84-15
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RES 0 L UTI 0 N
No. 84 -15
A RESOLUTION OF THE CITY OF CLEARWATER, FLORIDA,
AUTHORIZING THE EXECUTION AND FILING OF A GRANT
APPLICATION UNDER THE COMMUNITY SERVICES BLOCK
GRANT WITH THE STATE OF FLORIDA DEPARTMENT OF
COMMUNITY AFFAIRS.
WHEREAS, local governments are eligible to submit applicdtions
for funding under the community Servicos Block Grant Program administered
by the Florida Department of Community Affairs; and
WHEREAS, the City of Clearwater desires to submit such a grant
application; and
WHEREAS, such grant applications must be filed on or before
February 15, 1994; and
WHEREAS, each county has been allocated a share of this money and
any local governmental unit may apply for the funds available within its
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Coun ty;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF CLEARWATER, FLORIDA, IN SESSION DULY AND REGULARLY
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ASSEMBLED, AS FOLLOWS:
1. That the appropriate officials are hereby authorized and
directed to execute and file a grant application for Community Services
Block Grant Assistance with the Florida Department of community Affairs, as
per copy attached hereto and made a part hereof, and to furnish all inform-
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ation and data necessary to complete said grant application.
2. That all funds necessary to meet the contract obligations of
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the City with the Department have been appropriated and said funds are un-
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expended and unencumbered and are available for payment as prescribed in
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the applicati.on.
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That this resolution shall become effective immediately upon
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its adoption.
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PASSED AND ADOPTED this 2nd day of
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Attest:
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city Clerk
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84,-15
2:"2-84
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CSBG APPLICATION
STATEMENT OF ASSURANCES
The appllcant hereby assures and certlffes as a condftlon of recelpt of Communfty
ServIces Block Grant lCSBG) funds, that It and Its subgrantees wIll comply wlth
the requIrements of Federal and State taws, rutes, regutatfons and guIdelInes. As
a part of thls applIcatIon and as a part of acceptance and use of CSBG funds, the
applIcant assures and certfffes that:
1. It possesses legal authorlty to appJy for the grant, that the appllcatJon ha5
been approved by the appllcant's governlng body, IncludIng all assurances
contafned hereln.
2. It wlJt utilize CSBG funds to provlde a range of servlces and actlvltles
havlng measurable and potentIally major Impact on causes of poverty In the
communJty and those areas of the communIty where poverty Is a partIcularly
acute problem.
3. In the ease of a communIty actIon agency or non-proflt private organlzatlon,
It assures and provIdes documentation that each Board of DIrectors Is con"
stltuted so that:
8. one-thIrd of the members of the board are elected public offlclals
currently holding offIce or their representatives, except that If the
number of elected offlcls's reasonably avallable and wllllny to serve
Is less than one..thlrd of the membership of the board, membership on the
board of appotntlve publlc offrcrals may be counted tn meeting such one-
third requirement.
b. at least one~thlrd of the members of the board are persons chosen In
accordance with democratic seJectlon procedures adequate to assure that
they are representatives of the poor tn the area served; and
c. the remaJnder of the members of the board are offIcials or members of
busrness, labor, Industry, relIgious, welfare, education, or other major
groups and Intere~ts ln the communlty.
4. In the =as~ of a limIted purpose agency, It assures and provIdes documentation
that the Board of' OJ rectors Is composed of at least one..thl rd representatives
of the poor or ari advIsory committee at least a majority of whIch are
democratically selected representatlves of the poor.
5. In the case of a seasonal and migrant fannworker organlzatlon, It assures and
provIdes ~ocumentatlon that the Board of Directors consists of at le3st 51%
representatives of seasonal and migrant fanmworkers.
6. Funds will not be used for polltlcal actIvIties and wIll prohibit any actlvitles
to provide voters and prospectIve voters with transportation to the polls or
provIde similar assistance In connectlon with an election or any voter
registration activity.
7. It will provlde for coordlnatlon among antIpoverty programs In each communIty,
where approprIate, with emergency energy crIsis Intervention programs under
Title XXV, of the Low-Income Home Energy AssIstance Act conducted In each
COllITlunlty.
8. at possesses the sound flseal control and fund accountIng procedures necessary
to assure the proper disbursal of and accountlng for Federal funds received
under the Community ServIces Biock Grant.
