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HomeMy WebLinkAboutContract 51356 CITY SECRETARY CONTRACT NO. y3t% VATE OF TEXAS § § G�cS�cP COUNTIES OF TARRNT, WISE § A AND DENTON § BOYS & GIRLS CLUBS OF GREATER TARRANT COUNTY,INC. SAFE HAVEN YOUTH PROGRAM-MARTIN This Agreement is made between the City of Fort Worth("City"),a municipal corporation, acting herein by and through Jesus J.Chapa,its duly authorized Assistant City Manager,and Boys & Girls Clubs of Greater Tarrant County, Inc., ("BGCGTC") acting by and through Daphne Barlow Stigliano, its duly authorized CEO. RECITALS WHEREAS, City has determined that Safe Haven Youth Programs are necessary to support the City's commitment to crime prevention throughout the City. The Safe Haven Youth Programs will enhance the prevention focus previously adopted by the police department, support the community, and provide a secure environment for children; and WHEREAS, BGCGTC has agreed to operate a Safe Haven Youth Program which will provide a secure environment in which children can receive educational tutoring assistance; and support the adoption of a prevention focus by the police department and the community; and WHEREAS, City desires to enter into an agreement with BGCGTC to operate the Safe Haven Youth Program at their Martin Community Center("BGCGTC SITYP"); and WHEREAS, City, as consideration for the performance of BGCGTC, has appropriated monies in the Crime Control and Prevention District ("CCPD") Fund Budget in the amount of $307,015.00("Program Funds")to provide to BGCGTC on a reimbursement basis for the operation of the BGCGTC SITYP 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: 1. This Agreement for the BGCGTC SITYP RECEIVED 2. Exhibit A-Scope of Work OCT -3 2018 3. Exhibit B—Budget 4. Exhibit C—Request for Reimbursement CITY GF FORT WORTH CITY SECRETARY 5. Exhibit D—Program Activities Report 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, made a part of this Agreement for all purposes. In the event of any conflict between the terms and conditions of OFFICIAL RECORD BGCGTC SITYP FY 2019 CITY SECRETARY City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Pa e I oo 22 ffy,y �r�. , �A+� r tiOO Exhibits A through F, and the terms and conditions set forth in the body of this Agreement,the terms and conditions set forth in the body of this Agreement shall control. DEFINITIONS The term"City"shall include City, and its officers,agents, employees, and representatives. The term "BGCGTC" shall include BGCGTC, and its officers, agents, employees, representatives, servants,contractors,and subcontractors. The term "Party" shall refer to either City or BGCGTC. The term"Parties" shall refer to both City and BGCGTC. AGREEMENT 1. Responsibilities of BGCGTC. BGCGTC 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" — Scope of Work. BGCGTC shall be responsible for day-to-day administration of the BGCGTC SITYP. BGCGTC agrees to expend the Program Funds in accordance with its BGCGTC SITYP budget, described in Exhibit `B" — Budget. Program activities shall be reported in accordance with Exhibit "D" Program Activities Report and effectiveness measurements shall be reported in accordance with Exhibit "E" Program Effectiveness Measurement Report. 2. Prollram Funds. 2.1 In no event shall the total distribution from City made to BGCGTC during the term of this Agreement exceed the total sum of$307,015.00("Program Funds"). 2.2 Payment of the Program Funds from City to BGCGTC shall be made on a cost- reimbursement basis following receipt by City from BGCGTC of a signed Request for Reimbursement (RFR), as described in Exhibit "C," and copies of all receipts and support documentation. BGCGTC shall deliver to City a written detailed Program Activities Report and Program Effectiveness Measurement Report as described in Section 4.2 below with each RFR to support expenditure of Program Funds. Such reports shall be signed by BGCGTC or duly authorized officer of BGCGTC. 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. The monthly RFR with an original signature by an authorized representative must be submitted to the to the Grant Management Section of the Fort Worth Police Department, ATTENTION: Grant Specialist,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. Additionally, a quarterly Program Effectiveness Measurement Report from BGCGTC 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. BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Grcater Tarrant County Page 2 of 22 2.3 BGCGTC 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, BGCGTC must submit the Budget Modification Form(Exhibit"F")to City,with the monthly RFR,in the month when 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 any budget 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 cannot 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 any budget 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 cannot 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. The Budget Modification Form (Exhibit "F") shall be submitted to the Grant Management Section of the Fort Worth Police Department, ATTENTION: Grant Specialist at Bob Bolen Public Safety Complex at 505 W.Felix St.,Fort Worth,Texas,76115. 3. Term. This Agreement shall commence upon October 1, 2018 ("Effective Date"), and shall end on September 30, 2019 ("End Date"). All of BGCGTC's expenditures under this Agreement must be completed no later than September 30,2019. 4. Program Performance. 