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HomeMy WebLinkAboutContract 44868STATE OF TEXAS COUNTY OF TARRANT § § § - ;� . �; � � :'� . /_ - , This contract ("Contract") is made and entered into by and between the City of Fort Worth (hereafter "City") and Lena Pope Hoine, Inc. (hereafter "Agency"), a Texas nonprofit coiporation. City and Agency may be refei7•ed to individually as a"Party" and jointly as "the Pai�ties". . The Parties state as follows: WHEREAS, City receives grant monies fi•om the United States Department of Housing and Urban Development ("HUD") tlu•ough the Community Development Blocic Grant ("CDBG") Program, Program No. B-13-MC-48-0010, Catalog of Federal Domestic Assistance No. 14.218; WHEREAS, a national objective of the CDBG program is to benefit low and moderate income citizens in accordance with 24 CFR Part 570.200 (a)(2); ; WHEREAS, Agency submitted a proposal to use CDBG funds for an eligible program under the CDBG Regulations whereby Agency will provide seivices to low and rnoderate income City citizens; WHEREAS, City citizens, the Community Development Council, and the City Council have determined that CDBG programs are needed by the City's citizens; NOW, THEREFORE, the Parties understand and agree as follows: 1. INCORPORATION OF RECITALS. City and Agency hereby agree that the recitals set forth above are true and coi7•ect and form the basis upon which the Parties have entered into this Contract. 2. DEFINITIONS. In addition to terms defined in the body of this Contract, the terms set fot-th below shall have the definitions ascribed to them as follows: Area Median Income or AMI means the median family income for� the Fort Worth- Arlington metropolitan statistical area as established annually by HUD. The 2013 income limits are attached hereto as Exhibit "A-1" — 2013 HUD Income Limits. Business Diversity Enterprise Ordinance or BDE means the Ciry's Business Diversity Ordinance, Ordinance No. 20020-12-2011. CDBG means Community Development Blocic Grant. � '.' ,' � �_�� - � 4 �' ' CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. I;ECEI`�ED ��P �`� ZOi� Complete Documentation means the following documentation as applicable: • Attachments I, II, and III, with supporting documentation including: o Proof of expense: copies of timesheets, invoices, leases, seivice contracts or other documentation showing that payment is due by Agency. o Proof of payment: cancelled checks, banlc statements, or wire transfers necessary to demonstrate that amounts due by Agency were actually paid by Agency. o Proof of client eligibility: (i) Source Documentation sufficient to show that clients participating in the Prograin are CDBG Eligible Clients; or (ii) documentation other than Source Documentation to show that clients seived by the Program are CDBG Eligible Clients. • Complete Documentation shall ineet the standards described in the attached Exhibit "F" - Standards for Complete Documentation. • Any other document or record reasonably necessaiy to verify costs spent and client eligibility for the Program. CDBG Eligible Client means a client whose annual incorne adjusted for family size does not exceed 80% of AMI using the most current HUD Income Guidelines and Teclmical Guidance for Determining Income and Allowances verified by either Source Documentation or the form in Exhibit "E" - Form of Income Self-Certification. Agencies Serving 100% Clientele must follow the requirements set forth in Section 6.1.3. CDBG Funds means the CDBG grant funds supplied by City to Agency under the terms of this Contract. CDBG Regulations means regulations found at 24 CFR Part 570 et seq. DBE means disadvantaged business enteiprise. Director means the Director of the City's Housing and Economic Development Department. Effective Date means October 1, 2013. HED Department means the City's Housing and Economic Development Department. HUD means the United States Depai-tment of Housing and Urban Development. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 2 IDIS rneans HUD's Integrated Disbursement Information System. National Objective means at least 51% of the clients served under this Contract tnust have incomes at or below 80 % of AMI in accordance with 24 CFR 570.208(a)(2). Program means the seivices described in Exhibit "A" — Program Summary. Reimbursement Request means all reports and other documentation described in Section 9. Source Documentation means any docuinentation allowed under the definition of annual income in 24 CFR Part 5.609 Unduplicated Clients ineans a count of CDBG Eligible Clients served once in the Contract Term. CDBG Eligible Clients served more than once in the Contract Tei�n will only be counted once when deteimining the number of Unduplicated Clients. 3. TERM. The tei7n of this Contract begins on October 1, 2013 and terminates on September 30, 2014 unless earlier tei7ninated as provided in this Contract. 4. DUTIES AND RESPONSIBILITIES OF CITY. 4.1 Provide CDBG Funds. City shall provide up to EIGHTY-TWO THOUSAND THREE HUNDRED TWENTY-SIX and 00/l00 Dollars ($82,326.00) of CDBG Funds on a reimbursement of expenses basis, under the terms and conditions herein. 4.2 Monitor. City will monitor the activities and performance of Agency and any of its contractors, subcontractors or vendors as necessary, but no less than annually. 5. DUTIES AND RESPONSIBILITIES OF AGENCY. 5.1 Required Services. Agency shall perform the services desci•ibed in Exhibit "A" — Program Summary in accordance with the terms and conditions of this Contract. 5.2 Use of CDBG Funds. 5.2.1. Compliance with CDBG Re�ulations and Contract. Agency shall be reimbursed for eligible Program costs with CDBG Funds only if City detertnines in its sole discretion that: CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,' INC. 3 e 5.2.1.1 Costs are eligible expenditzues in accordance with CDBG Regulations. 5.2.1.2 Costs are in compliance with this Contract and are i•easonaUle and consistent with industty nortns. 5.2.1.3 Complete Documentation is submitted to City by Agency. 5.2.2 Bud�et• Agency agrees that CDBG Funds will be paid on a reimbursement basis in accordance with Exhibit "B" - Budget. During the term of this Contract, Agency may submit written requests to increase or decrease line-item amounts in the Budget, including an explanation of why such increases or decreases are necessaty. All such requests inust be approved by the Director in writing, with such approval being in the Director's sole discretion. If Director approves the Agency's proposed Budget amendment (as approved, the "Amended BudgeY'), then the Amended Budget will take effect on the first day of the znonth following the inonth in which it was approved by Director, unless otherwise specified in the amendment. All requests for Budget amendments must be submitted by August 15, 2014. 5.2.3 Change in Program Budget. 5.2.3.1 Agency will notify City promptly of any additional funds it receives for operation of the Program, and City reserves the right to amend this Contract in such instances to ensure compliance with HUD regulations governing cost allocation. 5.2.3.2 Agency agrees to utilize funds available under this Contract to supplement rather thari supplant funds otherwise available for use in the Prograin. 5.2.4 Pavment of CDBG Funds to Agency. CDBG Funds will be disbursed to Agency upon City's approval of Agency's written and signed Reirnbursement Requests including submission of Complete Docuinentation to City in compliance with Section 9. If Agency expends all funds budgeted for the Program prior to September 20, 2014, City may hold back a small amount of the CDBG Funds until the end of the term. During this interim period, Agency must continue to submit Reimbursement Requests with an invoiced amount of $0. It is expressly agreed by the Parties that any CDBG Funds either not spent or not approved for reimbursement to Agency shall reinain with City. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 4 5.3 Pro�ram Performance Milestones. Agency wai7•ants that the Program will achieve the following milestones: Failure of Agency to meet these milestones or a material deviation froln them as outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section, "material deviation" shall inean more than 10% lower than the specified goal. In the event of such breach, City reserves the right at its sole option to delay or witl�liold payment of Reimbursement Requests, to lower Agency's allocation of CDBG Funds, or to terminate this Contract. 5.4 Identifv Pro�ram Expenses Paid with CDBG Funds. Agency will keep accoiuits and records in such a mamier that City may readily identify and account for Program expenses reimbursed with CDBG Funds. These records shall Ue made available to City for audit purposes and shall be retained as required hereunder. 5.5 Meet National Obiective. Agency certiiies that the activities car�ied out under the Program and this Contract will meet the National Objective. 6. CLIENT ELIGIBILITY VERIFICATION. 6.1 Client Eli�ibilitv Agency will document the eligibility of all �rospective clients. Agency will document client eligibility using the specific method described below in Section 6.1:2. All other subsections of this Section 6.1 are not applicable to Agency under this Contract. 61.1 A�encies Servin� a Presumed Benefit Clientele. Agency must document that all clients served fall under a"presumed benefit" category as defined in 24 CFR 570. Relevant categories of presumed benefit are: severely disabled adults, homeless persons, abused or neglected children and youth or elderly persons. Eligible forms of documentation include: 6.1.1.1 Severely Disabled Adults. Agency fot-�n, approved by the City, iilled out by Agency staff or the CDBG Client indicating client meets the Census definition of "severely disabled." As an acceptable alternative, Agency may use the form attached CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 5 hereto as Exhibit "H" — Severely Disabled Certiflcation Form. 6.1.1.2 Homeless Persons. Written, signed and dated certiiication fi•otn an outreach worlcer. 6.1.1.3 Abused or Neglected Children and Youth. Written, signed and dated certification from an outreach worlcer. 6.1.1.4 Elderly Persons. A birth cer-tificate, driver's license, passport, irmnigration card, military identification, or any other state, local, national or international documentation, provided it contains cui-�•ent infotmation about the age or bii-th of the possessor. The for�n in Exhibit "E" — Form of Income Self Certification also requires that potential clients list their age and certify the validity of the information provided. This inay be sufficient but should only be used as a last resort with an explanation in the file case notes indicating why the formal forms of verification were not available. An elderly person is defined as being at least 62 years of age. 6.1.2 Agencies Serving a General Clientele. Agency must verify all new clients' incoine eligibility with either Source Docuinentation or the for7n attached as Exhibit "E" — Form of Income Self Certification. Agency must use the annual income definition in 24 CFR 5.609 to establish client income eligibility and must use the most current HLTD Income Guidelines. All clients' income must be documented, but only 51°/a of clients rnust ineet income eligibility requirements described in 24 CFR 5.609. 6.1.3 A�encies Servin� 100% Clientele. Agency must verify income eligibility of all Unduplicated Clients with Sotuce Documentation. Source Documentation must be collected and maintained in Agency files even if Agency reports income eligibility using the form attached as Exhibit "E" — Form of Income Self Certification. 6.2 Submission of Complete Documentation. Agency must submit copies of all eligibility verification documentation described in Section 6.1 with Attachment III in each month's Reimbursement Request for all Unduplicated Clients seived for the first time, and must maintain copies of such documentation as required under this Contract. 7. Additional CDBG Requirements. Agency agrees to comply with all requirements of the CDBG Program as stated ili the CDBG Regulations, including but not limited to the following: 7.1 Environmental Review. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,INC. 6 CDBG Funds will not be paid, and costs cannot be incurred until City has conducted and completed an environmental review as required by 24 CFR Part 58. The enviromnental review may result in a decision to proceed with, modify, or cancel the funding for the Program. Further, Agency will not undertalce or commit any funds to physical or choice limiting actions as described in any applicable Federal regulations. Any violation of this provision will (i) cause this Contract to tei-�ninate imtnediately; and (ii) require Agency to repay to City the CBDG Funds it has already received and forfeit any future payments of CDBG Funds. 7.1.2 Environmental Mitigation. If applicable, Agency must talce the initigation actions outlined in Exhibit "A-2" — Environmental Mitigation Actions. Failure to complete the required mitigation action is an event of default under this Contract. 7.2 Contract Not Constitutin� Commitment of Funds. Notwithstanding any provisiou of this Contract, the Parties agree and acicnowledge that this Contract does not constiiute a cominitment of funds, and that such commitment of funds or approval may occur only upon (i) satisfactoiy completion of enviromnental review and receipt by City of an authorization to use grant funds from HUD under 24 CFR Part 58, (ii) approval of City's 2013-2014 Action Plan, and (iii) receipt by City of grant agreernent from HUD. 7.3 Monitoring. 7.3.1 Agency understands and agrees that City will monitor the adequacy and timeliness of Agency's performance under the tei7ns of this Contract as well as its compliance with the CDBG Regulations. Agency is subject to such monitoring during the term of this Contract and for 5 years after the Conhact tertn ends. Agency will provide reports and access to Program files as requested by City for during this 5 year period. For purposes of this Contract, this 5 year period for monitoring is deemed to begin on October l, 2014 and end on September 30, 2019 regardless of whether or not this Contract is earlier terminated. 7.3.2 Representatives of City, HUD, and the United States Comptroller General shall have access during regular business hours, upon 48 hours prior notice, to Agency's offices and records pertaining to the use of the CDBG Funds, and to Agency's officers, directors, agents, employees, cont��actors, subcontractors and vendors for the puipose of such monitoring. 7.3.3 In addition to other provisions of this Contract regarding frequency of rnonitoring, City reserves the right to perform desk reviews or on-site monitoring of Agency's compliance with the terms and conditions of this Contract. After each monitoring visit, City shall provide Agency with a written report of the monitor's findings. If the monitoring report notes deficiencies in Agency's performance, the report shall include requirements for the tiinely coi�ection of said deficiencies by Agency. Failure by Agency to take the action speci�ed in the inonitoring report may be cause for suspension or tei�nination of this Cont�•act as provided herein. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 7 7.3.4 Agency agrees to likewise monitor the effectiveness of the seivices and work to be performed by its contractors, subcontractors and vendors. 7.3.5 This Section 7.3 shall suivive the earlier termination or expiration of this Contract. 7.4 Agencv Procurement Standards. Agency shail comply with all applicable federal, state and local laws, regulations, and ordinances for making procurements under this Contract. Agency shall establish procurement procedur•es to ensure that materials and services are obtained in a cost effective manner. When procuring services to be provided under this Contract, Agency shall comply at a minimum with the procurement standards at 24 CFR Part 84.40 through 24 CFR Part 84.48. 7.5 Cost Principles/Cost Reasonableness. Agency shall administer its use of CDBG Funds in coinpliance with OMB Circular A-122, "Cost Principles for Non-Pro�t Organizations", as amended from tiine to time. The allowability of costs incut�ed for performance rendered shall be determined in accordance with OMB Circular A-122 as supplemented by the provisions of this Conn act. 7.6 Accountin� Standards. Agency 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 supporting and back-up documentation for all costs incur�•ed. 7.7 Uniform Administrative Requireirtents. Agency will comply with the Unifoi7n Adininistrative Requirements set forth in � 24 CFR Part 57.502 or any reasonably equivalent procedures and requirements that City may require. 7.8 Terms Applicable to Contractors, Subcontractors and Vendors. Agency understands and agrees that all terms of this Contract, whether regulatory or otherwise, shall apply to any and all cont�•actors, subcontractors and vendors of Agency which are in any way paid with CDBG Funds or who perform any worlc in connection with the Program. Agency shall cause all applicable provisions of this Contract to be included in and made a part of any contract or subcontract executed in the performance of its obligations hereunder including its obligations regarding the CDBG Regulations. Agency shall monitor the seivices and work performed by its contractors, subcontractors and vendors on a regular basis for compliance with the CDBG Regulations and Contract provisions. Agency must cure all violations of the CDBG Regulations committed by its contractors, subcont�actors or vendors. City inaintains the right to insist on Agency's full compliance with the terms of this Contract and the CDBG Regulations and Agency is responsible for such compliance regardless of whether actions CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 8 talcen to fulfill the requirements of this Contract are talcen by Agency or by Agency's contractors, subcontractors or vendors. Agency acicnowledges that the provisions of this Section shall suivive the earlier ter7nination or expiration of this Cont�act. 7.9 Copyri�ht and Patent Rights. No reports, maps, or other documents produced in whole or in part uuder this Contract shall be the subject of an application for copyright by or on behalf of Agency. HCTD and City shall possess all rights to invention or discovery, as well as rights in data, which may arise as a result of Agency's performance under this Contract. S. RECORD KEEPING• REPORTING AND DOCUMENTATION REQUIREMENTS; AUDIT. 8.1 Record Keepin�. Agency shall maintain a record-lceeping system as part of its performance of this Contract and shall prouiptly provide City with copies of any document City deems necessary for the effective fulfillment of City's inonitoring and evaluation responsibilities. Specifically, Agency will keep or cause to be lcept an accurate record o� all actions taken and all funds spent, with supporting and back-up documentation. Agency will maintain all records and documentation related to this Contract for 5 years after the Connact term ends. If any claim, litigation, or audit is initiated before the expiration of the 5 year period, the relevant records and documentation must be retained until all such claims, litigation or audits have been resolved. For purposes of this Contract, this 5 year period for record retention is deemed to begin on October 1, 2014 and end on September 30, 2019 regardless of whether or not this Contract is earlier terminated. 