HomeMy WebLinkAboutContract 60494CDBG-CV 51% PSA CONTRACT Page 1
Center for Transforming Lives Rev.6/15/2020
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 Center for Transforming Lives (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 (HUD) through the Community Development Block Grant (“CDBG”)
Program, Program No. B-19-MC-48-0010, Catalog of Federal Domestic Assistance No. 14.218;
WHEREAS, City has received an additional allocation of CDBG grant monies under the
Coronavirus Aid, Relief, and Economic Security Act (“CARES” Act), referenced by HUD as
“CDBG-CV”;
WHEREAS, the CDBG regulations and related HUD guidance publications establish all
requirements for the CDBG-CV funds except for those specifically described in this Contract as
deriving from the CARES Act;
WHEREAS, a national objective of the CDBG program is to benefit low and moderate
income citizens in accordance with 24 CFR Part 570, as amended from time to time;
WHEREAS, Agency submitted a proposal and was selected to use CDBG-CV funds for a
financial stability 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:
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Area Median Income or AMI means the median family income for the Fort Worth-Arlington
metropolitan statistical area as established annually by HUD. The income limits are attached
hereto as EXHIBIT “A-1” – 2020 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:
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 and documentation of client need directly
related to and/or caused by the Coronavirus Pandemic; and other eligibility
documentation further described in Exhibit “A” – Program Summary
Complete Documentation shall meet the standards described in the attached
EXHIBIT “F” - Standards for Complete Documentation.
Any other document or record reasonably necessary to verify costs spent and client
eligibility for the Program.
CDBG-CV Funds means the CDBG-CV 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 March 13, 2020.
HUD means the United States Department of Housing and Urban Development.
IDIS means Integrated Disbursement Information System, HUD’s project tracking system.
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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 5l%of the clients served by the Program must be Income
Eligible Clients.
Neighborhood Services Department means the City’s Neighborhood Services Department.
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 Term. 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 eighteen (18) months
following the date of Contract execution unless earlier terminated as provided in this Contract.
This Contract may be extended if such extension is necessary for completion of the program and
is authorized by the CDBG Regulations and the City’s Grant Agreement with HUD. The Contract
Term shall include any extension, if exercised, as provided herein.
4. DUTIES AND RESPONSIBILITIES OF CITY.
4.1 Provide CDBG-CV Funds.
City shall provide up to $100,000.00 of CDBG-CV Funds under the terms 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
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determining whether Agency is meeting the National Objective during the term of this Contract.
5. DUTIES AND RESPONSIBILITIES OF AGENCY.
5.1 Required Services.
Agency shall perform the services described in EXHIBIT “A” – Program Summary in
accordance with the terms and conditions of this Contract.
5.2 Use of CDBG-CV Funds.
5.2.1.Compliance with CDBG Regulations and Contract.
Agency shall be reimbursed for eligible Program costs with CDBG-CV Funds only if City
determines in its sole discretion that:
5.2.1.1 Costs are eligible expenditures in accordance with CDBG Regulations.
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-CV 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 or Director’s designee in writing,
with such approval being in the City’s sole discretion. If the Agency’s
proposed Budget amendment is approved (as approved, the “Amended
Budget”), then the Amended Budget shall be memorialized in a written
amendment to this Contract. The Amended Budget will take effect on
the first day of the month following the month in which the Contract
amendment is executed, unless otherwise specified in the amendment.
All requests for Budget amendments must be submitted no later than 90
days prior to the date of the end of the term of this Contract.
5.2.3 Change 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.
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5.2.3.2 Agency agrees to utilize the CDBG-CV Funds to supplement rather than
supplant funds otherwise available for the Program.
5.2.4 Payment of CDBG-CV Funds to Agency.
CDBG-CV 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 completion of 90% of performance
goals, City may hold back a small amount of the CDBG-CV funds until the end of the term to
ensure completion of all performance goals. During this interim period, Agency must continue to
submit Attachment III – Client Data Report in EXHIBIT “D” – Reimbursement Forms monthly.
It is expressly agreed by the Parties that any CDBG-CV Funds not spent or approved for
reimbursement to Agency shall remain with City.
5.3 Program 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:
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-CV Funds, or (iii) terminate this Contract.
5.3.3 Failure to meet at least 80%of its performance milestones or serve _60_
Unduplicated Clients under this Contract may, in City’s sole discretion, disqualify Agency for
consideration under future City’s Requests for Proposals for federal grant funds.
5.3.4 Amendments to performance milestones regarding CDBG-CV Funds 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 shall be
memorialized in a written amendment to this Contract. The Amended Performance Milestones
will take effect on the first day of the month following the month in which the Contract
Amendment is executed unless otherwise specified in the amendment. All requests for
amendments to performance milestones must be submitted by six months prior to the date of the
Month Expenditures
Unduplicated Clients as
specified in EXHIBIT
“A” – Program
Summary
3 15% 15%
6 30% 30%
9 50% 50%
12 65% 65%
15 80% 80%
18 100% 100%
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end of the term of this Contract. 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-CV Funds .
Agency will keep accounts and records in such a manner that City may readily identify and
account for Program expenses reimbursed with CDBG-CV Funds. These records shall be made
available to City for audit purposes and shall be retained as required hereunder.
5.5 Meet National Objective.
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-CV Funds
without City’s written consent.
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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 of Income Statement attached as EXHIBIT “E” – Form
of Income Self-Certification or a similar form approved by City. 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 Program clients must be documented and at least
51% of them must be Income Eligible Clients. In addition, Agency must document client
eligibility for CARES Act assistance by maintaining records of client need directly related to
and/or caused by the Coronavirus Pandemic, as well as other eligibility documentation further
described in Exhibit “A” – Program Summary.
6.1.1.1 If Agency serves both Fort Worth and non-Fort Worth clients, the
proportion of Program costs allocated to the CDBG-CV-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 Verification of Program Eligibility.
6.1.2.1 At the end of each quarter during the Contract term, Agency shall verify
CDBG-CV Program Eligibility by confirming that at least 51% of
clients served by the Program to date are Income Eligible Clients as
reported on Attachment III.
6.1.2.2 If Agency fails to verify Program eligibility on a quarterly basis in
compliance with this Section, Agency will have 30 calendar days or
until the next monthly invoice to cure.
6.1.2.3 City will notify Agency by e-mail within 14 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 7
calendar days from the date of the e-mail notice to meet these
requirements.
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
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payment of Reimbursement Requests, to lower Agency’s allocation of
CDBG-CV Funds, or to terminate this Contract.
6.2 Submission of Complete Documentation.
Agency must submit copies of documentation of client eligibility described 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-CV REQUIREMENTS.
Agency agrees to comply with all requirements of the CDBG Program as stated in the
CDBG Regulations, as well as any further requirements established by HUD regarding CDBG-
CV funds upon receiving notification of such additional requirements from City, including but not
limited to the following:
7.1 Environmental Review.
CDBG-CV Funds will not be paid, and costs cannot be incurred until City has conducted
an environmental review and completed an Environmental 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 described 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-CV Funds it has already received and forfeit any future payments of CDBG-CV
Funds.
7.2 Contract Not Constituting 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 an environmental review (ii) approval
of City’s Substantial Amendment to the 2019-2020 Action Plan regarding CARES Act grant funds,
and (iii) receipt by City of a grant agreement from HUD.
