CHARTING THE COURSE FOR YOUTH AGREEMENT (5)DocuSign Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
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Nr Juvenile Welfare Board
Investing in children. Strengthening our community.
PROGRAM CONTRACT/AMENDMENT REVIEW AND APPROVAL FORM
Agency Name:
City of Clearwater
Program Name:
Charting the Course for Youth
Type of Document:
FY23 Agreement
Annualized
Contract Amount:
$ 468,897
Brief Explanation:
FY23 Agreement for City of Clearwater - Charting the Course for Youth program.
INSTRUCTIONS
1. The contract/amendment referenced above is attached and submitted for review and comment.
2. If you have suggested edits or concerns, please contact Karen Boggess at kboggess@jwbpinellas.org to
discuss.
3. Contract/amendment will be routed for signature via DocuSign workflow.
4. Administrative Specialist will archive review form and contract/amendment. < ,
Program Administration Mgr.
Program Evaluation Mgr.
(if applicable) M. Seales
8/25/2022 1 2:58 PM EDT
For Senior Manager, Program
S. Gill
Finance (if
applicable)
%lay Qat
8/25/2022 1 3:05 PM EDT
Chief Program Officer
K. Boggess
6u'un. bDI�t,Si
8/25/2022 13:09 PM EDT
Chief Financial Officer
L. Krueger Brock
8/26/2022 1 2:31 PM EDT
Chief Evaluation & Innovation
Officer
B. Morrison -Rodriguez
f jari'ava Auvrisev,--Ybkiouvj
8/26/2022 1 2:42 PM EDT
DocuSign Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
AGREEMENT
Between
THE JUVENILE WELFARE BOARD
And
City of Clearwater
Charting the Course for Youth
I. PURPOSE
The Juvenile Welfare Board of Pinellas County, hereinafter referred to as "JWB", and City of Clearwater,
hereinafter referred to as "Provider", enter into this mutual Agreement, including all attachments referred to
herein, for the period commencing October 1, 2022 and extending through September 30, 2023. This
Agreement does not take effect and JWB has no responsibility for any of its obligations hereunder until this
Agreement is executed by all parties to this Agreement.
II. STAFF
Provider agrees to employ staff, at its own expense, to execute services provided in accordance with this
Agreement. Such individuals shall not be considered employees of JWB, and are subject to the supervision,
personnel practices and policies of the Provider. Unless otherwise approved by JWB, all Provider staff shall
meet qualifications as stated in the approved position profile on file at JWB and any approved revisions which
are submitted for FY23 funding.
III. SERVICES
Provider offers after school programs for youth in North Pinellas County. The Ross Norton and North
Greenwood Recreation Complexes serve children aged 6 through 18 year-round. The program incorporates
enrichment activities that promote school success and healthy lifestyles, improve social skills, increase athletic
abilities, and develop leadership skills. All activities include aspects of positive character development
including courage, teamwork, compassion and community service.
Provider agrees to deliver services as stated in the currently approved program methodology on file at JWB and
to accomplish performance measures stated in Attachment 5, as determined by JWB, according to service areas
stated in Attachment 2, and pursuant to the General Conditions stated in Section VIII and Special Conditions
listed in Attachment 1. Any proposed changes in service delivery must be approved in writing by JWB in
advance of making those changes and program methodologies shall subsequently be updated within thirty (30)
calendar days of that approval. Costs associated with any unapproved changes in service delivery may not be
reimbursed.
IV. FUNDS
The program budget for both JWB and other funds (if any) for accomplishing the above stated services must be
approved in the JWB data system or other designated format before payment will commence. JWB agrees to
reimburse up to $468,897 for services rendered pursuant to this Agreement.
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V. METHOD OF PAYMENT
1. JWB issues reimbursements in accordance with the schedule listed on Attachment 3. The Provider shall
submit an accurate request for payment once a month. Reimbursements shall be made in timely manner
on pace throughout the fiscal year in order to allow for a consistent and orderly delivery of services.
Reimbursement requests shall be submitted timely and only for amounts actually incurred that should
properly be reimbursed per this Agreement within reasonably needed amounts based on the budget and
other funding sources. Request for payment must be accompanied by the appropriate documentation as
prescribed by JWB.
2. Requests for advance funds may be made, consistent with JWB policy.
VI. TERMINATION
1. It is the intent of JWB to ensure a consistent and orderly delivery of services. It is the further intent of
JWB to terminate Agreements in those situations where such action is essential to the protection of its
interests and the interests of children and families served by JWB, as determined solely by JWB.
2. In the event funds to finance this Agreement become unavailable, JWB may terminate the Agreement
upon no less than twenty-four (24) hours' notice in writing to the Provider. Said notice shall be delivered
in person, or by email, regular mail or delivery service.
3. JWB shall endeavor, whenever possible and consistent with its legal obligations and principles of
prudent management, to provide sixty (60) days' written notice for termination due to lack of funds.
JWB shall be the final authority as to the availability of funds and extension of notice beyond the
minimum time herein stated.
4. In addition to the rights as set forth in paragraph VI. 2 above, this Agreement may be terminated by
JWB for any reason whatsoever upon twenty-four (24) hours' written notice. Said notice shall be
delivered in person, or by email, regular mail or delivery service.
5. Provider shall only be compensated for services performed prior to the termination date. Provider may
only terminate this Agreement upon sixty (60) calendar days' written notice to JWB delivered in person,
or by email, regular mail or delivery service.
6. The above provisions shall not limit JWB's right to remedies at law or to damages.
VII. COMMENCEMENT OF PAYMENT
Unless specifically authorized by JWB, payment shall not be made for services rendered prior to the effective
date of this Agreement.
VIII. GENERAL CONDITIONS
1. Agreement Revisions
This Agreement and its attachments constitute the contractual relationship between the Provider and JWB. If
there is any discrepancy between program -related documents, this Agreement preempts all other documents. No
amendment to this Agreement or its attachments may be made without the prior written approval of JWB and
Provider, except as may be provided in General Condition #4.
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2. Fiscal Responsibility
a. Non-profit Providers and government entity Providers agree to maintain books, records, and documents
in accordance with generally accepted accounting principles and practices which accurately and
appropriately reflect all expenditures of funds listed in the approved budget on file at JWB.
b. For-profit Providers agree to maintain books, records, and documents on an acceptable basis of
accounting to include the cash basis of accounting known as Other Comprehensive Basis of Accounting
(OCBOA). The method of accounting should be consistent with industry practices which accurately and
appropriately reflect all expenditures of funds listed in the approved budget on file at JWB.
c. Provider agrees that all financial records, including personnel and salary information and supporting
documentation shall be subject at all times to inspection, review, or audit by JWB personnel or its duly
authorized agent.
d. Provider agrees to maintain and file with JWB in a timely fashion reports related to services provided
under this Agreement.
e. 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.
f. Payments during Disaster Recovery: JWB agrees to support funded programs that are unable to provide
normal services for a period of at least sixty (60) calendar days after a disaster has been declared,
provided the program agrees to comply with requests of JWB. This period may be extended at the
discretion of the Board upon recommendation of the Chief Executive Officer. Provider must file
insurance and may file FEMA claims or apply for other federal funding and shall reimburse JWB for
any amounts received from these sources that have previously been funded by JWB. The Provider must
submit to JWB a copy of the Provider's Continuity of Operations Plan within thirty (30) calendar days of
the effective date of this Agreement.
g. Provider agrees that salary adjustments for staff that are submitted to JWB for approval in budgets or
budget amendments have been reviewed and approved by the Provider in accordance with its fiscal
policies and adjustments can be sustained in future fiscal years. JWB shall not reimburse more than two
(2) weeks of accrued leave for terminating employees. JWB shall not reimburse expenses not previously
approved by JWB.
h. Provider agrees to have a written conflict of interest policy and to obtain appropriate signed statements
from its governing board members, officers, and employees on an annual basis.
3. Audit and Management Letter
Non-profit Providers and government entity Providers agree to submit to JWB 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 one hundred and eighty (180) calendar days of
the close of the Provider'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.
