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HomeMy WebLinkAboutContract 49981 34 56, v A N F TEXAS § CITY SECTTARY § CONTRACT NO, ... ,L426?6 1- 9.9 TY OF TARRANT § b £ Z This contract("Contract") is made and entered into by and between the City of Fort Worth (hereafter"City") and Sixty and Better, Inc. dba Senior Citizen Services (hereafter "Agency"), a Texas non-profit corporation. City and Agency may be referred to individually as a "Party" and jointly as "the Parties". The Parties state as follows: WHEREAS, City receives grant monies from the United States Department of Housing and Urban Development through the Community Development Block Grant("CDBG")Program, Program No. B-I 7-MC-48-00 10, Catalog of Federal Domestic Assistance No. 14.218; WHEREAS, a national objective of the CDBG program is to benefit low and moderate income citizens in accordance with 24 CFR Part 570,as amended from time to time; WHEREAS, Agency submitted a proposal to use CDBG funds for a program to serve individuals and families, of whom 100% must meet the HUD definition of a presumed benefit population; WHEREAS, City citizens, the Community Development Council, and the City Council have determined that CDBG programs are needed by the City's citizens. NOW, THEREFORE,the Parties understand and agree as follows: 1. INCORPORATION OF RECITALS. City and Agency hereby agree that the recitals set forth above are true and correct and form the basis upon which the Parties have entered into this Contract. 2. DEFINITIONS. In addition to terms defined in the body of this Contract, the terms set forth below shall have the definitions ascribed to them as follows: Area Median Income or AMI means the median family income for the Fort Worth-Arlington metropolitan statistical area as established annually by HUD. The 2017 income limits are attached hereto as EXHIBIT "A-1"—2017 HUD Income Limits. Business Diversity Enterprise Ordinance or BDE means the City's Business Diversity Ordinance, Ordinance No. 20020-12-2011. CDBG means Community Development Block Grant. '° " "Y . `_ Y CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 1 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 Complete Documentation means the following documentation as applicable: • Attachments I,II,and III,with supporting documentation including: o Proof of expense:copies of timesheets,invoices,leases,service contracts or other documentation showing that payment is due by Agency. c Proof of payment: cancelled checks, bank statements, or wire transfers necessary to demonstrate that amounts due by Agency were actually paid by Agency. o Proof of client eligibility: Client eligibility for all clients as outlined in Section 6. • Complete Documentation shall meet the standards described in the attached EXHIBIT "F"- Standards for Complete Documentation. • Any other document or record reasonably necessary to verify costs spent and client eligibility for the Program. CDBG Funds means the CDBG grant funds supplied by City to Agency under the terms of this Contract. CDBG Regulations means regulations found at 24 CFR Part 570 et seq. DBE means disadvantaged business enterprise in accordance with 49 CFR Part 26. Director means the Director of the Neighborhood Services Department. Effective Date means October 1, 2017. HUD means the United States Department of Housing and Urban Development. IDIS means Integrated Disbursement Information System,HUD's project tracking system. Income Eligible Client means a client whose annual income adjusted for family size does not exceed 80% of AMI using the most current HUD Income Guidelines and Technical Guidance for Determining Income and Allowances. The definition of annual income to determine client income eligibility shall be the definition contained in 24 CFR Part 5.609, as amended from time to time. National Objective means an activity that benefits low and moderate income persons. For the purposes of this Contract,at least 100%of the clients served by the Program fall into a"presumed benefit"category as defined in 24 CFR Part 570,and therefore are presumed to be Income Eligible Clients. Neighborhood Services Department means the City's Neighborhood Services Department. OMB means the Office of Management and Budget. Program means the services described in EXHIBIT "A"—Program Summary. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 2 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 Reimbursement Request means all reports and other documentation described in Section 9. Source Documentation means documentation of full household income of any type described under the definition of annual income in 24 CFR Part 5.609, including but not limited to copies of paychecks, Social Security and disability verification letters, interest or rental income statements, retirement income statements, child support and alimony verification, unemployment benefit letters, and the like. Unduplicated Clients means a count of all clients served by the Program at least once in the Contract Term. Clients served by the Program more than once in the Contract Term will only be counted the first time they are served when determining the total count of Unduplicated Clients. 3. TERM. The term of this Contract begins on the Effective Date and terminates on September 30, 2018 unless earlier terminated as provided in this Contract. 4. DUTIES AND RESPONSIBILITIES OF CITY. 4.1 Provide CDBG Funds. City shall provide up to $101,800 of CDBG Funds under the terms and conditions of this Contract. 4.2 Monitor. City will monitor the activities and performance of Agency and any of its contractors, subcontractors or vendors as necessary,but no less than annually. Monitoring by City will include determining whether Agency is meeting the National Objective during the term of this Contract. 5. DUTIES AND RESPONSIBILITIES OF AGENCY. 5.1 Required Services. Agency shall perform the services described in EXHIBIT "A"—Program Summary in accordance with the terms and conditions of this Contract. 5.2 Use of CDBG Funds. 5.2.1. Compliance with CDBG Regulations and Contract. Agency shall be reimbursed for eligible Program costs with CDBG Funds only if City determines in its sole discretion that: 5.2.1.1 Costs are eligible expenditures in accordance with CDBG Regulations. 5.2.1.2 Costs are in compliance with this Contract and are reasonable and consistent with industry norms. 5.2.1.3 Complete Documentation, as applicable, is submitted to City by Agency. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 3 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 5.2.2 Budget. 5.2.2.1 The CDBG Funds will be paid on a reimbursement basis in accordance with EXHIBIT `B"-Budget. 5.2.2.2 During the term of this Contract, Agency may submit written requests to increase or decrease line-item amounts in the Budget, including an explanation of why such increases or decreases are necessary. All requests shall be approved by Director in writing, with such approval being in the Director's sole discretion. If Director approves the Agency's proposed Budget amendment (as approved, the "Amended Budget"),then the Amended Budget will take effect on the first day of the month following the month in which it was approved by Director, unless otherwise specified in the amendment. All requests for Budget amendments must be submitted by June 1,2018. 5.2.3 Change in Program Budget. 5.2.3.1 Agency will notify City promptly of any additional funds it receives for operation of the Program, and City reserves the right to amend this Contract in such instances to ensure compliance with HUD regulations governing cost allocation. 5.2.3.2 Agency agrees to utilize the CDBG Funds to supplement rather than supplant funds otherwise available for the Program. 5.2.4 Payment of CDBG Funds to Agency. CDBG Funds will be disbursed to Agency upon City's approval of Reimbursement Requests including submission of Complete Documentation to City in compliance with Section 9. If Agency expends all funds budgeted for the Program prior to September 30, 2018, City may hold back a small amount of the CDBG Funds until the end of the term. During this interim period, Agency must continue to submit Attachment III — Client Data Report in Exhibit "D" — Reimbursement Forms monthly. It is expressly agreed by the Parties that any CDBG Funds not spent or approved for reimbursement to Agency shall remain with City. 5.3 Program Performance Milestones. 5.3.1 Agency represents that the Program will achieve the following milestones in accordance with EXHIBIT "A"—Program Summary and the table below: CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 4 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 Unduplicated Clients as specified in EXHIBIT "X'—Program Month Expenditures Summar 3 25% 25% 6 50% 50% 9 75% 75% 12 100% 100% 5.3.2 Failure of Agency to meet these milestones or a material deviation from them as outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section,"material deviation" shall mean more than 10% lower than the specified goal. In the event of such breach, City reserves the right in its sole option to (i) delay or withhold payment of Reimbursement Requests, (ii) lower Agency's allocation of CDBG Funds, or(iii)terminate this Contract. 5.3.3 Failure to meet at least 80% of its performance milestones or serve 240 Unduplicated Clients under this Contract may, in City's sole discretion disqualify Agency for consideration under the City's Request for Proposals for the 2018-2019 Program Year for federal grant funds. 5.3.4 Amendments to performance milestones regarding CDBG Funds must be approved by the Director in writing, with such approval being in the Director's sole discretion. If Director approves the Agency's proposed amended performance milestones (as approved, the "Amended Performance Milestones"), then the Amended Performance Milestones will take effect on the first day of the month following the month in which it was approved by Director,unless otherwise specified in the amendment. All requests for amendments to performance milestones must be submitted by June 1, 2018. Notwithstanding the above, any amendments to this Contract shall not reduce the number of Unduplicated Clients stated in Section 5.3.3 and in EXHIBIT "A" - Program Summary. 5.4 Identify Program Expenses Paid with CDBG Funds. Agency will keep accounts and records in such a manner that City may readily identify and account for Program expenses reimbursed with CDBG Funds. These records shall be made available to City for audit purposes and shall be retained as required hereunder. 5.5 Meet National Objective. Agency shall ensure that the activities carried out in the Program will meet the National Objective. 5.6 Program Subcontracts. Agency shall not enter into a subcontract with another agency, contractor, or vendor to provide a service to clients for any part of the Program that will be paid with CDBG Funds without City's written consent. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 5 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 6. CLIENT ELIGIBILITY VERIFICATION. 6.1 Client Eligibility. Agency will document client eligibility as follows: 6.3.1 Agency Clients. Agency must document that all clients served by the Program fall under a "presumed benefit"category as defined in 24 CFR Part 570. For purposes of this Contract,the categories of presumed benefit are: severely disabled adults, homeless persons, abused or neglected children and youth, or elderly persons. Eligible forms of documentation for each category include: 6.3.1.1 Severely Disabled Adults. Written, signed and dated diagnosis from a licensed medical professional. As an acceptable alternative, Agency may use the form attached hereto as Exhibit"H"—Severely Disabled Certification Form. 6.3.1.2 Homeless Persons. Written, signed and dated certification from an outreach worker. 6.3.1.3 Abused or Neglected Children and Youth. Written,signed and dated certification from an outreach worker. 6.3.1.4 Elderly Persons. An elderly person is an individual at least 62 years of age. Copy of a birth certificate, driver's license,passport, immigration card, military identification, or any other state, local, national or international documentation, must be provided showing current information about the age or birth date of the client. The form in Exhibit "E" — Form of Income Self Certification, or a similar document,will also be required in order to collect demographic data. 6.4 Submission of Complete Documentation. Agency must submit copies of documentation of client eligibility described in Section 6.1 with Attachment III with each month's Reimbursement Request for all Unduplicated Clients. 6.3 Maintain Documentation. Agency must maintain copies of all documentation required by this Section for 5 years following the expiration of the Contract term. This Section shall survive the earlier termination or expiration of this Contract. 7. ADDITIONAL CDBG REQUIREMENTS. Agency agrees to comply with all requirements of the CDBG Program as stated in the CDBG Regulations, including but not limited to the following: CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 6 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 7.1 Environmental Review. CDBG Funds will not be paid, and costs cannot be incurred until City has conducted an environmental review and completed an Environmental Review Record as required by 24 CFR Part 58. The environmental review may result in a decision to proceed with,modify,or cancel the funding for the Program. Further, Agency will not undertake or commit any funds to physical or choice limiting actions as described in any applicable federal regulations. Any violation of this provision will (i) cause this Contract to terminate immediately, and (ii) require Agency to repay City the CDBG Funds it has already received and forfeit any future payments of CDBG Funds. 7.2 Contract Not Constituting Commitment of Funds. Notwithstanding any provision of this Contract, the Parties agree and acknowledge that this Contract does not constitute a commitment of funds, and that such commitment of funds or approval may occur only upon(i) satisfactory completion of an environmental review and receipt by City of an authorization to use grant funds from HUD under 24 CFR Part 58, (ii) approval of City's 2017-2018 Action Plan,and(iii)receipt by City of a grant agreement from HUD. 7.3 Monitoring. 7.3.1 Agency understands and agrees that it will be subject to monitoring by City for compliance with terms and provisions of this Contract and the CDBG Regulations for the term of this Contract. Agency is subject to such monitoring during the term of this Contract and for 5 years after the Contract term ends. Agency will provide reports and access to Program files as requested by City during this 5 year period. For purposes of this Contract, this 5 year period for monitoring is deemed to begin on October 1,2018 and end on September 30,2023 regardless of whether or not this Contract is earlier terminated. 7.3.2 Representatives of City, HUD, HUD Office of Inspector General, and the United States Comptroller General shall have access during regular business hours, upon 48 hours prior notice,to Agency's offices and records pertaining to the use of the CDBG Funds, and to Agency's officers, directors, agents, employees, contractors, subcontractors and vendors for the purpose of such monitoring. 7.3.3 In addition to other provisions of this Contract regarding frequency of monitoring, City reserves the right to perform desk reviews or on-site monitoring of Agency's compliance with the terms and conditions of this Contract. City shall provide Agency with a written report of the monitor's findings after each monitoring visit. If the monitoring report notes deficiencies in Agency's performance, the report shall include requirements for the timely correction of said deficiencies by Agency. Failure by Agency to take the action specified in the monitoring report may be cause for suspension or termination of this Contract as provided herein. 7.3.4 Subsections 7.3.1 through 7.3.3 shall be applicable for the Contract term and for 5 years thereafter and shall survive the earlier termination or expiration of this Contract. 7.3.5 Agency shall provide City annually the results of any state or federal monitoring. Such results shall be submitted within 60 days of receipt of such state or federal monitoring report, or with the January Reimbursement Request,whichever is earlier. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 7 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 7.4 ARency Procurement Standards. Agency shall comply with all applicable federal, state and local laws, regulations, and ordinances for making procurements under this Contract. In addition to the conflict of interest provisions in Section 14.13.3, Agency shall establish written procurement procedures to ensure that materials and services are obtained in a cost effective manner and that provides for full and open competition. When procuring materials and services for this Contract,Agency shall comply at a minimum with the procurement standards in 2 CFR Part 200.317 through Part 200.326. 7.4.1 Contracts in excess of $10,000.00 made by Agency using CDBG Funds must address termination for cause and convenience including the manner by which such termination shall be effected and the basis for settlement of the terminated contract, if any, as required by Appendix II(B), 2 CFR Part 200. 7.4.2 Agency shall not make any contract with parties listed on the government wide System for Award Management, www.sam.gov ("SAM"). Agency must confirm by search of SAM that all contractors paid with CDBG Funds are not listed by SAM as being debarred, both prior to hiring and prior to submitting a Reimbursement Request which includes invoices from any such contractor. Failure to submit such proofs of search shall be an event of default. 7.5 Cost Principles/Cost Reasonableness. Agency shall administer its use of CDBG Funds in compliance with 2 CFR Part 200, as applicable. The eligibility of costs incurred for performance rendered shall be determined in accordance with 2 CFR Part 200.400 through Part 200.475. 7.6 Financial Management Standards. Agency agrees to comply with 2 CFR Part 200,as applicable. Agency also agrees to adhere to the accounting principles and procedures required therein,utilize adequate internal controls,and maintain necessary supporting and back-up documentation for all costs incurred in accordance with 2 CFR Part 200.302 and Part 200.303. 7.7 Uniform Administrative Requirements, Cost Principles, and Audit Requirements. Agency will comply with the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards in 2 CFR Part 200, as applicable, or any reasonably equivalent procedures and requirements that City may require. 7.8 Terms Applicable to Contractors, Subcontractors and Vendors. Agency understands and agrees that all terms of this Contract, whether regulatory or otherwise, shall apply to any and all contractors,subcontractors and vendors of Agency which are in any way paid with CDBG Funds or who perform any work in connection with the Program. Agency shall cause all applicable provisions of this Contract to be included in and made a part of any contract or subcontract executed in the performance of its obligations hereunder including its obligations regarding the CDBG Regulations. Agency shall monitor the services and work performed by its contractors, subcontractors and vendors on a regular basis for compliance with the CDBG Regulations and Contract provisions. Agency must cure all violations of the CDBG Regulations committed by its contractors, subcontractors or vendors. City maintains the right to CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 8 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 insist on Agency's full compliance with the terms of this Contract and the CDBG Regulations and Agency is responsible for such compliance regardless of whether actions taken to fulfill the requirements of this Contract are taken by Agency or by Agency's contractors, subcontractors or vendors. Agency acknowledges that the provisions of this Section shall survive the earlier termination or expiration of this Contract and shall be applicable for 5 years after the Contract term ends. 7.9 Copyright and Patent Rights. No reports,maps,or other documents produced in whole or in part under this Contract shall be the subject of an application for copyright by or on behalf of Agency. HUD and City shall possess all rights to invention or discovery,as well as rights in data,which may arise as a result of Agency's performance under this Contract. 7.10 Conflict of Interest Disclosure. In accordance with the requirements of Section 14.13.2.1 and 14.13.4, Agency shall establish conflict of interest policies for federal awards. Agency shall disclose to City in writing any potential conflict of interest. 7.11 Compliance with FFATA and Whistleblower Protections. Agency shall comply with the requirements of 2 CFR 300(b), including provisions of the Federal Funding Accountability and Transparency Act ("FFATA") governing requirements on executive compensation and provisions governing whistleblower protections contained in 10 U.S.C. 2409,41 U.S.C. 4712, 10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310. 7.11.1 Agency shall provide City with its DUNS number. 7.12 Internal Controls. In compliance with the requirements of 2 CFR Part 200.303,Agency shall: 7.12.1 Establish and maintain effective internal control over the CDBG Funds that provides reasonable assurance that Agency is managing the CDBG Funds in compliance with federal statutes,regulations,and the terms and conditions of this Contract. These internal controls shall be in compliance with guidance in "Standards for Internal Control in the Federal Government" issued by the Comptroller General of the United States or the "Internal Control Integrated Framework" issued by the Committee of Sponsoring Organizations of the Treadway Commission("COSO"); 7.12.2 Comply with federal statutes, regulations, and the terms and conditions of this Contract; 7.12.3 Evaluate and monitor Agency's compliance with statutes,regulations and the terms and conditions of this Contract; 7.12.4 Take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings; and CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 9 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 7.12.5 Take reasonable measures to safeguard protected personally identifiable information and other information that HUD or City designates as sensitive or Agency considers sensitive consistent with applicable federal, state, local and tribal laws regarding privacy and obligations of confidentiality. 8. RECORD KEEPING; REPORTING AND DOCUMENTATION REOUIREMENTS; AUDIT. 8.1 Record Keeping. Agency shall maintain a record-keeping system as part of its performance of this Contract and shall promptly provide City with copies of any document City deems necessary for the effective fulfillment of City's monitoring and evaluation responsibilities. Specifically, Agency will keep or cause to be kept an accurate record of all actions taken and all funds spent, with supporting and back-up documentation. Agency will maintain all records and documentation related to this Contract for 5 years after the Contract term ends. If any claim, litigation,or audit is initiated before the expiration of the 5 year period, the relevant records and documentation must be retained until all such claims, litigation or audits have been resolved. For purposes of this Contract, this 5 year period for record retention is deemed to begin on October 1, 2018 and end on September 30,2023 regardless of whether or not this Contract is earlier terminated. 8.2 Access to Records. Representatives of City, HUD and any duly authorized officials of the federal government will have full access to, and the right to examine, audit, copy, excerpt and/or transcribe any of Agency's records pertaining to all matters covered by this Contract for 5 years after the Contract term ends. Such access shall be during regular business hours and upon at least 48 hours prior notice. For purposes of this Contract, this 5 year period for access to records is deemed to begin on October 1,2018 and end on September 30,2023 regardless of whether or not this Contract is earlier terminated. 8.3 Reports. Agency will submit to City all reports and documentation described in this Contract in such form as City may prescribe. Agency may also be required to submit a final performance and/or final financial report if required by City at the termination of this Contract in such form and within such times as City may prescribe. Failure to submit to City any report or documentation described in this Contract shall be an event of default of this Contract and City may exercise all of its remedies for default under this Contract. 8.3.1 Additional Information. Agency shall provide City with additional information as may be required by state or federal agencies to substantiate Program activities and/or expenditure eligibility. 8.4 Change in Reporting Requirements and Forms. City retains the right to change reporting requirements and forms at its discretion. City will notify Agency in writing at least 15 days prior to the effective date of such change, and the Parties shall execute an amendment to the Contract reflecting such change if necessary. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 10 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 8.5 Audit. 8.5.1 Entities that Expend $750,000 or more in Federal Funds Per Year. All non-federal entities that expend $750,000 or more in federal funds within 1 year, regardless of the source of the federal award, must submit to City an annual audit prepared in accordance with specific reference to 2 CFR Part 200.501 through Part 200.521. The audit shall cover the Agency's fiscal years during which this Contract is in force. The audit must be prepared by an independent certified public accountant,be completed within 6 months following the end of the period being audited and be submitted to City within 30 days of its completion. Agency's audit certification is attached hereto as EXHIBIT "C" — "Audit Certification Form" and "Audit Requirements". The Audit Certification Form must be submitted to City prior to or with the first Reimbursement Request. Entities that expend less than $750,000 a year in federal funds are exempt from federal audit requirements for that year, but records must be available for review or audit by appropriate officials of the federal agency, City, and General Accounting Office. 8.5.2 City Reserves the Right to Audit. City reserves the right to perform an audit of Agency's Program operations and finances at any time during the term of this Contract and for 5 years after the Contract term ends if City determines that such audit is necessary for City's compliance with the CDBG Regulations or other City policies. Agency agrees to allow access to all pertinent materials as described herein for such audit. For purposes of this Contract, this 5 year period for City audit is deemed to begin on October 1, 2018 and end on September 30, 2023 regardless of whether or not this Contract is earlier terminated. If such audit reveals a questioned practice or expenditure, such questions must be resolved within 15 business days after notice to Agency of such questioned practice or expenditure. If questions are not resolved within this period, City reserves the right to withhold further funding under this Contract and/or any other contracts with Agency. IF AS A RESULT OF ANY AUDIT IT IS DETERMINED THAT AGENCY HAS FALSIFIED ANY DOCUMENTATION OR MISUSED, MISAPPLIED OR MISAPPROPRIATED CDBG FUNDS OR SPENT CDBG FUNDS ON ANY INELIGIBLE ACTIVITIES, AGENCY AGREES TO REIMBURSE CITY THE AMOUNT OF SUCH MONIES PLUS THE AMOUNT OF ANY SANCTIONS,PENALTY OR OTHER CHARGE LEVIED AGAINST CITY BY HUD BECAUSE OF SUCH ACTIONS. 9. REIMBURSEMENT REQUIREMENTS. 9.1 Deadline for Submitting Reimbursement Requests. 9.1.1 Reimbursement Requests shall be submitted monthly to the City and must be received by the City on or before the 15th day of the month following the month expenses were paid by Agency. For example, the Reimbursement Request for June expenses must be received by July 15. In the event the 15th falls on a weekend or City holiday, Reimbursement Requests shall be due the next day that the City is open for business. Failure to submit a Reimbursement Request in a timely fashion will result in City taking the actions outlined in Section 10.1. NOTWITHSTANDING ANYTHING ABOVE, THE REIMBUSEMENT REQUEST FOR EXPENSES INCURRED FOR SEPTEMBER 2018 MUST BE RECEIVED BY OCTOBER 1, 2018. COMPLETE DOCUMENTATION FOR ALL SEPTEMBER 2018 EXPENSES MUST BE SUBMITTED BY OCTOBER 15, 2018. FAILURE TO SUBMIT A FINAL CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 11 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 REIMBURSEMENT REQUEST WITH COMPLETE DOCUMENTATION BY OCTOBER 15, 2018 WILL RESULT IN FORFEITURE OF PAYMENT OF THE SEPTEMBER REIMBURSEMENT REQUEST. 9.1.2 City will notify Agency by e-mail within 20 calendar days if a Reimbursement Request is lacking Complete Documentation or corrections are needed. Agency will have 10 business days from the date of the e-mail notice to submit any requested information or missing documentation. Agency may be penalized, at City's sole discretion in the Request for Proposal for the 2018-2019 Program Year for any notifications received under this Section. If Agency fails to submit all the required information or missing documentation within 30 calendar days from the first e-mail,Agency shall forfeit any payments otherwise due that month and failure to submit any requested information will be considered an event of default as outlined in Section 10.1.2. 9.2 Submission of Reimbursement Requests. Agency shall provide City with Complete Documentation and the following reports as shown in EXHIBIT "D"—Reimbursement Forms with each Reimbursement Request: 9.2.1 Attachment I—Invoice. This report shall contain the amount requested for reimbursement each month,the cumulative reimbursement requested to date (inclusive of that month's request). 9.2.2 Attachment II—Expenditure Worksheet. This report shall itemize each expense requested for reimbursement by Agency and shall include the Account corresponding the expense to a Budget line item. In order for this report to be complete the following must be submitted: 9.2.2.1 For payroll expenses,timesheets signed by employees and approved by supervisor for all payroll expenses listed. Timesheets must distinguish between CDBG-funded time and non-CDBG funded time and reflect actual time spent on CDBG-funded activities. Agency may not submit payroll expenses dated 60 calendar days prior to the date of the Reimbursement Request. 9.2.2.2 For non-payroll expenses, invoices for each expense listed with an explanation as to how the invoiced expense pertains to the Program. Agency may not submit invoices dated 60 calendar days prior to the date of the Reimbursement Request. 9.2.2.3 Proof that each expense was paid by Agency, which proof can be satisfied by cancelled checks,wire transfer documentation,paid receipts or other appropriate banking documentation. 9.2.3 Attachment III—Client Data Report. This report shall list each Unduplicated Client served during the month along with his or her demographic information. The Client Data Report must maintain a list of all clients served during the Contract term. In order for this report to be complete,the following must be submitted: CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 12 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 9.2.3.1 Documentation of"presumed benefit"eligibility for each Unduplicated Client the first time the client is served by the Program, as defined in Section 6. 9.2.4 Delivery of Reimbursement Request. Reimbursement Requests can be mailed or delivered in person to Neighborhood Services Department, 908 Monroe Street, Fort Worth, Texas 76102. In addition, Agency can submit Reimbursement Requests via email to psa@fortworthtexas.gov or to the Agency's designated City contract administrator. 9.3 Withholding Payment. CITY SHALL HAVE NO OBLIGATION TO PAY ANY REIMBURSEMENT REQUEST THAT IS NOT RECEIVED BY THE DUE DATE. Failure to timely submit Reimbursement Requests and Complete Documentation along with any required reports shall be an event of default. 10. DEFAULT AND TERMINATION. 10.1 Failure to Submit Reimbursement Request or Required Documentation. 10.1.1 If Agency fails to submit a Reimbursement Request in accordance with Section 9, Agency shall be in default of this Contract. City will notify Agency in writing of such default and the Agency will have 10 business days from the date of the written notice to submit such Reimbursement Request to cure the default. If Agency fails to cure the default within such time, Agency shall forfeit any payments otherwise due that month. 10.1.2 If Agency fails to submit requested information or missing documentation as set forth in Section 9.1.2, then Agency shall forfeit payment due that month and the failure to submit shall be considered an event of default that shall not be cured. 