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Home My WebLink AboutC02-251 CDPHECod - Z S1- zz- COLORADO WASTE TIRE GRANT PROGRAM Form DLG-B: Recycling Incentives Reimbursement Application (Rev.7-02) Entity Applying for Funds Eagle County Health and Human Services (Must be an eligible local government) Type of Applicant: Municipality X County City/County State Agency Special District Federal Identification Number: 84-600076 Address (where checks will be sent) P.O. Box 660, 500 Broadway City Eagle State Colorado Zip 81631 Name of Primary Contact Person Kathleen Forinash Director Phone (970) 328-8840 Fax (970) 328-8829 Email forinashReagle- county.com Description of product(s) made with Colorado -generated recycled tire being considered for purchase: Pla_yflex is a clean safe soft ground cover that absorbs impact and cushions falls. It is composed of small irregularly shaped pieces of clean recycled Colorado Tires. Playflex does not deteriorate nor does it need to be constantly replaced like sawdust wood chips or bark. 2. Description of public project in which the product(s) made with Colorado -generated recycled tires will be used: This product will be used to provide ground covering for the plaverounds of one pre-school, one town park and the play ground for a low income housing program run by Eagle County. 3. Location(s) where the product(s) will be used: Saint Mary's Preschool, Town of Red Cliff and Riverview Apartments 4. Estimated unit cost of recycled tire product(s) $400.00 (e.g., $$/lb. Or $$/Ton) 5. Estimated total cost of your purchase: $12,600.00 6. Supplier of the Product: Jaitire Industries, Inc Contact name Cornet/ Snyder Phone: 303-322-7887 7. Please attach proof of use of Colorado -generated waste tires in the product (obtain from supplier). Enclosed 8. Estimated number or weight of waste tires contained in the quantity of the product being purchased here: 31.50 Tons 9. Is there a comparable product made without any Colorado -generated waste tire material that this recycled tire product is replacing? X Yes No If yes, please describe: Gravel and sand 10. If yes, what is the cost of the non -tire product this recycled tire product is replacing? $1257.00 11. Have you complied with your agency's, district's or jurisdiction's competitive procurement policy in arranging for the purchase of this product? Yes X No. If no, please explain why not: This is the sole -source for crumb rubber playground safety surfacing made from Colorado scrap tires. 12. Project Start Date: September 15, 2002 (Note that you cannot be reimbursed for the purchase of products dated before the date on the "notice of grant award" letter from the Waste Tire Program.) 13. Estimated End Date: September 30, 2004 Please note: This is a grant reimbursement program. Applicants will be notified about the amount of funds the Department of Local Affairs will award to your project, an amount that cannot exceed 75% of the total cost of actual product purchase price. Applicants must purchase the materials in accordance with standard bidding procedures (or provide sole -source documentation) for a public project and submit original copies of the invoice(s) to the Department of Local Affairs (the Department). The Department will reimburse your entity for the costs approved. In addition, recipients of these grant funds will be required to submit a report providing information regarding how the funds were used, how much waste tire material was used, the use to which they were put, and the total cost of the project together with the invoice for reimbursement, and certification that the product purchased was made from Colorado generated waste tires. NOTICE TO APPLICANT: The Contractor's submission of this application constitutes an offer, acceptance of which shall result in a binding contract effective upon acceptance of the application and award of the grant. The terms of this contract include; the applicant's Colorado Waste Tire Program Recycling Incentives Reimbursement Application; the Award Letter; and, the Colorado Waste Tire Grant Program Application Guidelines (including the General Provisions dated July 2002 and the Colorado Special Provisions, dated 12/01 /01), which are incorporated hereby by reference. Acceptance By signing below, I certify that my agency has followed all application requirements for these funds and that I have the authority to enter into this contract as a representative of the applicant. Contractor (entity applying for grant funds): Eagle County Government Address (if different from address listed earlier): City State Zip Phone: (970) 328-8858 Fax: (970) 328-8829 Email: forinash@eagle- county. com ignaturE Bull Imal Name Please print name Michael L. Gallagheposition (Title) Chairman of the Board of County Commissioners Federal ID Number 84-6000762 Attest (Seal) Date September 1.0, 2002 Mail Completed Application to: Colorado Waste Tire Program, Department of Local Affairs 1313 Sherman Street, Room 521 Denver, CO 80203, by September 15, 2002 or April 15, 2003. Rev. 7-02 Dit! IB___ UTI�N Oriai_ nay- I. Contract Book 2. 3. �) 4.� Cooi_O ►o' 1.Accounting z. 3.