HomeMy WebLinkAboutContract 48243 ATY SECRETARYG ;
CONTRACT Ni®.
AGREEMENT FOR COMMUNITY BASED PROGRAM
yThe Women's Center of Tarrant County,Inc
FISCAL YEAR 2017
In consideration of the mutual covenants, promises and agreements contained herein, THIS
AGREEMENT ("Agreement") is made and entered into between CITY OF FORT WORTH, a
home rule municipal corporation of the State of Texas, ("City") acting by and through Valerie R.
Washington, its duly authorized Assistant City Manager, and The Women's Center of Tarrant
County, Inc., a Texas private non-profit corporation ("Contractor") acting by and through Laura
Hilgart,President/Chief Executive Officer,its duly authorized representative.
RECITALS
WHEREAS, City has determined that Community-Based Programs are necessary to
support crime prevention in City during Fiscal Year 2017 to meet one or more of the Crime
Control and Prevention District ("CCPD') goals, which are (1) to support efforts to reduce
violent crime and gang-related activities through enhanced enforcement activities and crime
prevention programs, (2) to support efforts to increase the safety of residents and to decrease
crime throughout Fort Worth neighborhoods, and (3) to support efforts to increase the safety of
youth and reduce juvenile crime through crime prevention and intervention programs; and
WHEREAS, Contractor has agreed to operate a Community-Based Program called Play
it Safe! Child Sexual Abuse Prevention Program, which will support the police department's
crime prevention efforts throughout the community; and
WHEREAS, City desires to enter into an agreement with Contractor to operate the Play
it Safe! Child Sexual Abuse Prevention Program; and
WHEREAS, City, as consideration for the performance of Contractor, has appropriated
monies in the CCPD Budget as reimbursed by the CCPD in the amount of$25,000.00 ("Program
Funds") to provide to the Contractor for the operation of the Play it Safe! Child Sexual Abuse
Prevention Program;
NOW, THEREFORE, in consideration of the mutual covenants herein expressed, the
parties agree as follows:
AGREEMENT DOCUMENTS
The Agreement documents shall include the following:
1. This Agreement between City and Contractor
2. Exhibit A—Proposal Abstract and Narrative
3. Exhibit B—Budget
4. Exhibit C—Request for Reimbursement
5. Exhibit D—Program Activities Report
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The Women's Center of Tarrant County,Inc.
6. Exhibit E—Program Effectiveness Measurement Report
7. Exhibit F—Request for Budget Modification
Exhibits A through F,which are attached hereto and incorporated herein, are made a part of this
Agreement for all purposes. In the event of any conflict between the terms and conditions of
Exhibits A through F and the terms and conditions set forth in the body of this Agreement, the
terms and conditions of this Agreement control.
DEFINITIONS
The term"City"shall include City, and its officers, agents, employees, and representatives.
The term"Contractor"shall include Contractor, and its officers,agents, employees,
representatives, servants, contractors, and subcontractors.
The term"Party"shall refer to either City or Contractor.
The term"Parties"shall refer to both City and Contractor.
AGREEMENT
1. Responsibilities of Contractor.
Contractor covenants and agrees to fully perform, or cause to be performed, with good
faith and due diligence, all work and services described in Exhibit "A" — Proposal Narrative.
Contractor shall be responsible for day-to-day administration of Play it Safe! Child Sexual Abuse
Prevention Program. Contractor agrees to expend the Program Funds in accordance with the
Budget as described in Exhibit"B". Program activities shall be reported in accordance with the
Exhibit "D"-Program Activities Report and effectiveness measures shall be reported in
accordance with Exhibit"E"-Program Effectiveness Measures Report.
2. Program Funds.
2.1 In no event shall the total distribution from City made to the Contractor during the term
of this Agreement exceed$25,000.00("Program Funds").
2.2 Payment of the Program Funds from City to Contractor shall be made on a cost-
reimbursement basis following receipt by City from Contractor of a signed Request for
Reimbursement (RFR), as described in Exhibit "C" along with copies of all receipts and other
supporting documentation. Contractor shall deliver to City a written detailed Program Activities
Report and Program Effectiveness Measures Report as described in Section 4.2 below with each
RFR to support expenditure of Program Funds. Such reports shall be signed by the Contractor or
duly authorized officer of the Contractor. The RFR and monthly Program Activities Report shall
be submitted to City no later than the 15th day following the end of the month. Submittal of a
monthly RFR and Program Activities Report is required even if services are not provided.
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The monthly RFR,with an original signature by an authorized representative, must be submitted
to the Grants and Program Management Section of the Fort Worth Police Department,
ATTENTION: Program Support Division,Bob Bolen Public Safety Complex, 505 W. Felix
St., Fort Worth, Texas, 76115. Reimbursements will not be made until after receipt of an
acceptable and approved RFR and a monthly Program Activities Report from the Contractor.
Additionally, a quarterly Program Effectiveness Measurement Report from Contractor is
required as described in section 4.2 and must be approved prior to reimbursements.
Reimbursements shall be made within 30 days receipt of said documents.
2.3 Contractor is authorized to modify up to five (5)percent of any budgeted line-item in the
original approved budget without prior written permission from City. However, Contractor
must submit the Request for Budget Modification Form (Exhibit "F")to City, with the monthly
RFR, during the month the modification took place. The new modified budget cannot exceed the
total amount of Program Funds.
2.4 Any modifications of more than five(5)percent of any budgeted line-item in the original
approved budget must have prior written permission from City before the modifications are
made. The Budget Modification Form (Exhibit "F") must be submitted, and request must be
approved by City, before any money is moved to the line-item. Once the Budget Modification is
approved, the modified budget will take effect on the first day of the following month. The new
modified budget shall not exceed the total amount of Program Funds.
2.5 Any modifications to zero line-items in the original approved budget must have prior
written permission from City before the modifications are made. The Budget Modification Form
(Exhibit"F")must be completed and approved by City before money is transferred into the new
line-item. Once the Budget Modification is approved,the modified budget will take effect on the
first day of the following month. The new modified budget shall not exceed the total amount of
Program Funds.
2.6 Budget modification can only occur within the Direct and Indirect costs. Funds may not
be moved from a Direct line-item into an Indirect line-item, or vise versus. Modification of
Direct and Indirect approved budgets must follow the guidelines outlined in sections 2.3,2.4. and
2.5.
Budget adjustments shall be submitted to the Program Support Division of the Fort Worth
Police Department at Bob Bolen Public Safety Complex at 505 W. Felix St., Fort Worth,
Texas, 76115.
3. Term. This Agreement shall commence upon October 1, 2016 ("Effective Date"), and
shall end on September 30, 2017 ("End Date"). All of Contractor's expenditures under this
Agreement must be completed no later than September 30,2017.
