HomeMy WebLinkAboutContract 30266 STATE OF TEXAS § CITY SECRETARY
CONTRACT NO.
COUNTY OF TARRANT §
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 Tarrant County Samaritan
Housing, Inc. ("Contractor"), by and through Mr. Steve Dutton, its duly authorized Executive
Director. Contractor's business address is 929 Hemphill, Fort Worth, TX 76104.
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 Housing
Opportunities for Persons with AIDS ("HOPWA") grant program for Year 2004-2005; and,
WHEREAS, the City of Fort Worth has been designated to service the Tarrant, Johnson, Hood,
and Parker Counties through HOPWA; and,
WHEREAS,HOP WA funds paid under this contract are exclusively for the care of person(s)with
acquired immune deficiency syndrome or related diseases who is a low-income individual and the
person's family as defined in 24 CFR§ 574.3, and individuals affected by the disease; and under no
circumstances for AIDS prevention, education, or risk reduction for the general public;
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NOW, THEREFORE, THIS AGREEMENT FURTHER WITNESSETH:
THAT, the parties covenant and agree as follows:
1. Scope of Services
a. Contractor will provide essential services for the care of persons with AIDS under the program
name Samaritan House ("Program"), for the term from 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. 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. Funds -Disbursement
City will disburse HOPWAYear 2004-2005 monies in an amount up to$242,539 to Contractor on
a reimbursement of expenses basis.
xxx HOPWACNT.DOC July 16,2004ffff
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3. Funds-Requirements
a. Payments will be processed by City following receipt from Contractor of Attachment I, Sub-
Grantees Request For Funds and applicable supporting documents described in paragraph 4.
Reimbursement for the payment of eligible expenses shall be made against the line item budget
specified in Exhibit C,Program Operating Budget. The City is under no obligation to authorize
payments for expenditures which occurred prior to the first day of the month for which the report
is submitted.
b. Contractor agrees to utilize all disbursed HOPWA 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 HOPWA Program
Operating Budget without prior written approval by the City.
c. It is understood that the total cost for operation of this program is $1,300,404 and that
Contractor will obtain the remaining funds in excess of the HOPWA amount as detailed in the
Program Operating Budget. Contractor will notify City promptly of any additional funding it
receives for operation of the Program,and City reserves the right to amend the Program Operating
Budget in such instances.
d. Contractor agrees to keep all HOPWA 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.
e. Contractor will not commingle HOPWA monies with any other funds in any manner which
would prevent City from readily identifying program expenditures for operation of the Program.
f. Contractor agrees that all program income from operation of the Program in proportion to the
amount of HOPWA funds received hereunder will be expended prior to expending HOPWA
monies and that any such program income is subject to the terms of this contract.HOPWA 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
HOPWA funds in the overall operating budget.
g. 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. The Contractor shall procure all materials, property, or
services in accordance with the requirements of OMB circular A-110.
4. 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. i r
XXX HOPWACNT.DOC July 16,2004 2
b. Documentation and Record Keeping
i. Contractor shall maintain all records pertinent to the activities to be funded under this
Agreement required by HUD regulations specified in 24 CFR § 574.530. In addition,
Contractor agrees to keep records to fully document all expenditures charged to the HOPWA
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) 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 § 574.630.
iii. 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.
iv. 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-110 and A-122 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 HOPWA funds in an amount proportional to that of the HOPWA
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-1 28. City will perform six (6) month
and year-end financial and programmatic audits with periodic site visits as appropriate.
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.
XXX HOPWACNT.DOC July l6,2004 3
5. Reporting Procedures
a.Financial Reports
Contractor will submit to City on a monthly basis: (1)Attachment I-Sub-Grantees's Request For
Funds, (2) Attachment II-Detailed Statement of Costs; and (3) Attachment III-Expenditures
Worksheet Report, as applicable, for expenses incurred for services and activities accomplished
by Contractor in performance of this Contract. The reports must be signed by a duly authorized
agent of Contractor and submitted by the 15`h of the month following the month being reported.
b. Performance Reports
Contractor will submit to City on a monthly basis: (1)Attachment IV and(2)Attachment IV(A),
Program Services Report to City for services and activities accomplished 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.
