MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM (2)
~'
""--.. ~
AGREEMENT
Between
THE JUVENILE WELFARE BOARD
And
City of Clearwater, Florida
Parks and Recreation Department
(Middle School-Aged Summer Scholarship Program)
l~~~
F, '-':;:;
J UL ""lVl.."':i'~_,
1 !l? ~.,{_j I
~X:'............ ."(00; /
' ------
--~--------
I. PURPOSE
The Juvenile Welfare Board of Pinellas County, a Pinellas County special taxing district, whose
address is 6698 - 68th Avenue North, Pinellas Park, Florida 33781, hereinafter referred to as "JWB",
and the City of Clearwater, Florida, a municipal corporation of Florida, whose address is Post Office
Box 4748, Clearwater, Florida 33758-4748, hereinafter referred to as "Provider", enter into this
mutual Agreement, including all attachments referred to herein, for the period commencing May 9,
2002 and extending through September 30, 2002.
The parties to this contract each in consideration of the undertakings, promises and agreement on
the part of the other herein contained, do hereby undertake, promise and agree as follows:
II. STAFF
Provider agrees to employ staff, at its expense, to execute services provided in accordance with this
Agreement. Such individuals shall not be considered employees of JWB or the County of Pinellas,
and are subject to the supervision, personnel practices and policies of the provider, Unless
otherwise approved by JWB, all staff shall meet qualifications as stated in the application and any
approved revisions, which are submitted for fiscal year 01-02 funding.
III. SERVICES
Provider agrees to deliver services as stated in the currently approved program methodology on file
at JWB and to accomplish objectives stated in Attachment 2 in accordance with recognized child
welfare practices, as determined by JWB, in service areas stated in Attachment 3, and pursuant to
the General Conditions listed in Attachment 1, and any special conditions as stated in Section VIII of
this Agreement.
IV. FUNDS
The budget for both JWB and other funds (if any) for accomplishing the above stated services shall
be as set forth in Attachment 4, JWB agrees to reimburse up to $50,600 for the Middle School-Aged
Summer Scholarship Program for services rendered pursuant to this agreement. .
V. METHOD OF PAYMENT
1. JWB issues reimbursements in accordance with the schedule listed on Attachment 5 (or on the
preceding working day in case of a holiday). The Provider may select to submit a request for
payment every other week or once a month. Request for payment must be accompanied by the
appropriate documentation as prescribed by JWB.
2, Requests for advance funds may be made, consistent with JWB policy.
Agency: City of Clearwater
Page 1 of 3
Section I
5/30/02
VI. TERMINATION
1. It is the intent of the JWB to assure a consistent and orderly delivery of children's services. It is
the further intent of JWB to terminate Agreements only in those situations where such action is
essential to protection of its interests and the interests of children, as determined by JWB.
2. Except as provided in subparagraphs 3 and 4 below, either party upon no less than thirty (30)
days notice may terminate this Agreement. Said notice shall be delivered by certified mail,
return receipt requested, or in person with proof of delivery.
3. In the event funds to finance this Agreement become unavailable, JWB may terminate the
contract upon no less than twenty-four (24) hours notice in writing to the Provider. Said notice
shall be delivered by certified mail, return receipt requested, or in person with proof of delivery.
JWB shall endeavor, whenever possible and consistent with its legal obligations and principles
of prudent management, to provide 30 days notice for Termination for Lack of Funds. JWB shall
be the final authority as to the availability of funds and extension of notice beyond the minimum
time herein stated.
4. In addition to the rights as set forth in paragraph VI., 2 above, this Agreement may be
terminated by JWB for any breach by Provider of the terms of this Agreement, including all
attachments, upon twenty-four (24) hours written notice. Said notice shall be delivered by
certified mail, return receipt requested, or in person with proof of delivery. JWB at its discretion
may waive any breach by the Provider in writing, but such waiver shall not constitute a waiver of
any future breaches, including breaches of the same type.
5. The above provisions shall not limit the Parties right to remedies at law or to damages.
VII. COMMENCEMENT OF PAYMENT
Unless specifically authorized by JWB, payment for services rendered under this Agreement shall
not commence prior to its effective date.
VIII. SPECIAL CONDITIONS
The following condition(s) apply to all listed programs within City of Clearwater.
