth-focused coalitions
within the community.
One stumbling block to the prevention of adolescent problem behaviors in Fort Collins, identified through
our resource assessment, has been a lack of coordination between existing coalitions and services, resulting
in a duplication and fragmentation of services and resources. Often times there are several organizations
and agencies fumbling over each other as they seek to do the same work. The results are intermittent and
unfocused
As the FCBAG works towards integrating and institutionalizing risk-focused prevention into the
fabric and decision-making process of the community, it has become clear that we need to develop a more
systematized approach to reducing risks, adolescent problem behaviors, and to enhancing protective
factors. We believe that continuing to identify how we can coordinate our efforts with like-minded
coalitions and taking a lead in those efforts is critical.
One such coalition is the Healthier Communities Coalition(HCC) which we officially collaborated
with during the 1999-2000 year. Using one staff person as the Project Director for the combined groups
has reduced duplication, ensures continued coordination and communication to work together collectively.
The budget narrative gives a detailed explanation to the division and payment of the salary and benefits for
the Project Director. A new 501 C.3 Board of Director's, working committers and sub-groups focused on
specific issues, have been established with representation from both initiatives plus new community
members.
Although Healthier Communities Coalition has a broader scope which includes all aspects of
community life and the FCBAG concerns itself solely on youth, ages birth through 18, it is evident that the
missions, processes, and desired outcomes are very much related The Healthier Communities Coalition has
agreed to adopt the FCBAG planning process and act as emissaries for the CTC model as their primary
tool to accomplish their desired outcomes. Therefore, combining processes, while targeting different
segments of the population is an extremely promising strategy. An example is our role with HCC as they
create an overall community plan, called, "Community Vision 2010". The findings of our risk and
resource assessment, gaps analysis, and strategic plan will become a part of this overall community plan.
FCBAG is in a much better position to use the results of our planning process to make recommendations
regarding services, programs, policies, and resource allocation and to influence the direction of our local
prevention efforts. The combined group brings more clout and presence in driving policy.
C. Community Involvement and Commitment to Prevention
How doe,Bds profecift w/rh the nrinton JratormW of the gpflcnnt qqe ?
The mission of FCBAG is to link systems together so that services are delivered in a cohesive and effective
manner to all residents. By tying community systems together, all children in Fort Collins are protected
from risks and live in an environment that enables then to thrive and grow into healthy, productive
members of our community.
The purpose of these funds is intended to support communities trained and engaged in the FCBAG
risk-focused prevention process. FCBAG have committed to using risk-focused prevention as the basis for
making our decisions in terms of addressing adolescent problem behaviors in Fort Collins. FCBAG work
9b
. to use the results of the risk-focused prevention process to bring community systems together so that
decisions regarding programs, resources, and public policy have their basis in the same framework.
Fgdaln how the project will include prevention activides, addressing the prioritzed risk factors,for youth anger birth
through is in the defined community.
Our geographic boundary is comprised of the City of Fort Collins. We have engaged in this
planning process in order to develop prevention activities for youth birth through 18. Our
resource assessment indicated significant gaps for children within different developmental age
groups — need for prevention strategies from early childhood through pre-teens, need for
recreational activities for all children, need for mentoring for youth of all ages, need for bi-lingual
services, etc. Our strategic prevention plan will be developed and implemented to address these
needs, thus including prevention activities for youth ages birth through 18.
Briefly 10m*which plomdV process steps your com w*y has aceanpllrbed to daft Ifa condmu sdon project, what
bm ltr har your community cWerlemcrd to date as a result artpardeoW ng in the Band A Ge nesanion proem?
BAG had completed all the steps to the point of begiming to develop the strategic prevention plan. Due to
lack of a staff person for several months, then the collaboration process with HCC, the data and resource
assessment is in the updating process. The results will determine if there is any adjustment to the original
outcome-based plan. Once completed, the strategic prevention plan will be finalized and published. Our
community has experienced the following benefits as a result of participating the in the project:
• it has allowed us to collaborate with multiple jurisdictions
• It allows the board to make decisions based on research-based information
• It has allowed us to identify our most harmful risks and the most prevalent gaps in services and
programs
. • It has provided us a structure for developing and implementing a strategic plan that will reduce risk
and enhance protection for youth.
