HomeMy WebLinkAboutContract 37488 (2)CITY SECRETARI( g
cQr�sTRAcT NO. 31
STATE OF TEXAS
COUNTY OF TARRANT
THIS contract ("Contract") is made and entered into by and between the City of Fort
Worth ("City"), whose address is 1000 Throckmorton St., Fort Worth Texas 76102, acting by
and through Joe Paniagua, Jr., its duly authorized First Assistant City Manager, and Mental
Health Association of Tarrant County (Ombudsman) ("Contractor"), whose address is 3136
West 4th Street, Fort Worth, Texas, 76107, acting by and through Ms. Linda Ragsdale , its
duly authorized Executive Director. (Sometimes City and Contractor are referred to
individually as a "Party" and collectively as the "Parties".)
WHEREAS, City has received grant monies from the United States Department of
Housing and Urban Development ("HUD") under Title 1 of the Housing and Community
Development Act of 1974, as amended, (42 USC 5301 et seq.) for utilization in connection
with its Community Development Block Grant ("CDBG"), Program No. B-08-MC-48-0010,
for Year XXXIV;
WHEREAS, one of the national objectives of the CDBG program is to benefit low and
moderate income citizens (the "National Objective");
WHEREAS, the assigned Catalog of Federal Domestic Assistance (CFDA) number is
14.218 for this Federal program; and
WHEREAS City citizens, the Community Development Council, and the City Council
have determined that CDBG programs are needed by the City's low and moderate -income
citizens.
NOW, THEREFORE, THIS AGREEMENT FURTHER WITNESSETH:
THAT, the Parties covenant and agree as follows:
1. Scope of Services
a. Contractor will administer ombudsman services to citizens of the City of Fort
Worth under the program name Long Term Ombudsman ("Program"), for the term
June 1, 2008 to May 31, 2009.
b. Contractor will be responsible for administering Long Term Ombudsman in a
manner satisfactory to City and consistent with any standards required as a condition
of providing the CDBG funds (as hereinafter defined). The Program will include
the following CDBG eligible activities: Contractor will provide the services and
activities as set forth in Exhibit A -Program Summary in accordance with Exhibit
B-Program Services Schedule.
c. Contractor agrees to meet the National Objective of activities benefiting low and
moderate -income individuals and to maintain full documentation supporting
fulfillment of this National Objective in its files as defined in 24 CFR 570.208.
actor certifies that the activities carried out under this Contract will serve low
OFFICIAL REC oderate-income persons. Contractor will obtain information on family size
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and income of Program participants. All such documentation shall be furnished to
City upon request if necessary for City to fulfill its obligations under its Federal
grant. If this documentation is not maintained and furnished to City on request,
City may exercise all remedies available under this Contract, including the right to
withhold payment to Contractor on this Contract or any other contract with
Contractor, or terminate this Contract as described herein.
d. City will monitor and evaluate Contractor's performance using the goals and
performance standards required in this Contract. Substandard performance as
determined by City monitoring will constitute non-compliance with this Contract. If
action to correct such substandard performance is not taken by Contractor within a
reasonable period of time after being notified in writing by City, procedures to
suspend or terminate the Contract will be initiated.
e. If applicable, Contractor shall comply and assist City in complying with the
provisions of any federal requirements regarding displacement, relocation and/or
real property acquisition.
f. Contractor agrees to take reasonable steps to ensure meaningful access to the
Program and associated activities by limited English proficient persons.
2. Compensation and Method of Payment
a. City will disburse CDBG Year �'Z'�IV funds ("CDBG Funds") in an amount up to
fifteen thousand seven hundred fifty and no/100 dollars. $15,750 to Contractor on a
reimbursement of expenses basis.
b. Payment will be processed by City following receipt from Contractor of the
following monthly financial documents: (1) Attachment I- Request For Funds, (2)
Attachment II -Detail Statement of Costs, and (3) Attachment III -Expenditures
Worksheet. Payment by City to Contractor shall require completion of all City
forms and copies of adequate supporting documentation verifying eligibility of
expenses as well as, where applicable, eligibility of Program participants.
Reimbursement for the payment of eligible expenses shall be made against the
budget specified in Exhibit C-Program Operating Budget and in accordance with
performance specified in Exhibit B-Program Services Schedule. City will not
disburse funds for expenditures that occurred prior to the beginning date of the
term of this Contract.
c. Contractor agrees to utilize all disbursed CDBG Funds for the benefit of the
Program. Contractor agrees that all funds will be expended in accordance with
Exhibit C-Program Operating Budget. Contractor may not increase or decrease line -
item amounts in the approved CDBG Funds portion of Exhibit C-Program
Operating Budget without City's prior written approval. Contractor acknowledges
and agrees that any CDBG Funds not used in accordance with the CDBG
Regulations and the terms of this Contract will be repaid to City.
d. It is understood that the total cost for operation of this Program is $26,182 and that
Contractor will obtain from other sources the remaining funds in excess of the
CDBG Funds as detailed in Exhibit C-Program Operating Budget. Contractor will
notify City promptly of any additional funds it receives for operation of the
Program, and City reserves the right to amend Exhibit C-Program Operating Budget
in such instances.
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e. Contractor agrees to keep all CDBG Funds on hand in interest bearing accounts. All
interest earned shall be reported to City on a monthly basis, at the same time as
submission of the monthly report following the end of the Contract month during
which the interest was earned. Interest in an amount of $25.00 or less per month
may be used for authorized Program expenses. These amounts must be reported on
the monthly financial statements filed pursuant to this Contract. Interest earned in
excess of $25.00 per month is subject to remittance to City as directed by City.
£ Contractor will not commingle CDBG Funds with any other funds in any manner
that would prevent City from readily identifying expenditures for operation of the
Program.
3. Uniform Administrative Keguirements and Program Management Standards
a. Financial Management
i. Accounting Standards
Contractor agrees to comply with OMB Circular A-110, "Uniform
Administrative Requirements for Grants and Agreements with Institutions of
Higher Education, Hospitals and other Non -Profit Organizations", and agrees to
adhere to the accounting principles and procedures required therein, utilize
adequate internal controls, and maintain necessary source documentation for all
costs incurred.
n. Cost Principles
Contractor shall administer the Program in conformance with OMB Circular A-
122, "Cost Principles for Non -Profit Organizations" and attachments and
revisions thereto, regarding principles for determining costs for the Program.
b. Documentation and Record Keeping
i. Requirement
Contractor shall maintain all records pertinent to the activities to be funded
under this Contract required in 24 CFR § 570.506. In addition, Contractor
agrees to keep records to fully document all expenditures charged to the CDBG
portion of the Program, including records documenting the eligibility of
Program participants as more particularly described herein. The documentation
must support the amounts charged to the Program, the eligibility of the Program
participants, and demonstrate that the expenditures were appropriate to the
stated goals of the Program and allowable and/or eligible under applicable
Federal, state and City guidelines.
ii. Retention
(1) All records pertaining to Program shall be retained for four (4) years
following the termination of this Contract. Contractor may destroy Program
records at the end of this four (4) year period if no outstanding audit finding
exists.
