Loading...
HomeMy WebLinkAbout2006-331Y. AM (o - 331 INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract") entered into effective this Z day of October 2006 , by and between Indian River County, a political subdivision of the State of Florida; 1840 251" Street, Vero Beach , Florida , 32960-3365; and United For Families (Recipient), of: United For Families 10570 S. Federal Highway, Suite 301 Port St. Lucie, Florida 34996 Camp Foster Child 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 . Background 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 - AM (o - 331 INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract") entered into effective this Z day of October 2006 , by and between Indian River County, a political subdivision of the State of Florida; 1840 251" Street, Vero Beach , Florida , 32960-3365; and United For Families (Recipient), of: United For Families 10570 S. Federal Highway, Suite 301 Port St. Lucie, Florida 34996 Camp Foster Child 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 . Background 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: SEVENTEEN THOUSAND , SIX HUNDRED DOLLARS ($ 17,600). The County agrees to reimburse the Recipient from such Grant funds for actual documented casts 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 $1 ,000,000 combined single limit for bodily injury and property - 2 - 4. Grant Funds and Payment. The approved Grant for the Grant Period is: SEVENTEEN THOUSAND , SIX HUNDRED DOLLARS ($ 17,600). The County agrees to reimburse the Recipient from such Grant funds for actual documented casts 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. - 3 - IN WITNESS WHEREOF, County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By: Gary C . ,41 e1er , Cpairman BCC Approved: - /D - `� — d (� Attest: J . K. Barton , Clerk By �0. ,.. ,.. o. . . P Deputy Clerk Approved : Jose hA. Baird County Administrator Ap , ed as to form and legal sufficienc .. :ar ian E. Fell , Ass sta ounty A torney RECIPIENT: By: United for Families - 4 - 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. - 3 - EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - United for Families, Camp Foster Child, Children's Services Advisory Committee PROGRAM COVER PAGE Organization Name: United for Families Executive Director: Christine Demetriades E-mail : Christine.demetriades@uff.us Address: 10570 S . Federal Hwy Telephone (772) 398-2920 Ext. 315 Ste. 300 Port St. Lucie, FL 34952 Fax: (772) 398-2925 Program Director: Christina Kaiser E-mail: Christina.kaiserguff us Address : above Telephone: (772) 398-2920 Ext. 302 Fax: (772) 398-2925 Program Title: Camp Foster Child Priority Need Area Addressed: Child Care Access/ Taxonomy No. PL-640. 150 Brief Description of the Program: United for Families will provide summer camp opportunities to up to 49 school-age children in Indian River County during the summer of 2007 By doing so UFF will create a safer and more creative environment for children during non-school hours and also provide needed respite to existing foster parents SUMMARY REPORT — (Enter Information In The Black Cells Only) LAmountRequestedquested from Funder for 2006 /07 : $ 17 , 600 sedProgram Budget for 2006 / 07 : $ 41 , 096 Total Program Budget : 428 % gram Funding (2005 /06 ) : $ - ease /( decrease ) in request : $ 17 , 600 rease /( decrease ) in request * * # DIV /0 ! UIM nduplicated Number of Children to be served Individually : 49 Unduplicated Number of Adults to be served Individually : 46 Unduplicated Number to be served via Group settings : - Total Program Cost per Client : 432 . 59 * *If request increased 5 % or more, briefly explain why: N/A If these funds are being used to match another source, name the source and the $ amount: The Organization 's Bo of Directors has approved this application ro-(i te), lea 04P <st r Is D . cc aL tIL Name of Presidem/Chair of the Board Si l�Vl (�I ��u'IYi J , � (� 1 Name of Executive Director/CEO Signature IN WITNESS WHEREOF, County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By: Gary C . ,41 e1er , Cpairman BCC Approved: - /D - `� — d (� Attest: J . K. Barton , Clerk By �0. ,.. ,.. o. . . P Deputy Clerk Approved : Jose hA. Baird County Administrator Ap , ed as to form and legal sufficienc .. :ar ian E. Fell , Ass sta ounty A torney RECIPIENT: By: United for Families - 4 - United for Families, Camp Foster Child, Children's Services Advisory Committee - ORGANIZATION: United for Families PROGRAM: Camp Foster Child 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. g Section of the Pro osal Pa e # COVER PAGE (with signatures). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TABLE OF CONTENTS (check list) A. ORGANIZATION CAPABILITY (one page maximum) 9C 1 . Mission and Vision of organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 x 2. Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . 1 B. PROGRAM NEED STATEMENT (one page maximum) 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 2 V 2 . Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . 2 C. PROGRAM DESCRIPTION (two pages maximum) u 1 . Funding priority 3 u 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . 0 . . . . . . . 3 3 . Evidence that program strategy will work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4. Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . 3 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 . . . . . 3 Y 6. Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . 3 X D. MEASURABLE OUTCOMES (two pages maximum) . . . . . . . . . . . . . . . . . . . . . . . . . 4 X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 F. PROGRAM EVALUATION (two pages maximum) )( 1 . Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . 6 2. Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . 6 3 . Reporting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X G. TIMETABLE (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 H. UNDUPLICATED CLIENT COUNT X 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 . . . . . . . . . . . . 8 2. Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I;nited for Families, Carnp Foster Child, Children's Services Advisory Committee I. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B1 -B5 J. FUNDER SPECIFIC/ADDITIONAL SHEETS _—XK. APPENDIX EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - United for Farnilies, Camp Foster Child, 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 8 't/z" X 11 " paper and number each page. These directions and the graphic boxes may be deleted if space is needed. A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1. Provide the mission statement and vision of your organization. United for Families ' mission is to help end the cycle of child abuse through a diverse network of community providers and innovative services. We were created in 2003 in response to Community Based Care, a statewide initiative that privatized public child welfare services. We are a non-profit agency charged with developing local services and supports for children and families in Okeechobee and the Treasure Coast. Our commitment to the community is to ensure safety to all children and to provide permanent homes for them. We envision a community where the safety and well-being of children is the concern of every individual; where "Safe Place" is not just a sign on a door, but a creed in every home. We believe that every child deserves a healthy family, and that every weakened family deserves a chance to heal itself. UFF will lead the community in the pursuit of these ideals. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. UFF is the local umbrella agency in child protective services. We believe that the best way to respond to our community' s unique needs is to bring all local providers of child-abuse services to a single table and to take advantage of existing resources . The services are provided by agencies such as Children' s Home Society and Exchange Club CASTLE, but the design and payment of those services and the children they target are completely the responsibility of UFF. By choosing to provide services through partner agencies, we believe we have fully embraced the true spirit of community based care. For example, UFF recognized the need for greater recruitment efforts to increase the number of licensed foster homes. We developed a program to address that need and, using state and federal grant dollars, hired Hibiscus Children' s Center to provide the service. Our network of providers and the services we entrust to them is comprehensive. Children and families in St. Lucie, Indian River, Martin and Okeechobee counties have access to services that include: Domestic violence and substance abuse prevention, housing assistance, foster care and adoption, family support services, individual and group counseling and behavior management. Since our incorporation in 2003 , we have decreased the length of time children are removed from their homes from 18 months to less than a year. We found more adoptive homes for children than all but one region of the state. Most important, UFF ranked third in the state for keeping children out of the system once they returned home. This indicates that parent-education programs — created to prevent the re-abuse of children — are working. Furthermore, UFF accomplished these tasks with nearly half the funding per child as our sister agencies in South Florida ($8,000 per child locally compared to $ 15 ,382 per child in Palm Beach County) . 