PROVIDE YOUTH AND FAMILY SERVICES
AGREEMENT
This Funds Agreement is made and entered into between the City of Clearwater, hereinafter
referred to as the City, and Foundation Village Neighborhood Family Center, hereinafter referred
to as the Agency.
WHEREAS, it has been determined to be highly desirable and socially responsible to provide
youth and family services to those who would not otherwise have a means to fill these needs; and
WHEREAS, the City desires to help those in need by providing funding for the above services;
and
WHEREAS, the Agency provides such services and operates in the City;
NOW, THERFORE, the parties agree as follows:
ARTICLE I. TERM
The term of this agreement shall be for a period of 12 months commencing on the 1 st day of
October, 2000 and continuing through the 30th day of September, 2001 (the Termination Date)
unless earlier terminated under the terms of this agreement.
ARTICLE II. RESPONSIBILITIES OF THE AGENCY
1. Services to be Provided: The Agency shall provide the above stated service in
accordance with the proposal submitted by the Agency and approved by the City, which
is attached and incorporated herein by reference.
2. Area to be Served: Services rendered through this agreement shall be provided within
the corporate limits of the City as it now exists and as its boundaries may be changed
during he term of this agreement.
3. Scheduled Reports of Agency Activities: The Agency shall furnish the City Human
Relations Department, Grants Coordinator, with an annual report of activities conducted
under the provisions of this agreement by October 31, 2001. Each report is to identify the
number of clients served, the costs of such service, and commentary on the viability,
effectiveness, results of measurable goals and objectives as set out in the agency's
proposal, and trends affecting the program. The agency will also provide a copy of its
most recent independent financial audit.
4. Use and Disposition of Funds Received: Funds received by the Agency from the City
shall be used to pay for the above services as further described in the grant proposal
submitted by the Agency to the City. Funds existing and not used for this purpose at the
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end of this agreement term shall be deemed excess to the intended purpose and shall be
returned to the City.
5. Creation, Use, and Maintenance of Financial Records:
a) Creation of Records: Agency shall create and maintain financial and accounting
records, books, documents, policies, practices, procedures and any information
necessary to reflect fully the financial activities of the Agency. Such records shall
be available and accessible at all times for inspection, review, or audit by
authorized City representatives.
b) Use of Records: Agency shall produce such reports and analyses that may be
required by the City and other duly authorized agencies to document the proper
and prudent stewardship and use of the monies received through this agreement.
c) Maintenance of Records: All records created hereby are to be retained and
maintained for a period not less than five (5) years from the termination of this
agreement.
6. Non-discrimination: Notwithstanding any other provisions of this agreement during the
term of this agreement, the Agency for itself, agents and representatives, as part of the
consideration for this agreement, does covenant and agree that:
a) No Exclusion from Use: No person shall be excluded from participation in,
denied the benefits of, or otherwise be subjected to discrimination in the operation
ofthis program on the grounds of race, color, religion, sex, age, national origin, or
disability.
b) No Exclusion from Hire: In the management, operation, or provision of the
program activities authorized and enabled by this agreement, no person shall be
excluded from participation in or denied the benefits of or otherwise be subject to
discrimination on the grounds of or otherwise be subj ected to discrimination on
the grounds of race, color, religion, sex, age, national origin, or disability.
c) Inclusion in Subcontracts: The Agency agrees to include the requirement to
adhere to Title VI and Title VII ofthe Civil Rights Act of 1964 in all approved
sub-contracts.
d) Breach of Nondiscrimination Covenants: In the event of conclusive evidenced
of a breach of any of the above non-discrimination covenants, the City shall have
the right to terminate this agreement.
7. Liability and Indemnification: The Agency shall act as an independent contractor and
agrees to assume all risks of providing the program activities and services herein agreed
and all liability therefore, and shall defend, indemnify, and hold harmless the City, its
officers, agents, and employees from and against any and all claims of loss, liability, and
damages of whatever nature, to persons and property, including, without limiting the
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generality of the foregoing, death of any person and loss of the use of any property, except
claims arising from the negligence or willful misconduct of the City or City's agents or
employees. This includes, but is not limited to matters arising out of or claimed to have
been caused by or in any manner related to the Agency's activities or those of any
approved or unapproved invitee, contractor, subcontractor, or other person approved,
authorized, or permitted by the Agency in or about its premises whether or not based on
negligence
ARTICLE III. RESPONSIBILITIES OF THE CITY
1. Grant of Funds: The City agrees to provide a total grant of$1.300.00 to fund the
program in accordance with this agreement and subject to City Commission budget
approval.
