HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9191774 (2)1
RECIPIENT SERVICE AGREEMENT
COMPETITIVE PROCESS: HUMAN SERVICE CATEGORY
KEEP FORT COLLINS GREAT HUMAN SERVICE PROGRAM FUNDING
AN AGREEMENT, by and between the City of Fort Collins hereinafter referred to as “City” and
NEIGHBOR TO NEIGHBOR, hereinafter referred to as “Recipient”, by which the funding recipient agrees
to carry out specific activities under the City’s Keep Fort Collins Great Human Service Program funding
program and establishing certain other terms and conditions of operation.
IT IS MUTUALLY AGREED AS FOLLOWS:
ARTICLE I PROJECT
SECTION 1 SCOPE OF SERVICES
The City, in allocating Keep Fort Collins Great (KFCG) Human Service Program (HSP) monies,
hereby designates the Recipient to undertake, and the Recipient hereby agrees to undertake the
activities specifically described in its Competitive Process application and summarized below:
A. General Statement
Neighbor to Neighbor will use their Homelessness Prevention Program to help low-income
individuals and families in Fort Collins evaluate and access affordable housing options and
access rent assistance up to $500, paired with supportive services. The services provided will be
in accordance with Neighbor to Neighbor’s Spring 2019 Competitive Process proposal, and as
approved by City Council on June 4, 2019.
B. Recipient Shall:
Work to attain the following goals for the project:
It is anticipated that approximately 100 unduplicated Fort Collins resident clients will be served over
the course of this 12-month contract: 80 clients at the 0-30% AMI level; 20 clients at the 31-50% AMI
level; 0 clients at the 51-80% AMI level; and 0 clients at or above the 81% AMI level.
It is anticipated that progress will be measured towards the following programmatic outcome targets:
• 80% of Homeless Prevention program participants will remain stably housed six months after
receiving assistance.
• 75% of Homeless Prevention program participants will have an improved understanding of
their budget.
KFCG HSP grant funds of $126,000 will be used to assist with direct client assistance in the form of
emergency and first month’s rent support (50% of funding award), up to $500 per household, partial
salaries and benefits* of two Housing Counselors who will administer the program at the Murphy
Center (40% of funding award), and indirect expenses associated with administering the program
(10% of funding award). *Actual hours worked. Vacation, medical or other leave not eligible.
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SECTION 2 PROJECT DESCRIPTION
Type of Project: Human Service Funded Amount: $126,000
Project Location: 1550 Blue Spruce Drive, Fort Collins, CO 80524 Fiscal Year: 2019
Population Served: Homeless and Low-income Adults
SECTION 3 TERM OF AGREEMENT
The term of this Agreement is October 1, 2019 through September 30, 2020, but may be
extended should additional time for auditing this project be required, in accordance with law; this
Agreement shall be deemed automatically extended until such time as the said audit shall be completed.
Notwithstanding other provisions of this Agreement, the term of this Agreement shall cover the period
that the Recipient has control over KFCG HSP funds.
SECTION 4 PROGRAM REPORTING
The Recipient shall submit such reports as required by the City to meet its local obligations and
regulations. The City will prescribe the report format, as well as the time and location for submission of
such reports. Required reports include but are not limited to the following:
(A) Quarterly reports which shall include the progress made to date, or justification for lack of
progress, in providing the services specified in Article I, Section 1, Scope of Services, of this
Agreement, including demographic and income information regarding persons assisted by the
Recipient through this Agreement.
(B) Mid-term and end-of-term progress reports on the measurable outcomes specified in Article I,
Section 1, Scope of Services, of this Agreement.
(C) Close out reports including a final performance report and final financial report, upon
termination or completion of the award.
Quarterly reports are due 15 calendar days after the reporting period. The final performance report will
be due 30 calendar days after the Agreement term expires.
In addition, the Recipient will promptly notify the City at the address specified in Section 9 below of any
change in Recipient’s personnel directly connected with the Project or administration of HSP funds
subject to this Agreement, including Recipient’s Executive Director.
