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HomeMy WebLinkAbout2007-308O M � . " . 308 D Indian River County Grant Contract LL This Grant Contract ("Contract") entered into effective this �) 5 day of October 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 Street , ero Beach FL , 32960 ("County' ) and Substance Abuse Council of Indian River Count , ecipient); of: 1151 19th Street, Vero Beach , FL . 32960 For: Lifeskills Training 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") . - 1 - M � . " . 308 D Indian River County Grant Contract LL This Grant Contract ("Contract") entered into effective this �) 5 day of October 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 Street , ero Beach FL , 32960 ("County' ) and Substance Abuse Council of Indian River Count , ecipient); of: 1151 19th Street, Vero Beach , FL . 32960 For: Lifeskills Training 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") . - 1 - 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2007/2008 ("Grant Period " ). The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Ninety Thousand Dollars ($90,000). 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. - 2 - 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2007/2008 ("Grant Period " ). The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Ninety Thousand Dollars ($90,000). 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. - 2 - 5 .4 .2 The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 Insurance Requirements. Recipient shall , no later than October 21 , 2006 , provide to the Indian River County Risk Management Division a certificate or certificates issued by an insurer or insurers authorized to conduct business in Florida that is rated not less than category A-: VII by A. M . Best, subject to approval by Indian River County's risk manager, of the following types and amounts of insurance : (i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 ,000 combined single limit for bodily injury and property damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; (ii) Business Auto Liability Insurance in an amount not less than $ 1 ,000 , 000 per occurrence combined single limit for bodily injury and property damage, including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and (iii ) Workers' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Workers' Compensation insurance . The Recipient shall , upon ten ( 10) days' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract. 5. 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents, officials, and employees from and against any and all claims , liabilities , losses , damage , or causes of action which may arise from any misconduct , negligent act, or - 3 - omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. 5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes (Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this Contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY Attest: J . K. Ba n , Clerk BOARD OF COUNTY COMMISSIONERS By Deputy Cle ByLc Gary . Wheeler Chairman BCC Approvedid- 1 Approved : seph A Baird ounty Administrator Approved as to form and legal sufficiency: Marian E. Fell , Assistant County Attorney RECIPIENT : By: - - �r� e v rkon, Cha rpeXSo r7 SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY 3 z - 4 - 5 .4 .2 The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 Insurance Requirements. Recipient shall , no later than October 21 , 2006 , provide to the Indian River County Risk Management Division a certificate or certificates issued by an insurer or insurers authorized to conduct business in Florida that is rated not less than category A-: VII by A. M . Best, subject to approval by Indian River County's risk manager, of the following types and amounts of insurance : (i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 ,000 combined single limit for bodily injury and property damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; (ii) Business Auto Liability Insurance in an amount not less than $ 1 ,000 , 000 per occurrence combined single limit for bodily injury and property damage, including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and (iii ) Workers' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Workers' Compensation insurance . The Recipient shall , upon ten ( 10) days' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract. 5. 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents, officials, and employees from and against any and all claims , liabilities , losses , damage , or causes of action which may arise from any misconduct , negligent act, or - 3 - EXHIBIT A [Copy of complete proposal/application] Substance Abuse Council of Indian River County Life Skills Training Program CSAC of [RC 3d PROGRAM COVER PAGE Organization Name : Substance Abuse Council of Indian River County Executive Director: Colette Heid E-mail : sacircAbellsouth.net Address : 1151 19th Street Telephone:772-770-4811 Vero Beach, Florida 32960 Fax : 772-770-4822 Program Director: Colette Heid E-mail : sacirc(a�bellsouth.net Address : 1151 19th Street Telephone: 772-770-4811 Vero Beach, Florida 32960 Fax: 772-770-4822 Program Title: LifeSkills Training Program Priority Need Area Addressed: DRUG ABUSE PREVENTION- Increase drug and alcohol abuse prevention programs aimed at the elementary and secondary populations especially older teens. Substance Abuse Education/Prevention LX-825 (According to the Taxonomy of Human Services) Brief Description of the Program: It is the LST program' s intent to provide a comprehensive research based proven effective substance abuse prevention program LST is targeted at reducing and preventing substance use/abuse among IRC middle school youth. There is a direct correlation between changing adolescent perceptions of the benefits vs. the risks of Alcohol, Tobacco and other Drugs (ATOD) to delaying the age of onset of initial use. By increasing protective factors and changing attitudes towards ATOD the age of initial use can be delayed or put off completely. SUMMARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2007 /08 : $ 100 , 000 . 00 Total Proposed Program Budget for 2007 /08 : $ 100 , 000 . 00 Percent of Total Program Budget : 100 . 0 % Current Program Funding (2006 /07 ) : $ 90 , 000 Dollar increase/ ( decrease ) in request : $ 105000 Percent increase / ( decrease) in request * * : 11 . 1 % Unduplicated Number of Children to be served Individually : - Unduplicated Number of Adults to be served Individually : - Unduplicated Number to be served via Group settings : 5 ,400 Total Program Cost per Client : 18 . 52 **If request increased 5% or more, briefly explain why: The Council continues to see demand for program services Additional classes have been added as recipients of program services. This increase will -result in a 12% increase in number of youth served. The increase in funding will be used to provide additional program services . If these funds are being used to match another source, name the source and the $ amount: The Organization 's Board of Directors has approved this application on (date). 4-I8-2007 Fred Jones Name of President/Chair of the Board Colette Heid Name of Executive Director/CPO Signature ' 2 omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. 5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes (Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this Contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY Attest: J . K. Ba n , Clerk BOARD OF COUNTY COMMISSIONERS By Deputy Cle ByLc Gary . Wheeler Chairman BCC Approvedid- 1 Approved : seph A Baird ounty Administrator Approved as to form and legal sufficiency: Marian E. Fell , Assistant County Attorney RECIPIENT : By: - - �r� e v rkon, Cha rpeXSo r7 SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY 3 z - 4 - Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC ORGANIZATION: Substance Abuse Council of Indian River Countv PROGRAM: Life Skills Training 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) . . . . . . . . . . . . . . . . . . . . . . . q . q . . . . . . . . . . . . . . . . . . . . . . . . . . . . . COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 A. ORGANIZATION CAPABILITY (one page maximum) L Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 2. Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 B. PROGRAM NEED STATEMENT (one page maximum) 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . 37 2. Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 3 . Evidence that program strategy will work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 4. Staffing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 39 5 . Awareness of program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 6. Accessibility of program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . ... . . .. . .. . .. . . ... . . . .. . . .. . . . . . . . . .. . . . . . . . . .. . . . .. .. . . . .. . .. . . . . 40-43 E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 F. UNDUPLICATED CLIENTS 1 . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 2. Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 47-48 3S Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page. 1 . Provide the mission statement and vision of your organization. MISSION STATEMENT: The Substance Abuse Council is committed to preventing the use of illicit drugs and abuse of addictive, mind-altering substances . It is the Council 's vision to increase community awareness concerning the levels of drug use in Indian River County; empower the community with the belief that the level of substance and drug use/abuse is directly related to the level of community interaction with prevention activities; and to enlist the community 's participation in prevention related activities. The community needs to continue to place an emphasis on and dedicate resources to substance and drug prevention educational programs. We must strive to eradicate the negative social and economic impacts associated with substance and drug use/abuse. 2 . Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. The Substance Abuse Council is dedicated to prevention education. It was founded in 1989 and was incorporated as a not-for-profit agency in 1990. Services are provided for all residents of IRC regardless of age or race. The Council is the only agency focusing specifically on substance abuse prevention education. The Council is licensed by the Department of Children and Families to provide substance abuse information/referral, Level 1 /Level 2 prevention services and Intensive Outpatient and Outpatient services for adults and youth. The Council has administered the Federal Bryne-JAG Grant for Indian River County since 1990. The Council has kept abreast of the County' s constantly changing and emerging drug use problem and carries out its goals through a variety of programs. The following is a list of programs provided by the Council. • Community Education and Information and Referral • Drug-Free Workplace Education • PRIDE Survey Administration & Planning • Lending Library of videos, books & materials • Deep Impact- PREVENT Improv Troupe • Program Success After-School Programs in Indian River and St Lucie Counties • Right Choice Program • Life Skills Training Program • Tobacco Violators Education Classes • Changing Alcohol Norms (CAN) Program • Adult Court Ordered Community Service Coordination • Program AWARE • Drug Testing Program • Drug-Free Events, ie: Say Boo to Drugs, Red Ribbon, Brown Ribbon, Kick Butts Day • Administration of the Federal Byrne Anti-Drug Abuse Grant for Indian River County 3 Cv EXHIBIT A [Copy of complete proposal/application] Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC , B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page. 1 . a) What is the unacceptable condition requiring change? b) Who has the need? c) Where do they live? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. According to the Florida Youth Substance Abuse (FYSA) and PRIDE Surveys, IRC youth exhibit above average risk factors and levels of drug usage. They reveal the extent of substance abuse occurring amongst our young. Even though there has been a downward pattern in drug use trends over the past few years, IRC youth are still reporting drug use and delinquent behavior that will negatively affect their lives and our society. IRC youth key Drug- Use Trends from the FYSA Survey 2000 to the 2006 reflect the same observed pattern of reduced ATOD use as in the statewide survey. • The "past-30-day use of alcohol" by surveyed middle school students declined from 25% to 19. 8% . • "Past-30-day use of marijuana" by surveyed middle school students declined from 5 . 8% in 2000 to 4. 9%. • Cigarette use among students declined sharply in the past years. In 2000, 22.7% of surveyed students reported some use of cigarettes over the `past 30 days ", compared to 12. 2% in 2006 , but Smokeless Tobacco has increased from 4.7% to 5 .5%. Attitudes toward Drug Use • 73 % of students perceive daily use of cigarettes poses a "great risk" of harm, (up from 64%). • The "perceived harm" of marijuana use declines as students get older, while the fear of cigarette use actually appears to increase. While 73 .3% of surveyed middle school students (up from 69 .6% in 06) believe regular marijuana use poses a "great risk" of harm, this number drops to 51 . 1 % (down from 59.7% in 06) among high school students • Disapproval of substance use appears to decline as students get older. For instance, disapproval of alcohol use 77 .7 % in middle school and 47 .6% in high school, disapproval of cigarette use 88.7% in middle school and 62. 1 % in high school and disapproval of marijuana use (91 . 3 % in middle school and 66 . 5% in high school) all decline between middle school and high school . Risk and Protective Factors • Surveyed students reported higher scores on the Transitions and Mobility, Poor Family Management and Favorable Attitudes toward Antisocial Behavior risk factor scales when compared to the national average of 50. This means that students in IRC are at greater risk for involvement in drug use and other antisocial behaviors due to a lack of long-term neighborhood connection, poor family management and due to students ' acceptance of antisocial behaviors. Parental use/parental attitude towards ATOD/use also correlate with adolescent attitudes towards/use. These key findings illustrate the complexity of drug use and antisocial behavior among IRC ' s youth and the possible factors that may contribute to these activities. While some of the findings indicate positive change and compare favorably to the national findings, IRC youth are still reporting drug use and delinquent behavior that will negatively affect their lives and exceed state and national averages. These risk and protective factors also indicate that there continues to be a need for a comprehensive substance abuse prevention program. 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. Local Law enforcement provides the DARE program to all 5` ' grade students. No specific substance abuse prevention programs are directed at the middle schools. Additionally, New Horizons and DATA provide Student Support Specialists and services in the public middle schools. These agencies work with a very small, indicated population of students and do not serve the entire population. These remaining youth would receive no additional program services if the LST program were not available. Collaboration is a part of the services provided to universal populations. The LST program provides no duplication of services. 4 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC B. PROGRAM DESCRIPTION (Entire Section C 1 - 6, not to exceed tivo pages. List Priority Needs area addressed. DRUG ABUSE PREVENTION 1 . Briefly describe program activities including location of services . The LST program is a three year prevention program designed to be conducted in school classrooms . Based on Theoretical framework, the LST program was developed to impact drug-related knowledge, attitudes and norms; teach skills for resisting social influences to use drugs and promote the development of general personal self-management skills and social skills. Consistent with this , the LST program can be best conceptualized as consisting of management skills. The second component focuses on teaching general social skills. The third component includes information and skills that are specifically related to the problem drug abuse. The first two components are designed to enhance overall personal competence and decrease both the motivations to use drugs and vulnerability to drug related social influences. The problem specific component is designed to provide students with materials relating directly to drug abuse (drug resistance skills, anti-drug attitudes, and anti-drug norms). Services are provided in Indian River County Middle Schools . This year we propose to serve high school students also. The LST program is a primary prevention program that targets individuals who have not yet developed drug abuse problems . The goal of the program is to prevent the use of gateway substance use among adolescents by making an impact on risk and protective factors associated with tobacco, alcohol, and marijuana use, particularly occasional and experimental use. Simultaneously a systematic community awareness campaign is conducted. It is designed to impact community norms and educate the community regarding the incidence of substance abuse. On the FYSA Survey, Indian River County scored higher than the State and other like Counties in the following risk factor areas : • Poor Family Management • Family Conflict • Family History of Antisocial Behavior • Youth Attitude Favorable to Antisocial Behavior • Parental Attitude Favorable to • Youth Attitude Favorable to ATOD use Antisocial Behavior • Peer Rewards for Antisocial Behavior According to Center for Substance Abuse prevention (CSAP), Selected Findings In Prevention, A Decade of Results from the Center For Substance Abuse Prevention, 1997, the findings indicate that the proposed strategies above are effective with this target population. They demonstrated repeated documentation that adolescent risk perceptions were favorably impacted by reducing favorable parental, peer and community attitudes towards ATOD. We must take these facts and information and as with all knowledge, empower ourselves and educate our youth and community. The LST program is a research based, proven effective curriculum in the reduction of adolescent drug usage and has been endorsed by the Center for Disease Control (CDC). The LST program was selected by the Center for the Study and Prevention of Violence (CSPV), University of Colorado at Boulder as a Blueprint 2000 program and OJJDP selected the LST program for replication nation-wide and is 1 of only 11 programs that is considered "exemplary" by all program evaluators. 2. 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 LST program is based on Theoretical framework. The LST program was developed to impact 5 36 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of [RC 3d PROGRAM COVER PAGE Organization Name : Substance Abuse Council of Indian River County Executive Director: Colette Heid E-mail : sacircAbellsouth.net Address : 1151 19th Street Telephone:772-770-4811 Vero Beach, Florida 32960 Fax : 772-770-4822 Program Director: Colette Heid E-mail : sacirc(a�bellsouth.net Address : 1151 19th Street Telephone: 772-770-4811 Vero Beach, Florida 32960 Fax: 772-770-4822 Program Title: LifeSkills Training Program Priority Need Area Addressed: DRUG ABUSE PREVENTION- Increase drug and alcohol abuse prevention programs aimed at the elementary and secondary populations especially older teens. Substance Abuse Education/Prevention LX-825 (According to the Taxonomy of Human Services) Brief Description of the Program: It is the LST program' s intent to provide a comprehensive research based proven effective substance abuse prevention program LST is targeted at reducing and preventing substance use/abuse among IRC middle school youth. There is a direct correlation between changing adolescent perceptions of the benefits vs. the risks of Alcohol, Tobacco and other Drugs (ATOD) to delaying the age of onset of initial use. By increasing protective factors and changing attitudes towards ATOD the age of initial use can be delayed or put off completely. SUMMARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2007 /08 : $ 100 , 000 . 00 Total Proposed Program Budget for 2007 /08 : $ 100 , 000 . 00 Percent of Total Program Budget : 100 . 0 % Current Program Funding (2006 /07 ) : $ 90 , 000 Dollar increase/ ( decrease ) in request : $ 105000 Percent increase / ( decrease) in request * * : 11 . 1 % Unduplicated Number of Children to be served Individually : - Unduplicated Number of Adults to be served Individually : - Unduplicated Number to be served via Group settings : 5 ,400 Total Program Cost per Client : 18 . 52 **If request increased 5% or more, briefly explain why: The Council continues to see demand for program services Additional classes have been added as recipients of program services. This increase will -result in a 12% increase in number of youth served. The increase in funding will be used to provide additional program services . If these funds are being used to match another source, name the source and the $ amount: The Organization 's Board of Directors has approved this application on (date). 4-I8-2007 Fred Jones Name of President/Chair of the Board Colette Heid Name of Executive Director/CPO Signature ' 2 Substance Abuse Council of Indian River County We Skills Training Program CSAC of IRC ' • drug-related knowledge • attitudes and norms • teach skills for resisting social influences to use drugs • promote the development of general personal self-management skills and social skills. Since all of these skills are directly related and positively impact Drug Use Trends; Attitudes towards Drug Use and Risk and Protective Factors, the continuation of the LST program and it' s protective skill building framework should continue to contribute to the: • Decline in Drug Use Trends • Increase in perceived risk or harm of substances • Decrease risk factors such as Favorable attitudes to ATOD use Delay the age of onset for early initiation of drug use 3. 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). The LST program is currently staffed by two Council employees. The LST Coordinator assumes primary responsibility for the LST program. One hundred percent (33 hours per week) of this position is currently allocated to the program. Two additional LST instructors (30 hours per week) are also assigned to this program and currently dedicated 100% of the position. During year 3 , all 8th graders will continue with LST booster instruction, while we concurrently implement the 1st and 2nd year classes to the 6s & 7tb grades. Each year an estimated total of 5,400 students will receive • 15 sessions in the 6th grade With on going LST booster sessions, instruction will continue with • 10 sessions in the 7a' grade • 5 sessions in the 8a' grade The LST Coordinator has had 8 years of experience in the substance abuse prevention field. The other two LST instructors possess a Bachelors degree and have one years experience teaching Life Skills . All LST instructors are nationally certified to teach the LST curriculum. 4. How will the target population be made aware of the program? The LST program has been offered to all middle schools in Indian River County. In order to qualify as an OJJDP site all middle schools had to agree to allow the Substance Abuse Council to implement the LST program in a classroom period. The remaining private schools were also invited to receive services from the Substance Abuse Council. They were made aware of the program by letter with a follow-up face to face meeting. 5. How will the program be accessible to target population (i.e., location, transportation, hours of operation)? As previously stated, LST program is implemented during the school day in all Indian River County Middle and High Schools. Instructors render themselves to the individual school sites. . 6 3cf ' Substance Abuse Council or Indian River County Life Skills Training Prop am CSAC of IRC D. PROGRAM OUTCOMES AND ACTIVITIES MATRIX. 