HomeMy WebLinkAboutContract 30239 ' CITY SECRETARY
STATE OF TEXAS § CONTRACT INO . 3--ffl
COUNTY OF TARRANT § - -
THIS contract is made and entered into by and between the City of Fort Worth ("City"), acting and
through Charles Boswell, its duly authorized Assistant City Manager, and YWCA of Fort Worth and
Tarrant County ("Contractor"), by and through, Ms. Judi Bishop, its duly authorized agent, Contractor's
business address is, 512 West 4th Street, Fort Worth, TX 76102.
WHEREAS,the City of Fort Worth has been notified that it will receive grant monies from the United
States Department of Housing and Urban Development ("HUD") through the Emergency Shelter Grant
("ESG") contained in Title IV of Stewart B. McKinney Homeless Assistance Act (PL 100-77) for Year
2003-2004; and,
WHEREAS, the Catalog of Federal Domestic Assistance (CFDA) assigned Emergency Shelter
Grant/Entitlement Grants number 14.231; and
WHEREAS,the purposes of the ESG are to provide for the benefit of homeless citizens of Fort Worth;
and,for the rehabilitation or conversion of buildings for use as emergency shelter for the homeless,for the
payment of certain operating and social service expenses in connection with emergency shelter for the
homeless, and for homeless prevention activities.The Emergency Shelter Grants program authorized by the
Homeless Housing Act of 1986 is contained in 24 CFR Part 575.
WHEREAS, the citizens of Fort Worth and the City Council of Fort Worth have determined that
homeless assistance services are needed in Fort Worth;
NOW, THEREFORE, THIS AGREEMENT FURTHER WITNESSETH:
THAT, the parties covenant and agree as follows:
1. Scope of Services
a. Contractor will administer services to citizens of the City of Fort Worth under the program name My
Own Place ("Program"), for the term June 1, 2004 to May 31, 2005.
b. Contractor will provide the services and activities delineated in Exhibit A, Program Summary in
accordance with Exhibit B, Program Services Schedule.
c. City will monitor the performance of the Contractor against the goals and performance standards
required herein. Substandard performance as determined by City will constitute non-compliance with
this Agreement. If action to correct such substandard performance is not taken by Contractor within a
reasonable period of time after being notified in writing by City, contract suspension or termination
procedures will be initiated.
2. Funds -Disbursement
City will disburse ESG Year 2003-2004 monies in an amount up to $19,794 to Contractor on a
reimbursement of expenses basis.
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xxX ESGCNT June 30,2004 1
3. Funds -Requirements
a. Payments will be processed by City following receipt from Contractor ofAttachment I, Sub-Grantees
Request For Funds and applicable supporting documents described in paragraph 5.Reimbursement for
the payment of eligible expenses shall be made against the line item budget specified in Exhibit C,
Program Operating Budget.
b. Contractor must provide the matching funds specified in Exhibit C in accordance with 24 CFR Ch.
V, §576.51.
c. Contractor agrees to utilize all disbursed ESG funds for the benefit of the Program.Contractor agrees
that funds will be expended in accordance with the Program Operating Budget. Contractor may not
increase or decrease line-item amounts in the approved ESG Program Operating Budget without prior
written approval by the City.
d. It is understood that the total cost for operation of this program is$247,455 and that Contractor will
obtain the remaining funds in excess of the ESG amount as detailed in the Program Operating Budget.
Contractor will notify City promptly of any additional funding it receives for operation of the Program,
and City reserves the right to amend the Program Operating Budget in such instances.
e. Contractor agrees to keep all ESG monies on hand in interest bearing accounts. All interest earned
shall be reported to City on a monthly basis, at the same time as submission of the monthly report
following the end of the contract month during which the interest was earned. Interest in an amount of
$25.00 or less per month may be used for authorized program expenses. These amounts must be
reported on the monthly financial statements filed pursuant to this contract.Interest earned in excess of
$25.00 per month is subject to remittance to City as directed by City.
f. Contractor will not commingle ESG monies with any other funds in any manner which would
prevent City from readily identifying program expenditures for operation of the Program.
g. Contractor agrees that all program income from operation of the Program in proportion to the
amount of ESG funds received hereunder will be expended prior to expending ESG monies and that any
such program income is subject to the terms of this contract. ESG monies may be expended by the
Contractor only if program income is insufficient to meet all eligible program activity expenses.
Contractor agrees to return to City at the end of the Contract any remaining program income earned
from operation of the Program in proportion to the amount of ESG funds in the overall operating
budget.
h. The Contractor shall comply with City policy concerning the purchase of equipment and shall
maintain inventory records of all non-expendable personal property,as defined by such policy,procured
with funds provided herein. The Contractor shall procure all materials, property, or services in
accordance with the requirements of OMB circular A-110, Procurement Standards.
4. Uniform Administrative Requirements and Program Management Standards
a. Financial Management
i. Accounting Standards
The Contractor agrees to comply with OMB Circular A-110 and agrees to adhere to the accounting
principles and procedures required therein,utilize adequate internal controls,and maintain necessary
source documentation for all costs incurred.
ii. Cost Principles
Contractor shall administer the Program in conformance with OMB Circular A-122, "Cost
Principles for Non-Profit Organizations"and attachments and revisions thereto,regarding principles
for determining costs for the Program.