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The Provider's auditor must comply with the Independence Rule and comply with the General Requirements for
Performing Nonattest Services and Documentation Requirements When Providing Nonattest Services. Such
nonattest services include:
(1) financial statement preparation; (2) cash to accrual conversions; (3) reconciliations; (4) advisory services;
(5) appraisal, valuation and actuarial services; (6) benefit plan administration; (7) bookkeeping, payroll and
other disbursements including proposed standard, adjusting or correcting journal entries; (8) preparation of
depreciation schedules; (9) business risk consulting; (10) corporate finance consulting (11) executive or
employee recruiting; (12) forensic accounting; (13) hosting services; (14) information systems design,
implementation or integration; (15) internal audit; (16) investment advisory or management; (17) tax services.
The Provider is required to engage an audit firm that follows Government /Non -Profit Audit Standards when
conducting the fmancial audit and that shows evidence of a peer review report completed every three (3) years.
For-profit Providers agree to submit annual financial statements based on industry OCBOA standards prepared
by an independent Certified Public Accounting Firm within a period not to exceed one hundred and eighty
(180) calendar days of the close of the Provider's fiscal year. The financial statements must be prepared in
accordance with applicable Preparation, Compilation and Review Standards.
4. Other Financial Support
a. Provider shall report within ninety (90) calendar days any major changes in non-JWB revenue which
would impact targeted service levels in JWB funded programs during the fiscal year.
b. JWB funds shall not be used for expenditures also funded by other sources. JWB funds shall not be used
to supplant other sources of revenue.
c. Generally, JWB encourages use of its funds as financial match for securing funds from other sources.
However, in such instances, Provider is required to obtain prior written approval to submit an
application with JWB committed funds.
d. Revenues earned in a JWB funded program must remain in that program as a condition of funding.
e. Programs charging a fee for services supported by JWB funding must forward a copy of the fee schedule
to JWB within thirty (30) calendar days of the effective date of this agreement and upon making changes
to the fee schedule.
5. Program Monitoring and Data Quality
Provider agrees to submit monitoring, site visit, accreditation, and licensing reports supplied by funding,
accreditation, and licensing entities, as applicable, to JWB no more than thirty (30) calendar days following
Provider receipt. Provider agrees to submit progress reports and other information in such format and at such
times as may be prescribed by JWB (including JWB Databases, JWB Secure Portals, and Provider specific data
collection systems), and to cooperate in monitoring activities including, but not limited to, access to sites, staff,
fiscal and participant records, logs, participant rights and responsibilities policies, participant handbooks,
grievance and complaint procedures, and the provision of related participant and participant rights information.
Provider shall maintain and have available for audit inspection participant records for five (5) years post
termination of services. Provider agrees to abide by the JWB Board Policy Section IV: JWB Funded Program
Monitoring.
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Provider agrees to provide JWB representatives access, without presence of the Provider supervisor, to staff or
program participants during any monitoring with or without advance notice. Youth participants will only be
interviewed in group settings or with staff present unless parental consent is obtained.
Provider staff shall adhere to JWB's Data Quality Manual and JWB's Financial Policies and Procedures for
Funded Programs, and all staff who have any responsibility (supervisory or direct) for data entry shall be trained
within thirty (30) calendar days of hire. The Provider is responsible for maintaining written policies and
procedures for providing data to JWB in a timely manner. The Provider is responsible for reviewing JWB
Database and JWB Secure Portal User Access to ensure that all users are active employees with access to
appropriate data systems and modules. The Provider is responsible for implementing appropriate procedures
into their data policies to protect data and prevent accidental or malicious disclosure of participant information.
The Provider is responsible for maintaining fiscal access and workflow approval throughout the fiscal year.
Provider shall notify JWB no less than ninety (90) days prior to implementation of data system(s) used for
participant and/or financial information that are used to share data with JWB.
6. Board Members and Training
Provider shall submit to JWB an updated roster of board members to include the start date of all members
within thirty (30) calendar days of the effective date of this Agreement and within thirty (30) calendar days of
any change to board composition. Board member rosters shall also include the email, physical address, phone
number, and place of employment for all board members.
Orientation of new board members shall occur within two (2) months of the member joining the board and
evidence of this orientation maintained in Provider files. Training of new board members by an external trainer
is required within six (6) months of joining the Provider board. Evidence of training must be provided to JWB
within 30 days of the training. Training must consist of the following topics: nonprofit governance, fiduciary
risks, and liabilities. Documentation of this training shall include an outline of topics covered, the board
members in attendance, date the board member joined the board, and who provided the training. Providers that
are governmental entities, higher education institutions, and hospitals are exempt from this training requirement.
7. Nondiscrimination
Providers receiving funding from 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,
age, veteran status, sexual orientation, pregnancy, and genetic information, or any other legally protected
category except that programs may target services for specific participant groups as defined in the application.
Additionally, Providers 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 - Endorsements
Requests for endorsements that require a commitment of JWB resources shall be submitted to JWB for its
consideration. However, endorsements which do not require JWB resources may be given to those Providers
that support the focus and priorities of the JWB Board, at the discretion of the JWB Chief Executive Officer.
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JWB's logo must be visible at Provider's administrative and program sites, be featured on the Provider's
website, and be present on the following Provider materials as an acknowledgement of support:
• Annual report
• Program brochures and marketing materials
• Program stationery
JWB's logo may not be used on any other publications requiring JWB resources without JWB 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 Chief Executive Officer.
9. Not Used
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, including transportation of participants, without prior written
approval of JWB through an approved budget or other written approval on file at JWB. No such approval by
JWB of any assignment or subcontract shall be deemed in any event or in any manner to provide for the
incurrence of any obligation by JWB in addition to the total dollar amount stated in this Agreement. JWB shall
have the right to require the Provider to replace any Subcontractor found, in the reasonable judgment of JWB, to
be unacceptable.
All such assignments or subcontracts shall be subject as applicable to the terms and General Conditions of this
Agreement and to any conditions of approval that JWB shall deem necessary. Subcontracts for program service
delivery described in the approved program methodology must be reviewed according to the Subcontract
Assessment found on the Provider page of the JWB website. The assessment outlines elements that must be
included in subcontracts. Subcontracts and the corresponding Subcontract Assessment shall be submitted to
JWB within thirty (30) calendar days of the effective date of this Agreement and upon revision, amendment and
execution of the subcontract thereafter.
To the extent Provider is permitted by JWB to subcontract any of provider's responsibilities under this
agreement, the subcontracting entity or agency shall be obligated to assume all applicable obligations of the
Provider under this agreement, including the obligation to preserve and maintain insurance as outlined in
General Condition 25 and 26. Provider shall have full responsibility for the successful performance and
completion of all subcontracted duties under this Agreement to the same extent as if the Provider performed
such duties. The Provider shall be the sole point of contact for subcontracts with regard to all matters under this
Agreement. Provider is responsible for monitoring subcontracts of JWB funded programs unless otherwise
specified in a Special Condition of this Agreement. Documentation of monitoring of subcontracts shall be
submitted to JWB no more than thirty (30) calendar days following completion of the monitoring activities.
11. Confidential Information
Provider must follow all laws regarding confidentiality of information including, but not limited to, HIPAA.
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
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following exceptions: a) such information may be revealed as may be necessary to conform to Fiscal
Responsibility and Program Monitoring requirements as stated in the General Conditions of this Agreement; 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. Provider is responsible to
adopt appropriate policies, notifications, authorizations, and other relevant information that allows for the
sharing of confidential information with JWB.
The Provider shall also maintain in participant files a completed copy of a JWB-approved form for authorizing
client consent to release information for each participant receiving services. As allowed by law and Provider
policy, the Provider shall add JWB to consent forms including HIPAA consent forms to facilitate data sharing
and implement the Fiscal Responsibility and Program Monitoring requirements as stated in the General
Conditions of this Agreement and advise JWB within two (2) business days if a participant has withdrawn
consent to share data and note this withdrawal of consent in the case file. JWB has full discretion as to the use
of data and JWB owns all data once transferred to JWB.
