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HomeMy WebLinkAbout2006-331A. INDIAN RIVER COUNTY GRANT CONTRACT kU This Grant Contract ("Contract") entered into effective this day of October 2006, by and between Indian River County, a political subdivision of the State of Florida; 1840 25th Street, Vero Beach , Florida , 32960-3365; and Boys & Girls Clubs of Indian River County, Inc. , (Recipient), of: Boys & Girls Clubs of Indian River County, Inc. P .O . Box 643068 Vero Beach , Florida 32964 Youth Volunteer Corps 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 farm 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 "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 2006/2007 ("Grant Period"). The Grant Period commences on October 1 , 2006 and ends on September 30, 2007 . - 1 - 4. Grant Funds and Payment. The approved Grant for the Grant Period is: THIRTY SIX THOUSAND, DOLLARS ($36,000). 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 - 2 - 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 . - 3 - IN WITNESS WHEREOF, County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD. OF COMMISSIONERS By: Arthur R. - Neuger ha��rnan . BCC Approved : d . - , d� Attest: J . K. Barton, Clerk JL eputy Clerk Approved Jose h A. Baird County Administrator Approv d as to form and legal sufficiency: By: /Ktarian ell , A s ant County Attorney f RECIPIENT By: Boys & Girls Clubs of Indian River County, Inc. - 4 - EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children 's Services Advisory Committee PROGRAM COVER PAGE for 2006-2007 fir► Organization Name : Boys & Girls Clubs of Indian River County Inc. President & CEO : Ronnie Hewett E-mail : RonnieHewett(a BGCIRC. ore Address : P . O. Box 643068 Telephone : 772-299-7449 Vero Beach, Florida 32964-3068 Fax : 772-299-3840 Director of Finance : Heidi Watkins E-mail : HeidiWatkins/7a BGCIRC . org Address: P. O. Box 643068 Telephone : 772-299-7449 Vero Beach, Florida 32964-3068 Fax : 772-299-3840 Program Title: Vero Beach Teen Center/Youth Volunteer Corps Priority Need Area Addressed : Mental Wellness Issues & Childcare Access Brief Description of the Program : Taxonomy Definition FN- 150 . 360 Programs that offer a variety of activities for youth who are at risk for behavior which is likely to involve them in the iuvenile Justice system with the objective of assisting them to improve self-esteem to become aware of alternative ways of dealing with feelings and leisure time and to take responsibility for the consequences of their actions Included may be counseling rap and discussion groups tutoring companionship programs alternative peer group experiences and supervised recreational activities The Boys & Girls Clubs ' — Youth Volunteer Corps (YVC) is a community outreach service where young people work in teams, which are led by trained staff Team Leaders in projects which assist local agencies and educational institutions. Through our Teen Center we are able to offer facilitv based programming such as : SMART Moves — a drug alcohol and pre-mature sexual activity prevention `ftw program ; Job Ready; and Career Launch . SUMMARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2006 / 07 : $ 403000 . 00 Total Proposed Program Budget for 2006 /07 : $ 166 , 231 . 61 Percent of Total Program Budget : 24 . 1 % Current Funding ( 2005 /06 ) : $ 365106 Dollar increase / ( decrease ) in request : $ 31894 Percent increase / (decrease ) in request * * 10 . 8 % Unduplicated Number of Children to be served Individually : 11600 Unduplicated Number of Adults to be served Individually : 141 Unduplicated Number to be served via Group settings : 195 Total Program Cost per Client : 85 . 86 * * If request increased 5 % or more, briefly explain why: Our Teen Center is now operational and cost such as insurance and utilities continue to rise . Additionally , we are requesting the same level of funding that the CSAC recommended last year prior to the budget cuts If these funds are being used to match another source, name the source and the $ amount: N/A The Organization 's Board of Directors has approved this app4,,on (date). FearyJay McNamara Name of President/Chair of the Board \� �✓ Ronnie Hewett Name of Executive Director/CEO Signature 1 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's Services Advisory Committee ORGANIZATION : Boys & Girls Clubs of Indian River County, Inc. ham. PROGRAM: Vero Beach Teen Center/Youth Volunteer Corps TABLE OF CONTENTS for 2006-2007 X Section of the Proposal Pa e # X COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I X TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 A. ORGANIZATION CAPABILITY (one page maximum) X I . Mission and Vision of organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 X 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . 4 B. PROGRAM NEED STATEMENT (one page maximum) X 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 X 2 . Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 C. PROGRAM DESCRIPTION (two pages maximum) XI . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X4 . Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X 6 . Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X D. MEASURABLE OUTCOMES (two pages maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 F. PROGRAM EVALUATION (two pages maximum) X1 . Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 -X 2 . Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 X3 . Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 X G. TIMETABLE (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 H. UNDUPLICATED CLIENT COUNT X 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 X 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 I. BUDGET FORMS X 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 ``. 2 Boys & Gids Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's Services Advisory Committee J. FUNDER SPECIFIC/ADDITIONAL SHEETS (On White Paper) %MW X 1 . List of current officers and directors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J- 1 2 . Latest Financial Audit Report & Management Letter that conforms with the J-2 X AICPA Audit Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 3 . Most recent IRS Form 990, Including all schedules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J- 14 4. Most recent Internal Financial Statement (i.e. : Balance Sheet and Operating XBudget) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-39 X 5 . Staff Organizational Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-44 X 6 . Most recent Annual Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-45 X 7 . 