       IDesILaytags   ASDDSHS 05180c05_180c180                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   B         4   j        .3        *5   CA   @      @a   A-   A  s   C      А       2-                                                                                     &    ,    2    8    >    D    J    P    V    \    b    h    n    t    z                            6     `         Submit                        6       2W @B                            6         s                                  6    $                                          6  4  *        35140800190180187                j  H   4                workpage   -           #####;#####-####                  (    )      -           (###) ###-####           @@                 X           
          
 9           @@                        @@                     @@              @@                       @    @@             .        .   T 8T       T ݲ9      0    /  _T      0    9        /  5M
8 T .     M
    l T / | L N
M
           N
  T    M
   "T / 'T 0    /  T LA .    /  T .    .  \A M
                A                       .    A .           @@ @                                        
                                 @@                    N    6  8                                                               3 3                                                                        1&@  XX     jdV      XX         d            '               ʄ -M?           d       
f                       
    @@     m                                	                   5       P                 AGENCY NAME                     &  ,       @$@     n                                	                  6       P$                 DATE                    $ &        @                JDAI GRANT APPLICATION      	                 h      @$@     o                         @       	              #    7       A$                 PROJECT TITLE                    $ >  .       @ $    C              0 0            .   10.  STATEMENT OF WORK AND IMPLEMENTATION PLAN      
    	        	       	    /p"0 $                PAGE 7      	                         @/@$D@     p                          0                         8       01$             :   Project's Plan to hire a qualified, independent evaluator:      
    	         	    	     @0$P             z   The contractor agrees to perform the following minimum statement of work:	Submit the AECF-JDAI Quarterly Report and annual Results Report, no later than 30 days after the end of each quarter to include:      a	Detention Population Report      a	Alternative Programs Report      a	Detention Referrals Screened Report      a	Detention Risk Assessment Instrument Override Report	Attend JDAI Quarterly Meetings, State and National JDAI Conferences (as held / applicable)	Conduct a minimum of four (4) JDAI Stakeholder Meetings per year	Conduct a Detention Self-Inspection every two (2) years	Submit quarterly progress and financial reports to the Office of Juvenile Justice on reporting forms provided by OJJ.	Work collaboratively with the JDAI statewide coordinator and the Office of Juvenile Justice in efforts to address DMC through JDAI.Attach the County JDAI Implementation Plan addressing the eight core strategies of JDAI, including at a minimum:	Description of the current status of eight (8) JDAI strategies	Objectives for the contract period (July 1, 2011  June 30, 2012)	Activities and tasks to meet objectives 	     	               	 V             	               	 V             	              	 V            	             I 	 V           J 	                    @$                           P008  objectives                       `                      $                           P008                    $                           P008   |Q  k   A 	  }    9 H  ] ' 3 , H r@Y                         <                           	   
                                                                      !   "   #   $   %   &   '   (   )   *   +   ,   -   .   /   0   1   2   3   4   5   6   7   8   9   :   ;   <   =   >   ?   @   A   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   W   X   Y   Z   [   \   ]   ^   _   `   a   b   c   d   e   f   g   h   i   j   k   l   m   n   o   p   q   r   s   t   u   v   w   x   y   z   {   |   }   ~                                                     <ͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤ  G   ContractNumberProgramArea	DateStamp
AgencyNameAgencyTelephone	AgencyFAXAgencyAddress_StreetAgencyAddress_CityAgencyAddress_StateAgencyAddress_ZipAgencyMailingAddress_StreetAgencyMailingAddress_CityAgencyMailingAddress_StateAgencyMailingAddress_ZipImplementingNameImplementingAddress_StreetImplementingAddress_CityImplementingAddress_StateImplementingAddress_ZipImplementingTelephoneSSNProjectTitleLegalAuthorityNameAgencySignatureDateAcceptance_YesAcceptance_NoOJJSignatureDateProjectDirectorNameProjectDirectorAddress_StreetProjectDirectorAddress_CityProjectDirectorAddress_StateProjectDirectorAddress_ZipProjectDirectorTelephoneProjectDirectorFAXProjectDirectorEmailFinancialOfficerNameFinancialOfficerAddress_StreetFinancialOfficerAddress_CityFinancialOfficerAddress_StateFinancialOfficerAddress_ZipFinancialOfficerTelephoneFinancialOfficerFAXFinancialOfficerEmailAgencyName1DateProjectTitle1 A_PositionTitlesA_AnnualSalaryA_TimePercentToProjectA_ItemTotalA_AnnualSalary_TotalA_Percent_TotalA_ItemTotal_TotalA_JustificationAgencyName2Date1ProjectTitle2 	B_ListingB_Unit
B_UnitCostB_ItemTotalB_Total 	C_ListingC_Unit
C_UnitCostC_ItemTotalC_TotalAgencyName3Date2ProjectTitle3 	D_ListingD_Unit
D_UnitCostD_ItemTotalD_Total 	E_ListingE_Unit
E_UnitCostE_ItemTotalE_TotalAgencyName4Date3ProjectTitle4 	F_ListingF_Unit
F_UnitCostF_ItemTotalF_Total 	G_ListingG_Unit
G_UnitCostG_ItemTotalG_TotalAgencyName5Date4ProjectTitle5ProposedTime_FromDateProposedTime_ToDateA_Personnel_TotalB_Supplies_TotalC_Other_TotalD_CapitalOutlay_TotalE_Travel_TotalF_Contractual_TotalTotalDirectChargesG_IndirectCharges_TotalTotalProjectCostFederal_TotalMatchOtherSourceOtherSourceAmountSourceOfFunds_TotalProjectSummaryOtherSource1OtherSourceAmount1OtherSource2OtherSourceAmount2OtherSource3OtherSourceAmount3OtherSource4OtherSourceAmount4FederalPercentMatchPercentageOtherSourcePercentSourceOfFunds_PercentOtherSourcePercent1OtherSourcePercent2OtherSourcePercent3OtherSourcePercent4AgencyName7Date6ProjectTitle7ProjectPlan                         





