HomeMy WebLinkAbout2005-328d INDIAN RIVER COUNTY
GRANT CONTRACT
This Grant Contract ("Contract" ) entered into effective this day of October 2005 , by and
between Indian River County, a political subdivision of the State of Florida ; 1840 25th Street , Vero
Beach , Florida , 32960-3365 ; and Gifford Youth Activity Center ( Recipient) , of:
Gifford Youth Activity Center
487543 rd Avenue
Vero Beach , Florida 32967
School Age Children Fine Arts 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 .
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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 :
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( 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 .
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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 : /0 — 0 5
Attest : J . K . Barton , Clerk
:
BY
Deputy CI rk
too D4044 , 'Approved .
Josepo Baird
County Administrator
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Marian E . Fel , s ' n ou Att e
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RECIPIENT :
By:
Gifford Youth Activity Center
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EXHIBIT A
(Copy of complete Request for Proposal )
EXHIBIT - A -
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PROPOSAL NARRATIVE
Please respond to each question in the allotted space for each section. In responding to each section of
the proposal narrative, please retain the section-label and/or question that you are addressing . Type
using 12 pt. font on 8 %2" X 11 " paper and number each page . These directions and the graphic boxes
may be deleted if space is needed .
A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page)
1 . Provide the mission statement and vision of your organization .
GYAC Mission Statement is :
With God ' s guidance our vision is to establish a partnership among youth, adults and the
Gifford-Indian River County area that develops self-esteem, teaches character and encourages
each individual to his/her ultimate potential .
GYAC Vision is :
To provide supplemental educational and character enhancing opportunities to children and
families in the Gifford-Indian River Community to enhance their educational and personal
development. In doing so , it is the GYAC ' s charge to enhance our children and families '
educational and professional success .
2 . Provide a brief summary of your organization including areas of expertise,
accomplishments , and population served .
Expertise, accomplishments & population served by GYAC is .
The GYAC was established in 1998 to meet the educational and personal development needs of
the Gifford-Indian River Community through supplemental children ' s education and family
development opportunities . The GYAC has also established a network of programs to enhance
behavioral outcomes of these children. The GYAC employs educational experts and partners
with many organizations to provide these services . The GYAC has utilized the expertise of
partners including : the Indian River County (IRC) School District, the Indian River Community
College, Project Hope, Indian River Library System, the Cultural Counsel, the Vero Beach
Museum of Art, the Riverside Children ' s Theater and many more . Successful programs include :
Upward Bound, the Freedom School , the Cultural Camp , the After School Program, the
Preschool Early Literacy Program and much more .
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Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page)
1 . a) What is the unacceptable condition requiring change ? b) Who has the need ?
c) Where do they live ? d) Provide local, state, or national trend data, with reference
source, that corroborates that this is an area of need .
What : Limited number of affordable programs available to working parents throughout the year
in Indian River County. FCAT scores have demonstrated need for enhanced supplemental
education, particularly in literacy education. Mental wellness of children in Indian River County
is another area of critical need . Who : Children with risk factors such as qualifying for the free
or reduced lunch program, living in single parent homes, alcohol tobacco or drug use, symptoms
of depression, displaying anti - social behavior or dropping out of school . Many families have
single parents or both parents working full time . Many parents find themselves stretched to the
limit just trying to provide basic needs . Only 36% of the GYAC ' s children come from two-
parent households . 94% are minority children . 80 % of the local children are reading below grade
level in the 2nd grade . Only 23 % of local children are currently graduating from high school .
Where : The numbers of school aged children living in Indian River County are located in the
western, central and southern ends of the county. The children with the greatest socioeconomic
need are centrally located in the county. The School Age Children ' s program provides
productive, supervised activities that give children tools for education and living. The arts are a
tremendous vehicle for enhancing educational and character skills learning to improve mental
wellness . Data : Figures form the Florida Department of Education indicate a steady increase in
students in Indian River County eligible for the free or reduced lunch program . In 1999-200 , the
percentage was 39% and for 2001 -2002 , the figure rose to 46 %, a 7% increase in just one year .
This translates into 6 , 856 of the county ' s 14 , 904 students being eligible for the free or reduced
lunch program . Data from the needs assessment conducted in 2002 by the Children' s Services
Advisory Committee indicated that the percent growth in impoverished families with children in
Indian River County had a 46% rise from 1990-2000 . A subsidized childcare and wait list chart
in that same report indicated that there is a capacity for 182 in- school children, but the need is for
250 , revealing a gap of 68 that need a place for childcare after school . Evident in the report was a
need for mental wellness for children in our county. Prevention of mental distress and illness
was the recommended outcome . The School Age Children's program gives each child the
opportunity participate in arts programs that require discipline and perseverance in mastering
various crafts, which gives the child a healthy outlet for expression, increases his or her feelings
of self worth and gives the child constructive ways to spend spare time in healthy recreation. All
of these skills assist in the prevention of mental distress and illness .
2 . a) Identify similar programs that are currently serving the needs of your targeted
population ; b) Explain how these existing programs are under-serving the targeted
population of your program .
a) Some of the other programs in Indian River County that service children in after school
settings with arts programs include : the Boys & Girls Club, The Daisy Hope Center, and Our
Lady of Guadeloupe Catholic Church. However, none of these services the children in the
Central County-Gifford area. Which has been shown to be an area of extreme need .
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C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages)
1 . List Priority Needs area addressed .
Focus Area I. Mental Wellness Issues in Children ages 7- 18. This program improves the
capacity of children in Indian River County to succeed to adulthood in a safe, healthy, and
productive manner by meeting the following objectives : Promotes enhanced emotional and
social skills ; Provides early intervention screening for children; Promotes life skills training and
effective use of emotional and social skills ; Promotes independent living skills ; Promotes
accessible locations for healthy, productive activities .
Focus Area II. Childcare Access. This program supports caregivers , a child ' s most important
resource, to be and do what is needed to shepherd children to adulthood in a safe , healthy, and
productive manner by meeting several stated objectives . Increases the availability of affordable
quality childcare ; increases access to affordable extended/after school programs ; increases access
to cultural and ethnic activities ; increases tutorial and mentoring programs .
Focus Area III. EducationlLiteracy. This program will utilize experiential education through the
arts to compliment education and literacy, by bringing classroom learning to life through fine
arts . All arts instruction will coordinate with educational staff to insure topical areas compliment
their instruction in a holistic approach . Other performing arts , sports, fitness and other general
activities will all do the same to insure teaching educational subject matter to meet all forms of
children ' s learning. By so doing all children regardless of their learning modality will have an
excellent opportunity to learn . This also redundantly presents the topical material in myriad ways
that helps children retain the subject matter much better than traditional classroom learning by
itself.
Focus Area IV. Character Development. In addition to the educational enhancements offered by
the use of arts in education and literacy arts instruction will be used to teach each of the Six
Pillars of Character Counts to enhance the children ' s personal development . One of the premier
benefits of enhancing character is that it also enhances education by making children more,
conscientious, dependable, responsible and self disciplined .
2 . Briefly describe program activities including location of services .
The main activities of this program are chosen to provide children with creative tools to help
enhance education and personnel development of children to enhance their opportunities for
educational and professional success in adulthood. Community artists teach the classes in fine
arts . Character Counts ! activities are an integral part of the arts program . Field trips to cultural
venues, such as the Vero Beach Museum of Art, compliment what they are learning and provide
them with other experiential leaning opportunities . Art and other classes are held at the Gifford
Youth Activities Center all of which compliment the children ' s educational curriculum learning.
