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HomeMy WebLinkAboutC17-367 Colorado Health FoundationDocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
1780 Pennsylvania St. - Denver. CD 80203 • phone: 303-953-3600 - fax: 303-953-4576
www.coloradohealth.org
GENERAL GRANT TERMS, CONDITIONS AND UNDERSTANDINGS
Title of Project:
Requirement
Eagle County WIC Innovation
11/2/2017
Grant 1134: 8791
$72,371 11/9/2017
Purpose of Project -
roject:increase
Progress Report
In cre as eenrollment of children ane to four years old in Eagle County WIC from a current rate of 54% to 75%of children eligible to participate.
Grantee Organization:
Final Report
Checks to be Made Payable to:
Eagle County Health and Human Services
Eagle County Government
500 Broadway
500 Broadway
Eagle, CO 81631
Eagle, CO 81631
Tax Identification Number., 846000762
Amount of Grant Awarded:
Period for Which Support is Granted:
$170,688 over a 24 -month period
From 11/1/2017 Through 10/31/2019
Contingencies:
intended Measurable Results to be Reported on:
Increase number of children and adults who have convenient access
to affordable fruits and vegetables:
Anticipated Year 1 Quantity: 638
Anticipated Year 2 Quantity: 740
Expected Intermediate Milestones:
1. Draft and finalize contract for InteGreat!.
2. Design and implement strategic planning process and plan with partners,
including the InteGreat! Coalition, MFHC, and clients.
3. Test and implement a referral card' system.
4. Identify appropriate sites and iunplenent co -location of staff.
5. Fnroll an additional 204 children.
Payment and Requirements Schedule:
Requirement Due Date
Requirement
Payment Amount Approximate Payment Schedule
11/2/2017
Signed Grant Agreement
$72,371 11/9/2017
11/1/2018
Progress Report
$98,317 12/20/2018
11/30/2019
Final Report
Payments are contingent upon receipt and approval of the associated requirements.
The Foundation uses an online system to receive reports and other requirements. Please visit www.coloradohealth.org for more information.
00-
C17-367
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
*Project Director
(please correct the information below if necessary)
Ms. Jennie Wahrer
Maternal and Child Health Manager, Public Health
Eagle County Health and Human Services
500 Broadway
Eagle, CO 81631
**Grantee Organization Primary Contact
(please correct the information below if necessary)
Ms. Jiiiian Ryan
Chair, Eagle County Board of Commissioners
Eagle County Health and Human Services
500 Broadway
Eagle, CO 81631
■ The project director is the individual directly responsible for developing the proposed activity, its implementation, and day-to-day direct
supervision of the project. * *The organization primary contact is the CEOIExecutive Director of the grantee organization.
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
The Colorado Health Foundation is awarding this Grant to the above named organization ("Grantee') and
Grantee agrees to, the following:
1. Tax Exempt Status, Grantee represents that:
a. To provide current and appropriate documentation if organization is a government supported
agency, such as school, museum, library or government agency or department.
b. To provide The Colorado Health Foundation with immediate written notification of any changes
in the organization's tax-exempt status.
2. Expenditure of Funds
Tliis Agreement (together with any income earned upon investment of Grant fiends) is made for the
purpose outlined herein and may not be expended for any other purpose without The Colorado
Health Foundation's prior written approval. Expenditures of Grant fluids must adhere to the specific
line items in the attached Grant Budget. If the grant is greater than $50,000, changes to individual
line items (increases and decreases) that are greater than 25% of that lute item and greater than
$1,000 must be requested in writing to The Colorado Health Foundation Grants Director and
approved in writing by Foundation staff. Requests should be submitted using the form and
instructions found at www.ColoradoHealtli.org in the "For Grantees" section.
If the Grant is intended to support a specific project or for a specific period, any portion of the Grant
unexpended at the completion of the project or the end of the period specified above on Page 1 (the
`5Grant Period') shall be returned immediately to The Colorado Health Foundation. With prior
written approval from The Colorado Health Foundation the Grant Period may be extended in order to
reach the anticipated outcomes. Requests should be submitted using the form and instructions found
at www.ColoradoHealth.oria in the `For Grantees" section.