501 (C)(3) IRS Exemption Letter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-79 X 8 . Articles of Incorporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-80 X9 . Agency' s Bylaws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-94 X 10 . Agency ' s written policy regarding Affirmative Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J- 104 X 11 . Parent & Member Surveys for all programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J- 105 X 12 . Taxonomy Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J- 119 K. APPENDIX: Supporting Documentation X 1 . Not for profit agency certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I X 2 . Indian River County Authorization for Release of Information . . . . . . . . . . . . . . . . . . . . II X3 . Sworn Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V X 4 . Proof of Liability & Worker' s Compensation Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . XV '\r 3 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen CenteriYouth Volunteer Corps Grant Application to the Children's Services Advisory Committee PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization. Mission Statement: To enable all young people, especially those who need us most, to reach their full potential as productive, caring, responsible citizens. Vision : To accomplish our mission by establishing neighborhood clubs and outreach services in Indian River County with quality programs and staff. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. The Boys & Girls Club of Indian River County offers a diverse, affordable program to kids in a positive atmosphere. Our daily after-school and summer programs, offered through our "Clubhouse" locations and our outreach services that are provided through our Youth Volunteer Corps, allow us to provide valuable services to the children of Indian River County . These program activities attract and sustain young people, ages 6 through 18, who pay a nominal annual membership fee of $35 . 00 (which includes a free Boys & Girls Club t-shirt) and a summer program fee which varies by location. In cases of financial hardship, no kid is turned away because we have established a scholarship fund . Youth Volunteer Corps members do not pay any fees . Nowhere in the Indian River County area can kids or parents find such valuable services offered in multiple locations so inexpensively. While our method of program delivery may change with seasonal activities , or school related endeavors, the core of what and how we conduct daily activities remains much the same. The overall Boys & Girls Club program structure can be divided into "Five Core Service Areas". Together, these core service areas provide a diverse base of activities designed to meet the needs and interests of every member. The following Five Core program areas represent the Club ' s service offerings to its membership : • Education and Career Development . . . enables youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career and life in general. • Character and Leadership Development . . . empowers youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self- image, participate in the democratic process and respect their own and others ' cultural identities . • Health and Life Skills . . . develops young people ' s capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults . • The Arts . . . enables youth to develop their creativity and cultural awareness through knowledge and appreciation of the visual arts, crafts, performing arts and creative writing. • Sports , Fitness and Recreation . . . develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. 4 Boys & Girls Club of Indian River County, Ina — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's services Advisory Committee 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.) Limited access to affordable after school and weekend programs for children 11 — 18 years of age, low economics, juvenile crime and below average academic achievement is the condition requiring change . b. & c. ) We define those who have a need as children between the ages of 11 to 18 years of age, with a special interest in working with disadvantaged youth. We define disadvantaged youth as children from low economic status, one-parent families and latch key kids . The Youth Volunteer Corps is a community wide outreach program that provides daily opportunities for kids to participate in community service projects throughout Indian River County. d. ) Area of need : • Based on the 2000 Census, 19.2% of the total population or 21 ,685 youth are under 18 in Indian River County. • Based on the 2001 Kids Count Data Book, funded by the Annie E. Casey Foundation, 30% or 6,505 of those youth are living in a single parent home, 82% of a student' s time is spent outside of school . • All Indian River County students are released from school early on Wednesday afternoons which adds additional time onto a student' s out of school hours . • Based on the 1998 report from Carnegie Council on Adolescent Development, youth ages 12- 17 are unsupervised for 12 or more hours per week . 65% of youth involved in criminal Now activities, sexual activity and substance and alcohol abuse participated in those activities between the hours of 3 : 00 pm to 6 : 00 pm on weekdays. 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. a . The Boys & Girls Clubs of Indian River County is the only county-wide, facility based, youth development organization that provides programming every day after school and all day during the summer. For every child the Boys & Girls Clubs serves, our youth development activities are designed to build the following traits : • Positive self-identity. A healthy self-concept, a strong belief in one ' s self-worth, and a sense of hope about one ' s future . • Educational , employment, social , emotional and cultural competencies. The knowledge, skills, strategies and attitudes necessary to have a positive foundation for success. • Community and civic involvement . A sense of belonging to community, family and/or group; willingness to take civic responsibility. • Health and well-being . Living a healthy lifestyle, taking part in regular fitness activities, able to access health care resources and engage in positive behaviors . • Moral compass . Youth have values enabling them to develop positive relationships with others. b . Our target population is underserved by other programs for the following reasons : affordability, accessibility and scope of services . 