HomeMy WebLinkAboutContract 37404 (2)STATE OF TEXAS CITY SECRETARY
COUNTY OF TARRANT CONTRACT NO, OL
THIS contract ("Contract") is made and entered into by and between the City of Fort Worth ("City"),
whose address is 1000 Throckmorton St., Fort Worth Texas 76102, acting by and through Joe Paniagua,
Jr., its duly authorized First Assistant City Manager, and Tarrant County Samaritan House ("Contractor"),
whose address is 929 Hemphill Fort Worth, TX 76104, acting by and through Mr. Steve Dutton, its duly
authorized Executive Director (Sometimes City and Contractor are referred to individually as a "Party"
and collectively as the "Parties".)
WHEREAS, City has received grant monies fiom the United States Department of Housing and
Urban Development ("HUD") under the AIDS Housing Opportunity Act, as amended, (42 USC 12901 et
seq.) for utilization in connection with the Housing Opportunities for Persons with AIDS ('HOPWA")
program, Giant No. TXH-08-MC-17002, for Year 2008-2009;
WHEREAS, the objective of he HOPWA program is to address the needs of eligible persons
associated with the challenge of living with HIV/AIDS and their families;
WHEREAS, City has been designated by HUD to service Tarrant, Johnson, Hood and Parker
Counties through HOPWA;
WHEREAS, City citizens, the Community Development Council, and the City Council have
determined that HOPWA programs are needed by the City's low and moderate -income citizens with
documented HIV/AIDS status and their families as defined in 24 CFR 574.3(2).
NOW, THEREFORE, THIS AGREEMENT FURTHER WITNESSETH:
THAT, the Parties covenant and agree as follows:
1. Scope of Sej•�ices
a. Contractor will administer HOPWA services to citizens of the City of Fort Worth for the purpose
of preventing homelessness of low-income persons with HIV/AIDS and their families under the
program name Supportive Services ("Program"), for the term June 1, 2008 to May 31, 2009.
Contractor agrees to ensure the confidentiality of the name of any Program participant assisted
under the Program and any other information regarding individuals receiving assistance.
b. Contractor will provide the services and activities as set forth in Exhibit A -Program Summary in
accordance with Exhibit B-Program Services Schedule.
c. Contractor agrees to abide by the HOPWA Regulations, 24 CFR 24 574 (et seq.) and will utilize
HOPWA funds to benefit low income individuals with documented HIV/AIDS status and their
families. Contractor agrees to conduct an annual assessment of the housing assistance and assure
the adequate provision of the supportive services described in 24 CRR 574.300 (b) (7) to Program
participants assisted with housing under this Contract. No fee except rent shall be charged of any
Program participant for any housing or services provided with funds from this Contract.
Contractor will comply with 24 CFR 574.310(e) regarding any termination of assistance.
Contractor agrees to maintain full documentation supporting fulfillment of these requirements in
its files. All such documentation shall be furnished to City upon request if necessary for City to
fulfill its obligations under its Federal grant. If this documentation is not maintained and furnished
to City on request, City may exercise all remedies available under this Contract, including the right
to withhold payment to Contractor on this Contract or an ontractor, or
terminate this Contract as described herein. OFFICIAL RECORD
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d. City will monitor and evaluate Contractor's performance using the goals and performance standards
required in this Contract. Substandard performance as determined by City monitoring will
constitute non-compliance with this Contract. If action to correct such substandard performance is
not taken by Contractor within a reasonable period of time after being notified in writing by City,
procedures to suspend or terminate the Contract will be initiated.
e. If applicable, Contractor shall comply and assist City in complying with the provisions of 24 CFR
574.630 regarding displacement, relocation and real property acquisition. If Contractor agrees to
take reasonable steps to ensure meaningful access to the program and associated activities by
limited English proficient person.
2. Conzpertsation aJzd Method of Paynle�zt
a. City will disburse HOPWA Year 2008-2009 funds ("HOPWA Funds") in an amount up to two
hundred and sixty two thousand, two hundred eleven and no/100 dollars, $262,211 to Contractor
on a reimbursement of expenses basis. HOPWA Funds may be used to assist all forms of housing
designed to prevent homelessness including emergency housing, shared housing arrangements,
apartments, single room (SRO) occupancy dwellings, community residences, and supportive
housing services such as case management, in accordance with 24 CFR 574.300. Contractor shall
not use any HOPWA Funds for any prohibited activities as set forth in 24 CFR 574.
b. Payment will be processed by City following receipt from Contractor of the following monthly
financial documents: (1) Attachment I- Request For Funds, (2) Attachment II -Detail Statement of
Costs, and (3) Attachment III -Expenditures Worksheet. Payment by City to Contractor shall
require completion of all City forms and copies of adequate supporting documentation verifying
eligibility of expenses as well as, where applicable, eligibility of Program participants.
Reimbursement for the payment of eligible expenses shall be made against the budget specified in
Exhibit C-Program Operating Budget and in accordance with performance specified in Exhibit B-
Program Services Schedule. City will not disburse funds for expenditures that occurred prior to the
beginning date of the term of this Contract.
c. Contractor agrees to utilize all disbursed HOPWA Funds for the benefit of the Program. Contractor
agrees that all funds will be expended in accordance with Exhibit C-Program Operating Budget.
Contractor may not increase or decrease line -item amounts in the approved HOPWA Funds
portion of Exhibit C-Program Operating Budget without City's prior written approval. Contractor
acknowledges and agrees that any HOPWA Funds not used in accordance with the HOPWA
Regulations and terms of this Contract must be repaid to City.
d. It is understood that the total cost for operation of this Program is $1,664,507 and that Contractor
will obtain from other sources the remaining funds in excess of the HOPWA Funds as detailed in
Exhibit C-Program Operating Budget. Contractor will notify City promptly of any additional
funds it receives for operation of the Program, and City reserves the right to amend Exhibit C-
Program Operating Budget in such instances.
e. Contractor agrees to keep all HOPWA Funds on hand in interest bearing accounts. All interest
earned shall be reported to City on a monthly basis, at the same time as submission of the monthly
report following the end of the Contract month during which the interest was earned. Interest in an
amount of $25.00 or less per month may be used for authorized Program expenses. These amounts
must be reported on the monthly financial statements filed pursuant to this Contract. Interest
earned in excess of $25.00 per month is subject to remittance to City as directed by City.
f. Contractor will not commingle HOPWA Funds with any other funds in any manner that would
prevent City from readily identifying expenditures for operation of the Program.
3. Ulziforriz Adnliizistrative Bequirevientr and Program Matzagenlefat Standards
a. Financial Management
i. Accounting Standards
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OFFICIAL RECORD
CITY SECRETARY Rev. 07-28-08
FT. WORTH, TX I Page 2
The Contractor agrees to comply with OMB Circular A-110, "Uniform Administrative
Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and
other Non -Profit Organizations", and agrees to adhere to the accounting principles and
procedures required therein, utilize adequate internal controls, and maintain necessary source
documentation for all costs incurred.
ii. Cost Principles
Contractor shall administer the Program in conformance with OMB Circular A-122, "Cost
Principles for Non -Profit Organizations" and attachments and revisions thereto, regarding
principles for determining costs for the Program.
b. Documentation and Record Keeping
i. Requirement
Contractor shall maintain all records pertinent to the activities to be funded under this Contract
required in 24 CFR j 574.530. In addition, Contractor agrees to keep records to fully document
all expenditures charged to the HOPWA portion of the Program, including records
documenting the eligibility of Program participants as more particularly described herein. The
documentation must support the amounts charged to the Program, the eligibility of the Program
participants, and demonstrate that the expenditures were appropriate to the stated goals of the
Program and allowable and/or eligible under applicable Federal, state and City guidelines.
n. Retention
(1) All records pertaining to Program shall be retained for four (4) years following the
termination of this Contract. Contractor may destroy Program records at the end of this
four (4) year period if no outstanding audit finding exists.
(2) Contractor will retain any Program loan records until four (4) years after the expiration of
any loan.
m. Real Property Records
Contractor shall maintain real property inventory records that clearly identify properties
purchased, improved, or sold. Properties retained shall meet eligibility criteria and shall conform
to the requirements of 24 CFR 574.630.
iv. Closeouts
Contractor'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: making final
payments, disposing of Program assets (including the return of all unused materials, equipment,
unspent cash advances, Program income balances, and accounts receivable to City), and
determining the custodianship of records.