ARTICLE II FINANCIAL CONDITIONS
SECTION 1 BUDGET AND COMPENSATION
The City shall reimburse the Recipient its allowable costs for the services identified in this
Agreement not to exceed ONE HUNDRED AND TWENTY-SIX THOUSAND DOLLARS ($126,000), upon
presentation of properly executed reimbursement forms as provided or approved by the City.
Such reimbursement shall constitute full and complete payment by the City under this
Agreement. Allowable costs shall mean those necessary and proper costs identified in the Recipient’s
Competitive Process application and approved by the City unless any or all such costs are disallowed by
the State of Colorado.
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Any reimbursements made under this Agreement must comply with the applicable City
regulations. The Recipient may not request disbursement of funds under this Agreement until the funds
are needed for payment of eligible costs. The amount of each request must be limited to the amount
needed.
Time of Payment: Payment shall be made within 30 days of receipt of accurate and complete
reimbursement request documents submitted through ZoomGrants.
Where Payments Are Made: Payments shall be made to: Neighbor to Neighbor, 1550 Blue Spruce
Drive, Fort Collins, CO 80524 or by electronic deposit into Recipient’s bank account, whichever system is
established by Recipient with the City.
The Recipient shall apply the funds received from the City under this Agreement in accordance with the
parameters outlined in Article I, Section 1, Scope of Services. Any line item expense, by itself - or in
combination with any other line item expense change, equal to or greater than 10% of the total budget
amount over the life of the Agreement - shall require a formal amendment to the Agreement. Any
request for a line item expense, by itself - or in combination with any other line item expense change,
equal to or less than 10% of the total budget amount - shall be submitted in writing and shall specifically
state the reasons for the requested increase and a justification for the corresponding decrease in other
line item(s). All budget revision and/or amendment requests will be reviewed and approved or denied
by the City.
SECTION 2 DOCUMENTATION OF COSTS AND OTHER FINANCIAL REPORTING
All costs shall be supported by properly executed payrolls, time records, invoices, vouchers or
other official documentation, as evidence of the nature and propriety of the charges. All accounting
documents pertaining in whole or in part to this Agreement shall be clearly identified and readily
accessible, and upon reasonable notice, the City shall have the right to audit the records of the Recipient
as they relate to the work. The Recipient shall also:
(A) Maintain an effective system of internal fiscal control and accountability for all KFCG HSP funds
and property acquired or improved with KFCG HSP funds, and ensure the same are used solely
for authorized purposes.
(B) Keep a continuing record of all disbursements by date, check number, amount, vendor,
description of items purchased and line item from which money was expended, as reflected in
the Recipient’s accounting records. The line item notations must be substantiated by a receipt,
invoice marked “Paid,” or payroll record.
(C) Maintain payroll, financial, and expense reimbursement records for a period of five (5) years
after receipt of final payment under this Agreement.
(D) Permit inspection and audit of its records with respect to all matters authorized by this
Agreement by representatives of the City, or the State Auditor at any time during normal
business hours and as often as necessary.
(E) Inform the City concerning any funds allocated to the Recipient, that the Recipient anticipates
will not be expended during the Agreement period, and permit reassignment of the same by the
City to other Recipients.
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(F) Repay to the City any funds in its possession at the time of termination of this Agreement that
may be due to the City.
(G) By executing this Contract, Recipient verifies and affirms that it has not been suspended or
debarred from participating in or receiving federal government contracts, subcontracts, loans,
grants or other assistance programs.
SECTION 3 REIMBURSEMENT
The City shall reimburse the Recipient only for actual incurred costs upon presentation of
properly executed reimbursement forms approved by the City. Only those allowable costs directly
related to the Agency’s Competitive Process application, approved by the City shall be paid consistent
with Article II, Section 2, Documentation of Costs and Other Financial Reporting. The amount of each
request must be limited to the amount needed for payment of eligible costs. The City will not issue more
than 50% of the total grant award for reimbursement in any quarterly reimbursement period unless
such a payment is (1) specifically provided for in this Agreement; or (2) otherwise requested in advance
in writing by the Recipient and authorized by the City.