10.1.3 NOTWITHSTANDING THE PROVISIONS OF SECTION 10.1.1 OR 10.1.2, IF AGENCY FAILS TO SUBMIT THE REIMBURSEMENT REQUEST DUE OCTOBER 15, 2018, OR IF THE SUBMITTED REIMBURSEMENT REQUEST FOR OCTOBER 15,2018 IS LATE,INCOMPLETE OR OTHERWISE NOT IN COMPLIANCE WITH THIS CONTRACT OR THE CDBG REGULATIONS AS DETERMINED BY CITY IN ITS SOLE DISCRETION, THERE WILL BE NO CURE PERIOD AND ANY REIMBURSEMENT WILL BE FORFEITED. 10.1.4 In the event of(i)an uncured default under Section 10.1.1 or an event of default under 10.1.2 or(ii) more than 2 instances of default, cured or uncured,under these Sections, City reserves the right at its sole option to terminate this Contract effective immediately upon written notice of such intent with no penalty or liability to City. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 13 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 10.1.5 Notwithstanding anything to the contrary herein, City will not be required to pay any CDBG Funds to Agency during the period that any Reimbursement Request, report or documentation is past due or is not in compliance with this Contract or the CDBG Regulations,or during any period during which Agency is in default of this Contract. 10.1.6 In the event of termination under this Section 10.1, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds. 10.2 Failure to Maintain Records or Submit Reports and Documentation. If Agency fails to maintain all records and documentation as required in Section 8,or if the maintained or submitted report or documentation is not in compliance with this Contract or the CDBG Regulations as determined by City in its sole discretion,City will notify Agency in writing and Agency will have 30 calendar days from the date of the written request to obtain or recreate the missing records and documentation or submit or resubmit any such report or documentation to City. If Agency fails to maintain the required reports or documentation, or fails to submit or resubmit any such report or documentation within such time,City shall have the right to terminate this Contract effective immediately upon written notice of such intent with no penalty or liability to City. 10.2.1 In the event of termination under this Section 10.2, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds, and any CDBG Funds paid to Agency must be repaid to City within 30 days of termination. If such CDBG Funds are not repaid to City within the 30 day period, City shall exercise all legal remedies available under this Contract. 10.3 In General. 10.3.1 Subject to Section 10.2, and unless specifically provided otherwise in this Contract,Agency shall be in default under this Contract if Agency breaches any term or condition of this Contract. In the event that such a breach remains uncured after 30 calendar days following written notice by City (or such other notice period as may be specified herein) or, if Agency has diligently and continuously attempted to cure following receipt of such written notice but reasonably requires more than 30 calendar days to cure, as determined by both Parties mutually and in good faith, City shall have the right to elect in City's sole discretion to (i)extend Agency's time to cure, (ii)terminate this Contract effective immediately upon written notice of such intent to Agency, or(iii)pursue any other legal remedies available to City under this Contract. 10.3.2 City's remedies may include: 10.3.2.1 Direct Agency to prepare and follow a schedule of actions for carrying out the affected activities, consisting of schedules, timetables and milestones necessary to implement the affected activities. 10.3.2.2 Direct Agency to establish and follow a management plan that assigns responsibilities for carrying out the remedial activities. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 14 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 10.3.2.3 Reprogram CDBG Funds that have not yet been expended from affected activities to other eligible activities or withhold CDBG Funds. 10.3.2.4 Any other appropriate action including but not limited to any remedial action legally available such as declaratory judgment, specific performance, damages, temporary or permanent injunctions,termination of this Contract or any other contracts with Agency, and any other available remedies. 10.3.3 In the event of termination under this Section 10.3, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds, and any CDBG Funds already paid to Agency must be repaid to City within 30 days of the termination. Failure to repay such CDBG Funds within the 30 day period will result in City exercising all legal remedies available under this Contract. 10.4 No Funds Disbursed while in Breach. Agency understands and agrees that no CDBG Funds will be paid to Agency until all defaults are cured to City's satisfaction. 10.5 No Compensation After Date of Termination. Agency shall not receive any compensation for work undertaken after the date of the termination. 10.6 Rights of City Not Affected. Termination shall not affect or terminate any of the existing rights of City against Agency, or which may thereafter accrue because of Agency's default and this provision shall be in addition to any and all other rights and remedies available to City under the law. Such termination does not terminate any provisions of this Contract that have been expressly noted as surviving the term or termination of the Contract. No delay or omission by City in exercising any right or remedy available to it under this Contract shall impair any such right or remedy or constitute a waiver or acquiescence in any Agency default. 10.7 Waiver of Breach Not Waiver of Subsequent Breach. The waiver of a default or breach of any term,covenant, or condition of this Contract shall not operate as a waiver of any subsequent default or breach of the same or any other term,covenant or condition hereof. 10.8 Civil, Criminal and Administrative Penalties. Failure to perform all the Contract terms may result in civil, criminal or administrative penalties, including,but not limited to those set out in this Contract. 10.9 Termination for Cause. 10.9.1 City may terminate this Contract in the event of Agency's default, inability, or failure to perform subject to notice, grace and cure periods. In the event City terminates this Contract for cause, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 15 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 be immediately rescinded and Agency shall have no further right to such funds and any CDBG Funds already paid to Agency must be repaid to City within 30 days of termination. Failure to repay such CDBG Funds within 30 days will result in City exercising all legal remedies available to City under this Contract. AGENCY ACKNOWLEDGES AND AGREES THAT IF CITY TERMINATES THIS CONTRACT FOR CAUSE, AGENCY OR ANY AFFILIATES OF AGENCY SHALL NOT BE CONSIDERED FOR ANY OTHER CITY CONTRACT FOR CDBG FUNDS FOR A MINIMUM OF 5 YEARS FROM THE DATE OF TERMINATION. 10.9.2 Agency may terminate this Contract if City does not provide the CDBG Funds substantially in accordance with this Contract. 10.10 Termination for Convenience. In terminating in accordance with 2 CFR Part 200, Appendix II, this Contract may be terminated in whole or in part only as follows: 10.10.1 By City with the consent of Agency in which case the Parties shall agree upon the termination conditions, including the effective date and in the case of partial termination, the portion to be terminated; or 10.10.2 By Agency upon at least 30 days written notification to City, setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. In the case of a partial termination,City may terminate the Contract in its entirety if City determines in its sole discretion that the remaining portion of the Contract to be performed or CDBG Funds to be spent will not accomplish the purposes for which the Contract was made. 10.11 Dissolution of Agency Terminates Contract. This Contract shall terminate in the event Agency is dissolved or ceases to exist. In the event of termination under this Section,all CDBG Funds are subject to repayment and/or City may exercise all of its remedies under this Contract. 10.12 Reversion of Assets. In the event this Contract is terminated with or without cause,all assets acquired by Agency with the CDBG Funds including cash, interest payments from loans or otherwise, all outstanding notes, mortgages or other security instruments, any accounts receivable attributable to the use of the CDBG Funds, and any real or personal property owned by Agency that was improved with the CDBG Funds shall automatically transfer to City or to such assignee as City may designate. 11. REPAYMENT OF CDBG FUNDS. All CDBG Funds are subject to repayment in the event the Program does not meet the requirements of this Contract or in the CDBG Regulations. If Agency takes any action that results in the City being required to repay all or any portion of the CDBG Funds to HUD, Agency agrees it will reimburse City for such repayment. If Agency takes any action that results in City receiving a finding from HUD about the Program,whether or not repayment of all or any portion of the CDBG Funds is required of City,Agency agrees City may require that 10% of the CDBG Funds be repaid to City as liquidated damages. The Parties agree that CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 16 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 City's damages in the event of either repayment to HUD being required or receiving a finding from HUD are uncertain and would be difficult to ascertain and may include an impact on City's CDBG grant or other federal grant funds, in addition to the finding by HUD or a required repayment of funds to HUD by City. Therefore,the Parties agree that payment under this Section of 10% of the CDBG Funds by Agency to City is liquidated damages and not a penalty. 12. CHANGE IN NON-PROFIT STATUS. Agency must provide City with written notification of any changes to its non-profit status within 15 calendar days of being notified of the change. Regardless of notice by Agency, if the non-profit status of Agency changes after the date of this Contract, City may but is not obligated to, terminate this Contract. In the event of termination under this Section 12, all CDBG Funds awarded but not yet paid to Agency pursuant to this Contract shall be immediately rescinded and Agency shall have no further right to such funds. City in its sole discretion, may require that any CDBG Funds already paid to Agency must be repaid to City within 30 calendar days of termination under this Section. 13. SURVIVAL. Any provision of this Contract that pertains to auditing, monitoring, client income eligibility, record keeping and reports, City ordinances, or applicable CDBG requirements, and any default and enforcement provisions necessary to enforce such provisions, shall survive the termination of this Contract for 5 years after the Contract term ends and shall be enforceable by City against Agency. For purposes of this Contract, this 5 year period for survival of certain Contract provisions is deemed to begin on October 1, 2018 and end on September 30, 2023 regardless of whether or not this Contract is earlier terminated. 14. GENERAL PROVISIONS. 14.1 Agency an Independent Contractor. Agency shall operate hereunder as an independent contractor and not as an officer, agent, servant or employee of City. Agency shall have exclusive control of, and the exclusive right to control, the details of the work and services performed hereunder, and all persons performing same, and shall be solely responsible for the acts and omissions of its officers, members, agents, servants, employees, contractors, subcontractors,vendors, clients, licensees or invitees. 14.2 Doctrine of Respondeat Superior. The doctrine of respondeat superior shall not apply as between City and Agency, or its officers, members, agents, servants, employees, contractors, subcontractors, vendors, clients, licensees or invitees, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Agency. City does not have the legal right to control the details of the tasks performed hereunder by Agency, its officers, members, agents, employees, contractors, subcontractors,vendors, clients, licensees or invitees. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 17 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 14.3 Agency Property. City shall under no circumstances be responsible for any property belonging to Agency,or its officers, members, agents, employees, contractors, subcontractors, vendors, clients, licensees or invitees that may be lost, stolen or destroyed or in any way damaged and AGENCY HEREBY INDEMNIFIES AND HOLDS HARMLESS CITY AND ITS OFFICERS, AGENTS, AND EMPLOYEES FROM ANY AND ALL CLAIMS OR SUITS PERTAINING TO OR CONNECTED WITH SUCH PROPERTY. 14.5 Religious Organization. Agency shall comply with all applicable requirements as more particularly described in 24 CFR Part 5.109. No portion of the CDBG Funds shall be used in support of any sectarian or religious activity. In addition,there must be no religious or membership criteria for clients of a CDBG-funded service. 14.5.1. Separation of Explicitly Religious Activities. Agency retains its independence and may continue to carry out its mission, including the definition, development practice, and expression of its religious beliefs,provided that it does not use CDBG Funds to support or engage in any explicitly religious activities (including activities that involve overt religious content such as worship, religious instruction, or proselytization), or in any other manner prohibited by law. 14.5.2 Explicitly Religious Activities. If Agency engages in explicitly religious activities (including activities that involve overt religious content such as worship,religious instruction,or proselytization),the explicitly religious activities must be offered separately,in time or location,from the programs or activities supported by CDBG Funds and participation must be voluntary for clients of a CDBG-funded service. 14.5.3 Required Notices. If Agency constitutes a Faith-based organization under 24 CFR Part 5.109, Agency must provide all clients of a CDBG-funded service with the notice attached as EXHIBIT"K"—Notice of Beneficiary Rights. Such notice shall be provided to the client prior to enrollment in any CDBG-funded program or activity. In addition,if a client or prospective client of a CDBG-funded service objects to the religious character of Agency, then Agency must promptly undertake reasonable efforts to identify and refer the client or prospective client to an alternate provider to which the client or prospective client has no such objection, as more particularly described in 24 CFR Part 5.109. 14.6 Venue. Venue shall lie in Tarrant County, Texas for any action,whether real or asserted, at law or in equity, arising out of the execution,performance,attempted performance or non-performance of this Contract. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 18 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 14.7 Governing Law. This Contract shall be governed by and construed in accordance with the laws of the State of Texas. If any action, whether real or asserted, at law or in equity, arises out of the execution, performance or non-performance of this Contract or on the basis of any provision herein, for any issue not governed by federal law,the choice of law shall be the laws of the State of Texas. 14.8 Severability. The provisions of this Contract are severable, and if for any reason a clause, sentence, paragraph or other part of this Contract shall be determined to be invalid by a court or federal or state agency, board or commission having jurisdiction over the subject matter thereof, such invalidity shall not affect other provisions which can be given effect without the invalid provision. 14.9 Written Agreement Entire Contract. This written instrument and the Exhibits, Attachments, and Addendums attached hereto, which are incorporated by reference and made a part of this Contract for all purposes, constitute the entire agreement by the Parties concerning the work and services to be performed under this Contract. Any prior or contemporaneous oral or written agreement which purports to vary the terms of this Contract shall be void. Any amendments to the terms of this Contract must be in writing and executed by the Parties. 14.10 Paragraph Headings for Reference Only, No Legal Significance; Number and Gender. The paragraph headings contained herein are for convenience in reference to this Contract and are not intended to define or to limit the scope of any provision of this Contract. When context requires,singular nouns and pronouns include the plural and the masculine gender shall be deemed to include the feminine or neuter and the neuter gender to include the masculine and feminine. The words"include"and"including"whenever used herein shall be deemed to be followed by the words"without limitation". 