 					           N         /`/	P                DSHS 05-180C (REV. 04/2013)       	                 r               
masterpage              
masterpage                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  *5  <  s    (         l    _ m    r k    J n     j    @ p     q     o     r     h    %        4        4    5        i    0                  $                  p    T        |    ^    e d              !                  @        @    6    g       /                                 ,   E           y                   +    u    a        G   T    p    T    |    ^    e   {                     u   . v   G t    w   a s    y   y    	                       9   Y         &   F   f!   #   $   %   &    e        '    C    	    `                {8   1    {           F        F    7   #        "       z      h     =ContractNumberProgramArea	DateStamp
AgencyNameAgencyTelephone	AgencyFAXAgencyAddress_StreetAgencyAddress_CityAgencyAddress_StateAgencyAddress_ZipAgencyMailingAddress_StreetAgencyMailingAddress_CityAgencyMailingAddress_StateAgencyMailingAddress_ZipImplementingNameImplementingAddress_StreetImplementingAddress_CityImplementingAddress_StateImplementingAddress_ZipImplementingTelephoneSSNProjectTitleLegalAuthorityNameAgencySignatureDateAcceptance_YesAcceptance_NoOJJSignatureDateProjectDirectorNameProjectDirectorAddress_StreetProjectDirectorAddress_CityProjectDirectorAddress_StateProjectDirectorAddress_ZipProjectDirectorTelephoneProjectDirectorFAXProjectDirectorEmailFinancialOfficerNameFinancialOfficerAddress_StreetFinancialOfficerAddress_CityFinancialOfficerAddress_StateFinancialOfficerAddress_ZipFinancialOfficerTelephoneFinancialOfficerFAXFinancialOfficerEmailAgencyName1DateProjectTitle1A_PositionTitlesA_AnnualSalaryA_TimePercentToProjectA_ItemTotalA_AnnualSalary_TotalA_Percent_TotalA_ItemTotal_TotalA_JustificationAgencyName2Date1ProjectTitle2	B_ListingB_Unit
B_UnitCostB_ItemTotalB_Total	C_ListingC_Unit
C_UnitCostC_ItemTotalC_TotalAgencyName3Date2ProjectTitle3	D_ListingD_Unit
D_UnitCostD_ItemTotalD_Total	E_ListingE_Unit
E_UnitCostE_ItemTotalE_TotalAgencyName4Date3ProjectTitle4	F_ListingF_Unit
F_UnitCostF_ItemTotalF_Total	G_ListingG_Unit
G_UnitCostG_ItemTotalG_TotalAgencyName5Date4ProjectTitle5ProposedTime_FromDateProposedTime_ToDateA_Personnel_TotalB_Supplies_TotalC_Other_TotalD_CapitalOutlay_TotalE_Travel_TotalF_Contractual_TotalTotalDirectChargesG_IndirectCharges_TotalTotalProjectCostFederal_TotalMatchOtherSourceOtherSourceAmountSourceOfFunds_TotalProjectSummaryOtherSource1OtherSourceAmount1OtherSource2OtherSourceAmount2OtherSource3OtherSourceAmount3OtherSource4OtherSourceAmount4FederalPercentMatchPercentageOtherSourcePercentSourceOfFunds_PercentOtherSourcePercent1OtherSourcePercent2OtherSourcePercent3OtherSourcePercent4AgencyName7Date6ProjectTitle7ProjectPlanunt1OtherSource2OtherSourceAmount2OtherSource3OtherSourceAmount3OtherSource4OtherSourceAmount4FederalPercentMatchPercentageOtherSourcePercentSourceOfFunds_PercentOtherSourcePercent1OtherSourcePercent2OtherSourcePercent3OtherSourcePercent4AgencyName6Date5ProjectTitle6AgencyName7Date6ProjectTitle7ProjectPlanAgencyName8Date7ProjectTitle8ProjectOutcomes1ProjectObjectives1Month1_1Month2_1Month3_1Month4_1Month5_1Month6_1Month7_1Month8_1Month9_1	Month10_1	Month11_1	Month12_1AgencyName9Date8ProjectTitle9ProjectOutcomes2ProjectObjectives2Month1_2Month2_2Month3_2Month4_2Month5_2Month6_2Month7_2Month8_2Month9_2	Month10_2	Month11_2	Month12_2rojectObjectives2Month1_2Month2_2Month3_2Month4_2Month5_2Month6_2Month7_2Month8_2Month9_2	Month10_2	Month11_2	Month12_2AgencyName10Date9ProjectTitle10AgencyName11Date10ProjectTitle11ProjectEvaluatorSupervisorProjectPlan1AgencyName12Date11ProjectTitle12LogicModel_OutcomesLogicModel_Indicators LogicModel_DataCollectionMethods"LogicModel_DataCollectionFrequencyLogicModel_SamplingStrategy           ;\                 <        :            !  }       %;\                     &     
                         &                             }    &       s                    z                             X        N  .3  Z   3     Submit                              @  f    05180c22003  T 8T    1   T   R<      `  ASD  _T      `    R<DSHS     X J  I     05_180c \ T / l <                               @a  l           3'    3' &        3'    d            '   `=@         ʤ SS      
  o  d                              6  A-  r                                       A         	Signature        Version   	Data Vers \  $	Blue Keys        *Graphics   0Header    6	FieldList \  <	Form Info        fLayoutProps l'  xDesPathInfo l'  ~CellDisplayName                    6  B  ~   this                                   R]  C  T  K      0`                fOFFICE OF JUVENILE JUSTICE (OJJ)Juvenile Detention Alternatives Initiative Grant ApplicationPlease read all instructions carefully.      	                     
         !              ]      
         ^ 
    	              0`P                For assistance, contact the Department of Social and Health Services (DSHS) Office of Juvenile Justice at (360) 902-7526 or FAX (360) 902-7527.      	             @@ I < oh   <   I  h   o        
 8                        
 I < oh ,  Arial          ( Y HMFor assistance, contact the Department of Social and Health Services (DSHS)                   ( b ZCOffice of Juvenile Justice at (360) 902-7526 or FAX (360) 902-7527.             @                              0       	                    d       1p                 CONTRACT NUMBER                       =       p@                                     	                    e       p                 PROGRAM AREA                       1       `$     G              `$                 	FOR OJJ USE ONLY                     # @U     #  U   @        
 I < oh                        
 # @U ,  Arial         ( 4FOR OJJ USE ONLY              `p$@                                     	                   g       p$              
   DATE STAMP                       '       p $    G                            (   1.  APPLICANT:  DO NOT USE PERSON'S NAME                               @                                     	                    h       0                 AGENCY NAME                       ,         @                                     	                    i       0p                 TELEPHONE NUMBER                       @        $ @                                     	                    j       0$              
   FAX NUMBER                       '       
  @                              	        	                    k       	!                 STREET ADDRESS                       7       
 $                  
  @                              	        	                    l       	!p                 CITY                              
 @     	                         	        	                   m       	!                 STATE                              
 $ @     
                         	        	                    n       	!$                 ZIP CODE                              
  @                              
       	                    o       
0
                 MAILING ADDRESS                       7       
 $                  
  @                              
       	                    p       
0
p                 CITY                              
 @                              
       	                   q       
0
                 STATE                              
 $ @                              
       	                    r       
0
$                 ZIP CODE                              P$    G              P"             |   2.  IMPLEMENTING AGENCY:  ENTER AGENCY, DEPARTMENT OR CONTRACTOR DIRECTLY IMPLEMENTING THE PROJECT (DO NOT USE PERSON'S NAME                            P @                                     	                    s       `                 NAME                              P @                              P       	                    t       Q                 STREET ADDRESS                       7       P                  Pp @                                     	                    u       ``                 CITY                              Pp@                                     	                   v       `                 STATE                              P @                                     	                    w       `                 ZIP CODE                              P$ @                                     	                    y       `$                 TELEPHONE NUMBER                       @       $ @                                     	                    z       $              e   FEDERAL EMPLOYER IDENTIFICATION NUMBER OR SOCIAL SECURITY NUMBER (MANDATORY FOR FEDERAL TAX PURPOSES)                    ` T  `     T           
 8                 
 ` T ,  Arial          ( k:FEDERAL EMPLOYER IDENTIFICATION NUMBER OR SOCIAL SECURITY             ( k+NUMBER (MANDATORY FOR FEDERAL TAX PURPOSES)              $    G              0             ;   3.  PROJECT TITLE:  ENTER BRIEF, DESCRIPTIVE PROJECT TITLE                               $ @                                      	              #     {       `$                 NAME                               $    G              @                4.  APPLICANT'S AGREEMENT                       f      + /0$                  Omission of any required information or certification may be cause for denial of the application.  The Department shall take a final approval/disapproval action on all applications within 90 days of receipt by the Department of a conforming application, together with all required certifications.  The Department shall not consider an application conforming unless the applicant has completed all items in accordance with instructions and has submitted the necessary certifications.  The applicant must submit two signed completed applications to:  OFFICE OF JUVENILE JUSTICE, DEPARTMENT OF SOCIAL AND HEALTH SERVICES, PO BOX 45828 OLYMPIA WA  98504-5828.      	             ll J       J          
 ` T                 
 J ,  Arial          ( "Omission of any required information or certification may be cause for denial of the application.  The Department shall take a final approval/disapproval             ( "action on all applications within 90 days of receipt by the Department of a conforming application, together with all required certifications.  The             ( "Department shall not consider an application conforming unless the applicant has completed all items in accordance with instructions and has submitted            ( "the necessary certifications.  The applicant must submit two signed completed applications to:  OFFICE OF JUVENILE JUSTICE, DEPARTMENT OF             ( "@SOCIAL AND HEALTH SERVICES, PO BOX 45828 OLYMPIA WA  98504-5828.              0$ @                              0       	                           1$                 NAME AND TITLE OF AUTHORIZED OFFICER (PERSON WITH LEGAL AUTHORITY:  COUNTY COMMISSIONERS' CHAIRMAN OF THE BOARD, MAYOR, CITY/TOWN MANAGER, AGENCY DIRECTOR)                      ,       0$ @                                     	                           @$                 DATE                              P                APPLICANT'S SIGNATURE                          M      0                   0               *   ACCEPTANCE OF OFFER COUNTEROFFER FOR DSHS                                !0                    ` ! 0@                                                               p!                
   Acceptance      	               -        `0! @                                                               p !                  Non-acceptance      	               >         0P              $   OJJ CONTRACTING OFFICER'S SIGNATURE                                 !0                  !0$@                               0       	                            1$                 DATE                              !0!$    G              !p!#              ~   5.  PROJECT DIRECTOR:  PERSON IN DIRECT CHARGE OF PROJECT (DAY-TO-DAY OPERATIONS AND PREPARATION OF REQUIRED PROGRESS REPORTS)                            !#` @                              "`       	                           !"a                 NAME AND TITLE                       2       #`$ @                              #       	                           #p#                 STREET ADDRESS                       7       $&`                  $&`p @                              %`       	                           $%a`                 CITY                              $p&`@                              %`       	                          $%a                 STATE                              $&` @                               %`       	                           $%a                 ZIP CODE                              !#`$ @     !                         "`       	                           !"a$                 TELEPHONE NUMBER                       @       #`$$ @     "                         #       	                           #p#$              
   FAX NUMBER                       '       $&`$ @     #                         %`       	                           $%a$                 E-MAIL ADDRESS                       3       &`'$    G              &'$                6.  FINANCIAL OFFICER:  PERSON IN CHARGE OF FISCAL MATTERS (ACCOUNTING, FUNDS MANAGEMENT, EXPENDITURE, VERIFICATIONS, FINANCIAL REPORTS)                      +      '( @     $                         '       	                           ' '                 NAME AND TITLE                       2       (* @     %                         )       	                           ()                 STREET ADDRESS                       7       *+                  *+p @     &                         *       	                           * *`                 CITY                              *p+@     '                         *       	                          * *                 STATE                              *+ @     (                         *       	                           * *                 ZIP CODE                              '($ @     )                         '       	                           ' '$                 TELEPHONE NUMBER                       @       (*$ @     *                         )       	                           ()$              
   FAX NUMBER                       '       *+$ @     +                         *       	                           * *$                 E-MAIL ADDRESS                       3        $                  The applicant is applying for a grant award in the amount shown in the proposed BUDGET SUMMARY (Section 8 of this application) for the purposes identified in this application.  By signing and submitting this application, the applicant agrees that this document, together with the GENERAL TERMS AND CONDITIONS (Attachment A of this application), becomes an offer to contract with Washington State Department of Social and Health Services (DSHS or the Department) which, if accepted, binds the applicant to the following:      	             4 tJ     4  J  t        
 8                 
4 tJ ,  Arial          (F "The applicant is applying for a grant award in the amount shown in the proposed BUDGET SUMMARY (Section 8 of this application) for the purposes             (Q "identified in this application.  By signing and submitting this application, the applicant agrees that this document, together with the GENERAL TERMS             (\ "AND CONDITIONS (Attachment A of this application), becomes an offer to contract with Washington State Department of Social and Health Services            (g "R(DSHS or the Department) which, if accepted, binds the applicant to the following:                $                   The applicant agrees that this offer becomes a binding contract when a copy of this page is signed by the OJJ Director and returned to the applicant together with an Approved Budget and Special Conditions form provided, however:      	             b J     b  J          
4 tJ                 
b J ,  Arial          (t "The applicant agrees that this offer becomes a binding contract when a copy of this page is signed by the OJJ Director and returned to the applicant            ( "Otogether with an Approved Budget and Special Conditions form provided, however:             P                    a.      	               {  6     {   6          
b J                 
{  6 ,  Arial          ( "a.              P$                  In the event any budget category amount differs from the amount shown in Section 8 of this application, as modified by the Approved budget and Special Conditions, that amount shall be considered to be a counteroffer.  The Department shall consider the counteroffer accepted by the applicant unless rejected in writing within 30 days after the date of mailing of such counteroffer by the Office of Juvenile Justice (hereinafter referred to as OJJ) to the applicant.      	             { "J   "  {  J          
{  6                 
{ "J ,  Arial          ( ,In the event any budget category amount differs from the amount shown in Section 8 of this application, as modified by the Approved budget and            ( ,Special Conditions, that amount shall be considered to be a counteroffer.  The Department shall consider the counteroffer accepted by the applicant             ( ,unless rejected in writing within 30 days after the date of mailing of such counteroffer by the Office of Juvenile Justice (hereinafter referred to as OJJ)             ( ,to the applicant.             0                   b.      	                 6        6          
{ "J                 
  6 ,  Arial          ( "b.              0$                   Upon acceptance of this offer/counteroffer, the applicant shall be referred to as the "Contractor" and the Contractor agrees to accept and abide by the special terms and conditions.      	             VV "J   "    J          
  6                 
 "J ,  Arial          ( ,Upon acceptance of this offer/counteroffer, the applicant shall be referred to as the "Contractor" and the Contractor agrees to accept and abide by the             ( ,special terms and conditions.             $                  +/@$                  /p"0 $                PAGE 1      	                         `                  xL`#  B        Grant Application            P001         P001    P001                          p@                I?xJ  B        Grant Application            P001              S      /p"0 $                PAGE 1      	                         p@                I?xJ  B        Grant Application                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         :  CA          @@     ,                                	                           P                 AGENCY NAME                       ,       @$ @     -                                	                          P$                 DATE                              @                JDAI GRANT APPLICATION      	                 h      @$@     .                         @       	              #            A$                 PROJECT TITLE                       .       @ $     G               p            ,   10.  BUDGET DETAILS:  CATEGORY A.  PERSONNEL      
    	        	       	    /p"0 $                PAGE 3      	                          $p             4    This category is for services rendered by all personnel employed by the project.  Costs incurred include salaries, benefits, uniforms, and special clothing.SALARIES AND WAGES:     Payment for personal services rendered in accordance with rates, hours, terms and conditions as authorized by law or stated in employment contracts.OVERTIME, HAZARDOUS DUTY, ETC.PERSONAL BENEFITS:  FICA, retirements, insurance, etc.UNIFORMS AND CLOTHING:  Only uniforms for special clothing required by the nature of the employment and paid for by the employer may be listed.NOTE:  Project funds may not be used to pay a percentage of the compensation of any person who was employed by the implementing agency before the project starting date without prior specific authorization from the Department separate from the grant approval.  Specific authorization is not required if a person currently employed by the applicant or the implementing agency is transferred from his/her prior position to the project if the transfer creates a personnel vacancy to be filled by hiring a new employee.      	               	              	             K 	            } 	              	             	              _  Q      _  Q           
 "J                 
 _  Q ,  Arial          ( q "This category is for services rendered by all personnel employed by the project.  Costs incurred include salaries, benefits, uniforms, and special clothing.                 (  "SALARIES AND WAGES            (  }:     Payment for personal services rendered in accordance with rates, hours, terms and conditions as authorized by law or stated             (  "in employment contracts.          (  "OVERTIME, HAZARDOUS DUTY, ETC.        (  "PERSONAL BENEFITS:            (  }$ FICA, retirements, insurance, etc.           (  "UNIFORMS AND CLOTHING:            (  z  Only uniforms for special clothing required by the nature of the employment and paid for by the employer may be listed.                   (  "NOTE:  Project funds may not be used to pay a percentage of the compensation of any person who was employed by the implementing agency before the             (  "project starting date without prior specific authorization from the Department separate from the grant approval.  Specific authorization is not required if a             (  "person currently employed by the applicant or the implementing agency is transferred from his/her prior position to the project if the transfer creates a             (  "8personnel vacancy to be filled by hiring a new employee.              p$ @    /                                  
                                              Title           
                  p  @    /                               
                                           LIST POSITION TITLES      	                 V        p @    /                               
                        0                ANNUAL SALARY      	                 B       p 0@    /                               
                                           PERCENT OF TIME TO PROJECT      	                                 
 _  Q                        
  ,  Arial          ( PERCENT OF                   (TIME TO                    (PROJECT               0p$@    /                               
                         @$             
   ITEM TOTAL      	                 /        $                  @P 0                %          
        
