HomeMy WebLinkAboutContract 30260 STATE OF TEXAS §
CITY SECRETARY
COUNTY OF TARRANT § CONTRACT NO.
2QL_()
THIS contract is made and entered into by and between the City of Fort Worth ("City"), acting and
through Charles Boswell,its duly authorized Assistant City Manager,and Northside-Inter Church Agency
(MICA) ("Contractor"), by and through Ms. Connie Nahoolewa, its duly authorized Executive Director.
Contractor's business address is 1600 Circle Park Blvd, Fort Worth, TX 76106.
WHEREAS, the City of Fort Worth has been notified that it will receive grant monies from the United
States Department of Housing and Urban Development ("HUD") through the Community Development
Block Grant ("CDBG") for Year XXX; and,
WHEREAS,the primary purpose of the CDBG Program is to benefit low and moderate income citizens
of Fort Worth; and,
WHEREAS, the Catalog of Federal Domestic Assistance(CFDA) assigned Community Development
Block Grants/Entitlement Grants number 14.218; and
WHEREAS,the citizens of Fort Worth,the Community Development Council,and the City Council of
Fort Worth have determined that CDBG Programs are needed by low and moderate income citizens of Fort
Worth;
NOW,THEREFORE,THIS AGREEMENT FURTHER WITNESSETH:
THAT, the parties covenant and agree as follows:
1. Scope of Services
a. Contractor will administer Economic Development services to citizens of the City of Fort Worth
under the program name Good Works/Buenas Obras Program("Program"), for the term June 1,2004 to
May 31, 2005.
b. Contractor will provide the services and activities delineated in Exhibit A-Program Summary in
accordance with Exhibit B-Program Services Schedule.
c. Contractor agrees to meet the National Objective of activities benefiting low and moderate income
individuals and to maintain full documentation supporting fulfillment of this National Objective in its
files.
d. City will monitor the performance of the Contractor against the goals and performance standards
required herein. Substandard performance as determined by City will constitute non-compliance with
this Agreement. If action to correct such substandard performance is not taken by Contractor within a
reasonable period of time after being notified in writing by City, contract suspension or termination
procedures will be initiated.
2. Compensation and Method of Payment
a. City will disburse CDBG Year XXX monies in an amount up to 528,9 Contractor on a
reimbursement of expenses basis. � �
1 XXX CDBGCNT June 29,2004 ` `" p7Yg � �'
b. Payment will be processed by City following receipt from Contractor of the following monthly
financial documents: (1) Attachment I-Sub-Grantee's Request For Funds, (2) Attachment II-Detail
Statement of Costs, and (3) Attachment III-Expenditures Worksheet Report. Reimbursement for the
payment of eligible expenses shall be made against the line item budget specified in Exhibit C-Program
Operating Budget and in accordance with performance specified in Exhibit B-Program Services
Schedule. The City is under no obligation to disburse funds for expenditures which occurred prior to
the first day of the month for which the report is submitted.
c. Contractor agrees to utilize all disbursed CDBG funds for the benefit of the Program. Contractor
agrees that funds will be expended in accordance with the Program Operating Budget. Contractor may
not increase or decrease line-item amounts in the approved CDBG Program Operating Budget without
prior written approval by the City.
d. It is understood that the total cost for operation of this program is$68,488 and that Contractor will
obtain the remaining funds in excess of the CDBG amount as detailed in the Program Operating Budget.
Contractor will notify City promptly of any additional fiinding it receives for operation of the Program,
and City reserves the right to amend the Program Operating Budget in such instances.
e. Contractor agrees to keep all CDBG monies on hand in interest bearing accounts.All interest earned
shall be reported to City on a monthly basis, at the same time as submission of the monthly report
following the end of the contract month during which the interest was earned. Interest in an amount of
$25.00 or less per month may be used for authorized program expenses. These amounts must be
reported on the monthly financial statements filed pursuant to this contract.Interest earned in excess of
$25.00 per month is subject to remittance to City as directed by City.
f. Contractor will not commingle CDBG monies with any other funds in any manner which would
prevent City from readily identifying program expenditures for operation of the Program.
3. Uniform Administrative Requirements and Program Management Standards
a. Financial Management
i. Accounting Standards
The Contractor agrees to comply with OMB Circular A-110 and agrees to adhere to the accounting
principles and procedures required therein,utilize adequate internal controls,and maintain necessary
source documentation for all costs incurred.
ii. Cost Principles
Contractor shall administer the Program in conformance with OMB Circular A-122, "Cost
Principles for Non-Profit Organizations"and attachments and revisions thereto,regarding principles
for determining costs for the Program.
b. Documentation and Record Keeping
i. Requirement
Contractor shall maintain all records pertinent to the activities to be funded under this Agreement
required by HUD regulations specified in 24 CFR§ 570.506. In addition,Contractor agrees to keep
records to fully document all expenditures charged to the CDBG program.The documentation must
support the amounts charged to Program and demonstrate that the expenditures were appropriate to
the stated goals of the Program and allowable under applicable federal, state and City guidelines.
ii. Retention
(1) All records pertaining to Program shall be retained for four (4) years following the date of
termination of this contract. Contractor may destroy Program records at the end of this four(4)year
period if no outstanding audit finding exists.
(2) Contractor will retain Program loan records until four(4)years after the expiration of the loan.
