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HomeMy WebLinkAbout2005-328c r INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract" ) entered into effective thisday of October 2005 , by and between Indian River County, a political subdivision of the State of Florida ; 1840 25'h Street , Vero Beach , Florida , 32960-3365 ; and Exchange Club Castle ( Recipient) , of: Exchange Club Castle P . O . Box 12908 Fort Pierce , Florida 34979 Valued Visits 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 - r INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract" ) entered into effective thisday of October 2005 , by and between Indian River County, a political subdivision of the State of Florida ; 1840 25'h Street , Vero Beach , Florida , 32960-3365 ; and Exchange Club Castle ( Recipient) , of: Exchange Club Castle P . O . Box 12908 Fort Pierce , Florida 34979 Valued Visits 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 : THIRTEEN THOUSAND , FIVE HUNDRED FORTY DOLLARS ($ 13 , 540 . 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 : - 2 - 4 . Grant Funds and Payment . The approved Grant for the Grant Period is : THIRTEEN THOUSAND , FIVE HUNDRED FORTY DOLLARS ($ 13 , 540 . 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 : - 2 - ( i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property 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 - • i IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By: Thomas S . Lowther, //Chairman BCC Approved : Attest : J . K. Barton , Clerk aas , R B AZ Deputy Clerk r M' ,approve " = Jose h A. gird / County Administrator • r , tR £ C Approved a o orm and legal sufficiency: By: /Maor(E . ell , Assists t o y RECIPIENT: By: �� Exchange Club Castle - 4 - r � ( i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property 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 - Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 PROGRAM COVER PAGE Organization Name : Exchange Club CASTLE Executive Director: Theresa Garbarino-May Email : tgarbarino-may(a)exchangecastle org Address : P . O. Box 12908 Telephone : 772-465 -6011 Fort Pierce FL 34979 Fax : 772-465 -6013 Program Director: Cherie Huttman Email : chuttman(a)exchangecastle org__ Address : 1275 Old Dixie Highway Telephone : 772- 567- 5700 Vero Beach FL 32960 Fax : 772- 567- 9242 Program Tit Valued Visits Priority Nee e ocus Area II: Parental Support and Education Brief Description of the Program : Taxonomy# PH-600 . 65 0 - Parental Visitation Monitoring Valued Visits is a supervised visitation center that provides a safe and nurturing place for children to visit a parent who has hurt them when these visits are court ordered. Court ordered supervision occurs when there is anongoing risk of harm due to child abuse and/or domestic violence. FAmount Requested from Funder for 2005 /06 : $ 15 000 oposed Program Budget for 2005 /06 : $ 170 , 368 of Total Program Budget :Funding (2004 /05 ) : 8 . 8 % $ 15 , 000 Dollar increase/(decrease) in request : n/a Percent increase/(decrease ) in request : n/a Unduplicated Number of Children to be served Individually : 95 Unduplicated Number of Adults to be served Individually : 131 Unduplicated Number to be served via Group settings : Total Program Cost per Client : 753 . 84 If these funds are being used to match another source, name the source and $ amount: Junior League of Indian River County: $30. 000 • United Way of Indian River County $ 30, 0007 United for Families $ 5 , 032 The Organization ' s Board of Directors has approved this application on 1 /25/0 Michael Dillman Name of President/Chair of the Board ignature _Theresa-Garbarino-May Name of Executive Director/CEO Sature 3 r • i IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By: Thomas S . Lowther, //Chairman BCC Approved : Attest : J . K. Barton , Clerk aas , R B AZ Deputy Clerk r M' ,approve " = Jose h A. gird / County Administrator • r , tR £ C Approved a o orm and legal sufficiency: By: /Maor(E . ell , Assists t o y RECIPIENT: By: �� Exchange Club Castle - 4 - Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 ORGANIZATION : Exchange Club CASTLE PROGRAM . Valued Visits TABLE OF CONTENTS Please `X" the parts of the grant application to indicate they are included. Also, please put the page number where the information can be located. X Section of the Proposal Pa e # X TABLE OF CONTENTS (Check list) . . . . . . . 1 X COVER PAGE (with signatures) , 3 A. ORGANIZATION CAPABILITY (one page maximum) X 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . 4 X 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . 4 Be PROGRAM NEED STATEMENT (one page maximum) X 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 2 . Programs that address need and gaps in service . . . . . . . . . . C. PROGRAM DESCRIPTION (two pages maximum) X 1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X 2 . Description of program activities . . . . . . . . go@. . . . . . . . . . . . . . . . . . . . 0 all , 6 X 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . 6 X 4. Staffmg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . 7 X 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X 6. Accessibility of program . . . . . . . . . X D. MEASURABLE OUTCOMES (two pages maximum) , , , , 8 X E . COLLABORATION (one page maximum) . . . . . . . . . . . . . g F. PROGRAM EVALUATION (two pages maximum) X 1 . Demographics . . . . . . 1 . 1 . . . . . . . . . . . . X2 . Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 X 3 . Reporting , , , , . , , , , " , 110 , 0010 . 1 I I I I I I 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 a 6 . a a 0 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 0 10 G. TIMETABLE . . . . . I . . . . . . . . . . . . . . 11 H. UNDUPLICATED CLIENT COUNT X 1 . Projections by Location12 X 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1 Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 I. BUDGET FORMS . . . . . . . . . 99004 000 ego 0 * 8 0 0 0 see * so as * be * see * 13 J. APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2 i EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - organization : Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) F e the mission statement and vision of your organization . n of the Exchange Club CASTLE is to improve the quality of family life while 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. F2. 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: Valued Visits 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 contact between a parent and child that puts the child at risk. The child is at risk for abuse, at risk of witnessing domestic violence between parents, and at risk of being used in a manipulative manner by estranged parents . Following Florida law, visitation rights are often ordered between a parent and child, even if the parent poses a risk to that child, or has hurt that child in the past. It is unacceptable that these visits take place in the community, without supervision, placing the child, the ex-spouse, and the general community in jeopardy. Who : Children who are at risk of abuse, or are from homes where domestic violence is present. Where : Last year, parents were served in all parts of Indian River County Provide Data : In Indian River County, in 2002-2003 , there were 121 children who came under the supervision . of the Department of Children and Families . There were a total of 479 domestic violence crimes . There were 1 , 039 abuse reports . These children are eligible for Valued Visits, should visiting a parent pose a risk. (FDLE crime reports, DCF abuse hotline statistics) . r r2. 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. There are no other supervised visitation centers in Indian River County. Before Valued Visits opened, supervised visits occurred in the offices of Department of Children and Family caseworkers, the homes of relatives, at fast food restaurants, or in police station lobbies . Visits in these locations were often poorly supervised, and inadequately secure. Research shows that the majority of visits scheduled under these conditions were cancelled and did not occur as scheduled, which does not allow the parent/child relationship to mend. 5 i � Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 PROGRAM COVER PAGE Organization Name : Exchange Club CASTLE Executive Director: Theresa Garbarino-May Email : tgarbarino-may(a)exchangecastle org Address : P . O. Box 12908 Telephone : 772-465 -6011 Fort Pierce FL 34979 Fax : 772-465 -6013 Program Director: Cherie Huttman Email : chuttman(a)exchangecastle org__ Address : 1275 Old Dixie Highway Telephone : 772- 567- 5700 Vero Beach FL 32960 Fax : 772- 567- 9242 Program Tit Valued Visits Priority Nee e ocus Area II: Parental Support and Education Brief Description of the Program : Taxonomy# PH-600 . 65 0 - Parental Visitation Monitoring Valued Visits is a supervised visitation center that provides a safe and nurturing place for children to visit a parent who has hurt them when these visits are court ordered. Court ordered supervision occurs when there is anongoing risk of harm due to child abuse and/or domestic violence. FAmount Requested from Funder for 2005 /06 : $ 15 000 oposed Program Budget for 2005 /06 : $ 170 , 368 of Total Program Budget :Funding (2004 /05 ) : 8 . 8 % $ 15 , 000 Dollar increase/(decrease) in request : n/a Percent increase/(decrease ) in request : n/a Unduplicated Number of Children to be served Individually : 95 Unduplicated Number of Adults to be served Individually : 131 Unduplicated Number to be served via Group settings : Total Program Cost per Client : 753 . 84 If these funds are being used to match another source, name the source and $ amount: Junior League of Indian River County: $30. 