HomeMy WebLinkAbout2006-331N. INDIAN RIVER COUNTY
GRANT CONTRACT
This Grant Contract ("Contract") entered into effective thisday of October 2006, by and
between Indian River County, a political subdivision of the State of Florida; 1840 25t" Street, Vero
Beach , Florida, 32960-3365; and St. Peters Human Services , Inc. , ( Recipient), of:
St. Peters Human Services, Inc. ,
4250 381" Avenue
Vero Beach , Florida 32967
Village of Excellence Training Institute for Girls
Background Recitals
A. The County has determined that 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 proposal 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
(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 the Grant. The Grant shall be used only for the purposes set forth in the complete
proposal submitted by the Recipient, attached hereto as Exhibit Wand 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
2006/2007 ("Grant Period"). The Grant Period commences on October 1 , 2006 and ends on
September 30, 2007.
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4 . Grant Funds and Payment. The approved Grant for the Grant Period is: TWENTY SEVEN
THOUSAND DOLLARS ($27,000). The County agrees to reimburse the Recipient from such
Grant funds for actual documented costs incurred for the 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 Obligation 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 to written notice.
5.2 . Compliance with Laws. The Recipient shall comply at all times with all applicable
federal , state, and local laws and regulations .
5 . 3 . Quarterly Performance Reports. The Recipient shall submit quarterly, cumulative ,
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 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 the 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 the 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 October 21 , 2006 provide to
Indian River County Risk Management Division a certificate, or certificates, issued by an
insurer, or insurers, authorized to conduct business in Florida 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
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damage, including coverage for premises/operations ,
product/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) Worker's 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 the County. In
addition, the County may request such other proofs and assurances as it may
reasonable 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 Worker's 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.
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.
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IN WITNESS WHEREOF, County and Recipient have entered into this Contract on the date
first above written .
INDIAN RIVER COUNTY BOARD OF COMMISSIONERS
rY1 A A 0 1�
By:
Arthur R. Neuber Chairman
BCC Approved : /0 I
Attest: J . K. Barton, Clerk
By: c
Deputy Clerk
Approved :
Joseph A. Baird
County Administrator
Approved as to form and legal sufficiency:
rr '
rian E . Fell, Assistant County Attorney
REC NT:
By
: _�
St. Peters Human ery es, Inc.
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EXHIBIT A
(Copy of complete Request for Proposal)
EXHIBIT - A -
Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
PROGRAM COVER PAGE
Organization Name: Village of Excellence Training Institute for Girls
Executive Director: Pastor Andrew Jefferson E-mail :stpetersschool(a,bellsouth.net
Address: 4250 38th Avenue Telephone : 772-562-6863
Vero Beach, F132967 Fax: 772-562-8920
Program Director: Mrs. Darlene Jackson E-mail: Same as above
Address : Same as above Telephone :
Fax:
Program Title: Boy' s Developmental and Training Institute
Priority Need Area Addressed: To reduce juvenile delinquency and crime.
Brief Description of the Program: The program seeks to provide for school age children and teens (7-
16 years old) access to a weekend training program that offers recreation, academic supportself
esteem, character building and community services experience. The program also provides positive
role models through investors to equip the girls with knowledge about substance abuse, violence
pregnancy, abuse, hygiene and gang activity.
SUMMARY REPORT — (Enter Information In The Black Cells Only)
Amount Requested from Funder for 2006 / 07 : $ 53 ,449 . 11
Total Proposed Program Budget for 2006 / 07 : $ 53 ,449 . 11
Percent of Total Program Budget : 100 . 0 %
Current Program Funding (2005 /06 ) : $ 27 , 080
Dollar increase /( decrease ) in request : S 26 , 369
Percent increase /( decrease ) in request * * 97 . 4 %
Unduplicated Number of Children to be served Individually : 40
Unduplicated Number of Adults to be served Individually : -
Unduplicated Number to be served via Group settings : 40
Total Program Cost per Client : 668 . 11
* *If request increased 5 % or more, briefly explain why: The program is requesting an additional
$ 9,640:00 for food and $2,600.00 for transportation cost as indicated in the variance section of the
application.
If these funds are being used to match another source, name the source and the $ amount:
The Organization 's Board of Directors has approved this application on (date),
Andrew Jefferson
Name of President/Chair of the Board S"
e
Larry Taylor le
Name of Executive Director/CEO Signature
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Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
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 that you are addressing. Type
using 12 pt. font on 8 %" 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.
Mission Statement: St. Peter' s Human Services, Inc. ' s mission is to increase the success rate of
high risk students by providing educational support, drug awareness, and character education
through operation of a public school of choice. The organization works cooperatively with
established social programs to assist the targeted population of Indian River County to become
self sufficient members of society.
Vision: The St. Peter' s Human Services Corporation is a non religious, non denominational
organization in operation since December 1996. The Agency's vision is to address social
problems and needs in targeted areas of Indian River County, Florida. The agency is designed to
provide short and long tern services in the areas of affordable quality child/daycare services,
before and after school childcare, public school of choice for children with special needs who
may not be successful in the regular school system, youth intervention programs, and assisted
living care for certain targeted groups.
2. Provide a brief summary of your organization including areas of expertise,
accomplishments, and population served.
Since its incorporation, the agency has provided quality daycare services for families with
children ages zero to five years of age. The center also serves children who are Title 20 and
ALPI Certified. The agency has a chartered public school of choice, serving 90 to 100 "at-risk"
students of Indian River County. The Agency has also successfully implemented a Boy' s
Development and Training Program for the targeted population, ages 7 to 16. The program' s
highlights include organized drills, academic support, self esteem/character building, and
exploration and exposure to educational and recreational activities through field trips and
workshops. The Program is the only one of its kind the Indian River County.
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organization: St Peter's Human services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's service Council
B. 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.
a. The unacceptable condition is juvenile delinquency that leads to further lives of
crime, truancy, dropping out of school, pregnancy, sexual abuse, low self esteem, etc. because
the approach has been only to lockup the offenders without changing the behaviors.
b. The children in need are the at-ask females between the ages of 7 and 16 who are
discouraged learners, have low self-esteem, stressful family conditions, and have exhibited
problem behaviors, such as school disciplinary referrals, chronic school truancy, repeated school
suspensions, poor academic performance, a history of alcohol, tobacco and other drugs,
rebellion, running away, mental and emotional health issues and those with a history of
delinquent behavior.
c. In Indian River County, 90% of the at-risk females involved in the program are from
the surrounding community.
d. DJJ' s fact sheet on female juvenile offenders quoted Bill Bankhead, "We have a
growing problem with serious delinquency among girls . . . Girls need specialized attention and
direction on dealing with issues like peer pressure, self-image and goal setting. " There has been a
44% increase in the number of girls arrested annually for committing crimes during the past 10
years. (Percentage of boys only rose 12.5%). The number of girls arrested for violent felony
offenses doubled over the past ten years — and it is expected to continue to climb. In the DJJ
report, The Girls Initiative, it stated that girls have unique needs and problems, such as sexual
and/or physical abuse, teen pregnancy, poor academic performance and mental health needs. The
fact sheet on female offenders states, "The need for appropriate new programs for girls
continues. What happens to girls in the system is critical not only because of their large numbers;
girls ' circumstances are different than boys. The relevant issues to girls include avoiding teen
pregnancy, getting a good education, learning about health and hygiene, dealing with all kinds of
abuse, acquiring parenting skills, developing self esteem and being mentored by a female adult."
(www.djj .state.fl .us/statsnresearch/factsheets/femaleoffenders .html)
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.
There are two programs that serve the targeted population, however neither of the programs are
structured to address the additional areas provided through the Girl's Training Institute.
Ia. Gifford Youth Activity Center provides an afterschool program for all youth, not just
females . 1 b. The program does not provide many of the services rendered by our program i.e.
mentoring, community services, Life Skills, Drug Awareness and Character Education, overnight
stay on site, meals, recreational, and academic support and tracking the girls for six months after
successful completion of the program through DJJ, schools and parents.
2a. Hope Academy provides an alternative day program for suspended students from public
schools, while the Girl ' s Institute seeks to serve the social, emotional and academic needs of the
child, ensuring that all areas are addressed.
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Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages)
1 . List Priority Needs area addressed.
To reduce juvenile delinquency and crimes.