4.1 BGCGTC agrees to maintain full documentation supporting the performance of the work and fulfillment of the objectives set forth in Exhibit"A." 4.2 BGCGTC agrees to provide a monthly Program Activities Report and quarterly Program Effectiveness Measurement Report to document the performance of the work described in Exhibit "D" and Exhibit `B," respectively. The Program Activities and Effectiveness Measurements 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 Measurement 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 any successes realized in descriptive detail. The monthly Program Activities and quarterly Program Effectiveness Measurement Reports shall be submitted to City no later than the 15'day after the end of each month. BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 3 of 22 4.3 BGCGTC agrees that the monthly RFR and Program Activities Report and quarterly Program Effectiveness Measurement Report will be submitted to City no later than the 151 day after the end of each month. Should BGCGTC not meet these requirements, BGCGTC will be given an additional 15 days to submit the required reports to City. If, at the end of this 15-day extension period,BGCGTC has not submitted the required reports,City will send a non-compliance letter notifying BGCGTC's duly authorized representative of a possible suspension of program funding. 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 BGCGTC hereunder shall be exclusively from monies received from the CCPD, and not from any other monies of City. In the event that funds from the CCPD are not received prior to the execution of this contract by the parties, in whole or in part,City may,at its sole discretion,terminate this Agreement and City shall not be liable for payment for any work or services performed by BGCGTC 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 BGCGTC 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 This Agreement may be terminated by City, in whole or in part, at any time and for any reason upon written notice as specified in section 5.4. 5.4 Termination will be effected by delivering to BGCGTC a notice of termination, specifying the portion of the Agreement affected and the effective date of termination. Upon BGCGTC's receipt of notice of termination,BGCGTC shall: (a) Stop work under the Agreement on the date and to the extent specified in the notice of termination; (b) Place no further order or subcontracts, except as may be necessary for completion of the work not terminated; (c) Terminate all orders and contracts to the extent that they relate to the performance of the work terminated by the notice of termination;and (d) Cease expenditures of Program Funds, except as may be necessary for completion of the work not terminated. 5.5 In the event City suspends or terminates this Agreement, BGCGTC 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,BGCGTC shall return to City any property provided hereunder.City will have no responsibility or liability for BGCGTC's expenditures or actions occurring after the effective date of termination of the Agreement. BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 4 of 22 6. Equipment and Maintenance. All equipment purchased with Program Funds must meet all eligibility requirements of City. BGCGTC shall maintain all equipment used in the administration and execution of the BGCGTC SITYP. BGCGTC shall maintain, replace, or repair any item of equipment used in support of the BGCGTC SITYP and/or for use under the terms of this Agreement that no longer functions or is lost or stolen. The cost for maintenance, replacement,or repair of any equipment used in support of the BGCGTC SITYP and/or for use under the terms of this Agreement is the sole responsibility of BGCGTC. BGCGTC shall not use Program Funds to repair or replace said equipment. BGCGTC shall use any and all equipment purchased with Program Funds exclusively in support of the BGCGTC SITYP. Within 10 days following the purchase of equipment,BGCGTC shall submit to City a detailed inventory of all equipment purchased with Program Funds to the Grant 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 BGCGTC 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 BGCGTC under this Agreement. BGCGTC, 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 BGCGTC's operations will be undertaken and may be conducted either by City or an independent auditor of City's choice.BGCGTC shall submit a copy of any audit performed by their independent auditor within 30 days of receipt of the final audit report. 7.2 If any audit reveals a questioned practice or expenditure, such questions must be resolved within fifteen(15)days after notice to BGCGTC by City. If questions are not resolved within this period,City reserves the right to withhold further funding under this and/or future contract(s)with BGCGTC. 7.3 If,as a result of any audit,it is determined that BGCGTC misused,misapplied, or misappropriated all or any part of the Program Funds, BGCGTC 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 BGCGTC's obligation to City shall not end until all closeout requirements are completed. Activities during this closeout period shall include, but are not limited to: providing final Program Activities Report and Program Effectiveness Measurement Reports, making final payments,disposing of BGCGTC SITYP assets as appropriate,if deemed required by City in its sole discretion. 7.5 BGCGTC covenants and agrees to fully cooperate with City in monitoring the effectiveness of the services and work to be performed by BGCGTC under this Agreement and City shall have access at all reasonable hours to offices and records of BGCGTC, its officers, members,agents,employees,and subcontractors for the purpose of such monitoring. BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 5 of 22 Section 7 shall survive the expiration or termination of this Agreement. 