PROGRAM CONTRACT - AMENDMENT REVIEW AND APPROVAL FORM (4)Docusign Envelope ID: 56140B3A-CFED-44FC-8649-E93BFEE4CB78
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`r 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
Contract Amount:
$569,723
Brief Explanation:
FY26 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.
Director of Program Administration
E. Melkioty
9.444 Mello
8/19/2025 1 12:40 PM EDT
Director of Performance and Evaluation
M. Seales
'ktlu., State, -
8/22/2025 1 3:18 PM EDT
Senior Manager, Program Finance
S. Gill
Stu& Gal
8/25/20251 8:16 AM EDT
Chief Operating Officer
K. Boggess
6trui, totyl,ss
8/26/20251 9:58 AM EDT
Chief Financial Officer
R. Stivers
IeaGbi Sli Mxs
8/26/20251 11:25 AM EDT
Docusign Envelope ID: 56140B3A-CFED-44FC-B649-E93BFEE4CB78
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, 2025 and extending through September 30, 2026. 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 at the Ross Norton and North Greenwood Recreation Complexes.
The program incorporates enrichment activities that promote school success and healthy lifestyles, improve social
skills, increase athletic abilities, and develop leadership skills.
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 $569,723 for services rendered pursuant to this Agreement.
V. METHOD OF PAYMENT
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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 a 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 and paid 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
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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.
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The Provider's auditor must comply with the Independence Rule and comply with the General Requirements for
Performing Nonattest Services and Documentation Requirements When Providing Nonattest Services. Such
nonattest services include:
(1) financial statement preparation; (2) cash to accrual conversions; (3) reconciliations; (4) advisory services; (5)
appraisal, valuation and actuarial services; (6) benefit plan administration; (7) bookkeeping, payroll and other
disbursements including proposed standard, adjusting or correcting journal entries; (8) preparation of depreciation
schedules; (9) business risk consulting; (10) corporate finance consulting (11) executive or employee recruiting;
(12) forensic accounting; (13) hosting services; (14) information systems design, implementation or integration;
(15) internal audit; (16) investment advisory or management; (17) tax services.
The Provider is required to engage an audit firm that follows Government /Non -Profit Audit Standards when
conducting the 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, licensing reports, and any corrective action 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 data in such format and at
such times as may be prescribed by JWB (including uploading to JWB Databases, JWB Secure Portals, and
Provider specific data collection systems), and to cooperate in monitoring activities including, but not limited to,
access to sites, staff, fiscal and participant records, logs, participant rights and responsibilities policies, participant
handbooks, grievance and complaint procedures, and the provision of related participant and participant rights
information. Provider shall maintain and have available for audit inspection participant records for five (5) years
post termination of services. Provider agrees to abide by the JWB Board Policy Section IV: JWB Funded Program
Monitoring.
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If the Provider fails to meet performance standards, deliverables, or timelines outlined in this Agreement, JWB
may initiate progressive discipline, in its sole discretion, as follows:
1. Notice of Non -Compliance: JWB will issue a written notice to the Provider specifying the nature of the
non-compliance and affected deliverables.
2. Performance Improvement or Corrective Action plans
3. Monitoring and Follow -Up: JWB will monitor the Provider's progress in implementing corrective action. If
the Provider fails to comply with corrective action or if the deficiencies persist, JWB may take additional
actions, including but not limited to:
a. Withholding payments
b. Disqualifying the Provider from future procurement opportunities
c. Termination
Notwithstanding the foregoing, JWB reserves the right, in its sole discretion, to forego progressive discipline or
skip any step in progressive discipline and proceed to termination of the contract without engaging in progressive
discipline. Progressive discipline does not alter any of JWB's rights to terminate pursuant to Section VI.
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
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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
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, both print and electronic, 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
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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
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 the 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
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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.
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.
