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HomeMy WebLinkAboutContract 41943 (2)CITY SECRETARY quis _SONTRAC T No, AGREEMENT FOR SERVICES THIS AGREEMENT ("Agreement") is made and entered into by and between THE CITY OF FORT WORTH, a home rule municipal corporation of the State of Texas (hereinafter referred to as "City"), acting by and through Susan Alanis, its duly authorized Assistant City Manager, and SAFEHAVEN, a nonprofit Texas corporation (hereinafter referred to as "Contractor"), acting by and through Ms. Mary Lee Hafley, its duly authorized CEO/President. RECITALS WHEREAS, Contractor provides shelter services; and WHEREAS, such services serve a public purpose in serving low to moderate income individuals which benefits the Fort Worth community; and WHEREAS, City and Contractor desire to enter into a contract to have such services provided which benefit the Fort Worth community. NOW, THEREFORE, in consideration of the mutual covenants herein expressed, the parties agree as follows: AGREEMENT 1. SCOPE OF SERVICES. Contractor covenants and agrees to fully perform, or cause to be performed, with good faith and due diligence, all services and objectives described in Exhibit "A," attached and incorporated herein for all purposes incident to this Agreement ("Services"). 2. COMPENSATION. In consideration of the Services to be performed hereunder by Contractor, City agrees to reimburse Contractor via monthly installments up to a total amount not to exceed Six Thousand Seven Hundred and No/100 ($6,700.00) ("Funds"). Any funds not requested as provided in Section 3 shall remain with the City. I OFFICIAL RECORD ©11T"Y SECRETARY IFt WORTH, TX • 3. REPORTING OF EXPENDITURES. a. Contractor shall deliver to City a monthly statement of the request for reimbursement ("Request for Reimbursement") of Funds detailing how the Funds were expended by Contractor to accomplish performance of the Services. All expenditures included in the Request for Reimbursement must be eligible for reimbursement by federal funds as determined by City in its sole discretion. The monthly statement shall be in the same format as the attached Exhibit "B" which is incorporated herein for all purposes. b. Each month's Request for Reimbursement is due to City by 5 00 p.m. on the 10t1' day of the following month (for example all expenses for June must be submitted to City by July lOth). City will not accept late Requests for Reimbursement. If a timely Request for Reimbursement is not received for any month, Conti actor will not receive reimbursement for that month. Notwithstanding the above, the Request for Reimbursement for the month of September shall be due by September 23 2011 The failure to make such request by September 23, 2011 shall result in no funds being paid for the month of September. c. Each Request for Reimbursement must be prepared and signed by an authorized representative of the Contractor. d. If the Contractor deviates from the reporting requirements in Sections 3(a), 3(c) or Section 4, the Contractor will be considered in non-compliance with this Agreement. City will notify Contractor of such non-compliance, and Contractor will have ten (10) business days to cure such non compliance (the "Cure Period"). If the noncompliance is not cured by the expiration of the Cure Period to City's satisfaction, Contractor will be in default of this Agreement and will not receive reimbursement. e. Any non-compliance by Contractor under Section 3 of this Agreement may jeopardize the Contractor's ability to receive future finding from the City. 4. REPORTING OF SERVICES. A report of services shall accompany each Request for Reimbursement. The report of services shall be in substantial conformity with the attached Exhibit "C" and Exhibit "C-1" and Exhibit ` C-2", if applicable. Contractoi shall be subject to a review by the City of its services and activities in performance of this Agreement. 5. TERM AND TERMINATION. a. This Agreement shall be for a term beginning June 1, 2011 and ending September 30, 2011. b. Either party may cancel this Agreement upon thirty (30) days notice in writing to the other party of such intent to terminate. 2 c. The City may terminate this Agreement immediately for any violation by Contractor of Section 3, "Request for Reimbursement" or Section 4, "Reporting of Services," above. d. In the event no funds or insufficient funds are appropriated by the City in any fiscal period for any payments hereunder, City will notify the Contractor of such occurrence and this Agreement shall terminate on the last day of the fiscal pei iod for which appropriations were received without penalty or expense to City of any kind whatsoever except as to the portions of the payments herein agreed upon for which funds shall have been appropriated. 