MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM
"
~., '~,
.
AGREEMENT .
THE JUVENI~:~~~ARE BOARD ~~CF7~,:f\7E\Dl
and 2 2005
City of Clearwater Florida Parks and Recreation Departmen By. ~. ... ... ./ :
(Middle School-Aged Summer Scholarship Program) --7. ==J
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
I.
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 $118,320 for Middle School-Aged
Summer Scholarship Program 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.
Agency: City of Clearwater
Page 1 of 3
Section I
6/7/200512:56:25 PM
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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 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 conditions 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
6/7/200512:56:25 PM
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IX. INDEMNIFICATIQN
The Parties recognize and agree to abide by the provisions of S 768.28, Fla. Stat.
IN WITNESS WHEREOF, the parties hereto have set their hands and seal this ;23,(1 day of
Sun -e.. ,2005.
Signed, sealed and delivered
In the presence of:
rint Name: :r ~~ fj ,Nl \ i is
~~
Witness Signature
Print Name: ~'-1 'b.4kL\
~~O>l~
Witness Signature
Print Name: ~J,j.e ffudrV
-If\
IN WITNESS WHEREOF, the parties hereto have set their hands and seal this /7 day of
~2005.
Countersigned:
&-~3-DS-
Date
-j~~
...-/
Frank Hibbard
CITY OF CLEARWATER, FLORIDA
BY~Jl..
William B. Horne, "
~fO~:
La~ra Lipowski
Assistant City Attorney
Attest:
~~2. h..~c~~
Cynt '. E. .=Goudeau
City Clerk
Agency: City of Clearwater
Page 3 of 3
6/1/200512:12:58 PM
Section I
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II
ATTACHMENT 1
GENERAL CONDITIONS OF THE AGREEMENT
1. A~reement 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 Responsibilitv - 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 Mana~ement 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 ofJWB
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 Of3
Section II
6/7/200512:56:25 PM
(\5. F'roaram 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 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 loeallaw 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 Of3
Section II
6n1200512:56:25 PM
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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 Of3
Section II
6/7/2005 12:56:25 PM
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ATTACHMENT 2
City of Clearwater
Middle School-Aged Summer Scholarship Program
MEASURABLE OBJECTIVES
FY04-05
Client level Measurable Objectives (COG)
All Primary Participants will be measured through the Measurable Objective reporting module in SAMIS
within a twelve month period.
Service Component: Summer Camp
Objective 10 Objective Description
2498 Eighty percent (80%) of primary youth, in conjunction with a staff member, will establish two
personal development goals related to MSASS activities and will achieve satisfactory attainment
of each goal as measured by a 4 or 5 on the Goal Writing Worksheet. Staff will rate each youth's
progress on each goal on the Goal Writing Worksheet during the ninth week of the summer camp
program. Staff will enter data into SAMIS by the final day of the program (post). (COG Summary)
2499 Eighty percent (80%) of primary youth will show improvement in their interpersonal skills by the
end of the summer camp program as measured by an increase of at least three points from pre to
post on the Interpersonal Assessment Scale. Program staff will complete the Interpersonal
Assessment Scale by the end of the first week of the summer camp program (pre) and during the
final week of the summer camp program (post). Staff will enter data into SAMIS by the final day of
the program. (COG Summary)
Service Component: Summer Camp level 15
Objective 10 Objective Description
2500 Enter raw score for reading, language, and math. Used for data collection purposes only.
Service Component: Summer Camp level 16
Objective 10 Objective Description
2501 Enter raw score for reading, language, and math. Used for data collection purposes only.
Service Component: Summer Camp level 17
Objective 10 Objective Description
2502 Enter raw score for reading, language, and math. Used for data collection purposes only.
Service Component: Summer Camp level 18
Objective 10 Objective Description
2503 Enter raw score for reading, language, and math. Used for data collection purposes only.
Contracted Service levels
Client level Minimum Service levels (COG)
Agency: City of Clearwater
Page10f 2
Section III
6171200512:56:25 PM
Status: Submitted
r' ..Pr'ini'aJo/ Participants
Contracted Primary Youth: 140
Contracted Primary Adults: 0
Total Contracted Primary Youth and Adults: 140
Secondary Participants
Estimated Secondary Youth: 0
Estimated Secondary Adults: 0
Total Secondary Youth and Adults:O
Group level Minimum Service levels (Group Activity)
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
Adults
Agency: City of Clearwater
Page 2 Of 2
Section III
6/7/2005 12:56:25 PM
Status: Submitted
( .-
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A IT ACHMENT 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-Aged Summer Scholarship Program
33755, 33756
Agency: City of Clearwater
Page 1 Of 1
Section IV
6m200512:56:25 PM
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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
6nt2005 12:56:25 PM
.