Provider shall obtain permission and license for the use of any and all photographs, videotaping, audio
recordings, or written interviews/stories of participants, to include use of name, image and other identifiable
information in connection with a press release, news story, testimonial, or story that may be viewed by the
general public, and that the participant will not receive compensation for participation in the use of this
information. For youth under the age of eighteen (18), Providers will obtain the signature of a parent or legal
guardian.
In no event should participant identifying information ever be emailed or faxed to JWB.
In the event of an improper disclosure of participant information by Provider, Provider shall inform JWB of the
improper disclosure and extent thereof within two (2) business days of becoming aware of the improper
disclosure. Provider shall cooperate fully with JWB 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 shall
defend, indemnify and hold harmless JWB from any and all damages caused by the improper disclosure of any
confidential information as defined by law including, but not limited to, Protected Health Information under
HIPAA and any and all costs associated with remedying the disclosure. Provider shall defend, indemnify and
hold harmless JWB from any and all damages caused by the improper disclosure as defined by law of any
information including but not limited to personally identifiable information (PII) and protected health
information (PHI) as required under HIPAA, HITECH and FIPA regulations or other information that is
confidential and/or exempt from disclosure per F.S. 119. This provision shall survive the termination of this
Agreement.
Likewise, in the event of an improper disclosure of Provider's participant information by JWB, JWB shall
inform Provider of the improper disclosure and extent thereof within two (2) business days of becoming aware
of the improper disclosure. JWB shall cooperate fully with Provider and take all necessary steps to correct and
remedy any damage caused by JWB's improper disclosure and to prevent future improper disclosure. JWB shall
defend, indemnify and hold harmless Provider from any and all damages caused by JWB's improper disclosure
and any and all costs associated with remedying the disclosure subject to the doctrine of sovereign immunity
and limitations set forth in F.S. 768.28.
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12. Public Records
JWB is a public entity subject to Florida's Public Records Law, which includes provisions relating to records
retention, production, and confidentiality. For purposes of this section, Provider is also referred to as Contractor.
Provider subcontracts that arise out of this Agreement must apply the entirety of this public records condition to
the Subcontractor.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119,
FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT:
Juvenile Welfare Board of Pinellas County
14155 58th St. No., Ste. 100
Clearwater, FL 33760
(727) 453-5600
publicrecordsAwbpinellas .org
Contractors acting on behalf of JWB must comply with 119.0701 and must:
a. Keep and maintain public records required by JWB to perform the service.
b. Upon request from JWB's custodian of public records, provide JWB with a copy of the requested
records or allow the records to be inspected or copied within a reasonable time at a cost that does not
exceed the cost provided in F.S. 119 or as otherwise provided by law.
c. Ensure that public records that are exempt or confidential and exempt from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the contractor does not transfer the records to the public agency.
d. Upon completion of the contract, transfer, at no cost, to JWB all public records in possession of
Contractor or keep and maintain public records required by JWB to perform the service. If the
Contractor transfers all public records to JWB upon completion of the contract, Contractor shall destroy
any duplicate public records that are exempt or confidential and exempt from public records disclosure
requirements. If Contractor keeps and maintains public records upon completion of the contract, the
Contractor shall meet all applicable requirements for retaining public records. All records stored
electronically must be provided to JWB, upon request from JWB's custodian of public records, in a
format that is compatible with the information technology systems of JWB.
In addition, Contractors should be aware that Social Security numbers are confidential and exempt from
disclosure (119.071(5)) and personal identifying information of a child or the parent or guardian of the child
held by JWB or service provider under contract with JWB is exempt from disclosure (125.901(11)). There are
many other exemptions in the law that Provider should be cognizant exist. However, for all Providers, any and
all contracts between JWB and Provider, program methodology, budgets, requests for reimbursements, emails,
other written correspondence and any other documents exchanged between the Provider and JWB are generally
public records and will be disclosed in the sole discretion of JWB and must be retained in accordance with
Florida's record retention policy. Providers should not provide any documents to JWB containing Trade Secrets,
as defined by F.S. 812.08, or exempt or confidential and exempt information to JWB without specifically
marking such document. By submitting any documents or information whatsoever to JWB, Provider agrees that
JWB may use and disclose all information and documents submitted for any purpose JWB sees fit and that it is
within JWB's sole discretion to determine if any information submitted is exempt from disclosure.
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Any Provider who receives a public records request for records pertaining to JWB or services funded by JWB,
must advise JWB within two (2) business days of the records request and JWB and Provider will work together
to respond to any such request. This provision shall survive termination of this Agreement.
13. Return of Funds
Provider agrees to return to JWB any overpayment due to costs not incurred or costs disallowed pursuant to the
terms of this Agreement and such funds shall be considered JWB funds and shall be refunded to JWB in
accordance with its instructions. Should Provider fail to return said funds, Provider shall be responsible for all
costs and fees of collection incurred by JWB - including, but not limited to, attorney fees and court costs
including any pre -suit collections fees and costs. This provision survives termination of this Agreement and
return of funds for overpayment or disallowance will be required even if the overpayment or disallowance is
discovered after this Agreement is terminated.
14. Special Situations and Incidents
Provider agrees to inform JWB within one (1) business day 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. Participant incidents are required to be reported for situations that occur only while under the
Provider's care and includes anything that may reflect negatively or critically upon JWB.
Certain personnel are mandated by law to report their suspicions of child abuse, neglect, or abandonment to the
Florida Abuse Hotline (1 -800 -96 -ABUSE). All concerns regarding suspected abuse, neglect, or abandonment of
a child or vulnerable adult by the Provider shall first be reported to the Florida Abuse Hotline and then reported
to JWB. Incident reporting does not preclude mandated reporting requirements.
Critical Incidents are defined as follows:
Abduction - An incident in which an individual who does not have care and custody of a child has taken the
child. Concerns of child abductions shall immediately be reported to the appropriate law enforcement personnel.
Abuse or Neglect - Reasonable cause to suspect that a child has been harmed or is believed to be threatened
with harm while in the Provider's care.
Baker Act — A participant is involuntarily admitted for psychiatric care under Florida lawTorBaker Act during
the course of service delivery regardless if the incident occurred while under Provider's care.
Breach of Information - Sensitive, protected or confidential data has potentially been viewed, stolen or used by
an individual unauthorized to do so.
Elopement- When a minor participant leaves a setting without permission or authorization.
Employee Arrest - Employee conduct or activity that results in potential liability to the Provider or JWB, death
or harm to a participant, or results in a law violation, including falsification of official records. If an arrest is
made for a potentially disqualifying offense under Level 2 background screening requirements, or if the arrest
occurred while in the performance of an employee's official duties, the incident should be reported immediately.
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Investigation or Lawsuit - Any formal investigation or legal action brought against Provider which relates to the
services funded by JWB or which may reasonably be considered to jeopardize its capability to continue to meet
its obligations under the terms of this Agreement.
Media Coverage or Public Inquiry - Media coverage or public reaction that may have an impact on the Provider
or JWB's ability to protect and serve its participants, or other significant effect on the Provider or JWB.
Participant Death - The death of any participant receiving JWB services, regardless if the death occurred while
under Provider's care.
Participant Illness - An illness of a participant requiring a response by Emergency Medical Services AND
transport to a medical facility due to the severity of the illness while participant is attending the program.
Participant Injury - A medical condition of a participant requiring a response by Emergency Medical Services
AND transport to the hospital due to the severity of the medical condition or injury while the participant is
attending the program.
Note in both instances of Participant Illness and Participant Injury the parents may use Emergency Medical
Services as transportation to the hospital - if it is used solely for this purpose an incident report is not required.
In the event that the participant leaves the program and requires emergency care due to an injury or illness
incurred at the program, an incident report should be completed when the program becomes aware.
Sexual Battery - An allegation of sexual battery involving a participant or employee as evidenced by medical
evidence or law enforcement involvement. Sexual battery includes participant on participant incidents,
employee, agent or volunteer on participant, and participant on employee, agent or volunteer.
Suicide Attempt - An act which clearly reflects the physical attempt by an active participant to cause his or her
own death, which results in bodily injury requiring medical treatment by a licensed health care professional.
In addition, the Provider shall notify JWB immediately upon knowledge of any action or incident involving
Provider 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.
