CHARTING THE COURSE FOR YOUTH AGREEMENT (2)
AGREEMENT
Between
THE JUVENILE WELFARE BOARD
And
City of Clearwater, Florida
Parks and Recreation Department
(Charting the Course for Youth)
NOV 2 4 2003
BY:
I. PURPOSE
The Juvenile Welfare Board of Pine lias 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 October
1, 2003 and extending through September 30, 2004.
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 apprqved by JWB, all staff shall meet qualifications as stated in the application and any
approved revisions, which are submitted for fiscal year 03-04 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 $103,545 for Charting the Course
for Youth for actual costs incurred 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 10f3
Section I
9/26/03
()~ /') .O/>.( 0;
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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 JWBfor 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 aboveprovision~ 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 the 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
9/26/03
IX INDEMNIFICATION
The Parties recognize and agree to abide by the provisions of 9768.28, Fla. Stat.
__ 1-1,-
IN WITNESS WHEREOF, the parties hereto have set their hands and seal thi~~day
ovV~ bv-.- ,2003.
"b;4-/'7
JUVENILE WELFARE BOARD OF
INELLAS CO~
JJ~J t
E cutive Director
Signed, sealed and delivered
In the presence of:
~S~
E. M dLS
--"
DATE ~+o."'"
~-':' \*1 MY COMMISSION # CC916960 EXPIRES
~;;. ..~1 March 8, 2004
...~'"~~~
IN WITNESS WHEREOF, the parties hereto' have set their hands and seal this ~
of \\mHr<v\~
Print Name: Pa It I. ~ e. At( j/prL/
,2003.
By:
CITY OF CLEARWATER, FLORIDA
~_""B.~"Jt
William B. Horne, II
City Manager
Approved as to form:
~
Laura l.! powski
Assistant City Attorney
Attest:
'c.)Lo.
Agency: City of Clearwater
Page 3 of 3
Section I
9/26/03
ATTACHMENT 1
GENERAL CONDITIONS OF THE AGREEMENT
1 . Aareement 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 Manaaement Letter
Within 120 days of the close of its fiscal year, Provider agrees to submit to JWB an independent audit of the
financial statements of the entity in its entirety and any accompanying management letter(s). The audit must
be performed by a firm licensed to perform audits in the State of Florida and conducted in accordance with
generally accepted auditing standards and standards established by the American Institute of Certified Public
Accountants. 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
09/24/03 11 :39:47 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 (including SAMIS and A.S.S.E.T.), 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 (authorization) of the recipient, or the recipient's responsible parent or guardian, where
authorized by law. The provider is responsible to adopt appropriate policies, notifications, authorizations, and
other relevant information that allows for the sharing of confidential information.
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
09/24/03 11 :39:47 AM
13. SDecial 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 MembershiD on Board
Provider agrees that provider staff shall not serve as members of the Provider's governing board.
15. Measurable Objectives
Provider agrees to negotiate measurable outcomes for services covered by this contract consistent with
established JWB policies and procedures.
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
09/24/03 11 :39:47 AM
A IT ACHMENT 2
City of Clearwater
. Charting the Course for Youth
MEASURABLE OBJECTIVES
FY 03-04
Service Component: General Youth Services
Objective 10 Objective Description
1933 Primary youth enrolled in the program will develop or increase interpersonal skills by the end of 6
(six) months or case closure as measured by at least a twenty percent (20%) increase in scores
from pre to post on the Interpersonal Assessment Scale. The Interpersonal Assessment Scale will
be given when the youth enter the program (pre) and at the end of 6 (six) months or case closure,
whichever occurs first. (COG-Summary)
Primary youth in the program will maintain satisfactory grade point average (defined as a "C" or
higher) or improve their overall grade point average by the end of the school year as measured by
the difference between pre and post school report card letter grades. School report cards will be
reviewed for the semester before program participation begins (pre) and at the end of the school
year or at least for one semester subsequent to enrollment in the program (post). .
