Loading...
PROGRAM CONTRACT - AMENDMENT REVIEW AND APPROVAL FORM (2)DocuSign Envelope ID: BDE6D597-FDC1-4FD3-6BFC-093B0CFD36D7 Nib 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 Contract Amendment Annualized Contract Amount: $ 480, 897 Brief Explanation: This is Contract Amendment #1 - FY23 Water Safety Instruction Expansion. 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 Elaine Melkioty at emelkioty@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. Senior Manager, Program Administration E. Melkioty a:44Htk q 2/9/2023 110:46 AM EST Senior Manager, Performance and Evaluation (if applicable) M. Seales 2/11/2023 1 6:30 AM EST Senior Manager, Program Finance (if applicable) S. Gill G 2/13/2023 1 7:54 AM EST Chief Program Officer K. Boggess bows 2/13/2023 1 8:34 AM EST Chief Financial Officer L. Krueger Brock K444421€4,14.064 2/13/2023 1 9:54 AM EST Chief Evaluation & Innovation Officer B. Morrison -Rodriguez Vr. Nrifara IM.ewisaln.—leet,rir-A) 2/13/2023 1 10:03 AM EST DocuSign Envelope ID: BDE6D597-FDC1-4FD3-8BFC-093B0CFD36D7 tiWb Nio Juvenile Welfare Board Investing in children. Strengthening our community. BOARD MEMBERS Michael G. Mikurak, Chair Gubernatorial Appointee The Honorable Patrice Moore, Vice Chair Sixth Judicial Circuit Court The Honorable Rick Butler, Secretary Gubernatorial Appointee Brian J. Aungst, Jr. Gubernatorial Appointee The Honorable Bruce Bartlett State Attorney Kevin K. Hendrick Pinellas County Schools Superintendent The Honorable Chris Latvala Pinellas County Commissioner Division Chief Jim Millican Gubernatorial Appointee The Honorable Sara Mollo Public Defender Mrs. Susan Rolston Gubernatorial Appointee Beth A. Houghton Chief Executive Officer Juvenile Welfare Board of Pinellas County 14155 58th St. N., Ste. 100 Clearwater, FL 33760 P: 727.453.5600 F: 727.453.5610 JWBPinellas.org @JWBPinellas February 9, 2023 Jennifer Poirrier, Interim City Manager City of Clearwater P.O. Box 4748 Clearwater, Florida 33758 Subject: FY23 Amendment #1 to JWB Agreement Dear Mrs. Poirrier, This letter serves to amend the FY23 Agreement between the City of Clearwater Charting the Course for Youth and Juvenile Welfare Board of Pinellas County (JWB). On February 1, 2023, the JWB Chief Executive Officer approved a one-time budget increase in the amount of $12, 000 to support the expansion of swim lessons at McMullen Booth and Eisenhower Elementary schools for students in Kindergarten through Second grade. Further, approved funding will support the staffing of certified swim instructors. This is amendment #1 to the Agreement and increases the total allocation from $468, 897 to $480, 897. This letter will become an amendment to the current agreement and will become effective on the date of the final signature of the Juvenile Welfare Board Chief Executive Officer. All other terms and conditions of the Agreement shall remain the same. If you have any questions or concerns relating to this contract amendment, please contact me at (727) 453-5663. If this Amendment meets your approval, please sign on the signature line below and return this contract amendment to the Juvenile Welfare Board. Sincerely, SDsewow 710... 