9. It wlll permIt and cooperate wlth Federal and State lnvestigatlons deslgned
to evaluate complIance with the law.
10. It wIll gIve the Department, the Auditor General or any authorIzed representatIve
complete access to examine all records, books, papers, or documents related to
the grant, includIng those of any subgrantee.
11. It will, In accordance with FlorIda Statutes and Section 677 of Public Law
97-35, comply with non-discrImination provfslons.
12. It will comply with the match requlrements of the CSSG and maintain verificatIon
of.type and source.
2
Res. 84-15
2-2-84
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ASSURANCES (continued)
l3. It will comply with Section 680 of Public Law 97-35 which prohibits use
of CSBG funds for purchase or ImprOVement of land or the purchase,
construction, or penmanent Improvement (other than Jow-cost resIdential
weatherization or other energy related home repaIrs) of any buIlding or
other facll1ty.
14. It will comply wIth the CSBG Administrative Rule whIch provides that CSBG
administrative expenses shall not exceed a maximum of fIfteen percent of
the total csaG funding.
IS. If the applIcant requests secondary administrative costs, It will provide
substantial documentation that these costs are justified and support
eligible Block Grant activities.
16. ThJs application and Its various sections, including budget data, are
true and correct. This application will become part of this contract
between the Department and the Applicant.
17. This Agreement has been approved by the governing body by official action
and the officer listed below Is duly authorized to sign this Agreement.
.. CITY OF CLEARWATER,
FLORIDA
countersigned:
By.:
city Manager
Mayor-Commissioner
Attest:
Approved as to form and
correctness:
city Clerk
City Attorney
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Raa.' 84-15
3.
2-2-84
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ACCOUNTING SYSTEM CERTIFICATION
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INSTRUCTIONS:
Complete Section I OR Sectlnn II (Pe~ulrement for ~Appllcants)
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~~ _ _ _ _ _ _ _ _ ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L_.. _>> _ _ _ _ .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _._ _ _ __ _ _ _ _ _ _I
SECTION I - STATEMENT OF PUBLIC FINANCIAL OFFICER (To be completed only If
Applicant 15 a public agency/local government; ~ when the accounting
system of a private non-profit agency will be maintained by a public
agency.)
I am the Chief Financial Officer of City of Clearwater, Florida
(Type Name of Local Government)
and, In this capacity, will be responsible for providing financial services
adequate to Insure the establishment and maintenance of an accounting ~ystem for
the city of Clea~water, Florida which Is a public
(Name of Applicant)
(or non-profit) agency or local Dov~rnment charged wi th carrying out a program(s)
under the Community Services Block Grant in the City of Clearwater, Florida
(Name of Community)
The accounting system will have Internal controls adequate to safeguard the assets
of such agency(les), check the accuracy and reliability of accounting data, promote
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operating efficiency, and encourage compliance with prescribed management policies
'of the ,agency (Jes) .
City of Clearwater
(Type Name of Local Govarn~ent)
Oaniel J. Deignan
Type Name of Chief Financial Officer)
Date
{Signature of Chief FinanCial Officer}
~~Iai==---;;-------=----=--~----===-----..iiiiiiliI--~
SECTION II - STATEMENT OF CERTIFIED PUBLIC ACCOUNTN~T (To be completed only if
Applicant is a private non-profit agency; or a public agency whose
accounting system will not be maintained b~a public agency.)
I am a certified or duly licensed public accountant and have been engaged to
examine ~nd report on the financial accounts of the
which Is a private non-profit organ-
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(Name of Applicant)
Iz~tlon (or public agency) carrying out a program(s) under the Community Services
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Block Grant In
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I h3ve reviewed
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(Name of Community)
the accounting system that this agency has established and, In my opinion, it
Includes Internal controls adeQuate to safeguard the assets of the agency, check
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the accuracy and reliability of accounting data. promote operating efficiency, and
encourage compliance with prescribed management policies of th~ agency.