3. Prohibited Use of Funds
Grantee will not permit any Grant funds or income derived from such fiznds to be used for
"political expenditures" as defined in Section 4955 of the Code, including but not limited to
participation or intervention in a political campaign for a public office.
This grant is not in any way earmarked to support or carry on any lobbying or voter registration
drive. Grantee hereby reaffirms that the project's current budget, attached to this grant
agreement, accurately reflects Grantee's present intention to expend at least the amount of this
grant on project non -lobbying and non-voter registration activities in Grantee's current fiscal
year.
Grantee represents that it is knowledgeable about Executive Order 13224 and the USA Patriot
Act of 2001 and Grantee will not permit any Grant fiinds or income derived from such fiznds to
be expended or re -granted so as to benefit any person or organization with ties to terrorists.
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
4. Anti -Discrimination Expectations
Grantee will not willfully discriminate against a particular class of individuals and will abide by all
applicable local, state, and federal anti -discrimination laws in luring, employment practices and when
providing services.
5. No Assignment or Delegation
Grantee may not assign or otherwise transfer its rights or delegate any of its obligations under this
Agreement without the prior written approval of The Colorado Health Foundation.
6. Records and Reports
Grantee must keep a record of all receipts and expenditures relating to this Agreement and to provide
The Colorado Health Foundation with a written report summarizing the project promptly following
the end of the Grant Period. The Colorado Health Foundation may also require interum reports.
Grantee reports should describe progress achieving the Grant Purposes (including progress toward
measurable results and intermediate milestones outlined above on Page 1) and include a detailed
accounting of the uses or expenditure of all Grant funds. Grantee also agrees to provide any other
information reasonably requested by The Colorado Health Foundation. If Grantee obtains any
audited financial statements covering any part of the period of this Agreement, copies of such
statements shall be provided to The Colorado Health Foundation promptly after receipt. Grantee
must keep the financial records with respect to the Grant and this Agreement, along with copies of
any reports submitted to The Colorado Health Foundation, for at least four years following the year
in which all Grant fimds are fully expended.
7. Required Notification
Grantee must provide The Colorado Health Foundation with immediate written notification of: (1)
its inability to expend the Grant Runds for the Grant Purposes; or (2) any expenditure of Grant fiends
for any purpose other than the Grant Purposes; and, (3) any other breach by Grantee of this
Agreement.
8. Reasonable Access for Evaluation and
The Colorado Health Foundation incorporates evaluation into its charitable grant -making so that it
and the Grantee can understand the unpact of the Grant and how to improve the impact of the
charitable grant -making moving forward, and for the benefit of other Grantees and for the State of
Colorado. As a condition to the receipt of this Grant, Grantee agrees to comply with and to
participate un any requests from The Colorado Health Foundation to conduct an evaluation of the
effectiveness of this grant (the ' Evaluation's either individually with the Grantee or with multiple
grantees as part of a broader strategy of The Colorado Health Foundation, including but not limited
to follow-up reporting and/or additional activities above and beyond those listed in the Payment and
Requirements section of this Agreement.
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
�yyr
Grantee will permit The Colorado Health Foundation and its representatives, at its request, to have
reasonable access during regular business hours to its files, records, accounts, personnel and clients,
or other beneficiaries for the purpose of making such financial audits, verifications, or program
evaluations as The Colorado Health Foundation deems necessary or appropriate concenning the Grant
and to discuss Grantee's programs, procedures and operations with Grantee's personnel.
9. Research Involving Human Subjects:
If the Grant is to be used in whole or in part for research involving human subjects, Grantee hereby
certifies that Grantee, applying the ethical standards and the criteria for approval of grants set forth in
its Internal Review Boards and professional oaths, has determined that the human subjects involved
in this Grant will not experience risk over and above that involved in the normal process of care and
are likely to benefit from the proposed research program.
