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HomeMy WebLinkAbout2005-328b INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract" ) entered into effective this day of October 2005 , by and between Indian River County, a political subdivision of the State of Florida ; 1840 25th Street, Vero Beach , Florida , 32960-3365 ; and Exchange Club Castle ( Recipient) , of: Exchange Club Castle P . O . Box 12908 Fort Pierce , Florida 34979 Safe Families 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 2005/2006 ("Grant Period") . The Grant Period commences on October 1 , 2005 and ends on September 30 , 2006 . - 1 - INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract" ) entered into effective this day of October 2005 , by and between Indian River County, a political subdivision of the State of Florida ; 1840 25th Street, Vero Beach , Florida , 32960-3365 ; and Exchange Club Castle ( Recipient) , of: Exchange Club Castle P . O . Box 12908 Fort Pierce , Florida 34979 Safe Families 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 2005/2006 ("Grant Period") . The Grant Period commences on October 1 , 2005 and ends on September 30 , 2006 . - 1 - 4 . Grant Funds and Payment . The approved Grant for the Grant Period is : FORTY THOUSAND , SIX HUNDRED NINETEEN ($40 , 619 . 00 ) . 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 September 21 , 2005 provide to Indian River County Risk Management Division a certificate, or certificates , issued by an insurer, or insurers , authorized to conduct business in Florida that is rated not-less-than Category A- :VII by A . M . Best, subject to approval by Indian River County's Risk Manager, of the following types and amounts of insurance : ( i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property - 2 - 4 . Grant Funds and Payment . The approved Grant for the Grant Period is : FORTY THOUSAND , SIX HUNDRED NINETEEN ($40 , 619 . 00 ) . 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 September 21 , 2005 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 Thomas S . Lowther, Chairman d BCC Approved : / Attest: J . K . Barton , Clerk o tlBY : A �`, • • ' " * 04 o ' • , <-. Deputy Clerk IA o . ApproVed r c = Josep . Baird CountyAdministrator o , 01 • . . . . C ci Appro ed a o f ma gal sufficiency: w By Ma ' E . Fell , Assistant nt Att ney RECIPIENT : By: 45�z Exchange Club Castle - 4 - damage , including coverage for premises/operations , product/completed operations , contractual liability, and independent contractors ; (ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and (iii ) Worker's Compensation and Employer's Liability (current Florida statutory limit. ) . 5 . 6 . Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30 ) calendar days prior written notice having been given the County. In addition , the County may request such other proofs and assurances as it may reasonable require that the insurance is and at all times remains in full force and effect . Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Worker's Compensation Insurance . The Recipient shall , upon ten ( 10 ) days prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract , then the County may, at its sole option , terminate this Contract . 5 . 7 . Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses , damage , or causes of action which may arise from any misconduct , negligent act, or omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. 5 . 8 . Public Records . The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes (Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County, 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . - 3 - EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - S Organization: Exchange Club CASTLE Program Name : Safe Families ' Funder: Children ' s Services Advisory Committee RFP# 7052 PROGRAM COVER PAGE Organization Name : Exchange Club CASTLE Executive Director: Theresa Garbarino-May E-mail : tgarbarino-may(aa exchangecastle org Address : PO Box 12908 Telephone : 772-465 -6011 Fort Pierce FL 34979 Fax : 772-465 -6013 Program Director: Ruth Orenstein E-mail : rorenstein(a)exchangecastle ore Address : 1275 Old Dixie Hwy Telephone : 772- 567- 5700 Vero Beach FL 32960 Fax : 772 -567-9242 Program Title : Safe Families � �� � 9 Priority Need Area Addressed: Focus Area II : Parental Support and Education Brief Description of the Program : Taxonomy #PH-610 330 - Home based parent education and sup ort designed to prevent child abuse and neglect and help families remain intact Through long term up to one year) intensive (at least weekly) visits from a counselor, families learn to reduce risk factors associated with abuse and neglect, and increase the Drotective factors associated with non- abusive, caring and stable families SUMMARY REPORT — (Enter Information In The Black Cells FAmountpRe,, quested from Funder for 2005 / 06 : $sed Program Budget for 2005 / 06 : 00 otal Program Budget : $ 285 , 4100 gram Funding ( 2004 / 05 : 15 ' 80 Dollar increase / ( decrease ) in request : $ 30 , 000 $ 15 , 000 Percent increase / ( decrease ) in request * : Unduplicated Number of Children to be served Individuall 50 . 0 % y Unduplicated Number of Adults to be served Individually : 2 10 Unduplicated Number to be served via Group settings : 145 Total Program Cost per Client : * * 40 _j 722 . 57 *If request increased 5 % or more, briefly explain why : To add a parent education group component, If these funds are being used to match another source, name the source and the $ amount : United Way Indian River County $ 85 , 000 ; United for Families : $ 116 , 742 , The Organization 's Board of Directors has approved this application on (date) . 1/25/ Michael Dillman Name of President/Chair of the Board ASignaturTheresa Garbarino-May 12 Name of Executive Director/CEO 3 IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS Thomas S . Lowther, Chairman d BCC Approved : / Attest: J . K . Barton , Clerk o tlBY : A �`, • • ' " * 04 o ' • , <-. Deputy Clerk IA o . ApproVed r c = Josep . Baird CountyAdministrator o , 01 • . . . . C ci Appro ed a o f ma gal sufficiency: w By Ma ' E . Fell , Assistant nt Att ney RECIPIENT : By: 45�z Exchange Club Castle - 4 - Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization . The mission of the Exchange Club CASTLE is to improve the quality of family life while preventing child abuse and neglect, by providing community education, support and resources for families in need of assistance . The CASTLE envisions a community where each child is allowed to grow to his or her full potential, free from abuse and neglect, and families have access to the supports they need to create healthy living and learning environments for children. 2 . Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. The CASTLE began in 1981 , and now serves as the model for a national network of child abuse prevention centers that span 97 locations in 27 states . With an involved, active Board of Directors, and an Executive Director, Theresa Garbarino-May, who is beginning her 19th year at the helm of the agency, the CASTLE is known for its steady leadership and quality programs . The CASTLE is accredited by the Council on Accreditation, an organization that promotes best practices and the highest national standards for programs working with families . The CASTLE also received an award as the "Best Place to Work" in St. Lucie County this year. The CASTLE offers an array of services designed to prevent child abuse, and cultivate the parent-child relationship . Our core program Safe Families, offers long term, home based, parenting skills development. Other programs offered by the CASTLE include : Families First, a training seminar for divorcing parents ; High Hopes for Kids, offering support to children whose parents have divorced; Positive Parenting, a support group for parents facing difficulties raising their children; Valued Visits, a supervised visitation center; and Co-Parenting, a support group aimed at helping divorced parents reduce conflict surrounding shared custody. All CASTLE services utilize a continuous quality improvement (CQI) model to monitor and improve the delivery of services . This model includes peer reviews, client satisfaction surveys, measurements of program effectiveness, and the use of this information to make improvements in the program. The population served is : families who are at risk for abusing or neglecting their children; families who have had a reported incident of abuse or neglect, but who, with support and education, can eliminate further episodes of abuse ; families with children 0- 18 ; and families who live within Indian River County. This year ' s demographics indicate that 49 % of enrolled families are single mothers or fathers, 69% are White, 14% are Hispanic and 17% are Black. Fifty- eight percent of families served (Safe Families only) are below the federal poverty level . 4 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) Fa) t is the unacceptable condition requiring change ? b) Who has the need ? re do they live ? d) Provide local, state, or national trend data, with reference that corroborates that this is an area of need. What: The unacceptable condition requiring change is child abuse and neglect . Child abuse and neglect has well-documented, long term, harmful effects on children, including permanent physical injuries, chronic low self esteem, developmental delays, difficulty in forming attachments and relationships, mental illness, aggressive behavior, and a cycle wherein an abused child is much more likely to, in turn, abuse his or her own children. ' Who : Parents who pose a risk to their children, because of identifiable risk factors such as poverty, a lack of parenting knowledge/skills, or a parent ' s own history of abuse or addiction. Where : Last year, parents were served in all parts of Indian River County. Provide Data . The overwhelming majority of families that abuse or neglect their children can, with the proper support, learn to parent in a manner that is non-abusive (research shows that home based parent education is the most effective way to prevent abuse and neglect"). This allows the family to remain intact and avoid the trauma of an out of home placement for the child. Research indicates that 96-98% of families who engage in home-based parent education programs such as Safe Families, do not re-abuse their children. This reduces by almost two- thirds, the number of children who face further abuse at the hands of their caretakers . "' Locally, Indian River County has a child abuse rate of 16 . 3 children per 1 , 000 . This is lower than the state rate of 20 . 7 children per 1 , 000, but higher than the national rate of 12 children per 1 ,000 . '" In conclusion, the data show that 1 ) home based parent education prevents abuse ; 2) home based parent education helps children stay out of foster care; 3) Indian River County is doing better than the state at protecting its children, but worse when compared to national statistics; 4) with more home based parent education, Indian River County can make a significant impact in reducing the number of children abused. 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. Safe Families serves a population that is not served by the other abuse prevention programs in Indian River County. However, in concert with two other programs, there is a seamless system of prevention efforts that spans all age levels and all risk levels . * CASTLE ' s Safe Families serves : Children ages 0- 18 , primary and secondary risk levels . Accepts referrals from all agencies and accepts self-referrals . *Healthy Families serves : Pregnant mothers and newborns (up to 15 days old) . *Hibiscus (Hope) pro grain serves : Families who are at imminent risk of having their children removed (tertiary risk level) . Accepts only DC&F referrals . These eligibility differences help each program specialize in a particular target population. Duplication is avoided by stringent adherence to the eligibility requirements of each provider. The intake process of all three providers assesses all services in the home, and this acts as another barrier to duplication of services . Safe Families is a program that is in high demand throughout the four county area, with referrals outnumbering available slots by an almost 2 : 1 margin see chart in attachment section) . 5 EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children' s Services Advisory Committee RFP# 7052 C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages) 1 . List priority needs area addressed. Focus Area II : Parental Support and Education. Promoting programs that focus on "individual" parenting programs ; Encouraging agencies to provide age appropriate arentin support, 2 . Briefly describe program activities including location of services . 1 . Upon receiving a referral, a counselor visits the family, and assesses the need for home-based parent education (Safe Families) . This is accomplished through interview, observation, and completion of an initial needs assessment. To avoid duplication or overlap with other service providers, a review is done of all services being offered to the family. When necessary, and with consent, other service providers are contacted in order to coordinate services to the family. If eligible for Safe Families , the family will begin a program of regular visits, and a family plan, including specific goals, will be developed. The family is an active participant in this process, collaborating on the initial plan for services . 2 . Once a family plan is developed, the counselor makes weekly visits to address the family plan goals . Weekly visits take place for up to one year, with the visits taking place in the family' s home, thus increasing the counselor ' s ability to assess the safety of the children, and evaluate improvements made by the family. Parents remain active participants during the weekly visits , teaming with their counselor to initiate improved parenting techniques . 