HomeMy WebLinkAbout2007-308J e? �Q7 - 358 J
'J
Indian River County Grant Contract
This Grant Contract ("Contract") entered into effective this day of.9eteHef 2007 b +
and between Indian River County, a political subdivision oft a State of Florida , 1801 27
Street, Vero Beach FL, 32960 ("County") and United for Families , (Recipient); of:
10570 S . Federal Highway, Ste. 300 , Port St. Lucie , FL 34952
For: Caregiver Support Program
Background Recitals
A. The County has determined that it is in the public interest to promote healthy
children in a healthy community.
B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") and
established the Children 's Services Advisory Committee to promote healthy children in a
healthy community and to provide a unified system of planning and delivery within which
children's needs can be identified , targeted , evaluated and addressed .
C . The Children ' s Services Advisory Committee has issued a request for proposals
from individuals and entities that will assist the Children's Services Advisory Committee in
fulfilling its purpose .
D . The proposals submitted to the Children 's Services Advisory Committee and the
recommendation of the Children 's Services Advisory Committee have been reviewed by
the County.
E . The Recipient, by submitting a proposal to the Children's Services Advisory
Committee, has applied for a grant of money ("Grant") for the Grant Period (as such term
is hereinafter defined ) on the terms and conditions set forth herein .
F . The County has agreed to provide such Grant funds to the Recipient for the Grant
Period (as such term is hereinafter defined ) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein
contained , and other good and valuable consideration , the receipt and adequacy of which
are hereby acknowledged , the parties agree as follows :
1 . Background Recitals . The background recitals are true and correct and form a
material part of this Contract.
2 . Purpose of Grant. The Grant shall be used only for the purposes set forth in the
complete proposal submitted by the Recipient attached hereto as Exhibit "A" and
incorporated herein by this reference (such purposes hereinafter referenced as "Grant
Purposes" ).
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e? �Q7 - 358 J
'J
Indian River County Grant Contract
This Grant Contract ("Contract") entered into effective this day of.9eteHef 2007 b +
and between Indian River County, a political subdivision oft a State of Florida , 1801 27
Street, Vero Beach FL, 32960 ("County") and United for Families , (Recipient); of:
10570 S . Federal Highway, Ste. 300 , Port St. Lucie , FL 34952
For: Caregiver Support Program
Background Recitals
A. The County has determined that it is in the public interest to promote healthy
children in a healthy community.
B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") and
established the Children 's Services Advisory Committee to promote healthy children in a
healthy community and to provide a unified system of planning and delivery within which
children's needs can be identified , targeted , evaluated and addressed .
C . The Children ' s Services Advisory Committee has issued a request for proposals
from individuals and entities that will assist the Children's Services Advisory Committee in
fulfilling its purpose .
D . The proposals submitted to the Children 's Services Advisory Committee and the
recommendation of the Children 's Services Advisory Committee have been reviewed by
the County.
E . The Recipient, by submitting a proposal to the Children's Services Advisory
Committee, has applied for a grant of money ("Grant") for the Grant Period (as such term
is hereinafter defined ) on the terms and conditions set forth herein .
F . The County has agreed to provide such Grant funds to the Recipient for the Grant
Period (as such term is hereinafter defined ) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein
contained , and other good and valuable consideration , the receipt and adequacy of which
are hereby acknowledged , the parties agree as follows :
1 . Background Recitals . The background recitals are true and correct and form a
material part of this Contract.
2 . Purpose of Grant. The Grant shall be used only for the purposes set forth in the
complete proposal submitted by the Recipient attached hereto as Exhibit "A" and
incorporated herein by this reference (such purposes hereinafter referenced as "Grant
Purposes" ).
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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 Twenty
Thousand Dollars ($20 ,000) . The County agrees to reimburse the Recipient from such
Grant funds for actual documented costs incurred for Grant Purposes provided in
accordance with this Contract. Reimbursement requests may be made no more frequently
than monthly. Each reimbursement request shall contain the information , at a minimum ,
that is set forth in Exhibit "B" attached hereto and incorporated herein by this reference . All
reimbursement requests are subject to audit by the County. In addition , the County may
require additional documentation of expenditures , as it deems appropriate .
5 . Additional Obligations of Recipient .
5. 1 Records. The Recipient shall maintain adequate internal controls in order to safeguard
the Grant. In addition , the Recipient shall maintain adequate records fully to document the
use of the Grant funds for at least three (3) years after the expiration of the Grant Period .
The County shall have access to all books , records , and documents as required in this
Section for the purpose of inspection or audit during normal business hours at the County's
expense , upon five (5 ) days prior written notice .
5. 2 Compliance with Laws . The Recipient shall comply at all times with all applicable
federal , state , and local laws , rules , and regulations .
5. 3 Quarterly Performance Reports . The Recipient shall submit quarterly, 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 .
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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 Twenty
Thousand Dollars ($20 ,000) . The County agrees to reimburse the Recipient from such
Grant funds for actual documented costs incurred for Grant Purposes provided in
accordance with this Contract. Reimbursement requests may be made no more frequently
than monthly. Each reimbursement request shall contain the information , at a minimum ,
that is set forth in Exhibit "B" attached hereto and incorporated herein by this reference . All
reimbursement requests are subject to audit by the County. In addition , the County may
require additional documentation of expenditures , as it deems appropriate .
5 . Additional Obligations of Recipient .
5. 1 Records. The Recipient shall maintain adequate internal controls in order to safeguard
the Grant. In addition , the Recipient shall maintain adequate records fully to document the
use of the Grant funds for at least three (3) years after the expiration of the Grant Period .
The County shall have access to all books , records , and documents as required in this
Section for the purpose of inspection or audit during normal business hours at the County's
expense , upon five (5 ) days prior written notice .
5. 2 Compliance with Laws . The Recipient shall comply at all times with all applicable
federal , state , and local laws , rules , and regulations .
5. 3 Quarterly Performance Reports . The Recipient shall submit quarterly, 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 .
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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
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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. pacon , Clerk BOARD OF COUNTY COM- 06 S$ IONERS
By _ '
Dep* Clerk By /
Gary C h ,ejor,'Chairman
BCC Approved : ��
Approved :
oseph . Baird
ounty Administrator
;provAast0form and legal sufficiency:
ian E . Fell , Assis ant County Attorney
RECIPI _
By: ,
UNITED FOR FAMILIES
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
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EXHIBIT A
[Copy of complete proposal/application]
Type the Organization and Program Name
2007=2008 CORE 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 : United for Families/Caregiver Support Program
FUNDER : Children's Services Advisory Committee of Indian River County
: CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should :
! be used for providing information and calculations only.
Funder Specific Total Agency
REVENUES Proposed Total Program Budget Budget Budget
1 Children's Services Council-St. Lucie 30,000.00
2 Children's Services Council-Martin
3 Advisory Committee-Indian River 20,000.00 20,000.00 20,000.00
4 United Way-St. Lucie County
5 United Way-Martin County
6 United Way-Indian River County
7 Department of Children & Families 22,904,788.00
8 County Funds
9 Contributions-Cash 30,000.00
10 Program Fees
11 Fund Raising Events-Net
12 Sales to Public - Net
13 Membership Dues
14 Investment Income
15 Miscellaneous
16 Legacies & Bequests
17 Funds from Other Sources 48,410 .00
18 Reserve Funds Used for Operating
19 In-Kind Donations (Not included in total) 6,727 .27
20 TOTAL REVENUES
(doesn't include line 19) $20 ,000.00 $20 ,000 .00 $23,033, 198.00
B c
EXPENDITURES Proposed Total Program Budget Funder Specific Total Agency
Budget Bud et
21 Salaries - (must complete chart on next page) 7,900.00 7 ,200. 00 1 ,932 ,609 .00
22 FICA - Total salaries x 0.0765 550.80
eiremen - Annual pension torqualie
23 staff
Life/Health - e ica enta ort-term
24 Disab.
Workers Compensation - # employees x
25 rate 429. 12
Florida Unemployment - projected
26 employees x $7,000 x UCT-6 rate 193.00
11181207 8.1
omissions of the Recipient , its agents , officers , or employees in connection with the
performance of this Contract.
5. 8 Public Records . The Recipient agrees to comply with the provisions of Chapter 119,
Florida Statutes ( Public Records Law) in connection with this Contract.
6 . Termination . This Contract may be terminated by either party, without cause , upon
thirty (30) days prior written notice to the other party. In addition , the County may
terminate this Contract for convenience upon ten ( 10) days prior written notice to the
Recipient if the County determines that such termination is in the public interest.
7 . Availability of Funds . The obligations of the County under this Contract are subject
to the availability of funds lawfully appropriated for its purpose by the Board of County
Commissioners of Indian River County.
8 . Standard Terms, This Contract is subject to the standard terms attached hereto as
Exhibit C and incorporated herein in its entirety by this reference .
IN WITNESS WHEREOF , County and Recipient have entered into this Contract on
the date first above written . , , ,
INDIAN RIVER COUNTY, ;
Attest: J . K. pacon , Clerk BOARD OF COUNTY COM- 06 S$ IONERS
By _ '
Dep* Clerk By /
Gary C h ,ejor,'Chairman
BCC Approved : ��
Approved :
oseph . Baird
ounty Administrator
;provAast0form and legal sufficiency:
ian E . Fell , Assis ant County Attorney
RECIPI _
By: ,
UNITED FOR FAMILIES
4 -
Type the Organization and Program Name
SALARIES I Gross I! N
111 % of Gross Annual
POSITION LISTING Annual Salary Portion of Salary on Proposed Funder Specific Budget Salary
Position Title / Total Hrs/wk (Agency) Program Requested(CIA)
Example: Executive Director140hrs 70,000.00 10,000.00 51000.00 7. 14%
Foster Care Coordinator 40,000 .00 7,200.00 71200 .00 18.00%
Supervisor 70,000. 00 700.00 0.00%
non-program salaries 1 ,822,609. 00 0.00 0.00 0.00%
#DIV/0 !
#DIV/0 !
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
Remaining positions throughout the agency
Total Salaries $7,900 .00 $7,200.001 0.37%
FRINGE BENEFITS DETAIL
(Funder Specific Budget I Funder 0 /it IV V VI VII
Specific Budget FICA 7.65% Pension Health Worker's Unemployme Total Fringes Funder
Column C only, from line 21 to 26) (Ax %) Ins. Compens. nt Compens. Speck
Position Title / Total Hrs/wk
Example: Case Manager/40hrs 51000.00 382.50 200.00 500.00 300.00 200.00 1,582.50
Foster Care Coordinator 7,200.00 550.80 288.00 72.00 429. 12 0.00 1 , 339.92
Supervisor 0.00 0.00 0.00
non-program salaries 0.00 0.001 0.00
0 0.00 0.00 0.00
0 0.00 0. 00 0.00
0 0.00 0. 00 0.00
0 0.00 0. 00 0.00
0 0. 00 0. 00 0.0
0 0. 00 0. 00 0. 0
0 0. 00 0. 00 0. 0
0 0. 00 0. 00 1 0.0
0 0, 001 0. 00 1 0.00
0 0. 00 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. 00 0.00 0. 0
0 0.00 0.00 0. 0
0 0.00 0.00 0.:001
0 0.00 a001 1 0. 00
Total Funder Request Fringe Benefits $7,200.001 $550.801 $288.001 $72. 001 . 1 0 1 ,339. 9
1102007 a-i
Type the Organization and Program Name
B
EXPENDITURES Proposed Total Program Budget Funder Specific Total Agency
Budget Budget
27 Travel-Daily 0 .001 30,575.00
# of Staff x average # of miles/wk x 50 wks x
$ = Estimated Daily Travel/M ileage Reimb. # of staff X average # miles/wk X $ = Estimated Daily TraveUMileage Reimb,
28 Travel/ConferenceslTraining 400 .001 61 ,000.00
• National Conference (cost per staff)
• Training/Seminar (cost per staff)
- Other Trainings (cost of travel, lodging,
registration, food)
29 Office Supplies 30,000.00
- Office supplies (monthly average x 12
months = estimated cost of office supplies
based on present history.
30 Telephone 56,778.00
• # 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 PostagelShipping 132.001 132.001 10,000.00
- Quarterly Mailing of Newsletter
• Special events, etc.
• Bulk mailings - appeals monthly newsletter to 23 homes at .39 each
32 Utilities
• Electricity ($ x 12 months)
• Water/Sewer ($ x 12 months)
• Garbage ($ x 12 months)
33 Occupancy (Building 8. Grounds) 280, 930. 00
- Mortgage/Rent ($ x 12 months)
- Janitorial ($ x 12 months)
• Grounds Maint. ($ x 12 months)
• Real Estate Taxes
34 Printing & Publications 132 . 00 132 . 001 20 , 000 . 00
• Quarterly Newsletter ($ x 4)
• Letterheads, Envelopes, etc.
• Fundraising materials
- Other .39 per calor newsletter for 23 homes
35 Subscription/Dues/Memberships 15,000.00
• Membership to National Organization
• Dues
• Subscriptions to Newspapers/magazines,
etc.
36 Insurance 28 ,565.00
• Directors/Officers Liab.
• Commercial/General Insurance
• Bond Ins.
• Auto Insurance
37 Equipment:Rental & Maintenance 0.001 126,627.00
• Copier lease ($ x 12 months)
- Meter lease ($ x 12 months)
• Copier Maintenance ($ x 12 months)
• Computer Maintenance ( $ x 12 months)
• Other
38 Advertising 0.00
• Newspaper ads
Fundraising ads/promotions
• Other (vacancies)
39 Equipment Purchases:Capital Expense 150,280. 00
• Computerlmonitor (# x $)
• Laser Printer
1 venoo
sn
EXHIBIT A
[Copy of complete proposal/application]
Type the Organization and Program Name
40 Professional Fees (Legal, Consulting) 554 ,605 .00
• Legal advice ( estimated #hrs x $)
• Consultant fees
• Other
41 Books/Educational Materials 0 .00
• Books/videos
• Materials ($ x staff)
42 Food & Nutrition 0 .00
• Meals ( # meals x clients x 5days x 50 wks)
Snacks
43 Administrative Costs 3,000. 001 636 . 00 0 .00
Admin . Cost (% of total budget) Fiscal support for invoice processing
44 Audit Expense 0. 001 0. 001 32 , 500 .00
Independent Audit Review
45 Specific Assistance to Individuals 7,500. 00 4 ,606-Fol 8 , 194 , 317 . 00
• Medical assistance
• Meals/Food flexible funding to ensure safety and quality of life for children in care, particularly child safety seats and other
• Rent Assistance infant equipment as well as assistance for sports and other extra-curricular activities that enhance a child's
• Other emotional well being while in care, or $ 193 per family.