5 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's Services Advisory Committee C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages) �r 1 . List Priority Needs area addressed. Mental Wellness Issues and Childcare Access 2. Briefly describe program activities including location of services. The Youth Volunteer Corps ' services focus on education, skill building, and leadership development while providing ongoing positive activities for youth outside of school hours, everyday after school , during the weekends and throughout the summer. The following in a list of programs offered to youth through out Indian River County in the YVC program: • VIP PROGRAMS (Volunteers in Partnership) Weekend Service Projects throughout Indian River County. • YVC Summer Program : Service projects are provided daily throughout the summer for teams of Youth Volunteers which are led by YVC Staff Team Leaders . • PALS ("Pupils Assisting Learning in Schools ') After School Tutoring Program : Youth Volunteers work in teams under the leadership of an YVC Staff Team Leader in a structured tutoring program in elementary after school programs . • Exploring Your Community Through the Scientific Method : The Youth Volunteer Corps, provides service activities to replace required Science Fair projects in FLC ' s Biology classes . • Teen Center: Offer facility based programming for teens every day after school and all day ,%we during the summer with programming such as : help with homework; drug and alcohol prevention classes ; and career development . 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 . Most youth programs reinforce the disconnection that young people feel in our society by treating them as clients rather than contributors. The youth volunteer is the primary focus of the YVC program, but the youths who participated in this program are given the responsibility as the contributors of service. The Youth Volunteer Corps places these young people into an environment of meeting the needs of others . Studies have linked adverse youth behavior with low self esteem. Treating youth as resources and putting them in responsible, serving roles builds self esteem. Search Institute ' s study of 46,000 young people, described in The Troubled Journey, found that youth who serve others are less likely to be involved in negative behaviors . The study showed that participating in "helping behavior" lowered adolescents ' involvement in substance abuse, dropping out of school , teen pregnancy, and other negative behaviors. 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 to the information in the Position Listing on the Budget Narrative Worksheet). I full-time President & CEO — with a Bachelors Degree with a minimum of three years working in the non profit sector, dedicating 10 hours per week of his/her time in program support, evaluation and staff training. 6 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children 's Services Advisory Committee 1 fill-time Director of Finance — with a Bachelors Degree with a minimum of three years working in the L non profit sector, dedicating 10 hours per week of his/her time in supplemental program support, planning and facility management. 1 fiill-time YVC Director — with a Bachelors Degree with a minimum of three years experience working with youth, dedicating 40 hours per week of his/her time in planning, coordinating and directing the daily program at the YVC Teen Center and outreach services as well as facility and personnel management . 2 part-time Team Leaders — with a High School Diploma, working towards a college degree with demonstrated capability in working positively with youth, dedicating 32 hours per week of his/her time in providing onsite supervision of YVC projects. 3 part-time Team Leaders — with a High School Diploma, working towards a college degree with demonstrated capability in working positively with youth, dedicating 19 hours per week of his/her time in providing onsite supervision of YVC projects. I part-time Team Leader — with a High School Diploma, working towards a college degree with demonstrated capability in working positively with youth, dedicating 40 hours per week for 10 weeks during the summer of his/her time in providing onsite supervision of YVC projects. Volunteers - Demonstrated capability in working positively with youth. As many as we can get, dedicating specialized program opportunities for YVC members. 5. How will the target population be made aware of the program ? • School : Service Learning projects and clubs, bulletin board, announcements, distribution of calendars and flyers • Newsletter: YVC Volunteer Newsletter/Calendars, mailings, Junior League Wavelengths monthly newsletter • Court Ordered : Individuals ordered by probation to do community service • Newspaper: Press Journal and Vero Beach Forum Volunteer Watch column or articles • Family/Friend : Word of mouth • Service Projects : Recruitment source during weekend and after school projects • Phone Book • Presentations are given to schools and service organizations. 6. How will the program be accessible to target population (i.e., location, transportation, hours of operation) ? The key factor in reaching the clients of the Youth Volunteer Corps is through the efforts of the Team Leaders . Each team leader is assigned to a number of schools and specific projects (offered daily after school and on weekends) . They are responsible for recruiting, marketing, and "reaching out" to the community to ensure participation and interest. Each team leader has a regional area to saturate with flyers, calendars, sign up sheets, and announcements . They are also responsible for arranging transportation, if needed, organizing car pools, recruiting adult volunteers for transport and supervisory purposes, and for calling and following up on those who didn ' t make it to a project. There is a complex and intricate system of molding many forms of communication together to bring a project to a successful level . This system of "outreach" is significantly dependant on the dedication and efficiency of the YVC staff and the Team Leaders promoting the projects . **AW Now that YVC has its own facility it will not only provide community service projects almost every day during the year, but it will also be open every day after school for facility based programming as well . 