HomeMy WebLinkAboutContract 49725 CITY SECRETARY
CONTRACT NO.
AGREEMENT FOR COMMUNITY BASED PROGRAM
Girls Incorporated of Tarrant County
FISCAL YEAR 2018
In consideration of the mutual covenants, promises and agreements contained herein, THIS
AGREEMENT ("Agreement") is made and entered into between CITY OF FORT WORTH, a
home rule municipal corporation of the State of Texas, ("City") acting by and through Valerie
R. Washington, its duly authorized Assistant City Manager, and Girls Incorporated of Tarrant
County, a Texas private non-profit corporation ("Contractor") acting by and through
Jennifer Limas, President/CEO, its duly authorized representative.
RECITALS
WHEREAS, City has determined that Community-Based Programs are necessary to
support crime prevention in City during Fiscal Year 2018 to meet one or more of the Crime Control
and Prevention District ("CCPD") goals, which are (1) to support efforts to reduce violent crime
and gang-related activities through enhanced enforcement activities and crime prevention
programs,(2)to support efforts to increase the safety of residents and to decrease crime throughout
Fort Worth neighborhoods, and (3) to support efforts to increase the safety of youth and reduce
juvenile crime through crime prevention and intervention programs; and
WHEREAS, Contractor has agreed to operate a Community-Based Program called Girls
Inc. Prevention and Leadership in Fort Worth, which will support the police department's crime
prevention efforts throughout the community; and
WHEREAS, City desires to enter into an agreement with Contractor to operate the Girls
Inc. Prevention and Leadership in Fort Worth Program and
WHEREAS, City, as consideration for the performance of Contractor, has appropriated
monies in the CCPD Budget in the amount of $38,053.00 ("Program Funds") to provide to
Contractor on a reimbursable basis for the operation of the Girls Inc. Prevention and Leadership
Program subject to and in accordance with this agreement;
NOW, THEREFORE, in consideration of the mutual covenants herein expressed, the
parties agree as follows:
AGREEMENT DOCUMENTS
The Agreement documents shall include the following:
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1. This Agreement between City and Contractor 9�� y
2. Exhibit A—Proposal Abstract and Narrative
3. Exhibit B—Budget
4. Exhibit C—Request for Reimbursei ent
5. Exhibit D—Program Activities Rep OFFICIAL RECORD 9�
CITY SECRETARY
FY 2018 Community Based FT.WORTH,TX _...._....w,. „
Program Girls Incorporated of Page 1 of 14
Tarrant County
6. Exhibit E—Program Effectiveness Measurement Report
7. Exhibit F—Request for Budget Modification
Exhibits A through F, which are attached hereto and incorporated herein, are made a part of this
Agreement for all purposes. In the event of any conflict between the terms and conditions of
Exhibits A through F and the terms and conditions set forth in the body of this Agreement, the
terms and conditions of this Agreement control.
DEFINITIONS
The term"City" shall include City, and its officers, agents, employees, and representatives.
The term"Contractor" shall include Contractor, and its officers, agents, employees,
representatives, servants, contractors, and subcontractors.
The term"Party" shall refer to either City or Contractor.
The term"Parties" shall refer to both City and Contractor.
AGREEMENT
1. Responsibilities of Contractor.
Contractor covenants and agrees to fully perform,or cause to be performed,with good faith
and due diligence,all work and services described in Exhibit"A"—Proposal Narrative. Contractor
shall be responsible for day-to-day administration of the Girls Inc. Prevention and Leadership
program. Contractor agrees to expend the Program Funds in accordance with the Budget as
described in Exhibit `B". Program activities shall be reported in accordance with Exhibit "D"-
Program Activities Report and effectiveness measures shall be reported in accordance with Exhibit
"B"- Program Effectiveness Measures Report.
2. Program Funds.
2.1 In no event shall the total distribution from City made to the Contractor during the Term
of this Agreement exceed $38,053.00 ("Program Funds").
2.2 Payment of the Program Funds from City to Contractor shall be made on a cost-
reimbursement basis following receipt by City from Contractor of a signed Request for
Reimbursement (RFR), as described in Exhibit "C" along with copies of all receipts and other
supporting documentation. Contractor shall deliver to City a written detailed Program Activities
Report and Program Effectiveness Measures Report as described in Section 4.2 below with each
RFR to support expenditure of Program Funds. Such reports shall be signed by the Contractor or
duly authorized officer of the Contractor. The RFR and monthly Program Activities Report shall
be submitted to City no later than the 15th day following the end of the month. Submittal of a
monthly RFR and Program Activities Report is required even if services are not provided.
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The monthly RFR, with an original signature by an authorized representative, must be submitted
to the Grants and Program Management Section of the Fort Worth Police Department,
ATTENTION: Contract Compliance Specialist,Financial Management Division, Bob Bolen
Public Safety Complex,505 W. Felix St., Fort Worth,Texas,76115. Reimbursements will not
be made until after receipt of an acceptable and approved RFR and a monthly Program Activities
Report from the Contractor. Additionally,a quarterly Program Effectiveness Measurement Report
from Contractor is required as described in section 4.2 and must be approved prior to
reimbursements. Reimbursements shall be made within 30 days receipt of said documents.
2.3 Contractor is authorized to modify up to five (5) percent of any budgeted line-item in the
original approved budget without prior written permission from City. However, Contractor must
submit the Request for Budget Modification Form (Exhibit "F") to City, with the monthly RFR,
during the month the modification took place. The new modified budget cannot exceed the total
amount of Program Funds.
2.4 Any modifications of more than five (5)percent of any budgeted line-item in the original
approved budget must have prior written permission from City before the modifications are made.
The Budget Modification Form(Exhibit"F")must be submitted, and request must be approved by
City,before any money is moved to the line-item. Once the Budget Modification is approved,the
modified budget will take effect on the first day of the following month. The new modified budget
shall not exceed the total amount of Program Funds.
2.5 Any modifications to zero line-items in the original approved budget must have prior
written permission from City before the modifications are made. The Budget Modification Form
(Exhibit "F") must be completed and approved by City before money is transferred into the new
line-item. Once the Budget Modification is approved, the modified budget will take effect on the
first day of the following month. The new modified budget shall not exceed the total amount of
Program Funds.
2.6 Budget modification can only occur within the Direct and Indirect costs. Funds may not
be moved from a Direct line-item into an Indirect line-item, or vise versus. Modification of Direct
and Indirect approved budgets must follow the guidelines outlined in sections 2.3, 2.4. and 2.5.
Budget adjustments shall be submitted to the Contract Compliance Specialist, Financial
Management Division, the Fort Worth Police Department at Bob Bolen Public Safety
Complex at 505 W. Felix St., Fort Worth,Texas, 76115.
3. Term. This Agreement shall commence upon October 1, 2017 ("Effective Date"), and
shall end on September 30, 2018 ("End Date"). All of Contractor's expenditures under this
Agreement must be completed no later than September 30, 2018.
4. Program Performance.
4.1 Contractor agrees to maintain full documentation supporting the performance of the work
and fulfillment of the objectives set forth in Exhibit "A."