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3 . Briefly describe how your program addresses the stated need/problem . Describe
how your program follows a recognized " best practice" (see definition on page 12 of the
Instructions) and provide evidence that indicates proposed strategies are effective with
target population. Several studies cite the use of the arts as a prevention tool and for positive
development of children . A recent report issued to the Florida Senate from the Committee on
Criminal Justice in December 2002 , entitled "Review Effectiveness of Juvenile Programs that
use a Visual and Performing Arts-Based Intervention Approach" summarized numerous studies
that illustrate the positive impact these types of arts programs, especially ones containing
mentorship opportunities and relationships to the community, influence at-risk children toward
positive goals and behaviors . ( The Arts and Prosocial Impact Study, Rand, 1999 . ) Students who
have been consistently involved in music and theatre exhibit higher levels of success in math and
reading. (Secretary 's Commission on Achieving Necessary Skills, U . S . Department of Labor,
199 1 ) A lengthy national project that studied children form low income backgrounds found that
those exposed to arts learning were more likely to be class officers, involved with math and
science fairs and to be recognized with a writing award . (Community Counts : How Youth
Organizations Matter for Youth Development), Shirley Brice Health, Milbrey W. McLaughlin,
2000 . Exposure to arts impacts the developmental growth of children and helps to equalize the
learning curve that cuts across diverse socio-economic backgrounds . (UCLA Imagination
Project, Americans for the Arts, 1998) By providing arts opportunities and choices at a young
age, children become motivated and engaged in this healthy outlet for expression.
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).
Staffing : 3 arts instructors (generalists in the instruction of visual arts)
5 . How will the target population be made aware of the program ?
Currently, the GYAC serves between 140- 180 "at-risk" children per day . These children will
participate in the program . 94 % of these children are minorities . The vast majority are also low
income, qualifying for free or reduced student lunch through the IRC - School District (73 % form
the 32967 postal zip code) . Only 36 % have any male figure in the household . It is anticipated
that offering increased fine arts, performing arts, gardening and other specialty programs will
also increase the number of children served .
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6 . How will the program be accessible to target population (i. e. , location , transportation,
hours of operation) ?
The GYAC has a cooperative arrangement with the IRC School District to bus children from all
schools in the county to the GYAC . Parents have to provide transportation home. During
Summer programs parents need to drop off and pick up children from GYAC . The GYAC is
centrally located in Indian River County making it accessible many children ' s parents .
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D. MEASURABLE OUTCOMES (Description of Intent)
Use the Measurable Outcomes orm. This description nage does not need to be included in the proposal.
In order to show the impact that your program is having on the target population and the
community, the funders are requiring measurable outcomes . Please review the examples and
summaries below to insure your understanding of what is expected .
OUTCOMES : Describes what you want to achieve with the target population . Indicates the
results of the services you provide, not the services you provide . Outcomes utilize action words
such as maintain, increase, decrease , reduce, improve, raise and lower.
ACTIVITIES : Describes the tasks that will be accomplished in the program to achieve the
results stated in the outcomes . Activities utilize action words such as complete, establish, create,
provide, operate, and develop . The activities should reflect the services described in the
PROGRAM DESCRIPTION (C2) .
Use the following elements to develop your outcomes. All elements must be included:
• Direction of change • Time frame
• Area of change • As measured by
• Target population • Baseline : The number that you will be
• Degree of chane measuring against
Example 1 (Outcome) :
To decrease (direction of change) number of unexcused absences (area of change) of enrolled
boys and girls (target population) by 75 % (degree of change) in one year (time frame) as
reported by the 2003 School Board attendance records (as measured by) . Baseline : 2003 School
Board attendance records for enrolled boys and girls .
Example 1 (Activity) :
To provide anger management classes to enrolled boys and girls 2 times a week for 12 weeks .
Example 2 (Outcome) :
75 % (degree of change) of youth (target population) who have participated in the academic
enrichment activities (as measured by) for 6 months or more (time frame), will improve
(direction of change) their scores in one or more subject area (area of change) . 25 % of
participants in academic enrichment activities will maintain the initial level of performance
assessed at entry. Baseline : Pre-test scores from the academic enrichment test.
Example 2 (Activity) :
1 ) Provide pre and post-test exercises on the Advanced Learning System software ; 2)
Participants will go through the one lesson per week and be graded for 10 weeks .
IMPORTANT NOTE :
Keep in mind when developing your PROGRAM OUTCOMES , that if funded, this will be what
you are held accountable to accomplish. Also , the PROGRAM OUTCOMES should reflect the
information described in the PROGRAM NEED STATEMENT (B 1 ) .
All Program Need Statements should flow from the Mission & Vision. Measurable Outcomes
should be based on and measure program needs . Activities are the tasks you do that are going to
influence the outcome and impact the unacceptable condition in your Program Need Statement .
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D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages)
OUTCOMES ACTIVITIES
Add all o the elements or the Measurable Outcome(s) Add the tasks to accomplish the Outcome(s)
1 . 1 : Each child enrolled in the free or reduced
1 . Provide an increase in affordable arts and lunch program at GYAC will be informed of
cultural programs for children ages 7- 12 the School Age Children ' s Educational -Fine
enrolled in the free/reduced lunch program by Arts Program .
providing ongoing arts programs as measured
by other affordable programs offered at this 1 . 2 : Promotional information will be delivered
time . to school throughout the county promoting the
Baseline = 0 program, specifically targeting those of low
income and/or of educational or behavioral
need .
2 . Increase appreciation of their own artistic 2 . 1 : Each participants will be given a pre-test
ability by children ages 7 - 12 as shown by an on the first day of the program.
increase in positive self-reports after the
experiencing the program for one year. Using 2 . 2 : Each participant will be given a post-test
as a baseline a pre -test at the start of the on the last day of the program.
program, compared to the self-report on a post-
test at the end of the program. 2 . 3 : Results from the pre -test & post-test will
Baseline= pre-test scores be presented in the final report.
3 . Enhance education/literacy of the "at risk" 3 . 1 : GYAC will analyze FCAT data and detail
youth via this and other programs designed to improvements in academic achievement.
compliment educational curriculum. We will
utilize current and future FCAT literacy scores
to determine if children in the 32967 postal zip
code area have improved their testing scores
over the course of the school year from the
previous .
Baseline= FCAT performance , particularly in
literacy
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OUTCOMES ACTIVITIES
Add all of the elements or your Measurable Outcome(s) Add the tasks to accomplish the Outcome(s)
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E . COLLABORATION (Entire Section E not to exceed one page)
1 . List your program ' s collaborative partners and the resources that they are providing to
the program beyond referrals and support. (See individual funder requirements for
inclusion of collaborative agreement letters . )
Collaborative Agency Resources provided to the program
Cultural Council of Indian River Provide existing arts instruction once per week .
County
Vero Beach Museum of Art Provide visual arts expertise, instructors and materials .
GYAC is seeking funding through this grant for this
assistance , also seeking donations to offset this and
other arts program offering costs .
Indian River County School District Provide transportation to GYAC from schools .
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F. PROGRAM EVALUATION (Entire Section F not to exceed two pages)
1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order
to accurately describe your target population including demographics (age, gender, and
ethnic background) required by the funder in Section H ? What are the pieces of
information that qualify them for your target population ? How do you document their
need for services or their " unacceptable condition requiring change" from Section B1 ?
Necessary data will be collected from GYAC registration forms, it will be indicated that the
information will be used for grant reporting purposes only . Children that are participating in the
free or reduced lunch program, have an additional risk factor identified by the student support
specialist or teacher in a school , indication from a teacher that there is a strong interest in art all
qualify students to attend this program. The presence of risk factors will be documented and
shared with staff, as deemed appropriate by the GYAC Program Coordinator.