14.11 Compliance With All Applicable Laws and Regulations. Agency agrees to comply fully with all applicable laws and regulations that are currently in effect or that are hereafter amended during the performance of this Contract. Those laws include,but are not limited to: ➢ CDBG Regulations found in 24 CFR Part 570 ➢ Title I of the Housing and Community Development Act of 1974, as amended, (42 USC 5301) ➢ Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d et seq.) including provisions requiring recipients of federal assistance to ensure meaningful access by persons of limited English proficiency ➢ The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. Sections 3601 et seq.) ➢ Executive Orders 11063, 11246 as amended by 11375 and 12086 and as supplemented by Department of Labor regulations 41 CFR Part 60 ➢ The Age Discrimination in Employment Act of 1967 ➢ The Age Discrimination Act of 1975 (42 U.S.C. Sections 6101 et seq.) CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 19 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 ➢ The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (42 U.S.C. Sections 4601 et seq. and 49 CFR Part 24) ("URA") ➢ Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sections 794 et seq.) and 24 CFR Part 8 where applicable ➢ National Environmental Policy Act of 1969, as amended, 42 U.S.C. Sections 4321 et seq. ("NEPA")and the related authorities listed in 24 CFR Part 58. ➢ The Clean Air Act,as amended, (42 U.S.C. Sections 1251 et seq.)and the Clean Water Act of 1977, as amended (33 U.S.C. Sections 1251 et seq.) and the related Executive Order 11738. In no event shall any amount of the assistance provided under this Contract be utilized with respect to a facility that has given rise to a conviction under the Clean Air Act or the Clean Water Act. ➢ Immigration Reform and Control Act of 1986 (8 U.S.C. Sections 1101 et seq.) specifically including the provisions requiring employer verifications of legal status of its employees ➢ The Americans with Disabilities Act of 1990 (42 U.S.C. Sections 12101 et seq.), the Architectural Barriers Act of 1968 as amended (42 U.S.C. Sections 4151 et seq.) and the Uniform Federal Accessibility Standards, 24 CFR Part 40,Appendix A ➢ Regulations at 24 CFR Part 87 related to lobbying, including the requirement that certifications and disclosures be obtained from all covered persons ➢ Drug Free Workplace Act of 1988 (41 U.S.C. Sections 701 et seq.) and 24 CFR Part 23, Subpart F ➢ Executive Order 12549 and 24 CFR Part 5.105(c) pertaining to restrictions on participation by ineligible, debarred or suspended persons or entities ➢ Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act ➢ Guidelines of the Environmental Protection Agency at 40 CFR Part 247 ➢ For contracts and subgrants for construction or repair, Copeland"Anti-Kickback" act (18 U.S.C. 874) as supplemented in 29 CFR Part 5 ➢ For construction contracts awarded by Agency in excess of$2,000, and in excess of $2,500 for other contracts which involve the employment of mechanics or laborers, Sections 103 and 107 of the Contract Work Hours and Safety Standards Act(40 U.S.C. 327A 300)as supplemented by 29 CFR Part 5 ➢ Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), as amended by the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et seq.)and implementing regulations at 24 CFR Part 35, subparts A,B,M, and R ➢ Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, 2 CFR Part 200 et seq. ➢ Federal Funding Accountability and Transparency Act of 2006 ("FFATA") (Pub.L. 109-282, as amended by Section 6205(a) of Pub.L. 110-252 and Section 3 of Pub.L. 113-101) ➢ Federal Whistleblower Regulations, as contained in 10 U.S.C. 2409, 41 U.S.C. 4712, 10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310. 14.12 HUD Assisted Proieets and Employment and other-Eeonomie Oppertuni CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 20 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 14.13 Prohibition Against Discrimination. 14.13.1 General Statement. Agency shall comply in the execution, performance or attempted performance of this Contract,with all non-discrimination requirements of 24 CFR Part 570.607 and Chapter 17,Article III,Division 4—Fair Housing of the City Code. Agency may not discriminate against any person because of race, color,sex,gender,religion,national origin,familial status,disability or perceived disability, sexual orientation, gender identity, gender expression, or transgender, nor will Agency permit its officers,members, agents, employees, or clients to engage in such discrimination. This Contract is made and entered into with reference specifically to Chapter 17, Article III,Division 3 -Employment Practices of the City Code,and Agency hereby covenants and agrees that Agency, its officers, members, agents, employees and contractors, have fully complied with all provisions of same and that no employee, or applicant for employment has been discriminated against under the terms of such ordinances by either or its officers, members, agents, employees or contractors. 14.13.2 No Discrimination in Employment during the Performance of This Contract. During the performance of this Contract Agency agrees to the following provision, and will require that its contractors and subcontractors also comply with such provision by including it in all contracts with its contractors: [Contractor's,Subcontractor's or Vendor's name]will not unlawfully discriminate against any employee or applicants for employment because of race, color, sex, gender,religion,national origin,familial status,disability or perceived disability,sexual orientation,gender identity,gender expression or transgender. [Contractor's.Subcontractor's or Vendor's name l will take affirmative action to ensure that applicants are hired without regard to race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity,gender expression or transgender and that employees are treated fairly during employment without regard to their race, color, sex, gender, religion, national origin,familial status, disability or perceived disability,sexual orientation,gender identity,gender expression or transgender. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. [Contractor's, Subcontractor's or Vendor's name] agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause. [Contractor's. Subcontractor's or Vendor's name] will, in all solicitations or advertisements for employees placed by or on behalf of [Contractor's. Subcontractor's or Vendor's name], state that all qualified applicants will receive consideration for employment without regard to race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 21 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 [Contractor's. Subcontractor's or Vendor'sname] covenants that neither it nor any of its officers, members, agents, employees, or contractors, while engaged in performing this Contract, shall, in connection with the employment, advancement or discharge of employees or in connection with the terms, conditions or privileges of their employment, discriminate against persons because of their age or because of any disability or perceived disability, except on the basis of a bona fide occupational qualification, retirement plan or statutory requirement. [Contractor's. Subcontractor's or Vendor's name] further covenants that neither it nor its officers,members,agents,employees,contractors, or persons acting on their behalf, shall specify, in solicitations or advertisements for employees to work on this Contract, a maximum age limit for such employment unless the specified maximum age limit is based upon a bona fide occupational qualification, retirement plan or statutory requirement. 14.13.3 Agency's Contractors and the ADA. In accordance with the provisions of the Americans With Disabilities Act of 1990 ("ADA"), Agency warrants that it and any of its contractors will not unlawfully discriminate on the basis of disability in the provision of services to the general public,nor in the availability,terms and/or conditions of employment for applicants for employment with,or employees of,Agency or any of its contractors. AGENCY WARRANTS IT WILL FULLY COMPLY WITH THE ADA'S PROVISIONS AND ANY OTHER APPLICABLE FEDERAL, STATE AND LOCAL LAWS CONCERNING DISABILITY AND WILL DEFEND, INDEMNIFY AND HOLD CITY HARMLESS AGAINST ANY CLAIMS OR ALLEGATIONS ASSERTED BY THIRD PARTIES, CONTRACTORS SUBCONTRACTORS, VENDORS OR AGENTS AGAINST CITY ARISING OUT OF AGENCY'S AND/OR ITS CONTRACTORS', SUBCONTRACTORS', VENDORS' OR AGENTS' OR THEIR RESPECTIVE EMPLOYEES'ALLEGED FAILURE TO COMPLY WITH THE ABOVE-REFERENCED LAWS CONCERNING DISABILITY DISCRIMINATION IN THE PERFORMANCE OF THIS CONTRACT. 14.14. Conflicts of Interest and Violations of Criminal Law. 14.14.1 Agency Safeguards. Agency shall establish safeguards to prohibit its employees,board members, advisors and agents from using positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business or other ties. Agency shall disclose to City any such conflict of interest or potential conflict of interest, immediately upon discovery of such. 14.14.2 General Prohibitions Against Conflicts of Interest. No employees, agents, consultants, officers or elected officials or appointed officials of City or of Agency who exercise or have exercised any functions or responsibilities with respect to activities assisted with CDBG funds or who are in a position to participate in a decision-making process or gain inside information with regard to these activities may utilize CDBG services,may obtain a financial interest or benefit from a CDBG-assisted activity, or have an interest in any contract, subcontract or agreement with respect thereto, or the proceeds thereunder, either for themselves or those with whom they have family or business ties,during their tenure or for 1 year thereafter. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 22 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 14.14.2.1 Agency shall establish conflict of interest policies for federal awards including the CDBG Funds and shall disclose in writing potential conflicts of interest to City as authorized by 2 CFR Part 200.112. 14.14. 3 Conflicts of Interest Involving Procurement. The conflict of interest provisions of 2 CFR Part 200.31 shall apply in the procurement of property and services by Agency. In all cases not governed by this Section, the provisions of 24 CFR Part 570.611 of the CDBG Regulations shall apply. 14.14.3.1 As more particularly described in 2 CFR Part 200.318,Agency shall maintain and submit to City written standards of conduct covering conflicts of interest and governing the performance of its employees engaged in the selection,award,and administration of contracts. No employee, officer, or agent may participate in the selection, award, or administration of a contract supported by a federal award if he or she has a real or apparent conflict of interest. The standards of conduct must provide for disciplinary actions to be applied for violations of such standards by officers, employees, or agents of Agency. 14.14.3.2 The officers, employees, and agents of Agency shall neither solicit nor accept gratuities, favors, or anything of monetary value from contractors or parties to subcontracts. 14.14.3.3 Notwithstanding the prohibition contained in Section 14.13.3.2, Agency may set standards of conduct for situations in which the financial interest is not substantial or the gift is an unsolicited item of nominal value. Such standards of conduct must provide for disciplinary actions to be applied for violations of such standards by Agency's officers,employees or agents. 14.14.3.4 Agency shall maintain written standards of conduct covering organizational conflicts of interest. Organizational conflicts of interest means that because of relationships with a parent company, affiliate, or subsidiary organization,Agency is unable or appears to be unable to be impartial in conducting a procurement action involving a related organization. 14.14.3.5 Agency must maintain records sufficient to detail the history of procurement. These records will include, but are not necessarily limited to the following: rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. 14.14.4 Disclosure of Conflicts of Interest. In compliance with 2 CFR Part 200.112,Agency is required to timely disclose to City in writing any potential conflict of interest. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 23 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 14.14.5 Disclosure of Texas Penal Code Violations. Agency affirms that it will adhere to the provisions of the Texas Penal Code which prohibit bribery and gifts to public servants. 14.14.6 Disclosure of Federal Criminal Law Violations. In compliance with 2 CFR Part 200.113, Agency is required to timely disclose to City all violations of federal criminal law involving fraud, bribery or gratuity violations potentially affecting the Agency. 14.15 Subcontracting with Small and Minority Firms, Women's Business Enterprises and Labor Surplus Areas. 14.15.1 For procurement contracts $50,000.00 or larger that are paid for, in part or in full,with the CDBG Funds,Agency agrees to abide by City's policy to involve Minority Business Enterprises and Small Business Enterprises and to provide them equal opportunity to compete for contracts for construction,provision of professional services,purchase of equipment and supplies and provision of other services required by City. Agency agrees to incorporate the City's BDE Ordinance, and all amendments or successor policies or ordinances thereto, into all contracts and subcontracts for procurement larger than $50,000.00 or larger that are paid for, in part or in full, with the CDBG Funds and will further require all persons or entities with which it so contracts to comply with said ordinance. 14.15.2 It is national policy to award a fair share of contracts to disadvantaged business enterprises ("DBEs"), small business enterprises ("SBEs"), minority business enterprises ("MBEs"), and women's business enterprises ("WBEs"). Accordingly,affirmative steps must be taken to assure that DBEs, SBEs, MBEs, and WBEs are utilized when possible as sources of supplies, equipment, construction and services. 14.15.2.1 In order to comply with federal reporting requirements in 24 CFR Part 570.506 (g)(6), Agency must submit the form attached hereto as EXHIBIT "I" — MBE Reporting Form for each contract or subcontract with a value of$10,000.00 or more paid or to be paid with the CDBG Funds. Agency shall submit this form by the date specified in EXHIBIT"I"—MBE Reporting Form. 14.16 Other Laws. The failure to list any federal, state or City ordinance, law or regulation that is applicable to Agency does not excuse or relieve Agency from the requirements or responsibilities in regard to following the law, nor from the consequences or penalties for Agency's failure to follow the law, if applicable. 14.17 Assignment. Agency shall not assign all or any part of its rights,privileges,or duties under this Contract without the prior written approval of City. Any attempted assignment of same without approval shall be void, and shall constitute a breach of this Contract. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 24 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 14.18. Right to Inspect Agency Contracts. It is agreed that City has the right to inspect and approve in writing any proposed contracts between Agency and any contractor or vendor engaged in any activity in conjunction with this CDBG-funded Program prior to any charges being incurred. 14.19 Force Maieure If Agency becomes unable, either in whole or part, to fulfill its obligations under this Contract due to acts of God, strikes, lockouts, or other industrial disturbances, acts of public enemies, wars, blockades, insurrections, riots, epidemics, earthquakes, fires, floods, restraints or prohibitions by any court,board,department,commission or agency of the United States or of any States, civil disturbances, or explosions, or some other reason beyond Agency's control (collectively, "Force Majeure Event"), the obligations so affected by such Force Majeure Event will be suspended only during the continuance of such event. Agency will give City written notice of the existence,extent and nature of the Force Majeure Event as soon as reasonably possible after the occurrence of the event. Failure to give notice will result in the continuance of Agency's obligation regardless of the extent of any existing Force Majeure Event. Agency will use commercially reasonable efforts to remedy its inability to perform as soon as possible. 