In the event the City determines any funds were expended by the Recipient for unauthorized or
ineligible purposes - or the expenditures constitute disallowed costs in any other way - the City may
order repayment of the same. The Recipient shall remit the disallowed amount to the City within thirty
(30) days of written notification of the disallowance.
(A) The Recipient agrees that funds determined by the City to be surplus upon completion of the
Agreement will be subject to cancellation by the City.
(B) The City shall be relieved of any obligation for payments if funds allocated to the City cease to
be available for any cause other than misfeasance of the City itself.
(C) The City reserves the right to withhold payments pending timely delivery of program reports or
documents as may be required under this Agreement.
SECTION 4 PROGRAM INCOME
Use of any program income received by the Recipient as a result of, or in connection with, KFCG
HSP funds shall be used for the current operation and benefit of the specific program/project for which
KFCG HSP funding was awarded.
ARTICLE III. GENERAL CONDITIONS
SECTION 1 BENEFIT TO LOW INCOME PEOPLE
All Recipients providing direct benefit services shall provide such services to benefit extremely
low, very low, and low income persons to the maximum extent feasible (but not less than 51% of the
persons receiving the service). Individual persons or families provided a specific direct benefit or service
must qualify under current income eligibility limits (% of Area Median Income), as established by the
Department of Housing and Urban Development (HUD). Any deviation can be made only if it is clear
that the service or benefit, to a person whose income exceeds very low and low income persons, is
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otherwise necessary as an integral part of the activity. The Recipient shall maintain records that clearly
document the income range and household size of the persons it serves. Furthermore, the Recipient
shall maintain records documenting if the person being served is a female or male head of household, is
an ethnic/racial minority, and/or has a disability.
SECTION 2.1 COMPLIANCE WITH LAWS
The Recipient, in performance of this Agreement, agrees to comply with all applicable Federal,
State and local laws, regulations and ordinances. Recipient agrees to comply with all provisions of the
Americans with Disabilities Act and all regulations interpreting or enforcing such act.
SECTION 2.2 COMPLIANCE WITH C.R.S. § 24-76.5-101 (HB1023): Proof of Lawful Presence
Recipient acknowledges that the City funds are a “public benefit” within the meaning of C.R.S. §
24-76.5-102. As such, the Recipient shall ensure compliance with C.R.S. § 24-76.5-103 by performing the
required verifications as appropriate. Specifically, when required the Recipient shall ensure that:
a. If the public benefit provided by the funds flows directly to a natural person (i.e., not a
corporation, partnership, or other legally-created entity) 18 years of age or older,
he/she must do the following:
(i) complete the affidavit attached to this Agreement as Exhibit A.
(ii) attach a photocopy of the front and back of one of the following forms of
identification: a valid Colorado driver’s license or Colorado identification card; a
United States military card or military dependent’s identification card; a United
States Coast Guard Merchant Mariner identification card; or a Native American
tribal document.
b. If an individual applying for the benefits identified herein executes the affidavit stating
that he/she is an alien lawfully present in the United States, Recipient shall verify his/her
lawful presence through the federal systematic alien verification or entitlement
program, known as the “SAVE Program,” operated by the U.S. Department of Homeland
Security or a successor program designated by said department. In the event Recipient
determines through such verification process that the individual is not an alien lawfully
present in the United States, the Recipient shall not provide benefits to such individual
with City funds.
City acknowledges that the Scope of Services provided by Recipient herein may fall within
several exceptions to the verification requirements of C.R.S. § 24-76.5-103 for non-profits. For example,
certain programs, services, or assistance such as, but not limited to, soup kitchens, crisis counseling and
intervention, short-term shelter or prenatal care are not subject to the verification requirements of
C.R.S. § 24-76.5-103.