V. Audits and Inspections
(1) City, HUD, and the United States Comptroller General, or their respective representatives,
shall have access to any books, documents, records and papers relating to the operations of
Contractor under this Contract for the purpose of audit, examination, exception and
transcription at all of Contractor's offices at all reasonable hours.
(2) All non-federal entities that expend $500,000 or more in Federal funds within one (1) year,
regardless of the source of the Federal award, must submit to City an annual audit
prepared in accordance with 24 CFR Sections § 570.502-570.503 generally, with specific
reference to OMB Circulars (with attachments) A-122, "Cost Principles for Non -Profit
Organizations", and A-133, `Audits of States, Local Governments, and Non -Profit
Organizations", as appropriate. The audit may cover either Contractor's fiscal year during
which this Contract is in force or cover the period of this Contract. The audit must be
prepared by an independent certified public accountant, be completed within nine (9)
months following the end of the period being audited and be submitted to City within
thirty (30) days of its completion. Contractor's audit certification is attached hereto as
Exhibit D - Audit Schedule Independent Audit Re ' ement. The Audit Schedule Form
must be submitted to City within sixty (60) days of theT
jeriobeing audited
(Contractor's fiscal year). Costs of preparation �Ft an allowable
expenditure of HOPWA Funds in an amount prop •tiGiOPWA Funds
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Tarrant County Samaritan House Page 3
used in Contractor's total agency operating budget. Non-profit entities that expend less
than $500,000 a year in Federal funds are exempt from Federal audit requirements for that
year, but records must be available for review or audit by appropriate officials of the
Federal agency, City, and General Accounting Office ("GAO").
(3) City reserves the right to perform an audit of Contractor's agency operations and finances
at any time during the term of this Contract, if City determines that such audit is necessary
for City's compliance with OMB Circular A-133. Contractor agrees to allow access to all
relevant books, records and materials. If such audit reveals a questioned practice or
expenditure, such questions must be resolved within thirty (30) days after notice to
Contractor. If questions are not resolved within this period, City reserves the right to
withhold further funding under this Contract and/or any other contract(s) with Contractor.
(4) If as a result of any audit it is determined that Contractor has misused, misapplied or
misappropriated all or any part of the HOPWA Funds, Contractor agrees to reimburse the
City the amount of such monies so misused, misapplied or misappropriated, plus the
amount of any sanction, penalty or other charge levied against City because of such
misuse, misapplication or misappropriation.
4. Keporting P� ocedu� er
a. Financial Reports
Contractor will submit to City on a monthly basis: (1) Attachment I -Request for Funds, (2)
Attachment II -Detailed Statement of Costs, (3) Attachment III -Expenditures Worksheet, as
applicable, for expenses incurred for services and activities accomplished by Contractor in
performance of this Contract. Actual cash receipts for claimed expenditures must be provided at
the time the request for funds is presented. The reports must be signed by a duly authorized agent
of the Contractor and submitted by the 15`h of the month following the month being reported.
City will not disburse funds for expenditures that occurred prior to the beginning date of the term
of this Contract
b. Progress Reports
Contractor will submit to City on a monthly basis as applicable to Program: (1) Attachment IVa-
Program Services Report, (2) Attachment IVb, (3) IVe-Supportive Services Report, (4) Attachment
V- Performance Report, (5) Attachment VI -Client Data Report for services and activities
undertaken by Contractor in performance of this Contract. The report will be signed by a duly
authorized agent of Contractor and submitted by the 15'h of the month following the month that is
reported. City will not disburse funds for expenditures that occurred prior to the beginning date of
the term of this Contract.
c. Procurement
i. Compliance
Contractor shall comply with City policy concerning the purchase of equipment and shall
maintain inventory records of all non -expendable personal property, as defined by such policy,
procured with funds provided under this Contract.
no OMB Standards
Contractor shall procure all materials, property, or services in accordance with the requirements
of 24 CFR Part 84, Procurement Standards and Property Standards
d. Program Participant Records
i. Contractor will keep or cause to be kept an accurate record of all actions taken and all HOPWA
Funds expended, with source documents, in performance of this Contract. Such records shall
be kept for the time period mandated by the HOPWA Regulations and this Contract.
ii. Contractor will obtain and keep on file and furnish to City on request the following information
and/or documentation on each Program participant served by the Program demonstrating such
participant's eligibility for services provided:
a. Participant's name, documented HIV/AIDS status,a level or other
basis for determining income eligibility, and family s e i F� 6l�► p boouDs hold.
HOPWA YEAR 2008-2009 CONTRACT CITY $LR�1"i4RV Rev. 07-28-08
Tarrant County Samaritan House FT. WORTH, TX Page 4
b. Source documentation used for income verification including but not limited to pay check
stubs, food stamp award letters, income tax returns, SSI award letters, letters awarding
unemployment benefits, W2s and the like.
c. City shall have the final determination, in its sole discreti fion, as to whether source
documentation used for income verification is adequate.
5. Reversion of Assets
a. Contractor agrees to return to City any HOPWA Funds remaining on an at the end of the
Contract.
b. All property purchased with HOPWA Funds under this Contract will be used solely for operation
of the Program. Contractor agrees to obtain City approval prior to purchase of property and
Contractor agrees to notify City upon receipt of property so that it may be properly tagged and
inventoried. Title to such property will be vested in City, and Contractor will deliver all such
property to City for disposition at City's sole discretion at the termination of the Program.
6. Aj�plicable Laaa�s
a. Federal
Contractor agrees to comply with the following laws and the applicable regulations as they are
currently written or are hereafter amended during performance of this Contract:
• AIDS Housing Opportunity Act, as amended, (42 USC 12901 et seq.)
• Regulations at 24 CFR Part 574 pertaining to HOPWA ("HOPWA Regulations")
• Title VI of the Civil Rights Act of 1964 (42 USC 2000d et seq.)
• Title VIII of the Civil Rights Act of 1968 (42 USC 3601 et seq.)
• Executive Orders 110633 11246, as amended by Executive Orders 11375 and 12086 and as
supplemented by 41 CFR Part 60
• The Age Discrimination in Employment Act of 1967 (29 USC 621)
• The Age Discrimination Act of 1975 (42 USC 6101 et seq.)
• Section 504 of the Rehabilitation Act of 1973 (29 USC 794 et seq.) and 24 CFR Part 8 where
applicable
• The Americans with Disabilities Act of 1990 (42 USC 12101 et seq)
• National Environmental Policy Act of 1969, as amended, 42 USC 4321 et seq. ('NEPA") and
the related authorities listed 24 CFR Part 58
• The Clean Air Act, as amended (42 USC 7401 et seq.), the Clean Water Act of 1977, as amended
(33 USC 1251 et seq.) and the related EPA regulations at 40 CFR Part 15, as amended from time
to time, and Executive Order 11738. In no event shall any amount of the assistance provided
under this Contract be utilized with respect to a facility that has given rise to a conviction under
the Clean Air Act or the Clean Water Act.
• The Immigration Reform and Control Act of 1986 (8 USC 1101 et seq.), specifically including
the provisions requiting employer verification of the legal status of its employees
• The Americans with Disabilities Act of 1990 (42 USC 12101 et seq.)
• Drug Free Workplace Act of 1988 (41 USC 701 et seq.) and 24 CFR Part 23, Subpart F
• Regulations as 24 CFR Part 87 related to lobbying, including the requirement that certifications
and disclosures be obtained from all covered persons
• Executive Order 12549 and 24 CFR Part 5.105 (c) pertaining to restrictions on participation by
ineligible, debarred, or suspended persons or entities.
b. Section 3 of the Housing and Urban Development Act of 1968, as 2 C 170 u et seq.
�����d� RCORD
and its related regulations at 24 CFR Part 135 CITY SECRETARY
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Tarrant County Samaritan HouseLM:Page 5
As the work to be performed under this Contract is on a project assisted under a program
providing direct Federal financial assistance from HUD, Section 3 of 24 CFR 135.38 ("Section 3")
requires that the following clause be inserted in all covered contracts ("Section 3 Clause"):
`A. The work to be performed under this contract is subject to the requirements of section 3 of
the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (section 3).
