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AGREEMENT FOR OUT OF SCHOOL TIME PROGRAM - OSTr AGREEMENT Between COORDINATED CHILD CARE OF PINELL.AS, INC. and City of Clearwater, Florida, Parks and Recreation Department Out of School Time Program- (OST) I. PURPOSE Coordinated Child Care of Pinellas, Inc., hereinafter referred to as "CCC", 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 June 3, 2009 and extending through September 30, 2009. 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 CCC or the Juvenile Welfare Board The Children's Services Council of Pinellas County (JWB), and are subject to the supervision, personnel practices and policies of the provider. Unless otherwise approved by CCC, all staff shall meet qualifications as stated and in accordance with approved program methodology job descriptions on file at CCC and any approved revisions which are submitted for FY08-09 agreement year. III. SERVICES Provider agrees to deliver services as stated in the currently approved program methodology on file at CCC; and to comply with General Conditions in Attachment 1; and to accomplish objectives stated in Attachment 2 in accordance with recognized child welfare practices, as determined by CCC; and comply with any Special Conditions listed in Attachment 3; and abide by budget as listed/approved in Attachment 4; and comply with reimbursement schedule listed in Attachment 5. IV. FUNDS A. The budget detail and narrative for both CCC and other funds (if any) for accomplishing the above stated services shall be as set forth in Attachment 4. CCC agrees to reimburse Provider at a daily attendance rate of 16.02 per day for up to but not to exceed 58 care days for a maximum allocation of 140 OST Summer program scholarship slots totaling a maximum earning potential of up to but not to exceed $123,354 commencing June 3, 2009 and ending August 23, 2009 for services rendered pursuant to this Agreement and in accordance with program attendance and eligibility requirements. B. The budget detail and narrative for both CCC and other funds (if any) for accomplishing the above stated services shall be as set forth in Attachment 4. CCC agrees to reimburse at a daily attendance rate of 13.26 per day for up to but not to exceed 28 care days for a maximum allocation of 58 OST Fall program scholarship slots totaling a maximum earning potential of up to but not to exceed 21,534 commencing August 24, 2009 and ending September 30, 2009 for services rendered pursuant to this Agreement and in accordance with program attendance and eligibility requirements. METHOD OF PAYMENT A. CCC issues reimbursements in accordance with the schedule listed on Attachment 5 (or on the preceding working day in case of a holiday). A request for bi-weekly reimbursements may be considered with CCC prior approval and based on a documented need. Request for payment must be accompanied by the appropriate documentation as prescribed by CCC. B. Reimbursement payments cannot exceed maximum allowable reimbursement qualified to earn for the current payment/reimbursement period. C. Requests for advance funds may be made, consistent with CCC/JWB policy. CCC-OST Agrccmcnt FY08-09 (Summcr-Fall) Page 1 of 17 D. Provider agrees to return any disallowed funds pursuant to the terms of this Agreement that were disbursed to the provider by CCC for FY08-09 commencing Oct 1, 2008 and ending September 30, 2009. Such funds are considered funds belonging to the Funder and will be remitted to CCC on behalf of the Funder upon request in accordance with its instructions. CCC reserves the right to withdraw funds through reverse EFT within five (5) days if overpayment of any type is made as applicable. In the event that CCC utilizes reverse EFT to recover disallowed funds, CCC will make every effort to contact the Provider prior to withdrawal of funds. VI. TERMINATION A. It is the intent of the CCC/JWB to assure a consistent and orderly delivery of children's services. It is the further intent of CCC/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 solely by CCC/JWB. B. In the event funds to finance this Agreement become unavailable, CCC/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. CCC 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. CCC/JWB shall be the final authority as to the availability of funds and extension of notice beyond the minimum time herein stated. C. In addition to the rights as set forth in paragraph VI. 2 above, this