8.2 Access to Records. City and any duly authorized of�cials of the Feder�l government will have full access to, and the right to exarnine, audit, copy, exceipt and/or transcribe any of Agency's records pertaining to all matters covered by this Contract for 5 years after the Contract term ends. Such access shall be during regular business hours and upon at least 48 hours prior notice. For puiposes of this Contract, this 5 year period far access to records is deemed to begin on October 1, 2014 and end on September 30, 2019 regardless of whether or not this Contract is earlier terminated. 8.3 Reuorts. Agency will submit to City all reports and docuinentation described in this Contract in such form as City may prescribe. Agency may also be required to submit a final performance and/or final financial report if required by City at the termination of this Contract in such foi7n and within such times as City may prescribe. Failure to submit to City any repart or documentation described in this Contract shall be an event of default of this Contract and City may exercise all of its remedies for default under this Contract. 8.4 Chan�e in Reportin� Requirements and Forms. City retains the right to change reporting requirements and forms at its discretion. City will notify Agency in writing at least 15 days prior to the effective date of such CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 9 change, and the Parties shall execute an amendment to the Contract reflecting such change if necessaty. 8.5 Audit. 8.5.1 Entities that Expend $500,000 or more in Federai Funds Per Year. All non-federal entities that expend $500,000 or more in Federal funds within one year, regardless of the source of the Federal award, must subrnit to City an annual audit prepared in accordance with specific reference to OMB Circular A-133. The audit shall cover the Agency's fiscal years during which this Contract is in force. The audit inust be prepared by an independent certified public accountant, be cotnpleted within 6 months following the end of the period being audited and be submitted to City within 30 days of its completion. Agency's audit certification is attached hereto as Exhibit "C" —"Audit Certification Form" and "Audit Requirements". The Audit Certification Form must be submitted to City prior to or with the first Reimbursement Request. Entities that expend less than $500,000 a year in Federal funds are exempt from Fedet•al audit requirements for that year, but records must be available for review or audit by appropriate officials of the Federal agency, City, and General Accounting Office. 8.5.2 Citv Reserves the Right to Audit. City reseives the right to perform an audit of Agency's Program operations and �nances at any time during the terin of this Contract and for 5 years after the Contract Tenn ends if City detei7nines that such audit is necessaiy for City's coinpliance with the CDBG Regulations or other City policies. Agency agrees to allow access to all pertinent lnaterials as described herein for such audit. For purposes of this Contract, this 5 year period for City audit is deemed to begin on October 1, 2014 and end on September 30, 2019 regardless of whether or not this Contract is earlier tei7ninated. If such audit reveals a questioned practice or expenditure, such questions must be resolved within 15 business days after notice to Agency of such questioned practice or expenditure. If questions are not resolved within this period, City reseives the right to withhold further funding under this Contract and/or any fuhue conhacts with Agency. IF AS A RESULT OF ANY AUDIT IT IS DETERMINED THAT AGENCY HAS FALSIFIED ANY DOCUMENTATION OR MISUSED, MISAPPLIED OR MISAPPROPRIATED CDBG FUNDS OR SPENT CDSG FUNDS ON ANY INELIGIBLE ACTIVITIES, AGENCY AGREES TO REIMBURSE CITY THE AMOUNT OF SUCH MONIES PLUS THE AMOUNT OF ANY SANCTIONS, PENALTY OR OTHER CHARGE LEVIED AGAINST CITY BY HUD BECAUSE OF SUCH ACTIONS. 9. REIMBURSEMENT REQUIREMENTS. 9.1 Deadline for Submitting Reimbursement Requests. Each Reimbursement Request shall be received by the City on or before the 15t�' day of the month following the month expenses were paid by Agency. For example, the Reimbursement Request for June expenses must be received by July 15. In the event the 15th falls on a weekend or City holiday, Reimbursement Requests shall be due the next day that the City is open for business. Failure to subinit a Reimburseinent Request in a timely fashion will result in City taking the actions outlined in Section 10.1. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,'INC. 10 NOTWITHSTANDING ANYTHING ABOVE, EXPENSES FOR SEPTEMBER 2014 MUST BE RECEIVED BY SEPTEMBER 20, 2014. FAILURE TO SUBMIT A FINAL REIMBURSEMENT REQUEST BY SEPTEMBER 20, 2014 WILL RESULT IN AUTOMATIC FORFEITURE OF PAYMENT OF THE SEPTEMBER REIMBURSEMENT REQUEST. 9.2 Agency shall provide City with Complete Documentation and the following reports as shown in Exhibit "D" —Reimbursement Forms with each Reimbursement Request: 9.2.1 Attachment I — Invoice. This report shall contain the amount requested for reimbursement each month, the cumulative reimburseinent requested to date (inclusive of that month's request), and must be signed by an authorized signatory of Agency. By signing Attachment I, Agency is cei�tifying that the costs are valid, eligible, consistent with the terrns and conditions of this Contract, and the data contained in the report is true and cor�ect. This report must be submitted even if Agency is requesting $0 for a particular month. 9.2.2 Attachment II — Expenditure Worksheet. This report shall itemize each expense requested for reimbursement by Agency and shall include the Account corresponding the expense to a Budget line item in Attachment II. In order for this report to be complete the following must be submitted: 9.2.2.1 For payroll expenses, timesheets signed by einployees and approved by supeivisor for all payroll expenses listed. Timesheets must distinguish between CDBG-funded time and non-CDBG funded time and reflect actual time spent on CDBG-funded activities. 9.2.2.2 For non-payroll expenses, invoices far each expense listed with an explanation as to how the invoiced expense pertains to the Program. 9.2.2.3 Proof that each expense was paid by Agency, which proof can be satisfied by cancelled checks, wire transfer documentation, paid receipts or other appropriate banking documentation. 9.2.3 Attachment III — Client Data Report. This report shall list each Unduplicated Client served during the month along with his or her demographic infoi7nation. The Client Data Report must contain a list of all clients served during the Contract period. In order for this report to be complete the following must be submitted: 9.2.3.1 Documentation of income verification for each Unduplicated Client the first time he or she is se�ved, which will either be the Source Documentation described in Section 6.1 or the completed foi�n attached hereto as Exhibit "E" - Form of CDBG PSA CONTRACT 2013-2014 - LENA' POPE HOME,'INC. 11 Income Self Certification. AGENCIES SERVING 100% CLIENTELE MUST FOLLOW THE REQUIREMENTS SET FORTH IN SECTION 6.1.3. 9.3 Withholdin� Pavment. CITY HAS NO OBLIGATION TO MAKE PAYMENT ON ANY REIMBURSEMENT REQUEST THAT IS NOT RECEIVED BY THE DUE DATE. Failure to timely submit Reimbw•sement Requests and Complete Documentation along with any required reports shall be an event of default. 10. DEFAULT AND TERMINATION. 10.1 Failure to Submit Required Documentation month. 10.1.1 If Agency fails to submit a Reimbursement Request, or if the subinitted Reimbursement Request is incomplete or otherwise not in compliance with this Contract or CDBG Regulations as determined by City in its sole discretion, Agency shall be in default of this Contract. City will notify Agency in writing of such default and the Agency will have 10 calendar days from the date of the written notice to submit or resubmit any such Reimbursement Request to cure the default. If Agency fails to cw-e the default within such time, Agency shall forfeit any payments otherwise due that 10.1.2 NOTWITHSTANDING THE PROVISIONS OF SECTION 10.1.1, IF AGENCY FAILS TO SUBMIT THE REIMBURSEMENT REQUEST DUE SEPTEMBER 20, 2014, OR IF THE SUBMITTED REIMBURSEMENT REQUEST FOR SEPTEMBER 20, 2014 IS LATE, INCOMPLETE OR OTHERWISE NOT IN COMPLIANCE WITH THIS CONTRACT OR CDBG REGULATIONS AS DETERMINED BY CITY IN ITS SOLE DISCRETION, THERE WILL BE NO CURE PERIOD AND ANY REIMBURSEMENT WILL BE AUTOMATICALLY FORFEITED. 10.1.3 In the event of (i) an uncured default under Section 10.l.lor (ii) more than 2 instances of default, cured or uncured, under such Section, City reserves the right at its sole option to tei7ninate this Contract effective immediately upon written notice of such intent with no penalty or liability to City. 10.1.4 Notwithstanding anything to the contraiy herein, City will not be required to pay any CDBG Funds to Agency during the period that any Reiinbursement Request, report or documentation is past due or is not in compliance with this Contract or the CDBG Regulations, or during any period during which Agency is in default of this Contract. 10.1.5 In the event of termination under this Section 10.1, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 12 10.2 Failure to Maintain Records or Submit Reports and Documentation. If Agency fails to maintain all records and documentation as required in Section 8, or if the maintained or a submitted report or documentation is not in compliance with this Contract or the CDBG Regulations as determined by City in its sole discretion, City will notify Agency in writing and Agency will have 30 calendar days from the date of the written request to obtain or recreate the missing records and documentation or submit or resubmit any such report or documentation to City. If Agency fails to maintain the required reports or documentation, or fails to submit or resubmit any such report or documentation within such time, City shall have the right to terminate this Conri•act effective iinmediately upon written notice of such intent with no penalty or liability to City. 10.2.1 In the event of tertnination under this Section 10.2, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no fu2�ther right to such funds, and any CDBG Funds paid to Agency must be repaid to City within 30 days of tei7nination. If such CDBG funds are not repaid to City within the 30 day period, City shall exercise all legal remedies available under this Contract. 10.3 In General. Subject to Section 10.1, and unless specifically provided otherwise in this Contract, Agency shall be in default under this Contract if Agency breaches any term or condition of this Contract. In the event that such a breach reinains unciued after 30 calendar days following written notice by City (or such other notice period as may be speci�ed herein) or, if Agency has diligently and continuously attempted to cure following receipt of such written notice but reasonably requires more than 30 calendar days to cure, as determined by both Parties mutually and in good faith, Ciry shall have the right to elect in City's sole discretion to (i) extend Agency's time to cure, (ii) terminate this Contract effective immediately upon written notice of such intent to Agency, or (iii) pursue any other legal remedies available to City. 10.3.1 In the event of tei�rnination under this Section 10.3, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no fiu-ther right to such funds, and any CDBG Funds al�eady paid to Agency must be repaid to City within 30 days of the tennination. If such CDBG funds are not repaid to City within the 30 day period, City shall exercise all legal remedies available under this Contract. 10.4 No Funds Disbursed while in Breach. Agency understands and agrees that no CDBG Funds will be paid to Agency until all defaults are cured to City's satisfaction. 10.5 No Compensation After Date of Termination. Agency shall not receive any compensation for work undertaken after the date of the termination. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 13 10.6 Ri�hts of City Not Affected. Termination shall not affect or terminate any of the existing rights of City against Agency, or which may thereafter accrue because of Agency's default. Such tei7nination does not tei7ninate any provisions of this Contract that have been expressly noted as surviving the term or termination of the Contract. 10.7 Waiver of Breach Not Waiver of Subsequent Sreach. The waiver of a default or breach of any term, covenant, or condition of this Contract shall not operate as a waiver of any subsequent default or breach of the same or any other ter�n, covenant or condition hereof. 10.8 Civil Criminal and Administrative Penalties Failure to perfoi�rn all the Contract terms may result in civil, criminal or administrative penalties, including, but not limited to those set out in this Contract. 10.9 Tet•mination for Cause. 10.9.1 City may terminate this Contract in the event of Agency's default, inability, or failure to perform subject to notice, grace and cure periods. In the event City tenninates this Contract for cause, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately rescinded and Agency shall have no fui�ther right to such funds and any CDBG Funds already paid to Agency tnust be repaid to City within 30 days of termination. Failure to repay such CDBG Funds within 30 days will result in City exercising all legal remedies available to City under this Contract. AGENCY ACKNOWLEDGES AND AGREES THAT IF CITY TERMINATES THIS CONTRACT FOR CAUSE, AGENCY OR ANY AFFILIATES OF AGENCY SI�ALL NOT BE CONSIDERED FOR ANY OTHER CITY CONTRACT FOR CDBG FUNDS FOR A MINIMUM OF 5 YEARS FROM THE DATE OF TERMINATION. 10.9.2 Agency may ter7ninate this Contract if City does not provide the CDBG Funds substantially in accordance with this Contract. 10.10 Termination for Convenience. In terminating in accordance with 24 C.F.R. 85.44 this Contract may be terminated in whole or in part only as follows: 10.10.1 By City with the consent of Agency in which case the Parties shall agree upon the termination conditions, including the effective date and in the case of partial termination, the portion to be terminated; or 10.10.2 By the Agency upon written notification to City, setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. In the case of a partial termination, City may terininate the Contract in its entirety if City determines in its sole discretion that the remaining portion of the Cont�act to be perfor�ned or CDBG Funds to be spent will not accomplish the purposes for which the Contract was made. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,' 1NC. 14 10.11 Dissolution of A�encY Terminates Contract. In the event Agency is dissolved or ceases to exist, this Contract shall terminate. In the event of terinination under this Section, all CDBG Funds are subject to repayment and/or City may exercise all of its remedies under this Contract. 10.12 Reversion of Assets. In the event this Contract is teiminated with or without cause, all assets acquired with the CDBG Funds including cash, interest payments from loans or otherwise, all outstanding notes, mortgages or other security instruments, any accounts receivable attributable to the use of the CDBG Funds, and any real or personal proper�ty owned by Agency that was acquired or improved with CDBG Funds shall automatically transfer to City or to such assignee as City may designate. 11. REPAYMENT OF CDBG FUNDS. All CDBG Funds are subject to repayment in the event the Program does not meet the requirements as set out in this Contract or in the CDBG Regulations. If Agency takes any action that results in the City being required to repay all or any portion of the CDBG Funds to HUD, Agency agrees it will reimburse City for such repayment. If Agency takes any action that results in City receiving a finding from HUD about the Program, whether or not repayment of all or any portion of the CDBG Funds is required of City, Agency agrees it will pay City 10% of the CDBG Funds as liquidated damages. The Parties agree that City's dainages in the event of either repayment to HUD being required or receiving a fmding from HUD are uncertain and would be dif�cult to ascertain and may include an impact on City's CDBG grant or other Federal grant funds, in addition to a finding by HCTD or a repayment of funds to HUD by City. Therefore, the Parties agree that payment under this Section of 10% of the CDBG Funds by Agency to City is liquidated damages and not a penalty. 12. C�IANGE IN NON-PROFIT STATUS. If the non-profit status of Agency changes after the date of this Contract, City may but is not obligated to, terminate this Contract. Agency must provide City with written notification of any changes to its non-profit status within 15 calendar days of being notified of the change. City has 30 calendar days to make such deterinination after receipt of notice fiom Agency and failure to make such determination will constitute a waiver. In the event of tei-�nination under this Section 12, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds. Any CDBG Funds already paid to Agency rnust be repaid to City within 30 calendar days of termination. 13. SURVIVAL. Any provision of this Contract that pertains to auditing, monitoring, client income eligibility, record lceeping and reports, City ordinances, or applicable CDBG requirements, and any default and enforcement provisions necessary to enfarce such provisions, shall suivive the ter-�nination of this Contract for 5 years after the Contract CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 15 teim ends and shall be enforceable by City against Agency. For purposes of this Contract, this 5 year period for survival of certain Contract provisions is deemed to begin on October l, 2014 and end on Septelnber 30, 2019 regardless of whether oi• not this Contract is earlier terminated. 14. GENERAL PROVISIONS 14.1 A�encv an Independent Contractor. Agency shall operate hereunder as an independent contractor and not as an officer, agent, setvant or employee of City. Agency shall have exclusive control of, and the exclusive right to control, the details of the work and services performed hereunder, and all persons performing same, and shall be solely responsible for the acts and otnissions of its officers, members, agents, seivants, employees, contractors, subcontractors, vendors, clients, licensees or invitees. 14.2 Doctrine of Respondeat Superior. The doctrine of respondeat superior shall not apply as between City and Agency, or its officers, members, agents, seivants, employees, contractors, subcontractors, vendors, clients, licensees or invitees, and nothing herein shall be const�ued as creating a partnership or joint enteiprise between City and Agency. City does not have the legal right to control the details of the taslcs perfoi�rned hereunder by Agency, its officers, members, agents, employees, contractors, subcontractors, vendors, clients, licensees or invitees. 