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HomeMy WebLinkAboutC21-133 Early Head Start COLA Letter* 1. Type of Submission:* 2. Type of Application: * 3. Date Received:4. Applicant Identifier: 5a. Federal Entity Identifier:5b. Federal Award Identifier: 6. Date Received by State:7. State Application Identifier: * a. Legal Name: * b. Employer/Taxpayer Identification Number (EIN/TIN):* c. Organizational DUNS: * Street1: Street2: * City: County/Parish: * State: Province: * Country: * Zip / Postal Code: Department Name:Division Name: Prefix:* First Name: Middle Name: * Last Name: Suffix: Title: Organizational Affiliation: * Telephone Number:Fax Number: * Email: * If Revision, select appropriate letter(s): * Other (Specify): State Use Only: 8. APPLICANT INFORMATION: d. Address: e. Organizational Unit: f. Name and contact information of person to be contacted on matters involving this application: Application for Federal Assistance SF-424 Preapplication Application Changed/Corrected Application New Continuation Revision OMB Number: 4040-0004 Expiration Date: 10/31/2019 084024447 Increase Award 08CH011349 Child, Family & Adult Services Mrs. CO: Colorado 846000762 Eagle County Department of Human Services (970) 328-8827 Human Services Eagle County Department of Human Services PO Box 660 Kleinschmidt 08CH011349 N/A USA: UNITED STATES Eagle Eagle County 551 Broadway Deputy Director 81631 Kendra kendra.kleinschmidt@eaglecounty.us DocuSign Envelope ID: E32ADADA-1150-419B-855A-66C9BBDFCE13 C21-133 * 9. Type of Applicant 1: Select Applicant Type: Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): * 10. Name of Federal Agency: 11. Catalog of Federal Domestic Assistance Number: CFDA Title: * 12. Funding Opportunity Number: * Title: 13. Competition Identification Number: Title: 14. Areas Affected by Project (Cities, Counties, States, etc.): * 15. Descriptive Title of Applicant's Project: Attach supporting documents as specified in agency instructions. Application for Federal Assistance SF-424 Early Head Start COLA County Government N/A 93.600 Not Applicable eGrants-N/A Head Start ACF-Head Start Not Applicable Eagle County, Colorado DocuSign Envelope ID: E32ADADA-1150-419B-855A-66C9BBDFCE13 * a. Federal * b. Applicant * c. State * d. Local * e. Other * f. Program Income * g. TOTAL . Prefix:* First Name: Middle Name: * Last Name: Suffix: * Title: * Telephone Number: * Email: Fax Number: * Signature of Authorized Representative:* Date Signed: 18. Estimated Funding ($): 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 subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) ** 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: Application for Federal Assistance SF-424 * a. Applicant Attach an additional list of Program/Project Congressional Districts if needed. b. Program/Project * a. Start Date:* b. End Date: 16. Congressional Districts Of: 17. Proposed Project: a. This application was made available to the State under the Executive Order 12372 Process for review on b. Program is subject to E.O. 12372 but has not been selected by the State for review. c. Program is not covered by E.O. 12372. Yes No ** I AGREE * 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? If "Yes", provide explanation and attach 12,359 12,359 CO-003 Matt.Scherr@eaglecounty.us Mr. Scherr CO-003 (970) 328-8605 0 01/01/2021 0 Matt Chair, Board of County Commissioners 12/31/2021 DocuSign Envelope ID: E32ADADA-1150-419B-855A-66C9BBDFCE13 4/28/2021