1 United for Families, Camp Foster Child, Children's services Advisory Committee B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) FRiver is the unacceptable condition requiring change? b) Who has the need? e do they live? d) Provide local, state, or national trend data, with reference hat corroborates that this is an area of need. County has a critical shortage of foster parents. This shortage is exacerbated by a n rate: In 2005, Indian River County lost 25 percent of its foster homes. Exit ggest the No. 1 reason these foster parents opted not to renew their licenses was all lack of support. Furthermore, a 2003 survey of existing foster parents identified summer camp as a critical support component. Foster parents interviewed for this proposal agreed that summer camp is an important retention tool because it provides a few hours of respite for parents who spend much of their time grappling not only with the special needs of foster children, but also with the child-welfare system and their children' s frustrated biological parents. It also is important that foster children, who carry an increased risk for anti-social behavior, participate in safe, structured and supervised activities during non-school hours. "Most of the teen-agers I had, you couldn't leave unattended," said Beck Rexroad, an adoptive parent and former foster parent who cared for more than 50 children in a 12-year period. "There is a need for organized activities to keep them focused and out of trouble." Foster Parent Judy Watts said foster children have special needs that make it important to keep them active during the summer. "They've already got problems," she said. "Some of these children like to run, and I don' t want that." Foster children are at a greater risk for crime, delinquency and teen-pregnancy than their peers. For example, a 2001 national study by the Annie E. Casey Foundation found that 58 percent of young adults seeking homeless shelters in 1997 were former foster children, while 41 percent spent time in jail within 2.5 and 4 years after leaving foster care and 42 percent became parents within that same time frame. Summer camp plays a significant role in reducing risk to young people, as studies have found that crime and sexual activity among that population increase during non-school hours and in the summer. (Sickmond, Snyder, and Poe-Yamagata, 1997, p. 26.) a) Identify similar programs that are currently serving the needs of your targeted population; b) Explain how these existing programs are under-serving the targeted population of your program. The Early Learning Coalition provides summertime childcare funding to children under the protective services of United for Families. This funding, however, is limited in that foster parents are required to pay parent fees, registration and field trip fees and the balance of any costs above the ELC reimbursement rate. Additionally, ELC does not fund children ages 13 and older. All of these costs are unallowable expenses for United for Families under current contract language with the Department of Children and Families, which provides the bulk of UFF funding. 2 United for Families, Camp Foster Child, Children's Services Advisory Committee PROGRAM COVER PAGE Organization Name: United for Families Executive Director: Christine Demetriades E-mail : Christine.demetriades@uff.us Address: 10570 S . Federal Hwy Telephone (772) 398-2920 Ext. 315 Ste. 300 Port St. Lucie, FL 34952 Fax: (772) 398-2925 Program Director: Christina Kaiser E-mail: Christina.kaiserguff us Address : above Telephone: (772) 398-2920 Ext. 302 Fax: (772) 398-2925 Program Title: Camp Foster Child Priority Need Area Addressed: Child Care Access/ Taxonomy No. PL-640. 150 Brief Description of the Program: United for Families will provide summer camp opportunities to up to 49 school-age children in Indian River County during the summer of 2007 By doing so UFF will create a safer and more creative environment for children during non-school hours and also provide needed respite to existing foster parents SUMMARY REPORT — (Enter Information In The Black Cells Only) LAmountRequestedquested from Funder for 2006 /07 : $ 17 , 600 sedProgram Budget for 2006 / 07 : $ 41 , 096 Total Program Budget : 428 % gram Funding (2005 /06 ) : $ - ease /( decrease ) in request : $ 17 , 600 rease /( decrease ) in request * * # DIV /0 ! UIM nduplicated Number of Children to be served Individually : 49 Unduplicated Number of Adults to be served Individually : 46 Unduplicated Number to be served via Group settings : - Total Program Cost per Client : 432 . 59 * *If request increased 5 % or more, briefly explain why: N/A If these funds are being used to match another source, name the source and the $ amount: The Organization 's Bo of Directors has approved this application ro-(i te), lea 04P <st r Is D . cc aL tIL Name of Presidem/Chair of the Board Si l�Vl (�I ��u'IYi J , � (� 1 Name of Executive Director/CEO Signature United for Farnilies, Camp Foster Child, Children's services Advisory Committee C. PROGRAM DESCRIPTION (Entire Section C, 1 - 6, not to exceed two pages) List Priority Needs area addressed. The support of those in need of special assistance/access to childcare. 1. Briefly describe program activities including location of services. United for Families will provide summer-camp opportunities to at least 22 and no more than 49 school-age foster children in Indian River County during the summer of 2007. The project will make use of existing camp resources, particularly those offered by city and county parks and recreation, the Boys and Girls Club, Life for Youth Ranch and other popular summer venues within Indian River County. We also are interested in educating foster homes on the types of camps available and to provide children and their families with a choice of camp experience during the summer months. The amount requested will pay for field trips and registration for children under the age of 13 and for tuition, registration and field trips for teen-agers. 2. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population. Summer camp meets a special two-pronged need in the foster-care community: First, it promotes self esteem, sportsmanship and the feeling of community among children whose development in these areas and whose connection to other human beings has been dramatically curtailed by previous maltreatment. It is particularly important to ensure opportunities such as summer camp to these children to keep them from feeling further alienated from society. Second, summer camp is an important component in the retention of foster homes. A 2003 United for Families telephone survey of foster parents who opted to leave the system indicated that the No. 1 requested support among foster parents is summer care. It is essential that UFF responds to these requests for support if we are to improve the retention of foster parents in Indian River County, where foster homes are so limited. 3. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform with the information in the Position Listing on the Budget Narrative Worksheet). No additional United for Families staffing will be required. 4. How will the target population be made aware of the program? United for Families will promote the program through Foster Parent Association meetings and in a monthly foster parent newsletter. 5. How will the program be accessible to target population (i.e., location, transportation, hours of operation)? Parents will have a choice in where their children go to camp, and therefore in the location and hours of operation. 3 United for Families, Camp Foster Child, Children's Semoes Advisory Committee D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements or the Measurahle F Add the tasks to accomplish the Outcomes) Increase by 27 percent the number oContact foster parents during the spring of children who attend camp during the 2007 to discuss summer camp opportunities. of 2007. Baseline : 2005 enrollment r children.) Decrease the number of disruptions to Indian UFF staff will respond immediately to foster River County child placements by 25 percent parent requests for summer respite by linking in one year as reported by 2007 UFF their foster children to available summer camp placement records. Baseline: 2005 placement programs. and disruption records ( 13 children.) 4 United for Families, Camp Foster Child, Children's Services Advisory Committee - ORGANIZATION: United for Families PROGRAM: Camp Foster Child 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. g Section of the Pro osal Pa e # COVER PAGE (with signatures). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TABLE OF CONTENTS (check list) A. ORGANIZATION CAPABILITY (one page maximum) 9C 1 . Mission and Vision of organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 x 2. Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . 1 B. PROGRAM NEED STATEMENT (one page maximum) 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 2 V 2 . Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . 2 C. PROGRAM DESCRIPTION (two pages maximum) u 1 . Funding priority 3 u 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . 0 . . . . . . . 3 3 . Evidence that program strategy will work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4. Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . 3 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 . . . . . 3 Y 6. Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . 3 X D. MEASURABLE OUTCOMES (two pages maximum) . . . . . . . . . . . . . . . . . . . . . . . . . 4 X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 F. PROGRAM EVALUATION (two pages maximum) )( 1 . Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . 6 2. Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . 6 3 . Reporting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X G. TIMETABLE (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 H. UNDUPLICATED CLIENT COUNT X 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 . . . . . . . . . . . . 8 2. Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I;nited for Families, Carnp Foster Child, Children's Services Advisory Committee I. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B1 -B5 J. FUNDER SPECIFIC/ADDITIONAL SHEETS _—XK. APPENDIX United for Families, Carnp Foster Child, Children's Services Advisory Cammdtee E. COLLABORATION (Entire Section E not to exceed one page) 1. List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative a reement letters. Collaborative A enc Resources provided to the program Early Learning Coalition of Indian Coalition has made UFF children in protective services a River, Martin and Okeechobee service priority and funds those children for child care Counties and camp . Indian River County Foster Parent Helps relay information; offers venue for Association speaking/education Indian River County Schools Offers location for Foster Parent Association meetings. 