l 4
FORM 2
MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM
CURRENT & PROPOSED OPERATING BUDGET
(ROUND NUMBERS UP TO THE NEAREST DOLLAR)
(1)
03-04
ACCT# TITLE
PROG.
BUDG.
569.120
Salary Accounts:
Regular Salaries and Wages
Total Salary :
569.210
Fringe Accounts:
FICA
569.220
569.230
569.240
569.250
Total Fringe:
Retirement Contributions
Life and Health Insurance
Workers Compensation
$0
Unemployment Compensation
$0
$0
569.310
Operating Expense Accounts:
$0
569.311
569.320
569.321
569.330
569.340
569.350
569.400
569.401
Professional Services
Professional ServiceslWorkshops
$0
Accounting and Auditing
$0
Bank Services
$0
Court/Legal Services
$0
Other Contractual Services
$0
Investigations
$0
Travel and Per Diem
$0
Conference
$0
Agency: City of Clearwater
Page1 Of 3
Section VI
(2)
04-05
PROG.
BUDG.
$0
$51,336
$0
$51,336
$0
$2,585
$0
$1,341
$0
$3,315
$7,241
$43,150
(3)
%
CHG.
100%
100%
100%
100%
100%
$0
0%
$0
0%
100%
100%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
(4)
03-04
JWB
ALLOC.
(5)
04-05
JWB
ALLOC.
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
(6)
%
CHG.
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
$0
0%
6/7/200512:56:25 PM
Status: Submitted
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(1) (2) (3) (4) (5) (6)
03-04 04-05 03-04 04-05
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
569.402 Transportation $0 $10,315 100% $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-I nternet $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 $118,320 100%
Agency: City of Clearwater Page 2 Of 3 6nJ2005 12:56:25 PM
Section VI Status: Submitted
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, (1) (2) (3) (4) (5) (6)
03-04 04-05 03-04 04-05
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. 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 $0 $700 100% $0 $0 0%
569.515 Participant Expenses $0 $30,268 100% $0 $0 0%
569.520 Operating Supplies $0 $9,050 100% $0 $0 0%
569.521 Food & Nutrition $0 $5,250 100% $0 $0 0%
569.540 Subscriptions $0 $0 0% $0 $0 0%
569.541 Books $0 $0 0% $0 $0 0%
569.542 Dues & Memberships $0 $0 0% $0 $0 0%
569.543 Educational Materials $0 $2,820 100% $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)
9 Test Enhancements $0 $0 0% $0 $0 0%
Total Operating Expense: $0 $101,553 100% $0 $118,320 100%
Total Program Expenses: $0 $160,130 100% $0 $118,320 100%
Agency: City of Clearwater
Page 3 Of 3
Section VI
6/7/2005 12:56:25 PM
Status: Submitted
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FORM 3
MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM
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
coordinator laterza 1% $54,926 $549 $115 $0 $0 0.00%
programmer cone 15% $25,232 $3,785 $1,252 $0 $0 0.00%
Rec Leader calaman 100% $4.248 $4,248 $325 $0 $0 0.00%
Rec Leader crayder 100% $4,248 $4,248 $325 $0 $0 0.00%
Rec Leader davis 100% $4,248 $4,248 $325 $0 $0 0.00%
Rec Leader gresham 100% $4,248 $4,248 $325 $0 $0 0.00%
Rec leader Mitchell 100% $4,248 $4,248 $325 $0 $0 0.00%
Rec Leader williams 100% $4,247 $4,247 $325 $0 $0 0.00%
Rec Leader-LW cooper 100% $4,460 $4,460 $341 $0 $0 0.00%
Rec Leader-LW Marshall 50% $4,460 $2,230 $171 $0 $0 0.00%
specialist miller 25% $42,785 $10,696 $2,432 $0 $0 0.00%
supervisor richardson 5% $41,258 $2.063 $490 $0 $0 0.00%
supervisor sowada 5% $41,320 $2,066 $490 $0 $0 0.00%
Agency: City of Clearwater
Page 1 Of 2
Section VII
6nJ200512:56:25 PM
Status: Submitted
.'" ,. ,
, 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
TOTALS $239,928 $51,336 $7,241 $0 $0 0.00%
Agency: City of Clearwater
Page 20f2
Section VII
6nt2005 12:56:25 PM
Status: Submitted
~~ ...I...