46 Other/Miscellaneous 900. 001 900.001 51 ,260 . 00
• Background check/drug test
• Other 18 percent of district cost for foster parent appreciation (18 percent of $5,000)
47 Other/Contract 6,000. 001 6, 000.001 10 , 996 , 340. 00
• Sub-contract for program services $500 monthly stipend for mentor
48 TOTAL EXPENSES $26,736.92 $205000.00 $22 , 571 , 386. 00
1 V8/2007 e4
C 6
United for Families, Caregiver SuppoII Program, Indian River County Children's Services Advisory Committee
It
PROGRAM COVER PAGE
Organization Name: United for Families
Executive Director: Christine DemetriadesE-mail: Christine demetriades(a Uffus
Address : 10570 S . Federal Hwy . Ste. 300 Port St. Lucie FL 34952
Telephone: (772) 398-2920 Fax: (772) 398 -2925
Program Director: Jill Feaster E-mail : jill feaste64uff us
Address: 10570 S . Federal Hwy. Ste . 300 Port St. Lucie. FL 34952
Telephone: (772) 398-2920 Fax: (772) 398-2925
Program Title : Caregiver_ Support Program (formerly Foster Parent Mentor Program)
Priority Need Area Addressed: Mental Health Taxonomy PH- 140. 500
Brief Description of the Program: Interruptions in the continuity of a child ' s care are detrimental ;
repeat d moves from home to home compound the adverse consequences that stress and inadequate
parenting have on a child' s development and ability to cope. United for Families will enhance
children' s mental and emotional stability by decreasing the number of times they move from home to
home within the foster-cares stem. We will do this through a mentor program that uses veteran foster
parents to counsel and educate new foster parents The program objective is to increase foster-parent
retention thereby decreasing disruptions to children.
SUMMARY REPORT — (Enter Information In The Black Cells Only)
Amount Requested from Funder for 2007 / 08 : $ 206 , 00
Total Proposed Program Budget for 2007 ! 08 : 37
74 . 9 %
Percent of Total Program Budget : 20 , 000
Current Program Funding (2006 / 07 ) : S
Dollar increase / ( decrease ) in request : $
0 . 0 °�
Percent increase / ( decrease ) rst * * : 81
Unduplicated Number of Chilin request
- to be served Individually : 30
Unduplicated Number of Adults to be served Individually :
Unduplicated Number to be served via Group settings : 240 . 87
Total Program Cost per Client :
**If request increased 5 % or more, briefly explain why:
If these funds are being used to match another source, name the source and the $ amount:
The Or ani zation 's Board of Directors has approved this application on (date) . _ 17 pC00
ar / 1�lcCv �
°e of President/Chair off e oard Sia'
e�Y"
Name of Executive Director.�CPO Signature
2
t
t
I
Type the Organization and Program Name
2007=2008 CORE 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 : United for Families/Caregiver Support Program
FUNDER : Children's Services Advisory Committee of Indian River County
: CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should :
! be used for providing information and calculations only.
Funder Specific Total Agency
REVENUES Proposed Total Program Budget Budget Budget
1 Children's Services Council-St. Lucie 30,000.00
2 Children's Services Council-Martin
3 Advisory Committee-Indian River 20,000.00 20,000.00 20,000.00
4 United Way-St. Lucie County
5 United Way-Martin County
6 United Way-Indian River County
7 Department of Children & Families 22,904,788.00
8 County Funds
9 Contributions-Cash 30,000.00
10 Program Fees
11 Fund Raising Events-Net
12 Sales to Public - Net
13 Membership Dues
14 Investment Income
15 Miscellaneous
16 Legacies & Bequests
17 Funds from Other Sources 48,410 .00
18 Reserve Funds Used for Operating
19 In-Kind Donations (Not included in total) 6,727 .27
20 TOTAL REVENUES
(doesn't include line 19) $20 ,000.00 $20 ,000 .00 $23,033, 198.00
B c
EXPENDITURES Proposed Total Program Budget Funder Specific Total Agency
Budget Bud et
21 Salaries - (must complete chart on next page) 7,900.00 7 ,200. 00 1 ,932 ,609 .00
22 FICA - Total salaries x 0.0765 550.80
eiremen - Annual pension torqualie
23 staff
Life/Health - e ica enta ort-term
24 Disab.
Workers Compensation - # employees x
25 rate 429. 12
Florida Unemployment - projected
26 employees x $7,000 x UCT-6 rate 193.00
11181207 8.1
United for Families, Caregiver support Program, Indian River County Children's Services .Advisory Committee
ORGANIZATION : United for Families
PROGRAM : Caregiver Support Program
2007/2008 CORE APPLICATION TABLE OF CONTENTS
"X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located.
X Section of the Proposal Pa e #
_TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . 2
A. ORGANIZATION CAPABILITY (one page maximum) 3
1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Summary of expertise, accomplishments, and population served. . . . . . . . . . . . . . . . . . . . . . . . . . . 3
B. PROGRAM NEED STATEMENT (one page maximum) 4
I . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2 . Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. PROGRAM DESCRIPTION (two pages maximum) 5
1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. 5
I 3 . Evidence that program strategy will work. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . 5
4. Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . 6
6
5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . 6
6 . Accessibility. of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . .
D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes 7. 10
E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . .
11
F. UNDUPLICATED CLIENTS
1 . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . 12
12
2. Projections by Age Group . . " " " " " " " " " " " " " " ' . .
G. BUDGET FORMS
1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . B1 -5
H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
1
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
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 question that you are addressing. Do not
change the Times New Roman 12 pt. font or other settings . Directions, such as these, may be deleted
if space is needed, but again, do NOT delete the Section headers or the numbered questions
A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page. Box will
expand as you type. )
Provide the mission statement and vision of your organization.
United for Families ' mission is to break the cycle of child abuse through a diverse network of
community providers and innovative services . Our commitment to the community is to ensure
safety to all children and to provide permanent homes for them. We envision a community where
the safety and well-being of children is the concern of every individual ; where "Safe Place" is not
just a sign on a door, but a creed in every home. We believe that every child deserves a healthy
family, and that every weakened family deserves a chance to heal. UFF will lead the community
in the pursuit of these ideals and be a recognized statewide lead, providing a continuum of
dynamic and innovative services for children and families.
Provide a brief summary of your organization including areas of expertise,
accomplishments, and population served.
United for Families was created in 2002 in response to Community Based Care, a statewide, bi-
artisan initiative that privatized public child welfare services. We are a non-profit agency
charged with delivering local services and supports for children and families in Okeechobee and
the Treasure Coast. Our network of providers and the services we entrust to them are
comprehensive. More than 1 , 800 children and families in St. Lucie, Martin, Indian River and
Okeechobee counties have access to services that include: Domestic violence and substance abuse
prevention, housing assistance, foster care and adoption, family support services , individual and
group counseling and behavior management. Through these services, we hope to strengthen
families, send children home faster and reduce the number of children in the child-welfare system
to 1 ,300 .
We proudly present the following achievements :
* In 2005 , 96 percent of children remained safe while in care. The state target for this
measurement was 95 percent, placing United for Families third among other Community Based
Care organizations throughout Florida.
* The average stay for these children was 1 1 months . State target was less than a year.
* United for Families oversaw the successful adoption of 76 children, exceeding the agency' s
annual goal of 75 .
* Programs were established to maintain a level of normalcy among children in care. These
programs included a car-seat and crib loaner program and a network of donations closets. We also
instituted new programs to keep children from entering the foster-care system and reduce the
umber of times children move. These programs include the Caregiver Support Program
(formerly the Foster Parent Mentor Program) and Relatives As Parents Program, which is
educing the number of disruptions among children in kinship care.
3
Type the Organization and Program Name
SALARIES I Gross I! N
111 % of Gross Annual
POSITION LISTING Annual Salary Portion of Salary on Proposed Funder Specific Budget Salary
Position Title / Total Hrs/wk (Agency) Program Requested(CIA)
Example: Executive Director140hrs 70,000.00 10,000.00 51000.00 7. 14%
Foster Care Coordinator 40,000 .00 7,200.00 71200 .00 18.00%
Supervisor 70,000. 00 700.00 0.00%
non-program salaries 1 ,822,609. 00 0.00 0.00 0.00%
#DIV/0 !
#DIV/0 !
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
Remaining positions throughout the agency
Total Salaries $7,900 .00 $7,200.001 0.37%
FRINGE BENEFITS DETAIL
(Funder Specific Budget I Funder 0 /it IV V VI VII
Specific Budget FICA 7.65% Pension Health Worker's Unemployme Total Fringes Funder
Column C only, from line 21 to 26) (Ax %) Ins. Compens. nt Compens. Speck
Position Title / Total Hrs/wk
Example: Case Manager/40hrs 51000.00 382.50 200.00 500.00 300.00 200.00 1,582.50
Foster Care Coordinator 7,200.00 550.80 288.00 72.00 429. 12 0.00 1 , 339.92
Supervisor 0.00 0.00 0.00
non-program salaries 0.00 0.001 0.00
0 0.00 0.00 0.00
0 0.00 0. 00 0.00
0 0.00 0. 00 0.00
0 0.00 0. 00 0.00
0 0. 00 0. 00 0.0
0 0. 00 0. 00 0. 0
0 0. 00 0. 00 0. 0
0 0. 00 0. 00 1 0.0
0 0, 001 0. 00 1 0.00
0 0. 00 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. 00 0.00 0. 0
0 0.00 0.00 0. 0
0 0.00 0.00 0.:001
0 0.00 a001 1 0. 00
Total Funder Request Fringe Benefits $7,200.001 $550.801 $288.001 $72. 001 . 1 0 1 ,339. 9
1102007 a-i
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
B . PROGRAM NEED STATEMENT (Entire Section B not to exceed one page. Box will
expand as You type)
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.
lack of support services threatens the stability of children in the foster-care system because
caregivers who do not feel supported are more likely to quit or request that a child be moved to
mother home. UFF strongly believes that a menu of both group and in-home support services is the
est way to improve caregiver retention and reduce the number of times children move in the
system. We created the Caregiver Support Program, for
known as the Foster Parent Mentor
Program, to address this need.
The need for the program best is illustrated by recent placement disruption reports. UFF
laced 175 Indian River County children in care from July 2006 to January 2007 . Of those
children, 25 percent moved two or more times in a six-month period and 6 percent moved four
oves were requested by caregivers , citing lack of
times or more in the same time period. The m
support as their primary reason.
We currently license 22 foster homes in Indian River County, of which 15 actively tak
children. Because only 68 percent of homes currently have beds available, 28 Indian River Coun
children live in shelters while still more live in other parts of the state. This typeof placemen
finders the reunification process and lowers the probability that the children will return home,
(Petr and Entriken, 1995, Service System Barriers to Reunification, Families in Society, 76(9) 523
533) .
Furthermore, interruptions in the continuity of a child' s caregiver are often detrimental;
according to the American Academy of Pediatrics . "Repeated moves from home to home
compound the adverse consequences that stress and inadequate parenting have on a child' s
development and ability to cope," (American Academy of Pediatrics : Developmental Issues for
Young Children in Foster Care; Committee on Early childhood, Adoption and Dependent Care,
Vol. 106, No. 5, November 2000, pp. 1145- 1150.)
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.
UFF contracts case management services to Children' s Home Society and Family
Preservation Services . Both agencies indirectly serve foster parents through the case-management
of children on their caseloads. The needs of foster parents, however, often go unaddressed in the
daily struggle to deal with child-related issues . Hibiscus Children' s Center also serves foster
arents through UFF recruitment and training program. These services, however, end once the
foster parent is licensed.
4
United for Families, Caregiver support Program, Indian River County Children's services Advisory Committee
C . PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages. Box will
ex and as you type)
ist Priority Needs area addressed. Mental Health
rTheprogramn
fly describe program activities including location of services .
objective is to retain foster parents in Indian River County and decrease the numbertions to local foster children. To achieve this, UFF hired one
Indian River County mentorool of qualified, veteran foster parents. The mentor receives $ 500 monthly in return forgroup and in-home support to new foster parents
.
The mentor was one of five who received 15 hours of training from a Certified Behavior
Analyst in 2006 by the Department of Children and Families . A foster parent coordinator
oversees the program, supervises all five mentors, and provides additional training to help mentors
identify local resources . Children' s Services Advisory Committee funding is used to fund the
mentor position in Indian River County.
Indian River County' s mentor attends all Foster Parent Association meetings, assists in the
training of new foster parents and meets regularly with the foster parent coordinator. Group
activities take place at the UFF location in Vero Beach, while in-home services are provided
throughout the county. The mentor is assigned to new foster parents as they are licensed and
assists in troubleshooting problems, identifying and coordinating community resources, and
guiding foster parents through the system. The mentor serves the general foster care community in
he same fashion.
Some of the questions mentors might address include:
• Why isn ' t my foster child responding to the discipline techniques I learned in training?
• How do I relate to my foster child' s biological parents, and how much interaction should I
have with them?
• My foster teen-ager thinks she' s in charge of her siblings — How do I make her understand
her new role as child and not caregiver?
The mentor monitors all phone calls and reports all activity with foster parents. The foster
parent coordinator files reports of all activity, tracks problems and requests and monitors mentor
esponsiveness and overall program success . The mentor is available to all foster parents for the
duration of their service. Exit interviews with foster parents who leave the system help indicate
rogram res onsiveness.
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 number of foster homes recruited each year is not enough to make up for the homes that
decline re-licensing. Though the reasons foster parents leave the system vary from home to home,
,there is one universal indicator: "Lack of support is the biggest reason foster parents leave the
Isystem," Foster Parent David Hall said in a 2006 interview . "We're trained how to deal with
(Children' s behaviors one way, but in reality, there's nothing you learned that can help you deal
��n�� „,,,ith those problems."
5
Type the Organization and Program Name
B
EXPENDITURES Proposed Total Program Budget Funder Specific Total Agency
Budget Budget
27 Travel-Daily 0 .001 30,575.00
# of Staff x average # of miles/wk x 50 wks x
$ = Estimated Daily Travel/M ileage Reimb. # of staff X average # miles/wk X $ = Estimated Daily TraveUMileage Reimb,
28 Travel/ConferenceslTraining 400 .001 61 ,000.00
• National Conference (cost per staff)
• Training/Seminar (cost per staff)
- Other Trainings (cost of travel, lodging,
registration, food)
29 Office Supplies 30,000.00
- Office supplies (monthly average x 12
months = estimated cost of office supplies
based on present history.
30 Telephone 56,778.00
• # 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 PostagelShipping 132.001 132.001 10,000.00
- Quarterly Mailing of Newsletter
• Special events, etc.
• Bulk mailings - appeals monthly newsletter to 23 homes at .39 each
32 Utilities
• Electricity ($ x 12 months)
• Water/Sewer ($ x 12 months)
• Garbage ($ x 12 months)
33 Occupancy (Building 8. Grounds) 280, 930. 00
- Mortgage/Rent ($ x 12 months)
- Janitorial ($ x 12 months)
• Grounds Maint. ($ x 12 months)
• Real Estate Taxes
34 Printing & Publications 132 . 00 132 . 001 20 , 000 . 00
• Quarterly Newsletter ($ x 4)
• Letterheads, Envelopes, etc.
• Fundraising materials
- Other .39 per calor newsletter for 23 homes
35 Subscription/Dues/Memberships 15,000.00
• Membership to National Organization
• Dues
• Subscriptions to Newspapers/magazines,
etc.
36 Insurance 28 ,565.00
• Directors/Officers Liab.
• Commercial/General Insurance
• Bond Ins.