• in addition, key leaders have embraced the BAG planning process and have helped to develop the
original outcome-based plan.
What does your community see as the benaft ff this year's proposal is funded?
If this year's proposal is funded, the final steps of the strategic plan can be completed and published, and
the integrated collaboration with Healthier Communities Coalition will be strengthened so that risk-focused
prevention continues to be institutionalized in Fort Collins. We will also be in a better position to bring
local community decision-makers to the same table to coordinate efforts, eliminate duplication and
prioritize the use of resources.
We also believe that the State will benefit from our efforts. By witnessing our successes and
Mures of developing a new organizational structure with other like-minded coalitions, we will be able to
supply an evolved model of collaboration and coordination for other BAG communities to use for
themselves as they implement risk-focused prevention
CPP Board Structure and Functions
L Esp/dn how the board v organized and s&ucaved provide biforwadon abort terms of nkvnbmhfp and office,
eowrnfuem dedtlon-naM rprocmm meadugrquisemartr,etc
The Community Prevention Policy Board is made up of 15 members who work under the John Carver
model of Policy Board Governance. Within that model, the Board develops policies to carry out the
mission of BAG and the Director is given the responsibility and authority to carry out activities necessary
to meet the organizational goals within the framework defined within Board policy. There is a chairperson,
vice-chair,and a secretary/treasurer who act as officers, with terms of office for one year. Board members
. are appointed for a three-year, renewable term The board meets monthly and for special needs, the total
board makes decisions, and the board speaks with one voice. Planning groups are made up of people who
are working with the issues.
2 In a dear and concise manner,erplam the board's defined role In overseeing therejunds andjor implernendng the
Build A Generation process step&
The board assigned its secretary/treasurer to oversee external monitoring of financial matters including site
visits to the fiscal agent and the Project Directors office. The secretary/treasurer compares the Director's r
records with the reports of the fiscal agent. He looks at expenditures to assure that they stay within defined
limits and assesses that bills are paid in a timely manner. The board is responsible for overseeing the
implementation of the BAG process steps.
I who Is spacllkally responsiblejor antrang,monitomv,and overseeing the acslvhia of the local eooreinator and
any otker paid gaff?
The Board is responsible for assuring that the Director acts within the defined limits and means defined
within the Policy Board Governance structure. It is defined within these policies which area will require
external monitoring, when that monitoring will occur and who is responsible for completion of the
monitoring.
A Ltrt which cwalidons,pnvengon eff&,%mud youth servhtg agenda cumaw 'eidw hs your rwmmuntry 07rlch ones
are repraerued on your board? Now doa your board hdend to ksdade those not rgwese=ed on your board?
Many of the coalition groups working on prevention efforts,and youth serving agencies are members of the
Healthier Communities Coalition which has the goal to promote collaboration in order to coordinate efforts
to leverage health improvements and reduce competition. These groups are either members of the
Community Prevention Policy Board,Healthier Communities Coalition or community members we have
worked with directly. Some of the groups are:
Healthier Commumt1l; .+.ridge Members—Assets,City of Fort Collins,Children's Clinic.Communities in
SdtooL% Gentle Touch Curriculum, Lorimer County Probation, Mental Health, Poudre Health Services District,
Poudir Valley Hospital,Restorative Justice,TEAM Fort Collins,Teen Pregnancy Prevention Advocate,and Victim
Community Preventiae Policy Board R.n _BASE Camp,Colorado State Patrol,Fat Collins Police,
Latimer County District A tomey's Of or, Lorimer Comity Health & Environment, Law Enforcement, local
Businesses, Poudre School District, City of Fort Collins Pants and Recreation, Parents and families, youth service
providers and senior citizens.
