HomeMy WebLinkAboutContract 48377 Cri Y SECRETARY Ul
,CONTRACT NO.
STATE OF TEXAS §
COUNTY OF TARRANT §
This contract ("Contract") is made and entered into by and between the City of Fort
Worth (hereafter "City") and Camp Fire First Texas (hereafter "Agency"), a Texas non-profit
corporation. City and Agency may be referred to individually as a "Party" and jointly as "the
Parties".
The Parties state as follows:
WHEREAS, City receives grant monies from the United States Department of Housing
and Urban Development through the Community Development Block Grant ("CDBG")
Program,Program No. B-15-MC-48-0010, Catalog of Federal Domestic Assistance No. 14.218;
WHEREAS, a national objective of the CDBG program is to benefit low and moderate
income citizens in accordance with 24 CFR Part 570, as amended from time to time;
WHEREAS, Agency submitted a proposal to use CDBG funds for a program to serve
individuals and families, 51% of whom must be low and moderate income;
WHEREAS, City citizens, the Community Development Council, and the City Council
have determined that CDBG programs are needed by the City's citizens.
NOW, THEREFORE,the Parties understand and agree as follows:
1. INCORPORATION OF RECITALS.
City and Agency hereby agree that the recitals set forth above are true and correct and
form the basis upon which the Parties have entered into this Contract.
2. DEFINITIONS.
In addition to terms defined in the body of this Contract, the terms set forth below shall
have the definitions ascribed to them as follows:
Area Median Income or AMI means the median family income for the Fort Worth-Arlington
metropolitan statistical area as established annually by HUD. The 2016 income limits are
attached hereto as EXHIBIT "A-1"—2016 HUD Income Limits.
Business Diversity Enterprise Ordinance or BDE means the City's Business Diversity
Ordinance, Ordinance No. 20020-12-2011.
CDBG means Community Development Block Grant.
Complete Documentation means the following documentation as applicable:
CDBG 51%PSA CONTRACT 2016-2017 OFFICIAL RECORD Page 1
Camp Fire First Texas CITY SECRETARY Rev.9.27.2016
FT.WORTH TX
• Attachments I, 11, and III, with supporting documentation including:
o Proof of expense: copies of timesheets, invoices, leases, service contracts
or other documentation showing that payment is due by Agency.
o Proof of payment: cancelled checks, bank statements, or wire transfers
necessary to demonstrate that amounts due by Agency were actually paid
by Agency.
o Proof of client eligibility: either (i) verifiable self-certification of income
such as the City's Certification Income Statement attached as EXHIBIT
"E" — Form of Income Self-Certification or a similar form approved by
City, or(ii) Source Documentation.
• Complete Documentation shall meet the standards described in the attached
EXHIBIT "F" - Standards for Complete Documentation.
• Any other document or record reasonably necessary to verify costs spent and
client eligibility for the Program.
CDBG Funds means the CDBG grant funds supplied by City to Agency under the terms of this
Contract.
CDBG Regulations means regulations found at 24 CFR Part 570 et seq.
Countywide Agencies means agencies with 10% or more of clients that reside outside of the
boundaries of the City. All other agencies are considered Fort Worth agencies.
DBE means disadvantaged business enterprise in accordance with 49 CFR Part 26.
Director means the Director of the Neighborhood Services Department.
Effective Date means October 1, 2016.
HUD means the United States Department of Housing and Urban Development.
IDIS means Integrated Disbursement Information System, HUD's project tracking system.
Income Eligible Client means a client whose annual income adjusted for family size does not
exceed 80% of AMI using the most current HUD Income Guidelines and Technical Guidance
for Determining Income and Allowances. The definition of annual income to determine client
income eligibility shall be the definition contained in 24 CFR Part 5.609, as amended from time
to time.
National Objective means an activity that benefits low and moderate income persons. For the
purposes of this Contract, at least 51% of the clients served by the Program must be Income
Eligible Clients.
Neighborhood Services Department means the City's Neighborhood Services Department.
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OMB means the Office of Management and Budget.
Program means the services described in EXHIBIT "A"—Program Summary.
Reimbursement Request means all reports and other documentation described in Section 9.
Source Documentation means documentation of full household income of any type described
under the definition of annual income in 24 CFR Part 5.609, including but not limited to copies
of paychecks, Social Security and disability verification letters, interest or rental income
statements, retirement income statements, child support and alimony verification, unemployment
benefit letters, and the like.
Unduplicated Clients means a count of all clients served by the Program at least once in the
Contract Term. Clients served by the Program more than once in the Contract Term will only be
counted the first time they are served when determining the total count of Unduplicated Clients.
3. TERM.
The term of this Contract begins on the Effective Date and terminates on September 30,
2017 unless earlier terminated as provided in this Contract.
4. DUTIES AND RESPONSIBILITIES OF CITY.
4.1 Provide CDBG Funds.
City shall provide up to $78,905.00 of CDBG Funds under the terms and conditions of
this Contract.
4.2 Monitor.
City will monitor the activities and performance of Agency and any of its contractors,
subcontractors or vendors as necessary, but no less than annually. Monitoring by City will
include determining whether Agency is meeting the National Objective during the term of this
Contract.
5. DUTIES AND RESPONSIBILITIES OF AGENCY.
5.1 Required Services.
Agency shall perform the services described in EXHIBIT "A"—Program Summary in
accordance with the terms and conditions of this Contract.
5.2 Use of CDBG Funds.
5.2.1. Compliance with CDBG Regulations and Contract.
Agency shall be reimbursed for eligible Program costs with CDBG Funds only if City
determines in its sole discretion that:
5.2.1.1 Costs are eligible expenditures in accordance with CDBG Regulations.
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5.2.1.2 Costs are in compliance with this Contract and are reasonable and
consistent with industry norms.
5.2.1.3 Complete Documentation, as applicable, is submitted to City by
Agency.
5.2.2 Budget.
5.2.2.1 The CDBG Funds will be paid on a reimbursement basis in accordance
with EXHIBIT `B"-Budget.
5.2.2.2 During the term of this Contract, Agency may submit written requests
to increase or decrease line-item amounts in the Budget, including an
explanation of why such increases or decreases are necessary. All
requests shall be approved by Director in writing, with such approval
being in the Director's sole discretion. If Director approves the
Agency's proposed Budget amendment (as approved, the "Amended
Budget"), then the Amended Budget will take effect on the first day
of the month following the month in which it was approved by
Director, unless otherwise specified in the amendment. All requests
for Budget amendments must be submitted by June 1,2017.
5.2.3 Change in Program Budget.
5.2.3.1 Agency will notify City promptly of any additional funds it receives
for operation of the Program, and City reserves the right to amend this
Contract in such instances to ensure compliance with HUD regulations
governing cost allocation.
5.2.3.2 Agency agrees to utilize the CDBG Funds to supplement rather than
supplant funds otherwise available for the Program.
5.2.4 Payment of CDBG Funds to Agency.
CDBG Funds will be disbursed to Agency upon City's approval of Reimbursement
Requests including submission of Complete Documentation to City in compliance with Section
9. If Agency expends all funds budgeted for the Program prior to September 30, 2017, City
may hold back a small amount of the CDBG Funds until the end of the term. During this interim
period, Agency must continue to submit Attachment III— Client Data Report in EXHIBIT "D"
—Reimbursement Forms monthly. It is expressly agreed by the Parties that any CDBG Funds
not spent or approved for reimbursement to Agency shall remain with City.
5.3 Program Performance Milestones.
5.3.1 Agency represents that the Program will achieve the following milestones in
accordance with EXHIBIT "A"—Program Summary and the table below:
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Unduplicated Clients as
specified`in EXHIBIT
Program
Month Ex enditures` Summa ;
3 25% 25%
6 50% 50%
9 75% 75%
12 100% 100%
5.3.2 Failure of Agency to meet these milestones or a material deviation from them as
outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section,
"material deviation" shall mean more than 10% lower than the specified goal. In the event of
such breach, City reserves the right in its sole option to (i) delay or withhold payment of
Reimbursement Requests, (ii) lower Agency's allocation of CDBG Funds, or (iii) terminate this
Contract.
5.3.3 Failure to meet at least 80% of its performance milestones or serve 96
Unduplicated Clients under this Contract may, in City's sole discretion, disqualify Agency for
consideration under the City's Request for Proposals for the 2017-2018 Program Year for federal
grant funds.
5.3.4 Amendments to performance milestones regarding CDBG Funds must be
approved by the Director in writing, with such approval being in the Director's sole discretion.
If Director approves the Agency's proposed amended performance milestones (as approved, the
"Amended Performance Milestones"), then the Amended Performance Milestones will take
effect on the first day of the month following the month in which it was approved by Director,
unless otherwise specified in the amendment. All requests for amendments to performance
milestones must be submitted by June 1, 2017. Notwithstanding the above, any amendments to
this Contract shall not reduce the number of Unduplicated Clients stated in Section 5.3.3 and in
EXHIBIT "A" -Program Summary.
5.7 Identify Program Expenses Paid with CDBG Funds.
Agency will keep accounts and records in such a manner that City may readily identify
and account for Program expenses reimbursed with CDBG Funds. These records shall be made
available to City for audit purposes and shall be retained as required hereunder.
5.8 Meet National Obiective.
Agency shall ensure that the activities carried out in the Program will meet the National
Objective.
5.9 Program Subcontracts.
Agency shall not enter into a subcontract with another agency, contractor, or vendor to
provide a service to clients for any part of the Program that will be paid with CDBG Funds
without City's written consent.
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CLIENT ELIGIBILITY VERIFICATION.
6.1 Client Eligibility.
Agency will document client eligibility as follows:
6.3.1 Agency Clients.
Agency must verify all new clients' income with either a verifiable self-certification of
income such as the City's Certification of Income Statement attached as EXHIBIT "E" —Form
of Income Self-Certification or a similar form approved by City, or Source Documentation.
Agency must use the annual income definition in 24 CFR Part 5.609 to establish client income
and must use the most current HUD Income Guidelines. The income of all Program clients must
be documented and at least 51% of them must be Income Eligible Clients.
6.3.1.1 If Agency serves both Fort Worth and non-Fort Worth clients, the
proportion of Program costs allocated to the CDBG-funded portion of
the Program Budget must be consistent with the proportion of Fort
Worth clients to all clients.
6.3.1.2 All Program clients must be reported on EXHIBIT "D" —
Reimbursement Forms, Attachment III. All Program clients whose
income has not been verified will be deemed to not be Income Eligible
Clients and shall not be included in the 51%.
6.3.2 Verification of Program Eligibility.
6.3.2.1 At the end of each quarter during the Contract term, Agency shall
verify CDBG Program Eligibility by confirming that at least 51% of
clients served by the Program to date are Income Eligible Clients as
reported on Attachment III.
6.3.2.2 If Agency fails to verify Program eligibility on a quarterly basis in
compliance with this Section, Agency will have 30 calendar days or
until the next monthly invoice to cure.
6.3.2.3 City will notify Agency by e-mail within 20 calendar days if the
Program performance milestones were not met within the requirements
outlined in this Section 6.1.2.2. Agency will have an additional 30
calendar days from the date of the e-mail notice to meet these
requirements. If Agency fails to submit all the required information,
Agency shall forfeit any payments otherwise due that month and
failure to submit any requested information will be considered an
event of default as outlined in Section 10.1.2.
6.3.2.4 In the event the Agency fails to meet the Program performance
milestones, City reserves the right in its sole option to delay or
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withhold payment of Reimbursement Requests, to lower Agency's
allocation of CDBG Funds, or to terminate this Contract.
6.4 Submission of Complete Documentation.
Agency must submit copies of documentation of client eligibility described in Section 6.1
with Attachment III with each month's Reimbursement Request for all Unduplicated Clients.
6.5 Maintain Documentation.
Agency must maintain copies of all documentation required by this Section 6 for 5 years
following the expiration of the Contract term. This Section shall survive the earlier termination
or expiration of this Contract.
7. ADDITIONAL CDBG REQUIREMENTS.
Agency agrees to comply with all requirements of the CDBG Program as stated in the
CDBG Regulations, including but not limited to the following:
7.1 Environmental Review.
CDBG Funds will not be paid, and costs cannot be incurred until City has conducted an
environmental review and completed an Environmental Review Record as required by 24 CFR
Part 58. The environmental review may result in a decision to proceed with, modify, or cancel
the funding for the Program. Further, Agency will not undertake or commit any funds to
physical or choice limiting actions as described in any applicable federal regulations. Any
violation of this provision will (i) cause this Contract to terminate immediately, and (ii) require
Agency to repay City the CDBG Funds it has already received and forfeit any future payments of
CDBG Funds.
7.2 Contract Not Constituting Commitment of Funds.
Notwithstanding any provision of this Contract, the Parties agree and acknowledge that
this Contract does not constitute a commitment of funds, and that such commitment of funds or
approval may occur only upon (i) satisfactory completion of an environmental review and receipt
by City of an authorization to use grant funds from HUD under 24 CFR Part 58, (ii) approval of
City's 2016-2017 Action Plan, and (iii) receipt by City of a grant agreement from HUD.
7.3 Monitoring.
7.3.1 Agency understands and agrees that it will be subject to monitoring by City for
compliance with terms and provisions of this Contract and the CDBG Regulations for the term of
this Contract. Agency is subject to such monitoring during the term of this Contract and for 5
years after the Contract term ends. Agency will provide reports and access to Program files as
requested by City during this 5 year period. For purposes of this Contract, this 5 year period for
monitoring is deemed to begin on October 1, 2017 and end on September 30, 2022 regardless
of whether or not this Contract is earlier terminated.
7.3.2 Representatives of City, HUD, HUD Office of Inspector General, and the United
States Comptroller General shall have access during regular business hours, upon 48 hours prior
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notice, to Agency's offices and records pertaining to the use of the CDBG Funds, and to
Agency's officers, directors, agents, employees, contractors, subcontractors and vendors for the
purpose of such monitoring.
7.3.3 In addition to other provisions of this Contract regarding frequency of monitoring,
City reserves the right to perform desk reviews or on-site monitoring of Agency's compliance
with the terms and conditions of this Contract. City shall provide Agency with a written report
of the monitor's findings after each monitoring visit. If the monitoring report notes deficiencies
in Agency's performance, the report shall include requirements for the timely correction of said
deficiencies by Agency. Failure by Agency to take the action specified in the monitoring report
may be cause for suspension or termination of this Contract as provided herein.
7.3.4 Subsections 7.3.1 through 7.3.3 shall be applicable for the Contract term and for 5
years thereafter and shall survive the earlier termination or expiration of this Contract.
7.3.5 Agency shall provide City annually the results of any state or federal monitoring.
Such results shall be submitted within 60 days of receipt of such state or federal monitoring
report, or with the January Reimbursement Request, whichever is earlier.
7.4 Ai4ency Procurement Standards.
Agency shall comply with all applicable federal, state and local laws, regulations, and
ordinances for making procurements under this Contract. In addition to the conflict of interest
provisions in Section 14.13.3, Agency shall establish written procurement procedures to ensure
that materials and services are obtained in a cost effective manner and that provides for full and
open competition. When procuring materials and services for this Contract, Agency shall
comply at a minimum with the procurement standards in 2 CFR Part 200.317 through Part
200.326.
7.4.1 Contracts in excess of $10,000.00 made by Agency using CDBG Funds must
address termination for cause and convenience including the manner by which such termination
shall be effected and the basis for settlement of the terminated contract, if any, as required by
Appendix II (B), 2 CFR Part 200.
7.4.2 Agency shall not make any contract with parties listed on the government wide
System for Award Management, www.sam.gov ("SAM"). Agency must confirm by search of
SAM that all contractors paid with CDBG Funds are not listed by SAM as being debarred, both
prior to hiring and prior to submitting a Reimbursement Request which includes invoices from
any such contractor. Failure to submit such proofs of search shall be an event of default.
