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HomeMy WebLinkAboutC23-377 Mountain Youth_grant
GRANT AGREEMENT BETWEEN
EAGLE COUNTY, COLORADO
AND
MOUNTAIN YOUTH
THIS GRANT AGREEMENT (“Agreement”) is effective as of _____________ by and between
Mountain Youth, a Colorado nonprofit corporation (hereinafter “Grant Recipient”), and Eagle
County, Colorado, a body corporate and politic (hereinafter “Grantor” or the “County”) through
its Department of Public Health (“ECPHE”).
RECITALS
WHEREAS, the County works to promote the health, safety, and welfare of Eagle County citizens
of all ages; and
WHEREAS, ECPHE has identified a significant community need for funding and services
dedicated to the ‘promotion’ phase of care, which addresses root causes of local health disparities,
which lead to a myriad of individual high-risk behaviors; and
WHEREAS, the observed and reported fragmentation of community organizations and non-
profits leads to a lack of strategy in services and programming across systems of care; and
WHEREAS, ECPHE would like to extend staff knowledge and experience to offer organizational
support while administering funds with the intent of infusing equity and inclusion from a systemic
level; and
WHEREAS, among the services Eagle County provides in order to promote such health, safety,
and welfare are grants-in-aid to local organizations whose work assists the County in
accomplishment of the goal to create and sustain a safe, healthy, environmentally and
economically vital and socially diverse community; and
WHEREAS, the County introduced the 2023 Pilot Advancing Systems Change Grants (the “ASC
Grants”), which intend to fulfill capacity-building needs that support selected grant recipients’
projects which lead to expanding the ability to advance efforts to address root causes, enhance
inter-agency partnerships and collaboration, and incorporate community-based decision-making
in operations; and
WHEREAS, the County issued a Request for Proposals on June 26, 2023 to determine appropriate
entities to receive the ASC Grants. Grant Recipient submitted a proposal and was selected on July
31, 2023 as an appropriate entity to receive the Grant. Grant Recipient’s proposal is attached
hereto as Exhibit A and incorporated herein by this reference; and
WHEREAS, Grant Recipient has agreed to provide services that create and sustain a healthy
environmentally and economically vital and socially diverse community in Eagle County; and
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
12/4/2023
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Eagle County Grant Final 5/14
WHEREAS, this Agreement shall govern the relationship between Grant Recipient and County
in connection with the Services.
GRANT AGREEMENT
Now, therefore, in consideration of the foregoing premises and the following promises, Eagle
County and Grant Recipient enter into this Agreement for payment of the grant award in the
amount of twenty-five thousand, eight hundred and fifty dollars ($25,850) (the “Grant”) to
Grant Recipient.
A. Grant Recipient agrees that funds awarded by County may be used and expended solely to
provide access to information regarding the needs, gaps in services, and overall well-being of the
young adult/older youth population of Eagle County as specified in its 2023 Community Service
Grant Application and Grant Application Budget Section. All funds will be expended in the
specified grant period as outlined in the Scope of Work (the “Grant Period”), which is attached
hereto and incorporated herein as Exhibit B. The Grant Award set forth herein is for the specific
Grant period and the Grantor makes no representations, nor should Grant Recipient rely on this
award as a representation of any future awards for other grant periods.
B. In return for the award of the Grant, Grant Recipient agrees to submit required
documentation discussing how the funds were expended, deliverables as outlined in the Scope of
Work, and how they tie back to creating and sustaining a healthy environmentally and
economically vital and socially diverse community.
C. Payment of the Grant will be made in two installments, with 70% of funds paid at upon
execution of this Agreement, and the final 30% paid in December of 2023 following the County’s
satisfactory review of deliverables as outlined in the Scope of Work.
D. Grant funds under this Grant Agreement are to be used and expended within the Grant
Period. Any funds not used or expended during the Grant Period must be returned to Grantor.
E. If, after payment of the Grant Award, Eagle County reasonably determines that payment
was improper because the purposes for which the payment was made were misrepresented, or the
terms of this Agreement were breached, then upon written notice of such determination and request
for reimbursement from Eagle County, Grant Recipient shall forthwith return such payment to
Eagle County.
F. Grant Recipient shall comply at all times and in all respects with all applicable federal,
state and local laws, resolutions and codes; and specifically, with the requirements of the Civil
Rights Act of 1964 and Section 504, Rehabilitation Act of 1973, concerning discrimination on the
basis of race, color, sex, age, religion, political beliefs, national origin or handicap.
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G. Grant Recipient shall not assign any of its rights or duties under this Grant Agreement to a
third party without the prior written consent of the Grantor. The Grantor shall terminate this Grant
Agreement in the event of any assignment without its prior written consent, in which case, any
unused Grant Funds must be returned to Grantor.
H. Grant Recipient agrees that no agent, employee or volunteer of Grant Recipient shall be
deemed an agent, employee or volunteer of County.
I. Grant Recipient shall maintain, for a minimum of three (3) years, adequate financial and
programmatic records for reporting to Grantor on performance of its responsibilities hereunder.
Grant Recipient shall be subject to financial audit by federal, state or county auditors or their
designees. Grant Recipient authorizes Grantor to perform audits or to make inspections during
normal business hours, upon 48 hour notice to Grant Recipient for the purpose of evaluating
performance under this Grant Agreement. Grant Recipient shall cooperate fully with authorized
Eagle County representatives in the observation and evaluation of the program and records. Grant
Recipient shall have the right to dispute any claims of misuse of funds and seek an amicable
resolution with Grantor.
J. This Agreement shall be governed by the laws of the State of Colorado. Jurisdiction and
venue for any suit, right or cause of action arising under, or in connection with this Agreement
shall be exclusive in Eagle County, Colorado.
K. This Grant Agreement supersedes all previous communications, negotiations, and/or
agreements between the respective parties hereto, either verbal, or written, and the same not
expressly contained herein are hereby withdrawn and annulled.
L. This Grant Agreement does not, and shall not be deemed or construed to confer upon or
grant to any third party or parties any right to claim damages or to bring any suit, action or other
proceeding against either Grant Recipient or Grantor because of any breach hereof or because of
any of the terms, covenants, agreements and conditions contained herein.