6. RIGHT TO MONITOR SERVICES. Contractor covenants and agrees to fully cooperate with City in monitoring the effectiveness of the Services to be performed under this Agreement, and City shall have access at all reasonable hours to offices and records of Contractor for the purpose of such monitoring during the term of this agreement. 7. INDEPENDENT CONTRACTOR. 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 Services performed hereunder and all persons performing same, and shall be solely responsible for the acts and omissions of its officers, agents, servants, employees subcontractors and program participants. The doctrine of respondeat superior shall not apply as between the City and Contractor, its officers, agents, servants, employees subcontractors, or program participants, 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, agent, employee, or subcontractor of Contractor is in the paid service of City. 8. LIABILITY AND INDEMNIFICATION. CITY SHALL IN NO WAY OR UNDER ANY CIRCUMSTANCES BE RESPONSIBLE FOR ANY PROPERTY BELONGING TO CONTRACTOR, ITS OFFICERS, AGENTS, EMPLOYEES, SUBCONTRACTORS, PROGRAM PARTICIPANTS, OR RECIPIENTS, WHICH MAY BE LOST, STOLEN, DESTROYED, OR IN ANY WAY DAMAGED. CONTRACTOR HEREBY AGREES TO INDEMNIFY AND HOLD HARMLESS THE CITY, ITS OFFICERS, AGENTS, AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS CONCERNING SUCH PROPERTY. CONTRACTOR COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND, AT ITS OWN EXPENSE, CITY AND ITS OFFICERS, AGENTS, SERVANTS, AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR NONPERFORMANCE OF THIS AGREEMENT AND/OR THE 3 OPERATIONS, ACTIVITIES AND SERVICES 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 AGREEMENT AND/OR THE OPERATIONS, ACTIVITIES AND SERVICES 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, PROGRAM PARTICIPANTS, OR RECEIPIENTS, WHETHER OR NOT 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 AGREEMENT, EVEN IF THE INJURY, DEATH, DAMAGE OR LOSS IS CAUSED BY CITY'S SOLE OR CONCURRENT NEGLIGENCE. Contractor shall require all of its subcontractors and Recipients to include in their subcontracts a release and indemnity in favor of City in substantially the same form as above. 9. MISAPPRORIATION OF FUNDS. IN THE EVENT IT IS DETERMINED THAT CONTRACTOR HAS MISUSED, MISAPPLIED OR MISAPPROPRIATED ALL OR ANY PART OF THE FUNDS PROVIDED HEREUNDER, CONTRACTOR AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND THE CITY OF FORT WORTH, ITS OFFICERS, AGENTS, SERVANTS, AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS RESULTING FROM SUCH MISUSE, MISAPPLICATION OR MISAPPROPRIATION. 4 10. CHARITABLE IMMUNITY. If Contractor, as a charitable or nonprofit organization has or claims an immunity or exemption (statutory or otherwise) from and against liability for damage or injury, including death to persons or property, Contractor hereby expressly waives its rights to plead defensively such immunity or exemption as against the City. 11. ASSIGNMENT AND SUBCONTRACTING. Contractor shall not assign or subcontract all or any part of its rights, privileges or duties under this Agreement without the prior written consent of City, and any attempted assignment or subcontract of same without such prior written approval shall be void and constitute a breach of this agreement. 12. COMPLIANCE WITH LAWS, ORDINANCES, RULES AND REGULATIONS. Contractor, its officers, agents, employees and subcontractors, shall abide by and comply with all laws, federal, state and local, including all ordinances, rules and regulations of City. It is agreed and understood that, if City calls to the attention of Contractor any such violation on the part of Contractor or any of its officers, agents employees or subcontractors, then Contractor shall immediately desist from and correct such violation. 13. NON-DISCRIMATION COVENANT. Contractor, in the execution, performance or attempted performance of this contract and Agreement, will not discriminate against any person or persons because of disability, age familial status, sex, race, religion, color, national origin, gender identity, gender expression or transgender nor will Contractor permit its officers, agents, employees, or subcontractors to engage in such discrimination. This Agreement is made and entered into with reference specifically to Chapter 17, Article III, Division 3, of the City Code of the City of Fort Worth ( Discrimination in Employment Practices"), and Contractoi hereby covenants and agrees that Contractor, its agents, employees and subcontractors have fully complied with all provisions of same and that no employee or employee -applicant has been discriminated against by either Contractor, its agents, employees or subcontractors. 