We intend to have at least two meetings per year with Fort Collins Youth Advisory Council to coordinate
with teen representatives. We are working with the communication/mobilization committee of HCC to
develop means and tools to collaborate with many other entities throughout the community. The initial
steps were a luncheon in March to inform participating initiatives of our collaborative efforts, plus tlhe Key
Leader Breakfast to update on the collaboration, the community planning process, etc. In addition, the
Director and board members will continue to meet with Key Leaders to keep them informed and to use their
input in helping set the direction of planning for youth.
I EVdn how new CPPB members arc recruited,orhmed and rushed
Old board members recruit new board members. The board brainstorms potential candidates with
intent to represent the diverse perspectives of the community and to find members who will help uphold
board values and help achieve goals. It establishes a committee to contact potential candidates and explain
the purpose of their participation should they join, invites potential members to a meeting and confirms
their appointment after the board has discussed each candidate and the candidate has accepted the offer to
participate. The Project Director helps with this process. This includes the vision of BAG statewide
and locally,an overview of the project,their role as a board member and an orientation on John Carver's
Policy Governance, and of the CTC model.
A. List one or two methwh that have been used to educate the mmmanity about your prevention efform
• We have engaged in a variety of methods. Examples include: holding two community breakfasts,
community presentations in the CTC model, press releases, brochures, newspaper articles, etc.
7. How has collaboration benefited your community?
Feedback from board members describe a high level of satisfaction that BAG has provided an avenue for
many different segments of the community to talk face to face on a monthly basis. The Healthier
Communities Coalition has voted to incorporate the BAG process into their role and share a director to
eliminate duplication and fragmentation as well as to combine the use of resources.
8. Give one example of how the CPPB U rift Ash-faaeud p evetdon ter podelpate In and rn,/lunwe public aula des
and pulley deddons relate to preventim
As a result of two Poudre School District (PSD) employees participation on the FCBAG board and the
findings from the risk assessment in 1996, PSD - Colorado Kids Ignore Drugs program and TEAM Fort
Collins have collaborated through a grant from the Colorado Alcohol and Drug Abuse Division. In the
summer of 1999, three representatives from the group were educated at Hawkins-Catalano in Seattle on a
curriculum to use the risk and protective model for educating parents,around the substance abuse issues, in
the Fort Collins community. Five week classes are held throughout the community, including presentations
in businesses through their human resource divisions. Last February, representatives from Hawkins-
Catalano presented additional training in Fort Collins for 10 additional people working with this program
E. Staff Position
What phasa of the Commwnida 7l4t Care+rd"hig has the local coordinator paritcoded in and when? if the sttlo'has
not been trained Ow ffiw how the board plan to lware that the local eoordneor becoines trained See the Project
Diredors job dara*don an asAtiadtmati A
. The Project Director was hired last April and is committed to being educated through the Division of
Criminal Justice training process. Initially,the Director had on*-on-one training with a DO technical
assistant. She has also attended all training through DO during the last year. In addition,the Director
will:
• Maintain an orientation manual which includes information on the CTC model, list of key
contacts, goals and objectives to be fulfilled,a copy of the 2000 AAF,a copy of the Fort
Collins grant application,board manual,and all completed published documents to date(risk
assessment, resource assessment,outcome-based plan, etc.)
• Attend all training offered by DCJ.
• Attend and participate in the Communities Committee meetings.
• Attend and participate in the annual Communities Informational Exchange.
F. Goab and Objectives
list the goats of this project and their related objediva,taster,responsWifty and dnw Bnes.
1. To complete and publish a three-year prevention plan with goat and objectives, strategies,
Program+, responsibilities assigned,resources needed,resources available and timelines.
Objective 1: Update Risk and Resource Assessment/originally created 1096-1997)
Action: By June 30,2000,form committees to review original risk and resource assessments.
Action: Committee members will be responsible for collecting and analyzing new data.
