HomeMy WebLinkAbout2003-253N 1%
CHILDREN'S SERVICES ADVISORY COMMITTEE
C/O Human Services J
1840 25`" Street
Vero Beach , Florida 32960-3394
Phone : 561 -567-8000 (Ext. 467 or 524)
Fax: 978-1798
E-Mail : Jcadson(cDbcc.co. indian-river.fl . us
Mmastersonabcc.co. indian-dver.fl . us
To : Beth Jordan
From : Joyce Johnston-Carlson
Date : October 16 , 2003
Re : Grant Contracts 2003 - 04
The attached is a Children ' s Service Advisory Committee Grant Contract for:
Substance Abuse Council of IRC Life Skills Training Program
Please review the insurance certificate and verify that it is adequate by signing on the line
below. Contact me if you have any questions . Thank you.
Beth Jordan Date 3 3
Indian River County Grant Contract
This Grant Contract (" Contract" ) entered into effective this 1st day of October 2003 by and between
Indian River County, a political subdivision of the State of Florida , 1840 25th Street, Vero Beach FL ,
32960 (" County" ) and Substance Abuse Council of IRC ( " Recipient" ) ;
of: (Address )
Substance Abuse Council of IRC
2501 27th Avenue , Suite A-7
Vero Beach , Florida 32960
Dasie Hope Program
Background Recitals
A. The County has determined that it is in the public interest to promote healthy children in a
healthy community.
B . The County adopted Ordinance 99- 1 on January 19 , 1999 (" Ordinance" ) and established the
Children 's Services Advisory Committee to promote healthy children in a healthy community
and to provide a unified system of planning and delivery within which children ' s needs can be
identified , targeted , evaluated and addressed .
C . The Children 's Services Advisory Committee has issued a request for proposals from
individuals and entities that will assist the Children ' s Services Advisory Committee in fulfilling
its purpose .
D . The proposals submitted to the Children ' s Services Advisory Committee and the
recommendation of the Children ' s Services Advisory Committee have been reviewed by the
County .
E . The Recipient, by submitting a proposal to the Children ' s Services Advisory Committee , has
applied for a grant of money (" Grant" ) for the Grant Period ( as such term is hereinafter
defined ) on the terms and conditions set forth herein .
F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period ( as
such term is hereinafter defined ) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and
other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged ,
the parties agree as follows :
1 . Background Recitals The background recitals are true and correct and form a material
part of this Contract.
2 . Purpose of Grant The Grant shall be used only for the purposes set forth in the
complete proposal submitted by the Recipient attached hereto as Exhibit "A" and
incorporated herein by this reference ( such purposes hereinafter referenced as " Grant
Purposes " ) .
3 . Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal
year 2003/2004 ( " Grant Period " ) . The Grant Period commences on October 1 , 2003
and ends on September 30 , 2004 .
— 1 —
4 . Grant Funds and Payment The approved Grant for the Grant Period is Sixty Five
Thousand Dollars ( $65 , 000 ) . The County agrees to reimburse the Recipient from
such Grant funds for actual documented costs incurred for Grant Purposes provided in
accordance with this Contract. Reimbursement requests may be made no more
frequently than monthly . Each reimbursement request shall contain the information , at
a minimum , that is set forth in Exhibit " B" attached hereto and incorporated herein by
this reference . All reimbursement requests are subject to audit by the County . In
addition , the County may require additional documentation of expenditures , as it
deems appropriate .
5 . Additional Obligations of Recipient.
5 . 1 Records . The Recipient shall maintain adequate internal controls in order to
safeguard the Grant. In addition , the Recipient shall maintain adequate records fully
to document the use of the Grant funds for at least three ( 3 ) years after the expiration
of the Grant Period . The County shall have access to all books , records , and
documents as required in this Section for the purpose of inspection or audit during
normal business hours at the County' s expense , upon five ( 5) days prior written
notice .
5 . 2 Compliance with Laws . The Recipient shall comply at all times with all applicable
federal , state , and local laws , rules , and regulations .
5 . 3 Quarterly Performance Reports . The Recipient shall submit Quarterly Performance
Reports to the Human Services Department of the County within fifteen ( 15 ) business
days following : December 31 , March 31 , June 30 , and September 30 .
5 . 4 Audit Requirements . If Recipient receives $25 , 000 or more in the aggregate from
all Indian River County government funding sources , the Recipient is required to have
an audit completed by an independent certified public accountant at the end of the
Recipient' s fiscal year. Within 120 days of the end of the Recipient' s fiscal year, the
Recipient shall submit the audit to the Indian River County Office of Management and
Budget. The fiscal year will be as reported on the application for funding , and the
Recipient agrees to notify the County prior to any change in the fiscal period of
Recipient . The Recipient acknowledges that the County may deny funding to any
Recipient if an audit required by this Contract for a prior fiscal year is past due and has
not been submitted by May 1 .
5 . 4 . 1 The Recipient further acknowledges that, promptly upon receipt of a
qualified opinion from its independent auditor, such qualified opinion shall
immediately be provided to the Indian River County Office of Management and
Budget. The qualified opinion shall thereupon be reported to the Board of
Commissioners and funding under this Contract will cease immediately . The
foregoing termination right is in addition to any other right of the County to
terminate this Contract .
5 . 4 . 2 The Indian River County Office of Management and Budget reserves
the right at any time to send a letter to the Recipient requesting clarification if
there are any questions regarding a part of the financial statements , audit
comments , or notes .
5 . 5 Insurance Requirements . Recipient shall , no later than September 23 , 2003 ,
provide to the Indian River County Risk Management Division a certificate or
certificates issued by an insurer or insurers authorized to conduct business in Florida
2 -
that is rated not less than category A-: VII by A. M . Best, subject to approval by Indian
River County' s risk manager, of the following types and amounts of insurance :
( i ) Commercial General Liability Insurance in an amount not less than
$ 1 , 000 , 000 combined single limit for bodily injury and property damage ,
including coverage for premises/operations , products/completed operations ,
contractual liability, and independent contractors ;
( ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000
per occurrence combined single limit for bodily injury and property damage ,
including coverage for owned autos and other vehicles , hired autos and other
vehicles , non-owned autos and other vehicles ; and
( iii ) Workers' Compensation and Employer' s Liability ( current Florida statutory
limit)
5 . 6 Insurance Administration . The insurance certificates , evidencing all required
insurance coverages shall be fully acceptable to County in both form and content,
and shall provide and specify that the related insurance coverage shall not be
cancelled without at least thirty ( 30) calendar days prior written notice having been
given to the County . In addition , the County may request such other proofs and
assurances as it may reasonably require that the insurance is and at all times
remains in full force and effect. Recipient agrees that it is the Recipient' s sole
responsibility to coordinate activities among itself, the County, and the Recipient's
insurer( s) so that the insurance certificates are acceptable to and accepted by
County within the time limits set forth in this Contract. The County shall be listed as
an additional insured on all insurance coverage required by this Contract, except
Workers' Compensation insurance . The Recipient shall , upon ten ( 10 ) days' prior
written request from the County , deliver copies to the County , or make copies
available for the County' s inspection at Recipient' s place of business , of any and all
insurance policies that are required in this Contract. If the Recipient fails to deliver or
make copies of the policies available to the County ; fails to obtain replacement
insurance or have previous insurance policies reinstated or renewed upon
termination or cancellation of existing required coverages ; or fails in any other regard
to obtain coverages sufficient to meet the terms and conditions of this Contract, then
the County may , at its sole option , terminate this Contract.
5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County , its
agents , officials , and employees from and against any and all claims , liabilities ,
losses , damage , or causes of action which may arise from any misconduct, negligent
act, or omissions of the Recipient, its agents , officers , or employees in connection
with the performance of this Contract .
