AGREEMENT FOR OUT OF SCHOOL TIME PROGRAM - OST (2),r
AGREEMENT
Between
COORDINATED CHILD CARE OF PINELLAS, INC.
and
City of Clearwater, Florida, Parks and Recreation Department
Out of School Time Program- (OST)
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 October 1, 2009 and
extending through Se tember 30, 2010.
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 FY09-10 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 an annual rate per OST
Program Scholarship slot of $3,461 for a maximum allocation of 58 OST program scholarship slots, and
a maximum earning potential of up to but not to exceed 20 _0,738 commencing October 1 2009 and
ending September 30, 2010 for services rendered pursuant to this Agreement and in accordance with
program attendance and eligibility requirements.
V. 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). 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.
D. Provider agrees to return any disallowed funds pursuant to the terms of this Agreement that were
disbursed to the provider by CCC for FY 09-10 commencing Oct 1, 2009 and ending September 30
2010. 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.
CCC-OST Agreement FY 09-10 Page 1 of 23
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.
Authorized Representative
Print/Type Name: Guy M. Cooley
Title: Executive Director
gnature
_/0
_ ,Z9-2 2-
ate _
Countersigned:
Frank V. Hibbard
Mayor
Approved as to form:
Laura Lipowski Mahony
Assistant City Attorney
CITY OF CLEARWATER, FLORIDA
By: Ill. m., , . . 1® . "--Z
William B. Horne, II
City Manager
Y A v? Attest:
f
ily
y is E. Goudeau
it lerk
City of Clearwater, Florida, Parks and
Recreation Department
Authorized Representative:
Print/type Name
Title:
Signature
qi /7-.1 a s
Date
CCC-OST Agreement FY 09-10 Page 2 of 23
ATTACHMENT 1
GENERAL CONDITIONS OF THE AGREEMENT
1. Agreement 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.
The agency is required to engage an audit firm which follows Government Audit Standards when
conducting the financial audit and which shows evidence of a peer review report completed every
three years.
CCC-OST Agreement FY 09-10 Page 3 of 23
4. Other Financial Support
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 Meetings
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 Support
Provider agrees to identify JWB support in its annual report and program brochures. JWB's logo may not
be used on any other publications without JWB approval.
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
that the program is supported by JWB. Provider agrees that CCC/JWB will have unlimited use of
copyrighted materials developed under this Agreement.
CCC-OST Agreement FY 09-10 Page 4 of 23
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
provide for adequate protection.
CCC-O5T Agreement FY 09-10 Page 5 of 23
18. Youth Worker Trainina
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).
20. Drug-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 Iniury, and PropeMi 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 $500,000 each accident
Damage Liability $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.
MGM Agreement FY 09-10 Page 6 of 23
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 3d of the following month. Provider will retain daily attendance records as supporting
documentation/back-up in accordance with record retention policy.
Starting October 1, 2009, all Providers will be required to use a new attendance recording system
that will employ biometric technology linking to the JWB SAMIS module to help create a "point of
presence" attendance record for all CCC funded OST program participants.
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. Eligibility
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.
Page 7 of 23
CCC-OST Agreement FY 09-10
ATTACHMENT 2
City of Clearwater
Charting the Course for Youth-OST
MEASURABLE OBJECTIVES & SERVICE LEVELS
FY 09-10
(October 1, 2009 to September 30, 2010)
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 FY 09-10 Page 8 of 23
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 scholarship youth will attend the program a minimum of eighty
percent (80%) of the time the program is available. Program staff are required to take attendance
with in the first hour of scheduled program. All attendance must be entered into SAMIS. (This is an
annual objective).
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 Gatherer (CDG)
Primary Participants
Contracted Primary Youth (Oct 1 - Sept 30, 2010): Baseline Data Collection
Total Contracted Primary Participants: 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 Agreement FY 09-10 Page 9 of 23
ATTACHMENT 3
SPECIAL CONDITIONS
1. General Condition #3 (Audit and Management Letter) is waived.
2. General Condition #6 (Board Members and Meetings) is waived.
3. General Condition #23 (Insurance) is waived.
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 24).
5. Provider is required to collect Pinellas County School Board student ID numbers for all program participants
and enter in SAMIS.
6. Provider will enter and maintain applicant data in the SAMIS Waiting List Module (or other data system as
approved by JWB).