8. Independent Contractor. 8.1 BGCGTC shall operate hereunder as an independent contractor and not as an officer, agent, or servant or employee of City. BGCGTC 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 BGCGTC, 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 BGCGTC. No federal, state, or local income tax, nor any payroll tax of any kind, shall be withheld or paid by City on behalf of BGCGTC. BGCGTC shall not be treated as an employee with respect to the services performed 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 BGCGTC, and any program participants hereunder are not eligible for, and shall not participate in any employer pension, health, or other fringe benefit plan provided by City. It is expressly understood and agreed that City does not have the legal right to control the details of the tasks performed hereunder by BGCGTC, 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 BGCGTC, 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. BGCGTC SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND ALL PROPERTY LOSS,PROPER TYDAMA GE,AND/OR PERSONAL INJURY,INCL VDING 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 OFBGCGTC,ITS OFFICERS,AGENTS,SERVANTS, OR EMPLOYEES. BGCGTC AGREES TO DEFEND, INDEMNIFY, AND HOLD THE CITY, ITS OFFICERS, AGENTS, SERVANTS, AND EMPLOYEES HARMLESS AGAINST ANY AND ALL CLAIMS, LAWSUITS, ACTIONS, COSTS, AND EXPENSES OF ANY KIND, INCLUDING, BUT NOT LIMITED TO, THOSE FOR PROPER TY DAMAGE OR LOSS (INCLUDING ALLEGED DAMAGE OR LOSS TO OWNER'S BUSINESS AND ANY RESULTING LOST PROFITS) AND/OR PERSONAL INJURY(INCLUDING DEATH) THAT MAY RELATE TO, ARISE OUT OF, OR BE OCCASIONED BY(I) BGCGTC'S BREACH OF ANY OF THE TERMS OR PROVISIONS OF THIS AGREEMENT OR (II) ANY NEGLIGENT ACT OR OMISSION OR INTENTIONAL MISCONDUCT OF BGCGTC, ITS OFFICERS, AGENTS, ASSOCIATES, EMPLOYEES, CONTRACTORS (OTHER THAN THE CITY), OR SUBCONTRACTORS RELATED TO THE PERFORMANCE OF THIS AGREEMENT, EXCEPT THAT THE INDEMNITY PROVIDED FOR IN THIS SECTION SHALL NOT APPLY TO ANY LIABILITY RESULTING FROM THE SOLE NEGLIGENCE OF THE CITY OR ITS OFFICERS, BGCGTC SITYP FY 2019 City of Foil Worth and Boys&Girls Clubs of Greater Tarrant County Page 6 of 22 AGENTS, EMPLOYEES, OR SEPARATE CONTRACTORS, AND IN THE EVENT OF JOINT AND CONCURRENT NEGLIGENCE OF BOTH CONSULTANT AND CITY, RESPONSIBILITY, IF ANY, SHALL BE APPORTIONED COMPARATIVELY IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS. NOTHING HEREIN SHALL BE CONSTRUED AS A WAIVER OF THE CITY'S GOVERNMENTAL IMMUNITYAS FURTHER PROVIDED BY THE LAWS OF TEXAS. BGCGTC 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 BGCGTC shall be effective without City's prior written approval. 11. Prohibition Against Interest. 11.1 No member, officer,or employee of City, or its designees or agents;no member of the governing body of the locality in which the BGCGTC SITYP is situated; and no other public official of such locality or localities who exercises any functions or responsibilities with respect to the BGCGTC SITYP 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. BGCGTC 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 BGCGTC 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 BGCGTC of any land,materials, supplies, or services purchased with any funds transferred hereunder, except on behalf of BGCGTC, as an officer, employee, member, or program participant. Any willful violation of this paragraph with the knowledge, expressed or implied, of BGCGTC 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, BGCGTC 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 BGCGTC will not unlawfully discriminate against any person or persons because of age, race, color, religion, sex, disability, national origin, or sexual orientation, nor will BGCGTC permit its officers, members, agents, employees, subcontractors, or program participants to engage in such discrimination. BGCGTC SffYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 7 of 22 13. Compliance. 13.1 BGCGTC, 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 BGCGTC in writing any such violation on the part of BGCGTC or any of its officers,members,agents,employees, subcontractors, or program participants, then BGCGTC shall immediately desist from and correct such violation. 13.2 BGCGTC 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 BGCGTC in writing to any such violations on the part of BGCGTC or any of its officers, members, agents, employees, program participants, or subcontractors, then BGCGTC shall immediately desist from and correct such violation. 14. Waiver of Immunity. If BGCGTC 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,BGCGTC hereby expressly waives its rights to plead defensively such immunity or exemption as against City. This section shall not be construed to affect City's immunities under constitutional,statutory,or common law. 15. Insurance Requirement. 15.1 BGCGTC shall procure and shall maintain during the term of this Agreement the following insurance coverage: (a) Commercial General Liability(CGQ: $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 interests of the City. 15.2 BGCGTC'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. 15.3 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. 