, .
ACCOUNT #
569.120
569.210
569.220
569.230
569.240
569.250
FORM 4
MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM
SALARY AND FRINGE PREPARATION NARRATIVE
FISCAL YEAR 04-05
ACCOUNT NAME
Regular Salaries and
Wages
FICA
Retirement
Contributions
Life and Health
Insurance
Workers Compensation
Unemployment
Compensation
Agency: City of Clearwater
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASE/DECREASE OR OTHER
EXPLANATION AS NEEDED
LINE ITEM $
AMOUNT
$51,336
5/26/2005 5/26/2005 New
$2,585
$1,341
$3,315
$0
$0
Page 1 Of 8
Section VIII
PERCENT
INCREASE/
DECREASE
100%
100%
100%
100%
0%
0%
6/7/200512:56:25 PM
Status: Submitted
i;' .-,...-
"
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 Servi.ces $43,150 100%
5/26/2005 5/26/2005 5/26/2005 5/26/2005 5/23/2005
Youth Arts Corp has been hired to provide the
educational component.
Start up-
Administrative meetings 6 artists@$221hr x 25 hrs
=$3300 plus 1 teacher @$221hr x 25 hrs=$550
Materials-$1,500
Program costs
certified teacher- $221hrx5hr/day x 3 dayslwk x 10
weeks=$3,300
Curriculum development-$550
NG artists
4@$22/hr x 5hr/day x 3dayslwk x 10wks =
$13,200
Planning hrs 100 x $22/hr = $2,200
Supplies-$3.500
RN artists
2 @ $221hr x 5hr/day x 3 days x 10 wks = $6,600
Planning 50hr x $22/hr = $1,100
Supplies-$1,750
8% administration = $2,800
NG-Everyone's an artist
artist $2,800
Original Budget Calculation
=3300+1500+550+3300+550+13200+2200+
3500+6600+1100+1750+2800+2800
569.311 Professional $0 0%
ServiceslWorkshops
Original Budget Calculation
=0+0
569.320 Accounting and Auditing $0 0%
Original Budget Calculation
=0+0
569.321 Bank Services $0 0%
Original Budget Calculation
=0+0
569.330 Court/Legal Services $0 0%
Original Budget Calculation
=0+0
569.340 Other Contractual $0 0%
Services
Original Budget Calculation
=0+0
Agency: City of Clearwater
Page 2 Of 8
Section VIII
6/7/200512:56:25 PM
Status: Submitted
Agency: City of Clearwater
Page 3 Of 8
Section VIII
6n1200512:56:25 PM
Status: Submitted
Agency: City of Clearwater
Page 4 Of 8
Section VIII
6/7/200512:56:25 PM
Status: Submitted
Agency: City of Clearwater
Page 5 Of 8
Section VIII
6nJ2005 12:56:25 PM
Status: Submitted
l "f
-~-ll
ACCOUNT #
569.515
ACCOUNT NAME
Participant Expenses
Agency: City of Clearwater
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASE/DECREASE OR OTHER
EXPLANATION AS NEEDED
5/26/2005 5/26/2005 5/26/2005 5/23/2005 NG Field
Trips
Bowling 100 @$5.40= $540
Cici's pizza 100 @ $4.52 = $452
Movies 100 kids, 8 CITs, 5 staff@ $6 = $677
Busch Gardens/Adventure Island + meals 100 kids,
8 CITs, 5 staff@ $70 = $7910
4 Museums 4 @ 113 admissions @ $6 = $2712
Celebration Station 100 kids, 8 CITs, 5 staff@17
=$1921
Astroskate 100 kids, 8 CITs, @$5 =$540
Islands of Adventure + meals 100 kids, 8 CITs, 5
staff @$44 =$4971
Disney World + meals 100 kids, 8 CITs, 5 staff @65
