PROVIDE FOOD 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 Religious Community Services, Inc. - Food Pantry, hereinafter
referred to as the Agency.
WHEREAS, it has been determined to be highly desirable and socially responsible to provide
food 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 15t 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
of this 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 subjected 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 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
4?
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 $7,000.00 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.
I. If to City, addressed to Grants Coordinator, Human Relations Department, P.O Box 4748,
Clearwater, FL 33758
rV
2. If to Agency, addressed to Religious Community Services, Inc. - Food Pantry, 1855
South Highland Ave., Clearwater, FL 33756.
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
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--1L-dayof
-1~
,2001.
CITY OF CLEARWATER, FLORIDA
Countersigned:
BY~~ .,$.. /k.-.1I
William B. Home II, InterimCity Manager
Approved as to form:
Attest:
P
~~~
Cyn , E. Goutf~J};. City ~lerk. .'
Witnesses as to Agency:
AgelnCY\ ~
By:\JJtQQlaA\' l~
WPresident
il//atYI T: Tl'"'4tcfzue/J-1
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&:We,L}. r5jDru,'/1
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!' BI9~";ES
Attest:
Q.,-tc ('s;:?C4
f(ebe~4- P. C~/e..
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CJ:TY 01' CLEARWATER
SOCJ:AL SERVICES GRANT
PROJECT APPLJ:CATJ:ON PORM
Phone: (727) 562-4060 for assistance
Due: January 26, 2001
A. Application J:nfor.mation
Applicant:
(Sponsor/Developer)
THE FOOD PANTRY OF RELIGIOUS COMMUNITY SVCS.
Organization Name:
(If different)
RELIGIOUS COMMUNITY SERVICES, INC
Address:
1855 SOUTH HIGHLAND AVE.
City; State; Zip
CLEARWATER, FLORIDA 33756
Telephone Number:
(727) 584-3528
Contact Person:
JAMIA AUSTIN
Title:
DIRECTOR
Telephone Number:
(727) 443-4031
Period for which funds
are being requested:
OCTOBER 1, 2000 - SEPTEMBER 30, 2001
Signature
Date
\ l 'V~ I 0\
Wu..1 thI1 --r~drW~/1'I"
Board of Directors Chairperson
NOTE:
The City of Clearwater reserves the right to fund applicants at a
level lower than requested.
2
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B. Activity (Check One)
Adult Crime
Child Abuse
Elderly
Hunger
x
Juvenile Crime
Physical Illness
Parenting
Adolescents
Substance Abuse
Unsupervised
Children
Youth Development
Other
(Describe Below)
3
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c. AMOUNT OF FtJNDXNG CORRENTLY REQUESTED:
(Not to exceed $10,000)
$10,000.00
D. SPECIFICALLY FOR WHAT WILL TBJ:S MONEY BE USED.
(Line item budget for this amount)
Funds from this grant would be used to Durchase food
E. BRIEF DESCRIPTION OF PROJECT YOU WISH TO FOND UTILIZING THIS
GRANT.
The Food Pantry program of ReS provides emeriency and sllppl~m~n~~l fnnN~J
enough for 3 to 4 meals, to families and individuals who Rr~ ~xp~Ti~nring
hunger due to some economic diffil'1I1~y Th~ pnp..l"'t'inn tbat lI~ili.,.~~ ~n~
Food Pantry are persons whose income levels are zero to h~lnw pnv~r~y level,
which includes the workin2 Door. Th~ gn~l of the Food Pantry i~ ~n
temporarily reduce hun2er and 900r nll~ri~inn of households exp~ri~nl'ing
a crisis.
F. BRIEF DESCRIPTION OF YOUR OVERALL ORGANIZATION.
Religious Community Services. Inc. is R no~-fnr-prnfi~ aeency estahli~hpn
in 1967 to provide food for those experiencin2 hun2er. shelter for the
homeless, shelter, legal advocacy and counseling for vir~im'~ nf ~nmg~t';r
violence. The Food Pantry has been Drovidini servir~~ for nvpr 1~ yg"'T~
and provides services to 85 households daily.
4
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. .
-
....
G.
NUMBER OF CLIENTS SBRVBD BY THIS PROGRAM.
36,332 yearly
H. PERCENTAGE OF THESE CLIENTS WHO ARE CITIZENS OF CLEARWATER.
80%
I. CURRENT OVERALL ORGANIZATION BtJDGET (PLEASE ATTACH) .
SEE ATTACHED
J. IF THIS IS START UP OR MATCHING MONEY, SPECIFY THE DETAILS
i.e.:
WHICH AGENCY OR ORGANIZATION WILL PROVIDE THE MATCH, THE
REQt1J:REMENTS AND THE AMOUNT OF THE MATCH.
NA
K. IS YOUR AGENCY A REG:I:STERED 501 (C) (3) NON-PROFIT AGENCY OR IN
THE PROCESS OF BECOMDlG ONE.
We are a registered 501(C) (3)
L. DOES YOUR FACILITY HAVE OR IS IT r.N THE PROCESS OF ACQUIRING
THE APPROPRIATE LICENSURE FOR THE DELIVERY OF THE SERVICES
DESCRIBED IN THIS APPLICATION.
