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HomeMy WebLinkAbout2006-331D. ao� 6 �3 31 INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract") entered into effective this2eA day of November 2006 , by and between Indian River County , a political subdivision of the State of Florida; 1840 25'h Street, Vero Beach , Florida , 32960-3365; and United For Families (Recipient), of: Early Learning Coalition 10 Central Parkway, Suite 400 Stuart, FL 34994 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: THIRTY THOUSAND, DOLLARS ($30, 000). The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for the Grant Purposes provided in accordance with this Contract. Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit " B" , attached hereto and incorporated herein by this reference. All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures, as it deems appropriate. 5. Additional Obligation of Recipient. 5. 1 . Records. The Recipient shall maintain adequate internal controls in order to safeguard the Grant. In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3) years after the expiration of the Grant Period . The County shall have access to all books, records, and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5) days prior to written notice. 5 .2. Compliance with Laws. The Recipient shall comply at all times with all applicable federal, state , and local laws and regulations. 5 .3 . Quarterly Performance Reports. The Recipient shall submit quarterly, cumulative, Performance Reports to the Human Services Department of the County, within fifteen ( 15) business days following : December 31 , March 31 , June 30 and September 30 . 5.4. Audit Requirements. If Recipient receives $25 , 000, or more in aggregate, from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget. The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for the prior fiscal year is past due and has not been submitted by May 1 . 5.4 . 1 . The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from its independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate the Contract. 5.4 . 2 . The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments, or notes . 5 . 5. Insurance Requirements. Recipient shall, no later than October 21 2006 provide to Indian River County Risk Management Division a certificate, or certificates, issued by an insurer, or insurers , authorized to conduct business in Florida that is rated not-less-than Category A-:VII by A. M . Best, subject to approval by Indian River County's Risk Manager, of the following types and amounts of insurance: (i) Commercial General Liability Insurance in an amount not less than $ 1 , 000, 000 combined single limit for bodily injury and property - 2 - damage, including coverage for premises/operations , product/completed operations, contractual liability, and independent contractors; ( ii) Business Auto Liability Insurance in an amount not less than $ 1 ,000, 000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles; and (iii) Worker's Compensation and Employer's Liability (current Florida statutory limit. ). 5.6. Insurance Administration. The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given the County. In addition, the County may request such other proofs and assurances as it may reasonable require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Worker's Compensation Insurance. The Recipient shall , upon ten ( 10) days prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option, terminate this Contract. 5.7 . Indemnification. The Recipient shall indemnify and save harmless the County, its agents, officials, and employees from and against any and all claims, liabilities, losses, damage, or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient, its agents, officers, or employees in connection with the performance of this Contract. 5. 8. Public Records. The Recipient agrees to comply with the provisions of Chapter 119, Florida Statutes (Public Records Law) in connection with this Contract. 6. Termination. This Contract may be terminated by either party, without cause, upon thirty (30) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7. Availability of Funds. The obligations of the County under this contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8. Standard Terms. This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference. - 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: Z&2: ! r�. • 'Gc � Ga G: Wheeler, Chairman BCC Approved: : 10-3-06 Attest: J. K. rt,,Clerk By: Deputy Clerk Approved: l Jose oh A. Baird County Administrator Approves to form and lega(sufficiency: BAManan . Fell, Assista " o Attorney REIPIE yjBy: Early Lea ng Coaltion - 4 - EXHIBIT A (Copy of complete Request for Proposal) EXHIBIT - A - Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc. RFP - Indian River County Board of County Commissioners PROGRAM COVER PAGE Organization Name : Error! Not a valid link. Executive Director: Olan Faulk E-mail : ofaulk(.a elcirmo. org Address : 2415 S . 291h Street Telephone : 772-489- 8120 Ft. Pierce, FL 34981 Fax: 772-489- 8124 Program Director: Linda Prutisto E-mail : 1prutisto(a�elctrmo .org Address : _ (Same) Telephone : (Same) Fax : (Same) Program Title: Priority Need Area Addressed: Childcare Access Brief Description of the Program: This is the 6% local match required by the Child Care Development Fund Six cents of every dollar paid for childcare is spent on the working poor in the form of subsidy to eligible parents, and must be derived from the local community. * *(See below) SUMMARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2006 /07 : $ 30 , 000 . 00 Total Proposed Program Budget for 2006 /07 : $ 110 , 000 . 00 Percent of Total Program Budget : 27 . 3 % Current Program Funding (2005 /06 ) : $ - Dollar increase /( decrease ) in request : $ 30 , 000 Percent increase /( decrease ) in request * * 4DIV /01 Unduplicated Number of Children to be served Individually : 478 Unduplicated Number of Adults to be served Individually : - Unduplicated Number to be served via Group settings : - Total Program Cost per Client : 230 . 13 * *If request increased 5% or more, briefly explain why: If these funds are being used to match another source, name the source and the $ amount: The funds will be used to match federal dollars provided through the Child Care Development Fund (CCDF) for subsidized childcare in the amount of $ 1 .2 million. The Organization 's Board of Directors has approved this ap is ion on (date). May 24, 2006 Gerald T. Roden Name of President/Chair of the Board ' Signa re Olan Faulk Name of Executive Director/CEO Signature **Taxonomy Definition : Childcare Subsidies — NL-300. 150 Programs that underwrite the cost of child care in public and private child care centers or private family child care homes for 3 low-income families in situations where the parent(s) are working, in school or in training. Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc. RFP - Indian River County Board of County Commissioners 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 'h" X 11 " paper and number each page. These directions and the graphic boxes may be deleted if space is needed . A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization. The mission of ELCIRMO is : "Provide quality opportunities for social, physical, emotional, and intellectual development of children, by partnering with parents, providers, and communities. " Our vision is that: "There are quality resources and environments that prepare all children in Indian River, Martin and Okeechobee Counties for a successful educational experience." Our goals include, but are not limited to : Providing Early Learning programs that prepare children for success in school ; Provide Early Learning programs that involve parents as their child' s first teacher and support family skill building; Provide an integrated and seamless system of services in all Early Learning programs; Coordinate Early Learning programs and ensure all public funding is integrated to achieve effectiveness and efficiency; and Examine local programs and delivery systems, with the purpose of establishing concrete steps to improve service integration, efficiency, and quality. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. The Early Learning Coalition of Indian River, Martin, and Okeechobee Counties, Inc. (ELCIRMO) is defined and described in sections 411 .01 and 1002, Florida Statutes. The Coalition was originally created in 1999 as a School Readiness Coalition and became an Early Learning Coalition with the signing of the VPK legislation on January 2, 2005 . ELCIRMO offers subsidized child care assistance and programs that give children a competitive start in life. ELCIRMO is responsible for the planning and implementation of school readiness and voluntary pre-kindergarten services in the three county areas, and for making decisions to meet the early education and child care needs of the children in these communities . Furthermore, the Coalition sets priorities that are relevant to the children and families that we serve . We are currently serving in excess of 3800 children daily, from all socio-economic backgrounds, through a network of child care and resource and referral programs including the VPK Program. Our computerized data system allows trained counselors to track both supply and demand for all types of child care services on a daily basis. Parents seeking quality child care have a variety of options including center-based care, family child care, after-school care, preschool, summer camp, nanny information, odd hour, and sick care. In addition to Resource and Referral we work to enhance both the quality and supply of care through recruitment and training programs. Whether seeking to provide family child care in their homes or planning to open a child care center, we offer start-up and technical assistance, as well as follow-up training and support. 4 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc . RFP - Indian River County Board of County Commissioners B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) 1. a) What is the unacceptable condition requiring change? b) Who has the need ? c) Where do they live? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. The extremely high incidence of children who live in poverty and are at risk of school failure due to lack of needed resources is the condition to be addressed. Too many families in Indian River County are unable to afford the cost of quality child care for their children. Families must be able to access child care in order to work and be self-sufficient. Too many children, often those from low-income families, are not ready to be successful when they enter Kindergarten. For this group of children, especially, studies show that a quality child care experience with trained professional teachers, low teacher-student ratios, and use of a developmentally appropriate curriculum, can greatly increase each child' s chances for success in school. Children from many low-income families in Indian River County depend on school readiness programs to assist their parents in paying for child care. "Working Poor" families can earn no more than 150% of the Federal Poverty Level in order to qualify for assistance through this program . There are currently 478 unduplicated children enrolled in this category. Children in our Child Care Services Program reside throughout Indian River County. Data is derived from census and community needs. Data sources include : www.answers.com — demographics http ://csc. fmhi.usf.edu/flkc.htm - child demographics http://factfinder.census . gov/ - demographics www.myflorida.com — health, employment, education hiip://guickfacts. census. eov/qfd/states/ 12/html - census information www.sustainabletc.oriz/documents/CSTC FINALREPORT 11 -02-05Interim.pdf 2. 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. Similar programs include Head Start, Redlands Christian Migrant Association (RCMA) Child Care, and Child Care Resources (CCR) . Each of these programs serves as many children from low-income families as they can with available funding. With 8% of the population living below the poverty level, there is a tremendous need for dollars to provide the resources necessary for the children in these situations to be afforded the same educational opportunities as their peers in settings with higher standards of living. Providing subsidized child care to families between 0 — 200 % of the federal poverty level will reduce the number of children not currently receiving educational opportunities and help to increase the number of working families who will rise above the 200% FPL. It is the intent of the Legislature that school readiness programs not exist as isolated programs, but build upon existing services and work in cooperation with other programs for young children, and that school readiness programs be coordinated and funding integrated to achieve full effectiveness for all children. School readiness programs depend on federal and state funding, grants from foundations, and business and individual contributions. Each program continues to have a waiting list — there is insufficient funding to provide child care for all the eligible families and children The Coalition is able to fill gaps in the services provided by similar programs by arranging wrap-around care (before and after school, on holidays or school breaks), or night or weekend care when available. 5 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc. RFP - Indian River County Board of County Commissioners C. PROGRAM DESCRIPTION (Entire Section C 1 — 6, not to exceed two pages) 1 . List Priority Needs area addressed. Focus Area III : Childcare Access Goal #1 : Improve the capacity of children in Indian River County to succeed to adulthood in a safe, healthy, and productive manner. Goal #2 : Support caregivers, a child' s most important resource, to be and do what is needed to shepherd children to adulthood in a safe, healthy, and productive manner. 2. Briefly describe program activities including location of services. Providing affordable and accessible quality early childcare and education to eligible children ages birth- 8 , is the top priority of the Coalition. Funding is provided through the Agency for Workforce Development, Office of Early Learning, which serves as the administrative entity for federal and state dollars allocated to child care . The Coalition staff provides services to find and oversee child care providers, determine eligibility, and assist providers in maintaining quality programs and completing child screenings. Parents of eligible children have a right to choose their child care provider and most have chosen providers contracted with the Coalition. These providers undergo an initial and annual monitoring to ensure that they meet the Coalition' s requirements for quality services. These providers are also required to have a family involvement component in order to encourage parent interaction with their children and the child' s teacher. Each family pays a sliding parent fee, based on their income and the number of individuals in the family. In addition to child care services, preschool age children are screened for appropriate developmental progress and social/emotional well-being. Health screenings are provided in the areas of height, weight, body mass index, dental, hearing, vision, speech and language. Child care providers in every region of Indian River County receive additional training through a variety of Coalition programs and offerings . 3. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population. We provide access to child care services for children of eligible parents and pay for that child care with federal dollars and the 6% local match. 6 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc. RFP - Indian River County Board of County Commissioners 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform with the information in the Position Listing on the Budget Narrative Worksheet). Not Applicable. Any funding derived from this application will be directly paid to providers in the form of childcare subsidy. None of these funds will be used to cover administrative expenses. 5. How will the target population be made aware of the program? The Coalition' s Resource and Referral component is responsible for letting eligible clients know of the program offerings . They accomplish this through Yellow Pages and newspaper advertising; word of mouth among clients; constant interaction with other social service agencies ; participation in community awareness programs such as Stand For Children and Treasure Coast Life Styles Expo hosted by Treasure Coast Square Mall, and daily interactions with childcare providers. Resource and Referral Specialists are located in the Vero Beach office and when needed will set up in certain other geographic locations within the county, such as Sebastian or Fellsmere. 6. How will the program be accessible to target population (i.e., location, transportation, hours of operation) ? Child care providers are located throughout the county, and parents have the option of placing their children with the provider that best suits the needs of the parent and child. Parents provide their own transportation, usually dropping the child off on the way to work. Child care providers contracted with the Coalition are required to be open for at least 10 hours/day and some have flexible evening and/or weekend hours. CCR&R has extensive information available on individual provider programs. 7 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc . RFP - Indian River County Board of County Commissioners D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements for the Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) As a result of this funding the Early Learning ELCIRMO will maintain a minimum average Coalition of Indian River Martin and enrollment of 400 children in the working poor Okeechobee Counties (ELCIRMO) will be category (BG8) each month, as evidence by the able to increase by 102, the number of children EFS report submitted on a monthly basis. One served in Indian River, bringing this number to hundred and two (102) of these children will 400 children served per month. benefit from your funding. 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 Agency Resources provided to the program Indian River Community College Provides child care provider training. 8 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc. RFP - Indian River County Board of County Commissioners F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) 1 . DEMOGRAPHICS: What information (data elements) will you need to collect in order to accurately describe your target population including demographics (age, gender, and ethnic background) required by the funder in Section H? What are the pieces of information that qualify them for your target population? How do you document their need for services or their "unacceptable condition requiring change" from Section Bl ? The following information is required in order to accurately describe the target population and qualify them for services : Residence — Must be Indian River County residents Ages Served — Children birth to eight (B-8) years old To qualify, each family' s income must not be more than 150% of the Federal Poverty Level and both parents must be working or in educational pursuit. Face to face interviews with every client is the method use to capture and document the need for services/unacceptable condition requiring change. 2. MEASURES : What data elements will you need to collect to show that you have achieved (or made progress toward) your Measurable Outcomes in Section D? What tools or items are you using as measures (grades, survey scores, attendance, absences, skill levels) for your program ? Are you getting baseline information from a source on your Collaboration List in Section E? Are there results from your Activities in Section D that need to be documented ? How often do you need to collect or follow-up on this data ? The enrollment and attendance data collected from Child Care providers each month are the tools use to measure our achievement. 9 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc. RFP - Indian River County Board of County Commissioners 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 ? With 8% of the population living below the poverty level, there is a tremendous need for dollars to provide the resources necessary for the children in these situations to be afforded the same educational opportunities as their peers in settings with higher standards of living. Providing subsidized child care to families between 0 — 200 % of the federal poverty level will reduce the number of children not currently receiving educational opportunities and help to increase the number of working families who will rise above the 200% FPL. It is the intent of the Legislature that school readiness programs not exist as isolated programs, but build upon existing services and work in cooperation with other programs for young children, and that school readiness programs be coordinated and funding integrated to achieve full effectiveness for all children. All information gathered will be compared to the baseline in order to determine the extent of change . Screening results will be shared with the parent and the child' s child care provider. Results of the developmental and social/emotional screenings are also shared with the child' s Kindergarten teacher, with parental permission. General (not individual) reports on screenings are given to the Coalition and the Office of Early Learning, and are shared with the community through the Coalition' s annual report. Parents, child care providers, and the Coalition will use screening results to continually assess each child' s individual needs and make referrals for follow-up services. The Coalition utilizes all other available information to assess and make improvements to programs and services. 10 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc . RFP - Indian River County Board of County Commissioners 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 July 1 , 2006 Develop baseline for the number being served in the BG8 (Working Poor) Category. August, 2006 — June Each subsequent month, complete attendance process in EFS to 2007 determine the number of children being served. 