14.3 A�encv Propertv. City shall under no circumstances be responsible far any property belonging to Agency, or its officers, uiembers, agents, employees, contractors, subconnactors, vendors, clients, licensees ar invitees that may be lost, stolen or destroyed or in any way damaged and AGENCY HEREBY INDEMNIFIES AND HOLDS HARMLESS CITY AND ITS OFFICERS, AGENTS, AND EMPLOYEES FROM ANY AND ALL CLAIMS OR SUITS PERTAINING TO OR CONNECTED WITH SUCH PROPERTY. 14.5 Religious Or�anization. No portion of the CDBG Funds shall be used in support of any sectarian or religious activity. In addition, there must be no religious or membership criteria for clients of a CDBG-funded service. 14.6 Venue. Venue for any action, whether real or asserted, at law or in equity, arising out of the execution, performance, attempted performance or non-performance of this Contract, shall lie in Tai7ant County, Texas. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 16 14.7 Governing Law. This Contract shall be governed by and construed in accordance with the laws of the State of Texas. If any action, whether real or asser•ted, at law or in equity, arises out of the execution, perfoi�rnance or non-performance of this Contract or on the basis of any provision herein, for any issue not governed by Federal law, the choice of law shall be the laws of the State of Texas. 14.8 Severabilitv. The provisions of this Contract are severable, and, if for any reason a clause, sentence, paragraph or other part of this Contract shall be detennined to be invalid by a court or Federal or state agency, board or commission having jurisdiction over the subject matter thereof, such invalidity shall not affect other provisions which can be given effect without the invalid provision. 14.9 Written A�reement Entire Contract. This written instrurnent and the Exhibits, Attachments, and Addendums attached hereto, which are incoiporated by reference and made a part of this Contract for all puiposes, constitute the entire agreement by the Parties hereto concerning the work and services to be performed under this Contract. Any prior or contemporaneous oral or written agreement, which purports to vaiy the terms of this Contract, shall be void. Any amendinents to the teims of this Contract must be in writing and must be executed by each Party to this Contract. 14.10 ParaLraph Headings for Reference Onlv, No Legal Si�nificance; Number and Gender. The paragraph headings contained herein are for convenience in reference to this Contract and are not intended to define or to limit the scope of any provision of this Contract. When context requires, singular nouns and pronouns include the plural and the rnasculine gender shall be deemed to include the feminine or neuter and the neuter gender to include the masculine and feminine. The words "include" and "including" whenever used herein shall be deemed to be followed by the words "without limitation". 14.11 Compliance With All Applicable Laws and Regulations. By signing this Connact, Agency certifies that it complies with all applicable laws and regulations that are cui�rently in effect or that are hereafter ainended during the performance of this Contract. Those laws include, but are not limited to: ➢ CDBG Regulations found in 24 CFR Part 570. ➢ Title I of the Housing and Colnmunity Development Act of 1974, as amended, (42 USC 5301 ➢ Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d et seq.) including provisions requiring recipients of federal assistance to ensure meaningful access by person of limited English proficiency ➢ The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. Sections 3601 et seq.) ➢ Executive Orders 11063, 11246 as amended by 11375 and 12086 and as supplemented by Department of Labor regulations 41 CFR, Part 60 CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 17 ➢ The Age Discrimination in Employment Act of 1967 ➢ The Age Discrimination Act of 1975 (42 U.S.C. Sections 6101 et seq.) ➢ The Unifonn Relocation Assistance and Real Property Acquisiiion Policies Act of 1970 (42 U.S.C. Sections 4601 et seq. and 49 CFR Part 24) ("URA") ➢ Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sections 794 et seq.) and 24 CFR Part 8 where applicable ➢ National Environmental Policy Act of 1969, as amended, 42 U.S.C. sections 4321 et seq. ("NEPA") and the related authorities listed in 24 CFR Part 58. ➢ The Clean Air Act, as ainended, (42 U.S.C. Sections 1251 et seq.) and the Clean Water Act of 1977, as amended (33 U.S.C. Sections 1251 et seq.) and the related Executive Order 11738. In no event shall any amount of the assistance provided under this Contract be utilized with respect to a facility that has given rise to a conviction under the Clean Air Act or the Clean Water Act. ➢ Immigration Reform and Control Act of 1986 (8 U.S.C. Sections 1101 et seq.) specifically including the provisions requiring euiployer verifications of legal status of its employees ➢ The Americans with Disabilities Act of 1990 (42 U.S.C. Sections 12101 et seq.), the Architeciural Bat7iers Act of 1968 as amended (42 U.S.C. sections 4151 et seq.) and the Uniform Federal Accessibility Standards, 24 CFR Part 40, Appendix A ➢ Regulations at 24 CFR Part 87 related to lobbying, including the requirement that certifications and disclosures be obtained frorn all covered persons ➢ Drug Free Worlcplace Act of 1988 (41 U.S.C. Sections 701 et seq.) and 24 CFR Part 23, Subpart F ➢ Executive Order 12549 and 24 CFR Part 5.105(c) pertaining to restrictions on participation by ineligible, debarred or suspended persons or entities ➢ Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recoveiy Act ➢ Guidelines of the Environinental Protection Agency at 40 CFR Part 247 ➢ For cont�acts and subgrants for construction or repair, Copeland "Anti- Kickback" act (18 U.S.C. 874) as supplemented in 29 CFR Par-t 5 ➢ For construction contracts awarded by Agency in excess of $2,000, and in excess of $2,500 for othet• contracts which involve the employment of mechanics or labarers, Sections 103 and 107 of the Contract Work Hours and Safery Standards Act (40 U.S.C. 327A 300) as supplemented by 29 CFR Part 5 ➢ Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), as amended by the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et seq.) and implementing regulations at 24 CFR Part 35, subparts A, B, M, and R ➢ Uniform Administration Requirements of 24 CFR Part 85 CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 18 14.11 HUD-Assisted Proiects and Employment and other Economic OpUortunities; Section 3 Requirements. 14.1 l.l Requirement that Law Be Quoted in Covered Contracts. — Certain Requirements Pertainin� to Section 3 of the Housing and Urban Development Act of 1968 as Amended (12 U.S.C. Sections 1701 et seq.) and its Related Regulations at 24 CFR Part 135. If the Program results in the creation of new employment, training, or contracting opportunities on a contractor or subcontractor level resulting from the expenditure of the CDBG Funds, Agency shall comply with the following and will ensure that its contractors also comply. If the work performed under this Contract is on a project assisted under a program providing direct Federal financial assistance from HUD, Section 3 of 24 CFR 13538 ("Section 3") requires that the following clause, shown in italics, be inserted in all covered contracts ("Section 3 Clause"): Section to be quoted in covered contracts begins: "A. The woriz to be performed under this cont��act is subject to the requirenaents of Section 3 of Housing ancl Urban Development Act of 1968, as amentled, 12 U.S.C. section 1701u (Sectio�z 3). The pzcrpose of Section 3 is io ens�ure that employment and other economic opportunities generated by HUD c�ssisted or HUD-assisted progran�s covered by Section 3, shall to tlze gr�eatest extent feasible, be dit�ected to low- ancl very-low income persons, pat°ticulaYly persoi�s who are �°ecipients of HUD assistance for hoitsing. B. The parties to this contract agree to comply with HUD's regz�lations in 24 CFR Part 135, �vhich inzplement Section 3. As evidenced by their execution of this contt•act, the parties to this contract cet°tify that they are under� no contractual or othef• impediment that would prevent them firon2 con2plyirag wit1� the PaYt 135 regulations. C. The contf°actor• agrees to send to euch labor orgunization or f�epresentative of wor•Izers with which it has �a collective bargaining agreen2ent or otheY understanding, if a1ay, a notice advising the labor organization ot� worizers' representatives of the contracto��'s commitme��ts ui�der this Section 3 clai�se and will post copies of the� notice in cons�icuous places at the wor7z site where botla employees and applicants for training and employn�.ent positians can see the notice. The notice shall descf�ibe the Section 3 p�eference, shall set fo��th nziT2imuf�z nufnber and job titles subject to hir•e, availability of appi•entice and ti-aining positions, t7�e qualifications for eac12; and the na�ne and location of the person(s) taking applications for each of tlae positions; and the anticipated date the �vork shall begin. D. The contractor agrees that it will include this Section 3 clause in ever;y subcoiztr�act to comply with Yegulation in 24 CFR Part 135, and agf�ees to take appropriate action, as provided in an applicable pYovisioi2 of the subcont��act or• in this Section 3 clause, upon finding that the subco��tractor is in violation of the r�egulatio��s ifa 24 CFR Part 135. The CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,'iNC. 19 contractof� will not subcontract witlz any subcontractof� where it has notice or I�Zowledge that the subcontractoY has been found in violation of f•egulations in 24 CFR 135. E. The contr�actor• will cei�tify that any vacant employn2ent positians, inclZtding trainifag positions that are filed: (1) after tlae contf�actor is selected but before the contract is executed, and (2) with per�sons other than those to wlaom the Yegulations of 24 CFR Paf�t 135. TI7e contr•actor will not sttbcontract with any subco��zt��actor where it Izas notice or knowledge that th�e subcontractor• has been found in violatio�a of regulations in 24 CFR 135. F. Noncoinpliance with HUD's regulatio�a in 24 CFR PaYt 13S n�ay reszclt in sanctioi�s, termination of this contr�act for default, and debarment or suspension from future HUD assisted contracts. G. With r�espect to work perfornaed in connection with Sectiofa 3 covered Indiai� housing assistance, section 7(b) of the bzdiayz Self- Determination and Education Assistance Act (25 U.S. C. section 450e) also applies to the work to be perfornzed under this Contract. Section 7(b) requires tlzat to the greatest exteiZt feasible (i) pr•eference and opporiu�zities for tr�aining and employ�nent shall be given to bzdians, and (ii) prefef•ence in the award of contracts and sacbcont��acts shall be given to Indian organizations and Indian-owned Econonzic Enteyprises. Pa�-ties to this contract that are sirbject to the provisions of Section 3 and Section 79b) agree to coi�iply with Section 3 to the rnaxirnum extent feasible, but not in derogation of complia��ce with Section 7(b). " Section to be quoted in covered contracts ends. 14.11.2 Agency Responsibilities for Section 3 Requirements. City and Agency 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 Agency, and their respective successors, assigns, contractors and subcontractors. Failure to fulfill these requirements shall subject Agency and its cont�actors and 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. Agency's responsibilities include: 14.11.2.1 Implementing procedures to notify Section 3 residents and business concerns about naining, einployment, and contracting opportunities generated by Section 3 covered assistance; 14.11.2.2 Notifying potential conhactors working on Section 3 covered projects of their responsibilities; 14.11.2.3 Facilitating the training and employrnent of Section 3 residents and the award of cont�acts to Section 3 business CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,' INC. 20 concerns; 1411.2.4 Assisting and actively cooperating with the HED Department in making con�-actors and subcontractors comply; 14.11.2.5 Refraining from entering into contracts with contractors that are in violation of Section 3 regulations; 14.11.2.6 Documenting actions talcen to coinply with Section 3; and 14.11.2.7 Submitting Section 3 Annual Summary Reports (form HUD-60002) in accordance with 24 CFR Part 135.90. 14.11.3 Section 3 Reportin� Requirements. In order to comply with the Section 3 requirements, Agency must submit the forms attached hereto as Exhibit "G" - Section 3 Reporting Forms. 14.11.3.1 Report to the City on a quarterly basis all applicants for employment, and all applicants for employment by contractors and any subcontractors. This shall include name, address, zip code, date of application, and status (hired/not-hired) as of the date of the report. 14.11.3.2 Advertise available positions to the public for open competition, and provide documentation to City with the quarterly report that demonsnates such open advertisement, in the form of printout of Texas Worlcforce Coinmission posting, copy of newspaper advertisement, copy of flyers and listing of locations where flyers were dishibuted, and the like. 14.12 14.11.33 Report to the City on a quarterly basis all contracts awarded by contractors and any subcontractors. This shall include name of contractor and/or subcontractor, address, zip code, and amount of award as of the date of the report. Prohibition Against Discrimination. 14.12.1 General Statement. � Agency, in the execution, perforinance or attempted perfoi-�nance of this Contract, shall comply with all non-discrimination requirements of 24 CFR 570.607 and the ordinances codified at Chapter 17, Article III, Division 4— Fai�° Housing of the City Code. Agency may not discriminate against any person because of race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression, or transgender, nor will Agency permit its officers, inembers, agents, einployees, or clients to engage in such discrimination. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC: 21 This Contract is made and entered into with reference specifically to the ordinances codified at Chapter 17, Article III, Division 3- Employment Practices of the City Code, and Agency hereby covenants and agrees that Agency, its officers, members, agents, employees and contractors, have fully complied with all provisions of same and that no employee, or applicant for employment has been discriminated against under the teims of such ordinances by either or its officers, lnembers, agents, employees or contractors. 14.12.2 No Discrimination in Emplovment durin� the Performance of This Contract. During the performance of this Contract Agency agrees to the following provision, and will require that its contractors and subcont�actors also comply with such provision by including it in all contracts with its contractors: [Contractor or subcont�actor�'s naine] will not unlawfully discriminate against any employee or applicants for employment because of race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. Agency will take afiii-mative action to ensure that applicants are hired without regard to race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender and that employees are treated fairly during employment without regard to their race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other foi7ns of coinpensation, and selection for training, including apprenticeship. Agency agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause. [Contractor or subcontractor's name] will, in all solicitations or advertisements for employees placed by or on behalf of Agency, state that all qualified applicants will receive consideration for• employrnent without regard to race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. [Contractor� or subcontractor•'s name] covenants that neither it nor any of its ofiicers, members, agents, employees, or contractors, while engaged in performing this Contract, shall, in connection with the employment, advanceinent or discharge of employees or in connection with the terms, conditions or privileges of their employment, discriminate against persons because of their age or because of any disability or perceived disability, except on the basis of a bona fide occupational qualification, retirement plan or statutory requirement. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 22 [Contractor or subcontractof�'s name] further covenants that neither it nor its officers, members, agents, ernployees, contractors, or persons acting on their behalf, shall specify, in solicitations or advertisements for employees to work on this Coutract, a maximum age limit for such employment unless the specified maximum age limit is based upon a bona fide occupational qualification, retirement plan or statutory requirement. 14.12.3 A�encv's Contractors and the ADA. In accordance with the provisions of the Americans With Disabilities Act of 1990 ("ADA"), Agency warrants that it and any of its contractor•s will not unlawfully discriminate on the basis of disability in the provision of services to the general public, nor in the availability, terms and/or conditions of employment for applicants for einployment with, or employees of Agency or any of its contractois. AGENCY 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 CONTRACTORS AGAINST CITY ARISING OUT OF AGENCY'S AND/OR ITS CONTRACTORS', AGENTS' OR EMPLOYEES' ALLEGED FAILURE TO COMPLY WITH THE ABOVE-REFERENCED LAWS CONCERNING DISABILITY DISCRIMINATION IN THE PERFORMANCE OF THIS CONTRACT. 14.13. Prohibition Against Interest / Conflict of Interest. 14.13.1 Agency shall establish safeguards to prohibit its employees, board ineinbers, advisors and agents from using positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business or other ties. Agency shall disclose to City any conflict of interest or potential conflict of interest described above, immediately upon discoveiy of such. 14.13.2 No persons who are employees, agents, consultants, ofiicers or elected officials or appointed officials of City or of Agency who exercise or have exercised any functions or responsibilities with respect to activities assisted with CDBG funds or who are in a position to participate in a decision-making process or gain inside infoi7nation with regard to these activities may utilize CDBG seivices, may obtain a financial interest or benefit frorn a CDBG-assisted activity, or have an interest in any contract, subcontract or agreement with respect thereto, or the proceeds thereunder, either for themselves or those with whom they have family or business ties, during their tenure or for 1 year thereafter•, unless they are accepted in accordance with the procedures set forth at 24 CFR 570.611. 14.13.3 Agency affit7ns that it will adhere to the provisions of the Texas Penal Code which prohibits bribeiy and gifts to public seivants. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 23 14.13.4 The conflict of interest provisions of 24 CFR Part 85.36 and 24 CFR Part 84.42, respectively, shall apply in the procurement of property and seivices by Agency. In all cases not governed by those sections, the provisions of 24 CFR 570.6ll of the CDBG Regulations shall apply. 14.14 Subcontracting with Small and Minoritv Firms, Women's Business Enterprises and Labor Surplus Areas. 