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HomeMy WebLinkAboutContract 37832C1 FY SIFORETARY �oNTRACT NO , .0 a13 STATE OF TEXAS COUNTY OF TARRANT n 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 Cook Children's Health Care System ("Contractor"), whose address is 801 Seventh Avenue, Fort Worth, Texas, 76104, acting by and through Ms. Linda Chappell, its duly authorized Senior Vice President, Quality Management. (Sometimes City and Contractor are referred to individually as a "Party" and collectively as the "Parties".) WHEREAS, City has received grant monies fiom 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 Giant ("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 youth services to citizens of the City of Fort Worth under the program name Save a Smile ("Program"), for the term June 1, 2008 to May 0 b. Contractor will be responsible for administering Save a Smile 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. Contractor certifies that the activities carried out under this Contract will serve low and moderate -income persons. Contractor will obtain information on family size 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 an�Ic furnished to City on request, City may exercise all remedies available under this Contract, including the„ iAD YF NARY ;TX CDBG YEAR XXXIV CONTRACT Rev, 06-19 07 Cook Children's Health Care System Page 1 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 titne after being notified in writing by City; procedures to suspend or terminate thc 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. Co���ela.ratio�z a�ad Method of Pay�neaat a. City will disburse CDBG Year ��'ZN funds ("CDBG Funds") in an amount up to twenty one thousand and eight hundred seventy and no/100 dollars, $21,870 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 $340,926 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. 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. CDBG YF..AR 3�)V CONTRACT Rev. 06-19-07 Coolz Children's Health Care System Page 2 f. 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 Begnirements and Program Management Standard 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. ii. 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, I ncluding 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 Cite guidelines. He 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. in. 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 570.505. iv. Closeouts 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. CDBG YEAR XXXIV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 3 (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 deterinined 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. 4. Repos�ilag Procedarre.r 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"' of the month following the month being reported. City is under no obligation to disburse funds for expenditures that occurred prior to die first day of the month for which the report is submitted. b. 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 CDBG YEAR HIV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 4 Contractor in performance of this Contract. The report will be signed by a duly audhorized agent of Contractor and submitted by the 15`t' of the month following d1e 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 dus 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 widh funds provided under dhis Contract. It 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, %vita source documents, in performance of this Contract. Such records shall be kept for the time period mandated by the CDBG Regulations and this Contract. us Contractor will obtain and keep on file and furnish to City on request the following information and/or documentation on each Program participant 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 whedier source documentation used for income verification is adequate. 5. Aeversioiz 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 wide 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. Tide 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. CDBG YEAR X=IV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 5 6. Applicable Lazes a. Federal Contractor agrees to comply Nvith 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 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 Nvith 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 Nvith 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"): CDBG YEAR XXl'IV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 6 `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 Nvith 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 minunuin number and job titles subject to lire, 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 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 contractor's 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 die 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 CDBG YEAR XA'XIV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 7 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. 