14. INSURANCE. Contractor shall procure and shall maintain during the term of this Agreement the following insurance coverage: 1. Commercial General Liability (CGL): $1,000,000 per occurrence, with a $2,000,000.00 annual aggregate limit, in a form that is acceptable to the City's Risk Manager. 2. 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. 5 Contractor's insurer(s) must be authorized to do business in the State of Texas for the lines of insurance coverage provided and be currently rated in terms of financial strength and solvency to the satisfaction of the City's Risk Manager. Each insurance policy required herein shall be endorsed with a waiver of subrogation in favor of the City. Each insurance policy required by this Agieement, 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 i evise insurance coverage requirements under this Agreement. Contractor further agrees that it shall comply with the Worker's Compensation Act of Texas and shall provide sufficient compensation insui ance to protect Contractor and City from and against any and all Worker's Compensation claims arising from the work and services provided under this Agreement. 15. RIGHT TO AUDIT RECORDS. Contractor agrees that the City shall, until the expiration of three (3) years after final payment under this Agreement, have access to and the right to examine, whether in hard copy or electronic format, any directly pertinent books, documents papers and records of the Contractor involving transactions relating to this Agreement. Contractor agrees that the City shall have access during normal working hours to all necessary Contractor facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. The City shall give Contractor reasonable advance notice of intended audits. Contractor further agrees to include in all of its subcontractor and Recipient agreements hereunder a provision to the effect that the subcontractor and/or the Recipient agrees that the City shall, until the expiration of three (3) years after final payment under the subcontract or this Agreement, have access to and the right to examine, whether in hard copy or electronic format, any directly pertinent books, documents, papers and records of such subcontractor involving transactions to the subcontract or this Agreement, and further that City shall have access during normal working hours to all subcontractor or Recipient facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this paragraph City shall give subcontractor or Recipient reasonable advance notice of intended audits. This Section 16 shall survive the expiration of the term of this Agreement 16. GOVERNING LAW AND VENUE. This Agreement shall be governed by and construed under the laws of the state of Texas. Should any action, whether real or asserted, at law or in equity arise out of the execution performance, attempted performance of this Agreement, venue for said action shall Ile in Tarrant County, Texas. 6 17. NOTICES. Notices to be provided hereunder shall be sufficient if forwarded to the other party by hand -delivery or via U.S. Postal Service certified mail, postage prepaid to the address of the other party shown below: Jesus"Jay" Chapa Director of Economic Development City of Fort Worth 1000 Throckmorton St. Fort Worth, Texas 76102 18. NO WAIVER. Ms. Mary Lee Hafley CEO/President Safehaven 6815 Manhattan Blvd., Suite 105 Fort Worth, TX 76120 The failure of City or Contractor 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 or Contractor's right to assert or rely upon any such term or right on any future occasion. 19. DISCLOSURE OF CONFLICTS AND CONFIDENTIAL INFORMATION. Contractor hereby warrants to the City that Contractor has made full disclosure in writing of any existing or potential conflicts of interest related to Contractor's services under this Agreement. In the event that any conflicts of interest arise after the Effective Date of this Agreement, Contractor hereby agrees immediately to make full disclosure to the City in writing Contractor, for itself and its officers, agents and employees, further agrees that it shall treat all information provided to it by the City as confidential and shall not disclose any such information to a third party without the prior written approval of the City. Contractor shall store and maintain City Information in a secure manner and shall not allow unauthorized users to access, modify, delete or otherwise corrupt City Information in any way. Contractor shall notify the City immediately if the security or integrity of any City information has been compromised or is believed to have been compromised. 