5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter
119 , Florida Statutes ( Public Records Law) in connection with this Contract.
6 . Termination . This Contract may be terminated by either party , without cause , upon
thirty ( 30 ) days prior written notice to the other party. In addition , the County may
terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the
Recipient if the County determines that such termination is in the public interest.
7 . Availability of Funds . The obligations of the County under this Contract are subject
to the availability of funds lawfully appropriated for its purpose by the Board of
County Commissioners of Indian River County .
3 —
8 . Standard Terms . This Contract is subject to the standard terms attached hereto as
Exhibit C and incorporated herein in its entirety by this reference .
IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date
first above written .
INDIAN RIVER COUNTY BOARD OF COUNTY
COMMISSK RS
By : '
e net t, Chairman
Attest: J . K. Barton , Clerk
By .
f 32�%kLi
Deputy Clerk
7
Approved : 1- -'
meshandler, County Ad istrat
/ariaZA�/ell ,,�.4,6sisi(aKt �County�P�o
or legal sufficienc
ey
RECIPIENT :
Substance Abuse Council of IRC
2501 27th Avenue , Suite A-7
Vero Beach , Florida 32960
By :
Name
r
� XeL 64 ,�e Are C /J- '
Title
4 -
a
EXHIBIT A
[Copy of complete proposal/application ]
- 1 -
Substance Abuse Council of Indian River County Dasie Hope Program Children Services Advisory Committee
PROGRAM COVER PAGE
9
Organization Name : Substance Abuse Council of IRC
Executive Director: Colette Heid, MS . Ed, CAPP Email : sacirc(a),bellsouth.net
Address : 2501 27th Avenue, Suite A-7 Telephone : (772) 770-4811
Vero Beach, F132960 Fax : (772) 770-4822
Program Director: Verna Wright Email :
Address : 8465 62Ave. Telephone : (772) 589-3535
Wabasso , F132970 Fax : (772) 770-4811
Program Title : Dasie Hope Program
Priority Need Area Addressed: Latchkey Safety Program JR- 820 .650-45
Brief Description of the Program : This projram is designed to help educate and ensure the
safety of youngsters who normally would have to stay unsupervised in their homes after school
or throught the day because their parents are working and child care is unavailable.
Amount Requested from Funder for 2003 /04 : $ 65 , 000
Total Proposed Program Budget for 2003 /04 : $ 140 , 000
Percent of Total Program Budget : 46 . 4 %
Current Funding (2002 /03 ) : $ 25 ,000
Dollar increase/( decrease) in request : $ 40 , 000
Percent increase/(decrease) in request : 160 . 0 %
Unduplicated Number of Children to be served Individually :
Unduplicated Number of Adults to be served Individually : -
Unduplicated Number to be served via Group settings : 100
Total Program Cost per Client : 1400 . 00
Will these funds be used to match another source? No
If yes , name the source :
Amount : $ -
The Organization 's Board oofDirectors has approved this application on date). May 22, 2003
( : A ;40
ro / / ''n /o l � t
Name of President/Chair of the B and 1 e
o IeAc 'cl
Name of Executive Director/CEO Signature
�d
` SAC / DASIE HOPE CENTER
PROPOSAL NARRATIVE
Please respond to each question in the allotted space for each section. In responding to each
section of the proposal narrative, please retain the section-label and/or question you are
addressing. Type using 12 pt. Font on 8 %i X 11 paper and number each page. These directions
and the graphic boxes may be deleted if space is needed.
A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page)
1 . Provide the mission statement and vision of your organization.
The Mission statement reads : Offering a nurturing environment where youth and adults can
learn, dream and aspire by developing their self-esteem and learning life survival skills.
Vision
Through a dedicated commitment from the community, become an agency that will inspire
residents to grow by improving their employability skills and filling them with a sense of self-
worth and pride.
2. Provide a brief summary of your organization including areas of expertise,
accomplishments and population served.
= The Dasie Hope Center was established on September 5 , 2001 in memory of Dasie Bridgewater
(a lifelong resident of Wabasso). Ms. Bridgewater gave back to the community by providing
food, clothing and shelter to those in need. The Center is committed to providing a sense of
community pride for the Wabasso residents by providing the youth a safe place to live to learn.
The Center is dedicated to providing Indian River County residents with the opportunity to
acquire educational and marketable employment skills, with special emphasis on an after school
program specially designed for children 7 to 18 . The areas of expertise assigned to the after
school program include:
• After-School Tutoring
• Computer Training and Desktop publishing
• Interpersonal Skill Development (Etiquette, Professional demeanor, Leadership)
• Peer Shadowing/Mentoring
• Reading Buddies Club
• Art classes
• Career development classes
• Basic financial skills class
• Life Skills Training program
• Substance Abuse Prevention classes
• GED program
• Girl Scouts
The population to be served includes all of the Wabasso community which is considered to
North Indian River County.
51
y SAC / DASIE HOPE CENTER
Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page)
1 . a) What is the unacceptable condition requiring change? b) Who has the need ?
c) Where do they live? d) Provide local, state or national trend data, with reference
source, that corroborates that this is an area of need.
Studies have shown that in rural and low-income areas, after-school programs are essential to
counteract the effects of factors that can contribute to youth ' s lack of opportunities and ability to
success academically (Posner and Vandell, 1994).
The total number of persons living below the poverty level in Indian River County is comprise of
over 11 .2% ( 12,650 individuals) of the county' s total population. A total of 20. 3 % of Indian
River County youth live below the poverty level. A higher portion of those persons living
below the poverty level live within the Wabasso community. Many of the households include
youth who also fall below the poverty level.
Additionally, a lack of public transportation is a major issue for the Wabasso community.
Access to locations that provide services are unavailable to Wabasso residents due to a lack of
transportation.
Community services are lacking with in the Wabasso community. The vision of the Dasie Hope
Center is to provide a sense of community pride by providing the youth a safe place to live and
to learn. The Dasie Hope Center will address, meet and hopefully revitalize the needs of the
Wabasso community by providing localized community services.
US Census Bureau Statistics 2000* for Indian River County are as follows:
Population: 112,947 (Over 25 % increase)
Persons under 18 : 19.2%
High School Grads : 51 ,000 (About 50%)
College Grads: 12,679 (About 10%)
Households w/ persons under 18 : 24.3 %
Persons below poverty level : 11 .2%
Children below poverty level : 20. 3 %
*Taken from quicacts. census. ov
2. a) Identify similar programs that are currently serving the needs of your targeted
population ; b) Explain how these existing programs are under-serving the targeted
population of your program.
Other programs dedicated to helping the Wabasso community include :
• Gifford Youth Activity Center
• The Boys and Girls Club of Sebastian
• Wabasso Head Start Program
Many of the youth who live in the Wabasso community do not have the necessary transportation
to travel to Sebastian or Gifford. Thus the youth are unable to acquire services from the
above mentioned programs. Almost all of the youth who utilize the Dasie Hope Center' s
services are latchkey kids. These youth would be forced to return to an unsupervised,
empty home after school if not for Dasie Hope Center. Our center is within walking
distance for most residents of Wabasso and has become an official school bus stop in the
Wabasso community.
s' z
SAC / DASiE HOPE CENTER
C. PROGRAM DESCRIPTION (Entire Section C. I — 6, not to exceed two pages)
1 . List Priority Needs area addressed.
Child Care Access
2. Briefly describe program activities including location of services.
The Dasie Hope Center is located at 8465 -62id Ave., Wabasso, Florida 32970. Due to its central
location, most youth receive services directly following school at the center. For example, our
present location is in front of four school bus stops, thereby allowing children to come safely and
directly to the Center after school.