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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
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. Critical Incidents
Provider agrees to inform JWB within one (1) business day of any Critical Incident as defined below or 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. Critical Incidents involving participants are required to be reported
for situations that occur only while under the Provider's care. Critical Incidents also include anything that may
reflect negatively or critically upon JWB.
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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
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.
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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.
Other - Anything that may reflect negatively or critically upon JWB, or 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 Critical 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 Operating Officer within three (3) hours of knowledge of the incident.
All email communications made or received by JWB members or staff are considered public records and are
retained and, upon request, made available to the public and media in accordance with Chapter 119, Florida
Statutes.
Provider must adhere to the reporting requirements hereunder after the termination of this Agreement if Provider
becomes aware of a Critical Incident after the termination of the Agreement if the Critical Incident occurred during
the term of the Agreement and/or relates to the services funded by JWB.
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. Not Used
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 and/or participant data 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, volunteers, independent
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contractors, and staff of subcontractors regardless of the funder supporting the position and those who may have
access to youth participants and/or participant data. 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 Level 2 standards set forth in F.S. 435 through Volunteer and
Employee Criminal History System (VECHS) background screening. Only in the event the Provider does not
qualify to receive a national Level 2 background check in accordance with F.S. 435 and is not eligible to
participate in VECHS, then the Provider must engage a third -party vendor to conduct a national background
check and must comply with the Level 2 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 435.04. Personnel and volunteer files shall reflect who verified whether
the employee or volunteer candidate passed the Level 2 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.
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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.
23. JWB Policies and Procedures
Provider agrees to follow all JWB applicable policies and procedures which are located on the JWB website at
www.jwbpinellas.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
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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_
General Aggregate $3,000,000
Products/Completed Operations Aggregate $3,000,000
Personal and Advertising Injury $3,000,000
Each Occurrence $3,000,000
Such insurance shall be no more restrictive than that provided by the latest edition of the standard
Commercial General Liability Form (Form CG 00 01) as filed for use in the State of Florida by the
Insurance Services Office (ISO) without any restrictive endorsements other than any endorsements
specifically required by ISO or the State of Florida.
JWB and JWB's Board members, employees, volunteers, and agents shall be included as an "Additional
Insured" on the Commercial General Liability coverage a form no more restrictive than ISO form CG 20
10 (Additional Insured - Owners, Lessees, or Provider).
c. Automobile Such insurance shall cover all owned, hired and non -owned vehicles operated by, or on behalf
of, the Provider.
Combined single limit - (Vehicles transporting JWB Participants)
$1,500,000
Combined single limit - (All other vehicles used in the performance of work under this
Agreement)
$500,000
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[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
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.
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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.
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
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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
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 N/A
Annual Aggregate N/A
Provider shall maintain 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
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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
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
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liabilities, claims, judgments, or actions including, but not limited to, attomey'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 attomey'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
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 Terrorism Sector 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 that Boycott Israel List created pursuant to s. 215.4725, are not on the Scrutinized
Companies with Activities in Sudan List, are not on the Scrutinized Companies with Activities in the Iran
Terrorism 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
Terrorism 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
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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.
IX. SIGNATURES
Ito is ati 6. I tt.itaw'alk
Interim Chief Executive Officer: Juvenile Welfare City Manager: City of Clearwater
Board of Pinellas County
Michael G. Mikurak Jennifer Poirrier
8/26/20251 12:03 PM EDT
Date Date
Countersigned:
Bruce Rector
Mayor
Date
Approved as to form: Attest:
Melissa Isabel
Senior Assistant City Attorney
FY26 City of Clearwater Charting the Course for Youth
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Date
Rosemarie Call
City Clerk
Date
Countersigned: CITY OF CLEARWATER, FLORIDA
By:
Jen i'Yeroir ier
City Manager
Approved as to form:
'ssa Isabel
Assistant City Attorney
Rosemarie Call
City Clerk
Docusign Envelope ID: 56140B3A-CFED-44FC-B649-E93BFEE4CB78
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 (ELC) 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.