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4.2 Contractor agrees to provide a monthly Program Activities Report and quarterly Program
Effectiveness Measurement Report to document the performance of the work described in Exhibit
"D" and Exhibit "E," respectively. The Program Activities and Effectiveness Measures shall
document the program activity names, numbers of participants attending, details of the activities,
and a description of the goals achieved in support of the CCPD goals. Program Effectiveness
Measures shall be reported on a quarterly basis and included in the January, April, July, and
October RFR and Program Activities Report submittals. Additionally, the Program Effectiveness
Measurement Report must include descriptions of any realized successes. The monthly Program
Activities and quarterly Program Effectiveness Measurement Reports shall be submitted to City
no later than the 15th day after the end of each month.
4.3 Contractor agrees that the monthly Request for Reimbursement and Program Activities
Report and quarterly Program Effectiveness Measurement Report will be submitted to City no
later than the 15th day after the end of each month. Should Contractor not meet these requirements,
Contractor will be given an additional 15 days to submit the required reports to City. If, at the end
of this 15-day extension period, Contractor has not submitted the required reports, City will send
a non-compliance letter notifying Contractor's duly authorized representative of a possible
suspension of program funding.
4.4 A representative of the program shall attend quarterly meetings of the Crime Control and
Prevention District Board as requested.
5. Default and Termination.
5.1 This Agreement is wholly conditioned upon the actual receipt by City of Program Funds
from the CCPD. All monies distributed to Contractor hereunder shall be exclusively from monies
received from the CCPD, and not from any other monies of City. In the event that funds from the
CCPD are not received in whole or in part, City may, at its sole discretion, terminate this
Agreement and City shall not be liable for payment for any work or services performed by
Contractor under or in connection with this Agreement.
5.2 In the event no funds or insufficient funds are appropriated by the City in any fiscal year for
any payments due hereunder, City will notify Contractor of such occurrence and this Agreement
shall terminate on the last day of the fiscal period for which appropriations were received without
penalty or expense to the City of any kind whatsoever, except as to the portions of payments herein
agreed upon for which funds have been appropriated.
5.3 The City may terminate this Agreement at any time and for any reason by providing the
other party with thirty(30) days' written notice of termination.
5.4 Termination will be effected by delivering to Contractor written notice of termination.
Upon Contractor's receipt of notice of termination, Contractor shall:
(a) Stop work under the Agreement on the date and to the extent specified in the notice of
termination;
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(b) Place no further order or subcontracts, except as may be necessary for completion of the
work not terminated;
(c) Terminate all orders and contracts to the extent that they relate to the performance of the
work terminated by the notice of termination; and
(d) Cease expenditures of Program Funds, except as may be necessary for completion of the
work not terminated.
5.5 In the event City suspends or terminates this Agreement, Contractor expressly waives any
and all rights to monetary damages, including but not limited to actual,consequential,and punitive
damages, court costs and attorney's fees.
5.6 Within thirty(30)days following the date of termination of this Agreement,Contractor shall
return to City any property provided hereunder. City will have no responsibility or liability for
Contractor's expenditures or actions occurring after the effective date of termination of the
Agreement.
6. Equipment and Maintenance. All equipment purchased with Program Funds must meet
all eligibility requirements of City. Contractor shall maintain all equipment used in the
administration and execution of Girls Inc. Prevention and Leadership Program. Contractor shall
maintain,replace,or repair any item of equipment used in support of the Girls Inc.Prevention and
Leadership program or for use under the terms of this Agreement that no longer functions or is lost
or stolen. The cost for maintenance, replacement or repair of any equipment used in support of
Girls Inc. Prevention and Leadership program and/or for use under the terms of this Agreement is
the sole responsibility of Contractor. Contractor shall not use Program Funds to repair or replace
said equipment. Contractor shall use any and all equipment purchased with Program Funds
exclusively in support of the Girls Inc. Prevention and Leadership program. Within 10 days
following the purchase of equipment, Contractor shall submit to City a detailed inventory of all
equipment purchased with Program Funds to the Grants and Program Management Section at the
address set forth in paragraph 2.2 above. The equipment inventory shall include an itemized
description of each piece of equipment, the date each piece of equipment was purchased, the cost
of purchase for each piece of equipment, and the location of each piece of equipment.
7. Administrative Requirements.
7.1
Contractor agrees to keep sufficient records to document its adherence to applicable local, state, and
federal regulations,along with documentation and records of all receipts and expenditures of Program
Funds. All records shall be retained for three (3) years following the termination or completion of
this Agreement. City or its representatives shall have the right to investigate, examine, and audit at
any time any and all such records relating to operations of Contractor under this Agreement.
Contractor,its officers,members,agents, employees, and subcontractors,upon demand by City, shall
make such records readily available for investigation, examination, and audit. In the event of such
audit by City, a single audit of all Contractor's operations will be undertaken and may be conducted
either by City or an independent auditor of City's choice. Contractor shall submit a copy of any audit
performed by their independent auditor within 30 days of receipt of the final audit report.
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7.2 If any audit reveals a questioned practice or expenditure, City shall notify Contractor as
soon as reasonably practical. Contractor shall have fifteen(15) days to provide City with a written
explanation and any supporting documentation regarding the practice or expenditure. If Contractor
fails to resolve or cure the questioned practice or expenditure, to the City's satisfaction,within the
fifteen(15)day period,City reserves the right to withhold further Program Funds under this and/or
future agreement(s)with Contractor.
7.3 If, as a result of any audit, it is determined that Contractor misused, misapplied or
misappropriated all or any part of the Program Funds, Contractor agrees to reimburse City the
amount of such monies so misused, misapplied or misappropriated, plus the amount of any
sanction, penalty, or other charge levied against City because of such misuse, misapplication or
misappropriation.
7.4 Contractor's obligation to City shall not end until all closeout requirements are completed.
The closeout requirements shall include,but are not limited to: providing final Program Activities
Report and Program Effectiveness Measurement Reports, making final payments, and disposing
of Girls Inc.Prevention and Leadership assets as appropriate,if deemed required by the City in its
sole discretion.
7.5 Contractor covenants and agrees to fully cooperate with City in monitoring the
effectiveness of the services and work to be performed by Contractor under this Agreement, and
work to be performed by Contractor under this Agreement and City shall have access at all
reasonable hours to offices and records of Contractor, its officers, members, agents, employees,
and subcontractors for the purpose of such monitoring.
Section 7 shall survive the expiration or termination of this Agreement.
8. Independent Contractor.
8.1 Contractor shall operate hereunder as an independent contractor and not as an officer,
agent,or servant or employee of City. Contractor shall have exclusive control of,and the exclusive
right to control, the details of the work and services performed hereunder, and all persons
performing same, and shall be solely responsible for the acts and omissions of its officers,
members,agents,servants,employees, subcontractors,program participants,licensees,or invitees.