(2) Contractor will retain any Program loan records until four (4) years after the
expiration of any loan.
iii. Real Property Records
Contractor shall maintain real property inventory records that clearly identify
properties purchased, improved, or sold. Properties retained shall meet eligibility
criteria and shall conform to the requirements of 24 CFR 570.5054
iv. Closeouts
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Contractor's obligation to City shall not end until all closeout requirements are
completed. Activities during this closeout period shall include, but are not
limited to: making final payments, disposing of Program assets (including the
return of all unused materials, equipment, unspent cash advances, Program
income balances, and accounts receivable to City), and determining the
custodianship of records.
v. Audits and Inspections
(1) City, HUD, and the United States Comptroller General, or their respective
representatives, shall have access to any books, documents, records and
papers relating to the operations of Contractor under this Contract for the
purpose of audit, examination, exception and transcription at all of
Contractor's offices at all reasonable hours.
(2) All non-federal entities that expend $500,000 or more in Federal funds within
one (1) year, regardless of the source of the Federal award, must submit to
City an annual audit prepared in accordance with 24 CFR Sections § 570.502-
570.503 generally, with specific reference to OMB Circulars (with
attachments) A-122, "Cost Principles for Non -Profit Organizations", and A-
133, `Audits of States, Local Governments, and Non -Profit Organizations",
as appropriate. The audit may cover either Contractor's fiscal year during
which this Contract is in force or cover the period of this Contract. The
audit must be prepared by an independent certified public accountant, be
completed within nine (9) months following the end of the period being
audited and be submitted to City within thirty (30) days of its completion.
Contractor's audit certification is attached hereto as Exhibit D - Audit
Schedule Independent Audit Requirement. The Audit Schedule Form must
be submitted to City within sixty (60) days of the end of the period being
audited (Contractor's fiscal year). Costs of preparation of this audit may be
an allowable expenditure of CDBG Funds in an amount proportional to that
of the CDBG Funds used in Contractor's total agency operating budget.
Non-profit entities that expend less than $500,000 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 ("GAO").
(3) City reserves the right to perform an audit of Contractor's agency operations
and finances at any time during the term of this Contract, if City determines
that such audit is necessary for City's compliance with OMB Circular A-133.
Contractor agrees to allow access to all relevant books, records and materials.
If such audit reveals a questioned practice or expenditure, such questions
must be resolved within fifteen (15) days after notice to Contractor. If
questions are not resolved within this period, City reserves the right to
withhold further funding under this Contract and/or any other contract(s)
with Contractor.
(4) If as a result of any audit it is determined that Contractor has misused,
misapplied or misappropriated all or any part of the CDBG Funds,
Contractor agrees to reimburse the City the amount of such monies so
misused, misapplied or misappropriated, plus the amount of any sanction,
penalty or other charge levied against City because of such misuse,
misapplication or misappropriation.
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4. Deporting Proceddures
a. Financial Reports
Contractor will submit to City on a monthly basis: (1) Attachment I -Request for
Funds, (2) Attachment II -Detailed Statement of Costs, (3) Attachment III -
Expenditures Worksheet, as applicable, for expenses incurred for services and
activities accomplished by Contractor in performance of this Contract. Actual cash
receipts for claimed expenditures must be provided at the time the request for funds
is presented. The reports must be signed by a duly authorized agent of the
Contractor and submitted by the 15`h of the month following the month being
reported. City is under no obligation to disburse funds for expenditures that
occurred prior to the first day of the month for which the report is submitted.
Do Progress Reports
Contractor will submit to City on a monthly basis: (1) Attachment IVa-Program
Services Report, (2) Attachment IVb-Direct Benefit Data Report, (3) Attachment V-
Performance Report, and (4) Attachment VI -Client Data Report for services and
activities undertaken by Contractor in performance of this Contract. The report will
be signed by a duly authorized agent of Contractor and submitted by the 15`h of the
month following the month that is reported. City is under no obligation to disburse
funds for expenditures that occurred prior to the beginning date of this Contract.
c. Program Income
Contractor agrees that all program income from operation of the Program in
proportion to the amount of CDBG Funds received hereunder will be expended
prior to expending CDBG Funds and that any such program income is subject to the
terms of this Contract. Contractor may expend CDBG Funds only if program
income is insufficient to meet all eligible Program activity expenses. Contractor
agrees to return to City at the end of the Contract any remaining program income
earned from operation of the Program in proportion to the amount of CDBG
Funds in Exhibit A -Program Summary and Exhibit B-Program Operating Budget.
d. Procurement
i. Compliance
Contractor shall comply with City policy concerning the purchase of equipment
and shall maintain inventory records of all non -expendable personal property, as
defined by such policy, procured with funds provided under this Contract.
ii. OMB Standards
Contractor shall procure all materials, property, or services in accordance with
the requirements of 24 CFR Part 84, Procurement Standards and Property
Standards, as modified by 24 CFR Part 570.502(b)(6), covering utilization and
disposal of property.
e. Program Participant Records
i. Contractor will keep or cause to be kept an accurate record of all actions taken
and all CDBG Funds expended, with source documents, in performance of this
Contract. Such records shall be kept for the time period mandated by the
CDBG Regulations and this Contract.
ii. Contractor will obtain and keep on file and furnish to City on request the
following information and/or documentation on each Program participant
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served by the Program demonstrating such participant's eligibility for services
provided:
a. Participant's name, address, annual income level or other basis for
determining income eligibility, and family size of participant's household.
b. Source documentation used for income verification including but not limited
to pay check stubs, food stamp award letters, income tax returns, SSI award
letters, letters awarding unemployment benefits, W2s and the like.
c. City shall have the final determination, in its sole discretion, as to whether
source documentation used for income verification is adequate.
5. Revej:rion of Assets
a. Contractor agrees to return to City any CDBG Funds remaining on hand at the end
of the Contract.
b. All property purchased with CDBG Funds under this Contract will be used solely
for operation of the Program. Contractor agrees to obtain City approval prior to
purchase of property and Contractor agrees to notify City upon receipt of property
so that it may be properly tagged and inventoried. Title to such property will be
vested in City, and Contractor will deliver all such property to City for disposition at
City's sole discretion at the termination of the Program.
6. Applicable L.azvs
a. Federal
Contractor agrees to comply with the following laws and the applicable regulations
as they are currently written or are hereafter amended during performance of this
Contract:
• Regulations at 24 CFR Part 570 pertaining to CDBG ("CDBG Regulations")
• Title I of the Housing and Community Development Act of 1974 (42 USC
5301 et seq.)
• Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970 (42 USC 4601 et seq.) and its related regulations at 49 CFR Part 24
• Title VI of the Civil Rights Act of 1964 (42 USC 2000d et seq.)
• Title VIII of the Civil Rights Act of 1968 (42 USC 3601 et seq.)
• Executive Orders 11063, 11246, as amended by Executive Orders 11375 and
12086 and as supplemented by 41 CFR Part 60
• The Age Discrimination in Employment Act of 1967 (29 USC 621)
• The Age Discrimination Act of 1975 (42 USC 6101 et seq.)
• Section 504 of the Rehabilitation Act of 1973 (29 USC 794 et seq.) and 24 CFR
Part 8 where applicable
• The Americans with Disabilities Act of 1990 (42 USC 12101)
• National Environmental Policy Act of 1969, as amended, 42 USC 4321 et seq.
("NEPA") and the related authorities listed 24 CFR Part 58
• The Clean Air Act, as amended (42 USC 7401 et seq.), the Clean Water Act of
1977, as amended (33 USC 1251 et seq.) and the related EPA regulations at 40
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CFR Part 15, as amended from time to time, and 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.
