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HomeMy WebLinkAbout2006-331K. ^} - .T INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract") entered into effective this 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 Hibiscus Children 's Center. (Recipient), of: Hibiscus Children 's Center P .O . Box 305 Jensen Beach , Florida 34958 Hibiscus HOPE (Healthy Opportunities for parenting Excellence) Program Background Recitals A. The County has determined that is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99-1 on January 19, 1999 ("Ordinance"), and established the Children's Services Advisory Committee to promote healthy children in a healthy community, and to provide a unified system of planning and delivery within which children's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling its purpose . D . The proposal submitted to the Children 's Services Advisory Committee and the recommendation of the Children's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children's Services Advisory Committee , has applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter defined) on the terms and conditions set forth herein . F. The County has agreed to provide such Grant funds to the Recipient for the Grant Period (such term is hereinafter defined) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows: 1 . 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: NINE THOUSAND , SIX HUNDRED DOLLARS ($9 ,600). 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 BOAT �O�, POMMISSIONERS . G r . By: Ed wk Arthur R. Neuberger, CI ai a1T BCC Approved : Attest: J . K. Barton , Clerk By: cny Deputy Clerk Approved : Jose h A. Baird County Administrator Approved as o form and legal sufficiency: By. = r f avian E. ell , Assistan tor ey At RECIPIEN By: J - LLC Cob Hibiscus Children 's C nter - 4 - EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - -Hibiscus Children's Center HOPE (Healthy Opportimfies for Parenting Excellence) Program Children's services Advisory C/o'nunittee PROGRAM COVER PAGE Q v Organintion Name: Hibiscus Children's Center Executive Director. Jan S. Uuffert M.S.W.. A.C.S.W. E-mail: ishuffertQhcc4kids.ora_ Address: Post Office Box 305 Telephone: 772-334-9311x101 Jensen Beach, FL 34958 Fax: 772-334- 1991 Program Director: Kathryn Garbowski E-mail: kaarbows1d(a)hcc4kids.org Address: Post Office Box 305 Telephone: 772-334-931 lx801 Jensen Beach. FL 34958 Fax: 772-334- 1991 Taxonomy PH-650.15040 Program Title: HOPE (Healthy Oonortunitiesfor Parenting Excellence) Program Priority Need Area Addressed: Parental Support and Education Brief Description of the Program: The HOPE Program is an intensive in-home family preservation program for families referred through the cid protection system HOPE targets families who are at ^a^t/intetmediate risk of losing their children due to child abuse and/or neglect or are in the process of high risk reunification of children with their families of origin. By working with parents and children in their own environment. HOPE helps them resolve the crisis that has led to abuse — and keep them together safely as a hmily The goal of the HOPE program is to help remove the risk in the family and not the child from the family. SUMMARY REPORT ter Information In The Black Cells Only) Amount Requested from Funder for 2006/07 : S 9 ,593 .00 Total Proposed Program Budget for 2006 /07 : $ 3272351 .00 Percent of Total Program Budget: 2 . 9 % Current Program Funding (2005 /06 ) : $ Dollar increase/(decrease) in request : $ 99593 Percen! nerease/(deELe.1, 1n re uest * * : # DIV /0 ! Undo Num er o ren to be served individualF)" 223 Unduplicated Number of Adults to be served Individually : 123 Unduplicated Number to be served via Group settings : Total Program Cost per Client: 946 . 10 **If request increased 5% or more, briefly explain why: Not funded FY 05-06. If these funds are being used to match another source, name the source and the $ amount: The Organization 's Board of Directorw has approved this application on (date). January 25, 2006 Beth Eaton 1 Name of President/Chair of the Board Signa Jan S Ruffed Name of Executive Director/CEO Signature 2 r l ibis= Childtm's Cmur HOPE (Healthy opportmMw fm Parenting Excdk=) Pmg� Children's Savim Advisory Committee ORGANIZATION: Hibiscus Children's Center PROGRAM: HOPE (Healthy Onoortunities for Parenting Excellence) Proeram TABLE OF CONTENTS X Section of the Proposal Pa e # X TABLE OF CONTENTS (check list) I X COVER PAGE (with signatures). . . . . . . . . . . . . . . . . . . . . . . . . .. . . I . . . . . . . . . . . . . . . . . . . . . . . . . 2 X A. ORGANIZATION CAPABILITY (one page maximum) X 1 . Mission and Vision of organization. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 X 2. Summary of expertise, accomplishments, and population served. . . . . . . . . . . . . . . . 3 X B. PROGRAM NEED STATEMENT (one page maximum) X1 . Program Need Statement, . . . . . " I . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 .11 . . . . . . . . . . . . . . . . . . . . . .. . 4 X 2. Programs that address need and gaps in service. . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . .. 4 X C. PROGRAM DESCRIPTION (two pages maximum) X 1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . 5 X 2. Description of program activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 X 3 . Evidence that program strategy will work. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . I . . . . 5-6 X4. Staffing. . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X 5. Awareness of program. . . . . . . . . . . . . . . . . I . . . . . . . . . " I . .. . . . . . . . . . . . . . . . . . . . . . 6 X 6. Accessibility of program" . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X D. MEASURABLE OUTCOMES (two pages maximum). . . . . . . . . .. . . . . . . . . . . . . . . 7 X E. COLLABORATION (one page maximum) . . . . . . . . . .. 8 X F. PROGRAM EVALUATION (two pages maximum) X1 . Demographics, . . . . I . . . . . . . . . .. 00 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M . . . . . . . 9 X2. Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . 9 X3. Reporting. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. 10 X G. TIMETABLE (one page maximum) . . . . . . . . . . . . . . . . . . . . . ....... . . . . . . . . . . . . . . . . . . . 11 X H. UNDUPLICATED CLIENT COUNT X1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 X 2. Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . 12 X I. BUDGET FORMS X 1 . Financial Budget Forms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bl -135 X J. FUNDER SPECIFIC/ADDITIONAL SHEETS JI -J36 XI-XV X K. APPENDIX 1 Hioisms Chil&rn's Cettd HOPE (Healthy Oppahmitm Srr Parenting Excellence) PMFM Children's Services Advisory Commitft PROPOSALNARRATIVE A. ORGAN17ATION CAPABILITY a Section A not to exceed one page) 1. Provide the mission statement and vision of your organization. The mission of Hibiscus Children's Center is to prevent and reduce child abuse and neglect Hibiscus provides a comprehensive continuum of services that meet identified needs of children and families in our community. From primary prevention to the most intrusive interventions, the vision of Hibiscus Children's Center is to identify strengths and capacity that are innate in all fiamily systems, work in partnership to build family resiliency, and ensure children grow up free of abuse and neglect with the ability to reach their highest potential. Hibiscus Children's Center is a quality service provider that maximim funding streams from multiple sources and is a shining example of community based care at its finest Hibiscus Children's Center works together with state and local finders to meet program operations and raises approximately 30- 35% of its overall budget through private donations and fundraising activities. Child abuse, neglect and abandonment are the result of community problems . . . and Hibiscus understands that solutions are based on the commitmentaiLd investment of the E29pLuEily as a whole. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. Hibiscus HOPE is a diversionary program that works with families whose children are at imminent risk of removal due to allegations of abuse and neglect The program also works to safely reunify children with their family of origin. Hibiscus Crisis Nursery is a primary prevention program that families in crisis seek voluntarily. The program enables families to reduce the impact of poverty, unemployment, domestic violence, behavior management, and other stressful situations that can precipitate child abuse. By providing family support and respite services we can help families prevent problems from escalating into abuse and neglect. Hibiscus Foster Care provides recruitment, training, licensure, and relicensure of foster parents and their homes to increase capacity in Martin, St Lucie, Indian River, and Okeechobee counties. Hibiscus Children's Shelter is a 24 hour awake emergency shelter for children ages birth to 12 and their siblings who have been removed from their homes due to egregious abuse and neglect Hibiscus Children' s Village opened in April 2004 increasing capacity and providing thousands of nights of safety to hundreds otchildren ages birth to 12 and their siblings in a home-like setting. Hibiscus embarked on a $5.1 million capital campaign "Building Hope ... Mending Lives " which was completed in 2005, gamering a prestigious Kresge Foundation Grant for $500,000, and allowing it to open its doors debt free. Hibiscus Treasure House provides thrift store resources to children and families in program services and in need in the community. It also provides a source of revenue for program operations. Hibiscus Volunteers & Guild work tirelessly on behalf of the children and families we serve bringing over 33,000 hours of volunteerism each year in a variety of functions, in addition toraising millions of dollars to meet community identified needs for our most vulnerable children and families. Hibiscus strives to be a valuable resource for the community in the field of child abuse`and neglect Hibiscus actively works to remain at the forefront of best practices in child welfare through our membership in the Child Welfare League of America, Florida Coalition for Children, and being accredited through Council On Accreditation For Children and Family Services. 