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HomeMy WebLinkAboutContract 47289 (2)STATE OF TEXAS COUNTY OF TARRANT This contract ("Contract") is made and entered into by and between the City of Fort Worth (hereafter "City") and Lena Home Pope, Inc. (hereafter "Agency"), a Texas non-profit corporation. City and Agency may be referred to individually as a "Party" and jointly as "the Parties". The Parties state as follows: WHEREAS, City receives grant monies from the United States Department of Housing and Urban Development through the Community Development Block Grant ("CDBG") Program, Program No. B-15-MC-48-0010, Catalog of Federal Domestic Assistance No. 14.218; WHEREAS, a national objective of the CDBG program is to benefit benefit low and moderate income citizens in accordance with 24 CFR Part 570, as amended from time to time; WHEREAS, Agency submitted a proposal to use CDBG funds for a program to serve individuals and families, 51 % of whom must be low and moderate income; WHEREAS, City citizens, the Community Development Council, and the City Council have determined that CDBG programs are needed by the City's citizens. NOW, THEREFORE, the Parties understand and agree as follows: 1. INCORPORATION OF RECITALS. City and Agency hereby agree that the recitals set forth above are true and correct and form the basis upon which the Parties have entered into this Contract. 2. DEFINITIONS. In addition to terms defined in the body of this Contract, the terms set forth below shall have the definitions ascribed to them as follows: Area Median Income or AMI means the median family income for the Fort Worth -Arlington metropolitan statistical area as established annually by HUD. The 2015 income limits are attached hereto as EXHIBIT "A-1" — 2015 HUD Income Limits. Business Diversity Enterprise Ordinance or BDE means the City's Business Diversity Ordinance, Ordinance No. 20020-12-2011. CDBG means Community Development Block Grant. Complete Documentation means the following documentation as applicable: CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX (3kp 11 RECEIVED DEC -1 2015 0! (;I pi 1Y WORTH '.off, 1O.28.261` , �5 ) Et AID. { Rev. "Pa' ei 1. • •o 04) • Attachments I, II, and III, with supporting documentation including: o Proof of expense: copies of timesheets, invoices, leases, service contracts or other documentation showing that payment is due by Agency. o Proof of payment' cancelled checks, bank statements, or wire transfers necessary to demonstrate that amounts due by Agency were actually paid by Agency. o Proof of client eligibility either (i) verifiable self -certification of income such as the City's Certification Income Statement attached as EXHIBIT "E' - Form of Income Self -Certification or a similar form approved by City, or (ii) Source Documentation. • Complete Documentation shall meet the standards described in the attached EXHIBIT "F" - Standards for Complete Documentation o Any other document or record reasonably necessary to verify costs spent and client eligibility for the Program. CDBG Funds means the CDBG grant funds supplied by City to Agency under the terms of this Contract. CDBG Regulations means regulations found at 24 CFR Part 570 et seq. Countywide Agencies means agencies with 10% or more of clients that reside outside of the boundaries of the City. All other agencies are considered Fort Worth agencies. DBE means disadvantaged business enterprise in accordance with 49 CFR Part 26. Director means the Director of the Neighborhood Services Department Effective Date means October 1, 2015. HUD means the United States Department of Housing and Urban Development IDIS means Integrated Disbursement Information System, HUD's project tracking system. Income Eligible Client means a client whose annual income adjusted for family size does not exceed 80% of AMI using the most current HUD Income Guidelines and Technical Guidance for Determining Income and Allowances. The definition of annual income to determine client income eligibility shall be the definition contained in 24 CFR Part 5.609, as amended from time to time. National Objective means an activity that benefits low and moderate income persons. For the purposes of this Contract, at least 51% of the clients served by the Program must be Income Ehgible Clients Neighborhood Services Department means the City's Neighborhood Services Department. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 2 Rev. 10 28 2015 OMB means the Office of Management and Budget. Program means the services described in EXHIBIT "A" - Program Summary. Reimbursement Request means all reports and other documentation described in Section 9 Source Documentation means documentation of full household income of any type described under the definition of annual income in 24 CFR Part 5.609, including but not limited to copies of paychecks, Social Security and disability verification letters, interest or rental income statements, retirement income statements, child support and alimony verification, unemployment benefit letters, and the like. Unduplicated Clients means a count of all clients served by the Program at least once in the Contract Tenn. Clients served by the Program more than once in the Contract Term will only be counted the first time they are served when determining the total count of Unduplicated Clients. 3. TERM. The term of this Contract begins on the Effective Date and terminates on September 30, 2016 unless earlier terminated as provided in this Contract. 4. DUTIES AND RESPONSIBILITIES OF CITY. 4.1 Provide CDBG Funds City shall provide up to $75,000.00 of CDBG Funds under the teams and conditions of this Contract. 4.2 Monitor. City will monitor the activities and performance of Agency and any of its contractors, subcontractors or vendors as necessary, but no less than annually. Monitoring by City will include determining whether Agency is meeting the National Objective during the tem' of this Contract. 5. DUTIES AND RESPONSIBILITIES OF AGENCY. 5.1 Required Services. Agency shall perfotuu the services described in EXHIBIT "A" - Program Summary in accordance with the terms and conditions of this Contract. 5.2 Use of CDBG Funds. 5.2.1. Compliance with CDBG Regulations and Contract. Agency shall be reimbursed for eligible Program costs with CDBG Funds only if City determines in its sole discretion that: 5.2.1.1 Costs are eligible expenditures in accordance with CDBG Regulations. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 3 Rev. 10.28.2015 5.2.1.2 Costs are in compliance with this Contract and are reasonable and consistent with industry norms. 5.2.1.3 Complete Documentation, as applicable, is submitted to City by Agency. 5.2.2 Budget. 5.2.2.1 The CDBG Funds will be paid on a reimbursement basis in accordance with EXHIBIT "B" - Budget 5.2.2.2 During the term of this Contract, Agency may submit written requests to increase or decrease line -item amounts in the Budget, including an explanation of why such increases or decreases are necessary. All requests shall be approved by Director in writing, with such approval being in the Director's sole discretion. If Director approves the Agency's proposed Budget amendment (as approved, the "Amended Budget"), then the Amended Budget will take effect on the first day of the month following the month in which it was approved by Director, unless otherwise specified in the amendment All requests for Budget amendments must be submitted by June 1, 2016. 5.2.3 Chance in Program Budget. 5.2.3.1 Agency will notify City promptly of any additional funds it receives for operation of the Program, and City reserves the right to amend this Contract in such instances to ensure compliance with HUD regulations governing cost allocation. 5.2.3.2 Agency agrees to utilize the CDBG Funds to supplement rather than supplant funds otherwise available for the Program 5.2.4 Payment of CDBG Funds to Aaencv. CDBG Funds will be disbursed to Agency upon City's approval of Reimbursement Requests including submission of Complete Documentation to City in compliance with Section 9 If Agency expends all funds budgeted for the Program prior to September 30, 2016, City may hold back a small amount of the CDBG Funds until the end of the term. During this interim period Agency must continue to submit Reimbursement Requests with an invoiced amount of $0. It is expressly agreed by the Parties that any CDBG Funds not spent or approved for reimbursement to Agency shall remain with City. 5.3 Proaram Performance Milestones. 5.3.1 Agency represents that the Program will achieve the following milestones in accordance with EXHIBIT "A" - Program Summary and the table below: CDBG 51 % PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 4 Rev. 10 28 2015 Month Expenditures 3 6 9 12 25% 50% 75% 100% Unduplicated Clients as specified in EXIIIBIT "A" --Program Summary 25% 50% 75% 100% 5.3.2 Failure of Agency to meet these milestones or a material deviation from them as outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section, "material deviation" shall mean more than 10% lower than the specified goal. In the event of such breach, City reserves the right in its sole option to (i) delay or withhold payment of Reimbursement Requests, (ii) lower Agency's allocation of CDBG Funds, or (iii) terminate this Contract. 5.3.3 Failure to meet at least 80% of its performance milestones or serve 100 Unduplicated Clients will automatically disqualify Agency for consideration under the City's Request for Proposals for the 2016-2017 Program Year for federal grant funds. 5.3.4 Amendments to performance milestones must be approved by the Director in writing, with such approval being in the Director s sole discretion. If Director approves the Agency's proposed amended performance milestones (as approved, the ` Amended Performance Milestones"), then the Amended Performance Milestones will take effect on the first day of the month following the month in which it was approved by Director unless otherwise specified in the amendment All requests for amendments to performance milestones must be submitted by June 1, 2016. Notwithstanding the above, any amendments to this Contract shall not reduce the number of Unduplicated Clients stated in Section 5.3.3 and in EXHIBIT "A" - Program Summary. 5.4 Identify Program Expenses Paid with CDBG Funds Agency will keep accounts and ecords in such a manner that City may readily identify and account for Program expenses reimbursed with CDBG Funds. These records shall be made available to City for audit purposes and shall be retained as required hereunder. 5.5 Meet National Obiective. Agency shall ensure that the activities carried out in the Program will meet the National Objective. 5.6 Program Subcontracts. Agency shall not enter into a subcontract with another agency, contractor, or vendor to provide a service to clients for any part of the Program that will be paid with CDBG Funds without City's written consent CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 5 Rev. 10 28 2015 6. CLIENT ELIGIBILITY VERIFICATION. 6.1 Client Eligibility. Agency will document client eligibility as follows: 6.1.1 Agency Clients. Agency must verify all new clients' income with either a verifiable self -certification of income such as the City's Certification Income Statement attached as EXHIBIT "E' - Form of Income Self-Certificationor a similar form approved by City, or Source Documentation Agency must use the annual income definition in 24 CFR Part 5.609 to establish client income and must use the most current HUD Income Guidelines. The income of all Piogram clients must be documented and at least 51% of them must be Income Eligible Clients 6.1.1.1 If Agency serves both Fort Worth and non -Fort Worth clients, the proportion of Program costs allocated to the CDBG-funded portion of the Program Budget must be consistent with the proportion of Fort Worth clients to all clients 6.1.1.2 All Program clients must be reported on EXHIBIT "D ' Reimbursement Forms, Attachment III. All Program clients whose income has not been verified will be deemed to not be Income Eligible Clients and shall not be included in the 51%. 6.1.2 Program Performance Milestones. 6.1.2.1 Agency represents that the Program will achieve the following Program performance milestones: Program Performance Outcome as specified in EXHIBIT "A" Month Program Summary 3 = to or >51 % Income Eligible 6 = to or >51 % Income hligible 9 = to or >51 % Income Eligible 12 = to or >51 % Income Eligible 6.1.2.2 If Agency fails to meet these milestones or a there is a material deviation from them, it will have 30 calendar days or until the next monthly invoice to cure. For the purpose of this Section, `material deviation" shall mean more than 10% lower than the specified milestone. 6.1.2.3 City will notify Agency by e-mail within 20 calendar days if the Program performance milestones were not met within the requirements outlined in this Section 6.1.2.2. Agency will have an additional 30 calendar days from the date of the e-mail notice to meet these CDBG 51% PSA CONTRACT 2015-2016 Page 6 Lena Pope Home, Inc. Rev. 10 28 2015 requirements If Agency fails to submit all the required information, Agency shall forfeit any payments otherwise due that month and failure to submit any requested information will be considered an event of default as outlined in Section 10.1.2. 6.1.2.4 In the event the Agency fails to meet the Program performance milestones, City reserves the right in its sole option to delay or withhold payment of Reimbursement Requests, to lower Agency's allocation of CDBG Funds, or to terminate this Contract. 6.2 Submission of Comnlete Documentation Agency must submit copies of documentation of client eligibility desciibed in Section 6 1 with Attachment III with each month's Reimbursement Request for all Unduplicated Clients. 6.3 Maintain Documentation. Agency must maintain copies of all documentation required by this Section 6 for 5 years following the expiration of the Contract term. This Section shall survive the earlier termination or expiration of this Contract. 7. ADDITIONAL CDBG REOUIREMENTS. Agency agrees to comply with all requirements of the CDBG Program as stated in the CDBG Regulations, including but not limited to the following: 7.1 Environmental Review. CDBG Funds will not be paid, and costs cannot be incurred until City has conducted an environmental review and completed an hnvironmental Review Record as required by 24 CFR Part 58. The environmental review may result in a decision to proceed with, modify, or cancel the funding for the Program. Further, Agency will not undertake or commit any funds to physical or choice limiting actions as desciibed in any applicable federal regulations. Any violation of this provision will (i) cause this Contract to terminate immediately, and (ii) require Agency to repay City the CDBG Funds it has already received and forfeit any future payments of CDBG Funds. 7.2 Contract Not Constitutint Commitment of Funds. Notwithstanding any provision of this Contract, the Parties agree and acknowledge that this Contract does not constitute a commitment of funds, and that such commitment of funds or approval may occur only upon (i) satisfactory completion of environmental review and receipt by City of an authorization to use grant funds from HUD under 24 CFR Part 58, (ii) approval of City's 2015-2016 Action Plan, and (iii) receipt by City of a grant agreement from HUD. 7.3 MonitorinE. 7.3.1 Agency understands and agrees that it will be subject to monitoring by City for compliance with terms and provisions of this Contract and the CDBG Regulations for the term of this Contract. Agency is subject to such monitoring during the term of this Contract and for 5 CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 7 Rev. 10 28 2015 years after the Contract term ends Agency will provide reports and access to Program files as requested by City during this 5 year period. For purposes of this Contract, this 5 year period for monitoring is deemed to begin on October 1, 2016 and end on September 30, 2021 regardless of whether or not this Contract is earlier terminated. 7.3.2 Representatives of City, HUD, HUD Office of Inspector General, and the United States Comptroller General shall have access during regular business hours, upon 48 hours prior notice, to Agency's offices and records pertaining to the use of the CDBG Funds, and to Agency s officers, directors, agents, employees, contractors, subcontractors and vendors for the purpose of such monitoring. 7.3.3 In addition to other provisions of this Contract regarding frequency of monitoring, City reserves the right to perform desk reviews or on -site monitoring of Agency's compliance with the terms and conditions of this Contract. City shall provide Agency with a written report of the monitor's findings after each monitoring visit If the monitoring report notes deficiencies in Agency's performance the report shall include requirements for the timely correction of said deficiencies by Agency. Failure by Agency to take the action specified in the monitoring report may be cause for suspension or termination of this Contract as provided herein. 7.3.4 Subsections 7.3.1 through 7.3.3 shall be applicable for the Contract teiiu and for 5 years thereafter and shall survive the earlier tennnninatron or expiration of this Contract. 7.3.5 Agency shall provide City annually the results of any state or federal monitoring. Such results shall be submitted within 60 days of receipt of such state or federal monitoring report, or with the January Reimbursement Request, whichever is earlier. 7.4 Aaencv Procurement Standards. Agency shall comply with all applicable federal, state and local laws, regulations and ordinances for making procurements under this Contract In addition to the conflict of interest provisions in Section 14.13.3, Agency shall establish written procurement procedures to ensure that materials and services are obtained in a cost effective manner and that provides for full and open competition When procuring materials and services for this Contract, Agency shall comply at a minimum with the procurement standards in 2 CFR Part 200.317 through Part 200.326. 7.4.1 Contracts in excess of $10,000.00 made by Agency using CDBG Funds must address termination for cause and convenience including the manner by which such termination shall be effected and the basis for settlement of the terminated contract, if any, as required by Appendix II (B), 2 CFR Part 200. 