3 . During the weekly visits, counselors use a multifaceted approach to teaching, including utilizing parenting videos , working through parenting programs, creating behavior management plans, and establishing family meetings , or other formalized methods to improve family communication. Positive discipline and family stability are two over- arching goals . 4 . All weekly visits are geared toward reducing risk factors (characteristics that increase the likelihood that abuse will occur) , and increasing protective factors (characteristics that decrease the likelihood that abuse will occur) . Safe Families has identified the following risk and protective factors that form the basis of each counselor ' s work with a family : Risk Factors: Lack of parenting knowledge/skills; Parent 's past history of abuse; Parent 's history of drug or alcohol abuse, or mental health issues; Poverty/financial stress; Teen and young parent; Social isolation . Protective Factors: Housing stability; Delay of subsequent pregnancy; Enrollment in childcare and health care; Livable wage employment; Involvement in child 's school. 5 . Frequent supervisory review and a regular peer review ensure that each family is continually evaluated for the frequency and intensity of services needed. 6 . Follow-up occurs for three months after closure of the case . Monthly visits are paid to the family to ensure the continued use of techniques learned. In addition, the Department of Children and Families tracks families for one year after completion of services to determine if re- abuse has occurred. Follow-up may also include parent education groups . 7 . Program Enhancement — This year, as a program enhancement, Safe Families will add parent education groups . Positive Parenting will augment the Safe Families home based intervention. Positive Parenting will consist of 12- 18 hours of parenting education classes . Enrollment in the class will be available to 1 ) those on a waiting list for Safe Families ; 2) parents who do not need the intensity of in-home services ; and 3) parent who have completed Safe Families, but continue to need follow-up services . These classes allow parents time to separate from the support of an in-home counselor, reduce isolation, and solidify their newly learned techniques . Co-Parenting, a group that teaches parents to share custody of their child after the divorce, will also be added. Parenting groups will be held at the CASTLE office in Vero Beach, during day, evening or weekend hours, on 'a rotating basis . 6 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 3 . Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized " best practice" and provide evidence that indicates proposed strategies are effective with target population. The stated need or problem is child abuse and neglect . Safe Families prevents child abuse and neglect by replacing patterns of abusive behaviors with non-violent, positive approaches to parenting; and by establishing long term supports so that families remain abuse free long after involvement with the program ends . The family ' s relationship with their counselor is a critical element to the success of the program. Over the course of the program, the counselor guides, supports, and teaches the parent to create a nurturing, healthy environment for their children. Best practices for home visiting programs include intensive services over a long period of time, a focus on parenting skills, frequent observation of the home situation, and frequent review of the family to determine the need for and intensity of the service . ' Safe Families incorporates all of these best practices . Here are conclusions from five independent studies that demonstrate the effectiveness of the home-based model of preventing child abuse and neglect : "There is strong evidence to recommend home visitation to reduce child maltreatment"" "Home visiting has a higher retention rate (70-90%) than center-based services (60-70%) "The positive effects of early home visitation re-emerge when the children reach age 8 """' "In Pinellas County Florida, parents enrolled in a home visiting program had abuse rates of 1 . 6% as opposed to non-enrollees who had a rate of 4 . 9% "" "Home visiting programs that target high risk and/or low income mothers and children are effective and return from $ 6 , 000 to $ 17,200 peryouth"' 4. List staffing needed for your program, including required experience and estimated hours per week for each staff member and/or volunteers (this section should conform to the information in the Position Listing on the Budget Narrative Worksheet). Safe Families Program Manager — 6 hrs/wk — MA/2yrs . supervisory experience in field . Safe Families Supervisor — 18 hours/wk — BA/ 1 yr. supervisory exp . in field. Safe Families counselors (3 . 0 FTE) - 40 hours/wk — BA/2 years exp . in services to families . Parenting Group Facilitators (3 ) — 3 hrs/wk BA/2yrs . experience providing services to families . Secretary/Receptionist — 25 hours/wk — 1 -year secretarial experience. Human Resources Specialist — 7 hrs ./wk — BA — 2 years HR experience . Development Director — 4 hrs ./wk. — 5 years development experience . Community Relations Coord. - 6 hrs ./wk. — 2 years experience in related field . 5. How will the target population be made aware of the program? Families are made aware of the program through referrals from agencies, schools , parents, the Dept . of Children and Families, and United for Families . In addition, the CASTLE participates in local outreach/networking efforts ; the CASTLE participates in National Child Abuse Prevention Month; the CASTLE affiliates with many local businesses through fund raising and service clubs ; and the CASTLE ' s speaker' s bureau does informational talks and trainin s . 6. How will the program be accessible to target population (i. e. , location, transportation , hours of operation) ? Families are visited in their homes, with no required visits to the CASTLE administrative offices . To enroll in the program, all a parent must do is call the office . An intake screening is done over the phone . If the family seems appropriate for Safe Families, a home visit is scheduled within the next 48 hours . Referrals from other sources are accepted by fax or by mail . CASTLE offices are opened from 8 : 00am - 5 : 0 m . Home visits are scheduled weekda s, and weekday evenings . 7 S Organization: Exchange Club CASTLE Program Name : Safe Families ' Funder: Children ' s Services Advisory Committee RFP# 7052 PROGRAM COVER PAGE Organization Name : Exchange Club CASTLE Executive Director: Theresa Garbarino-May E-mail : tgarbarino-may(aa exchangecastle org Address : PO Box 12908 Telephone : 772-465 -6011 Fort Pierce FL 34979 Fax : 772-465 -6013 Program Director: Ruth Orenstein E-mail : rorenstein(a)exchangecastle ore Address : 1275 Old Dixie Hwy Telephone : 772- 567- 5700 Vero Beach FL 32960 Fax : 772 -567-9242 Program Title : Safe Families � �� � 9 Priority Need Area Addressed: Focus Area II : Parental Support and Education Brief Description of the Program : Taxonomy #PH-610 330 - Home based parent education and sup ort designed to prevent child abuse and neglect and help families remain intact Through long term up to one year) intensive (at least weekly) visits from a counselor, families learn to reduce risk factors associated with abuse and neglect, and increase the Drotective factors associated with non- abusive, caring and stable families SUMMARY REPORT — (Enter Information In The Black Cells FAmountpRe,, quested from Funder for 2005 / 06 : $sed Program Budget for 2005 / 06 : 00 otal Program Budget : $ 285 , 4100 gram Funding ( 2004 / 05 : 15 ' 80 Dollar increase / ( decrease ) in request : $ 30 , 000 $ 15 , 000 Percent increase / ( decrease ) in request * : Unduplicated Number of Children to be served Individuall 50 . 0 % y Unduplicated Number of Adults to be served Individually : 2 10 Unduplicated Number to be served via Group settings : 145 Total Program Cost per Client : * * 40 _j 722 . 57 *If request increased 5 % or more, briefly explain why : To add a parent education group component, If these funds are being used to match another source, name the source and the $ amount : United Way Indian River County $ 85 , 000 ; United for Families : $ 116 , 742 , The Organization 's Board of Directors has approved this application on (date) . 1/25/ Michael Dillman Name of President/Chair of the Board ASignaturTheresa Garbarino-May 12 Name of Executive Director/CEO 3 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 D. MEASURABLE OUTCOMES (Entire section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements or the Measurable Outcomes Add the tasks to accomplish the Outcome(s) 1 . Reduce the risk factors associated with child 1 . Provide information and education abuse for families in the Safe Families program regarding identified risk factors, during home by at least one, during enrollment in the visits, so that major risk factors are reduced or program and /or at the conclusion of the eliminated. program, for 92 % of families who have been enrolled at least 3 months, as measured by a risk assessment tool (see appendix) . No more than 8 % of families who have been enrolled for 3 months or more will show no (zero) risk factor reduction. 2003/2004 baseline : 100% of families reduced at least one risk factor. 0% showed no risk factor reduction. 2 . Maintain the reduction in risk factors (by at 2 . Conduct monthly follow-up visits for 3 least one) for a period of 90 days after months after services have been completed. At enrollment, for families who have successfully the end of this 90 period, complete the risk completed the program, as measured by a risk assessment tool . Compare the results of the assessment tool (see appendix) in 90% of follow-up assessment to the previous families . No more than 10% of families who assessment done at the close of service , have successfully completed the program will fail to maintain a risk factor reduction. 2003/2004 baseline : This is a new goal, baseline will be determined this year. 3 . Increase the protective factors associated 3 . Provide information and education with a reduction in the risk of child abuse for regarding identified protective factors, during families in the Safe Families program by at home visits, so that major protective factors are least one, during enrollment in the program increased and/or improved upon. and /or at the conclusion of the program, for 92 % of families who have been enrolled for at least 3 months , as measured by a protective factor assessment tool (see appendix) . No more than 81/o of families who have been enrolled for at least 3 months will fail to increase at least one protective factor. 2003/2004 baseline 100% of families increased at least one protective factor. 0% of families failed to increase at least one protective factor. 8 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 OUTCOMES ACTIVITIES Add all of the elements for your Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) 4 . Maintain the increase in protective factors 4 . Conduct monthly follow-up visits for 3 (by at least one) for a period of 90 days after months after services have been completed. At enrollment for families who have successfully the end of this 90 period, complete the risk completed the program, as measured by a assessment tool . Compare the results of the protective factor assessment tool (see follow-up assessment to the previous appendix) in 90% of families . No more than assessment done at the close of service. 10% of families who have successfully completed the program will fail to maintain an increase in at least one protective factor. 2003/2004 baseline : This is a new goal, baseline will be determined this year. 5 . Maintain at 94%, the number of families 5a. Provide information and education who complete the Safe Families program that regarding identified risk and protective factors, will have no confirmed reports or re-reports of during home visits, so that parents develop the abuse for up to one year after completing skills necessary to eliminate abuse/neglect as a services as measured by the state data base on risk in their home . abuse. No more than 6% of the families who complete the Safe Families program will have 5b . The Department of Children and Families a confirmed report or re-report of abuse for up will compare the names of families who to one year after completing services . complete the Safe Families program against 2003/2004 baseline : 98 % of families had no those reported for abuse/neglect to the state reports or re-reports of abuse. 2 % had a report abuse hotline, and provide the program with or re-report of abuse. this information. 6 . Maintain at 92 % the number of families 6 . The AAPI test will be administered at the who, after successfully completing the Safe initiation of and at the conclusion of services . Families program, show improvement on the Scores will be compared to determine whether AAPI test, as measured by comparing their improvement has been made . pre-test score to their post-test score. No more than 8 % of families who, after successfully completing the program, will have no increase in a post test score. 2003/2004 baseline : 95 % of families who successfully completed the program improved on their post test AAPI scores . 5 % did not improve . 