XXX ESGCNT July 13,2004 2 [RON
b. Documentation and Record Keeping
i. Contractor shall maintain all records pertinent to the activities to be funded under this Agreement
as required by HUD regulations specified in 24 CFR § 576.65 for four(4)years following the date
of termination of this contract. Contractor may destroy Program records at the end of this four(4)
year period if no outstanding audit finding exists. In addition, Contractor agrees to keep records to
fully document all expenditures charged to the ESG program.The documentation must support the
amounts charged to Program and demonstrate that the expenditures were appropriate to the stated
goals of the Program and allowable under applicable federal, state and City guidelines.
ii. Close Outs
The Contractor's obligation to City shall not end until all close-out requirements are completed.
Activities during this close-out period shall include,but are not limited to: making final payments,
disposing of program assets(including the return of all unused materials, equipment,unspent cash
advances, program income balances, and accounts receivable to City), and determining the
custodianship of records.
iii. Audits and Inspections
(1) City, HUD, and the United States Comptroller General, or their representatives, shall have
access to any books, documents,records and papers relating to the operations of Contractor under
this Agreement for the purpose of audit,examination,exception and transcription at all reasonable
hours at all offices of Contractor.
(2) For all contracts in which Contractor is cumulatively receiving federal monies in the amount of
$300,000 or more, Contractor must submit to City an annual audit prepared in accordance with 24
CFR Sections § 570.502-570.503 generally, with specific reference to OMB Circulars (with
attachments)A-122 and A-133 as appropriate. The audit may cover either Contractor's fiscal year
during which this contract is in force or cover the period of this contract.The audit must be prepared
by an independent certified public accountant,be completed within twelve (12)months following
the end of the period being audited and be submitted to City within thirty (30) days of its
completion. Contractor's audit schedule is attached hereto as Exhibit D -Audit Schedule. Costs of
preparation of this audit may be an allowable expenditure of ESG funds in an amount proportional
to that of the ESG funds used in contractor's total agency operating budget.
(3) City reserves the right to perform an audit of Contractor's program operations and finances at
any time during the term of this contract, if City determines that such audit is necessary for City's
compliance with OMB Circular A-128. City will perform six(6)month and year-end financial and
programmatic audits with periodic site visits as appropriate. Contractor agrees to allow access to all
pertinent materials. If such audit reveals a questioned practice or expenditure, such questions must
be resolved within fifteen(15) days after notice to Contractor. If questions are not resolved within
this period, City reserves the right to withhold further funding under this and/or future contract(s).
(4) If, as a result of any audit, it is determined that Contractor has misused, misapplied or
misappropriated all or any part of the grant funds described herein, Contractor agrees to reimburse
the City the amount of such monies so misused,misapplied or misappropriated,plus the amount of
any sanction,penalty or other charge levied against City because of such misuse,misapplication or
misappropriation.
5. Reporting Procedures
a.Financial Reports
Contractor will submit to City on a monthly basis: (1)Attachment H,Detailed Statement of Costs; and
(2)Attachment Ell,Expenditures Worksheet Report,as applicable,for expenses incurred for services and
activities accomplished by Contractor in performance of this Contract. The reports must be signed by a
XXX ESGCNT June 30,2004 3
duly authorized agent of Contractor and submitted by the 15th of the month following the month being
reported.The City is under no obligation to authorize payments for expenditures which occurred prior to
the first day of the month for which the report is submitted.
b. Performance Reports
Contractor will submit to City on a monthly basis: (1) Attachment IV and (2) Attachment IV(A),
Program Services Report to City for services and activities accomplished by Contractor in performance
of this contract. The report will be signed by a duly authorized agent of Contractor and submitted by the
15th of the month following the month which is reported.
6. Reversion of Assets
a. Contractor agrees to return to City any ESG funds remaining on hand at the end of the Contract.
b. All property purchased with ESG funds under this contract will be used solely for operation of the
Program. Contractor agrees to obtain City approval prior to purchase of property. Contractor agrees to
notify City upon receipt of property so that it may be properly tagged and inventoried. Title to such
property will be vested with the City,and, at the termination of the Program for which ESG funds have
been received, Contractor will deliver all such property to City for disposition at City's sole discretion.
7. Applicable Laws
a. Federal
Contractor agrees to comply with the following laws and the regulations issued thereunder as they are
currently written or are hereafter amended during performance of this contract:
• Title VI of the Civil Rights Act of 1964 (42 USC 2000d et seq)
• Title VIII of the Civil Rights Act of 1968 (42 USC 3601 et seq)
• Executive Orders 11063, 11246, as amended by 11375 and as supplemented by Department of
Labor regulations (41 CFR, Part 60)
• The Age Discrimination Act of 1975 (42 USC 6101-07 and implementing regulations at 24
CFR part 146
• Section 504 of the Rehabilitation Act of 1973 (29 USC 794)
• The Immigration Reform and Control Act of 1986(Pub.L.99-603, 100 Stat.3359,as amended),
specifically including the provisions requiring employer verification of the legal status of its
employees
• The Housing and Community Development Act of 1987 (Pub. L. 100-242, 101 Stat. 1815, as
amended)
• The Americans with Disabilities Act of 1990 (42 USC 12101 et seq)
• The Drug Free Workplace Act of 1988 (24 CFR part 23, subpart F)
• The Fair Housing Act (42 use 3601-20 and implementing regulations at 24 CFR part 100
• Section 3 of the Housing and Urban Development Act of 1968 (12 USC 1701) and the
regulations in 24 CFR part 135
• Executive Orders 11625, 12432, 12138, and 12372
b. Other Laws
Contractor covenants and agrees that its officers,members,agents,employees,program participants and
subcontractors shall abide by and comply with all other laws, federal, state and local, relevant to the
performance of this contract, including all ordinances, rules and regulations oe City of Fort Worth
and the Housing and Community Development Act of 1974 (Pub. L. 9343, 885 Stat.-633;), as
amended,and all regulations pertaining thereto. Contractor further promises and agrees that it has read,
XXX ESGCNT June 30,2004 4
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and is familiar with, terms and conditions of the Emergency Shelter Grant under which funds are
granted and that it will fully comply with same. It is agreed and understood that, if City calls the
attention of Contractor to any such violation on the part of Contractor or any of its officers, members,
agents, employees, program participants or subcontractors, then Contractor shall immediately desist
from and correct such violation.