1. General Condition #3 (Audit and Management Letter) is waived.
2. General Condition #6 (Board Members and Meetings) is waived.
Agency: City of Clearwater
Page 2 of 3
Section I
5/30/02
IX. INDEMNIFICATION
The Parties recognize and agree to abide by the provisions of 9768.28, Fla. Stat.
IN WITNESS WHEREOF, the parties hereto have set their hands and seals this ~day
of ~v J'-( ,2002.
Signed, sealed and delivered
In the presence of:
~es~ture
Pfft Name: Il/IL '1 ~,..j '7
--r~~.)n.0Y)~
Witness Signature
Print Name: Paull~-i M. Mti..IIUrtf
s
nt Name: ;r ~A\..""~ 10' JlAdlS
'-1j/I./" 'J...
.
DATE
J.-~
IN WITNESS WHEREOF, the parties hereto have set their hands and seals this ~day
of ir1 ' 2002.
Countersi ned: CITY OF CLEARWATER, FLORIDA
Approved as to form:
Attest:
L.
Jane C. Hayman
Assistant City Attorney
Agency: City of Clearwater
Page 3 of 3
Section I
5/30/02
ATTACHMENT 1
GENERAL CONDITIONS OF THE AGREEMENT
1 . AQreement Revisions
This Agreement, and attachments 1 through 4, constitute the contractual relationship between the Provider and
JWB. No amendments to this Agreement or its attachments may be made without the prior written approval of
JWB and Provider, except as may be provided in General Condition #4.
2. Fiscal Responsibility - Provider agrees:
A. To maintain books, records and documents in accordance with generally accepted accounting
procedures and practices which accurately and appropriately reflect all expenditures of funds listed in
Attachment 4.
B. That all financial records and supporting documentation shall be subject at all times to inspection, review,
or audit by JWB personnel or its duly authorized agent.
C. To maintain and file with JWB in a timely fashion reports related to services provided under this
Agreement.
D. To retain all financial records, supporting documentation, statistical records, and any other documents
pertinent to this Agreement for a period of five (5) years after termination of this Agreement. If an audit
has been initiated and audit findings have not been resolved at the end of five (5) years, all records shall
be retained until resolution of audit findings.
3. Audit and ManaQement Letter
Within 120 days of the close of its fiscal year, Provider agrees to submit to JWB a certified independent fiscal
audit of all its corporate activities and any accompanying management letter(s). This audit shall be conducted
consistent with American Institute of Certified Public Accountants (AI CPA) Standards for Non Profit
Organizations or other mutually agreed upon standard. The audit will separately identify JWB revenues, fees
and donations, and expenditures by program.
4. Other Financial Support
A. Within 30 days of the effective date of this Agreement, and at any subsequent time as a revision in the
budget may be reasonably anticipated, Provider will submit to JWB for its approval a revised budget
which again includes all resources to be applied to the program funded under this Agreement. A written
justification will be made of any difference in the proposed budget revision and the approved budget.
Statements which reflect reductions in excess of 5% of total program funding or $5,000, whichever is
least, as reflected in the approved budget, or reduction in any amount which in the judgment of JWB
would significantly interfere with implementation of the program as originally approved, may be grounds
for breach of Agreement.
B. Provider will report any request to any other source for financial support relating to this program for this
fiscal year; and report any other financial support received which amounts to 10% of the total program
cost or $5,000, whichever is least, and an explanation of how such additional funds will be used. A full
copy of requests or applications for other financial support will be provided if requested by JWB.
C. JWB funds will not be used for expenditures also funded by other sources.
D. Generally, JWB encourages use of its funds as financial match for securing funds from other sources.
However, in such instances Provider is required to obtain prior approval from JWB.
Agency: City of Clearwater
Page 1 Of 3
Section II
06/03/0210:26:50 AM
5. Proaram Monitorina
Provider agrees to submit progress reports and other information in such format and at such times as may be
prescribed by JWB, and to cooperate in site visits and other on-site monitoring (including, but not limited to,
access to sites, staff, fiscal and client records, and logs and the provision of related information).
6. Board Members and Meetinas
Within 30 days of the effective date of this Agreement, Provider will submit to JWB a calendar of scheduled
Board meetings for the current fiscal year. Approved Board minutes and an updated list of Board Members
shall be submitted in accordance with JWB policy.