2 XXX CDBGCNT June 29,2004
iii. Property Records
The contractor shall maintain real property inventory records which clearly identify properties
purchased, improved, or sold. Properties retained shall meet eligibility criteria and shall conform
with 24 CFR § 570.505.
iv. Close Outs
The Contractor's obligation to City shall not end until all close-out requirements are completed.
Activities during this close-out period shall include,but are not limited to: making final payments,
disposing of program assets(including the return of all unused materials, equipment,unspent cash
advances, program income balances, and accounts receivable to City), and determining the
custodianship of records.
v. Audits and Inspections
(1) City, HUD, and the United States Comptroller General, or their representatives, shall have
access to any books, documents,records and papers relating to the operations of Contractor under
this Agreement for the purpose of audit, examination, exception and transcription at all reasonable
hours at all offices of Contractor.
(2) For all contracts in which Contractor is cumulatively receiving federal monies in the amount of
$300,000 or more, Contractor must submit to City an annual audit prepared in accordance with 24
CFR Sections § 570.502-570.503 generally, with specific reference to OMB Circulars (with
attachments)A-122 and A-133 as appropriate. The audit may cover either Contractor's fiscal year
during which this contract is in force or cover the period of this contract.The audit must be prepared
by an independent certified public accountant, be completed within twelve.(12) months following
the end of the period being audited and be submitted to City within thirty (30) days of its
completion. Contractor's audit schedule is attached hereto as Exhibit D -Audit Schedule. Costs of
preparation of this audit may be an allowable expenditure of CDBG funds in an amount
proportional to that of the CDBG funds used in contractor's total agency operating budget.
(3) City reserves the right to perform an audit of Contractor's program operations and finances at
any time during the term of this contract, if City determines that such audit is necessary for City's
compliance with OMB Circular A-128. Contractor agrees to allow access to all pertinent materials.
If such audit reveals a questioned practice or expenditure, such questions must be resolved within
fifteen (15) days after notice to Contractor. If questions are not resolved within this period, City
reserves the right to withhold further funding under this and/or future contract(s).
(4) If as a result of any audit it is determined that Contractor has misused, misapplied or
misappropriated all or any part of the grant funds described herein, Contractor agrees to reimburse
the City the amount of such monies so misused,misapplied or misappropriated,plus the amount of
any sanction,penalty or other charge levied against City because of such misuse,misapplication or
misappropriation.
4. Reporting Procedures
Financial Reports
a. Contractor will submit to City on a monthly basis: (1) Attachment I, Attachment II, Detailed
Statement of costs; and (2) Attachment III, Expenditures worksheet as applicable, for expenses
incurred for services and activities accomplished by Contractor in performance of this contract,and
(3)Actual cash receipts for claimed expenditures must be provided at the time the request for funds
is presented. The reports must be signed by a duly authorized agent of the Contractor submitted by
the 15th of the month following the month being reported.
- 1 f
3 XXX CDBGCNT June 29,2004
b. Progress Reports
Contractor will submit monthly Attachment IV- Program Services Report to City for services and
activities undertaken by Contractor in performance of this contract. The report will be signed by a duly
authorized agent of Contractor and submitted by the 15th of the month following the month which is
reported.
c. Program Income
Contractor agrees that all program income from operation of the Program in proportion to the amount of
CDBG funds received hereunder will be expended prior to expending CDBG monies and that any such
program income is subject to the terms of this contract. CDBG monies may be expended by the
Contractor only if program income is insufficient to meet all eligible program activity expenses.
Contractor agrees to return to City at the end of the Contract any remaining program income earned
from operation of the Program in proportion to the amount of CDBG funds in the overall operating
budget.
d. Procurement
i. Compliance
The Contractor shall comply with City policy concerning the purchase of equipment and shall
maintain inventory records of all non-expendable personal property, as defined by such policy,
procured with funds provided herein.
ii. OMB Standards
The Contractor shall procure all materials,property, or services in accordance with the requirements
of OMB Circular A-110,Procurement Standards,and shall subsequently comply with Attachment N,
Property Management Standards as modified by 24 CFR 570.502(b)(6), covering utilization and
disposal of property.
5. Reversion of Assets
a. Contractor agrees to return to City any CDBG funds remaining on hand at the end of the Contract.
b.All property purchased with CDBG funds under this contract will be used solely for operation of the
Program. Contractor agrees to obtain City approval prior to purchase of property. Contractor agrees to
notify City upon receipt of property so that it may be properly tagged and inventoried. Title to such
property will be vested with the City, and, at the termination of the Program for which CDBG funds
have been received, Contractor will deliver all such property to City for disposition at City's sole
discretion.
6. Applicable Laws
a. Federal
Contractor agrees to comply with the following laws and the regulations issued thereunder as they are
currently written or are hereafter amended during performance of this contract:
• Title VI of the Civil Rights Act of 1964 (42 USC 2000d et seq)
• Title VIII of the Civil Rights Act of 1968 (42 USC 3601 et seq)
• Executive Orders 11063, 11246, as amended by 11375 and as supplemented by Department of
Labor regulations (41 CFR, Part 60)
• The Age Discrimination in Employment Act of 1973 (29 USC 794)
• Section 504 of the Rehabilitation Act of 1973 (29 USC 794)
• The Immigration Reform and Control Act of 1986(Pub.L.99-603, 100 Stat. 3359,as amended),
specifically including the provisions requiring employer verification of the legal status of its
employees
4 XXX CDBGCNT June 29,2004
• The Housing and Community Development Act of 1987 (Pub. L. 100-242, 101 Stat. 1815, as
amended)
• The Americans with Disabilities Act of 1990 (42 USC 12101 et seq)
b. Other Laws
Contractor covenants and agrees that its officers,members,agents,employees,program participants and
subcontractors shall abide by and comply with all other laws, federal, state and local, relevant to the
performance of this contract, including all ordinances,rules and regulations of the City of Fort Worth
and the Housing and Community Development Act of 1974 (Pub. L. 93-383, 885 Stat. 633,) as
amended,and all regulations pertaining thereto. Contractor further promises and agrees that it has read,
and is familiar with, terms and conditions of the Community Development Block Grant under which
funds are granted and that it will fully comply with same. It is agreed and understood that, if City calls
the attention of Contractor to any such violation on the part of Contractor or any of its officers,
members,agents,employees,program participants or subcontractors,then Contractor shall immediately
desist from and correct such violation.
