HomeMy WebLinkAbout2004-229F (2) I • T
Indian River County Grant Contract
This Grant Contract ("Contract") entered into effective this 1st day of October 2004 by and between
Indian River County, a political subdivision of the State of Florida , 1840 25th Street, Vero Beach FL ,
32960 ("County') and Big Brothers Big Sisters of Indian River County, ( Recipient) , of:
Big Brothers Big Sisters of Indian River County
P . O . Box 547
Vero Beach , Florida 32961
CSAC Jump Into Reading 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") .
3 , Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal
year 2004/2005 ("Grant Period") . The Grant Period commences on October 1 , 2004
and ends on September 30 , 2005 .
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4 . Grant Funds and Payment The approved Grant for the Grant Period is Thirty
Thousand Dollars ($30 . 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 Performance
Reports to the Human Services Department of the County within fifteen ( 15) business
days following : December 31 , March 31 , June 30 , and September 30 .
5 .4 Audit Requirements . If Recipient receives $25 , 000 or more in 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 .
5 .4 .2 The Indian River County Office of Management and Budget reserves the
right at any 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 September 21 , 2004 ,
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 :
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(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 omissions of the Recipient, its agents , officers , or employees in connection
with the performance of this Contract.
5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter
119 , Florida Statutes ( Public Records Law) in connection with this Contract .
6 . Termination . This Contract may be terminated by either party, without cause , upon
thirty (30 ) days prior written notice to the other party. In addition , the County may
terminate this Contract for convenience upon ten ( 10) days prior written notice to the
Recipient if the County determines that such termination is in the public interest.
7 . Availability of Funds . The obligations of the County under this Contract are subject
to the availability of funds lawfully appropriated for its purpose by the Board of
County Commissioners of Indian River County,
8 , Standard Terms . This Contract is subject to the standard terms attached hereto as
Exhibit C and incorporated herein in its entirety by this reference .
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IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date
first above written .
INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS
By:
Caroline D . Ginn , Chairman
BCC Approved : � 7
.{ 1 ,
Attest: J . K . Barton , Clerk
B z"
� 11 �t� ,° AlEL
Approved : ' ,
Jos ph A. Baifd
County Administrator
Appro as to form and legal sufficiency:
F , Assistant torney
RECIPIENT :
By: Quo
Big Brothers and Big Sisters of Indian River County
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EXHIBIT A
[Copy of complete proposal/application]
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a
Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
PROGRAM COVER PAGE
Organization Name: Big Brothers Big Sisters of Indian River County
Executive Director: Judi Miller E-mail : millerj@stlucie. kl2 . fl . us
Address: P . O . Box 547 Telephone: (772) 770-6000
Vero Beach, Florida 32961 Fax: (772) 466-5951
Program Director: Melodee Daniello E-mail : meldaniello@bellsouth . net
Address: 4131 South U. S . I . Building 2, #4 Telephone: (772) 466- 8535
Ft . Pierce, Florida 34982 Fax: (772) 466-5951
Program Title : t CSAC Jump Into Readin
Priority Need Area Addressed : Focus III-Child Care Access and Focus I-Mental Wellness Issues
Brief Description of the Program : (Taxonomy # PH 150 . 500- 10)+ "Jump into Reading" increases
mentoring and tutoring opportunities to build resiliency and literacy skills in young Indian River
County children with the help of caring adult volunteers who become mentors and role models . The
mentors encourage academic achievement, school success, enhanced emotional-social growth, school
attendance and healthy behaviors to help boys and girls improve their capacity of to succeed to
adulthood in a safe, healthy and productive manner .
SUMMARY REPORT — (Enter Information In The Black Cells Only)
Amount Requested from Funder for 2004 /05 : $ 50 , 000 . 00
Total Proposed Program Budget for 2004 /05 : $ 115 , 000 . 00
Percent of Total Program Budget : 43 . 5 °:�
Current Program Funding ( 2003 / 04 ) :
Dollar increase/ ( decrease ) in request : $ 50 . 000
Percent increase /( decrease ) in request * * : # DIV / Ol
Unduplicated Number of Children to be served Individually : 75
Unduplicated Number of : dults to be served Individually : 150
Unduplicated Number to be served via Group settings : -
Total Program Cost per Client :
* * If request increased 5 % or more, briefly explain why : Jump into Reading is a new program
for Children ' s Services Advisory Committee in Indian River County.
If these funds are being used to match another source, name the source and the $ amount : ,
The Organi nn a of Dire s has approved this a lic on date). 2 D
Paul Hio
Name of President/C air the Board Signature n n
Judi Miller tom-
Name of Executive Director/CEO Si afore
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Big Brothers Big Sisters of Indian River County, Jump Into Reading, Children's Services Advisory Committee
I. BUDGET FORMS
X 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . 16
X J. FUNDER SPECIFIC/ADDITIONAL SHEETS 25
X K. APPENDIX
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Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
c
ORGANIZATION : Big Brothers Big Sisters of Indian River County
PROGRAM : CSAC Jump into Reading
TABLE OF CONTENTS
Please 'X " the parts of the grant application to indicate that they are included. Also, please put the page number where the information
can be located.
X Section of the Proposal Pa e #
X TABLE OF CONTENTS (check list) I
X COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . 3
A. ORGANIZATION CAPABILITY (one page maximum)
X 1 . Mission and Vision of organization ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . 4
X 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . 4
B . PROGRAM NEED STATEMENT (one page maximum)
X 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . 5
X 2 . Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . 5
C. PROGRAM DESCRIPTION (two pages maximum)
X 1 . Funding priority . . , . . , , . , . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 6
X 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . 6 . . . . . . . 6
X 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . 6
X4 . Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
X 5 . Awareness of program , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
X 6 . Accessibility of program ' . . . . . . . . . . q . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . 7
X D . MEASURABLE OUTCOMES (two pages maximum) . . . . . . : . . . . . . . . . . . . . . . . . . 9
X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . 11
F. PROGRAM EVALUATION (two pages maximum)
X1 . Demographics . . . . . . . . . . . . I . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . .
. . * . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
X2 . Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
X3 . Reporting , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . .
. . I . . . . . . . . . . . . . . . . . . . . . . . 13
X G. TIMETABLE (one page maximum) 14
H. UNDUPLICATED CLIENT COUNT
X 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 15
X 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . 15
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Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
PROPOSAL NARRATIVE
Please respond to each question in the allotted space for each section . In responding to each section of
the proposal narrative, please retain the section-label and/or question that you are addressing. Type
using 12 pt . font on 81/z" X 11 " paper and number each page. These directions and the graphic boxes
may be deleted if space is needed.
A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page)
1 . Provide the mission statement and vision of your organization. The mission of Big
Brothers Big Sisters of Indian River County (BBBS) is to foster positive mentoring relationships
and bonding with caring adult volunteers so that children grow to be capable, confident,
productive, caring, responsible men and women who reach their full potential . The agency ' s
vision is to achieve the promise of mentoring through school-based "matches" that build
resiliency and literacy skills in children while combating risky behaviors resulting in early
educational failure, increased drop-out rates, substance abuse, mental health issues, gang
participation, early and persistent antisocial behavior, delinquency, truancy and teen pregnancy .