3 - 4 program outcomes only. One matrix table per outcome. Each matrix table must not exceed two (2) pages . (NOTE: Boxes for Outcomes and cells in Matrix tables will expand as you type) Outcomes: In general, a program should have 3 -4 program outcomes. The Outcome indicates the measurable impact or change the program will have on the clients its serves . The outcome should detail the results of the services provided, not the services provided . Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. Please incorporate the following into the outcome description: * Direction of change * Time frame * Area of change * As measured by * Target population * Baseline: the number you will be measuring against * Degree of change Example Outcome : To decrease (direction of change) number of unexcused absences (area of change) of enrolled boys and girls (target population) by 75 % (degree of change) in one year (timeframe) as reported by the 2006-2007 School Board attendance records (as measured by). Baseline: 2005-06 School Board attendance records for enrolled boys and girls. Activities Matrix : The matrix is designed to identify specific activities the program will provide to achieve the stated outcomes. The matrix identifies : 1 ) the specific activity; 2) how often the service/activity is provided; 3) who, by position, is responsible to deliver the service/activity; and 4) expected change in client from providing service/activity. In addition, the matrix is designed to capture the evaluation of services provided: 5) indicator or measurement of change; 6) source of measurement; and 7) how frequently it is measured. A separate PROGRAM OUTCOMES AND ACTIVITIES MATRIX needs to be completed for each outcome. Use a separate row for each activity and group activities under their related outcomes. To add more rows, if needed, simply locate the cursor at the last cell in the last row and press the "TAB" button on the keyboard. See examples provided in the instructions . IMPORTANT NOTE: Keep in mind when developing PROGRAM OUTCOMES that, if funded, these will be what you are accountable to accomplish. Also, the PROGRAM OUTCOMES should reflect the information described in the PROGRAM NEED STATEMENT (B . 1 .). All PROGRAM NEED STATEMENTS should flow from the MISSION & VISION. MEASURABLE OUTCOMES should be based on and measure program needs. Activities are the tasks you do to influence the outcome and impact the unacceptable condition in your PROGRAM NEED STATEMENT. (B. 1 .). 7 40 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC ORGANIZATION: Substance Abuse Council of Indian River Countv PROGRAM: Life Skills Training 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) . . . . . . . . . . . . . . . . . . . . . . . q . q . . . . . . . . . . . . . . . . . . . . . . . . . . . . . COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 A. ORGANIZATION CAPABILITY (one page maximum) L Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 2. Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 B. PROGRAM NEED STATEMENT (one page maximum) 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . 37 2. Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 3 . Evidence that program strategy will work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 4. Staffing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 39 5 . Awareness of program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 6. Accessibility of program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . ... . . .. . .. . .. . . ... . . . .. . . .. . . . . . . . . .. . . . . . . . . .. . . . .. .. . . . .. . .. . . . . 40-43 E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 F. UNDUPLICATED CLIENTS 1 . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 2. Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 47-48 3S Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page. 1 . Provide the mission statement and vision of your organization. MISSION STATEMENT: The Substance Abuse Council is committed to preventing the use of illicit drugs and abuse of addictive, mind-altering substances . It is the Council 's vision to increase community awareness concerning the levels of drug use in Indian River County; empower the community with the belief that the level of substance and drug use/abuse is directly related to the level of community interaction with prevention activities; and to enlist the community 's participation in prevention related activities. The community needs to continue to place an emphasis on and dedicate resources to substance and drug prevention educational programs. We must strive to eradicate the negative social and economic impacts associated with substance and drug use/abuse. 2 . Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. The Substance Abuse Council is dedicated to prevention education. It was founded in 1989 and was incorporated as a not-for-profit agency in 1990. Services are provided for all residents of IRC regardless of age or race. The Council is the only agency focusing specifically on substance abuse prevention education. The Council is licensed by the Department of Children and Families to provide substance abuse information/referral, Level 1 /Level 2 prevention services and Intensive Outpatient and Outpatient services for adults and youth. The Council has administered the Federal Bryne-JAG Grant for Indian River County since 1990. The Council has kept abreast of the County' s constantly changing and emerging drug use problem and carries out its goals through a variety of programs. The following is a list of programs provided by the Council. • Community Education and Information and Referral • Drug-Free Workplace Education • PRIDE Survey Administration & Planning • Lending Library of videos, books & materials • Deep Impact- PREVENT Improv Troupe • Program Success After-School Programs in Indian River and St Lucie Counties • Right Choice Program • Life Skills Training Program • Tobacco Violators Education Classes • Changing Alcohol Norms (CAN) Program • Adult Court Ordered Community Service Coordination • Program AWARE • Drug Testing Program • Drug-Free Events, ie: Say Boo to Drugs, Red Ribbon, Brown Ribbon, Kick Butts Day • Administration of the Federal Byrne Anti-Drug Abuse Grant for Indian River County 3 Cv Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC (Boxes will expand as you type) Outcome # 1 : . To delay the mean age of first use of substance abuse for IRC youth. (Baseline 2006 FYSAS Survey) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) Columns 5-7) 11 2 0 4 5 © 0 Program Activities Frequency - Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) • To provide 5 ,400 Weekly LST group LST Program Increase by one As reported by the Pre and post One year middle school sessions to youth Coordinator and month the mean FYSAS 2008 test youth LST group according to the LST instructors age of first use (Baseline: FYSAS evaluations, YSand sessions, following schedule: towards 2006) FKASPs • 15 sessions substance use in the 60' grade • 10 sessions in the 70` grade 5 sessions in the 8th grade Provide factual, current Weekly LST LST Program Increase by one As reported by the Pre and post One year Coordinator and FYSAS 2008 test and up-to-date group sessions month the mean information concerning LST instructors age of first use (Baseline: FYSAS evaluations, 2006) FYSAS and drugs and their harmful towards KABP ' s effects . substance use • Pre/ post testing will I nductedand to indicate a e in knowledge. 8 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC (Boxes will expand as you e. Outcome # 2 : To increase knowledge of program participants concerning drugs and their harmful effects . (Baseline: Individual and group administered Pre-tests of program participants.) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 1 2 0 4 0 © L 7 Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) To provide factual , Once a week according LST Program Increase in knowledge A 25 % Pre/ post Pre and post current and up-to-date to the following LST Coordinator and of harmful effects of increase in testing will through program information via on- schedule: LST instructors substance use and knowledge be conducted participation, the going sessions . 15 sessions in impact the protective following and rated to FYSAS and concerning drugs and the 6th grade factor of Social Skills educational indicate a PRIDE Survey their harmful effects . . 10 sessions in thus resulting in a presentation, change in annually. decrease in the risk the 7th grade factor of Favorable and an knowledge • 5 sessions in the attitude ofATOD use decrease in and self- 8`h grade. and a reduction in Favorable disclosure. use. attitude of ATOD use and a reduction in use as reported by the FYSAS and PRIDE Surveys. 9 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC , B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page. 1 . a) What is the unacceptable condition requiring change? b) Who has the need? c) Where do they live? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. According to the Florida Youth Substance Abuse (FYSA) and PRIDE Surveys, IRC youth exhibit above average risk factors and levels of drug usage. They reveal the extent of substance abuse occurring amongst our young. Even though there has been a downward pattern in drug use trends over the past few years, IRC youth are still reporting drug use and delinquent behavior that will negatively affect their lives and our society. IRC youth key Drug- Use Trends from the FYSA Survey 2000 to the 2006 reflect the same observed pattern of reduced ATOD use as in the statewide survey. • The "past-30-day use of alcohol" by surveyed middle school students declined from 25% to 19. 8% . • "Past-30-day use of marijuana" by surveyed middle school students declined from 5 . 8% in 2000 to 4. 9%. • Cigarette use among students declined sharply in the past years. In 2000, 22.7% of surveyed students reported some use of cigarettes over the `past 30 days ", compared to 12. 2% in 2006 , but Smokeless Tobacco has increased from 4.7% to 5 .5%. Attitudes toward Drug Use • 73 % of students perceive daily use of cigarettes poses a "great risk" of harm, (up from 64%). • The "perceived harm" of marijuana use declines as students get older, while the fear of cigarette use actually appears to increase. While 73 .3% of surveyed middle school students (up from 69 .6% in 06) believe regular marijuana use poses a "great risk" of harm, this number drops to 51 . 1 % (down from 59.7% in 06) among high school students • Disapproval of substance use appears to decline as students get older. For instance, disapproval of alcohol use 77 .7 % in middle school and 47 .6% in high school, disapproval of cigarette use 88.7% in middle school and 62. 1 % in high school and disapproval of marijuana use (91 . 3 % in middle school and 66 . 5% in high school) all decline between middle school and high school . Risk and Protective Factors • Surveyed students reported higher scores on the Transitions and Mobility, Poor Family Management and Favorable Attitudes toward Antisocial Behavior risk factor scales when compared to the national average of 50. This means that students in IRC are at greater risk for involvement in drug use and other antisocial behaviors due to a lack of long-term neighborhood connection, poor family management and due to students ' acceptance of antisocial behaviors. Parental use/parental attitude towards ATOD/use also correlate with adolescent attitudes towards/use. These key findings illustrate the complexity of drug use and antisocial behavior among IRC ' s youth and the possible factors that may contribute to these activities. While some of the findings indicate positive change and compare favorably to the national findings, IRC youth are still reporting drug use and delinquent behavior that will negatively affect their lives and exceed state and national averages. These risk and protective factors also indicate that there continues to be a need for a comprehensive substance abuse prevention program. 