7.4.2 Agency shall not make any contract with parties listed on the governmentwide System for Award Management, www.sam gov ("SAM"). Agency must confirm by search of SAM that all contractors paid with CDBG Funds are not listed by SAM as being debarred, both prior to hiring and prior to submitting a Reimbursement Request which includes invoices from any such contractor Failure to submit such proofs of search shall be an event of default. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 8 Rev. 10 28 2015 7.5 Cost Principles/Cost Reasonableness. Agency shall administer its use of CDBG Funds in compliance with 2 CFR Part 200, as applicable. The eligibility of costs incurred for performance rendered shall be determined in accordance 2 CFR Part 200.400 through 2 CFR Part 200.475. 7.6 Financial Management Standards. Agency agrees to comply with 2 CFR Part 200 as applicable. Agency also agrees to adhere to the accounting principles and procedures required therein, utilize adequate internal controls, and maintain necessary supporting and back-up documentation for all costs incurred in accordance with 2 CFR Part 200.302 and Part 200.303. 7.7 Uniform Administrative Requirements. Agency will comply with the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards in 2 CFR Part 200, as applicable, or any reasonably equivalent procedures and requirements that City may require 7.8 Terms Applicable to Contractors, Subcontractors and Vendors. Agency understands and agrees that all terms of this Contract, whether regulatory or otherwise, shall apply to any and all contractors, subcontractors and vendors of Agency which are in any way paid with CDBG Funds or who perform any work in connection with the Program. Agency shall cause all applicable provisions of this Contract to be included in and made a part of any contract or subcontract executed in the performance of its obligations hereunder including its obligations regarding the CDBG Regulations. Agency shall monitor the services and work performed by its contractors, subcontractors and vendors on a regular basis for compliance with the CDBG Regulations and Contract provisions. Agency must cure all violations of the CDBG Regulations committed by its contractors, subcontractors or vendors. City maintains the right to insist on Agency's full compliance with the terms of this Contract and the CDBG Regulations and Agency is responsible for such compliance regardless of whether actions taken to fulfill the requirements of this Contract are taken by Agency or by Agency's contractors, subcontractors or vendors. Agency acknowledges that the provisions of this Section shall survive the earlier termination or expiration of this Contract and shall be applicable for 5 years after the Contract term ends. 7.9 Copvriaht and Patent Rights. No reports, maps, or other documents produced in whole or in part under this Contract shall be the subject of an application for copyright by or on behalf of Agency. HUD and City shall possess all rights to invention or discovery, as well as rights in data, which may arise as a result of Agency's performance under this Contract. 7.10 Conflict of Interest Disclosure. In accordance with the requirements of Section 14.13.2 1 and 14.13 4, Agency shall establish conflict of interest policies for federal awards. Agency shall disclose to City in writing any potential conflict of interest. 7.11 Compliance with FFATA and Whistleblower Protections. Agency shall comply with the requirements of 2 CFR 300(b), including provisions of the CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 9 Rev. 10.28.2015 Federal Funding Accountability and Transparency Act ("FFATA") governing requirements on executive compensation and provisions governing whistleblower protections contained in 10 U.S.C. 2409, 41 U.S.C. 4712, 10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310. 7.11.1 Agency shall provide City with its DUNS number. 7.12 Internal Controls. In compliance with the requirements of 2 CFR Part 200.303, Agency shall: 7.12.1 Establish and maintain effective internal control over the CDBG Funds that provides reasonable assurance that Agency is managing the CDBG Funds in compliance with federal statutes, regulations, and the terms and conditions of this Contract. These internal controls shall be in compliance with guidance in "Standards for Internal Control in the Federal Government issued by the Comptroller General of the United States or the "Internal Control Integrated Framework" issued by the Committee of Sponsoring Organizations of the Treadway Commission ("COSO"); 7.12.2 Comply with federal statutes, regulations, and the terms and conditions of this Contract; 7.12.3 Evaluate and monitor Agency's compliance with statutes, regulations and the terurs and conditions of this Contract; 7.12.4 Take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings; and 7.12.5 Take reasonable measures to safeguard protected personally identifiable information and other information that HUD or City designates as sensitive or Agency considers sensitive consistent with applicable federal, state, local and tribal laws regarding privacy and obligations of confidentiality. 8. RECORD KEEPING; REPORTING AND DOCUMENTATION REOUIREMENTS; AUDIT. 8.1 Record Keening. Agency shall maintain a record -keeping system as part of its performance of this Contract and shall promptly provide City with copies of any document City deems necessary for the effective fulfillment of City's monitoring and evaluation responsibilities. Specifically, Agency will keep or cause to be kept an accurate record of all actions taken and all funds spent, with supporting and back-up documentation Agency will maintain all records and documentation related to this Contract for 5 years after the Contract term ends. If any claim, litigation, or audit is initiated before the expiration of the 5 year period, the relevant records and documentation must be retained until all such claims, litigation or audits have been resolved. For purposes of this Contract, this 5 year period for record retention is deemed to begin on October 1, 2016 and end on September 30, 2021 regardless of whether or not this Contract is earlier terminated. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 10 Rev. 10 28 2015 8.2 Access to Records. Representatives of City, HUD and any duly authorized officials of the federal government will have full access to, and the right to examine, audit, copy, excerpt and/or transcribe any of Agency's records pertaining to all matters covered by this Contract for 5 years after the Contract teuu ends Such access shall be during regular business hours and upon at least 48 hours prior notice. For purposes of this Contract, this 5 year period for access to records is deemed to begin on October 1, 2016 and end on September 30, 2021 regardless of whether or not this Contract is earlier terminated. 8.3 Reports. Agency will submit to City all reports and documentation described in this Contract in such foini as City may prescribe. Agency may also be required to submit a final performance and/or final financial report if required by City at the termination of this Contract in such foini and within such times as City may prescribe. Failure to submit to City any report or documentation described in this Contract shall be an event of default of this Contract and City may exercise all of its remedies for default under this Contract. 8.3.1 Additional Information. Agency shall provide City with additional information as may be required by state or federal agencies to substantiate Program activities and/or expenditure eligibility. 8.4 Change in Reporting Requirements and Forms. City retains the right to change reporting requirements and forms at its discretion. City will notify Agency in writing at least 15 days prior to the effective date of such change, and the Parties shall execute an amendment to the Contract reflecting such change if necessary. 8.5 Audit. 8.5.1 Entities that Expend $750,000 or more in Federal Funds Per Year. All non-federal entities that expend $750,000 or more in federal funds within 1 year, regardless of the source of the federal award, must submit to City an annual audit prepared in accordance with specific reference to 2 CFR Part 200.501 through Part 200.521. The audit shall cover the Agency's fiscal years during which this Contract is in force. The audit must be prepared by an independent certified public accountant be completed within 6 months following the end of the period being audited and be submitted to City within 30 days of its completion. Agency's audit certification is attached hereto as EXHIBIT "C" - ' Audit Certification Form" and "Audit Requirements". The Audit Certification Form must be submitted to City prior to or with the first Reimbursement Request Entities that expend less than $750,000 a year in federal funds are exempt from federal audit requirements for that year, but records must be available foi review or audit by appropriate officials of the federal agency, City, and General Accounting Office. 8.5.2 City Reserves the Right to Audit. City reserves the right to perform an audit of Agency's Program operations and finances at any time during the term of this Contract and for 5 years after the Contract teuii ends if City determines that such audit is necessary foi City's compliance with the CDBG Regulations or other City policies. Agency agrees to allow access to all pertinent materials as described herein CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc Page 11 Rev. 10 28 2015 for such audit. For purposes of this Contract, this 5 year period for City audit is deemed to begin on October 1, 2016 and end on September 30, 2021 regardless of whether or not this Contract is earlier terminated. If such audit reveals a questioned practice or expenditure, such questions must be resolved within 15 business days after notice to Agency of such questioned practice or expenditure If questions are not resolved within this period, City reserves the right to withhold further funding under this Contract and/or any other contracts with Agency. IF AS A RESULT OF ANY AUDIT IT IS DETERMINED THAT AGENCY HAS FALSIFIED ANY DOCUMENTATION OR MISUSED, MISAPPLIED OR MISAPPROPRIATED CDBG FUNDS OR SPENT CDBG FUNDS ON ANY INELIGIBLE ACTIVITIES, AGENCY AGREES TO REIMBURSE CITY THE AMOUNT OF SUCH MONIES PLUS THE AMOUNT OF ANY SANCTIONS, PENALTY OR OTHER CHARGE LEVIED AGAINST CITY BY HUD BECAUSE OF SUCH ACTIONS. 9. REIMBURSEMENT REOUIREMENTS. 9.1 Deadline for Submittintt Reimbursement Reauests. 9.1.1 Reimbursement Requests shall be submitted monthly to the City and must be received by the City on or before the 15th day of the month following the month expenses were paid by Agency. For example, the Reimbursement Request for June expenses must be received by July 15. In the event the 15th falls on a weekend or City holiday, Reimbursement Requests shall be due the next day that the City is open for business. Failuie to submit a Reimbursement Request in a timely fashion will result in City taking the actions outlined in Section 10.1. NOTWITHSTANDING ANYTHING ABOVE, THE REIMBURSEMENT REQUEST FOR EXPENSES INCURRED FOR SEPTEMBER 2016 MUST BE RECEIVED BY OCTOBER 1, 2016. COMPLETE DOCUMENTATION FOR ALL SEPTEMBER 2016 EXPENSES MUST BE SUBMITTED BY OCTOBER 15, 2016. FAILURE TO SUBMIT A FINAL REIMBURSEMENT REQUEST WITH COMPLETE DOCUMENTATION BY OCTOBER 15, 2016 WILL RESULT IN FORFEITURE OF PAYMENT OF THE SEPTEMBER REIMBURSEMENT REQUEST. 9.1.2 City will notify Agency by e-mail within 20 calendar days if a Reimbursement Request is lacking Complete Documentation or corrections are needed. Agency will have 10 business days from the date of the e-mail notice to submit any requested information or missing documentation. Agency will be penalized in the Request for Proposal for the 2016-2017 Program Year for any notifications received under this Section If Agency fails to submit all the required information or missing documentation within 30 calendar days from the first e-mail, Agency shall forfeit any payments otherwise due that month and failure to submit any requested information will be considered an event of default as outlined in Section 10.1.2. 9.2 Submission of Reimbursement Requests. Agency shall provide City with Complete Documentation and the following reports as shown in EXHIBIT "D" -Reimbursement Forms with each Reimbursement Request: 9.2.1 Attachment I - Invoice. This report shall contain the amount requested for reimbursement each month, the cumulative reimbursement requested to date (inclusive of that month's request), and must be CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 12 Rev. 10 28 2015 signed by an authorized signatory of Agency. By signing Attachment I, Agency is certifying that the costs are valid, eligible, consistent with the teiius and conditions of this Contract, and the data contained in the report is true and correct. This report must be submitted even if Agency is requesting $0 for a particular month. 9.2.2 Attachment II — Expenditure Worksheet. This report shall itemize each expense requested for reimbursement by Agency and shall include the Account corresponding the expense to a Budget line item. In older for this report to be complete the following must be submitted: 9.2.2.1 For payroll expenses, timesheets signed by employees and approved by supervisor for all payroll expenses listed. Timesheets must distinguish between CDBG-funded time and non-CDBG funded time and reflect actual time spent on CDBG-funded activities. Agency may not submit payroll expenses dated 60 calendar days prior to the date of the Reimbursement Request. 9.2.2.2 For non -payroll expenses, invoices for each expense listed with an explanation as to how the invoiced expense pertains to the Program. Agency may not submit invoices dated 60 calendar days prior to the date of the Reimbursement Request. 9.2.2.3 Proof that each expense was paid by Agency, which proof can be satisfied by cancelled checks, wire transfer documentation, paid receipts o1 other appropriate banking documentation 9.2.3 Attachment III — Client Data Report. This report shall list each Unduplicated Client served during the month along with his or her demographic information. The Client Data Report must maintain a list of all clients served during the Contract term. In order for this report to be complete, the following must be submitted: 9.2.3.1 Documentation of income verification for each Unduplicated Client the first time the client is served by the Program, which will either be the completed form of EXHIBIT "E" - Form of Income Self Certification or similar form approved by City, or Source Documentation. 9.2.4 Delivery of Reimbursement Request. Reimbursement Requests can be mailed or delivered in person to Neighborhood Services Department, 908 Monroe Street, Fort Worth, Texas 76102 In addition, Agency can submit Reimbursement Requests via email to psa(a fortworthtexas sov, but Agency must submit a signed original of Attachment I by the deadline in Section 9 1 1 9.2.5 Countywide Agencies. Countywide Agencies shall submit EXHIBIT "A-2' — Reporting Requirements for Countywide Agencies quarterly with the January, April, July and October Reimbursement Requests. A paper copy must be submitted with the Reimbursement Request, and an electronic copy must also be emailed to psa(a),fortworthtexas.gov. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 13 Rev. 10.28.2015 9.3 Withholding Payment. CITY SHALL HAVE NO OBLIGATION TO PAY ANY REIMBURSEMENT REQUEST THAT IS NOT RECEIVED BY THE DUE DATE. Failure to timely submit Reimbursement Requests and Complete Documentation along with any required reports shall be an event of default. 10. DEFAULT AND TERMINATION. 10.1 Failure to Submit Reimbursement Request or Required Documentation. 10.1.1 If Agency fails to submit a Reimbursement Request in accordance with Section 9, Agency shall be in default of this Contract. City will notify Agency in writing of such default and the Agency will have 10 business days from the date of the written notice to submit such Reimbursement Request to cure the default. If Agency fails to cure the default within such time, Agency shall forfeit any payments otherwise due that month 10.1.2 If Agency fails to submit requested information or missing documentation as set forth m Section 9 1 2, then Agency shall forfeit payment due that month and the failure to submit shall be considered an event of default that shall not be cured. 10.1.3 NOTWITHSTANDING THE PROVISIONS OF SECTION 10.1.1 OR 10.1.2, IF AGENCY FAILS TO SUBMIT THE REIMBURSEMENT REQUEST DUE OCTOBER 1, 2016, OR IF THE SUBMITTED REIMBURSEMENT REQUEST FOR OCTOBER 1, 2016 IS LATE INCOMPLETE OR OTHERWISE NOT IN COMPLIANCE WITH THIS CONTRACT OR THE CDBG REGULATIONS AS DETERMINED BY CITY IN ITS SOLE DISCRETION, THERE WILL BE NO CURE PERIOD AND ANY REIMBURSEMENT WILL BE FORFEITED. 10.1.4 In the event of (i) an uncured default under Section 10.1.1 or an event of default under 10.1.2 or (ii) more than 2 instances of default, cured or uncured, under these Sections, City reserves the right at its sole option to terminate this Contract effective immediately upon written notice of such intent with no penalty or liability to City. 10.1.5 Notwithstanding anything to the contrary herein, City will not be required to pay any CDBG Funds to Agency during the period that any Reimbursement Request, report or documentation is past due or is not in compliance with this Contract or the CDBG Regulations, or during any period during which Agency is in default of this Contract. 10.1.6 In the event of tenniination under this Section 10.1, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds 10.2 Failure to Maintain Records or Submit Reports and Documentation. If Agency fails to maintain all records and documentation as required in Section 8, or if the maintained or submitted ieport or documentation is not in compliance with this Contract or the CDBG Regulations as determined by City in its sole discretion, City will notify Agency in CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 14 Rev. 10.28.2015 writing and Agency will have 30 calendar days from the date of the written request to obtain or recreate the missing records and documentation or submit or resubmit any such report or documentation to City. If Agency fails to maintain the required reports or documentation, or fails to submit or resubmit any such report or documentation within such time, City shall have the right to terminate this Contract effective immediately upon written notice of such intent with no penalty or liability to City. 10.2.1 In the event of termination under this Section 10.2, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds, and any CDBG Funds paid to Agency must be repaid to City within 30 days of termination If such CDBG Funds are not repaid to City within the 30 day period, City shall exercise all legal remedies available under this Contract. 