20. SEVERABILITY. If any provision of this Agreement is held to be invalid, illegal or unenforceable, the validity legality and enforceability of the remaining provisions shall not in any way be affected or impaired. 21. FORCE MAJEURE. The City and Contractor shall exercise their best efforts to meet their respective duties and obligations as set foith in this Agreement, but shall not be held liable for any delay or omission in performance due to force majeure or other causes beyond their reasonable control (force majeure), including but not limited to, compliance with any government law, ordinance or regulation, acts of God, acts of the public enemy, fires, strikes, lockouts, natural disasters, 7 wars, riots, material or labor restrictions by any governmental authority, transportation problems and/or any other similar causes. 22. HEADINGS NOT CONTROLLING. Headings and titles used in this Agreement are for reference purposes only and shall not be deemed a part of this Agreement 23. ENTIRETY OF AGREEMENT. This written instrument constitutes the entire agreement by the parties hereto concerning the work and services to be performed her eunder, and any prior or contemporaneous, oral or written agreement, which purports to vary from the terms hereof shall be void. [SIGNATURES APPEAR ON FOLLOWING PAGE.] 8 IN WITNESS WHEREOF, the parties hereto have executed this agreement in multiples in Fort Worth, Tarrant County, Texas, to be effective June 1, 2011. ATTE At e; k(127,B 47 dents of nti9 /kg? y. rty/l4endrix ( % 4► a o it Secretar rind ano y y pl CITY OF FORT WORTH Date: L1Iay/�j � o%)10- 0.0 APPROVED AS TO FORM A�/ AUTHORIZATION: ceftim/v( tfr Leann D. Guzman Assistant City Attorney Date: ATTEST Name: Title: °ao� S'usa� Alanis a� 00 Assistant City Manager C9( 11- t G ate: Y: CONTRACT M&C: C-24905 Date Approved: 05/17/2011 Safehaven: By: 6717 Name: Ms. a y Lee Halley Title: CEO/President Date: 6///u 9 STATE OF TEXAS COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Ms. Mary Lee Hafley, known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that the same was the act of the Safehaven and that she executed the same as the act of said Safehaven for the purpose and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this f day of 2011. t‘g., ` ;f;j 01 i tt • y-' t.+tf a1�,,•`del'0. • I •_ STATE OF TEXAS MARILYN J. MEADOR Notary Public, State of Texas My Commission Expires September 23, 2014 COUNTY OF TARRANT § 16 d&ry1/4blic in .= d for t e State of Texas t BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Susan Alanis, known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that the same was the act of the City of Fort Worth for the purpose and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this d‘11 day of :1 U'1-c , 2011. tea. o ary Public in and for the SG�t e of Texas iMisraW IJNDA M. MALINGER MY COMMISSION EXPIRES February 2, 2014 if OFFICIAL RECORD CITY SECRETARY � FT. WORTH, TX 10 EXHIBIT A SERVICES 11 SafeHaven of Tarrant County EXHIBIT A Shelter Operations SCOPE OF SERVICES PROGRAM SUMMARY EMERGENCY SHELTER GRANT (ESG) June 1, 2011 — September 20, 2011 PERIOD SCOPE OF SERVICES This Scope of Services is based on the proposal prepared and submitted by the Subrecipient through the City of Fort Worth's annual Request for Proposal (RFP) process. The Subrecipient agrees to operate this Emergency Shelter Grant (ESG) program in a manner consistent with the program delivery stated in the approved proposal. However, in the event of any conflict between the proposal and any provision contained, herein, this Agreement shall control. The SafeHaven of Tarrant County will provide ESG services to homeless persons or persons at risk of homelessness at the Fort Worth Shelter location (address is confidential and available upon request). The Shelter Operations program will include the following tasks and activities; provide emergency shelter, answer hotline calls, provide meals, offer support groups, children's recreation, access to an on -site school, and case management. All services will be provided at the Fort Worth Shelter location (address is confidential and available upon request) from Monday through Sunday, the emergency shelter operation is 24 hours a day, 7 days a week, 365 days a year. The purpose of the program will be to provide emergency shelter to victims of domestic violence and their minor children In addition reduce family violence through services that support victims and their families and prevent abuse through intervention and education. The specific objectives, goals and level of services to be provided are listed below along with the geographical location of clients served. All services will be provided from June 1, 2011 to September 30, 2011. The funds will be used to pay for food electric, gas, and water/waste disposal