7. Nondiscrimination
a. Contractor,in the execution,performance or attempted performance of this contract and agreement,
will not unlawfully discriminate against any person or persons because of sex, race, religion, age,
disability,color or national origin,nor will Contractor permit its officers,members,agents, employees,
subcontractors or program participants to engage in such discrimination.
b. In accordance with the policy of the Executive Branch of the federal government, Contractor
covenants that neither it nor any of its officers, members, agents, employees, program participants or
subcontractors, 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 except on the basis of bona fide
occupational qualification, retirement plan or statutory requirement.
c. Contractor further covenants that neither it nor its officers, members, agents, employees,
subcontractors,program participants,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.
d. In accordance with the provisions of the Americans With Disabilities Act of 1990 ("ADA"),
Contractor warrants that it and any and all of its subcontractors 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 Contractor, or employees of Contractor
or any of its subcontractors. Contractor warrants it will fully comply with 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 or subcontractors against City
arising out of Contractor's and/or its subcontractors'alleged failure to comply with the above-referenced
laws concerning disability discrimination in the performance of this agreement.
e. This agreement is made and entered into with reference specifically to the ordinances codified at
Chapter 17,Article III,Division 3 ("Discrimination in Employment Practices"), of the City Code of the
City of Fort Worth, and Contractor hereby covenants and agrees that Contractor,its officers,members,
agents, employees and subcontractors, have fully complied with all provisions of same and that no
employee, employee-applicant or program participant has been discriminated against by the terms of
such ordinances by either the Contractor or its officers,members,agents, employees or subcontractors._
5 XXX CDBGCNT June 29,2004J.Y(7 J L
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8. Prohibition Against Interest
a. No member,officer or employee of City or its designees or agents;no member of the governing body
of the locality in which the Program is situated; and no other public official of such locality or localities,
who exercises any functions or responsibilities with respect to the Program funded hereunder during his
or her tenure or for one year thereafter, shall have any interest, direct or indirect, in any contract or
subcontract,or the proceeds thereof,for work to be performed hereunder. Contractor shall incorporate,
or cause to be incorporated, like language prohibiting such interest in all contracts and subcontracts
hereunder.
b. No member,officer, employee,or program participant of Contractor or its subcontractors shall have a
financial interest,direct or indirect,in this contract or the monies transferred hereunder or be financially
interested, directly or indirectly, in the sale to Contractor of any land, materials, supplies or services
purchased with any funds transferred hereunder,except on behalf of Contractor,as an officer,employee,
member or program participant. Any willful violation of this paragraph with the knowledge,expressed
or implied, of Contractor or its subcontractors shall render this contract voidable by the City of Fort
Worth.
9. Minority and Women Business Enterprise Commitment
Contractor agrees to abide by the City of Fort Worth's policy to involve Minority and Women Business
Enterprises(MWBEs)in all phases its procurement practices and to provide them an equal opportunity
to compete for contracts for construction,provision ofprofessional services,purchase of equipment and
supplies and provision of other services required by City. Therefore, Contractor agrees to incorporate
City Ordinance No. 15530,and all amendments or successor policies thereto,into all contracts and will
further require all persons or entities with whom it contracts to comply with said Policy.
10.Non Assignment
Contractor will not assign any or all of its rights or responsibilities under this contract without the prior
written approval of City. Any purported assignment without such approval will be a breach of this
contract and void in all respects.
11.Independent Contractor
a. Contractor shall operate hereunder as an independent contractor and not as an officer,agent,servant
or employee of City. Contractor shall have exclusive control of,and the exclusive right to control,the
details of the 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,
subcontractors,program participants,licensees or invitee. The doctrine of respondeat superior shall not
apply as between City and Contractor, its officers, members, agents, servants, employees,
subcontractors, program participants, licensees or invitees, and nothing herein shall be construed as
creating a partnership or joint enterprise between City and Contractor. It is expressly understood and
agreed that no officer,member,agent,employee,subcontractor,licensee or invitee of the Contractor,nor
any program participant hereunder, is in the paid service of City and that City does not have the legal
right to control the details of the tasks performed hereunder by Contractor,its officers,members,agents,
employees, subcontractors, program participants, licensees or invitees.
6 XXX CDBGCNT June 29,2004
b. City shall in no way nor under any circumstances be responsible for any property belonging to
Contractor, its officers,members, agents, employees,subcontractors,program participants,licensees or
invitees, which may be lost, stolen, destroyed or in any way damaged; and Contractor hereby
indemnifies and holds harmless City and its officers,agents,and employees from and against any and all
claims or suits.