The purpose of Section 3 is to ensure that employment and other economic opportunities
generated by HUD assistance or HUD -assisted projects covered by Section 3, shall, to the
greatest extent feasible, be directed to low- and very low-income persons, particularly persons
who are recipients of HUD assistance for housing.
B. The Parties to this contract agree to comply with HUD's regulations in 24 CFR Part 135,
which implement Section 3. As evidenced by their execution of this contract, the Parties to
this contract certify that they are under no contractual or other impediment that would prevent
them from complying with the Part 135 regulations.
Co The contractor agrees to send to each labor organization or representative of workers with
which the contractor has a collective bargaining agreement or other understanding, if any, a
notice advising the labor organization or workers' representative of the contractor's
commitments under this section 3 clause, and will post copies of the notice in conspicuous
places at the work site where both employees and applicants for training and employment
positions can see the notice. The notice shall describe the Section 3 ,preference, shall set forth
minimum number and job titles subject to hire, availability of apprenticeship and training
positions, the qualifications for each; and the name and location of the person(s) taking
applications for each of the positions; and the anticipated date the work shall begin.
D. The contractor agrees to include this section 3 clause in every subcontract subject to
compliance with regulations in 24 CFR Part 135, and agrees to take appropriate action, as
provided in an applicable provision of the subcontract or in this Section 3 clause, upon a
finding that the subcontractor is in violation of the regulations in 24 CFR Part 135. The
contractor will not subcontract with any subcontractor where the contractor has notice or
knowledge that the subcontractor has been found in violation of the regulations in 24 CFR
Part 135.
E. The contractor will certify that any vacant employment positions, including training positions,
that are filled (1) after the contractor is selected but before the contract is executed, and (2)
with persons other than those to whom the regulations of 24 CFR Part 135 require
employment opportunities to be directed, were not filled to circumvent the contractor's
obligations under 24 CFR Part 135.
E Noncompliance with HUD's regulations in 24 CFR Part 135 may result in sanctions,
termination of this contract for default, and debarment or suspension from future HUD
assisted contracts.
G. With respect to work performed in connection with Section 3 covered Indian housing
assistance, section 7(b) of the Indian Self -Determination and Education Assistance Act (25
U.S.C. 450e) also applies to the work to be performed under this contract. Section 7(b) requires
that to the greatest extent feasible (i) preference and opportunities for training and
employment shall be given to Indians, and (ii) preference in the award of contracts and
subcontracts shall be given to Indian organizations and Indian -owned Economic Enterprises.
Parties to this contract that are subject to the provisions of section 3 and section 7(b) agree to
comply with Section 3 to the maximum extent feasible, but not in derogation of compliance
with section 7(b)."
City and Contractor understand and agree that compliance with the provisions of Section 3, the
regulations set forth in 24 CFR Part 135, and all applicable rules and orders of HUD shall be a
condition of the Federal financial assistance provided to the Program, binding upon City and
Contractor, and their respective successors, assigns and subco fill these
requirements shall subject Contractor and its subcontractors, anMck
j ucc ssors and
assigns, to those sanctions specified by the Grant Agreement Fe`de� istance is
ECRET
provided and to such sanctions as are specified by 24 CFR Part 1 5. ARY
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c. Other Laws
Contractor covenants and agrees that its officers, members, agents, employees, Program
participants and subcontractors shall abide by and comply with all other laws, Federal, state and
local, relevant to the performance of this Contract, including all applicable City ordinances, rules
and regulations and the AIDS Housing Opportunity Act, as amended, (42 USC 12901 et seq.) and
the. HOPWA Regulations, as amended, (24 CFR Part 574 et seq.). Contractor further promises and
agrees that it has read, and is familiar with, the terms and conditions of the Housing Opportunities
for Persons with Aids program, and the HOPWA Regulations, under which HOPWA Funds are
granted and that it will fully comply with them. It is agreed and understood that, if City notifies
Contractor of any such violation on the part of Contractor or any of its officers, members, agents,
employees, Program participants or subcontractors, then Contractor shall immediately desist from
and correct such violation.
7. Nondisc�znaination
a. Contractor will not unlawfully discrinate against any person or persons because of sex, race,
religion, age, disability, color, national origin, or familial status, nor will Contractor permit its
officers, members, agents, employees, subcontractors or Program participants to engage in such
discrimination.
b. Contractor covenants that neither it not any of its officers, members, agents, employees, Program
participants or subcontractors, while engaged in performing this Contract, shall, in connection with
the employment, advancement or discharge of employees or in connection with the terms,
conditions or privileges of their employment, discriminate against persons because of their age
except on the basis of bona fide occupational qualification, retirement plan or statutory
requirement.
c. Contractor further covenants that neither it nor its officers, members, agents, employees,
subcontractors, Program participants, or persons acting on their behalf, shall specify, in solicitations
or advertisements for employees to work on this contract, a maximum age limit for such
employment unless the specified maximum age limit is based upon a bona fide occupational
qualification, retirement plan or statutory requirement.
d. In accordance with the provisions of the Americans With Disabilities Act of 1990 ("ADA" ),
Contractor warrants that it and any and all of its subcontractors will not unlawfully discriminate on
the basis of disability in the provision of services to the general public, not in the availability, terms
and/or conditions of employment for applicants for employment with Contractor, or employees of
Contractor or any of its subcontractors. Contractor warrants it will fully comply with ADA's
provisions and any other applicable Federal, state and local laws concerning disability and will
defend, indemnify and hold City harmless against any claims or allegations asserted by third parties
or subcontractors against City arising out of Contractor's and/or its subcontractors' alleged failure
to comply with the above -referenced laws concerning disability discrimination in the performance
of this Contract.
e. This Contract is made and entered into with reference specifically to the ordinances codified at
Chapter 17, Article III, Division 3 "Discrimination in Employment Practices", of the City Code,
and Contractor hereby covenants and agrees that Contractor, its officers, members, agents,
employees and subcontractors, have fully complied with all provisions of same and that no
employee, employee -applicant or Program participant has been discriminated against by the terms
of such ordinances by either the Contractor or its officers, members, agents, employees or'
subcontractors.
8. Prohibition Against Interest
a. No member, officer or employee of City or its designees or ag nts; no mem er o governing
body of the locality in which the Program is situated; and no o e{�i�d/�tE£�:�a�F�B locality or
localities, who exercises any functions or responsibilities wi �(3MRLftTA •am funded
HOPWA YEAR 2008-2009 CONTRACT FT. WORTH, TX v. 07-28-08
Tarrant County Samaritan House Page 7
hereunder during his or her tenure or for one year thereafter, shall have any interest, direct or
indirect, in any contract or subcontract, or the proceeds thereof, for work to be performed
hereunder. Contractor shall incorporate, or cause to be incorporated, like language prohibiting such
interest in all contracts and subcontracts entered into in connection with the Program.
b. No member, officer, employee, or Program participant of Contractor or its subcontractors shall
have a financial interest, direct or indirect, in this Contract or the HOPWA Funds transferred
hereunder or be financially interested, directly or indirectly, in the sale to Contractor of any land,
materials, supplies or services purchased with any HOPWA Funds transferred hereunder, except on
behalf of Contractor, as an officer, employee, member or Program participant. Any willful
violation of this paragraph with the expressed or implied knowledge of Contractor or its
subcontractors shall render this Contract voidable by City.
9. Minozzty atzd Wlontett Business Entet�rise Commitment
Contractor agrees to abide by City's policy to involve Minority and Women Business Enterprises
("MWBEs") in all phases of its procurement practices and to provide them an equal opportunity to
compete for contracts for construction, provision of professional services, purchase of equipment and
supplies and provision of other services required by City. Contractor agrees to incorporate City
Ordinance No. 15530, and all amendments or successor policies thereto, into all contracts and will
further require all persons or entities with whom it contracts to comply with said MWBEs policy.
10. Non Assignment
No assignment or delegation of duties under this Contract by Contractor shall be effective without
City's prior written approval.