M. Invalidity or unenforceability of any provision of this Grant Agreement shall not affect the
other provisions hereof, and this Grant Agreement shall be construed as if such invalid or
unenforceable provision was omitted.
N. To the extent required to perform under this Grant Agreement, Grant Recipient represents
and warrants that it has the expertise and personnel necessary to properly perform the Grant
Agreement and its professional personnel are duly licensed to perform.
O. No failure or delay by either party in the exercise of any right hereunder shall constitute a
waiver thereof. No waiver of any breach shall be deemed a waiver of any preceding or
succeeding breach.
P. The signatories to this Grant Agreement aver to their knowledge, no employee of the
County has any personal or beneficial interest whatsoever in the matters described in this Grant
Agreement. The Grant Recipient has no beneficial interest, direct or indirect, that would conflict
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Eagle County Grant Final 5/14
in any manner or degree with the performance of the Grant Agreement and Grant Recipient shall
not employ any person having such known interests.
Q. Grant Recipient shall be responsible for the completeness and accuracy of its
performance under the Grant Agreement, including all supporting data or other documents
prepared or compiled in performance of the Grant Agreement, and shall correct, at its sole
expense, all significant errors and omissions therein. The fact that the Grantor has accepted or
approved the work performed shall not relieve Grant Recipient of any of its responsibilities.
Grant Recipient shall perform the Grant Agreement in a skillful, professional and competent
manner and in accordance with the standard of care, skill and diligence applicable to Grant
Recipients performing similar services. This paragraph shall survive termination of this Grant
Agreement.
S. Grant Recipient shall carry workers compensation insurance as required by law and
automobile and commercial general liability insurance as necessary and appropriate during the
term of the Grant Agreement, proof of which is attached hereto as Exhibit C.
T. The Grant Recipient shall indemnify and hold harmless Grantor, and any of its officers,
agents and employees against any losses, claims, damages or liabilities for which Grantor may
become subject to insofar as an such losses, claims, damages or liabilities arise out of, directly or
indirectly, this Grant Agreement, or are based upon any performance or nonperformance by
Grant Recipient or any of its sub-recipients hereunder including claims for bodily injury or
personal injury including death, or loss or damage to tangible or intangible property; and Grant
Recipient shall reimburse Grantor for reasonable attorney fees and costs, legal and other
expenses incurred by Grantor in connection with investigating or defending any such loss, claim,
damage, liability or action. This indemnification shall not apply to claims by third parties
against the Grantor to the extent that Grantor is liable to such third party for such claims without
regard to the involvement of the Grant Recipient. This paragraph shall survive expiration or
termination hereof.
U. Grant Recipient certifies that it has read the Grant Agreement, understands each and every
term and the requirements set forth herein, and agrees to comply with the same.
[signature page follow]
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IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set
forth above.
COUNTY OF EAGLE, STATE OF COLORADO,
By and Through Its COUNTY MANAGER
By: _______________________
Jeff Shroll, County Manager
GRANTEE
By: ________________________
Name: ______________________
Title: _______________________
Mailing Address:
__________________________
__________________________
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Mikayla Curtis
PO Box 4613
Edwards, CO 81632
Director of Strategic Impact
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Eagle County Grant Final 5/14
EXHIBIT A
Grant Recipient Proposal
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https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QAStQ…1/18
Advancing Systems Change Grant: Pilot
Program Application 2023
Eagle County Public Health & Environment is thrilled to introduce the Pilot 2023 Advancing Systems
Change Grant! Involvement will be highly interactive and adaptable to the grantee's needs, goals, and
limitations, with the intent of fostering a supportive funding relationship. This 9-month grant cycle will
begin September 2023, with an application period beginning Monday, June 26th, 2023, and closing
Friday, July 21st, 2023. A virtual information session will be held virtually on July 6th, 2023 at 4pm to
offer applicants an opportunity to ask questions and learn more detail about the grant. Any additional
submitted questions will be publicly posted with coinciding answers.
This program wishes to fulll capacity-building needs that support applicants’ projects which leads to
expanding ability to advance root cause efforts, enhance inter-agency partnerships & collaboration, and
incorporate community-based decision-making in operations. These capacity-building efforts must be
directly linked to the development or support of projects which serve populations in our community that
experience disadvantages due to inequities in policies, practices, social norms, and the distribution of
resources. It is through dedication to these efforts that gradual system-level change can be
accomplished.
Eligible use of funds include:
Community outreach, engagement, and building efforts
Community member empowerment (training, strengthening connections, advocacy)
Equity-focused professional development - staff and board
Strategic planning and organization development for board (re)development, capacity building,
fundraising, and other services
Recruitment of a Board of Directors or staff that represents the diverse populations of the
community
Projects which address/pursue: Strengthening partnerships with coinciding groups, organizations,
and strategies, strengthening community trust and relationships, and/or enhancing community
involvement in the development of projects and identication of need
The application will be open through Friday, July 21st, 2023.
For more details and information on the application, timeline, and grant process, please see the grant
information packet. Please reach out to Chelsea Carnoali at chelsea.carnoali@eaglecounty.us with
additional questions or needs.
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https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QAStQ…2/18
Email *
mcurtis@mountainyouth.org
Eligibility and Requirements
Eligibility:
To be considered for funding, organizations must provide information identifying the following:
Registration as a nonprot with the State of Colorado and provide evidence of local programming or
projects which fosters community building and root cause work
Project applied for will directly impact residents of Eagle County, with the applicant’s service area
focused on the Eagle County and/or Roaring Fork Mid-Valley
Familiarity with unique needs, culture, and present services available within Eagle County and/or
Roaring Fork Mid-Valley
Awareness of the organization's role and function within the applicable systems
Requirements:
1. Sign a standard Eagle County Contract, including a Scope of Work
2. Participation in coordination meetings: Minimum of three (3) meetings with ECPHE staff,
attendance in existing applicable collaboration meetings relevant to the proposed
project (ex: youth-focused organizations group convenings)
3. Data repor ting: Mid-grant and post-grant outcome reporting as outlined in repor ting template with
outcomes and indicators identied by grantee, annual report sharing as published in standard format
4. Evaluation: Par ticipation in pre-grant and post-grant evaluation and quality measurement, as
identied by ECPHE staff
Attachments
Please provide the following attachments at the time of application submission:
Please email required attachments to chelsea.carnoali@eaglecounty.us. Online Google Form applications
do not need to be submitted as an attachment, virtual submission as directed after completion of the
application will suce.