8. Nondiscrimination
a. Contractor,in the execution,performance or attempted performance of this contract and agreement,
will not unlawfully discriminate against any person or persons because of sex, race, religion, age,
disability,color or national origin,nor will Contractor permit its officers,members,agents,employees,
subcontractors or program participants to engage in such discrimination.
b. In accordance with the policy of the Executive Branch of the federal government, Contractor
covenants that neither it nor any of its officers, members, agents, employees, program participants or
subcontractors, while engaged in performing this contract, shall, in connection with the employment,
advancement or discharge of employees or in connection with the terms,conditions or privileges of their
employment, discriminate against persons because of their age except on the basis of bona fide
occupational qualification, retirement plan or statutory requirement.
c. Contractor further covenants that neither it nor its officers, members, agents, employees,
subcontractors,program participants,or persons acting on their behalf, shall specify,in solicitations or
advertisements for employees to work on this contract, a maximum age limit for such employment
unless the specified maximum age limit is based upon a bona fide occupational qualification,retirement
plan or statutory requirement.
d. In accordance with the provisions of the Americans with Disabilities Act of 1990 ("ADA"),
Contractor warrants that it and any and all of its subcontractors will not unlawfully discriminate on the
basis of disability in the provision of services to the general public,nor in the availability,terms and/or
conditions of employment for applicants for employment with Contractor,or employees of Contractor
or any of its subcontractors. Contractor warrants it will fully comply with ADA's provisions and any
other applicable federal, state and local laws concerning disability and will defend,indemnify and hold
City harmless against any claims or allegations asserted by third parties or subcontractors against City
arising out of Contractor's and/or its subcontractors'alleged failure to comply with the above-referenced
laws concerning disability discrimination in the performance of this agreement.
e. This agreement is made and entered into with reference specifically to the ordinances codified at
Chapter 17,Article III,Division 3 ("Discrimination in Employment Practices"),of the City Code of the
City of Fort Worth,and Contractor hereby covenants and agrees that Contractor, its officers,members,
agents, employees and subcontractors, have fully complied with all provisions of same and that no
employee, employee-applicant or program participant has been discriminated against by the terms of
such ordinances by either the Contractor or its officers,members, agents, employees or subcontractors.
9. Prohibition Against Interest
a. No member,officer or employee of City or its designees or agents;no member of the governing body
of the locality in which the Program is situated; and no other public official of such locality or localities,
who exercises any functions or responsibilities with respect to the Program funded hereunder during his
or her tenure or for one year thereafter, shall have any interest, direct or indirect, in any contract or
subcontract,or the proceeds thereof,for work to be performed hereunder. Contractor shall incorporate,
or cause to be incorporated, like language prohibiting such interest in all contracts and fubcontracts
hereunder. +
XXX ESGCNT June 30,2004 5
b. No member,officer, employee,or program participant of Contractor or its subcontractors shall have a
financial interest,direct or indirect,in this contract or the monies transferred hereunder or be financially
interested, directly or indirectly, in the sale to Contractor of any land, materials, supplies or services
purchased with any funds transferred hereunder,except on behalf of Contractor,as an officer,employee,
member or program participant. Any willful violation of this paragraph with the knowledge,expressed
or implied, of Contractor or its subcontractors shall render this contract voidable by the City of Fort
Worth.
10. Minority and Women Business Enterprise Commitment
Contractor agrees to abide by the City of Fort Worth's policy to involve Minority and Women Business
Enterprises(M/WBE)in all phases its procurement practices and to provide them an equal opportunity
to compete for contracts for construction,provision of professional services,purchase of equipment and
supplies and provision of other services required by City. Therefore, Contractor agrees to incorporate
City Ordinance No. 11923,and all amendments or successor policies thereto,into all contracts and will
further require all persons or entities with whom it contracts to comply with said Policy.
11. Non-Assignment
Contractor will not assign any or all of its rights or responsibilities under this contract without the prior
written approval of City. Any purported assignment without such approval will be a breach of this
contract and void in all respects.
12. Independent Contractor
a. Contractor shall operate hereunder as an independent contractor and not as an officer,agent,servant
or employee of City. Contractor shall have exclusive control of, and the exclusive right to control,the
details of the work and services performed hereunder, and all persons performing same, and shall be
solely responsible for the acts and omissions of its officers, members, agents, servants, employees,
subcontractors,program participants,licensees or invitee. The doctrine of respondeat superior shall not
apply as between City and Contractor, its officers, members, agents, servants, employees,
subcontractors, program participants, licensees or invitees, and nothing herein shall be construed as
creating a partnership or joint enterprise between City and Contractor. It is expressly understood and
agreed that no officer,member, agent,employee,subcontractor,licensee or invitee of the Contractor,nor
any program participant hereunder, is in the paid service of City and that City does not have the legal
right to control the details of the tasks performed hereunder by Contractor,its officers,members,agents,
employees, subcontractors,program participants, licensees or invitees.
b. City shall in no way nor under any circumstances be responsible for any property belonging to
Contractor,its officers,members, agents,employees, subcontractors,program participants,licensees or
invitees, which may be lost, stolen, destroyed or in any way damaged; and Contractor hereby
indemnifies and holds harmless City and its officers,agents,and employees from and against any and all
claims or suits.