11. Itadepetadezlt Contractor
a. Contractor shall operate hereunder as an independent contractor and not as an officer, agent,
servant or employee of City. Contractor shall have exclusive control of, and the exclusive right to
control, the details of the work and services performed hereunder, and all persons performing
same, and shall be solely responsible for the acts and omissions of its officers, members, agents,
servants, employees, subcontractors, Program participants, licensees or invitee. The doctrine of
respondeat superior shall not apply as between City and Contractor, its officers, members, agents,
servants, employees, subcontractors, Program participants, licensees or invitees, and nothing herein
shall be construed as creating a partnership or joint enterprise between City and Contractor. It is
expressly understood and agreed that no officer, member, agent, employee, subcontractor, licensee
or invitee of the Contractor, nor any Program participant hereunder, is in the paid service of City
and that City does not have the legal right to control the details of the tasks performed hereunder
by Contractor, its officers, members, agents, employees, subcontractors, Program participants,
licensees or invitees.
b. City shall in no way not under any circumstances be responsible for any property belonging to
Contractor, its officers, members, agents, employees, subcontractors, Program participants,
licensees or invitees, which may be lost, stolen, destroyed or in any way damaged; and Contractor
hereby indemnifies and holds harmless City and its officers, agents, and employees from and against
any and all claims or suits.
12. Indemnification, Insurance and Bonding
a. CONTRACTOR COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS
AND DEFEND, AT ITS OWN EXPENSE, CITY AND ITS RS, AGENTS,
SERVANTS AND EMPLOYEES FROM AND AGAINST ANY MS R
SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR P �__ Y, 40
HOPWA YEAR 2008-2009 CONTRACT I FT. WORTH T� 8
Tarrant County Samaritan House Y ge
INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR
CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN
CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED
PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE
OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED
HEREIN, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY ALLEGED
NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES,
CONTRACTORS OR SUBCONTRACTORS OF CITY; AND CONTRACTOR HEREBY
ASSUMES ALL LIABILITY AND RESPONSIBILITY OF CITY AND ITS OFFICERS,
AGENTS, SERVANTS, AND EMPLOYEES FOR ANY AND ALL CLAIMS OR SUITS
FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING
DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KINDS OR
CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN
CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED
PERFORMANCE OR NON-PERFORMANCE OF THIS CONTRACT AND
AGREEMENT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES OF
THE PROGRAMS DESCRIBED HEREIN, WHETHER OR NOT CAUSED IN
WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS,
SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY.
CONTRACTOR LIKEWISE COVENANTS AND AGREES TO AND DOES HEREBY
INDEMNIFY AND HOLD HARMLESS CITY FROM AND AGAINST ANY AND ALL
INJURY, DAMAGE OR DESTRUCTION OF PROPERTY OF CITY, ARISING OUT OF
OR IN CONNECTION WITH ALL ACTS OR OMISSIONS OF CONTRACTOR, ITS
OFFICERS, MEMBERS, AGENTS, EMPLOYEES, SUBCONTRACTORS, INVITEES,
LICENSEES, OR PROGRAM PARTICIPANTS, OR CAUSED, IN WHOLE OR IN
PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS,
EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY.
CONTRACTOR AGREES TO AND SHALL RELEASE CITY, ITS AGENTS,
EMPLOYEES, OFFICERS AND LEGAL REPRESENTATIVES FROM ALL LIABILITY
FOR INJURY, DEATH, DAMAGE OR LOSS TO PERSONS OR PROPERTY
SUSTAINED IN CONNECTION WITH OR INCIDENTAL TO PERFORMANCE
UNDER THIS CONTRACT, EVEN IF THE INJURY, DEATH, DAMAGE OR LOSS IS
CAUSED BY THE CITY'S SOLE OR CONCURRENT NEGLIGENCE.
CONTRACTOR SHALL REQUIRE ALL OF ITS SUBCONTRACTORS TO INCLUDE
IN THEIR SUBCONTRACTS A RELEASE AND INDEMNITY IN FAVOR OF THE
CITY IN SUBSTANTIALLY THE SAME FORM AS ABOVE.
b. Contractor will maintain blanket fidelity coverage in the form of a bond in the amount of
$262,211, to insure against loss from the fraud, theft or dishonesty of any of Contractor's
officers, agents, trustees, directors or employees. The proceeds of such bond shall be used
to reimburse City for any and all loss of HOPWA Funds occasioned by such misconduct.
To effectuate such reimbursement, such bond shall include a rider stating that
reimbursement for any loss or losses thereunder shall be made directly to City for the uses
and benefit of Contractor.
c. Contractor shall furnish certificates of insurance as proof that it has secured and paid for
policies of workers' compensation, public liability and automobile liability insurance
covering all risks incident to or in connection with the execution, performance, attempted
performance or nonperformance of this Contract. The amounts of such insurance shall
not be less than the maximum liability that can be imposed on City under the Yaws-o the
State of Texas. Contractor understands and agrees that such irsutrC$ie} y be
HOPWA YEAR 2008-2009 CONTRACT
Tarrant County Samaritan House
CITY SECRETARY
9
revised upward at City's option and that Contractor shall revise such amounts within thirty
(30) days following notice to Contractor of such requirements.
d. Contractor will submit documentation to City that it has obtained insurance coverage and
has executed bonds as required in this contract within thirty (30) days of the execution of
this Contract and prior to payment of any monies hereunder.
e. Any failure on part of the City to request certificate(s) of insurance shall not be construed as
a waiver of such requirement or as a waiver of the insurance requirements themselves.
Insurers of Contractor insurance policies shall be licensed to do business in the State of
Texas by the Department of Insurance or be otherwise eligible and authorized to business
in the state of Texas. Insurers shall be acceptable to City insofar as their financial strength
and solvency and each such company shall have a current minimum A.M. Best Key Rating
Guide rating of A: VII or other equivalent insurance industry standard rating unless
otherwise approved by City. Deductible limits on insurance policies shall not exceed $5,000
per occurrence unless otherwise approved by City.
f. Any local, federal or other regulatory insurance or bonding requirements for the Program
that exceed those specified herein shall prevail.
g. Contractor shall agree to require its subcontractors to maintain applicable insurance
coverages, limits, and other requirements as those specified herein; and, Contractor shall
require its subcontractors to provide Contractor with certificate(s) of insurance
documenting such coverage. Also, Contractor shall require its subcontractors to have City
and Contractor endorsed as additional insured (as their interests may appear) on their
respective insurance policies. Contractor shall require its subcontractors to maintain
builders risk insurance at the limit of applicable project(s) costs when the value of materials
involved exceeds $10,000 or at a different limit value limit as specified by City.
13. 1Plaiver of Im�nznrity
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
propertST; 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.
14. Tee rniization
a. In addition to, and not in substitution for, other provisions of dus Contract regarding the provision
of public services with HOPWA Funds, pursuant to the AIDS Housing Opportunity Act, as
amended, (42 USC 12901 et seq.) the HOPWA Regulations , it is expressly understood and agreed by
and between the Parties that this Contract is wholly conditioned upon the actual receipt by City of
Federal HOPWA Year 2008-2009 funds; that all monies distributed to Contractor hereunder shall
be exclusively from Federal monies received under said grant and not from any other monies of
City; and that if such funds under City's grant are not timely forthcoming, in whole or in part, City
may, at its sole discretion, terminate this Contract and City shall not be liable for payment for any
work or services performed by Contractor under or in connection widi this Contract.
b. City may terminate this Contract whenever such termination is determined to be in City's best
interest, in event of Contractor's default, inability or failure to perform or to comply with any of
the terms herein, or, for other good cause.
c. The Parties acknowledge that HOPWA Funds paid hereunder are intended to provide only partial
funding for Contractor's program operations. CitST may terminate this Contract if non-HOPWA
funds included in the Operating Budget are not forthcoming to Contractor during the Contract
term.
HOPWA YEAR 2008-2009 CONTRACT
Tarrant County Samaritan House
OFFICIAL RECORD
CITY SECRETAF��� o�-2s-os
FZ WORTH, TX Page 10
d. HOPWA Funds provided hereunder may not be used as collateral for loans to Contractor to defray
program operation expenses, and any attempted use of HOPWA Funds for this purpose willresult
in termination of this Contract by City.
e. Termination will be effected by written notice to Contractor, specifying the portions of the Contract
affected and the effective date of termination. Upon Contractor's receipt .of such termination
notice, Contractor will:
• Stop work under the Contract on the date and to the extent specified by City;
• Cease expenditures of HOPWA Funds, except as necessary for completion of the portions of
the Contract not terminated; and
• Terminate all orders and contracts to the extent that they relate to portions of the Contract
being terminated.
f. Contractor will return to City any unused HOPWA Funds previously advanced by City under this
Contract within thirty (30) days of the effective date of Contract termination. City will have no
responsibility or liability for Contractor's expenditures or actions occurring after the effective date
of Contract termination.