2/9/2023 1 9:51 AM EST Desmon Newton Senior Program Consultant DocuSign Envelope ID: BDE6D597-FDC1-4FD3-8BFC-093B0CFD36D7 6UL Lkou ew 2/13/2023 1 10:18 AM EST Beth Houghton Chief Executive Officer Juvenile Welfare Board of Pinellas County CITY OF CLEARWATER, FLORIDA J:" fe i' oirrier Interim City Manager Ap Date ved as to form: Attest: wen K . hler Lead Assistant City Attorney Rosemarie Call City Clerk Ce, rii ate t € Completion Envelope Id: BDE6D597FDC14FD38BFC093BOCFD36D7 Subject: FY23 City of Clearwater - Charting the Course for Youth Contract Amendment #1 Source Envelope: Document Pages: 3 Certificate Pages: 6 AutoNav: Enabled Envelopeld Stamping: Enabled Time Zone: (UTC -05:00) Eastern Time (US & Canada) Signatures: 8 Initials: 0 Record Tracking Status: Original 2/9/2023 6:05:55 AM Signsr Events Desmon Newton dnewton@jwbpinellas.org Senior Program Consultant JWB - Pinellas Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Elaine Melkioty emelkioty@jwbpinellas.org Senior Manager, Program Administration JWB - Pinellas Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Megan Seales mseales@jwbpinellas.org Senior Manager, Performance and Evaluation JWB - Pinellas Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Stacey Gill sgill@jwbpinellas.org Sr Program Finance Manager JWB - Pinellas Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Holder: Desmon Newton dnewton@jwbpinellas.org Signa Signature Adoption: Pre -selected Style Using IP Address: 174.211.225.170 E14:44 Hetia44j Signature Adoption: Pre -selected Style Using IP Address: 136.174.187.5 litulsaik, Sulu. Signature Adoption: Pre -selected Style Using IP Address: 47.203.170.148 Signed using mobile Suay Signature Adoption: Pre -selected Style Using IP Address: 65.35.26.7 DocuSigrr Status: Completed Envelope Originator: Desmon Newton 14155 58th Street North Clearwater, FL 33760 dnewton@jwbpinellas.org IP Address: 67.9.155.55 Location: DocuSign Timestap Sent: 2/9/2023 6:42:17 AM Viewed: 2/9/2023 9:51:42 AM Signed: 2/9/2023 9:51:49 AM Sent: 2/9/2023 9:51:59 AM Viewed: 2/9/2023 10:46:38 AM Signed: 2/9/2023 10:46:50 AM Sent: 2/9/2023 10:46:58 AM Viewed: 2/11/2023 6:29:55 AM Signed: 2/11/2023 6:30:05 AM Sent: 2/11/2023 6:30:13 AM Viewed: 2/13/2023 7:53:50 AM Signed: 2/13/2023 7:54:17 AM Signer Events Karen Boggess KBoggess@jwbpinellas.org Chief Program Officer Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 2/13/2023 8:33:35 AM ID:3e41ecd0-f856-43ad-b7d8-a98a115f0b8d Laura Krueger Brock Ibrock@jwbpinellas.org Chief Financial Officer Juvenile Welfare Board Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 10/14/2020 9:51:52 AM ID:67c5b7c9-f9e6-4b3f-9807-c8d3a18f6bbe Dr. Barbara Morrison -Rodriguez bmorrisonrodriguez@jwbpinellas.org CEIO Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 2/13/2023 10:03:26 AM ID: 3c2a7adc-f323-44ee-8126-32f48b9e2eba Beth Houghton bhoughton@jwbpinellas.org CEO Juvenile Welfare Board Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 2/13/2023 10:18:20 AM ID:603945ad-af98-439e-8123-24099954e408 In Person Signer Events Editor Delivery Eve Agent Delivery Events s gnatu karw, fjbwSS Signature Adoption: Pre -selected Style Using IP Address: 35.142.94.64 14•••4a ,444•41,14* Signature Adoption: Pre -selected Style Using IP Address: 96.59.167.163 boxim a i uvrisat&—Kb Signature Adoption: Pre -selected Style Using IP Address: 107.123.37.50 Signed using mobile Signature Adoption: Pre -selected Style Using IP Address: 47.197.223.17 Signed using mobile Tirnestamp Sent: 2/13/2023 7:54:23 AM Viewed: 2/13/2023 8:33:35 AM Signed: 2/13/2023 8:34:10 AM Sent: 2/13/2023 8:34:17 AM Viewed: 2/13/2023 9:54:09 AM Signed: 2/13/2023 9:54:36 AM Sent: 2/13/2023 9:54:41 AM Viewed: 2/13/2023 10:03:26 AM Signed: 2/13/2023 10:03:46 AM Sent: 2/13/2023 10:04:00 AM Viewed: 2/13/2023 10:18:20 AM Signed: 2/13/2023 10:18:52 AM tnterlmedlary Delivery Event Certified Delivery Events Carton Copy Events Jennifer Poirrier Jennifer.poirrier@myclearwater.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign COPIED Sent: 2/13/2023 10:03:54 AM Carbon Copy Events Sandy Clayton Sandra.Clayton@myclearwater.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 10/13/2021 9:02:25 AM ID: 2871d8cc-8530-4126-8ab4-2495089dbac4 Ramon Pires Ramon.Pires@MyClearwater.