Youth services are designed to be provided on site at the Center via the after-school program.
The youth arrive at the Center at 3 : 30 p.m. and remain until 6: 30 p.m. The following program
activities are carried out throughout the week, with numerous services occurring daily.
After-School Tutoring- Several retired teachers provide one on one tutoring Monday, Tuesday,
Wednesday and Thursday.
• Computer Training and Desktop publishing- An adult volunteer teaches computer training
classes on Tuesday.
• Interpersonal. Skill Development (Etiquette, Professionalism, Leadership} An adult volunteer
teaches Interpersonal Skill Development classes on Monday and Wednesday.
• Reading Buddies Club- Provided daily in conjunction with IRC School District and the
Charter High School Key Club
• Art classes- Volunteers from the Cultural Council provide instruction every Wednesday
• Basic financial skills class- An adult volunteer teaches Basic Financial Skills classes on
Thursday.
• Life Skills Training program- Substance Abuse Council staff provides Elementary Life Skills
Training every other Wednesday
• Substance Abuse Prevention classes- Substance Abuse Council staff Substance Abuse
Prevention Training every other Wednesday
• GED program- IRC School District provides a teacher on Tuesday and Thursday evenings
• Girl Scouts- Volunteer troop leaders conduct troop activities every other Tuesday
• Iadentorin - Volunteers provide services t0 youth on a monthly basis.
3. Briefly describe how your program intends to address the stated need/problem.
Include reference to any studies or evidence that indicate proposed strategies are
effective with target population.
Studies have shown that in urban and low-income areas, after-school programs are essential to
counteract the effects of a range of factors that can contribute to youth' s lack of opportunities
and ability to success academically (Posner and Vandell, 1994).
After-school programs have been called a key component # . . i
" n efforts to raise standards and
improve educational outcomes for all students." It has also been stated that "there is acritical
need for after-school programs in many communities . . . most in need come from disadvantaged
areas characterized by high unemployment and high crime rates. Youngsters in these settings
often lack opportunities to socialize in a safe environment, receive effective academic support, or
participate in sports or recreational activities.
5` 3
SAC / DASIE HOPE CENTER
The Dasie Hope Center' s program is designed to follow the methodology of improving academic
performance, teaching violence prevention through improved conflict resolution skills, reducing
incidents of violence both in and out of school. The curriculum is modeled after the structure of
national programs which include the following areas of study:
Language Arts : Reading Buddies Club is designed to increase literacy and language skills
Study Skills : After School tutoring is designed for at-risk students whose lack of study
and comprehension skills may hamper their academic achievement
Academic Subjects: Computer training is designed to teach basic computer skills
Tutoring: Students will participate in one-on-one literacy training sessions
Community Based: Inter-personal skill development is taught to students and youth are
encouraged to participate in community activities to help them learn how to become productive
community leaders.
4. List staffing needed for your program, including required experience and estimated
hours per week in program for each staff member and/or volunteers (This section
should conform with the information in the Position Listing on the Budget Narrative
Worksheet).
Position One - Director (40 hours per week)
The Board of Directors has approved Verna Wright to be the Center' s Program Director. Ms.
Wright worked for the Indian River County School District for 19 years and served as a Program
Director and Coordinator at the Gifford Youth Activity Center.
Paid Staff
Verna Wright 40 hours weekly.
Part-time Asst. ( 1 ) 32 hours weekly
Part-time Assist. (2) 32 hours weekly
Volunteers are utilized to provide all program services.
5. How will the target population be made aware of the program?
The target population is made aware of program services via newsletters, church announcements,
flyers posted in schools, parent support group presentations, civic league presentations, radio,
TV, door-to-door recruitment and referrals.
6. How will the program be accessible to target population (i.e. location, transportation,
hours of operation)?
The center is centrally located and within walking distance of many members of the targeted
population. The center hours are 10:00 a.m. — 6:30 p .m. Monday — Friday.
57q
SAC / DASIE HOPE CENTER
1)4 * FY03-04 MEASURABLE OUTCOMES (Entire Section D not to exceed two pages)
FY03-04 OUTCOMES ACTIVITIES
Add all the elements or the Measurable Outcomes Add the tasks to accomplish the Outcome(s)
1 . To increase academic performance of 1 . Conduct one-on-one tutoring sessions in all
enrolled youth by at least 30% during the 2nd academics subjects 5x ' s per week. Reading
semester following program participation will be major focus of tutoring with high
during the 2003 -2004 academic year. school, college students and
Baseline: Students 2003 academic record retired teacher's assistance. Pre & Post reading
tests will be administered to determine youth' s
reading levels and improvements.
3 . To decrease the number of disciplinary 3 . Conduct social skill, peer shadowing and
referrals of enrolled youth by at least 60% anger management classes for enrolled
during the 2nd semester following youth 4x per week for 12 weeks.
program participation during the 2003 - Professionals from within IRC will be
2004 academic year. Disciplinary reports matched with enrolled youth to develop
generated from within IRC School leadership and social skills. An incentive
District. system will be attached to this program to
encourage youth to perform and progress to
their highest level of excellence.
3 . To decrease the number of positive drug 4. Random drug screen will be conducted on
screens of enrolled youth by at least 50% middle and high school enrolled youth.
during the I " semester following program
participation during the 2003-2004 school
year.
FY0344 OUTCOMES ACTIVITIES
Add all the elemenaforyour Measurable Outcomes Add the tasks to acro lish the Outcome(s)
SAC / DAStE HOPE CENTER
E. COLLABORATION (Entire Section E not to exceed one page)
1 . List your program's collaborative partners and the resources they are providing to the
program beyond referrals and support. [NOTE : Collaborative agreement letters are
not required by United Way of Indian River County.]
Collaborative Agenty Resources provided to the program
Data collection and sharing
Indian river County School District
Youth snacks
Treasure Coast Food Bank
IRC Charter High School Youth key Club volunteers
IRCC Farm Workers Program Paid Staff
Volunteers
Cultural Council
Wabasso Friendly Lodge (Masons) space
SAC / DASIE HOPE CENTER
F. PROGRAM EVALUATION. (Entire Section F not to exceed two pages)
1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order
to accurately describe your target population including demographics (age, gender and
ethnic background) required by the funder in Section H ? What are the pieces of
information that qualify them for your target population ? How do you document their
need for services or their "unacceptable condition requiring change" from Section Bl ?
Youth participation will be tracked through daily attendance reports. Academic performance will be
tracked via a secure Access database. This database will report performance progress by grade level and
age and will be updated weekly.
Each boy and girl enrolled will have a one-on-one interview session with the Center Director and their
parent(s). A developmental profile of each student will be created and the youth will be matched with a
peer/mentor and receive tutoring.
An in house pre and post test will be administered to each enrolled youth. Progress and report cards will
be collected from the each youth distributed by IRC School District. (These reports are issued every 9
weeks). Youth will receive tutoring in areas of weakness as needed by volunteers from school district and
retired instructors.
Progress reports will be compared to the reports generated by the Dasie Hope Center to continue to adjust
requirements to ensure students' success.
Youth will be enrolled in life skills programs such as substance abuse prevention, etiquette classes, social
skills, mentoring and financial skills to make a successful transition into adulthood. Classes are offered
through Substance Abuse Council, Cultural Council, Indian River School District and professional
volunteers.
2. MEASURES : What data elements will you need to collect to show that you have
achieved (or made progress toward) your Measurable Outcomes in Section D? What
tools or items are you using as measures (grades, survey scores, attendance, absences,
skill levels) for your program? Are you getting baseline information from a source on
your Collaboration List in Section E ? Are there results from your Activities in Section
D that need to be documented? How often do you need to collect or follow-up on this
data?