=$7345
RN Field Trips
Ice Skating 40 @$7.50 = $300
Treasure Island Center 40 @$5 =$200
Advenure Island 2 @40 @$16.25= $1300
Laser Xtreme 40 @ $13.75 =$550
Lithia Springs 40 @$1.25 =$50
Bowling 40 @$6.25 =$250
MOSI 40 @$6.25 =$250
Clw Marine Aquarium 40 @$7.50 =$300
Original Budget Calculation
=540+452+677+7910+2712+1921+540+497
1+7345+300+200+1300+550+50+250+250+
300
Page 6 Of 8
Section VIII
LINE ITEM $
AMOUNT
$30,268
PERCENT
INCREASEI
DECREASE
100%
6"'200512:56:25 PM
Status: Submitted
Agency: City of Clearwater
Page 7 Of 8
Section VIII
6n1200512:56:25 PM
Status: Submitted
Agency: City of Clearwater
Page 8 Of 8
Section VIII
6/7/2005 12:56:25 PM
Status: Submitted
1 . ,. ' .~ .
FORM 5
Middle School-Aged Summer Scholarship Program
SOURCES OF REVENUE
02-03 03-04 03-04 03-04 04-05 04-05 04-05 Percent
Funder Type/Funder Total Budget Amend Total Budget Amend Total Increase/
Decrease
Government - Local
(City/County)
City of Clearwater $0 $0 $0 $0 $35,857 $0 $35,857 100%
$0 $0 $0 $0 $35,857 $0 $35,857 100%
Other/Miscellaneous
Miscellaneous Funding $0 $0 $0 $0 $1,753 $0 $1,753 100%
$0 $0 $0 $0 $1,753 $0 $1,753 100%
Program Revenue
Fees for Service $0 $0 $0 $0 $4,200 $0 $4,200 100%
$0 $0 $0 $0 $4,200 $0 $4,200 100%
Grand Total $0 $0 $0 $0 $41,810 $0 $41,810 100%
FY 04-05 Totals
Total Program Revenue $160,130
Total Program Budget $160,130
Difference $0
Total CSC Allocation $118,320
Agency: City of Clearwater
Page 1 Of 1
Section IX
6/7/200512:56:25 PM
Status: Submitted
t . ~-I ..
Funder Type/Funder
Government - Local (City/County)
City of Clearwater
Other/Miscellaneous
Miscellaneous Funding
Program Revenue
Fees for Service .
Agency: City of Clearwater
FORM 6
Middle School-Aged Summer Scholarship Program
SOURCES OF REVENUE
NARRATIVE
FY 04-05 Total
Narrative
$35,857
$1,753
$4,200
Page 1 Of 1
Section X
6/7/200512:56:25 PM
Status: Submitted
,J"'J~ \"..
END OF PROGRAM BUDGET FOR
Middle School-Aged Summer Scholarship Program
Agency: City of Clearwater
Page 1 Of 1
Section XI
6m200512:56:25 PM
, t, -\-,.' ~. ,_
ATTACHMENT 5
JWB REIMBURSEMENT SCHEDULE
04-05 Submission Reimbursement
Reimbursement Date Date
Schedule
1 10/1/2004 1 0/8/2004
2 10/15/2004 10/22/2004
3 10/29/2004 11/5/2004
4 11/12/2004 11/19/2004
5 11/26/2004 12/3/2004
6 12/1 0/2004 12/17/2004
7 12/24/2004 12/31/2004
8 117/2005 1/14/2005
9 1/21/2005 1/28/2005
10 2/4/2005 2/11/2005
11 2/18/2005 2/25/2005
12 3/4/2005 3/11/2005
13 3/18/2005 3/25/2005
14 4/1/2005 4/8/2005
15 4/15/2005 4/22/2005
16 4/29/2005 5/6/2005
17 5/13/2005 5/20/2005
18 5/27/2005 6/3/2005
19 6/10/2005 6/17/2005
20 6/24/2005 7/1/2005
21 7/8/2005 7/15/2005
22 7/22/2005 7/29/2005
23 8/5/2005 8/12/2005
24 8/19/2005 8/26/2005
25 9/2/2005 9/9/2005
26 9/16/2005 9/23/2005
27 9/30/2005 1 0/7/2005
Agency: City of Clearwater Page1Of1 6/7/2005 12:56:25 PM
Section XII
t
i
:.