5 United for Families, Carnp Foster Child, Children 's Services Advisory Committee F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) F PHICS : What information (data elements) will you need to collect in order describe your target population including demographics (age, gender, and round) required by the funder in Section H? What are the pieces of hat qualify them for your target population? How do you document their ices or their "unacceptable condition requiring change" from Section Bl ? United for Families keeps data on all children in care on a daily basis. From databases such as Argos and HomeSafeNet, we can run current lists of children, ages, race, types of placement, address, placement history and case status . To place children in summer camp, United for Families will run data reports on children who are living in out-of-home care, including those living in licensed foster homes, and with relatives and non-relatives (such as neighbors). We will target Indian River County children ages 13 and older. Children who are under the age of 13 also will be targeted, though on a more limited basis. For those children, United for Families is seeking CSAC funds to pay for any summer-care expenses unmet through the Early Learning Coalition. These unmet expenses include registration and parent fees. Fthat ES: What data elements will you need to collect to show that you have or made progress toward) your Measurable Outcomes in Section D? What ms are you using as measures (grades, survey scores, attendance, absences, ) for your program? Are you getting baseline information from a source on boration List in Section E? Are there results from your Activities in Section to be documented? How often do you need to collect or follow-up on this I United for Families will use camp enrollment records, including the Early Learning Coalition' s authorization form and the UFF internal Camp Cover Sheet, to gauge enrollment numbers. We also will use placement and disruption reports generated monthly by the UFF Program Services Office. These reports will help us track the number of child disruptions caused by a lack of support. Finally, United for Families will conduct an annual survey of foster parents to determine the effectiveness of summer camp in retaining child placements. 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 ? All data will be compiled in an annual report and distributed among management staff, the UFF board of directors, placement staff, case management agencies and foster parents. The data will be reviewed by all parties to determine what aspects of the program work best and what need change. While the summer program is in progress, data will be reviewed periodically to ensure that measurable objectives are being met. If they are not, the UFF executive management team and representatives from the local Foster Parent Association and case-management agencies will meet to discuss corrective action. 6 United for Farnilies, Camp Foster Child, 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 8 't/z" X 11 " paper and number each page. These directions and the graphic boxes may be deleted if space is needed. A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1. Provide the mission statement and vision of your organization. United for Families ' mission is to help end the cycle of child abuse through a diverse network of community providers and innovative services. We were created in 2003 in response to Community Based Care, a statewide initiative that privatized public child welfare services. We are a non-profit agency charged with developing local services and supports for children and families in Okeechobee and the Treasure Coast. Our commitment to the community is to ensure safety to all children and to provide permanent homes for them. We envision a community where the safety and well-being of children is the concern of every individual; where "Safe Place" is not just a sign on a door, but a creed in every home. We believe that every child deserves a healthy family, and that every weakened family deserves a chance to heal itself. UFF will lead the community in the pursuit of these ideals. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. UFF is the local umbrella agency in child protective services. We believe that the best way to respond to our community' s unique needs is to bring all local providers of child-abuse services to a single table and to take advantage of existing resources . The services are provided by agencies such as Children' s Home Society and Exchange Club CASTLE, but the design and payment of those services and the children they target are completely the responsibility of UFF. By choosing to provide services through partner agencies, we believe we have fully embraced the true spirit of community based care. For example, UFF recognized the need for greater recruitment efforts to increase the number of licensed foster homes. We developed a program to address that need and, using state and federal grant dollars, hired Hibiscus Children' s Center to provide the service. Our network of providers and the services we entrust to them is comprehensive. Children and families in St. Lucie, Indian River, Martin and Okeechobee counties have access to services that include: Domestic violence and substance abuse prevention, housing assistance, foster care and adoption, family support services, individual and group counseling and behavior management. Since our incorporation in 2003 , we have decreased the length of time children are removed from their homes from 18 months to less than a year. We found more adoptive homes for children than all but one region of the state. Most important, UFF ranked third in the state for keeping children out of the system once they returned home. This indicates that parent-education programs — created to prevent the re-abuse of children — are working. Furthermore, UFF accomplished these tasks with nearly half the funding per child as our sister agencies in South Florida ($8,000 per child locally compared to $ 15 ,382 per child in Palm Beach County) . 1 United for Families, Camp Foster Child, Children's services Advisory Committee B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) FRiver is the unacceptable condition requiring change? b) Who has the need? e do they live? d) Provide local, state, or national trend data, with reference hat corroborates that this is an area of need. County has a critical shortage of foster parents. This shortage is exacerbated by a n rate: In 2005, Indian River County lost 25 percent of its foster homes. Exit ggest the No. 1 reason these foster parents opted not to renew their licenses was all lack of support. Furthermore, a 2003 survey of existing foster parents identified summer camp as a critical support component. Foster parents interviewed for this proposal agreed that summer camp is an important retention tool because it provides a few hours of respite for parents who spend much of their time grappling not only with the special needs of foster children, but also with the child-welfare system and their children' s frustrated biological parents. It also is important that foster children, who carry an increased risk for anti-social behavior, participate in safe, structured and supervised activities during non-school hours. "Most of the teen-agers I had, you couldn't leave unattended," said Beck Rexroad, an adoptive parent and former foster parent who cared for more than 50 children in a 12-year period. "There is a need for organized activities to keep them focused and out of trouble." Foster Parent Judy Watts said foster children have special needs that make it important to keep them active during the summer. "They've already got problems," she said. "Some of these children like to run, and I don' t want that." Foster children are at a greater risk for crime, delinquency and teen-pregnancy than their peers. For example, a 2001 national study by the Annie E. Casey Foundation found that 58 percent of young adults seeking homeless shelters in 1997 were former foster children, while 41 percent spent time in jail within 2.5 and 4 years after leaving foster care and 42 percent became parents within that same time frame. Summer camp plays a significant role in reducing risk to young people, as studies have found that crime and sexual activity among that population increase during non-school hours and in the summer. (Sickmond, Snyder, and Poe-Yamagata, 1997, p. 26.) a) Identify similar programs that are currently serving the needs of your targeted population; b) Explain how these existing programs are under-serving the targeted population of your program. The Early Learning Coalition provides summertime childcare funding to children under the protective services of United for Families. This funding, however, is limited in that foster parents are required to pay parent fees, registration and field trip fees and the balance of any costs above the ELC reimbursement rate. Additionally, ELC does not fund children ages 13 and older. All of these costs are unallowable expenses for United for Families under current contract language with the Department of Children and Families, which provides the bulk of UFF funding. 2 United for Families, Camp Foster Child, 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 January 2007 Meet with FPA to discuss camp options February Prepare camp registration paperwork and meet with Early Learning Coalition to ensure registration process for children under the age of 13 March Send camp registration instructions and enrollment paperwork to case management agencies April Begin enrollment May Enrollment/Review enrollment numbers June Camp begins July Review enrollment numbers and verify placement Invoicing begins August Camp ends/ school begins Invoicing September Follow up survey of foster parents/ fmal report October Report on findings November Brainstorm procedural changes if necessary December Establish procedure for coming year 7 , 111 ' 1 II 1 1 I 1 1 11 W. ✓ I r lee 11 1 6311111 1 • � i qrfl 1 1 I • 1 1 • � 1 �■�a MartinCounty1 . Port Saint Lucic • 1 1 . VOTTITITaTiTS i II I ' 1 1 1 1 Miff GjmI 13 , lee • 1 United for Farnilies, Camp Foster Child, Children's services Advisory Committee C. PROGRAM DESCRIPTION (Entire Section C, 1 - 6, not to exceed two pages) List Priority Needs area addressed. The support of those in need of special assistance/access to childcare. 1. Briefly describe program activities including location of services. United for Families will provide summer-camp opportunities to at least 22 and no more than 49 school-age foster children in Indian River County during the summer of 2007. The project will make use of existing camp resources, particularly those offered by city and county parks and recreation, the Boys and Girls Club, Life for Youth Ranch and other popular summer venues within Indian River County. We also are interested in educating foster homes on the types of camps available and to provide children and their families with a choice of camp experience during the summer months. The amount requested will pay for field trips and registration for children under the age of 13 and for tuition, registration and field trips for teen-agers. 2. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population. Summer camp meets a special two-pronged need in the foster-care community: First, it promotes self esteem, sportsmanship and the feeling of community among children whose development in these areas and whose connection to other human beings has been dramatically curtailed by previous maltreatment. It is particularly important to ensure opportunities such as summer camp to these children to keep them from feeling further alienated from society. Second, summer camp is an important component in the retention of foster homes. A 2003 United for Families telephone survey of foster parents who opted to leave the system indicated that the No. 1 requested support among foster parents is summer care. It is essential that UFF responds to these requests for support if we are to improve the retention of foster parents in Indian River County, where foster homes are so limited. 3. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform with the information in the Position Listing on the Budget Narrative Worksheet). No additional United for Families staffing will be required. 4. How will the target population be made aware of the program? United for Families will promote the program through Foster Parent Association meetings and in a monthly foster parent newsletter. 5. How will the program be accessible to target population (i.e., location, transportation, hours of operation)? Parents will have a choice in where their children go to camp, and therefore in the location and hours of operation. 3 United for Families, Camp Foster Child, Children's Semoes Advisory Committee D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements or the Measurahle F Add the tasks to accomplish the Outcomes) Increase by 27 percent the number oContact foster parents during the spring of children who attend camp during the 2007 to discuss summer camp opportunities. of 2007. Baseline : 2005 enrollment r children.) Decrease the number of disruptions to Indian UFF staff will respond immediately to foster River County child placements by 25 percent parent requests for summer respite by linking in one year as reported by 2007 UFF their foster children to available summer camp placement records. Baseline: 2005 placement programs. and disruption records ( 13 children.) 4 United! for Families Camp Foster Child 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 : United for Families/Camp Foster Child FUNDER : CSAC j CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should I Abe used for calculations and to write information only. e�T " S FOR Pro osed Total Program Funder Specific Total Agency REVENUES RGExcr usE oxLr P jaxow �EruLa Budget. Budget Budget cALcuianoxsi 1 Children's Services Council-St Lucie 36,000.0 2 Children's Services Council-Martin 3 Advisory Committee-Indian River 17,600.00 17,600.00 4 United Way-St Lucie County 5 United Way-Martin County 6 United Way-Indian River County 18,893,994.00 7 Department of Children & Families 8 County Funds 9 Contributions-Cash 10 Program Fees 11 Fund Raising Events-Net 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 15 Miscellaneous 16 Legacies & Bequests 17 Funds from Other Sources 20,250.00 337,000.00 18 Reserve Funds Used for Operating 19 in-Kind Donations (Not Included in total) 3,246.70 20 TOTAL REVENUES (doesnY include line 19) $37,850.00 $17,600.0 $19,266,994.00 A 8 C D EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific Total Agency AGENCY USE ONLY (SHOW CAIX"nOxs) -' Budget Budget Budget 21 Salaries (must complete chart on next page) 2,499.001 0.00 1 ,376,522.00 Salary 22 FICA - Total salaries x 0.0765 7.65% 747.00 O.OD 406,209.00 e Iremen - nnua pension or qua Re___ 0.00 0.00 23 staff 1 ea - e Ica enta ort-term 0.00 0.00 24 Disab. Workers Compensation - # employees x 0.00 0.00 25 rate Florida unemployment - # projected 26 employees x $7,000 x UCT-6 rate 0.00 0.00 SALARIES A s Gross Annual C % of Gross Annual POSITION LISTING salary Portion of P�m Proposed Funder Specific Budget Salary Position Title / Total NrsAvk (Agency) g Requested(CIA) Example: Executive Director/40hre 70,000.00 70,000.00 5,000.00 7.14% a-0 5/16/20W United! for Families Camp Foster Child ' • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, registration, food) 29 Office Supplies 0.00 0.00 29,004.00 • Office supplies (monthly average x 12 - months = estimated cost of office supplies based on present history. 30 Telephone 0.00 0.00 115,004.00 • # Phone lines x average cost per month x 12 months = local phone cost • Average long distance calls x 12 months = Estimated cost of long distance - 31 PostagelShipping _ 0.00 0.00 9,996.00 • Quarterly Mailing of Newsletter - - • Special events, eta • Bulk mailings - appeals 32 Utilities 0.0ol 0.00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) 33 Occupancy (Building & Grounds) 0.001 0.00 559,521 .00 • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications 0.00 0.00 10,004.00 • Quarterly Newsletter ($ x4) • Letterheads, Envelopes, etc. • Fundraising materials • Other 35 Subscription/Dues/Memberships 0.00 0.00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. 361nsurance 0.000.00 20,816.00 • Directors/Officers Liab. - • Commercial/General Insurance • Bond Ins. • Auto Insurance 37 Equipment:Rental & Maintenance 0.00 0.00 70,604.00 • Copier lease ($ x 12 months) ' Meter lease ($ x 12 months) - • Copier Maintenance ($ x 12 months) - • Computer Maintenance ( $ x 12 months) - • Other 38 Advertising 0.00 D.Do • Newspaper ads • Fundraising ads/promotions - • Other (vacancies) 39 Equipment Purchases:Capital Expense 0.00 0.00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 0.00 0.00 37,992.00 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 41 Books/Educational Materials 0.00 0.00 • Booksivideos • Materials ($ x staff) 42 Food & NutritionI 0.001 0.00 s�ierzoos a-� United for Families, Carnp Foster Child, Children's Services Advisory Cammdtee E. COLLABORATION (Entire Section E not to exceed one page) 1. List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative a reement letters. Collaborative A enc Resources provided to the program Early Learning Coalition of Indian Coalition has made UFF children in protective services a River, Martin and Okeechobee service priority and funds those children for child care Counties and camp . Indian River County Foster Parent Helps relay information; offers venue for Association speaking/education Indian River County Schools Offers location for Foster Parent Association meetings. 5 United for Families, Carnp Foster Child, Children 's Services Advisory Committee F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) F PHICS : What information (data elements) will you need to collect in order describe your target population including demographics (age, gender, and round) required by the funder in Section H? What are the pieces of hat qualify them for your target population? How do you document their ices or their "unacceptable condition requiring change" from Section Bl ? United for Families keeps data on all children in care on a daily basis. From databases such as Argos and HomeSafeNet, we can run current lists of children, ages, race, types of placement, address, placement history and case status . To place children in summer camp, United for Families will run data reports on children who are living in out-of-home care, including those living in licensed foster homes, and with relatives and non-relatives (such as neighbors). We will target Indian River County children ages 13 and older. Children who are under the age of 13 also will be targeted, though on a more limited basis. For those children, United for Families is seeking CSAC funds to pay for any summer-care expenses unmet through the Early Learning Coalition. These unmet expenses include registration and parent fees. Fthat ES: What data elements will you need to collect to show that you have or made progress toward) your Measurable Outcomes in Section D? What ms are you using as measures (grades, survey scores, attendance, absences, ) for your program? Are you getting baseline information from a source on boration List in Section E? Are there results from your Activities in Section to be documented? How often do you need to collect or follow-up on this I United for Families will use camp enrollment records, including the Early Learning Coalition' s authorization form and the UFF internal Camp Cover Sheet, to gauge enrollment numbers. We also will use placement and disruption reports generated monthly by the UFF Program Services Office. These reports will help us track the number of child disruptions caused by a lack of support. Finally, United for Families will conduct an annual survey of foster parents to determine the effectiveness of summer camp in retaining child placements. 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 ? All data will be compiled in an annual report and distributed among management staff, the UFF board of directors, placement staff, case management agencies and foster parents. The data will be reviewed by all parties to determine what aspects of the program work best and what need change. While the summer program is in progress, data will be reviewed periodically to ensure that measurable objectives are being met. If they are not, the UFF executive management team and representatives from the local Foster Parent Association and case-management agencies will meet to discuss corrective action. 