• The Immigration Reform and Control Act of 1986 (8 USC 1101 et seq.),
specifically including the provisions requiring employer verification of the legal
status of its employees
• The Housing and Community Development Act of 1987 (42 USC 5301 et seq.)
• The Americans with Disabilities Act of 1990 (42 USC 12101 et seq.)
• Drug Free Workplace Act of 1988 (41 USC 701 et seq.) and 24 CFR Part 23,
Subpart F
• Regulations as 24 CFR Part 87 related to lobbying, including the requirement that
certifications and disclosures be obtained from all covered persons
• Executive Order 12549 and 24 CFR Part 5.105 (c) pertaining to restrictions on
participation by ineligible, debarred, or suspended persons or entities.
b. Section 3 of the Housing and Urban Development Act of 1968, as amended, (12
USC 1701u et seq. and its related regulations at 24 CFR Part 135
As the work to be performed under this Contract is on a project assisted under a
program providing direct Federal financial assistance from HUD, Section 3 of 24
CFR 135.38 ("Section 3") requires that the following clause be inserted in all covered
contracts ("Section 3 Clause"):
"A. The work to be performed under this contract is subject to the requirements of
section 3 of the Housing and Urban Development Act of 1968, as amended, 12
U.S.C. 1701u (section 3). The purpose of Section 3 is to ensure that employment
and other economic opportunities generated by HUD assistance or HUD -
assisted projects covered by Section 3, shall, to the greatest extent feasible, be
directed to low- and very low-income persons, particularly persons who are
recipients of HUD assistance for housing.
B. The Parties to this contract agree to comply with HUD's regulations in 24 CFR
Part 135, which implement Section 3. As evidenced by their execution of this
contract, the Parties to this contract certify that they are under no contractual or
other impediment that would prevent them from complying with the Part 135
regulations.
C. The contractor agrees to send to each labor organization or representative of
workers with which the contractor has a collective bargaining agreement or other
understanding, if any, a notice advising the labor organization or workers'
representative of the contractor's commitments under this section 3 clause, and
will post copies of the notice in conspicuous places at the work site where both
employees and applicants for training and employment positions can see the
notice. The notice shall describe the Section 3 preference, shall set forth
minimum number and job titles subject to hire, availability of apprenticeship and
training positions, the qualifications for each; and the name and location of the
person(s) taking applications for each of the positions; and the anticipated date
the work shall begin.
D. The contractor agrees to include this section 3 clause in every subcontract
subject to compliance with regulations in 24 CFR Part 135, and agrees to take
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appropriate action, as provided in an applicable provision of the subcontract or
in this Section 3 clause, upon a finding that the subcontractor is in violation of
the regulations in 24 CFR Part 135. The contractor will not subcontract with any
subcontractor where the contractor has notice or knowledge that the
subcontractor has been found in violation of the regulations in 24 CFR Part 135.
E. The contractor will certify that any vacant employment positions, including
training positions, that are filled (1) after the contractor is selected but before the
contract is executed, and (2) with persons other than those to whom the
regulations of 24 CFR Part 135 require employment opportunities to be directed,
were not filled to circumvent the contractors obligations under 24 CFR Part 135.
F. Noncompliance with HUD's regulations in 24 CFR Part 135 may result in
sanctions, termination of this contract for default, and debarment or suspension
from future HUD assisted contracts.
G. With respect to work performed in connection with Section 3 covered Indian
housing assistance, section 7(b) of the Indian Self -Determination and Education
Assistance Act (25 U.S.C. 450e) also applies to the work to be performed under
this contract. Section 7(b) requires that to the greatest extent feasible (i)
preference and opportunities for training and employment shall be given to
Indians, and (ii) preference in the award of contracts and subcontracts shall be
given to Indian organizations and Indian -owned Economic Enterprises. Parties
to this contract that are subject to the provisions of section 3 and section 7(b)
agree to comply with Section 3 to the maximum extent feasible, but not in
derogation of compliance with section 7(b)."
City and Contractor understand and agree that compliance with the provisions of
Section 3, the regulations set forth in 24 CFR Part 135, and all applicable rules and orders
of HUD shall be a condition of the Federal financial assistance provided to the Program,
binding upon City and Contractor, and their respective successors, assigns and
subcontractors. Failure to fulfill these requirements shall subject Contractor and its
subcontractors, and their respective successors and assigns, to those sanctions specified
by the Grant Agreement through which Federal assistance is provided and to such
sanctions as are specified by 24 CFR Part 135.
c. Other Laws
Contractor covenants and agrees that its officers, members, agents, employees,
Program participants and subcontractors shall abide by and comply with all other
laws, Federal, state and local, relevant to the performance of this Contract, including
all applicable City ordinances, rules and regulations and Title I of the Housing and
Community Development Act of 1974 (42 USC 5301 et seq.), as amended, and the
CDBG Regulations, as amended, (24 CFR Part 570 et seq.). Contractor further
promises and agrees that it has read, and is familiar with, the terms and conditions of
the Community Development Block Grant under which CDBG Funds are granted
and any applicable provisions of the CDBG Regulations and that it will fully comply
with them. It is agreed and understood that, if City notifies Contractor of any such
violation on the part of Contractor or any of its officers, members, agents,
employees, Program participants or subcontractors, then Contractor shall
immediately desist from and correct such violation.
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7. Nondiscrimination
a. Contractor will not unlawfully discriminate against any person or persons because of
sex, race, religion, age, disability, color, national origin, or familial status, not will
Contractor permit its officers, members, agents, employees, subcontractors or
Program participants to engage in such discrimination.
b. Contractor covenants that neither it nor any of its officers, members, agents,
employees, Program participants or subcontractors, 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 except on the basis
of bona fide occupational qualification, retirement plan or statutory requirement.
c. Contractor further covenants that neither it nor its officers, members, agents,
employees, subcontractors, Program participants, 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.
d. In accordance with the provisions of the Americans With Disabilities Act of 1990
("ADA"), Contractor warrants that it and any and all of its subcontractors will not
unlawfully discriminate on the basis of disability in the provision of services to the
general public, not in the availability, terms and/or conditions of employment for
applicants for employment with Contractor, or employees of Contractor or any of
its subcontractors. Contractor warrants it will fully comply with 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 or subcontractors against City arising out of Contractor's and/or its
subcontractors' alleged failure to comply with the above -referenced laws concerning
disability discrimination in the performance of this Contract.
e. This Contract is made and entered into with reference specifically to the ordinances
codified at Chapter 17, Article III, Division 3 "Discrimination in Employment
Practices", of the City Code, and Contractor hereby covenants and agrees that
Contractor, its officers, members, agents, employees and subcontractors, have fully
complied with all provisions of same and that no employee, employee -applicant or
Program participant has been discriminated against by the terms of such ordinances
by either the Contractor or its officers, members, agents, employees or
subcontractors.
8. Prohibition Against Interest
a. No member, officer or employee of City or its designees or agents; no member of
the governing body of the locality in which the Program is situated; and no other
public official of such locality or localities, who exercises any functions or
responsibilities with respect to the Program funded hereunder during his or her
tenure or for one year thereafter, shall have any interest, direct or indirect, in any
contract or subcontract, or the proceeds thereof, for work to be performed
hereunder. Contractor shall incorporate, or cause to be incorporated, like language
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prohibiting such interest in all contracts and subcontracts entered into in connection
with the Program.
b. No member, officer, employee, or Program participant of Contractor or its
subcontractors shall have a financial interest, direct or indirect, in this Contract or
the CDBG Funds transferred hereunder or be financially interested, directly or
indirectly, in the sale to Contractor of any land, materials, supplies or services
purchased with any CDBG Funds transferred hereunder, except on behalf of
Contractor, as an officer, employee, member or Program participant. Any willful
violation of this paragraph with the expressed or implied knowledge of Contractor
or its subcontractors shall render this Contract voidable by City.