CCC-OST Agreement FY 09-10 Page 10 of 23
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 FY 09-10 Page 11 of 23
FORM 2
CHARTING THE COURSE FOR YOUTH-OST
CURRENT & PROPOSED OPERATING BUDGET
(ROUND NUMBERS UP TO THE NEAREST DOLLAR)
(1) (2) (3) (4) (5) (6)
08-09 09-10 08-09 09-10
ACCT# TITLE
PROD. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
Salary Accounts:
569.120 Regular Salaries and Wages $64,447 $152,711 137% $41,128 $0 -100%
Total Salary: $64,447 $152,711 137% $41,128 $0 -100%
Fringe Accounts:
569.210 FICA $935 $3,298 253% $596 $0 -100%
569.220 Retirement Contributions $12,102 $25,337 109% $7,723 $0 -100%
569.230 Life and Health Insurance $11,435 $22,614 98% $8,598 $0 -100%
569.240 Workers Compensation $1,484 $3,859 160% $870 $0 -100%
569.250 Unemployment Compensation $0 $0 0% $0 $0 0%
Total Fringe: $25,956 $55,108 112% $17,787 $0 -100%
Operating Expense Accounts:
569.310 Professional Services $0 $18,000 100% $0 $0 0%
569.311 Professional Services/Workshops $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%
569.402 Transportation $0 $16,500 100% $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-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%
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 $250 $1,000 300% $250 $0 -100%
569.515 Participant Expenses $9,920 $33,964 242% $9,920 $0 -100%
569.520 Operating Supplies $2,000 $21,020 951% $2,000 $0 -100%
569.521 Food & Nutrition $4,006 $15,300 282% $4,006 $0 -100%
569.540 Subscriptions $720 $0 -100% $720 $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)
Page 12 of 23
(1) (2) (3) (4) (5) (6)
08-09 09-10 08-09 09-10
ACCT# TITLE
FROG. PROG. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
UNIT Individual Counseling Units $0 $0 0% $0 $0 0%
COST
UNIT Group Counseling Units $0 $0 0% $0 $0 0%
COST
UNIT Family Counseling Units $0 $0 0% $0 $0 0%
COST
UNIT Parent Education Units $0 $0 0% $0 $0 0%
COST
UNIT Case Management Units $0 $0 0% $0 $0 0%
COST
UNIT Daily Per Diem Units $0 $0 0% $0 $0 0%
COST
UNIT Unit Costs (New System Units) $0 $0 0% $0 $0 0%
COST
UNIT Health Assessment/Screening Units $0 $0 0% $0 $0 0%
COST
UNIT Summer Program $0 $0 0% $0 $0 0%
COST
UNIT Out of School Time (OST) $0 $0 0% $144,888 $200,738 100%
COST
UNIT Crisis Intervention Units $0 $0 0% $0 $0 0%
COST
UNIT Support Group Units $0 $0 0% $0 $0 0%
COST
Total Operating Expense: $16,896 $105,784 526% $161,784 $200,738 1088%
Total Program Expenses: $107,299 $313,603 192% $220,699 $200,738 165%
Page 13 of 23
FORM 3
CHARTING THE COURSE FOR YOUTH-OST
SALARY AND FRINGE PREPARATION
FISCAL YEAR 09-10
% Time Gross Salary in Fringe in JWB Request JWB Request Salary
Position Staff Hrs1Wk Salary Program Program For Salary For Fringe Funding 0%
# Wks 09-10 09-10 09-10 09-10 09-10
Camp counselor 1 100% $4,642 $4,642 $356 $0 $0 0.00%
40
11
camp counselor 2 100% $4,642 $4,642 $356 $0 $0 0.00%
40
11
camp counselor 3 100% $4,642 $4,642 $356 $0 $0 0.00%
40
11
camp counselor 4 100% $4,642 $4,642 $356 $0 $0 0.00%
40
11
camp counselor 5 100% $4,642 $4,642 $356 $0 $0 0.00%
40
11
Programmer II 50% $31,389 $15,694 $7,318 $0 $0 0.00%
20
52
Recreation Coordinator LaTerza, Kathleen 20% $64,729 $12,946 $4,367 $0 $0 000%
Recreation
Programmer
Recreation
Programmer
Recreation
Programmer
8
52
Dixon, Freda 100% $30,352 $30,352 $13,100 $0 $0 0.00%
40
52
Llauget, John 50% $44,144 $22,072 $8,381 $0 $0 0.00%
20
52
auskalnis, richard 100% $28,741 $28,741 $12768 $0 $0 000%
Recreation Supervisor Moon, Barbara
II
Recreation Supervisor Sowada, Karen
11
Position staff
40 r o
52
20% $48,681 $9,736 $3,673 $0 $0 0.00%
8
52
20% $49,800 $9,960 $3,721 $0 $0 0.00%
8
52
1/9 Time Gross Salary in Fringe in JWB Request JWB Request Salary
HrsNVk Salary Program Program For Salary For Fringe Funding %
# Wks 09-10 09-10 09-10 09-10 09-10
TOTALS $321,046 $152,711 $55,108 $0 $0 0.00%
Page 14 of 23
FORM 4
CHARTING THE COURSE FOR YOUTH-OST
SALARY AND FRINGE PREPARATION NARRATIVE
FISCAL YEAR 09.10
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASEIDECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.120 Regular Salaries and $152,711 137%
Wages
9110/2009 One JWB funded program that we had last year was deleted so all of the percentage
time in the program were adjusted. Employees are not budgeted for an increase in salary for
FY2010.