14.14.1 For procurement contracts larger than $50,000.00 Agency agrees to abide by City's policy to involve Minority Business Enterprises and Small Business Enteiprises and to provide them equal opportunity to coinpete for contracts for construction, provision of professional services, purchase of equipment and supplies and provision of other seivices required by City. Agency agrees to incorporate the City's BDE Ordinance, and all amendments or successor policies or ordinances thereto, into ail contracts and subcontracts for procurement larger than $50,000.00 and will further require all persons or entities with which it so connacts to comply with said ordinance. 14.14.2 It is national policy to award a fair share of contracts to disadvantaged business enteiprises ("DBEs"), sinall business enteiprises ("SBEs"), minority business enteiprises ("MBEs"), and woinen's business enterprises ("WBEs"). Accordingly, affirmative steps must be talcen to assure that DBEs, SBEs, MBEs, and WBEs are utilized when possible as sources of supplies, equiptnent, constiuction and seivices. 14.15 Other Laws. The failure to list any federal, state or City ordinance, law or regulation that is applicable to Agency does not excuse or relieve Agency fiom the requirements or responsibilities in regard to following the law, nor from the consequences or penalties for Agency's failure to follow the law, if applicable. 14.16 Assi�nment. Agency shall not assign all or any part of its rights, privileges, or duties under this Contract without the prior written approval of Director. Any attempted assignment of saine without approval shall be void, aud shall constitute a breach of this Contract. 14.17. Right to Insuect A�encv Contracts. It is agreed that City has the right to inspect and approve in writing any proposed contracts between Agency and any contractor engaged in any activity in conjunction with this CDBG-funded Program prior to any charges being incui7ed. 14.18 Force Maieure If Agency becomes unable, either in whole or• part, to fulfill its obligations under this Contract due to acts of God, shikes, lockouts, or other industrial disturbances, acts of public enemies, wars, blockades, insut7ections, riots, epidemics, earthqualces, fires, floods, resnaints or prohibitions by any court, board, departlnent, coinmission or agency of the United States or of any States, civil disturbances, or explosions, or some other reason beyond Agency's control (collectively, "Force Majeure Event"), the obligations so affected by such Force Majeure Event will be suspended only dur•ing the continuance of CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 24 such event. Agency will give City written notice of the existence, extent and nature of the Force Majeure Event as soon as reasonably possible after the occui7ence of the event. Failure to give notice will result in the continuance of Agency's obligation regardless of the extent of any existing Force Majeure Event. Agency will use commercially reasonable efforts to remedy its inability to perform as soon as possible. 15. INDEMNIFICATION AND RELEASE. AGENCY COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND, AT ITS OWN EXPENSE, CITY AND ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICE5 OF THE PROGRAM DESCRIBED HEREIN, WHETHER OR NOT CAUSED IN WHOLE OR IN PART, SY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY; AND AGENCY HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY OF CITY AND ITS OFFICERS, AGENTS, SERVANTS, AND EMPLOYEES FOR ANY AND ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJIJRY, 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 NONPERFORMANCE OF THIS CONTRACT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED HEREIN, WHETHER OR NOT CAUSED IN WHOLE OR IN PART BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY. AGENCY LIKEWISE COVENANTS AND AGREES TO AND DOES HEREBY INDEMNIFY AND HOLD HARMLESS CITY FROM AND AGAINST ANY AND ALL INJURY, DAMAGE OR DESTRUCTION OF PROPERTY OF CITY, ARISING OUT OF OR IN CONNECTION WITH ALL ACTS OR OMISSIONS OF AGENCY, ITS OFFICERS, MEMBERS, AGENTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, INVITEES, LICENSEES, OR CLIENTS, OR CAUSED, IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY. IT IS THE EXPRESS INTENTION OF THE PARTIES, BOTH AGENCY AND CITY, THAT THE INDEMNITY PROVIDED FOR THIS SECTION INCLUDES INDEMNITY BY AGENCY TO INDEMNIFY AND PROTECT CITY FROM THE CONSEQUENCES OF CITY'S OWN NEGLIGENCE, WHETHER CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 25 THAT NEGLIGENCE IS ALLEGED TO BE THE SOLE OR CONCURRING CAUSE OF THE INJURY, DAMAGE OR DEATH. AGENCY AGREES TO AND SHALL RELEASE CITY, ITS AGENTS, EMPLOYEES, OFFICERS AND LEGAL REPRESENTATIVES FROM ALL LIABILITY FOR INJURY, DEATH, DAMAGE OR LOSS TO PERSONS OR PROPERTY SUSTAINED IN CONNECTION WITH OR INCIDENTAL TO PERFORMANCE UNDER THIS CONTRACT, EVEN IF THE INJURY, DEATH, DAMAGE OR LOSS IS CAUSED BY CITY'S SOLE OR CONCURRENT NEGLIGENCE. AGENCY SHALL REQUIRE ALL OF ITS CONTRACTORS AND SUBCONTRACTORS TO INCLUDE IN THEIR CONTRACTS AND SUBCONTRACTS A RELEASE AND INDEMNITY IN FAVOR OF CITY IN SUBSTANTIALLY THE SAME FORM AS ABOVE. 16. WAIVER OF IMMUNITY BY AGENCY. If Agency, as a charitable or nonprofit oiganization, has or claims an immunity or . exemption (statutoiy or otherwise) from and against liability for damages or injury, including death, to persons or property, Agency hereby expressly waives its rights to plead defensively such immunity or exemption as against City. This section shall not be const�ued to affect a governmental entity's iinmunities under constitutional, statutory or common law. 17. INSURANCE AND BONDING. Agency will maintain coverage in the form of insurance or bond in the amount of $82,326.00 to insure against loss from the fraud, theft or dishonesty of any of Agency's officers, agents, trustees, directors or employees. The proceeds of such insurance or bond shall be used to reimburse City for any and all loss of CDBG Funds occasioned by such misconduct. To effectuate such reimbursernent, such fidelity coverage shall include a rider stating that reimbursement for any loss or losses shall name the City as a Loss Payee. Agency shall furnish to City in a timely manner, but not later than the Effective Date, cez�tificates of insurance as proof that it has secured and paid for policies of commercial insurance as specified herein. If City has not received such certificates by the Effective Date, Agency shall be in default of the Contract and City may, at its option, tei�iiinate the Contract. Such insurance shall cover all insurable rislcs incident to or in connection with the execution, performance, attempted performance or nonperformance of this Contract. Agency shall maintain, or require its general cont�actor to maintain, the following coverage and limits thereo£ CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,' INC. 26 Commercial General Liability (CGL1 Insurance $500,000 each occuiyence $1,000,000 aggregate limit Non-Profit Orp-anization Liability or Directors & Officers Liability $1,000,000 Each Occunence $1,000,000 Annual Aggregate Limit Business Automobile Liabilitv Insurance $1,000,000 each accident on a combined single-limit basis, or $250,000 Property Datnage $500,000 Bodily Injuiy per person per occurrence $2,000,000 Aggregate Insurance policy shall be endorsed to cover "Any Auto", de�ned as autos owned, hired, and non- owned. Pending availability of the above coverage and at the discretion of City, the policy shall be the primary responding insurance policy versus a personal auto insurance policy if or when in the course of Agency's business as contracted herein. Worlcers' Compensation Insurance Part A: Statutoty Limits Part B: Employer's Liability $100,000 each accident $100,000 disease-each employee $500,000 disease-policy limit Note: Such insurance shall covet• employees performing work on any and all projects including but not limited to construction, deinolition, and rehabilitation. Agency or its contractars shall maintain coverages, if applicable. In the event the respective contractors do not maintain coverage, Agency shall maintain the coverage on such contractor, if applicable, for each applicable cont�•act. Additional Requirements Such insurance amounts shall be revised upward at City's reasonable option and no more frequently than once eveiy 12 months, and Agency shall revise such amounts within 30 days following notice to Contractor of such requirements. Agency will submit to City documentation that it has obtained insm�ance coverage and has executed bonds as required in this Contract prior to payment of any monies provided hereunder. Where applicable, insurance policies required herein shall be endorsed to include City as an additional insured as its interest may appear. Additional insured parties shall include employees, officers, agents, and volunteers of City. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 27 The Workers' Compensation Insurance policy shall be endorsed to include a waiver of subrogation, also referred to as a waiver of rights of recoveiy, in favor of City. Any failure on part of City to request certificate(s) of insurance shall not be constiued as a waiver of such requirement or as a waiver of the insurance requirements themselves. Insurers of Agency's insurance policies shall be licensed to do Uusiness in the state of Texas by the Department of Insurance or be otherwise eligible and authorized to do business in the state of Texas. Insurers shall be acceptable to City insofar as their financial strength and solvency and each such company shall have a current minimum A.M. Best Key Rating Guide rating of A-: VII or other equivalent insurance industry standard rating otheitivise approved by City. Deductible limits on insurance policies shall not exceed $5,000 per occurrence miless otherwise approved by City. In the event there are any local, federal or other regulatory insurance or bonding requirements for the Program, and such requireinents exceed those specified herein, the foi-�ner shall prevail. Agency shall require its contractors to inaintain applicable insurance coverages, limits, and other requirements as those specified herein; and Agency shall require its contractors to provide Agency with certificate(s) of insluance documenting such coverage. Also, Agency shall require its contractors to have City and Agency endorsed as additional insureds (as their interest may appear) on their respective insurance policies. Directors and Officers Liability coverage shall be in force and inay be provided on a claims-made basis. This coverage may also be refei7ed to as Management Liability, and shall protect the insured against clairns arising out of alleged ei7ors in judgtnent, breaches of duty and wrongful acts arising out of their organizational duties. Coverage shall protect not only the entity, but all past, present and future directors, officers, tlustees, employees, volunteers and committee members. 18. CERTIFICATION REGARDING LOBBYING. The undersigned representative of Agency hereby certifies, to the best of his or her lcnowledge and belief, that: No Federal appropriated funds have been paid or will be paid, by or on behalf of Agency, to any person for influencing ar attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress in connection with the awarding of any Federal contract, the malcing of any Fedei•al grant, the making of any Federal loan, the entering into of any cooperative agreement and the extension, continuation, renewal, arnendment, or modiiication of any Federal contract, grant, loan or cooperative agreement. CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,' INC. 28 If any funds other than federally appropriated funds have been paid or will Ue paid to any person for influencing or attempting to influence an officer or employee of any agency, meinber of Congress in co�lection with this Federal contract, grant, loan or cooperative agreement, Agency shall coinplete and submit Standard Form-LLL, "Disclosure Form to Repoi�t Lobbying," in accordance with its instructions. This cei-tification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certificate is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. Section 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure. Agency shall require that the language of this certification be included in all subcontracts or agreements involving the expenditure of Federal funds. 19. LITIGATION AND CLAIMS. Agency shall give City iinmediate notice in writing of any action, including any proceeding before an administrative agency, filed against Agency in conjunction with this Contract or the Program. Agency shall furnish immediately to City copies of all pertinent papers received by Agency with respect to such action or claim. Agency shall provide a notice to City within 10 days upon filing under any bankruptcy or financial insolvency provision of law. 20. NOTICE. All notices required or permitted by this Contract must be in writing and are deemed delivered on the earlier date of the date actually received or the third day following deposit in a United States Postal Seivice post office or receptacle; with proper postage, certified mail return receipt requested; and addressed to the other Party at the address set out below or at such other address as the receiving Party designates by proper " notice to the sending Party. City City Attorney's Office 1000 Throckmor-ton Street Fort Worth, TX 76102 Telephone: 817-3 92-7600 Copy to: Director of Housing and Economic Development 1000 Throckmorton Street Fort Worth, TX 76102 Telephone: 817-392-7540 CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME,INC. 29 Copy to: Program Coordinator-Housing and Economic Development 1000 Tluoclanorton Street Fort Worth, TX 76102 Telephone: 817-392-6342 Agenc� Lena Pope Home, Inc. Executive Director 3131 Sanguinet St�eet Fort Worth, TX'76107 817-255-2676 21. AGENCY HAS LEGAL AUTHORITY TO ENTER INTO CONTRACT. Agency represents that it possesses the legal authority, pursuant to any proper, appropriate and official motion, resolution or action passed or taken, to enter into this Contract and to perfoi�n the responsibilities herein required. 22. COUNTERPARTS. This Contract may be executed in multiple counterparts, each of which shall be considered an original, but all of which shall constitute one instrument which may be sufficiently evidenced by one counteipart. [SIGNATURES APPEAR ON NEXT PAGE] CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 30 � r'�7 .*; ;.- a �,.. � WITNESS WHEREOF, the Pai�ties hereto have executed 4 duplicate this Contract in Fort Worth, Tarrant County, Texas. � �'�°�"'" �"� : �. ��t,�� �ST: ; � —_ City S cr ar , / �_. M&C: C- 6 69 Date: August 6, 2013 CITY OF FORT WORTH C APP�,OVED AS TO ORM AND LEGALITY: ���� �� Assistant City Attorney LENA POPE HOME, INC. —� $y; �o'�P 7�1_ Name: 7�u �f. �a-•,d• Title: �.t�cc.•�7�'� 17��' 4 � STATE OF TEXAS § COUNTY OF TARRANT § This instrument was acknowledged before me on Fernando Costa, Assistant City Manager of the Ci Fort Worth. � �"'° EVONiA DANIELS � :'>o'` � �`'.='-- - � �: Notory Public, State of texas �; = r'•.l�P; My Commission Expires .',,rF,. _ •<F ; �` Julv 1 f�. 2p] 7 otat� ��-,��'i ��i_� ;! � , 2013 by ort Worth, on behalf the City of ic,'State of Texas STATE OF T�XAS § COUNTY OF TARRANT § �T iis in trument was acicnowl d ed bef re me on ' � ��. 2C , 2013 by [Name], the j' itle] of Lena Pope Home, Inc., a TeYas non- profit corpo • tion, on behalf said cot•poration. Notary c�F OFFICIAL RECORD ,. CDBG PSA CONTRACT 2013-2014 — LENA POPE HOME, INC. of Texas JUDY VALE NOTARY PUBLIC State of Texas Comm. F�cp. 11-18-2Ga5 � � , Fernando Costa, Assistant City Manager EXHIBITS: Exhibit "A" — Program Summary Exhibit "A-1" — 2013 HUD Income Limits Exhibit "A-2" — Environmental Mitigation Action Exhibit "B" — Budget Exhibit "C" — Audit Certification Form Exhibit "D" — Reimbursement Forms Exhibit "E" — Form of Income Self-Certification Exhibit "F" — Standards for Complete Documentation Exhibit "G" — Section 3 Reporting Forms Exhibit "H" — Severely Disabled Certification Form CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 32 Lena Pope Home, Inc. EXHIBIT A Second Opportunity for Success PROGRAM SUMMARY PROGRAM SUMMARY Community Development Block Grant (CDBG) October 1, 2013 to September 30, 2014 PERIOD $82,326.00 AMOUNT PROGRAM: The program will provide youth and family group education classes to Fort Worth residents for the purpose of reducing juvenile crime and delinquency. Program services include an initial phase of group life-skill improvement classes for parents and their children. Upon completion of the group program, the program will monitor client progress and provide clients with follow-up case management. Youth who successfully complete the program will not be adjudicated for their crimes. CDBG funds will be used to pay for salaries, FICA, and fringe benefits for program employees. CDBG funds will pay for a portion of general commercial liability and program facility rent. Program services will be available at 3800 Hulen, Suite 230, Fort Worth, TX 76107; Monday through Friday during regular business hours. Group classes and intake �vill be held Wednesday and/or Thw•sday, 5:00 to 8:00 pm. REGULATORY CLASSIFICATION: IDIS Matrix Code(s) and Service Category: OS Other Public Services National Objective Citation: LMC Low/Mod Limited Clientele 24 CFR 570.208(a)(2) Regulatory Citation(s): 24 CFR 570.201(e) Based on the nature of the service provided, Agency will maintain documentation that verifies that 51% of clients served by the Program are income eligible with current household incomes at or below 80% of Area Median Income (AMn as established or defined by the United States Department of Housing and Urban Development (HUD). PROGRAM GOALS: Provide program services to approximately 125 Unduplicated Clients EXHIBIT A- CDBG: LENA POPE HOME, INC. EXHIBIT "A-1" 2013 HUD INCOME LIMITS 2013 Median Family Income — Fort Worth/Arlington, TX* 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons 30%�MI $13,850 $15,800 $17,800 $19,750 $21,350 $22,950 $24,500 $26,100 50% AMI $23,050 $26,350 $29,650 $32,900 $35,550 $38,200 $40,800 $43,450 80°/a AMI $36,900 $42,150 $47,400 $52,650 $56,900 $61,100 $65,300 $69,500 *Income limits are established and published at least annually by HUD. EXHIBIT "A-2" ENVIRONMENTAL MITIGATION ACTION NONE REQUIRED EXHIBIT B - BUDGET Account ' Grant Bud et A B C TOTAL ' ADRSINISTRATIVE Salaries 1001 FICA 1002 Life Insurance 1003 Health Lisurance 1004 Disability Insurance 1005 Uneuiployment-State 1006 Accounting 1007 TOTAL ADMINISTRATIVE EXPENSES 20,971 2Q971 % Administrative Cost PROGRAbIPERSONNEL Salaries 2001 57,692 0 57,692 FICA 2002 4,413 0 4,413 Life I�isurance 2003 473 0 473 Health Insurance 2004 IQ000 3,755 13,755 Unemployment 2005 902 0 902 Worker's Compei�sation 2006 629 0 629 Retirement 2007 2,885 0 2,885 SUPPLIES AND SERVICES Office Su lies 3001 0 4,374 4,374 Office E ui ment Rental 3002 Postage 3003 Printing 3004 MISCELLANEOUS Construction/Building Materials (ouly REACI� 4001 Coutract Labor (City needs copy of coutract befoce ex enses can be reimbursed) 4Q02 Craft Supplies 4003 Field Trip Adinission Expenses 4004 Ottier Field Tri Ex enses (if rea roved b Ci 4005 Food Su lies 4006 Teaching Aids 4007 Milea e 0 1,375 1,375 Other Em loyee Benefits 0 2,279 2,279 Other Professional Fees 0 1,729 1,729 FACILITY �1�TD UTILITIES Tele hone 5001 0 3,755 3,755 Electric 5002 0 2,099 2,099 Gas 5003 Water and Wastewater 5004 Solid Waste Disposal 5005 Rent (City needs copy of lease before espenses can be reimbursed) 5006 4,178 14,995 19,173 Custodial Services 5007 0 3,051 3,051 Repairs 5008 Cleaning Su lies 5009 LEGAL, FINANCIAL, AND INSLTRANCE Fideli Bond or E uivalent 6001 Directois and Officers 6002 General Commercial Liability 6003 1,154 1,154 Contract Accounting 6005 DIREiCT�r�SSISTANCE��� .