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. Local Law enforcement provides the DARE program to all 5` ' grade students. No specific substance abuse prevention programs are directed at the middle schools. Additionally, New Horizons and DATA provide Student Support Specialists and services in the public middle schools. These agencies work with a very small, indicated population of students and do not serve the entire population. These remaining youth would receive no additional program services if the LST program were not available. Collaboration is a part of the services provided to universal populations. The LST program provides no duplication of services. 4 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC B. PROGRAM DESCRIPTION (Entire Section C 1 - 6, not to exceed tivo pages. List Priority Needs area addressed. DRUG ABUSE PREVENTION 1 . Briefly describe program activities including location of services . The LST program is a three year prevention program designed to be conducted in school classrooms . Based on Theoretical framework, the LST program was developed to impact drug-related knowledge, attitudes and norms; teach skills for resisting social influences to use drugs and promote the development of general personal self-management skills and social skills. Consistent with this , the LST program can be best conceptualized as consisting of management skills. The second component focuses on teaching general social skills. The third component includes information and skills that are specifically related to the problem drug abuse. The first two components are designed to enhance overall personal competence and decrease both the motivations to use drugs and vulnerability to drug related social influences. The problem specific component is designed to provide students with materials relating directly to drug abuse (drug resistance skills, anti-drug attitudes, and anti-drug norms). Services are provided in Indian River County Middle Schools . This year we propose to serve high school students also. The LST program is a primary prevention program that targets individuals who have not yet developed drug abuse problems . The goal of the program is to prevent the use of gateway substance use among adolescents by making an impact on risk and protective factors associated with tobacco, alcohol, and marijuana use, particularly occasional and experimental use. Simultaneously a systematic community awareness campaign is conducted. It is designed to impact community norms and educate the community regarding the incidence of substance abuse. On the FYSA Survey, Indian River County scored higher than the State and other like Counties in the following risk factor areas : • Poor Family Management • Family Conflict • Family History of Antisocial Behavior • Youth Attitude Favorable to Antisocial Behavior • Parental Attitude Favorable to • Youth Attitude Favorable to ATOD use Antisocial Behavior • Peer Rewards for Antisocial Behavior According to Center for Substance Abuse prevention (CSAP), Selected Findings In Prevention, A Decade of Results from the Center For Substance Abuse Prevention, 1997, the findings indicate that the proposed strategies above are effective with this target population. They demonstrated repeated documentation that adolescent risk perceptions were favorably impacted by reducing favorable parental, peer and community attitudes towards ATOD. We must take these facts and information and as with all knowledge, empower ourselves and educate our youth and community. The LST program is a research based, proven effective curriculum in the reduction of adolescent drug usage and has been endorsed by the Center for Disease Control (CDC). The LST program was selected by the Center for the Study and Prevention of Violence (CSPV), University of Colorado at Boulder as a Blueprint 2000 program and OJJDP selected the LST program for replication nation-wide and is 1 of only 11 programs that is considered "exemplary" by all program evaluators. 2. 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 LST program is based on Theoretical framework. The LST program was developed to impact 5 36 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC (Boxes will expand as you pe) Outcome #3 : To maintain or decrease the past 30 use trend in alcohol, cigarettes and marijuana. (Baseline 2006 FYSAS) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5 -7) - - 1 2 0 �_ 4 © L �J Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties Outcomes/change Measurements (where) Measurement (who) (why) (evidence) (when) • To provide 5 ,400 Weekly LST group LST To maintain or A 2 % decrease Pre/ post Pre and post middle school sessions to youth Program decrease by 2% the through y among middle testing will be g youth LST group according to the Coordinator incidences of middle school conducted and Prob'rm and LST school adolescents participation, sessions . following schedule: instructors students in rated to • 15 sessions in reporting the past 30 incidences of indicate a the FYSAS the 6a' grade day use trend in past 30 day use change in and PRIDE alcohol cigarettes and Survey • 10 sessions in marijuana following trend in alcohol, knowledge annually. the 7 grade LST program cigarettes and mardisclosure.and self- ijuana • 5 sessions in the participation. following 8th grade. (Baseline 2006 FYSAS) educational presentation, aq reported by the FYSAS and PRIDE Surveys. 10 Substance Abuse Council of Indian River County Life Skills Training Progrmn CSAC of IRC E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters.) Collaborative Agency Resources provided to the piingmiw Indian River School District Referrals to program Case management of Client Progress Venue for presentation University of Miami Provide technical assistance for program evaluation Provide technical assistance in student progress evaluations Office of Juvenile Justice Provide Technical assistance for program Delinquency Prevention implementation Provide curriculum for student population receiving LST instruction Center for Violence Prevention, Provide Technical assistance for fidelity of program University of Boulder delivery 11 44 Substance Abuse Council of Indian River County We Skills Training Program CSAC of IRC ' • drug-related knowledge • attitudes and norms • teach skills for resisting social influences to use drugs • promote the development of general personal self-management skills and social skills. Since all of these skills are directly related and positively impact Drug Use Trends; Attitudes towards Drug Use and Risk and Protective Factors, the continuation of the LST program and it' s protective skill building framework should continue to contribute to the: • Decline in Drug Use Trends • Increase in perceived risk or harm of substances • Decrease risk factors such as Favorable attitudes to ATOD use Delay the age of onset for early initiation of drug use 3. 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). The LST program is currently staffed by two Council employees. The LST Coordinator assumes primary responsibility for the LST program. One hundred percent (33 hours per week) of this position is currently allocated to the program. Two additional LST instructors (30 hours per week) are also assigned to this program and currently dedicated 100% of the position. During year 3 , all 8th graders will continue with LST booster instruction, while we concurrently implement the 1st and 2nd year classes to the 6s & 7tb grades. Each year an estimated total of 5,400 students will receive • 15 sessions in the 6th grade With on going LST booster sessions, instruction will continue with • 10 sessions in the 7a' grade • 5 sessions in the 8a' grade The LST Coordinator has had 8 years of experience in the substance abuse prevention field. The other two LST instructors possess a Bachelors degree and have one years experience teaching Life Skills . All LST instructors are nationally certified to teach the LST curriculum. 4. How will the target population be made aware of the program? The LST program has been offered to all middle schools in Indian River County. In order to qualify as an OJJDP site all middle schools had to agree to allow the Substance Abuse Council to implement the LST program in a classroom period. The remaining private schools were also invited to receive services from the Substance Abuse Council. They were made aware of the program by letter with a follow-up face to face meeting. 5. How will the program be accessible to target population (i.e., location, transportation, hours of operation)? As previously stated, LST program is implemented during the school day in all Indian River County Middle and High Schools. Instructors render themselves to the individual school sites. . 6 3cf ' Substance Abuse Council or Indian River County Life Skills Training Prop am CSAC of IRC D. PROGRAM OUTCOMES AND ACTIVITIES MATRIX. 3 - 4 program outcomes only. One matrix table per outcome. Each matrix table must not exceed two (2) pages . (NOTE: Boxes for Outcomes and cells in Matrix tables will expand as you type) Outcomes: In general, a program should have 3 -4 program outcomes. The Outcome indicates the measurable impact or change the program will have on the clients its serves . The outcome should detail the results of the services provided, not the services provided . Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. Please incorporate the following into the outcome description: * Direction of change * Time frame * Area of change * As measured by * Target population * Baseline: the number you will be measuring against * Degree of change Example Outcome : To decrease (direction of change) number of unexcused absences (area of change) of enrolled boys and girls (target population) by 75 % (degree of change) in one year (timeframe) as reported by the 2006-2007 School Board attendance records (as measured by). Baseline: 2005-06 School Board attendance records for enrolled boys and girls. Activities Matrix : The matrix is designed to identify specific activities the program will provide to achieve the stated outcomes. The matrix identifies : 1 ) the specific activity; 2) how often the service/activity is provided; 3) who, by position, is responsible to deliver the service/activity; and 4) expected change in client from providing service/activity. In addition, the matrix is designed to capture the evaluation of services provided: 5) indicator or measurement of change; 6) source of measurement; and 7) how frequently it is measured. A separate PROGRAM OUTCOMES AND ACTIVITIES MATRIX needs to be completed for each outcome. Use a separate row for each activity and group activities under their related outcomes. To add more rows, if needed, simply locate the cursor at the last cell in the last row and press the "TAB" button on the keyboard. See examples provided in the instructions . IMPORTANT NOTE: Keep in mind when developing PROGRAM OUTCOMES that, if funded, these will be what you are accountable to accomplish. Also, the PROGRAM OUTCOMES should reflect the information described in the PROGRAM NEED STATEMENT (B . 1 .). All PROGRAM NEED STATEMENTS should flow from the MISSION & VISION. MEASURABLE OUTCOMES should be based on and measure program needs. Activities are the tasks you do to influence the outcome and impact the unacceptable condition in your PROGRAM NEED STATEMENT. (B. 1 .). 7 40 . , MIM. FRIII a. lreg"My MI . ' - ■ Port Saint Lucie St. Lucie Other Locations � 1 ` 11 • 11 • 11 FOR 7 >Y ORWON € o�ff' � � '" �E � .�� Yt`� tt lae •` i i spa iglp to 10 . 11 ' ll 11 ' ll ` ee�ee� iiiiiiiiiiiiiiiiiiiiiillillillillillillI OPEN i Substance Abuse Council of Indian Riva County Life Skills Training Program CSAC of IRC G. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below. In the Excel portion of this RFP you will find the following pages/tabs : 1 . Budget Narrative Worksheet (4 pages) 2. Total Agency Budget 3 . Total program Budget 4. Funder Specific Budget 5 . Explanation for Variances Make sure to print all the forms by going to each tab and selecting the Print icon. Al Microsoft Office Excel Worksheet 13 4 � Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC (Boxes will expand as you type) Outcome # 1 : . To delay the mean age of first use of substance abuse for IRC youth. (Baseline 2006 FYSAS Survey) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) Columns 5-7) 11 2 0 4 5 © 0 Program Activities Frequency - Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) • To provide 5 ,400 Weekly LST group LST Program Increase by one As reported by the Pre and post One year middle school sessions to youth Coordinator and month the mean FYSAS 2008 test youth LST group according to the LST instructors age of first use (Baseline: FYSAS evaluations, YSand sessions, following schedule: towards 2006) FKASPs • 15 sessions substance use in the 60' grade • 10 sessions in the 70` grade 5 sessions in the 8th grade Provide factual, current Weekly LST LST Program Increase by one As reported by the Pre and post One year Coordinator and FYSAS 2008 test and up-to-date group sessions month the mean information concerning LST instructors age of first use (Baseline: FYSAS evaluations, 2006) FYSAS and drugs and their harmful towards KABP ' s effects . substance use • Pre/ post testing will I nductedand to indicate a e in knowledge. 8 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC (Boxes will expand as you e. Outcome # 2 : To increase knowledge of program participants concerning drugs and their harmful effects . (Baseline: Individual and group administered Pre-tests of program participants.) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 1 2 0 4 0 © L 7 Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) To provide factual , Once a week according LST Program Increase in knowledge A 25 % Pre/ post Pre and post current and up-to-date to the following LST Coordinator and of harmful effects of increase in testing will through program information via on- schedule: LST instructors substance use and knowledge be conducted participation, the going sessions . 15 sessions in impact the protective following and rated to FYSAS and concerning drugs and the 6th grade factor of Social Skills educational indicate a PRIDE Survey their harmful effects . . 10 sessions in thus resulting in a presentation, change in annually. decrease in the risk the 7th grade factor of Favorable and an knowledge • 5 sessions in the attitude ofATOD use decrease in and self- 8`h grade. and a reduction in Favorable disclosure. use. attitude of ATOD use and a reduction in use as reported by the FYSAS and PRIDE Surveys. 9 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 : Substance Abuse Council of IRC !Life Skills Training Program FUNDER: CSAC of IRC . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 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 I used for providing information and calculations only. REVENUES Proposed Total Program Budget Funder SpecificBvdget TofaCAgency Budget 1 Children's Services Council-St. Lucie 0.00 0.00 2 Children's Services Council-Martin 0.0 3 Advisory Committee-Indian River 100,000,00 100,000.00 296,000. 00 4 United Way-St. Lucie County 0.00 0.00 5 United Way-Martin County 0.00 0.00 6 United Way-Indian River County 0.00 0.00 43,000. 00 7 Department of Children & Families 0. 00 90,000.00 8 County Funds 0.00 0.00 9 Contributions-Cash 0.00 259000.00 10 Program Fees 0.00 76,400.00 11 Fund Raising Events-Net 0.00 25,000.00 12 Sales to Public - Net 0.0 0.00 13 Membership Dues 0.00 30,000.00 14 Investment Income 0.00 200.00 15 Miscellaneous 0.00 0.00 16 Legacies & Bequests 0.00 0.00 17 Funds from Other Sources 0.00 241 ,561 .00 18 Reserve Funds Used for Operating 0.00 0.00 19 In-Kind DonationstNot included in total) 0.00 0.00 20 TOTAL REVENUE doesnl include line l9 $100,000.00 $100,000.00 $827, 161 .00 EXPENDITURESA - - Proposei B C 9 L Total Agency total Program Sudget Funder speclficBudget Bud et 21 Salaries - must complete chart on next page 72,852.00 72,85Z00 383,576. 00 22 FICA - Total salaries x 0.0765 5,573. 18 5,573. 18 29,343.56 Retirement - Annual pension for qualified 23 staff 875. 16 875. 16 5,212.26 Life/Health - Medical/Dental(Short-tern 24 Disab. 8,400.0 8,400.00. 42,000.00 Workers Compensation - it employees x 25 rate 1 , 136.49 1 , 136.49 5,983.7 on a Unemployment - projected 26 employees x $7,000 x UCT-6 rate 0.00 0.00 0.0 s+i+zam et 46 - 1 ' Type Ire Organaalion and Proomm Nane SALARIEScross IV POSITION LISTING Annual Salary If Funder % of Gross Annual Portion of Salary on Proposed Program Specific Budget Salary Position Title / Total Hrs/wk (Agency) Requested(CIA) Example: Executive Director/40 his 70,000.00 10,000.00 5,000.00 7.14% Executive Director 75,000.00 0.00 0.00% Prevention Program Coordiantor 45,000.00 0.00 0.00 0.00% Information Specialist $13.5 x 35 /w x 52wk 24,570.00 0.00 0.00 0.o0% Prevention Program Coordiantor $22.71xl5hi 17,714.001 0.00% Prevent Program Assistant $14 x 40hr/wk x 5 29, 120.001 0.00% LST Pro ram Coord $17 x 33 /w x52 wk 29, 172.00 29, 172.00 29, 172.00 100.00% LST Educator 1 $14x 30hr p1w x 52 21 ,840.00 21 ,840.00 21 ,840.00 74.87% LST Educator 2 $14x 30hr /w x 52 21 840.00 21 ,840.00 21 ,840.00 100.00% Pro r am Success Coord STLude 30,000.00 0.00% Program Success IRC Coord IRC 28,000.00 0.00% Program Success IRC $14x 20hr plw x 52 14,560.00 0.00% Program SuccessSt Lucie $14x 20hr p1w x 5 14,560.00 0.00% Drug Testing Pro Coord CMA 25,000.0 - 0.00% JJCRISP Coord 7,200.00 0.00% #VALUE! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIVIO! Remaining positions throughout the a ency Total Salaries $383,576.00 $72,852.00 $72,852.00 FRINGE BENEFITS DETAIL (Funder Speciflc Budget It - Funder ri ID Iv y vl wl Specans Budget FICA 7.65% -� health lth ins. Worker Unemployme Total Fdnges-Fundis Columir C only, from line 27 fp 26� (A x Vol 6ompens. of Compens. Specific Position:Title / Total Hrslwk Exanrp/e.: Case Manager 40 hrs S,OOdbO 582.50. 304.00 500.00 300.00 - 200.00 158250 Executive Director 0.00 0.00 0.00 0.00 0.00 0.00 0.0 Prevention Program Coordiantor 0.00 0.00 0.00 0.00 0.0 0.00 0-0 Information Specialist $13.5 x 35 /w x 52wk 0.00 0.00 0.00 0.00 0.00.00 0.0 Prevention Program Coordiantor $22.71xl5h 0.()Ol 0.00 0.00 Prevent Pro ram Assistant $14 x 40hr/wk x 5 0.00 0.00 0.0 LST Pro ram Coord $17 x 33 /w x52 wk 29,172.00 2,231 .66 875.16 4,200.00 455.08 0.00 7,761 .90 LST Educator 1 $14x 30hr p1w x 52 21 ,840.00 1 ,670.76 0.00 4,200.00 340.70 0.00 6,211 .46 LST Educator 2 $14x 30hr x 52 21 ,840.00 1 ,670.76 0.00 0.00 340.70 0.00 2,011 .46 Pro r am Success Coord STLucie 0.00 0.00 0.00 Program Success IRC Coord IRC 0.00 0.00 0.0 Program Success IRC $14x 20hr /w x 52 0.00 0.00 0-0 Program SuccessSt Lucie $14x 20hr p1w x 5 0.00 0.00 0.00 Drug Testing Pro Coord CMA 0.00 0.00 0.0 JJCRISP Coord D.DO 0.00 0.00 0.0 0.00 1 0.00 0 0.00 0.00 0.0 0 0.0 0.00 0.00 0 0.0 0.110 0.00 0 0.0 0.00 0.0 0 0.0 0.00 0- 00 Total Funder Request Fringe Benefit $72,852.001 $5,5734 9;1 14.46 MCA C EXPENDITURES A Total Program Budget ProposedFunder Specific Budget Total Agency Budget 27 Travel-Daily 2,500.00 2,500MI 15,000.0 # of Staff x average # of miles/wk x 50 wks x $ = Estimated Daily TraveVMilea a Reimb. 28 Travel/C0.00 0.00 15,000.00 anonoper sialrT- • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, re istra[ion, food) 29 Office Su lies 500.001 500.00 15, 000.00 smzom B-t b 2 Substance Abuse Council of Indian River County Life Skills Training Program CSAC of IRC (Boxes will expand as you pe) Outcome #3 : To maintain or decrease the past 30 use trend in alcohol, cigarettes and marijuana. (Baseline 2006 FYSAS) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5 -7) - - 1 2 0 �_ 4 © L �J Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties Outcomes/change Measurements (where) Measurement (who) (why) (evidence) (when) • To provide 5 ,400 Weekly LST group LST To maintain or A 2 % decrease Pre/ post Pre and post middle school sessions to youth Program decrease by 2% the through y among middle testing will be g youth LST group according to the Coordinator incidences of middle school conducted and Prob'rm and LST school adolescents participation, sessions . following schedule: instructors students in rated to • 15 sessions in reporting the past 30 incidences of indicate a the FYSAS the 6a' grade day use trend in past 30 day use change in and PRIDE alcohol cigarettes and Survey • 10 sessions in marijuana following trend in alcohol, knowledge annually. the 7 grade LST program cigarettes and mardisclosure.and self- ijuana • 5 sessions in the participation. following 8th grade. (Baseline 2006 FYSAS) educational presentation, aq reported by the FYSAS and PRIDE Surveys. 10 Substance Abuse Council of Indian River County Life Skills Training Progrmn CSAC of IRC E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters.) Collaborative Agency Resources provided to the piingmiw Indian River School District Referrals to program Case management of Client Progress Venue for presentation University of Miami Provide technical assistance for program evaluation Provide technical assistance in student progress evaluations Office of Juvenile Justice Provide Technical assistance for program Delinquency Prevention implementation Provide curriculum for student population receiving LST instruction Center for Violence Prevention, Provide Technical assistance for fidelity of program University of Boulder delivery 11 44 Type tee Organization and Program Name Office supplies (monthly average z months = estimated cost of office supplies based on present history. 30 Telephone 0. 00 0. 00 12,319.00 8 one toes x average cos per mon[ x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance 31 hi 0.00 ,000.00 y g • Special events, etc. • Bulk mailings - appeals 32 Utilities 600.00 600. 00 6,000.00 ec to - x - months) Water/Sewer ($ x 12 months) . Garbage $ x 12 months 330ccu anc Buildin BGrounds - E'000-OIA 6,000.001 38,856.00 • Janitorial ($ x 12 months) . • Grounds Malnt. ($x 12. months) • Real Estate Taxes 34 Printin 8 Publications 200-001 200.00 25,000.00 Letterheads, Envelopes, etc. - - Fundraising materials - Other 35 Subscri tionMues/Membershi s 0.00 0.00 1 ,000.00 Membership to National Organizat ion .•Dues •'Subscriptions toNewspapers/magazines; _ etc. 0 361nsurance 0.001 0.001 12,000.0 • Commercial/Generallnsurance • Bond Ins. - • Auto Insurance - 37 E ui ment:Rental & Maintenance D.0 0.00 8,000.0 • Copier tease Is x 12 months • Meter tease ($ x 12 months) • Copier Maintenance ($ x 12 months). • - _ • Computer Maintenance ( $ x 12 months} -Other 38 Advertisin 0.00 0.00 25,000.00 • ewspaPera s _ • Fundraising adsfpromotions • Other vacancies: 39 ECoui meriYtPuhrase'.E 0.001 5,000.00s mpufemho - - - - Laser Printer. 40 Professional Fees Le al, Consultin ' 0.0 0.00 30,000.00 -ego a vice -e mac x ,. . • Consultant fees • Other 364 41 Books/Educational Materials 364.001 364. 06r 30,000.00 • Books/Videos _ • Materials $ x staff) 42 Food & Nutrition 0.001 0.001 5,000-00 • Meals ( # meals x clients x 5days x 50 wks) • Snacks 43 Administrative Costs - 0.001 0.00 0 .00 Admin- Cost % of total budget) 44 Audit Expense 1 ,000.001 1 ,000.0of 9,000.00 Independent Audit Review 45 S ecific Assistance to Individuals 0.001 0.00 2,000.00 - Meals/Food Rent Assistance Other 517200] a-t 4(0 -3 Type the Organization and Program Name 46 Other/Miscellaneous 0.00 0.00 28,410.00 • Background check/drug test • Other 47 Other/Contract 0.001 0.001'60,000.00 • Sub-contract for program services LMHC 48 TOTAL EXPENSES $100,000.83 $100,000. 8 $813,700.61 smz007 a-1 4 o . , MIM. FRIII a. lreg"My MI . ' - ■ Port Saint Lucie St. Lucie Other Locations � 1 ` 11 • 11 • 11 FOR 7 >Y ORWON € o�ff' � � '" �E � .�� Yt`� tt lae •` i i spa iglp to 10 . 11 ' ll 11 ' ll ` ee�ee� iiiiiiiiiiiiiiiiiiiiiillillillillillillI OPEN i Substance Abuse Council of Indian Riva County Life Skills Training Program CSAC of IRC G. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below. In the Excel portion of this RFP you will find the following pages/tabs : 1 . Budget Narrative Worksheet (4 pages) 2. Total Agency Budget 3 . Total program Budget 4. Funder Specific Budget 5 . Explanation for Variances Make sure to print all the forms by going to each tab and selecting the Print icon. Al Microsoft Office Excel Worksheet 13 4 � 2007-2008 CORE GRANT APPLICATION TOTALAGENCY BUDGET AGENCYlPROGRAM NAME: Substance Abuse Council Right Choice Program FY 05106 FY 06/0] FY 07108 % INCREASE FYE FYE_9130107FYE 9130108 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED IEDI. CCDI. sycd. B REVENUES BUDGETED BUDGETED i Children's Services Council-St- Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 0.00 3 Advisory Committeeandian River 260,000.00 260,906.00 296,000.00 13.850/6 4 United Way-St. Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 41,000.00 41 ,000.00 43,000.00 4.88% 7 Department of Children & Families 0.00 30,000.00 90,000.00 200.00% a County Funds 0.00 0.00 0.00 9 Contributions-Cash 25,000.00 25,000.00 25,000.00 0.000/6 10 Program Fees 126,308.00 67,000.00 76,400.00 14.03% 11 Fund Raisin Events44et 51,729.00 25,000.00 25,000.00 0.00% 12 Sales to Public-Net 0.00 - 0.00 0.00 13 Membership Dues 3,265.00 3,000.00 30,000.00 900.00% 14 Investment Income 0.00 500.00 200.00 60.00% 15 Miscellaneous 18,000.00 0.00 0.00 16 Legacies & Bequests 0.00 0.00 0.00 17 Funds from Other Sources 181,134.00 243,082.00 241,561 .00 -0.63% 18 Reserve Funds Used for Operating 0.00 0.00 191n-Kind Donations (Non eocwde mloop 0.00 0.00 20 TOTAL 706,436.00 694,582.00 827,161 .00 19.09% EXPENDITURES 21 Salaries 323,913.00 351 ,696.00 383,576.00 9.06% 22 FICA 24,779.00 26,904.00 29,343.56 9.07% 23 Retirement 4,858.00 5,566.00 5,212.26 -0.36% 24 Life/Health 23,821.00 37,800.00 42,000.00 11 .11 % 25 Workers Compensation 4,178.00 5,486.00 5,983.79 9.07% 26 Florida Unemployment 0.00 0.00 0.00 27 Travel-Dail 12,020.00 23,500.00 15,000.00 -36.17% 29 Travel/Conferences/Training 28,088.001 24,000.00 15,000.00 37.50% 29 Office Supplies 14,000.00 7,832.00 15,000.00 91 .52% 30 Telephone 14,858.00 13,000.00 12,319.00 -5.24% 31 Postage/Shipping 3,804.00 2,500.00 5,000.00 100.00% 32 Utilities 7,924.00 9,000.00 6,000.00 33.33% 33 Occupancy (Building & Grounds 52,437.00 42,000.00 38,856.00 -7.49% M Printing & Publications 650000 5,000.00 25,000.00 400.00;A 35 Subscri tion/Dues/Membershi s 1,051 .00 750.00 1,000.00 33.33% 36 Insurance 3,956.00 6,000.00 12,000.00 100.00% 37 E ui ment:Rental & Maintenance 8,509.00 13,000.00 8,000.00 38.46% 38 Advertising 7,841 .00 7,500.00 25,000.00 233.33% 39 Equipment Purchases:Ca ital Expense 0.00 0.00 5,000.00 4o Professional Fees (Legal, Consulting) 2,898.00 3,000.00 30,000.00 900.00% 41 Books/Educational Materials 15,799.00 10,000.00 30,000.00 200.00% 42 Food & Nutrition 0.00 0.00 5,000.00 43 Administrative Costs 0.00 0.00 0.00 44 Audit 'Expense 9,000.00 9,000.00 9,000.00 0.00% 45 S ific Assistance to Individuals 500.00 3,500.00 2,000.00 -02.86 46 Other/Miscellaneous 104,509.00 30,549.00 28,410.00 -7.00% 47 Other/Contract 43,235.00 50,000.00 60,000.00 20.00% as TOTAL 718,476.00 687,583.00 813,700.61 18.34% 49 REVENUES OVERT UNDER EXPENDITURES -12,042.00 6,999.00 13,460.39 92.32% v:.pD, 4(o - ,>. q. a w „mN"- 2007.2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Substance Abuse Council of IRC I Life Skills Taining Program FY 05106 FY 06/07 FY 07108 % INCREASE FYE_97301D6 FYE_9130107 FYE 9130108 CURRENT VS. NEXT FY BUDGET A B C 0 ACTUAL TOTAL PROPOSED Icor. Cc01. Bycol, B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 0.00 3 Advisory Committee4ndian River 56,416.00 90,000.00 100,000.00 11 .11 % 4 United Way-St. Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 0.00 0.00 0.00 7 Department of Children & Families 0.00 0.00 0.00 8 County Funds 0.00 0.00 0.00 9 Contdbutions�Cash - 0.00 0.00 0.00 10 Program Fees 0.00 0.00 30,000.00 11 Fund Raising Events-Net 0.00 0.00 0.00 12 Sales to Public-Net 0.00 0.00 0.00 13 Membership Dues 0.00 0.00 0.00 14 Investment Income 0.00 0.00 0.00 15 Miscellaneous - 0.00 0.00 0.00 16 Legacies 8 Bequests 0.00 0.00 0.00 17 Funds from Other Sources 0.00 0.00 0.00 18 Reserve Funds Used for Operating 0.00 0.00 0.00 19 In-Kind Donations (Nd induam in Mail 0.00 0.00 0.00 20 TOTAL 56,416.00 90,000.00 130,000.00 44.44% EXPENDITURES 21 Salaries 44,023.00 54,260.00 72,852.00 34.26% 22 FICA 3,806.00 4,150.00 5,573.18 34.29% 23 Retirement 1,492.00 1,927.00 875.16 '54.58% 24 LifeMealth 2,100.00 8,400.00 8,400.00 0.007 25 Workers Compensation 641 .00 563.00 1,136.49 101 .86% _ 26 Florida Unemployment 0.00 0.00 0.00 27 Travel-Daily 500.00 1,200.00 2,500.00 108.33 28 Travel/Conferences/Tainin 0.00 0.00 0.00 29 Office Supplies 200.00 1,000.00 500.00 50.007 30 Telephone 0.00 1,200.00 0.00 -100.00% 31 Postage/Shipping 50.00 0.00 0.00 32 Utilities 0.00 1,200.00 600.00 50.00% 33 Occupancy (Building & Grounds 2,854.00 6,000.00 6,000.00 - 0.00% 34 Printing 8 Publications 0.00 100.00 200.00 100.00% 35 Subscri tion/Dues/Membershi s 0.00 0.00 0.00 36 Insurance 0.00 0.00 0.00 37 E ui ment:Rental & Maintenance 0.00 0.00 0.00 38 Advertising - 0.00 0.00 0.00 39 Equipment Purchases:Ca itai Expense 0.00 0.00 0.00 a0 Professional Fees (Legal, Consulting) 0.00 0.00 0.00 41 Books/Educational Materials 250.00 9,000.00 364.00 -95.96% 42 Food 8 Nutrition 0.00 0.00 0.00 a3 Administrative Costs 0.00 0.00 0.00 4a Audit Expense 500.00 1 ,000.00 1,000.00 0.00% 45 Specific Assistance to Individuals 0.00 0.00 0.00 46 Other/Miscellaneous 0.00 0.00 0.00 47 Other/Contract 0.00 0.00 0.00 48 TOTAL 56,416.00 90,000.00 100,000.83 '11.11 % 49 REVENUES OVER/(U DEREXPENDITURES 0.00 0.00 29,999.17 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 : Substance Abuse Council of IRC !Life Skills Training Program FUNDER: CSAC of IRC . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 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 I used for providing information and calculations only. REVENUES Proposed Total Program Budget Funder SpecificBvdget TofaCAgency Budget 1 Children's Services Council-St. Lucie 0.00 0.00 2 Children's Services Council-Martin 0.0 3 Advisory Committee-Indian River 100,000,00 100,000.00 296,000. 00 4 United Way-St. Lucie County 0.00 0.00 5 United Way-Martin County 0.00 0.00 6 United Way-Indian River County 0.00 0.00 43,000. 00 7 Department of Children & Families 0. 00 90,000.00 8 County Funds 0.00 0.00 9 Contributions-Cash 0.00 259000.00 10 Program Fees 0.00 76,400.00 11 Fund Raising Events-Net 0.00 25,000.00 12 Sales to Public - Net 0.0 0.00 13 Membership Dues 0.00 30,000.00 14 Investment Income 0.00 200.00 15 Miscellaneous 0.00 0.00 16 Legacies & Bequests 0.00 0.00 17 Funds from Other Sources 0.00 241 ,561 .00 18 Reserve Funds Used for Operating 0.00 0.00 19 In-Kind DonationstNot included in total) 0.00 0.00 20 TOTAL REVENUE doesnl include line l9 $100,000.00 $100,000.00 $827, 161 .00 EXPENDITURESA - - Proposei B C 9 L Total Agency total Program Sudget Funder speclficBudget Bud et 21 Salaries - must complete chart on next page 72,852.00 72,85Z00 383,576. 00 22 FICA - Total salaries x 0.0765 5,573. 18 5,573. 18 29,343.56 Retirement - Annual pension for qualified 23 staff 875. 16 875. 16 5,212.26 Life/Health - Medical/Dental(Short-tern 24 Disab. 8,400.0 8,400.00. 42,000.00 Workers Compensation - it employees x 25 rate 1 , 136.49 1 , 136.49 5,983.7 on a Unemployment - projected 26 employees x $7,000 x UCT-6 rate 0.00 0.00 0.0 s+i+zam et 46 - 1 ' Type Ire Organaalion and Proomm Nane SALARIEScross IV POSITION LISTING Annual Salary If Funder % of Gross Annual Portion of Salary on Proposed Program Specific Budget Salary Position Title / Total Hrs/wk (Agency) Requested(CIA) Example: Executive Director/40 his 70,000.00 10,000.00 5,000.00 7.14% Executive Director 75,000.00 0.00 0.00% Prevention Program Coordiantor 45,000.00 0.00 0.00 0.00% Information Specialist $13.5 x 35 /w x 52wk 24,570.00 0.00 0.00 0.o0% Prevention Program Coordiantor $22.71xl5hi 17,714.001 0.00% Prevent Program Assistant $14 x 40hr/wk x 5 29, 120.001 0.00% LST Pro ram Coord $17 x 33 /w x52 wk 29, 172.00 29, 172.00 29, 172.00 100.00% LST Educator 1 $14x 30hr p1w x 52 21 ,840.00 21 ,840.00 21 ,840.00 74.87% LST Educator 2 $14x 30hr /w x 52 21 840.00 21 ,840.00 21 ,840.00 100.00% Pro r am Success Coord STLude 30,000.00 0.00% Program Success IRC Coord IRC 28,000.00 0.00% Program Success IRC $14x 20hr plw x 52 14,560.00 0.00% Program SuccessSt Lucie $14x 20hr p1w x 5 14,560.00 0.00% Drug Testing Pro Coord CMA 25,000.0 - 0.00% JJCRISP Coord 7,200.00 0.00% #VALUE! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIVIO! Remaining positions throughout the a ency Total Salaries $383,576.00 $72,852.00 $72,852.00 FRINGE BENEFITS DETAIL (Funder Speciflc Budget It - Funder ri ID Iv y vl wl Specans Budget FICA 7.65% -� health lth ins. Worker Unemployme Total Fdnges-Fundis Columir C only, from line 27 fp 26� (A x Vol 6ompens. of Compens. Specific Position:Title / Total Hrslwk Exanrp/e.: Case Manager 40 hrs S,OOdbO 582.50. 304.00 500.00 300.00 - 200.00 158250 Executive Director 0.00 0.00 0.00 0.00 0.00 0.00 0.0 Prevention Program Coordiantor 0.00 0.00 0.00 0.00 0.0 0.00 0-0 Information Specialist $13.5 x 35 /w x 52wk 0.00 0.00 0.00 0.00 0.00.00 0.0 Prevention Program Coordiantor $22.71xl5h 0.()Ol 0.00 0.00 Prevent Pro ram Assistant $14 x 40hr/wk x 5 0.00 0.00 0.0 LST Pro ram Coord $17 x 33 /w x52 wk 29,172.00 2,231 .66 875.16 4,200.00 455.08 0.00 7,761 .90 LST Educator 1 $14x 30hr p1w x 52 21 ,840.00 1 ,670.76 0.00 4,200.00 340.70 0.00 6,211 .46 LST Educator 2 $14x 30hr x 52 21 ,840.00 1 ,670.76 0.00 0.00 340.70 0.00 2,011 .46 Pro r am Success Coord STLucie 0.00 0.00 0.00 Program Success IRC Coord IRC 0.00 0.00 0.0 Program Success IRC $14x 20hr /w x 52 0.00 0.00 0-0 Program SuccessSt Lucie $14x 20hr p1w x 5 0.00 0.00 0.00 Drug Testing Pro Coord CMA 0.00 0.00 0.0 JJCRISP Coord D.DO 0.00 0.00 0.0 0.00 1 0.00 0 0.00 0.00 0.0 0 0.0 0.00 0.00 0 0.0 0.110 0.00 0 0.0 0.00 0.0 0 0.0 0.00 0- 00 Total Funder Request Fringe Benefit $72,852.001 $5,5734 9;1 14.46 MCA C EXPENDITURES A Total Program Budget ProposedFunder Specific Budget Total Agency Budget 27 Travel-Daily 2,500.00 2,500MI 15,000.0 # of Staff x average # of miles/wk x 50 wks x $ = Estimated Daily TraveVMilea a Reimb. 28 Travel/C0.00 0.00 15,000.00 anonoper sialrT- • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, re istra[ion, food) 29 Office Su lies 500.001 500.00 15, 000.00 smzom B-t b 2 Type the Organization and Program Name 2007-2008 CORE GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : Substance Abuse Council / Lifeskills Training Program FUNDER : Children Services Advisory Com A B C FY 07/08 FY 07/08 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A) EXPENDITURES 21 Salaries 729852.00 725852. 00 100.00% 22 FICA 51573. 18 5,573. 18 100.00% 23 Retirement 875. 16 875.16 100.00% 24 Life/Health 82400.00 80400.00 100.00% 25 Workers Compensation 11136.49 19136.49 100.00% 26 Florida Unemployment 0. 00 0. 00 #DIV/01 27 Travel-Daily 21500.00 25500.00 100.00% 28 Travel/Conferences/Training 0. 00 0.00 #DIV/01 29 Office Supplies 500.00 500.00 100.00% 30 Telephone 0.00 0.00 #DIV/01 31 Postage/Shipping 0.00 0.00 #DIV/01 32 Utilities 600.00 600.00 100.00% 33 Occupant (Building & Grounds 6,000.00 62000.00 100.00% 34 Printing & Publications 200.00 200.00 100.00% 35 Subscription/Dues/Memberships 0.00 0.00 #DIV/01 36 Insurance 0.00 0.00 #DIV/01 37 Equipment: Rental & Maintenance 0 .00 0.00 #DIV/01 38 Advertising 0.00 0.00 #DIV/0! 39 Equipment Purchases:Capital Expense 0.00 0.00 #DIV/0! 40 Professional Fees (Legal, Consulting) 0.00 0.00 #DIV/0 ! 41 Books/Educational Materials 364.00 364. 00 100.00% 42 Food & Nutrition 0.00 0.00 #DIV/01 43 Administrative Costs 0.00 0.00 #DIV/0! 44 Audit Expense 1 ,000.00 19000.00 100.00% 45 Specific Assistance to Individuals 0 .00 0.00 #DIV/01 46 Other/Miscellaneous 0.00 0.001 #DIV/0! 47 Other/Contract 0.00 0.00 #DIV/01 48 TOTAL $1005000.83 $100,000 .83 100.00% 5.9!2007 BA 4�o _ q Substance Abuse Council of Indian River County Life Skills Trainine Pm.ram CSAC of IRC H. FUNDER SPECIFIC REQUIREMENTS MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages) Note period outcomes/results reflect: October 1 , 2005 to September 30, 2006. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut and paste from last years application. 1 . To decrease by 5 % the "first use" numbers of To provide 4,500 youth weekly LST group drug and alcohol use among middle school (6a', sessions to youth according to the following 7a', 8`a grade) students over a period of one year schedule: as reported by the 2004 FYSAS survey. • 15 sessions in the 6t' grade (Baseline 2002 FYSAS Survey) 0 10 sessions in the 7a' • 5 sessions in the 8th fides. It is important to note that the initial age onset of substance abuse use has increased from: Total Served : 4, 604 • Alcohol from 12.3 years in 2000 to 12.7 years in 2005. Goa! Met According to the 2004 Indian • Tobacco from 12.0 years in 2000 to River FYSA Survey administered in 12.4 years in 2005. the spring of 2004, 19. 