HomeMy WebLinkAbout064542 - General - Contract - Easter Seals Central Texas dba Easterseals Lone StarCSC No. 64542
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 Easter Seals Central Texas dba Easterseals Lone Star (hereafter "Agency"),
a Texas non-profit corporation. City and Agency may be referred to individually as a "Party" and
jointly as "the Parties".
The Parties state as follows:
WHEREAS, City receives grant monies from the United States Department of Housing
and Urban Development through the Community Development Block Grant ("CDBG") Program,
Program No. B-25-MC-48-0010, Catalog of Federal Domestic Assistance No. 14.218;
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 to use CDBG funds for a program to serve
individuals and families, 51 % of whom must be low and moderate income;
WHEREAS, City citizens, the Community Development Council, and the City Council
have determined that CDBG programs are needed by the City's citizens.
NOW, THEREFORE, the Parties understand and agree as follows:
1 INCORPORATION OF RECITALS.
City and Agency hereby agree that the recitals set forth above are true and correct and form
the basis upon which the Parties have entered into this Contract.
2. DEFINITIONS.
In addition to terms defined in the body of this Contract, the terms set forth below shall
have the definitions ascribed to them as follows:
Area Median Income or AMI means the median family income for the Fort Worth -Arlington
metropolitan statistical area as established annually by HUD. The 2025 income limits are
attached hereto as EXHIBIT "A-1" - 2025 HUD Income Limits.
CDBG means Community Development Block Grant.
Complete Documentation means the following documentation as applicable:
• Attachments I, II, and III within Exhibit "D", with supporting documentation
including:
101 a a :s] /_10:7 x9107:111
CITY SECRETARY
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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, if applicable, confirmation of eligibility
through the Systematic Alien Verification for Entitlements (SAVE)
program.
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 Funds means the CDBG grant funds supplied by City to Agency under the terms of this
Contract.
CDBG Regulations means regulations found at 24 CFR Part 570 et seq.
Countywide Agencies means agencies with 10% or more of clients that reside outside of the
boundaries of the City. All other agencies are considered Fort Worth agencies.
DBE means disadvantaged business enterprise in accordance with 49 CFR Part 26.
Director means the Director of the Neighborhood Services Department.
Effective Date means October 1, 2025.
HUD means the United States Department of Housing and Urban Development.
IDIS means Integrated Disbursement Information System, HUD's project tracking system.
Income Eligible Client means a client whose annual income adjusted for family size does not
exceed 80% of AMI using the most current HUD Income Guidelines and Technical Guidance for
Determining Income and Allowances. The definition of annual income to determine client income
eligibility shall be the definition contained in 24 CFR Part 5.609, as amended from time to time.
National Objective means an activity that benefits low- and moderate -income persons. For the
purposes of this Contract, at least 51% of the clients served by the Program must be Income
Eligible Clients.
Neighborhood Services Department means the City's Neighborhood Services Department.
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Neighborly Software — Online database for Agency to submit monthly reimbursement requests.
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.
Subrecipient means Agency receiving funds under this Contract to perform program activities
funded by the CDBG grant and that assumes responsibility for meeting all grant requirements,
regulations, and performance obligations passed down from the City as the grantee.
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 on September 30,
2026, unless earlier terminated as provided in this Contract. This Contract may be extended by
mutual agreement of the Parties in writing if such extension is necessary for completion of the
program. Extensions will be memorialized in an amendment to the Agreement so long as the
amendment is in compliance with City policies and all applicable laws and regulations governing
the use of federal grant funds. The Contract term shall include any extension, if exercised, as
provided herein.
4. DUTIES AND RESPONSIBILITIES OF CITY.
4.1 Provide CDBG Funds.
City will provide up to $92,000.00 of CDBG 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
determining whether Agency is meeting the National Objective during the term of this Contract.
5. DUTIES AND RESPONSIBILITIES OF AGENCY.
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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 Funds.
5.2.1. Compliance with CDBG Regulations and Contract.
Agency shall be reimbursed for eligible Program costs with CDBG Funds only if City
determines in its sole discretion that:
5.2.1.1 Costs are eligible expenditures in accordance with CDBG Regulations.
5.2.1.2 Costs are in compliance with this Contract and are reasonable and
consistent with industry norms.
5.2.1.3 Complete Documentation, as applicable, is submitted to City by
Agency.
5.2.2 Budget.
5.2.2.1 The CDBG Funds will be paid on a reimbursement basis in accordance
with EXHIBIT `B" - Budget.
5.2.2.2 During the term of this Contract, Agency may submit written requests
to increase or decrease line -item amounts in the Budget, including an
explanation of why such increases or decreases are necessary. All
requests shall be approved by Director 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 by April
15, 2026.
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.
5.2.3.2 Agency agrees to utilize the CDBG Funds to supplement rather than
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supplant funds otherwise available for the Program.
5.2.4 Pavment of CDBG Funds to A2encv.
CDBG Funds will be disbursed to Agency upon City's approval of Reimbursement
Requests including submission of Complete Documentation to City in compliance with Section 9.
If Agency expends all funds budgeted for the Program prior to September 30, 2026, City may
hold back a small amount of the CDBG Funds until the end of the term. During this interim period,
Agency must continue to submit Attachment III — Client Data Report in EXHIBIT "D" —
Reimbursement Forms monthly. It is expressly agreed by the Parties that any CDBG Funds not
spent or approved for reimbursement to Agency shall remain with City.
5.3 Protiram Performance Milestones, Review and Corrective Action.
5.3.1 Agency represents that the Program will achieve the following milestones in
accordance with EXHIBIT "A" — Program Summary and the table below:
Month
% of Unduplicated
Clients Served (as
specified in EXHIBIT
"A" — Program
25% 25%
6
50%
50%
9
75%
75%
12
100%
100%
5.3.2 Failure of Agency to meet these milestones or a material deviation from them as
outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section, "material
deviation" shall mean more than 10% lower than the specified goal. In the event of such breach,
City reserves the right in its sole option to delay or withhold payment of Reimbursement Requests,
(ii) institute a Corrective Action plan as described below, (iii) to lower Agency's allocation of
CDBG Funds, or terminate this Contract.
5.3.2.1 Corrective Action.
Corrective action will be unique to the Agency and the Program and will be designed to
ensure that the Agency (i) expends the funds allocated to it by the City, and (ii) serves the
required number of unduplicated clients through the Program. The City may issue verbal or
informal directive requiring the Agency to take corrective action. A corrective action may
require additional outreach or marketing, additional reporting, additional monitoring, or any
other mechanism that will reasonably ensure the Program goals are met and that expenditures are
roughly proportional to the number of eligible, unduplicated clients served. Informal corrective
action shall not be considered a formal written corrective action plan or amendment to this
Contract. Formal written corrective action shall be required only when expressly stated in writing
by the City.
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5.3.3 Failure to meet at least 80% of its performance milestones or serve 112
Unduplicated Clients under this Contract may, in City's sole discretion, disqualify Agency for
consideration under the City's Request for Proposals for the 2026-2027 Program Year for federal
grant funds.
5.3.4 Amendments to performance milestones must be approved by the Director in
writing, with such approval being in the Director's sole discretion. If Director approves the
Agency's proposed amended performance milestones (as approved, the "Amended Performance
Milestones"), then the Amended Performance Milestones will take effect on the first day of the
month following the month in which it was approved by the Director, unless otherwise specified
in the amendment. All requests for amendments to performance milestones must be submitted by
June 1, 2026. Except in extreme circumstances, notwithstanding the above, any amendments to
performance milestones shall not reduce the number for serving 112 Unduplicated Clients stated
in Section 5.3.3.
5.4 Identify Program Expenses Paid with CDBG Funds.
Agency will keep accounts and records in such a manner that City may readily identify and
account for Program expenses reimbursed with CDBG Funds. These records shall be made
available to City for audit purposes and shall be retained as required hereunder.
5.5 Meet National Obiective.
Agency shall ensure that the activities carried out in the Program will meet the National
Objective.
5.6 Program Subcontracts.
Agency shall not enter into a subcontract with another agency, contractor, or vendor to
provide a service to clients for any part of the Program that will be paid with CDBG Funds without
City's written consent.
6. CLIENT ELIGIBILITY VERIFICATION.
6.1 Client Eligibility.
Agency will document client eligibility as follows:
6.1.1 Auencv 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" — Self -
Certification of Income Form or a similar form approved by City, or Source Documentation.
Agency must use the annual income definition in 24 CFR Part 5.609 to establish client income and
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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.
If applicable, the Agency must comply with the eligibility and verification requirements
that apply under title IV of the Personal Responsibility and Work Opportunity Reconciliation Act
of 1996, as amended (8 U.S.C. 1601-1646) (PRWORA) and use the Systematic Alien Verification
for Entitlements (SAVE) or an equivalent verification system approved by the Federal
government, to prevent any Federal public benefit from being provided to an ineligible alien who
entered the United States illegally or is otherwise unlawfully present in the United States, unless
the Agency is a nonprofit charitable organization exempt from this requirement under 8 U.S.C. §
1642(d).
6.1.1.1 If Agency serves both Fort Worth and non -Fort Worth clients, the
proportion of Program costs allocated to the CDBG-funded portion of
the Program Budget must be consistent with the proportion of Fort
Worth clients to all clients.
6.1.1.2 All Program clients must be reported on EXHIBIT "D" —
Reimbursement Forms, Attachment III. All Program clients whose
income has not been verified will be deemed not to be Income Eligible
Clients and shall not be included in the 51 %.
6.1.1.3 Both the City's Certification of Income Statement attached as
EXHIBIT "E" — Self -Certification of Income Form or a similar form
approved by City, or Source Documentation and, if applicable, such
confirmation of eligibility through the SAVE program are required to
verify the eligibility of Program clients.
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 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 meet the requirements of Section 6.1.2.1, Agency will
have thirty (30) calendar days, or until the next monthly invoice, to cure.
6.1.2.3 City will notify Agency by e-mail within fourteen (14) calendar days if
the client eligibility requirements outlined in this Section are not cured
within the timeline outline in 6.1.2.2. Agency will have seven (7)
calendar days from the date of the e-mail notice to meet these
requirements. If Agency fails to meet the requirements, Agency may
forfeit any payments otherwise due that month and failure to meet the
client eligibility requirements will be considered an event of default as
outlined in Section 10.1.
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6.1.2.4 In the event the Agency fails to meet the client eligibility requirements,
City reserves the right in its sole option to delay or withhold payment of
Reimbursement Requests, to lower Agency's allocation of CDBG
Funds, or to terminate this Contract.
6.2 Submission of 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 7 years
following the expiration of the Contract term. This Section shall survive the earlier termination or
expiration of this Contract.
7. ADDITIONAL CDBG REOUIREMENTS.
Agency agrees to comply with all requirements of the CDBG Program as stated in the
CDBG Regulations, including but not limited to the following:
7.1 Environmental Review.
CDBG Funds will not be paid, and costs cannot be incurred until City has conducted an
environmental review and completed an 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 Funds it has already received and forfeit any future payments of CDBG 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 and receipt
by City of an authorization to use grant funds from HUD under 24 CFR Part 58, (ii) approval of
City's 2025-2026 Action Plan, 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 7
years after the Contract term ends. Agency will provide reports and access to Program files as
requested by City during this 7 year period.
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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 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 7
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,
or with the January Reimbursement Request, whichever is earlier.
7.4 Agencv Procurement Standards.
Agency shall comply with all applicable federal, state and local laws, regulations, and
ordinances for making procurements under this Contract. In addition to the conflict of interest
provisions in Section 14.13.3, Agency shall establish written procurement procedures to ensure
that materials and services are obtained in a cost effective manner and that provides for full and
open competition. When procuring materials and services for this Contract, Agency shall comply
at a minimum with the procurement standards in 2 CFR Part 200.317 through Part 200.326.
7.4.1 Contracts in excess of $10,000.00 made by Agency using CDBG Funds must
address termination for cause and convenience including the manner by which such termination
shall be effected and the basis for settlement of the terminated contract, if any, as required by
Appendix II (B), 2 CFR Part 200.
7.4.2 Agency shall not make any contract with parties listed on the government wide
System for Award Management, www.sam.gov ("SAM"). Agency must confirm by search of
SAM that all contractors paid with CDBG Funds are not listed by SAM as being debarred, both
prior to hiring and prior to submitting a Reimbursement Request which includes invoices from any
such contractor. Failure to submit such proofs of search shall be an event of default.
7.5 Cost Princivles/Cost Reasonableness.
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Agency shall administer its use of CDBG Funds in compliance with 2 CFR Part 200, as
applicable. The eligibility of costs incurred for performance rendered shall be determined in
accordance with 2 CFR Part 200.400 through 2 CFR Part 200.475.
7.6 Financial Management Standards.
Agency agrees to comply with 2 CFR Part 200, as applicable. Agency also agrees to adhere
to the accounting principles and procedures required therein, utilize adequate internal controls, and
maintain necessary supporting and back-up documentation for all costs incurred in accordance
with 2 CFR Part 200.302 and Part 200.303.
7.7 Uniform Administrative Requirements, 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 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 7 years after the Contract term
ends.
7.9 Couvright and Patent Rights.
No reports, maps, or other documents produced in whole or in part under this Contract shall
be the subject of an application for copyright by or on behalf of Agency. HUD and City shall
possess all rights to invention or discovery, as well as rights in data, which may arise as a result of
Agency's performance under this Contract.
7.10 Conflict of Interest Disclosure.
In accordance with the requirements of Section 14.13.2.1 and 14.13.4, Agency shall
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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.
7.12 Internal Controls.
In compliance with the requirements of 2 CFR Part 200.303, Agency shall:
7.12.1 Establish and maintain effective internal control over the CDBG Funds that
provides reasonable assurance that Agency is managing the CDBG Funds in compliance with
federal statutes, regulations, and the terms and conditions of this Contract. These internal controls
shall be in compliance with guidance in "Standards for Internal Control in the Federal
Government" issued by the Comptroller General of the United States or the "Internal Control
Integrated Framework" issued by the Committee of Sponsoring Organizations of the Treadway
Commission ("COSO");
7.12.2 Comply with federal statutes, regulations, and the terms and conditions of this
Contract;
7.12.3 Evaluate and monitor Agency's compliance with statutes, regulations and the 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
REOUIREMENTS. 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
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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 7 years after the Contract term ends, regardless of whether or not this Contract is
earlier terminated. If any claim, litigation, or audit is initiated before the expiration of the 7 year
period, the relevant records and documentation must be retained until all such claims, litigation or
audits have been resolved.
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 7 years after the Contract
term ends, regardless of whether or not this contract is earlier terminated. Such access shall be
during regular business hours and upon at least 48 hours prior notice.
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 fifteen (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 $1,000,000.00 or more in Federal Funds Per Year.