6. Reversion of Assets
a. Contractor agrees to return to City any HOPWA funds remaining on hand at the end of the
Contract.
b.All property purchased with HOPWA 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 u
inventoried. Title to such property will be vested with the City, and, at the termination of the
Program for which HOPWA funds have been received,Contractor will deliver all such property to
City for disposition at City's sole discretion.
7. 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), 11625, 12138, and 12432,
• The Age Discrimination Act of 1975 (42 USC 6101-07 and implementing regulations at
24 CFR part 146)
• 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
• 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)
• The Drug Free Workplace Act of 1988 (24 CFR Part 23, subpart F)
• The Fair Housing Act(42 USC 3601-19) and implementing regulations at 24 CFR Part
100
I _
XXX HOPWACNT.DOC July l6,2004 4 �.
• The applicable standards for eligible housing activities, rental assistance, short-term
supported housing, and community residences in 24 CFR 574.310-340
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 Housing.
Opportunities for Person With AIDS (HOPWA) 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.
8. 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 lawsconcerning 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 Ell, 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.
XXX HOPWACNT.DOC July]6,2004 5
9. 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.
10. 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 (M/WBE) in all phases its procurement practices and to provide them an
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. 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.
11. 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.
12. 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
)M HOPWACNT.DOC July 16,2004 6
hereunder by Contractor, its officers, members, agents, employees, subcontractors, program
participants, licensees or invitees.
b. City shall in noway nor under any circumstances be responsible for any property belonging to
Contractor, its officers, members, agents, employees, subcontractors, program participants,
licensees or invitees,which maybe lost,stolen,destroyed or in anyway damaged;and Contractor
hereby indemnifies and holds harmless City and its officers, agents, and employees from and
against any and all claims or suits.
13. 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
$237,909,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 HOPWA 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.
XXX HOPWACNT.DOC Jul l6 2004 7
Y - �
14. Waiver oflmmunity
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, including death, to
persons or property; Contractor 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.
15. Termination
a. In addition to, and not in substitution for, other provisions of this Agreement regarding the
provision of services provided with HOPWA 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 HOPWA Year 2003-2004 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 l
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 HOPWA funds paid hereunder are intended to provide only
partial funding for Contractor's program operations. If non-HOPWA funds included in the
Operating Budget are not forthcoming to Contractor during the contract term,City may terminate
this contract.
d. HOPWA funds provided hereunder may not be used as collateral for loans to Contractor to
defray program operation expenses,and any attempted use of HOPWA 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 HOPWA 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.
16. 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
XXX HOPWACNT.DOC July 16,2004 8
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.
b. If any funds 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.
P�
17. Miscellaneous Provisions
a. All terms of this contract shall apply to any and all subcontractors of Contractor who are in any
way paid with HOPWA fiends or who perform any work in connection with Contractor's program.
b. The provisions of this agreement are severable, and, if for any reason 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 j
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.
4±� i
XXX HOPWACNT.DOC July 16,2004 9 1
r
IN WITNESS WHEREOF,the parties h reto have execs ted thr, e copies of this contract in Fort
Worth, Tarrant County, Texas, this �'tn day of ,A.D. 20 .
CITY OF FORT WORTH Tarrant County Samaritan Housing,Inc.
By: VPV` r By:
Charles R. Boswell Mr. Steve Dutton
Assistant City Manager Executive Director
APPROVED AS TO FORM AND LEGALITY:
City Attorney
Date
ATTEST:
k4Vd� City Secretary
J �.