10. Public i :
The Colorado Health Foundation encourages Grantee to publicize information concerning the Grant
in the Grantee's newsletters, annual reports, press releases, Web -site and oflner relevant media.
Grantee will obtain written approval by The Colorado Health Foundation of any content promoting
information related to the grant, the organization or Foundation staff prior to releasing or publicizing
such information. If Grantee has received these fiends for `"General Operating Support," The
Colorado Health Foundation expects to be acknowledged as a sponsor for major events by the
inclusion of The Colorado Health Foundation's logo un the event promotion materials and print
collateral.
The Colorado Health Foundation welcomes any photographs relevant to the Grant for The Colorado
Health Foundation's use. Photos must have prior client releases (if applicable) for publication
purposes.
Without further notice to or consent from Grantee, The Colorado Health Foundation may include
information regarding this Agreement and/or Grant, the amount and purpose of the Grant and
photographs, logo or trademark, and other published/printed information or materials (provided by
Grantee) and its activities, in The Colorado Health Foundation's periodic public reports, newsletters,
Web -site and news releases.
11. Colorado Charitable S olicitations Act
Grantee represents that it is aware of and in compliance with the Colorado Charitable S olicitations
Act governing fiundraising in Colorado.
12. Right to Modify or Revoke
The Colorado Health Foundation reserves the right to discontinue, modify or withhold any payments
to be made under this Agreement or to require a total or partial refimd of any Grant fiends if, in The
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
Colorado Health Foundation's sole judgment, such action is necessary or prudent: (1) because the
Grantee has not fully complied with the terms and conditions of this Agreement; (2) to protect the
purpose and objectives of this Agreement or any other charitable interest of The Colorado Health
Foundation; or (3) to comply with the requirements of any law or regulation applicable to Grantee,
The Colorado Health Foundation, or this Grant.
12. Termination
The Colorado Health Foundation's obligations under this Agreement shall automatically terminate in
the event of the insolvency, receivership, bankruptcy filing, or dissolution of Grantee.
In addition to its right of revocation under Paragraph 12 above, The Colorado Health Foundation
may terminate this Agreement at any time by giving Grantee at least 30 days of written notice. Upon
termination of this agreement for any reason, all payments by The Colorado Health Foundation to
Grantee shall cease at such time as may be determined by The Colorado Health Foundation.
Termination or revocation of this Agreement by The Colorado Health Foundation will not terminate
Grantee's obligations under this Agreement with respect to Grant fimds expended or otherwise not
returned to The Colorado Health Foundation. Grantee's obligations under Paragraphs 6, 8, 10 and 16
shall also survive termination of thus Agreement.
13. Special Conditions and Reporting
Grantee will submit reports to The Colorado Health Foundation according to the reporting schedule
set forth on page one of this Agreement.
14. Amendment
This Agreement may be amended, supplemented or extended only by written communication signed
by The Colorado Health Foundation.
15. No Partnership Agency or Third Party Beneficiaries
Nothing contained in this Agreement shall create or be deemed to create a partnership or agency
between The Colorado Health Foundation and Grantee and nothing contained in this Agreement shall
be deemed to give rise to any rights or benefits to third parties not a party to finis Agreement.
16. Intellectual Property
(a) Grantee represents and warrants that it owns or has the right to use all intellectual property that
will be employed by Grantee or its agents in the performance of thus Agreement, including without
limitation, Grantee's obligations under subsection (c) below.
(b) All works and matters created or discovered through the performance of this Agreement,
including but not limited to, implementation methodologies, best practices guides and training
curricula (the "Work"), are owned by the Grantee provided, however, that the Work may be used by
Grantee only in furtherance of charitable purposes (i.e., activities recognized by the IRS as charitable
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
and not resulting in —unrelated business taxable income" as defined in Section 512 of the Code),
unless otherwise agreed in writing by The Colorado Health Foundation.