7.3 Monitoring.
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
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 the date after the final date of the full eighteen-month contract
term including any extensions in term, and end on the date five full years after that date .
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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-CV 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 Term and for 5
years thereafter and shall survive the earlier termination 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
during the term of this contract.
7.4 Agency 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-CV 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 government wide
System for Award Management, www.sam.gov (“SAM”). Agency must confirm by search of
SAM that all contractors paid with CDBG-CV 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.
7.5 Cost Principles/Cost Reasonableness.
Agency shall administer its use of CDBG-CV Funds in compliance with 2 CFR Part 200,
as applicable. The eligibility of costs incurred for performance rendered shall be determined in
accordance with 2 CFR Part 200.400 through 2 CFR Part 200.475.
7.6 Financial Management Standards.
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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, Cost Principles, and Audit
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-CV 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 Copyright 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 14.14.2.1 and 14.14.4, 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
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.
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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-CV Funds that
provides reasonable assurance that Agency is managing the CDBG-CV 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 terms
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
REQUIREMENTS; AUDIT.
8.1 Record Keeping.
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 the date after the final date
of the full eighteen month contract term and end on the date five full years after that date regardless
of whether or not this Contract is earlier terminated.
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
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term 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 the date after the final date of the full eighteen month contract term and end on the date five
full years after that date 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
form 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 form 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 for 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 term ends if City
determines that such audit is necessary for City’s compliance with the CDBG-CV Regulations or
other City policies. Agency agrees to allow access to all pertinent materials as described herein
for such audit. For purposes of this Contract, this 5 year period for City audit is deemed to begin
on the date after the final date of the full eighteen month contract term and end on the date five
full years after that date 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
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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-CV FUNDS OR SPENT
CDBG-CV-CV 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 REQUIREMENTS.
9.1 Deadline for Submitting Reimbursement Requests.
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. Failure to submit a Reimbursement
Request in a timely fashion will result in City taking the actions outlined in Section 10.1. If
expenditures exceed $20,000 per month, Agency may elect to submit two reimbursement requests
per month, with the first reimbursement request being submitted on the 15 th of the month covering
expenses paid from the 16th through the end of the preceding month, and the second reimbursement
request being submitted on the 30th of the month covering expenses paid in the first 15 days of the
month. Agency must advise City in writing no later than 15 days in advance, of their intent to
submit two reimbursement requests for any month during the contract term.
9.1.2 City will notify Agency by e-mail within 14 calendar days if a Reimbursement
Request is lacking Complete Documentation or corrections are needed. Agency will have 7
calendar days from the date of the e-mail notice to submit any requested information or missing
documentation. If Agency fails to submit all the required information or missing documentation
within 7 calendar days from the first e-mail, Agency may, at the City’s sole discretion, shall forfeit
any payments otherwise due that month and failure to submit any requested information may, at
the City’s sole discretion, 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).
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 order for this report to
be complete the following must be submitted:
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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-CV-funded time and non-CDBG-CV funded time and
reflect actual time spent on CDBG-CV-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
or 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 must be submitted through required software system
approved by City or in other manner required by City by the deadline(s) 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 December, March, June and September Reimbursement
Requests. Reports due under this section have the same due date as the Reimbursement Request. .
9.3 Withholding Payment.
Failure to timely submit accurate and complete 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 5 calendar 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 may, at the City’s sole discretion, shall forfeit any payments otherwise due that month.
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10.1.2 If Agency fails to submit requested information or missing documentation as
set forth in 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 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.
10.1.4 Notwithstanding anything to the contrary herein, City will not be required to
pay any CDBG-CV 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.
10.1.5 In the event of termination under this Section 10.1, all CDBG-CV 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
records maintained or submitted report 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
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-CV 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-CV Funds paid to Agency must be repaid
to City within 30 days of termination. If such CDBG-CV 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 term or condition
of this Contract. In the event that such a breach remains uncured after 30 calendar days following
written notice by City (or 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.
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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-CV Funds that have not yet been expended from
affected activities to other eligible activities or withhold CDBG-CV
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.
10.3.3 In the event of termination under this Section 10.3, all CDBG-CV 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-CV Funds already paid to Agency must
be repaid to City within 30 days of the termination. Failure to repay such CDBG-CV 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-CV 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 Rights 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 term, covenant, or condition of this Contract shall
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not operate as a waiver of any subsequent default or breach of the same or any other term, 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-CV 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-CV Funds already paid to Agency must be repaid to City within 30 days of termination.
Failure to repay such CDBG-CV 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-CV FUNDS FOR A MINIMUM OF 5 YEARS FROM THE
DATE OF TERMINATION.
10.9.2 Agency may terminate this Contract if City does not provide the CDBG-CV
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 termination, 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-CV Funds to be spent will not accomplish the purposes for which the Contract was
made.
10.11 Dissolution of Agency 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-CV 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
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with the CDBG-CV 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-CV Funds, and any real or personal property owned by Agency that was
improved with the CDBG-CV Funds shall automatically transfer to City or to such assignee as
City may designate.
11. REPAYMENT OF CDBG-CV FUNDS.
All CDBG-CV Funds are subject to repayment in the event the Program does not meet the
requirements of this Contract or in the CDBG-CV Regulations. If Agency takes any action that
results in the City being required to repay all or any portion of the CDBG-CV 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-CV Funds is required of City, Agency agrees City may
require that 10% of the CDBG-CV Funds be repaid to City 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-CV grant or other federal grant funds, in addition to the finding by
HUD or a required repayment of funds to HUD by City. Therefore, the Parties agree that payment
under this Section of 10% of the CDBG-CV Funds by Agency to City is liquidated damages and
not a penalty.
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. Regardless of notice by Agency, if the
non-profit status of Agency changes after the date of this Contract, City may but is not obligated
to, terminate this Contract. In the event of termination under this Section 12, all CDBG-CV 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. City, in its sole discretion, may require that any
CDBG-CV 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-CV 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 the date after the final date of the full eighteen month
contract term and end on the date five full years after that date regardless of whether or not this
Contract is earlier terminated.
14. GENERAL PROVISIONS
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14.1 Agency 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 Agency 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.
14.5 Religious Organization.
Agency shall comply with all applicable requirements as more particularly described in 24
CFR Part 5.109. No portion of the CDBG-CV 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-CV-funded service.
14.5.1. Separation of Explicitly Religious Activities.
Agency retains its independence and may continue to carry out its mission, including the
definition, development practice, and expression of its religious beliefs, provided that it does not
use CDBG-CV Funds to support or engage in any explicitly religious activities (including activities
that involve overt religious content such as worship, religious instruction, or proselytization), or
in any other manner prohibited by law.
14.5.2 Explicitly Religious Activities.
If Agency engages in explicitly religious activities (including activities that involve overt
religious content such as worship, religious instruction, or proselytization), the explicitly religious
activities must be offered separately, in time or location, from the programs or activities supported
by CDBG-CV Funds and participation must be voluntary for clients of a CDBG-CV-funded
service.
14.5.3 Required Notices.
If Agency constitutes a Faith-based organization under 24 CFR Part 5.109, Agency must
provide all clients of a CDBG-CV-funded service with the notice attached as EXHIBIT “K”—
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Notice of Beneficiary Rights. Such notice shall be provided to the client prior to enrollment in
any CDBG-CV-funded program or activity. In addition, if a client or prospective client of a
CDBG-CV-funded service objects to the religious character of Agency, then Agency must
promptly undertake reasonable efforts to identify and refer the client or prospective client to an
alternate provider to which the client or prospective client has no such objection, as more
particularly described in 24 CFR Part 5.109.
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-performance 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 provision 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 or written agreement which purports to vary the
terms of this Contract shall be void. Any amendments to the terms 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 or 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 are currently
in effect or that are hereafter amended during the performance of this Contract. Those laws
include, but are not limited to:
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CDBG-CV Regulations found in 24 CFR Part 570
Coronavirus Aid, Relief, and Economic Security Act of 2020
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
persons 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 Uniform 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 Water Act.
Immigration Reform 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 related 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
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the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et
seq.) and implementing regulations at 24 CFR Part 35, subparts A, B, M, and R
Uniform 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.
14.12 HUD-Assisted Projects and Employment and other Economic Opportunities;
Section 3 Requirements.
14.13 Prohibition Against Discrimination.
14.13.1 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 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.
14.13.2 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
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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 or 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.
14.13.3 Agency’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.
14.14. Conflicts of Interest and Violations of Criminal Law.
14.14.1 Agency 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,
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business or other ties. Agency shall disclose to City any such conflict of interest or potential
conflict of interest, immediately upon discovery of such.
14.14.2 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-CV Funds or who are in a position to participate in a decision-
making process or gain inside information with regard to these activities may utilize CDBG-CV
funded services, may obtain a financial interest or benefit from a CDBG-CV-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.
14.14.2.1 Agency shall establish conflict of interest policies for federal awards
including the CDBG-CV Funds and shall disclose in writing
potential conflicts of interest to City as authorized by 2 CFR Part
200.112.
14.14.3 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-CV Regulations shall apply.
14.14.3.1 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.
14.14.3.2 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.
14.14.3.3 Notwithstanding the prohibition contained in Section 14.14.3.2,
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.
14.14.3.4 Agency shall maintain written standards of conduct covering
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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.
14.14.3.5 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.
14.14.4 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.
14.14.5 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.
14.14.6 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.
14.15 Subcontracting with Small and Minority Firms, Women’s Business
Enterprises and Labor Surplus Areas.
14.15.1 For procurement contracts $50,000.00 or larger that are paid for, in part or in
full, with the CDBG-CV Funds, Agency agrees to abide by City’s policy to involve Minority
Business Enterprises and Small Business Enterprises and to provide them equal opportunity to
compete for contracts for construction, provision of professional services, purchase of equipment
and supplies and provision of other services required by City. 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-CV Funds and will further require all persons or entities with which
it so contracts to comply with said ordinance.
14.15.2 It is national policy to award a fair share of contracts to disadvantaged business
enterprises (“DBEs”), small business enterprises (“SBEs”), minority business enterprises
(“MBEs”), and women’s business enterprises (“WBEs”). Accordingly, affirmative steps must be
taken to assure that DBEs, SBEs, MBEs, and WBEs are utilized when possible as sources of
supplies, equipment, construction and services.
14.15.2.1 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
CDBG-CV 51% PSA CONTRACT Page 26
Center for Transforming Lives Rev.6/15/2020
with the CDBG-CV Funds. Agency shall submit this form by the
date specified in EXHIBIT “I” – MBE Reporting Form.
14.16 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.
14.17 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.
14.18. 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-CV-funded Program prior to any charges being incurred.
14.19 Force Majeure
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
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 Event”), 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.
14.20 IMMIGRATION NATIONALITY ACT.
City actively supports the Immigration & Nationality Act (INA) which includes provisions
addressing employment eligibility, employment verification, and nondiscrimination. Agency shall
verify the identity and employment eligibility of all employees who perform work under this
Agreement. Agency shall complete the Employment Eligibility Verification Form (I-9), maintain
photocopies of all supporting employment eligibility and identity documentation for all
employees, and upon request, provide City with copies of all I-9 forms and supporting eligibility
documentation for each employee who performs work under this Agreement. Agency shall
establish appropriate procedures and controls so that no services will be performed by any
employee who is not legally eligible to perform such services. Agency shall provide City with a
certification letter that it has complied with the verification requirements required by this
Agreement. Agency shall indemnify City from any penalties or liabilities due to violations of this
provision. City shall have the right to immediately terminate this Agreement for violations of this
provision by Agency.
CDBG-CV 51% PSA CONTRACT Page 27
Center for Transforming Lives Rev.6/15/2020
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
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
CDBG-CV 51% PSA CONTRACT Page 28
Center for Transforming Lives Rev.6/15/2020
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 form of insurance or bond in the amount of $ 100,000
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-CV 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 Date of Execution
of the Contract, 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 Date of
Execution of the Contract, Agency shall be in default of the Contract and City may, at its option,
terminate 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
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
CDBG-CV 51% PSA CONTRACT Page 29
Center for Transforming Lives Rev.6/15/2020
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: Employer’s Liability
$100,000 each accident
$100,000 disease-each employee
$500,000 disease-policy limit
Note: Such insurance shall cover employees performing 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
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.
CDBG-CV 51% PSA CONTRACT Page 30
Center for Transforming Lives Rev.6/15/2020
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-CV 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 Form-LLL, “Disclosure Form to
Report Lobbying,” in accordance with its instructions.
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
CDBG-CV 51% PSA CONTRACT Page 31
Center for Transforming Lives Rev.6/15/2020
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
200 Texas Street
Fort Worth, TX 76102
Telephone: 817-392-7600
Copy to:
Neighborhood Services Department
200 Texas Street
Fort Worth, TX 76102
Attention: Director
Telephone: 817-392-7540
Copy to:
Neighborhood Services Department
200 Texas Street
Fort Worth, TX 76102
Attention: Senior Contract Compliance Specialist
Telephone: 817-392-7333
Agency:
Center for Transforming Lives
Carol Klocek
512 W. 4th Street
Fort Worth, Texas 76102
Telephone: 817-332-6191
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 perform
the responsibilities herein required.
CDBG-CV 51% PSA CONTRACT Page 32
Center for Transforming Lives Rev.6/15/2020
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.
23. PROGRAM INCOME
Parties agree that no program income as defined by HUD shall be earned as a result of this
contract.
24.PROHIBITION ON CONTRACTING WITH COMPANIES THAT BOYCOTT
ISRAEL
If Agency has less than ten employees, this contract is for less than $100,000, or Agency
does not meet the definition of a “company” under the applicable section of the Texas Government
Code, this provision shall not apply. Agency acknowledges that in accordance with Chapter 2270
of the Texas Government Code, the City is prohibited from entering into a contract with a company
for goods or services unless the contract contains a written verification from the company that it:
(1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. The
terms “boycott Israel” and “company” shall have the meanings ascribed to those terms in Section
808.001 of the Texas Government Code. By signing this contract, Agency certifies that Agency’s
signature provides written verification to the City that Agency: (1) does not boycott Israel; and (2)
will not boycott Israel during the term of the contract.
25. PROHIBITION ON BOYCOTTING ENERGY COMPANIES
Agency acknowledges that in accordance with Chapter 2274 of the Texas Government
Code, as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2, the City is prohibited from entering
into a contract for goods or services that has a value of $100,000 or more that is to be paid wholly
or partly from public funds of the City with a company with 10 or more full-time employees unless
the contract contains a written verification from the company that it: (1) does not boycott energy
companies; and (2) will not boycott energy companies during the term of the contract. The terms
“boycott energy company” and “company” have the meaning ascribed to those terms by Chapter
2274 of the Texas Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2. To the
extent that Chapter 2274 of the Government Code is applicable to this Agreement, by signing this
Agreement, Agency certifies that Agency’s signature provides written verification to the City that
Agency: (1) does not boycott energy companies; and (2) will not boycott energy companies during
the term of this Agreement.
26. PROHIBITION ON DISCRIMINATION AGAINST FIREARM AND
AMMUNITION INDUSTRIES
CDBG-CV 51% PSA CONTRACT Page 33
Center for Transforming Lives Rev.6/15/2020
Agency acknowledges that except as otherwise provided by Chapter 2274 of the Texas
Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 19, § 1, the City is prohibited
from entering into a contract for goods or services that has a value of $100,000 or more that is to
be paid wholly or partly from public funds of the City with a company with 10 or more full-time
employees unless the contract contains a written verification from the company that it: (1) does
not have a practice, policy, guidance, or directive that discriminates against a firearm entity or
firearm trade association; and (2) will not discriminate during the term of the contract against a
firearm entity or firearm trade association. The terms “discriminate,” “firearm entity” and “firearm
trade association” have the meaning ascribed to those terms by Chapter 2274 of the Texas
Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 19, § 1. To the extent that Chapter
2274 of the Government Code is applicable to this Agreement, by signing this Agreement, Agency
certifies that Agency’s signature provides written verification to the City that Agency: (1) does not
have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm
trade association; and (2) will not discriminate against a firearm entity or firearm trade association
during the term of this Agreement.
[SIGNATURES APPEAR ON NEXT PAGE]
CDBG-CV 51% PSA CONTRACT Page 34
Center for Transforming Lives Rev.6/15/2020
IN WITNESS WHEREOF, the Parties hereto have executed 1 original of this Contract
in Fort Worth, Tarrant County, Texas.
ATTEST:CITY OF FORT WORTH
_________________________________ By: _____________________________________
City Secretary Fernando Costa, Assistant City Manager
M&C: 23-0594
1295 Certification No. 2023-1029118
Date: June 27, 2023
APPROVED AS TO FORM AND LEGALITY :
_________________________________
Jessika Williams, Assistant City Attorney
APPROVED BY:
_________________________________________
Victor Turner
Director, Neighborhood Services Department
CONTRACT COMPLIANCE MANAGER:
By signing, I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements
_________________________________________
Charletta Moaning, Sr. Contract Compliance Specialist
CENTER FOR TRANSFORMING LIVES
By: _____________________________
Carol Klocek, Chief Executive Officer
CDBG-CV 51% PSA CONTRACT Page 35
Center for Transforming Lives Rev.6/15/2020
EXHIBITS:
EXHIBIT “A” –Program Summary
EXHIBIT “A-1” – 2020 HUD Income Limits
EXHIBIT “A-2” – Reporting Requirements for Countywide Agencies
EXHIBIT “B” – Budget
EXHIBIT “C” – Audit Certification Form
EXHIBIT “D” – Reimbursement Forms
EXHIBIT “E” – Form of Income Self-Certification
EXHIBIT “F” – Standards for Complete Documentation
EXHIBIT “G” – Section 3 Reporting Forms (NOT APPLICABLE)
EXHIBIT “H” – Severely Disabled Certification Form
EXHIBIT “I” – MBE Reporting Form
EXHIBIT “J” – Duties of the Parties for Use of NSD Community Centers
EXHIBIT “K” – Notice of Beneficiary Rights
Page 1
CENTER FOR TRANSFORMING LIVES EXHIBIT “A”
Microenterprise Support Program PROGRAM SUMMARY
PROGRAM SUMMARY
(CDBG-CV)
October 1, 2023- March 31, 2025 $100,000.00
PERIOD AMOUNT
CDBG-CV 51% PSA CONTRACT CARES ACT 2020 Page 2
Center for Transforming Lives
2023 CDBG Income limits
AMI 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 people
30% $20,100 $23,000 $25,850 $28,700 $31,000 $33,300 $35,600 $37,900
50% $33,500 $38,300 $43,100 $47,850 $51,700 $55,550 $59,350 $63,200
60% $40,200 $45,960 $51,720 $57,420 $62,040 $66,660 $71,220 $75,840
80% $53,600 $61,250 $68,900 $76,550 $82,700 $88,800 $94,950 $101,050
TW effective 6/15/2023
CDBG CV 51% PSA CONTRACT 2020 - EXHIBIT “A-2”
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
CENTER FOR TRANSFORMING LIVES
EXHIBIT “A-2”
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
CDBG CV 51% PSA CONTRACT 2020 - EXHIBIT “A-2”
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
CENTER FOR TRANSFORMING LIVES
CENTER FOR TRANSFORMING LIVES
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
Quarterly Report
The purpose of the Quarterly Report is for the Countywide Agencies to report the number of non-Fort
Worth clients who participate in the Program. The Quarterly Report must be submitted with the
September 2020, December 2020, March 2021, June 2021, and September 2021 Reimbursement
Requests. The report is due and is to be submitted with the corresponding Reimbursement Request as
indicated in the chart below. The information provided in the Quarterly Report will be reviewed and
monitored by the Neighborhood Services Department Compliance Division.
DUE DATE REPORTING RANGE
# OF FORT
WORTH
CLIENTS
# OF NON-FORT
WORTH
CLIENTS
TOTAL # OF
CLIENTS
SERVED BY
THE
PROGRAM
(C+D)
% OF
FORT WORTH
CLIENTS
(C÷E)
A B C D E F
EXAMPLE:250 200 450 250÷450=55%
September 15, 2020 June 1, 2020 –
August 31, 2020
December 15, 2020 September 1, 2020 –
November 30, 2020
March 15, 2021 December 1, 2020 –
February 28, 2021
June 15, 2021 March 1, 2021 –
May 31, 2021
September 15, 2021 June 1, 2021 –
August 31, 2021
TOTAL
I, Agency representative, certify that I verified the information I reported this quarter and it is correct
to the best of my knowledge.
Certified by: Date:
Signature/Title:
Account Grant Budget
Remaining
Balance Increase Decrease Total
PROGRAM PERSONNEL
Salaries 1001 78,000.00$
FICA 1002 5,967.00$
Life/Disability Insurance 1003 -$
Health/Dental Insurance 1004 7,800.00$
Unemployment-State 1005 2,028.00$
Worker's Compensation 1006 702.00$
Retirement 1007 1,170.00$
Staff Training 1008 -$
SUPPLIES AND SERVICES
Office/Program Supplies 2001 -$
Postage 2002 -$
Printing 2003 -$
Adv/Media, Dues/Pub, Printing,
Bank Fees -$
other 2004 -$
MISCELLANEOUS
Contract Labor Food
Supplies/Meals (City needs copy
of contract before expenses can be
reimbursed)3001 -$
Food Supplies 3002 -$
Teaching Aids 3003 -$
Craft Supplies 3004 -$
Field Trip Expenses 3005 -$
Mileage 3006 -$
FACILITY AND UTILITIES
Telephone 4001 -$
Electric 4002 -$
Gas 4003 -$
Water and Wastewater 4004 -$
Solid Waste Disposal 4005 -$
Rent (City needs copy of lease
before expenses can be
reimbursed)4006 -$
Cleaning Supplies 4007 -$
Repairs 4008 -$
Custodial Services 4009 -$
Utilities, Transportation, PP &E 4010 -$
LEGAL, FINANCIAL AND
INSURANCE
Fidelity Bond or Equivalent 5001 -$
Directors and Officers 5002 -$
General Commercial Liability 5003 -$
Bank fees -$
volunteer -$
volunteer -$
Prof Fees 5004 -$
DIRECT ASSISTANCE
Audit/IT/Legal Volunteer
Recruitment, Misc.6001 4,333.00$
BUDGET TOTAL 100,000.00$ -$ -$ -$ 100,000.00$
FUNDING A:
FUNDING B:
FUNDING C:
EXHIBIT "B" - BUDGET
Page 1
Annual Salary
Est. Percent to
Grant
Amount to
Grant
52,000.00$ 150.0% 78,000.00$
52,000.00$ 78,000.00$
Percent of
Payroll Amount
Est. Percent to
Grant
Amount to
Grant
FICA 3,978.00$ 150.0% 5,967.00$
Life/Disability Insurance -$ 150.0% -$
Health/Dental Insurance 5,200.00$ 150.0% 7,800.00$
Unemployment-State 1,352.00$ 150.0% 2,028.00$
Worker's Compensation 468.00$ 150.0% 702.00$
Retirement 780.00$ 150.0% 1,170.00$
Staff Training -$ 150.0% -$
TOTAL 11,778.00$ 17,667.00$
Total Budget
Est. Percent to
Grant
Amount to
Grant
-$
The following tables were created for the purpose of preparing, negotiating, and determining the cost
reasonableness and cost allocation method used by the Agencyfor 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 .
TOTAL
FRINGE DETAIL-PROGRAM PERSONNEL
SALARY DETAIL-PROGRAM PERSONNEL
Position Title
Program Coordinator
SUPPLIES AND SERVICES
Office/Program Supplies
Adv/Media, Dues/Pub, Printing, Bank Fees
Postage
Printing
TOTAL
Total Budget
Est. Percent to
Grant
Amount to
Grant
#DIV/0!
-$ #DIV/0! -$
Total Budget
Est. Percent to
Grant
Amount to
Grant
-$
Total Budget
Est. Percent to
Grant
Amount to
Grant
-$
Total Budget
Est. Percent to
Grant
Amount to
Grant
4,300.00$ 100%4,333.00$
4,300.00$ 4,333.00$
Custodial Services
MISCELLANEOUS
Mileage
Teaching Aids
Craft Supplies
Contract Labor
Food Supplies
Field Trip Expenses
Repairs
LEGAL, FINANCIAL AND INSURANCE
TOTAL
Utilities, Transportation, PP & E
Solid Waste Disposal
TOTAL
FACILITY AND UTILITIES
Rent
Telephone
Electric
Gas
Water and Wastewater
Cleaning Supplies
Audit/IT/Legal Volunteer Recruitment, Misc.
TOTAL
Fidelity Bond or Equivalent
Directors and Officers
Prof Fees
TOTAL
DIRECT ASSISTANCE
General Commercial Liability
�XHIBIT "C"
AUDIT CERTIFICATION FORM
CDBG-CV 51% PSA CONTRACT - EXHIBIT "C' -- AUDIT CERTIFICATION FORM --
AUDIT CERTIFICATION FORM AND AUDIT REQUIREM�NTS
Agency:
Fiscal Yeai• �nding: Septembei• 30, 2023
� During the fiscal year in which fa��ds will be received, we will excee�€ the federal expenditure
threshold of $750,000. We will have our Single Audit or Progcam Specific Audit completed
and will submit the audit ceport desccibed 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.
� During the �scal year in which funds will be received, we will not exceed the $750,000
federal expenditure threshold rec�uired for a Single Audit o�• a Pcog�•am Speci�c Audit to be
performed this fiscal yeac. (Fill out sche�la�le beloi��)
F'ailure to submit this or a similac statement or failuce to submit a completed single audit package
as described in the federally required audit i•equireinents described in 2 CFR Pai�t 200, as
applicable, by the required due date may result in suspension of f'unding and may affect eligibility
foc future funding. Notwithsta�idi�ig tlie above, tl�is cei•tification acicnowledges the agency's
commitment to meet all otlie�� financial i•epo�•ti�►g, financial statements, and other audit
�•equirements as may be set forth in the Contx•act.
CDBG-CV 51 % PSA CONTRACT - EXHI$IT "C" - AUDIT CERTIrICATION FORM
Agency:
Address:
City, State, Zip:
Program:
Month of Service:
Tax ID Number:
Contract Number:
Case ID:
P.O. Number:
FID Number:
IDIS Number:
Original Amount This Invoice Cumulative to Date Remaining Balance
(Program Name) Case ID
Salaries 1001 -$ -$
FICA 1002 -$ -$ -$ -$
Life/Disability Insurance 1003 -$ -$ -$ -$
Health/Dental Insurance 1004 -$ -$ -$ -$
Unemployment-State 1005 -$ -$ -$ -$
Worker’s Compensation 1006 -$ -$ -$ -$
Office Supplies 1007 -$ -$ -$ -$
Food Supplies 1008 -$ -$ -$ -$
Insurance 1009 -$ -$ -$ -$
Accounting 1010 -$ -$ -$ -$
Contract Labor 1011 -$ -$ -$ -$
-$
-$
TOTAL -$ -$ -$ -$
Request Summary Budget Expenditure Percentage Spent Table Total
-$ -$ #DIV/0! -$
22-Oct 22-Nov 22-Dec 23-Jan 23-Feb 23-Mar
-$ -$ -$ -$ -$ -$
23-Apr 23-May 23-Jun 23-Jul 23-Aug 23-Sep
-$ -$ -$ -$ -$ -$
Client Goals Goal Amount Cumulative Total Goal Met % Table Total
0 0 #DIV/0! 0
22-Oct 22-Nov 22-Dec 23-Jan 23-Feb 23-Mar
1 0 0 0 0 0
23-Apr 23-May 23-Jun 23-Jul 23-Aug 23-Sep
0 0 0 0 0 0
Exhibit D
Program AmountAccount
Attachment I- Request Summary
Agency:
Program:
Only highlighted codes can be reimbursed
Please group like account codes.
Line
No.Check No. Date Payee Description/Job Title*
Account Code
(See Key to
Right)Amount
Expense Line Item
Account
1
2
3 Salaries 1001
4 FICA 1002
5 Life/Disability Insurance 1003
6 Health/Dental Insurance 1004
7 Unemployment-State 1005
8 Worker’s Compensation 1006
9 Office Supplies 1007
10
11
12 Food Supplies 1008
13 Insurance 1009
14 Accounting 1010
15 Contract Labor 1011
16 Other() 1012
17
18 Maintenance 2001
19 Security 2002
20 Insurance 2003
21 Utilities 2004
22 Supplies 2005
23 Repairs 2006
24 Other() 2007
25
26
27 Salaries 3001
28 FICA 3002
29 Life/Disability Insurance 3003
30 Health/Dental Insurance 3004
31 Unemployment-State 3005
32 Worker’s Compensation 3006
33 Other() 3007
34
35 Salaries 4001
36 FICA 4002
37 Life/Disability Insurance 4003
38 Health/Dental Insurance 4004
39 Unemployment-State 4005
40 Worker’s Compensation 4006
41 Other() 4007
42
43
44 Rental Assistance 5001
45
46 Utility Payments 5002
47
48 Rental Assistance 6001
49 Security Deposits 6002
Utility Deposits 6003
Total -$ Utility Payments 6004
*For Salaries, state employee's title under Description/Job Title. Rent must identify tenant Moving Costs 6005
Motel/Hotel Vouchers 6006
HMIS Software Costs 7001
REHOUSING
ATTACHMENT II
City of Fort Worth
Neighborhood Services Department
Expenditure Worksheet
EMERGENCY SHELTER
ESSENTIAL SERVICES
SHELTER OPERATIONS
HOUSING RELOCATION AND STABILIZATION
PREVENTION
FINANCIAL ASSISTANCE
PREVENTION
REHOUSING
HMIS
Agency:
Program:
Month:
#DIV/0!
*Do not revise the client goal unless the contract is amended, accordingly.
2 2A 3 4 5 10
<30%AMI 30%-50% AMI 51%-80%
AMI >80% AMI UNKNOWN
1<$20,100 1<$33,500 1<$53,600 1>$53,600
2<$23,000 2<$38,300 2<$61,250 2>$61,250
3<$25,850 3<$43,100 3<$68,900 3>$68,900
4<$28,700 4<$47,850 4<$76,550 4>$76,550
5<$31,000 5<$51,700 5<$82,700 5>$82,700
6<$33,300 6<$55,550 6<$88,880 6>$88,880
7<$35,600 7<$59,350 7<$94,950 7>$94,950
8<$37,900 8<$63,200 8<$101,050 8>$101,050
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
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
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Instructions:This report is meant to list all unduplicated clients served during the Contract term (October 1, 2022 to September 30, 2023). Each month, please report the information of clients not previously reported. You are required to attach eligibility verification documentation for each new client. New unduplicated clients should be listed below any previously reported clients so that this sheet will act as a rolling tally.
Please only list clients one time during the first month that they receive service. Clients that continue to receive Program services for multiple months only need to be listed one time. Put an "X" in each appropriate box regarding the client's sex, ethnicity, race, etc. Please note that reimbursement for salaries will require that the agency report to the City all the clients that were served by that particular staff
person in that program. Information for each client listed below must have the demographic information reflected in columns 1 thru 12.
ATTACHMENT III
CLIENT DATA REPORT
Undup Clts for CURRENT MONTH * Please highlight new clients for the month.
CUMULATIVE Unduplicated Clients
*Proposed Client Goal Per Contract
% of Milestone Met
11 12
DATE
CLIENT
RECEIVED
SERVICE
FORT
WORTH
RESIDENT?
YES OR NO
SERVICE
LOCATION (IF
APPLICABLE)
NAME STREET ADDRESS
(Client Address)
AGE
1 6 7 8
AMERICAN
INDIAN OR
ALASKAN
NATIVE AND
WHITE
ASIAN AND
WHITE
BLACK OR
AFRICAN
AMERICAN
AND WHITE
AMERICAN
INDIAN OR
ALASKA
NATIVE AND
BLACK OR
AFRICAN
AMERICAN
9
FHOH
(Indicate
One)
MALE FEMALE HISPANIC
NON-
HISPANIC
AMERICAN
INDIAN OR
ALASKAN
NATIVE ASIAN
BLACK OR
AFRICAN
AMERICAN
NATIVE
HAWAIIAN OR
OTHER
PACIFIC
ISLANDER WHITE
GENDER
(Indicate One)
ETHNICITY
(Indicate One)
RACE
(Indicate One)
DISABLED
(Indicate One)
YES NO
HH
SIZE
HH INCOME
(Only choose 1 of the 5 columns)
OTHER
MULTIPLE
RACE
COMBINAT-
IONS*YES NO
CDBG-CV 51% PSA CONTRACT-- EXHIBIT “E” -- INCOME CERTIFICATION FORMS Page 1
EXHIBIT “E”
INCOME CERTIFICATION FORMS
CDBG-CV 51% PSA CONTRACT-- EXHIBIT “E” -- INCOME CERTIFICATION FORMS Page 2
City of Fort Worth
CERTIFICATION OF INCOME STATEMENT
Applicant Name: ____________________________________
Current Address: ____________ Phone #:
City and Zip: _____________
Household Members and Income
(including applicant)
Last Name First Name Age Monthly
Income $$
Source of Income
TOTAL NUMBER OF FAMILY MEMBERS (Include Yourself, Spouse, Children, etc.)
Total Gross Annual Household Income: ________
PERSONAL INFORMATION: (Check one in each item. This Information is Required for Federal Reporting Purposes)
a. MALE b. WHITE BLACK/AFRICAN AMERICAN BLACK/AFRICAN AMERICAN & WHITE
FEMALE AMERICAN INDIAN/ALASKAN NATIVE ASIAN
AMERICAN INDIAN/ALASKAN NATIVE & WHITE ASIAN & WHITE
NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER BALANCE/OTHER
AMERICAN INDIAN/ALASKAN NATIVE & BLACK/AFRICAN AMERICAN
c. ETHNICITY d. DISABLED e. IS HEAD OF HOUSEHOLD FEMALE?
HISPANIC YES YES
NON-HISPANIC NO NO
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.
__________________ _____________
Signature of Applicant Date
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.
-----------------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: Õ
Staff Assessment of Demographics: ____________________________________________________________
Person Making Determination: Date:
NOTE: Address, income amounts and sources for ALL household members are required.
CDBG-CV 51% PSA CONTRACT-- EXHIBIT “E” -- INCOME CERTIFICATION FORMS Page 3
Ciudad de Fort Worth
CERTIFICACIÓN DE DECLARACIÓN DE INGRESOS
Nombre del Solicitante:
Dirección de Actualidad: Teléfono:
Ciudad y Código Postal: ______
Miembros Del Hogar e Ingresos
(Incluyendo el/la Solicitante)
Apellido Nombre Edad Ingreso
Mensual
Origen de Ingresos
* TOTAL NÚMERO DE MIEMBROS DEL HOGAR
(Inclúyase Usted.)
Total, Anual de Ingresos del hogar:
**INFORMACIÓN PERSONAL: (Seleccione uno en cada artículo. Esta información es requerida por el Gobierno federal.)
a. MASCULINO b. BLANCO NEGRO/AFRICANO AMERICANO NEGRO/AFRICANO AMERICANO & BLANCO
FEMININO INDIO AMERICANO/NATIVO DE ALASKA ASIATICO
INDIO AMERICANO/NATIVO DE ALASKA & BLANCO ASIATICO & BLANCO
NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS BALANCE/OTRO
INDIO AMERICANO / NATIVO DE ALASKA & NEGRO/AFRICANO AMERICANO
c. ETHNICIDAD d. INCAPACITADO e. ¿ES LA CABEZA DEL HOGAR MUJER?
HISPANO SI SI
NO-HISPANO NO NO
Certificación: Yo certifico que la información que yo estoy proporcionando es verdadera y puedo ser sujeto a
verificación a cualquiera hora por tercera parte. Yo también reconozco que la provisión de información falsa
puede dejarme sujeto a penalidades Federales, Estatales, y a ley local.
Firma del Solicitante Fecha
ADVERTENCIA:TITULO 18,SECCIÓN 1001 DEL CÓDIGO DE LOS ESTADOS UNIDOS INDICA QUE UNA
PERSONA ES CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMENTE HACER DECLARACIONES FALSOS O
FRAUDULENTAS A CUALQUIER DEPARTAMENTO DE GOBIERNO DE LOS ESTADOS UNIDOS .
-----------------Para use de empleados de la agencia-----------------
# De Miembros de Familia: Ingreso Anual:
Límite de Ingreso: ¿Es solicitante elegible?:
Compruebe si el solicitante se negó a dar su información personal: Õ
Evaluación del empleado sobre información personal: ____________________________________________
Persona haciendo la determinación: Fecha:
Note: La dirección de la casa y los ingresos (y sus orígenes) para todos miembros del hogar son requerido
CDBG PSA CONTRACT -- EXHIBIT “F” -- STANDARDS OF DOCUMENTATION
EXHIBIT “F”
STANDARDS OF DOCUMENTATION
CDBG PSA CONTRACT Exhibit "F" -- STANDARDS FOR COMPLETE DOCUMENTATIONInvoiceProof of Payment*TimesheetContract/AgreementSAM.gov SearchLeaseExplanation of how expense is related to ProgramNotes/Other
Salaries 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.
FICA/Medicare X X X
Life Insurance X X X
Health
Insurance X X X
Disability
Insurance X X X
Unemployment
Insurance X X X
Retirement X X X
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. Invoice and proof of payment are only required with the first reimbursement request and
at any time there are changes to amounts, enrollments, disenrollments, etc.
Office Supplies X X X
Office
Equipment
Rental
X X X X X
Postage X X X
Printing X X X
Construction &
Building
Materials
X X X X This category is only available for the REACH Program and Habitat for Humanity.
Sport and
Recreation
Equipment
X X X
Cleaning
Supplies X X X
Teaching Aids X X X
Craft Supplies X X X
Food Supplies X X X This category is only available to the Program provided by Meals on Wheels.
Telephone X X
Gas X X
Water/Wastew
ater X X
Electric X X
Solid Waste X X
Documentation Standards for
CDBG Public Service Contract Expenses
Budget Line
Items
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.
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. Invoice and proof of payment are only required with the first reimbursement request and
at any time there are changes to amounts, enrollments, disenrollments, etc.
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.
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.
CDBG PSA CONTRACT Exhibit "F" -- STANDARDS FOR COMPLETE DOCUMENTATION
Facility
Maintenance
and Repairs
X 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.
Rent X X X
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.
Contract Labor X X X X X
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
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
Insurance 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
CDBG-funded program.
Childcare
Scholarships X X
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
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
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
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.
Audit Services X X X X
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.
as of SK
Miscellaneous
*Proof of payment effective October 1,: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.
CDBG PSA CONTRACT -- EXHIBIT “G” -- SECTION 3 REPORTING FORMS Page 1
EXHIBIT “G”
SECTION 3 REPORTING FORMS
NOT APPLICABLE
EXHIBIT “H”
SEVERELY DISABLED CERTIFICATION FORM
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 t he 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 08/29/201
CDBG PSA CONTRACT 2-- EXHIBIT “I” -- MBE REPORTING FORM Page 1
EXHIBIT “I”
MBE REPORTING FORM
CDBG-CV 51% PSA CONTRACT - EXHIBIT “J” – DUTIES OF THE PARTIES - USE OF NEIGHBORHOOD SERVICES
DEPARTMENT COMMUNITY CENTERS
EXHIBIT “J”
DUTIES OF THE PARTIES
USE OF NEIGHBORHOOD SERVICES DEPARTMENT
COMMUNITY CENTERS
CDBG PSA CONTRACT - EXHIBIT “J” - DUTIES OF THE PARTIES - USE OF NEIGHBORHOOD SERVICES
DEPARTMENT COMMUNITY CENTERS
DUTIES OF THE PARTIES
USE OF NEIGHBORHOOD SERVICES DEPARTMENT
COMMUNITY CENTERS
Agency’s Responsibilities:
Agency will perform the following in relation with the use of Community Center:
Agency will furnish the Center Coordinator with a schedule of Program activities at least four weeks
prior to their occurrence.
Agency will, at its sole expense, furnish materials, supplies, copies and conduct a structured Program.
Agency will ensure that the designated Community Center space is maintained in a neat and orderly
fashion.
Agency will ensure that the City’s standards are maintained regarding security; cleanliness and
communication between and among programs housed at the Community Center and will ensure
cooperation with other Community Center staff and agencies/programs.
Agency will report to the Center Coordinator or designee for problems immediately if/when problems
occur.
Agency will work with the Center Coordinator or designee to schedule any use of the Community
Center for related activities outside of agencies designated meeting time and/or the Community
Center’s regular days and hours.
Agency will maintain sole responsibility and liability for its employees, volunteers and separate
contractors for their actions.
Agency shall ensure that each of its employees, volunteers and participants desiring to participate in
Community Center-sponsored programs/activities are aware of the requirement to have a current
community center membership card to participate.
Agency agrees to perform background screenings and checks on staff and volunteers, with such
screenings and checks meeting or exceeding the requirements that the City imposes for checks and
screenings on staff, volunteers and participants in the City’s own programs.
Agency will provide the Center Coordinator with designated staff contact information for the
purposes of emergencies (center closing, schedule changes or scheduled maintenance)
CDBG PSA CONTRACT - EXHIBIT “J” - DUTIES OF THE PARTIES - USE OF NEIGHBORHOOD SERVICES
DEPARTMENT COMMUNITY CENTERS
City’s Responsibilities:
City will perform the following in relation with Agency’s use of a Community Center:
City will provide space for conducting the Program, including basic utilities and will also supply the
Agency with appropriate facility access. For purposes of this Contract, basic utilities shall not include
telephone or computer service, which shall remain the sole responsibility of the Agency.
City will ensure that the reserved space is set up with appropriate tables and chairs to accommodate
program and/or services.
City will not be responsible for any additional security other than what is currently available at the
Community Center.
City assumes no liability or responsibility for the loss of any personal property or office contents of
the Agency, its agents, employees, volunteers, participants or licensees while at the Community
Center.
City will allow the Agency to conduct properly scheduled classes and other Program related activities
during the days and hours specified in Exhibit “A” PROGRAM SUMMARY*. In addition, City
may, but is not required, through the Center Coordinator, allow Agency to schedule other classes and
Program related activities outside of the days and hours specified in Exhibit “A” PROGRAM
SUMMARY.
City will maintain sole responsibility and liability for its employees, volunteers and separate
contractors for their actions.
City will have the discretion to put the Agency in any available room. If placed in a different location,
it is to be only one room.
*The City is closed in observance of the following holidays:
New Year’s Day (January 1st)
M.L.K. Jr. Day (Third Monday of January)
Memorial Day (Last Monday in May)
Juneteenth (June 19th)
Independence Day (July 4th)
Labor Day (First Monday in September)
Thanksgiving Day (Fourth Thursday of November)
Day after Thanksgiving (Fourth Friday in November)
Christmas Day (December 25th)
**City of Fort Worth observes the above holidays on Friday if they fall on Saturday and on a Monday if they fall on
Sunday.
Additionally, the Community Centers are utilized as shelters during an emergency. If the Community
Center will be closed due to an emergency, Center Coordinator or designee will inform Agency of the
closure.
CDBG-CV 51% PSA CONTRACT- EXHIBIT “K” - NOTICE OF BENEFICIARY RIGHTS
EXHIBIT “K”
NOTICE OF BENEFICIARY RIGHTS
CDBG-CV 51% PSA CONTRACT- EXHIBIT “K” - NOTICE OF BENEFICIARY RIGHTS
Notice of Beneficiary Rights
Name of Agency:
Name of Program:
Contact information for Program Staff (name, phone number, and e-mail address, if appropriate):
Because this program is supported in whole or in part by direct Federal financial assistance from
the Federal Government, we are required to let you know that:
• We may not discriminate against you on the basis of religion, religious belief, a refusal
to hold a religious belief, or a refusal to attend or participate in a religious practice;
• We may not require you to attend or participate in any explicitly religious activities that
are offered by us and any participation by you in these activities must be purely
voluntary;
• We must separate, in time or location, any privately funded explicitly religious activities
from activities supported by direct Federal financial assistance;
• If you object to the religious character of our organization, we must make reasonable
efforts to identify and refer you to an alternative provider to which you have no such
objection; and
• You may report an organization's violations of these protections, including any denial of
services or benefits, by contacting or filing a written complaint to HUD [or the
intermediary, if applicable].
We must give you this written notice before you enroll in our program or activity, as required by
24 CFR 5.109.
(check applicable)
and my date of birth is _______________________.
(street) (state) (zip code) (country)
(year)(month)
_______, ______________, _________.
State of ________________, on the _____day of ___________, 20_____.
(city)
(Declarant)
Carol Klocek April 26, 1967
3713 Echo Trail Fort Worth TX 76109 USA
Tarrant TX 2nd June 23
M&C Review
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Official site of the City of Fort Worth, Texas
CITY COUNCIL AGENDA
Create New From This M&C
DATE:6/27/2023 REFERENCE
NO.:
**M&C 23-
0594 LOG NAME:19NS CARES ACT HUD FUNDS
REALLOCATION
CODE:C TYPE:CONSENT PUBLIC
HEARING:NO
SUBJECT: (ALL) Authorize a Change in Use and Adjust Existing Appropriations in the CARES Act
Community Development Block Grant Funds in the Amount of $800,000.00 to Fund
Particular Programs and Activities; Approve a Substantial Amendment to the City of
Fort Worth's 2019-2020 Annual Action Plan for the Use of Federal Grant Funds in the
Amount of $800,000.00 from the Coronavirus Aid, Relief, and Economic Security Act
Community Development Block Grant Program; and Authorize Execution of Related
Contracts
RECOMMENDATION:
It is recommended that City Council:
1. Authorize a change in use and adjust existing appropriations in the CARES Act Community
Development Block Grant Funds in the amount of $800,000.00 to fund particular programs and
activities;
2. Approve a Substantial Amendment to the City of Fort Worth's 2019-2020 Annual Action Plan for
submission to the U.S. Department of Housing and Urban Development for the use of federal
grant funds in the amount of $800,000.00 to be awarded through the CARES Act Community
Development Block Grant program, including allocations of grant funds to particular programs
and activities as detailed below;
3. Authorize the City Manager or his designee to execute contracts for eighteen-month terms with
the nonprofit agencies listed in Table 1 below for CARES Act Community Development Block
Grant funds, contingent upon receipt of funding and satisfactory completion of all regulatory
requirements; and
4. Authorize the City Manager or his designee to extend 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 contracts if necessary to achieve program goals, provided any
amendment is within the scope of the program and complies with City policies and all
applicable laws and regulations governing the use of federal grant funds.
DISCUSSION:
In June 2020, the City of Fort Worth was awarded $4,360,291.00 in CARES Act CDBG-CV funds
and in September 2020 was awarded $5,468,206.00 in CARES Act CDBG-CV3 funds to provide
services to low and moderate-income residents to prevent, prepare, and respond to the impact of
the Coronavirus Pandemic. The Fort Worth City Council subsequently awarded these funds to
local nonprofit organizations providing a variety of urgently needed COVID-19-related services to
eligible populations.
Additional funding has been made available through unprogrammed funding previously allocated to
organizations with unexpended balances and reallocated administrative funds totaling
$800,000.00. It is recommended that these funds be awarded directly to agencies for the activities
listed in Table 1 below addressing the following three priority activities:
Elderly Services/Aging in Place
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Fund Department
ID
Account Project
ID
Program Activity Budget
Year
Reference #
(Chartfield 2)
Amount
Fund Department
ID
Account Project
ID
Program Activity Budget
Year
Reference #
(Chartfield 2)
Amount
Employment Related Services
Food Insecurity
On May 19,2020, City Council approved a Substantial Amendment to the City's 2019-20 Action
Plan for U.S. Department of Housing and Urban Development (HUD) grant funds stating how
CARES Act grant funds were to be used, and amended the Citizen Participation Plan to reduce
public comment period for CARES Act funds from thirty days to five days as authorized by the
CARES Act (M&C 20-0330). This 5-day public comment period was held from June 6, 2023 to
June 13, 2023. Notice of this public comment period was published in the Fort Worth Star-
Telegram, posted on the City's website and other ongoing communications activities of the
Communications and Public Engagement Office. Any comments received are maintained by the
Neighborhood Services Department in accordance with federal regulations.
TABLE 1: CDBG-CV AGENCIES
AGENCY PROGRAM
FUNDING
SOURCE AMOUNT
Center for Transforming Lives Economic Mobility Program
(Microenterprise)
CDBG-
CV $100,000.00
Tarrant Area Food Bank Grocery Delivery (SNAP
Participants)
CDBG-
CV3 $60,000.00
Meals-On-Wheels, Inc. of
Tarrant County Transportation Program CDBG-
CV3 $350,000.00
The Presbyterian Night
Shelter of Tarrant County,
Inc.
Journey Home Guides CDBG-
CV3 $290,000.00
TOTAL CDBG-CV CONTRACTS $800,000.00
These programs are available in ALL COUNCIL DISTRICTS.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that approval of these recommendations will have no material
effect on City funds.
TO
FROM
Submitted for City Manager's Office by:Fernando Costa (6122)
Originating Department Head:Victor Turner (8187)
Additional Information Contact:Sharon Burkley (5785)
Terrance Jones (7563)
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ATTACHMENTS
CDBG-CV and CV3 Available Funds Table_060223.xlsx (CFW Internal)
CDBG-CV and CV3 FID Table_060223.xlsx (CFW Internal)
Form 1295 Certificate - CDBG-CV ME -signed.pdf (CFW Internal)
Form 1295_2023 Meals On Wheels 1295 Transit CDBG-CV $350K.pdf (CFW Internal)
PNS CDBG-CV Form 1295.pdf (CFW Internal)
SOS Business Search_CDBG-CV_CDBG-CV3 060223.pdf (Public)
TAFB CDBG-CV_Form 1295.pdf (CFW Internal)