7 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's services Advisory Committee D. MEASURABLE OUTCOMES - PROPOSED, (Section D not to exceed trvo pages) OUTCOMES ACTIVITIES List all o the elements or the Measurable Outcome(s) Last the tasks to accomplish the Outcome(s) 1 . To maintain registered YVC members • Make available weekend projects every weekend ( 1600) as reported by the 2006-2007 year and after school and during every school end YVC registered member totals. vacation. Baseline : 2005-2006 registered member • Provide full time summer programs with all day totals . service projects for youth to participate in as contributors of service under the guided 2 . To maintain YVC service projects 100% leadership of YVC staff and community partners. (200) with service to 50 agencies as • Make available to YVC members, which are reported by the 2006-2007 year end YVC ongoing, that teach about special needs children service projects totals. Baseline : 2005 - and adults on weekend nights (Aktion Kiwanis) 2006 service project totals. and on weekend days (Sun Up) • Make available weekend and ongoing senior 3 . To maintain an average daily attendance of companionship projects (Clare Bridge Cottage, Atlantic Health Care) 25 teens per day participating in activities . Make available after-school mentoring/tutoring provided at the Vero Beach Teen Center. projects to YVC members for after school service Baseline : 2005-2006 average daily opportunities. attendance totals . • Maintain programs, which are appealing to youth on all levels such monitored by the YVC 4 . Maintain that YVC members ' cumulative Advisory Council (made up of YVC members). volunteer hours will exceed 12,000 hours . • Provide 5 h graders with an introduction to YVC Baseline: 2005 -2006 YVC cumulative projects and service through PATHWAYS in volunteer hours total . elementary schools. • Opened new teen center within walking distance 5 . 75% of youth who have participated in of Vero Beach High School and the Freshmen YVC for 50 hours or more, will increase Learning Center. their self awareness that teenagers can have • Continue/enhance the implementation of the an impact on the community. Baseline : SMART Moves program that will be offered on Pre/Post survey scores from the YVC a weekly basis. personal perspective impact on to their • Nominate eligible, deserving 14 year olds as community. Question : Do you think Youth of the Month. Nominees will be requested teenagers can have a genuine impact on the to complete a nomination form to be judged to communit determine the organizations Youth of the Year. community? • Continue/enhance a Keystone Club for members 14 — 18 years that will meet a minimum of twice a month. • Continue/enhance a Job Ready program that will be offered during the summer. • Continue/enhance a Career Launch program that will be offered year round to teenagers accessing the web at the Boys & Girls Club. • Provide daily access to computers to improve technology coTpetency levels. 8 Boys & Girls Club of Indian River County. Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's Services Advisory Committee 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. Collahorative Agency Resources provided to the program Indian River School District Promotion of YVC programs in middle and high schools, implementing YVC Clubs at schools, partnering with school service clubs to implement joint service projects, assisting teachers in service leaming activities, PALS After school tutoring program Indian River Little House Association They provide space for us to house our Teen Center free of charge . The Substance Abuse Council Reciprocal recruitment source, implement joint service projects, work together in Tobacco Program, Right Choice Program , and Teen Plus Program Juvenile Justice Department Youth in our diversion program work with court counselors and probation officers and the YVC Director and Team Leaders to strengthen our goal to divert youth from the system by placing them into Youth Volunteer Corps projects . 9 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's Services Advisory Committee 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 ? Each participant will be required to fill out a membership application that is manually entered into a computer software program called "Member Tracking". This program allows us to electronically maintain a database on each member that includes demographic, age, gender, race, family economics , daily attendance, and activities in which they participated. Our target population is tracked by age. We are able to track our special interest in serving disadvantaged youth by asking and collecting the following : • Does your child receive free or reduced lunch? (Asked to determine low economics). • Who does your child live with? (Asked to determine single parent family status). Limited access to affordable after school programs for children 6 — IS years of age, low economics, juvenile crime and below average academic achievement is the condition requiring change . 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 ` 4w 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 ? Youth Volunteer Corps : Structured Reflective Process : the Team Leader documents collected thoughts and /or collects written documentation from each Youth Volunteer. This information is retained for evaluation and tracking purposes. YVC Staff Evaluation : After each project each Team Leader who is present completes an evaluation. This document measures the impact and effectiveness of the youth volunteers and evaluates positive and negative elements of the project. After each PALS site, the YVC Team Leader completes a weekly evaluation of the existing program, listing the level of participation, journal documentation, problems and success. The Tutees and Tutors journals are held by each YVC Team Leader for long-range tracking and analysis. After each week of the Summer Program, the Team Leader completes weekly evaluations from their sites. The youth volunteers reflection paperwork is held by each Team Leader for long-range tracking and analysis. Pre/Post- Survey: After selected projects, a pre- and post survey is given to youth volunteers to measure personal growth and their learning experience. Parent Evaluations: After the summer program, a program evaluation is sent home to receive feedback from the parents of the youth volunteers to gain insight in ways to improve or change the program in the future. Agency Evaluations : After the Youth Volunteer Corps has done a project at any agency, an vr„ evaluation is sent to receive feedback from the staff and supervisors of that agency. This is to measure 10 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children 's Services Advisory Committee effectiveness of the YVC ' s presence at their site and honestly evaluate the program. t� YVC Staff/ Team Leader Weekly Activity Sheets: This form is required by the YVC Director to evaluate the productivity and effectiveness of each YVC Staff Team Leader. Journals: In the PALS program, the tutor and the tutee is required to place a daily entry into their journals. This is used to track the impact on both parties from the experience and to measure personal and academic growth. Even if the Tutee is not able to write, single drawings or words learned can serve as an effective tool of measurement. Youth Volunteer Corps Advisory Council: This group is made up of 12 adult members of the community who represent the spectrum of socioeconomic backgrounds that are representative in the Indian River County area. Much time is spent in both the evaluation process and the project planning process. Teen Center: Membership Applications are collected upon registering for the program. Membership renewal applications are updated continuously throughout the year, with the bulk registering at the beginning of the school year. Daily average attendance is collected by recording the number of members that attend daily divided by the numbers of days of service. Results are maintained and available on a monthly basis. Club Activities are collected daily to track members ' participation in the various activities that are offered throughout the day. Pre and Post Surveys are distributed prior to all drug, alcohol and teen pregnancy prevention programs to measure the knowledge gained through participation in our SMART Moves programs. Juvenile Crime Rates will be collected by providing the Department of Juvenile Justice with the names of all children enrolled in the program; they will then notify us regarding the number of y� members arrested. Comparisons can be run on a quarterly basis. School Achievement will be measured by collecting report card data and providing a comparison of grades from quarter to quarter. A baseline will be established the I " quarter of each year and compared to results at the end of the year. Parent & Member Surveys will be distributed to each parent & member in April to evaluate services being delivered. B&GCA Outcome Measurements Tool every member is encouraged to enter a baseline survey upon registering for the program. Ongoing surveys are administered each year. 1 . 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? Public trust and accountability are our top priority. Our core promise to our members is to provide a safe positive place and have a positive impact on their lives . We accomplish this by upholding high ethical standards in all areas, especially in overseeing our finances, providing accurate membership data, being good stewards of the donor dollar and representing ourselves to the public . We plan on presenting an organizational annual report in 2007, which will showcase the outcome of our core promise to our members, funders and the community. Finally, all of the information we gather as a result of our measures will enable us to continuously �r update and improve our program to ensure it meets the needs of our members and the community. 11 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's Services Advisory Committee 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 January 2006 Develop Program Budget for February Approval March 2006 Write and Prepare grants for next fiscal year April 2006 Implement PATHWAYS program May 2006 Close PALS program May 2006 Register Summer Program Participants May 2006 Hire Summer Team Leaders/Interns May 2006 Close YVC School Year Activities May 2006 Train YVC Summer Staff June 2006 Train Summer YVC Program Participants September 2006 — December 2006 School Presentations September - November 2006 Train YVC participants and PALS members September 2006 PALS Program begins November, February, May, August Evaluation of YVC Programs 12 Boys & Girls Club of Indian River County, Inc. — Vero Beach Teen Center/Youth Volunteer Corps Grant Application to the Children's Services Advisory Committee H. PROJECTIONS FOR UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location i Current Fiscal Year 3 Location T Si Budget 2005/06 T ` I ' Unduplicated Clients Unduplicated Clients Unduplicated Clients N. Indian River County 112 200 200 S. Indian River County 973 1 ,736 1 ,736 Indian River Co. Total 1 ,085 1 ,936 1 ,936 Greater Stuart - - Hobe Sound - h>diantown - - Jensen Beach - - - Palm City - - - Martin County Total - - - Fort Pierce - - - Port Saint Lucie - - - St. Lucie Co. Total - Other Locations - �'' TOTAL SERVED 1 ,085 1 ,9361 13936 Number of Unduplicated Clients by Age IF zt fGr. dpin l '+ ar Current Fiscal Year Location M Budget 2005/06 ME r� Individual Group tlivtdn ou t w _ 0 to 4 - (Pre-school) - - - - 5 to 10 - (Elementary) - 60 60 11 to 14 - (Middle) 510 753 50 775 50 15 to 18 - (High School) 575 847 25 825 25 Total Children 1 ,085 11600 135 100 135 19 to 59 - (Adults) - 35 50 35 50 60 + (Seniors) 106 10 106 10 Total Adults 141 60 141 60 TOTAL SERVED 1 ,085 - 11741 195 11741 195 `rrr 13 Boys 8 Girls Clubs of Indian River County, Inc. Vero Beach Teen CenlarNouth Volunteer Corps 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. AGENCY/PROGRAM NAME : Boys & Girls Clubs of Indian River County, Inc ./Teen Center/YVC FUNDER : Children 's Services Advisory Committee CAUTION Do not enter any figures where a cell is colored in dark blue • Formulas and/or links are in place. Gray areas should • be used for providing information and calculations only. REVENUES Proposed Tote/ Pi iigrant Budg11 et: Funder Specffc Total Agency Budget Budget 1 Children's Services CouncilSt Lucie 0.00 0.00 1000 2 Children's Services Council-Martin 0.00 0.00 3 Advisory Committee-Indian River 40,000. 00 40,000.00 105 4 United Way-St. Lucie County 0 .00 0.00 5 United Way-Martin County 0 .00 0.00 6 United Way-Indian River County 55,000.00 0.00 160 7 Department of Children & Families 0.00 0.00 8 County Funds 0.00 0. 00 0.00 9 Contributions-Cash 0.00 0. 00 236, 194. 00 10 Program Fees 250.00 0 .00 58,000.00 1 1d Raising Events-Net 0 .00 0.00 108 ,000.00 1 Woes to Public - Net 0 .00 0.00 0 .00 13 Membership Dues 1 ,250 .00 0.00 20,000.00 14 Investment Income 0.00 0.00 1 ,600.00 15 Miscellaneous 0.00 0.00 0.00 16 Legacies & Bequests 0.00 0.00 0.00 17 Funds from Other Sources 54 , 843.34 0.00 241 , 121 .34 18 Reserve Funds Used for Operating 0.00 0.00 0.00 19 In-Kind Donations (Not included In total) 0.00 0 .00 12,000.00 20 TOTAL REVENUES (doesn't include line 19) $ 151 , 343.34 $40 ,000.00 $929, 915.34 B C EXPENDITURES proposed'Totaf Program budget Funder Specific Total Agency ... l BudgetBudget 21 Salaries - (must complete chart on next page) 106,617 .75 35,631 . 75 512 ,025.00 22 FICA - Total salaries x 0.0765 5,344.26 2 , 725 . 83 36,358 .00 Retirement - Annual pension Tor qua le 23 staff 2 ,929 .00 0.00 30,784.00 Life/Health - Medical/Dental/Short-term 241 Disab. 41188 . 00 1 ,642 .42 41 , 000. 00 or ers ompensa Ion - 0-employees x 25 rate 896.00 0.00 12 , 737 . 00 on a nemp oymen - proiec e 26 employees x $7,000 x UCT-6 rate 378 .00 0 . 00 4 ,347.00 �Illli / 51232006 14 Boys & Girls Clubs o/ Indian River County. Inc. Vero Beach Teen Center/Youth Volunteer Corps SALAP49Sr . cross n IV ISITION LISTING AntivarSalary Portion olSalary on Proposed fit Ya of Gross Annual program FunderSpecffic Budget Salary soon Me / Tofu Nrstwsc RegU@sted(C!A) F.xamAle: Exaeumre.Dlractor/40 tms T0000.0A f0OM# ;5100000 -7.14°%e. President & CEO/40 hrs 103,320. 00 25, 830 . 00 0 . 00 0.00% Director of Finance/40 hrs 42,527.00 10,631 . 75 10 ,631 . 75 25.00% YVC Director/40 hrs 30, 000.001 30 ,000.00 25 ,000.00 83.33% YVC Team Leader/32 his 11 , 391001 11 ,393.00 0.00 0.00% YVC Team Leader/32 hrs 10,500.00 10,500.00 0.00 0. 00% YVC Team Leader/19 hrs 5,581 .001 5,581 .00 0.00 0 . 00% YVC Team Leader/19 hrs 4,732.00 4,732.00 0.00 0.00% YVC Team Leader/19 hrs 4,550.00 4,550.00 0.00 0.00% Summer YVC Team Leader/40 hrs/10 wks 3,400.00 3,400. 00 0 . 00 0.00% Remaining positions throughout the agency 296 ,022.00 Total Salaries $512 ,025.00 $ 106,617.75 $35,631 . 751 6.96% 'INGE BENEFITS DETAIL (Funder Specific Budget I Funder If 7rf lv v w tnl Specific Budget FICA 7.65% Pension Health Worker's Unemployme Total Fringes Funder Position le only, from line 21 to 26) (A z %) kis, Comports. nt Compens. Speeipc Position Title / / Fotas HrsAvk ' Example: Casa Managerr40hrs 5,000.00 38250 '200.00 500.00 300.00 200.00 1,582.50 President & CEO/40 hrs 0. 00 0.00 0.00 0.00 0.00 0. 00 OM Director of Finance/40 hrs 10,631 .75 813.33 0.00 0. 00 0. 00 0. 00 813. 33 YVC Director/40 hrs 25,000.001 1 ,912,50 0.00 1 ,642.42 0. 00 0.00 3,554.92 YVC Team Leader/32 hrs 0.00 0. 00 0.00 0.00 0. 00 0 .00 0.0 YVC Team Leader/32 hrs 0.00 0. 00 0. 00 0.00 0.00 UO O.O YVC Team Leader/19 hrs MO 0.00 0. 00 0.00 0.00 0.00 0.00 YVC Team Leader/19 hrs 0.00 0.00 0.00 0.00 0 .00 0.00 0.00 YVC Team Leader/19 hrs 0.00 0.00 0.00 0.00 0.00 0.00 0.06 Summer YVC Team Leader/40 hrs/10 wks 0. 00 0.00 0 .00 0.00 0.00 0. 00 0.00 Total Funder Request Fringe Benefits 35,631 .75 2, 5.83 0.00 $1 ,642.4 $0. 001 $0.0014, 5 Now 5123/2006 15 Boys & Girls Clubs of Incian River County, Inc. Vero Beach Teen CenterrYouth Volunteer Corps B C EXPENDITURES Proposed Total Program Budget II Funder Specific Total Agency Budget Budget 2ravel-Daily 2,600.00 mol 5,000.00 # of Staff x average # of mtieslwk x 50 wks x $ = Estimated Daily TraverMi(l Reimb We reimburse at a rate of 39.5 cents:per mile 52 Wks x $40. 28 Travel/ConferenceslTraining - 2 , 500. 001 0.001 12 ,000.00 • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Tramtngs (cost of travel, lodging; registration food) Recommendation from.Boys & Girls Clubs of America is to invest 5% of an employee'ssalary to training:, 29 Office Supplies 750.00 0.00 6,650 .00 • Office supplies (monthly average x 12 months = estimated cost of once supplies based on present history. $62.50 monthly average x 12 30 Telephone 3,860.001 0 .001 13,588.34 • # Phone lines average cost per month 12 months = local phone cost: • Average long distance calls z 12 months -_ Estimated cost of long distance 2lines +:long distance. $126 x 12 & Cell Phones $195 x 12 31 Postage/shipping 1 , 000.001 0.001 3 ,000. 00 •Quarterly Mailing of Newsletter • Special events, etc. • Bulk mailings - appeals Monthly mailing of YVC,project calendars to members - 32 Utilities 2,000.001 0.001 20,000.00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) • Garbage ($x 12 months) - Water/Sever ($40 x 12) Electric ($60 x 12) Garbage ($33 x '12), 331occupancy (Building & Grounds) 2 ,930. 001 0.00F 92 , 557.00 lrtgage/Rent.($ x 12 months) nitorial ($ x 12 months) • Grounds Maint ($ x 12 months) • Real Estate Taxes Janitors[ ($122 x 12) Building Maintenance ($122 .x 12) 34 Printing & Publications 3, 750.001 0.001 21 , 100.00 • Quarterly Newsletter ($ x4) : • Letterheads, Envelopes, etc. • Fundraising . materials • Other A share:of the organizations printing. is divided over the programs. 35 Subscription/Dues/Memberships 21613.60 0 . 001 13,413 . 60 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, eta BGCA Dues , Florida Area Alliance Dues. 36 Insurance 9, 794.001 0.001 37,080.00 • Directors/Officers Liab • CommerciaPGeneral Insurance • Bond Ins • Auto Insurance Directors/Officers, Commercial, Bond, Auto Member Accident. 37 Equipment: Rental & Maintenance 2,743.001 0 . 001 16 , 298 .00 • Copier lease ($ Ix 12 months)' • Meter lease ($ x12 months) • Copier Maintenance ($ x 12 months) • Computer Maintenance ( $ x '12 months)>. • Other Copier lease ($43 x 12) VehicleMaintenance (V65.x 12) Computer Maintenance ($26 x 12) 38 Advertising 0. 001 0.001 0.00 • Newspaper ads -ndraising ads/promotions her (vacancies) 39 Equipment Purchases: Capital Expense 0 .00 0. 00 0.00 • Computerlmonitot (# x ) • Laser Printer 512312OW Boys & Girls Clubs of Indian River County, Inc. Vero Beach Teen CenterYouth Volunteer Corps 40 Professional Fees (Legal, Consulting) 0.00 0 .001 0.00 Legal advice ( estimated #hrs x $) 'ohsultant fees 44 Cher 41 Books/Educational Materials 2 ,250.00 0.001 10,500.00 • Books/videos • Materials ($ x staff) Program supplies purchased throughout the year. 42 Food & Nutrition 354.001 0.001 3, 554 . 00 • Meals ( # meals clients x Sdays x 50 wits) • Shacks Snack program ($29x 12) 43 Administrative Costs 250.001 0, 001 4,786.40 Admin. Cost (% of total budget) 44 Audit Expense 21000.00 0, 001 8 ,000.00 • Independent Audit Review Audit expenses are divided up over all programs. 45 Specific Assistance to Individuals 0,00F 0 ,001 0.00 • Medical assistance • -MealslFood- • Rent Assistance • Other 46 Other/Miscellaneous - 6 ,484.001 0.001 25, 13200 • Background check/drug test • Other Background checks, Drug Screens Member field tripshravel, other. 47 Other/Contract 0 .001 0 00F, 0.00 Sub-contract for program services 481 TOTAL EXPENSES $166 , 231 .61 $40,000 . 00 $929,915.34 'ice• rrr 51232006 17 Bops• Olhs Club d IMhn Rivn [amry, Inc Vno¢eun TmvC Mvgw Vd.nlnt Cnpt UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME: Bos & Girls Clubs of Indian River County/Teen Center/YVC FY O4/05 FY 05/06 FY 06/07 % INCREASE FYE June 30 HE June 30 FYE June 30 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED Icor. c-c01. eycoi. e REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 0.00 0.00 #DIV101 2 Children's Services Council-Martin 0.00 0.00 0.00 #DIV101 3 Advisory Committee-Indian River 108308.47 91200.00 105000.00 15.13% 4 United Way-St Lucie County 0.00 0.00 0.00 #DIV101 5 United Way-Martin County 0.00 0.00 0.00 #DIV/0I 6 United Way-Indian River County 132t533.29 140 000.00 160 000.00 14.29% 7 Department of Children & Families 0.00 0.00 0.001 #DIV101 8 County Funds 0.00 0.00 0.00 #DIV101 9 Contributions-Cash 194767.37 221 694.00 236194.00 6.54% 18 Program Fees 7453.76 18000.00 58000.00 222.22% 11 Fund Raising Events-Net 98950,22 104500.00 108000.00 3.35% 