000 • United Way of Indian River County $ 30, 0007 United for Families $ 5 , 032 The Organization ' s Board of Directors has approved this application on 1 /25/0 Michael Dillman Name of President/Chair of the Board ignature _Theresa-Garbarino-May Name of Executive Director/CEO Sature 3 Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages) EFocus st Priority Needs area addressed. Area 11 : Parental Support and Education 2. Briefly describe program activities including location of services. The purpose of Valued Visits is to provide a location for visiting parents to meet with their children in a safe, supervised manner. The participants in the program are referred by the courts due to contentious divorces or domestic violence, or by the Department of Children and Families because of the risk of child abuse or neglect . All referred families are screened for the appropriateness of Valued Visits, and given a date for a program orientation. Both parents and/or caretakers must complete orientation. Following successful completion of orientation, families are given a visitation schedule . The hour and date agreed upon for the family will be consistent on a weekly basis, until such time as visits are no longer needed. The visits occur in a recreation room type setting, to enhance the programs attractiveness to children, and to ensure a comfortable setting that encourages a positive, interactive visit. Age appropriate games and activities are provided for children from ages 0- 18 . Valued Visits is open for visits on Thursday and Friday evenings from 5 : 30 to 8 : 30pm, on Saturdays, from 8 : 30 to 1 : 30pm, and on Sunday from 2 : 00pm to 6 : OOpm each week. We are fortunate to have volunteers (Junior League members) to help monitor visits . The volunteers augment paid staff, and allow the program to increase its capacity. This year we will expand by offering a weekday afternoon session of visits . The services offered at Valued Visits include : Monitored Exchange — Supervised exchange of children between the residential and non- residential parent . Supervised Visitation — Supervised visits between a non-residential parent and a child. The visit is observed at all times by a monitor. The visit occurs on- site, at Valued Visits, and follows strict guidelines as to what can be said and done during the visit. Unless rules are violated, the monitor does not interact with the parent or child. Therapeutic Supervision — Supervised visits between the non-residential parent and a child. In this case, the visit monitor is a licensed mental health counselor, and takes an active role in the visit, working with the parent and child to improve the relationship . Parenting Classes — Non-residential parents are offered parent education classes before and after each visit. Services are provided at the CASTLE office at 1275 Old Dixie Highway, Vero Beach, F describe how your program intends to address the stated need/problem. e how your program follows a recognized " best practice" (see definition on page e instructions) and provide evidence that indicates proposed strategies are e with target population . The stated need or problem is unsupervised visits or contact between a child and a parent that puts that child at risk. Valued Visits addresses this need by offering a safe, enriched setting in which to supervise this contact. Valued Visits also fosters boundary and limit setting, holds parents accountable for their behavior, and enrolls non-residential parents in a parenting education class . In some cases, therapeutic intervention is offered when ordered by the court. 6 Organization: Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 The policies and procedures of Valued Visits follow the guidelines recommended by the Florida Clearinghouse on Supervised Visitation the Florida Supreme Court Standards for Supervised Visitation progTams and the "Recommendations from the National Council of Juvenile and Family Court Judges , " ensuring that Valued Visits utilizes both state and national standards for best practices . Evidence that supervised visitation works comes from both in-house statistics (there have been no instances of abuse, or witnessing of domestic violence by a child since the programs inception, during visits by families) and external statistics (" Supervised Visitation Beneficial for Young Children, " U. S . Dept. of Health and Human Services ; July, 2004) : • Only 17% of families using supervised visitation centers missed their appointments, compared with 71 % of families who use Department of Children and Families caseworkers to supervise visits . • Families using visitation centers were likely to have 10 or more visits, about 3 times more than if caseworkers supervised visits . • 50% of children who had regular family visits were in foster care for less than one year, while only 10% of children who had infrequent visits were in foster care for less than one year. • Children who use visitation centers have their court cases resolved sooner than children who use caseworkers to supervise family visits . 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (This section should conform with the information in the Position Listing on the Budget Narrative Worksheet). One program manager 17 hrs . - Required credentials/experience : BA/5 years 5 P/T visit monitors (includes site sup .) ( 100% of time) Required credentials/experience : High School/ 1 yr. Secretary 17 hrs . - Required credentials/experience : High School/ 1 yr. One /lead monitor - 13 hrs . - Required credentials/experience : High School/2yrs . 16 Volunteers 100% of time) Required credentials/experience : High School/ 1 [All . How will the target population be made aware of the program ? families using Valued Visits are court ordered to do so . Families are made aware of the ogram through the judge presiding at their court appearance, or in dependency cases, through eir DCF caseworker. This year we have added a court liaison to assist families and explain supervised visitation during and after court hearings . Program enrollment begins when a family provides a copy of the court order to the CASTLE . 6. How will the program be accessible to target population (i. e. location, transpor7Enrolled hours of operation) ? Valued Visits is open in the evenings and on weekends, ensuring accessibility to worki families . The program office is located on a major thoroughfare in South Vero Beach. families provide their own transportation, 7 Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 ORGANIZATION : Exchange Club CASTLE PROGRAM . Valued Visits TABLE OF CONTENTS Please `X" the parts of the grant application to indicate they are included. Also, please put the page number where the information can be located. X Section of the Proposal Pa e # X TABLE OF CONTENTS (Check list) . . . . . . . 1 X COVER PAGE (with signatures) , 3 A. ORGANIZATION CAPABILITY (one page maximum) X 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . 4 X 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . 4 Be PROGRAM NEED STATEMENT (one page maximum) X 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 2 . Programs that address need and gaps in service . . . . . . . . . . C. PROGRAM DESCRIPTION (two pages maximum) X 1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X 2 . Description of program activities . . . . . . . . go@. . . . . . . . . . . . . . . . . . . . 0 all , 6 X 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . 6 X 4. Staffmg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . 7 X 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 X 6. Accessibility of program . . . . . . . . . X D. MEASURABLE OUTCOMES (two pages maximum) , , , , 8 X E . COLLABORATION (one page maximum) . . . . . . . . . . . . . g F. PROGRAM EVALUATION (two pages maximum) X 1 . Demographics . . . . . . 1 . 1 . . . . . . . . . . . . X2 . Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 X 3 . Reporting , , , , . , , , , " , 110 , 0010 . 1 I I I I I I 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 a 6 . a a 0 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 0 10 G. TIMETABLE . . . . . I . . . . . . . . . . . . . . 11 H. UNDUPLICATED CLIENT COUNT X 1 . Projections by Location12 X 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1 Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 I. BUDGET FORMS . . . . . . . . . 99004 000 ego 0 * 8 0 0 0 see * so as * be * see * 13 J. APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2 organization : Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) 7successful, UTCOMES ACTIVITIES elements or the Measurable Outcomes Ft:hetasks to accomplish the Outcome(s) e that visits occurring at Valued Visitsrovide each adult participant in the ssful, in that the visit will not be program with orientation training prior to the d for a rules violation (i . e. abuse, first visit, and monitor each adult participant at ate touch, spousal alienation, etc . ) all times during the scheduled visit. f the visits occurring at the program, ed by case notes, and significant event reports . Baseline >99% . 2 . Ensure the learning of parenting skills in 2 . Non-residential parents will be offered non-residential parents for 90% of enrolled parenting education classes while on site at parents, as measured by competency based Valued Visits . After each class, the parent questions (a post test) after each parenting will be given questions to answer that deal class session, during enrollment in Valued directly with that session ' s topic. The Visits . Baseline : 100% . parenting instructor will review all questions answered incorrectly with the enrolled parents, until competency is achieved. 3 . 95 % of custodial parents will express 3 . Administer a satisfaction survey to satisfaction with the program services as custodial parents . The survey will emphasize measured by the results of a satisfaction survey enrollment procedures, safety, and changes in given prior to the end of services . Baseline: their child ' s behavior as a result of attending 98 % ' Valued Visits , 4. Maintain at 20% the number of families 4. Interviews, in person or by phone, will be who receive follow-up contact to ensure that conducted regarding the success of any any service linkages provided were successful, linkages with other services made by visitation as measured by a follow up survey delivered center staff. within 90 days of the service linkage. Baseline 20%. 8 Organization: Exchange Club CASTLE • Program; Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 E . COLLABORATION (Entire Section E not to exceed one age) 1 . List your program ' s collaborative partners and the resources 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 Junior League of Indian River Core funding for the program ; assistance in securing foundation funding; volunteers for the program; serve on advisory board. Indian River County Sheriff' s Provide security to Valued Visits during all operating De artment hours . 50% of services will be donated. Department of Children and Families Cooperation on dependency cases ; access to caseworkers; sharingof information. 19 Judicial Circuit Use of Valued Visits for court ordered supervised visitation; support of program; conduct quarterly ro am oversi t meetin s . Children ' s Home Society Share information on client progress to help caseworkers determine com liance with case lans . Family Preservation Services Share information on client progress to help caseworkers determine compliance with case plans . 9 organization : Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) F e the mission statement and vision of your organization . n of the Exchange Club CASTLE is to improve the quality of family life while 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. F2. 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: Valued Visits 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 contact between a parent and child that puts the child at risk. The child is at risk for abuse, at risk of witnessing domestic violence between parents, and at risk of being used in a manipulative manner by estranged parents . Following Florida law, visitation rights are often ordered between a parent and child, even if the parent poses a risk to that child, or has hurt that child in the past. It is unacceptable that these visits take place in the community, without supervision, placing the child, the ex-spouse, and the general community in jeopardy. Who : Children who are at risk of abuse, or are from homes where domestic violence is present. Where : Last year, parents were served in all parts of Indian River County Provide Data : In Indian River County, in 2002-2003 , there were 121 children who came under the supervision . of the Department of Children and Families . There were a total of 479 domestic violence crimes . There were 1 , 039 abuse reports . These children are eligible for Valued Visits, should visiting a parent pose a risk. (FDLE crime reports, DCF abuse hotline statistics) . r r2. 