� Cl�ildcare Scholarsl�i s 7001 Short-temi Rent Assistance 7002 Short-term Mortgage Assistance 7003 Short-tenn Utilities Assistance 7004 Tenant Based Reutal Assistance 7005 TOTAL 82,326 58,383 140,709 FtJNDING A: LENA POPE HOME, INC FUNDING B: FUNDING C: EXHIBIT B- CDBG: LENA POPE HOME, INC. The following tables are purely informational and were created solely for puiposes of preparing, negotiating, and determining tl�e reasonableness of the overall line item budget on the first page of this EXHIBIT B- BUDGET and are not to be considered part of the terins and conditions of this Contract. Contractor may make ci�anges to any column except the "Position" colunm in the "Salary Detail" table without the City's consent so long as the total amounts charged to the grant do not exceed the line items on the fust page of the EXHIBIT B- BUDGET." Changes to the column labeled "Position" may only be made with the prior written consent of the City. �v.� : ; . r:��� Position Name Rate Annual Hours Percent to Grant Amount to Grant Su eivisor 30.13 2080 13% 7,834 Admin Assistant 16.03 2080 23% 7,6b7 Family Specialist 18.88 2080 9% 3,643 Famil Specialist 19.21 2080 46% 18,533 Famil Specialist 20.71 2080 46% 20,015 1�1:71►[eT�l7�llr� Percent of Pa •oll Amount Percent to Grant Amount to Grant FICA 7.65% 4,413 100% 4,413 Life Insurance .82% 473 100% 473 Health Insurance 23.84% 13,755 73% 10,000 Uneinployment 7.29% 902 100% 902 Workers Compensation 1.09% 629 100% 629 Retirement 5% 2,885 100% 2,885 Ri TPPT,TF.S AND SERVICES Total Budget Percent to Grant Amount to Grant Office Supplies 4,397 0% 0 Office Equipment Rental Postage Printing MISCELLANEOUS Total Budget Percent to Grant Amount to Grant Contract Labor Craft Supplies Facility Fees Field Trip Costs Food Supplies Teaching Aids FAC'TT.TTY ANT� TJTiLITIES Total Budget Percent to Grant Amount to Grant Telephone 3,755 0% 0 Electric 2,099 0% 0 Gas Water and Wastewater Solid Waste Disposal Rent 19,173 22% 4,177 Custodial Seivices 3,051 0% 0 Repairs Cleaning Supplies b- EXHIBIT B- CDBG: LENA POPE HOME, INC. 2 FINANCIAL AND INSURANCE Total Budget Percent to Grant Amount to Grant Fidelity Boud (or Equivalent) General Coimnercial Liability 1,154 100% 1,154 Directors and Officers Conhact Accounting DIRECT ASSISTANCE Total Budget Percent to Grant Ainount to Grant Childcare Scholarships Shoi�t-Tei�u Rent Assistance Short Teim Mortgage Assistance Short Tei-�n Utilities Assistance Tenant Based Rental Assistance EXHIBIT B- CDBG: LENA POPE HOME, INC. 3 EX�IIBIT "C" Audit Certification Form [See attached] AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS Agency: � Fiscal Year Ending: September 30, 2014 C . During the fiscal year in which funds will be received, we will exceed the federal expenditure threshold of $500,000. We will have our Single Audit or Program Specific Audit completed and will submit the A-133 audit report within seven (7) months after the end of the audited fiscal year or thirty (30) days within its coinpletion, whichever is the earlier date. ❑ During the fiscal year in which funds will be received, we will not exceed the $500,000 federal expenditure tlu•eshold required for a Single Audit or a Program Specific Audit to be perfoimed this fiscal year. (Fill out schedzrle below) Federal �xpenditm�e Disclosure MUST be filled out if Single Audit oi• Progra�n Audit is NOT requirec Federal Grautor Pass Through Program Name & Contract Grautor CFDA Number Number Federal i � c �— �..� t� �t�"' Signatory and Title 0 1 Expenditures ��I� Failure to submit this or a similar statement or failure to submit a completed sirigle audit pacicage as described in the federally required audit requu•ements described in OMB Circulars A-133 by the required due date may result in suspension of funding and may affect eligibiliry for future funding. Notwithstanding the above, this certification acknowledges the agency's commitment to meet all other financial reporting, financial statements, and other audit requirements as may be set forth � for this Fiscal Year: in the Contract. Exhibit "D" - Reimbursement Forms [See attached] Attachment I INVOICE Agency: Address: City, State, Zip: Program: Period of Service: Agency's C;ertitication: 1 certity that the costs incurred are valid and consistent with the terms and conditions of the contract between City and Agency. By signing this invoice, I certify that to the best of my knowledge and belief the data included in this report is true and accurate. It is acknowledged that the provision of false information could leave the certifying official subject to the Signature and Date: Name : Title: Attachment II Ciry of Fart R'nrth Hausing and Emnomic Decelopmen/ Department Expenditure R'orkshee[ Agzncy: Namc Program: Pro�ramName 'Pa��oll must identiCy employce. Rent musl identify (enant Other paymznts should identify individuaL flighlighted are ihe oniV relevant codes for Ihis Program. � � =o _� �� zF _< �a �� U Exhibit "E" Form of Income 5elf-Certification [See attached] CERTIFICATION OF INCOME STATEMENT Applicant Name: Current Address: Phone #: **PERSONAL INFORMATION: (Check one in each itein. Optional Infoi7nation for Federal Reporting Puiposes) a. ❑ MALE b. � WHITE ❑ BLACK/AFRICAN AMERICAN ❑ BLACK/AFRICAN AMERICAN & WHITE ❑ FEMALE ❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ ASIAN ❑ AMERICAN INDIAN/ALASKAN NATIVE & WHITE ❑ ASIAN & WHITE ❑ NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER ❑ BALANCE/OTHER ❑ AMERICAN 1NDIAN/ALASKAN NATIVE & BLACK/AFRICAN AMERICAN c. ETHNICI'I`Y d. DISABLED e. IS CLIENT WOMEN HEAD OF HOU5EHOLD ❑ HISPANIC ❑ YES ❑ YES ❑ NON-HISPANIC ❑ NO ❑ NO * TOTAL NUMBER OF HOUSEHOLD (Include Yourself AND eveiyone who MEMBERS lives in the house.) Total Anticipated Annual Household Income: Cei�tiiication: I certify that the infoi�rnation I am providing is true and could be subject to veri�cation at any time by a third party. I also acknowledge that the provision of false information could leave me subject to the penalties of Federal, State and local law. WARNING: TITLE iS, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY A4AI�ING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT. Signature of Applicant Date For use by funding agency: Household Size: Incoine Limit: Person Malcing Detennination: Date: Annual Income: Is Applicant Eligible: Household Members and Income CERTIFICACION DE DECLARACION DE INGRESOS Nombre del Solicitante: Domicilio Actual: Numero de Telefono: Miembros en el Ho ar�e In r� esos **INFORMACION PERSONAL: (Seleccione uno en cada categoria. Informacion opcional para propositos de iuformacion Federal) a. ❑ MASCULINO U. ❑ CAUCASICO ❑ NEGRO/AFRICANO AMERICANO ❑ NEGRO/AFRICANO AMERICANO & CAUCASICO ❑ FEMININO ❑ INDIO AMERICANO/NATIVO DE ALASKA ❑ ASIATICO ❑ INDIO AMERICANO/NATIVO DE ALASKA & CAUCASICO ❑ ASIATICO & CAUCASICO ❑ NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS ❑ BALANCE/OTRO ❑ iNDIO AMERICANO / NATIVO DE ALASKA & NEGRO/AFRICANO AMERICANO c. ETNICIDAD d. DISCAPACITADO e. �ES EL SOLICITANTE iTNA MLT7ER Y CABECERA DEL HOGAR? ❑ HISPANO ❑ SI ❑ SI ❑ NO-HISPANO ❑ NO ❑ NO * NUMERO TOTAL DE MIEMBROS EN EL HOGAR Ingreso total del hogar anual anticipado: (Incluye a si inismo y a todos los que viven en la casa) Certificacion: Certifico que la informacion que proporciono es verdad y podria ser susceptible a la comprobacion a cualquier tieinpo por terceros. Yo tambien reconozco que la provision de informacion falsa ine podria dejar sujeto a las penalidades Federales, Estatales y locales. . ADVERTENCIA: TITULO 18, SECCION 1001 DEL CODIGO DE EE.UU. QUE UNA PERSONA ES CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMENTE HACER DECLARACIONES FALSAS O FRAUDULENTAS A CUALQUIER DEPARTAMENTO DEL GOBIERNO ESTADOUNIDENSE. Firma del Solicitante Fecha Para el uso de la agencia financiando: # De Miembros en el Hogar: Limite de Ingreso: Ingreso Anual: �,Es el solicitante elegible? : Persona haciendo la deter-minacion: F Exhibit "F" - Standards for Complete Documentation [See attached] 2013-2014 Documentation Standards for Public Service Contract Expenses an employee works solety vrith Contract eli9ible Gients and sofeiy on Contract eligible items, then ihe employee's entire salary is eligibte k imbursement. Twice in each calendar year, lhe Glent must submit a written statement verifying tha[ the above wnditions are still We. The atement must aiso be signed be a person aulhorized to sign on behalf of the agency. an employee worics on a variery ot programs, or works with a mizlure of Contract eligible clients and non-eligible clients, then ihe Ciry vrill oniy :imburse for a reasonable portion of the employee's sa�ary. Each reimborsement requesl must include not only the employee's timesheet, but also work log breaking out the employee's time by project or activity. For employees paid with multiple funding sources, timesheets musl re0ec[ all inding sources. If separate timesheeis are kept for each funding source, all such timesheets must be submitted to City. employees are paid by direG deposit rather than check, then lhe agency must submit both lhe direct deposit paymeni company's repoA (such as ADT report) and a bank statement or check showing payment to Ihe direct deposit company. gross saiary, tnis is aireaay mcmoea u ine ciry pays tne emp�oyer porti ot how the invoiced amount was calculated. and include documentation he city pays gross saiary, this is aireaay incwaea u we pay the empioyer pomon, men me empioyer must snow a caicmavon a�a aocu how the invoiced amount was calculated, must indude an Invoice from the insurer, and must indude documentation showing payment. [ne ary pays gross saiary, [ni: F how Ihe invoiced amount was the City pays gross salary, thi: f how the invoiced amount was the City pays gross salary, thi: f how the invoiced amount was we pay gross salary, this is aln ie invoiced amount vras calcula =rsonnei policy regarding retire an audit is�required because fe ncmaea u we pay me emp�oyer portwn, men me empioyer mus[ snow a caicuiauon ano ooa must inGude an invoice fmm the insurer, and must include documentation showing payment. Iready induded. Ifwe pay the employer portion, then the employer mus[ show a calculation and documen ulated, musl include an invoice from the insuret, and must inGude documentation showing payment. Iready Included. If we pay the employer portion, �hen the employer must show a calculation and documen ulated, and must include documentation showing payment. � included. If we pay Ihe empioyer portion, then the employer must show a caiculalion and documentation must and include documentatlon showing payment, and prior lo lhe first reimbursement, must inGude the sources. icy should maintain information regarding mailou(s. If the agency has a Pitney Bowes machine or like posiage machine, the records ol must be on file. �ikewise, if mail is categorized by payment source, �hen those records must be on file. For large mailouts, the agency in aaamon m admission ezpenses, tooa expenses vnn aiso ne anowea so iong as tne agency routine purchases on all field trips, not just Contract-funded field trips. . FiiFl the Contract F7L7 � requires that the agency submit its fee schedule, showing a breakout of income levels, and tor each level a breakou[ of the portion of the ense to be paid by family and the poAion to be reimbursed by ihe City. This tee schedule is required prior lo the first payment We also require income eligiblity of each household so ihat we can determine'rf wa are being changed i� confortnance with the fee schedule. If lhe fee scheduie nges at any time during the conVact year, the agency mus[ notify City and provide a new schedule within 30 days of the change. *Proof of payment effective October 1, 2013: Payments or Expenses must be documented in the foliowing manner: A) Image of the check AND bank statement showing the check cleared the bank; OR, B) Image of the cancelled check (ex. At end of bank statement); OR, C) Payroll'Advace" or Statemen[ AND Bank Siatement indicating payroll; OR, D) For wire or e-Vans(ers: Reciept or statement from payeeNendor OR bank statement. EXHIBIT "G" SECTION 3 REPORTING FORMS ExxIBIT ��G�� Seciion 3 Summary Report Economic Opportunities for Low — and Very Low-Income Persons U.S. Department of Housing and Urban Development Office of Fair Housing And Equal Opportunity OMB Approval No: 2529-0043 (exp. 11 /30/2010) HUD Field Office: Section back of page for Public Reporting Burden slatement 1. Recipient Name & Address: (street, city, state, zip) 2. Federal identification: (grant no.) 3. Total Amount of Award: 4. Contact Person 5. Phone: (Include area code) 6. Lengih of Grant: 7. Reporting Period: 8. Date Report Submitted: 9. Program Code: (Use separa[e sheet 10. Program Name: for each program code) Part I: Em lo ment and Trainin " Columns B, C and F are mandato fields. Include New Hires in E&F A 8 C D E F Number of Number of New % of Aggregate Number k of Total Staff Hours Number of Sectio� 3 Job Category New Hires Hires that are of Staff Hours of New Hires for Section 3 Empioyees Trainees Sec. 3 Residents lhat are Sec. 3 Residenls and Trainees Professionals ` Technicians Office/Clerical ' Construction by Trade (List) Trade Trade Trade Trade Trade Other �ist Total ` Program Codes 3= Publicllndian Housing 4= Homeless Assistance 1= Fiexibie Subsidy A= Development, 5= HOME 2= Section 202/811 B= Operation 6= HOME State Adminislered C= Modemization 7= CDBG Entitlement Page 1 of 2 8 = CDBG State Administered 9 = Other CD Programs 10 = Other Housing Programs form HUD 60002 (6/2001) Ref 24 CFR 135 Part 11: Contracts Awarded 1. Construction Contracts: A. Total dollar amount of all contracts awarded on the project B. Total doliar amount of contracts awarded to Section 3 businesses C. Percentage of the total doliar amount that was awarded to Section 3 businesses D. Total number of Section 3 businesses receiving contracts % 2. Non-Construction Contracts: A. Total dollar amount all non-construction contracts awarded on the projecUactivity B. Total dollar amount of non-construction contracts awarded to Section 3 businesses C. Percentage of the total doliar amount that was awarded to Section 3 businesses D. Total number of Section 3 businesses receiving non-construction contracts Part III: Summary % Indicate the efforts made to direct the employment and other economic opportunities generated by HUD financial assistance for housing and community development programs, to the greatest extent feasible, toward low-and very low-income persons, particulariy those who are recipients of government assistance for housing. (Check all that apply.) ____ Attempted to recruit low-income residents through: local advertising media, signs prominentiy displayed at the project site, contracts with the community organizations and public or private agencies operating within the metropolitan area (or nonmetropolitan county) in which the Section 3 covered program or project is located, or similar methods. ____ Participated in a HUD program or other program which promotes the training or employment of Section 3 residents. _____ Participated in a HUD program or other program which promotes the award of contracts to business concerns which meet the definition of Section 3 business concerns. ___ Coordinated with Youthbuild Programs administered in the metropolitan area in which the Section 3 covered project is located. ____ Other, describe below. Pubiic reporting for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB number. Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701 u, mandates that the Department ensures that employment and other economic opportunities generated by its housing and community development assistance programs are directed toward low- and very-low income persons, particularly those who are recipients of government assistance housing. The regulations are found at 24 CFR Part 135. The information will be used by the Department to monitor program recipients' compliance with Section 3, to assess the results of the DepartmenYs efforts to meet the statutory objectives of Section 3, to prepare reports to Congress, and by recipients as self-monitoring tool. The data is entered into a database and will be analyzed and distributed. The collection of information involves recipients receiving Federal �nancial assistance for housing and community development programs covered by Section 3. The information will be collected annually to assist HUD in meeting its reporting requirements under Section 808(e)(6) of the Fair Housing Act and Section 916 of the HCDA of 1992. An assurance of confidentiality is not applicable to this form. The Privacy Act of 1974 and OMB Circular A-108 are not applicable. The reporting requirements do not contain sensitive questions. Data is cumulative; personal identifying information is not included. Page 2 of 2 form HUD 60002 (11/2010) Ref 24 CFR 135 Form HUD-60002, Section 3 Summary Report, Economic Opportunities for Low- and Very Low-Income Persons. Instructions: This form is to be used to report annual accomplishments regarding employment and other economic opportunities provided to low- a�d very low-income persons under Section 3 of the Housing and Urban Development Act of 1968. The Section 3 regulations apply to any public and lndian housing programs that receive: (1) development assistance pursuant to Section 5 of the U.S. Housing Act of 1937; (2) operating assistance pursuaM to Section 9 of ihe U.S. Housing Act of 1937; or (3) modernization grants pursuant to Section 14 of the U.S. Housing Act of 1937 and to recipients of housing and community development assistance in excess of $200,000 expended for: (1) housing rehabilitation (including reduction and abatement of lead-based paint hazards); (2) housing construction; or (3) other public construction projects; and to contracts and subcontracts in excess of $100,000 awarded in connection with the Section-3-covered activity. Form HUD-60002 has three parts, which are to be completed for all programs covered by Seciion 3. Part I relates to employment and training. The recipient has the option to determine numerical employmenUtraining goals either on the basis of the number of hours worked by new hires (columns B, D, E and F). Part II of the form relates to contracting, and Part Iil summarizes recipients' efforts to compiy with Section 3. Recipients or contractors subject to Section 3 requirements must maintain appropriate documentation to establish that HUD financial assistance for housing and community development programs were directed toward low- and very low-income persons.