AGREEMENT FOR OUT OF SCHOOL TIME PROGRAM - OST (3)1.-
AGREEMENT
Between
COORDINATED CHILD CARE OF PINELLAS, INC.
and
City of Clearwater, Florida, Parks and Recreation Department
Out of School Time Program- (OST)
1. 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. 2010 and extending
through September 30, 2011.
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 FY 10-11 agreement year.
III. SERVICES
Provider agrees to deliver services as outlined in the Provider Handbook, 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 13,461 for a maximum allocation of 60 OST program scholarship slots, and a
maximum earning potential of up to but not to exceed $207,66-0 commencing October 1. 2010 and ending
September 30, 2011 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 10-11 commencing October 1 2010 and ending Se t„p ember
30, 2011. 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.
Page 1 of 22
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
S;Rjnature
9 I/o iy
Date --
Countersigned:
Frank V. Hibbard
Mayor
Approved as to form:
4 .11A A
Laura Lipowski Mahony
Assistant City Attorney
City of Clearwater, Florida, Parks and
Recreation Department
Authorized Repre ntative-
Print/t a Na e KR?j'.r?. ?vr\6xz
Title: '
Signature
9 113; C/ ca
Date
Page 2 of 22
CITY OF CLEARWATER, FLORIDA
By:
William B. Horne, II
City Manager
F4.
Attest:
Rosemarie Call-
City Clerk
s d&
ATTACHMENT1
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
A. Provider agrees 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. Provider agrees to 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. Provider agrees to maintain and file with CCC in a timely fashion reports related to services provided
under this Agreement.
D. Provider agrees 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.
F. Provider agrees to provide prior to their budget submission or subsequent amendment, a written
explanation of their Board approved merit compensation plan, if JWB funds are to be utilized to pay
merit increases or bonus [payments of any kind, or if annualized salary or benefit changes may
impact future budgets]. CCC will not reimburse more than two weeks of accrued leave for terminating
employees. CCC will not reimburse expenses not previously approved by CCC.
3. Audit and Management Letter
A. 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.
Page 3 of 22
B. 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.
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.
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 is responsible for maintaining written policies and procedures for providing data
to CCC in a timely manner. The Provider is responsible for reviewing User Access to ensure that all
users are active employees with access to appropriate data systems and modules. 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. The Provider is
responsible for implementing, appropriate procedures into their data policies to protect data and
prevent accidental or malicious disclosure of participant information.
C, Provider agrees to cooperate with CCC corrective action policy and procedures. Provider agrees to
provide CCC and 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 funding in this program must forward a copy
of the fee schedule to CCC.
6. Board Members Meetin s and Trainin 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. Evidence of Board
training by an external qualified trainer is required annually prior to issuance of a subsequent contract.
Provider must submit Board meeting agenda listing the training, minutes from the Board meeting with the
training and attendance roster from the Board meeting. Training must consist of the following topics: non-
profit governance, including roles and responsibilities, fiduciary risks, and liabilities. Training is available
via the JWB, free of charge. "Providers, who are governmental entities, higher education institutions, and
hospitals, may be exempted from this policy upon written approval of CCC".
Page 4 of 22
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 - Endorsements
Requests for endorsements that require a commitment of JWB resources will be submitted to the JWB
Board for its consideration. However, endorsements, which do not require JWB resources, may be given
to those Providers which support the focus and priorities of the JWB Board, at the discretion of the JWB
Executive Director. JWB's logo must be present on the following Provider materials as an
acknowledgement of support:
• Annual Report
• Program Brochures
• Stationery
JWB's logo may not be used on any other publications requiring JWB resources without JWB Board
approval. However, if a publication does not require a monetary commitment or indicate sponsorship,
use of the JWB logo may be authorized at the sole discretion of the JWB Executive Director.
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.
10. Assi nments 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. Providers will adhere to JWB's written statement of purpose for
collection of confidential data in compliance with Section 119.071(5), Florida Statutes (2007). A copy of
this statement is available upon request and shall be distributed to recipients of JWB-funded programs
and services. Provider is responsible to adopt appropriate policies, notifications, authorizations, and other
relevant information that allows for the sharing of confidential information with JWB.
