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2007-308G
� I J t f + l `� Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this day of October 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 " Street, Vero Beach FL , 32960 ("County") and St. Peter' s Human Services , Inc. , ( Recipient); of: 4250 38th Avenue , Vero Beach , FL 32967 For: St. Peter's Village of Excellence Training Program for Girls Background Recitals A. The County has determined that it is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") and established the Children 's Services Advisory Committee to promote healthy children in a healthy community and to provide a unified system of planning and delivery within which children 's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children's Services Advisory Committee in fulfilling its purpose. D . The proposals submitted to the Children 's Services Advisory Committee and the recommendation of the Children's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals. The background recitals are true and correct and form a material part of this Contract. 2 . Purpose of Grant. The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes" ) . - 1 - � I J t f + l `� Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this day of October 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 " Street, Vero Beach FL , 32960 ("County") and St. Peter' s Human Services , Inc. , ( Recipient); of: 4250 38th Avenue , Vero Beach , FL 32967 For: St. Peter's Village of Excellence Training Program for Girls Background Recitals A. The County has determined that it is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") and established the Children 's Services Advisory Committee to promote healthy children in a healthy community and to provide a unified system of planning and delivery within which children 's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children's Services Advisory Committee in fulfilling its purpose. D . The proposals submitted to the Children 's Services Advisory Committee and the recommendation of the Children's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals. The background recitals are true and correct and form a material part of this Contract. 2 . Purpose of Grant. The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes" ) . - 1 - 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2007/2008 ("Grant Period") . The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Thirteen Thousand , Five Hundred Dollars ($13, 500) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for Grant Purposes provided in accordance with this Contract. Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit " B" attached hereto and incorporated herein by this reference. All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate. 5 . Additional Obligations of Recipient . 5 . 1 Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant. In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period . The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5) days prior written notice . 5. 2 Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws , rules , and regulations . 5 .3 Quarterly Performance Reports . The Recipient shall submit quarterly, 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 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program's performance throughout the Grant Period . 5 .4 Audit Requirements . If Recipient receives $25 ,000 or more in the aggregate from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient' s fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget. The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for a prior fiscal year is past due and has not been submitted by May 1 . 5 .4 . 1 The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from it' s independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate this Contract. - 2 - 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2007/2008 ("Grant Period") . The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Thirteen Thousand , Five Hundred Dollars ($13, 500) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for Grant Purposes provided in accordance with this Contract. Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit " B" attached hereto and incorporated herein by this reference. All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate. 5 . Additional Obligations of Recipient . 5 . 1 Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant. In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period . The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5) days prior written notice . 5. 2 Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws , rules , and regulations . 5 .3 Quarterly Performance Reports . The Recipient shall submit quarterly, 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 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program's performance throughout the Grant Period . 5 .4 Audit Requirements . If Recipient receives $25 ,000 or more in the aggregate from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient' s fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget. The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for a prior fiscal year is past due and has not been submitted by May 1 . 5 .4 . 1 The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from it' s independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate this Contract. - 2 - 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 the 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 damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; (ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 ,000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and (iii ) Workers' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates, evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Workers ' Compensation insurance . The Recipient shall , upon ten ( 10) days' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient' s place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract. 5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses, damage , or causes of action which may arise from any misconduct, negligent act, or - 3 - 