15. Ce�tification Kega�ding Lobbying
a. The undersigned representative of Contractor hereby certifies, to the best of his or her knowledge
and belief, that: No federal appropriated funds have been paid or will be paid, by or on behalf of
Contractor, to any person for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, an officer or employee of Congress or an employee of a member
of Congress in connection with the awarding of any Federal contract, the making of any Federal
grant, the making of any Federal loan, the entering into of any cooperative agreement and the
extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan
or cooperative agreement. Contractor shall require that the language of this certification be
included in all subcontracts or agreements involving the expenditure of Federal funds.
b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of
Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with this Federal contract, grant, loan or cooperative agreement, Contractor shall
complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance
with its instructions.
c. This certification is a material representation of fact upon which reliance was placed when this
Contract was made or entered into. Submission of this certificate is a prerequisite for making or
entering into this Contract imposed by 31 USC Section 1352. Any person who fails to file the
required certification shall be subject to a civil penalty of not less than $10,000.00 and not more
than $100,000.00 for each such failure.
16. Miscellaneous Provisions
a. All terms of this Contract shall apply to any and all subcontractors of Contractor who are in any
way paid with HOPWA Funds or who perform any work in connection with Contractor's program.
b. The provisions of this Contract are severable, and, if for any reason a clause, sentence, paragraph or
other part of this Contract shall be determined to be invalid by a court or Federal or state agency,
board or commission having jurisdiction over the subject matter thereof, such invalidity shall not
affect other provisions which can be given effect without the invalid provision.
c. City's failure to insist upon the performance of any term or provision of this Contract 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 hit„re. oc raason_
HOPWA YEAR 2008-2009 CONTRACT
Tarrant County Samaritan House
OFE~1^,EAi. RECORD
OETh'" S��:R�TARx
T. WORTH, TX
07-28-08
Page 11
d. Should any action, whether real or asserted, at law or in equity, arise out of the execution,
performance, attempted performance or nonperformance of this Contract, venue for action shall
lie in Tarrant County, Texas.
e. This written instrument and the exhibits attached hereto, which are incorporated by reference and
made a part of this Contract for all purposes, constitute the entire agreement between the Parties
concerning the work and services to be performed hereunder, and any prior or contemporaneous,
oral or written agreement which purports to vary from the terms hereof shall be void. Any
amendments to the terms of this Contract must be in writing and must be approved by each Party.
f. All notices required or permitted by this Contract 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 set out in the preamble of this
Contract or at such other address as the receiving Party designates by proper notice to the sending
Party.
g. In accordance with the requirements of 24 CFR Part 574.300, none of the performance rendered
under this Contract shall involve, and no portion of the HOPWA Funds received hereunder shall
be used, directly or indirectly, for the construction, operations, maintenance or administration of
any sectarian or religious facility or activity, not shall said performance rendered or funds received
be utilized so as to benefit, directly or indirectly, any such sectarian or religious facility or activity.
h. 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 Contract and to perform the
responsibilities herein required.
i. 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 Contract.
[SIGNATURES APPEAR ON FOLLOWING PAGE]
HOPWA YEAR 2008-2009 CONTRACT
Tarrant County Samaritan House
01=�ICIAL RECORD
CITY SECRETARY
FT, WORTHP TX
Rev.07-28-08
Page 12
IN WITNESS WHEREOF, the Parties hereto have executed ee dupli ate originals of us Contract
in Fort Worth, Tarrant County, Texas, thus I� day of 200Ie.
ISA
CITY OF FORT WOR
By:
Joe Pai> tg
First Assistant City
APPR D AS T�O' FO
v.
City Attorney
ATTEST:
(Nm�*\
City Secretary
STATE OF TEXAS �
COUNTY OF TARRANT §
LEGALITY:
This instrument was acknowledged before
Paniagua, Jr., the First Assistant City Manager of
Worth.
MASIA S, SANCFIE2
NOTARY PUBI-IC
STATE OF; EXAo 9
My Comm.
Tarrant County Sama ' n House
By:
teve Dutton
Executive Director
1 I
�cnr_ract Autrhorizatioa
$I191C)
:ate
me on / 2008 by Joe
the City of Fort orth, on behalf of the City of Fort
STATE OF TEXAS �
COUNTY OF TARRANT �
This instrument was acknowledged before me on � Z lq
2008 by Steve
Dutton, the Executive Director of Tarrant County Samaritan House, a Texas non-profit corporation, on
behalf of said corporation.
* ,Notary Publ(c, State of Tex.
My Commisslon Expires
1.1 &2012
Notary Public, State of Texas
OF�=ICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
HOPWA YEAR 2008-2009 CONTRACT
Tarrant County Samaritan House
Rev. 07-28-08
Page 13
Tarrant County Samaritan Housing, Inc. EXHIBIT A
Supportive Housing SCOPE OF SERVICES
PROGRAM SUMMARY
CONTRACT NO, June 1, 2008 — May 31, 2009 Amount
Period $2623211
SCOPE OF SERVICES
This Scope of Services is based on the proposal prepared and submitted by the Subrecipient through
the City of Fort Worth and the Housing Department Contract Management Division's annual
Request for Proposal )RFP) process. However, in the event of any conflict between the proposal and
any provision contained therein, this Agreement shall control. In addition to the activities listed
below, the Subrecipient agrees to operate this Housing Opportunities for Persons with AIDS program
consistent with the program delivery stated in the approved proposal.
Samaritan House is an affordable, service -enriched housing community for individuals living with
HIV/AIDS and other special needs. The program is located at 929 Hemphill Street, Fort Worth, TX
76104
COUNCIL DISTRICTS) -ALL
PROGRAM OBJECTIVES
Samaritan House not only helps residents manage their life with HIV and improve their health. The
organization is focused on fostering independence and developing skills that enable clients to become
vital, contributing members of society. This is valuable to the community because housing of this
type has also been shown to be more cost-effective than temporary shelters or incarceration. In
addition, recent studies have demonstrated that affordable housing models such as Samaritan House
are important factors in reducing new HIV infections.
In addition to the normal administrative services required as part of this contract, the Subrecipient
agrees to document progress using reporting requirements specified in the Contract's Reporting
Procedures, Progress Report (b).
PROGRAM GOALS
To provide supportive housing to 106 unduplicated clients, including housing, medical and social
case management, nutritional counseling, attended health care, life skills support, chemical
dependency counseling, and nutritional services (three hot meals per day).
PROGRAM SERVICES AND ACTIVITIES:
Unduplicated Clients -
Number Units Case Mgmt —
Number Units of Attended Health Care —
Meals/Nutrition -
OFFICIAL RECORD
CITY SECRETARY
FT; W0-R'Th
GOALS
11�
6,336
9,504
2,534
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O��I�:IAL RECORD
CITY SECRETARY
F1: WORTH, TX
City of Fort Worth
HOPWA Year 2008-2009
Contract Period - 6/1/2008 to 5/31/2009
Tarrant ("nnn+c� Camariitnn Nnucina_ Tnc_
Exhibit C page 1 of 3
Sunnortive Housing
Total
Grant
Other Sources **
Expense Category
Budget
[A]
Budget
[B]
[C]
[D]
IN
[F]
PERSONNEL SERVICES
150535640
2045000
1165908
1005504
167,776
464,452
Salaries
FICA
745456
15,606
85663
85988
12,835
283364
Life Insurance
%600
13000
3,228
1,000
1,412
25960
Health Insurance
88,320
16,105
18,415
145972
14,735
243093
Unemployment - State
15,000
33000
35453
2,000
45513
2,034
Unemployment - Federal
Worker's Compensation
203000
2,000
10,098
33000
3,000
15902
Retirement
SUPPLIES
51000
15500
35000
500
Office Supplies
Postage
15680
600
1,080
Medical Supplies
25400
15491
909
Other (Specify) *(Food)
755400
50,704
11,400
13,296
CONTRACTUAL SERVICES
45800
41600
200
Telephone
Electric
Gas [Utilities]
Water/Waste Disposal
Rent [Building]
All Other
623097
1,219
19,650
65526
345702
Office Equipment Rental *
9,350
4,250
2,385
25715
Printing
75500
25000
35070
2,430
Repairs
Fidelity Bond***
2>202
2,202
Liability Insurance***
Legal & Accounting
155000
8,000
55550
6,000
43549
3,000
500
1,066
1,901
434
Private Auto Allowance
12,000
13200
956
13818
21400
5,626
Rental Assistance
1983062
1985062
CAPITAL OUTLAY
Furniture, Fixtures
Office Equipment, Computers
Office Equipment
TOTALS
1,6645507
2623211
2193684
3785549
2145263
5891800
Note: Column A should be the total of Columns B through F.