1. Most recent organization's budget
2. Most recent nancial statement
3. Project Budget & Timeline Sheet
4. Organizational chart or staff list, including job function
5. Board Member list/description
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Applicant Information
Mikayla Curtis
Eagle River Youth Coalition, Inc. dba Mountain Youth
mcurtis@mountainyouth.org
970-949-9250
www.mountainyouth.org
PO Box 4613, Edwards, CO 81632
First & Last Name (person who is filling out application)*
Name of Organization *
Contact Email *
Contact Phone *
Organization's Website *
Mailing Address *
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501(c)(3)
Using scal agent/nancial sponsor
Other:
Mountain Youth was founded in 2001 to provide cohesion among youth service providers. Since inception,
Mountain Youth has taken a leadership role in assessing local youth behaviors and perceptions, evaluating
gaps, and mobilizing the community to address priority youth needs. Mountain Youth collects and
disseminates critical data that benefits the community, and utilizes conversations to ensure youth needs
are met, gaps are addressed, and coordination is occurring. Working with diverse service community and
focus population leaders, stakeholders and providers, the community can more effectively and efficiently
assess and meet the changing needs of youth and mobilize collectively for positive change.
Mountain Youth also offers a variety of prevention programming based on identified gaps. Through
prioritization of local needs, Mountain Youth provides youth leadership and advocacy opportunities,
substance use prevention and family education efforts throughout the Eagle River Valley in par tnership with
youth, governmental entities, as well as youth program providers. Celebrating over 20 years of service,
Mountain Youth helps foster a healthy and suppor tive community that makes youth a priority, increases
their self-sufficiency and enables them to reach their full potential.
Tax Exempt Status *
Organization Background: Explain the original issue and/or oppor tunity the organization was
founded to address, and how that may have changed over time:
*
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Coalition Effor ts: Mountain Youth builds capacity among par tners through community events, professional
development, service referral, strategic planning, dissemination of youth data trends, and program gap
analysis.
Comprehensive Data Assessment: Mountain Youth administers the biennial Healthy Kids Colorado Survey
(HKCS) to local 6th-12th grade youth. HKCS was administered in fall 2021 to 3,382 youth at 12 local middle
and high schools. Local data and resource assessments are utilized to encourage stakeholder engagement,
community collaboration, steer critical programming, secure resources, encourage policy change, create
efficiencies in service access and delivery, and guide initiatives to best support youth and families.
Life Skills Education: Mountain Youth par tners with schools to facilitate evidence-based programs that
develop healthy coping and communication skills, resistance skills, improve decision making, and develop
motivation to choose positive health behaviors. Programs reach approximately 1,200 youth annually in
elementary, middle and high schools to reinforce skills at key life stages to prevent risky behaviors.
Mountain Youth, ECSD and BE Par tners created a comprehensive SEL development plan that aligns with
state health standards and is implemented across schools. For youth using substances, Mountain Youth
offers an early intervention program that has been successful in reducing youth substance use.
Youth Leadership: Valley’s Voice youth advocacy and leadership program engages a youth executive board
and any interested local youth in projects that result in youth-led positive changes in the community. All
aspects of the program are youth-led, adult suppor ted. Youth identify priority areas, lead passion projects,
and organize “For Youth By Youth” events that are positive, safe, and fun. Over 50 middle and high school
youth par ticipate in Valley’s Voice and engage over 850 youth annually in prosocial activities.
Community Education Efforts: Annually, over 900 family members attend free bilingual and bicultural
educational and skills-building programs for youth 5th grade and up with their parents/guardians. Large
informational forums bring community and exper ts together to discuss mental and behavioral health topics.
A more intimate program, We Hear U, for youth and parents referred by the school addresses specific
behaviors and establishes new shared expectations and communication.
Environmental Change: Collaboration with local law enforcement, government, healthcare, businesses,
transit providers, event producers and schools focus on reducing youth substance access and use, impaired
or distracted driving, and awareness of young driver laws. Prevention education and awareness strategies,
designed to reach the entire community, include education, media campaigns, increased signage, policy
review, enforcement, increasing protective factors, and reducing risk factors.
Current Projects: Provide a brief description of the organization’s current projects/programs.
Include population and numbers served, as well as expected results:
*
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Mountain Youth has experience operating in public health frameworks that focus on upstream prevention
effor ts and require the organization, par tners, committees and collaboratives to identify and address root
causes through an equity lens. The Strategic Prevention Framework and the Communities that Care
framework, both evidence-based approaches for prevention, ask the coalition and backbone agency of the
coalition - Mountain Youth in this case - to identify and engage community leaders and members that are
most impacted by the efforts of the coalition (the focus population) and provide decision-making power to
impact positive change in the community to benefit the focus population. The organization is charged with
building the capacity of community leaders and stakeholders to complete the steps of the framework and
effectively implement change. Community capacity building can come through professional development,
compensation, building skills and knowledge, recruitment and engagement of more members of the focus
population to the decision-making processes, and securing resources to implement the efforts identified by
the coalition. Prior to beginning any planning or implementation, the coalition must undergo a
comprehensive assessment process wherein data is collected and reviewed to understand the problem,
identify root causes, and identify who is most impacted by the problem area. This can be done through
formal data collection and review of outcomes at the aggregate level and by specific demographics, review
of secondary data sources, focus groups, key informant interviews, community gatherings, and a data
crosswalk to understand the problem area, root causes, systems that impact or perpetuate this problem,
and who is most impacted. From this assessment and capacity building period, the coalition goes through a
planning process to identify the implementation strategies that will be most effective for the problem and
focus population, with the ultimate decision being made by the community leaders and stakeholders that
can most effectively create change in the focus population. Implementation occurs at the recommendation
and in par tnership with the coalition, and the entire process is evaluated by the coalition to understand the
effectiveness of the implementation, how it has affected change in the systems and problem area for the
focus population, and what could be done to not only maintain this change but to continue to improve it so
that the problem area is no longer a concern.