2 . MEASURES : What data elements will you need to collect to show that you have
achieved (or made progress toward) your Measurable Outcomes in Section D ? What
tools or items are you using as measures (grades , survey scores , attendance, absences,
skill levels) for your program ? Are you getting baseline information from a source on
your Collaboration List in Section E ? Are there results from your Activities in Section
D that need to be documented ? How often do you need to collect or follow-up on this
data ?
• Registration for use by arts instructors, teachers and support specialists .
• Database of participating students, including demographic information and indicated risk
factors .
• Pre-test & Post-test of arts learning .
• Identification of children with risk factors .
• Comparison of Pre-test & post test results .
• FCAT achievement scores .
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 ?
The most important information gathered would be the presence of risk factors indicted y the
referring entity, instructors during the course of the program or at the end of the program. Parents
& guardians will be involved in addressing these risk factors . A final report, including all test
results , will be shared with the funder. Also, pre and post FCAT scores will be analyzed to
determine academic achievement . All final reports are also on file at the GYAC office .
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G. TIMETABLE (Section G not to exceed one page)
1 . List the major action steps , activities, or cycles of events that will occur within the
program year. New programs should include any start-up planning that may occur
outside the funding year. In completing the timetable, review information detailed in
prior sections .
Month/Period Activities
Summer 2005 • Recruit arts educational staff
• Develop promotional material
• Continue fundraising to add additional arts and other programs
to compliment educational curriculum and classroom learning
• Coordinate start of the program for the beginning of October
with partners
• Start working on supply list
• Start framework for scheduling activities
September 2005 . Send out informational flyer in September to schools
• Assemble referrals form schools and returning GYAC school
age participants
• Create updated database of participants
• Finalize supplies needed for program
October 2005 . Order materials for program
• Begin program
• Pre-test for arts knowledge
C Examine baseline FCAT academic achievement data
October 2005 • Continue program
— July 2006 • Continue fundraising to add additional arts and other programs
to compliment educational curriculum and classroom learning
July 2006 . Conduct post-test of arts knowledge
• Examine resultant FCAT academic achievement data from the
Spring
• Examine results of test and FCAT data to determine artistic and
academic achievement
• Office Wrap-up from program
Prepare final report
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I. BUDGET FORMS - To open the Budget Forms , please double-click on the icon below.
" Core Budget Forms "
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Type the Organization and Program Name
UNIFORM GRANT APPLICATION
BUDGET NARRATIVE WORKSHEET
IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your
program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific
Budget Forms.
AGENCY/PROGRAM NAME :
FUNDER :
r - - - - - - - - - - • - - - - - . . _ . . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - • - - - - - -
- - - - - - - - - - - • - - - - - - - - • - - - - - • - - - - - - - I
CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should
I be used for calculations and to write information only. I
L _ .
- D
GRAY AREAS FOR "Pro osed Total Pro
REVENUES AGENCY GSE °NLY p gram Funder Specific Total Agency
lsRowoEraLs Bud et
CALCULAT10NSl g - Budget Budget
1 Children's Services Council-St Lucie
2 Children's Services Council-Martin
3 Advisory Committee-Indian River 30,237.26 16,097.76 5893400 .00
4 United Way-St Lucie County
5 United Way-Martin County
6 United Way-Indian River County
7 Department of Children & Families
8 CountyFunds
9 Contributions-Cash
0 Program Fees
I Fund Raising Events-Net
12 Sales to Public - Net
13 Membership Dues
14 Investment Income
15 Miscellaneous
16 Legacies & Bequests
17 Funds from Other Sources
18 Reserve Funds Used for Operating
19 In-Kind Donations (Not included in total)
20 TOTAL REVENUES
(doesn't include line 19) $30,237 .26 $ 16,097 .76 $ 589 ,400 .00
A B C D
EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific Total Agency
- AGENCY USE ONLY
(SHOW CALCUTAnONS) Budget Budget Budget
21 Salaries - (must complete chart on next page) 19,400. 00 14 ,400.00 19,400. 00
MILM o
Salary
22 FICA - Total salaries x 0.0765 7.65%0 1 ,484. 10 1 , 101 .60 1 .484. 10
e lremen - nual pension Or qua I le
23 staff 0 . 00
Life/Health - e Ica enta ort-term
24 Disab. 0 .00
Workers Compensation - # employees x
25 rate 803. 16 596 . 16 803. 16
Florida nemp oymen - projec e
26 employees x $7,000 x UCT-6 rate 0 .00
5/17/2005 F3-1
Type the Organization and Program Name
SALARIES A B D
Gross Annual C % of Gross Annual
POSITION LISTING Salary Portion of Salary Proposed Funder Specific Budget Salary
(
Position Title / Total Hrs/wk (Agency) Programm 9 Y) Requested(C/A)
Example: Executive Director / 40 70,000.00 10, 000.00 5,000.00 7. 14%
Arts Instuctor/2.5 hours per week 71200.00 71200.00 71200.00 100. 00%
Arts Instructor/2.5 hours per week 71200.00 71200 .00 7 ,200.00 100 . 00%
Art Instructor/2.0 hours per week 51000.00 51000 .00 0.00 0 .00%
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
#DIV/0 !
Remaining positions throughout the agency
Total Salaries $ 19,400.00 $ 19400. 00 1 $ 14 ,400.00 74 .230/6
FRINGE BENEFITS DETAIL A
(Funder.Specific Budget Funder B c D E F G
Specific FICA Z65% Pension Health Ins. Worker's Unemployme Total Fringes Funder
Column C only, from line 22 to 27) Budget (AX %) Compens. nt Compens. Specific
Position Title /Total Hrs/wk
Example: ' Case 'Manager / 40 his 51000.00 382.50 200.00 500.00 4. 14 200.00 1,286. 64
Arts Instuctor/2. 5 hours per week 71200.00 550 .80 298.08 848.88
Arts Instructor/2. 5 hours per week 7 ,200. 00 550 . 80 298.08
848.88
Art Instructor/2 . 0 hours per week 0. 00 0 .00 0.00
0 0. 00 0 .00 0. 00
0 0.00 0.00 0 . 00
0 0.00 0.00 0. 00
0 0 .00 0 . 00 0 .00
0 0 .00 0 .00 0 .00
0 0. 00 0 . 00 0. 0
0 0. 00 0 .00 0. 0
0 0.00 0. 00 0.00
0.00 0. 00 0.0
0 0 .00 0 . 00 0 .00
0 0 .00 0 . 00 0 .00
0 0 .00 0 .00 0 . 00
0 0.00 0 . 00 1 0 .00
0 0. 00 0.00 0 .00
0 0. 00 0 . 00 0 .00
0 0 .00 0 .00 0. 00
so 0.001 0 .00 0 .00
Total Funder Request Fringe Benefits $ 14 ,400- 001 $ 1 , 101 .60 $0 .00 $o. 001 $596 . 16 $0 .00 $ 1 , 697.76
5/17/2005
6-1
Type the Organization and Program. Name
A B C D
EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Speciflc Total A enc1,
AGENCY USE ONLY TO Agency]
SHOW DETAIL Budget Budget Budget
27 Travel-Daily 0.00 0 .00 0 .00
# of Staff x average # of miles/wk x 50 wks x
$ = Estimated Daily Travel/Mileage Reimb .
28 Travel/Conferences/Training 3,000 .00 0.00 31000.00
• National Conference (cost per staff)
• Training/Seminar (cost per staff)
• Other Trainings (cost of travel, lodging ,
registration , food)"Program /children's Tray.