An in house pre and post test will be administered to each enrolled youth. Progress and report cards will
be collected from the each youth distributed by IRC School District. (These reports are issued every 9
weeks). Youth will receive tutoring in areas of weakness as needed by volunteers from school district and
retired instructors.
Progress reports will be compared to the reports generated by the Dasie Hope Center to continue to adjust
requirements to ensure students ' success .
Youth will be enrolled in life skills programs such as substance abuse prevention, etiquette classes, social
skills, mentoring and financial skills to make a successful transition into adulthood. Classes are offered
through Substance Abuse Council, Cultural Council, Indian River School District and professional
volunteers.
517
SAC / DAS [E HOPE CENTER
3. REPORTING: What will you do with this information to show that change has
occurred? How will you use or present these results to the consumer, the funder, the
program, and the community? How will you use this information to improve your
program?
Attendance data will be collected daily and academic data will be collected weekly. There will be a folder
for each student that corresponds to his or her Access database file. Reports will be given to the Center' s
director weekly. The Director will review the progress reports and work with both the student and their
parent(s) to develop on-going development plans.
umber of 11 1 1 Clients by Location
p' � r � �' '+d.'t✓ rF3t -(?` Current
Budget
. 1 •
1 _ , �M 101MMIUMMI MM 1lrMR*M Undu licated
. ,Clients
1 11
1 11
• a 11 -
Numberof U11 11 1111licated Clients 1 '
x:
Current Fiscal Year PH
�
Locat 0111
RPM M
UO-
13",01114 = M
. . . .
• to 5 •
TOTALSERVED
Substance Abuse Council of IRC
UNIFORM GRANT APPLICATION
BUDGET NARRATIVE WORKSHEET
IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for
your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder
Spec Budget Forms.
AGENCY/PROGRAM NAME : Substance Abuse Council of IRC I Dasie Hope Program
FUNDER: Children Services Advisory Committee
CAUTION : Do not enter any irigures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should
be used for calculations and to write information only.
c ENCT4 llswrtPeoposed Total Program Funder Specific Total Agency
REVENUES Ilcalcro orrma
. .i Budget Budget Budget
1 Children's Services Council-St, Lucie 0.00 0.00
2 Children's Services Council-Martin 0.00 0.00
3 Children's Services Council-Okeechobee 0.00 0.00
4 Advisory Committee-Indian River 65,000.00 65,000.00 175,000.00
5 United Way-St, Lucie County 0.00 0.00 '
6 United Way-Martin County 0.00 0.00
7 United Way-Okeechobee County 0.00 0.00
8 United Way-indian River County 409000.00 0.00 86,000.00
9 Department of Children & Families 0.00 75,000.00
10 County Funds 0.00 19850.00
11 Contributions-Cash 309000.00 50,000.00
12 Program Fees 0.00 21 ,300.00
13 Fund Raising Events-Net 51000.00 25,000.00
14 Sales to Public - Net 0.00 8,x•00
15 Membership Dues 0.00 6v5OD.00
16 Investment Income 0.00 800.00
17 Miscellaneous 0.00 0.00
18 Legacies A Bequests 0.00 0.00
19 Funds from Other Sources 0.00 334,279.00
20a Reserve Funds Used for Operating 0.00 0.00
20b ln-Kind Donations (Not included in total) 0.001 1 0.00
21 TOTAL REVENUES (doesn'
Include line 20b) 1 1402000.00 $65,000.001 $783,729.00
A B C D
EXPENDITURES GMrPJWMF Proposed Total Program Funder Specific Total Agency
MENCT USE O1<r
tcxxUU1 Budget Budget Budget
22 Salaries - (must complete chart on next page) 62,452.00 47,476.00 402,470.00
Salary
23 FICA - Total salaries x 0.0765 7.65% 4,778.00 3,631 .00 30,789.00
24 Retirement - Annual pension for qualified staff 975.00 975.00 7,626.00
25 LifelHeaRh - Medica0ental/Short-term Disab. 0.00 0.00 29,400.00
26 Workers Compensation - # employees x rate 743.00 565.00 41790.00
Ronda Unemployment
27 employees x $7,000 x UCT-6 rate 0.00 0.00 5,000.00
5/26/2003 161
• Substance Abuse Council of IRC
SALARIES AGross Annual e C Funder �
Portion of Salary on Proposed % of Gross Annuaf
POSITION LISTING Salary Spectre Budget tea, RequestedJUA)
Position ride / Tobd HrsAvk (Agency)
Example: awe wive Meciart4ohra 7g0o0.Oo 10200000 5,OODOO 7. 149E
Executive Director -40 hrs/ wk 54,724.00 0.00 0.00°
Prevention Program Coordinator-40 hrs / wk 37,500.00 0.00 0.00 0.00%
LST Coordinator -35 hrs /wk/$16.5 301030.00 0.00 0.00%
PREVENT Program Coordinator-40 hrs ! wk 289000.00 0.00 0.00°
Peer Educator- 30 hrs /wk / $9 14,040.00 0,00 0.00°x6
Lifeskills Educator (1 ) - 33 hrs / wk/$13.75 23,595.00 0.001 0.00
Lifeskills Educator (2) -33 hrs / wk/$13.25 22,737.00 0.001 0.00%
Diversion Specialist -40 hrs / wk 279500.00 0.00 0.00°
HIV Program Coordinator-40 hrs / wk 28,500.00 0,00 0.00%
HIV Program Assistant -40 hrs / wk 25,500.001 0.00 0.00
Information Specialist- 30 hrs / wk/ $11 .50 173940.00 0.00 0.00 0.00
HIV Peer Educator- 24hrs / wk/ $10 12,480.00 0,00 0.00%
Case Manager - 24 hrs / wk $14.00 17,472.00 0.00 0.00%
Dasie Hope Coordiantor - 40 hrs / wk 32,500.00 323500.00 329500,00 186.01
Dasie Hope Assistant (1 ) - 32 hrs / wk/ $9 14,976.00 149976.00 149976.00 46.08
Dasie Hope Assistant (2) - 32 hrs ! wk/ $9 1 14,976.00 14,976.00 0.00 100.00%
0.00 0.00%
Remaining positions throughout the agency
Total Salaries $402,470.001 $62,452.00 $47,476.00 11 .80%
FRINGE BENEFITS DETAIL A
(Funder Specific Budget Funder a Persson D wort� une�loyme Total Fringes Funder
Column C on iY from tine 22 to 2, 7) Sped'ffc FM4 7M Heam ins
Budget
x-� taornperis. M Compens. Sped6c
Position Tide / Total H►sAvk
mw1ggw casemensgcrf4eMs 5,000.00 382.50 20000 500.00 300,001 200.00 1,582.50
Executive Director -40 hrs/ wk 0.00 0.00 0.
Prevention Program Coordinator-40 hrs / wk 0.00 0.
LST Coordinator -35 hrs /wk/$ 16.5 0.00 0.
PREVENT Program Coordinator-40 hrs / wk 0.00 0.00 0.
Peer Educator- 30 hrs /wk / $9 0.00 0.00 0.
Lifeskills Educator (1 ) - 33 hrs / wk/$13.75 0.00 0.
Lifeskills Educator (2) -33 hrs / wk/$ 13.25 0.00 0.00 0.
Diversion Specialist -40 hrs / wk 0.00 0.00 0.