6 United for Families Camp Faster Child Development Director 60,000.00 1 ,500.00 0.00 0.00% Community Resource Coordinator 40, 000.00 999.00 0.00 O.DO% #DIVlO! #DIVIO! #DIV/0! #DIV10! #DIV/OI #DIV/01 #DIVIO! #DIV10! #DIVIO! #DIVIO! #DIV/0! #DIV/01 #DIV/OI #DIVI01 #DIV10! #DIV/0! Total Remaining Agency Salaries 1 ,276,522.00 0.00 FEE E I #DIVI O ! Remaining positions throughout the agency Total Salaries $1 ,376,522.001 $2,499.00 $0.00 0.00% FRINGE BENEFITS DETAIL A c D E F G (Funder Specific Budget Funder a pension worker's unemp�oyme Total Fringes Funder SBudget peck FICA 7.65*1 Health Ins. Compels. nt Compens. Specific C only, from line 22 to 27) (Ax q) - Position Tifle / Total Hrs/wk Example: Case ManagerlMhrs 5,000.00 382.50 200.00 500.00 300.00 200.00 1,582.50 Development Director 0.00 0.00 0.00 0.00 O.OD 0.00 0.0 Community Resource Coordinator 0.00 0.00 0 .0 0 0.00 0.00 0.0 D.o 0 0.00 0.00 0.0 0 0.00 0.00 0 0.00 0.00 0.0 0.0 0 0.00 0.00 0 0 0 0.00 O.OD 0 0.00 0.00 0.0 0 0in 00 000 0 .0 0 00 0.00 0 00 0.0 0 00 O.D 0 00 0.0 0 00 D.0 O 00 0.0 D .o 0 00 0.0 0 00 Total Remaining Agency Salaries .00I i O.D 0 0.00 0.00 O.D Total Funder Request Fringe Benellds $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.0 A B C D EXPENDITURES GMYAaEIASFOR Proposed Total Program Funder Specifics Total Agency AGENCY USE ONLY to sNGW aETMIL -. Budgef: Budget Budget 27 Travel-Daily 0.00 0.00 21 ,000.00 # of Staff x average # of mi!es/wk x 50 wks x $ = Estimated Daily TraveVMileage Re!mb. 28 TraveUConferences/Training I 0.00 0.00 159,413.00 a-t 511WOM Limited for Families Camp Foster Child WAssistance ( # meals x clients x 5days x 50 wks) 43trative Costs O.OD :$17,500.00 0D 99,496.00 Cost (% of total budget) 44xpense 348,911 .00 ndent Audit Review 45 Assistance to Individuals 20,250.00 00 7,729,484.00 l assistance • Meals/Food• Rent Assistance • Other ELC contribution @ $75/child/week 46 Other/Miscellaneous 0.00 00 • Background check/drug test • Other 47 OtherlContract 17,600.00 00 8,273,018• Sub-contract for program services 48 TOTAL EXPENSES $41 ,096.00 $19,266,994.00 5/1&2005 6-1 United for Families, Camp Foster Child, 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 January 2007 Meet with FPA to discuss camp options February Prepare camp registration paperwork and meet with Early Learning Coalition to ensure registration process for children under the age of 13 March Send camp registration instructions and enrollment paperwork to case management agencies April Begin enrollment May Enrollment/Review enrollment numbers June Camp begins July Review enrollment numbers and verify placement Invoicing begins August Camp ends/ school begins Invoicing September Follow up survey of foster parents/ fmal report October Report on findings November Brainstorm procedural changes if necessary December Establish procedure for coming year 7 , 111 ' 1 II 1 1 I 1 1 11 W. ✓ I r lee 11 1 6311111 1 • � i qrfl 1 1 I • 1 1 • � 1 �■�a MartinCounty1 . Port Saint Lucic • 1 1 . VOTTITITaTiTS i II I ' 1 1 1 1 Miff GjmI 13 , lee • 1 UNIFORM GRANT APPLICATION TOTALAGENCY BUDGET AGENCYIPROGRAM NAME: United for Families) Camp Foster Child FY 04/05 FY D5106 FV D6107 % INCREASE FYE FYE FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED !vol. Ecol. ePam. a REVENUES BUDGETED BUDGETED 1 Children's Services CouncilSt Lucie 36,000.00 36 000.00 36 000.00 0.00% 2 Children's Services Council-Martin 0.00 #DIV101 3 Advisory Committee-Indian River 0.00 #DIVIO! 4 United Way-St Lucie CountV 0.00 #DIV101 s United Way-Martin County 0.00 #DIV/01 s United Way-Indian River County 0.00 #DIV/0I 7 Department of Children & Families 16,221 717.00 18,893,994.00 18893,994.00 0.00% a County Funds 0.00 #DIV/01 9 Contributions-Cash 18294.D0 0.00 #DIV/01 10 Program Fees O.DO #DIV/01 11 Fund Raising Events-Net 0.00 #DIV/01 12 Sales to Public-Net 0.00 #DIVIO! 13 Membershi Dues 0.00 #DIV10! 14 Investment Income 0.00 #DIVI01 is Miscellaneous 133468.00 0.00 #DIV/o! 16 Legacies; & Bequests 0.00 #DIVID! 17 Funds from Other Sources 22,255.00 337,000.00 337,000.00 0.00% 18 Reserve Funds Used for Operating 0.00 #DIVIO! is In-Kind Donations (Nu incl 4 inmml 0.00 #DIV/O! m TOTAL 16,431 ,734.00 19 266,994.00 19,266 994.00 0.00% EXPENDITURES 21 Salaries 918228.00 1 ,376522.00 1 ,376,522.00 0.00% m FICA 393,526.00 406 209.00 406 209.00 0.00% 23 Retirement 0.00 #DIV/DI 24 Life/Health 0.00 #DIV101 zs Workers Compensation 0.00 1kDIV701 26 Florida Unemployment 0.00 #DIV/0! 27 Travel-Daily 523023.00 21 ,000.00 21 ,000.00 0.007A 2e Treve#Conferences/Trainin 159413.00 159,413.00 0.00% 29 Office Supplies 29 004.00 29,004. 0 0.00% 3a Tele hone 115,004.00 115,004.00 0.00% 31 PostagelShipping 9 996.D0 9,996.00 0.00% 32 Utilities 0.00 #DIV101 33 Occupancy (Building & Grounds 157 880.00 559 521 .00 559,521.00 D.00% m Printing & Publications 10,004.00 10,004.00 D.00% 35 Subscription/Dues/Memberships 0.00 #DIV10! 36 Insurance 42,479.00 20 816.00 20,816.00 0.00% 37 E ui men -Rental & Maintenance 70 604.00 70,604.00 11.00% 38 Advertising 0.00 #DIV/O! 39 Equipment Purchases:Ca ital Expense 17 051 .00 0.00 #DIV10! a Professional Fees (Legal, Consulting) 65p799.00 37 992.00 37,992.01) 0.00% 41 BookslEducational Materials 0.00 #DIVI01 42 Food & Nutrition 0.00 #DIV10! 43 Administrative Costs 99496.00 99,496.OD 0.00% 44 Audit Expense 348 911 .00 348 911 .00 0.00% 45 Specific Assistance to Individuals 14302,902.01) 7729484.00 7729484.00 0.00% 4s Other/Miscellaneous 0.00 #DIVIO! 47 Other/Contract 8,273 018.00 8273018 O.DO% 4a TOTAL 16 414,888.00 19 266 994.00 19,266 994.00 0.00% 491 REVENUES OVER/ UNDER EXPENDITURES 16,846.00 0.0D 0.00 #DIV101 ez ,.�, UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: United for Families/Camp Foster Child FY N4/D5 FV 05/06 FY W07 % INCREASE FYE FYE FYE CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (cal. Gcal. BVcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie - 0.00 #DIV101 2 Children's Services Council-Martin 0.00 #DIV/0! 3 Advisory Committee-Indian River 0.00 0.00 1760000 #DIV/01! 4 United Way-SL Lucie CountV 0.00 #DIV/O1 5 United Way-Martin County 0.00 #DIV/0! 6 United Way-Indian River ounty 0.00 #DIVIO! 7 Department of Children & Families 0.00 DIV/OI s County Funds 0.00 #DIV/01 9 Contributions-Cash 0.00 #DIV/GI 10 Program Fees 0.00 #DIV/0! 11 Fund Raising Events-Net 0.00 #DIV/0! 12 Sales to Public-Net 0.001 #DIVIO! 13 Membersh! Dues 0.00 #DIVI01 14 Investment Income 0.00 #DIV/0! i5 Miscellaneous 0.00 #DIV101 16 Legacies & Bequests 0.00 9DIV101 17 Funds from Other Sources 20,260.00 #DIV/01 is Reserve Funds Used for Operating 0.00 #DIVIO! is In-Kind Donations (Not inclw a in mm) 3,246.70 #DIVIO! 20 TOTAL 0.00 0.00 37560.00 #DIV/01 EXPENDITURES 21 Salaries - 2,499.00 #DMD! 22 FICA 747.00 #DIVIO! 23 Retirement 0.00 #DIVIO! 24 Life/Health 0.00 #DIVIO! 25WP�taqe/Shippinq Compensation 0.00 #DIV101 26 Unem I ment 0.00 #DIV70! 27ail 0.00 #DIVIO! ` 28Conferences/Treinin 0.00 #DIV/0! 29u lies 0.00 #DIV/0! 3( Telephone 0.00 #DIVIO! 31a/Shi in 0.00 #DIV101 32 0.01) #DIVI01 33 Buildin & Grounds 0.00 #DIV10! 34 Printin & Publication 0.00 #DIV10! 35 Subscri tion/DueslMembershi s 0.00 #DIV101 36 Insurance 0.00 #DIV/01 37 E ui ment icental & Maintenance 0.00 #DIV/O! 3e Advertising 0.00 #DIVIO! 39 Equipment Purchases:Ca ital Expense 0.00 #DIV10! 40 Professional Fees (Legal, Consulting) D.00 #DIV/01 41 Books/Eduwtional Materials 0.00 #DIV101 42 Food & Nutrition 0.00 #DIV/0! 43 Administrative Costs 0.00 #DIVIO! 44 Audit Expense 0.001 #DIV/01 45 Specific Assistance to Individuals 20,250.00 #DIV/01 46 Other/Miscellaneous 0.00 #DIV/01 47 Other/Contract 17,600.OD #DIV101 48 TOTAL 0.00 0.00 41 ,096.00 #DIV/0! 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 .3,246.00 #DIVIO! shvmm as United! for Families Camp Foster Child 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 : United for Families/Camp Foster Child FUNDER : CSAC j CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should I Abe used for calculations and to write information only. e�T " S FOR Pro osed Total Program Funder Specific Total Agency REVENUES RGExcr usE oxLr P jaxow �EruLa Budget. Budget Budget cALcuianoxsi 1 Children's Services Council-St Lucie 36,000.0 2 Children's Services Council-Martin 3 Advisory Committee-Indian River 17,600.00 17,600.00 4 United Way-St Lucie County 5 United Way-Martin County 6 United Way-Indian River County 18,893,994.00 7 Department of Children & Families 8 County Funds 9 Contributions-Cash 10 Program Fees 11 Fund Raising Events-Net 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 15 Miscellaneous 16 Legacies & Bequests 17 Funds from Other Sources 20,250.00 337,000.00 18 Reserve Funds Used for Operating 19 in-Kind Donations (Not Included in total) 3,246.70 20 TOTAL REVENUES (doesnY include line 19) $37,850.00 $17,600.0 $19,266,994.00 A 8 C D EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific Total Agency AGENCY USE ONLY (SHOW CAIX"nOxs) -' Budget Budget Budget 21 Salaries (must complete chart on next page) 2,499.001 0.00 1 ,376,522.00 Salary 22 FICA - Total salaries x 0.0765 7.65% 747.00 O.OD 406,209.00 e Iremen - nnua pension or qua Re___ 0.00 0.00 23 staff 1 ea - e Ica enta ort-term 0.00 0.00 24 Disab. Workers Compensation - # employees x 0.00 0.00 25 rate Florida unemployment - # projected 26 employees x $7,000 x UCT-6 rate 0.00 0.00 SALARIES A s Gross Annual C % of Gross Annual POSITION LISTING salary Portion of P�m Proposed Funder Specific Budget Salary Position Title / Total NrsAvk (Agency) g Requested(CIA) Example: Executive Director/40hre 70,000.00 70,000.00 5,000.00 7.14% a-0 5/16/20W United! for Families Camp Foster Child ' • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, registration, food) 29 Office Supplies 0.00 0.00 29,004.00 • Office supplies (monthly average x 12 - months = estimated cost of office supplies based on present history. 30 Telephone 0.00 0.00 115,004.00 • # Phone lines x average cost per month x 12 months = local phone cost • Average long distance calls x 12 months = Estimated cost of long distance - 31 PostagelShipping _ 0.00 0.00 9,996.00 • Quarterly Mailing of Newsletter - - • Special events, eta • Bulk mailings - appeals 32 Utilities 0.0ol 0.00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) 33 Occupancy (Building & Grounds) 0.001 0.00 559,521 .00 • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications 0.00 0.00 10,004.00 • Quarterly Newsletter ($ x4) • Letterheads, Envelopes, etc. • Fundraising materials • Other 35 Subscription/Dues/Memberships 0.00 0.00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. 361nsurance 0.000.00 20,816.00 • Directors/Officers Liab. - • Commercial/General Insurance • Bond Ins. • Auto Insurance 37 Equipment:Rental & Maintenance 0.00 0.00 70,604.00 • Copier lease ($ x 12 months) ' Meter lease ($ x 12 months) - • Copier Maintenance ($ x 12 months) - • Computer Maintenance ( $ x 12 months) - • Other 38 Advertising 0.00 D.Do • Newspaper ads • Fundraising ads/promotions - • Other (vacancies) 39 Equipment Purchases:Capital Expense 0.00 0.00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 0.00 0.00 37,992.00 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 41 Books/Educational Materials 0.00 0.00 • Booksivideos • Materials ($ x staff) 42 Food & NutritionI 0.001 0.00 s�ierzoos a-� UrMed hr Fe 1i Camp FwW CNM UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : United for Families/Camp Foster Child FUNDER: CSAC A B C FY 06107 - FY 06107 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. B/col. A) EXPENDITURES 21 Salaries 25499.00 0.00 0.00% 22 FICA 747 .00 0.00 0.00% 23 Retirement 0.00 0.00 #DIVIO ! 24 Life/Health 0.00 0.00 #DIV/O ! 25 Workers Compensation 0.00 0.00 #DIV10 ! 26 Florida Unemployment 0 .00 0.00 #DIV101 27 Travel-Dail 0.00 0.00 #DIV101 28 Travel/Conferencesrrrain Ing 0.00 0.00 #DIV101 29 Office Su lies 0.00 0 .00 #DIV/O ! 