29 Office Supplies 1 ,750.00 0.00 11750. 00
Office supplies (monthly average x 12
months = estimated cost of office supplies
based on present history.` Art Supplies
30 Telephone 150 .00 0.00 150. 00
# Phone lines x average cost per month x
12 months = local phone cost
• Average long distance calls x 12 months =
Estimated cost of long distance
31 Postage/Shipping 75.00 0.00 75.00
• Quarterly Mailing of Newsletter
• Special events, etc.
• Bulk mailings - appeals
32 Utilities 750.00 0 .00 750.00
• Electricity ($ x 12 months)
• Water/Sewer ($ x 12 months)
• Garbage ($ x 12 months)
33 Occupancy (Building & Grounds) 0.00 0.00 0.00
• Mortgage/Rent ($ x 12 months)
• Janitorial ($ x 12 months)
• Grounds Maint. ($ x 12 months)
• Real Estate Taxes
34 Printing & Publications 0.00 0.00 0.00
Quarterly Newsletter ($ x 4)
Letterheads, Envelopes, etc.
Fundraising materials
Other
35 Subscription/Dues/Memberships 0.00 0.00 0.00
• Membership to National Organization
• Dues
• Subscriptions to Newspapers/magazines,
etc.
36 Insurance 450.00 0.00 450 . 00
• Directors/Officers Liab.
• Commercial/General Insurance
• Bond Ins.
• Auto Insurance
37 Equipment: Rental & Maintenance 0.00 0.00 0.00
• Copier lease ($ x 12 months)
• Meter lease ($ x 12 months)
• Copier Maintenance ($ x 12 months)
• Computer Maintenance ( $ x 12 months)
• Other
C Advertising 600.00 0.00 600.00
• Newspaper ads
• Fundraising ads/promotions
• Other (vacancies)
5/1712005
B-1
Type the Organization and Program Name
'9 Equipment Purchases : Capital Expense 0.00 0.00 0.00
• Computer/monitor (# x $)
• Laser Printer
40 Professional Fees ( Legal, Consulting ) 0.00 0.00 0 .00
• Legal advice ( estimated #hrs x $)
• Consultant fees
• Other
41 Books/Educational Materials 225.00 0.00 225.00
• Books/videos
• Materials ($ x staff)
42 Food & Nutrition 0.00 0.00 0. 00
• Meals ( # meals x clients x 5days x 50 wks)
• Snacks
43 Administrative Costs 11500.00 0.00 1 ,500 .00
Admin. Cost (% of total budget)
44 Audit Expense 50.00 0.00 50.00
Independent Audit Review
45 Specific Assistance to Individuals 0.00 0.00 0.00
• Medical assistance
• Meals/Food
• Rent Assistance
• Other
46 Other/Miscellaneous 0.00 0.00 0.00
• Background check/drug test
• Other
47 Other/Contract 0.00 0.00 0.00
• Sub-contract for program services
48 TOTAL EXPENSES $30,237.26 $ 16 , 097.76 $30 ,237.26
5/17/2005
B-I
Type the Oryantrn°m mid Pm°iam Name -
UNIFORM GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCY/PROGRAM NAME:
FY 03/04 FY 04/05 FY 05/06 % INCREASE
FYE FYE FYE CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED !col. Ctol. BNcol. B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0. 00 #DIV/01
2 Children's Services Council-Martin 0.00 #DIV/01
3 Children's Services-Indian River 707000-00 30,000.00-1
16,097 '00 46.34%
4 United Way-St. Lucie County
0.00 #DIV/0!
5 United Way-Martin County0.00 #DIV/0!
6 United Way-Indian River Count
0.00 #DIV/0!
7 Department of Children & Families
0.00 #DIV/0 !
s CountyFunds 120, 513.00 122 443.00 126 000.00 2.91 %
9 Contributions-Cash 45 000.00 136 750.00 165 000.00 20.66%
10 Program Fees 0.00 #DIV/01
11 Fund Raising Events-Net 57500.001 71000.00 67000.00 -14.29%
12 Sales to Public-Net 0.00 #DIV/01
13 Membership Dues 2000.00
79500.00 61000.00 20.00%
14 Investment Income 100 000.00 3000.00 -97.00%
15 Miscellaneous 0.00 #DIV/01
16 Legacies & Bequests 0.00 #DIV101
17 Funds from Other Sources 274 545.00 199 500.00 267 303.00 33. 99%
18 Reserve Funds Used for Operating 0.00 #DIV/0 !
19 In-Kind Donations (Not Included In total) 0.00 #DIV/0 !
20 TOTAL 517 558.00 603 193.00 589 400.00 -2.29%
EXPENDITURES
21 Salaries 242 058.00 294 226.00 312 000.00 6.04%
22 FICA 22 508.00 22 919.00 2300000 0.35%
23 Retirement 87827.00 81988.00 91000.00 0. 13%
24 Life/Health 27 363.00 28 184.00 3000000 6.44%
25 Workers Compensation 12 626.00 12 853.00 13 000.00 1 . 14%
26 Florida Unemployment
1 ,182.00 1 , 194.00 19150.00 -3.69%
27 Travel-Dai 5 738.00 11 358.00 21000.00 -82.39%
28 Travel/Conferences/Training31000.00 #DIV/O !
29 Office Supplies 14 508.00 18 002.00 18 050.00 0.27%
30 Telephone 17 052.00 18 002.00 9 000.00 -50.01 %
31 Postage/Shipping3 300.00 3 501 .00 3v700.00 5.68%
32 Utilities 36 000.00 37 900.00 35 000.00 7.65%
33 Occupancy (Building & Grounds 25 800.00 27 900.00
67500.00 -76.70%
34 Printing & Publications 0.00 #DIV/01
35 Subscription/Dues/Memberships 21 404.00 35p654.00 37 500.00 5. 18%
36lnsurance 0.00 #DIV/01
37 E ui ment:Rental & Maintenance 0.00 #DIV/01
38 Advertising0.00 #DIV/o !
39 Equipment Purchases:Ca ital Expense 0. 00 #DIV/01
40 Professional Fees (Legal, Consulting) 0.00 #DIV/01
41 Books/Educational Materials 500.00 #DIV/01
42 Food & Nutrition #DIVlO!
43 Administrative Costs 61 087.00 81 000.00 32.60%
44 Audit Expe4 650.00 6 500.00 500000 -23.08%
45 Specific Assistance to Individuals 91086.00 0 .00 #DIV/01
46 Other/Miscellaneous 81815.00 881500 0.00 100. 00%
47 Other/Contract 0.00 #DIV/0 !
48 TOTAL 460 917.00 597 083.00 589 400.00 -1 .29%
49 REVENUES OVER/ UNDER EXPENDITURES 561641 .00 61110. 00 0. 00 -100.00%
snranos
EZ
Type Me 0Mw=§w end P OWM Name '
UNIFORM GRANT APPLICATION
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME:
FY 03/04 FY 04/05 FY 05/06 % INCREASE
FYE FYE FYE CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (col. Ccol. BNcol. e
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St. Lucie 0.00 #DIV/0!