(c) Grantee hereby grants to The Colorado Health Foundation a nonexclusive, irrevocable, perpetual,
worldwide, fully transferable, royalty -free license to (i) the Work, to make, use, sell, license to
others, reproduce, create derivative works of, publish, republish, distribute, perform and display the
Work in any current or future form and for any purpose in furtherance of charitable purposes, and (ii)
any other intellectual property incorporated into or used in connection with the Work to the extent
reasonably necessary to enable The Colorado Health Foundation to use and practice the licensed
Work. The license herein granted to The Colorado Health Foundation shall vest without any further
action on the part of Grantee. Without the prior written consent of The Colorado Health Foundation,
Grantee will not enter into any agreement with a third party that would restrict Grantee's ability to
perform its obligations under this subsection (c).
17. Disclaimer
Nothing contained herein, including the required reporting and review procedures, shall be construed
as a warranty, representation, or approval by The Colorado Health Foundation that the services
rendered by Grantee are adequately or properly rendered oil either an individual or program -wide
basis. Grantee shall have sole responsibility for all damages, costs, fines, attorneys' fees, or
liabilities of any kind or nature arising from any claims, demands or suits resulting from the
Grantee's performance or failure to perform under this Agreement.
18. Controlling Document
The terms and conditions of this Agreement shall be the controlling document between The Colorado
Health Foundation and Grantee. All verbal communication, notes, minutes or other documentation
of The Colorado Health Foundation shall be deemed merged into this Agreement. In making this
Grant, The Colorado Health Foundation has relied on the information and representations submitted
to The Colorado Health Foundation by Grantee and Grantee represents that all such information and
representations are true and complete.
19. Future Funding
Grantee acknowledges that, except as expressly provided in this Agreement, The Colorado Health
Foundation has no obligation to Grantee with respect to any additional or future funding.
20. Counterparts; Electronic Signature
T7is Agreement may be signed in multiple counterparts, which may be signed by the parties
separately, but together shall constitute a single agreement. The counterparts of this Agreement may
be executed and delivered by facsimile, email, other means of electronic transmission, or other
electronic signature and shall be deemed to have the same legal effect as delivery of an original
executed copy of this Agreement.
[Signature Page Follows]
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
M4y,�qAp?_i�1 , 2017
Amy Date
Vice President, Philanthropy
The Colorado Health Foundation
The undersigned certify that they are duly authorized officers of Grantee and, as such, are authorized to
accept this contract on behalf of Grantee, to obligate the Grantee to observe all of the terms and conditions
placed on this Agreement, and in coruiection with this Agreement to make, execute, and deliver on behalf of
the Grantee all agreements, representations, receipts, reports, and other instruments of every kind.
ACCEPTED AND AGREED TO:
Jillian H. Ryan
Chair, Eagle County Board of Commissioners of Eagle County Health and Human Services
(typed/printed name)
11/02/2017
Chair, Eagle County Board of Commissioners (signature) Date
DocuSign Envelope ID: AF5F7CE2-OAA8-47D7-B253-6319FCB137CB
Dor
310bli4
Organization Name: Eagle Colony Health and Huivan Services
Project Title: Eagle County WIC Iiuiovation
Request ID: 8791
Proposal. -
at .-
GeneralOperating
Year I
Year 2 Year 3
$
Tota IDire
-
Program/Project
$
-
Personnel
$
61, 252.00
$
91, 505.00
$
152, 757.00
Program m 1 ng/ Project Costs
$
6,619.90
$
5,012.99
$
11,631.90
Administrative costs related to program
Is
-
Capital
I $
-
Tota I Direct Costs
Other Costs
$
67, 871.00
$
96, 517.00 $
1 $
164, 388.00
$
4,500.00
$
1,800.00
$
6,300.00
Other
$
-
Fiscal Sponsors Fee (If applicable)
$
-
Indirect Costs (max 10%)
$
-
Total Other Costs
$
4,500.00
$
1,800.00 $ -
$
6,300.00
GRAND TOTAL
$
72, 371.00
$
98, 317.00 $ -
$
170, 688.00