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. IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY Attest: J . K. Ba on , Clerk BOARD OF COUNTY COMMISSIONERS J , By Deputy Clerk By � .; Gary heeler, Chairman: BCC Approved : Approved : J eph A. Baird unty Administrator A ved as to form legal sufficiency: Marian . Fell , Assiste tounty Attorney RECIPIENT: By: S R' S 4UMAN SERVICES., INC . - 4 - 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 the 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 damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; (ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 ,000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and (iii ) Workers' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates, evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Workers ' Compensation insurance . The Recipient shall , upon ten ( 10) days' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient' s place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract. 5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses, damage , or causes of action which may arise from any misconduct, negligent act, or - 3 - EXHIBIT A [Copy of complete proposal/application] 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@bellsouth.net Address : 4250 38th Avenue Telephone : 772-562-6863 Vero Beach, F132967 Fax : 772-562-8920 Program Director: Mrs . Ruth Jefferson 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 delipAuencv 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) AmountRequested from Funder for 2007 /08 : $ 53 ,449 . 11 Total Proposed Program Budget for 2007 /08 : $ 53 ,449 . 11 Percent of Total Program Budget;_ _ —__ 100 . 0 % j Current Pro ram Fundin 2006 /07 ) : $ 27 ,080 Dollar increase /( decrease ) in request : $ 263369 Percent increase / decrease in request " : 97 . 4 % { Unduplicated Number of Children to be served Individually : 40 ` Unduplicated Number of Adults to be served Individually : _ _ i Unduplicated Number to be served via Group _settings : __4_0_1 Total Pro ram Cost per Client : fi68 . 11I * *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. f 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 Larry Taylor ( L Name of Executive Director/CEO Signature 3 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. IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY Attest: J . K. Ba on , Clerk BOARD OF COUNTY COMMISSIONERS J , By Deputy Clerk By � .; Gary heeler, Chairman: BCC Approved : Approved : J eph A. Baird unty Administrator A ved as to form legal sufficiency: Marian . Fell , Assiste tounty Attorney RECIPIENT: By: S R' S 4UMAN SERVICES., INC . - 4 - 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 t/z" 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 term 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. 4 Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) 1 . a) What is the unacceptable condition requiring change? b) Who has the need? c) Where do they live? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. 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-risk 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. DJJ' Girls Forum Report indicates that in Florida, nearly 30 percent of juveniles arrested are female. Between 1993 -94 and 2002-03 , the rates of arrest per 1 ,000 youth decreased. Boys arrest rates decreased by 23%, whereas girls ' rates of arrest decreased by only 6% . Between 1993 -94 and 2002-03 , the number of girls referred for violent felonies increased 24%. Among girls in residential commitment in Florida; almost 50% have been sexually abused; 60% have been physically abused; 60% witnessed domestic violence in their homes; 25% have been in foster or DCF custody as a result of abuse or neglect; more than 60% have a parent who has been arreated; 75% have run away from home at least once; almost one-fifth are mothers; and about 50% of their violent felony arrests are domestic violence related. National research indicates that girls in delinquency programs are three times as likely as boys to have experienced sexual abuse and that such abuse is usually perpetrated by a family member or close family friend; the girls are likely to have learning disabilities and are often a grade behind in school; more than 50% have reported attempting suicide and of those, 64% have tried more than once to kill themselves. 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 states, "The need for appropriate new programs for girls continues. What happens to girls in the system is critical because of their large numbers; girls ' circumstances are different than boys. The relevant issues include avoiding teen pregnancy, education, health and hygiene, dealing with abuse, parenting skills, self esteem and mentoring." (www.dii .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. 1a. 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 5 EXHIBIT A [Copy of complete proposal/application] Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council 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. 6 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 38th 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, 7 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@bellsouth.net Address : 4250 38th Avenue Telephone : 772-562-6863 Vero Beach, F132967 Fax : 772-562-8920 Program Director: Mrs . Ruth Jefferson 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 delipAuencv 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) AmountRequested from Funder for 2007 /08 : $ 53 ,449 . 11 Total Proposed Program Budget for 2007 /08 : $ 53 ,449 . 11 Percent of Total Program Budget;_ _ —__ 100 . 0 % j Current Pro ram Fundin 2006 /07 ) : $ 27 ,080 Dollar increase /( decrease ) in request : $ 263369 Percent increase / decrease in request " : 97 . 4 % { Unduplicated Number of Children to be served Individually : 40 ` Unduplicated Number of Adults to be served Individually : _ _ i Unduplicated Number to be served via Group _settings : __4_0_1 Total Pro ram Cost per Client : fi68 . 