Agreement may be terminated by CCC/JWB for any reason whatsoever 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. E. The above provisions shall not limit CCC/JWB s right to remedies at law or to damages. VII. COMMENCEMENT OF PAYMENT Unless specifically authorized by CCC/JWB, payment for services rendered under this Agreement shall not commence prior to the effective date of this contract. IN WITNESS THEREOF, the parties have caused this two page Agreement including all accompanying Attachments to be executed by their undersigned officials as duly authorized. Coordinated Child Care of Pinellas, Inc City of Clearwater, Florida, Parks and Recreation Department Authorized Representative Print/Type Name: Doug Oakes Title: Assistant Executive Director tom. Si ature D Date CCC-OST Agreement FY08-09 (Summcr`Fall) Authorized Repres n tive: Print/type?lame .., :~ Title: L]• CC Signature '7/6/ 0 Date Page 2 of 17 Countersigned: Frank V. Hibbard Mayor Approved as to form: 0? Lx? L ??l? aura Lipowski Mahony Assistant City Attorney CITY OF CLEARWATER, FLORIDA By: 7d W-??•1?e.^ William B. Horne, II City Manager Attest: 0-? 0a'a" Cynthia E. Goudeau City Clerk 00.. 1 ___.._ _ CCC-QST Agreement FY08-09 (Summer-Fall) Page 3 of 17 ATTACHMENT 1 GENERAL CONDITIONS OF THE AGREEMENT 1. Aareement Revisions & Modifications A. This Agreement and its attachments constitute the contractual relationship between the Provider and CCC. If there is any discrepancy between program-related documents, this contract preempts all other documents. No amendments to this Agreement or its attachments may be made without the prior written approval of CCC and Provider, except as may be provided in General Condition #4. B. CCC reserves the right to waive requirements of the General Conditions or any and all Attachments to this Agreement where warranted by special circumstances. C. Emergency problems with availability of funding may result in temporary or ongoing reductions after a minimum of twenty-four (24) hour written notice. JWB and/or CCC will be the sole and final authorities as to the availability of funds for this Agreement. 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 CCC and/or JWB personnel or CCC/JWB duly authorized agent. C. To maintain and file with CCC 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. E. Payments During Disaster Recovery: CCC/JWB agrees to support previously approved funded programs unable to provide normal services for a period of at least 60 days after a disaster has been declared, provided the program agrees to comply with requests of CCC/JWB and the Human Services Disaster Recovery Leadership Network Task Force. The Provider will submit to CCC a copy of the agency's current contract year Continuity Of Operations Plan (COOP) within thirty days of the effective date of this agreement. 3. Audit and Management Letter A. The Provider agrees to submit to CCC an independent audit of the financial statements of the entity in its entirety and any accompanying management letter(s) immediately upon receipt by the Provider's board, but within a period not to exceed 120 days of the close of the agency's fiscal year. 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 CCC/JWB revenues, fees and donations, and expenditures by the CCC program under this agreement. B. The provider's auditor shall not provide any non-audit service to an issuer contemporaneously with the audit, including: (1) bookkeeping or other services related to the accounting records or financial statements of the audit client; (2) financial information systems design and implementation; (3) appraisal or valuation services, fairness opinions, or contribution-in-kind reports; (4) actuarial services; (5) internal audit outsourcing services; (6) management functions or human resources; (7) broker or dealer, investment adviser, or investment banking services; (8) legal services and expert services unrelated to the audit. 4. Other Financial Support CCC-osT Agrccmcnt Fv08-09 (Summer-Fall) Page 4 of 17 A. Provider will report within fifteen working days any changes in other non- CCC/JWB revenue that relates to this program as they occur during the agreement year. B. CCC/JWB funds will not be used for expenditures also funded by other sources. C. Generally, CCC/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 CCC. D. Revenues earned in CCC/JWB funded program must remain in the funded program, as a condition of funding. 