15.4 BGCGTC further agrees that it shall comply with the Worker's Compensation Act of Texas and shall provide sufficient compensation insurance to protect BGCGTC and City from and against any and all Worker's Compensation claims arising from the work and services provided under this Agreement. BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 8 of 22 15.5 The commercial general liability policy shall name the City as an additional insured thereon, as its interests may appear. 15.6 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. 15.7 Any failure on the part of the City to request required insurance documentation shall not constitute a waiver of the insurance requirement. 15.8 Certificates of Insurance evidencing that the BGCGTC has obtained all required insurance shall be delivered to the City prior to BGCGTC proceeding with any work pursuant to this Agreement. 16. Miscellaneous Provisions. 16.1 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. 16.2 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. 16.3 Should any action, whether real or asserted, at law or in equity, arise out of the execution,performance,attempted performance,or non-performance of this Agreement,venue for said action shall lie in state courts located in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division. 16.4 BGCGTC 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. 16.5 This written instrument, including Exhibits A through F, constitutes 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. Any amendments to the terms of this Agreement must be in writing and must be signed by authorized representatives of each party. 16.6 All notices required or permitted by this Agreement must be in writing and are deemed delivered on the earlier of the date actually received or the third day following (i) deposit in a United States Postal Service post office or receptacle; (ii) with proper postage (certified mail,return receipt requested); and(iii)addressed to the other party at the address as follows or at such other address as the receiving party designates by proper notice to the sending party: BGCGTC SITYP FY 2019 City of Foil Worth and Boys&Girls Clubs of Grcatcr Tarrant County Page 9 of 22 CITY: Jesus J.Chapa Assistant City Manager City Manager's Office City of Fort Worth 200 Texas Street Fort Worth,TX 76102 Copies To: Grant Management Section Bob Bolen Public Safety Complex 505 W. Felix St. Fort Worth,TX 76115 City Attorney's Office ATTN: Police Contracts 200 Texas Street Fort Worth,TX 76102 BGCGTC: James Newson, Senior Vice President, Operations Boys&Girls Clubs of Greater Tarrant County 3218 E.Belknap St. Fort Worth,TX 76111 16.7 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. 16.8 Captions and headings used in this Agreement are for reference purposes only and shall not be deemed a part of this Agreement. 16.9 The provisions and conditions of this Agreement are solely for the benefit of City and BGCGTC and are not intended to create any rights, contractual or otherwise,to any other person or entity. 16.10 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. 16.11 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 its employees who perform work under this Agreement, including completing the Employment Eligibility Verification Form(I-9)which will be subject to review by the City. Contractor shall adhere to all Federal and State laws as well as establish appropriate procedures and controls so that no services will be performed by any Contractor employee who is not legally eligible to perform such services. CONTRACTOR SHALL INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY CONTRACTOR, CONTRACTOR'S EMPLOYEES, SUBCONTRACTORS, AGENTS, OR LICENSEES. City, upon written BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 10 of 22 notice to Contractor,shall have the right to immediately terminate this Agreement for violations of this provision by Contractor. 16.12 It is understood that by execution of this Agreement, the City does not waive or surrender any of it governmental powers. 16.13 Contractors are required to conduct criminal background screenings for all volunteers or employees who will be working with children under the proposed program. All criminal background checks shall be in compliance with Texas Department of Family and Protective Services standards, the Texas Administrative Code and all other applicable law. Contractors will be responsible for conducting criminal background screening and for maintaining appropriate records, which will be subject to review by the City. CONTRACTOR SHALL INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY CONTRACTOR, CONTRACTOR'S EMPLOYEES, SUBCONTRACTORS, AGENTS, OR LICENSEES. [REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK] [SIGNATURE PAGE TO FOLLOW] BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Cheater Tarrant County Page I I of 22 IN WITNESS WHEREOF,the parties hereto havef cu�ted thi r e ent in multiples in Fort Worth,Tarrant County,Texas,to be effective this,��(_:y of ,20 /D APPROVED AND AGREED FOR CITY APPROVED AND AGREED FOR BOYS& OF FORT WORTH GIRLS CLUBS OF GREATER TARRANT COUNTY Jesus J.Chapa � •-� sc.s!.v Assistant City Manager Daphne Barlow Stigliano CEO,President Date: l /'a'Pl Date: /o`/ � APPR LADED RAPPROVED AS TO FORM AND G{ LEGALITY FOR BOYS AND GIRLS Chief Joel F.Fitzgeral CLUBS OF GREATER TARRANT Chief of Police COUNTY Date: BGC45TC Attorney APPROVED AS TO FORM AND LEGALITY FOR CITY OF FORT / WORTH Date: Matthew A. Murray ATTEST Assistant City Attorney Date: ary J. cr tr;' City Secretary Form 1295 Certification No:2018-398594 Date: p(�j (� Contract Compliance Manager: M&C No.C C� M