All non-federal entities that expend $1,000,000.00 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 nine 9 months following the
end of the period being audited and be submitted to City within thirty 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
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or with the first Reimbursement Request. Entities that expend less than $1,000,000.00 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 Citv 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 7 years after the Contract term ends, regardless
of whether or not this Contract is earlier terminated, if City determines that such audit is necessary
for City's compliance with the CDBG Regulations or other City policies. Agency agrees to allow
access to all pertinent materials as described herein for such audit. If such audit reveals a
questioned practice or expenditure, such questions must be resolved within fifteen (15) business
days after notice to Agency of such questioned practice or expenditure. If questions are not
resolved within this period, City reserves the right to withhold further funding under this Contract
and/or any other contracts with Agency. IF AS A RESULT OF ANY AUDIT IT IS
DETERMINED THAT AGENCY HAS FALSIFIED ANY DOCUMENTATION OR
MISUSED, MISAPPLIED OR MISAPPROPRIATED CDBG FUNDS OR SPENT CDBG
FUNDS ON ANY INELIGIBLE ACTIVITIES, AGENCY AGREES TO REIMBURSE
CITY THE AMOUNT OF SUCH MONIES PLUS THE AMOUNT OF ANY SANCTIONS,
PENALTY OR OTHER CHARGE LEVIED AGAINST CITY BY HUD BECAUSE OF
SUCH ACTIONS.
9. REIMBURSEMENT 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 15t" 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 15t' 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.
NOTWITHSTANDING ANYTHING ABOVE, THE REIMBURSEMENT REQUEST FOR
EXPENSES INCURRED FOR SEPTEMBER 2026 MUST BE RECEIVED BY OCTOBER
4, 2026. COMPLETE DOCUMENTATION FOR ALL SEPTEMBER 2026 EXPENSES
MUST BE SUBMITTED BY OCTOBER 15, 2026. FAILURE TO SUBMIT A FINAL
REIMBURSEMENT REQUEST WITH COMPLETE DOCUMENTATION BY
OCTOBER 15, 2026 WILL RESULT IN FORFEITURE OF PAYMENT OF THE
SEPTEMBER REIMBURSEMENT REQUEST.
9.1.2 City will notify Agency by e-mail within fourteen (14) calendar days if a
Reimbursement Request is lacking Complete Documentation or corrections are needed. Agency
will have seven (7) calendar days from the date of the e-mail notice to submit any requested
information or missing documentation. At City's sole discretion, Agency may be penalized, in the
Request for Proposal for the 2026-2027 Program Year for any notifications received under this
Section. If Agency fails to submit all the required information or missing documentation within
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seven (7) calendar days from the first e-mail, Agency may forfeit any payments otherwise due that
month and failure to submit any requested information will be considered an event of default as
outlined in Section 10.1.2.
9.2 Submission of Reimbursement Requests.
Agency shall provide City with Complete Documentation and the following reports
as shown in EXHIBIT "D" —Reimbursement Forms with each Reimbursement Request:
9.2.1 Attachment I — Request Summarv.
This report shall contain the amount requested for reimbursement each month, and 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:
9.2.2.1 For payroll expenses, timesheets signed by employees and approved by
supervisor for all payroll expenses listed. Timesheets must distinguish
between CDBG-funded time and non-CDBG funded time and reflect
actual time spent on CDBG-funded activities. Agency may not submit
payroll expenses dated sixty (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 sixty 60 calendar days prior to
the date of the Reimbursement Request.
9.2.2.3 Proof that each expense was paid by Agency. 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" — Self- Certification of Income Form or similar form approved
by City, and Source Documentation.
9.2.4 Delivery of Reimbursement Request.
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Reimbursement Requests must be submitted through Neighborly Software or other
reporting software as approved by the City by the deadline in Section 9.1.
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 Pavment.
CITY SHALL HAVE NO OBLIGATION TO PAY ANY REIMBURSEMENT
REQUEST THAT IS NOT RECEIVED BY THE DUE DATE AS OUTLINED HEREIN.
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 seven (7) calendar days from the date of the written Default Notice to
submit such Reimbursement Request to cure the default. If Agency fails to cure within such time,
Agency shall forfeit any payments otherwise due that month.
10.1.2 NOTWITHSTANDING THE PROVISIONS OF SECTION 10.1.1, IF
AGENCY FAILS TO SUBMIT THE REIMBURSEMENT REQUEST DUE OCTOBER 4,
2026 OR IF THE SUBMITTED REIMBURSEMENT REQUEST DUE OCTOBER 4, 2026
IS LATE, INCOMPLETE OR OTHERWISE NOT IN COMPLIANCE WITH THIS
CONTRACT OR THE CDBG REGULATIONS AS DETERMINED BY CITY IN ITS
SOLE DISCRETION, THERE WILL BE NO CURE PERIOD AND ANY
REIMBURSEMENT WILL BE FORFEITED.
10.1.3 In the event of an uncured default under this Section, 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 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 Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no further right to such funds.
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10.2 Failure to Maintain Records or Submit Reports and Documentation.
If Agency fails to maintain all records and documentation as required in Section 8, or if the
maintained or submitted 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 thirty (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 Section 10.2, all CDBG Funds awarded but
unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall have
no further right to such funds.
10.2.2 In the event of termination under Section 10.2, any CDBG Funds paid to
Agency must be repaid to City within thirty (30) days of termination. If such CDBG Funds are not
repaid to City within the thirty (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 thirty (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 thirty (30) calendar days to cure, as determined by both Parties
mutually and in good faith, City shall have the right to elect in City's sole discretion to: (i) extend
Agency's time to cure, (ii) terminate this Contract effective immediately upon written notice of
such intent to Agency, or (iii) pursue any other legal remedies available to City under this Contract.
10.3.2 City's remedies may include:
10.3.2.1 Direct Agency to prepare and follow a schedule of actions for
carrying out the affected activities, consisting of schedules,
timetables and milestones necessary to implement the affected
activities.
10.3.2.2 Direct Agency to establish and follow a management plan that
assigns responsibilities for carrying out the remedial activities.
10.3.2.3 Reprogram CDBG Funds that have not yet been expended from
affected activities to other eligible activities or withhold CDBG
Funds.
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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 Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no further right to such funds, and any CDBG Funds already paid to Agency must be repaid
to City within thirty (30) days of the termination. Failure to repay such CDBG Funds within the
thirty (30) day period will result in City exercising all legal remedies available under this Contract.
10.4 No Funds Disbursed while in Breach.
Agency understands and agrees that no CDBG Funds will be paid to Agency until all
defaults are cured to City's satisfaction.
10.5 No Compensation After Date of Termination.
Agency shall not receive any compensation for work undertaken after the date of the
termination.
10.6 Rights of Citv 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
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.
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10.9.1 City may terminate this Contract in the event of Agency's default, inability, or
failure to perform subject to notice, grace and cure periods. In the event City terminates this
Contract for cause, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall
be immediately rescinded and Agency shall have no further right to such funds and any CDBG
Funds already paid to Agency must be repaid to City within thirty (30) days of termination. Failure
to repay such CDBG Funds within thirty (30) days will result in City exercising all legal remedies
available to City under this Contract. AGENCY ACKNOWLEDGES AND AGREES THAT
IF CITY TERMINATES THIS CONTRACT FOR CAUSE, AGENCY OR ANY
AFFILIATES OF AGENCY SHALL NOT BE CONSIDERED FOR ANY OTHER CITY
CONTRACT FOR CDBG FUNDS FOR A MINIMUM OF 7 YEARS FROM THE DATE
OF TERMINATION.
10.9.2 Agency may terminate this Contract if City does not provide the CDBG Funds
substantially in accordance with this Contract.
10.10 Termination for Convenience.
In terminating in accordance with 2 CFR Part 200, Appendix II, this Contract may be
terminated in whole or in part only as follows:
10.10.1 By City with the consent of Agency in which the Parties 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 thirty (30) days written notification to City, setting
forth the reasons for such termination, the effective date, and in the case of partial termination, the
portion to be terminated. In the case of a partial termination, City may terminate the Contract in
its entirety if City determines in its sole discretion that the remaining portion of the Contract to be
performed or CDBG Funds to be spent will not accomplish the purposes for which the Contract
was made.
10.11 Dissolution of Aeencv Terminates Contract.
This Contract shall terminate in the event Agency is dissolved or ceases to exist. In the
event of termination under this Section, all CDBG Funds are subject to repayment and/or City may
exercise all of its remedies under this Contract.
10.12 Non-approuriation of Funds.
In the event no funds or insufficient funds are appropriated by City in any fiscal period for
any payments due hereunder, City will notify Agency of such occurrence and this Agreement shall
terminate on the last day of the fiscal period for which appropriations were received without
penalty or expense to City of any kind whatsoever, except as to the portions of the payments herein
agreed upon for which funds have been appropriated.
10.13 Reversion of Assets.
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In the event this Contract is terminated with or without cause, all assets acquired by Agency
with the CDBG Funds including cash, interest payments from loans or otherwise, all outstanding
notes, mortgages or other security instruments, any accounts receivable attributable to the use of
the CDBG Funds, and any real or personal property owned by Agency that was improved with the
CDBG Funds shall automatically transfer to City or to such assignee as City may designate.
11. REPAYMENT OF CDBG FUNDS.
All CDBG Funds are subject to repayment in the event the Program does not meet the
requirements of this Contract or in the CDBG Regulations. If Agency takes any action that
results in the City being required to repay all or any portion of the CDBG Funds to HUD,
Agency agrees it will reimburse City within thirty (30) days of notice from the City for such
repayment. Additionally, if Agency takes any action that results in City receiving a finding
from HUD about the Program, whether or not repayment of all or any portion of the CDBG
Funds is required of City, Agency agrees City may require that 10% of the CDBG 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 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 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 fifteen (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
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 Funds already paid to Agency must be repaid to City within thirty (30) calendar days
of termination under this Section.
13. SURVIVAL.
Any provision of this Contract that pertains to auditing, monitoring, indemnity obligations,
client income eligibility, record keeping and reports, City ordinances, or applicable CDBG
requirements, and any default and enforcement provisions necessary to enforce such provisions,
shall survive the termination of this Contract for 7 years after the Contract term ends, regardless
of whether or not this Contract is earlier terminated, and shall be enforceable by City against
Agency.
14. GENERAL PROVISIONS
14.1 Agency an Independent Contractor.
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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 Agencv Propertv.
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.
14.4 Religious Organization.
Agency shall comply with all applicable requirements as more particularly described in 24
CFR Part 5.109. No portion of the CDBG Funds shall be used in support of any sectarian or
religious activity. In addition, there must be no religious or membership criteria for clients of a
CDBG-funded service.
14.4.1. 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 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.
14.4.2 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 Funds and participation must be voluntary for clients of a CDBG-funded service.
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14.4.3 Required Notices.
If Agency constitutes a Faith -based organization under 24 CFR Part 5.109, Agency must
provide all clients of a CDBG-funded service with the notice attached as EXHIBIT "I" —Notice
of Beneficiary Rights. Such notice shall be provided to the client prior to enrollment in any
CDBG-funded program or activity. In addition, if a client or prospective client of a CDBG-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.
14.5 Venue.
Venue shall lie in state courts in Tarrant County, Texas or the United States District
Court for the Northern District of Texas, Fort Worth Division 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.
14.6 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.
14.7 Severabilitv.
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.
14.8 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.
14.9 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
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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".
14.10 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:
➢ CDBG Regulations found in 24 CFR Part 570
➢ Title I of the Housing and Community Development Act of 1974, as amended, (42
USC 5301)
➢ Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d et seq.) including
provisions requiring recipients of federal assistance to ensure meaningful access by
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
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➢ Section 6002 of the Solid Waste Disposal Act, as amended by the Resource
Conservation and Recovery Act
➢ Guidelines of the Environmental Protection Agency at 40 CFR Part 247
➢ For contracts and subgrants for construction or repair, Copeland "Anti -Kickback" act
(18 U.S.C. 874) as supplemented in 29 CFR Part 5
➢ For construction contracts awarded by Agency in excess of $2,000, and in excess of
$2,500 for other contracts which involve the employment of mechanics or laborers,
Sections 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C.
327A 300) as supplemented by 29 CFR Part 5
➢ Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), as amended by
the Residential Lead -Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et
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.
➢ The Build America, Buy America Act (BABA) enacted under Division G, Title IX of
the Infrastructure Investment and Jobs Act (IIJA, Pub. L. No. 117-58) signed into law
on November 15, 2021.
➢ General Administrative, National, and Departmental Policy Requirements and Terms
for HUD's Financial Assistance Programs (2025), as referenced in the Notice of
Funding Opportunity (NOFO) for this award.
➢ Compliance with OMB requirements on the Unique Entity Identifier (UEI) and
SAM.gov registration, as well as reporting under 2 CFR Part 25 and Part 170.
➢ Adherence to all applicable requirements related to noncompliance and termination, as
described in 2 CFR §§ 200.339-200.340.
➢ Report suspected fraud, waste, and abuse to HUD and the Office of Inspector General
(OIG), and to inform employees of their protections under 41 U.S.C. § 4712.
14.12 Prohibition Against Discrimination.
14.12.1 General Statement.
Agency shall comply in the execution, performance or attempted performance of this
Contract, with all non-discrimination requirements of 24 CFR Part 570.607 and Chapter 17, Article
III, Division 4 — Fair Housing of the City Code. Agency may not discriminate against any person
because of race, color, sex, gender, religion, national origin, familial status, disability or perceived
disability, sexual orientation, gender identity, gender expression, or transgender, nor will Agency
permit its officers, members, agents, employees, or clients to engage in such discrimination.
This Contract is made and entered into with reference specifically to Chapter 17, Article
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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.
14.12.2 No Discrimination in Emplovment during the Performance of This
Contract.
During the performance of this Contract Agency agrees to the following provision, and
will require that its contractors and subcontractors also comply with such provision by including
it in all contracts with its contractors:
[Contractor's, Subcontractor's or Vendor's name] will not unlawfully discriminate against
any employee or applicants for employment because of race, color, sex, gender, religion, national
origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender
expression or transgender. [Contractor's, Subcontractor's or Vendor's name] will take affirmative
action to ensure that applicants are hired without regard to race, color, sex, gender, religion,
national origin, familial status, disability or perceived disability, sexual orientation, gender
identity, gender expression or transgender and that employees are treated fairly during employment
without regard to their race, color, sex, gender, religion, national origin, familial status, disability
or perceived disability, sexual orientation, gender identity, gender expression or transgender. Such
action shall include, but not be limited to, the following: employment, upgrading, demotion or
transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms
of compensation, and selection for training, including apprenticeship. Contractor's,
Subcontractor's or Vendor's name] agrees to post in conspicuous places, available to employees
and applicants for employment, notices setting forth the provisions of this nondiscrimination
clause.
(Contractor's, Subcontractor's or Vendor's name] will, in all solicitations or
advertisements for employees placed by or on behalf of Contractor's, Subcontractor's or
Vendor's name], state that all qualified applicants will receive consideration for employment
without regard to race, color, sex, gender, religion, national origin, familial status, disability or
perceived disability, sexual orientation, gender identity, gender expression 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.
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14. l 2.3 Agencv'S Contractors and the ADA.