5. Program Monitoring A. Provider agrees to submit progress reports and other information as may be prescribed by CCC/JWB and to cooperate in site visits and other on-site monitoring including, but not limited to, access to sites, staff, fiscal and participant records, and logs and the provision of related information. B. Provider is responsible for entering all program, fiscal, and all other required data into SAMIS. Program staff will adhere to SAMIS Business Rules and all staff who have any responsibility (supervisory or direct) for SAMIS data entry will be trained in SAMIS within sixty (60) calendar days of hire. The Provider will notify the SAMIS Help Desk immediately (maximum of 48 hours) when a staff person's access to SAMIS must be inactivated due to the reasons outlined in SAMIS Business Rules. C. Provider agrees to cooperate with CCC corrective action policy and procedures. Provider agrees to provide CCC/JWB representatives access, without presence of the Provider supervisor, to staff or program participants during any monitoring with or without advance notice. D. Programs charging a fee for services supported by CCC/JWB funding in this program must forward a copy of the fee schedule to CCC. E. Governmental entities are exempt from fiscal and personnel file review. 6. Board Members and Meetin s Within 30 days of the effective date of this Agreement, Provider will submit to CCC a calendar of scheduled Board meetings for the current fiscal year. Approved Board minutes and an updated list of Board Members shall be submitted to CCC within thirty calendar days of approval. 7. Nondiscrimination Programs receiving funding from the CCC/JWB 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. Publicizing of JWB Su ort 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 CCC, 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 CCC-OST Agreement FY08-09 (Summer-Fall) Page 5 of 17 that the program is supported by JWB. Provider agrees that CCC/JWB will have unlimited use of copyrighted materials developed under this Agreement. 10. Assignments 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 CCC. No such approval by CCC of any assignment or subcontract shall be deemed in any event or in any manner to provide for the incurrence of any obligation by CCC 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 CCC shall deem necessary. 11. Confidential Information Provider shall not use or disclose any information which specifically identifies a recipient of services under this Agreement, and shall adopt appropriate procedures for employees' handling of confidential data 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 CCC any overpayment due to unearned funds or funds disallowed pursuant to the terms of this Agreement that were disbursed to Provider by CCC, and such funds shall be considered CCC/JWB funds and shall be refunded to CCC/JWB in accordance with its instructions. 13. Special Situations Provider agrees to inform CCC 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. This includes the reporting of any critical incidents, including anything that may reflect negatively or critically upon CCC. Specifically, the Provider shall notify CCC immediately upon knowledge of any incident resulting in the injury to a program participant. Within 24 hours, the Provider must submit a completed Incident Report to CCC with full details and disposition of the incident. In addition, the Provider shall notify CCC immediately upon knowledge of any action or incident involving agency staff or volunteers that could potentially jeopardize the terms of this Agreement which includes misconduct, malfeasance during working hours, or any conduct that results in the arrest of a staff member or volunteer after hours. 14. Provider Staff Membership on Board Provider agrees that provider staff shall not serve as members of the Provider's governing board. 15. Waiver CCC reserves the right to waive requirements of this Agreement and General Conditions where warranted by special circumstances. 16. Agency & Program Data Maintained In 2-1-1 Database Provider agrees to maintain accurate and up-to-date agency and program data in the 2-1-1 Tampa Bay Cares database. The Provider will review and update (as necessary) this data at least once annually. The Provider will list data for newly funded program(s) within thirty (30) calendar days of the date that CCC funds the program. This requirement applies to all programs accepting 2-1-1 referrals. 