7. Non�liscrznai�aation 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, nor I n 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 die performance of this Contract. CDBG YEAR X��IV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 8 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. S. Prohi6itian Against Interest a. No member, officer or employee of City or its designees of 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 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. Minority and IY/onren Barsiness Enterprise Commitment If applicable, Contractor agrees to abide by City's policy to involve Mino>ity and Women Business Entea.-prises ("Iv1WBEs") 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 Contt�ctor 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, CDBGYEARI= CONTRACT Rev. 0649-Q7 Cook Glcildren's Health Cace System Page 9 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 nor 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 any Nvay 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. Inde��alaification, In.r�rance a�a�l Bola�ling 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 KTND 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 PERSONAL INJURY, INCLUDING DEATH, 'I'O 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, CDBG YEAR XXxIV CONTRACT Rev. 0649-07 Cools Children's Health Care System Page 10 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 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 fidelitjT coverage in the form of a bond in the amount of $21,870, 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 CDBG YEAR XXXIV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 11 require its subcontractors to provide Contractor with certificates) 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. 13. 1TVaiver 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 Year XXXIV 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. £ Contractor will return to City any unused CDBG Funds previously advanced by City under this Contract within thirty (30) days of the effective date of Contract termination. City will CDBG YEAR XX}ZIV CONTRACT Rev. 0649-07 Cook Children's Health Care System Page 12 have no responsibility or liability for Contractor's expenditures or actions occurring after the effective date of Contract termination. 15. Certification KegarcdingLobbying a. The undersigned tepresentative of Contractor hereby certifies, to the best of lus 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 requite 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 Nvith this Federal contract, grant, loan or cooperative agreement, Contractor shall complete and submit Standard Forinn-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 unposed by 31 USC Section 1352. Any person who fails to file the requited 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. 112i.rcellaneozrr 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 CDBG YEAR XXXIV CONTRACT Rev. 06-19-07 Cools Children's Hea1th Care 0ystem Page 13 hereof shall be void. Any amendments to die terms of this Contract must be in writing and must be approved by each Party. f. All notices requited 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 (hi) addressed to the other Party at tic 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 tendered under this Contract shall involve, and no portion of tie 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, nor shall said performance tendered or funds received be utilized so as to benefit, directly or inditecdy, 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 ��IV CONTRACT Rev. 06-19-07 Cools Children's Health Care System Page 14 IN WITNESS WHEREOF, the Parties hereto have executed three copies of this Contract in Fort Worth, Tarrant County, Texas, this 3rd-1 day of ) Cc•dbf •r , 20 02_. CITY OF FORT WORTH By: 'jF�h'1" �•Ii0'O,inS First Assistant City Manager APPROVED AS TO FORM AND LEGALITY ATTEST: CitST Secretary STATE OF TEXAS � COUNTY OF TARRANT Cook Children's Health Care System Ms. Linda Ch ppell VV Senior Vice President, Quality Management C�aa��g Contract AuthorizaltiONL L O Date c1 •g TvS instrument was acknowledged before me on 2 Z , 2008 by Joe Assistant City Manager of the City of Fort Worth, on behalf of the City of Fort Worth. MR >'"Y P"� ROSELLA BARNES *' MY COMMISSION EXPIRES = OW March 31, 20D9 �19 „W Notary Public, State of Texas STATE OF TEXAS � COUNTY OF TARRANT � This instrument was acknowledged before me on .OdU 90o 2, 2008 by Ms. Linda Chappell, the Senior Vice President, Quality Management of Cook Children's Health Care System, a Texas non-profit corporation, on behalf of said corporation. SUSAN D.ROBERTSHAW MY COMMISSION EXPIRES April 