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HomeMy WebLinkAboutC08-263APPLICATION FOR 2. DATE SUBMITTED: Applicant Identifier 08CH0149 FEDERAL ASSISTANCE 9/16/2008 1. TYPE OF SUBMISSION Application Preapplication 3. DATE RECEIVED BY STATE: State Application Identifier Construction Non-Construction ~ Construction 0 Non•Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier 5. APPLICANT INFORMATION Legal Name: Eagle County Health & Human ServiCeS ESH Organizational Unk: Department: Organizational DUNS: 08402447 Division: Address: Name and telephone number of the person to be contacted on matters treet: 551 Broadway involving this application (give area code) POB 660 Pre ix: First Name: Jennie City: Eagle Middle Name: County: Eagle Last Name: Wahrer State: C Zip Code: 81631 Su x: ountry: U A mail: jennie.vvahrer#eaglecounty.us 6. EMPLOYER IDENTIFICATION NUMBER (EIN) 8 4 . 6 0 0 0 7 6 2 Phone Number (give area code) 970-569-3184 Fax Number (give area code) 970-328-8829 8. TYPE OF APPLICATION New ~ Continua^U'on 8 Revision If Revision, enter appropriate letter(s) in box(es): 7. TYPE OF APPLICANT (enter appropriate letter in box) ^g Other (specify) Other (specify) 9. NAME OF FEDERAL AGENCY: Office of Head Start 10. CATALOG OF FEDERAL DOMESTIC 9 3 ^ 6 0 0 ASSISTANCE NUMBER: TITLE (Name of Program):Eady Head Start 11. DESCRIPTNE TITLE OF APPLICANT'S PROJECT: 2009 Continuation & TITA plan 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States etc.): Eagle County 13. PROPOSED PROJECT: 14. CONGRESSIONAL DISTRICTS OF: Start Date: 1101/2009 Ending Date: 12131/2009 a. Applicant3rd DisVict b. Project 3rd District 15. ESTIMATED FUNDING 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS? a Federal $ 404,783.00 a. YES THIS PREAPPLICATIONIAPPLICATION WAS MADE AVAILABLE TO THE STATE b Applicant $ 212,896 .00 EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON c State S 0 .00 Date d Local $ 0 .00 b. NO ~ PROGRAM IS NOT COVERED BY E.O. 12372 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW e Other $ 0 .00 f Program Income $ 0 .00 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g Total $ 617,679.00 ~ Yes If "Yes," attach an explanation. ~ No 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION 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. Authorized Representative Prefix First Name Peter Middle Name f. Last Name Runyon C Q Suffix b. Title Chair, BoCC v ~ ~~ c. Telephone number g70-328-8605 d. Signature of Authorized Representative a Date Signed Standard Form 4Z4 (Rev.9-2003) Prescribed by OMB Circular A-102 BUDGET INFORMATION -Non-Construction Programs OMB Approval No. 0348-0044 SEGTI4N A-BUDGET SUMMARY Grant Program Function Catalog of Federal Domestic Assistance Estimated Unobligated Funds New or Revised Budget or Activity (a) Number (b) Federal Non-Federal Federal Non-Federal Total 1. Program Operation 93.600 $395,201 $212,896 $608,097 2. T&TA 93.600 $9,582 $9,582 3. 4. 5. Totals $404,783 $212,896 $617,679 SECTION B -BUDGET GATEGQRIES 6 Object Class Cate ories GRANT PROGRAM, FUNCTION OR ACTIVITY Total . g (1) Program Operation (2) T&TA (3) (4) a. Personnel $337,480 $337,480 b. Fringe Benefits $17,182 $17,182 c. Travel $494 $494 d. Equipment e. Supplies $16,090 $16,090 f. Contractual $10,454 $10,454 g. Construction h. Other $13,501 $9,582 $23,083 i Total Direct Charges (sum of 6a - 6h) $395,201 $9,582 $404,783 j. Indirect Costs k. TOTALS (sum of 6a - 6j) $395,201 $9,582 $404,783 7. Program Income Authorized for Locai Reproduction Standard Form 424A (Rev. 7-97) Prescribed by OMB Circular A-102 08CH0149 / 0 2009 Eagle County Health ~ Human Services ESH Basic EHS Grant Application Continuation Authorized for Local Reproduction 08CH0149 / 0 2009 Eagle County Health & Human Services ESH Basic EHS Grant Application Standard Form 424A (Rev. 7-97) Paget Continuation U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPENDIUM OF REQUIRED CERTIFICATIONS AND ASSURANCES SF 4246 ASSURANCES -NON-CONSTRUCTION PROGRAMS Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the intergovernmental Personnel Act of 1970 (42 U.S.C. 4278-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM=s Standards for a Merit System of Personnel Administration (5 CFR 900, Subpart F). 6. Will comply with all Federal statutes relating to non-discrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the bases of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to non-discrimination on the basis of drug abuse; (>) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to non-discrimination on the bases of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of the alcohol and drug abuse patient records; (h) Title Vll of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to non-discrimination in the sale, rental or financing of housing; (I) any other non-discrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (1) the requirements of any other non-discrimination statute(s) which may apply to the application. 