SECTION 2.3 COMPLIANCE WITH C.R.S. § 8-17.5-101 (HB 1343): Prohibition Against
Employing Illegal Aliens
Recipient represents and agrees that:
1. As of the date of this Agreement:
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A. Recipient does not knowingly employ or contract with an illegal alien who will
perform work under this Agreement; and
B. Recipient will participate in the electronic employment verification program
created in Public Law 104-208, as amended, and expanded in Public Law 108-156, as
amended, and jointly administered by the United States Department of Homeland
Security and the Social Security Administration, or its successor program (the “E-verify
Program”) in order to confirm the employment eligibility of all employees who are
newly hired for employment to perform work under this Agreement.
2. Recipient shall not knowingly employ or contract with an illegal alien to perform work under
this Agreement or enter into a contract with a subcontractor that fails to certify to Recipient
that the subcontractor shall not knowingly employ or contract with an illegal alien to perform
work under this Agreement.
3. Recipient has confirmed the employment eligibility of all employees who are newly hired for
employment to work under this Agreement through either the E-verify Program or the
employment verification program established by the State of Colorado, pursuant to Section 8-
17.5-102 (5)(c), C.R.S. (the “Department Program”).
4. Recipient is prohibited from using the E-verify Program or the Department Program
procedures to undertake pre-employment screening of job applicants while this Agreement is
being performed.
5. If Recipient obtains actual knowledge that a subcontractor performing work under this
Agreement knowingly employs or contracts with an illegal alien, Recipient shall:
A. Notify such subcontractor and the City within three days that Recipient has actual
knowledge that the subcontractor is employing or contracting with an illegal alien;
and
B. Terminate the subcontract with the subcontractor if within three days of receiving
the notice required pursuant to this section the subcontractor does not cease
employing or contracting with the illegal alien; except that Recipient shall not
terminate the contract with the subcontractor if during such three days the
subcontractor provides information to establish that the subcontractor has not
knowingly employed or contracted with an illegal alien.
6. Recipient shall comply with any reasonable request by the Colorado Department of Labor and
Employment (the “Department”) made in the course of an investigation that the Department
undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5),
C.R.S.
7. If Recipient violates any provision of this Agreement pertaining to the duties imposed by
Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is so
terminated, Recipient shall be liable for actual and consequential damages to the City arising out
of Contractor’s violation of Subsection 8-17.5-102, C.R.S.
8. The City will notify the Office of the Secretary of State if Recipient violates this provision of
this Agreement and the City terminates the Agreement for such breach.
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SECTION 3 FEDERAL STANDARDS FOR EMPLOYMENT PRACTICES
The Recipient shall comply with Executive Order 11246 as amended by Executive Order 12086
and the regulations issued pursuant thereto (41 CFR Chapter 60) will not discriminate against any
employee or applicant for employment because of race, color, creed, religion, ancestry, national origin,
sex, disability or other handicap, age, marital status, or status with regard to public assistance. The
Recipient will take affirmative action to ensure that all employment practices are free from such
discrimination. Such employment practices include but are not limited to the following: hiring,
upgrading, demotion, transfer, recruitment or recruitment advertising, layoff, termination, rates of pay
or other forms of compensation and selection for training, including apprenticeship.
The Recipient agrees to post in conspicuous places, available to employees and applicants for
employment, notices setting forth the provisions of this nondiscrimination clause. The Recipient will, in
all solicitations or advertisements for employees placed by or on behalf of the Recipient, state that it is
an Equal Opportunity or Affirmative Action Employer.
Where employees are engaged in activities not covered under the Occupational Safety and Health
Act (OSHA) of 1970, they shall not be required or permitted to work, be trained or receive services in
buildings or surroundings or under working conditions which are unsanitary, hazardous or dangerous to
the participants’ health or safety.
SECTION 4 DISCRIMINATION PROHIBITED
(A) The Recipient shall not, on the grounds of race, color, national origin, religion, creed, disability,
age, sex, actual or perceived sexual orientation, gender identity, marital status, familial status, or
because a family includes children:
(1) Deny a qualified individual any facilities, financial aid, services or other benefits
provided under this Agreement;
(2) Provide any facilities, services, financial aid, or other benefits which are different, or are
provided in a different manner, from those provided to others under this Agreement;
(3) Subject an individual to segregated or separate treatment in any facility in, or in any
matter if process related to receipt of any service or benefit under this Agreement;
(4) Restrict an individual in any way in access to, or in the enjoyment of any advantage or
privilege enjoyed by others in connection with any service or benefit under this
Agreement;
(5) Treat anyone differently from others in determining if they satisfy any admission,
enrollment, eligibility, membership or other requirement or condition which the
individual must meet to be provided a service or benefit under this Agreement;
(6) Deny anyone an opportunity to participate in any program or activity as an employee,
which is different from that afforded others under this Agreement.