10.3 In General. 10.3.1 Subject to Section 10.2, and unless specifically provided otherwise in this Contract, Agency shall be in default under this Contract if Agency breaches any turn or condition of this Contract In the event that such a breach remains uncured after 30 calendar days following written notice by City (oi such other notice period as may be specified herein) or, if Agency has diligently and continuously attempted to cure following receipt of such written notice but reasonably requires more than 30 calendar days to cure, as determined by both Parties mutually and in good faith, City shall have the right to elect in City's sole discretion to (i) extend Agency s time to cure, (ii) terminate this Contract effective immediately upon written notice of such intent to Agency, or (iii) pursue any other legal remedies available to City under this Contract. 10.3.2 City's remedies may include: 10.3.2.1 Direct Agency to prepare and follow a schedule of actions for carrying out the affected activities, consisting of schedules, timetables and milestones necessary to implement the affected activities. 10.3.2.2 Direct Agency to establish and follow a management plan that assigns responsibilities for carrying out the remedial activities. 10.3.2.3 Reprogram CDBG Funds that have not yet been expended from affected activities to other eligible activities or withhold CDBG Funds. 10.3.2.4 Any other appropriate action including but not limited to any remedial action legally available such as declaratory judgment, specific performance, damages temporary or permanent injunctions, termination of this Contract or any other contracts with Agency, and any other available remedies. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc Page 15 Rev. 10 28 2015 10 3.3 In the event of termination under this Section 10.3, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have no further right to such funds, and any CDBG Funds already paid to Agency must be repaid to City within 30 days of the termination. Failure to repay such CDBG Funds within the 30 day period will result in City exercising all legal remedies available under this Contract. 10.4 No Funds Disbursed while in Breach. Agency understands and agrees that no CDBG Funds will be paid to Agency until all defaults are cured to City's satisfaction. 10.5 No Compensation After Date of Termination. Agency shall not receive any compensation for work undertaken after the date of the termination 10.6 RiLhts of City Not Affected. Termination shall not affect or terminate any of the existing rights of City against Agency, or which may thereafter accrue because of Agency's default and this provision shall be in addition to any and all other rights and remedies available to City under the law. Such termination does not terminate any provisions of this Contract that have been expressly noted as surviving the term or termination of the Contract. No delay or omission by City in exercising any right or remedy available to it under this Contract shall impair any such right or remedy or constitute a waiver or acquiescence in any Agency default. 10.7 Waiver of Breach Not Waiver of Subsequent Breach. The waiver of a default or breach of any teen, covenant, or condition of this Contract shall not operate as a waiver of any subsequent default or breach of the same or any other teen, covenant or condition hereof. 10.8 Civil, Criminal and Administrative Penalties. Failure to perform all the Contract terms may result in civil, criminal or administrative penalties, including, but not limited to those set out in this Contract. 10.9 Termination for Cause. 10.9.1 City may terminate this Contract in the event of Agency's default, inability, or failure to perform subject to notice grace and cure periods. In the event City terminates this Contract for cause, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall be immediately rescinded and Agency shall have no further right to such funds and any CDBG Funds already paid to Agency must be repaid to City within 30 days of termination Failure to repay such CDBG Funds within 30 days will result in City exercising all legal remedies available to City under this Contract. AGENCY ACKNOWLEDGES AND AGREES THAT IF CITY TERMINATES THIS CONTRACT FOR CAUSE, AGENCY OR ANY AFFILIATES OF AGENCY SHALL NOT BE CONSIDERED FOR ANY OTHER CITY CONTRACT FOR CDBG FUNDS FOR A MINIMUM OF 5 YEARS FROM THE DATE OF TERMINATION. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 16 Rev. 10.28.2015 10.9.2 Agency may terminate this Contract if City does not provide the CDBG Funds substantially in accordance with this Contract. 10.10 Termination for Convenience. In terminating in accordance with 2 CFR Part 200, Appendix II, this Contract may be terminated in whole or in part only as follows: 10.10.1 By City with the consent of Agency in which case the Parties shall agree upon the termination conditions, including the effective date and in the case of partial tennnination, the portion to be terminated; or 10.10.2 By Agency upon at least 30 days written notification to City, setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. In the case of a partial termination, City may terminate the Contract in its entirety if City determines in its sole discretion that the remaining portion of the Contract to be performed or CDBG Funds to be spent will not accomplish the purposes for which the Contract was made. 10.11 Dissolution of Aaencv Terminates Contract. This Contract shall terminate in the event Agency is dissolved or ceases to exist. In the event of termination under this Section, all CDBG Funds are subject to repayment and/or City may exercise all of its remedies under this Contract. 10.12 Reversion of Assets. In the event this Contract is terminated with or without cause, all assets acquired by Agency with the CDBG Funds including cash, interest payments from loans or otherwise, all outstanding notes, mortgages or other security instruments, any accounts receivable attributable to the use of the CDBG Funds, and any real or personal property owned by Agency that was improved with the CDBG Funds shall automatically transfer to City or to such assignee as City may designate. 11. REPAYMENT OF CDBG FUNDS. All CDBG Funds are subject to repayment in the event the Program does not meet the requirements of this Contract or in the CDBG Regulations. If Agency takes any action that results in the City being required to repay all or any portion of the CDBG Funds to HUD, Agency agrees it will reimburse City for such repayment. If Agency takes any action that results in City receiving a finding from HUD about the Program, whether or not repayment of all or any portion of the CDBG Funds is required of City, Agency agrees it will pay City 10% of the CDBG Funds as liquidated damages. The Parties agree that City's damages in the event of either repayment to HUD being required or receiving a finding from HUD are uncertain and would be difficult to ascertain and may include an impact on City's CDBG grant o1 other federal grant funds in addition to the finding by HUD or a required repayment of funds to HUD by City. Therefore, the Parties agiee that payment under this Section of 10% of the CDBG Funds by Agency to City is liquidated damages and not a penalty. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Horne, Inc. Page 17 Rev. 10 28 2015 12. CHANGE IN NON-PROFIT STATUS. Agency must provide City with written notification of any changes to its non-profit status within 15 calendar days of being notified of the change If the non-profit status of Agency changes after the date of this Contract, City may but is not obligated to, terminate this Contract. City has 30 calendar days to make such determination after receipt of written notice from Agency and failure to make such determination will constitute a waiver. In the event of termination under this Section 12, all CDBG Funds awarded but not yet paid to Agency pursuant to this Contract shall be immediately rescinded and Agency shall have no further right to such funds Any CDBG Funds already paid to Agency must be repaid to City within 30 calendar days of termination under this Section 13. SURVIVAL. Any provision of this Contract that pertains to auditing, monitoring, client income eligibility, record keeping and reports, City ordinances, or applicable CDBG requirements, and any default and enforcement provisions necessary to enforce such provisions, shall survive the termination of this Contract for 5 years after the Contract term ends and shall be enforceable by City against Agency. For purposes of this Contract, this 5 year period for survival of certain Contract provisions is deemed to begin on October 1, 2016 and end on September 30, 2021 regardless of whether or not this Contract is earlier terminated. 14. GENERAL PROVISIONS 14.1 Aeencv an Independent Contractor. Agency shall operate hereunder as an independent contractor and not as an officer, agent, servant or employee of City. Agency 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, contractors, subcontractors, vendors, clients, licensees or invitees. 14.2 Doctrine of Respondeat Superior. The doctrine of respondeat superior shall not apply as between City and Agency, or its officers, members, agents servants, employees, contractors, subcontractors, vendors, clients, licensees or invitees, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Agency. City does not have the legal right to control the details of the tasks performed hereunder by Agency, its officers, members, agents, employees, contractors, subcontractors, vendors, clients, licensees or invitees. 14 3 Aaencv Property. City shall under no circumstances be responsible for any property belonging to Agency, or its officers, members, agents, employees, contractors, subcontractors, vendors, clients, licensees or invitees that may be lost, stolen or destroyed or in any way damaged and AGENCY HEREBY INDEMNIFIES AND HOLDS HARMLESS CITY AND ITS OFFICERS, AGENTS, AND EMPLOYEES FROM ANY AND ALL CLAIMS OR SUITS PERTAINING TO OR CONNECTED WITH SUCH PROPERTY. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 18 Rev. 10 28 2015 14.5 Religious Organization. No portion of the CDBG Funds shall be used in support of any sectarian or religious activity In addition, there must be no religious or membership criteria for clients of a CDBG- funded service. 14.6 Venue. Venue shall lie in Tarrant County, Texas for any action, whether real or asserted, at law or in equity, arising out of the execution, performance, attempted performance or non-perfoinnance of this Contract. 14.7 Governing Law. This Contract shall be governed by and construed in accordance with the laws of the State of Texas. If any action, whether real or asserted, at law or in equity, arises out of the execution, performance or non-performance of this Contract or on the basis of any piovision herein, for any issue not governed by federal law, the choice of law shall be the laws of the State of Texas. 14.8 Severability. 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. 14.9 Written Agreement Entire Contract. This written instrument and the Exhibits, Attachments, and Addendums attached hereto, which are incorporated by reference and made a part of this Contract for all purposes, constitute the entire agreement by the Parties concerning the work and services to be performed under this Contract. Any prior or contemporaneous oral of written agreement which purports to vary the teens of this Contract shall be void. Any amendments to the teinns of this Contract must be in writing and executed by the Parties. 14.10 Paragraph Headings for Reference Only, No Legal Significance; Number and Gender. The paragraph headings contained herein are for convenience in reference to this Contract and are not intended to define or to limit the scope of any provision of this Contract. When context requires singular nouns and pronouns include the plural and the masculine gender shall be deemed to include the feminine of neuter and the neuter gender to include the masculine and feminine. The words "include" and "including" whenever used herein shall be deemed to be followed by the words "without limitation" 14.11 Compliance With All Applicable Laws and Regulations. Agency agrees to comply fully with all applicable laws and regulations that aie currently in effect of that are hereaftei amended during the performance of this Contract. Those laws include, but are not limited to: CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 19 Rev. 10 28 2015 ➢ CDBG Regulations found in 24 CFR Part 570 ➢ Title I of the Housing and Community Development Act of 1974, as amended, (42 USC 5301 ➢ Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d et seq.) including provisions requiring recipients of federal assistance to ensure meaningful access by person of limited English proficiency ➢ The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. Sections 3601 et seq.) ➢ Executive Orders 11063, 11246 as amended by 11375 and 12086 and as supplemented by Department of Labor regulations 41 CFR Part 60 ➢ The Age Discrimination in Employment Act of 1967 ➢ The Age Discrimination Act of 1975 (42 U.S.C. Sections 6101 et seq.) ➢ The Unifoini Relocation Assistance and Real Property Acquisition Policies Act of 1970 (42 U.S.C. Sections 4601 et seq. and 49 CFR Part 24) (` URA") ➢ Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sections 794 et seq.) and 24 CFR Part 8 where applicable ➢ National Environmental Policy Act of 1969, as amended, 42 U.S.C. Sections 4321 et seq. ("NEPA") and the related authorities listed in 24 CFR Part 58. ➢ The Clean Air Act, as amended, (42 U.S.C. Sections 1251 et seq.) and the Clean Water Act of 1977, as amended (33 U.S.C. Sections 1251 et seq.) and the related 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 Watei Act. ➢ Immigration Refoim and Control Act of 1986 (8 U.S.C. Sections 1101 et seq.) specifically including the provisions requiring employer verifications of legal status of its employees ➢ The Americans with Disabilities Act of 1990 (42 U.S.C. Sections 12101 et seq.), the Architectural Barriers Act of 1968 as amended (42 U.S.C. Sections 4151 et seq.) and the Uniform Federal Accessibility Standards 24 CFR Part 40, Appendix A ➢ Regulations at 24 CFR Part 87 ielated to lobbying, including the requirement that certifications and disclosures be obtained from all covered persons ➢ Drug Free Workplace Act of 1988 (41 U.S.C. Sections 701 et seq.) and 24 CFR Part 23, Subpart F ➢ Executive Order 12549 and 24 CFR Part 5.105(c) pertaining to restrictions on participation by ineligible, debarred or suspended persons or entities ➢ Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act ➢ Guidelines of the Environmental Protection Agency at 40 CFR Part 247 ➢ For contracts and subgrants for construction or repair, Copeland "Anti -Kickback" act (18 U.S.C. 874) as supplemented in 29 CFR Part 5 ➢ For construction contracts awarded by Agency in excess of $2,000, and in excess of $2,500 for other contracts which involve the employment of mechanics or laborers, Sections 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327A 300) as supplemented by 29 CFR Part 5 ➢ Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq), as amended by the Residential Lead -Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 20 Rev. 10 28 2015 seq.) and implementing regulations at 24 CFR Part 35, subparts A, B M, and R ➢ Unifoim Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, 2 CFR Part 200 et seq. ➢ Federal Funding Accountability and Transparency Act of 2006 ("FFATA") (Pub L 109-282, as amended by Section 6205(a) of Pub L 110-252 and Section 3 of Pub L 113-101) ➢ Federal Whistleblower Regulations, as contained in 10 U.S.C. 2409, 41 U.S.C. 4712, 10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310. 14.11 HUD -Assisted Proiects and Employment and other Economic Opportunities: Section 3 Requirements. 14.11.1 Requirement that Law Be Ouoted in Covered Contracts. — Certain Requirements Pertaining to Section 3 of the Housing and Urban Development Act of 1968 as Amended (12 U.S.C. Sections 1701 et seq.) and its Related Regulations at 24 CFR Part 135. If the Program results in the creation of nevi employment, training, or contracting opportunities on a contractor or subcontractor level resulting from the expenditure of the CDBG Funds, Agency shall comply with the following and will ensure that its contractors also comply. If the work perfoiined under this Contract is on a project assisted under a program providing direct federal financial assistance from HUD, Section 3 of 24 CFR Part 135.38 ("Section 3") requires that the following clause, shown in italics, be inserted in all covered contracts ("Section 3 Clause"): Section to be quoted in covered contracts begins: "A. The work to be performed under this contract is subject to the requirements of Section 3 of Housing and Urban Development Act of 1968, as amended, 12 U.S.C. section 1701 a (Section 3). The purpose of Section 3 is to ensure that employment and other economic opportunities generated by HUD assisted or HUD -assisted programs 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 certifr that they are under no contractual or other impediment that would prevent them from complying with the Part 135 regulations. C. The contractor agrees to send to each labor organization or representative of workers with which it has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representatives 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 apprentice and CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Horne, Inc. Page 21 Rev. 10 28 2015 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 that it will include this Section 3 clause in every subcontract to comply with regulation 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 finding that the subcontractor is in violation of the regulations in 24 CFR Part 135. The contractor will not subcontract with any subcontractor where it has notice or knowledge that the subcontractor has been found in violation of regulations in 24 CFR Part 135. E. The contractor will cent( that any vacant employment positions, including training positions that are filed: (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. The contractor will not subcontract with any subcontractor where it has notice or knowledge that the subcontractor has been found in violation of regulations in 24 CFR Part 135. F. Noncompliance with HUD's regulation 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 US.C. Section 450(e) 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). " Section to be quoted in covered contracts ends. 14.11.2 Agency Responsibilities for Section 3 Requirements. City and Agency 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 Agency and their respective successors, assigns contractors and subcontractors. Failure to fulfill these requirements shall subject Agency and its contractors and subcontractors and their respective successors and assigns to those sanctions specified by the grant agreement through which federal assistance is provided and to such sanctions as are specified by 24 CFR Part 135. Agency's responsibilities include: 14.11.2.1 Implementing procedures to notify Section 3 residents and business concerns about training, employment, and contracting opportunities generated by Section 3 covered assistance; 14.11.2.2 Notifying potential contractors working on Section 3 covered projects of their responsibilities; CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 22 Rev. 10 28 2015 14.11.2.3 Facilitating the training and employment of Section 3 residents and the award of contracts to Section 3 business concerns; 14.11.2.4 Assisting and actively cooperating with the HED Department in making contractors and subcontractors comply; 14.11.2.5 Refraining from entering into contracts with contractors that are in violation of Section 3 regulations; 14.11.2.6 Documenting actions taken to comply with Section 3; and 14.11.2.7 Submitting Section 3 Annual Summary Reports (Foiiu HUD- 60002) in accordance with 24 CFR Part 135.90. 