3 its a I I, a • • 1 '. I 1 : 1 • ! I ! ! 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At least 95% of active families will have la. Maintain list of families served. no verified reports of abuse or neglect lb. Provide a list of families served to UFF for during service provision as measured by identification of families with verified UFF, cases of abuse or neglect. ic. Receive data back from UFF and determine percentages, I d. Review the families with verified cases and determine strategies to prevent further occurrences. 2. Maintain at least 95% of families, 2a. Administer and score AAPI as part of completing services Successfiillyshowing initial assessment course of action for each improvement in one domain of their family and include in the family safety parenting abilities through the use of the plan. Adult Adolescent Parentis inventory 2b. Administer and score AAPI as part of post (AAPI) as a pre and post test 45+ days after test for families successfully completing services being implemented. services. 2c. Individual data is to be maintained in the client files and entered into the quarterly peer record reports. 2d. If percentages are not met a corrective action plan will be developed in response to the quarterly peer review and monitored through the next peer review. 2e. Data will be trended using an established data management system. 3 . For those clients who successfully 3a. Families will be given a satisfaction survey complete the program 95% of client by their HOPE counselor upon satisfaction surveys will indicate a completion of services. satisfactory or better rating. 3b. Satisfaction surveys will be reviewed and analyzed quarterly as part of the CQI Process, 3c. Data will be trended using an established data management system. 4. 951/o of families completing the HOPE 4a. The HOPE counselor together with the Program will demonstrate knowledge and client family will develop a discharge plan competency in accessing community resources inclusive of community resources, phone on their own by identifying three relevant numbers, names and directions on making resources for their family with the resources a self referral for future assistance. name and instructions on how to make a self 4b. Data will be trended using an established referral. data ement s stem. 7 Hibiscus Chfldrm's Center HOPE (Helly Opport u des for Puml ng Excdlmm) Program Childrw's Swdms Advisory Committm E. COLLABORATION Entire Section E not to exceed one a e 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 reern t-letters. Collaborative Azency Resources provided to the program Indian River Human Services Client Sys. — assistance for obtaining & paying for rx, food, rent, burial and assistance in negotiating the system of disability, SSL and'public assistance Big Lakes Mission Outreach School supplies, personal items, food, clothing, household items, provide referrals for case mgmt & respite Caring Children/Clothing Children Clothing and shoes; provide referrals for case mgmt & Inc. respite Exchange Club CASTLE Parenting and prevention of duel enrollment; provide referrals for respite Healthy Families — St. Lucie County Case management, parenting for pregnant mothers and mothers of newbornsrovide referrals for respite Martin County School District Head Preschool education and support services for children Start Program and families; provide referrals for case mgmt & respite Indiantown Non-profit Housing Provide program space for parenting skills and case management as needed; provide referrals for case mgmt & respite Helping People Succeed Baby Steps Provide developmental assessments and mental health and Children's Mental Health services; provide referrals for case mgmt & respite Homeless Family Center Inc. Assistance with referral for benefits and housing assistance services; provide refierrals for case mgmt & respite Salvation Army Food, occasional utility and rent assistance; provide referrals for case mgmt & respite Society of St. Vincent de Paul Clothing, fumiture, appliance, etc. donations, utility bill payment; vide referrals for case mgrnt & respite Children's Home Society Provide referrals for reunification services Family Preservation Refer families for reunification services & coordinate services provided Department of Children and Families Provide referrals for diversion services Suncoast Provide mental health services; provide referrals for case mgmt & respite