The doctrine of respondeat superior shall not apply as between City and Contractor, its officers,
members,agents,servants,employees, subcontractors,program participants,licensees,or invitees,
and nothing herein shall be construed as creating a partnership or joint enterprise between City and
Contractor.No federal, state,or local income tax,nor any payroll tax of any kind,shall be withheld
or paid by City on behalf of Contractor. Contractor shall not be treated as an employee with respect
to the services perfonned pursuant to this Agreement for federal or state tax purposes. It is
expressly understood and agreed that officers, members, agents, employees, subcontractors,
licensees, or invitees of Contractor, and any program participants hereunder are not eligible for,
and shall not participate in any employer pension, health, or other fringe benefit plan provided by
City. It is expressly understood and agreed that City does not have the legal right to control the
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details of the tasks performed hereunder by Contractor, its officers, members, agents, employees,
subcontractors,program participants, licensees, or invitees.
8.2 City shall in no way nor under any circumstances be responsible for any property belonging
to Contractor, its officers, members, agents, employees, subcontractors, program participants,
licensees or invitees,which may be lost, stolen, destroyed, or in any way damaged.
9. Liability and Indemnification.
CONTRACTOR SHALL BE LIABLE AND RESPONSIBLE FOR ANYAND ALL PROPERTY
LOSS, PROPERTY DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH, TO
ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER, WHETHER REAL OR
ASSERTED, TO THE EXTENT CAUSED BY THE NEGLIGENT ACT(S) OR OMISSION(S),
MALFEASANCE OR INTENTIONAL MISCONDUCT OF CONTRACTOR,ITS OFFICERS,
AGENTS, SERVANTS OR EMPLOYEES.
CONTRACTOR AGREES TO DEFEND, INDEMNIFY, AND HOLD THE CITY, ITS
OFFICERS, AGENTS, SERVANTS,AND EMPLOYEES HARMLESS AGAINSTANYAND
ALL CLAIMS, LAWSUITS, ACTIONS, COSTS, AND EXPENSES OF ANY KIND,
INCLUDING, BUT NOT LIMITED TO, THOSE FOR PROPERTY DAMAGE OR LOSS
(INCLUDING ALLEGED DAMAGE OR LOSS TO OWNER'S BUSINESS AND ANY
RESULTING LOST PROFITS) AND/OR PERSONAL INJURY (INCLUDING DEATH)
THAT MAYRELATE TO,ARISE OUT OF, OR BE OCCASIONED BY(I) CONTRACTOR'S
BREACH OF ANY OF THE TERMS OR PROVISIONS OF THIS AGREEMENT OR (II)
ANY NEGLIGENT ACT OR OMISSION OR INTENTIONAL MISCONDUCT OF
CONTRACTOR,ITS OFFICERS,AGENTS,ASSOCIATES,EMPLOYEES, CONTRACTORS
(OTHER THAN THE CITY), OR SUBCONTRACTORS RELATED TO THE
PERFORMANCE OF THISAGREEMENT,EXCEPT THAT THE INDEMNITYPROVIDED
FOR IN THIS SECTION SHALL NOT APPLY TO ANY LIABILITY RESULTING FROM
THE SOLE NEGLIGENCE OF THE CITY OR ITS OFFICERS, AGENTS, EMPLOYEES,
OR SEPARATE CONTRACTORS, AND IN THE EVENT OF JOINT AND CONCURRENT
NEGLIGENCE OFBOTH CONTRACTOR AND CITY,RESPONSIBILITY,IFANY,SHALL
BE APPORTIONED COMPARATIVELY IN ACCORDANCE WITH THE LAWS OF THE
STATE OF TEXAS. NOTHING HEREIN SHALL BE CONSTRUED ASA WAIVER OF THE
CITY'S GOVERNMENTAL IMMUNITY AS FURTHER PROVIDED BY THE LAWS OF
TEXAS.
Contractor shall require all of its subcontractors to include in their subcontracts a release and
indemnity in favor of City in substantially the same form as above.
This section shall survive the expiration or termination of this Agreement.
10. Non-Assignment. No assignment or delegation of duties under this Agreement by
Contractor shall be effective without City's prior written approval.
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11. Prohibition AEainst Interest.
11.1 No member, officer, or employee of City, or its designees or agents; no member of the
governing body of the locality in which the Girls Inc. Prevention and Leadership program is
situated; and no other public official of such locality or localities who exercises any functions or
responsibilities with respect to the Girls Inc. Prevention and Leadership program during his tenure
or for one year thereafter, shall have any interest, direct or indirect, in any contract or subcontract,
or the proceeds thereof, for work to be performed hereunder. Contractor shall incorporate,or cause
to be incorporated, like language prohibiting such interest, in all contracts and subcontracts
hereunder.
11.2 No officer, employee,member, or program participant of Contractor shall have a financial
interest,direct or indirect, in this Agreement or the monies transferred hereunder, or be financially
interested, directly or indirectly, in the sale to Contractor of any land, materials, supplies, or
services purchased with any funds transferred hereunder, except on behalf of Contractor, as an
officer, employee, member, or program participant. Any willful violation of this paragraph with
the knowledge, expressed or implied, of Contractor or its subcontractors, shall render this
Agreement voidable by City of Fort Worth.
12. Nondiscrimination.
12.1 In accordance with the federal, state, and local laws and ordinances, Contractor
covenants that neither it nor any of its officers,members, agents,employees,program participants,
or subcontractors, while engaged in performing this Agreement shall in connection with the
employment, advancement, or discharge of employees, in connection with the terms, conditions
or privileges of their employment,discriminate against persons because of their age, except on the
basis of a bona fide occupational qualification, retirement plan, statutory requirement, or statutory
or ordinance exception.
12.2 Contractor will not unlawfully discriminate against any person or persons because of
age, race, color, religion, sex, disability, national origin, or sexual orientation, nor will Contractor
permit its officers,members,agents,employees,subcontractors,or program participants to engage
in such discrimination.
IF ANY CLAIM ARISES FROM AN ALLEGED VIOLATION OF THIS NON-
DISCRIMINATION COVENANT BY CONTRACTOR, ITS PERSONAL
REPRESENTATIVES, ASSIGNS, SUBCONTRACTORS OR SUCCESSORS IN
INTEREST, CONTRACTOR AGREES TO ASSUME SUCH LIABILITY AND TO
INDEMNIFY AND DEFEND THE CITY AND HOLD THE CITY HARMLESS FROM
SUCH CLAIM.
This section shall survive the expiration or termination of this Agreement.
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13. Compliance.
13.1 Contractor, its officers, members, agents, employees, program participants, and
subcontractors, shall abide by and comply with all laws, federal, state and local, including all
ordinances, rules and regulations of City. If City calls to the attention of Contractor in writing to
any such violation on the part of Contractor or any of its officers, members, agents, employees,
subcontractors or program participants, then Contractor shall immediately desist from and correct
such violation.
13.2 Contractor shall utilize Program Funds strictly for those purposes and goals intended under
the terms and conditions of this Agreement. If City calls the attention of Contractor in writing to
any such violations on the part of Contractor or any of its officers, members, agents, employees,
program participants or subcontractors, then Contractor shall immediately desist from and correct
such violation.
14. Governmental Powers. It is understood that by execution of this Agreement, the City does
not waive or surrender any of it governmental powers.