2. Briefly describe program activities including location of services.
Activities, Results, and Program Requirements: The following services will be provided/required
by the program: tutoring and academic instruction, counseling (rehabilitative, social, mental and
emotional), drills for discipline training, character and self esteem building classes, conflict
resolution and life skills and parenting classes, rap sessions to develop communication skills,
recreational activities, field trips, mentoring, guest speakers, etc . Overall results : reduced juvenile
delinquency and increased self esteem and responsibility . Process and Intended Outcomes —
Client Involvement from start to finish : Referrals are made by schools, local churches, parents of
enrolled girls from other partnering agencies. The girl is accepted into the program and must
participate on every level while attending. The girl ' s school attendance, records, etc ., are closely
monitored and discussed during the duration of the program. Above is a list of those areas
which the girl will participate. Expected Outcomes and Changes: The outcomes generally include
increased academic performance, decreased negative behavior, improved relationships among
peers, increased community awareness and increased awareness of substance abuse addiction,
pregnancy, and HIV risk factors. The outcomes that would benefit the community include
reduced juvenile delinquency, reduced crimes, increased responsibility as a citizen of the
community, etc . Follow-up: After successful discharge, the girls are followed up on a monthly
basis through DJJ for a total of six months. In addition, a concerned parent/school official is
encouraged to contact the program director if there are any situations that arise that might be
handled by the program director or counselors. The services are provided at St. Peter's
Missionary Baptist Church, 4250 38 h Avenue, Gifford/Vero Beach, FL 32967. The hours of
operation are from Friday, 4 : 30 p.m. through Saturday, 5 :00 p.m.
3 . Briefly describe how your program addresses the stated need/problem. Describe how
your program follows a recognized "best practice" (see definition on page 12 of the
Instructions) and provide evidence that indicates proposed strategies are effective with
target population.
The Village of Excellence Training Institute addresses the need to reduce juvenile delinquency
by providing a program for at-risk females who are affected by chemical addictions, violence,
poor family environment, and lack of social and academic skills, poor self esteem and other areas
in need of improvement in a female youth' s life. The focus of this program centers on addressing
these young female issues along the same lines as DJJ, as indicated in the editorial written by the
Secretary of DJJ, Bill Bankhead, where he stated (concerning the DJJ programs), "Individualized
resources that meet the needs of the particular juvenile and his or her family are provided. These
can include mental health counseling, substance abuse treatment and tutoring . . . to get everyone
working together positively on issues and to give the kids a way up and out of failure." When
looking at the Girl' s Institute, these areas have been addressed through a variety of mediums,
mentors, discipline training, academic accountability, tutoring, parental involvement, community
involvement (which increases ties to the community), mental health assessment and counseling,
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Organization: St- Peter's Human services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
substance abuse awareness and referral (if necessary), etc . The DJJ report on Community
Involvement indicated that evidence show that communities can deter juvenile crime by targeting
the key risk factors of truancy, school failure, access to weapons, not enough positive activities
to keep kids busy. It indicated that " . . . some of the same strategies that can prevent delinquency
from ever happening in a child' s life also can stop a juvenile offender from re-offending and
recycling back into the delinquency system." The articles closes with this statement: "No matter
how good an individual juvenile system program strives to be, a young person sooner or later
returns to his home community ." St. Peter' s Girl' s Program assists in diverting the girls ' lives
away from crimes in their communities. It is a community program that develops community
attachments for the youth while addressing the needs that placed the child at risk in the first
place. According to DJJ Secretary , Bill Bankhead, " . . . outreach must be done in the
neighborhoods where juvenile crime is high. " Govemor Bush said of the successful outreaches,
" . . . they focus on preservine the unity and integrity of family and emphasizing parental
responsibility in dealing with troubled youth." (_ ryvN djj . state. fl .us/features/runaways.html).
Delinquency prevention is paramount to DJJ' s plan, which includes three elements: targeting the
most at risk, cooperation between community- based programs working with the government to
approach families, and accountability through data collection and measurement of program
success. The Girl' s Institute does all three and goes beyond in preventing or reversing the
patterns and risk factors associated with delinquency while addressing specific female needs .
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).
1 — Administrator (PT, BA degree preferred, 2 yrs. experience working with at-risks children) .
Oversees the overall operation of the program, including data collection, quarterly-reporting and
financial management of the program. Supervise and oversee all staff, including book-keeping,
clerical, operations; must also meet with parents, teachers and outside agency representatives
regarding the program.
1 — Program Operations Manager (PT, Minimum HS diploma/equivalency, training in child
development, at least .2 years experience in working with at-risk children). Responsible for
overnight supervision of program. Will monitor institute teachers and trainers in addressing the
social and educational needs of the enrollees, ensuring a safe, nurturing environment conducive
to learning. House parenting for the weekend and assisting with data collected from schools and
teachers. Responsible for planning activities, working with institute staff, mentors and
volunteers.
2 — Institute Teachers (Part time. Must have education and experience in working with at-risk
children.) Will teach appropriate information addressing educational needs of enrollees during
program hours including computer instruction and reading clinic; will monitor progress and
maintain records.
1 — Institute Prevention Coordinator (BA degree in related field and/or 2 years of experience
in social setting working with youth. Knowledge of children and teaching basic skills.)
Recruitment and new referrals, handle data, planning, parent training, discipline, counseling,
Quarterly Reporting and assisting with data collection from schools including school visits, on-
site monitoring and coordination with teachers.
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Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
5. How will the target population be made aware of the program?
The program continues to provide awareness through word-of-mouth, advertisement, flyers,
local churches, parents of enrolled students, and through collaboration with other partnering
agencies.
6. How will the program be accessible to target population (i.e., location, transportation,
hours of operation)?
St. Peter' s Village of Excellence Training Institute for Girls is located in the heart of 90% of the
targeted population. The address is St. Peter' s Missionary Baptist Church, 4250 381h Avenue,
Vero Beach, FL. Transportation is provided by the parents and Institute staff when needed. The
program is open from Friday, 4 : 30 p.m. to Saturday, 5 : 00 p .m.
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Organization: St. Peter's Human Services, Inc. Prograrn: Village of Excellence Training Institute for Girls Founder: Children's Service Council
D. MEASURABLE OUTCOMES (Description oflntent)
Use the Measurable Outcomesform. This description VaZe does not need to be included in the propasaL
In order to show the impact that your program is having on the target population and the
community, the funders are requiring measurable outcomes. Please review the examples and
summaries below to insure your understanding of what is expected.
OUTCOMES: Describes what you want to achieve with the target population. Indicates the
results of the services you provide, not the services you provide. Outcomes utilize action words
such as maintain, increase, decrease, reduce, improve, raise and lower.
ACTIVITIES : Describes the tasks that will be accomplished in the program to achieve the
results stated in the outcomes. Activities utilize action words such as complete, establish, create,
provide, operate, and develop . The activities should reflect the services described in the
PROGRAM DESCRIPTION (C2).
Use the following elements to develop your outcomes. All elements must be included:
• Direction of change • Timeframe
• Area of change • As measured by
• Target population • Baseline: The number that you will be
• Degree of chane measuring against
Example 1 (Outcome) :
To decrease (direction of change) number of unexcused absences (area of change) of enrolled
boys and girls (target population) by 75% (degree of change) in one year (time frame) as
reported by the 2003 School Board attendance records (as measured by). Baseline : 2003 School
Board attendance records for enrolled boys and girls.
Example 1 (Activity) :
To provide anger management classes to enrolled boys and girls 2 times a week for 12 weeks.
Example 2 (Outcome) :
75% (degree of change) of youth (target population) who have participated in the academic
enrichment activities (as measured by) for 6 months or more (time frame), will improve
(direction of change) their scores in one or more subject area (area of change) . 25% of
participants in academic enrichment activities will maintain the initial level of performance
assessed at entry. Baseline : Pre-test scores from the academic enrichment test.
Example 2 (Activity) :
1 ) Provide pre and post-test exercises on the Advanced Learning System software; 2)
Participants will go through the one lesson per week and be graded for 10 weeks.
IMPORTANT NOTE :
Keep in mind when developing your PROGRAM OUTCOMES, that if funded, this will be what
you are held accountable to accomplish . Also, the PROGRAM OUTCOMES should reflect the
information described in the PROGRAM NEED STATEMENT (Bl ).
All Program Need Statements should flow from the Mission & Vision. Measurable Outcomes
should be based on and measure program needs. Activities are the tasks you do that are going to
influence the outcome and impact the unacceptable condition in your Program Need Statement.
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OrgItnization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
D, MEASURABLE OUTCOMES (Entire Section D not to exceed two pages)
OUTCOMES ACTIVITIES
Add all of the elements or the Measurable Outcome(s) Add the tasks to accomplish the Outcome(s)
OBJECTIVE #I : Improved academic Provide tutoring each week to enrolled girls
performance. Seventy-five percent (75%) of including a designated study hour each week
the program participants will increase their and classroom instruction each Saturday
GPA (grade point average) by a minimum of morning from 9 :00 a.m. to 12 : 00 p.m. in
25% by the end of the school term each year. critical core subject areas. Measuring tools —
Brigance Comprehensive Inventory of Basic
Skills pre-post test, report cards and progress
OBJECTIVE #2 : Decreased reports .
negative/disruptive behavior, Sixty five percent
(65 %) of the participants will reduce the
number of school behavior referrals for Provide rap sessions for enrolled girls weekly .
disruptive behavior, including bullying and Provide mentoring with positive role models
aggression toward peers and adults, as on a weekly basis . Provide character/self
measured by school disciplinary records and esteem training session, and conflict resolution.
weekly parent behavior report forms. Measuring tools : Entrance Behavior
Description Report — reviewed beginning, mid
OBJECTIVE #3 Raise Awareness level of and end of year-collect and monitor school
chemical addictions, STD and HIV for enrolled behavior and discipline forms.
girls. Eighty-five percent (85%) of the girls
will show increased knowledge of drug abuse Invite guest speakers from the Substance
addictions and effects, STD, and HIV by the Abuse Council, Indian River County Health
end of the program each year as indicated in Department, and other agencies. Training
pre and post surveys and questionnaires. sessions will be held by Substance Abuse
Council, IRC Health Department, and other
Agencies that will address alcohol, drug abuse,
STD, HIV, abstinence, etc. Measuring tools :
pre-post tests/questionnaire. The Institute will
hold a minimum of four sessions per year.