13. Insurance and Bonding
a. Contractor covenants and agrees to indemnify, hold harmless and defend, at its own expense, City
and its officers,agents, servants and employees from and against any and all claims or suits for property
loss or damage and/or personal injury, including death, to any and all persons; of whatsoever kind or
character, whether real or asserted, arising out of or in connection with the execution, performance,
XXX ESGCNT June 30,2004 6
attempted performance or nonperformance of this contract and agreement and/or the operations,
activities and services of the Program described'herein,whether or not caused, in whole or in part,by
alleged negligence of officers, agents, servants, employees, contractors or subcontractors of City; and
Contractor hereby assumes all liability and responsibility of City and its officers, agents, servants,and
employees for any and all claims or suits for property loss or damage and/or personal injury,including
death,to any and all persons,of whatsoever kinds or character,whether real or asserted,arising out of or
in connection with the execution, performance, attempted performance or non-performance of this
contract and agreement and/or the operations, activities and services of the programs described herein,
whether or not caused in whole or in part,by alleged negligence of officers,agents,servants,employees,
contractors or subcontractors of City. Contractor likewise covenants and agrees to and does hereby
indemnify and hold harmless City from and against any and all injury,damage or destruction of property
of City, arising out or in connection with all acts or omissions of Contractor, its officers, members,
agents,employees, subcontractors,invitees, licensees,or program participants,or caused,in whole or in
part, by alleged negligence of officers, agents, servants, employees, contractors or subcontractors of
City.
b. Contractor will maintain a blanket fidelity coverage in the form of a bond in the amount of$19,794,
to insure against loss from the fraud,theft or dishonesty of any of Contractor's officers, agents,trustees,
directors or employees. The proceeds of such bond shall be used to reimburse City for any and all loss
of ESG monies occasioned by such misconduct. To effectuate such reimbursement, such bond shall
include a rider stating that reimbursement for any loss or losses thereunder shall be made directly to City
for the uses and benefit of Contractor.
c. Contractor shall furnish certificates of insurance as proof that it has secured and paid for policies of
workers'compensation,public liability and automobile liability insurance covering all risks incident to
or in connection with the execution, performance, attempted performance or nonperformance of this
contract and agreement. The amounts of such insurance shall not be less than the maximum liability
which can be imposed on City under the laws of the State of Texas. Contractor understands and agrees
that such insurance amounts may be revised upward at City's option and that Contractor shall revise
such amounts within thirty(30) days following notice to Contractor of such requirements.
d. Contractor will submit documentation to City that it has obtained insurance coverage and has
executed bonds as required in this contract within thirty(30)days of the execution of this contract and
prior to payment of any monies hereunder.
14. Waiver of Immunity
If Contractor, as a charitable or nonprofit organization, has or claims an immunity or exemption
(statutory or otherwise) from and against liability for damages or injury, including death,to persons or
property; Contractor hereby expressly waives its rights to plead defensively such immunity or
exemption as against City. This section shall not be construed to affect a governmental entity's
immunities under constitutional, statutory or common law.
15. Termination
a. In addition to,and not in substitution for,other provisions of this Agreement regarding the provision
of public services with ESG funds,pursuant to Title I of the Housing and Community Development Act
of 1974, as amended,it is expressly understood and agreed by and between the parties hereto that this
agreement is wholly conditioned upon the actual receipt by City of Federal ESG Year 2003-2004 funds;
that all monies distributed to Contractor hereunder shall be exclusively from Federal monies received
under said grant and not from any monies of City; and that if such funds under said grant are not timely
forthcoming,in whole or in part, City may, at its sole discretion,terminate this contract and agreement
XXX ESGCNT June 30,2004 7
and City shall not be liable for payment for any work or services performed by Contractor under or in
connection with this contract.
b. City may terminate this contract whenever such termination is determined to be in the best interest of
City,in event of Contractor's default,inability or failure to perform or to comply with any of the terms
herein, or for other good cause.
c. The parties acknowledge that ESG funds paid hereunder are intended to provide only partial funding
for Contractor's program operations. If non-ESG funds included in the Operating Budget are not
forthcoming to Contractor during the contract term, City may terminate this contract.
d. ESG funds provided hereunder may not be used as collateral for loans to Contractor to defray
program operation expenses, and any attempted use of ESG funds for this purpose will result in
termination of this contract by City.
e. Termination will be effected by written notice to Contractor, specifying the portions of the contract
affected and the effective date of termination. Upon Contractor's receipt of such termination notice,
Contractor will:
• Stop work under the contract on the date and to the extent specified by City;
• Cease expenditures of ESG monies, except as necessary for completion of the portions of the
contract not terminated; and
• Terminate all orders and contracts to the extent that they relate to terminated portions of the
contract.
f. Contractor will return to City any unused monies previously advanced by City under this contract
within thirty(30) days of the effective date of contract termination. City will have no responsibility or
liability for Contractor's expenditures or actions occurring after the effective date of contract
termination.