By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract,including ensuring all performance and reporting requi e Name' yv 0� lam, Title Cay }tt�c� C,ex"�A�Mce s�z � st OFFICIAL.RECORD I I CITY SECRETARY FT.WORTH,TX BGCGTC SITYP FY 2019 City of Fon Worth and Boys&Girls Clubs of Grcalcr Tarrant County Page I2 of 22 EXHIBIT A SCOPE OF WORK The Scope of Work is to be performed and documented in compliance with the monthly program activities and quarterly effectiveness measurement reports outlined in exhibits D and E. • The Boys & Girls Clubs of Greater Tarrant County—Martin (Safe Haven) Branch provides high quality, afterschool and summer programming for youth ages 6— 18. Programming is focused on three key outcomes: Academic Success, Healthy Lifestyles and Character / Citizenship. Within each of these outcome areas are a wide variety of program offerings aimed at enriching the lives of young people and setting them on a path for success. • Branch Positions: o Branch Director ■ Bachelor's Degree from an accredited college OR equivalent experience with requirement to obtain Bachelor Degree ■ within 18 months ■ Minimum of two years of management or supervisory experience ■ Minimum of one year of fiscal responsibility including budgeting and spending ■ Minimum of two years youth programming experience o Healthy Lifestyles Specialist ■ High school diploma or equivalent,Bachelor Degree preferred ■ One(1) year experience with youth(professional or volunteer) ■ One(1)year youth programming experience o Education Specialist ■ Bachelor's Degree from an accredited college or university required; preferred majors include Education, Social Work, ■ Psychology, Counseling, and Family Studies ■ • One(1) year experience with youth(professional or volunteer) ■ • One (1) year youth programming experience; educational programming preferred o Activity Leader ■ High school diploma or equivalent, some college preferred ■ Minimum 6 months experience working with youth • The project will achieve a broad range of outcomes/experiences for participating youth including: o High rates of on time grade progression. o Participation in community service. o Access the healthy nutrition programming and daily meal(snack and dinner) service. o Parenting support services including: school supplies,onsite vision care and family focused education opportunities. BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 13 of 22 o Free counseling for participants provided through onsite LPC with specific focus on trauma. o Drug, alcohol and tobacco prevention programming aimed at reducing utilization rates among participants. o Average daily attendance for both teens and primary age groups that meets ,'exceeds targeted goals for building capacity. o High quality program implementation focused on each of the three priority outcome areas. o Access to nationally recognized Boys & Girls Clubs programming. o Highly trained and engaged staff members. • Crime prevention is addressed through the implementation of two highly important functions of the program:the relationships fostered between staff and youth,as well as the targeted programming aimed at holistically equipping young people to make the right decisions and plan for the future. • Typical schedule (school year): 0 3:OOPM—3:30PM: School pick up/ Snack 0 3:30PM — 4:30PM: Power Hour (mandatory tutoring, homework and educational support) 0 4:30PM— 5:30PM: Rotation 1 —participants are divided into groups based on age/gender and will attend area specific programming in either the Gym, Education Room,Art Room or Game Room. 0 5:30PM—6:OOPM: Dinner 0 6:OOPM—7:OOPM: Rotation 2—participants are divided into groups based on age/gender and will attend area specific programming in either the Gym, Education Room, Art Room or Game Room. • Programmatic Offerings: o Power Hour: tutoring support services o Stride: computer based literacy programming o NetSmartz: online safety curriculum o STEM: programming focused on science, technology and math o Literacy: staff provided literacy intervention in both large and small group settings o Workforce Development: internships, job shadowing, career preparation workshops o College Readiness: partnership with internal Upward Bound and Educational Talent Search programs to assist first generation, low income students in attending college o Healthy Habits: diet and nutrition programming o Intramural Sports: developmental leagues for a variety of sports o SMART Girls: life skills group for young women o Passport to Manhood: life skills group for young men o Keystone Club: leadership programming for older teens o Torch Club: leadership programming for younger teens o Junior Staff leadership and workforce development program BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 14 of 22 Exhibit B BUDGET NARRATIVE FY 2019 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. DIRECT COSTS—Total $276,314.00 A. Program Personnel—Total $193,395.49 Branch Director — The Branch Director has direct daily contact with participants and oversees program staff to insure implementation of programs and activities designed to maximize program outcomes. 