YES
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M. HAS YOUR ORGAN7ZATXON RBCB:IVEDOR XS XT BXPECTXNG TO RBCEXVB
PONDXNG (WRBTHBR CASH OR m-ItXND CONTRXBlJTXONS) PROM THE CXTY
OF CLEARWATER DtJRmG THE FXSCAL YEAR FROM OCTOBER 1, 2000
THROUGH SEPTEMBER 30, 2001?
YES
NO X
XF YES, PLEASE BXPLAXN:
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9/30100
Religious Community Services. Inc.-Food Pantry
FYE9/30/01 Operating Budget
Detail of Additions to Property and Equipment
Current Vear Addition. to Fundlna
prODifty and l!aulDment Amount Source
Forklift (Used?) 1 ??oo Unrestricted
Teleohone System Uoarade 3500 Unrestricted
,Copy Machine (Xerox?) 5000 Unrestricted
Total Addition. 1
:
I
Anticipated Future Need.
In Prioritized Order Amount
Total Future Need. I 0
Approved by Executive Committee September 12. 2000
51301OO
Religious Community Services, Inc.-Food Pantry
FYE 9130/01 Operating Budget
PCSA Un.. ""'WiV USDA I Unl'8llfd.
"
Food PanIry
.... Ravenue
~dIId BUD. & An.
citY of C1wr. SocIal Services 0 0
~____. 13000 13000
PC~___- ___-,-.199.99.f-------
United Wa'L- 29859
USDA 27000
~ ~d. SUp. & An. 88859
Unrestrict8d SUp. & R8v.
B8Guests --
~_ese~
Contributions
Fundraisinjl- Prolects
In Kind-Food-Public
In Kind-Food-USDA
Res G&A Allocation
~~S Prog~a!tlSupport A1loe,
Total Urnst'd. Sup. & An.
~~~i.RMnue
hvlall Ex~
Salaries
FICA
Medicare
Workman ~omP. Ins.
Retirement
Sta~_Q~I!'~ Tax
!"Iealth Ins.
~!~:
Ufe Ins.
~ Payroll ExpenMa
Operating ~
Casual Labor 1000
CasuaRvlns. 6114
Conference 800
Contract Services 4000
~~mef.1!~_ent 1500
~esRent 12120
Food 65000
In Kind-FOod-Publlc 300000
In K1nd-FoOd-USOA 145000
Licenses and T8llIIS 150
Maintenance and ReDaifs 4000
Miac:8ll8Oeou. 1100
~otorve~~ ~
Office SU~i.. 2200
0D8r8iin 2500
Penonnel Recruitment 800
Pest Control 500
~~~ 300
Printing 500
~~onal_~~__- ___ __4~ _----
Public Awareness 500
RCS G&A Allocation 932441
SecUritY 965
Subscri~tions and Dues 100
TelePhont! 2500
Tools ~E~t 1500
Travel 500
Utilities 8000
TobII OperatIng e.....- 664893
c.Ditii - - --
~ --
~r=~~:-~~------------
Reserve lor Equip.Replaeemen 0
totaicapiia E....- 23500
~-~_ 834058
~~(Deftclt) , 0
MEMO, Depreciation
:---c- L:
-T....I ~Cf5,6:
o
13000
. ...... 19000 ..'- ." - - --..
.-.- 29859 -- --
27000
19000 29859 27000 0
5000
30000
160000
5000
300000
145000
93244
6955
745199
834058
--
5000
, - -~Q~Q
160000
5000
30??oo
145000
93244
6955
o 745199
27000 745199
.
o
o
o
13000
o
19000
o
29859
115204
7143
1670
2859
3080
193
13097
1706
713
145665
.-
9000 29859 18500 57845
7143
1670
-~
-~
____ 1~~
13097
1706
713
9000 29859 18500 88306
1000
0 6114
800
4000
1500
3434 8686
10000 42000
- 39.~
145000
150
4000
500 800
---- . --- 6000
--- 2200
2500
800
500
-- 300
---
. 500
1514 2486
-- ---.--- --_.... . 500
- 932441
965
- ---- 100
2500
1500
500
3052 4948
10000 0 8500 633393
k
o
o
o
13000
L
.
r
..
,
o
13000
o
o
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13000
..------......--
.----.- --'--.--- 18500
--~
0
0 0 0 23500
19000 29859 27000 745199
r
0 0 0 0
0 0 0 9000
o
o
Approved by executive Committee September 12. 2000
9000
o
o
.41
%
9130/00
Religious Community Services. Inc.-Food Pantry
FYE 9130101 Payroll Budget
FP tume ' Standerd CurrHl P--, ArvMIal FICA I MED WIC WIC RetI__ SUTA .0041 H..1th Dental life Total
EmD. and Week Belarv or Sa.arv or I Groas 0.082 0.01. Ins. lna. 0.03 x 11m \naUra.- lna....- 1nIura.- Payroll
. PoeIIIDn In HcMn HDUrlV R.w HDW1Y R.w hv x Groea x Groea R.w xG_ $7000 Groas 1111.101M0. 123.7011Io. 11.I01M0.