2 . Provide a brief summary of your organization including areas of expertise,
accomplishments, and population served . BBBS is a structured mentoring program intended
to improve the capacity of children in Indian River County to succeed to adulthood in a safe,
healthy and productive manner. It is based on the Social Development Strategy Model that is
goal oriented toward the development of healthy behaviors, communication of healthy beliefs
and clear standards, bonding, social and emotional growth, opportunities to contribute, learning
skills and recognition . Primary prevention services are provided through school-based
mentoring . Expertise in volunteer recruitment, background screening, interviewing, assessment,
training, matching, one-to-one mentoring, case management, program evaluation and family
literacy enables the Agency to consistently achieve its goals and objectives. Volunteers undergo
a careful screening process, orientation and training prior to being matched, followed by ongoing
supervision and support . Matches meet weekly in two, thirty-minute sessions on school grounds,
during the school day . Regular contact is maintained among the Case Managers, volunteers,
schools and clients . Goals are set with the help of stakeholders. All aspects of the program are
governed by Big Brothers Big Sisters of America (BBBSA) Standards of Service. These are
nationally adopted, strict standards to ensure BBBS agencies are providing a quality, research-
based mentoring service. BBBS is outcome-based and has been acknowledged for its ability to
promote bonding, healthy beliefs, clear standards, positive attitudes and academic results by
reputable researchers such as Public Private Ventures and CTC Prevention Strategies: A
Research Guide to What Works. Big Brothers Big Sisters has a track record of local, state and
national success. The Governor' s Mentoring Initiative has just completed a statewide study of
mentoring outcomes indicating that Florida BBBS clients have shown marked improvement in
reading, math and conduct as compared with non-mentored students �Grise, Florida State
University, 2003 ) . Our target population includes Kindergarten, I " and 2n graders from varied
ethnic backgrounds . Volunteers also come from diverse backgrounds relative to age, ethnicity
and gender,
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Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page)
1 . a) What is the unacceptable condition requiring change? Every child ' s future depends on
his ability to read, write and build relationships . But too many children, in Indian River County,
start Kindergarten, 1 " and 2nd grades at a disadvantage, hindered by a lack of readiness skills and
poor socialization skills. b) Who has the need ? The target population includes 75 students
enrolled in Kindergarten, l � or 2nd grades. The schools will be selected by the Superintendent
and the Director of Elementary Curriculum based on the number of students on Free & Reduced
lunch, the percentage of children performing at Levels 1 & 2 on FCAT, absenteeism rates and
the number of discipline referrals. Clients are referred by their teachers based on need and a
mentor' s ability to make a positive impact. Teachers refer children when they begin
demonstrating reading problems, early academic failure, low motivation for education and risk
factors such as poor self- esteem, lack of bonding, excessive absences and/or anti- social behavior.
Despite their young age, children are already struggling socially and academically. Members of
the target population are frequently eligible for free or reduced lunch. Eligibility guidelines are
worded carefully to avoid duplication of services for clients who are already receiving assistance
through Exceptional Education or Federal Programs . c) Where do they live? They live in
neighborhoods characterized by economic and social deprivation such as areas in the 32948 and
32967 zip codes. d) Provide local, state, or national trend data, with reference source, that
corroborates that this is an area of need. Local statistics show that 40% of Indian River
County ' s elementary school children are considered "economically needy" as compared to the
statewide average of 44 . 6%. However, rate of growth in the number of impoverished children in
the county exceeds state and peer counties . Research reveals that students living in poverty are
more likely to develop problems linked to school failure, health, delinquency and teen pregnancy
(St. Lucie Hand-in Hand, 14). A high percentage of IRC adults (22%) have very limited literacy
skills leaving their children with minimal exposure to books, words and the support they need, at
home, to help them read effectively. (Florida Literacy Data & Statistics Reference) . Data
elicited confirms concerns over academic achievement in 2003 -04 . Poverty, illiteracy and
excessive absences have led to academic failure as confirmed by 34% of the 3rd graders who
score at level 2 or below on the FCAT thus indicating limited success with challenging content in
2004 . Of particular concern is the apparent achievement gap evident in minority students where
60% of the African American students and 65% of the Hispanic students scored at levels 1 or 2 .
2. a) Identify similar programs that are currently serving the needs of your targeted
population ; Other mentoring programs, available in Indian River County, include: Youth
Guidance, RSVP, Community Church, Gifford Youth and Take Stock in Children. However,
Youth Guidance does no school-based mentoring and the other programs target older children.
Next year, Big Brothers Big Sisters will be starting an AmeriCorps Indian River Reads program
in conjunction with this current proposal . We have also implemented a BISS "Jump into
Reading" program, funded by Department of Education and BBBSA, during the 2003 -2004
school year at Thompson, Highlands and Fellsmere Elementary . " b) Explain how these existing
programs are under-serving the targeted population of your program. Indian River
mentoring programs tend to target older elementary, middle and/or high school children.
Despite the presence of 75 mentor relationships in the State funded Jump program and the 100 to
be served by AmeriCorps next year, the school district has asked our agency to serve an
additional 3 schools. This, along with the gap referenced in the Community Needs Assessment,
indicates that we are currently underserving our target population.
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• Big Brothers Big Sisters of Indian River County, Jump Into Reading, Children's Services Advisory Committee
co PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages)
1 . List Priority Needs area addressed. Focus III-Childcare Access and Focus I-Mental
Wellness Issues.
2. Briefly describe program activities including location of services. (Taxonomy # PH
150 . 50040+) Big Brothers Big Sisters provides role models for young children in Indian River
County who are at risk. Jump into Reading mentoring program is school-based . It revolves
around one-to-one reading mentoring to promote school success, improve literacy and increase
socialization skills . Mentoring services are generally delivered in the media center; however,
volunteers have the option of working in the classroom. Activities related to mentoring and
family literacy services involve: client referral from teachers; parent permission; client interview;
pre-testing; volunteer recruitment; background screening; volunteer training to promote best
practices in mentoring that support the social development strategy model ; one-to-one
mentoring ; case management with volunteers, clients, teachers and parents to promote school
success and healthy lifestyles ; family literacy; post-testing; evaluation & assessment ;
reassessment of need; client satisfaction survey; case closure ; referral and follow-up . Intended
outcomes revolve around on-grade level promotion, enhanced literacy skills, academic
improvement, consistent school attendance, increased self-esteem, enhanced emotional- social
skills and the ability to build positive relationships to promote healthy lifestyles and increased
resiliency .
3. Briefly describe how your program addresses the stated need/problem. Describe
how your program follows a recognized "best practice" (see definition on page 12 of the
Instructions) and provide evidence that indicates proposed strategies are effective with
target population . Mentors make a commitment to be a dependable, steady presence in a child ' s
life. They meet with their student, one hour per week in two , 30 minute sessions and provide
protective factors that help build resiliency and limit exposure to risks . Time together is spent
building a relationship, reading aloud, responding appropriately to a child ' s reading, promoting
writing, praising efforts and making reading fun ! Mentors learn to build personal connections to
books to promote academic success . They are urged to make stories come alive and share related
experiences that can broaden the child ' s world of knowledge . Volunteers reinforce the
association between oral and written language while emphasizing good attitudes about learning .
Mentors utilize Book Buddies activities to reinforce phonemic awareness, phonics, fluency,
vocabulary and comprehension . This source was designed for volunteer use and is based on a
balanced reading approach adopted at the state level by Department of Education. Each match
session includes work with familiar books, word study (word bank, alphabet basic phonics and
phonemic awareness), writing and new books. Keep-It Books are sent home with the student on
a weekly basis. Parents are encouraged to read aloud with their children at home to reinforce
reading skills . The Case Managers supervise and support matches; assist in ongoing goal setting;
monitor school performance; expedite other referrals when appropriate; and act as a facilitator
among key stakeholders . Follow-up continues on a bi-monthly basis for a period of 8 months
after they have exited . Big Brothers Big Sisters (BBBS) is a structured mentoring program that
has been acknowledged, as a "best practice", by such reputable independent researchers as
Public Private Ventures ( 1994, 1996, 1999) and Communities That Care Prevention Strategies:
A Research Guide to What Works, 1996 for its ability to promote healthy beliefs, clear
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' Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
standards and bonding. According to these resources, BBBS mentors help fight risk factors such
as early academic failure, lack of commitment to school, alienation, rebelliousness, early and
persistent anti-social behavior and early initiation of problem behavior. Resiliency research — the
study of youth who have "beaten the odds" — points to the presence of a caring adult as the
pivotal reason why children who should have succumbed to deleterious life circumstances
instead thrive as a result of mentoring (Public/Private Ventures, 1999) . Empirical reading
research supports the use of Book Buddies, with volunteers, as significant improvement has been
demonstrated with emergent and early readers (Morris, Shaw & Perney, 1990 ; Juel, 1991 &
1996 ; Invernizzi et al. , 1997 ; Wasik, 1997) . Studies indicate that the best results are achieved
when students are identified early and enrolled in prevention programs in primary school before
they have a chance to fail (Farrington, 1991 ) . "Reading Buddies" places a strong emphasis on
early prevention targeting Kindergarten through 2nd graders .