12. The Provider will maintain in participant files a completed copy of a JWB-approved form for authorizing
client consent to release information. As allowed by law and agency policy, the Provider will add JWB
to consent forms to facilitate data sharing and advise JWB within 48 hours if a participant has
withdrawn consent to share data.
13. In the event of an improper disclosure of participant information, Provider will inform CCC of the
improper disclosure and extent thereof within 48 hours of becoming aware of the improper disclosure.
Provider will cooperate fully with CCC and take all necessary steps to correct and remedy any damage
caused by the Provider's improper disclosure and to prevent future improper disclosure. Provider will
defend, indemnify and hold harmless CCC and JWB from any and all damages caused by the improper
disclosure and any and all costs associated with remedying the disclosure.
Page 5 of 22
14. 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.
15. Special Situations
A. Provider agrees to inform CCC in a timely manner, not to exceed twenty-four (24) hours or next
business day, of any circumstances or events, other than the requirements listed in sections B, C and
D below, 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. Critical incidents also include
any occurrences that result in law enforcement intervention and Department of Children & Families
(DCF) notification.
B. The Provider shall notify CCC within one (1) hour of learning of any incident resulting in the injury
to a program participant. The Provider must submit a written report on CCC forms within three (3)
workdays with full details and disposition of the incident.
C. 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.
D. Provider must notify CCC within 5 business days, of any change in key program staff and major
changes in programmatic operations.
16. Provider Staff Membership on Board
Provider agrees that provider staff shall not serve as members of the Provider's governing board.
17. Waiver
CCC reserves the right to waive requirements of this Agreement and General Conditions where
warranted by special circumstances.
18. 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.
(www.21 l tampabay.org)
19. Funded Agency Staff Backaround Checks
All staff involved in a program funded by CCC/JWB are required to undergo and pass a national level 2
background check that includes fingerprinting prior to beginning work. This requirement applies to
employees regardless of the (under supporting the position and all volunteers who may interact with
youth. The Provider's policy and practice must provide for adequate protection.
20. Youth Worker Training
BEST training for year round and permanent part-time staff working directly with youth (ages 11 to 17) is
required.
21. 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).
22. Drua-Free _Workl2lace
As applicable, the Provider will comply with the Drug-Free Workplace Act, Section 440.101, Florida
Statutes.
Page 6 of 22
23.
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.
24
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 implemented 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.
25. Insurance Public Liabillily. Bodily In"ury, and Pro a Damage
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, Personal Injury, Employment Practices Liability,
and Sexual Molestation Insurance 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
Employment Practice Liability $250,000
Sexual Molestation $1,000,000
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.
26. Indemnification
Provider will defend, 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 any person or entity on account of any claim including
but not limited to, personal injury, property damage, loss of monies, civil rights violation, or discrimination
allegedly caused in whole or part by any act or omission, including but not limited to, breach of contract,
negligent act, wrongful act, intentional act, omission and 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)
Page 7 of 22
27. 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 using the
Program Units of Service (PUGS) module regularly and before the 3`d 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 in section 2.D of the General Conditions.
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.
D. Provider is required to adhere to all approved systems/policies and procedures related to attendance
tracking.
E. Provider agrees to abide by the Provider Holiday/Closure Schedule. Any changes to said schedule
must be approved by CCC in advance of closure. OST Providers are authorized up to twelve (12)
holidays (reimbursable) per fiscal year. All providers are responsible for submitting their selected
dates that their site(s) will be closed for holidays and any additional planned days and dates (non-
reimbursable) between October 1 st and September 301h of the current fiscal year.
28. 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.
29. 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
thirty (30) days in advance by CCC, Changes must be in accordance with Funder identified
participant zones and program methodology.
30. SAMIS Data Entrv
A. Provider is required to collect Pinellas County School Board ID numbers for all program participants
and enter them in SAMIS.