* Specify on Budget Detail (following pages)
**Use one colunm for each non -grant funding source; note below which colunm equates to each source (from
*** Fidelity bond and liability insurance are required of all subcontractors and may be paid from grant funds of
[C] RWI RWII, State Services [E] _SHP
[D] HOPWA SNAP / TBLA [F] All Other- Foundations, Fundraisin1j, Contributic
of Funds
mrw2MM11
�1rHa I A
GRANT BUDGET DETAIL
(GRANT FUNDED ITEM S ONLY)
STAFF SALARIES
Position/Title
[A]
Salary
Hourly Rate
[B]**
Annual
Hours X
[C] [D]
% of Time Total
= Amount
1.
Executive Director
35.45
2080
6.78 5,000
2.
Director of Finance
24.95
2080
7.70 45000
3.
Administrative Assistant
20.00
2080
9.62 49000
4.
Medical Case Manager
24.55
2080
5.87 39000
5,
Associate Exec Director
2495
2080
30.83 169000
6.
Prep Cook-2
12.05
2080
11.97 35000
7.
Resident Care Attendant
14.50
2080
59.68 189000
g.
Resident Care Attendant
10.00
2080
48.08 10,000
9.
Resident Care Attendant
10.00
2080
48.08 109000
10
Resident Care Attendant
10.00
2080
48.08 109000
11
Resident Care Attendant
10.00
2080
48.08 10,000
12
Resident Care Attendant
10.00
2080
48.08 105000
13
Kitchen Manager/Cook
17.30
2080
27.79 10,000
14
Weekend Cook
12.05
2080
27.93 79000
15
Prep Cook-1
12.05
2080
27.93 71000
16
Caretaker
16.35
2080
64.69 229000
17
Follow Up Coordinator
15.35
2080
56.38 185000
18
Social Work Case Mgr
18.25
2080
23.71 95000
19
Social Work Case Mgr
16.10
2080
29.86 105000
20
Social Work Case Mgr
16.10
2080
29.86 10,000
21
Housing Coordinator
22.10
2080
17.40 89000
22
23
24
25
TOTAL STAFF SALARIES 204,000
** Note: 2,080 hours annually comprise afull-time position.
FRINGE BENEFITS
Category
% of
Payroll
Amount
%Paid by
Employer
%Paid by Total
Grant Amount
FICA
T06
74,456
79.04
20.96 159606
Life Insurance
.91
91600
89.58
10.42 19000
Health Insurance
8.38
887320
81.77
18.23 16,105
Unemployment Insurance
1.42
15,000
80.00
20.00 39000
Worker's Compensation
1.99
20,000
90.00
10.00 29000
Retirement
TOTAL FRINGE BENEFITS 379711
TOTAL PERSONNEL SERVICES (Total Staff Salaries + Total Fringe Benefits) ::241,711
OFFICIAL RECORD
GRANT BUDGET DETAIL
(GRANT FUNDED ITEMS ONLY)
CONTINUED)
Category
Average Cost
Per Month
Number of Total
Months Amount
Telephone — Basic service for Residents
Electric
Gas
Water/Waste Disposal
Other (Specify)
TOTAL UTILITIES
BUILDING RENTAL
Building Location
No. of
Square Feet
Cost Per
Square Foot
Number of Total
Months Amount
1.
2.
3.
TOTAL BUILDING RENT
OTHER EXPENSES (See Note Below)
Category
Total Charge
% Charged Total
to Grant Amount
Fidelity Bond
-
Liability Insurance / D&O
59550
Legal & Accounting
69000
Other (Specify) (Office Equipment Repairs, Supplies, Printing, Auto Allow)
49700
TOTAL OTHER EXPENSES 169250
CONFERENCES
& SEMNARS
Event
Total Charge
% Charged Total
to Grant Amount
1.
2.
3.
TOTAL CONFERENCES & SEMINARS
Item
Total Charge
%Charged Total
to Grant Amount
1 i t Computer for Client service delivery Tr ckina
4150
2.
3.
TOTAL OFFICE EQUIPMENT RENTAL 4 2250
Note: %charged to CDBG cannot exceed 20% of CDBG budget allocation, 7% of HOPwA budget allocation, or 10% of ESG budget allocation.
OPFICiAL RECORD
CITY SECRETARY
FT: WORTH, TX
EXHIBIT "D"
AUDIT SCHEDULE
INDEPENDENT AUDIT REQUIREMENT
BUSINESS/AGENCY NAME:
PROGRAM:
HOPWA YEAR:
AMOUNT FUNDED:
Tarrant County Samaritan House
Supportive Services
2008-2009
$262,211
Name of Independent Auditor who will perform agency audit:
Independent Auditor to be contracted during HOPWA contract period.
Date audit is to be performed:
Within 60 days of completion of HOPWA funded project.
The following language is a condition of your contract with the City:
(1) For all contracts in which Contractor is cumulatively receiving federal
monies in the amount of $500,000 or more, Contractor must submit to City an
annual audit prepared in accordance with 24 CFR Sections § 570.502-570.503
generally, with specific reference to OMB Circulars (with attachments) A-122
and A-133 as appropriate. The audit may cover either Contractor's fiscal year
during which this contract is in force or cover the period of this contract. The
audit must be prepared by an independent certified public accountant, be
completed within nine (9) months following the end of the period being audited
and be submitted to City within thirty (30) days of its completion. Contractor's
audit schedule is attached hereto as Exhibit D - Audit Schedule. Costs of
preparation of this audit may be an allowable expenditure of HOPWA funds in
an amount proportional to that of the HOPWA funds used in contractor's total
agency operating budget.
This form is to be completed and submitted to the Housing Department Contract Management
Division at the berg of each contract year.
�'��FfCiAL #RECORD
CITY SECRETARY
FT: WORTH, TX
Tarrant County Supportive Services
Supportive Services
EXHIBIT E
CONFLICT OF INTEREST
All Applicants
The standards in OMB Circular A-110, Subpart C, provide that no employee, officer, or agent shall participate in the
selection, award, or administration of a contract supported by Federal funds if real or apparent conflict of interest would
be involved. Such a conflict would arise when an employee, officer, or agent, any member of his or her immediate
family, his or her partner, or an organization which employs or is about to employ any of the parties indicated herein, has
a financial or other interest in the firm selection for an award.
CDBG and HOME Applicants Only
The CDBG regulations at 24 CFR 570 570.611 and HOME regulations at 24 CFR 92.356 provide that no person who is
an employee, agent , consultant, officer, or elected official or appointed official of the recipient or Subrecipient that are
receiving CDBG or HOME funds and (1) who exercises or has exercised any functions or responsibilities with respect to
activities assisted with CDBG funds; or (2) who is in a position to participate in a decision -making process or gain inside
information with regard to these activities, may obtain a financial 'interest from a CDBG-assisted or HOME -assisted
activity, or have any interest in any contract, subcontract, or agreement with respect thereto, or the proceeds thereunder,
either for themselves or those with who they have family or business ties, during their tenure or for one (1) year
thereafter.