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Tessa Burnsed tburnsed@jwbpinellas.org Department Coordinator JWB - Pinellas Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Danielle Hintz dhintz@jwbpinellas.org Community Collaborations Manager Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 2/6/2023 12:04:05 PM ID:d656868d-4ff5-4b75-bfba-853538bb1e2f Owen Kohler Owen.Kohler@MyClearwater.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Art Kader Art.Kader@myClearwater.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Envelope Summary Envelope Sent Certified Delivered Signing Complete Completed Payment Ev Electronic Record and Signal Status COPIED COPIED COPIED COPIED COPIED COPIED Signature Sigc Status Hashed/Encrypted Security Checked Security Checked Security Checked tatus ure Timestamp Sent: 2/13/2023 10:03:54 AM Viewed: 2/13/2023 11:10:15 AM Sent: 2/13/2023 10:03:54 AM Viewed: 2/13/2023 10:10:12 AM Sent: 2/13/2023 10:19:02 AM Sent: 2/13/2023 10:19:09 AM Sent: 2/13/2023 10:19:16 AM Viewed: 2/13/2023 10:29:55 AM Sent: 2/13/2023 10:19:23 AM Timestamp Timestamp Tim tam 2/9/2023 6:42:17 AM 2/13/2023 10:18:20 AM 2/13/2023 10:18:52 AM 2/13/2023 10:19:23 AM Electronic Record and Signature Disclosure created on: 10/6/2020 9:41:24 AM Parties agreed to: Karen Boggess, Laura Krueger Brock, Dr. Barbara Morrison -Rodriguez, Beth Houghton, Sandy Clayton, Danielle Hintz ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, Juvenile Welfare Board (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to `I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below. Withdrawing your consent If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. How to contact Juvenile Welfare Board: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by phone call: 727-453-5688 To contact us by email send messages to: pshaw@jwbpinellas.org To contact us by paper mail, please send correspondence to: Juvenile Welfare Board 14155 58th Street North Clearwater, FL 33760 To advise Juvenile Welfare Board of your new email address To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at pshaw@jwbpinellas.org and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address. If you created a DocuSign account, you may update it with your new email address through your account preferences. To request paper copies from Juvenile Welfare Board To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to pshaw@jwbpinellas.org and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any. To withdraw your consent with Juvenile Welfare Board To inform us that you no longer wish to receive future notices and disclosures in electronic format you may: i. decline to sign a document from within your signing session, and on the subsequent page, select the check -box indicating you wish to withdraw your consent, or you may; ii. send us an email to pshaw@jwbpinellas.org and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process.. Required hardware and software The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guide- signing-system-requirements. Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check -box next to `I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system. By selecting the check -box next to `I agree to use electronic records and signatures', you confirm that: • You can access and read this Electronic Record and Signature Disclosure; and • You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and • Until or unless you notify Juvenile Welfare Board as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by Juvenile Welfare Board during the course of your relationship with Juvenile Welfare Board.