4. List staffing needed for your program , including required experience and estimated
hours per week in program for each staff member and/or volunteers (this section should
conform with the information in the Position Listing on the Budget Narrative Worksheet) .
Staff includes an Executive Director (8 hrs), a Case Manager (40 hrs), an AmeriCorps Case
Manager ( 10 hours) and a Volunteer Recruiter ( 10 hours) . Case Managers must have a minimum
of a Bachelor' s Degree in Social Work (BSW) or related field with experience in social work or
education. A Master' s Degree is preferred for the Executive Director. The Volunteer Recruiter
must have a minimum of an Associates Degree with experience in public relations, marketing
and sales.
5. How will the target population be made aware of the program ?
The target population includes teachers, 75 children, 75 parents and approximately 75 volunteers
(some mentors provide a 1 -to 1 match with more than one child . ) Teachers are given
an
orientation in the Spring of each year as they are a critical part of the referral process . Outreach
to new teachers is done at the start of school . Parents are informed about our program through a
letter sent by the school . When necessary, there is follow-up by the teacher or a school social
worker. Parents complete an application/release form and return it to the school. Contact is then
made by the BBBS Case Manager. The children are interviewed on the school grounds by
BBBS staff. Pre-testing is done just prior to matching . Volunteers are recruited through
corporations, city and county government, small business, clubs, civic organizations, state
agencies, fund raisers, churches, condo associations and retirement communities . Big Brothers
Big Sisters also builds collaborative relationships with businesses and other non-profits such as
RSVP to increase our visibility and help us better serve the target population .
6. How will the program be accessible to target population (i. e., location, transportation ,
hours of operation) ? Our program is highly accessible to the target population . Services will
The Director of Elementary Curriculum is currently choosing the three schools to be served
through this funding source, based on need relative to FCAT results. Transportation is not an
issue as mentoring is offered during the school day on campus. Client referral and scheduling are
at the teacher' s discretion . This valuable tutorial/mentoring service is provided at no cost to the
school or parent. Ease of accessibility, case manager support and capable, trained volunteers
keep the referrals coming and the parents satisfied with the service.
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Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
D. MEASURABLE OUTCOMES (Description of Intent)
Use the Measurable Outcomes form. This descri tion aa e does not need to be included in the proposal.
In order to show the impact that your program is having on the target population and the
community, the funders are requiring measurable outcomes. Please review the examples and
summaries below to insure your understanding of what is expected .
OUTCOMES : Describes what you want" to achieve with the target population . Indicates the
results of the services you provide, not the services you provide. Outcomes utilize action words
such as maintain, increase, decrease, reduce, improve, raise and lower.
ACTIVITIES : Describes the tasks that will be accomplished in the program to achieve the
results stated in the outcomes. Activities utilize action words such as complete, establish, create,
provide, operate, and develop . The activities should reflect the services described in the
PROGRAM DESCRIPTION (C2).
Use the following elements to develop your outcomes. All elements must be included:
Direction of change • Time frame
• Area of change • As measured by
• Target population • Baseline : The number that you will be
• Degree of chane measuring against
Example 1 (Outcome) :
To decrease (direction of change) number of unexcused absences (area of change) of enrolled
boys and girls (target population) by 75 % (degree of change) in one year (time frame) as
reported by the 2003 School Board attendance records (as measured by) . Baseline : 2003 School
Board attendance records for enrolled boys and girls .
Example 1 (Activity) :
To provide anger management classes to enrolled boys and girls 2 times a week for 12 weeks .
Example 2 (Outcome) :
75 % (degree of change) of youth (target population) who have participated in the academic
enrichment activities (as measured by) for 6 months or more (time frame), will improve
(direction of change) their scores in one or more subject area (area of change) . 25 % of
participants in academic enrichment activities will maintain the initial level of performance
assessed at entry . Baseline : Pre-test scores from the academic enrichment test.
Example 2 (Activity) : '
1 ) Provide pre and post-test exercises on the Advanced Learning System software; 2)
Participants will go through the one lesson per week and be graded for 10 weeks .
IMPORTANT NOTE :
Keep in mind when developing your PROGRAM OUTCOMES, that if funded, this will be what
you are held accountable to accomplish . Also, the PROGRAM OUTCOMES should reflect the
information described in the PROGRAM NEED STATEMENT (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 that are going to
influence the outcome and impact the unacceptable condition in your Program Need Statement.
8
• Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages)
OUTCOMES ACTIVITIES
Add all of the elements or the Measurable Outcomes) Add the tasks to accomplish the Outcomes)
1 . 85 % of the youth who have participated in To recruit qualified mentors. To complete
reading mentor activities for 6 months or more background screening, interview and
will be promoted to the next grade level by assessment . To obtain client referrals and
June, 2005 . Baseline: 2004-2005 IRC School parent permission. To interview and pre-test
Board promotion/retention records for enrolled clients . To develop a case plan for each client
boys and girls. documenting needs, goals and action plans to
be reviewed on a quarterly basis . To match
mentors and clients. To provide 1 to 1
mentoring sessions, one hour weekly in two,
30 minute intervals to 75 children . To utilize
the social development strategy in emphasizing
individual characteristics, opportunities to
contribute, learning skills, recognition,
bonding, communication of healthy beliefs &
clear standards and healthy behaviors . To
review daily mentoring log to verify weekly
visits with the mentor. To provide quarterly
training opportunities for volunteers. To
complete match supervision calls regarding
frequency and quality of the match
relationships . To document progress of match
in case notes . To collect all report card
information through IRC Schools . To evaluate
progress throughout the year and document
promotion status. To document grades,
conduct, attendance and promotion status . To
conduct anonymous satisfaction surveys ;
results reported to and discussed with staff and
outside agencies. To close cases where
students have achieved their goals and service
is no longer necessary. To follow-up over a 9
month period with terminated clients to
determine the long-term impacts of mentoring .
2 . 80% of the youth who have participated in To administer pre and post testing utilizing
reading mentoring activities for 6 months or DIBLES (Dynamic Indicators of Basic Early
more will improve reading performance in one Literacy Skills). Also see activities listed for
or more areas of the DIBLES by June, 2005 . Outcome 1 .
Baseline: pre-test scores from the reading
achievement instrument for 2004 — 2005
school year.
9
Big Brothers Big Sisters of Indian River County, Jump Into Reading, Children's Services Advisory Committee
3 . 85 % of the youth who have participated in To complete the FOAR (pre and post survey)
reading mentoring for 6 months or more will assessing grades, attendance, discipline and
improve performance in one or more areas of socialization skills with the assistance of the
the Florida Outcome Assessment Report teachers, mentors, parents and children. Also
regarding grades (by a minimum of one grade see activities listed for Outcome 11
level) , attendance (by a minimum of 15 % on
unexcused absences), conduct and/or
socialization skills (by a minimum of one
grade level) by June, 2005 . Baseline: FOAR
pre-test scores for 2004 — 2005 school year.
10
Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
E. COLLABORATION (Entire Section E not to exceed one page
1 . List your program ' s collaborative partners and the resources that they are providing to
the program beyond referrals and support. (See individual funder requirements for
inclusion of collaborative agreement letters.
Collaborative Agency Resources provided to the program
Provides space for Advisory Board Meetings and
Our Savior Lutheran Church Orientation sessions.
Treasure Coast Builder' s Association Facilitates a year long campaign for mentors and money .
Provides periodic fund raising events at the restaurant on
Mulligan ' s Restaurant behalf of Big Brothers Big Sisters of Indian River
County.
ComCast Organizes an annual book drive
Education Foundation of Indian River Provides books for the reading mentors to use at the
County school sites
School Board of Indian River County Provides space for mentors. Furnishes referrals and
report card information on each client .
Produced TV cause related marketing commercials for
John Kennedy our reading mentor programs.