Within one (1) business day of knowledge of any incident, the Provider must submit electronically a completed
Incident Report to IRreviewteam@jwbpinellas.org with full details and disposition of the incident, excluding
identifying information such as name, date of birth, and address. In the event of a participant death please
contact by phone the JWB Chief Program Officer within three (3) hours of knowledge of the incident.
All email communications made or received by JWB members or staff are considered public records and are
retained and, upon request, made available to the public and media in accordance with Chapter 119, Florida
Statutes.
Provider must adhere to the reporting requirements hereunder after the termination of this Agreement if
Provider becomes aware of a Critical Incident after the termination of the Agreement if the Critical Incident
occurred during the term of the Agreement and/or relates to the services funded by JWB.
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15. Provider Staff Membership on Board
Provider agrees that Provider staff shall not serve as voting members of the Provider's governing board.
16. Waiver
JWB reserves the right to waive requirements of this Agreement and General Conditions where warranted by
special circumstances. Any waiver shall be in writing and signed by JWB.
17. Provider & Program Data Maintained In 2-1-1 Database
Provider agrees to maintain accurate and up-to-date Provider 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 JWB funds the program.
This requirement applies to all programs accepting 2-1-1 referrals.
18. Provider Staff Background Checks
All program staff and Provider staff (including employees, independent contractors, and staff of
subcontractors), volunteers and those who may have access to youth participants are required to undergo and
pass a national Level 2 background check that complies with the standards set forth in F.S. 435. Those
individuals must provide written consent to the Provider to have documentation released to JWB which
confirms no disqualifying offenses listed in F.S. 435.04. for which they have not received an exemption in
accordance with Florida law. All staff and volunteers must continue to qualify to pass a Level 2 screening at all
times and must notify their employer if at any time they no longer qualify to pass a Level 2 screening. Proof of
Level 2 background clearance, including current executed affidavits/attestations of good moral character, must
be maintained at all times in the appropriate files and the screening repeated every five (5) years or more often
in accordance with law or as requested by JWB. Provider must collect written consent for the release of this
information to JWB for purposes of verification. This requirement applies to employees regardless of the
funder supporting the position and all volunteers and subcontractors who may have access to youth. Volunteers
and subcontractors who assist on an intermittent basis for less than ten (10) hours per month do not have to be
screened if a person who meets the screening requirement of this section is always present and has the volunteer
and subcontractor within his or her line of sight. The Provider is required to clearly document which volunteers
meet the criteria for a Level 2 background screening and affidavits of good moral character, and which are
exempt according to the terms of this Agreement. The Provider's policy and practice for background screening
must provide for adequate protection and must comply with all applicable laws and implementing regulations
including, but not limited to F.S. 435.
The Florida Department of Children and Families provides an exemption process under this statute. JWB does
not provide an exemption or waiver process.
Should a Provider not be statutorily authorized to receive a national Level 2 background check in accordance
with F.S. 435, the Provider must still comply with the standards set forth in F.S. 435 through VECHS
background screening. Only in the event the Provider does not qualify to receive a national Level 2 background
check in accordance with F.S. 435 and is not eligible to participate in VECHS, then the Provider must engage a
third -party vendor to conduct a national background check and must comply with the standards as set forth in
F.S. 435.
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Providers using VECHS, or any other third -party vendor which does not allow the release of background
screening results to JWB, must sign and provide to JWB an affidavit which ensures compliance with the
entirety of this section. This affidavit must be renewed annually by the Provider's Executive Director or
equivalent and submitted within thirty (30) calendar days of the effective date of this Agreement and upon
change of staff in this position. Provider must also provide a written procedure within thirty (30) calendar days
of the effective date of this Agreement which outlines the process by which compliance is ensured with the
entirety of this section, including the person responsible for conducting verification between results of VECHS
information and the disqualifying offenses according to F.S 435. Personnel and volunteer files shall reflect who
verified whether the employee or volunteer candidate passed the background screening according to F.S.
435.04.
Provider agrees to submit to monitoring of personnel and volunteer files and other required documents to ensure
compliance with this section. Monitoring will include, but not be limited to, review of training logs, position
descriptions, applications, resumes, salary information, Affidavits of Good Moral Character, the results of
background screenings and Provider verification of staff credentials. Consents executed by employees to release
Affidavits of Good Moral Character and background screening results will be provided to JWB for review.
Providers shall not release Protected Health Information to JWB and Providers shall keep this information
separate from personnel and volunteer files. Parental consent for JWB monitoring activities must be evident in
the personnel and volunteer files of minors.
19. Not Used
20. Link to JWB's Website
Provider website shall include the JWB logo that links to the JWB website (www.jwbpinellas.org).
21. Drug -Free Workplace
The Provider shall have and enforce a Drug and Alcohol Free Workplace Policy. This policy shall be submitted
to JWB within thirty (30) calendar days of the execution of this Agreement.
22. Public Entity Crimes
Per Section 287.133, F.S., 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 thirty-six (36) months from the date of being placed on the convicted
vendor list.
23. JWB Policies and Procedures
Provider agrees to follow all JWB policies and procedures which can be located on the JWB website at
www.jwbpinellas.org and which are incorporated into this Agreement in their entirety. Said policies include, but
are not limited to, all Board policies, funding policies, JWB Financial Policies and Procedures for Funded
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Programs, security policies, JWB Data Quality Manual, and policies that may be promulgated by JWB within
its sole discretion from time to time. JWB reserves the right to change these policies from time to time within its
sole discretion. JWB will provide a minimum of thirty (30) calendar days' notice to the Provider and it is the
responsibility of the Provider to be in compliance with all policies and procedures at all times.
Provider is encouraged to provide certification of current accreditation by a recognized national accrediting
body appropriate to the programming funded by JWB.
Regardless of accreditation, the Provider must meet the highest professional standards established through its
specific field.
24. Conflict of Interest
The Provider must have no interest and shall acquire no interest, either direct or indirect, which would conflict
in any manner with the performance or services required hereunder. The Provider further represents that no
person having any such interest shall be employed or subcontracted by the Provider during the Agreement term
and any extensions.
The Provider shall promptly notify JWB, in person, or by email, regular mail or delivery service, of all potential
conflicts of interest for any prospective business association, interest, or other circumstance, which may
influence or appear to influence the Providers judgment or quality of services being provided hereunder. Such
written notification shall identify the prospective business association, interest or circumstance, the nature of
work that the Provider may undertake and request an opinion of the JWB Chief Executive Officer as to whether
the association, interest or circumstance would, in the opinion of JWB, constitute a conflict of interest if entered
into by the Provider. JWB agrees to notify the Provider of its opinion, in person, or by email, regular mail or
delivery service, within thirty (30) days of receipt of notification by the Provider.
25. Insurance Requirements - Basic Provisions
The Provider will procure, pay for, and maintain, throughout the period of this Agreement, on behalf of the
Provider and JWB, the following MINIMUM limits of basic insurance coverage with responsible companies,
eligible to do business in the State of Florida, which maintain a rating of A -(IX) or higher with A.M. Best.
a. Workers' Compensation
Part One: "Statutory"
Part Two: Each Accident $500,000
Disease - Policy Limit $500,000
Disease - Each Employee $500,000
Such insurance shall be no more restrictive than that provided by the latest edition of the standard
Workers' Compensation Policy, as filed for use in Florida by the National Council on Compensation
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Insurance (NCCI), without any restrictive endorsements other than any endorsements required by NCCI
or the State of Florida. In addition to coverage for the Florida Workers' Compensation Act, where
appropriate, coverage is to be included for the Federal Employer's Liability Act and any other applicable
Federal or State law.
b. Commercial General Liability
General Aggregate $3,000,000
Products/Completed Operations Aggregate $3,000,000
Personal and Advertising Injury $3,000,000
Each Occurrence $3,000,000
Such insurance shall be no more restrictive than that provided by the latest edition of the standard
Commercial General Liability Form (Form CG 00 01) as filed for use in the State of Florida by the
Insurance Services Office (ISO) without any restrictive endorsements other than any endorsements
specifically required by ISO or the State of Florida.