11I * *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. f 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 Larry Taylor ( L Name of Executive Director/CEO Signature 3 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." Governor Bush said of the successful outreaches, " . . . they focus on preserving the unity and integrity of family and emphasizing parental responsibility in dealing with troubled youth." (www.dii .state.fl.us/features/runaways.html). ham). 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. 8 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 38th Avenue, Vero Beach, FL. Transportation is provided by the parents and Institute staff when needed. The program iso en from Friday, 4 :30 p.m. to Saturday, 5 : 00 p.m. 9 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 t/z" 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 term 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. 4 Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) 1 . a) What is the unacceptable condition requiring change? b) Who has the need? c) Where do they live? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. 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-risk 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. DJJ' Girls Forum Report indicates that in Florida, nearly 30 percent of juveniles arrested are female. Between 1993 -94 and 2002-03 , the rates of arrest per 1 ,000 youth decreased. Boys arrest rates decreased by 23%, whereas girls ' rates of arrest decreased by only 6% . Between 1993 -94 and 2002-03 , the number of girls referred for violent felonies increased 24%. Among girls in residential commitment in Florida; almost 50% have been sexually abused; 60% have been physically abused; 60% witnessed domestic violence in their homes; 25% have been in foster or DCF custody as a result of abuse or neglect; more than 60% have a parent who has been arreated; 75% have run away from home at least once; almost one-fifth are mothers; and about 50% of their violent felony arrests are domestic violence related. National research indicates that girls in delinquency programs are three times as likely as boys to have experienced sexual abuse and that such abuse is usually perpetrated by a family member or close family friend; the girls are likely to have learning disabilities and are often a grade behind in school; more than 50% have reported attempting suicide and of those, 64% have tried more than once to kill themselves. 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 states, "The need for appropriate new programs for girls continues. What happens to girls in the system is critical because of their large numbers; girls ' circumstances are different than boys. The relevant issues include avoiding teen pregnancy, education, health and hygiene, dealing with abuse, parenting skills, self esteem and mentoring." (www.dii .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. 1a. 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 5 Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council D. MEASURABLE OUTCOMES (Description oflntent) Use the Measurable Outcomes orm. This description Pare does not need to be included in the proposal. 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 ii the PROGRAM DESCRIPTION (C2). Use the following elements to develop your outcomes. All elements must be included: • Direction of change • Time frame • 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 (timeframe) 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 (B1 ). 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. 10 Organization: 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 o the elements for the Measurable Outcomes Add the tasks to accomplish the Outcome(s) OBJECTIVE #1 : 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, HN, abstinence, etc . Measuring tools : pre-post tests/questionnaire. The Institute will hold a minimum of four sessions per year. . 11 Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council 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. 6 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 38th 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, 7 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 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 12 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 andspreadsheet 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 b'e' 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. 13 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." Governor Bush said of the successful outreaches, " . . . they focus on preserving the unity and integrity of family and emphasizing parental responsibility in dealing with troubled youth." (www.dii .state.fl.us/features/runaways.html). ham). 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. 8 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 38th Avenue, Vero Beach, FL. Transportation is provided by the parents and Institute staff when needed. The program iso en from Friday, 4 :30 p.m. to Saturday, 5 : 00 p.m. 9 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. 14 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. 15 Organization: St. Peter's Human Services, Inc. Program: Village of Excellence Training Institute for Girls Founder: Children's Service Council D. MEASURABLE OUTCOMES (Description oflntent) Use the Measurable Outcomes orm. This description Pare does not need to be included in the proposal. 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 ii the PROGRAM DESCRIPTION (C2). Use the following elements to develop your outcomes. All elements must be included: • Direction of change • Time frame • 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 (timeframe) 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 (B1 ). 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. 10 Organization: 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 o the elements for the Measurable Outcomes Add the tasks to accomplish the Outcome(s) OBJECTIVE #1 : 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, HN, abstinence, etc . Measuring tools : pre-post tests/questionnaire. The Institute will hold a minimum of four sessions per year. . 