which is consistent with Exhibit B Detailed Statement of Costs. Match dollars will be spent on supplies and shelter operation expenses (electric, gas, water/waste disposal.) REGULATORY CLASSIFICATION: Regulatory Citation & Activity Allocated Funds "A) of Total Allocation 24 CFR 576.3; 576.21(a)(2) Essential Services 24 CFR 576.3; 576.21(a)(3) Operational Costs 24 CFR 576.3; 576.21(a)(4) Homeless Prevention Based on the nature of the service provided, Subrecipient, SafeHaven of Tarrant County will maintain documentation that verifies that 100% clients served are homeless; or for prevention activities, documentation that verifies clients served by the homeless prevention program are at risk of homelessness through eviction notices or notices of termination of utility services. Eviction/disconnection notices must be supported by documentation verifying (I) the inability of the family to make the required payments is due to a sudden reduction in income, (2) the assistance is necessary to avoid the eviction or termination of services; (3) there is a reasonable prospect that the family will be able to resume payments within a reasonable period of time; and (4) the assistance will not supplant funding for preexisting homelessness prevention activities from other sources. GEOGRAPHICAL LOCATION: Site Address: The physical address is confidential and is available upon request. Client Beneficiary Location (Neighborhood, District, Citywide...): City of Fort Worth PROGRAM GOALS: Provide emergency shelter to victims of domestic violence and their minor children. In addition, reduce family violence through services that support victims and their families and prevent abuse through intervention and education PROGRAM OBJECTIVES: Provide emergency shelter to 1,400 unduplicated women and children. PROGRAM SERVICES and ACTIVITIES Total Unduplicated Clients Served 475 Hotline calls 20 900 Meal service (annually @ 3 meals a day) , 2 3, 275 1 45 Support group — youth (duplicated) 1 9 5 Support group — adults (duplicated) Children's recreation 260 On -site school 40 3 .4 9 0 Case management units Level of service should be identified in a quantifiable unit and directly related to specified objectives. EXHIBIT B FORM OF REQUEST FOR REIMBURSEMENT [ATTACHED] 12 CITY OF FORT WORTH HOUSING AND ECONOMIC DEVELOPMENT DEPARTMENT COMPLIANCE DIVISION REQUEST FOR FUNDS AGENCY: ADDRESS: PROGRAM: CONTRACT NUMBER: CONTRACT AMOUNT: CONTRACT DATE: DATE OF REQUEST: IDIS NUMBER: SECTION I (AGENCY) CURRENT MONTH CUMULATIVE 1. Reimbursement Request A. Expenditures: $ $ B. Reimbursement $ $ 2. Requested By: A. Agency (Name) (Signature) (Date) SECTION II (CITY) 1. BUYSPEED - Purchasing Request A. BUYSPEED INPUT: Vendor/PO Number/Requisition Number: B. Fund/Account/Center: C. Total Amount of this Request: $ SECTION III (CITY) 1. Verification A. Contract Compliance Specialist B. Accounting 2. Authorization A. Grants Manager B. Sr. Admin. Services Mgr C. Director Mark Folden (Name) (Signature) (Date) Benedict George (Name) Robin Bentley (Signature) (Date) (Name) (Signature) (Date) Socorro Gray (Name) (Signature) (Date) Jesus Chapa (Name) Note: Any Request for Funds that exceeds $25,000 requires the Director's signature (Signature) (Date) CITY OF FORT WORTH HOUSING AND ECONOMIC DEVELOPMENT DEPARTMENT DETAIL STATEMENT OF COSTS AGENCY PROGRAM CONTRACT NO. TO DATE REPORT PERIOD COST CATEGORY PROGRAM BUDGET BALANCE MONTHLY CUMULATIVE TO DATE EXPENDITURES ADMINISTRATIVE COSTS Salaries FICA Life Insurance Health Insurance Unemployment Tax Worker's Comp Legal and Accounting Office Supplies PROGRAMMATIC COSTS Salaries FICA Insurance Life Health Insurance Unemployment — Federal Unemployment — State Workers Compensation Medical Supplies Security Utilities (Telephone, Water, Wastewater, Gas, Disposal) 4,857.00 Electric, Waste Rent Office Equipment Rental Printing Accounting Postage Building Maintenance and Repa. Office Supplies Food 1,843.00 Other Operating Supplies Liability Insurance Private Auto Allowance Childcare Scholarships Meals Teaching Aids Contractual Services Contract Labor Conferences and Seminars Short Term Rent, Mortgage Assistance (STRMU) and Utility Tenant Based Rental Assistance (TBRA) TOTAL $0.00 $0.00 $0.00 $0.00 Contractor's 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. NAME and TITLE OF AUTHORIZED OFFICER SIGNATURE and DATE CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT EXPENDITURES WORKSHEET Agency Program 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 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 TOTAL $0.00 TITLE OF AUTHORIZED OFFICER SIGNATURE AND DATE EXHIBIT C FORM OF SERVICES REPORT 16 CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 1. Name and Address of