569.210 FICA $3,298 253%
9/10/2009 Municipal employees with a pension plan hired after 1986 only pay FICA-Med at 1.45
percent of annual salary. Llauget was hired before 1986 and does not pay any FICA.
569.220 Retirement $25,337 109%
Contributions
9/1012009 City pension plan is calculated at 19% of annual salary. This percentage increased
from 13% last year due to the health of the pension. All grant employees are eligible for the
pension plan. All of the pension amount is paid into the plan by the city for each employee In the
first 6 months of the fiscal year.
569.230 Life and Health $22,614 98%
Insurance
9/10/2009 Full time employees receive $6,200 per year in medical insurance; employer's cast is
set by bid, FY 08109= $6,200. 09/10 bid not yet received. All employees receive Group Life
insurance at 2.3 % of salary annually. Coordinators and Supervisors, LaTerza, Sowada, Moon
receive additional management level life insurance.
569.240 Workers Compensation $3,859 160%
9/10/2009 The City of Clearwater pays $1625 per full time employee for Worker's
Compensation for City paid program employees (3) and $629 for grant paid employees-Dixon,
Auskalnis. Worker's Comp is set per Department depending on the number and cost of claims
made previously. The grant paid employees are in a separate category (special programs) and
therefore are not charged the same rate as the City paid P&R staff.
569.250 Unemployment $0 0%
Compensation
9/1012009 The City of Clearwater is self insured and does not budget for unemployment
compensation Insurance. Unemployment compensation is only paid when we get a claim. There
have been no claims for this budget.
Page 15 of 23
OPERATING EXPENSE BUDGET NARRATIVE
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.310 Professional Services $18,000 100%
9/14/2009 Summer Fitness/Nutrition Inst
5 groups x $25/hr x 4 hr/wk x 8 wk = $4,000
Afterschool
Leagues
$35/hr x 4 hrs x 2 centers x 5 wks/session x 7 sessions (6wks ea) _ $9800
fitness
$25/hr x 42 wk x 2 centers x 2 hrs/wk = $4,200
Original Budget Calculation
4000+9800+4200
569.311 Professional $0 0%
Services/Workshops
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
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 $16,500 100%
9/1 412 0 0 9 Summer
RN-8 buses at average $350 each = $2800
NG-16 buses ® $350 ea =$5600
Winter
van/bus rental $150 x 2 sites x 27 trips = $8100
Original Budget Calculation
=2800+5600+8100
569.410 Comm unications-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-Intemet $0 0%
Original Budget Calculation
=0+0
569.430 Utility Services $0 0%
Original Budget Calculation
=0+0
Page 16 of 23
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
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
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
569.498 Day Program Hourly $0 0%
Unit Cost
Original Budget Calculation
=0+0
569.510 Office Supplies $1,000 300%
9/14/2009150 Notebooks / dividers x $2 = $300
Pencils/Pens/Paper/3x5 cards and holders = $200
20 x $25 Color Printer Cartridges $500
Original Budget Calculation
=300+200+500
Page 17 of 23
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.515 Participant Expenses $33,964 242%
9/14/2009 After school
1 trips/mo x 9 mo x $12 ea x 58 kids=6264
Summer x 100 kids
Busch Gardens @$70 = $7,000
Extreme Fun Center (x3$12 = $1,200
Astro Skate @$11 = $1,100
Islands of Adventure@$60 = $6,000
Wet n Wild@$40 = $4,000
Games Works/ Vertical Ventures@$12 = $1,200
Archery @$12 = $1,200
Florida Aquarium @$20 = $2,000
Adventure Island @$40 = $4,000
Original Budget Calculation
=6264+7000+1200+1100+6000+4000+1200+1200+2000+4000
569.520 Operating Supplies $21,020 951%
9/14/2009 After school
Educational supplies $2,500 x 2 sites $5,000.00
Fitness equipment $1500 x 2 $3,000.00
Sports equipment $2,000 x 2 $4,000.00
Games $1,000x2$2,000.00
summer
200 T-shirts @ $8 1600
20 board games x $20 400
6 card tables x $100 600
Sports equipment 2000
Awards 500
Movies 20 x $16 320
Swim gear 1000
photo paper, supplies 600
Original Budget Calculation
=5000+3000+4000+2000+1600+400+600+2000+500+ 320+1000+600
569.521 Food & Nutrition $15,300 282%
9/14/2009 After school
Snacks $100 wk/site x 2 sites x 42 wks = 8400
Summer
200 Hotdogs / 8 boxes of 50 hotdogs x $50 = 400
50 Pizza's @ $10 = 500
Ice Cream Sundae makings= 500
Chips / Potato Salad / Baked Beans =200
Chicken Wings for 1,000 = 300
Snacks $200/wk x 10 wks = 2000
Summer Parent banquet 100 kids + 2 guests ea x $10= 3000
Original Budget Calculation
=8400+400+500+500+200+300+2000+3000
569.540 Subscriptions $0 -100%
9/14/2009 Due to program change from teen lounge to OST, we will not be p urchasing
Subscriptions at this time.