7 . Ninety percent of parents participating in 7 . Conduct parenting education classes . the parenting education services (groups) will Evaluate the participants ' understanding of the demonstrate an improved knowledge of class material at the end of each session. parenting issues, as measured by a survey after each group session. Baseline : This is a new goal, baseline to be determined . 9 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization . The mission of the Exchange Club CASTLE is to improve the quality of family life while preventing child abuse and neglect, by providing community education, support and resources for families in need of assistance . The CASTLE envisions a community where each child is allowed to grow to his or her full potential, free from abuse and neglect, and families have access to the supports they need to create healthy living and learning environments for children. 2 . Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. The CASTLE began in 1981 , and now serves as the model for a national network of child abuse prevention centers that span 97 locations in 27 states . With an involved, active Board of Directors, and an Executive Director, Theresa Garbarino-May, who is beginning her 19th year at the helm of the agency, the CASTLE is known for its steady leadership and quality programs . The CASTLE is accredited by the Council on Accreditation, an organization that promotes best practices and the highest national standards for programs working with families . The CASTLE also received an award as the "Best Place to Work" in St. Lucie County this year. The CASTLE offers an array of services designed to prevent child abuse, and cultivate the parent-child relationship . Our core program Safe Families, offers long term, home based, parenting skills development. Other programs offered by the CASTLE include : Families First, a training seminar for divorcing parents ; High Hopes for Kids, offering support to children whose parents have divorced; Positive Parenting, a support group for parents facing difficulties raising their children; Valued Visits, a supervised visitation center; and Co-Parenting, a support group aimed at helping divorced parents reduce conflict surrounding shared custody. All CASTLE services utilize a continuous quality improvement (CQI) model to monitor and improve the delivery of services . This model includes peer reviews, client satisfaction surveys, measurements of program effectiveness, and the use of this information to make improvements in the program. The population served is : families who are at risk for abusing or neglecting their children; families who have had a reported incident of abuse or neglect, but who, with support and education, can eliminate further episodes of abuse ; families with children 0- 18 ; and families who live within Indian River County. This year ' s demographics indicate that 49 % of enrolled families are single mothers or fathers, 69% are White, 14% are Hispanic and 17% are Black. Fifty- eight percent of families served (Safe Families only) are below the federal poverty level . 4 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) Fa) t is the unacceptable condition requiring change ? b) Who has the need ? re do they live ? d) Provide local, state, or national trend data, with reference that corroborates that this is an area of need. What: The unacceptable condition requiring change is child abuse and neglect . Child abuse and neglect has well-documented, long term, harmful effects on children, including permanent physical injuries, chronic low self esteem, developmental delays, difficulty in forming attachments and relationships, mental illness, aggressive behavior, and a cycle wherein an abused child is much more likely to, in turn, abuse his or her own children. ' Who : Parents who pose a risk to their children, because of identifiable risk factors such as poverty, a lack of parenting knowledge/skills, or a parent ' s own history of abuse or addiction. Where : Last year, parents were served in all parts of Indian River County. Provide Data . The overwhelming majority of families that abuse or neglect their children can, with the proper support, learn to parent in a manner that is non-abusive (research shows that home based parent education is the most effective way to prevent abuse and neglect"). This allows the family to remain intact and avoid the trauma of an out of home placement for the child. Research indicates that 96-98% of families who engage in home-based parent education programs such as Safe Families, do not re-abuse their children. This reduces by almost two- thirds, the number of children who face further abuse at the hands of their caretakers . "' Locally, Indian River County has a child abuse rate of 16 . 3 children per 1 , 000 . This is lower than the state rate of 20 . 7 children per 1 , 000, but higher than the national rate of 12 children per 1 ,000 . '" In conclusion, the data show that 1 ) home based parent education prevents abuse ; 2) home based parent education helps children stay out of foster care; 3) Indian River County is doing better than the state at protecting its children, but worse when compared to national statistics; 4) with more home based parent education, Indian River County can make a significant impact in reducing the number of children abused. 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. Safe Families serves a population that is not served by the other abuse prevention programs in Indian River County. However, in concert with two other programs, there is a seamless system of prevention efforts that spans all age levels and all risk levels . * CASTLE ' s Safe Families serves : Children ages 0- 18 , primary and secondary risk levels . Accepts referrals from all agencies and accepts self-referrals . *Healthy Families serves : Pregnant mothers and newborns (up to 15 days old) . *Hibiscus (Hope) pro grain serves : Families who are at imminent risk of having their children removed (tertiary risk level) . Accepts only DC&F referrals . These eligibility differences help each program specialize in a particular target population. Duplication is avoided by stringent adherence to the eligibility requirements of each provider. The intake process of all three providers assesses all services in the home, and this acts as another barrier to duplication of services . Safe Families is a program that is in high demand throughout the four county area, with referrals outnumbering available slots by an almost 2 : 1 margin see chart in attachment section) . 5 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 D . COLLABORATION (Entire Section E not to exceed one page) 1 . List your program ' s collaborative partners and the resources thata they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters .) Collaborative Agency Resources provided to the program United For Families CASTLE staff serves on the Board of Directors of UFF ; Agencies jointly advocate for adequate funding; CASTLE assists in the on-going implementation of the utilization management system developed by UFF . Children' s Home Society Share relevant case information when necessary to assist families ; ensure that there is no dual enrollment through intake/assessment process and information sharing. Healthy Families Share relevant case information when necessary to assist families ; ensure that there is no dual enrollment through intake/assessment process and information sharing; participate jointly in advocacy efforts to support child abuse prevention programs . Department of Children and Share relevant case information when necessary to assist Families families ; ensure that there is no dual enrollment through intake/assessment process and information sharing. Provide a list of families where abuse or re-abuse has occurred. Treasure Coast Food Bank CASTLE will continue to host a food pantry for emergency food distribution. Tykes and Teens Tykes and Teens staff trained CASTLE staff on maternal depression. Re-entry program — Public Defenders CASTLE staff trained fathers who were leaving prison Office on parentin issues and re-engaging with their children. 10 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 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 B19 Age, gender, ethnicity, marital status, and address are collected upon intake . Eligibility for the program requires that parents pose a risk to their children, because of an identifiable risk factor such as poverty, lack of parenting knowledge and skills, or a parent ' s own history of abuse, addiction or family violence . Families must exhibit at least one risk factor to be eligible for enrollment. Families must have children living in the home who are between the ages of 0- 18 . There is a three step process to documenting the need for service . First, a referral is reviewed by the program supervisor. This may include a discussion with the referral source to gather additional information. Second, if the client appears eligible from the first review, a home visit by a Safe Families counselor is scheduled. At this visit, an initial needs assessment (INA) is completed. Finally, the results of the INA are reviewed with the Program Supervisor, and eligibility is determined. 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? Outcome 1 (to reduce risk factors associated with abused is measured by a risk assessment tool that lists the risk factors identified at intake (see appendix) . Identified risk factors become the focus of intervention until they are resolved. Risk is assessed at least quarterly Outcome 2 (to maintain the reduction in risk factors This is a follow-up measure . The risk assessment tool is used again ninety days after program completion, to see if the reduction in risk factors shown at the end of service is being maintained. Outcome 3 (to increase protective factors associated with a lower risk of child abuse . is measured by a protective factor assessment tool that lists the protective factors identified at intake, and subsequently (see appendix) . Identified protective factors are a focus of intervention once risk factors have been reduced. Protective factors are assessed at least quarterly. Outcome 4 (to maintain the increase in protective factors) This is a follow-up measure. The protective factor assessment tool is used again ninety days after program completion, to see if the increase in protective factors shown at the end of service is being maintained . 11 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children' s Services Advisory Committee RFP# 7052 C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages) 1 . List priority needs area addressed. Focus Area II : Parental Support and Education. Promoting programs that focus on "individual" parenting programs ; Encouraging agencies to provide age appropriate arentin support, 2 . Briefly describe program activities including location of services . 1 . Upon receiving a referral, a counselor visits the family, and assesses the need for home-based parent education (Safe Families) . This is accomplished through interview, observation, and completion of an initial needs assessment. To avoid duplication or overlap with other service providers, a review is done of all services being offered to the family. When necessary, and with consent, other service providers are contacted in order to coordinate services to the family. If eligible for Safe Families , the family will begin a program of regular visits, and a family plan, including specific goals, will be developed. The family is an active participant in this process, collaborating on the initial plan for services . 2 . Once a family plan is developed, the counselor makes weekly visits to address the family plan goals . Weekly visits take place for up to one year, with the visits taking place in the family' s home, thus increasing the counselor ' s ability to assess the safety of the children, and evaluate improvements made by the family. Parents remain active participants during the weekly visits , teaming with their counselor to initiate improved parenting techniques . 3 . During the weekly visits, counselors use a multifaceted approach to teaching, including utilizing parenting videos , working through parenting programs, creating behavior management plans, and establishing family meetings , or other formalized methods to improve family communication. Positive discipline and family stability are two over- arching goals . 4 . All weekly visits are geared toward reducing risk factors (characteristics that increase the likelihood that abuse will occur) , and increasing protective factors (characteristics that decrease the likelihood that abuse will occur) . Safe Families has identified the following risk and protective factors that form the basis of each counselor ' s work with a family : Risk Factors: Lack of parenting knowledge/skills; Parent 's past history of abuse; Parent 's history of drug or alcohol abuse, or mental health issues; Poverty/financial stress; Teen and young parent; Social isolation . Protective Factors: Housing stability; Delay of subsequent pregnancy; Enrollment in childcare and health care; Livable wage employment; Involvement in child 's school. 5 . Frequent supervisory review and a regular peer review ensure that each family is continually evaluated for the frequency and intensity of services needed. 6 . Follow-up occurs for three months after closure of the case . Monthly visits are paid to the family to ensure the continued use of techniques learned. In addition, the Department of Children and Families tracks families for one year after completion of services to determine if re- abuse has occurred. Follow-up may also include parent education groups . 