* A recipient of Section 3 covered assistance shall submit one copy of this report to HUD Headquarters, Office of Fair Housing and Equal Opportunity. Where the program providing assistance requires an annuai performance report, this Section 3 report is to be submitted at the same time the program performance report is submitted. Where an annual performance report is not required, this Section 3 report is to be submitted by January 10 and, if the project ends before December 31, within 10 days of project compietion. Only Prime Recipients are required to report to HUD. The report must inc/ude accomplishments of all recipients and their Secfion 3 covered contractors and subcontractors. HUD Field Office: Enter the Fieid O�ce name . 1. Recipient: Enter the name and address of the recipient submitting this report. 2. Federal Identification: Enter the number that appears on the award form (with dashes). The award may be a grant, cooperative agreement or contract. 3. Doilar Amount of Award: Enter the dollar amount, rounded to the nearest dollar, received by the recipient. 4& 5. Contact Person/Phone: Enter the name and telephone number of the person with knowledge of the award and the recipienYs implementation of Section 3. 6. Reporting Period: Indicate the time period (months and year) this report covers. 7. Date Report Submitted: Enter the appropriate date. S. Program Code: Enter the appropriate program code as lisied at the bottom of the page. 9. Program Name: Enter the name of HUD Program corresponding with the "Program Code" in number 8. Part I: Employment and Training Opportunities Column A: Contains various job categories. Professionals are defined as people who have special knowledge of an occupation (i.e. supervisors, architects, surveyors, planners, and computer programmers). For construction positions, list each trade and provide data in columns B through F for each trade where persons were employed. The category of "Other" includes occupations such as service workers. Column B: (Mandatory Field) Enter the number of new hires for each category of workers identified in Column A in conneciion with this award. New hire refers to a person who is not on the contractor's or recipienYs payroll for employment at the time of selection for the Section 3 covered award or at the time of receipt of Section 3 covered assistance. Column C: (Mandatory Field) Enter the number of Section 3 new hires for each category of workers identified in Column A in connection with this award. Section 3 new hire refers to a Section 3 resident who is not on the contractor's or recipienYs payroll for empioyment at the time of selection for the Section 3 covered award or at the time of receipt of Section 3 covered assistance. Column D: Enter the percentage of all the staff hours of new hires (Section 3 residents) in connection with this award. Column E: Enter the percentage of the total staff hours worked for Section 3 employees and trainees (including new hires) connected with this award. Include staff hours for part-time and full-time positions. Column F: (Mandatory Fieid) Enter the number of Section 3 residents that were trained in connection with this award. Part II: Contract Opportunities Block 1: Construction Contracts Item A: Enter the total doliar amount of all contracts awarded on the projecUprogram. Item B: Enter the total dollar amount of contracts connected with this projecUprogram that were awarded to Section 3 businesses. Item C: Enter the percentage of the total doliar amount of contracts connected with this projecUprogram awarded to Section 3 businesses. Item D: Enter the number of Section 3 businesses receiving awards. Block 2: Non-Construction Contracts item A: Enter the total dollar amount of all contracts awarded on the project/program. Item B: Enter the total doilar amount of contracts connected with this project awarded to Section 3 businesses. Item C: Enter the percentage of the total dollar amount of contracts connected with this projectlprogram awarded to Section 3 businesses. Item D: Enter the number of Section 3 businesses receiving awards. Part ill: Summary of Efforts — Self -explanatory Submit one (1) copy of this report to the HUD Neadquarters Office of Fair Housing and Equal Opportunity, at the same time the performance report is submitted to the program office. The Section 3 report is submitted by January 10. Inciude only contracts executed during the period specified in item 8. PHAs/IHAs are to report ail contracts/s ubcontracts. ` The terms "low-income persons" and very low-income persons" have the same meanings given the terms in section 3(b) (2) of the United States Housing Act of 1937. Low-income persons mean families (including single persons) whose incomes do not exceed 80 percent of the median income for the area, as determined by the Secretary, with adjustments for smaller and larger families, except that Pagei The Secretary may establish income ceilings higher or lower than 80 percent of the median for the area on the basis of the Secretary's findings such that variations are necessary because of prevailing levels of construction costs or unusuaily high- or low-income families. Very low-income persons mean low-income families (including single persons) whose incomes do not exceed 50 percent of the median family income area, as determined by the Secretarywith adjustments orsmailer and largerfamilies, except that the Secretary may establish income ceilings higher or lower than 50 percent of the median for the area on the basis of the Secretary's findings that such variations are necessary because of unusuaily high or low family incomes. form HUD 60002 (11/2010) Ref 24 CFR 135 EXHIBIT "H" — Severely Disabled Certification Form [See attached] [AGENCY) CERTIFICATION FORM DOCUMENTING CLIENT STATUS AS "SEVERELY DISABLED ADULT" Client Name: Address: City, State, Zip Client Identification No. CHECK ALL THAT APPLY � ❑� � � U U Has used a wheelchair, a walker, cane , crutches or other special aid for six rnonths or longer Has been diagnosed with one of the following conditions: Alzheimer's disease, mental retardation or other developmental disability, senility or deinentia, cerebral palsy, or autism; or has another mental or emotional condition that seriously interferes with everyday tasks. Is unable to perform one or more of the following "Functional Activities": seeing, heariug, speaking and having one's speech understood, lifting or cai7ying, using stairs, grasping small objects, or wallcing. Is unable to perform or needs assistance to pei-form one or more of the following Activities of Daily Living (ADL): getting around inside the home, getting in or out of bed or a chair, bathing, dressing, eating, and toileting. Is unaUle to perfoim or needs assistance to perfor�n one or more of the following Instrumental Activities of Daily Living (IADL): going outside the home, keeping track of inoney and bills, preparing meals, doing light housework, talcing prescription medications in the right amount and at the right tiine, and using the telephone. Has a condition that prevents thern from working at a job or doing housework. The undeisigned agency representative conducted a visual assessment of identified on this form and certifies that the client meets at least one of the indicated above, which determines that he/ she meets the definition o: disabled" according to the U.S. Census Bureau. Certified by: Signature/Title: Date: the client conditions "severely CFW HED: Revised as ofAugust 30, 2013 Form ��� (Rev.January 2011) Department of theTreasury Internal Revenue Service N o> m ro a 0 N O. p � '�i �� 0 c '� 5 n. � U w �n w a� � Request for Taxpayer Identification Number and Certification Neme (as shown on your income tax retu LENA POPE HOME, INC Business name/dlsregarded entity name, Give Form to the requester. Do not send to the IRS. Check appropriete box for federal tax classificailon (required): ❑ I�dlviduaUsole proprietor �✓ C Corporation ❑ S Corporation ❑ Partnership ❑ TrusVestate ❑ Llmited Ilablllty company. Enter the tax class(fication (C=C corporation, S=S corporatlon, P=partnership) ► ---------------------------- ❑ Other (see instructions Address (number, street, an� 3131 SANGUINET ST apt. or Clty, state, and ZIP cotle FORT WORTH, TEXAS 76107 list account number(s) here (optlonaly Exempt payee Enter your TIN In the appropriate box. The TIN provided must match the name glven on the "Name" Ilne to avo(d backup withholding. For fndfvlduals, this Is your social securlty �umber (SSN). However, for a resldent alien, sole proprletor, or disregarded entiry, see the Part I instructlons on page 3. For other entltles, It Is your employer ldentii(cation number (EIN). If you do not have a number, see Now to get a T1N on page 3, Note. If the account Is in more than one name, see the chart on page 4 for guldelines on whose number to enter. name and address (optlonal) 7I5�—I6IOIOI3I5�8�3 �:F1Z��� cert�t�cation Under penalties of perjury, I certify that: 1, Tho number shown on this form is my correct taxpayer (dentlfication number (or I am walting for a number to be Issued to me), and 2, I am not subject to backup withholding because: (a) I am exempt from backup wlthhoiding, or (b)1 have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a fallure to report all Interest or dividends, or (c) the �RS has notffled me that I am no longer subJect to backup withholding, and 3. I am a U.S, citizen or other U.S, person (detined below). Certification instructions. You must cross out item 2 above If you have been notifled by the IRS that you are currently subJect to backup w(thholding because you have falled to report all Interest and dividends on your tax return. For real estate transactlons, ftem 2 does not app�y, For mortgage Interest pald, acqulsitlon or abandonment of secured property, cancellation of debt, contributlons to an indfvfduai retirement arrangement (IRA), and generally, payments other tha Interest and dividends, you are not requlred to sign the certificatlon, but you must ovfde your correct TIN. See the Instructlons on page 4. � Sign Signature of � � �/ Here U.S. person ► � l Ct j� �u P.�� °� ► `C ( Z (� General lnstructions Section references are to the Internal Revenue Code unless othenvlse noted. Purpose of Form A person who is required to flle an informatlon return with the IRS must obtain your correct taxpayer ldentificatlon number (fIN) to report, for exampie, income paid to you, reai estate transactions, mortgage interest you paid, acquisitlon or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only If you ara a U.S, person (including a resident allen), to provide your correct TIN to the person requesting it (the requester) and, when appllcable, to: 1. Certify that the TIN you are giving is correct (or you are walting for a number to be Issued), 2. Certify that you are not subJect to backup withholding, or 3. Claim exemptlon from bacl<up withholding if you are a U.S. exempt payee. lf applicable, you are aiso certifying that as a U.S, person, your allocable share of any partnershlp Income from a U.S, trade or buslness Is not subJect to the wlthholding tax on forelgn partners' share of effectivety connected Income. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantialiy similar to this Form W-9. Deflnitlon of a U.S. person. For federal tax purposes, you are considered a U,S, person If you are: • An Indtvldual who Is a U.S, citizen or U.S. resident allen, • A partnership, corporation, company, ar assoclation created or organ(zed in the United States or under the laws of the United States, • An estate (other than a forefgn estate), or � A domestic trust (as defined in Regulations sectlon 301.7701-7). Special rules for partnerships. Partnershlps that cohduct a trade or busfness In the United States are generally required to pay a withholding tax on any fore(gn partners' share of Income from such buslness, Further, in certain cases where a Form W-9 has not been recefved, a partnership Is required to presume that a partner is a forefgn person, and pay the withholding tax. Therefore, If you are a U.S, person that is a partner In a partnership conducting a trade or business In the United States, provide Form W-9 to the partnership to establish your U,S. status and avold withholding on your share of partnership Income. Cat, No. 10231X Form N/-9 (Rev. 1-2011) I�. w ;, � � ��� � .... 1. • 1..� � . :_ ,� ►. ., DATE (MMlDP1YYYY) THfS CERTIFtCATE fS (SSUED AS A MATTER OF INFORMATfON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVEI.Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGB AFFORDED BY THE POUCIES ,� BELQW. THIS CERTtFICATE OF INSURANCE DOES NOT CqNSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CER7IFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAl.. INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A staiement on this cortificate does not confer rights io the certificaie holder in tieu of such endorsement(s). PRODUCER iigginbotham Insurance Agency, Inc. i00 W. 13th Sfreet =art Worth TX 76102 _ .: � .� � INSURED Lena Pope Home, inc. 3131 Sanguinet Fort Worth TX 76107 c INSURER r� COVERAGES CERTIFICATE NUMBER: �113763583 REVISIUN NUMtitK: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE �OR THE POLICY PERIOD INDICATED. NOTWfTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS. INSI2 TypEOFINSURANCE A e pOUCYEFF POLICYEXP LTR INSR WVD POLICYNUMBER MMIDD MMIDD/YYYY LIMITS C GENERAI. �IABILITY NCPKG0254500 /1/2013 /1/2014 EqCH OCCURRENCE S1,000,000 COMMERCIAI GENERAL LIABILITY PREM SE8 a occurrence 5100,000 X CLAIMS-MADE � OCCUR MED BXP (Any one erson) $10,000 PERSONAL&ADVINJURY 51,000,000 GENERALAGGREGATE 33,000,000 GEN'LAGGREGATELIMITAPPLIESPER: PRO�UCTS-COMP/OPAGG 53000,000 POLICY �ao- x �p� Employee Dlshonesty 5500,000 ; AUTOMOBILE LIABILITY NCAU70254500 /112013 !1/2014 Ea accident 51,000,000 _ x ANYAUTO BODIIYINJURY(Perperson) S ALLOWNED SCHEDULED BODILYINJURY(Peracdden�) $ AUTOS NON-0WNED PROPERTY DAMAGE � HIREpAUTOS A�TOS Peracciden� S C UMBRELLA LIAF3 pCCUR NCFXS0254500 Hl2013 h/2014 EpCH OCCURRENCE S10,000,000 X EXCESS LIA6 X CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTIONS "SeeSub-Iimit S g WORKERSCOMPENSA710N SF111174020130201 /1l2013 11I2014 X 0 S7A7U- OTH- AND EMPLOYERS LIABILITY y� N ANY PROPRIETOR/PARTNER/EXECUTIVE N � A E.l. EACH ACCIDENT S1,000,000 OPFICEft/MEMBER EXC�UDED? � (Mandatory In NH) E.l.. DISEASE - EA EMPLOYE S1,U00,000 I(yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 51,000,000 A Dlrectors/Otflcers & EPL PHSDB0015q /1/2013 1/2014 D& O/ Emp Prac $5,000,000 C Professfonal-Claims Made NCPI<G0254500 /1/2013 (1/2014 $1,000,000 $3,000,000 AbuselMolesfai(on-Clafms Made $1,000,000 $3,OOD,00O DESCRIPTION OF OPERATIONS / LOCA710NS! VEHICLES (Attach ACORD 101, Addillonal Remarks Schedule, (f more spaca �s requlred) *** Excess includes Sexual Abuse and Professional at a$5,000,000 Sublimit Policy #NCPKG0254500 includes: Professional Liabilify coverage part is "Claims Made" with a Retro Date of 2-1-2004 Sexual Abuse & Sexual Molestation coverage part is "Claims Made" with a Refro Date of 2-1-2004 Lena Pope Home, Inc. 3131 Sanguinet ) Fort Worth TX 76107 ACORD 25 (2010/05) GA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE�LED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILI BE DELIVERED ItJ ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED O�1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EXHIBITS: Exhibit "A" — Program Summary Exhibit "A-1" — 2013 HUD Income Limits Exhibit "A-2" — Environmental Mitigation Action Exhibit "B" — Budget Exhibit "C" — Audit Certification Form Exhibit "D" — Reimbursement Forms Exhibit "E" — Form of Income Self-Certification Exhibit "F" — Standards for Complete Documentation Exhibit "G" — Section 3 Reporting Forms Exhibit "H" — Severely Disabled Certification Form CDBG PSA CONTRACT 2013-2014 - LENA POPE HOME, INC. 32 Lena Pope Home, Inc. EXHIBIT A Second Opportunity for Success PROGRAM SLJMMARY PROGRAM SUMMARY Community Development Block Grant (CDBG) October 1, 2013 to September 30, 2014 PERIOD $82,326.00 AMOUNT PROGRAM: The program will provide youth and family group education classes to Fort Worth residents for the purpose of reducing juvenile crime and delinquency. Program services include an initial phase of group life-skill improvement classes for parents and their children. Upon completion of the group program, the program will monitor client progress and provide clients with follow-up case management. Youth who successfully complete the program will not be adjudicated for their crimes. CDBG funds will be used to pay for salaries, FICA, and fringe benefits for program employees. CDBG funds will pay for a portion of general commercial liability and program facility rent. Program services will be available at 3800 Hulen, Suite 230, Fort Worth, TX 76107; Monday through Friday during regular business hours. Group classes and intake will be held Wednesday and/or Thursday, 5:00 to 8:00 pm. REGULATORY CLAS5IFICATION: IDIS Matrix Code(s) and Service Category: 05 Other Public Services National Objective Citation: LMC Low/Mod Limited Clientele 24 CFR 570.208(a)(2) Regulatory Citation(s): 24 CFR 570.201(e) Based on the nature of the service provided, Agency will maintain documentation that verifies that 51% of clients served by the Program are income eligible with current household incomes at or below 80% of Area Median Income (AMI) as established or de�ned by the United States Department of Housing and Urban Development (HUD). PROGRAM GOALS: Provide program services to approa�imately 125 Unduplicated Clients EXHIBIT A- CDBG: LENA POPE HOME, INC. EXHIBIT "A-1" 2013 HUD INCOME LIMIT5 2013 Median Family Income — Fort Worth/Arlington, TX* 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons 30% AMI $13,850 $15,800 $17,800 $19,750 $21,350 $22,950 $24,500 $26,100 50% AMI $23,050 $26,350 $29,650 $32,900 $35,550 $38,200 $40,800 $43,450 80% AMI $36,900 $42,150 $47,400 $52,650 $56,900 $61,100 $65,300 $69,500 XIncome limits are established and published at least annually by HUD. EXHIBIT "A-2" CNVIRONMENTAL MITIGA'fION ACTION NONE REQUIRED EXHIBiT R- Ri 1T�( TFT FUNDING B: F[JNDING C: EXHIBIT B- CDBG: LENA POPE HOME, INC. The following tables are purely informational and were created solely for purposes of preparing, negotiating, and determining the reasonableness of the overall line item budget on the first page of this EXHIBIT B— BUDGET and are not to be considered part of the terms and conditions of this Contract. Contractor may make changes to any column except the "Position" column in the "Salary Detail" table without the City's consent so long as the total amounts charged to the grant do not exceed the line items on the first page of the EXHIBIT B— BUDGET." Changes to the column labeled "Position" may only be made with the prior written consent of the City. SALARY DETAIL Position Name Rate Annual Hours Percent to Grant Amount to Grant Su ervisor 30.13 2080 13% 7,834 Admin Assistant 16.03 2080 23% 7,667 Famil S ecialist 18.88 2080 9% 3,643 Famil S ecialist 19.21 2080 46% 18,533 Famil S ecialist 20.71 2080 46% 20,015 FRINGE DETAIL Percent of Pa oll Amount Percent to Grant Amount to Grant FICA 7.65% 4,413 100% 4,413 Life Insurance .82% 473 100% 473 Health Insurance 23.84% 13,755 73% 10,000 Unem lo ment 7.29% 902 100% 902 Workers Com ensation 1.09% 629 100% 629 Retirement 5% 2,885 100% 2,885 SUPPLIES AND SERVICES Total Bud et Percent to Grant Amount to Grant Office Su lies 4,397 0% 0 Office E ui ment Rental Postage