7.5 Cost Principles/Cost Reasonableness.
Agency shall administer its use of CDBG Funds in compliance with 2 CFR Part 200, as
applicable. The eligibility of costs incurred for performance rendered shall be determined in
accordance with 2 CFR Part 200.400 through 2 CFR Part 200.475.
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7.6 Financial Management Standards.
Agency agrees to comply with 2 CFR Part 200, as applicable. Agency also agrees
to adhere to the accounting principles and procedures required therein, utilize adequate internal
controls, and maintain necessary supporting and back-up documentation for all costs incurred in
accordance with 2 CFR Part 200.302 and Part 200.303.
7.7 Uniform Administrative Requirements, Cost Principles, and Audit
Requirements.
Agency will comply with the Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards in 2 CFR Part 200, as applicable, or any reasonably
equivalent procedures and requirements that City may require.
7.8 Terms Applicable to Contractors, Subcontractors and Vendors.
Agency understands and agrees that all terms of this Contract, whether regulatory or
otherwise, shall apply to any and all contractors, subcontractors and vendors of Agency which
are in any way paid with CDBG Funds or who perform any work in connection with the
Program. Agency shall cause all applicable provisions of this Contract to be included in and
made a part of any contract or subcontract executed in the performance of its obligations
hereunder including its obligations regarding the CDBG Regulations. Agency shall monitor the
services and work performed by its contractors, subcontractors and vendors on a regular basis for
compliance with the CDBG Regulations and Contract provisions. Agency must cure all
violations of the CDBG Regulations committed by its contractors, subcontractors or vendors.
City maintains the right to insist on Agency's full compliance with the terms of this Contract and
the CDBG Regulations and Agency is responsible for such compliance regardless of whether
actions taken to fulfill the requirements of this Contract are taken by Agency or by Agency's
contractors, subcontractors or vendors. Agency acknowledges that the provisions of this Section
shall survive the earlier termination or expiration of this Contract and shall be applicable for 5
years after the Contract term ends.
7.9 Copyright and Patent Rights.
No reports, maps, or other documents produced in whole or in part under this Contract
shall be the subject of an application for copyright by or on behalf of Agency. HUD and City
shall possess all rights to invention or discovery, as well as rights in data, which may arise as a
result of Agency's performance under this Contract.
7.10 Conflict of Interest Disclosure.
In accordance with the requirements of Section 14.14.2.1 and 14.14.4, Agency shall
establish conflict of interest policies for federal awards. Agency shall disclose to City in writing
any potential conflict of interest.
7.11 Compliance with FFATA and Whistleblower Protections.
Agency shall comply with the requirements of 2 CFR 300(b), including provisions of the
Federal Funding Accountability and Transparency Act ("FFATA") governing requirements on
executive compensation and provisions governing whistleblower protections contained in 10
U.S.C. 2409, 41 U.S.C. 4712, 10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310.
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7.11.1 Agency shall provide City with its DUNS number.
7.12 Internal Controls.
In compliance with the requirements of 2 CFR Part 200.303, Agency shall:
7.12.1 Establish and maintain effective internal control over the CDBG Funds that
provides reasonable assurance that Agency is managing the CDBG Funds in compliance with
federal statutes, regulations, and the terms and conditions of this Contract. These internal
controls shall be in compliance with guidance in "Standards for Internal Control in the Federal
Government" issued by the Comptroller General of the United States or the "Internal Control
Integrated Framework" issued by the Committee of Sponsoring Organizations of the Treadway
Commission("COSO");
7.12.2 Comply with federal statutes, regulations, and the terms and conditions of this
Contract;
7.12.3 Evaluate and monitor Agency's compliance with statutes, regulations and the
terms and conditions of this Contract;
7.12.4 Take prompt action when instances of noncompliance are identified including
noncompliance identified in audit findings; and
7.12.5 Take reasonable measures to safeguard protected personally identifiable
information and other information that HUD or City designates as sensitive or Agency considers
sensitive consistent with applicable federal, state, local and tribal laws regarding privacy and
obligations of confidentiality.
8. RECORD KEEPING; REPORTING AND DOCUMENTATION
REQUIREMENTS; AUDIT.
8.1 Record Keeping.
Agency shall maintain a record-keeping system as part of its performance of this Contract
and shall promptly provide City with copies of any document City deems necessary for the
effective fulfillment of City's monitoring and evaluation responsibilities. Specifically, Agency
will keep or cause to be kept an accurate record of all actions taken and all funds spent, with
supporting and back-up documentation. Agency will maintain all records and documentation
related to this Contract for 5 years after the Contract term ends. If any claim, litigation, or audit
is initiated before the expiration of the 5 year period, the relevant records and documentation
must be retained until all such claims, litigation or audits have been resolved. For purposes of
this Contract, this 5 year period for record retention is deemed to begin on October 1, 2017 and
end on September 30,2022 regardless of whether or not this Contract is earlier terminated.
8.2 Access to Records.
Representatives of City, HUD and any duly authorized officials of the federal
government will have full access to, and the right to examine, audit, copy, excerpt and/or
transcribe any of Agency's records pertaining to all matters covered by this Contract for 5 years
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after the Contract term ends. Such access shall be during regular business hours and upon at
least 48 hours prior notice. For purposes of this Contract, this 5 year period for access to records
is deemed to begin on October 1,2017 and end on September 30, 2022 regardless of whether or
not this Contract is earlier terminated.
8.3 Reports.
Agency will submit to City all reports and documentation described in this Contract in
such form as City may prescribe. Agency may also be required to submit a final performance
and/or final financial report if required by City at the termination of this Contract in such form
and within such times as City may prescribe. Failure to submit to City any report or
documentation described in this Contract shall be an event of default of this Contract and City
may exercise all of its remedies for default under this Contract.
8.3.1 Additional Information.
Agency shall provide City with additional information as may be required by state or
federal agencies to substantiate Program activities and/or expenditure eligibility.
8.4 Change in Reporting Requirements and Forms.
City retains the right to change reporting requirements and forms at its discretion. City
will notify Agency in writing at least 15 days prior to the effective date of such change, and the
Parties shall execute an amendment to the Contract reflecting such change if necessary.
8.5 Audit.
8.5.1 Entities that Expend $750,000 or more in Federal Funds Per Year.
All non-federal entities that expend $750,000 or more in federal funds within 1 year,
regardless of the source of the federal award, must submit to City an annual audit prepared in
accordance with specific reference to 2 CFR Part 200.501 through Part 200.521. The audit shall
cover the Agency's fiscal years during which this Contract is in force. The audit must be
prepared by an independent certified public accountant, be completed within 6 months following
the end of the period being audited and be submitted to City within 30 days of its completion.
Agency's audit certification is attached hereto as EXHIBIT "C"—"Audit Certification Form"
and "Audit Requirements". The Audit Certification Form must be submitted to City prior to
or with the first Reimbursement Request. Entities that expend less than $750,000 a year in
federal funds are exempt from federal audit requirements for that year, but records must be
available for review or audit by appropriate officials of the federal agency, City, and General
Accounting Office.
8.5.2 City Reserves the Right to Audit.
City reserves the right to perform an audit of Agency's Program operations and finances
at any time during the term of this Contract and for 5 years after the Contract term ends if City
determines that such audit is necessary for City's compliance with the CDBG Regulations or
other City policies. Agency agrees to allow access to all pertinent materials as described herein
for such audit. For purposes of this Contract, this 5 year period for City audit is deemed to begin
on October 1, 2017 and end on September 30, 2022 regardless of whether or not this Contract
is earlier terminated. If such audit reveals a questioned practice or expenditure, such questions
must be resolved within 15 business days after notice to Agency of such questioned practice or
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expenditure. If questions are not resolved within this period, City reserves the right to withhold
further funding under this Contract and/or any other contracts with Agency. IF AS A RESULT
OF ANY AUDIT IT IS DETERMINED THAT AGENCY HAS FALSIFIED ANY
DOCUMENTATION OR MISUSED, MISAPPLIED OR MISAPPROPRIATED CDBG
FUNDS OR SPENT CDBG FUNDS ON ANY INELIGIBLE ACTIVITIES, AGENCY
AGREES TO REIMBURSE CITY THE AMOUNT OF SUCH MONIES PLUS THE
AMOUNT OF ANY SANCTIONS, PENALTY OR OTHER CHARGE LEVIED
AGAINST CITY BY HUD BECAUSE OF SUCH ACTIONS.
9. REIMBURSEMENT REQUIREMENTS.
9.1 Deadline for Submitting Reimbursement Requests.
9.1.1 Reimbursement Requests shall be submitted monthly to the City and must be
received by the City on or before the 15th day of the month following the month expenses were
paid by Agency. For example, the Reimbursement Request for June expenses must be received
by July 15. In the event the 15th falls on a weekend or City holiday, Reimbursement Requests
shall be due the next day that the City is open for business. Failure to submit a Reimbursement
Request in a timely fashion will result in City taking the actions outlined in Section 10.1.
NOTWITHSTANDING ANYTHING ABOVE, THE REIMBURSEMENT REQUEST
FOR EXPENSES INCURRED FOR SEPTEMBER 2017 MUST BE RECEIVED BY
OCTOBER 1, 2017. COMPLETE DOCUMENTATION FOR ALL SEPTEMBER 2017
EXPENSES MUST BE SUBMITTED BY OCTOBER 15,2017. FAILURE TO SUBMIT A
FINAL REIMBURSEMENT REQUEST WITH COMPLETE DOCUMENTATION BY
OCTOBER 15, 2017 WILL RESULT IN FORFEITURE OF PAYMENT OF THE
SEPTEMBER REIMBURSEMENT REQUEST.
9.1.2 City will notify Agency by e-mail within 20 calendar days if a Reimbursement
Request is lacking Complete Documentation or corrections are needed. Agency will have 10
business days from the date of the e-mail notice to submit any requested information or missing
documentation. Agency may be penalized, at City's sole discretion, in the Request for Proposal
for the 2017-2018 Program Year for any notifications received under this Section. If Agency
fails to submit all the required information or missing documentation within 30 calendar days
from the first e-mail, Agency shall forfeit any payments otherwise due that month and failure to
submit any requested information will be considered an event of default as outlined in Section
10.1.2.
9.2 Submission of Reimbursement Requests.
Agency shall provide City with Complete Documentation and the following
reports as shown in EXHIBIT "D" —Reimbursement Forms with each Reimbursement
Request:
9.2.1 Attachment I—Invoice.
This report shall contain the amount requested for reimbursement each month, the
cumulative reimbursement requested to date (inclusive of that month's request), and must be
signed by an authorized signatory of Agency. By signing Attachment I, Agency is certifying
that the costs are valid, eligible, consistent with the terms and conditions of this Contract, and the
data contained in the report is true and correct.
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9.2.2 Attachment II—Expenditure Worksheet.
This report shall itemize each expense requested for reimbursement by Agency and shall
include the Account corresponding the expense to a Budget line item. In order for this report to
be complete the following must be submitted:
9.2.2.1 For payroll expenses, timesheets signed by employees and approved
by supervisor for all payroll expenses listed. Timesheets must
distinguish between CDBG-funded time and non-CDBG funded time
and reflect actual time spent on CDBG-funded activities. Agency may
not submit payroll expenses dated 60 calendar days prior to the date of
the Reimbursement Request.
9.2.2.2 For non-payroll expenses, invoices for each expense listed with an
explanation as to how the invoiced expense pertains to the Program.
Agency may not submit invoices dated 60 calendar days prior to the
date of the Reimbursement Request.
9.2.2.3 Proof that each expense was paid by Agency, which proof can be
satisfied by cancelled checks, wire transfer documentation, paid
receipts or other appropriate banking documentation.
9.2.3 Attachment III—Client Data Report.
This report shall list each Unduplicated Client served during the month along with his or
her demographic information. The Client Data Report must maintain a list of all clients served
during the Contract term. In order for this report to be complete, the following must be
submitted:
9.2.3.1 Documentation of income verification for each Unduplicated Client the
first time the client is served by the Program, which will either be the completed
form of EXHIBIT "E" - Form of Income Self Certification or similar form
approved by City, or Source Documentation.
9.2.4 Delivery of Reimbursement Request.
Reimbursement Requests can be mailed or delivered in person to Neighborhood
Services Department, 908 Monroe Street, Fort Worth, Texas 76102. In addition, Agency can
submit Reimbursement Requests via email to psa@fortworthtexas.gov or to the Agency's
designated City contract administrator, but Agency must submit a signed original of Attachment
I by the deadline in Section 9.1.1.
9.2.5 Countywide Agencies.
Countywide Agencies shall submit EXHIBIT "A-2" — Reporting Requirements for
Countywide Agencies quarterly with the January, April, July and September Reimbursement
Requests. A paper copy must be submitted with the Reimbursement Request, and an electronic
copy must also be emailed to psa@fortworthtexas.gov or to the Agency's designated City
Contract administrator.
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9.3 Withholding Payment.
CITY SHALL HAVE NO OBLIGATION TO PAY ANY REIMBURSEMENT
REQUEST THAT IS NOT RECEIVED BY THE DUE DATE. Failure to timely submit
Reimbursement Requests and Complete Documentation along with any required reports
shall be an event of default.
10. DEFAULT AND TERMINATION.
10.1 Failure to Submit Reimbursement Request or Required Documentation.
10.1.1 If Agency fails to submit a Reimbursement Request in accordance with
Section 9, Agency shall be in default of this Contract. City will notify Agency in writing of such
default and the Agency will have 10 business days from the date of the written notice to submit
such Reimbursement Request to cure the default. If Agency fails to cure the default within such
time,Agency shall forfeit any payments otherwise due that month.
10.1.2 If Agency fails to submit requested information or missing documentation as
set forth in Section 9.1.2, then Agency shall forfeit payment due that month and the failure to
submit shall be considered an event of default that shall not be cured.
10.1.3 NOTWITHSTANDING THE PROVISIONS OF SECTION 10.1.1 OR
10.1.2, IF AGENCY FAILS TO SUBMIT THE REIMBURSEMENT REQUEST DUE
OCTOBER 1, 2017, OR IF THE SUBMITTED REIMBURSEMENT REQUEST FOR
OCTOBER 1,2017 IS LATE,INCOMPLETE OR OTHERWISE NOT IN COMPLIANCE
WITH THIS CONTRACT OR THE CDBG REGULATIONS AS DETERMINED BY
CITY IN ITS SOLE DISCRETION, THERE WILL BE NO CURE PERIOD AND ANY
REIMBURSEMENT WILL BE FORFEITED.
10.1.4 In the event of (i) an uncured default under Section 10.1.1 or an event of
default under 10.1.2 or (ii) more than 2 instances of default, cured or uncured, under these
Sections, City reserves the right at its sole option to terminate this Contract effective
immediately upon written notice of such intent with no penalty or liability to City.
10.1.5 Notwithstanding anything to the contrary herein, City will not be required to
pay any CDBG Funds to Agency during the period that any Reimbursement Request, report or
documentation is past due or is not in compliance with this Contract or the CDBG Regulations,
or during any period during which Agency is in default of this Contract.
10.1.6 In the event of termination under this Section 10.1, all CDBG Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no further right to such funds.
10.2 Failure to Maintain Records or Submit Reports and Documentation.
If Agency fails to maintain all records and documentation as required in Section 8, or if
the maintained or submitted report or documentation is not in compliance with this Contract or
the CDBG Regulations as determined by City in its sole discretion, City will notify Agency in
writing and Agency will have 30 calendar days from the date of the written request to obtain or
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recreate the missing records and documentation or submit or resubmit any such report or
documentation to City. If Agency fails to maintain the required reports or documentation, or
fails to submit or resubmit any such report or documentation within such time, City shall have
the right to terminate this Contract effective immediately upon written notice of such intent with
no penalty or liability to City.