25, 2012 CDBG YEAR XXXIV CONTRACT Cook Children's Health Care System Public, State of Texas _�, �►�ElGIA�. E�ECC}RQ CITY SECRETARY FTI WORTH, TX - Rev.06-19-07 Page 15 Cook Children's Health Care System Save a Smile PROGRAM SUMMARY June 1, LWO — May 31, 2009 CONTRACT NO. PERIOD Scone of Services EXHIBIT A SCOPE OF SERVICES $21,870 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. CDBG funds will assist with the salaries of case aides and their supervising licensed Master's level social workers, who facilitate the provision of free dental care, translation services and transportation services to targeted low-income children, pre --kindergarten through third grade, who would otherwise lack access to dental care. COUNCIL DISTRICT (S) — 2, 4, 8, 9 PROGRAM OBaIECTIVES Educate 100% of targeted children seen by Save a Smile volunteer dentists in proper oral health via educational materials, provide 100% of targeted children with a dental hygiene kit and provide referral to a volunteer provider, Medicaid, CHIP or JPS county dental clinic for children in need of immediate treatment (Class 1's). PROGRAM GOALS To improve the dental health and awareness of proper dental care of children in targeted schools. PROGRAM SERVICES and ACTIVITIES Total Units of Services for Year Dental Screenings 4,600 Follow up Phone calls 100 o 0 O m CD A c� L a L c� G a, o 0 o Lo � � M N (NitO Ui N a a a ca C U C C N � N O A � � U Q- �+ Q 7 a o 0 0 LL CITY OF FORT WORTH CDBG BUDGET 2008-2009 CONTRACT PERIOD From: 6/1/2008 To: 5/31/2009 Name of Sub Grantee Name of Program I:cl10JE>i.A Page 1 of 3 Cook's Children Healthcare System Save a Smile Program CDBG Cost Category Budget Funds [a] [b] [c] [d] PERSONAL SERVICES Salaries 104,910000 104,910000 FICA 71344,00 7,344.00 Life & Disability Insurance 420.00 420.00 Health & Dental Insurance 10,911400 10,911000 Other 3,043.00 31043000 Unemployment- State 105.00 105.00 Employment Tax - Federal Worker's Comp 839.00 839.00 Retirement 31252600 3,252.00 SUPPLIES Office Supplies Postage 11150,00 11000,00 1,150.00 11000,00 Teaching Aids Food Supplies 40000000 41000000 Other (Dental Hygiene Kits) 21,000,00 21,000,00 CONTRACTUAL SERVICES Contract Labor (temp) 31000,00 3,000,00 Consulting (staff) 152,000000 21,870,00 152,000400 Contracted Services (courier) 250.00 250.00 Water/Waste Disposal Rent [Building] 1,872.00 11872,00 Custodial Services Travel/Parking 31000400 31000000 Marketing -Printing 12,450,00 121450,00 Repairs Fidelity Bond Liability Insurance Legal & Accounting Private Auto Allowance - Advertising 3,300.00 31300,00 Marketing -Spec Events 6,100.00 61100000 Inter Department 250.00 250.00 Awards & Recognition 30.00 30.00 Education 500.00 500.00 CAPITAL OUTLAY Office Furniture Office Equipment (minor) 200.00 200.00 Other: [Described] TOTAL 340,926.00 21,870.00 340,926.00 MATCHING FUND SOURCES a) Other Grants/Gifts CCHCS-In Kind Contribution over $25,000 in support BUDGET DETAIL PERSONAL SERVICES Page 2 of 3 Hourly Annual % of Position / Title Rate Hours Time Amount Licensed Master's Social Worker 19.23 2,080.00 9% 31645,00 Case Aide 1 FTE 11.50 21080,00 15% 31645,00 Case Aide 3 FTEs @ $11 each 11.00 21080000 19% 10,935,00 Case Aide 1 FTE 10.25 21080,00 20% 3,645.00 TOTAL STAFF SALARIES 21,870.00 Category FICA H Life Insurance ealth Insurance Employment Tax -State Employment Tax- Federal Worker's Comp Retirement TOTAL FRINGE BENEFITS TOTAL PERSONAL SERVICES CATEGORY Telephone Electric Gas Waste/Water Disposal FRINGE BENEFITS f %Paid %Paid o Payroll Amount by Agency by CDBG Amount BUDGET DETAIL ON SELECTED MONTHLY EXPENSES Page 3 of 3 UTILITIES AVERAGE COST PER NUMBER OF MONTHS MONTH ►I W 17i•lr � Other Total Utilities Space uses TOTAL BUILDING LEASE CATEGORY Fidelity Bond Liability Insurance Legal & Accounting (Other) Contractual Services (alarm) (Other) Contractual Services (mowing) TOTAL OTHER EXPENSES TOTAL CONFERENCES AND SEMINARS ITEM Office furniture &equipment Maintenance TOTAL OFFICE EQUIPMENT RENTAL BUILDING LEASE BUILDING COST PER SQUARE LOCATION NO. SQUARE FOOT FOOT AMOUNT OTHER EXPENSES TOTAL CHARGE %CHARGED TO CDBG CONFERENCES AND SEMINARS IMEWTAMMIN TOTAL CHARGE %CHARGED TO CDBG OFFICE EQUIPMENT RENTAL TOTAL CHARGE %CHARGED TO CDBG AMOUNT RTW�P►I I AMOUNT i SmileWave a 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 k��ME A��li:canta �>alV 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 CD13&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 to the best of my knowledge, no conflict of interest exists between The City of Fort Worth and Cook Children's Health Care S s� tam (Name of Organization) X I certify that to the best of my knowledge, no conflict of interest exists between the subcontractors of and Cook Children's Health Care System (Name of Organization) 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 ofsubcontractor) (Name of Organization) Describe the nature of the