224 R. C. PolI8r II 40 17.00 17.21 114._.80 ! Im.80 $217.45 0.1031 11.648.17 $337.43 132.20 $2.182.80 $284.40 1111.80 $20.1145.85
D ~ I
! ..
225 J. A.. AuIlIn 40 130.000.00 130.800.00 130.800,00 ! 11.815.80 $448.05 0.0131 1404.78 1827.00 132.20 $2.182.80 1284.40 1111.80 137,213.84
PIMIW'II DIredIlr ~ I
UnII8d Way 128,_.00 $0.00 $0.00 NlA $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $29,859.00
UnraIlricted 11.041.00 1t.815.80 $448.05 NlA S404.78 S927 .00 $32.20 $2,182,80 $284.40 111 8.80 17.354.84
228 J. E. MIInUIII 40 17.21 57.43 115.446.70 : _7.70 $223.98 0.0131 1202.35 $483.40 132.20 $2.182.80 $284.40 11111.80 118.112.33
WanIhouIe HelDer 3~
228 D. J. Orr 40 18.00 18.00 111.840.00 I 11.031.111 $241.28 0.0131 $217.. 1374.40 132.20 12.182.80 1284.40 1111.80 121,123.54
claltl DOE 7124/00 I
PCSA 11.000.00 $0.00 $0.00 NlA $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8.000.00
,UI....1.:b.4 I $7,140.00 11.031.. I 1241.28, NlA I S217.. $374.40 I $32.20 I $2,112.80 I $284.40 I 1111.80 I 112,123.54
! I
227 B.G.B" 40 vacant 118.500.00 I $11.500.00 I 11.147.00 I $288.2n 0.0131 I 1242.35 I $418.25 I 132.20 I 12.182.80 I 1284.40 I '118.80 I $23.182.05
AIlrr*1. Au\. IDOE 6f22IOO I I I I I I I I $0.00 I I
USDA 111.500.00 $0.00 $0.00 NlA $0,00 $0.00 $0,00 $0.00 $0.00 111.IilXl.oo
U~ $0.00 51.147.00 5268.25 NlA 1242.35 $416.25 132.20 $2,182.80 $284.40 111 8.80 14,692.05
I
2xll tMwHinI 40 vacant 59.00 111.720.00 i 11.180.84 $271.44 0.0131 $245.23 5561.110 132.20 12.182.80 $284.40 1111,80 S23.5n.11
w.r.tIouM Mar.
~ "'A :mg: :mm: ~ Jm![
PCSA $8.000.00 $0.00 $0.00 NA $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8.000.00
UnIad Way 129.859.00 $0.00 $0.00 NlA $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $29,_.00
USDA 111.500.00 $0.00 $0.00 NlA $0.00 $0.00 $0,00 $0.00 $0.00 $0.00 111.IilXl.oo
I UrnIlricted 157.844.50 57.142.62 51.670.45 NlA 12.858.88 13.080.08 5183.20 513.096.80 51.706.40 5712.80 188,305.73
, I TataI 11152D3.50 17.142.62 11.670.45 $0,00 1193.20 113.1Il6.8O 11.706.40 17f2.80 1145....~
Approved by Executive Committee September 12. 2000
~
c.o~y"
To: (funder): City of Clearwater
Social Services"
Applicant InforllUltion (Dr;nt or tvpe):
For time period of: October 1, 2000 to
September 30, 2001
Legal Name of Organization: ReI igious Communi ty Services, Inc.
Complete Address: 1855 Highland Avenue SoUti1
Clearwater, FL 33756
727
Phone (/'.~1 584-3528
Fax (72j 587-7747
E-Mail rcs-inc.~mindspring . can
Federal Tax Identification Number: 59-1309186
Contact Penon: Ron Dickman TItle: Executive Director
Organization Type: _Public _Private ~ Non-profit _ Other
Northern Pine lIas
Service Area: !- County _ City of
Other
Agency currently funded by (' check all that apply):
_ St. Petenburg ....!. Florida Dept. of Children & Families
~ Oearwater ....x.. Florida Dept. of Justice
.JL Largo -!.. PineDas County Foundation (pending)
.!.. PineDas County -X.. Allegany Franciscan Foundation
_ Area Agency on Aging _ Eckerd Family Foundation
X Juvenile Welfare Bd. X Other: HUD, U.S.D.A., D.O.E.
X United Way -
Certificatious: (1) If required to register for s06dtatiOD of fuels, is the Agency currently
registered with the State? ~ Yes _ No De Couty? ~ Yes _ No
(2) If iDcorporated, has the AgeDcy Annual Report beeD med with the Florida
Secretary of State? ~ Yes_No
Name aDd Title of AgeDcy RepreseDtative submitting this fudiDg request:
Jarnia A. Austin
Proaram Director- Food Pantrv of ReS
,
.....
SigDature of AgeDcy Director (seDior st8fr member) or Board Chair:
a ~ ~ ~ Date: 1/12-)01
I ~
(Executive Director)
Received iD fUDder's office by:
Date:
UFAl
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