• Auto Insurance
37 Equipment:Rental & Maintenance 0.001 126,627.00
• Copier lease ($ x 12 months)
- Meter lease ($ x 12 months)
• Copier Maintenance ($ x 12 months)
• Computer Maintenance ( $ x 12 months)
• Other
38 Advertising 0.00
• Newspaper ads
Fundraising ads/promotions
• Other (vacancies)
39 Equipment Purchases:Capital Expense 150,280. 00
• Computerlmonitor (# x $)
• Laser Printer
1 venoo
sn
United for Families, Caregiver Support Program; Indian River County Children's services Advisory Committee
Hall's assessment is backed by a 2005 United for Families data report that suggests 34
ercent of home closures were due in some part to lack of support. Those closures represent a loss
of up to 36 beds that could have been given to children. Furthermore, those children must be
laced somewhere else, increasing pressure on all remaining homes and increasing the likelihood
at those homes eventually will decline re-licensing.
Making a mentor available to foster parents will help decrease the number of times children
move within the system, thereby increasing their emotional stability, by providing a resource and
emotional outlet for stressed foster parents.
An annual foster parent appreciation dinner also is planned as part of the program and will
offer another avenue for retention activities as is a small fund to help pay for necessities such as
aby cribs and child safety seats . Studies show that recognition and praise is instrumental to
successfully engage any type of volunteer activity. Similarly, foster parents must have the right
ools if they are going to properly care for children.
United for Families , which offers the only known foster parent mentor program in the state,
drew from conclusions of the 2000 Governor' s Blue Ribbon Panel for Foster Care Recruitment
and Retention in designing this program. The study, which engaged foster parents from
throughout Florida, found that the key to improving recruitment and retention is to increase both
financial and non-financial support to existing foster parents. Peep mentors were specifically
amed as a best practice in foster parent retention.
List staffing needed for your program, including required experience and estimated
hours per week in program for each staff member and/or volunteers (this section should
conform to the information in the Position Listing on the Budget Narrative Worksheet).
Foster Parent Coordinator: Coordinator will have experience working with foster parents and in
accessing local resources. The coordinator will serve approximately 40 hours per week ( 1S
ercent of that in IRC. ) and be expected to attend all monthly foster parent association meetings .
Mentor: The mentor is a foster parent who resides in Indian River County and who has more than
20 years experience as a foster parent. She serves at least 10 hours per month.
How will the target population be made aware of the program?
The UFF foster parent coordinator will assign mentors to new foster homes during the licensing
rocess . UFF will make the program available to the foster care community in general and
increase awareness of the program through a monthly newsletter and during monthly foster parent
association meetings . The program will be incorporated in all foster parent training courses, and
case managers will learn about the rogram through required pre- service training.
How will the program be accessible to target population (i.e., location, transportation,
hours of operation) ?
The mentor will make home visits when necessary and be accessible 24 hours a day, all week.
The mentor also will be available during monthly foster parent association meetings, which take
lace in Vero Beach, or by phone. Problems arising at night that require the coordinator or any
other UFF staff will be handled at the start of the next business day. After-hour emergencies ,
however, will be handled via an on-call worker.
6
United for Families, Caregiver Support Fmgram, Indian River County Children's Services Advisory Coinnin ee
D . PROGRAM OUTCOMES AND ACTIVITIES MATRIX. 3 - 4 prograin outcomes only One matrix table per outcome Each matrix
table must not exceed two L21pagI. (NOTE: Boxes for Outcomes and cells in Matrix tables will expand as you type.)
(Boxes will expand as you type.)
g
tcome i 1 : At least 70 percent of children living in Indian River County out-of-home foster care will not experience placement
ruptions within a six-month period.
Evaluation Design & Data Collection
Program Design & Task Management (Columns 5-7)
(Columns 1 -4)
1 Z 3
4 5 6 7
Program Activities Frequency Responsible Parties Expected Outcomes/change Indicator Measurements D ta here nice (wrlien)f Measurement
(what) (how often) (who) (why) (evidence) (where)
Support group Monthly Foster Care 70 percent of children will not onthly placement HomeSafeNet Six months and 12 months
after the start of the
meetings Coordinator; Foster experience placement disruption reports rogram and every six
Parent President disruptions within a 6-month months afterward.
cried
HomeSafeNet same
Mentoring Daily Foster Parent Mentor; 70 percent of children will not same
ester Care experience placement
Coordinator disruptions within a 6-month
cried
HomeSafeNet same
Appreciation events Yearly Foster Care 70 percent of will not same
Coordinator; Kinship experience placement
Coordinator disruptions within a 6-month
cried
Same Donations/resource evelopment same
Offer resources Daily, as needed Foster Care tracking software Database
(resource guide, green Coordinator, Mentor,
book, clothing closet, Resource Coordinator
etc)
7
Type the Organization and Program Name
40 Professional Fees (Legal, Consulting) 554 ,605 .00
• Legal advice ( estimated #hrs x $)
• Consultant fees
• Other
41 Books/Educational Materials 0 .00
• Books/videos
• Materials ($ x staff)
42 Food & Nutrition 0 .00
• Meals ( # meals x clients x 5days x 50 wks)
Snacks
43 Administrative Costs 3,000. 001 636 . 00 0 .00
Admin . Cost (% of total budget) Fiscal support for invoice processing
44 Audit Expense 0. 001 0. 001 32 , 500 .00
Independent Audit Review
45 Specific Assistance to Individuals 7,500. 00 4 ,606-Fol 8 , 194 , 317 . 00
• Medical assistance
• Meals/Food flexible funding to ensure safety and quality of life for children in care, particularly child safety seats and other
• Rent Assistance infant equipment as well as assistance for sports and other extra-curricular activities that enhance a child's
• Other emotional well being while in care, or $ 193 per family.
46 Other/Miscellaneous 900. 001 900.001 51 ,260 . 00
• Background check/drug test
• Other 18 percent of district cost for foster parent appreciation (18 percent of $5,000)
47 Other/Contract 6,000. 001 6, 000.001 10 , 996 , 340. 00
• Sub-contract for program services $500 monthly stipend for mentor
48 TOTAL EXPENSES $26,736.92 $205000.00 $22 , 571 , 386. 00
1 V8/2007 e4
United Cor Families, Caregiver Support Program, Indian River County Children's Services Advisory Comimttee
(Boxes will expand as you type. )
Fby
utcome # 2_At least 80 percent of Indian River County foster parents will become
re-licensed following a year in the program as reported
2007 re-licensing reports .
Evaluation Dcs� & Data Collection
Program Design & Task Mana ement (Col
wnns 5 -7)
(Columns 1 -4)
6 7
1 2 3
4 5
Indicator Data Source (where) Time of Measurement
Program Activities Frequency Responsible Parties Expected (when)
(what) (how often) (who) outcomes/change Measurements
(Why) (evidence)
Mentoring aily Foster Parent Mentor More foster homes will 2007 re-licensing HotncSafeNet Every six following Che fi st
be retained eports
onth of the program
Foster Parent Mentor More foster homes will Mentor activity Department of Program Every six months
Resource referral Daily Services
e retained tracker
Foster Parent Mentor ore foster homes will Mentor activity Servant Department of Program Every six months
Problem solving Daily
e retained tracker
Department of Program Monthly
Foster Parent Mentor Monthly Foster Parent Mentors Better communication mutes
Meetings
and Foster Care between foster parents Services
Coordinator and the agency; fast
solutions to problems
8
United for Families, Caregiver support Pmgrum, Indian River County Children's Services Advisory Committee
(Boxes will expand as yout e.)
Outcome #3-: Increase by 20 percent the number of Indian River County caregivers who attend monthly support meetings, trainings or
work groups as reported by monthly attendance sheets . Baseline 15 parents.
Program Desitin & Task Management Evaluation Desitin & Data Collection_
(Columns 1 -4) (Columns 5 -7)
1 2 3 4 5 6 7
Program Activities Frequency Responsible Parties Expected Indicator Data Source (where) Time of Measurement
(what) (how often) (who) Outcomes/change Measurements (when)
(why) (evidence)
Resource offerings and Monthly Foster parent More caregivers will Attendance rosters Department of Program Monthly
donations will be made association president; ttend their respective Services
available at meetings foster care coordinator meetings
Sought-after speakers and Monthly Foster parent Marc caregivers will Attendance rosters Department of Program Monthly
curriculum will be offered association president; attend their respective Services
foster care coordinator meetings
Child care will be offered, or Monthly Foster parent More caregivers will Attendance rosters Department of Program Monthly
activities will be offered on association president; attend their respective Services
site to children foster care coordinator meetings
Transportation will be Monthly Foster parent More caregivers will Attendance rosters Department of Program Monthly
arranged when necessary association president; attend their respective Services
foster care coordinator eetings
9
C 6
United for Families, Caregiver SuppoII Program, Indian River County Children's Services Advisory Committee
It
PROGRAM COVER PAGE
Organization Name: United for Families
Executive Director: Christine DemetriadesE-mail: Christine demetriades(a Uffus
Address : 10570 S . Federal Hwy . Ste. 300 Port St. Lucie FL 34952
Telephone: (772) 398-2920 Fax: (772) 398 -2925
Program Director: Jill Feaster E-mail : jill feaste64uff us
Address: 10570 S . Federal Hwy. Ste . 300 Port St. Lucie. FL 34952
Telephone: (772) 398-2920 Fax: (772) 398-2925
Program Title : Caregiver_ Support Program (formerly Foster Parent Mentor Program)
Priority Need Area Addressed: Mental Health Taxonomy PH- 140. 500
Brief Description of the Program: Interruptions in the continuity of a child ' s care are detrimental ;
repeat d moves from home to home compound the adverse consequences that stress and inadequate
parenting have on a child' s development and ability to cope. United for Families will enhance
children' s mental and emotional stability by decreasing the number of times they move from home to
home within the foster-cares stem. We will do this through a mentor program that uses veteran foster
parents to counsel and educate new foster parents The program objective is to increase foster-parent
retention thereby decreasing disruptions to children.
SUMMARY REPORT — (Enter Information In The Black Cells Only)
Amount Requested from Funder for 2007 / 08 : $ 206 , 00
Total Proposed Program Budget for 2007 ! 08 : 37
74 . 9 %
Percent of Total Program Budget : 20 , 000
Current Program Funding (2006 / 07 ) : S
Dollar increase / ( decrease ) in request : $
0 . 0 °�
Percent increase / ( decrease ) rst * * : 81
Unduplicated Number of Chilin request
- to be served Individually : 30
Unduplicated Number of Adults to be served Individually :
Unduplicated Number to be served via Group settings : 240 . 87
Total Program Cost per Client :
**If request increased 5 % or more, briefly explain why:
If these funds are being used to match another source, name the source and the $ amount:
The Or ani zation 's Board of Directors has approved this application on (date) . _ 17 pC00
ar / 1�lcCv �
°e of President/Chair off e oard Sia'
e�Y"
Name of Executive Director.�CPO Signature
2
t
t
I
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Cmnmurce
Boxes will ex and as au type.)
_Outcome #4 80 percent of participants will report being satisfied with the program the end of 17 months
Evaluation Design & Data Collection
Program Desisn & Task Management (Columns 5-7)
(Columns 1 -4)
1
3
4 5 6 7
2
Indicator Data Source (where) Time of Measurement
Responsible Parkes Expected (when)
Program Activities (howFreq
(who)
Outcomes/change Measurements
(what) (how o[ten) ( (why) (evidence)
Mentors; volunteer More caregivers will be Six month Department of Quality Every six months after
Problem solving Daily the first month of the
kinship coordinator; satisfied with the satisfaction survey Management
foster care coordinate program and more will program
attend activities
Mentors; volunteer ore caregivers will be Six month Department of Quality Every six months after
etworking Monthly
kinship coordinator; atisfied with the satisfaction survey Management t rogram oath of e
foster care coordinate rogram and more will
attend activities
Department of Quality Every six months after
Resource referral Daily/monthly Mentors; volunteer ore caregivers will be Six month
kinship coordinator; satisfied with the satisfaction survey Management Progrannonth of the
foster care coordinato program and more will
attend activities
Mentors; volunteer More caregivers will be Six month Department of Quality Every six months after
Communication Daily the first month of the
kinship coordinator; satisfied with the satisfaction survey anagemettt program
foster care coordinate rogram and more will
attend activities
10
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
E. COLLABORATION (Entire Section E not to exceed one page)
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 agreement letters.)
Collaborative A enc Resources rovided to the pro ram
Hibiscus Children' s Center Program inclusion as part of foster-parent trainings
Department of Children and Families Certified Behavior Analyst training of mentors and use of
uilding for foster parent meetings
Indian River County Foster Parent Provide speaking opportunities and a training forum
Association
Children ' s Home Society Program inclusion in case-management pre-service
rainings
Indian River County School Board se of school for FPA meetings
I1
United for Families, Caregiver support Program, Indian River County Children's Services .Advisory Committee
ORGANIZATION : United for Families
PROGRAM : Caregiver Support Program
2007/2008 CORE APPLICATION TABLE OF CONTENTS
"X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located.
X Section of the Proposal Pa e #
_TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . 2
A. ORGANIZATION CAPABILITY (one page maximum) 3
1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Summary of expertise, accomplishments, and population served. . . . . . . . . . . . . . . . . . . . . . . . . . . 3
B. PROGRAM NEED STATEMENT (one page maximum) 4
I . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2 . Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. PROGRAM DESCRIPTION (two pages maximum) 5
1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. 5
I 3 . Evidence that program strategy will work. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . 5
4. Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . 6
6
5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . 6
6 . Accessibility. of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . .
D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes 7. 10
E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . .
11
F. UNDUPLICATED CLIENTS
1 . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . 12
12
2. Projections by Age Group . . " " " " " " " " " " " " " " ' . .
G. BUDGET FORMS
1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . B1 -5
H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
1
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
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 question that you are addressing. Do not
change the Times New Roman 12 pt. font or other settings . Directions, such as these, may be deleted
if space is needed, but again, do NOT delete the Section headers or the numbered questions
A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page. Box will
expand as you type. )
Provide the mission statement and vision of your organization.
United for Families ' mission is to break the cycle of child abuse through a diverse network of
community providers and innovative services . Our commitment to the community is to ensure
safety to all children and to provide permanent homes for them. We envision a community where
the safety and well-being of children is the concern of every individual ; where "Safe Place" is not
just a sign on a door, but a creed in every home. We believe that every child deserves a healthy
family, and that every weakened family deserves a chance to heal. UFF will lead the community
in the pursuit of these ideals and be a recognized statewide lead, providing a continuum of
dynamic and innovative services for children and families.
Provide a brief summary of your organization including areas of expertise,
accomplishments, and population served.
United for Families was created in 2002 in response to Community Based Care, a statewide, bi-
artisan initiative that privatized public child welfare services. We are a non-profit agency
charged with delivering local services and supports for children and families in Okeechobee and
the Treasure Coast. Our network of providers and the services we entrust to them are
comprehensive. More than 1 , 800 children and families in St. Lucie, Martin, Indian River and
Okeechobee counties have access to services that include: Domestic violence and substance abuse
prevention, housing assistance, foster care and adoption, family support services , individual and
group counseling and behavior management. Through these services, we hope to strengthen
families, send children home faster and reduce the number of children in the child-welfare system
to 1 ,300 .
