PROGRAM CONTRACT - AMENDMENT REVIEW AND APPROVAL FORM -CHARTING THE COURSE FOR YOUTHDocusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
b
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:
Annual Agreement
Annualized
Contract Amount:
$553,129
Brief Explanation:
FY25 Annual Agreement
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
8/15/2024 1 6:27 PM EDT
E. Melkioty
Senior Manager, Performance and
Evaluation (if applicable)
M. Seales
Senior Manager, Program Finance (if
applicable)
Chief Program Officer
K. Boggess
Chief Financial Officer
R. Stivers
8/16/2024 1 4:01 PM EDT
8/16/2024 1 4:10 PM EDT
8/19/2024 8:52 AM EDT
S iws
8/19/2024 1 11:57 AM EDT
Chief Evaluation & Innovation Officer
N/A
B. Morrison -Rodriguez
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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, 2024 and extending through September 30, 2025. 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 during the term of this Agreement.
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 such as courage,
teamwork, compassion, and responsibility.
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 $553,129 for services rendered pursuant to this Agreement.
FY2S City of Clearwater Charting the Course for Youth
Page 1 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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) calendar 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.
2. Fiscal Responsibility
FY25 City of Clearwater Charting the Course for Youth
Page 2 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
a. Non-profit Providers and government entity Providers agree to maintain books, records, and documents in
accordance with Generally Accepted Accounting Principles (GAAP) 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 shall maintain a Continuity of
Operations Plan which shall be available for review by JWB personnel upon request.
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. In addition to the audit, Provider shall submit all auditor communications to
the Provider board, including required communications and all adjustments, whether corrected or uncorrected. 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.
FY25 City of Clearwater Charting the Course for Youth
Page 3 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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 financial 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.
FY25 City of Clearwater Charting the Course for Youth
Page 4 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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 maintaining user access
to JWB's Database, including workflow. 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 Provider staff who no longer need access to the JWB Database should have their access terminated
immediately. The Provider is responsible for implementing appropriate procedures into their data policies to
protect data and prevent accidental or malicious disclosure of participant information.
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 shall be maintained in Provider files. Training of new board members by an external
trainer is required within six (6) months of joining the Provider board. Training must consist of the following
topics: nonprofit governance, fiduciary risks, and liabilities. Evidence of training, including an outline of topics
covered, the board members in attendance, and who provided the training, shall be available for review by JWB
personnel upon request. 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. JWB's
FY25 City of Clearwater Charting the Course for Youth
Page 5 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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. Legal Compliance
Provider agrees that it will comply with all applicable laws, rules, and regulations.
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 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.
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 available for review by JWB personnel upon
request.
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
following exceptions: a) such information may be revealed as may be necessary to conform to Fiscal
FY25 City of Clearwater Charting the Course for Youth
Page 6 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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.
FY25 City of Clearwater Charting the Course for Youth
Page 7 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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
publicrecords@jwbpinellas.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) 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
FY25 City of Clearwater Charting the Course for Youth
Page 8 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
Florida statutes, F.S.688.002, 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.
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 law for Baker 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
FY25 City of Clearwater Charting the Course for Youth
Page 9 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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.
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.
FY25 City of Clearwater Charting the Course for Youth
Page 10 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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.
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/Attestations 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 the Volunteer &
Employee Criminal History System (VECHS) for background screening. Only in the event the Provider does not
qualify to receive a national Level 2 background check in.
FY25 City of Clearwater Charting the Course for Youth
Page 11 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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.
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/Attestations of Good Moral Character, the
results of background screenings and Provider verification of staff credentials. Consents executed by employees
and volunteers to release Affidavits/Attestations of Good Moral Character and background screening results, if
permitted by law, 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. Human Trafficking Affidavit
In accordance with F.S. 787.06(13), nongovernmental entity Providers must submit an affidavit under penalty of
perjury in a form approved by JWB and executed by an officer or a representative of Provider attesting that
Provider does not use coercion for labor or services as that term is defined in F.S. 787.06.
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. Policy shall be available for
review by JWB personnel upon request.
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.
FY25 City of Clearwater Charting the Course for Youth
Page 12 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
23. JWB Policies and Procedures
Provider agrees to follow all JWB applicable policies and procedures which are located on the JWB website at
www.jwbpi.nellas.org and which are incorporated into this Agreement. Said policies include, but are not limited to,
applicable Board policies, funding policies, JWB Financial Policies and Procedures for Funded Programs, security
policies, JWB Data Quality Manual, and applicable 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 applicable 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
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 -(VIII) or higher with A.M. Best.