In accordance with the provisions of the Americans With Disabilities Act of 1990
("ADA"), Agency warrants that it and any of its contractors will not unlawfully discriminate on
the basis of disability in the provision of services to the general public, nor in the availability, terms
and/or conditions of employment for applicants for employment with, or employees of, Agency or
any of its contractors. AGENCY WARRANTS IT WILL FULLY COMPLY WITH THE
ADA'S PROVISIONS AND ANY OTHER APPLICABLE FEDERAL, STATE AND
LOCAL LAWS CONCERNING DISABILITY AND WILL DEFEND, INDEMNIFY AND
HOLD CITY HARMLESS AGAINST ANY CLAIMS OR ALLEGATIONS ASSERTED BY
THIRD PARTIES, CONTRACTORS SUBCONTRACTORS, VENDORS OR AGENTS
AGAINST CITY ARISING OUT OF AGENCY'S AND/OR ITS CONTRACTORS',
SUBCONTRACTORS', VENDORS' OR AGENTS' OR THEIR RESPECTIVE
EMPLOYEES' ALLEGED FAILURE TO COMPLY WITH THE ABOVE -REFERENCED
LAWS CONCERNING DISABILITY DISCRIMINATION IN THE PERFORMANCE OF
THIS CONTRACT.
14.13 Conflicts of Interest and Violations of Criminal Law.
14.13.1 Agencv Safeguards.
Agency shall establish safeguards to prohibit its employees, board members, advisors and
agents from using positions for a purpose that is or gives the appearance of being motivated by a
desire for private gain for themselves or others, particularly those with whom they have family,
business or other ties. Agency shall disclose to City any such conflict of interest or potential
conflict of interest, immediately upon discovery of such.
14.13.2 General Prohibitions Against Conflicts of Interest.
No employees, agents, consultants, officers or elected officials or appointed officials of
City or of Agency who exercise or have exercised any functions or responsibilities with respect to
activities assisted with CDBG funds or who are in a position to participate in a decision -making
process or gain inside information with regard to these activities may utilize CDBG services, may
obtain a financial interest or benefit from a CDBG-assisted activity, or have an interest in any
contract, subcontract or agreement with respect thereto, or the proceeds thereunder, either for
themselves or those with whom they have family or business ties, during their tenure or for 1 year
thereafter.
14.13.2.1 Agency shall establish conflict of interest policies for federal awards
including the CDBG Funds and shall disclose in writing potential
conflicts of interest to City as authorized by 2 CFR Part 200.112.
14. l 3.3 Conflicts of Interest Involving Procurement.
The conflict of interest provisions of 2 CFR Part 200.318 shall apply in the procurement
CDBG 51 % PSA CONTRACT 2025-2026 25
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of property and services by Agency. In all cases not governed by this Section, the provisions of 24
CFR Part 570.611 of the CDBG Regulations shall apply.
14.13.3.1 As more particularly described in 2 CFR Part 200.318, Agency shall
maintain and submit to City written standards of conduct covering
conflicts of interest and governing the performance of its employees
engaged in the selection, award, and administration of contracts. No
employee, officer, or agent may participate in the selection, award,
or administration of a contract supported by a federal award if he or
she has a real or apparent conflict of interest. The standards of
conduct must provide for disciplinary actions to be applied for
violations of such standards by officers, employees, or agents of
Agency.
14.13.3.2 The officers, employees, and agents of Agency shall neither solicit
nor accept gratuities, favors, or anything of monetary value from
contractors or parties to subcontracts.
14.13.3.3 Notwithstanding the prohibition contained in Section 14.13.3.2,
Agency may set standards of conduct for situations in which the
financial interest is not substantial or the gift is an unsolicited item
of nominal value. Such standards of conduct must provide for
disciplinary actions to be applied for violations of such standards by
Agency's officers, employees or agents.
14.13.3.4 Agency shall maintain written standards of conduct covering
organizational conflicts of interest. Organizational conflicts of
interest means that because of relationships with a parent company,
affiliate, or subsidiary organization, Agency is unable or appears to
be unable to be impartial in conducting a procurement action
involving a related organization.
14.13.3.5 Agency must maintain records sufficient to detail the history of
procurement. These records will include, but are not necessarily
limited to the following: rationale for the method of procurement,
selection of contract type, contractor selection or rejection, and the
basis for the contract price.
14.13.4 Disclosure of Conflicts of Interest.
In compliance with 2 CFR Part 200.112, Agency is required to timely disclose to City in
writing any potential conflict of interest.
14.13.5 Disclosure of Conflicts of Interest for Ai!encv Clients.
Agency understands that its clients will be receiving assistance partially or fully funded
utilizing Housing and Urban Development (HUD) funds received by City. Agency will assist City
CDBG 51 % PSA CONTRACT 2025-2026 26
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in determining whether eligible clients have a potential relationship to the City that constitutes a
conflict of interest by having clients fill out the Conflict of Interest Disclosure Form, attached
hereto as Exhibit "J". In the event a conflict of interest exists, this may affect the client's eligibility
to receive services. As a result, if a potential client provides information on the form that a conflict
may exist, Agency must notify City for a determination prior to providing services.
14.13.6 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. Agency will timely disclose to City all violations.
14.13.7 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.
14.14 Subcontracting with Small and Minority Firms, Women's Business
Enterprises and Labor Surplus Areas.
14.14.1 For procurement contracts $100,000.00 or larger that are paid for, in part or in
full, with the CDBG Funds, Agency agrees to abide by City's policy to involve Minority Business
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. To the extent applicable, Agency agrees to
comply with all City Ordinances, and all amendments or successor policies or ordinances thereto,
for all contracts and subcontracts for procurement larger than $100,000.00 or larger that are paid
for, in part or in full, with the CDBG Funds and will further require all persons or entities with
which it so contracts to comply with said ordinance.
14.14.2 It is national policy to award a fair share of contracts to disadvantaged business
enterprises ("DBEs"), small business enterprises ("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.
14.14.2.1 In order to comply with federal reporting requirements 24 CFR Part
570.506 (g)(6), Agency must submit the form attached hereto as
EXHIBIT "H" — MBE Reporting Form for each contract or
subcontract with a value of $25,000.00 or more paid or to be paid
with the CDBG Funds. Agency shall submit this form by the date
specified in EXHIBIT "H" — MBE Reporting Form.
14.15 Other Laws.
The failure to list any federal, state or City ordinance, law or regulation that is applicable
CDBG 51 % PSA CONTRACT 2025-2026 27
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to Agency does not excuse or relieve Agency from the requirements or responsibilities in regard
to following the law, nor from the consequences or penalties for Agency's failure to follow the
law, if applicable.
14.16 Assignment.
Agency shall not assign all or any part of its rights, privileges, or duties under this Contract
without the prior written approval of City. Any attempted assignment of same without approval
shall be void, and shall constitute a breach of this Contract.
14.17 Right to Inspect Agencv Contracts.
It is agreed that City has the right to inspect and approve in writing any proposed contracts
between Agency and any contractor or vendor engaged in any activity in conjunction with this
CDBG-funded Program prior to any charges being incurred.
14.18 Force Maieure.
If Agency becomes unable, either in whole or part, to fulfill its obligations under this
Contract due to acts of God, strikes, lockouts, or other industrial disturbances, acts of public
enemies, wars, blockades, insurrections, riots, epidemics, pandemics, 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.
14.19 IMMIGRATION NATIONALITY ACT.
Agency shall verify the identity and employment eligibility of its employees who perform
work under this Contract, including completing the Employment Eligibility Verification Form (I-
9). Upon request by City, Agency shall provide City with copies of all I-9 forms and supporting
eligibility documentation for each employee who performs work under this Contract. Agency
shall adhere to all Federal and State laws as well as establish appropriate procedures and controls
so that no services will be performed by any Agency employee who is not legally eligible to
perform such services. AGENCY SHALL INDEMNIFY CITY AND HOLD CITY
HARMLESS FROM ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO
VIOLATIONS OF THIS PARAGRAPH BY AGENCY, AGENCY'S EMPLOYEES,
SUBCONTRACTORS, AGENTS, OR LICENSEES. City, upon written notice to Agency, shall
have the right to immediately terminate this Contract for violations of this provision by Agency.
15. INDEMNIFICATION AND RELEASE.
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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
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
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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
$92,000.00 to insure against loss from the fraud, theft or dishonesty of any of Agency's officers,
agents, trustees, directors or employees. The proceeds of such insurance or bond shall be used to
reimburse City for any and all loss of CDBG Funds occasioned by such misconduct. To effectuate
such reimbursement, such fidelity coverage shall include a rider stating that reimbursement for
any loss or losses shall name the City as a Loss Payee.
Agency shall furnish to City in a timely manner, but not later than the Effective Date,
certificates of insurance as proof that it has secured and paid for policies of commercial insurance
as specified herein. If City has not received such certificates by the Effective Date, Agency shall
be in default of the Contract and City may, at its option, 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 Liabilitv (CGL) Insurance
$ 500,000 each occurrence
$1,000,000 aggregate limit
Non -Profit Organization Liabilitv or Directors & Officers Liabilitv
$1,000,000 Each Occurrence
$1,000,000 Annual Aggregate Limit
Business Automobile Liability Insurance
$1,000,000 each accident on a combined single -limit basis, or
$ 250,000 Property Damage
$ 500,000 Bodily Injury per person per occurrence
$2,000,000 Aggregate
Insurance policy shall be endorsed to cover "Any Auto", defined as autos owned, hired,
and non -owned. Pending availability of the above coverage and at the discretion of
City, the policy shall be the primary responding insurance policy versus a personal
CDBG 51 % PSA CONTRACT 2025-2026 30
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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 thirty (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.
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
CDBG 51 % PSA CONTRACT 2025-2026 31
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contractors to have City and Agency endorsed as additional insureds (as their interest may appear)
on their respective insurance policies.
Directors and Officers Liability coverage shall be in force and may be provided on a claims -made
basis. This coverage may also be referred to as Management Liability, and shall protect the insured
against claims arising out of alleged errors in judgment, breaches of duty and wrongful acts arising
out of their organizational duties. Coverage shall protect not only the entity, but all past, present
and future directors, officers, trustees, employees, volunteers and committee members.
Notwithstanding any provision in this Contract to the contrary, when applicable, Agency
shall comply with the requirements of 2 CFR 200.310 and shall, at a minimum, provide the
equivalent insurance coverage for real property and equipment acquired or improved with
CDBG Funds as provided to property owned by Agency.
18. CERTIFICATION REGARDING LOBBYING.
The undersigned representative of Agency hereby certifies, to the best of his or her
knowledge and belief, that:
No federal appropriated funds have been paid or will be paid, by or on behalf of Agency,
to any person for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, an officer or employee of Congress in connection with the
awarding of any federal contract, the making of any federal grant, the making of any federal
loan, the entering into of any cooperative agreement and the extension, continuation,
renewal, amendment, or modification of any federal contract, grant, loan or cooperative
agreement.
If any funds other than federally appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency,
member of Congress in connection with this federal contract, grant, loan or cooperative
agreement, Agency shall complete and submit Standard 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
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.
CDBG 51 % PSA CONTRACT 2025-2026 32
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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
100 Fort Worth Trail
Fort Worth, TX 76102
Telephone: 817-3 92-7600
Copy to:
Neighborhood Services Department
100 Fort Worth Trail
Fort Worth, TX 76102
Attention: Kacey Thomas
Telephone: 817-3 92-7540
Copy to:
Neighborhood Services Department
100 Fort Worth Trail
Fort Worth, TX 76102
Attention: Mary Tenorio
Telephone: 817-3 92-643 2
Agency:
Easter Seals Central Texas dba Easterseals Lone Star
Emily Ditmore
6900 Anderson Blvd., Ste 104
Fort Worth, TX 76120
Telephone: 682-666-9703
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.
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
CDBG 51 % PSA CONTRACT 2025-2026 33
Easter Seals Central Texas dba Easterseals Lone Star
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 2276 of the Texas Government
Code, 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. To the extent that Chapter 2276 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
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 Agency 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. 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,
CDBG 51 % PSA CONTRACT 2025-2026 34
Easter Seals Central Texas dba Easterseals Lone Star
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.
27. ELECTRONIC SIGNATURES.
This Contract may be executed by electronic signature, which will be considered as an
original signature for all purposes and have the same force and effect as an original signature. For
these purposes, "electronic signature" means electronically scanned and transmitted versions (e.g.
via pdf file or facsimile transmission) of an original signature, or signatures electronically inserted
via software such as Adobe Sign.
[SIGNATURES APPEAR ON NEXT PAGE]
CDBG 51 % PSA CONTRACT 2025-2026 35
Easter Seals Central Texas dba Easterseals Lone Star
IN WITNESS WHEREOF, the Parties hereto have executed this Contract in Fort Worth,
Tarrant County, Texas.
ATTEST:
F Foa>°da
41A
ago e=o
Jannette Goodall
City Secretary
M&C: 25-0676
Date: August 12, 2025
1295 Certification No. 2025-1275299
RECOMMENDED BY:
Koey Thomas
Kacey Thomas (Ian 8, 202617:19:50 CST)
Kacey Thomas
Neighborhood Services Director
APPROVED AS TO FORM AND LEGALITY:
4td
L i Hunt (Jan 8, 202617:26:36 CST)
Sophie Mathews
Assistant City Attorney II
CITY OF FORT WORTH:
n ,r,n a. irghrinft (ia" n, 9076 700 4CST)
Dana Burghdoff
Assistant City Manager
CONTRACT COMPLIANCE ADMINISTRATOR:
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
II a4X
Mary Tenorio, Neighborhood Development Specialist
EASTER SEALS CENTRAL TEXAS DBA EASTERSEALS LONE STAR
51 DocuSigned by:
�—M7901CD281C4CF...
Kenneth Brezenoff, Executive Director
CDBG 5 1 % PSA CONTRACT 2025-2026
Easter Seals Central Texas dba Easterseals Lone Star
1•I.1;1Is] r,3q.0x411*1V W,
Is] kWdM @IV=k fil3'1
FT. WORTH, TX 36
EXHIBITS:
EXHIBIT "A" —Program Summary
EXHIBIT "A-1" — 2025 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" — Self -Certification of Income Form
EXHIBIT "F" — Standards for Complete Documentation
EXHIBIT "G" — Severely Disabled Certification Form (only applicable to Presumed
Benefit contracts)
EXHIBIT "H" — MBE Reporting Form
EXHIBIT "I" — Notice of Beneficiary Rights
EXHIBIT "J" — Conflict of Interest Disclosure Form
EXHIBIT "K" — Certificate of Compliance: Additional Program -Specific Policy
Requirements
CDBG 51 % PSA CONTRACT 2025-2026 37
Easter Seals Central Texas dba Easterseals Lone Star
Easter Seals Central Texas dba Easterseals Lone Star EXHIBIT "A"
Employment Services PROGRAM SUMMARY
Community Development Block Grant
(CDBG)
October 1, 2025 to September 30, 2026 $92,000.00
PERIOD AMOUNT
Capitalized terms not defined herein shall have meanings assigned to them in the Contract.