     	  
    `P 0                %          
        
     	  
    P0 0                %          
        
     	  
    PP 0                %          
        
     	  
    Pp 0                %          
        
     	  
    P 0                %          
        
     	  
     P 0                %          
        
     	  
     P 0                %          
        
     	  
    @P 0                %          
        
     	  
    `P 0                %          
        
     	  
    P0 0                %          
        
     	  
    PP 0                %          
        
     	  
    p                   p H     0                                
                     p!Pq            	   2.  Match           	          	  %  
     p 0H     1                                
                        p!Pq             	   2.  Match           	          	  %  
     @                 %          
        
     	  
    p 0$H     2                                
                     p!Pq            	   2.  Match           	          	  %  
                       CATEGORY TOTAL      	                 I      p                   p 0                  p 0$                  /@$D@     3                         !       
                          !!$                 JUSTIFICATION AND EXPLANATION:  Justify all positions in terms of days and/or hours required to perform the GOALS, OBJECTIVES, AND TASKS set forth.  Calculate fringe benefits for each position or class of positions.      	             xx T       T          
 8                 
 T ,  Arial          ( JUSTIFICATION AND EXPLANATION:  Justify all positions in terms of days and/or hours required to perform the GOALS, OBJECTIVES, AND TASKS set            ( Jforth.  Calculate fringe benefits for each position or class of positions.               Budget 1            P002  s for each position or class of positions.               Budget 1            P002  T      N =    H          H  B   = M    Budget 1              	   2.  Match           	         	  	 %  
      $$                 %           
          
       	       `$                   ` $ H     =                                
                         p!Pq             	   2.  Match           	          	  "  %  
     @$ $                 %           
          
       	       ` $                     H     >                                
                          p!Pq             	   2.  Match           	          	  "  %  
        ` H     ?                                
                          p!Pq             	   2.  Match           	          	   " %  
       ` $  H     @                                
                          p!Pq             	   2.  Match           	          	  "  %  
     `$ $                 %           
          
       	        ` $                   `H     M                               
                                          TOTAL PROJECT FUNDS      
    	        	  	 l  	      `$  H     N                                
                          p!Pq             	   2.  Match           	         	  	 %  
      $$                 %           
          
       	       `$                  p$    C               pp             D   9.  PROJECT SUMMARY:  GIVE A BRIEF NARRATIVE SUMMARY OF THE PROJECT.                               p/@$ H     O                                
                          p!Pq             	   2.  Match           	          	  "  %  
     /`/             B   DSHS 05-180 (REV. 09/2002) PROPOSED REVISION - DO NOT PRINT MILLIE                                /p"0 $                PAGE 2      	                             @ H     A                                
                          p!Pq             	   2.  Match           	          	  "  %  
      @ ` H     B                                
                          p!Pq             	   2.  Match           	          	   " %  
       `@$  H     C                                
                          p!Pq             	   2.  Match           	          	  "  %  
     $@$                 %           
          
       	        `@$                  @` H     D                                
                          p!Pq             	   2.  Match           	          	  "  %  
     @` ` H     E                                
                          p!Pq             	   2.  Match           	          	   " %  
     @ ``$  H     F                                
                          p!Pq             	   2.  Match           	          	  "  %  
     $`$                 %           
          