14.11.3 Section 3 Reporting Requirements. In order to comply with the Section 3 requirements, Agency must submit the forms attached hereto as EXHIBIT "G" - Section 3 Reporting Forms. 14.11.3.1 Report to the City on a quarterly basis all applicants for employment, and all applicants for employment by contractor and subcontractor. This shall include name, address, zip code, date of application, and status (hired/not hired) as of the date of the report. 14.11.3.2 Advertise available positions to the public for open competition, and provide documentation to City with the quarterly report that demonstrates such open advertisement in the foini of printout of Texas Workforce Commission posting, copy of newspaper advertisement, copy of flyers and listing of locations where flyers were distributed, and the like. 14.11.3.3 Report to the City on a quarterly basis all contracts awarded by contractor and subcontractor. This shall include name of contractor and/or subcontractor, address, zip code, and amount of award as of the date of the report. 14.12 Prohibition Against Discrimination. 14.12.1 General Statement. Agency shall comply in the execution, performance or attempted performance of this Contract with all non-discrimination requirements of 24 CFR Part 570.607 and Chapter 17, Article III, Division 4 — Fair Housing of the City Code. Agency may not discriminate against any person because of race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression, or transgender, nor will Agency permit its officers, members, agents, employees, or clients to engage in such discrimination. This Contract is made and entered into with reference specifically to Chapter 17, Article III, Division 3 - Employment Practices of the City Code, and Agency hereby covenants and CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 23 Rev. 10 28 2015 agrees that Agency, its officers, members, agents, employees and contractors, have fully complied with all provisions of same and that no employee, or applicant for employment has been discriminated against under the terms of such ordinances by either or its officers, members, agents, employees or contractors. 14.12.2 No Discrimination in Employment during the Performance of This Contract. During the performance of this Contract Agency agrees to the following provision, and will require that its contractors and subcontractors also comply with such provision by including it in all contracts with its contractors: [Contractor's, Subcontractor's or Vendor's name] will not unlawfully discriminate against any employee or applicants for employment because of race, color, sex, gender, religion, national origin familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. [Contractor 's, Subcontractor's or Vendor's name] will take affirmative action to ensure that applicants are hired without regard to race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender and that employees are treated fairly during employment without regard to their race, color, sex, gender, religion, national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression or transgender. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. [Contractor's, Subcontractor's or Vendor's name] agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause. [Contractor's, Subcontractor's or Vendor's name] will, in all solicitations or advertisements for employees placed by or on behalf of [Contractor's, Subcontractor's or Vendor 's name], state that all qualified applicants will receive consideration for employment without regard to race, color, sex, gender, religion national origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender expression of transgender. [Contractor's, Subcontractor's or Vendor's name] covenants that neither it nor any of its officers members, agents employees, or contractors, 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 or because of any disability or perceived disability, except on the basis of a bona fide occupational qualification, retirement plan or statutory requirement. [Contractor's, Subcontractor's or Vendor's name] further covenants that neither it nor its officers members, agents, employees, contractors, 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 CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 24 Rev. 10.28.2015 14.12.3 Aeencv s Contractors and the ADA. In accordance with the provisions of the Americans With Disabilities Act of 1990 ( `ADA"), Agency warrants that it and any of its contractors will not unlawfully discriminate on the basis of disability in the provision of services to the general public, nor in the availability, terms and/or conditions of employment for applicants for employment with, or employees of, Agency or any of its contractors. AGENCY WARRANTS IT WILL FULLY COMPLY WITH THE 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, CONTRACTORS SUBCONTRACTORS, VENDORS OR AGENTS AGAINST CITY ARISING OUT OF AGENCY'S AND/OR ITS CONTRACTORS', SUBCONTRACTORS', VENDORS' OR AGENTS' OR THEIR RESPECTIVE EMPLOYEES' ALLEGED FAILURE TO COMPLY WITH THE ABOVE -REFERENCED LAWS CONCERNING DISABILITY DISCRIMINATION IN THE PERFORMANCE OF THIS CONTRACT. 14.13. Conflicts of Interest and Violations of Criminal Law. 14.13.1 Aeencv Safeguards. Agency shall establish safeguards to prohibit its employees, board members, advisors and agents from using positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business or other ties. Agency shall disclose to City any such conflict of interest or potential conflict of interest, immediately upon discovery of such 14.13.2 General Prohibitions Against Conflicts of Interest. No employees, agents, consultants, officers or elected officials or appointed officials of City or of Agency who exercise or have exercised any functions or responsibilities with respect to activities assisted with CDBG funds or who are in a position to participate in a decision - making process or gain inside infoulnation with regard to these activities may utilize CDBG services, may obtain a financial interest or benefit from a CDBG-assisted activity or have an interest in any contract, subcontract or agreement with respect thereto, or the proceeds thereunder, either for themselves or those with whom they have family or business ties, during their tenure or for 1 year thereafter, unless they are accepted in accordance with the procedures set forth at 24 CFR Part 570.611. 14.13.2.1 Agency shall establish conflict of interest policies for federal awards including the CDBG Funds and shall disclose in writing potential conflicts of interest to City as authorized by 2 CFR Part 200.112. 14.13.3 Conflicts of Interest Involving Procurement. The conflict of interest provisions of 2 CFR Part 200.318 shall apply in the procurement of property and services by Agency In all cases not governed by this Section, the provisions of 24 CFR Part 570.611 of the CDBG Regulations shall apply. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Horne, Inc Page 25 Rev. 10 28 2015 14.13.3.1 As more particularly described in 2 CFR Part 200.318, Agency shall maintain and submit to City written standards of conduct covering conflicts of interest and governing the performance of its employees engaged in the selection, award, and administration of contracts. No employee, officer, or agent may participate in the selection, award, or administration of a contract supported by a federal award if he or she has a real or apparent conflict of interest. The standards of conduct must provide for disciplinary actions to be applied for violations of such standards by officers, employees, or agents of Agency 14.13.3.2 The officers, employees, and agents of Agency shall neither solicit nor accept gratuities, favors, or anything of monetary value from contractors or parties to subcontracts. 14.13.3.3 Notwithstanding the prohibition contained in Section 14.13.3 2, Agency may set standards of conduct for situations in which the financial interest is not substantial or the gift is an unsolicited item of nominal value. Such standards of conduct must provide for disciplinary actions to be applied for violations of such standards by Agency's officers, employees or agents 14.13.3.4 Agency shall maintain written standards of conduct covering organizational conflicts of interest. Organizational conflicts of interest means that because of relationships with a parent company, affiliate, or subsidiary organization, Agency is unable or appears to be unable to be impartial in conducting a procurement action involving a related organization. 14.13.3.5 Agency must maintain records sufficient to detail the history of procurement These records will include, but are not necessarily limited to the following: rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. 14.13.4 Disclosure of Conflicts of Interest. In compliance with 2 CFR Part 200.112, Agency is required to timely disclose to City in writing any potential conflict of interest. 14.13.5 Disclosure of Texas Penal Code Violations. Agency affirms that it will adhere to the provisions of the Texas Penal Code which prohibit bribery and gifts to public servants. 14.13.6 Disclosure of Federal Criminal Law Violations. In compliance with 2 CFR Part 200.113, Agency is required to timely disclose to City all violations of federal criminal law involving fraud, bribery or gratuity violations potentially affecting the Agency. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 26 Rev. 10 28 2015 14.14 Subcontracting with Small and Minority Firms, Women's Business Enterprises and Labor Surplus Areas. 14.14.1 For procurement contracts $50,000.00 or larger that are paid for, in part or in full, with the CDBG Funds, Agency agrees to abide by City's policy to involve Minority Business 1-interprises and Small Business Enterprises and to provide them equal opportunity to compete for contracts foi construction, provision of professional services, purchase of equipment and supplies and provision of other services required by City. Agency agrees to incorporate the City's BDE Ordinance, and all amendments or successor policies or ordinances thereto, into all contracts and subcontracts for procurement larger than $50,000.00 or larger that are paid for, in part or in full, with the CDBG Funds and will further require all persons or entities with which it so contracts to comply with said ordinance. 14.14.2 It is national policy to award a fair share of contracts to disadvantaged business enterprises ("DBEs"), small business enterprises ("SB hs"), minority business enterprises ("MBEs"), and women's business enterprises ("WBEs"). Accordingly, affirmative steps must be taken to assure that DB hs, SBEs, MBEs, and WBEs are utilized when possible as sources of supplies, equipment, construction and services. 14.14.2.1 In order to comply with federal reporting requirements 24 CFR Part 570.506 (g)(6), Agency must submit the form attached hereto as EXHIBIT ` I" — MBE Reporting Form for each contract or subcontract with a value of $10,000 00 or more paid or to be paid with the CDBG Funds Agency shall submit this form by the date specified in EXHIBIT "I" — MBE Reporting Form. 14.15 Other Laws. The failure to list any federal, state or City ordinance, law or regulation that is applicable to Agency does not excuse or relieve Agency from the requirements or responsibilities in regard to following the law, nor from the consequences or penalties for Agency's failure to follow the law, if applicable. 14.16 Assignment. Agency shall not assign all or any part of its rights, privileges, or duties under this Contract without the prior written approval of City. Any attempted assignment of same without approval shall be void, and shall constitute a breach of this Contract. 14.17. Right to Inspect Agency Contracts. It is agreed that City has the right to inspect and approve in writing any proposed contracts between Agency and any contractor or vendor engaged in any activity in conjunction with this CDBG-funded Program prior to any charges being incurred. 14.18 Force Maieure If Agency becomes unable, either in whole or part, to fulfill its obligations under this Contract due to acts of God, strikes, lockouts, or other industrial disturbances, acts of public CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 27 Rev. 10 28 2015 enemies, wars, blockades, insurrections, riots, epidemics, earthquakes, fires, floods restraints or prohibitions by any court, board, department, commission or agency of the United States or of any States, civil disturbances, or explosions or some other reason beyond Agency's control (collectively, "Force Majeure hvent"), the obligations so affected by such Force Majeure Event will be suspended only during the continuance of such event Agency will give City written notice of the existence, extent and nature of the Force Majeure Event as soon as reasonably possible after the occurrence of the event Failure to give notice will result in the continuance of Agency's obligation regardless of the extent of any existing Force Majeure Event. Agency will use commercially reasonable efforts to remedy its inability to perform as soon as possible. 15. INDEMNIFICATION AND RELEASE. AGENCY 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 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 AGENCY 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 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. AGENCY 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 AGENCY, ITS OFFICERS, MEMBERS, AGENTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, INVITEES, LICENSEES, OR CLIENTS, OR CAUSED, IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY. IT IS THE EXPRESS INTENTION OF THE PARTIES, BOTH AGENCY AND CITY, THAT THE INDEMNITY PROVIDED FOR THIS SECTION INCLUDES CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 28 Rev. 10 28 2015 INDEMNITY BY AGENCY TO INDEMNIFY AND PROTECT CITY FROM THE CONSEQUENCES OF CITY'S OWN NEGLIGENCE, WHETHER THAT NEGLIGENCE IS ALLEGED TO BE THE SOLE OR CONCURRING CAUSE OF THE INJURY, DAMAGE OR DEATH. AGENCY 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 CITY'S SOLE OR CONCURRENT NEGLIGENCE. AGENCY SHALL REQUIRE ALL OF ITS CONTRACTORS AND SUBCONTRACTORS TO INCLUDE IN THEIR CONTRACTS AND SUBCONTRACTS A RELEASE AND INDEMNITY IN FAVOR OF CITY IN SUBSTANTIALLY THE SAME FORM AS ABOVE. 16. WAIVER OF IMMUNITY BY AGENCY. If Agency, as a charitable or nonprofit organization, has or claims an immunity or exemption (statutory or otherwise) from and against liability for damages or injury, including death to persons or property, Agency 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. 