100%of the Branch Director's time and efforts are spent at this location. ($55,723.98 @ 100%_$55,723.98) Other Program Staff—Other Program Staff are directly involved with participants in the program or maintenance of the program site on a daily basis. Activity Leaders provide program participants with instruction and lead participants in educational, health, social, and cultural activities. Other Program Staff also provide transportation to the facility from school for participants. Education Specialist($33,309.12 @ 100%_$33,309.12) Activity Leader($11.00/hr. @1,365 hrs._$15,015.00) Activity Leader($11.41/hr. @ 1,365 hrs._$15,574.65) Activity Leader($11.63/hr. @ 1,365 hrs._$15,874.95) Activity Leader($11.00/hr. @ 1,365 hrs._$15,015.00) Activity Leader($10.50/hr. @ 1,365 hrs._$14,332.50) Front Desk Specialist($11.00/hr. @ 1,365 hrs._$15,015.00) After School Driver($10.00/hr. @ 220 hrs._$2,200.00) After School Driver($10.00/hr. @ 555 hrs._$5,550.00) Janitor($12.88/hr. @ 1,040 hrs._$13,395.20) Activity Leader($12.28/hr. @ 1,365 hrs._$16,762.20) Activity Leader Summer($10.00/hr. @ 200 hrs._$2,000.00) Vacancy Allowance—During the program year vacancies in staff positions will occur. The current staff vacancy rate is estimated for the program year at 12%. Budgeted program salaries are reduced by this amount. ($219,767.60 X-12% _-$26,372.11) B. Fringe Benefits—Total $29,475.84 FICA —7.65% of the portion of the above listed salaries allocated to this program are budgeted in this line item. (7.65% X$193,375.93)_$14,793.26) Health,Dental,Vision Insurance, Retirement—(2 FTE @ $6,500.00/yr. _$13,000.00) BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 15 of 22 Unemployment Insurance—($99,750.00 @ 1.6853% =$1,681.09) C. Travel and Training — To provide program staff and participants travel for supplies, training,trips to administration building, and field trips —Total $20,947.00 Mileage (Vehicle Operating) — Staff mileage for supplies, to and from admin building, other program related travel. (175 miles/mo. X 12 mo. X 54.5 cents per mile=$1,144.50) Participant Travel—Member travel/training/field trips/field trip entry fees. ($272.50 @ 100%= $272.50). Staff Travel/Training — Staff meals and travel to and from training and training expense. ($3,000.00 @ 100%) Bus Mileage - ($1.74 per mile @ 9,500 miles per year = $16,530.00) Buses are used to transport program participants from school to the program site and are essential to the successful achievement of program goals. Without access to transportation many students in the program would be unable to participate in program activities. Operation of buses from the school sites to the program sites occur during peak traffic hours. In order to be available to participants and to provide them with a comfortable environment while waiting for other participants arrive,buses are deployed early and are typically left running, depending on weather conditions. All of these circumstances increase the fuel and maintenance costs associated with providing bus service to program participants. Costs included in the mileage rate in this budget include fuel costs,bus insurance costs for the specific buses assigned to the program, and a conservative estimate of average bus repair costs for the buses specifically assigned to the program. Depreciation expense is not included in the mileage rate calculation. D. Equipment E. Supplies - To provide materials and supplies needed to conduct the program, perform direct program administrative tasks, track participant attendance, and track program effectiveness—Total $29,845.67 Office Supplies — Background and employment screening, drug screening,job posting fees,job referral fees,pens,pencils,pencil lead refills, erasers,highlighters,paper, staplers, staple removers, scissors, letter openers, tape dispensers, tape, staples, notepads, notebooks, binders, post-it notes, calendars, paper clips, tissues, toner/ink cartridges, hand sanitizers, folders, files, desk organizers. Office furniture and equipment (less than $5,000.00 cost) for direct program staff including office chairs, desks,file cabinets, storage cabinets,computers, software,keyboards, monitors,replacement parts,charge cords,calculators. ($7,500.00 @ 100% =$7,500.00). Postage—($50.00 @ 100%) Printing — Advertising, brochures, event promotions, schedules, communications with parents. ($50.00 @ 100%). Food Supplies —Participant/Direct Staff meals and snacks,drinks ($2,000.00 @ 100%) BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 16 of 22 Teaching Aids/Program Supplies — Program supplies will include the following: Computer software for academic studies, attendance tracking, intemet content filtering, and program effectiveness measurement; Security camera system maintenance, game consoles and supplies, community service supplies, education room supplies, athletic equipment and event entry/participation fees; Sports equipment, books, videos, and classroom computers, monitors, and operating systems; Classroom and lunchroom furniture used by program participants; Paint, paint brushes,paper,scissors,pencils,pens,markers,glue,and craft materials. ($20,245.67 @ 100%) F. Contracts/Consultants—Total $2,650.00 Copier Lease—($100.00/mo. X 12 =$1,200.00 @ 100%) Referees—Throughout the program year referees are contracted to officiate program sporting events. ($50/hr. X 9/hrs._$450.00 @ 100%) IT Contract Labor—Routine IT repairs and maintenance for education &teen room computers, direct staff computers, and other IT infrastructure at the program site are contracted at $25.00/hr. ($25.00/hr. X 40 hrs._$1,000.00 @ 100%) G. Other Approved Expenses INDIRECT COSTS—Total$30,701.00 A. Personnel B. Fringe Benefits C. Travel & Training D. Equipment E. Supplies F. Contracts/Consultants- Total$3,575.00 Audit-Audit fees for annual independent audit to assure sound financial practices,procedures,and internal controls. ($35,500.00 @ 5% _$1,775.00) Professional Fees — Accounting and HR employee tracking/hiring/allocation software