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4. Program Performance.
4.1 Contractor agrees to maintain full documentation supporting the performance of the work
and fulfillment of the objectives set forth in Exhibit"A."
4.2 Contractor agrees to provide a monthly Program Activities Report and quarterly Program
Effectiveness Measurement Report to document the performance of the work described in
Exhibit "D" and Exhibit`B," respectively. The Program Activities and Effectiveness Measures
shall document the program activity names, numbers of participants attending, details of the
activities, and a description of the goals achieved in support of the CCPD goals. Program
Effectiveness Measures shall be reported on a quarterly basis and included in the January,April,
July, and October RFR and Program Activities Report submittals. Additionally, the Program
Effectiveness Measurement Report must include descriptions of any realized successes. The
monthly Program Activities and quarterly Program Effectiveness Measurement Reports shall be
submitted to City no later than the 15th day after the end of each month.
4.3 Contractor agrees that the monthly Request for Reimbursement and Program Activities
Report and quarterly Program Effectiveness Measurement Report will be submitted to City no
later than the 15th day after the end of each month. Should Contractor not meet these
requirements, Contractor will be given an additional 15 days to submit the required reports to
City. If, at the end of this 15-day extension period, Contractor has not submitted the required
reports, City will send a non-compliance letter notifying Contractor's duly authorized
representative of a possible suspension of program funding.
4.4 A representative of the program shall attend quarterly meetings of the Crime Control and
Prevention District Board as requested.
5. Default and Termination.
5.1 This Agreement is wholly conditioned upon the actual receipt by City of Program Funds
from the CCPD. All monies distributed to Contractor hereunder shall be exclusively from
monies received from the CCPD, and not from any other monies of City. In the event that funds
from the CCPD are not received prior to the execution of this contract by the parties, in whole or
in part, City may, at its sole discretion, terminate this Agreement and City shall not be liable for
payment for any work or services performed by Contractor under or in connection with this
Agreement.
5.2 In the event no funds or insufficient funds are appropriated by the City in any fiscal year
for any payments due hereunder, City will notify Contractor of such occurrence and this
Agreement shall terminate on the last day of the fiscal period for which appropriations were
received without penalty or expense to the City of any kind whatsoever,except as to the portions of
payments herein agreed upon for which funds have been appropriated.
5.3 The City may terminate this Agreement at any time and for any reason by providing the
other party with thirty(3 0) days' written notice of termination.
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5.4 Termination will be effected by delivering to Contractor written notice of termination.
Upon Contractor's receipt of notice of termination, Contractor shall:
(a) Stop work under the Agreement on the date and to the extent specified in the notice of
termination;
(b) Place no further order or subcontracts, except as may be necessary for completion of the
work not terminated;
(c) Terminate all orders and contracts to the extent that they relate to the performance of the
work terminated by the notice of termination; and
(d) Cease expenditures of Program Funds, except as may be necessary for completion of the
work not terminated.
5.5 In the event City suspends or terminates this Agreement, Contractor expressly waives
any and all rights to monetary damages, including but not limited to actual, consequential, and
punitive damages, court costs and attorney's fees.
5.6 Within thirty (30) days following the date of termination of this Agreement, Contractor
shall return to City any property provided hereunder. City will have no responsibility or liability
for Contractor's expenditures or actions occurring after the effective date of termination of the
Agreement.
6. _Equipment and Maintenance. All equipment purchased with Program Funds must
meet all eligibility requirements of City. Contractor shall maintain all equipment used in the
administration and execution of the Play it Safe! Child Sexual Abuse Prevention Program.
Contractor shall maintain, replace or repair any item of equipment used in support of the Play it
Safe! Child Sexual Abuse Prevention Program and/or for use under the terms of this Agreement
that no longer functions or is lost or stolen. The cost for maintenance, replacement or repair of
any equipment used in support of the Play it Safe! Child Sexual Abuse Prevention Program
and/or for use under the terms of this Agreement is the sole responsibility of Contractor.
Contractor shall not use Program Funds to repair or replace said equipment. Contractor shall use
any and all equipment purchased with Program Funds exclusively in support of the Play it Safe!
Child Sexual Abuse Prevention Program. Within 10 days following the purchase of equipment,
Contractor shall submit to City a detailed inventory of all equipment purchased with Program
Funds to the Grants and Program Management Section at the address set forth in paragraph 2.2
above. The equipment inventory shall include an itemized description of each piece of
equipment, the date each piece of equipment was purchased,the cost of purchase for each piece
of equipment,and the location of each piece of equipment.
7. Administrative Requirements.
7.1
Contractor agrees to keep sufficient records to document its adherence to applicable local, state, and
federal regulations, along with documentation and records of all receipts and expenditures of
Program Funds. All records shall be retained for three (3) years following the termination or
completion of this Agreement. City or its representatives shall have the right to investigate,
examine, and audit at any time any and all such records relating to operations of Contractor under
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this Agreement. Contractor, its officers, members, agents, employees, and subcontractors, upon
demand by City,shall make such records readily available for investigation, examination,and audit.
In the event of such audit by City, a single audit of all Contractor's operations will be undertaken
and may be conducted either by City or an independent auditor of City's choice. Contractor shall
submit a copy of any audit performed by their independent auditor within 30 days of receipt of the
final audit report.
7.2 If any audit reveals a questioned practice or expenditure, City shall notify Contractor as
soon as reasonably practical. Contractor shall have fifteen (15) days to provide City with a
written explanation and any supporting documentation regarding the practice or expenditure. If
Contractor fails to resolve or cure the questioned practice or expenditure, to the City's
satisfaction, within the fifteen (15) day period, City reserves the right to withhold further
Program Funds under this and/or future agreement(s)with Contractor.
7.3 If, as a result of any audit, it is determined that Contractor misused, misapplied or
misappropriated all or any part of the Program Funds, Contractor agrees to reimburse 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.
This section shall survice the expiration or termination of this agreement
7.4 Contractor's obligation to City shall not end until all closeout requirements are
completed. The closeout requirements shall include, but are not limited to: providing final
Program Activities Report and Program Effectiveness Measurement Reports, making final
payments, and disposing of Play it Safe! Child Sexual Abuse Prevention Program assets as
appropriate,if deemed required by the City in its sole discretion.
7.5 Contractor covenants and agrees to fully cooperate with City in monitoring the
effectiveness of the services and work to be performed by Contractor under this Agreement, and
work to be performed by Contractor under this Agreement and City shall have access at all
reasonable hours to offices and records of Contractor, its officers, members, agents, employees,
and subcontractors for the purpose of such monitoring.