17. INSURANCE AND BONDING. Agency will maintain coverage in the foini of insurance or bond in the amount of $75,000.00 to insure against loss from the fraud, theft or dishonesty of any of Agency's officers, agents, trustees, directors or employees. The proceeds of such insurance or bond shall be used to reimburse City for any and all loss of CDBG Funds occasioned by such misconduct. To effectuate such reimbursement, such fidelity coverage shall include a rider stating that reimbursement for any loss or losses shall name the City as a Loss Payee. Agency shall furnish to City in a timely manner, but not later than the Effective Date, certificates of insurance as proof that it has secured and paid for policies of commercial insurance as specified herein. If City has not received such certificates by the Effective Date, Agency shall be in default of the Contract and City may, at its option, teinumate the Contract. Such insurance shall cover all insurable risks incident to or in connection with the execution, performance, attempted performance or nonperformance of this Contract. Agency shall maintain the following insurance coverage and limits: Commercial General Liability (CGL) Insurance $ 500,000 each occurrence $1,000,000 aggregate limit CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc Page 29 Rev. 10 28 2015 Non -Profit Organization Liability or Directors & Officers Liability $1,000,000 Each Occurrence $1,000,000 Annual Aggregate Limit Business Automobile Liability Insurance $1,000,000 each accident on a combined single -limit basis, or $ 250,000 Property Damage $ 500,000 Bodily Injury per person per occurrence $2,000,000 Aggregate Insurance policy shall be endorsed to cover "Any Auto", defined as autos owned, hired, and non -owned. Pending availability of the above coverage and at the discretion of City, the policy shall be the primary responding insurance policy versus a personal auto insurance policy if or when in the course of Agency's business as contracted herein. Workers' Compensation Insurance Part A: Statutory Limits Part B: N,mployer's Liability $100,000 each accident $100,000 disease -each employee $500,000 disease-pohcy limit Note: Such insurance shall cover employees pertaining work on any and all projects including but not limited to construction, demolition, and rehabilitation. Agency or its contractors shall maintain coverages, if applicable In the event the respective contractors do not maintain coverage, Agency shall maintain the coverage on such contractor, if applicable, for each applicable contract. Additional Requirements Such insurance amounts shall be revised upward at City's reasonable option and no more frequently than once every 12 months, and Agency shall revise such amounts within 30 days following notice to Contractor of such requirements. Agency will submit to City documentation that it has obtained insurance coverage and has executed bonds as required in this Contract prior to payment of any monies provided hereunder. Where applicable, insurance policies required herein shall be endorsed to include City as an additional insured as its interest may appear. Additional insured parties shall include employees, officers, agents, and volunteers of City. Any failure on part of 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 Agency's 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 do business in the state of CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 30 Rev. 10.28.2015 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 otherwise approved by City. Deductible limits on insurance policies shall not exceed $5,000 per occurrence unless otherwise approved by City. In the event there are any local, federal or other regulatory insurance or bonding requirements for the Program, and such requirements exceed those specified herein, the former shall prevail. Agency shall require its contractors to maintain applicable insurance coverages, limits and other requirements as those specified herein; and Agency shall require its contractors to provide Agency with certificate(s) of insurance documenting such coverage. Also, Agency shall require its contractors to have City and Agency endorsed as additional insureds (as their interest may appear) on their respective insurance policies. Directors and Officers Liability coverage shall be in force and may be provided on a claims - made basis This coverage may also be referred to as Management Liability, and shall protect the insured against claims arising out of alleged errors in judgment, breaches of duty and wrongful acts arising out of their organizational duties. Coverage shall protect not only the entity, but all past, present and future directors, officers, trustees, employees, volunteers and committee members. Notwithstanding any provision in this Contract to the contrary, when applicable, Agency shall comply with the requirements of 2 CFR 200.310 and shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired or improved with CDBG Funds as provided to property owned by Agency. 18. CERTIFICATION REGARDING LOBBYING. The undersigned representative of Agency 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 Agency, 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 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 If any funds other than federally 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, member of Congress in connection with this federal contract, grant, loan or cooperative agreement, Agency shall complete and submit Standard Fortn-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 31 Rev. 10 28 2015 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 U S.C. 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. Agency shall require that the language of this certification be included in all subcontracts or agreements involving the expenditure of federal funds 19. LITIGATION AND CLAIMS. Agency shall give City immediate notice in writing of any action, including any proceeding before an administrative agency, filed against Agency in conjunction with this Contract or the Program. Agency shall furnish immediately to City copies of all pertinent papers received by Agency with respect to such action or claim Agency shall provide a notice to City within 10 days upon filing under any bankruptcy or financial insolvency provision of law. 20. NOTICE. All notices required or permitted by this Contract must be in writing and are deemed delivered on the earlier date of the date actually received or the third day following deposit in a United States Postal Service post office or receptacle; with proper postage, certified mail return receipt requested; and addressed to the other Party at the address set out below or at such other address as the receiving Party designates by proper notice to the sending Party. City: City Attorney's Office 1000 Throckmorton Street Fort Worth, TX 76102 Telephone: 817-392-7600 Copy to: Neighborhood Services Department 1000 Throckmorton Street Fort Worth, TX 76102 Attentions Assistant Director Telephones 817-392-7540 Copy to: Neighborhood Services Department 1000 Throckmorton Street Fort Worth, TX 76102 Attention* Program Coordinator Telephones 817-392-6342 CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 31-1 Rev. 10 28 2015 Atencv: Lena Pope Home, Inc. Sonya Mosley 3131 Sanguinet Street Fort Worth, TX 76107 Telephone: 817-255-2676 21. AGENCY HAS LEGAL AUTHORITY TO ENTER INTO CONTRACT. Agency 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 peifonn the responsibilities herein required. 22. COUNTERPARTS. This Contract may be executed in multiple counterparts, each of which shall be considered an original, but all of which shall constitute one instrument which may be sufficiently evidenced by one counterpart. [SIGNATURES APPEAR ON NEXT PAGE] CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 31-2 Rev. 10.28.2015 IN WITNESS WHEREOF, the Parties hereto have executed 4 duplicate originals of this Contract in Fort Worth, Tarrant County, Texas. ATTEST: CITY F FORT WORTH ORTH City Secretary M&C: 18521 Date: August 4, 2015 By: APPROVED AS TO FORM AND LEGALITY: Assistant City Attorney CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Horne, Inc. Fernando Costa, Assistant City Manager LENA POP TOME, INC. By: Name: Title: Aetei )1. tante., e et) a OFFICIAL RECORD CITY SECRETARY Ft WORTH, TX Page 32 Rev. 09.01.2015 IN WITNESS WHEREOF, the Parties hereto have executed 4 duplicate originals of this Contract in Fort Worth, Tarrant County, Texas. ATTEST: ity Se M&C: 8521 Date: August 4, 201 Cpp cP0 �1 Qcoo `I-t. AeAAe ocacioo CITY OF FORT WORTH By: APPROVED AS TO FORM AND LEGALITY: Assistant City Attorney Fernando Costa, Assistant City Manager LENA POPE HOME, INC. By: Name: Todd A. Landry Title: CEO OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc. Page 32 Rev. 10.28.2015 EXHIBITS: EXHIBIT EXHIBIT EXHIBIT EXHIBIT EXHIBIT EXHIBIT EXHIBIT EXHIBIT EXHIBIT EXHIBIT EXHIBIT "A" —Program Summary "A-1" — 2015 HUD Income Limits "A-2" — Reporting Requirements for Countywide Agencies "B" — Budget "C" — Audit Certification Form "D" — Reimbursement Forms "E" — Form of Income Self -Certification "F" — Standards for Complete Documentation "G" — Section 3 Reporting Forms "H" — Severely Disabled Certification Form "I" — MBE Reporting Form CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Home, Inc Page 33 Rev. 10.28.2015 LENA POPE HOME EXHIBIT "A" Second Opportunity for Success PROGRAM SUMMARY PROGRAM SUMMARY (CDBG) October 1, 2015 to September 30, 2016 PERIOD $75,000.00 AMOUNT Capitalized teiins not defined herein shall have meanings assigned them in the Contract. PROGRAM: The Program will provide counseling to youth ages 13 to 19 years and their families for the purpose of reducing juvenile crime and delinquency. Program services include group life -skill improvement classes and counseling for parents and their children Upon completion of the group portion of the Program, client progress will be monitored and clients will be provided with follow-up case management Agency is a Countywide Agency that provides services to Fort Worth and no less than 10% of Non -Fort Worth clients through a Fort Worth program and Non -Fort Worth program. The Program serves Fort Worth clients only, and Agency will submit documentation which verifies that 51% of Program clients are Income Eligible Clients with current household incomes at or below 80% of AMI. Agency will also submit quarterly reports as required through EXHIBIT `A-2" - Reporting Requirements for Countywide Agency Programs CDBG Funds will be used to pay for a percentage of salaries and fringe benefits for Program employees. The percentage of salaries for Program employees will not exceed the percentage of Fort Worth clients participating in the Program. Agency's office and Program services will be available at 3200 Sanguinet St., Fort Worth, TX 76107, Monday through Friday during regular business hours. Group services and intake will be held Wednesday and Thursday evenings from 6'00 p.m. to 8:00 p.m. Intakes will be scheduled prior to the group classes to be held from 5:00 p.m. to 6:00 p.m. REGULATORY CLASSIFICATION: IDIS Matrix Code(s) and Service Category. 05 Other Public Services National Objective Citation: LMC Low/Mod Limited Clientele 24 CFR 570.208(a)(2) Regulatory Citation(s): 24 CFR 570.201(e) CDBG 51% PSA CONTRACT 2015-2016 — EXHIBIT "A" — PROGRAM SUMMARY Page 1 Lena Pope Home PROGRAM GOALS: Minimum Countywide Agency Program Performance Outcome: At least 51% of Fort Worth clients must be Income Eligible Clients. For example if 800 clients out of 1,000 clients served by the Countywide Agency are from Fort Worth, 408 of those Fort Worth clients must also be Income Eligible Clients In this example, Agency would be required to furnish City 800 Certification of Income Statements that prove at least 408 of the Fort Worth clients served by the Program are Income Eligible Clients The 200 Non -Fort Worth clients will be reported in the quarterly reports through EXHIBIT `A-2" — Reporting Requirements for Countywide Agency Programs. Minimum Number of Fort Worth Clients to be Served: The Program must serve a minimum of 125 Unduplicated Clients from Fort Worth as shown by the monthly reports on Attachment III. When determining the number of clients which constitutes 51%, HUD regulations require that partial numbers must be rounded up. CDBG 51% PSA CONTRACT 2015-2016 — EXHIBIT "A" — PROGRAM SUMMARY Page 2 Lena Pope Home 30% AMI 50% AMI 80% AMI EXHIBIT "A-1" 2015 HUD INCOME LIMITS 2015 Median Family Income - Fort Worth/Arlington, TX* 1 Person 2 Persons 3 Persons $14,650 $24,400 $39,050 $16,750 $27,900 $44,600 4 Pei sons 5 Persons $20,090 $24,250 $31,400 $34,850 $50,200 $55,750 $28,410 $37,650 $60,250 6 Persons $32,570 $40,450 $64,700 *Income limits are published at least annually by HUD. 7 Persons $36,730 $43,250 $69,150 8 Persons $40,890 $46,050 $73,600 CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "A-1" —2015 HUD INCOME LIMITS Lena Pope Home, Inc. Page 1 EXHIBIT "A-2" REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "A-2" REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Lena Pope Home, Inc. Page 1 Lena Pope Home, Inc. REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Quarterly Report The purpose of the Quarterly Report is for the Countywide Agencies to report the number of non -Fort Worth clients who participate in the Program The Quarterly Report must be submitted with the January, April, July and October Reimbursement Requests. A paper copy must be submitted with the Reimbursement Request, and an electronic copy must also be emailed to usa a,fortworthtexas.gov. The information provided in the Quarterly Report will be reviewed and monitored by the Neighborhood Services Department Compliance Division. DUE DATE A REPORTING RANGE . B # OF FORT .• WORTH CLIENTS C # OF NON -FORT WORTH CLIENTS D TOTAL''°# OF CLIENTS SERVED BY THE PROGRAM (C+D) E %OF FORT WORTH CLIENTS (CFE) January 15, 2016 April 15, 2016 July 15, 2016 September 20, 2016 EXAMPLE: October 1, 2015 December 31, 2015 January 1, 2016 March 30, 2016 April 1, 2016 June 30, 2016 July 1, 2016 September 20 2016 TOTAL 250 200 450 250=450=55% I, Agency representative, certify that I verified the information I reported this quarter and it is correct to the best of my knowledge. Certified by: Signature/Title: Date: CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "A-2" REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES Lena Pope Home, Inc Page 2 ADMINISTRATIVE Salaries FICA Life Insurance Health Insurance Disability Insurance Unemployment -State Accounting TOTAL ADMINISTRATIVE EXPENSES % Administrative Cost PROGRAM PERSONNEL Salaries FICA Life Insurance Health Insurance Unemployment Worker's Compensation Retirement SUPPLIES AND SERVICES Office Supplies Office Equipment Rental Postage Printing MISCELLANEOUS Construction/Building Materials (only REACH) Contract Labor (City needs copy of contract before expenses can be reimbursed) Craft Supplies Field Trip Admission Expenses Other Field Trip Expenses (if preapproved by City) Food Supplies Teaching Aids Mileage Other (EE Benefits, Prof. Services, Admin Exp) FACILITY AND UTILITIES Telephone Electric Gas Water and Wastewater Solid Waste Disposal Rent (City needs copy of lease before expenses can be reimbursed) Custodial Services Repairs Cleaning Supplies LEGAL, FINANCIAL, AND INSURANCE Fidelity Bond or Equivalent Directors and Officers General Commercial Liability Contract Accounting DIRECT ASSISTANCE Childcare Scholarships Short-term Rent Assistance Short-term Mortgage Assistance Short-term Utilities Assistance OTHER EXPENSES TOTAL FUNDING A: LENA POPE FUNDING B: FUNDING C: EXHIBIT B - BUDGET Account Grant Budget 1001 1002 1003 1004 1005 1006 1007 2001 2002 2003 2004 2005 2006 2007 3001 3002 3003 3004 4001 4002 4003 4004 4005 4006 4007 5001 5002 5003 5004 5005 5006 5007 5008 5009 6001 6002 6003 6005 7001 7002 7003 7004 73,024 1,976 75,000 A 3,610 599 21,010 753 1,088 3,244 5,578 1,650 37,528 12,132 6,265 1,460 94,319 B C TOTAL 73,024 5,586 599 21,010 753 1,088 3,244 5,578 1,650 37,528 12,132 6,265 1,460 169,319 CDBG 51% PSA CONTRACT 2014-2015 Lena Pope Horne, Inc. EXHIBIT "B" — BUDGET Page 1 The following tables were created for the purpose of preparing, negotiating, and determining the cost reasonableness and cost allocation method used by the Agency for the line item budget represented on the first page of this EXHIBIT "B" — Budget. The information reflected in the tables is to be considered part of the terms and conditions of the Contract. Agency must have prior written approval by the City to make changes to any line item in the Budget as outlined in Section 5 2 2 in the Contract. The deadline to make changes to EXHIBIT ` B" — Budget is June 1, 2016. Position Name Community Based Services Supervisor Administrative Assistant Family Therapist Family Specialist Family Specialist Family Specialist TOTAL FICA Life Insurance Health Insurance Unemployment Workers Compensation Retirement TOTAL Office Supplies Office Equipment Rental Postage Printing Hourly Rate 31.34 16.50 19.64 19.98 21.54 18.54 265,283.20 Percent of Payroll 7.65% SALARY DETAIL Annual Hours Percent to Grant Amount to Grant 2080 10% 6,520 2080 2080 2080 2080 2080 FRINGE DETAIL Amount 5,598 30% 4% 56% 56% 17% 27.5% 10,296 1,634 23,134 24,940 6,500 73,024 Percent to Grant Amount to Grant 35.2% 5,598 35.2% SUPPLIES AND SERVICES Total Budget Percent to Grant Contract Labor Craft Supplies Facility Fees Field Trip Costs Food Supplies Teaching Aids CDBG 51% PSA CONTRACT 2014-2015 Lena Pope Home, Inc. MISCELLANEOUS Total Budget Percent to Grant EXHIBIT `B" BUDGET 1,976 1,976 Amount to Grant Amount to Grant Page 2 FACILITY AND UTILITIES Total Budget Percent to Grant Telephone hlectric Gas Water and Wastewater Solid Waste Disposal Rent Custodial Services Repairs Cleaning Supplies Fidelity Bond (or Equivalent) General Commercial Liability Directors and Officers Contract Accounting Childcare Scholarships Short -Teter Rent Assistance Short Term Mortgage Assistance Short Tenn Utilities Assistance Tenant Based Rental Assistance FINANCIAL AND INSURANCE Total Budget Percent to Grant Amount to Grant DIRECT ASSISTANCE Total Budget Percent to Grant Amount to Grant Amount to Grant CDBG 51% PSA CONTRACT 2014-2015 — EXHIBIT "B" BUDGET Page 3 Lena Pope Home, Inc EXHIBIT "C" AUDIT CERTIFICATION FORM CDBG 51% PSA CONTRACT 2015-2016 — EXHIBIT "C" — AUDIT CERTIFICATION FORM Page 1 Lena Pope Home, Inc. AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS Agency: Lena Pope Home, Inc. Fiscal Year Ending: September 30, 2016 During the fiscal year in which funds will be received, we will exceed the federal expenditure threshold of $750,000. We will have our Single Audit or Program Specific Audit completed and will submit the audit report described in 2 CFR Part 200 within 7 months after the end of the audited fiscal year or 30 days within its completion, whichever is the earlier date. [wring the fiscal year in which funds will be received, we will not exceed the $750,000 federal expenditure threshold required for a Single Audit or a Program Specific Audit to be performed this fiscal year. (Fill out schedule below) .0041 Ecpendltu.re. Disclosure. MUST be.filled 'out if Sin Pass Through ` PO. grann Name & • Grantor CFDA Number C.N.P.. lb.is5s aloe EiLtasksa -Th I SEA sisetkir t ri4 Federal Grantor aek-a k9itCk\ektvt, l �C ra petit 11E4S 0994 ku(a Art QGsvt�I5.LtJtLt � � S I VYM efrfiVt nt I 113SS9 lo%94°/oa'toI ±%aCSO .t 3/4` Cas.)