Tykes and Teens Provide mental health services, provide referrals for case mgmt and respite New Horizons Provide mental health services; provide referrals Drug Dependency Court Program Continuum of services through dependency case management and Guardian Ad Litem program with HOPE 8 Htbisws Children's Center NOPE (Healthy Oppommitles for Parenting Excellence) Program Children's services Advisory Committee F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) L 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 diem for your target population? How do you document their need for services or their "unacceptable condition requiring change" from Section Bl? The HOPE Program collects client data in many different ways, in .order to meet a variety of funder requirements. Client data including age, gender, race, economic level, education level, parenting situation (i.e. single, dual, grandparents, guardian etc.) is collected on every family served The information is compiled on a monthly basis and put into a data spreadsheet that is used for reporting to fimders. Monthly, quarterly, and year-end reports are provided upon request based on the specific requirements of each funder. All families are referred either through the Protective Investigations or the Dependency Case Management System. HOPE provides to these families, who by the nature of their identifying factors, either in the imminent'risk of removal or high risk reunification, require more than the standard services provided by the dependency system as it currently operates. By working with parents and children in their own environment increasing both the quantity and quality of interactions and interventions, HOPE helps them resolve the crisis, circumstances or situation that has led to abuse — and keep them together safely as a family. The documented need for services is the intake referral form. 2a 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? Outcomes (abuse histories) are measured through United for Families (UFF), our collaborative partner, client information system. UFF conducts an initial review of the family prior to Hibiscus accepting the family into services. Annually, UFF monis the HOPE Program and reports one year follow-up information on whether or not abuse occurred during services or within one year post services. In addition, the HOPE Program completes an AAPI pre-test on all families and a post-test on families who receive services for over 45 days. The AAPI is a valid and reliable tool that measures improvement in family functioning, in particular in parenting, empathy, corporal punishment, role reversal, and understanding development stages. The results are reported to our internal Continuous Quality Improvement committees including Peer Record Review and Risk Management. Another data element that will be collected is satisfaction rates of clients who successfully complete the program. The satisfaction survey results will be evaluated quarterly and then annually for trends Lastly, another data element that is collected in the HOPE Program is a discharge plan which is created with each family upon closure of their case. This is maintained in the client file and analyzed with an established data mane ement sylltern on a quarterly basis. 9 + HiAbco Childreds Cerner HOPE (Heshhy OppmUmihes for Pazmtmg Exaeb=) Pmgam Mldrm's Services Advisory Commitee 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? Quarterly data from the 4 measurable objectives will be trended each quarter to identify positive trends which will continue to.be supported; or negative trends which will be analyzed for contributing factors leading to less than agreed upon objective measurements. Interventions for negative trends will be identified, implemented and monitored for improvement back to the agreed upon objective measurements. Results, both positive and negative will be shared with staff and administration, other finders, and interested community parties. Risk Management and Peer Review, based on Council on Accreditation (COA) standards, are completed and reviewed by Standing Committees of the Operating Board of Directors to ensure continuous quality improvement and identification of program risk indicators. In the development and implementation of individual Family Support Plans, families are an integral part of all service provision from the intake process to case closure and completion of satisfaction surveys. DCF, UFF, Children's Services Councils, United Ways, and other funding entities set benchmarks and performance outcomes that are monitored monthly and/or quarterly and annually to ensures stems and mechanisms for continuous quality improvement, 10 Hrbsws Children's Cel HOPE (Heakhy Opporttmities fN Parenting Exoellence) Program Children's services Advisory Committee G. TIMETABLE (Section G not to exceed one page) IL 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 ongoing • Families are