PROGRAM:
Easter Seals Central Texas's (ESCT) Employment Services Program will provide a person -centered
approach to job attainment for individuals with disabilities and other barriers to employment in
accordance with HUD requirements, including veterans, justice -involved individuals, and those
experiencing poverty or homelessness. ESCT matches participants' skills with job opportunities and
provides job -readiness training, job placement, coaching, and long-term follow-up.
CDBG funds will support a portion of staff salaries for the Employment Coordinator, Senior
Director, and two Community Liaisons involved in the daily operations of the program, as well as
office and program supplies, printing, and rent. Funds will also cover a portion of administrative
and indirect costs necessary for program operations, including finance, IT, HR, and compliance
services provided by the parent organization. In addition, funds will support transportation passes
for client transportation needs related to employment and program participation. The percentage of
any Program employee's salary and allocated funds will not exceed the percentage of Fort Worth
clients participating in the Program and shall be cost allocated in accordance with the amount
applicable to the CDBG funded Program.
Agency's office is located at 6900 Anderson Boulevard, Suite 104, Fort Worth, TX 76120, from
8:00 a.m. to 5:00 pm; the Job Club is held every Monday and Tuesday from 11:00 a.m. to 1:00 p.m.
with additional client meetings and trainings scheduled one-on-one from 8:00 a.m. to 4:00 p.m.,
Monday through Friday.
Countywide Agency shall not change any locations without prior City written approval. Costs
incurred at any locations that have not been approved by City shall not be reimbursed. Service
location revisions will trigger the City's Citizen Participation Plan and will require a 30-day public
notice.
Agency is a Countywide Agency: Provides services to Fort Worth and Non -Fort Worth clients
through a Fort Worth and a Non -Fort Worth program. Non -Fort Worth clients constitute 10% or
more of total clients served. The Program serves Tarrant County clients only, and Agency will
submit documentation that verifies that 51 % of Program clients are Income Eligible Clients with
current household incomes at or below 80% of AMI. Agency will also submit quarterly reports
as required through EXHIBIT "A-2" — Reporting Requirements for Countywide Agency
Programs.
CDBG 51 %-COUNTYWIDE-EXHIBIT A
Easter Seals Central Texas Page 1
REGULATORY CLASSIFICATION:
IDIS Matrix Code(s) and Service Category: 05H Employment Training
National Objective Citation: LMC Low/Mod Limited Clientele 24 CFR 570.208 (a)(2)
Regulatory Citation(s): 24 CFR 570.201(e)
PROGRAM GOALS:
Minimum Number of Fort Worth Clients to be Served: The Program must serve a minimum
of 112 Unduplicated Clients from Fort Worth, as shown by the monthly reports on Attachment
III -Client Data Report.
Per HUD regulations, any fractional results when calculating the 51% income eligibility
requirement must be rounded up.
OTHER AGENCY REOUIREMENTS:
Upon completion of the program year, Easterseals Lone Star will submit with the final
reimbursement request a summary of client outcomes measured through satisfaction surveys,
participant employment milestones, business involvement, and training activities, demonstrating
program effectiveness and impact.
CDBG 51 %-COUNTYWIDE-EXHIBIT A
Easter Seals Central Texas Page 2
EXHIBIT "A-1"
2025 HUD INCOME LIMITS
AMI 1 person
2 people
3 people
4 people
5 people
6 people
7 people
8 people
30% $22,400
$25,600
$28,800
$32,200
$34,600
$37,150
$39,700
$42,250
50% $37,350
$42,700
$48,050
$53,350
$57,650
$61,900
$66,200
$70,450
80% $59,750
$68,300
$76,850
$85,350
$92,200
$99,050
$105,850
$112,700
*Income limits are published at least annually by HUD.
Effective 610112025
EXHIBIT "A-2"
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
(ONLY APPLICABLE TO COUNTYWIDE AGENCIES)
CDBG PSA CONTRACT-- EXHIBIT "A-2"
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
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
December, March, June and September Reimbursement Requests. The submission of the Quarterly
Report is through Neighborly Software. The information provided in the Quarterly Report will be
reviewed and monitored by the Neighborhood Services Department Compliance Division.
A B C D E F
EXAMPLE: 250 200 450 250=450=55%
January 15, 2026 October 1, 2025 —
December 31, 2025
April 15, 2026 January 1, 2026 —
March 30, 2026
July 15, 2026 April 1, 2026 —
June 30, 2026
October 1, 2026 July 1, 2026—
September 30, 2026
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:
Signature/Title:
CDBG PSA CONTRACT-- EXHIBIT "A-2"
REPORTING REQUIREMENTS FOR COUNTYWIDE AGENCIES
Date:
EXHIBIT "B"
BUDGET
EXHIBIT "B" - BUDGET
Account
Grant Budget
A
E
Total
PROGRAM PERSONNEL
EL
Salaries
1001
$ 69,328.20
$
10,670.70
$ 20,405.40
$
100,404.30
FICA
1002
$
2,534.71
$ 5,146.22
$
7,680.93
Life/Disability Insurance
1003
$
231.93
$ 470.90
$
702.83
Health/DentalInsurance
1004
$
3,346.47
$ 6,794.36
$
10,140.83
Unemployment -State
1005
$
861.47
$ 1,749.04
$
2,610.51
Worker's Compensation
1006
$
927.74
$ 1,883.58
$
2,811.32
Retirement
1007
$
2,584.41
$ 5,247.13
$
7,831.54
Other
1008
$
778.64
$ 1,580.86
$
2,359.50
SUPPLIES AND SERVICES
Office/Program Supplies
2001
$ 1,000.00
$
1,000.00
$
2,000.00
Postage
2002
$
750.00
$
750.00
Printing
2003
$ 1,000.00
$
250.00
$
1,250.00
Adv/Media, Dues/Pub, Printing,
Bank Fees
other - Transportation Passes
2004
$ 584.61
$
584.61
MISCELLANEOUS
Contract Labor Food
Supplies/Meals (City needs copy
of contract before expenses can be
reimbursed)
3001
$ -
Food Supplies
3002
Teaching Aids - Computers
3003
$
2,000.00
$
2,000.00
Craft Supplies
3004
Field Trip Expenses
3005
Mileage
3006
$ -
$
2,000.00
$
2,000.00
FACILITY AND UTILITIES
Telephone
4001
$
1,500.00
$
1,500.00
Electric
4002
$
1,500.00
$
1,500.00
Gas
4003
Water and Wastewater
4004
$
75.00
$
75.00
Solid Waste Disposal
4005
Rent (City needs copy of lease
before expenses can be
reimbursed)
4006
$ 6,287.19
$
2,694.51
$
8,981.70
Cleaning Supplies
4007
$
1,500.00
$
1,500.00
Repairs
4008
$
1,000.00
$
1,000.00
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
$
2,800.00
$
2,800.00
Bank fees
CDBG PSA S1% CONTRACT 202S-26 - EXHIBIT "B" - BUDGET Page 1
volunteer
volunteer
Administrative Services 5004 $ 13,800.00 $ 15,000.00 $ 6,722.51 $ 35,522.51
DIRECT ASSISTANCE
Audit/IT/Legal Volunteer
Recruitment, Misc. 6001
BUDGET TOTAL $ 92,000.00 $ 54,005.58 $ 50,000.00 $ 196,005.58
FUNDING A: Ticket to Work
FUNDING B: CVS Grant Funding
CDBG PSA 51% CONTRACT 2025-26 - EXHIBIT "B" - BUDGET Page 2
The following tables were created for the purpose of preparing, negotiating, and determining the cost
reasonableness and cost allocation method used by the Agency for the line item budget represented on
the first page of this EXHIBIT "B" — Budget. The information reflected in the tables is to be
considered part of the terms and conditions of the Contract. Agency must have prior written approval
by the City to make changes to any line item in the Budget as outlined in Section 5.2.2 in the
Contract. The deadline to make changes to EXHIBIT "B" — Budget is April 15, 2026.
SALARY DETAIL -PROGRAM PERSONNEL
Est. Percent to
Amount to
Position Title
Annual Salary
Grant
Grant
Employment Coordinator
$
37,440.00
70.0%
$
26,208.00
Sr. Director
$
63,654.00
30.0%
$
19,096.20
Community Liaison
$
34,320.00
40.0%
$
13,728.00
Community Liaison
$
17,160.00
60.0%
$
10,296.00
TOTAL
$
152,574.00
45.4%
$
69,328.20
FRINGE DETAIL -PROGRAM PERSONNEL
Est. Percent to
Amount to
Percent of Payroll
Amount
Grant
Grant
FICA
7.65%
$
7,680.93
0.0%
Life/Disability Insurance
0.70%
$
702.83
0.0%
Health/Dental Insurance
10.10%
$
10,140.83
0.0%
Unemployment -State
2.60%
$
2,610.51
0.0%
Worker's Compensation
2.80%
$
2,811.32
0.0%
Retirement
7.80%
$
7,831.54
0.0%
Other
2.35%
$
2,359.50
0.0%
TOTAL
$
34,137.46
0.0%
$
-
SUPPLIES AND
SERVICES
Est. Percent to
Amount to
Total Budget
Grant
Grant
Office/Program Supplies
$
2,000.00
50.0%
$
1,000.00
Postage
$
750.00
0.0%
$
-
Printing
$
1,250.00
80.0%
$
1,000.00
Other- Transportation Passes
$
584.61
100.0%
$
584.61
TOTAL
$
4,584.61
56.4%
$
2,584.61
CDBG PSA 51% CONTRACT 2025-26 -EXHIBIT "B" -BUDGET Page 3
Contract Labor
Teaching Aids
Craft Supplies
Field Trip Expenses
Mileage
TOTAL
Telephone
Electric
Gas
Water and Wastewater
Solid Waste Disposal
Rent
Cleaning Supplies
Repairs
Custodial Services
Utilities, Transportation, PP & E
MISCELLANEOUS
Est. Percent to Amount to
Total Budget Grant Grant
FACILITY AND UTILITIES
Est. Percent to Amount to
Total Budget
Grant Grant
$
1,500.00
0.0%
$
1,500.00
0.0%
$
75.00
0.0%
$
8,981.70
70.0% $ 6,287.19
$
1,500.00
0.0%
$
1,000.00
0.0%
TOTAL $ 14,556.70 43.2% $
LEGAL, FINANCIAL AND INSURANCE
Est. Percent to
Total Budget Grant
Fidelity Bond or Equivalent
Directors and Officers
General Commercial Liability
Administrative Services
TOTAL
$ 2,800.00
$ 35,522.51
$ 38,322.51
DIRECT ASSISTANCE
Total Budget
Audit/IT/Legal Volunteer Recruitment, Misc.
TOTAL
GRAND TOTAL 1 $ 244,175.28 1
0.0% $
36.0% $
36.0% $
Est. Percent to
Grant
6,287.19
Amount to
Grant
13,800.00
43,800.00
Amount to
Grant
37.68%1 $ 92,000.00 1
CDBG PSA 51% CONTRACT 2025-26 -EXHIBIT "B" -BUDGET Page 4
EXHIBIT "C"
AUDIT CERTIFICATION FORM
PSA CONTRACT - EXHIBIT "C" - AUDIT
CERTIFICATION FORM --
AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS
Agency:
Fiscal Year Ending: September 30, 2026
❑✓ During the fiscal year in which funds will be received, we will exceed the federal expenditure
threshold of $1,000,000.00. We will have our Single Audit or Program Specific Audit
completed and will submit the audit report described in 2 CFR Part 200 within 9 months
after the end of the audited fiscal year or 30 days within its completion, whichever is the
❑ earlier date.
During the fiscal year in which funds will be received, we will not exceed the
$1,000,000.00 federal expenditure threshold required for a Single Audit or a Program
Specific Audit to be performed this fiscal year. (Fill out schedule below)
Federal Expenditure Disclosure
MUST be filled out if Single Audit or Program Audit is NOT required.
Pass Through Program Name & Contract
Federal Grantor Grantor CFDA Number Number Expenditures
Total Federal Expenditures for this Fiscal Year:
George Bayiokos, Controller 12 11 /13/2025
Signatory and Title Date
Failure to submit this or a similar statement or failure to submit a completed single audit package
as described in the federally required audit requirements described in 2 CFR Part 200, as
applicable, by the required due date may result in suspension of funding and may affect eligibility
for future funding. Notwithstanding the above, this certification acknowledges the agency's
commitment to meet all other financial reporting, financial statements, and other audit
requirements as may be set forth in the Contract.
PSA CONTRACT - EXHIBIT " C" - AUDIT CERTIFICATION FORM
EXHIBIT "D"
REIMBURSEMENT FORMS
Exhibit D
Attachment I- Request Summary
Agency:
Address:
City, State, Zip:
Program:
Month of Service:
Tax ID Number:
Contract Number:
Case ID:
P.O. Number:
FID Number:
IDIS Number:
Account
Amount
Original Amount This Invoice Cumulative to Date I Remaining Balance
(Program Name) Case ID
Salaries
1001
$
- $
$
FICA
1002
$
$
$
$
Life/Disability Insurance
1003
$
$
$
$
Health/DentalInsurance
1004
$
$
$
$
Unemployment -State
1005
$
$
$
$
Worker's Compensation
1006
$
$
$
$
Office Supplies
1007
$
$
$
Food Supplies
1008
$
$
$
$
Insurance
1009
$
$
$
$ -
Accounting
1010
$
$
$
$
Contract Labor
1011
$
$
$
$
TOTAL
$
$
$
$
Pr
Request Summary
Budget
Expenditure
Percentage Spent
10
Table Total
$
$
#DIV/0!
$
Oct-25
Nov-25
Dec-25
Jan-26
Feb-26
Mar-26
Apr-26
May-26
Jun-26 Jul-26
Aug-26
Sep-26
$ -
$ -
S - $ -
$ -
$ -
Client Goals
Goal Amount
Cumulative Total
Goal Met %
Table Total
0
#DIV/0!
0
Oct-25
Nov-25
Dec-25
Jan-26
Feb-26
Mar-26
0
0
0
0
0
0
Apr-26
May-26
Jun-26
Jul-26
Aug-26
Sep-26
0
0
0
0
0
0
ATTACHMENT II
City of Fort Worth
Neighborhood Services Department
Expenditure Worksheet
Agency.
Program:
Please group like account codes.