Cox rac uthor atioa
Date
XXX HOPWACNT.DOC July 16,2004 10
STATE OF TEXAS §
COUNTY OF TARRA]VT §
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 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 ay of ,A.D. 20 04'
r��`vP�e�•, ROSELLABARNES
2r `O NOTARY PUBLIC
'A f*= State of Texas
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 Mr. Steve Dutton, 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 Tarrant County Samaritan Housing, Inc. and in
the capacity therein stated as its duly authorized officer or representative.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this ay o -A.D. 20 ZI
�iCLINTON;P"rui "q-e
otary Pu . w"i7i an f r
WTwn� a nATE0FT State'of�Texas
COMMON Exnites:
SEPTEMBER 7,2005
IZ
XXX HOPWACNT.DOC July 16,2004 11
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 § 574.300 (c). Contractor agrees that in
connection with this contract:
a. It will not discriminate against any employee or applicant for employment on the basis of religion and
will not limit employment or give preference in employment to persons on the basis of religion.
b. It will not discriminate against any person applying for any of the eligible activities under this part on
the basis of religion and will not limit such housing or other eligible activities or'give preference to
persons on the basis of religion.
c. It will provide no religious instruction or counseling, conduct no religious services or worship, engage
in no religious services or worship, engage in no religious proselytizing, and exert no other religious
influence in the provision of eligible activities under this part.
d. Assistance will not be provided to a project sponsor that is a primarily religious organization to
construct or acquire a structure.
EXHIBIT A
PROGRAM SUMMARY
Tarrant County Samaritan Housing, Inc.
AGENCY
Samaritan House
PROGRAM
00000 June 1, 2004-May 31, 2005 $242,539
CONTRACT NO. PERIOD AMOUNT
PROGRAM DESCRIPTION
HOPWA funds are used to provide residential housing , health care and supportive social services for
individuals with HIV/AIDS in order to prevent homelessness.
COUNCIL DISTRICT (S)
ALL
PROGRAM GOALS
Prevent homelessness for individuals with HN/AIDS
PROGRAM OBJECTIVES
Provide housing for 65 clients (unduplicated); Provide medical care/case management and home health
care services for 65 clients.
PROGRAM SERVICES and ACTIVITIES GOALS
Number Unduplicated Clients Served 65
Number Client Units of Medical Case Management; 5,100
Number Client Units of Attended Health Care 8970
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PROGRAM BUDGET EXHIBIT C
HOPWA
2004-2005 Page 1 of 3
CONTRACT PERIOD From: 6/1/2004 To: 5/31/2005
Name of Sub Grantee Name of Program }
TARRANT COUNTY SAMARITAN HOUSING,INC SAMARITAN HOUSE
Program HOPWA
Cost Category Budget Funds [a] b] c [d
ADMINISTRATIVE SERVICES
Salaries 141,877 11,000 7,075 8,150 - 115,652
FICA 10,854 810 541 624 - 8,879
Health Insurance 18,000 1,500 373 800 - 15,327
Worker's Comp 1,500 250 205 25 - 1,020
Life. Disability. Dental 1,750 375 376 125 - 874
State Unemployment 2,256 240 408 79 - 1,529
Office Supplies 3,500 300 3,012 188
Liability Insurnace 6,212 2,000 3,400 812
Rent(Building) 5,850 - - 5,850
Office Equipment Rental 2,250 500 1,750
Printing - - -
TOTAL ADMIN EXPENSES 194,049 16,975 8,978 16,215 - 151,881
%Administrative Cost 14.9% 7.0% 4.0% 6.6% 0.0%
SUPPORTIVE SERVICES
Salaries 427,589 156,055 77,000 87,922 22,590 84,022 it
FICA 30,778 11,900 5,479 6,726 1,728 4,945
Health Insurance 48,000 14,350 13,605 6,500 550 12,995
Worker's Comp 8,250 3,684 2,020 2,000 250 296
Life.Disability. Dental 13,070 3,600 2,601 2,492 198 4,179
State Unemployment 6,744 4,275 1,638 - 675 156
Water/Waste Disposal 8,019 - 1,500 6,519
Rent(Building) 119,954 - - 32,000 87,954
Office Supplies 5,598 4,200 600 798 �.
