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PROGRAM CONTRACT - AMENDMENT REVIEW AND APPROVAL FORM (3) DocuSign Envelope I D: DFC9571 C-21 F3-4366-AFDO-8BDDE7125AF8 ojwb 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: FY24 Contract Amendment Annualized Contract Amount: $510,211 Brief Explanation: Contract Amendment#I for the City of Clearwater— Charting the Course for Youth program to support swim lessons and retention of qualified staff. 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. REVIEWER TITLESIGNATURE DATE Senior Manner, Pro ram Administration Elm Mcl(a. 1/26/2024 1 4:32 PM E5 E. Melkio Senior Manner, Performance nd Evaluation if applicable �y� S � V 1/26/2024 1 5:19 PM E5 M. Scales Senior Manner, Program Finance if licable S. Gill 1/29/2024 1 8:08 AM EST Chief Program Officer K. BoggessaVt,tn I°Jb�c SS 1/29/2024 1 8:41 AM EST Chief Financial Officer L. Krueger Brock � � 3� 1/29/2024 1 9:46 AM EST Chief Evaluation& Innovation Officer B. Morrison-Rodriguez Vr. barara A/I.bVY'w,—O,Vtjw� 1/29/2024 1 9: 53 AM EST DocuSign Envelope ID: DFC9571 C-21 F3-4366-AFDO-8BDDE7125AF8 I b F No.00 Juvenile Welfare Board Investing in children. Strengthening our community BOARD MEMBERS January 17, 2024 The Honorable Patrice Moore, Chair Jennifer Poirrier, City Manager Sixth Judicial Circuit Court City of Clearwater P.O. Box 4748 Division Chief Jim Millican,Vice Clearwater, Florida 33758 Chair Gubernatorial Appointee Subject: FY24 Amendment#1 to JWB Agreement The Honorable Bruce Bartlett, Board Secretary Dear Ms. Poirrier, State Attorney Brian J.Aungst,Jr. This letter serves to amend the FY24 Agreement between the City of Gubernatorial Appointee Clearwater Charting the Course for Youth and Juvenile Welfare Board of Pinellas County (JWB). On January 2, 2024, the JWB Chief Executive Kristen Gnage Officer approved a continual budget increase in the amount of$24, 000 to Gubernatorial Appointee support swim lessons and retain qualified employees. Kevin K. Hendrick Pinellas County Schools Moreover, the funding will cover the costs for full-time lifeguard's and their Superintendent benefits at McMullen Elementary, Eisenhower Elementary, Skycrest The Honorable Chris Latvala Elementary and Bellaire Elementary schools. Funding will support budget Pinellas County Commissiondiscrepancies resulting from an increase in salaries due to a Class and er Compensation study. Michael G. Mikurak Gubernatorial Appointee This is amendment#1 to the Agreement and increases the total allocation from $486,211 to $510,211. The Honorable Sara Mollo Public Defender This letter will become an amendment to the current agreement and will Melissa Rutland become effective on the date of the final signature of the Juvenile Welfare Gubernatorial Appointee 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 Beth A. Houghton this Amendment meets your approval, please sign on the signature line below Chief Executive Officer and return this contract amendment to the Juvenile Welfare Board. Sincerely, Juvenfle Welfare Board D"~,V W~ on, 1/29/2024 1 9: 54 AM EST of Pinellas County Desmon Newton Date 14155 58uh S'. N., Ste. 100 Senior Program Consultant Clearv,ater, FL 337(,:')o P: 727.,J53.56'-)0 F: 72-1.45-1,,.S610 JW B P i ne I a s.o r�:i (d)J W B P i n e I I a s DocuSign Envelope ID: DFC9571 C-21 F3-4366-AFD0-8BDDE7125AF8 CITY OF CLEARWATER, FLORIDA ,,t,laltirt,V' Poivnt,r 2/1/2024 1 1:30 PM EST Jennifer Poirrier City Manager