Account Code
Line (See Key to
No. I Check No. I Date Payee Descn twn/Job Title* Right) Amount
13
14
15
16
17
18
19
I 10
I 11
I I2
I i3
I 14
I 15
I 16
I 17
I 18
I 19
I 20
I 21
I 22
I 23
I 24
I 25
I 26
I 27
I 28
I 29
I 30
I 31
I 32
I 33
I 34
I 35
I 36
I 37
I 38
I 39
I 40
I 41
I 42
I 43
I 44
I 45
I 46
I 47
I 48
I 49
I
Total
*For Salaries, state employee's title u,der Description/Job Title. Rent must idenlly tenant
Only highlighted codes can be reimbursed
Expense Line Item
Account
PROGRAM PERSONNEL
Salaries 1001
I FICA 1002
I Lite/Disability Insurance 1003
I Health/Dental Insurance t004
I Unemployment -State 1005
I Worker's Compensation 1006
Retirement I007
SUPPLIES AND SERVICES
Office/Progmm Supplies
2001
Postage
2002
I PrintigfC
2003
Other(CaseWorthy, Phones, Computers)
2004
MISCELLANEOUS
Contract Labor 3001
I Food Supplies 3002
I Teaching Aids 3003
I Craft Supplies 3004 I
I Field Trip Expenses 3005
I Mde3006 I
Othe��y n007
Other(Client Credentialing Fund) 3008
FACILITY AND UTILITIES
Telephone 4001
I Electric 4002
I Gas 4003
I Water and Wastewater 4004
I Solid Waste Disposal 4005
I Rent 4006
I Cleanir, So plies 4007
Other(Custodial Services, Repairs, Use 4008
LEGAL, FINANCIAL, AND INSURANCE
Fidelity Bond or Equivalent
5001
I Directors and Officers
5002
I General Commercial Liability
5003
Othell!) Interpretation)
5004
DIRECT ASSISTANCE
Other(Traimng, Transportation) 1 6001
H4
-----------------------------------------------------------------------------------
EXHIBIT "E"
SELF -CERTIFICATION FORMS
INCOME CERTIFICATION
(NOT SUBJECT TO CITIZENSHIP AND IMMIGRATION VERIFICATION)
INCOME AND CITIZENSHIP/IMMIGRATION CERTIFICATION
(SUBJECT TO CITIZENSHIP AND IMMIGRATION VERIFICATION)
City of Fort Worth
Applicant Name:
Current Address:
Last Name
First Name
Total Gross Annual Household Income:
TOTAL NUMBER OF FAMILY MEMBERS
CERTIFICATION OF INCOME STATEMENT
Phone #:
City and Zip:
Household Members and Income
(including applicant)
Age I Monthly Income
(Include Yourself, Spouse, Children, etc.)
Source of Income
PERSONAL DEMOGRAPHIC INFORMATION: (Check one box in each category. This information is required for federal reporting under HUD guidelines.)
a. ❑ MALE b. ❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ ASIAN
❑ FEMALE ❑ BLACK/AFRICAN AMERICAN ❑ NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER
❑ WHITE ❑ AMERICAN INDIAN/ALASKAN NATIVE & WHITE
❑ ASIAN & WHITE ❑ BLACK/AFRICAN AMERICAN & WHITE
❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ OTHER MULTI -RACIAL
& BLACK/AFRICAN AMERICAN
c. ETHNICITY d. DISABLED e. IS HEAD OF HOUSEHOLD FEMALE?
❑ HISPANIC ❑ YES ❑ YES
❑ NON -HISPANIC ❑ NO ❑ NO
Certification: I certify that all information I provide is true and may be subject to verification at any time by a third party. I agree to
furnish accurate and truthful information when applying for and receiving services. I understand that providing false or misleading
information may subject me to penalties under applicable Federal, State, and local laws.
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.
Household Size:
Applicable Income Limit:
-----------------For use by Agency staff only -----------------
Gross Annual Income:
Is Applicant Eligible?
Check if Applicant refused to provide demographic information:
Staff Assessment of Demographics:
Person Making Determination: Date:
NOTE: Agency staff are required to verify all information provided in this Certification of Income Statement. This form must include the address,
income amounts, and income sources for all household members, and all information must be verified.
2025-2026 CDBG PSA Contract
City of Fort Worth
CERTIFICATION OF INCOME & U.S. CITIZENSHIP/IMMIGRATION STATEMENT
Applicant Name:
Current Address:
Name (First & Last Name)
Total Gross Annual Household Income:
TOTAL NUMBER OF FAMILY MEMBERS
Phone #:
City and Zip:
Household Members and Income
(including applicant)
DOB Monthly Income
Source of Income
(Include Yourself, Spouse, Children, etc.)
With/out U.S.
Citizenship/
Immigration
Verification
❑YES ❑NO
❑YES ❑NO
❑YES ❑NO
❑YES ❑NO
❑YES ❑NO
PERSONAL DEMOGRAPHIC INFORMATION: (Check one box in each category. This information is required for federal reporting under HUD guidelines.)
a. ❑ MALE b. ❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ ASIAN
❑ FEMALE ❑ BLACK/AFRICAN AMERICAN ❑ NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER
❑ WHITE ❑ AMERICAN INDIAN/ALASKAN NATIVE & WHITE
❑ ASIAN & WHITE ❑ BLACK/AFRICAN AMERICAN & WHITE
❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ OTHER MULTI -RACIAL
& BLACK/AFRICAN AMERICAN
c. ETHNICITY d. DISABLED e. IS HEAD OF HOUSEHOLD FEMALE?
❑ HISPANIC ❑ YES ❑ YES
❑ NON -HISPANIC ❑ NO ❑ NO
Certification: I certify that all information I provide is true and may be subject to verification at any time by a third party. I agree to furnish accurate
and truthful information when applying for and receiving services. I understand that providing false or misleading information may subject me to
penalties under applicable Federal, State, and local laws.
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 income eligible? ❑YES ❑ NO Is everyone in the household a U.S. citizen or able to provide immigration verification?
❑YES ❑NO
Applicant citizenship/immigration status verification method used: ❑SAVE Documentation ❑ Govern ment-issued Documents
❑ Check if Applicant refused to provide demographic information:
Staff Assessment of Demographics:
Person Making Determination:
Date:
NOTE: Agency staff are required to verify all information provided in this Certification of Income Statement. This form must include the address,
income amounts, and income sources for all household members, citizenship status and all information must be verified.
2025-2026 CDBG PSA Contract
EXHIBIT "F"
STANDARDS OF DOCUMENTATION
CDBG 5 1 % PSA CONTRACT -- EXHIBIT "F" -- STANDARDS OF DOCUMENTATION
2025-26 Documentation Standards for
CDBG Public Service Contract Expenses
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 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 maybe 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.
Salaries X X 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 x x x
Insurance
Disability x x x
Insurance
Unemployment x x x
Insurance
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 anytime there are changes to amounts, enrollments, disenrollments, etc.
If the City pays gross salary, this is already included. If the City pays the employer portion, the Agency must provide proof that the
Retirement x x x employee is enrolled in the benefit plan, must show a calculation and documentation of how the invoiced amount was calculated, and
must provide documentation showing payment. 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.
Office Supplies X X
Office
Equipment
X X
X
X
X
Rental
Postage
X X
X
�Printinq
X X
X
Construction &
Building
X X
X
X This category is only available for the REACH Program and Habitat for Humanity.
Materials
Sport and
Recreation
X X
X
Equipment
Cleaning
X X
X
Supplies
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.
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.
Telephone
X X
Gas
X X
Water/Wastew
X X
ater
Electric
X X
Solid Waste
X( )!
I
CDBG 51 % PSA CONTRACT 2025-2026 Exhibit 7' -- STANDARDS FOR COMPLETE DOCUMENTATION
Facility
Maintenance X X X
and Repairs
Rent X X
Miscellaneous
Contract Labor X X X
This item requires approval by the City prior to the execution of the CDBG Contract. Repairs may be categorized as major/minor
rehabilitation projects and must be approved through the full HUD Environmetal Review.
City will pay for a portion of the rent for the Program facility so long as its in proportion to the square footage attributable to the CDBG-
funded program.
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 X X
City will only pay for a percentage of the City -required insurance so long as it's in proportion to the square footage attributable to the
Insurance
CDBG-funded program.
City requires that the agency submit its fee schedule or formula on how the Agency calculates the childcare scholarship amount. The
fee schedule/formula should demonstrate a breakout of income levels, and for each income level the schedule should demonstrate
Childcare X X
which portion of the expense is to be paid by the family and which portion of the expense is to be reimbursed by the City. A fee
Scholarships
schedule/formula must be submitted to the City prior to the first payment. Agency must submit documentation supporting that the client
is income eligible and that the household is being charged in conformance with the fee schedule. If the fee schedule/formula changes at
any time during the contract term, the Agency must immediately notify City on the date the new fee schedule/formula takes into effect.
"$0" Income
Agecies that are required to verify and provide proof of household income to determine eligibility, must require that anyone who is over
Certifications
the age of 18, living in the housohold, submit a $0 Income Certification.
If an audit is required because federal funds exceed $1,000,000.00, then the cost should be split evenly by all grant funding sources.
Audit Services X X X X
Agency must show calculation on how the CDBG portion of the accounting services were calculated. For example, if the CDBG grant is
10% of your Agency's budget, then invoice shall not exceed 10% of the overall cost. Agency must show a calculation and
documentation of how the invoiced amount was calculated, and must provide documentation showing payment.
*Proof of payment effective October 1,2025:
Payments or Expenses must be documented in the following manner:
A) Image of the check AND bank statement showing the check cleared the bank; OR,
B) Image of the cancelled check (ex. At end of bank statement); OR,
C) Payroll Check Stub, "Advice", or Statement AND Bank Statement indicating payroll; OR,
D) For wire or e-transfers: Reciept or statement from payee/vendor OR bank statement.
Revised as of 09/29/2025 MT
CDBG 51 % PSA CONTRACT 2025-2026 Exhibit"F" -- STANDARDS FOR COMPLETE DOCUMENTATION
EXHIBIT "G"
SEVERELY DISABLED CERTIFICATION FORM
CDBG 51 % PSA CONTRACT - EXHIBIT "G" - 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 the following
❑ Activities of Daily Living (ADL): getting around inside the home, getting in or
out of bed or a chair, bathing, dressing, eating, and toileting.
Is unable to perform or needs assistance to perform one or more of the following
Instrumental Activities of Daily Living (IADL): going outside the home,
❑ keeping track of money and bills, preparing meals, doing light housework,
taking prescription medications in the right amount and at the right time, and
using the telephone.
❑ Has a condition that prevents them from working at a job or doing housework.
The undersigned Agency representative conducted a visual assessment of the client identified on this
form and certifies that the client meets at least one of the conditions indicated above, which
determines that he/ she meets the definition of "severely disabled" according to the U.S. Census
Bureau.
Certified by:
Signature/Title:
Date:
CFW Neighborhood Services Dept.: Revised 08/29/2019
CDBG 51% PSA CONTRACT - EXHIBIT "G" - SEVERELY DISABLED CERTIFICATION FORM
EXHIBIT "H"
MBE REPORTING FORM
CDBG 51 % PSA CONTRACT -- EXHIBIT "H" -- MBE REPORTING FORM Page 1
Contract and Subcontract Activity U.S. Department of Housing and Urban Development OMB Approval No.: 2577-0088 OMB
Approval No.: 2502-0355
Public reporting burden for this collection of information is estimated to average .5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The
Information is voluntary. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB Control Number.
Executive Orders dated July 14, 1983, directs the Minority Business Development Plans shall be developed by each Federal Agency and the these annual plans shall establish minority business development objectives. The information is used by HUD to monitor and evaluate MBE activities against
the total program activity and the designated minority business enterprise (MBE) goals. The Department requires the information to provide guidance and oversight for programs for the development of minority business enterprise concerning Minority Business Development. If the information is
not collected HUD would not be able to establish meaningful MBE goals nor evaluate MBE performance against these goals.
Privacy Act Notice = The United States Department of Housing and Urban Development, Federal Housing Administration, is authorized to solicit the Information requested in this form by virtue of Title 12, United States Code, Section 1701 et seq., and regulation. It will not be disclosed or
relesed outside the United States Department of Housing and Urban Development without your consetn, except as required or permitted by Law.
1. Grantee/Project Owner/Developer/Spomor/Builder/Agency
Check if: 2. Location (City, State Zip Code)
PH
IH
CPD
Housing
3a. Name of Contact Person
3b. Phone Number (Including Area Code)
4. Reporting
Period
5. Program Code (Not applicable for CPD programs.)
6. Date Submitted to Field Office
See explanation of Codes at bottom of Page Use a
❑
❑
Oct. 1 - S. ;pt. 30 (Annual -FY)
separate sheet for each program code.
Contractor or
Grant/Project Number or HUD
Subcontractor
Case Number or other
Amount of Type of Trade
Business
Subcontractor
Contractor/Subcontractor Name and Address
identification of property,
Contract or Code
Racial/Ethnic
Woman Owned Business Prime Contractor Identification (ID)
Identification (ID)
7j.
subdivision, dwelling unit, etc.
Subcontact (See below)
(See below)
(Yes or No) Number
See. 3
Number Sec. 3
7a.
7b. 7c.
7d.
7e. 7f.
7g.
7h 7i.
Name Street City State Zip
CPD:
L = New Construction
2 = Education/Traming
3 = Other
7c: Type of Trade Codes:
Housing/Public Housing:
1—New Construction 6 = Professional
2 — Substantial Rehab. 7 = Tenant Services
3 — Repair 8 = Education/Traming
4 = Service 9 = Arch./Engrg. Appraisal
5 — Project Mang[. 0 = Other
7d: Racial/Ethnic Codes: 5: Program Codes (Complete for Housing and Public and Indian Housing programs only):
1 = White Americans
1 = All Insured, including Section8
5 = Section 202
2 = Black Americans
2— Flexible Subsidy
6 — HLJD-Held (Management)
3 = Native Americans
3 = Section 8 Noninsured, Non-HFDA
7 — Public/India Housing
4 = Hispanic Americans
4 = Insured (Management)
8 — Section 811
5 = Asian/Pacific Americans
6 = Hasidic Jews
Previous editions are obsolete. form HUD-2516 (8/98)
EXHIBIT "I"
NOTICE OF BENEFICIARY RIGHTS
CDBG PSA CONTRACT- EXHIBIT "I" - NOTICE OF BENEFICIARY RIGHTS
Notice of Beneficiary Riehts
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.
CDBG PSA CONTRACT- EXHIBIT "I" - NOTICE OF BENEFICIARY RIGHTS
EXHIBIT "J"
CONFLICT OF INTEREST DISCLOSURE:
FOR CITY OF FORT WORTH PROGRAMS ONLY
CDBG 51 % PSA CONTRACT -- EXHIBIT "J" -- CONFLICT OF INTEREST DISCLOSURE
FORT WORTH
CONFLICT OF INTEREST DISCLOSURE:
FOR CITY OF FORT WORTH PROGRAMS ONLY
The assistance you are applying for is funded using Housing and Urban Development (HUD) funds and because
of this our office is requesting the following information in order to comply with the funding requirements. Please
complete this form to the best of your ability, sign it, and return it to this Agency at your earliest convenience.
Ili ►TJM
TELEPHONE:
ADDRESS:
E-MAIL ADDRESS (if applicable)
1. Are you employed by the City of Fort Worth? ❑ YES I ❑ NO
1 a. If yes, by which Department and Division:
2. Were you employed by the City of Fort Worth within the most recent 12-month period? ❑ YES I ❑ NO
2a. If yes, by which Department and Division:
3. Are any members of your immediate family currently employed by the City of Fort Worth?
("Immediate Family" includes (whether by blood or adoption): the spouse, parent (including a stepparent), ❑ YES ❑ NO
child (including a stepchild), brother, sister (including a stepbrother or stepsister), grandparent, grandchild,
and in-laws.)