7. Nondiscrimination
Programs receiving funding from the Juvenile Welfare Board shall not discriminate against an employee,
volunteer, or participant of the provider on the basis of race, color, gender, religion, national origin, citizenship,
disability, marital status, or age except that programs may target services for specific participant groups as
defined in the application. Additionally, agencies receiving funds shall demonstrate the standards, policies, and
practices necessary to render services in a manner that respects the worth of the individual and protects and
preserves the dignity of people of diverse cultures, classes, races, religions, and ethnic backgrounds.
8. Publicizina of JWB Support
Provider agrees to identify JWB support on its letterhead, agency newsletter, and other printed materials, and
to utilize every reasonable opportunity to publicize the support received from JWB.
9. Publications
Provider agrees to supply JWB, without charge, up to three (3) copies of any publication developed in
connection with implementation of programs addressed by this Agreement. Such publications will state that the
program is supported by JWB. Provider agrees that JWB will have unlimited use of copyrighted materials
developed under this Agreement.
10. Assianments and Subcontracts
Provider shall not assign the responsibility of this Agreement to another party nor subcontract for any of the
work contemplated under this Agreement, unless so specified in Attachment 4, without prior written approval of
JWB. No such approval by JWB of any assignment or subcontract shall be deemed in any event or in any
manner to provide for the incurrence of any obligation by JWB in additon to the total dollar amount stated in this
Agreement. All such assignments or subcontracts shall be subject to the conditions of this Agreement and to
any conditions of approval that JWB shall deem necessary.
11. Confidential Information
Provider shall not use or disclose any information which specifically identifies a recipient of services under this
Agreement, with the following exceptions: a) such information may be revealed as may be necessary to
implement General Conditions 2 and 5; b) such information may be revealed as may be necessary pursuant to
applicable federal, state, or local law and related regulations; and c) such information may be revealed with the
written consent of the recipient, or the recipient's responsible parent or guardian, where authorized by law.
12. Return of Funds
Provider agrees to return to JWB any overpayment due to unearned funds or funds disallowed pursuant to the
terms of this Agreement that were disbursed to Provider by JWB, and such funds shall be considered JWB
funds and shall be refunded to JWB in accordance with its instructions.
Agency: City of Clearwater
Page 2 Of 3
Section II
06/03/02 10:26:50 AM
13. Special Situations
Provider agrees to inform JWB in a timely manner of any circumstances or events which may reasonably be
considered to jeopardize its capability to continue to meet its obligations under the terms of this Agreement.
14. Provider Staff Membership on Board
Provider agrees that provider staff shall not serve as members of the Provider's governing board.
15. Measurable Obiectives
A. Measurable objectives, objective levels and minimum service levels will be negotiated during the first
sixty days of the fiscal year and will be retroactive to October 1 st. The measurable objectives, objective
levels and minimum service levels of the previous fiscal year shall apply until they are renegotiated.
B. In instances when measurable objectives, objective levels and minimum service levels cannot be
mutually renegotiated between JWB and the provider, the matter will be referred to the Executive Director
of the Juvenile Welfare Board for resolution with the agency. If resolution is not reached at this level the
matter will be presented to the Juvenile Welfare Board at their January meeting for further action.
16. Waiver
JWB reserves the right to waive requirements of the above stated Agreement and General Conditions where
warranted by special circumstances.
Agency: City of Clearwater
Page 3 Of 3
Section II
06/03/0210:26:50 AM
Attachment #2
City of Clearwater
Parks and Recreation Department
Summer Middle School Camps
Middle School-Aged Summer Scholarship Program
Measurable Objectives
FY 2001-2002
1. Program will input demographic data on all youth served with JWB
scholarships into the JWB SAMIS (Services and Activities
Management Information System) by September 30,2002.
2. Program will administer the participant and parent "Middle School
Summer Camp Evaluations" at the end of the seventh week of the
program and submit all evaluations to JWB by August 30,2002.
3. Documentation of individual youth/family eligibility for free and
reduced lunch or residence in public housing programs must be
provided for onsite review.
4. Reimbursement requests are per diem and require documentation of
participant enrollment and attendance upon submission with your
agency's request for reimbursement.