12 Sales to Public-Net 0.00 0.00 0.00 #DIV101 13 Membership Dues 11745.00 18000.00 20000.00 11 .11% 14 Investment Income 2389.06 1600.00 1600.00 0.00% 15 Miscellaneous 0.00 0.00 0.00 #DIVl01 16 Legacies 8 Bequests 0.00 0.00 0.001 #DIV/01 17 Funds from Other Sources 101274.18 259698.00 241121 .34 -7.15% 16 Reserve Funds Used for Operating 0.00 0.00 0.00 #DIVIO! is In-Kind Donations (Not Included in toted 61205.50 12000.00 12000.00 0.00% 28 TOTAL 657 421 .35 854 692.00 929 915.34 8.80% EXPENDITURES 21 Salaries 37d 219.52 465 503.00 512 025.00 9.99% 22 FICA 28 963.68 3685500 36 358.00 -1 .35% 23 Retirement 25 511 .89 29,515.001 30 784.00 4.30% 24 LifelHealth 32 074.20 41 000.00 41r000.00 0.00% 25 Workers Compensation 8191 .28 13162.00 12737.00 -3.23% 26 Florida Unemployment 1 ,392.48 1 701 .00 4 347.00 155.56% 27 Travel-Daily 31899.01 500000 5,000.00 0.00% 28 Tmvel/Confemnces/Trainin 9,298.49 8,000.00 12 000.00 50.00% 29 Office Supplies 51595.69 665000 6,650.00 0.00% 30 Telephone 12180.19 14940.00 13588.34 -9.05% 31 Postage/Shipping 2433.82 3000.00 3,000.001 0.00% 32 Utilities 10941 .92 16500.00 20,000-001 21 .21% 33 Occupancy (Building & Grounds 71 110.21 86177.00 92557.00 7.40% 34 Printing 8 Publications 16 669.71 21 ,100,0D 21 100.00 0.00% 35 Subscri tion/Dues/Membershi s 10552.17 11720.00 13413.60 14.45% 36 Insurance 22663.33 32841.00 37080.00 12.91% 37 Eui ment:Rental B Maintenance 13363.83 15798.00 16298.00 3.16% 38 Advertising 0.00 0.00 0.00 #DIV101 39 Equipment Purchases:Ca ital Expense 0.00 0.00 0.00 #DIV101 40 Professional Fees (Legal, Consulting) 0.00 0.00 0.00 #DIV/0! 41 Books/Educational Materials 10 341 .83 8,691 .00 10 500.00 20.81% 42 Food & Nutrition 2,669.13 355400 3,554.00 0.00% 43 Administrative Costs 4,044.00 500000 4,786.40 -4.27% u Audit Expense 8,535.00 7,500-00 8,000.00 6.67% 45 Specific Assistance to Individuals 0.00 0.00 0.00 #DMO! 46 Other/Miscellaneous 32403.94 20485.00 25137.00 22.71 % 47 Other/Contract 82177.69 0.000.00 #DIV/01 48 TOTAL 715 233.01 854169; .00 929 915.34 8.80% 49 REVENUES OVER/ UNDER EXPENDITURES .57,811 .661 0.00 0.001 #DIVIO! ��� 18 yam, � r� C.Nrn� Vd reR Owes UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME : Bos & Girls Clubs of Indian River Count [Teen Center[YVC FY 04105 FY 05106 FY 06/07 % INCREASE NOW FYE June 30 FYE June 30 FYE June 30 CURRENT VS. NEXT FY BUDGET A e C D ACTUAL TOTAL PROPOSED (col. Ccal. BVcol. B REVENUES BUDGETED BUDGETED I 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 #DIV/01 3 Advisory Committee-Indian River 39 769.07 3360000 40 000.00 19.05% 4 United Way-St. Lucie County 0.00 0.00 0.00 #DIV/01 5 United Way-Martin County 0.00 0.00 0.00 #DIVl01 5 United Way-Indian River County 46 000.08 50 000.00 55 000.00 10.00% 7 Department of Children & Families 0.00 0.00 0.00 #DIV/01 8 County Funds 0.00 0.00 0.00 #DIV/01 9 Contributions-Cash 0.00 0.00 (1.00 #DIV101 to Program Fees 227.00 0.00 250.00 #DIV/01 11 Fund Raising Events-Net 0.00 0.00 0.001 #DIVI01 12 Sales to Public-Net 0.00 0.00 0.00 #DIV/01 13 Membership Dues 0.00 750.00 1 250.00 66.67% 14 Investment Income 0.00 0.00 0.00 #DIV101 15 Miscellaneous 0.00 0.00 0.00 #DIV/01 16 Legacies & Bequests 0.00 0.00 0.00 #DIV101 17 Funds from Other Sources 9,227.22 7304600 54 843.34 -24.92% 18 Reserve Funds Used for O eretin 0.00 0.00 0.00 #DIV/01 191n-Kind Donations Not Included in total) 2333.75 0.00 0.00 76IV/01 20 TOTAL 95 223.37 157 396.00 151 343.34 -3.85% EXPENDITURES 21 Salaries 96 210.59 97 211 .50 106 617.75 9.68% 22 FICA 7,447.22 7 182.00 5,344.26 -25.59% 23 Retirement 3,327.84 293600 2,929.00 -0.24% 24 Life/Health 3,92D.16 342800 4,188.00 22.17% 25 Workers Compensation 1984.62 2005.00 896.00 -55.31% 26 Florida Unemployment 268.03 189.00 378.00 100.00% 27 Travel-Dally 2,151 .63 22600.00 2,600.00 0.00% 28 TavellConferences/Trainin 1 ,032.84 1 ,000.00 2,500.00 150.00% 29 Office Supplies 436.75 750.00 750.00 0.00% 30 Telephone 2 251 .44 456000 3,860.00 -15.35% 31 Posta a/Shi in 267.11 1 000.00 1000.00 0.00% 32 Utilities 344.86 2 000.00 2 000.00 0.00% 33 Occupancy (Building & Grounds 4,527-55 298000 25930.00 -1 .68% 34 Printing & Publications 2,474.82 3,750.00 3,750.00 0.00% 35 Subscription/Dues/Memberships 2442.23 2325.00 2,613.601 12.41 % 36 Insurance 5r121 .85 8439.00 9,794.00 16.06% 37 Eui ment:Rental & Maintenance 2769.08 2643.00 2743.00 3.78% 38 Advertisinq 0.00 0.00 0.00 #DIV101 39 E ui ment Purchases:Ca ital Ex ensu 0.00 0.00 0.00 #DIV101 4o Professional Fees Le al Consulting) 0.00 0.00 0.00 #DIV101 41 Books/Educational Materials 11758.20 160000 2,250.00 40.63% 42 Food & Nutrition 0.00 354.00 354.00 0.00% 43 Administrative Costs 70.63 325.00 250.00 -23.08% 44 Audit Expense 2, 133.75 1 875.00 Z000.00 6.67% 45Specific Assistance to Individuals 0.00 0.00 0.00 #DIV/0! as Other/Miscellaneous 4,510.35 4 321 .00 6 484.00 50.06% 47 Other/Contract 2695.05 0.00 0.00 #DIV101 48 TOTAL 148 146.60 153 473.50 166 231 .61 8.310/6 49 REVENUES OVERT UNDER EXPENDITURES -52,923.23 3,922.50 -14 888.27 -079.56% �r 19 Srza.AV6 Boys & Gas Clubs of Indian River County, Inc. Verb Bacei Teen CenterNoun Volunteer Corps UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET `✓ PROGRAM EXPENSES AGENCY/PROGRAM NAME : Boys & Girls Clubs of Indian River County, Inc./Teen CenterlYVC FUNDER : Children's Services Advisory Committee A B C FY 06107 FY 06107 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. B/i A) iiiiiip EXPENDITURES 21 Salaries 106,617.75 35,631 .75 33.42% 22 FICA 5,344.26 21l725.83 51 .00% 23 Retirement 2,929.00 0.00 0.00% 24 Life/Health 4, 188.00 19642.42 39.22% 25 Workers Compensation 896.00 0.00 0 .00% 26 Florida Unemployment 378 .00 0.00 0 .00% 27 Travel-Daily 21600 .00 0.00 0 .00% 28 Travel/Conferences/Training 21l500.00 0.00 0.00% 29 Office Supplies 750.00 0.00 0. 00% 30 Telephone 3 ,860.00 0 .00 0.00% 31 Postage/Shipping 11000. 00 0.001 0 .00% 32 Utilities 21000. 00 0.00 0.00% 33 Occupancy (Building & Grounds 21930.00 0.00 0 .00% 34 Printing & Publications 3,750.00 0.00 0 .00% 35 Subscription/Dues/Memberships 2,613.60 0.00 0 .00% 36 Insurance 9,794.00 0. 00 0 .00% 37 Equipment: Rental & Maintenance 2,743.00 0.00 0.00% 38 Advertising 0 .00 0.00 #DIV/O ! 39 Equipment Purchases : Ca ital Expense 0 .00 0.00 #DIV/O ! 40 Professional Fees (Legal , Consulting) 0.00 0.00 #DIV/0 ! 41 Books/Educational Materials 29250.00 0 .00 0.00% 42 Food & Nutrition 354.00 0 .001 0.00% 43 Administrative Costs 250.00 0.00 0.00% 44 Audit Expense 21000. 00 0.00 0 .00% 45 Specific Assistance to Individuals 0.00 0. 00 #DIV/01 46 Other/Miscellaneous 61484. 00 0. 00 0 .00% 47 Other/Contract 0.001 0.00 #DIV/O ! 