17. Funded Agency Staff Background Checks All staff involved in a program funded by CCC/JWB are required to undergo a national background check that includes fingerprinting. This requirement applies to employees regardless of the funder supporting the position and all volunteers who may interact with youth. The Provider's policy and practice must CCC-OST Agreement FY08-09 (Su nmer-Fall) Page 6 of 17 provide for adequate protection. 18. Youth Worker Trainin BEST training for year round staff working directly with youth (ages 11 to 17) is required. The Provider must have a CCC-approved plan to ensure full compliance by 9/30/2010. 19. Link to JWB's Websites Providers with an agency website will include links on their website to the JWB website (www.jwbpinellas.org) and JWB's About Pinellas Kids website (www.aboutpinellaskids.org) including the respective logos. 20. Dru -Free Workplace As applicable, the Provider will comply with the Drug-Free Workplace Act, Section 440.101, Florida Statutes. 21. Public Entity Crimes Per Section 287.133, Florida Statutes, a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with a public entity, and may not transact business with a public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 22. CCC/JWB Policies and Procedures Provider agrees to follow all CCC/JWB policies and procedures which are incorporated into this Agreement in their entirety. Said policies include, but are not limited to, all CCC/JWB Board policies, funding policies, SAMIS business rules and policies that may be promulgated by CCC/JWB within its sole discretion from time to time. CCC/JWB reserves the right to change these policies with no prior notice from time to time within its sole discretion and it is the responsibility of the provider to be in compliance with all CCC/JWB policies and procedures at all times. 23. Insurance, Public Liability, Bodily Injury, and Property Damage The Provider will procure, pay for, and maintain, throughout the period of this Agreement, on behalf of the Provider, CCC/JWB, the following insurance coverage with responsible companies, eligible to do business in the State of Florida, acceptable to CCC/JWB: Commercial General Liability for premises and operations of the Provider including Personal Injury and Contractual for this Agreement, with CCC/JWB as an additional insured for the operations of the Provider, with limits for Bodily Injury, Property Damage and Personal Injury of not less than: Each Occurrence $1,000,000 Personal Injury $1,000,000 General Aggregate $1,000,000 Products & Completed Operations $1,000,000 Fire Legal Liability $50,000 Automobile Liability Insurance for the Provider's operation, maintenance and use of owned, non- owned, hired, and leased automobiles, with the interest of the CCC/JWB included as an insured, with limit of not less than: Bodily Injury & Property Damage Liability $500,000 each accident $500,000 each accident The Provider will submit to CCC a certificate of insurance which describes the insurance maintained by the Provider. The certificate will state that the insurance company will not cancel the insurance except on 15 day's prior written notice to CCC. CCC-OST Agreement FY08-09 (Summer-Fall) Page 7 of 17 24. Indemnification The Provider will indemnify and hold harmless the CCC/JWB, its agents, and employees from and against any and all liabilities, claims, judgments, or actions including court costs and attorney's fees that may hereafter at any time be made or brought by anyone on account of any personal injury, property damage, loss of monies, civil rights violation, or discrimination allegedly caused or occurring in whole or part by any breach of contract; negligent, wrongful or intentional act or omission; or used on any acts of fraud or defalcation of the Provider, its agents, employees, or subcontractors, during performance under this Agreement. In no event will the Provider be liable for or have any obligation to defend CCC/JWB against such liability, claims, judgments, or actions, including costs and attorney's fees, arising out of the sole negligent acts of CCC/JWB. (Any required information/clause(s) in addition to this section as stated above will be noted in Attachment 3 Special Conditions as applicable) 25. Attendance A. Provider is required to maintain daily participant attendance records in accordance with CCC/JWB established attendance policies/guidelines and enter participant attendance into SAMIS regularly and before the 