2 Children's Services Council-Martin 0.00 #DIV/0!
3 Children's Services-Indian River 16 ,097.76 #DIV/01
4 United Way-St Lucie County0.00 #DIVlO!.
5 United Way-Martin County0.00 #DIVIO[
6 United Way-Indian River County 0.00 4DIV/01
7 Department of Children & Families 0.00 #DIV/0!
8 County Funds 0.00 #DIV/0!
9 Contributions-Cash 0.00 #DIVlO!
10 Program Fees 0.00 #DIV/01
11 Fund Raisin Events-Net 0. 00 #DIV/O!
12 Sales to Public-Net 0.00 #DIV/O!
13 Membership Dues 0.00 #DIV/0!
14 Investment Income 0.00 #DIV/0!
15 Miscellaneous 0.00 #DIV/0 !
16 Legacies & Bequests 0.00 #DIV/01
17 Funds from Other Sources - Cultural Council & GYAC 11 900.00 14 139. 50 18.82%
18 Reserve Funds Used for Operating
#DIV/0!
i9 In-Kind Donations (Not Included In total) 0.00 #DIV/0!
20 TOTAL 0.00 11 900.00 30 237.26 154.09%
EXPENDITURES
21 Salaries
57000.00 1940000 288 .00%
22 FICA 382.50 11484. 10 288 .00%
23 Retirement 0.00 0.00 #DIV/01
24 Life/Health Mw
0.00 0.00 #DIV/01
25 Workers Compensation 207.00 803.16 288.00%
26 Florida Unemployment 0.00 0.00 #DIV/01
27 Travel-Daily0.00 0.00 #DIV/01
28 Travel/Conferences/Traininq 200000 3 000.00 50.00%
29 Office Supplies wm� 875.00 17750.00 100.00%
30 Telephone 75.00 150.00 100.00%
31 Postage/Shipping 37.50 75.00 100.00%
32 Utilities EE375.00 750.00 100.00%
33 Occu anc (Building & Grounds 0.00 0.00 #DIV/01
34 Printing & Publications 0.00 0.00 #DIV/0!
35 Subscri ion/Dues/Memberships 0.00 0.00 #DIV/01
36 Insurance 325.00 450.00 38.46%
37 Equipment: Rental & Maintenance 0.00 0.00 #DIV/01
38 Advertising300.00 600.00 100.00%
39 Equipment Purchases:Ca ital Expense 0.00 0.00 #DIV/O!
40 Professional Fees (Legal, Consulting) 0.00 0.00 #DIV/Ol
41 Books/Educational Materials 112.50 225.00 100.07%
42 Food & Nutrition 0.00 0.00 #DIV/0!
43 Administrative Costs
11000.00 11500.00 50.00%
44 Audit Expense 35.00 50.00 42.860/0
45 Specific Assistance to Individuals 0.00 0.00 #DIV/0!
46 Other/Miscellaneous 11175.501 0.00 -100.00%
47 Other/Contract 0.00 0.00 #DIV/01
48 TOTAL 0.00 11 900.00 30,237.26 154.090%
49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 0.00 #DIV/0!
5117r.M
84
Type the Organization and Program Name
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCY/PROGRAM NAME :
FUNDER : A B C
FY 05/06 FY 05/06 % OF
TOTAL FUNDER TOTAL VS,
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET (col. B/col. A)
EXPENDITURES
21 Salaries 19 ,400 . 00 14 ,400 .00 74. 23 %
22 FICA 1 ,484. 10 1 , 101 . 60 74 . 23 %
23 Retirement 0 . 00 0 . 00 #DIV/0 !
24 Life/Health 0 . 00 0 . 00 #DIV/0 !
25 Workers Compensation 803 . 16 596 . 16 74. 23 %
26 Florida Unemployment ment 0 .00 0 .00 #DIV/0 !
27 Travel -Dail 0 . 00 0 . 0.0 #DIV/0 !
28 Travel/Conferences/Training 31000 . 00 0 . 00 0 . 00 %
29 Office Supplies 17750 . 00 0 . 00 0 . 00 %
30 Telephone 150 . 00 0 .00 0 . 00%
31 Postage/Shipping 75 . 00 0.00 0 . 00 %
32 Utilities 750 . 00 0 . 00 0 . 00 %
33 Occupancy ( Building & Grounds 0 . 00 0 . 00 #DIV/01
34 Printing & Publications 0 . 00 0 .00 #DIV/01
35 Subscription/Dues/Memberships 0 . 00 0 . 00 #DIV/01
36 Insurance 450 . 00 0 . 00 0 . 00%
37 Eq ui ment: Rental & Maintenance 0. 00 0 .00 #DIV/0 !
38 Advertising 600 . 00 0 .00 0 . 00 %
39 Equipment Purchases : Ca ital Expense 0 . 00 0 . 00 #DIV/0 !
40 Professional Fees ( Legal , Consulting) 0 . 00 0 .00 #DIV/01
41 Books/Educational Materials 225 . 00 0 .00 0 . 00 %
42 Food & Nutrition 0 . 00 0 . 00 # DIV/0 !
43 Administrative Costs 17500 . 00 0 . 00 0 . 00%
44 Audit Expense 50 . 00 0 . 00 0 . 00 %
45 Specific Assistance to Individuals 0 .00 0 . 00 #DIV/0 !
46 Other/Miscellaneous 0 . 00 0 .00 #DIV/0 !
47 Other/Contract 0 . 00 0 , 001 # DIV/0 !
48 TOTAL $30 ,237 . 26 $ 16 , 097 . 76 53 . 24%
5/17!2005 84
Type the Organaabon and Program Name
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME :
FUNDER :
*� LaIMETEMfi� HE � �_ ' PLA_N,:4TLONFORVA'R/ANCE ' y € ry � � � � a
W
- .
17 Funds from other sources Program expansion to serve all children in the after school and Summer programs
21 Salaries Program expansion to serve all children in the after school and Summer programs
28 Travel Program expansion to serve all children in the after school and Summer programs
29 Office suorrijes Program expansion to serve all children in the after school and Summer programs
30 Telephone Program expansion to serve all children in the after school and Summer programs
31 Postage Program expansion to serve all children in the after school and Summer programs
32 Utilities Program expansion to serve all children in the after school and Summer programs
35 Workers Compensation Program expansion to serve all children in the after school and Summer programs
36 Insurance Program expansion to serve all children in the after school and Summer programs
38 Advertising Program expansion to serve all children in the after school and Summer programs
41 Books/educational materials Program expansion to serve all children in the after school and Summer programs
43 Administrative costs Program expansion to serve all children in the after school and Summer programs
44 Audit Program expansion to serve all children in the after school and Summer programs
48 Total Program expansion to serve all children in the after school and Summer programs
Funds from Other Sources - Cultural Council & Program expansion to serve all children in the after school and Summer programs
stnrzoos
e-s
Name : Age :
GYAC/CCIRC
Summer Cultural Camp
Pre - Test for Students
................................................................ ............................................................................_...............................................
...................................................................................................................... ..............................................................................
Artistic means many creative things like :
painting drawing, dancing playing or listening to music,
being in a play, writing a poem, singing or sculpting with clay .
Maybe you can think of more !
:....................................... .........................................................................-----------....................................................
........................................
..........................................
What are your Do you like to
favorite artistic share your
things to do? artwork to your
friends?
Do you like to
share your Do you like to talk
artwork with your with your
family9 teachers about
your artwork?
Do you know anybody
else here? If yes, who are
they?
Na}7,e9 Age:
GYAC/CCIRC
Summer Cultural Camp
Post - Test for Students
....................._.........._..................................................................................._............... ..............................................
......................................................................................................................................................... .....................................
.........,
Artistic means many creative things like :
painting drawing, dancing playing or listening to music,
being in a play, writing a poem, singing or sculpting with clay.
Maybe you can think of more !
............. ..................................................................................................................................................................................
................................................................................................................................................................................................
......