30 Telephone 0.00 0 .00 #DIV/01 31 Postage/Shipping 0.00 0 .00 #DIV101 32 Utilities 0.00 0 .00 #DIV10! 33 Occupancy (Building & Grounds 0 .00 0 .00 #DIV/O ! 34 Printing & Publications 0.00 0 .00 #DIV10 ! 35 Subscri tion/Dues/Membershi s 0 .00 0 .00 #DIV/O ! 36 Insurance 0.00 0 .00 #DIV101 37 E ui ment: Rental & Maintenance 0.00 0 .00 #DIV10 ! 38 Advertising 0.00 0.00 #DIV101 39 Equipment Purchases : Capita I Expense 0 .00 0.00 #DIV/01 40 Professional Fees (Legal, Consulting) 0.00 0.00 #DIV101 41 Books/Educational Materials 0 .00 0.00 #DIV/01 42 Food & Nutrition 0 .00 0.00 #DIV101 43 Administrative Costs 0.00 0.00 #DIV/0! 44 Audit Expense 0.00 0.00 #DIV/0! 45 Specific Assistance to Individuals 20,250.00 0.00 0.00% 46 Other/Miscellaneous 0 .001 0.00 #DIV101 47 Other/Contract 175600 .00 17 ,600.00 100.00% 48 TOTAL $417096.06 $17,600 .00 42.83% S16l2 84 Unrdnr F. UW Fw Chi] UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCY/PROGRAM NAME: United for Families/Camp Foster Child FUNDER: CSAC r#DiV101 E f7E ' EXPLAMAPON,FDKVARW4CE "".' ro! /01 /DI /01 /0! /01 lol ID! /01 /01 /01 01 /01 ID! /01 01 01 01 #DNID! #ON/01 #DN/01 #DIV/01 this is a first-year program; UFF is asking 100 percent for cormact fees for camp expenses. However, ELC is contributing bulk of Other/Contract expense under aid to individuals line. silwm ad United for Families Camp Faster Child Development Director 60,000.00 1 ,500.00 0.00 0.00% Community Resource Coordinator 40, 000.00 999.00 0.00 O.DO% #DIVlO! #DIVIO! #DIV/0! #DIV10! #DIV/OI #DIV/01 #DIVIO! #DIV10! #DIVIO! #DIVIO! #DIV/0! #DIV/01 #DIV/OI #DIVI01 #DIV10! #DIV/0! Total Remaining Agency Salaries 1 ,276,522.00 0.00 FEE E I #DIVI O ! Remaining positions throughout the agency Total Salaries $1 ,376,522.001 $2,499.00 $0.00 0.00% FRINGE BENEFITS DETAIL A c D E F G (Funder Specific Budget Funder a pension worker's unemp�oyme Total Fringes Funder SBudget peck FICA 7.65*1 Health Ins. Compels. nt Compens. Specific C only, from line 22 to 27) (Ax q) - Position Tifle / Total Hrs/wk Example: Case ManagerlMhrs 5,000.00 382.50 200.00 500.00 300.00 200.00 1,582.50 Development Director 0.00 0.00 0.00 0.00 O.OD 0.00 0.0 Community Resource Coordinator 0.00 0.00 0 .0 0 0.00 0.00 0.0 D.o 0 0.00 0.00 0.0 0 0.00 0.00 0 0.00 0.00 0.0 0.0 0 0.00 0.00 0 0 0 0.00 O.OD 0 0.00 0.00 0.0 0 0in 00 000 0 .0 0 00 0.00 0 00 0.0 0 00 O.D 0 00 0.0 0 00 D.0 O 00 0.0 D .o 0 00 0.0 0 00 Total Remaining Agency Salaries .00I i O.D 0 0.00 0.00 O.D Total Funder Request Fringe Benellds $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.0 A B C D EXPENDITURES GMYAaEIASFOR Proposed Total Program Funder Specifics Total Agency AGENCY USE ONLY to sNGW aETMIL -. Budgef: Budget Budget 27 Travel-Daily 0.00 0.00 21 ,000.00 # of Staff x average # of mi!es/wk x 50 wks x $ = Estimated Daily TraveVMileage Re!mb. 28 TraveUConferences/Training I 0.00 0.00 159,413.00 a-t 511WOM Limited for Families Camp Foster Child WAssistance ( # meals x clients x 5days x 50 wks) 43trative Costs O.OD :$17,500.00 0D 99,496.00 Cost (% of total budget) 44xpense 348,911 .00 ndent Audit Review 45 Assistance to Individuals 20,250.00 00 7,729,484.00 l assistance • Meals/Food• Rent Assistance • Other ELC contribution @ $75/child/week 46 Other/Miscellaneous 0.00 00 • Background check/drug test • Other 47 OtherlContract 17,600.00 00 8,273,018• Sub-contract for program services 48 TOTAL EXPENSES $41 ,096.00 $19,266,994.00 5/1&2005 6-1 UM d W FamY Caw Fo CFi! UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF IS% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: United for Families FUNDER: CSAC `v im"-" ;y LNE(TEM ix. . " 4 zs`^ ' ^° ... � -*z EXPLANATION FOR M.ARIANCE§," - MWO! #DN/O! #DIV/01 #DN/O! #DN/O! #DN/01 #DN/O! #DN101 #DIV/O! #DN101 #DN/01 #DIV101 #DN/O! #DIV/01 #DIV101 #DNIO! #DIV101 #DIV101 #DN/01 #DIV/01 #DIV/0! #DN/01 #DN101 #DN101 #DN/O! #DN/01 #DIV/01 #DIV/01 #DNIO! #DIV/01 #DN/OI #DN/O! #DIVI01 #DIV/01 #DIV/01 #DN101 #DN101 #DIV/01 #DN101 #DN/0! #DIV/01 #Drvrol #DIVIO! #DN101 #DNI01 #DN101 6s 61t6(NJfi 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 301") 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 - UNIFORM GRANT APPLICATION TOTALAGENCY BUDGET AGENCYIPROGRAM NAME: United for Families) Camp Foster Child FY 04/05 FY D5106 FV D6107 % INCREASE FYE FYE FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED !vol. Ecol. ePam. a REVENUES BUDGETED BUDGETED 1 Children's Services CouncilSt Lucie 36,000.00 36 000.00 36 000.00 0.00% 2 Children's Services Council-Martin 0.00 #DIV101 3 Advisory Committee-Indian River 0.00 #DIVIO! 4 United Way-St Lucie CountV 0.00 #DIV101 s United Way-Martin County 0.00 #DIV/01 s United Way-Indian River County 0.00 #DIV/0I 7 Department of Children & Families 16,221 717.00 18,893,994.00 18893,994.00 0.00% a County Funds 0.00 #DIV/01 9 Contributions-Cash 18294.D0 0.00 #DIV/01 10 Program Fees O.DO #DIV/01 11 Fund Raising Events-Net 0.00 #DIV/01 12 Sales to Public-Net 0.00 #DIVIO! 13 Membershi Dues 0.00 #DIV10! 14 Investment Income 0.00 #DIVI01 is Miscellaneous 133468.00 0.00 #DIV/o! 16 Legacies; & Bequests 0.00 #DIVID! 17 Funds from Other Sources 22,255.00 337,000.00 337,000.00 0.00% 18 Reserve Funds Used for Operating 0.00 #DIVIO! is In-Kind Donations (Nu incl 4 inmml 0.00 #DIV/O! m TOTAL 16,431 ,734.00 19 266,994.00 19,266 994.00 0.00% EXPENDITURES 21 Salaries 918228.00 1 ,376522.00 1 ,376,522.00 0.00% m FICA 393,526.00 406 209.00 406 209.00 0.00% 23 Retirement 0.00 #DIV/DI 24 Life/Health 0.00 #DIV101 zs Workers Compensation 0.00 1kDIV701 26 Florida Unemployment 0.00 #DIV/0! 27 Travel-Daily 523023.00 21 ,000.00 21 ,000.00 0.007A 2e Treve#Conferences/Trainin 159413.00 159,413.00 0.00% 29 Office Supplies 29 004.00 29,004. 0 0.00% 3a Tele hone 115,004.00 115,004.00 0.00% 31 PostagelShipping 9 996.D0 9,996.00 0.00% 32 Utilities 0.00 #DIV101 33 Occupancy (Building & Grounds 157 880.00 559 521 .00 559,521.00 D.00% m Printing & Publications 10,004.00 10,004.00 D.00% 35 Subscription/Dues/Memberships 0.00 #DIV10! 36 Insurance 42,479.00 20 816.00 20,816.00 0.00% 37 E ui men -Rental & Maintenance 70 604.00 70,604.00 11.00% 38 Advertising 0.00 #DIV/O! 39 Equipment Purchases:Ca ital Expense 17 051 .00 0.00 #DIV10! a Professional Fees (Legal, Consulting) 65p799.00 37 992.00 37,992.01) 0.00% 41 BookslEducational Materials 0.00 #DIVI01 42 Food & Nutrition 0.00 #DIV10! 43 Administrative Costs 99496.00 99,496.OD 0.00% 44 Audit Expense 348 911 .00 348 911 .00 0.00% 45 Specific Assistance to Individuals 14302,902.01) 7729484.00 7729484.00 0.00% 4s Other/Miscellaneous 0.00 #DIVIO! 47 Other/Contract 8,273 018.00 8273018 O.DO% 4a TOTAL 16 414,888.00 19 266 994.00 19,266 994.00 0.00% 491 REVENUES OVER/ UNDER EXPENDITURES 16,846.00 0.0D 0.00 #DIV101 ez ,.�, UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: United for Families/Camp Foster Child FY N4/D5 FV 05/06 FY W07 % INCREASE FYE FYE FYE CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (cal. Gcal. BVcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie - 0.00 #DIV101 2 Children's Services Council-Martin 0.00 #DIV/0! 3 Advisory Committee-Indian River 0.00 0.00 1760000 #DIV/01! 4 United Way-SL Lucie CountV 0.00 #DIV/O1 5 United Way-Martin County 0.00 #DIV/0! 6 United Way-Indian River ounty 0.00 #DIVIO! 7 Department of Children & Families 0.00 DIV/OI s County Funds 0.00 #DIV/01 9 Contributions-Cash 0.00 #DIV/GI 10 Program Fees 0.00 #DIV/0! 11 Fund Raising Events-Net 0.00 #DIV/0! 12 Sales to Public-Net 0.001 #DIVIO! 13 Membersh! Dues 0.00 #DIVI01 14 Investment Income 0.00 #DIV/0! i5 Miscellaneous 0.00 #DIV101 16 Legacies & Bequests 0.00 9DIV101 17 Funds from Other Sources 20,260.00 #DIV/01 is Reserve Funds Used for Operating 0.00 #DIVIO! is In-Kind Donations (Not inclw a in mm) 3,246.70 #DIVIO! 20 TOTAL 0.00 0.00 37560.00 #DIV/01 EXPENDITURES 21 Salaries - 2,499.00 #DMD! 22 FICA 747.00 #DIVIO! 23 Retirement 0.00 #DIVIO! 24 Life/Health 0.00 #DIVIO! 25WP�taqe/Shippinq Compensation 0.00 #DIV101 26 Unem I ment 0.00 #DIV70! 27ail 0.00 #DIVIO! ` 28Conferences/Treinin 0.00 #DIV/0! 29u lies 0.00 #DIV/0! 3( Telephone 0.00 #DIVIO! 31a/Shi in 0.00 #DIV101 32 0.01) #DIVI01 33 Buildin & Grounds 0.00 #DIV10! 34 Printin & Publication 0.00 #DIV10! 35 Subscri tion/DueslMembershi s 0.00 #DIV101 36 Insurance 0.00 #DIV/01 37 E ui ment icental & Maintenance 0.00 #DIV/O! 3e Advertising 0.00 #DIVIO! 39 Equipment Purchases:Ca ital Expense 0.00 #DIV10! 40 Professional Fees (Legal, Consulting) D.00 #DIV/01 41 Books/Eduwtional Materials 0.00 #DIV101 42 Food & Nutrition 0.00 #DIV/0! 43 Administrative Costs 0.00 #DIVIO! 44 Audit Expense 0.001 #DIV/01 45 Specific Assistance to Individuals 20,250.00 #DIV/01 46 Other/Miscellaneous 0.00 #DIV/01 47 Other/Contract 17,600.OD #DIV101 48 TOTAL 0.00 0.00 41 ,096.00 #DIV/0! 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 .3,246.00 #DIVIO! shvmm as 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 1840 25'" Street Vero Beach , Florida 32960-3365 Recipient: United for Families 10570 S. Federal Highway, Suite 301 Port St. Lucie, Florida 34996 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 - Nov 2i 2006 11 � 2t�14 CCUMUN ' TY IN3UR � NCE CiFVICES CORD_ CERTIFICATE OF LIABILITY INSURANCE oPlly - °"� "^°°°^ ' TmrrsO 10 25 05 �JNCER THIS CERTIFICATE IS ISSUED AS A NATTER OFINFORMATFON Y own 4 BrOwa of i'lorida , Iro-. ONLY AND CONFERS NORi^HTSLIPONTHE CERT7FIC4TB Daytona Beach Office HOLDER. THIS CFaTIFICA7cDOES NOT AKND, LKaNDOR P . O . Hoa 2412 ALTER THE. COVFKAGEAMRDED BY THE POLCIES BELOW. Daytona Beach FL 32115-2412 Phone : 386-252 -9601 R'ax : 386-239-1729 INSURERS AFFORDING COVERAGE NAIC9 NAJeEO i % Rh XL Specialty Ins Co _ 37085 General eter Ind 7"t 37362 Unit2d pp Faailleai , j�§yyC . ' Ro. New Hampshire Ina Co 23841 10570 60VTN II'ICDT,RxI, RIPSC ST 301 Ir- __- _ PORT ST 7:VCIE FL 34992 ►auRERD. �OVERAGcS —. �" THE POLICES OF INSURANCE LISTED NLOW HAVE WN NOJEO TO THE INBURE.1 NAMED ABOVE FOR THE POLJOY PERIOD RIOICA, c 1. nV MTTNSIANDNG ANY REDIM4XI$JT, T WM OR CONDITION OF ANY COMPACT OR OTHER O°tYTMENT WTH RESPECT TU W HCJITHI$ CERTIFICATE MAY Bi CESj ED OR MAY PERTAN, THE INSURANCE AFFORDED W THE POLICES OLSCRIBEOHEREN I:. WIJECTTO ALL THE TERMS, TJ!°LLTSONb AND OCNL-^IONS OF DdCH y'POUCS.LA3=GATELMYTSLW155HOWNM%Y HAVE OEEN REDUCED Bf PAD CuIm& pFJ��p MMS TYPE OF IRSURANOE POLICY NUMBER 16A. . ( T 6flEr I uYrta _. ""'MAL UANU?y I EACH oct� RR 1�pG0 000 rTMRAGE TOT: ier. RcaALcrNFaALLweurr 01LX89985280 03/15106 03/35 / 07 PREWSEBIEa .