3nd of the following month. Provider will retain daily attendance records as supporting documentation/back-up in accordance with record retention policy. B. Provider is responsible for maintaining a sign-in/sign-out sheet on all participants attending their OST program. Provider will maintain these records on site as supporting documents for attendance and will have them available to review upon request. Provider will retain sign-in/sign-out records in accordance with record retention policy. C. Provider is required to have an attendance policy for their OST program in accordance with the CCC OST Attendance Guideline and provide parents/guardians with a written copy of said policy. 26. Elloibility A. Provider Understands Payment will be made only for those services specified in this Agreement as authorized by CCC for participants who have been properly certified as eligible and authorized in advance for CCC reimbursement. No payment can be made for those participants who have been determined ineligible or for any unfilled/vacant OST allocated scholarship slot. The Provider agrees to serve as a conduit for information between the participant(s) family and CCC when it is deemed in the best interest of the participant(s)/family. B. Provider is responsible for complying with policies, procedures and guidelines as established by CCC/JWB related to OST eligibility determination, redetermination of scholarship, reinstatement, enrollment, attendance and for timely notification of any changes to the above, to all applicable parties, as appropriate and in accordance to established guidelines. 27. Geo ra hical Service Area A. To provide quality Out of School Time Program services in Pinellas County, Florida for participants who meet the eligibility and enrollment requirements of CCC/JWB whose parents/guardians have chosen their facility. B. Provider agrees whenever possible to maintain service sites which are accessible by public transportation and convenient to the target participant zone in accordance with funder requirements and geographical services identified in the Providers current approved methodology. C. Provider will advise CCC of any requested changes made in service sites. The Provider agrees that any site(s) change(s) will be submitted in advance to CCC for review and must be approved at least ten (10) days in advance by CCC. Changes must be in accordance with Funder identified participant zones and program methodology. CCC-OST Agreement FY08-09 (Summa-Fall) Page 8 of 17 ATTACHMENT 2 City of Clearwater Charting the Course for Youth-OST MEASURABLE OBJECTIVES & SERVICE LEVELS FY08-09 (June 3, 2009 to September 30, 2009) Participant Level Measurable Objectives (CDG) All Primary Participants will be measured through the Measurable Objective reporting module in SAMIS within the contract period. Measured is defined as each participant having all the appropriate administration points required during the fiscal year based on the language of each Measurable Objective. Service Component: General Youth Services (163) Objective ID Objective Description Target Level % 2758 Increased Resiliency - Internal Strengths 70 % Seventy percent (70%) of primary youth (ages 9 and over) will show significant improvement in developing internal assets. Significant improvement is defined as an increase of at least 7 points on the internal resiliency assets component of the Healthy Kids Resilience Assessment (HKRA). For youth entering the program at age 9 or older, they should be attached to the Service Component and the HKRA will be administered within two (2) weeks of program entry and each year on the anniversary date of program intake or at episode closure. For youth who turn age 9 during the program year, they should be attached to the Service Component and the HKRA should be administered within two (2) weeks of their next anniversary date of intake and each year on their anniversary date or at episode closure. Staff will enter data into SAMIS within two (2) weeks of data collection. (CDG Summary) 2759 Increased Resiliency - External Support 70 % Seventy percent (70%) of primary youth (ages 9 and over) will show significant improvement in developing external assets. Significant improvement is defined as an increase of at least 11 points on the external resiliency assets component of the Healthy Kids Resilience Assessment (HKRA). For youth entering the program at age 9 or older, they should be attached to the Service Component