8. Independent Contractor.
8.1 Contractor shall operate hereunder as an independent contractor and not as an officer,
agent, or 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 invitees. The doctrine of respondent 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. No federal, state, or local income tax, nor any payroll
tax of any kind,shall be withheld or paid by City on behalf of Contractor. Contractor shall not be
treated as an employee with respect to the services performed pursuant to this Agreement for
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federal or state tax purposes. It is expressly understood and agreed that officers, members,
agents, employees, subcontractors, licensees, or invitees of Contractor, and any program
participants hereunder are not eligible for, and shall not participate in any employer pension,
health, or other fringe benefit plan provided by City. It is expressly understood and agreed 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.
8.2 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.
9. Liability and Indemnification.
CONTRACTOR SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND ALL
PROPERTY LOSS, PROPERTY DAMAGE AND/OR PERSONAL INJURY, INCLUDING
DEATH, TO ANY AND ALL PERSONS, OF ANY BIND OR CHARACTER, WHETHER
REAL OR ASSERTED, TO THE EXTENT CAUSED BY THE NEGLIGENT ACTS) OR
OMISSION(S),MALFEASANCE OR INTENTIONAL MISCONDUCT OF CONTRACTOR,
ITS OFFICERS,AGENTS,SERVANTS OR EMPLOYEES.
CONTRACTOR AGREES TO DEFEND, INDEMNIFY, AND HOLD THE CITY, ITS
OFFICERS,AGENTS,SERVANTS,AND EMPL 0 YEES H4 AMLESSAGAINSTANYAAD
ALL CLAIMS, LAWSUITS, ACTIONS, COSTS, AND EXPENSES OF ANY KIND,
INCLUDING, BUT NOT LIMITED TO, THOSE FOR PROPERTY DAMAGE OR LOSS
(INCLUDING ALLEGED DAMAGE OR LOSS TO OWNER'S BUSINESS AND ANY
RESULTING LOST PROFITS) AND/OR PERSONAL INJURY (INCLUDING DEATH)
THAT MAY RELATE TO, ARISE OUT OF, OR BE OCCASIONED BY (I)
CONTRACTOR'S BREACH OF ANY OF THE TERMS OR PROVISIONS OF THIS
AGREEMENT OR (11) ANY NEGLIGENT ACT OR OMISSION OR INTENTIONAL
MISCONDUCT OF CONTRACTOR, ITS OFFICERS, AGENTS, ASSOCL4TES,
EMPLOYEES, CONTRACTORS (OTHER THAN THE CITI), OR SUBCONTRACTORS
RELATED TO THE PERFORMANCE OF THIS AGREEMENT, EXCEPT THAT THE
INDEMNITY PROVIDED FOR IN THIS SECTION SHALL NOT APPLY TO ANY
L)ABILITY RESULTING FROM THE SOLE NEGLIGENCE OF THE CITY OR ITS
OFFICERS, AGENTS, EMPLOYEES, OR SEPARATE CONTRACTORS, AND IN THE
EVENT OF JOINT AND CONCURRENT NEGLIGENCE OF BOTH CONTRACTOR AND
CITY, RESPONSIBILITY, IF ANY, SHALL BE APPORTIONED COMPARATIVELY IN
ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS. NOTHING HEREIN
SHALL BE CONSTRUED AS A WAIVER OF THE CITY'S GOVERNMENTAL
IMMUNITYAS FURTHER PROVIDED BY THE LAWS OF TEXAS.
Contractor shall require all of its subcontractors to include in their subcontracts a release and
indemnity in favor of City in substantially the same form as above.
This section shall survive the expiration or termination of this Agreement.
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10. Non-Assignment. No assignment or delegation of duties under this Agreement by
Contractor shall be effective without City's prior written approval.
11. Prohibition Against Interest.
11.1 No member, officer or employee of City, or its designees or agents; no member of the
governing body of the locality in which the Play it Safe! Child Sexual Abuse Prevention
Program is situated; and no other public official of such locality or localities who exercises any
functions or responsibilities with respect to the Play it Safe! Child Sexual Abuse Prevention
Program during his tenure or for one year thereafter, shall have any interest, direct or indirect, in
any contract or subcontract, or the proceeds thereof, for work to be performed hereunder.
Contractor shall incorporate, or cause to be incorporated, like language prohibiting such interest,
in all contracts and subcontracts hereunder.
11.2 No officer, employee, member, or program participant of Contractor shall have a
financial interest, direct or indirect, in this Agreement 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 Agreement voidable by City of Fort Worth.
12. Nondiscrimination.
12.1 In accordance with the federal, state, and local laws and ordinances, Contractor
covenants that neither it nor any of its officers, members, agents, employees, program
participants, or subcontractors, while engaged in performing this Agreement shall in connection
with the employment, advancement, or discharge of employees, in connection with the terms,
conditions or privileges of their employment, discriminate against persons because of their age,
except on the basis of a bona fide occupational qualification, retirement plan, statutory
requirement, or statutory or ordinance exception.
12.2 Contractor will not unlawfully discriminate against any person or persons because of
age,race, color,religion, sex, disability, national origin, or sexual orientation,nor will Contractor
permit its officers, members, agents, employees, subcontractors, or program participants to
engage in such discrimination.
IF ANY CLAIM ARISES FROM AN ALLEGED VIOLATION OF THIS NON-
DISCRIMINATION COVENANT BY CONTRACTOR, ITS PERSONAL
REPRESENTATIVES, ASSIGNS, SUBCONTRACTORS OR SUCCESSORS IN
INTEREST, CONTRACTOR AGREES TO ASSUME SUCH LIABILITY AND TO
INDEMNIFY AND DEFEND THE CITY AND HOLD THE CITY HARMLESS FROM
SUCH CLAIM.
This section shall survive the expiration or termination of this Agreement.
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13. Compliance.
13.1 Contractor, its officers, members, agents, employees, program participants, and
subcontractors, shall abide by and comply with all laws, federal, state and local, including all
ordinances, rules and regulations of City. If City calls to the attention of Contractor in writing
any such violation on the part of Contractor or any of its officers, members, agents, employees,
subcontractors or program participants, then Contractor shall immediately desist from and
correct such violation.
13.2 Contractor shall utilize Program Funds strictly for those purposes and goals intended
under the terms and conditions of this Agreement. If City calls the attention of Contractor in
writing to any such violations 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.
14. Governmental Powers. It is understood that by execution of this Agreement, the City does
not waive or surrender any of it governmental powers.
15. Waiver of Immunity. If Contractor is a charitable or nonprofit organization and has or
claims an immunity or exemption(statutory or otherwise)from and against liability for damages
or injury,including death,to persons or property; Contractor hereby expressly waives its rights to
plead defensively such immunity or exemption as against City. This section shall not be
construed to affect a governmental entity's immunities under constitutional, statutory or common
law.