Action: Present results to the CPP Board to identify community's priority risks and gaps.
Action: Update and publish the reports by December 31,2000.
�2
Objective 2: Use newly identified priority risk factors Raps and promising approaches to develop a
strate�c plan.
Action: By October 30, 2000 form committees to develop recommended strategies to address gaps in
the prioritized risk areas.
Action: Facilitate meetings with board members to finalize goals and objectives, strategies, programs,
responsibilities, resources available, resources needed and timelines.
Action: By June 30, 2001 a strategic plan will be in published form and will include the following:
Problem Behavior Outcomes; Risk Factor Outcomes; Protective Factor Outcomes; Program
and Participant Outcomes; Action plans to accomplish—strategies, resources, responsibilities,
timelines,etc.; and a Method of Evaluation to monitor progress.
Obiective 3: Continue to develop a mechanism for the board to increase Youth participation in the planning
and implementation process of the plan as measured by the following:
Action: The Director will schedule at least two meetings between representatives of the board and the
Fort Collins Youth Advisory Council to educate them about BAG and increase youth
participation in the planning per•
Action: On an on-going basis,the Director will sponsor and participate in youth related forums or
meetings to solicit input and participation in developing strategies for the plan.
2. Use the results of the risk-focused prevention process to bring community systems together so that
decisions regarding programs, resources and public policy have their basis m the same f1 aumirork.
Obiective 1: Work with HCC. and the"Compass 2000" tool to insure that FCBAG strategic plan becomes
part of their overall community plan.
Action: The Project Director and at least four board representatives will participate on the HCC
Board of Director's,plus attend HCC committees that are focused on developing an
overall Community Plan.
Action: By January 31,2001, present results of the risk and resource assessments,to the HCC Board
of Director's. Educate about the CTC model and discuss implications in regards to the
Community Plan
Action: By June 30,2001, present the strategic plan to the HCC Board of Director's and determine
process to integrate into the overall Community Plan.
OObiective 2: Guide HCC in utilizing the CTC model to develop and implement their Community Plan
Action: The Project Director and four representatives of FCBAG will participate and facilitate the
HCC sub-groups committees which are based on specific issues; such as substance abuse and
teen pregnancy.
Action: By January 31,2001,create a task force committed to integrate and implement the strategic
plan into the sub-groups of HCC, utilizing the CTC model, identifying ways to work together
on identified risk and protective factors plus promising approaches.
3. Develop a coordinated process to disseminate the plan to the community to mobilize support for,
buy-in from,and commitment to BAG and the strategic plan.
Cibiective 1• Work with Key Leaders and community members about the plan and its implementation
Action: On an on-going basis,schedule fopnal and informal meetings and presentations with those
identified leaders and community members to educate and mobilize support and buy-m.
Action: On an on-going basis,develop marketing and public relations materials(brochures,press
releases, newspaper articles,etc.)to continually educate the community about FCBAG and
the plan
. Objective 2: Advocate for the BAG proiect and the plan with local and state policy makers.
.fiction: The board and key leaders will contact local and state policy makers to solicit support for
FCBAG. commitment and buy-in for the plan, and to inform them about accomplishments and
benefits of FCBAG process.
G. Evaluation and Long-term Plan
Identify how the CPPB WH mtarure whether or not they have successfully achieved the goals outlined In this grant
appllcadon. prplain what efforts, if arty, are bdng used to secure future funding for the Band A Generation efforts in
your community.
We will develop a tracking system with the goals, objectives, actions and timelines listed and monitor what
is being accomplished on a monthly basis. The Director will report the accomplishments to the Board also
on a monthly basis. Quarterly and final reports will be submitted to DO within all required timeframes.
One of the primary motivations for collaborating was to ensure continuation of the project through
collaborative fund-seeking efforts. By demonstrating a high level of community collaboration, we increase
the likelihood of getting grants and foundation support; increase the number of grants we can apply for
because we represent a broader scope; decrease the number of individual grants submitted from Fort
Collins community while decreasing competition within Fort Collins for those dollars. This leads to more
cohesive focused efforts on behalf of children.