Sub -Grantee 2. Program Name 5. Program Services and Activities Number of New Households and/or Persons Served Current Month Month & Year Cumulative 6. Direct Benefit (Continued) Current Month Cumulative Extremely Low Very Low Income Income (0<30%) (31-50%) Low Income (51-80%) Above Low Income (80%>) Household Size 1 2 3 4 5 6 7 8 0-30% $13,850 $15,850 $17,800 $19,800 $21,400 $22, 950 $24, 550 $26,150 31-50% $23,100 $26, 400 $29,700 $33, 000 $35,650 $38, 300 $40, 900 $43,550 51-80% $36,950 $42,250 $47, 500 $52,800 $57,000 $61,250 $65,450 $69, 700 Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Date: Submitted by: Phone No. Signature Required 17 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name Month & Year 8. Direct Benefit Data (New Household and /or Persons Served) Race: Section Must tth itv• Section Must be .Corfipl`eted) be Completed) Current Month Cumulative , Hlspan�c Cumulative r-% Non mcy a Gurrent w.� Morith „ Non li�spanic . Cumulative_r H�spa Current White Black/AfricanAmerican Asian American indian/Alaskan Native Native Hawaiian/Other Pacific Islander Indian/Alaskan Native & White Asian & White Black/African American&White American Indian/Alaskan Native & Black African American Other Multi -Racial 0 0 0 0 0 0 TOTAL Female Head of Household Current Month Cumulative Certification: The undersigned, hereby gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Submitted by: Signature Required Date: 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 5. PROGRAM SERVICES AND ACTIVITIES - Unduplicated Clients CURRENT CUMULATIVE Mir 6. SCOPE OF WORK NARRATIVE• 7. PROBLEMS ENCOUNTERED / SOLUTIONS PROPOSED 8. ANTICIPATED ACTIVITY DURING THE NEXT MONTH Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Date: Submitted By: Phone No. Signature Required 19 CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT CLIENT DATA REPORT 1. Name and Address of Sub -Grantee 2. Program Name Month & Year Name Age Sex Ethnicity Race Disabled # Fam Income FHOH Street Address Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Date: Submitted by: Phone Number: EXHIBIT C-1 ADDITIONAL FORM OF SERVICES REPORT - ESG AGENCIES 1. Name and Address of Sub -Grantee Beneficiary by Housing Tvoe CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 3. Contract Number 4. Date of Request EMERGENCY OR TRANSITIONAL SHELTERS Date and Year Current Month Cumulative Chronically Homeless (Emergency Shelter only) Severely Mentally III Chronic Substance Abuse Other Disability Veterans Persons with HIV/AIDS Victims of Domestic Violence Elderly TOTAL 0 0 Beneficiary by Housing Type: Number served in Emergency or Transitional Shelters SHELTER TYPE Current Month Cumulative Barracks Group/Large House Scattered Site Apartment Single Family Detached House Single Room Occupancy Mobile Home/Trailer Hotel/Motel Other TOTAL 0 0 ESG Funding Sources : Funding Amount Current Month Cumulative Total ESG Other Federal Local Government Private Fees Other Total Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying offici Date: Submitted by: Phone No, Signature Required 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 3. Contract Number 4. Date of Request Date and Year EMERGENCY OR TRANSITIONAL SHELTERS N UMBER OF INDIVIDUAL HIOUSEHOLDS (SINGLES: U naccompanied 18 and over Male U naccompanied under 18 Male Current Month Cumulative Female Female N UMBER OF FAMILY HOUSEHOLDS WITH CHILDREN HEADED BY: Current Month Cumulative Single 18 and over Single under 18 Male I Female Male Female N UMBER OF FAMILY HOUSEHOLDS WITH NO CHILDREN: TOTAL Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying offici Date: Submitted by: Phone No, Signature Required EXHIBIT C-2 ADDITIONAL FORM OF SERVICES REPORT - IIOPWA AGENCIES 24 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 3. Contract Number 4. Date of Request Date and Year 5. Program Services and Activities (Report Clients, Not Payments HOPWA CURRENT MONTH ONLY Cumulative # Assisted With Other Funds Amount of Other Funds a.# of Tenant -Based Rental Assistance (TBRA) b.# of Short -Term Rental, Mortgage and Utility Assistance (STRMU) c.