Retired Senior Volunteer Program Recruits mentors
Dodgers Provides baseball tickets for books read with mentor
Has agreed to promote our literacy effort through one-
Junior League day action projects .
Literacy Services of Indian River Initiate planning with Literacy Service to form Family
County Literacy Coalition
� 1
Big Brothers Big Sisters of Indian River County, Jump Into Reading, Children's Services Advisory Committee
F. PROGRAM EVALUATION (Entire Section F not to exceed two pages)
1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order
to accurately describe your target population including demographics (age, gender, and
ethnic background) required by the funder in Section H? The Case Manager will be
responsible for gathering, entering and updating demographic data on a daily basis using an
Excel spreadsheet . Data elements to be tracked include name; social security number; address ;
zip code; telephone number; age ; gender; ethnic background; dates regarding inquiry, interview,
match, and closure for every parent, child and volunteer. This will allow management to track
quality issues such as volunteer yield rates, length of match, premature match closure rates, costs
per match, match closure rates and processing time. Note: a separate database will be
maintained on each reading mentor program to document unduplicated count. All participants
will sign a CSC Release form granting permission for basic information to be used in program
tracking. What are the pieces of information that qualify them for your target population ?
Clients in Kindergarten through second grade are qualified to become a part of our target
population based on reading difficulties, socialization issues and/or high absenteeism . The
child ' s classroom teacher documents the need for service, in writing, on a referral form. The
Case Manager records baseline data regarding grades, attendance, conduct, and socialization
skills on the FOAR (Florida Outcome Assessment Report). She also completes an assessment
that details need for service or the `unacceptable condition requiring change" . Any student
seeking to participate in the Jump into Reading program for more than one year, must
demonstrate progress but continue to show need when baseline data is compared to year end
statistics on reading grades, attendance, conduct, socialization skills and pre and post diagnostic
test results.
2. MEASURES : What data elements will you need to collect to show that you have
achieved (or made . progress toward) your Measurable Outcomes in Section D ? What tools
or items are you using as measures (grades, survey scores, attendance, absences, skill
levels) for your program ? Are you getting baseline information from a source on your
Collaboration List in Section E ? Are there results from your Activities in Section D that
need to be documented ? How often do you need to collect or follow-up on this data ? Pre and
post testing, using the DIBLES (Dynamic Indicators of Basic Early Literacy Skills) will be
completed by Case Managers upon initiating a match and at year-end to evaluate reading
progress. In schools where DIBLES is currently being used, scores will be shared as per signed
agreement . This instrument helps Case Managers monitor progress in reading growth . There are
five measures that are administered including : initial sound fluency, letter naming fluency,
phoneme segmentation fluency, nonsense word fluency and oral reading fluency . FOAR
(Florida Outcome Assessment Report) is a statewide survey developed in cooperation with Big
Brothers Big Sisters of Florida. The instrument is based on research provided by our National
organization and the Search Institute. It measures outcomes in the areas of literacy, grades,
attendance, behavior, promotion and socialization skills as rated by teacher, child and Case
Manager opinions. Information on grades, attendance and behavior is also collected at the end of
the I '% 2nd, 3 `d and 4th quarters via report cards. Data will be evaluated as a whole and then
transferred to each child ' s individual case file. A satisfaction survey for Jump into Reading will
also be distributed at year-end as a means of identifying programmatic strengths and/or concerns .
After termination, each client will receive a nine-month follow-up call to determine the long-
term impact of mentoring services. This information will be tracked on an Excels read sheet and
12
Big Brothers Big Sisters of Indian River County, Jump Into Reading, Children's Services Advisory Committee
incorporated into the program evaluation report . Rematch rates will also be calculated to rate
customer satisfaction.
3. REPORTING: What will you do with this information to show that change has
occurred ? How will you use or present these results to the consumer, the funder, the
program , and the community? How will you use this information to improve your
program ? Program goals and measurable outcomes have been established in order to determine
the overall effectiveness of our program. A comprehensive assessment system has been designed
to evaluate the extent to which outcomes related to promotion, reading skills, attendance, grades,
behavior and socialization have been achieved . Children' s reading skills are measured through
the use of pre and post testing . Additional documentation on grades, attendance, behavior and
socialization skills is gained from a pre and post survey completed with the help of the classroom
teacher and volunteer. Data is analyzed using SPSS , a statistical analysis software package.
Year-end statistics on every client are recorded and then compared with their baseline data to
determine the effects of mentoring on academic success, truancy and socialization. Data is
disaggregated by gender, ethnicity, age and family structure to determine the effects of
mentoring unique to subgroups . The overall significance of the results is considered .
Programmatic adjustments are made accordingly relative to feedback and outcome information.
Satisfaction surveys are distributed to all stakeholders to determine the impace of service on our
customers .
Evaluative information is communicated internally to the Board, Advisory Board, program
manager and staff. Externally it is shared with the appropriate stakeholders including all funders,
public officials, schools, community leaders, volunteers, corporate partners, supporters, other
community providers, and media. Big Brothers Big Sisters of America has committed to make a
difference for children by helping their affiliated agencies become data-driven, research-based,
coordinated and focused on outcomes. Their intent, like Children' s Services Committee, is to
ensure that BBBS service reaches program goals and promotes meaningful changes in the lives
of our clients . At the national level, they have completed an impact study utilizing nationally
recognized, independent evaluators through Public Private Ventures to determine best practices
in school and community-based mentoring . Evaluation findings have been integrated into local
agency policy and procedures thereby developing opportunities for systemic improvement in
program management and outcomes . National standards and procedures promote quality
assurance through local program audit performed by the Board ' s Program Committee. This
involves an annual review of record keeping . BBBSA also evaluates all their affiliates on a five-
year cycle. Case files are reviewed every 6 months by the Program Manager to verify that
national standards of practice are being met regarding service, time spent with clients, and
contacts with family. Signed consent forms are also reviewed along with other necessary
documentation such as law enforcement checks, background checks, reference and releases.
Personnel working in the program are professionals whose qualifications and experience afford
them the best opportunity to impact our clients. Annual in- service training is required .
Internally, staff meetings are held on a monthly basis and focus on program development and
quality assurance issues. Factors such as outcome data regarding client goals, coordination of
service, level of client satisfaction and family participation are reviewed. Year end goals and
outcomes have been attained in all school-based mentoring efforts over the past four years ,
13
• Big Brothers Big Sisters of Indian River County, Jump into Reading, Children's Services Advisory Committee
G. TIMETABLE (Section G not to exceed one page)
1 . List the major action steps, activities, or cycles of events that will occur within the
program year. New programs should include any start-up planning that may occur
outside the funding year. In completing the timetable, review information detailed in
prior sections.
Month/Period Activities
1 " Week Inquiry calls are received from Volunteers and Parents . Orientation is
scheduled .
2nd Week Orientation occurs . Volunteers fill out application and complete
background screening. Simultaneously, the school selects students who
need the service and sends home application/release forms to be signed
and returned by parents .
Weeks 3 — 5 Reference and background screening results are returned . Volunteers
receive a volunteer interview. Preferences and schedules are
determined . Simultaneously, the Parent applications/release forms are
returned and the clients receive a child interview at the school as well
as pre-testing. Assessments are completed, baseline data is recorded
and decisions about potential matches are made.
Week 5 Mentor and Reading Trainings are given . Case Manager completes a
case plan with input from all parties.
Week 6 The Mentor is invited to the school . The Case Manager reviews school
rules and introduces the mentor to the child and his/her teacher. The
Case Manager shows both parties materials and location they will meet .
Case Manager reviews the goals in the case plan. The Case Manager
spends the first thirty-minute session together with both match parties.
Week 8 Within the 1 '` two weeks of the match, the Case Manager contacts the
mentor, child and teacher for the purposes of supervision and support.
Thereafter, supervision is once per month if by telephone and a
minimum of by-monthly if in person .
Quarterly Assessment of grades and FOAR is completed .
April Volunteer Appreciation Event is held.
May Post-testing is done . Data is recorded and compared with baseline
information.