6 of middle • Mariivana from 13 .2 years in 2000 school youth reported "ANY ILLICIT to 13 .6 years in 2005. DRUG USE" in their lifetime. (This figure is down from 25. 8% in 200.) This equates to a 33.33 % increase in the initial age of onset over the past 5 years 2. To reduce by 2% the incidences of sixth grade 2. To provide a total of fifteen ( 15) weekly adolescents reporting the use of tobacco, alcohol ongoing education sessions to sixth grade and marijuana following the first year of LST students on the various substance abuse and Program as reported by the 2004 FYSAS resiliency skills building topics survey (Baseline 2002 FYSAS Survey) Goa! Met. According to the 2004, 25. 5% of middle school youth reported "ALCOHOL, TOBACCO OR MARIJUANA USE" in their lifetime. (This figure is down from 33. 23% in 2000 and down from 31. 0% in 2002.) 3 . To reduce by 2% the incidences of seventh 3 . We will provide a total of ten ( 10) weekly grade adolescents reporting the use of tobacco, ongoing booster education sessions to seventh alcohol , and marijuana following the second grade students on the various substance abuse year of LST program as reported by the 2006 and resiliency skill building topics FYSAS survey (Baseline 2004 FYSAS Survey) Goal Met. According to the 2004 Indian 14 49 Type tee Organization and Program Name Office supplies (monthly average z months = estimated cost of office supplies based on present history. 30 Telephone 0. 00 0. 00 12,319.00 8 one toes x average cos per mon[ x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance 31 hi 0.00 ,000.00 y g • Special events, etc. • Bulk mailings - appeals 32 Utilities 600.00 600. 00 6,000.00 ec to - x - months) Water/Sewer ($ x 12 months) . Garbage $ x 12 months 330ccu anc Buildin BGrounds - E'000-OIA 6,000.001 38,856.00 • Janitorial ($ x 12 months) . • Grounds Malnt. ($x 12. months) • Real Estate Taxes 34 Printin 8 Publications 200-001 200.00 25,000.00 Letterheads, Envelopes, etc. - - Fundraising materials - Other 35 Subscri tionMues/Membershi s 0.00 0.00 1 ,000.00 Membership to National Organizat ion .•Dues •'Subscriptions toNewspapers/magazines; _ etc. 0 361nsurance 0.001 0.001 12,000.0 • Commercial/Generallnsurance • Bond Ins. - • Auto Insurance - 37 E ui ment:Rental & Maintenance D.0 0.00 8,000.0 • Copier tease Is x 12 months • Meter tease ($ x 12 months) • Copier Maintenance ($ x 12 months). • - _ • Computer Maintenance ( $ x 12 months} -Other 38 Advertisin 0.00 0.00 25,000.00 • ewspaPera s _ • Fundraising adsfpromotions • Other vacancies: 39 ECoui meriYtPuhrase'.E 0.001 5,000.00s mpufemho - - - - Laser Printer. 40 Professional Fees Le al, Consultin ' 0.0 0.00 30,000.00 -ego a vice -e mac x ,. . • Consultant fees • Other 364 41 Books/Educational Materials 364.001 364. 06r 30,000.00 • Books/Videos _ • Materials $ x staff) 42 Food & Nutrition 0.001 0.001 5,000-00 • Meals ( # meals x clients x 5days x 50 wks) • Snacks 43 Administrative Costs - 0.001 0.00 0 .00 Admin- Cost % of total budget) 44 Audit Expense 1 ,000.001 1 ,000.0of 9,000.00 Independent Audit Review 45 S ecific Assistance to Individuals 0.001 0.00 2,000.00 - Meals/Food Rent Assistance Other 517200] a-t 4(0 -3 Type the Organization and Program Name 46 Other/Miscellaneous 0.00 0.00 28,410.00 • Background check/drug test • Other 47 Other/Contract 0.001 0.001'60,000.00 • Sub-contract for program services LMHC 48 TOTAL EXPENSES $100,000.83 $100,000. 8 $813,700.61 smz007 a-1 4 o EXHIBIT B [From policy adopted by Indian River County Board of County Commissioners on February 19 , 2002] " D . Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check. Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners. In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1 " may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year end (September 30°i) 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 32960-3365 Recipient: Substance Abuse Council of Indian River County, 1151 19'h Street, Vero Beach , FL 32960; Attention : Colette Heid , Director 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 2007-2008 CORE GRANT APPLICATION TOTALAGENCY BUDGET AGENCYlPROGRAM NAME: Substance Abuse Council Right Choice Program FY 05106 FY 06/0] FY 07108 % INCREASE FYE FYE_9130107FYE 9130108 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED IEDI. CCDI. sycd. B REVENUES BUDGETED BUDGETED i Children's Services Council-St- Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 0.00 3 Advisory Committeeandian River 260,000.00 260,906.00 296,000.00 13.850/6 4 United Way-St. Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 41,000.00 41 ,000.00 43,000.00 4.88% 7 Department of Children & Families 0.00 30,000.00 90,000.00 200.00% a County Funds 0.00 0.00 0.00 9 Contributions-Cash 25,000.00 25,000.00 25,000.00 0.000/6 10 Program Fees 126,308.00 67,000.00 76,400.00 14.03% 11 Fund Raisin Events44et 51,729.00 25,000.00 25,000.00 0.00% 12 Sales to Public-Net 0.00 - 0.00 0.00 13 Membership Dues 3,265.00 3,000.00 30,000.00 900.00% 14 Investment Income 0.00 500.00 200.00 60.00% 15 Miscellaneous 18,000.00 0.00 0.00 16 Legacies & Bequests 0.00 0.00 0.00 17 Funds from Other Sources 181,134.00 243,082.00 241,561 .00 -0.63% 18 Reserve Funds Used for Operating 0.00 0.00 191n-Kind Donations (Non eocwde mloop 0.00 0.00 20 TOTAL 706,436.00 694,582.00 827,161 .00 19.09% EXPENDITURES 21 Salaries 323,913.00 351 ,696.00 383,576.00 9.06% 22 FICA 24,779.00 26,904.00 29,343.56 9.07% 23 Retirement 4,858.00 5,566.00 5,212.26 -0.36% 24 Life/Health 23,821.00 37,800.00 42,000.00 11 .11 % 25 Workers Compensation 4,178.00 5,486.00 5,983.79 9.07% 26 Florida Unemployment 0.00 0.00 0.00 27 Travel-Dail 12,020.00 23,500.00 15,000.00 -36.17% 29 Travel/Conferences/Training 28,088.001 24,000.00 15,000.00 37.50% 29 Office Supplies 14,000.00 7,832.00 15,000.00 91 .52% 30 Telephone 14,858.00 13,000.00 12,319.00 -5.24% 31 Postage/Shipping 3,804.00 2,500.00 5,000.00 100.00% 32 Utilities 7,924.00 9,000.00 6,000.00 33.33% 33 Occupancy (Building & Grounds 52,437.00 42,000.00 38,856.00 -7.49% M Printing & Publications 650000 5,000.00 25,000.00 400.00;A 35 Subscri tion/Dues/Membershi s 1,051 .00 750.00 1,000.00 33.33% 36 Insurance 3,956.00 6,000.00 12,000.00 100.00% 37 E ui ment:Rental & Maintenance 8,509.00 13,000.00 8,000.00 38.46% 38 Advertising 7,841 .00 7,500.00 25,000.00 233.33% 39 Equipment Purchases:Ca ital Expense 0.00 0.00 5,000.00 4o Professional Fees (Legal, Consulting) 2,898.00 3,000.00 30,000.00 900.00% 41 Books/Educational Materials 15,799.00 10,000.00 30,000.00 200.00% 42 Food & Nutrition 0.00 0.00 5,000.00 43 Administrative Costs 0.00 0.00 0.00 44 Audit 'Expense 9,000.00 9,000.00 9,000.00 0.00% 45 S ific Assistance to Individuals 500.00 3,500.00 2,000.00 -02.86 46 Other/Miscellaneous 104,509.00 30,549.00 28,410.00 -7.00% 47 Other/Contract 43,235.00 50,000.00 60,000.00 20.00% as TOTAL 718,476.00 687,583.00 813,700.61 18.34% 49 REVENUES OVERT UNDER EXPENDITURES -12,042.00 6,999.00 13,460.39 92.32% v:.pD, 4(o - ,>. q. a w „mN"- 2007.2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Substance Abuse Council of IRC I Life Skills Taining Program FY 05106 FY 06/07 FY 07108 % INCREASE FYE_97301D6 FYE_9130107 FYE 9130108 CURRENT VS. NEXT FY BUDGET A B C 0 ACTUAL TOTAL PROPOSED Icor. Cc01. Bycol, B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 0.00 3 Advisory Committee4ndian River 56,416.00 90,000.00 100,000.00 11 .11 % 4 United Way-St. Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 0.00 0.00 0.00 7 Department of Children & Families 0.00 0.00 0.00 8 County Funds 0.00 0.00 0.00 9 Contdbutions�Cash - 0.00 0.00 0.00 10 Program Fees 0.00 0.00 30,000.00 11 Fund Raising Events-Net 0.00 0.00 0.00 12 Sales to Public-Net 0.00 0.00 0.00 13 Membership Dues 0.00 0.00 0.00 14 Investment Income 0.00 0.00 0.00 15 Miscellaneous - 0.00 0.00 0.00 16 Legacies 8 Bequests 0.00 0.00 0.00 17 Funds from Other Sources 0.00 0.00 0.00 18 Reserve Funds Used for Operating 0.00 0.00 0.00 19 In-Kind Donations (Nd induam in Mail 0.00 0.00 0.00 20 TOTAL 56,416.00 90,000.00 130,000.00 44.44% EXPENDITURES 21 Salaries 44,023.00 54,260.00 72,852.00 34.26% 22 FICA 3,806.00 4,150.00 5,573.18 34.29% 23 Retirement 1,492.00 1,927.00 875.16 '54.58% 24 LifeMealth 2,100.00 8,400.00 8,400.00 0.007 25 Workers Compensation 641 .00 563.00 1,136.49 101 .86% _ 26 Florida Unemployment 0.00 0.00 0.00 27 Travel-Daily 500.00 1,200.00 2,500.00 108.33 28 Travel/Conferences/Tainin 0.00 0.00 0.00 29 Office Supplies 200.00 1,000.00 500.00 50.007 30 Telephone 0.00 1,200.00 0.00 -100.00% 31 Postage/Shipping 50.00 0.00 0.00 32 Utilities 0.00 1,200.00 600.00 50.00% 33 Occupancy (Building & Grounds 2,854.00 6,000.00 6,000.00 - 0.00% 34 Printing 8 Publications 0.00 100.00 200.00 100.00% 35 Subscri tion/Dues/Membershi s 0.00 0.00 0.00 36 Insurance 0.00 0.00 0.00 37 E ui ment:Rental & Maintenance 0.00 0.00 0.00 38 Advertising - 0.00 0.00 0.00 39 Equipment Purchases:Ca itai Expense 0.00 0.00 0.00 a0 Professional Fees (Legal, Consulting) 0.00 0.00 0.00 41 Books/Educational Materials 250.00 9,000.00 364.00 -95.96% 42 Food 8 Nutrition 0.00 0.00 0.00 a3 Administrative Costs 0.00 0.00 0.00 4a Audit Expense 500.00 1 ,000.00 1,000.00 0.00% 45 Specific Assistance to Individuals 0.00 0.00 0.00 46 Other/Miscellaneous 0.00 0.00 0.00 47 Other/Contract 0.00 0.00 0.00 48 TOTAL 56,416.00 90,000.00 100,000.83 '11.11 % 49 REVENUES OVER/(U DEREXPENDITURES 0.00 0.00 29,999.17 DATE (MM/DDlY ) ACORDTMCERTIFICATE OF LIABILITY INSURANCE , on4nYYY007 PRODUCER Phone: (772) 562-3369 Fax (772) 562-3466 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HILB ROGAL & HOBBS OF FLORIDA, INC. - VERO BEACH ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE NAIC # —.. . _- INSURED INSURER A: Guarantee Insurance Co _ -, SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY, INC. INSURER B: P.O. BOX 6460 I INSURER C: VERO BEACH FL 32960 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ; aUovlr TYPE OF INSURANCE POLICY NUMBER ? A EY EFFECTIVE POLICY EXPIRATION LIMITS LTO INSRd GATE MMIODM' GATE MMIOOIVY GENERAL LIABILITY EACH OCCURRENCE _ $ COMMERCIAL GENE OCCUR R MIETOIE RENTED D COMMERCIAL GENERAL PREMISES (Ea bmlrenceJ is - CLAIMS r—', MED. EXP (Any one person) "Tj $ L PERSONAL BACV INJURY Is PRO GENERAL AGGREGATE $ PR -I ODUCTSCOMP/OP AGG. $ GEN L AGGREGATE LIMIT APPLIES PER _._ - POLICY )ECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO ' (Ed accident) -_- I' $ ALL OWNED AUTOS B(Per person) ' (Per person) $ SCHEDULED AUTOS ) - - -- HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) I - PROPERTY DAMAGE is (Per acudent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT _ $OTHE L I ANY AUTO ' AUTOONLY. _EAA. CC $ . ._ AUTO OAGG $ _ ... EOCCUR I : EACH OCCURRENCE EXCESS I UMBRELLA LABILITY CLAIMS FAGGREGAT E $ I Lk I i DEDUCTIBLE —. — - -- $ HRETENTION $ $ WC "u ' OTHER WORKERS COMPENSATION AND GWGC100002483-107 01110/07 01110106 TORY LIMITS- 11 EMPLOYERS' LIABILITY El. EACH ACCIDENT $ 100,000 A ~ OFFICERMEMBER EXCLUDED? E.L. DISEASE-EA EMPLOY My PROPRIETORTARTNER/EXECUTIVE Et� _ 1DD,600 N yes, describe under E.L. DISEASE-POLICY LIMIT I $ 500,000 ,SPECIAL PROVISIONS below OTHER: DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIALPROVISIONS - - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, INDIAN RIVER COUNTY - BOARD OF COUNTY ITS AGENTS OR REPRESENTATIVES. COMMISSIONERS AUTHORIZED REPRESENTATIVE 27TH STREET VER K VERO BEACH, FL 32960 Attention : Robert S ACORD 25 (2001108) Certificate # 109167 © ACORD CORPORATION 1988 • t M I • • • t -_ • • ' 1 I ' • 1 t • i • t • t • 1 Jill In 111111111111111;Jill - . . • ; 1 . . 1 •_ 1 I r�. \• t• 1 1 J. k••1 ! ' 1 1I 1 i 1 . - Y •♦ r 1 ' I9 111 sqa 1 all ] i 1i1 . III III • 1 ! •.. .I • '� 11 I ■ 1 • f ■ 1 \1 - 1•Lt X1:'9 - ♦ Y � • '1 1 • I 11 1 : Type the Organization and Program Name 2007-2008 CORE GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : Substance Abuse Council / Lifeskills Training Program FUNDER : Children Services Advisory Com A B C FY 07/08 FY 07/08 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A) EXPENDITURES 21 Salaries 729852.00 725852. 