referred by United for Families and their collaborative partners_ • Families are assessed and safety plans are developed with the family to meet their identified needs. • Services and interventions are provided as identified on plan. • Cases are closed as needs are addressed and risk level to family and child is diminished. • Cases are staffed with collaborative partners to identify new Weekly families and update existing cases. • Cases are staffed with supervisor to ensure appropriate level of intervention to meet the needs of the family. • Risk Management Committee reviews any significant events that Monthly occurred ding the month involving the program and/or individuals served. • Reports are submitted on cumulative client demographics. Quarterly Records are reviewed as part of internal Peer Record Review to ensure compliance with funder, Council On Accreditation, and "best practice" standards. Six Months Narrative report submitted on progress toward program outcomes. Annualiy • End of year narrative report given on progress toward program outcomes. • Monitoring occurs by United for Families to determine if any verified incidents of abuse or neglect occurred during service provision or within one year of completion of services. • Monitoring occurs by Children' s Services Councils and United Ways for program effectiveness and efficiency. 11 • • r . 1 II 1 ' 1 Id 1 1 : t I t 1 11 la 7L LL 44, 1 ✓. 1 I sgt rt )`( 4 'J" a s ' : 1 ii I ^ . ' 1 1 fi � repuf-'�` . I I E 1 :✓ _ fa . . � l I I i t V: . 1 � 16 i t 1 V: : 1 1 A FI . 1 � • n e 11nil 1:111 It Ii 1 ! l 3 f 1 11 t 1 i /. i • • z 1 VI 7 1 ,� i � � ° , ° �• � � i 1 ' 1 '' I I 1 =' 21, 1 ,` C5) ^ � I� 9 1 :. '� MIX 1 1 1MIl 11 i 1 • Hbisca CbildRn's Ceuta HOPE (Heahhy Oppaamides furPme ding.Excellmce) Program CWdren's Services Advisory Committce L BUDGET FORMS " To open the Budget Forms, please double-click on the icon below. Core Budget Forms 13 ,a,m. or.a. o.+.a.taxc�a UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: Ttte Butlget NarretAre artDttMPmWds d ml Y the e6ttiutd7equeded Mt eerh l9te Mem off0e bt t forf�p' s• Ft2at M m7d(6t18et, y wfia a Na be linked to the TotalAgerwy BudgK TaW PmV m Budget and Fm dor Speone Bttdgef Forms. AGENCYIPROGRAM NAME: Hibiscus Children's Cetder. Inc.MOPE FUNDER: Children's Services Advisory Co nmhtee of Indian River County _.._. .._.._. .._.._.._ .._.._.._ .._.._.._ ._.._.._.._.._.._.._ .._.. ................................ ICAU770N: DonotanaranyM awvt; %are a cola corandlndm bko-Fwmua &RdW& s in PAooa Gmganwanwwbe used for i ica os wd$0 ttrMhMwnutlon REYRAMS w proposed ihWPtopun Flmdarspso16o Budget t ow I Ch6Nmh Smvoas CamrA ft tach 786 194,069 2. ChOlm 's Sorwim Couaa 3 21 tow 9 9 24693 W OMAN 91,98& 4 Unrmd f 90,000. UnYN 6 UNIW e9att RMr 7 o1ChlNmn 6 Fanelks �9.w75 B coulft Fumy 9 Cash to P Fop it Fund Fgids4 et 300, 128at"to Pun6s-140t ViE 4000. 13 _ ..Pas 14 9w9aba0m htwma is i a 6,006,095. 17 Fusds Uam Otwr scm as 24706[ I 8 Reserve Fulls Uswfor 19 NN9od Donae9es9u19s WW" 43AM 2p TOTAL awnT Y1 MAD E' PBIDITURES ptapae4idioY119op7m0 pyndrSpeUMcBudpet DADe�'Y . Buda W 21 SWwim •(mvd CwW1$ud®dwnef6pega) 470.0WA0 7214 4XW0J1 B `T 22 HCA. Twds91®99axomm 7 130467" Soo' Pe0a00 OB0' 9 23 Sow - - 24 0". a S - 968 346.638• x rima 4X510t 117,791 2e xf7A00z UCT49tw 842.00. : 26. 26,342. SALARIES 124410( n O&W.WaeAs^wY Capse¢ �PojdwT m1TvWHr -PbsMooTMe/TOWfkaMk19 16 14.00HOPE CwwaW40 Hour 37 .00OLD 0.0011 HOPE Coumwbm Haus 32 .00 7214 MitHOPE C01msWM Huxs 110 0'AM HOPE CBWuMorHO HoursDAasistentl Hous 4 A0 0 0101VAtAOfua mmm mxm whim Rmngrdw tM , raw SMds f4,001,319. 674010-00 37,0[4. sr fFoo�-* ®■ MOM SEEM -INKM ■® MOM MEN=1 P mom, � IIIIIIII 1114 SEEM . „ � �.m.�•.u...�a6Pe • Nawspap6raas Clhw ed. xesbd rdpioepi AxchnR:CapRal 0 0. 147 . Cwquwm Ax(xxS) • Leser Prhw FVR;-& of Fan . tone 805 0. 47,M7. - Lehi edNee ( es&yww fire xS) : Corudm bee . Oyler . H gookal6tlautlorul Nahrbb 0. 0. . 5.495 eooksibnsd . Food a Robitloe 0 - 0. 190=. • 6bab (#n x tlbnb x 5orys x50 wke) snackg A4mbislri6ea Cosa 0 817.374 • AdMn. Cosi albbi butl -•211• • S773N - - • 1T%- - 3UAm- F Aum &11 . 0. 11,617. . WA Resisw sxat 00 45 Speeiap Asdgt n W krmvllsb 25000 0. 60.595. Mo9lvF000 • RerdAul b . Oyyr AsWna- !1 ]8633 msie nwM 41 O6+rt#kboe6aroew 2.834 0. 21.695. • 0 0.001 47 ONerlConbw SORmnoxGbr aervkes ' - 7D7AL 6%PEMSES s39 i" �• M -ill jT . I SOME! ■ mmmmr= mmrmffm�- MONK=m MEE LIN SOME, smigm=7 e 1 ® ® ® — �'a � � � r � � �? T"3OEM �2 r f q1 in MmmrrwT" mmmr= OEM � r MEOW= _ _ SEE I SOMME= wsi _ mmor.