HomeMy WebLinkAbout2006-331P. INDIAN RIVER COUNTY
GRANT CONTRACT
This Grant Contract ("Contract") entered into effective thisday of October 2006 , by and
between Indian River County, a political subdivision of the S tfa a of Florida; 1840 25th Street, Vero
Beach , Florida, 32960-3365; and Substance Abuse Council of Indian River County, ( Recipient),
of:
Substance Abuse Council of Indian River County
1151 191h Street
Vero Beach , Florida 32960
PREVENT! Program
Background Recitals
A. The County has determined that is in the public interest to promote healthy children in a
healthy community.
B . The County adopted Ordinance 99- 1 on January 19, 1999 ("Ordinance'), and established
the Children's Services Advisory Committee to promote healthy children in a healthy
community, and to provide a unified system of planning and delivery within which
children's needs can be identified , targeted , evaluated and addressed .
C. The Children 's Services Advisory Committee has issued a request for proposals from
individuals and entities that will assist the Children 's Services Advisory Committee in
fulfilling its purpose.
D. The proposal submitted to the Children 's Services Advisory Committee and the
recommendation of the Children 's Services Advisory Committee have been reviewed by
the County.
E . The Recipient, by submitting a proposal to the Children's Services Advisory Committee,
has applied for a grant of money ("Grant") for the Grant Period (as such term is
hereinafter defined ) on the terms and conditions set forth herein .
F. The County has agreed to provide such Grant funds to the Recipient for the Grant Period
(such term is hereinafter defined) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein contained ,
and other good and valuable consideration , the receipt and adequacy of which are hereby
acknowledged, the parties agree as follows :
1 . Backqround Recitals. The background recitals are true and correct and form a material part
of this contract.
2. Purpose of the Grant. The Grant shall be used only for the purposes set forth in the complete
proposal submitted by the Recipient, attached hereto as Exhibit "A" and incorporated herein
by this reference (such purposes hereinafter referenced as `Grant Purposes") .
3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year
2006/2007 ("Grant Period") . The Grant Period commences on October 1 , 2006 and ends on
September 30, 2007.
- 1 -
4 . Grant Funds and Payment. The approved Grant for the Grant Period is : EIGHTY
THOUSAND, DOLLARS ($80,000). The County agrees to reimburse the Recipient from such
Grant funds for actual documented costs incurred for the Grant Purposes provided in
accordance with this Contract. Reimbursement requests may be made no more frequently
than monthly. Each reimbursement request shall contain the information , at a minimum , that
is set forth in Exhibit "B" , attached hereto and incorporated herein by this reference. All
reimbursement requests are subject to audit by the County. In addition , the County may
require additional documentation of expenditures, as it deems appropriate.
5. Additional Obligation of Recipient
5. 1 . Records. The Recipient shall maintain adequate internal controls in order to safeguard
the Grant. In addition, the Recipient shall maintain adequate records fully to document
the use of the Grant funds for at least three (3) years after the expiration of the Grant
Period . The County shall have access to all books, records, and documents as required
in this Section for the purpose of inspection or audit during normal business hours at the
County's expense, upon five (5) days prior to written notice .
5.2 . Compliance with Laws The Recipient shall comply at all times with all applicable
federal , state, and local laws and regulations .
5 . 3 . Quarterly Performance Reports The Recipient shall submit quarterly, cumulative,
Performance Reports to the Human Services Department of the County, within fifteen
( 15) business days following : December 31 , March 31 , June 30 and September 30.
5.4 . Audit Requirements . If Recipient receives $25,000, or more in aggregate, from all
Indian River County government funding sources, the Recipient is required to have an
audit completed by an independent certified public accountant at the end of the
Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the
Recipient shall submit the audit to the Indian River County Office of Management and
Budget. The fiscal year will be as reported on the application for funding , and the
Recipient agrees to notify the County prior to any change in the fiscal period of
Recipient. The Recipient acknowledges that the County may deny funding to any
Recipient if an audit required by this Contract for the prior fiscal year is past due and has
not been submitted by May 1 .
5.4 . 1 .The Recipient further acknowledges that, promptly upon receipt of a qualified
opinion from its independent auditor, such qualified opinion shall immediately be
provided to the Indian River County Office of Management and Budget. The
qualified opinion shall thereupon be reported to the Board of Commissioners and
funding under this Contract will cease immediately. The foregoing termination right
is in addition to any other right of the County to terminate the Contract.
5.4 .2 .The Indian River County Office of Management and Budget reserves the right at
any time to send a letter to the Recipient requesting clarification if there are any
questions regarding a part of the financial statements , audit comments, or notes .
5. 5. Insurance Requirements . Recipient shall , no later than October 21 , 2006 provide to
Indian River County Risk Management Division a certificate, or certificates , issued by an
insurer, or insurers, authorized to conduct business in Florida that is rated not-less-than
Category A-:VII by A. M . Best, subject to approval by Indian River County's Risk
Manager, of the following types and amounts of insurance:
(i ) Commercial General Liability Insurance in an amount not less than
$ 1 ,000,000 combined single limit for bodily injury and property
- 2 -
damage, including coverage for premises/operations ,
product/completed operations, contractual liability, and
independent contractors;
(ii) Business Auto Liability Insurance in an amount not less than
$1 ,000,000 per occurrence combined single limit for bodily injury
and property damage , including coverage for owned autos and
other vehicles , hired autos and other vehicles , non-owned autos
and other vehicles; and
(iii) Worker's Compensation and Employer's Liability (current Florida
statutory limit. ) .
5.6. Insurance Administration . The insurance certificates, evidencing all required insurance
coverages shall be fully acceptable to County in both form and content, and shall
provide and specify that the related insurance coverage shall not be cancelled without at
least thirty (30) calendar days prior written notice having been given the County. In
addition, the County may request such other proofs and assurances as it may
reasonable require that the insurance is and at all times remains in full force and effect.