What are your Do you like to
share your
favorite artistic artwork to your
things to do? friends?
Do you like to Do yto talk
ou like
with your
share your teachers about
artwork with your
family? your artwork?
Have you made
any new friends? If
yes, who are they?
EXHIBIT B
( From policy adopted by Indian River County Board of county Commissioners on February 19 ,
2002 )
" D . Nonprofit Agency Responsibilities After Award Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis only.
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check . Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the
Board of Commissioners . In the event an agency provides inadequate documentation on a
consistent basis , funding may be discontinued immediately. Additionally, this may adversely
affect future funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example , no expenditures prior to October 1st may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners .
All requests for reimbursement at fiscal year and (September 30th) must be submitted on a timely
basis . Each year, the Office of Management and Budget will send a letter to all nonprofit
agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is
typically early to mid October, since the Finance Department does not process checks for the
prior fiscal year beyond that point .
Each reimbursement request must include a summary of expense by type . These summaries
should be broken down into salaries , benefit, supplies , contractual services , etc . If Indian River
County is reimbursing an agency for only a portion of an expense (e . g . salary of an employee) ,
then the method for this portion should be disclosed on the summary. The Office of Management
& Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures . These expenditure types
are listed below .
a ) Travel expenses for travel outside the County including but not limited to : mileage
reimbursement, hotel rooms , meals , meal allowances , per diem , and tolls . Mileage
reimbursement for local travel (within Indian River County) is allowable .
b ) Sick or Vacation payments for employees . Since agencies may have various sick and
vacation pay policies , these must be provided from other sources .
c) Any expenses not associated with the provision of the program for which the County has
awarded funding .
d ) Any expense not outlined in the agency's funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary."
EXHIBIT - B -
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices . Any notice , request, demand , consent , approval , or other communication
required or permitted by this Contract shall be given , or made in writing , by any of the
following methods : facsimile transmission ; hand delivery to the other party; delivery by
commercial overnight courier service ; or mailed by registered or certified mail (postage
prepaid ) , return receipt requested at the addresses of the parties shown below :
County : Joyce Johnston -Carlson , Director
Indian River County Human Services
1840 25th Street
Vero Beach , Florida 32960-3365
Recipient : Gifford Youth Activity Center
4875 43rd Avenue
Vero Beach , FL 32967
Attention : Michael Hubler, Executive Director
2 . Venue : Choice of Law. The validity, interpretation , construction , and effect of this
Contract shall be in accordance with and governed by the laws of the State of Florida
only. The location for settlement of any and all claims , controversies , or disputes , arising
out of or relating to any part of this Contract, or any breach hereof, as well as any
litigation between the parties , shall be Indian River county, Florida for claims brought in
state court, and the Southern District of Florida for those claims justifiable in federal court .
3 . Entirety of Agreement. This Contract incorporates and includes all prior and
contemporaneous negotiations , correspondence , conversations , agreements , and
understandings applicable to the matters contained herein and the parties agree that
there are no commitments , agreements , or understandings concerning the subject matter
of this Contract that are not contained herein . Accordingly, it is agreed that no deviation
from the terms hereof shall be predicated upon any prior representations or agreements ,
whether oral or written . It is further agreed that no modification , amendment or alteration
in the terms and conditions contained herein shall be effective unless contained in a
written document signed by both parties .
4 . Severability . In the event any provision of this Contract is determined to be
unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining
provisions of this Contract, and every other provision and term of this Contract shall be
deemed valid and enforceable to the extent permitted by law . To that extent, this
Contract is deemed severable .
5 . Captions and Interpretations . Captions in this Contract are included for convenience only
and are not to be considered in any construction or interpretation of this Contract or any
of its provisions . Unless context indicates otherwise , words importing the singular number
include the plural number, and vise versa . Words of any gender include the correlative
words of the other genders , unless the sense indicates otherwise .
6 . Independent Contractor. The Recipient is and shall be an independent contractor for all
purposes under this Contract . The Recipient is not an agent or employee of the County,
and any and all persons engaged in any of the services or activities funded in whole or in
part performed pursuant to this Contract shall at all times and in all places be subject to
the Recipient's sole direction , supervision and control .
7 . Assignment . This Contract may not be assigned by the Recipient without the prior written
consent of the County.
EXHIBIT - C -
Edit this Header. Type the organization and program name and the funder for whom it is being completed. The page # is already set at the bottom
right .
of every page.
PROGRAM COVER PAGE
Organization Name : Gifford Youth Activities Center (GYAC).
Executive Director : Michael S . Hubler E-mail : mhublerggyac . cc
Address : 4875 43rd Ave . Telephone : (772) 794- 1005 x22
Vero Beach, FL 32967 Fax : (772) 569 - 5563
Program Director : Paul Baker E-mail : pbaker@gyac . cc
Address : 4875 43rd Ave . Telephone : (772) 794- 1005 x
Vero Beach FL 32967 Fax : (772) 569 - 55563
Program Title : School Age Children ' s Educational-Fine Arts Program
Priority Need Area Addressed: Promoting Education Art Skills Development and Appreciation
Mental Wellness and Childcare Access
Brief Description of the Program : Weekly educational-fine arts programs for school age children Art
activities will compliment educational curriculum and character development subject matter to
enhance learning and behavioral development Program will run 48 weeks per year to include arts
instruction in the after school and summer camp programs (not to include the 2 weeks of cultural
camp) . Educational-arts programs will mirror the schools topical curriculums as well as reinforcing
the six pillars of Character Counts .
SUMMARY REPORT — (Enter Information In The Black Cells Only)
Amount Requested from Funder for 2005 / 06 : $ 169097 . 76
Total Proposed Program Budget for 2005 / 06 : $ 30 , 237 . 26
Percent of Total Program Budget : 53 . 2 %
Current Program Funding ( 2004 / 05 ) : _
Dollar increase / ( decrease ) in request : $ _
Percent increase / ( decrease ) in request * * 100 . 0 %
Unduplicated Number of Children to be served Individually : 321
Unduplicated Number of Adults to be served Individually : _
Unduplicated Number to be served via Group settings : _
Total Program Cost per Client : 94 . 20
* * If request increased 5 % or more, briefly explain why :
If these funds are being used to match another source, name the source and the $ amount :
The Organization 's Board of Directors has approved this application (da e). J 1 b
John Dean ��L
Name of President/Chair of the Board i natu e
_Michael S . Hubler t
Name of Executive Director/CEO St ure
3
_NTERILI.L REVEMIE S �; VICE
? . O . BOX 2508 OCZP.ARTMEPIT C : _ THE, TRE SUR ..
CINCINNATI , of 45201
Date : OCT 0 82002 Employer identification Number :
43 - 195091 '_
DLN :
17053266015032
GIFFORD YOUTH ACTIVITY CM ER INC Contact Person :
4875 43RD AVE DALE T SCH.a33ERu
VERO BEA
CH , FL 32967IDm 31175
Contact Telephone Number :
( 877 ) 829 - 5500
Accounting Period Ending :
December 31
Foundation Status Classification :
509 ( a ) ( 1 )
Advance Ruling Period Begins :
December 27 , 2001
Advance Ruling Period Ends :
December 31 , 2005
Addendum Applies :
No
Dear ADplicant :
Based on information you supplied , . and as
stated in your asuming your operations will be as
pplication for recognition of exemption , we have determined you
are exempt from federal income tax under section 501 ( a ) of the Internal Revenue
Code as an organization described in section 501 ( c ) ( 3 )
Because you are a newly created organization , we are not now making a
final determination of your foundation status under section 509 ( a ) of the Code .