We proudly present the following achievements :
* In 2005 , 96 percent of children remained safe while in care. The state target for this
measurement was 95 percent, placing United for Families third among other Community Based
Care organizations throughout Florida.
* The average stay for these children was 1 1 months . State target was less than a year.
* United for Families oversaw the successful adoption of 76 children, exceeding the agency' s
annual goal of 75 .
* Programs were established to maintain a level of normalcy among children in care. These
programs included a car-seat and crib loaner program and a network of donations closets. We also
instituted new programs to keep children from entering the foster-care system and reduce the
umber of times children move. These programs include the Caregiver Support Program
(formerly the Foster Parent Mentor Program) and Relatives As Parents Program, which is
educing the number of disruptions among children in kinship care.
3
United for Fantilies, Caregiver Support Program, Indian River County Children's Services Advisory Committee
F. UNDUPLICATED CLIENTS
Number of Unduplicated Clients by Location
L �seL i' a7� Current Fiscal Yeartsl"Fear
Location Budget 2006/0700
Unduplicated Clients Unduplicated Clients Unduplicated Clients
North Indian River Co . 25 16
South Indian River Co . - 98 95
Indian River Co Total - 123 l 11
Greater Stuart -
Hobe Sound -
Indiantown -
Jensen Beach
Palm City -
Martin County Total -
Fort Pierce -
Port Saint Lucie -
St. Lucie Co. Total -
Other Locations - -
TOTAL SERVED 123 111
Number of Unduplicated Clients by Age
atc� �n Current Fiscal Year � c sea '
Location cu215�2#lfi1 . _ . Budget 2006/07
IndlrriifIs aroug 4:; Individual Group ZnIual aul* ii
s
. ,.,
� .
0 to 4 - (Pre- school) - - 28 46
5 to 10 - (Elementary) - - 25 19
11 to 14 - (Middle) - - 15 6
15 to 18 - (High School) - - 9 10
Total Children
19 to 59 - (Adults) 46 30 15
60 + ( Seniors) -
Total Adults - 46 30 15
TOTAL SERVED - 123 - lll 15
12
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
H. FUNDER SPECIFIC REQUIREMENTS
MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages)
Note period outcomes/results reflect: October 2006 to April2007.
OUTCOMES RES7percent
ist all elements of last year 's measurable outcomes. Cut List the results s.
nd paste from last years application,
o decrease the number of disruptions to Indian Goal Met. From the timcement of
River County child placements by 25 percent in he grant until now ; therfive
one year as reported by 2006 UFF placement disruptions to Indian Rihild
ecords . Baseline : 2005 placement and disruption the number of disruptioment. The outcome t t in one se
ecords (12 children) .
ear.
To decrease by 30 percent the number of Indian Goal Met. At this time, there have been 5 foster
River County foster parents who rescind their ome closures in Indian River County. The
licenses following a year in the program as number of foster parents who rescind their
eported by 2006 re-licensing reports. Baseline: licenses following a year in the program have
2005 re-licensing reports (7 closures) . ecreased by 30 percent.
Increase by 50 percent the number of Indian Goal Not Met. The average number of foster
River County foster parents who attend monthly arents who attend the monthly Foster Parent
Foster Parent Association meetings as reported Association is currently 12 parents . This has
y monthly sign-in sheets . Baseline: 2005 increased 20 percent from the 2005 attendance
attendance average (10 parents) . average of 10 parents. United for Families
expects to reach its goal by maintaining this rate
of increase during the next six months.
13
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
B . PROGRAM NEED STATEMENT (Entire Section B not to exceed one page. Box will
expand as You type)
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.
lack of support services threatens the stability of children in the foster-care system because
caregivers who do not feel supported are more likely to quit or request that a child be moved to
mother home. UFF strongly believes that a menu of both group and in-home support services is the
est way to improve caregiver retention and reduce the number of times children move in the
system. We created the Caregiver Support Program, for
known as the Foster Parent Mentor
Program, to address this need.
The need for the program best is illustrated by recent placement disruption reports. UFF
laced 175 Indian River County children in care from July 2006 to January 2007 . Of those
children, 25 percent moved two or more times in a six-month period and 6 percent moved four
oves were requested by caregivers , citing lack of
times or more in the same time period. The m
support as their primary reason.
We currently license 22 foster homes in Indian River County, of which 15 actively tak
children. Because only 68 percent of homes currently have beds available, 28 Indian River Coun
children live in shelters while still more live in other parts of the state. This typeof placemen
finders the reunification process and lowers the probability that the children will return home,
(Petr and Entriken, 1995, Service System Barriers to Reunification, Families in Society, 76(9) 523
533) .
Furthermore, interruptions in the continuity of a child' s caregiver are often detrimental;
according to the American Academy of Pediatrics . "Repeated moves from home to home
compound the adverse consequences that stress and inadequate parenting have on a child' s
development and ability to cope," (American Academy of Pediatrics : Developmental Issues for
Young Children in Foster Care; Committee on Early childhood, Adoption and Dependent Care,
Vol. 106, No. 5, November 2000, pp. 1145- 1150.)
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.
UFF contracts case management services to Children' s Home Society and Family
Preservation Services . Both agencies indirectly serve foster parents through the case-management
of children on their caseloads. The needs of foster parents, however, often go unaddressed in the
daily struggle to deal with child-related issues . Hibiscus Children' s Center also serves foster
arents through UFF recruitment and training program. These services, however, end once the
foster parent is licensed.
4
United for Families, Caregiver support Program, Indian River County Children's services Advisory Committee
C . PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages. Box will
ex and as you type)
ist Priority Needs area addressed. Mental Health
rTheprogramn
fly describe program activities including location of services .
objective is to retain foster parents in Indian River County and decrease the numbertions to local foster children. To achieve this, UFF hired one
Indian River County mentorool of qualified, veteran foster parents. The mentor receives $ 500 monthly in return forgroup and in-home support to new foster parents
.
The mentor was one of five who received 15 hours of training from a Certified Behavior
Analyst in 2006 by the Department of Children and Families . A foster parent coordinator
oversees the program, supervises all five mentors, and provides additional training to help mentors
identify local resources . Children' s Services Advisory Committee funding is used to fund the
mentor position in Indian River County.
Indian River County' s mentor attends all Foster Parent Association meetings, assists in the
training of new foster parents and meets regularly with the foster parent coordinator. Group
activities take place at the UFF location in Vero Beach, while in-home services are provided
throughout the county. The mentor is assigned to new foster parents as they are licensed and
assists in troubleshooting problems, identifying and coordinating community resources, and
guiding foster parents through the system. The mentor serves the general foster care community in
he same fashion.
Some of the questions mentors might address include:
• Why isn ' t my foster child responding to the discipline techniques I learned in training?
• How do I relate to my foster child' s biological parents, and how much interaction should I
have with them?
• My foster teen-ager thinks she' s in charge of her siblings — How do I make her understand
her new role as child and not caregiver?
The mentor monitors all phone calls and reports all activity with foster parents. The foster
parent coordinator files reports of all activity, tracks problems and requests and monitors mentor
esponsiveness and overall program success . The mentor is available to all foster parents for the
duration of their service. Exit interviews with foster parents who leave the system help indicate
rogram res onsiveness.
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 number of foster homes recruited each year is not enough to make up for the homes that
decline re-licensing. Though the reasons foster parents leave the system vary from home to home,
,there is one universal indicator: "Lack of support is the biggest reason foster parents leave the
Isystem," Foster Parent David Hall said in a 2006 interview . "We're trained how to deal with
(Children' s behaviors one way, but in reality, there's nothing you learned that can help you deal
��n�� „,,,ith those problems."
5
Type the Organization and Program Name
2007-2008 CORE 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 : United for Families/Caregiver Support Program
FUNDER : Children's Services Advisory Committee of Indian River County
CAUTION Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should
• be used for providing information and calculations only.
REVENUES Proposed Total Program Budget Funder Specific Total Agency
. Budget . Budget
1 Children's Services Council-St. Lucie 30,000.00
2 Children's Services Council-Martin
3 Advisory Committee-Indian River 20 ,000 .00 20,000. 00 20,000 .00
4 United Way-St. Lucie County
5 United Way-Martin County
6 United Way-Indian River Coun
7 Department of Children & Families 22,904,788.00
8 County Funds
9 Contributions-Cash 30, 000.00
10 Program Fees
' 1 Fund Raising Events-Net
l2 Sales to Public - Net
13 Membership Dues
14 Investment Income
15 Miscellaneous
16 Legacies & Bequests
17 Funds from Other Sources 48,410.00
18 Reserve Funds Used for Operating
19 In-Kind Donations (Not included in total) 6 , 727 .27
20 TOTAL REVENUES
(doesn4 include line 19) $20 ,000.00 go on .DO $23,033 , 198.00
B C
EXPENDITURES A Funder Specific Total Agency
Proposed Total Program Budget Budget Bud et
21 Salaries - (must complete charton next page 7 ,900.00 7 ,200 .00 1 ,932 , 609 .00
22 FICA - Total salaries x 0 .0765 550 .80
ehrement - nnua pension or qua
23 staff 288 .00
Ll a eat - e ica enta ort-term
24 Disab. 72 . 00
Workers ompensatlon - emp oyees x
25 rate 429. 12
on a unemployment - pro)ecte
26 employees x $7,000 x UCT-6 rate 288.00
srvzom
a-1
Type the Organization and Program Name
SALARIES I Gross II o fv
Ifl ko( Gross Annual
POSITION LISTING Annual Salary Portion of Salary on Proposed Funder Specific Budget Salary
Position Title / Total Hrs/wk (Agency) Program Requested(C(A)
Erample: ErecvvmDirector140hrs 70,000.00 -00,000.00 5,000.00 7. 14%"
Foster Care Coordinator 40,000 .00 71200 .00 7 ,200 .00 18.00°/n
Supervisor 70,000 .00 700 .00 0.000i°
non-program salaries 11822 ,609 .00 0 .00 0 .00 0.00 %
#DIV/0!
#DIV/O!
#DIV/O !
#DN/O !
#DIV/0!
#DMU
#DIV/a!
#DIVIO !
#DIVIO !
#DN/0!
#DIV/O!
#DIV/0!
#DIVIO !
#DIV/0 !
#DNI() !
#DIVIO!
#DIV/0!
Remaining positions throughout the agency
Total Salaries ###### $7,900 .00 $7 ,200 .00 0 . 370/<
FRINGE BENEFITS DETAIL
11
Fundrs Specific Budget /it lv v w Ni
(Funder dt I Fund
{� g - Pension Health Worker's llnemployme, . Total Fringes Funder
Column C only, from line 21 to 26) Specific Budget FICA 7,65% (A x %) Ins. compens. nt Compens. Specific
Position Title / Total Hrs/wk
Example: case Manger hrs 5,000.001 382.50 200.00 50MOD 300.00 ' - ' 200.00. 1,582.50
Foster Care Coordinator 7,200.00 550 .80 288. 00 72.00 429. 12 288 .00 1 ,627 .92
Supervisor 0. 00 0, 00 0 .00
non-program salaries 0.00 0.00 0 .00
0 0.00 0.00 0. 00
0 0.00 0.00 0.0
0 0 .00 0 .00 0.00
0 0 .00 O.CO O .DC
a o.Do o.Da 0 .0a
0
a001 0.00 0. 0
0 0.00 0.020.0
0 MCI 0.00 0.0
0 0 .00 0 .00 0 .0
0
0 .00 0, 00 o .00
0 0.001 0.00 0.00
0 0
0 .0a a.OD 0 .0
0.00 0.00 0.0
0 0.00 0 .00 0 or
0 0 .00 0 .00 0 .0
0 0. 00 O.Oa O.00
D
0.001 0.00 0.0
Total Funder Request Fringe Benefits $7,200.00 550.50 $288. 00 $72.00 429. 12 $288.00 (,; l
srvzow
s-i
United for Families, Caregiver Support Program; Indian River County Children's services Advisory Committee
Hall's assessment is backed by a 2005 United for Families data report that suggests 34
ercent of home closures were due in some part to lack of support. Those closures represent a loss
of up to 36 beds that could have been given to children. Furthermore, those children must be
laced somewhere else, increasing pressure on all remaining homes and increasing the likelihood
at those homes eventually will decline re-licensing.
Making a mentor available to foster parents will help decrease the number of times children
move within the system, thereby increasing their emotional stability, by providing a resource and
emotional outlet for stressed foster parents.
An annual foster parent appreciation dinner also is planned as part of the program and will
offer another avenue for retention activities as is a small fund to help pay for necessities such as
aby cribs and child safety seats . Studies show that recognition and praise is instrumental to
successfully engage any type of volunteer activity. Similarly, foster parents must have the right
ools if they are going to properly care for children.
United for Families , which offers the only known foster parent mentor program in the state,
drew from conclusions of the 2000 Governor' s Blue Ribbon Panel for Foster Care Recruitment
and Retention in designing this program. The study, which engaged foster parents from
throughout Florida, found that the key to improving recruitment and retention is to increase both
financial and non-financial support to existing foster parents. Peep mentors were specifically
amed as a best practice in foster parent retention.
List staffing needed for your program, including required experience and estimated
hours per week in program for each staff member and/or volunteers (this section should
conform to the information in the Position Listing on the Budget Narrative Worksheet).
Foster Parent Coordinator: Coordinator will have experience working with foster parents and in
accessing local resources. The coordinator will serve approximately 40 hours per week ( 1S
ercent of that in IRC. ) and be expected to attend all monthly foster parent association meetings .
Mentor: The mentor is a foster parent who resides in Indian River County and who has more than
20 years experience as a foster parent. She serves at least 10 hours per month.
How will the target population be made aware of the program?
The UFF foster parent coordinator will assign mentors to new foster homes during the licensing
rocess . UFF will make the program available to the foster care community in general and
increase awareness of the program through a monthly newsletter and during monthly foster parent
association meetings . The program will be incorporated in all foster parent training courses, and
case managers will learn about the rogram through required pre- service training.
How will the program be accessible to target population (i.e., location, transportation,
hours of operation) ?
The mentor will make home visits when necessary and be accessible 24 hours a day, all week.
The mentor also will be available during monthly foster parent association meetings, which take
lace in Vero Beach, or by phone. Problems arising at night that require the coordinator or any
other UFF staff will be handled at the start of the next business day. After-hour emergencies ,
however, will be handled via an on-call worker.
6
United for Families, Caregiver Support Fmgram, Indian River County Children's Services Advisory Coinnin ee
D . PROGRAM OUTCOMES AND ACTIVITIES MATRIX. 3 - 4 prograin outcomes only One matrix table per outcome Each matrix
table must not exceed two L21pagI. (NOTE: Boxes for Outcomes and cells in Matrix tables will expand as you type.)
(Boxes will expand as you type.)
g
tcome i 1 : At least 70 percent of children living in Indian River County out-of-home foster care will not experience placement
ruptions within a six-month period.