%et g fi I `i.21$ I3cs I 7S1663 Total Federal Expenditures for this Fiscal Year: I (Q t2.O(S le Audit. or Prograrn.Audit- is NOT require 'Contract Number tit iN;tll e\ Signatory and Title 9/as( Date Failure to submit this or a similar statement or failure to submit a completed single audit package as described in the federally required audit requirements described in 2 CFR Part 200, as applicable, by the required due date may result in suspension of funding and may affect eligibility for future funding. Notwithstanding the above, this certification acknowledges the agency's commitment to meet all other financial reporting, financial statements, and other audit requirements as may be set forth in the Contract. CDBG 51% PSA CONTRACT 2015-2016 — EXHIBIT "C" — AUDIT CERTIFICATION FORM Page 2 Lena Pope Home, Inc. EXHIBIT "D" REPORTING FORMS CDBG 51% PSA CONTRACT 2015-2016 — EXHIBIT "D" — REPORTING FORMS Page 1 Lena Pope Home, Inc Agency: Address: City, State Zip Program: Period of Service: Program ATTACHMhNT I Invoice This Invoice Amount Cumulative to Date Agency's Certification: By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false fictitious or fraudulent information, or the omission of any material fact, may subject me to criminal civil, or administrative penalties for fraud, false statements, false claims, or otherwise. U.S. Code Title 18, Sec. 1001 and Title 31, Sec. 3729-3730 and 3801-3812. Signature and Date: Name: Title: CDBG 51% PSA CONTRACT 2015-2016 — EXHIBIT "D" — REPORTING FORMS Page 2 Lena Pope Home, Inc Line No. 1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Total Agency: Program. Check No. Payee ATTACHMENT II Expenditure Worksheet City of Fort Worth Neighborhood Services Department Expenditure Worksheet Please group like account codes. Account Code (See Key to Right) Amount Description* 1 *Payroll must identify employee. Rent must identify tempt. Other payments should identify individuals, if applicable. I 1 1 1 1 Highlighted are the only relevant codes for this Program. Expense Line Item ADMINISTRATIVE (HOP WA Only) IAccount Salaries FICA Life Insurance Health Insurance Disability Insurance Unemployment -State LqAccounting PROGRASIPERSONNEL Salaries FICA Life Insurance Health Insurance Unemplovrnent Worker's Compensation Retirement SUPPI.IFS AND SERVICES Office Supplies Office Equipment Rental Postage Printing MISCELLANEOUS Conference & Seminars Construction/Building Nlaterials Contract Labor Craft Supplies Credit Reports Facility Fees Field Trip Costs Food Supplies Mileage Teaching Aids FACILITY UTILITIES Telephone Electric Gas Water and Wastestater Solid Waste Disposal Rent Custodial Services Repairs Cleaning Supplies LEGAL. FINANCIAL‘AND INSURANCE Fidelity Bond or Equivalent Directors and Officers General Commercial Liability Legal Fees Contract Accounting DIRECT ASSISTANCE Childcare Scholarships Counseling - Indisidual Sessions Counseling - Group Sessions Short-term Rent Assistance Short-term Mortgage Assistance Short-term Utilities Assistance Tenant Based Rental Assistance CAPITAL OUTLAY Furniture. Fixtures Computers Office Equipment Sport and Recreation Equipment 1001 1002 1003 1004 1005 1006 1007 2001 2002 2003 2004 2005 2006 2007 3001 3002 3003 3004 4001 4002 4003 4004 4005 4006 4007 4008 4009 4010 5001 5002 5003 5004 5005 5006 5007 5008 5009 6001 6002 6003 6004 6005 7001 7002 7003 7004 7005 7006 7007 8001 8002 8003 8004 CDBG 51% PSA CONTRACT 2015-2016 EXHIBIT "D" REPORTING FORMS Page 3 Lena Pope Home, Inc. ATTACHMENT III Client Data Report Agency: Program: Month: Instructions: TEis report Is neat to list *11 unduplicated clients used daring the Contract teen (October 1.2015 to 5eptember30.2016). Eats month, please report the Informationof clients rot previously reported_ You are required to dtzb eligibility verification documentation for escb new client New oatpllcated ciitati should be listed below any previously reported ones so that this sheet .Ill act as a rolling tally. Please only list clients one time during the first month that they teethe seniet- Cients fast continue to receive Protract senicts (or ndtiple smooths only need to be listed one time. Put as "S" is each appropriate box regarding the client's ser.ethole' tr,ram etc. Please note tkat reimbursement for salaries will require thst tke agency report to the City all the that were served by flat particular staff persca that program. Informationfor each client listed &law must last the de mographie Info notion reflected In columns 1 thru 12. 1 DATE area RECFI\fl Mtt,reM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 16 17 I8 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 3 44 45 45 47 48 49 50 1 2 Fri iiT WORTH RE(ne.-t YES OR.NO J 2_A SERVICE LOCATION ()F APFIICAELE) 3 NAME Und%f'� Clts for CURRENT MONTH I• Please highlight new clients for the mortis. I CUMULKTIVELnd (icattd Clients I 1 •Proposed Olen of � Contract 1 I o estaneMet NDIV%0! I D. tot vibe dr cieut gang cntess the coatrxt b are d arcerd yh. 4 STREET ADDRESS (Chem Address) 5 ADE 6 7 SEX Ell L PJT - tEmEc'eOm) (IE Orl MALE F E A1..E ILSPA.NIC Nu)I- IiL4FA`.'1(' ASLA`I BLACK OP AFRIA`: AYs�J=a�: NATIVE UAtt'AILA NOR. OTHER PACIFIC LSLAN DER 8 RACE ib.r >eOm) MUTE ALOE ICAN N'D1AH c-g ALASKAN 1umE AND w1ff1E ASIAN AND WRITE ELACIti OR AFPJi AN a' A! N AXD A'HIU A-' !CAN LC'DLAN OR ALA_KA NATIVE Al SL%CE CAR AFRI^AN AM JC.AN Ora M tA)LTiFLE RAVE CD taNA TF)NS• 1 1 1 1 1 1 1 I i 1 9 10 DiSaBIPD •Infrmte Orel YES 1 NO 11 Ell INCOS(E (Odycleat 1 oftdr 5cabaa) act' 7 9 45, FRF I7 SiMI 5I4Dra 1;_sa,... AsII AM .:e A J lJ' ENO N !Panned esm KIND AS I) YES NO CDBG 51% PSA CONTRACT 2015-2016 Lena Pope Horne, Inc. EXHIBIT "D" REPORTING FORMS Page 4 EXHIBIT "E" INCOME CERTIFICATION FORMS CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "E" -- INCOME CERTIFICATION FORMS Page 1 Lena Pope Home, Inc. Lena Pope Home, Inc. CERTIFICATION OF INCOME STATEMENT Applicant Name: Current Address: Phone : Household Members and Income (Including Applicant) Last Name First Name Age Monthly Source/Employer Name Income **PERSONAL INFORMATION: (Check one in each item. Optional Information for Federal Reporting Purposes) a. ❑ MALE b. f WHITE ❑ BLACK/AFRICAN AMERICAN ❑ BLACK/AFRICAN AMERICAN & WHITE 0 FEMALE ■ AMERICAN INDIAN/ALASKAN NATIVE ■ ASIAN 0 AMERICAN INDIAN/ALASKAN NATIVE & WHITE ❑ ASIAN & WHI I NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER ❑ BALANCE/OTHER AMERICAN INDIAN/ALASKAN NATIVE & BLACK/AFRICAN AMERICAN ■ ■ c. ETHNICITY d. DISABLED e. IS CLIENT WOMEN HEAD OF HOUSEHOLD ❑ HISPANIC ■ YES ■ YES ❑ NON -HISPANIC ■ NO ■ NO * TOTAL NUMBER OF HOUSEHOLD MFMBERS Total Anticipated Annual Household Income• (Include Yourself AND everyone who lives in the house.) Certification: I certify that the information I am providing is true and could be subject to verification at any time by a third party. I also acknowledge that the provision of false information could leave me subject to the penalties of Federal, State and local law. WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT. Signature of Applicant Date For use by Agency staff only Household Size: Gross Annual Income• Applicable Income Limit Is Applicant Eligible? Check if Applicant refused to provide demographic information: ❑ Staff Assessment of Demographics: Person Making Determination• Date: NOTE: Address, income amounts and sources for ALL household members are required. CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "E" -- INCOME CERTIFICATION FORMS Page 2 Lena Pope Home, Inc. Lena Pope Home, Inc. CERTIFICACION DE DECLARACION DE INGRESOS Nombre del Solicitante: Domicilio Actual: Ntimero de Telefono• Miembros en el Hogar e Ingresos (Incluir el/la solicitante) Apellido Nombre Edad Ingreso Fuente de Ingresos/Nombre de Empleador Mensual **INFORMACION PERSONAL (Seleccione uno en cada categoria. Informacion opcional para propositos de informacion Federal) a. ❑ MASCULINO b. ❑ CAUCASICO ❑ NEGRO/AFRICANO AMERICANO ❑ NEGRO/AFRICANO AMERICANO & CAUCASICO ❑ FEMININO ■ INDIO AMERICANO/NATIVO DE ALASKA ❑ ASIATICO INDIO AMERICANO/NATIVO DE ALASKA & CAUCASICO ■ ASIATICO & CAUCASICO NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS ❑ BALANCE/OTRO ❑ INDIO AMERICANO / NATIVO DE ALASKA & NEGRO/AFRICANO AMERICANO c. ETNICIDAD d. DISCAPACITADO e. tES EL SOLICITANTE UNA MUJER Y CABECERA DEL HOGAR? ❑ HISPANO ❑ SI ❑ SI ❑ NO-HISPANO ❑ NO ❑ NO ■ * NUMERO TOTAL DE MIEMBROS EN EL HOGAR Ingreso total del hogar anual anticipado: (Incluye a si mismo y a todos los que viven en la casa) Certificacion: Certifico que la informacion que proporciono es verdad y podria ser susceptible a la comprobacion a cualquier tiempo por terceros. Yo tambien reconozco que la provision de informacion falsa me podria dejar sujeto a las penalidades Federales, Estatales y locales. ADVERTENCIA: TITULO 18, SECCION 1001 DEL CODIGO DE EE.UU. QUE UNA PERSONA Es CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMENTE RACER DECLARACIONES FALSAS 0 FRAUDULENTAS A CUALQUIER DEPARTAMENTO DEL GOBIERNO ESTADOUNIDENSE. Firma del Solicitante Fecha Para use de empleados de la agenda # De Miembros de Familia: Ingreso Anual: Limite de Ingreso: Compruebe si el solicitante se nego a dar su informacion personal Evaluacion del empleado sobre infotniacion personal: 1,Es solicitante elegible? : Persona haciendo la detenninacion: Fecha• Note: La direccion de la casa y los ingresos (y sus origenes) para todos miembros del hogar son requeridos. CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "E" -- INCOME CERTIFICATION FORMS Page 3 Lena Pope Home, Inc. EXHIBIT "F" STANDARDS OF DOCUMENTATION CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "F" -- STANDARDS OF DOCUMENTATION Page 1 Lena Pope Home, Inc. 1 1 2015-2016 Documentation Standards for CDBG Public Service Contract Expenses Notes/Other Employee Salaries and Benefits - City will only reimburse a percentage of any employee's salary and benefits who work directly with the CDBG-funded Program. Percentages will be cost allocated and determined prior to the execution of the CDBG Contract. Agencies requesting the reimbursement of 100% of any Agency employee will require prior City approval. Agencies must show calculation on how the CDBG portion of employee salaries and benefits were calculated consistently with the CDBG Contract. Salaries FICA/Medicare X I X Life Insurance 1 X 1 X Health X X Insurance Disability Insurance U nemployment x Insurance X X X If an employee works on both a CDBG eligible and non-CDBG eligible program(s), the City will only reimburse for a reasonable portion of the employee's salary. Prior to the execution of the CDBG Contract, the Agency will priovide the City with a written statement on how each employee's time will be allocated. If an employee works 100% of their time directly with the CDBG-funded Program, then 100% of the employee's salary may be eligible for reimbursement. Agency must submit a written statement that 100% of the employee's time is spent working directly with the CDBG-funded Program. Statements must be signed by a person authorized to sign on behalf of the Agency and will be submitted with the October invoice. Reimbursement requests must include a timesheet and work log that reflects the hours worked by the employee(s) working directly on the CDBG-funded Program. For employees who are paid with multiple funding sources, timesheets must reflect all funding sources. If separate timesheets are kept for each funding source, all such timesheets must be submitted to City. Timesheets must be signed by employee and supervisor. Agency must show a calculation and documentation of how the employee's salary was calculated and invoiced to City. `If employees are paid by direct deposit rather than check, then the agency must submit both the direct deposit payment company's report (such as an ADT report) and a bank statement or check showing payment to the direct deposit company. If the City pays gross salary, this is already included. If the City pays the employer portion, the Agency must provide proof that the employee is enrolled in the benefit plan, must show a calculation and documentation of how the invoiced amount was calculated, and must provide documentation showing payment. If the City pays gross salary, this is already included. If the City pays the employer portion, the Agency must provide proof that the Retirement X X employee is enrolled in the benefit plan, must show a calculation and documentation of how the invoiced amount was calculated, and must provide documentation showing payment. Materials, Equipment, Goods and Supplies - City will only reimburse for the cost allocated percent or amount spent in support of the CDBG-funded Program. Agencies requesting reimbursement for these items will require prior City approval. Agencies must show calculation on how the CDBG portion of these expenses were calculated consistently with the CDBG Contract. Office Supplies Office Equipment Rental Postaae P rintina Construction & Building Materials Sport and Recreation Eouipment Cleaning S upplies Teachina Aids !Craft Supplies Food Supplies xx x X X X X X X X X X X X X X X X This category is only available for the REACH Program. X X I 1 1 x 1 1 1 1 x 1 X 'This category is only available to the Program provided by Meals on Wheels. Rent, Utilities and Maintenance - City will only pay for a portion of these expenses. The portion of these expenses will be determined by the square footage attributable to the CDBG-funded Program and shall be cost -allocated in accordance with the amount of space used for the CDBG-funded Program. These expenses may only be in support of the CDBG-funded Program. The items listed below require prior City approval and the Agency is required to identify any funding source that pays for the portion of the expenses that is not paid with CDBG funds. Agencies must show calculation on how the CDBG portion of these expenses were calculated consistently with the CDBG Contract. I I I Telephone X X Gas X X Water/Wastew X X ater Electric X X Solid Waste X X Facility Maintenance X X X and Repairs Rent X X X This item requires approval by the City prior to the execution of the CDBG Contract. Repairs may be categorized as major/minor rehabilitation projects and must be approved through the full HUD Environmetal Review. City will pay for a portion of the rent for the Program facility so long as its in proportion to the square footage attributable to the CDBG- funded program. 1 1 CDBG 51% PSA CONTRACT 2015-2016 E4iibit "F" -- STANDARDS FOR COMPLETE DOCUMENTATION Miscellaneous This item requires prior approval by the City. Prior to the execution of the CDBG Contract, the Agency must submit a written statement that lists the contract labor services to be used during the Contract term. Agency will submit a memo related to the procurement of such Contract Labor X X X X X services and will forward any information pertaining to the procurement process to City. This requirement applies to, but is not limited to, services retained for security services, legal, accounting, transportation providers, educational facilitators, custodial services, etc. Agencies may not use the contract services of any City of Fort Worth Department. City -required X X City will only pay for a percentage of the City -required insurance so long as it's in proportion to the square footage attributable to the Insurance CDBG-funded program. City requires that the agency submit its fee schedule or formula on how the Agency calculates the childcare scholarship amount. The fee schedule/formula should demonstrate a breakout of income levels, and for each income level the schedule should demonstrate Childcare X X which portion of the expense is to be paid by the family and which portion of the expense is to be reimbursed by the City. A fee Scholarships schedule/formula must be submitted to the City prior to the first payment. Agency must submit documentation supporting that the client is income eligible and that the household is being charged in conformance with the fee schedule. If the fee schedule/formula changes at any time during the contract term, the Agency must immediately notify City on the date the new fee schedule/formula takes into effect. "$0" Income Certifications Audit Services X X X X Agecies that are required to verify and provide proof of household income to determine eligibility, must require that anyone who is over the age of 18, living in the housohold, submit a $0 Income Certification. If an audit is required because federal funds exceed $750,000, then the cost should be split evenly by all grant funding sources. Agency must show calculation on how the CDBG portion of the accounting services were calculated. For example, if the CDBG grant is 10% of your Agency's budget, then invoice shall not exceed 10% of the overall cost, Agency must show a calculation and documentation of how the invoiced amount was calculated, and must provide documentation showing payment. *Proof of payment effective October 1, 2013: Payments or Expenses must be documented in the following manner: A) Image of the check AND bank statement showing the check cleared the bank; OR, B) Image of the cancelled check (ex. At end of bank statement); OR, C) Payroll Check Stub, "Advice", or Statement AND Bank Statement indicating payroll; OR, D) For wire or e-transfers: Reciept or statement from payee/vendor OR bank statement. Revised 08 22 2015 /hr 1 CDBG 51 % PSA CONTRACT 2015-2016 Exhibit aF. -- STANDARDS FOR COMPLETE DOCUMENTATION EXHIBIT "G" SECTION 3 REPORTING FORMS CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "G" -- SECTION 3 REPORTING FORMS Page 1 Lena Pope Home, Inc. EXHIBIT "G" Section 3 Summary Report Economic Opportunities for Low — and Very Low -Income Persons Section back of page for Public Reporting Burden statement 1. Recipient Name & Address: (street, city, state, zip) U.S. Department of Housing and Urban Development Office of Fair Housing And Equal Opportunity 2. Federal Identification: (grant no.) 4. Contact Person 6. Length of Grant: 8. Date Report Submitted: 9. Program Code: (Use separate sheet for each program code) Part 1. Employment and Traininq ("` Columns B, C and F are mandatory fields. Include New A B C D Number of Number of New % of Aggregate Number Job Category New Hires Hires that are of Staff Hours of New Hires Sec. 3 Residents that are Sec. 3 Residents Professionals Technicians Office/Clerical Construction by Trade (List) Trade Trade Trade Trade Trade Other (List) Total Program Codes 1 = Flexible Subsidy 2 = Section 202/811 3 = Public/Indian Housing A = Development, B = Operation C = Modemization OMB Approval No: 2529-0043 (exp. 11/30/2010) HUD Field Office: 3. Total Amount of Award: 5. Phone: (Include area code) 7. Reporting Period: 10. Program Name: Hires in E &F) E of Total Staff Hours for Section 3 Employees and Trainees 4 = Homeless Assistance 5=HOME 6 = HOME State Administered 7 = CDBG Entitlement F Number of Section 3 Trainees 8 = CDBG State Administered 9 = Other CD Programs 10 = Other Housing Programs Page 1 of 2 form HUD 60002 (6/2001) Ref 24 CFR 135 Part II: Contracts Awarded 1. Construction Contracts: A. Total dollar amount of all contracts awarded on the project B. Total dollar amount of contracts awarded to Section 3 businesses C. Percentage of the total dollar amount that was awarded to Section 3 businesses D. Total number of Section 3 businesses receiving contracts 2. Non -Construction Contracts: A. Total dollar amount all non -construction contracts awarded on the project/activity B. Total dollar amount of non -construction contracts awarded to Section 3 businesses $ C. Percentage of the total dollar amount that was awarded to Section 3 businesses D. Total number of Section 3 businesses receiving non -construction contracts Part III: Summary Indicate the efforts made to direct the employment and other economic opportunities generated by HUD financial assistance for housing and community development programs, to the greatest extent feasible, toward low -and very low-income persons particularly those who are recipients of government assistance for housing. (Check all that apply.) Attempted to recruit low-income residents through: local advertising media, signs prominently displayed at the project site, contracts with the community organizations and public or private agencies operating within the metropolitan area (or nonmetropolitan county) in which the Section 3 covered program or project is located, or similar methods. Participated in a HUD program or other program which promotes the training or employment of Section 3 residents. Participated in a HUD program or other program which promotes the award of contracts to business concerns which meet the definition of Section 3 business concerns. Coordinated with Youthbuild Programs administered in the metropolitan area in which the Section 3 covered project is located. Other describe below. Public reporting for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB number. Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701 u, mandates that the Department ensures that employment and other economic opportunities generated by its housing and community development assistance programs are directed toward low- and very -low income persons, particularly those who are recipients of government assistance housing. The regulations are found at 24 CFR Part 135. The information will be used by the Department to monitor program recipients' compliance with Section 3, to assess the results of the Department's efforts to meet the statutory objectives of Section 3 to prepare reports to Congress, and by recipients as self -monitoring tool. The data is entered into a database and will be analyzed and distributed. The collection of information involves recipients receiving Federal financial assistance for housing and community development programs covered by Section 3. The information will be collected annually to assist HUD in meeting its reporting requirements under Section 808(e)(6) of the Fair Housing Act and Section 916 of the HCDA of 1992. An assurance of confidentiality is not applicable to this form. The Privacy Act of 1974 and OMB Circular A-108 are not applicable. The reporting requirements do not contain sensitive questions. Data is cumulative; personal identifying information is not included Page 2 of 2 form HUD 60002 (11/2010) Ref 24 CFR 135 Form HUD-60002, Section 3 Summary Report, Economic Opportunities for Low- and Very Low -Income Persons. Instructions: This form is to be used to report annual accomplishments regarding employment and other economic opportunities provided to low- and very low-income persons under Section 3 of the Housing and Urban Development Act of 1968. The Section 3 regulations apply to any public and Indian housing programs that receive: (1) development assistance pursuant to Section 5 of the U.S. Housing Act of 1937; (2) operating assistance pursuant to Section 9 of the U.S. Housing Act of 1937; or (3) modernization grants pursuant to Section 14 of the U.S. Housing Act of 1937 and to recipients of housing and community development assistance in excess of $200,000 expended for: (1) housing rehabilitation (including reduction and abatement of lead -based paint hazards); (2) housing construction; or (3) other public construction projects; and to contracts and subcontracts in excess of $100,000 awarded in connection with the Section-3-covered activity. Form HUD-60002 has three parts, which are to be completed for all programs covered by Section 3. Part I relates to employment and training. The recipient has the option to determine numerical employment/training goals either on the basis of the number of hours worked by new hires (columns B, D, E and F). Part II of the form relates to contracting, and Part III summarizes recipients' efforts to comply with Section 3. Recipients or contractors subject to Section 3 requirements must maintain appropriate documentation to establish that HUD financial assistance for housing and community development programs were directed toward low- and very low-income persons.* A recipient of Section 3 covered assistance shall submit one copy of this report to HUD Headquarters, Office of Fair Housing and Equal Opportunity. Where the program providing assistance requires an annual performance report, this Section 3 report is to be submitted at the same time the program performance report is submitted. Where an annual performance report is not required, this Section 3 report is to be submitted by January 10 and, if the project ends before December 31, within 10 days of project completion. Only Prime Recipients are required to report to HUD. The report must include accomplishments of all recipients and their Section 3 covered contractors and subcontractors. HUD Field Office: Enter the Field Office name . 1. Recipient: Enter the name and address of the recipient submitting this report. 2. Federal Identification: Enter the number that appears on the award form (with dashes). The award may be a grant, cooperative agreement or contract. 3. Dollar Amount of Award: Enter the dollar amount, rounded to the nearest dollar, received by the recipient. 4 & 5. Contact Person/Phone: Enter the name and telephone number of the person with knowledge of the award and the recipient's implementation of Section 3. 6. Reporting Period: Indicate the time period (months and year) this report covers. 7. Date Report Submitted: Enter the appropriate date. Submit one (1) copy of this report to the HUD Headquarters Office of Fair Housing and Equal Opportunity, at the same time the performance report is submitted to the program office. The Section 3 report is submitted by January 10. Include only contracts executed during the period specified in item 8. PHAs/IHAs are to report all contracts/subcontracts. The terms "low-income persons" and very low-income persons" have the same meanings given the terms in section 3 (b) (2) of the United States Housing Act of 1937. Low-income persons mean families (including single persons) whose incomes do not exceed 80 percent of the median income for the area, as determined by the Secretary, with adjustments for smaller and larger families, except that 8. Program Code: Enter the appropriate program code as listed at the bottom of the page. 9. Program Name: Enter the name of HUD Program corresponding with the "Program Code" in number 8. Part I: Employment and Training Opportunities Column A: Contains various job categories. Professionals are defined as people who have special knowledge of an occupation (i.e. supervisors, architects, surveyors, planners, and computer programmers). For construction positions, list each trade and provide data in columns B through F for each trade where persons were employed. The category of "Other" includes occupations such as service workers. Column B: (Mandatory Field) Enter the number of new hires for each category of workers identified in Column A in connection with this award. New hire refers to a person who is not on the contractor's or recipient's payroll for employment at the time of selection for the Section 3 covered award or at the time of receipt of Section 3 covered assistance. Column C: (Mandatory Field) Enter the number of Section 3 new hires for each category of workers identified in Column A in connection with this award. Section 3 new hire refers to a Section 3 resident who is not on the contractor's or recipient's payroll for employment at the time of selection for the Section 3 covered award or at the time of receipt of Section 3 covered assistance. Column D: Enter the percentage of all the staff hours of new hires (Section 3 residents) in connection with this award. Column E• Enter the percentage of the total staff hours worked for Section 3 employees and trainees (including new hires) connected with this award. Include staff hours for part-time and full-time positions. Column F: (Mandatory Field) Enter the number of Section 3 residents that were trained in connection with this award. Part II: Contract Opportunities Block 1: Construction Contracts Item A: Enter the total dollar amount of all contracts awarded on the project/program. Item B: Enter the total dollar amount of contracts connected with this project/program that were awarded to Section 3 businesses. Item C: Enter the percentage of the total dollar amount of contracts connected with this project/program awarded to Section 3 businesses. Item D: Enter the number of Section 3 businesses receiving awards. Block 2: Non -Construction Contracts Item A: Enter the total dollar amount of all contracts awarded on the project/program. Item B: Enter the total dollar amount of contracts connected with this project awarded to Section 3 businesses. Item C: Enter the percentage of the total dollar amount of contracts connected with this project/program awarded to Section 3 businesses. Item D: Enter the number of Section 3 businesses receiving awards. Part III: Summary of Efforts — Self -explanatory The Secretary may establish income ceilings higher or lower than 80 percent of the median for the area on the basis of the Secretary's findings such that variations are necessary because of prevailing levels of construction costs or unusually high- or low-income families. Very low-income persons mean low-income families (including single persons) whose incomes do not exceed 50 percent of the median family income area, as determined by the Secretary with adjustments or smaller and larger families, except that the Secretary may establish income ceilings higher or lower than 50 percent of the median for the area on the basis of the Secretary's findings that such variations are necessary because of unusually high or low family incomes. Page i form HUD 60002 (11/2010) Ref 24 CFR 135 EXHIBIT "H" SEVERELY DISABLED CERTIFICATION FORM CDBG 51 % PSA CONTRACT 2015-2016 EXHIBIT "H" SEVERELY DISABLED CERTIFICATION FORM Page 1 Lena Pope Home, Inc. Lena Pope Home, Inc. CERTIFICATION FORM DOCUMENTING CLIENT STATUS AS '`SEVERELY DISABLED ADULT" Client Name: Address: City, State, Zip Client Identification No. CHECK ALL THAT APPLY Has used a wheelchair, a walker, cane , crutches or other special aid for six months or longer Has been diagnosed with one of the following conditions: Alzheimer's disease, mental retardation or other developmental disability, senility or dementia, cerebral palsy, or autism; or has another mental or emotional condition that seriously interferes with everyday tasks. Is unable to perform one or more of the following "Functional Activities": seeing, hearing, speaking and having one's speech understood, lifting or carrying, using stairs, grasping small objects, or walking. Is unable to perform or needs assistance to perform one or more of the following Activities of Daily Living (ADL)• getting around inside the home, getting in or out of bed or a chair, bathing, dressing, eating, and toileting. Is unable to perform or needs assistance to perform one or more of the following Instrumental Activities of Daily Living (IADL)• going outside the home, keeping track of money and bills, preparing meals, doing light housework, taking prescription medications in the right amount and at the right time, and using the telephone. Has a condition that prevents them from working at a job or doing housework. The undersigned Agency representative conducted a visual assessment of the client identified on this form and certifies that the client meets at least one of the conditions indicated above, which determines that he/ she meets the definition of "severely disabled' according to the U.S. Census Bureau. Certified by: Date: Signature/Title: CFW Neighborhood Services Dept.: Revised 08.30.2013 CDBG 51% PSA CONTRACT 2015-2016 — EXHIBIT "H" — SEVERELY DISABLED CERTIFICATION FORM Page 2 Lena Pope Home, Inc EXHIBIT "I" MBE REPORTING FORM CDBG 51% PSA CONTRACT 2015-2016 -- EXHIBIT "I" -- MBE REPORTING FORM Page 1 Lena Pope Home, Inc. Contract and Subcontract Activity U.S. Department of Housing and Urban Development OMB Approval No,: 2577-0088 OMB Approval No,: 2502-0355 Public reporting burden for this collection of information is estimated to average .5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The Information is voluntary. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB Control Number. Executive Orders dated July 14, 1983, directs the Minority Business Development Plans shall be developed by each Federal Agency and the these annual plans shall establish minority business development objectives. The information is used by HUD to monitor and evaluate MBE activities against the total program activity and the designated minority business enterprise (MBE) goals. The Department requires the information to provide guidance and oversight for programs for the development of minority business enterprise conccming Minority Business Development. If the information is not collected HUD would not be able to establish meaningful MBE goals nor evaluate MBE performance against these goals. Privacy Act Notice = The United States Department of Housing and Urban Development, Federal Housing Administration, is authorized to solicit the Informon requested in this form by virtue of Title 12, United States Code, Section 1701 ct seq., and regulation. It will not be disclosed or rclesed outside the United States Department of Housing and Urban Development without your consetn, except as required or permitted by Law. I. Grantee/Project Owner/Developer/Sponsor/Builder/Agency City of Fort Worth 3a. Name of Contact Person 3b. Phone Number (Including Area Code) Sarah Burkett 817-392-7538 Grant/Project Number or IIUD Case Number or other identification of properly, sntdivision. dwelling unit, etc. Amount of Contract or Subcontuct 7u. 7b. CPD: I = New Construction 2 - Education/Training 3 - Other Previous editions arc obsolete 1 - New Construction 2 = Substantial Rehab. 3 - Repair 4 - Service 5 - Prnicct Mont. Type of Trade Code (See below) Contractor or Subcontractor Business Racial/Ethnic Wonsan Owned Business (Sec below) (Yes or No) 7c. 7d. 7e. Scc. 3 Business (Yes or No) 7c: Type of Trade Codes: Housing/Public housing: 6 = Professional 7 - Tenant Services 8 = Education/Training 9 -Arch,/Engrg. Appmisnl 0 - Other Prime Contractor Identification (ID) Number 71. 4. Reporting Period Oct. 1 - Sept. 30 (Annual - Y) Sec. 3 7a. Subcontractor Identification OD) Number 711 7d: Racial/Ethnic Codes: 1 - White Americans 2 - Block Americans 3 - Nonce Americans 4 - Hispanic Americans 5 = Asian/Pacific Americans 6 = Hasidic lows Sec. 3 7i. Check if: PH IH CPD Housing 5 Program Code (Not applicable for CPD programs.) See explanation of Codes at bosom of P ge Use a separate sheet for each program code. Contractor/Subcontractor Name and Address Name 2. Location (City, State Zip Code) 1000 Throckmtorton- Fort Worth. TX 76102 Street 6. Dote Submitted to Field Office City Stale 5: Program Codes (Complete for Housing and Public and Indian Housing programs only): I - All Insured, including Soction8 2- Flexible Subsidy 3 - Section 8 Noninsured, Non-HFDA 4 - Insured (Management) 5 ` Section 202 6 = IIUD-Held (Management) 7 - Public/India Housing 8 = Section 811 form HUD-2516 (8/981 7j. Zip II New h Ncw hires arc °6 Sec. 3 Hires Sec. 3 Res. New Hires #DIV/0! #DFV/01 #DIV/0! #DIV/0! #DIV/0! I A) W/O! d DIV/01 IDIV/0! #DIV/01 //DIV/0! #DN/ot #DIV/01 #DIV/0! #DN/0! #DFV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! This report is to be completed by grantees, developers, sponsors, builders, agencies, and/or project owners for reporting contract and subcontract activities of S10,000 or more under the following programs: Community Development Block Grants (entitlement and small cities); Urban Development Action Grants; Housing Development Grants; Multifamily Insured and Noninsured; Public and Indian Housing Authorities; and contracts entered into by recipients of CDBG rehabilitation assistance, Contracts/subcontracts of less than $10,000 need be reported only if such contracts represent a significant portion of your total contracting activity. Include only contracts executed during this reporting period, This form has been modified to capture Section 3 contract data in columns 7g and 7i. Section 3 requires that the employment and other economic opportunities generated by HUD financial assistance for housing and community development programs shall, to the greatest extent feasible, be directed toward low- and very low-income persons, particularly those who are recipients of government assistance for housing. Recipients using this form to report Section 3 contract data must also use Part I of form HUD-60002 to report employment and training opportunities data. Form HUD-2516 is to be Community Development Programs 1. Grantee: Enter the name of the unit of government submitting this report. 3. Contact Person: Enter name and phone of person responsible for maintaining and submitting contract/subcontract data. 7a. Grant Number: Enter the HUD Community Development Block Grant Identification Number (with dashes). For example: B-32-MC-25-0034. For Entitlement Programs and Small City multi -year comprehensive programs, enter the latest approved grant number. 7b. Amount of Contract/Subcontract: Enter the dollar amount rounded to the nearest dollar. If subcontractor ID number is provided in 7f, the dollar figure would be for the subcontract only and not for the prime contract. 7c. Type of Trade: Enter the numeric codes which best indicates the contractor's/subcontractor's service. If subcontractor ID number is provided in 7f., the type of trade code would be for the subcontractor only and not for the prime contractor. The "other" category includes supply, professional services and all other activities except construction and education/training activities. 