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SECTION 5 CONFLICT OF INTEREST
No member, officer, or employee of the Recipient, or its designees or agents, no member of the
governing body of the City of Fort Collins, and no other public official, employee, or Board or
Commission member of the City of Fort Collins, who exercises any function or responsibilities with
respect to the program during his tenure or for one year thereafter, shall have any interest, direct or
indirect, in this Agreement or any Subagreement, hereto or the proceeds thereof. Any potential conflict
on the part of any of these parties shall be disclosed to representatives of the City’s Social Sustainability
Department or the City’s Attorney’s Office.
SECTION 6 SEPARATION OF CHURCH AND STATE
In addition to, and not in substitution for, other provisions of this Agreement regarding the
provision of services utilizing Human Service Program funds the Recipient agrees that, in connection
with such services:
(A) It will not discriminate against any employee or applicant for employment on the basis of
religion and will not limit employment or give preference in employment to persons on the basis
of religion;
(B) It will not discriminate against any person applying for such public services on the basis of
religion and will not limit such services or give preference to persons on the basis of religion;
(C) It will provide no mandatory religious instruction or counseling, conduct no religious worship or
services, engage in no religious proselytizing, and exert no other religious influence in the
provision of such services;
SECTION 7 LICENSING AND PROGRAM STANDARDS
The Recipient agrees to comply with and to obtain at its own expense, if necessary, all
applicable Federal, State, County or Municipal standards for licensing, certification and operation of
facilities and programs, and accreditation and licensing of individuals, and any other standards or criteria
as described in the Agreement to assure quality of services.
In the event of an investigation or suspension regarding any licensing related to the services for which
the City is providing funding under this Agreement, the City may terminate this Agreement and withhold
all further Agreement funds. In addition, monies already received under the terms of this Agreement,
may be owed back to the City. The City may also declare the Recipient ineligible for any further
participation in City Human Service Program (HSP), Keep Fort Collins Great (KFCG) Community
Development Block Grant (CDBG), HOME Investment Partnership (HOME), or Affordable Housing Fund
(AHF) Agreements.
SECTION 8 INDEMNITY
The Recipient agrees to defend, indemnify and save harmless the City, its appointed and elected
officers and employees from and against any and all liability, loss, costs, damage and expense, including
costs and attorney fees in defense thereof because of actions, claims or lawsuits for damages resulting
from personal or bodily injury, including death at any time resulting from there, sustained or alleged to
have been sustained by any person or persons and on account of damage to property, arising or alleged
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to have arisen directly or indirectly out of or in consequence of or the performance of this Agreement,
whether such injuries to persons or damage to property is due to the negligence of Recipient, its
subcontractors, agents, successor, assigns. This provision shall be inapplicable to the extent the City is
judicially found solely negligent for such damage or injury.
SECTION 9 NOTICES
Any notices required to be given by the City to the Recipient or by the Recipient to the City shall
be in writing and delivered to the following parties by hand, by U.S. Mail, or by overnight commercial
courier at the following addresses:
City: Recipient:
Human Services Program Executive Director
Social Sustainability Department Neighbor to Neighbor
City of Fort Collins 1550 Blue Spruce Drive
PO Box 580 (222 Laporte Ave, 80521) Fort Collins, CO 80524
Fort Collins, CO 80522-0580
Notices shall be deemed received upon delivery if delivered by hand, the next business day if sent by
commercial courier, or on the third business day after mailing if sent by U.S. Mail.