Root-Cause Experience: Describe the organization’s experience with root-cause work
(see Grant Information Packet for definition and detailed reference).
*
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Mountain Youth is comprised of a board of directors that governs the nonprofit entity. The organization also
convenes advisory councils, committees, collaboratives, and par tners made up of diverse community
leaders and stakeholders to oversee different aspects and focus areas of the organization and its effor ts.
Mountain Youth’s Board of Directors represents 12 sectors of the community to ensure diverse
perspectives, including: Youth, Parent, Business, Media, School, Youth Serving, Religious, Law Enforcement,
Civic/Volunteer, Health Care, Government, and Substance Use. Of the 18 current board members, 5 are
youth representing various backgrounds, schools, and experiences.
The full board of directors convenes every other month and an Executive Committee meets with the
Executive Director monthly. The Executive Committee recommends actions for approval of the full board
and is responsible for all fiscal oversight. Other subcommittees focus on strategic action related to
Development and Events, Sustainability, Communities that Care, and Safe Driving. Directors are elected at
the January meeting for terms of 3 years and shall be eligible to serve no more than two consecutive terms.
The board continuously conducts assessments of needs, review of issues, prioritization and evaluation of
research-based strategies and monitoring resources.
Each board meeting beginnings with an opportunity for members to share a mission connection they
experienced or were a par t of since the last meeting. This gives an oppor tunity for members to reflect on
the mission, how they are contributing to it, and how they experience it in their own personal or professional
lives. Board members are also asked to serve in a sector role and to represent this voice and perspective in
the community. This strays from a traditional board role in that the board is intentional in its recruitment
process to ensure diverse viewpoints are serving on the board.
Each fall, the board and staff convene a review of the strategic plan, progress made towards goals, and
updates to action items over the course of the next year. In fall 2022, a more in-depth review of the strategic
plan was completed for a new 3 year period that set goals based on current priority needs of youth and
families identified through data and board member perspectives. The board works with staff to set the
strategic plan of the organization that accomplishes the mission.
The fulfillment of the mission and work of the organization is also carried out through committees, advisory
councils, and action teams that are comprised of staff, board, community leaders, par tners, and
stakeholders. These groups operationalize the goals set out in the strategic plan and utilize the evidence-
based frameworks to ensure there is understanding and consensus of the problem area, who it is impacting,
recruiting stakeholders to plan and implement change and review evaluation results to revise and renew
effor ts.
Board Structure: Describe the role of the board of directors in advancing the mission of the
organization.
*
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Through board assessments, oppor tunities are recognized to improve board recruitment of members
representing diverse sectors and perspectives, a focus on improving the onboarding process for new
members to more fully understand all the work of the organization and their role within it, maintaining
training and leadership development oppor tunities for board and staff, and building board member
leadership skills to successfully move into an executive board member role and join the executive
committee. These goals are not just for the nonprofit board of directors but for all avenues in which
community and focus population leaders, and partners are asked to engage with and contribute to the work
of the organization.
The executive director works with an internal leadership team and the board’s executive committee to
identify opportunities to work toward these goals and brings recommendations to the full board and
committee members to adopt or make additional recommendations.
Mountain Youth employs a community liaison role to improve outreach and engagement with members of
the Hispanic/Latino/a/x community, as well as youth advisors who support broadening engagement
amongst youth in the community who bring unique voices and perspectives to the collective work. Board
members who also represent unique perspectives in the community also suppor t recruitment and
engagement with other members of the community who share a similar perspective that may not be fully
represented in the current make-up of the board and committees. Active outreach and engagement is a
priority of the organization to ensure a robust representation of our local population is recognized in our
work.
Project Funding Request
Board/Team Structure: Describe the key issues related to board effectiveness that are being
addressed this year:
*
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Project Title: Community led assessment, data storytelling, and prioritization of youth, older youth, and
parent/guardian needs
Mountain Youth’s assessment project will build on current effor ts of data collection, analysis, review, and
storytelling to create a more comprehensive process that allows stakeholders to own the data, determine
priority areas, and lead decision-making processes that result in positive community change and
improvement in behavioral health outcomes. With a focus on youth (9-18), older youth (19-25), and their
parents/guardians, Mountain Youth will work with focus population leaders, stakeholders and community
leaders to review survey tools and administration processes, administer surveys to each focus population,
work with evaluators to analyze the data of the current administration as well as trends in behaviors and
responses over administrations, and engage stakeholders from the focus populations in reviewing the data
results, driving questions and conversations that bring awareness to root causes, and leading planning
processes that identify effective strategies for individual, community, and systems level changes that
address root causes.
Mountain Youth seeks to build the community’s capacity to access data related to youth, older youth, and
parents/guardians that creates a comprehensive understanding of health behavior, attitudes, and
perceptions. Not only is the data impor tant to guide agencies in making decisions related to priority, needs,
and effor ts, but it’s impor tant to steer conversations with community members and focus population
stakeholders to understand why areas of concern are noted through the data, contributing factors, systems
from which those concerns arise, and root causes that lead to the concern, and ways to address the
concern that will be effective and sustainable.
Funding Request: Provide a project title and description of the proposed use of funds:*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
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For the Healthy Kids Colorado Survey, Mountain Youth seeks to upgrade the current data dashboard to a
more interactive and digestible format that will allow community members to understand specific behavior
areas and trend behaviors over time, and be able to break the data down by sub-populations and
demographics, to understand what behavior areas are of most concern and who it impacts most. Currently,
the HKCS dashboard is challenging to navigate and filter into subpopulations. While it offers a way to view
the historical trend data for various behaviors, navigating the dashboard requires existing knowledge of the
survey and questions. Updating the dashboard with new information requires extensive time on the
contractor and has led to migrating the data to a new tableau files, and broken out for high school, middle
school, English, and Spanish.