# of STRMU clients that have to TBRA moved d.Total # of Unduplicated Clients (a+b)-c Number of Households HOPWA CURRENT MONTH ONLY CUMULATIVE AMOUNT OF HOPWA FUNDS # ASSISTED W/ OTHER FUNDS AMOUNT OF OTHER FUNDS 6. Supportive Services 7. Resource Identification/Technical Assistance 8. Housing Information Services 9. Permanent Housing Placement Services 10. Monthly Income Groups of Households for all Unduplicated Clients , Tenant Assistance (TBRAj,r Based Rental $0-250 $251- 500 $501-1000 $1001-1500 $1501-2000 Over $2000 TOTAL Current Month 0 Cumulative 0 Short, -Term, Rent, Mortgge,%Utility Assf "(STFt ) $0-250 $251- 500 $501-1000 $1001-1500 $1501-2000 Over $2000 TOTAL Current Month 0 Cumulative 0 $0-250 $251- 500 $501-1000 $1001-1500 $1501-2000 Over $2000 TOTAL Current Month 0 Cumulative 0 Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. DATE: Submitted by: Signature Required Phone Number: 25 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 3. Contract Number 4. Date of Request Date and Year Tenant Based Rental Assistance-(TBRA) Race: Section Must be Completed) White Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander Indian/Alaskan Native & White Asian & White Black/African American&White American Indian/Alaskan Native & Black African American Other Multi -Racial TOTAL Current Month Cumulative 0 m t 0 mulatti 0 Unduplicated Beneficiary Data Total Number of persons Children with HIV/AIDS received Housing Assistance (Adults and who Number of Other Persons in Family unit who received Housing Assistance Households Previously Homeless Of Previously Homeless Households, number of those who were Chronically Homeless This data relates to participants Current Month Cumulative Female Head of Household Current Month Unduplicated Aae Female TBRA Participants Male TBRA Participants 17 and Under 18 to 30 Years 31 to 50 Years 51 Years and Older Total Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Date: Submitted by: Phone No. Signature Required 26 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 3. Contract Number 4. Date of Request Date and Year Short Term Rent, Mortgage, and Utility Assistance (STRMU) Race: Section Must be Completed) White Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander Indian/Alaskan Native & White Asian & White Black/African American&White American Indian/Alaskan Native & Black African American Other Multi -Racial TOTAL Current Month Cumulative 0 nicitv:'(Sec 0 0 0 Unduplicated Beneficiary Data Total Number of persons Children with HIV/AIDS received Housing Assistance (Adults and who Number of Other Persons in Family unit who received Housing Assistance Households Previously Homeless Of Previously Homeless Households, number of those who were Chronically Homeless This data relates to participants Current Month Cumulative Female Head of Household Current Month Unduplicated A Female TBRA Participants Male TBRA Participants 17 and Under 18to30 Years 31 to 50 Years 51 Years and Older Total Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Date: Submitted by: Phone No. Signature Required 27 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 3. Contract Number 4. Date of Request Date and Year S upportive Services Race: Section Must be Completed) Black/African American Asian American Indian/Alaskan Native N ative Hawaiian/Other Pacific Islander Indian/Alaskan Native & White Asian & White Black/African American&White American Indian/Alaskan Native & Black African American Other Multi -Racial TOTAL Current Month Cumulative 0 0 malat)ver U nduplicated Beneficiary Data Total Number of persons Children with HIV/AIDS received Housing Assistance (Adults and who Number of Other unit who received Assistance Persons in Family Housing Households Previously Homeless of those who Of Previously Homeless Households, number were Chronically Homeless This data relates to participants Current Month Cumulative Female Head of Household Current Month Unduplicated A Female TBRA Participants Male TBRA Participants 17 and Under 18 to 30 Years 31to50 Years 51 Years and Older Total Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Date: Submitted by: Phone No. Signature Required 28 1. Name and Address of Sub -Grantee CITY OF FORT WORTH HOUSING & ECONOMIC DEVELOPMENT DEPARTMENT 2. Program Name 3. Contract Number 4. Date of Request Date and Year **All data reported should be unduplicated for the current month a. Outreach b. Case Management c. Life Management d. Nutritional Services/Meals e . Adult Day Care and Personal Assistance f. Child Care and other Children's Services g. Education h Employment Assistance i. Alcohol and Drug Abuse Services j. Mental Health Services k. Health/Medical/Intensive Care Services I. Transportation m. Other (specify) n . Other (specify) o . Number of Jobs that resulted from g. and h. TOTAL (current month HOPWA expenditure column should equal total in supportive service section on Attachment 11) Current Month Unduplicated Only Receiving Supportive Services w/ Housing Assistance Receiving Supportive Services Only Persons with HIV/AIDS Other Persons in Family Unit Certification: The undersigned, hereby, gives assurance that to the best of my knowledge and belief, the data included in this report is true and accurate. It is also acknowledged that the provision of false information could leave the certifying official subject to the penalties of