10.2.1 In the event of termination under this Section 10.2, all CDBG Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no further right to such funds, and any CDBG Funds paid to Agency must be repaid to City
within 30 days of termination. If such CDBG Funds are not repaid to City within the 30 day
period, City shall exercise all legal remedies available under this Contract.
10.3 In General.
10.3.1 Subject to Section 10.2, and unless specifically provided otherwise in this
Contract, Agency shall be in default under this Contract if Agency breaches any term or
condition of this Contract. In the event that such a breach remains uncured after 30 calendar
days following written notice by City (or such other notice period as may be specified herein) or,
if Agency has diligently and continuously attempted to cure following receipt of such written
notice but reasonably requires more than 30 calendar days to cure, as determined by both Parties
mutually and in good faith, City shall have the right to elect in City's sole discretion to (i) extend
Agency's time to cure, (ii) terminate this Contract effective immediately upon written notice of
such intent to Agency, or (iii) pursue any other legal remedies available to City under this
Contract.
10.3.2 City's remedies may include:
10.3.2.1 Direct Agency to prepare and follow a schedule of actions for
carrying out the affected activities, consisting of schedules,
timetables and milestones necessary to implement the affected
activities.
10.3.2.2 Direct Agency to establish and follow a management plan that
assigns responsibilities for carrying out the remedial activities.
10.3.2.3 Reprogram CDBG Funds that have not yet been expended from
affected activities to other eligible activities or withhold CDBG
Funds.
10.3.2.4 Any other appropriate action including but not limited to any
remedial action legally available such as declaratory judgment,
specific performance, damages, temporary or permanent
injunctions, termination of this Contract or any other contracts with
Agency, and any other available remedies.
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10.3.3 In the event of termination under this Section 10.3, all CDBG Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no further right to such funds, and any CDBG Funds already paid to Agency must be repaid
to City within 30 days of the termination. Failure to repay such CDBG Funds within the 30 day
period will result in City exercising all legal remedies available under this Contract.
10.4 No Funds Disbursed while in Breach.
Agency understands and agrees that no CDBG Funds will be paid to Agency until all
defaults are cured to City's satisfaction.
10.5 No Compensation After Date of Termination.
Agency shall not receive any compensation for work undertaken after the date of the
termination.
10.6 Rights of City Not Affected.
Termination shall not affect or terminate any of the existing rights of City against
Agency, or which may thereafter accrue because of Agency's default and this provision shall be
in addition to any and all other rights and remedies available to City under the law. Such
termination does not terminate any provisions of this Contract that have been expressly noted as
surviving the term or termination of the Contract. No delay or omission by City in exercising
any right or remedy available to it under this Contract shall impair any such right or remedy or
constitute a waiver or acquiescence in any Agency default.
10.7 Waiver of Breach Not Waiver of Subsequent Breach.
The waiver of a default or breach of any term, covenant, or condition of this Contract
shall not operate as a waiver of any subsequent default or breach of the same or any other term,
covenant or condition hereof.
10.8 Civil, Criminal and Administrative Penalties.
Failure to perform all the Contract terms may result in civil, criminal or administrative
penalties, including, but not limited to those set out in this Contract.
10.9 Termination for Cause.
10.9.1 City may terminate this Contract in the event of Agency's default, inability, or
failure to perform subject to notice, grace and cure periods. In the event City terminates this
Contract for cause, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract
shall be immediately rescinded and Agency shall have no further right to such funds and any
CDBG Funds already paid to Agency must be repaid to City within 30 days of termination.
Failure to repay such CDBG Funds within 30 days will result in City exercising all legal
remedies available to City under this Contract. AGENCY ACKNOWLEDGES AND
AGREES THAT IF CITY TERMINATES THIS CONTRACT FOR CAUSE, AGENCY
OR ANY AFFILIATES OF AGENCY SHALL NOT BE CONSIDERED FOR ANY
OTHER CITY CONTRACT FOR CDBG FUNDS FOR A MINIMUM OF 5 YEARS
FROM THE DATE OF TERMINATION.
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10.9.2 Agency may terminate this Contract if City does not provide the CDBG Funds
substantially in accordance with this Contract.
10.10 Termination for Convenience.
In terminating in accordance with 2 CFR Part 200, Appendix lI, this Contract may be
terminated in whole or in part only as follows:
10.10.1 By City with the consent of Agency in which case the Parties shall agree upon
the termination conditions, including the effective date and in the case of partial termination, the
portion to be terminated; or
10.10.2 By Agency upon at least 30 days written notification to City, setting forth the
reasons for such termination, the effective date, and in the case of partial termination, the portion
to be terminated. In the case of a partial termination, City may terminate the Contract in its
entirety if City determines in its sole discretion that the remaining portion of the Contract to be
performed or CDBG Funds to be spent will not accomplish the purposes for which the Contract
was made.
10.11 Dissolution of A2ency Terminates Contract.
This Contract shall terminate in the event Agency is dissolved or ceases to exist. In the
event of termination under this Section, all CDBG Funds are subject to repayment and/or City
may exercise all of its remedies under this Contract.
10.12 Reversion of Assets.
In the event this Contract is terminated with or without cause, all assets acquired by
Agency with the CDBG Funds including cash, interest payments from loans or otherwise, all
outstanding notes, mortgages or other security instruments, any accounts receivable attributable
to the use of the CDBG Funds, and any real or personal property owned by Agency that was
improved with the CDBG Funds shall automatically transfer to City or to such assignee as City
may designate.
11. REPAYMENT OF CDBG FUNDS.
All CDBG Funds are subject to repayment in the event the Program does not meet the
requirements of this Contract or in the CDBG Regulations. If Agency takes any action that
results in the City being required to repay all or any portion of the CDBG Funds to HUD,
Agency agrees it will reimburse City for such repayment. If Agency takes any action that
results in City receiving a finding from HUD about the Program, whether or not
repayment of all or any portion of the CDBG Funds is required of City, Agency agrees City
may require that 10% of the CDBG Funds be repaid to City as liquidated damages. The
Parties agree that City's damages in the event of either repayment to HUD being required or
receiving a finding from HUD are uncertain and would be difficult to ascertain and may include
an impact on City's CDBG grant or other federal grant funds, in addition to the finding by HUD
or a required repayment of funds to HUD by City. Therefore, the Parties agree that payment
under this Section of 10% of the CDBG Funds by Agency to City is liquidated damages and not
a penalty.
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12. CHANGE IN NON-PROFIT STATUS.
Agency must provide City with written notification of any changes to its non-profit status
within 15 calendar days of being notified of the change. Regardless of notice by Agency, if the
non-profit status of Agency changes after the date of this Contract, City may but is not obligated
to, terminate this Contract. In the event of termination under this Section 12, all CDBG Funds
awarded but not yet paid to Agency pursuant to this Contract shall be immediately rescinded and
Agency shall have no further right to such funds. City, in its sole discretion, may require that
any CDBG Funds already paid to Agency must be repaid to City within 30 calendar days of
termination under this Section.
13. SURVIVAL.
Any provision of this Contract that pertains to auditing, monitoring, client income
eligibility, record keeping and reports, City ordinances, or applicable CDBG requirements, and
any default and enforcement provisions necessary to enforce such provisions, shall survive the
termination of this Contract for 5 years after the Contract term ends and shall be enforceable by
City against Agency. For purposes of this Contract, this 5 year period for survival of certain
Contract provisions is deemed to begin on October 1, 2017 and end on September 30, 2022
regardless of whether or not this Contract is earlier terminated.
14. GENERAL PROVISIONS
14.1 A14ency an Independent Contractor.
Agency shall operate hereunder as an independent contractor and not as an officer, agent,
servant or employee of City. Agency shall have exclusive control of, and the exclusive right to
control, the details of the work and services performed hereunder, and all persons performing
same, and shall be solely responsible for the acts and omissions of its officers, members, agents,
servants, employees, contractors, subcontractors, vendors, clients, licensees or invitees.
14.2 Doctrine of Respondeat Superior.
The doctrine of respondeat superior shall not apply as between City and Agency, or its
officers, members, agents, servants, employees, contractors, subcontractors, vendors, clients,
licensees or invitees, and nothing herein shall be construed as creating a partnership or joint
enterprise between City and Agency. City does not have the legal right to control the details of
the tasks performed hereunder by Agency, its officers, members, agents, employees, contractors,
subcontractors, vendors, clients, licensees or invitees.
14.3 Agency Property.
City shall under no circumstances be responsible for any property belonging to Agency,
or its officers, members, agents, employees, contractors, subcontractors, vendors, clients,
licensees or invitees that may be lost, stolen or destroyed or in any way damaged and AGENCY
HEREBY INDEMNIFIES AND HOLDS HARMLESS CITY AND ITS OFFICERS,
AGENTS, AND EMPLOYEES FROM ANY AND ALL CLAIMS OR SUITS
PERTAINING TO OR CONNECTED WITH SUCH PROPERTY.
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14.5 Religious Organization.
Agency shall comply with all applicable requirements as more particularly described in
24 CFR Part 5.109. No portion of the CDBG Funds shall be used in support of any sectarian or
religious activity. In addition, there must be no religious or membership criteria for clients of a
CDBG-funded service.
14.5.1. Separation of Explicitly Religious Activities.
Agency retains its independence and may continue to carry out its mission, including the
definition, development practice, and expression of its religious beliefs, provided that it does not
use CDBG Funds to support or engage in any explicitly religious activities (including activities
that involve overt religious content such as worship, religious instruction, or proselytization), or
in any other manner prohibited by law.
14.5.2 Explicitly Religious Activities.
If Agency engages in explicitly religious activities (including activities that involve overt
religious content such as worship, religious instruction, or proselytization), the explicitly
religious activities must be offered separately, in time or location, from the programs or activities
supported by CDBG Funds and participation must be voluntary for clients of a CDBG-funded
service.
14.5.3 Required Notices.
If Agency constitutes a Faith-based organization under 24 CFR Part 5.109, Agency must
provide all clients of a CDBG-funded service with the notice attached as EXHIBIT "K"—
Notice of Beneficiary Rights. Such notice shall be provided to the client prior to enrollment in
any CDBG-funded program or activity. In addition, if a client or prospective client of a CDBG-
funded service objects to the religious character of Agency, then Agency must promptly
undertake reasonable efforts to identify and refer the client or prospective client to an alternate
provider to which the client or prospective client has no such objection, as more particularly
described in 24 CFR Part 5.109.
14.6 Venue.
Venue shall lie in Tarrant County, Texas for any action, whether real or asserted, at law
or in equity, arising out of the execution,performance, attempted performance or
non-performance of this Contract.
14.7 Governing Law.
This Contract shall be governed by and construed in accordance with the laws of the
State of Texas. If any action, whether real or asserted, at law or in equity, arises out of the
execution, performance or non-performance of this Contract or on the basis of any provision
herein, for any issue not governed by federal law, the choice of law shall be the laws of the State
of Texas.
14.8 Severability.
The provisions of this Contract are severable, and if for any reason a clause, sentence,
paragraph or other part of this Contract shall be determined to be invalid by a court or federal or
state agency, board or commission having jurisdiction over the subject matter thereof, such
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invalidity shall not affect other provisions which can be given effect without the invalid
provision.
14.9 Written Agreement Entire Contract.
This written instrument and the Exhibits, Attachments, and Addendums attached hereto,
which are incorporated by reference and made a part of this Contract for all purposes, constitute
the entire agreement by the Parties concerning the work and services to be performed under this
Contract. Any prior or contemporaneous oral or written agreement which purports to vary the
terms of this Contract shall be void. Any amendments to the terms of this Contract must be in
writing and executed by the Parties.
14.10 Paragraph Headings for Reference Only, No Legal Significance; Number
and Gender.
The paragraph headings contained herein are for convenience in reference to this
Contract and are not intended to define or to limit the scope of any provision of this Contract.
When context requires, singular nouns and pronouns include the plural and the masculine gender
shall be deemed to include the feminine or neuter and the neuter gender to include the masculine
and feminine. The words "include" and "including" whenever used herein shall be deemed to be
followed by the words "without limitation".
14.11 Compliance With All Applicable Laws and Regulations.
Agency agrees to comply fully with all applicable laws and regulations that are currently
in effect or that are hereafter amended during the performance of this Contract. Those laws
include, but are not limited to:
➢ CDBG Regulations found in 24 CFR Part 570
➢ Title I of the Housing and Community Development Act of 1974, as amended, (42
USC 5301)
➢ Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d et seq.) including
provisions requiring recipients of federal assistance to ensure meaningful access by
persons of limited English proficiency
➢ The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. Sections
3601 etseq.)
➢ Executive Orders 11063, 11246 as amended by 11375 and 12086 and as
supplemented by Department of Labor regulations 41 CFR Part 60
➢ The Age Discrimination in Employment Act of 1967
➢ The Age Discrimination Act of 1975 (42 U.S.C. Sections 6101 et seq.)
➢ The Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970 (42 U.S.C. Sections 4601 et seq. and 49 CFR Part 24) ("URA")
➢ Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sections 794 et seq.) and 24
CFR Part 8 where applicable
➢ National Environmental Policy Act of 1969, as amended, 42 U.S.C. Sections 4321 et
seq. ("NEPA") and the related authorities listed in 24 CFR Part 58.
➢ The Clean Air Act, as amended, (42 U.S.C. Sections 1251 et seq.) and the Clean
Water Act of 1977, as amended (33 U.S.C. Sections 1251 et seq.) and the related
Executive Order 11738. In no event shall any amount of the assistance provided
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under this Contract be utilized with respect to a facility that has given rise to a
conviction under the Clean Air Act or the Clean Water Act.
➢ Immigration Reform and Control Act of 1986 (8 U.S.C. Sections 1101 et seq.)
specifically including the provisions requiring employer verifications of legal status
of its employees
➢ The Americans with Disabilities Act of 1990 (42 U.S.C. Sections 12101 et seq.), the
Architectural Barriers Act of 1968 as amended (42 U.S.C. Sections 4151 et seq.) and
the Uniform Federal Accessibility Standards, 24 CFR Part 40,Appendix A
➢ Regulations at 24 CFR Part 87 related to lobbying, including the requirement that
certifications and disclosures be obtained from all covered persons
➢ Drug Free Workplace Act of 1988 (41 U.S.C. Sections 701 et seq.) and 24 CFR Part
23, Subpart F
➢ Executive Order 12549 and 24 CFR Part 5.105(c) pertaining to restrictions on
participation by ineligible, debarred or suspended persons or entities
➢ Section 6002 of the Solid Waste Disposal Act, as amended by the Resource
Conservation and Recovery Act
➢ Guidelines of the Environmental Protection Agency at 40 CFR Part 247
➢ For contracts and subgrants for construction or repair, Copeland "Anti-Kickback" act
(18 U.S.C. 874) as supplemented in 29 CFR Part 5
➢ For construction contracts awarded by Agency in excess of$2,000, and in excess of
$2,500 for other contracts which involve the employment of mechanics or laborers,
Sections 103 and 107 of the Contract Work Hours and Safety Standards Act (40
U.S.C. 327A 300) as supplemented by 29 CFR Part 5
➢ Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), as amended by
the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et
seq.) and implementing regulations at 24 CFR Part 35, subparts A,B, M, and R
➢ Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, 2 CFR Part 200 et seq.
➢ Federal Funding Accountability and Transparency Act of 2006 ("FFATA") (Pub.L.
109-282, as amended by Section 6205(a) of Pub.L. 110-252 and Section 3 of Pub.L.
113-101)
➢ Federal Whistleblower Regulations, as contained in 10 U.S.C. 2409, 41 U.S.C. 4712,
10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310.
14.12 HUD Assisted Proieets and Employ—ent and other Economie
14.13 Prohibition Against Discrimination.
14.13.1 General Statement.
Agency shall comply in the execution, performance or attempted performance of this
Contract, with all non-discrimination requirements of 24 CFR Part 570.607 and Chapter 17,
Article III, Division 4 — Fair Housing of the City Code. Agency may not discriminate against
any person because of race, color, sex, gender, religion, national origin, familial status, disability
or perceived disability, sexual orientation, gender identity, gender expression, or transgender, nor
will Agency permit its officers, members, agents, employees, or clients to engage in such
discrimination.