15. Waiver of Immunity. If Contractor is a charitable or nonprofit organization and has or
claims an immunity or exemption (statutory or otherwise) from and against liability for damages
or injury, including death, to persons or property; Contractor hereby expressly waives its rights to
plead defensively such immunity or exemption as against City. This section shall not be construed
to affect a governmental entity's immunities under constitutional, statutory or common law.
16. Insurance Requirement.
16.1 Coverages and Limits. Contractor shall provide the City with certificate(s) of insurance
documenting policies of the following minimum coverage limits that are to be in effect prior to
commencement of any work pursuant to this Agreement:
(a) Commercial General Liability (CGL): $1,000,000 per occurrence, with a $2,000,000.00
annual aggregate limit, in a form that is acceptable to the City's Risk Manager.
(b) Non-Profit Organization Liability or Directors & Officers Liability: $1,000,000 per
occurrence, with a $1,000,000 annual aggregate limit, in a form that is acceptable to the
City's Risk Manager.
(c) Automobile Liability: $1,000,000 each accident on a combined single limit basis OR split
limits are acceptable if limits are at least $250,000 Bodily Injury per person, $500,000
Bodily Injury per accident and $100,000 Property Damage.
(d) Any other insurance the City may reasonably require to protect the interest of the City.
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16.2 Contractor's insurer(s)must be authorized to do business in the State of Texas for the lines
of insurance coverage provided and be currently rated in terms of financial strength and solvency
to the satisfaction of the City's Risk Manager. All insurers must have a minimum rating of A-VII
in the current A.M. Best Key Rating Guide, or have reasonably equivalent financial strength and
solvency to the satisfaction of Risk Management. If the rating is below that required, written
approval of Risk Management is required.
16.3 Each insurance policy required herein shall be endorsed with a waiver of subrogation in
favor of the City. Each insurance policy required by this Agreement, except for policies of
worker's compensation or accident/medical insurance shall list the City as an additional
insured. City shall have the right to revise insurance coverage requirements under this Agreement.
16.4 Contractor further agrees that it shall comply with the Worker's Compensation Act of
Texas and shall provide sufficient compensation insurance to protect Contractor and City from and
against any and all Worker's Compensation claims arising from the work and services provided
under this Agreement.
16.5 The commercial general liability policy shall name the City as an additional insured thereon,
as its interests may appear.
16.6 A minimum of Thirty (30) days' notice of cancellation or reduction in limits of coverage
shall be provided to the City. Ten(10)days' notice shall be acceptable in the event of non-payment
of premium. Notice shall be sent to the Risk Manager, City of Fort Worth, 200 Texas Street, Fort
Worth,Texas 76102, with copies to the City Attorney at the same address.
16.7 Any failure on the part of the City to request required insurance documentation shall not
constitute a waiver of the insurance requirement.
16.8 Certificates of Insurance evidencing that the Contractor has obtained all required insurance
shall be delivered to the City prior to Contractor proceeding with any work pursuant to this
Agreement.
17. Miscellaneous Provisions.
17.1 The provisions of this Agreement are severable, and, if for any reason a clause, sentence,
paragraph, or other part of this Agreement shall be determined to be invalid by a court or Federal or
state agency,board,or commission having jurisdiction over the subject matter thereof,such invalidity
shall not affect other provisions which can be given effect without the invalid provision.
17.2 City's failure to insist upon the performance of any term or provision of this Agreement or
to exercise any right herein conferred shall not be construed as a waiver or relinquishment to any
extent of City's right to assert or rely upon any such term or right on any future occasion.
17.3 Should any action, whether real or asserted, at law or in equity, arise out of the execution,
performance, attempted performance or non-performance of this Agreement,venue for said action
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shall lie in state courts located in Tarrant County,Texas or the United States District Court for the
Northern District of Texas, Fort Worth Division.
17.4 Contractor represents that it possesses the legal authority, pursuant to any proper,
appropriate and official motion, resolution or action passed or taken, to enter into this Agreement
and to perform the responsibilities herein required.
17.5 This written instrument and Exhibits A through F constitute the entire agreement between
the parties concerning the work and services to be performed hereunder, and any prior or
contemporaneous, oral or written agreement which purports to vary from the terms hereof shall be
void.
17.6 Any amendments to the terms of this Agreement must be in writing and must be signed by
authorized representatives of each Party.
17.7 None of the performance rendered under this Agreement shall involve, and no portion of
the Program Funds received hereunder shall be used, directly or indirectly, for the construction,
operations,maintenance or administration of any sectarian or religious facility or activity,nor shall
said performance rendered or funds received be utilized so as to benefit, directly or indirectly, any
such sectarian or religious facility or activity.
17.8 The parties acknowledge that each party and its counsel have reviewed this Agreement and
that the normal rules of construction to the effect that any ambiguities are to be resolved against
the drafting party shall not be employed in the interpretation of this Agreement or exhibits hereto.
17.9 Captions and headings used in this Agreement are for reference purposes only and shall
not be deemed a part of this Agreement.
17.10 The provisions and conditions of this Agreement are solely for the benefit of City and
Contractor and are not intended to create any rights, contractual or otherwise, to any other person
or entity.
17.11 Contractor certifies that it has obtained a 501(c)(3) Certificate from the Internal Revenue
Service. Contractor shall notify City in writing of any changes to its 501(c)(3) tax-exempt status
during the term of this Agreement.
18. Notice.
Notices to be provided hereunder shall be sufficient if forwarded to the other party by hand-delivery or via
U.S. Postal Service certified mail,postage prepaid, to the address of the other party shown below:
CITY: Valerie R. Washington,Assistant City Manager
City Manager's Office
City of Fort Worth
200 Texas Street
Fort Worth,TX 76102
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Copies To: Financial Management Division
Bob Bolen Public Safety Complex
505 West Felix St.
Fort Worth,TX 76115
City Attorney's Office
Attn: Police Contracts
200 Texas Street
Fort Worth,TX 76102
CONTRACTOR: Sonya Mosley, LCSW
Director of School and Community Based Services
3200 Sanguinet Street
Fort Worth,TX 76107
19. IMMIGRATION NATIONALITY ACT.
City actively supports the Immigration&Nationality Act(INA)which includes provisions
addressing employment eligibility, employment verification, and nondiscrimination. Contractor
shall verify the identity and employment eligibility of all employees who perform work under this
Agreement. Contractor shall complete the Employment Eligibility Verification Form (I-9),
maintain photocopies of all supporting employment eligibility and identity documentation for all
employees, and upon request, provide City with copies of all I-9 forms and supporting eligibility
documentation for each employee who performs work under this Agreement. Contractor shall
establish appropriate procedures and controls so that no services will be performed by any
employee who is not legally eligible to perform such services. Contractor shall provide City with
a certification letter that it has complied with the verification requirements required by this
Agreement. Contractor shall indemnify City from any penalties or liabilities due to violations of
this provision. City shall have the right to immediately terminate this Agreement for violations of
this provision by Contractor.