7 . Program Enhancement — This year, as a program enhancement, Safe Families will add parent education groups . Positive Parenting will augment the Safe Families home based intervention. Positive Parenting will consist of 12- 18 hours of parenting education classes . Enrollment in the class will be available to 1 ) those on a waiting list for Safe Families ; 2) parents who do not need the intensity of in-home services ; and 3) parent who have completed Safe Families, but continue to need follow-up services . These classes allow parents time to separate from the support of an in-home counselor, reduce isolation, and solidify their newly learned techniques . Co-Parenting, a group that teaches parents to share custody of their child after the divorce, will also be added. Parenting groups will be held at the CASTLE office in Vero Beach, during day, evening or weekend hours, on 'a rotating basis . 6 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 3 . Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized " best practice" and provide evidence that indicates proposed strategies are effective with target population. The stated need or problem is child abuse and neglect . Safe Families prevents child abuse and neglect by replacing patterns of abusive behaviors with non-violent, positive approaches to parenting; and by establishing long term supports so that families remain abuse free long after involvement with the program ends . The family ' s relationship with their counselor is a critical element to the success of the program. Over the course of the program, the counselor guides, supports, and teaches the parent to create a nurturing, healthy environment for their children. Best practices for home visiting programs include intensive services over a long period of time, a focus on parenting skills, frequent observation of the home situation, and frequent review of the family to determine the need for and intensity of the service . ' Safe Families incorporates all of these best practices . Here are conclusions from five independent studies that demonstrate the effectiveness of the home-based model of preventing child abuse and neglect : "There is strong evidence to recommend home visitation to reduce child maltreatment"" "Home visiting has a higher retention rate (70-90%) than center-based services (60-70%) "The positive effects of early home visitation re-emerge when the children reach age 8 """' "In Pinellas County Florida, parents enrolled in a home visiting program had abuse rates of 1 . 6% as opposed to non-enrollees who had a rate of 4 . 9% "" "Home visiting programs that target high risk and/or low income mothers and children are effective and return from $ 6 , 000 to $ 17,200 peryouth"' 4. List staffing needed for your program, including required experience and estimated hours per week for each staff member and/or volunteers (this section should conform to the information in the Position Listing on the Budget Narrative Worksheet). Safe Families Program Manager — 6 hrs/wk — MA/2yrs . supervisory experience in field . Safe Families Supervisor — 18 hours/wk — BA/ 1 yr. supervisory exp . in field. Safe Families counselors (3 . 0 FTE) - 40 hours/wk — BA/2 years exp . in services to families . Parenting Group Facilitators (3 ) — 3 hrs/wk BA/2yrs . experience providing services to families . Secretary/Receptionist — 25 hours/wk — 1 -year secretarial experience. Human Resources Specialist — 7 hrs ./wk — BA — 2 years HR experience . Development Director — 4 hrs ./wk. — 5 years development experience . Community Relations Coord. - 6 hrs ./wk. — 2 years experience in related field . 5. How will the target population be made aware of the program? Families are made aware of the program through referrals from agencies, schools , parents, the Dept . of Children and Families, and United for Families . In addition, the CASTLE participates in local outreach/networking efforts ; the CASTLE participates in National Child Abuse Prevention Month; the CASTLE affiliates with many local businesses through fund raising and service clubs ; and the CASTLE ' s speaker' s bureau does informational talks and trainin s . 6. How will the program be accessible to target population (i. e. , location, transportation , hours of operation) ? Families are visited in their homes, with no required visits to the CASTLE administrative offices . To enroll in the program, all a parent must do is call the office . An intake screening is done over the phone . If the family seems appropriate for Safe Families, a home visit is scheduled within the next 48 hours . Referrals from other sources are accepted by fax or by mail . CASTLE offices are opened from 8 : 00am - 5 : 0 m . Home visits are scheduled weekda s, and weekday evenings . 7 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 Outcome 5 (no re-reports of abuse) : is measured by the state database on abuse. Families who complete the Safe Families program are checked to see if there have been any subsequent reports to the child abuse hotline . This check is done quarterly. Outcome 6 (improve on post test score) : is measured by the AAPI (Adult Adolescent Parenting Inventory) which is a nationally accepted standardized test that measures parent attitudes and beliefs . Low scores are associated with an increased risk of abuse ; high scores are associated with a lower risk of abuse . The test is administered during intake, and prior to closure. Outcome 7 (knowledge gained from parenting_ orgy ups) : is measured by administering survey questions to group participants at the end of each parenting class . The questions will relate directly to the topic presented. Other data collected include satisfaction surveys from all clients, and completion of family plan goals for each family, 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? Information collected is used to measure the progress of enrolled families, and to help determine the length and content of the intervention. Families are aware of their progress on the AAPI, risk/protective factor checklist, and family plan goals and counselors utilize their progress to motivate participants . The CASTLE operates under a Continuous Quality Improvement model (CQI) . The outcomes of all programs are reviewed quarterly through a "Service Delivery" committee . The Service Delivery committee then recommends program improvements which are implemented by the Program Manager. Results from collected information are reported to funders on a regular basis through monthly, quarterly or semi-annual reports . Staff, Board members, and other stakeholders are made aware of results through the CQI process, and feedback at all-team and Board meetings . The community is made aware of results through an annual report . 12 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 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 October 1 , 2005 Safe Families is a continuing program and will be fully staffed and in full operation at the start of the contract year. Regarding the program operation : 1 . Referred families are contacted within 48 hours . 2 . Referred families are assessed within 14 days . 3 . A family plan is developed within 30 days . 4 . Weekly visits take place for up to one year. 5 . Monthly and quarterly progress reports track client progress . 6 . Post testing and protective/risk factor assessments take place near the end of services . 7 . Follow-up is done for three months after case closure . October 1 , 2005 8 . Parent education services (groups) are offered to families who do not need the intensity of home visitation services, are on a waiting list, or need additional follow-up in a supervised setting to remain abuse free . 13 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 D. MEASURABLE OUTCOMES (Entire section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements or the Measurable Outcomes Add the tasks to accomplish the Outcome(s) 1 . Reduce the risk factors associated with child 1 . Provide information and education abuse for families in the Safe Families program regarding identified risk factors, during home by at least one, during enrollment in the visits, so that major risk factors are reduced or program and /or at the conclusion of the eliminated. program, for 92 % of families who have been enrolled at least 3 months, as measured by a risk assessment tool (see appendix) . No more than 8 % of families who have been enrolled for 3 months or more will show no (zero) risk factor reduction. 2003/2004 baseline : 100% of families reduced at least one risk factor. 0% showed no risk factor reduction. 2 . Maintain the reduction in risk factors (by at 2 . Conduct monthly follow-up visits for 3 least one) for a period of 90 days after months after services have been completed. At enrollment, for families who have successfully the end of this 90 period, complete the risk completed the program, as measured by a risk assessment tool . Compare the results of the assessment tool (see appendix) in 90% of follow-up assessment to the previous families . No more than 10% of families who assessment done at the close of service , have successfully completed the program will fail to maintain a risk factor reduction. 2003/2004 baseline : This is a new goal, baseline will be determined this year. 3 . Increase the protective factors associated 3 . Provide information and education with a reduction in the risk of child abuse for regarding identified protective factors, during families in the Safe Families program by at home visits, so that major protective factors are least one, during enrollment in the program increased and/or improved upon. and /or at the conclusion of the program, for 92 % of families who have been enrolled for at least 3 months , as measured by a protective factor assessment tool (see appendix) . No more than 81/o of families who have been enrolled for at least 3 months will fail to increase at least one protective factor. 2003/2004 baseline 100% of families increased at least one protective factor. 0% of families failed to increase at least one protective factor. 8 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 OUTCOMES ACTIVITIES Add all of the elements for your Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) 4 . Maintain the increase in protective factors 4 . Conduct monthly follow-up visits for 3 (by at least one) for a period of 90 days after months after services have been completed. At enrollment for families who have successfully the end of this 90 period, complete the risk completed the program, as measured by a assessment tool . Compare the results of the protective factor assessment tool (see follow-up assessment to the previous appendix) in 90% of families . No more than assessment done at the close of service. 10% of families who have successfully completed the program will fail to maintain an increase in at least one protective factor. 2003/2004 baseline : This is a new goal, baseline will be determined this year. 5 . Maintain at 94%, the number of families 5a. Provide information and education who complete the Safe Families program that regarding identified risk and protective factors, will have no confirmed reports or re-reports of during home visits, so that parents develop the abuse for up to one year after completing skills necessary to eliminate abuse/neglect as a services as measured by the state data base on risk in their home . abuse. No more than 6% of the families who complete the Safe Families program will have 5b . The Department of Children and Families a confirmed report or re-report of abuse for up will compare the names of families who to one year after completing services . complete the Safe Families program against 2003/2004 baseline : 98 % of families had no those reported for abuse/neglect to the state reports or re-reports of abuse. 2 % had a report abuse hotline, and provide the program with or re-report of abuse. this information. 6 . Maintain at 92 % the number of families 6 . The AAPI test will be administered at the who, after successfully completing the Safe initiation of and at the conclusion of services . Families program, show improvement on the Scores will be compared to determine whether AAPI test, as measured by comparing their improvement has been made . pre-test score to their post-test score. No more than 8 % of families who, after successfully completing the program, will have no increase in a post test score. 2003/2004 baseline : 95 % of families who successfully completed the program improved on their post test AAPI scores . 5 % did not improve . 7 . Ninety percent of parents participating in 7 . Conduct parenting education classes . the parenting education services (groups) will Evaluate the participants ' understanding of the demonstrate an improved knowledge of class material at the end of each session. parenting issues, as measured by a survey after each group session. Baseline : This is a new goal, baseline to be determined . 9 Number of Unduplicated Clients by Location Ilk C rrent Fiscal Year Budget 2004/05 FF 11 1Pffl- 1ra ' 1 II 1 ' 1 ' 1 11 1 MITRIN ' I • I County1 Port Saint Lucie Co.St. Lucie Total Other 1 1 1 Numberof Und-uplicated Clients by Age � �"' A'� x ' • ' �' � y Y . f$ 1 f • 1 • a + @`Yya.T.nPx ' s K^>'� Location oil 1 s MU�Ilallm �l ��.W. 1. �. 