HomeMy WebLinkAboutC02-205 RSVP annual grant application- 3 L �)
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PART I - FACE SHEET
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APPLICATION FOR FEDERAL ASSISTANCE
1. TYPE OF SUBMISSION:
Non- Constmction
2a. DATE SUBMITTED TO CORPORATION
3. DATE RECEIVED BY STATE:
STATE APPLICATION IDENTIFIER:
FOR NATIONAL AND COMMUNITY
SERVICE (CNCS):
4. DATE RECEIVED:
GRANTNUMBER: '
2b. APPLICATION ID:
03SR020628
5. APPLICATION INFORM4TION
LEGALNAME: EAGLE CO GOVCHLTH &HUMAN SVCS
NAME AND CONTACT INFORMATION FOR PROJECT DIRECTOR OR OTHER
PERSON TO BE CONTACTED ON MATTERS INVOLVING THIS APPLICATION (give
area codes):
NAME: Kathleen Fort nash
ADDRESS (give street address, city, state and ap code):
TELEPHONE NUMBER: 970- 328 -8858
500 Broadway
Eagle GO 81631
FAXNUMBER: 970 - 328 -8229
INTERNET E -MAIL ADDRESS: volnimc@cagle- county.com
6. EMPLOYER IDENTIFICATION NUMBER (EIM:
7. TYPE OF APPLICANT:
846000762
7a. Local Goverment- County
7b.
8. TYPE OF APPLICATION:
❑X NEW CONTINUATION
❑ REVISION
If Revision, enter appropriate letter(s) in box(es): O E]
A. Increase Award B. Decrease Award C. Increase Duration
D. Decrease Duration
9. NAME OF FEDERAL AGENCY:
Corporation for National and Community Service
10a. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 94.002
11. DESCRIPTIVE TITLE OF APPLICANTS PROJECT:
10b. TITLE: Retired and Senior Volunteer Program
EAGLE/SUMMIT CO RSVP
12. AREAS AFFECTED BY PROJECT (List Cities, Counties, States, etc):
Eagle CO: Basalt,Eagle, Gypsum Mintum, RedcliQ Vail, McCoy Sumrit CO: Dillion,
Frisco, Breckenridge, Silverthome
13. PROPOSED PROJECT: START DATE: 09/01/02 END DATE: 08/31/03
14. PERFORMANCE PERIOD: START DATE: END DATE:
15. ESTIMATED FUNDING:
16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE
ORDER 12372 PROCESS?
a. FEDERAL
S 94,943.00
YES, THIS PREAPPLICATION /APPLICATION WAS MADE AVAILABLE
b. APPLICANT
$ 41,896.00
TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR
REVIEW ON:
c. STATE
S 0.00
DATE:
d. LOCAL
S 41,896.00
e. OTHER
S 0.00
f. PROGRAM INCOME
S 0.00
17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT?
YES if "Yes;' attach an explanation. NO
g. TOTAL
5 136,839.00
18. 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 THE ASSISTANCE
IS AWARDED.
a. TYPED NAME OF D REPRESENTATIVE:
b. TITLE:
c. TELEPHONE NUMBER:
Am N. Menconi
- l'4 I and ofCounty Comrissio
(970)328 -8605 Ar
6 O A
d. DATE:
6 -f 1
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