B. Provider will enter and maintain applicant data in the SAMIS Waiting List Module (or other data
system as approved by JWB).
Page 8 of 22
31. Quality Improvement System (QIS)
Provider is responsible for complying with policies, procedures and guidelines as
established by CCC/JWB related to the Quality Improvement System.
32. Enrichment Ovedly System (1150S)
A. Provider is responsible for complying with policies, procedures and guidelines as established by
CCC/JWB related to the Enrichment Overlay System (EOS).
B. Provider agrees to include a minimum of two (2) Enrichment Overlays into their OST
programming schedule.
C. Provider must comply with all policies and procedures as described in the "Memorandum of
Understanding" in the OST Provider Handbook.
Page 9 of 22
City of Clearwater, Florida, Parks and Recreation Department
Out of School Time Program- (OST)
MEASURABLE OBJECTIVES & SERVICE LEVELS
FY 10-11
(October 1, 2010 to September 30, 2011)
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.
Objective ID Objective Description
Target Level 100%
One Hundred percent (100%) of primary youth (ages 9 and over) will be tested with the 2010-
2011 Healthy Kids Resiliency Assessment (HKRA). For youth entering the program at age 9 or
older, they will be attached to the Service Component and the HKRA will be administered within
one (1) week of program entry and each subsequent 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 one (1) week of
their next anniversary date of intake and each subsequent year on their anniversary date or at
episode closure. Staff will enter data into SAMIS within two (2) weeks of data collection. (CDG
Detail - Baseline)
Manual Measurable Objectives
Objective ID Objective Description
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).
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.
Page 10 of 22
ATTACHMENT 3
SPECIAL CONDITIONS
1. General Condition #3 (Audit and Management Letter) is waived.
2. General Condition #5 (Government - Fiscal/Personnel Review) is Waived.
3. General Condition #6 (Board Members and Meetings and Trainings) is waived.
4. General Condition #25 (Insurance) is waived.
5. 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).
Page 11 of 22
ATTACHMENT 4
SUDGST(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,
Page 12 of 22
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)
09-10 10-11 09-10 10-11
ACCT## TITLE
FROG. PROD. % JWB JWB %
BUDG. BUDG. CHG. ALLOC. ALLOC. CHG.
Salary Acco unts:
569.120 Regular Salaries and Wages $152,711 $162,984 7% $0 $0 0%
Total Salary : $152,711 $162,984 7% $0 $0 0%
Fringe Acco unts:
569.210 FICA $3,298 $4,179 27% $0 $0 0%
569.220 Retirement Contributions $25,337 $30,847 22% $0 $0 0%
569.230 Life and Health Insurance $22,614 $22,612 0% $0 $0 0%
569.240 Workers Compensation $3,849 $3,859 0% $0 $0 0%
569.250 Unemployment Compensation $0 $0 0% $0 $0 d%
Total Fringe : $55,098 $61,497 12% $0 $0 0%
Operating Expense Accounts:
Exp.310 Professional Services $18,000 $20,100 12% $0 $0 0%
Exp.311 Professional Services/ Workshops $0 $0 0% $0 $0 0%
Exp.320 Accounting and Auditing $0 $0 0% $0 $0 0%
Exp.321 Bank Services $0 $0 0% $0 $0 0%
Exp.330 Court/Legal Services $0 $0 0% $0 $0 0%
Exp.340 Other Contractual Services $0 $0 0% $0 $0 0%
Exp.350 Investigations $0 $0 0% $0 $0 0%
Exp.400 Travel and Per Diem $0 $0 0% $0 $0 0%
Exp.401 Conference $0 $0 0% $0 $0 0%
Exp.402 Transportation $16,500 $16,500 0% $0 $0 0%
Exp.410 Communications-Telephone $0 $0 0% $0 $0 0%
Exp.411 Communications-Lang Distance $0 $0 0% $0 $0 0%
Exp.412 Communications-Postage and $0 $0 0% $0 $0 0%
Shipping
Exp,413 Communication-Internet $0 $0 0% $0 $0 0%
Exp.430 Utility Services $0 $0 0% $0 $0 0%
Exp.431 Water/Sewer/Sanitation $0 $0 0% $0 $0 0%
Exp.440 Rentals & Leases (Building & Land) $0 $0 0% $0 $0 0%
Exp.441 Rentals & Leases - Equipment $0 $0 0% $0 $0 0%
Exp.450 Insurance $0 $0 0% $0 $0 0%
Exp.460 Repair & Maintenance Services - $0 $0 0% $0 $0 0%
Equipment
Exp.461 Repair & Maintenance Services - $0 $0 0% $0 $0 0%
Property
Exp.462 Repair & Maintenance Services - $0 $0 0% $0 $0 0%
Grounds
Exp.463 Vehicle Repair and Maintenance $0 $0 0% $0 $0 0%
Services
Exp.470 Printing & Binding $0 $0 0% $0 $0 0%
Exp.471 Copying & Binding $0 $0 0% $0 $0 0%
Exp.480 Promotional Activities $0 $0 0% $0 $0 0%
Exp.481 Advertising $0 $0 0% $0 $0 0%
Exp.493 Match $0 $0 0% $0 $0 0%
Exp.494 Administrative Cost $0 $0 0% $0 $0 0%
PER DIEM Residential Per Diem Units $0 $0 0% $0 $0 0%
PER DIEM Day Program Per Diem Units $0 $0 0% $0 $0 0%
Exp.497 Day Program Subsidy $0 $0 0% $0 $0 0%
Del,498 Day Program Hourly Unit Cost $0 $0 0% $0 $0 0%
Exp.510 Office Supplies $1,000 $1,000 0% $0 $0 0%
Exp.515 Participant Expenses $33,964 $34,180 1% $0 $0 0%
Exp.520 Operating Supplies $21,020 $21,100 0% $0 $0 0%
Exp.521 Food & Nutrition $15,300 $16,900 10% $0 $0 0%
Exp.540 Subscriptions $0 $0 0% $0 $0 0%
Exp.541 Books $0 $0 0% $0 $0 0%
Exp.542 Dues & Memberships $0 $0 0% $0 $0 0%
Exp.543 Educational Materials $0 $0 0% $0 $0 0%
Exp.544 Educational Training $0 $0 0% $0 $0 0%
Exp.590 Depreciation $0 $0 0% $0 $0 0%
Exp.600 Other/Miscellaneous $0 $0 0% $0 $0 0%
Exp.640 Machinery & Equipment (Capital $0 $0 0% $0 $0 0%
Outlay)
Exp.660 Books, Publications, and Library $0 $0 0% $0 $0 0%
Materials (Capital)
UNIT Youth Services Units $0 $0 0% $0 $0 0%
COST
UNIT COST Group Counseling Units $0 $0 0% $0 $0 0%
Page 13 of 22
ACCT# TITLE
UNIT Family Counseling Units
COST
UNIT Parent Education Units
COST
UNIT Case Management Units
COST
PER DIEM Daily Per Diem Units
UNIT Unit Costs (New System Unlts)
COST
UNIT Health Assessment/Screening Units
COST
UNIT Summer Program
COST
UNIT Out of School Time (OST)
COST
UNIT Crisis Intervention Units
COST
UNIT Support Group Units
COST
UNIT After Care Units
COST
UNIT Home Visitation
COST
UNIT Consultation
COST
UNIT Information and Referral
COST
UNIT Family Life Education
COST
UNIT Community Outreach
COST
UNIT Workshop/Seminar
COST
UNIT Case Consultation/Clinical
COST Supervision
Total Operating Expense:
Total Program Expenses:
(1) (2) (3) (4) (6)
09-10 10-11 09-10 10-11
PROG. PROG. % JWB JWB
BUDG. BURG. CHG. ALLOC. ALLOC.