16. Certification Regarding Lobbying
a. The undersigned representative of Contractor hereby certifies,to the best of his or her knowledge and
belief,that: No federal appropriated funds have been paid or will be paid,by or on behalf of Contractor,
to any person for influencing or attempting to influence an officer or employee of any agency,a member
of Congress,an officer or employee of Congress or an employee of a member of Congress in connection
with the awarding of any federal contract, the making of any federal grant, the making of any federal
loan, the entering into of any cooperative agreement and the extension, continuation, renewal,
amendment, or modification of any federal contract,grant, loan or cooperative agreement. Contractor
shall require that the language of this certification be included in all subcontracts or agreements
involving the expenditure of federal funds.
b. If any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of Congress,an
officer or employee of Congress, or an employee of a member of Congress in connection with this
federal contract, grant, loan or cooperative agreement, Contractor shall complete and submit Standard
Form-LLL, Disclosure Form to Report Lobbying," in accordance with its instructions.
17. Miscellaneous Provisions
a. All terms of this contract shall apply to any and all subcontractors of Contractor who are in any way
paid with ESG funds or who perform any work in connection with Contractor's program.
b. The provisions of this agreement are severable,and,if for any reason a clause, pentence,paragraph or
other part of this agreement shall be determined to be invalid by a court or feder or state agency,board
or commission having jurisdiction over the subject matter thereof,such invalidi shall not affect other
provisions which can be given effect without the invalid provision.
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XXX ESGCNT June 30,2004 8
c. The failure of the City to insist upon the performance of any term or provision of this agreement or to
exercise any right herein conferred shall not be construed as a waiver or relinquishment to any extent of
City's right to assert or rely upon any such term or right on any future occasion.
d. Should any action, whether real or asserted, at law or in equity, arise out of the execution,
performance,attempted performance or nonperformance of this contract and agreement,venue for said
action shall lie in Tarrant County, Texas.
e. This written instrument and the exhibits attached hereto, which are incorporated by reference and
made a part of this contract for all purposes,constitute the entire agreement between the parties hereto
concerning the work and services to be performed hereunder, and any prior or contemporaneous,oral or
written agreement which purports to vary from the terms hereof shall be void. Any amendments to the
terms of this contract must be in writing and must be approved by each party to this contract.
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XXX ESGCNT June 30,2004 9
IN WITNESS WHEREOF, the parties-hereto have executed three (3) copies of this co tract in Fort
Worth, Tarrant County, Texas, this_ate day of ,A.D. 20 .
CITY OF FORT WORTH YWCA of Fort Worth and Tarrant County
Z I "'I All
By: y:
Charles R. Boswell Ms. Judi Bishop
Assistant City Manager Executive Director
PROVED AS TO FORM AND LEGALITY:
dtyAitomey
Date
ATTEST:
11117CitAAecretary
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Con ract A thorizatiola
Da$L*
XXX ESGCNT July 1,2004 10
STATE OF TEXAS §
COUNTY OF TARRANT §
BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day
personally appeared Charles Boswell, known to me to be the person whose name is subscribed to the
foregoing instrument,and acknowledged to me that the same was the act of the City of Fort Worth and that
he executed the same as the act of said City of Fort Worth for the purposes and consideration therein
expressed and in the capacity therein stated.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of ,A.D. 20 .
ZPPY P B• ROSELLA BARNES
NOTARY PUBLIC
State of Texas Notary Public in and for
•tilF pF 5�;.''Comm. Exp.03-31-2005 the State of Texas
STATE OF TEXAS §
COUNTY OF TARRANT §
BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day
personally appeared Ms. Judi Bishop, known to me to be the person whose name is subscribed to the
foregoing instrument, and acknowledged to me that he\she executed the same for the purposes and
consideration therein expressed, as the act and deed for YWCA of Fort Worth and Tarrant County and in
the capacity therein stated as its duly authorized officer or representative.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of A.D. 20
Cl11rT0N SPRUILLof Pu in an or
NOTAInMRICl�A1EOFT!>w �'
COMMISSION EXPIRES: the St a of Texas
F`.`} SEPTEM!!ER 7,20M
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XXX ESGCNT June 30,2004
EXHIBIT A
PROGRAM SUMMARY
YWCA of Fort Worth and Tarrant County
AGENCY
My Own Place
PROGRAM
00000 June 1, 2004-May 31, 2005 $19,794
CONTRACT NO. PERIOD AMOUNT
PROGRAM DESCRIPTION
Funds allocated by the City will be used to reimburse a portion of the costs of essential services
incurred by the My Own Place Program. The program is designed to assist young women who are
aging out of foster care reach self-sufficiency. ESG funds are used to pay for the Mentor Coordinator's
position.
COUNCIL DISTRICT (S)
2/8
PROGRAM GOALS
To prevent homelessness by increasing the self-sufficiency of young women exiting the foster care system.
PROGRAM OBJECTIVES
For 65% of the participants to reach their program goals. For 90% of the participants who reach their
program goals have the resources needed to be self-sufficient.
PROGRAM SERVICES and ACTIVITIES GOALS
Number of unduplicated clients served 33
Nights of housing provided 5445
Hours of counseling provided 96
Hours of mentoring provided 408
Hours of case management provided 1440
EXHIBIT B
PROGRAM SERVICE SCHEDULE
YWCA of Fort Worth and Tarrant County
AGENCY
My Own Place
PROGRAM
Activity JunJuly AugSet OctNov ec anFeb Mar r a Total
Number of clients served 3 3 3 3 3 3 3 3 3 2 2 2 33
Nights of housingprovided 450 465 450 465 450 465 420 465 420 420 465 420 5445
ours of counselingprovided 8 8 8 8 8 8 8 8 1 8 8 8 8 96
Hours of mentoring provided 34 34 34 34 34 34 34 34 334 34 34 34 408
Hours of case management
provided 120 120 120 120 120 120 120 120 120 1 120 120 120 1440
EXHIBIT "D"
AUDIT SCHEDULE
INDEPENDENT AUDIT REQUIREMENT
BUSINESS/AGENCY NAME: YWCA of Fort Worth and Tarrant County
PROGRAM: My Own Place
ESG YEAR: XXX
AMOUNT FUNDED: $19,794
Name of Independent Auditor who will perform agency audit:
Independent Auditor to be contracted during ESG contract period.