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. There are no other supervised visitation centers in Indian River County. Before Valued Visits opened, supervised visits occurred in the offices of Department of Children and Family caseworkers, the homes of relatives, at fast food restaurants, or in police station lobbies . Visits in these locations were often poorly supervised, and inadequately secure. Research shows that the majority of visits scheduled under these conditions were cancelled and did not occur as scheduled, which does not allow the parent/child relationship to mend. 5 Organization: Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) F GRAPHICS : What information (data elements) will you need to collect in order rately describe your target population including demographics (age, gender and background) required by the funder in Section H? What are the pieces of ation that qualify them for your target population ? How do you document their need for services or their "unacceptable condition requiring change" from Section 1119 Age, gender, ethnicity, marital status, and address are collected upon intake . Eligibility for the program requires that a judge has deemed that contact between a child and a non-residential parent poses a risk of harm to that child. Intake and eligibility are further assessed during the intake and orientation sessions required by Valued Visits . 7skin URES : What data elements will you need to collect to show that you have ed (or made progress toward) your Measurable Outcomes in Section D ? What r items are you using as measures (grades, survey scores , attendance, absences, vels) 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 (successful visits) is measured by visit monitor notes and significant event reports which track the number of visits terminated for a rules violation. Visit monitor notes are reviewed weekly; significant events are reviewed immediately, and again quarterly at the Risk Management committee meeting. Outcome 2 (learning parenting skills) is measured with competency-based tests (post-tests) given after each parenting class . Participants must get all answers correct, or remediation is done by the group facilitator. Tests are collected after every parenting class . Outcome 3 (satisfaction survey) is measured with a survey that is administered prior to the case closing. Results are collated quarterly and reported to the Service Delivery committee. Outcome 4 follow-u contact is performed with families who have been give a service linkage contact. Contact is made by phone if the family is no longer enrolled in the program, and in person, if the family is still enrolled. Results are tabulated quarterly, and reported to the Service Delivery committee. 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 reported to funders on a regular basis , through monthly, quarterly or semi-annual reports . Staff, board members, employees and other stakeholders are made aware of results through the CASTLE Continuous Quality Improvement process, and feedback at all-team and Board meetings . Recommendations for program improvement are developed through this CQI process . The community is made aware of results through an annual report. 10 Organization: Exchange Club CASTLE Program: Valued Visits 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 Nor sections. Month/Period Activities October 1 , 2005 Valued Visits 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 . A court order for supervised visitation is received by fax or mail . 2 . Families have 10 days to contact the CASTLE . 3 . Once contact is made, an orientation is scheduled for both the residential and non-residential parent (orientations are scheduled at different times and days for each parent) . 4 . Visits are commenced as recommended by the court . 5 . Visits continue until the court ends or changes the court order, or until a family is terminated for rules violations . 6 . Parents are offered parenting education classes prior to and after visits . 7. Parents needing additional services are referred to these services . 8 . Follow-up is done with parents who have been referred to ensure the success of the referral . 11 Organization : Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages) EFocus st Priority Needs area addressed. Area 11 : Parental Support and Education 2. Briefly describe program activities including location of services. The purpose of Valued Visits is to provide a location for visiting parents to meet with their children in a safe, supervised manner. The participants in the program are referred by the courts due to contentious divorces or domestic violence, or by the Department of Children and Families because of the risk of child abuse or neglect . All referred families are screened for the appropriateness of Valued Visits, and given a date for a program orientation. Both parents and/or caretakers must complete orientation. Following successful completion of orientation, families are given a visitation schedule . The hour and date agreed upon for the family will be consistent on a weekly basis, until such time as visits are no longer needed. The visits occur in a recreation room type setting, to enhance the programs attractiveness to children, and to ensure a comfortable setting that encourages a positive, interactive visit. Age appropriate games and activities are provided for children from ages 0- 18 . Valued Visits is open for visits on Thursday and Friday evenings from 5 : 30 to 8 : 30pm, on Saturdays, from 8 : 30 to 1 : 30pm, and on Sunday from 2 : 00pm to 6 : OOpm each week. We are fortunate to have volunteers (Junior League members) to help monitor visits . The volunteers augment paid staff, and allow the program to increase its capacity. This year we will expand by offering a weekday afternoon session of visits . The services offered at Valued Visits include : Monitored Exchange — Supervised exchange of children between the residential and non- residential parent . Supervised Visitation — Supervised visits between a non-residential parent and a child. The visit is observed at all times by a monitor. The visit occurs on- site, at Valued Visits, and follows strict guidelines as to what can be said and done during the visit. Unless rules are violated, the monitor does not interact with the parent or child. Therapeutic Supervision — Supervised visits between the non-residential parent and a child. In this case, the visit monitor is a licensed mental health counselor, and takes an active role in the visit, working with the parent and child to improve the relationship . Parenting Classes — Non-residential parents are offered parent education classes before and after each visit. Services are provided at the CASTLE office at 1275 Old Dixie Highway, Vero Beach, F describe how your program intends to address the stated need/problem. e how your program follows a recognized " best practice" (see definition on page e instructions) and provide evidence that indicates proposed strategies are e with target population . The stated need or problem is unsupervised visits or contact between a child and a parent that puts that child at risk. Valued Visits addresses this need by offering a safe, enriched setting in which to supervise this contact. Valued Visits also fosters boundary and limit setting, holds parents accountable for their behavior, and enrolls non-residential parents in a parenting education class . In some cases, therapeutic intervention is offered when ordered by the court. 6 Organization: Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 The policies and procedures of Valued Visits follow the guidelines recommended by the Florida Clearinghouse on Supervised Visitation the Florida Supreme Court Standards for Supervised Visitation progTams and the "Recommendations from the National Council of Juvenile and Family Court Judges , " ensuring that Valued Visits utilizes both state and national standards for best practices . Evidence that supervised visitation works comes from both in-house statistics (there have been no instances of abuse, or witnessing of domestic violence by a child since the programs inception, during visits by families) and external statistics (" Supervised Visitation Beneficial for Young Children, " U. S . Dept. of Health and Human Services ; July, 2004) : • Only 17% of families using supervised visitation centers missed their appointments, compared with 71 % of families who use Department of Children and Families caseworkers to supervise visits . • Families using visitation centers were likely to have 10 or more visits, about 3 times more than if caseworkers supervised visits . • 50% of children who had regular family visits were in foster care for less than one year, while only 10% of children who had infrequent visits were in foster care for less than one year. • Children who use visitation centers have their court cases resolved sooner than children who use caseworkers to supervise family visits . 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (This section should conform with the information in the Position Listing on the Budget Narrative Worksheet). One program manager 17 hrs . - Required credentials/experience : BA/5 years 5 P/T visit monitors (includes site sup .) ( 100% of time) Required credentials/experience : High School/ 1 yr. Secretary 17 hrs . - Required credentials/experience : High School/ 1 yr. One /lead monitor - 13 hrs . - Required credentials/experience : High School/2yrs . 16 Volunteers 100% of time) Required credentials/experience : High School/ 1 [All . How will the target population be made aware of the program ? families using Valued Visits are court ordered to do so . Families are made aware of the ogram through the judge presiding at their court appearance, or in dependency cases, through eir DCF caseworker. This year we have added a court liaison to assist families and explain supervised visitation during and after court hearings . Program enrollment begins when a family provides a copy of the court order to the CASTLE . 6. How will the program be accessible to target population (i. e. location, transpor7Enrolled hours of operation) ? Valued Visits is open in the evenings and on weekends, ensuring accessibility to worki families . The program office is located on a major thoroughfare in South Vero Beach. families provide their own transportation, 7 ' • 1 11 ' 1 11 1 1 11 1 11 1177 1 7 e ` ' �_ x6} o z s � . Location tV Budget 2004/05 LAM 11 • 1 1 II 1 1 1 11 1 1 1 / • • , • • 1 r,=1 • 1 1 1 WMIN • 1 1 • ' • • Hobe Sound III[IINIII . 1 IDIWOMI Martin County Total ,' Fort Pierce Port Saint St. Lucie Co. Total : OtherLocations ff$T AM IY 1Isca ea �' x1 , ` ^�.. ��, l Budget 1 I ' I `I rt :; . .�..�- aa ':.. , .. . .. � . . . , �k� . :u ! sem±. 4 �. � F „ `• Exdwge Cub CASTLE value visits 2005 - 2006 UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each rine item of the budget for your program. From this worksheet, your figures will be rinked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Exchange Club CASTLE / Value Visits FUNDER: Children Services Advisory Council - Indian River County CAUTION : Do not enter any rigures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should be used for providing information and calculations only. • Total A nc REVM1 ; Proposed Total Program Budget Funder Speciric Budget Budget 1 Children's Services CouncilSt. Lucie 202 500 00 2 Children's Services Council-Martin 167,483. Oq 3 Advisory Committee-Indian River 15,000.00 15,000. 