�,ra,0 9100 000 ' CLAIMS MAGE X NFO aCCut 'ii .. LJ EuY' a„ p 65 , 000 _ PFASOuaLSAOVNJURV § 1 , 000 ODO _ EE , GENERU A6. -REGA IT s3 100 000 VWLAGGREGATEtMT APPLIES R' r PRO- PRDDU.rs.GCMPQMAS'. a 1 . 700 000 POS I JECT I .. . LO,. IAUTOMON EUAFILnY AW AUTO _ WLONEDILM ELIMT § (.B YTlJtlAn11 . ALS OWNED A{1 0Z "eO1EDUlEO AUTO (FODLYINARn' B Per praaoJ 1 1 HIRED AUTCS . . . . NONDANLG AUTOS II iBODIY INJURY § W 9rAlI W _— I �PROPERTVOMMGE . T (Par s¢IOAm1 I 6ARJ.GE lfA191LITY AUTO ONLY. RA ACCIDENT ARi . Y AUTO i OTHER ONLY: EA ACC �'''''T��L— I I AUTO OY: A" ! EXCEELUNBREW NCE 1MIULVN I FACH OWURRES ODIC °caTa ❑ ^1AINSMADE 110 =02739700 03 /15/06 + 03/15/07 AccREGATE. f_ ' OEWCOBLF � 'L' i� RETENTKIN ' S E 5 COM►fNtATONANb I TORr uWTs ER ANT PROPRIETOWPARTNEREXECLTNE i j ELwHA0CJD9M § ipFFh RME1�Eli EXCLUDED' EL. OIBEABF - EA Eu— j `rPECIAL�P SIS CNOMI ::: E.L. bvSt if FgLILY LIyIT ' Oi n I --�-I 4ird 11CSC966102E77601 03/21/ 06 /3/21/07 J PzopertyLSeotsen I noms961A 03/15 /06 ! 03 / 15/ 07 contents 1501:`0 CRR*11pN OF OPBTAnONS! LOCATONS /VEMi°LFS r EXCiVSI0N5 AOOED BY TO+oplBENEM/ $JR:OLAL PROVISIONS MUTY DAYS NOTICE OF CANCELLATION , TEN AAPS NOTICE DUE TO NON- PAYNLNR X : 772 - 398w2925 1p ZTIFICATE HOLDER CANCELLATION ' IND nko4 {MOULD ANY OP TNEIdOVE BE§CARiED POlJCIEi EF CAAU'ECIFD BEFORE 7HE 'FJfPoN .nOA DATE TMHLEOF. THE 55YING INSURER WLL ENOEAYOR TO YAIL 30 DAYb WR, HN .i NOTKE TO TME CERTIFI[ATE NDLaEJi TJAMS:O TO THE LEFT, FLIT FAILCRC TO 0:: TD annLl I=1" RIVER COUNTY IAD0w NO cow"TTON OR LMFIUTYOF ANY 00 UPON THE4wit"R, US AO, . Tu? 1040 25TH ST R9R6SFNTAttVEL VERO BLACK Ft 32960 _ T�PRESENT+RIy4 7R02s (2wilcal 8C v e a me_DC `. . 2 : . — 1 : ) OV 'W VACORD CORPDRATION 1853 UrMed hr Fe 1i Camp FwW CNM UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : United for Families/Camp Foster Child FUNDER: CSAC A B C FY 06107 - FY 06107 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. B/col. A) EXPENDITURES 21 Salaries 25499.00 0.00 0.00% 22 FICA 747 .00 0.00 0.00% 23 Retirement 0.00 0.00 #DIVIO ! 24 Life/Health 0.00 0.00 #DIV/O ! 25 Workers Compensation 0.00 0.00 #DIV10 ! 26 Florida Unemployment 0 .00 0.00 #DIV101 27 Travel-Dail 0.00 0.00 #DIV101 28 Travel/Conferencesrrrain Ing 0.00 0.00 #DIV101 29 Office Su lies 0.00 0 .00 #DIV/O ! 30 Telephone 0.00 0 .00 #DIV/01 31 Postage/Shipping 0.00 0 .00 #DIV101 32 Utilities 0.00 0 .00 #DIV10! 33 Occupancy (Building & Grounds 0 .00 0 .00 #DIV/O ! 34 Printing & Publications 0.00 0 .00 #DIV10 ! 35 Subscri tion/Dues/Membershi s 0 .00 0 .00 #DIV/O ! 36 Insurance 0.00 0 .00 #DIV101 37 E ui ment: Rental & Maintenance 0.00 0 .00 #DIV10 ! 38 Advertising 0.00 0.00 #DIV101 39 Equipment Purchases : Capita I Expense 0 .00 0.00 #DIV/01 40 Professional Fees (Legal, Consulting) 0.00 0.00 #DIV101 41 Books/Educational Materials 0 .00 0.00 #DIV/01 42 Food & Nutrition 0 .00 0.00 #DIV101 43 Administrative Costs 0.00 0.00 #DIV/0! 44 Audit Expense 0.00 0.00 #DIV/0! 45 Specific Assistance to Individuals 20,250.00 0.00 0.00% 46 Other/Miscellaneous 0 .001 0.00 #DIV101 47 Other/Contract 175600 .00 17 ,600.00 100.00% 48 TOTAL $417096.06 $17,600 .00 42.83% S16l2 84 Unrdnr F. UW Fw Chi] UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCY/PROGRAM NAME: United for Families/Camp Foster Child FUNDER: CSAC r#DiV101 E f7E ' EXPLAMAPON,FDKVARW4CE "".' ro! /01 /DI /01 /0! /01 lol ID! /01 /01 /01 01 /01 ID! /01 01 01 01 #DNID! #ON/01 #DN/01 #DIV/01 this is a first-year program; UFF is asking 100 percent for cormact fees for camp expenses. However, ELC is contributing bulk of Other/Contract expense under aid to individuals line. silwm ad V0. J10 V4 bOV VaV aa6 + r-' • vr.rr [_ vvv a- . va • - -ter. � • �. p �- ) : Indian River COMPANY : ACORD DATE Ni 12/0612OC6 PRODUCER Serial # 621931 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AON RISK SERVICES OF FLORIDA HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1001 BRICKELL BAY DRIVE, SUITE 1100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MIAMI, FL 33131 COMPANIES AFFORDING COVERAGE (305) 372-9950 COMPAN- A ZURICH AMERICAN INSURANCE COMPANY INSURED caJPAN" Oasis Outsourcing Holdings, Inc. B All. Ei United FOr Families, Inc. ceMCaN• 4400 N Congress Ave . , Suite 250 -- — West Palen Beach, FI 33407.3258 COMFAN" -D- THIS IS TO CEP,TI FY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT70 ALLTHE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE POLICY EXPIRATION' LIMB LTR TYPE OF INSURANCE POLICY NUMBER OAIE RAMAIOIYY) DATE WMJDOrTY) GENERAL LIABILITYGENERA: AGGREGA-E 8 7CddAIERCU¢ GENERA. LrAETLITT PPODUCTG - 0.'MWOP AGG $ PERCONAL 4P0VtNJUF"+ S NER': S OONTRAC70R3 *ROT EPCH OCCURRENCE I $ FIRE DAM E (4y oreflnl $ cess; $ AUTOMOBILE LIABILITY CpdEINED SRJGLE _P!R 8 —I ANY AUTO ALL OWN ED AUTOS IEppL.r ln.ILPx S � LPa arsv SCHEDULED AUTGS i _ I _ ___ _ HIRED AUTOS � I EIOOP Y IN.LRT $ NON-OWNED AUTOS Pr awmen; PFO�DPMAGE GARAGE LIABILITY 14T ONI • - EA ACCfMN- Is ANY AU10 HER T HAN_ _ �EAOIACGDENT n.GGREGATF is EXCESS LIABILITY IEACM OCCURRENCE $ � LM BRELLA FORM iA30RE34TE _— �j_—__-__-_ CTHER THAN UMSRELLP FORM j $ A WORKER'S COMPENSATION AND 'WC 29-36-687-04 06101106 OEM1107 I. T`'�T LN`rt: F_I EMPLOYE45' WBILRY EL EACS ACCIDENT is 1000000 THEIJb4 ETLRI X ltn'CL sEAGE attrw usarT s 1000000 PAHTNEPS1AECu71'.' 399R43 APE E;; EL Df:SE - SA SM PL OTSE $ 1000000 OTHER DESCRIPTION OF OPERATIONSILOCA7. IONSIVEHICLE39PECIAL ITEMS ONLY THOSE EMPLOYEES LEASED TO BJT NOT SUBCONTRACTORS OF: UNITED FOR FAMILIES, INC #2031 SHOULDANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE INDIAN RIVER COUNTY HUMAN SERVICES EXPIRATION DATE THEREOF, THE ISSUING COMPANY WLL ENDEAVOR TO MAIL CHILDREN'S SERlACES ADVISORY COMMITTEE 30 DAYS WRITTEN NOTICE TO TME CERTIFICATE HOLDER NAMED TO THE LEFT, ATTN: MARION E MASTERSON BUT FAILURE TO MAIL SUCH NOTICE SHALL I MPOSE NO OMIGA710H CR LIASIL ITY 1840 25TH ST OF ANY KIND UPON THE COMPANY, RS AGENTS OR REPRESENTATIVES, VERC BEACH, FL 32960 ALT A • 10570 S . FEDERAL HIGHWAY, SUITE 301 ufor PORT SAINT LUCIE, FL 34952 nltedPhone: (772) 398-2920; Fax: (772) 398-2925 Families w .ufEus OCT . 31 , 2006 Children's Services Advisory Committee of Indian River County Attn: Marion Masterson Dear Marion, Please accept this letter as notification that United for Families will not transport children for its Foster Parent Mentor of summer camp programs. Thank you, Christina Kaiser Development Director UM d W FamY Caw Fo CFi! UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF IS% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: United for Families FUNDER: CSAC `v im"-" ;y LNE(TEM ix. . " 4 zs`^ ' ^° ... � -*z EXPLANATION FOR M.ARIANCE§," - MWO! #DN/O! #DIV/01 #DN/O! #DN/O! #DN/01 #DN/O! #DN101 #DIV/O! #DN101 #DN/01 #DIV101 #DN/O! #DIV/01 #DIV101 #DNIO! #DIV101 #DIV101 #DN/01 #DIV/01 #DIV/0! #DN/01 #DN101 #DN101 #DN/O! #DN/01 #DIV/01 #DIV/01 #DNIO! #DIV/01 #DN/OI #DN/O! #DIVI01 #DIV/01 #DIV/01 #DN101 #DN101 #DIV/01 #DN101 #DN/0! #DIV/01 #Drvrol #DIVIO! #DN101 #DNI01 #DN101 6s 61t6(NJfi 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 301") 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 - United for Families Board of Directors January 1, 2006 — June 30, 2006 POSITION TELEPHONE NUMBER ON NAME ORGANIZATION EMAIL ADDRESS BOARD BOARD TENURE Family Preservation Services of FL 121 N. Second Street 772-595-37735 (Ext. 228) Boccabella, Lou Fort Pierce, FL 34950 Iboccabella@ sco . com President Aril 2002 - Present Children's Home Society of FL 1485 S. Semoran Blvd. , Ste. 1448 321 -397-3000 Secretary/ DeMark, Diane (Mrs.) Winter Park, FL 32792 diane. DeMark@chs . o Treasurer Aril 2002 - Present 191 SE Fallon Drive 772-879-4356 (Fax: 879-3505) Community Bailey, Rose (Mrs.) Port St Lucie, F134983 rbaile 6 aboo. com Memberanua 2005 Present Children's Home Society of FL 1485 S . Semoran Blvd., Ste. 1448 321 -397-3000 Brien, Kim s. Winter Park, FL 32792 kim. brien@chs . or Member October 2004 - Present Exchange Club CASTLE Garbarino-Map, Theresa 3525 W. Midway Road 772-465-6011 Ms.) Fort Pierce, FL 34981 (1garbanno-may@exchangecartle.org) Member April 2002 - Present Family Preservation Services of FL 121 N. Second Street 772-595-3773 Prisco, jo-Ann s. Fort Pierce, FL 34950 risco@ sco . com Member April 2002 - Present New Horizon of the Treasure Cst. 4500 W. Midway Road 772-467-5532 uain, Robert Fort Pierce, FL 34981 uam@nbtcanc. or Member januajj 2004 - Present r ` Trns fnsr ray _ Surplus lino Agmt's Name: T to r' . i 'a SuVu it LaA s Pu, o S 1343 I!= hut's Adm: mrm V C=ian QLfA01 by Su f p!us Lm ai '.er Aspen "Ped . Ity - FL 33433 P. nlncdon or re ria da j a Surplus hues Agent's license• AI 0 'fa extent oany -gv Co y Ic e V Prodreing Agent's Name: ' Ihgator of an jr solves a iic rl, s Producing Agent's Address: / $o 1 lfJ'1 Pf"r . POLICY NUMBER: SS000011 TOtalPremiu0 2 T �02�> CG DS 01 10 01 $crvicc Fee: 0 Agents t"Q'amcc COMMERCIAL GENERAL & PROFESSIONAL LIABILITY DECLARATIONS ASPEN SPECIALTY INSURANCE COMPANY CRC Insurance Services, Inc. 99 HIGH STREET 30 Jericho Executive Plaza, Suite 200C BOSTON, MASSACHUSETTS 02110-2320 Jericho, NY 11753 NAMED INSURED : United for Families, Inc. MAILING ADDRESS: 10570 S. Federal Hwy., Suite. 