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This Contract is made and entered into with reference specifically to Chapter 17, Article
III, Division 3 - Employment Practices of the City Code, and Agency hereby covenants and
agrees that Agency, its officers, members, agents, employees and contractors, have fully
complied with all provisions of same and that no employee, or applicant for employment has
been discriminated against under the terms of such ordinances by either or its officers, members,
agents, employees or contractors.
14.13.2 No Discrimination in Employment during the Performance of This
Contract.
During the performance of this Contract Agency agrees to the following provision, and
will require that its contractors and subcontractors also comply with such provision by including
it in all contracts with its contractors:
[Contractor's, Subcontractor's or Vendor's name] will not unlawfully discriminate
against any employee or applicants for employment because of race, color, sex, gender, religion,
national origin, familial status, disability or perceived disability, sexual orientation, gender
identity, gender expression or transgender. [Contractor's Subcontractor's or Vendor's name]
will take affirmative action to ensure that applicants are hired without regard to race, color, sex,
gender, religion, national origin, familial status, disability or perceived disability, sexual
orientation, gender identity, gender expression or transgender and that employees are treated
fairly during employment without regard to their race, color, sex, gender, religion, national
origin, familial status, disability or perceived disability, sexual orientation, gender identity,
gender expression or transgender. Such action shall include, but not be limited to, the following:
employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or
termination, rates of pay or other forms of compensation, and selection for training, including
apprenticeship. [Contractor's, Subcontractor's or Vendor's name] agrees to post in conspicuous
places, available to employees and applicants for employment, notices setting forth the
provisions of this nondiscrimination clause.
[Contractor's, Subcontractor's or Vendor's name] will, in all solicitations or
advertisements for employees placed by or on behalf of [Contractor's, Subcontractor's or
Vendor's name], state that all qualified applicants will receive consideration for employment
without regard to race, color, sex, gender, religion, national origin, familial status, disability or
perceived disability, sexual orientation, gender identity, gender expression or transgender.
[Contractor's, Subcontractor's or Vendor's name] covenants that neither it nor any of its
officers, members, agents, employees, or contractors, 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 or because of any disability or perceived disability, except on the
basis of a bona fide occupational qualification, retirement plan or statutory requirement.
[Contractor's Subcontractor's or Vendor's name] further covenants that neither it nor its
officers, members, agents, employees, contractors, 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.
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14.13.3 A2ency's Contractors and the ADA.
In accordance with the provisions of the Americans With Disabilities Act of 1990
("ADA"), Agency warrants that it and any of its contractors 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, or employees of,
Agency or any of its contractors. AGENCY WARRANTS IT WILL FULLY COMPLY
WITH THE 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, CONTRACTORS
SUBCONTRACTORS, VENDORS OR AGENTS AGAINST CITY ARISING OUT OF
AGENCY'S AND/OR ITS CONTRACTORS', SUBCONTRACTORS', VENDORS' OR
AGENTS' OR THEIR RESPECTIVE EMPLOYEES' ALLEGED FAILURE TO
COMPLY WITH THE ABOVE-REFERENCED LAWS CONCERNING DISABILITY
DISCRIMINATION IN THE PERFORMANCE OF THIS CONTRACT.
14.14. Conflicts of Interest and Violations of Criminal Law.
14.14.1 Agency Safeguards.
Agency shall establish safeguards to prohibit its employees, board members, advisors and
agents from using positions for a purpose that is or gives the appearance of being motivated by a
desire for private gain for themselves or others, particularly those with whom they have family,
business or other ties. Agency shall disclose to City any such conflict of interest or potential
conflict of interest, immediately upon discovery of such.
14.14.2 General Prohibitions Against Conflicts of Interest.
No employees, agents, consultants, officers or elected officials or appointed officials of
City or of Agency who exercise or have exercised any functions or responsibilities with respect
to activities assisted with CDBG funds or who are in a position to participate in a decision-
making process or gain inside information with regard to these activities may utilize CDBG
services, may obtain a financial interest or benefit from a CDBG-assisted activity, or have an
interest in any contract, subcontract or agreement with respect thereto, or the proceeds
thereunder, either for themselves or those with whom they have family or business ties, during
their tenure or for 1 year thereafter.
14.14.2.1 Agency shall establish conflict of interest policies for federal
awards including the CDBG Funds and shall disclose in writing
potential conflicts of interest to City as authorized by 2 CFR Part
200.112.
14.14.3 Conflicts of Interest Involving Procurement.
The conflict of interest provisions of 2 CFR Part 200.318 shall apply in the procurement
of property and services by Agency. In all cases not governed by this Section, the provisions of
24 CFR Part 570.611 of the CDBG Regulations shall apply.
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14.14.3.1 As more particularly described in 2 CFR Part 200.318, Agency
shall maintain and submit to City written standards of conduct
covering conflicts of interest and governing the performance of its
employees engaged in the selection, award, and administration of
contracts. No employee, officer, or agent may participate in the
selection, award, or administration of a contract supported by a
federal award if he or she has a real or apparent conflict of interest.
The standards of conduct must provide for disciplinary actions to
be applied for violations of such standards by officers, employees,
or agents of Agency.
14.14.3.2 The officers, employees, and agents of Agency shall neither solicit
nor accept gratuities, favors, or anything of monetary value from
contractors or parties to subcontracts.
14.14.3.3 Notwithstanding the prohibition contained in Section 14.14.3.2,
Agency may set standards of conduct for situations in which the
financial interest is not substantial or the gift is an unsolicited item
of nominal value. Such standards of conduct must provide for
disciplinary actions to be applied for violations of such standards
by Agency's officers, employees or agents.
14.14.3.4 Agency shall maintain written standards of conduct covering
organizational conflicts of interest. Organizational conflicts of
interest means that because of relationships with a parent company,
affiliate, or subsidiary organization, Agency is unable or appears to
be unable to be impartial in conducting a procurement action
involving a related organization.
14.14.3.5 Agency must maintain records sufficient to detail the history of
procurement. These records will include, but are not necessarily
limited to the following: rationale for the method of procurement,
selection of contract type, contractor selection or rejection, and the
basis for the contract price.
14.14.4 Disclosure of Conflicts of Interest.
In compliance with 2 CFR Part 200.112, Agency is required to timely disclose to City in
writing any potential conflict of interest.
14.14.5 Disclosure of Texas Penal Code Violations.
Agency affirms that it will adhere to the provisions of the Texas Penal Code which
prohibit bribery and gifts to public servants.
14.14.6 Disclosure of Federal Criminal Law Violations.
In compliance with 2 CFR Part 200.113, Agency is required to timely disclose to City all
violations of federal criminal law involving fraud, bribery or gratuity violations potentially
affecting the Agency.
CDBG 51%PSA CONTRACT 2016-2017 Page 24
Camp Fire First Texas Rev.9.27.2016
14.15 Subcontracting with Small and Minority Firms, Women's Business
Enterprises and Labor Surplus Areas.
14.15.1 For procurement contracts $50,000.00 or larger that are paid for, in part or in
full, with the CDBG Funds, Agency agrees to abide by City's policy to involve Minority
Business Enterprises and Small Business Enterprises and to provide them 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. Agency agrees to incorporate the
City's BDE Ordinance, and all amendments or successor policies or ordinances thereto, into all
contracts and subcontracts for procurement larger than $50,000.00 or larger that are paid for, in
part or in full, with the CDBG Funds and will further require all persons or entities with which it
so contracts to comply with said ordinance.
14.15.2 It is national policy to award a fair share of contracts to disadvantaged
business enterprises ("DBEs"), small business enterprises ("SBEs"), minority business
enterprises ("MBEs"), and women's business enterprises ("WBEs"). Accordingly, affirmative
steps must be taken to assure that DBEs, SBEs, MBEs, and WBEs are utilized when possible as
sources of supplies, equipment, construction and services.
14.15.2.1 In order to comply with federal reporting requirements 24 CFR
Part 570.506 (g)(6), Agency must submit the form attached hereto
as EXHIBIT "I" — MBE Reporting Form for each contract or
subcontract with a value of$10,000.00 or more paid or to be paid
with the CDBG Funds. Agency shall submit this form by the date
specified in EXHIBIT "I"—MBE Reporting Form.
14.16 Other Laws.
The failure to list any federal, state or City ordinance, law or regulation that is applicable
to Agency does not excuse or relieve Agency from the requirements or responsibilities in regard
to following the law, nor from the consequences or penalties for Agency's failure to follow the
law, if applicable.
14.17 Assignment.
Agency shall not assign all or any part of its rights, privileges, or duties under this
Contract without the prior written approval of City. Any attempted assignment of same without
approval shall be void, and shall constitute a breach of this Contract.
14.18. RiLht to Inspect ALrency Contracts.
It is agreed that City has the right to inspect and approve in writing any proposed
contracts between Agency and any contractor or vendor engaged in any activity in conjunction
with this CDBG-funded Program prior to any charges being incurred.
14.19 Force Maieure
If Agency becomes unable, either in whole or part, to fulfill its obligations under this
Contract due to acts of God, strikes, lockouts, or other industrial disturbances, acts of public
enemies, wars, blockades, insurrections, riots, epidemics, earthquakes, fires, floods, restraints or
CDBG 51%PSA CONTRACT 2016-2017 Page 25
Camp Fire First Texas Rev. 9.27.2016
prohibitions by any court, board, department, commission or agency of the United States or of
any States, civil disturbances, or explosions, or some other reason beyond Agency's control
(collectively, "Force Majeure Event"), the obligations so affected by such Force Majeure Event
will be suspended only during the continuance of such event. Agency will give City written
notice of the existence, extent and nature of the Force Majeure Event as soon as reasonably
possible after the occurrence of the event. Failure to give notice will result in the continuance of
Agency's obligation regardless of the extent of any existing Force Majeure Event. Agency will
use commercially reasonable efforts to remedy its inability to perform as soon as possible.
15. INDEMNIFICATION AND RELEASE.
AGENCY COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS
AND DEFEND, AT ITS OWN EXPENSE, CITY AND ITS OFFICERS, AGENTS,
SERVANTS AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR
SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY,
INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR
CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN
CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED
PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE
OPERATIONS, ACTIVITIES AND 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 AGENCY HEREBY
ASSUMES ALL LIABILITY AND RESPONSIBILITY OF CITY AND ITS OFFICERS,
AGENTS, SERVANTS, AND EMPLOYEES FOR ANY AND ALL CLAIMS OR SUITS
FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL 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 NONPERFORMANCE OF THIS CONTRACT AND/OR THE
OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED
HEREIN, WHETHER OR NOT CAUSED IN WHOLE OR IN PART BY ALLEGED
NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES,
CONTRACTORS OR SUBCONTRACTORS OF CITY. AGENCY LIKEWISE
COVENANTS AND AGREES TO AND DOES HEREBY INDEMNIFY AND HOLD
HARMLESS CITY FROM AND AGAINST ANY AND ALL INJURY, DAMAGE OR
DESTRUCTION OF PROPERTY OF CITY, ARISING OUT OF OR IN CONNECTION
WITH ALL ACTS OR OMISSIONS OF AGENCY, ITS OFFICERS, MEMBERS,
AGENTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, INVITEES,
LICENSEES, OR CLIENTS, OR CAUSED, IN WHOLE OR IN PART, BY ALLEGED
NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES,
CONTRACTORS OR SUBCONTRACTORS OF CITY.
IT IS THE EXPRESS INTENTION OF THE PARTIES, BOTH AGENCY AND
CITY, THAT THE INDEMNITY PROVIDED FOR THIS SECTION INCLUDES
INDEMNITY BY AGENCY TO INDEMNIFY AND PROTECT CITY FROM THE
CDBG 51%PSA CONTRACT 2016-2017 Page 26
Camp Fire First Texas Rev. 9.27.2016
CONSEQUENCES OF CITY'S OWN NEGLIGENCE, WHETHER THAT
NEGLIGENCE IS ALLEGED TO BE THE SOLE OR CONCURRING CAUSE OF THE
INJURY,DAMAGE OR DEATH.
AGENCY AGREES TO AND SHALL RELEASE CITY, ITS AGENTS,
EMPLOYEES, OFFICERS AND LEGAL REPRESENTATIVES FROM ALL
LIABILITY FOR INJURY, DEATH, DAMAGE OR LOSS TO PERSONS OR
PROPERTY SUSTAINED IN CONNECTION WITH OR INCIDENTAL TO
PERFORMANCE UNDER THIS CONTRACT, EVEN IF THE INJURY, DEATH,
DAMAGE OR LOSS IS CAUSED BY CITY'S SOLE OR CONCURRENT
NEGLIGENCE.
AGENCY SHALL REQUIRE ALL OF ITS CONTRACTORS AND
SUBCONTRACTORS TO INCLUDE IN THEIR CONTRACTS AND SUBCONTRACTS
A RELEASE AND INDEMNITY IN FAVOR OF CITY IN SUBSTANTIALLY THE
SAME FORM AS ABOVE.
16. WAIVER OF IMMUNITY BY AGENCY.
If Agency, as a charitable or nonprofit 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, Agency 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.
17. INSURANCE AND BONDING.
Agency will maintain coverage in the form of insurance or bond in the amount of
$78,905.00 to insure against loss from the fraud, theft or dishonesty of any of Agency's officers,
agents, trustees, directors or employees. The proceeds of such insurance or bond shall be used to
reimburse City for any and all loss of CDBG Funds occasioned by such misconduct. To
effectuate such reimbursement, such fidelity coverage shall include a rider stating that
reimbursement for any loss or losses shall name the City as a Loss Payee.
Agency shall furnish to City in a timely manner, but not later than the Effective Date,
certificates of insurance as proof that it has secured and paid for policies of commercial
insurance as specified herein. If City has not received such certificates by the Effective Date,
Agency shall be in default of the Contract and City may, at its option, terminate the Contract.
Such insurance shall cover all insurable risks incident to or in connection with the
execution, performance, attempted performance or nonperformance of this Contract. Agency
shall maintain the following insurance coverage and limits:
Commercial General Liability(CGL) Insurance
$ 500,000 each occurrence
$1,000,000 aggregate limit
CDBG 51%PSA CONTRACT 2016-2017 Page 27
Camp Fire First Texas Rev.9.27.2016
Non-Profit Organization Liability or Directors & Officers LiabilitX
$1,000,000 Each Occurrence
$1,000,000 Annual Aggregate Limit
Business Automobile Liability Insurance
$1,000,000 each accident on a combined single-limit basis, or
$ 250,000 Property Damage
$ 500,000 Bodily Injury per person per occurrence
$2,000,000 Aggregate
Insurance policy shall be endorsed to cover "Any Auto", defined as autos owned, hired,
and non-owned. Pending availability of the above coverage and at the discretion of
City, the policy shall be the primary responding insurance policy versus a personal
auto insurance policy if or when in the course of Agency's business as contracted
herein.
Workers' Compensation Insurance
Part A: Statutory Limits
Part B: Employer's Liability
$100,000 each accident
$100,000 disease-each employee
$500,000 disease-policy limit
Note: Such insurance shall cover employees performing work on any and all projects
including but not limited to construction, demolition, and rehabilitation. Agency or its
contractors shall maintain coverages, if applicable. In the event the respective contractors
do not maintain coverage, Agency shall maintain the coverage on such contractor, if
applicable, for each applicable contract.
Additional Requirements
Such insurance amounts shall be revised upward at City's reasonable option and no more
frequently than once every 12 months, and Agency shall revise such amounts within 30 days
following notice to Contractor of such requirements.
Agency will submit to City documentation that it has obtained insurance coverage and has
executed bonds as required in this Contract prior to payment of any monies provided hereunder.