Office Equipment Rental 7,563 4,500 - 2,387 676
Telephone 11,400 - 2,400 - 9,000
Repairs 42,200 2,000 40,200
General Supplies 12,200 4,000 5,475 2,725
Liability Insurance 43,388 14,000 17,008 12,380 ''
Legal&Accounting 13,635 5,000 - 8,635
Private Auto Allowance-Local 4,607 4,607
All Other and Contractual Services 303,360 - 84,296 91,267 127,797
OPERATIONS -
Rent/Mortgage/Utilities Payments
I
TOTALI 1,300,404 1 242,539 1 224,600 1 247,509 1 25,991 1 559,765
MATCHING FUND SOURCES
[a] RYAN WHITE 1&2 [c] STATE SERVICES
[b] HOPWA SNAP [d] FUNDRAISING/Etc.
BUDGET DETAIL FOR SPECIFIED MONTHLY EXPENSES Page 2 of 3
PERSONAL SERVICES
Hourly Annual %of
Position/Title Rate Hours Time Amount
1 Executive Director 33.17 2080 5.1% 3,500
2 Director of Finance 20.55 2080 9.4% 4,000
3 Administrative Asst. 14.49 2080 11.6% 3,500
4
5 -
TOTAL STAFF SALARIES $ 11,000.00
FRINGE BENEFITS
%of % Paid % Paid
CATEGORY Payroll Amount by Agency by Grant Amount
FICA 7.65% 10,854 92.5% 7.5% 810
Insurance 12.68% 18,000 91.7% 8.3% 1,500
Worker's Comp 1.05% 1,500 83.3% 16.7% 250
SUTA 3.00% 2,256 89.4% 10.6% 240
Life,Disability,and Dental Ins 1.24% 1,750 78.6% 21.4% 375
TOTAL FRINGE BENEFITS $ 3,175.00
TOTAL PERSONAL SERVICES (Total Staff Salaries+Total Fringe Benefits) $ 14,175.00
BUDGET DETAIL
STAFF SALARIES -SUPPORTIVE SERVICES
Hourly Annual %of
Position/Title Rate Hours Time Amount
1 Kitchen Mgr/Cook(Spears) 15.43 2080 15.6% 5,000
2 Cook(Guzman) 11.00 2080 52.4% 12,000
3 Prep Cook(Guzman) 9.00 2080 26.7% 5,000
4 Medical Case Manager(Sapp) 22.46 2080 43.9% 20,500
5 Caretaker 10.00 2080 62.5% 13,000
6 Resident Care Att-(RCA) 12.98 2080 51.9% 14,000
7 Resident Care Att-(RCA) 9.90 2080 68.0% 14,000
8 Resident Care Att-(RCA) 9.50 2080 70.9% 14,000
9 Resident Care Att-(RCA) 9.50 2080 70.9% 14,000
10 Resident Care Att-(RCA) 9.50 1248 50.6% 6,000
11 Resident Care Att-(RCA) 9.50 2080 70.9% 14,000
12 Assistant Case Manager(Stults) 17.58 2080 16.4% 6,000
13 Associate Exec Director(Lovato) 21.63 2080 41.2% 18,555
TOTAL STAFF SALARIES $ 156,055.00
FRINGE BENEFITS-SUPPORTIVE SERVICES
%of % Paid by % Paid by
Category Payroll Amount Agency Grant Amount
FICA 7.65% 30,778 61.3% 38.7% 11,900
Insurance 13.74% 48,000 70.1% 29.9% 14,350
Worker's Compensation 1.93% 8,250 55.3% 44.7% 3,684
SUTA 3.00% 6,744 36.6% 63.4% 4,275
Life, Disability, Dental Ins. 3.75% 13,070 72.5% 27.5% 3,600
TOTAL FRINGE BENEFITS $ 37,809.00
ITOTAL PERSONAL SERVICES(TOTAL STAFF SALARIES+TOTAL FRINGE BENEFITS) $ 208,039.00
BUDGET DETAIL FOR SPECIFIED MONTHLY EXPENSES Page 3 of 3
UTILITIES
% Paid % Paid
Category Amount by Agency by HOPWA Amount
Telephone
Electric
Water/Waste Disposal
TOTAL UTILITIES 0
BUILDING RENTAL
% Paid % Paid
Building Location Amount by Agency by HOPWA Amount
1 -
2 -
3 -
TOTAL BUILDING RENT -
OTHER EXPENSES
% Paid % Charged
Category Amount by Agency To HOPWA Amount
Insurance: P & L $ 48,600 67.1% 32.9% 16,000
Legal and Accounting $ 13,635 63.3% 36.7% 5,000
General Supplies $ 12,200 67.2% 32.8% 4,000
Office Supplies $ 9,098 50.5% 49.5% 4,500
TOTAL OTHER EXPENSES 0 $ 29,500.00
CONFERENCES &SEMINARS