(Type Harne of Firm)
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Date
Telephone)
(SlgnMture of Accountant)
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Res. 84-15
2-2-84
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APPLICANT:
CITY OF CLEARWATER
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SUBGRANTEE:
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IV.PROBLEM STATEHENT/PROPOSED SOLUTIONS
INSTRUCTIONS: Hake multIple copies of this page. For EACH probl~ or need that you plan to
address with CSSG funds, please answer on this form questions one through fou~
Each problem or need you Identify must relate to the program areas and obJec-
tives In your CSBG Work Plan. Each question must be answered for this appli-
cation to be considered complete. Please be specIfic.
1. State the specIfIc problem or need that you plan to address with CSBG funds.
Homebound elderly city residents of low income require nutrional assistance in
obtaining adequate meals due to physical, mental, or psychological limitations;
and due to funding shortages by local service organizations that address this
problem.
2. List the factors or conditIons contrIbutIng to this problem or need.
Low income elderly City residents require nutritional assistance in their homes
due to:
A) They cannot afford to eat adequately.
B) They lack the skills/knowledge to select and prepare well-balanced meals.
C) They suffer from feelings of rejection or loneliness which reduces the'
incentive to prepare and eat a meal alone.
3. Are there any other programs Including those within your agency currently operating
in your area which address thIs problem?
Ixl YES I~NO
If yes, how will CSBG funds be used in order to ensure non-duplication of services?
Neighborly Senior Services conducts a "Meals on Whee]s" program. Twenty-eight
Clearwater residents are cUrl'ently on the "Meals on Wheels" waiting list. The
City of Clearwater intends to contract with a local provider to supply 1,208
meals to those currently not being serviced by "Meals on Wheels" during the 6
month grant.period.
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~. Identify the Program Area in your CSBG York Plan that addresses this prOblem or need.
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Program Area:
Food & Nutrition
Work Plan Page:
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APPLICANT:
REVENUE
I . CSIIG Grlnt fl.equast
2.. ~.h Hitch
3. In Ktnd Hatch
It. Total KItch (t 1M. 2.+,"
5. Tot~l ~.venue (lln.~
csaG FUNDED PROGRAKS
ONLY (I1nol 6 to"~l>'
-------
GRANTEE ADK I N I STRAT I VE EXPENSE
6. Salarl.. (Including ~rln;. ben.fltl)
7. n..nc . . . . . . . . . .
8. Utltltfu.
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10. Supplies . .
11. Equ'~t. . . . . . . .
12. Other. . . . .
13. TOTAL (line. 6 through 12) . . . .
SU!GRAHTEE S AO'UHISTRATrVE EXPENS
1~. Sat5rl.. (Including fringe beneftts)
15.
16.
17.
18.
1'.
10.
. . .
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. . .
Rant . . . . . . .
UtI (J ties. .. . .. .
TrllYtll . . . . . . . . .
Suppll.. . . . . .
Eqvlpttant. . .
Other. . . . . . . .
n. TOTAL (I tnG' ,It through :0).
22. TOTAL ADNIIIISTRAT1VE EXPEltSES
(1Ino. 13 .nd 11). . . . . . .
13. TOTAL CS!li AOOINISTRATIVE EXPEHSE
PDCOOA-'E (lINst not 0JtCeISd 1~
of l1n8 1) .. . . . . . . . . . . .
214.
2$.
26.
2.7.
28.
GRNlTEE ~ROGMH EXPENSE
Salarte. (IncludIng frlns- ben.flt.)
Rant . .
. .
. . .
.
Utt lit I...
Tr.ft1 .
Supplle. . . .
Equipment.
. .. .
. . .
2.,.
30. Other. . . . .
31. TOTAL (llna~ 2~ throuih 3Q).
SUDGRANTEE(sl PROCRAK EX~EH~
5alarJ~. {Ir-eludlng frJngQ ben.flts
. . .
32.
33. bnt . .
3~.
35.
,6.
37.
38. Othar. . .'
)g. TOTAL (lIne. 32 through 38).
40. TOTAL PROGRAH EXPEHSE(lrno. 31 + 39
~I.. TOTAL CS8G EXPENDITURES
(1In~. 22 and 40). . . , . . . . .
. . .
. . .
UtI I Itl... .. .
Travel .
Suppllec . .. .
EquIpment. . .
. . .
. . .
. .
. . .
. .
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J,2. SECONDARY ADmHJSTAA11VE EXPENSES
43.. TOTAL BUDGET (lltuu: Ii 1 end liZ) . .