HIV Program Coordinator-40 hrs / wk 0.00 0.00 O .ik
HIV Program Assistant -40 hrs / wk 0.00 0.00 O.Oc
Information Specialist- 30 hrs / wk/ $ 11 .50 0.00 0-24
HIV Peer Educator- 24hrs / wk/ $ 10 0.00 0.00 0.001
Case Manager - 24 hrs / wk $ 14.00 0.00 0.00 0.
Dasie Hope Coordiantor - 40 hrs / wk 32,500.00 21486.25 975.00 0.00 387.00 31848.2
Dasie Hope Assistant (1 ) - 32 hrs / wk/ $9 141976.00 19145.66 0.00 0.00 178.00 11323 .6
Dasie Hope Assistant (2) - 32 hrs / wk/ $9 1 0.001 0.00 O .OGj
0.00
0 0.001 0.00 0.00
0 O.Ool 0.00 0.00
0 1 0.001 0.001 0.00
Tota! Funder Request Fringe Benefits $47,476.001 $3,631 .911 $975.00 $0.00 $565.001 $0.001 $5, 171 .91
5!26/2003
Substance Abuse Council of IRC
A B C D
EXPENDITURES (MY AREMFOR Proposed Total Program Funder Specfic Total Agency
SHOVIDETALTO Budget Budget Budget
28 Travel-Daily 29400.00 11200.00 21 ,380.00
UW 292miles x 12months = 3500 miles
x .29=$1 ,015
SWAT 210 miles a month
LST 385 miles a month
DIV 300 miles a month
HIV 310 miles a month
Prevent 250 miles a month
RC 250 miles a month = 1705 miles a
month x 12 months =20,460 miles x .29
= $5,933 Ex Director 1050 miles a
month x 12 months= 12,600 miles x
# of Staff x average # of miles/wk x 50 wks x $ .32=$4,032 Van (Gas) $200 per week
= Estimated Daily Travel/Milmge Reimb. x52 weeks=$10,400
29 TravellConferenceslTralnirg 8,000.00 0.00 24,566.00
FADDA registration $250 Hotel
$150 per night x 3 nights = $450
$21 Per diem per day x 3 days = $63
250 miles x .29 = $72.50
Tolls $15 PRIDE $9000
Other Programs FADDA registration
$250 x 11 x 2 conf per year—$5500
Kids of TC Conference $50x11 =$550
Hotel $150 per night x 3 nights x 6
rooms x 2--$5400 $21 Per diem per
• National Conference (cost per staff) day x 3 days = $63 x 11 empotyees
=$693 x 2events=$1386 1000miles x
• Training/Seminar (cost per staff) .29 = $290
• Other Trainings (cost of travel, lodging, Tolls $100 other Airfare $360 x 2
registration, food) ltripsxc720 x 2 1440
30 Office Supplies 11000.00 600.00 62600.00
• Office supplies (monthly average x 12 months $50 x 12 months for UW =
= estimated cost of office supplies based on Other Programs $500 a month x 12
present history. months = $6000
31 Telephone 21500.00 11403.00 81460.00
7 Business lines x 32.00= 224 a month x
12 months= $2688
Long distance charges $120 per month x
12 months--1440
Cell phones 4 phones x $60 per fine per
month =240x 12 months= 2880
• # Phone lines x average cost per month x 12 Pages $8 per month x 12 employees
months = local phone cost =96 x t = 1152
Interne! connection $ 25 per month x 12
Average long distance calls x 12 months = months= $300
Estimated cost of long distance Web Hosting
32 Postage/Shipping 11000.00 500.00 41220.00
$ 170 every 2 months x 6 months= 1020
Bulk Mal $ 200 per month x 12
months= 2400
Quarterly Mailing of Newsletter Bulk real 1em-A $300
Post office Box Rental $200
• Special events, etc. Fed Ex or Airborne $25 per month x 12
• Bulk mailings - appeals months $300
33 t)tilkles 39000.00 2,400.00 41000.00
• Electricity ($ x 12 months)
• Water/Sewer ($ x 12 months) Utilities $333 per month x 12 months+
• Garbage ($ x 12 months) $4000
34 Occupancy (Building & Grounds) 2,500.00 21500.00 239028.00
• Mortgage/Rent ($ x 12 months)
• Janitorial ($ x 12 months)
• Grounds Maint. ($ x 12 months) Rent $1919 a month x 12 months
• Real Estate Taxes $930 not paid by grants
5rz6rz003 16 �
Substance Abuse Council of IRC
35 Printing & Publications 81000.00 0.00 41 ,400.00
• Quarterly Newsletter ($ x 4)
• Letterheads, Envelopes, etc. LefterhNewsletters $300 x 0 1200
• Fundraisin materials PRIDE Survey
$1200
9 PRIDE Survey $9000
• Other Other $30,000
36 Subscription/DuestMemberships 500.00 0.00 1 ,000.00
• Membership to National Organization FADDA $250 CADCA
• Dues $250
• Subscriptions to Newspapers/magazines, etc. Subscriptions $500
37 Insurance 21500.00 11000.00 10,071 .00
• Directors/Officers Liab.
• Commercial/General Insurance Auto $7821
• Bond Ins. Commercial Liability $1750
• Auto Insurance Employee Bond $500
38 Equipment: Rental & Maintenance 31500.00 11000.00 61000.00
, Copier Iose ($ x 12 months)
• Meter lease ($ X 12 months) Copier Main $150 x 12= 1800 DASIE
• Copier Maintenance ($ x 12 months) $50 x1200 Computer Main $
• Computer Maintenance ( $ x 12 months) 100 x 12 =1200 Other (Vehicle)
Other $200 per month x 12 months--2400
39 Advertising 21000.00 0.00 14,419.00
- Newspaper ads Ads $250 x 10=2500
• Fundraising ads/promotions other $500
• Other (vacancies) Promotions $2000 Bitiboards $4000
40 Equipment Purchases:Capital Expense 3,000.00 0.00 31000.00
• Computedmonitor (# x $)
- Laser Printer 2 computer systems wl monitors $1500
41 Professional Fees (Legal, Consulting) 0.00 0.00 21000.00
• Legal advice ( estimated #hrs x $)
• Consultant fees
• Other Consulting Fees $2,000
42 Books/Educational Materials 129092.00 11500.00 50,968.00
• BooksAddeos
• Materials ($ x staff) 11317.00
43 Food & Nutrition 1 ,560.00 0.00 11560.00
• Meals ( # meals x clients x 5days x 50 wks)
• Snacks Youth snacks $30 a week x 52 weeks
44 Administrative Costs 14,000.00 0.00 0.00
• Admin. Cost (% of total budget)
45 Audit Expense 21000.00 0.00 9,000.00
• independent Audit Review - 9,000.00
46 Specific Assistance to Individuals 500.00 0.00 51000.00
• Medical assistance
- Meals/Food
• Rent Assistance
• Other
47 Other/Miscellaneous 19000,00 250.00 6,350.00
Background checks $32 x 5= 160
Bmag keens $38 x 5= 190
• Background check/drug test
• Other Drug Screen Kits $500 per month x
12=$6000
48 OthertContract 0.00 0.00 31 ,500.00
Program AWARE $90 per session x1
session per week x 50 weeks=$4,500
Right Choice $ 90 per session x4
sessions per week x 50 weeks = $18,000
Lifeskiils Tr•ainings $750 per 2 day
training x 2 a year= $3000
• Sub-contract for program services Prevent 50 psychosocials x $60= 3000
49 TOTAL EXPENSES $ 140,000.00 $65,000.00 753 , 729. 00
5/2&2003
Type Cie Orgarzebm lord Program Name
UNIFORM GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCY/PROGRAM NAME: Substance Abuse Council