billed per active program employee. ($150.00/month X 12 months= $1,800.00) G. Other Approved—Total $27,126.00 Electricity—Program staff and participants occupy the program site for 50%of total operating hours for nine months of the year and 31%of their total operating hours for three months of the year. 70% of electric service cost will be charged to the Save Haven program. ($1,285.71 X 70% _ 900.00/mo. X 12 mos._$10,800.00) Gas —Program staff and participants occupy the program site for 50% of total operating hours for nine months of the year and 31% of their total operating hours for three months of the year. 70% of gas service cost will be charged to the Safe Haven program. ($285.71 X 70% _$200.00/mo. X 12 mos. _$2,400.00) BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 17 of 22 Water&Sewer—Program staff and participants occupy the program site for 50%of total operating hours for nine months of the year and 31%of their total operating hours for three months of the year. 70%of water&sewer service cost will be charged to the Safe Haven program. ($571.43 X 70%_ $400.00/mo. X 12 mos. =$4,800.00) Building Maintenance—Program staff and participants occupy the program site for 50%of total operating hours for nine months of the year and 31%of their total operating hours for three months of the year. 70%of building maintenance costs will be charged to the Safe Haven program. Building maintenance costs will include lawn care in addition to repairs conducted to maintain a safe, secure, sanitary, functional, and comfortable environment for program participants. ($1,086.43 X 70% _ $760.50/mo.X 12 mos. =$9,126.00) BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 18 of 22 FORT WORTH. EYbiWtC far Reimbursement(RFIt) FY 2019 CRIME CONTROL. AND PREVENTION DLSTRICT Submitting Boys&Girls Club of Greater Tarrant County- Submit TO: g enc y' Safe Haven Bob Bolen Public Salty Conplex Contact Name: Bob EL ret Atm: Keith Morris Financial Management Division Phone Number: 817-834-4711 ext 211 505 West Felix St. Email: hehretCa fo worth dds.ora Fort Worth,TX 76115 Remit Address: 3218 E Belknap,Fort Worth,TX 76111 Invoice Number: Month of Request: DIRFLTCOSIS(90%Mlrimum) A B C D E Total of Predaus (B+C) (A-D) Budget Category Budget Amount Reimbursements Ibis Month's Request Requested Total Requested Remaining Balance q l Date Available A Personnel S 193,395.49 5 - S 193,395.49 B Fringe Benefits S 29,47554 S - S 29,475.84 C Travel&Training S 20,947.00 S - S 20,947.00 D Equipment $ - S - S - E SrPplies S 29,845.67 S 29,945.67 F Contracus/Consultanta $ 2,650.001 $ 2,650.00 Total Direct Conn $ 276,314.00 S S is 276,314.00 INDIRBCTCOSTS(10%Maximum) A B C D E Total of Previous (B+C) (A-D) 1kMouth', Budget Category ry Bud et Amount Reimhursementt Request Total Requested Remaining Balance Requested To-Dat Available A Personnel T S - S - S - B Fringe Benefits S - S - S - C Travel&Training S - $ - S - D Equipment $ S - S - E Supplies S - S - S F ContractslC—Wtants $ 3,575.00 $ - $ 3,575.00 G Other Approved $ 27,126.00 S 27,126.00 Totat lnDirect Costs $ 30,701.00 S S S $ 30,701.00 Sipponing docummts regLimd with monthly requests. Sum ms": This iodudes,timeaheets depicting CCPDfmdedamivities, Total Budget: S 307,015.00 copy of paychec"invoices and receipts detailing a6 CCPD _Previous Requests:!S funded expenditures. This Request: S Total RequeseedT o-DateI S Remaining Funds*r�s 307 015.00 I have tautened this request and certify that there lined etpenser and support documenmdon arc accurate. Authorized Spatory, signatory Title Date Fiscal Agent Use Only Purchase Order 40 Fund Dept W Account RFR.4ppreved Far Payment Grant Staff Signature i i Date Finance Received Stamp Placed Below BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 19 Of 22 FORT WORTH cma COMM,. &P raxnon Dmwm Exhibit D Fiscal Year 2018 Monthly Program Activities Report Current Reporting Month Submitting Agency Boys & Girls Clubs of Greater Tarrant County Contact Name Phone Number and Email Remit Address 3218 E. Belknap St. Ft. Worth,TX. 76111 Activity Current To Date Year End Month Total Goal Tota I _ 1 Total Unduplicated Participants—number of total branch participants each 750 month 2 Power Hour-number of participant visits in power hour/homework help. 25,000 3 Literacy- number or participant visits in literacy activities. 12,000 4 STEM - number of participant visits in STEM activities. 12,000 5 Daily Challenges/Exercise - number of participant visits in daily physical 33,000 challenges/exercise. 6 Healthy Habits/Nutrition - number of participant visits in healthy 10,000 habits/nutrition activities. 7 Practices/Clinics- number of participant visits in sports practices/clinics. 10,000 8 Character & Leadership - number of participant visits in Leadership Clubs 3,000 including Keystone,Torch,Triple Play and Junior Staff. 9 High Yield Learning Activities - number of participant visits in high yield 17,500 learning activities. I have reviewed this report and certify that the measures provided are accurate and appropriately reflect the CCPD goals set forth in the contract. Authorized Signatory Signatory Title Date BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 20 of 22 FORTWORTH CMM COtfML &PREVEmwr4 N"mcr Exhibit E Fiscal Year 2019 Quarterly Program Effectiveness Measurement Report Current Reporting Quarter Submitting Agency Boys &Girls Clubs of Greater Tarrant County-SaveHaven Contact Name Matthew Sinclair Phone Number and Email (817)834-4711, ext. 215 msinclair@fortworthkids.org Remit Address 3218 E. Belknap St. Ft. Worth,TX. 76123 Please include outcome narrative that describes how measure was accomplished for each quarter. Effectiveness Measures and Quaderly Outcomes Measure 1 Average Daily Attendance (ADA) will average 200 members during each quarter. Outcome Measure 2 Average Daily Attendance(ADA)for members between the ages of 13—18 will average 40 members during each quarter. Outcome Measure 3 35%of members reach an annual goal of 52 visits per year. Outcome Measure 4 85%of members progress to the next school grade on time (measured annually) Outcome Measure 5 Club members collectively complete an average of 100 community service each month per quarter. 