(COG-Summary)
1934
1935
Primary youth in the program will express satisfaction with the program as indicated by a score of
at least 49 points on the Youth Satisfaction Survey. The Youth Satisfaction Survey will be
administered at the end of every semester (Oecember and May). Measurement must be
completed by the end of the JWB fiscal year. (COG - Summary)
Contracted Service levels
All Primary Participants will be measured through the Measurable Objective reporting module
in SAMIS within a twelve month period.
Primary Participants
Contracted Primary Youth - 90
Contracted Primary Adults - 0
Total Contracted Primary Youth and Adults: 90
Secondary Participants
Estimated Secondary Youth - 0
Estimated Secondary Adults - 0
Total Secondary Youth and Adults: 0
Agency: City of Clearwater
Page 1 Of '2
Section III
09/26/038:55:36 AM
Status: Submitted
ATTACHMENT 2
City of Clearwater
Charting The Course For Youth
MEASURABLE OBJECTIVES
FY 03-04
Service Component: Adult Satisfaction
Obiective Description
1. Caretakers (Primary adults) of primary youth in the program will express satisfaction with the
program as indicated by a score of at least 46 points on the Caretaker Satisfaction Survey.
The Caretaker Satisfaction Survey will be administered at the end of every Semester
(December and May). Measurement must be completed by the end of the JWB fiscal year.
(Manual)
Contracted Service levels
90 Primary Adults
SAMIS Group Activities Module
Program will document all community activities and events sponsored in the SAMIS Group Data Module.
Agency: City of Clearwater
Page 2 of 2
Section III
9/26/032:17 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)
Charting the Course for Youth
33755, 33756
Agency: City of Clearwater
Page 1 Of 1
Section IV
09/24/03 11 :39:47 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
subs~quent 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
09/24/03 11 :39:47 AM
FORM 2
CHARTING THE COURSE FOR YOUTH
CURRENT & PROPOSED OPERATING BUDGET
(ROUND NUMBERS UP TO THE NEAREST DOLLAR)
(1) (2) (3) (4) (5) (6)
02-03 03-04 02-03 03-04
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
Salary Accounts:
569.120 Regular Salaries and Wages $75,898 $116,197 53% $37,715 $68,9821 83%
Total Salary :
$75,898
$116,197 53%
$37,715
$68,982 83%
Fringe Accounts:
569.210 FICA $1,101 $1,415 29% $547 $1.0001 83%
569.220 Retirement Contributions $5,314 $7,642 44% $2,640 $4,830 I 83%
569.230 Life and Health Insurance $14,461 $24,610 70% $9,201 $16,488 79%
569.240 Workers Compensation $3,089 $7,866 155% $1,140 $5,400 374%
569.250 Unemployment Compensation $0 $0 0% $0 $0 0%
Total Fringe:
$23,965
$41,533 73%
$13,528
$27,718 105%
Operating Expense Accounts:
569.310 Professional Services $2,100 $1,050 -50% $2,100 $1,050 -50%
569.311 Professional ServiceslWorkshops $0 $0 0% $0 $0 0%
569.320 Accounting and Auditing $0 $0 0% $0 $0 0%
569.321 Bank Services $0 $0 0% $0 $0 0%
569.330 Court/Legal Services $0 $0 0% $0 $0 0%
569.340 Other Contractual Services $0 $0 0% $0 $0 0%
569.350 Investigations $0 $0 0% $0 $0 0%
569.400 Travel and Per Diem $0 $0 0% $0 $0 0%
569.401 Conference $0 $0 0% $0 $0 0%
Agency: City of Clearwater
Page 1 Of 3
Section VI
09/24/03 11 :39:47 AM
Status: Submitted
(1) (2) (3) (4) (5) (6)
02-03 03-04 02-03 03-04
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
569.402 Transportation $400 $0 -100% $400 $0 -100%
569.410 Communications-Telephone $0 $0 0% $0 $0 0%
569.411 Communications-Long Distance $0 $0 0% $0 $0 0%