FY 0102 FY 02103 FY 03104 % INCREASE
FYE _Sept 30,2003 FYE Sept 30,2004 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (COL CKat Byes. 6
REVENUES BUDGETED BUDGETED
t Children's Services Council-St Lucie 0.00 0.00 0.00 0.00%
2 Children's Services Council-Martin 0.00 0.00 0.00 0.00%1
3 Children's Services CounciloOkeechobee 0.00 0.00 0.00 0.00%
4 Advisory Committee-Indian River 75 000.00 110 000,00 175 000.00 59.09%
5 United Way-St Lucie County 0.00 0.00 0.00 0.00%
6 United Way-Martin County 0.00 0.00 0.00 0.00%
7 United Way-Okeechobee County 0.00 0.00 0.00 0.00%
8 United Way4ndian River County 40A19.001 62 000.00 86 000.00 38.71 %
9 Department of Children & Families 75"0,00 75 000.00 7500000 0.00%
to County Funds 11850.00 19850.00 19850.00 0.00%
11 Contributions-Cash 47 594.00 50 000,00 50 000.00 0.00%
12 Program Fees 45 754.00 15 000,00 21 300.00 42,00%
13 Fund Raising Events-Net 36r256.001 25 000.00 25 000.00 0.00%
14 Sales to Public-Net 89071 ,00 81000100 8 000.00 0.00%
15 Membership Dues 61400.001 616W.00 6t500.001 0.00%
16 Investment Income 0.00 800.00 800.00 0.00%
17 Miscellaneous 0,00 0.00 0.00 0.00%
16 Legacies & Bequests 0,00 0.00 0.00 0.00%
19 Funds from Other Sources 282 848.00 314 19,00 334 279.00 6,38%
2oa Reserve Funds Used for Operating 0.00 0.00 0.00 0.00%
In4(ind Donations (wt kwkwed in tahil 0,00 0.00 0.00 0.00%
21 TOTAL 618192.00 668 369,00 783 729.00 17,26%
EXPENDITURES
22 Salaries 320 928.00 333 6.00 402 70.00 20.69%
23 FICA 27 .00 27 926.00 30 789.00 10,25%
24 Retirement 6,831 .00 41882,00 7 626.00 56.21 %
25 LifelHealth 20 381 ,00 43w200.00 29 400.00 31 .94%
26 Workers Compensation 31819,00 32967.00 479000 20.75%
27 Florida Unemployment 0.00 19500.00 5 000.00 233.33%
28 Travel4)aily 16152.00 15 028,00 21 380.00 42.27%
29 Travel/Conferences/Training 161"1 ,00 15 566.00 24 566.00 57.82%
3o Office Supplies 5l778.00 6j600.00 61600.00 0.00%
M Telephone 10 968.00 960000 8460.0041 .88%
32 Po efShi "n 21599,00 39000.00 4 220.00 40.67%
33 Utilities 3t629.00 3y"0.00 41000.00 9.89%
34 OccupancyBuilth & Grounds 23147.00 23 028.00 23 028.00 0.00%
35 Printing & Publications 18 936.00 41 400.00 41 400.00 0.00%
36 Subscriembershi s 599.00 1 000.001 000.00 0.00%
37 Insurance 51698.00 69971 .00 10 071 .00 44.47%
38 EquipmentwRental & Maintenance 2 76.00 5AW.00 69000.00 11 .11 %
39 Advertisinq 14 70.00 14 .00 14 419.00 0.13%
4o Equipment Purchases:Ca I Expense 0.00 12500.00 300000 100.00%
41 Professional Fees I Consulti 0.00 29000.00 22000.00 0.00%
42 Books/Educational Materials 50 18,00 51 885.00 50 968.00 -1 .77%
43 Food & Nutrition 0.00 11560.001 M 19560.001 0.00%
44 Administrative Costs 0.00 0,00 0.00 0.00%
45 Audit Expense 8 334.008 000.00 9 000.00 12.50%
46 Specific Assistance to Individuals 4108.00 M 31000.001 5 000.00 66.67%1
47 Other/Depreciation/Miscellaneous 16 951 .00 61350.00 635000 0.00%
48 Other/Contract 39120.00 28y600.00 3150000 10.53%
49 TOTAL 619 687.00 663 369.00 753 729.00 13.62%
50 REVENUES OVE UNDER EXPENDITURES -11496.00 52000.00 302000.001 500.00%
srzerzoM ® s
Type " Orgmush n &W Program Nb
UNIFORM GRANT APPLICATION
TOTAL PROGRAM BUDGET
AGENCYIPROGRAM NAME: Substance Abuse Council I Dasie Hope Pr ram
FY 01102 FY 02103 FY 03004 % INCREASE
FYESept 30, 2002 FYESept 30 92003 FYESept 30, 2004 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (COL Cia. eyca. e
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0.00 0.00 0.00 #DIV/01
2 Children's Services Council-Martin 0.00 0.00 0.00 #DIVIO!
3 Children's Services Council-Okeechobee 0.00 0.00 0.00 #DIVIO!
4 Advisory Committee-Indian River 0.00 25 000.00 65 000.00 160.00%
5 United Way-St Lucie County 0.00 0.00 0.00 #DIVIO!
6 United Way-Martin County 0.00 0.00 0.00 #DIVIO!
7 United Way-Okeechobee County 0.00 0.00 0.00 #DIV/01
6 United Waywindlan River County 0.00 20 000.00 40 000.00 100.00%
9 Department of Children & Families 0.00 0.00 0.00 #DIVIO!
to County Funds 0.00 0.00 0.00 #DIVIO!
11 Contributions-Cash 21 358.0046 690.00 30 000.00 35.75%
12 Pr ram Fees 0.00 0.00 0.00 #DIV/o!
13 Fund Raising Events-Net 0.00 2,000,00 500000 150.00%
14 Sales to Public-Net 0.00 0.00 0.00 #DIV101
15 Membership Dues 0.00 0.00 0.00 #DIVIO!
16 Investment Income 0.00 0.00 0.00 #/D1V/01
17 Miscellaneous 0.00 0.00 0.00 #DIVIO!
19 Legacies & Bequests 0.00 0.00 0.00 #DIV/0!
19 Funds from Other Sources 0.00 0.00 0.00 #DIV/0!
20a Reserve Funds Used for Operating 0.00 0.00 0.00 #DIVIO!
lob In-Kind Donations pwe :wknwintato 0.00 0.00 0.00 #DIVIO!
21 TOTAL 21 358.00 9369000 140 000.00 49.43%
EXPENDITURES
22 Salaries 15M8.001 45 000.00 62 462.00 38.78%
23 FICA 1 164.00 3A43,00 41778.00 38.77%
24 Retirement 0.00 0.00 975.00 #DIV/01
25 Life/Health 0.00 0.00 0.00 #DIVIO!
26 Workers Compensation 181 .00 536.00 743.00 38.62%
27 Florida Unemployment 0.00 0.00 0.00 #DIVIO!
28 Travel-Daily 0.00 12015.00 29400.001 136.45%
29 TravellConferences/Training 0.00 31483.00 81000.00 129.69%
30 Office Supplies 827.00 11124.00 19000.00 41 .03%
31 Telephone 450.00 1 V500,00 250000 66.67%
32 PostagelShipping 0.00 600.00 11000.00 66.67%
33 Utilities 360.00 19600.00 31000.001 87.50%
34 Occupancy Buildin & Grounds 10.00 120.00 2500.00 1983.33%
35 Printing & Publications 158.00 69000.00 800000 33.33%
36 Subscription/Dues/Memberships 0.00 250.00 500.00 100.00%
37 Insurance 0.00 11500.00 222a 66.67%
38 EquipmentRental & Maintenance 0.00 69800.00 3,500.001 -48.53%
39 Advertising 0.00 0.00 21000.00 #DIV/0!
40 Equipment Purchases:Ca ital Expense 0.00 0.00 32000.00 #DIVIO!
41 Professional Fees al Consulting) 0.00 0.00 0.00 #DIV/0!
42 Books/Educational Materials 0.00 8 000.0012 092.00 51 .15%
43 Food & Nutrition 3j000.00 31000.00 11560.00 48.00%
44 Administrative Costs 0.00 9".00 14 000.00 49.43%
45 Audit Expense 0.00 0.00 21000.00 #DIV/0!
46 Specific Assistance to Individuals 0.00 0.00 500.00 #DIV/O!
47 Other/Miscellaneous 0.00 350.00 1 1000.00 185.71 %
48 Other/Contract 0.00 0.00 0.00 #DIVIO!
49 TOTAL 21 368.00 93t690.001 140s000.00 49.43%
50REVENUES OVE UNDER EXPENDITURES 0.00 0.001 0 .001 #DIVIO!