SECTION 10 CITIZEN AND CLIENT PARTICIPATION
The Recipient will have processes in place (satisfaction surveys, Board representation, grievance
procedures, etc.) which receive, document and utilize the input from low-income persons potentially
benefiting or affected by the program or project covered under this Agreement.
SECTION 11 ASSIGNMENT AND SUBCONTRACTING
The Recipient shall not assign or subcontract any portion of the services provided within the
terms of this Agreement without obtaining prior written approval from the City. All terms and
conditions of this Agreement shall apply to any approved subcontract or assignment related to the
Agreement.
SECTION 12 RESERVATION OF RIGHTS
Failure to insist upon strict compliance with any terms, covenants or conditions of this
Agreement shall not be deemed a waiver of such, nor shall any waiver or relinquishment of such right or
power at any time be taken to be a waiver of any other breach.
SECTION 13 AMENDMENTS TO AGREEMENT
The parties hereby further agree that this Agreement cannot be amended or modified without
the written concurrence of both parties.
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SECTION 14 FAILURE TO PERFORM
In the event of a failure by the Recipient to comply, with any terms or conditions of this
Agreement or to provide in any manner the activities or other performance as agreed to herein, the City
reserves the right to temporarily withhold all or any part of payment pending correction of the
deficiency, suspend all or part of the Agreement, or prohibit the Recipient from incurring additional
obligations of funds until the City is satisfied that corrective action has been taken or completed. The
option to withhold funds is in addition to, and not in lieu of, the City’s right to terminate as provided in
the General Conditions, Article III, Section 15, Termination, of this Agreement. The City may consider
performance under this Agreement when considering future awards.
SECTION 15 TERMINATION
If the Recipient fails to comply with the terms and conditions of this Agreement, the City may
pursue such remedies as are available, including but not limited to, the termination of this Agreement in
the manner specified herein.
(A) Termination for Cause - If the Recipient fails to comply with the terms and conditions of this
Agreement and any of the following conditions exist:
(1) The lack of compliance with the provisions of this Agreement is of such scope and
nature that the City deems continuation of this Agreement to be substantially non-
beneficial to the public interest;
(2) The Recipient has failed to take satisfactory corrective action as directed by the City or
its authorized representative within the time specified by same;
(3) The Recipient has failed within the time specified by the City or its authorized
representative to satisfactorily substantiate its compliance with the terms and
conditions of this Agreement.
The City may terminate this Agreement in whole or in part; and thereupon shall notify in writing
the Recipient of the termination, the reasons therefore, and the effective date. The effective date shall
not be prior to notification of the termination by the City to the Recipient. Costs resulting from
obligations incurred by the Recipient after termination of the Agreement are not allowable unless
specifically authorized in writing by the City.
(B) Termination for Convenience - The award may be terminated for convenience, in whole or in
part, as follows:
(1) By the City with the consent of the Recipient. The two parties shall agree upon the
termination conditions, including the effective date and in the case of partial
termination, the portion to be terminated, or
(2) By the Recipient upon submitting written notification to the City. The written
notification must set forth the reasons for the termination, the effective date, and in the
case of partial termination, the portion to be terminated. However, in the case of a
proposed partial termination, the City may terminate the award in its entirety if the City
determines that the remaining portion will not accomplish the purpose for which the
award was made.
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(C) Termination for Withdrawal, Reduction or Limitation of Funding
In the event that funding is withdrawn, reduced or limited in any way after the effective date of
this Agreement, and prior to its normal completion, the City may summarily terminate this
Agreement as to the funds reduced or limited, notwithstanding any other termination provision
of this Agreement. If the level of funding so reduced or limited is so great that the City of Fort
Collins deems that the continuation of the program covered by the Agreement is no longer in
the best interest of the public, the City may summarily terminate this Agreement in whole
notwithstanding any other termination provisions of this Agreement. Termination under this
Section shall be effective upon receipt of written notice by the Recipient or its representative.
(D) Remedies
In the event of termination for cause, the City may pursue any remedies available to it at law or
in equity, including, without limitation, damages, specific performance, and criminal remedies.