Date audit is to be performed:
Within 60 days of completion of ESG funded project.
The following language is a condition of your contract with the City:
(1) For all contracts in which Contractor is cumulatively receiving federal
monies in the amount of$300,000 or more, Contractor must submit to City an
annual audit prepared in accordance with 24 CFR Sections § 570.502-570.503
generally, with specific reference to OMB Circulars (with attachments) A-122
and A-133 as appropriate. The audit may cover either Contractor's fiscal year
during which this contract is in force or cover the period of this contract. The
audit must be prepared by an independent certified public accountant, be
completed within twelve (12) months following the end of the period being
audited and be submitted to City within thirty (30) days of its completion.
Contractor's audit schedule is attached hereto as Exhibit D - Audit Schedule.
Costs of preparation of this audit may be an allowable expenditure of ESG
funds in an amount proportional to that of the ESG funds used in contractor's
total agency operating budget.
This form is to be completed and submitted to the Intergovernmental Affairs and Grants
Management Division at the beginning of each contract year.
Signature
PROGRAM BUDGET EXHIBIT C
ESG
2004-2005 Page 1 of 3
CONTRACT PERIOD From: 6!1/2004 To: 5/31!2005
Name of Sub Grantee Name of Program
YWCA of Fort Worth and Tarrant County My Own Place
Program ESG
Cost Category Budget Funds [a] [b] [c] [d]
ESSENTIAL SERVICES
Salaries 102,550 19,794 21,826 60,930 -
FICA 8,200 8,200 -
Life Insurance - - - -
Health Insurance 5,125 5,125 - -
Employment Tax-State -
Worker's Comp 1,580 1,580 -
Retirement 3,880 3,880 -
OPEARATIONS AND MAINTENANCE
Food Supplies 1,000 1,000 -
Telephone 1,275 - 1,275 -
Electric 18,175 18,175
Gas[Utilities] 1,000 1,000
Water/Waste Disposal - -
Building Lease - -
Custodial Services -
Office Equipment Rental 940 940
Printing 200 200 -
Repairs 3,100 2,695 405
Fidelity Bond 150 150
Liability Insurance 1,680 1,680
Professional Services 900 900
Legal&Accounting 1,215 1,215
Auto Allowance 700 700
Advertising 300 300
Conferences&Seminars 500 500
Contractual Services
Other- 94,985 14,061 80,924
Other Matching Funds -
CAPITAL OUTLAY
Furniture, Fixtures - - - - -
Office Equipment,Computer - - - -
Other Equipment - - - - -
TOTALI 247,455 19,794 21,826T 105,000 19,911 80,924
MATCHING FUND SOURCES
[a] Special Events
[b] Government
[c] United Way
[d] Fund Raising
Other"Post PAL$45335;Admin$26962;misc.$22688
BUDGET DETAIL Page 2 of 3
ESSENTIAL SERVICES -SALARIES
Hourly Annual % % Charged
Position/Title Rate Hours Match To ESG Amount
1 Services Coordinator 9.52 2080 100.0% 100% 19,794
2 (Case Manager)
3
4 -
5 -
6 -
7 -
8 -
9 -
10 -
TOTAL STAFF SALARIES 19,794
FRINGE BENEFITS
% Of % % Paid
CATEGORY Payroll Amount Match by ESG Amount
FICA 7.65% - 0 0% -
Life Insurance 0.0% - 0 0% -
Health Insurance 0.00% - 0 0% -
Employment Tax-State 0.00% - 0 0% -
Employment Tax-Federal 0.00% - 0 0% -
Worker's Comp 0.00% - 0 0% -
Retirement 0.00% - 0 0% -
TOTAL FRINGE BENEFITS -
TOTAL PERSONAL SERVICES 19,794
BUDGET DETAIL Page 3 of 3
UTILITIES
Average Cost Number of
Category Per Month Months Amount
Telephone 0 0 0
Electric 0 0 -
Gas 0 0 -
Water/Waste Disposal 0 0 -
Other: [Specify] 0 0 -
TOTAL UTILITIES 0
BUILDING LEASE
No. Square Cost Per
Building Location Foot Square Foot Amount
1 0 0 -
2 0 0 -
3 0 0 -
TOTAL BUILDING LEASE -
OTHER EXPENSES
Total % Charged
Category Charge To CDBG Amount
Fidelity Bond 0 0.0% -
Liability Insurance 0 0.0% -
Legal &Accounting 0 0.0% -
TOTAL OTHER EXPENSES 0
CONFERENCES &SEMINARS
Total % Charged
Event Charges to CDBG Amount
1 0 0.0% 0
2 0 0.0% 0
3 0 0.0% 0
TOTAL CONFERENCES & SEMINARS 0
OFFICE EQUIPMENT RENTAL
Total % Charged
Item Charge to CDBG Amount
1 0
2 0
3 0
TOTAL OFFICE EQUIPMENT RENTAL 0
CITY OF FORT WORTH Attachment I
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DIVISION
REQUEST FOR FUNDS
AGENCY: PROGRAM:
ADDRESS: CONTRACT NUMBER:
CONTRACT AMOUNT:
CONTRACT DATE:
DATE OF REQUEST:
SECTION I (AGENCY) CURRENT MONTH CUMULATIVE
I. Reimbursement Request
1. Expenditures: $ $
2. Income