l)~~ FORM 2
MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM
CURRENT & PROPOSED OPERATING BUDGET
(ROUND NUMBERS UP TO THE NEAREST DOLLAR)
569.120
Regular Salaries and Wages
(1) (2) (3) (4) (5) (6)
03-04 04-05 03-04 04-05
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC; CHG.
$0 $51,336 $0 $0 0%
$0 $51,336 100% $0 $0 0%
ACCT# TITLE
Salary Accounts:
Total Salary :
Fringe Accounts:
569.210 FICA $0 $2,585 100% $0 $0 0%
569.220 Retirement Contributions $0 $1,341 100% $0 $0 0%
569.230 Life and Health Insurance $0 $3,315 100% $0 $0 0%
569.240 Workers Compensation $0 $0 0% $0 $0 0%
569.250 Unemployment Compensation $0 $0 0% $0 $0 0%
Total Fringe:
$0
$7,241
100%
$0
$0
0%
Operating Expense Accounts:
569.310 Professional Services $0 $43,150 100% $0 $0 0%
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 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: Cil}' of Clearwater
Page 1 Of 3
Section VI
5/26/20051:06:13 PM
Status: Submitted
(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 $10,315 100% $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-Internet $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 $118,320 100%
Agency: City of Clearwater
Page 2 Of 3
Section VI
5/26/20051:06:13 PM
Status: Submitted
(1) (2) (3) (4) (5) (6)
03-04 04-05 03-04 04-05
ACCT# TITLE
PROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. 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 $0 $700 100% $0 $0 0%
569.515 Participant Expenses $0 $30,268 100% $0 $0 0%
569.520 Operating Supplies $0 $9,050 100% $0 $0 0%
569.521 Food & Nutrition $0 $5,250 100% $0 $0 0%
569.540 Subscriptions $0 $0 0% $0 $0 0%
569.541 Books $0 $0 0% $0 $0 0%
569.542 Dues & Memberships $0 $0 0% $0 $0 0%
569.543 Educational. Materials $0 $2,820 100% $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)
9 Test Enhancements $0 $0 0% $0 $0 0%
Total Operating Expense:
$0
$101,553
100%
$0
$118,320
1000/.
Total Program Expenses:
$0
$160,139
100%
$0
$118,320
100%
Agency: City of Clearwater
Page 3 Of 3
Section VI
5/26/20051:06:13 PM
Status: Submitted
. ,
.
FORM 3
MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM
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
coordinator laterza 1% $54,926 $549 $115 $0 $0 0.00%
programmer cone 15% $25,232 $3,785 $1,252 $0 $0 0.00%
Ree Leader calaman 100% $4,248 $4,248 $325 $0 $0 0.00%
Ree Leader crayder 100% $4,248 $4,248 $325 $0 $0 0.00%
Ree Leader davis 100% $4,248 $4,248 $325 $0 $0 0.00%
Ree Leader gresham 100% $4,248 $4,248 $325 $0 $0 0.00%
Ree leader Mitchell 100% $4.248 $4,248 $325 $0 $0 0.00%
Ree Leader williams 100% $4,247 $4,247 $325 $0 $0 0.00%
Ree Leader-LW cooper 100% $4,460 $4,460 $341 $0 $0 0.00%
Ree Leader-LW Marshall 50% $4,460 $2,230 $171 $0 $0 0.00%
specialist miller 25% $42,785 $10,696 $2,432 $0 $0 0.00%
supervisor riehardson 5% $41,258 $2,063 $490 $0 $0 0.00%
supervisor sawada 5% $41,320 $2,066 $490 $0 $0 0.00%
Agency: City of Clearwater Page 1 Of 2 5/26/2005 1 :06:13 PM
Section VII Status: Submitted
. ,
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
I TOTALS $239,928 $51,336 $7,241 $0 $0 0.00"/0
Agency: City of Clearwater Page 2 Of 2 5/26/20051:06:13 PM
Section VII Status: Submitted
FORM 4
MIDDLE SCHOOL-AGED SUMMER SCHOLARSHIP PROGRAM
SALARY AND FRINGE PREPARATION NARRATIVE
FISCAL YEAR 04-05
ACCOUNT #
ACCOUNT NAME
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASElDECREASE OR OTHER
EXPLANATION AS NEEDED
LINE ITEM $
AMOUNT
PERCENT
INCREASE!