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[SIGNATURE PAGE FOLLOWS]
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IN WITNESS WHEREOF, the parties hereto hav- executed this agreement in multiples in Fort
Worth, Tarrant County, Texas, to be effective this -qday of ! , 20
APPROVED AND AGREED FOR APPROVED AND AGREED FOR
CITY OF FORT WORTH Girls Incorporated of Tarrant County
Valerie R. Washington Jnnif Lima
Assistant City Manager President/CEO
Date: 01 Date:
APPROVED AS TO FORM AND
LEGALITY FOR Girls Incorporated
APPROVAL RECOMMENDED of Tarrant County
4?7? 4t/-
Joel F. Fitzgerald
Chief of Police Girls Incorporated of Tarrant County
Date:
Z � 1FRT �O
Date:
APPROVED AS TO FORM AND
LEGALITY FOR CITY OF FORT V`.
WORTH5
ATT ST ......�:. P
Jofitant'City
at
Attorney Mary J. e
City Secretary
Date: 2A 7 IZ2
Date: l
M&C No. NOT REQUIRED
OFFICIAL RECORD
CITY SECRETARY 1295 CERTIFICATION: 1 �
FT.WORTH, TX
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Girls Inc.of Tarrant County Page 13 of 14
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
4ame
4 uack 5&
Title i
OFFICIAL RECORD
CITY SECRETARY
FT. WORTHY TX
FY 2018 Community Based Program
Girls Incorporated of Tarrant County Page 14 of 14
Exhibit A
Proposal Abstract and Narrative
PROGRAM ABSTRACT
Provide a short description of your program to be funded. Please summarize the problem and what
your program will do to address it.(Roughly 2 paragraphs in length on a separate page)
The Girls Inc.Prevention and Leadership program at Washington Heights Elementary School program
addresses the problems of youth violence, substance abuse, and other crime by delivering programs that
increase protective factors and decrease risk factors for girls.The program also addresses literacy for first
through third grade girls,which meets the special emphasis requirement of the grant. Girls Inc.'s Literacy
Initiative is a successful program that supports school districts to improve the literacy skills of first
through third grade girls who are not currently reading at grade level.As part of the Fort Worth Literacy
Partnership, Girls Inc. of Tarrant County is committed to helping Fort Worth ISD achieve the goal for
100%of third graders to be reading at grade level by 2025.
Washington Heights Elementary School is located in Fort Worth's Northside community(Zip code
76106), which has high rates of crime,truancy and school dropout,and substance abuse. Girls Inc.
provides researched-based programs during and after school in a safe,supportive and mentoring
environment on the campus of Washington Heights Elementary School. Seventy(70)first through fifth
grade girls will be served with CCPD funds.Girls Inc. curricula educates and empowers girls to:
• Build skills to positively navigate social situations and overcome relational.aggression that can
escalate into violent behavior.
• Build skills to resist pressure to use/abuse alcohol, drugs and other harmful substances.
• Participate in community service activities through our Leadership and Community Action.
• Improve first through third grade girls' literacy skills by supporting their classroom learning with
additional literacy instruction and practice.
PROPOSAL NARRATIVE:
Provide a 4-5 page description of your program to be funded. In this narrative, please respond to
each of the following questions:
1) In one sentence,describe the purpose of your proposed program.
The purpose of the Girls Inc.Prevention and Leadership program at Washington Heights Elementary
School is to provide research-based programming to teach 41'and 59'grade girls decision-making
skills to avoid involvement in violence and crime and to provide literacy instruction and practice to
improve first through third grade girls' literacy skills.
2) What geographic area will it serve? Please describe if it will be city wide,a specific council district,
or a specific zip code?Please include geographic boundaries and a map.
The program will serve first through fifth grade girls at Washington Heights Elementary School, 3215
N.Houston Street,Fort Worth, 76106,in the Northside neighborhood, located in Council District 2.
3) Describe in detail the problem that your program addresses.
The problems addressed by this program are poor literacy skills, school dropout,bullying, and crime.
Literacy and School Dropout
Only 30%0 of all Fort Worth third graders read at grade level. Studies show that 75 percent of
students who struggle with reading in third grade never catch up(read fortworth.org).In the 2015-16
school year, only 52%of third grade students at Washington Heights Elementary School were reading
at STAAR Level II Satisfactory Standard or Above.Fifty-six percent of students at the school are
English.Language Learners.Reading on grade level is a predictor of future.success.Those students
who are not reading at grade level by third grade are four times as likely to drop out of high school
(readfortworth.org). Washington Heights Elementary students will one day be going to high school at
North Side High School,where the dropout rate for the Class of 2015 was 10.6%(Four-
,year
Longitudinal Data, Texas Education Agency). 33.6%of children in 76106 live below poverty, and in
homes where a single mother is the head of household,55.7%of children live in poverty(American
Fac4finder, U.S. Census, 2015 Community Data).
A high school diplouaa and a college education are key to women's ability to be fenancially
independent adults. Among women aged 25 years and older,nearly one-third(32.8 percent)of those
without a high school diploma were living in poverty, compared to 16.0 percent of those with a high
school diploma or equivalent, 11.5 percent of those with some college education,and 4.9 percent of
those with a Bachelor's degree or higher(U.S. Dept.of Health and Human Services,2013).Literacy
and education are a pathway out of poverty for the girls that we serve.
Bullying
Victims of bullying display a range of responses, even many years later,such as low self-esteem,
difficulty trusting others, lack of assertiveness, aggression,difficulty controlling anger,isolation,and
RFP No. 17-0237;FY2018 Community Based Programs
Page 7 of 25
even suicide.Bullying can threaten students'physical and emotional safety at school and can
negatively impact their ability to learn.The best way to address bullying is to stop it before it starts
(www.stopbullying.gov).
Crime
Fort Worth's Northside Community(Zip codes 76106 and 76164)has been targeted by the Texas
Department of Family and Protective Services as two of 15 Zip code areas in the State with the highest
incidence of youth crime(DFPS, 2017). Girls Inc.has a large presence in the Northside Community,
providing programs at several elementary,middle, and high schools,as well as the Northside Library
and Northside Community Center.
Saving Futures, Saving Dollars: The Impact of Education on Crime Reduction and Earnings notes the
disparity between annual federal spending on students and inmates.The United States spends $12,643
to educate one student for one year versus the annual cost of$28,323 to house one inmate."If the
nation made a comparable investment in effort and dollars in schools as it does in jails and prisons, the
return would be decreased levels of criminal activity and incarceration as well as significant and life-
changing impacts on the individual,"the report notes(http://all4ed.org/press/crime-rates-linked-to-
educational-attainment-new-alliance-report-finds/).
4) Describe what your program does to 1)support efforts to reduce violent crime and gang related
activities through enhanced enforcement activities and crime prevention programs, 2) support
efforts to increase the safety of residents and to decrease crime throughout Fort Worth
neighborhoods; and 3) support efforts to increase the safety of youth and reduce juvenile crime
through crime prevention and intervention programs.4) address a literacy element as required
by the CCPD Board.