00 60,000.00 4 United WaySt. Lucie County 652000.00 5 United Way-Martin County 40 00000 6 United Way-Indian River County 3010DO.001 126 00000 7 United for Families 51032.23 423,668.50 8 County Funds 9 Contributions-Cash 13,960.34 100,000.00 10 Program Fees 8,000 00 73t780.00 11 Fund Raising Events-Net 11150000 1629000.00 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 101000.00 15 Miscellaneous 5 00000 16 Legacies & Bequests 17 Funds from Other Sources 86,875.28 372,570.77 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not included in total) 20 TOTAL REVENUES doesn't include Zine 19 $ 170, 367.85 $ 159000.00 $1 , 808, 002.271 ETotal AProposed BCTotal Program BudgetFunder Specific Budget Total AgencyBud et 21complete chart on next page) 89, 930. 87 11 , 689. 00 868,042. 12 22ries x 0.0765 6, 879.71 894.21 65,351 .44 Annualpension Tor qua i 23 staff 21960. 88 0. 00 417000.00 I ea - i erm 24 Disab. Workers Compensation - employees x 4,076.83 400.00 55,511 .93 25 rate 11613. 19 168.00 13, 723. 21 Florida Unemployment - a projec 26 employees x $7,000 x UCT-6 rate 573. 25 0. 00 51000. 00 5/162005 13 organization : Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) 7successful, UTCOMES ACTIVITIES elements or the Measurable Outcomes Ft:hetasks to accomplish the Outcome(s) e that visits occurring at Valued Visitsrovide each adult participant in the ssful, in that the visit will not be program with orientation training prior to the d for a rules violation (i . e. abuse, first visit, and monitor each adult participant at ate touch, spousal alienation, etc . ) all times during the scheduled visit. f the visits occurring at the program, ed by case notes, and significant event reports . Baseline >99% . 2 . Ensure the learning of parenting skills in 2 . Non-residential parents will be offered non-residential parents for 90% of enrolled parenting education classes while on site at parents, as measured by competency based Valued Visits . After each class, the parent questions (a post test) after each parenting will be given questions to answer that deal class session, during enrollment in Valued directly with that session ' s topic. The Visits . Baseline : 100% . parenting instructor will review all questions answered incorrectly with the enrolled parents, until competency is achieved. 3 . 95 % of custodial parents will express 3 . Administer a satisfaction survey to satisfaction with the program services as custodial parents . The survey will emphasize measured by the results of a satisfaction survey enrollment procedures, safety, and changes in given prior to the end of services . Baseline: their child ' s behavior as a result of attending 98 % ' Valued Visits , 4. Maintain at 20% the number of families 4. Interviews, in person or by phone, will be who receive follow-up contact to ensure that conducted regarding the success of any any service linkages provided were successful, linkages with other services made by visitation as measured by a follow up survey delivered center staff. within 90 days of the service linkage. Baseline 20%. 8 Organization: Exchange Club CASTLE • Program; Valued Visits Funder: Children's Services Advisory Committee RFP# 7052 E . COLLABORATION (Entire Section E not to exceed one age) 1 . List your program ' s collaborative partners and the resources 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 Junior League of Indian River Core funding for the program ; assistance in securing foundation funding; volunteers for the program; serve on advisory board. Indian River County Sheriff' s Provide security to Valued Visits during all operating De artment hours . 50% of services will be donated. Department of Children and Families Cooperation on dependency cases ; access to caseworkers; sharingof information. 19 Judicial Circuit Use of Valued Visits for court ordered supervised visitation; support of program; conduct quarterly ro am oversi t meetin s . Children ' s Home Society Share information on client progress to help caseworkers determine com liance with case lans . Family Preservation Services Share information on client progress to help caseworkers determine compliance with case plans . 9 Exchange Ckb CASTLE vakre YiSKS SALARIES r Gross IV POSITION LISTING Annual Salary H Portion 111 Funder % of Gross Annual 1 1, 1 o' - Title / Total Hts/wk (Agency) of Salary on Proposed Program Speciffc Budget Salary Requested(OA) Owi pie: Exe"Wve Dkft%Mr140 drs 70,000.00 10,000 00 5S000.00 7.14% Secretary, Madden 252880.40 2, 003.53 0.00 0.00% Receptionist, Lewis 23,499.84 21239.90 0.00 0. 00% Human Resources, Cleveland 32,912.88 21768.94 0.00 0. 00% Receptionist, Prince 21 ,840.00 41669. 68 2,500.00 11 . 45% Director Development 31 ,500. 00 21520.00 0.001 0. 00% Comm. Relations Coord. 311500.00 19772.09 0.001 0. 00% Program Manager, Huttman 38, 241 . 84 16,670.00 9s189.001 24. 03% Program AssUlLead Monitor, Hooks 28,370. 16 91216.85 0.001 0. 00% Supervisor, Foster 91984.00 91685.66 0.001 0.00% Monitor, Woodside 81112.00 81092.94 0.001 0. 00% Monitor, Pena 9,984.001 9,952.34 0.001 0. 00% Monitor, Owens 31132.90 91980.54 0.001 0.00% Court Liason 12,480.001 41118.40 0.001 0. 00°k Monitor, TooGn 61240.00 61240.000.00 0. 000/0 Remaining positions throughout the agency 584,364. 10 #DIV/0! Total Salaries $868, 042. 121 $89,930. 87 1 $111689.00 1 . 35% FRINGE BENEFITS DETAIL? (Funder Specific Budget r Funder r► ar Penstun ►v V W W1 Specific Budget F7CR 7.65% A x % worker's Unemployme Total Fr►n es Funder (aDlumn C only, front line 22 to 27) ( ) Health Ins Compens. ,. nt Compens, Spec►ric 1Pbsillorr Title t Total Hrslwk t xarriptc C seAtaniyer/4Dhrs 5,000.00 ' , 38ZW 200M 500.00 300.00 20000 f,Suez Secretary, Madden 0.001 0,00 0 .001 Receptionist, Lewis 0,00 0.00 0.001 Human Resources, Cleveland 0.00 0.00 0.001 Receptionist, Prince 2 ,500.00 191 .25 200.00 68.00 459.2 51 Director Development 0.00 0.00 0.001 Comm. Relations Coord. 0.00 0.00 0.001 Program Manager, Huttman 91189.00 702.96 200.00 100,00 11002 .961 Program Asstlead Monitor, Hooks 0.00 0.00 0.001 Supervisor, Foster 0.00 0.00 0.001 Monitor, Woodside 0.00 0.00 0.001 Monitor, Pena 0,00 0.0010 Monitor, Owens 0,00 000 0 Court Liason 0,00 000 0 Monitor, Toolin 0,00 0.00 0 "TotalFunder 0.00 0.00 0. Request Fringe Benefits $11 ,689.001 $894.211 $0.001 $400. 001 $168.001 $0.001 $1 ,462.21 5/162005 14 Exdmnge Ck>b CASTLE Vakie Visits EXPENDITURES '4 Proposed B C Totaf Program Budget Funder Specific Budget Total Agency Budget 27 Travel-Daily 886.23 34,384. 64 # of Staff x average # of miles/wk x 50 wks x $ = Estimated Daily TraveVMileage Reimb. 50 miles per week @ $.34 per mile 28 Travel/Conferences/Training 31 &93.381 22, 000.00 • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, registration, food) Conferences & training for employees_ Includes travel and meals 29 Office Supplies 2F456. 131 22, 500.00 Office supplies (monthly average x 12 months = estimated cost of office supplies based on present history. $204 per month, copy paper, pens. pencils, paper clips, etc_ 30 Telephone 21567. 16 31 , 692.00 # Phone lines x average cost per month x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance $214 per month, includes cell phone, land One, intemet 31 Postage/Shipping 721 .40112,440. 00 • Quarterly Mailing of Newsletter • Special events, etc. • Bulk mailings - appeals $60 per month for quarterlynewsletter mailing, general mailing, and special events mailing,. etc_ 32 Utilities 11027.28 22 920.00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) $85 per month for water and electricity 33 Occupancy (Building & Grounds) 161170. 46 11200.00 101 , 693.58 • MortgagelRent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes I $1340 per month, rent,"cleaning, pest control; security systems, ground malintenance, ebL 34 Printing & Publications 21803.20 32,640.00 Quarterly Newsletter ($ x 4) Letterheads, Envelopes, etc. Fundraising materials Other Quarterly newsletters, letterhead, emrelopes, special events materials, etc 35 Subscription/Dues/Memberships 228. 001 41000.00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. Memberships, dues, subscriptions to magazines and organitiaons, etc. 36 Insurance 11092.32 100.00 19, 000.00 • Directors/Officers Liab. • Commercial/General insurance Bond Ins. Auto Insurance Directors insurance, general Wbility, auto, prof rrabirity, etc. 37 Equipment:Rental & Maintenance 996. 721 17 810.00 • Copier lease ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) • Computer Maintenance ( $ x 12 months) • Other $83 per month, copier lease, meter lease, computer maintenace, copier maintenance, etc. 38 Advertising f— 1 ,040.52 10,000. 00 Newspaper ads Fundraising adalpromotions Other (vacancies) Help wanted ads, Fundraisin and g promotions ads, etc. 39 Equipment Purchases:Capital Expense 34, 250. 00 Computerlmonitor (# x $) Laser Printer 40 Professional Fees (Legal, Consulting) 1417751 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 33424 67102oub 15 Organization: Exchange Club CASTLE Program: Valued Visits Funder: Children 's Services Advisory Committee RFP# 7052 F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) F GRAPHICS : What information (data elements) will you need to collect in order rately describe your target population including demographics (age, gender and background) required by the funder in Section H? What are the pieces of ation that qualify them for your target population ? How do you document their need for services or their "unacceptable condition requiring change" from Section 1119 Age, gender, ethnicity, marital status, and address are collected upon intake . Eligibility for the program requires that a judge has deemed that contact between a child and a non-residential parent poses a risk of harm to that child. Intake and eligibility are further assessed during the intake and orientation sessions required by Valued Visits . 7skin URES : What data elements will you need to collect to show that you have ed (or made progress toward) your Measurable Outcomes in Section D ? What r items are you using as measures (grades, survey scores , attendance, absences, vels) 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 (successful visits) is measured by visit monitor notes and significant event reports which track the number of visits terminated for a rules violation. Visit monitor notes are reviewed weekly; significant events are reviewed immediately, and again quarterly at the Risk Management committee meeting. Outcome 2 (learning parenting skills) is measured with competency-based tests (post-tests) given after each parenting class . Participants must get all answers correct, or remediation is done by the group facilitator. Tests are collected after every parenting class . Outcome 3 (satisfaction survey) is measured with a survey that is administered prior to the case closing. Results are collated quarterly and reported to the Service Delivery committee. Outcome 4 follow-u contact is performed with families who have been give a service linkage contact. Contact is made by phone if the family is no longer enrolled in the program, and in person, if the family is still enrolled. Results are tabulated quarterly, and reported to the Service Delivery committee. 