However , we have determined that You can reasonably expect to be a publicly
supported organization described in sections 509 ( 4 ) ( 1 ) and 170 ( b ) ( 1 ) ( A ) ( vi ) _
Accordingly , during an advance ruling -period you will be treated as a
Publicly supported organization , and not as a private foundation . This advance
ruling period begins and ends on the dates shown above .
Within 90 days after the end of your advance ruling period , you must
us t1%4 im orilatlon needed to determk _; e whether you _ iso_ ro
aq
ments of the applicable support test during the advance rulinm� t period . QifYyou
establish that you have been - a publicly supported organization , we will classi -
fy you as a section 509 ( a ) ( 1 ) or 509 ( a ) ( 2 ) organization as long as you contin7:.e
to meet the requirements of the applicable support test . If y
the public support requirementou do not meet
s during the advance ruling period , we will
classify ;rou as a private foundation for future periods . Also , if we classify
jou as a private foundation , we will treat- you as a private foundation from
_your beginning date for purposes of section 507 ( d ) and 4940 .
Grantors and contributors may rely on our determination that -rou are not a
Private foundation until 90 days after the end of yo
If rur advance ruling period .
ou send us the required information within the 90 days , grantors and
contributors may continue to rely on the advance determination until we make
Lett &r 1045 ; DO / CG )
GIFFORD YouTrT -�_CTIVJTY C= T^. p. LdC
a final determination of Jour foundation status .
If we publish a notice in the Internal Revenue Bulletin stating
will no longer treat you as a publicly supported organizationthat we
, grantors and
contributors may not rely on this determination after the date we publish the
notice . In addition , if you lose your status as a publicly supported organi -
zation , and a grantor or contributor was responsible for , or was aware of , , the
act or failure to act , that resulted in your loss of such status , that person
may not rely on this determination from the date of the act or failure to act .
Also , iz a grantor or contributor learned that we had given notice that you
would be removed from classification as a publicly supported organization , then
that person may not rely on this determination as of the date . he or she
acquired such knowledge .
If you change your sources of support , your purposes , character , or method
of operation , please let us know so we can consider the effect of the change on
your exempt status and foundation status . If you amend your organizational
document or bylaws , please send us a copy of the amended document or bylaws .
Also , let us know all changes in Your name or address . _
ror soca security taxes under
the Federal Insurance Conttions Act on amounts of $ 100 or more
each of your employees during a calendar year . r rou nay to
imposed under the Federal Unemployment Tax Act ou are not liable for the tax
( FLTTA ) .
Organizations that are not private foundations are not subject to the pri -
vate foundation excise taxes under Chapter 42 of the Internal Revenue Code .
However , you are not automatically exempt from other federal excise taxes . If
You have any questions about excise , employment , or other federal taxes , please
let us know .
Donors may deduct contributions to you as provided in section 170 of the
Internal Revenue Code . Bequests , legacies , devises , transfers , or gifts to you
or for your use are deductible for Federal estate and gift tax purposes if they
meet the applicable provisions of sections 2055 , 2106 , and 2522 of the Code .
Donors may deduct contributions to you . onl
y to the contributions are gifts , with no consideration received . at th
L. �YT cketent rpurchases and
similar payments in conjunction with fundraising events may not necessarily
qualify as deductible contributions , depending on the circumstances . Revenue
Ruling 67 - 2461 published in Cumulative Bulletin 1967 - 2 , on page 104 , gives
guidelines regarding when taxpayers may deduct payments for admission to , or
other participation in , fundraising activities for charity .
You are not required to file Form 990 Return _
Income Tax , if your gross receipts each _rear are normallya$25a0o0nor Exempt From
You receive a Form 990 package in the mail , simply attach
check the box in the heading to indicate that your annual gross label provided ,
normally $ 25 , 000 or less , and sign the ret' g- wil _ e tri e s are
return . Because you will be treated as
a public charity for return filing purposes during ✓our entre advance ruling
period , you should file Form 990 for each _rear 4M !.reur advance o
ruling per= od
Letter 110 ^ 5- ; Do / C^ )
GIFFORD YOUTH ACTIVITY CENTER INC
that you exceed the $ 25 , 000 filing threshold even i = o
do not satisf _r the 1 your sc :.i_ ces of support
public support test specified in the hem "
d_ag of this letter .
If a return is required , it must be filed by the 15th day of the fifth
month after the end of your annual accounting period . A penalty of $ 20 a day
_
is charged when a return is filed late , unless there is reasonable cause for
the delay . However , the maximum penalty charged cannot exceed $ 10 , 000 or
5 percent of your gross receipts for the year , whichever is less . For
organizations with gross receipts exceeding $ 1 , 000 , 000 in any year , the penalty
is $ 100 per day per return , unless there is reasonable cause for the delay_ .
The maximum penalty for an organization with gross receipts ecceeding
$ 1 , 000 , 000 shall not exceed $ 50 , 000 . This penalty may also be charged if a
return is not complete . So , please be sure your return is complete before you
file it .
You are not required to file federal income tax returns unless you are
subject to the tax on unrelated business income under section 511 of the Code .
= r _, cu are subject to tiffs tax , you ;rust file an income CdX return on Form
990 - T , Exempt Organization Business Income Tax Return . In tni. s letter we are
not determining whether any of your present or proposed act _ lities are unre -
� at�d—t-r-a-de—e-r—bits-rrie��—a--s�}e f=ri --
lon o t e Code .
You are required ' to make your annual information return , Form 990 or
Form 990 - EZ , available for public inspection for three years after the later
of the due date of the return or the date the return is filed . You are also
required to make available for public inspection your eYempticn application ,
any supporting documents , and your exemption letter . Copies of these
documents are also required to be provided to any individual upon written or in
person request without charge other than reasonable fees for copying and
Postage . You may fulfill this requirement by placing these documents on the
Internet . Penalties may be imposed for failure to comply with these
requirements . Additional information is available in Publication 557 ,
Tax - Exempt Status for Your Organization , or you may call our toll free
number shown above .
You need an employer identification number even if you have no employees .
If an employer identification number was not entered on your application , :ve
will assign a number to you and advise you of it . Please use that number on
all returns - you file and in all correspondence with the Internal Revenue
Service .
If we said in the heading of this letter that an .addendum applies , the
addendum enclosed is an integral part of this letter
Because this letter could help us resolve an
status and foundation status , you should keep it in ouripermanent records .eexempt
We have sent a copy of this letter to your representative as indicate :
in your power of attorney .