Companies not rated by A.M. Best may be used to satisfy this requirement if approved by JWB in writing. If
insured by a company that is not rated by A.M. Best, the company must have been successfully operating in the
State of Florida for a minimum of five consecutive years and JWB reserves the right to request a copy and review
the company's most recent annual report or audited financial statement to determine the financial viability of the
organization, including an unencumbered net worth of $25 million or more.
a. Workers' Compensation
Such insurance shall comply with Chapter 440, Florida Statutes, as required by law.
b. Commercial General Liability
FY25 City of Clearwater Charting the Course for Youth
Page 13 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
General Aggregate $3,000,000
Products/Completed Operations Aggregate 53,000,000
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)
$5,000,000
Combined single limit - (All other vehicles used in the performance of work under this
Agreement)
$500,000
[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.
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, excluding ride share and taxi services, shall be
required to maintain verification of transportation vendor's automobile liability insurance limits in the same
FY25 City of Clearwater Charting the Course for Youth
Page 14 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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. Professional Liability
Each Claim
Annual Aggregate
$1,000,000
$1,000,000
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.
e. Cyber Liability -
Each Claim
Annual Aggregate
$500,000
$500,000
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.
f. Abuse and Molestation Liability
Each Claim
Annual Aggregate
$1,000,000
$1,000,000
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.
FY25 City of Clearwater Charting the Course for Youth
Page 15 of 28
Docusign Envelope ID: 545739A3-73C8.421D-A9E9-ECOA3D84EF02
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.
g. Crime Insurance
Such insurance shall be on a form acceptable to JWB and shall provide the following coverages in the
following amounts:
Employee Dishonesty: $300,000
Forgery or Alteration: $300,000
Robbery (on or off premises): $300,000
Computer Fraud: $300,000
Funds Transfer Fraud: $300,000
h. Watercraft Liability
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
i. 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.
The minimum limits (inclusive of any amounts provided by an umbrella or excess policy) shall be:
Each Claim N/A
FY25 City of Clearwater Charting the Course for Youth
Page 16 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
Annual Aggregate N/A
JWB and JWB's Board members, employees, volunteers, and agents shall be included as an "Additional
Insureds" on the policy.
j. Drone Liability
Each Claim
Annual Aggregate
N/A
N/A
Provider shallmaintain liability coverage for both bodily injury and property damage naming "JWB and
JWB's Board members, employees, volunteers, and agents" as additional insureds on a primary and non-
contributory basis.
k. 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.
1. 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.
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.
m. Notice of Cancellation
FY25 City of Clearwater Charting the Course for Youth
Page 17 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
All required policies must be endorsed to provide JWB with thirty (30) calendar days' prior notice of
cancellation.
n. 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.
o. Self -Insurance
Notwithstanding any provision in this agreement to the contrary, and only with the prior written approval
of JWB, the specified insurance requirements may be satisfied by a certification of a valid program of self-
insurance established and maintained in accordance with all applicable Florida laws and regulations.
p. 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. 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 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.
27. Certification that Provider is legally able to contract with JWB
In compliance with F.S. 287.135(2)(a), a Provider is ineligible to and may not enter into a contract with JWB if the
FY25 City of Clearwater Charting the Course for Youth
Page 18 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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(2)(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.
28. E -Verify
In accordance with F. S. 448.095(5), 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 in F. S. § 448.095. Subcontractors are defined in F.S. 448.095 as a person or entity that provides
labor, supplies or services to or for a contractor or another subcontractor in exchange for salary, wages, or other
remuneration. 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.
FY25 City of Clearwater Charting the Course for Youth
Page 19 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
64- hiviktOin,
Chief Executive Officer: Juvenile Welfare City Manager: City of Clearwater
Board of Pinellas County
Beth A. Houghton
8/19/2024 1 1:13 PM EDT
Jennifer Poirrier
p „ t-unbeA7 i)- .)-02ttl
Date Date
FY25 City of Clearwater Charting the Course for Youth
Approved as to form:
Melissa Isabel
Senior Assistant City Attorney
Attest:
./L1,4-UVlia(Z1 04 -et ,v,4„0„),
Date
Rosemarie Call
City Clerk
Page 20 of 28
Date
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
Attachment 1
Special Conditions of the Agreement
The following condition(s) applies to the Program:
Charting the Course for Youth
As a condition of JWB funding, the Provider and all facilities are required to maintain licensure by the Pinellas
County Licensing Board (PCLB). Facilities not required to be licensed must maintain a Certificate of Substantial
Compliance issued by 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. If a
probationary license is issued, this may result in JWB corrective action. Provider authorizes JWB to speak with
PCLB, and any other entity regulating the Provider about anything relevant to Provider's childcare license, history
of providing care or anything else deemed relevant by JWB.