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 reported to funders on a regular basis , through monthly, quarterly or semi-annual reports . Staff, board members, employees and other stakeholders are made aware of results through the CASTLE Continuous Quality Improvement process, and feedback at all-team and Board meetings . Recommendations for program improvement are developed through this CQI process . The community is made aware of results through an annual report. 10 Organization: Exchange Club CASTLE Program: Valued Visits 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 Nor sections. Month/Period Activities October 1 , 2005 Valued Visits 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 . A court order for supervised visitation is received by fax or mail . 2 . Families have 10 days to contact the CASTLE . 3 . Once contact is made, an orientation is scheduled for both the residential and non-residential parent (orientations are scheduled at different times and days for each parent) . 4 . Visits are commenced as recommended by the court . 5 . Visits continue until the court ends or changes the court order, or until a family is terminated for rules violations . 6 . Parents are offered parenting education classes prior to and after visits . 7. Parents needing additional services are referred to these services . 8 . Follow-up is done with parents who have been referred to ensure the success of the referral . 11 Exchange Ckb CASTLE value VMS 41 Books/Educational Materials - - - - 670. 401 2W.001 33,424.40 • Books/videos • Materials ($ x staff) Update books and materials for staff and clients $83Jmonth 42 Food & Nutrition • Meals ( # meals x clients x 5days x 50 wks) • Snacks 43 Administrative Costs 149064.23 194, 257.79 Admin. Cost (% of total budget) 44 Audit Expense 1934225 348. 791 5,500.00 Independent Audit Review Annual independent audit 45 Specific Assistance to Individuals 950. 14 10,010.00 • Medical assistance • Meals/Food Rent Assistance Other Rent assistance, utility assistance, etc 46 Other/Miscellaneous 515.431 89576. 16 • Background check/drug test • Other Bcw-4r ound/drug checks 47 Other/Contract 12,947.871 1271500.00 Sub-contract for program services Development and marketing contracts, security guards, etc 40 TOTAL EXPENSES $ 170,367. 85 $ 15,000. 00 $ 1 ,8081002.27 5/162005 16 UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME: EXCHANGE CLUB CASTLE / SAFE FAMILIES FY 03104 FY 04105 FY 05106 % INCREASE FYE 9130104 FYE 9130105 FYE 9130/06 CURRENT VS. NEXT FY BUDGET A B C D REVENUES ACTUAL TOTAL PROPOSED (col. Coot SycoL 6 BUDGETED BUDGETED 1 Children's Services CouncilSt Lucie 143598.47 1 U34550.001 202 500.00 10.26°� 2 Children's Services Council-Martin 132682.041 138 298.00 167 483.00 21 ,10°� 3 Adviso Committee-Indian River 48113.48 45.000.001 60 000.00 33.33°h 4 United Wa St Lucie County55,500.01 57,000.00 65 000.00 14.04° 5 United Wa -Martin Coun 34 855.50 1 441 Alit nol 409000.001 27,32% 6 United Way-Indian River Countv 97T250.011 101 ,000.00 126,000.00 7 United For Families 24.75% 360,268.281 354.021 .001 423.968.601 19.67% s Coun Funds 9 Contributions-Cash J 0.001 #DIV/0! 1Fees 169,042.58 50 000.00 100 000.00 100.00 111 sing ram 45174.79 73 780.00 73 780.00 0.00% Fund RaiEvents-Net 609794.13 162 000.00 162 000.001 0.00°� 12 Sates to public-Net 13 Membershi Dues n 001 #DIV/O! 14 Investment Income 0.001 #DIV/O► 41511 .861 10 000.00 15 10 000.00 0.00°k Miscellaneous 4 812.86 5 000.00 5 000.00 16 L acies 8 uests 0.00% 17 Funds from Other Sources 0.001 #DIV/O! 1s Funds Used for Operating 61858".101 397,713.98 372 570.77 -6.32% Reserve 19 In-IGndDonations (mat kwkdedintot* 01001 #DIV/0! 20 TOTAL 0 00 #DIV/Ol 1,775,44821 1 608 878 98 19808oOO2.271 12.38° 21 Salaries 22 FICA 1 088 710.42 940 776.00 868 042.12 -7.73%23 Reti81 006.67 73 596.37 ° rement 65 351 .44 -1120 � 24 Life/Health 40 865.00 29,000.00 41 000.00 41 ,38% 55 813.36 39 962.73 ° 25 Workers Com nation 55 511 .93 38.91 /e 9A06.601 l3e396.651 13 723.21 2.44"/e 26 Florida Unemplovment 4,629.741 5,000.00 e 27 Travel-Dai! 5 000.00 0.00 h 38.232.641 28o432.001 34v384.641 20.94% 28 TravellConferences[Trainina 21 651 .07 20,294.00 22 000.00 29 Office Su ies 8.41 % 32114 57 20 946.32 22 500.00 7.42% 30 Tele hone 267795.40 22 775. e 31 Posta elShi in 00 31 692.00 39.15 ,6 66830.06 87474,001 12 440.00 46.80% 3 Utilities 17,115.60 17,060.00 � Occu n Buildin 8: Grounds 22 920.00 34.35% 1 71549.81 95,036.83 101 .693-581 7,00% 34 Printin & Publications 22 342.66 250100.00 ° 35 Subscri tionJDues/Membershi s 32640.00 30.04 %° 2 929.63 3,500.00 4,000.001 14.29% 36 Insurance 18 367.17 14 650.00 ° 37 E ut ment Rental >I< Maintenance 19 000.00 29.69 9,102.14 17 310.00 17 810.00 2.89% 38 Advertisin 4619.93 7 312.00 ° 39 E ul mentPurchases:Ca italEx se 10,000.00 36. 19567.75 30536.92 34 250.00 12.11 6 % 6% 40 Professional Fees L al Consultin 2400.00 18,800.00 ° 41 Books/Educational Materials 14 775.00 -21 .41 /e 71014.75 31 ,805.00 33 424.40 5.09% Administra 42 Food 8: Nutrition 43 live Costs 0.00 #DIV/01 44 Audit EX se 194 257.79 #DIV/0! 71040.00 55500.001 5,500.001 0.000d 45 S fic Assistance to Individuals 8518.20 6,310.001 46 OthedMiscellaneous 10.010.00158.64% 923.48 73,305.16 8 576.76 $8.30% 47 Other/Contract 105 6.98 60,000.00 48 TOTAL 127 500.00 112.50% - y r T `; 1 702 983 63 1 608 878.98 1 ,808w002.271 12.38% 49 REVENUES OVER/ UNDER EXPENDITURES 72 464.58 0.00 0.00 #DIV/0! 17 ' • 1 11 ' 1 11 1 1 11 1 11 1177 1 7 e ` ' �_ x6} o z s � . Location tV Budget 2004/05 LAM 11 • 1 1 II 1 1 1 11 1 1 1 / • • , • • 1 r,=1 • 1 1 1 WMIN • 1 1 • ' • • Hobe Sound III[IINIII . 1 IDIWOMI Martin County Total ,' Fort Pierce Port Saint St. Lucie Co. Total : OtherLocations ff$T AM IY 1Isca ea �' x1 , ` ^�.. ��, l Budget 1 I ' I `I rt :; . .�..�- aa ':.. , .. . .. � . . . , �k� . :u ! sem±. 4 �. � F „ `• Exdwge Cub CASTLE value visits 2005 - 2006 UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each rine item of the budget for your program. From this worksheet, your figures will be rinked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Exchange Club CASTLE / Value Visits FUNDER: Children Services Advisory Council - Indian River County CAUTION : Do not enter any rigures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should be used for providing information and calculations only. • Total A nc REVM1 ; Proposed Total Program Budget Funder Speciric Budget Budget 1 Children's Services CouncilSt. Lucie 202 500 00 2 Children's Services Council-Martin 167,483. Oq 3 Advisory Committee-Indian River 15,000.00 15,000. 00 60,000.00 4 United WaySt. Lucie County 652000.00 5 United Way-Martin County 40 00000 6 United Way-Indian River County 3010DO.001 126 00000 7 United for Families 51032.23 423,668.50 8 County Funds 9 Contributions-Cash 13,960.34 100,000.00 10 Program Fees 8,000 00 73t780.00 11 Fund Raising Events-Net 11150000 1629000.00 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 101000.00 15 Miscellaneous 5 00000 16 Legacies & Bequests 17 Funds from Other Sources 86,875.28 372,570.77 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not included in total) 20 TOTAL REVENUES doesn't include Zine 19 $ 170, 367.85 $ 159000.00 $1 , 808, 002.271 ETotal AProposed BCTotal Program BudgetFunder Specific Budget Total AgencyBud et 21complete chart on next page) 89, 930. 87 11 , 689. 00 868,042. 12 22ries x 0.0765 6, 879.71 894.21 65,351 .44 Annualpension Tor qua i 23 staff 21960. 88 0. 00 417000.00 I ea - i erm 24 Disab. Workers Compensation - employees x 4,076.83 400.00 55,511 .93 25 rate 11613. 19 168.00 13, 723. 21 Florida Unemployment - a projec 26 employees x $7,000 x UCT-6 rate 573. 25 0. 00 51000. 00 5/162005 13 E am CAME V" Vista 2°05- 200° UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: E=harw Cbjb CASnE I Vakx Msits FY 03104 FY 04105 FY 05106 % INCREASE FYE 9430104 FYE M0105 FYE 9430106 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (COL CKoL Bkc°L B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 #DIV/0! 2 Children's Services Council-Martin 0.00 #DN/0! 3 Advisory Committee-Indian River 13y670.07 15,000.00 15 000.00 0.00% 4 United Wa St Lucie County 0.00 #DN/0! 5 United Way-Martin County0.00 #DN/0! 6 United Way-Indian River County30 000.00 #DN/O! 7 De rtment of Children & Families 51032.23 #DN/O! 8 County Funds 0.00 #DIV/0! 9 Contributions-Cash 30 000.00 1396034 -63A7% 10 Pr ram Fees 21500.00 160000 89000.00 433.33% 11 Fund Raising Events-Net 15105.18 11 500.00 -23.87% 12 Sales to Public-Net 0.00 #DN/0! 13 Membershi Dues 0.00 #DN/O! 14 Investment Income 0.00 #DIV/^! 15 Miscellaneous 0.00 #DN/01 16 L acies & UP.Sts 0.00 #DN/01 17 Funds from Other Sources U1978.48 42L405.00 86 875.28 104.87% 1B Reserve Funds Used for Operating 0.00 #DN/01 1s In-Kind Donations ( latkwkdWinta i) 0.00 #DN/0! 20 TOTAL 51 148.55 104 010.18 170 367.85 63.80% EXPENDITURES 21 Salaries 33 510A3 54 769.00 89 930.87 64.20°h 2z FICA 2563.52 2365.00 61879.71 190.90% 23 Retirement 496.32 11000.00 29960.88 196.09% 24 Life/Health 910.54 19505.00 4 076.83 170.89% 25 Workers Compensation 338.89 495.00 1 ,613.19 225.90% 26 Florida employment I 573.25 #DN/01 27 Travel Daily 64.88 11275.00 886.23 30.49°k 28 TraveUConferences/Training 15.00 17000,00 31863,38 285.34°k 29 Office Su lies 206.17 250.00 2456.13 882.45% 30 Tele a 750.00 600.00 2,567.16 327.86% 31 Posta hipping 27.27 300.00 721 .40 140.47% UbllUes 405.00 600.00 11027.28 71 .21 % 33 Occu an (Building S Grounds 712737.9F6 69000.00 1617046 169.51 % 34 Printing & Publications 103.82 500.00 2y803.20 460.64% 35 Subscri tion/Dues/Membershi s 51 .25 100.00 228.00 128.00% 361nsurance 425.001 1000.00 1092.32 9.23% 37 E ui ntRental & Maintenance 250.00 500.00 996.72 99.34% 38 Advertisin 57OA0 200.00 1 y040,52 420.26% 39 E ui mentPurchases:Ca ital Expense 0.00 0.00 #DN/01 40 Professional Fees al Consulting) 0.00 0.00 #DN/01 41 Books/Educational Materials 200.00 670A0 235.20% 42 Food & Nutrition 0.00 #DIV/O! 43 Administrative Costs 31549.30 12 773.18 14 064.23 10.11 % 4a Audit Ex se 1 ,026.00 19078.00 1 342.25 24.51 % 45 S fic Assistance to Individuals 47.31 150.00 950.14 533.43% 4s Other/Miscellaneous 381 .00 350.00 515.43 47.27°h 47 Other/Contract 4s019.21 17 000.00 129947.87 -23.84% 48 TOTAL 56t985.2 104 010.18 170 367.85 63.80% 49 REVENUES OVER/ UNDER EXPENDITURES 51836.72 0.00 0.00 #DN/01 `.JiN1005 18 Exchange CW CASTLE Value Visits 2005 - 2" UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME , Exchange Club CASTLE / Value Visits FUNDER: Children Services Advisory Cour A B C FY 05/06 FY 05/06 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/cdn l EXPENDITURES 21 Salaries 893930.87 11 689 .00 22 FICA 6 ,879.71 894.21 23 Retirement 2,960.88 0.00 24 Life/Health 4,076.83 400.00 25 Workers Com Compensation 1 ,613. 19 168.00 26 Florida Unemployment 573.25 0.00 27 Travel-Daily886.23 0 .00 28 Travel/Conferences/Training 3,853.38 0.00 . 29 Office Supplies NEEMEN 29456. 13 OWN 0.00% 30 Telephone 29567. 16 0.00 0.00% 31 Postage/Shipping721 .40 0.00 0.00% 32 Utilities NEENEEN 19027.28 0. 00 0.00% 33 Occupancy (Building & Groundsnnnnn 16, 170.46 11200.00 7,42% 34 Printing & Publications 2,803 .20 0.00 0.00% 35 Subscription/Dues/Memberships 228.00 O.00 0.00% 36 Insurance 11092.32 100.00 9. 