16. Insurance Requirement.
16.1 Coverages and Limits. Contractor shall provide the City with certificate(s) of insurance
documenting policies of the following minimum coverage limits that are to be in effect prior to
commencement of any work pursuant to this Agreement:
(a) Commercial General Liabilay (CGL): $1,000,000 per occurrence, with a $2,000,000.00
annual aggregate limit, in a form that is acceptable to the City's Risk Manager.
(b) Non-Profit Organization Liability or Directors & Officers Liability: $1,000,000 per
occurrence, with a $1,000,000 annual aggregate limit, in a form that is acceptable to the
City's Risk Manager.
(c) Automobile Liability: $1,000,000 each accident on a combined single limit basis OR
split limits are acceptable if limits are at least $250,000 Bodily Injury per person,
$500,000 Bodily Injury per accident and$100,000 Property Damage.
(d) Any other insurance the City may reasonably require to protect the interest of the City.
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16.2 Contractor's insurer(s) must be authorized to do business in the State of Texas for the
lines of insurance coverage provided and be currently rated in terms of financial strength and
solvency to the satisfaction of the City's Risk Manager. All insurers must have a minimum
rating of A- VII in the current A.M. Best Key Rating Guide, or have reasonably equivalent
financial strength and solvency to the satisfaction of Risk Management. If the rating is below
that required,written approval of Risk Management is required.
16.3 Each insurance policy required herein, except for Director's and Officer's Liability
policies, shall be endorsed with a waiver of subrogation in favor of the City. Each insurance
policy required by this Agreement, except for policies of worker's compensation or accident/
medical insurance shall list the City as an additional insured. City shall have the right
to revise insurance coverage requirements under this Agreement.
16.4 Contractor further agrees that it shall comply with the Worker's Compensation Act of
Texas and shall provide sufficient compensation insurance to protect Contractor and City from
and against any and all Worker's Compensation claims arising from the work and services
provided under this Agreement.
16.5 The commercial general liability policy shall name the City as an additional insured
thereon, as its interests may appear.
16.6 A minimum of Thirty (30)days' notice of cancellation or reduction in limits of coverage
shall be provided to the City. Ten (10) days' notice shall be acceptable in the event of non-
payment of premium. Notice shall be sent to the Risk Manager, City of Fort Worth, 1000
Throckmorton,Fort Worth,Texas 76102,with copies to the City Attorney at the same address.
16.7 Any failure on the part of the City to request required insurance documentation shall not
constitute a waiver of the insurance requirement.
16.8 Certificates of Insurance evidencing that the Contractor has obtained all required
insurance shall be delivered to the City prior to Contractor proceeding with any work pursuant
to this Agreement.
17. Miscellaneous Provisions.
17.1
The provisions of this Agreement are severable, and,if for any reason a clause,sentence,paragraph,
or other part of this Agreement shall be determined to be invalid by a court or Federal or state
agency, board, or commission having jurisdiction over the subject matter thereof, such invalidity
shall not affect other provisions which can be given effect without the invalid provision.
17.2 City's failure 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.
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17.3 Should any action,whether real or asserted, at law or in equity, arise out of the execution,
performance, attempted performance or non-performance of this Agreement, venue for said
action shall lie in state courts located in Tarrant County, Texas or the United States District
Court for the Northern District of Texas,Fort Worth Division..
17.4 Contractor represents that it possesses the legal authority, pursuant to any proper,
appropriate and official motion,resolution or action passed or taken,to enter into this Agreement
and to perform the responsibilities herein required.
17.5 This written instrument and Exhibits A through F constitute the entire agreement between
the parties concerning the work and services to be performed hereunder, and any prior or
contemporaneous, oral or written agreement which purports to vary fiom the terms hereof shall
be void.
17.6 Any amendments to the terms of this Agreement must be in writing and must be signed
by authorized representatives of each Party.
17.7 None of the performance rendered under this Agreement shall involve, and no portion of
the Program Funds received hereunder shall be used, directly or indirectly, for the construction,
operations, maintenance or administration of any sectarian or religious facility or activity, nor
shall said performance rendered or funds received be utilized so as to benefit, directly or
indirectly, any such sectarian or religious facility or activity.
17.8 The parties acknowledge that each party and its counsel have reviewed this Agreement
and that the normal rules of construction to the effect that any ambiguities are to be resolved
against the drafting party shall not be employed in the interpretation of this Agreement or
exhibits hereto.
17.9 Captions and headings used in this Agreement are for reference purposes only and shall
not be deemed a part of this Agreement.
17.10 The provisions and conditions of this Agreement are solely for the benefit of City and
Contractor and are not intended to create any rights, contractual or otherwise,to any other person
or entity.
17.11 Contractor certifies that it has obtained a 501 (c) (3) Certificate from the Internal
Revenue Service. Contractor shall notify City in writing of any changes to its 501 (c) (3) tax-
exempt status during the term of this Agreement.
18.Notice.
Notices to be provided hereunder shall be sufficient if forwarded to the other party by hand-delivery or
via U.S.Postal Service certified mail,postage prepaid,to the address of the other party shown below:
CITY. Valerie R.Washington,Assistant City Manager
City Manager's Office
FY 2017 Community Based Program
The Women's Center of Tarrant County,Inc. Page 11 of 13
City of Fort Worth
1000 Throckmorton Street
Fort Worth,TX 76102
Copies To: Brittany Taylor
Program Support Division
Bob Bolen Public Safety Complex
505 West Felix St.
Fort Worth,TX 76115
CONTRACTOR: Jasmine Folan
Grants Manager
1723 Hemphill St.
Fort Worth,TX 76110
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[SIGNATURE PAGE TO FOLLOW]
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IN WITNESS WHEREOF, the parties hereto have execute �this agreement in ul 'ples in
Fort Worth, Tarrant County, Texas, to be effective this !f 1isday of ,
204/—.
APPROVED AND AGREED FOR APPROVED AND AGREED FOR
CITY OF FORT WORTH THE WOMEN'S CENTER OF
1-1
7N Y ,�
Valerie R. Washington
Assistant City Manager Laura Hilgart
President/CEO
Date: I( 7J11
Date: q I ��D v%�0
APPROVED AS TO FORM AND
R V REC DED ' LEGALITY FOR THE WOMEN'S
CENTER OF TARRANT COUNTY
Joel F.Fitzgeral
Chief of Police The Women's Center of Tarrant County
Attorney
Date: C�
Date:
APPROVED AS TO FORM AND
LEGALITY FOR CITY OF FORT
AWOH J ATTE
7 O ` .
o Ann Pa y Mar J.K ,� � �,
y
®� Q
Assistant City Attorney City Secretary
§6,® o
Date: Q��'I Date:
e
OF I
1295 CERTIFICATION: M&C No.NOT REQUIRED
OFFICIAL RECORD
FY 2017 Community Based Program CITY SEC �/�R
The Women's Center of Tarrant County,Inc. / ge 13 0l
J FT W®R`CH, TX
Exhibit A
Proposal Abstract and
Narrative
Play it Safe!@ Child Sexual Abuse Prevention Program.