Girls Inc. of Tarrant County supports efforts to increase the safety of youth and reduce juvenile crime
through our Girls Beyond Bullying anti-bullying and Friendly PEERsuasion substance abuse
prevention programs,which we will be providing to fourth and fifth grade girls.These Girls Inc.
programs teach girls age-appropriate decision-making skills to help them prevent and avoid violence
and substance abuse.The Girls Inc. Leadership and Community Action program will also provide
protective factors by teaching girls leadership skills and giving them the opportunity to provide
community service.The curricula Girls Inc. will be using at Washington Heights Elementary
includes:
➢ Girls Beyond Bullying empowers girls how to create positive bonds among peers and work
together to create positive solutions to potentially violent situations,helping girls build skills to
positively navigate social situations and overcome relational aggression that can escalate into
violent behavior.The program increases girls' awareness of the many ways that girls and women
experience violence, and builds their skills in assessing,responding to, and avoiding potentially
violent situations.
➢ Friendly PEERsuasion builds girls' skills for resisting pressure to use harmful substances such
as alcohol, tobacco,household chemicals, and other drugs which can lead to participation in other
RFP No. 17-0237,FY2018 Community Based Programs
Page 8 of 25
criminal activity. This substance abuse prevention program teaches girls healthy ways to manage
stress and confront peer,media and other pressures as well as to understand the dangerous
consequences of drugs and alcohol use.Girls participate together in program activities that build
positive peer support.
➢ Leadership and Community Action—Girls work together to build leadership skills and enact
social change through community action projects. Girls learn and celebrate the heritage of girls
and women as leaders and social change agents and realize their own power as community
resources. When working on projects, girls work research community needs and potential
projects,plan projects, implement/complete project and reflect on their accomplishments and
impact on their community.
➢ Literacy Initiative—The Girls Inc.'s Literacy Initiative provides literacy instruction and practice
to strengthen the literacy skills of K-3rd grade girls and to encourage them to develop a love of
reading.Literacy skills are the foundation on which all future academic learning is based. Girls
Inc.works with girls to support and complement what the girls are learning in school The
program brings together research-based best practices for literacy programming and a positive
youth development framework that incorporates the Girls Inc.programming approach of
addressing the"whole girl"to support girls in achieving these goals.
Curriculum for the Girls Inc. Literacy Initiative focuses on: vocabulary development,phonics and
spelling,integrating writing, fluency, reading comprehension,implementing high quality read
alouds, and supporting English Language Learners.At least 50%of our girls are English
Language Learners so literature in students'native language and bilingual staff are provided.
The program utilizes fun and engaging activities-incorporating active learning such as skits,
games, songs, flash cards,visual aids,posters,picture books,and structured conversations with
classmates.Girls Inc. also uses technology devices with literacy applications into the program,
which engages the girls to practice reading skills and also increases their technology literacy
skills.
Parent/caregiver engagement and support are key to the project. Staff maintain good
communication with parents by hosting family literacy nights,parent nights and other activities to
keep families engaged and connected, such as take home packets with books and activities that
encourage parents and caregivers to read with their children.
Led by Mayor Betsy Price and Fort Worth ISD Superintendent Kent Scribner, the Fort Worth
Literacy Partnership has a goal to ensure that 100 percent of Fort Worth third-graders are reading
at grade level by 2025. Girls Inc. of Tarrant County participates in the Fort Worth Literacy
Partnership,with our Chief Program Officer,Becky Balarin,leading one of the committees,
which meets at the Girls Inc. office in Downtown Fort Worth. Girls Inc. is committed to
providing our research-based Literacy Initiative program to support Fort Worth ISD in reaching
the goal of all third-grade children reading on grade level by 2025.
RFP No. 0-0237,FY201.8 Gomnwnity Based Programs
Page 9 of 25
5) Does your program address the CCPD priority/special emphasis of the prevention or intervention
of youth violence and/or family violence or incorporate literacy instruction or skills for children
ages 0-9? Yes, Girls Inc. addresses both of these priorities.
Describe how your program addresses this priority?
Girls Inc. addresses the prevention of youth violence through our program Girls Beyond Bullying
program,which is a bullying and violence prevention program.
Girls Inc. incorporates literacy instruction and skill building through the Literacy Initiative for first
through third grade girls.
6) How will you measure the effectiveness of the program? You must include specific performance
measures within the Activities and Outcomes Summary and describe evaluation tools and the
method of data collection that you will use. If awarded funding,these performance measures will
be included as an exhibit in the contract,and you will be required to report progress towards these
measures, which will be reported to the CCPD Board.
Girls Inc. of Tarrant County will measure program effectiveness by pre-and post-testing girls
participating in Girls Beyond Bullying and Friendly PEERsuasion programs .The performance
standard is that girls will score 86%or higher on their post-test or raise their score by at least 20%.
(See performance measures in the Activities and Outcomes Summary.)To measure Leadership and
Community Action programming,we set a goal of conducting six community service projects during
the year.
For the Literacy Initiative program,Dynamic Indicators,of Basic Early Literacy Skills(DIBELS)is
utilized in tracking student progress and success.Developed at the University of Oregon,DIBELS
measures the following skills of early literacy; phonemic awareness,alphabetic principle, accuracy
and fluency, vocabulary and comprehension.The tool was designed for grades K-6 with different
tests administered at different grade levels.Oral reading fluency is measured by the number of words
read per minute.Girls are also assessed to see how many sight words they can recognize per minute.
Depending on reading levels, we have English Language Learners in higher grades who are still
working'on letter recognition.We work with the teachers to help us determine the specific literacy
needs of the girls.Bilingual staff lead this program as the majority of girls at Washington Heights
Elementary come from Spanish-speaking homes.
7) What makes this program unique from any other crime prevention program in Fort Worth?
Girls Inc. of Tarrant County is unique in that our programming is based on nationally-researched
curriculum that addresses the gender-specific risk factors that make girls vulnerable to participating in
violent behavior,abusing illegal substances,bullying, and other problems including truancy,
academe failure,high school dropout and engaging in early/risky sexual behavior. Girls Inc.'s
national organization includes a National Resource Center(NRC)in Indianapolis which serves as the
research,information services,and training site on gender-specific issues.Research and evaluation
conducted by the NRC provide the foundation for Girls Inc.programs.
RFP No. 17-0237,FY2018 Community Based Programs
Page 10 of 25
8) Is the program already in operation? If so, how long have you operated the program? What
resources are currently used to operate the program? Why are CCPD funds necessary at this
time?
The program is already in operation. It began in 2015 with Fort Worth ISD providing funding in the
amount of$40,000 in Year 1 and$38,000 in Year 2 and was supplemented with funding raised by Girls
Inc. of Tarrant County.CCPD funds are necessary because the Fort Worth ISD funding which provided
program support in 2015-16 and 2016-17 is ending.
9) Is this a new program? If so, what other funds have you applied for? Also, please describe the
sequence of steps needed to implement your program and the timeframe in which this will occur.
Girls Inc. of Tarrant County has been providing the program for the last two school years,2015-16
and 2016-17.The program started out providing Girls Inc. Operation SMART STEM(science,
technology,engineering and mathematics)and Leadership and Community Action programs to girls at
Washington Heights Elementary School. Principal Cantu requested that we also provide literacy
programming for.her first through third grade students, so that component has been recently added.