To achieve these goals, the board has collaborated with HCC to develop a permanent home for a
combined Director, who will eventually be finded through grants,contributions,and dues paid to HCC.
H. Past Performance
Continuation applicants mart include status hrformadon related to the Special Conditions that were Usted on
their last Statement of GrantAwwra and a summary of their progress toward meeting the goals and objectives of their last
. grant Aet the Spedd Conditions and report wnrmawe.
1) The project Director is responsible to have all staff and volunteers assigned to this funded project read and
understood the rights afforded to crime victims panaant to Colorado Victim Rights Act and its enabling legislation,24-
4.1-302.5,24-4.1-303 and 24-1-304,Colorado Revised Stoma.
A copy of the Colorado Victim Rights Act will be sent from the DO office to be read by the staff and
volunteers.
2) Any changes in personnel funded through this grant mot be communicated to the DCJ Build
Generation State project manger. DCJ reserves the right to review and modify staff funding levels In the event of any
changes.
There are no changes to personnel as of March 31,2000.
3) Staff positions funded through this grant mot be trained in the entire series of Communities That Caro
risk-focused prevention model. And mot attend the annual Community Information Exchange meeting In its entirety.
The staff person has been trained in the CTC model and the keyleader training of Communities That Caro
risk-focused prevention model. The staff person will also attend the Risk and Resource Assessment
training in Denver in May 2000. The staff person attended the annual Community Information Exchange
meeting in Woodland Park and Cripple Creek on January 19-21".
4) All Build A Generation related printed products and publications mast recognize and give funding credit
to Build A Generation and must be coordinated through and approved by DCJ prior to printing. Two copies of the
printed products and publieadom,as wen as,copies of local newspaper articles and meeting minutes must be
forwarded to DCJ.
All minutes and any articles are forwarded to DO office of Pat Cervera on a monthly bases. Included with
the March 2000 report were copies of the imitation, agenda andJlyer for the Key Leader breakfast on
April 26,2000. Build A Generation is one of the sponsors of this event. These were turned in to DO with
the March 2000 narrative report.
•
�4
COLORADO BUILD A GENERATION®
APPLICATION FOR FUNDS
PION DATES: From:Adv 1 2000 Ta June 30 pool
:ERTIFICATION/SIGNATURES:Original signatures required. Please sing in BLUE ink.
ie APPLICANT,through the following signatories, understands and agrees that any grant received as a result of this project proposal shag be
,b'ect to and incorporate the statements made herein including the Certified Assurances and Special Provisions. "The signatories certify that
e nave read the instructions for this application and are fully cognizant of our duties and responsibibes for this project"
uthoriaed Official (Person mencrlsb to a to Into bkwing commanwnes on behalf of the applicant
egency)
Sgndusd/Wfariaso UMM T Z� r6scho
Data
_ Frank W B mo AsateMnt rw u
rypad Name
TYb
Agerrry3 Melling Addron: City d Fort Collins arre• 11
Fndc1:111 1111 o n a11-5M Fort Collins.
Tdaphow_ 97D•221.M FAX__ 970.2244107 E-rral:
•ofect Director (Person trap be In direct Mrge of the"ocl)
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It
Sandm Kay Coffins
Typed Name
P
Agency&AAeSrrg Address. 11M A(i swelierr-c/c rdZrMw v 6 Fc�.wrw.Deaeloom10LJQZ4ScuthLwwAmnft
Tim- 1170 4W7503 FAX 9'7n•dK.7617
- - E-rtlefi ela:l raafi ere
nancial Officer (Person reeponebb for necd matters misurrg to this project)
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T,pad
ne rt.e n:e ,e
Agency&frig Address• 52a SaM Cosaea Fod C � r.�t10521
Tdaptarra-----QM2Z FAX ere•,^ `15i
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