IF NO CONFLICTS EXIST, COMPLETE THE FOLLOWING:
I certify that no conflict of interest exists between The City of Fort Worth and
(Name of Organization)
I certify that no conflict of interest exists between the subcontractors of and
(Name of
IF THERE IS A CONFLICT, COMPLETE THE FOLLOWING:
I certify that a conflict of interest does exist between The City of Fort Worth and
(Name of Organization)
I certify that a conflict of interest does exist between
(Name of subcontractor)
(Name of Organization)
Describe the nature of the
Signature of
and
ind'vtdual, employment, and the conflict or potential conflict [their affiliation with your
r
Steve Dutton, Executive Director
Typed Name and Title
FT. VIIQRTH,
CITY OF FORT WORTH
HOUSING DEPARTMENT
CONTRACT MANAGEMENT DIVISION
REQUEST FOR FUNDS
AGENCY: Tarrant County Samaritan House
ADDRESS: 929 Hemphill
Fort Worth, TX 76104
SECTION I (AGENCY)
I. Reimbursement Request
1. Expenditures:
2, Income
A. Program Income
B. City of Fort Worth
C. Interest Earned CDBG Funds
3. Reimbursement (1 minus 2)
II. Advance Pay Requests/Repayment
III. Reporting Interest
1. Interest over $25 per quarter returned to City of Fort Worth
SECTION II (CITY)
I. BYSPEED - Purchasing Request
A. BYSPEED INPUT: Vendor/PO Number/Requisition Number:
B. Fund/Account/Center:
C. Total Amount of this Request:
SECTION III
I. Verification
A. Contract Compliance Specialist
B. BYSPEED -Purchasing
C. Accounting
II. Authorization
A. Agency
B. Sr. Contract Compliance
C. Housing Director
Charletra Hurt
(Name)
(Name)
(Name)
Steve Dutton
(Name)
Marilyn Jackson
(Name)
J. Walker
PROGRAM:
Attachment I
Samaritan House
CONTRACT NUMBER:
CONTRACT AMOUNT: $262,21 1
CONTRACT DATE: 6/1 /2008
DATE OF REQUEST:
CURRENT MONTH CUMULATIVE
$ $
$ $
$ $
$ $
$ $
G R76/539120/005206298030
$
(Signature) (Date)
(Signature) (Date)
(Signature) (Date)
(Signature) (Date)
(Signature)
(Name)
(Signature) _....'".'
"� SECRE7ARl(
Note: Any Request for Funds that exceed $8500 must be signed by both Marilyn Jackson and Jerome Walk�r lj
j u k UVt4 ujj- I A
(Date)
(Date)
CITY OF FORT WORTH
ATTACHMENT II
HOUSING DEPARTMENT
CONTRACT MANAGEMENT DIVISION
DETAIL STATEMENT OF COSTS
Tarrant County Samaritan Housing
AGENCY
Supportive Services
PROGRAM
CONTRACT NO.
REPORT PERIOD
TO
DATE
6/1 /2008
COST CATEGORY
ACCOUNT
PROGRAM
BUDGET
MONTHLY
EXPENDITURES
CUMULATIVE
TO DATE
BALANCE
ADMINISTRATIVE EXPENSES
Salaries
516 010
$13,000,00
FICA
518 010
$994,00
Life Insurance
518 050
$104.00
Health Insurance
518 060
$2,935.00
Unemployment
518090
$600,00
Legal and Accounting
Office Supplies
Postage
Worker's Compensation
538050
521010
521020
535 010
$200000
$200,00
ADMINISTRATIVE EXPENSES SUB -TOTAL $18,033,00
ADMINISTRATIVE EXPENSES PERCENT OF TOTAL COST = 6.9 %
SUPPORT SERVICES
Salaries
516 010
$191,000600
FICA
518 010
$14,612.00
Life Insurance
518 050
$896,00
Health Insurance
518 060
$13,170,00
Disability Insurance
508070
Unemployment - State
Worker's Compensation
Retirement
535 020
535 010
535 030
$21400.00
$1,800.00
Office Supplies
537 010
$1,300.00
Postage
Audit
539 220
536 010
$6,000.00
Lease
538 210
Office Equipment Rental
Printing
Fidelity Bond
Liability Insurance
Private Auto Allowance
538 050
532130
534020
532130
539120
$4,250,00
$2,000,00
$5,550.00
$11200.00
Conferences & Seminars
539120
Rent/Mortgage/Utilities AssistancE
539120
Total Support Services
$244,178.00
TOTAL
$262,21 1,00
Contractors Certification: I certify that the costs incurred are taken from the books of account and that such costs are valid and consistent with the terms of the
agreement.
OFFICIAL RECORD
NAME and TITLE OF AUTHORIZED OFFICER D%r KV SECRETARY
F d WORTH, TX
ATTACHMENT III
Tarrant CounSamar Lan Housing
Agency
Supportive Services
Program
CITY OF FORT WORTH
HOUSING DEPARTMENT
CONTRACT MANAGEMENT DIVISION
EXPENDITURES WORKSHEET
Contract Number Date
TO
REPORT PERIOD
NO
DATE
CHECK
NO.
PAYEE
DESCRIPTION
ACCOUNT NO,
AMOUNT
1
2
3
4
5
6
7
8
9
10
I1
12
13
14
15
16
17
18
19
20
21
22
23
24
26
TOTAL
TITLE OF AUTHORIZED OFFICER
SIGNATURE and DA
D�=�9'�pA� RECORD
CITY SECRETARY
FT: WORTH, TX
3
Attachment IVA
CITY OF FORT WORTH
HOUSING DEPARTMENT
HOPWA
1. Name and Address of Subgrantee: 2. Project Name:
Supportive Services
Tarrant County Samaritan House
3. Contract Number:
929 Hemphill
4. Contract Date:
June 1 2008- May 31, 2009
Fort Worth, TX 76104
5. Date of Request:
Month &Year
# Assisted
HOPWA
With Other
Amount of
CURRENT
Cumulative
Funds
Other Funds
Number of Unduplicated Clients (New Households Only)
Provide Tenant -Based Rental Assistance Payments
Provide Short -Term Rental, Mortgage and Utility Assistance
# ASSISTED
AMOUNT
HOPWA
AMOUNT OF
W/ OTHER
OF OTHER
CURRENT
HOPWA FUNDS
FUNDS
FUNDS
7, Resource Idendification/Technical Assistance
8. Housing Information Services
9. Permanent Housing Placement Services
10. Monthly Income Groups of Households
$0 $1-250 $251-500 $501-1000 $1001-1500 $1501-2000 Over$2000
11. Tenant Based Rent
12.
SRO
1 Bedroom
2 Bedroom
3 Bedroom
4 Bedroom
5 +
Current Month
Cumulative
o - erm, en ,
Mortgage, Utilities
SRO
1 Bedroom
2 Bedroom
3 Bedroom
4 Bedroom
5 +
Current Month
Cumulative
13, CERTIFICATION: The undersigned hereby gives assurance that to the best of my knowledge and belief, the
included in this report is true and accurate, and if anon -profit agency, has been approved by the governing body
of the organization prior to submission.
DATE: Submitted by: Phone Number:
- M93
Name and Address of Sub-G
Tarrant County Samaritan House
929 Hemphill
Weatherford. Texas 76104
Services
Current Month (New Individuals)
Cumulative
Current Month
Cumulative
Beneficiary Data
CITY OF FORT WORTH
CONTRACT MANAGEMENT DIVISION
HOPWA YEAR 2008-2009
Black
White African/American
2. Project Name Supportive Services
3. Contract No.
4. Date of Request
Month &Year
Asian
Attachment IVB
Indian/Alaskan Native Hawaiian/Other Indian/Alaskan
Native Pacific Islander Native and White
American
Indian/Alaskan
Black/African Native & Black Other Multi -
Asian and White American&White African American Racial
Total
um er o persons u s an
Children with HIV/AIDS who
received Housing Assistance
Number of Other Persons in Famil
unit who received Housing
Assistance
Households Previously Homeless
Of Previously Homeless
Households, list those who were
Chronically Homeless
Female Head of
Household
Current Month
Cumulative
Female ICKH IVlale I[i t(H
Aae Participants Participants
17 and Under
18 to 30 Years
31 to 50 Years
51 Years and
Older
Total
Cerrrfication: The undersigned hereby gives assurance that to the
best of my knowledge
and belief, the data included
in this report is
(rue and accurate, and
if anon -profit ag
by the governing body of the organization prior to submission.