1: 5 to 10 � (Elementary) Total . • � � � • to 5 • (Adults) • 1 + (Seniors) ' ' UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requestedin each fine item of the budget foryour program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Exchange Club CASTLE / Safe Families FUNDER: Children Services Advisory Council - Indian River County • CAUTION : Do not enter any figures where a cell is colored in dark blue - Fonnulas and/or links are In place. Gray areas should be used 11for providing information and calculations only, j REVENUES Proposed Tota/ Program B9ud et Ftmder S h Total Agengy pecific Budget 'Budget 1rAdvisory ildren's Services Councl4St Lucie 202,500.00 2ildren's Services Council-Martin 167 483 00 3Committee-Indian River 45,000.00 45,000.00 60,000.004ited Wa St Lucie County653000.00 5 United Wa -Martin County40 00000 6 United Wa -Indian River County85 00000 126 00000 7 United For Families 1163742.00 423,668.50 8 Cou Funds 8 Contributions-Cash 10 000 1000000.00 10 Pr ram Fees 73,780.00 11 Fund Raisin Events-Net 20 000 00 162 00000 12 Sales to Public - Net 13 Membershi Dues 14WOther Income 10 00000 15ous 5 DDO 16 B uests .001 17 Other Sources 8,672.74372,570.77 18nds Used for O 19ations Not included in total) 20TOTAL REVENUES doesn't include line 19)1 285 414.74 $ 45 000.00 $ 1 ,808,002.2 EXPENDITURES A �OIDOS G B • - , < C rota Total Program Budget Funder SpecrTic Budget Agency Budget x . . 21 Salaries - (must com fete chart on next pagg 147,669.00 33,000.001 868,042. 12 22 FICA - Total salaries x 0. 0765 11 ,29627 2,524.50 65,351 .44 Rat rem nnua pension r u_aTffiid� 23 staff 7,508.82 21000.00 412000.00 ea ;$77,000 Ica o - erm 24 Dior 10,842.00 2,200.00 55,511 .93 or ers oen on - emp oyees x 25 rate on a neoyme - prol 2,067.00 554.50 139723.21 26 employees x x UCT-6 rate 51684 5,000.00 SALARIES fTIOIV! LIST11V6 a riraa►SaFary; ° = r� ort{oir ;# IL I ofSMWYa► r FarrdrrSpeciGeBudget % of GrossAnmral x Position TIHe l Total Hrs/Nik ' (A9e►xy1 SalaryRequested(GAj 0.OMOV . ' 4 /.y.'� poilkator, a , Madden 25,880.40 229592 0%tionist, Lewis 23,499.84 973.38 - 0% n Resources, Cleveland 32,912.88 589449 - 0% tionist, Prince 21 ,840.00 1158152 0% rDevelo ment 31 ,500.00 3,780.00 0% . Relations Coord. 31 ,x.00 4 967 - 0% m Mana er, Orenstein 42,282.24 6,080.20 - 0% isor 33,600.00 14,818.92 2,500.00 7% elor, Sudbrook 30,204.72 30,204.72 10,000.00 33% lor, Pachon 25,399.92 25,399.92 9,500.00 37% lor, Shottland, L 32,780.33 32,780.33 11 ,000.00 34% tor, Anderson 12,000.00 2,964.00 - 0% Facilitator, Del ino 12,000.00 2,964.001 - 0% Facilitator, Pietantuono 12,000.00 21964.00 - 0% #DIV10! #DN/0! #DN/0! Remaining ositions throughout thea en 500,641 .79 Total Salaries $ 868,042.12 $ 147,669.00 $ 33,000.00 4% Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 D . COLLABORATION (Entire Section E not to exceed one page) 1 . List your program ' s collaborative partners and the resources thata they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters .) Collaborative Agency Resources provided to the program United For Families CASTLE staff serves on the Board of Directors of UFF ; Agencies jointly advocate for adequate funding; CASTLE assists in the on-going implementation of the utilization management system developed by UFF . Children' s Home Society Share relevant case information when necessary to assist families ; ensure that there is no dual enrollment through intake/assessment process and information sharing. Healthy Families Share relevant case information when necessary to assist families ; ensure that there is no dual enrollment through intake/assessment process and information sharing; participate jointly in advocacy efforts to support child abuse prevention programs . Department of Children and Share relevant case information when necessary to assist Families families ; ensure that there is no dual enrollment through intake/assessment process and information sharing. Provide a list of families where abuse or re-abuse has occurred. Treasure Coast Food Bank CASTLE will continue to host a food pantry for emergency food distribution. Tykes and Teens Tykes and Teens staff trained CASTLE staff on maternal depression. Re-entry program — Public Defenders CASTLE staff trained fathers who were leaving prison Office on parentin issues and re-engaging with their children. 10 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 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 B19 Age, gender, ethnicity, marital status, and address are collected upon intake . Eligibility for the program requires that parents pose a risk to their children, because of an identifiable risk factor such as poverty, lack of parenting knowledge and skills, or a parent ' s own history of abuse, addiction or family violence . Families must exhibit at least one risk factor to be eligible for enrollment. Families must have children living in the home who are between the ages of 0- 18 . There is a three step process to documenting the need for service . First, a referral is reviewed by the program supervisor. This may include a discussion with the referral source to gather additional information. Second, if the client appears eligible from the first review, a home visit by a Safe Families counselor is scheduled. At this visit, an initial needs assessment (INA) is completed. Finally, the results of the INA are reviewed with the Program Supervisor, and eligibility is determined. 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? Outcome 1 (to reduce risk factors associated with abused is measured by a risk assessment tool that lists the risk factors identified at intake (see appendix) . Identified risk factors become the focus of intervention until they are resolved. Risk is assessed at least quarterly Outcome 2 (to maintain the reduction in risk factors This is a follow-up measure . The risk assessment tool is used again ninety days after program completion, to see if the reduction in risk factors shown at the end of service is being maintained. Outcome 3 (to increase protective factors associated with a lower risk of child abuse . is measured by a protective factor assessment tool that lists the protective factors identified at intake, and subsequently (see appendix) . Identified protective factors are a focus of intervention once risk factors have been reduced. Protective factors are assessed at least quarterly. Outcome 4 (to maintain the increase in protective factors) This is a follow-up measure. The protective factor assessment tool is used again ninety days after program completion, to see if the increase in protective factors shown at the end of service is being maintained . 11 pr N0M0) ' ' ' 0 '� w lip. O + S -eprer� S y� '111 SI If S vIf 1f1 S S S S r COS � NNr N fIL N .- : N ' � N .- I If �. „ N - N H M N IN V d1 0. . If IIfp'tA 11h r 86 8� ' S mv If1 O 1 1 1 1 ' N , '� t ',v ,� �TOf 0 0 0 0 If I If :E g ooino If f If Q o ri v ui v fq rS ohon oIf > 3 ° e1 4 1If I- If (p y lr� O O O O S h ,. pSp t0 S tel' CO ,C,k SZ O O O P` Io�p ~ far O~� . �O CO cpV� , . � V' I If If R xE If N ,'E M fp j'',,�� et fV V !f! mf� 71 • '@of a_ g t@fop mm If O O O O O O C O O C i s Ira >< iV N h N 100 O 1W I GI f(F �S OI 1. 3$ M Qto IfO 4r re I el C 1� CMOI N M ,., r' tinw n If If 4 ,SQA {E, (� ; -v 3U� 00 I p- w a If pe If X IIIf fl e N EIr L o 'd c r r . gg ILLr ,w a_, d • � } Npr I 9 .. pie �q % e ler rr AQ c _ .E ° c a K O c Qj J O a s � . v [{.^ g y NIf �. r •� N ' - � �' . eN- C y W ` C � - ; V c y v $ O c c o � ys$q+ pr IL � ' LS L ' ca �c©$ Yll I ` a xt E ; x ¢?� Ir If el! IS 00 U OC E N N d L C C �G : :i: O ' C ���pp uy �,.r � ' t�7 C 01 10: � , x .Nt 9 N . _`tl ar ' Z ip � 'O p ` d 0 0 'o U O 0 ._ ;:$. y C Olj. yG:', x„ 'DriG .� CI s�ia: � � 7 r[; i 0 , v �:+�', Cy C � p1 m = ° `° O m t -° N v c ' Ns' , O. x • m �'' W I pp ,� (7 .' ; 0 . o - m c c E w , a 3 E : K x ' I- 0 2 S c W ` o rn a ro a o a = c :; a m :plr4 t ° o m _ 6.; ° p m o `o o ° o o • E'_. � � 7 _Ili�� r� o p E udi N m m m N Z 13{rE �,' r,., c , — E a� E �° c c c = m�i r� :W a c a� . 7 . r �o ' o 4c �° ° � °. g m A m C x';11 : p ��$j. Y , @ - Fgsl U) 2 o E U U V t1 F I. ?, ;- m N d,' C7 VJ ,4y Sy� rE vi lLs ._q� c f5 C� < o U d vi LL U- h .» W 0. O -1 , y �„ Si `� W pp p p y �p -. M r o ob AT po o m g$ n O 9 ART InA $ O fD O p ' ry n N N I. in ;. O n t0 CN O M (M co r In O oo t>0 N O r co r y r c 'm E w d � AT Cd CLAV •$ ppo E c O � • O W f7 r r n In a LO co P VI CL O C A O C Nl r C .0 � C �y � N Y N @ -g CL $ • ; . 8 rQ 3 3S LcJ E c S m . . •pa a rr g r a . � ."c Q al 1.11 L IZ C O G x ' ° a N H _ If H �+. N M r p12 m , �� ' 9 W el E E . x . . ' �i .� rn :' aXW -. v� E .� (r. X. 111 Lpp J C x 3 ,� ,� C r^a O J 0. _ y �p s C �C � ' Ol rytO C . d Eta � � Of ` + ; � x C C1 � N � A4'' to 0 l0 lQ N C C C L C UTt �. ..�� `�� 7 E C w`. y y. �l 1�j t (N� � Cr •,' F` 0011 .rte y�.+ t , 1� . 'm •1. y 'O Q l0 y � rd L E L ell C' W S rC 11pp 7 �L J' �. Snr N N d 1 p c O 'p_ � �Ol rQ pa +j (a FE 01rL , QE ' t' , `y 9 z lL . CJ r N : C E r 'p yy N y� O Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 Outcome 5 (no re-reports of abuse) : is measured by the state database on abuse. Families who complete the Safe Families program are checked to see if there have been any subsequent reports to the child abuse hotline . This check is done quarterly. Outcome 6 (improve on post test score) : is measured by the AAPI (Adult Adolescent Parenting Inventory) which is a nationally accepted standardized test that measures parent attitudes and beliefs . Low scores are associated with an increased risk of abuse ; high scores are associated with a lower risk of abuse . The test is administered during intake, and prior to closure. Outcome 7 (knowledge gained from parenting_ orgy ups) : is measured by administering survey questions to group participants at the end of each parenting class . The questions will relate directly to the topic presented. Other data collected include satisfaction surveys from all clients, and completion of family plan goals for each family, 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? Information collected is used to measure the progress of enrolled families, and to help determine the length and content of the intervention. Families are aware of their progress on the AAPI, risk/protective factor checklist, and family plan goals and counselors utilize their progress to motivate participants . The CASTLE operates under a Continuous Quality Improvement model (CQI) . The outcomes of all programs are reviewed quarterly through a "Service Delivery" committee . The Service Delivery committee then recommends program improvements which are implemented by the Program Manager. Results from collected information are reported to funders on a regular basis through monthly, quarterly or semi-annual reports . Staff, Board members, and other stakeholders are made aware of results through the CQI process, and feedback at all-team and Board meetings . The community is made aware of results through an annual report . 12 Organization: Exchange Club CASTLE Program Name : Safe Families Funder: Children ' s Services Advisory Committee RFP# 7052 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 October 1 , 2005 Safe Families is a continuing program and will be fully staffed and in full operation at the start of the contract year. Regarding the program operation : 1 . Referred families are contacted within 48 hours . 2 . Referred families are assessed within 14 days . 3 . A family plan is developed within 30 days . 4 . Weekly visits take place for up to one year. 5 . Monthly and quarterly progress reports track client progress . 6 . Post testing and protective/risk factor assessments take place near the end of services . 7 . Follow-up is done for three months after case closure . October 1 , 2005 8 . Parent education services (groups) are offered to families who do not need the intensity of home visitation services, are on a waiting list, or need additional follow-up in a supervised setting to remain abuse free . 13 UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCYIPROGRAM NAME: EXCHANGE CLUB CASTLE I SAFE FAMILIES FY 03104 FY 04105 FY 05106 % INCREASE FYE 9130104 FYE 980105 FYE 980106 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED IcoL CcoL BycoL 6 REVENUES BUDGETED BUDGETED 1 Children's Services CouncilSt Lucie 143598.47 183 650.00 202 500.00 10.26% 2 Children's Services Council-Martin 1329682.04P 138 298.00 167 483.00 21 .10% 3 Advisory Committee-Indian River 1 48113.48 45 000.00 60 000.00 33.33% 4 United Way-St Lucie County 55,500.01 57 000.00 65 000.00 14.04% 5 United Way-Martin County 347855.50 31 ,416.00 40 000.00 27.32% 6 United Way-Indian River County 97 250.01 101 000.00 126 000.00 24.750/6 7 United For Families 3609268.28 354 021 .00 423 668.50 19.67% 8 CountyFunds 0.00 #DIV/0! 9 Contributions Cash 169 042.68 50,000.00 100 000.00 100.00% 10 Program Fees 45,174.79 73 780.00 73 780.00 0.00% 11 Fund Raising Events-Net 60 794.13 1629000.00 162 000.00 0.00% 12 Sales to Public-Net 0.00 #DIV/01 13 Membership Dues 0.00 #DIV/01 14 Investment Income 41511 .86 10 000.00 10 000.00 0.00% 15 Miscellaneous 41812.86 51000.00 51000.00 0.00% 16 Legacies 8 Bequests 0.00 #DN/01 17 Funds from Other Sources 618 844.10 397 713.98 372t570.77 -6.32% 18 Reserve Funds Used for Operating 0.00 #DIV/01 19 In-Kind Donations (Nd mckK wintofa ) 0.00 #DIV/01 20 TOTAL 11776,448.21 1 608 878.98 198089002.27 12.38% _ - . . EXPENDITURES 21 Salaries 1 088 71OA2 940 776.00 868 042.12 -7.73% 22 FICA 81 900&67 73 596.37 65 351 .44 -11 .20% 23 Retirement 40186&00 299000.00 41 000.00 41 .38% 24 Life/Health 55j813.36 39t962.73 55 511 .93 38,91 % 25 Workers Compensation 97406.60 13 396.65 13 723.21 2A4°k 26 Florida Unemployment 4t629.74 5 000.00 59000.00946.80% % 27 Travel-Dail 38 232.64 28 432.00 349384.64 % 28 Travel/Conferences/Trainin 21 651 .07 20 294.00 22 000.00 % 29 Office Supplies 32114.57 2019".32 2250000 % 30 Telephone 26 795.40 22 775.00 31 692.00 % 31 Posta elShi in 69830.06 87474.00 12 440.00 32 Utilities 17115.60 17 060.00 22 920.00 34.35% 33 Occupancy (Building 8 Grounds 71 549.81 95 036.83 101 693.58 7.00% 34 Printing & Publications 22 342.66 25100.00 32 640.00 30.04% 35 Subscri tion/Dues/Membershi s 27929.63 31500.00 41000.00 14.29% 36 Insurance 18 367.17 14 650.00 19 000.00 29.69% 37 E ui ment:Rental & Maintenance 9102.14 17 310.00 1781000 2.89% 38 Advertising 47619.93 71312,00 1000000 36.76% 39 Equipment Purchases:Ca ital Expense 19 557.75 30 536.92 3425000 12.16% 40 Professional Fees (Legal, Consulting) 29400.00 18 800.00 14 775.00 -21 .41 % 41 Books/Educational Materials 7,014.751 31 ,80:5.00 33 424.40 5.09% 42 Food 8 Nutrition 0.00 #DN/01 43 Administrative Costs 194 257.79 #DIV/O! 44 Audit Expense 71040.00 51500.00 51500.00 0.00% 45 Specific Assistance to Individuals 81518.20 61310.00 10 010.00 58.64% 46 Other/Miscellaneous 923.48 73y305.116 857616 -88.30% 47 OthedContract 105 6.98 60 000.00 127 500.00 112.50% 48 TOTAL 11702,983.63 1 T6089878.98 18089002.271 12.380 49 REVENUES OVER/ UNDER EXPENDITURES 72 464.58 0.00 0.001 #DN/0! 