11 Early Leaming Coalition of Indian River, Martin and Okeechobee Counties Inc. RFP - Indian River County Board of County Commissioners H. PROJECTIONS FOR UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location Last Fiscal Year . Current Fiscal Year Next Fiscal Year Location Actua12004/2005 Budget 2005/06 Prolecti6ns2006/07 Unduplicated Clients Unduplicated Clients Unduplicated Clients N. Indian River County 226 255 275 S. Indian River County 224 214 225 Indian River Co. Total 450 469 500 Greater Stuart - - - Hobe Sound - - Indiantown - Jensen Beach - - Palm City - - Martin County Total - - - Fort Pierce - - - Port Saint Lucie - - - St. Lucie Co. Total - - - Other Locations - - - TOTAL SERVED 450 469 500 Total Children 450 469 500 - 19 to 59 - (Adults) - - - - - - 60 + (Seniors) - - - Total Adults - - - - TOTAL SERVED 450 - 469 - 500 - 12 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc . RFP - Indian River County Board of County Commissioners I. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below. " Core Budget Forms " 1 � Type the Organization and Program Name UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCYIPROGRAM NAME : EARLY LEARING COALITION OF INDIAN RIVER, MARTIN AND OKEECF FUNDER: INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . _ . . _ . . _ . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ I CAUTION : Do not enter anY figures where a cell is colored in dark blue - Formulas and/or links are in lace. Gra areas should 1 Abe used for calculations and to write information only. CRAY AREAS FOR REVENUES noencr use ONLY Proposed Total Program Funder Specific Total Agency 1aHOVCALCU ATION ° Budget Budget Budget CALLUTATI°NS) 1 Children's Services Council-St. Lucie 2 Children's Services Council-Martin 700,000.00 3 Advisory Committee-Indian River 4 United Way-St. Lucie County 5 United Way-Martin County 6 United Way-Indian River County 74,000.00 74,000.00 74,000.00 7 Department of Children & Families 8 County Funds 30,000.00 30,000.00 30,000.00 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 6,000.00 6,000.001 14,650,979.00 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not included in total) 20 TOTAL REVENUES (does include line 19) $110,000.00 $110,000.00 $ 15,454,979.00 A B C D EXPENDITURES GRAY AREAS r Proposed Total Program Funder Specific Total Agency ISNow cALcutATIONsl Budget Budget Bud et 21 Salaries - (must complete chart on next page) 0.00 0.001 1 ,381 ,250.00 Salary 22 FICA - Total salaries x 0.0765 7.65% 0.00 Retirement - Annual pension tor qua I ie 23 staff 0.00 I eat - e Ica enta ort-term 24 Disab. 0.00 Workers Compensation - # employees x 25 rate 0.00 Florida Unemployment - # projected 26 employees x $7,000 x UCT-6 rate 0,00 523/2006 a.r Type the Organization and Program Name A D SALARIES Gross Annual B C % of Gross Annual POSITION LISTING Salary Portion of Salary on Proposed Funder Specific Budget Salary Position Title / Total Hrs/wk (Agency) Program Requested(C/A) Example: Executive Director/ 40 Ins 70,000.00 10,000.00 50000.00 7. 14% Executive Director/40 hours 90,000. 00 0.00% Executive Assistants (2) 40 hours 133,900 .00 0.00% Chief Financial Officer/ 40 hours 66,950.001 0.00% Senior Accountant/40 hours 46,350.00 0.00% I .T. Coordinator/40 hours 41 ,200.00 0.00% Sr. Assessment Specialist/40 hours 41 ,200.00 0.00% Infant Toddler Specialist/40 hours 41 ,200.00 0.00% Assessment Specialist/40 hours 37,080. 00 0.00% Contract Coordinator/40 hours 43,260.00 0.001% Resource & Referral Specialist (6) 40 hours 148,426 .00 0.00% VPK Fam. Service Specialist/ 40 hours 28 ,840.00 0.00% Resource Coordinators (3) 40 hours 113 ,300.00 0.00% Sr. Eligibility Specialistf40 hours 32, 960.00 0.00% SR RR Specialist/40 hours 32,960.00 0.00% Reimbursement Specialist/40 hours 36,050.00 0.00% VPK Coordinator/40 hours 56,650.00 0.00% Office Administrator/40 hours 44,290.00 0.00% Data Entry Clerk/25 hours 17,996.00 0.00% Finance Clerk/10 hours 91888.00 0.00% Benefits @ 30% 318,750.00 1 0.000 Remaining positions throughout the agency Total Salaries $1 ,381 ,250.00 $0.00 $0.00 v23n0o6 a.� Type the Organization and Program Name FRINGE BENEFITS DETAIL A (Funder Specific Budget Funder B c D E F c lns Column Pension Health Worker's Unemployme Total Fringes Funder Title only, from line 22 to 27 Specific FICA 7.65Health . � SpeciBudget (A x %J Campers. of Comports. Specific Position Title / Tota! Hrs/wk Example: Case Manager/40 hrs 5,000.00 382.50 200.00 - 500.00 300.00 200.00 1,582.50 Executive Director/40 hours 0.00 0.00 0. 00 Executive Assistants (2) 40 hours 0.00 0.00 . 0.0 Chief Financial Officer/ 40 hours - 0.00 0.00 0.00 Senior Accountant/40 hours 0.00 0.00 0.00 I.T. Coordinator/40 hours 0.00 0.00 0.0 Sr. Assessment Specialist/40 hours 0.00 0.00 0.00 Infant Toddler Specialist/40 hours 0.00 0.00 0.0 Assessment Specialist/40 hours 0.00 0.00 0.0 Contract Coordinator/40 hours 0.00 0.00 0.0 Resource & Referral Specialist (6) 40 hours 0.00 0.00 0.0 VPK Fam. Service Specialist/ 40 hours 0.00 0.00 0.00 Resource Coordinators (3) 40 hours 0.00 0.00 0.0 Sr. Eligibility Specialist/40 hours 0.00 0.00 0.00 SR RR Specialist/40 hours 0.00 0.00 0.00 Reimbursement Specialist/40 hours 0.00 0.00 0. 00 VPK Coordinator/40 hours 0.00 0.00 0.00 Office Administrator/40 hours 0.00 0.00 0.00 Data Entry Clerk/25 hours 0.00 0.00 0.00 Finance Clerk/10 hours 1 0.001 0.001 0.00 Benefits @ 30% 0.00 0 .00 0.00 Total Funder Request Fringe Benefits $0.001 $0.00 $0.00 $0.00 $0.001 mool $0.00 A B C D EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific Total Agency AGENCY USE EOTNLro SHOW Budget Budget Budget SHOW 27 Travel-Daily 30,000.00 # of Staff x average # of miles/wk x 50 wks x $ = Estimated Daily Travel/Mileage Reimb. 28 Travel/Conferences/Training 0.00 • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Trainings (cost of travel , lodging, registration, food) 29 Office Supplies 10,000.00 Office supplies (monthly average x 12 months = estimated cost of office supplies based on present history. 30 Telephone 17,000.00 • # 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 Postage/Shipping 12 ,400.00 • Quarterly Mailing of Newsletter • Special events, etc. _ • Bulk mailings - appeals 32 Utilities 0.00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) 33 Occupancy (Building & Grounds) 134,461 .00 52312006 B-1 Type the Organization and Program Name • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications 13,600.00 • Quarterly Newsletter ($ x 4) • Letterheads , Envelopes, etc. • Fundraising materials • Other 35 Subscription/Dues/Memberships • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. 36 Insurance 12,000.00 • Directors/Officers Liab. • Commercial/General Insurance • Bond Ins. • Auto Insurance 37 Equipment:Rental & Maintenance 30,000.00 • Copier lease ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) • Computer Maintenance ( $ x 12 months) • Other 38 Advertising 20,000.00 • Newspaper ads • Fundraising ads/promotions • Other (vacancies) 39 Equipment Purchases:Capital Expense 50,000.00 • Computerlmonitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 10,000.00 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 41 Books/Educational Materials • Books/videos • Materials ($ x staff) 42 Staff Development 20,000.00 • Meals ( # meals x clients x 5days x 50 wks) • Snacks 43 Program Services 12,539,117.00 • Admin. Cost (% of total budget) 44 Audit Expense 40,000.00 Independent Audit Review 45 Specific Assistance to Individuals • Medical assistance • Meals/Food • Rent Assistance • Other 46 Other/Miscellaneous 1 ,000.00 • Background check/drug test • Other 47 Unallocated 1 ,134, 151 .00 • Sub-contract for program services 48 TOTAL EXPENSES $0.00 $0.00 $ 15,454,979.00 5123!2005 6-1 rice the ogmuxtim and ?nt Name UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCYIPROGRAM NAME : INDIAN RIVER COUNTY ELC or IRMO CO ELC or IRMO CO FY 04105 FY 05/06 FY 06107 % INCREASE FYE FYE FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. Csol. B)lcol. B REVENUES BUDGETED BUDGETED Children's Services Council-St. Lucie 0.00 #DIV/0! Children's Services Council-Martin 651 000.00 700,000.00 7.53% Advisory Committee-Indian River 0.00 #DIV/01 United Way-St Lucie Countv 0.00 #DIV/0! United Way-Martin County 0.00 #DIV/01 United Way-Indian River County 70525.00 74000.00 4.93% Department of Children & Families 0.00 Z1 01 County Funds 30,000.00 #1 Contributions-Cash 0.00 #DIVI01 Program Fees. 0.00 #DIVI01 Fund Raising Events-Net 0.00 #DIV/0! Sales to Public-Net 0.00 #DIV/O! Membership Dues 0.00 #DIV/01 Investment Income 0.00 #DIVIO! Miscellaneous 0.00 #DIV/0! Legacies & Bequests 0.00 #DIV/01 Funds from Other Sources 2 209 268.00 13 936,220.00 14,650,979.00 5.13% Reserve Funds Used for O eratin 0.00 #DIV/O! In-Kind Donations (Not lncludw In New 0.00 #DMO! TOTAL 2,209,268.00 14,657 745.00 15,454,979.00 5.44% EXPENDITURES Salaries 65 DB4.00 135749900 1 ,381 ,250.00 1.75% FICA 0.00 #DIV/0! Retirement 0.00 #DIV/O! Life/Health 0.00 #DIV/O! Workers Compensation 0.00 #DIV/O! Florida Unemployment 0.00 #DIV/01 Travel-Datily 30,000.00 30,000.00 0.00% Travel/Conferences/Trainin 0.00 0.00 #DIV/01 Office Supplies 15 200.00 10 000.00 -34.21% Telephone 5 000.00 17 000.00 240.00°k Postage/Shipping 13,461 .00 12,400.00 -7.88% Utilities 0.00 #DIV/0! Occupancy (Building & Grounds 144786.00 134,461 .00 -7.13% Printing & Publications 8500.00 13,600.00 60.00% Subscription/Dues/Memberships 0.00 #DIVIO! Insurance 5,000.00 12,000.001 140.00% E ui ment:Rental & Maintenance 29,000.00 30,000.00 3.45% Advertising 5,000.00 20,000.00 300.00% Equipment Purchases:Ca ital Expense 40 500.00 50,000.00 23.46% Professional Fees Le al Consulting) 5,000.00 10,000.00 100.000A Books/Educational Materials 0.00 #DIVI01 Staff Development 41500.00 20 000.00 344.44% Program Services 2,137,886.00 . 11 ,465,299.00 12,539,117.00 9.370/6 Audit Expense 32 000.00 40,000.00 25.00% Specific Assistance to Individuals 0.00 #DIV101 Other/Miscellaneous 34554.00 7000.00 1,000.00 -85.71% Unallacated 1490000.00 1134, 151 .00 -23.88% TOTAL 2,237,524.00 14,657,745.00 15,464,979.00 5.44% REVENUES OVER/ UNDER EXPENDITURES -28,256.00 0.00 0.00 #DIVIOI vors�o az Trieu.e Onga^aa5an and Precan Nam. UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME : INDIAN RJt Rco ELC of IRMO CO ELC of IRMO CO FY 04!05 FY 05106 FY 06/07 % INCREASE FYE FYE FYE CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. ccoi. 6pcol. 8 REVENUES BUDGETED BUDGETED Children's Services Counc!ISL Lucie 0.00 #DIVIDI #DIVfO! Children's Services Council-Martin 0.00 #DIV/01 #DIV/01 Advisory Committee-Indian River 0.00 #DIV101 #DIVIDI United Way-St. Lucie County 0.00 #DIV10! #DIV/01 United Way-Martin County 0.00 #DIV/01 #DN101 United Way-Indian River County 70,525.00 74,000.00 4.93% No need Department of Children & Families 0.00 #DIV/0! #DNICI County Funds 30000.00 #DIVIDI ,#DtVro! Contributions-Cash 0.00 #DIV/01 #Dlvrol Program Fees 0.00 #DIV/01 aaaa #DIWI]i Fund Raising Events-Net 0.00 #DIV/0! #DIV101 Sales to Public-Net 0.00 #DIV/01 #DNro! Membership Dues D.001 #DIV/0! #DIVED! Investment Income 0.00 #DIVIDI #DNro! Miscellaneous 0.00 #DIV/0! #DIVm! Legacies & Bequests 0.00 #DIV10! #DIVIDI Funds from Other Sources 2 209 268.00 6,000.00 #DIV/0! #DNro! Reserve Funds Used for Operating 0.00 #DIV/0! #DN/01 In-Kind Donations (Not included infovi! 0.00 #DIV/0! #DIV1O! TOTAL 2,209,268.001 70 525.00 110 000.00 55.97% EXPENDITURES Salaries 65 084.00 0.00 #DIV101 #DIV/01 FICA 0.00 #1 #DIV/01 Retirement 0.00 #DIV/01 #DIV101 Life/Health 0.00 #DIV/0! #D!v/O! Workers Compensation 0.00 #DIV/01 #DIVIO! Florida Unemployment 0.00 #DIV101 #DNro! Travel-Dail 0.00 #DN/01 #Dlvro! Traval/Conferences/Trainin 0.00 #DIVIDI #DImD! Office Supplies 1 0.001 #DIVJ0! #DIV/0! Telephone 0.00 #DIV/0! #DN/O! Posta elShi in 0.00aaaV/DI #DIVlO! #DI Utilities 0.00 aaaaaaaa #DIV/0! #DIV101 Occupancy (Building & Grounds 0.00 #DIVIDI #DNro! Printing & Publications 0.00 #DIV101 #DIV/01 Subscri tion/Dues/Membershi s 0.00 #DIV70! #Dlvfo! Insurance 0.00 #DIV/0! #DIV10! E ui menta Rental & Maintenance 0.00 #DIV/0! #DN/0I Advertising0.00 #DIV/0! #DII Equipment Purchases:Ca ital Expense 0.00 #DIV/01 #DIVro! Professional Fees (Legal, Consulting) 0.00 #DIV101 #DNro! Books/Educational Materials 0.110 #D11 #DIVIDI Staff Development 0.00 #DIV101 #DN1D! Program Services 1 2 137,886.00 0.00 #DIV/Ol #DN/O! Audit Expense 0.00 #DIV/O! #DNlO! Specific Assistance to Individuals 0.00 #DIV/01 #DNro! Other/Miscellaneous 34,554.00 0.00 #DIV/01 #D!VIC! Other/Contract 0.00 #DIVIDI #DNro! TOTAL 2 237,524.00 0.00 0.00 #DIV101 #DIV/O! REVENUES OVER/ UNDER EXPENDITURES -28,256.00 70,525.00 110,000.00 55.97 smrna Bi Type the Drganizadon and Program Name UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME: FUNDER: A B C FY 06107 FY 06107 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. Bfcol. A) EXPENDITURES Salaries 0.00 0.00 #DIV/0 ! #Divi) FICA 0.00 0.00 #DIV/01 #DIVAO! Retirement 0.00 0.00 #DIV/0! #D)m), Life/Health 0.00 0.00 #DIV/01 #DImO! Workers Compensation 0.00 0.00 #DIV/O! #DIVIDI Florida Unemployment 0.00 0.00 #DIV/0 ! #DIV101 Travel-Dail 0.00 0.00 #DIV/O ! #DIVAO! Travel/Conferences/Training 0.00 0.00 #DIV/0! #DIVA)! Office Supplies 0.00 0.00 #DIV/01 #Diwm Telephone 0.00 0.00 #DIV/01 #glia! Postage/Shipping 0.00 0.00 #DIV/O! #D111101 Utilities 0.00 0.00 #DIV/0 ! #DIVIDI Occupancy (Building & Grounds 0.00 0.00 #DIV/O! IV/o! Printing & Publications 0.00 0.00 #DIVIO! #DIVICI Subscription/Dues/Memberships 0.00 0.00 #DIV101 #Damm Insurance 0.00 0.00 #DIV/0! #DImO! Equipment: Rental & Maintenance 0.00 0.00 #DIV/0 ! #DIV101 Advertising 0.00 0.00 #DIV/0! #Dlma! Equipment Purchases:Ca ital Expense 0.00 0.00 #DIV/O! #DIVA)! Professional Fees (Legal , Consulting) 0.00 0.00 #DIV/01 #Dlm01 Books/Educational Materials 0.00 0.00 #DIV/0 ! #olio! Food & Nutrition 0.00 0.00 #DIV/0 ! DIVro! Administrative Costs 0.00 0.00 #DIV/0! DIV)! Audit Expense 0.00 0.00 #DIV/01 Specific Assistance to Individuals 0.00 0.00 #DIV/01 #DWOl Other/Miscellaneous 0.00 0.00 #DIV/0! #Div/Ol Other/Contract 0.00 0.00 #DIV/0 ! DIV/01 TOTAL $0.00 $0.00 #DIV/01 VMO% BA Trye the Organnabon and Program Name UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: FUNDER: , �LIWTEM;? ,tiz we»?:�-�. . t „s .