12. Insurance and Bonding
a. Contractor covenants and agrees to indemnify, hold harmless and defend, at its own expense, City
and its officers,agents,servants and employees from and against any and all claims or suits for property
loss or damage and/or personal injury, including death, to any and all persons, of whatsoever kind or
character, whether real or asserted, arising out of or in connection with the execution, performance,
attempted performance or nonperformance of this contract and agreement 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
Contractor hereby assumes all liability and responsibility of City and its officers, agents, servants, and
employees for any and all claims or suits for property loss or damage and/or personal injury, including
death,to any and all persons,of whatsoever kinds or character,whether real or asserted,arising out of or
in connection with the execution, performance, attempted performance or non-performance of this
contract and agreement and/or the operations,activities and services of the programs described herein,
whether or not caused in whole or in part,by alleged negligence of officers,agents,servants,employees,
contractors or subcontractors of City. Contractor likewise covenants and agrees to and does hereby
indemnify and hold harmless City from and against any and all injury,damage or destruction of property
of City, arising out or in connection with all acts or omissions of Contractor, its officers, members,
agents, employees, subcontractors,invitees, licensees,or program participants,or caused,in whole or in
part, by alleged negligence of officers, agents, servants, employees, contractors or subcontractors of
City.
b. Contractor will maintain a blanket fidelity coverage in the form of a bond in the amount of$28,933,
to insure against loss from the fraud,theft or dishonesty of any of Contractor's officers,agents,trustees,
directors or employees. The proceeds of such bond shall be used to reimburse City for any and all loss
of CDBG monies occasioned by such misconduct. To effectuate such reimbursement,such bond shall
include a rider stating that reimbursement for any loss or losses thereunder shall be made directly to City
for the uses and benefit of Contractor.
c. Contractor shall furnish certificates of insurance as proof that it has secured and paid for policies of
workers'compensation,public liability and automobile liability insurance covering all risks incident to
or in connection with the execution, performance, attempted performance or nonperformance of this
contract and agreement. The amounts of such insurance shall not be less than the maximum liability
which can be imposed on City under the laws of the State of Texas. Contractor understands and agrees
that such insurance amounts may be revised upward at City's option and that Contractor shall revise
such amounts within thirty (30) days following notice to Contractor of such requirements.
d. Contractor will submit documentation to City that it has obtained insurance coverage and has
executed bonds as required in this contract within thirty(30)days of the execution of this contract and
prior to payment of any monies hereunder.
13. Waiver of Immunity
If Contractor, as a charitable or nonprofit organization, has or claims an immunity or exemption
(statutory or otherwise) from and against liability for damages or injury,includit , .,,�o
property; Contractor hereby expressly waives its rights to plead defensiv 1y , tM711, ' 1t oil
7 XXX CDBGCNT June 29,2004
exemption as against City. This section shall not be construed to affect a governmental entity's
immunities under constitutional, statutory or common law.
14. Termination
a. In addition to, and not in substitution for,other provisions of this Agreement regarding the provision
of public services with CDBG funds, pursuant to Title I of the Housing and Community Development
Act of 1974, as amended, it is expressly understood and agreed by and between the parties hereto that
this agreement is wholly conditioned upon the actual receipt by City of Federal CDBG Year XXX
funds; that all monies distributed to Contractor hereunder shall be exclusively from Federal monies
received under said grant and not from any monies of City; and that if such funds under said grant are
not timely forthcoming, in whole or in part, City may, at its sole discretion, terminate this contract and
agreement and City shall not be liable for payment for any work or services performed by Contractor
under or in connection with this contract.
b. City may terminate this contract whenever such termination is determined to be in the best interest of
City, in event of Contractor's default, inability or failure to perform or to comply with any of the terms
herein, or for other good cause.
c. The parties acknowledge that CDBG funds paid hereunder are intended to provide only partial
funding for Contractor's program operations. If non-CDBG funds included in the Operating Budget are
not forthcoming to Contractor during the contract term, City may terminate this contract.
d. CDBG funds provided hereunder may not be used as collateral for loans to Contractor to defray
program operation expenses, and any attempted use of CDBG funds for this purpose will result in
termination of this contract by City.
e. Termination will be effected by written notice to Contractor, specifying the portions of the contract
affected and the effective date of termination. Upon Contractor's receipt of such termination notice,
Contractor will:
• Stop work under the contract on the date and to the extent specified by City;
• Cease expenditures of CDBG monies, except as necessary for completion of the portions of the
contract not terminated; and
• Terminate all orders and contracts to the extent that they relate to terminated portions of the
contract.
f. Contractor will return to City any unused monies previously advanced by City under this contract
within thirty(30) days of the effective date of contract termination. City will have no responsibility or
liability for Contractor's expenditures or actions occurring after the effective date of contract
termination.
15. Certification Regarding Lobbying
a. The undersigned representative of Contractor 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 Contractor,
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 or an employee of a member 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. Contractor
shall require that the language of this certification be included in all subcontracts or agreements
involving the expenditure of federal funds.
8 XXX CDBGCNT June 29,2004
b. If any fluids other than federal 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,a member of Congress,an
officer or employee of Congress, or an employee of a member of Congress in connection with this
federal contract, grant, loan or cooperative agreement, Contractor shall complete and submit Standard
Form-LLL, Disclosure Form to Report Lobbying," in accordance with its instructions.