Date Approved as to form: Attest: etwuA, r`&tr 1/29/2024 1 3:54 PA S Q4U 2/1/2024 1 4:04 PM EST Owen Kohler Date Rosemarie Call Lead Assistant City Attorney City Clerk Beth Houghton Chief Executive Officer Juvenile Welfare Board of Pinellas County 2/1/2024 1 5:13 PM EST Date Date 2 Docu i nk Certificate Of Completion Envelope Id:DFC9571 C21 F34366AFD08BDDE7125AF8 Status:Completed Subject: FY24 City of Clearwater-Charting the Course for Youth Contract Amendment#1 for Signature Source Envelope: Document Pages:3 Signatures: 11 Envelope Originator: Certificate Pages:7 Initials:0 Desmon Newton AutoNav: Enabled 14155 58th Street North Envelopeld Stamping: Enabled Clearwater, FL 33760 Time Zone:(UTC-05:00)Eastern Time(US&Canada) dnewton@jwbpinellas.org IP Address:67.9.155.55 Record Tracking Status:Original Holder: Desmon Newton Location:DocuSign 1/26/2024 3:50:37 PM dnewton@jwbpinellas.org Signer Events Signature Timestamp Elaine Melkioty Sent: 1/26/2024 4:18:36 PM emelkioty@jwbpinellas.org E""".w4za�' Viewed: 1/26/2024 4:32:18 PM Senior Manager,Program Administration Signed: 1/26/2024 4:32:27 PM JWB-Pinellas Security Level: Email,Account Authentication Signature Adoption:Pre-selected Style (None) Using IP Address:35.137.197.201 Signed using mobile Electronic Record and Signature Disclosure: Not Offered via DocuSign Megan Seales Sent: 1/26/2024 4:32:28 PM mseales@jwbpinellas.orge SPGQR� Viewed: 1/26/2024 5:19:15 PM Senior Manager,Performance and Evaluation Signed: 1/26/2024 5:19:25 PM JWB-Pinellas Security Level: Email,Account Authentication Signature Adoption:Pre-selected Style (None) Using IP Address: 172.56.97.206 Signed using mobile Electronic Record and Signature Disclosure: Not Offered via DocuSign Stacey Gill Sent: 1/26/2024 5:19:27 PM sgill@jwbpinellas.org '" `�G"u Viewed: 1/29/2024 8:08:07 AM Sr Program Finance Manager Signed: 1/29/2024 8:08:17 AM JWB-Pinellas Security Level: Email,Account Authentication Signature Adoption:Pre-selected Style (None) Using IP Address:65.35.26.7 Electronic Record and Signature Disclosure: Not Offered via DocuSign Karen Boggess Sent: 1/29/2024 8:08:18 AM KBoggess@jwbpinellas.org ]5b%GSS Viewed: 1/29/2024 8:41:36 AM Chief Program Officer Signed: 1/29/2024 8:41:53 AM Security Level: Email,Account Authentication (None) Signature Adoption:Pre-selected Style Using IP Address:35.142.89.148 Electronic Record and Signature Disclosure: Accepted: 1/29/2024 8:41:36 AM I D:455eec73-2c3f-45a6-ac97-f65eb55ce6a3 Signer Events Signature Timestamp Laura Krueger Brock Sent: 1/29/2024 8:41:57 AM Ibrock@jwbpinellas.org �" "�GOGk Viewed: 1/29/2024 9:46:14 AM Chief Financial Officer Signed: 1/29/2024 9:46:49 AM Juvenile Welfare Board Security Level: Email,Account Authentication Signature Adoption:Pre-selected Style (None) Using IP Address:96.59.170.4 Electronic Record and Signature Disclosure: Accepted: 10/14/2020 9:51:52 AM ID:67c5b7c9-f9e6-4b3f-9807-c8d3a18f6bbe Dr. Barbara Morrison-Rodriguez ��''"� Sent: 1/29/2024 9:46:50 AM bmorrisonrodriguez@jwbpinellas.org Or. �7x&rx MbVVtSDtn—'Dat vt�Ut Rj Viewed: 1/29/2024 9:53:05 AM COO Signed: 1/29/2024 9:53:30 AM Security Level: Email,Account Authentication (None) Signature Adoption:Pre-selected Style Using IP Address: 12.75.127.49 Signed using mobile Electronic Record and Signature Disclosure: Accepted: 1/29/2024 9:53:05 AM I D:a782cca5-f289-45d9-b587-2cc3c6362806 Desmon Newton Sent: 1/29/2024 9:53:34 AM dnewton@jwbpinellas.org ��'NOf �2e�Of Viewed: 