HomeMy WebLinkAboutContract 37832-A1 (2),z
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TRACT No
AMENDMENT TO CITY SECRETARY
CONTRACT NO.37832
WHEREAS, on October 23, 2008, the City of Fort Worth ("City") and Cook Children's
Healthcare System ("Contractor") made and entered into City Secretary Contract No. 37832 (the
"Contract"),
WHEREAS, the Contract provided funding to Contractor pursuant to a grant received by
City from the United States Department of Housing and Urban Development ("HUD") under
Title 1 of the Housing and Community Development Act of 1974, as amended, (42 USC 5301 et
seq.) for utilization in connection with its Community Development Block Grant ("CDBG"),
Program No. B-08-MC48-0010 for Year XXXIV;
WHEREAS, it is desirable to extend the date certain monthly reports are submitted and
amend the Program Summary and Program Services Schedule to provide more specificity as to
objectives and goals for the Program, including schools served in the Fort Worth Independent
School District; and
WHEREAS, it is the mutual desire of City and Contractor to amend the Contract.
NOW, THEREFORE, City, whose address is 1000 Throckmorton St., Fort Worth TX
76102, acting by and through T.M. Higgins, its duly authorized Assistant City Manager, and
Cook Children's Healthcare System, whose address is 801 Seventh Avenue, Fort Worth, TX
76104 ("Contractor"), acting by and through Linda Chappell, its duly authorized Senior Vice
President of Quality Management, do hereby agree as follows:
I.
4. Reporting Procedzzres
a. Financial Reports
The third sentence of this section is amended to be and read as follows:
"The reports must be signed by a duly authorized agent of Contractor and submitted by
the 20`t' of the month following the month that is reported."
II.
Exhibits A and B attached to the Contract arc hereby replaced with Exhibits A and B
attached hereto.
All other terms and conditions of City Secretary Contract N
remain unaffected and in full force and effect, are binding upon
ratified by the Parties.
CONTRACT AMENDMENT CSC NO. 37832
Cook Children's Health Care System (CDBG) XXXIV 2008-2009
o. 37832 not amended herein
the Parties, and_ are hereby
OFFICIAL RECQRD
GITYS�CRETARY
FT.WORTH, Vge
IN WITNESS WHEREOF, the Parties hereto have executed three duplicate originals of
this Contract Amendment in Fort Worth, Texas, this day of , 2009.
ATTEST:
CITY OF FORT WORTH
By:
City Secreta
APPR VED AS TO FORAND LEGALITY:
// A ////
M,R
G
Assistant City A
i .i
Fi
vi. r-�iggins
rst Assistant City Manager
1
Cook Children's Healt
Linda°.Ch4ppell
Senior Vice President,
re System
ty Management
STATE OF TEXAS §
COUNTY OF TARRANT § o
This instrument was acknowledged before me on l4 , 2009
by T.M. Higgins, the Assistant City Manager of the City of Fort rth, on behalf of the City of
Fort Worth. n /1 2 A • �
MAF11A S. SANCHEZ NO. ARY PUBLIC, STATE F TEXA
NS
OTARY PUBLIC
STATr OF TEXAS
My Comm. Exp, 12.14.2009
STATE OF TEXAS §
COUNTY OF TARRANT §
This instrument was acknowledged before me on / , 2009
by Linda Chappell, Senior Vice President, Quality Manageme t of Cook Children's Healthcare
System, a Texas non-profit corporation, on behalf f said corporation. TEXAS
PUBLIC.) STA
1
1 ��
!I:
CONTRACT AMENDMENT CSC NO. 37832
Cook Children's Health Care System (CDBG) XXXIV 2008-2009
OFFICIALOFFICIALI�ECAR®
CITYSEC
RETARY
FT. WORTH, TX
Page 2
Cook Children's Health Care System
Save a Smile
CONTRACT NO. 37832
Scope of Services
PROGRAM SUMMARY
June 1, 2008 — May 31, 2009
PERIOD
EXHIBIT A
SCOPE OF SERVICES
$21,0/v
AMOUNT
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 herein, this Agreement shall
control. In addition to the activities listed below, the Subrecipient agrees to operate this Community Development Block
Grant program consistent with the program delivery stated in the approved proposal.
CDBG funds will assist with the salaries of case aides and their supervising licensed Master's level social
workers, who facilitate the provision of free dental care, translation services and transportation services to
targeted low-income children, pre --kindergarten through third grade, who would otherwise lack access to
dental care. *CDBG funding will be utilized for initial dental appointments, follow up appointments and
follow up phone calls only, As income verification for these services sample pay
income verification documents and letters from homeless shelters will be obtained.
COUNCIL DISTRICT (S) — 2, 4, 8, 9
PROGRAM OBJECTIVES
Educate 100% of targeted children seen by Save a Smile volunteer dentists in proper oral health, provide 100%
of targeted children with a dental hygiene kit and provide referral to a volunteer provider or Medicaid for
children in need of treatment.
PROGRAM GOALS
To improve the dental health and awareness of proper dental care of children in the following nine FWISD
elementary schools: Diamond Hill, Sam Rosen, Oakhurst, Natha Howell, Hubbard Heights, Dolores Huerta,
M.L. Kirkpatrick, Meadowbrook, M.H. Moore; and the following two Keller ISD schools: North Riverside,
Parkview. Please note* The two Keller ISD schools served are in the Fort Worth city limits. Please see
attached list of schools including addresses.
PROGRAM SERVICES and ACTIVITIES Total Units of Services for Year
Dental Screenings
*Initial Dental Appointments
*Follow -Up Appointments
*Follow -Up Phone Calls
' REG�IVED JAPI 21 200�
4,298
220
315
500
O6��CRETARY
�T: WORTH, TX
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OFFICIAL RECORD
CITYSECRETARY
a lr%TW WORTH, TIC
Diamond Hill (FWISD
2000 Dewey
Ft. Worth, TX 76106
817- 814-0400
Sal Espino- District 2
Oakhurst (FWISD)
2700 Yucca Ave.
Ft. Worth TX 76111
817- 814-9500
Sal Espino- District 2
Natha Howell (FWISD)
1324 Kings Hwy
Ft. Worth, TX 76117
817- 814-9300
Danny Scarth-District 4
Hubbard Heights (FWISD
1333 W. Spurgeon
L. Worth, TX 76115
817- 814-7500
Joel Burns -District 9
Dolores Huerta (FWISD)
3309 Long Ave.
Ft. Worth, TX 76106
817- 740-5550
Sal Espino- District 2
*North Riverside (Keller)
7900 North Riverside
Ft. Worth, Tx 76137
817-744-5300
Danny Scarth- District 4
Sam Rosen IFWISD
2613 Roosevelt
Ft. Worth, TX 76106
817- 814-4800
Sal Espino- District 2
M.L. Kirkpatrick (FWISD)
3229 Lincoln
Ft. Worth, TX 76106
817-8144600
Sal Espino- District 2
*Parkview IKellerl
6900 Bayberry
Fort Worth, Tx 76137
817-744-5500
Danny Scarth- District 4
Meadowbrook (FWISD
4330 Meadowbrook
Ft. Worth, TX 76103
817- 531-6440
Kathleen Hicks- District 8
M.H. Moore IFWISD
1809 N E 36"' St
Ft. Worth, TX 76111
817-815-0600
Sal Espino- District 2
* Please note: Keller ISD schools served are in the Fort Worth city limits.