Program Abstract
The problem of child sexual abuse is overwhelming—in the number of children abused;in the
impact on-the lives-of individual children;and on the negative repercussions for the community
at large. A recent study conductedd by the Institute on Domestic Violence&Sexual Assault at
the University of Texas Austin found 22.2%of Texas girls and 10.4%of Texas boys under the
age of 13 have been sexually abused(2015).It 2014,the Texas Department of Family and
Protective Services reported 1,558 confirmed cases of child sexual abuse in North Texas.The
same year,Cook Children's Medical Center in Fort*Worth treated 449 victims of sexual abuse.
While these statistics are frightening,child sexual abuse is a gravely underreported crime,often
because the child victims know their abuser(parents,family members,family friends,
caregivers)and are afraid of the consequences for both themselves and the perpetrator if they
tell.The same UT Austin study found that only 9%of-victims report to police and only 6.4%
seek medical attention.If the 449 children treated at Cook's Medical Center represents-only
6.4%of child victims in 2014,then the true number could be as high as 7,000 youth.
Research documents that the consequences of sexual abuse are serious•and long lasting:
depression,anxiety,substance abuse,PTSD;eating disorders,school drop-out,teen pregnancy,
suicidal tendencies;future victimization;future abuse of own-children and other criminal
behavior(https./Iwww.childhetp.org/child-abuse-statistics/).
Play it Safe!0 is a specialized,age-appropriate child sexual-abuse prevention program for children
ages pre-school throrigh 12th grade,as well as their parents,teachers and caregivers.The program
is provided one classroom at a time with a curriculum that has beenresearched,wjitten and scripted
over 30 years by The Women's Center. Play it Safe!®prevents abuse by teaching children to
identify sexually abusive behavior,and provides tools children need to be safe including specific,
age appropriate actions to take in threatening situations.It also provides a safe forum for children
to disclose abuse and trains care-giving adults to recognize the signs of child sexual victimization
and to take the necessary steps to support a chilli's outcry and recovery.
PROGRAM ABSTRACT
Provide a short description,of your program to be funded.Please summarize the problem and what your program
will do to address it.(Roughly 2 paragraphs in length on a separate:page)
Attached
PROPOSAL NARRATIVE:
Provide a 4-5 page description of your program to be funded. In this narrative,please respond to each of the following
questions:
1) In one sentence,describe the purpose of your proposed program.
The flay it Safe!®program aims to prevent the sexual abuse of children and adolescents by teaching and
empowering them to.recog ize,respond appropriately,and report abuse.
2) Who will the-program benefit? How many people? What age group?
The Women's Center's Play it Safeprogram(PIS)will serve children k pre-K through 121 grade(ages 4-18)
attending publiSafer program
and private schools in Fort Worth and their parents,teachers and caregivers.In the 2015/2016
academic year,the program reached 65,597 Fort Worth children and adolescents—a program record.
Because sexual abuse crosses all boundaries such as age of child,race,socioeconomic status,gender,and
neighborhood,the PIS curriculum is different and age appropriate at each grade level,designed to relate to both
sexes,available in English and Spanish,and provided in any school that requests it-free.of charge.
3) What geographic-area will it serve? Please describe if it will be city wide, a specific council district, or a
specific zip code?Please include geographic boundaries and a map.
PIS serves all of Tarrant County,but funds from this grant will serve specifically the City of Fort Worth on a city
wide basis.
4) Describe in detail the_problem that your program addresses.
The problem of child sexuaLabuse is overwhelming--in the number of children abused;in the impact on the lives
of individual children,and on the negative repercussions forthe community at large. A recent study conducted by
the Iristitute on Domestic Violence&Sexual Assault at the University of Texas Austin found 22.2%of Texas
girls and 10.40/6 of Texas boys under the age-of 13 have been sexually abused(2015).In 2014,the Texas
Department of Family and Protective Services reported 1,558 confirmed cases of child sexual abuse in North
Texas.The same year;Cook Children's Medical Center in Fort Worth treated 449 victims of sexual abuse. While
these statistics are frightening,.child.sexual abuse is a gravely underreported crime,often•becausethe child
victims.know their abuser(parents,family members,family friends,caregivers)and are afraid of the
consequences for both themselves and the perpetrator if they tell.The same UT Austin study found that only 9%
of victims report to police and only 6.4%seek medical attention.If the 449 children treated at Cook's Medical
Center represenst only 6.4%of child victims in 2014,then the true-number could be as high as 7,000 youth.
Research documents that the consequences of sexual abuse are serious and long,lasting:depression,anxiety,
substance abuse,PTSD,eating disorders,school drop-out,teen pregnancy,suicidal tendencies;future
victimization;future abuse of own children and other criminal behavior(https Ilww.w.childhelp.orglcliild-abuse-
statisticsi.
The good news is children are incredibly resilient and can,with help,move beyond their trauma to live healthy,
productive lives.PTS not only teaches children how to recognize and protect themselves from abuse,-it also
provides children with an opportunity to disclose abuse and receive help:In the-2415/2016 school year,97 Fort
Worth children disclosed.abuse to a PIS trainer and were connected with Child Protective:Services and with
RFP No.16-0125,FY2017 Community Based Programs
Rage 15 of 32
counseling services.to begin the healing process.Please note:This statistic underestimates the impact ofP.IS
because it does not include children who tell another trusted adult after the presentation.
5) Describe what your program does to X)support efforts to reduce violent crime.and gang-related activities
through enhanced enforcement activities and crime.prevention programs;2)support efforts to increasethe.
safety of residents and to decrease crime.throughout Fort Worth neighborhoods; and 9)support efforts to
increase the safety of youth and reduce juvenile crime through crime prevention and intervention programs.
The Play it Safe!®(PIS)program support efforts to increase the safety of residents and to decrease crime throughout
Fort Worth neighborhoods, and support efforts to increase the safety of youth and reduce juvenile.crime through
crime prevention and intervention programs.