Evaluation Design & Data Collection
Program Design & Task Management (Columns 5-7)
(Columns 1 -4)
1 Z 3
4 5 6 7
Program Activities Frequency Responsible Parties Expected Outcomes/change Indicator Measurements D ta here nice (wrlien)f Measurement
(what) (how often) (who) (why) (evidence) (where)
Support group Monthly Foster Care 70 percent of children will not onthly placement HomeSafeNet Six months and 12 months
after the start of the
meetings Coordinator; Foster experience placement disruption reports rogram and every six
Parent President disruptions within a 6-month months afterward.
cried
HomeSafeNet same
Mentoring Daily Foster Parent Mentor; 70 percent of children will not same
ester Care experience placement
Coordinator disruptions within a 6-month
cried
HomeSafeNet same
Appreciation events Yearly Foster Care 70 percent of will not same
Coordinator; Kinship experience placement
Coordinator disruptions within a 6-month
cried
Same Donations/resource evelopment same
Offer resources Daily, as needed Foster Care tracking software Database
(resource guide, green Coordinator, Mentor,
book, clothing closet, Resource Coordinator
etc)
7
Type the Organization and Program Name
B C
EXPENDITURES A Funder Specific Total Agency
Proposed Total Program Budget Budget Budget
e7 Travel-Daily 2 ,293 .20 2 ,293.20 30 , 575.00
# :of Staff z:average # of miles/wk x 50:wks x
$ = Estimated Daily Travel/Mileage Reimb. # of staff X average # mdeslwk X 5 ' Estimated Daily TravellMileage Reimb.
28 Travel/ConferenceslTraining 61 ,000 .00
National Conference (cost per staff) , ,
Training/Seminar (cost per staff)
Other Trainings (cost of travel, lodging,
registration, food)
29 Office Supplies 30 ,000 .00
Office supplies (monthly average x12 .
months = estimated cost of office supplies
based on present history.
30 Telephone 1 .034.00 56,778 .00
# Phone lines x average cost per month x
12 months = local phone cost
Average long distance calls 12 months =
Estimated cost of long dstance 1 line at $221month
31 Postage/Shipping 107.64 10 ,000 .00
Quarterly;Malting of Newsletter
Special events, etc.
Bulk mailings appeals monthly newsletter So 23 homes at 39 each
32 Utilities
Electricity ($z 12 months)
' 'Water/Sewer,($ x 12 months)
Garbage ($ z 12 months)
33 Occupancy (Building & Grounds) 3 ,235.00 280,930 . 00
Mortgage/Rent (S x 12 months)
'Janitorial ($ 'x 12 months) .
Grounds Maint (S x 12months)
Real Estate Taxes 21 percent of occupancy @ 1;283 75/month based on square footage
34 Printing & Publications 107.641 20 ,000 .00
Quarterly Newsletter ($ x 4)
Letterheads, Envelopes, etc.
-'Fundraising materials
-Other 39 per color newsletter for 23 homes
35 SubscriptionlDues/Memberships 15 ,000 .00
.Membership to National Organrzation' _
Dues
Subscriptions to Newspapers/magazines,
etc.
3 Insurance 28 ,565 .00
Directors/Officers Liab.
Comm ercial/General Insurance
Bond Ins
Auto Insurance
37 Equipment:Rental & Maintenance 0.00 17
Copier lease ($ x12 months)
Meter lease ($ x 12 months)
Copier Maintenance ($. x 12 months)
Computer Maintenance ( $ x 12 months) -
Other.
0 .00
38 Advertising
Newspaper ads -
Fundraisingads/promotions
Other (vacancies)
39 Equipment Purchases: Capital Expense 150 ,280 .00
Computertmonitor {#x $)
Laser Printer
5iv20m a-1
Type the Organization and Program Name
554,605 .00
40 Professional Fees (Legal, Consulting)
Legal advice :( estimated #hrs x $)
:onsultantfees
Xher 0 .00
41 BooksfEducational Materials
Books/videos
Materials ($ xstaff) 0 .00
42 Food & Nutrition
Meals ( # meals x clients x ,5days x 50 wks)
Snacks 626.32 636 .32 0 . 00
43 Administrative Costs
Admin Cost (% of total budget) 3 percent of program budget 0 .00 65 .00 32 , 500 .00
Audit Expense
Independent Audlt Review total program cost divided by total agency cost = percent of audit applied to program
45 Specific Assistance to Individuals
2 ,895.48 2 ,895.48 8 , 194,317 .00
Medical assistance
MeaislFood Flexible funding to ensure safety and quality of life for children in rare particularly child safety, seats and other
Rent Assistance infant equipment as well as assistance for sports and other extra cumcular activities that enhance a child's
Other emotional well being while in care, or $493 per family. g00 .oD 51 ,260 .00
900 00
46 Other/Miscellaneous -
Background check/drug test
Other 18 percent of district for foster parent appreciation (18 percent of $5;000) 10 ,996 , 340 .00
6 .000 .00 6 , 000 . 00
47 OthedContract
Sub-contract for program services $500 monthly stipend for mentor
$26 ,727 .20 $ 19 ,990 .00 $22 ; 571 ,386.00
48 TOTAL EXPENSES
a-�
51V20�7
United Cor Families, Caregiver Support Program, Indian River County Children's Services Advisory Comimttee
(Boxes will expand as you type. )
Fby
utcome # 2_At least 80 percent of Indian River County foster parents will become
re-licensed following a year in the program as reported
2007 re-licensing reports .
Evaluation Dcs� & Data Collection
Program Design & Task Mana ement (Col
wnns 5 -7)
(Columns 1 -4)
6 7
1 2 3
4 5
Indicator Data Source (where) Time of Measurement
Program Activities Frequency Responsible Parties Expected (when)
(what) (how often) (who) outcomes/change Measurements
(Why) (evidence)
Mentoring aily Foster Parent Mentor More foster homes will 2007 re-licensing HotncSafeNet Every six following Che fi st
be retained eports
onth of the program
Foster Parent Mentor More foster homes will Mentor activity Department of Program Every six months
Resource referral Daily Services
e retained tracker
Foster Parent Mentor ore foster homes will Mentor activity Servant Department of Program Every six months
Problem solving Daily
e retained tracker
Department of Program Monthly
Foster Parent Mentor Monthly Foster Parent Mentors Better communication mutes
Meetings
and Foster Care between foster parents Services
Coordinator and the agency; fast
solutions to problems
8
United for Families, Caregiver support Pmgrum, Indian River County Children's Services Advisory Committee
(Boxes will expand as yout e.)
Outcome #3-: Increase by 20 percent the number of Indian River County caregivers who attend monthly support meetings, trainings or
work groups as reported by monthly attendance sheets . Baseline 15 parents.
Program Desitin & Task Management Evaluation Desitin & Data Collection_
(Columns 1 -4) (Columns 5 -7)
1 2 3 4 5 6 7
Program Activities Frequency Responsible Parties Expected Indicator Data Source (where) Time of Measurement
(what) (how often) (who) Outcomes/change Measurements (when)
(why) (evidence)
Resource offerings and Monthly Foster parent More caregivers will Attendance rosters Department of Program Monthly
donations will be made association president; ttend their respective Services
available at meetings foster care coordinator meetings
Sought-after speakers and Monthly Foster parent Marc caregivers will Attendance rosters Department of Program Monthly
curriculum will be offered association president; attend their respective Services
foster care coordinator meetings
Child care will be offered, or Monthly Foster parent More caregivers will Attendance rosters Department of Program Monthly
activities will be offered on association president; attend their respective Services
site to children foster care coordinator meetings
Transportation will be Monthly Foster parent More caregivers will Attendance rosters Department of Program Monthly
arranged when necessary association president; attend their respective Services
foster care coordinator eetings
9
ra uK ay.mUm. mn vagom Name
2007-2008 CORE GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCY/PROGRAM NAME: United for Families Caregiver Support Program
FY 05106 FY 06109 FY 07108 % INCREASE
FYE FYE FYE CURRENTVS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED Icor. C-col, eyrol. B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St. Lucie 36,000.001 30,000.00 -16.67%
2 Children's Services Council-Martin 0 .00
3 Advisory Committee-Indian River 20,000.00
4 United Way-St. Lucie County 0 .00
5 United Way-Martin County 0.00
6 United Way-Indian River County 0-00
7 Department of Children & Families 18,893,994.00 18,893.994.001 22,904,7W001 21 .23%
e County Funds 0 .00
9 Contributions-Cash 30,000.00
10 Program Fees 0.00
11 Fund Raising Events-Not 0.00
12 Sales to Public-Net 0.00
13 Membership Dues 0.00
14 Investment Income 0.09
15 Miscellaneous 0'00
16 L acies & Be uests 0.00
n Funds from Other Sources 337,000.001 48,410 .00 -85.64%
113 Reserve Funds Used for Operating 0.00
19 In-Kind Donations (Not ncwdadm romp D.DQ
20 TOTAL 18,891994.00 19,266,994.00 23,033,196.00 19.55%
EXPENDITURES
21 Salaries 1 ,376 522.00 1 .932,609.00 40.40%
22 FICA 406,209.00 0.06 -100.00%
23 Retirement 0.00
24 Life/Health 0.00
25 Workers Compensation - 0.00
26 Florida Unemployment 0.00
27 Travel-Daily 21 .000.001 30,575.001 45.6096
2a TmvellConferences/rrainin 159.413.001 61 ,000 .00 -61 .73%
29 Office Supplies 29.OG4.001 30,000.001 3.43%
30 Telephone 115.004.001 56,778.001 -5D .63%
31 PostagetShipping 9.996.001 10,owool 0 .04%
32 Utilities 1 0 .00
33 Occupancy (Building & Grounds 559.521 .001 280,930.00 -49.790/c
3a Printing & Publications 1 10.004.001 20.000.001 99.92%
35 Subscri tionlDues/Membershi s 1 15,000.00
1 eeeeeee�
36 Insurance 20,816.001 28,565.001 37.230io
37 E ui ment:Rental & Maintenance 70,604.001 126,627.00 79.35010
3a Advertising 0.00
39 Equipment Purchases:Ca ital Expense I 150,280.D0
40 Professional Fees Le al, Consulting) 37.992.001 554, 605.001 1359.79%
41 BookslEducational Materials 1 0 .00
42 Food & Nutrition 1 0.00
43 Administrative Costs 99,496.00 0.00 -100 .00%
44 Audit Expense 348.911 .001 32,500.00 -90.69%
45
Specific Assistance to Individuals 7,729,484.00 8, 194,317 .00 6.010ra
46 Other/Miscellaneous 8,273 018.00 51 .260.00 -99.380/c
47 Other/Contract - 10,996,340.00
4a TOTAL 0.00 19,266,994.01) 22.571 ,386.00 17.15%
49 REVENUES OVERT UNDER EXPENDITURES 18,893,994.00 0.00 461 .812.00
Td,= m. aPQZ�01 ,'d PIenm N=m+
2007.2008 CORE GRANT APPLICATION
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME: United for Families Caregiver Support Program
FY 051D6 FY 06/07 FY 07108 % INCREASE
FYE FYE FYE CURRENTVS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED Idol. C<01. apc01. B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St. Lucie 0.00
2 Children's Services Council-Martin 0.00
3 Advisory Committee-Indian River 20,000.00 20,000.00 0,00%
4 United Way-St. Lucie County 0.0o
5 United Way-Martin County OAO
s United Wa -Indian River purity 0.00
7 Department of Children & Families 0.00
8 County Funds 0.00
9 Contributions-Cash 909.88 0.00 .100.00%
tD Pro ram Fees 0-00
it Fund Raising Events-Net 0.00
12 Sales to Public-Net 0 .00
13 Membership Dues 0 .00
i Investment Income 0.00
is Miscellaneous 0.00
is Legacies & Bequests 0.00
11 Funds from Other Sources 0.00
is Reserve Funds Used for Operating
0.00
19 In-Kind Donations lNdlmdwded intoWi) 4,380 .88 6,727.27 53 .56%
20 TOTAL 0.00 20,909.88 20,000.00 4.35%
EXPENDITURES
21 Salaries 8,526.00 7.900.00 -7.34%
22 FICA 652.24 550.80 .15.55%
23 Retirement 341 .04 286.00 -15.55%
24 LifelHealth 852.60 72.00 -91 .56%
25 Workers Compensation 511 .56 429.12 -16.12%
26 Florida Unemployment 341 .04 288-00 -15.55%
27 Travel-Dail 1 ,827.00 2,293.20 25.52%
28 Travel/Conferences/rrain inn 210.00 0 .00 -100.00%
29 Office Supplies 0.00
30 Telephone 1 034.00 1 ,034.00 0,00%
31 Postage/Shipping 107.64 107.64 0.00%
32 Utilities 0.00
33 Occupancy (Building & Grounds 3,235.00 3,235.00 0.00%
34 Printing & Publications 107.64 10264 0.00%
35 Subscription/Dues/Memberships 0 .00
36 Insurance 0.00
37 E ui ment:Rental & Maintenance 0.00
38 Advertisinq 0.00
39 Equipment Purchases :Ca ital Expense 0.00
40 Professional Fees Le al, Consultin 0.00
41 Books/Educational Materials 0 .00
42 Food & Nutrition 0.00
43 Administrative Costs 495.00 626.32 26.53%
44 Audit Expense 0.00
45 Specific Assistance to IndividualsAII�IIIIIIIIIII 2,885.48
46 Other/Miscellaneous 1 ,050.00 900 .00 .1429%
47 Other/Contract 6,000.00 6,000 .00 0.00%
48 TOTAL 0.00 25,290.76 26.727.20 5.68
49 REVENUES OVER/ UNDER EXPENDITURES 0.00 -4,380.88 -6,727.20
si+rzwT �`
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Cmnmurce
Boxes will ex and as au type.)
_Outcome #4 80 percent of participants will report being satisfied with the program the end of 17 months
Evaluation Design & Data Collection
Program Desisn & Task Management (Columns 5-7)
(Columns 1 -4)
1
3
4 5 6 7
2
Indicator Data Source (where) Time of Measurement
Responsible Parkes Expected (when)
Program Activities (howFreq
(who)
Outcomes/change Measurements
(what) (how o[ten) ( (why) (evidence)
Mentors; volunteer More caregivers will be Six month Department of Quality Every six months after
Problem solving Daily the first month of the
kinship coordinator; satisfied with the satisfaction survey Management
foster care coordinate program and more will program
attend activities
Mentors; volunteer ore caregivers will be Six month Department of Quality Every six months after
etworking Monthly
kinship coordinator; atisfied with the satisfaction survey Management t rogram oath of e
foster care coordinate rogram and more will
attend activities
Department of Quality Every six months after
Resource referral Daily/monthly Mentors; volunteer ore caregivers will be Six month
kinship coordinator; satisfied with the satisfaction survey Management Progrannonth of the
foster care coordinato program and more will
attend activities
Mentors; volunteer More caregivers will be Six month Department of Quality Every six months after
Communication Daily the first month of the
kinship coordinator; satisfied with the satisfaction survey anagemettt program
foster care coordinate rogram and more will
attend activities
10
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
E. COLLABORATION (Entire Section E not to exceed one page)
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 agreement letters.)
