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14000000062 Contract
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14000000062 Contract
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Last modified
2/5/2014 11:46:35 AM
Creation date
2/5/2014 11:46:35 AM
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Loan Projects
Contract/PO #
14000000062
Contractor Name
Applegate Group, Inc.
Contract Type
Grant
Loan Projects - Doc Type
Contract Documents
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a <br />Grant Fundina Application <br />The following owner information is required to receive grant funds: <br />Owner Information: <br />Dam Name: � � — <br />Dam Owner's Representative: �? I���Lf' �.4'r �. �� � U� <br />Lega! Name of Dam Owner: '�`io .�+ .�s � , S� t �' � _-- - <br />Mailing Address of Owner. i�O ! l� ��'Z ��`� k�- � 0 6'�'1 � b <br />Phone #: S�! �►,� 3 � t-- �4� �3 � <br />Fax #: �� !6) 3 3 � - 2a � <br />E-mail: �-%t 5 �i�� l9��� ��00� �'i <br />Federal Emplover ldentification Number (FEIN1: <br />In order for money to be disbursed by the State of Colorado, a taxpayer I.D. is required. This <br />number is included on the W-9 or Form 147C from the IRS. In many cases the dam owner is <br />already in the State's system and the above information is not necessary. Upon receipt of the <br />application you will be notified if the FEIN number or W-9 is required. <br />D-U-N-S Number: <br />For an entity to receive federal funds as a direct recipient or subrecipient (as in this case), <br />a D-U-N-S number is required. The D-U-N-S number can be easily obtained by accessing the <br />following website: http://fedaov.dnb.com/webform . Provide documentation of the DUNS number <br />with the application. <br />Office of Manaqement and Budaet (OMB1 Audit: <br />For your information, the Federal pass-through funds you will receive as part of this grant could be <br />subject to an Audit in Accordance with the OMB Circular A-133. To comply with this Audit, the <br />Department of Natural Resources (DNR) will contact you requesting certification that your entity <br />has not received over $500,000 is Federal funding within the fiscal year, or is in compliance with <br />Circular A-133. <br />If the entity received less than $500,000 in Federal funding in the fiscal year you are not subject to <br />the requirements of Circular A-133 and the certification requires a simple check box and signature. <br />You will be contacted following the completion of the project. Contact John Batka with questions <br />related to this audit at 970-352-8712 x1251. <br />Colorado Dam Safety Branch December z0, 2012 <br />Inundation Mapping Grant Program Guidelines Page 2 of 2 <br />
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