569.412 Communications-Postage and $0 $01 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 0%
569.440 Rentals & Leases (Building & Land) $0 $0 0% $0 $0 0%
569.441 Rentals & Leases - Equipment $0 $0 0% $0 $0 0%
569.450 Insurance $0 $0 0% $0 $0 0%
569.460 Repair & Maintenance Services - $0 $0 0% $0 $0 0%
Equipment
569.461 Repair & Maintenance Services - $0 $0 0% $0 $0 0%
Property
569.462 Repair & Maintenance Services - $0 $0 0% $0 $0 0%
Grounds
569.463 Vehicle Repair and Maintenance $0 $0 0% $0 $0 0%
Services
569.470 Printing & Binding $0 $0 0% $0 $0 0%
569.471 Copying & Binding $0 $0 0% $0 $0 0%
569.480 Promotional Activities $0 $0 0% $0 $0 0%
569.481 Advertising $0 $0 0% $0 $0 0%
569.493 Match $0 $0 0% $0 $0 0%
569.494 Administrative Cost $0 $0 0% $0 $0 0%
569.495 Residential Per Diem $0 $0 0% $0 $0 0%
569.496 Day Program Per Diem $0 $0 0% $0 $0 0%
Agency: City of Clearwater
Page 2 Of 3
Section VI
09/24/03 11 :39:47 AM
Status: Submitted
(1) (2) (3) (4) (5) (6)
02-03 03-04 02-03 03-04
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLoe. CHG.
569.497 Day Program Subsidy $0 $0 0% $0 $0 0%
569.498 Day Program Hourly Unit Cost $0 $0 0% $0 $0 0%
569.510 Office Supplies $197 $460 134% $197 $460 134%
569.515 Participant Expenses $0 $1,025 100% $0 $1,025 100%
569.520 Operating Supplies $6,084 $2,195 -64% $6,084 $2,195 -64%
569.521 Food & Nutrition $1,650 $1,855 12% $1,650 $1 ,855 12%
569.540 Subscriptions $240 $260 8% $240 $260 8%
569.541 Books $0 $0 0% $0 $0 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 $0 $0 0% $0 $0 0%
569.590 Depreciation $0 $0 0% $0 $0 0%
569.600 Other/Miscellaneous $0 $0 0% $0 $0 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:
$10,671
$6,845 -36%
Total Program Expenses:
$168,544 52%
$110,534
Agency: City of Clearwater
Page 3 Of 3
Section VI
$10,671
$61,914
$6,845
-36%
$103,545
67%
09/26/033:16:36 PM
Status: Submitted
..-' -- ---- - - -- - ------.-
FORM 3
CHARTING THE COURSE FOR YOUTH
SALARY AND FRINGE PREPARATION
FISCAL YEAR 03-04 .
Gross Salary In Fringe In JWB Request JWB Request Salary
Position Employee % Time Salary Program Program For Salary For Fringe Funding %
In
03-04 03-04 03-04 03-04 03-04
Program Coordinator Clayton 2% $45,457 $909 $223 $0 $0 0.00%
Program Coordinator LaTerza 5% $52,813 $2,641 $2,491 $0 $0 0.00%
Programmer Menchaca 50% $26,413 $13,207 $4,722 $0 $0 0.00%
Rec Programmer TSD 100% $25,254 $25,254 $9,598 $25,254 $9,598 100.00%
Recreation Leader C Jenkins 100% $20,848 $20,848 $8,974 $20,848 $8,974 1 00.00%
Recreation Leader D. Thompson 100% $22,880 $22,880 $9,146 $22,880 $9,146 100.00%
Recreation Supervisor TSD 10% $36,478 $3,648 $1,074 $0 $0 0.00%
Specialist Miller 50% $41,140 $20,570 $3,136 $0 $0 0.00%
Supervisor II Richardson 10% $31,203 $3,120 $1,089 $0 $0 0.00%
Supervisor II Sowada 10% $31,203 $3,120 $1,080 $0 $0 0.00%
I TOTALS $333,689 $116,197 $41,533 $68,982 $27,718 59.37%
Agency: City of Clearwater Page 1 Of 1 09/24/03 11 :39:47 AM
. Section VII Status: Submitted
FORM 4
CHARTING THE COURSE FOR YOUTH
SALARY AND FRINGE PREPARATION NARRATIVE
FISCAL YEAR 03-04
ACCOUNT #
ACCOUNT NAME
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASE/DECREASE OR OTHER
EXPLANATION AS NEEDED
LINE ITEM $
AMOUNT
PERCENT
INCREASE/
DECREASE
569.120 Regular Salaries and 09/2612003 Budget includes in-kind support of $118,217 56%
Wages Coordinators, Supervisors, and Programmers. JWB
provides 100% support for Recreation Leaders and
Programmer.