and the HKRA will be administered within two (2) weeks of program entry and each year on the anniversary date of program intake or at episode closure. For youth who turn age 9 during the program year, they should be attached to the Service Component and the HKRA should be administered within two (2) weeks of their next anniversary date of intake and each year on their anniversary date or at episode closure. Staff will enter data into SAMIS within two (2) weeks of data collection. (CDG Summary) Service Component: Summer Program (609) Objective ID Objective Description Target Level % 2965 Increased Resiliency - Internal Strengths 70 % Seventy percent (70%) of primary youth (ages 9 and over at the start of the summer program) who did not attend the year-round program (participants are summer only) will show significant improvement in developing internal resiliency assets. Significant improvement is defined as an increase of at least 4 points on the internal assets component of the Healthy Kids Resilience Assessment (HKRA). The HKRA will be administered during the first week of summer camp and during the last week of summer camp. Staff will enter data into SAMIS within two (2) weeks of data collection. (CDG Summary) 2966 Increased Resiliency - External Support 70 % CCC-OST Agreement FY08-09 (Summer-Fall) Page 9 of 17 Seventy percent (70%) of primary youth (ages 9 and over at the start of the summer program) who did not attend the year-round program (participants are summer only) will show significant improvement in developing external resiliency assets. Significant improvement is defined as an increase of at least 4 points on the external assets component of the Healthy Kids Resilience Assessment (HKRA). The HKRA will be administered during the first week of summer camp and during the last week of summer camp. Staff will enter data into SAMIS within two (2) weeks of data collection. (CDG Summary) Manual Measurable Objectives Objective ID Objective Description MMO-669 Eighty percent (80%) of primary youth will attend the after school program a minimum of 3 days per week for the duration of the after school program. Program staff will take attendance daily within the first two hours of program operation. Staff will enter data into SAMIS prior to submission Contracted Service Levels Failure to meet one or more of the Contracted Service Levels identified below may result in a reduction in the funding allocation and service levels. Participant Contracted Service Levels Case Data Gath Primary Participants Contracted Primary Youth Summer (Jun 3 -Aug 21, 09): Contracted Primary Youth Fall: (Aug 24 - Sep 30, 09) Contracted Primary Adults: Total Contracted Primary Participants: erer (CDG) Baseline Data Collection Baseline Data Collection 0 Baseline Data Collection There are no Secondary Participants or Group Contracted Service Levels required in this agreement. CDG (Case Data Gatherer): The module in SAMIS where information for the case, participant, episode, and the measurable objective is entered and viewed. CCC-OST Agrcomont FY08-09 (Summcr-Full) Page 10 of 17 ATTACHMENT 3 SPECIAL CONDITIONS 1. General Condition #3 (Audit and Management Letter) is waived. 2. General Condition #6 (Board Members and Meetings) are waived. 3. General Condition #24 (Provider will have met General Condition #24 Insurance. Public Liability. Bodily Injury, and Property Damage by submission of a formal letter from the municipality indicating self insurance and summary explanation of that coverage). 4. Nothing herein shall be construed as a consent by the City of Clearwater Florida to be sued by third parties, or as a waiver or modification of the provisions of Section 768.28, Florida Statutes or the Doctrine of Sovereign Immunity. (Reference General Condition, paragraph 25). 5. Provider will submit an updated program methodology to CCC by close of business on August 14, 2009. 