Recipient agrees that it is the Recipient's sole responsibility to coordinate activities
among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates
are acceptable to and accepted by County within the time limits set forth in this Contract.
The County shall be listed as an additional insured on all insurance coverage required
by this Contract, except Worker's Compensation Insurance. The Recipient shall , upon
ten ( 10) days prior written request from the County, deliver copies to the County, or
make copies available for the County's inspection at Recipient's place of business, of
any and all insurance policies that are required in this Contract. If the Recipient fails to
deliver or make copies of the policies available to the County; fails to obtain replacement
insurance or have previous insurance policies reinstated or renewed upon termination or
cancellation of existing required coverages; or fails in any other regard to obtain
coverages sufficient to meet the terms and conditions of this Contract, then the County
may, at its sole option, terminate this Contract.
5 . 7. Indemnification . The Recipient shall indemnify and save harmless the County, its
agents, officials , and employees from and against any and all claims , liabilities, losses,
damage, or causes of action which may arise from any misconduct, negligent act, or
omissions of the Recipient, its agents , officers, or employees in connection with the
performance of this Contract.
5 .8 . Public Records. The Recipient agrees to comply with the provisions of Chapter 119,
Florida Statutes (Public Records Law) in connection with this Contract.
6 . Termination . This Contract may be terminated by either party, without cause , upon thirty
(30) days prior written notice to the other party. In addition , the County may terminate this
Contract for convenience upon ten ( 10) days prior written notice to the Recipient if the County
determines that such termination is in the public interest.
7 . Availability of Funds The obligations of the County under this contract are subject to the
availability of funds lawfully appropriated for its purpose by the Board of County
Commissioners of Indian River County.
8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C
and incorporated herein in its entirety by this reference.
IN WITNESS WHEREOF, County and Recipient have entered into this Contract on the date
first above written .
- 3 -
INDIAN RIVER COUNTY BOARD OF COMMISSIONERS
By:
Gary ` 14he01 e ChairmarE
BCC Approved :
Attest: J . K. Barton , Clerk,
By:
Deputy Clerk
Approved : qcQtose h A. aird
County Administrator
Appr as to form and legal sufficiency:
Marian E. Fell , ssistant County Attorney
RECIPIENT:
By:
Substance Abus until of Indian River County
Frcd
- 4 -
EXHIBIT A
(Copy of complete Request for Proposal )
EXHIBIT - A -
' substance Abuse Council of Indian River County PREVENT! Indian Riva County CSAC
PROGRAM COVER PAGE
Organization Name: Substance Abuse Council of Indian River County
Executive Director. Colette Heid MS Ed., CAPP E-mail: saciro(a2bellsouth.net
Address: 1151 19'h Street Telephone: 772-77011811
Vero Beach. Florida 32960 Fax: 772-7704822
Program Director: Colette Heid E-mail:
Address: Telephone:
Fax:
Program Title: PREVENT !
Priority Need Ares Addressed: Mental Wellness Issues / Substance Abuse Coumselinu
RP-450.050, PB-183. LX-825. ajO: (According to Me Tswnornv ofHuman Services)
Brief Description of the Program: The PREVENTI pmgram is a 10 week individual and groom
counseling program that is targeted at reducing and preventing substance use/abuse among IRC youth
This program is designed to chancre adolescent and parental cerceotions of risk vs benefits of ATOD use
Additionally, this program provide communWty wide prevention education via the DEEP Impact TARGET
trovae.
SUMMARY REPORT — (Enter Information In The Black Cells Only)
Amount Requested from Funder for 2006/07 : $ 869414 .00
Total Proposed Program Budget for 2006 /07 : $ 86 ,414 . 00
Percent of Total Program Budget: 100 .0 %
Current Program Funding (2005 /06) : $ 562416
Dollar increase/(decrease ) in request : $ 29 ,998
Percent increase/(decrease) in request * * 53 .2 %
Unduplicated Number of Children to be served Individually : 130
Unduplicated Number of Adults to be served Individually : 55
Unduplicated Number to be served via Group settings : 6 ,000
Total Program Cost per Client: 13 . 97
**If request increased 5% or more, briefly explain why:
If these funds are being used to match another source, name the source and the $ amount:
The Organization 's Board ofDirectors leas approved this application on (date). 5/17/06
Fred J Chairman
Name of President/Chair ofthe Board Signature
Colette Heid. CAPP Executive Director
Name of Executive Director/CEO Signature
3
s�
substance Abuse Council of Indian Riva County PREVENTI Indian Riva Cowry CSAC
PROPOSAL NARRATIVE
A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page)
1. Provide the mission statement and vision of your organization,
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.
Unless the community's emphasis is directed to substance and drug prevention educational programs,
we can expect negative social and economic impacts associated with substance and drug
use/abuse to continue."
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, and universal, selee4ve and indicated prevention services. The
Council has administered the Federal Bryne Block 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 are 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
4
5�
Substsice Abuse Council of Indian Riva County PREVENT! Indian Riva County CSAC
IL PROGRAM NEED STATEMENT Entire Section B not to exceed one pgje
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.
Alcohol and drug abuse continues to be the number one problem facing the youth of America. The use
of mind altering chemicals has proven to be especially harmful to the adolescent growth and
development process. Psychoactive drugs interfere with physical, social and emotional growth during
the critical years of adolescent development.
An adolescent who uses intoxicants is not only at high risk of becoming drug dependent but is also at
an increased risk of dropping out of school, getting involved in crime, attempting suicide, or becoming
involved in an assortment of dangerous behaviors.
The prevention of adolescent drug and alcohol abuse is most likely to occur when parents, teachers, and
other individuals in the community who are part of the youth's circle:
➢ are well informed of the harmful effects of drugs
➢ recognize behavioral changes that accompany drug use
➢ understand how drug use is encouraged and accepted in the social world of a youth.
According to the 2005 PRIDE Survey of Indian River County students, IRC students continue to have
incidences of substance abuse that are above national averages. Over the 14 years of data gathered, we
have seen significant changes in youth usage, but our youth continue to reuort a high level of
availability for alcohol, marijuana and other illegal drugs. Of 9'" through 12 graders, 32.3% also
reported a perceived harm for usage of alcohol as very harmful, but continue to use alcohol at a rate of
62.3%. (PRIDE 2005).
When comparing the PRIDE Survey to the Florida Substance Abuse Survey (FSAS), we see
comparable rates within Indian River County. Reporting levels indicate that Indian River County youth
are at the highest category for Binge Drinking, Alcohol use in the past 30 days and Marijuana use in the
past 30 days. (FSAS 2004)
All of this combined have made it increasingly more important for efforts to focus on behavior
strategies and intervention for youth by promoting behavioral change including healthy lifestyles. (i.e.,
not using drugs, alcohol, tobacco; practicing abstinence; participating in school; anger control with
focus on alternatives to violence) With substance use/abuse intertwined with so many other high risk
behaviors, early intervention must be available Wspecifically target the prevention education needs.
a) Identify similar programa 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.
The Substance Abuse Council's program is the only program that provides comprehensive community
based prevention education within Indian River County. Suncoast Mental Health and the Mental
Health Association do provide crisis intervention services are available but are not specifically
substance abuse related and not for youth New Horizons provides Student Support Specialist in the
middle schools. DATA also provides services to youth. Both these agencies work with a very small
indicated population of students and can not serve the entire indicated population of youth. These youth
would receive no additional program services if the PREVENT! Program was not available. The
PREVENT! program provides no duplication of services.
5
Substance Abuse Council of Indian Riva County PREVENT! - Indian River County CSAC
CO PROGRAM DESCRIPTION Entire Section C, 1 — 6, not to exceed two a es)
1. List Priority Needs area addressed. Mental Wellness Issues
2. Briefly describe program activities including location of services.
PREVENT! combines outreach and group support to reach economically disadvantaged youth. These
youth are ages 13- 18;
✓ who have repeated failure in school and/or little commitment to school
✓ do not have a supportive environment and
✓ whose lack of decision making skills may lead them to abuse tobacco, alcohol and other
drugs.
The Substance Abuse Council, is a substance abuse prevention agency, proposes to continue this project
through a comprehensive range of substance abuse and educational activities for males and females with
substance abuse issues. Daily program services are provided by a full time program coordinator,
assistant coordinator and a licensed mental health counselor.
Two different components will constitute the PREVENT! program. The components are as follows:
• Crisis Intervention and Counseling
• Deep Impact-TARGET Troupe participation
The first component of the PREVENT program will be comprised of Crisis Intervention/ Counseling.
✓ A total of 130 individuals will receive Crisis Intervention or counseling services. The program
will be cyclical in nature, servicing approximately 15 individuals per cycle. Each treatment and
education cycle will last for ten (10) weeks.
✓ A total of 27 families will be provided with comprehensive assessments. Evaluation of
adolescents identified via psycho-socials comprehensive evaluations will be conducted.
Adolescents selected from this population will also be assigned to the Crisis Intervention and
Counseling component.
✓ On-going, fiequent drug screening will be conducted tdprovide IRC juveniles and families with
objective and accurate drug testing. An accurate testing program is the most objective and
efficient way to establish a framework for accountability and to gauge each participant's progress.
Modem technology offers highly reliable testing to determine if an individual has recently used
specific drugs
Substance abuse counseling and education will consist of a group therapy or individual sessions a week,
and one aftercare session weekly focused on relapse prevention. There will also be family workshops
conducted at SAC for family members during the treatment cycle. Once the ten week cycle is completed,
Aftercare will be conducted weekly. The Aftercare component is structured to focus on relapse prevention
and fife skills development.
Behavioral Therapy for adolescents incorporates the principle that unwanted behavior can be changed by
clear demonstration of the desired behavior and consistent reward of incremental steps towards achieving
it. Therapeutic activities include fulfilling specific assignments, rehearsing desired behaviors, and
recording and reviewing progress, with praise and privileges given for meeting assigned goals. Urine
samples are collected regularly to monitor drug use. The program aims to equip the individual to gain
three types of control:
✓ Stimulus Comml- helps individual avoid situations associated with drug use and learn to
spend more time in activities incompatible with drug use
✓ Urge Control- helps individual recognize and change thoughts, feelings, and plans that lead to
drug use.
✓ Social Control- involves family members and other people important in helping individuals
avoid drugs. A parent or significant other attends program sessions when possible and assists
with assignments and reinforcing desired behavior.
According to research studies, these type of services help adolescents become drug free and increase their
ability to remain drug free after the program ends. Adolescents also show improvement in several other
6
57n
Snbst x Abuse Comcil of Indian River Cowley PREVENTI Indian Riva County CSAC
areas—employment/school attendance, family relationships, depression, institutionalization, and alcohol
use. Such favorable results are attributed largely to including family members in services and rewarding
drug abstinence as verified by urinalysis.
The second component will be Deep Impact-TARGET troupe. The Deep Impact-TARGET troupe actively
develops innovative and high energy skits related to life issues they and their peers are facing. The troupe
has created a collections of 35 different skits for performances. The troupe continues to develop skits
dealing with issues on substance abuse/use, dieting (anorexia and bulimia), HIV/AIDS, pregnancy and
violence and will reach approximately 6,000 individuals. The Deep Impact-TARGET troupe members
are mentors to other youth, as well as friends, family and neighbors within the community. Participants in
the Deep Impact-TARGET troupe need not have any previous acting experience, just a desire to
participate. In many cases, we find that high risk youth become the best performers. Their presentations
via improvisation is not acting, but is real and from the heart. 80% of the youth participating in the
troupe have never had any formal training in acting.
3. Briefly describe how your program addresses the stated need/problem. Describe how your-
program
ourprogram 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.
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 target population. They demonstrated repeated documentation that
adolescent risk perceptions were favorably impacted by reducing favorable parental, peer and community
attitudes towards ATOD. The National Institute in Drug Abuse (NIDA) indicates that three decades of
scientific research and clinical practice have yielded a variety of approaches to prevent drug addiction.
The PREVENT! Program incorporates those approaches into its program design.
4. List staffing needed for your program, including required ezperience 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 Worksbeet).
The PREVENT program will be staffed by two Council employee and one Licensed Mental Health
Counselor. The Program Coordinator assumes primary responsibility for the PREVENT! program. A
Program Assistant is also assigned to this program and will dedicates 100% of the position's time to the
program. Both have five (5) years experience and have an extensive backgrounds in program coordination
and evaluation. The Licensed Mental Health Counselor holds a Masters Degree in Mental Health and is
licensed by the State of Florida as a Clinical Certiftted Forensics Counselor with a specialty in criminal
offender counseling and youthfiil offender counseling.
5. How will the target population be made aware of the program?
The PREVENT./ program awareness was designed with the target population in mind. Many different
marketing campaigns are utilized to make the community at large aware the services are available. The
program is open to all residents of Indian River County.
The Council promotes the use of the PREVENT! program via it's newsletters and brochures. Law
enforcement, school personnel, probation officers, student support specialist have all been briefed on the
PREVENT! program. The Council also recommends the PREVENT! program to parents. Youth and
families can be referred to the PREVENT?
How will the program be accessible to target population (Le., location, transportation, hours of
operation)? The Council attempts to be very accommodating in service offering times / hours for the
community, including weekends and evenings. . The PREVENT! Program services occur Monday
through Friday. Group sessions begin either at 4:30 p.m. or 6:30 p.m. to accommodate work and travel
schedules. Individual appointments accommodate the individual schedules. The Council office is located
in Vero Beach and is open from 8 a.m. to 5 p.m.
7
60
Substance Abuse Council of Indian River County PREVENfI Indian River County CSAC
D. MEASURABLE OUTCOMES (Description oflntent)
Use the Measurable Outcomes form! This docr&Won Pare does not need to be included in the proposaL
In order to show the impact that your program is having on the target population and the community,
the funders are requiring measurable outcomes. Please review the examples and summaries below to
insure your understanding of what is expected.
OUTCOMES: Describes what you want to achieve with the target population. Indicates the results of
the services you provide, not the services you provide. Outcomes utilize action words such as
maintain, increase, decrease, reduce, improve, raise and lower.
ACTIVITIES: Describes the tasks that will be accomplished in the program to achieve the results
stated in the outcomes. Activities utilize action words such as complete, establish, create, provide,
operate, and develop. The activities should reflect the services described in the PROGRAM
DESCRIPTION (C2).
Use the following elements to develop your outcomes. AU 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 I (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 (Bl ).
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 unpact the unacceptable condition in your Program Need Statement.
8
Subshme Abuse Coundl of Indian River County PREVENT! Indian Riva County CSAC
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 Outcome(s)
Ia. To provide PREVENT! Individual and group
1 . To decrease the number of positive drug sessions to individual and families
screens among enrolled PREVENT! participants We will provide a total of ten( 10) weekly 1 hour
by W/o over a 10 weeks as reported by random individual and group sessions on various substance
drug screen. abuse and resiliency skills building topics. Session
Baseline: Initial drug screening results prior to admission are based upon Behavioral Therapy for Adolescent
to Prevent program. Program which focuses upon increasing protective
factors, decreasing risk factors, Stimulus Control, Urg
Control and Social Control
b. Conduct weekly random sampling of program
participants following four weeks in program.
1 b. To create a system of substance abuse screening,
assessment and intervention for youth involved in
the PREVENT! Program.
■ Heighten the youth's awareness to:
➢ The realities of drug use
➢ Victim awareness education
➢ Legal consequences of drug and alcohol
uselpossession
Build external & internal protective factors of:
➢ Empowerment
➢ Boundaries & Expectations
➢ Positive values
➢ Social competency
➢ Positive Identity
2. To increase audience knowledge of program 2. To provide factual, current and up-to-date
participants by 25% following Deep Impact- information via Deep Impact- TARGET sessions
TARGET educational presentation concerning concerning drugs and their harmful effects.
drugs and their harmful effects as reported by pre/ post testing will be conducted and rated to
self-disclosure on pre-testing. indicate a change in knowledge.
(Baseline: Individual and group administered Pre-tests of
forum participants.)
3. To reduce self- o rted high-risk behaviors 3.To provide factual, current and up-to-date
information via Deep Impact- TARGET educational
responses repotted by audience participants by
205/6 following Deep hnpact- TARGET sessions concerning high-risk behaviors and resulting
educational presentation forums. (Baseline: harmful effects.
Individual and group administered KABP [Knowledge ■ Pre(post evaluations of the KABPs to indicate a
attitude, belief and practice] of forum participants.) change in participation in high-risk behaviors.
9
/ c �
Substana Abuse Council of Indian Riva County PUV04TI Indian Riva County CSAC
E. COLLABORA71ON (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.
CoflaborativeAgency Resources provided to theprogram
Indian River School District Referrals to program
Mental Health Association
Children's Home Society Referrals to program
CINS /FINS Case management of Client Progress
Vero Beach School Resource Referrals Co program
Officers
Sebastian Police Resource Officers
Indian River County Sheriffs
Office
10
63
Substance Abuse Council of Indian Riva County PREVENT! Indian Riva County CSAC
F. PROGRAM EVALUATION (Entire Section F not to exceed two es
1. DEMOGRAPHICS: What information (data elements) will you need to collect in order to
accurately describe your target population including demographics (age, gender, and ethnic
background) required by the funder in Section H? What are the pieces of information that
qualify them for your target population? How do you document their need for services or
their "unacceptable condition requiring change" from Section Bl ?
As a licensed substance abuse provider in the State of Florida, the Council is required to utilize the
State of Florida, Department of Children and Families, MA-SA (Mental Health-Substance Abuse) Data
Warehouse Database. Complete, detailed, but confidential information is complied an all clients who
request services of the Council. The demographic information required includes but is not limited to:
• Name • Living accommodations • Family composition
• Address • Type of services provided • Frequency of Use
• Type of services • Gender and ethnic • Length of Stay
needed background
• Age • Duration of services • SS #
• Drug of Abuse • Age of onset
In addition non-client specific data is also maintained. Time, duration, number of participants, location
of service delivery and date are maintained. Client and non-client specific data are maintained in a
confidential, password protected database.
Additionally the Council maintains statistics on the PREVENT! Program. Clients may access
confidential Information and Referral services by the telephone, or in person. This additional
information helps the Council to track new trends of use or abuse, types of drugs being used, types of
services needed and provides information on the type of educational development and continuing
education needed for both staff and community.
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?
The collection of data elements will be collected as described in section F. 1 .
Client demographic information is requested of clients upon the client intake. Each client is provided a
client questionnaire.
The PREVENT! Program utilizes several short term indicators to measure the impact on
achievement of this program's goals. The evaluation tools used are as follows:
• Pre and Post testing - Pre test are performed to measure the audience's basal knowledge
prior to the presentation. Following the presentation, post tests are conducted.
It is possible to measure the increase in knowledge directly related to the educational
presentation. Changes in attitudes, beliefs and practices take longer to manifest in the target
population. It is for this reason that a KABP was designed.
KABP - (Knowledge, Attitude, Beliefs and Practice) is administered prior to and again following
presentations. This tool may be administered several times to the target population. This evaluation
tool indicates if an impact has manifested itself into daily life, but no change in attitudes, beliefs or
practices can be expected without the prevention education.
11
(J �
• Substance Abuse Council of Indian River County PREVENT! Indian River County csAC
I 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?
Data is complied via computer database programs. Each staff member is responsible for the collection
of his or her confidential program data. Data and statistics are shared, as the law allows, with the
appropriate concerned parties
12
(5
Substma Abuse Couwil of Indira Riv Carty PREVENT[ Mm Riva Courcy CSAC
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 mpleting the timetable, review information detailed in prior sections.
Month/Period Activities
October 2006- June Coordinate the PREVENT? Program Schedule
2007
Coordinate delivery and implementation of the program
Coordinate the collection of program statistical data for evaluation.
Post testing following program completion.
December 2006 Compilation and evaluation of data for the 1 " quarterly report
March 2007 Compilation and evaluation of data for the 2d quarterly report
June 2007 Compilation and evaluation of data for the 3'd quarterly report
September 2007 Compilation and evaluation of data for the 0 quarterly and annual report
Ongoing collaboration with all collaborating agency on program progress,
October 2006- June obstacles and any other program responsibilities as they arise.
2007
Address any additional program responsibilities
13
(pto/
M
1
Number1 11 1 W. . 1Clients1 1 11
11 1 r: : 1 : I A � I I 1 ✓ : 1 11 1 1 1 r' : 1 . 1 I,
F111 ' : I 1 it 111 t1 1 •
fl 1 ' 1 i � • 11 Ili
11 I ' : 1%71,
X� 11 : 1 ill
Oki Me ITITW71
' ft'1 • � 1 1 .II
' 4S _ __J1 }l ■
DINT5 511 . 1
Number I 1 1 1 1ated "ents1 Age
ggg
J
NOT "Iff, I
MMMOM
M Ell irl WS 51
1 � � ® III III
Substance Abuse Council of Indian Riva County PREVENT! Children Services Advisory Committee
I. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below.
"Core Budget Forms"
15
Cog
CAUTION : I
1 1 1 1 I I 1 11
' ` " of=L " _7 MOM^ MOMMOM 1 1 1 1 1 1 1 11
-MINE
11 11 : 11
MM�MMMMMM --OEM
1 11 1 11 1 11
' 7 " L�k
r MOMM 1 11 FII IJ
1Iff
' " 111 1 11 1 11
1 11 1 11 . 1 111 11
OMMEMMOM
� " ' 1 II 111 • 1 11 II
1 11 1 11
111 1 11 : 11 11
- ` ^ • 1 11 1 I I 1 11
MMOMEMIN
1 = 1
1 11 111 1 11
i " ^ — 111 111 11
'
. r • 1 �1
SOMME
: : - 11 : r 11 • . . 11
7l • � l v r" I -
T .r•TT-` . - - : :rte I I
� 111 • 111 II
I � - � 1111 1111 11111
T : : - • � __
111 . 111 ' . 111
c . • n �a 111 , r' 1 11 I I1 1 11
. . / ll rl I rlr II / II ll ®
1 1MEMO=U111,
1 - 11 11' 1 11 111 1 11 ' .
1001939m, 1 1 Ii 111 111 ' ,
w I 1 . 11 1 : 11 1 . 11 1111 • .
• • . . 1 . - - . 111 . 1 II 111 1111 •
. �. 1. : , • r+ ;• 1 1 1 . 1 11. 1 11 1 11 111 ' .
o- : � • •� u 1 1 1 . 1 11 1 11 1 11 1 11 ' .
• • . . •rc, • • . • . ;. 1 11111 111 111 111 ' .
• • n rr : r: 1 : I 11 111 111 111 ' .
IMME
1 11 11 1 11 1 11 1 11 ' .
- • 1 � I 11 111 111 111 ' .
' • • u 1 . 111 111 111 111 ' .
/ • � 1 • • •. -. • • • 1 �: IYI 11 111 111 111 ' .
—_
' 11 • 11 ' 1 . 11
y t
-
- •1 c 1 1 1 I I It 111 1 11 1 11 1 I
- _ 1 1 11 1 11 1 1 1 1 11 1 11 1 1'1
• . ' r • r . : c 1 1 1 1 1 1 1 1 1 1 _��{{..�1 1^^1'' 1 1 1 1 11
.7 Y/ 1 1 . 11 ® 1 11 . 11 1 I �•.:_na•. 1 11
� V a 1 11 1 ! 1 1 11 1 11 1 11 1 11 1 11
x • . .. I • 1 1 I I 1 11 1 I I 1 11 1 11 111 1 11
r7 • '17 • 1 1 1 11 1 11 111 1 11 1 I I 1 11 1 11
• • •• _.. •. • • • u 1 111 111 1 II 1 II 111 111 111
� I 111 111 111 111 111 111 111
1 111 111 111 111 111 111 111
• 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
• • v ;• 1 1 11 1 11 1 11 1 11 1 11 1 11 1 IJ
• • _" • � • • ' • ' • 1 1 11 1 11 111 111 I II 111 1 II
1 11 1 I I 1 11 111 1 11 111
1 I I 1 1 1 1 1 1 1 I I 1 1 1 1 11
1 11 1 1 1 1 1 1 1 1 1 1 1 1 1 11
1 11 1 11 1 11 111 1 11 1 11
1 11 1 11 111 1 11 1 11
111 111 — 111 111 111
• . . • . , _. . . : : -. . : • 11 1 tl 1111 111 ` . 111 1 . : � 1
1i 11 11 11 11 111 11
X111its. —.
_ .
• TrainurglSenunar (cost per staff)
$21 Per diem par clay x 3 days = $63
registration, food) �250 miles x 29 Is $72.50
- INE& rrr rr err rr
rrr rr
r
' _
: 12 months = local phone
T rr , r r „ r
ost
``i .
Esibnated cost of kxV distance
• � .: . � � . . . � r r , r , r , r r r r r.r r r
I- GaFbage ($ x 12 months)
rr r
u
. . Jvl IL
Estate• Janitorial ($ x 12 months) LST 500 x 12
• Real - .
Prev
x12 = 2D40 r rr -
rrr rr rrr rr rrr rr
.
Letterheads, _ rr
Other
some
s . . .
: � . i ':: r . i r it i , r rtr rr
'711 C Lw111w ,
rr i rr
Meter lease ($ x 12 months)
• Copier Maintenance ($ x 12 monft)
- r ri — i ri r , r rr
. '.,
Other - it irr rrr
rrr ri rrr r , rrr rr
r i rr
• . . . � . rii rrr , ii
� 1 :: "iT� l :^:.71t'!1T1S.�^4r �?,i!1� r it rrr rrr rr
i rr
R . r rrr.
. u .
Subsfanoe abuse council vaEVEWn Prog� Indian River County CSAC
42 Food & NubWoon 0.00 0. 4, 195.00
• Meals x clients x 5days x 50 S
• Snacks Youth snadw $30 a week x 52 weeks 0.
0.00 0. 0.00
- Admirt Cost (% of total budget) 0.
44 Audit Eqmm 1 ,000.00 1 ,000. 9,000.00
lm;FK� Audit e`er 9,000.00
0. 1 ,000.00
41 Specillic Assistance to kxNviduab
• Medical assistance
• MeaWFood
• Rent Assistance
• Odw 0.
46 OdwrAlIlliscallisimmus
0.00 0. 14,907.05
*at nm Soeea s38 x 5= 190
• OCIer Drug Sveen FC#S50 per mantlex 0.
47 Opwm%ipia
91000.00 9,000. 80,000.00
• Sub-contraG for program services
per walk x 50 weeks= .
*Dnig tDs0ng SOp *ms $9,000 LxesMls Trallop SI50per2 O.00
48 TOTAL EXPENSES 86,414.40 86,414.4C 767,466.00
$0.00
0.00
SnN1a0G B-1
70
1II 11 II 111 .
1 1 1 1 1 1 1 1 1
� � II111 �
• • ' :: I11 � 111
—'l��'i� �I 11111\ 1 Ill 11 �IJ,11�j
� � 111 11
. . . ,. a � •. �� 1 I I -:1 1
� � 11 11 1 11
� � : 1111 11.1
� � �
mmmrm=- ®
MMMVA
�I�I•1I�1�1
- L' 1 111 MMMMV= 1 11
SPIIIi !1 =' •W11 11•WI 11
��• � 111 11 1 I I
r` • i - - . . . . - : � � : 111 11
� � 11 11 1 11
. ... . - �. � . a • . r .. � � �1•Yy 11!;1 1 11
���}}�� � � 11 ' .
• ,. • I , MEEK= : 1 111 11
• • • Emmr � 111 111 '
- . �1� .. • la : ll . LO : i � . +yl :. J: � 111 111 1 11 ' .
I
T
�! 7mmm9mmm ]mmmmffmm
• Topa Me orjw& tl a fvopam Nance
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCYIPROGRAM NAME: Substance Abuse Council I PREVENT I Program
FUNDER: IRC CSAC A B c
FY 06107 FY 06/07 % OF
TOTAL FUNDER TOTAL VS.
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET col. B/col.
EXPENDITURES
21 Salaries 3226600 32 266.00 100.00%
22 FICA 2 468.35 2468-35 100.00%
23 Retirement 0.00 0.00 #DIV/01
2a Li omealth 8y400,00 8 400.00 100.00%
25 Workers Compensation 200.05 200.05 100.00%
26 Florida Unemployment 0.00 0.00 #DIVl01
27 Travel-DaRy 1 200.00 11200.00 100.00%
28 ravel/Conferences/Trainiri 0.00 0.00 #DN/01
29 Office Supplies 3y000.00 3y000,00 100.00%
Telephone 1200.00 1200.00 100.00%
31 Postasia/Shipping zow.00 2 000.00 100.00%
32 Utilities 1 200.00 1 200.00 100.00%
33 Occupancy (Building 8a Grounds 69480.00 61480.00 100.00%
34 Printing 8a Publications 11000.00 17000.00 100.00%
35 Subscrl embershi 0.00 0.00 #DN/01
36 Insurance 0.00 0.00 #DIV101
37 E ui ent:Rentai & Maintenance 0.00 0.00 #DIV/01
38 Adverfisina 5000.00 5.000.00 100.00%
39 Equipment Purchases:Ca 1 Expense 0.00 0.00 #DIV/01
40 Professional Fees t Consulting) 0.00 0.00 #DIV/01
41 Books/Educational Materials 12000=001 12s000.00 100.00%
42 Food & Nutrition 0.00 0.00 #DIV/01
43 Administrative Costs 0.00 0.00 #DIV/01
44 Audit parse 100000 100000 100.00%
45 Specific Assistance to Individuals 0.00 0.001 #DIV/01
146 Other/Miscellaneous 0.00 0.00 #DIV101
47 OthedContract 9 000.00 9 000.00 100.00%
48 TOTAL $869414.40 $86414.40 100.00%
�W18/d108 B4
'�5
' nnwuP+den .a rApw ran.
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARKNCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCYIPROGRAM NAME: Substance Abuse Coin cW Prevent 1 Program
FUNDER: IRC CSAC
R IRC CSAC Provides 100% of We funding for the PREVENT 1 Program
Intleevne due b ad=OM staff and addronal services.
I
pl
vrvaaro e8 !�/7
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARUMM OF 75% OR MORE
FUNDER SPEORC BUDGET
AGENCYRROGRAM NAME: Substance Abuse CouneW Prevent 1 Program
FUNDER: IRC CSAC
Maeasa due b addaoan sW rW add wW services.
Massae dm to addacerd SW and add DW SWAM.
Mamse due b addbDM ams and MOM services.
Massae due du addboad smil and add mM services.
Maeme doe to adddoard SW and addbnal services.
Massae deem 8000"1 services.
Maeasedu to addmrrelservims.
MaeOse due b addMd services.
Massae duem addlmW advices.
Massae due b Massae in coat d red
mamdak Massae due to addorW Services.
Massae b redad cost daudi
I
due m
77 snavnee as
EXHIBIT B
(From policy adopted by Indian River County Board of county Commissioners on February 19,
2002 )
" D. Nonprofit Agency Responsibilities After Award Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis only.
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check. Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the
Board of Commissioners . In the event an agency provides inadequate documentation on a
consistent basis, funding may be discontinued immediately. Additionally, this may adversely
affect future funding requests.
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example, no expenditures prior to October 1s` may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners.
All requests for reimbursement at fiscal year and (September 301h) must be submitted on a timely
basis . Each year, the Office of Management and Budget will send a letter to all nonprofit
agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is
typically early to mid October, since the Finance Department does not process checks for the
prior fiscal year beyond that point.
Each reimbursement request must include a summary of expense by type. These summaries
should be broken down into salaries , benefit, supplies, contractual services, etc. If Indian River
County is reimbursing an agency for only a portion of an expense (e. g . salary of an employee),
then the method for this portion should be disclosed on the summary. The Office of Management
& Budget has summary forms available.
Indian River County will not reimburse certain types of expenditures . These expenditure types
are listed below.
a) Travel expenses for travel outside the County including but not limited to: mileage
reimbursement, hotel rooms , meals, meal allowances, per diem , and tolls . Mileage
reimbursement for local travel (within Indian River County) is allowable.
b) Sick or Vacation payments for employees . Since agencies may have various sick and
vacation pay policies , these must be provided from other sources .
c) Any expenses not associated with the provision of the program for which the County has
awarded funding .
d) Any expense not outlined in the agency's funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary."
EXHIBIT - B -
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices . Any notice, request, demand , consent, approval, or other communication
required or permitted by this Contract shall be given , or made in writing, by any of the
following methods : facsimile transmission ; hand delivery to the other party; delivery by
commercial overnight courier service; or mailed by registered or certified mail (postage
prepaid), return receipt requested at the addresses of the parties shown below:
County: Brad E. Bernauer, Director
Indian River County Human Services
184025 1h Street
Vero Beach , Florida 32960-3365
Recipient: Substance Abuse Council of Indian River County
1151 19`h Street
Vero Beach , Florida 32960
2 . Venue: Choice of Law. The validity, interpretation , construction , and effect of this
Contract shall be in accordance with and governed by the laws of the State of Florida
only. The location for settlement of any and all claims, controversies, or disputes , arising
out of or relating to any part of this Contract, or any breach hereof, as well as any
litigation between the parties , shall be Indian River county, Florida for claims brought in
state court, and the Southern District of Florida for those claims justifiable in federal court.
3 . Entirety of Agreement. This Contract incorporates and includes all prior and
contemporaneous negotiations, correspondence, conversations , agreements, and
understandings applicable to the matters contained herein and the parties agree that
there are no commitments , agreements, or understandings concerning the subject matter
of this Contract that are not contained herein . Accordingly, it is agreed that no deviation
from the terms hereof shall be predicated upon any prior representations or agreements ,
whether oral or written . It is further agreed that no modification , amendment or alteration
in the terms and conditions contained herein shall be effective unless contained in a
written document signed by both parties.
4. Severability. In the event any provision of this Contract is determined to be
unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining
provisions of this Contract, and every other provision and term of this Contract shall be
deemed valid and enforceable to the extent permitted by law. To that extent, this
Contract is deemed severable.
5. Captions and Interpretations . Captions in this Contract are included for convenience only
and are not to be considered in any construction or interpretation of this Contract or any
of its provisions . Unless context indicates otherwise , words importing the singular number
include the plural number, and vise versa. Words of any gender include the correlative
words of the other genders, unless the sense indicates otherwise.
6 . Independent Contractor. The Recipient is and shall be an independent contractor for all
purposes under this Contract. The Recipient is not an agent or employee of the County,
and any and all persons engaged in any of the services or activities funded in whole or in
part performed pursuant to this Contract shall at all times and in all places be subject to
the Recipient's sole direction , supervision and control .
7 . Assignment. This Contract may not be assigned by the Recipient without the prior written
consent of the County.
EXHIBIT - C -
MENNEN
11 / 01 / 200E IE : Jl 7 ?2771) 4822 SUBTANCE_ABUSE_COUt� PAVE 02
; fU%010
[ A�S28Q CERTIFICATE OF LIABILITY INSURANCE
OA-1 112 G6
: u,ot/zoos
=11UMAR ( 772) 231 - 2a2a RAC( ( 772) 231- 4413 TIRE CERTIIRCATE1512SUEDASA MATTER OFINFORMATRDN
Felten 6 Assovotes ONLYANOCONFERSNORR Il"$ Il ONTMFCERTIPIC.ATa
OR
2911 Cardinal Drive (32963) HL.TERT THE
COVERAGE
AFFFORD9�WEIS NBY�ROUIN" 1O
P . O . Box 3455 4LTER TN COVERAGE AFF R D 7N POL'q,Fi tlW, _,_,
Vero Beach , F1, 32%4- 340 : INSURERS AFFORDING COVERAGE jNJUCA
. . . . ,
; INRUAlD $YbStdnCe Abusr. COLJI Indian timer Coantr ' Colony Insurance
P0 Bos 6460 .. -_-----_.._..__..._.. _..._ ._ ..,,.,._..,."._. .._ __...... .�._..__, _
' + .� - R Progressive Express 10143
Vero Beach , PL 32961 Con, wiree B Industry Insurance —
9iJFS' :i I
MFltAGES
THE POLICIES OF RISURANCE L!STEC BELOW 4" BEEN ISSUED TO TME INW14 ED NAMED ABOVE FOR THE POLICY PERIOD INDCATED NOTWRHSTM O ING
ANY REO'JIRE VIEW. TERM 004 CONOTM)R OF ARY GONMACi OR CTMER WXUWENT 'NTM R PSP ECT TO VVH.CH THIS CERT",F:OATE MAY e ISSUED OR
MAY PERTAK TME INSURANCE AFFORDED BY TME POU MES DESCRRED HEREIN IS SUBJECT -C AL L THE TE!SMB. E.W1,01ONS ANO CON07I0NB OF SVC4
POLICIES. AGGREGATE L MITS SHOWN MAY MA,VE BEEN RFDUOEO BY PAID CLAIMS. /
^RFPF MdUMNCfi tiI g IKFY PNI - -" -
!MR IULIL wUMaEE aiM �Iarc'a
PENERA: LuaIUTE �I GL3303 S25A � 11/Oaj20O6 I Sl/06 ^� °P �L = T 1000
VT f4•^V ur:.1 . 1 : 1 Ir ( 04
so
X f
A 1 ..� 1 �E%C UDE
21 DOD , _
�� • , ASrtPM°RLI LMKT' 04437R465 ! 03/061 . 06 1 03/05/2007
12.000 , 0
I i r
raic.
':�TETCERRAyaRELLA LaBILT E+i•� .-:'CI. Rf'T.:F E
eMPLOYWLASI•MnoNARP WC1aB 1443 ' 01/10/2006 03 !10,1007 _ -�^ _- ___
j aMPLPYERR' A{LIT'
,
100O
300 , 0.
° Jx
500 , DW
oTNIR I
i I I I
' PIR<RWTIAN PF PIlRAnoNRI LX41PN9 : VIMICLIR I E%CUAIPNR AppFURY RnpPMIMRMT : IPE'YL MIOVM°M
Certificate Holde - included as apditional insured with respect to general liability policy listed
abO V°
-_CERTIFICATE HOLGER _ ANCELLATION
WOULD MfOP TnE MOYE MnP POL•C*596 CANCRU:O RRFORE THE
eY`RER�LEnoN DL E'N4REr6. TME HRU.M 04JOER VEYL E.PEAVOR T
Ihdlah RIVer County , Florida ' JY_ DAYS wRIITb+ ntiME 'dTM4 CIR"�ICATa Mc'.PF 'dYIRC TP SHl LEFT.
Beth ]orlon f eUT -MLLMI To NIL -VCM K:YME +Ma"_L NOaaE wO/LNA*IM. PL.Aii.x
1640 25th Street CE 11 * MI OLION Me Iw+AIRR :n AZiTam REAT41ayTRTIVY9 -
Vero Beach , FL 32950 - 3365 AUTNORMWSPUIWATr4
ACORD 26 (20010fLACORDCORPORATION 109
Nov r 7 2006