569.210 FICA 09/05/200308107/2003 Municipal employees with a $1,415 29%
pension plan hired before 1986 do not pay FICA,
those hired after 1986 only pay FICA-Med at 1.45
percent of annual salary.
9 of 10 employees pay FICA med.
569.220 Retirement 09/26/2003 City pension plan is calculated at 7% of $8,277 56%
Contributions annual salary. 10 employees are elegible for the
pension plan.
569.230
Life and Health
Insurance
09/05/200308/07/2003 Full time employees receive
medical insurance at no cost to the employee;
employer's cost is set by bid, FY 03/04= $5,400. 10
employees receive Group Life insurance at $12
annually and medical insurance. 4 employees
receive additional life insurance at 1 % of employee's
base salary.
$25,924
79%
569.240
Workers Compensation
09/051200308107/2003 The City of Clearwater pays
$1800 per full time employee for Worker's
Compensation for all 10 program employees.
$7,866
155%
569.250
Unemployment
Compensation
$0
0%
Agency: City of Clearwater
Page 1 Of 6
Section VIII
09/26/0310:55:47 AM
Status: Submitted
ACCOUNT #
ACCOUNT NAME
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASEJDECREASE OR OTHER
EXPLANATION AS NEEDED
LINE ITEM $
AMOUNT
PERCENT
INCREASE!
DECREASE
Agency: City of Clearwater
Page 2 Of 6
Section VIII
09/26/033:16:36 PM
Status: Submitted
Agency: City of Clearwater
Page 3 Of 6
Section VIII
09/26/03 3:16:36 PM
Status: Submitted
Agency: City of Clearwater
Page 4 Of 6
Section VIII
09/24/0311:39:47 AM
Status: Submitted
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE!
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.498 Day Program Hourly $0 0%
Unit Cost
Original Budget Calculation
=0+0
569.510 Office Supplies 08107/2003 Norton-Office supplies-pens, paper, $460 134%
etc=$80
Joe DiMaggio-$80
N. Greenwood-$300
Original Budget Calculation
=80+80+300
569.515 Participant Expenses 09/26/2003 Field trips $1,025 $1,025 100%
Original Budget Calculation
=1025
569.520 Operating Supplies 09/26/200308/07/2003 Ross Norton $2,195 -64%
VCR games $115.00
Art supplies $200
Awards $225.00
Board Games $50
Decorations $75
Film, Blank CDs $100
N. Greenwood
Video Games for Playstation $300
T shirts 50 x $5 + $30 set up $280
Compact sewing machines-5 x $50=$250
DVD movies 5 x $20=$100
Joe DiMaggio
Video games-$150
CDs-movies, music-$150
Trophies, awards-$200
Original Budget Calculation
=115+200+225+50+75+100+300+280+250+
100+150+150+200
569.521 Food & Nutrition 08/07/2003 Ross Norton- $1,855 12%
Snacks $100.00
Meals-$300
Joe DiMaggio-
Cookies, Pretzels, Snacks, Hot Dogs, Buns
$1,000
N. Greenwood
Chips, snacks-$200
Pizza-$255
Original Budget Calculation
=100+300+1000+200+255
Agency: City of Clearwater
Page 5 Of 6
Section VIII
09/26/03 3:16:36 PM
Status: Submitted
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.540 Subscriptions 08107/2003 Ross Norton $260 8%
CD subscription club-$160/yr
Magazines $100
Original Budget Calculation