00 100.00% 22 FICA 51573. 18 5,573. 18 100.00% 23 Retirement 875. 16 875.16 100.00% 24 Life/Health 82400.00 80400.00 100.00% 25 Workers Compensation 11136.49 19136.49 100.00% 26 Florida Unemployment 0. 00 0. 00 #DIV/01 27 Travel-Daily 21500.00 25500.00 100.00% 28 Travel/Conferences/Training 0. 00 0.00 #DIV/01 29 Office Supplies 500.00 500.00 100.00% 30 Telephone 0.00 0.00 #DIV/01 31 Postage/Shipping 0.00 0.00 #DIV/01 32 Utilities 600.00 600.00 100.00% 33 Occupant (Building & Grounds 6,000.00 62000.00 100.00% 34 Printing & Publications 200.00 200.00 100.00% 35 Subscription/Dues/Memberships 0.00 0.00 #DIV/01 36 Insurance 0.00 0.00 #DIV/01 37 Equipment: Rental & Maintenance 0 .00 0.00 #DIV/01 38 Advertising 0.00 0.00 #DIV/0! 39 Equipment Purchases:Capital Expense 0.00 0.00 #DIV/0! 40 Professional Fees (Legal, Consulting) 0.00 0.00 #DIV/0 ! 41 Books/Educational Materials 364.00 364. 00 100.00% 42 Food & Nutrition 0.00 0.00 #DIV/01 43 Administrative Costs 0.00 0.00 #DIV/0! 44 Audit Expense 1 ,000.00 19000.00 100.00% 45 Specific Assistance to Individuals 0 .00 0.00 #DIV/01 46 Other/Miscellaneous 0.00 0.001 #DIV/0! 47 Other/Contract 0.00 0.00 #DIV/01 48 TOTAL $1005000.83 $100,000 .83 100.00% 5.9!2007 BA 4�o _ q Substance Abuse Council of Indian River County Life Skills Trainine Pm.ram CSAC of IRC H. FUNDER SPECIFIC REQUIREMENTS MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages) Note period outcomes/results reflect: October 1 , 2005 to September 30, 2006. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut and paste from last years application. 1 . To decrease by 5 % the "first use" numbers of To provide 4,500 youth weekly LST group drug and alcohol use among middle school (6a', sessions to youth according to the following 7a', 8`a grade) students over a period of one year schedule: as reported by the 2004 FYSAS survey. • 15 sessions in the 6t' grade (Baseline 2002 FYSAS Survey) 0 10 sessions in the 7a' • 5 sessions in the 8th fides. It is important to note that the initial age onset of substance abuse use has increased from: Total Served : 4, 604 • Alcohol from 12.3 years in 2000 to 12.7 years in 2005. Goa! Met According to the 2004 Indian • Tobacco from 12.0 years in 2000 to River FYSA Survey administered in 12.4 years in 2005. the spring of 2004, 19. 6 of middle • Mariivana from 13 .2 years in 2000 school youth reported "ANY ILLICIT to 13 .6 years in 2005. DRUG USE" in their lifetime. (This figure is down from 25. 8% in 200.) This equates to a 33.33 % increase in the initial age of onset over the past 5 years 2. To reduce by 2% the incidences of sixth grade 2. To provide a total of fifteen ( 15) weekly adolescents reporting the use of tobacco, alcohol ongoing education sessions to sixth grade and marijuana following the first year of LST students on the various substance abuse and Program as reported by the 2004 FYSAS resiliency skills building topics survey (Baseline 2002 FYSAS Survey) Goa! Met. According to the 2004, 25. 5% of middle school youth reported "ALCOHOL, TOBACCO OR MARIJUANA USE" in their lifetime. (This figure is down from 33. 23% in 2000 and down from 31. 0% in 2002.) 3 . To reduce by 2% the incidences of seventh 3 . We will provide a total of ten ( 10) weekly grade adolescents reporting the use of tobacco, ongoing booster education sessions to seventh alcohol , and marijuana following the second grade students on the various substance abuse year of LST program as reported by the 2006 and resiliency skill building topics FYSAS survey (Baseline 2004 FYSAS Survey) Goal Met. According to the 2004 Indian 14 49 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 150009000 Medical Expense 59000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 29000 , 000 S00 Basis : Per Claim ; Applies : Both BI & PD Fire Damage 509000 Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim EXHIBIT B [From policy adopted by Indian River County Board of County Commissioners on February 19 , 2002] " D . Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check. Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners. In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1 " may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year end (September 30°i) 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 OCT . 25 , 2001 1 : 48PM NAT L CITY INSURANCE NO. 735 P . 2 NATIONAL CITY INS 6078 20TH ST VERO BEACH, FL 32966 772-569-2626 Policy number: 056626320 Undermieen by. PROGRESSIVE EXPRESS INS COMPANY October 25, 2007 Page i of 1 Certificate of Insurance CettlRcate R«derInsured . .......... ... ..... . . .. . ..... . .. . ..... ...... .. . ... . . . . . . . .. . .. add tional Insured SUBSTANCE ABUSE COUNCIL T.. ... .. . IONAL . NATCITY INS .. .. ." " " " " " " " ' IRC BRD OF CO COMM 1151 19TH STREET 1601 27TH ST 6078 BEAN VERO BEACH, FL 32960 VERO BEACH, FL32960 VERO BEACH, FL 32966 This document certifies that insurance policies identified below have been issued by the designated Insurer to the insured named above for the pariod(s) indicated. This Cer ifirate is issued for Information purposes only, it confers no rights upon the Certificate holder and does not change, after, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies, .... .. •... .. . ... ... . . ..I . .. . , . ... ... . . . . .. .I.Policy Effective Date: Mar 1 , 2007 EVirat. Date: Mart Polity Expiration Date; Mar 1 , 2008 . . ... ..... . .. ... ........ .... ... " . . . Insurance coverogg(d Dmia .PERT.. ...AM• ... . ... ... .... . . .. . . .. .. . .. $ 1 .. ...... .... .. ,, . .., .... ,.... . ,, .. . ... . . ... . . .,. .. . ... . . ............ . .. . ... .. , .. . .. ... ... .. . .,. .... BODILY I..... . ROPERTY .. . S1,OOD,000 COMBINED SINGLE LIMIT UNINSUREDMOTORtST , ..0100. ... . ... ... .. .... ........ . ............. . ......... .. . . .. . . . .. . . ... ... .. . .. . .... . . . . . .. .... 81 ,000,000 CSL 4 1 . ...... 1 PERSONAL INIURY PROTECTR]N .. 0046.... . . .......... ... Si0,000W/SO DED - NAMm INSURED ONLY .. ...... ... .... ..... .... ... .... .... ... .... Description of L0catf0nfVehicleV5pedal Items 5dreduled autos only ... . ... . .. . ...... ........ .. .. . . 1999 FORD EON E350 SUPR 1 FBS53152XHC31695 . . . .. . .. . . . .. .. . Stated Amount 520,0(Nl . .. .. . .. . .. .... ... •.... . .. . ... MEDICAL PAYMENTS SS,D00 COMPREHENSIVE 31 ,000 DED COLLISION $ 1,000 DED Certificate number 29807NET632 Please be advised that additional insureds and loss payees will be notified In the event of a Infdderm cancellation, ram 5241 n 01021 Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 1 , 0009000 Medical Expense 55000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 2 , 0009000 500 Basis : Per Claim ; Applies : Both BI & PD Fire Damage 509000 Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim 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 32960-3365 Recipient: Substance Abuse Council of Indian River County, 1151 19'h Street, Vero Beach , FL 32960; Attention : Colette Heid , Director 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 DATE (MM/DDlY ) ACORDTMCERTIFICATE OF LIABILITY INSURANCE , on4nYYY007 PRODUCER Phone: (772) 562-3369 Fax (772) 562-3466 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HILB ROGAL & HOBBS OF FLORIDA, INC. - VERO BEACH ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE NAIC # —.. . _- INSURED INSURER A: Guarantee Insurance Co _ -, SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY, INC. INSURER B: P.O. BOX 6460 I INSURER C: VERO BEACH FL 32960 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ; aUovlr TYPE OF INSURANCE POLICY NUMBER ? A EY EFFECTIVE POLICY EXPIRATION LIMITS LTO INSRd GATE MMIODM' GATE MMIOOIVY GENERAL LIABILITY EACH OCCURRENCE _ $ COMMERCIAL GENE OCCUR R MIETOIE RENTED D COMMERCIAL GENERAL PREMISES (Ea bmlrenceJ is - CLAIMS r—', MED. EXP (Any one person) "Tj $ L PERSONAL BACV INJURY Is PRO GENERAL AGGREGATE $ PR -I ODUCTSCOMP/OP AGG. $ GEN L AGGREGATE LIMIT APPLIES PER _._ - POLICY )ECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO ' (Ed accident) -_- I' $ ALL OWNED AUTOS B(Per person) ' (Per person) $ SCHEDULED AUTOS ) - - -- HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) I - PROPERTY DAMAGE is (Per acudent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT _ $OTHE L I ANY AUTO ' AUTOONLY. _EAA. CC $ . ._ AUTO OAGG $ _ ... EOCCUR I : EACH OCCURRENCE EXCESS I UMBRELLA LABILITY CLAIMS FAGGREGAT E $ I Lk I i DEDUCTIBLE —. — - -- $ HRETENTION $ $ WC "u ' OTHER WORKERS COMPENSATION AND GWGC100002483-107 01110/07 01110106 TORY LIMITS- 11 EMPLOYERS' LIABILITY El. EACH ACCIDENT $ 100,000 A ~ OFFICERMEMBER EXCLUDED? E.L. DISEASE-EA EMPLOY My PROPRIETORTARTNER/EXECUTIVE Et� _ 1DD,600 N yes, describe under E.L. DISEASE-POLICY LIMIT I $ 500,000 ,SPECIAL PROVISIONS below OTHER: DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIALPROVISIONS - - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, INDIAN RIVER COUNTY - BOARD OF COUNTY ITS AGENTS OR REPRESENTATIVES. COMMISSIONERS AUTHORIZED REPRESENTATIVE 27TH STREET VER K VERO BEACH, FL 32960 Attention : Robert S ACORD 25 (2001108) Certificate # 109167 © ACORD CORPORATION 1988 • t M I • • • t -_ • • ' 1 I ' • 1 t • i • t • t • 1 Jill In 111111111111111;Jill - . . • ; 1 . . 1 •_ 1 I r�. \• t• 1 1 J. k••1 ! ' 1 1I 1 i 1 . - Y •♦ r 1 ' I9 111 sqa 1 all ] i 1i1 . III III • 1 ! •.. .I • '� 11 I ■ 1 • f ■ 1 \1 - 1•Lt X1:'9 - ♦ Y � • '1 1 • I 11 1 : IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 150009000 Medical Expense 59000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 29000 , 000 S00 Basis : Per Claim ; Applies : Both BI & PD Fire Damage 509000 Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim OCT . 25 , 2001 1 : 48PM NAT L CITY INSURANCE NO. 735 P . 2 NATIONAL CITY INS 6078 20TH ST VERO BEACH, FL 32966 772-569-2626 Policy number: 056626320 Undermieen by. PROGRESSIVE EXPRESS INS COMPANY October 25, 2007 Page i of 1 Certificate of Insurance CettlRcate R«derInsured . .......... ... ..... . . .. . ..... . .. . ..... ...... .. . ... . . . . . . . .. . .. add tional Insured SUBSTANCE ABUSE COUNCIL T.. ... .. . IONAL . NATCITY INS .. .. ." " " " " " " " ' IRC BRD OF CO COMM 1151 19TH STREET 1601 27TH ST 6078 BEAN VERO BEACH, FL 32960 VERO BEACH, FL32960 VERO BEACH, FL 32966 This document certifies that insurance policies identified below have been issued by the designated Insurer to the insured named above for the pariod(s) indicated. This Cer ifirate is issued for Information purposes only, it confers no rights upon the Certificate holder and does not change, after, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies, .... .. •... .. . ... ... . . ..I . .. . , . ... ... . . . . .. .I.Policy Effective Date: Mar 1 , 2007 EVirat. Date: Mart Polity Expiration Date; Mar 1 , 2008 . . ... ..... . .. ... ........ .... ... " . . . Insurance coverogg(d Dmia .PERT.. ...AM• ... . ... ... .... . . .. . . .. .. . .. $ 1 .. ...... .... .. ,, . .., .... ,.... . ,, .. . ... . . ... . . .,. .. . ... . . ............ . .. . ... .. , .. . .. ... ... .. . .,. .... BODILY I..... . ROPERTY .. . S1,OOD,000 COMBINED SINGLE LIMIT UNINSUREDMOTORtST , ..0100. ... . ... ... .. .... ........ . ............. . ......... .. . . .. . . . .. . . ... ... .. . .. . .... . . . . . .. .... 81 ,000,000 CSL 4 1 . ...... 1 PERSONAL INIURY PROTECTR]N .. 0046.... . . .......... ... Si0,000W/SO DED - NAMm INSURED ONLY .. ...... ... .... ..... .... ... .... .... ... .... Description of L0catf0nfVehicleV5pedal Items 5dreduled autos only ... . ... . .. . ...... ........ .. .. . . 1999 FORD EON E350 SUPR 1 FBS53152XHC31695 . . . .. . .. . . . .. .. . Stated Amount 520,0(Nl . .. .. . .. . .. .... ... •.... . .. . ... MEDICAL PAYMENTS SS,D00 COMPREHENSIVE 31 ,000 DED COLLISION $ 1,000 DED Certificate number 29807NET632 Please be advised that additional insureds and loss payees will be notified In the event of a Infdderm cancellation, ram 5241 n 01021 Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 1 , 0009000 Medical Expense 55000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 2 , 0009000 500 Basis : Per Claim ; Applies : Both BI & PD Fire Damage 509000 Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim