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CHARTING THE COURSE FOR YOUTH AGREEMENT (3) ~".~' "U', AGREEMENT Between THE JUVENILE WELFARE BOARD and City of Clearwater Florida Parks and Recreation Department (Charting the Course for Youth) I Y:<.F' c;~'\r\j-L--- In. .t. ";~j"_".J!S" !!_~~J NOV 2 2 2004 inv.~~ l --'.l ".- ~-"- -~-- "0 _'_~'_ I. PURPOSE The Juvenile Welfare Board of Pinellas County, hereinafter referred to as "JWB", and City of Clearwater Florida Parks and Recreation Department , hereinafter referred to as "Provider", enter into this mutual Agreement, including all attachments referred to herein, for the period commencing October 1,2004 and extending through September 30, 2005. 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 04-05 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 $105,616 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 V (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. 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, this Agreement may be terminated by either party upon no less than thirty (30) days notice. 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 Agency: City of Clearwater Page 1 of 3 Section I 9/30/049:38:10 AM C:I.-J - del ,[ - () \ (;Jj ~.. , f ;' 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 JWB's 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 9/30/049:38:10 AM ."k'~ .~". 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 seal this ~day of ,va J t"/}I ~ 11, 2004. Signed, sealed and delivered In the presence of: JUVENILE WELFARE BOARD OF PINELLAS C UNTY a~ 't. 4 Witness Signature Print Name: A/l( Y .{. ~ A {Y Atd.i.e. )n . OncdULui Witness Signature - a rint Name:~Il.L.'e So. ~. 1J..J.,1b, -. '- . --- . Print Name: /b1A/O~ 11. fljk/lf ~ --- ~ -~- . ~ , . '..........- ~ - IN WITNESS WHEREOF, the parties hereto have set their hands and seal this ~ day of (\D~",~ ,2004. CITY OF CLEARWATER, FLORIDA By: NfJ'h.....J5. ~-::rJ. William B. Horne, II City Manager Approved as to form: Attest: Laura Lipowski Assi ant City Attorney Agency: City of Clearwater Page 3 of 3 Section I 9/30/049:38:10 AM ~,' ~ .~ ~ , 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 ManaQement 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, maybe 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 9/30/049:38:10 AM .' :]I I'" I , -1 .," 5. ProClram 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 MeetinCls 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. PublicizinCl 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 addition 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 9/30/049:38:10 AM _, '. 'r ,-, 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 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 9/30/049:38:10 AM ,. ~ .....; -., ATTACHMENT 2 City of Clearwater Charting the Course for Youth MEASURABLE OBJECTIVES FY 04-05 Client Level Measurable Objectives (CDG) All Primary Participants will be measured through the Measurable Objective reporting module in SAMIS within a twelve month period. Service Component: General Youth Services Objective ID Objective Description 2417 Ninety percent (90%) of primary youth will improve interpersonal skills measured by at least a nine (9) point increase in scores from pre to post on the Interpersonal Assessment Scale. Program staff will complete the Interpersonal Assessment Scale when the youth enter the program (pre) and the six (6) month anniversary date of enrollment, the twelve (12) month anniversary date of enrollment, the twenty-four (24) month anniversary date of enrollment, the thirty-six (36) month anniversary date of enrollment, the forty-eight (48) month anniversary date of enrollment, the sixty (60) month anniversary date of enrollment, and the seventy-two (72) month anniversary date of enrollment, or at case closure, whichever occurs first (post). (CDG-Summary) 2451 Ninety percent (90%) of primary youth will express satisfaction with the program as indicated by a score of at least 49 points on the Youth Satisfaction Survey. Program staff will administer the self-report Youth Satisfaction Survey at the twelve (12) month anniversary date of enrollment, the twenty-four (24) month anniversary date of enrollment, the thirty-six (36) month anniversary date of enrollment, the forty-eight (48) month anniversary date of enrollment, the sixty (60) month anniversary date of enrollment, and the seventy-two (72) month anniversary date of enrollment, or at case closure, whichever occurs first (post). Data will be entered into SAMIS as it is collected. (COG - Summary) Manual Measurable Objectives Objective ID Objective Description MMO-173 Program will document all community activities and events sponsored in the SAMIS Group Data Module. Contracted Service Levels Client Level Minimum Service Levels (CDG) 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 Group Level Minimum Service Levels (Group Activity) Agency: City of Clearwater Page 1 Of 2 Section III 9/30/049:38:10 AM Status: Submitted .' .- '.., "II r Section I: Minimum Service Levels for Group Activities Contracted Youth: 0 Contracted Adults: 0 Total Contracted Youth and Adults: 0 Section II: Number of Activities Activity Type Quantity Section III: Number of Youth and Adults per Activity Activity Type Youth Agency: City of Clearwater Page 2 Of 2 Section III Adults 9/30/049:38:10 AM Status: Submitted T. 1iIL. -J" , r.l 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 9/30/049:38:10 AM .1 j ... i.r , " 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 10/05/00. Copies of these guidelines are available from JWB upon request. In all instances, budget amendments require electronic approval in SAMIS by JWB staff. For all amendments, 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. 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 9/30/049:38:10 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) ACCT# TITLE 03-04 04-05 03-04 04-05 PROG. PROG. % JWB JWB % BUDG. BUDG. CHG. ALLOC. ALLOC. CHG. Salary Accounts: 569.120 Regular Salaries and Wages $118,217 $122,184 $68,982 $70,489 2% Total Salary: $118,217 $122,184 3% $68,982 $70,489 2% Fringe Accounts: 569.210 FICA $1,415 $1,528 8% $1,000 $1,022 2% 569.220 Retirement Contributions $8,277 $8,556 3% $4,830 $4,935 2% 569.230 Life and Health Insurance $25,924 $27,037 4% $16,488 $18,636 13% 569.240 Workers Compensation $7,866 $3,884 -51% $5,400 $1,770 -67% 569.250 Unemployment Compensation $0 $0 0% $0 $0 0% Total Fringe: $43,482 $41,005 -6% $27,718 $26,363 -5% Operating Expense Accounts: 569.310 Professional Services $1,050 $1,350 29% $1,050 $1,350 29% 569.311 Professional ServicesIWorkshops $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 CourtlLegal 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 9/30/049:38:10 AM Status: Submitted ~.. -.. l " ., (1) (2) (3) (4) (5) (6) ACCT# TITLE 03.04 04-05 03-04 04-05 PROG. PROG. % JWB JWB % BUDG. BUDG. CHG. ALLOC. ALLOC. CHG. 569.402 Transportation $0 $0 0% $0 $0 0% 