2. Payments: The total amount requested will be paid by the City to the Agency within 30
days after execution of this agreement by the City and the Agency but no earlier than
October 1 of the budget year for which the funds are authorized.
ARTICLE IV. DISCLAIMER OF WARRANTIES
This Agreement constitutes the entire Agreement ofthe parties on the subject hereof and may not
be changed, modified, or discharged except by written Amendment duly executed by both
parties. No representations or warranties by either party shall be binding unless expressed herein
or in a duly executed Amendment hereof.
ARTICLE V. TERMINATION
1. For Cause: Failure to adhere to any of the provisions of this agreement as determined by
the City shall constitute cause for termination. This agreement may by terminated with 5
days notice without any further obligation by City.
2. Disposition of Fund Monies: In the event of termination for any reason, monies made
available to the Agency but not expended in accordance with this agreement shall be
returned to the City.
ARTICLE VI. NOTICE
Any notice required or permitted to be given by the provisions of this agreement shall be
conclusively deemed to have been received by a party hereto on the date it is hand-delivered to
such party at the address indicated below (or at such other address as such party shall specify to
the other party in writing), or if sent by registered or certified mail (postage prepaid), on the fifth
(5th) business day after the day on which such notice is mailed and properly addressed.
1. If to City, addressed to Grants Coordinator, Human Relations Department, P.O Box 4748,
Clearwater, FL 33758
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2. If to Agency, addressed to Foundation Village Neighborhood Family Center, 918
Woodlawn Street, Clearwater, FL 33756.
ARTICLE VII. EFFECTIVE DATE
The effective date ofthis agreement shall be as of the first day of October, 2000.
.IN WITNESS WHEREOF, the parties hereto have set their hands and seals this
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----f-L----- day of
r
, 2001.
CITY OF CLEARWATER, FLORIDA
Countersigned:
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Approved as to form:
~ Akm, City Attorney
Attest:
c' L~
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. a E. Goudeau, City Clerk
Agency:
BY~-1~.A./V
Pres' t ~
Attest:
JJOWNY
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CITY OF CLEARWATER
SOCIAL SERVICES GRANT
PROJECT APPLICATION FORM
Phone:
(721) 562-4060 for assistance
Due: January 26,2001
A. Application Information
Applicant:
(Sponsor/Developer )
Foundation Village Neighborhood Family Center
Organization Name:
(If Different)
Address:
918 Woodlawn St.
City; State; Zip
Clearwater. Florida 33756
Telephone Number:
(721) 445-9504
Contact Person:
Judv Walker
Title:
Executive Director
Telephone Number:
(727) 445-9504
Period for which funds
are being requested:
6/11/01 - 8/1 0/01
Sig
\"'--' ~* 1I'4~rf3
Board of irectors ChairpersOn
Date 1/22 /01
NOTE:
The City of Clearwater reserves the right to fund applicants at a level lower than
requested.
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B. Activity (Check One)
Adult Crime
Child Abuse
Elderly
Hunger
Juvenile Crime
Physical Illness
Parenting
Adolescents
Substance Abuse
Unsupervised
Children X
Youth Development
Other
(Describe Below)
3
C. AMOUNT OF FUNDING CURRENTLY REQUESTED:
(Not to exceed $10,000)
52.680
D. SPECIFICALLY FOR WHAT Wll..L THIS MONEY BE USED.
(Line item budget for this amount)
To hire a certified teacher to work with 8JleCial needs children for nine weeks
(6/11/01 - 8110/01), $13.00 per hour x 40 hours per week = 5520 per week x 9
weeks = $4.680. We have already received $2.000 start up funds from Kids
KommitteeInc.. a division of "Festival of Trees".
E. BRIEF DESCRIPTION OF PROJECT YOU WISH TO FUND UTll..IZING
THIS GRANT.
A Summer Enrichment Program for ten children in the South Greenwood CommunitY of
Clearwater who are unable to function in a traditional summer camp environment.
Examples are children who have been diaenosed with or exhibit signs of learning
disabilities. Attention Deficit Disorder. emotional handicaps. and above alL the resuhing
behavior problems. We have learned that there is an urgent need in our community for a
summer yro~ for children who either would not be accepted into or would be quickly
dismissed from local summer ProifBlDS. A Social Skills Assessment test will be
administered as a pre test in week one of the program and again as a post test in week
nine. Our goal is to see a 300A, increase in over-all scores.