sxrzoo3 � 10
Type ft Orgarkaton and Program Name
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCY/PROGRAM NAME : Substance Abuse Council / Dasie Hope Program
FUNDER: Children Services A B C
FY 03/04 FY 03/04 % INCREASE
TOTAL FUNDER TOTAL VS.
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET col. Wool. A)
EXPENDITURES
22 Salaries 627452.00 47 476.00 76.02%
23 FICA 4 778.00 3y631 mOO 75.99%
24 Retirement 975.00 975.00 100.00%
25 Life/Health 0.00 0.00 #DIV/0!
26 Workers Compensation 743.00 565.00 76.040/6
27 Florida Unemployment 0.00 0.00 #DN/01
28 Travel-Daily 29400 .00 11200a00 50 .00%
29 Travel/Conferencesrrrainin 8 000 .00 0.00 0 .00%
30 Office Supplies 17000 .00 600.00 60.00%
31 Telephone 2 500.00 1740100 56.12%
32 Postage/Shipping 11000 .00 500.00 50.00%
33 Utilities 37000w00 2 400.00 80.00%
34 Occupancy ( Building & Grounds 21500 .00 27500000 100.00%
35 Printing & Publications 87000800 0.00 0 .00%
36 Subscription/Dues/Memberships 500 .00 0.00 0.00%
37 Insurance 2 500.00 1 000.00 40.00%
38 Equipment: Rental & Maintenance 31500w00 19000.00 28 .57%
39 Advertising 2 000.00 0.00 0 .00%
4o Equipment Purchases :Ca ital Expense 3 000.00 0.00 0 .00%
41 Professional Fees (Legal, Consulting) 0.00 0 .00 #DIV/01
42 Books/Educational Materials 12 092.00 1550100 12 .40%
43 Food & Nutrition 11560.00 0 .00 0 .00%
44 Administrative Costs 149000 .00 0 .00 0 .00%
45 Audit Expense 29000.00 0 .00 0 .00%
46 Specific Assistance to Individuals 500 .00 0 .00 0 .00%
47 Other/Miscellaneous 19000 .00 250 .00 25.00%
48 Other/Contract 0 .00 0 .00 #DN/0 !
49 TOTAL $ 140,000 .00 $659000.00 46 .43%
5262003 67
. 1 1 • 1 • t • t
t � t t • 1
_ szn
r _ -ss-,s� s.�t .�"a�" � �"+1 .-s " `° 1 7 � �" �>S' �- •. 'i r
s3 w+ } •�^�. 4: lr =1-s...-�. 3d .�:T'3 �J ' i� ,f.� � "rS,_ S • < �'..> 'e �.
F'_" i `�u"- 3 .s�4."sa.
-
. / 1
. • 1
increased f • 1request due to increase 1 r ;ram services
: •
• •
increase uest due to increase in program services
• 1 1
• • 1
• • 1
• 1
� • 1
: • 1
: •
: • 1
: • 1
/ y
���-Add�rhomla - - hi. require increased hourly salarv_ e)1 • Y wndrespective FICA
: • 1
MIT
: • 1
� I • a • J • -� - • -1 xn - / • U 1 :., • irl
: • 1
/ -y. j / - 1 • . 1 / 1 h J - 1 MaM
Travel/Conferencesffraining !I t -J. • 11 ii• • 1 - h • • • 1 /
IFITM
1
• • • Y 1
SubscriptiordDues/Memberships ' • • r,If. • ' In
01W, 11 - 1MT-7""SI.
• • 1
• • 1
y Y
11 l M - • - • 1 • 1 -
: / Y
• 1
UNIFORM
APPLICATION• •
EXPLANATION FOR VARIANCES OF OR
FUNDED SPECIFIC BUDGET
AGENCYIPROGRAM NAME: Substance Abuse Council I Dasle Hope Program
Oar� F :s n.`� 2. -3 pt�'�t � � 1 �" -x X� u _ j � d fyt 15 e$ 0 d L° °' e(` t 1
�.{'d��i u'.?�i�'evs yak s` q>"` .� t..'_z„� s� r..- -✓fir
Salaries
Additional� � v _ seMoes require� - u hourly salary e)qxmses and COL
FICA Addiftional student services require inemased hourly salary expermes and respective FIGA
Rellrement Addkbml studentservicesrequirehJ. s • hourlyexpenses andrespective
p •
Workers compensation AddRional student services require increased hourly salary expenses and respective WC
XDIVAY 1
TraveI43aily Increasein mileage due to addRional servicesincreased travel
OfficeIncrease in Training due to need to train addifional program staff
Addkional studentf- require • • • supplies
Telephone Pro rated share d teLephone increase
PostagelfShipping Pro rated share of postage increase
utilities • ratedshare 1 '' utiliftes increase
• Changelocation
Insurance • ratedshare • ' irtsuranoe cost increase
-'
Equipmentitental & Maintenance Irailease to cover ir=ease cost involved wrth technology repairs
. : . 1
• 1
#w/o!
•
EXHIBIT B
[ From policy adopted by Indian River County Board Of County Commissioners on February 19 ,
2002 ]
" D . Nonprofit Agency Responsibilities After Award of Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis
only.
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check . Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the
Board of Commissioners . In the event an agency provides inadequate documentation on a
consistent basis , funding may be discontinued immediately . Additionally, this may adversely
affect future funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example , no expenditures prior to October 1St may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners .
All requests for reimbursement at fiscal year end ( September 30th) must be submitted on a timely
basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies
advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early
to mid October, since the Finance Department does not process checks for the prior fiscal year
beyond that point .
Each reimbursement request must include a summary of expenses by type . These summaries
should be broken down into salaries , benefits , supplies , contractual services , etc . If Indian River
County is reimbursing an agency for only a portion of an expense ( e . g . salary of an employee ) , then
the method for this portion should be disclosed on the summary . The Office of Management &
Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures . These expenditure types are
listed below .
a . Travel expenses for travel outside the County including but not limited to ; mileage reimbursement ,
hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel
(within Indian River County) is allowable .
b . Sick or Vacation payments for employees . Since agencies may have various sick and vacation
pay policies , these must be provided from other sources .
c. Any expenses not associated with the provision of the program for which the County has awarded
funding .
d . Any expense not outlined in the agency' s funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary . "
- 1 -
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices : Any notice , request , demand , consent , approval or other
communication required or permitted by this Contract shall be given or made
in writing , by any of the following methods : facsimile transmission ; hand
delivery to the other party ; delivery by commercial overnight courier service ;
or mailed by registered or certified mail (postage prepaid ) , return receipt
requested at the addresses of the parties shown below:
County : Joyce Johnston -Carlson , Director
Indian River County Human Services
184025 th Street
Vero Beach , Florida 32960-3365
Recipient : Verna Wright, Program Director
Dasie Hope Program
Substance Abuse Council of IRC
2501 27th Avenue , Suite A-7
Vero Beach , Florida 32960
2 . Venue ; Choice of Law : The validity , interpretation , construction , and effect
of this Contract shall be in accordance with and governed by the laws of the
State of Florida , only . The location for settlement of any and all claims ,
controversies , or disputes , arising out of or relating to any part of this
Contract , or any breach hereof, as well as any litigation between the
parties , shall be Indian River County , Florida for claims brought in state
court , and the Southern District of Florida for those claims justifiable in
federal court .
3 . Entirety of Agreement : This Contract incorporates and includes all prior and
contemporaneous negotiations , correspondence , conversations ,
agreements , and understandings applicable to the matters contained herein
and the parties agree that there are no commitments , agreements , or
understandings concerning the subject matter of this Contract that are not
contained herein . Accordingly , it is agreed that no deviation from the terms
hereof shall be predicated upon any prior representations or agreements ,
whether oral or written . It is further agreed that no modification ,
amendment or alteration in the terms and conditions contained herein shall
be effective unless contained in a written document signed by both parties .
4 . Severability : In the event any provision of this Contract is determined to be
unenforceable or invalid , such unenforceability or invalidity shall not affect
the remaining provisions of this Contract , and every other term and
provision of this Contract shall be deemed valid and enforceable to the
extent permitted by law. To that extent , this Contract is deemed severable .
5 . Captions and Interpretations : Captions in this Contract are included for
convenience only and are not to be considered in any construction or
interpretation of this Contract or any of its provisions . Unless the context
— 1 —
Y
V
indicates otherwise , words importing the singular number include the plural
number, and vice versa . Words of any gender include the correlative words
of the other genders , unless the sense indicates otherwise .
6 . Independent Contractor. The Recipient is and shall be an independent
contractor for all purposes under this Contract . The Recipient is not an
agent or employee of the County , and any and all persons engaged in any
of the services or activities funded in whole or in part performed pursuant to
this Contract shall at all times and in all places be subject to the Recipient' s
sole direction , supervision , and control .
7 . Assignment . This Contract may not be assigned by the Recipient without
the prior written consent of the County .
2 -
10 ' 09 ; 03 THU 08 : 59 FAX 7722114413 FELTEN & ASSOCIATES Z001
• . w — - DATE IMMMOMMI
ACUI4L , CERTIFICATE OF LIABILITY INSURANCE 10/08/2003
FkODVCER ( 772 ) 231- 282 $ FAX ( 772) 231 -4413 THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION
Felten & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND , EXTEND OR
2911 Cardinal Drive (32963 ) ALTERTHECOVERAGE AFFORDS 6Y THE POLICIES BELOW.
r
P . O . Bax 3485
Vero Reach , FL 32964 - 3458 INSURERS AFFORDING COVERAGE NA1C ;#
wsuRED Substance Abuse Council O Indian River County INSURER A: Colony Insurance
2501 27th Ave Ste A - 7 INSURER B: Progressive Express 10193
Vera Beach , FL 32960 INSUREM C: Commerce & Industry_ Insurance
INSUR5R D :
1 NS'JRER E: -�
COVERAGES
THE POLICIES OF INSURANCE LSTED BELOW 14AVE BEEN ISSUED TO THI INSURED NAMED ABOVE FOR THE POLICY PERIOD IPSOICATED NQTWITH57ANL!N
ANY REGUIF%ENENT, TERM OR CONDITION OF ANY CONTRk• T OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERT?,UJ, THE INSURANCE AFFORDED 8Y THE POI.ICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSI 'DNS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE L11W, TS SHOWN MAY HAVE HEEN REbUCED BY PAID CLAIMS , —
INSR OD' I POLICY EFFECTIVE POLICY EXPIRATION — LIMITS
LTATYPCOFINSURANCE , POLICY NUMBER aATC� /AltdtD
GU41ERALUABILIY MP71413 �F 04 /01/2003 04/01/2004 EACH OCCURRENCE -- S I, � Q0Q , 000
QALL4GE TO RENTED \ S 50 , 000
X COMMERCIAL GENERAL LIABILITY l A t C� E
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DESCRIPTICN OF CfCAA rIONS I LOCATIONS l Vlt410LES ; EXCLUSIONS ADDED BY EN0WEMbNT I SPECIAL PAWL310N9
ERTIFICATE HOLDER NAMED BELOW IS LISTED AS ' ADDITIONAL INSURED ' AS RESPECTS TO GENERAL LIABILITY AND
UTOP708ILE LIABILITY POLICIES LISPED ABOVt .
., = 30 days notice of cancellation applies to Workers Compensation only"
CERTIFICATE HQLDER _. CANC TION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CD.NCELLED BEFORE THE
EXPLRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Indian River
I� ITT
_ DAYS WREN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEF'. ,
County , Florida
Attn : Beth Jordan , Risk Manager BUT FAILURE TO MIULSUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
154D 25th Street OF ANY HIND UPON THB INSURER, ITS AGENTS OR REPRRSENTS`
'ATWE
Vero Beach , FL 32960 - 3365 AUTHORIZED P.EPRE:ENTATIVE
_ Kenneth D . Felten , LUTCF; LB
ACORN 25 (?.001 /08) �DACORD CORPORATION 1988
INTERNAL REVENUE SERV ' r DI ZTMENT OF THE TREASURY
DISTRICT DIRECTOR —
• 401 W . PEACHTREE ST . NW
T ATLANTA , OA 30365
Gate :
,� pN 27 1995 Emp l oyer Ident i fricat i on Number :
65 - 0202836
Case Number :
585009oss
SUBSTANCE ABUSE COUNCIL OF INDIAN Contact Persons
RIVER COUNTY INC LORETTA HAMILTON
PO BOX 6460 Contact Telephone Number :
VERO BEACH , FL 32961 - 6460 ( 404 ) 331 - 0927
• Our Letter Dated ;
April 25 , 1991
Addendum Applies .
Y •
No
Dear. Applicant :
This modifies our letter of the above date in which we stated that you
Hould be treated as an organization that is not a . private foundation until the
expiration of your advance ruling period .
'.` Your exempt status under section 501 ( a ) of the Internal Revenue Code as an .
organization described in section 501 ( c ) ( 3 ) is still in effect . Erased on the •
information you submitted , He have determined that you are not a private
foundation within the meaning of section 509 ( a ) of the Code because you are an
organization of the type described in section - 509 ( x ) ( 1 ) and 170 ( b ) ( 1 ) ( A ) ( vi ) .
Grantors and contributors may rely on this determination unless the
Internal Revenue Service publishes notice. to the contrary . However , if you
lose your section 509 ( a ) ( 1 ) status , a grantor or contributor may not rely on
this determination if he or she Has in part responsible for , or Has aware of ,
the act or failure to act , or the substantial or material change on the part of
the organization that resulted in your loss of such status , or if he or she '
acquired knowledge that the Internal Revenue Service had given notice that you
would no longer be classified as a section 509 ( a ) ( 1 ) 6organization ,
If we have indicated in the heading of this letter that an addendum
applies , the . addendum enclosed Is an Integral part of this letter .
Because this letter could help resolve any questions about your private
foundation status , please keep It In4your permanent records .
If you have any questi6ns , lease contact the
P person whose name and
telephone number are shown above .
Sincerely yours ,
��� Nelson A . Brooke
District Director