Original Budget Calculation
569.541 Books $0 0%
Original Budget Calculation
=0+0
569.542 Dues & Memberships $0 0%
Original Budget Calculation
=0+0
569.543 Educational Materials $0 0%
Original Budget Calculation
=0+0
569.544 Educational Training $0 0%
Original Budget Calculation
=0+0
569.590 Depreciation $0 0%
Original Budget Calculation
=0+0
569.600 Other/Miscellaneous $0 0%
Original Budget Calculation
=0+0
569.640 Machinery & Equipment $0 0%
(Capital Outlay)
Original Budget Calculation
=0+0
Page 18 of 23
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.660 Books, Publications, and $0 0%
Library Materials
(Capital)
Original Budget Calculation
=0+0
UNIT COST Individual Counseling $0 0%
Units
Original Budget Calculation
=0+0
UNIT COST Group Counseling Units $0 0%
Original Budget Calculation
=0+0
UNIT COST Family Counseling Units $0 0%
Original Budget Calculation
=0+0
UNIT COST Parent Education Units $0 0%
Original Budget Calculation
=0+0
UNIT COST Case Management $0 0%
Units
Original Budget Calculation
=0+0
UNIT COST Daily Per Diem Units $0 0%
Original Budget Calculation
=0+0
UNIT COST Unit Costs (New System $0 0%
Units)
Original Budget Calculation
=0+0
UNIT COST Health $0 0%
Assessment/Screening
Units
Original Budget Calculation
=0+0
UNIT COST Summer Program $0 0%
Original Budget Calculation
=0+0
UNIT COST Out of School Time 58 Scholarship slots @ $3461 = $200,738 $0 0%
(OST)
Original Budget Calculation
UNIT COST Crisis Intervention Units $0 0%
Original Budget Calculation
=0+0
UNIT COST Support Group Units $0 0%
Original Budget Calculation
=0+0
Page 19 of 23
FORM 5
Charting the Course for Youth-OST
SOURCES OF REVENUE
07-08 08-09 08-09 08-09 09-10 09-10 09-10 Percent
Funder Type/Funder Total Budget Amend Total Budget Amend Total Increase/
Decrease
Government - Local
(City/County)
City of Clearwater $68,872 $31,488 $0 $31,488 $112,865 $0 $112,865 258%
$68,872 $31,488 $0 $31,488 $112,865 $0 $112,865 258%
Grand Total $68,872 $31,488 $0 $31,488 $112,865 $0 $112,865 258%
FY 09-10 Totals
Total Program Revenue $313,603
Total Program Budget $313,603
Difference $0
Total CSC Allocation $200,738
Total CSC Budget $200,738
Difference $0
Page 20 of 23
FORM 6
Charting the Course for Youth-OST
SOURCES OF REVENUE
NARRATIVE
Funder Type/Funder
Government - Local (City/County)
City of Clearwater
FY 09.10 Total
$112,865
Narrative
Parks and Recreation in-kind dollars funds supervisory oversight,
program leadership and youth workers. The Department is funded by
the City's general fund which receives most of its funding from Ad
Valorem taxes.
Page 21 of 23
END OF PROGRAM BUDGET FOR
Charting the Course for Youth-OST
Page 22 of 23
..' i :w
ATTACHMENT 5
REIMBURSEMENT SCHEDULE
FY09.10
Attendance records are to be completed/entered by the 3r° of each month in accordance with Attachment 1 Section 25.
If attendance records are approved by the 101h, payment will be processed and mailed on Thursday, as shown below:
Records Approved Checks/EFT Remittance Mailed
October 9, 2009 October 15, 2009
November 10, 2009 November 19, 2009
December 10, 2009 December 17, 2009
January 11, 2010 January 14, 2010
February 10, 2010 February 18, 2010
March 10, 2010 March 18, 2010
April 9, 2010 April 15, 2010
May 10, 2010 May 13, 2010
June 10, 2010 June 17, 2010
July 9, 2010 July 15, 2010
August 10, 2010 August 19, 2010
September 10, 2010 September 16, 2010
October 11, 2010 October 14, 2010
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 101h of the month CCC will make every
attempt to process the payment within 10 days subject to JWB approval.
CCC-OST Agreement FY 09-10
Page 23 of 23