For older youth, 19-25 year olds, there is not currently a behavioral health assessment tool similar to HKCS
that is administered. There are different studies and surveys related to workforce and substance use
behavior but not a comprehensive health related assessment. Mountain Youth would work with a contractor,
par tners, and focus population leaders to craft an assessment tool that would gather behavioral health data
that would be of importance for the community to understand the needs, gaps, and oppor tunities for
serving this age group. The survey would be administered through the local college, businesses, par tner
organizations, and across the community. Survey results would be shared with the focus population and
par tners to hold conversations that assessed factors, systems, and root causes contributing to areas of
concern, and to discuss ways to address those concerns systemically. The assessment and subsequent
stakeholder engagement process would allow Mountain Youth and par tners to better work with and serve
this focus population that will suppor t the needs they’ve identified with solutions they believe will be most
impactful.
The community parent/guardian survey will be in its four th administration this school year and will continue
to assess their behaviors, perceptions and attitudes. Mountain Youth seeks to make this data more
accessible by creating a dashboard or integrating data into a community-level dashboard. Mountain Youth
also seeks to work with an evaluator to create a trend analysis repor t that highlights priority areas from the
data to be shared with parent leaders, as well as create a cross-analysis repor t of youth and parent behavior
concerns that could be addressed across age groups and that would be effective in creating community
and systems-level change that address broader behavior concerns. Mountain Youth will also work with
parent/guardians and par tners over the year to re-envision the parent advisory council and how to make it
an ongoing council of diverse parent leaders that are leading positive and effective community-level and
systems change work.
Purpose: Describe the issue and/or opportunity addressed in pursuing this project, including
the systems change identified (see Grant Information Packet for definition and detailed
reference):
*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7/31/23, 11:11 AM Advancing Systems Change Grant: Pilot Program Application 2023
https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QASt…11/18
July – September:
- Review assessment tools for each focus populations with stakeholders, partners, and contractors to
ensure that all indicators desired are included.
- Recruit focus population leaders to support the assessment process over the year
October – November: For the older youth and parent survey (which are locally created)
-Ensure tools are translated properly, tested with members of the focus population to not only ensure the
tool is clear complete but that it is structured properly to produce measurable results that can be utilized by
stakeholders and par tners.
- Work with focus populations to identify incentives that will be meaningful and encourage par ticipation
- Work with focus populations to identify how the tools will be administered and goals around sample size
that will drive administration activities
- Recruit partners to suppor t marketing and administration of the survey across community settings to
encourage a robust sample size
September – November: HKCS
- Ensure par tner schools have confirmed par ticipation and educated on administration process
- Recruit volunteers to suppor t survey administration
- Work with youth leaders to identify ways to improve survey administration for their peers to feel value in
the survey, value in the survey process, and value in answering questions honestly
- Work with youth leaders to identify incentives that will encourage participation from their peers.
- Work with a contractor, HKCS state coordinators, par tners, and stakeholders to review different options for
upgrading the existing dashboard and prep it for integration of the newest dataset
December – February: Administer all surveys in a similar window that allows a comparable review across
age groups.
March – April:
- Work with an evaluator to process and analyze the older youth and parent survey results, creating repor ts
that can be shared with members of the focus populations
- Work with members of the focus populations to brainstorm how they want the data to be accessible to the
community and timeline for releasing information
- Work with a contractor, state par tners, community partners, and stakeholders, to determine how all data
will be organized through repor ts and a dashboard to shared publicly
April – June:
- Work with focus population leaders to create a data review process with focus populations and partners to
review and discuss evaluation results, contributing factors, systems, and root causes, and work with these
populations to identify priority areas and strategies that will address those areas. This may include
recruitment of more leaders from focus populations, focus groups across different age groups, key
informant interviews, or other strategies for reviewing the data with larger groups from the focus
populations.
Activities and Actions: Describe the steps and actions that will be taken in project
implementation including timeline:
*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7/31/23, 11:11 AM Advancing Systems Change Grant: Pilot Program Application 2023
https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QASt…12/18
Funding to sustain Mountain Youth initiatives remains an ongoing priority, particularly diversifying revenue
funds as government grants and contracts continue to dictate much of Mountain Youth’s annual revenue.
Through a committed team of leaders, Mountain Youth continues to review and update sustainability,
strategic marketing and fundraising plans. Mountain Youth routinely reviews and updates its policies with
guidance from the Principles & Practices for Nonprofit Excellence. Mountain Youth has been able to secure
multi-year grants that suppor t current efforts, and to develop a reserve of 3-6 months operating balance.
Through these effor ts, Mountain Youth has developed financial and strategic stability that will continue its
work into the future. Mountain Youth is eager to use this foundation to broaden its impact in the
community.
The organization has been successful in securing multi-year grants through various government
depar tments and foundations. The organization has been focused over the last couple of years on
expanding corporate and individual donors that have a connection to the mission and believe the work is
impor tant to sustain in order for all youth in the Eagle River Valley to thrive. Through a board and staff team,
they have been working on sustainability planning, as well as building relationships and contacts in the
community that connect with the organization’s mission and suppor t the work.
Mountain Youth is also currently the recipient of two multi-year grants through SAMHSA that end in 2024
and will be reapplying for similar funding this winter. The organization will prioritize this assessment work in
these two applications to ensure that sustainability of the effor ts maintains beyond the Eagle County grant
period. Mountain Youth is also seeking renewed foundation suppor t that would also support this work.
Evaluation and Outcomes
Sustainability planning: Describe how the program will be sustained using complementary
funding sources or other methods of financial security:
*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7/31/23, 11:11 AM Advancing Systems Change Grant: Pilot Program Application 2023
https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QASt…13/18
The goal of the project is to make data accessible to the community, par ticularly the focus populations and
stakeholders, community par tners, and the broad community as a whole to understand priority behavior
areas of concern, facilitate processes and conversations that prioritize the voice and direction of the focus
populations, and create systems-level solutions that address contributing factors and root causes.
Objective 1: Increase recruitment and engagement of diverse members of the three focus populations to
suppor t facilitation of assessment activities and resulting review and planning processes.