9. Minoyzty and l�omen Business Enter�rzse Commitment
Contractor agrees to abide by City's policy to involve Minority and Women Business
Enterprises ("MWBEs") in all phases of its procurement practices and to provide them
an 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. Contractor agrees to incorporate City Ordinance No. 15530,
and all amendments or successor policies thereto, into all contracts and will further
require all persons or entities with whom it contracts to comply with said MWBEs
policy.
10. Non Assignment
No assignment or delegation of duties under this Contract by Contractor shall be
effective without City's prior written approval.
11. Independent Contractor•
a. Contractor shall operate hereunder as an independent contractor and not as an
officer, agent, servant or employee of City. Contractor 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,
subcontractors, Program participants, licensees or invitee. The doctrine of
respondeat superior shall not apply as between City and Contractor, its officers,
members, agents, servants, employees, subcontractors, Program participants,
licensees or invitees, and nothing herein shall be construed as creating a partnership
or joint enterprise between City and Contractor. It is expressly understood and
agreed that no officer, member, agent, employee, subcontractor, licensee or invitee
of the Contractor, not any Program participant hereunder, is in the paid service of
City and that City does not have the legal right to control the details of the tasks
performed hereunder by Contractor, its officers, members, agents, employees,
subcontractors, Program participants, licensees or invitees.
b. City shall in no way not under any circumstances be responsible for any property
belonging to Contractor, its officers, members, agents, employees, subcontractors,
Program participants, licensees or invitees, which may be lost, stolen, destroyed or in
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any way damaged; and Contractor hereby indemnifies and holds harmless City and
its officers, agents, and employees from and against any and all claims or suits.
12. Indemnification, In.ratrance ayad Bonding
a. CONTRACTOR 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
OR SUBCONTRACTORS OF CITY; AND CONTRACTOR 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
PERSONA. INJURY, INCLUDING DEATH, TO ANY AND ALL
PERSONS, OF WHATSOEVER KINDS OR CHARACTER, WHETHER
REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH
THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE
OR NON-PERFORMANCE OF THIS CONTRACT AND AGREEMENT
AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES OF THE
PROGRAMS DESCRIBED HEREIN, WHETHER OR NOT CAUSED IN
WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS,
AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR
SUBCONTRACTORS OF CITY. CONTRACTOR 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 CONTRACTOR, ITS OFFICERS, MEMBERS, AGENTS,
EMPLOYEES, SUBCONTRACTORS, INVITEES, LICENSEES, OR
PROGRAM PARTICIPANTS, OR CAUSED, IN WHOLE OR IN PART, BY
ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS,
EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY.
CONTRACTOR 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
CDBG YEAR XXXIV CONTRACT Rev. 6/19/07
Mental Health Association of Tarrant County -Ombudsman Page 11
IF THE INJURY, DEATH, DAMAGE OR LOSS IS CAUSED BY THE
CITY'S SOLE OR CONCURRENT NEGLIGENCE.
CONTRACTOR SHALL REQUIRE ALL OF ITS SUBCONTRACTORS
TO INCLUDE IN THEIR SUBCONTRACTS A RELEASE AND
INDEMNITY IN FAVOR OF THE CITY IN SUBSTANTIALLY THE
SAME FORM AS ABOVE.
b. Contractor will maintain blanket fidelity coverage in the form of a bond in the
amount of $15,750, to insure against loss from the fraud, theft or dishonesty of any
of Contractor's officers, agents, trustees, directors or employees. The proceeds of
such bond shall be used to reimburse City for any and all loss of CDBG Funds
occasioned by such misconduct. To effectuate such reimbursement, such bond shall
include a rider stating that reimbursement for any loss or losses thereunder shall be
made directly to City for the uses and benefit of Contractor.
c. Contractor shall furnish certificates of insurance as proof that it has secured and
paid for policies of workers' compensation, public liability and automobile liability
insurance covering all risks incident to or in connection with the execution,
performance, attempted performance or nonperformance of this Contract. The
amounts of such insurance shall not be less than the maximum liability that can be
imposed on City under the laws of the State of Texas. Contractor understands and
agrees that such insurance amounts may be revised upward at City's option and that
Contractor shall revise such amounts within thirty (30) days following notice to
Contractor of such requirements.
d. Contractor will submit documentation to City that it has obtained insurance coverage
and has executed bonds as required in this contract within thirty (30) days of the
execution of this Contract and prior to payment of any monies hereunder.
e. Any failure on part of the 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 Contractor 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 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 unless otherwise approved by City.
Deductible limits on insurance policies shall not exceed $5,000 per occurrence unless
otherwise approved by City.
£ Any local, federal or other regulatory insurance or bonding requirements for the
Program that exceed those specified herein shall prevail.
g. Contractor shall agree to require its subcontractors to maintain applicable insurance
coverages, limits, and other requirements as those specified herein; and, Contractor
shall require its subcontractors to provide Contractor with certificate(s) of insurance
documenting such coverage. Also, Contractor shall require its subcontractors to
have City and Contractor endorsed as additional insured (as their interests may
appear) on their respective insurance policies. Contractor shall require its
subcontractors to maintain builders risk insurance at the limit of applicable project(s)
costs when the value of materials involved exceeds $10,000 or at a different limit
value limit as specified by City.
CDBG YEAR XXXIV CONTRACT Rev. 6/19/07
Mental Health Association of Tarrant County -Ombudsman Page 12
1I Waiver of Immunity
If Contractor is a charitable or nonprofit organization and has or claims an immunity or
exemption (statutory or otherwise) from and against liability for damages or injury,
including death, to persons or property; Contractor 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.
14. Termination
a. In addition to, and not in substitution for, other provisions of this Contract
regarding the provision of public services with CDBG Funds, pursuant to Title I of
the Housing and Community Development Act of 1974, as amended, (42 USC 5301
et seq.) and the CDBG Regulations, it is expressly understood and agreed by and
between the Parties that this Contract is wholly conditioned upon the actual receipt
by City of Federal CDBG XXXIV Year funds; that all monies distributed to
Contractor hereunder shall be exclusively from Federal monies received under said
grant and not from any other monies of City; and that if such funds under City's
grant are not timely forthcoming, in whole or in part, City may, at its sole discretion,
terminate this Contract and City shall not be liable for payment for any work or
services performed by Contractor under or in connection with this Contract.
b. City may terminate this Contract whenever such termination is determined to be in
City's best interest, in event of Contractor's default, inability or failure to perform or
to comply with any of the terms herein, or, for other good cause.
c. The Parties acknowledge that CDBG Funds paid hereunder are intended to provide
only partial funding for Contractor's program operations. City may terminate this
Contract if non-CDBG funds included in the Operating Budget are not forthcoming
to Contractor during the Contract term.
d. CDBG Funds provided hereunder may not be used as collateral for loans to
Contractor to defray program operation expenses, and any attempted use of CDBG
Funds for this purpose will result in termination of this Contract by City.
e. Termination will be effected by written notice to Contractor, specifying the portions
of the Contract affected and the effective date of termination. Upon Contractor's
receipt of such termination notice, Contractor will:
• Stop work under the Contract on the date and to the extent specified by City;
• Cease expenditures of CDBG Funds, except as necessary for completion of the
portions of the Contract not terminated; and
• Terminate all orders and contracts to the extent that they relate to portions of
the Contract being terminated.
f. Contractor will return to City any unused CDBG Funds previously advanced by City
under this Contractwithin thirty (30) days of the effective date of Contract
termination. City will have no responsibility or liability for Contractors expenditures
or actions occurring after the effective date of Contract termination.