18 UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: EXCHANGE CLUB CASTLE / SAFE FAMILIES FY 03/04 FY 04/05 FY OS/00 X INCREASE FYE 9!30/04 FYE 9MIMS FYE MOM CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED teoL CeoL SycoL e REVENUES BUDGETED BUDGETED I Children's Services Council-St. Lucie 0.001 0.061 #DN/O! #DNIO! 2 Children's Services Council-Martin 0.00 0.00 #DN/0! #DNiO! 3 visory Committee-Indian River 36,045.651 30,000,00 45000.00 50.00% AddtioralCounselorAdded 4 United W St Lucie County0.001 0.001 #DNIO! #DIViDI 5 United Way-Martin County 0.00 0.00 11OIVl0! #DN/0! 8 United W Indian River County74 583.38 85U000.001 $5.000.001 0.00% No need to write an explanation T De ant of Children 8 Families 72A33MI 57,111.001 116 742.00 104A1% MMonal Counselor Added 8 Cou Funds 0.001 #DN10! #DNiO! 9 CorltributionsCash 115W.001 10.000.001 10 000.00 0.00% No need to write an 10 ram Fees explanation 11 Fund Raisin Events-Net 0.00 #ONTO! #DNiO! 1ublic-Net 750.00 20,000.00 20.000.00 0.00% No need to write an explanation 2 Sales to P 13 Membershi Dues 0.00 #D[V10! #DMO! 11 nvestmerrt Income 0.001 #DIVIO! #DIV/0! 0.001 #DN/O! #DNro! i5 Miscellaneous 0.8010.o0I #DN/O! #plV]Dl to acnes 8 nests 0.001 #DN/O! #DNAI 'A Funds from Other Sources 7,335.171 8,672.741 18.24% Rea Dcation of funds 18 Reserve Funds USM for Operating 0.001 tDNIOr 18 In-Kind Donations tMorkWkP kd to tohq #DNiDI 211 OTAL 0.001 #DIV/0! #DNro! 185,312.911209 17 285 14.74 36.27% EXPENDITURES 21 es 7 106 8.00 147 669.00 39,04% Additional Counselor Added 22 FICA 3 812491 11.296.271 39.03% 'onal Counselor Added 23 Retiremerrt 4,000.001 7,508.821 87.72% Additional Counselor Added LrfelHeatth 1U OW•� 10 2.00 8A2%, oral Couselor Added on 1062.80 2 067.00 94A9% Additional Counselor Added ent 0.00 516.84 #DN/O! #D!V/OI 5 .00 7197.00 37.09% Additional Counselor Added rainin 2 000.00 2,087.74 4.39% No need to write an explanation 4 600.00 4,502.061 -2.13% No need to write an nation 30 Tele hone 21775.651 3)M.001 4,841.001 27.39% nc ear q,00,_ Loaf, kna �+ce. MWM@t WL 3t elShi in 1 891 1,M,001 2A97.601 31A5% m a,a, ehc UtilWes 1593.87 1 .00 3,316.721 74.56% 33 Occur (Building8 Grounds �"O1�' '�`b'c� '"'°�"• °� 8171.59 16 000.00 16 788,00 4.93% No need to write an tion 34 Prirrtin S Publications 3 A4 2.229.001 4 .80 119.60% .w� - -- .� .�, • 35 SnitscN 'o NDues!Membershi s 280.08 750.00 492,00 -34AO% Noneedtn@Ks . 38 Insurance 2 584,37 an explanation 2100.00 2,984A8 42.12% Liabody insurance required and needed 37 ui meal Rental Maintenance 3 .08 8 500.00 4v319.881 -49.18% No need to write an 38 ertisin explanation 838A6 1500.00 1618.26 7.88% No creed to write an explanation 39 i meat Purchases: ital Ex use 1,853.30 0.00 1A00.001 tmN/0r 40 Professional Fees L I Consultin #DIV)DI 0.00 0.00 975.00 �NIO! #DN)D! 41 BoolalEdueational Materials 239A8 1,200.001 2a500.001 108.33% Resource and 42 Food 8 Nutritiontrakft books and videos for staf ireplacement of hurricane me 0.00 #ON/O! #DMO! 43 Administrative Costs 15,546.09 253721A6 40 074.96 44 Audit Ex use 55.80% Acufai Adrninistrative Costs 380.65 1500.00 992.86 No need to write an explanatlon 45 fie Assistance to Individuals 677.61 500.00 3.392A61 Rent assistance, ugHes, food bank 48 Other/Miscellaneous 41.60 300.00 208.90 No need to write an explanation OtberlCo 5 1T9 431.09 Reallocated to Inc 48 TOTAL 194 209 specific items X146.17 285 14.74 please see above, 49 REVENUES OVER/ UNDER EXPENDITURES -9,243.36 0.00 0.001#fflDP410! 19 Number of Unduplicated Clients by Location Ilk C rrent Fiscal Year Budget 2004/05 FF 11 1Pffl- 1ra ' 1 II 1 ' 1 ' 1 11 1 MITRIN ' I • I County1 Port Saint Lucie Co.St. Lucie Total Other 1 1 1 Numberof Und-uplicated Clients by Age � �"' A'� x ' • ' �' � y Y . f$ 1 f • 1 • a + @`Yya.T.nPx ' s K^>'� Location oil 1 s MU�Ilallm �l ��.W. 1. �. 1: 5 to 10 � (Elementary) Total . • � � � • to 5 • (Adults) • 1 + (Seniors) ' ' UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requestedin each fine item of the budget foryour program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Exchange Club CASTLE / Safe Families FUNDER: Children Services Advisory Council - Indian River County • CAUTION : Do not enter any figures where a cell is colored in dark blue - Fonnulas and/or links are In place. Gray areas should be used 11for providing information and calculations only, j REVENUES Proposed Tota/ Program B9ud et Ftmder S h Total Agengy pecific Budget 'Budget 1rAdvisory ildren's Services Councl4St Lucie 202,500.00 2ildren's Services Council-Martin 167 483 00 3Committee-Indian River 45,000.00 45,000.00 60,000.004ited Wa St Lucie County653000.00 5 United Wa -Martin County40 00000 6 United Wa -Indian River County85 00000 126 00000 7 United For Families 1163742.00 423,668.50 8 Cou Funds 8 Contributions-Cash 10 000 1000000.00 10 Pr ram Fees 73,780.00 11 Fund Raisin Events-Net 20 000 00 162 00000 12 Sales to Public - Net 13 Membershi Dues 14WOther Income 10 00000 15ous 5 DDO 16 B uests .001 17 Other Sources 8,672.74372,570.77 18nds Used for O 19ations Not included in total) 20TOTAL REVENUES doesn't include line 19)1 285 414.74 $ 45 000.00 $ 1 ,808,002.2 EXPENDITURES A �OIDOS G B • - , < C rota Total Program Budget Funder SpecrTic Budget Agency Budget x . . 21 Salaries - (must com fete chart on next pagg 147,669.00 33,000.001 868,042. 12 22 FICA - Total salaries x 0. 0765 11 ,29627 2,524.50 65,351 .44 Rat rem nnua pension r u_aTffiid� 23 staff 7,508.82 21000.00 412000.00 ea ;$77,000 Ica o - erm 24 Dior 10,842.00 2,200.00 55,511 .93 or ers oen on - emp oyees x 25 rate on a neoyme - prol 2,067.00 554.50 139723.21 26 employees x x UCT-6 rate 51684 5,000.00 SALARIES fTIOIV! LIST11V6 a riraa►SaFary; ° = r� ort{oir ;# IL I ofSMWYa► r FarrdrrSpeciGeBudget % of GrossAnmral x Position TIHe l Total Hrs/Nik ' (A9e►xy1 SalaryRequested(GAj 0.OMOV . ' 4 /.y.'� poilkator, a , Madden 25,880.40 229592 0%tionist, Lewis 23,499.84 973.38 - 0% n Resources, Cleveland 32,912.88 589449 - 0% tionist, Prince 21 ,840.00 1158152 0% rDevelo ment 31 ,500.00 3,780.00 0% . Relations Coord. 31 ,x.00 4 967 - 0% m Mana er, Orenstein 42,282.24 6,080.20 - 0% isor 33,600.00 14,818.92 2,500.00 7% elor, Sudbrook 30,204.72 30,204.72 10,000.00 33% lor, Pachon 25,399.92 25,399.92 9,500.00 37% lor, Shottland, L 32,780.33 32,780.33 11 ,000.00 34% tor, Anderson 12,000.00 2,964.00 - 0% Facilitator, Del ino 12,000.00 2,964.001 - 0% Facilitator, Pietantuono 12,000.00 21964.00 - 0% #DIV10! #DN/0! #DN/0! Remaining ositions throughout thea en 500,641 .79 Total Salaries $ 868,042.12 $ 147,669.00 $ 33,000.00 4% UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : EXCHANGE CLUB CASTLE / SAFE FAMILIES FUNDER : Children Services Advisory Cow A B C FY 05/06 FY 05/06 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. Blcol. A EXPENDITURES 21 Salaries 147y669,00 33,000.00 22.35% Additional Counselor added 22 FICA 11 296.27 2524,50 22.35% Additional Counselor added 23 Retirement 7 508.82 21000,00 26.64% Additional Staff Eligible for Benefits 24 LifelHealth 10 842.00 2 200.00 20.29% increased rates, Additional staff 25 Workers Compensation 29067,00 554.50 26.83% Increased rates, Additional staff 26 Florida Unemployment 516.84 0.00 0.00% No need to write an explanation 27 Travel-Dail 7 197.00 0.00 0.00% No need to write an explanation 28 Travel/Conferences/Trainin 21087,74 0.00 0.00% No need to write an explanation 29 Office Supplies 49502,06 500.00 11 .11 % No need to write an explanation 3o Telephone 4 841 .00 0.00 0.00% No need to write an explanation 31 PostagefShippinig 21497,60 0.00 0.00% No need to write an explanation 32 Utilities 3,316,72 0.00 0.00% No need to write an explanation 33 Occupancy Bufidin & Grounds) 16 788.00 4,000,00 23.83% New Facility (Hurricane) 34 Printing & Publications 41894,80 0.00 0.00% No need to write an explanation 36 SubscriptionMuesiMemberships 492.00 0.00 0.00% No need to write an explanation 36 Insurance 21984,48 221 .00 7.40% No need to write an explanation 37 E of ment:Rental & Maintenance 4319,88 0.00 0.00% No need to write an explanation 38 Advertising1 ,618,26 0.00 0.00% No need to write an explanation 39 Equipment Purchases:Ca ital Expense 1 400.00 0.00 0.00% No need to write an explanation 40 Professional Fees (Legal, Consults 975.00 0.00 0.00% No need to write an explanation 41 BookslEducational Materials 21500,00 0.00 0.00% No need to write an explanation 42 Food & Nutrition 0.00 0.00 #DIV/O ! #Dlvrot 43 Administrative Costs 40A74,96 0.00 0.00% No need to write an explanation 44 Audit Expense 992.86 0.00 0.00% No need to write an explanation 4s Specific Assistance to Individuals 31392,461 0.00 0.00% No need to write an explanation 46 Other/Miscellaneous 208.90 0.00 0.00% No need to write an explanation 47 Other/Contract 431 .09 0.00 0.00% No need to write an explanation 48 TOTAL $ 285 414.74 $ 45,000.001 16% 20 UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: EXCHANGE CLUB CASTLE / SAFE FAMILIES FUNDER: Children Services Advisory Council EXPLANATION FOR VARiAWE ITEW _azi K Wro! #DMO! A Commutes-IrK9an River Adcr ionml Counselor Added e of Chen 3 FamOes Addlborml Counselor Added Funds from Other Sotrrees Reedocatlon of kinds salaFfOS Additional Corrselor Added FICA lAddiflormi Counselor Added Retirement lAddlional Counselor Added Work Additional Counselor Added rrave Arb-fi" al Cormselor Added T $40.3/math ins cei . Loeal 6stw= "met ad P 5206Arnorrth for rewsfeder maiiing. gerwal maiiing, and special events maiiing, etc. Miles $276hnonth electric, water, do P PubNcafloos increase in quantrty of newsletter letterhead es 'al events materials eta Nsuaame Addrliorrel Liability Insurance regured and needed Books/Edueatlonal Materials Resource and trainirig tools and videos for staff lacerrent of IMrricane materials Adutirgshadve costs Acutal Adminstrative Costs e area to Yufvkkrds Rerd assistance a tirrUes food beak Other/Carrlraet Reallocated to One specific dens UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE I Safe Families FUNDER: Children Services Advisory Council - Indian River County KRefir TIONFORVARlAA10EAdditional Counselor added Adddformf Coursebr added Additional Salf EA for Benefits Increasedn Increased rates Additional Staff Oe 3 Grounds New Fed Hurricane 21 pr N0M0) ' ' ' 0 '� w lip. O + S -eprer� S y� '111 SI If S vIf 1f1 S S S S r COS � NNr N fIL N .- : N ' � N .- I If �. „ N - N H M N IN V d1 0. . If IIfp'tA 11h r 86 8� ' S mv If1 O 1 1 1 1 ' N , '� t ',v ,� �TOf 0 0 0 0 If I If :E g ooino If f If Q o ri v ui v fq rS ohon oIf > 3 ° e1 4 1If I- If (p y lr� O O O O S h ,. pSp t0 S tel' CO ,C,k SZ O O O P` Io�p ~ far O~� . �O CO cpV� , . � V' I If If R xE If N ,'E M fp j'',,�� et fV V !f! mf� 71 • '@of a_ g t@fop mm If O O O O O O C O O C i s Ira >< iV N h N 100 O 1W I GI f(F �S OI 1. 3$ M Qto IfO 4r re I el C 1� CMOI N M ,., r' tinw n If If 4 ,SQA {E, (� ; -v 3U� 00 I p- w a If pe If X IIIf fl e N EIr L o 'd c r r . gg ILLr ,w a_, d • � } Npr I 9 .. pie �q % e ler rr AQ c _ .E ° c a K O c Qj J O a s � . v [{.^ g y NIf �. r •� N ' - � �' . eN- C y W ` C � - ; V c y v $ O c c o � ys$q+ pr IL � ' LS L ' ca �c©$ Yll I ` a xt E ; x ¢?� Ir If el! IS 00 U OC E N N d L C C �G : :i: O ' C ���pp uy �,.r � ' t�7 C 01 10: � , x .Nt 9 N . _`tl ar ' Z ip � 'O p ` d 0 0 'o U O 0 ._ ;:$. y C Olj. yG:', x„ 'DriG .� CI s�ia: � � 7 r[; i 0 , v �:+�', Cy C � p1 m = ° `° O m t -° N v c ' Ns' , O. x • m �'' W I pp ,� (7 .' ; 0 . o - m c c E w , a 3 E : K x ' I- 0 2 S c W ` o rn a ro a o a = c :; a m :plr4 t ° o m _ 6.; ° p m o `o o ° o o • E'_. � � 7 _Ili�� r� o p E udi N m m m N Z 13{rE �,' r,., c , — E a� E �° c c c = m�i r� :W a c a� . 7 . r �o ' o 4c �° ° � °. g m A m C x';11 : p ��$j. Y , @ - Fgsl U) 2 o E U U V t1 F I. ?, ;- m N d,' C7 VJ ,4y Sy� rE vi lLs ._q� c f5 C� < o U d vi LL U- h .» W 0. O -1 , y �„ Si `� W pp p p y �p -. M r o ob AT po o m g$ n O 9 ART InA $ O fD O p ' ry n N N I. in ;. O n t0 CN O M (M co r In O oo t>0 N O r co r y r c 'm E w d � AT Cd CLAV •$ ppo E c O � • O W f7 r r n In a LO co P VI CL O C A O C Nl r C .0 � C �y � N Y N @ -g CL $ • ; . 8 rQ 3 3S LcJ E c S m . . •pa a rr g r a . � ."c Q al 1.11 L IZ C O G x ' ° a N H _ If H �+. N M r p12 m , �� ' 9 W el E E . x . . ' �i .� rn :' aXW -. v� E .� (r. X. 111 Lpp J C x 3 ,� ,� C r^a O J 0. _ y �p s C �C � ' Ol rytO C . d Eta � � Of ` + ; � x C C1 � N � A4'' to 0 l0 lQ N C C C L C UTt �. ..�� `�� 7 E C w`. y y. �l 1�j t (N� � Cr •,' F` 0011 .rte y�.+ t , 1� . 'm •1. y 'O Q l0 y � rd L E L ell C' W S rC 11pp 7 �L J' �. Snr N N d 1 p c O 'p_ � �Ol rQ pa +j (a FE 01rL , QE ' t' , `y 9 z lL . CJ r N : C E r 'p yy N y� O 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 30th) 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: Joyce Johnston-Carlson , Director Indian River County Human Services 184025 th Street Vero Beach , Florida 32960-3365 Recipient : Exchange Club Castle P . O . Box 12908 Fort Pierce , Florida 34979 Attention : Theresa Garbarino-May, Executive Director 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 - UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCYIPROGRAM NAME: EXCHANGE CLUB CASTLE I SAFE FAMILIES FY 03104 FY 04105 FY 05106 % INCREASE FYE 9130104 FYE 980105 FYE 980106 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED IcoL CcoL BycoL 6 REVENUES BUDGETED BUDGETED 1 Children's Services CouncilSt Lucie 143598.47 183 650.00 202 500.00 10.26% 2 Children's Services Council-Martin 1329682.04P 138 298.00 167 483.00 21 .10% 3 Advisory Committee-Indian River 1 48113.48 45 000.00 60 000.00 33.33% 4 United Way-St Lucie County 55,500.01 57 000.00 65 000.00 14.04% 5 United Way-Martin County 347855.50 31 ,416.00 40 000.00 27.32% 6 United Way-Indian River County 97 250.01 101 000.00 126 000.00 24.750/6 7 United For Families 3609268.28 354 021 .00 423 668.50 19.67% 8 CountyFunds 0.00 #DIV/0! 