Res. 84-15
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.CSBG BUDGET SU~~RY
DEPARTMENT USE ONLY
Co 1 UlJWl It
'CS8e:
FUNDS
Column 5
CASH
MATCH
Co hJllll1 6
IN KIND
KATCH
-0-
-0-
-0-
-0-
-0-
-0-
-0-
Column 7
TOTAL
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$3,200.0q to purchase 1,208 home delivered
nutritious meals for low income
elderly residents.
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38
city of Clearwater General Fund
$557~OO
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CSBG ~ORK PLAN INSTRUCTIONS
GENERAL INSTRUCTIONS: Hake multiple copIes of the WORK PLAN form for completion
by the APPLICANT and all potentlal SUBGRANTEES. Work P'an objectIves and actIvIties
must correlate with the InformatIon provided In the Problems/Solutions section.
All work plans must be typed. BE SURE TO COHPLETE AT LEAST ONE PAGE OF THE WORK
PROGRAM FOR EACH PROGRAM AREA THAT IS lOENTIFIED.
(Items " and '2) APPLICANT/SUBGRANTEE: Enter the name of the agency/local
government making applIcation In line 11. Enter the name of the subgrantee In
Jlne 12 only on the subgrantee's work plan. EACH SUBGRANTEE IS RESPONSIBLE FOR
FILLING OUT A SEPARATE WORK PLAN.
('tern 13) PROGRAM AREA - Enter the appropriate Program Area (~.g. HousIng,
Transportation, Employmentt CSBG Program Administration, Food and NutrItIon, etc.)'
that you Intend to fund with CSBG monies. IF YOU PLAN TO USE CSBG FUNDS FOR
SECONDARY ADHIHISTRATlVE EXPENSES, YOU MUST COMPLETE A SEPARATE PAGE OF THE WORK
:~EJ~:T ~gs~o~~o~~Sr~~~C~sY~8 ~~P~8:~lt~~gu~MRslEfN~~~~~~E~8RS~H9~R ~SBBkft~
REQUESTING SECONDARY ADH'HISTRATIVE EXPENSES.
(Item 14) STAFF PERSON - Enter the appropriate title of the staff person respon-
sible for this program area.
(Item 65) GEOGRAPHIC AREA TO BE SERVED - Identify specific areas (neighborhood,
City, county, etc.) to be served and Impacted by your proposed objective.
(Item 66) CS8G AMOUNT BUDGETED FOR THIS PROGRAM AREA - Indicate amount of CSBG
dollars that you plan to spend on this program, the amount of match (cash and/or
ln~klnd) and total. The sum of all these amounts must total your Program
Budget Total.
(Item #7) OBJECTIVE{S)- Number each objective. Each objective must state a
Quantifiable or measurable expected result within a specIfic time frame. Every
objective you Identify must relate to the problems or needs you Identified In the
Problem/Soiutrons Part of this application. For all program areas, except
administration. all quantitIes must be identified as number of househoids or
number of IndivIduals. Examp 1 c:
Objective 11: To secure employment for at least 25 low income elderlv heads of
households before ttarch 31, 1984.
(Item #8) ANTICIPATED IMPACT ON POVERTY PROBlEH(S) - Indicate HOW your proposed
objective will alleviate the problems you Identified In the'Pr~ems/Solutlons
Section. Following the sample objectrve grven above, the AntIcipated -Impact(s)
of that objectIve mI9~t be:
Example:
By accomplishing this objective, 25 low income families will earn
enouQh money to SUDDort themselves. this will result in:
(1) having approximately 125 less persons receIving public assistance
In the target area; (2) Increasing economic Qrowth In the c~unlty'
and (3) increased tax contrlhuti~ns. - ,
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(Item 19) ACTIVITIES - lIst specific actIvitIes you Intend to carry out to
accomplish your proposed objective.
Example:
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Actlvrties: 1.1 - Identify and survey private and public employers in the target
area to identify vacancies and possible on-the-job training
employment opportunities.
1.2 Develop a master lIst of employment opportunities.
1.3 DistrIbute list to 25 unemployed heads of households per month.
(Item 110) STARTING DATE" For each activity, write the exact starting date.
(r~em '11) ENDING DATE: - For each activity, write the exact endlnq date.
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(Item 112) FOR DCA USE ONLY - Do not write In this column.
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