15. Certification KegatdingLob bying
CDBG YEAR XXXN CONTRACT Rev. 6/19/07
Mental Health Association of Tarrant County -Ombudsman Page 13
a. The undersigned representative of Contractor 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 Contractor, 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 or an employee of a member 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. Contractor shall require that the
language of this certification be included in all subcontracts or agreements involving
the expenditure of Federal funds.
b. If any funds other than Federal 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, a member of Congress, an officer or employee of Congress, or an employee
of a member of Congress in connection with this Federal contract, grant, loan or
cooperative agreement, Contractor shall complete and submit Standard Form-LLL,
"Disclosure Form to Report Lobbying," in accordance with its instructions.
c. 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 USC 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.
16. Miscellaneous Provisions
a. All terms of this Contract shall apply to any and all subcontractors of Contractor
who are in any way paid with CDBG Funds or who perform any work in connection
with Contractor's Program.
b. 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.
c. City's failure to insist upon the performance of any term or provision of this
Contract or to exercise any right herein conferred shall not be construed as a waiver
or relinquishment to any extent of City's right to assert or rely upon any such term
or right on any future occasion.
d. Should any action, whether real or asserted, at law or in equity, arise out of the
execution, performance, attempted performance or nonperformance of this
Contract, venue for action shall lie in Tarrant County, Texas.
e. This written instrument and the exhibits attached hereto, which are incorporated by
reference and made a part of this Contract for all purposes, constitute the entire
agreement between the Parties concerning the work and services to be performed
hereunder, and any prior or contemporaneous, oral or written agreement which
purports to vary from the terms hereof shall be void. Any amendments to the terms
of this Contract must be in writing and must be approved by each Party.
CDBG YEAR XXXIV CONTRACT Rev. 6/19/07
Mental Health Association of Tarrant County -Ombudsman Page 14
f. All notices required or permitted by this Contract must be in writing and are deemed
delivered on the earlier of the date actually received or the third day following (i)
deposit in a United States Postal Service post office or receptacle; (ii) with proper
postage (certified mail, return receipt requested); and (iii) addressed to the other
Party at the address set out in the preamble of this Contract or at such other address
as the receiving Party designates by proper notice to the sending Party.
g. None of the performance rendered under this Contract shall involve, and no portion
of the CDBG Funds received hereunder shall be used, directly or indirectly, for the
construction, operations, maintenance or administration of any sectarian or religious
facility or activity, not shall said performance rendered or funds received be utilized
so as to benefit, directly or indirectly, any such sectarian or religious facility or
activity.
h. Contractor 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.
i. Contractor certifies that it has obtained a 501 (c) (3) Certificate from the Internal
Revenue Service. Contractor shall notify City in writing of any changes to its 501 (c)
(3) tax-exempt status during the term of this Contract.
[SIGNATURES APPEAR ON FOLLOWING PAGE]
CDBG YEAR XXXIV CONTRACT Rev. 6/19/07
Mental Health Association of Tartant County -Ombudsman Page 15
IN WITNESS WHEREOF, the Parties hereto have executed four copies of this Contract in
Fort Worth, Tarrant County, Texas, this_ day of , 200
i
CITY OF FORT WORTH
By:
First Assistant City Manager
AS TO FORM AND LEGALITY:
City Attorney
STATE OF TE�'AS �
COUNTY OF TARRANT
Mental Health Association of
Tarrant Countyjmbudsman)
By: ram— )✓�G�� I
Ms. Linda Ragsdale
Executive Director
y
�ontraot Authorizatioll
gl� �I 2
This instrument was acknowledged before me on
by Joe Paniagua, Jr., the First Assistant City Manager of the Citoof Fort Worth, on behalf
of the City of Fort Worth.
MARIA S. SANCHEZ
NOTARY PUBLIC
STATE OF TEXAS
My Comm. UP.12-14-2009
STATE OF TEAS �
COUNTY OF TARRANT �
This instrument was acknowledged
by Ms. Linda Ragsdale, the Executive Director of Mental Heal Association of Tarrant
County (Ombudsman), a Texas non-profit corporation, on behalf of said corporation.
���gYPUg� LINDA FULMER
NOTARY PUBLIC
STATE OF TEXAS
MY COMM. EXP.1-8=11
CDBG YEAR XxXIV CONTRACT
Mental Health Association of Tarrant County -Ombudsman
Public, State of
OFFICIAL RECORD
CITY SECRETARY
0 T. WORTH, TX Rev. 6/19/07
Page 16
Mental Health Association
Ombudsman Program
CONTRACT NO.
Scope of Services
PROGRAM SUMMARY
June 1, 2008 - May 31, 2009
PERIOD
EXHIBIT A
SCOPE OF SERVICES
$15,750
AMOUNT
This Scope of Services is based on the proposal prepared and submitted by the Subrecipient through the City of Fort
Worth and the Housing Department Contract Management Division's annual Request for Proposal (RFP) process.
However, in the event of any conflict between the proposal and any provision contained herein, this Agreement shall
control. In addition to the activities listed below, the Subrecipient agrees to operate this Community Development Block
Grant program consistent with the program delivery stated in the approved proposal.
Provide staff OMBUDSMAN services for residents of inner-city nursing facilities. OMBUDSMAN will
conduct weekly visits to monitor facilities, investigate complaints, instruct staff and residents, and assist
residents and families. CDBG funds will be used to fund the salary for a Long Term Ombudsman staff person.
COUNCIL DISTRICT (S) -All
PROGRAll�i OBJECTIVES
Resolve 95% of substantiated complaints
PROGRAM GOALS
Prevent use and neglect of residents in long-term care facilities.
PROGRAM SERVICES and ACTIVITIES Total Units of Services for Year
Conduct weekly monitoring visits to 7 nursing homes
Conduct resident interviews
Investigate/resolve complaints
Provide in-service educational programs for facility staff
350
842
300
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CITY OF FORT WORTH
CDBG YEAR XXXIV
EXHIBIT C
Page 1 of 3
CONTRACT PERIOD From: 6/1/2008 To: 5/31/2009
Name of Sub Grantee Mental Health Association of Tarrant County Name of Program: Long Term Care Omb.