11 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 t Current Fiscal Year Location a 0 Budget 2006/07 Unduplicated Clients Unduplicated Clients Unduplicated Clients N. Indian River County 29 40 40 S . Indian River County Indian River Co . Tota 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 Current Fiscal Year Location Budget 2006/07 ndividual Group 0 to 4 - (Pre-school) 5 to 10 - (Elementary) - 11 25 - 25 11 to 14 - (Middle) - I 1 - 15 - 15 15 to 18 - (High School) Total Children - 22 - 40 40 19 to 59 - (Aduhs) 60 + (Seniors) Total Adults TOTAL SERVED - 22 - 40 - 40 16 Edit this Header. Type the organization 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. v "Gore Budget Forms' 17 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 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 12 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 andspreadsheet 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 b'e' 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. 13 Type the Organization and 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. AGENCY/PROGRAM NAME : Village of Excellence Training Institute for Girls FUNDER : Children's Services Council _ . . _ . . _ . . _ . . _ . . _ . . . . . _ . . _ . . . . . . . . . . . . . . _ . . _ . . . . . . . . . . • — • - _ . . _ . . _ . — — . . _ . . _ _ . . _ . . - - • —. I CAUTION : Do not enter anYfigures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should :be used for calculations and to write information only. arcriARZANcrweFOR . " Proposed;Total Program Funder Specific ' Total Agency REVENUES coo Budget : ' ; " Budget ," 2 , Budget 1 Children's Services Council-St Lucie 2 Children's Services Council-Martin 3 Advisory Committee-Indian River 53,449.11 53,449.11 53,449. 11 4 United Way-St Lucie County 5 United Way-Martin County 6 United Way-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 16Le acies & Bequests 17 Funds from Other Sources 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not Included In total) 20 TOTAL REVENUES (doesn't Include line 19) ' ' -- " $53,449.11 $53,449.11 $53,449. 11 A 8 C r: D. EXPENDITURES, ae,YApFd m " " Proposed Total Program FunderSpec)go Tota/ Agency noeacvu�ox�r ' _ - = taeoaFxctxnriarwt Budget Budget Budgetg 21 Salaries - (must complete chart on next page) 32,372.00 32,372.DO 32,372.00 Salary 22 FICA - Total salaries x 0.0765 7.65% 2,476.46 2,476.46 2,476.46 Retirement - Annual pension tor qualified 23 staff 0.00 I e ea - e ICs en a O - emn 24 Disab. 0.00 Workers Compensation • # employees x - 25 rate 0.00 ori a Unemployment - # projected 26 employees x $7,000 x UCT-6 rate 0.00 A D: POSITION LUSTING Grose Annual B C % of Gress Annual Portion of Salary on Proposed Salary Program Funder SpecHk Budget Salary Position TWe / Total Hrslwk (Agency) Requeated(CI.4 example: Executhn D/rector/40hrs 70,000.00 _ 10,000.00 5,000.00 7. 14% s19r20m -1 Type the Organization and Program Name Program Director/Administration 10 hrs7,800.00 7,800.00 7,800. 100.00% Program O erabons Manager 25 hrs. 15,500.00 15,500.00 15,500.00 100.000/C Institute Prevention Coordinator - 12 Hrs. 4,860.001 4,860.00 4,860.00 100.00Y (2) Institute Trainers/Teachers - 6 hrs. 4,212.00 4,212.00 4,212.00 100.00° #DIV/01 #DIV/0! #DIV/01 #DIV/01 #DIV/01 #DIV/0! #DIV/01 #DIV/01 #DIV/01 #DIV/01 MIMI #DIV/01 #DIV/01 #DIV/01 #DIV/01 #DIV/0! Remaining positions throughout the agency Total Salaries $32,372.00 $32,372.00 $32,372.00 100.00% FRINGE BENERITS DETAIL - A, - (Funt ► t specific kucr4ii Funder a C F c Pension Specffk; FICA 7.85% Health Ins. Werkar's Unemp/oyme Total rdnges Ander Columb C only, from /file 22 to PTS - B4d �f X 9rJ compws nt Company, specificPosidon 71deFTotallits [vk Example: Ca:ett/eneparfab"N+" . 3r000.00 382:50 200.00 500.00 300.00 Mile ' 1.582.50 Program Director/Administration 10 hrs 7,800.00 596.70 596.7 Program Operations Mana er 25 hrs. 15,500.00 1 ,185.75 1 ,185.7 Institute Prevention Coordinator - 12 Hrs. 4,860.00 371 .79 5. 371 .7 (2) Institute Trainers/Teachers - 6 hrs. 4,212.001 322.22 322.22 0 0.001 0.00 0.001 00.0 0.00 0.0 0 0.00 0.00 0.0 0 0.00 0.00 0.0 0 0.00 0.00 0.0 0 0-04- 0.00 0.0 0 0.0m 0.00 0.0 0 0.001 0.00 0.0 0 0.001 0.00 0.0 0 0.00 0.00 0.0 0 O.ON 0.00 0.0 0 0.001 0.00 0 0 0 0.00 0.00 O.00j 0 0.00 0.00 0.0 0 0.00 0.00 0.0 0 0.0 0.00 - 0.001 Total Funder Request Fringe BeneritS $32,372.00 $2,476.x6 $0.00 $0.00 $0.00 $0.00 $2,476.4 B C , D EXPENDITURES d0r� rare Proposed Total Program Funder S eciflc mrxcrusa MYTc BP Total Agency Budget 9 Budget Budget 27 Travel-Daily # of Staff x average # of milesfwk x 50 wks x - $ = Estimated Daily TravellMileage Reimb. 28 TravellConferences/Training 518r"7 e-t 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. 14 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. 15 Type the Organization eM Pmgrem 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, etc. • Bulk mailings - appeals 32 Utilities • Electricity ($ x 12 months) _ • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) 33 Occupancy (Building & Grounds) - - • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) JI- • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications • Quarterly Newsletter ($ x 4) • Letterheads, Envelopes, etc. • 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 36 Advertising 500.00 500.00 500.00 • Newspaper ads • Fundraising ads/promotions • Other (vacancies) 39 Equipment Purchases:Capital Expense • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) • Legal advice ( estimated #hrs x $) • Consultant fees - • Other 41 Books/Educational Materials 1 ,000.001 1 ,000.00 1 ,000.00 • Books/videos • Materials ($ x staff) 42 Food & Nutrition 9,656.401 9,656.40 9,656.40 5/6@007 B-1 Type the Organization and Program Name • MgExpense als x clients x 5days x 50 wks) • S 43 Ade Costs • A (% of total budget) - 44 Audite 1 ,000.00 1 ,000.0 1 ,000.00 • InAudit Review 45 Spistance to Individuals • Medical assistance • Meals/Food - • Rent Assistance Other 46 Other/Miscellaneous 2,600.00 2,600.00 2,600.00 • Background checddrug test • Otherlrransportation 47 Other/Contract • Sub-contract for program services 48 TOTAL EXPENSES $49,604.86 $48,604.8 $49,604.86 51WO07 6-1 , 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 t Current Fiscal Year Location a 0 Budget 2006/07 Unduplicated Clients Unduplicated Clients Unduplicated Clients N. Indian River County 29 40 40 S . Indian River