9 Contributions Cash 169 042.68 50,000.00 100 000.00 100.00% 10 Program Fees 45,174.79 73 780.00 73 780.00 0.00% 11 Fund Raising Events-Net 60 794.13 1629000.00 162 000.00 0.00% 12 Sales to Public-Net 0.00 #DIV/01 13 Membership Dues 0.00 #DIV/01 14 Investment Income 41511 .86 10 000.00 10 000.00 0.00% 15 Miscellaneous 41812.86 51000.00 51000.00 0.00% 16 Legacies 8 Bequests 0.00 #DN/01 17 Funds from Other Sources 618 844.10 397 713.98 372t570.77 -6.32% 18 Reserve Funds Used for Operating 0.00 #DIV/01 19 In-Kind Donations (Nd mckK wintofa ) 0.00 #DIV/01 20 TOTAL 11776,448.21 1 608 878.98 198089002.27 12.38% _ - . . EXPENDITURES 21 Salaries 1 088 71OA2 940 776.00 868 042.12 -7.73% 22 FICA 81 900&67 73 596.37 65 351 .44 -11 .20% 23 Retirement 40186&00 299000.00 41 000.00 41 .38% 24 Life/Health 55j813.36 39t962.73 55 511 .93 38,91 % 25 Workers Compensation 97406.60 13 396.65 13 723.21 2A4°k 26 Florida Unemployment 4t629.74 5 000.00 59000.00946.80% % 27 Travel-Dail 38 232.64 28 432.00 349384.64 % 28 Travel/Conferences/Trainin 21 651 .07 20 294.00 22 000.00 % 29 Office Supplies 32114.57 2019".32 2250000 % 30 Telephone 26 795.40 22 775.00 31 692.00 % 31 Posta elShi in 69830.06 87474.00 12 440.00 32 Utilities 17115.60 17 060.00 22 920.00 34.35% 33 Occupancy (Building 8 Grounds 71 549.81 95 036.83 101 693.58 7.00% 34 Printing & Publications 22 342.66 25100.00 32 640.00 30.04% 35 Subscri tion/Dues/Membershi s 27929.63 31500.00 41000.00 14.29% 36 Insurance 18 367.17 14 650.00 19 000.00 29.69% 37 E ui ment:Rental & Maintenance 9102.14 17 310.00 1781000 2.89% 38 Advertising 47619.93 71312,00 1000000 36.76% 39 Equipment Purchases:Ca ital Expense 19 557.75 30 536.92 3425000 12.16% 40 Professional Fees (Legal, Consulting) 29400.00 18 800.00 14 775.00 -21 .41 % 41 Books/Educational Materials 7,014.751 31 ,80:5.00 33 424.40 5.09% 42 Food 8 Nutrition 0.00 #DN/01 43 Administrative Costs 194 257.79 #DIV/O! 44 Audit Expense 71040.00 51500.00 51500.00 0.00% 45 Specific Assistance to Individuals 81518.20 61310.00 10 010.00 58.64% 46 Other/Miscellaneous 923.48 73y305.116 857616 -88.30% 47 OthedContract 105 6.98 60 000.00 127 500.00 112.50% 48 TOTAL 11702,983.63 1 T6089878.98 18089002.271 12.380 49 REVENUES OVER/ UNDER EXPENDITURES 72 464.58 0.00 0.001 #DN/0! 18 UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: EXCHANGE CLUB CASTLE / SAFE FAMILIES FY 03/04 FY 04/05 FY OS/00 X INCREASE FYE 9!30/04 FYE 9MIMS FYE MOM CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED teoL CeoL SycoL e REVENUES BUDGETED BUDGETED I Children's Services Council-St. Lucie 0.001 0.061 #DN/O! #DNIO! 2 Children's Services Council-Martin 0.00 0.00 #DN/0! #DNiO! 3 visory Committee-Indian River 36,045.651 30,000,00 45000.00 50.00% AddtioralCounselorAdded 4 United W St Lucie County0.001 0.001 #DNIO! #DIViDI 5 United Way-Martin County 0.00 0.00 11OIVl0! #DN/0! 8 United W Indian River County74 583.38 85U000.001 $5.000.001 0.00% No need to write an explanation T De ant of Children 8 Families 72A33MI 57,111.001 116 742.00 104A1% MMonal Counselor Added 8 Cou Funds 0.001 #DN10! #DNiO! 9 CorltributionsCash 115W.001 10.000.001 10 000.00 0.00% No need to write an 10 ram Fees explanation 11 Fund Raisin Events-Net 0.00 #ONTO! #DNiO! 1ublic-Net 750.00 20,000.00 20.000.00 0.00% No need to write an explanation 2 Sales to P 13 Membershi Dues 0.00 #D[V10! #DMO! 11 nvestmerrt Income 0.001 #DIVIO! #DIV/0! 0.001 #DN/O! #DNro! i5 Miscellaneous 0.8010.o0I #DN/O! #plV]Dl to acnes 8 nests 0.001 #DN/O! #DNAI 'A Funds from Other Sources 7,335.171 8,672.741 18.24% Rea Dcation of funds 18 Reserve Funds USM for Operating 0.001 tDNIOr 18 In-Kind Donations tMorkWkP kd to tohq #DNiDI 211 OTAL 0.001 #DIV/0! #DNro! 185,312.911209 17 285 14.74 36.27% EXPENDITURES 21 es 7 106 8.00 147 669.00 39,04% Additional Counselor Added 22 FICA 3 812491 11.296.271 39.03% 'onal Counselor Added 23 Retiremerrt 4,000.001 7,508.821 87.72% Additional Counselor Added LrfelHeatth 1U OW•� 10 2.00 8A2%, oral Couselor Added on 1062.80 2 067.00 94A9% Additional Counselor Added ent 0.00 516.84 #DN/O! #D!V/OI 5 .00 7197.00 37.09% Additional Counselor Added rainin 2 000.00 2,087.74 4.39% No need to write an explanation 4 600.00 4,502.061 -2.13% No need to write an nation 30 Tele hone 21775.651 3)M.001 4,841.001 27.39% nc ear q,00,_ Loaf, kna �+ce. MWM@t WL 3t elShi in 1 891 1,M,001 2A97.601 31A5% m a,a, ehc UtilWes 1593.87 1 .00 3,316.721 74.56% 33 Occur (Building8 Grounds �"O1�' '�`b'c� '"'°�"• °� 8171.59 16 000.00 16 788,00 4.93% No need to write an tion 34 Prirrtin S Publications 3 A4 2.229.001 4 .80 119.60% .w� - -- .� .�, • 35 SnitscN 'o NDues!Membershi s 280.08 750.00 492,00 -34AO% Noneedtn@Ks . 38 Insurance 2 584,37 an explanation 2100.00 2,984A8 42.12% Liabody insurance required and needed 37 ui meal Rental Maintenance 3 .08 8 500.00 4v319.881 -49.18% No need to write an 38 ertisin explanation 838A6 1500.00 1618.26 7.88% No creed to write an explanation 39 i meat Purchases: ital Ex use 1,853.30 0.00 1A00.001 tmN/0r 40 Professional Fees L I Consultin #DIV)DI 0.00 0.00 975.00 �NIO! #DN)D! 41 BoolalEdueational Materials 239A8 1,200.001 2a500.001 108.33% Resource and 42 Food 8 Nutritiontrakft books and videos for staf ireplacement of hurricane me 0.00 #ON/O! #DMO! 43 Administrative Costs 15,546.09 253721A6 40 074.96 44 Audit Ex use 55.80% Acufai Adrninistrative Costs 380.65 1500.00 992.86 No need to write an explanatlon 45 fie Assistance to Individuals 677.61 500.00 3.392A61 Rent assistance, ugHes, food bank 48 Other/Miscellaneous 41.60 300.00 208.90 No need to write an explanation OtberlCo 5 1T9 431.09 Reallocated to Inc 48 TOTAL 194 209 specific items X146.17 285 14.74 please see above, 49 REVENUES OVER/ UNDER EXPENDITURES -9,243.36 0.00 0.001#fflDP410! 19 , 1Vv V� GVVJ li ' JV Ac ww CERTIFIGATE 0� LIABILITY INSURANLt ' 11 / 04 / 05J� - � IU EXCHA- 1 ►RUDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HARBOR INSURANCE AG910Cy HOLDER. THIS CERTIFICATE DOE$ NOT AMEND, EXTEND OR 2222 Colonial Road , Saito 100 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Fort Pierce TL 34950 - 5309 Phoae : 772 - 461 - 6040 Faxo172w460 - 2315 INSURERS AFFORDING COVERAGE NAICaI� INSURER INURER A: Philadelphia Indemnity Ins Co Thee chanes Club Ce ter � Hartford Ins Co of the Midwest fo the Prevention o� S i INSURER 0: Ch ld Abuse DBA INSURER C: 8xchange Club C . A , S . T * L . B . PO Bqx 12 908 INSURER 0: Yt Pierce FL 34979 RG MSUR� E: COVERAGES Tk9 POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY "RIOD INDICATED, NOTWITHSTANDING ANY REQUIREMONT, TERM OR CONOfTICN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDE13 BY THE POLICIES DESCRIBED HEREIN IS SUIJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INIVIq LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE M1WD PIlaA 09 M DIYYI LIMITS� ., EM L GENERAL LIABILITY EACH OCCURRENCE 13110001000 A I X XX COMMERCIAL GENERAL LIABILITY PHPXI12827 03 / 76 / 05 03 / 26 / 06 PFffmI s Kex 52001000 CLAIMS MADE Li OCCUR MED IiXP (Any or* Person) S $ , OQO „ PERSONAL a ADVINJORY � $ 1 000 , 000 GENERAL AGGREGATE s3 000 , 000 GEN'L AGOREGATE LOAT APPLIES PER! PRODUCTS • OOMPloP A03 5 OOO OOO POLICYIn 7 LOC AUTOMOBILE LIABILITY COMSINEO SINGLE; UMIT = ANYAIJTO I (EeaWdem) ALL OWNED AUTOS BODILY INJURY SC41EDULED AUTOS (Per penal) _ HIRED AUTOS GODLY INJURY S N0""60 AUTOS (Per ?CelOenU PROPERTY DAMAGE 6 (Por accid6m) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO 0 THERTI�A� EA ACC S AUTO ONLY; AGC! 5 bccESMIMORELLAL,IABILm EACH occURRENCE t _ OCCUR El CLAIMS MADE AGGREGATE �a fi f DEDUCTIBLE _ S r— RETENTION S S WORHw COuDENswnON AND IT RY LIMITS X ER EMPLOYEiq'IETLIABLRY EACH ACCIDENT S 500 Q00 8 21�PBA49567 12 / 01 / 04 12 / OZ / OS E• . ' ANY PROPRORIiARTNERlE7(ECUTIVE 1 —•— OFFICERArREMBER0CLUOEW E.L. DISEASE • EAEN1PLovEE S $ OO OOO wL ,I�sto"N S o�w E .L. DISEASE • POLICY LIMIT s 50 0 000 OTHER A Professional Liab . PKPX112027 03 / 26 / 05 03 / 26 / 06 Occurrent $ 10000 , 000 A sexual / hV Abuse PHPK122927 03 / 26 / 05 03 / 26 / 061 Aggregate $ 2 000 000 DESCRIPTION OF OP RATIONS I LOCATION& I VEMGLU I EXCLUSIONS ADDED BY ON60RSEMENT I 4PECIAL PROVISION * 10 days tori- payment of premium . Certificate Holder is named as as Additional Insured for General Liability coverage . CERTIFICATE HOLDER CANCELLATION INDIAw 2 SHOYLD ANY OF THE ABOVE DESCRISEO POLICIES SE CANCKLLED BEFORE THE EXPIRATION DATE THEREOF, TME 18511,1410 INSURER MALL ENDEAVOR TO MAIL 30 * DAYS WOU'rTEN NOTICE TO THE CERTIFICATE HOLDER NAMES) TO THE LEFT, WT FAILURE TO 00 SO SHALL Indian River County IMPOSK NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1840 25th 0traet Veto Beach FL 32960 REPRESENTATIVES, AUTHOMiED 149PRESF.NTATi r Cind McCa3. 1 ACORD 25 (2001 /08) 0 AC RD CORPOPATION 1 BFB NUV-04 - 2005 11 : 56 P . 02/02 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 endomement(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 policWs listed thereon . The information contained in this transmission is client privileged and confidential, or considered confidential under staftfiederal statutes or regulations. It is intended only for the use of the individual or entity named above. jfthe reader of this m essage is n of the intended recipient, you are h ereby n o rif ed that a ny dissemination, distribution o r copy of this communication is strictly prohibited. If you received this message in error, please immediately not(& us by the telephone and return the original message to us at our address via the United States Postal Service. nank you. WORD 25 (2001108) TOTAL P . 02 UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : EXCHANGE CLUB CASTLE / SAFE FAMILIES FUNDER : Children Services Advisory Cow A B C FY 05/06 FY 05/06 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. Blcol. A EXPENDITURES 21 Salaries 147y669,00 33,000.00 22.35% Additional Counselor added 22 FICA 11 296.27 2524,50 22.35% Additional Counselor added 23 Retirement 7 508.82 21000,00 26.64% Additional Staff Eligible for Benefits 24 LifelHealth 10 842.00 2 200.00 20.29% increased rates, Additional staff 25 Workers Compensation 29067,00 554.50 26.83% Increased rates, Additional staff 26 Florida Unemployment 516.84 0.00 0.00% No need to write an explanation 27 Travel-Dail 7 197.00 0.00 0.00% No need to write an explanation 28 Travel/Conferences/Trainin 21087,74 0.00 0.00% No need to write an explanation 29 Office Supplies 49502,06 500.00 11 .11 % No need to write an explanation 3o Telephone 4 841 .00 0.00 0.00% No need to write an explanation 31 PostagefShippinig 21497,60 0.00 0.00% No need to write an explanation 32 Utilities 3,316,72 0.00 0.00% No need to write an explanation 33 Occupancy Bufidin & Grounds) 16 788.00 4,000,00 23.83% New Facility (Hurricane) 34 Printing & Publications 41894,80 0.00 0.00% No need to write an explanation 36 SubscriptionMuesiMemberships 492.00 0.00 0.00% No need to write an explanation 36 Insurance 21984,48 221 .00 7.40% No need to write an explanation 37 E of ment:Rental & Maintenance 4319,88 0.00 0.00% No need to write an explanation 38 Advertising1 ,618,26 0.00 0.00% No need to write an explanation 39 Equipment Purchases:Ca ital Expense 1 400.00 0.00 0.00% No need to write an explanation 40 Professional Fees (Legal, Consults 975.00 0.00 0.00% No need to write an explanation 41 BookslEducational Materials 21500,00 0.00 0.00% No need to write an explanation 42 Food & Nutrition 0.00 0.00 #DIV/O ! #Dlvrot 43 Administrative Costs 40A74,96 0.00 0.00% No need to write an explanation 44 Audit Expense 992.86 0.00 0.00% No need to write an explanation 4s Specific Assistance to Individuals 31392,461 0.00 0.00% No need to write an explanation 46 Other/Miscellaneous 208.90 0.00 0.00% No need to write an explanation 47 Other/Contract 431 .09 0.00 0.00% No need to write an explanation 48 TOTAL $ 285 414.74 $ 45,000.001 16% 20 UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: EXCHANGE CLUB CASTLE / SAFE FAMILIES FUNDER: Children Services Advisory Council EXPLANATION FOR VARiAWE ITEW _azi K Wro! #DMO! A Commutes-IrK9an River Adcr ionml Counselor Added e of Chen 3 FamOes Addlborml Counselor Added Funds from Other Sotrrees Reedocatlon of kinds salaFfOS Additional Corrselor Added FICA lAddiflormi Counselor Added Retirement lAddlional Counselor Added Work Additional Counselor Added rrave Arb-fi" al Cormselor Added T $40.3/math ins cei . Loeal 6stw= "met ad P 5206Arnorrth for rewsfeder maiiing. gerwal maiiing, and special events maiiing, etc. Miles $276hnonth electric, water, do P PubNcafloos increase in quantrty of newsletter letterhead es 'al events materials eta Nsuaame Addrliorrel Liability Insurance regured and needed Books/Edueatlonal Materials Resource and trainirig tools and videos for staff lacerrent of IMrricane materials Adutirgshadve costs Acutal Adminstrative Costs e area to Yufvkkrds Rerd assistance a tirrUes food beak Other/Carrlraet Reallocated to One specific dens UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE I Safe Families FUNDER: Children Services Advisory Council - Indian River County KRefir TIONFORVARlAA10EAdditional Counselor added Adddformf Coursebr added Additional Salf EA for Benefits Increasedn Increased rates Additional Staff Oe 3 Grounds New Fed Hurricane 21 i2ub EGD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CHANGE IN INFORMATION PAGE INSURER : HARTFORD INSURANCE COMPANY OF THE MIDWEST NCCI Company Number: 20605 AUDIT PERIOD : ANNUAL POLICY EFFECTIVE DATE : 12 / 01 / 04 POLICY EXPIRATION DATE : 12 / 01 / 05 E� Policy Number: 21 WB DU9567 Endorsement Number: 01 HOUSING CODE : DH T-i Effective Date: 12 / 01 / 04 Effective hour is the same as stated in the Information Page of the policy. C> Named Insured and Address : EXCHANGE CLUB CENTER FOR THE PREVENTION OF CHILD ABUSE DBA Ln PO BOX 12908 o FORT PIERCE , FL 34979 Ln FEIN Number: 592094472 PRO RATA FACTOR : 1 . 