conflict of interest below: (Please identify the individual, employment, and the conflict or potential conflict [their affiliation with your LJ Signature of Linda S. Chappell, Senior Vice President, Quality Management Typed Name and Titte APPENDIX A — CONSTITUTIONAL PROVISION 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: Cook Children's Healthcare System ADDRESS: 801 Seventh AVenUe Fort Worth, Texas 76104 SECTION I (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 I11 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 Chappell (Name) Marilyn Jackson (Name) (Name) CONTRACT NUMBER: CONTRACT AMOUNT: CONTRACT DATE DATE OF REQUEST: CURRENT MONTH 0 G R76/529120/005206270320 (Signature) (Signature) (Signature) (Signature) (Signature) (Signature) 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 Attachment I Save a Smile $211870 6/1 /2008 CUMULATIVE (Date) (Date) (Date) (Date) (Date) (Date) CITY OF FORT WORTH HOUSING DEPARTMENT CONTRACT MANAGEMENT DIVISION DETAIL STATEMENT OF COSTS Cook Children's Healthcare System AGENCY Save a Smile PROGRAM CONTRACT NO. REPORT PERIOD TO ATTACHMENT II DATE 6/1 /2008 COST CATEGORY ACCOUNT PROGRAM BUDGET MONTHLY EXPENDITURES CUMULATIVE TO DATE BALANCE PERSONAL SERVICES Salaries 516 010 FICA 518 010 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 21,870,00 CAPITAL OUTLAY Furniture, Fixtures 541 330 Office Equipment, Computers 541 370 Other Equipment 541 320 TOTAL 21,870,00 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: 1 Copy -Accounting I Copy -CM I Copy - Agency 2 SIGNATURE and DATE IABGM FORM Apri12002 ATTACHMENT III CITY OF FORT WORTH HOUSING DEPARTMENT CONTRACT MANAGEMENT DIVISION EXPENDITURES WORKSHEET Cook Children's Healthcare System Agency Save a Smile Program Contract Number To Report Period 6/1/2008 Date 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 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 Save a Smile Cook Children's Healthcare System 801 Seventh Avenue 3. Contract No. Fort Worth, Texa 76104 4. Date of Request Month & Year 6, 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%) (31-60%) (61-80%) (80%>) Current Month Cumulative Household Size 1 2 3 4 5 6 7 8 0-30% $13,600 $15,500 $17,450 $19,400 $20,950 $22,500 $24,050 $25,600 31=50% $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. Name and Address of Sub -Grantee Cook Children's Healthcare 01 Seventh Avenue Fort Worth, Texas 76104 I8. Direct Benefit Data CITY OF FORT WORTH CONTRACT MANAGEMENT DIVISION CDBG YEAR XXXIV PUBLIC SERVICE Household and /or Persons 2. Project Name 3. Contract No. 4. Date of Request Month &Year Save a Smile Completed) Hispanic Non -Hispanic Month ive American >_ction Must be Black Indian/Alaskan ed) White African/American Asian Native urrent Month (Cumulative Asian and Black/African White American&White Month Female Head of Household Month umulative American Indian/Alaskan Native & Black African American Other Multi -Racial Attachment IVb Native Hawaiian/Other American Indian/Alaskan) 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- profitagency, has been approved by the governing body of the organization prior to submission. Date: Submitted by: IWiL.7iLa01ia nature Required Step 1: Ethnicity- Report whether client identifies themselves as Hispanic orNon-Hispanic Step 2: Race -Identify the category chosen by the clientt Agency/Address CITY OF FORT WORTH HOUSING DEPARTMENT PUBLIC SERVICE 2. Project Name Cook Children's Healthcare System 3. Contract No: 801 Seventh Avenue Fort Worth, Texas 76104 4. Date of Request: Month &Year Save a Smile ATTACHMENT V Contract Date: June 1, 2008 ContractAmount:_ 21,870 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 O LL LL. O H- Z LL.1 m IWM a (L w a 0 Z U) a O N ci � E rr M d Z QL m a >o m NcoM d G1 E i N ,p fn U) d V Ile N 4w CD TOM aNi y � ti L = C N 'O Q N F- L s c=a Illinoisc -� a� s E U d Z O ax � rm r- U coo LL N Inc44 0 It LL _ t7 CL tII .. a W U C Rf Q a ISBN a 40111 IN Ma N t1 a' Gl O LO OONE U. a L 4° U d = J tm allool DOMINION W a N no Page 1 of 3 City of Fort Worth, Texas .: • • • .• • 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 : //app s. cfwnet. org/council�acket/Reports/mc�rint. asp 10/23/2008 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) Organization 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 $16,521.00 $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 : //app s. cfwnet. org/council�acket/Reports/mc�rint. asp 10/23/2008 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/AccountlCenters Submitted for City Manager's Office b� Originating Department Head: Additional Information Contact: FROM Fund/Account/Centers GR76 539120 005206274XXX $837,110.00 GR76 539120 005206273XXX $278, 595.00 GR76 539120 005206270XXX $955,147.00 Joe Paniagua (6140) Jerome Walker (7537) Sherry Johnson (7333) http://apps.cfwnet.org/council�acket/Reports/mc�rint.asp 10/23/2008