Where applicable, insurance policies required herein shall be endorsed to include City as an
additional insured as its interest may appear. Additional insured parties shall include employees,
officers, agents, and volunteers of City.
Any failure on part of City to request certificate(s) of insurance shall not be construed as a
waiver of such requirement or as a waiver of the insurance requirements themselves.
Insurers of Agency's insurance policies shall be licensed to do business in the state of Texas by
the Department of Insurance or be otherwise eligible and authorized to do business in the state of
CDBG 51%PSA CONTRACT 2016-2017 Page 28
Camp Fire First Texas Rev.9.27.2016
Texas. Insurers shall be acceptable to City insofar as their financial strength and solvency and
each such company shall have a current minimum A.M. Best Key Rating Guide rating of A-: VII
or other equivalent insurance industry standard rating otherwise approved by City.
Deductible limits on insurance policies shall not exceed $5,000 per occurrence unless otherwise
approved by City.
In the event there are any local, federal or other regulatory insurance or bonding requirements for
the Program, and such requirements exceed those specified herein, the former shall prevail.
Agency shall require its contractors to maintain applicable insurance coverages, limits, and other
requirements as those specified herein; and Agency shall require its contractors to provide
Agency with certificate(s) of insurance documenting such coverage. Also, Agency shall require
its contractors to have City and Agency endorsed as additional insureds (as their interest may
appear) on their respective insurance policies.
Directors and Officers Liability coverage shall be in force and may be provided on a claims-
made basis. This coverage may also be referred to as Management Liability, and shall protect
the insured against claims arising out of alleged errors in judgment, breaches of duty and
wrongful acts arising out of their organizational duties. Coverage shall protect not only the
entity, but all past, present and future directors, officers, trustees, employees, volunteers and
committee members.
Notwithstanding any provision in this Contract to the contrary, when applicable, Agency
shall comply with the requirements of 2 CFR 200.310 and shall, at a minimum, provide the
equivalent insurance coverage for real property and equipment acquired or improved with
CDBG Funds as provided to property owned by Agency.
18. CERTIFICATION REGARDING LOBBYING.
The undersigned representative of Agency 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 Agency,
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 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.
If any funds other than federally 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,
member of Congress in connection with this federal contract, grant, loan or cooperative
agreement, Agency shall complete and submit Standard Form-LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions.
CDBG 51%PSA CONTRACT 2016-2017 Page 29
Camp Fire First Texas Rev. 9.27.2016
This certification is a material representation of fact upon which reliance was placed
when this Contract was made or entered into. Submission of this certificate is a
prerequisite for making or entering into this Contract imposed by 31 U.S.C. Section
1352. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than$10,000.00 and not more than$100,000.00 for each such failure.
Agency shall require that the language of this certification be included in all subcontracts
or agreements involving the expenditure of federal funds.
19. LITIGATION AND CLAIMS.
Agency shall give City immediate notice in writing of any action, including any
proceeding before an administrative agency, filed against Agency in conjunction with this
Contract or the Program. Agency shall furnish immediately to City copies of all pertinent papers
received by Agency with respect to such action or claim. Agency shall provide a notice to City
within 10 days upon filing under any bankruptcy or financial insolvency provision of law.
20. NOTICE.
All notices required or permitted by this Contract must be in writing and are deemed
delivered on the earlier date of the date actually received or the third day following deposit in a
United States Postal Service post office or receptacle; with proper postage, certified mail return
receipt requested; and addressed to the other Party at the address set out below or at such other
address as the receiving Party designates by proper notice to the sending Party.
City:
City Attorney's Office
1000 Throckmorton Street
Fort Worth, TX 76102
Telephone: 817-392-7600
Copy to:
Neighborhood Services Department
1000 Throckmorton Street
Fort Worth, TX 76102
Attention: Assistant Director
Telephone: 817-392-7540
Copy to:
Neighborhood Services Department
1000 Throckmorton Street
Fort Worth, TX 76102
Attention: Management Analyst II
Telephone: 817-392-7369
CDBG 51%PSA CONTRACT 2016-2017 Page 30
Camp Fire First Texas Rev.9.27.2016
Allency:
Camp Fire First Texas
Ann Sheets, President& CEO
2700 Meacham Blvd.
Fort Worth, TX 76137
Telephone: 817-831-2111
21. AGENCY HAS LEGAL AUTHORITY TO ENTER INTO CONTRACT.
Agency represents that it possesses the legal authority, pursuant to any proper,
appropriate and official motion, resolution or action passed or taken, to enter into this Contract
and to perform the responsibilities herein required.
22. COUNTERPARTS.
This Contract may be executed in multiple counterparts, each of which shall be
considered an original, but all of which shall constitute one instrument which may be sufficiently
evidenced by one counterpart.
[SIGNATURES APPEAR ON NEXT PAGE]
CDBG 51%PSA CONTRACT 2016-2017 Page 31
Camp Fire First Texas Rev.9.27.2016
IN WITNESS WHEREOF, the Parties hereto have executed 4 duplicate originals of this
Contract in Fort Worth, Tarrant County, Texas.
T ST: CITY OF FORT WORTH
ty Secretary rnando Costa,Assistant City Manager
M&C: G-18793 /�� �o°a°°o0 i
Date: August 9, 2016
APPROVED AS TO FORMA 7L!,��fjUGAT;y7T'Y:�c
���8953
0Qpm a
Assistant C' , .Atltorney
CAMFIRE FIRST TEXAS
By: _ "I �tc' --
Ann Sheets,President& CEO
OFFICIAL RECORD
CITY SECRETARY
FT WORTH, TX
CDBG 51%PSA CONTRACT 2016-2017 Page 32
Camp Fire First Texas Rev.9.27.2016
EXHIBITS:
EXHIBIT "A"—Program Summary
EXHIBIT "A-1"—2016 HUD Income Limits
EXHIBIT "A-2"—Reporting Requirements for Countywide Agencies
EXHIBIT "B"—Budget
EXHIBIT "C"—Audit Certification Form
EXHIBIT "D"—Reimbursement Forms
EXHIBIT "E"—Form of Income Self-Certification
EXHIBIT "F"—Standards for Complete Documentation
EXHIBIT "G"—Section 3 Reporting Forms (NOT APPLICABLE)
EXHIBIT "H"—Severely Disabled Certification Form
EXHIBIT "I"—MBE Reporting Form
EXHIBIT "J"—Duties of the Parties for Use of NSD Community Centers
EXHIBIT "K"—Notice of Beneficiary Rights
CDBG 51%PSA CONTRACT 2016-2017 Page 33
Camp Fire First Texas Rev.9.27.2016
CAMP FIRE FIRST TEXAS EXHIBIT "A"
Step-Up Program PROGRAM SUMMARY
PROGRAM SUMMARY
(CDBG)
October 1, 2016 to September 30, 2017 $78,905.00
PERIOD AMOUNT
Capitalized terms not defined herein shall have meanings assigned them in the Contract.
PROGRAM:
Program provides life-skills training including conflict resolution, communication skill building,
and goal setting for at-risk youth ages 13 to 19 years of age in a supportive group atmosphere.
Program includes two parent meetings at the North Tri-Ethnic Neighborhood Center.
CDBG Funds will be used to pay for a percentage of salaries and fringe benefits for Program
employees. The percentage of any Program employee's salary will not exceed the percentage of
Fort Worth clients participating in the Program and shall be cost allocated in accordance with the
amount applicable to the CDBG funded Program.
Agency's office is located at 2700 Meacham Blvd., Fort Worth, TX 76137.
Agency will provide Program services during the school year at the following locations on the
following days and times:
North Side High School
2211 McKinley Avenue, Fort Worth, TX 76164
Monday and Wednesday, 3:30 p.m. to 4:30 p.m.
Additional services may be provided during school lunch at this location
Diamond Hill-Jarvis High School
chool
1411 Maydell Street, Fort Worth, TX 76106
Tuesday and Thursday, 3:30 p.m. to 4:30 p.m.
Additional services may be provided during school lunch at this location
W.A. Meacham Middle School
3600 Weber Street, Fort Worth, TX 76106
Tuesday and Thursday, 4:20 p.m. to 5:30 p.m.
Additional services may be provided during school lunch at this location
Kirkpatrick Middle School
3201 Refugio Avenue, Fort Worth, TX 76106
Monday and Wednesday, 4:20 p.m. to 5:30 p.m.
Additional services may be provided during school lunch at this location
CDBG 51%PSA CONTRACT 2016-2017—EXHMIT"A"—PROGRAM SUMMARY Page 1
Camp Fire First Texas
North Tri-Ethnic Neighborhood Center
2950 Roosevelt Avenue, Fort Worth, TX 76106
Friday, 4:30 p.m. to 5:30 p.m.
Program services will also be provided during the summer at the following City of Fort Worth
Neighborhood Center locations:
North Tri-Ethnic Neighborhood Center
2950 Roosevelt Avenue, Fort Worth, TX 76106
Tuesday and Thursday, 2:30 p.m. to 4:30 p.m.
Northside Neighborhood Center
1100 NW 18th Street, Fort Worth, TX 76164
Monday and Wednesday, 2:30 p.m. to 4:30 p.m.
Agency shall not change any locations without prior City approval. Costs incurred at any
locations that have not been approved by City shall not be reimbursed.
Agency is a Fort Worth Agency which means at least 90% of clients served by the Program are
Fort Worth residents. Agency will submit documentation which verifies that at least 51% of all
clients served by the Program, whether Fort Worth residents or not, are Income Eligible Clients
with current household incomes at or below 80% of AMI .
REGULATORY CLASSIFICATION:
IDIS Matrix Code(s) and Service Category: 05D Youth Services
National Objective Citation: LMC Low/Mod Limited Clientele 24 CFR 570.208(a)(2)
Regulatory Citation(s): 24 CFR 570.201(e)
PROGRAM GOALS:
Minimum Fort Worth Agency Program Performance Outcome: At least 51% of all
Program clients must be Income Eligible Clients. Agency must furnish City a Certification of
Income Statement for all clients served. For example, if the Program serves 1,000 clients, 510
must be Income Eligible Clients. In this example, Agency would be required to furnish City
1,000 Certification of Income Statements that prove at least 510 of the clients served by the
Program are Income Eligible Clients.
Minimum Number of Clients to be Served: The Program must serve a minimum of 120
Unduplicated Clients as shown by the monthly reports on Attachment III.
When determining the number of clients which constitutes 51%, HUD regulations require that
partial numbers must be rounded up.
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"A"—PROGRAM SUMMARY Page 2
Camp Fire First Texas
EXHIBIT "A-1"
2016 HUD INCOME LIMITS
2016 Median Family Income -Fort Worth/Arlington, TX*
1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons
Extremely $14,600 $16,650 $20,160 $24,300 $28,440 $32,580 $36,730 $40,890
Low
Income
50%AMI $24,300 $27,800 $31,250 $34,700 $37,500 $40,300 $43,050 $45,850
80%AMI $38,850 $44,400 $49,950 $55,500 $59,950 $64,400 $68,850 $73,300
*Income limits are published at least annually by HUD.
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"A-1"—2016 HUD INCOME LIMITS Page 1
Camp Fire First Texas
EXHIBIT "A-2"
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"A-2"
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Page 1
Camp Fire First Texas
Camp Fire First Texas
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
Quarterly Report
The purpose of the Quarterly Report is for the Countywide Agencies to report the number of non-Fort Worth
clients who participate in the Program. The Quarterly Report must be submitted with the January,April, July
and September Reimbursement Requests. A paper copy must be submitted with the Reimbursement Request,
and an electronic copy must also be emailed to psa@fortworthtexas.gov or to Agency's designated City
Contract administrator. The information provided in the Quarterly Report will be reviewed and monitored by
the Neighborhood Services Department Compliance Division.
• a OF OF
OF •-T #OF NON-FORT CLIENTS FORT WORTH
DUE DATE ••- WORTH WORTH CLIENTS SERVED BY THE CLIENTS
CLIENTS PROGRAM
A B C D E F
EXAMPLE: 250 200 450 250=450=55%
January 15,2017 October 1,2016-
December 31,2016
April 15,2017 January 1,2017-
March 30,2017
July 15,2017 April 1,2017-
June 30,2017
October 1,2017 July 1,2017-
September 30,2017
TOTAL
I, Agency representative, certify that I verified the information I reported this quarter and it is correct to the
best of my knowledge.
Certified by: Date:
Signature/Title:
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"A-2"
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Page 2
Camp Fire First Texas
EXHIBIT"B"-BUDGET
Account Grant Budget .A B C Total
PROGRAllI PERSONNEL
Salaries 1001 $ 65,480.00 $ 12,707.00 $ 7,000.00 $ 15,273.92 $ 100,460.92
FICA 1002 $ 5,009.22 $ 2,676.04 $ 7,685.26
Life/Disability Insurance 1003
Health/Dental Insurance 1004 $ 6,129.60 $ 3,274.57 $ 9,404.17
Unemployment-State 1005 $ 1,211.38 $ 647.15 $ 1,858.53
Worker's Compensation 1006 $ 654.80 $ 349.81 $ 1,004.61
Retirement 1007 $ 420.00 $ 224.37 $ 644.37
SUPPLIESAlYD'SERYICES
Office/Program Supplies 2001 $ 6,877.92 $ 6,877.92
Postage 2002 $ 55.23 $ 55.23
Printing 2003 $ 510.90 $ 510.90
Other(Transporation) 2004 $ 548.81 $ 4,175.06 $ 4,723.87
iVIISCELI:AN�OIIS
Contract Labor(City needs copy
of contract before expenses can be
reimbursed) 3001 $ 1,261.13 $ 1,261.13
Food Supplies 3002
Teaching Aids 3003 $ 659.43 $ 189.00 $ 848.43
Craft Supplies 3004
Field Trip Expenses 3005 $ 1,534.22 $ 1,534.22
Mileage 3006
Other(Subscriptions) 3007 $ 119.67 $ 119.67
OtherO 3008
FACILITY AND UTIILTT�S.
Telephone 4001 $ 366.68 $ 366.68
Electric 4002
Gas 4003
Water and Wastewater 4004
Solid Waste Disposal 4005
Rent(City needs copy of lease
before expenses can be
reimbursed) 4006
Cleaning Supplies 4007
Other() 4008
I:EGAL,FINANCTpT,�M
INSII12 i�CE . ,
Fidelity Bond or Equivalent 5001
Directors and Officers 5002 $ 359.01 $ 359.01
General Commercial Liability 5003
Other() 5004
DIRECT�ASS�STANG�
Other() 6001
BUDGET TOTAL $ 78,905.00 $ 25,000.00 $ 7,000.00 $ 26,809.92 $ 137,714.92
FUNDING A:Andrews
FUNDING B:Hudson
FUNDING C:Council Support
CDBG 51%PSA CONTRACT 2016-2017-EXHIBIT"B"-BUDGET
Camp Fire First Texas Page 1
The following tables were created for the purpose of preparing, negotiating, and determining the cost
reasonableness and cost allocation method used by the Agency for the line item budget represented on
the first page of this EXHIBIT "B"—Budget. The information reflected in the tables is to be
considered part of the terms and conditions of the Contract. Agency must have prior written approval
by the City to make changes to any line item in the Budget as outlined in Section 5.2.2 in the
Contract. The deadline to make changes to EXHIBIT "B"—Budget is June 1, 2017.