7d. Business Racial/Ethnic/Gender Code: Enter the numeric code which indicates the racial/ethnic/gender character of the owner(s) and controller(s) of 51% of the business. When 51 % or more is not owned and controlled by any single racial/ethnic/gender category, enter the code which seems most appropriate. If the subcontractor ID number is provided, the code would apply to the subcontractor and not to the prime contractor. 7e. Woman Owned Business: Enter Yes or No. 7f. Contractor Identification (ID) Number: Enter the Employer (IRS) Number of the Prime Contractor as the unique identifier for prime recipient of HUD funds. Note that the Employer (IRS) Number must be provided for each contract/subcontract awarded. 7g. Section 3 Contractor: Enter Yes or No. 7h. Subcontractor Identification (ID) Number: Enter the Employer (IRS) Number of the subcontractor as the unique identifier for each subcontract awarded from HUD funds. When the subcontractor ID Number is provided, the respective Prime Contractor ID Number must also be provided. 7i. Section 3 Contractor: Enter Yes or No. 7j. Contractor/Subcontractor Name and Address: Enter this information for each firm receiving contract/subcontract activity only one time on each report for each firm. completed for public and Indian housing and most community development programs. Form HUD- 60002 is to be completed by all other HUD programs including State administered community development programs covered under Section3. A Section 3 Contractor/subcontractor is a business concern that provides economic opportunities to low and very Low-income residents of the metropolitan area (or nonmetropolitan county), including a business concern that is 51 person or more owned by low-income residents; or provides subcontracting or business development opportunities to businesses owned by low or low-income residents. Low and very low-income residents; include participants in Youthbuild programs established under Subtitle D of Title IV of the Cranston -Gonzalez National Affordable Housing Act. The terms "low-income persons" and "very low-income persons" have the same meanings given the terms in section3(b)(2) of the United States Housing Act of 1937. Low-income persons mean families (including single persons) whose incomes do not exceed 80 per centum of the median income for the area, as determined by the Secretary, with adjustments for smaller an larger families, except that the Secretary may establish income ceilings higher or lower than 80 per centum of the median for the area on the basis of the Secretary's findings that such variations are necessary because of prevailing levels of construction Multifamily Housing Programs 1. Grantee/Project Owner: Enter the name of the unit of government, agency or mortgagor entity submitting this report. 3. Contact Person: Same as item 3 under CPD Programs. 4. Reporting Period: Check only one period. 5. Program Code: Enter the appropriate program code. 7a. Grant/Project Number: Enter the HUD Project Number or Housing Development Grant or number assigned. 7b. Amount of Contract/Subcontract: Same as item 7b. under CPD Programs. 7c. Type of Trade: Same as item 7c. under CPD Programs. 7d. Business Racial/Ethnic/Gender Code: Same as item 7d. under CPD Programs. 7e. Woman Owned Business: Enter Yes or No. 7f. Contractor Identification (ID) Number: Same as item 7f. under CPD Programs. 7g. Section 3 Contractor: Enter Yes or No. 7h. Subcontractor Identification (ID) Number: Same as item 7h, under CPD Programs. 7i. Section 3 Contractor: Enter Yes or No. 7j. Contractor/Subcontractor Name and Address: Same as item 7j. under CPD Programs. costs or unusually high or low-income families. Very low-income families (including single persons) whose incomes do not exceed 50 per centum of the median family income for the area, as determined by the Secretary with adjustments for smaller and larger families, except that the secretary may establish income ceilings higher or lower than 50 per centum of the median for the area on the basis of the Secretary's findings that such variations are necessary because of unusually high or low family incomes. Submit two (2) copies of this report to your local HUD Office within ten (10) days after the end of the reporting period you checked in item 4 on the front, Complete item 7h. Only once for each contractor/subcontractor on each semi-annual report. Enter the prime contractor's ID in item 7f. for all contracts and subcontracts. Include only contracts expected during this reporting period. PHAs/IHAs are to report all contracts/subcontracts. Public Housing and Indian Housing Programs PHAs/IHAs are to report all contracts/subcontracts. Include only contracts executed during this reporting period. 1. Project Owner: Enter the name of the unit of government, agency or mortgagor entity submitting this report. Check box as appropriate. 3. Contact Person: Same as item 3 under CPD Programs. 4. Reporting Period: Check only one period. 5. Program Code: Enter the appropriate program code. 7a. Grant/Project Number: Enter the HUD Project Number or Housing Development Grant or number assigned. 7b. Amount of Contract/Subcontract: Same as item 7b. under CPD Programs. 7c. Type of Trade: Same as item 7c. under CPD Programs. 7d. Business Racial/Ethnic/Gender Code: Same as item 7d. under CPD Programs. 7e. Woman Owned Business: Enter Yes or No. 7f. Contractor Identification (ID) Number: Same as item 7f. under CPD Programs. 7g. Section 3 Contractor: Enter Yes or No. 7h. Subcontractor Identification (ID) Number: Same as item 7h. under CPD Programs. 7i. Section 3 Contractor: Enter Yes or No. 7j. Contractor/Subcontractor Name and Address: Same as item 7]. under CPD Programs. M&C Review CITY COUNCIL AGENDA CONTINUED FROM A PREVIOUS WEEK REFERENCE 17NS DATE-7/28/2015 NO : G-18521 LOG NAME- HUDACTIONPLANPY2015- 2016 CODE- G TYPE- NON- PUBLIC YES CONSENT HEARING: SUBJECT: Conduct Two Public Hearings and Approve the City's 2015-2016 Action Plan for the Use of Federal Grant Funds in the Amount of $9,820,979.00 from the United States Department of Housing and Urban Development from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant and Housing Opportunities for Persons with AIDS Grant Programs, Authorize Collection and Use of Program Income, Authorize Waiver of Application of Indirect Cost Rates Authorize Execution of Related Contracts and Adopt Appropriation Ordinance (ALL COUNCIL DISTRICTS) RECOMMENDATION: It is recommended that the City Council: 1. Conduct two public hearings to allow citizen input and consideration of the City's 2015-2016 Action Plan for use of federal grant funds from the United States Department of Housing and Urban Development in the amount of $9,820,979.00 from the Community Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant and Housing Opportunities for Persons with AIDS grant programs and for the use of program income from activities using prior years' federal grant funds; 2. Approve the City's 2015-2016 Action Plan for submission to the United States Department of Housing and Urban Development including allocations of grant funds to particular programs and activities as detailed below; 3. Authorize the collection and use of an estimated $50,000.00 of program income, which resulted from activities using prior years' Community Development Block Grant fund, for the reconstruction of City streets; 4. Authorize the collection and use of an estimated $200,000.00 of program income, which resulted from activities using prior years HOME Investment Partnerships Program funds, for the City's Homebuyer Assistance Program; 5. Authorize the City Manager or his designee to execute contracts for a one-year term with the agencies listed in Tables 1, 2 and 3 below for Program Year 2015-2016 for Community Development Block Grant, Emergency Solutions Grant and Housing Opportunities for Persons with AIDS grant funds, contingent upon receipt of funding; 6. Authorize the City Manager or his designee to extend the contracts for up to one year if an agency or department requests an extension and such extension is necessary for completion of the program or to amend the contracts if necessary to achieve program goals provided any amendment is within the scope of the program and in compliance with City policies and all applicable laws and regulations governing the use of federal grant funds; FORT WORTH http://apps.cfwnet.org/council_p acket/mcreview.asp7ID=21233&councildate=8/4/2015[8/5/2015 8:44:59 AM] M&C Review 7. Authorize a waiver of indirect cost rates as applicable for the Grants Fund in accordance with the City's Administrative Regulations; and 8. Adopt the attached appropriation ordinance increasing the estimated receipts and appropriations to the Grants Fund in the total amount of $9,820 979 00 consisting of $6 332,270.00 in Community Development Block Grant funds, $1,934,447.00 in HOME Investment Partnerships Program funds, $552 108.00 in Emergency Solutions Grant funds and $1,002,154.00 in Housing Opportunities for Persons with AIDS grant funds, plus any program income, all subject to receipt of such funds. DISCUSSION.: The City's 2015-2016 Action Plan summarizes the major housing and community development activities and proposed expenditures for the program year beginning October 1, 2015 and ending September 30, 2016 for use of federal grant funds totaling $9,820,979.00 from the United States Department of Housing and Urban Development (HUD) for Community Development Block Grant (CDBG), HOME Investment Partnerships Program (HOME), Emergency Solutions Grant (ESG) and Housing Opportunities for People with AIDS (HOPWA) grant programs. It also summarizes the use of program income resulting from activities using prior years' CDBG and HOME funds. The purpose of these grant funds is to primarily benefit low and moderate income City residents with ESG funds primarily benefiting homeless persons and HOPWA funds primarily benefiting persons with HIV/AIDS. Staff developed recommendations for the allocation of the estimated funding from HUD and presented them to the Community Development Council (CDC) on May 20, 2015 and to the City Council at its Pre -Council meeting on June 16, 2015. Notice of a 30-day public comment period from July 1 2015 to July 31, 2015 was published in the Fort Worth Star-Telearam on June 28 2015. Any comments received will be maintained by the Neighborhood Services Department in accordance with federal regulations. The City will hold two public hearings as part of the HUD - required citizen participation process, the first on July 28, 2015 and the second on August 4, 2015 at which time the City Council is scheduled to approve the Action Plan. In addition, public hearings were held on June 18 2015 at 11:30 a m. and 6:00 p.m. for citizens to provide comment on the proposed list of neighborhood streets eligible for reconstruction using CDBG funds. A summary of the CDC's funding recommendations is provided below in Tables 1 2 and 3 and a spreadsheet of all specific funding recommendations is attached The 2015-2016 Action Plan must be submitted to HUD by August 14, 2015. CDBG For Program Year 2015-2016, it is recommended that the amount of $6,332,270.00 in CDBG funds and the estimated amount of $50,000.00 of CDBG program income be allocated as follows: Public Services - $949,840.00 This item includes social services for low to moderate income, disabled and disadvantaged populations. Housing Programs and Services - $2,175 600.00 This item includes funding for the City's Priority Repair Program, Cowtown Brush -Up, homebuyer and housing services, accessibility modifications to the homes of senior and/or disabled individuals and related project delivery costs for these programs. Infrastructure Services - $1,201,521.53 This item includes funding for the reconstruction of neighborhood streets. http://apps.cfwnet.org/council_packet/mc review.asp?ID=21233&councildate=8/4/2015[8/5/2015 8:44:59 AM] M&C Review CDBG Economic Development - $738,854.47 This item is the City s annual payment on its Section 108 loan from HUD. CDBG Estimated Program Income - $50,000.00 This item includes funding for the reconstruction of City streets in addition to the funds listed above under Infrastructure Services. CDBG program income that is received which is over the estimated amount but not used for reconstruction of City streets will be allocated to priority activities in the City's Consolidated Plan subject to Council approval. CDBG General Administration - $1,266,454.00 This item includes costs for administering the CDBG grant including allocations for Financial Management Services, Internal Audit and Transportation and Public Works Departments. HOME For Program Year 2015-2016, it is recommended that the amount of $1,934,447.00 in HOME funds and the estimated amount of $200,000.00 of HOME program income be allocated as follows: Homebuyer Assistance Program (HAP) - $1,097,400.00 This item includes funding for down payment and/or closing cost assistance to low and moderate income homebuyers. Community Development Housing Organizations (CHDO) Set Aside - $290,168.00 HUD requires that a minimum of 15 percent of HOME funds be allocated to CHDOs for affordable housing projects and CHDO administrative operating costs. These funds will be used by Tarrant County Housing Partnership, Inc. (TCHP), a CHDO, to construct additional single family houses for the 21 lot Hardy Street Single Family Infill Development in the Diamond Hill -Jarvis neighborhood (Council District 2). The houses will be sold to homebuyers making at or below 80 percent of area median income set by HUD. Single -Family Development - $353,435 00 This item includes funding for construction by TCHP of additional single family houses for the Hardy Street Single Family Infill Development HOME General Administration - $193,444.00 This item includes costs for administering the HOME grant. HOME Estimated Program Income - $200,000.00 This item includes funding for the City's HAP for closing cost and/or down payment assistance in addition to the funds listed above. HOME program income that is received which is over the estimated amount but not used for HAP will be allocated to priority activities in the City's Consolidated Plan subject to Council approval HUD allows the City to take 10 percent of any HOME program income to be used for the costs for administering the HOME grant. HOPWA For Program Year 2015-2016, it is recommended that the amount of $1,002,154.00 in HOPWA funds be allocated as follows: Non -Profit Service Providers - $972,090.00 HOPWA Program Administration - $30,064.00 ESG http://apps.cfwnet.org/council_packet/mc review.asp?ID=21233&councildate=8/4/2015[8/5/2015 8:44:59 AM] M&C Review For Program Year 2015-2016, it is recommended that the amount of $552,108.00 in ESG funds be allocated as follows: Non -Profit Service Providers - $510,700.00 ESG Program Administration - $41,408.00 1 CONTRACT RECOMMENDATIONS The CDC and Staff recommend that contracts be executed with the listed agencies for the amounts shown in the following tables: Community Development Block Grant Contracts.: Table 1 - CDBG Agencies Organization Cenikor Foundation Senior Citizen Services of Greater Tarrant County Inc. YMCA of Metropolitan Fort Worth YWCA of Fort Worth and Tarrant County Clayton Child Care Inc. d/b/a Clayton YES! Girls Inc. of Tarrant County Camp Fire First Texas Lena Pope Home, Inc. The Ladder Alliance Tarrant County Housing Partnership, Inc. Presbyterian Night Shelter The Salvation Army, a Georgia Corporation Meals on Wheels, Inc. of Tarrant County CDBG Public Service Subtotal Rehabilitation Education and Advocacy for Persons with Handicaps, dba REACH, Inc.** Total CDBG Contracts Program Substance Abuse Senior Services Child Care Services Child Care Services Child Care Services Youth Services Youth Services Youth Services Employment/Job Training Housing Counseling and Education Amount $ 75,000.00 $ 75,000.00 75,000.00 49,840.00 75,000.00 75,000.00 75,000.00 75,000.00 $ 75,000.00 $ 75,000.00 Case Management/Main $ 75,000.00 Shelter Homeless Services $ 75,000.00 Home delivered $ 75,000.00 Meals Program $ 949,840.00 Project Ramp $ 100,000.00 **REACH will be funded from the CDBG Housing Programs $1,049,840.00 and Services budget http://apps.cfwnet.org/council_packet/mc review.asp?ID=21233&councildate=8/4/2015[8/5/2015 8:44:59 AM] M&C Review Housing Onnortunities For Persons With AIDS Contracts: Organization Tarrant County Samaritan Housing, Inc. AIDS Outreach Center, Inc. TOTAL HOPWA Contracts Organization S afeHaven of Tarrant County P resbyterian Night Shelter Day Resource Center for the Homeless The Salvation Army, a Georgia Corporation YWCA Fort Worth and Tarrant County TOTAL ESG Contracts Administration (seven percent), Supportive Services, and Facility Based Housing Subsidy Assistance Table 2 - HOPWA Agencies Program Amount $420,063.00 Administration (seven percent), Supportive Services, Tenant Based Rental Assistance (TBRA), and Short $552,027.00 Term Rent Mortgage and Utility Assistance (STRMU) Emeraencv Solutions Grant Contracts: Table 3 - ESG Agencies Program S helter Services S helter Services S helter Services Homelessness P revention Rapid Re -Housing These programs are available in ALL COUNCIL DISTRICTS. $972,090.00 Amount $104,265.00 $ 85,908.00 $141,092.00 $100,000.00 $ 79,435.00 $510,700.00 FISCAL INFORMATION/CERTIFICATION: The Financial Management Services Director certifies that upon approval of the above recommendations, adoption of the attached appropriation ordinance and receipt of grant funds, funds will be available in the current operating budget, as appropriated, of the Grants Fund. TO Fund/Account/Centers. FROM Fund/Account/Centers 21001 4310013 019CDBG $6.332.270.00 http://apps.cfwnet.org/council packet/mc review.asp9ID=21233&councildate=8/4/2015[8/5/2015 8:44:59 AM] M&C Review 21001 21001 21001 21001 21001 21001 21001 21001 21001 21001 21001 5XXXXXX 019CDBG 4310013 019HOME 5XXXXXX 019HOME 4310013 019ESG 5XXXXXX 019ESG 4921001 019CDBG 5XXXXXX 019CDBG. 4310013 019HOPWA 5XXXXXX 019HOPWA 4921001 019HOME 5XXXXXX 019HOME $6.332.270.00 $1.934.447.00 $1.934.447.00 $552.108.00 $552.108.00 $50.000.0(1 $50.000.00. $1.002.154.00, $1.002.154.00 $200.000.00 $200.000.00 Submitted for City Manaaer's Office bv: Oriainatina Department Head: Additional Information Contact: Fernando Costa (6122) Allison Gray (8030) Avis Chaisson (6342) Leticia Rodriguez (7319) ATTACHMENTS 17NS HUDACTIONPLANPY2015-2016 GR76 AO FY2015.docx, Action Plan 15 16 FINAL MandC Slides LHR.odf Proposed 2015 CDBG Infrastructure P aiect MandC.ndf http://apps.cfwnet.org/council packet/me review.asp9ID=21233&councildate=8/4/2015[8/5/2015 8:44:59 AM]