Provider agrees to adhere to the Components of Quality Out -of -School Time Programming at all times. Identified
requirements are listed on JWB's website. JWB will provide a minimum of thirty (30) calendar days' written notice
to the Provider if requirements change.
This program's participant retention will be analyzed during FY26. Providers shall continue to report participation
data consistent with prior methodologies. This data will be used for monitoring purposes and baseline data
collection to support JWB's review and redefinition of the Annual Participation measure.
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.
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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
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
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ensuring subcontractors of the Agreement are in compliance with the minimum insurance requirements as
described in General Condition #25.
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.
FY26 City of Clearwater Charting the Course for Youth
Page 23 of 29
Docusign Envelope ID: 56140B3A-CFED-44FC-B649-E93BFEE4CB78
Attachment 2
Geographical Service Area
Provider agrees whenever possible to maintain service sites which are accessible by public
transportation and convenient to the target participant group. Provider will advise JWB of any
changes made in service sites.
The geographical service area for this agreement is as follows:
Program Name
Charting the Course for
Youth
Participants
are eligible
Countywide
No
Participants are
eligible who
reside in the
following ZIP
codes:
33755, 33756
Participants are
eligible from the
following service
areas:
Participants will
primarily reside in zip
codes 33755,and
33756. In addition,
participants can reside
in surrounding mid and
north county zip codes.
FY26 City of Clearwater Charting the Course for Youth
Page 24 of 29
Docusign Envelope ID: 56140B3A-CFED-44FC-B649-E93BFEE4CB78
Attachment 3
�Juvenile Welfare Board
In order
requests
to receive payment on the Reimbursement Date, invoices/reimbursement
must be submitted to JWB by Close of Business on the Submission Due Date
Wednesda to allow or ' ro s er review and a i royal b JWB sta
R
Pay#
Submission Due Date *
(Wednesday)
Reimbursement Date
(Friday)
1
10/01/25
10/10/25
2
10/15/25
10/24/25
3
10/29/25
11/07/25
4
11/12/25
11/21/25
5
Monday- 11/24/25
12/05/25
6
12/10/25
12/19/25
7
Monday- 12/22/25
01/02/26
8
01/07/26
01/16/26
9
01/21/26
01/30/26
10
02/04/26
02/13/26
11
02/18/26
02/27/26
12
03/04/26
03/13/26
13
03/18/26
03/27/26
14
04/01/26
04/10/26
15
04/15/26
04/24/26
16
04/29/26
05/08/26
17
05/13/26
05/22/26
18
05/27/26
06/05/26
19
06/10/26
06/19/26
20
06/24/26
07/03/26
21
07/08/26
07/17/26
22
07/22/26
07/31/26
23
08/05/26
08/14/26
24
08/19/26
08/28/26
25
09/02/26
09/11/26
26
09/16/26
09/25/26
27
09/30/26
10/8/2026 (September business)
28
10/14/26
10/22/2026 (September business)
FY26 City of Clearwater Charting the Course for Youth
Page 25 of 29
Docusign Envelope ID: 56140B3A-CFED-44FC-B649-E93BFEE4CB78
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
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
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
Executive Director Affidavit
(Providers using VECHS)
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)
Within thirty (30) calendar days of the
effective date of this Agreement
Agency Specific JWB Secure
Portal Site
Insurance Documentation
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
FY26 City of Clearwater Charting the Course for Youth
Page 26 of 29
Docusign Envelope ID: 56140B3A-CFED-44FC-8649-E93BFEE4CB78
Prov°icier 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.
Subcontract monitoring
documentation
Available for review by JWB personnel upon request.