A. Program Income $ $
B. City of Fort Worth $ $
C. Interest Earned CDBG Funds $ $
3. Reimbursement(1 minus 2) $ $
II.Advance Pay Requests/Repayment $ $
III. Reporting Interest
1. Interest over$25 per quarter returned to City of Fort Worth $ $
SECTION II (CITY)
I. BYSPEED - Purchasing Request
A.BYSPEED INPUT:VendorlPO Number/Requisition Number:
B. Fund/Account/Center:
C.Total Amount of this Request: $
SECTION III
I. Verification
A. Contract Compliance Specialist
(Name) (Signature) (Date)
B. BYSPEED-Purchasing
(Name) (Signature) (Date)
C. Accounting
(Name) (Signature) (Date)
II.Authorization
A. Agency
(Name) (Signature) (Date)
B. Contract Manager D.Emerson
(Name) (Signature) (Date)
C. Budget Director B. Garrett
(Name) (Signature) (Date)
Distribution:
1 Copy-Accounting
1 Copy-IAGM
1 Copy-Agency
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT ESG ATTACHMENT 2
CONTRACT MANAGEMENT DIVISION
ESG 2004-2005
Agency Period
Contract Numer
engram Date Request
ESG EXPENDITURES MATCHING FUNDS
ACCOUNT PROGRAM MONTHLY CUMULATIVE PROGRAM MONTHLY CUMULATIVE
COST CATEGORY Number BUDGET EXPENDITURES TO DATE Balance BUDGET EXPENDITURES TO DATE Balance
ESSENTIAL SERVICES
Salaries 516 010 - - - -
FICA 518 010
Life Insurance 518 050
Health Insurance 518 060 - - -
Employment Tax-State 518 090 - - - -
Worker's Comp 518 040 -
Retirement 518 070 - - - - - -
OPERATIONS AND MAINTENANCE
Salaries 516 010 - - -
FICA 518 010 - - - -
Life Insurance 518 050 - - - -
Health Insurance 518 060 - - - - - -
Employment Tax-State 518 090 - - - -
Worker's Comp 518 040 - -
Retirement 518 070
Food Supplies 552 030 -
Telephone 535 040
Electric 535 020 -
Gas[Utilities] 535 010
Water I Waste Disposal 535 030 - - - -
Building Lease 537 010 - - - -
Custodial Services 539 220 -
Office Equipment Rental 537 030 - -
Printing 533 030 - - -
Repairs 536 010 - - - - - -
Fidelity Bond 538 210
Liability Insurance 534 020 -
Prfessional Services 531 200
Legal 8 Accountng 538 050 - -
Auto Allowance 532 130 - -
Advertising 533 010 -
Conferences 8 Seminars 531 180 -
Contractual Services 539 120
CAPITAL OUTLAY
Fumiture,Fixtures 541 330 - - -
Office Equipment,Computers 541 370 -
Other Equipment 541 320 - - - -
TOTAL - - - - - -
Contractor Certification: I certify that the costs incurred are taken from the books of account and that such costs are valid and consistent with the terms of the agreement
NAME and TITLE OF AUTHORIZED OFFICER SIGNATURE and DATE
DISTRIBUTION:
1 Copy-Accounting
1 Copy-IAGM
1 Copy-Agency
ATTACHMENT 3
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DIVISION
EXPENDITURES WORKSHEET
Agency Contract Number Date
To
Program Report Period
NO DATE CHECK NO PAYEE DESCRIPTION ACCOUNT NO. AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
TOTAL
TITLE OF AUTHORIZED OFFICER SIGNATURE AND DATE
Distribution:
1 copy-Accounting
1 copy-IAGM
1 copy-Agency
ATTACHMENT 4
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
ESG XXX
1. NAME AND ADDRESS OF SUB-GRANTEE 2. PROJECT NAME:
3. CONTRACT No:
4. DATE OF
REQUEST:
MONTH&YEAR
5. PROGRAM SERVICES AND ACTIVITIES
CURRENT
MONTH CUMUIA=
Residential Services:
Average Number Served Daily Adults:
Children:
Average Number Served Yearly(Unduplicated):
Non-Residential Services:
Average Number Served Daily:
6. RESIDENTIAL SERVICES DATA(Beneficiaries)
Enter Approximate Percentages of:
Unaccompanied 18 and Over Male: % Female:
Unaccompanied under 18 Male: % Female: %
Families With Children Headed By:
Single 18 and Over Male: % Female: %
Youth 18 and Under: Male: % Female: %
Two Parents 18 and Over: 0/0
Two Parents Under 18: %
Families With No Children: %
On An Average Day,Percentage Of The Population Served Who Are:
Battered Spouse: %
Runaway/Throwaway Youth: %
Chronically Mentally Ill: %
Developmentally Disabled: %
HIV/AIDS: %
Alcohol Dependent Individuals: %
Drug Dependent Individuals: %
Elderly: %
Veterans: %
Physically Disabled: %
Other: %
8. CERTIFICATION: The undersigned hereby gives assurance that to the best of my knowledge and belief, the data included in
this report is true and accurate, and if a non-profit agency, has been approved by the governing body of the organization prior to
submission.