16. Miscellaneous Provisions
a. All terms of this contract shall apply to any and all subcontractors of Contractor who are in anyway
paid with CDBG funds or who perform any work in connection with Contractor's program.
b. The provisions of this agreement are severable,and,if for anyreason a clause,sentence,paragraph or
other part of this agreement 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.
c. The failure of the City to insist upon the performance of any term or provision of this agreement or to
exercise any right herein conferred shall not be construed as a waiver or relinquishment to any extent of
City's right to assert or rely upon any such term or right on any future occasion.
d. Should any action, whether real or asserted, at law or in equity, arise out of the execution,
performance,attempted performance or nonperformance of this contract and agreement,venue for said
action shall lie in Tarrant County,Texas.
e. This written instrument and-the exhibits attached hereto, which are incorporated by reference and
made a part of this contract for all purposes, constitute the entire agreement between the parties hereto
concerning the work and services to be performed hereunder,and any prior or contemporaneous,oral or
written agreement which purports to vary from the terms hereof shall be void. Any amendments to the
terms of this contract must be in writing and must be approved by each party to this contract.
9 XXX CDBGCNT dune 29,2004
IN WITNESS WHEREO e arties hereto 114peexecuted four copies of this contract in Fort Worth,
Tarrant County,Texas, this day of ,A.D. 20 .
CITY OF FORT WORTH Northside-Inter Church Agency (NICA)
C�
By: By: ,pace
Charles R. Boswell Ms. Connie Nahoolewa
Assistant City Manager Executive Director
APPROVED AS TO FORM AND LEGALITY:
Ci ry Atto1rn//fey
—C)y
Date
ATTEST:
)' tJ-,%City Secretary
Contract Autho ization
I r) -R
.O
Date
'rJ
10 XXX CDBGCNT June 29,2004 �L
STATE OF TEXAS §
COUNTY OF TARRANT §
BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day
personally appeared Charles Boswell, known to me to be the person whose name is subscribed to the
foregoing instrument, and acknowledged to me that the same was the act of the City of Fort Worth and that
he/she executed the same as the act of said City of Fort Worth for the purposes and consideration therein
expressed and in the capacity therein stated.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of ,
A.D. 20—oV.
ROSELLA BARNES
NOTARY PUBLIC
*l` * State of Texas% * r�
`. . ;'Comm.Exp.03-31-2005 Notary Public in and for
the State of Texas
STATE OF TEXAS §
COUNTY OF TARRANT §
BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day
personally appeared Ms. Connie Nahoolewa,known to me to be the person whose name is subscribed to
the foregoing instrument, and acknowledged to me that he\she executed the same for the purposes and
consideration therein expressed,as the act and deed for Northside-Inter Church Agency(MICA) and in the
capacity therein stated as its duly authorized officer or representative.
GIVEN UNDER MY HAND AND SEAL OF OFFIC is &( day of �y
A.D. 20 ,_ .
U
PATSY COX
NOTARY PUBLIC Notary lic inAnd for
*�, * State of Texas the State of Texas
?E�i;�•;' Comm Exp 12-18-2004
11 XXX CDBGCNT June 29,2004
APPENDIX A—CONSTITUTIONAL PROVISION
Contractor represents that it is, or may be deemed to be, a religious or denominational institution or an organization
operated for religious purposes which is supervised or controlled by or in connection,with a religious or
denominational institutional or organization. Pursuant to Title 24 CFR CH.V§ 570.2000). Contractor agrees that in
connection with this contract:
a. It will not discriminate against any person applying for such public services on the basis of religion
and will not limit such services or give preference to persons on the basis of religion, and;
b. It will not discriminate against any person applying for such public services on the basis of religion
and will not limit such services or give preference to persons on the basis of religion, and;
c. It will provide no religious instruction or counseling, conduct no religious worship or services, engage
in no religious proselytizing, and exert no other religious influence in the provision of such public
services,and;
d. Where public services provided tuider paragraph 0)(3) of section 24 CFR 500.200 are carried out on
property owned by the primarily religious entity, CDBG funds may also be used for minor repairs to
such property which are directly related to carrying out the public services where the cost constitutes in
dollar terms only an incidental portion of the CDBG expenditure for the public services.
EXHIBIT A
PROGRAM SUMMARY
Northside-Inter Church Agency (NICA)
AGENCY
Good Works/Buenas Obras Program
PROGRAM
00000 June 1, 2004-May 31, 2005 $28,933
CONTRACT NO. PERIOD AMOUNT
PROGRAM DESCRIPTION
The Good Works-Buenas Obras program will provide an increased variety of vital goods and services
designed to aid and empower and thereby improve the nutrition and quality of life for low-income seniors
living in their homes. CDBG funds will be used to pay for four staff persons, telephone and electric bills.
COUNCIL DISTRICT (S)
2
PROGRAM GOALS
To provide comprehensive assessments to clients in order to determine their needs.