=i � SOMME mmmmT' mMMmM= mmmm=_10111001=1_ NNER=, MMMMEj=, . majm� mmllml ®® • , 10e1010 • ; mmmm= MEMO= _ e - • - r e e _ • MINE NFAEE= mmmma= e r MMMmM= MNEmM=_MmmMM=7 _i • � = Emmmffm MINE MEMEM=o MENNEN=, mmmml= mmmm� mmmm= SEEN! 1=1 MINE . , - ® ommooKM ® NEEM M0&diwftCw tr, WrJHOPE UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCYIPROGRAM NAME: fibfscus Children's Center, IncJHOPE FUNDER; Children's Services Advisory Gw 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 1769040.00 71814.00 4.44% 22 FICA13 467.00 597.77 4.44% 23 Retirement 0.00 0.00 #DIN/O! 24 LifelHeatth 8 935.00 963.00 10.78% 25 orkers Compensation 4 365,00 192.23 4.40°A Florida Unemployment 642.00 26.00 4.05% Travel-Dail 18 77$.00 0.00 0.00% TravellConferenceslTralni 1M,80 0.00 0.00% 29 Office Su ies 4,802.00 0.00 0.00% 3 ele hone 17 533.00 0.00 0.00% 31 Postage/Shipping 360.00 0.00 0.00% 32 Utilities 1 ,782.00 0.00 0.00% 33 Occu n (Building & Grounds 7 579.00 0.00 0.00% 34 Printing & Publications 100.00 0.00 0.00% 35 Subscri tionlDueslMembers 3,498.00 0.00 0.00% 36 Insurance 3951,00 0.00 0.00% 37 E ui ment:Rental & Maintenance 8151.00 0.00 0.00% 38 Advertising 538.00 0.00 0.00% 30 Equipment Purchases:C! a 0.00 0.00 #DN101 4o Professional Fees (Legal, Consulting) 905.00 0.00 0.00% 41 BookslEducational Materials 0.00 0.00 #DN101 42 Food & Nutrition 0.00 0.00 #DN/01 43 AdministrativeCosts 29395.00 0.00 0.00% 44 Audit Ex nse 21841 ,00 0.00 0.00°A 45 Specific Assistance to Individuals 25r000,00 0.00 0.00% 46 Other/Miseettaneous 21834,00 0.00 0.00% 4 Other/Contract 0.00 0.00 #DN101 411TOTAL $327,351 ,00 $9,593.00 2.93% si snefmas �;, , �CT 0111 44 ,.. 1� F .9 i ,�GWaG�Y. YCIIIM@ UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET A60"IPROGRAIN NAME, Hibiscus Children's Center, W.JHOPE FSJNOER. Children's Services Advisory Consnitiee Of hull&n River County 77 l M 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 - 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 18402 51h Street Vero Beach , Florida 32960-3365 Recipient: Hibiscus Children's Center P. O. Box 305 Jensen Beach , Florida 34958 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 - HIBISCUS CHILDREN 'S CENTER CORE PROGRAM SERVICE MANUAL HUMAN RESOURCE DEVELOPMENT ALL PROGRAMS 9. Report immediately to the Human Resources Director any charge of moving violation , suspensions , or failure to renew a valid driver's license; 10 . Carry documentation of driver's eligibility while operating the vehicle. This includes valid driver' s license and statement of insurance coverage; 11 . Drivers are required to pull to the side of the road and stop the vehicle prior to using a cellular telephone; 12 . Employees may not operate a Hibiscus Children 's Center owned or leased truck while under the influence of drugs or alcohol , including prescribed and over-the- counter medications which may include drowsiness or affect driving ability. OPERATION OF VEHICLES A. Vehicle Inspections Drivers of Hibiscus Children's Center owned or leased vehicles are required to perform the following : 1 . Perform daily vehicle inspections prior to , and following operation of the vehicle. This will include, but not be limited to , the following : (a) thorough examination of vehicle (interior and exterior); ( b) inspection of all safety equipment including condition of seat belts; (c) a check of the first aid kit, county map, valid registration form ; proof of insurance coverage, accident reporting procedures , road hazardous kits and other supplies ; 2 . Recording mileage before leaving and again upon returning in the mileage log ; 3 . Filling the gas tank when the gauge registers ''/< tank or less ; 4 . Advise the Human Resources Director of irregular vehicle maintenance concerns ; 5 . Report any vehicle damage to the Human Resources Director immediately. Under no circumstances will an unsafe vehicle be used to transport passengers Drivers must report any vehicle safety concerns immediately to the Human Resources Director or Program Administrator or Director of Operations for Residential Services. B . Operating Guidelines The following guidelines must be followed during operation of any Hibiscus Children's Center vehicle: 1 . Drivers must have a cellular telephone with them and turned on at all times while operating a Hibiscus Children 's Center vehicle ; 2 . Drivers are required to pull to the side of the road and stop the vehicle prior to using a cellular telephone; 3 . Drivers and passengers of Hibiscus Children 's Center vehicles that contain seat belts are required to have them fastened at all times while in the vehicle . Anyone who refuses to wear a seat belt when applicable, will not be transported by Hibiscus Children 's Center staff; Approved by the Operating Board of Directors 8/24105; 7/26/06 Jan Swink Huffer(, M.S. W., A.C.S. W., Chief Executive Officer HIBISCUS CHILDREN 'S CENTER CORE PROGRAM SERVICE MANUAL HUMAN RESOURCE DEVELOPMENT ALL PROGRAMS (a) The employee is required to report an accident to the Human Resources Director immediately; (b ) The employee is required to report to an approved drug testing facility as instructed by the Chief Executive Officer or designee for a drug screening test; (c) The Employee may be asked to provide documentation of his/her travel departure and destination locations at the time