       	      @ ``$                  ` H     G                                
                          p!Pq             	   2.  Match           	          	  "  %  
     ` ` H     H                                
                          p!Pq             	   2.  Match           	          	   " %  
     ` `$  H     I                                
                          p!Pq             	   2.  Match           	          	  "  %  
     $$                 %           
          
       	      ` `$                   H     J                                
                          p!Pq             	   2.  Match           	          	  "  %  
      ` H     K                                
                          p!Pq             	   2.  Match           	          	   " %  
      `$  H     L                                
                          p!Pq             	   2.  Match           	          	  "  %  
     $$                 %           
          
       	       `$                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          $      #      @@     4                                	                           P                 AGENCY NAME                       ,       @$@     5                                	                          P$                 DATE                              @                JDAI GRANT APPLICATION      	                 h      @$@     6                         @       	              #            A$                 PROJECT TITLE                       .       @ $    G              @             +   10.  BUDGET DETAILS:  CATEGORY B.  SUPPLIES      
    	        	       	    /p"0 $                PAGE 4      	                         $`                 This category is for articles and commodities which are consumed or materially altered when used.  The following are types of supplies.OFFICE SUPPLIES:  For example, office stationery, forms, small items of equipment, and maps, films, books, periodicals, and tapes.OPERATING SUPPLIES: For example, chemicals, drugs, medicines, laboratory supplies, cleaning and sanitation supplies, fuel, household and institutional supplies, and clothing.  (Federal OJP funds may not be used to purchase food and/or beverages for any meeting, conference, training, or other event.  Providing food and/or beverages to youth as part of programmatic activity is not subject to this restriction because such activity does not fall within the definition of a conference, training, or meeting.)REPAIR AND MAINTENANCE SUPPLIES:  For example, building materials and supplies, paints and painting supplies, plumbing supplies, electrical supplies, motor vehicle repair materials and supplies, other repair and maintenance supplies, and small tools.      	               	              	              	             	              	            ( 	             \\ ^  P      ^  P           
 T                 
 ^  P ,  Arial          ( p !This category is for articles and commodities which are consumed or materially altered when used.  The following are types of supplies.                  (  !OFFICE SUPPLIES:            (  ks  For example, office stationery, forms, small items of equipment, and maps, films, books, periodicals, and tapes.          (  !OPERATING SUPPLIES:           (  }v For example, chemicals, drugs, medicines, laboratory supplies, cleaning and sanitation supplies, fuel, household and             (  !institutional supplies, and clothing.  (Federal OJP funds may not be used to purchase food and/or beverages for any meeting, conference, training, or             (  !other event.  Providing food and/or beverages to youth as part of programmatic activity is not subject to this restriction because such activity does not fall            (  !>within the definition of a conference, training, or meeting.)           (  ! REPAIR AND MAINTENANCE SUPPLIES:            (  l  For example, building materials and supplies, paints and painting supplies, plumbing supplies, electrical             (  !nsupplies, motor vehicle repair materials and supplies, other repair and maintenance supplies, and small tools.              $ @    7                                  
                                              Title           
                  0 @    8                               
                                        *   ITEMIZED LISTING (DESCRIPTION OF THE ITEM)      	                        0 @    9                               
                        @                UNIT      	                         0@    :                               
                                      	   UNIT COST      	                 +        0$@    ;                               
                        @$             
   ITEM TOTAL      	                 /        $                   0                   0$H     8                                
                      p!Pq            	   2.  Match           	          	  %  
     @                CATEGORY TOTAL      	                 I       0$                  $    G              	 P            =   10.  BUDGET DETAILS:  CATEGORY C.  OTHER SERVICES AND CHARGES      
    	        	    @  	    " . $ @    9                                  
                                              Title           
                  " . 0  @    8                        "       
                          ""              H   ITEMIZED LISTING (WORD OR WORDS DESCRIBING THE COST ITEM, I.E., POSTAGE)      	                E       " 0.   @    9                        "       
                        "@"                UNIT      	                        " .  0 @    :                        "       
                       ""               	   UNIT COST      	                 +       "  0. $ @    ;                        "       
                       " @"$             
   ITEM TOTAL      	                 /       . /@ 0                  .  0/@$H     :                                
                      p!Pq            	   2.  Match           	          	  %  
     ./@                CATEGORY TOTAL      	                 I      .  0/@$                  P !#                 This category is for services other than PERSONNEL which are required in the administration of the project.  Such services may be provided by some agency of the government unit or by private business organizations.  The following are types of services and charges classified under this category.COMMUNICATION:  For example, telephone, telegraph, and postage.TRANSPORTATION:  For example, freight and express charges, and messenger service.ADVERTISINGPUBLIC UTILITY SERVICEPRINTING AND BINDINGREPAIRS AND MAINTENANCEINSURANCERENTALS:  For example, buildings, and equipment and machinery.MISCELLANEOUS:  For example, tuition and other training fees, dues, subscriptions and memberships, and taxes. 	     	             ) 	            8 	             i 	            y 	              	             	             T 	            c 	             RR #F       F  #        
 ^  P                 
 #F ,  Arial          ( "This category is for services other than PERSONNEL which are required in the administration of the project.  Such services may be provided by some            ( "agency of the government unit or by private business organizations.  The following are types of services and charges classified under this category.                 ( "COMMUNICATION:            ( l1 For example, telephone, telegraph, and postage.          ( "TRANSPORTATION:             ( qB For example, freight and express charges, and messenger service.           ( "ADVERTISING         ( "PUBLIC UTILITY SERVICE        ( "PRINTING AND BINDING        ( "REPAIRS AND MAINTENANCE         (  "
INSURANCE         ( "	RENTALS:            ( L6 For example, buildings, and equipment and machinery.           ( "MISCELLANEOUS:            ( l^ For example, tuition and other training fees, dues, subscriptions and memberships, and taxes.              " $                  Budget 2            P003                                                                                                                                                                                                                                                        А          @@     ;                                	                           P                 AGENCY NAME                       ,       @$@     <                                	                          P$                 DATE                              @                JDAI GRANT APPLICATION      	                 h      @$@     =                         @       	              #            A$                 PROJECT TITLE                       .       @ $    G               !            ;   10.  BUDGET DETAILS:  CATEGORY D.  CAPITAL OUTLAY/EQUIPMENT      
    	        	    2  	    /p"0 $                PAGE 5      	                          
 $p                > This category is for nonexpendable outlays which result in the acquisition of, rights to, or additions to fixed assets, other than structures.  The following are some of the types of charges under this category.  NOTE:  Exclude small tools.MACHINERY AND EQUIPMENT:  For example, communications equipment (typewriter, microcomputer), janitorial; laboratory, office furniture and equipment, heavy duty work equipment, and other machinery and equipment.      	               	            	 	              _  Q      _  Q           
 #F                 
 _  Q ,  Arial          ( q "This category is for nonexpendable outlays which result in the acquisition of, rights to, or additions to fixed assets, other than structures.  The following are             ( | "Osome of the types of charges under this category.  NOTE:  Exclude small tools.                 (  "MACHINERY AND EQUIPMENT           (  s:  For example, communications equipment (typewriter, microcomputer), janitorial; laboratory, office furniture and            (  "Hequipment, heavy duty work equipment, and other machinery and equipment.              
p$ @    >                                  
                                              Title           
                  
p0 @    ?                        P       
                          
Q              )   ITEMIZED LISTING (DESCRIBE THE COST ITEM)      	                        
p0 @    @                        P       
                        
@Q                UNIT      	                        
p 0@    A                        P       
                       
Q               	   UNIT COST      	                 +       
p 0$@    B                        P       
                       
 @Q$             
   ITEM TOTAL      	                 /        
p$                   0                   0$H     ?                                
                      p!Pq            	   2.  Match           	          	  %  
     `                CATEGORY TOTAL      	                 I       0$                  $    G              0	P             )   10.  BUDGET DETAILS:  CATEGORY E.  TRAVEL      
    	        	       	    . $ @    @                                  
                                              Title           
                  . 0  @    A                               
                                           ITEMIZED LISTING      	                 F       0.   @    B                               
                        @                UNIT      	                        .  0 @    C                               
                                      	   UNIT COST      	                 +        0. $ @    D                               
                        @$             
   ITEM TOTAL      	                 /       . /@ 0                  .  0/@$H     A                                
                      p!Pq            	   2.  Match           	          	  %  
     ./@                CATEGORY TOTAL      	                 I      .  0/@$                  p 0#                 Travel costs are for domestic travel.  Contractors may follow their own established rate for staff travel as long as the rate does not exceed the allowable state rate.The allowable state rate for mileage will be used.  Air fare should be the lowest coach fare.      	              F       F          
 _  Q                 
 F ,  Arial          ( "Travel costs are for domestic travel.  Contractors may follow their own established rate for staff travel as long as the rate does not exceed the allowable             ( "state rate.                   ( "]The allowable state rate for mileage will be used.  Air fare should be the lowest coach fare.             $                  Budget 3            P004  h fare.             $                  Budget 3            P004  AFT      N =    H          H        = M    Budget 3                                                                                                                                                                                                                                                                                                                                                                                                                                                  =    0   q    	            (###) ###-####             #####;#####-####           
  /  /       r     ###0   00           #,##0.00          0           0    2      ###0           #,##0       @@                 X           
          