> , a +I'„rib 1 ;tn ^'rt:�,'PdFXPLANA;TION PORIVARIANCE,r. ?; #DIV/01 #DIV/01 #DIV/DI #DIV/01 #DIV/O! #DIV/OI #DIV/01 #DIV/01 #DIV/01 #DIVI01 #DIV/01 #DIV/01 #DIV/01 #DIV/O! #DIV/01 #D1V/0! #DIV/01 #DIV/01 #DIV/0! #DIV/0! #DIV101 #DIVI01 #DIVIO! #DIV/01 #DIV/0! #DIV/01 #DIV/01 #DIV/01 #DIV/01 #DIV/O! #DIV/01 #DIV/O! #DIV/01 #DIV/0! #DIV/01 #DIV/01 #DIV/01 #DIV/0I #DIV/01 #DIV/01 MIMI #DIV/01 #DIV/01 #DIV/01 #DIVl01 srz�rzooe OF e-s Type the 0h wa000 and Program Name UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCYIPROGRAM NAME: FUNDER: LINEITEM ,-„ ., ,, r",h✓k v . k � . j ; v r+ , ,.;ir r2. . (, «a , L'XPUANA'CIONiFORS.VAR/ANCE�"�'� #DIV/01 #DIV/0! #DIV/0! #DIV/01 #DIV/01 #DIV/OI #DIV/01 #DMO! #DIV/OI #DIV/01 #DIV/01 #DIV/01 #DIV/01 #DIVI01 #DIV101 #0IV/01 #DIV101 #DIV/01 #DIV101 #DIV/O! #DIV101 #DIV/01 #DIV/01 #DIV/OI #DIV/01 #DIV/01 52M(08 B-5 Tydema Organ Katon and Program Nam• UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCYIPROGRAM NAME: FUNDER: o-EXP,LANATIOWFORTVARIANCE � #DIV/01 #DIV/01 #DIV/0! #DIV101 #DIV/0! #DIV/01 #DIV/01 #DIV/01 #DIVI01 #DlVlol #DIV/0! #DIV/O! #DIV/0! #DIV/01 #DIV101 #DIV/01 #DIV/0! #DIV/01 #D1w01 #DIV/01 #DIV/01 #DIV101 #DIV101 #DIV/0! #DIV/01 #DIV101 #DIV/01 snaaooe e-s NOT FOR PROFIT AGENCY CERTIFICATION The County of Indian River requires , as a matter of policy, that any Consultant or firm receiving a contract or award resulting from the Request for Qualifications issued by the County of Indian River, Florida , shall make certification as below. Receipt of such certification , under oath , shall be a prerequisite to the award of contract and payment thereof. I (we) hereby certify that if the contract is awarded to me , our firm , partnership , or corporation , that no members of the elected governing body of Indian River County, nor any professional management, administrative official or employee of the County, nor members of his or her immediate family , including spouse , parents , or children , nor any person representing or purporting to represent any member or members of the elected governing body or other official , has solicited , has received or has been promised , directly or indirectly, any financial benefit, including but not limited to a fee , commission , finder's fee, political contribution , goods or services in return for favorable review of any Proposal submitted in response to the Request for Qualifications or in return for execution of a contract for performance or provision of services for which Proposals are herein sought . The undersigned certifies that he/she is a principal or officer of the firm applying for consideration and is authorized to make the above acknowledgments and certifications for and on behalf of the applicant. The undersigned certifies that the Applicant has not been convicted of a public entity crime within the past 36 months, as set forth in Section 287 . 133 , Florida Statutes . Failure to sign this form will result in disqualification. Handwritten Signature of Authorized Principal (s) : DATE : /` 7 /) �0 NAME : CLAN FAULK TITLE : EXECUTIVE DIRECTOR NAME OF FIRM/PARTNERSHIP/CORPORATION : EARLY LEARNING COALITION OF INDIAN RIVER , MARTIN & OKEECHOBEE COUNTIES , INC . FOR AND ON BEHALF OF THE APPLICANT: Sworn to and subscribed to me, a Notary Public, this _day of f/. 2006 . BY: , U OLAN FAULK EXECUTIVE bIRECTOR Xe' C ,e-el 1 ;l /I �P7c (SEAL) (TYPE NAME & TITLE) /l� c of � �, z Maureen tack My Commission DD- 33376 \ I W n Ecpires July 11 , 2008 XI AUTHORIZATION FOR RELEASE OF INFORMATION Indian River County and Early Learning Coalition of Indian River. Martin and Okeechobee Counties . Inc . (Agency/Individual are in the process of negotiation of a contract for Childcare Access Indian River County is authorized to make an investigation of the Agency/Individual regarding its experience and qualifications . The Agency/Individual authorized the release of all relevant information concerning prior services furnished , contracts and background information of the Agency/Individual . The Agency/Individual authorizes any individual or organization that is in possession of relevant factual contract and background information , to release such data to Indian River County in response of the County's request. When an individual employee of the Agency signs Authorization for Release of Information , such individual authorizes the County to obtain relevant background information concerning such employee's criminal record , if any, and such other information that may be relevant to employee 's good character and work experience . Authorization is given here by the Agency/Individual and such employees who execute this authorization with the understanding and limitation that Indian River County will utilize the information obtained for the purposes set forth herein and that such information shall not be disclosed to third parties except as provided by law. Name Agency/Individual EARLY LEARNING COALITION OF INDIAN RIVER , MARTIN AND OKEECHOBEE COUNTIES , INC . Print name Name Employee Providing au oriz tion OLAN FAUCK rint nam Signature (in blue ink) Date XII SWORN STATEMENT UNDER SECTION 105. 08, INDIAN RIVER COUNTY CODE, ON DISCLOSURE OF RELATIONSHIPS THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS . 1 . This sworn statement is submitted with RFP No. 2006061 for Children 's Services Advisory Committee Grant Funds for Children 's Programs — Childcare Access 2 . This sworn statement is submitted by : EARLY LEARNING COALITION OF INDIAN RIVER, MARTIN AND OKEECHOBEE COUNTIES INC (Name of entity submitting Statement) whose business address is : 2415 South 29th Street and (if applicable) its Federal Employer Identification Number ( FEIN) is 65- 1035652 ( If the entity has no FEIN , include the Social Security Number of the individual signing this sworn statement 3 . My name is OLAN FAULK ( Please print name of individual signing) and my relationship to the entity named above is EXECUTIVE DIRECTOR 4 . 1 understand that an "affiliate" as defined in Section 105 . 08 , Indian River County Code, means : The term "affiliate" includes those officers, directors, executives , partners, shareholders, employees, members , and agents who are active in the management of the entity. 5 . I understand that the relationship with a County Commissioner or County employee that must be disclosed as follows : Father, mother, son , daughter, brother, sister, uncle , aunt , first cousin , nephew, niece , husband , wife, father-in-law, mother-in-law, daughter- in-law, son-in-law, brother-in-law, sister-in-law, stepfather, stepmother, stepson , stepdaughter, stepbrother, stepsister, half brother, half sister, grandparent, or grandchild . 6 . Based on information and belief, the statement, which I have marked below is true in relation to the entity submitting this sworn statement. [Please indicate which statement applies . ] X Neither the entity submitting this sworn statement, nor any officers , directors , executives , partners , shareholders, employees , members, or agents who are active in management of the entity , have any relationships as defined in section XIII 105. 08 , Indian River County Code , with any County Commissioner or County employee . The entity submitting this sworn statement, or one or more of the officers , directors , executives , partners , shareholders , employees , members , or agents , who are active in management of the entity have the following relationships with a County Commissioner or County employee : Name of Affiliate Name of County Commissioner Relationship or entity or employee XIV / (signature) (date) STATE OF FLORIDA COUNTY OF INDIAN RIVER e foregoing instrumentwas ackn edged before me this 42' , 2006, by (J(��c� t � Lwhs personally known to me or who t1�s produced fication NOTARY PUBLIC �— SIGN - PRINT: /h i�d_ a� /✓ �� 1 State of Florida at Large My Commission Expires: (Seal) ypMaureen zackey y My Commisswn D0133375 ein4 Expires July 11, 2009 XV SUPPORTING DOCUMENTS CHECKLIST RFP 2006061 _X_ Cover Page _X_ Application X List of current officers and directors _ X _ Latest Financial Audit Report & Management Letter that conforms with the AICPA Audit Guide _ X _ Most recent IRS Form 990, including all schedules _ X _ Most recent Internal Financial Statement (i . e . : Balance Sheet and Operating Budget _X_ Staff Organizational Chart _X_ Most Recent Annual Report ( if available) _X_ 501 (C) (3) IRS Exemption Letter _X_ Articles of Incorporation _X_ Agency's Bylaws _X_ Agency's written policy regarding Affirmative Action Nepotism Statement Taxonomy Definition for each program XVI INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS FUNDING APPLICATION FOR EARLY LEARNING COALITION OF INDIAN RIVER, MARTIN, AND OKEECHOBEE COUNTIES , INC . FY 2006-2007 RFP # 2006061 Taxonomy Definition Child Care Subsidies — NL-300 . 