Minimum Service Levels - COG
11 5 Youth
Agency: City of Clearwater
1 of 1
6/4/022:46 PM
ATTACHMENT 3
GEOGRAPHICAL SERVICE AREA
Provider agrees whenever possible to maintain service sites which are accessible by public transportation and
convenient to the target client group. Provider will advise JWB of any changes made in service sites.
The geographical service area for this agreement is as follows:
Program Name
Service will be
provided
countywide
Services will be provided less
than countywide. Service will
be provided in the following zip
codes (list all zip codes of the
target area)
Middle School-Age Summer Scholarship Program
33755,33756
Agency: City of Clearwater
Page 1 Of 1
Section IV
06/03/0210:26:50 AM
ATTACHMENT 4
BUDGET(S)
The provider will deliver services according to the budget(s) following this page.
Revised budgets should be submitted by the provider in accordance with the provision of General Condition 4A as
found in Attachment 1 of this agreement.
Provider may make budget amendments during the fiscal year in accordance with JWB forms and procedures as
delineated in the budget amendment approval guidelines established on 7/19/00. Copies of these guidelines are
available from JWB upon request. In many instances, budget amendments require the approval of JWB staff.
However, there are instances when providers may amend the budget and then notify the contract manager. In such
instances, the following guidelines apply:
A. Funded programs shall make adjustments in accordance with forms and procedures as established
by JWB staff.
B. A change in an individual position salary or fringe expenditure shall be considered as separate line
items. The program may make transfers between individual salary and fringe lines, but such
transfers may not exceed 10% of individual salary and may not exceed the aggregate amount of
approved salary and fringe.
C. The program may make transfers between operating expense line items of the JWB Allocation not
exceeding $1,500 (except Administrative Cost) per line item, and not exceeding $3,000 in aggregate
per amendment.
D. In accordance with the budget amendment approval guidelines. the program may only amend the
budget twice per contract year without JWB approval. Additional budget amendment requests will
require the approval of the JWB as per the guidelines.
E. Any adjustments made by funded agencies which are not in accordance with JWB policy shall be
subject to reimbursement of JWB at the discretion of JWB.
No adjustment may be made after the budget amendment closing date in September.
Reimbursement on per diem contracts may not exceed one-fourth of the total annual JWB allocation in any quarter
of the fiscal year without prior JWB approval. Any unused per diem in one quarter may be carried over to a
subsequent quarter within the fiscal year given adequate justification and with the prior approval of JWB.
Agency: City of Clearwater
Page 1 Of 1
Section V
06/03/0210:26:50 AM
FORM 2
MIDDLE SCHOOL-AGE SUMMER SCHOLARSHIP PROGRAM
CURRENT & PROPOSED OPERATING
(ROUND NUMBERS UP TO THE NEAREST DOLLAR)
(1) (2) (3) (4) (5) (6)