DECREASE
569.120 Regular Salaries and $51,336 100%
Wages ~2&2005~2&2005New
569.210 FICA $2,585 100%
569.220 Retirement $1,341 100%
Contributions
569.230 Life and Health $3,315 100%
Insurance
569.240 Workers Compensation $0 0%
569.250 Unemployment $0 0%
Compensation
Agency: City of Clearwater
Page 1 Of 8
Section VIII
5126/20051 :06:13 PM
Status: Submitted
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 $43,150 100%
5/2612005 5/2612005 5/26/2005 5/26/2005 5/23/2005
Youth Arts Corp has been hired to provide the
educational component.
Start up-
Administrative meetings 6 artists@$22Jhr x 25 hrs
=$3300 plus 1 teacher @$22Ihr x 25 hrs=$550
Materials-$1,500
Program costs
certified teacher- $22Ihrx5hr/day x 3 dayslwk x 10
weeks=$3,300
Curriculum development-$55O
NG artists
4@$22Ihr x Shr/day x 3dayslwk x 10wks =
$13,200
Planning hrs 100 x $22Ihr = $2,200
Supplies-$3,500
RN artists
2 @ $22Ihr x Shr/day x 3 days x 10 wks = $6,600
Planning 50hr x $22Ihr = $1,100
Supplies-$1,75O
8% administration = $2,800
NG-Everyone's an artist
artist $2,800
Origi~Ud9et Calculation
=3300+1500+550+3300+550+13200+2200+
3500+6600+1100+1750+2800+2800
569.311 Professional $0 0%
ServicesIWorkshops
Original Budget Calculation
=0+0
569.320 Accounting and Auditing $0 0%
Original Budget Calculation
=0+0
569.321 Bank Services $0 0%
Original Budget Calculation
=0+0
569.330 Court/Legal Services $0 0%
Original Budget Calculation
=0+0
569.340 Other Contractual $0 0%
Services
Original Budget Calculation
=0+0
Agency: City of Clearwater
Page 2 Of 8
Section VIII
5/26/20051:06:13 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
569.350 Investigations $0 0%
Original Budget Calculation
=0+0
569.400 Travel and Per Diem $0 0%
Original Budget Calculation
=0+0
569.401 Conference $0 0%
Original Budget Calculation
=0+0
569.402 Transportation $10,315 100%
5/26/2005 RN school buses
4 7hr trips $2400
57.5 hr trips $3500
1 4 hr trip $450
1 6.5 hr trip $550
210 hr trips $1800
NG school buses
Parking 3 @ $20 = $60
Skating $180
Phillippe Park $175
Treasure Island Center $150
Adventure Island $225
Laser Xtreme $175
Lithia Springs $225
Buses cost $.90 per mile and $18.75 per hour. Trip
estimates are based on previous usage.
Bowling $125
MOSI $200
Clw Marine Aquarium $100
Original Budget Calculation
=2400+3500+450+550+1800+60+180+175+
150+225+175+225+125+200+100
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 Communication-Internet $0 0%
Original Budget Calculation
=0+0
Agency: City of Clearwater
Page 3 Of 8
Section VIII
5/26/2005 1 :06:13 PM
Status: Submitted
>II.
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASEI
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
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
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
Agency: City of Clearwater
Page 4 Of 8
Section VIII
5/26/2005 1 :06:13 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
569.481 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%
512612005 5/2612005 5/2612005 5/26/2005 New
Original Budget Calculation
=0
569.497 Day Program Subsidy $0 0%
Original Budget Calculation
=0+0
.