Date: Submitted by: Phone Num:
IAGM/April 2002
ATTACHMENT 4
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
ESG XXX
1.NAME AND ADDRESS OF SUB-GRANTEE 2. PROJECT NAME:
3. CONTRACT N0:
4. DATE OF
REQUEST:
MONTH&YEAR
7. HOUSING SERVICES DATA(Data Associated with Residential Services)
Number of
Shelter Type Persons Housed
Barracks:
Group/Large House:
Scattered Site Apartment:
Single Family Detached House:
Single Rom Occupancy:
Mobile Home/Trailer:
Hotel/Motel:
Other:
Total:
8. ESG FUNDING SOURCES
Source of Funds Funding Amount Current Month Cumulative Total
ESG:
Other Federal:
Local Government:
Private:
Fees:
Other:
8. CERTIFICATION: The undersigned hereby gives assurance that to the best of my knowledge and belief, the data included in
this report is true and accurate, and if a non-profit agency, has been approved by the governing body of the organization prior to
submission.
Date: Submitted by: Phone Num:
IAGM/April 2002
ATTACHMENT 5
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
1.Agency/Address 2.Project Name:
3.Contract No: Contract Date:
Contract Amount:
4.Date of Request:
MONTH&YEAR
5. PROGRAM SERVICES AND ACTIVITIES: CURRENT CUMULATIVE
6. SCOPE OF WORK NARRATIVE:
7. PROBLEMS ENCOUNTERED / SOLUTIONS PROPOSED:
8. ANTICIPATED ACTIVITY DURING THE NEXT MONTH:
9. CERTIFICATION: The undersigned hereby gives assurance that to the best of my knowledge and belief,the data included in this report is true
and accurate,and if a non-profit agency,has been approved by the governing body of the organization prior to submission.
Date: Submitted by: Phone Num:
Attachment 6
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CLIENT DATA REPORT
t. Name and Address of Sub-Grantee:
2.Project Name:
3.Contract No:
Contract Amount:
4.Date of Request:
MONTH&YEAR
NAME AGE SEX RACE H/C #FAM INCOME FHOH STREETADDRESS ZIP
B.CERTIFICATION: The undersigned hereby gives assurance that to the best of my knowledge and belief,the data included in this report are true and
accurate,and if a non-profit agency,has been approved by the governing body of the organization prior to submission.
Date: Submitted by: Phone Num:
IAGM/April 2002
Attachment 6
CLIENT DATA REPORT
(CONTINUATION SHEET)
AGENCY PROGRAM CONTRACT#
MONTH&YEAR
NAME AGE SEX RACE HJC #FAM INCOME FHOH STREET ADDRESS ZIP
Page 1 of 3
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 6/8/2004
DATE: Tuesday, June 08, 2004
LOG NAME: 02ACTIVITY REFERENCE NO.: **C-20095
SUBJECT:
Community Development Block Grant Year XXX, Emergency Shelter Grant Year 2004-2005, and
Housing Opportunities for Persons with AIDS 2004-2005 Contract Activities
RECOMMENDATION:
It is recommended that the City Council:
Authorize the City Manager to execute Community Develoment Block Grant (CDBG) Year XXX,
Emergency Shelter Grant (ESG) Year 2004-2005 and Housing Opportunities for Person with AIDS _
(HOPWA) -Year 2004-2005, contracts with the following organizations to administer them respective
programs, contingent upon approval and receipt of adequate funding from the U.S. Department of Housing
and Urban Development (HUD), for a term beginning June 1, 2004, and ending May 31, 2005:
I. Community Development Block Grant (CDBG)
Contract with the listed agencies for an amount not to exceed the following:
Southside Area Ministries (SAM'S Kids) $ 4 ,610
Habitat for Humanity $14,762.00
REACH, Inc. $19,683.00
Centro Cultural de las Americas $27,540.00
Boys and Girls Clubs (NINOS) $19,829.00
Boys and Girls Club(KEYS) $18,266.00
JMAC Yough Center of Tarrant County $25,000.00
East Fort Worth Montessori $22,385.00
Latin Arts Associaton $17,250.00
Summerbridge Fort Worth $27,338.00
CJ's Studio of Perfuming Arts $9,000.00
Women's Center of Tarrant County $27,000.00
YWCA of Fort Worth (AIM) $20,986.00
YWCA of Fort Worth (Child Care) $150,000.00
Child Care Associates $130,000.00
Fort Worth Housing Authority(AMAKA) $30,000.00
YMCA $120,375.00
Clayton Child Care $60,000.00
Southside Area Ministries (Mid South Seniors) $2,570.00
Senior Citizen Services of Tarrant County(COMO) $17,597.00
http://www.cfwnet.orq/council 6/14/2004
Page 3 of 3
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that funds will be available in the current operating budget, as appropriated,
of the Grants Fund contingent upon approval and receipt of adequate funding from the U.S. Department of
Housing and Urban Development (HUD) for the term beginning June 1, 2004, and ending May 31, 2005.
TO Fund/Account/Centers FROM Fund/Account/Centers
GR76 5 $258,092.00
(VARIOUS) XXX206931XXX
GR76 5
(VARIOUS) XXX206932XXX $809,950.00
GR76 5
(VARIOUS) XXX206929XXX $1,216,916.00
Submitted for City Manager's Office by: Charles Boswell (8511)
Originating Department Head: Bridgette Garrett (6183)
Additional Information Contact: Deidra Emerson (7563)
http://www.cfwnet.orq/council_packet/Reports/mc-print.asp 6/14/2004