Total % Charged
Event Charges to HOPWA Amount
1
TOTAL CONFERENCES & SEMINARS 0
OFFICE EQUIPMENT RENTAL
% Paid % Charged
Item Amount by Agency to HOPWA Amount
Copier/Computer Lease $ 9,813 49.0% 51.0% 5,000.00
TOTAL OFFICE EQUIPMENT RENTAL $ 5,000.00
Total Other $ 34,500.00
EXHIBIT "D"
AUDIT SCHEDULE
INDEPENDENT AUDIT REQUIREMENT
BUSINESS/AGENCY NAME: Tarrant County Samaritan Housing, Inc.
PROGRAM: Samaritan House
HOPWA YEAR: XXX
AMOUNT FUNDED: $242,539
Name of Independent Auditor who will perform agency audit:
Independent Auditor to be contracted during HOPWA contract period.
Date audit is to be performed:
Within 60 days of completion of HOPWA 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 HOPWA
funds in an amount proportional to that of the HOPWA 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
ATTACHMENT 1
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DIVISION
REQUEST FOR FUNDS
AGENCY: Tarrant County Samaritan Housing,Inc.
929 Hemphill PROGRAM NAME: Samaritan House
Fort Worth,TX 76104 CONTRACT NUMBER:
CONTRACT AMOUNT:
CONTRACTDATE:
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) $ $
11.Advance Pay Requests/Repayment $ $
III.Reporting Interest
1. Interest over$25 per quarter returned to City of Fort Worth $ $
SECTION 11(CITY)
I.BYSPEED—Purchasing Request
A. BYSPEED INPUT:Vendor/PO Number/Requisition Number:
B. Fund/Account/Center: GR76/
C. Total Amount of this Request: $
SECTION III
I. Verification
A. Contract Manager Tamika Miller
(Name) (Signature) (Date)
B.BYSPEED—Purchasing
(Name) (Signature) (Date)
C.Accounting
(Name) (Signature) (Date)
II.Authorization
A. Agency
(Name) (Signature) (Date)
B. IAGM Supervisor D.Emerson
(Name) (Signature) (Date)
C. Budget Administrator B.Garrett
(Name) (Signature) (Date)
DISTRIBUTION:
I Copy-Accounting
I Copy-IAGM
I Copy-Agency
I
CITY OF FORT WORTH ATTACHMENT
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DIVISION
DETAIL STATEMENT OF COSTS
Tarrant County Samaritan House
AGENCY CONTRACT NO. DATE
Supportiv Housing TO
PROGRAM REPORT PERIOD
PROGRAM MONTHLY CUMULATIVE
COST CATEGORY ACCOUNT BUDGET EXPENDITURES TO DATE BALANCE
ADMINISTRATIVE EXPENSES
Salaries 616 010
FICA 518 010
Health Insurance 518 050
Worker's Comp 518 060
Retirement 518 040
Office Supplies 521 010
Postage 521 020
Telephone 535 040
Rent[Building] 537 010
Office Equipment Rental 537 030
Printing 533 030
ADMINISTRATIVE EXPENSES SUB-TOTAL
ADMINISTRATIVE EXPENSES PERCENT OF TOTAL COST = %
SUPPORT SERVICES
Salaries 516 010
FICA 518 010
Health Insurance 518 050
Worker's Comp 518 060
Retirement 518 040
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
Contractual Services 539 120
OPERATIONS
Rent/Mortgage/Utilities Payments 539 120
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 the
NAME and TITLE OF AUTHORIZED OFFICER SIGNATURE and DATE
PREPARE ONE FORM FOR EACH SOURCE OF FUNDS
DISTRIBUTION:
1 Copy-Accounting
1 Copy-IAGM
1 Copy- Agency
2 IA&GM FORM May 2009
ATTACHMENT 3
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
CONTRACT MANAGEMENT DMSION
EXPENDITURES WORKSHEET
Tarrant County Samaritan Housin)Z,Inc.