Program CDBG
Cost Category Budget Funds [a] [b] [c] [d]
PERSONNEL SERVICES
Salaries $17,500.00 $ 15,750.00 $ 13750.00
FICA $ 1,339.00 $ - $ 11339.00
Life Insurance $ 184.00 $ - $ 184.00
Health Insurance $ - $ - $ -
Employment Tax - State $ 193.00 $ - $ 193.00
Employment Tax - Federal $ - $ - $ -
Worker's Comp $ 233.00 $ - $ 233.00
Retirement $ 1,050.00 $ - $ 11050.00
SUPPLIES
Office Supplies $ 332.00 $ - $ 332.00
Postage $ 198.00 $ - $ 198.00
Teaching Aids $ - $ - $ -
Food Supplies $ - $ - $ -
Other Operating Expenses $ - $ - $ -
CONTRACTUAL SERVICES
Telephone $ 392.00 $ - $ 392:00
Electric $ 749.00 $ - $ 749.00
Gas $ - $ - $ -
Water/Waste Disposal $ - $ - $ -
Rent [Building] $ - $ - $ -
Custodial Services $ 242.00 $ - $ 242.00
Office Equipment Rental $ 942.00 $ - $ 942.00
Printing $ 268.00 $ - $ 268.00
Repairs $ 294.00 $ - $ 294.00
Fidelity Bond $ 7.00 $ - $ 7.00
Liability Insurance $ 361.00 $ - $ 361.00
Legal & Accounting $ 698.00 $ - $ 698.00
Private Auto Allowance - Local $ 1,200,00 $ - $ 11200.00
Advertising $ - $ - $ -
Conference & Seminars $ - $ - $ -
Contractual Services $ - $ -
Miscellaneous $ - $ -
CAPITAL OUTLAY $ - $ -
Office Furniture $ - $ -
Computer Equipment $ - $ -
Other: [Described] $ - $ -
$0.00 $0.00
TOTAL $26,182.00 $15,750.00 $10,432.00 $0.00 $0.00 $0.00
MATCHING FUND SOURCES
[a] United Way
[b]
[c]
[d]
1
2
3
4
5
6
7
8
TOTAL STAFF SALARIES
CATEGORY
FICA
Life Insurance
Health Insurance
Employment Tax
Worker's Comp
Retirement
TOTAL FRINGE BENEFITS
BUDGET DETAIL
PERSONAL SERVICES
Hourly Annual % of
Position / Title Rate Hours Time
Staff Ombudsman 16.83 2080 45%
n/a
TOTAL PERSONNEL SERVICES
FRINGE BENEFITS
of %Paid %Paid
Payroll Amount by Agency by CDBG
7.65% 100%
1.05% 100%
3.38% 100%
0.81 % 100%
6.00% 100%
Page 2 of 3
Amount
15,750
15,750
Amount
CATEGORY
Telephone
Electric
Gas
Waste/Water Disposal
Other
Total Utilities
1
2
3
TOTAL BUILDING LEASE
CATEGORY
Fidelity Bond
Liability Insurance
Legal & Accounting
Office Supplies
Postage
Printing
Mileage
Advertising
TOTAL OTHER EXPENSES
EVENT
BUDGET DETAIL
UTILITIES
AVERAGE COST PER NUMBER OF MONTHS
MONTH
Page 3 of 3
AMOUNT
BUILDING LEASE
BUILDING COST PER SQUARE
LOCATION NO. SQUARE FOOT FOOT AMOUNT
OTHER EXPENSES
TOTAL CHARGE %CHARGED TO CDBG AMOUNT
CONFERENCES AND SEMINARS
TOTAL CHARGE %CHARGED TO CDBG
1
2
3
TOTAL CONFERENCES AND SEMINARS
ITEM
OFFICE EQUIPMENT RENTAL 70
TOTAL CHARGE
AMOUNT
CHARGED TO CDBG AMOUNT
1 Copier Lease 0%
2
TOTAL OFFICE EQUIPMENT RENTAL
C
ExIIIBIT 10
AUDIT SCHEDULE
INDEPENDENT AUDIT REQUIREMENT
BUSINESS/AGENCY NAME: Mental Health Association of Tarrant County
PROGRAM: Ombudsman
CDBG YEAR: �S:XXIV
AMOUNT FUNDED: $15,750
Name of Independent Auditor who will perform agency audit:
Independent Auditor to be contracted during CDBG contract period.
Date audit is to be performed:
Within 60 days of completion of CDBG funded project.
The following language is a condition of your contract with the City:
(1) For all contracts in which Contractor is cumulatively receiving federal
monies in the amount of $500,000 or more, Contractor must submit to City an
annual audit prepared in accordance with 24 CFR Sections § 570.502-570.503
generally, with specific reference to OMB Circulars (with attachments) A422
and A-133 as appropriate. The audit may cover either Contractor's fiscal year
during which this contract is in force or cover the period of this contract. The
audit must be prepared by an independent certified public accountant, be
completed within nine (9) months following the end of the period being audited
and be submitted to City within thirty (30) days of its completion. Contractor's
audit schedule is attached hereto as Exhibit D - Audit Schedule. Costs of
preparation of this audit may be an allowable expenditure of CDBG funds in an
amount proportional to that of the CDBG funds used in contractor's total agency
operating budget.
This form is to be completed and submitted to the Housing Department Contract Management
Division at the beginning a`ch contract year.
Mental Health Association of Tarrant County EXHIBIT E
Ombudsman CONFLICT OF INTEREST
All Applicants
The standards in OMB Circular A -I 10, Subpart C, provide that no employee, officer, or agent shall participate in the
selection, award, or administration of a contract supported by Federal funds if real or apparent conflict of interest would
be involved. Such a conflict would arise when an employee, officer, or agent, any member of his or her immediate
family, his or her partner, or an organization which employs or is about to employ any of the parties indicated herein, has
a financial or other interest in the firm selection for an award.
CDBG and HOME Applicants Only
The CDBG regulations at 24 CFR 570 570.611 and HOME regulations at 24 CFR 92.356 provide that no person who is
an employee, agent, consultant, officer, or elected official or appointed official of the recipient or Subrecipient that are
receiving CDBG or HOME funds and (1) who exercises or has exercised any functions or responsibilities with respect to
activities assisted with CDBG funds; or (2) who is in a position to participate in a decision -making process or gain inside
information with regard to these activities, may obtain a financial interest from a CDBG-assisted or HOME -assisted
activity, or have any interest in any contract, subcontract, or agreement with respect thereto, or the proceeds thereunder,
either for themselves or those with who they have family or business ties, during their tenure or for one (1) year
thereafter.
IF NO CONFLICTS EXIST, COMPLETE THE FOLLOWING:
I certify that no conflict of interest exists between The City of Fort Worth and
I certify that no confli t of inter exists between
(Name of rganization)
IF THERE IS A CONFLICT, COMPLETE THE FOLLOWING:
I certify that a conflict of interest does exist between The City of Fort Worth and
(Name of Organization)
I certify that a conflict of interest does exist between
and
(Name of subcontractor)
(Name of Organization)
Describe the nature of the conflict int st below: (Please identify the individual, employment, and the conflict or potential conflict [their affiliation with your
Signature of Authorized Agency Official
Linda Ragsdale, Executive Director
Typed Name and Title
APPENDIX A — CONSTITUTIONAL PROVLSION
Contractor represents that it is, or may be deemed to be, a religious or denominational institution or an organization
operated for religious purposes which is supervised or controlled by or in connection with a religious or
denominational institutional or organization. Pursuant to Title 24 CFR CH. V § 570.2000). Contractor agrees that in
connection with this contract:
a. It will not discriminate against any person applying for such public services on the basis of religion
and will not limit such services or give preference to persons on the basis of religion, and;
b. It will not discriminate against any person applying for such public services on the basis of religion
and will not limit such services or give preference to persons on the basis of religion, and;
c. It will provide no religious instruction or counseling, conduct no religious worship or services, engage
in no religious proselytizing, and exert no other religious influence in the provision of such public
services, and;
d. Where public services provided under paragraph 0)(3) of section 24 CFR 570. 200 are carried out on
property owned by the primarily religious entity, CDBG funds may also be used for minor repairs to
such property which are directly related to carrying out the public services where the cost constitutes in
dollar terms only an incidental portion of the CDBG expenditure for the public services.