 "J            @@                        @@                     @@              @@                       @    @@            A   G |  G   N" cx       N" G   N" G   N" x<      N"   A < x       N"       p t  l N" aA        <      A         N" N"        A @A    N" A    >    ~5" A    Γ    >M 6" J  Γ\  ]       r     &  Q 9P    < J  QK    < f\       @@ @                                        
                               @@                X           
         
  "            @@ @                                        
                                @@                X           
         
                  @@ @                                      
                               @@                X           
         
              @@        N" x<                     @@                 X       
               2  
                       H    N   T                                                 &     
                         &                 I           @@     B                                	                           P                 AGENCY NAME                       ,       @$@     C                                	                          P$                 DATE                              @                JDAI GRANT APPLICATION      	                 h      @$@     D                         @       	              #            A$                 PROJECT TITLE                       .       @ $    G                            7   10.  BUDGET DETAILS:  CATEGORY F.  CONTRACTUAL SERVICES      
    	        	      	    /p"0 $                PAGE 6      	                          $p                  The following types of personal services may be contracted:EVALUATION/RESEARCHLEGALACCOUNTINGMEDICAL AND HEALTH SERVICESAUDITINGSOCIAL SERVICES        	              _  Q      _  Q           
 F                 
 _  Q ,  Arial          ( q "<The following types of personal services may be contracted:                   (  "EVALUATION/RESEARCH            (  "LEGAL            (  "ACCOUNTING           (  "MEDICAL AND HEALTH SERVICES            (  "	AUDITING           (  "SOCIAL SERVICES               p$ @    E                                  
                                              Title           
                  p0 @    F                               
                                            ITEMIZED LISTING      	                 F       0p @    G                               
                         @                UNIT      	                        p 0@    H                               
                                       	   UNIT COST      	                 +        0p$@    I                               
                         @$             
   ITEM TOTAL      	                 /        $                  p 0                  p 0$H     F                                
                      p!Pq            	   2.  Match           	          	  %  
                      CATEGORY TOTAL      	                 I      p 0$                  p$    G              p            3   10.  BUDGET DETAILS:  CATEGORY G.  INDIRECT CHARGES      
    	        	      	    . $ @    G                                  
                                              Title           
                  . 0  @    H                               
                                        )   ITEMIZED LISTING (DESCRIBE THE COST ITEM)      	                        0.   @    I                               
                        @                UNIT      	                        .  0 @    J                               
                                      	   UNIT COST      	                 +        0. $ @    K                               
                        @$             
   ITEM TOTAL      	                 /       . /@ 0                  .  0/@$H     H                                
                      p!Pq            	   2.  Match           	          	  %  
     ./@                CATEGORY TOTAL      	                 I      .  0/@$                   P#             
    Indirect costs may not exceed 10% of the total direct charges.  Indirect costs include costs of operating the agency which are not directly attributed to this project (e.g., maintaining physical plan, depreciation, receptionist, agency administration salaries, etc.)      	              F       F          
 _  Q                 
 F ,  Arial          ( "Indirect costs may not exceed 10% of the total direct charges.  Indirect costs include costs of operating the agency which are not directly attributed to             ( "pthis project (e.g., maintaining physical plan, depreciation, receptionist, agency administration salaries, etc.)              p$                  Budget 4            P005   etc.)              p$                  Budget 4            P005  AFT      N =    H          H        = M    Budget 4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                @     ?      @@     I                                	                           P                 AGENCY NAME                       ,       @$@     J                                	                          P$                 DATE                              @                JDAI GRANT APPLICATION      	                 h      @$@     K                         @       	              #            A$                 PROJECT TITLE                       .       @$    G                              7.  PROJECT PERIOD                       H      p@ 0             g   A project period is one year and may not exceed one year except by prior agreement with the Department.      	                  w      0@ H     L                         
      
                          @P
                Proposed project period is from      	                 o       0 H     M                               
                          @                to      	                        	 $                  	 	$    G              	@	                8.  BUDGET SUMMARY                       N      
 @$P             7   The proposed project budget is shown below.   If the proposal is accepted for contracting, the budget on the Approved budget and Special conditions form supersedes the proposed budget shown below.The following items are allowable costs under this contract:	Travel (JDAI Quarterly Meetings, State and National Conferences, Model Site Visits)	Local Coordination to implement the eight (8) JDAI strategies	Detention Alternatives	Data Collection and Analysis	Case Processing Improvements including Expediter	Indirect (up to 10% of direct charges), as noted below.      	             ``  O        O          
 F                 
  O ,  Arial          (  $The proposed project budget is shown below.   If the proposal is accepted for contracting, the budget on the Approved budget and Special conditions             (  $1form supersedes the proposed budget shown below.                  (  $=The following items are allowable costs under this contract:           (  .TTravel (JDAI Quarterly Meetings, State and National Conferences, Model Site Visits)            (  .>Local Coordination to implement the eight (8) JDAI strategies            (  .Detention Alternatives           (  .Data Collection and Analysis           (  .1Case Processing Improvements including Expediter           (  .7Indirect (up to 10% of direct charges), as noted below.             	$                  0                  0@                 BUDGET CATEGORIES      	                   X      p@p             V    
Enter the category totals from Section 10.  BUDGET DETAILS.  The sum of categories A - F is entered as TOTAL DIRECT CHARGES.  If indirect costs are claimed, enter the amount in G.  These may not exceed ten (10) percent of the TOTAL DIRECT CHARGES.  Add TOTAL DIRECT CHARGES and INDIRECT CHARGES, and enter the sum on TOTAL PROJECT COSTS line.      	             ll q           q        
  O                 
 q  ,  Arial          ( $3Enter the category totals from Section 10.  BUDGET            (( $4DETAILS.  The sum of categories A - F is entered as             (2 $-TOTAL DIRECT CHARGES.  If indirect costs are            (< $6claimed, enter the amount in G.  These may not exceed             (F $/ten (10) percent of the TOTAL DIRECT CHARGES.             (P $&Add TOTAL DIRECT CHARGES and INDIRECT             (Z $,CHARGES, and enter the sum on TOTAL PROJECT             (d $COSTS line.             0 `H     N                               
                        0                A.  Personnel           	          	  6  
 	    0P `H     O                               
                       @P                B.  Supplies           	          	  0  
 	    Pp `H     P                               
                      `p                C.  Other services and charges           	          	  |  
 	    p `H     Q                               
                                      D.  Capital outlay/equipment           	          	  q  
 	     `H     R                               
                                   
   E.  Travel           	          	  '  
 	     `H     S                               
                                      F.  Contractual services           	          	  ^  
 	     `H     T                               
                                      TOTAL DIRECT CHARGES      
    	         	  q  	 	     `H     U                               
                                       G.  Indirect charges           	          	  N  
 	    0 `H     V                               
                       0                TOTAL PROJECT COST      
    	         	  f  	 	    0#0                  P@p                SOURCE OF FUNDS      	                   M      @0                   
1.      	                 :        :          
 q                  
  : ,  Arial          ( $1.                             _    
May not exceed amount approved by the Washington State Partnership Council on Juvenile Justice.      	                "    "               
 8                 
 "  ,  Arial          ( ,1May not exceed amount approved by the Washington            ( ,.State Partnership Council on Juvenile Justice.              P@                   
2.      	                 :        :          
 "                  
  : ,  Arial          ( $2.              P               J    
Must be funds specifically appropriated for project in applicant's budget.      	                "    "               
  :                 
 "  ,  Arial          ( ,7Must be funds specifically appropriated for project in            ( ,applicant's budget.             0@!                  
Project income must be applied to project operational costs or deducted from the grant award.  It is important that all anticipated project income be included in the budget.      	            hh %           %        
 "                  
 %  ,  Arial         ( $*Project income must be applied to project          ( $-operational costs or deducted from the grant         ( $5award.  It is important that all anticipated project         ( $!income be included in the budget.             0P `H     W                               
                      @P                1.  JDAI           	          	     
 	    Pp ` H     Y                               
               	       `p             	   2.  Match           	          	  %  
 	    #@$p                 %          
        
     	  
    0 `P$                  #`$p                 %          
        
     	  
    P `p$                  p H     [                                
                         p!Pq             	   2.  Match           	          	  %  
     p ` H     \                                
                      p!Pq             	   2.  Match           	          	  %  
 	    #$p                 %          
        
     	  
    p `$                  "#0 `H     j                               
                      " #0                TOTAL PROJECT FUNDS      
    	         	  l  	 	    "p## $p                 %          
        
     	  
    " `#0$                  #0#$    G              #p#p             D   9.  PROJECT SUMMARY:  GIVE A BRIEF NARRATIVE SUMMARY OF THE PROJECT.                            #/@$ H     l                                
                         p!Pq             	   2.  Match           	          	  %  
     /p"0 $                PAGE 2      	                          H     ^                                
                         p!Pq             	   2.  Match           	          	  %  
      ` H     _                                
                      p!Pq             	   2.  Match           	          	  %  
 	    #$p                 %          
        