federal, state, and local law. Date: Submitted by: Phone No. Signature Required M&C Review Page 1 of 3 Official site of the City of Fort Worth, Texas FORT WORTH COUNCIL ACTION: Approved on 5/17/2011 DATE: 5/17/2011 REFERENCE NO.: **C-24905 LOG NAME: 17PSAGAP CODE: C TYPE: CONSENT PUBLIC HEARING: NO SUBJECT: Authorize Execution of Contracts and Interdepartmental Letters of Agreement to Extend Public Service Programs Funded by Community Development Block Grant, Emergency Shelter Grant and Housing Opportunities for Persons with AIDS Grant Funds from June through September of 2011 (ALL COUNCIL DISTRICTS) RECOMMENDATION: It is recommended that the City Council: 1. Authorize the City Manager or his designee to execute contracts or interdepartmental letters of agreement to extend public service programs funded with Community Development Block Grant, Emergency Shelter Grant and Housing Opportunities for Persons with AIDS grant funds for the period from June to September 2011; and 2. Authorize the City Manager or his designee, to amend the contracts or letter agreements, if necessary, to achieve program goals, provided any amendment is within the scope of the program and in compliance with all applicable laws and regulations governing the use of federal grant funds. DISCUSSION: On August 17, 2010, the City Council approved contracts with agencies to deliver public services using federal grant funds from the United States Department of Housing and Urban Development (HUD) under the Community Development Block Grant (CDBG), HOME Investment Partnerships Program (HOME), Emergency Shelter Grant (ESG) and Housing Opportunities for Persons With AIDS Program (HOPWA) (M&C C-24401). The City has traditionally used a June to May Program Year, but is changing the Program Year to October to September to correspond with the City's Fiscal Year. In September, 2010, the City Council requested a change in the City's Program Year for Federal Funding from a June to May year to an October to September year. When the City made this change to the Program Year, it caused a funding gap for the public service agencies. In order to ensure continuity of services, the City Council allocated General Funds to extend services until the beginning of the new grant year. The City Council's authorization allows for the funding of the public service agencies from June 1, 2010 to September 30, 2011. In March of 2011, Staff asked agencies with current contracts to submit budget requests for the four month period. Upon review of the requests, Staff recommends entering into contracts with the following agencies for the following amounts: Community Development Block Grant (CDBG) Boys & Girls Club FWHA Meals on Wheels Cultural Center of the Americas United Community Centers YMCA Childcare Associates YWCA - Child Care 4,800.00 9,500.00 11,232.00 6,592.00 5,400.00 15,000.00 39,000.00 45,000.00 http://apps.cfwnet.org/council_packet/mc review.asp?ID=15257&councildate=5/17/2011 6/1/2011 M&C Review Page 2 of 3 YWCA - My Own Place Ladder Alliance Day Resource Center AB Christian Learning Center Clayton YES! - Greenbriar Clayton YES! - After School S enior Citizens - Como S enior Citizens - Doc Sessions S enior Citizens - Diamond Hill Cornerstone PACS - Como PACS - Northside CAP PACS - Woodhaven N orthside Inter -Church Agency Mental Health Association - Ombudsman Mental Health Association - Advocate Girls Inc CDBG Total Emergency Shelter Grant (ESG) YWCA - Supportive Living PACS - SHIPP S afeHaven - Supportive Childcare S afeHaven - Shelter Operations P resbyterian Night Shelter ESG Total Housing Opportunities for Persons with AID Samaritan House ARRT AIDS Outreach Center HOPWA Total GRAND TOTAL $ 5,876.00 $ 6,640.00 $ 16,667.00 $ 5,000.00 $ 8,300.00 $ 19,000.00 $ 6,000.00 $ 5,333.33 $ 6,000.00 $ 5,099.00 $ 2,083.00 $ 8,748.00 $ 2,116.00 $ 7,341.00 $ 5,233.00 $ 7,425.00 $ 4,200.00 $ 257,585.33 4,346.00 16,600.00 5,500.00 6,700.00 55,411.00 88,557.00 S (HOPWA) $ 98,975.00 $ 35,331.00 $ 152,947.00 $ 287,253.00 $ 633,395.33 These programs are available in ALL COUNCIL DISTRICTS. FISCAL INFORMATION/CERTIFICATION: The Financial Management Services Director certifies that funds are available in the current operating budget, as appropriated, of the General Fund. TO Fund/Account/Centers FROM Fund/Account/Centers GG01 539180 0171000 $633,395.33 Submitted for City Manager's Office by: Originating Department Head: Additional Information Contact: Susan Alanis (8180) Jay Chapa (5804) Mark Folden (8634) Robin Bentley (7315) http://apps.cfwnet.org/council_packet/mc review.asp7ID=15257&councildate=5/17/2011 6/1/2011 M&C Review Page 3 of 3 ATTACHMENTS http://apps.cfwnet.org/council packet/mc review.asp?ID=15257&councildate=5/17/2011 6/1/2011