CITY OF FORT WORTH
HOUSING DEPARTMENT
CONTRACT MANAGEMENT DIVISION
REQUEST FOR FUNDS
AGENCY: Mental Health Association of Tarrant County
ADDREss: 3136 West 4th Street
Fort Worth. Texas 76107
SECTION 1(AGENCY)
I. Reimbursement Request
1. Expenditures:
2. Income
A. Program Income
B. City of Fort Worth
C. Interest Earned CDBG Funds
3. Reimbursement (1 minus 2)
II. Advance Pay Requests/Repayment
III. Reporting Interest
1. Interest over $25 per quarter returned to City of Fort Worth
SECTION II (CITY)
I. BYSPEED - Purchasing Request
A. BYSPEED INPUT: Vendor/PO Number/Requisition Number:
B. Fund/Account/Center:
C. Total Amount of this Request:
SECTION III
I. Verification
A. Contract Compliance Specialist
B. BYSPEED -Purchasing
C. Accounting
II. Authorization
A. Agency
B. Sr. Contract Compliance
C. Housing Director
Charletra Hurt
(Name)
(Name)
(Name)
Linda Ragsdale
(Name)
Marilyn Jackson
(Name)
PROGRAM:
CONTRACT NUMBER:
CONTRACT AMOUNT:
CONTRACT DATE
DATE OF REQUEST:
CURRENT MONTH
0
0
Attachment I
Long -Term Ombudsman
0
0
$15,750
6/1/2008
CUMULATIVE
G R76/539120/005206270570
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
Distribution:
1 Copy -Accounting
1 Copy -Con. Mgmt
Note: Any Request for Funds that exceed $8500 require the signature of both Marilyn Jackson and Jerome Walker
CITY OF FORT WORTH
HOUSING DEPARTMENT
CONTRACT MANAGEMENT DIVISION
DETAIL STATEMENT OF COSTS
Mental Health Association of Tarrant County
AGENCY
Long -Term Ombudsman
PROGRAM
CONTRACT NO.
TO
6/1/2008
DATE
COST CATEGORY
OUNT
PROGRAM
BUDGET
MONTHLY
EXPENDITURES
CUMULATIVE
TO DATE
BALANCE
PERSONAL SERVICES
Salaries
010
t5l
15,750.00
FICA
010
Life Insurance
518 050
Health Insurance
518 060
Unemployment Tax- State
518 090
Worker's Comp
518 040
Retirement
518 070
SUPPLIES
Office Supplies
521 010
Postage
521 020
Teaching Aids (Equipment)
522 030
Food Supplies
522 030
Other Operating Supplies
523 300
CONTRACTUAL SERVICES
Telephone
535 040
Electric
535 020
Gas [Utility]
535 010
Water/Waste Disposal
535 030
Rent [Building]
537 010
Custodial Services
539 220
Office Equipment Rental
537 030
Printing
533 030
Repairs
536 010
Fidelity Bond
538 210
Liability Insurance
534 020
Legal & Accounting
538 050
Private Auto Allowance- Local
532 130
Advertising
533 010
Conferences & Seminars
531 180
Contractual Services
539 120
CAPITAL OUTLAY
Furniture, Fixtures
541 330
Office Equipment, Computers
541 370
Other Equipment
541 320
TOTAL
15,750.00
Contractors Certification: I certify that the costs incurred are taken from the books of account and that such costs are valid and consistent with the terms of
NAME and TITLE OF AUTHORIZED OFFICER
PREPARE ONE FORM FOR EACH SOURCE OF FUNDS
DISTRIBUTION:
I Copy -Accounting
I Copy -CM
I Copy - Agency
SIGNATURE and DATE
IABGM FORM April 2002
ATTACHMENT III
CITY OF FORT WORTH
HOUSING DEPARTMENT
CONTRACT MANAGEMENT DIVISION
EXPENDITURES WORKSHEET
Mental Health Association of Tarrant County
Agency
Long -Term Ombudsman
Proaram
6/1 /2008
Contract Number Date
To
Report Period
NO
DATE
CHECK NO
PAYEE
DESCRIPTION
ACCOUNT NO.
AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26:::T
TOTAL
TITLE OF AUTHORIZED OFFICER
Distribution:
1 copy -Accounting
1 copy-IAGM
1 copy -Agency
SIGNATURE AND DATE
City of Fort Worth
Contract Management Division
CDBG Year XXXIV
Public Service
Attachment IVa
1. Name and Address of Sub -Grantee
2. Project Name Long -Term Ombudsman
Mental Health Association of Tarrant
Count
3136 West 4th Street
3. Contract No.
Fort Worth, Texas 76107
4. Date of Request
Month & Year
5. Program Services and Activities
Current Month
Cumulative
Number of New
Households and/or
Persons Served
6. Direct Benefit
(Continued)
Extremely Low
Low Income
Moderate Income
Above Moderate Income
Income
(0<30%)
(31-50%)
(51-80%)
(80%>)
Current Month
Cumulative
Household Size
1
2
3 4
5
6
7
8
0=30%
$13,600
$15500
$17,450 $19,400
$203950
$22,500
$2050
MOO
31-5O%
$22,600
$25,850
$29,050 $32,300
$34,900
$37,450
$40,050
$42,650
51=80%
$36,200
$41,350
$46,550 $51,700
$55,850
$59,950
$64,100
$68,250
Certification: The undersigned hereby gives assurance that to the best of my knowledge and belief, the data
included in this
report is true
and accurate,
and if a
non-profit agency, has been approved by the governing body
of the organization
prior to submission.
Date: Submitted by:
Phone No.
�1. Name and Address of Sub -Grantee
IMental Health Association of Tarrant Co
13136 West 4th Street
IFort Worth, Texas 76107
CITY OF FORT WORTH
CONTRACT MANAGEMENT DIVISION
CDBG YEAR XXXIV
PUBLIC SERVICE
2. Project Name Long -Term Ombudsman
3. Contract No.
4. Date of Request
Month &Year
Direct Benefit Data (New Household and /or Persons Served)
Must be Completed) Hispanic Non -Hispanic
Current Month
Cumulative
American
Race: Section Must be Black Indian/Alaskan
Completed) White African/American Asian Native
Month
umulative
Asian and Black/African
White American&White
Month
mutative
Female Head of Household
u� Q�ii1
ulative
American
Indian/Alaskan Native
& Black African
American
Other Multi -Racial
Attachment IVb
Native Hawaiian/Other American Indian/Alas
Pacific Islander Native and White
Certification:
The
undersigned hereby gives assurance that to
the best of my knowledge and belief, the data included in this report is true and accurate, and if a non-
profit agency,
has
been approved by the governing body of the
organization prior to submission.