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 $0 0% $0 $0 0% Shipping 569.413 Communication-Intemet $0 $0 0% $0 $0 0% 569.430 Utility Services $0 $0 0% $0 $0 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 9/30/049:38:10 AM Status: Submitted f 1 ,~ ',' " (1) (2) (3) (4) (5) (6) ACCT# TITLE 03-04 04-05 03-04 04-05 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 $460 $184 -60% $460 $184 -60% 569.515 Participant Expenses $1,025 $2,250 120% $1,025 $2,250 120% 569.520 Operating Supplies $2,195 $2,100 -4% $2,195 $2,100 -4% 569.521 Food & Nutrition $1,855 $2,880 55% $1,855 $2,880 55% 569.540 Subscriptions $260 $0 -100% $260 $0 -100% 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: $6,845 $8,764 28% $6,845 $8,764 28% Total Program Expenses: $168,544 $171,953 2% $103,545 $105,616 2% Agency: City of Clearwater Page 3 Of 3 Section VI 9/30/049:38:10 AM Status: Submitted FORM 3 CHARTING THE COURSE FOR YOUTH SALARY AND FRINGE PREPARATION FISCAL YEAR 04-05 Gross Salary In Fringe In JWB Request JWB Request Salary Position Employee % Time Salary Program Program For Salary For Fringe Funding % In 04-05 04-05 04-05 04-05 04-05 Program Coordinator Clayton 10% $47,304 $4,730 $1,194 $0 $0 0.00% Program Coordinator laTerza 10% $54,719 $5,472 $1,313 $0 $0 0.00% Programmer TBD 30% $24,439 $7,332 $2,975 $0 $0 0.00% Rec Programmer F Dixon 100% $25,021 $25,021 $8,917 $25,021 $8,917 100.00% Recreation Leader A Menchaca 100% $25,311 $25,311 $8,941 $25,311 $8,941 100.00% Recreation Leader TBD 100% $20,157 $20,157 $8,505 $20,157 $8,505 100.00% Specialist Miller 40% $42,626 $17,050 $4,541 $0 $0 0.00% Supervisor II Richardson 20% $42,746 $8,549 $2,309 $0 $0 0.00% Supervisor II Sowada 20% $42,811 $8,562 $2,310 $0 $0 0.00% TOTALS $70,489 $26,363 Agency: City of Clearwater Page 1 Of 1 Section VII 9/30/049:38:10 AM Status: Submitted JI'." I',.r, , FORM 4 CHARTING THE COURSE FOR YOUTH SALARY AND FRINGE PREPARATION NARRATIVE FISCAL YEAR 04-05 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 $122,184 3% Wages 8/5/2004 Budget includes in-kind support of Coordinators, Supervisors, and Programmers. JWB provides 100% support for Recreation Leaders and a Programmer. 569.210 FICA $1,528 8% 9/27/200409/05/200308/07/2003 Municipal employees with a pension plan hired before 1986 do not pay FICA, those hired after 1986 only pay FICA-Med at 1.45 percent of annual salary. 8 of 9 employees pay FICA med. 569.220 Retirement $8,556 3% Contributions 9/27/200409/26/2003 City pension plan is calculated at 7% of annual salary. 9 employees are elegible for the pension plan. 569.230 Life and Health Insurance $27,037 4% 8/16/2004 Full time employees receive medical insurance at no cost to the employee; employer's cost is set by bid, FY 04/05= $6,200. 9 employees receive Group Life insurance at $12 annually. 2 employees receive additional life insurance at 1 % of employee's base salary. 5 employees receive additional management level life insurance. 569.240 Workers Compensation $3,884 -51% 8/16/2004 The City of Clearwater pays $1625.64 per full time employee for Worker's Compensation for 6 program employees and $590 for 3 employees. 569.250 Unemployment Compensation $0 0% Agency: City of Clearwater Page 1 Of 7 Section VIII 9/30/049:38:10 AM Status: Submitted '. It- ACCOUNT # ACCOUNT NAME DERIVATION OF FIGURES AND JUSTIFICATION OF INCREASE/DECREASE OR OTHER EXPLANATION AS NEEDED LINE ITEM $ AMOUNT PERCENT INCREASE/ DECREASE OPERATING EXPENSE BUDGET NARRATIVE 569.310 Professional Services $1,350 29% 8/5/2004 Ross Norton Instructors Speakers $100 Drumming-$20/hr x 15 hr = $300 Workshop-$50 Wood Valley Instructors Speakers $100 Drumming-$20/hr x 15 hr = $300 Workshop-$50 N. Greenwood Speakers $100 Drumming-$20/hr x 15 hr = $300 Workshop-$50 Original Budget Calculation =100+300+50+100+300+50+100+300+50 569.311 Professional $0 0% Services/Workshops Original Budget Calculation =O+D 569.320 Accounting and Auditing $0 0% Original Budget Calculation =l)+D 569.321 Bank Services $0 0% Original Budget Calculation =O+D 569.330 CourVLegal Services $0 0% Original Budget Calculation =l)+D 569.340 Other Contractual $0 0% Services Original Budget Calculation =l)+D 569.350 Investigations $0 0% Original Budget Calculation =l)+D 569.400 Travel and Per Diem $0 0% Original Budget Calculation =0+0 569.401 Conference $0 0% Original Budget Calculation =O+D Agency: City of Clearwater Page 2 Of 7 Section VIII 9/30/049:38:10 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 569.402 Transportation 08/07/20030 $0 0% Original Budget Calculation =0 569.410 Communications-Teleph $0 0% one Original Budget Calculation =0+0 569.411 Communications-Long $0 0% Distance Original Budget Calculation =0+0 569.412 Communications-Postag $0 0% e and Shipping Original Budget Calculation =0+0 569.413 Commun ication-Internet $0 0% Original Budget Calculation =0+0 569.430 Utility Services $0 0% Original Budget Calculation =0+0 569.431 Water/Sewer/Sanitation $0 0% Original Budget Calculation =0+0 569.440 Rentals & Leases $0 0% (Building & Land) Original Budget Calculation =0+0 569.441 Rentals & Leases - $0 0% Equipment Original Budget Calculation =0+0 569.450 Insurance $0 0% Original Budget Calculation =0+0 569.460 Repair & Maintenance $0 0% Services - Equipment Original Budget Calculation =0+0 Agency: City of Clearwater Page 3 Of 7 Section VIII 9/30/049:38:10 AM Status: Submitted t. ,_-..:. !.," DERIVATION OF FIGURES AND LINE ITEM $ PERCENT JUSTIFICATION OF AMOUNT INCREASE! ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE EXPLANATION AS NEEDED 569.461 Repair & Maintenance $0 0% Services - Property Original Budget Calculation =0+0 569.462 Repair & Maintenance $0 0% Services - Grounds Original Budget Calculation =0+0 569.463 Vehicle Repair and $0 0% Maintenance Services Original Budget Calculation =0+0 569.470 Printing & Binding $0 0% Original Budget Calculation =0+0 569.471 Copying & Binding $0 0% Original Budget Calculation =0+0 569.480 Promotional Activities $0 0% Original Budget Calculation =0+0 569.481 Advertising $0 0% Original Budget Calculation =0+0 569.493 Match $0 0% Original Budget Calculation =0+0 569.494 Administrative Cost $0 0% Original Budget Calculation =0+0 569.495 Residential Per Diem $0 0% Original Budget Calculation =0+0 569.496 Day Program Per Diem $0 0% Original Budget Calculation =0+0 569.497 Day Program Subsidy $0 0% Original Budget Calculation =0+0 Agency: City of Clearwater Page 4 Of 7 Section VIII 9/30/049:38:10 AM Status: Submitted ,A, ACCOUNT # ACCOUNT NAME DERIVATION OF FIGURES AND JUSTIFICATION OF INCREASE/DECREASE OR OTHER EXPLANATION AS NEEDED LINE ITEM $ AMOUNT PERCENT INCREASE/ DECREASE 569.498 Day Program Hourly Unit Cost $0 0% Original Budget Calculation =0+0 569.510 Office Supplies $184 -60% 8/5/2004 Norton-Office =$50 Wood Valley-$50 N. Greenwood-$84 Original Budget Calculation =50+50+84 569.515 Participant Expenses $2,250 120% 8/5/2004 8/5/2004 Ross Norton Field trips $750 Wood Valley Field trips $750 N. Greenwood Field trips $750 Original Budget Calculation =750+750+750 569.520 Operating Supplies $2,100 -4% 8/5/2004 8/5/2004 8/5/2004 Ross Norton Video games $300 Art supplies $200 Board Games $50 Decorations $50 Film, Blank CDs $100 Wood Valley Video games $300 Art supplies $200 Board Games $50 Decorations $50 Film, Blank CDs $100 N. Greenwood Video games $300 Art supplies $200 Board Games $50 Decorations $50 Film, Blank CDs $100 Original Budget Calculation =300+200+50+50+100+300+200+50+50+10 0+300+200+50+50+100 Agency: City of Clearwater Page 5 Of 7 Section VIII 9/30/049:38:10 AM Status: Submitted y .. <, DERIVATION OF FIGURES AND LINE ITEM $ PERCENT JUSTIFICATION OF AMOUNT INCREASE! ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE EXPLANATION AS NEEDED 569.521 Food & Nutrition $2,880 55% 8/5/2004 8/5/2004 Ross Norton- Snacks $200.00 Meals-$300 Pizza $460 Wood Valley Snacks $200.00 Meals-$300 Pizza $460 N. Greenwood Snacks $200.00 Meals-$300 Pizza $460 Original Budget Calculation =200+300+460+200+300+460+200+300+46 0 569.540 Subscriptions $0 .100% 8/16/2004 not used. Original Budget Calculation =0 569.541 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/M iscellaneous $0 0% Original Budget Calculation =0+0 569.640 Machinery & Equipment $0 0% (Capital Outlay) Original Budget Calculation =0+0 Agency: City of Clearwater Page 6 Of 7 Section VIII 9/30/04 9:38:10 AM Status: Submitted '. .J .':: LINE ITEM $ AMOUNT PERCENT INCREASE/ DECREASE ACCOUNT # ACCOUNT NAME DERIVATION OF FIGURES AND JUSTIFICATION OF INCREASE/DECREASE OR OTHER EXPLANATION AS NEEDED 569.660 0% Books, Publications, and Library Materials (Capital) $0 Original Budget Calculation =0+0 Agency: City of Clearwater - Page 7 Of 7 Section VIII 9/30/049:38:10 AM Status: Submitted ;-'. OJ [. , . FORM 5 Charting the Course for Youth SOURCES OF REVENUE 02-03 03-04 03-04 03-04 04-05 04-05 04-05 Percent Funder TypelFunder Total Budget Amend Total Budget Amend Total Increase! Decrease Government - Local (City/County) City of Clearwater $0 $64,999 $0 $64,999 $66,337 $0 $66,337 2% $0 $64,999 $0 $64,999 $66,337 $0 $66,337 2% Grand Total $0 $64,999 $0 $64,999 $66,337 $0 $66,337 2% FY 04-05 Totals Total Program Revenue Total Program Budget Difference $171,953 $171,953 $0 Total CSC Allocation $105,616 Agency: City of Clearwater Page 1 Of 1 Section IX 9/30/049:38:10 AM Status: Submitted I ~ 1! .. r,t .r' FORM 6 Charting the Course for Youth SOURCES OF REVENUE NARRATIVE Funder TypelFunder FY 04-05 Total Narrative Government - Local (City/County) City of Clearwater $66,337 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. Agency: City of Clearwater Page 1 Of 1 Section X 9/30/049:38:10 AM Status: Submitted . . 1" t t' r' H .,) - Agency: City of Clearwater END OF PROGRAM BUDGET FOR Charting the Course for Youth Page 1 Of 1 Section XI 9/30/049:38:10 AM ~ '!', '"- , ~.~t~..... >. ATTACHMENT 5 JWB REIMBURSEMENT SCHEDULE 04-05 Submission Reimbursement Reimbursement Date Date Schedule 1 1 0/1 /04 1 0/8/04 2 1 0/1 5/04 1 0/22/04 3 1 0/29/04 11 /5/04 4 11/12/04 11/19/04 5 11 /26/04 12/3/04 6 12/10/04 12/17/04 7 12/24/04 12/31/04 8 1 fl /05 1/14/05 9 1/21/05 1/28/05 10 2/4/05 2/11/05 11 2/1 8/05 2/25/05 12 3/4/05 3/11/05 13 3/18/05 3/25/05 14 4/1/05 4/8/05 15 4/1 5/05 4/22/05 16 4/29/05 5/6/05 17 5/1 3/05 5/20/05 18 5/27/05 6/3/05 19 6/1 0/05 6/17/05 20 6/24/05 7/1 /05 21 7/8/05 7/15/05 22 7/22/05 7/29/05 23 8/5/05 8/12/05 24 8/19/05 8/26/05 25 9/2/05 9/9/05 26 9/1 6/05 9/23/05 27 9/30/05 1 Ofl /05 Agency: City of Clearwater Page 1 Of 1 9/30/049:38:10 AM Section XII