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Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
E. COLLABORATION Entire Section E not to exceed one page)
1 . List your program 's collaborative partners and the resources that they are providing to
the program beyond referrals and support. (See individual funder requirements for
inclusion of collaborative a reement letters.
Collaborative Agency Resources provided to the program
Substance Abuse Council Drug Awareness
Sheriff' s Department Scared Straight Jail Tour
i
IRC Health Department Sexually Transmitted Diseases
Gifford Youth Activity Center Seminar, "Raising Them Chaste"
Black Faith-Based Organization, Inc. Dance Competition and Talent Show
IRC Mental Health Center Referrals — Individual and Family Services
II
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Organization: St. Peter's Human services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
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 ?
The information to be collected includes : name, age ethnic background, birth date and grade. To
qualify for the target population, a prospective enrollee will be at-risk for at least two of the
following conditions: At-risk females between the ages of 7 and 16 who have exhibited at least
two of the problem behaviors as follows : school disciplinary referrals, chronic school truancy,
repeated school suspensions, poor academic performance, a history of alcohol , tobacco and other
drugs, rebellion, running away, mental and emotional health issues and those with a history of
delinquent behavior. The unacceptable condition is juvenile delinquency and is documented
through DJJ reports, school reports, parent reports, etc. This shall be documented and maintained
through a database and spreadsheet programs.
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?
Data will be collected from participants via progress reports/report cards on a nine week basis.
Copies of schedules and activities listing the study hour, rap sessions and dates and times of
guest speakers will be maintained on location. An entrance description of behaviors will be
maintained and reviewed quarterly for improvement. Upon exiting a program, a summary- of
progress made while attending the program will be documented. Measurement items include
grades, attendance sheets, progress reports, school conduct codes report, pre and post test reports,
counselor reports, prevention activity attendance sheets, etc . The progress report/report cards will
be collected every nine weeks and at the end of the semester. The schedule of activities will be
collected on an ongoing basis. The entrance and exit behavior description will be collected upon
entering and exiting the program. Progress notes on behavior improvement will be documented
quarterly or as needed. After successful discharge, there will be a monthly follow-up for six
months via parents, school and DJJ.
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?
The data will be compiled in a notebook under each activity and also copies of the
progress/report cards will be placed in each enrollee' s file. The information will be provided
upon request to any requesting agency, collaborative partners and the Human Service Board of
Directors.
12
Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
In areas where the increase in a positive attribute is low or minimal, the program director and
board will determine and research new ways to implement a more substantial increase in the
positive attribute. It will also be utilized to determine what is working so that it can be continued.
13
Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council
G, TIMETABLE (Section G not to exceed one page)
1 . List the major action steps, activities, or cycles of events that will occur within the
program year. New programs should include any start-up planning that may occur
outside the funding year. In completing the timetable, review information detailed in
prior sections.
Month/Period Activities
Weekly Tutoring — study hour and classes 9:00 a.m. — 12 :00 p.m. Saturdays.
Weekly Character/self esteem building sessions; community activities; conflict
resolution.
As needed - ongoing Life Skills sessions; rap sessions
Each nine weeks Academic improvement (progress reports and report cards)
Weekly — ongoing Reducing negative behaviors — through rap sessions, field trips,
seminars, training and mentoring.
Weekly Recreational activities and drills
Weekly Institute counseling and referrals.
14
Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute For Girls Founder: Children's Service Council
H. PROJECTIONS FOR UNDUPLICATED CLIENTS
Number of Unduplicated Clients by Location
Current Fiscal Year t
Location Budget 2005/06
Unduplicated Clients Unduplicated Clients Unduplicated Clients
N. Indian River County 29 40 40
S. Indian River County -
Indian River Co. Total 29 40 40
Greater Stuart - - -
Hobe Sound - - -
Indiantown - - -
Jensen Beach - - -
Pahn City - -
Martin County Total
Fort Pierce -
Port Saint Lucie - -
St. Lucie Co. Total -
Other Locations - - -
TOTAL SERVED 29 40 40
Number of Unduplicated Clients by Age
a� -
Current Fiscal Year Nexf.Fiscai 'Yea19r
Location
Budget 2005/06 Pro,echons,2006/07
=r.
In _: Individuals Group Indm
dual5 ' Group '
0 to 4 - (Pre-school) - - -
5 to 10 - (Elementary) - 11 - 25 25
I 1 to 14 - (Middle) - 11 - 15 15
15 to 18 - (High School) - - -
Total Children 22 40 - 40
19 to 59 - (Adults) - - -
60 + (Seniors) - - -
Total Adults -
TOTAL SERVED - 22 - 40 40
15
Edit this Header. Tyne the organintion and program name and the funder for whom it is being completed. The page # is already set at the bottom right
of every page.
I. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below.
I H
"Core Budget Forms"
16
Type the Organization anti Program Name
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 Specific
Budget Forms.
AGENCYIPROGRAM NAME : Village of Excellence Training Institute for Girls
FUNDER: Children's Services Council
CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should
I be used for calculations and to write information only. I
,�'�;E' Proposed Total Program Funder Specific 7Tot.alAgiency
REVENUES Budget Budget et
1 Children's Services Council-St Lucie
2 Children's Services Council-Martin
3 Advisory Committee4ndian River
4 United Way-St Lucie County 53,449.11 53,449.11 53,449. 11
5 United Way-Martin County
6 United Wa -Indian River County -
7 Department of Children & Families
8 County Funds
9 Contributions-Cash
10 Program Fees
11 Fund Raising Events-Net
12 Sales to Public - Net
13 Membership Dues
14 Investment Income
15 Miscellaneous -
16 Legacies & Bequests
17 Funds from Other Sources
18 Reserve Funds Used for Operating
19 In-Kind Donations (not included in total)
20 TOTAL REVENUES
(doesnl include line 19) $53.449. 11 $53,449. 11 $53,449. 11
A : . B C D
EXPENDITURES �Y�� Proposed Total Program Funder Specific Total Agency
KYMCY W
,a [pRY
> �a Budget Budget Budget
21 Salaries - (must complete Chart on next page) 36 ,872.001 36,872.001 36.872.00
-ASalary , r '=
22 FICA - Total salaries x 0.0765 > 7.6VA 2,820.71 2 ,820 .71 2,820.71
Retirement - Annual pension for qualitted
23 staff 0.00
Life/Health - e Ica enta ort-term
24 Disab. 0.66
Workers Compensation - # employees x
25 rate : , 0. 00
Florida nemp oymen - pro)e a
26 employees x $7,000 x UCT-6 rate
0.06
SALARIES G.oasAaln�aal °
�' C y o/ Gross Annual
POSITION LJST,ING , 5 j '• "Poraon o ¢alary on Proposed Funder Specific Budget Salary
PositlonTlde`-f�otrl,NrslCvlrRequested(GAJ- '-
Erample: 6cecuttvitNmctorl/afirs " ` `.70,00000 :i»'!�' ,. n. � ..'" 10,000.00 5.000.00 - 7.14%
srzzrzogs en
Type the Organization and Program Name
Program Director/Administrator 10 hrs 7,800.00 7,800.00 7,8WOO 10000
Po ram Operations Manager 25 hrs. 15,500.00 15,500.00 15,500.00 100. 00
Institute Prevention Coordinator - 12 Hrs. 9,360. 00 9,360.00 9,360.00 100. 00
(2) Institute Trainersrreachers - 6 hrs. 4,212.00 4,212.00 4,212.0 100.00%
#DIV/0!
#DIV/01
#DIV/0!
#DIV101
#DIVI01
#DIV101
#DIV/OI
#DIV/01
#DIVIOI
#DIVi01
#DIV/OI
#DIV/01
#DI V!C 1
#DIVIo !
