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HomeMy WebLinkAboutC17-331 Early Head StartHUMAN SERVICES
976-328-8846
FAX: 976-328-8829
www.eaglecounty.us
-EAGLE COUNTY
Human Services
Consent and Authorization for 2018 Early Head Start Grant Application
ECONOMIC SERVICES
CHILDREN, FAMILY & ADULT SERVICES
FINANCIAL SUPPORT SERVICES
Eagle County Department of Human Services (ECDHS) intends to apply for $1,175,459 in Early Head
Start (EHS) funding for the federal fiscal year 2018 to provide services to 82 children and families in Eagle
County, Colorado. These dollars are broken down into the following categories:
Total federal costs $ 940,367
Includes training & tuition $ 22,042
Total non-federal costs $ 235,092
Grant Development
The EHS grant application is for the funded enrollment of 82 children and families. The program is
designed to serve those 82 children and families through 45 home-based slots and 37 center based slots.
The center based slots are divided into 22 combination program and 15 full-time center based.
Grant Approval
The Board of County Commissioners authorizes ECDHS to submit the EHS grant application for Early
Head Start funding for federal fiscal year 2018.
Approved by the Board of County Commissioners
dillian H. Ryan
Chairman of the Board
Eagle County Board of County Commissioners
09/26/2017
Date
Eagle County Old Courthouse, 551 Broadway, P.O. Box 660, Eagle, Colorado 81631-660
C17-331
OMB Number: 4040-0004
Expiration Date: 10/31/2019
Application for Federal Assistance SF -424
1. Type of Submission:
F] Preapplication
❑X Application
© Changed/Corrected Application
' 2. Type of Application: ' If Revision, select appropriate leffer(s):
❑ New
❑X Continuation ' Other (Specify):
Revision
' 3. Date Received: 4. Applicant Identifier:
08CH1149
5a. Federal Entity Identifier:
5b. Federal Award Identifier:
08CH__49
NIA
State Use Only:
B. Date Received by Statc:
7. State Application Identifier:
S. APPLICANT INFORMATION:
' a. Legal Name: Hp GLH, CO -JN'--'- Or'
' b. Employe rlTaxpayer Identification Number [EINITIN]:
' c. Organizational DUNS:
084024447
84fiflflfl762
d. Address:
' Streetl: 55_ Broadway
Street2:
' City: Eagle
County/Parish: Eagle County
' State: CO: Colorado
Province:
Country: USA; UNITED STATES
Zip 1 Postal Code: 18'-631
e. Organizational Unit:
Department Name:
Division Name:
Harty Head Start
llepartrrent of Human Services
f. Name and contact information of person to be contacted on matters Involving this application:
Prefix: Mr First Name:
Middle Name:
Joey
' Last Name: Peplinski
Suffix:
Title: EHS Manager
Organizational Affiliation:
'Telephone Number: (970) 328-2609
Fax Number: (855) 848-8826
'Email: jooy,paplinski@eagleGounty.us
Application for Federal Assistance SF-424
' 9. Type of Applicant 1: Select Applicant Type:
County GQvernnient
Type of Applicant 2: SeleCt Applicant Type:
Type of Applicant 3: Select Applicant Type:
Other (specify):
' 10. Name of Federal Agency:
ACF—Head Start
11. Catalog of Federal Domestic Assistance Number:
93.600
CFDA Title:
Head Start
* 12. Funding Opportunity Number:
eGrants-NIA
Title:
NIA
13. Competition Identification Number:
Not Applicable
Title:
Not Applicable
14. Areas Affected by Project [Cities, Counties, States, etc.]:
Eagle County, CO
' 15. Descriptive Title of Applicant's Project:
Harly Head Start
Attach supporting documents as specified in agency instructions.
Application for Federal Assistance SF424
16. Congressional Districts Of:
"a. Applicant CO-fl03 b. PrograrrdProject CO-003
Aft ach an additional list of Program/Project Congressional Districts if needed.
17. Proposed Protect:
` a. Start Date p 1 fl 1 2 fl 18 ' b. End Date: 1213112 fl 18
18. Estl'rnoWd Funding { :
a. Federal 940, 367
b. Applicant 235, 092
G. State
d. Local
e. Other fl
f. Program Income
'g. TOTAL _,175,459
' 19. Is Application Subject to Review By State Under Executive Order 12372 Process?
❑ a. This application was made available to the State under the Executive Order 12372 Process for review on
b. Program is subject to E. 0. 12372 but has not been selected by the State for review.
FX1c. Program is not covered by E, 0. 12372.
'20. Is the Applicant Delinquent On Any Federal Debt? [If "Yes," provide explanation in attachment.]
n Yes 0 No
If "Yes", provide explanation and attach
21.'By signing this application, I certify (1) to the statements contained In the list of certifications" and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances" and agree to
comply with any resulting terms If I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
s?**
ect me to criminal, civII, or administrative penalties. (U.S. Code, Title 218, Section 1001 )
IAGREE
" The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
Prefix: ' First Name: Jill
Middle Name:
Last Name: Ryan
Suffix:
Title: Chairman
'Telephone Number: (970) 328-8605 Fax Number:
'Email: I jill.ryan@eagleGounty.us
'Signature of Authorized Representative: a3a og„eases ' Date Signed: 7
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