=160+100
569.541 Books $0 0%
Original Budget Calculation
=0+0
569.542 Dues & Memberships $0 0%
Original Budget Calculation
=0+0
569.543 Educational Materials $0 0%
Original Budget Calculation
=0+0
569.544 Educational Training $0 0%
Original Budget Calculation
=0+0
569.590 Depreciation $0 0%
Original Budget Calculation
=0+0
569.600 Other/Miscellaneous $0 0%
Original Budget Calculation
=0+0
569.640 Machinery & Equipment $0 0%
(Capital Outlay)
Original Budget Calculation
=0+0
569.660 Books, Publications, and $0 0%
Library Materials
(Capital)
Original Budget Calculation
=0+0
Agency: City of Clearwater
Page 6 Of 6
Section VIII
09/24/0311:39:47 AM
Status: Submitted
FORM 5
Charting the Course for Youth
SOURCES OF REVENUE
01-02
Actual Revenue
02-03
Actual YTD As
of
09/26/03
02-03
Revenue
Projected Thru
End of Year
02-03
Total
03-04
Future Fiscal
Year Revenue
% Change
*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 $64,999 0%
Other $0 $0 $0 $0 $0 0%
SUBTOTAL $0 $0 $0 $0 $64,999 0
CSC Continuation $60,700 $30,350 $30,350 $60,700 $103,545 71%
CSC Equip/Renovation $0 $0 $0 $0 $0 0%
CSC Other $0 $0 $0 $0 $0 0%
SUBTOTAL $60,700 $30,350 $30,350 $60,700 $103,545 71%
TOTAL $60,700 $30,350 $30,350 $60,700 $168,544 178%
CROSS CHECK ITEMS:
FUTURE FISCAL YEAR PROGRAM EXPENDITURES:
$168,544
*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 solicited or unsolicited nature (Donations) as well as memberships which do
not entitle the donor to program services.
*FEES: Charges for services rendered. This may include revenue from memberships when such memberships entitle the member to program
services.
Agency: City of Clearwater
Page 1 Of 1
09/26/03 11 :35:02 AM
Section IX
Status: Submitted
FORM 6
Charting the Course for Youth
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 Valorem taxes.
CSC Continuation
Agency: City of Clearwater
Page 1 Of 1
09/26/033:16:36 PM
Section X
Status: Submitted
'11, ~ ..
Agency: City of Clearwater
END OF PROGRAM BUDGET FOR
Charting the Course for Youth
Page 1 Of 1
Section XI
09124103 11 :39:47 AM
,
.
. . . r
i
ATTACHMENT 5
JWB REIMBURSEMENT SCHEDULE
03-04 Submission Reimbursement
Reimbursement Date Date
Schedule
1 10/03/03 10/10/03
I 2 10/17/03 I 10/24/03 I
I 3 10/31/03 I 11/07/03 I
I 4 11/14/03 I 11/21/03 I
I 5 11 /28/03 12/05/03 I
I 6 12/12/03 12/19/03 I
I 7 12/26/03 01/02/04 I
I 8 01/09/04 01/16/04 I
I 9 01/23/04 01 /30/04 I
I 10 02/06/04 02/13/04 I
I 11 02/20/04 02/27/04 I
I 12 03/05/04 03/12/04 I
I 13 03/19/04 03/26/04 I
I 14 04/02/04 04/09/04 I
I 15 04/16/04 04/23/04 I
I 16 04/30/04 05/07/04 I
I 17 05/14/04 OS/21/04 I
I 18 OS/28/04 06/04/04 I
I 19 I 06/11/04 06/18/04 I
I 20 I 06/25/04 07/02/04 I
I 21 I 07/09/04 07/16/04 I
I 22 I 07/23/04 07/30/04 I
I 23 I 08/06/04 08/13/04 I
I 24 I 08/20/04 08/27/04 I
I 25 I 09/03/04 09/10/04 I
I 26 I 09/17/04 09/24/04 I
Agency: City of Clearwater Page 1 Of 1 09/24/03 11 :39:47 AM
Section XII