PROGRAM OBJECTIVES
To improve the dietary needs of the seniors served; To improve essential services needed by the seniors
PROGRAM SERVICES and ACTIVITIES GOALS
Number of Unduplicated Seniors and disabled served 540
Number of seniors provided food distribution 3,504
Number of seniors provided information and referral 324
Number of seniors provided follow-up telephone calls 2160
Number of seniors provided emergency financial aid 36
Number of seniors provided home delivery of groceries 516
Number of seniors provided in-home maintenance or chore services 10
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PROGRAM BUDGET EXHIBIT C
CDBG
2004-2005 Page 1 of 3
CONTRACT PERIOD From: 6/1/2004 To: 5/31/2005
Name of Sub Grantee Name of Program
North Side Inter-Church Agency Good Works-Buenas Obras
Program CDBG
Cost Category Budget Funds [a] [b] [c] [d
PERSONAL SERVICES
Salaries 34,633 27,133 7,500
FICA 575 575
Life Insurance - - -
Health Insurance -
Employment Tax-State 120 120 - -
Employment Tax-Federal -
Worker's Comp 415 415 -
Retirement -
SUPPLIES
Office Supplies 800 800 -
Postage 720 720 -
Teaching Aids - - -
Other Operating Expenses - -
CONTRACTUAL SERVICES
Telephone 720 600 120 -
Electric 1,890 1,200 690 - -
Gas - -
Water/Waste Disposal 350 350 -
Building Lease 250 250 -
Janitorial Services 1,350 1,350
Office Equipment Rental - -
Printing 800 800
Repairs 1,800 1,800 -
Fidelity Bond 100 100 - -
Liability Insurance 940 940 -
Legal&Accounting 1,325 1,325 - -
Private Auto Allowance-Local 200 200 - - -
Advertising -
Conference&Seminars 200 200 -
Contractual Services 1,300 - -
Direct Assistance 20,000 15,000 5,000
CAPITAL OUTLAY
Office Furniture - - -
Computer Equipment -
Other: [Described] - - - -
TOTAL 68,488 28,933 19,555 15,000 5,000 -
MATCHING FUND SOURCES
[a]Individual Donars
[b]Emergency Food and Shelter National Board Program Funds
[c]Local Congregations
BUDGET DETAIL Page 2 of 3
PERSONAL SERVICES
Hourly Annual % of
Position /Title Rate Hours Time Amount
1 Volunteer Coordinator 15.00 1560 32.70% 7,644
2 Director of Services 12.00 2080 37.50% 9,360
3 Storefront Director 10.00 1560 25.20% 3,932
4 Case Manager 9.00 1560 44.10% 6,197
5 -
6 -
7 -
8 -
9 -
10 -
TOTAL STAFF SALARIES 27,133
FRINGE BENEFITS
% of % Paid % Paid
CATEGORY Payroll Amount by Agency by Fund Amount
FICA 7.65% 2,076 0 100%
Life Insurance 0.06% - 0 0% -
Health Insurance 0.00% - 0 100% -
Employment Tax-State 0.30% 81 91 0.00% -
Employment Tax-Federal 0.00% - 0 0.00% -
Worker's Comp 0.53% 144 160 0% -
Retirement 0.00% - 0 0% -
TOTAL FRINGE BENEFITS -
TOTAL PERSONAL SERVICES 27,133
r - -
BUDGET DETAIL Page 3 of 3
UTILITIES
Average Cost Number of
Category Per Month Months Amount
Telephone 50 12 600
Electric 100 12 1,200
Gas 0 0 -
Water/Waste Disposal 0 0 -
Other: [Specify] 0 0 -
TOTAL UTILITIES 1800
BUILDING LEASE 71
No. Square Cost Per
Building Location Foot Square Foot Amount
1 0 0 -
2 0 0 -
3 0 0 -
TOTAL BUILDING LEASE
OTHER EXPENSES
Total % Charged
Category Charge To CDBG Amount
Fidelity Bond 0 0.0% -
Liability Insurance 0 0.0% -
Legal &Accounting 0 0.0%
TOTAL OTHER EXPENSES 0
CONFERENCES &SEMINARS
Total % Charged
Event Charges to CDBG Amount
1 0
2 0 0.0% 0
3 0 0.0% 0
TOTAL CONFERENCES &SEMINARS 0
OFFICE EQUIPMENT RENTAL
Total % Charged
Item Charge to CDBG Amount
1 0
2 0
3 0
TOTAL OFFICE EQUIPMENT RENTAL 0
EXHIBIT "D"
AUDIT SCHEDULE
INDEPENDENT AUDIT REQUIREMENT
BUSINESS/AGENCY NAME: Northside-Inter Church Agency (MCA)
PROGRAM: Good Works/Buenas Obras Program
CDBG YEAR: XXX
AMOUNT FUNDED: $28,933
Name of Independent Auditor who will perform agency audit:
Independent Auditor to be contracted during CDBG contract period.
Date audit is to be performed:
Within 60 days of completion of CDBG funded project.
The following language is a condition of your contract with the City:
(1) For all contracts in which Contractor is cumulatively receiving federal
monies in the amount of$300,000 or more, Contractor must submit to City an
annual audit prepared in accordance with 24 CFR Sections § 570.502-570.503
generally, with specific reference to OMB Circulars (with attachments) A-122
and A-133 as appropriate. The audit may cover either Contractor's fiscal year
during which this contract is in force or cover the period of this contract. The
audit must be prepared by an independent certified public accountant, be
completed within twelve (12) months following the end of the period being
audited and be submitted to City within thirty (30) days of its completion.
Contractor's audit schedule is attached hereto as Exhibit D - Audit Schedule.
Costs of preparation of this audit may be an allowable expenditure of CDBG
funds in an amount proportional to that of the CDBG funds used in contractor's
total agency operating budget.
This form is to be completed and submitted to the Intergovernmental Affairs and Grants
Management Division at the beginning of each contract year.