$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 $0
$0 $0 0% $200,738 $207,660
$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 $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%
3%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$105,784 $109,780 4% $200,738 $207,660 3%
$313,593 $334,261 7% $200,738 $207,660 3%
Page 14 of 22
FORM 3
CHARTING THE COURSE FOR YOUTH-OST
SALARY AND FRINGE PREPARATION
FISCAL YEAR 10.11
% Time Gross Salary In Fringe In JW13 Request JWB Request Salary
Position Staff HM/Wk Salary Program Program For Salary For Fringe Funding %
# Wks 10-11 10-11 10-11 10-11 10-11
Camp counselor 1 100% $4,642 $4,642 $355 $0 $0 0.00%
40
12
Camp counselor 2 100% $4,642 $4,642 $355 $0 $0 0.00%
40
52
Camp counselor 3 100% $4,642 $4,642 $355 $0 $0 0.00%
40
52
Camp counselor 4 100% $4,642 $4,642 $355 $0 $0 0.00%
40
52
Camp counselor 5 100% $4,642 $4.642 $355 $0 $0 0.00%
40
52
Programmer II Clemons, Jackie 50% $29,444 $14,722 $7,696 $0 $0 0.00%
40
52
Programmer II Llauget, John 50% $44,144 $22,072 $9,264 $0 $0 0.00%
40
52
Recreation Coordinator LaTerza, Kathleen 20% $64,729 $12,946 $4,886 $0 $0 0.00%
40
52
Recreation Leader Miles, Antonio 100% $11,245 $11,245 $860 $0 $0 0.00%
20
52
Recreation Dixon, Freda 100% $30,352 $30,352 $14,623 $0 $0 0.00%
Programmer 40
52
Recreation 50% $0 $0 $0 $0 $0 0.00%
Programmer 40
52
Recreation auskalnis, richard 100% $28,741 $28,741 $14,211 $0 $0 0.00%
Programmer 40
52
Recreation Supervisor Moon, Barbara 20% $48,681 $9,736 $4,063 $0 $0 0.00%
II 40
52
Recreation Supervisor Sowada, Karen 20% $49,800 $9,960 $4,119 $0 $0 0.00%
I I 40
52
TOTALS $330,346 $162,984 $61,497 $0 $0 0.00%
Page 15 of 22
FORM 4
CHARTING THE COURSE FOR YOUTH-OST
SALARY AND FRINGE PREPARATION NARRATIVE
FISCAL YEAR 10-11
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
569.120 Regular Salaries and $162,984 7%
Wages
8/312010 Employees are not budgeted for an increase In salary for FY2011, Due to the number of children served, the City has added a part time
Recreation Leader, Miles that was not budgeted last year.
569.210 FICA $4,179 27%
8/3/2010 Municipal employees with a pension plan hired after 1986 only pay FICA-Med at 1,45 percent of annual salary. $106,457x0.0145=
$1544. Llauget was hired before 1986 and does not pay any FICA. Camp counselors and part time employees pay 7.65%, $34,455 x.0765 =
$2635.$1544 +$2635 =$4179,
569.220 Retirement $30,847 22%
Contributions
8/3/2010 City pension plan is calculated at 24% of annual salary. All full time 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. The percentage increase is due to City Finance
Dept's efforts to keep the plan fiscally healthy. Increased funds have to be added due to the state of the economy. $128,529 x.24 = $30,847
569.230 Life and Health $22,612 0%
Insurance
7122/2010 Full time employees receive $6,200 per year in medical insurance; employers cost is set by bid, FY 09/10= $6,200. 10/11 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 0%
7/2212010 The City of Clearwater pays $1625 per full time employee for Workers 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
7/22/2010 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.