Collaborative A enc Resources rovided to the pro ram
Hibiscus Children' s Center Program inclusion as part of foster-parent trainings
Department of Children and Families Certified Behavior Analyst training of mentors and use of
uilding for foster parent meetings
Indian River County Foster Parent Provide speaking opportunities and a training forum
Association
Children ' s Home Society Program inclusion in case-management pre-service
rainings
Indian River County School Board se of school for FPA meetings
I1
Type the Organization and Program Name
2007-2008 CORE GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCY/PROGRAM NAME : United for Families Caregiver Support Program C
FUNDER: CSAC
A B
FY 07108 FY 07108 % OF
TOTAL FUNDER TOTALVS .
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET col. Blcol. A)
EXPENDITURES
71,900 .00 71,200 .00 91 . 14%
21 Salaries
0 ,00 0 .00 #DIVtO !
22 FICA
0 .00 0 . 00 #DIVtO !
23 Retirement
0 ,00 0 .00 #DMO !
24 Life/Health
0 .00 0 .00 #DIV10 !
25 Workers Com ensation 0 .00 0 .00 #DIV/01
26 Florida Unem to ment 2 293.20 #DIV10 !
0 .00
27 Travel-Dail
0.00 0 .00 #DIV10 !
28 Travel/Conferences/Trainin 0 .00 0.00 #DIV10 !
29 Office Su lies 0 .00 0 .00 #DIV101
3o Tele hone
0 ,00 0 .00 #Dlv1a !
39 Posta a/Shi in
0 .00 0 .00 #DN/O !
32 Utilities
o .oa 000 #Dlvro !
33 Occu anc Buildin 0 . 00& Grounds 0 .00 #DIV/0 !
34 Printin & Publications 0 .00 0 .001 #DIV10 !
35 Subscri tion/Dues/Memberships 0 .00 0 .00 #DIV10 !
36 Insurance
0 .00 0 . 00 #D{vla !
37 Equi ment: Rental & Maintenance 0 .00 0.00 #DIV10 !
38 Advert{sin
0 . 00 0 .04 #DIV/0 !
39 Equi ment Purchases: Capital Ex ense 0 .00 #DIV10 !
ao Professional Fees (Legal , Consulting)
0 .00
0 ,00 0 .00 #DIV101
41 Books/Educational Materials
42 Food & Nutrition
a .0o 0 .00 #DIV101
0.00 636.32 #DIV10 !43 Administrative Costs 0 .00 65.00 #DIV/0 !
44 Audit Ex ense
0 .00 21895 .48 #DIV10 !
45 S ecific Assistance to Individuals 0 .00 900 .00 #DIV101
46 Other/Miscellaneous
0 ,00 61000 . 00 #DNlO !
47 Other/Contract
$7 ,900 .00 �y19 ,Ann . 0
as TOTAL
a 253. 04°/g
er
s;vzw�
Type Ne Organisstian and Program Name
2007-2008 CORE GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCYIPROGRAM NAME: United for Families Caregiver Support Program
FUNDER: CSAC
i.;ln41i09E �XPL #AN . T{OAfFQR ARfANfE ;^ ,: ,
Children's 'I t SLC program piece is funded separately and treated as a separate program
Ch'ld c C l M in MC program piece is funded separately and treated as a separate program
united Wav-St. i no funding
United -M n no funding
United W Rin no funding
bartaftatenitaGbildimen & Familino funding for this program
no funding other than CSAC
r m no program fees
Fund Raising -N any private contributions are captured under "contributions' line item
Sales to Public-Net nJa
Membership Na
Investment Income I We
full n/a
Legacies & Bequests fila
Funds from Oth Sources all sources listed either under "CSAC" or "contributions' line item
n n/a
In-KindD n - N i i United for Families absorbed more costs internally this year for accoun&ng purposes
r n I-D ' - reflects mileage increase to .49 per mile
Offi S I' program-specifc expense absorbed by agency
Ut I't'es program-specific expense absorbed by agency
Subscript M Na
Insurance n/2
E n n n/a
A v n/a
Equipment n r✓a
Professional Na
BoolusfiEducational Materials n/a
F d & Nutrit on has
Administrative Cost refects increase from 2 b 3 percent
Audithis is first year audit expense treated as a line dem
Specific A < t t I db'd als new service. United for Families reduced some costs to expand program without adding to total program cost.
vracm ss
United for Fantilies, Caregiver Support Program, Indian River County Children's Services Advisory Committee
F. UNDUPLICATED CLIENTS
Number of Unduplicated Clients by Location
L �seL i' a7� Current Fiscal Yeartsl"Fear
Location Budget 2006/0700
Unduplicated Clients Unduplicated Clients Unduplicated Clients
North Indian River Co . 25 16
South Indian River Co . - 98 95
Indian River Co Total - 123 l 11
Greater Stuart -
Hobe Sound -
Indiantown -
Jensen Beach
Palm City -
Martin County Total -
Fort Pierce -
Port Saint Lucie -
St. Lucie Co. Total -
Other Locations - -
TOTAL SERVED 123 111
Number of Unduplicated Clients by Age
atc� �n Current Fiscal Year � c sea '
Location cu215�2#lfi1 . _ . Budget 2006/07
IndlrriifIs aroug 4:; Individual Group ZnIual aul* ii
s
. ,.,
� .
0 to 4 - (Pre- school) - - 28 46
5 to 10 - (Elementary) - - 25 19
11 to 14 - (Middle) - - 15 6
15 to 18 - (High School) - - 9 10
Total Children
19 to 59 - (Adults) 46 30 15
60 + ( Seniors) -
Total Adults - 46 30 15
TOTAL SERVED - 123 - lll 15
12
United for Families, Caregiver Support Program, Indian River County Children's Services Advisory Committee
H. FUNDER SPECIFIC REQUIREMENTS
MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages)
Note period outcomes/results reflect: October 2006 to April2007.
OUTCOMES RES7percent
ist all elements of last year 's measurable outcomes. Cut List the results s.
nd paste from last years application,
o decrease the number of disruptions to Indian Goal Met. From the timcement of
River County child placements by 25 percent in he grant until now ; therfive
one year as reported by 2006 UFF placement disruptions to Indian Rihild
ecords . Baseline : 2005 placement and disruption the number of disruptioment. The outcome t t in one se
ecords (12 children) .
ear.
To decrease by 30 percent the number of Indian Goal Met. At this time, there have been 5 foster
River County foster parents who rescind their ome closures in Indian River County. The
licenses following a year in the program as number of foster parents who rescind their
eported by 2006 re-licensing reports. Baseline: licenses following a year in the program have
2005 re-licensing reports (7 closures) . ecreased by 30 percent.
Increase by 50 percent the number of Indian Goal Not Met. The average number of foster
River County foster parents who attend monthly arents who attend the monthly Foster Parent
Foster Parent Association meetings as reported Association is currently 12 parents . This has
y monthly sign-in sheets . Baseline: 2005 increased 20 percent from the 2005 attendance
attendance average (10 parents) . average of 10 parents. United for Families
expects to reach its goal by maintaining this rate
of increase during the next six months.
13
TYPe Ne oieanl anion and Ro9.em Name
2007=2008 CORE GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
FUNDER SPECIFIC BUDGET
AGENCYIPROGRAM NAME :
FUNDER:
` i 9NEiTEM' , PONFOR VAR 3,. ;! - _.
Umtetl fr Families is seeking CSAC funds to pay for this salaned position. It represents t8 percent of employee's time, which is the
5alar es percentaoge of time employee spends in Indian River County.
py i
#DN/QI
#DNJD-1
#DNIO!
#DIVro!
#DMO!
#DIV/0-1
#DIVIO-1
#DN/0I
#DN/0l
#DIY&T
#DIV&&
# llmt
01DOI!
#DIVM,l
# MWE
#DIV1011
#DIVIQI
#DIY&I
#DIVIOr
#DIV10�
#DYLOJI
#pN10�
#pN/QI
DLVf
#DIVIo!
BS
SihPOW
EXHIBIT B
[From policy adopted by Indian River County Board of County Commissioners on February 19,
2002]
" D. Nonprofit Agency Responsibilities After Award of Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis only.
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check. Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board
of Commissioners . In the event an agency provides inadequate documentation on a consistent
basis , funding may be discontinued immediately. Additionally, this may adversely affect future
funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example, no expenditures prior to October 1st may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners.
All requests for reimbursement at fiscal year end (September 30th) must be submitted on a timely
basis. Each year, the Office of Management & Budget will send a letter to all nonprofit agencies
advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically
early to mid October, since the Finance Department does not process checks for the prior fiscal
year beyond that point .
Each reimbursement request must include a summary of expenses by type . These summaries
should be broken down into salaries, benefits, supplies , contractual services , etc. If Indian River
County is reimbursing an agency for only a portion of an expense (e .g . salary of an employee),
then the method for this portion should be disclosed on the summary. The Office of Management
& Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures. These expenditure types are
listed below.
a . Travel expenses for travel outside the County including but not limited to; mileage
reimbursement, hotel rooms , meals, meal allowances, per Diem , and tolls. Mileage reimbursement
for local travel (within Indian River County) is allowable.
b. Sick or Vacation payments for employees. Since agencies may have various sick and vacation
pay policies , these must be provided from other sources .
c. Any expenses not associated with the provision of the program for which the County has
awarded funding .
d . Any expense not outlined in the agency's funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary. "
1
Type the Organization and Program Name
2007-2008 CORE 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 : United for Families/Caregiver Support Program
FUNDER : Children's Services Advisory Committee of Indian River County
CAUTION Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should
• be used for providing information and calculations only.
REVENUES Proposed Total Program Budget Funder Specific Total Agency
. Budget . Budget
1 Children's Services Council-St. Lucie 30,000.00
2 Children's Services Council-Martin
3 Advisory Committee-Indian River 20 ,000 .00 20,000. 00 20,000 .00
4 United Way-St. Lucie County
5 United Way-Martin County
6 United Way-Indian River Coun
7 Department of Children & Families 22,904,788.00
8 County Funds
9 Contributions-Cash 30, 000.00
10 Program Fees
' 1 Fund Raising Events-Net
l2 Sales to Public - Net
13 Membership Dues
14 Investment Income
15 Miscellaneous
16 Legacies & Bequests
17 Funds from Other Sources 48,410.00
18 Reserve Funds Used for Operating
19 In-Kind Donations (Not included in total) 6 , 727 .27
20 TOTAL REVENUES
(doesn4 include line 19) $20 ,000.00 go on .DO $23,033 , 198.00
B C
EXPENDITURES A Funder Specific Total Agency
Proposed Total Program Budget Budget Bud et
21 Salaries - (must complete charton next page 7 ,900.00 7 ,200 .00 1 ,932 , 609 .00
22 FICA - Total salaries x 0 .0765 550 .80
ehrement - nnua pension or qua
23 staff 288 .00
Ll a eat - e ica enta ort-term
24 Disab. 72 . 00
Workers ompensatlon - emp oyees x
25 rate 429. 12
on a unemployment - pro)ecte
26 employees x $7,000 x UCT-6 rate 288.00
srvzom
a-1
Type the Organization and Program Name
SALARIES I Gross II o fv
Ifl ko( Gross Annual
POSITION LISTING Annual Salary Portion of Salary on Proposed Funder Specific Budget Salary
Position Title / Total Hrs/wk (Agency) Program Requested(C(A)
Erample: ErecvvmDirector140hrs 70,000.00 -00,000.00 5,000.00 7. 14%"
Foster Care Coordinator 40,000 .00 71200 .00 7 ,200 .00 18.00°/n
Supervisor 70,000 .00 700 .00 0.000i°
non-program salaries 11822 ,609 .00 0 .00 0 .00 0.00 %
#DIV/0!
#DIV/O!
#DIV/O !
#DN/O !
#DIV/0!
#DMU
#DIV/a!
#DIVIO !
#DIVIO !
#DN/0!
#DIV/O!
#DIV/0!
#DIVIO !
#DIV/0 !
#DNI() !
#DIVIO!
#DIV/0!
Remaining positions throughout the agency
Total Salaries ###### $7,900 .00 $7 ,200 .00 0 . 370/<
FRINGE BENEFITS DETAIL
11
Fundrs Specific Budget /it lv v w Ni
(Funder dt I Fund
{� g - Pension Health Worker's llnemployme, . Total Fringes Funder
Column C only, from line 21 to 26) Specific Budget FICA 7,65% (A x %) Ins. compens. nt Compens. Specific
Position Title / Total Hrs/wk
Example: case Manger hrs 5,000.001 382.50 200.00 50MOD 300.00 ' - ' 200.00. 1,582.50
Foster Care Coordinator 7,200.00 550 .80 288. 00 72.00 429. 12 288 .00 1 ,627 .92
Supervisor 0. 00 0, 00 0 .00
non-program salaries 0.00 0.00 0 .00
0 0.00 0.00 0. 00
0 0.00 0.00 0.0
0 0 .00 0 .00 0.00
0 0 .00 O.CO O .DC
a o.Do o.Da 0 .0a
0
a001 0.00 0. 0
0 0.00 0.020.0
0 MCI 0.00 0.0
0 0 .00 0 .00 0 .0
0
0 .00 0, 00 o .00
0 0.001 0.00 0.00
0 0
0 .0a a.OD 0 .0
0.00 0.00 0.0
0 0.00 0 .00 0 or
0 0 .00 0 .00 0 .0
0 0. 00 O.Oa O.00
D
0.001 0.00 0.0
Total Funder Request Fringe Benefits $7,200.00 550.50 $288. 00 $72.00 429. 12 $288.00 (,; l
srvzow
s-i
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: United for Families , 10570 S Federal Hwy, Ste . 300 , Port St. Lucie , FL. , 34952:
Attention : Christine Demetriades
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
NOV. 28 . 2007 . 1 : 00PM UNITED FOR. FAMILIES NO. 0949 P . 3
AC€OR CERTIFICATE OF LIABILITY INSURANCE DNOIFlu PA 11 /02/TE 07
PNODUOBt THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown 6 Brown of Florida , Tae . ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE
Dayt6na Baach Office HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P . O , box 2412 ALTER THE COVERAGE AFFORDED BYT14E POLICIES BELOW.
Daytmna Beach FL 32115 -2412
Ph6n'tE : 366-252-9601 Fax : 306-239-5729 INSURERS AFFORDING COVERAGE NAIC ;9
INSUREW INSURCTiA LLO � B InD _
INSURER New Hampshire Ins Co 23841
UNITED FOR FAMILIES , INC .