00-01 01-02 00-01 01-02
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
Salary Accounts:
569.120 Regular Salaries and Wages $47,888 $42,379 \ -12% $0 $0 I 0%
Total Salary :
$47,888
$42,379 -12%
$0
$0
0%
Fringe Accounts:
569.210 FICA $3,669 $3,243\ -12% $0 $0 I 0%
569.220 Retirement Contributions $0 $0 0% $0 $0 I 0%
569.230 Life and Health Insurance $0 $01 0% $0 $0 I 0%
569.240 Workers Compensation $487 $0 -100% $0 $0 I 0%
569.250 Unemployment Compensation $0 $01 0% $0 $0 I 0%
Total Fringe:
$4,156
$3,243 -22%
$0
$0
0%
Operating Expense Accounts:
569.310 Professional Services $4,500 $4,200 -7% $0 $0 I 0%
569.311 Professional Services/Workshops $0 $0 0% $0 $0 I 0%
569.320 Accounting and Auditing $0 $0 0% $0 $0 I 0%
569.321 Bank Services $0 $0 0% $0 $0 I 0%
569.330 Court/Legal Services $0 $0 0% $0 $0 I 0%
569.340 Other Contractual Services $0 $0 0% $0 $0 I 0%
569.350 Investigations $0 $0 0% $0 $0 I 0%
569.400 Travel and Per Diem $0 $0 0% $0 $0 I 0%
569.401 Conference $0 $01 0% $0 $0 I 0%
Agency: City of Clearwater
Page 1 Of 3
Section VI
06/06/022:12:38 PM
(1 ) (2) (3) (4) (5) (6)
ACCT# TITLE 00-01 01-02 00-01 01-02
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
569.402 Transportation $18,420 $11,9121 -35% $0 $0 0%
569.410 Communications-Telephone $0 $01 0% $0 $0 0%
569.411 Communications-Long Distance $0 $0 0% $0 $0 0%
569.412 Communications-Postage and $0 $0\ 0% $0 $0 \ 0%
Shipping
569.413 Communication-Internet $0 $0 0% $0 $0 0%
569.430 Utility Services $0 $0 0% $0 $0 I 0%
569.431 Water/Sewer/Sanitation $0 $0 0% $0 $0 I 0%
569.440 Rentals & Leases (Building & Land) $0 $01 0% $0 $0 I 0%
569.441 Rentals & Leases - Equipment $0 $0 0% $0 $0 0%
569.450 Insurance $0 $01 0% $0 $0 I 0%
569.460 Repair & Maintenance Services - $0 $0 0% $0 $0 0%
Equipment
569.461 Repair & Maintenance Services - $0 $01 0% $0 $0 I 0%
Property
569.462 Repair & Maintenance Services - $0 $0 0% $0 $0 I 0%
Grounds
569.463 Vehicle Repair and Maintenance $0 $01 0% $0 $0 0%
Services
569.470 Printing & Binding $0 $0 0% $0 $0 0%
569.471 Copying & Binding $0 $01 0% $0 $0 I 0%
569.480 Promotional Activities $0 $0\ 0% $0 $0 0%
569.481 Advertising $0 $0 0% $0 $0 I 0%
569,493 Match $0 $0 0% $0 $0 0%
569.494 Administrative Cost $0 $01 0% $0 $0 I 0%
569.495 Residential Per Diem $0 $0 0% $0 $0 0%
569.496 Day Program Per Diem $0 $0 0% $72,955 $50,600 -31%
Agency: City of Clearwater
Page 2 Of 3
Section VI
06/06/022:12:38 PM
(1) (2) (3) (4) (5) (6)
00-01 01-02 00-01 01-02
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
569.497 Day Program Subsidy $0 $01 0% $0 $0 0%
569.498 Day Program Hourly Unit Cost $0 $01 0% $0 $0 0%
569.510 Office Supplies $0 $0 0% $0 $0 0%
569.515 Participant Expenses $0 $01 0% $0 $0 0%
569.520 Operating Supplies $32,082 $18,378 -43% $0 $0 0%
569.521 Food & Nutrition $3,861 $854 -78% $0 $0 0%
569.540 Subscriptions $0 $0 0% $0 $0 I 0%
569.541 Books $0 $01 0% $0 $01 0%
569.542 Dues & Memberships $0 $0 0% $0 $0 0%
569.543 Educational Materials $0 $0 0% $0 $0 0%
569.544 Educational Training $20 $20 0% $0 $0 0%
569.590 Depreciation $0 $01 0% $0 $0 I 0%
569.600 Other/Miscellaneous $0 $0 0% $0 $0 I 0%