Date:
Submitted by:
®��iDIA�. �?ECORD
Phon NGITY SEGRETARN'
has been approved
Step 1: Ethnicity -Report whether client idenrrfies themselves as Hispanic or Non -Hispanic 2: Race -Identify the category chosen by the clientt
CITY OF FORT WORTH
CONTRACT MANAGEMENT DIVISION
HOPWA YEAR 2008-2009
1. Name and Address of Su
(Tarrant County Samaritan House
1929 Hemphill
(Fort Worth. TX 76104
ntee
Month &Year
la. Outreach
Ib. Case
Ic. Life
Id. Nutritional SeivicesJMeals
le. Adult Dav Care and Personal Assistance
If. Child Care and other Cluldren's Services
Education
Assistance
li. Alcohol and Dice Abuse Services
Mental Health Services
HealthMledical/Intensive Care Services
Other
Other
lo. Number of Jobs that resulted from g. and h.
Receiving
Supportive Services
Receiving
W/ Housing
Supportive Services
Assistance
Only
Persons with HIV/AIDS
Other Persons in Family Unit
2. Project Name
3. Contract No.
4. Date of Request
Certification: The undersigned hereby gives assurance that to the best of my know/edge and belife, the data included in
and if a non-profit agency, have been approved bythe governing bodyof the organization prior to submission.
Date: Submitted by:
Attachment IVE
Supportive Services
OFFICIAL RECORD
r�iTV SECRETi41�Y
TX
Agency/Address
Tarrant County Samaritan House
929 Hemphill
Fort Worth, TX 76104
CITY OF FORT WORTH ATTACHMENT V
HOUSING DEPARTMENT
CONTRACT MANAGEMENT DIVISION
HOPWA YEAR 200&2009
2. Project Name
3. Contract No:
4. Date of Request:
Supportive Services
Contract Date: June 1 2008
Contract Amount: $ 262,211.00
Month &Year
5. PROGRAM SERVICES AND ACTIVITIES: CURRENT CUMULATIVE
6. SCOPE OF WORK NARRATIVE
7. PROBLEMS ENCOUNTERED / SOLUTIONS PROPOSED
8. ANTICIPATED ACTIVITY DURING THE NEXT MONTH
9, Certification: The undersigned hereby gives assurance that to the best of m knowledge and beliefs t'i
C) a
9 Y 9 Y g �6TAL �� F
report is true and accurate, and is a non-profit agency, has been approved by the governing body of the oraq tigg Apr to c�,on.
FM WORTH, T
Date: Submitted By: Phone No.
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Page 1 of 3
City of Fort Worth, Texas
• • • • •
DATE: Tuesday, August 19, 2008
LOG NAME: 050809GRANTACT
REFERENCE NO.: C-22978
SUBJECT:
Authorize Execution of Contracts for Community Development Block Grant Year XXXIV, Emergency
Shelter Grant Year 2008-2009 and Housing Opportunities for Persons with AIDS 2008-2009
Contracts
RECOMMENDATION:
It is recommended that the City Council authorize the City Manager to:
1. Execute contracts for Community Development Block Grant Year XXXIV, Emergency Shelter Grant
Year 2008-2009 and Housing Opportunities for Persons with AIDS Year 2008-2009 with the listed
organizations to administer their respective programs, contingent upon approval and receipt of adequate
funding from the United States Department of Housing and Urban Development, for a term beginning June
1, 2008, and ending May 31, 2009;
2. Extend or renew the contracts for up to one year if an organization requests an extension and such
extension is necessary for completion of the project; and
3. Amend the contract, if necessary, to achieve program goals, provided the amendment is within the
scope of the project and in compliance with all applicable laws and regulations governing the use of federal
grant funds.
Community Development Block Grant (CDBG)
Organization
CJ's Studio of Performing Arts -Performing Arts
CFW-PACSD-Como Kids
Cooks Childrens Hospital -Save a Smile
All Church Home for Children -Buffalo Soldiers
CFW-PACSD-Woodhaven After School Enrichment
Boys and Girls Club-ESTRELLAS
Southside Youth Association-U.N.I.T.Y
YWCA -Child Delopment Program
Child Care Associates
FWHA-AMAKA Child Care Center
Clayton YES -School Aged Child Care
JMAC Youth Center of Tarrant County
Clayton YES-Greenbriar Preshool
Senior Citizen Services -Como Senior Citizens
Meals on Wheels
Senior Citizen Services -Riverside Senior Citizens
CFW-PACSD-Community Action Partners (CAP)
Amount (Not to Exceedl
$10,886.00
$25,000.00
$21, 870.00
$14,580.00
$16,200.00
$14,400.00
$9,000.00
$135,000.00
$117,000.00
$27,000.00
$54,000.00
$25,000.00
$18,000.00
$17,597.00
$33,696.00
$15,271.00
$25,724.00
http://apps. cfwnet.org/council�acket/Reports/mc�rint. asp
8/19/2008
Page 2 of 3
Mental Health Assoc.- Mental Health Advocate
Mental Health Assoc. -Long Term Ombudsman
United Community Centers -Crisis Intervention Program
CFW-PACSD-SHIPP
CFW-PACSD-Utility Assistance Program
Centro Cultural De Las Americas-GED Classes
Northside InterChurch Agency -Good Works
Tarrant Area Food Bank -Community Kitchen
MASS, Inc. -Serving Poor and Incarcerated
Housing Counseling
A -Prep Center of Tarrant County
Reach Inc, -Project Ramp
TOTAL CDBG:
Emergency Shelter Grant LSG)
Organization
YWCA -Supportive Living
Cornerstone Assistance -New Life Center
Presbyterian Night Shelter- Homeless Shelter
SafeHaven of Tarrant County
YWCA -My Own Place
Presbyterian Night Shelter- Elderly and Infirmary
CFW-PACSD-SHIPP
SafeHaven of Tarrant County -Supportive Child Care
Cenikor Foundation -Emergency Shelter
Parents and Children Together, Inc.
TOTAL ESG:
Housing Opportunities for Persons with HIV/AIDS (HOPWA)
Organization
AIDS Outreach Center
Tarrant County Samaritan Housing, Inc.
AIDS Resources of Rural Texas
TOTAL HOPWA:
DISCUSSION:
$22,275.00
$15,750.00
$16,200.00
$37,800.00
$66,759.00
$18, 070.00
$21,092.00
$18,000.00
$27,000.00
$50,000.00
$60,477.00
$21,500.00
$955,147.00
Amount (Not to Exceedl
$13,039.00
$15,297.00
$138,474.00
$20,000.00
$17,628.00
$14,161.00
$15,500.00
$14,997.00
$12,978.00
$16,521.00
$278,595.00
Amount (Not to Exceed)
$460,701.00
$262,211.00
$114,198.00
$837,110.00
On April 8, 2008, the City Council adopted the budgets and the appropriation ordinance increasing
estimated receipts and appropriations for the Year XXXIV (June 1, 2008, to May 31, 2009) Community
Development Block Grant (CDBG) funds, 2008-2009 Emergency Shelter Grant (ESG) funds and 2008-2009
Housing Opportunities for Persons with AIDS (HOPWA) grant funds as part of the City's Consolidated Plan
and Consolidated Action Plan. The Consolidated Plan, as adopted by the City Council, included program
descriptions on each program listed above.
The above programs are consistent with the City's approved funding policies and priorities. Each program
meets the requirements of the Department of Housing and Urban Development (HUD) regulations defining
"eligible activity." These programs provide services City-wide.
http://apps.cfwnet.org/council�acket/Reports/mc�rint.asp 8/19/2008
Page 3 of 3
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that funds will be available in the current operating budget as appropriated, in
the Grants Fund contingent upon approval and receipt of adequate funding from the United States
Department of Housing and Urban Development (HUD) for the term beginning June 1, 2008, and ending
May 31, 2009.
TO Fund/AccountlCenters
Submitted for City Manager's Office bv:
Originating D�artment Head:
Additional Information Contact:
FROM Fund/Account/Centers
GR76 539120 005206274XXX
GR76 539120 005206273XXX
GR76 539120 005206270XXX
Joe Paniagua (6140)
Jerome Walker (7537)
Sherry Johnson (7333)
$837,110.00
$278,595.00
$955,147.00
http://apps.cfwnet.org/coLuicil�acket/Reports/mc�rint.asp 8/19/2008