1/29/2024 9:54:15 AM Senior Program Consultant Signed: 1/29/2024 9:54:25 AM JWB-Pinellas Security Level: Email,Account Authentication Signature Adoption:Pre-selected Style (None) Using IP Address: 174.218.247.252 Electronic Record and Signature Disclosure: Not Offered via DocuSign Owen Kohler Sent: 1/29/2024 9:54:28 AM Owen.Kohler@MyClearwater.com I�WUA, 6Wkr Viewed: 1/29/2024 3:54:33 PM Security Level: Email,Account Authentication Signed: 1/29/2024 3:54:58 PM (None) Signature Adoption:Pre-selected Style Using IP Address:47.198.2.217 Electronic Record and Signature Disclosure: Accepted: 1/29/2024 3:54:33 PM ID:679e1275-d83a-4389-a727-9afdc1ce2e81 Jennifer Poirrier Sent: 1/29/2024 3:55:00 PM Jennifer.poirrier@myclearwater.com , bt.lAaFtr pbimtr Resent: 1/30/20244:30:32 PM Security Level: Email,Account Authentication Viewed:2/1/2024 1:30:13 PM (None) Signed:2/1/2024 1:30:30 PM Signature Adoption:Pre-selected Style Using IP Address:4.53.173.18 Electronic Record and Signature Disclosure: Accepted:2/1/2024 1:30:13 PM ID: 1d981a23-b134-4ae4-95dc-f90540946d74 Rosemarie Call �^^ Sent:2/1/2024 1:30:32 PM n Rosemarie.CalI@myclearwater.com k"tW A,11 LXX. Viewed:2/1/2024 4:04:39 PM City Clerk Signed:2/1/2024 4:04:59 PM City of Clearwater Security Level: Email,Account Authentication Signature Adoption:Pre-selected Style (None) Using IP Address:4.53.173.18 Electronic Record and Signature Disclosure: Signer Events Signature Timestamp Accepted: 1/25/2024 2:21:09 PM ID:2460c08l-a8f0-4c5e-9abd-043b5942b310 Beth Houghton Sent:2/1/2024 4:05:01 PM bhoughton@jwbpinellas.org 154 N+6v" Viewed:2/1/2024 5:13:04 PM CEO Signed:2/1/2024 5:13:45 PM Juvenile Welfare Board Security Level: Email,Account Authentication Signature Adoption:Pre-selected Style (None) Using IP Address:47.201.162.134 Signed using mobile Electronic Record and Signature Disclosure: Accepted:2/1/2024 5:13:04 PM ID:d628d3f7-ec56-4f6b-a0ff-749471164647 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Amanda Baier � Sent:2/1/2024 5:13:47 PM abaier@jwbpinellas.org ED Viewed:2/1/2024 5:18:34 PM Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 1/8/2024 8:51:47 AM ID:4b6d0e22-a5b2-4486-a59f-58f34178623d Braxton Everett Sent:2/1/2024 5:13:47 PM beverett@jwbpinellas.org ED Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 1/29/2024 12:12:09 PM ID:c30bele0-65e2-4ec2-a711-22clf4a0e991 Mallory Armstrong Sent:2/1/2024 5:13:47 PM marmstrong@jwbpinellas.org ED Department Coordinator Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Art Kader � Sent:2/1/2024 5:13:47 PM Art.Kader@myClearwater.com ED Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Sandy Clayton Sent:2/1/2024 5:13:47 PM Sandra.Clayton@myclearwater.com ED Viewed:2/2/2024 12:56:14 PM Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Carbon Copy Events Status Timestamp Accepted: 10/16/2023 12:41:39 PM ID:3e992b12-b486-468b-af2a-92816ddfe243 Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 1/26/2024 4:18:36 PM Certified Delivered Security Checked 2/1/2024 5:13:04 PM Signing Complete Security Checked 2/1/2024 5:13:45 PM Completed Security Checked 2/1/2024 5:13:47 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure 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,Owen Kohler,Jennifer Poirrier, Rosemarie Call,Beth Houghton,Amanda B 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:Hsupport.docusign.com/guides/signer-eug ide- 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.