Should Provider be a party to any written agreement with the Early Learning Coalition (EL C) during the term of
this Agreement, Provider must advise JWB in writing of the contract. If Provider's contract with ELC is
terminated 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. At all times
during this Agreement, Provider must be considered in Good Standing with ELC, which is defined as having no
contract probation and no outstanding corrective action with ELC. If an ELC contract is in probationary status or
terminated, this may result in JWB corrective action. Provider authorizes JWB to speak with ELC and any other
entity regulating the Provider about anything relevant to Provider's ELC contract, childcare license, history of
providing care or anything else deemed relevant by JWB.
The Provider shall upload a Safety Around Water (SAW) end of the year report to JWB's Secure Portal or the
JWB Participant Management System by October 15th. The report shall include aggregate data from the fiscal
year including the total number of unduplicated youths served through SAW.
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.
Provider approved COST program shall adhere to the JWB approved Program Service Matrix Model Program
Components for Out of School Time Programming.
General Condition #10 -Assignments and Subcontracts- The last sentences of paragraph two and of paragraph
three in this section are waived: Provider is exempted from submitting Subcontracts and Subcontract monitoring
FY25 City of Clearwater Charting the Course for Youth
Page 21 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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.
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 meet the criteria in the
Child Care/School Age (CC/SA) 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 following condition(s) applies to the Provider:
City of Clearwater
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
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 - 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 Condition #25.
FY25 City of Clearwater Charting the Course for Youth
Page 22 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
General Condition #26 - 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."
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.
FY25 City of Clearwater Charting the Course for Youth
Page 23 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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
Participants
are eligible
Countywide
Participants are
eligible who
reside in the
following ZIP
codes:
Participants are
eligible from the
following service
areas:
Charting the Course for
Youth
FY25 City of Clearwater Charting the Course for Youth
No
Page 24 of 28
Participants will
primarily reside in zip
codes 33755,and 33756.
In addition, participants
can reside in
surrounding mid and
north county zip codes.
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
Attachment 3
Juvenile Welfare Board
*In order
Business
to receive payment on Reimbursement Date,invoices/reimbursement request must be submitted to JWB by Close of
on the Submission Due Date (Wednesday), to allow foreview, and approval by JWB staff_
_pper
ACCOUNTS PAYABLE SCHEDULE FY 2025
Pay#
Submission Due Date *
(Wednesday)
Reimbursement Date
(Friday)
1
10/02/24
10/11/24
2
10/16/24
10/25/24
3
10/30/24
11/08/24
4
11/13/24
11/22/24
5
11/27/24
12/06/24
6
12/11/24
12/20/24
7
12/25/24
01/03/25
8
01/08/25
01/17/25
9
01/22/25
01/31/25
10
02/05/25
02/14/25
11
02/19/25
02/28/25
12
03/05/25
03/14/25
13
03/19/25
03/28/25
14
04/02/25
04/11/25
15
04/16/25
04/25/25
16
04/30/25
05/09/25
17
05/14/25
05/23/25
18
05/28/25
06/06/25
19
06/11/25
06/20/25
20
06/25/25
07/04/25
21
07/09/25
07/18/25
22
07/23/25
08/01/25
23
08/06/25
08/15/25
24
08/20/25
08/29/25
25
09/03/25
09/12/25
26
09/17/25
09/26/25
27
10/01/25
10/9/25 (September business)
28
10/15/25
10/23/25 (September business)
FY25 City of Clearwater Charting the Course for Youth
Page 25 of 28
Docusign Envelope ID: 545739A3 -73C8-421 D-A9E9-ECOA3D84EF02
Attachment 4
Document Submittal Chart
This chart is intended as a guide. Submittals required in the General and Special Conditions of
the Agreement supersede this guide.
Provider Document
Approved program
methodology
Time Frame
Throughout the period of the
Agreement
Submit To
Agency Specific JWB Secure
Portal Site
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
Agency Specific JWB Secure
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 JWB Secure
Portal Site
Monitoring, Site Visit,
Accreditation and
Licensing Reports
No more than thirty (30)
calendar days following
Provider receipt
Agency Specific JWB Secure
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 Chief Executive
Officer
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 JWB Secure
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
execution thereafter.
Agency Specific JWB Secure
Portal Site
Incident Reports
Within one (1) business day of
knowledge of any incident
IRreviewteam@jwbpinellas.org
FY25 City of Clearwater Charting the Course for Youth
Page 26 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
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
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
Documents Available Upon Request
Provider Document
COOP
Time Frame
Available for review by JWB personnel upon request.
Board Training (Outline
of topics, members in
attendance, and who
provided training)
Available for review by JWB personnel upon request.
Drug -Free Workplace
policy
Available for review by JWB personnel upon request.