of the accident; (d) Employees who seek medical treatment following a traffic accident shall advise healthcare providers that the injury is a work related accident. D. Passenger Vans ( 15 passengers or less ) Hibiscus Children 's Center requires drivers of all Hibiscus Children 's Center owned or leased passenger vans to meet a standard of qualifications for safety and liability purposes. The following summarizes the minimum qualifications: 1 . Possess a valid Florida driver's license; 2. Can read and speak English fluently; 3 . At least three years driving experience; 4. Be an approved Hibiscus Children 's Center driver; 5. Abide by any and all restrictions listed on the employee's driver's license; 6 . Wear seat belt at all times during operation of vehicle ; 7. Obey all traffic laws while operating the vehicle; 8. Maintain a satisfactory motor vehicle driver's record ; 9 . Report immediately to the Human Resources Director any charge of moving violation , suspensions, or failure to renew a valid driver's license; 10. Carry documentation of driver's eligibility while operating the vehicle. This includes valid driver's license and statement of insurance coverage ; 11 . Employees may not operate a Hibiscus Children 's Center owned or leased passenger van while under the influence of drugs or alcohol, including prescribed and over-the- counter medications which may induce drowsiness or affect driving ability. E. Truck (Class D) The United States Department of Transportation , Federal Highway Administration requires drivers of trucks to meet strict standards of qualifications. The following summarizes the minimum qualification as well as Hibiscus Children 's Center requirement: 1 . Possess a valid Class D Florida Driver's License ; 2 . Can read and speak English fluently; 3 . At least two years experience as a truck driver; 4. Be an approved Hibiscus Children's Center driver; 5 . Abide by any and all restrictions listed on the employee 's driver's license; 6 . Obey all traffic laws while operating the vehicle; 7 . Wear seat belt at all times during operation of vehicle ; 8. Maintain a satisfactory motor vehicle driver's record ; Approved by the Operating Board of Directors 8/24/05; 7/26/06 Jan Swink Huffert, M. S. W., A. C.S. W., Chief Executive Officer HIBISCUS CHILDREN 'S CENTER CORE PROGRAM SERVICE MANUAL HUMAN RESOURCE DEVELOPMENT ALL PROGRAMS Serious Violations : (a) DUI/DWI — Drugs or Alcohol ; (b) Hit and Run ; (c) Failure to report an accident; (d ) Negligent homicide using a motor vehicle ; (e) Driving while license is suspended or revoked ; (f) Using a motor vehicle of the commission of a felony; (g ) Operating a motor vehicle in the commission of a felony; (h ) Permitting an unlicensed to drive ; (i) Reckless driving ; (j) Speed contest; (k) Illegal passing of a school bus ; (1) Other violations considered serious by state law. B1 . Monitoring Drivers A. A Motor Vehicle Records (MVR) check will be done on all drivers at least annually. B . A driver's motor vehicle record may become unacceptable during the course of employment. If the employee is required in job descriptions to transport client or operate agency vehicles , employment will be terminated . C. Marginal drivers , including any driver 21 tears of age or younger, will have MVR checks at least twice a year. C. Personal Vehicles Hibiscus Children 's Center requires employees who drive their personal vehicles for business to meet the following qualifications for safety and liability purposes : 1 . Be an approved Hibiscus Children 's Center driver; 2 . Abide by any and all restrictions listed on the employee's driver's license ; 3. Submit a copy of proof of, at least $ 10 , 000 personal injury protection and property damage land $20 , 000 bodily injury liability insurance coverage to Human Resources. 4. Wear seat belts at all times during operation of vehicle ; 5 . Obey all traffic laws while operating the vehicle ; 6 . Assure that their personal vehicle is properly maintained and in safe operating condition ; 7 . Maintain a satisfactory motor vehicle driver's record ; 8. Carry documentation of driver's eligibility while operating the vehicle . This includes valid Florida driver's license and statement of insurance coverage; 9 . Employees may not operate his/her personal vehicle for Hibiscus Children 's Center business while under the influence of drugs or alcohol , including prescribed and over-the-counter medications which may induce drowsiness or affect driving ability; 10 . In the event of a traffic accident while driving a personal vehicle for Hibiscus Children 's Center business , the following procedures shall be followed : Approved by the Operating Board of Directors 8/24/05, 7/26/06 Jan Swink Huffert, M.S. W., A. C.S. W., Chief Executive Officer HIBISCUS CHILDREN ' S CENTER CORE PROGRAM SERVICE MANUAL HUMAN RESOURCE DEVELOPMENT ALL PROGRAMS 1 . 