3a. If yes, please provide relative's name(s), Department(s), and Division(s):
4. If No, were any members of your immediate family employed by the City of Fort Worth YES NO
within the most recent 12-month period? El El4a. If yes, please provide relative's name(s), previous Department(s), and Division(s):
5. Are you an elected or appointed official, or agent or consultant, of the City of Fort Worth? YES NO
5a. If yes, by which Department and Division: ❑ ❑
6. Are any immediate family members an elected or appointed official, or agent or consultant YES NO
of the City of Fort Worth? El El6a. If yes, please provide relative's name(s), Department(s), and Division(s):
Certification: I understand and agree that the City may/will contact the City of Fort Worth department including all supervisors in
order to determine whether any of these persons' employment or official functions are or were related to the City's use of federal
grant funds and whether federal funds can be provided. I certify that the information I am providing is true and could be subject
to verification at any time by a third party. I also acknowledge that the provision of false information could leave me subject
to the penalties of Federal, State and local law.
WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY
MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF THE UNITED STATES GOVERNMENT.
Applicant/Prospective Applicant Signature
Date
Fpr_City_5taff Only: Once this form is completed and if "Yes" is marked on any of the above questions, please return it
to your Compliance Specialist as soon as possible for processing. If you have any questions, please contact Leticia
Rodriguez, Compliance Administrator, Compliance Division, at 817-392-7319, or Charletta Moaning, Sr. Contract
Compliance Specialist, at 817-392-7333 or at charletta,moaning@a fortworthtexas.gpy.
Neighborhood Services Department -Conflict Disclosure Form, Dated September 23, 2024-City Only
Docusign Envelope ID: 3DOA3DA3-4C64-47OC-A31C-F2844BBEFBEB
EXHIBIT "K"
CERTIFICATE OF COMPLIANCE:
ADDITIONAL POLICY REQUIREMENTS
Docusign Envelope ID: 3DOA3DA3-4C64-47OC-A31C-F2844BBEFBEB
CERTIFICATE OF COMPLIANCE:
ADDITIONAL POLICY REQUIREMENTS
The following policy requirements set forth in "EXHIBIT "K" — Certificate of Compliance:
Additional Policy Requirements" are dictated by the Department of Housing and Urban
Development (HUD) and are imposed upon the City of Fort Worth as the named Recipient of the
Federal award agreement. The terms outlined in this addendum are hereby incorporated by
reference into this Contract and shall be binding upon the Agency as a subrecipient of this award.
The Agency shall comply with all applicable provisions of EXHIBIT "K" — Certificate of
Compliance: Additional Program -Specific Policy Requirements as if fully stated herein.
This compliance is subject to new guidance, court decisions, or new regulatory actions that could
change the interpretation, application, or enforcement of these requirements. By signing this
certification, the Subrecipient is certifying that they have read and will comply with these
requirements and will monitor HUD guidance and other actions that may require changes or
updates to their own program policies. Any contractual requirement contained herein determined
to be unenforceable by a legal opinion, directive from a federal agency, court order, or executive
order (the "Determination"), shall be performed in a manner that complies with the Determination
to the greatest extent possible even if such compliance means non-performance.
In addition to all applicable federal statutes and regulations, the Subrecipient certifies that it has
read and agrees to comply with the attached policy requirements, if applicable, established under
the federal award agreement between the Department of Housing and Urban Development and the
City of Fort Worth, and which are a material condition of this Agreement:
A:l]DEI' DUM 1. POUGY REQUIRRMENTS
It applicame;
i, The Recltllenr shaLL not use grant funds to promote "gender J&otogy." as defined In Expcullve ()rder
(E.O.1 141E-9, DcfondlnE Women from Gendei Idfinlogy Utremisrn and Resialing Rlolog cal.Truth to
the Federal (owernment:
2. Thee Redpierkt agrees that its compliance in all respects with all applicable Federat antl-
dlscriminatlan taws Is raelefial. to the US, Govelrllrrinm's payment decisions tGr purposes of 5eclicn
372;%b)(4) al title 31, United States CDde,,
TO RecApieritcertifies that it does not operate any programs that uiotate any applicQN-P. FWerak
antl-discrimination Iaws. Including Title VI of the Civll FiIghts Act of 1 ;
A- The Reciplet1t a�aLL not use any grant funds to fund or Pmmate electlw abortions, as required byr
E.0. 14182, Enfarc.in9the Hyd? AMentimenl; and that,
Docusign Envelope ID: 3DOA3DA3-4C64-47OC-A31C-F2844BBEFBEB
5. NDtwithsItan d ing an0hri ng In the N QF0 Apr Applica ton. this Grant shall not be goverfl ed by Executive
Orders revoked by E.O.14154, Iiiciila0Irig E,0. 14008, or NOFO rQgWr-emerits Implementing
Executive Ordefs that have bc-en revolkoM.
6_ The Recipient must i3drM'Iirlister its giant Frti arrordmce wiiLh all applicable immigration restrictions
and fcquirem-pints, lnclucling the eliKi#Ilily And verlllcatlan requimmoths that a pply Andef title iv of
tree Pefsofnat Sespflnsibillty n-na Work Opporkunity ReronrWtIon Mt, of 1995. as amanded M.U.S.f..;,
JEO1,16461 �PRW-0RA) and any appikahle mquirornenl:s that HU11, the Attorney Gen Pral, or the U.S.
Citixens:hip and ImrnIgraklorr SerVices may Prtablish from time to time toroinplyrwlt1i PfMORA,
F x�.QflW Order.142 M ar other E-lopcu lave Or -de rs or i mmigration laws.
7. No stake or unit of gonrrral 40cal gwernment thatMcCtives londirtgundef this grant may use that
funding in a nianinef that bydesFgn or effect facfllt es the subsidization of proinolIon of Illeegal
kminagration or shields IIfugal al.1eiis tronn deport&icin, Including by malMal hlrtg policies or practic�s
that r'nakeriatlyim a anforcemerit of federal irlmigrataorl slalutes and regulatiDns,
8 The Reciplerlt 11' Ust use SAVE, or an equlualeM Vehlicalion system approwd by the rederal
gavGy nm erlt. to pfevarit a riy Federal PW WliC benefit from be ing pravicled to an ilnet[.Vhr a alien wh ❑
errgered the Unlied States il;eg�iIIV or Is otherwise un;awfultyprewnl in the U1nited 5tatos.
9. Faith•basO organ)-Fa#Ions maybe srlbr.QcipiRrlkS f0i iunds on the same tmsls aSany ether
arganl2atloii. Recipients may net, in th a seler tiori of subrec ipierim. d Iscrl minate against an
organlzatlon based on the Drgi4n[Zatlon's reffoousfiharacter, afflliall on, or exercise.
Certification and Acknowledgement
This certification shall be deemed incorporated by reference into the main Contract. By signing
below, the Agency hereby certifies, acknowledges, and agrees that:
• Agency has read and understands all terms and conditions set forth in this EXHIBIT "K"
— Certificate of Compliance: Additional Program -Specific Policy Requirements;
• Agency shall comply with these requirements in both program practice and written policies
and procedures;
• Agency agrees to be in compliance with these requirements as a material condition of this
Contract and a prerequisite to the receipt and continued use of grant funds; and
• Agency understands that any violation of these terms may result in the suspension or
termination of funding, repayment of funds, or other remedies available under law or
regulation.
Authorized Certification
Name of Agency: Easter Seals Central Texas, Inc (DBA Easterseals Lonestar)
Name of Authorized Official: Kenneth Brezenoff
Title: General Counsel
Signature: Date:12/29/2025
CDo
cuftnedby,
A" 6"Whff
7D7901 CD281 C4CF...
QPP-(MENrp'1 U.S. Department of Housing and Urban
N Development
451 Seventh Street, SW
oL IIIIIIII �� Washington, DC 20410
�e�N DEVE'�Q www.hud.00v
espanol.hud.00v
Environmental Review
for Activity/Project that is Exempt or
Categorically Excluded Not Subject to Section 58.5
Pursuant to 24 CFR 58.34(a) and 58.35(b)
Proiect Information
Project Name: 25034-Easter-Seals-North-Texas
HEROS Number: 900000010502486
Start Date: 10/09/2025
State / Local Identifier: 25034
Project Location: 6900 Anderson Blvd Ste 104, Fort Worth, TX 76120
Additional Location Information:
N/A
Description of the Proposed Project [24 CFR 50.12 & 58.32; 40 CFR 1508.25]:
The Employment Services program promotes economic empowerment and financial resilience by creating
pathways to meaningful employment for individuals with physical, intellectual, and behavioral disabilities.
Through skills training and job placement support, participants are equipped to earn a living wage and
achieve greater independence. The program also connects Fort Worth residents to job readiness training and
industry -recognized certifications, helping them access stable employment opportunities with local
businesses and build long-term financial stability.
Level of Environmental Review Determination
Activity / Project is Exempt per 24 CFR 58.34(a):
58.34(a)(4)
Funding Information
Grant Number HUD Program
B25MC480010 Community Planning and
Development (CPD)
Estimated Total HUD Funded Amount: $92,000.00
Program Name
Community Development Block
Grants (CDBG) (Entitlement)
Estimated Total Project Cost [24 CFR 58.2 (a) (5)]: $92,000.00
$92,000.00
25034-Easter-SeaIs- North -Texas Fort Worth, TX
900000010502486
Mitigation Measures and Conditions ICFR 1505.2(c)l:
Summarized below are all mitigation measures adopted by the Responsible Entity to reduce, avoid or
eliminate adverse environmental impacts and to avoid non-compliance or non-conformance with the
above -listed authorities and factors. These measures/conditions must be incorporated into project
contracts, development agreements and other relevant documents. The staff responsible for
implementing and monitoring mitigation measures should be clearly identified in the mitigation plan.
Law, Mitigation Measure or Condition
Authority, or
Factor
Preparer Signature:
Name / Title/ Organ��� : Juliet Moses / / FORT WORTH
Comments on Complete
Completed Measures
Date:
Responsible Entity Agency Official Signature: tleA
Date:Name/ Title: 46V (A(�{ l S+r&� `�K► 1 . &Vtp I JIB f(,174—
i
This original, signed document and related supporting material must be retained on file by the
Responsible Entity in an Environment Review Record (ERR) for the activity / project (ref: 24 CFR Part
58.38) and in accordance with recordkeeping requirements for the HUD program(s).
10/09/2025 16:04 Page 2 of 2
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
OFFICE OF COMMUNITY PLANNING AND DEVELOPMENT
FEDERAL AWARD AGREEMENT
A. General Federal Award Information
1. Recipient name (must match Unique Entity Identifier
name) and address:
Fort Worth
100 Fort Worth Trail
FORT WORTH, TX 76102
2. Recipient's Unique Entity Identifier:
ENS6MKS1ZL18
3. Tax identification number:
756000528
4. Federal Award Identification Number (FAIN):
B25MC480010
5. Instrument type:
Grant ® Cooperative agreement ❑
Loan Guarantee ❑
6. Period of performance start and end date:
10/1/2024 - See Addendum 2
7. Budget period start and end date:
10/1/2024 - See Addendum 2
8. Initial Agreement ® Amendment❑ #
9. Indirect cost rate (per § 200.414):
Recipients must complete Addendum 3: Indirect Cost
Rate Schedule
10. Is this award for research and development (per 2
C.F.R. § 200.1)?Yes ❑ No
11. Awarding official name and contact information:
Leticia Ibarra CPD Director
12. Assistance listing number and title:
• 14.218, Community Development Block Grant
Program for Entitlement Communities
• 14.225, Community Development Block Grant
Program for Insular Areas
• 14.228, Community Development Block Grant
Program for States and Non -Entitlement
Grants in Hawaii
13. Amount of federal funds obligated by this action:
$7,116,438.00
14. Total amount of federal funds obligated:
$7,116,438.00
15. Total approved cost sharing (if applicable):
N/A
16. Total federal award amount, including approved
cost sharing:
$7,116,438.00
17. Budget approved by HUD: 1 2/9/2U25
18. Fiscal year:
2025
19. Statutory authority:
42 U.S.C. 5301 et seq.
20. Applicable appropriations act(s):
Public Law 119-4
21. Notice/notice of funding opportunity this award is
made under (if applicable):
N/A
22. Program regulations (if applicable):
24 C.F. R. Part 570
23. Federal award description:
The CDBG program provides funding to eligible grantees for the development of viable urban
communities, by providing decent housing and a suitable living environment and expanding economic
opportunities, principallyfor persons of low and moderate income.
Addendum 1. Policy Requirements
Addendum 2. Program -Specific Requirements
Addendum 3. Indirect Cost Rate Schedule
Authority and Agreement. This agreement between the U.S. Department of Housing and Urban Development (HUD)
and the Recipient is made pursuant to the statutory authority above (box 19) and is subject to the applicable
appropriations act(s) (box 20). This agreement incorporates by reference the Community Development Block Grant
program statute 42 U.S.C. 5301 et seq., the program regulations at 24 C.F.R. § 570 (as now in effect and as may be
Page 1 of 8
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. Department of Housing and Urban Development —Fed era[ Award Agreement
amended from time to time), Recipient's consolidated plan/action plan, the relevant funding notice (box 21), any
attached Specific Terms and Conditions, and the attached addenda (box 23).
B. Terms and Conditions
1. General terms and requirements. The Recipient must comply with all applicable federal laws, regulations, and
requirements, unless otherwise provided through HUD's formal waiver authorities. This agreement, including
any attachments and addenda, may only be amended in writing executed by parties to this agreement and any
addenda.
2. Administrative requirements. The Recipient must comply with the following requirement(s) if checked below:
❑ The administrative requirements in the HUD General Administrative, National, and Departmental Policy
Requirements and Terms for HUD's Financial Assistance Programs 2025, as indicated in the relevant
NOFO, apply to this agreement.
® The grantee shall comply with requirements established by the Office of Management and Budget (OMB)
concerning the Unique Entity Identifier (UEI); the System for Award Management (SAM.gov.); the Federal
Funding Accountability and Transparency Act as provided in 2 C.F.R. part 25, Universal Identifier and
General Contractor Registration; and 2 C.F.R. part 170, Reporting Subaward and Executive Compensation
Information.
3. Applicability of2C.FR. part 200.
® The Recipient must comply with the applicable requirements at 2 C.F.R. part 200, as maybe amended
from time to time. If any previous or future amendments to 2 C.F.R. part 200 replace or renumber any part
200 section cited in HUD's regulations in Title 24 of the Code of Federal Regulations, the amended part
200 requirements will govern award activities carried out after the amendments' effective date.
❑ The Recipient must complywith the applicable requirements at 2 C.F.R. part 200. If any previous
amendments to 2 C.F.R. part 200 replace or renumber any part 200 section cited in HUD's regulations in
Title 24 of the Code of Federal Regulations, the amended part 200 requirements will govern award
activities carried out after the amendments' effective date.