Objective 2: Administer assessments to the three focus populations
Objective 3: Increase community access to data related to the three focus populations
Objective 3.1: Work with contractors, focus population leaders, stakeholders and partners to identify the
best way to display the data through online resources, repor ts, and media avenues that will create more
accessibility and engagement with the data
Objective 4: Utilize assessment results to identify priority areas of concern, facilitate conversations that
identify contributing factors and root causes, and facilitate processes with focus population leaders,
stakeholders, and par tners that lead to environmental and systems-level changes to address areas of
concern
Objective 4.1: Work with contractors, focus population leaders, stakeholders and partners to review the
data, select priority areas to address.
Objective 4.2: Facilitate a data review process determined appropriate by the focus populations that engage
more leaders and stakeholders of the focus population in reviewing the data, discussing contributing
factors, and identifying root causes.
Objective 4.3: Work with focus population leaders, stakeholders, and par tners to identify systems-level
solutions that address priority concerns, and create action steps and timelines that will work towards
achieving those focus population driven solutions.
Describe the project goals and objectives:*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7/31/23, 11:11 AM Advancing Systems Change Grant: Pilot Program Application 2023
https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QASt…14/18
Evaluation is embedded into everything Mountain Youth does. Mountain Youth follows the Strategic
Prevention Framework to assess Eagle County’s needs based on epidemiological data to build prevention
capacity, develop and implement strategic plans, programs and policies, and evaluate outcomes. HKCS data
influences and encourages policy implementation that fosters a safer and healthier community. HKCS data
and supplementary evaluations notate youth trends, attitudes, perceptions and behaviors in order to stay
current on the behaviors and needs of local youth. HKCS data is utilized to ensure effectiveness of youth
services, alleviate service gaps, confirm appropriate resources and plan for future programs and services.
Mountain Youth’s survey administrator role builds capacity of youth-serving organizations and focus
population leaders as it allows par tners to understand broad community youth needs.
Program and project evaluations are critical in assessing effectiveness of various strategies. Mountain
Youth tracks program outputs and attendance, and utilizes matched pre and post evaluations, retrospective
post evaluations, satisfactory surveys, a community parent survey, and the Healthy Kids Colorado Survey
(HKCS) data to determine effectiveness of strategies and to assess outcomes.
Mountain Youth tracks all outputs through utilization of an online database system that all staff have been
trained to use and how the data should be entered to compile output results. For this project, Mountain
Youth will track:
- number of focus population leaders, stakeholders, and par tners who are a part of each phase of the
project, the number of meetings attended and hours, and other hours they contribute to the project outside
of meetings
- number of focus population members that complete the assessment tools
- number of focus population members, leaders, stakeholders, and par tners that par ticipate in data review
processes and how they’re engaged, number of sessions they attend and hours they contribute
- number of individuals who view online data resources once they are made public
- number of focus population leaders, stakeholders, and par tners that par ticipate in solutions-building
meetings, number of meetings attended, and hours they contribute
Describe the organization's overall approach to evaluation:*
How will your organization measure the outputs (the direct results of program activities such as
number of people engaged, number of hours of staff time, attendance etc.) of the project that is
the subject of this proposal?
*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7/31/23, 11:11 AM Advancing Systems Change Grant: Pilot Program Application 2023
https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QASt…15/18
Mountain Youth utilizes two assessment tools to measure outcomes related to stakeholder engagement
and their role in decision-making processes. One assessment tool is a lens of difference survey that was
created by youth leaders to understand how they are engaging diverse members of focus populations in
contributing to and facilitating the work. The survey asks individuals to share diverse backgrounds,
experiences, and lens they may have that contribute to the work and to the whole group. A second
assessment tool measures the growth in leadership skills and their viewpoint on how their voice is valued
and contributes to community-level decision-making. This survey is administered as a pre and post and has
been reviewed by youth leaders in the past 6 months to reflect their most recent goals in understanding
leadership growth and advocacy skills. For all individuals who are engaged in the project, they will be asked
to complete a lens of diversity survey. For individuals who are engaged throughout the entire process, they
will also be asked to complete the leadership survey to share how their skills and perspectives have shifted
over the course of the project. If they initiate engagement with the project after November, the survey will be
administered as a retrospective survey that asks their opinions now and before they became involved in the
project.
At the conclusion of the grant cycle time period, a project assessment will be completed with all leaders,
stakeholders and par tners that contributed throughout the process to assess the project process,
integration of diverse leaders, stakeholders, and partners, and ability to make connections and
relationships, and ability of the process to fulfill the project goals and objectives that contribute to inclusive
decision-making and systems-level changes. They will also make recommendations for improving the
process for future cycles and how to ensure the process is meaningful and fulfilling its goals.
This project facilitates a focus population engagement process that allows those who own the data to
determine what’s most impor tant from the data to assess and prioritize, and facilitates stakeholder
engagement processes that allow systems-level solutions to be determined and led by the focus population
with partners. The project addresses root causes as it asks focus population leaders, stakeholders, and
par tners to dive into the data to understand contributing factors, systems that perpetuate the area of
concern, and solutions identified and led by the focus population that will be effective in creating systems-
level changes.
Partnerships and Collaboration
Describe how your organization will measure the outcomes (specific changes in people or
organizations such as behavior, attitudes, knowledge, relationships etc.) of the project that is
the subject of this proposal.
*
How does this project address root causes (see Grant Information Packet for definition and
detailed reference)?
*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7/31/23, 11:11 AM Advancing Systems Change Grant: Pilot Program Application 2023
https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QASt…16/18
Mountain Youth maintains its original foundation of collaboration and currently engages in partnerships
with over 50 entities. The success of Mountain Youth’s effor ts is the collaborative manner in which key
community stakeholders are convened to address the changing needs of local youth and families.
Partnerships with critical entities prepare professionals to address concerns rapidly and effectively.
Mountain Youth hosts various trainings, meetings, educational forums and presentations to ensure that
necessary par tners are working in an informed, coordinated and collaborative manner, and are in consistent
alignment with needs identified through local data. Par ticipation in various collaborations, community
workgroups, and initiatives suppor ts Mountain Youth’s goals to work with the community to share
information, identify current needs, and par tner to create solutions and services that are efficient and non-
duplicative.