     	  
     `$                   H     a                                
                         p!Pq             	   2.  Match           	          	  %  
      ` H     b                                
                      p!Pq             	   2.  Match           	          	  %  
 	    #$p                 %          
        
     	  
     `$                    H     d                                
                         p!Pq             	   2.  Match           	          	  %  
       ` H     e                                
                      p!Pq             	   2.  Match           	          	  %  
 	     0# $p                 %          
        
     	  
     ` $                   " H     g                                
                         p!Pq             	   2.  Match           	          	  %  
      " ` H     h                                
                      p!Pq             	   2.  Match           	          	  %  
 	    !P#" $p                 %          
        
     	  
      `"$                  0                  0$                  0P                  0P$                  Pp                  Pp$                  p                  p$                                    $                                    $                                    $                                    $                  0                  0$                  0P                  0P$                  Pp                  Pp$                  p                  p$                                    $                                    $                                      $                   "                   "$                  "#0                  "#0$                  0 `P#H     X                                
                     p!Pq            	   2.  Match           	          	  %  
     P `p#H     Z                                
                      p!Pq            	   2.  Match           	          	  %  
     p `# H     ]                                
               !       p!Pq            	   2.  Match           	          	  %  
     " `#0# H     k                                
               "       p!Pq            	   2.  Match           	          	  %  
      `# H     `                                
               #       p!Pq            	   2.  Match           	          	  %  
      `# H     c                                
               $       p!Pq            	   2.  Match           	          	  %  
      ` # H     f                                
               %       p!Pq            	   2.  Match           	          	  %  
       `"# H     i                                
               &       p!Pq            	   2.  Match           	          	  %  
               0                    0P                    Pp          Budget Summary            P006        Pp          Budget Summary            P006                                                                                                                        2-  x     7                 "                                                                                               5 6 7      ͤͤͤͤͤͤȒ\\C\Cͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤͤ   7                                                                             porpsila  Z   porpsila  `     < E            porpsila  l   porpsila  r                         pData                                                                                       {    z    y    w    v    u    t    s    r    q    p    o    n    m    l    k    j    i    h    g    e    d                       
                                                                                                                                                                
    
    
            &   %   $   #   "   !                                              	                                                                                                                                                                  &     
              h          &     
              {          \     <                       ;\      ,       ;\                      :                 %;\                     :                 (;\                     :                 %;\                     &     
              h         &     
                        &     
              {         >                  ;\                        :                 %                       >                  ;\                        :                 %;\                     &     
              h         &     
                       &     
              {         >                  ;\                       :                 %;\                    >                  ;\                       :                 %;\                    &     
              h         &     
                       &     
              {         >                                            :                 %                       >                  ;\                       :                 %;\                    &     
              h          &     
                        &     
              {          &     
                        &     
                        &     
                        &     
                        &     
                        &     
                                          ;\          ;\ ,         ;\ @            T 	        ;\ h        %;\ |                              &     
                        R     2                        %   ,                    &     
                                        ;\             ,            @         ;\ T 	        ;\ h         ;\ |        %;\            	                   &     
              h         &     
                       &     
              {         Arial                                                           Times New Roman                                                 Wingdings 3                                                    V  &     
              h         &     
                       &     
              {         &     
              h         &     
                       &     
              {         Arial                                                           Times New Romane             \;$ e\e             \      3I s  B  <   l           +  l           -     EMF   <                            ,                               ,  m   	      -    M            +  l           -                 ?          ?             l   4       ,  m   (   ,  m                                   XXXhhh|||&&&!!!bbbxxxTTT```NNN<<<SSSsssvvvlllfffUUU            RRR                        MMM               EEE            ZZZQQQ            '''                              wwwRRR                              


                                    yyy                  III                  UUU777                                                                     222LLL      &&&zzzGGG%%%,,,,,,((("""///''',,,,,,&&&000000      ***      lll((()))CCC''',,,,,,(((dddOOO      ~~~%%%,,,,,,%%%|||$$$,,,'''777         '''HHH      qqq''',,,,,,%%%dddAAA222(((,,,)))...222      CCCggg      uuu(((   


			$$$                                    eee;;;                                                   ```                  hhh...         QQQPPP===            sss      %%%666      bbb)))      ^^^www         ***         zzz               sss         (((   OOO      TTT111         yyy      '''   ...      ]]]!!!ggg         CCC;;;      ~~~                                    zzzGGG                                                                           iii         bbbYYY666   ___sss            000\\\      DDD               


222                  OOOccc   GGG      +++   000qqq   }}}                  ```vvv                  QQQ                                                                  NNN            ```   dddrrr      ```      RRR   FFFLLL   HHH   ~~~         


<<<;;;   zzz         YYY         ddd   HHHmmm            tttHHH   LLL```                  ***ddd                  ZZZ                                    


                                 999   ###JJJ         cccqqq            jjj   ;;;WWW   GGG            


HHHaaa   LLLlll      %%%   ...ccc   GGG---      111   DDD                  OOO               eee                                                      {{{                  ...888   ___yyy      kkk   cccqqq      			   bbb			\\\   GGG            


TTT   000JJJ         \\\AAAccc   GGG   bbbwww   


>>>      RRR                  >>>               ppp                  ~~~                                    VVV                  SSSJJJ   ttt         cccqqq      


   )))^^^XXXjjj   <<<444   GGG            


   +++III   XXXYYYddd         ccc   GGG


   rrr   PPPZZZbbbwww               TTT                  YYY)))               yyy                  wwwhhh                  )))               ,,,                  zzz   eeezzz         ccc   dddrrr         ---///      ```   GGG            


!!!      888RRR   ***///###         [[[      ccc   GGG   ~~~   )))...%%%      mmm         iii                              """                  nnnQQQ                  ===                                 """   @@@   ^^^   dddsss      ///         UUU   FFF            


QQQ            hhhxxx   GGG   |||         EEENNNgggccc   GGGEEE         ppp      AAA444                                 555                  ccc>>>                  JJJ                              %%%   [[[888   888%%%   QQQRRRQQQQQQRRR###      www   zzz      333   AAA         ttt                     ,,,      hhh   ///eee   GGG   BBB???         <<<~~~                  QQQ               NNN                  YYY,,,                  ```                                    nnn&&&            nnn                                    222   NNN   (((   \\\iii                                 '''ggg   <<<   GGG111   %%%         UUU>>>                              ```                  PPP                  nnn               rrr                  000   000   WWWddd      ppp   rrr   nnnjjj777                     000      CCCsss            555{{{   RRR111   ===|||   ___      ooo      DDD666      FFF[[[(((   @@@PPP   @@@***                                 xxx                  EEE                                 FFF                  [[[   $$$MMM   eeettt            ]]]vvv      QQQ   vvv            >>>      JJJ!!!      EEEUUUmmm   ))),,,,,,)))***,,,"""///AAANNN      ,,,      888;;;         kkk                                                      :::


                                 """                     \\\NNN   cccqqq               777                     GGG                              111                                                   ~~~      cccqqq               ===   ZZZyyy***               qqq                              )))                                 zzz                  '''         dddqqq         qqq      [[[   TTT$$$                  ^^^               '''                                                SSS                  KKK```      aaattt                     """]]]   xxx               gggJJJ               ???


                                                   ,,,                  sss			```"""         ;;;QQQ            fff   000   ^^^&&&         :::               999               SSS                                                                     sss      222NNN$$$555


666            ...   111      ###                     $$$               kkk                                                               kkk___qqqfffwww:::               iii               )))                                                                  ///               &&&               :::                                                ooo                  ,,,                                 MMM               ~~~                  


               FFF                  TTTEEE''':::888                  }}}               bbb                  sss                                 !!!                  xxx777      jjjXXX               @@@ggg               xxx                  ggg                                                      


               ```                                 ^^^                                                      


            VVV               &&&                  RRR                  ###                                    


EEE               TTT               NNN                  HHH                  +++               HHH                  SSS                  ]]]               ggg                  >>>                  444                                 )))+++555---!!!HHH777      ---         |||111333'''888'''666***      aaa%%%666,,,999***,,,333%%%@@@)))000   RRR			      ppp###111...+++222'''   ...   			\\\///"""222***ooo...         BBB???   (((nnn         000333$$$LLLppp,,,///'''III'''555)))222               ccc               @@@                  444                  ;;;                                          


:::???!!!      ;;;@@@      			///         777+++            [[[   JJJ"""   			www         VVV---         @@@      rrryyy         ---


999      xxx      &&&               ppp<<<   hhh888   			   ~~~TTT   CCC               (((###^^^      @@@         III   YYY   YYYTTTUUUUUUUUUUUUUUUUUUUUUUUUUUUVVVQQQ            qqq                  ,,,                  rrr)))                  FFF                                 			   aaa[[[         ---}}}   GGG


   JJJ444   fff   888XXX   www   ***                  RRR:::   ...   999---EEEvvv   222   bbb   ^^^         YYY666      XXX   FFFlll                                                      """                                                         ZZZ                  QQQ               mmm                  """   dddJJJ   %%%kkk         			   FFF      ddd   :::TTT   FFFqqq   ,,,      uuu      {{{      


      lll      888FFF   [[[               ooo            UUU   HHHkkk                                                      kkk...                                                      GGG                  XXX               HHH                  GGG   ccc   ***      


   


   ccc   999UUU   HHHqqq   +++      QQQ         


         000   CCC   888LLL666   999   (((                  UUU   GGG                                                                                                         222                  bbb                                 rrr   cccPPP      ]]]   


   bbb   777   ccc   999UUU   GGGqqq   +++      ===   888      


         GGG      888(((   VVV$$$   ===      xxx      MMM   EEE   UUU   GGG                                                aaa                                                   


                  jjj                                    ccc         000vvvvvvyyy   


   BBB   ppp			   ccc   999UUU   GGGqqq   +++      888   uuuvvvwww      


         EEE   


   888   GGG   GGG      sss   '''   DDD   fff   UUU   GGG                                          666666                                                         ttt                                    ccc      rrr   &&&)))         


   jjjyyy888   ccc   :::UUU   GGGqqq   +++      DDD   


###)))      hhh      


         ...   