14.20 IMMIGRATION NATIONALITY ACT. City actively supports the Immigration&Nationality Act(INA)which includes provisions addressing employment eligibility,employment verification,and nondiscrimination.Agency shall verify the identity and employment eligibility of all employees who perform work under this Agreement. Agency shall complete the Employment Eligibility Verification Form (I-9), maintain photocopies of all supporting employment eligibility and identity documentation for all employees, and upon request,provide City with copies of all I-9 forms and supporting eligibility documentation for each employee who performs work under this Agreement. Agency shall establish appropriate procedures and controls so that no services will be performed by any employee who is not legally eligible to perform such services. Agency shall provide City with a certification letter that it has complied with the verification requirements required by this Agreement. Agency shall indemnify City from any penalties or liabilities due to violations of this provision. City shall have the right to immediately terminate this Agreement for violations of this provision by Agency. 15. INDEMNIFICATION AND RELEASE. AGENCY COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND, AT ITS OWN EXPENSE, CITY AND ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED HEREIN, WHETHER OR NOT CAUSED IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS,AGENTS,SERVANTS,EMPLOYEES,CONTRACTORS CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 25 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 OR SUBCONTRACTORS OF CITY; AND AGENCY HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY OF CITY AND ITS OFFICERS, AGENTS, SERVANTS, AND EMPLOYEES FOR ANY AND ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY,INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER HINDS OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED HEREIN,WHETHER OR NOT CAUSED IN WHOLE OR IN PART BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY. AGENCY LIKEWISE COVENANTS AND AGREES TO AND DOES HEREBY INDEMNIFY AND HOLD HARMLESS CITY FROM AND AGAINST ANY AND ALL INJURY,DAMAGE OR DESTRUCTION OF PROPERTY OF CITY,ARISING OUT OF OR IN CONNECTION WITH ALL ACTS OR OMISSIONS OF AGENCY, ITS OFFICERS, MEMBERS, AGENTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, INVITEES, LICENSEES, OR CLIENTS, OR CAUSED, IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS,EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY. IT IS THE EXPRESS INTENTION OF THE PARTIES, BOTH AGENCY AND CITY, THAT THE INDEMNITY PROVIDED FOR THIS SECTION INCLUDES INDEMNITY BY AGENCY TO INDEMNIFY AND PROTECT CITY FROM THE CONSEQUENCES OF CITY'S OWN NEGLIGENCE,WHETHER THAT NEGLIGENCE IS ALLEGED TO BE THE SOLE OR CONCURRING CAUSE OF THE INJURY, DAMAGE OR DEATH. AGENCY AGREES TO AND SHALL RELEASE CITY, ITS AGENTS, EMPLOYEES,OFFICERS AND LEGAL REPRESENTATIVES FROM ALL LIABILITY FOR INJURY, DEATH, DAMAGE OR LOSS TO PERSONS OR PROPERTY SUSTAINED IN CONNECTION WITH OR INCIDENTAL TO PERFORMANCE UNDER THIS CONTRACT, EVEN IF THE INJURY, DEATH, DAMAGE OR LOSS IS CAUSED BY CITY'S SOLE OR CONCURRENT NEGLIGENCE. AGENCY SHALL REQUIRE ALL OF ITS CONTRACTORS AND SUBCONTRACTORS TO INCLUDE IN THEIR CONTRACTS AND SUBCONTRACTS A RELEASE AND INDEMNITY IN FAVOR OF CITY IN SUBSTANTIALLY THE SAME FORM AS ABOVE. 16. WAIVER OF IMMUNITY BY AGENCY. If Agency, as a charitable or nonprofit organization, has or claims an immunity or exemption (statutory or otherwise) from and against liability for damages or injury, including death,to persons or property,Agency hereby expressly waives its rights to plead defensively such immunity or exemption as against City. This Section shall not be construed to affect a governmental entity's immunities under constitutional, statutory or common law. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 26 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 17. INSURANCE AND BONDING. Agency will maintain coverage in the form of insurance or bond in the amount of$101,800 to insure against loss from the fraud, theft or dishonesty of any of Agency's officers, agents, trustees, directors or employees. The proceeds of such insurance or bond shall be used to reimburse City for any and all loss of CDBG Funds occasioned by such misconduct. To effectuate such reimbursement, such fidelity coverage shall include a rider stating that reimbursement for any loss or losses shall name the City as a Loss Payee. Agency shall furnish to City in a timely manner, but not later than the Effective Date, certificates of insurance as proof that it has secured and paid for policies of commercial insurance as specified herein. If City has not received such certificates by the Effective Date, Agency shall be in default of the Contract and City may, at its option,terminate the Contract. Such insurance shall cover all insurable risks incident to or in connection with the execution,performance,attempted performance or nonperformance of this Contract. Agency shall maintain the following insurance coverage and limits: Commercial General Liability(CGL) Insurance $ 500,000 each occurrence $1,000,000 aggregate limit Non-Profit Orizanization Liability or Directors & Officers Liability $1,000,000 Each Occurrence $1,000,000 Annual Aggregate Limit Business Automobile Liability Insurance $1,000,000 each accident on a combined single-limit basis, or $ 250,000 Property Damage $ 500,000 Bodily Injury per person per occurrence $2,000,000 Aggregate Insurance policy shall be endorsed to cover"Any Auto",defined as autos owned,hired, and non-owned. Pending availability of the above coverage and at the discretion of City,the policy shall be the primary responding insurance policy versus a personal auto insurance policy if or when in the course of Agency's business as contracted herein. Workers' Compensation Insurance Part A: Statutory Limits Part B: Employer's Liability $100,000 each accident $100,000 disease-each employee $500,000 disease-policy limit CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 27 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 Note: Such insurance shall cover employees performing work on any and all projects including but not limited to construction, demolition, and rehabilitation. Agency or its contractors shall maintain coverages, if applicable. In the event the respective contractors do not maintain coverage, Agency shall maintain the coverage on such contractor, if applicable, for each applicable contract. Additional Requirements Such insurance amounts shall be revised upward at City's reasonable option and no more frequently than once every 12 months, and Agency shall revise such amounts within 30 days following notice to Contractor of such requirements. Agency will submit to City documentation that it has obtained insurance coverage and has executed bonds as required in this Contract prior to payment of any monies provided hereunder. Where applicable, insurance policies required herein shall be endorsed to include City as an additional insured as its interest may appear. Additional insured parties shall include employees, officers,agents, and volunteers of City. Any failure on part of City to request certificate(s)of insurance shall not be construed as a waiver of such requirement or as a waiver of the insurance requirements themselves. Insurers of Agency's insurance policies shall be licensed to do business in the state of Texas by the Department of Insurance or be otherwise eligible and authorized to do business in the state of Texas. Insurers shall be acceptable to City insofar as their financial strength and solvency and each such company shall have a current minimum A.M. Best Key Rating Guide rating of A-: VII or other equivalent insurance industry standard rating otherwise approved by City. Deductible limits on insurance policies shall not exceed $5,000 per occurrence unless otherwise approved by City. In the event there are any local, federal or other regulatory insurance or bonding requirements for the Program, and such requirements exceed those specified herein,the former shall prevail. Agency shall require its contractors to maintain applicable insurance coverages, limits, and other requirements as those specified herein;and Agency shall require its contractors to provide Agency with certificate(s) of insurance documenting such coverage. Also, Agency shall require its contractors to have City and Agency endorsed as additional insureds(as their interest may appear) on their respective insurance policies. Directors and Officers Liability coverage shall be in force and may be provided on a claims-made basis. This coverage may also be referred to as Management Liability,and shall protect the insured against claims arising out of alleged errors in judgment,breaches of duty and wrongful acts arising out of their organizational duties. Coverage shall protect not only the entity, but all past, present and future directors, officers,trustees, employees,volunteers and committee members. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 28 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 Notwithstanding any provision in this Contract to the contrary, when applicable, Agency shall comply with the requirements of 2 CFR 200.310 and shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired or improved with CDBG Funds as provided to property owned by Agency. 18. CERTIFICATION REGARDING LOBBYING. The undersigned representative of Agency hereby certifies, to the best of his or her knowledge and belief,that: No federal appropriated funds have been paid or will be paid, by or on behalf of Agency, to any person for influencing or attempting to influence an officer or employee of any agency,a member of Congress, an officer or employee of Congress in connection with the awarding of any federal contract,the making of any federal grant,the making of any federal loan, the entering into of any cooperative agreement and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan or cooperative agreement. If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, member of Congress in connection with this federal contract, grant, loan or cooperative agreement, Agency shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certificate is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. Section 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than$100,000.00 for each such failure. Agency shall require that the language of this certification be included in all subcontracts or agreements involving the expenditure of federal funds. 19. LITIGATION AND CLAIMS. Agency shall give City immediate notice in writing of any action,including any proceeding before an administrative agency, filed against Agency in conjunction with this Contract or the Program. Agency shall furnish immediately to City copies of all pertinent papers received by Agency with respect to such action or claim. Agency shall provide a notice to City within 10 days upon filing under any bankruptcy or financial insolvency provision of law. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 29 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 20. NOTICE. All notices required or permitted by this Contract must be in writing and are deemed delivered on the earlier date of the date actually received or the third day following deposit in a United States Postal Service post office or receptacle; with proper postage, certified mail return receipt requested; and addressed to the other Party at the address set out below or at such other address as the receiving Party designates by proper notice to the sending Party. City: City Attorney's Office 100 Texas Street Fort Worth, TX 76102 Telephone: 817-392-7600 Copy to: Neighborhood Services Department 200 Texas Street Fort Worth, TX 76102 Attention: Assistant Director Telephone: 817-392-7540 Copy to: Neighborhood Services Department 200 Texas Street Fort Worth, TX 76102 Attention: Management Analyst II Telephone: 817-392-7369 Agency: Sixty and Better,Inc. dba Senior Citizen Services Attention: Jerome H.Mosman, Chief Executive Officer 1400 Circle Drive#300 Fort Worth, Texas 76119 Telephone: 817-413-4949 CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 30 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 21. AGENCY HAS LEGAL AUTHORITY TO ENTER INTO CONTRACT. Agency represents that it possesses the legal authority,pursuant to any proper,appropriate and official motion,resolution or action passed or taken,to enter into this Contract and to perform the responsibilities herein required. 22. COUNTERPARTS. This Contract may be executed in multiple counterparts,each of which shall be considered an original, but all of which shall constitute one instrument which may be sufficiently evidenced by one counterpart. 23. PROGRAM INCOME Parties agree that no program income as defined by HUD shall be earned as a result of this contract. [SIGNATURES APPEAR ON NEXT PAGE] CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 31 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 IN WITNESS WHEREOF,the Parties hereto have executed 4 duplicate originals of this Contract in Fort Worth,T ant County, Texas. AT T: FUR F FORT WORTH ity Secre&4 ' Fe do Costa, Assistant City Manager M&C: G-1 9V6 U 1295 Certification No. 2017-235 'k Date: August 1, 2017xja, APPROVED AS TO FORM AND LEGALITY: Paige Meba e,Assistant City Attorney CONTRACT COMPLIANCE MANAGER: By signing, I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements Barbara Asbury Compliance and Planning Manager SIXTY AND BETTER,INC.DBA SENIOR CITIZEN SERVICES By: 9 ---- Jerome H. Mosman, Chief Executive Officer CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 32 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 EXHIBITS: EXHIBIT "A"—Program Summary EXHIBIT "A-1"—2017 HUD Income Limits EXHIBIT "A-2"—Reporting Requirements for Countywide Agencies EXHIBIT "B"—Budget EXHIBIT"C"—Audit Certification Form EXHIBIT "D"—Reimbursement Forms EXHIBIT "E"—Form of Income Self-Certification EXHIBIT "F"—Standards for Complete Documentation EXHIBIT "G"—Section 3 Reporting Forms (NOT APPLICABLE) EXHIBIT "H"—Severely Disabled Certification Form EXHIBIT "I"—MBE Reporting Form EXHIBIT "J"—Duties of the Parties for Use of NSD Community Centers EXHIBIT "K"—Notice of Beneficiary Rights CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 Page 33 Sixty and Better,Inc.dba Senior Citizen Services Rev.9.25.2017 SIXTY AND BETTER, INC. DBA SENIOR EXHIBIT "A" CITIZEN SERVICES Connecting Seniors to Community PROGRAM SUMMARY PROGRAM SUMMARY (CDBG) October 1,2017 to September 30, 2018 $101,800.00 PERIOD AMOUNT Capitalized terms not defined herein shall have meanings assigned them in the Contract. PROGRAM: The Program will provide transportation services to Fort Worth seniors age 62 and over to and from their homes to activity centers and for shopping or field trips. CDBG Funds will be used to pay for a percentage of salaries for Program employees supervising the Program and administering the transportation contracts. CDBG Funds will also be used to pay for rides for clients on a per unit basis. Cost for rides shall be the same as the rate charged to the Agency by the vendor or subcontractor providing the rides. Agency's office is located at 1400 Circle Dr. #300, Fort Worth, TX 76119,with operating hours of 8:00 a.m.to 5:00 p.m.,Monday through Friday. Program services will be available to and from client homes to the following locations: City of Fort Worth Neighborhood Centers Como Neighborhood Center-4900 Horne Street, Fort Worth,TX 76107 Northside Neighborhood Center- 1100 NW 18th, Fort Worth, TX 76164 Worth Heights Neighborhood Center- 3551 New York, Fort Worth,TX 76110 North Tri-Ethnic Community Center-2950 Roosevelt, Fort Worth,TX 76106 Fellowship Corner- 1601 New York, Fort Worth, TX 76104 Additional Locations Barnabas House, Christ Lutheran-4409 Sycamore School Road,Fort Worth, TX 76133 CASA- 3201 Sandra, Fort Worth,TX 76107 Diamond Hill Community Center- 1701 NE 36th,Fort Worth, TX 76106 Eugene McCray Community Center-4932 Wilbarger, Fort Worth,TX 76119 Handley-Meadowbrook Community Center- 6201 Beaty, Fort Worth,TX 76112 Hometown at Matador Ranch—8500 Crowley Road,Fort Worth, TX 76134 Jewish Family Services-4900 Briarhaven, Fort Worth,TX 76109 CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"A"—PROGRAM SUMMARY Sixty and Better,Inc.dba Senior Citizen Services Page I Agency shall not change any locations without prior City approval. Costs incurred at any locations that have not been approved by City will not be reimbursed. REGULATORY CLASSIFICATION: IDIS Matrix Code(s)and Service Category: 05A Senior Services National Objective Citation: LMC Low/Mod Limited Clientele 24 CFR 570.208(a)(2) Regulatory Citation(s): 24 CFR 570.201(e) Agency will maintain documentation which verifies that 100% of clients served by the Program are Elderly in accordance with the CDBG Presumed Benefit clientele definition. PROGRAM GOALS: Minimum Number of Fort Worth Clients to be Served: The Program must serve a minimum of 300 Unduplicated Clients from Fort Worth as shown by the monthly reports on Attachment III. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"A"—PROGRAM SUMMARY Sixty and Better,Inc.dba Senior Citizen Services Page 2 EXHIBIT "A-1" 2017 HUD INCOME LIMITS 2017 Median Family Income -Fort Worth/Arlington, TX* 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons 30%AMI $15,000 $17,150 $19,300 $21,400 $23,150 $24,850 $26,550 $28,250 50%AMI $25,000 $28,600 $32,150 $35,700 $38,600 $41,450 $44,300 $47,150 80%AMI $40,000 $45,700 $51,400 $57,100 $61,700 $66,250 $70,850 $75,400 *Income limits are published at least annually by HUD. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"A-1"—2017 HUD INCOME LIMITS Sixty and Better,Inc.dba Senior Citizen Services Page 1 EXHIBIT "A-2" REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"A-2" REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Page I Sixty and Better,Inc.dba Senior Citizen Services Sixty and Better,Inc. dba Senior Citizen Services REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Quarterly Report The purpose of the Quarterly Report is for the Countywide Agencies to report the number of non-Fort Worth clients who participate in the Program. The Quarterly Report must be submitted with the December, March, June and September Reimbursement Requests. A paper copy must be submitted with the Reimbursement Request, and an electronic copy must also be emailed to psa@fortworthtexas.gov or to Agency's designated City Contract administrator. The information provided in the Quarterly Report will be reviewed and monitored by the Neighborhood Services Department Compliance Division. TOTAL#OF #OF FORT #OF NON-FORT CLIENTS FORT WORTH DUE DATE REPORTING RANGE WORTH WORTH SERVED BY CLIENTS CLIENTS CLIENTS THEPROGRAM r A B C D E F EXAMPLE: 250 200- 450 250_450=55% January 15,2018 October 1,2017- December 31,2017 April 15,2018 January 1,2018- March 30,2018 July 15,2018 April 1,2018- _June 30,2018 October 1,2018 July1T 2018- September 30,2018 TOTAL I,Agency representative, certify that I verified the information I reported this quarter and it is correct to the best of my knowledge. Certified by: Date: Signature/Title: CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"A-2" REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Page 1 Sixty and Better,Inc.dba Senior Citizen Services EXHIBIT"B" BUDGET Account Grant Budget A B C D E Total PROGRAM PERSONNEL Salaries 1001 $ 15,270.00 $ 15,000.00 $ 6,150.00 $ 300.00 $ 36,720.00 FICA 1002 Life/Disability Insurance 1003 Health/DentalInsurance 1004 Unemployment-State 1005 Worker's Compensation 1006 Retirement 1007 Staff Training --- SUPPLIES AND SERVICES Office/Program Supplies 2001 Postage Printing C)(herO 11 lISCClp.LLA+IE1J[y Contract Labor City needs copy cit contract before expenses can be reimbursed) 3001 $ 86,530.00 $ 85,000 ! S 31.5 :i,tili I. 1 S _',,o ,W.00 Food Supplies 3002 Teaching Aids 3003 Craft Supplies 3004 Field Trip Expenses 3005 Mileage 3006 FACILITY AND UTILITIES Telephone 4001 Electric 4002 Gas 4003 Water and Wastewater 4004 Solid Waste Disposal 4005 Rent(City needs copy of lease before expenses can be reimbursed) 4006 Cleaning Supplies 4007 Repairs 4008 Custodial Services 4009 Other O 4010 1.1U:A1.,I.INANCIA1.AN1) 7 INS11RANC'.E At 12dclm 1iqw%;11011 500( 1)ir ttt�rs ('rnrial L ahait; DIREC"I'ASSISI ANC E 131 W.ETTOTAL $ 101,800.00 S 100,000.011 S 41,1100.011 $ 2,000.00 $ 244,8011.00 FUNDING A.Area Agency on Aging FUNDING B:Tarrant County FUNDING C:Participant Contributions CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018-EXHIBIT"B"-BUDGET Sixty and Better,Inc.dba Senior Citizen Services Page 1 The following tables were created for the purpose of preparing, negotiating, and determining the cost reasonableness and cost allocation method used by the Agency for the line item budget represented on the first page of this EXHIBIT "B"—Budget. The information reflected in the tables is to be considered part of the terms and conditions of the Contract. Agency must have prior written approval by the City to make changes to any line item in the Budget as outlined in Section 5.2.2 in the Contract. The deadline to make changes to EXHIBIT "B"—Budget is June 1,2018. SALARY DETAIL-PROGRAM PERSONNEL Est. Percent to Amount to Position Title Annual Salan- Grant Grant Director of Operations 5 i.20 1.00 29.8% $ 15,270.00 TOTAL $ 51,201.00 29.8% $ 15,270.00 FRINGE DETAIL-PROGRAM PERSONNEL Percent of Est.Percent to Amount to Payroll Amount Grant Grant FICA I.ife/Disabilit} Insurance Health/De wal Insurance Unemployment-State Worker's Compensation Retirement Staff Training TOTAL SUPPLIES AND SERVICES Est. Percent to Amount to Total Budget Grant Grant OfficeJli-oi-,ram Supplies PostaL�c Printing. Other() TOTAL CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018-EXHIBIT'B"-BUDGET Sixty and Better,Inc.dba Senior Citizen Services Page 2 MISCELLANEOUS Est. Percent to Amount to Total Budget Grant Grant Contract Labor $ 208,080.00 41.6% $ 86,530.00 Food SLIpplies Teaching Aids Craft Supplies Field Trip Expenses Mileage TOTAL 1 $ 208,080.00 1 41.6%1 $ 86,530.00 FACILITY AND UTILITIES Est. Percent to Amount to Total Budget Grant Grant Telephone Electric Gas Water and Wastewater Solid Waste Disposal Rent Cleaning Supplies Repairs Custodial Services Other() TOTAL LEGAL,FINANCIAL AND INSURANCE Est. Percent to Amount to Total Budget Grant Grant Fidelity Bond or Equivalent Directors and Officers General Commercial Liability TOTAL DIRECT ASSISTANCE Est. Percent to Amount to Total Budget Grant Grant Other() TOTAL CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018-EXHIBIT'B"-BUDGET Sixty and Better,Inc.dba Senior Citizen Services Page EXHIBIT "C" AUDIT CERTIFICATION FORM CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018–EXHIBIT"C"—AUDIT CERTIFICATION FORM 1 Sixty and Better,Inc.dba Senior Citizen Services AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS Agency: Sixty and Better,Inc.dba Senior Citizen Services Fiscal Year Ending: September 30,2018 During the fiscal year in which funds will be received,we will exceed the federal expenditure threshold of$750,000. We will have our Single Audit or Program Specific Audit completed and will submit the audit report described in 2 CFR Part 200 within 7 months after the end of the audited fiscal year or 30 days within its completion, whichever is the earlier date. ❑ During the fiscal year in which funds will be received,we will not exceed the$750,000 federal expenditure threshold required for a Single Audit or a Program Specific Audit to be performed this fiscal year.(Fill out schedule below) Federal Expenditure Disclosure — MUST be f ll.ed out if Sing] Audit or Program Audit is NOT re uired. Pass Through Program.Name& Contract Federal Grantor Grantor CF'DA.Number Number Expenditures Total Federal Expenditures for this Fiscal Year: Signatory an -id Date Failure to submit this or a similar statement or failure to submit a completed single audit package as describgd in the federally required audit requirements described in 2 CFR Part 200, as applicable,by the required due date may result in suspension of funding and may affect eligibility for future funding. Notwithstanding the above, this certification acknowledges the agency's commitment to meet all other financial reporting, financial statements, and other audit requirements as may be set forth in the Contract. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"C"—AUDIT CERTIFICATION FORM 2 Sixty and Better,Inc.dba Senior Citizen Services EXHIBIT "D" REPORTING FORMS CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"D'—REPORTING FORMS Page 1 Sixty and Better,Inc.dba Senior Citizen Services ATTACHMENT I Invoice Attachment I INVOICE Agency: Address: s City, State, Zip: Program: Period of Service: Tax ID No. P.O. No. FID No. Pro ram Amount g This Invoice Cumulative to Date CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"D"—REPORTING FORMS Page 2 Sixty and Better,Inc.dba Senior Citizen Services ATTACHMENT II Expenditure Worksheet ATTACHMENT II Neighborhood Services Department Expenditure Worksheet Only highlighted coder can be reimbu—d Please g oup like:recount codes. Account line Code(See Expense line Item No. Chk No, Date Pavee Descri lioWlob Title• KeytoRmhOl A=unt I Account. I PROGRAM PERSONNEL l?ti:irr: 2 Snlanes loot 3 FICA 1002 4 life/Disabdity Insurance 1003 5 Health;Dental Insurance 1004 6 Un—.l—nrent5tate Ioo5 7 WrrrL,:r 4:'.r!;:_n,,:•.i.i 1006 8 R.ew:ins,', 1007 9 S1 PP:IJIS AND SFRVIC.."S n4„�wPr a5,`>}.a,"l'r 10 Vltr,::P:, Sin-b,•s 2001 II Posta:, 2002 12 Prinlrn: 21MCi 13 2(m It 14 hILS CLU-Aldl t.t5 15 Contractl a! ✓_ 3as1 16 FoodSu .It.•,. 3002 17 Teaching A.:,�—.T_...._ 3003 18 Craft Su yhr, 3001 19 Field Tri L1•enses 3005 20 Mileage 3006 21 Othe 1 3(X)7 22 otbero 3ao8 23 VA_C LM'AND I!TILME5 rx >� " 24 1:I"—,.._,._._. 4(X)1 . 25 flecu. 4002 26 Cas 4003 27 Water and Wastewater 4004 28 Solid WesteDisposal 4005 29 Rent 4(X)(, 30 Clewing Supplies 4007 31 Other() dryrx 32 LE7(:AL FINANC CAL,AND EN S I TRANCE: 33 I:.I i.: Rind or 'usahml 34 tr;n!.>•i and Officers 35 r.n.r. t�rmreraial Liability 51rr; 36 4rciri 5001 37 ))JRkX I'AS515'I ANCE T17 ^+ .�'—.„.. 38 Oth"i i fi(1Rl 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Total 50,00 'For Salaries,state erMloyee's title under Description/Job Title.Rent nest identify tenant CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"D"—REPORTING FORMS Page 3 Sixty and Better,Inc,dba Senior Citizen Services ATTACHMENT III exercise Client Data Report ATTAC mlu MWTU.ITA¢ITO¢T 4-Y Ftopvn: UWth: .�. ... .ruP...��p wiw-...+u nrr.r•IAi.r.W.)....x..ww...rwre-rr®r�.w.r..�a..wa...V �H�i�.asm..�".0 Lk ImQ¢Clfam. neM rr.rr-w.uw....mw.�•�..)�r rw.e.rrr�...��.rx... �.w.,".w.m......r Y^ n n..�a.".....Inwxrrr.d.�./n�•arra��r.r.r�..n�.uwur�wrw"r.Wy.e,..—..Inufi.w...iw.ri. w•µr4Mwrr LN.I'Li'iISE I'N 1 � taf+.e�i I wwttre pMix ¢.�.+.dd MidroJ M�d.W lo$dr.11Mfa.r) G a1 mm pRM K Tf@TA�ID 9.Y2 CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"D"—REPORTING FORMS Page 4 Sixty and Better,Inc.dba Senior Citizen Services EXHIBIT "E" INCOME CERTIFICATION FORMS CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT`B"--INCOME CERTIFICATION FORM Sixty and Better,Inc.dba Senior Citizen Services Page 1 City of Fort Worth CERTIFICATION OF INCOME STATEMENT Applicant Name: Current Address: Phone City and Zip: Household "'fern: er, id Tnoome Last Name First Name Age Monthi Source of Income Income $$ TOTAL NUMBER OF FAMILY MEMBERS (Include Yourself,Spouse,Children,etc.) Total Gross Annual Household Income: PFRSONAl.INFORMATION:(Check one in each item. This Information is Required for Federal Reporting Purposes) a. Q,­­ , o.❑WHITE ❑BLACK/AFRICAN AMERICAN ❑BLACK/AFRICAN AMERICAN&WHITE FEMALE ❑AMERICAN INDIAN/ALASKAN NATIVE ❑ASIAN ❑AMERICAN INDIAN/ALASKAN NATIVE&WHITE ❑ASIAN&WHITE ❑NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER ❑BALANCE/OTHER ❑AMERICAN INDIAN/ALASKAN NATIVE&BLACK/AFRICAN AMERICAN c. ETHNICITY d. DISABLED e. IS HEAD OF HOUSEHOLD FEMALE? ❑HISPANIC ❑YES ❑YES ❑NON-HISPANIC ❑NO ❑NO Certification: I certify that the information I am providing is true and could be subject to verification at any time by a third party. I also acknowledge that the provision of false information could leave me subject to the penalties of Federal, State and local law. Signature of Applicant Date WARNING: TITLE 18,SECTION 1001 OF THE U.S.CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT. --------------For use by Agency staff only------__°------- Household Size: Gross Annual Income: Applicable Income Limit: Is Applicant Eligible? Check if Applicant refused to provide demographic information: ❑ Staff Assessment of Demographics: Person Making Determination: Date:__ NOTE. Address, income amounts and sources for ALL household members are required. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"E"--INCOME CERTIFICATION FORM Sixty and Better,Inc.dba Senior Citizen Services Page 2 Ciudad de Fort Worth CERTIFICACION DE DECLARAC16N DE INGRESOS Nombre del Solicitante: Direcci6n de Actualidad: Teldfono: Ciudad y C6digo Postal: Miembros Del Ho ag r�Ingresos (Incluyendo el/la Solicitante) Apellido Nombre Had Ingreso Origen de Ingresos Mensual *TOTAL NUMERO DE MIEMBROS DEL HOGAR (Inchiyase Usted.) Total Anual de Ingresos del hogar: **INFORMACi6N PERSONAL:(Selection uno en cada articulo. Esta infonnacion es requerida por el Gobierno federal.) a. ❑MASCULINO b.❑BLANCO ❑NEGRO/AFRICANO AMERICANO ❑NEGRO/AFRICANO AMERICANO&BLANCO ❑FEMININO ❑INDIO AMERICANO/NATIVO DE ALASKA ❑ASIATICO ❑INDIO AMERICANO/NATIVO DE ALASKA&BLANCO ❑ASIATICO&BLANCO ❑NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS ❑BALANCE/OTRO ❑INDIO AMERICANO/NATIVO DE ALASKA&NEGRO/AFRICANO AMERICANO c. ETHNICIDAD d. INCAPACITADO e. LES LA CABEZA DEL HOGAR MUJER? ❑HISPANO ❑SI ❑SI ❑NO-HISPANO ❑NO ❑NO Certificaci6n: Yo certifico que la informaci6n que yo estoy proporcionando es verdadera y puedo ser sujeto a verificaci6n a cualquiera hora por tercera parte. Yo tambidn reconozco que la provision de informaci6n falsa puede dejarme sujeto a penalidades Federales,Estatales, y a ley local. Firma del Solicitante Fecha ADVERTENCIA:TITULO 18,SECCION 1001 DEL CODIGO DE LOS ESTADOS UNIDOS INDICA QUE UNA PERSONA ES CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMENTE RACER DECLARACIONES FALSOS O FRAUDULENTAS A CUALQUIER DEPARTAMENTO DE GOBIERNO DE LOS ESTADOS UNIDOS. ----,---Para use de em leados de la age n-hi----------------- #De Miembros de Familia: Ingreso Anual:_ _ Limite de Ingreso: ZEs solicitante elegible? Compruebe si el solicitante se neg6 a dar su informaci6n personal: ❑ Evaluaci6n del empleado sobre informaci6n personal: Persona haciendo la determinaci6n: Fecha:_ Note: La direction de la casa y los ingresos (y sus origenes) para todos miembros deo ho,�Lir on reguerido CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"E"--INCOME CERTIFICATION FORM Sixty and Better,Inc.dba Senior Citizen Services Page 3 EXHIBIT "F" STANDARDS OF DOCUMENTATION CDBG PRESUMED BENEFIT PSA CONTRACT 2018-2018--EXHIBIT"F"--STANDARDS OF DOCUMENTATION Sixty and Better,Inc.dba Senior Citizen Services Page 1 2017-2018 Documentation Standards for CDBG Public Service Contract Expenses Employee Salaries and Benefits City will only reimburse a percentage of any employee's salary and benefits who work directly with the CDBG-funded Program. Percentages will be cost allocated and determined prior to the execution of the CDBG Contract Agencies requesting the reimbursement of 100%of any Agency employee will require prior City approval. Agencies must show calculation on how the CDBG portion of employee salaries and benefits were calculated consistently with the CDBG Contract. If an employee works on both a CDBG eligible and non-CDBG eligible program(s),the City will only reimburse for a reasonau:portion of the employee's salary. Prior to the execution of the CDBG Contract,the Agency will priovide the City with a written statement on how each employee's time will be allocated. If an employee works 100%of their time directly with the CDBG-funded Program,then 100%of the employee's salary may be eligible for reimbursement. Agency must submit a written statement that 100%of the employee's time is spent working directly with the CDBG-funded Program. Statements must be signed by a person authorized to sign on behalf of the Agency and will be submitted with the October invoice. Salaries X x• Reimbursement requests must include a timesheet and work log that reflects the hours worked by the employee(s)working directly on the CDBG-funded Program. For employees who are paid with multiple funding sources,timesheets must reflect all funding sources. If separate timesheets are kept for each funding source,all such timesheets must be submitted to City. Timesheets must be signed by employee and supervisor. Agency must show a calculation and documentation of how the employee's salary was calculated and invoiced to City. 