150 Programs that underwrite the cost of child care in public and private child care centers or private family child care homes for low-income families where the parent(s) are working, in school, or in training. DUE : 2 :00 p.m. WEDNESDAY, MAY 24, 2006 Indian River County Purchasing Division 2525 St. Lucie Avenue Vero Beach, FL 32960 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc . RFP - Indian River County Board of County Commissioners ORGANIZATION : Early Learning Coalition of Indian River. Martin and Okeechobee Counties, Inc PROGRAM : Early Learning Local Match for Working Poor BG 8) 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. FX-F- Section of the Proposal Pa e # X TABLE OF CONTENTS (check list) X COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 A. ORGANIZATION CAPABILITY (one page maximum) X 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 X 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . 4 B. PROGRAM NEED STATEMENT (one page maximum) X 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 X 2 . Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 C. PROGRAM DESCRIPTION (two pages maximum) X1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X4. Staffing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X 6 . Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X D. MEASURABLE OUTCOMES (two pages maximum) . . . . . . . . . . . . . . . . . . . . . . . . . 8 X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 F. PROGRAM EVALUATION (two pages maximum) X1 . Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 X2. Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 X3 . Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 X G. TIMETABLE (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 H. UNDUPLICATED CLIENT COUNT X 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 X 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1 Early Learning Coalition of Indian River, Martin and Okeechobee Counties Inc . RFP - Indian River County Board of County Commissioners I. BUDGET FORMS X 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 X J. FUNDER SPECIFIC/ADDITIONAL SHEETS X K. APPENDICES A List of Current Officers and Directors B Latest Financial Audit Report & Management Letter that conforms with the AICPA Audit Guide. C Most Recent IRS Form 990, including all schedules D Most Recent Internal Financial Statement (i .e. Balance Sheet and Operating Budget) E Staff Organizational Chart F Most Recent Annual Report G 501 (C) (3) IRS Exemption Letter H Articles of Incorporation I Agency' s Bylaws J Agency' s Written Policy Regarding Affirmative Action K Nepotism Statement L Taxonomy Definition for each Program 2 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 1st may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners. All requests for reimbursement at fiscal year 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 - 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`h Street Vero Beach , Florida 32960-3365 Recipient : Early Learning Coalition 101 Central Parkway, Suite #400 Stuart, Florida 34994 2. Venue: Choice of Law: The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida , only. The location for settlement of any and all claims, controversies, or disputes , arising out of or relating to any part of this Contract, or any breach hereof, as well as any litigation between the parties, shall be Indian River County, Florida for claims brought in state court, and the Southern District of Florida for those claims justifiable in federal court . 3 . Entirety of Agreement: This Contract incorporates and includes all prior and contemporaneous negotiations , correspondence, conversations, agreements, and understandings applicable to the matters contained herein and the parties agree that there are no commitments , agreements, or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements, whether oral or written . It is further agreed that no modification , amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4 . Severability: In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other term and provision of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable. 5. Captions and Interpretations : Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions. Unless the context indicates otherwise, words importing the singular number include the plural number, and vice versa. Words of any gender include the correlative words of the other genders , unless the sense indicates otherwise. 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract. The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision , and control . 7 . Assignment. This Contract may not be assigned by the Recipient without the prior written consent of the County. - EXHIBIT C - im: Laura ;`•'mger At: R V Johnson Insurance FaxID: TO: Dorette Veflliams Date: 10/112006 1BAD AM Page: 2 of ACORD_ CERTIFICATE OF LIABILITY INSURANCE OP ID L DATE 11* AD/YVYY) EARLY-3 10 / 11/06 RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE L . V . Johnson Agency , Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ' 041 SE Ocean Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ituart TL 34996 2hone : 772 -287 -3366 rax : 772 -287 -4255 INSURERS AFFORDING COVERAGE NAIC # JSURED INSURER A. Announce caimp p of A xf.ca 19305 Early Learning Coalition of INSURER 6- Indian River , Martin 6 INSURER C . Okeechobee Counties Inc . 2020 E Ocean Blvd I INSURER Stuart FL 34996 INSURER E :OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMEM, TERM OR CONDITION OF PNr CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR NSR TYPE OF INSURANCE POIIiUJ LICY NUMBER DATE Cy(MNUDDrYY) DATE (MMIODIYY) LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X coMMERaAL GENERAL UABIUTY PPs42911710 01 /05 / 06 01 /05/07 PREMISES (Ea occwence) $ 1000000 CLAIMS MADE 1XI OCCUR MED EXP (Any one person) $ 10000 PERSONAL & ACV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GENU AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPA)F AGG $ 2000000 POLICY71 JCT PEC- LOC AUTOMOBILE UABILUY COMBINED SINGLE LIMIT $ ANY AUTO NOT WITH THIS AGENCY (Ea accident) ALL OWNED ALPOS BODILY INJURY $ (Per persor) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per acoidenn N'ONLOWNED AUTOS PROPERTY DAMAGE $ (Per accident! GARAGE LIABILITY AUTO ONLY - E- ACCIDENT $ ANr AUTO NOT WITH THIS AGENCY OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMSMADE NOT WITH THIS AGENCY AGGREGATE $ S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I TORY LIMITS ER EMPLOYERS' LIABLLrIY NOT WITH THIS AGENCY EL EACH ACCIDENT $ ANY PROPRIETORIPARTNER/ ECUTIVE OFFICEWMEMBER EXCLUDED? E L DISEASE - EA EMPLOYEE $ It yes describe under SPECIAL PROVISIONS belwv EL DISEASE - POLICY LIMIT $ OTHER ESCRPnON OF OPERATIONS I LOCATIONS U VEHICLES U EXCLUSIONS ADDED BY ENDORSEMENT U SPECIAL PROVISIONS ,ertificate Holder is listed as additional insured for general liability . :ERTIFICATE HOLDER CANCELLATION Imi A41 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 * DAYS WRTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Indian River County 1840 25th Street REPRESENTATIVES. Vero Beach FL 32960 AU-1) R PRE (CORD 25 (2001108) 0 ACORD CORPORATION 1988 gym : Laurar zinger At: R V Johnson Insurance FaxID: To: Dorette VWlliams Date: 10/112006 10:40 AM Page: 3 of IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon kCORD 25 (2001/08) V ITV / aVVV > Vias oy� . ACOS' CERTIFICATE OF LIABILITY INSURANCE io/ii2 6 DDUCER ( 772) 231 - 2828 FAX (772 ) 231 - 4413 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bl ten & Associates ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE 911 Cardinal Drive (32963 ) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. . 