Printin MISCELLANEOUS Total Budget Percent to Grant Amount to Grant Contract Labor Craft Su lies Facility Fees Field Tri Costs Food Su lies Teachin Aids FACILITY AND UTILITIES Totat Bud et Percent to Grant Ainount to Grant Tele hone 3,755 0% 0 Electric 2,099 0% 0 Gas Water and Wastewater Solid Waste Dis osal Rent 19,173 22% 4,177 Custodial Services 3,051 0% 0 Re airs Cleaning Su lies EXHIBIT B- CDBG: LENA POPE HOME, INC. 2 FINANCIAL AND INSURANCE Total Budget Percent to Grant Amount to Grant Fidelity Bond or E uivalent) General Commercial Liability 1,154 100% 1,154 Directors and Officers Contract Accountin DIRECT ASSISTANCE Total Bud et Percent to Grant Amount to Grant Childcare Scholarshi s Short-Term Rent Assistance Short Term Mort a e Assistance Short Term Utilities Assistance Tenant Based Rental Assistance EXHIBIT B- CDBG: LENA POPE HOME, INC. 3 EXHIBIT "C" Audit Certification Form [See attached] AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS Agency: Fiscal Year Ending: September 30, 2014 ❑ During the fiscal year in which funds will be received, we will exceed the federal expenditure threshold of $500,000. We will have our Single Audit or Program Specific Audit completed and will submit the A-133 audit report within seven (7) months after the end of the audited fiscal year or thirty (30) days within its completion, whichever is the earlier date. ❑ During the fiscal year in which funds will be received, we will not exceed the $500,000 federal expenditure threshold required for a Single Audit or a Program Specific Audit to be performed this fiscal year. (Fill out schedule below) Signatory and Title Date Failure to submit this or a similar statement or failure to submit a completed single audit package as described in the federally required audit requirements described in OMB Circulars A-133 by the required due date may result in suspension of funding and may affect eligibiliry for future funding. Notwithstanding the above, this certification acknowledges the agency's commitment to meet all other �nancial reporting, financial statements, and other audit requirements as may be set forth in the Contract. Exhibit "D" - Reimbursement Forms [See attached] Attachment I INVOICE Agency: Address: City, State, Zip: Program: Period of Service: Agency's C;ertitication: 1 certity that the costs incurred are valid and consistent with the terms and conditions of the contract between City and Agency. By signing this invoice, I certify that to the best of my knowledge and belief the data included in this report is true and accurate. It is acknowledged that the provision of false information could leave the certifying official subject to the Signature and Date: Name: Title: Attachment II City of Fort Worth Housing and Ecanomfc Development Depnrtment Eapenditure Workshee[ Agency Yome Program: Prognm Name •Payroll must identify employcz. Rcm muat identify trnanL Other paymenls should identify individuaU Hlgh8g6hd erc tEe onty r¢levant coda for NB Program � F i .�y �� S6 VD 6 �. k� U Exhibit "E" Form of Income Self-Certification [See attached] CERTIFICATION OF INCOME STATEMENT Applicant Name: Current Address: #: **PERSONAL INFORMATION: (Check one in each item. Optional Information for Federal Reporting Purposes) a. ❑ MALE b. ❑ WHITE ❑ BLACK/AFRICAN AMERICAN ❑ BLACK/AFRICAN AMERICAN & WHITE ❑ FEMALE ❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ ASIAN ❑ AMERICAN INDIAN/ALASKAN NATIVE & WHITE ❑ ASIAN & WHITE ❑ NATIVE HAWAIIAN/O"I'HER PACIFIC ISLANDER ❑ BALANCE/OTHER ❑ AMERICAN iNDIAN/ALASKAN NATIVE & BLACK/AFRICAN AMERICAN c. ETFiNICITY d. DISABLED e. IS CLIENT WOMEN HEAD OF HOUSEHOLD ❑ HISPArtIC ❑ YES ❑ YES ❑ NON-HISPANIC ❑ NO ❑ NO * TOTAL NUMBER OF HOUSEHOLD (Include Yourself AND everyone who MEMBERS lives in the house.) Total Anticipated Annual Household Income: Certification: I certify that the information I am providing is true and could be subject to verification at any time by a third party. I also acknowledge that the provision of false information could leave me subject to the penalties of Federal, State and local law. WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT. Signature of Applicant Date For use by funding agency: Household Size: Income Limit: Person Making Determination: Date: Annual Income: Is Applicant Eligible: Household Members and Income CERTIFICACION DE DECLARACION DE INGRESOS Nombre del Solicitante: Domicilio Actual: Numero de Telefono: Miembros en el Hogar e Ingresos a. ❑ MASCULINO ❑ FEMININO ;SONAL: (Seleccione uno en cada categoria. Informaci6n opcional para propositos de informacibn Federal) b. � CAUCASICO ❑ NEGRO/AFRICANO AMERICANO ❑ NEGRO/AFRICANO AMERICANO & CAUCASICO ❑ INDIO AMERICANO/NATIVO DE ALASKA ❑ ASIATICO ❑ INDIO AMERICANO/NATIVO DE ALASKA & CAUCASICO ❑ ASIATICO & CAUCASICO ❑ NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS ❑ BALANCE/OTRO ❑ INDIO AMERICANO / NATIVO DE ALASKA & NEGRO/AFRICANO AMERICANO c. ETNICIDAD d. DISCAPACITADO e. �ES EL SOLICITANTE UNA MLJJER Y CABECERA DEL HOGAR? ❑ HISPANO ❑ SI ❑ SI ❑ NO-HISPANO ❑ NO ❑ NO * NLTMERO TOTAL DE MIEMBROS EN EL HOGAR Ingreso total del hogar anual anticipado: Certificacion: (Incluye a si mismo y a todos los que viven en la casa) Certifico que la informacion que proporciono es verdad y podria ser susceptible a la comprobacion a cualquier tiempo por terceros. Yo tambien reconozco que la provision de informacion falsa me podria dejar sujeto a las penalidades Federales, Estatales y locales. ADVERTENCIA: TITULO 18, SECCION 1001 DEL CODIGO DE EE.UU. QUE UNA PERSONA ES CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMENTE HACER DECLARACIONES FALSAS O FRAUDULENTAS A CUALQUIER DEPARTAMENTO DEL GOBIERNO ESTADOUNIDENSE. Firma del Solicitante Fecha Para el uso de la agencia financiando: # De Miembros en el Hogar: Limite de Ingreso: Ingreso Anual: �Es el solicitante elegible? : Persona haciendo la determinacion: Fecha: Exhibit "F" - Standards for Complete Documentation [See attached] 2013-2014 Documentation Standards for Public Service Contract Expenses It an employee vrorks solely with Contract eligibie dients and solely on Co�tracl eli9ibie items, lhen lhe employee's entire sa�ary is eligible for reimbursemant Twice in each calendar year, �ha dient must submd a wr0ten statement verifyin9 lhat the above conditions are slili true. The statemenl must also be signed be a person aufhorized to sign on behaM of the agency. an employee wortcs on a variety of progrems, or works vrith a mbcWie of Contract elgible dients and non-elgibie dienls, then the City wili only ��imburse for a reasonabie portion oi lhe employea's salary. Each reimbursement request must indude nol onty the empbyee's timesheei, bul aiso woiic bg breaki�g out the empbyee's time by project or activ'rty. for employees paid wdh multiple funding sources, timesheets must reflect all nding sources. Itseparate timesheets are kept for each funding somce, all such timesheets must be submitted to City. employees are paid by direct deposit rether than chedc, then the agency must submit bolh the dired deposit payment companys report (suct� as ADT report) and a bank slatemeM or check showing payment to the direct deposit company. PaYg 9ross he Gity pays gross salary, ihis is already included. If we pay ihe employer portion, then the empioyer must show a cakulation and doci how the invoiced amount was calculated, must inciude an invoice irom the insurer, and must include documentation showing payment. ne crty pays gross salary, this is already included. If we pay !he employer portion, then Ihe employer must show a calwlalion and dcei how the invoiced amount was calwlated, must indude an invoice fmm tha insurer, and must inGude documenlalion showing payment. he City pays gross saiary, lhis is aiready inciuded. If we pay the empbyer portion, ihen lhe employer must show a calculation and doa how the invoiced amount was calcuiated, must include an invoice hom lhe insurer, and must indude dceumenlation showing payment. I'l�}� we pay gross sa�ary, tn e invoiced amount was an sourcas. agency shoultl mainlain information regarding maibuts. If the agancy has a Pitney Bowes machine or like postage machina, Ihe records of hine must be on fiie. Likewise,'rf maii is categorized by payment source, Ihen thase records must be on file. For large mailouts, lhe agency Ad keeo a coov of the letter and a list ot ali addressees. ion to atlmission expenses, food expenses wili also be allowed so long as the agency purchases on alI field trips, notjust Contrect-funded field Uips. and the Contract � r reqmres mac [ne agency suomrt ¢s tee srneawe, snowing a oreaKout ui Income levels, antl tor each levei a breaKoul ot lhe portion af lha �ense to be paid by famity and lhe portbn to be reimbursed by lhe City. Thk fee schedule is required prior to lhe first paymenl. We also require income eiigibiity of each household so Ihaf we can determine'rf we are being changed in conformance wilh the fee schedule. I} the fea schedule nges at any time during the contrad year, the agency musl notify City and provide a new schedule within 30 days of the cbange. we pay incivaeu. it we pay 1he employer portion, then the employer must show a calcuiation and documentation must and include documentatbn showing payment, and prior lo fhe first reimbursement, must include the 'Praof of payment effective October 1, 2013: Payments or Expenses must be documented in the tolbwing manner. A) Image of ihe check AND bank statement sbowing lhe chedc deared the bank; OR, B) Image of the cancelied check (ex. Al end ot bank slatement); OR, C) Payroll'Advace' or Statement AND Bank Statement indicating paymll; OR, D) For wire or e-trensfers: Redept or statement from payee/vendor OR bank statement. EXHIBIT "G" SECTION 3 REPORTING FORMS EXHIBIT "G" �ection 3 Summary Report Economic Opportunities for Low — and Very Low-Income Persons Secdon back of page for Public Reporting Burden statement U.S. Department of Housing and Urban Development O�ce of Fair Housing And Equal Opportunity OMB Approval No: 2529-0043 (exp. 11/30/2010) HUD Field Office: � t. Recipienl Name & Address: (sUeet, city, state, zip) 2. Federel Identification: (grant no.) 3. Total Amount of Award: 4. Contact Person 5. Phone: (Indude area code) 6. Length of Grent: 7. Reporting Period: 8. Date Report Submilted: 9. Program Code: (Use separale sheet 10. Pmgram Neme: for each program code) Part 1: Em lo ment and Trainin '* Columns B, C and F are mandato fields. Include New Hires in E&F A B C D E F Number of Number of New % of Aggregate Number % of Total Staff Hours Number of Section 3 Job Category New Hires Hires lhat are of Staff Hours of New Hires for Sectlon 3 Employees Trainees Sec. 3 Residents lhat are Sec. 3 Residents and Treinees Professionals Technicians Office/Clerical Construction by Trade (List) Trade Trade Trade Trade Trade Other List Total ' Program Codes 3= Pubiicllndian Housing 4= Homeless Assistance t= Flexible Subsidy A= Development, 5= HOME 2= Section 202/811 8= Operation 6= HOME State Administered C= Modemizatlon 7= CDBG Entitiement Page 1 of 2 8 = CDBG State Administered 9 = Other CD Progrems 10 = Other Housing Programs form HUD 60002 (6/2001) Ref 24 CFR 135 Part II: Contracts Awarded Construction Contracts: A. Total dollar amount of all co�tracts awarded on the project B. Total doilar amount of contracts awarded to Section 3 businesses C. Perceniage of Ihe total dollar amount that was awarded to Section 3 businesses D. Total number of Section 3 businesses receiving contracts 2. NornConstruction Contracts: A. Total doilar amount ail non-construction contracts awarded on the projecUactivity B. Total dollar amou�t of non-construction contracts awarded to Section 3 businesses C. Percentaga of the total dollar amount that was awarded to Section 3 businesses D. Total number of Sectfon 3 businesses receiving non-construction contracts Part ill: Summary % % Indicate the efforts made to direct the employment and other economic opportunities generated by HUD financial assistance for housing and community development programs, to the greatest extent feasible, toward low-and very low-income persons, particulariy those who are recipients of government assistance for housing. (Check all that apply.) Attempted to recruit low-income residents through: local advertising media, signs prominenily displayed at the project site, contracts with the community organizations and public or private agencies operating within the metropolitan area (or nonmetropolitan county) in which the Section 3 covered program or project is located, or similar methods. Participated in a HUD program or other program which promotes the training or employment of Seciion 3 residents. Particfpated in a HUD program or other program which promotes the award of contracts to business concerns which meet the definition of SecUon 3 business concerns. Coordinated with Youthbuiid Programs administered in the metropolitan area in which the Section 3 covered project is located. Other; describe below. Public reporting for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining ihe data needed, and completing and reviewing the coliection of information. This agency may not coliect this information, and you are not required to complete ihis form, uniess it displays a currently valid OMB number. Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701 u, mandates that the Department ensures ihat employment and other economic opportunities generated by its housing and communily development assistance programs are directed toward low- and very-low income persons, particularly those who are recipients of government assistance housing. The regulations are found at 24 CFR Part 135. The information wili be used by the Department to monitor program recipients' compliance with Section 3, to assess the results of the DepartmenYs efforts to meet the statutory objectives of Section 3, to prepare reports to Congress, and by recipients as self-monitoring tool. The data is entered into a database and will be analyzed and distributed. The collection of information involves recipients receiving Federal financiai assistance for housing and community development programs covered by Section 3. The information will be collected annually to assist HUD in meeting its reporting requirements under Section 808(e)(6) of the Fair Housing Act and Section 916 of the HCDA of 1992. An assurance of confidentiality is not appiicable to this form. The Privacy Act of 1974 and OMB Circular A-108 are not applicable. The reporting requirements do not contain sensitive questions. Data is cumulative; personal identifying information is not included. Page 2 of 2 Iorm HUD 60002 (11/2010) Ref 24 CFR 135 Form HUD-60002, Section 3 Summary Report, Economic Opportunities for Low- and Very Low-Income Persons. instructions: This (orm is to be used io report annuai accomplishments regarding employment and other economic opportunities provided to low- and very low-income persons under Section 3 of the Housing and Urban Development Act of 1968. The Section 3 regulations appiy to any pubilc and /nd/an housing programs that receive: (1) development assistance pursuant to Section 5 of the U.S. Housing Act of 1937; (2) operating assistance pursuant to Section 9 of the U.S. Housing Act of 1937; or (3) modernization grants pursuant to Section 14 of the U.S. Housing Act of 1937 and to recipients of housing and commun(ty development assistance in excess of 5200,000 expended for: (1) housing rehabilitation (including reduction and abatement of lead-based paint hazards); (2) housing construction; or (3) other public construction projects; and to contracts and subcontracfs in excess of $100,000 awarded in connection with the Section-3-covered activity. Form HUD-60002 has three parts, which are to be completed for all programs covered by Section 3. Part I relates to employment and trafning. The recipient has the option to determine numerical employmenUtraining goals either on the basis of the number of hours worked by new hires (columns B, D, E and F). Part II of the form relates to contracting, and Part III summarizes recipients' eNorts to compiy wiih Section 3. Recipients or contractors subject to Section 3 requirements must maintain appropriate documentaiion to estabiish that HUD financial assistance for housing and community development programs were directed toward low- and very iow-income persons.` A recipient of Section 3 covered assistance shail submit one copy of this report to HUD Headquarters, Office of Fair Housing and Equal Opportunity. Where the program providing assistance requires an annuat performance report, this Section 3 report is to be submitted at ihe same time the program performance report is submitted. Where an annual performance report is not required, this Section 3 report is to be submitted by January 10 and, if the project ends before December 31, within 10 days of proJect completion. Only Pr/me Reclpients are required to report to HUD. The report mustlnclude accomp/lshments of al/ reclplents and the/r Sectfon 3 covered confractors and subcontractors. HUD Field Office: Enter ihe Field Office name . 1. Recipient: Enter the name and address of the recipient submitting this report. 2. Federal Identification: Enter the number that appears on the award form (with dashes). The award may be a grant, cooperative agreement or contract. 3. Dollar Amount of Award: Enter the dollar amount, rounded to the nearest doilar, received by the recipient. 4& 5. Contact Person/Phone: Enter the name and telephone number of the person with knowledge of the award and the recipienYs implementation of Section 3. 6. Reporting Period: Indicate the time period (months and year) this report covers. 