OPERATING EXPENSE BUDGET NARRATIVE
Exp.310 Professional Services $20,100 12%
8/3/2010 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) _ $9600
fitness
$251hr x 42 wk x 2 centers x 2 hrs/wk = $4,200
Skateboarding lessons
$25/hr x 42 wk x 2 hr = $2100
Original Budget Calculation
4000+9800+4200+2100
Exp.311 Professional $0 0%
Services/Workshops
Exp.320 Accounting and Auditing $0 0%
Exp.321 Bank Services $0 0%
Exp.330 Court/Legal Services $0 0%
Exp.340 Other Contractual $0 0%
Services
Exp.350 Investigations $0 0%
Exp.400 Travel and Per Diem $0 0%
Exp.401 Conference $0 0%
Exp.402 Transportation $16,500 0%
813/2010 Summer
RN-8 buses at average $350 each = $2800
NC-16 buses @ $350 ea =$5600
Winter
van/bus rental $150 x 2 sites x 27 trips = $8100
Original Budget Calculation
=2800+5600+8100
Page 16 of 22
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
Exp.410 Communications-Teleph $0 0%
Exp.411 Communications-Long $0 0%
Exp.412 Communications-Postag $0 0%
Exp.413 Communication-Internet $0 0%
Exp.430 Utility Services $0 0%
Exp.431 Water/Sewer/Sanitation $0 0%
Exp.440 Rentals & Leases $0 0%
(Building & Land)
Exp.441 Rentals & Leases - $0 0%
Equipment
Exp.450 Insurance $0 0%
Exp.460 Repair & Maintenance $0 0%
Services - Equipment
Exp.461 Repair & Maintenance $0 0%
Services - Property
Exp.462 Repair & Maintenance $0 0%
Services - Grounds
Exp.463 Vehicle Repair and $0 0%
Maintenance Services
Exp.470 Printing & Binding $0 0%
Exp.471 Copying & Binding $0 0%
Exp.480 Promotional Activities $0 0%
Exp.481 Advertising $0 0%
Exp.493 Match $0 0%
Exp.494 Administrative Cost $0 0%
PER DIEM Residential Per Diem $0 0%
Units
PER DIEM Day Program Per Diem $0 0%
Units
Exp.497 Day Program Subsidy $0 0%
Del.498 Day Program Hourly $0 0%
Unit Cost
Exp.510 Office Supplies $1,1100 0%
8/3/2010 Notebooks ! dividers x $2 w $300
Pencils/Pens/Paper/3x5 cards and holders = $200
20 x $25 Color Printer Cartridges $500
Original Budget Calculation
=300+200+500
Exp.515 Participant Expenses $34,180 1%
8/312010 Afterschool
1 trips/mo x 9 mo x $12 ea x 60 kids=6480
Summer x 100 kids
Busch Gardens @$70 = $7,000
Extreme Fun Center @$12 = $1,200
Astro Skate @$11 = $1,100
Islands of Adventureg$60 = $0,000
Wet n Wild@$40 = $4,000
Games Works/ Vertical Ventures t@$12 = $1,200
Archery @$12 = $1,200
Florida Aquariam @$20 = $2,000
Adventure Island @$40 = $4,000
Original Budget Calculation
=6480+7000+1200+1100+6000+4000+1200+1200+20 00+4000
Exp.520 Operating Supplies $21,100 0%
81312010 Afterschool
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 $1,000 x 2 $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 $20 400
Swim gear 1000
photo paper, supplies 600
Original Budget Calculation
=5000+3000+4000+2000+1600+400+600+2000+500+ 400+1000+600
Page 17 of 22
DERIVATION OF FIGURES AND LINE ITEM $ PERCENT
JUSTIFICATION OF AMOUNT INCREASE/
ACCOUNT # ACCOUNT NAME INCREASE/DECREASE OR OTHER DECREASE
EXPLANATION AS NEEDED
Exp.521 Food & Nutrition $16,900 10%
8/312010 Afterschool
Snacks $100 wk/site x 2 sites x 42 wks = 8400
Nutrition program food $800 x 2 sites =$1600
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+1600+400+500+500+200+300+2000+3000
Exp.540 Subscriptions $0 0%
Exp.541 Books $0 0%
Exp.542 Dues & Memberships $0 0%
Exp.543 Educational Materials $0 0%