0 . Box 3488 ero Beach , FL 32964- 3488 INSURERS AFFORDING COVERAGE NAIC # :uRED Indian River County School Readiness Coalition INSURER A. American Economy Insurance Co . 09043 Early Learning Coalition of Indian River , INSURER B: Martin & Okeechobee Counties INSURER C. 1416 Old Dixie Highway INSURER D: Vero Beach , FL 32960 INSURER )V AGES RHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING WY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR NAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH DOLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R DD' TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTNE POUCYEXPIRATION DATE MMIDD� DATE (MWDDNY) LIMITS GENERAL LIABILITY 02BOB496667 03 /21/2006 03 /21/2007 EACH OCCURRENCE $ 2, 10001000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDt $ 210001000 CLAIMS MADE � OCCUR MED EXP (My one person) $ 101 PERSONAL & ADV INJURY $ 21000900 GENERAL AGGREGATE $ 430003000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMRIOP AGO $ 210003000 POLICY F JEPCT LOC AUTOMOBILE UABILT' COMBINED SINGLE LIMIT $ PINY AUTO (Ea accident) ALL OWNED ANDS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABLLITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TOR STAT4 -0TRF P.V LIMITS EMPLOYERS' LIABILnY ANY PROPRIETOR/PARTNEP/EXECUPVE EL EACH ACCIDENT $ OFFCERPOEMBER EXCLUDED? E DISEASE - EA EJNPLOYE $ If yes, describe antler SPECIAL PROVISIONS below EL DISEASE - POLICY LIIdIT $ OTHER SCRIPTION OF OPERATIONS f LOCATIONS !VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS �RTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ DAYS WRIT EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Indian River County BUT FAILURE TO MALL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1840 25th Street OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. Vero Beach , FL 32960 AUTHORIZED REPRESENTATIVE Kenneth D . Felten LUTCF/D0h :ORD 25 (2001108) ©ACORD CORPORATION 1988 1V / iV / aWvuaye i IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . - DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend , extend or atter the coverage afforded by the policies listed thereon . :ORD 25 (2001/06) 01 / 11 / LOOT TRU L0 : 1i FAX 613 ? 854311 Prime Group IQC 01 ! 002 � �A�CORD� CERTIFICATE OF LIABILITY INSURANCE i 10120 FYI PI RODUCEP ( 813 890- 0415 FAX : { 8 '_ 3 ) 885- 4311 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION N THE CERTIFICATE Prise Grcup Insurance Servica•s HOLDER.O DER. THIY AND SCCERTIFICATE ONFERS NO R DOES NOIGHTS T AMEND, EXTEND R l5-w' BeauTont Center Blvd . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite N445 TampIa. FL 33634 INSURERS AFFORDING COVERAGE MAIC 7F NSUR£0 INSURERA: AeCrUiCao Insurance Early Learning Coalition of in Sian River , NSLRER R: ._._.—_*— ----1'-----'-.- 2415 South 29th Street IN'SL'RERC INSURER D: r Ft , Pierce FL 34981 ' INSI;RERE VERAGES THE POLICIES OF NS'JRANCE LISTED BELOW HAVE EESN ISSUED TO THE WSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRAL T OR OTHER DOCUMENT 'WRH RESPECT TO WHICH THIS CERTIFCATE MAY BE ISSUED OR MAY PERTH.N. THE INSURANCE AFFORDED BY THE POLICIES DESCI:ISED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PXtCIES rREQATr LIMITS SHOWN M IjAV- BEEN REDUCED L IHSR ADD'L TYPE OF INSURANCE PO.:GY NUMBER, DATEM PECTNE PODATEI T:ON UBTS _ GENERALL:ABILRY r EACH rv . - .y f CDN, CV,L GENERAL LIABILITY I DFU -E RENTED 1 _ J ' i J iiAilAS MODE L DCGDP AtEA EXP (ATY ma pmOnr $ I _ FFRSOHAL A AW iIIUW 4B ___ GEIJERAL AGGRE�...A'(E I8 GEN'LAUORECATEUMfI APPLIES PER:rr7 PROTL'CTS - LAP PA _ _ 5--_ VOLICY PRO LOC AUTOMOBILE LIABILITY COVHINED SWG.E LIMIT IS -.-I ANYAUTO (SPC ' _ ALLOWNEDAUTOS � f00AIY iN„URY S f 3CHEGULFDAUTOS Pw °rsml HIREDAUTOS BODILY IN:UR'Y NONOWNiL AJIOS ' (Pw e_ndmQ . ,—� PROPIRTY DAMAGE S I j (PM a. arm0 GARAGE LIABILITYIAS UIO MLY - EA ACGOErr IS ANY AUTO CTNEI THAN EA ACC _ _ 1 'wTO , NLY: A. S E%CESSr'UMBRELLA LIABILITY— c TCURRENCE _ S OCCJR � CLAPJS MADE ' AGGREyATE ____ S _ — DEDUCTIBLERETENTION S IE W^ "TAMAM J - jA WGRRERS COMPENSATION AA'D RR ib,N EMPLOYERS LLABRJTY E1EACH AL :IO£Yi S SDODDD ANY PROPRtETOFUPAfRTNER'FXEC.JTF/E r OFPICERm7EMaER EXCLUD=ED- IWC07065217 7 /1/2006 7/ 1/2007 , RYwS. C�Cd9e w,dae �1015EP%E - *.-A -eMPLO`^- f IODr000 GAL PRUYf510N$ Je E.L. aI - P,LICY LMeN 3 50Dr000 IPIIIPIIIIdd O HER I _ I i DESCRIPTION OF 0"WATICNSR0C+ TIONSIVEHM ES1EXCLUSIONS ADDEC BY Elia A 8EWNTWECLAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (772 ) 978 -1798 SHOULD ANY OF THE ABOVE DESCRIBED POLH ES BE CANC -LLED BEFORE THE Indian River C' 1nty EXPIRATION DATE THEREOF. THE LASUNG INIFiREF WLL I.NDEAVOR TO WIL 1840 25th Strei t 10 DAYS WRITTEN NCTICE TO THE CERTIFICATE ROLLFR NAN ED TO THE LEFT, BUT Vero Beach , Fl. 32950 FAF_URE TO Do 40 SHALL IMPOSE NO OBLIGAMC'N OF. 0AB.ITYf ' ANY KIND UPON THE INSURER OS AGENTS OR REPRESENTATIVES. AUTHOR= REPRESENTATIVE E E1 isas ^er NAO'7 '1197 / ACORD 25 (2001N)8) :: ACORD CORPORATION 1988 IN3026 pDloa�.oaA /?,qw Icf2 V ii Ll / Yuur 1HU LJ : 13 rA& G136d J43 . 1 Yr Ille GZD1D IMPORTANT If the certificate holder is an oc )DITIONAL NSURED, the pollcy(iss) mist be endorsad. A atatemant on this certificate does not confer rightsr the certificat& holder in Iieu of such endorsament(s). If SUBROGATION IS WAIVED, subject tr the te. im3 and conditions of the pe)lwy, certain polices may require an endorsement . A statement on this "en 'Cate daes not confer rights to n = : ertifcate, `wider in lieu V such endorement(s). DISCLAIMER The Certificate of Insurance on the reverse aide of this Poon does not conr,ti^.ute a -�oritract between the issuing i msurerfs), autho^zed representative or prodccer, and the certificate holder. nor does 1 affirmatively or negain" amend , exterd or alter the coverage afforded t. / the p0des listed thereon. ACORD 25 (2001108) INS025 (i+oai.oe.. pba 2 of 2 Ole' ! 1f20Ca ' 17 : 56 7722201229 EL :CIFP13c' STUART PAGE 01 / 0'' • Early Learning Coalition of Ind* Rh, i Martin & Okeechobee Counties, Inc, . 10 SE Central Parkway, Ste 400 Stuart, FL 34994 (772) 220. 1220 (677) 220-1223 Fax: (772) 220.1229 lEwgy tawfing C0011Nron Ct> January 11 , 2007 Gerstd T. Roden tR Mj:gh9yj Nan Griggs Indian River County 2n° A0-Chalr 1840 25"' St. Ken Miller Vero Beach , FL 32960 Sandy Akrs cheryi Dunn Attn . : Risk Management Leonard Edwards Gentlem6n : Pstar Engle This letter serves to verify that the Early Leai : ° g Coalition Dawn Hoover of Indian River, Martin and Okeechobee COU - ' ss Inc. does Lorraine Johnson not transport children nor do we plan to tram ; : '1!Nidren . Vern Melvin The coalition only provides .funding for child r I acilittes in Tom peer the three counties it serves . Juslie Perry I Should you have any questions , please cont : o tr offices in Sandy perry Stuart . Sam smith Sincerely, Gwends Thompson Eddie Trent !, r t '6 ".1 . Fillberto Valero Nqfhcy�Kline: Executive D rector Dr. Sara Wilcox harry a. yatec NK/maz Paula Younger cc: Marion Masterson Executive Diraetor Nancy Kilns rm's Services Qua A.n�k nite 9 rydi¢¢ screr S'o¢ er lbfvtaion A; vide quelin) opportnnifiex forsotd02, plipvco1, em0t70n0(, 0710 277011eeru0l < mens q!ri:iidrer., fiy parrnerrne r�ith =rarenrs, providers , mt3com'numfic