#DIV'01
#DIViOI
Remaining positions throughout thea enc
Total Salaries $36.872. 00 $36.872.00 $36.872. 00 10C-.70`-4
FRINGE BENEFITS DETAIL A
(Funder Specific Budget Funder B c o E F G
- Pension Workers Unemployme Total Fringes Funder
Column C only, from line 22 to 27 Speck FICA 7.65% Heafdl ins.
y - Budget
(Ax X) Compens. nt Compens. Specific
Paskfon Tkk% Totrl f/rsAvk -
Ez Mjale, Case Owligr/40His 5,000.00 38250 200.00 500.00 300.00 200.00 1,582.50
Program Director/Administrator 10 hrs 7, 800.00 596.70 590. 70
Porgram Operations Manager 25 hrs. 15, 500.00 1 , 185.75 ' 'I '35 75
Institute Prevention Coordinator - 12 Hrs, 9, 360.00 716. 04 71 s. Ca
(2) Institute TrainersfTeachers - 6 hrs.
4.212 .00 322.22 12° . -'2
0 0 .00 0. 00
0 0 . 00 0. 00
0 0 .00 0. 00
0 0 .00 0.00 3 --
0 0 .00 0.00
0 000 0.00
0 0.00 0.00 � .
0 0 .00 0.00
0 000 0.00
0 0-00 0.00 O C6
0 0. 00 0.00
0 0.00 0.00 0 . 00
0 0. 00 0 .00 0 . 00
0 0. 00 0 .00 0 �r
0 1 0001 0 .00 10 S';
0 0, 00 0 .001 1 1 1 0 . 3C
Total Funder Request Fringe Benefits 1 $36,872. 001 $2, 820 .711 $0.001 $0.001 $0.001 wool 32 ,820 . 71
� ENDI l S aMV b FOR Proposed Total Program Riinder Speck Total Agency
Budget "- Budget Budget '
27 Travel-Daity
# of Staff x average # of milestwk x 50 wks x
$ = Estimated Daily TravelfMileage Reimb.
28 Travel/Confefences/Training
Type tlr Oryrura wand Prog v Name
• National Conference (cost per staff)
• Training/Seminar (cost per staff) '' -
• Other Trainings (cost of travel, lodging,
registration, food) � ' • - .` . ` -"- " ' .:.
29 Office Supplies ^'
• Office supplies (monthly average x 12 -
months = estimated cost of office supplies
based on present history. _
30 Telephone _?
• # Phone lines x average cost per month x
12 months = local phone cost -
• Average long distance calls x 12 months - -
Estimated cost of long distance
31 Postage/Shipping _
• Quarterly Mailing of Newsletter
• Special events, eta
• Bulk mailings - appeals
32 Utilities
• Electricity ($ x 12 months)
• WatedSewer ($ x 12 months) r
- Garbage ($ x 12 months)
33 Occupancy (Building & Grounds)
• Mortgage/Rent ($ x 12 months)
• Janitorial ($ x 12 months)
• Grounds Maint ($ x 12 months)
- Real Estate Taxes -
34 Printing & Publications
• Quartedy Newsletter ($ x 4)
• Letterheads, Envelopes, eta
• Fundraising materials -
- Other
35 Subscription/Dues/Memberships
- Membership to National Organization • �' - _
• Dues
• Subscriptions to Newspapers/magazines, -
etc.
36 Insurance
• Directors/Officers Liab.
• Commercial]General Insurance
• Bond Ins.
- Auto Insurance
37 Equipment:Rental & Maintenance
• Copier lease ($ x 12 months)
• Meter lease ($ x 12 months)
• Copier Maintenance ($ x 12 months)
• Computer Maintenance ( $ x 12 months) -
• Other
38 Advertising 500.00 500 .00 500.00
• Newspaper ads
• Fundraising ads/promotions
• Other (vacancies)
39 Equipment Purchases:Capital Expense
• Computerlmonitor (# x $)
• Laser Printer
40 Professional Fees (Legal, Consulting) ;. ��> _
• Legal advice ( estimated #hrs x $) _
- Consultant fees -
• Other
41 Books/Educational Materials 1 ,000.00 1 ,000.00 1 ,000.00
• Books/videos `. i ' <
• Materials ($ x staff) : NOW
42 Food & Nutrition - 9,656.40 9,656.46 9,656.40
B-1
5/2M"
Type the Organvalion wd Program Nemo
• Meals ( # meals x clients x 5days x 50 wks)
• Snacks
43 Administrative Costs
• Admin. Cost (% of total budget) - -
44 Audit Expense -
• Independent Audit Review -
45 Specific Assistance to Individuals
• Medical assistance -
• Meals/Food -
• Rent Assistance -
• Other
46 Other/Miscellaneous 2,600.00 2,600.00 2,600.00
• Background check/drug test
• Other/Transportabon
47 Other/Contract
• Sub-contract for program services
48 TOTAL EXPENSES S53.4-491 1 S53449 11 353.449. 11
522¢006 a-1
WIN 1111
AFFIRMATION ACTION PLAN
It is the policy of St. Peter' s Human Services , Inc. that no person shall
on the basis of race , color, national origin , marital status or handicap ,
be excluded from participation in , or be denied the benefits of, or be
subjected to discrimination under any program or activity receiving
state financial assistance , or be so treated on the basis of sex under
educational programs or activities receiving state assistance .
NEPOTISM STATEMENT
The St. Peter' s Human Services Agency, in the interest of good
practices and sound judgment, refrains from hiring family members as
listed in the Indian River County' s Nepotism Policy.
The Agency's Administrator and/or Board of Directors however, will as
does the Indian River County Personnel Director, and as indicated in
the Indian River County' s Nepotism Policy, at its discretion hire family
members if it is determined in the best interest of the Agency .
Vi i, 4 '
Authorized Principal
ar
Notary
i
Date
R171}i SSION # RSOP! � �}
r My COMMISSION # DO 19901:0
EXPIRES: May 6, 2007
eoeae rally pnaunw, nas
INDIAN RIVER COUNTY
l� +f PURCHASINGDIVISION
Q" 2525 ST. LUclEAVENUE
Q yVERoBEAcHFL 32960-3365
.�, (772) 567-8000 ExT 1416 FAX (772) 770-5140
REQUEST FOR PROPOSAL
PROJECT NAME: Children's Services Advisory Committee Grant Funds for
Children's Programs
RFP NUMBER: 2006061
REFER TECHNICAL QUESTIONS TO:
MARION MASTERSON
OFFICE OF HUMAN SERVICES
TELEPHONE: (772) 226-1524 FAx: (772) 978-1798
E-MAIL: mmasterson2airc ov. com
REFER GENERAL TERMS & CONDITIONS QUESTIONS TO:
JERRY DAVIS
PURCHASING MANAGER
TELEPHONE: (772) 567-226-1416 FAx: (772) 770-5140
E-MAIL: purchasingLa,iregov . com
BID OPENING DATE: MAY 24, 2006
BID OPENING TIME: 2:00 P.M_
ALL PROPOSALS MUST BE RECEIVED IN THE PURCHASING DIVISION
LOCATED AT 2525 ST, LUCIE AVENUE, VERO BEACH, FLORIDA 32960
PRIOR TO THE DATE AND TIME SHOWN ABOVE. LATE PROPOSALS WILL
BE RETURNED UNOPENED,
PLEASE SUBMIT ONE (1) ORIGINAL AND EIGHTEEN (18) COPIES OF YOUR
PROPOSAL
I
2006/07 CHILDREN ' S SERVICES ADVISORY
COMMITTEE
REQUEST FOR PROPOSAL ( RFP )
#2006061
RFP is to allow Not-for-Profit, For-Profit, Government Agencies and Individuals to apply
for funding to provide programs for Indian River County children.
Application form is available on "disk" (Microsoft Word & Excel) , and in print.
DELIVER THIS APPLICATION TO:
Indian River County Purchasing Division
2525 St, Lucie Avenue
VERO BEACH , FLORIDA, 32960
Phone : 772 -567- 8000 ; Ext. 1416
FAX: 772-770-5140
Mandatory Applicants Orientation Conference
May 53 2006 at 1 :00 p.m.
DEADLINE FOR SUBMITTING RFP
2:00 p.m.
Wednesday, May 24, 2006
II
TABLE OF CONTENTS
Introduction and Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . V
MissionStatement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . V
VisionStatement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . V
Overarching Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . V
Focus Areas, Goals & Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . VI
TimeTable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . VII
Disqualification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . VIII
Procedures and Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . VIII
EvaluationCriteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . VIII
Standards for Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . IX
Special Contract Terms and Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IX
Contract Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . IX
Period of Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . IX
Invoicing and Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . X
Nepotism. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . X
Not-for-Profit Agency Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . XI
Authorization for Release of Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XII
Sworn Statement — Disclosure of Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XIII
Supporting Documents Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . XVI
III
INDIAN RIVER COUNTY, FLORIDA
REQUEST FOR PROPOSAL
To allow Not for Profit, For Profit, Government Agencies and Individuals to apply for
funding, to provide programs for Indian River County Children.
RFP NUMBER : 2006061
DEADLINE TO SUBMIT: 2 : 00 p.m . May 249 2006
ADDRESS TO SUBMIT: Indian River County Purchasing Division
2525 St. Lucie Avenue
Vero Beach , Florida 32960
Phone : 772-567-8000, Extension 1416
MANDATORY ORIENTATION MEETING :
May 5, 2006, 1 : 00 p.m.
Indian River County Administration Building
1840 25"' Street
Vero Beach, Florida 32960-3365
Conference Room A
REQUESTS FOR INFORMATION :
Requests for information regarding this RFP should be directed to:
Human Services, Director, or
Marion Masterson
Indian River County Human Services
1900 27" Street
Vero Beach , FL 32960
Phone (772) 567-8000 Extension 1524
Fax (772) 978- 1798
Email address mmasterson(a)ircgov. com
DOCUMENT: Applicants shall submit one original packet, marked "ORIGINAL",
plus eighteen (18) copies of the RFP. Each complete copy of the RFP shall be in a
sealed, manila envelope, numbered "Copy #1 " through "Copy #18".
IV
INTRODUCTION & BACKGROUND
The Children's Services Advisory Committee of Indian River County was formed by
County Ordinance as an advisory board to the Indian River County Board of
Commissioners. The Children's Services Advisory Committee was created to plan and
coordinate social services for children and families in Indian River County. The
Children's Services Advisory Committee recommends funding for programs to the Board
of County Commissioners. The final decision for funding will be made by the Indian
River County Board of County Commissioners.
The Children' s Services Advisory Committee is seeking programs that provide services
to the children and families of Indian River County. These programs are documented as
needed in the community. Priority needs areas are designated by the needs
assessment conducted by Indian River County. Applications are accepted. from:
governmental agencies , for-profit, and not-for-profit organizations; and from individuals.
MISSION STATEMENT
The mission of the Children's Services Advisory Committee is to facilitate and coordinate
the planning and development of an effective and collaborative health and human
services delivery system to meet the needs of the children and families of Indian River
County.
The Children's Services Advisory Committee strongly supports cultural diversity and
encourages its funded programs to demonstrate the inclusion of all children and families
in program development and implementation.
VISION STATEMENT
The efforts of the Children' s Services Advisory Committee will insure the development of
a shared vision for the health and human services delivery system in Indian River
County enabling funding sources and providers to define and perform their roles in a
dynamically changing environment.
OVER-ARCHING OUTCOMES
Improve the capacity of children in Indian River County to succeed to adulthood in a
safe, healthy and productive manner.
Support caregivers — a child's most important resource — to be and do what is needed to
shepherd children to adulthood in a safe, healthy and productive manner.
V
FOCUS AREAS , GOALS & OBJECTIVES
FOCUS AREA I: Mental Wellness Issues
GOAL: Improve the capacity of children in Indian River County to succeed to adulthood
in a safe, healthy, and productive manner.
OBJECTIVES :
Ages: 0-5
Increasing programs that promote enhanced emotional-social skills :
• Increasing early intervention services for "border line" children-
physical/emotional.
Age 6-12
Increasing programs that promote enhanced emotional-social skills .
Increasing early intervention services for "border line" children-
physical/emotional.
• Increasing primary prevention for substance abuse education .
Ages 13-15
• Promoting life skills training emotional-social skills .
• Increasing primary prevention for substance abuse education .
Ages 16- 18
• Promoting independent living skills.
• Promoting accessible locations for healthy activities .
FOCUS AREA ll : Parental Support and Education
GOAL: Support caregivers, a child's most important resource , to be and do what is
needed to shepherd children to adulthood in a safe, healthy, and productive manner.
OBJECTIVES :
Ages 0-5
Promoting programs that focus on "individual" parenting programs.
• Increasing clinical psycho-educational training for special needs children
(behavioral , emotional , and physical needs) .
Ages 6-18
• Encouraging interactive parent/child enrichment programs.
• Encouraging agencies to provide age appropriate parenting support programs.
FOCUS AREA III : Childcare Access
GOAL: Improve the capacity of children in Indian River County to succeed to adulthood
in a safe, healthy, and productive manner.
GOAL: support caregivers, a child's most important resource , to be and do what is
needed to shepherd children to adulthood in a safe, healthy, and productive manner.
OBJECTIVES:
Ages 0-5
• Increasing the availability of affordable quality childcare .
Ages 6-15
Increasing access to affordable extended/after school programs .
• Increasing access to cultural and ethnic activities.
• Increasing tutorial and mentoring programs.
FOCUS AREA IV: Health and Dental Care, Including Nutrition
GOAL: Improve the capacity of children in Indian River County to succeed to adulthood
in a safe, healthy, and productive manner.
Vi
GOAL: support caregivers, a child's most important resource, to be and do what is
needed to shepherd children to adulthood in a safe, healthy, and productive manner.
OBJECTIVES;
Ages 0-5
Increasing health and nutritional access
Increasing programs which address identification of special needs
Ages 6-15
• Promoting health and nutritional programs.
Increasing programs which address identification of special needs.
TIMETABLE
1 . RFP Applications Available on April 26, 2006. Applications will be mailed on
April 26, 2006, or may be picked up Monday through Friday between the hours
of 8:00 a. m . and 4: 00 p.m . at the Indian River County Purchasing Division , 2525
St. Lucie Avenue , Vero Beach , Florida (Phone: 567-8000; Ext. 1416)
2. Applicants Orientation Conference. May 57 2006 at 1 :00 p.m. The Orientation
Conference will be held in the Indian River County Administration Building , 1840
25th Street, Vero Beach , FL. , Conference Room A. All prospective applicants are
required to attend.
3. Proposals Due on May 24, 20063 2:00 p.m., to the Indian River County
Purchasing Division , 2525 St. Lucie Avenue, Vero Beach, Florida (Phone: 567-
8000; Ext. 1416).
4. An official authorized to bind the applicant to the proposed activity must sign the
proposals. Applicant's audit should be included in the RFP (if available) .
5. Copies Required . Each submission must include one ( 1 ) original proposal,
marked "Original" , plus eighteen ( 18) copies, marked , "Copy #1 " though "Copy
#18" . All proposals must be received in a sealed packet.
6. Grant Review Sub-Committee' s Recommendations for Funding are approved, or
disapproved, by the Children's Services Advisory Committee in June, 2006; and
presented to the Board of County Commissioners at the Budget Hearings, July
2006 .
7. Contract Dates are from October 1 , 2006 through September 30, 2007 .
VII
DISQUALIFICATION
Any one, or combination of, the three items listed below, will disqualify an applicant from
further consideration as a qualified applicant.
1 . Failure to include proof of ability to obtain all required liability insurance having
Indian River County Commissioners as an additional insured , contained in the
contract attached to the proposal
2. Failure to include the proper number of copies of the application .
3. Failure to submit proposal within the stated time frame.
PROCEDURES AND REQUIREMENTS
• All applicants are required to attend the Applicants' Orientation Conference on
May 51 2006, 1 :00 p.m., Indian River County Administration Building , 1840 25'"
Street, Vero Beach , FL, Conference Room A. The purpose of the meeting is to
go over the application , general requirements, and for staff to respond to any
questions. After this meeting all questions and answers shall be reduced to
writing , and mailed to all attendees.
• All agencies, or individuals, receiving a grant will be required to mention Indian
River County as a funder, or partial funder of the program , in all printed material
and press releases.
• All agencies, or individuals, - receiving a $25,000 grant or more, will be required to
provide Indian River County with a financial audit within 120 days after the end of
the agency's fiscal year.
The following items will NOT be reimbursed by the Indian River County Board of
County Commissioners, or by the Children's Services Advisory Committee:
• Any expense not outlined in the agency's funding application .
• Capital expenses of any amount.
• Cell phone charges.
• Costs incurred by applicants in responding to the RFP.
• Expenses other than those related to the curriculum or staffing of the program .
• Expenses incurred prior to the first date of the grant.
• Travel expenses not related to the delivery of the program .
• Travel outside of Indian River County
• Sick or vacation day payments for employees .
• Salary payments to relatives working for agencies receiving grant funds , per the
Indian River County's policy on nepotism.
All materials and supporting documentation submitted in response to the RFP become
public documents and the property of the Indian River Board of County Commissioners.
EVALUATION CRITERIA
The proposals will be reviewed and evaluated by the Grant Review Sub-Committee,
which consists of members of the Children's Services Advisory Committee and other
citizens of Indian River County.
VIII
STANDARDS FOR EVALUATION
1 . The program addresses, directly or indirectly, one or more of the Children's
Services Advisory Committee's Focus Areas.
2. The program incorporates a system to bring the target population in need of
services to the program.
3 . The program has a substantial impact, directly or indirectly, on the
achievement of one or more of the Children 's Services Advisory. Committee's
Focus Areas, and incorporates measurable outcomes to demonstrate such
impact.
4. The focus of the program is early intervention ; the prevention of a problem
before it occurs, rather than the treatment and rehabilitation of an individual
after the problem occurs.
5. The amount of funding requested is a wise investment of community funds.
The amount spent is reasonable relative to the number of persons served
and the results achieved .
6. The agency offering the program has the organizational capacity to deliver
the program successfully (management, financial stability , board
effectiveness, community support, etc. )
7. This program is part of a coordinated collaborative approach designed to
achieve one of the Children's Services Advisory Committee's Focus Areas.
Upon the Indian River County Board of Commissioners decision , contracts with applicant
will be finalized as soon as possible. Program monitoring , written quarterly reports, and
mid-year presentations to the Grant Review Sub-Committee will be developed with grant
recipients after contract finalization.
THE CHILDREN'S SERVICES ADVISORY COMMITTEE AND THE BOARD OF COUNTY
COMMISSIONERS RESERVE THE RIGHT TO REJECT ANY OR ALL PROPOSALS, TO WAIVE ANY
NOWSUBSTANTIVE DEFICIENCY OR IRREGULARITY, AND TO AWARD A CONTRACT IN WHAT THE
CHILDREN'S SERVICES ADVISORY COMMITTEE AND BOARD OF COUNTY COMMISSIONERS
BELIEVE TO BE IN THE BEST INTEREST OF INDIAN RIVER COUNTY CHILDREN.
SPECIAL CONTRACT TERMS AND CONDITIONS
Contract Procedures
• For Profit Applicants must provide a copy of most recent Federal Tax Return with
application .
• All successful applicants are expected to enter into a contract with Indian River
County Commissioners substantially in the form set forth in Exhibit #1 .
Period of Performance
• Grant contract will run from October 1 , 2006 through September 30,
2007.
IX
Invoicing and Payment
• All payments are based on reimbursement.
• All requests for payment should be submitted to Indian River County Human
Services Department, Attention : Marion Masterson , 1840 2Vh Street, Vero
Beach , Florida 32960.
• Request for payment must be submitted in a timely manner (monthly, whenever
possible) .
• Each reimbursement request must have a Cover Sheet detailing all expenses.
For each expense listed , a backup invoice and any other pertinent data must be
attached. If the agency requests reimbursement for salaries, other related
documentation (i.e. , copies of payroll checks, payroll tax checks, invoices,
checks for benefits) must be included.
• Travel inside the county will be reimbursed according to Florida Statute 112 .061 .
• Payment may be delayed for three reasons ;
o Improper filing of request.
o Not filing quarterly reports with the Department of Human Services within
30 days after the end of each quarter.
o Not filing the agency's audit, as required by IRC, in a timely manner.
Nepotism Policy and Disclosure Requirements.
Agencies will not be reimbursed for salary payments to relatives working for agencies
receiving grant funds, per the Indian River County's policy on nepotism .
Agencies receiving grant funds must list on a sworn (notarized) statement, all employees
who are related to each other, or to Directors and Principals of the agency .
Such relationships should be listed specifically as: Father, mother, son, daughter,
brother, sister, uncle, aunt, first cousin, nephew, niece , husband , wife, father-in-law,
mother-in-law, daughter-in-law, son-in-law, brother-in-law, sister-in-law, stepfather,
stepmother, stepson, stepdaughter, stepbrother, stepsister, half brother, half sister,
grandparent, or grandchild.
If the agency does not have any related parties working for that entity, a sworn
(notarized) statement asserting this fact should be attached to the RFP.
If the agencies have an existing Nepotism Policy, that policy shall be attached to this
RFP.
X
NOT FOR PROFIT AGENCY CERTIFICATION
The County of Indian River requires, as a matter of policy, that any Consultant or firm
receiving a contract or award resulting from the Request for Qualifications issued by the
County of Indian River, Florida, shall make certification as below. Receipt of such
certification , under oath, shall be a prerequisite to the award of contract and payment
thereof.
I (we) hereby certify that if the contract is awarded to me , our firm , partnership, or
corporation , that no members of the elected governing body of Indian River County , nor
any professional management, administrative official or employee of the County, nor
members of his or her immediate family, including spouse, parents , or children , nor any
person representing or purporting to represent any member or members of the elected
governing body or other official , has solicited, has received or has been promised ,
directly or indirectly, any financial benefit, including but not limited to a fee, commission ,
finder's fee, political contribution , goods or services in return for favorable review of any
Proposal submitted in response to the Request for Qualifications or in return for
execution of a contract for performance or provision of services for which Proposals are
herein sought.
The undersigned certifies that he/she is a principal or officer of the firm applying for
consideration and is authorized to make the above acknowledgments and certifications
for and on behalf of the applicant.
The undersigned certifies that the Applicant has not been convicted of a public entity
crime within the past 36 months, as set forth in Section 287 . 133, Florida Statutes .
Failure to sign this fonn will result in disgualficatlon.
Handwritten Signature of Authorized Principal(s) : DATE: May 23 , 2006
NAME: Andrew Jefferson
TITLE : President
NAME OF FIRM/PARTNERSHIP/CORPORATION : St. Peter's Human Services, Inc.
FOR AND ON BEHALF OF THE APPLICANT:
Sworn to and su scribed to
e, " Notary u lic, this
qday of z 2006 . BY: C, E:', G
Andrew Jefferson 7r" �5 its
(SEAL) (TYPE(TYPE NAME & TITLE)
nn' oa.�ISSION 6,DD 20070W
&
xi
AUTHORIZATION FOR RELEASE OF INFORMATION
Indian River County and St. Peter's Human Services . Inc. (Agency/Individual are in the
process of negotiation of a contract for Village of Excellence Training Institute for Girls
Indian River County is authorized to make an investigation of the Agency/Individual
regarding its experience and qualifications. The Agency/Individual authorized the
release of all relevant information concerning prior services furnished, contracts and
background information of the Agency/Individual . The Agency/Individual authorizes any
individual or organization that is in possession of relevant factual contract and
background information , to release such data to Indian River County in response of the
County's request.
When an individual employee of the Agency signs Authorization for Release of
Information , such individual authorizes the County to obtain relevant background
information concerning such employee's criminal record , if any, and such other
information that may be relevant to employee's good character and work experience .
Authorization is given here by the Agency/Individual and such employees who execute
this authorization with the understanding and limitation that Indian River County will
utilize the information obtained for the purposes set forth herein and that such
information shall not be disclosed to third parties except as provided by law.
Name Agency/Individual St. Peter's Human Services , Inc.
Print name
Name Employee Providing authorization Andrew Jefferson
, . Print name
Signature (in blue ink)
Date May 23, 2006 ,
XII
SWORN STATEMENT UNDER SECTION 105.08 ,
INDIAN RIVER COUNTY CODE, ON DISCLOSURE OF RELATIONSHIPS
THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR
OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS .
1 . This sworn statement is submitted with RFP No. 2006061 for Village of Excellence
Training Institute for Girls .
2. This sworn statement is submitted by: St. Peter's Human Services , Inc.
(Name of entity submitting Statement)
whose business address is:
4250 38 " Avenue , Vero Beach, FL 32967 and
(if applicable)
its Federal Employer Identification Number (FEIN ) is 31 - 1480633
(If the entity has no FEIN , include the Social Security Number of the individual signing
this sworn statement
3. My naive is Andrew Jefferson
(Please print name of individual signing)
and my relationship to the entity named above is President.
4 . 1 understand that an "affiliate" as defined in Section 105 . 08 , Indian River County
Code, means :
The term " affiliate" includes those officers, directors , executives , partners , shareholders ,
employees, members, and agents who are active in the management of the entity.
5. 1 understand that the relationship with a County Commissioner or County employee
that must be disclosed as follows :
Father, mother, son , daughter, brother, sister, uncle, aunt, first cousin ,
nephew, niece , husband , wife, father-in-law, mother-in-law, daughter-
in-law, son-in-law, brother-in-law, sister-in-law, stepfather, stepmother,
stepson, stepdaughter, stepbrother, stepsister, half brother, half sister,
grandparent, or grandchild .
6 . Based on information and belief, the statement, which I have marked below is true in
relation to the entity submitting this sworn statement. [Please indicate which statement
applies. ]
Neither the entity submitting this sworn statement, nor any officers , directors ,
executives , partners, shareholders, employees, members, or agents who are
active in management of the entity, have any relationships as defined in section
XIII
105 . 08 , Indian River County Code, with any County Commissioner or County
employee.
X The entity submitting this sworn statement, or one or more of the officers,
directors, executives, partners, shareholders, employees, members, or agents ,
who are active in management of the entity have the following relationships with
a County Commissioner or County employee:
Name of Affiliate Name of County Commissioner Relationship
or entity or employee
St. Peter's Human Rosemary Teague Sister-in-law
Services, Inc. (County Employee)
XIV
�/ (signature)
May 23. 2006
(date)
STATE OF Florida
COUNTY OF INDIAN RIVER COUNTY
p he foregoing instrume t was acknowledged before me this%�day of
, 2006 by who is personally known tome
or who h produced .,r,a4 U Cep as identification .
N RY PU LIC J L�
PRINT: uth Jeffertbnr f
State of Flo d a at L g
My Commission Expires :
(Seal)
ry �
EEMY:
RUTH L JTFEp90N
COMMISSION # DO19M
EXPIRES: May 6, 2007
endThoNt yP&kUtleM%W
XV
(signature)
(date)
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me this day of
2006 , by who is personally known to me
or who has produced as identification .
NOTARY PUBLIC
SIGN :
PRINT:
State of Florida at Large
My Commission Expires:
(Seal)
XV
SUPPORTING DOCUMENTS CHECKLIST
RFP 2006061
Cover Page
Application
List of current officers and directors
Latest Financial Audit Report & Management Letter that conforms with the
AICPA Audit Guide
Most recent IRS Form 990, including all schedules
Most recent Internal Financial Statement (i .e. : Balance Sheet and Operating
Budget
Staff Organizational Chart
Most Recent Annual Report (if available)
501 (C) (3) IRS Exemption Letter
Articles of Incorporation
Agency's Bylaws
Agency's written policy regarding Affirmative Action
Nepotism Statement
Taxonomy Definition for each program
XVI
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N M t�f INxJ M M M t��l N1 M n p � y
Type the Organtralion and Program Name
• Meals ( # meals x clients x 5days x 50 wks) y' a , _ , r , ty j „• r-' t . '... tx ,., x �.
• Snacks tr
43 Administrative Costs
• Admin. Cost (% Of total budget) ,,,e. .. . ? � rws";z' . r ' +Audi44 t Expense
• Independent Audit Review + �kg,
45 Specific Assistance to Individuals
• Medicalassistance .
• Meals/Food '• ,�". `' .� �`_"�. ' k'..
• Rent Assistance
• Other
46 Other/Miscellaneous 2.600.0 2,600.00 2,600.00
• Background check/drug test
• OthedTransportation
47 Other/Contract
• Sub-contract for program services - ' , <•x� p .
48 TOTAL EXPENSES #VALUE! $53,449. 11 $53,449. 11
6/62008 B•1
Tnw M amara and rwa N.
UNIFORM GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCY/PROGRAM NAME:
F704105 FY 05/05 FY 06107 Y. INCREASE
FYE FYE FYE CURRENT VS.
NE)(T FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (Col. C<Ql. eyca. a
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0.00 #DIVIOI
2 Children's Services Council-Martin 0.00 #DIVIOI
3 Advisory Committee-Indian River 53449.11 #DIVIOI
4 United Way-St Lucie County O.OGI #DIV10!
5 United Way-Martin County O.00l #DIV/01
6 United Wa 4ndtan River County0.00 #DNlOI
7 Department of Children & Families 0.00 #DIVIOI
a County Funds 0.00 #DIV/01
s Contributions-Cash 0.00 #DIVIOI
III
Program Fees 0.00 #DIV/OI
11aisin Events-Net 0.00 #DNlO!
12o Public-Net 0.00 #DIVIOI
13 Membership Dues 0.00 #DIVIOI
14entlncome 0.00 #DIVIOI
15aneous O.OD #DIVJ01
15es & Be uests0.00 #DN/0!
17from Other Sources 0.00 #DIV/0!
t5e Funds Used for Operating
0.00 #DIVIOI
1e In-Kind Donations (Not Includedn tate) - 0.00 #DIVIOI
20 TOTAL 0.00 0.00 53,449.11 #DIVIOI
• .r , �, . , - , ,, f , -I, .G,- - _ . 71 7
EXPENDITURES
zt Salaries 36,972.00 #DIVIOI
22 FICA 2820.71 #DIV/01
M Retirement 0.001 #DIV1Dl
24 Life/Health 0.00 #DMO!
25 Workers Compensation 0.00 #DIVO!
26 Florida Unemployment 0.00 #DIVIOI
27 Travel-Dail 0.00 #DIVIOI
n Travel/Confemnces/Trainin 11.00 #DIV701
2e Office Supplies 0.00 #DIVIOI
30 Telephone 0.00 #DIV/0!
31 Postage/Shipping0.00 #DIVIOI
32 Utilities 0.00 #DIVIOI
33 Occu anc (Building & Grounds 0.001 #DIVIOI
34 Printinit & Publications 0.00 #DIVIO!
35 Subscri tion/Dues/Membershi s 0.00 #DIVIOI
36 insurance 0.00 #DN/01
37 E ui ment:Rental & Maintenance 0.00 #DNl01
ae Advertising500.00 #DIV/01
as Equipment Purchases:Ca ital Expense 0.00 11
M Professional Fees (Legal, Consulting) 0.00 #DIV/0!
41 Books/Educational Materials
1 .000.00 #DIVIOI
42 Food & Nutrition 9.656.401 #DNf01
43 Administrative Costs 0.00 #DI70I
44 Audit Expense 0.00 #DIV10!
45 Specific Assistance to Individuals 0.00 #DIV/OI
46 Other/Miscellaneous) Trans ortation/Fuel 2600.00 #DIV/0!
47 Other/Contract 0.00 itDN101
4a TOTAL 0.00 D.00 53 449. 11 111
4e REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 0.00 #DIVlO!
Beaune
ea
Tip MGpMM MR�wHm
UNIFORM GRANT APPLICATION
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME:
FY 04/05 FY 05106 FY 06/07 %. INCREASE
FYE FYE FYE CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (Col. C<oL BY=LB
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St. Lucie 0.00 #DIVl01
2 Children's Services Council-Martin 0.00 #DIVI01
3 Advisory Committee-Indlan River 5344911 #DIV/01
4 United Way-St. Lucie County 0.00 #DIVl01
5 United Way-Martin County0.00 #DIV/01
6 United Way-Indian River County O.OD #DIV/01
7 Department of Children & Families 0.00 #OIVIOI
B CountyFUnds 0.00 #DIVI01
9 Contributions-Cash
0.0ol itDN10!
10 Program Fees 0.00 #DIVI01
11 Fund Raising Events-Net
0.00 #DIV/01
/2 Sales to Public-Net 0.00 #DIV/01
13 Membership Dues 0.00 #DIVI01
14 Investment Income 0.00 #DN101
15 Miscellaneous 0.00 #DIVlO!
is Legacies & Bequests 0.00 #DIV/01
17 Funds from Other Sources 0.00 #DIV/01
to Reserve Funds Used for Operating 0.001 #DIV/DI
is In-Kind Donations tea mciw.d In tmae 0.001 #DIV/01
20 TOTAL 0.00 0.00 53 449.11 #DIV/01
EXPENDITURES
21 Salaries 36872.00 #DIV/O!
22 FICA 2,820.71 #DIV/Ol
23 Retirement 0.00 #DNlOI
24 LifelRealth 0.00 #DMO!
25 Workers Compensation 0.00 #DIV/01
26 Florida Unemployment 0.00 #DIV701
27 Travel-Dally0.00 #DN/01
20 Travel/Conferencesfirainln
00011 #DIV/Ol
29 Office Supplies 0.00 #DIVl01
30 Telephone 0.00 #DIV/01
31 Posta a/ShI In 0.00 #DIV701
32 Utilities 0.00 #DIVI01
33 Occupancy (Building & Grounds) 0.00 #DIV/01
34 Prindna & Publications 0.00 #DNl01
35 Subscrition/Dues/Membershi s 0.00 itDIV101
]s Insurance
0.001 #DIV701
37 E ul ment:Rental & Maintenance 0.00 #DIV/01
39 Advertising500.00 #DIVI01
39 Equipment Purchases:Ca Ral Expense 0.00 #DNI01
4o Professional Fees (Legal. Consulting) 0.00 #DIV/Ol
41 Books/Educational Materials 1.000.00 #VALUEI
42 Food & Nutrition
9,656.40 #DIVlO!
u Administrative Costs 0.00 #DIV701
N Audit Expense 0.00 #DIV/01
45 S eciflc Assistance to individuals 0.00 #6IV/01
46 Other/Miscellaneous/fuel transportation 2.600.00 #VALUEI
47 Other/Contract 0.00 #DIV101
4s TOTAL 0.00 0.00 4994911 #OIVlO!
49 REVENUES OVERT UNDER EXPENDITURES 0.00 0.00 360000 #DIVI01
anmve Bd
Type Vie Organeation and Program Name
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCY/PROGRAM NAME :
FUNDER: A B c
FY 06/07 FY 06/07 % OF
TOTAL FUNDER TOTAL VS.
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET (col. B/col. Al
EXPENDITURES
21 Salaries 36,872.00 369872.00 100.00 %
22 FICA 25820.71 29820.71 100.00%
23 Retirement 0.00 0.00 #DIV/0 !
24 Life/Health 0.00 0.00 #DIV/01
25 Workers Compensation 0.00g�n
0 .00 #DIV/0!