15% 37 Equipment: Rental & Maintenance 996.72 O.00 0.00% MEN 38 Advertising1 ,040.52 ME 0.00 0.00% 39 Equipment Purchases: Ca ital Expense 0. 00 0.00 #DN/0! 40 Professional Fees (Legal, Consulting ) 0.00 0.00 #DN/01 41 Books/Educational Materials 670.40 200.00 29.83% 42 Food & Nutrition 0.00 0.00 #DN/0 ! 43 Administrative Costs 14,064.23 0. 00 0.00% 44 Audit Expense 11342 .25 348.79 25.990 45 Specific Assistance to Individuals 950. 14 0.00 O.00% 46 Other/Miscellaneous 515.43 0.00 0.00% 47 Other/Contract 129947.87 0.00 0.00% 48 TOTALOn MEMNON $ 170,367.85 $ 159000.00 8, 80% 5/172005 19 Exchange Ckb CASTLE vakre YiSKS SALARIES r Gross IV POSITION LISTING Annual Salary H Portion 111 Funder % of Gross Annual 1 1, 1 o' - Title / Total Hts/wk (Agency) of Salary on Proposed Program Speciffc Budget Salary Requested(OA) Owi pie: Exe"Wve Dkft%Mr140 drs 70,000.00 10,000 00 5S000.00 7.14% Secretary, Madden 252880.40 2, 003.53 0.00 0.00% Receptionist, Lewis 23,499.84 21239.90 0.00 0. 00% Human Resources, Cleveland 32,912.88 21768.94 0.00 0. 00% Receptionist, Prince 21 ,840.00 41669. 68 2,500.00 11 . 45% Director Development 31 ,500. 00 21520.00 0.001 0. 00% Comm. Relations Coord. 311500.00 19772.09 0.001 0. 00% Program Manager, Huttman 38, 241 . 84 16,670.00 9s189.001 24. 03% Program AssUlLead Monitor, Hooks 28,370. 16 91216.85 0.001 0. 00% Supervisor, Foster 91984.00 91685.66 0.001 0.00% Monitor, Woodside 81112.00 81092.94 0.001 0. 00% Monitor, Pena 9,984.001 9,952.34 0.001 0. 00% Monitor, Owens 31132.90 91980.54 0.001 0.00% Court Liason 12,480.001 41118.40 0.001 0. 00°k Monitor, TooGn 61240.00 61240.000.00 0. 000/0 Remaining positions throughout the agency 584,364. 10 #DIV/0! Total Salaries $868, 042. 121 $89,930. 87 1 $111689.00 1 . 35% FRINGE BENEFITS DETAIL? (Funder Specific Budget r Funder r► ar Penstun ►v V W W1 Specific Budget F7CR 7.65% A x % worker's Unemployme Total Fr►n es Funder (aDlumn C only, front line 22 to 27) ( ) Health Ins Compens. ,. nt Compens, Spec►ric 1Pbsillorr Title t Total Hrslwk t xarriptc C seAtaniyer/4Dhrs 5,000.00 ' , 38ZW 200M 500.00 300.00 20000 f,Suez Secretary, Madden 0.001 0,00 0 .001 Receptionist, Lewis 0,00 0.00 0.001 Human Resources, Cleveland 0.00 0.00 0.001 Receptionist, Prince 2 ,500.00 191 .25 200.00 68.00 459.2 51 Director Development 0.00 0.00 0.001 Comm. Relations Coord. 0.00 0.00 0.001 Program Manager, Huttman 91189.00 702.96 200.00 100,00 11002 .961 Program Asstlead Monitor, Hooks 0.00 0.00 0.001 Supervisor, Foster 0.00 0.00 0.001 Monitor, Woodside 0.00 0.00 0.001 Monitor, Pena 0,00 0.0010 Monitor, Owens 0,00 000 0 Court Liason 0,00 000 0 Monitor, Toolin 0,00 0.00 0 "TotalFunder 0.00 0.00 0. Request Fringe Benefits $11 ,689.001 $894.211 $0.001 $400. 001 $168.001 $0.001 $1 ,462.21 5/162005 14 Exdmnge Ck>b CASTLE Vakie Visits EXPENDITURES '4 Proposed B C Totaf Program Budget Funder Specific Budget Total Agency Budget 27 Travel-Daily 886.23 34,384. 64 # of Staff x average # of miles/wk x 50 wks x $ = Estimated Daily TraveVMileage Reimb. 50 miles per week @ $.34 per mile 28 Travel/Conferences/Training 31 &93.381 22, 000.00 • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, registration, food) Conferences & training for employees_ Includes travel and meals 29 Office Supplies 2F456. 131 22, 500.00 Office supplies (monthly average x 12 months = estimated cost of office supplies based on present history. $204 per month, copy paper, pens. pencils, paper clips, etc_ 30 Telephone 21567. 16 31 , 692.00 # Phone lines x average cost per month x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance $214 per month, includes cell phone, land One, intemet 31 Postage/Shipping 721 .40112,440. 00 • Quarterly Mailing of Newsletter • Special events, etc. • Bulk mailings - appeals $60 per month for quarterlynewsletter mailing, general mailing, and special events mailing,. etc_ 32 Utilities 11027.28 22 920.00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) $85 per month for water and electricity 33 Occupancy (Building & Grounds) 161170. 46 11200.00 101 , 693.58 • MortgagelRent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes I $1340 per month, rent,"cleaning, pest control; security systems, ground malintenance, ebL 34 Printing & Publications 21803.20 32,640.00 Quarterly Newsletter ($ x 4) Letterheads, Envelopes, etc. Fundraising materials Other Quarterly newsletters, letterhead, emrelopes, special events materials, etc 35 Subscription/Dues/Memberships 228. 001 41000.00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. Memberships, dues, subscriptions to magazines and organitiaons, etc. 36 Insurance 11092.32 100.00 19, 000.00 • Directors/Officers Liab. • Commercial/General insurance Bond Ins. Auto Insurance Directors insurance, general Wbility, auto, prof rrabirity, etc. 37 Equipment:Rental & Maintenance 996. 721 17 810.00 • Copier lease ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) • Computer Maintenance ( $ x 12 months) • Other $83 per month, copier lease, meter lease, computer maintenace, copier maintenance, etc. 38 Advertising f— 1 ,040.52 10,000. 00 Newspaper ads Fundraising adalpromotions Other (vacancies) Help wanted ads, Fundraisin and g promotions ads, etc. 39 Equipment Purchases:Capital Expense 34, 250. 00 Computerlmonitor (# x $) Laser Printer 40 Professional Fees (Legal, Consulting) 1417751 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 33424 67102oub 15 rCkk C45RE V*R � Mw- 2w UNIFORM GRANT APPLICATION EXPLANATION FOR INCREASES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE I Value Visits FUNDER: Children Services Advisory Council - Indian River County UNE /TE #.fAk' t 5�`3t 3 ''. .s r. Ea L ANAT/ON FOR VARIANCa�.. s , S wz � f{D11/ #aura # ro P Fees I Beck uP frwn taut to calect fees ffDN # rol # Fm-nFm-njft from her Sate Havens, Jtrdor Lea TOTAL 1 rfProgram e rsion, for FY 20042005 Program on, for FY 20042005 R 'wr, far FY 20042005 Lif a far FY 20042005 Wo nation Program eVanslort underbudcleW for FY 20042005 fIDNro ra a raining ac991 Pam wyeryse, for FY 2004-2005 r u tea acftml ERM e3perise, for FY 20042005 ° achesfor FY 20042005 Po a h in acWd for FY 20042005 Util 'es ecWel m dforFY20042005 n (buildina 14 G nds) uWarbudgeted for FY 2004_ Printi 8 Publications achmlunderbudgehad for FY 20042005 SubscriptionfouesWernberphips wderbidgeted for FY 2004-2W5 E nt 1 Maintenance achml ted for FY 20042005 Advertiai acWel for FY 20042005 #DIV/01 Book& ffiducational Materials acWai ted for FY 20042005 NW/01 Xudif se aches for FY 2004-2005 3 c tstance to Individuals I actual program experse, ur4erbudgetadfar FY 20042005 her/M "floneous for FY 20042005 UNIFORM GRANT APPLICATION EXPLANATION FOR INCREASES OF MORE THAN 5% FUNDER HISTORY AGENCYIPROGRAM NAME: Exchange Club CASTLE I Value Visits FUNDER: Children Services Advisory Council - Indian River County EXMAIIL4.17O1Y 1R VARfANCE'� rol ffDIN # 1 ro Nro1 #DNro1 # rol ro #avro #1XVrol #orvrol #DIVro1 #DIVro #aVro! Yn1t005 20 Appendix 21 Exchange Ckb CASTLE value VMS 41 Books/Educational Materials - - - - 670. 401 2W.001 33,424.40 • Books/videos • Materials ($ x staff) Update books and materials for staff and clients $83Jmonth 42 Food & Nutrition • Meals ( # meals x clients x 5days x 50 wks) • Snacks 43 Administrative Costs 149064.23 194, 257.79 Admin. Cost (% of total budget) 44 Audit Expense 1934225 348. 791 5,500.00 Independent Audit Review Annual independent audit 45 Specific Assistance to Individuals 950. 14 10,010.00 • Medical assistance • Meals/Food Rent Assistance Other Rent assistance, utility assistance, etc 46 Other/Miscellaneous 515.431 89576. 16 • Background check/drug test • Other Bcw-4r ound/drug checks 47 Other/Contract 12,947.871 1271500.00 Sub-contract for program services Development and marketing contracts, security guards, etc 40 TOTAL EXPENSES $ 170,367. 85 $ 15,000. 00 $ 1 ,8081002.27 5/162005 16 UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME: EXCHANGE CLUB CASTLE / SAFE FAMILIES FY 03104 FY 04105 FY 05106 % INCREASE FYE 9130104 FYE 9130105 FYE 9130/06 CURRENT VS. NEXT FY BUDGET A B C D REVENUES ACTUAL TOTAL PROPOSED (col. Coot SycoL 6 BUDGETED BUDGETED 1 Children's Services CouncilSt Lucie 143598.47 1 U34550.001 202 500.00 10.26°� 2 Children's Services Council-Martin 132682.041 138 298.00 167 483.00 21 ,10°� 3 Adviso Committee-Indian River 48113.48 45.000.001 60 000.00 33.33°h 4 United Wa St Lucie County55,500.01 57,000.00 65 000.00 14.04° 5 United Wa -Martin Coun 34 855.50 1 441 Alit nol 409000.001 27,32% 6 United Way-Indian River Countv 97T250.011 101 ,000.00 126,000.00 7 United For Families 24.75% 360,268.281 354.021 .001 423.968.601 19.67% s Coun Funds 9 Contributions-Cash J 0.001 #DIV/0! 1Fees 169,042.58 50 000.00 100 000.00 100.00 111 sing ram 45174.79 73 780.00 73 780.00 0.00% Fund RaiEvents-Net 609794.13 162 000.00 162 000.001 0.00°� 12 Sates to public-Net 13 Membershi Dues n 001 #DIV/O! 14 Investment Income 0.001 #DIV/O► 41511 .861 10 000.00 15 10 000.00 0.00°k Miscellaneous 4 812.86 5 000.00 5 000.00 16 L acies 8 uests 0.00% 17 Funds from Other Sources 0.001 #DIV/O! 1s Funds Used for Operating 61858".101 397,713.98 372 570.77 -6.32% Reserve 19 In-IGndDonations (mat kwkdedintot* 01001 #DIV/0! 20 TOTAL 0 00 #DIV/Ol 1,775,44821 1 608 878 98 19808oOO2.271 12.38° 21 Salaries 22 FICA 1 088 710.42 940 776.00 868 042.12 -7.73%23 Reti81 006.67 73 596.37 ° rement 65 351 .44 -1120 � 24 Life/Health 40 865.00 29,000.00 41 000.00 41 ,38% 55 813.36 39 962.73 ° 25 Workers Com nation 55 511 .93 38.91 /e 9A06.601 l3e396.651 13 723.21 2.44"/e 26 Florida Unemplovment 4,629.741 5,000.00 e 27 Travel-Dai! 5 000.00 0.00 h 38.232.641 28o432.001 34v384.641 20.94% 28 TravellConferences[Trainina 21 651 .07 20,294.00 22 000.00 29 Office Su ies 8.41 % 32114 57 20 946.32 22 500.00 7.42% 30 Tele hone 267795.40 22 775. e 31 Posta elShi in 00 31 692.00 39.15 ,6 66830.06 87474,001 12 440.00 46.80% 3 Utilities 17,115.60 17,060.00 � Occu n Buildin 8: Grounds 22 920.00 34.35% 1 71549.81 95,036.83 101 .693-581 7,00% 34 Printin & Publications 22 342.66 250100.00 ° 35 Subscri tionJDues/Membershi s 32640.00 30.04 %° 2 929.63 3,500.00 4,000.001 14.29% 36 Insurance 18 367.17 14 650.00 ° 37 E ut ment Rental >I< Maintenance 19 000.00 29.69 9,102.14 17 310.00 17 810.00 2.89% 38 Advertisin 4619.93 7 312.00 ° 39 E ul mentPurchases:Ca italEx se 10,000.00 36. 19567.75 30536.92 34 250.00 12.11 6 % 6% 40 Professional Fees L al Consultin 2400.00 18,800.00 ° 41 Books/Educational Materials 14 775.00 -21 .41 /e 71014.75 31 ,805.00 33 424.40 5.09% Administra 42 Food 8: Nutrition 43 live Costs 0.00 #DIV/01 44 Audit EX se 194 257.79 #DIV/0! 71040.00 55500.001 5,500.001 0.000d 45 S fic Assistance to Individuals 8518.20 6,310.001 46 OthedMiscellaneous 10.010.00158.64% 923.48 73,305.16 8 576.76 $8.30% 47 Other/Contract 105 6.98 60,000.00 48 TOTAL 127 500.00 112.50% - y r T `; 1 702 983 63 1 608 878.98 1 ,808w002.271 12.38% 49 REVENUES OVER/ UNDER EXPENDITURES 72 464.58 0.00 0.00 #DIV/0! 17 Parental Visitation Monitoring (PH-600 . 650) Page 1 of 1 The AIRS INFO I:,INI* Login Taxonomy of Human Servioes AXRS� Search Print Downio I ad cent Changes Resources Keyword Code Drilidown Related Concept External System Home » Parental Visitation Monitoring (PH-600 .650) Term Parental Visitation Monitoring Code PH - 600 . 