000 rn PRODUCER NAME : HARBOR INSURANCE A A GENCY PRODUCER CODE : 220020 It is agreed that the policy is amended as follows : N C) IN CONSIDERATION OF AN ADDITIONAL - PREMIUM OF $ 6 , 948 IT IS AGREED THAT : 0 0 C) THIS ENDORSEMENT REFLECTS ADJUSTMENT IN PREMIUM BASIS DUE TO * RECENT AUDIT COMPLETED FOR THIS ` INSURED . ( A ) POLICY IS AMENDED TO CHANGE PAYROLL ON CLASS 8861 FOR INSD 01 ST 09 LOC 01 FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE : WC000406 Countersigned by Aut orized Representative Form WC 99 00 06 A (1 ) Printed in U . S.A. Pagel ( CONTINUED ON NEXT PAGE ) Process Date: 01 / 2 6 / 0 5 Policy Expiration Date: 12 / 01 / 05 ORIGINAL CHANGE IN INFORMATION PAGE (Continued) Policy Number: 21 WB DU9567 i SCHEDULE IT IS AGREED THAT THE POLICY IS AMENDED AS FOLLOWS : CLASS CODE NUMBER ESTIMATED RATES ESTIMATED AND DESCRIPTION TOTAL ANNUAL PER 100 OF ANNUAL REMUNERATION REMUNERATION PREMIUMS c° ( A ) � 8861 999 , 739 CD C> 999 , 739 OR WELFARE ORGANIZATION - 1 . 52 15 , 196 PROFESSIONAL EMPLOYEES & CLERICAL Ln ALL OTHER STATE CLASS PREMIUM N 2 , 336 O r� TOTAL CLASSPREMIUM 17 , 532 L INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT 85 °` TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 17 , 617 A FL - INTRA EXPERIENCE MODIFICATION 091190907 1 . 020 'N N PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 N TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 17 , 969 C) PREMIUM DISCOUNT 2 . 5 PERCENT - 449 C> EXPENSE CONSTANT ( 0900 ) * TERRORISM RISK INS ACT OF 2002 9740 1 , 376 , 439 200 TOTAL ESTIMATED ANNUAL PREMIUM - FL . 030 413 18 , 133 INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT 85 TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 17 , 617 FL - INTRA EXPERIENCE MODIFICATION 091190907 _= 1 . 02 0 _ PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 17 , 969 PREMIUM DISCOUNT 2 . 5 PERCENT - 449 EXPENSE CONSTANT 0900 200 =- TERRORISM RISK INS ACT OF 2002 , ( 9740 ) 413 TOTAL ESTIMATED ANNUAL PREMIUM 18 , 133 ESTIMATED ANNUAL ADDITIONAL ENDORSEMENT PREMIUM 61948 0 Form WC 99 00 06 A (1 ) Printed in U.S.A. Page 2 Process Date : 01 / 26 / 05 Policy Expiration Date : 12 / 01 / 05 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 30th) 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 - f t ( THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, PREMIUM DISCOUNT ENDORSEMENT 0 0 C) Policy Number: 21 WB DU9567 Endorsement Number: 01 Ln Effective Date: 12 / 01 / 04 Effective hour is the same as stated on the Information Page of the policy. N Named Insured and Address: EXCHANGE CLUB CENTER FOR THE 0 t PREVENTION OF CHILD ABUSE DBA Ln PO BOX 12908 FORT PIERCE , FL 34979 N The premium for this policy and the policies, if any, listed in Item 3 of the Schedule may be eligible for a discount. This o endorsement shows your estimated discount in Item 1 or 2 of the Schedule . The final calculation of premium discount CD will be determined by our manuals and your premium basis as determined by audit. Premium subject to retrospective * rating is not subject to premium discount. -= SCHEDULE State First Next Next $5,000 $95,000 $4001Balance FL _= 00 . 0 % 3 . 5 % 5 . 0 % 7 . 0 % Other Policy Numbers : Countersigned by Authorized Representative Foran WC 00 04 06 T Printed in U.S.A. Process Date : 01 / 26 / 05 Policy Expiration Date : 12 / 01 / 05 Child Abuse Services, Training & Life Enrichment October 18 , 2005 Marion Masterson Indian River County Administration Building 184025 th Street, Vero Beach, FL 32960 Dear Ms . Masterson, The CASTLE does not transport children for its programs in Indian River County. Theresa arbarino-May Executive Director EXCHANGE CLUB CASTLE Mailing Addresg: P. O. Box 12908 • Fort Pierce, F134979 Office: 3525 SW Midway Road • Fort Pierce, FL 34981 Voice: 772.465 . 6011 • Fax: 772.465 .6013 • Email: tgarbarino-may@exchangecastle. org Sponsored in part by Exchange Clubs, the State of Florida, United for Families, United Way of Indian River, Martin, St. Lucie and Okeechobee Counties, Children's Services Councils of Martin and St. Lucie Counties and CSN of Indian River County. EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices . Any notice , request , demand , consent, approval , or other communication required or permitted by this Contract shall be given , or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the addresses of the parties shown below: County: Joyce Johnston-Carlson , Director Indian River County Human Services 184025 th Street Vero Beach , Florida 32960-3365 Recipient : Exchange Club Castle P . O . Box 12908 Fort Pierce , Florida 34979 Attention : Theresa Garbarino-May, Executive Director 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 - , 1Vv V� GVVJ li ' JV Ac ww CERTIFIGATE 0� LIABILITY INSURANLt ' 11 / 04 / 05J� - � IU EXCHA- 1 ►RUDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HARBOR INSURANCE AG910Cy HOLDER. THIS CERTIFICATE DOE$ NOT AMEND, EXTEND OR 2222 Colonial Road , Saito 100 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Fort Pierce TL 34950 - 5309 Phoae : 772 - 461 - 6040 Faxo172w460 - 2315 INSURERS AFFORDING COVERAGE NAICaI� INSURER INURER A: Philadelphia Indemnity Ins Co Thee chanes Club Ce ter � Hartford Ins Co of the Midwest fo the Prevention o� S i INSURER 0: Ch ld Abuse DBA INSURER C: 8xchange Club C . A , S . T * L . B . PO Bqx 12 908 INSURER 0: Yt Pierce FL 34979 RG MSUR� E: COVERAGES Tk9 POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY "RIOD INDICATED, NOTWITHSTANDING ANY REQUIREMONT, TERM OR CONOfTICN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDE13 BY THE POLICIES DESCRIBED HEREIN IS SUIJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INIVIq LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE M1WD PIlaA 09 M DIYYI LIMITS� ., EM L GENERAL LIABILITY EACH OCCURRENCE 13110001000 A I X XX COMMERCIAL GENERAL LIABILITY PHPXI12827 03 / 76 / 05 03 / 26 / 06 PFffmI s Kex 52001000 CLAIMS MADE Li OCCUR MED IiXP (Any or* Person) S $ , OQO „ PERSONAL a ADVINJORY � $ 1 000 , 000 GENERAL AGGREGATE s3 000 , 000 GEN'L AGOREGATE LOAT APPLIES PER! PRODUCTS • OOMPloP A03 5 OOO OOO POLICYIn 7 LOC AUTOMOBILE LIABILITY COMSINEO SINGLE; UMIT = ANYAIJTO I (EeaWdem) ALL OWNED AUTOS BODILY INJURY SC41EDULED AUTOS (Per penal) _ HIRED AUTOS GODLY INJURY S N0""60 AUTOS (Per ?CelOenU PROPERTY DAMAGE 6 (Por accid6m) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO 0 THERTI�A� EA ACC S AUTO ONLY; AGC! 5 bccESMIMORELLAL,IABILm EACH occURRENCE t _ OCCUR El CLAIMS MADE AGGREGATE �a fi f DEDUCTIBLE _ S r— RETENTION S S WORHw COuDENswnON AND IT RY LIMITS X ER EMPLOYEiq'IETLIABLRY EACH ACCIDENT S 500 Q00 8 21�PBA49567 12 / 01 / 04 12 / OZ / OS E• . ' ANY PROPRORIiARTNERlE7(ECUTIVE 1 —•— OFFICERArREMBER0CLUOEW E.L. DISEASE • EAEN1PLovEE S $ OO OOO wL ,I�sto"N S o�w E .L. DISEASE • POLICY LIMIT s 50 0 000 OTHER A Professional Liab . PKPX112027 03 / 26 / 05 03 / 26 / 06 Occurrent $ 10000 , 000 A sexual / hV Abuse PHPK122927 03 / 26 / 05 03 / 26 / 061 Aggregate $ 2 000 000 DESCRIPTION OF OP RATIONS I LOCATION& I VEMGLU I EXCLUSIONS ADDED BY ON60RSEMENT I 4PECIAL PROVISION * 10 days tori- payment of premium . Certificate Holder is named as as Additional Insured for General Liability coverage . CERTIFICATE HOLDER CANCELLATION INDIAw 2 SHOYLD ANY OF THE ABOVE DESCRISEO POLICIES SE CANCKLLED BEFORE THE EXPIRATION DATE THEREOF, TME 18511,1410 INSURER MALL ENDEAVOR TO MAIL 30 * DAYS WOU'rTEN NOTICE TO THE CERTIFICATE HOLDER NAMES) TO THE LEFT, WT FAILURE TO 00 SO SHALL Indian River County IMPOSK NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1840 25th 0traet Veto Beach FL 32960 REPRESENTATIVES, AUTHOMiED 149PRESF.NTATi r Cind McCa3. 1 ACORD 25 (2001 /08) 0 AC RD CORPOPATION 1 BFB NUV-04 - 2005 11 : 56 P . 02/02 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 endomement(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 policWs listed thereon . The information contained in this transmission is client privileged and confidential, or considered confidential under staftfiederal statutes or regulations. It is intended only for the use of the individual or entity named above. jfthe reader of this m essage is n of the intended recipient, you are h ereby n o rif ed that a ny dissemination, distribution o r copy of this communication is strictly prohibited. If you received this message in error, please immediately not(& us by the telephone and return the original message to us at our address via the United States Postal Service. nank you. WORD 25 (2001108) TOTAL P . 02 i2ub EGD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CHANGE IN INFORMATION PAGE INSURER : HARTFORD INSURANCE COMPANY OF THE MIDWEST NCCI Company Number: 20605 AUDIT PERIOD : ANNUAL POLICY EFFECTIVE DATE : 12 / 01 / 04 POLICY EXPIRATION DATE : 12 / 01 / 05 E� Policy Number: 21 WB DU9567 Endorsement Number: 01 HOUSING CODE : DH T-i Effective Date: 12 / 01 / 04 Effective hour is the same as stated in the Information Page of the policy. C> Named Insured and Address : EXCHANGE CLUB CENTER FOR THE PREVENTION OF CHILD ABUSE DBA Ln PO BOX 12908 o FORT PIERCE , FL 34979 Ln FEIN Number: 592094472 PRO RATA FACTOR : 1 . 000 rn PRODUCER NAME : HARBOR INSURANCE A A GENCY PRODUCER CODE : 220020 It is agreed that the policy is amended as follows : N C) IN CONSIDERATION OF AN ADDITIONAL - PREMIUM OF $ 6 , 948 IT IS AGREED THAT : 0 0 C) THIS ENDORSEMENT REFLECTS ADJUSTMENT IN PREMIUM BASIS DUE TO * RECENT AUDIT COMPLETED FOR THIS ` INSURED . ( A ) POLICY IS AMENDED TO CHANGE PAYROLL ON CLASS 8861 FOR INSD 01 ST 09 LOC 01 FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE : WC000406 Countersigned by Aut orized Representative Form WC 99 00 06 A (1 ) Printed in U . S.A. Pagel ( CONTINUED ON NEXT PAGE ) Process Date: 01 / 2 6 / 0 5 Policy Expiration Date: 12 / 01 / 05 ORIGINAL CHANGE IN INFORMATION PAGE (Continued) Policy Number: 21 WB DU9567 i SCHEDULE IT IS AGREED THAT THE POLICY IS AMENDED AS FOLLOWS : CLASS CODE NUMBER ESTIMATED RATES ESTIMATED AND DESCRIPTION TOTAL ANNUAL PER 100 OF ANNUAL REMUNERATION REMUNERATION PREMIUMS c° ( A ) � 8861 999 , 739 CD C> 999 , 739 OR WELFARE ORGANIZATION - 1 . 52 15 , 196 PROFESSIONAL EMPLOYEES & CLERICAL Ln ALL OTHER STATE CLASS PREMIUM N 2 , 336 O r� TOTAL CLASSPREMIUM 17 , 532 L INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT 85 °` TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 17 , 617 A FL - INTRA EXPERIENCE MODIFICATION 091190907 1 . 020 'N N PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 N TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 17 , 969 C) PREMIUM DISCOUNT 2 . 5 PERCENT - 449 C> EXPENSE CONSTANT ( 0900 ) * TERRORISM RISK INS ACT OF 2002 9740 1 , 376 , 439 200 TOTAL ESTIMATED ANNUAL PREMIUM - FL . 030 413 18 , 133 INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT 85 TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 17 , 617 FL - INTRA EXPERIENCE MODIFICATION 091190907 _= 1 . 02 0 _ PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 17 , 969 PREMIUM DISCOUNT 2 . 5 PERCENT - 449 EXPENSE CONSTANT 0900 200 =- TERRORISM RISK INS ACT OF 2002 , ( 9740 ) 413 TOTAL ESTIMATED ANNUAL PREMIUM 18 , 133 ESTIMATED ANNUAL ADDITIONAL ENDORSEMENT PREMIUM 61948 0 Form WC 99 00 06 A (1 ) Printed in U.S.A. Page 2 Process Date : 01 / 26 / 05 Policy Expiration Date : 12 / 01 / 05 f t ( THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, PREMIUM DISCOUNT ENDORSEMENT 0 0 C) Policy Number: 21 WB DU9567 Endorsement Number: 01 Ln Effective Date: 12 / 01 / 04 Effective hour is the same as stated on the Information Page of the policy. N Named Insured and Address: EXCHANGE CLUB CENTER FOR THE 0 t PREVENTION OF CHILD ABUSE DBA Ln PO BOX 12908 FORT PIERCE , FL 34979 N The premium for this policy and the policies, if any, listed in Item 3 of the Schedule may be eligible for a discount. This o endorsement shows your estimated discount in Item 1 or 2 of the Schedule . The final calculation of premium discount CD will be determined by our manuals and your premium basis as determined by audit. Premium subject to retrospective * rating is not subject to premium discount. -= SCHEDULE State First Next Next $5,000 $95,000 $4001Balance FL _= 00 . 0 % 3 . 5 % 5 . 0 % 7 . 0 % Other Policy Numbers : Countersigned by Authorized Representative Foran WC 00 04 06 T Printed in U.S.A. Process Date : 01 / 26 / 05 Policy Expiration Date : 12 / 01 / 05 Child Abuse Services, Training & Life Enrichment October 18 , 2005 Marion Masterson Indian River County Administration Building 184025 th Street, Vero Beach, FL 32960 Dear Ms . Masterson, The CASTLE does not transport children for its programs in Indian River County. Theresa arbarino-May Executive Director EXCHANGE CLUB CASTLE Mailing Addresg: P. O. Box 12908 • Fort Pierce, F134979 Office: 3525 SW Midway Road • Fort Pierce, FL 34981 Voice: 772.465 . 6011 • Fax: 772.465 .6013 • Email: tgarbarino-may@exchangecastle. org Sponsored in part by Exchange Clubs, the State of Florida, United for Families, United Way of Indian River, Martin, St. Lucie and Okeechobee Counties, Children's Services Councils of Martin and St. Lucie Counties and CSN of Indian River County.