SALARY DETAIL-PROGRAM PERSONNEL
Est. Percent to Amount to
Position Title Annual Salary Grant Grant
Step Up Program Specialist $ 34,320.00 75.0% $ 25,740.00
Step Up Program Specialist $ 34,320.00 75.0% $ 25,740.00
VP Youth Development 1 $ 70,000.00 20.0%1 $ 14,000.00
TOTAL 1 $ 138,640.00 47.2%1 $ 65,480.00
FRINGE DETAIL-PROGRAM PERSONNEL
Percent of Est. Percent to Amount to
Payroll Amount Grant Grant
FICA 7.65% $ 7,685.26 65.2% $ 5,009.22
Life/Disability Insurance
Health/Dental Insurance $ 9,404.17 65.2% $ 6,129.60
Unemployment-State 1.85% $ 1,858.53 65.2% $ 1,211.38
Worker's Compensation 1.00% $ 1,004.61 65.2% $ 654.80
Retirement $ 644.37 65.2% $ 420.00
TOTAL 1 $ 20,596.94 1 65.2%1 $ 13,425.00
SUPPLIES AND SERVICES
Est. Percent to Amount to
Total Budget Grant Grant
Office/Program Supplies $ 6,877.92
Postage $ 55.23
Printing $ 510.90
Other(Transportation) $ 4,723.87
TOTAL $ 12,167.92
CDBG 51%PSA CONTRACT 2016-2017-EXHIBIT"B"-BUDGET
Camp Fire First Texas Page 2
MISCELLANEOUS
Est. Percent to Amount to
Total Budget Grant Grant
Contract Labor $ 1,261.13
Food Supplies
Teaching Aids $ 848.43
Craft Supplies
Field Trip Expenses $ 1,534.22
Mileage
Other(Subscriptions) $ 119.67
Other()
TOTAL $ 3,763.45
FACILITY AND UTILITIES
Est. Percent to Amount to
Total Budget Grant Grant
Telephone $ 366.68
Electric
Gas
Water and Wastewater
Solid Waste Disposal
Cleaning Supplies
OtherO
TOTAL I $ 366.68
LEGAL, FINANCIAL AND INSURANCE
Est. Percent to Amount to
Total Budget Grant Grant
Fidelity Bond or Equivalent
Directors and Officers $ 359.01
General Commercial Liability
OtherO
TOTAL $ 359.01
DIRECT ASSISTANCE
Est. Percent to Amount to
Total Budget Grant Grant
Other()
TOTAL
CDBG 51%PSA CONTRACT 2016-2017-EXHIBIT"B"-BUDGET
Camp Fire First Texas Page 3
EXHIBIT "C"
AUDIT CERTIFICATION FORM
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"C"—AUDIT CERTIFICATION FORM Page 1
Camp Fire First Texas
AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS
Agency: Camp Fire First Texas
Fiscal Year Ending: September 30,2017
❑ During the fiscal year in which funds will be received, we will exceed the federal
expenditure threshold of $750,000. We will have our Single Audit or Program Specific
Audit completed and will submit the audit report described in 2 CFR Part 200 within 7
months after the end of the audited fiscal year or 30 days within its completion, whichever
is the earlier date.
During the fiscal year in which funds will be received, we will not exceed the $750,000
federal expenditure threshold required for a Single Audit or a Program Specific Audit to be
performed this fiscal year. (Fill out schedule below)
Federal Expenditure Disclosure
MUST be.filled out if Single Audit or Program Audit is 1�OT required,
Pass.Through Program Name& ` Contract
Federal Grantor = Expenditures
Grantor . CFDA Num bet :Nuziabex
U.A3 9 s
11 A otal Federal Expenditures Mr this Fiscal Year:
Signatory and Title Date
Failure to submit this or a similar statement or failure to submit a completed single audit package
as described in the federally required audit requirements described in 2 CFR Part 200, as
applicable, by the required due date may result in suspension of funding and may affect
eligibility for future funding. Notwithstanding the above, this certification acknowledges the
agency's commitment to meet all other financial reporting, financial statements, and other
audit requirements as may be set forth in the Contract.
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"C"—AUDIT CERTIFICATION FORM Page 2
Camp Fire First Texas
EXHIBIT "D"
REPORTING FORMS
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"D"—REPORTING FORMS Page I
Camp Fire First Texas
ATTACHMENTI
Invoice
Agency:
Address:
City, State, Zip:
Program:
Period of Service:
Tax ID No.
P.O. No.
FID No.
Program r
Amount
This-Invoice' ;: Cumutative to`Date`
Agency's Certification: By signing this report, I certify to the best of my
knowledge and belief that the report is true, complete, and accurate,
and the expenditures, disbursements and cash receipts are for the
purposes and objectives set forth in the terms and conditions of the
Federal award. I am aware that any false, fictitious or fraudulent
information, or the omission of any material fact, may subject me to
criminal, civil, or administrative penalties for fraud, false statements,
`false claims, or otherwise. U.S. Code Title 18, Sec. 1001 and Title 31,
"Sec. 3729-3730 and 3801-3812.
Signature and Date:
Name:
Title:
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"D"—REPORTING FORMS Page 2
Camp Fire First Texas
ATTACHMENT II
Expenditure Worksheet
ATTACHMENT II
City o f Fo rt Worth
Neighborhood Services Department
_... Expenditure Worksheet
Agency:
Program
Only highlighted codes can be reimbursed
Please grou like account codes.
Account
Code(See. 1rpeuse Iiue Item
laTo.` CheckNa: Date:
Payee Description/Job Title': Ke'to Ri ht ' Amounts '' Aecounf
1 PROGRAMPERSONNEL
2 Salaries 1001
3 FICA 1002
4 Life/Disability Insurance 1003
5 Health/Dental Insurance 1004
6 Une loymant-State 1005
7 Worker's Co ensation 1006
8 Retirement 1007
9 SUPPLIES AND SE RVICFS"
10 Office/progrurnsupplies 2001
11 Postage 2002
12 Printing 2003
13 Othe 2004
14 111ISCELLANEOUS .
15 Contract Labor 3001
16 Food Supplies 3002
17 Teaching Aids 3003
18 Craft Supplies 3004
19 Field Trip E eases 3005
20 Mileage 3006
21 Otherp 3007
22 Othero 3008
23 FACKMAND ULRJTIPS
24 Telephone 4001
25 Electric 4002
26 Gas 4003
27 Water and Wastewater 4004
28 Solid Waste Disposal 4005
29 Rent 4006
30 Cleaning Supplies 4007
31 OtherO 4008
32 LEGAL,FINANCIAL;AND INSURANCE' .
33 Fidelity Bond or Equivalent 5001
34 Directors and Officers 5002
35 General Corranercial Liability 5003
36 Others 5004
37 DRRECrASSISTANCE,
38 Othe0 6001
39
40 _...
41
42
43
44
45
46
47
48
49
50
51
52
53 _...
54
55
56
57
58 _....
59 _...
60
Totall 1 $0.00.
'For Salaries,state employee's title under Description/lob Title.Rent rrust identify tenant
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"D"—REPORTING FORMS Page 3
Camp Fire First Texas
ATTACHMENT III
Client Data Report
A.—<<
Month,'
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CDBG 51%PSA CONTRACT 2016-2017—EXHMIT"D"—REPORTING FORMS Page 4
Camp Fire First Texas
EXHIBIT "E"
INCOME CERTIFICATION FORMS
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT`E"--INCOME CERTIFICATION FORMS Page 1
Camp Fire First Texas
City of Fort Worth
CERTIFICATION OF INCOME STATEMENT
Applicant Name:
Current Address: Phone#:
City and Zip:
Household Members and Income
(including applicant)
Last Name First Name Age Monthly Source of Income
Income $$
TOTAL NUMBER OF FAMILY MEMBERS (Include Yourself, Spouse,Children,etc.)
Total Gross Annual Household Income:
PERSONAL INFORMATION:(Check one in each item. This Information is Required for Federal Reporting Purposes)
a. ❑MALE b.❑WHITE ❑BLACK/AFRICAN AMERICAN ❑BLACK/AFRICAN AMERICAN&WHITE
❑FEMALE ❑AMERICAN INDIAN/ALASKAN NATIVE ❑ASIAN
❑AMERICAN INDIAN/ALASKAN NATIVE&WHITE ❑ASIAN&WHITE
❑NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER ❑BALANCE/OTHER
❑AMERICAN INDIAN/ALASKAN NATIVE&BLACK/AFRICAN AMERICAN
c. ETHNICITY d. DISABLED e. IS HEAD OF HOUSEHOLD FEMALE?
❑HISPANIC ❑YES ❑YES
❑NON-HISPANIC ❑NO ❑NO
Certification: I certify that the information I am providing is true and could be subject to verification at any
time by a third party. I also acknowledge that the provision of false information could leave me subject to the
penalties of Federal, State and local law.
Signature of Applicant Date
WARNING: TITLE 18,SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY
FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF
THE UNITED STATES GOVERNMENT.
-----------------For use by Agency staff only-----------------
Household Size: Gross Annual Income:
Applicable Income Limit: Is Applicant Eligible?
Check if Applicant refused to provide demographic information: ❑
Staff Assessment of Demographics:
Person Making Determination: Date:
NOTE: Address, income amounts and sources for ALL household members are required.
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT`B"--INCOME CERTIFICATION FORMS Page 2
Camp Fire First Texas
Ciudad de Fort Worth
CERTIFICACION DE DECLARACION DE INGRESOS
Nombre del Solicitante:
Direcci6n de Actualidad: Telefono:
Ciudad y C6digo Postal:
Miembros Del Ho a r e Ingresos
(Incluyendo el/la Solicitante)
Apellido Nombre Had Ingreso Origen de Ingresos
Mensual
*TOTAL NOMERO DE MIEMBROS DEL HOGAR (Incluyase Usted.)
Total Anual de Ingresos del hogar:
**INFORMACION PERSONAL:(Seleccione uno en cada articulo. Esta informaci6n es requerida por el Gobierno federal.)
a. ❑MASCULINO b.❑BLANCO ❑NEGRO/AFRICANO AMERICANO ❑NEGRO/AFRICANO AMERICANO&BLANCO
❑FEMININO ❑INDIO AMERICANO/NATIVO DE ALASKA ❑ASIATICO
❑INDIO AMERICANO/NATIVO DE ALASKA&BLANCO ❑ASIATICO&BLANCO
❑NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS ❑BALANCE/OTRO
❑INDIO AMERICANO/NATIVO DE ALASKA&NEGRO/AFRICANO AMERICANO
c. ETHNICIDAD d. INCAPACITADO e. SES LA CABEZA DEL HOGAR MUJER?
❑MSPANO ❑ SI ❑ SI
❑NO-HISPANO ❑NO ❑NO
Certificaci6n: Yo certifico que la informaci6n que yo estoy proporcionando es verdadera y puedo ser sujeto a
verificaci6n a cualquiera hora por tercera parte. Yo tambi6n reconozco que la provisi6n de informaci6n falsa
puede dejarme sujeto a penalidades Federales, Estatales, y a ley local.
Firma del Solicitante Fecha
ADVERTENCIA:TITULO 18,SECCION 1001 DEL CODIGO DE LOS ESTADOS UNIDOS INDICA QUE UNA
PERSONA ES CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMENTE RACER DECLARACIONES FALSOS O
FRAUDULENTAS A CUALQUIER DEPARTAMENTO DE GOBIERNO DE LOS ESTADOS UNIDOS.
----------------- afa use de em leados de la a encia-----------------
#De Miembros de Familia: Ingreso Anual:
Limite de Ingreso: 6Es solicitante elegible?
Compruebe si el solicitante se neg6 a dar su informaci6n personal: ❑
Evaluaci6n del empleado sobre informaci6n personal:
Persona haciendo la determinaci6n: Fecha:
Note: La direccion de la casa y los ingresos (y sirs origenes) para todos mienibros del hogar son requeridos.
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT`B"--INCOME CERTIFICATION FORMS Page 3
Camp Fire First Texas
EXHIBIT "F"
STANDARDS OF DOCUMENTATION
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"F"--STANDARDS OF DOCUMENTATION Page I
Camp Fire First Texas
2016-2017 Documentation Standards for
CDBG Public Service Contract Expenses
Budget Line E �o.9
> E�. Iwo 11 Notes/Other
Employee Salanes and Benefits City wdl only reimburse a percentage of any employee s salary and benefits who work tluectly with the CDBG`funded Program
Percentages wilt pe cos#allocated and determined pnor to the execution of the CDBG Contract Agencies reques#mg the reimbursement of 100%of anyAgency employee;��
will requira, A rGity approval -Ageneies:must show calculattQn"on hovq.ttie CDBG iSort�on of employee salariesantl beneffs were caiculate`d consistentlywittitfie CDBG'
If an employee works on both a CDBG eligible and non-CDBG eligible program(s),the City will only reimburse for a reasonable portion
of the employee's salary. Prior to the execution of the CDBG Contract,the Agency will priovide the City with a written statement on how
each employee's time will be allocated. If an employee works 100%of their time directly with the CDBG-funded Program,then 100%of
the employee's salary may be eligible for reimbursement. Agency must submit a written statement that 100%of the employee's time is
spent working directly with the CDBG-funded Program. Statements must be signed by a person authorized to sign on behalf of the
Agency and will be submitted with the October invoice.
Salaries X x* Reimbursement requests must include a timesheet and work log that reflects the hours worked by the employee(s)working directly on
the CDBG-funded Program. For employees who are paid with multiple funding sources,timesheets must reflect all funding sources. If
separate timesheets are kept for each funding source,all such timesheets must be submitted to City. Timesheets must be signed by
employee and supervisor. Agency must show a calculation and documentation of how the employee's salary was calculated and
invoiced to City.
'If employees are paid by direct deposit rather than check,then the agency must submit both the direct deposit payment company's
report(such as an ADT report)and a bank statement or check showing payment to the direct deposit company.
FICA/Medicare IX X
Life Insurance X X
Health X X If the City pays gross salary,this is alreadyincluded.If the City pays the employer portion,the Agency must provide roof that theInsurance
employee is enrolled in the benefit plan,must show a calculation and documentation of haw the invoiced amount was calculated,and
Disability X X must provide documentation showing payment.
Insurance
Unemployment X X
Insurance
If the City pays gross salary,this is already included.If the City pays the employer portion,the Agency must provide proof that the
RetirementXTX11TIT
employee is enrolled in the benefit plan,must show a calculation and documentation of how the invoiced amount was calculated,and
must provide documentation showing payment.
Ma#eriais Equipmegt,Goods and Supplies-Citywilt only reimburse for the cost allocated percent or am spet
t nt in supporofthe CDBG-funded Program.,Agencies
requesting r"etm6ursement for these items wilt require prior City approval:"pgenciesmust show calculation on-flow the CDBG`portion'of these expenses were,calculated
consistenttywiththiiObGiContract
Office Supplies X X X
Office
EquipmentX X X X X
Rental
Postage X X X
Printing X X X
Construction&
Building X XX X This category is only available for the REACH Program.
Materials
Sport and
Recreation X X X
E ui ment
Cleaning X X X
Su lies
Teaching Aids X X X
Craft Supplies X X X
Food Supplies X X X This category is only available to the Program provided by Meals on Wheels.
Rent U4hties and Maintenance Citywdl oniy'pay for a portwn ofthese expenses The portion oIfthese expenses will be;tletermiged_byfhe sgvare footage atfributable to :.
the CDBG funded program and shall'be cost allocatedimaccoMance with the amount nfspace=used-.for,tue CDBG funded Pfogram.=[hese expenses`may only be in supporE
ofthe CDBG funded Program The items listed�betow7equire pnorCity approval and thrce that pays for the portion of the;;,
eXpenses that isnot and with GDBGfunds `Agencies'mustshow calculatioh on how the,CDBG porttonof theseexpenses;rGere calculated consistent[yrwitfi the CDBG
P
ContractG '
Telephone X X
Gas X X
WaterMastew X X
ater
Electric X X
Solid Waste X X
CDBG 51%PSA CONTRACT 2016-2017 Exhibd"F'--STANDARDS FOR COMPLETE DOCUMENTATION 1
Facility
Maintenance X X X X This item requires approval by the City prior to the execution of the CDBG Contract. Repairs may be categorized as major/minor
and Repairs rehabilitation projects and must be approved through the full HUD Environmetal Review.