650 Definition Programs that provide supervised visitation for people who have been ordered by the court to have their visits with minor children only in the presence of a neutral , responsible person . Also included are programs that link parents with people who are trained to act as monitors , either free of charge or for remuneration . Created 10/ 20/ 04 Changed 3/ 17/05 _ . . ... .. . . ._. . ..... ._ . ._........... .. ......... .......... .. ....... .... ... ...... ... . ...... ... .. . .. _ .. . .. . . . .__.... . . ...... .. ..... ._ . . . . .. _. Use References Monitored Child Visitation Supervised Visitation See Also References External Child Abuse Prevention ( NPC IO2 . 05 . 02 ) Classification Child Abuse Prevention ( NTE I72 ) Terms Related Child Abuse Concepts Children and Youth Copyright © INFO LINE of Los Angeles. All rights reserved. Version 2. 0. 2. Please read our Privacy Policy and Terms of Use . 22 http ://www. 211taxonomy . org/search/record?code=PH%2d600%2e650 5/2/2005 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 - E am CAME V" Vista 2°05- 200° UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: E=harw Cbjb CASnE I Vakx Msits FY 03104 FY 04105 FY 05106 % INCREASE FYE 9430104 FYE M0105 FYE 9430106 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (COL CKoL Bkc°L B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 #DIV/0! 2 Children's Services Council-Martin 0.00 #DN/0! 3 Advisory Committee-Indian River 13y670.07 15,000.00 15 000.00 0.00% 4 United Wa St Lucie County 0.00 #DN/0! 5 United Way-Martin County0.00 #DN/0! 6 United Way-Indian River County30 000.00 #DN/O! 7 De rtment of Children & Families 51032.23 #DN/O! 8 County Funds 0.00 #DIV/0! 9 Contributions-Cash 30 000.00 1396034 -63A7% 10 Pr ram Fees 21500.00 160000 89000.00 433.33% 11 Fund Raising Events-Net 15105.18 11 500.00 -23.87% 12 Sales to Public-Net 0.00 #DN/0! 13 Membershi Dues 0.00 #DN/O! 14 Investment Income 0.00 #DIV/^! 15 Miscellaneous 0.00 #DN/01 16 L acies & UP.Sts 0.00 #DN/01 17 Funds from Other Sources U1978.48 42L405.00 86 875.28 104.87% 1B Reserve Funds Used for Operating 0.00 #DN/01 1s In-Kind Donations ( latkwkdWinta i) 0.00 #DN/0! 20 TOTAL 51 148.55 104 010.18 170 367.85 63.80% EXPENDITURES 21 Salaries 33 510A3 54 769.00 89 930.87 64.20°h 2z FICA 2563.52 2365.00 61879.71 190.90% 23 Retirement 496.32 11000.00 29960.88 196.09% 24 Life/Health 910.54 19505.00 4 076.83 170.89% 25 Workers Compensation 338.89 495.00 1 ,613.19 225.90% 26 Florida employment I 573.25 #DN/01 27 Travel Daily 64.88 11275.00 886.23 30.49°k 28 TraveUConferences/Training 15.00 17000,00 31863,38 285.34°k 29 Office Su lies 206.17 250.00 2456.13 882.45% 30 Tele a 750.00 600.00 2,567.16 327.86% 31 Posta hipping 27.27 300.00 721 .40 140.47% UbllUes 405.00 600.00 11027.28 71 .21 % 33 Occu an (Building S Grounds 712737.9F6 69000.00 1617046 169.51 % 34 Printing & Publications 103.82 500.00 2y803.20 460.64% 35 Subscri tion/Dues/Membershi s 51 .25 100.00 228.00 128.00% 361nsurance 425.001 1000.00 1092.32 9.23% 37 E ui ntRental & Maintenance 250.00 500.00 996.72 99.34% 38 Advertisin 57OA0 200.00 1 y040,52 420.26% 39 E ui mentPurchases:Ca ital Expense 0.00 0.00 #DN/01 40 Professional Fees al Consulting) 0.00 0.00 #DN/01 41 Books/Educational Materials 200.00 670A0 235.20% 42 Food & Nutrition 0.00 #DIV/O! 43 Administrative Costs 31549.30 12 773.18 14 064.23 10.11 % 4a Audit Ex se 1 ,026.00 19078.00 1 342.25 24.51 % 45 S fic Assistance to Individuals 47.31 150.00 950.14 533.43% 4s Other/Miscellaneous 381 .00 350.00 515.43 47.27°h 47 Other/Contract 4s019.21 17 000.00 129947.87 -23.84% 48 TOTAL 56t985.2 104 010.18 170 367.85 63.80% 49 REVENUES OVER/ UNDER EXPENDITURES 51836.72 0.00 0.00 #DN/01 `.JiN1005 18 Exchange CW CASTLE Value Visits 2005 - 2" UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME , Exchange Club CASTLE / Value Visits FUNDER: Children Services Advisory Cour A B C FY 05/06 FY 05/06 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/cdn l EXPENDITURES 21 Salaries 893930.87 11 689 .00 22 FICA 6 ,879.71 894.21 23 Retirement 2,960.88 0.00 24 Life/Health 4,076.83 400.00 25 Workers Com Compensation 1 ,613. 19 168.00 26 Florida Unemployment 573.25 0.00 27 Travel-Daily886.23 0 .00 28 Travel/Conferences/Training 3,853.38 0.00 . 29 Office Supplies NEEMEN 29456. 13 OWN 0.00% 30 Telephone 29567. 16 0.00 0.00% 31 Postage/Shipping721 .40 0.00 0.00% 32 Utilities NEENEEN 19027.28 0. 00 0.00% 33 Occupancy (Building & Groundsnnnnn 16, 170.46 11200.00 7,42% 34 Printing & Publications 2,803 .20 0.00 0.00% 35 Subscription/Dues/Memberships 228.00 O.00 0.00% 36 Insurance 11092.32 100.00 9. 15% 37 Equipment: Rental & Maintenance 996.72 O.00 0.00% MEN 38 Advertising1 ,040.52 ME 0.00 0.00% 39 Equipment Purchases: Ca ital Expense 0. 00 0.00 #DN/0! 40 Professional Fees (Legal, Consulting ) 0.00 0.00 #DN/01 41 Books/Educational Materials 670.40 200.00 29.83% 42 Food & Nutrition 0.00 0.00 #DN/0 ! 43 Administrative Costs 14,064.23 0. 00 0.00% 44 Audit Expense 11342 .25 348.79 25.990 45 Specific Assistance to Individuals 950. 14 0.00 O.00% 46 Other/Miscellaneous 515.43 0.00 0.00% 47 Other/Contract 129947.87 0.00 0.00% 48 TOTALOn MEMNON $ 170,367.85 $ 159000.00 8, 80% 5/172005 19 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 1840 251h 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 . Entiret ofA reement . 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 . Ass ' This Contract may not be assigned by the Recipient without the prior written consent of the County. EXHIBIT - C - ACQRD. CERTIFICATE OF LIABILITY tNSURANLtEx KN i 11 / 04 / 05 PROQUCFA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HARHOR Ir,PStTrimcs AGjwCY HOLDER. THIS CERTIFICATE DOE$ NOT AMEND* EXTEND OR 2222 Colonial Road , Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. sort Pierce TL 34950 - 5309 Phone1772 - 4614040 8ax : 772 - 460 - 2315 INSURERS AFFORDING COVERAGE NAIC0 INSURER INSURED A: Philadelphia Indemnit Ina o Thefor acchange Club Ce tar INsURER6: Hartford Ina Co of the Midw st fezz the Prevention o� —, -- •- - Child Abuse DBA "SURER C: ftchange Club C . A . S . T . L . 8 . PO X 12908 INSURER D. rt pierce TL 34979 INSURR ER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPHCTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSION AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NBA TYPE Of INSURANCE POLICY NUMYER DATE MMI DATE M D1YYI LIMITS GENERAL LIABILITY EACH OCCURRENCE 3110001000 Al X X COMMERCIALGENERALLIABILITY PIIPX112827 03 / 26 / 05 I 03 / 26 / 06 PREMISS Eeocwrence $ 200F000 CLAIMS MADE L OCCUR MED EXP (Any one person) S 5 10 00 PERSONAL i ADV INJURY — S 1 00 0 , 0 0 0 GENERAL AGGREGATE S AAO 0 , 000 GEML ACGREGATE LOAT APPLIES PER: PRODUCTS • OOMPIOP AGO 83 00wa 000 LEI qq�Q � POLICY )ppECT LOC 1 I AUTONH30I6E LIABILITY COMSINEO SINGLE LIMIT = ANY AUTO (Ey uadenl) — ~T ALL OWNED AUTOS BODILY INJURY a SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY a NON-OWNED AUTOS (Per ACaaenq PROPERTY DAMAGE S (Por ecsleenr) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT i !� ANY AUTOOTHER T EA ACC a AUTO ONLY TACO i E9CE8SNMORELLALIA1SIUT'Y EAOHOCCURRENCE a_ _ OCCURCLAIMS MADE AO OREGATHa Ell I DEDUCTIBLE _ .. �- RETENTION a lk a WORKERS COMPENSATION AND 7 RY LjM X ER _. EMPLOYERS' "ABILITY 8 210PSD179567 12 / 01 / 04 12 / 01 / 05 E.L. EACH4CCIDENT a 500 , 000 ' ANY PROPRIETOWAARTNER)EXECUTIVE —'— OFFICfRIMEMBER EXCLUDED" E.L. DISEASE . EA EMPLOYEE 5 .500 , 00 0 dyra, dp*V" under I E . L. DISEASE • POLICY LIMIT 1 $ 500P000 9PEGIAL PROVISIONS slow OTHER A Professional Liab . PUPX112827 03 / 26 / 05 03 / 26 / 06 Occurreao $ 1 , 0000000 A Sexual / hy Abuse PKPK112221 03 / 26 / 05 03 / 26 / 061 ASqreqatq $ 2j000 , 000 DESCRIPTION OF OP RAnom I LOCATIONS I VEHIC"A I EXCWSWNS ADDED BY ENBORSEMENT i aPECIAL PROVISIONS * 10 days =mwpayment of premium , Certificate Rolder is named as an Additional Insured for General Liability coverage . CERTIFICATE HOLDER CANCELLATION I=XA - 2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 99 CANCtELLED BEFORE THE EKPRATION DATE THEREOF, TME ISSU;NO INSURER WILL ENDEAVOR TO MAIL 30 * DAYS WRRrEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LE07, BLIP FAILURE TO 00 SO SHALL Indian River County IMPOSR NO OBLIGATION OR "ABILnY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1840 25th Street Vero Beach PL 32960 UTHORIZEDRUME. _ AUTHORISED REPRESENTATI r Czrid McCallae 4 ! 2 ACORD 25 12001/08) Cl Or 0A RD COFkPOR4TION 1988 rCkk C45RE V*R � Mw- 2w UNIFORM GRANT APPLICATION EXPLANATION FOR INCREASES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE I Value Visits FUNDER: Children Services Advisory Council - Indian River County UNE /TE #.fAk' t 5�`3t 3 ''. .s r. Ea L ANAT/ON FOR VARIANCa�.. s , S wz � f{D11/ #aura # ro P Fees I Beck uP frwn taut to calect fees ffDN # rol # Fm-nFm-njft from her Sate Havens, Jtrdor Lea TOTAL 1 rfProgram e rsion, for FY 20042005 Program on, for FY 20042005 R 'wr, far FY 20042005 Lif a far FY 20042005 Wo nation Program eVanslort underbudcleW for FY 20042005 fIDNro ra a raining ac991 Pam wyeryse, for FY 2004-2005 r u tea acftml ERM e3perise, for FY 20042005 ° achesfor FY 20042005 Po a h in acWd for FY 20042005 Util 'es ecWel m dforFY20042005 n (buildina 14 G nds) uWarbudgeted for FY 2004_ Printi 8 Publications achmlunderbudgehad for FY 20042005 SubscriptionfouesWernberphips wderbidgeted for FY 2004-2W5 E nt 1 Maintenance achml ted for FY 20042005 Advertiai acWel for FY 20042005 #DIV/01 Book& ffiducational Materials acWai ted for FY 20042005 NW/01 Xudif se aches for FY 2004-2005 3 c tstance to Individuals I actual program experse, ur4erbudgetadfar FY 20042005 her/M "floneous for FY 20042005 UNIFORM GRANT APPLICATION EXPLANATION FOR INCREASES OF MORE THAN 5% FUNDER HISTORY AGENCYIPROGRAM NAME: Exchange Club CASTLE I Value Visits FUNDER: Children Services Advisory Council - Indian River County EXMAIIL4.17O1Y 1R VARfANCE'� rol ffDIN # 1 ro Nro1 #DNro1 # rol ro #avro #1XVrol #orvrol #DIVro1 #DIVro #aVro! Yn1t005 20 Appendix 21 NUV-04 -2005 11 : 56 P . 02V02 IMPORTANT if the certificate holder is an ADDITIONAL. INSURED , the policy( les) must be endorsed . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsrment(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 Cortificete holder In lieu of such endorsement(s) , DISCLAIMER The Certificate of insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend , extend or after the coverage afforded by the policies listed thereon . The information contained in this transmission is client privileged and conftdendal, or considered confidential under statelfederal statutes or regulations. It is intended only for the use of the individual or entity named above. {f the reader of this message is not the intended recipient, you a re h ereby notified that any dissemination, distribution or copy of this communication is strictly prohibited. If you received this message in error, please immediately notify+ us by the telephone and return the original message to us at our address via the United States Postal Service. 7wank you. WORD :5 (2001108) TOTAL P . 02 a RED j A N 3 12005, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CHANGE IN INFORMATION PAGE INSURER : HARTFORD INSURANCE COMPANY OF THE MIDWEST NCCI Company Number: 2 0 6 05 AUDIT PERIOD * ANNUAL POLICY EFFECTIVE DATE : 12 / 01 / 04 POLICY EXPIRATION DATE : 12 / 01 / 05 r Policy Number: 21 WB DU9567 Endorsement Number: 01 HOUSING CODE : DH r-A 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 r Ln FEIN Number: 592094472 PRO RATA FACTOR : 1 . 