   888      ggg$$$   HHH      {{{   ---   uuu555      UUU   GGG                                 ~~~                                 


   ccc   RRR111            ddd			   ccc   777UUU   GGGqqq   ---      SSS   SSS   bbb      


               888{{{            777   AAA         &&&      UUU   GGGtttuuuuuuuuuuuuuuuuuuuuuuuuxxxkkk^^^aaaaaaaaaaaaaaaaaaaaa\\\


               			                                 ccc                  )))   ccc   ===}}}   sss               zzz   eee   ZZZ   JJJsss      yyyddd      DDD   uuu   ddd      


      ___   ;;;               !!!___   )))      


|||         UUU   GGGvvv                                             XXX                                                                                       ;;;                  PPP   ccc   888            )))      666:::      RRR   ...			MMM!!!   ``````      rrrRRR         (((   qqq      )))   '''GGG   ;;;aaa@@@   [[[      hhhCCC   nnnqqq                  ,,,   ###   GGGnnn			   ###AAA      UUU   GGG                                                                                                                                                               uuu   ccc   999qqq   sss   eeeWWW   FFF            +++&&&      888      777>>>   QQQ         ]]]   $$$			      GGG      LLL   PPP)))   AAA}}}   


HHH


         VVV===            bbb888   )))WWW               qqq         333CCC   ddd      TTT   XXXGGG   mmm      000'''      UUU   GGG                                                                                                                                                                  ccc      JJJ      VVVAAA]]]      %%%222      ,,,>>>!!!PPP   777JJJDDD666      [[[            555aaa+++XXX      <<<   vvv&&&         :::zzz   &&&===      SSS[[[         vvv         tttccc(((      ###UUU   GGG                                                   qqq---                                                                                                nnn                     ccc      ```~~~YYY   JJJ   |||   ;;;000   ~~~UUU   GGG{{{                                                ???                                                                                 


               FFF                  BBB   ccc555      UUU   GGG      888;;;   ]]]UUU   GGGuuuqqqqqqqqqqqqqqqqqqqqqqqqfffddd666            000         ~~~,,,                                                                        eee   ccc         MMM   ===      999RRR   ]]]SSSUUU   GGGxxx            CCC         iii                  ttt                                                      ggg         sss$$$:::   www+++   &&&JJJ"""WWW   GGG            ```               RRRmmm                  hhh                                                            FFFNNN      :::QQQ      yyy...      eeeEEE   GGG               ggg                  LLLvvv                  }}}___                  			                                 ```         aaaQQQ      ZZZ   +++444      @@@      qqq444      CCC               gggSSS                  ===                  qqqTTT                                 bbb                  ###]]]   ^^^ccc[[[|||TTT777~~~@@@UUU+++               AAA,,,                                    gggHHH                                 ===                  FFF               YYY               www                  ^^^???                                                   oooGGG            }}}               SSS                  UUU555                                                               UUU            AAA                  KKK***                  '''333               yyy                              fff            <<<                  ???                  111KKK               qqq~~~                  			            ZZZ            HHH               666                  :::777               nnn888                  ===$$$            :::               [[[               ,,,                  EEE               lll                  ~~~CCC            ccc               {{{               $$$                  HHH               kkk                  ^^^hhh888...{{{               mmm               			                                    


(((,,,,,,'''                  eee                     """KKK000                  +++                                                                                                            sssEEE                                                                                 uuu~~~~~~333{{{vvvwww>>>                  ///]]]iiiMMM                                                                                                                                                                                                


LLL333QQQmmm:::666111<<<lll...---)))'''!!!___hhhDDDQQQyyyeee555UUU888FFFVVV(((ddd111222;;;lllLLLHHH]]]:::hhh777                                             LLL               			~~~                                                                           ***                                                                              %%%DDDPPP___   !!!ooofffKKKUUUBBB&&&444III***hhh000888FFF{{{???   777***...wwwLLL			                                       ###               sss                                                                                                                                                      ---<<<pppLLLMMMDDD


???LLLuuu111]]]AAA@@@&&&yyyYYY$$$777IIIyyy\\\...###$$$111fff                                 <<<---               hhh                                                                                                                                                (((000???333&&&AAA000AAA]]]~~~444qqq...


<<<ddd+++aaaqqqCCC```]]]===<<<hhh                  """///               ^^^                     CCC????????????????????????????????????@@@XXXrrr___aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa``````FFFAAAcccIIIUUU{{{***"""			}}}^^^XXXIII777222sss^^^>>>TTTjjj;;;VVV   CCCPPPWWWxxxTTT___###CCCAAA:::rrrUUUMMM^^^~~~                  RRR                     555hhhHHH222!!!sss:::


???'''777ooo\\\```CCC!!!444kkk%%%AAADDD{{{QQQ@@@---aaa222***,,,,,,,,,---111888;;;333111666;;;666000,,,,,,,,,,,,,,,,,,,,,,,,,,,%%%                        uuuGGG                        ggg                                                                  666IIInnn@@@xxxRRRwwwMMMzzzpppPPPttt888***!!!vvv			   ???%%%666\\\JJJ                                                                                                      ooo]]]                                                                        


bbbfff                                                                           ???@@@QQQaaa000YYYhhhDDD222YYYVVVRRR$$$lll333ddd555www!!!|||***%%%@@@   HHHAAAmmmtttyyyfffLLL$$$YYYbbb                                                                                                      zzz                                                                              PPP                                                                              xxx'''III   RRRWWW   zzzsss[[[TTT444gggFFF$$$```KKK888aaatttNNNsss***}}}                                                                                                                                                                                                                                                                     000,,,zzzPPP111###---{{{                                                                                                   &&&                                                                              )))                                                                                 |||   %%%___ppphhhPPP777444>>>


UUULLL                                                                                                ///                                                                              aaa                                                                              ///000@@@DDDBBB666[[[ggg                                                            HHH                                                                           


                  DDD               eeewww~~~yyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyzzz			               VVV                                                                                             PPP                                                                        ___                  


@@@                                                                                    ,,,jjj                                                                           			111                  kkk                                                                                       [[[                                                                              vvv                                                                                                            BBB                                                                           555                  $$$                                                                                                                                                                     QQQ                  555yyy                                                                                          >>>}}}                                                                        ,,,ccc                     EEE++++++++++++++++++++++++++++++++++++++++++++++++++++++,,,***                                       ,,,+++++++++++++++---                     )))                  YYY'''                  }}}                  ccc                                    uuu                  QQQ                  ###___                  HHH"""               SSS                     $$$                  BBB                                                         ***                  999                                                      &&&'''                  999                                    TTT                  ***                  999                                                                  JJJ                  rrreee                                    pppLLL                  ___                  AAA                                                               			                  lll               