On-going 9 month follow-up is done with clients who have been terminated to
determine long-range benefits of service
14
Big Brothers Big Sisters of Indian River County, Jump Into Reading, Children's Services Advisory Committee
H. PROJECTIONS FOR UNDUPLICATED CLIENTS
Number of Unduplicated Clients by Location
i. Current Fiscal Year
LocationBudget 2003/04
� +` . tri■
Unduplicated Clients Unduplicated Clients Unduplicated Clients
N. Indian River County - - 113
S , Indian River County - - 112
Indian River Co. Total - - 225 ,
Greater Stuart - -
Hobe Sound - - -
Indiantown - - -
Jensen Beach - - -
Palm City
Martin County Total - - -
Fort Pike
Port Saint Lucie - -
St. Lucie Co. Total
Other Locations
TOTAL SERVED - - 225
Number of Unduplicated Clients by Age
,r q Current Fiscal Year p
Location
Budget 2003/04 b l
III
�. WITire
s z d Individuals GroupiUrZ
$1<s
0 to 4 - (Pre-school) - - - - -
5 to 10 - (Elementary) - - - - 75 -
11 to 14 - (Middle) - - - - - -
15 to 18 - (High School) - - - - - -
fatal Children - - - - 75 _
19 to 59 - (Adults) - - - - 100 -
60 + (Seniors) - - - - 50 -
Total A alts - - - - 150 -
TOTAL SERVED - - - - 225 -
15
Type the Organization and Program Name
UNIFORM GRANT APPLICATION
BUDGET NARRATIVE WORKSHEET
IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for
your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder
Specific Budget Forms.
AGENCY/PROGRAM NAME : Big Brothers Big Sisters -- CSAC Jump into Reading
FUNDER : Children ' s Services Advisory Committee
CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should
Lbe used for calculations and to write information only.
" ' " Proposetal Program Funder Speck. TotalA
,, en
REVENUES Y d To
g
PHM „°E`er" ' Buddet ; Budget Budget
1 Children's Services Council-St. Lucie 168 434,pp
2 Children's Services Council-Martin
3 Advisory Committee-Indian River 501000.00 500000.00 500000. 00
4 United Way-St, Lucie County 851000.00
5 United Way-Martin County
6 United Way-Indian River County
7 Department of Children & Families
8 County Funds
9 Contributions-Cash 25,000.00
10 Program Fees
11 Fund Raising Events-Net 809000.00
12 Sales to Public - Net
13 Membership Dues
14 Investment Income
15 Miscellaneous
16 Legacies & Bequests
17 Funds from Other Sources 65,000.00 0.00 2671000.00
18 Reserve Funds Used for Operating
19 In-Kind Donations (Not included in total) 80,000.00 802000.00 440,250.00
20 TOTAL REVENUES
(doesn't include tine 19) $115 ,000.00 $50,000.00 $675,434 .00
A B C . . . B
E7CPENDlTURES crwY Aroma Faa Proposed Total Program Funder Specelc Total, Agency
AGENCY UBE ONLY
c.Lwu Budget ''Bud et Bud of .
21 Salaries - (must complete chart on next page) 902500.00 45,500.00 497, 204 .00
o
of 7
Salary
22 FICA - Total salaries x 0.07657:65% 6,923.00 3. 480 . 75 389036.00
23 Retirement - Annual pension for qualified staff 0,00
24 Life/Health - MedicaVDentaVShort-term Disab. 0 . 00
25 Workers Compensation - # employees x rate 11177.00 591 .00 61464.00
Florida Unemployment - # projected
26 lemployees x $7,000 x UCT-6 rate 0"00
SALARIES A Gross Annual B G Funder ;
POSITION LISTING Salary Portion of Salary on Proposed 5peclHc Bu et of Gross Annua!
POsitlon 77GB1 Totef Hi'SI4V/C (Agency) Program "� salary Requested(C/A)
l �o
Type the Organization and Program Name
e: Exett ftW D1recforf4Q'hYs70,000:00 1D,OOD 00" " 6,000,00 7. f4A
Executive Director/40 hrs. 41 ,200.00 8,000.00 80000.00 19 . 42 °,
Program Manager/40 hrs. 32,618.00 0.00 0.00 0 . 00°x.
Case Manager/40 hrs. 25,000.00 25,000.00 25,000.00 100 . 00%
Case Manager/40 hrs. 300552.00 0.00 0.00 0 .00%
Case Manager/40 hrs. 279500.00 0.00 0.00 0 .00 ,
Case Manager/1 0 hrs. 61250.00 0.00 0.00 0 . 00
Senior Case Manager (Core)/20 hrs. 15,520.00 0.00 0.00 0700°,
Case Manager/20 hrs. 15,392.00 0.00 0.00 0. 00%
Case Manager20 hrs. 14,458.00 0.00 0.00 0. 00
Group Mentoring Facilitator/15 hrs. 120145.00 0.00 0.00 0 .00%
Counselor/30 hrs. 26,971 .00 0.00 0.00 0 . 00';4
AmeriCorps Program Manager/40 hrs. 340000.00 56000.00 0.00 0 ,00%
AmeriCorps Case Manager/1 0 hrs.-IRC 61250.00 6,250.00 6,250.00 100. 00%
AmeriCorps Case Manager/10 hrs.-SLC 71545.00 0.00 0.00 0. 0004,
Case Manager/40 hrs. 259750.00 000 0 ,000i,
Volunteer Recruiter/40 hrs. 25,794.00 0.00 0.00 0.00%
Volunteer Recruiter/10 hrs. 61250.00 61250.00 60250.00 100.00%
Secretary/bookeeper/6 hrs. 51252.00 0.00 0.00 0 .00%
Case Manager26 hrs. 16, 100.00 0.00 0.00 0. 0 %
AmeriCorps Living Stipends 100,846.001 4OV000.001 0.001 0.00°,
Remaining positions throughout the agency 21 ,811 .00
Total Salaries $497,204. 001 $90,500.00 $45,500.00 9 . 151-:
Fk111%GE E�1lE) DETAIL: A
(FunderSpreCIC Budget " rurrde�' B ° v E F a
Pension Work
unemp/oyme Tota/ Fringes Funder
COIU/li/2 C Oh ft'ona Ah- 22, td 27 spec/flc FICA 7 m k/eafth Ins
:17 .- , " Budgei %) Comperes of Canpens Spec
(A x c".
tti
PoslSon Tette %Iotal HtMv
Example:
ca" bIa►NxjerC40 his : . 6, 000.00 382: 50 200 00 " 500 00 300.00 . 200.00 . 58ZSO
Executive Director/40 hrs. 8 ,000.00 612 . 00 104.00 716 . 00
Program Manager/40 hrs: 0. 00 0 .00 O, OC
Case Manager/40 hrs. 25 , 000. 06 1 ,912 . 50 325. 00 2 . 237. 56
Case Manager/40 hrs . 0. 00 0. 00 O.Gr,
Case Manager/40 hrs . 0. 00 0 . 00 O. 00
Case Manager/10 hrs . 0. 00 0. 00 O .CC
Senior Case Manager (Core)/20 hrs. 0 .00 0 .00 0 .0 .
