PROVIDE ECONOMIC SELF-SUFFICIENCY PROGRAMS TO THOSE IN NEED
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AGREEMENT
This Funds Agreement is made and entered into between the City of Clearwater, hereinafter
referred to as the City, and Partners in Self-Sufficiency, rnc" hereinafter referred to as the
Agency,
WHEREAS, it has been determined to be highly desirable and socially responsible to provide
economic self-sufficiency programs to those who would not otherwise have a means to fill these
needs; and
WHEREAS, the City desires to help those in need by providing funding for the above services;
and
WHEREAS, the Agency provides such services and operates in the City;
NOW, THERFORE, the parties agree as follows:
ARTICLE I. TERM
The term of this agreement shall be for a period of 12 months commencing on the 1st day of
October, 2000 and continuing through the 30th day of September, 2001 (the Termination Date)
unless earlier terminated under the terms of this agreement.
ARTICLE II. RESPONSIBILITIES OF THE AGENCY
1.
Services to be Provided: The Agency shall provide the above stated service in
accordance with the proposal submitted by the Agency and approved by the City, which
is attached and incorporated herein by reference.
2,
Area to be Served: Services rendered through this agreement shall be provided within
the corporate limits of the City as it now exists and as its boundaries may be changed
during he term of this agreement.
3.
Scheduled Reports of Agency Activities: The Agency shall furnish the City Human
Relations Department, Grants Coordinator, with an annual report of activities conducted
under the provisions of this agreement by October 31, 2001. Each report is to identify the
number of clients served, the costs of such service, and commentary on the viability,
effectiveness, results of measurable goals and objectives as set out in the agency's
proposal, and trends affecting the program. The agency will also provide a copy of its
most recent independent financial audit.
4,
Use and Disposition of Funds Received: Funds received by the Agency from the City
shall be used to pay for the above services as further described in the grant proposal
submitted by the Agency to the City. Funds existing and not used for this purpose at the
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end of this agreement term shall be deemed excess to the intended purpose and shall be
returned to the City,
5, Creation, Use, and Maintenance of Financial Records:
a) Creation of Records: Agency shall create and maintain financial and accounting
records, books, documents, policies, practices, procedures and any information
necessary to reflect fully the financial activities ofthe Agency, Such records shall
be available and accessible at all times for inspection, review, or audit by
authorized City representatives,
b) Use of Records: Agency shall produce such reports and analyses that may be
required by the City and other duly authorized agencies to document the proper
and prudent stewardship and use of the monies received through this agreement.
c) Maintenance of Records: All records created hereby are to be retained and
maintained for a period not less than five (5) years from the termination of this
agreement.
6, Non-discrimination: Notwithstanding any other provisions of this agreement during the
term of this agreement, the Agency for itself, agents and representatives, as part of the
consideration for this agreement, does covenant and agree that:
a) No Exclusion from Use: No person shall be excluded from participation in,
denied the benefits of, or otherwise be subjected to discrimination in the operation
ofthis program on the grounds of race, color, religion, sex, age, national origin, or
disability,
b) No Exclusion from Hire: In the management, operation, or provision of the
program activities authorized and enabled by this agreement, no person shall be
excluded from participation in or denied the benefits of or otherwise be subject to
discrimination on the grounds of or otherwise be subjected to discrimination on
the grounds of race, color, religion, sex, age, national origin, or disability,
c) Inclusion in Subcontracts: The Agency agrees to include the requirement to
adhere to Title VI and Title VII of the Civil Rights Act of 1964 in all approved
sub-contracts,
d) Breach of Nondiscrimination Covenants: In the event of conclusive evidenced
of a breach of any of the above non-discrimination covenants, the City shall have
the right to terminate this agreement.