F. BRIEF DESCRIPTION OF YOU OVERALL ORGANIZATION.
Foundation Vill~e Neighborhood Family Center designs and intplements programs to serve
families in the South Greenwood Community. The goal of the Center is to improve the lives of
families from birth onward to the maltimum level possible. Bv the creation of a su-P.POrtive
environment. members can develop community-based prowam!; to prevent abuse and neglect.
preserve families. foster education and create a healthier. more stable environment in which to
raise children Foundation Village Neighborhood Family Center strives to promote the well
being of children and families and otherwise enhance child development. The Center also makes
every effort to empower families and promote autoIlOI1\Y on the part of the governing body and
participating members.
4
G. NUMBER OF CLIENTS SERVED BY THIS PROGRAM.
1ilt1
10 children with special needs.
H. PERCENTAGE OF THESE CLIENTS WHO ARE CmZENS OF
CLEARWATER.
1 OOOA.
I. CURRENT OVERALL ORGANIZATIONAL BUDGET (pLEASE ATIACH).
$246.725.00
J. IF THIS IS START UP OR MATCHING MONEY, SPECIFY THE DETAILS
i.e.:
WHICH AGENCY OR ORGANIZATION WILL PROVIDE THE MATCH, THE
REQUIREMENTS AND THE AMOUNT OF THE MATCH.
Kids Kommitte Inc.. a division of Festival of Trees has provided start up funds
in the amount of$2.000. The only requirement is that we provide the proposed
service as described.
K. IS YOUR AGENCY A REGISTERED 501~ 3 NON-PROFIT AGENCY OR IN
THE PROCESS OF BECOMING ONE.
Yes
L. DOES YOUR FACILITY HAVE OR IS IT IN TIlE PROCESS OF ACQUIRING
THE APPROPRIATE LICENSURE FOR THE DELIVERY OF THE SERVICES
DESCRIBED IN THIS APPUCA TION.
Not apl'licable.
5
aO
M. HAS YOUR ORGANIZATION RECEIVED OR IS IT EXPECTING TO
RECEIVE FUNDING (WHETHER CASH OR IN-KIND CONTRIBUTIONS)
FROM THE CITY OF CLEARWATER DURING THE FISCAL YEAR FROM
OCTOBER 1, 1999 THROUGH SEPTEMBER 30, 2000?
YES X
(In-kind)
NO
IF YES, PLEASE EXPLAIN:
The City of Clearwater owns our building which they lease to Foundation Village Neighborhood
Family Center for $1.00
6
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Fiscal Year:
GOO':
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Agency:
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: ~t.:,~~!it.~:.); riD,j(i ; .~ii:!;..
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i8 Allocation
Current Status:
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Account #
Title
Set Scroll ON trogram Budget
JWB
AUocation
Amended
JWB
Total
Regular Salaries and Wages S131,622.00 S94,746.00 S94,746.00
FICA S9,182.00 S7,248.00 S7,248.00
Retirement Contributions SO.OO SO.OO SO.OO
Life and Health Insurance S13,125.00 S10,500.00 SIO,500.00
Workers Compensation SI,44 1.00 SI,138.00 SI,138.00
Unemployment Compensation 5920.00 $745.00 S745.00
SI56,290.00 $114,377.00 $114,377.00
569.120
569.210
569.220
569.230
569.240
569.250
Expense Accounts
.unt # Title Program BudKet JWB Amended
Allocation JWB
.5\J~.310 Professional SeIVices SO.OO SO.OO SO.OO
569.311 Professional ServicesIW orkshops SO.OO $0.00 SO.OO
569.320 Accounting and Auditing S2,500.00 52,500.00 S2,500.00
569.321 Bank SeIVices SI20.00 S120.00 S120.00
569.330 CourtlLegal SeIVices $0.00 SO.OO SO.OO
569.340 Other Contractual Services S7,100.00 $1,400.00 SI,400.00
569.350 Investigations $0.00 $0.00 $0.00
569.400 Travel and Per Diem $735.00 S735.00 $735.00
569.401 Conference 52,700.00 52,700.00 52,700.00
569.402 Transportation 53,610.00 51,900.00 51,900.00
569.410 Communications- Telephone 53,300.00 53,300.00 $3,300.00
569.411 Communications-Long Distance $0.00 SO.OO SO.OO
569.412 Communications-Postage and Shipping 51,320.00 $660.00 $660.00
569.413 Communication-Internet $1,080.00 $1,080.00 $1,080.00
569.430 Utility Services $4,800.00 $4,800.00 $4,800.00
569.431 Water/Sewer/Sanitation S720.00 S720.00 $720.00
.. 440 Rentals & Leases (Building & Land) S24,OOO.00 SO.OO $0.00
~41 Rentals & Leases - Equipment SO.OO so. 00 SO.OO