County Indian River Co . Tota 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 Current Fiscal Year Location Budget 2006/07 ndividual Group 0 to 4 - (Pre-school) 5 to 10 - (Elementary) - 11 25 - 25 11 to 14 - (Middle) - I 1 - 15 - 15 15 to 18 - (High School) Total Children - 22 - 40 40 19 to 59 - (Aduhs) 60 + (Seniors) Total Adults TOTAL SERVED - 22 - 40 - 40 16 Edit this Header. Type the organization 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. v "Gore Budget Forms' 17 T". PSN. UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: FY DUOS FY 05108 FY 06107 % INCREASE FYE FYE FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (mi. uoL eyml. a. REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucia 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 0.00 #DIVI01 5 United Way-Martin County 0.00 #DIV101 6 United Way-Indian River County 0.00 #DIV10i 7 Department of Children & Families 0.00 #DIV101 e County Funds 0.00 #DIV/OI 9 Contributions-Cash 0.00 #DIV/OI AAAAA 10 Program Fees 0.00 #DIVI01 11 Fund Raising Events-Net 0.00 #DIV/01 12 Sales to Public-Net 0.00 #DIV/OI 13 Memberehl Dues 0.00 #DIV/01 14 Investment Income 0.00 #DIV/01 AAAAA 15 Miscellaneous 0.00 #DIV/01 AAAAAAA 18 Legacies & Bequests 0.00 #DIV/01 17 Funds from Other Sources 0.00 #DIV/01 16 Reserve Funds Used for Operating 0.00 #DIVI01 191n-Kind DonationslNa iMIUM in taaq 0.00 #DIVIDI 20 TOTAL 0.00 0.00 53 449.11 #DIV/01 EXPENDITURES AAAAA 21 Salaries 3237200 #DIV101 22 FICA 247646 #DN101 23 Retirement 0.00 #DIVl01 24 Life/Health 0.00 #DIV/01 25 Workers Compensation 0.00 #DIV101 26 Florida Unemployment 0.00 #DIV/01 27 Travel-Dail OADI 9DN/01 28 Travel/Conferences/Treinin 0.00 #DIV/01 29 Offlca Su Iles 0.00 #DIV/01 so Telephone 0.00 #DIV/01 31 Posta e/Shl in 0.00 #DIV/01 32 Utilities 0.00 #DIV/01 33 Occupancy (Building & Grounds 0.00 #DIV/01 34 Printing & Publications 0.00 #DIV/01 35 Subscription/Dues/Memberships 0.00 #DIV/01 36 Insurance 0.00 #DIV/01 37 Fqulpment.Rental & Maintenance 0.00 #DIV/01 38 Advertising 500.00 #DIV/01 39 Equipment Purchases:Ca ital Expense 0.00 #DIV/01 40 Professional Fees al Consulting) 0.00 #DIVI01 41 Books/Educational Materials 1.000.00 #VALUE] 42 Food & Nutrition 9656.40 #DIV/01 43 Administrative Costs0.00 #DIV/01 44 Audit Expense AAAAA 1 000.00 #DIVI01 45 Specific Assistance to Individuals 0.00 #DIVI01 46 Other/Mlscallaneous/fuel transportation 2.600.011 #VALUE] 47 Other/Contract 0.00 #DMO! 4a TOTAL 0.00 0.00 46 D04.88 f1DIVl0l 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 7444.25 iH/1V101 ssxmr ea Type tae OrgaNragon and Program Nam UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCYIPROGRAM NAME: FUNDER: A B C FY 06107 FY 06/07 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. B/col. A EXPENDITURES 21 Salaries 32,372.00 32,372.00 100.00% 22 FICA 2,476.46 2,476.46 100.00% 23 Retirement 0.00 0.00 #DIV/01 24 Life/Health 0.00 0.00 #DIV/01 25 Workers Compensation 0.00 0.00 #DIV/01 26 Florida Unemployment 0.00 0.00 #DIV/01 27 Travel-Dail 0.00 0.00 #DIV/01 28 TraveUConferenceslrrainin 0.00 0.00 #DIV/01 29 Office Su lies 0.00 0.00 #DIV/01 30 Telephone 0.00 0.00 #DIV/01 31 Postage/Shipping 0.00 0.00 #DIV/01 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/01 35 Subscription/Dues/Memberships 0.00 0.00 #DIV/01 36 Insurance 0.00 0.00 #DIVI01 37 Equipment: Rental & Maintenance 0.00 0.00 #DIV/Ol 38 Advertising 500.00 500.00 100.00% 39 Equipment Purchases:Ca ital Expense 0.00 0.00 #DIV/01 40 Professional Fees (Legal, Consulting) 0.00 0.00 ;1 #DIV/01 41 Books/Educational Materials 11000.00 19000.00 100.00% 42 Food & Nutrition 9,656.40 91656.40 100.00% 43 Administrative Costs 0.00 0.00 #DIV/O! 44 Audit Expense 19000.00 11000.00 100.00% 45 Specific Assistance to Individuals 0.00 0.00 #DIV/0! 46 Other/Miscellaneous 21600.00 21600.00 100.00% 47 Other/Contract 0.00 0.00 #DIV/01 48 TOTAL $49,604.86 $499604.86 100.00% 5W00] 84 Type the Organization and 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. AGENCY/PROGRAM NAME : Village of Excellence Training Institute for Girls FUNDER : Children's Services Council _ . . _ . . _ . . _ . . _ . . _ . . . . . _ . . _ . . . . . . . . . . . . . . _ . . _ . . . . . . . . . . • — • - _ . . _ . . _ . — — . . _ . . _ _ . . _ . . - - • —. I CAUTION : Do not enter anYfigures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should :be used for calculations and to write information only. arcriARZANcrweFOR . " Proposed;Total Program Funder Specific ' Total Agency REVENUES coo Budget : ' ; " Budget ," 2 , Budget 1 Children's Services Council-St Lucie 2 Children's Services Council-Martin 3 Advisory Committee-Indian River 53,449.11 53,449.11 53,449. 11 4 United Way-St Lucie County 5 United Way-Martin County 6 United Way-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 16Le acies & Bequests 17 Funds from Other Sources 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not Included In total) 20 TOTAL REVENUES (doesn't Include line 19) ' ' -- " $53,449.11 $53,449.11 $53,449. 11 A 8 C r: D. EXPENDITURES, ae,YApFd m " " Proposed Total Program FunderSpec)go Tota/ Agency noeacvu�ox�r ' _ - = taeoaFxctxnriarwt Budget Budget Budgetg 21 Salaries - (must complete chart on next page) 32,372.00 32,372.DO 32,372.00 Salary 22 FICA - Total salaries x 0.0765 7.65% 2,476.46 2,476.46 2,476.46 Retirement - Annual pension tor qualified 23 staff 0.00 I e ea - e ICs en a O - emn 24 Disab. 0.00 Workers Compensation • # employees x - 25 rate 0.00 ori a Unemployment - # projected 26 employees x $7,000 x UCT-6 rate 0.00 A D: POSITION LUSTING Grose Annual B C % of Gress Annual Portion of Salary on Proposed Salary Program Funder SpecHk Budget Salary Position TWe / Total Hrslwk (Agency) Requeated(CI.4 example: Executhn D/rector/40hrs 70,000.00 _ 10,000.00 5,000.00 7. 14% s19r20m -1 Type the Organization and Program Name Program Director/Administration 10 hrs7,800.00 7,800.00 7,800. 