4. Future budget periods. If the period of performance spans multiple budget periods, subsequent budget
periods are subject to the availability of funds, program authority, satisfactory performance, and compliance
with the terms and conditions of the Federal award.
Indirect Cost Rate. If the Recipient intends to use a negotiated or de minimis rate for indirect costs, the
Recipient must submit an Indirect Cost Rate form to HUD, either with its application using HUD-426
(competitive grants) or with this agreement using "Addendum #3 "Indirect Cost Rate Schedule" (formula and
congressional grants). The submitted form/addendum will be incorporated into and made part of this
agreement, provided that the rate information is consistent with the applicable requirements under 2 C.F.R. §
200.414. If there is any change in the Recipient's indirect cost rate, it must immediately notify HUD and
execute an amendment to this agreement to reflect the change if necessary.
6. Recipient integrity and performance matters. If the Federal share of this award is more than $500,000 over the
period of performance (box 6), the terms and conditions in 2 C.F.R. part 200 Appendix XII apply to this
agreement.
Recordkeeping and Access to Records. The Recipient hereby agrees to maintain complete and accurate
books of account for this award and award activities in such a manner as to permit the preparation of
statements and reports in accordance with HUD requirements, and to permit timely and effective audit. The
Recipient agrees to furnish HUD such financial and project reports, records, statements, subrecipient data,
and documents at such times, in such form, and accompanied by such reporting data as required by HUD.
HUD and its duly authorized representative shall have full and free access to all Recipient offices and
facilities, and to all books, documents, and records of the Recipient relevant to the administration, receipt,
and use of this award and award activities, including the right to audit and make copies. The Recipient agrees
to maintain records that identify the source and application of funds, including relevant subrecipient data, in
[14.218, 14.225,14.228, CDBG, FY 20251 Page 2 of 8
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. Department of Housing and Urban Development— Federal Award Agreement
such a manner as to allow HUD to determine that all funds are and have been expended in accordance with
program requirements and in a manner consistent with applicable law.
Further, the Recipient hereby acknowledges that HUD is in the process of implementing new grants
management and reporting tools, which will be made available for the Recipient's use in the future. The
Recipient agrees to report on grant performance and financial activities (including vendor and cash
disbursement supporting details for the Recipient and its subrecipients) using these new tools when they are
released. HUD will work with the Recipient to support the Recipient's transition to this new reporting
environment. Once implemented, timely reporting in this new environment will be mandatory. HUD reserves
the right to exercise all of its available rights and remedies for any noncompliance with these grants
management and financial reporting requirements, to include, without limitation, requiring 100% review,
suspension of disbursements, and all other legally available remedies, to the furthest extent permitted by law,
as amended.
Noncompliance. If the Recipient fails to comply with the provisions of this agreement, HUD may take one or
more of the actions provided in program statutes, regulations or 2 C.F.R. § 200.339, as applicable. Nothing in
this agreement shall limit any remedies otherwise available to HUD in the case of noncompliance by the
Recipient. No delay or omissions by HUD in exercising any right or remedy available to it under this agreement
shall impair any such right or remedy or constitute a waiver of or acquiescence in any Recipient
noncompliance.
9. Termination provisions. Unless superseded by program statutes, regulations or NOFOs, the termination
provisions in 2 C.F.R. § 200.340 apply.
10. Build America, BuyAmerica. The Recipient must comply with the requirements of the Build America, Buy
America (BABA) Act, 41 U.S.C. § 8301 note, and all applicable rules and notices, as may be amended, if
applicable. Pursuant to HUD's Notice, "Public Interest Phased Implementation Waiver for FY2022 and 2023
of Build America, Buy America Provisions as Applied to Recipients of HUD Federal Financial Assistance" (88
Fed. Reg, 17001), BABA requirements apply to any infrastructure projects HUD has obligated funds for after
the effective dates, unless excepted by a waiver.
11. Waste, Fraud, Abuse, and Whistleblower Protections. Any person who becomes aware of the existence or
apparent existence of fraud, waste, or abuse of any HUD award must report such incidents to both the HUD
official responsible for the award and to HUD's Office of Inspector General (OIG). Allegations of fraud, waste,
and abuse related to HUD programs can be reported to the HUD OIG hotline via phone at 1-800-347-3735 or
online hotline form. The Recipient must comply with 41 U.S.C. § 4712, which includes informing employees in
writing of their rights and remedies, in the predominant native language of the workforce. Under 41 U.S.C. §
4712, employees of a government contractor, subcontractor, recipient, and subrecipient—as well as a
personal services contractor —who make a protected disclosure about a Federal award or contract cannot be
discharged, demoted, or otherwise discriminated against if they reasonably believe the information they
disclose is evidence of (1) gross mismanagement of a Federal contract or award; (2) waste of Federal funds;
(3) abuse of authority relating to a Federal contract or award; (4) substantial and specific danger to public
health and safety; or (5) violations of law, rule, or regulation related to a Federal contract or award.
12. Third -Party Claims. Nothing in this agreement shall be construed as creating or justifying any claim against
the federal government or the Recipient by any third party.
13. Rule of Construction and No Construction Against Drafter. Notwithstanding anything contained in this
agreement, the terms and conditions hereof are to be construed to have full and expansive effect in both
interpretation and application, and the parties agree that the principle of interpretation that holds that
ambiguities in terms or conditions are construed against the drafter shall not apply in interpreting this
agreement.
C. Federal Award Performance Goals
The Recipient must meet any applicable performance goals, indicators, targets, and baseline data as required by
applicable program requirements.
[14.218,14.225, 14.228, CDBG, FY 20251 Page 3 of 8
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. Department of Housing and Urban Development— Federal Award Agreement
D. Specific Terms and Conditions Not applicable ® Attached ❑
For the U.S. Department of HUD
Signature
Date
(name and title of authorized official)
by,
Leticia Ibarra CPD Director
ESign,d
Gia IfoaVVa
12/9/2025
715224OD2832458...
For the Recipient
Signature
Date
(name and title of authorized official)
Dana Burghdoff-Assistant City Manager
rghd.ff(Oa3,20251138' i j
Oct 3, 2025
[14.218, 14.225, 14.228, CDBG, FY 20251 Page 4 of 8
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. Department of Housing and Urban Development — Federal Award Agreement
ADDENDUM 1. POLICY REQUIREMENTS
If applicable:
1. The Recipient shall not use grant funds to promote "gender ideology," as defined in Executive Order
(E.O.)14168, Defending Women from Gender Ideology Extremism and Restoring Biological Truth to
the Federal Government;
2. The Recipient agrees that its compliance in all respects with all applicable Federal anti-
discrimination laws is material to the U.S. Government's payment decisions for purposes of section
3729(b)(4) of title 31, United States Code;
3. The Recipient certifies that it does not operate any programs that violate any applicable Federal
anti -discrimination laws, including Title VI of the Civil Rights Act of 1964;
4. The Recipient shall not use any grant funds to fund or promote elective abortions, as required by
E.O. 14182, Enforcing the Hyde Amendment; and that,
5. Notwithstanding anything in the NOFO or Application, this Grant shall not be governed by Executive
Orders revoked by E.0.14154, including E.O.14008, or NOFO requirements implementing
Executive Orders that have been revoked.
6. The Recipient must administer its grant in accordance with all applicable immigration restrictions
and requirements, includingthe eligibility and verification requirements that apply under title IV of
the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as amended (8 U.S.Ca
1601-1646) (PRWORA) and any applicable requirements that HUD, the Attorney General, or the U.S.
Citizenship and Immigration Services may establish from time to time to comply with PRWORA,
Executive Order 14218, or other Executive Orders or immigration laws.
7. No state or unit of general local government that receives funding under this grant may use that
funding in a manner that by design or effect facilitates the subsidization or promotion of illegal
immigration or shields illegal aliens from deportation, including by maintaining policies or practices
that materially impede enforcement of federal immigration statutes and regulations.
8. The Recipient must use SAVE, or an equivalent verification system approved by the Federal
government, to prevent any Federal public benefit from being provided to an ineligible alien who
entered the United States illegally or is otherwise unlawfully present in the United States.
9. Faith -based organizations maybe subrecipients for funds on the same basis as any other
organization. Recipients may not, in the selection of subrecipients, discriminate against an
organization based on the organization's religious character, affiliation, or exercise.
[14.218, 14.225, 14.228, CDBG, FY 2025] Page 5 of 8
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. Department of Housing and Urban Development —Federal Award Agreement
ADDENDUM 2. PROGRAM -SPECIFIC REQUIREMENTS
Assistance Listing 14.218, Community Development Block Grant Program for Entitlement Communities
Assistance Listing 14.225, Community Development Block Grant Program for Insular Areas
Assistance Listing 14.228, Community Development Block Grant Program for States and Non -
Entitlement Grants in Hawaii
Environmental Review. The Recipient agrees to assume all the responsibilities for environmental
review, decision making, and actions, as specified and required in regulations issued by the
Secretary pursuant to section 104(g) of title I of the Housing and Community Development Act of
1974 and published in 24 C.F.R. part 58; except that if the Recipient is a state, the Recipient must
require the unit of general local government to assume that responsibility and must comply with the
state's responsibilities under 24 C.F.R. 58.4.
2. Public Use. The Recipient shall ensure that no CDBG funds are used to support any Federal, State,
or local projects that seek to use the power of eminent domain, unless eminent domain is
employed onlyfor public use. Forthe purposes of this requirement, public use shall not be
construed to include economic development that primarily benefits private entities. Any use of
funds for mass transit, railroad, airport, seaport, or highway projects as well as utility projects that
benefit or serve the general public (including energy-, communication-, water-, and wastewater -
related infrastructure), other structures designated for use bythe general public or which have other
common -carrier or public -utility functions that serve the general public and are subject to
regulation and oversight bythe government, and projects Forthe removal of an immediate threat to
public health and safety or brownfield as defined in the Small Business Liability Relief and
Brownfields Revitalization Act (Pub. Law No.107-118) shall be considered a public use for purposes
of eminent domain.
3. Prohibition on Selling, Trading, and Transferring Funds. The Recipient or unit of general local
government that directly or indirectly receives CDBG funds may not sell, trade, or otherwise transfer
all or any such portion of such funds to another such entity in exchange for any otherfunds, credits
or non -Federal considerations, but must use such funds for activities eligible under title I of the
Housing and Community Development Act of 1974.
4. Construction ofWaterand Sewer Facilities. Notwithstanding any other provision of this agreement,
the Recipient may not obligate or expend award funds to plan or construct water or sewer facilities,
including any new or revised activities, until after 1) it completes the review procedures required
under Executive Order 12372, Intergovernmental Review of Federal Programs, and 24 C.F.R. part 52
and 2) HUD provides written notice of the release of funds.
5. Funds for For -Profit Entities. Under42 U.S.C. § 5305(a)(17), CDBG funds may not be provided to a
for -profit entity unless such activity or project has been evaluated and selected in accordance with
Appendix A to 24 C.F.R. § 570, Guidelines and Objectives for Evaluating Project Costs and Financial
Requirements.
6. Violence Against Women Act. The Recipient will comply with the right to report crime and
emergencies protections at 34 U.S.C. § 12495 of the Violence Against Women Act.
[14.218, 14.225, 14.228, CDBG, FY 20251 Page 6 of 8
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. Department of Housing and Urban Development— Federal Award Agreement
7. Funding Information and Period of Performance and Budget Period End Dates
Source of Funds Amount Period of Performance End Date Budget Period End Date
2025 $7,116,438.00 9/30/2033 9/30/2033
[14.218, 14.225, 14.228, CDBG, FY 20251 Page 7 of 8
Docusign Envelope ID: 24A3C888-9750-4BAC-8D5E-82871241BDA2
U.S. Department of Housing and Urban Development —Fed eral. Award Agreement
ADDENDUM 3. INDIRECT COST RATE SCHEDULE
As the duly authorized representative of the Recipient, I certify that the Recipient:
M Will not use an indirect cost rate to calculate and charge indirect costs under the grant.
❑ Will calculate and charge indirect costs under the grant by applying a de minimis rate as provided
by 2 C.F.R. g 200.414(f), as may be amended from time to time.
❑ Will calculate and charge indirect costs under the grant using the indirect cost rate(s) listed below,
and each rate listed is included in an indirect cost rate proposal developed in accordance with the
applicable appendix to 2 C.F.R. part 200 and, if required, was approved by the cognizant agencyfor
indirect costs.
Agency/department/major function Indirect cost rate Type of Direct Cost Base
Instructions for the Recipient:
The Recipient must mark the one (and only one) checkbox above that best reflects how the
Recipient's indirect costs will be calculated and charged under the grant. Do not include indirect
cost rate information for subrecipients.
The table following the third box must be completed only if that box is checked. When listing a rate
in the table, enter both the percentage amount (e.g., 10%) and the type of direct cost base to be
used. For example, if the direct cost base used for calculating indirect costs is Modified Total Direct
Costs, then enter "MTDC" in the "Type of Direct Cost Base" column.
If using the Simplified Allocation Method for indirect costs, enterthe applicable indirect cost rate
and type of direct cost base in the first row of the table.
If using the Multiple Allocation Base Method, enter each major function of the organization for
which a rate was developed and will be used under the grant, the indirect cost rate applicable to
that major function, and the type of direct cost base to which the rate will be applied.
If the Recipient is a government and more than one agency or department will carry out activities
under the grant, enter each agency or department that will carry out activities under the grant, the
indirect cost rate(s) for that agency or department, and the type of direct cost base to which each
rate will be applied.
To learn more about the indirect cost requirements, see 2 C.F.R. part 200, subpart E and AppendixVII to Part
200 (for state and local governments).
[14.218, 14.225, 14.228, CDBG, FY 20251 Page 8 of 8
M&C Review Page 1 of 5
Official site of the City of Fort Worth, Texas
A CITY COUNCIL AGEND FORoRm
T W
Create New From This M&C
192025-2026 HUD
DATE: 8/12/2025 REFERENCE NO.: M&C 25-0676 LOG NAME: ANNUAL ACTION
PLAN
CODE: C TYPE: NOW PUBLIC CONSENT HEARING:
YES
SUBJECT: (ALL) Conduct Public Hearing and Approve the City of Fort Worth's 2025-2026 Annual
Action Plan for the Use of Federal Grant Funds in the Amount of $13,273,355.77 to be
Awarded by the United States Department of Housing and Urban Development from the
Community Development Block Grant, HOME Investment Partnerships Program,
Emergency Solutions Grant, and Housing Opportunities for Persons with AIDS Program,
Authorize Collection and Use of Program Income, Authorize Execution of Related
Contracts, Adopt Appropriation Ordinance, and Authorize Waiver of Indirect Costs
(PUBLIC HEARING - a. Staff Available for Questions: Juliet Moses; b. Public Comment c.