The long-term impact of the Play it SafeW program is to prevent child sexual abuse,mitigate the consequences of
past or current sexual abuse and its related-trauma on children and their families,and through disclosure stop
existing perpetrators from continuing to abuse.The consequences of child sexual abuse can be short-term and
long-lasting and can include depression,substance abuse,revictimization as an adult,poor school performance-
and drop out,even suicide(American Psychological Association 2014.)The prevention of child sexual abuse and
the identification of current victims of abuse is critical to limiting this crime's emotional,physical,academic and
mental health consequences,which can translate-into adulthood and result insignificant costs to both the
individuals and the community,including lower academic achievement,lost productivity,increased mental health
care;unhealthy relationships, a continued cycle of violence,and criminal activity.
Play it Safe!®(PIS)is a specialized,.age-appropriate child sexual abuse prevention program for pre-K to 12th
grade children,their patents,teachers-and caregivers. PIS prevents abuse by teaching children to identify sexually
abusive behavior,and provides tools children need to.be safe including age-appropriate actions to take in
"threatening situations:It also provides a safe forum for children to disclose abuse,and trains.caregivers to
recognize the signs of child sexual abuse and to.take the necessary steps to support a child's outcry and recovery.
PIS is provided one classroom at a time with an evidenced based curriculum that has.been researched and written
over 30 years by The Women's Center.Each grade level's curriculum is different than the previous year's
curriculum and speaks to children in ways they can best Team and respond.Presentations include short;age-
appropriate films and,for younger children,dolls and coloring books.Program topics-include safe,unsafe,and
confusing touch for elementary school children and.sexting,adult on adolescent abuse of power and dating
violence foxupper grades.
Provided free.of charge in English and Spanish to Fort Worth.public/private schools,PIS continues to grow each
year.In the 2015/2016 academic year,PIS reached 65,597 Fort Worth children—a 1&1%increase from the
23,339 children served in 2007. Most iimportantly during.the 2015/2.016 academic year,97 Fort Worth children
disclosed abuse to a.PIS trainer and were connected to Child Protective Services as well as.to the.Center's free
support services(crisis intervention,clinical counseling and case management)to promote healing and recovery
from trauma.Please note:this statistic does not reflect children who as a result ofPXS disclosed abuse to another
trusted adult.This tremendous growth stems from increases in the local population as well as the excellent
reputation PIS has in the community for effective prevention and riskreduction programming.
6) Does your program address the CCPD priority/special.emphasis.of the prevention or intervention of youth
violence and/or family violence?Describe how your program addresses this priority?
Yes,the Play it Safe!@ program addresses the CCPD-priority of prevention and intervention of youth,and/or family
violence as it is the primary purpose of the program. Please see numbers 4 and 5 above for details.
7) How will you-measure the effectiveness of the program? You must iinclude specfc performance measures
within the Activities-and Outcomes Summary and describe evaluation tools and the method of data collection
that you will use. If awarded funding, these performance measures will be included as an exhibit in the
contract,and you will be required to report progress towards these measures,.which will be reported to the
CCPD Board.
RFP No.16-0125;FY2017 Community Based.Programs
Page t6 of 32
The Women's Center executes three varied strategies to evaluate the.impact of the Play it SafeW child sexual
abuse prevention program
• We administer age-appropriate post-tests to program participants two weeks after a Play It Safe!®presentation
to measure what-they learn from the program and to identify the information they retain.With prevention
programs,a direct correlation between the program and the-result/impact(which can be long term in nature)is
difficult to document. Knowledge based testing is one of the few cost effective methods that is also a recognized
and accepted method for demonstrating program outcomes.
Performance standard: 80%of program participants will score 809/o or better onpost-tests.
In 2015,85%of children who-received PIS and scored 80%or better.
Evaluation Process:
.1. Prior to attending a school,the school is given the choice for students to complete a post-test via a paper
'copy or electronically on a survey website.
2: The school contact isprovidedwith an instructional letter on how to administer the tests and is asked to
provide the tests 2 weeks after the presentation.
a. If a school requests-paper copies,paperpost-tests and a self-addressed return envelope for each
class are provided to the-school.
b. If the school has the,means to administer post-tests electronically,the post-test link is sent to the
school contact, who then sends it to teachers 2 weeks after the program is presented in the
classrooms.
3. Teachers administer the test by eitherpassing out the hard copies, orproviding the link to students in the
classroom. If the test is a paper copy;the teacher mails:in the completed post tests. Electronic tests are
automatically sent to PIS staff.
4. A PISsta„{f'grades the tests and enters the a data into an Exeelspreadsheetfor evaluation.
5. PIS stafffollow up with schools if they do not receive the post-.tests within.$weeks q ter tlje presentation.
6.. Evaluation results are reviewed by the Program Director, CEO, and Board Program Committee for(lie
purpose.of accountability and continuous program improvement, and communicated to funders and other
constituents.
• As noted above,we also keep an annual record of themumber of children/adolescents who disclose past
or current abuse to a Play It SafeM Txainer following a program presentation.During the 2015/2016
academic year,97 Fort Worth children disclosed abuse to a PIay It Safe!®Trainer.The Center does not
evaluate the success of PIS M program based solely on the number of outcries eachyear;however,if this
metric drastically increases.or.decreases from year-to-year,we thoroughly research the-cause to identify
trends in child sexual abuse in the-community,aind evaluate our program#plementation.
• Lastly,a scholarly study conducted by Joan Blakey- with the University of Wisconsin(published in 2015)
found that Play it Safe*is ari effective,evidence-based program.The study-evaluated pre-test and post-test
data from.a sample of kindergarten to fifth grade students and concluded that Play it Safel.®increases
children's knowledge,arsd.understanding:about physical and sexual abuse.
When combined,these three program evaluation methods help The Women's Center understand the impact of the
Play It Safe!®program,identify any needed program improvements,and share results with program staff;program
stakeholders,such as principals,counselors,parents,etc.;and public and private funders.
-8) What makes this programunique from any other crime prevention program in Fort Worth?
In order to serve 65,000 children a year, The Women's Center maintains a unique; well established and strong
partnership with Fort Worth ISD. play it SafelO(PIS) is the only program in Fort Worth that teaches/empowers
children,rather than adult caregivers(parents,caregivers.,etc)to recognize,respond,and report abuse. In addition,
PIS is the only program that focuses specifically on child sexual abuse. Finally,PIS'is the only program that has a
RFP No.16-0I25,FY20.17 Community Based Programs
.Page 17.of 32
grade specific curriculum from-pre-k to lVf grade,ensuring that ebildren/youth are given age appropriate training
.on which they canbuild year after year.
9) Is the program already in operation? If so,how long have you operated the program? What resources.are
currently used to operate the program? Why are CCPD funds necessary at this time?
-Yes—Play it Safer has been in.operation for 30 years.