7. Will comply, or has already complies, with the requirements of Titles ll and 111 of the Uniform Relocation Assistance and Rea! Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or Federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C. 874), and the Contract Work Hours and 'Safety Standards Act (40 U.S.C. 327-333), regarding labor standards for Federally assisted construction subagreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10, 000 or more. 11. Will comply with environmental standards which maybe prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451 et seq.); (t) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205) 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P. L. 89-544, as amended, 7 U. S. C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.) which prohibits the use of lead based paint in the construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the single Audit Act of 1984. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. DRUG-FREE WORKPLACE REQUIREMENTS GRANTEES OTHER THAN INDIVIDUALS By signing and/or submitting this application or grant agreement, the grantee is providing the certification sef out below. This certification is required by regulations implementing the Drug-Free Workplace Act of 1988, 45 CFR, Part 76, Subpart F. The regulations published in the January 31, 1989 Federa! Register, require certification by grantees that they will maintain adrug-free workplace. The certification set out below is a material representation of fact upon which reliance will be placed when HHS determines to award the grant. False certification or violation of the certification shall be grounds for suspension of payments, suspension or termination of grants, or government-wide suspension or debarment. Workplaces under grants, for grantees other than individuals, need not be identified on the certification. If known, they maybe identified in the grant application. If the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee must keep the identity of the workplace(s) on file in its office and make the information available for Federal inspection. Failure to identify alI known workplaces constitutes a violation of the grantee's drug-free workplace requirements. Workplace identifications must include the actual address of buildings (or parts of building) or other sites where work under the grant takes place. Categorical descriptions maybe used (e.g. all vehicles of a mass transit authority of State highway department while in operation, State employees in each local unemployment office, performers in concert halls or radio studios). if the workplace identified to HHS changes during the performance of the grant, the grantee shall inform the agency of the change(s), it previously identified the workplaces in question (see above). Definitions of terms in the Nonprocurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification. Grantees' attention is called, in particular, to the following definitions from these rules: "Controlled substance"means a controlled substance in Schedules l through V of the Controlled Substances Act (21 USC 812) and as further defined by regulations (21 CFR, 1308.11 through 1308.15). "Conviction" means a finding of guilt (including a plea of no% contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the Federal of State criminal drug statutes; "Criminal drug statute"means aFederal ornon-Federal criminal statute involving the manufacture, distribution, dispensing use, or possession of any controlled substance; "Employee" means the employee of a grantee directly engaged in the performance of work under a grant including: (i) A// "direct charge"employees; (ii) al! "indirect charge" employees unless their impact of involvement is insignificant to the performance of the grant; and (iii) temporary personnel and consultants who are directly engaged in the performance of work under the grant and who are on the grantee's payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement; consultants or independent contractors not on the grantee's payroll, or employees of subrecipients or subcontractors in covered workplaces). The grantee certifies that it will provide adrug-free workplace by: a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; b) Establishing