4a TOTAL $ 166 ,231 .61 $40, 000.00 24.06% WM006 20 aon 4 Rrs cwEs of I'd" pros,Count. Inc voo Barn Teen CenleMoute vaumeer Corps UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE v�,,� TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: Boys & Girls Clubs of Indian River County/Teen CenterNouth Volunteer Corps FUNDER: Children's Services Advisory Committee #13IV101 #DIV/el Advisory Committee-Indian River We are requesting the same funding that the CSAC recommended that we be granted last year, prior to the budget cuts. #DN101 #DIV/01 #DIV/01 #DIV/01 #DIV/01 #DIV/0l #DIVI01 #DIVIeI Membership Dues Now that the Teen Center is operational we charge a $35 annual fee per member. #DIV/01 #DIV/01 #DN/01 #DIVI01 #DIV/01 Life/Health This plan is age rated therefore when we hired an older person to 1191 the position, the premium increased. Florida Unernialohiment Unemployment claims last year caused an anticipated rate increase. TravellConferences,prrainfino Increased due to the need to train additional stall. Insurance Annual increases/addition of bus to insure. #DIV/01 #DIVI01 #DIV/01 Books/Educational Materials IThe need to replace/buy new programleducational materials is anticipated. #DIVI01 Member field tripsitravel is included in this line item and all programs are always seeking out new and exciting trips to take using funds Other/Miscellaneous raised by their Advisory Councils. #DIV/01 006 21 Bon B per CbM oflnelan Rest Counto Inc Vern Bexn Teen Ce^IerttoWB Volunteer Corps UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE rte,,,, FUNDER SPECIFIC BUDGET AGENCY(PROGRAM NAME: Boys & Girls Clubs of Indian River County, Inc./Teen Center/YVC FUNDER: Children's Services Advisory Committee Our request is for the funding part of our Branch/Finance Directors salarylbenefits for which the portion of this line dem charged off to this grant would be 3342% of the line Item's budget. Additionally, we obtain support staff through the AmeriCorps program, which means we are able to hire people and share the cost of their salaries with AmeriCorps (a federally funded program) and they pay the full Salaries Cost of payroll taxes, medical insurance and distribute scholarships to the workers upon completion of their hours. Our request is for the funding part of our BranchlFinanoe Directors salary/benefits for which the portion of this line item charged off to this grant would be 51 % of the line item's budget. Additionally, we obtain support staff through the AmeriCorps program, which means we are able to hire people and share the cost of their salaries with AmeriCorps (a federally funded program) and they pay the full cost of FICA payroll taxes, medical insurance and distribute scholarships to the workers upon completion of their hours. Our request is for the funding part of our Branch/Finance Directors salary/benefits for which the portion of this line item charged off to this grant would be 39.22% of the line item's budget. Additionally, we obtain support staff through the AmeriCorps program, which means we are able to hire people and share the cost of their salaries with AmeriCorps (a federally funded program) and they pay the full Lifelflealth cost of payroll taxes, medical insurance and distribute scholarships to the workers upon completion of their hours. #DIV/0! ^IV/0! 70! Now #DIM #DIVIO! "111111111110, 512L MS 22 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 18` 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`h) 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 1840251h Street Vero Beach , Florida 32960-3365 Recipient : Boys & Girls Clubs of Indian River County, Inc. P. O. Box 643068 Vero Beach , Florida 32964 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 - acer J-V1`ae / 2V1J0 slmex 4 : 21 PM To : 0 299 - 3840 Pager 005 A ORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM DGMM� 10/23 /2006 PRODUCER (772) 231 - 2828 FAX (772 ) 231 -4413 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Felten & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2911 Cardinal Drive (32963 ) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O . Box 3488 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Vero Beach , FL 32964- 3488 INSURERS AFFORDING COVERAGE NAIC # INSURED Boys & Girls Club of Indian River County , Inc . INSURERA. Philadelphia Indemnity Ins Co P . O . Box 3068 INSUBERB Florida Retail Federation Vero Beach , FL 32964- 3068 INSURER C. INSURER D NSURER F COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 7GENE�L 7L�BILMY ���PHPC!90417 ANCE POLICY NUMBER POLICY EFFECTIVE POLICYEXPIRATION LIMITS PHPK190417 09/13 /2006 09/13 /2007 EACH OCCURRENCE $ 1 , 000 , 000 RAL LIABILITY DAMAGE TO RENTED $ 100 , 000 � OCCUR MED EXP (My one person) $ 5 00 PERSONAL & ADV INJURY $ 1 , 000 , OO GENERAL AGGREGATE $ 3QQO00 APPLIES PER'. PRODUCTS - COMP/OP AGG $Loc 3 , 000 , 00 AUTDMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED ALTOS $ ODIL NJ HIRED AUTOS INJURY NJURY NON-OWNED AUTOS (Per LY N U) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY P- POLICY LY - EA ACCIDENT $ANYAUTOEA ACC $HANLY. AGG $ESSNMBRELLA LIABILITY CURRENCE gOCCUR El CLAIMS MADE ATE $DEDUCTIBLE RETENTION $ $WORKERS COMPENSATION AND 520- 25864 09/13 /2006 09/13 /2007 STATU- X OTU+EMPLOYERS' LIABILITY TORY I M11B ANY PROPRIETORPARTNER/EXECUTIVE H ACCIDENT $ 500 , 000 OFFICERVENEER EXCLUDED? If yes. Oescroe under ASE - EA EMPLOYEE $ 500 $ 000 SPECIAL PROVISIONS Delm ASE - POLICY LIMIT $ 500 , 00 roessional Liability PHPK190417 09/13 /2006 09/13/2007 $ 1 , 000 , 000 Occurrence A $ 3 , 000 , 000 Aggregate DESCRIPTION OF OPERATIONS 1 LOCATIONS VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ertificate holder is named additional insured CERTIFICATE HOI DER ANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Indian River County Board 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, of County Commissioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1840 25th St OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, Vero Beach , FL 32960 AUTHORIZED REPRESENTATIVE Kenneth D . Felten LUTCF 7AI`--i(?W. ACORD 25 (2001108) ©ACORD CORPORATION 1988 iVWAZIVvq '"me : s : Zi rn 'f0 : W Z99 - 3a40 Page : 006 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed . A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s) . If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) o �e � +enc � icevo acme : sill rn x'O : LYY - Sa4V Page : 007 Additional Coverages and Factors 10/23/2006 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor General Aggregate 330009000 Products /Completed Ops 3 , 0009000 Aggregate Personal & Advertising 1 , 0009000 Injury Each Occurrence 11000 , 000 Fire Damage 100 , 000 Medical Expense 51000 Abuse/Molestation/Occur 150005000 Abuse/Molestation/Aggr 1 , 0009000 Employee Benefits 190009000