JWB and JWB's Board members, employees, volunteers, and agents shall be included as an "Additional
Insured" on the Commercial General Liability coverage a form no more restrictive than ISO form CG 20
10 (Additional Insured - Owners, Lessees, or Provider).
c. Automobile Such insurance shall cover all owned, hired and non -owned vehicles operated by, or on
behalf of, the Provider.
Combined single limit - (Vehicles transporting JWB Participants)
Owned: A $5,000,000 ❑ $3,000,000 ❑ $2,000,000 ❑ $1,000,000 ❑ $500,000 ❑ N/A0 Other:
Non -Owned: ❑ $5,000,000 ❑ $3,000,000 ❑ $2,000,000 ❑ $1,000,000 ❑ $500,000 N/A CI Other:
Hired: 0 $5,000,000 ❑ $3,000,000 0 $2,000,000 0 $1,000,000 0 $500,000 CI N/A0 Other:
Combined single limit - (All other vehicles used in the performance of work under this Agreement)
Owned: ❑ $5,000,000 ❑ $3,000,000 ❑ $2,000,000 ❑ $1,000,000 0 $500,000 N/A0 Other:
Non -Owned: ❑ $5,000,000 0 $3,000,000 ❑ $2,000,000 0 $1,000,000 0 $500,000 r N/A0 Other:
Hired: 0 $5,000,000 El $3,000,000 El $2,000,000 0 $1,000,000 0 $500,000 r N/A0 Other:
[The determination of which of the Provider's vehicles will be subject to the limit stated above for
"Vehicles transporting JWB Participants" and will be based upon the responses given by the Provider in
the most recent JWB Insurance Survey.]
Such insurance shall be no more restrictive than that provided by Section II (Liability Coverage) of the
most recent version of the standard Business Auto Policy (ISO Form CA 00 01) without any restrictive
endorsements, including coverage for liability contractually assumed, and shall cover all owned, non -
owned, and hired autos used in the performance of the work under this Agreement.
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Providers that transport JWB Participants will be required to insure any vehicle used for such Participant
transportation in the amount shown in the Participant Transportation section of the Automobile
Insurance Requirements matrix. Such amount shall be determined by JWB based upon the maximum
number of passengers per vehicle (including driver) in the vehicle being utilized. All other Provider
vehicles are required to be insured in the amount shown in the matrix which corresponds to the rest of
the Providers operations, excluding participant transportation.
Providers that hire participant transportation services shall be required to maintain verification of
transportation vendor's automobile liability insurance limits in the same amount that the Provider would
be required to maintain if Provider were providing the transportation services directly. Such amount
shall be determined by JWB based upon the maximum number of passengers per vehicle (including
driver) in the vehicle being utilized. The applicable limits can be found on JWB's website.
d. Excess or Umbrella Insurance:
All required limits of insurance may be satisfied by the use of any combination of primary and
excess/umbrella liability insurance coverages. All Certificates of Insurance for umbrella and excess
liability policies should clearly indicate which underlying policies such excess or umbrella liability
policies are applicable to on an excess basis.
e. Evidence of Insurance:
Provider shall not commence work until the required insurance is in force and evidence of insurance
meeting all of the requirements set forth herein has been provided to JWB.
JWB at all times reserves the right to request such additional documentation and evidence of insurance
as in its sole discretion it may require and the Provider hereby agrees to provide same. An appropriate
Certificate of Insurance signed by an authorized representative of the insurer shall be satisfactory
evidence of insurance. With respect to the Commercial General Liability, an appropriate Certificate of
Insurance signed by an authorized representative of the insurer, and copies of the actual additional
insured endorsement(s) as issued on the policy(ies), shall be satisfactory evidence of such insurance.
The evidence of insurance provided by Provider must include a disclosure of the amount(s) of all
deductibles or self-insured retentions applicable to any policy of insurance required under this section.
Until such insurance is no longer required by this Agreement, Provider shall provide JWB with renewal
or replacement evidence of insurance at least fifteen (15) calendar days prior to the expiration or
termination of such insurance.
Notwithstanding the prior submission of a Certificate of Insurance, copies of endorsements, or other
evidence initially acceptable to JWB, if requested by JWB, Provider shall, within thirty (30) calendar
days after receipt of a written request from JWB, provide JWB with a certified copy(ies) of the
policy(ies) providing the coverage required herein. Provider may redact or omit, or cause to be redacted
or omitted, those provisions of the policy or policies which are not relevant to the insurance required
herein.
f. Notice of Cancellation:
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All required policies must be endorsed to provide JWB with thirty (30) calendar days' prior notice of
cancellation.
g. Primary and Non -Contributory:
The insurance provided by the Provider shall apply on a primary basis to and shall not require
contribution from, any insurance maintained by JWB. Any insurance or self-insurance maintained by
JWB shall be in excess of, and shall not contribute with, the insurance provided by Provider.
h. Deductibles/Self-Insured Retentions:
Except as otherwise specifically authorized in this Agreement, no deductible or self-insured retention for
any insurance required of Provider pursuant to this Agreement will be allowed. To the extent any
required insurance is subject to any deductible or self-insured retention (whether with or without prior
approval of JWB), Provider shall be solely responsible for paying any such deductible or self-insured
retention.
i. Non-Waiver/Remedies:
Compliance with these insurance requirements shall not limit the liability of Provider, its subcontractors,
sub -subcontractors, employees or agents. Any remedy provided to JWB or JWB's Board members,
employees, volunteers, and agents by the insurance provided by Provider shall be in addition to and not
in lieu of any other remedy (including, but not limited to, as an indemnitee of Provider) available to
JWB under this Agreement or otherwise.
Neither approval nor failure to disapprove insurance furnished by Provider shall relieve Provider from
the responsibility to provide insurance as required by this Agreement.
Provider shall provide JWB with renewal or replacement evidence of insurance at least fifteen (15)
calendar days prior to the expiration or termination of such insurance. If Provider cannot meet this
timeline, notification must be made to the assigned JWB Program Consultant and maintain
communication until such time as evidence of insurance can be submitted to JWB.
26. Insurance Requirements - Additional Coverages
The Provider will procure, pay for, and maintain, throughout the period of this Agreement, on behalf of the
Provider and JWB, the following MINIMUM limits of additional insurance coverage with responsible
companies, eligible to do business in the State of Florida, which maintain a rating of A -(IX) or higher with
A.M. Best.
a. Professional Liability
Each Claim $1,000,000
Annual Aggregate $1,000,000
Maximum Deductible or Maximum Self -Insured Retention $25,000
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Such insurance shall be on a form acceptable to JWB and shall cover Provider for those sources of
liability arising out of the rendering or failure to render professional services in the performance of the
services required in the Agreement including any hold harmless and/or indemnification agreement.
If the Professional Liability is provided on a Claims Made Form, the retroactive date must be no later
than the first date of this Agreement and such claims -made coverage must respond to all claims reported
within three (3) years following the period for which coverage is required.
b. Cyber Liability
Each Claim $500,000
Annual Aggregate $500,000
Maximum Deductible or Maximum Self -Insured Retention $25,000
The Cyber Liability insurance shall be on a form acceptable to JWB and shall cover Security & Privacy
Liability and Breach Response Coverage, including Notification Expenses.
If the Cyber Liability is provided on a Claims Made Form, the retroactive date must be no later than the
first date of this Agreement and such claims -made coverage must respond to all claims reported within
three (3) years following the period for which coverage is required.
The required Cyber Liability coverage may be included as part of the Professional Liability coverage
and limits required above.
c. Abuse and Molestation Liability
Each Claim $1,000,000
Annual Aggregate $1,000,000
Maximum Deductible or Maximum Self -Insured Retention $25,000
Such insurance shall be on a form acceptable to JWB and shall cover Provider and its employees for
liability arising out of any occurrence of abuse or molestation in relation to the work provided by
Provider under the Agreement.