Mountain Youth staff par ticipate in the BE Par tners (made up of Eagle County Schools, Bright Future
Foundation, Efec, Red Ribbon Project, SpeakUp ReachOut, and Mountain Youth), Eagle Valley Outdoor
Movement, Eagle County Gives, Mountain Safe Response Team, Western Slope Regional Leadership
Committee, Colorado Youth Driver’s Alliance, Eagle County School’s District Wellness Advisory Committee,
Eagle County Climate Action Collaborative, state Healthy Kids Colorado Survey Advisory Committee,
Colorado Prevention Association Community Board, and the Eagle County Prevention Committee.
Participation on these collaboratives helps to ensure that par tners are aware of Mountain Youth’s effor ts
and vice versa in order to create alignment in efforts, build upon them, and identify and share resources to
make them most sustainable.
Mountain Youth also convenes a family engagement action team with YouthPower365, the safe driving
steering committee comprised of many community members and sectors, Communities that Care boards
and committees, including the youth recruit and reward committee, and Valley’s Voice to suppor t develop
strategic plans and goals, facilitate the collective work, and to implement projects that result in positive
youth prevention.
Inclusivity and Equity
Describe the organization’s most significant interactions with other organizations and efforts,
including local strategic planning groups or projects and close working partnerships with
community entities:
*
Describe how the organization intends to utilize local partnerships and collaborations to
strengthen and strategize project efficacy:
*
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7/31/23, 11:11 AM Advancing Systems Change Grant: Pilot Program Application 2023
https://docs.google.com/forms/d/1RE2iMaeVCPeyPvZt8hrh7QIHY7UR34LkWjGs_iKyBMY/edit#response=ACYDBNhg_0meA9FbMv7Gi9ZQ7QASt…17/18
Requirements
Please review participation requirements outlined below, checking boxes next to each identied
requirement as an indication of commitment. If you cannot, for any reason, check one of these
requirements below, please describe reasoning in the section below.
Sign a standard Eagle County Contract
Participate in required meetings or convenings as described above
Work collaboratively with Eagle County Public Health throughout grant period
n/a
As I spoke with Jeff, the form was giving me errors for the last e questions so I have included those in an
email to both Chelsea and Jeff.
Describe the organization's use of input and/or collaboration with the population(s) impacted by
the proposed project:
*
How does your staff represent the population that the project will serve in a culturally
competent manner:
*
I Agree To:*
Reason unable to fulfill any requirements listed above:*
Additional comments or questions:
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
7
Eagle County Grant Final 5/14
EXHIBIT B
Scope of Work
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
AGREEMENT FOR PROFESSIONAL SERVICES
BETWEEN EAGLE COUNTY GOVERNMENT
AND
Mountain Youth
EXHIBIT B
Scope of Work: Terms of Funding, Deliverables, and Deadlines
These provisions are to be read and interpreted in conjunction with the provisions of the
Contract specified above.
I. Entity Name: Mountain Youth
II. Project Description:This project serves to provide access to information regarding the
needs, gaps in services, and overall well-being of the young adult/older youth population of
Eagle County.
III. Definitions:
Community Voice:An approach to decision-making, project management, and strategic
planning which incorporates direct feedback and redistributes power to community
members most impacted by the project or programming.
Root cause:A descriptor for the underlying reasons that create the differences seen in
health outcomes which originates from the community in which people live, and the
systems that dictate accessibility to resources and opportunities necessary for survival.
Systems change/systems-level-work:The shift of responsibility for poor health outcomes
from individual behavior, to the community systems which individuals rely on, where
inequities in access to opportunities for success exist. This addresses population health
measures on social, racial/ethnic, economic, and physical factors- often referred to as social
determinants of health.
Health Equity Framework:A Public Health Framework developed to collect data,
establish and evaluate projects/resources, and approach strategic planning in a manner that
includes and addresses health disparities and inequities.
Young adult/Older youth:A descriptor for community members between the ages of
ECPHE:Eagle County Public Health and Environment
MY:Mountain Youth
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
IV.Work Plan
Goal I:Contractor will report progress specific to the funded project which show
transparency in use of funds,adherence to grant focus,and project purpose.
Objective Ia:Contractor will report budgetary,programmatic,and evaluation progress with
ECPHE staff at a minimum of three (3)occurrences throughout the grant funding cycle,with an
additional evaluation meeting taking place one-year following grant closure,in adherence to
transparency,participation,and project-specific expectations.
Deliverables Deadlines
1.Contractor will provide ECPHE with budget
updates with specificity and transparency in direct
correlation with funded project.The reporting
template/format is flexible to contractor ’s
discretion,with approval from ECPHE staff.
December 2023 (specific date to be
determined),April 2024 (specific
date to be determined),and June
2024 (specific date to be
determined)
2.Contractor will provide ECPHE with
project-specific updates using both narrative and
indicator progress.Reporting template/format is
flexible to contractor ’s discretion,however,use of
the selecting health equity indicators is required.
December 2023 (specific date to be
determined),April 2024 (specific
date to be determined),and June
2024 (specific date to be
determined)
3.Contractor will provide ECPHE with evaluation
updates using the ECPHE Evaluation template.
December 2023 (specific date to be
determined),April 2024 (specific
date to be determined),June 2024
(specific date to be determined),
and post-grant meeting roughly
June 2025.
Objective Ia:Contractor will provide project-specific updates that indicate progress and
adherence to the project timeline and goals.
Deliverables Deadlines
1.Contractor will provide ECPHE updates regarding
the development of the older youth survey,
including:
a.Identification of desired indicators
b.Survey tool and methodology
c.Survey distribution plan,including key
partners and networks
d.Survey analysis process/approach
e.Equitable data accessibility/results
distribution plan
Reporting due:December 2023
(specific date to be determined),
April 2024 (specific date to be
determined),and June 2024
(specific date to be determined)
Survey development and
implementation deadlines in
adherence to the proposal timeline
2
Eagle County-Advancing Systems Change Pilot Grant Program
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
2.Contractor will provide ECPHE updates regarding
the engagement of key population leaders,
including:
a.Method of recruitment
b.Population represented by advocate
c.Professional role of individual
d.Compensation processes
Reporting due:December 2023
(specific date to be determined),
April 2024 (specific date to be
determined),and June 2024
(specific date to be determined)
Recruitment deadlines in adherence
to the proposal timeline
3.Contractor will provide ECPHE updates regarding
community engagement,including:
a.Outreach method
b.Prioritization of indicators with community
input
c.Participation incentivization planning
d.Equitable data accessibility/results
distribution plan
December 2023 (specific date to be
determined),April 2024 (specific
date to be determined),and June
2024 (specific date to be
determined)
Engagement deadlines in adherence
to the proposal timeline
4.Contractor will share qualitative and quantitative
data collected throughout the project period which
reflects the efficacy and reach of programming,
including:
a.Number of community members and
stakeholders engaged
b.Description of events facilitated and/or
participated in,including the role and
purpose
c.Data collected by survey
December 2023 (specific date to be
determined),April 2024 (specific
date to be determined),and June
2024 (specific date to be
determined)
5.Contractor will provide ECPHE updates regarding
Mountain Youth’s role in participation of regular
(monthly/quarterly/etc)youth and/or
family-serving coalitions,groups,strategies,and/or
similar convenings (e.g.:CTC,BE Providers,
District Wellness Committee).