_"D~.450 Insurance S3,600.00 S3,6oo.00 S3,600.00
Repair & Maintenance Services -
· 569.460 Equipment $2,300.00 $550.00 $550.00
569.461 Repair & Maintenance Services - $3,000.00 $3,000.00 $3,000.00
Property
Q.462 Repair & Maintenance Services - $1,200.00 $1,200.00 $1,200.00
Grounds
~J9.463 Vehicle Repair and Maintenance $0.00 $0.00 $0.00
Services
569.470 Printing & Binding $500.00 $200.00 $200.00
569.471 Copying & Binding $400.00 $100.00 $100.00
569.480 Promotional Activities $2,000.00 $750.00 $750.00
569.481 Advertising $0.00 SO.OO $0.00
569.493 Match $0.00 $0.00 $0.00
569.494 Administrative Cost $0.00 $0.00 $0.00
569.495 Residential Per Diem $0.00 $0.00 $0.00
569.496 Day Program Per Diem $0.00 $0.00 $0.00
569.497 Day Program Subsidy $0.00 $0.00 $0.00
569.498 Day Program Hourly Unit Cost $0.00 $0.00 $0.00
569.510 Office Supplies $1,800.00 $1,400.00 $1,400.00
569.515 Participant Expenses $0.00 $0.00 $0.00
569.520 Operating Supplies $5,700.00 $1,000.00 $1,689.00
569.521 Food & Nutrition $3,000.00 $1,471.00 $1,471.00
569.540 Subscriptions S200.00 S100.00 $100.00
.,(,0.541 Books $2,500.00 $0.00 $0.00
542 Dues & Memberships $2~0.00 $IS0.00 $1 SO.OO
:jo~.543 Educational Materials $2,000.00 $500.00 $500.00
569.544 Educational Training $4,000.00 $0.00 $0.00
569.590 Depreciation $0.00 $0.00 $0.00
569.600 OtherlMisceUaneous $6,000.00 $0.00 $0.00
569.640 Machinery & Equipment (Capital $0.00 $0.00 $0.00
Outlay)
569.660 Books, Publications, and Libnuy $0.00 $0.00 $0.00
Materials (Capital)
Totals 590.435.00 533,936.00 534,625.00
Grand Total $246,725.00 5148,313.00 5149,002.00
:..::', I __
Comment History
Log:
Comment History
Log:
UNIFIED FUNDING APPLICATION
To: (funder) City of Clearwater
For time period:
6/11/01 - 8110/01
Applicallt Infol7lUltioll (prillt or tvPe):
Legal Name of Organization: Foundation Village Neighborhood Familv Center. Inc.
Complete Address: 918 Woodlawn Street
Clearwater. Florida 33756
Phone (727) 445-9504
Fax (727) 445-1938
E-Mail fvnfcenterfal.vahoo.com
Federal Tax Identification Number: 59-3480875
Contact Penon: Judy Walker
Title: Executive Director
Organization Type:
Public
Private X-- Non-profit
Other
Service Area:
County X-- City of Clearwater
Other
Agency currently funded by ( check aU that apply):
St. Petenburg X Florida Dept. of Children & Families
Clearwater Florida Dept. of Justice
Largo PineUas County Foundation
PineDas County Allegany Franciscan Foundation
Area Agency on Aging Eckerd Family Foundation
X Juvenile Welfare Board Other:
United Way
Certifieations: (I) If required to register for solicitation of funds, is the Ageney currendy
Registered with the state? X Yes No The County? _Yes _ No
(2) If incorporated, has the Agency Annal Report been filed with the Florida
Secremry of. Smte? X Yes No
Name and Title of Agency Represenmtive submiUing this funding request:
Judy Walker
Executive Director
Signature of Agency Director (senior stafl'member) or Board Chair:
~"'~ '.a<>"'~ Date: 1120101
Received in funder's oflice by: Date:
UFAI
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BOARD OF DIRECTORS -# reauired iD Bv Laws = 5
NAME/OFFICER OCCUPATION AREA OF EXPERTISE RACE/GENDER
1) Betsy Hernandez / Customer Service Cultural Competence Hispanic / Female
President Representative
2) Madeline Evans / Medical Secretary Health Caucasian / Female
Vice-President
3) Sharon Yount / Probation Officer Criminal Justice Caucasian / Female
Secretary
4) Julie Wagner / Housewife Community Relations Caucasian / Female
Treasurer
5) Tracy Donaldson / Hostess / Cashier Community Relations Black / Female
6) Dorothy Pearson Retired School Education Black / Female
Teacher
7) Carol Tryon Executive Admin- Project Management Caucasian / Female
istrative Assistant
* A requirement of our major funder, The Juvenile Welfare Boar~ is that a minimum of2/3 of our
Board be comprised of individuals who live in our neighborhood and are consumers of our services.