FY26 City of Clearwater Charting the Course for Youth
Page 27 of 29
Docusign Envelope ID: 56140B3A-CFED-44FC-B649-E93BFEE4CB78
Attachment 5
City of Clearwater
Charting the Course for Youth
Performance Measurement
10/1/2025 - 9/30/2026
Outcome Measure
Target Description
55% of youth participants that demonstrate learning
gains on the Florida Assessment of Student Thinking
(FAST) English Language Arts (ELA) Reading
90% of eligible participants will indicate satisfaction in
all applicable domains in the program's Out of School
Time (OST) survey.
85% of participants will miss less than 10% of school
days
60% of youth participants that demonstrate learning
gains on the Florida Assessment of Student Thinking
(FAST) Mathematics
40% of participants proficient on the Florida
Assessment of Student Thinking (FAST) English
Language Arts (ELA) Reading
FY26 City of Clearwater Charting the Course for Youth
Page 28 of 29
Notes
Learning gains are defined by Pinellas County Schools (PCS) in accordance with
guidelines from the Florida Department of Education. An eligible participant will be
in grades 4 and higher, served during the School Year with an Episode of 30 days or
more, and have two years' worth of scores on the Florida Assessment of Student
Thinking (FAST) English Language Arts (ELA) Reading. Measured by PCS through
the administration of the FAST and analyzed by JWB. Analysis uses end of school
year Progress Monitoring 3 (PM3) scores.
The survey assesses participant opinions about satisfaction in the program, including
in the domains of program engagement, resiliency, leadership, academics, STEAM,
and healthy decision making. Eligibility is defined as between the ages 8-18 at the
start of the administration period, enrolled before January, and active during the
administration period (April). The denominator indudes all participants who are
eligible, while the numerator counts the number of people, out of those eligible, who
took the survey. JWB will supply the program with a list of eligible participants. Age
is calculated using the participants' date of birth and their age as of April 1st of the
administration year.
The analysis includes both excused and unexcused absences from school. JWB will
evaluate school year attendance based on the participant's episode. Participants whose
episodes begin after the start of JWB's fiscal year are evaluated on attendance
between episode start and the end of the school year. Participants whose episode start
date begins prior to the start of JWB's fiscal year are evaluated on attendance during
the entire school year. Participants must have episode lengths of at least 30 days to be
eligible for the analysis.
Learning gains are defined by Pinellas County Schools (PCS) in accordance with
guidelines from the Florida Department of Education. An eligible participant will be
in grades 4 and higher, served during the School Year with an Episode of 30 days or
more, and have two years' worth of scores on the Florida Assessment of Student
Thinking (FAST) Mathematics. Measured by PCS through the administration of the
FAST and analyzed by JWB. Analysis uses end of school year Progress Monitoring
3 (PM3) scores.
Grade level proficiency is defined as scoring a Level 3, 4 or 5 on the Florida Student
Assessment of Student Thinking (FAST) English Language Arts (ELA) Reading. An
eligible participant will be in grades 3 to 10, served during the School Year with an
Episode of 30 days or more, and have an end of school year Progress Monitoring 3
(PM3) score. Measured by Pinellas County Schools (PCS) through the
administration of the FAST and analyzed by JWB.
Docusign Envelope ID: 56140B3A-CFED-44FC-B649-E93BFEE4CB78
50% of participants proficient on the Florida
Assessment of Student Thinking (FAST) Mathematics
Process Measure
Grade level proficiency is defined as scoring a Level 3, 4 or 5 on the Florida Student
Assessment of Student Thinking (FAST) Mathematics. An eligible participant will be
in grades 3 to 8, served during the School Year with an Episode of 30 days or more,
and have an end of school year Progress Monitoring 3 (PM3) score. Measured by
Pinellas County Schools (PCS) through the administration of the FAST and analyzed
by JWB.
Target Description Notes
70% of eligible participants will attend 70% of program
days or more
FY26 City of Clearwater Charting the Course for Youth
Page 29 of 29
The program calendar or dosed dates provided to JWB will define the available days
in a participant's episode. Attendance marked as unexcused or excused will count as
days the participant did not attend the program. Eligibility: Participants who have an
episode length of 30 days or more.