Case Manager/20 hrs. 0.06 0.00 0.0
Case Manager/20 hrs . 0 . 00 0. 00 0.0
Group Mentoring Facilitator/15 hrs . 0. 00 0 . 00 0.00
Counselor/30 hrs. 0. 00 0. 00 O ,OC
AmeriCorps Program Manager/40 hrs, 0. 00 0. 00 0 .00
AmeriCorps Case Manager/10 hrs.-IRC 6 ,250.00 478. 13 81 .00 559. 13
AmeriCorps Case Manager/10 hrs. -SLC 0. 00 0. 00 0.00
Case Manager/40 hrs. 0.00 0. 00 OAO
Volunteer Recruiter/40 hrs . 0 .00 0. 00 0 .00
Volunteer Recruiter/10 hrs. 6,250. 00 478. 13 81 .00 559. 13
Secretary/bookeeper/6 hrs. 0 . 00 O. GO 0.0
Case Manager/26 hrs. 0. 00 0 . 00 0. 0
AmeriC"Fun
Liing Stipends 0.00 0 .00 0. 0
Tor Request Fringe Benefits $45,500 .00 $3s480- 751 $0.001 $0. 00 $591 . 00 $0.00 $4 ,071 . 7IE
14
B C p
EXPENDITURES uuYrsrort Proposed Total Program Funder Specific Total Agency
k6ENCY USE ONLY TO
sN4woETµ BU , ev Budget Bualget
27 Travel-Daily t' 11885.00 0.00 139650.00
miles per wk, 2
# of Staff x average # of milesJwk x 50 wks x $ p•t 3125 x
= Estimated Daily Travel/Mileage Reimb. 29
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UNIFORM GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCYIPROGRAM NAME : 8BBS of Indian River Cou ICSAC Jump into Reading
PY 02101 FY 03104 FY 04/06 % INCREASE
FYE FYE FYE_12/31 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (ea CcaL BycoL B
REVENUES BUDGETED BUDGETED
i Children's Services Council-St Lucie 168,434. 00 #DMO !
2 Children's Services Council-Martin 0 .00 #DIV/01!
3 Advisory Committee-Indian River 50 ,000.00 #DIV101
4 United Way-St Lucie county 85.000 .00 #D1V10 !
6 United Way-Martin County 0 .00 #DIVIO!
6 United Way-Indian River County 0 .00 #DIV/O!
7 Department of Children & Families 0.00 #DIV/0!
8 County Funds 0.00 #DIV/0!
s Contributions-Cash 25,000 .00 #DIVIO!
10 Program Fees 000 #DIVIO!
11 Fund Raising Events-Net 80 ,000.00 #DIVIO!
12 Sales to Public-Net 0.00 #D!V/0!
13 Membership Dues 0.00 #DIVIO!
14 Investment Income 0.00 #DIV/01
is Miscellaneous 0 .00 #DIVIOI
1s Legacies & Bequests 0.00 #DIVIO!
17 Funds from Other Sources 267 .000 .00 #DIVIO !
1s Reserve Funds Used for Operating 0.00 #01\110 !
is In-Kind Donations (t&* harte.dintate ) 440 ,250 .00 #DIVIO !
20 TOTAL 0.00 0.00 675434.00 #DIVIO !
EXPENDITURES
21 Salaries 497 ,204.00 #DIV10!
22 FICA 38 ,036.00 #DIV/O!
23 Retirement 0.00 #DIVIO!
24 Life/Health 0.00 #DIV10!
26 Workers Compensation 6 ,464.00 #DIVIO !
21; Florida Unemployment 0.00 #DIV/0!
27 Travel-Dail 13,650 .00 #DIV101
28 Travel/ConferencestTrainin 1 ,000.00 #DIVIO !
29 Office Supplies 12 .000.00 #DIV10!
3o Telephone 5.400 .00 #DIVIO !
31 Postage/Shipping 41200 .00 #0111//0 !
32 Utilities 31600.00 #DIV/O !
33 Occupancy Buildin & Grounds 8.000 .00 #DIV/0 !
34 Printina & Publications 11000 .00 #DIVIOI
36 Subscription/Dues/Memberships 13 ,451 .00 #DMO !
36 Insurance 20,507.00 #DIVIO!
37 Equipment: Rental & Maintenance 4,600.00 #DIVIO !
38 Advertising 1 ,500 .00 #DIVIO !
35 Equipment Purchases:Ca ital Expense 8 ,500 .00 #QIV/O!
40 Professional Fees (Legal, Consulting) 1 ,000.00 #DIVIO!
41 Books/Educational Materials 21000 .00 #DIV/0 !
42 Food & Nutrition 2 .000 .00 #DIV/01
43 Administrative Costs 0 .00 #DIVIO !
44 Audit Expense 4,500 .00 #DIVIO !
46 Specific Assistance to Individuals 0 .00 #DIVIO !
46 Other/Miscellaneous 9,294.00 #DIVIO !
47 Other/Contract 18,028.00 #DIV/O !
49 TOTAL 0 .00 O.00 675,434.00 #DIVIO !
49 REVENUES OVER/ UNDER EXPENDITURES 0 .001 0 .001 0 .00 #DIVIO !
staa
20
Ty" Cr Org"*w ena ProQem r+enM
UNIFORM GRANT APPLICATION
• TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME: BBBS of Indian River Cou ICSAC Jump into Reading
FY 02103 FY 03/04 FY 04MG % INCREASE
FYE FYE FYE 12!31 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (col C- OL sycot B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0 . 00 #DIV10 !
2 Children's Services Council-Martin 0 .00 #DIV10!
3 Advisory Committee-Indian River 50 .000.00 #DIV/0!
4 United Wa St Lucie County 0.00 #DIV/01
I; United Way-Martin County 0.00 #DIV/0!
I; United Way-Indian River County 0.00 90IV/0!
7 Department of Children & Families 0.00 #DIV10!
s County Funds 0 .00 #DIV10!
s Contributions ash 0 .00 #DIV10!
to Pr " ram Fees 0 .00 #DIV10 !
ii Fund Raising Events-Net 0 .00 #DIV/0!
12 Sales to Public-Net 0.00 #DIV/0!
13 Membership Dues 0.00 #DIVIO!
14 Investment Income 0.00 #DIV10!
16 Miscellaneous 0 .40 #D(V/0!
is ;Reserve
es 8 uests 0 .00 #DIV/0!
17from Other Sources 65,000 .00 #DIV/0!
18 Funds Used for O ratin 0 . 00 #DIV/0!
13 Donations Ma wwkKiedintotaq 80 ,000.00 #DMO !
20 0.00 0.00 115.000.00 #DIVIO!
EXPENDITURES
21 Salaries 90 ,500.00 #DIVIO!
22 FICA 61923 .00 #DIV10 !
23 Retirement 0 .00 #DIV/01
24 Life/Health 0 .00 #DIV/0!
26 Workers Compensation 11177.00 #DIV10 !
26 Florida Unemployment 0.00 #DIVIO !
27 Travel-Dail 1 ,885.00 #DIVIO!
2s Travel/Conferences/Training 0.00 #DIV10!
2s Office Supplies 1 .584.00 #DIVIO!
3o Telephone 648.00 #DIV10 !
31 Postage/Shipping 500 .00 #DIV1O!
32 Utilities 480 .00 #DIV/0!
33 Occupancy Buildin & Grounds ) 1 ,056.00 #DIV/0!
34 Printing 8 Publications 500.00 #DIVIO!
36 Subscription/Dues/Memberships 15500.00 #DIV10 !
36 Insurance 2. 209.00 #DIV10!
37 E ui ment:Rental & Maintenance 500 .00 #DIVIO!
3s Advertising350,00 #DIViO!
33 Equipment Purchases:Ca ital Expense 0.00 #DIVIO !
4o Professional Fees (Legal, Consultin 0 .00 #DIV10!
41 Books/Educational Materials 21080.00 #0IV/0 !
42 Food $ Nutrition 500 .00 #DIV10!
43 Administrative Costs 0 .00 #DIVIO!
44 Audit Expense 671 .00 #DIV10!
45 Specific Assistance to Individuals 0.00 #DIV/0!
46 Other/Miscellaneous 11482.00 #DIV10!
47 Other/Contract 455.00 #DIV/01
48 TOTAL 0.00 0.00 115,000 .00 #DIVIO!
0 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.001 0 .001 #DIV10 !