100.00% Program O erabons Manager 25 hrs. 15,500.00 15,500.00 15,500.00 100.000/C Institute Prevention Coordinator - 12 Hrs. 4,860.001 4,860.00 4,860.00 100.00Y (2) Institute Trainers/Teachers - 6 hrs. 4,212.00 4,212.00 4,212.00 100.00° #DIV/01 #DIV/0! #DIV/01 #DIV/01 #DIV/01 #DIV/0! #DIV/01 #DIV/01 #DIV/01 #DIV/01 MIMI #DIV/01 #DIV/01 #DIV/01 #DIV/01 #DIV/0! Remaining positions throughout the agency Total Salaries $32,372.00 $32,372.00 $32,372.00 100.00% FRINGE BENERITS DETAIL - A, - (Funt ► t specific kucr4ii Funder a C F c Pension Specffk; FICA 7.85% Health Ins. Werkar's Unemp/oyme Total rdnges Ander Columb C only, from /file 22 to PTS - B4d �f X 9rJ compws nt Company, specificPosidon 71deFTotallits [vk Example: Ca:ett/eneparfab"N+" . 3r000.00 382:50 200.00 500.00 300.00 Mile ' 1.582.50 Program Director/Administration 10 hrs 7,800.00 596.70 596.7 Program Operations Mana er 25 hrs. 15,500.00 1 ,185.75 1 ,185.7 Institute Prevention Coordinator - 12 Hrs. 4,860.00 371 .79 5. 371 .7 (2) Institute Trainers/Teachers - 6 hrs. 4,212.001 322.22 322.22 0 0.001 0.00 0.001 00.0 0.00 0.0 0 0.00 0.00 0.0 0 0.00 0.00 0.0 0 0.00 0.00 0.0 0 0-04- 0.00 0.0 0 0.0m 0.00 0.0 0 0.001 0.00 0.0 0 0.001 0.00 0.0 0 0.00 0.00 0.0 0 O.ON 0.00 0.0 0 0.001 0.00 0 0 0 0.00 0.00 O.00j 0 0.00 0.00 0.0 0 0.00 0.00 0.0 0 0.0 0.00 - 0.001 Total Funder Request Fringe BeneritS $32,372.00 $2,476.x6 $0.00 $0.00 $0.00 $0.00 $2,476.4 B C , D EXPENDITURES d0r� rare Proposed Total Program Funder S eciflc mrxcrusa MYTc BP Total Agency Budget 9 Budget Budget 27 Travel-Daily # of Staff x average # of milesfwk x 50 wks x - $ = Estimated Daily TravellMileage Reimb. 28 TravellConferences/Training 518r"7 e-t T dn* Ory,n n and Program Nana UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 150/6 OR MORE TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: St Peter's Human Services, Inc./Village of Excellence Training Institute for Girls FUNDER: 8 a., Pr; ,% EXPLANATi011ffOR=V yi ass v v ^IXt #DN/01 #DN/01 #DN/DI #DNI01 #DNI01 #DIVroI #DNroI #DNI [ #DIVro! #DN/01 #DN/01 MR1101 #DN/01 #DN/DI #DN/O #DNI I #DN101 #Drvlol #DIVroI #DNroI #DNroI #DNroI #DNroI #DN/01 #DNI01 Represents funds needed to pmvide meals for the children including, dinner, breakfast, and lunch each week for 52 weeks #DNI I approximately $5.00 per youth eachweek. #DNroI #DNroI #DN/01 Represents fuel costs each week at $50.00 for 52 weeks. Program now providing pickupand drop ox services for students. #DIVro #DNroI #DIV/OI #DIV/01 #DNroI #DN I #DN/OI #DNI01 #DIV[ 1 #DNI01 #VALUE #DIVroI #DNroI #DNroI #DNroI #VALUE[ #DNroI EXHIBIT B [From policy adopted by Indian River County Board of County Commissioners on February 19 , 2002] " D. Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners. In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1 " may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners. All requests for reimbursement at fiscal year end (September 301h) must be submitted on a timely basis. Each year, the Office of Management & Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point. Each reimbursement request must include a summary of expenses by type . These summaries should be broken down into salaries, benefits, supplies , contractual services , etc. If Indian River County is reimbursing an agency for only a portion of an expense (e.g . salary of an employee) , then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available. Indian River County will not reimburse certain types of expenditures. These expenditure types are listed below. a . Travel expenses for travel outside the County including but not limited to; mileage reimbursement, hotel rooms, meals , meal allowances , per Diem , and tolls. Mileage reimbursement for local travel (within Indian River County) is allowable. b. Sick or Vacation payments for employees. Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c. Any expenses not associated with the provision of the program for which the County has awarded funding . d . Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary. " 1 Type the Organization eM Pmgrem 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, etc. • Bulk mailings - appeals 32 Utilities • Electricity ($ x 12 months) _ • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) 33 Occupancy (Building & Grounds) - - • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) JI- • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications • Quarterly Newsletter ($ x 4) • Letterheads, Envelopes, etc. • 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 36 Advertising 500.00 500.00 500.00 • Newspaper ads • Fundraising ads/promotions • Other (vacancies) 39 Equipment Purchases:Capital Expense • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) • Legal advice ( estimated #hrs x $) • Consultant fees - • Other 41 Books/Educational Materials 1 ,000.001 1 ,000.00 1 ,000.00 • Books/videos • Materials ($ x staff) 42 Food & Nutrition 9,656.401 9,656.40 9,656.40 5/6@007 B-1 Type the Organization and Program Name • MgExpense als x clients x 5days x 50 wks) • S 43 Ade Costs • A (% of total budget) - 44 Audite 1 ,000.00 1 ,000.0 1 ,000.00 • InAudit Review 45 Spistance to Individuals • Medical assistance • Meals/Food - • Rent Assistance Other 46 Other/Miscellaneous 2,600.00 2,600.00 2,600.00 • Background checddrug test • Otherlrransportation 47 Other/Contract • Sub-contract for program services 48 TOTAL EXPENSES $49,604.86 $48,604.8 $49,604.86 51WO07 6-1 , EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices : Any notice , request, demand , consent, approval or other communication required or permitted by this Contract shall be given or made in writing , by any of the following methods: facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service; or mailed by registered or certified mail (postage prepaid), return receipt requested at the addresses of the parties shown below: County: Brad E. Bernauer, Indian River County Human Services Director 1801 27`h Street, Vero Beach , Florida 32960. Recipient: St. Peter's Human Services , Inc. , 4250 38th Ave. , Vero Beach , FL 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 term and provision of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable. 5 . Captions and Interpretations : Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions . Unless the context indicates otherwise, words importing the singular number include the plural number, and vice versa. Words of any gender include the correlative words of the other genders, unless the sense indicates otherwise. 