16 AGENCY VEHICLE USE POLICY To establish guidelines for ensuring the safe operation of Hibiscus Children's Center vehicles and the security of the passengers that are being transported . Agency vehicles will be the primary source of transportation of HCC clients. Any use of personal vehicles to transport clients is prohibited . GENERAL POLICY The safety and security of Hibiscus Children 's Center residents and employees while being transported in a Hibiscus Children's Center owned or leased vehicle is of the utmost priority. Hibiscus Children 's Center feels the same considerations apply for employees who drive their personal vehicles while conducting Hibiscus Children 's Center business. DRIVER REQUIREMENTS — HIBISCUS CHILDREN' S CENTER VEHICLES A. Approved Hibiscus Children's Center Drivers Hibiscus Children's Center requires employees to be approved as a Hibiscus Children 's Center driver by the Human Resources Department prior to driving on Hibiscus Children 's Center business . Employees must meet the following qualifications: 1 . Possess a valid Florida driver's license for at least three years regardless of age; 2 . Be approved by the Agency's Insurance carrier. B . Unacceptable Drivers 1 . A driver with any one of the listed "Serious Violations" committed within three years ; 2 . A driver with more than two "Serious Violations" committed between three years and eight years ago; *Any driver with a past history, from 3-8 years old , with two to three "serious violations" will be considered marginal . See Section 81 on monitoring marginal drivers. 3 . A driver with. any combination of accidents (regardless of fault) and other moving violations which total three during the previous three years ; *Any driver with a combination of two will be considered marginal . See Section B1 on monitoring marginal drivers. 4 . A driver with an international or foreign driver's license ; 5. A driver licensed less than three years regardless of, age; 6. Florida law may require drivers to be re-licensed within a certain time frame (e.g . 30 days) of their move to the state. Any driver who is not licensed in the state where they reside within the required time is an unacceptable driver. Approved by the Operating Board of Directors 8/24105; 7/26106 Jan Swink Huffert, M.S. W., A. C. S. W., Chief Executive Officer .4Cr .W CERTIFICATE OF LIABILITY INSURANCE OP ID C DATE (MM/DDmvr) HIBIS-2 10 / 05 / 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE R . V . Johnson { GSM } HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2041 E Ocean Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Stuart FL 34996 Phone : 772 -287 - 3366 Fax : 772 - 287 - 4255 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: National Indemnity Co . INSURER B: Markel International Hibiscus Childress Center Inc . INsuREPC: Brid e£ield Employers Ins . 6Hibiscus Childress Foundation 4 P O Box 305 INSURER D: Jensen Beach FL 34958 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSR TYPE OF INSURANCE POLICYNUMBER POLI Y IVE PTI N GATE MM/OD/VY DATDAT I E MMlT! LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 B X COMMERCIALGENERALLIABILITY 3602SS255610 - 3 07 / 12 / 06 07 / 12 / 07 1 PREMISES (Eaomurence) $ 200 , 000 CLAIMS MADE [X ] OCCUR I MED EXP one person) g 155000 PERSONAL B ADV INJURY $ 1 , 000 , 000 X ABUSE /MOLES $ 1M/ $ GENERAL AGGREGATE $ 3 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $ 3 , 0001000 X POLICY � PRO- JEcr Loc E Ben . $ 1M/ $ 3M AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11 0001, 000 A X ANY AUTO BINDER #43766 07 / 12 / 06 07 / 12 / 07 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIREDAUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ OEXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 2 , OOO 1 OOO B X OCCUR CLAIMS MADE 4602SS255623 -2 07 / 12 / 06 07 / 12 / 07 ls2 , OOO , OOO 3 DEDUCTIBLE �$ X RETENTION $ 10000 $ WORKERS COMPENSATION AND TORY LIMITS X I H C EMPLOYERIETOWPAR 0830 -28580 - 02 22 ER ANYPROPRIETOR/PARTNER/EXECUTIVE / / O6 02 /22 / 07 E.L. EACH ACCIDENT $ 500000 OFFICERIMEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 500000 SPECIAL PROVISIONS belay E.L. DISEASE - POLICY LIMIT II $ 500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT ! SPECIAL PROVISIONS 30 days notice of cancellation for workers compensation coverage . Companies have the option to cancel 10 days for non-payment . Certificate holder is added as additional insured . CERTIFICATE HOLDER CANCELLATION INDIA02 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 • DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Indian River County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1840 25th Street REPRESENTATIVES. Vero Beach FL 32960 AUTHO D PRESENTpJIVE 10 ACORD 25 (2001108) C� © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy , certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend , extend or alter the coverage afforded by the policies listed thereon . ACORD 25 (2001/08)