Y�&0'
21
Type the organmanon and Program Name
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCY/PROGRAM NAME : BBBS of Indian River County/CSAC Jump into Reading
FUNDER : Children's Services Advisory A B C
FY 04105 FY 04/05 % OF
TOTAL FUNDER TOTAL VS,
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET (col. B/col. A)
EXPENDITURES
21 Salaries 901500 , 00 459500 . 00 50 ,28%
22 FICA 51923 . 00 31480 . 75 50 .28%
23 Retirement 0 ,00 0 , 00 # DIV/O !
24 Life/Health 0400 0 , 00 # DIV/01
25 Workers Compensation 11177 ,00 591400 50 . 21 %
26 Florida Unemployment 0 , 00 0 .00 #DIV/O !
27 Travel-Daily 11885400 0000 0. 00%
28 Travel/Conferences/Trainin 0 . 00 0 . 00 #DIV/0 !
29 Office Supplies 1 , 584 .00 0 . 00 0 , 00%
30 Telephone 648 .00 0400 0 . 00%
31 Postage/Shipping 500 .00 0 . 00 0 . 00%
32 Utilities 480 . 00 0 . 00 0 . 00%
33 Occupancy ( Building & Grounds 1 , 055 .00 0 . 00 0 .00%
34 Printing & Publications 500400 0 , 00 0 . 00%
35 Subscription/Dues/Memberships 19500 .00 0 . 00 0 .00%
36 Insurance 21209 . 00 0 . 00 0 . 00%
37 E ui ment: Rental & Maintenance 500 . 00 0 . 00 0 .00%
38 Advertising 350, 00 0 . 00 0 . 00%
39 Equipment Purchases : Capita I Expense 0 . 00 0 . 00 # DIxJ/0 !
40 Professional Fees ( Legal, Consulting ) 0 .00 0 . 00 # DIV/O !
41 Books/Educational Materials 29080 . 00 0 . 00 0 . 00%
42 Food & Nutrition 500 .00 0. 00 0 .00%
43 Administrative Costs 0 ,00 0 . 00 #DIV/0 !
44 Audit Expense 671 .00 0 . 00 0 . 00%
45 Specific Assistance to Individuals 0 .00 0 . 00 # DIV/01
46 Other/Miscellaneous 1,482 .00 42815 28 . 90%
47 Other/Contract 455 . 00 0. 00 0 .00%
48 TOTAL $ 115,000 . 00 $50 , 000 .00 43 .48%
5119AM
22
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME: BBBS of Indian River CourrtyICSAC Jump Into Reading
Children's Services Advisory Committee
5
#Drano!
#DrV/o!
#DIV/ol
#DIV/ot
#DIV/o!
#Dlvro!
#DIV/D!
#DIVro!
#DIV/0!
#DN/0!
#DIV/o!
#DrV/o!
#DIVro
#DIVro!
#DIVro!
#DIVro!
#DIV/0!
#Dn/ro!
#Dlvro!
#DNro!
#DIV/o!
#DIVro!
#Dlvro!
#DIVroI
#DlVio!
#DIVro!
#DIVro!
#DIVro!
#DIVro!
#DIVroI
#DIVro!
#DNro!
#DIVro!
#DIV/o!
#DIVro!
#DIVro!
Ivro!
#urV/o!
#D /o!
#DIVro!
#Drvro
#Div/o!
#DIv/0!
#DIV/D!
#DNro!
#DIVro!
23
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15%. OR MORE
FUNDER SPECIFIC BUDGET
AGENCYIPROGRAM NAME: BBBS of Indian River County/CSAC Jump into Reading
FUNDER: Children's Services Advisory Committee
QVIM
Salaries New program
FICA New pmgram
#DIV/o!
#DN/o!
Workers Compensation New program
#DIV !
#DN/o!
#DIVro!
#DIV/o!
#DIV/0!
#Dlv/o!
Other/Miscellaneous New program
snaa�
24
EXHIBIT B
[From policy adopted by Indian River County Board Of County Commissioners on February 19 ,
2002]
" D . Nonprofit Agency Responsibilities After Award of Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis
only.
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check . Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the
Board of Commissioners . In the event an agency provides inadequate documentation on a
consistent basis , funding may be discontinued immediately. Additionally, this may adversely
affect future funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example , no expenditures prior to October 1St may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners .
All requests for reimbursement at fiscal year end ( September 30th) must be submitted on a timely
basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies
advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early
to mid October, since the Finance Department does not process checks for the prior fiscal year
beyond that point .
Each reimbursement request must include a summary of expenses by type . These summaries
should be broken down into salaries , benefits , supplies , contractual services , etc . If Indian River
County is reimbursing an agency for only a portion of an expense (e . g . salary of an employee ) , then
the method for this portion should be disclosed on the summary. The Office of Management &
Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures . These expenditure types are
listed below.
a . Travel expenses for travel outside the County including but not limited to ; mileage reimbursement,
hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel
(within Indian River County) is allowable .
b . Sick or Vacation payments for employees . Since agencies may have various sick and vacation
pay policies , these must be provided from other sources .
c. Any expenses not associated with the provision of the program for which the County has awarded
funding .
d . Any expense not outlined in the agency's funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary. "
- 1 -
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices : Any notice , request, demand , consent , approval or other communication required or
permitted by this Contract shall be given or made in writing , by any of the following methods :
facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier
service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the
addresses of the parties shown below:
County: Joyce Johnston -Carlson , Director
Indian River County Human Services
1840 25" Street
Vero Beach , Florida 32960-3365
Recipient : Judi Miller, Executive Director/CEO
Big Brothers Big Sisters of Indian River County
P . O . Box 547
Vero Beach , Florida 32961
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 -
Sent By : John L Kirby $ Associates Inc . ; 904 387 9270 ; Oct - 14 - 04 12 : 39PM ; Page
2 / 2
,q�Ra� CERTIFICATE OF LIABILITY INSURANCE pp DATE
S
STI.LIC 1 10 / 14
0
PRODU"A THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
John L . Kirby & AssoClates HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4196 Herschel Street ALTER THE COVERAGE. AFFORDED BY THE POLICIES BELOW,
Jacksonville FL 32220 - 2260
Phones 904 - 387 - 9796 Faxt904 - 367 - 9270 INSURERS AFFORDING COVERAGE MAX #
INSURED - mSURERA: Granite State Insurance Co .
Big Brothers Big Sisters of tNstutERB.
St . Lucie County
4131 South US 4 INSURER C:
Bldg Suite INsuR�RD. '
Ft . Pierce FL 34982
INSURER E
COVERAGES
I HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THF. INSURED NAMLU ABOYK. FOR THE POLICY PERIOD INOIC,,ATED. NOTWII KSTANDING
ANY REOUIREMENI , TERMOR CONDITION OF ANY CONTRACT OR OYHER DOCUMCNT WITH NKSPECT TO WNICH THIS CER70CATF MAY BE ISSUED OR
MAY PERTAIN. Tkr.. INSURANCE AFFORDED BY THE POLICIES DFSCRIBED HERON IS SUBJECT TO ALL THE I*EMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEFN RCDUCFO BY PAID CI AIMS.
ILTR SK NS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECT ON LIMITS
OATt WDCVYY DATE MMlD
GENERAL LIABILITY EACHOCCURRENCC S 1 000100
MAPAA13IFTITRENTED $ 100 000
A X X CUMMFRCIALGENERAL LIAKIIITY 02 - LX - 6442539 - 0 08 / 10 / 04 08 / 10 / 05 PREFAISES.ttac � 1 ..
CLAIMS MAt& u OCCUR _MED EW' (Any aw parson) S S , 00 0
j YFRC,ONAL 5 ADV INJURY s 1 000 1 00
GENLRAI AOCAI ELATE - $ 2 000 OO
GERLAGGRF.GATELIMITAPPLIES PFR• PRODUCTS - COMPIOPAGG : 11 0 9.000
POLICY PA;T LOG
AUYOMOBILE LIABILITY COMBINFO SINGLE LIMIT
(Ea accidetrt) S
I ANY AUTO
ALL OWNED AUTOS - BODILY INJURY S
` SCHEDULEDAUIOS (PcPn +)
i
HIREOAUTOS : 130DILYINJURY
.• NON-OWNCDAUTOS (Pa accident) S
PROPERTY DAMAGE : Il
- (Pm xodent)
GARAGE LIABII ITY - AUTO ONLY - EA ACCIDENT S
ANY AUTO OTHER IHAN FAACC $
i AUTO ONLY: AGG S
EXCESSMA48RELLA LIABILITY EACH OCCURRENCE $
OCCUR n CLAIMSMADE AC-,GRCGATE , ,, S
S
DEDUCTIBLE $ -
RETENTION S $
WORKERS COMPENSATION AND LIMITS -.- I tR
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT S
. ANY PROPRIETOWPARTNFRIEXCCUTNE '-
0FFK:FRtM0ADCR 0(CLU0Ebi E.L DISEASE . EA EMPLOYEF S
I II yes, naccnhn wvjef
SPECIAL PROVISIONS below GL. DISEASE - 1°OLICY LIMB i
OTHER
i
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Additional Insureds Indian River County ad respects to general liability as
Funding Grantor .