569.498 Day Program Hourly $0 0%
Unit Cost
Original Budget Calculation
=0+0
569.510 Office Supplies $700 100%
5/26/2005 5/26/2005 5/2312005 NG
Pens, paper, markers $500
RN
Pens, paper, markers $200
Original Budget Calculation
=500+200
Agency: City of Clearwater
Page 5 Of 8
Section VIII
5/26/20051:06:13 PM
Status: Submitted
~ "'1
ACCOUNT #
ACCOUNT NAME
DERIVATION OF FIGURES AND
JUSTIFICATION OF
INCREASE/DECREASE OR OTHER
EXPLANATION AS NEEDED
LINE ITEM $
AMOUNT
PERCENT
INCREASE/
DECREASE
569.515
Participant Expenses
$30,268
100%
5/26/2005 5/26/2005 5/26/2005 5/23/2005 NG Field
Trips
Bowling 100 @$5.40= $540
Cici's pizza 100 @ $4.52 = $452
Movies 100 kids, 8 CITs, 5 staff@ $6 = $677
Busch Gardens/Adventure Island + meals 100 kids,
8 CITs, 5 staff @ $70 = $7910
4 Museums 4 @ 113 admissions @ $6 = $2712
Celebration Station 100 kids, 8 CITs, 5 staff@17
=$1921
Astroskate 100 kids, 8 CITs, @$5 =$540
Islands of Adventure + meals 100 kids, 8 CITs, 5
staff@$44 =$4971
Disney World + meals 100 kids, 8 CITs, 5 staff @65
=$7345
RN Field Trips
Ice Skating 40 @$7.5O = $300
Treasure Island Center 40 @$5 =$200
Advenure Island 2 @ 40 @$16.25= $1300
Laser Xtreme 40 @ $13.75 =$550
Lithia Springs 40@$1.25 =$50
Bowling 40 @$6.25 =$250
MOSI 40 @$6.25 =$250
Clw Marine Aquarium 40 @$7.50 =$300
Original Budget Calculation
=540+452+677+7910+2712+1921+540+497
1+7345+300+200+1300+550+50+250+250+
300
Agency: City of Clearwater
Page 6 Of 8
Section VIII
5/26/20051:06:13 PM
Status: Submitted
! ." ..
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASElDECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.520 Operating Supplies $9,050 100%
5/26/20055/26/20055/26120055/26/2005.5/23/2005
NG
Start up supplies
175 shirts @ $5 each = $875
games, monopoly, uno, etc 36 @ $25 each = $900
Trophies 20 1st, 2nd, 3rd place at $25 per set, plus
4 plaques at $25 each, plus 50 ribbons at $.50 each
= $700
Sports equipment, 10 basketballs @$25 each, 10
volleyballs @ $15 ea, 20 playground balls @ $10
ea, 10 footballs @ $15 each, one set football flags
and cones @ $50 = $800
Film, video tape 100 disposable cameras @ $5.50,
plus 10 blank video tapes @$5 = $600
Whistles, laynard 10 @ $6 each = $60
Card holders $35
DVD movies 10 @ $20 each = $200
Goggles 50 @3.98 each = $199
RN
start up
T shirts 50 @$7 =$350
Games & equipment- 25 board games @$20 each =
$500
Operating
Sports equipment 5 basketballs @ $25, 5 footballs
@$15, football flags & cones @$55, , 5 tennis
raquets @ $15 =$330
Video games 20 games @ $20.05 =$401
Fishing equipment 20 fishing pOles & tackle @ $20,
plus bait@100 = $500
Canoes 3 @ $700 = $2100
Boating supplies 6 oars @$25, 12 PFDs @ $29 =
$500
Original Budget Calculation
=875+900+700+800+600+60+35+200+199+
350+500+330+401+500+2100+500
569.521 Food & Nutrition $5,250 100%
5/26/2005 NG
3 Pizza Parties for 100 Participants - 30 pizzas @
$6 = $180 x 3 = $720
(2) Cookouts for @ $500 each = $1000
PowerAde Drink Mix -10 cases @ $75 each = $750
Variety Snack Pack (chips) - 46 @ $8 each = $368
Freeze Pops - 5 Boxes @$2 each = $10
RN
Snacks- cookies, crackers, ice cream @ $50 per
week = $500
2 ice cream parties @ $250 each = 500
Lunch 14 days of no school lunch @ $100 per day
= $1400
Original Budget Calculation
=720+1000+750+370+10+500+500+1400
569.540 Subscriptions $0 0%
Original Budget Calculation
=0+0
Agency: City of ClealWater
Page 7 Of 8
Section VIII
5/26/20051:06:13 PM
Status: Submitted
Agency: City of ClealWater
Page 8 Of 8
Section VIII
5/26/20051:06:13 PM
Status: Submitted
~ ." ..