'If employees are paid by direct deposit rather than check,then the agency must submit both the direct deposit payment company's report(such as an ADT report)and a bank statement or check showing payment to the direct deposit company. FICA/Medicare X X X Lite Insurance x x x Health If the City pays gross salary,this is already included.If the City pays the employer portion,the Agency must provide proof that the Insurance X x x employee is enrolled in the benefit plan,must show a calculation and documentation of how the invoiced amount was calculated,and Disability x xx must provide documentation showing payment.Invoice and proof of payment are only required with the first reimbursement request and Insurance at any time there are changes to amounts,enrollments,disenrollments,etc. Unemployment X X X Insurance If the City pays gross salary,this is already included.If the City pays the employer portion,the Agency must provide proof that the Retirement X x x employee is enrolled in the benefit plan,must show a calculation and documentation of how the invoiced amount was calculated,and must provide docun n showing paymei i proof of payment are only required with the first reimbursement request and la'any time there are changes to amounts enrol me,Is,disenrollments,etc. Materials,Equipment,Goods and Supplies-City will only reimburse for the cost allocated percent or amount spent in support of the CDBG-funded Program. Agencies requesting reimbursement for these items will require prior City approval. Agencies must show calculation on how the CDBG portion of these expenses were calculated consistently with the CDBG Contract Office Supplies X X X Office Equipment X X X X X Rental Postage X X X Printing X X X Construction& Building X X X X This category is only available for the REACH Program and Habitat for Humanity. Materials Sport and Recreation X x X Equipment Cleaning X X X Su lies Teaching Aids X X X Craft Su lies X X1 I X Food Supplies X X X This ry is only available to the Program provided by Meals on Wheels. cost-allocated v Rent, Utilities and Maintenance,,Cl wil o ty pay for a portion of these expenses. The portion of these expenses will be determined by the square footage attributable to the CDBG-funded Program and shall be allocated g in accordance with the amount of space used for the CDBG-funded Program. These expenses may only be in support of the CDBG-funded Program. The items listed below require prior City approval and the Agency is required to identify any funding source that pays for the portion of the expenses that is not paid with CDBG funds. Agencies must show calculation on how the CDBG portion of these expenses were calculated consistently with the CDBG Contract. �le... lep hone X X 7.4 .Gas X X aate,IWastew X X er Electric X X ._..... . _. Solid Waste X X CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 E#libit"P'-STANDARDS FOR COMPLETE DOCUMENTATION 1 Facility This item requires approval by the City prior to the execution of the CDBG Contract. Repairs may be categorized as major/minor MaintenanceX X X X rehabilitation projects and must be approved through the full HUD Environmetal Review. and Repairs RentX X X City will pay for a portion of the rent for the Program facility so long as its in proportion to the square footage attributable to the CDBG- funded program. This item requires prior approval by the City. Prior to the execution of the CDBG Contract,the Agency must submit a written statement that lists the contract labor services to be used during the Contract term. Agency will submit a memo related to the procurement of such Contract Labor X X X X X services and will forward any information pertaining to the procurement process to City. This requirement applies to,but is not limited to, services retained for security services,legal,accounting,transportation providers,educational facilitators,custodial services,etc. Agencies may not use the contract services of any City of Fort Worth Department. City-required X X City will only pay for a percentage of the City-required insurance so long as it's in proportion to the square footage attributable to the Insurance CDBG-funded program. City requires that the agency submit its fee schedule or formula on how the Agency calculates the childcare scholarship amount. The fee schedule/formula should demonstrate a breakout of income levels,and for each income level the schedule should demonstrate Childcare which portion of the expense is to be paid by the family and which portion of the expense is to be reimbursed by the City. A fee Scholarships X X scheduletformula must be submitted to the City prior to the first payment. Agency must submit documentation supporting that the client is income eligible and that the household is being charged in conformance with the fee schedule. If the fee schedule/formula changes at any time during the contract term,the Agency must immediately notify City on the date the new fee schedule/formula takes into effect. IV Income Agecies that are required to verify and provide proof of household income to determine eligibility,must require that anyone who is over Certifications the age of 18,living in the housohold,submit a$0 Income Certcation. If an audit is required because federal funds exceed$750,000,then the cost should be split evenly by all grant funding sources. Agency Audit Services X X X X must show calculation on how the CDBG portion of the accounting services were calculated. For example,if the CDBG grant is 10%of your Agencys budget,then invoice shall not exceed 10%of the overall cost. Agency must show a calculation and documentation of how the invoiced amount was calculated,and must provide documentation showing payment. `Proof of payment effective October 1,2013: Payments or Expenses must be documented in the following manner: A)Image of the check AND bank statement showing the check cleared the bank;OR, B)Image of the cancelled check(ex.At end of bank statement);OR, C)Payroll Check Stub,"Advice",or Statement AND Bank Statement indicating payroll;OR, D)For wire or e-transfers:Reciept or statement from payee/vendor OR bank statement. Final as of 092N1017 DC CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018 EXAIb#"P'—STANDARDS FOR COMPLETE DOCUMENTATION 1 EXHIBIT "G" SECTION 3 REPORTING FORMS NOT APPLICABLE CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"G"--SECTION 3 REPORTING FORMS Sixty and Better,Inc.dba Senior Citizen Services Page I EXHIBIT"H" SEVERELY DISABLED CERTIFICATION FORM CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"If'—SEVERELY DISABLED CERTIFICATION FORM Page 1 Sixty and Better,Inc.dba Senior Citizen Services Sixty and Better,Inc. dba Senior Citizen Services CERTIFICATION FORM DOCUMENTING CLIENT STATUS AS "SEVERELY DISABLED ADULT" Client Name: Address: City, State,Zip Client Identification No. CHECK ALL THAT APPLY ❑ Has used a wheelchair, a walker, cane , crutches or other special aid for six months or longer Has been diagnosed with one of the following conditions: Alzheimer's disease, ❑ mental retardation or other developmental disability, senility or dementia, cerebral palsy, or autism; or has another mental or emotional condition that seriously interferes with everyday tasks. Is unable to perform one or more of the following "Functional Activities": ❑ seeing, hearing, speaking and having one's speech understood, lifting or carrying, using stairs, grasping small objects, or walking. Is unable to perform or needs assistance to perform one or more of the following ❑ Activities of Daily Living(ADL): getting around inside the home, getting in or out of bed or a chair, bathing, dressing, eating, and toileting. Is unable to perform or needs assistance to perform one or more of the following Instrumental Activities of Daily Living (IADL): going outside the home, ❑ keeping track of money and bills, preparing meals, doing light housework, taking prescription medications in the right amount and at the right time, and using the telephone. ❑ Has a condition that prevents them from working at a job or doing housework. The undersigned Agency representative conducted a visual assessment of the client identified on this form and certifies that the client meets at least one of the conditions indicated above, which determines that he/ she meets the definition of"severely disabled" according to the U.S. Census Bureau. Certified by: Date: Signature/Title: CFW Neighborhood Services Dept.: Revised 08.30.2013 CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018—EXHIBIT"If'—SEVERELY DISABLED CERTIFICATION FORM Page 2 Sixty and Better,Inc.dba Senior Citizen Services EXHIBIT "I" MBE REPORTING FORM CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"P'--MBE REPORTING FORM Sixty and Better,Inc.dba Senior Citizen Services Page 1 Contract and Subcontract Activity US.Department of Hoofing end Urban Dmiepmeat OMB Approval No.:1577-0098 OMB Approval No.:2502-0355 Public reporting burden for this collection of infommtion is estimated to average.5 hours per response,including the time fm reviewing instructions,searching existing dem sources,gathering and maintaining the date needed,and completing and reviewing the collection of information.The Infiumation is voluntary.HUD may not collect this information,andyw ensues required to complete this form,unless it displays acmrently valid OMB Control Number. 13—tive Orders dated July 14,1983,directs the Ninunly Business Development Plans shall be developed by each Federal Agency and the these annual plans shall establish minority business development objectives.The information is used by HUD to monitor sod evaluate MBE activities against the tots)program activity and the designated minority business amerpnse(MBE)goals.The Department require the information to provide guidance and oversight for programs for the development of maturity business enterprise concerning Minority Business Development,If the information is not collected HUD would not be able to establish meaningful MBE goals nm e4sts MBE performance against these goals. Privacy Act Notice-The United States Department of Housing and Urban Development,Federal Hooting Administration,is authorized to solicit the Inforntion requested in this form by vimse of Title 12,United States Code,Section 1701 at sea.,and regulation it will not be disclosed or relseed outside the United States Department of Housing and Urban Development without your ransom,except as required or permitted by dew. Gmtm(Projec[0—fTieveloper/Sposm/Boader'Ag- 2.Location Ci Chink if (City,State Zip Code) PH LH CPD Hc.smg 3s.Nus orCamst Pcsoa 3b.PW=Number Oncludin Ara Code) 4.Reporting Period 5.Program Code(Not applicable for CPD praamma) ❑ 6.Date SaWnioed to PicW M. Sye ezphwion nrCdes m hoaom of£eye Us e Oct.I- t.30 Annual- s]>sne e6eet fm rmh Pro8'am code. Cows LbaeVHojen,Nu o TIUD Subcwtrxtar Care Number or other Amoantof T,,eofTrade Basi— Sb.-- Contractodss 5ubcontraetor Name and Addre idenifiratmn of-,m,, Contractor Code 9 i.a dodc Women Owned Biiunces Prime CooamtorldentSca.11.) IdeutiFutioo(in) wbdimirion.dwelling umi.ec. SO— (See W—) (S.below) (Yes or No) Number Sec,3 Number See.3 7j 7a, fi. lc. 7d. 7e. X 7 7a 7,. Name Street Cit State Zi 7e:Type of Trade Codes: 7d:Recial/Edmi,Codes: 5:Program Codex(Complete for Hoaxing and Poblie and Indian Housing programs only): CPD: 11—ft/Poblic Houdng: t-Whip Americom I-All lnxwcd.inchtding Sections 5-Seca.202 1-New Construction 1-N—Cwaracdan 6-Profeasimul 2=Black A-- 2-Flexibly Subsidy 6-HUD-Hyld(Mcuyamera) 2-FdanalioNTmieieg 2-Sob-61 Rehab. I-Team,Service, 3-Natin Americans 3-Section a Neal—L Non-HFDA 7-PubIkAldia Hissing 3-peer 3-Repan L-F.d—OWT—ft a-Hifpwic Americros 4-loomed(Maugmeml a-Section all 4-Serviac 9.Asch/Engrg Appnwl 5-Asim.dk Amvirans 5-Proiect Mrxt. a-phc 6-Hasidic kc, Prevbm eauwxm obnipe. form BUD-2516(8/96) EXHIBIT "J" DUTIES OF THE PARTIES USE OF NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"J"–DUTIES OF THE PARTIES— USE OF NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS Page 1 Sixty and Better,Inc.dba Senior Citizen Services Sixty and Better,Inc. dba Senior Citizen Services DUTIES OF THE PARTIES USE OF NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS Agency's Responsibilities: Agency will perform the following in relation with the use of Community Center: • Agency will furnish the Center Coordinator with a schedule of Program activities at least four weeks prior to their occurrence. • Agency will,at its sole expense,furnish materials,supplies,copies and conduct a structured Program. • Agency will ensure that the designated Community Center space is maintained in a neat and orderly fashion. • Agency will ensure that the City's standards are maintained regarding security;cleanliness and communication between and among programs housed at the Community Center and will ensure cooperation with other Community Center staff and agencies/programs. • Agency will report to the Center Coordinator or designee for problems immediately if/when problems occur. • Agency will work with the Center Coordinator or designee to schedule any use of the Community Center for related activities outside of agencies designated meeting time and/or the Community Center's regular days and hours. • Agency will maintain sole responsibility and liability for its employees, volunteers and separate contractors for their actions. • Agency shall ensure that each of its employees, volunteers and participants desiring to participate in Community Center-sponsored programs/activities are aware of the requirement to have a current community center membership card to participate. • Agency agrees to perform background screenings and checks on staff and volunteers,with such screenings and checks meeting or exceeding the requirements that the City imposes for checks and screenings on staff,volunteers and participants in the City's own programs. • Agency will provide the Center Coordinator with designated staff contact information for the purposes of emergencies (center closing, schedule changes or scheduled maintenance) City's Responsibilities: CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"T'–DUTIES OF THE PARTIES— USE OF NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS Page 1 Sixty and Better,Inc.dba Senior Citizen Services City will perform the following in relation with Agency's use of a Community Center: • City will provide space for conducting the Program, including basic utilities and will also supply the Agency with appropriate facility access. For purposes of this Contract, basic utilities shall not include telephone or computer service, which shall remain the sole responsibility of the Agency. • City will ensure that the reserved space is set up with appropriate tables and chairs to accommodate program and/or services. • City will not be responsible for any additional security other than what is currently available at the Community Center. • City assumes no liability or responsibility for the loss of any personal property or office contents of the Agency, its agents, employees, volunteers, participants or licensees while at the Community Center. • City will allow the Agency to conduct properly scheduled classes and other Program related activities during the days and hours specified in Exhibit "A" PROGRAM SUMMARY*. In addition,City may,but is not required,through the Center Coordinator, allow Agency to schedule other classes and Program related activities outside of the days and hours specified in Exhibit"A" PROGRAM SUMMARY. • City will maintain sole responsibility and liability for its employees, volunteers and separate contractors for their actions. • City will have the discretion to put the Agency in any available room. If placed in a different location, it is to be only one room. *The City is closed in observance of the following holidays: New Year's Day(January 1) M.L.K. Jr. Day(Third Monday of January) Memorial Day(Last Monday in May) Independence Day(July 4th) Labor Day(First Monday in September) Thanksgiving Day(Fourth Thursday of November) Day after Thanksgiving(Fourth Friday in November) Christmas Day(December 25th) "City of Fort Worth observes the above holidays on Friday if they fall on Saturday and on a Monday if they fall on Sunday. Additionally,the Community Centers are utilized as shelters during an emergency. If the Community Center will be closed due to an emergency, Center Coordinator or designee will inform Agency of the closure. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"J"--DUTIES OF THE PARTIES— USE OF NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS Page 2 Sixty and Better,Inc.dba Senior Citizen Services EXHIBIT "K" NOTICE OF BENEFICIARY RIGHTS CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT'W'—NOTICE OF BENEFICIARY RIGHTS Page 1 Sixty and Better,Inc.dba Senior Citizen Services Notice of Beneficiary Rights Name of Agency: Sixty and Better, Inc. dba Senior Citizen Services Name of Program: Connecting Seniors to Community Contact information for Program Staff(name,phone number, and e-mail address, if appropriate): Because this program is supported in whole or in part by direct Federal financial assistance from the Federal Government, we are required to let you know that: • We may not discriminate against you on the basis of religion, religious belief, a refusal to hold a religious belief, or a refusal to attend or participate in a religious practice; • We may not require you to attend or participate in any explicitly religious activities that are offered by us and any participation by you in these activities must be purely voluntary; • We must separate, in time or location, any privately funded explicitly religious activities from activities supported by direct Federal financial assistance; • If you object to the religious character of our organization,we must make reasonable efforts to identify and refer you to an alternative provider to which you have no such objection; and • You may report an organization's violations of these protections, including any denial of services or benefits,by contacting or filing a written complaint to HUD [or the intermediary, if applicable]. We must give you this written notice before you enroll in our program or activity, as required by 24 CFR 5.109. CDBG PRESUMED BENEFIT PSA CONTRACT 2017-2018--EXHIBIT"K"—NOTICE OF BENEFICIARY RIGHTS Page 2 Sixty and Better,Inc.dba Senior Citizen Services M&C Review Page 1 of 6 Official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA Foy Min COUNCIL ACTION: Approved on 8/1/2017 -Ordinance No. 22814-08-2017 DATE: 8/1/2017 REFERENCE G-19056 LOG NAME: 19NS HUDACTIONPLANPY2017- NO.: 2018 CODE: G TYPE: NON- PUBLIC YES CONSENT HEARING: SUBJECT: Conduct Public Hearing and Approve the City's 2017-2018 Action Plan for the Use of Federal Grant Funds in the Amount of$10,778,461.00 to be Awarded by the United States Department of Housing and Urban Development from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant and Housing Opportunities for Persons with AIDS Grant Programs, Authorize Collection and Use of Program Income, Authorize Waiver of Application of Indirect Cost Rates, Authorize Execution of Related Contracts and Adopt Appropriation Ordinance (ALL COUNCIL DISTRICTS) RECOMMENDATION: It is recommended that the City Council: 1. Conduct a public hearing to allow citizen input and consideration of the City's 2017-2018 Action Plan for use of federal grant funds to be awarded by the United States Department of Housing and Urban Development in the amount of$10,778,461.00 from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant, and Housing Opportunities for Person with AIDS grant programs, and for the use of program income from activities using prior years'federal grant funds; 2. Approve the City's 2017-2018 Action Plan for submission to HUD, including allocations of grant funds to particular programs and activities as detailed below; 3. Authorize the collection and use of an estimated $150,000.00 of program income which resulted from activities using prior years' Community Development Block Grant funds, for the City's Priority Repair Program; 4. Authorize the collection and use of an estimated $300,000.00 of program income which resulted from activities using prior years' HOME Investment Partnerships Program funds, for the completion of the Hardy Street and HFC Terrell Single Family Infill housing development projects and 10 percent for administrative costs as detailed below; 5. Authorize the City Manager or his designee to execute contracts for one year terms with the agencies listed in Tables 1, 2 and 3 below, for Program Year 2017-2018 for Community Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Person with AIDS grant funds, contingent upon receipt of funding and satisfactory completion of an Environmental Review and all regulatory requirements; 6. Authorize the City Manager or his designee to extend the contracts for up to one year if an agency or department requests an extension and such extension is necessary for completion of the program or to amend the contracts if necessary to achieve program goals provided any amendment is within the scope of the program and in compliance with City policies and all applicable laws and regulations governing the use of federal grant funds; 1kttn-//9T%T%Q rfcxma+ /7017 1 1/1 Chl11 7 M&C Review Page 2 of 6 7. Authorize a waiver of indirect cost rates as applicable for the Grants Fund in accordance with the City's Administrative Regulations; and 8. Adopt the attached appropriation ordinance increasing the estimated receipts and appropriations to the Grants Fund in the total amount of$10,778,461.00 consisting of$6,526,863.00 in Community Development Block Grant funds, $2,047,626.00 in HOME Investment Partnerships Program funds, $577,437.00 in Emergency Solutions Grant funds, and $1,176,535.00 in Housing Opportunities for Person with AIDS grant funds, plus any program income, all subject to receipt of such funds. DISCUSSION: The City's 2017-2018 Action Plan summarizes the major housing and community development activities and proposed expenditures for the program year beginning October 1, 2017 and ending September 30, 2018 for use of federal grant funds totaling $10,778,461.00 from the United States Department of Housing and Urban Development(HUD)for Community Development Block Grant (CDBG), HOME Investment Partnerships Program (HOME), Emergency Solutions Grant(ESG) and Housing Opportunities for Persons with AIDS (HOPWA) grant programs. It also summarizes the use of program income resulting from activities using prior years' CDBG and HOME funds, the primary purpose of which is to benefit low and moderate income City of Fort Worth residents. ESG funds primarily benefit homeless persons, and HOPWA funds primarily benefit low and moderate income persons with HIV/AIDS. Staff developed initial recommendations for the allocation of the estimated funding from HUD based on prior years' funding levels. A public hearing was held on April 19, 2017 to provide citizens the opportunity to participate in the development of the Action Plan. The Staff recommendations for award amounts were presented to the Housing and Neighborhood Services Committee on May 6, 2017 and were adopted by the Community Development Council (CDC) on May 10, 2017. Following the publication of final funding amounts for FY2017-18 from HUD on June 14, 2017, Staff recommendations were updated to reflect the actual grant amounts and these revised recommendations were forwarded to the CDC and presented to the City Council through an Informal Report at the City Council Work Session on June 20, 2017. Notice of a 30 day public comment period from June 30, 2017 to July 31, 2017 was published in the Fort Worth Star-Telegram on June 25, 2017, in La Estrella on June 27, 2017, and in La Vida News: The Black Voice on June 29, 2017. Any comments received are maintained by the Neighborhood Services Department in accordance with federal regulations. The City must hold two public hearings as part of the HUD-required citizen participation process. The first public hearing is scheduled to be held by City Staff on July 19, 2017, and the second public hearing is scheduled for August 1, 2017 at the City Council meeting. A summary of Staffs final funding recommendations is provided below and in Tables 1, 2 and 3. Additionally, a spreadsheet of all specific funding recommendations is attached. The 2017-2018 Annual Action Plan must be submitted to HUD by August 15, 2017. A waiver of indirect costs is being requested to maximize program benefits. The CDBG program provides for 23 full-time positions with estimated salaries of$1.3 million. Addition of indirect costs would result in reduction in Staff and services. The indirect costs that are being asked to be waived are estimated to be $215,386.00. CDBG For Program Year 2017-2018, it is recommended that the amount of$6,526,863.00 in CDBG funds, and an estimated amount of$150,000.00 in CDBG program income totaling $6,676,863.00 be allocated as follows: Public Services -$979,029.00 bffn-//anne rfixmat nrrt/�ro,n�;l n�rlrat/mom raviPxv��n9TTl—�a4no�...,,,n..;l.lara—Q/1/�n17 1 1/1 S/7n1 7 M&C Review Page 3 of 6 This item includes social services for low to moderate income, disabled and disadvantaged populations. Housing Program Services -$2,922,228.00 This item includes funding for the City's Priority Repair Program, Cowtown Brush-Up, homebuyer and housing services, accessibility modifications to the homes of senior and/or disabled individuals, the Lead Hazard Reduction Demonstration Grant Match, and related project delivery costs for these programs. Infrastructure Projects & Public Facilities -$579,255.00 This item includes funding for the Worth Heights Community Center Americans with Disability Act Improvements. CDBG Economic Development-$740,979.00 This item is the City's annual payment of its Section 108 loan from HUD. The Section 108 Program is a loan guarantee program which enables CDBG grantees to borrow up to five times the annual entitlement grant. CDBG Estimated Program Income -$150,000.00 This item includes funding for the City's Priority Repair Program. CDBG program income that is received which is over the estimated amount but not used for the City's Priority Repair Program will be allocated to priority activities in the City's Consolidated Plan subject to City Council approval. CDBG General Administration -$1,305,372.00 This item includes costs for administering the CDBG grant including allocations for Financial Management Services and Planning and Development Departments. HOME For Program Year 2017-2018, it is recommended that the amount of$2,047,626.00 in HOME funds, and an estimated amount of$300,000.00 in HOME program income totaling $2,347,626.00 be allocated as follows: Homebuyers Assistance Program (HAP) -$700,000.00 This item includes funding for down payment and/or closing cost assistance to low and moderate income homebuyers. Community Development Housing Organizations (CHDO) Set Aside -$307,144.00 HUD requires that a minimum of 15 percent of HOME funds be allocated to CHDOs for affordable housing projects and CHDO administrative operating costs. These funds will be used by Housing Channel (formerly Tarrant County Housing Partnership), a CHDO, for the Riverside Single Family Infill Development(COUNCIL DISTRICT 8). The houses will be sold to homebuyers making at or below 80 percent of the area median income as set by HUD. Rental Housing Development—$835,720.00 This item represents gap financing for a portion of the costs of developing Columbia Renaissance Square, Phase II, an affordable multifamily senior development(COUNCIL DISTRICT 8). httn•//nnr%c Mf xmat nrrTh r%imnil r aAn.t/mn raviaxxr /7(11 7 1 1/1 V101 7 M&C Review Page 4 of 6 HOME General Administration—$204,762.00 This item includes costs for administering the HOME grant. HOME Estimated Program Income -$300,000.00 This item represents gap financing for the Columbia Renaissance Square, Phase II multifamily senior development. HOME program income that is received which is over the estimated amount but not used for the Columbia Renaissance Square, Phase II project will be allocated to the Riverside Single Family Infill development, or to priority activities in the City's Consolidated Plan subject to Council approval. HUD allows the City to take 10 percent of any HOME program income to be used for the costs for administering the HOME grant. HOPWA For Program Year 2017-2018, it is recommended that the amount of$1,176,535.00 in HOPWA funds be allocated as follows: Non-Profit Service Providers -$1,141,239.00 HOPWA Program Administration—$35,296.00 ESG For Program Year 2017-2018, it is recommended that the amount of$577,437.00 in ESG funds be allocated as follows: Non-Profit Service Providers -$534,130.00 ESG Program Administration —$43,307.00 CONTRACT RECOMMENDATIONS The CDC and Staff recommend that contracts be executed with the listed agencies for the amounts shown in the following tables: Community Development Block Grant Contracts: Table 1 — CDBG Agencies Organization Program Amount AB Christian Learning Center Child Care Services $ 76,350.00 Catholic Charities Diocese of Fort EmploymenUJob Training $ 101,800.00 Worth, Inc. Girls Inc. of Tarrant County Youth Services $ 111,080.00 Goodwill Industries of Fort Worth, Employment/Job Training $ 76,350.00 Inc. Housing Channel Housing Counseling $ 118,088.00 Services The Ladder Alliance Employment/Job Training $ 94,974.00 Meals on Wheels, Inc. of Greater General & Special Needs $ 76,350.00 arrant Count httn //ar�ne r irm-t nrrr/rromril rarlra4/mr raviacxacr7TTl—)dQ(1QJP�rromrililata-52/1/7(11 7 1 1/1 S/7(11 7 M&C Review Page 5 of 6 Presbyterian Night Shelter of Public Service Special $ 144,987.00 Tarrant County Needs Sixty and Better, Inc. Public Services: Elderly $ 101,800.00 United Community Centers Child Care Services $ 76,350.00 CDBG Public Service Subtotal $ 979,029.00 Rehabilitation, Education and Accessibility $ 102,000.00 Advocacy for Persons with Handicaps, dba REACH, Inc.** Total CDBG Contracts $1,081,029.00 **REACH will be funded from the CDBG Housing Programs and Services budget Housing Opportunities For Persons With AIDS Contracts: Table 2— HOPWA Agencies Organization Program Amount Tarrant County Samaritan Housing, Administration (seven $ 510,204.00 Inc. percent), Supportive Services and Facility Based housing Subsidy Assistance AIDS Outreach Center. Inc. Supportive Services, $ 631,035.00 Tenant Based Rental Assistance (TBRA), and Short Term Rent Mortgage and Utility Assistance (STRMU) Total HOPWA Contracts $1,141,239.00 Emergency Solutions Grant Contracts: Table 3—ESG Agencies Organization Program Amount Presbyterian Night Shelter of Shelter $ 126,625.00 Tarrant County Operations/Services SafeHaven of Tarrant County Shelter $ 75,975.00 Operations/Services Lighthouse for the Homeless dba Shelter $ 95,343.00 True Worth Place Operations/Services The Salvation Army a Georgia Homeless Prevention $ 126,625.00 Corporation Center for Transforming Lives Rapid Rehousing $ 109,562.00 Total ESG Contracts $ 534,130.00 A waiver of the goal for MBE/SBE subcontracting requirements was requested by the Neighborhood Services Department and approved by the M/WBE Office, in accordance with the M/WBE or BIDE Ordinance, because the purchase of goods or services from source(s)where subcontracting or supplier opportunities are negligible. httn• /annc nfwnaf nra/nrn,nr;l nPA-Pf/mr rvv;PxxT a�n�rn—�a4n4��.,,,nr;lrlafa—Qr1/�n17 1 1/1 S/�n17 M&C Review Page 6 of 6 All figures have been rounded to the nearest dollar for presentation purposes. These programs are available in ALL COUNCIL DISTRICTS. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that upon approval of the above recommendations, adoption of the attached appropriation ordinance and receipt of grant funds, funds will be available in the current operating budget, as appropriated, of the Grants Operating Federal Fund. This is a reimbursement grant. The Neighborhood Services Department has the responsibility to validate the availability of funds prior to an expenditure being made. TO Fund Department Account Project Program Activity Budget l Reference# Amount ID ID Year I (Cha field 2 FROM Fund Department Account Project Program Activity Budget Reference# Amount ID ID Year (Chartfield 2 Submitted for City Manager's Office by: Fernando Costa (6122) Originating Department Head: Aubrey Thagard (8187) Additional Information Contact: Barbara Asbury (7331) David Reitz (7563) ATTACHMENTS 19NS HUDACTIONPLAN PY2017-2018 019 AO 17.docx Form 1295-All Agencies.pdf HUD 2017-18 AP Selected Slides.pdf httr •//�rre nfa:mnt nrn/nnnrnil ronlrn4/mn rnvium��,.7TTl=7A�l1�Rrnn»nni1r1o4u—Q/1/7117 1 1/1 G/7(11 7 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 C, _I. Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2017-235962 Sixty and Better, Inc. Fort Worth,TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 0711212017 being filed. City of Fort Worth Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. SECDBG2017 Providing programming for seniors that includes meals and socialization,educational and health presentations and workshops. Nature of interest 4 Name of Interested Party City,State,Country(place of business) (check applicable) Controlling intermediary S Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct. /- LEGA A.:RUIZNotary Pubifc,Staof Texas .y Notary ID 590720-9 Signature of authorized agent of contracting business entity M Nyr CotntrtiiSow Exp.12-1s-2Q AF Sworn to and subscribed before me,by the said ,this the / day of 20 ,to certify which,witness my hand and of office. Al� ignature of officer administering o Printed name of officer administering oath Title of o er administering o Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1,0.883