adrug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of be statement required by paragraph (a); d) Notifying the employee in the statement required by paragraph (a) that as a condition of employment under the grant, the employee will: (1) Abide by the terms of the statement,• and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; e) Notifying the agency in writing within ten days after receiving notice under subparagraph (d)(2), from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant the convicted employee was working, unless the Federal agency has designated a central point for the receipt ofsuch notices. Notice shall include the identification number(s) of each affected grant; fl Taking one of the fol%wing actions within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. g) Making a good faith effort to continue to maintain adrug-free workplace through implementation of paragraphs (a) through (f). CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal program either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds in medicare of medicaid; or facilities where W/C coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing this certification, the offeror/contractor (for acquisitions) or applicant/grantee (for grants) certifies that the submitting organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The submitting organization agrees that it will require that the language of this certification be included in any subawards which subrecipients shall certify accordingly. CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS -PRIMARY COVERED TRANSACTIONS By signing and submitting this proposal, the applicant, defined as the primary participant in accordance with 45 CFR Part 76 certifies to the best of his or her knowledge and believe that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transaction by any Federal Department or agency; (b) have not within a 3-year period preceding this proposal been convicted or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statement, or receiving stolen property; (c) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) have not within a 3-year period preceding this application/proposal had one or more public transaction (Federal, State or local) terminated for cause or default. The inability of a person to provide the certification required above will not necessarily result in denial of participation in this covered transaction. If necessary, the prospective participant shall submit an explanation of why it cannot provide the certification. The Department of Health and Human Services' (HHS) determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. The prospective primary participant agrees that by submitting this proposal, it will include the clause entitled 'Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions " provided below without modification in all lower tier covered transactions. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -LOWER TIER COVERED TRANSACTIONS (TO BE SUPPLIED TO LOWER TIER PARTICIPANTS) By signing and submitting this lower tier proposal, the prospective lower tier participant, as defined in 45 CFR, Part 76, certifies to the best of its knowledge and belief that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (b) where the prospective lower tier participant is unable to certify to any of the above, such prospective participant shall attach an explanation to this proposal. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause entitled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions, "without modification in all lower tier covered transactions and in all solicitations for lower tier covered transactions. CERTIFICATION REGARDING LOBBYING FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned certifies to the best of his or her knowledge and belief, that: (1) No Federal appropriate funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person influencing or attempting to influence an officer or employee or an agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this Federal contract, grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying,"in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certiflcafion is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required cert~cation shall be subject to a civil penalty or not less than $10, 000 and not more than $100, 000 for each such failure. l hereby a ee to the above certifications and assurances. I~ ignatu e of Certifying Official ~"k~~l ~ Vy~-i~~ Title ~((~~~, Date Applicant Organization Basic EHS Grant Application Eagle County Health & Human Services ESH 08CH0149 / 000 / 2009 Line Item Budget For Head Start and Early Head Start Line Item HS/NHS Cast for Program Operations MS/EHS Cost far Training 8~ echnicaE Assistance Nan-Federal Share (Cash and in-kind) Number of Persons Employed a.RER$ONNEL Child Health and Developmental Services Personnel 1 Program Managers 8~ Content Area Experts $84,495 $0 $0 1.10 2 Teachers/Infant Toddler Teachers 3 Family Child Care Personnel 4 Home Visitors $209,456 $0 $0 4.80 5 Teacher Aides & Other Education Personnel 6 Health/Mental Health Services Personnel 7 Disabilities Services Personnel 8 Nutrition Services Personnel 9 Other Child Services Personnel Family and Community Partnerships Personnel 10 Program Managers & Content Area Experts 11 Other Family 8~ Community Partnerships Personnel Program Design and Management Personnel 12 Executive Director/Other Supervisor of HS Director 13 Head Start/Early Head Start Director $36,041 $0 $0 0.40 14 Managers 15 Staff Development 16 Clerical Personnel 9/01 /2008 9:59:39 AM Basic EHS Grant Application Eagle County Health & Human Services ESH O8CHO149 / 000 / 2009 Line Item Budget For Head Start and Early Head Start HS/EHS Cast far Line Item HS/EHS Cost far Training & Nan-Federal Share Number of Persans Program Operations ethnical Assistance (Cash and in-kind) Employed 17 Fiscal Personnel 18 Other Administrative Personnel 9/01/2008 9:59:39 AM 4 Basic EHS Grant Application Eagle County Health & Human Services ESH 08CH0149 / 000 / 2009 Line Item Budget For Head Start and Early Head Start Line Item HS/EHS Cost for Program Operations HSfEHS Cost for Training ~ ethnical Assistance Nan-Federal Share (Cash and in-kind) Number of Persons Employed Other Personnel 19 Maintenance Personnel 20 Transportation Personnel 21 Other Personnel $7,488 $0 $0 0.03 TOTAL PERSONNEL (6a) $337,480 $0 $0 6.33 9/01 /2008 9:59:39 AM 5 Basic EHS Grant Application Eagle County Health & Human Services ESH 08CH0149 / 000 / 2009 Line Item Budget For Head Start and Early Head Start Line Item HS/EHS Cast for HS/EHS Cast far Training ~ Nan-Federal Share Program Operations Technical Assistance (Cash and in-kind} b. FRINGE BENEFITS 1 Social Security(FICA), State Disability, Unemployme $17 182 2 Health/Dental/Life Insurance , $0 $0 $8,062 3 Retirement $0 $141,050 4 Other Fringe $0 $0 $19,800 TOTAL FRINGE BENEFITS (6b) $17 182 , $0 $168,912 a. TRAVEL _. 1 Staff Out-Of-Town Travel $494 $0 $0 TOTAL TRAVEL (6c) $494 $0 $0 d. EQUIPMENT 1 Office Equipment 2 Classroom/Outdoor/Home-based/FCC 3 Vehicle Purchase 4 Other Equipment TOTAL EQUIPMENT (6d) e. SUPPLIES 1 Office Supplies $500 $0 $0 2 Child and Family Services Supplies $15,590 $0 $0 9/01 /2008 9:59:39 AM 6 Basic EHS Grant Application Eagle County Health & Human Services ESH 08CH0149 / 000 / 2009 Line Item Budget For Head Start and Early Head Start I-ine Item HSIEH5 Cost for HSlEHS Cast for Training ~ Program Operations Technical Assistance Non-Federal Share (Cash and in-kind} g. CONSTRUCTION 1 New Construction 2 Major Renovation 3 Acquisition of Buildings/Modular Unites TOTAL CONSTRUCTION (6g) 9/01 /2008 9:59:40 AM 7 3 Food Services Supplies 4 Other Supplies TOTAL SUPPLIES (6e) $16,090 $0 $0 Basic EHS Grant Application Eagle County Health & Human Services ESH 08CH0149 / 000 / 2009 Line Item Budget For Head Start and Early Head Start Line Item HS/EHS Cost for Program Operations NS/EHS Cost for Training & Technical Assistance Nan-Federal Share (Cash and in-kind) h. OTHER 1 Depreciation/Use Allowance 2 Rent $0 $0 $12,000 3 Mortgage 4 Utilities, Telephone $4,200 $0 $1,500 5 Building 8~ Child Liability Insurance 6 Building Maintenance/Repair and Other Occupancy 7 Incidental Alterations/Renovations 8 Local Travel $9,301 $0 $18,684 9 Nutrition Services 10 Child Services Consultants 11 Volunteers $0 $0 $5,000 12 Substitutes (if not paid benefits) 13 Parent Services $0 $0 $6,800 14 Accounting & Legal Services 15 Publications/Advertising/Printing 16 Training or Staff Development $0 $9,582 $0 17 Other TOTAL OTHER (6h) $13,501 $9,582 $43,984 9/01 /2008 9:59:40 AM Basic EHS Grant Application Eagle County Health ~ Human Services ESH 08CH0149 / 000 / 2009 Line Item Budget For Head Start and Early Head Start HS/EHS Cost for Line Item HS/EHS Cost #or Training ~ Non-Federal Share Program Operations Technical Assistance (Cash and in-kind} i. TOTAL DIRECT CHARGES $395,201 _$9,582 $212,896 j. INDIRECT COSTS k. TOTALS -ALL BUDGET CATEGORIES $395,201 $9,582 $212,896 9/01 /2008 9:59:40 AM g Eagle County Early Head Start Budget Justification -11te year -Cycle 3 January 1, 2009 through December 31, 2009 a. Personnel (object class 6a) Positions -total fte Federal Non-federal Early Head Start Director 0.4 fte 0 fte Health Coordinator 0.35 fte 0 fte Family Services Coordinator, Community Partnership Coordinator, Disabilities & Education Coordinator home visitor supervisor) 0.75 fte -0- Home Visitors 4.8 fte (6 home visitors) 4.8 fte -0- Executive Director (Administrative) -0- -0- Program Assistants 0.03 fte -0- TOTAL 6.33 fte 0.0 fte Position Fed Cost Fed fte Non-fed Non-fed cost fte Early Head Start Director and 041 36 .4 fte 0 0 Communit Partnershi Coordinator , Health Coordinator 26,041 0 fte 0 0 Family Services Coordinator, and (Disabilities & Education 454 58 .75 fte 0 0 Coordinator/home visitor supervisor) , One osition. Home Visitors 209,456 4.8 fte 0 0 Executive Director Administrative 0 0 0 0 Fiscal Technician 0 0 0 0 Program Assistants (assist with childcare during parent meetings-264 hrs and 7 488 .03 fte 0 0 during groups socializations-360 hrs or 5 , hrs x 72 GS=360 hrs) Total ersonnel $337 480 6.33 fte $0 0 fte b. Fringe Benefits (Object class 6b) In addition to mandatory benefits, EHS provides health, dental, vision coverage and life insurance for individuals and families. The average cost of coverage is $22,283 per employee. Retirement benefits begin after one full month of employment. Eagle County retirement contribution is 6% of gross salary. Frin e Benefit Fed Cost Non-fed cost 1. Social Security (FICA), State disabilit , unem to ment 17,182 8,062 (32%) 2. Health/DentaULife Ins 0 141,050 (100%) 3. Retirement 0 19800 100% Total Frin a Benefit 17182 168 912 Eagle County Early Head Start Budget Justification -11th year -Cycle 3 January 1, 2009 through December 31, 2009 c. Travel (object class 6c) This item represents out of county travel by the EHS Director and Family Services Coordinator to participate in regional meetings and for program cobrdination with the Roaring Fork portion of Eagle County which is separated from the Eagle River Valley by 55 miles and which must be reached by travel through another county. Federal Cost: Meals x 3 w/El Jebel staff = 180 Hotel x 4 CHSA meetings = 200 Meals x 4 CHSA meeting= 114 Total Travel 494 d. Equipment (object class 6d) No equipment purchases are planned for this program year. e. Supplies (Object class 6e) Federal Costs: Office Supplies: Office supplies (notebooks, file folder, paper products, mailings, etc.) 500 Child & Family Services Supplies: Home visit materials (average of $85 per enrolled child) 3825 (Ounce Scale materials, Family Albums) Policy Council materials 250 (notebooks, notebook dividers, table "toys') Parent Meeting materials 200 (notebooks, any special materials needed for projects) Food for group socialization & parent meetings 6,510 (9 PC, 12 parent meetings/trainings, 72 group socializations @ $70/meal) Food for annual parent orientation & PC retreat/orientation 1,000 (each @ $S00) Food for Health Advisory Committee 180 (3 meetings @ $30/meal) Group Socialization materials 2,000 (replacement toys & soft materials, cups, plates, eating utensils, napkins) Replenishing lending library materials 1,112 (annually purchase children books) Staff references (references requested by staff to support early childhood) 413 Total supplies 16,090 f. Contractual (object class 6f) Mental health consultation ($5,454 annually) 5,454 Program evaluator ($5,000 annually) 5,000 Total contractual 10,454 g. Construction (object class 6g) The program has no plans for construction costs. Eagle County Early Head Start Budget Justification -11th year -Cycle 3 January 1, 2009 through December 31, 2009 h. Other (class object 6h) Utilities, Telephone: 7 cell phones @ $50/month 4,200 Local travel: Family related -home visits 8275 miles @ .585 4,841 Reimbursement to families Personnel car Family related -home visits, 8920 miles @ .50 4,460 group social, parent meetings, EHS vehicles and special events Training & Technical Assistance 9.582 Total Other 23,083 TOTAL NON-PERSONNEL 50.121 TOTAL FEDERAL COSTS 404 783 Non-Federal Costs: b. Fringe benefits: • 32% of FICA 8,062 • 100% of Health Insurance 141,050 • 100% of Retirement 19.800 Total fringe benefits 168,912 h. Other • Lease for 1,288 sq. ft. of office, group socialization & storage 12,000 space in a 3,864 sq.ft. building leased by the applicant. Annual cost $36,000. • Utilities & Telephone: Standard telephone service for 8 phone lines 2 1,500 approximately $15.63 per month • Cost for Motor Pool to service and insure EHS vehicles Annually is $1,557/month 18,684 • Volunteers: 200 hours at an average of $25/hour 5,000 • Parent volunteer services: Policy Council, Parent Committees, Health 6,800 Services Advisory Committee. 34 hourslyear x 10 parents = 450 volunteer hours x $25 = $6,800 TOTAL BUDGET $617,679