26 Florida Unemployment 0. 000.00 #DIV/O !
27 Travel-Dail 0 .000.00 #DIV/01
28 Travel/Conferences/Training0.000 .00 #DIV/01
29 Office Supplies 0. 00 .00 #DIV/01
30 Telephone 0 .00 0.00 #DIV/01
31 Posta e/S hipping 0.00 0.00 #DIV/0!
32 Utilities 0.00 0.00 #DIV/01
33 Occupancy (Building & Grounds 0.00 0 .00 #DIV/01
34 Printing & Publications 0.00 0.00 #DIV/Di
35 Subscription/Dues/Memberships 0.00 0.00 #DIV/01
36 Insurance 0.00 0.00 #DIV/0 !
37 Equipment: Rental & Maintenance 0.00 0.00 #DIV/01
3s Advertising500.00 500.00 100.00%
39 Equipment Purchases : Capital Expense 0.00 0.00 #DIV/0!
40 Professional Fees (Legal, Consulting) 0.00 0. 00 #DIV/0 !
41 Books/Educational Materials 1 .000.00 19000.00 #VALUE !
42 Food & Nutrition 9,656.40 91656.40 100.00%
43 Administrative Costs 0.00 0.00 #DIV/0 !
44 Audit Expense 0.00 0.00 #DIV/01
45 S ecific Assistance to Individuals 0.00 0.00 #DIV/0 !
46 Other/Miscellaneous 2.600.00 2 ,600.00 #VALUE!
47 Other/Contract 0.00 0.00 #DIV/01
48 TOTAL $49,849. 11 $53,449.11 107.22%
fi/&2p°6
Bi
Tfp ON Qpm�YoN Fi W m Nw
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME:
FUNDER:
#DN/01
#DN/01
#DN/01
#DN/01
#DN701
#DN701
#DN/01
#DN/01
#DN/01
#DN/01
#DN101
#DN/01
#DN/01
#DN/01
#DIV/0!
#DN/01
#DN/01
#DN101
#DIV/01
#DN/01
#DN/01
#DIV/01
#DIV/01
#DN/01
#DN/01
#DN/01
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Type ns ppruebn eq pryrm Nero
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
FUNDER SPECIFIC BUDGET
AGENCY/PROGRAM NAME:
FUNDER:
SaWries _ ..
FICA
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EXHIBIT B
(From policy adopted by Indian River County Board of county Commissioners on February 19,
2002 )
"D. Nonprofit Agency Responsibilities After Award 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 1s' 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 and (September 30`") must be submitted on a timely
basis . Each year, the Office of Management and 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 expense by type . These summaries
should be broken down into salaries, benefit, 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."
EXHIBIT - B -
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: Brad E. Bernauer, Director
Indian River County Human Services
1840 25th Street
Vero Beach , Florida 32960-3365
Recipient: St. Peters Human Services , Inc. ,
425038 th Avenue
Vero Beach , Florida 32967
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 provision and term 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 context indicates otherwise, words importing the singular number
include the plural number, and vise 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.
EXHIBIT - C -
OCT-12-2606 14 : 32 HH I UHLH INbLMHIVI.t INR. . '1rJ r oma coon I- . II=
ID I
VAm INiNINNn r , r r
ACORV CERTIFICATE OF LIABILITY INSURANCE ST$E `FRAE 10 / 12 / 06
PRODUCER THN1 COITIFICATf IS ISSUED AS A MATTER OF INFORMATION
ONLY ANO CDNFERS NO RK3HTS UPON THE CERTIFICATE
Hatches Insurance , Inc . HOLOER. THIS CERTIFICATE DOSS NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P . O . Bos 540659
Orlando rL 32856 -0689
Phone : 407 - 841 -2686 ras : 407 - 841 -2688 INSURERS AFFORDING COVERAGE NAICs
INSUREDINSURER A: PAL1aAAJ N IoAurMoe Car . _
PISUPER 8: cwwA ME TRI.,•t" CVPA.T - .
St . Peters Academy Charter Sch INSURER C .-. - . -
St . 0pl rs human Services , Zno INwRcaO:
3�th Aveng
Vero Beach FL 3967 - 1711 INSURER I;
COVERAGES
THE POLICES OF INSURANCE LISTED BELOW HAVE WIN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REOUINEYENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PSRTMN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TSANS. EXCLUSIONS AND CONDITIONS OF SUCH
POI.ICES. AGOREOATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS -
POLIOY NUMBER G POLO LIYTi
L of INEtRANCi EACH OCCURRENCE $ 1000000
OBNERAL LNMnJTYf 100000
A X X coMMERcuL CENENALLwLITr P1{pR290953 09/17 /06 09/17 /07 PRENIKs� Io
eLUNs MADe ® occuR MED EXP ANF WO PI $ 5000 . .
X Educators Prof PHPK290953 09/17 /06 09/ 17/07 PERSONALaADVINNRY s 1000000 ,
GENERAL AGOREGATE 12000OOD
PROdIOTB . COMPIOPAGD 52000000
;EN-L AGOREOATS LIMIT APPLIES PER:
POLICY 7 Loc
AUTOMOaLE LWMTY COMBINED SINGLE L WIT t
(EA SxMMU
ANY AUTO
B
ALL OWNED AUTOS 000. "JURY
URY y
OGIL "
SCHSOULEDAUYOS -
NYLED AUTOS Booty INJURY y
IM1r A,GJMN _
NON,OWNSD AUTOS
RPR, EiERTYCAMACE y
AUTO ONLY - EAACCIDENT t - -
GARAOELMmLRY EA
ANY AUTO OTHER THAN ACC i
AUTO ONLY: ADD I
EACH OCCURRENCE 51000000
EXCE7BRILIBRELIAu�
A X occuR CLAMSIALOE PHUS070600 09 /17 /06 09/ 17 / 07 AGGREGATE $ 1000000
DEDUCTIBLE
L
X RETENTION 510000
WORKIRX T RYL R
n*V
y COMPENSATION ANDmPLOv
BMnw LwllJT' N'C8967849 09/ 17/06 09/ 17 / 07 ILL. EACH ACCIDENT $ 100000
B ANyY PROPRET CT ORSIX ECL IVE E.L. DISEASE - SA EMxova 1100000
9PECIA SCIONS IIIIW E.L. DISEASE - POLICY LSAT s500000
OTHER
DSBCRLTTION OF OFUATIORB/ LOCATIONS I YIMCUNB I EEC Iggwo ADDED BY ENODRSEBMINT I SPECIAL PRWMONE
Certificate holder is included as additional insured imregardiout of
general liability . Liability is limited to loan or age &riain ida Statute .
negligent acts of the insured . REXcept an required by
CERTIFICATE HOLDERCANCELLATION
INDIRIV SHOULD AMYOF THE ALLAN[ DBSORIBEDPOLICIES Y CANCELLED BEXORE THE EXPIRATION
DATt TNEIIEOP, THE ISBANO INSURER BELL fiRIDFAwRTOMAIL 30! DAYSwRTTEN
NOTICE TD THE CIRTIRCAFE NOLDEII NAMED TO THE LID. BUT FALURF TO 00 80 BHA"
Indian River County , Florida IMPOSE NO MLIGATEIN OR LIARLITY OF ARY BIND UPON THE REHIRES. ITS AUNTS OR
1840 25th Street RMREBe1TAIWM.
Vero Beach FL 32960 -3365 REF
ID ACORD CORPORATION 1985
ACORD ZS (ZW/68)
TOTAL P . 02
CERTIFICATE OF INSURANCE
ESPECTS THE INTEREST OF THE CERTIMATE HOLDER WILL NOT BE CANCELED OR OTHERMsE
.,.� r
EVEN111111111" THIS CERTWICATE BE VALID MOM THAN 30 DAYS FROM
DpdMWqANW THE . . BELOW
INSURANCEA== STATE FARM MUTUAL ALITOMOMILE
.
M STATE FARM FIRE AND CASUALTY COMPANY of @Wmkqtft 111,
how molparap to the fallowinill Named koured as ~ below :
NM Insured St. PeWs Milisionary Baptist Church Inc.
Address of Named knuf9d 4250 3e Ave
Vero Beach, FL 32957
000amim
®■®- 1W KAVWTM
• f� -
M
WX
• P - f
Each Person
a. voury
EschAcciderK
.-
309le Und Each +
COVERAGES WW.W Deductible SM1,00
• . . 000 • _ IM.00 Deductible
s. 22MMMMMI 's
5W.00 Deducillibb SSW. a . - . . ._ . . . . Dedlocible WK Deducliblet
EMPLOYEWS
NON40MINERSIVIR OYES RHO 13YES ONO DYES W40
• r
AI .�.-r'- c. • ■
LDASiBriaturear
A Agerd 2733 1W3=
Tfft Agents Code Number Daft
F-- Name and Address orCertillcm Holder �1 F� Name and Address of ADM
r .
1840 25* Sbee 2601 20M
Vero Bescho Fl. 32960 VWu Beacht FL 329W
Check da pemwwt Ceffillon of Insurance for liability coverage is needed: ■
Check If the Certificate Holder should be added as an Addiltional Insured: 0