If the Abuse and Molestation coverage is provided on a Claims Made Form, the retroactive date must be
no later than the first date of this Agreement and such claims -made coverage must respond to all claims
reported within three (3) years following the period for which coverage is required.
d. Directors and Officers/Employment Practices Liability
Each Claim $1,000,000
Annual Aggregate $1,000,000
Maximum Deductible or Maximum Self -Insured Retention $25,000
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Such insurance shall be on a form acceptable to JWB and shall cover Provider and its directors, officers
and employees for liability arising out of "Wrongful Acts" in the performance of their duties as
directors, officers and employees of Provider. In addition, coverage shall be included for "Wrongful
Acts" of Provider arising out of Provider's employment practices.
If the coverage is provided on a Claims Made Form, the retroactive date must be no later than the first
date of this Agreement and such claims -made coverage must respond to all claims reported within three
(3) years following the period for which coverage is required
e. Crime Insurance
Such insurance shall be on a form acceptable to JWB and shall provide the following coverages in the
following amounts:
Employee Dishonesty:
Forgery or Alteration:
Robbery (on or off premises):
Computer Fraud:
Funds Transfer Fraud:
$300,000
$300,000
$300,000
$300,000
$300,000
Maximum Deductible or Maximum Self -Insured Retention $25,000
f. Watercraft Liability
g.
To the extent watercraft are utilized, Provider shall purchase and maintain insurance which shall, at a
minimum, cover Provider for injuries or damage arising out of the use of all owned, non -owned, and
hired watercraft.
The insurance shall include JWB and JWB's Board members, employees, volunteers, and agents as
additional insureds.
The limits applicable to watercraft liability shall be:
Each Occurrence/Annual Aggregate N/A
Pollution Legal Liability
Such insurance shall cover Provider for liability resulting from pollution or other environmental
impairment arising out of, or in connection with, work performed under this Agreement, or which arises
out of, or in connection with this Agreement, including coverage for cleanup of pollution conditions and
third -party bodily injury and property damage claims arising from pollution conditions. Such insurance
shall also include transportation coverage and non -owned disposal site coverage.
Coverage must either be on an occurrence basis; or, if on a claims -made basis, the coverage must
respond to all claims reported within three (3) years following the period for which coverage is required
and which would have been covered had the coverage been on an occurrence basis.
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The minimum limits (inclusive of any amounts provided by an umbrella or excess policy) shall be:
Each Claim N/A
Annual Aggregate N/A
Maximum Deductible or Maximum Self -Insured Retention $25,000
JWB and JWB's Board members, employees, volunteers, and agents shall be included as an "Additional
Insureds" on the policy.
h. Excess or Umbrella Insurance:
All required limits of insurance may be satisfied by the use of any combination of primary and
excess/umbrella liability insurance coverages. All Certificates of Insurance for umbrella and excess
liability policies should clearly indicate which underlying policies such excess or umbrella liability
policies are applicable to on an excess basis.
i. Evidence of Insurance:
Provider shall not commence work until the required insurance is in force and evidence of insurance
meeting all of the requirements set forth herein has been provided to JWB.
JWB at all times reserves the right to request such additional documentation and evidence of insurance
as in its sole discretion it may require and the Provider hereby agrees to provide same. An appropriate
Certificate of Insurance signed by an authorized representative of the insurer shall be satisfactory
evidence of insurance. With respect to the Commercial General Liability, an appropriate Certificate of
Insurance signed by an authorized representative of the insurer, and copies of the actual additional
insured endorsement(s) as issued on the policy(ies), shall be satisfactory evidence of such insurance.
The evidence of insurance provided by Provider must include a disclosure of the amount(s) of all
deductibles or self-insured retentions applicable to any policy of insurance required under this section.
Until such insurance is no longer required by this Agreement, Provider shall provide JWB with renewal
or replacement evidence of insurance at least fifteen (15) calendar days prior to the expiration or
termination of such insurance.
Notwithstanding the prior submission of a Certificate of Insurance, copies of endorsements, or other
evidence initially acceptable to JWB, if requested by JWB, Provider shall, within thirty (30) calendar
days after receipt of a written request from JWB, provide JWB with a certified copy(ies) of the
policy(ies) providing the coverage required herein. Provider may redact or omit, or cause to be redacted
or omitted, those provisions of the policy or policies which are not relevant to the insurance required
herein.
j. Notice of Cancellation:
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All required policies must be endorsed to provide JWB with thirty (30) calendar days' prior notice of
cancellation.
k. Primary and Non -Contributory:
The insurance provided by the Provider shall apply on a primary basis to and shall not require
contribution from, any insurance maintained by JWB. Any insurance or self-insurance maintained by
JWB shall be in excess of, and shall not contribute with, the insurance provided by Provider.
1. Deductibles/Self-Insured Retentions:
Except as otherwise specifically authorized in this Agreement, no deductible or self-insured retention for
any insurance required of Provider pursuant to this Agreement will be allowed. To the extent any
required insurance is subject to any deductible or self-insured retention (whether with or without prior
approval of JWB), Provider shall be solely responsible for paying any such deductible or self-insured
retention.
m. Non-Waiver/Remedies:
Compliance with these insurance requirements shall not limit the liability of Provider, its subcontractors,
sub -subcontractors, employees or agents. Any remedy provided to JWB or JWB's Board members,
employees, volunteers, and agents by the insurance provided by Provider shall be in addition to and not
in lieu of any other remedy (including, but not limited to, as an indemnitee of Provider) available to
JWB under this Agreement or otherwise.
Neither approval nor failure to disapprove insurance furnished by Provider shall relieve Provider from
the responsibility to provide insurance as required by this Agreement.
Provider shall provide JWB with renewal or replacement evidence of insurance at least fifteen (15)
calendar days prior to the expiration or termination of such insurance. If Provider cannot meet this
timeline, notification must be made to the assigned JWB Program Consultant and maintain
communication until such time as evidence of insurance can be submitted to JWB.
27. Indemnification
Provider shall defend, indemnify, and hold harmless JWB, its agents, and employees from and against any and
all liabilities, claims, judgments, or actions including, but not limited to, attorney's fees and all costs 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, arising out of or relating to its performance of this Agreement or for Provider's
improper disclosure of confidential and/or exempt information, or failure to comply with F.S. 119 or any other
applicable law, rule or regulation. In no event will the Provider be liable for or have any obligation to defend
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JWB against such liability, claims, judgments, or actions, including costs and attorney's fees, arising out of the
sole negligent acts of JWB. This provision survives termination of the Agreement.
28. Certification that Provider is legally able to contract with JWB
In compliance with F.S. 287.135(a), a Provider is ineligible to and may not enter into a contract with JWB if the
Provider is on. the Scrutinized Companies that Boycott Israel List, created pursuant to s. 215.4725 or is engaged
in a boycott of Israel. In compliance with F.S. 287.135(b), for contracts of $1 million or more, a Provider is
ineligible to and may not enter into a contract with JWB if the Provider (1) is on the Scrutinized Companies
with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Section
List, created pursuant to s. 215.473 or, (2) is engaged in business operations in Cuba or Syria. By entering into
this Agreement, you are certifying that you are eligible to contract with JWB and are not participating in a
boycott of Israel, are not on the Scrutinized Companies with Activities in Sudan List, are not on the Scrutinized
Companies with Activities in the Iran Petroleum Energy Sector List and that you do not have business
operations in Cuba or Syria. In addition, this Agreement may be terminated if Provider (1) has found to have
submitted a false certification, (2) has been placed on the Scrutinized Companies that Boycott Israel List, or is
engaged in a boycott of Israel, (3) has been placed on the Scrutinized Companies with Activities In Sudan List
or the Scrutinized Companies with Activities in The Iran Petroleum Energy Sector List; or (4) has been engaged
in business operations in Cuba or Syria.
29. E-Verifv
In accordance with F. S. 448.095, no later than the first date of the term Agreement, Provider must register with
and use the U.S. Department of Homeland Security's E -Verify system to verify the work authorization status of
all employees hired on or after the first date of the term Agreement and during the remainder of the term of this
Agreement. Evidence may consist of, but is not limited to, providing notice of your E -Verify number. Instructions
on how to provide proof of participation/E-Verify enrollment is on the U.S Department of Homeland Security's
E -Verify website.