201 Port St. Lucie, FL 34952 i; POLICY PERIOD: FROM 03/15/2005 TO 03/1512006 AT 12 :01 A. M. TIME AT YOUR MAILING ADDRESS SHOWN ABOVE IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE GENERAL LIABILITY l EACH OCCURRENCE LIMIT $ 19000,000 DAMAGE TO PREMISES RENTED TO YOU LIMIT $ 100,000 Any one premises MEDICAL EXPENSE LIMIT $ 50000 Any one person PERSONAL & ADVERTISING INJURY LIMIT $ 1 ,000,000 Any one person or organization GENERAL AGGREGATE LIMIT $ 39000,000 PRODUCTS/COMPLETED OPERATIONS AGGREGATE LIMIT $ 1 ,000,000 Surplus Lines Tax: 44LJEI0 to PROFESSIONAL LIABILITY FSLSO Tax: Each Medical Incident Policy Fee: _ $ 11000, 000 Aggregate Insp. Fee: Company Fee: — $ 3,000,000 Retroactive date (If Applicable) FL EMPATF: —�— N/A Deductible NONE Each Medical Incident or Claim (including ALAE A-04 ,S 6758 3 9 DESCRIPTION OF BUSINESS FORM OF BUSINESS: ❑ INDIVIDUAL ❑ PARTNERSHIP () JOINT VENTURE ❑ TRUST ❑ LIMITED LIABILITY COMPANY X ORGANIZATION , INCLUDING A CORPORATION (BUT NOT INCLUDING A PARTNERSHIP, JOINT VENTURE OR LIMITED LIABILITY COMPANY) CG DS 01 10 01 © ISO Properties, Inc. , 2000 Page 1 of 2 0 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 1840 25'" Street Vero Beach , Florida 32960-3365 Recipient: United for Families 10570 S. Federal Highway, Suite 301 Port St. Lucie, Florida 34996 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 - ( BUSINESS DESCRIPTION : Social Service Agency ALL PREMISES YOU OWN , RENT OR OCCUPY LOCATION NUMBER 001 1 AS PER SCHEDULE ON FILE WITH COMPANY CLASSIFICATION AND PREMIUM LINE OF CLASSIFICATION PREMIUM TRIA TOTAL INCEPTION COVERAGE PREMIUM PROFESSIONAL LIABILITY As per $10,326 $310 $10, 636 Supplemental COMMERCIAL GENERAL As per $3, 075 $ 93 $3, 168 LIABILITY Submission on file TOTAL INCEPTION PREMIUM $ 13,804 ( MINIMUM RETAINED PREMIUM $3,451 AUDIT PERIOD (IF APPLICABLE) ❑ ANNUALLY ElSEMI- OQUARTERLY ❑ MONTHLY ANNUALLY ENDORSEMENTS ENDORSEMENTS ATTACHED TO THIS POLICY: SEE SCHEDULE OF APPLICABLE FORMS THESE DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORM(S) AND ANY ENDORSEMENT(S), COMPLETE THE Nor MBERED POLICY. Countersigned: By: 3118105 ( thon epresentative) l Page 2 of 2 © ISO Properties, Inc. , 2000 CG DS 01 10 01 13 Nov 2i 2006 11 � 2t�14 CCUMUN ' TY IN3UR � NCE CiFVICES CORD_ CERTIFICATE OF LIABILITY INSURANCE oPlly - °"� "^°°°^ ' TmrrsO 10 25 05 �JNCER THIS CERTIFICATE IS ISSUED AS A NATTER OFINFORMATFON Y own 4 BrOwa of i'lorida , Iro-. ONLY AND CONFERS NORi^HTSLIPONTHE CERT7FIC4TB Daytona Beach Office HOLDER. THIS CFaTIFICA7cDOES NOT AKND, LKaNDOR P . O . Hoa 2412 ALTER THE. COVFKAGEAMRDED BY THE POLCIES BELOW. Daytona Beach FL 32115-2412 Phone : 386-252 -9601 R'ax : 386-239-1729 INSURERS AFFORDING COVERAGE NAIC9 NAJeEO i % Rh XL Specialty Ins Co _ 37085 General eter Ind 7"t 37362 Unit2d pp Faailleai , j�§yyC . ' Ro. New Hampshire Ina Co 23841 10570 60VTN II'ICDT,RxI, RIPSC ST 301 Ir- __- _ PORT ST 7:VCIE FL 34992 ►auRERD. �OVERAGcS —. �" THE POLICES OF INSURANCE LISTED NLOW HAVE WN NOJEO TO THE INBURE.1 NAMED ABOVE FOR THE POLJOY PERIOD RIOICA, c 1. nV MTTNSIANDNG ANY REDIM4XI$JT, T WM OR CONDITION OF ANY COMPACT OR OTHER O°tYTMENT WTH RESPECT TU W HCJITHI$ CERTIFICATE MAY Bi CESj ED OR MAY PERTAN, THE INSURANCE AFFORDED W THE POLICES OLSCRIBEOHEREN I:. WIJECTTO ALL THE TERMS, TJ!°LLTSONb AND OCNL-^IONS OF DdCH y'POUCS.LA3=GATELMYTSLW155HOWNM%Y HAVE OEEN REDUCED Bf PAD CuIm& pFJ��p MMS TYPE OF IRSURANOE POLICY NUMBER 16A. . ( T 6flEr I uYrta _. ""'MAL UANU?y I EACH oct� RR 1�pG0 000 rTMRAGE TOT: ier. RcaALcrNFaALLweurr 01LX89985280 03/15106 03/35 / 07 PREWSEBIEa .�,ra,0 9100 000 ' CLAIMS MAGE X NFO aCCut 'ii .. LJ EuY' a„ p 65 , 000 _ PFASOuaLSAOVNJURV § 1 , 000 ODO _ EE , GENERU A6. -REGA IT s3 100 000 VWLAGGREGATEtMT APPLIES R' r PRO- PRDDU.rs.GCMPQMAS'. a 1 . 700 000 POS I JECT I .. . LO,. IAUTOMON EUAFILnY AW AUTO _ WLONEDILM ELIMT § (.B YTlJtlAn11 . ALS OWNED A{1 0Z "eO1EDUlEO AUTO (FODLYINARn' B Per praaoJ 1 1 HIRED AUTCS . . . . NONDANLG AUTOS II iBODIY INJURY § W 9rAlI W _— I �PROPERTVOMMGE . T (Par s¢IOAm1 I 6ARJ.GE lfA191LITY AUTO ONLY. RA ACCIDENT ARi . Y AUTO i OTHER ONLY: EA ACC �'''''T��L— I I AUTO OY: A" ! EXCEELUNBREW NCE 1MIULVN I FACH OWURRES ODIC °caTa ❑ ^1AINSMADE 110 =02739700 03 /15/06 + 03/15/07 AccREGATE. f_ ' OEWCOBLF � 'L' i� RETENTKIN ' S E 5 COM►fNtATONANb I TORr uWTs ER ANT PROPRIETOWPARTNEREXECLTNE i j ELwHA0CJD9M § ipFFh RME1�Eli EXCLUDED' EL. OIBEABF - EA Eu— j `rPECIAL�P SIS CNOMI ::: E.L. bvSt if FgLILY LIyIT ' Oi n I --�-I 4ird 11CSC966102E77601 03/21/ 06 /3/21/07 J PzopertyLSeotsen I noms961A 03/15 /06 ! 03 / 15/ 07 contents 1501:`0 CRR*11pN OF OPBTAnONS! LOCATONS /VEMi°LFS r EXCiVSI0N5 AOOED BY TO+oplBENEM/ $JR:OLAL PROVISIONS MUTY DAYS NOTICE OF CANCELLATION , TEN AAPS NOTICE DUE TO NON- PAYNLNR X : 772 - 398w2925 1p ZTIFICATE HOLDER CANCELLATION ' IND nko4 {MOULD ANY OP TNEIdOVE BE§CARiED POlJCIEi EF CAAU'ECIFD BEFORE 7HE 'FJfPoN .nOA DATE TMHLEOF. THE 55YING INSURER WLL ENOEAYOR TO YAIL 30 DAYb WR, HN .i NOTKE TO TME CERTIFI[ATE NDLaEJi TJAMS:O TO THE LEFT, FLIT FAILCRC TO 0:: TD annLl I=1" RIVER COUNTY IAD0w NO cow"TTON OR LMFIUTYOF ANY 00 UPON THE4wit"R, US AO, . Tu? 1040 25TH ST R9R6SFNTAttVEL VERO BLACK Ft 32960 _ T�PRESENT+RIy4 7R02s (2wilcal 8C v e a me_DC `. . 2 : . — 1 : ) OV 'W VACORD CORPDRATION 1853 V0. J10 V4 bOV VaV aa6 + r-' • vr.rr [_ vvv a- . va • - -ter. � • �. p �- ) : Indian River COMPANY : ACORD DATE Ni 12/0612OC6 PRODUCER Serial # 621931 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AON RISK SERVICES OF FLORIDA HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1001 BRICKELL BAY DRIVE, SUITE 1100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MIAMI, FL 33131 COMPANIES AFFORDING COVERAGE (305) 372-9950 COMPAN- A ZURICH AMERICAN INSURANCE COMPANY INSURED caJPAN" Oasis Outsourcing Holdings, Inc. B All. Ei United FOr Families, Inc. ceMCaN• 4400 N Congress Ave . , Suite 250 -- — West Palen Beach, FI 33407.3258 COMFAN" -D- THIS IS TO CEP,TI FY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT70 ALLTHE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE POLICY EXPIRATION' LIMB LTR TYPE OF INSURANCE POLICY NUMBER OAIE RAMAIOIYY) DATE WMJDOrTY) GENERAL LIABILITYGENERA: AGGREGA-E 8 7CddAIERCU¢ GENERA. LrAETLITT PPODUCTG - 0.'MWOP AGG $ PERCONAL 4P0VtNJUF"+ S NER': S OONTRAC70R3 *ROT EPCH OCCURRENCE I $ FIRE DAM E (4y oreflnl $ cess; $ AUTOMOBILE LIABILITY CpdEINED SRJGLE _P!R 8 —I ANY AUTO ALL OWN ED AUTOS IEppL.r ln.ILPx S � LPa arsv SCHEDULED AUTGS i _ I _ ___ _ HIRED AUTOS � I EIOOP Y IN.LRT $ NON-OWNED AUTOS Pr awmen; PFO�DPMAGE GARAGE LIABILITY 14T ONI • - EA ACCfMN- Is ANY AU10 HER T HAN_ _ �EAOIACGDENT n.GGREGATF is EXCESS LIABILITY IEACM OCCURRENCE $ � LM BRELLA FORM iA30RE34TE _— �j_—__-__-_ CTHER THAN UMSRELLP FORM j $ A WORKER'S COMPENSATION AND 'WC 29-36-687-04 06101106 OEM1107 I. T`'�T LN`rt: F_I EMPLOYE45' WBILRY EL EACS ACCIDENT is 1000000 THEIJb4 ETLRI X ltn'CL sEAGE attrw usarT s 1000000 PAHTNEPS1AECu71'.' 399R43 APE E;; EL Df:SE - SA SM PL OTSE $ 1000000 OTHER DESCRIPTION OF OPERATIONSILOCA7. IONSIVEHICLE39PECIAL ITEMS ONLY THOSE EMPLOYEES LEASED TO BJT NOT SUBCONTRACTORS OF: UNITED FOR FAMILIES, INC #2031 SHOULDANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE INDIAN RIVER COUNTY HUMAN SERVICES EXPIRATION DATE THEREOF, THE ISSUING COMPANY WLL ENDEAVOR TO MAIL CHILDREN'S SERlACES ADVISORY COMMITTEE 30 DAYS WRITTEN NOTICE TO TME CERTIFICATE HOLDER NAMED TO THE LEFT, ATTN: MARION E MASTERSON BUT FAILURE TO MAIL SUCH NOTICE SHALL I MPOSE NO OMIGA710H CR LIASIL ITY 1840 25TH ST OF ANY KIND UPON THE COMPANY, RS AGENTS OR REPRESENTATIVES, VERC BEACH, FL 32960 ALT A • 10570 S . FEDERAL HIGHWAY, SUITE 301 ufor PORT SAINT LUCIE, FL 34952 nltedPhone: (772) 398-2920; Fax: (772) 398-2925 Families w .ufEus OCT . 31 , 2006 Children's Services Advisory Committee of Indian River County Attn: Marion Masterson Dear Marion, Please accept this letter as notification that United for Families will not transport children for its Foster Parent Mentor of summer camp programs. Thank you, Christina Kaiser Development Director United for Families Board of Directors January 1, 2006 — June 30, 2006 POSITION TELEPHONE NUMBER ON NAME ORGANIZATION EMAIL ADDRESS BOARD BOARD TENURE Family Preservation Services of FL 121 N. Second Street 772-595-37735 (Ext. 228) Boccabella, Lou Fort Pierce, FL 34950 Iboccabella@ sco . com President Aril 2002 - Present Children's Home Society of FL 1485 S. Semoran Blvd. , Ste. 1448 321 -397-3000 Secretary/ DeMark, Diane (Mrs.) Winter Park, FL 32792 diane. DeMark@chs . o Treasurer Aril 2002 - Present 191 SE Fallon Drive 772-879-4356 (Fax: 879-3505) Community Bailey, Rose (Mrs.) Port St Lucie, F134983 rbaile 6 aboo. com Memberanua 2005 Present Children's Home Society of FL 1485 S . Semoran Blvd., Ste. 1448 321 -397-3000 Brien, Kim s. Winter Park, FL 32792 kim. brien@chs . or Member October 2004 - Present Exchange Club CASTLE Garbarino-Map, Theresa 3525 W. Midway Road 772-465-6011 Ms.) Fort Pierce, FL 34981 (1garbanno-may@exchangecartle.org) Member April 2002 - Present Family Preservation Services of FL 121 N. Second Street 772-595-3773 Prisco, jo-Ann s. Fort Pierce, FL 34950 risco@ sco . com Member April 2002 - Present New Horizon of the Treasure Cst. 4500 W. Midway Road 772-467-5532 uain, Robert Fort Pierce, FL 34981 uam@nbtcanc. or Member januajj 2004 - Present r ` Trns fnsr ray _ Surplus lino Agmt's Name: T to r' . i 'a SuVu it LaA s Pu, o S 1343 I!= hut's Adm: mrm V C=ian QLfA01 by Su f p!us Lm ai '.er Aspen "Ped . Ity - FL 33433 P. nlncdon or re ria da j a Surplus hues Agent's license• AI 0 'fa extent oany -gv Co y Ic e V Prodreing Agent's Name: ' Ihgator of an jr solves a iic rl, s Producing Agent's Address: / $o 1 lfJ'1 Pf"r . POLICY NUMBER: SS000011 TOtalPremiu0 2 T �02�> CG DS 01 10 01 $crvicc Fee: 0 Agents t"Q'amcc COMMERCIAL GENERAL & PROFESSIONAL LIABILITY DECLARATIONS ASPEN SPECIALTY INSURANCE COMPANY CRC Insurance Services, Inc. 99 HIGH STREET 30 Jericho Executive Plaza, Suite 200C BOSTON, MASSACHUSETTS 02110-2320 Jericho, NY 11753 NAMED INSURED : United for Families, Inc. MAILING ADDRESS: 10570 S. Federal Hwy., Suite. 201 Port St. Lucie, FL 34952 i; POLICY PERIOD: FROM 03/15/2005 TO 03/1512006 AT 12 :01 A. M. TIME AT YOUR MAILING ADDRESS SHOWN ABOVE IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE GENERAL LIABILITY l EACH OCCURRENCE LIMIT $ 19000,000 DAMAGE TO PREMISES RENTED TO YOU LIMIT $ 100,000 Any one premises MEDICAL EXPENSE LIMIT $ 50000 Any one person PERSONAL & ADVERTISING INJURY LIMIT $ 1 ,000,000 Any one person or organization GENERAL AGGREGATE LIMIT $ 39000,000 PRODUCTS/COMPLETED OPERATIONS AGGREGATE LIMIT $ 1 ,000,000 Surplus Lines Tax: 44LJEI0 to PROFESSIONAL LIABILITY FSLSO Tax: Each Medical Incident Policy Fee: _ $ 11000, 000 Aggregate Insp. Fee: Company Fee: — $ 3,000,000 Retroactive date (If Applicable) FL EMPATF: —�— N/A Deductible NONE Each Medical Incident or Claim (including ALAE A-04 ,S 6758 3 9 DESCRIPTION OF BUSINESS FORM OF BUSINESS: ❑ INDIVIDUAL ❑ PARTNERSHIP () JOINT VENTURE ❑ TRUST ❑ LIMITED LIABILITY COMPANY X ORGANIZATION , INCLUDING A CORPORATION (BUT NOT INCLUDING A PARTNERSHIP, JOINT VENTURE OR LIMITED LIABILITY COMPANY) CG DS 01 10 01 © ISO Properties, Inc. , 2000 Page 1 of 2 0 ( BUSINESS DESCRIPTION : Social Service Agency ALL PREMISES YOU OWN , RENT OR OCCUPY LOCATION NUMBER 001 1 AS PER SCHEDULE ON FILE WITH COMPANY CLASSIFICATION AND PREMIUM LINE OF CLASSIFICATION PREMIUM TRIA TOTAL INCEPTION COVERAGE PREMIUM PROFESSIONAL LIABILITY As per $10,326 $310 $10, 636 Supplemental COMMERCIAL GENERAL As per $3, 075 $ 93 $3, 168 LIABILITY Submission on file TOTAL INCEPTION PREMIUM $ 13,804 ( MINIMUM RETAINED PREMIUM $3,451 AUDIT PERIOD (IF APPLICABLE) ❑ ANNUALLY ElSEMI- OQUARTERLY ❑ MONTHLY ANNUALLY ENDORSEMENTS ENDORSEMENTS ATTACHED TO THIS POLICY: SEE SCHEDULE OF APPLICABLE FORMS THESE DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORM(S) AND ANY ENDORSEMENT(S), COMPLETE THE Nor MBERED POLICY. Countersigned: By: 3118105 ( thon epresentative) l Page 2 of 2 © ISO Properties, Inc. , 2000 CG DS 01 10 01 13