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract. The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision , and control . 7 . Assignment. This Contract may not be assigned by the Recipient without the prior written consent of the County. 1 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID B DATE (MWDD/YYYY) STPETEA 08 / 14 /07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hatcher Insurance , Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O . Box 540689 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orlando FL 32854 - 0689 Phone : 407 -841 - 2686 Fax : 407- 841 - 2688 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Philadelphia Insurance Cow . INSURER B: Comeeroa and Industry Company St . Peters Academy Charter Soh INSURER C: St . Peters Human Services , Inc 4250 Beth AFL 32 INSURER O: Vero Beach FL 32967 -1711 NSURER E: 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 CONTRACT OR OTHER DOCUMENT HATH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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. LTR INSRI TYPE OF INSURANCE POLICY NUMBER DATE MAID DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE E 1000000 A X X COMMERCIAL GENERAL LIABILITY PHPK254326 09/17/07 09/ 17 / 08 PREMISES Ea re CO $ 100000 CLAIMS MADE O OCCUR MED EXP (Any one person) $ 5'5000 X Educators Prof PERSONAL B ADV INJURY $ 1000000 GENERALAGGREGATE s2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 5 2000000 POLICY PRFF LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea ecadent) E ALL OWNED AUTOS SCHEOULEDAUTOS BODILY INJURY E (Per person) HIRED AUTO$ NON-OWNEDAUTOS BODILY INJURY S (Per accident) I PROPERTY DAMAGES (Peracacent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLjA LIABILITY EACH OCCURRENCE $ 1000000 A X OCCUR Lj' CLAIMS MADE PHM092599 09/ 17/07 09 /17/08 AGGREGATE , $ 1000000 E kDEDUCTIBLE S X RETENTION $ 10000 E WORKERS COMPENSATION AND X TORY LIMITS ER B EMPLOYERS' LIABIUTY WC8967849 ANY PROPRIETOR/PARTNEWEXECUTIVE 09 / 17 / 06 09 /17 / 07 E.L. EACH ACCIDENT $ 100000 OFFICERpAEs BER wear uncer EXCLUDED? Ce Itea. deacrl09/17/07 09/ 17 /08 E.L. DISEASE - EA EMPLOYEE $ 100000 SPECIAL PROVISIONS E Tow E.L. DISEASE - POLICY LIMIT 1 $ 500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is included as additional insured regarding general liability . Liability is limited to loss or damage arising out of negligent acts of the insured . *Except as required by Florida Statute . CERTIFICATE HOLDER CANCELLATION immiV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYSWRITTEN Indian River County , Florida NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1840 25th Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Vero Beach FL 32960 - 3365 REPRESENTATIVES. ACORD 25 (2001108) - — © ACORD CORPORATION 1988 T". PSN. UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: FY DUOS FY 05108 FY 06107 % INCREASE FYE FYE FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (mi. uoL eyml. a. REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucia 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 0.00 #DIVI01 5 United Way-Martin County 0.00 #DIV101 6 United Way-Indian River County 0.00 #DIV10i 7 Department of Children & Families 0.00 #DIV101 e County Funds 0.00 #DIV/OI 9 Contributions-Cash 0.00 #DIV/OI AAAAA 10 Program Fees 0.00 #DIVI01 11 Fund Raising Events-Net 0.00 #DIV/01 12 Sales to Public-Net 0.00 #DIV/OI 13 Memberehl Dues 0.00 #DIV/01 14 Investment Income 0.00 #DIV/01 AAAAA 15 Miscellaneous 0.00 #DIV/01 AAAAAAA 18 Legacies & Bequests 0.00 #DIV/01 17 Funds from Other Sources 0.00 #DIV/01 16 Reserve Funds Used for Operating 0.00 #DIVI01 191n-Kind DonationslNa iMIUM in taaq 0.00 #DIVIDI 20 TOTAL 0.00 0.00 53 449.11 #DIV/01 EXPENDITURES AAAAA 21 Salaries 3237200 #DIV101 22 FICA 247646 #DN101 23 Retirement 0.00 #DIVl01 24 Life/Health 0.00 #DIV/01 25 Workers Compensation 0.00 #DIV101 26 Florida Unemployment 0.00 #DIV/01 27 Travel-Dail OADI 9DN/01 28 Travel/Conferences/Treinin 0.00 #DIV/01 29 Offlca Su Iles 0.00 #DIV/01 so Telephone 0.00 #DIV/01 31 Posta e/Shl in 0.00 #DIV/01 32 Utilities 0.00 #DIV/01 33 Occupancy (Building & Grounds 0.00 #DIV/01 34 Printing & Publications 0.00 #DIV/01 35 Subscription/Dues/Memberships 0.00 #DIV/01 36 Insurance 0.00 #DIV/01 37 Fqulpment.Rental & Maintenance 0.00 #DIV/01 38 Advertising 500.00 #DIV/01 39 Equipment Purchases:Ca ital Expense 0.00 #DIV/01 40 Professional Fees al Consulting) 0.00 #DIVI01 41 Books/Educational Materials 1.000.00 #VALUE] 42 Food & Nutrition 9656.40 #DIV/01 43 Administrative Costs0.00 #DIV/01 44 Audit Expense AAAAA 1 000.00 #DIVI01 45 Specific Assistance to Individuals 0.00 #DIVI01 46 Other/Mlscallaneous/fuel transportation 2.600.011 #VALUE] 47 Other/Contract 0.00 #DMO! 4a TOTAL 0.00 0.00 46 D04.88 f1DIVl0l 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 7444.25 iH/1V101 ssxmr ea Type tae OrgaNragon and Program Nam UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCYIPROGRAM NAME: FUNDER: A B C FY 06107 FY 06/07 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. B/col. A EXPENDITURES 21 Salaries 32,372.00 32,372.00 100.00% 22 FICA 2,476.46 2,476.46 100.00% 23 Retirement 0.00 0.00 #DIV/01 24 Life/Health 0.00 0.00 #DIV/01 25 Workers Compensation 0.00 0.00 #DIV/01 26 Florida Unemployment 0.00 0.00 #DIV/01 27 Travel-Dail 0.00 0.00 #DIV/01 28 TraveUConferenceslrrainin 0.00 0.00 #DIV/01 29 Office Su lies 0.00 0.00 #DIV/01 30 Telephone 0.00 0.00 #DIV/01 31 Postage/Shipping 0.00 0.00 #DIV/01 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/01 35 Subscription/Dues/Memberships 0.00 0.00 #DIV/01 36 Insurance 0.00 0.00 #DIVI01 37 Equipment: Rental & Maintenance 0.00 0.00 #DIV/Ol 38 Advertising 500.00 500.00 100.00% 39 Equipment Purchases:Ca ital Expense 0.00 0.00 #DIV/01 40 Professional Fees (Legal, Consulting) 0.00 0.00 ;1 #DIV/01 41 Books/Educational Materials 11000.00 19000.00 100.00% 42 Food & Nutrition 9,656.40 91656.40 100.00% 43 Administrative Costs 0.00 0.00 #DIV/O! 44 Audit Expense 19000.00 11000.00 100.00% 45 Specific Assistance to Individuals 0.00 0.00 #DIV/0! 