Resources needed to operate include:Program Director,Program Support Specialist.,
Research/Education Coordinator,2 Education Specialists,20 part-time trainers,curriculum,forms/tests,
computers,videos,coloring books,office supplies,mileage,insurance,telephone,postage;office space
Funding from CCPD is needed in 2016 to enable The Women's Center to meet expanded local needs resulting
from population growth and an increase in the number of schools requesting Play it Safe!®.Iu the 2015/2016
academic year,PIS reached 65,597 FortWorth children—a 181%increase from the 23,339 children served in
2007.While The Women's Center welcomes-this amazing growth as an opportuniiy-to reach even more children
with information on how to stay safe and a chance to disclose abuse,program growth'is outpacing existing
resources.
10)Is this a new program? If so,what other funds have you applied for?Also,please describe the sequence of
steps needed to implement your program and the timeframe in which this will occur.
No-Play it Safe!®is not a new program
TIMEFI•.2AM:The Women's Center implements the Play it Safer'child sexual abuse program year round with
.most program presentations offered during the traditional school year.We concentrate program implementation
from September-December and January May.During the summer months (June, July, August), The Women's
Center will recruit and hire new Play it Safe!'trainers and provide initial and continuing education training to both
veteran and new program trainers.
September-December: January-May: June-August:
PtayitSafel®programimplementation Play it-Safel®program.implementation Trainerrecruitmertt,
hiring,and training
2016/2017
11)Briefly describe the specific ea-penditures planned for CCPD funding.You MUST fully complete attached
budget forms.
Personnel: ' 17%of Operations Lead positionwbaprovides point of contact.and scheduling•forprograms
delivered to children.and youth in Fort Worth schools.
50%of three Play it Safe!Trainer positions who provide the Play it Safe!program i1m Fort Worth school;
(Note:there are a total of 20 part-time trainers who provide Play It Safe!®in Tarrant County.)
Fringe Benefits:includes a portion of FICA,Medicare,and unemployment taxes on salaries charged-to grant
12)If funds are awarded,will flus program continue beyond the CCPD funding period?Please explain your plan
to sustain this program.
RFP No. 16-0125,FY2017 Community Based Programs
Page.18 of 32
The Women's Center has funded Play it Safel'child sexual abuse prevention program for 30 years.As the
population of Tarrant County and Fort Worth and the-popularity of PIS has grown,more andmoie resources are
needed in order to sustain services free-of-charge to Fort Worth schools.
The Women's Center makes a concerted effort to keep costs low to maximize funder investments and reach as
many students with high-quality programming as feasible.In fact;last-year The Women's Center was able to
deliver PIS for less than$4 a student_ Despite-effectively managed costs and conornunity funding support,The
Women's Center recognizes that additional sources of revenue will be necessary to meet the growing demand.
To sustain PIS program levels,The Women's Center has developed a diversified and comprehensive future funding
strategy including
.government dollars and-revenue from the sale.of Play it Safe!®outside of Tarrant County:These
strategies are described in more detail below:
1. Government Sources:
The Women's Center has a three-part-strategy to secure government funding for the Play it Safe!@ program.
a. Every Student Succeeds Act: Women's Center staff are carefully following the new Every Student
Succeeds Act-federal legislation which provides federal funding to support child sexual abuse prevention
training in public schools. This would increase available local funding for the program as the law
encourages partnerships between schools and-non-profits involved in sexual assault-and sexual abuse work.
Our longstanding relationship with Fort Worth ISD and our current presence as a Child Sexual Assault
Prevention provider puts us in a very good position to access these resources.
b. Funding front untapped federal agencies:The Center has identified four federal agencies that may have
resources to support Play it SafeM and-is actively researching applicable grant opportunities with these
agencies including-The Office on Violence Against Women,U.S.Department of Education,Department of
Health&Human Serriices and the Center for Disease Control and Prevention.
c. Redistribute currentfttndhig to Play it SafeM.We are evaluating our current government funding support
to see how we could leverage additional dollars to support Play it Safe!®.Recent increases in the Victim
of Crimes Act(VOCA)state formula distribution may allow us to coverthe majority of our Rape Crisis&
Victim-Services Counseling program.and therefore,free up dollars from our Texas Office of the.Attorney
General funding to be dedicated to Play it Safe.
2. Play it Safer Store-Sales:
In 2015,after patticipating in the Center for Nonprefit Management's nine-month Social Innovators Institute,
The Women's Center launched a business plan to sell the Play it Safer curriculum to communities outside of
Tarrant County The-revenue from this endeavor will be used to help support the cost of the local program_
While initial sells are lower than expected,The Women's Center continues to market the program across the
country. We anticipate that like most new businesses,the Play-it Safe!®store will reach the profitability mark
around Year 3 of operations(2018).and will begin to,support some of the cost to fundd,the local program.
13)Ras-your agency obtained funding through the Crime Control and Prevention District previously?
MYesO No U so,please fill out the.-form on page 16.
RFP No.16-0125,FY2017 Community Based Programs
Page 19 of 32
Exhibit B
Budget
BUDGET SUMMARY
Amount
Requested
A. Direct Personnel $ 22,888.25
B. Direct Fringe Benefits $ 2111.75
C. Direct Travel $ 0
D. Direct Equipment $ 0
E. Direct Supplies $ 0
F. Direct Contracts/Consultants $ 0
G. Indirect Cost up to 10% $ 0
TOTAL $ 25,000.00
BUDGET DETAIL
A. Direct-Personnel
Name Position Rate of Pay x#of Hours Cost
A. Stuffield Operations Lead $20.39 X 310 Hours $6,320.90
Pool of 20 Play it Safe! Trainers $15.13 X 1095 Hours $16,567.35
TOTAL Personnel $22,888.25
B. Direct-Fringe Benefits
Name Position Description of Benefits Cost
A. Stuffield Operations Lead FICA,Medicare,Unemployment $567.89
Pool of 20 Play it Safe! Trainers FICA,Medicare,Unemployment $1,543.86
TOTAL Fringe Benefits $$2,111.75
C. Direct-Travel
Purpose of Travel Location Item Cost
TOTAL Travel $0
D. Direct-Equipment
Item Cost per Item Quantity Cost
TOTAL Equipment $0
E. Direct-Supplies
Item Cost per Item Quantity Cost
TOTAL Supplies $0
F. Direct-Contracts/Consultants
Description of the Service Cost
TOTAL Contracts/Consultants $0
G.Indirect-Personnel
Name Position Rate of Pay x#of Hours Cost
TOTAL Personnel $0
H.Indirect,—Fringe Benefits
Name Position Description of Benefits Cost
TOTAL Fringe Benefits
$0
I. Indirect-Other Costs
Item Cost per Item Quantity Cost
TOTAL Other Cost $0
BUDGET NARRATIVE
A. Direct—Personnel; 17% of Operations Leadf or Play it Safel® program who provides point of contact
and scheduling for programs delivered to children and young adults in Pre-K through
high school.