SECTION 16 CLOSE-OUT
Upon termination of this Agreement, in whole or in part for any reason including completion of
the project, the following provisions shall apply:
(A) Upon written request by the Agency, the City shall make or arrange for payment to the
Recipient of allowable reimbursable costs not covered by previous payments.
(B) The Recipient shall submit within thirty (30) days after the date of expiration of this Agreement,
all financial, performance and other reports required by this Agreement, and in addition, will
cooperate in a program audit by the City or its designee.
(C) Close-out of funds will not occur unless all outstanding issues with the general contractor and or
subcontractor have been resolved to the satisfaction of the City.
SECTION 17 VENUE AND CHOICE OF LAW
If either party to this Agreement initiates any legal or equitable action to enforce the terms of
this Agreement, to declare the rights of the parties under this Agreement, or which relates to this
Agreement in any manner, the City and the Recipient agree that the proper venue for such action is the
Larimer County, Colorado, District Court. It is mutually understood and agreed that this Agreement shall
be governed by the laws of the State of Colorado, both as to interpretation and performance.
SECTION 18 SEVERABILITY CLAUSE
It is understood and agreed by the parties that if any part, term, or provision of this Agreement
is held by the courts to be illegal or in conflict with any law of the state where made, the validity of the
remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall
be construed and enforced as if the Agreement did not contain the particular part, term, or provision
held to be invalid.
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SECTION 19 INTEGRATED DOCUMENT
This Agreement with any attachments, the Recipient’s corresponding application for the City’s
Competitive Process, incorporated by reference, and the Recipient’s presentation before the CDBG
Commission, incorporated by reference, constitute the entire agreement between the parties and both
parties acknowledge that there are no other agreements, written or oral, that have not been fully set
forth in the text of this Agreement.
SECTION 20 AUTHORITY TO SIGN
The persons signing this Agreement on behalf of the Recipient hereby affirm that all
representations made by the Recipient to the City either in this Agreement or for the purpose of
inducing the City to execute this Agreement are true, correct, honest and forthright, and that one or
both of them have the authority to bind the Recipient to the terms of this Agreement.
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IN WITNESS WHEREOF, the parties have executed this Agreement as of the date of the most recent
signatory.
THE CITY OF FORT COLLINS, COLORADO
A Municipal Corporation
Date: _________________________ By: __________________________________
Darin A. Atteberry, City Manager
ATTEST:
______________________________
City Clerk
______________________________
(Printed Name)
APPROVED AS TO FORM:
______________________________
Assistant City Attorney
______________________________
(Printed Name)
SUBRECIPIENT:
NEIGHBOR TO NEIGHBOR
Date: _________________________ By: _____________________________________
President, Board of Directors
By: _____________________________________
Executive Director
Federal I.D. #: 84-0630214
ATTEST:
______________________________
Board Secretary
(Corporate Seal)
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9/23/2019
Ingrid Decker
Delynn Coldiron
9/25/2019
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EXHIBIT A
AFFIDAVIT PURSUANT TO C.R.S.24-76.5-103
I, _____________________________________, swear or affirm under penalty of perjury
under the laws of the State of Colorado that (check one):
_____ I am a United States citizen, or
_____ I am a Permanent Resident of the United States, or
_____ I am lawfully present in the United States pursuant to Federal law.
I understand that this sworn statement is required by law because I have applied for a public benefit.
I understand that state law requires me to provide proof that I am lawfully present in the United
States prior to receipt of this public benefit. I further acknowledge that making a false, fictitious, or
fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of
Colorado as perjury in the second degree under Colorado Revised Statute 18-8-503 and it shall
constitute a separate criminal offense each time a public benefit is fraudulently received.
____________________________________ ___________________________
Signature Date
INTERNAL USE ONLY: Valid Forms of Identification
• current Colorado driver’s license, minor driver’s license, probationary driver’s license,
commercial driver’s license, restricted driver’s license, instruction permit
• current Colorado identification card
• U.S. military card or dependent identification card
• U.S. coast guard merchant mariner card
• Native American tribal document
DocuSign Envelope ID: 51EC2DAA-2721-4264-97AE-7EA0A0A80F6E