Rent X X X City will pay for a portion of the rent for the Program facility so long as its in proportion to the square footage attributable to the CDBG-
funded program.
Miscellaneous .. :....,. ,., ....
This item requires prior approval by the City. Prior to the execution of the CDBG Contract,the Agency must submit a written statement
that lists the contract labor services to be used during the Contract term. Agency will submit a memo related to the procurement of such
Contract Labor X X X X X services and will forward any information pertaining to the procurement process to City. This requirement applies to,but is not limited to,
services retained for security services,legal,accounting,transportation providers,educational facilitators,custodial services,etc.
Agencies may not use the contract services of any City of Fort Worth Department.
City-requiredX X City will only pay for a percentage of the City-required insurance so long as it's in proportion to the square footage attributable to the
Insurance CDBG-funded program.
City requires that the agency submit its fee schedule or formula on how the Agency calculates the childcare scholarship amount. The
fee schedule/formula should demonstrate a breakout of income levels,and for each income level the schedule should demonstrate
Childcare X X which portion of the expense is to be paid by the family and which portion of the expense is to be reimbursed by the City. A fee
Scholarships schedule/formula must be submitted to the City prior to the first payment. Agency must submit documentation supporting that the client
is income eligible and that the household is being charged in conformance with the fee schedule. If the fee schedule/formula changes at
any time during the contract term,the Agency must immediately notify City on the date the new fee schedule/formula takes into effect.
"$0"Income Agecies that are required to verify and provide proof of household income to determine eligibility,must require that anyone who is over
Certifications the age of 18,living in the household,submit a$0 Income Certification.
If an audit is required because federal funds exceed$750,000,then the cost should be split evenly by all grant funding sources. Agency
Audit Services X X X X must show calculation on how the CDBG portion of the accounting services were calculated. For example,if the CDBG grant is 10%of
your Agency's budget,then invoice shall not exceed 10%of the overall cost. Agency must show a calculation and documentation of
how the invoiced amount was calculated,and must provide documentation showing payment.
*Proof of payment effective October 1,2013: payments or Expenses must be documented in the following manner:
A)Image of the check AND bank statement showing the check cleared the bank;OR,
B)Image of the cancelled check(ex.At end of bank statement);OR,
C)Payroll Check Stub,"Advice",or Statement AND Bank Statement indicating payroll;OR,
D)For wire or e-transfers:Reciept or statement from payee/vendor OR bank statement.
Final as of 09/162016 do
CDBG 51%PSA CONTRACT 2016-2017 Ehibft V—STANDARDS FOR COMPLETE DOCUMENTATION 1
EXHIBIT "G"
SECTION 3 REPORTING FORMS
NOT APPLICABLE
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"G"— SECTION 3 REPORTING FORMS Page I
Camp Fire First Texas
EXHIBIT "H"
SEVERELY DISABLED CERTIFICATION FORM
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"H"—SEVERELY DISABLED CERTIFICATION
FORM Page I
Camp Fire First Texas
Camp Fire First Texas
CERTIFICATION FORM
DOCUMENTING CLIENT STATUS AS "SEVERELY DISABLED ADULT"
Client Name:
Address:
City, State, Zip
Client Identification No.
CHECK ALL THAT APPLY
❑ Has used a wheelchair, a walker, cane , crutches or other special aid for six
months or longer
Has been diagnosed with one of the following conditions: Alzheimer's
❑ disease, mental retardation or other developmental disability, senility or
dementia, cerebral palsy, or autism; or has another mental or emotional
condition that seriously interferes with everyday tasks.
Is unable to perform one or more of the following "Functional Activities":
❑ seeing, hearing, speaking and having one's speech understood, lifting or
carrying, using stairs, grasping small objects, or walking.
Is unable to perform or needs assistance to perform one or more of the
❑ following Activities of Daily Living (ADL): getting around inside the home,
getting in or out of bed or a chair, bathing, dressing, eating, and toileting.
Is unable to perform or needs assistance to perform one or more of the
following Instrumental Activities of Daily Living (IADL): going outside the
❑ home, keeping track of money and bills, preparing meals, doing light
housework,taking prescription medications in the right amount and at the right
time, and using the telephone.
❑ Has a condition that prevents them from working at a job or doing housework.
The undersigned Agency representative conducted a visual assessment of the client identified on
this form and certifies that the client meets at least one of the conditions indicated above, which
determines that he/ she meets the definition of"severely disabled" according to the U.S. Census
Bureau.
Certified by: Date:
Signature/Title:
CFW Neighborhood Services Dept.: Revised 08.30.2013
CDBG 51%PSA CONTRACT 2016-2017—EXHIBIT"H"—SEVERELY DISABLED CERTIFICATION
FORM Page 2
Camp Fire First Texas
EXHIBIT "I"
MBE REPORTING FORM
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"I"--MBE REPORTING FORM Page 1
Camp Fire First Texas
Contract and Subcontract Activity U.S.Dc rtment afIlmoi n p
pa gond Urban Devclo meat OMB Approval No.:2577-0068 OMB
Approval No.:2502-0355
Public reporting burden for this collection of information is estimated to average.5 hours per response,including the time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and rer5esving the collection of information.Tlu Information is voluntary.HUD may not
collect this information,and you me not required to complete this form,unless it displays a currently valid OMB Control Number.
Esecutive Orders dated July 14,1983,directs the Mimmity Business Development Plans shall be developed by each Federal Agency and the these annual plans shall establish minority business development objectives.The information is used by HUD to monitor and evaluate MBE activities against the total program activity and
the designated minority business enterprise(1vI13E)goals.The Departmmn requires die information to provide guidance and oversight for programs for the development ofminorlty business enterprise eonceming Minority Business Development.H'the information is not collected HUD would not be able to establish meaningful
MBE goals nor evaluate MBE performance against these goals.
Privacy Act Notice=The United States Department of Housing and Urban Development,Federal Housing Administration,is authorized to solicit the Information requested in this form by virtue of Title 12,United States Code,Section 1701 or seq„and regulation.It will not be disclosed or relesed outside the United States
Department of Housing and Urban Development without your conscm,except as required or permitted by Law.
1.Grontee/Prgi=tO� /Developer/Sponsor/BuildcdAgency Cheek if: 2,Location(City,State Zip Code)
City of fore Worth U
1000 Throckmormn.Fort Worth,TX 76102
31.Nome nfConmet Person 3b.Phoac Number(Including Arca Code) 4,Reporting Period 5.Progrnut Code(Not applicable far CP ❑ G.Date Snbmincd to Field Otlicc
See e.plonotion ot'Codee at bottom or'Pngc Use o
Sarah Burkett 817.392-7538 w sheer for each
Out.1-Se I.3D Annual•P1O sepora progrwn code.
comm:cmr ar
cmnur ieatt4amber ar HUD smbeanmaemr
Case Number or ocher T ofTmde Bnsbtaa Subcrour-, Contcastor/Subcontractor Name and Address
meati llcarionofps,Nuy. Amonntafeanwer Code RvcinVEthnie Wmrm Owned Hmiress Prime Conancmr ldentificarion(ID) WniLcation(ID) 7)' ,New
subdirixioa dwelling unit etc. or Subcanma (Sec below) (See bel") (YesorNo) Sec.3 Dnsireso Number Sec.3 Nmnber Sec.3
7b. 7c. 7J. 7e. (Yes or No) 7f. 7. 71, 7i.
If NawHiroo mo 4'o Sec.3
Hires Sec.3Rea. New Hires
Name Street City State Zi
p MOMMEMM
#DIV/01
#DIV/01
#DIV/01
#DIV/01
#DIV101
#DIV/01
#DIV/01
#DIV/01
4DIV/01
#DIV/01
#DIV/01
#DIV/01
#DIV/01
4DIV/01
#DIV101
#—DIV/01
#DIV/01
4DIV/01
#DIV/0!
#DIV/01
7c:Type of Trade Codes: 7d:Radul/Ethnic Codes: 5:Program Codes(Complete for Housing and Public and Indian Housing programs only):
C'PD: II,wde/Pubac Horning: I'-Mice Americans I=All leaacd,iscludin8 SccrianB
56 SHZ ion202
1=New nvwe
Cotion 1=New Corelruction G=Prol'esviorial 2=61ockAmmcam 2=Flexible Subsidy 6=HU0.11e1d(MotmgemrnD
2=Edte.'anTsiain; 2=Suhassam Rehab. 7-T—at Services 3=Notiva Amerie— 3=Secdon B Nmun.ured.N—HFDA 7=Public/imlia Housing
3=Odo,r 3=Repair 8=Ed—tion7mininp 4-Hispardc Americatu 4=Iaaured(Mamgemenr) A=Secdon 811
4=Service 9-Arch./Engrg.Appraisal S=AsiaNPaciGc Amedcom
5=Pro cct Mnn c 0=Other 6=lWidk Jews
Prev -editions are absoletu.
forth HUD-2516 a/9B
This report is to be completed by grantees,developers,sponsors,builders,agencies,and/or completed for public and Indian housing and most community development programs.Form HUD- costs or unusually high or low-income families.Very low-income families(including single
project owners for reporting contract and subcontract activities of 510,000 or more under the 60002 is to be completed by all other HUD programs including State administered community persons)whose incomes do not exceed 50 per centum ofthe median family income for the area,as
following programs:Community Development Block Grants(entitlement and small cities); development programs covered under Section3.A Section 3 Contractor/subcontractor is a determined by the Secretary with adjustments for smaller and larger families,except that the
Urban Development Action Grants;Housing Development Grants:Multifamily Insured and business concern that provides economic opportunities to low and very Low-income residents of secretary may establish income ceilings higher or lower than 50 per centum ofthe median for die
Noninsured:Public and Indian Housing Authorities:and contracts entered into by recipients of the metropolitan area(or nonmetropolitan county),including a business concern that is 51 person area on the basis ofthe Secretary's findings that such variations are necessary because of unusually
CDBG rehabilitation assistance. or more owned by low-income residents; high or low family incomes.
Contracts/subcontracts of less than$10,000 need be reported only if such contracts represent a or provides subcontracting or business development opportunities to businesses owned by low or Submit two(2)copies of this report to your local HUD Office within ten(10)days after the end of
significant portion o£your total contracting activity.Include only contracts executed during this low-income residents. Low and very low-income residents:include participants in Youthbuild die reporting period you checked in item 4 on the front, Complete item 7h.Only once for each
reporting period. programs established under Subtitle D of Title IV of the Cranston-Gonzalez National Affordable contractor/subcontractor on each semi-annual report.
Housing Act.
This form has been modified to capture Section 3 contract data in columns 7g and 7i, Section 3 The terms"low-income persons"and"very low-income persons"have die same meanings given Enter the prime contractor's ID in item 7f for all contracts and subcontracts.Include only
requires that the employment and other economic opportunities generated by HUD financial die terms in section3(b)(2)ofthe United States Housing Act of 1937.Low-income persons mean contracts expected during this reporting period.PHAs1IHAs are to report all
assistance for housing and community development programs shall,to the greatest extent families(including single persons)whose incomes do not exceed 80 per centum ofthe median contracts/subcontracts.
feasible,be directed toward low-and very low-income persons,particularly those who are income for the area,as determined by the Secretary,with adjustments for smaller an larger families,
recipients of government assistance for housing.Recipients using this form to report Section 3 except that the Secretary may establish income ceilings higher or lower than 80 per centum ofthe
contract data must also use Part I of form HUD-60002 to report employment and training median for the area on the basis of die Secretary's findings that such variations are necessary
opportunities data.Form HUD-2516 is to be because of prevailing levels ofconstruction
Community Development Programs Multifamily Housing Programs Public Housing and Indian Housing Programs
1.Grantee:Enter die name ofthe unit of government submitting this report. 1.Grantee/Project Owner:Enter the name ofthe unit of government,agency or mortgagor entity PHAs/IHAs are to report all contracts/subcontracts.Include only contracts executed during this
submitting this report. reporting period.
3.Contact Person:Enter name and phone of person responsible for maintaining and submitting
contract/subcontract data 3.Contact Person:Same as item 3 under CPD Programs. 1.Project Owner:Enter the name ofthe unit of government,agency or mortgagor entity
submitting this report.Check box as appropriate.
7a.Grant Number:Enter the HUD Community Development Block Grant Identification
Number(with dashes).For example:B-32-MC-25-0034.For Entitlement Programs and Small 4.Reporting Period:Check only one period. 3.Contact Person:Same as item 3 under CPD Programs.
City multi-year comprehensive programs,enter the latest approved grant number.
7b.Amount of Contract/Subcontract:Enter the dollar amount rounded to the nearest dollar.If
subcontractor ID number is provided in 717,the dollar figure would be for the subcontract only 5.Program Code:Enter the appropriate program code. 4.Reporting Period:Check only one period.
and not for the prime contract,
7c.Type of Trade:Enter the numeric codes which best indicates the
contractoes/subcontractor's service.If subcontractor ID number is provided in 7f.,die type of 7a.Grant/Project Number:Enter the HUD Project Number or Housing Development Grant or
trade code would be for the subcontractor only and not for the prime contractor.
number assigned. 5.Program Code:Enter the appropriate program code.
The"other"category includes supply,professional services and all other activities except 7a.Grant/Project Number:Enter the HUD Project Number or Housing Development Grant or
construction and education/training activities. 7b.Amount of Contract/Subcontract:Same as item 7b,under CPD Programs,
number assigned.
7d.Business Racial/Ethnic/Gender Code:Enter the numeric code which indicates the
racial/ethnic/gender character ofthe owner(s)and controller(s)of SI%ofthe business. 7c.Type of Trade:Same as item 7c.trader CPD Programs. 7b.Amount of Contract/Subcontract: Same as item 7b.under CPD Programs.
When 51%or more is not owned and controlled by any single mcial/ethnic/gender category,
enter the code which seems most appropriate.If the subcontractor ID number is provided,the 7d.Business Racial/Ethnic/Gender Code:Same as item 7d.under CPD Programs, 7c.Type of Trade:Same as item 7c.under CPD Programs,
code would apply to the subcontractor and not to the prime contractor.
7e.Woman Owned Business:Enter Yes or No. 7e.Woman Owned Business:Enter Yes or No. 7d.Business Racial/Ethnic/Gender Code:Same as item 7d.under CPD Programs,
7f.Contractor Identification(ID)Number:Enter the Employer(IRS)Number ofthe Prime
Contractor as the unique identifier for prime recipient of HUD funds.Note that the Employer 7f.Contractor Identification(ID)Number:Same as item 7f under CPD Programs. 7e.Woman Owned Business:Enter Yes or No.
(IRS)Number must be provided for each contract/subcontract awarded.
7g.Section 3 Contractor:Enter Yes or No. 7g.Section 3 Contractor:Enter Yes or No. 7f.Contractor Identification(ID)Number:Same as item 7f under CPD Programs.
7h.Subcontractor Identification(ID)Number:Enter the Employer(IRS)Number of die
subcontractor as the unique identifier for each subcontract awarded from HUD funds.When the
subcontractor ID Number is provided,the respective Prime Contractor ID Number must also be 7h.Subcontractor Identification(ID)Number:Same as item 7h.under CPD Programs, 7g.Section 3 Contractor:Enter Yes or No.
provided.
7i.Section 3 Contractor:Enter Yes or No. 7i.Section 3 Contractor:Enter Yes or No. 7h.Subcontractor Identification(ID)Number:Same as item 7h.trader CPD Programs.
7j.Contractor/Subcontractor Name and Address:Enter this information for each firm
receiving contract/subcontract activity only one time on each report for each fine. 7j.Contractor/Subcontractor Name and Address:Same as item 7j.under CPD Programs, 7i.Section 3 Contractor:Enter Yes or No.
7j.Contractor/Subcontractor Name and Address:Same as item 7j,under CPD Programs.