CERTIFICATE HOLDER CANCELLATION
ISD=Am SHOULD ANY OF THE ABOVE 0WRIBED POLICIES FIX CANCELLED BEFORE THE EXP11ATION
DAT9 THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAR_ 10 DAYS WIRJ TTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 30 LL
Indian River County IMPOSE NO ODWATION OR LIABILITY OF ANY KIND UPON THE INSURER. RS AGENTS OR
2625 19th Ave REPRasENTATrves.
Vero Bench FL 32960 AUTHORREDREPRESENTAT
John L . Kitb
ACORD 25 (2001108) or — bor� %b� W%C0R*rRPOMTIOII1988
• e
® BIG BROTHERS BIG SISTERS P.O. Box 547 • Vero Beach, Florida 32961
'
Of INDIAN RIVER COUNTY PHONE: (772) 770-6000
To Whom It May Concern :
This letter is to verify that Big Brothers Big Sisters of Indian River County does not
transport children in company or personal vehicles .
Sincerely,
Judi Miller
Executive Director
Internal Revenue Service
Department of the Treasury
P . O . Box 2508
Date : March 4, 2004 Cincinnati , OH 45201
Big Brothers Big Sisters of St . Lucie County Person to Contact :
Inc . Ms . Edwards 31 -07427
4131 South US 1 Building 2 , No #4 Customer Service Representative
Fort Pierce , FL 34982 Toll Free Telephone Number :
8 : 00 a. m . to 6 : 30 p. m. EST
877- 829-5500
Fax Number:
513-263-3756
Federal Identification Number :
59-2455513
Dear Sir or Madam :
This is in response to your request of March 4 , 2004 , regarding your organization ' s tax-exempt status .
In January 1985 we issued a determination letter that recognized your organization as exempt from federal
income tax . Our records indicate that your organization is currently exempt under section 501 ( c)( 3 ) of the
Internal Revenue Code .
Based on information subsequently submitted , we classified your organization as one that is not a private
foundation within the meaning of section 509(a ) of the Code because it is an organization described in
sections 509 ( a ) ( 1 ) and 170 ( b )( 1 )( A)(vi ) .
This classification was based on the assumption that your organization ' s operations would continue as stated
in the application . If your organization 's sources of support , or its character, method of operations , or purposes
have changed , please let us know so we can consider the effect of the change on the exempt status and
foundation status of your organization .
Your organization is required to file Form 990 , Return of Organization Exempt from Income Tax , only if its
gross receipts each year are normally more than $ 25 , 000 . If a return is required , it must be filed by the 15th
day of the fifth month after the end of the organization ' s annual accounting period . The law imposes a penalty
of $ 20 a day, up to a maximum of $ 10 , 000 , when a return is filed late , unless there is reasonable cause
for the
delay.
All exempt organizations ( unless specifically excluded ) are liable for taxes under the Federal Insurance
Contributions Act (social security taxes ) on remuneration of $ 100 or more paid to each employee during a
calendar year. Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act
( FUTA ) .
Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the
Code . However, these organizations are not automatically exempt from other federal excise taxes .
Donors may deduct contributions to your organization as provided in section 170 of the Code . Bequests ,
legacies , devises , transfers , or gifts to your organization or for its use are deductible for federal estate and gift
tax purposes if they meet the applicable provisions of sections 2055 , 2106 , and 2522 of the Code .
-2-
Big Brothers Big Sisters of St. Lucie County Inc .
59-2455513
Your organization is not required to file federal income tax returns unless it is subject to the tax on unrelated
business income under section 511 of the Code . If your organization is subject to this tax , it must file an
income tax return on the Form 990-T, Exempt Organization Business Income Tax Return . In this letter , we are
not determining whether any of your organization 's present or proposed activities are unrelated trade or
business as defined in section 513 of the Code .
Section 6104 of the Internal Revenue Code requires you to make your organization ' s annual return available
for public inspection without charge for three years after the due date of the return . The law also requires
organizations that received recognition of exemption on July 15 , 1987 , or later, to make available for public
inspection a copy of the exemption application , any supporting documents and the exemption letter to any
individual who requests such documents in person or in writing . Organizations that received recognition of
exemption before July 15 , 1987 , and had a copy of their exemption application on July 15 , 1987 , are also
required to make available for public inspection a copy of the exemption application , any supporting documents
and the exemption letter to any individual who requests such documents in person or in writing .
For additional information on disclosure requirements , please refer to Internal Revenue Bulletin 1999 - 17 .
Because this letter could help resolve any questions about your organization ' s exempt status and foundation
status , you should keep it with the organization 's permanent records .
If you have any questions , please call us at the telephone number shown in the heading of this letter.
This letter affirms your organization 's exempt status .
Sincerely,
Janna K . Skufca , Acting Director, TE/GE
Customer Account Services
rat OWMMQWUMAMMOGM�
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Pt . Pierce , FL 34992
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a0r30 / 2004 14 : 41 7724EG5951 RIG BROTHERS SIG _SIS PAGE 02
Page of 1
Melodee Dit"10110
From: "Marlon Mat:tersott* <MMaMerson@Ircgov.c0M>
TOO <miRerj@SM cie . k? 2.fl.us> ; %n*ldanieAojQbelisouth. nat*
Sent: Friday, OcbAber 29 ; 2004 2:50 PM
ISUbj ct: coMf Mte of iftsurattoe far their workers Wrnpensaton
Hello, I have this fWsage from our Risk AAanagement Department.
Please contact &9 Br40thersl8ig Sisters to request certificate of insurance for their workers '
compensation; their auto and general Iiab{ lity are fine.
Please fax a copy to me at 978- a 790 - thanks
luiarion Masterson, Administrative Asstatant �-
Mmastemon i J
� +'o9ov .com
772-W7-MQ EXt. : 1524
COil0ged ftmw V NOTICE: Thos masseye >ind any si�chrrser>ks see for the so;e uae of the mfended reciplart(.) end mey wrepaln c»nrrderfdei ertd
privileged mforrr�atfan tint is exempt from pub►Ic CYsclne ore. Any retreuthodze4 revlow, uso, dracto Uft. or dnslrlbuttarf as prohibited. Ji yeu
have
reos4ved tfils aessa�e in error please aonbot the sender (by phone or reply elecbonlc rr" and then destroy of vopfes or the, ongfne) rMec6a9e_
t0/29/2004
L
Big
Brothers
FACSIMILE TRANSMITTAL SHEET
1
• `.
FAX NUMSERa
PHONE W)Mlf R; SENVER'S
. • REF
0 URGENT A Foe PEvIEW PLEASk COMMENT 0 Pt EASE R t-- Pt y P( EA $L RECYCLE
.rr w
roRr PqRce , FL .1499Z
CHILDREN'S SERVICES ADVISORY COMMITTEE
C/O Human Services
1840 25!' Street
Vero Beach , Florida 32960-3394
Phone: 561 -567-8000 (Ext. 467 or 524)
Fax: 978-1798
E-Mail : JcarIson0bcc.co. indian-river.fl . us
MmastersonObcc.co.indian-dver.fl . us
To : Beth Jordan
Risk Management
From : Joyce Johnston- Carls
Date : October 28 , 2004
Re : Contracts — Children ' s Services Advisory Committee Grant
BIG BROTHERS AND BIG SISTERS — JUMP INTO READING PROGRAM
Attached is the signed contract for the 2004-05 -grant year, along with the necessary
insurance certificates .
Please contact me if there are any changes necessary. Otherwise, please circulate .
Thank you for your help .
Risk Management : u�n✓