The first two year of the program were originally funded with grant funding from Fort Worth ISD
which is no longer available.
10) If funds are awarded, will this program continue beyond the CCPD funding period? Please
explain your plan to sustain this program.
The agency's financial stability is built on a foundation of state and federal grants,United Way
funding,and support from foundations and corporations, individual donations and special events. Girls
Inc. of Tarrant County also reinvests the income earned through our child care programs into the
programs and services that fulfill our mission.The Board,President/CEO, and management team are
working to strengthen the agency's fundraising capacity on all levels—individual and corporate
contributions,special events, online giving,mail appeals, auctions,and government grants as well as
foundations—and Are committed to expanding and diversifying funding resources for the agency. Our
corrunitment to.growing and sustaining the number of girls we serve and continuing to expand
programs, activities and opportunities for our girls translates into a strong commitment to continuing
to develop the financial resources to meet those goals.We will be researching and applying for
other grant funding to continue the program at Washington Heights Elementary as well as other
schools in Fort Worth ISD that we serve.
This is not just about a"number"but about the realization that each"number"is an individual girl
whose life that we have the opportunity to touch and to help her reach positive outcomes—to avoid
participating in,bullying,violence, or other delinquent activity, and instead to develop positive life
skills, to succeed academically; to graduate high school and plan for post-secondary education.
11) Has your agency obtained funding_through the Crime Control and Prevention District previously?
MR Yes ❑No If so, please fill out the form on page 17.
RFP No. 17-0237,FY2018 Community Based Programs
Page 11 of 25
Exhibit B
Budget Narrative and Summary
BUDGET SUMMARY
Amount
Requested
A. Direct Personnel 31,394
B. Direct Fringe Benefits 2,264
C. Direct Travel 1,100
D. Direct Equipment
E. Direct Supplies 3,295
F. Direct Contracts/Consultants
G. Indirect Cost up to 10%
TOTAL $38,053
BUDGET DETAIL
A. Direct-Personnel
Name Position Rate of Pay x#of Hours Cost
Hannah McAlister Program Director $14.42/hour x 1548.80 hours $22,334
Natalia Olvera Program Facilitator $15/hour x 484 hours $ 7,260
Interns(2) Stipend of$300 per semester x 3 semesters $ 1,800
TOTAL Personnel $31,394
B. Direct-Fringe Benefits
Name Position Description of Benefits Cost
Hannah McAlister Program Director FICA at 7.65%of wages $1,709
Natalia Olvera Program Facilitator FICA at 7.65%of wages $ 555
TOTAL Fringe Benefits $2,264
C. Direct-Travel
Purpose of Travel Location Item Cost
To deliver program Program site Mileage:200 mi/mo x
I Imo x .50/mi avg $1,100
TOTAL Travel $1,100
D. Direct-Equipment
Item Cost per Item Quantity Cost
N/A
TOTAL Equipment $
E. Direct- Supplies
Item Cost per Item Quantity Cost
Program Supplies $300 per month x 11 months avg $3,295
TOTAL Supplies $3,300
F. Direct- Contracts/Consultants
Description of the Service Cost
N/A
TOTAL Contracts/Consultants $
* The program budget may use up to 10 percent of the funds requested towards indirect/non-
program related expenses. Indirect costs include but are not limited to administrative staff salary,
rent or lease payments for administrative offices, utility costs for administrative offices, audit costs
and insurance premiums.
G. Indirect-Personnel
N/A
Name Position Rate of Pay x#of Hours Cost
TOTAL Personnel $
H. Indirect—Fringe Benefits
Name Position Description of Benefits Cost
N/A
TOTAL Fringe Benefits $
I. Indirect-Other Costs
Item Cost per Item Quantity Cost
N/A
TOTAL Other Cost $
BUDGET NARRATIVE
Please attach a detailed budget narrative that explains the need for all proposed expenditures by individual
item. The budget narrative should clearly explain how funds will be used and why expenditures are
necessary for successful implementation of your program. Please explain how costs are calculated.
A. Direct-Personnel
Program Director: The Program Director is responsible for program development, implementation
and reporting; delivery of programs,both directly and through staff and Interns; tracking and
monitoring program evaluation; training and supervising program staff,and working out scheduling
programs with the school. Cost is calculated by salary x percent of time dedicated to this program.
$14.42/hours x 1,548.8 hours(0.745 FTE)= $22,334
Program Facilitator: The Program Facilitator is responsible for assisting the Program Director with
delivery of programs and mentoring and supervision of students. $15.00/hour x 484 hours=$7,260.
INTERNS (2): Social work or social service related majors assist Program Director with delivery of
programs and mentoring and supervision of students. 2 Interns x 3 semesters x$300 stipend per
semester= $1,800.
B. Direct—Fringe
Cost is calculated by salary x 7.65%(FICA) x above salary for staff.Director$22,334+Facilitator
$7,260 x 7.65%=$2,264.
C. Direct-Travel
Program staff mileage to/from community meetings and other program-related business. Projected at
200 miles per month(includes all grant staff and interns) x 11 months avg x 50 cents per mile=
$1,100.
D. Direct—Equipment
N/A
E. Direct- Supplies
Supplies—cost for supplies necessary for delivery of the Girls Inc.programming at Washington
Heights Elementary School. Includes program supplies such as(but not limited to)paper,pens,
markers, construction paper, copy paper, educational dvds, literacy aids, flash cards,books, etc., and
Calculated at$300 per month x 11 months=$3,295
F. Direct- Contracts/Consultants
N/A
G. Indirect Cost up to 10%
N/A
H. Indirect Cost—Personnel
N/A
I. Indirect Cost—Fringe Benefits
N/A
J. Indirect Cost—Other Costs
N/A
BOARD INFORMATION
1. Is your organization registered as a non-profit? If yes, please attach your IRS tax exempt
status letter. Attached
2. How many board members does your organization have? 15
3. How often does your board meet? Six times per year
4. Who recruits board members? Board Nominating Committee
5. What portion of the board is elected annually? Approximately one-third
6. How long is a board term? How many consecutive terms may be served?
A board term is three years and two consecutive terms may be served.