Council Action: Close Public Hearing and Act on M&C)
RECOMMENDATION:
It is recommended that City Council:
1. Conduct a public hearing to allow citizen input and consideration of the City's 2025-2026 Annual
Action Plan for use of federal grant funds to be awarded by the United States Department of
Housing and Urban Development in the amount of $13,273,355.77 for the Community
Development Block Grant, HOME Investment Partnerships Program, Emergency Solutions Grant,
and Housing Opportunities for Persons with AIDS grant programs;
2. Approve the City's 2025-2026 Annual Action Plan for submission to the United States Department
of Housing and Urban Development, including allocations of grant funds to particular programs
and activities as detailed below;
3. Authorize the collection and use of an estimated $30,000.00 of program income which is
expected to result from activities using prior years' Community Development Block Grant funds
for the City's Priority Repair Program;
4. Authorize the collection and use of an estimated $30,000.00 of program income which is
expected to result from activities using prior years' HOME Investment Partnerships Program grant
funds for the City's Homebuyer Assistance Program, and authorize the use of 10 percent of the
program income for administrative costs;
5. Authorize the City Manager or his designee to execute contracts for one-year terms with the
agencies listed in Tables 1, 2, and 3 below for Program Year 2025-2026 for Community
Development Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons
with AIDS grant funds, contingent upon receipt of funding, and satisfactory completion of all
federal regulatory requirements;
6. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in
the Grants Operating Federal Fund in the total amount of $13,273,355.77 consisting of
$7,116,438.00 in Community Development Block Grant funds, $2,814,431.77 in HOME
Investment Partnerships Program funds, $615,818.00 in Emergency Solutions Grant funds, and
$2,726,668.00 in Housing Opportunities for Persons with AIDS grant funds, all subject to receipt
of such funds; and
7. Authorize a waiver of the Neighborhood Services Department indirect cost of 21.05\%, estimated
total of $264,698.00.
DISCUSSION:
The City's 2025-2026 Annual Action Plan summarizes the major housing and community development
activities and proposed expenditures for the program year beginning October 1, 2025 and ending
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M&C Review
Page 2 of 5
September 30, 2026 for use of federal grant funds totaling $13,273,355.77 from the United States
Department of Housing and Urban Development (HUD) from the Community Development Block Grant
(CDBG), HOME Investment Partnerships Program (HOME), Emergency Solutions Grant (ESG), and
Housing Opportunities for Persons with AIDS (HOPWA) grant programs, plus program income from the
CDBG and HOME grant programs totaling $60,000.00. It also summarizes the use of program income
resulting from activities using prior years' CDBG and HOME funds, the primary purpose of which is to
benefit low -and moderate -income persons in Fort Worth. ESG funds primarily benefit persons experiencing
homelessness, and HOPWA funds primarily benefit low -and moderate -income persons with HIV/AIDS.
A Request for Proposals from social service agencies and nonprofit organizations seeking grant funding
was published on January 15, 2025. All proposals were received on March 3, 2025. Staff reviewed all
proposals and developed recommendations for the allocation of estimated funding from HUD based on the
capacity of applicant organizations, grant experience, fiscal stability, and compliance with applicable
federal regulations. One public hearing was held on July 14, 2025, to provide citizens with the opportunity
to participate in the development of the Annual Action Plan. Recommendations for award amounts were
considered and adopted by the Community Development Council on June 11, 2025.
A 30-day public comment period was held from June 16, 2025, through July 16, 2025. Notice of this public
comment period was published in the Cleburne Times Review on June 10, 2025; in the Fort Worth Star
Telegram and Weatherford Democrat on June 11, 2025; and in La Vida News and the Wise County
Messenger on June 12, 2025.
Any comments received are maintained by the Neighborhood Services Department in accordance with
federal regulations. The City held two public hearings as a part of the HUD required citizen participation
process. The first public hearing was held by staff on July 14, 2025, and the second public hearing is
scheduled for the City Council Meeeting on August 12, 2025.
A summary of staffs final funding recommendations is provided below in Tables 1, 2, and 3. The 2025-
2026 Annual Action Plan will be submitted to HUD by August 15, 2025.
Indirect costs totaling approximately $264,698.00 could be charged to these grants, as the Neighborhood
Services Department indirect cost rate is 21.05\% in the City's most recent Cost Allocation Plan. A waiver
of these costs is requested to allow allocation of these funds to further support the programs and services
to assist low -to -moderate income citizens.
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG)
For Program Year 2025-2026, it is recommended that the amount of $7,116,438.00 in CDBG funds and an
estimated amount of $30,000.00 in CDBG program income totaling $7,146,438.00 be allocated as follows:
Public Service Agencies - $1,067,465.00 (Limited to 15\% of the grant allocation): Includes social services
for low- and moderate income persons, persons with disabilities, and disadvantaged persons; Housing
Programs - $2,665,000.00: Includes funding for the City's Priority Repair Program, Cowtown Brush -Up, and
accessibility modifications for seniors and persons with disabilities; Major Projects - $1,000,685.00:
Includes funding for street improvements; Program Delivery - $960,000.00: Includes program delivery
costs for housing programs; Administration - $1,423,288.00 (Limited to 20\% of the grant allocation):
Includes costs for administering the CDBG grant; Estimated Program Income - $30,000.00: Includes up to
$30,000.00 in funding for the City's Priority Repair Program. Any CDBG program income over the
estimated amount not used for the Priority Repair Program will be allocated to priority activities in the City's
Consolidated Plan, subject to the City Council approval.
HOME INVESTMENT PARTNERSHIPS PROGRAM (HOME)
For Program Year 2025-2026, it is recommended that the amount of $2,814,431.77 in HOME funds and an
estimated amount of $30,000.00 in HOME program income totaling $2,844,431.77 be allocated as follows:
Homebuyer Assistance Program - $1,110,824.77: Includes funding for down payment and closing cost
assistance for low- and moderate -income homebuyers through the Fort Worth Community Land Trust, the
City of Fort Worth and Trinity Habitat for Humanity; Community Housing Development Organizations
(CHDOs) for affordable housing projects - $422,164.00: These funds will be used by Housing Channel for
the Mason Heights affordable housing development in southeast Fort Worth. Funds will be used for the
acquisition of land and the new construction of 236 units. An estimated 183 units (approximately 77\%) will
be sold to low to moderate income households at or below 80\% Area Median Income (AMI); Major
Projects - $1,000,000.00 allocated to Fort Worth Housing Solutions (FWHS) as a part of Phase Six of the
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M&C Review
Page 3 of 5
Choice Neighborhood Initiative (CNI) grant benefiting low -moderate come residents in the Stop Six
Neighborhood of Fort Worth; Administration - $281,443.00 (Limited to 10\% of the grant allocation):
Includes costs for administering the HOME grant; Estimated Program Income - $30,000.00: Includes
funding for the Homebuyer Assistance Program and HOME grant administrative costs. HUD allows the City
to use 10 percent of any HOME program income towards the cost of administering the HOME grant.
HOME program income over the estimated amount not used for the Homebuyer Assistance Program will
be allocated to priority activities in the City's Consolidated Plan, subject to City Council approval.
HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS (HOPWA)
For Program Year 2025-2026, it is recommended that the amount of $2,726,668.00 in HOPWA funds be
allocated as follows: Public Service Agencies - $1,670,868.00; Neighborhood Services Department -
$974,000.00; Administration - $81,800.00 (Limited to 3\% of the grant allocation)
EMERGENCY SOLUTIONS GRANT (ESG)
For Program Year 2025-2026, it is recommended that the amount of $615,818.00 in ESG funds to be
allocated as follows: Public Service Agencies - $569,632.00; Administration - $46,186.00 (Limited to 7.5\%
of the grant allocation)
CONTRACT RECOMMENDATIONS
The Community Development Council and Neighborhood Services Department staff recommend that
contracts be executed with the public service and subrecipient agencies listed below for the amounts
shown in the following tables:
Community Development Block Grant Contracts
TABLE 1: CDBG AGENCIES
AGENCY CONSOLIDATED PLAN I PROGRAM AMOUNT
GOAL
Housing Channel Affordable Housing (Housing Counseling & $111,000.00
Education
Meals -On -Wheels, Inc. of Healthy Living and (Nutrition Program $120,000.00
Tarrant County Wellness
Money Smart+ Elder
Guardianship Services Inc.
Aging In Place
Financial Fraud
$80,000.00
Prevention Workshops
United Community Centers, Inc
Children and Youth
(Education Literacy
$125,000.00
Services
Program
Boys & Girls Club of Greater
Children and Youth
Youth Development at
lEastside
$72,000.00
Tarrant County
Services
Branch
Girls Inc of Tarrant County
Children and Youth
Services
(Whole Girl Program
$90,281.00
Camp Fire First Texas
Children and Youth
Services
(Teens In Action
$62,184.00
Junior Achievement of the
Children and Youth
(Cradle to Career
$50,000.00
Chisholm Trail, Inc.
Services
Initiative
The Women's Center of Tarrant
Economic Empowerment
(Employment Solutions
$90,000.00
County
and Financial Resilience
Easter Seals North Texas, Inc.
Economic Empowerment
and Financial Resilience
Employment Services
$92,000.00
Homelessness
Presbyterian Night Shelter Prevention and Special Moving Home Program $175,000.00
Needs Support
(CDBG Public Services Agencies Total II$1,067,465.001
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M&C Review Page 4 of 5
**Rehabilitation, Education and Accessibility
Advocacy for Citizens with Improvements Project Ramp $165,000.00
Handicaps dba REACH, Inc.
**Fort Worth Area Habitat for Housing Preservation and
Humanity, Inc. DBA Trinity Rehabilitation Cowtown Brush Up $500,000.00
Habitat for Humanity
JCDBG Subrecipient Agencies Total 11 $665,000.001
ITOTAL CDBG CONTRACTS II$1,732,465.001
"REACH and Trinity Habitat will be funded from the CDBG Housing Programs and Services budget.
Housing Opportunities for Persons with AIDS Contracts
TABLE 2: HOPWA AGENCIES
AGENCY CONSOLIDATED PLAN PROGRAM I AMOUNT
GOAL
HOPWA Program -
Administration, Tenant -
Based Rental Assistance
Tarrant County
Homelessness Prevention
(TBRA), Short -Term
Samaritan Housing,
and Special Needs
Rent, Mortgage, and
Inc.
Support
Utility Assistance
(STRMU), Supportive
Services, Facility -Based
Operations (FBO)
The Housing Assistance
Program
- Administration, Tenant -
AIDS Outreach
Homelessness Prevention
Based Rental Assistance
Center, Inc.
and Special Needs
(TBRA), Short -Term
Support
Rent, Mortgage, and
Utility Assistance
(STRMU), Supportive
Services
TOTAL HOPWA CONTRACTS
Emergency Solutions Grants Contracts
AGENCY
The Presbyterian Night
Shelter of Tarrant County,
Inc.
Lighthouse for the
Homeless dba True Worth
Place
The Salvation Army
Center for Transforming
Lives
TABLE 3: ESG AGENCIES
CONSOLIDATED PLAN PROGAM
GOAL
Homelessness Prevention and Shelter
Special Needs Support Operations/Services
Homelessness Prevention and Day Shelter
Special Needs Support Operations/Services
Z
melessness Prevention and Homelessness
ecial Needs Support Prevention
Homelessness Prevention and Rapid Re -Housing
Special Needs Support
11 11
$1,406,188.00
$264,680.00
$1,670,868.001
AMOUNT
$139,491.00
$150,000.00
��$127,141.00�
$73,000.00
II $80,000.001
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M&C Review Page 5 of 5
SafeHaven of Tarrant Homelessness Prevention and Shelter
County Special Needs Support Operations/Services
TOTAL ESG CONTRACTS 11$569,632.001
All figures have been rounded to the nearest dollar for presentation purposes.
Each of these grants are an entitlement grant rather than a competitive grant received from the United
States Department of Housing and Urban Development (HUD). Entitlement grants provide funds to
agencies based on a formula prescribed in legislation or regulation, rather than based on review. These
specific grants are allocated to the City of Fort Worth based on population size and per capita income each
year. The grants have been consistently awarded to the City since 1974 with the inception of the
Community Development Block Grant (CDBG) through the Housing and Community Development Act of
1974. The Emergency Shelter (renamed Solutions) Grant (ESG) was authorized in 1987 through the
McKinney-Vento Homelessness Assistance Act. The HOME Investment Partnerships Program (HOME)
and the Housing Opportunities for Persons with AIDS (HOPWA) Program were authorized through the
Cranston -Gonzales National Affordable Housing Act of 1990. With these grants, administrative and
program delivery allocations support approximately 90 FTE positions in the Neighborhood Services
Department, which is funded nearly 60\% with various grants including these entitlement grants.
Positions funded with HUD Entitlement grants are subject to grant availability. In the event of a grant award
being decreased or eliminated, the Neighborhood Services Department would review programs and
services funded by the grants and determine a level of service and staffing that aligns with the available
funding. Alternatives to consider may include staff and program reductions or eliminations.
The City of Fort Worth has certified that all programs receiving funding through the HOPWA, HOME, ESG,
and CDBG grants comply with applicable Executive Orders.
These programs are available in ALL COUNCIL DISTRICTS.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations and adoption of the
attached appropriation ordinance, funds will be available in the current operating budget, as appropriated,
of the Grants Operating Federal Fund. The Neighborhood Services Department (and Financial
Management Services) will be responsible for the collection and deposit of funds due to the City. Prior to
an expenditure being incurred, the Neighborhood Services Department has the responsibility to validate
the availability of funds. These are reimbursement grants.
TO
Fund Department Account Project Program Activity Budget Reference # Amount
ID ID Year (Chartfield 2)
FROM
Fund Department Account Project Program Activity Budget Reference # Amount
ID ID Year (Chartfield 2)
Submitted for Citv Manager's Office bv:
Oriqinatinq Department Head:
Additional Information Contact:
ATTACHMENTS
Dana Burghdoff (8018)
Kacey Bess (8187)
Juliet Moses (6203)
http://apps.cfwnet.org/council_packet/mc review.asp?ID=33536&councildate=8/12/2025 9/26/2025
FORT WORTH.
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: Easter Seals Central Texas dba Easterseals Lonestar
Subject of the Agreement: 2025-2026 CDBG 51% PSA Contract for Employment Services Progran
M&C Approved by the Council? * Yes 0 No ❑
If so, the M&C must be attached to the contract.
Is this an Amendment to an Existing contract? Yes ❑ No ❑✓
If so, provide the original contract number and the amendment number.
Is the Contract "Permanent"? *Yes ❑ No 0
If unsure, see back page for permanent contract listing.
Is this entire contract Confidential? *Yes ❑ No 0 If only specific information is
Confidential, please list what information is Confidential and the page it is located.
Effective Date: 10/01/2025 Expiration Date: 09/30/2026
If different from the approval date. If applicable.
Is a 1295 Form required? * Yes ❑ No 0
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If applicable.
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes ❑✓ No ❑
Contracts need to be routed for CSO processin4 in the following order:
1. Katherine Cenicola (Approver)
2. Jannette S. Goodall (Signer)
3. Allison Tidwell (Form Filler)
*Indicates the information is required and if the information is not provided, the contract will be
returned to the department.