- este _ . 045 ( DC , CC :
GIF FORD YOUTH ACTIVITY CEN=ER INC
If you nave any questicns , please contact the person whose name and
telephone number are shown in the heading of this letter _
Sincerely _yours ,
j7V (:
Lois G . Lerner
I� Director , Exempt Organizations
Enclosure ( s )
Form 872 - C
Lett = r = 015 ( DO / CS '•
M CORD I DATE (MMIDDlYY)
STM. CERTIFICATE OF LIABILITY INSURANCE ! OCT 1705
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PAT O'CONNELL IN 'URANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1148 VISTA ROYALE :,QUARE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
VERO BEACH FL 329x:2 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PHONE : 772567-7774
FAX: 772=5670166 INSURERS AFFORDING COVERAGE MAIC #
Agency LiC#: A194679
INSURED INSURER A: Westport Insurance
GIFFORD YOUTH ACTIVI-; Y CENTER , INC . f INSURER B :
P O BOX 339 INSURER C:
VERO BEACH FL 32961 � — —
INSURER D:
INSURER E : —
COVERAGES
THE POLICIES CF INSURANCE LISTED Bi '-0W HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERRI OR CONDITIOk OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE A.FFORDEL BY THE POLICIES DESCRIBED HEREIN IS SUBJEC' TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCfi
POLICIES, AGGREGATE LIMITS SHOWN MAY iAVE BEEN REDUCED BY PAID CLAIMS. ---�
TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE I POLICY EXPIRATION I LIMITS
LT DATE NNA)D,Nt I DATE MIDDIYY
GENERAL LIABILITY EACH OCCURRENCE
r F
COMMERCIAL GENERAL LIABILITY rDAM4GE TO RENTED
715E5 i a Drrduepcel $
CU41MS MADE OCCUR i IatED. EXP (Any One Pe 'oc) I—�—
PERSONAL b ADV INJURY $
GENERAL .AGGREGATE — $
GEN'LAGGREGATE
ELLIMIT APPLIES PER PRODUCTS-COMP/OPAGG . S
POLICY ( I I ---
IAUTOMOBILE LIABILITY
r__11 COMBINED SINGIE LIMIT i
! ANY AUTO . iEe accident) — I $
ALL OWNED AUTOS rSODIpi� URY
X SCHEDULEDAUTOS INJerson ) � $
HIRED AUTOS BODIL`! INJURY $
I NON-OWNED AUTOS i (Per ecudenl) I
PROPERTY DAMAGE $
,
GARAGE LIABILITY I ! AUTO ONLY - EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC I $
, AUTO ONLY: AGG 5---- ---- -- --- ---- -
I �. .
EXCESS / UMBERELLA LIABILITY i ! EACH OCCURRENCE S
L-1 OCCUR I CLAIMS MADE AGGREGATE $
I $
DEDUCTIBLE i S
RETENTION S I 5
1 WORKERS COMPENSATION AND {NL ' )(297281 JAN 4 GS JAN 4 06 I X i 'T"`O y uNlrs oTHEit I
EMPLOYERS' LIABILITY - -
A ANY PROPRIETORIPARTNmExECUTNE i I E.L. EACH ACCIDENT S 1000000
WICERIM@UBER EXCLUDED? E.L DISEASE-EA EMPLOYEE S 10U ,D00
1t yes, describe under I
SPECIAL PROVL410N9 bkwr E.L. DISEASE-POLICY LIMIT Is 500,000
( OTHER: j
DESCRIPTION OF OPERATIONSILOC rIONIVEHICLESJEXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS
CERTIFICATE HOLDER AODITIOK LINSURED; INSURER LETTER: _ CANCELLATION
INDIAN RIVER COUNTY SHOULD ANY CF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
BOARD OF COUNTY COk Yli 510 1 FXPIRATIDN DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
1840 25TH STREET FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
VERO BEACH, FL 32960 INSURER, 1'1 'S AGENTS CR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Attention :
ACORD 25 (2001108) Ceruncate # 1144 David O' Connell
11 / 04 ! 2005 09 : 24 FAX 772 562 3466 SID BANACK INS . za001
. 5/Irt N
A CERTIFICATE OF LIABILITY INSURANCE DATE (MNVDDNYYM
TM. MOV 4 05
HILOPRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
2045 ROGAL 6 HOODS OF FLA INC /SID BANACK INS. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATg
2043 i4TF1 AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O BOX 130 AlvT9R THE C04MAGIE AFFORDED BY THE P I I g 0 ,
VERO BEACH FL 32961
INSURERS AFFORDING COVERAGE NAIC Al
INSURED INSURER A: GRANRE STATE IN65e-6—
OIFF487S 43RD AVE Progressive D YOUTH ACTIVITY CENTER
4875 I INSURER 8: Pive American Insurance Co. 24252
43 _ .
VERO BEACH FL =6T INSURER Cc - -
INSURER D:
INSURER E -
COVERAGES
THE POUCIES Or INSURANCE LISTED BELOW NAVE BEEN 103UEO TO THE INSURED NAMED DOVE FOR THE POLICY PER*O INOK7ATED. NorwTHSTANDING
ANY REOUIREI ENT, TERM OR CONDITION OF ANY CONTRACT OR OTTER DOCUMFNT W111H RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLK065 DESCR18ftO HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POUCIE& AGGREGATE LIMITS SHOWN MAY HAV% BEEN REDUCED BY MID CLAW,
It,T R A TYPE OF INSURANCE POLICY NUMBER POLICY EFFiCT11A POUCYW"VM A; M
LTR 1 GATE o GAh UMITS
GENERAL LIABILITT O2d.X-04893300/000 MAY 15 05 MAY ig 06 EACH OCCunRENCE S 1 , 0 , 000
X � COMMERCIAL GENERAL LIAWLIT� OAMAW To IIENrE3
CLAMS MADEI X OCCUR I opgoo
MED. EXP (Any Oft vasoro S 105,0
A I I PERSONAL l ADV INJURY 3 , . ... 11000,000
_ I iOENERALAGGRECATE j3 3 000 QQQ
IGEN'LAGGREGATE LIMIT APPLIES PER,I I i r—
PRODUCTSCOMP;OP AGG. 13 100000000
117 POLICY F7 PAG*CT LOC - "'-- --
AUTOMOBILE LIABILITY 026263054 APR 23 05
X ANY AUTO APR Z3 06 COMBINED SINGLE LIMIT
(Ea sm=id my � s 1 , 000,000
All OWNED AUTOS BODILY INJURY —�
B
I
SCHEDULED AUTOS I (Per Peron) S
X {I HIRED AUTOS
BODILY INJIX I NOW"CDAUf03 I (PerswunlRY S
— 1
PROPERTY DAMAGE 13
"Mee LLABILITV (Pr y)
AUTO ONLY - EA ACCIDENT 113
ANY AUTO I OTHER THAN EA ACC —
AUTO ONLY: 3
"CESS I UMBRELLA LIABILITY JGACI OCCURRENCE S
J OCCUR 17 CLAIMS MADE AGGREGATE _ —
DEDUCYIELE - 3 -
RETENTION 3 I - • ••- 3
' S
WOMERS COMPENSATION AND YYCBTATV-
EMPLoYERsl LIAMLITY on4ut
ANY PROMIETOWARTIEElMftTr4 I EL, @ACMACCIDENT $
amemmumol 0=039"
eym Q,K, E.L. DISFASEFAEMPLOYEF S
MECAAI Fmom"m E.L. DISEASE-POLICY LIMIT S
OTHER:
DESCRIPTION OF OPERATIONS&& CATIONSNE IICLESJEXCLUSIONS ADDED DY ENDORSEMENT/ SPECIAL PROVISIONS
S1 ,000 DEDUCTIBLE BODILY INJURY AND PROPERTY DAMAGE COMBINED PER OCCURRENCE
INDIAN RIVER COUNTY IS NAMED AS AN ADDITIONAL INSURED WITH REGARDS TO THE GENERAL LIABILITY AND AUTO POLICIES WITH
RESPECTS TO THE OPERATIONS OF THE NAMED INSURED,
.CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF TNF ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAI_ to
DAYS YArrrEN NOTICE TO THE CERTIFICATE MOLDER MWEO TO THE LEFT, BUT
FAILURE TO DO SO SHALL IMF%E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INDIAN RIVER COUNTY INSURER ITS AGENTS OR REPRESENTATIVES.
1810 25TH STREET
VERO BEACH, FL, $2960 AUTHORIZED REPRESENTATIVE
Attention: Idney M aal�� 00p*4
ACORD 25 (2001108) Certificate # 90774 ® ACORD CORPORATION 1980