7. Date Report Submitted: Enter the appropriate date. 8. Program Code: Enter the appropriate program code as listed at the bottom of the page. 9. Program Name: Enter the name of HUD Program corresponding with the "Program Code" in number 8. Part I: Empioyment and Training OpportuniHes Column A: Contains various job categories. Professionals are defined as peopie who have special knowledge of an occupation (i.e. supervisors, architects, surveyors, pianners, and computer programmers). For construction pasitions, list each trade and provide data in columns B through F for each trade where persons were employed. The category of "Othe�' includes occupations such as service workers. Column B: (Mandatory Fieldj Enter the number of new hires for each category of workers identified in Column A in connection with this award. New hire refers to a person who is not on the contractor's or recipienYs payroll for employment at the time of selection for the Section 3 covered award or at the time of receipt of Section 3 covered assistance. Column C: (Mandatory Field) Enter the number of Section 3 new hires for each category of workers identified in Coiumn A in connection with this award. Section 3 new hire refers to a Section 3 resident who is not on the conUactors or recipient's payroll for employment at the time of selection for the Section 3 covered award or at the time of receipt of Section 3 covered assistance. Column D: Enter the percentage of all the staff hours of new hires (Section 3 residents) in connection wiih this award. Column E: Enter the percentage of the total staff hours worked for Section 3 employees and trainees (including new hires) connected with this award. Include staff hours for part-time and full-time positions. Column F: (Mandatory Field) Enter the number of Section 3 residents that were trained in connection with this award. Part II: Contract Opportunities Block 1: Construction Contracts Item A: Enter the total doilar amount of all contracts awarded on the projecUprogram. Item B: Enter the total dollar amount of contracts connected with this projecUprogram that were awarded to Section 3 businesses. Item C: Enter the percentage of the total doilar amount of co�tracts connected with this projecUprogram awarded to Section 3 businesses. Item D: Enter the number of Section 3 businesses receiving awards. Biock 2: Non-Construction Contracts Item A: Enter the total dollar amount of all contracts awarded on the projecUprogram. Item B: Enter the total dollar amount of contracts connected with this project awarded to Section 3 businesses. item C: Enter the percentage of the total doilar amount of contracts connected with this projecUprogram awarded to Section 3 businesses. Item D: Enter the number of Section 3 businesses receiving awards. Part IIi: Summary of EffoRs — Seif -explanatory Submit one (1) copy of this report to the HUD Headquarters O�ce of Fair Housing and Equal Opportunity, at the same time the performance report is submitted to the program o�ce. The Section 3 report is submitted by January 10. Include oniy contracts executed during the period specified in item 8. PHAs/IHAs are to report all contractslsubcontracts. ' The terms "low-income persons" and very low-income persons" have the same meanings given the terms in section 3(b) (2) of the United States Housing Act of 1937. Low•income persons mean families (including singie persons) whose incomes do not exceed 80 percent of the median income for the area, as determined by the Secretary, with adjustments for smailer and larger families, except that Pagei The Secretary may establish income ceilings higher or lower than 80 percent of the median for the area on the basis of the Secretar}rs findings such that variations are necessary because of prevailing leveis of construction costs or unusualiy high- or low-income families. Verylow-income persons mean low-income families (including sing�e persons) whose incomes do not exceed 50 percent of the median family income area, as determined by the Secretary with adjustments or smalier and Iarger families, except that the Secretary may estabiish income ceilings higher or lower than 50 percent of the median for the area on the basis of the Secretarys findings that such variations are necessary because of unusualiy high or low tamily incomes. form HUD 60002 (11/2010) Ref 24 CFR 135 CYHIBIT "H" — Severely Disabled Certification Form [See attached] (AGENCYj C�RTIFICATION FORM DOCUM�NTING CLIENT STATUS AS "SEVERELY DISABLED ADULT" Client Name: Address: City, State, Zip Client Idcnti�cation No. CHECK ALL THAT APPLY � ❑� � U � � Has used a wheelchair, a walker, cane , crutches or other special aid for six months or lon er Has been diagnosed with one of the following conditions: Alzheimer's disease, mental retardation or other developmental disability, senility or dementia, cerebral palsy, or autism; or has another mental or emotional condition that seriousl interferes with everyday tasks. Is unable to perform one or more of the following "Functional Activities": seeing, hearing, speaking and having one's speech understood, lifting or ca ing, using stairs, gras in small ob'ects, or walking. Is unable to perform or needs assistance to perform one or more of the following Activities of Daily Living (ADL): getting around inside the home, ettin in or out of bed or a chair, bathin , dressin , eatin , and toiletin . Is unable to perform or needs assistance to perform one or more of the following Instrumental Activities of Daily Living (IADL): going outside the home, keeping track of money and bills, preparing meals, doing light housework, taking prescription medications in the right amount and at the right time, and usin the telephone. Has a condition that revents them from working at a'ob or doing housework. The undersigned agency representative conducted a visual assessment of the client identified on this form and certifies that the client meets at least one of the conditions indicated above, which determines that he/ she meets the definition of "severely disabled" according to the U.S. Census Bureau. Certified by: Signature/Title: Date: CFW HED: Revised as ofAugust 30, 2013 M&C Review CITY COUNCIL AGENDA Page 1 of 6 O�cial site of the City of Fort Worth, Texas FOR� f� COUNCIL ACTION: Approved on 8/6/2013 - Ordinance No. 20854-08-2013 CONTINUED FROM A PREVIOUS WEEK DATE: 7/23/2013 REFERENCE C-26369 LOG NAME: 17HUDACTPLANPY13-14 NO.. CODE: C TYPE: CONSENT HEARING: YES SUBJECT: Conduct Public Hearings and Approve the City's 2013-2018 Consolidated Plan and 2013- 2014 Action Plan for the Use of Federal Grant Funds in the Amount of $9,413,143.00 from the United States Department of Housing and Urban Development for Program Year 2013-2014 from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant and Housing Opportunities for Persons with AIDS Grant Programs, Authorize Collection and Use of Program Income, Authorize Waiver of Application of Indirect Cost Rates, Authorize Execution of Related Contracts and Interdepartmental Letters of Agreement and Adopt Appropriation Ordinance (ALL COUNCIL DISTRICTS) RECOMMENDATION: It is recommended that the City Council: 1. Conduct a public hearing to allow citizen input and consideration of the City's 2013-2018 Consolidated Plan; 2. Approve the City's 2013-2018 Consolidated Plan for submission to the United States Department of Housing and Urban Development; 3. Conduct a public hearing to allow citizen input and consideration of the City's 2013-2014 Action Plan for use of federal grant funds from the United States Department of Housing and Urban Development in the amount of $9,413,143.00 for Program Year 2013-2014 from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant and Housing Opportunities for Persons with AIDS grant programs and for the use of program income from activities using prior years' federal grant funds; 4. Approve the City's 2013-2014 Action Plan for submission to the United States Department of Housing and Urban Development including allocations of grant funds to particular programs and activities as detailed below; 5. Authorize the collection and use of an estimated amount of $50,000.00 of program income resulting from activities using prior years' Community Development Block Grant funds for the programs and activities detailed below; 6. Authorize the collection and use of an estimated amount of $250,000.00 of program income resulting from activities using prior years' HOME Investment Partnerships Program funds for the City's Homebuyer Assistance Program; 7. Authorize the City Manager or his designee to execute contracts and Interdepartmental Letters of Agreement for a one year term with the agencies listed below in Tables 1, 2 and 3 for Program Year 2013- 2014 for Community Development Block Grant, Emergency Solutions Grant and Housing Opportunities for Persons with AIDS grant funds, contingent upon receipt of funding; 8. Authorize the City Manager or his designee to extend the contracts and Interdepartmental Letters of Agreement for up to one year if an agency or department requests an extension and such extension is http://apps.cfwnet.org/council�acket/mc review.asp?ID=18629&councildate=8/6/2013 8/21/2013 M&C Review � necessary for completion of the program; Page 2 of 6 9. Authorize the City Manager or his designee to amend the contracts and Interdepartmental Letters of Agreement if necessary to achieve program goals, provided any amendment is within the scope of the program and in compliance with City policies and all applicable laws and regulations governing the use of federal grant funds; 10. Authorize a waiver for indirect cost rates as applicable for the Grants Fund, in accordance with the City's Administrative Regulations; and 11. Adopt the attached appropriation ordinance increasing the estimated receipts and appropriations to the Grants Fund in the total amount of $9,413,143.00 (the amount of $6,079,622.00 in Community Development Block Grant funds, the amount of $1,996,541.00 in HOME Investment Partnerships Program funds, the amount of $425,325.00 in Emergency Solutions Grant funds and the amount of $911,655.00 in Housing Opportunities for Persons with AIDS Grant funds) plus any program income, all subject to receipt of such funds. DISCUSSION: The City receives an annual allocation of federal grant funds from the United States Department of Housing and Urban Development (HUD) for the Community Development Block Grant (CDBG), HOME Investment Partnerships Program (HOME), Emergency Solutions Grant (ESG) and Housing Opportunities for People with AIDS (HOPWA) grant programs. In order to continue to receive these funds, the City must submit a Consolidated Plan (ConPlan) every three to five years and an Annual Action Plan. The 2013- 2018 ConPlan summarizes housing and community development needs, particularly those of low-income persons or households and provides the goals, objectives and strategies to address HUD's goals for decent housing, suitable living environment and expanded economic opportunities. The ConPlan will cover the period from October 1, 2013 to September 30, 2018. The ConPlan consists of two parts: (i) the five year Strategic Plan (October 1, 2013 to September 30, 2018) and (ii) the Annual Action Plan, which includes housing and community development activities and proposed expenditures for the upcoming Program Year. The plan for the first year of the ConPlan is listed below. The City's Annual Action Plan is a comprehensive summary of the major housing and community development activities, programs and proposed expenditures for the use of $9,413,143.00 of federal grant funds from HUD from CDBG, HOME, ESG and HOPWA grant programs for the Program Year beginning October 1, 2013 and ending September 30, 2014. This year's Action Plan also summarizes the use of program income resulting from activities using prior years CDBG and HOME funds. The purpose of these grant funds is to primarily benefit low and moderate income City residents, with ESG funds primarily benefiting homeless persons and HOPWA funds primarily benefiting persons with HIV/AIDS. A notice was published in the Fort Worth Star-Telegram on June 21, 2013 regarding the 30-day public comment period for the City's proposed ConPlan and Annual Action Plan. The public comment period was held from June 23, 2013 to July 23, 2013. Any comments will be maintained by the Housing and Economic Development Department, in accordance with federal regulations. These public hearings on the City's ConPlan and Action Plan will be the first public hearings for the HUD-required citizen participation process. The second public hearings will be held August 6, 2013 at which time the City Council is scheduled to approve the ConPlan and the Action Plan. The ConPlan and Action Plan must be submitted to HUD by August 16, 2013. In addition, public hearings were held on June 20, 2013 at 10:00 a.m. and 6:00 p.m. for citizens to provide comment on the proposed list of neighborhood streets eligible for reconstruction using CDBG funds. The Transportation and Public Works Department prepared a list of priority streets in CDBG-eligible areas. The streets selected for reconstruction were based on the comments provided at the public hearings. A list of the streets is attached and will be included in the Action Plan. Staff developed recommendations for the allocation of the estimated funding from HUD and presented http://apps.cfwnet.org/council�acket/mc review.asp?ID=18629&councildate=8/6/2013 8/21/2013 M&C Review Page 3 of 6 them to the Community Development Council (CDC) on May 22, 2013 and to the Housing and Economic Development Committee on June 4, 2013. A summary of the CDC's funding recommendations is provided below in Tables 1, 2 and 3 and a spreadsheet of all specific funding recommendations is attached. For Program Year 2013-2014, it is recommended that the amount of $6,079,622.00 in CDBG funds and the estimated amount of $50,000.00 of CDBG program income be allocated as follows: Public Services - $911,943.00 This item includes social services for low to moderate income, disabled and disadvantaged populations. Housing Programs and Services - $2,149,193.50 This item includes funding for the City's Priority Repair Program, Cowtown Brush-Up, homebuyer and housing services and accessibility modifications to the homes of senior and/or disabled individuals and related project delivery costs for these programs. Demolition and Infrastructure Services - $1,066,211.30 This item includes funding for neighborhood streets reconstruction and demolition of residential structures to eliminate slum and blight in City neighborhoods. CDBG Economic Development - $736,349.80 This item is the City's annual payment on its Section 108 loan from HUD. CDBG Estimated Program Income - $50,000.00 The CDC recommended allocating any CDBG program income for the demolition of residential structures to eliminate slum and blight in City neighborhoods. CDBG General Administration - $1,215,924.40 This item includes costs for administering the CDBG grant including allocations for Financial Management Services, Internal Audit and Planning and Development Departments. For Program Year 2013-2014, it is recommended that the amount of $1,996,541.00 in HOME funds and the estimated amount of $250,000.00 of HOME program income to be allocated as follows: Homebuyer Assistance Program - $1,097,405.75 This item includes funding to provide down payment and/or closing cost assistance to low and moderate income homebuyers. Community Development Housing Organizations (CHDO) Set Aside -$299,481.15 HUD requires that a minimum of 15 percent of HOME funds be allocated to CHDOs for affordable housing projects and CHDO administrative operating costs. These funds will be used for the Hillside Morningside Single Family Infill Project by the Tarrant County Housing Partnership CHDO. Multi-family Development - $400,000.00 Funding will be used for the Angle Apartments Development (Development). The Development will result in approximately 306 units and 680 on-site parking spaces. This Development will address a need for quality affordable housing by providing 100 percent income restricted units to Fort Worth families at or below 80 percent of Area Median Income. The approximate address will be 3900 Angle Avenue, Fort Worth, Texas 76106, Council District 2. HOME General Administration - $199,654.10 This item includes costs for administering the HOME grant. Staff anticipates the receipt of program income in the 2013-2014 Program Year from activities using HOME funds. Any future program income will be used for the City's Homebuyer Assistance Program (HAP) after the 10 percent allocation, excluding recapture, for HOME General Administration. For Program Year 2013-2014, it is recommended that the amount of $911,655.00 in HOPWA funds be allocated as follows: http://apps.cfwnet.arg/council�acket/mc review.asp?ID=18629&councildate=8/6/2013 8/21/2013 M&C Review Non-Profit Service Providers - $884,305.35 HOPWA Program Administration - $27,349.65 Page 4 of 6 For Program Year 2013-2014, it is recommended that the amount of $425,325.00 in ESG funds be allocated as follows: Non-Profit Service Providers - $393,425.62 ESG Program Administration - $31,899.38 The CDC and Staff recommend that contracts be executed with the agencies listed below in the amounts shown in the following tables: Community Development Block Grant: Table 1- CDBG A encies Or anization Pro ram Amount Cenikor Foundation Substance Abuse Treatment $ 82,075.00 Childcare Associates Childcare Associates $ 35,335.00 Clayton Child Care. Inc. d/b/a Clayton Out of School Time YES! $ 82,326.00 Counseling/Shelter Day Resource Center for the Homeless Based Case Mana ement $ 43,908.00 Girls Inc. of Tarrant County Girls Inc. Northside Fort Worth $ 82,075.00 Lena Pope Home, Inc. Second Opportunity for Success $ 82,326.00 Meals on Wheels, Inc. of Tarrant County Home-Delivered Meals $ 82,326.00 Senior Citizens of Greater Tarrant Connecting Seniors to Count Communit $ 81,824.00 Tarrant County Housing Partnership Housing Counseling and Education $ 124,935.00 The Ladder Alliance Com uter Skills Trainin $ 100,235.00 he Salvation Army, a Georgia S.T.A.R.T Cor oration $ 43,908.00 YMCA of Metropolitan of Fort Worth Early Childhood Education $ 35,335.00 YWCA Fort Worth & Tarrant County Child Development Pro ram $ 35.335.00 CDBG Public Service Subtotal $911,943.00 *REACH Resource Center on Project Ramp Inde endent Livin $ 75.000.00 http://apps.cfwnet.org/council�acket/mc review.asp?ID=18629&councildate=8/6/2013 8/21/2013 M&C Review Page 5 of 6 � $ 986,943.00 ( grams budget. Housinq O�portunities For Persons With AIDS: Table 2- HOPWA A encies Or anization Pro ram Amount Tarrant County Samaritan Housing, Inc. Administration (three percent) and Supportive Services $ 261,611.35 AIDS Outreach Center, Inc. Administration (three percent), Supportive Services, Tenant Based Rental Assistance (TBRA), and Short Term Rent Mortgage and Utility Assistance (STRMU) $ 622,694.00 TOTAL HOPWA Contracts $ 884,305.35 Emergency Solutions Grant: Table 3- ESG A encies Or anization Pro ram Amount SafeHaven of Tarrant Count Shelter Services $ 85,065.00 Presb terian Ni ht Shelter Shelter Services $ 85,065.00 Day Resource Center for the Shelter Services Homeless $ 85,065.00 The Salvation Army, a Georgia Cor oration Homelessness Prevention/Ra id Re-Housin $ 43,136.00 CFW Parks and Community Services Homelessness Prevention/Ra id Re-Housin $ 63,015.62 Catholic Charities of Fort Worth Homelessness Prevention/Ra id Re-Housin $ 32,079.00 TOTAL ESG Contracts $ 393,425.62 I hese programs are available in ALL GUUNGIL UIS I KIG I 5. FISCAL INFORMATION/CERTIFICATION: The Financial Management Services Director certifies that upon approval of the above recommendations, adoption of the attached appropriation ordinance and receipt of grant funds, funds will be available in the current operating budget, as appropriated, of the Grants Fund. TO Fund/Account/Centers GR76 451727 017206650XXX �,.� •. �� GR76 5XXXXX 017206650XXX $6,079,622.00 GR76 451727 017206653XXX GR76 5XXX)CX 017206653XXX GR76 451727 017206654XXX GR76 5XXXXX 017206654XXX GR76._451685 017206650XXX GR76 5X�CXX 017206650XXX �425 325.00 $425.325.00 $911.655.00 $911.655.00 $50.000.00 $50,000.00 FROM Fund/Account/Centers http://apps.cfwnet.org/council�acket/mc review.asp?ID=18629&councildate=8/6/2013 8/21/2013 M&C Review GR76 451685 0172060651XXX GR76 5XXX)(X 017206651XXX GR76 451727 017206651XXX GR76 5XXXXX 017206651XXX $250,000.00 250.000.00 �1 996,541.00 $1,996.541.00 Submitted for City Manager's Office bv: Originating Department Head: Additional Information Contact: Fernando Costa (6122) Cynthia Garcia (8187) Robert Sturns (8003) Leticia Rodriguez (7319) ATTACHMENTS 17HUDACTPLANPY13-14 A013 VG(1 �.doc 2013-18ConPlanMemo HED6.4.13CG.pdf ActionPlan 2013-14 funding recommendations.pdf List of Selected Street for Action Plan 2013.�df http://apps.cfwnet.org/council�acket/mc review.asp?ID=18629&councildate=8/6/2013 Page 6 of 6 8/21/2013