December 2023 (specific date to be
determined),April 2024 (specific
date to be determined),and June
2024 (specific date to be
determined)
Goal II:Contractor will incorporate community voice of population(s)most impacted by
the organization’s programming/the funded project into decision-making processes.
Objective IIa:Contractor will assess the organization’s current decision-making process and
identify opportunities to incorporate direct community voice from the population(s)most
impacted by the organization’s programming/funded project.
Deliverables Deadlines
1.Contractor will identify the organization’s current
decision-making process and share this outline with
ECPHE staff.
No later than 6 weeks following
contract start-date using the
template provided by ECPHE.
3
Eagle County-Advancing Systems Change Pilot Grant Program
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
2.Contractor will assess the organization’s
opportunities to incorporate direct community
voice into decision-making.
No later than 12 weeks following
contract start-date with assistance
and template provided by ECPHE.
Objective IIa:Contractor will identify needs for internal capacity building to incorporate
community voice in decision-making processes.
Deliverables Deadlines
1.Contractor will assess current organizational
capacity for the incorporation of community voice
in decision-making,including but not limited to
staff and board representation,community-member
advisory roles,community boards,etc.
No later than 20 weeks following
contract start-date with assistance
and template provided by ECPHE.
Goal III:Contractor will build and/or strengthen authentic community connections with the
population(s)most impacted by the organization’s programming/funded project.
Objective IIIa:Contractor will connect directly with community members of the population
most impacted by the organization with the purpose of establishing trusted relationships and
authentic community-voice inclusion in operations/decision-making.
Deliverables Deadlines
1.Contractor will connect directly with community
members of the population most impacted by the
organizations via facilitation of groups,individual
interactions,participation in community events,
and/or similar methods of direct connection.
No later than 6 weeks following
contract start-date using the
template provided by ECPHE.
Goal IV:Contractor will collaborate with partners of shared population(s)served in an
effort to establish,determine,and/or strengthen the Organization’s role within the
population’s systems/system of care.
Objective IVa:Contractor will communicate/collaborate with key community partners in
assessing the needs of the population most impacted by the project.
Deliverables Deadlines
1.Contractor will identify key partners of service and
share this list with ECPHE staff.
No later than 6 weeks following
contract start-date using template
provided by ECPHE.
2.Contractor will identify groups,meetings,and/or
strategic planning initiatives with shared
population(s)of impact of the project.Contractor
will share this list with ECPHE staff.
No later than 6 weeks following
contract start-date using template
provided by ECPHE.
4
Eagle County-Advancing Systems Change Pilot Grant Program
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
3.Contractor will participate in partner/group
convenings,and/or individual partner collaborative
conversations as available.
Throughout contract period with
updates to ECPHE staff.
Objective IVb:Contractor will share knowledge of community needs as identified directly by
community voice with partners and/or groups.
Deliverables Deadlines
1.Contractor will participate in partner/group
convenings,and/or individual partner collaborative
conversations as available with the advocacy of
community voice and information gathered by use
of community voice.
Throughout contract period with
updates to ECPHE staff.
V.Monitoring:
Eagle County Public Health and Environment will monitor this Contract for compliance
with performance requirements throughout the Contract period.Methods used will include
progress meetings with ECPHE as needed/requested with required documentation provided
by the contractor.The Contractor’s performance will be evaluated in December of 2023
prior to the release of final payment of contract funds,at the end of the contract period,with
an evaluation discussion required one-year following contract closure.
VI.Resolution of Non-Compliance:
The Contractor will be notified in writing within 15 calendar days of discovery of a
compliance issue.Within 30 calendar days of discovery,the Contractor and Eagle County
Government will collaborate,when appropriate,to determine the action(s)necessary to
rectify the compliance issue and determine when the action(s)must be completed.The
action(s)and timeline for completion will be documented in writing and agreed to by both
parties.
5
Eagle County-Advancing Systems Change Pilot Grant Program
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
8
Eagle County Grant Final 5/14
EXHIBIT C
Insurance Certificate
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person)$
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $
PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
OTHER:$
COMBINED SINGLE LIMIT
$(Ea accident)
ANY AUTO BODILY INJURY (Per person)$
OWNED SCHEDULED
BODILY INJURY (Per accident)$AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
$AUTOS ONLY AUTOS ONLY (Per accident)
$
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
EAGL420 OP ID: MC1
03/06/2023
Marilyn Cox
NEISEN BORTH AGENCY
www.nbinsure.com
333 W. Hampden Ave. Ste. 305
Englewood, CO 80110
Todd Borth
303-781-6776 303-789-4409
mcox@nbinsure.com
Philadelphia Insurance Company
Eagle River Youth Coalition
P.O. Box 4613
Edwards, CO 81632
A X 1,000,000
X X PHPK2523564 03/01/2023 03/01/2024 100,000
5,000
X 1,000,000
2,000,000
2,000,000
Eagle County, its elected officials and employees are listed as Additional
Insured with respect to the General Liability when required by written
contract.
EAGLECY
Eagle County
PO Box 850
Eagle, CO 81631
303-781-6776
18058
Prof 1M/2M
DocuSign Envelope ID: 61D95143-D060-4F93-9357-AC86CB3E3463