Agency Contract Number Date
Samaritan House TO
Program REPORT PERIOD
NO DATE CHECK PAYEE DESCRIPTION ACCOUNT NO. AMOUNT
NO.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
i
22
23
24
26
TOTAL
TITLE OF AUTHORIZED OFFICER SIGNATURE and DATE
DISTRIBUTION
I Copy-Accounting
I Copy -IAGM
Copy -Agency [AGM FORM 2003
3
ATTACHMENT4
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
I. Tarrant County Samaritan Housing,Inc. 2.Project Name: Samaritan House
929 Hemphill 3.Contract No: Contract Date:
Fort Worth,TX 76104 Contract Amount:
4.Date of Request:
MONTH&YEAR
1. PROGRAM SERVICES AND ACTIVITIES: CURRENT CUMULATIVE
2. SCOPE OF WORK NARRATIVE:
3. PROBLEMS ENCOUNTERED/SOLUTIONS PROPOSED:
4. ANTICIPATED ACTIVITY DURING THE NEXT MONTH:
CERTIFICATION: The undersigned hereby gives assurance that to the best of my knowledge and belief,the data included in this report
is true and accurate,and if a non-profit agency,has been approved by the governing body of the organization prior to submission.
Date: Submitted by: Phone Num:
I-AGM/May 2003
HOPWA
ATTACHMENT 4A
CITY OF FORT WORTH
INTERGOVERNMENTAL AFFAIRS AND GRANTS MANAGEMENT
HOPWA
PROGRAM SERVICES AND TENANT-BASED RENTAL ASSISTANCE
1.NAME AND ADDRESS OF SUB-GRANTEE 2. PROJECT NAME: Samaritan House
Tarrant County Samaritan Housing, Inc. 3. CONTRACT No: Contract Date: June 1, 2003
929 Hemphill I�
4. DATE OF
Fort Worth,TX 76104 REQUEST:
MONTH&YEAR
5. PROGRAM SERVICES AND ACTIVITIES
CURRENT
MONTH CI AiULATrV E
Number of unduplicated clients:
(Example:Case Mgmt./Client Advocacy/Access to Benefits/Seryices)
Provide tenant-based rental assistance payments:
Provide short term rental,mortgage,and utility payments:
6. DIRECT BENEFIT DATA(HOUSEHOLD AND/OR PERSONS SERVED)
WHITE BLACK HISPANIC ASIAN PACIFIC AMERICAN TOTAL
NON-HISPANIC NON-HISPANIC ISLANDER INDIAN FEMALE-HEAD-
ALASKAN OF HOUSEHOLD !�
NATIVE
Current Month
Cumulative
7. TENANT-BASED RENT
SRO 0 BDRM 1 BDRM 2 BDRM 3 BDRM 4 BDRM 5+
CURRENT MONTH
CUMULATIVE
8. RENT MORTGAGE UTILITIES
SRO 0 BDRM 1 BDRM 2 BDRM 3 BDRM 4 BDRM 5+
CURRENT MONTH
CUMULATIVE
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:
-IAGM/May 2003
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.orq/council_packet/Reports/mc_print.asp 6/14/2004
Page 2 of 3
Meals on Wheels $33,696.00
Senior Citizen Services of Tarrant County (RIVERSIDE) $15,271.00
Mental Health Association (OMBLIDSMAN) $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.cfwnet.org/council_packet/Reports/mc_print.asp 6/14/2004