PROVIDE SHELTER AND SOCIAL SERVICES TO THOSE IN NEED
AGREEMENT
This Funds Agreement is made and entered into between the City of Clearwater, hereinafter
referred to as the City, and Quest Inn, Inc., hereinafter referred to as the Agency.
WHEREAS, it has been determined to be higWy desirable and socially responsible to provide
shelter 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
end of this agreement term shall be deemed excess to the intended purpose and shall be
returned to the City.
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5. Creation, Use, and Maintenance of Financial Records:
a) Creation of Records: Agency shall create and maintain fmancial 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 ofrace, 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 subjected to discrimination on
the grounds ofrace, 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 of the 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
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
IX)
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 $6,700.00 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 of the 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
2. Ifto Agency, addressed to Quest Inn, Inc., 509 N. Ft. Harrison Ave., Clearwater, FL
33755.
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ARTICLE VII. EFFECTIVE DATE
The effective date of this agreement shall be as of the first day of October, 2000.
.IN WITNESS WHEREOF, the parties hereto have set their hands and seals this
~dayof 1'^'-~
, 2001.
CITY OF CLEARWATER, FLORIDA
Countersigned:
BA~~&er
By:
Attest:
Approved as to form:
11~
Pamela K. Akin, City Attorney
Witnesses as to Agency:
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Attest:
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C:ITY OF CLEARWATER
SOC:IAL SERV:ICES GRANT
PROJECT APPL:ICAT:ION FORM
Phone: (727) 562-4060 for assistance
Due: January 26, 2001
A. Application Information
Applicant:
(Sponsor/Developer)
.~ 1: est :: :: B IRe.
Organization Name:
(If different)
Quest Inn Inc.
Address:
,09 Nor~h f~ h~rr;~nn ~VP.
City; State; Zip
Clearwater Fla. 33755
Telephone Number:
(727) 443-2067
Contact Person:
SU:Z:iRRQ Bi~~Qtt
Title:
Program Director
Telephone Number:
( 72'7 ) ',', ~ 2 O{) 7
Period for which funds
are being requested:
fiscal 2000-2001
Signatura:ia'~ j'L<J' J
v /
..
President
Board of Directors Chairperson
Date 1-16-200~
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
Youth Development
Other
(Describe Below)
x
communitY_h;l~pci rommllnit-y-fllncipci ~plf-hplp prngr;lm proviciinK
services for homeless adults.
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C. AMOUNT OF FeNDING CURRENTLY REQUESTED:
(Not to exceed $10,000)
$10,000.00
D. SPECIFICALLY FOR WHAT WILL THIS MONEY BE USED.
(Line item budget for this amount)
$~lnnn nn Utilitie~
$5,000.00 Maintenance & reoair
Contract services
Fire alarm/Pest control
E. BRIEF DESCRIPTION OF PROJECT YOU WISH TO FeND UTILIZING THIS
GRANT.
We are a community-based community-funded self-help program
for adults providing shelter, food personal hygiene items,
clothing, crisis intervention counseling, help in finding a job
and referrals to other resources as needed. We house men and women
in a safe drug free environment in order for them to be self- ~; .~,
sufficient.
F. BRIEF DESCRIPTION OF YOUR OVERALL ORGANIZATION.
.'
Quest Inn, Inc. is a 501 c(3) non-profit. We have been oroviding
shelter for the homeless for close to 30 years. We are an umbrella
project of Religious Community Services. Our governing board of
directors is made up of members of RCS member congregations and
other interested community groups. Our funding comes from RCS and
its member congregations and other private doners. The Emergency
shelter grant program, Pinellas County Social Action funding and
the City of Clearwater.
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G. NUMBER OF CLIENTS SERVED BY THIS PROGRAM.
200 Annually
H. PERCENTAGE OF THESE CLIENTS WHO ARE CITIZENS OF CLEARWATER.
75%
I. CURRENT OVERALL ORGANIZATION BUDGET (PLEASE ATTACH) .
$97,454.00
J. IF THIS IS START UP OR MATCHING MONEY, SPECIFY THE DETAILS
i.e. :
WHICH AGENCY OR ORGANIZATION WILL PROVIDE THE MATCH, THE
REQtT.I:REMENTS AND THE AMOUNT OF THE MATCH.
N/A
K. IS YOUR AGENCY A REGISTERED SOl(C) (3) NON-PROFIT AGENCY OR IN
THE PROCESS OF BECOMING ONE.