569.640 Machinery & Equipment (Capital $0 $0 0% $0 $0 0%
Outlay)
569.660 Books, Publications, and Library $0 $0 0% $0 $0 0%
Materials (Capital)
Total Operating Expense:
$58,883
$35,364 -40%
$72,955
Total Program Expenses:
$110,927
$80,986 -27%
$72,955
Agency: City of Clearwater
Page 3 Of 3
Section VI
$50,600
-31%
$50,600
-31%
06/06/022:12:38 PM
FORM 3
MIDDLE SCHOOL-AGE SUMMER SCHOLARSHIP PROGRAM
SALARY AND FRINGE PREPARATION
FISCAL 01-02
% Time Gross Salary Salary In Fringe In JWB Request JWB Request
Position Employee In Program Program For Salary For Fringe
01-02 01-02 01-02 01-02 01-02
Recreation Coordinator Clayton 2% $39,948 $799 $61 $0 $0
Recreation Coordinator Laterza 2% $48,645 $973 $74 $0 $0
Recreation Leader Whitter 10% $15,000 $1,500 $115 $0 $0
Recreation Programmer Henry 25% $32,990 $8,248 $631 $0 $0
Recreation Programmer Lightfoot 10% $35,318 $3,539 $271 $0 $0
Recreation Programmer Menchaca 10% $27,125 $2,713 $208 $0 $0
Recreation Supervisor Atherholt 4% $36,302 $3,630 $278 $0 $0
Recreation Supervisor Hinson 2% $49,013 $980 $75 $0 $0
Seasonal Recreation start up 1 100% $326 $326 $25 $0 $0
Leader
Seasonal Recreation start up 2 100% $326 $326 $25 $0 $0
Leader
Seasonal Recreation start up 3 100% $684 $684 $52 $0 $0
Leader
Seasonal Recreation TBH 1 100% $2,606 $2,606 $199 $0 $0
Leader
Seasonal Recreation TBH2 100% $2,606 $2,606 $199 $0 $0
Leader
Seasonal Recreation TBH 3 100% $2,737 $2,737 $209 $0 $0
Leader
Seasonal Recreation TBH 5 100% $3,513 $3,513 $269 $0 $0
Leader
Agency: City of Clearwater
Page 1 Of 2
Section VII
06/06/022:12:38 PM
% Time Gross Salary Salary In Fringe In JWB Request JWB Request
Position Employee In Program Program For Salary For Fringe
01-02 01-02 01-02 01-02 01-02
Seasonal Recreation TBH 6 100% $3,513 $3,513 $269 $0 $0
Leader
Seasonal Recreation TBH 7 100% $3,513 $3,513 $269 $0 $0
Leader
TBH Pool Guard P. Guard 1 100% $86 $87 $7 $0 $0
TBH Pool Guard P. Guard 2 100% $86 $86 $7 $0 $0
I TOTALS $304,336 $42,379 $3,243 $0 $0
Agency: City of Clearwater
Page 2 Of 2
Section VII
06/06/022:12:38 PM
FORM 4
MIDDLE SCHOOL-AGE SUMMER SCHOLARSHIP PROGRAM
SALARY AND FRINGE PREPARATION NARRATIVE
FISCAL YEAR 01-02
ACCOUNT #
ACCOUNT NAME
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASE/DECREASE OR OTHER
EXPLANATION AS NEEDED
LINE ITEM $
AMOUNT
PERCENT
INCREASEI
DECREASE
569.120 Regular Salaries and 06/06/2002 $42,379 -12%
Wages The Seasonal Recreation Leader at MLK is a
leadworker due to the size of the program and
number of employees in the program. TBH #3 is the
leadworker position; her salary is $8.55 per hour. All
other Seasonal Rec Leaders make $8.14 per hour.
569.210 FICA 06/03/2002 $3,243 -12%
FICA = Salary x 7.65%
569.220 Retirement $0 0%
Contributions
569.230 life and Health $0 0%
Insurance
569.240 Workers Compensation 03/22/2001 The City of Clearwater pays $736 per $0 -100%
full time employee for Workers Compensation. $736
divided by 2080 hours (annual full time equivilant)=
$.353 per hour. To calculate workers compensation
for part time or seasonal employees, multiply total
annual number of hours times $.353.