Signature
CITY OF FORT WORTH Attachment
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DIVISION
REQUEST FOR FUNDS
AGENCY: PROGRAM:
ADDRESS: CONTRACT NUMBER:
CONTRACT AMOUNT:
CONTRACT DATE:
DATE OF REQUEST:
SECTION I (AGENCY) CURRENT MONTH CUMULATIVE
i. Reimbursement Request
1. Expenditures: $ $
2. Income
A. Program Income $ $
B. City of Fort Worth $ $
C. Interest Earned CDBG Funds $ $
3. Reimbursement(1 minus 2) $ $
II.Advance Pay Requests/Repayment $ $
III. Reporting Interest
1. Interest over$25 per quarter returned to City of Fort Worth $ $
SECTION II (CITY)
I. BYSPEED - Purchasing Request
A.BYSPEED INPUT:Vendor/PO Number/Requisition Number:
B. Fund/Account/Center:
C.Total Amount of this Request: $
SECTION III
I. Verification
A. Contract Compliance Specialist
(Name) (Signature) (Date)
B. BYSPEED-Purchasing
(Name) (Signature) (Date)
C. Accounting
(Name) (Signature) (Date)
II.Authorization
A. Agency
(Name) (Signature) (Date)
B. Contract Manager D.Emerson
(Name) (Signature) (Date)
C. Budget Director B. Garrett
(Name) (Signature) (Date)
Distribution:
1 Copy-Accounting
1 Copy-IAGM
1 Copy-Agency
CITY OF FORT WORTH CDBG ATTACHMENT 2
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DIVISION
DETAIL STATEMENT OF COSTS
AGENCY CONTRACT NO. DATE
TO
PROGRAM REPORT PERIOD
PROGRAM MONTHLY CUMULATIVE
COST CATEGORY ACCOUNT BUDGET EXPENDITURES TO DATE BALANCE
PERSONAL SERVICES
Salaries 516 010
FICA 518 010
Life Insurance 518 050
Health Insurance 518 060
Unemployment Tax-State 518 090
Worker's Comp 618 040
Retirement 518 070
SUPPLIES
Office Supplies 521 010
Postage 521 020
Teaching Aids(Equipment) 522 030
Food Supplies 522 030
Other Operatincr Supplies 523 300
CONTRACTUAL SERVICES
Telephone 535 040
Electric 535 020
Gas[Utility] 535 010
Water/Waste Disposal 535 030
Rent[Building] 537 010
Custodial Services 539 220
Office Equipment Rental 537 030
Printing 533 030
Repairs 536 010
Fidelity Bond 538 210
Liability Insurance 534 020
Legal&Accounting 538 050
Private Auto Allowance-Local 532 130
Advertising 533 010
Conferences&Seminars 531 180
Contractual Services 539 120
CAPITAL OUTLAY
Furniture, Fixtures 541 330
Office Equipment, Com uters 541 370
Other Equipment 541 320
TOTAL
Contractors Certification: I certify that the costs incurred are taken from the books of account and that such costs are valid and consistent with the terms of
NAME and TITLE OF AUTHORIZED OFFICER SIGNATURE and DATE
PREPARE ONE FORM FOR EACH SOURCE OF FUNDS
DISTRIBUTION:
I Copy-Accouming
I Copy-1AGM
1 Copy-Agency 2
:lei '�'ei
ATTACHMENT 3
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DIVISION
EXPENDITURES WORKSHEET
Agency Contract Number Date
To
Program Report Period
NO DATE CHECK NO PAYEE DESCRIPTION ACCOUNT NO. AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
TOTAL
TITLE OF AUTHORIZED OFFICER SIGNATURE AND DATE
Distribution: J.:-
1 copy-Accounting
1 copy-IAGM
1 copy-Agency
CDBG ATTACHMENT 4A
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CDBG YEAR XXX
Public Service
1. Name and Address of Sub-Grantee
2. Project Name
3. Contract No.
4. Date of Request
Month &Year
5. Program Services and Activities
Current Month Cumulative
Number of New Households and/or Persons Served
6. Direct Benefit(Continued)
Low/Mod Low Income
Current Month
Cumulative
7. Age 0-4 5- 17 18-24 25-54 55-64 64+
Current Month
Cumulative
Certification: The undersigned hereby gives assurance that to the best of my knowledge and belief, the data
included in this report is true and curate, and if a non-profit agency, has been approved by the governing body
of the organization prior to submission.
Date: Submitted by: Phone No.
Attachment 413
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CDBG YEAR XXX
Public Service
1. Name and Address of Sub-Grantee
2. Project Name
3. Contract No.
4. Date of Request
Month &Year
8. Direct Benefit Data(New Household and/or Persons Served)
White Black/ Asian American Indian/ Native Hawaiian/ American Indian/ Asian
African Alaskan Native Other Pacific Alaskan Native &White
American Islander &White
#of Hispanic
Current Month
Cumulative
Am.Indian
Alaskan
Black/Afrlcan Native&
American& Black/African Other Multi- Asian/Pacific
White American racial Islander Hispanic
#of Hispanic
Current Month
Cumulative
Certification: The undersigned hereby gives assurance that to the best of my knowledge and belief, the data
included in this report is true and aurate, and if a non-profit agency, has been approved by the governing body
of the organization prior to submission.
Date: Submitted by: Phone No.
AT7ACHMENT5
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
1.Agency/Address 2.Project Name:
3.Contract No: Contract Date:
Contract Amount:
4.Date of Request:
MONTH&YEAR
5. PROGRAM SERVICES AND ACTIVITIES: CURRENT CUMULATIVE
6. SCOPE OF WORK NARRATIVE:
7. PROBLEMS ENCOUNTERED / SOLUTIONS PROPOSED:
8. ANTICIPATED ACTIVITY DURING THE NEXT MONTH:
9. CERTIFICATION: The undersigned hereby gives assurance that to the best of my knowledge and belief,the data included in this report is true
and accurate,and if a non-profit agency,has been approved by the governing body of the organization prior to submission.