7, Liability and Indemnification: The Agency shall act as an independent contractor and
agrees to assume all risks of providing the program activities and services herein agreed
and all liability therefore, and shall defend, indemnify, and hold harmless the City, its
officers, agents, and employees from and against any and all claims of loss, liability, and
damages of whatever nature, to persons and property, including, without limiting the
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generality of the foregoing, death of any person and loss ofthe use of any property, except
claims arising from the negligence or willful misconduct of the City or City's agents or
employees, This includes, but is not limited to matters arising out of or claimed to have
been caused by or in any manner related to the Agency's activities or those of any
approved or unapproved invitee, contractor, subcontractor, or other person approved,
authorized, or permitted by the Agency in or about its premises whether or not based on
negligence
ARTICLE III. RESPONSIBILITIES OF THE CITY
1. Grant of Funds: The City agrees to provide a total grant of $3,200,00 to fund the
program in accordance with this agreement and subject to City Commission budget
approval.
2, Payments: The total amount requested will be paid by the City to the Agency within 30
days after execution of this agreement by the City and the Agency but no earlier than
October 1 of the budget year for which the funds are authorized,
ARTICLE IV. DISCLAIMER OF WARRANTIES
This Agreement constitutes the entire Agreement of the parties on the subject hereof and may not
be changed, modified, or discharged except by written Amendment duly executed by both
parties. No representations or warranties by either party shall be binding unless expressed herein
or in a duly executed Amendment hereof,
ARTICLE V. TERMINATION
1. For Cause: Failure to adhere to any ofthe provisions of this agreement as determined by
the City shall constitute cause for termination, This agreement may by terminated with 5
days notice without any further obligation by City.
2, Disposition of Fund Monies: In the event oftermination for any reason, monies made
available to the Agency but not expended in accordance with this agreement shall be
returned to the City.
ARTICLE VI. NOTICE
Any notice required or permitted to be given by the provisions of this agreement shall be
conclusively deemed to have been received by a party hereto on the date it is hand-delivered to
such party at the address indicated below (or at such other address as such party shall specify to
the other party in writing), or if sent by registered or certified mail (postage prepaid), on the fifth
(5th) business day after the day on which such notice is mailed and properly addressed,
1. If to City, addressed to Grants Coordinator, Human Relations Department, P.O Box 4748,
Clearwater, FL 33758
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2, If to Agency, addressed to Partners in Self-Sufficiency, Inc" 210 Ewing Ave"
Clearwater, FL 33756.
ARTICLE VII. EFFECTIVE DATE
The effective date of this agreement shall be as of the first day of October, 2000,
,IN WITNESS WHEREOF, the parties hereto have set their hands and seals this
.~
------1L-dayof '1~
, 2001.
CITY OF CLEARWATER, FLORIDA
Countersigned:
B~~t~
By~.4""'f ~T
William B. Home II, Interim City Manager
Approved as to form:
~a~Akin, C;ty Attorney
Attest:
~-:. ~<<~.~
C~~j ia E. Goudeau, City Clerk
Witnesses as to Agency:
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Attest:
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At'll! /h-t4dLk
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CITY OF CLEARWATER
SOCIAL SERVICES GRANT
PROJECT APPLICATION FORM
Phone:
(727) 562-4060 for assistance
Due: January 26, 2001
A. Application Infor.mation
Applicant:
(Sponsor/Developer)
Partner!'! in Self-S1tff;r;~n,.y, TllC:
Organization Name:
(If different)
Address:
210 Ewing Avenue
City; State; Zip
Clearwater. FL ,,7')(;
Telephone Number:
461-3453
Contact Person:
Sylvia Costello
Title:
Executive Director
Telephone Number:
461-3453
Period for which funds
are being requested:
2001
(~~pr~mh~r 10)
Signature
Linda Chamberlain
Date
1/22/01
NOTE:
The City of Clearwater reserves the right to fund applicants at a
level lower than requested.
2
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B. Activity (Check One)
Adult Crime
Child Abuse
Elderly
Hunger
Juvenile Crime
Physical Illness
Parenting
Adolescents
Substance Abuse
Unsupervised
Children
Youth Development
Other
(Describe Below)
x
Economic self-sufficiency for Clearwater Housing Authority's Jasmine
Court residents.
OUR MEASURABLE OBJECTIVE T~ TO ~F.RVF. ?nn TOY TNrOME FAMIlIES FROM
APRIL 1. 2000 THROUGH MARr.H 11, ?nn1
3
M
C. AMOUNT OF FUNDING CURRENTLY REQUESTED:
(Not to exceed $10,000)
$5.000
D. SPECIFICALLY FOR WHAT WILL THIS MONEY BE USED.
(Line item budget for this amount)
To purchase a telpphnnp ~y~~pm rn~ th~ ~~9Remie self~~l1ffici~RQY
offices at Jasmine Court. The current ~y~~pm ;C! Pv~~pmply old .n~d
inadequate. Currently. there are fmIr ~tRff mpmhp~C!J ~nd ~ reFr~g9Rt2tive
from Pine lIas Work1'l whn nr'r'npy ~hpC!E' officiis ()11~ "'l1~~pn~ ..yst~m d99El Flot
have an intercom 1'lY1'ltpm, Rnn ~Tn; "'PC! aril b:arely 3\lEliBle.
E. BRIEF DESCRIPTION OF PROJECT YOU WISH TO FUND UTILIZING THIS
GRANT.
Clearwater Housing Authoritv contracts with PRTtnPT~ ;n ~plf-~l1ff;~i~R~Y
to operate their economic self-sufficiency pTngTRm~ ()n~ P"'~~;"';p"'ntli are
residents from all of CRA' 1'l pnhl;,. hnl1C!ing compliix&l~ nl1ring ~h<> lagt
four years of pro~ram operRtinn~, TilP h",u<> b<>Qn extr&lmaly El\leeessful ift
assistin~ nUT p"'T~;"';p~n~C! ~o beQoma eesFlsmieally lielf-sYffisieFlt. Over
fifteen families have become f;T~~ ~;mp homE'OT~erg
F. BRIEF DESCRIPTION OF YOUR OVERALL ORGANIZATION.
Partners in Self-Sufficiency R~~;~~~ 1nM ;n~ome rl~~~~:atgr reiElEleFltG to
in becoming economically !'lelf-~nff;,.;pn~ ~hrQ1.1gh emp19~eRt> JOB traifting,
education, and homeownership nppnrtnni~; pC! T.,.; t-h both the pri":ate 31'la
public sectors of our community.
4
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G.
NUMBER OF CLIENTS SERVED BY THIS PROGRAM.
200 low income famil;PR
H. PERCENTAGE OF THESE CLIENTS WHO ARE CITIZENS OF CLEARWATER.
100%
I. CURRENT OVERALL ORGANIZATION BUDGET (PLEASE ATTACH) .
$305.469.
J. IF THIS IS START UP OR MATCHING MONEY, SPECIFY THE DETAILS
i.e. :
WHICH AGENCY OR ORGANIZATION WILL PROVIDE THE MATCH, THE
REQUIREMENTS AND THE AMOUNT OF THE MATCH.
n I~
K. IS YOUR AGENCY A REGISTERED SOl (C) (3) NON-PROFIT AGENCY OR IN
THE PROCESS OF BECOMING ONE.
We are a registered 501(e)(3) agency.
L. DOES YOUR FACILITY HAVE OR IS IT IN THE PROCESS OF ACQUIRING
THE APPROPRIATE LICENSURE FOR THE DELIVERY OF THE SERVICES
DESCRIBED IN THIS APPLICATION.
Yes
5
d'
M. HAS YOUR ORGANIZATION RECEIVED OR IS IT EXPECTING TO RECEIVE
FUNDING (WHETHER CASH OR IN-KIND CONTRIBUTIONS) FROM THE CITY
OF CLEARWATER DURING THE FISCAL YEAR FROM OCTOBER 1, 2000
THROUGH SEPTEMBER 30, 2001?
YES ---X.....-
IF YES, PLEASE EXPLAIN:
NO
We have received a $25,000 Clearwater CDBG 2rant for the Ralary of
our PSS Secretarv.
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PARTNERS IN SELF-SUFFICIENCY
2000-2001 Budget
Approved: March 28, 2000
REVENUE
2001
Clw. CDBG
CHA
CHA FSS ADMIN.
Interest Income
PSS Partners
P.C. Social Action
P.C. Comm. Found.