6.. Provider is required to collect Pinellas County School Board student ID numbers for all program participants and enter in SAMIS. CCC-OST Agreement FY08-09 (Summa-Fall) Page 11 of 17 ATTACHMENT 4 BUDGET(S) The provider will deliver services according to the budget(s) as listed in Form 1 through Form 2 on the following page(s). Budgets are to be submitted by the provider in accordance with CCC policies and procedures. Provider may make budget amendments during the fiscal year in accordance with CCC forms and procedures as delineated in the budget amendment approval procedures. Copies of these procedures are available from CCC upon request. NOTE: Reimbursement is attendance based and must be in accordance with established attendance guidelines. Reimbursement may not exceed the maximum program allowable earned per qualified OST allocated scholarship slot for the payment period being requested, CCC-OST Agreement FY08-09 (Summer-Fall) Page 12 of 17 COST-City of Clearwater-Charting the Course for Youth-CST 569.31 Professional Services $40,500 $40,500 32500+6625+1375 Professional i 569.311 W Services/Workshops ? $0 - ? $0 =0+0 569.32 _ Accounting and Auditing $0 $0 _ _ =0+0 569_321 Bank Services $0 $0 =0+0 569.33 Court/Legal Services $0 $0 i =0+0 r Contractual j 569.34 ices j $0 $0 =0+0 569.35 Investigations R $0 $0 =0+0 569.4 Travel and Per Diem -- $0 $0 =0+0? - - -- ? 569.401 Conference so - -- $0 -- -- ?- =0+0 569.402 Transportation - - $12,515 $12,515 -- J? 3000+5600+2415+1500 Communications- - ---? 569.41 Telephone $0 $0 =0+0 Communications-Lon--- 569.411 Distance _ $0? -- -- $0 =0+0 _--`- -?? ,- i Communications- I 569.412 Postage and Shipping $0 $0 =0+0 569.41 _ Communication-Internet $0 $0 -_. _...--__ =0+0 ! - 156943 Utility Services J $0 _. _ _...__...... $0 - _ _ 0+0 - 1569.431 Water/Sewer/Sanitation i $OI $0 - -- ---- --..._ - __ =0+0 Rentals & Leases 1 569.44 (Building & Land) $0 Rentals & Leases - $0 =0+0 569.441 569.45 Equipment $0 Insurance $0 $0 $0 =0+0 =0+0 -- - ---- -__ ? Repair & Maintenance I i 569.46 Services - Equipment $0 $0 =0+0 Repair & Maintenance -I 569.461 Services - Property $0 $0 =0+0 -- 1 Repair & Maintenance I 569.462 Services - Grounds $0 $0 =0+0 ( 569.463 569.47 Vehicle Repair and Maintenance Services Printing & Binding ? T $0 $0 W - $0 =0+0 =0+0 -----_- --- 569.471 Copying & Binding__ $01 -- $0 ..- =0+0 _-__?-_ - - - 155669..48 Promotional Activities $0, $0 =0+0 j 5? 69.481 Advertising $0 $0 =0+0 - -?--- ?v -I 569.493 - Match $0 =0 +0 569.494 Administrative Cost-- - $0 _ $0 ? _ =0+0 R P ? ? 569.495 esidential er Diem $0 $0 =0+0 Page 13 of 17 _ - - - $16.02 x 140kids x 55 days = $123,354; $13.26 569.496 Day Program Per Diem $0 $0 x 58 kids x 28 days = $21,534 569`497 Day Program Subsidy ? $0 $0 =0+0 Day Program Hourly Uriit _ T 569.498 Cost $0 $0 =0+0 569.51 Office Supplies ' $700 $700 300+200+200 I 6300+1080+990+5400+3600+1080+1080+180 { 0+3600+900+675+360+1125+360+450+450+2 569.515 Participant Expenses ; $34,035 $34,035 25+360+1800+2400 1600+400+600+1000+500+300+1000+60 569.52 Operating Supplies ' $8,000 $8,000 0+1600 569.521 Food & Nutrition $9,200 $9,200 400+400+500+500+200+200+300+5500+1200 569.54 Subscriptions $0 $0 -?- 569.541 Books $0 $0 =0+0 569.542 Dues & Memberships { $0 $0 =0+0 569.543 Educational Materials $0 $0 =0+0 I 569.544 Educational Training $0 $0 =0+0 569.59 Depreciation $0 _ $0 =0+0 ?•??-__...._.._?_?_._.___-___ j $0 $0{=0+0 - 1569. T Other/Miscellaneous { Machinery & Equipment "569.64 (Capital Outlay) 1 $01=0+0 I Books, Publications, and Library Materials 569.66 (Capital) $0 $0 =0+0 i UNIT COST .. Case Management Units_L-_-__- $0 _- -_, $0 =0+0 COST Daily Per Diem Unit $0 - $0 =0+0 rt! UNIT --- -- i--- __ ___ f COST Family Counseling Units $0 $0 =0+0 UNIT- COST Group Counseling Units $0 $0 =0+0 UNIT Health COST Assessment/Screening $0 $0 =0+0 UNIT Individual Counseling COST Units $0 $0 =0+0 UNIT COST Parent Education Units $0 $0 =0+0 UNIT Unit Costs (New System _ ?- -- I COST Units) j $0 $9=0+0 $104,950 $144,888 Page 14 of 17 H W 0 7 Y ?O N O O U N rn G lV IL, T N N UI O!! I NI d l0 l0 d 4 V 0 O O O O O O m CA d b O C) O 69 69 C13 63 CA 69 (a 6 6 W 6 ? 69 69 6 9 6 9 6 4 0 6 m D) W W C0 W m 0 C7 0 0 0 0 0 N 9 N N N ?} CA cl3 Cfi fA V3 64 c O [ D ( D m ( p N rfr es V9 (U ? 6% 69 m 5T r co n ?m fb O O O -E -Cal O O U) to 69 69 b4 E!9 C# 64 6f} rl? 0 N M N co p C') m tD W co W 4t V) C# FA V3 69 69 69 P- m O O O o 0 o o O o O O O C,) co 6R 69 609, 69 69 69 b9 !f3 6!3 t!3 V3 V/ l v v N N d9 613 f.- CD co W ._cr) .? , O. O O - 0 4 O o m W ? O O W z 69 t H C f! 6 9 6 , 69 69 a d _ r N 6s ? N N ? 69 tF? 6s bc.? 69 69 W W W U.) O O O O o O O m t0 O O N 69 44 69 cfl 69 69 69 r r N N M N N Cp W Cp Cp tp t0 6 Cf3 ulj 69 to 69 69 V3 N r o o 0 O O r r r C O O, O m m 69 69 Vt v3 vi W W W fJ9 69 tf3 u3 M M m 4 H 6 9 6 9 69 N .. ^ N m O Ln ^ r- n r n n r m m N N R 69 M CO W W W W W W 69 CA d9 mm tmm mm mm mm mm mm 69 69 m m m to ui o r r r i- r r r m 0 m W 69 m W W W W W W W N m CD r W d m m m m m m m N N m m 6 69 69 fro 69 69 69 69 403, 69 69 69 cA l0 N C'? o F 4 Q m m m 0 , .. 