Yes, we are re2istered
L. DOES YOUR FACILITY HAVE OR IS IT :eN THE PROCESS OF ACQUIRING
THE APPROPRIATE LICENSURE FOR THE DELIVERY OF THE SERVICES
DESCRIBED m THIS APPLICATION.
Yes
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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, 2000
THROUGH SEPTEMBER 30, 2001?
YES X
NO
IF YES, PLEASE EXPLAIN:
Yes, we are requesting $10,000.00 for fiscal 2000-2001
,.
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Quest Inn, IDe.
Annual Budget .
Fiscal Year 200012001
Income
Contributions
Pinellas County Social Action Grant
Emergency Shelter Grant
Religious Community Services Grant
City of Clearwater Grant
In-Kind Donations
Total
$36,454.00
25,000.00
15,000.00
12,000.00
5,000.00
4,000.00
97,454.00
EXDenditures:
Salaries
Payroll Tax
Retirement
Health Insurance
Direct aid to clients:
Emergency Shelter Grant - Food
Emergency Shelter Grant - Consumables
In-kind donations
Office Expenses:
Postage ..
Printing
Supplies
Employee Travel
Utilities:
City of Clearwater (water, sewage, garbage, gas)
Florida Power
Telephone
Maintenance & Repair:
Building
Equipment
Grounds
Fire & Liability Insurance
Dues
Contract Services:
Fire & Smoke alarms
Pest control
Miscellaneous
Capital Equipment
Audit '(letter of review)
Total:
$42,250.00
3,254.00
1,000.00
6,000.00
4,000.00
4,500.00
4,000.00
200.00
100.00
600.00
200.00
8,750.00
6,000.00
2,900.00
3,000.00
2,000.00
200.00
2,600.00
300.00
250.00
700.00
250.00
2,500.00
1.900.00
97,454.00
To:~undery: Citv of ClearwaTPT
For time period of: F i sea ~ 2000 - ? 0 n 1
Applicant InforltUltion (Drint or tvDe):
Legal Name of Organization:
Quest Inn, Inc.
Complete Address:
509 N. Ft. Harrison Ave.
Clearwater, Florida 33755
Phone(7~7 443-2067
Fax ( ) r::l 1 1 r i r ~ 1-
~~il Questinninc@tampabay.rr.
Federal Tax Identification Number:
Contact Person: Suzanne Bisset t
Title: Program Director
Organization Type: _Public _Private _ Non-profit L Other
Service Area: .3- County _ City of
Other
Agency currently funded by ( check all that apply):
- St. Petersburg _ Florida Dept. of Children & Families
l Clearwater _ Florida Dept. of Justice
---- Largo _ Finellas County Foundation
L Pinellas County -L Allegany Franciscan Foundation
- Area Agency on Aging _ Eckerd Famfiy Foundation
Juvenile Welfare Bd. -.!. Other: Emergency Shel ter Gran t
_United Way Rel;p;n11!'l rnmmllni1-y Service
Certifications: (1) If required to register for solicitation of funds, is the Agency currently
registered with the State? ...L Yes _ No The County? l Yes _ No
(2) If incorporated, has the Agency Almual Report been filed with the Florida
Secretary of State? 2 Yes_No
.
DAMP- JJit -J
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QUEST INN BOARD OF DIRECTORS
,t-O
Georgia Jensen, President
(736-3898)
1641 Santa Barbara
Dunedin, Florida 34698
Eric A. Houghton, V. Pres.
(736-1560)
1515 Bayshore Blvd. #28
Dunedin, Florida 34698
Dale Shade, Treasurer
(784-6384)
357 Foxcroft Dr. E.
Palm Harbor, Florida 34683
Dolores Jordan, Secretary
( 726-8077)
3325 San Carlos St.
Clwr., Florida 33759
Louise McDaniel
(733-3743)
533 Milwaukee Ave.
Dunedin, Florida 34698
Joann Burrows
(443-1960)
1919 Flora Rd.
Clwr., Florida 33755
Jan Negley
(725-4513)
138 Woodcreek Dr. E.
Safety Harbor, FL. 34695
Barbara Ewert
(585-6018)
1306 Edmonton Dr.
Clwr., Florida 33756
Mary Blackmon
(587-7887)
1717 B. Belleair Forest Dr.
Belleair, Florida 33756
Cindy Steinmann
(523-1352) t4~'0~ 12/-Z-0/t>o
1310 Hamlin Dr.
Clearwater, Florida 33764
01/00
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