569.250 Unemployment $0 0%
Compensation
Agency: City of Clearwater
Page 1 Of 6
Section VIII
06/06/022:12:38 PM
ACCOUNT #
ACCOUNT NAME
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASEIDECREASE OR OTHER
EXPLANATION AS NEEDED
LINE ITEM $
AMOUNT
PERCENT
INCREASEI
DECREASE
OPERATING EXPENSE BUDGET NARRATIVE
569.310
Professional Services
06/04/2002
Kings Hwy Program:
Coping with self @$900.00
Etiquette {$50.00 per hr x 16 hrs.)$800.00
Program Subtotal: $1700.00
$4,200
-7%
Ross Norton Program:
Art Lesson: 2 grp {10 kids)x 1.5 hr x4 wks @ $75 =
$600
Magic Lesson: 2 grp {10 kids)x 1 hr x4 wks @ $50 =
$400
Program subtotal: $1,000.00
Martin Luther King Program:
Art Lesson - $25.00/hr x 20 hr. = $500.00
Cultural Crafts - $25.00/hr x 20 hr. = $500.00
Drama Program - $25.00/hr x 20 hr. = $500.00
Program subtotal: $1,500.00
569.311 Professional $0 0%
ServiceslWorkshops
569.320 Accounting and Auditing $0 0%
569.321 Bank Services $0 0%
569.330 Court/Legal Services $0 0%
569.340 Other Contractual 3/22/2001 $0 0%
Services
569.350 Investigations $0 0%
569.400 Travel and Per Diem $0 0%
569.401 Conference $0 0%
569.402 Transportation 06/03/2002 $11,912 -35%
Kings Hwy Program:
7 Van Trips @ $82 per trip = $574
Ross Norton Program:
8 trips x $167.25 each = $1338
Martin Luther King Program:
20 trips x 2 busses x $250 = 10,000
Agency: City of Clearwater Page 2 Of 6 06/06/022:12:38 PM
Section VIII
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASEI
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.410 Commun ications- T eleph $0 0%
one
569.411 Communications-Long $0 0%
Distance
569.412 Communications-Postag $0 0%
e and Shipping
569.413 Communication-Internet $0 0%
569.430 Utility Services $0 0%
569.431 Water/Sewer/Sanitation $0 0%
569.440 Rentals & Leases $0 0%
(Building & Land)
569.441 Rentals & Leases - $0 0%
Equipment
569.450 Insurance $0 0%
569.460 Repair & Maintenance $0 0%
Services - Equipment
569.461 Repair & Maintenance $0 0%
Services - Property
569.462 Repair & Maintenance $0 0%
Services - Grounds
569.463 Vehicle Repair and $0 0%
Maintenance Services
569.470 Printing & Binding $0 0%
569.471 Copying & Binding $0 0%
569.480 Promotional Activities $0 0%
569.481 Advertising $0 0%
Agency: City of Clearwater
Page 3 Of 6
Section VIII
06/06/022:12:38 PM
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASEI
ACCOUNT # ACCOUNT NAME INCREASEIDECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.493 Match $0 0%
569.494 Administrative Cost 3/23/2001 $0 0%
569.495 Residential Per Diem $0 0%
569.496 Day Program Per Diem 06/04/2002 $0 0%
Teen camp scholarships-115 youth x $50 per wk x 8
wks = $46,000
Start-up Cost, salary and operating costs to cover
program before camp starts = $4,600
569.497 Day Program Subsidy $0 0%
569.498 Day Program Hourly $0 0%
Unit Cost
569.510 Office Supplies $0 0%
569.515 Participant Expenses $0 0%
Agency: City of Clearwater
Page 4 Of 6
Section VIII
06/06/022:12:38 PM
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASEIDECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.520 Operating Supplies 06/03/2002 $18,378 -43%
Kings Hwy Start up
Games supplies = $315
Kings Hwy Operation
30 t-shirts @$4.50 = $135
Etiquette supplies-$1 00
Games-$130
Awards-$53
Museum of Fine Art 20 @ $2 = $40
Busch Gardens $20 @ $41 = $820
Bowling 20 @ $4 = 80
Ice Skating 20 @ $8 = $160
Adventure Island 20 @ $26 = $520
Skating 20 @ $4 = $80
Red Lobster 20 @ $15 = $300
Ross Norton start up
t-shirts 48 @ $5 = $240
goggles 24 @ $3 = $72
Arts-$1 00
Pool toys-$37
Ross Norton Operating
flag football flags-$140
cones 12 @ $57
paper cups $50
23 field trip admissions 184 @ $12.87 = $2368
sports eqipment $242
MLK start up
150 t shirts @ $6 = $900
arts & crafts supplies-$1 ,000
MLK operating
Busch Gardens/Adv. Is. tickets 79 @ $73.90 =
$5,838
Astro skate 75 @ $8 = $4,800
Museums 75 @ $8 x 8 wks = $4,800
Ice cream party-$116
569.521 Food & Nutrition 06/03/2002 $854 -78%
King's Highway Start up:
Gatorade Powder Drink Mix $100
Kings Hwy operational
Cookies, Pretzels, Snacks, Hot Dogs, Buns $390
MLK start up
Poweraide $364.00
569.540 Subscriptions $0 0%
569.541 Books $0 0%
569.542 Dues & Memberships $0 0%
569.543 Educational Materials $0 0%
Agency: City of Clearwater
Page 5 Of 6
Section VIII
06/06/022:12:38 PM
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASEI
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.544 Educational Training 06/04/2002 $20 0%
Kings Highway Start up:
1 staff JWB training @ $20 ea = $20.00
569.590 Depreciation $0 0%
569.600 Other/Miscellaneous $0 0%
569.640 Machinery & Equipment $0 0%
(Capital Outlay)
569.660 Books, Publications, and $0 0%
Library Materials
(Capital)
Agency: City of Clearwater
Page 6 Of 6
Section VIII
06/06/022:12:38 PM
-.