Donations
Fundraising
50,000
182,232
34,862
375
12,000
15,000
8,000
2,000
1,000
TOTAL REVENUE
$305,469
EXPENDITURES
Salaries:
FICA
Health/Life Insurance
Workers Compo
UCT
Retirement
Sub- Total
176,646
13,513
13,481
1,500
1,200
9,161
215,501
Client Expenses:
Childcare
Education
Employment
Misc.
Transportation
HOMESS
Sub- Total
6,500
2,500
3,250
4,500
5,500
1,250
23,500
Operating:
Advertising
Com. Relations
Computer
Conferences
Contractual
Dues/Fees
Insurance
Office Supplies
Operating Supplies
Postage
Printing/Copying
250
1,000
1,500
1,350
8,000
550
1,600
1,950
1,000
2,266
1,800
Rental/Building
Rental/Equipment
~epair/Maint-Bldg.
Repairs/Main!. -Equi p.
Telephone
Travel
Utilities
Vehicle Exp.
Vehicle/Repair & Maint
Misc.
Subtotal
2,100
5,426
1,600
450
5,300
1,600
3,600
200
1,000
23,926
66,468
TOTAL
$305,469
UNIFIED FUNDING APPLICATION
To: (funder): C,i t"y of C1 P:lTlJ:lt"PT Snri:l1 SPT For time period of: 2991
Applicant Information (print or tvpe):
Legal Name of Organization: Partners in Self-Stiff; d enry. Tnr
Complete Address:
210 'Ruing A't7a,.,,,o
Clearwater. F1 ~~7~~
Phone(7~ 461-~4~~
Fax tr2i 46.7-1.1 7?
E-Mail
rC:l1 rr; ra; ~t .mpA.Q 4~'I' . rr. e8m
Federal Tax Identification Number:
,q-?Q~14~7
Contact Person: Syhd:l c'oc:h>ll n
Tide: Executive Director
Organization Type: _Public _Private -L Non-profit _ Other
Service Area: _ County _ City of
Other
~, a.::ll'rt'aT!:If-O'"
Agency currently funded by ( check all that apply):
_ St. Petersburg _ Florida Dept. of Children & Families
...2L Clearwater Florida Dept. of Justice
_ Largo ..2L. Pinellas County Foundation
~ Pinellas County _ Allegany Franciscan Foundation
_ Area Agency on Aging _ Eckerd Family Foundation
Juvenile Welfare Bd. Other: CleaTlJ:lt"PT Hom::ing A1Irhn...;ty
_ United Way
Certifications: (1) If required to register for solicitation of funds, is the Agency currently
registered with the State? ~ Yes _ No The County? -L Yes _ No
(2) If incorporated, has the Agency Annual Report been med with the Florida
Secretary of State? .L- Yes _ No
Name and Title of Agency Representative submitting this funding request:
Sylvia Costello
Executive Director
,
.....
Signature of A ency Director (senior staff member) or Board Chair:
Date:
January 22, 2001
Received in funder's office by:
Date:
UFAl
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BOARD OF DIRECTORS
Name/Occupation Occupation Expertise Race/Gender
Linda Chamberlain Business Owner Attorney CIF
Board President
Aging Wisely
Lynn Chalache Business Owner Business Owner CIF
Board Vice-President
Daughter-on-Call
Evelyn Bethell Director Social Services CIF
Board Treasurer
Pinellas County Social Services
Amy Hudock Assistant Vice President Banking CIF
Board Secretary
Peoples Bank
John Stone, CCIM Real Estate Attorney Real Estate CIM
Colliers Arnold
Dee Fry Business Owner Health Care Services CIF
Ultimate Medical Academy
Ken Hayes Area Manager Corporate CIM
Board Secretary
Verizon
Larry Cinadr District Manager Corporate CIM
Target Stores
Rita Garvey Community Rep, CIF
Nancy Kaylor Editor Corporate CIF
CCH, Incorporated
Linda Chase Purchasing Manager PSS Alumni CIF
Tech Data, Inc.
Nancy Ritz Customer Service Manager Corporate CIF
Florida Power Corporation
Candy Zimmerman Community Rep. CIF
Junior League of
Clearwater/Dunedin League