10570 SOUTH FEDERAL RWY ST 300INSJ4ERP
PORT ST LUCIE FL 34952
NBURERE
COVEFtAGES
THE PI6L.ICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTUMTHSTANDING
AM' RgOUIREMEM, TERM OR CONDITION OF ANI CONTRACT OR OTHER DOCUMENT VJRH RESPEC. TO MCH THI6 CERTIFICATE MAY BE 16SUED OR
MAY Pt�'o�.•AIN. THE INSURANCE AFFORDED EY THE POUDES DESCRIBED 'e@REIN IS SUW;CTTO ALL THE iRMS, EXCLUSIONS AND OONDIT10NS OF SUCH
POLIGE5. AGG.n'EGATE LIMITS SNAIMJ MAY HAVE BEEN RED OBY PAID CLANS
IN�n ROU RJ
LTR S ' TYPEOFINSURANCE POLICY NUMBER PATFIMMMWyYl DATE100RAN IYY LIMITS
GENEMLMABILRY BAcn occuRRENCE ' s 1 , 000 , 000
B X5 XCOMMERCIAL GENERAL LIABILITY 01hX0996620 - 1 03/15 / 07 03/ 15 / 00 PREM as DEe m,.cuNxM 15100 , 000
d
CWMS MADE [K] OCCURMEOE (MY AmmrS ) s5� DDO
I � X PROF LLTiB - $1MIL PERSONAL 6 ADV INJURY 51 , 000 , 000
GeJERALAGGRGCATE s3 , D00 , 000
Y OENL AGGREGATE LIMIT APPJEE PE$ PRODUCTS - COMPIOP AGO slrDOO , DOD
Y
X I POLICY FljE LOC Zmp Ben . 1 , DOO , OOD
r AM MON" UAENLPry COMBINED SINGLE LIMB 51 , DGOXDOG
� MNAUTO 01LX699Bfi26- 1 03 / 15 / 07 03,/ 15 / 0B IE= >sxml
ALLOWNEDA'JTOS BODILY INJURY
SCHEDUFJ ADDS IPc,permiJ 5
X HIRED AUTOS
EDGILY INJURY $
qP X NONONNEO AUKS (Parv=d6m)
5 PROP=R CAM.AGE 5
(Perasdtlanp
I
I GARAGE LIABILRY AUTO ONLY - a ADCIDENT 6
{ ANY AUlC OTHERTHAN EAACC E
AUC ONLY: AOO s
R.
u; EXCEEERIMBRELL4 L1A91LIfY EACH OCCURRENOE__ _ X51 ODD , 000
B MX IDccus F7 : ms MADE 0170D0273B78 -1 03 /15 / 07 03/ 15 /06 ' 4GOREGATE 511000 , 000
DEDUCTIBLE s
k, X RETENTION 61 , 000
VS K6ZS COMPENSATION AND TORY LIMB$ IUER b
E''L,,IiiP''u YERT LIABILITY
Aryl. PROPRIM%rP.ARTNMAXECUTIVE E.L EACH ACCIDENT S
On C MEMSER EaCWDGM E.L DISEASE • EA EMPLOYEE s
5 6c AL PROM Shell w E.L DI EASE - POJCY UMIT E
OVER
A PROPERTY POLICY SCBOOO167 03/ 15 / 07 03/ 15 / 06 BUILDINGS 416000
51?ECIAL/ $100D DSD RC/ 1005 COINSURANCE
DESCRIPTION OF OPERATIONS ) LOCATIONS INEHICIFS I EXCLUSIONS ADDED BY ENDORSFMENTf SPECIAL PROVISIONS
THIR?'Y DAYS NOTICE OF OANOSLLATION , TEN DAYS NOTICE DUE TO NON—PAYMENT
a.
CERTIFICATE BOLDER IS INCLUDED AS ADDITIONAL INSURED UNDER THE H&NO AUTO
AND 6=21L LIABILITY WITH RESPECT TO TBE OPERATIONS OF TrM NAMED INSURED .
CONTRACT : 07 / 01 / 07 TO 06/30/ 03
CERTTRCATE HOLDER CANCELLATION
INDIAN2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EItPIRATIO
I DATETNBREOF, T MSUINGINSIIRERWIUMMAVORMNAIL 30 DAYS WKT(EN
NOTICE TO THE CERRROATE NOW01 NAMW TO THE LEFT, BUT FAILURE TO DO SO SHALL
INDIAN RIVER COUNTY IMPOSE NO OSUGATION OR LIABILITY OF MY RIND UPON THE INSURER, ITS AGENIS OR
1800 27TH STREET REPR6ENraTNEs.
VERO SEACH FL 32967 REPRESENT
ACOR X25 (2001108) m ACORD CORPORATION 1965
S
s
Type the Organization and Program Name
B C
EXPENDITURES A Funder Specific Total Agency
Proposed Total Program Budget Budget Budget
e7 Travel-Daily 2 ,293 .20 2 ,293.20 30 , 575.00
# :of Staff z:average # of miles/wk x 50:wks x
$ = Estimated Daily Travel/Mileage Reimb. # of staff X average # mdeslwk X 5 ' Estimated Daily TravellMileage Reimb.
28 Travel/ConferenceslTraining 61 ,000 .00
National Conference (cost per staff) , ,
Training/Seminar (cost per staff)
Other Trainings (cost of travel, lodging,
registration, food)
29 Office Supplies 30 ,000 .00
Office supplies (monthly average x12 .
months = estimated cost of office supplies
based on present history.
30 Telephone 1 .034.00 56,778 .00
# Phone lines x average cost per month x
12 months = local phone cost
Average long distance calls 12 months =
Estimated cost of long dstance 1 line at $221month
31 Postage/Shipping 107.64 10 ,000 .00
Quarterly;Malting of Newsletter
Special events, etc.
Bulk mailings appeals monthly newsletter So 23 homes at 39 each
32 Utilities
Electricity ($z 12 months)
' 'Water/Sewer,($ x 12 months)
Garbage ($ z 12 months)
33 Occupancy (Building & Grounds) 3 ,235.00 280,930 . 00
Mortgage/Rent (S x 12 months)
'Janitorial ($ 'x 12 months) .
Grounds Maint (S x 12months)
Real Estate Taxes 21 percent of occupancy @ 1;283 75/month based on square footage
34 Printing & Publications 107.641 20 ,000 .00
Quarterly Newsletter ($ x 4)
Letterheads, Envelopes, etc.
-'Fundraising materials
-Other 39 per color newsletter for 23 homes
35 SubscriptionlDues/Memberships 15 ,000 .00
.Membership to National Organrzation' _
Dues
Subscriptions to Newspapers/magazines,
etc.
3 Insurance 28 ,565 .00
Directors/Officers Liab.
Comm ercial/General Insurance
Bond Ins
Auto Insurance
37 Equipment:Rental & Maintenance 0.00 17
Copier lease ($ x12 months)
Meter lease ($ x 12 months)
Copier Maintenance ($. x 12 months)
Computer Maintenance ( $ x 12 months) -
Other.
0 .00
38 Advertising
Newspaper ads -
Fundraisingads/promotions
Other (vacancies)
39 Equipment Purchases: Capital Expense 150 ,280 .00
Computertmonitor {#x $)
Laser Printer
5iv20m a-1
Type the Organization and Program Name
554,605 .00
40 Professional Fees (Legal, Consulting)
Legal advice :( estimated #hrs x $)
:onsultantfees
Xher 0 .00
41 BooksfEducational Materials
Books/videos
Materials ($ xstaff) 0 .00
42 Food & Nutrition
Meals ( # meals x clients x ,5days x 50 wks)
Snacks 626.32 636 .32 0 . 00
43 Administrative Costs
Admin Cost (% of total budget) 3 percent of program budget 0 .00 65 .00 32 , 500 .00
Audit Expense
Independent Audlt Review total program cost divided by total agency cost = percent of audit applied to program
45 Specific Assistance to Individuals
2 ,895.48 2 ,895.48 8 , 194,317 .00
Medical assistance
MeaislFood Flexible funding to ensure safety and quality of life for children in rare particularly child safety, seats and other
Rent Assistance infant equipment as well as assistance for sports and other extra cumcular activities that enhance a child's
Other emotional well being while in care, or $493 per family. g00 .oD 51 ,260 .00
900 00
46 Other/Miscellaneous -
Background check/drug test
Other 18 percent of district for foster parent appreciation (18 percent of $5;000) 10 ,996 , 340 .00
6 .000 .00 6 , 000 . 00
47 OthedContract
Sub-contract for program services $500 monthly stipend for mentor
$26 ,727 .20 $ 19 ,990 .00 $22 ; 571 ,386.00
48 TOTAL EXPENSES
a-�
51V20�7
aNOV. 28. 20fl 12 59PM, UNIT - ,) FOR FAMiLIFSPAGE z / 2 xighcFaxNO, 0949 P . 2
7 : CBTona COIPANY : United for Families
DA i E MMIDDTM
ACRD„ 11ro7/aoD�
PRODUCER Serial # fi2G439 THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ADN RISK SERVICES OF FLORIDA HOLDER. THIS CERTIFICATE DOES NOT ANIEND, EXTEND OR
1001 BRICKELL BAY DRIVE, SUITE 1100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MIAMI, FL 33131 COMPANIES AFFORDING COVERAGE
(305) 372-9950 I cDMPAnv
A ZURICH AMERICAN INSURANCE COMPANY
INSURED EDMPANY
Oasis Outsourcing Holdings, Inc. H
Alt Emp,; Unh> drDr Families, Ina COMPANY
4400 N Congress Ave-, Suite 250 C
WesC Palm Beach, FI 33407-3288
D
TRLS45 TO CER71FYTHATTHE POUCIES OF INSURANCE1J37ED BELOW HAVE BEEN 1SSUEDTC THE INSURED NAMED ABOVE FORTH& POLICY PEFJOD
JNDIOATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POUCIES DESCRIBED HEREIN 15 SUSJ2.'.T TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS Or SUCH PCs-1CIE5, LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
cDTYPE OF IN80RANCE PlSI-ICY NUMBER Pp;TE {MPNDDnITDATTi IMMIDnHp " UMTS
TA
GE7IERAL LIABILITY G_T'ERA' AGDRESATE ( s
COMMERCVL GENETAC LIASILrY PRCDUC5 - SWP, AGG Is
0.NM5MADE 70LGUR PER3ONX & ACVNURY la
OUTJQ'S LGONTRACTORS PR DT JIG`. OccU^nR7JCE IS
FIRE DAMAGE (ArV wx rve! b
Mt". En (Ary Rne Rersem s
AuroNeBa E LIABILITY
C'SH®NEO SWGLt LIMn L
ANY AUTO
I ALL OWNED AU705 BOOLY MJuRY y
SCHEOULED AUYDS (Per w=)
HI RED AUTOS EODLY INJURY
NON-OWNED AUTOS
(Pv »emnn[)
PROPBRTY DAM AGE s
GARAGrUAWIM AUTO OraY - ? ACMDE s
ANY AUTO OTHS TITAN AJTO LIMY
RACH ACCIDENT Is
AGGREGATE S
EXCESS LIABILITY EAC4 OCOURRENCE s
UM EI FORM AGGREGATE s
OTHMT THAI UMRR3U FORM $
A WDrocExaDDMP17 NAND WC 2938-SOT-W 06/01/07 DSMI /08 x T���aMR= DEA
BMPLDYERT Lwsr_m 'za BAw AcuDEn� a 1DDOD00
h:EPPCPRIETOR/ }( INQDIDEA'� - PO_ICYLPdn b 1UDODOO
PARTNER^—,£�.DIliM1E
wicsls HIE Exa aDTEAsE - EA EMPLOY. s 10DOD00
OTHER
DESCRIPTION O< OPERATIDNSILOOATION$NBHICLESSPECIAL n--WS
ONLY THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF=
UNITED FOR FAMILIES, INC:
(WOULD ANY OF THE ABOVE DESCRIBED POLICIM0 BE CANCELLED BEFORE THE
UNITED FOR FAMILIES, INC EXPIRATION DATE THEREOF, THE ISSUNG COMPANY WILL 9JDEAVOR TO M 14
10570 5 FEDERAL HWY, STE 30130 DAYS WRDTEN NOTCETO THE DERT]FICATE HOLDER NAMED TD THE LEFT,
PORT ST LUCIE, FL 34952 BUT FALD = MAIL =H NOTiCS- - UIMPDSE NO OBLIGATION ORLAWLM
OF ANY qND WDIV Trig COMPANY, n'S AG_- Q OR R9�AnVE .
AITHORD:EDR�RSENTA DEPENDEHTINSGRAMCEIGENCY
ADN PJSK SERVICES, INC. OF FLORIDA
c:1Fr�mRDw6nICERTsorroaB,FPs
ra uK ay.mUm. mn vagom Name
2007-2008 CORE GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCY/PROGRAM NAME: United for Families Caregiver Support Program
FY 05106 FY 06109 FY 07108 % INCREASE
FYE FYE FYE CURRENTVS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED Icor. C-col, eyrol. B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St. Lucie 36,000.001 30,000.00 -16.67%
2 Children's Services Council-Martin 0 .00
3 Advisory Committee-Indian River 20,000.00
4 United Way-St. Lucie County 0 .00
5 United Way-Martin County 0.00
6 United Way-Indian River County 0-00
7 Department of Children & Families 18,893,994.00 18,893.994.001 22,904,7W001 21 .23%
e County Funds 0 .00
9 Contributions-Cash 30,000.00
10 Program Fees 0.00
11 Fund Raising Events-Not 0.00
12 Sales to Public-Net 0.00
13 Membership Dues 0.00
14 Investment Income 0.09
15 Miscellaneous 0'00
16 L acies & Be uests 0.00
n Funds from Other Sources 337,000.001 48,410 .00 -85.64%
113 Reserve Funds Used for Operating 0.00
19 In-Kind Donations (Not ncwdadm romp D.DQ
20 TOTAL 18,891994.00 19,266,994.00 23,033,196.00 19.55%
EXPENDITURES
21 Salaries 1 ,376 522.00 1 .932,609.00 40.40%
22 FICA 406,209.00 0.06 -100.00%
23 Retirement 0.00
24 Life/Health 0.00
25 Workers Compensation - 0.00
26 Florida Unemployment 0.00
27 Travel-Daily 21 .000.001 30,575.001 45.6096
2a TmvellConferences/rrainin 159.413.001 61 ,000 .00 -61 .73%
29 Office Supplies 29.OG4.001 30,000.001 3.43%
30 Telephone 115.004.001 56,778.001 -5D .63%
31 PostagetShipping 9.996.001 10,owool 0 .04%
32 Utilities 1 0 .00
33 Occupancy (Building & Grounds 559.521 .001 280,930.00 -49.790/c
3a Printing & Publications 1 10.004.001 20.000.001 99.92%
35 Subscri tionlDues/Membershi s 1 15,000.00
1 eeeeeee�
36 Insurance 20,816.001 28,565.001 37.230io
37 E ui ment:Rental & Maintenance 70,604.001 126,627.00 79.35010
3a Advertising 0.00
39 Equipment Purchases:Ca ital Expense I 150,280.D0
40 Professional Fees Le al, Consulting) 37.992.001 554, 605.001 1359.79%
41 BookslEducational Materials 1 0 .00
42 Food & Nutrition 1 0.00
43 Administrative Costs 99,496.00 0.00 -100 .00%
44 Audit Expense 348.911 .001 32,500.00 -90.69%
45
Specific Assistance to Individuals 7,729,484.00 8, 194,317 .00 6.010ra
46 Other/Miscellaneous 8,273 018.00 51 .260.00 -99.380/c
47 Other/Contract - 10,996,340.00
4a TOTAL 0.00 19,266,994.01) 22.571 ,386.00 17.15%
49 REVENUES OVERT UNDER EXPENDITURES 18,893,994.00 0.00 461 .812.00
Td,= m. aPQZ�01 ,'d PIenm N=m+
2007.2008 CORE GRANT APPLICATION
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME: United for Families Caregiver Support Program
FY 051D6 FY 06/07 FY 07108 % INCREASE
FYE FYE FYE CURRENTVS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED Idol. C<01. apc01. B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St. Lucie 0.00
2 Children's Services Council-Martin 0.00
3 Advisory Committee-Indian River 20,000.00 20,000.00 0,00%
4 United Way-St. Lucie County 0.0o
5 United Way-Martin County OAO
s United Wa -Indian River purity 0.00
7 Department of Children & Families 0.00
8 County Funds 0.00
9 Contributions-Cash 909.88 0.00 .100.00%
tD Pro ram Fees 0-00
it Fund Raising Events-Net 0.00
12 Sales to Public-Net 0 .00
13 Membership Dues 0 .00
i Investment Income 0.00
is Miscellaneous 0.00
is Legacies & Bequests 0.00
11 Funds from Other Sources 0.00
is Reserve Funds Used for Operating
0.00
19 In-Kind Donations lNdlmdwded intoWi) 4,380 .88 6,727.27 53 .56%
20 TOTAL 0.00 20,909.88 20,000.00 4.35%
EXPENDITURES
21 Salaries 8,526.00 7.900.00 -7.34%
22 FICA 652.24 550.80 .15.55%
23 Retirement 341 .04 286.00 -15.55%
24 LifelHealth 852.60 72.00 -91 .56%
25 Workers Compensation 511 .56 429.12 -16.12%
26 Florida Unemployment 341 .04 288-00 -15.55%
27 Travel-Dail 1 ,827.00 2,293.20 25.52%
28 Travel/Conferences/rrain inn 210.00 0 .00 -100.00%
29 Office Supplies 0.00
30 Telephone 1 034.00 1 ,034.00 0,00%
31 Postage/Shipping 107.64 107.64 0.00%
32 Utilities 0.00
33 Occupancy (Building & Grounds 3,235.00 3,235.00 0.00%
34 Printing & Publications 107.64 10264 0.00%
35 Subscription/Dues/Memberships 0 .00
36 Insurance 0.00
37 E ui ment:Rental & Maintenance 0.00
38 Advertisinq 0.00
39 Equipment Purchases :Ca ital Expense 0.00
40 Professional Fees Le al, Consultin 0.00
41 Books/Educational Materials 0 .00
42 Food & Nutrition 0.00
43 Administrative Costs 495.00 626.32 26.53%
44 Audit Expense 0.00
45 Specific Assistance to IndividualsAII�IIIIIIIIIII 2,885.48
46 Other/Miscellaneous 1 ,050.00 900 .00 .1429%
47 Other/Contract 6,000.00 6,000 .00 0.00%
48 TOTAL 0.00 25,290.76 26.727.20 5.68
49 REVENUES OVER/ UNDER EXPENDITURES 0.00 -4,380.88 -6,727.20
si+rzwT �`
Type the Organization and Program Name
2007-2008 CORE GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCY/PROGRAM NAME : United for Families Caregiver Support Program C
FUNDER: CSAC
A B
FY 07108 FY 07108 % OF
TOTAL FUNDER TOTALVS .