7. Please list the names and occupations of your board officers. Attached
8. Please attach a copy of your board by-laws. Attached
9. If any member of the board is related to another board member or an employee of the non-
profit corporation,please explain the relationship. N/A
Exhibit C
Request for Reimbursement
FORT WORTH Exhibit C
Request for Reimbursement(RFR)
FY 2018
CRIME CON-(BOL
AND PREVENTION DISTRICT
Submit To: Submitting Agency: Girls Inc.of Tarrant County
Bob Bolen Public Safety Complex Contact Name: Marlene Sweda
Attn:Brittany Taylor Phone Number: 817-259-1050
Financial Management Division Email: mswedatU)airlsinctarrant.ora
505 West Felix St.
Fort Worth,TX 76115 Remit Address: 1226 E.Weatherford St.,Fort Worth,TX 76102
Invoice Number:
Month of Request:
DIRECT COSTS(90%Minimum)
A B C D E
Total or Previous This Month's (B+C) (A-D)
Budget Category Budget Amount Reimbursements Total Requested Remaining Balance
Requested Request To-Date Available
A Personnel $ 31„194.00 S - S 31394.00
B Fringe Benefits $ 2,264.00 S - $ 2,264.00
C lTravel&Training $ 1,100.00 S S 1,100,00
D Equipment S - S - $ -
E Supplies $ 3,295.00 5 3,295.00
F Contracts/Consultants S - S
G Other Approved $ S
Total Direct Costs $ 38,053.00 S S S S 38.053.00
INDIRECT COSTS(10%Maximum)
A B C D E
Total of Previous (B+C) (A-D)
This Month's
Re
Budget Category Budget Amount Reimbursements Total Requested Remaining Balance
Requested Request
q To-Date Available
A Personnel $ S -
B Fringe Benefits S - S
C lTravel&Training S $ -
D Equipment $ S
E Supplies S $
F Contracts/Consultants S - S
G Other Approved $ S S
Total InDirect Costs S S $ $ S
Supporting documents required with monthly requests. Summary:
This includes,timesheets depicting CCPD funded activities, Total Budget: S 38,053.00
ropy of paychecks,invoices and receipts detailing all CCPD Previous Requests: $
funded expenditures' This Request: S
Total Requested To-Date S
Remaining Funds S 38,053.00
1 have reviewed this request and certify that these listed expenses and support documentation are accurate.
Authorized Signatory Signatory Title Date
Fiscal Agent Use Only
Purchase Order N Fund Dept.ID �trtnunt
RFR Approved For Payment
Grant StatTSignature Date
Finance Received Stamp Placed Below
)18 Interlocal Agreement Atter School Program
-f Fort Worth Girls Inc.of Tarrant County
Exhibit D
Activity Report
FORT WORTH
CRIME COKMOL
&PREvEM1om Dimicr
Exhibit D
Fiscal Year 2018
Monthly Program Activities Report
Current Reporting Month
Submitting Agency Girls Inc. of Tarrant County
Contact Name Becky Balarin
Phone Number and Email 817-259-1050/bbalarin@girlsinctarrant.org
Remit Address 1226 E. Weatherford St.,Fort Worth,TX 76102
Activity Current To Date Year
Month Total End
Total Goal
1 Unduplicated number of students receiving Friendly PEERsuasion 25
Curriculum(4th-5th grade girls)
2 Number of Students receiving Girls Beyond Bullying Curriculum Delivery 25
(4th-5th grade girls)
3 Number of students receiving literacy instruction and practice(1St through 45
3'd grade girls)
4 Unduplicated number of students participating in Leadership and 25
Community Action(community service projects) (4th-5th grade girls)
5
6
7
8
I have reviewed this report and certify that the measures provided are accurate and appropriately reflect the
CCPD goals setforth in the contract.
Authorized Signatory Signatory Title Date
FY 2018 Interlocal Agreement After School Program
City of Fort Worth&Girls Inc.of Tarrant County
Exhibit E
Quarterly Program
Effectiveness Measurement
Report
FoRTWORTH
CRIME CONTROL
&Puevexmm DuTmcT
Exhibit E
Fiscal Year 2018
Quarterly Program Effectiveness Measurement Report
Current Reporting Quarter
Submitting Agency Girls Inc. of Tarrant County
Contact Name Becky Balarin
Phone Number and Email 817-259-1050/bbalarin@girlsinctarrant.org
Remit Address 1226 E. Weatherford St., Fort Worth, TX 76102
Please include outcome narrative that describes how measure was accomplished for each quarter.
Effectiveness Measures and Quarterly Outcomes
Measure 1 80% of girls participating in the Girls Beyond Bullying program will score 80% or better on their
post-test, or will increase their score by 20% or more.
Outcome
Measure 2 80%of girls participating in the Friendly PEERsuasion program will score 80%or better on their post-test,
or will increase their score by 20%or more.
Outcome
Measure 3 85%of first, second, and third grade participants will increase their sight word reading by 20% or
more based on words per minute)
Outcome
Measure 4 85%of second and third grade participants will increase their ready fluency by 20% or more.
Outcome
Measure 5 80% of teachers surveyed will report that K-3 children participating in the Girls Inc. Literacy
Initiative have shown improvement in their literacy skills.
Outcome
Measure 6 80% of parents/caregivers surveyed will report their child who has participated in the Girls Inc.
Literacy Initiative has shown improvement in her literacy skills.
Outcome
I have reviewed this report and certify that the measures provided are accurate and appropriately reflect the
CCPD goals set forth in the contract.
President & CEO
Authorized Signatory Signatory Title Date
Report due each quarter: 1:t Quarter(Oct-Dec) due January 15 2"d Quarter(Jan-Mar)due April 15
3 Quarter(Apr-June)due July 15 4th Quarter(Jul-Sep)due October 15
FY 2018 Interlocal Agreement After School Program
City of Fort Worth&Girls Inc.of Tarrant County
Exhibit F
Request for Budget
Modification
FORT, O�R,TH
CRIME CONTROL
&PREVExnoN DLsswcr
• Up to 5%of any budgeted line-item does not need prior approval but form must be sent to City with monthly RFR
• More than 5%of any budgeted line-item must have prior City approval
• An increase in a zero line-item must have prior City approval
• Modifications cannot be made between Direct and Indirect costs
Exhibit F
Request for Budget Modification
Fiscal Year 2018
Date
Submitting Agency Girls Inc. of Tarrant Count
Contact Name Becky Balarin
Phone Number and Email 817-259-1050/bbalarin@girlsinctarrant.org
Remit Address 1226 E. Weatherford St., Fort Worth,TX 76102
DIRECT COSTS 90% minimum
Budget Category Approved Budget Change Requested Revised Budget
Personnel
Fringe Benefits
Travel and Training
Equipment
Supplies
Contracts/Consultants
Other Approved
Total Direct Costs
INDIRECT COSTS 10% maximum
Budget Category Approved Budget Change Requested Revised Budget
Personnel
Fringe Benefits
Travel and Training
Equipment
Supplies
Contracts/Consul tants
Other Approved
Total Indirect Costs
Modification Narrative describe in detail what change is for
1 have reviewed this request and certify that the listed modifications are correct.
Authorized Signatory Signatory Title Date
:Y,.rJ1, �1�'y „ ,QNJ►a :. .: . .''- rysRj4 '?d;.t= ; "' ?,;:'�- =ru;�
Q Modification Approved Q Modification NOT Approved
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
loft
Complete Nos.1-4 and 6 if there are interested parses. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
I Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-264983
Girls Inc.of Tarrant County
Fort Worth ,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 09/25/2017
being filed.
City of Fort Worth Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
FY18 CCPD Program
Life-changing programs and services to at-risk girls in Tarrant County.
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
5 Check only if there is NO Interested Party.
X
6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
MARLENE M. SWEDA
My Commission Expires lNotary Public,State of Texas (`
July 01, 2018
Sig ature of authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said C�eC'�ow this the -�-day of
20 ! to certify which,witness my hand and seal of office.
S gnature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337