46 Other/Miscellaneous 21600.00 21600.00 100.00% 47 Other/Contract 0.00 0.00 #DIV/01 48 TOTAL $49,604.86 $499604.86 100.00% 5W00] 84 T dn* Ory,n n and Program Nana UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 150/6 OR MORE TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: St Peter's Human Services, Inc./Village of Excellence Training Institute for Girls FUNDER: 8 a., Pr; ,% EXPLANATi011ffOR=V yi ass v v ^IXt #DN/01 #DN/01 #DN/DI #DNI01 #DNI01 #DIVroI #DNroI #DNI [ #DIVro! #DN/01 #DN/01 MR1101 #DN/01 #DN/DI #DN/O #DNI I #DN101 #Drvlol #DIVroI #DNroI #DNroI #DNroI #DNroI #DN/01 #DNI01 Represents funds needed to pmvide meals for the children including, dinner, breakfast, and lunch each week for 52 weeks #DNI I approximately $5.00 per youth eachweek. #DNroI #DNroI #DN/01 Represents fuel costs each week at $50.00 for 52 weeks. Program now providing pickupand drop ox services for students. #DIVro #DNroI #DIV/OI #DIV/01 #DNroI #DN I #DN/OI #DNI01 #DIV[ 1 #DNI01 #VALUE #DIVroI #DNroI #DNroI #DNroI #VALUE[ #DNroI EXHIBIT B [From policy adopted by Indian River County Board of County Commissioners on February 19 , 2002] " D. Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners. In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1 " may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners. All requests for reimbursement at fiscal year end (September 301h) must be submitted on a timely basis. Each year, the Office of Management & Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point. Each reimbursement request must include a summary of expenses by type . These summaries should be broken down into salaries, benefits, supplies , contractual services , etc. If Indian River County is reimbursing an agency for only a portion of an expense (e.g . salary of an employee) , then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available. Indian River County will not reimburse certain types of expenditures. These expenditure types are listed below. a . Travel expenses for travel outside the County including but not limited to; mileage reimbursement, hotel rooms, meals , meal allowances , per Diem , and tolls. Mileage reimbursement for local travel (within Indian River County) is allowable. b. Sick or Vacation payments for employees. Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c. Any expenses not associated with the provision of the program for which the County has awarded funding . d . Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary. " 1 EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices : Any notice , request, demand , consent, approval or other communication required or permitted by this Contract shall be given or made in writing , by any of the following methods: facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service; or mailed by registered or certified mail (postage prepaid), return receipt requested at the addresses of the parties shown below: County: Brad E. Bernauer, Indian River County Human Services Director 1801 27`h Street, Vero Beach , Florida 32960. Recipient: St. Peter's Human Services , Inc. , 4250 38th Ave. , Vero Beach , FL 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 term and provision of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable. 5 . Captions and Interpretations : Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions . Unless the context indicates otherwise, words importing the singular number include the plural number, and vice versa. Words of any gender include the correlative words of the other genders, unless the sense indicates otherwise. 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract. The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision , and control . 7 . Assignment. This Contract may not be assigned by the Recipient without the prior written consent of the County. 1 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID B DATE (MWDD/YYYY) STPETEA 08 / 14 /07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hatcher Insurance , Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O . Box 540689 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orlando FL 32854 - 0689 Phone : 407 -841 - 2686 Fax : 407- 841 - 2688 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Philadelphia Insurance Cow . INSURER B: Comeeroa and Industry Company St . Peters Academy Charter Soh INSURER C: St . Peters Human Services , Inc 4250 Beth AFL 32 INSURER O: Vero Beach FL 32967 -1711 NSURER E: 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 CONTRACT OR OTHER DOCUMENT HATH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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. LTR INSRI TYPE OF INSURANCE POLICY NUMBER DATE MAID DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE E 1000000 A X X COMMERCIAL GENERAL LIABILITY PHPK254326 09/17/07 09/ 17 / 08 PREMISES Ea re CO $ 100000 CLAIMS MADE O OCCUR MED EXP (Any one person) $ 5'5000 X Educators Prof PERSONAL B ADV INJURY $ 1000000 GENERALAGGREGATE s2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 5 2000000 POLICY PRFF LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea ecadent) E ALL OWNED AUTOS SCHEOULEDAUTOS BODILY INJURY E (Per person) HIRED AUTO$ NON-OWNEDAUTOS BODILY INJURY S (Per accident) I PROPERTY DAMAGES (Peracacent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLjA LIABILITY EACH OCCURRENCE $ 1000000 A X OCCUR Lj' CLAIMS MADE PHM092599 09/ 17/07 09 /17/08 AGGREGATE , $ 1000000 E kDEDUCTIBLE S X RETENTION $ 10000 E WORKERS COMPENSATION AND X TORY LIMITS ER B EMPLOYERS' LIABIUTY WC8967849 ANY PROPRIETOR/PARTNEWEXECUTIVE 09 / 17 / 06 09 /17 / 07 E.L. EACH ACCIDENT $ 100000 OFFICERpAEs BER wear uncer EXCLUDED? Ce Itea. deacrl09/17/07 09/ 17 /08 E.L. DISEASE - EA EMPLOYEE $ 100000 SPECIAL PROVISIONS E Tow E.L. DISEASE - POLICY LIMIT 1 $ 500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is included as additional insured regarding general liability . Liability is limited to loss or damage arising out of negligent acts of the insured . *Except as required by Florida Statute . CERTIFICATE HOLDER CANCELLATION immiV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYSWRITTEN Indian River County , Florida NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1840 25th Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Vero Beach FL 32960 - 3365 REPRESENTATIVES. ACORD 25 (2001108) - — © ACORD CORPORATION 1988