FORM 5
Middle School-Aged Summer Scholarship Program
SOURCES OF REVENUE
02-03 03-04 03-04 03-04 O4-oS 04.QS O4-oS Percent
Funder Type/Funder Total Budget Amend Total Budget Amend Total Increase/
Decrease
Government. Local
(City/County)
City of Clearwater $0 $0 $0 $0 $35,857 $0 $35,857 100%
$0 $0 $0 $0 $35,857 $0 $35,857 100%
Other/Miscellaneous
Miscellaneous Funding $0 $0 $0 $0 $1,753 $0 $1,753 100%
$0 $0 $0 $0 $1,753 $0 $1,753 100%
Program Revenue
Fees for Service $0 $0 $0 $0 $4,200 $0 $4,200 100%
$0 $0 $0 $0 $4,200 $0 $4,200 100%
Grand Total $0 $0 $0 $0 $41,810 $0 $41,810 100%
FY 04.Q5 Totals
Total Program Revenue $160,130
Total Program Budget $160,130
Difference $0
Total CSC Allocation $118,320
Agency: City of Clearwater
Page 1 Of 1
Section IX
5/26/20051:06:13 PM
Status: Submitted
'. ~. .
FORM 6
Middle School-Aged Summer Scholarship Program
SOURCES OF REVENUE
NARRATIVE
Funder Type/Funder
FY 04-05 Total
Narrative
Government - Local (City/County)
City of Clearwater
Other/Miscellaneous
Miscellaneous Funding
Program Revenue
Fees for Service
Agency: City of Clearwater
$35,857
$1,753
$4,200
Page 1 Of 1
Section X
5/26/20051:06:13 PM
Status: Submitted
't. * J. .
END OF PROGRAM BUDGET FOR
Middle School-Aged Summer Scholarship Program
Agency: City of Clearwater
Page 1 Of 1
Section XI
5/26/20051:06:13 PM
~ ~
~ \ "
, '
A IT ACHMENT 5
JWB REIMBURSEMENT SCHEDULE
04-05 Submission Reimbursement
Reimbursement Date Date
Schedule
1 10/1/2004 10/8/2004
I 2 I 10/15/2004 I 10/22/2004 I
I 3 I 10/29/2004 11/5/2004 I
I 4 I 11/12/2004 I 11/19/2004 I
I 5 I 11/26/2004 12/3/2004 I
I 6 I 12/10/2004 I 12/17/2004 I
I 7 I 12/24/2004 12/31/2004 I
I 8 I 1/7/2005 I 1/14/2005 I
I 9 I 1/21/2005 1/28/2005 I
I 10 I 2/4/2005 I 2/11/2005 I
I 11 I 2/18/2005 2/25/2005 I
I 12 I 3/4/2005 I 3/11/2005 I
I 13 I 3/18/2005 3/25/2005 I
I 14 I 4/1/2005 I 4/8/2005 I
I 15 I 4/15/2005 4/22/2005
I 16 I 4/29/2005 i 5/6/2005 I
I 17 I 5/13/2005 5/20/2005 I
I 18 I 5/27/2005 I 6/3/2005 I
I 19 I 6/10/2005 6/17/2005 I
I 20 I 6/24/2005 i 7/1/2005 I
I 21 I 7/8/2005 7/15/2005 I
I 22 I 7/22/2005 I 7/29/2005 I
I 23 I 8/5/2005 8/12/2005 I
I 24 I 8/19/2005 I 8/26/2005 I
I 25 I 9/2/2005 9/9/2005 I
I 26 I 9/16/2005 j 9/23/2005 I
I 27 I 9/30/2005 10/7/2005 I
Agency: City of Clearwater Page 1 Of 1 5/26/20051:06:13 PM
Section XII
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