FY25 City of Clearwater Charting the Course for Youth
Page 27 of 28
Docusign Envelope ID: 545739A3-73C8-421D-A9E9-ECOA3D84EF02
Attachment 5
City of Clearwater
Charting the Course for Youth
Performance Measurement
10/1/2024 - 9/30/2025
Outcome Measure
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
% of youth participants that demonstrate learning gains
on the FAST English Language Arts
% of youth participants that demonstrate learning gains
on the FAST Mathematics
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 (April). 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.
Learning gains are defined by Pinellas County Schools in accordance with guidelines
from the Florida Department of Education. This measure is a baseline measure while
sufficient data is collected in order to establish a target.
Learning gains are defined by Pinellas County Schools in accordance with guidelines
from the Florida Department of Education. This measure is a baseline measure while
sufficient data is collected in order to establish a target.
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
FY25 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
Page 28 of 28
Certificate Of Completion
Envelope Id: 545739A373C8421DA9E9ECOA3D84EF02
Subject: FY25 City of Clearwater - CTCFY Agreement for Signature
Source Envelope:
Document Pages: 29
Certificate Pages: 6
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC -05:00) Eastern Time (US & Canada)
Signatures: 6
Initials: 0
an
Status: Original
8/14/2024 4:31:05 PM
igner Eve
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
Karen Boggess
KBoggess@jwbpinellas.org
Chief Program Officer
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 8/19/2024 8:50:28 AM
ID: 663d0c9d-fb31-4ff0-ba92-8ae8b75fb6ae
Holder: Desmon Newton
dnewton@jwbpinellas.org
nate
E Httk;4tq
Signature Adoption: Pre -selected Style
Using IP Address: 35.137.197.201
11t ta,n. Ss 11k.o.
Signature Adoption: Pre -selected Style
Using IP Address: 47.205.87.14
StAuT
Signature Adoption: Pre -selected Style
Using IP Address: 65.35.26.7
ruA, bog -SS
Signature Adoption: Pre -selected Style
Using IP Address: 136.174.187.5
DocuSign.
Status: Completed
Envelope Originator:
Desmon Newton
14155 58th Street North
Clearwater, FL 33760
dnewton@jwbpinellas.org
IP Address: 67.9.146.57
Location: DocuSign
Sent: 8/14/2024 4:44:45 PM
Viewed: 8/15/2024 10:45:39 AM
Signed: 8/15/2024 6:27:55 PM
Sent: 8/15/2024 6:27:57 PM
Resent: 8/16/2024 11:04:46 AM
Viewed: 8/16/2024 4:00:32 PM
Signed: 8/16/2024 4:01:50 PM
Sent: 8/16/2024 4:01:52 PM
Viewed: 8/16/2024 4:10:07 PM
Signed: 8/16/2024 4:10:28 PM
Sent: 8/16/2024 4:10:30 PM
Viewed: 8/19/2024 8:50:28 AM
Signed: 8/19/2024 8:52:29 AM
Signer Even
Robbi Stivers
rstivers@jwbpinellas.org
Chief Financial Officer
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Beth Houghton
bhoughton@jwbpinellas.org
CEO
Juvenile Welfare Board
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 8/19/2024 1:00:23 PM
ID: 4beb6605-dc9a-4316-9681-x541 c4fb96c4
►ignature
f olki S{i‘44,5
Signature Adoption: Pre -selected Style
Using IP Address: 35.145.140.133
R
Signature Adoption: Pre -selected Style
Using IP Address: 47.201.200.154
Signed using mobile
Timestam
Sent: 8/19/2024 8:52:31 AM
Viewed: 8/19/2024 11:52:17 AM
Signed: 8/19/2024 11:57:07 AM
Sent: 8/19/2024 11:57:11 AM
Viewed: 8/19/2024 1:00:23 PM
Signed: 8/19/2024 1:13:07 PM
Sandy Clayton
Sandra.Clayton@myclearwater.com
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Mallory Armstrong
marmstrong@jwbpinellas.org
Department Coordinator
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
COPIED
COPIED
Sent: 8/19/2024 11:57:09 AM
Viewed: 8/19/2024 2:58:22 PM
Sent: 8/19/2024 1:13:09 PM
Envelope;
Envelope Sent
Envelope Updated
Envelope Updated
Certified Delivered
Signing Complete
Completed
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Security Checked
Security Checked
menta__,
8/14/2024 4:44:45 PM
8/15/2024 1:42:20 PM
8/15/2024 1:42:20 PM
8/19/2024 1:00:23 PM
8/19/2024 1:13:07 PM
8/19/2024 1:13:09 PM
Payment Event
imestamps
Electronic Recordeand Signature Disclosure
Electronic Record and Signature Disclosure created on: 8/13/2024 11:40:41 AM
Parties agreed to: Karen Boggess, Beth Houghton
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: 727-453-5600
To contact us by email send messages to: sphillips@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 sphillips@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 sphillips@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 sphillips@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.