Exp.544 Educational Training $0 0%
Exp.590 Depreciation $0 0%
Exp.600 Other/Miscellaneous $0 0%
Exp.640 Machinery & Equipment $0 0%
(Capital Outlay)
Exp.660 Books, Publications, and $0 0%
Library Materials
(Capital)
UNIT COST Youth Services Units $0 0%
UNIT COST Group Counseling Units $0 0%
UNIT COST Family Counseling Units $0 0%
UNIT COST Parent Education Units $0 0%
UNIT COST Case Management $0 0%
Units
PER DIEM Daily Per Diem Units $0 0%
UNIT COST Unit Costs (New System $0 0%
Units)
UNIT COST Health $0 0%
Assessment/Screening
Units
UNIT COST Summer Program $0 0%
UNIT COST Out of School Time $0 0%
(OST)
8/3/2010 60 slots x $3461 annual rate per scholarship slot
UNIT COST Crisis Intervention Units $0 0%
UNIT COST Support Group Units $0 0%
UNIT COST After Care Units $0 0%
UNIT COST Home Visitation $0 0%
UNIT COST Consultation $0 0%
UNIT COST Information and Referral $0 0%
UNIT COST Family Life Education $0 0%
UNIT COST Community Outreach $0 0%
UNIT COST Workshop/Seminar $0 0%
UNIT COST Case $0 0%
Consultation/Clinical
Supervision
Page 18 of 22
FunderType/Funder
Government - Local
(City/County)
City of Clearwater
Program Revenue
Fees for Service
Grand Total
FY 10-11 Totals
Total Program Revenue
Total Program Budget
Difference
Total CSC Allocation
Total CSC Budget
Difference
FORM 5
Charting the Course for Youth-OST
SOURCES OF REVENUE
08-09 09-10 09-10 09-10 10-11 10-11
Total Budget Amend Total Budget Amend
$31,488 $112,855 $0 $112,855 $123,601
$31,488 $112,855 $0 $112,855 $123,601
$0 $0 $3,000 $3,000 $3,000
$0 $0 $3,000 $1000 $3,000
$31,488 $112,865 $3,000 $116,866 $126,601
$334,261
$334,261
$0
$207,660
$207,660
$0
10-11 Percent
Total Increase/
Decrease
$0 $123,601 10%
$0 $123,601 10%
$0 $3,000 0%
$0 $3,000 0%
$0 $126,601 9%
Page 19 of 22
FORM 6
Charting the Course for Youth-OST
SOURCES OF REVENUE
NARRATIVE
Funder Type/Funder FY 10-11 Total Narrative
Government - Local (City/County)
City of Clearwater $123,601 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. There is a reduction from last year due to a higher
level position resignation. Duties were assigned to a Recreation
Leader.
Program Revenue
Fees for Service $3,000 Summer camp fees $30 x 100 kids = $3,000
Page 20 of 22
END OF PROGRAM BUDGET FOR
City of Clearwater, Florida, Parks and Recreation Department
Charting the Course for Youth-OST
Page 21 of 22
ATTACHMENT 6
REIMBURSEMENT SCHEDULE
FY 2010-2011
Attendance records are to be completed and entered by the 3rd of each month in accordance with Attachment 1 Section
25. If attendance records are approved by the 10'", payment will be processed and mailed on Thursday, as shown below;
Records Approved Checks/EFT
Remittance Mailed
October 11, 2010 October 14, 2010
November 10, 2010 November 18, 2010
December 10, 2010 December 16, 2010
January 10, 2011 January 13, 2011
February 10, 2011 February 17, 2011
March 10, 2011 March 17, 2011
April 11, 2011 April 14, 2011
May 10, 2011 May 19, 2011
June 10, 2011 June 16, 2011
July 11, 2011 July 14, 2011
August 10, 2011 August 18, 2011
September 12, 2011 September 15, 2011
October 10, 2011 October 13, 2011
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 10`" of the month CCC will 'make every attempt
to process the payment within 10 days subject to JWB approval.
Page 22 of 22