Date: Submitted by: Phone Num:
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Page 1 of 3
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 6/8/2004
DATE: Tuesday, June 08, 2004
LOG NAME: 02ACTIVITY REFERENCE NO.: **C-20095
SUBJECT:
Community Development Block Grant Year XXX, Emergency Shelter Grant Year 2004-2005, and
Housing Opportunities for Persons with AIDS 2004-2005 Contract Activities
RECOMMENDATION:
It is recommended that the City Council:
Authorize the City Manager to execute Community Develoment Block Grant (CDBG) Year XXX,
Emergency Shelter Grant (ESG) Year 2004-2005 and Housing Opportunities for Person with AIDS
(HOPWA) Year 2004-2005, contracts with the following organizations to administer their respective
programs, contingent upon approval and receipt of adequate funding from the U.S. Department of Housing
and Urban Development (HUD), for a term beginning June 1, 2004, and ending May 31, 2005:
i. Community Development Block Grant (CDBG)
Contract with the listed agencies for an amount not to exceed the following:
Southside Area Ministries (SAM'S Kids) $ 4 ,610
Habitat for Humanity $14,762.00
REACH, Inc. $19,683.00
Centro Cultural de las Americas $27,540.00
Boys and Girls Clubs (NINOS) $19,829.00
Boys and Girls Club (KEYS) $18,266.00
JMAC Yough Center of Tarrant County $25,000.00
East Fort Worth Montessori $22,385.00
Latin Arts Associaton $17,250.00
Summerbridge Fort Worth $27,338.00
CJ's Studio of Perfoming Arts $9,000.00
Women's Center of Tarrant County $27,000.00
YWCA of Fort Worth (AIM) $20,986.00
YWCA of Fort Worth (Child Care) $150,000.00
Child Care Associates $130,000.00
Fort Worth Housing Authority (AMAKA) $30,000.00
YMCA $120,375.00
Clayton Child Care $60,000.00
Southside Area Ministries (Mid South Seniors) $2,570.00
Senior Citizen Services of Tarrant County(COMO) $17,597.00
http://www.cfwnet_org/council_packet/Reports/mc_print.asp 6/14/2004
t
Page 2 of 3
Meals on Wheels $33,696.00
Senior Citizen Services of Tarrant County (RIVERSIDE) $15,271.00
Mental Health Association (OMBUDSMAN) $17,500.00
Mental Health Associstion (Advocate) $24,750.00
Northside Inter-Church Agency $28,933.00
Southside Area Ministries (Adult ESL) $3,500.00
Day Resource Center $30,000.00
Presbyterian Night Shelter (Bottle Deposit) $30,000.00
Job, Inc. $73,198.00
Fort Worth SER $72,224.00
A-PREP Center of Tarrant County $71,745.00
Fort Worth Economic Development Corp. (RLF) $51,908.00
TOTAL CDBG $1,216,916.00
II. Emergency Shelter Grant (ESG)
YWCA (Supportive Living) $13,500.00
Cornerstone Assistance Network $13,568.00
Presbyterian Night Shelter(Shelter) $151,308.00
Bridge Emergency Youth Services $7,082.00
Women's Haven of Tarrant County, Inc. $21,683.00
Presbyterian Night Shelter (Infirmary) $15,040.00
MHMR of Tarrant County $16,117.00
YWCA(My Own Place) $19,794.00
TOTAL ESG $258,092.00
III. Housing Opportunities for Persons with HIV/AIDS (HOPWA)
AIDS Outreach Center, Inc. $462,620.00
Tarrant County Samaritan Housing, Inc. $242,539.00
AIDS Resources of Rural Texas $104,791.00
TOTAL HOPWA $809,950.00
DISCUSSION:
On April 6, 2004, the City Council approved and adopted the budgets and the appropriation ordinance
increasing estimated receipts and appropriations for the Thirtieth (30th) Year Community Development
Block Grant (CDBG), (2004-2005), Emergency Shelter Grant (ESG), and (2004-2005) Housing
Opportunities for Persons with AIDS (HOPWA), grant funds as part of the City's Consolidated Action Plan.
The Consolidated Action Plan, as adopted by the City Council, included program descriptions for each of
the above funded programs.
The above programs are consistent with the City's approved priorities and the City Council's prior policies
and meet the requirements of the Department of Housing and Urban Development (HUD) regulations
concerning eligible "activities."
http://www.cfwnet.org/council_packet/Reports/mc_Print.asp 6/14/2004
Page 3 of 3
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that funds will be available in the current operating budget, as appropriated,
of the Grants Fund contingent upon approval and receipt of adequate funding from the U.S. Department of
Housing and Urban Development (HUD) for the term beginning June 1, 2004, and ending May 31, 2005.
TO Fund/Account/Centers FROM Fund/Account/Centers
GR76 5 $258,092.00
(VARIOUS) XXX206931XXX
GR76 5 $809,950.00
(VARIOUS) XXX206932XXX
GR76 5 $1,216,916.00
(VARIOUS) XXX206929XXX
Submitted for City Manager's Office by Charles Boswell (8511)
Originating Department Head: Bridgette Garrett (6183)
Additional Information Contact: Deidra Emerson (7563)
http://www.dwnet.orq/council_jacket/Reports/mc__print.osp 6/14/2004