000 rn D PRODUCER NAME : HARBOR INSURANCE AGENCY PRODUCER CODE : 220020 A It is agreed that the policy is amended as follows: N C:0 IN CONSIDERATION OF AN ADDITIONAL - PREMIUM OF $ 6 , 948 IT IS AGREED THAT : 0 0 CD 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 : W0000406 Countersigned by r C loe7' Aut orized Representative Form WC 99 00 06 A (1 ) Printed in U .S.A. Pagel ( CONTINUED ON NEXT PAGE ) Process Date: 01 / 26 / 05 Policy Expiration Date: 12 / 01 / 05 ORIGINAL Parental Visitation Monitoring (PH-600 . 650) Page 1 of 1 The AIRS INFO I:,INI* Login Taxonomy of Human Servioes AXRS� Search Print Downio I ad cent Changes Resources Keyword Code Drilidown Related Concept External System Home » Parental Visitation Monitoring (PH-600 .650) Term Parental Visitation Monitoring Code PH - 600 . 650 Definition Programs that provide supervised visitation for people who have been ordered by the court to have their visits with minor children only in the presence of a neutral , responsible person . Also included are programs that link parents with people who are trained to act as monitors , either free of charge or for remuneration . Created 10/ 20/ 04 Changed 3/ 17/05 _ . . ... .. . . ._. . ..... ._ . ._........... .. ......... .......... .. ....... .... ... ...... ... . ...... ... .. . .. _ .. . .. . . . .__.... . . ...... .. ..... ._ . . . . .. _. Use References Monitored Child Visitation Supervised Visitation See Also References External Child Abuse Prevention ( NPC IO2 . 05 . 02 ) Classification Child Abuse Prevention ( NTE I72 ) Terms Related Child Abuse Concepts Children and Youth Copyright © INFO LINE of Los Angeles. All rights reserved. Version 2. 0. 2. Please read our Privacy Policy and Terms of Use . 22 http ://www. 211taxonomy . org/search/record?code=PH%2d600%2e650 5/2/2005 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 - CHANGE IN INFORMATION PAGE (Continued) Policy Number: 21 WB DU9567 r" 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 m ( A ) � 8861 999 , 739 1 . 52 15 , 196 CD CHARITABLE OR WELFARE ORGANIZATION - PROFESSIONAL EMPLOYEES & CLERICAL Ln ALL OTHER STATE CLASS PREMIUM N 2 , 336 O TOTAL CLASS PREMIUM 17 , 532 `D INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT Q% TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 85 A FL - INTRA EXPERIENCE MODIFICATION 091190907 17 . 617 ` 1 * 020 N N PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 NTOTAL ESTIMATED ANNUAL STANDARD PREMIUM 17 , 969 CD PREMIUM DISCOUNT 2 . 5 PERCENT - 449 CD EXPENSE CONSTANT ( 0900 ) 200 TERRORISM RISK INS ACT OF 2002 9740 1 , 376 , 439 . 030 413 TOTAL ESTIMATED ANNUAL PREMIUM - FL 18 , 133 INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT 85 TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 17 , 617 FL - INTRA EXPERIENCE MODIFICATION 091190907 1 . 020 _ PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 TOTAL ESTIMATEDANNUAL 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 Form WC 99 00 06 A (1 ) Printed in U .S.A. Page 2 Process Date : 01 / 2 6 / 0 5 Policy Expiration Date : 12 / 01 / 05 r R G 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 PREVENTION OF CHILD ABUSE DBA rn PO BOX 12908 q FORT PIERCE , FL 34979 o The premium for this policy and the policies, if any, listed in Item 3 of the Schedule may be eligible for a discount. This CD endorsement shows your estimated discount in Item 1 or 2 of the Schedule . The final calculation of premium discount Co 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 $51000 $95,000 $400,000 Balance FL 00 . 0 % 3 . 5 % 5 . 0 % 7 . 0 % Other Policy Numbers: Countersigned by Authorized Representative Form WC 00 04 06 T Printed in U .S.A. Process Date: 01 / 26 / 05 Policy Expiration Date: 12 / 01 / 05 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 1840 251h 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 . Entiret ofA reement . 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 . Ass ' This Contract may not be assigned by the Recipient without the prior written consent of the County. EXHIBIT - C - Child Abuse Services, Training & Life Enrichment October 18 , 2005 Marion Masterson Indian River County Administration Building 184025 1h 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 Address : 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. r ACQRD. CERTIFICATE OF LIABILITY tNSURANLtEx KN i 11 / 04 / 05 PROQUCFA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HARHOR Ir,PStTrimcs AGjwCY HOLDER. THIS CERTIFICATE DOE$ NOT AMEND* EXTEND OR 2222 Colonial Road , Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. sort Pierce TL 34950 - 5309 Phone1772 - 4614040 8ax : 772 - 460 - 2315 INSURERS AFFORDING COVERAGE NAIC0 INSURER INSURED A: Philadelphia Indemnit Ina o Thefor acchange Club Ce tar INsURER6: Hartford Ina Co of the Midw st fezz the Prevention o� —, -- •- - Child Abuse DBA "SURER C: ftchange Club C . A . S . T . L . 8 . PO X 12908 INSURER D. rt pierce TL 34979 INSURR ER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPHCTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSION AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NBA TYPE Of INSURANCE POLICY NUMYER DATE MMI DATE M D1YYI LIMITS GENERAL LIABILITY EACH OCCURRENCE 3110001000 Al X X COMMERCIALGENERALLIABILITY PIIPX112827 03 / 26 / 05 I 03 / 26 / 06 PREMISS Eeocwrence $ 200F000 CLAIMS MADE L OCCUR MED EXP (Any one person) S 5 10 00 PERSONAL i ADV INJURY — S 1 00 0 , 0 0 0 GENERAL AGGREGATE S AAO 0 , 000 GEML ACGREGATE LOAT APPLIES PER: PRODUCTS • OOMPIOP AGO 83 00wa 000 LEI qq�Q � POLICY )ppECT LOC 1 I AUTONH30I6E LIABILITY COMSINEO SINGLE LIMIT = ANY AUTO (Ey uadenl) — ~T ALL OWNED AUTOS BODILY INJURY a SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY a NON-OWNED AUTOS (Per ACaaenq PROPERTY DAMAGE S (Por ecsleenr) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT i !� ANY AUTOOTHER T EA ACC a AUTO ONLY TACO i E9CE8SNMORELLALIA1SIUT'Y EAOHOCCURRENCE a_ _ OCCURCLAIMS MADE AO OREGATHa Ell I DEDUCTIBLE _ .. �- RETENTION a lk a WORKERS COMPENSATION AND 7 RY LjM X ER _. EMPLOYERS' "ABILITY 8 210PSD179567 12 / 01 / 04 12 / 01 / 05 E.L. EACH4CCIDENT a 500 , 000 ' ANY PROPRIETOWAARTNER)EXECUTIVE —'— OFFICfRIMEMBER EXCLUDED" E.L. DISEASE . EA EMPLOYEE 5 .500 , 00 0 dyra, dp*V" under I E . L. DISEASE • POLICY LIMIT 1 $ 500P000 9PEGIAL PROVISIONS slow OTHER A Professional Liab . PUPX112827 03 / 26 / 05 03 / 26 / 06 Occurreao $ 1 , 0000000 A Sexual / hy Abuse PKPK112221 03 / 26 / 05 03 / 26 / 061 ASqreqatq $ 2j000 , 000 DESCRIPTION OF OP RAnom I LOCATIONS I VEHIC"A I EXCWSWNS ADDED BY ENBORSEMENT i aPECIAL PROVISIONS * 10 days =mwpayment of premium , Certificate Rolder is named as an Additional Insured for General Liability coverage . CERTIFICATE HOLDER CANCELLATION I=XA - 2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 99 CANCtELLED BEFORE THE EKPRATION DATE THEREOF, TME ISSU;NO INSURER WILL ENDEAVOR TO MAIL 30 * DAYS WRRrEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LE07, BLIP FAILURE TO 00 SO SHALL Indian River County IMPOSR NO OBLIGATION OR "ABILnY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1840 25th Street Vero Beach PL 32960 UTHORIZEDRUME. _ AUTHORISED REPRESENTATI r Czrid McCallae 4 ! 2 ACORD 25 12001/08) Cl Or 0A RD COFkPOR4TION 1988 NUV-04 -2005 11 : 56 P . 02V02 IMPORTANT if the certificate holder is an ADDITIONAL. INSURED , the policy( les) must be endorsed . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsrment(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 Cortificete holder In lieu of such endorsement(s) , DISCLAIMER The Certificate of insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend , extend or after the coverage afforded by the policies listed thereon . The information contained in this transmission is client privileged and conftdendal, or considered confidential under statelfederal statutes or regulations. It is intended only for the use of the individual or entity named above. {f the reader of this message is not the intended recipient, you a re h ereby notified that any dissemination, distribution or copy of this communication is strictly prohibited. If you received this message in error, please immediately notify+ us by the telephone and return the original message to us at our address via the United States Postal Service. 7wank you. WORD :5 (2001108) TOTAL P . 02 a RED j A N 3 12005, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CHANGE IN INFORMATION PAGE INSURER : HARTFORD INSURANCE COMPANY OF THE MIDWEST NCCI Company Number: 2 0 6 05 AUDIT PERIOD * ANNUAL POLICY EFFECTIVE DATE : 12 / 01 / 04 POLICY EXPIRATION DATE : 12 / 01 / 05 r Policy Number: 21 WB DU9567 Endorsement Number: 01 HOUSING CODE : DH r-A 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 r Ln FEIN Number: 592094472 PRO RATA FACTOR : 1 . 000 rn D PRODUCER NAME : HARBOR INSURANCE AGENCY PRODUCER CODE : 220020 A It is agreed that the policy is amended as follows: N C:0 IN CONSIDERATION OF AN ADDITIONAL - PREMIUM OF $ 6 , 948 IT IS AGREED THAT : 0 0 CD 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 : W0000406 Countersigned by r C loe7' Aut orized Representative Form WC 99 00 06 A (1 ) Printed in U .S.A. Pagel ( CONTINUED ON NEXT PAGE ) Process Date: 01 / 26 / 05 Policy Expiration Date: 12 / 01 / 05 ORIGINAL CHANGE IN INFORMATION PAGE (Continued) Policy Number: 21 WB DU9567 r" 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 m ( A ) � 8861 999 , 739 1 . 52 15 , 196 CD CHARITABLE OR WELFARE ORGANIZATION - PROFESSIONAL EMPLOYEES & CLERICAL Ln ALL OTHER STATE CLASS PREMIUM N 2 , 336 O TOTAL CLASS PREMIUM 17 , 532 `D INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT Q% TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 85 A FL - INTRA EXPERIENCE MODIFICATION 091190907 17 . 617 ` 1 * 020 N N PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 NTOTAL ESTIMATED ANNUAL STANDARD PREMIUM 17 , 969 CD PREMIUM DISCOUNT 2 . 5 PERCENT - 449 CD EXPENSE CONSTANT ( 0900 ) 200 TERRORISM RISK INS ACT OF 2002 9740 1 , 376 , 439 . 030 413 TOTAL ESTIMATED ANNUAL PREMIUM - FL 18 , 133 INCREASED LIMITS PART TWO ( 9807 ) . 80 PERCENT 85 TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 17 , 617 FL - INTRA EXPERIENCE MODIFICATION 091190907 1 . 020 _ PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 17 , 969 TOTAL ESTIMATEDANNUAL 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 Form WC 99 00 06 A (1 ) Printed in U .S.A. Page 2 Process Date : 01 / 2 6 / 0 5 Policy Expiration Date : 12 / 01 / 05 r R G 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 PREVENTION OF CHILD ABUSE DBA rn PO BOX 12908 q FORT PIERCE , FL 34979 o The premium for this policy and the policies, if any, listed in Item 3 of the Schedule may be eligible for a discount. This CD endorsement shows your estimated discount in Item 1 or 2 of the Schedule . The final calculation of premium discount Co 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 $51000 $95,000 $400,000 Balance FL 00 . 0 % 3 . 5 % 5 . 0 % 7 . 0 % Other Policy Numbers: Countersigned by Authorized Representative Form 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 1h 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 Address : 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.