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HomeMy WebLinkAboutC01-192 Rural Resort Region RSVP Application for Federal AssistanceC PART, I - FACESHEET APPLICATION FOR FEDERAL ASSISTANCE 1. TYPE OF SUBMISSION: Application Non-Construction 2. DATE SUBMITTED TO CORPORATION FOR 3. a. DATE RECEIVED BY STATE. 3.b. STATE APPLICATION IDENTUML- NATIONAL SERVICE (CNS): June 26,2001 4. a. DATE RECEIVED BY CNS: 41. CNS GRANT NUM[BER:- 440W164-03 5. APPLICANT INFORMATION LEGALNAIAE: Eagle County Government NAME AM CONTACT INFORMATION FOR PROJECT DIRECTOR OR OTHER PERSON TO BE CONTACTED ON MATTERS INVOLVING THIS APPLICATION (give ORGANIZATIONALUNIT- Health & Human Services ama codes): NAME. . Kathleen Forinash ADDRESS (give street addmu, city. cowty, state andmp code): P.O. Box 660 TELEPHONE NUMBER- ( 970' ) 328 - 8858 Eagle, CO 81631 FAXNUMBER-(970 ) 328 - 6227 INTERNET E-MAIL ADDRESS: f o rinash@vail.net 6. EMPLOYER IDENTIFICATION NUMBER (EUq: 7- TYPE OF APPLICANT- (enter appropriate letter i. box) 18 14 1 - 16 1010 1 01 7 1 A. State 17L Independent School District 8. TYPE OF APPLICATION (Check appropriate box): ❑NEW CONTINUATION B. county L State Controlled Institution olHigherLearaing C. Municipal J. Private University []REVISION D. Township K. Indian Tribe IfRevision, enter appropriate letter(s) in box(es): ❑ ❑ E. Interstate L Individual - F. Intermunicipid K Profit Organization G. Special District N Private Non-Prafit aVonzauou A. Increase Award B. Decrease Award C. Increase Duration O. Other D. Decrease Duration E. Other (specify): 9. NAME OF FEDERAL AGENCY: Corporation for National Service, 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER- 11. DESCRIPTIVE I TITLE OF APPLICANTS PROJECT: RSVP: 94.002 FGP: 94.011 Rural Resort Region'RSVP - §erves older SCP: 94.016 M94 1 01 o 12 Senior Demonstration: adults, volunteer agencies and communities in Eagle and Summit Counties Colorado 12. AREAS AFFECTED BY PROJECT (List Cities, Counties, states, etc): Eagle CO: Basalt, Eagle, Gypsum, Minturn, RedCliff, Vail,McCoy Summit CO: Dillion, Frisc rec nri ilverthorne- 13 ATE: PROPOSUOJECiP SW �d END ,9t-:pt-PmbPr 30. 2001 Sentamber 29, 2002 14. ESTIMATED FUNDING: 15. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS? a. FEDERAL S 91,291 a. YES, THIS PREAPPLICATIONIAPPLICATION WAS MADE AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR b. APPLICANT $ 39,125 REVIEW ON: DATE c. STATE $ —0— b. NO. E] PROGRAM IS NOT COVERED By E.O_ 12372 ❑ OR PROGRAM HAS NOT BEEN SELECTED By STATE FOR REVIEW d. LOCAL S —0— c. OTHER —0— 16. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBI-) YES If"Yes:' attach anexplanation. ❑ NO LTOTAL 17. To THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/pREAppLICATION ARE TRUE AND CORRECT!, THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF TILE ASSISTANCE IS AWARDED. a. TYPED NAME OF AUTHORIZED REPRESENTATIVE: c. TELEPHONE NUMBER. Tom..C. Stone Chairman, Board o orers (970) 328-6805 d. SIGNATURE OF AUTHORIZED c. DATE SIGNED: Modified StniidardWr-m 424-NSSr /`V.�, 410' O PAGE 12