The statute also applies to subcontractors performing work under this Agreement. The subcontractor must use
the E -Verify system for any employees it may hire during the term of this Agreement. The Subcontractors must
provide affidavits stating the subcontractor does not employ, contract with, or subcontract with an unauthorized
alien, as defined by F. S. § 448.095(k). Subcontractors are defined in Florida Statute as both individuals and
legal entities. Provider must maintain copies of all subcontractor affidavits for the duration of the JWB
Agreement and these affidavits shall be subject at all times to inspection, review, or audit by JWB personnel or
its duly authorized agent.
Notwithstanding any other terms of this Agreement, if JWB has a good faith belief that you have knowingly hired,
recruited or referred an alien who is not duly authorized to work by the immigration laws or the Attorney General
of the United States, JWB shall terminate this Agreement. Provider may be liable for all costs associated with
JWB securing the same services, inclusive, but not limited to, higher costs for the same services and rebidding
costs (if necessary). Any challenge to termination under this provision must be filed in the Circuit Court no later
than 20 calendar days after the date of termination. If this Agreement is terminated for a violation of the statute,
Provider may not be awarded a public contract for a period of one (1) year after the date of termination.
FY23 City of Clearwater -Charting the Course for Youth
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IX. SIGNATURES
bcfL. tte44.6w
Chief Executive Officer: Juvenile Welfare Board
of Pinellas County
City Manager: City of Clearwater
Beth A. Houghton Jon Jennings
8/26/2022 1 4:25 PM EDT
Date
FY23 City of Clearwater -Charting the Course for Youth
Date fijigf2 7Z.
ATTEST
Rosemarie Call
City Clerk
APPROVED AS TO FORM AND CONTENT
Owen Kohler
Lead Assistant City Attorney
Countersigned:
Frank Hibbard
Mayor
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Attachment 1
Special Conditions of the Agreement
The following condition(s) applies to the program(s):
Charting the Course for Youth
Provider approved COST program shall adhere to the JWB approved Program Service Matrix Model Program
Components for Out of School Time Programming.
The Provider will work with the assigned JWB Evaluator to implement the Florida Afterschool Network
Quality Self -Assessment. The provider must identify a self-assessment coordinator who will work with the
JWB Evaluator to conduct the self-assessment. The self-assessment must be completed and associated
performance improvement plan (as appropriate) must be established by the end of the fiscal year.
The Provider and all facilities legally required to be licensed must maintain valid licensure. Facilities not
required to be licensed must maintain a Certificate of Substantial Compliance issued by the Pinellas County
License Board (PCLB). Facilities operated during the summer only are considered Summer Day Camps
pursuant to PCLB current regulations. Should any Provider or facility's license or certification be revoked, not
renewed, or suspended during the time services are being provided hereunder, the Provider must immediately
notify JWB within twenty-four (24) hours in writing and said Provider or facility is no longer qualified to
provide services to the Recipients under the terms of this Agreement. At all times during this Agreement,
Provider and/or facility's license must be considered in Good Standing, which is defined as having no
probationary license status within the preceding twelve (12) months. Should Provider be a party to any written
agreement with the Early Learning Coalition (ELC) during the term of this Agreement, Provider must advise
JWB in writing of the contract. If Provider's contract with ELC is terminated or suspended at any time during
this Agreement, Provider must, within twenty-four (24) hours, notify JWB in writing and Provider or facility
may no longer be qualified to provide the services pursuant to this Agreement. Provider authorizes JWB to
speak with PCLB, ELC and any other entity regulating the Provider about anything relevant to Provider's child
care license, history of providing care or anything else deemed relevant by JWB.
General Condition #10 - Assignments and Subcontracts- The last sentence of paragraph two and of paragraph
three in this section are waived: Provider is exempted from submitting Subcontracts, Subcontract Assessments
and Subcontract monitoring documentation for individual (not incorporated) providers of overlay services and
tutoring services if said individuals of those services are not left alone with children. All other terms of General
Condition #10 shall remain the same.
General Condition #18 - Provider is waived from personnel file.monitoring with JWB wherein the Provider has
no non -compliances on PCLB's most recent monitoring report/inspection checklist/complaint investigation in
the area of Personnel and at the time of JWB monitoring is in full compliance with all PCLB regulations
pertaining to Personnel, including, but not limited to, personnel records and background screening. JWB
reserves the right to monitor personnel files at any time, including if a non-compliance is noted during PCLB's
monitoring/inspection/investigation and at any time JWB deems necessary. Provider will give JWB staff access
to all PCLB monitoring reports/inspection checklist/complaint investigations. All other provisions of the
Condition remain.
FY23 City of Clearwater -Charting the Course for Youth
Page 23 of 31
DocuSign Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
Provider shall upload Quarterly Status Reports inclusive of staff turnover and vacancy rates. Quarterly reports
shall be uploaded to JWB's Secure Portal by the 20th of the month following the reporting period (i.e. January
20th, April 20th, July 20th, and October 20th). The reports and calculations shall be made using the rate
calculators provided in the Workforce Stabilization application.
Provider will ensure that any and all required certifications and credentials for water safety or swiminstruction
are current throughout the term Agreement period for all applicable staff.
Provider will ensure that all pool facilities used by Provider comply with all applicable laws, rules and
regulations and maintain current inspections, permits and licenses for safe operation of a public swimming pool
in accordance with the Florida Department of Health in Pinellas County.
JWB funding is contingent upon the Provider reporting the number of participants that receive swim lessons,
time period the lessons are provided, the type of certification held by Life guard/Water Instructor, hourly wage
and the number of hours allocated to the activity.
All vehicles used by the Provider to transport any program participants in a JWB funded program must be
equipped with an alarm system approved by the Department of Children and Families and meeting the criteria
in the CC/SS Facility Handbook that prompts the driver to inspect the vehicle for the presence of children
before exiting the vehicle. Alarms must be installed and maintained according to the manufacturer's
recommendations.
The program will be measured using the standardized assessment for English Language Arts as identified by
Pinellas County Schools.
The program will be measured using the standardized assessment for Math as identified by Pinellas County
Schools.
The following condition(s) applies to the Provider:
City of Clearwater
General Condition #2f - The last sentence is waived: Provider is not required to submit a Continuity of
Operations Plan to JWB.
General Condition #2h - The sentence is waived: Due to the Provider being subject to the Code of Ethics for
Public Officers and Employees, adopted by the Legislature as Part III of Chapter 112, Florida Statutes, the
Provider is not required to have a written conflict of interest policy and to obtain appropriate signed statements
from its governing board members, officers, and employees on an annual basis.
General Condition #6 - Board Members and Training is waived.
General Condition #11 - Confidential Information- fifth paragraph, the sentence that states, "Provider shall
defend, indemnify and hold harmless JWB from any and all damages caused by the improper disclosure of any
confidential information as defined by law including, but not limited to, Protected Health Information under
HIPAA and any and all costs associated with remedying the disclosure." is stricken and replaced with the
following: "Provider shall defend, indemnify, and hold harmless JWB from any and all damages caused by the
FY23 City of Clearwater -Charting the Course for Youth
Page 24 of 31
DocuSign Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
provider's improper disclosure of any information including, but not limited to, Protected Health Information
under HIPAA and any and all costs associated with remedying the disclosure subject to the doctrine of
sovereign immunity and limitations set forth in F.S. 768.28."
General Conditions #25 and #26- Insurance Requirements are waived wherein the Provider maintains
responsibility for the delivery of services. Should the Provider assign or subcontract any of the work
contemplated under this Agreement to a non-governmental entity, or to a non -Florida governmental entity, this
Insurance Requirements waiver is not applicable to the subcontracted services portion of the contract.
Nongovernmental subcontractors and non -Florida governmental subcontractors must demonstrate compliance
with the insurance requirements for all subcontracted services performed for Provider for JWB-funded
programs. Provider is solely responsible for ensuring subcontractors of the Agreement are in compliance with
the minimum insurance requirements as described in General Conditions #25 and #26.