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. Authorized Signatory Signatory Title Date Report due each quarter: V Quarter(Oct-Dec) due January 15 2"d Quarter(Jan-Mar) due April 15 3rd Quarter(Apr-June) due July 15 41h Quarter(Jul-Sep)due October 15 BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 21 Of 22 FORT WORTH CRM.CONTROL PRNeMION r>,s- r • 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 2019 Date Submitting Agency Contact Name Phone Number and Email Remit Address 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/Consultants Other Approved Total Indirect Costs Modification Narrative (describe in detail what change is for) I have reviewed this request and certify that the listed modifications are correct. Authorized Signatory Signatory Title Date �- FWPD STAFF USE ONLY Modification Approved [YModification NOT Approved FWPD Staff Signature Date BGCGTC SITYP FY 2019 City of Fort Worth and Boys&Girls Clubs of Greater Tarrant County Page 22 of 22 Official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA FORTH COUNCIL ACTION: Approved on 9/25/2018 REFERENCE 35BOYS AND GIRLS CLUB DATE: 9/25/2018 NO.: C-28875 LOG NAME: SAFE HAVEN YOUTH PROGRAM FY19 CODE: C TYPE: NON- PUBLIC NO CONSENT HEARING: SUBJECT: Authorize Execution of a Contract with the Boys and Girls Clubs of Greater Tarrant County, Inc., in the Amount of$307,015.00 for the Operation of a Safe Haven Youth Program at the Boys and Girls Club Martin Branch Located at 3123 Avenue G for Fiscal Year 2019 (CCPD Funded) (COUNCIL DISTRICT 8) RECOMMENDATION: It is recommended that the City Council authorize the execution of a Contract with the Boys and Girls Clubs of Greater Tarrant County, Inc., in the amount of$307,015.00 for the operation of a Safe Haven Youth Program at the Boys and Girls Club Martin Branch, located at 3123 Avenue G for Fiscal Year 2019. DISCUSSION: Youth Safe Havens are places where children in targeted neighborhoods can play and learn with other children without fear of being victims of a crime. The original Safe Haven Program was operated in the southeast part of Fort Worth and was later expanded to other neighborhoods in Fort Worth. Effective October 1, 2018, the Boys and Girls Clubs of Greater Fort Worth will be merging with the Boys and Girls Clubs of Arlington. The new combined organization will be called the Boys and Girls Clubs of Greater Tarrant County, Inc. The Boys and Girls Clubs of Greater Tarrant County, Inc., provides a Youth Safe Haven Program for youth living within a five-mile radius of the Boys and Girls Club Martin Branch, located at 3123 Avenue G. The program strives to offer character and leadership development, educational activities, cultural arts, health and life skills, and recreational opportunities. Program Staff address any additional educational, social, psychological, and physical needs that the youth may have. Program Staff provide the youth with the tools they need to become responsible adults. This Agreement will be effective October 1, 2018, and will end on September 30, 2019. This program serves COUNCIL DISTRICT 8. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that, contingent upon adoption of the Fiscal Year 2019 Budget by City Council, funds will be available in the Fiscal Year 2019 Budget of the Crime Control and Prevention District Fund and the Police Department is responsible for verifying the availability of funds prior to an expenditure being made. TO Fund Department Account Project Program Activity Budget Reference# Amount ID ID Year (Chartfield 2) FROM Fund Department Account Project Program Activity Budget I Reference# I Amount ID I I ID I I Year Chartfield 2 Submitted for City Manager's Office by: Jay Chapa (5804) Originating Department Head: Joel Fitzgerald (4231) Additional Information Contact: Tiffany Moore (4223) ATTACHMENTS HB 1295 SH.pdf &OASMI!!S CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll Complete Nos.l-4 and 6 if there are interested parties, OFFICE USE ONLY Complete Nos.1,2,3,5,and 6 it there are no Interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2t)18-398594 Boys&Girls Clubs of Greater Tarrant County FORT WORTH,TX United States Date Filed: 2 Name of governmental entry or state agency that is a party to the contract for whit t e orm s 08/30/2018 being filed. City of Fort Worth,TX DateAcknow edged: ioWll 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 he provided under the contract. FY19 CCPD Program Sate Haven Youth Program 4 Nature of Interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION / e My name is_ _T J — ^ / and my date of birth Is 711-0 My address Is._.Lr3� rir r �f1�/<< rr'1rer..,lf�/+a1 '� _, % #--, ems (street) (city) (elate) (zip coda) (country) I declare under penaltyofperjury that the forego ng is true and correct. Executed in T!}�1� County, State of on the 30 day of 2011L. (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics,state,tx,us Version V1.0.6711