EXHIBIT "J"
DUTIES OF THE PARTIES
USE OF NEIGHBORHOOD SERVICES DEPARTMENT
COMMUNITY CENTERS
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"J"—DUTIES OF THE PARTIES—USE OF
NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS Page 1
Camp Fire First Texas
Camp Fire First Texas
DUTIES OF THE PARTIES
USE OF NEIGHBORHOOD SERVICES DEPARTMENT
COMMUNITY CENTERS
ALlency's Responsibilities:
Agency will perform the following in relation with the use of Community Center:
• Agency will furnish the Center Coordinator with a schedule of Program activities at least
four weeks prior to their occurrence.
• Agency will, at its sole expense, furnish materials, supplies, copies and conduct a
structured Program.
• Agency will ensure that the designated Community Center space is maintained in a neat
and orderly fashion.
• Agency will ensure that the City's standards are maintained regarding security;
cleanliness and communication between and among programs housed at the Community
Center and will ensure cooperation with other Community Center staff and
agencies/programs.
• Agency will report to the Center Coordinator or designee for problems immediately
if/when problems occur.
• Agency will work with the Center Coordinator or designee to schedule any use of the
Community Center for related activities outside of agencies designated meeting time
and/or the Community Center's regular days and hours.
• Agency will maintain sole responsibility and liability for its employees, volunteers and
separate contractors for their actions.
• Agency shall ensure that each of its employees, volunteers and participants desiring to
participate in Community Center-sponsored programs/activities are aware of the
requirement to have a current community center membership card to participate.
• Agency agrees to perform background screenings and checks on staff and volunteers,
with such screenings and checks meeting or exceeding the requirements that the City
imposes for checks and screenings on staff, volunteers and participants in the City's own
programs.
• Agency will provide the Center Coordinator with designated staff contact information for
the purposes of emergencies (center closing, schedule changes or scheduled maintenance)
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"J"—DUTIES OF THE PARTIES—USE OF
NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS Page 2
Camp Fire First Texas
City's Responsibilities:
City will perform the following in relation with Agency's use of a Community Center:
• City will provide space for conducting the Program, including basic utilities and will also
supply the Agency with appropriate facility access. For purposes of this Contract, basic
utilities shall not include telephone or computer service, which shall remain the sole
responsibility of the Agency.
• City will ensure that the reserved space is set up with appropriate tables and chairs to
accommodate program and/or services.
• City will not be responsible for any additional security other than what is currently
available at the Community Center.
• City assumes no liability or responsibility for the loss of any personal property or office
contents of the Agency, its agents, employees, volunteers, participants or licensees while
at the Community Center.
• City will allow the Agency to conduct properly scheduled classes and other Program
related activities during the days and hours specified in Exhibit "A" PROGRAM
SUMMARY*. In addition, City may, but is not required, through the Center
Coordinator, allow Agency to schedule other classes and Program related activities
outside of the days and hours specified in Exhibit"A" PROGRAM SUMMARY.
• City will maintain sole responsibility and liability for its employees, volunteers and
separate contractors for their actions.
• City will have the discretion to put the Agency in any available room. If placed in a
different location, it is to be only one room.
*The City is closed in observance of the following holidays:
New Year's Day(January 1St)
M.L.K. Jr. Day(Third Monday of January)
Memorial Day (Last Monday in May)
Independence Day(July 4th)
Labor Day(First Monday in September)
Thanksgiving Day (Fourth Thursday of November)
Day after Thanksgiving(Fourth Friday in November)
Christmas Day (December 25th)
"City of Fort Worth observes the above holidays on Friday if they fall on Saturday and on a Monday if they
fall on Sunday.
Additionally,the Community Centers are utilized as shelters during an emergency. If the
Community Center will be closed due to an emergency, Center Coordinator or designee will
inform Agency of the closure.
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"J"–DUTIES OF THE PARTIES—USE OF
NEIGHBORHOOD SERVICES DEPARTMENT COMMUNITY CENTERS Page 3
Camp Fire First Texas
EXHIBIT "K"
NOTICE OF BENEFICIARY RIGHTS
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"K"—NOTICE OF BENEFICIARY RIGHTS Page 1
Camp Fire First Texas
Notice of Beneficiary RiLyhts
Name of Agency: Camp Fire First Texas
Name of Program: Step-Up Program
Contact information for Program Staff(name, phone number, and e-mail address, if appropriate):
Because this program is supported in whole or in part by direct Federal financial assistance from
the Federal Government, we are required to let you know that:
• We may not discriminate against you on the basis of religion, religious belief, a refusal
to hold a religious belief, or a refusal to attend or participate in a religious practice;
• We may not require you to attend or participate in any explicitly religious activities that
are offered by us and any participation by you in these activities must be purely
voluntary;
• We must separate, in time or location, any privately funded explicitly religious activities
from activities supported by direct Federal financial assistance;
• If you object to the religious character of our organization,we must make reasonable
efforts to identify and refer you to an alternative provider to which you have no such
objection; and
• You may report an organization's violations of these protections, including any denial of
services or benefits, by contacting or filing a written complaint to HUD [or the
intermediary, if applicable].
We must give you this written notice before you enroll in our program or activity, as required by
24 CFR 5.109.
CDBG 51%PSA CONTRACT 2016-2017--EXHIBIT"K"—NOTICE OF BENEFICIARY RIGHTS Page 2
Camp Fire First Texas
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Official site of the City of Fort Worth,Texas
CITY COUNCIL AGENDA FoRTWORTH
COUNCIL ACTION: Approved on 8/9/2016 - Ordinance No. 22351-08-2016
CONTINUED FROM A PREVIOUS WEEK
DATE: 8/2/2016 REFERENCE G-18793 LOG NAME: 19NS HUDACTIONPLANPY2016-
NO.: 2017
CODE: G TYPE: NON- PUBLIC YES
CONSENT HEARING:
SUBJECT: Conduct Two Public Hearings and Approve the City's 2016-2017 Action Plan for the Use of
Federal Grant Funds in the Amount of$10,094,608.00 from the United States Department
of Housing and Urban Development from the Community Development Block Grant,
HOME Investment Partnerships Program, Emergency Solutions Grant and Housing
Opportunities for Persons with AIDS Grant Programs, Authorize Collection and Use of
Program Income, Authorize Waiver of Application of Indirect Cost Rates, Authorize
Execution of Related Contracts and Adopt Appropriation Ordinance (ALL COUNCIL
DISTRICTS)
RECOMMENDATION:
It is recommended that the City Council:
1. Conduct two public hearings to allow citizen input and consideration of the City's 2016-2017 Action Plan
for use of federal grant funds from the United States Department of Housing and Urban Development in the
amount of$10,094,608.00 for the Community Development Block Grant, HOME Investment Partnerships
Program, Emergency Solutions Grant and Housing Opportunities for Person with AIDS grant programs and
for the use of program income from activities using prior years' federal grant funds;
2. Approve the City's 2016-2017 Action Plan for submission to the United States Department of Housing
and Urban Development including allocations of grant funds to particular programs and activities as detailed
below;
3. Authorize the collection and use of an estimated $130,000.00 of program income, which resulted from
activities using prior years' Community Development Block Grant fund, for the City's Priority Repair
Program;
4. Authorize the collection and use of an estimated $1,200,000 of program income, which resulted from
activities using prior years' HOME Investment Partnerships Program funds, for the completion of the Hardy
and HFC Terrell Single-Family housing development projects and 10 percent for administrative costs as
detailed below;
5. Authorize the City Manager or his designee to execute contracts for one-year terms with the agencies
listed in Tables 1, 2 and 3 below, for Program Year 2016-2017 for Community Development Block Grant,
Emergency Solutions Grant and Housing Opportunities for Persons with AIDS grant funds, contingent upon
receipt of funding and satisfactory completion of an Environmental Review and all regulatory
requirements;
6. Authorize the City Manager or his designee to extend the contracts for up to one year if an agency or
department requests an extension and such extension is necessary for completion of the program or to
amend the contracts if necessary to achieve program goals provided any amendment is within the scope of
the program and in compliance with City policies and all applicable laws and regulations governing the use
of federal grant funds;
7. Authorize a waiver of indirect cost rates as applicable for the Grants Fund in accordance with the City's
Administrative Regulations; and
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8. Adopt the attached appropriation ordinance increasing the estimated receipts and appropriations to the
Grants Fund in the total amount of$10,094,608.00 consisting of$6,414,009.00 in Community Development
Block Grant funds, $2,078,039.00 in HOME Investment Partnerships Program funds, $570,031.00 in
Emergency Solutions Grant funds and $1,032,529.00 in Housing Opportunities for Persons with AIDS grant
funds, plus any program income, all subject to receipt of such funds.
DISCUSSION:
The City's 2016-2017 Action Plan summarizes the major housing and community development activities
and proposed expenditures for the program year beginning October 1, 2016 and ending September 30,
2017 for use of federal grant funds totaling $10,094,608.00 from the United States Department of Housing
and Urban Development (HUD) for Community Development Block Grant (CDBG), HOME Investment
Partnerships Program (HOME), Emergency Solutions Grant (ESG) and Housing Opportunities for Persons
with AIDS (HOPWA) grant programs. It also summarizes the use of program income resulting from
activities using prior years' CDBG and HOME funds, for which the primary purpose is to benefit low and
moderate income City of Fort Worth residents. ESG funds primarily benefit homeless persons and HOPWA
funds primarily benefit low and moderate income persons with HIV/AIDS.
Staff developed initial recommendations for the allocation of the estimated funding from HUD, which were
adopted by the Community Development Council (CDC) on May 11, 2016 and were presented to the
Housing & Neighborhood Services Committee on May 3, 2016 and to the City Council at the Pre-Council
meeting on June 7, 2016. After these presentations, Staff developed revised recommendations which were
to be presented to the CDC at its meeting on July 13, 2016, but the meeting was not held due to the lack of
a quorum. A full explanation of revisions, including a comparison of the initial recommendations to the
revised recommendations, are set forth in the informal report presented to the City Council on August 2,
2016.
Notice of a 30-day public comment period from July 1, 2016 to August 1, 2016 was published in the Fort
Worth Star-Telegram on June 30, 2016. Any comments received are maintained by the Neighborhood
Services Department in accordance with federal regulations. The City is required to hold two public
hearings as part of the HUD-required citizen participation process. Initially, the first public hearing was
scheduled to be held at the CDC meeting on July 13, 2016 with a second public hearing scheduled for
August 2, 2016 at the City Council meeting. Because the CDC was unable to meet on July 13, 2016, these
dates were amended to reflect the first public hearing at the City Council meeting on August 2, 2016 with
the second public hearing to be held at the City Council meeting on August 9, 2016. Due to the revised
hearing dates, the public comment period was extended until August 8, 2016 and a notice of public
hearings and extension of public comment period was published in the Fort Worth Star-Telegram on July
17, 2016.
A summary of the Staffs final funding recommendations is provided below and in Tables 1, 2 and
3. Additionally, a spreadsheet of all specific funding recommendations is attached. The 2016-2017 Action
Plan must be submitted to HUD by August 15, 2016.
A waiver of indirect costs is being requested.
CDBG
For Program Year 2016-2017, it is recommended that the amount of$6,414,009.00 in CDBG funds and the
estimated amount of$130,000.00 of CDBG program income totaling $6,544,009.00 be allocated as follows:
Public Services -$962,101.00
This item includes social services for low to moderate income, disabled and disadvantaged populations.
Housing Program Services -$2,133,328.20
This item includes funding for the City's Priority Repair Program, Cowtown Brush-Up, homebuyer and
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housing services, accessibility modifications to the homes of senior and/or disabled individuals and related
project delivery costs for these programs.
Infrastructure Projects & Public Facilities -$1,295,000.00
This item includes funding for the SafeHaven of Tarrant County: Domestic Violence Shelter ADA
Improvements, CFW Planning & Development: Lake Como Neighborhood Sidewalk and Lighting Project
(Phase II), CFW Parks & Recreation Department: Bunche Park and CFW Code
Compliance: Neighborhood Improvements- Demolition and Clearance.
CDBG Economic Development-$740,778.80
This item is the City's annual payment on its Section 108 loan from HUD. This item is the City's annual
payment of its Section 108 loan from HUD. The Section 108 Program is a loan guarantee program, which
enables CDBG grantees to borrow up to five times the annual entitlement grant.
CDBG Estimated Program Income -$130,000.00
This item includes funding for the City's Priority Repair Program. CDBG program income that is received
which is over the estimated amount but not used for the City's Priority Repair Program will be allocated to
priority activities in the City's Consolidated Plan subject to Council approval.
CDBG General Administration -$1,282,801.00
This item includes costs for administering the CDBG grant including allocations for Financial Management
Services, Internal Audit, Planning and Development Departments.
HOME
For Program Year 2016-2017, it is recommended that the amount of$2,078,039.00 in HOME funds and the
estimated amount of$1,200,000.00 of HOME program income be allocated as follows:
Homebuyers Assistance Program (HAP) -$960,236.00
This item includes funding for down payment and/or closing cost assistance to low and moderate income
homebuyers.
Community Development Housing Organizations (CHDO) Set Aside -$402,500.00
HUD requires that a minimum of 15 percent of HOME funds be allocated to CHDO's for affordable housing
projects and CHDO administrative operating costs. These funds will be used by Tarrant County Housing
Partnership, Inc. (TCHP), a CHDO, for the completion of the Hillside/Morningside Single-Family Infill
Development (COUNCIL DISTRICT 8). The houses will be sold to homebuyers making at or below 80
percent of the area median income as set by HUD.
Rental Housing Development—$507,500.00
This item includes the construction of seven one-bedroom accessible apartments by Mental Health Housing
Development Corporation to serve citizens that are low-to-moderate income and disabled (COUNCIL
DISTRICT 3).
HOME General Administration —$207,803.00
This item includes costs for administering the HOME grant.
HOME Estimated Program Income -$1,200,000.00
This item includes funding for completion of the Hardy and HFC Terrell Single-Family Infill Projects. HOME
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program income that is received which is over the estimated amount but not used for the Hardy and HFC
Terrell Single-Family Infill Projects will be allocated to priority activities in the City's Consolidated Plan
subject to Council approval. HUD allows the City to take 10 percent of any HOME program income to be
used for the costs for administering the HOME grant.
HOPWA
For Program Year 2016-2017, it is recommended that the amount of$1,032,529.00 in HOPWA funds be
allocated as follows:
Non-Profit Service Providers -$1,001,554.00
HOPWA Program Administration —$30,975.00
ESG
For Program Year 2016-2017, it is recommended that the amount of$570,031.00 in ESG funds be
allocated as follows:
Non-Profit Service Providers -$527,279.00
ESG Program Administration —$42,752.00
CONTRACT RECOMMENDATIONS
The CDC and Staff recommend that contracts be executed with the listed agencies for the amounts shown
in the following tables:
Community Development Block Grant Contracts:
Table 1 —CDBG Agencies
Organization Program Amount
AB Christian Learning Center After-School Tutoring $ 45,486.00
Camp Fire First Texas Step Up Program $ 78,905.00
Cenikor Foundation Substance Abuse Services $ 110,000.00
Girls Inc. of Tarrant County Education, Prevention and $ 110,000.00
Leadership Program
Meals on Wheels Inc. of Tarrant Home Delivered Meals $ 75,000.00
County
Presbyterian Night Shelter Moving Home Program $ 75,000.00
Senior Citizen Services of Greater Connecting Seniors to the $ 100,000.00
Tarrant County, Inc. Community
Tarrant County Housing Homebuyer Counseling $ 116,000.00
Partnership, Inc. and Education
The Ladder Alliance Computer Skills Training $ 86,710.00
Program
United Community Centers Educational Enrichment $ 90,000.00
Program
YMCA of Metropolitan Fort Worth Early Childhood Education $ 75,000.00
CDBG Public Service Subtotal $ 962,101.00
Project Ramp $ 100,000.00
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