0- O. O 6 69 69 69 69 69 O O O H9 6G, C!3 U) 1 0 6 0 6 6 9 6 9 I I 6 9 69 ? N try N O V r ' co O m in m m m m m W w m C0 Co m to W W W (D to W O CA m tl O O O O Q O O co m N m N tf) m to to try C0 c0 69 V3 E9 E9 c9 69 69 69 CF 69 69 69 69 69 W O m N N r N m m m m m m m O 0 M m W W co W co W W W O d r W N r n C O C 4 O Ct O 6 O n m m m CD w c0 LO Lo C0 10 N m IT V W ?t M b3 (9 6f) cA V3 cf3 Wfl 69 69 69 Vi EA EA 69 l` tl) O tp C C N C ` m L N r E 'S v c m C LL m Y Y ? Q ? ? CO N ? n E H G O -0 O 12 0 O O a) p) h -W CO CO 3 CU y c 0 Mn L m x D u ° 6 5 2 05 - 'J F M E 'E a E c n co cp m v v m v LO M N N m N - - - - - - - - d - N - N - d - d - CU - lp - A l0 ld CD CO lC CD J O J E E O O E E J J . j `n . Mn E E ? ro- 0 0 0 0 E Z 2 m ro o . . . m m E m m ? m ? ? ? a) a) a a 0 °' rn a? m d d a? d a s ' z w U m m m N c n U d d i a w G C C C C C C ? ? ? ? ? ? ? 0 0 0 0 0 0 0 ;? iv m ro ? ro ca d N d lU N t p O c c c r_ ( c N C A U) U) t7 ! w A y N y O O d N CP N N ( l0 l p l0 ( N I O O lY LL' Q' d' d' W U) U) U) U) U) U) ?n H-100' m -ru o ? u u rV CD CD m v O f+'1 a a r Part: clpant expenses + North Greenwood 90 participants Ross Norton 45 participants Busch Gardens $70 $6,300 Arch/Chin $20.00 $900 Extreme Fun Center $12 $1,080 Kayaking $15.00 $675 Astro Skate $11 $990 Go Karts $8.00 $360 Islands of Adventure $60 $5,400 Buc Bay $25.00 $1,125 Wet n Wild $40 $3,600 Archery + $8.00 $360 Games Works/ Vertical Venture $12 $1,080 Ice Skatin $10.00 $450 Games Works/Vertical Venture: $12 $1,080 Lazer Tag $10.00 $450 Florida Aquariam $20 $1,800 Movies $5.00 $225 Adventure Island $40 $3,600 Archery $8.00 $360 Advnt Isla $40.00 $1,800 subtotal $24,930 subtotal $6,705 Total $34,035 $34,035 gffi_ce supplies 150 Notebooks / dividers x $2 = $300 Pencils/Pens/Paper/3x5 cards and holders = $200 8 x $25 Color Printer Cartridges $200 Total $700 Oneratlon summer 200 T-shirts @ $8 1600 20 board games x $20 400 6 card tables x $100 600 Sports equipment 1000 Awards 500 Movies 20 x $15 300 Swim gear 1000 photo paper, supplies 600 sunscreen, first aid supplies ----400 Total $8,000.00 6400 Food Summer 200 Hotdogs / 8 boxes of 50 hotdogs x $50 = $400 200 Hamburgers / 8 boxes of 50 hamburgers x $50 = $400 50 Pizza's @ $10 = $500 Ice Cream Sundae makings = $500 Chips / Potato Salad / Baked Beans = $200 Candy / Treats = $200 Chicken Wings for 1,000 = $300 Snacks $500/wk x 11 wks = $5,500 Total 9200 Fall $800/site x 2 sites $1,600.00 Fall Bowling, Skating $8 x 60 kids x 5 wks $2,400 Educational supplies, back packs, paper, books, pens, glue, etc Sports equipment Fitness equipment Fall Snacks $100 wk/site x 2 sites x 6 wks = 1200 Transportation RN-10 buses at average $300 each = $3000 Fall NG-2 buses 7 field trips x $400 = $5600 + 2 field trips x $603.75 = $2415 van/bus rental $150 x 2 sites x 5 weeks = $1500 Total 12,515 ofessi n I rvi e Clearwater Camp 2009 Youth Arts Corps 5.5 artists Artist Salary and Fringe Direct Service to Youth 25/hour x 15hrs/week x 10weeks training, Meetings, Curriculum Development $20,625 25/hour x 20 hours Fringe (total salary x 10.75%) $2,750 $2,217 Subtotal $25,592 Art Supplies Greenwood $3,000 Ross Norton $1,000 Educational Supplies $500 Subtotal $30,093 Administration (8%) $2,407 TOTAL Project Cost $32,500 Total $40,500 Fitness/Nutrition Inst RN $25/hr x 15 hr/wk x 5 wks 1875 NG $25/hr x 15 hr/wk x 10 wks $3,750 Supplies 100/wk x 10 wks 1000 6625 Fall $25/hr x 4 hr/wk x 5 wks 500 supplies $25 wk x 5 wks 125 Officials-fall $25/game x 2/week x 6 wks 750 1375 Page 16 of 17 subtotal $8,000 r ATTACHMENT 5 REIMBURSEMENT SCHEDULE FY08-09 Attendance records are to be completed/entered by the P of each month in accordance with Attachment 1 Section 25. If attendance records are approved by the 10th, payment will be processed and mailed on Thursday, as shown below: Records Approved July 10, 2009 August 10, 2009 September 10, 2009 October 10, 2009 Checks/EFT Remittance Mailed July 16, 2009 August 20, 2009 September 17, 2009 October 15, 2009 CCC encourages Electronic Fund Transfer (EFT) payments which will transfer your payment so that your bank should receive the payment on Friday immediately following the date of mailing indicated above. NOTE: If your attendance record is completed/entered prior to or after the 10th of the month CCC will make every attempt to process the payment within 10 days subject to JWB approval. CCC-OST Agreement FY08-09 (Summa-Fall) Page 17 of 17