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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 .~ / {J,-(f'1/ (:) (; 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 M 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 ,q(} 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 ~ ----f-L----- day of r , 2001. CITY OF CLEARWATER, FLORIDA Countersigned: -:7!' Approved as to form: ~ Akm, City Attorney Attest: c' L~ .~~~ ~ . a E. Goudeau, City Clerk Agency: BY~-1~.A./V Pres' t ~ Attest: JJOWNY pa 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. /F 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 ,((J Fiscal Year: GOO': '-~ Agency: i- 0 d;;.:J.~..: tiLl 11 \;:l ;:'1'...\;-' " ".,:ram: : ~t.:,~~!it.~:.); riD,j(i ; .~ii:!;.. .. t: J j tv!" i8 Allocation Current Status: ~ l-'~~,OO~.OQ j"'.l-' i; {U\/l~O 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 .4P ~ 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.