General Condition #27 - Indemnification is replaced with "The Provider agrees to be fully responsible for all
claims arising out of its own acts of negligence or its respective employees' acts of negligence when acting
within the scope of their employment and agrees to be liable for any damages proximately caused thereby;
provided, however, that the Provider's liability is subject to the monetary limitations and defenses imposed by
section 768.28, F.S. Nothing herein is intended to serve as a waiver of sovereign immunity by the Provider, nor
shall anything herein be construed as consent by the Provider to be sued by any third party for any cause or
matter arising out of or related to this Agreement except to the extent provided by 768.28, F.S."
FY23 City of Clearwater -Charting the Course for Youth
Page 25 of 31
DocuSign Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
Attachment 2
Geographical Service Area
Provider agrees whenever possible to maintain service sites which are accessible by public transportation and
convenient to the target participant group. Provider will advise JWB of any changes made in service sites.
The geographical service area for this agreement is as follows:
Program Name
Charting the
Course for
Youth
Participants
are eligible
Countywide
Participants are eligible NI ho reside Participants are eligible from the
in the following ZIP codes: follow ing sere ice areas:
Participants will primarily reside in zip codes
33755, and 33756. In addition, participants
can reside in the following zip codes: 33763,
33764, 33765, 33770, 33778, 34677, 34695
and 34698.
FY23 City of Clearwater -Charting the Course for Youth
Page 26 of 31
DocuSign Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
t•jwb
Juvenile Welfare Board Attachment 3
*In order to receive payment on the Reimbursement Date, invoices/reimbursement requests must be
submitted to JWB by the Submission Due Date (Wednesday), to allow for proper review, and approval by
JWB staff.
ACCOUNTS PAYABLE SCHEDULE - FY 2023
Pay#
Submission Due Date *
(Wednesday)
Reimbursement Date (Friday)
1
10/05/22
10/14/22
2
10/19/22
10/28/22
3
11/02/22
11/11/22
4
11/16/22
11/25/22
5
11/30/22
12/09/22
6
12/14/22
12/23/22
7
12/28/22
01/06/23
8
01/11/23
01/20/23
9
01/25/23
02/03/23
10
02/08/23
02/17/23
11
02/22/23
03/03/23
12
03/08/23
03/17/23
13
03/22/23
03/31/23
14
04/05/23
04/14/23
15
04/19/23
04/28/23
16
05/03/23
05/12/23
17
05/17/23
05/26/23
18
05/31/23
06/09/23
19
06/14/23
06/23/23
20
06/28/23
07/07/23
21
07/12/23
07/21/23
22
07/26/23
08/04/23
23
08/09/23
08/18/23
�
;:
.. w:.
LL .n. - _,x.138 3/23
-. '09/0170 .. _ ... _
25
09/06/23
09/15/23
26
09/20/23
09/29/23
27
10/04/23
10/12/2023 (September business)
FY23 City of Clearwater -Charting the Course for Youth
Page 27 of 31
DocuSign Envelope ID: DDBEB2CD-CE65-4047-8163-F92096A8C8D2
28
10/18/23
10/26/2023 (September business)
FY23 City of Clearwater -Charting the Course for Youth
Page 28 of 31
DocuSign Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
Attachment 4
Document Submittal Chart
This chart is intended as a guide. Submittals required in the General and Special Corsets_ _ _
•
•
the
Prov ides Document
Approved program methodology
A' reement su 1 erseae tms . uiue.
Time Frame
Throughout the period of the
Agreement
-- -_ - ---
Subn►it "lo
_
-
Agency Specific JW — '
Portal Site
COOP -WAIVED
Within thirty (30) calendar days of
effective date of Agreement
Agency Specific JW
iVIIIININEMWOMINNIIIMMOW•e
,•-.==
Portal Site -
v_
Most Recent Audit
Immediately upon receipt by the
Provider's board or not to exceed 180
days of the close of the Provider's
fiscal year
—
Y
Agency Specific JVD,
.
Portal Site
Fee Schedules
Within thirty (30) calendar days of the
effective date of this agreement and
upon making changes to the fee
schedule
Agency Specific JW '
Portal Site
Monitoring, Site Visit,
Accreditation and Licensing
Reports
No more than thirty (30) calendar days
following Provider receipt
Agency Specific Jw
:-
Portal Site —
Notification of Change in
Participant and/or Finance Data
Base
Within ninety (90) calendar days in
advance of any changes
Email to JWB ChiefF 1hv
Officer
s
x -
____ __
Board Member List -WAIVED
Within thirty (30) calendar days of the
effective date of this agreement and
approval of any change of board
composition
Agency Specific JA n ' t uri
Portal Site
,,,,,,,,;.;,;,...
Board Training (Outline of topics,
members in attendance, and who
provided training) -WAIVED
Within six (6) months of joining the
Provider board, evidence of training
new board members must be provided
to JWB within 30 days of the training.
J
Agency Specific JWWSecure
Portal Site
-
Subcontracts - Waived in the
case of independent providers of
tutoring and overlay providers
Within thirty (30) calendar days of the
effective date of this Agreement and
upon revision, amendment and
po----
execution thereafter.
_
Agency Specific JWB Secure
Portal Site
------ ----
__-- -- ___
Subcontract Assessment - Waived
in the case of independent
providers of tutoring and
overlay providers
Within thirty (30) calendar days of the
effective date of this Agreement ander
upon revision, amendment and
execution thereafter.
Ageeay�fie 1;..-,
N...,,.....
Portal Site
t
FY23 City of Clearwater -Charting the Course for Youth
Page 29 of 31
DocuSign Envelope ID: DDBEB2CD-CE65-4047-8163-F92096A8C8D2
Subcontract Monitoring
Documentation - Waived in the
case of independent providers of
tutoring and overlay providers
No more than thirty (30) calendar days
following completion of the
monitoring activities.
Agency Specific JWB Secure
Portal Site
Incident Reports
Within one (1) business day of
knowledge of any incident
IRreviewteam@jwbpinellas.org
Executive Director Affidavit
(Providers using VECHS) - Not
applicable
Within thirty (30) calendar days of the
effective date of this Agreement and
upon change of staff in this position
Agency Specific JWB Secure
Portal Site
Procedure for General Condition
#18 - Provider Staff Background
Checks (Providers using VECHS)
- Not applicable
Within thirty (30) calendar days of the
effective date of this Agreement
Agency Specific JWB Secure
Portal Site
Drug -Free Workplace policy
Within thirty (30) calendar days of
effective date of Agreement and upon
revision and approval by the Provider's
board
Agency Specific JWB Secure
Portal Site
Insurance Documentation -
WAIVED — Unless services are
Subcontracted
Throughout the period of the
Agreement and with renewal or
replacement at least fifteen (15)
calendar days prior to the expiration or
termination of such insurance.
Agency Specific JWB Secure
Portal Site
FY23 City of Clearwater -Charting the Course for Youth
Page 30 of 31
n Envelope ID: DDBEB2CD-CE65-4D47-8163-F92096A8C8D2
Attachment 5
City of Clearwater
Charting the Course for Youth
Performance Measurement
Outcome Measure
2022-10-01 - 2023-09-30
Target Description
90% of eligible participants will
indicate satisfaction in all
applicable domains in the
program's OST survey.
95% of participants will miss less
than 10% of school days
Process Measure
Notes
The survey assesses participant opinions about satisfaction in the
program, including in the domains of program engagement, SEL,
leadership, academics, STEAM, and healthy decision making.
Eligibility is defined as being enrolled in grades 3 or higher,
enrolled before January, and active during the administration
period (May). The denominator includes all participants who are
eligible, while the numerator counts the number of people, out of
those eligible, who took the survey. Applicable domains include
program engagement, SEL, academics, and STEAM.
This will include both excused and unexcused absences from
school. Eligibility: Participants who are enrolled between the
months of Aug of the prior FY and May who have at least 30
days of programmatic attendance.
2022-10-01 - 2023-09-30
Target Description
65% of eligible participants
continued in the program for at
least two consecutive years.
70% of eligible participants will
attend 70% of program days or
more
FY23 City of Clearwater -Charting the Course for Youth
Notes
Eligibility: Any participant who could return to the program.
Initially in the program 30 days. Currently in the program 30
days or more.
Consecutive years: Served in two fiscal years back to back.
Eligibility: Participants who attend the program for at least 30
days