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET col. Blcol. A)
EXPENDITURES
71,900 .00 71,200 .00 91 . 14%
21 Salaries
0 ,00 0 .00 #DIVtO !
22 FICA
0 .00 0 . 00 #DIVtO !
23 Retirement
0 ,00 0 .00 #DMO !
24 Life/Health
0 .00 0 .00 #DIV10 !
25 Workers Com ensation 0 .00 0 .00 #DIV/01
26 Florida Unem to ment 2 293.20 #DIV10 !
0 .00
27 Travel-Dail
0.00 0 .00 #DIV10 !
28 Travel/Conferences/Trainin 0 .00 0.00 #DIV10 !
29 Office Su lies 0 .00 0 .00 #DIV101
3o Tele hone
0 ,00 0 .00 #Dlv1a !
39 Posta a/Shi in
0 .00 0 .00 #DN/O !
32 Utilities
o .oa 000 #Dlvro !
33 Occu anc Buildin 0 . 00& Grounds 0 .00 #DIV/0 !
34 Printin & Publications 0 .00 0 .001 #DIV10 !
35 Subscri tion/Dues/Memberships 0 .00 0 .00 #DIV10 !
36 Insurance
0 .00 0 . 00 #D{vla !
37 Equi ment: Rental & Maintenance 0 .00 0.00 #DIV10 !
38 Advert{sin
0 . 00 0 .04 #DIV/0 !
39 Equi ment Purchases: Capital Ex ense 0 .00 #DIV10 !
ao Professional Fees (Legal , Consulting)
0 .00
0 ,00 0 .00 #DIV101
41 Books/Educational Materials
42 Food & Nutrition
a .0o 0 .00 #DIV101
0.00 636.32 #DIV10 !43 Administrative Costs 0 .00 65.00 #DIV/0 !
44 Audit Ex ense
0 .00 21895 .48 #DIV10 !
45 S ecific Assistance to Individuals 0 .00 900 .00 #DIV101
46 Other/Miscellaneous
0 ,00 61000 . 00 #DNlO !
47 Other/Contract
$7 ,900 .00 �y19 ,Ann . 0
as TOTAL
a 253. 04°/g
er
s;vzw�
Type Ne Organisstian and Program Name
2007-2008 CORE GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCYIPROGRAM NAME: United for Families Caregiver Support Program
FUNDER: CSAC
i.;ln41i09E �XPL #AN . T{OAfFQR ARfANfE ;^ ,: ,
Children's 'I t SLC program piece is funded separately and treated as a separate program
Ch'ld c C l M in MC program piece is funded separately and treated as a separate program
united Wav-St. i no funding
United -M n no funding
United W Rin no funding
bartaftatenitaGbildimen & Familino funding for this program
no funding other than CSAC
r m no program fees
Fund Raising -N any private contributions are captured under "contributions' line item
Sales to Public-Net nJa
Membership Na
Investment Income I We
full n/a
Legacies & Bequests fila
Funds from Oth Sources all sources listed either under "CSAC" or "contributions' line item
n n/a
In-KindD n - N i i United for Families absorbed more costs internally this year for accoun&ng purposes
r n I-D ' - reflects mileage increase to .49 per mile
Offi S I' program-specifc expense absorbed by agency
Ut I't'es program-specific expense absorbed by agency
Subscript M Na
Insurance n/2
E n n n/a
A v n/a
Equipment n r✓a
Professional Na
BoolusfiEducational Materials n/a
F d & Nutrit on has
Administrative Cost refects increase from 2 b 3 percent
Audithis is first year audit expense treated as a line dem
Specific A < t t I db'd als new service. United for Families reduced some costs to expand program without adding to total program cost.
vracm ss
TYPe Ne oieanl anion and Ro9.em Name
2007=2008 CORE GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
FUNDER SPECIFIC BUDGET
AGENCYIPROGRAM NAME :
FUNDER:
` i 9NEiTEM' , PONFOR VAR 3,. ;! - _.
Umtetl fr Families is seeking CSAC funds to pay for this salaned position. It represents t8 percent of employee's time, which is the
5alar es percentaoge of time employee spends in Indian River County.
py i
#DN/QI
#DNJD-1
#DNIO!
#DIVro!
#DMO!
#DIV/0-1
#DIVIO-1
#DN/0I
#DN/0l
#DIY&T
#DIV&&
# llmt
01DOI!
#DIVM,l
# MWE
#DIV1011
#DIVIQI
#DIY&I
#DIVIOr
#DIV10�
#DYLOJI
#pN10�
#pN/QI
DLVf
#DIVIo!
BS
SihPOW
EXHIBIT B
[From policy adopted by Indian River County Board of County Commissioners on February 19,
2002]
" D. Nonprofit Agency Responsibilities After Award of Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis only.
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check. Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board
of Commissioners . In the event an agency provides inadequate documentation on a consistent
basis , funding may be discontinued immediately. Additionally, this may adversely affect future
funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example, no expenditures prior to October 1st may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners.
All requests for reimbursement at fiscal year end (September 30th) must be submitted on a timely
basis. Each year, the Office of Management & Budget will send a letter to all nonprofit agencies
advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically
early to mid October, since the Finance Department does not process checks for the prior fiscal
year beyond that point .
Each reimbursement request must include a summary of expenses by type . These summaries
should be broken down into salaries, benefits, supplies , contractual services , etc. If Indian River
County is reimbursing an agency for only a portion of an expense (e .g . salary of an employee),
then the method for this portion should be disclosed on the summary. The Office of Management
& Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures. These expenditure types are
listed below.
a . Travel expenses for travel outside the County including but not limited to; mileage
reimbursement, hotel rooms , meals, meal allowances, per Diem , and tolls. Mileage reimbursement
for local travel (within Indian River County) is allowable.
b. Sick or Vacation payments for employees. Since agencies may have various sick and vacation
pay policies , these must be provided from other sources .
c. Any expenses not associated with the provision of the program for which the County has
awarded funding .
d . Any expense not outlined in the agency's funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary. "
1
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices : Any notice , request, demand , consent, approval or other communication required or
permitted by this Contract shall be given or made in writing , by any of the following methods:
facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier
service; or mailed by registered or certified mail (postage prepaid ), return receipt requested at the
addresses of the parties shown below:
County: Brad E . Bernauer, Indian River County Human Services Director
1801 27`h Street, Vero Beach , Florida 32960.
Recipient: United for Families , 10570 S Federal Hwy, Ste . 300 , Port St. Lucie , FL. , 34952:
Attention : Christine Demetriades
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
NOV. 28 . 2007 . 1 : 00PM UNITED FOR. FAMILIES NO. 0949 P . 3
AC€OR CERTIFICATE OF LIABILITY INSURANCE DNOIFlu PA 11 /02/TE 07
PNODUOBt THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown 6 Brown of Florida , Tae . ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE
Dayt6na Baach Office HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P . O , box 2412 ALTER THE COVERAGE AFFORDED BYT14E POLICIES BELOW.
Daytmna Beach FL 32115 -2412
Ph6n'tE : 366-252-9601 Fax : 306-239-5729 INSURERS AFFORDING COVERAGE NAIC ;9
INSUREW INSURCTiA LLO � B InD _
INSURER New Hampshire Ins Co 23841
UNITED FOR FAMILIES , INC .
10570 SOUTH FEDERAL RWY ST 300INSJ4ERP
PORT ST LUCIE FL 34952
NBURERE
COVEFtAGES
THE PI6L.ICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTUMTHSTANDING
AM' RgOUIREMEM, TERM OR CONDITION OF ANI CONTRACT OR OTHER DOCUMENT VJRH RESPEC. TO MCH THI6 CERTIFICATE MAY BE 16SUED OR
MAY Pt�'o�.•AIN. THE INSURANCE AFFORDED EY THE POUDES DESCRIBED 'e@REIN IS SUW;CTTO ALL THE iRMS, EXCLUSIONS AND OONDIT10NS OF SUCH
POLIGE5. AGG.n'EGATE LIMITS SNAIMJ MAY HAVE BEEN RED OBY PAID CLANS
IN�n ROU RJ
LTR S ' TYPEOFINSURANCE POLICY NUMBER PATFIMMMWyYl DATE100RAN IYY LIMITS
GENEMLMABILRY BAcn occuRRENCE ' s 1 , 000 , 000
B X5 XCOMMERCIAL GENERAL LIABILITY 01hX0996620 - 1 03/15 / 07 03/ 15 / 00 PREM as DEe m,.cuNxM 15100 , 000
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51?ECIAL/ $100D DSD RC/ 1005 COINSURANCE
DESCRIPTION OF OPERATIONS ) LOCATIONS INEHICIFS I EXCLUSIONS ADDED BY ENDORSFMENTf SPECIAL PROVISIONS
THIR?'Y DAYS NOTICE OF OANOSLLATION , TEN DAYS NOTICE DUE TO NON—PAYMENT
a.
CERTIFICATE BOLDER IS INCLUDED AS ADDITIONAL INSURED UNDER THE H&NO AUTO
AND 6=21L LIABILITY WITH RESPECT TO TBE OPERATIONS OF TrM NAMED INSURED .
CONTRACT : 07 / 01 / 07 TO 06/30/ 03
CERTTRCATE HOLDER CANCELLATION
INDIAN2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EItPIRATIO
I DATETNBREOF, T MSUINGINSIIRERWIUMMAVORMNAIL 30 DAYS WKT(EN
NOTICE TO THE CERRROATE NOW01 NAMW TO THE LEFT, BUT FAILURE TO DO SO SHALL
INDIAN RIVER COUNTY IMPOSE NO OSUGATION OR LIABILITY OF MY RIND UPON THE INSURER, ITS AGENIS OR
1800 27TH STREET REPR6ENraTNEs.
VERO SEACH FL 32967 REPRESENT
ACOR X25 (2001108) m ACORD CORPORATION 1965
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7 : CBTona COIPANY : United for Families
DA i E MMIDDTM
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PRODUCER Serial # fi2G439 THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ADN RISK SERVICES OF FLORIDA HOLDER. THIS CERTIFICATE DOES NOT ANIEND, EXTEND OR
1001 BRICKELL BAY DRIVE, SUITE 1100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MIAMI, FL 33131 COMPANIES AFFORDING COVERAGE
(305) 372-9950 I cDMPAnv
A ZURICH AMERICAN INSURANCE COMPANY
INSURED EDMPANY
Oasis Outsourcing Holdings, Inc. H
Alt Emp,; Unh> drDr Families, Ina COMPANY
4400 N Congress Ave-, Suite 250 C
WesC Palm Beach, FI 33407-3288
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TRLS45 TO CER71FYTHATTHE POUCIES OF INSURANCE1J37ED BELOW HAVE BEEN 1SSUEDTC THE INSURED NAMED ABOVE FORTH& POLICY PEFJOD
JNDIOATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POUCIES DESCRIBED HEREIN 15 SUSJ2.'.T TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS Or SUCH PCs-1CIE5, LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
cDTYPE OF IN80RANCE PlSI-ICY NUMBER Pp;TE {MPNDDnITDATTi IMMIDnHp " UMTS
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DESCRIPTION O< OPERATIDNSILOOATION$NBHICLESSPECIAL n--WS
ONLY THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF=
UNITED FOR FAMILIES, INC:
(WOULD ANY OF THE ABOVE DESCRIBED POLICIM0 BE CANCELLED BEFORE THE
UNITED FOR FAMILIES, INC EXPIRATION DATE THEREOF, THE ISSUNG COMPANY WILL 9JDEAVOR TO M 14
10570 5 FEDERAL HWY, STE 30130 DAYS WRDTEN NOTCETO THE DERT]FICATE HOLDER NAMED TD THE LEFT,
PORT ST LUCIE, FL 34952 BUT FALD = MAIL =H NOTiCS- - UIMPDSE NO OBLIGATION ORLAWLM
OF ANY qND WDIV Trig COMPANY, n'S AG_- Q OR R9�AnVE .
AITHORD:EDR�RSENTA DEPENDEHTINSGRAMCEIGENCY
ADN PJSK SERVICES, INC. OF FLORIDA
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