Date:
Submitted by:
INiL.Tita010
Signature Required
Step 1: Ethnicity- Report whether client identifies themselves as Hispanic orNon-Hispanic
Step 2: Race -Identify the category chosen by the client
AHumpy /Address
CITY OF FORT WORTH
HOUSING DEPARTMENT
PUBLIC SERVICE
2. Project Name
Mental Health Association %J Tarrant County 3. Contract No:
3136 West 4th Street
Fort Worth, Texas 76107 4. Date of Request:
Long -Term Ombudsman
ATTACHMENT V
Contract Date: June 1, 2008
Contract Amount:_ 15,750
Month &Year
5. PROGRAM SERVICES AND ACTIVITIES : CURRENT CUMULATIVE
6. SCOPE OF WORK NARRATIVE
7. PROBLEMS ENCOUNTERED / SOLUTIONS PROPOSED
8. ANTICIPATED ACTIVITY DURING THE NEXT MONTH
9. Certification:
The undersigned
hereby gives assurance
that to the best
of
my
knowledge
and belief,
the data included in this
report is true and
accurate, and is
anon -profit agency, has
been approved
by
the
governing
body of the
organization prior to submission.
Date:
Submitted
Phone No.
Signature Required
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Page 1 of 3
City of Fort Worth, Texas
• • • • �
im°�_e,,.:A���£t�'.:�'.,ii.-..:...a;2""i3.:,.,�. _�:=ie'.7.x`t;L.::�_._.,�m'�'-...�...:?i.:�r,<„_"�.-�' ����.a._:....;,.'+�.`.,:.._.:�..�..1"-".++�..cfi,:"T-��*".,.^..i?F�'<��.",:...w..^' _..n. .tea.... ._>x ,,,�„-... _.. .__ .G, 3-<.:.... �...., .... _;,�t
COUNCIL ACTION: Approved on 8/19/2008
DATE: Tuesday, August 19, 2008
LOG NAME: 050809GRANTACT
REFERENCE NO.: C-22978
SUBJECT:
Authorize Execution of Contracts for Community Development Block Grant Year XXXIV, Emergency
Shelter Grant Year 2008-2009 and Housing Opportunities for Persons with AIDS 2008-2009
Contracts
RECOMMENDATION:
It is recommended that the City Council authorize the City Manager to:
1. Execute contracts for Community Development Block Grant Year XXXIV, Emergency Shelter Grant
Year 2008-2009 and Housing Opportunities for Persons with AIDS Year 2008-2009 with the listed
organizations to administer their respective programs, contingent upon approval and receipt of adequate
funding from the United States Department of Housing and Urban Development, for a term beginning June
1, 2008, and ending May 31, 2009;
2. Extend or renew the contracts for up to one year if an organization requests an extension and such
extension is necessary for completion of the project; and
3. Amend the contract, if necessary, to achieve program goals, provided the amendment is within the
scope of the project and in compliance with all applicable laws and regulations governing the use of federal
grant funds.
Community Development Block Grant (CDBG)
Organization
CJ's Studio of Performing Arts -Performing Arts
CFW-PACSD-Como Kids
Cooks Childrens Hospital -Save a Smile
All Church Home for Children -Buffalo Soldiers
CFW-PACSD-Woodhaven After School Enrichment
Boys and Girls Club-ESTRELLAS
Southside Youth Association-U.N.I.T.Y
YWCA -Child Delopment Program
Child Care Associates
FWHA-AMAKA Child Care Center
Clayton YES -School Aged Child Care
JMAC Youth Center of Tarrant County
Clayton YES-Greenbriar Preshool
Senior Citizen Services -Como Senior Citizens
Amount (Not to Exceed)
$10,886.00
$25,000.00
$21,870.00
$14,580.00
$16,200.00
$14,400.00
$9,000.00
$135,000.00
$117,000.00
$27,000.00
$54,000.00
$25,000.00
$18,000.00
$17,597.00
http://apps.cfiunet.org/council�acket/Reports/mc�rint. asp
8/20/2008
Page 2 of 3
Meals on Wheels
Senior Citizen Services -Riverside Senior Citizens
CFW-PACSD-Community Action Partners (CAP)
Mental Health Assoc.- Mental Health Advocate
Mental Health Assoc. -Long Term Ombudsman
United Community Centers -Crisis Intervention Program
CFW-PACSD-SHIPP
CFW-PACSD-Utility Assistance Program
Centro Cultural De Las Americas-GED Classes
Northside InterChurch Agency -Good Works
Tarrant Area Food Bank -Community Kitchen
MASS, Inc. -Serving Poor and Incarcerated
Housing Counseling
A -Prep Center of Tarrant County
Reach Inc, -Project Ramp
TOTAL CDBG:
Emergency Shelter Grant �ESG�
Organization
YWCA -Supportive Living
Cornerstone Assistance -New Life Center
Presbyterian Night Shelter- Homeless Shelter
SafeHaven of Tarrant County
YWCA -My Own Place
Presbyterian Night Shelter- Elderly and Infirmary
CFW-PACSD-SHIPP
SafeHaven of Tarrant County -Supportive Child Care
Cenikor Foundation -Emergency Shelter
Parents and Children Together, Inc.
TOTAL ESG:
Housing Opportunities for Persons with HIV/AIDS (HOPWA)
�anization
AIDS Outreach Center
Tarrant County Samaritan Housing, Inc.
AIDS Resources of Rural Texas
TOTAL HOPWA:
DISCUSSION:
$33,696.00
$15,271.00
$25, 724.00
$22,275.00
$15,750.00
$16,200.00
$37,800.00
$66,759.00
$18,070.00
$21,092.00
$18,000.00
$27,000.00
$50,000.00
$60,477.00
$21,500.00
$955,147.00
Amount�Not to Exceed)
$13,039.00
$15,297.00
$138,474.00
$20,000.00
$17,628.00
$14,161.00
$15,500.00
$14,997.00
$12,978.00
$� 521.00
$278,595.00
Amount (Not to Exceed
$460,701.00
$262,211.00
$114,198.00
$837,110.00
On April 8, 2008, the City Council adopted the budgets and the appropriation ordinance increasing
estimated receipts and appropriations for the Year XXXIV (June 1, 2008, to May 31, 2009) Community
Development Block Grant (CDBG) funds, 2008-2009 Emergency Shelter Grant (ESG) funds and 2008-2009
Housing Opportunities for Persons with AIDS (HOPWA) grant funds as part of the City's Consolidated Plan
and Consolidated Action Plan. The Consolidated Plan, as adopted by the City Council, included program
descriptions on each program listed above.
http://apps.cfiwnet.org/council�acket/Reports/mc�rint.asp 8/20/2008
Page 3 of 3
The above programs are consistent with the City's approved funding policies and priorities. Each program
meets the requirements of the Department of Housing and Urban Development (HUD) regulations defining
"eligible activity." These programs provide services City-wide.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that funds will be available in the current operating budget as appropriated, in
the Grants Fund contingent upon approval and receipt of adequate funding from the United States
Department of Housing and Urban Development (HUD) for the term beginning June 1, 2008, and ending
May 31, 2009.
TO Fund/Account/Centers
Submitted for City Manager's Office b�
Originating Department Head:
Additional Information Contact:
FROM Fund/Account/Centers
GR76 539120 005206274XXX
GR76 539120 005206273XXX
GR76 539120 005206270XXX
Joe Paniagua (6140)
Jerome Walker (7537)
Sherry Johnson (7333)
$837,110.00
$278,595.00
$955.147.00
http://apps. cfwnet.org/council�acket/Reports/mc�rint.asp
8/20/2008