FORM 5
Middle School-Age Summer Scholarship Program
SOURCES OF REVENUE
99-00
Actual Revenue
00-01
Actual VTD As
of
06/06/02
00-01
00-01
Total
01-02
Future Fiscal
Year Revenue
% Change
Revenue
Projected Thru
End of Year
'Cash Forward From $0 $0 $0 $0 $0 0%
Fund Balance
'Fundraising $0 $0 $0 $0 $0 0%
'Participant Fees $0 $0 $0 $0 $0 0%
Insurance $0 $0 $0 $0 $0 0%
Reimbursements
Medicare/Medicaid $0 $0 $0 $0 $0 0%
United Way $0 $0 $0 $0 $0 0%
School Board In-kind $0 $0 $0 $0 $0 0%
Governmental $0 $0 $0 $0 $30,386 0%
Other $0 $0 $0 $0 $0 0%
SUBTOTAL $0 $0 $0 $0 $30,386 0
JWB Continuation $0 $0 $0 $0 $0 0%
JWB Equip/Renovation $0 $0 $0 $0 $0 0%
JWB Other $0 $0 $0 $0 $50,600 0%
SUBTOTAL $0 $0 $0 $0 $50,600 0
TOTAL I $0 I $0 I $0 I $0 I $80,9861 0
CROSS CHECK ITEMS:
FUTURE FISCAL YEAR PROGRAM EXPENDITURES: $80,986
'CASH FORWARD FROM FUND BALANCE: The amount of funds to be transferred forward from the agency's fund balance to the operation of
the program during this fiscal year.
'FUND RAISING: Any funds collected by the program of either a solidted or unsolicited nature (Donations) as well as memberships which do
not entitle the donor to program services.
'FEES: Charges for services rendered. This may indude revenue from memberships when such memberships entitle the member to program
services.
Agency: City of Clearwater
Page 1 Of 1
Section IX
06/061022:12:38 PM
FORM 6
Middle School-Age Summer Scholarship Program
SOURCES OF REVENUE
NARRATIVE
Source Name
Narrative
Governmental
The City of Clearwater Parks and Recreation Department provides in kind staff
and revenue support for this program. The Department is funded by the general
fund which recieves most of its funding from Ad Valoren taxes.
JWB Other
Agency awarded funding JWB Board Meeting 5/9/02.
Agency: City of Clearwater
Page 1 Of 1
Section X
06/06/022:12:38 PM
,
;f .... , .,
END OF PROGRAM BUDGET FOR
Middle School-Age Summer Scholarship Program
Agency: City of Clearwater
Page 1 Of 1
Section XI
06/03/0210:26:50
AU
. " . \. --
,
ATTACHMENT 5
JWB REIMBURSEMENT SCHEDULE
01-02 S.ubmission Reimbursement
Reimbursement Date Date
Schedule
1 10/05/01 10/12/01
2 10/19/01 10/26/01 I
3 11/02/01 11/09/01 I
4 11/16/01 11/23/01 I
5 11/30/01 12/07/01 I
6 12/14/01 12/21/01 I
7 12/28/01 01/04/02
8 01/11/02 01/18/02
9 01/25/02 02/01/02
10 02/08/02 02/15/02
11 02/22/02 03/01/02
12 03/08/02 03/15/02
13 03/22/02 03/29/02
14 04/05/02 04/12/02
15 04/19/02 04/26/02
16 05/03/02 05/10/02
17 05/17/02 OS/24/02
18 05/31/02 06/07/02
19 06/14/02 06/21/02
20 06/28/02 07/05/02
21 07/12/02 07/19/02
22 07/26/02 08/02/02
23 08/09/02 08/16/02
24 08/23/02 08/30/02
25 09/06/02 09/13/02
26 09/20/02 09/27/02
Agency: City of Clearwater Page 1 Of 1 06/03/02 10:26:50 AM
Section XII