               fff                     JJJ666                  999]]]                              WWW                                          lllTTT                              TTT                        oooppp                     UUU                              TTT                        666                        bbb                              ^^^uuu                                                         sss                                 qqq                                                               QQQ                  iii                  (((                                                         ###                                    ###                                                   )))                  EEEXXX                  ___                                       TTT___                     zzz&&&                     rrr333                        !!!mmm                        333555                        }}}aaaPPPGGGLLLYYYqqq                                                                  +++                                                            ***???                                                      GGGqqq                                                ddd\\\                              MMMbbb;;;***+++---PPP|||                :::222777EEEkkk666777kkkVVV<<<333;;;555999444111AAA===///ppp===777jjjQQQ999444<<<111777@@@+++;;;jjj777555:::666nnn777999뚚III666:::777888777rrr333<<<qqq666;;;ooo444===mmm999222>>>666---]]]===:::777777666;;;ooo)));;;999777韟WWW666555888<<<777555444WWW???444555999333DDDrrr333<<<ccc777555DDDppp000>>>݇777:::999<<<111999𛛛HHH000:::===888777OOO222666;;;666;;;444UUU   777888777888888:::777777555aaaZZZ888888888888888888888888777NNN888888888999777888<<<:::777888555777888666>>>111666:::555222999;;;888999===444<<<444888777:::>>>555iii777:::jjj<<<444999555lll222999jjj;;;888;;;<<<888999555777QQQ;;;999,,,???999777lll:::777jjj888888888<<<555777888777QQQ999999---===GGG888:::555777:::666GGGؚ777888]]]<<<===777<<<333<<<555>>>FFFjjj999777jjj888777iii:::777===999666666;;;888555@@@...999888999999888:::DDD555///BBB333TTT999444???222777888<<<888555;;;888[[[HHH<<<111>>>111;;;555;;;;;;jjjjjj999777444<<<555777jjj888888III000===:::666===...CCC666DDD]]]<<<888222:::;;;999666777QQQ777:::222999999333===666999AAAxxx   ###888555)))777888777888888999777888777dddjjj888888888888888888888888333<<<666555<<<111111AAA888,,,;;;;;;;;;<<<<<<:::111FFFYYY::::::777888===777;;;333lll[[[666666<<<999999666;;;///|||iii999888nnnwww444444888888rrr::::::gggWWW222333555|||SSS999777CCC{{{444222\\\999777lll:::777jjjNNN666444DDDoooOOO666777LLLrrr444333^^^;;;555555999TTTkkkbbbBBB666CCCsss999888^^^CCC999fffkkkDDD'''DDD___jjj999777jjj888777iii:::777EEE///222QQQGGG---EEE333999888999999888:::xxx000///```HHH333999===111888;;;:::444999888777444;;;BBBSSS111000BBByyyRRR<<<333==={{{jjj999777<<<999888666jjj888888QQQ111;;;555999hhhjjjFFF000666>>>GGGbbb999---AAA___ddd;;;888555bbb:::999333@@@nnn\\\...222CCC   ,,,:::888***777888888888777999777999999ggghhh888888888888888888888888<<<:::<<<???444<<<>>>///666BBB222555888777555<<<777---:::000;;;777777===444===777666999888999999<<<:::999;;;444iii<<<444nnn>>>666>>>999===HHHppp999666iii444666DDDKKK111222777AAA999777lll:::777jjj---;;;EEEHHH,,,>>>444999???777===FFFddd666555666999555666GGGOOO888888jjj999777jjj888777iii:::777>>>444333ooo000222III999888999999888:::nnn555FFF___333<<<<<<TTT޷NNN<<<555666eeeggg:::666TTT<<<222BBBjjj999777oooAAA444GGG777OOOjjj888888hhh888///<<<TTT+++666iii222666<<<FFF222???SSS666:::bbb555555OOO   ***555888+++777888999888777888666999;;;iiinnn888888888888888888888888444555333///777777888999999;;;666888;;;:::222888===666888CCCHHH;;;999555:::333888???333{{{ttt---===:::666888;;;;;;555fffiii<<<222kkk222<<<___NNN<<<777iii666666fffmmm;;;:::KKK777<<<999999777lll:::777jjjvvvAAA777QQQ--->>>;;;???999BBBXXX===777888HHH333444...<<<;;;jjj999777jjj888777iii:::777AAA;;;BBBddd888@@@999888999999888:::iii444:::777888222􆆆777>>>666===+++>>>;;;444[[[jjj999777JJJ<<<HHHwww:::===jjj888888888>>>777CCC???555III===333===///999000===SSSlll:::<<<   '''777:::---777888999888777888666:::<<<kkk;;;jjj888888888888888888888888777;;;777>>>;;;222888<<<888:::666888:::>>>666555999555:::777444:::999777666333<<<:::333======888777888888<<<;;;222:::===999;;;111>>>:::888555;;;555888iii999444kkk~~~999555222;;;hhh999<<<nnnppp666888@@@333444999777lll:::777jjjddd777777AAA111777QQQ555444+++@@@777111777___]]]555888jjj999777jjj888777iii:::777^^^666888888///UUU999888999999888:::jjj===999___666;;;kkkhhh///444ZZZ777BBBzzz>>>:::???jjj999777:::333333333jjj888888999000XXXooo666555,,,777WWWaaa777999???555888888   +++666777)))777888999888777888666:::<<<jjjUUU444bbbddd888888888888888888888888666999333///CCClllԹlll:::444999999888999666:::999???444<<<777;;;666888888888:::666444888666444888444888<<<555444777888;;;888:::777888000\\\iii666999mmmKKK666555333999RRRjjj999:::kkksss555999ZZZ;;;888999777lll:::777jjjkkk666888[[[;;;>>>777<<<999DDD222999777???nnnhhhjjj999777jjj888777iii:::777999555DDDnnniiiiii999888999999888:::jjj===999999555777???777444eee222888oooaaajjj999777333333555333YYYjjj888888VVV999===;;;<<<{{{:::666uuuhhh555EEE>>>///   +++===<<<---777888888888777888777999;;;iiittt555>>>000nnn888888888888888888888888999666LLLNNN;;;888888888:::777777///uuu666777888<<<999:::777444888888999>>><<<888999222;;;;;;444<<<777999777888777:::777999iii777999kkk888333ZZZOOO666888jjj777555^^^555888fff;;;999999777lll:::777jjj<<<333bbb888888===---TTTeee>>>999iii666888jjj999777jjj888777iii:::777888<<<hhh999888999999888:::lll888777;;;888YYY777CCC444<<<:::888jjj999777VVV444DDDbbb:::@@@jjj888888444::::::閖            e  
    @@     m                                	                   5       P                 AGENCY NAME                       ,       @$@     n                                	                  6       P$                 DATE                              @                JDAI GRANT APPLICATION      	                 h      @$@     o                         @       	              #    7       A$                 PROJECT TITLE                       .       @ $     G              0 0            .   11.  STATEMENT OF WORK AND IMPLEMENTATION PLAN      
    	        	       	    /p"0 $                PAGE 7      	                         /@$D@     p                          0                         8       01$             :   Project's Plan to hire a qualified, independent evaluator:      
    	         	    	     @@$P             y   The contractor agrees to perform the following minimum statement of work:	Submit the AECF-JDAI Quarterly Report and annual Results Report, no later than 30 days after the end of each quarter to include:    	Detention Population Report    	Alternative Programs Report    	Detention Referrals Screened Report    	Detention Risk Assessment Instrument Override Report	Attend JDAI Quarterly Meetings, State and National JDAI Conferences (as held / applicable	Participate in JDAI statewide Steering Committee / Leadership group meetings as requested)	Conduct a minimum of four (4) JDAI Stakeholder Meetings per year	Conduct a Detention Self-Inspection every two (2) years	Submit quarterly progress and financial reports to the Office of Juvenile Justice on reporting forms provided by OJJ.	JDAI sites will address Disproportionate Minority Contact (DMC) in a coordinated effort, to be specifically designed for each site in collaboration with       the JDAI Statewide Coordinator and with the Office of Juvenile Justice (OJJ) DMC Coordinator.  Sites will work to address recommendations made       in the OJJ DMC Assessment.      	              a O      a  O          
 8                 
 a O ,  Arial          ( q $JThe contractor agrees to perform the following minimum statement of work:                   (  $    (  1Submit the AECF-JDAI Quarterly Report and annual Results Report, no later than 30 days after the end of each quarter to include:                  (  $        (  :Detention Population Report            (  $        (  :Alternative Programs Report            (  $        (  :$Detention Referrals Screened Report            (  $        (  :5Detention Risk Assessment Instrument Override Report                  (  $    (  1ZAttend JDAI Quarterly Meetings, State and National JDAI Conferences (as held / applicable            (  $    (  1[Participate in JDAI statewide Steering Committee / Leadership group meetings as requested)           (  $    (  1AConduct a minimum of four (4) JDAI Stakeholder Meetings per year           (  $    (  18Conduct a Detention Self-Inspection every two (2) years            (  $    (  1vSubmit quarterly progress and financial reports to the Office of Juvenile Justice on reporting forms provided by OJJ.            (  $    (  1JDAI sites will address Disproportionate Minority Contact (DMC) in a coordinated effort, to be specifically designed for each site in collaboration with             (  $      the JDAI Statewide Coordinator and with the Office of Juvenile Justice (OJJ) DMC Coordinator.  Sites will work to address recommendations made             ( $       in the OJJ DMC Assessment.               p$                   @                Attach the County JDAI Implementation Plan addressing the eight core strategies of JDAI, including at a minimum:	Description of the current status of eight (8) JDAI strategies	Objectives for the contract period (July 1, 2013  June 30, 2014)	Activities and tasks to meet objectives      	              G         G        
 a O                 
 G ,  Arial          ( $qAttach the County JDAI Implementation Plan addressing the eight core strategies of JDAI, including at a minimum:                  (( $    (( 1?Description of the current status of eight (8) JDAI strategies           (1 $    (1 1BObjectives for the contract period (July 1, 2013  June 30, 2014)            (: $    (: 1'Activities and tasks to meet objectives             p/@$                           P008                                                                                                                                                                                                                                                                                                                                                                                                                                                      