1095 hours provided by 20 Play it Safe! Trainer positions who deliver the Play it
Safel® program to children
Costs are calculated based on time spent on this grant.
A. Direct—Fringe; Fringe benefits include a portion of FICA, Medicare,and unemployment taxes on
salaries charged to grant
B. Direct—Travel;
C. Direct—Equipment;
D. Direct—Supplies;
E. Direct-Contracts/Consultants;
F. Indirect Cost up to 10%
G. Indirect Cost—Personnel;Indirect Cost—Fringe Benefits;
H.Indirect Cost—Other Costs;
Exhibit C
Request for Reimbursement
FORTWORTH.
Request for Reimbursement(RFR)
FY 2017
CRIME CONTROL
AND PREVENTION DISTRICT
Submit To: Submitting Agency: The Women's Center of Tarrant County
Bob Bolen Public Safety Complex Contact Name: Jasmine Folon
Attn:Brittany Taylor Phone Number: 817-927-4040
Program Support Division Email: ifolantdlwomenscentertc.orc
505 West Felix 76115
Fort Worth,TX 7Remit Address: 1723 Hemphill,Fort Worth,TX 76110
Invoice Number:
Month of Request:
DIRECT COSTS(90%Minimum)
A _ ..:-: B7.-- C. D E
Total of PreviousThis MMonth'sB+C A-D
Budget Category BudgetAmount Reimbursements Total Requested Remaining Balance
Requested Request To-Date Available
A Personnel $22,888.25: S S- ''22,898,25 '
B Fringe Benefits S "2,111,75 S - -- $ 2,111.75
C Travel&Training - -- S,- - - - S = -
D Equipment -
E ISupplies _
F Contracts/Consultants _
Total Direct Costs S' 25 000.00 S $ S'. S" 25 000.00!
INDIRECT COSTS(10%Maximum)
Total of PreviousThir Month's + (A-ID)
Budget Category Budget Amount Reimbursements Total Requested Remaining Balance
Requested Request To-Date Available
A Personnel _ -
B Fringe Benefits S, - $ =
C Travel&Training S $
D Equipment -
E Supplies $ 2
F Contracts/Consultants
Total InDlrect Costs _s_:_-, $ S S S
Supporting documents required with monthly requests. Summary:
This includes,timesheets depicting CCPD funded activities, Total Budget: S 25,000.00
copy of paychecks,invoices and receipts detailing all CCPD Previous Requests: S
funded expenditures. This Request: S
Total Requested To-Date S
Remaining Funds S 25,000.00
I have reviewed this request and certify that these listed expenses and support documentation are accurate.
Authorized Signatory Signatory Title Datd.
AIAgent--i'1se:Only.—c,
-Purchase Order# - Fru& Dept ID Account
RFRApprowd ForPawrrent
Grant Staff Signature Date
Finance Received Stamp Placed Below
Exhibit D
Program Activities Report
FORT WORTH
CRIME CONTROL
&PREVENTION Dlsmcr
Fiscal Year 2017
Monthly Program Activities Report
Current Reporting Month
Submitting Agency The Women's Center of Tarrant County
Contact Name Jasmine Folan
Phone Number and Email 817-927-4040/ifolan@womenscentertc.org
org
Remit Address 1723 Hemphill,Fort Worth,TX 76110
Activity r _ -Current- To Date Year Efid.._
Month Total Goal.
Total
1 Recruitment and hiring of trainers in June and July.
• 40 Hours of training provided to trainers in August. 20 Trainers
2 Provide Play it Safe! Child sexual abuse prevention program to Fort 15,000
Worth Pre-K through 12111 grade students. students
3 Presentations presented to students throughout the City of Fort Worth 750
in up to 65 schools. presentations
3
5
3r
I have reviewed this report and certify that the measures provided are accurate and appropriately reflect the
CCPD goals set forth in the contract.
Authorized Signatory Signatory Title Date
Exhibit E
Program Effectiveness
Measurement Report
FORT WORTH
CRIME CONTROL
&PREVENTION DISTRICT
Fiscal Year 2017
Quarterly Program Effectiveness Measurement Report
Current Reporting Quarter
Submitting Agency The Women's Center of Tarrant County
Contact Name Jasmine Folan
Phone Number and Email 817-927-4040/jfolan@womenscentertc.org
Remit Address 1723 Hemphill,Fort Worth,TX 76110
Please include outcome narrative that describes how measure was accomplished for each quarter.
=Effectiveness Measures and-Quarterly Outcomes,
Measure 1 80%of children who receive the Play It Safe! Curriculum will score at least 80% correct on a post-
test given two weeks after the training.
Outcome
Measure 2 20 Fort Worth students will make an outcry of abuse to a PIS trainer as the result of a CCPD funded
presentation.
Outcome
Measure 3
Outcome
Measure 4
Outcome
Measure 5
Outcome
Ihave reviewed this report and certify that the measures provided are accurate and appropriately reflect the
CCPD goals setforth in the contract.
Authorized Signatory Signatory Title Date
Report due each quarter:Vt Quarter(Oct-Dec)due January 15 2nd Quarter(Jan-Mar)due April 15
3`d Quarter(Apr-June)due July 15 4th Quarter(Jul-Sep)due October 15
Exhibit F
Request for Budget
Modification
FORT WART
CRIME COMROL
&NwEMION DI$TmicT
• Up to 5%of any budgeted line-item does not need prior approval but form must be sent to City with monthly RFR
• More than 5%of any budgeted line-item must have prior City approval
• An increase in a zero line-item must have prior City approval
• Modifications cannot be made between Direct and Indirect costs
Exhibit F
Request for Budget Modification
Fiscal Year 2017
Date
Submitting Agency The Women's Center of Tarrant Coun
Contact Name Jasmine Folan
Phone Number and Email 817-927-4040/'folan womenscentertc.or
Remit Address 1723 Hemphill,Fort Worth,TX 76110
- - -
'DIRECT.-COST. 90% miaimum
--------
Budget Category Approved Budget Change Requested Revised Budget
Personnel
Su lies&Equipment
Program Services
Travel and Training
Other Approved
Total Direct Costs
INDIREECT COSTS 10% maim nu
Budget Category Approved Budget Change Requested Revised Budget
Personnel
Su lies&Equipment
Operational Services
Travel and Training
Facilities&Utilities
Other Approved
Total Indirect Costs
7.
�odificatioarrat�y_e desc�be in=detail-v�hat changes for)_ __:_ �___
I have reviewed this request and certify that the listed modifications are correct.
Authorized Signatory Signatory Title Date
EWPD STAFF USE.ONLX`_..
Q Modification Approved QModification NOT Approved
FWPD Staff Signature Date